Prevalence and Time Trends of Self-Reported Mental Health Problems Among Children and Adolescents Between 11 and 17 Years in the KiGGS Study.

Objective: Knowledge about the prevalence of mental disorders in childhood and adolescence is important for clinicians and policymakers. This study examines the prevalence and trends in self-reported mental health problems among 11- to 17-year-olds in Germany. Method: We evaluated data from the self-report version of the Strength and Difficulties Questionnaire (SDQ) of 6,725 children and adolescents from the baseline of the German Health Interview and Examination Survey (KiGGS, 2003-2006) and 6,145 from its second wave (KiGGS wave 2, 2014-2017). Results: According to the SDQ total difficulties score, the prevalence estimates did not vary significantly between the study waves, neither regarding the category "abnormal" (9.3 % vs. 9.4 %) nor the pooled categories "borderline/abnormal" (16.9 % vs. 15.4 %). We confirmed the results by linear regression analyses using mean values instead of the SDQ categories. Analyses of the SDQ subscales revealed gender and age-specific time trends. Conclusions: These findings differ from those based on the SDQ parent report, which suggests significant declines in symptom load between the study waves. The results indicate the importance of integrating youth self-reports when measuring mental health problems, at least as part of a multi-informant approach.

The relationship of self-reported and device-based measures of physical activity and health-related quality of life in adolescents.

BACKGROUND: Physical activity (PA) has beneficial effects on health and health-related quality of life (HRQoL), which is a protective factor of illness and mortality. The purpose of this examination was to investigate if self-reported and device-based measures of PA were related to HRQoL in adolescents. METHODS: Participants (N = 1565; 54.3% female; Mage = 14.37 years, SDage = 1.99) were recruited from 167 sample points across Germany. Adolescents self-reported their PA, supplemented by a 1-week examination of device-based PA using accelerometry. Additionally, they completed the multidimensional KIDSCREEN-27 to assess HRQoL. RESULTS: Results showed that self-reported PA was correlated with overall HRQoL, Physical Well-Being, Psychological Well-Being, Social Support & Peers, and School Environment, whereas device-based PA was only correlated with Physical as well as Psychological Well-Being. Further, self-reported PA significantly predicted all facets of HRQoL except for Autonomy and Parent Relations, whereas device-based PA solely heightened the amount of explained variance in the Physical Well-Being subscale. CONCLUSIONS: Findings demonstrate the importance of self-reported PA as it is related to almost all facets of HRQoL. Both measures of PA are not congruent in their relationship with HRQoL and thus implications have to be carefully considered. Future studies should investigate the direct effect of PA on HRQoL and health in a longitudinal approach to account for the causality of effects.

Health-related quality of life and mental health in children and adolescents with strabismus - results of the representative population-based survey KiGGS.

BACKGROUND: To estimate the effect of strabismus (squinting) on mental health and health-related quality of life aspects in children and adolescents. METHODS: Data from the German Health Interview and Examination Survey for Children and Adolescents KiGGS (2003-2006 baseline survey; N = 14,835, aged 3 to 17 years, 49% girls) were examined. The presence of strabismus was derived by parental questionnaire, and health-related quality of life and mental health were investigated with the KINDL-R and Strengths and Difficulties Questionnaire. Associations between strabismus and outcomes were analyzed using multivariable linear and logistic regression models. RESULTS: Of 12,989 children without missing data, 579 children (4.5% of the sample) were reported to have strabismus. Children with strabismus had lower scores in the parent-reported KINDL-R total scale (adjusted beta = - 1.02; 95%CI: -1.86 to - 0.18; p = 0.018) and sub-scale 'friends' (adjusted beta = - 2.18; 95%CI: -3.56 to -0.80; p = 0.002) compared to children without strabismus. The presence of strabismus was also associated with more mental health problems like 'hyperactivity/inattention' (adjusted OR = 1.50; 95%CI: 1.14 to 1.98; p = 0.005), and 'peer problems' (adjusted OR = 1.35; 95%-CI: 1.05 to 1.74; p = 0.018) as reported by parents. CONCLUSIONS: Strabismus in children and adolescents is associated with lower health-related quality of life.

[Health-related quality of life and its relation to chronic diseases and mental health problems among children and adolescents : Results from KiGGS Wave 2]. / Gesundheitsbezogene Lebensqualität und Zusammenhänge mit chronischen Erkrankungen und psychischen Auffälligkeiten bei Kindern und Jugendlichen : Ergebnisse aus KiGGS Welle 2.

BACKGROUND: Health-related quality of life (HRQoL) is increasingly established as an indicator for the subjective health of children and adolescents. The aim of this study was to describe the current HRQoL among children and adolescents in Germany aged between 11 and 17 years taking into account common chronic diseases (bronchial asthma, atopic dermatitis, obesity, ADHD) and mental health problems. METHODS: The analysis is based on information obtained from 6,599 children and adolescents (51.9% girls; 48.1% boys) from KiGGS Wave 2 (2014-2017). HRQoL was measured with the multidimensional KIDSCREEN-27. The chronic diseases and mental health problems under investigation were assessed by several indicators. RESULTS: Differences in HRQoL could be found as a function of age and gender. The HRQoL among girls was lower at an older age across all dimensions. These age-related differences are less pronounced among boys. The HRQoL of children and adolescents with chronic diseases and mental health problems was lower compared to their healthy peer groups. The comparison of the investigated chronic diseases and mental health problems revealed significant differences. Particularly, HRQoL was lower for children and adolescents with obesity and mental health problems. DISCUSSION: The distinction of several dimensions of HRQoL allows a comprehensive understanding of age- and gender-related effects and provides a detailed assessment of the impact of chronic diseases and mental health problems. The present findings underline the importance of HRQoL as an indicator for the subjective health of children and adolescents.

Co-occurrence, stability and manifestation of child and adolescent mental health problems: a latent transition analysis.

BACKGROUND: Complex constellations of socio-emotional and behavioural problems (i.e., mental health problems) in childhood and adolescence are common and heighten the risk for subsequent personality, anxiety and mood disorders in adulthood. Aims of this study included the examination of patterns of mental health problems (e.g., externalizing-internalizing co-occurrence) and their transitions to reported mental disorders by using a longitudinal person-centered approach (latent class and latent transition analysis). METHODS: The sample consisted of 1255 children and adolescents (51.7% female, mean age = 12.3 years, age range 8-26 years) from three time points of the comprehensive mental health and wellbeing BELLA study. Children and their parents completed the German SDQ (Strength and Difficulties Questionnaire, Goodman, 1997) and reported on diagnoses of ADHD, depression, and anxiety. RESULTS: Latent class analysis identified a normative class, an emotional problem class, and a multiple problem class. According to latent transition analysis, the majority of the sample (91.6%) did not change latent class membership over time; 14.7% of individuals showed a persistent pattern of mental health problems. Diagnoses of mental disorders were more likely to be reported by individuals in the emotional problem or multiple problem class. CONCLUSIONS: Results highlight the need for early prevention of mental health problems to avoid accumulation and manifestation in the transition to adolescence and young adulthood.

ADHD in children and adolescents in Germany. Results of the cross-sectional KiGGS Wave 2 study and trends.

Attention deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders in childhood and adolescence and is associated with functional, psychosocial and cognitive impairment. As part of the second wave of the German Health Interview and Examination Survey for Children and Adolescents (2014-2017), parents of children and adolescents aged between 3 and 17 years reported whether their child was diagnosed with ADHD by a physician or psychologist. Overall, 4.4% of children and adolescents have been diagnosed with ADHD in Germany. In comparison, the KiGGS baseline study (2003-2006) showed a reduction of lifetime ADHD diagnoses of almost one percentage point over a period of ten years. The reduction of parent-reported ADHD diagnoses primarily occurred among 3- to 8-year old children and boys. The results are discussed in terms of health promotion and the introduction of health care measures.

Mental health problems in children and adolescents in Germany. Results of the cross-sectional KiGGS Wave 2 study and trends.

Mental health problems in children and adolescents are associated with individual and family-related constraints as well as social costs. 20.0% of children and adolescents showed mental health problems at the KiGGS baseline study (2003-2006). This study investigates the current prevalence for KiGGS Wave 2 (2014-2017) as well as time trends in comparison with the KiGGS baseline study. Mental health problems were assessed for 3- to 17-year-old children and adolescents by using the parent-based version of the Strengths and Difficulties Questionnaire (SDQ). For KiGGS Wave 2, the prevalence of mental health problems was 16.9%. A decreasing trend is pronounced particularly among boys between 9 and 17 years of age. Mental health problems are displayed more frequently by girls and boys from families with a low socioeconomic status compared to their peers from families with a medium or high socioeconomic status. These findings are discussed in the light of various measures and actions in health promotion and health care.

Modeling students' instrumental (mis-) use of substances to enhance cognitive performance: Neuroenhancement in the light of job demands-resources theory.

BACKGROUND: Healthy university students have been shown to use psychoactive substances, expecting them to be functional means for enhancing their cognitive capacity, sometimes over and above an essentially proficient level. This behavior called Neuroenhancement (NE) has not yet been integrated into a behavioral theory that is able to predict performance. Job Demands Resources (JD-R) Theory for example assumes that strain (e.g. burnout) will occur and influence performance when job demands are high and job resources are limited at the same time. The aim of this study is to investigate whether or not university students' self-reported NE can be integrated into JD-R Theory's comprehensive approach to psychological health and performance. METHODS: 1,007 students (23.56 ± 3.83 years old, 637 female) participated in an online survey. Lifestyle drug, prescription drug, and illicit substance NE together with the complete set of JD-R variables (demands, burnout, resources, motivation, and performance) were measured. Path models were used in order to test our data's fit to hypothesized main effects and interactions. RESULTS: JD-R Theory could successfully be applied to describe the situation of university students. NE was mainly associated with the JD-R Theory's health impairment process: Lifestyle drug NE (p < .05) as well as prescription drug NE (p < .001) is associated with higher burnout scores, and lifestyle drug NE aggravates the study demands-burnout interaction. In addition, prescription drug NE mitigates the protective influence of resources on burnout and on motivation. CONCLUSION: According to our results, the uninformed trying of NE (i.e., without medical supervision) might result in strain. Increased strain is related to decreased performance. From a public health perspective, intervention strategies should address these costs of non-supervised NE. With regard to future research we propose to model NE as a means to reach an end (i.e. performance enhancement) rather than a target behavior itself. This is necessary to provide a deeper understanding of the behavioral roots and consequences of the phenomenon.

Reduced self-control leads to disregard of an unfamiliar behavioral option: an experimental approach to the study of neuroenhancement.

BACKGROUND: Neuroenhancement (NE), the use of psychoactive substances in order to enhance a healthy individual's cognitive functioning from a proficient to an even higher level, is prevalent in student populations. According to the strength model of self-control, people fail to self-regulate and fall back on their dominant behavioral response when finite self-control resources are depleted. An experiment was conducted to test the hypothesis that ego-depletion will prevent students who are unfamiliar with NE from trying it. FINDINGS: 130 undergraduates, who denied having tried NE before (43% female, mean age = 22.76 ± 4.15 years old), were randomly assigned to either an ego-depletion or a control condition. The dependent variable was taking an "energy-stick" (a legal nutritional supplement, containing low doses of caffeine, taurine and vitamin B), offered as a potential means of enhancing performance on the bogus concentration task that followed. Logistic regression analysis showed that ego-depleted participants were three times less likely to take the substance, OR = 0.37, p = .01. CONCLUSION: This experiment found that trying NE for the first time was more likely if an individual's cognitive capacities were not depleted. This means that mental exhaustion is not predictive for NE in students for whom NE is not the dominant response. Trying NE for the first time is therefore more likely to occur as a thoughtful attempt at self-regulation than as an automatic behavioral response in stressful situations. We therefore recommend targeting interventions at this inter-individual difference. Students without previous reinforcing NE experience should be provided with information about the possible negative health outcomes of NE. Reconfiguring structural aspects in the academic environment (e.g. lessening workloads) might help to deter current users.