Resilience in deaf children: A comprehensive literature review and applications for school staff.

Resilience is a dynamic, multidimensional complex concept that implies risk and protective factors, adaptation, and success. Communication and language are often identified as barriers in deaf children's development. However, research linking deafness in childhood and resilience is scarce. The present comprehensive literature review aims to verify which are the predominant risk factors for this group, which protective factors may be identified and if significant differences have been found between deaf and hearing children regarding resilience. A systematic search, performed in seven databases, identified 11 articles published in peer-reviewed journals between 2000 and 2019 that met the criteria. Deaf children experience exposure to risk through obstacles in communication, language, and information failure. Consequently, differences between hearing and deaf children are related to more difficulties in emotion regulation and interpersonal relationships. Principal protective factors are a supportive family, school staff, and peers. Practical implications and recommendations for future research are provided.

Dream Teens: Adolescents-Led Participatory Project in Portugal in the Context of the Economic Recession.

This article describes the implementation process of a nationwide project to enhance young people's participation and active citizenship in the context of Portugal's economic recession. This project used an innovative Positive Youth Development approach that engaged Portuguese youth (aged 11-18 years) through social media tools to facilitate their civic engagement and development. Participants from all over the country were empowered (1) to design and conduct research activities on topics of their choice and about their life contexts and (2) to create ways to improve youth civic participation in their communities, while developing supportive interactions with adults and peers. Overall, youth were engaged in their activities, felt their voices were heard, and felt that they were viewed as experts of their own well-being and living contexts. Youth research actions and preliminary findings were then compiled in a set of recommendations that was formally received by a high commissioner of the Ministry of Health. The article concludes with a discussion of the next steps for the project and its limitations so far.

Adolescent's subjective perceptions of chronic disease and related psychosocial factors: highlights from an outpatient context study.

BACKGROUND: Adolescents with chronic disease (CD) can be more vulnerable to adverse psychosocial outcomes. This study aims: 1) to identify differences in psychosocial variables (health-related quality of life, psychosomatic complaints, resilience, self-regulation and social support) among adolescents who feel that CD affects or does not affect school/peers connectedness (measured by self-reported participation in school and social activities); and 2) to assess the extent to which psychosocial variables are associated with connectedness in school and peer domains. METHODS: A cross-sectional study was conducted in 135 adolescents with CD (51.9% boys), average age of 14 ± 1.5 years old (SD = 1.5). Socio-demographic, clinical, and psychosocial variables were assessed, using a self-reported questionnaire, which included the Chronic Conditions Short Questionnaire, KIDSCREEN-10 Index, Symptoms Check-List, Healthy Kids Resilience Assessment Module Scale, Adolescent Self-Regulatory Inventory, and Satisfaction with Social Support Scale. Descriptive statistics, GLM-Univariate ANCOVA and Logistic Regression were performed using the IBM Statistical Package for Social Sciences (SPSS), version 22.0. The significance level was set at p < 0.05. RESULTS: Thirteen to eighteen percent of the adolescents felt that CD affected participation at school (PSCH) and participation in leisure time with friends (PLTF). These adolescents presented lower results for all psychosocial study variables, when compared with adolescents who did not feel affected in both areas of participation. From the studied psychosocial variables, the most important ones associated with PSCH (after controlling for age, gender, diagnosis, and education level of father/mother) were self-regulation and psychosomatic health. Concerning the PLTF, social support was the sole variable explaining such association. CONCLUSIONS: The present study pointed out the association between psychosocial variables; and living with a CD and school/peers connectedness. The need to focus on the assessment of the effects of a CD on adolescents' lives and contexts is suggested, as well as on the identification of vulnerable adolescents. Such identification could help to facilitate the maximization of social participation of adolescents with CD, and to plan interventions centered on providing support and opportunities for a healthy youth development. For that purpose, a complex and multifactorial approach that includes clinicians, schools, family, and peers may be proposed.

Ten years of "CHOICES" in Portugal: four generations, a real resilient opportunity.

"Escolhas" ("Choices") is a Portuguese programme that aims to promote children and youth social inclusion in deprived socioeconomic contexts. The present study aims to identify internal and external resources perceived by children and adolescents that participated in the programme, to understand the impact in life contexts, and to identify the resources nominated by their family, project professionals and partners. A qualitative method was used in order to analyze 365 discourses from four different groups: children and adolescents (149), family (40), project professionals (126) and project partners (50). The model used was Benard's Conceptual Model for Resilience and Youth Development. The conclusions highlight the success and relevance of Programa Escolhas ("CHOICES") regarding the children and the adolescents and their families, by promoting social inclusion in deprived socioeconomic contexts.

Truancy: The relevance of resilience-related internal assets, student engagement and perception of school success in youth living with parents and in residential care.

BACKGROUND: School absenteeism is associated with multiple negative short and long-term impacts, such as school grade retention and mental health difficulties. OBJECTIVE: The present study aimed to understand the role of resilience-related internal assets, student engagement, and perception of school success as protective factors for truancy. Additionally, we investigated whether there were differences in these variables between students living in residential care and students living with their parents. METHODS: This study included 118 participants aged 11 to 23 years old (M = 17.16, SE = 0.26). The majority were female (n = 61, 51.7 %) and Portuguese (n = 98, 83.1 %), with half living in residential care. In this cross-sectional study, participants responded to self-report questionnaires. Hierarchical regression analysis was used to understand the factors associated with truancy. RESULTS: There were no group differences in resilience-related internal assets and their perception of school success. On the contrary, participants in residential care reported more unexcused school absences, more grade retentions, higher levels of depression, and lower levels of student engagement. Moreover, hierarchical linear regression controlling for key variables (i.e., living in residential care or with parents, school grade retention, and depression) showed that perception of school success and resilience-related internal assets significantly contributed to truancy. CONCLUSIONS: Results are discussed in the context of universal and selective interventions. These interventions can foster individual strengths and provide opportunities for every student to experience success. Consequently, they promote engagement and reduce the likelihood of school absences, especially for those in more vulnerable situations such as youth in residential care.

Exposure to Intimate-Partner Violence and Resilience Trajectories of Adolescents: A Two-Wave Longitudinal Latent Transition Analysis.

Despite the serious emotional and social consequences of adolescents' exposure to intimate-partner violence (IPV) and the high prevalence of this exposure, few analyses have focused on person-centered models or considered psychological IPV. Studies that address exposure to violence tend to focus on physical IPV. Therefore, in this study, we examine (across two waves) the trajectories of resilience among adolescents who have witnessed psychological IPV by conducting a latent transition analysis and predicting class membership through socio-demographic and individual-level protective factors. Using a sample of 879 (T1, fall 2020) and 770 (T2, spring 2022) adolescent Swiss students with mean ages of 11.74 (SD = 0.64) and 13.77 (SD = 0.53), we identified four distinct time-invariant resilience classes: comorbid-frustrated, internalizing-frustrated, comorbid-satisfied, and resilient. The classes characterized by some level of psychopathological symptoms and basic psychological-needs frustration were the most stable over time. Furthermore, we found the four typical resilience trajectories: recovery, chronic, delayed, and improving. Gender, socioeconomic background, and protective factors showed a significant prediction of class membership in wave 1, highlighting the importance of increasing sensitivity to psychological-IPV exposure on the one hand, and reinforcing the relevance of prevention in schools regarding the promotion of protective factors on the other.

Supporting Preschoolers' Mental Health and Academic Learning through the PROMEHS Program: A Training Study.

There is compelling evidence that early school intervention programs enhance children's development of life skills, with a positive knock-on effect on their behaviors and academic outcomes. To date, most universal interventions have displayed gains in children's social-emotional competencies with a limited reduction in problem behaviors. This may depend on programs' curricula focused to a greater extent on preschoolers' social-emotional competencies rather than problem behaviors. Promoting Mental Health at Schools (PROMEHS) is a European, school-based, universal mental health program explicitly focused on both promoting students' mental health and preventing negative conduct by adopting a whole-school approach. In this study, we set out to evaluate the effectiveness of the program for Italian and Portuguese preschoolers. We recruited 784 children (age range = 4-5 years), assigning them to either an experimental group (six months' participation in the PROMEHS program under the guidance of their teachers, who had received ad hoc training) or a waiting list group (no intervention). We found that PROMEHS improved preschoolers' social-emotional learning (SEL) competencies, prosocial behavior, and academic outcomes. The more practical activities were carried out at school, the more children's SEL competencies increased, and the more their internalizing and externalizing behaviors decreased. Furthermore, marginalized and disadvantaged children were those who benefited most from the program, displaying both greater improvements in SEL and more marked decreases in internalizing problems compared to the rest of the sample.

Anxiety, depression and coping: CDI, MASC and CRI-Y for screening purposes in schools.

This study used depression (CDI - Kovacs, 1981), anxiety (MASC - March, 1997) and coping strategy (CRI-Y - Moos, 1993) scales and studied the fitness and discriminant validity of reduced versions. The sample consisted of 916 Portuguese pupils, 54.3% feminine, aged 10 to 21 years old. The participants were selected from a set of public schools nation-wide. Two classes were chosen from the 5th to the 12th grades. A set of principal component analyses was carried out in a randomly chosen sample (n = 394) and all the three reduced measures were found to be strongly correlated with the previous. Confirmatory factor analyses (CFA) using the other part of the sample (n = 522) revealed adjustment indexes suggesting a good fit for both the whole model and gender and age groups separately. All scales revealed a good internal consistency. Globally, girls were more anxious and developed more coping strategies than boys. Older students tended to be less depressed, while younger adolescents present higher scores in depression and anxiety and less coping strategies. Reduced scales are sensitive to gender and age differences and can be used in school settings in order to establish a baseline and roadmaps for both universal and selective mental health school based programs.

Substance use in Portuguese and Spanish adolescents: highlights from differences, similarities and moderating effects.

Many behaviors with lasting health impact are initiated in adolescence. Substance use is one such behavior. To analyse the factors involved in adolescent substance use among Portuguese and Spanish boys and girls, an explanatory model was developed using structural equations modelling. The model proposes that the impact of social contexts (family, friends, classmates and teachers) on substance use (tobacco, alcohol and illicit drugs) is mediated by perceptions of well-being (psychological symptoms, well-being and school satisfaction). Data on 1589 Portuguese (mean age = 13.27, SD = .59) and 4191 Spanish adolescents (mean age = 13.21; SD = .47) who took part in the HBSC/WHO survey were analysed. The model fits the data of each country (CFI > .90; RMSEA < .03) and the majority of the relationships proposed in the model have been as expected for both samples. The relations with a major effect, for both countries, were: the negative effect of family on psychological symptoms and the positive effect of family on subjective well-being; the negative effect of classmates on psychological symptoms; the positive effect of teachers on school satisfaction; the effect of psychological symptoms (negative) and school satisfaction (positive) on well-being; the negative effect of school satisfaction on tobacco and alcohol use; and the positive effect of tobacco on alcohol use, and alcohol use on cannabis. For each of the dependent factors studied (tobacco, alcohol and illicit drugs), the levels of explained variance varied between 9% (for tobacco use) and 46% (for alcohol use). Some non-invariant paths were obtained in country comparisons, controlling for gender. In multivariate analyses the paths from tobacco use to cannabis and from alcohol to cannabis were significant, but much stronger for Spanish girls than Portuguese girls.

Portuguese adolescents: the importance of parents and peer groups in positive health.

The purpose of this study is to examine the influence of peer groups and parents on adolescents' health. It was examined how communication relationships with peer groups and parents affect youngsters life satisfaction, sadness, irritability, being nervous, fear and troubles in falling asleep. The sample was comprised of individuals that participated in the study in continental Portugal, integrating the European study HBSC - Health Behavior in School - aged Children. The study was made during January 2006 and included a total of 4,877 students attending the 6th, 8th and 10th grades from Portuguese public schools, with an average age of 14 years of age. The instrument used was the HBSC questionnaire. The results showed that adolescents' health is influenced by their relationship with their parents and peers. When the communication with both is easy, youngsters are more satisfied with life and have less health negative symptoms. When compared with peers, parents influence positively the adolescents' health.

Does Online Implementation Make a Difference in the Effects of a Mental Health Curriculum at Schools?

COVID-19 changed and challenged education, with schools obliged to adapt to online settings. This study aims to evaluate the impact of a mental health curriculum implemented at schools, considering the implementation settings: online, onsite, and mixed (online and onsite). From kindergarten to high school, 933 students were evaluated by teachers regarding their social and emotional learning, strengths and difficulties, and academic outcomesin two measuring times: pre- and post-test. A qualitative analysis of teachers' adaptations to the online implementation was also conducted. Results revealed a positive impact with both mixed and onsite implementation. However, the mixed format demonstrated significant positive changes between the pre-and post-test, namely in relationship skills, responsible decision-making, internalized problems, and academic achievement. The mixed format with few online activities appears to have a more positive impact on students. Nevertheless, implementing social and emotional skills (SES) activities exclusively online seems to positively affect some SES domains more than onsite and mixed formats. Teachers used synchronous (e.g., digital platforms) and asynchronous (e.g., extra resources) adaptations for the implementation. This study shows that implementing mental health programs at schools, in this case, PROMEHS, is beneficial for students, even amidst the pandemic, and regardless of the implementation settings.

Consensus on the Best Practice Guidelines for Psychomotor Intervention in Preschool Children with Autism Spectrum Disorder.

Psychomotor intervention has been used to promote development by the enhancement of psychomotor and socio-emotional competence. However, studies with high-quality evidence, describing psychomotor-intervention processes and outcomes are scarce. Therefore, we aimed to generate expert consensus regarding psychomotor-intervention guidelines to support psychomotor therapists through the design and implementation of interventions for preschool (3−6 years old) children with autism spectrum disorder (ASD). A formal consensus process was carried out, using modified nominal group (phase I) and Delphi survey (phase II) techniques. We recruited 39 Portuguese experts in psychomotor intervention with preschool children with ASD in phase I. Experts participated in at least one of the five online meetings, discussing themes (e.g., objectives, methods, strategies) concerning psychomotor intervention with preschool children with ASD. A deductive thematic analysis from phase I resulted in 111 statements composing round 1 of the Delphi survey. Thirty-five experts completed round 1, and 23 round 2. The experts reached a consensus (agreement > 75%) on 88 statements, grouped under 16 sections, (e.g., intervention source, general setting, intended facilitation-style), reflecting generic psychomotor-intervention guidelines. Consensus guidelines may be used to support transparent and standard psychomotor interventions, although further studies should be undertaken to determine their efficacy.

The effectiveness of a school-based, universal mental health programme in six European countries.

As children and young people today face ever increasing social, emotional and mental health challenges, schools, as one of the primary systems in children's lives, are called to broaden their agenda and help to address these challenges. This paper discusses the evaluation of a school-based, universal mental health promotion programme developed recently for the European context. The programme provides a universal curriculum from early years to high school, aiming to promote social and emotional learning and resilience and prevent social, emotional, and behavioural problems in children and adolescents. A total of 7,789 students (and their teachers and parents) from kindergarten to high school across 6 countries in Europe were recruited from 434 classrooms in 124 schools, making use of cluster sampling. A quasi-experimental longitudinal design was used to evaluate the effectiveness of the programme on students' outcomes by comparing the groups' outcomes within times (pre-test vs. post-test) and between groups (experimental vs. control group). A total of 779 classroom teachers completed pre-and-post scales measuring students' social and emotional learning, mental health and academic achievement. Results indicate that the experimental group had significantly larger increase in social and emotional competence and prosocial behaviour, and a decrease in mental health issues (externalising and internalising problems). No significant impact was found for academic outcomes. The findings are discussed in view of the limitations of the study and areas for further research.

Adolescent social emotional skills, resilience and behavioral problems during the COVID-19 pandemic: A longitudinal study in three European countries.

Objectives: The consequences of long-lasting restrictions related to the COVID-19 pandemic have become a topical question in the latest research. The present study aims to analyze longitudinal changes in adolescents' social emotional skills, resilience, and behavioral problems. Moreover, the study addresses the impact of adolescents' social emotional learning on changes in their resilience and behavioral problems over the course of seven months of the pandemic. Methods: The Time 1 (T1) and Time 2 (T2) measuring points were in October 2020 and May 2021, characterized by high mortality rates and strict restrictions in Europe. For all three countries combined, 512 questionnaires were answered by both adolescents (aged 11-13 and 14-16 years) and their parents. The SSIS-SEL and SDQ student self-report and parent forms were used to evaluate adolescents' social emotional skills and behavioral problems. The CD-RISC-10 scale was administered to adolescents to measure their self-reported resilience. Several multilevel models were fitted to investigate the changes in adolescents' social emotional skills, resilience, and behavioral problems, controlling for age and gender. Correlation analysis was carried out to investigate how changes in the adolescents' social emotional skills were associated with changes in their resilience and mental health adjustment. Results: Comparing T1 and T2 evaluations, adolescents claim they have more behavioral problems, have less social emotional skills, and are less prosocial than perceived by their parents, and this result applies across all countries and age groups. Both informants agree that COVID-19 had a negative impact, reporting an increment in the mean internalizing and externalizing difficulties scores and reductions in social emotional skills, prosocial behavior, and resilience scores. However, these changes are not very conspicuous, and most of them are not significant. Correlation analysis shows that changes in adolescents' social emotional skills are negatively and significantly related to changes in internalized and externalized problems and positively and significantly related to changes in prosocial behavior and resilience. This implies that adolescents who experienced larger development in social emotional learning also experienced more increase in resilience and prosocial behavior and a decrease in difficulties. Conclusion: Due to its longitudinal design, sample size, and multi-informant approach, this study adds to a deeper understanding of the pandemic's consequences on adolescents' mental health.

Multi-informant validity evidence for the SSIS SEL Brief Scales across six European countries.

The SSIS SEL Brief Scales (SSIS SELb) are multi-informant (teacher, parent, and student) measures that were developed to efficiently assess the SEL competencies of school-age youth in the United States. Recently, the SSIS SELb was translated into multiple languages for use in a multi-site study across six European countries (Croatia, Greece, Italy, Latvia, Portugal, and Romania). The purpose of the current study was to examine concurrent and predictive evidence for the SEL Composite scores from the translated versions of the SSIS SELb Scales. Results indicated that SSIS SELb Composite scores demonstrated expected positive concurrent and predictive relationships with scores from the Connor-Davidson Resilience Scale (CD-RISC) and negative relationships with scores from the problem behavior scales of the Strengths and Difficulties Questionnaire (SDQ). Although there were a few exceptions, these patterns generally were consistent across informants (parents, teachers, and students) and samples providing initial validity evidence for the Composite score from the translated versions of the SSIS SELb Scales. Limitations and future research directions are discussed.

Catching the audience in a job interview: Effects of emotion regulation strategies on subjective, physiological, and behavioural responses.

In the emotion regulation process more than one strategy is often used, though studies continue to rely on the manipulation of one strategy alone. This study compares the effects of Combined Cognitive Reappraisal (CCR: acceptance and reappraise via perspective-taking) and suppression using the Trier Social Stress Test (TSST). One hundred participants were randomly assigned to one of the two groups and subjective, physiological, and behavioural data were recorded. Continuous electrocardiography was recorded to measure heart rate variability (HRV) and stress levels. Affective ratings were provided before and after the TSST. Behavioural expressions were videotaped and analysed independently. Trait social anxiety/fear, age and gender entered as covariates. Although no group differences were found on affective ratings, the CCR group presented less physiological stress, higher HRV, their speech was better perceived, displayed more affiliative smile and hand gestures. Results suggested that CCR is more appropriate than suppression for managing social stress situations.

Musculoskeletal symptoms in nursing students: concept analysis.

OBJECTIVE: to analyze the musculoskeletal symptomatology concept in undergraduate nursing students through Rodgers' evolutionary method. METHOD: An integrative review of the literature was performed for the identification and selection of ten articles. A concept analysis was performed according to Rodgers' evolutionary method. Article search was performed using the EBOSCO Host platform, Virtual Health Library and Google scholar for the years from 2004 to 2018. RESULTS: Based on the 3 elements of Rodgers model we found: 1) substitute terms and related concepts, where musculoskeletal disorders and musculoskeletal symptoms were highlighted; 2) as essential attributes of the concept we highlight pain and discomfort, as well as, measurement using the Nordic Musculoskeletal Questionnaire; and 3) risk factors were identified as antecedents, and the consequences were the impact on students' lives. CONCLUSIONS: This study contributes to the knowledge and clarification of the concept of musculoskeletal symptomatology in nursing students.

Sleep in adolescence: sex matters?

OBJECTIVE: Sleep is of upmost importance for everybody and especially for adolescents who face life and leisure challenges that may impair their sleep. This study aimed to verify if girls are at a higher risk to present sleep problems and if associations of a sleep perception are different between sexes even when accounting for biological maturation. METHODS: Data is from the HBSC Portuguese survey 2014, all variables were self-reported. Participants were 3869 adolescents (2057 girls), mean age 14.8 years. Participants' socio-demographic characteristics included sex, age, school grade, father and mother education; besides participants were inquired about sleep duration and characteristics of their sleep quality. RESULTS: Sleep deprivation was reported by 13.1% of the adolescents (girls 14.3%, boys 11.7%, p<0.05). The most prevalent characteristics of poor sleep quality were waking up tired (50.8%) and difficulties falling asleep (19.5%), for both girls presented higher prevalence than boys. Overall, girls presented a poorer sleep health with low quality and quantity of sleep. Furthermore, associations of an enough and good sleep were different between boys and girls, even when controlling for the impact of delayed pubertal maturity. DISCUSSION: Together with screen time, substance use, poorer nutrition, sedentary behaviours and abuse of screen time, sleep is an issue that must be addressed by professionals, families and public policies with impact in family life and family routines. Modelling a health education in schools should include the sleep topic. In addition, yes, sex matters and must be included on board.

What doesn't kill them doesn't make them stronger: Questioning our current notions of resilience.

This study expands on earlier analyses of the data generated by a cross-sectional study involving a random sample of 5149 middle-school students with a mean age of 14.5 years from four EU-countries (Austria, Germany, Slovenia, and Spain), in which every fourth respondent (23.0%) had been physically abused by his or her parents and almost every sixth respondent (17.3%) had witnessed physical spousal abuse. Contrary to expectations, some of these youths reported no engagement in peer violence and no symptoms of depression, which meant that they could be considered "resilient." Given their precarious conditions, we inquired into how these young people functioned on other protective and risk indicators when compared to non-violence exposed peers. Using Bonferroni post-hoc tests, we conducted an analysis of variance based comparison of levels of risk and protective factors on three groups of violence and depression-resilient youth (low, middle and high family violence experience) with those participants who reported no family violence or abuse, no depression and no use of violence. The violence and depression-resilient participants reported significantly higher levels of aggression supportive beliefs, alcohol consumption, drug use, verbal aggression towards and from teachers and use of indirect aggression, along with lower levels of social and personal protective characteristics such as self-acceptance, emotional self-control, optimism about the future, and positive relations with parents and teachers, than students without family violence experiences. We therefore concluded that while some family violence exposed young people may not engage in violence or experience depression, this does not automatically imply an absence of other challenges and calls into question our current notions of resilience.