Social determinants associated with psychological distress in children and adolescents during and after the first COVID-19-related lockdown in France: results from the CONFEADO study.

BACKGROUND: This study aimed to analyze the parental socio-demographic characteristics of children and adolescents aged 9 to 18 years old, as well as the living and housing conditions associated with the psychological distress in these two sub-populations during and after France's first national COVID-19-related lockdown in spring 2020. METHODS: We used data from the cross-sectional, observational, web-based study CONFEADO, which collected data on children and adolescents' living and housing conditions and socio-demographic characteristics as well as those of their parents. It also collected data on children's and adolescents' health behaviors and psychological distress. We assessed psychological distress using the 10-item Children and Adolescents Psychological Distress Scale (CAPDS-10), and performed a multinomial logistic regression. RESULTS: A total of 2882 children and adolescents were included in the present study. Factors associated with moderate psychological distress included being a female, parental financial difficulties, a lack of a private living space at home for the child/adolescent, and the following child health behaviors: no leisure or recreational activities with adults in the household, doing less than one hour of school homework a day, and not going outside during the lockdown. Severe psychological distress was associated with the parent's occupation (especially essential frontline workers), a lack of a private living space at home for the child/adolescent, and the following child health behaviors: spending over 5 h a day on social media, doing less than one hour of school homework a day, and no leisure or recreational activities with adults in the household. CONCLUSIONS: This study emphasizes the impact of housing and living conditions, as well as parents' socio-economic characteristics on children's health behaviors and psychological needs during the first COVID-19-related lockdown in France. Our results suggest that health policies implemented during future pandemics should consider these structural social determinants to prevent severe psychological distress in children and adolescents.

[Psychological care for the children of jihadists: modalities and challenges]. / La prise en charge psychologique des enfants de djihadistes : modalités et enjeux.

Since March 2017, minors returning from the terrorist groups' operation areas benefit from a medical and psychological assessment by referral centres throughout France. At the Avicenne hospital in Bobigny (AP-HP, 93), a team assesses the children of jihadists who land at Paris-Roissy-Charles-de-Gaulle airport. This evaluation raises unprecedented clinical questions and confronts professionals with challenges related to the history of these children and the context of their return.

[The infant faced with the loss of a parent]. / L'enfant face au deuil d'un parent.

Bereavement in an infant constitutes a complex process with a distinct temporality. It is closely linked to family bereavement. Based on a clinical example, it is possible to detail the necessary stages as well as the difficulties to take into account during this very specific ordeal which the sudden loss of a parent represents.

[Trauma-related disorders in children]. / Troubles liés aux traumatismes chez les enfants.

Trauma-related disorders in children. The discovery of posttraumatic stress disorder (PTSD) in children is a recent finding. Nowadays we know that young age does not protect from traumatism. However, PTSD will display differently according to age. Epidemiology shows that PTSD is a less frequent occurrence than being exposed to traumatic events, but that certain groups may be more likely to be affected. A chronic course of the disorder is always possible and can interfere with every aspect of the child's development. Even if parents minimize the disorder, practitioners should carefully examine the signs of PTSD after the trauma and repeat this examination several times in the first few weeks.

Troubles liés aux traumatismes chez les enfants. L'existence des troubles post-traumatiques chez l'enfant est récente. Aujourd'hui nous savons que le jeune âge ne protège pas du traumatisme. En revanche, le trouble de stress post-traumatique s'exprime différemment selon l'âge. L'épidémiologie montre que la survenue du trouble est moins fréquente que l'exposition à des événements traumatiques, mais qu'elle peut être élevée dans certains groupes. La chronicisation du trouble, toujours possible, interfère avec tous les aspects du développement de l'enfant. Même si les parents minimisent les troubles, le praticien doit rechercher attentivement, après la survenue d'un traumatisme, les signes de trouble de stress post-traumatique et répéter cet examen plusieurs fois dans les premières semaines.

[A tool for the language evaluation of bilingual children]. / Un outil pour l'évaluation langagière des enfants bilingues.

The native language is a vehicle for transmission and inscription into a culture. In children of migrants who grow up between two languages and two cultures, language develops in a context of bilingualism. This specific context requires bilingual assessments to ensure that a child's complete skills are assessed. The language assessment of non-French-speaking children and first-time immigrants, has been set up at Avicenne hospital in Bobigny. It is the first transcultural tool for the assessment of native languages.

[The drawing, an indicator of language divides]. / Le dessin, un révélateur des clivages langagiers.

The drawing is used as a mediation tool in the framework of a cross-cultural consultation "bilingual group". Clinical reference materials show that this mediation is suitable for children having difficulties switching between the language spoken at home and that spoken at school.

Children and Adolescents Psychological Distress Scale During COVID-19 Pandemic: Validation of a Psychometric Instrument (CONFEADO Study).

Aim and Object Purpose of the Study: In March 2020, the WHO declared a pandemic (COVID-19) due to the SARS-CoV-2 virus. In France, school closures and lockdowns were implemented. In this unprecedented context for French adolescents and children, the CONFEADO study surveyed children aged 9 to 18 years to assess their mental health, psychological distress, and resilience during and after the lockdown in relation to their living and housing conditions. To assess psychological distress, a psychometric tool (Children and Adolescent Psychological Distress Scale-CAPDS-10) was specifically designed for the research. This article presents the psychometric validity of the CAPDS-10. Methods: This cross-sectional study collected data from June 9 to September 14, 2020, from children and adolescents (9 to 18 years of age) via an online questionnaire after sending it to a large network of partners. Psychological distress, resilience, and trait anxiety were assessed using the CAPDS-10, the Child and Youth Resilience Measure (CYRM), and the State-Trait Anxiety Inventory for Children (STAIC). The CAPDS-10 measured perceived psychological distress in the most recent 2 weeks (primary endpoint). The predictive power of the CAPDS-10 was determined by statistical analysis. We proceeded to a confirmatory factor analysis to validate the scale at a clinical level. We carried out a psychometric validation with a step to verify the uni-dimensionality of the scale (PCA analysis) and the calculation of convergent and divergent validity, correlation coefficient between items and subscales, Cronbach's alpha for reliability, determination of a cut-off score for the AUROC index. Results: Three thousand and forty eight children and adolescents completed the CAPDS-10. Analysis confirmed a three-factor model (anxiety, depression, and aggressive behavior) (RMSEA = 0.072 [0.067; 0.077], CFI = 0.954), with a correlation coefficient between items >0.4. PCA analysis concluded that the scale is unidimensional. Reliability was satisfactory with Cronbach's alpha coefficients >0.7 (0.86). In addition, prediction was good with an AUROC index equal to 0.73 and a threshold score for severe distress greater than or equal to 19. Conclusion: The CAPDS-10 measures psychological distress over the most recent 2-week period with good psychometric qualities. It could be used in crisis or prevention contexts in the general population or in clinical settings.

Transcultural and familial factors in bilingualism and language transmission: A qualitative study of maternal representations of French-Maghrebi Arabic bilingual children.

This qualitative exploratory study examined transcultural and familial factors involved in bilingualism and minority language transmission among French and Arabic-speaking children. Participants included 30 children aged 4 to 6 years, born in France, and their bilingual French-Maghrebi Arabic-speaking parents. Children's bilingual language profiles were assessed with the ELAL Scale for Maghrebi Arabic (minority language) and the Neel Scale for French (majority language). Mothers participated in qualitative interviews about cultural and language practices and representations. Interview contents were compared with the children's language profiles. Results indicated that parents closely associated the transmission of the Arabic language with their cultural heritage transmission. The parents of fluent bilinguals had a strong desire to transmit the minority language. Mothers of minority language dominant bilingual children reported little perception of change in their lives since migration. Half of the mothers of majority language dominant bilingual children reported relationship or emotional difficulties with their children. Four minority language transmission types were identified: direct parent-child transmission; indirect transmission through private classes; indirect transmission through visits to family in the parents' native countries; and alternative transmission by another family member. Direct parent-child transmission was most frequent among the fluent bilinguals. Families' processes of hybridity were related to language transmission and bilingual development of children. Parental cultural affiliations to native country were related to minority language transmission. Perception of change since migration and affiliation to host country may also play a role in harmonious bilingual development. Moreover, the quality of family relationships can affect minority language transmission.

[Taking care of the families of air disaster victims]. / La prise en charge des families de victimes d'une catastrophe aérienne.

The medico-psychological emergency unit in Seine-Saint-Denis (93) was involved in managing the families of the victims of the AF447 flight crash which took place on the night of 31 May and 1 June 2009 between Rio de Janeiro (Brazil) and Paris. It is interesting to study the system set up at the airport, the symptomatology observed, and the parameters of the efficiency of the care provided.

Post-Traumatic Stress Disorder in Homeless Migrant Mothers of the Paris Region Shelters.

Migrant women are disproportionately more likely to experience traumatic events in their country of origin, during migration and after arriving in the host country. Homeless women are more likely to be exposed to multiple victimizations in childhood (emotional or physical maltreatment) and in adulthood (sexual abuse, street victimization). This study's objective was to describe the factors associated with the likelihood of post-traumatic stress disorder (PTSD) among homeless migrant mothers in the Paris region. Face-to-face interviews were conducted by bilingual psychologists and interviewers in a representative sample of homeless families in the Paris region. PTSD was ascertained using the Mini International Neuropsychiatric Interview (MINI) (n = 691 mothers). We studied PTSD in mothers using weighted Poisson regression. Homeless migrant mothers had high levels of PTSD (18.9%) in the 12 months preceding the study. In multivariate analysis, PTSD was associated with departure from the country of origin because of violence (PR = 1.45 95% CI 1.03; 2.04), depression in the preceding 12 months (PR = 1.82 95% CI 1.20; 2.76), and residential instability (PR = 1.93 95% CI 1.27; 2.93). Homeless migrant mothers have high levels of traumatic events and PTSD. Improvements in screening for depression and PTSD and access to appropriate medical care are essential for this vulnerable group.

Under-Age Children Returning From Jihadist Group Operation Areas: How Can We Make a Diagnosis and Construct a Narrative With a Fragmentary Anamnesis?

INTRODUCTION: Since 2011, the French government estimates that about 500 French children have been born in or taken by their parents to areas where terrorist operations prevail. Since May 2017, 75 children who returned to France have benefited from a dedicated health care system. METHOD: This article is the result of clinical interviews conducted with 53 patients evaluated and taken care of at Avicenne Hospital in Bobigny. To our knowledge, no studies have been published on this subject. RESULTS: A total of 32 evaluations have been completed, all of which indicated the need for care for these children. Of these children, 64% are under 5 years old, and 59% were born in France. Their clinical profiles are heterogeneous and fluctuate with time. DISCUSSION: The multiple adverse events experienced by these children and the uniqueness of children born to families suspected by authorities of having participated in activities related to terrorism make this situation unprecedented. How can we make a diagnosis of PTSD without the help of a precise anamnesis? How can we help these children form a structuring narrative that avoids the pitfalls inherent to generalized fascination?

The rule of virginity among young women of Maghrebine origin in France.

Interviews conducted with young women of Maghrebine origin in France show that norms of virginity represent a central means by which women negotiate Maghrebine-French identity and handle intergenerational relations. From the legacy of the colonial era to the current interethnic context, notions of virginity have played a significant role, in both official French discourse, and in the parental transmission of social values across generations. Standards of virginity stand as symbolic markers of women's identity positioning. Yet, women also reinterpret, transform and appropriate codes of virginity according to life experience and situational context.