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Children and Adolescents Mental Health: A Systematic Review of Interaction-Based Interventions in Schools and Communities

Rocío garcía-carrión.

1 Faculty of Education, Psychology and Social Work, Universitat de Lleida, Lleida, Spain

Beatriz Villarejo-Carballido

2 Faculty of Psychology and Education, University of Deusto, Bilbao, Spain

Lourdes Villardón-Gallego

Background: There is growing evidence and awareness regarding the magnitude of mental health issues across the globe, starting half of those before the age of 14 and have lifelong effects on individuals and society. Despite the multidimensional nature of this global challenge, which necessarily require comprehensive approaches, many interventions persist in seeking solutions that only tackle the individual level. The aim of this paper is to provide a systematic review of evidence for positive effects in children and adolescents' mental health resulting from interventions conducted in schools and communities in which interaction among different agents is an integral component.

Methods: An extensive search in electronic databases (Web of Knowledge, SCOPUS, ERIC, and PsycINFO) was conducted to identify interventions in which interactions between peers, teachers, families or other community members or professionals played a role. Their effects on children and adolescents' mental health were also reviewed. We carried out a systematic review of papers published from 2007 to 2017. Eleven studies out of 384 met the inclusion criteria. Seven of the articles reviewed focus on interventions conducted in schools and promote supportive interactions involving students, teachers, families and mental health professionals. Four of the articles develop interventions that engage community members in dialogic interactions with children and adolescents.

Results: Interventions in schools and communities implement strategies that foster supportive interactions among diverse actors including teachers, parents, community members, and other professionals. The effects of the mental health interventions reported on children and adolescents' problems include a decrease in disruptive behaviors and affective symptoms such as depression and anxiety, together with an increase in social skills, as well as an improvement in personal well-being.

Conclusions: There is evidence of a positive effect on the mental health of children and adolescents, both in decreasing symptoms of mental disorder and in promoting emotional well-being. Whereas, interactions among different actors seem to be a relevant aspect across the interventions, more research is needed to conclude its effect on the outcomes of the studies reviewed.

Introduction

Childhood and adolescence are critical periods to promote mental health as more than half of mental health problems start at these stages, and many of these persist throughout adult life (Kessler et al., 2005 ). Currently, this has become a priority as worldwide data shows an increase in the prevalence of mental health issues in childhood and adolescence (de la Barra M, 2009 ) and the percentage of those afflicted reaching nearly 20% (WHO, 2016 ). The situation is further exacerbated by the fact that many of these children and adolescents are not receiving the specialized care they require (Mills et al., 2006 ; Weist and Murray, 2008 ; Green et al., 2013 ).

Consequently, important efforts to bring together the best evidence about mental health have been done and raised the challenge of agreeing about fundamental issues in the field such as the definition of mental health and other related concepts (Mehta et al., 2015 ). According to WHO, mental health is understood not as a mere absence of illness, but rather, in a broader sense, as a state of well-being in which individuals develop their abilities, face the stress of daily life, perform productive and fruitful work, and contribute to the betterment of their community (WHO, 2004 ). This definition served as the basis for WHO Mental Health Action Plan, 2013–2020, which incorporates the concepts of mental health promotion, mental illness prevention and treatment, and rehabilitation. Particularly, developmental aspects of children and young people, including, for instance, the ability to manage thoughts, emotions, as well as to build social relationships, and the aptitude to learn, are emphasized in the plan as critical facets to be tackled in mental health interventions.

Mental health interventions conducted in schools and in the communities start from the premise that the problems experienced by adolescents are determined by the interaction of individual, environmental and family factors (Manjula, 2015 ). Accordingly, schools and communities offer an optimal context to intervene as children and adolescents grow and develop through social interaction. Schools and communities can make the most of its environment to foster child and youth development and to promote good mental health (Weist and Murray, 2008 ). Many of the mental health programs implemented in schools promote the development of social skills, socio-emotional competences, and learning outcomes while at the same time reducing disruptive behavior (Dowdy et al., 2010 ; Moreira et al., 2010 ; Durlak et al., 2011 ; Suldo et al., 2014 ). The school environment and climate can therefore play a critical role in encouraging the promotion of protective factors for mental health, such as social-emotional competences and skills (Osher et al., 2012 ).

Hence, social and cognitive development is enacted through social interactions in a particular cultural and social context (Vygotsky, 1978 ; Bronfenbrenner, 1979 ). Drawing on the contributions of Vygotsky's theory of cognitive development, human interaction that takes place in the social and cultural context enhances learning and is fundamental for psychological function. These cultural processes in which people learn and developed occur through interactions with others, including symmetrical (peer) as well as expert–novice (e.g., teacher–student) relations (Rogoff, 1990 ; Cole, 1996 ). Importantly, specific instruments have been produced to capture productive forms of dialogue across educational contexts (Hennessy et al., 2016 ).

Most of the research have been devoted to understanding the central role played by the quality of dialogue and interaction between students, in small group classrooms, or in whole class setting teacher-student interaction (see review by Howe and Abedin, 2013 ). Furthermore, research conducted in community-based schools has also reported the benefit of involving families and community members in learning interactions with elementary students, especially for those belonging to vulnerable populations (Flecha and Soler, 2013 ; Valls and Kyriakides, 2013 ). Accordingly, community plays a central role as human develop through their interactions in the sociocultural activities of their communities (Rogoff, 2003 ). Similar improvements have been reported among students with disabilities as a result of engaging in caring and supportive interactions among peers and with other adults when solving academic tasks in interactive groups (García-Carrión et al., 2018 ). The relevance of productive forms of dialogue and supportive interactions among peers, teachers and other community members, have also reported positive effects in 4th grade students prosocial behavior (Villardón-Gallego et al., 2018 ). These studies evidence the potential of educational interventions that draw on the potential of fostering interactions among different agents and promote productive dialogues as a tools for academic and social improvement.

However, when searching for mental health improvement through dialogic interactions, the research is scarce. The pioneering study carried out by Seikkula and Arnkil ( 2006 ) showed the psychological and social benefits of the therapy based on open and anticipation dialogues with adults and adolescents that also involved the family along with the professionals. Rather than focusing in the individual, facilitating supportive interactions among peers, professionals and family members might be an asset underpinning mental health interventions with children and adolescents. This study showed the critical role of collective interactions, which were very different from a dialogue between two individuals (Seikkula and Arnkil, 2006 ). They identified multi-system treatments (MST) characterized by engaging in close interaction professionals with adolescents, family, and other networks. Replication of these US studies in Norway found evidence of effectiveness, particularly, in the adolescents' social skills (Ogden and Halliday-Boykins, 2004 ). However, according to Seikkula and Arnkil ( 2006 , p. 181): “what ultimately caused the observed outcome was not revealed. After all, methods do not help or cure anyone as such. Psychological methods -and other interaction-based means- exist as they user activity.”

Whereas, determining the effect of the interaction itself in the outcomes obtained might be problematic, the authors of these paper aim to examine interaction-based mental health interventions, defined as those in which collective interactions, that involve professionals, family and community members with children and adolescents, are an integral component of the intervention. This systematic review focuses on those interventions conducted in schools and communities and its outcomes on children and adolescents' mental health. According to the WHO definition of mental health provided above, primary studies selected for this review will include positive outcomes in a broader sense, comprising not only the reduction of symptoms of mental disorder but also the promotion of emotional well-being.

The study carries out a systematic review (Gough et al., 2013 ), a methodology developed by the EPPI Centre of the UCL Institute of Education. We have also taken into account the recommendations by PRISMA (Moher et al., 2009 ) and checklist by Joanna Briggs Institute (JBI) (Lockwood et al., 2015 ), in order to offer transparency, validity, replicable, and updateable in this study.

Search Strategy

This systematic review has been focused and defined by the question: Do interaction-based mental health interventions in schools and communities have positive effects among children and adolescents? This question has been defined in terms of PICOS: In children and adolescents (Population) are interaction-based interventions (Intervention) effective in decreasing disruptive behaviors and affective symptoms such as depression and anxiety (in children and adolescents with mental health problems), and in increasing social skills, and improving well-being and academic engagement (in children and adolescents in general)? (Outcomes).

For the review, empirical articles published in international scientific journals in the areas of psychology, education, and mental health and focused on interventions among children and youth between 2007 and 2017 were searched and screened. To that effect, the following databases were analyzed: Web of Knowledge, SCOPUS, ERIC, and PsycINFO.

The articles were searched using the following keywords: “school-based,” “community-based,” “dialogue,” “mental health,” “well-being,” “emotional development,” “interventions,” “program,” “interaction,” and “prevention.” The exploration was completed with searches that employed synonyms or derivatives of the keywords. The keywords were also combined to refine the search. The publications containing the search criteria in the title, in the keywords and in the abstract were include.

Inclusion and Exclusion Criteria

In order to identify and select the studies most relevant to our research, inclusion and exclusion criteria were established.

The inclusion criteria were the following:

• - Special population group: children and adolescents.
• - Target age: 6 to 18 years of age, inclusive.
• - Mental health interventions in which collective interactions, including professionals, families, and community members with children and adolescents, are an integral component.
• - Studies reporting outcomes of the intervention in decreasing symptoms and/or promoting well-being.

The exclusion criteria were the following:

• - Interventions focus on early childhood, youth, or adults.
• - Target age is not specified, or the target population is below 5 or above 18 years.
• - Mental health interventions focusing on one-to-one interactions (i.e., professional-child/professional-adolescent).
• - The intervention is not described or assessed, as in trials, theoretical research or literature reviews.

Selection Process

The first part of the search yielded a total of 384 articles from indexed journals: 183 in published in the WOS database, 12 in Scopus, 33 in ERIC and 156 in PsycINFO. All these articles were entered into the Mendeley software for its screening and review. Basic information such as the title, year, authoring, and abstracts was obtained and introduced in a spreadsheet for a first screening.

From the 384 articles gathered in the initial search, the titles and their authors were subsequently revised in order to eliminate duplicates. This review was carried out by the members of the group independently in order to eliminate duplicate documents, specifically 83 were duplicates and were therefore discarded, resulting in a new total of 301 articles.

Abstracts of the 301 articles were reviewed according to the inclusion and exclusion criteria. As a result, 17 articles initially met the inclusion criteria and were eligible for the review (see Figure 1 ). The articles were downloaded for an in-depth review.

Flow diagram to show the process of study selection.

The three researchers examined the articles independently and extracted the most relevant information that was included in a spreadsheet. The information referred to: (a) study characteristics (author, country, selection criteria, design, data acquisition period), (b) population (target population, age and sample size), (c) settings, and (d) type of study. Once the articles were examined in depth against inclusion and exclusion criteria, discrepancies were discussed to reach a consensus in the final selection of the studies. This first review and discussion of the studies of the 11 articles lead to the elimination of a further six articles that did not adequately fit the inclusion criteria. Thus, a total of 11 articles were finally selected for analysis ( Figure 1 ).

Quality Assessment

The quality of the selected studies was assessed using a checklist following the methodological guidance for systematic reviews developed by the Joanna Briggs Institute (JBI) (Lockwood et al., 2015 ). The selected studies were checked against nine questions. The results of the evaluation are presented in the Table 1 .

Quality of studies.

Q1. Is there congruity between the stated philosophical perspective and the research methodology?

Q2. Is there congruity between the research methodology and the research question or objectives?

Q3. Is there congruity between the research methodology and the methods used to collect data?

Q4. Is there congruity between the research methodology and the representation and analysis of data?

Q5. Is there congruity between the research methodology and the interpretation of results?

Q6. Is the influence of the researcher on their search, and vice-versa, addressed?

Q7. Are participant, and their voices, adequately represented?

Q8. Is the research ethical according to current criteria or, for recent studies, and is there evidence of ethical approval by an appropriate body?

Q9. Do the conclusions drawn in the research report flow from the analysis or interpretation, of the data?

Data Analysis

For the analysis of the studies, the three researchers developed an analytical grid to systematize the most relevant information for the purpose of the review: study characteristics, interactions fostered during the intervention, positive effects and information for assessment of the risk of bias. Each researcher analyzed the studies independently aiming at identifying on the one hand, how the interventions promote interactions between different agents, and on the other hand, the effects of the interventions on the target population. Firstly, data was categorized following an inductive method. Secondly, researchers compared their analysis to reach a consensus to report main findings from the review.

The analysis of 11 mental health interventions targeting children and adolescents reported the benefits for both -students with mental health problems as well as healthy participants- resulting from their participation in the programs analyzed. Nine of the studies show the effects of preventive interventions aim to reduce future problems and to promote mental health among children and adolescents without mental health problems. Only two studies target children who had already contacted the school-based mental health service (Fazel, 2015 ) and adolescents who presented depressive symptoms (Connell and Dishion, 2008 ). Overall, the articles reviewed show a series of studies conducted mainly in the US context, seven out of ten, whereas the rest of the studies were carried out in the United Kingdom and Kenya. Seven of the interventions were conducted in schools and four of them were based in the community.

All the studies have shown to promote positive mental health in increasing well-being and preventing other related problems, as well as in reducing affective symptoms among those participants who were already affected. A detailed analysis of the strategies implemented across the mental health programs revealed an emphasis on fostering interactions among the children and adolescents engaging them in dialogues that involved different agents -teachers, families, community members, mental health professionals. An overview of the articles selected is provided in Table 2 .

Summary of included studies.

Supportive Interactions in Mental Health Interventions

Interactions among students, teachers, family, and community members and other professionals play an important role in the interventions analyzed. The mental health programs developed in schools and communities include specific strategies that have an emphasis on enacting peer support, partnerships and dialogic spaces for the children and adolescents to engage in supportive interactions with other relevant peers or adults.

Collaborative Interactions Among Children, Teachers and Parents in the School Context

Interactions between teachers and students underpin the strategies of the mental health interventions in different specific ways, which include tutoring, interviews, consultation meetings, peer-assisted learning strategies, interactive games, cooperative non-competitive building games, among others. (Bradshaw et al., 2009 ; Houlston et al., 2011 ; Cappella et al., 2012 ; Ohl et al., 2013 ; Atkins et al., 2015 ; Fazel, 2015 ). Overall, five of the studies implement strategies aim at developing children social skills through interaction and collaboration.

Similarly, interventions focus on “group interactions” as a preventive strategy that seek to reduce future mental health problems and to promote well-being (McWhirter and McWhirter, 2010 ). Specifically, two group-oriented prevention programs—Project Family Rejuvenation Education and Empowerment and Group-Oriented Psychological Education Prevention- are characterized by small-group discussions among students and with their mothers; in both settings participants engage in dialogue in a nonthreatening climate while encouraging cultivation of feedback and support between them (McWhirter and McWhirter, 2010 ).

Moreover, three studies promoted collaborative interactions between parents, teachers, and mental health professionals (Bradshaw et al., 2009 ; McWhirter and McWhirter, 2010 ; Atkins et al., 2015 ). Interactive features of these mental health programs include building positive peer groups and partnerships, solving problems peacefully, and fostering parent-student interactions, among others. This aligns with the need for an integration of the school ecology into program planning and the implementation of effective programs, as observed in the Link to Learning (L2L) service model instituted in classrooms and homes to support children with disruptive behavior disorders living in urban low-income communities (Atkins et al., 2015 ). In the same vein, collaboration between parents and teachers in classrooms is at the heart of the Family-School Partnership Program (Bradshaw et al., 2009 ). Discussion-based interactions include parents reading aloud to their children, with a particular emphasis in the promotion of reasoning among the students. Interaction is guided-by open-ended questions after the reading or using other materials, such as videotapes. Parents reacted to and discussed the situations and problem-solved alternative approaches. Discussions were also held on problem situations arising at home.

Fostering Communicative Skills and Home–School Interaction

Communication skills and family communication practice are a central component of READY—a family-based intervention program to prevent HIV infection and mental health problems (Puffer et al., 2016 ). The interaction and the communication skills training involved families, caregivers, children, and the community, as the intervention was carried out in religious congregations. By improving family communication as a protective factor against mental health disorders, READY draws on a promising approach to strengthen protective family processes that may prevent future negative outcomes for adolescents (Puffer et al., 2016 ). In conjunction with these activities, and while the program was being implemented, interaction was also fostered, using a voicemail system to cultivate parents' involvement and to provide consultation on an as-needed basis, and asking parents to fill in and return comment sheets indicating whether they had completed the weekly home activities and whether they had encountered any problems.

For their part, Atkins et al. ( 2010 ) carried out an intervention that targeted home-school communication and home routines that support learning, homework support, and daily readings. They promoted interaction between parents and teachers by means of two techniques: Daily Report Cards and Good News Notes. Daily Reports Cards, on the one hand, consist of cards in which teachers and parents join efforts to identify, monitor, and reinforce behaviors that interfere with learning. Teachers and parents agree on a rating system to track behaviors, a reward schedule, and a plan for monitoring intervals that will enhance both direct feedback to students and home-school communication. Good News Notes, on the other hand, are certificates that teachers send to families detailing desirable behaviors exhibited by children, as a means to provide positive weekly feedback to parents. The Notes identify students' strengths, scaffold behavior improvement by reinforcing small achievements, and balance infraction reports with positive feedback.

Overall, these studies report a multilevel approach, tackling schools, families, communities, and mental health providers and services. The three articles include programs that evidence the crucial role of family and parental engagement in promoting mental health among adolescents (Connell and Dishion, 2008 ; Puffer et al., 2016 ) and children (Atkins et al., 2015 ). According to Connell and Dishion ( 2008 ), providing family-centered services in the school environment facilitated family engagement in the program.

Engaging in Dialogue With Community Members

Engaging in dialogue with the very community members who might be at risk of suffering mental health problems is essential for the success of the intervention. Some strategies for their involvement include the creation of a local Community Advisory Committee (Puffer et al., 2016 ) or a Community Advisory Board (Kia-Keating et al., 2017 ). The latter engage participants in reciprocal dialogues on solutions for issues ranging from violence exposure and health disparities to the difficulties encountered by youth people seeking to thrive, as exemplified by the HEROES Project (Kia-Keating et al., 2017 ).

There have been other community-based organizations studied in California, aimed at promoting “cultures of health” by engaging people in building social networks, by fostering solidarity and collective efficacy, or by promoting a shared commitment to the collective well-being (Puffer et al., 2016 ). Overall, these programs promote dialogic spaces in which the voices of the minorities, who have often been excluded, are instead given prominence and listened to, in order to look for solutions that will address the inequalities affecting their communities.

The effects of the interventions carried out in schools and communities with an emphasis on fostering supportive interactions as discussed above have benefited children and adolescents as reported in the following dimensions:

• Internalizing symptomatology: Three studies include interventions that have had positive effects on the treatment and prevention of affective disorders such as depression and anxiety. Thus, Connell and Dishion ( 2008 ) ascertained, throughout 3 years, their potential to reduce and prevent the increase of depressive symptoms in at-risk early adolescents. Likewise, Ohl et al. ( 2013 ) confirmed the effectiveness of relationships for decreasing emotional symptoms. McWhirter and McWhirter ( 2010 ) garnered the results of the GOPEP intervention program (McWhirter et al., 1997 ), based on group sessions and on conjoint sessions, which entailed substantial collaboration between researchers and participants, and confirmed the effectiveness of the SOAR program (Student Optimistic Attitudes and Resilience Program) in reducing anxiety and depression. The FREE program, for its part, was effective in decreasing self-isolation among children and their mothers, survivors of domestic violence.
• Externalizing symptomatology: Four articles present improvements in aspects related to aggression and behavioral issues. Ohl et al. ( 2013 ) confirmed that the Pyramid project helped improve peer problems; however, they did not find positive effects on behavioral problems. McWhirter and McWhirter ( 2010 ) gathered evidence confirming the effectiveness of the FREE project in decreasing family conflict, and of the SCARE (Student-Created Aggression Replacement Education) program, one of the GOPEP intervention programs, in decreasing and managing aggression, anger, and violent behaviors. However, Cappella et al. ( 2012 ) did not find significative differences in behavioral regulation as an effect of their BRIDGE intervention, although children identified as having behavioral problems benefitted more than their peers in the area of social relations. On the other hand, Bradshaw et al. ( 2009 ) confirmed the long-term positive effects in reducing behavioral and mental-health problems resulting of the CC intervention.
• Personal well-being: Six of the studies reported positive effects on strengthening psychological-related aspects to well-being, including self-concept, self-esteem, self-efficacy, and empowerment, among others. Cappella et al. ( 2012 ) confirmed the existence of a positive effect of intervention on children's academic self-concept. Atkins et al. ( 2015 ) found a significantly greater improvement on social skills among children who had been involved in the intervention, whereas Ohl et al. ( 2013 ) ascertained its positive effect on prosocial behavior. Houlston et al. ( 2011 ) confirmed that peer support improves self-esteem in victims of bullying, as well as their perception of the support provided by friends and other students. Participants stated that peer support had a positive impact on students' relationships, improving and building peer networks with trained peer supporters and other students. More specifically, in bullying situations, students considered peer support to be helpful for a number of reasons, including being able to talk about it, having peers to interact with, or helping bullied students to tell others of their plight.
• Bloemraad and Terriquez ( 2016 ) gathered the opinions of people taking part in activities organized by CBOs (Community-Based Organizations). Results provide evidence of the impact that involvement in CBOs has on participants, namely when preparing to enroll and succeed in college, as well as on their self-reported civic capacity developing skills, which encompass skills as diverse as communicating with others, understanding the impact that government decisions have on the community, speaking in public, or planning events. Besides, the involvement in CBOs improves personal empowerment and self-efficacy, as participants learn to stand up for their beliefs, become more aware of health issues impacting their communities, and learn about their own culture or ethnic group. As for health and education outcomes, participants became more informed about college and career options, took better care of their personal health, and improved their school grades.
• McWhirter and McWhirter ( 2010 ) showed that the FREE project resulted in an increase in children's and women's emotional well-being, peer engagement and self-esteem in children, as well as women's self-efficacy.
• Context: Five of the interventions reported improvements on the classroom climate and teacher-student and peer interactions. The study carried out by Cappella et al. ( 2012 ), based on BRIDGE intervention, demonstrates how classroom interactions generate a positive climate where emotional support and teacher sensitivity are prominent. These interactions also promote a positive classroom climate, characterized by optimal behavior management, productivity, and instructional learning formats. Furthermore, they have been verified to help develop instructional support, more positive teacher expectations regarding children's behavior, and a more responsive teacher-student relationship. The study by McWhirter and McWhirter ( 2010 ), based on group interventions, highlights that interacting with other people helps build positive peer/adult relationships. These conclusions are shared by Puffer et al. ( 2016 ), whose study focused on family communication, and who conclude that intra-family communication improves well-being. In a similar vein, Bloemraad and Terriquez ( 2016 ) find that the interactions fostered by the intervention improve well-being in the community.

The present systematic review of studies has fulfilled the objective of identifying evidence for positive effects of interaction-based interventions in schools and communities in children's and adolescents' mental health. We have shown that mental health interventions, in which supportive interactions are fostered among different actors, have a positive effect in decreasing affective symptoms and in increasing personal wellbeing among children and adolescents.

We detected in these programs an emphasis on engaging children and adolescents in supportive interactions with other relevant adults, such as teachers, family, community members, and other professionals. Overall it showcases the benefits children and adolescents without mental health problems can reap, particularly in preventive interventions as nine of the studies focused on. Only two studies target adolescents and children with mental health problems (Connell and Dishion, 2008 ; Fazel, 2015 ). The literature analyzed sheds light on the importance of preventive interventions where different agents work together toward the common goal of promoting children's and adolescents' mental health (Atkins et al., 2015 ; Kia-Keating et al., 2017 ).

Positive effects on mental health are achieved through interventions that are culturally appropriate and culturally grounded (Bloemraad and Terriquez, 2016 ; Puffer et al., 2016 ; Kia-Keating et al., 2017 ). This is particularly important in those interventions which require the active engagement of families and community members. The role of family and community members emerges as particularly relevant and providing them with communicative skills and fostering home-school communication are assets for the mental health interventions. Schools thus become an ideal space to facilitate family and community involvement, and they consequently present a great potential for enhancing positive parent-teacher, teacher-student and student-student interactions. This is consistent with other research that has focused on the benefits of school-based mental health interventions to help them develop cognitively, socially, and emotionally (Fazel et al., 2014 ).

There is enough supporting evidence on the potential of these interventions for schools to create a positive climate based on instructional and emotional support, solidarity and friendship that improves the well-being of children and communities (McWhirter and McWhirter, 2010 ; Bloemraad and Terriquez, 2016 ; Puffer et al., 2016 ). Available evidence on the effectiveness of these studies attests to the attainment of positive gains in students' academic achievement, which will also lead to other long-term positive effects that will help prevent behavioral and mental-health problems (Bradshaw et al., 2009 ). This positive effect is particularly strong in high poverty contexts (Atkins et al., 2015 ). Particularly relevant is the reduction of anxiety and depression, especially in light of the marked increase of the latter, currently ailing 4,4% of the world population (WHO, 2017 ).

Overall, we argue that interaction-based approaches in mental health interventions, that involve diverse actors in productive forms of dialogue and supportive interactions, are consistent with the benefits reported by the sociocultural approaches to learning and development (Vygotsky, 1978 ). However, in this systematic review we have not been able to determine the effect of the interaction on the effectiveness of the intervention. This is consistent with the literature, as effective mental health interventions, which include collective interactions among different agents as a central element of the intervention, did not revealed how those interactions were linked to the positive outcomes obtained (Seikkula and Arnkil, 2006 ). Similarly, the primary studies reviewed do not established a direct link of the interaction component of the intervention with the positive mental health outcomes. This question still remains.

Limitation and Future Directions

In this systematic review we have reviewed a set of interventions for both adolescents and children, without explicitly distinguishing within the two study groups. This raises a limitation as children and adolescents can potentially show different needs in terms of mental and behavioral support. Consequently, there could be potential differences in the outcomes that have not been considered in this review. In the same vein, this study only reviewed research in English and most research was conducted in the United States, which could also limit the generalizability of the results.

On the other hand, the concept of interaction we explored it is a broad concept that presents some limitations in providing a consistent definition within the interventions. Furthermore, the primary studies reported the effects of the intervention as a whole. Therefore, their methodological designs do not allow to identify the specific effect on mental health of the interaction itself. Still there is a gap to determine the effect of the interactions on the mental health outcomes. Further research is needed to explore the particular role and potential of social interaction to promote children and adolescents' mental health.

Conclusions

This systematic review of 11 studies has focused on mental health interventions in which interaction plays an important role. Supportive interactions carried out in the framework of mental health interventions involve various contexts, agents and systems, including teachers, parents, mental-health professionals, and members of the community.

There is evidence of a positive effect on the mental health of children and adolescents, both in decreasing internalizing and externalizing symptoms, and in promoting personal well-being. Factors that foster mental health as social support or engagement also increase with interventions programs that include interaction as a main feature.

However, more research is needed into the specific impact of interaction on the mental health of children and adolescents, as well as analyzing the type of interactions that have the most beneficial effect.

Author Contributions

RG-C wrote the proposal of this systematic review with the input and contributions of the research team BV-C and LV-G. RG-C and LV-G planned the search in databases and defined exclusion and inclusion criteria for the selection of the articles. BV-C carried out the search, screen the materials and proposed a selection. All the authors checked and refined the selection of the studies. Each author drafted a section of this manuscript. All authors reviewed the whole manuscript, read and approved the submitted version.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Funding. The work leading to this invention has received funding from the Spanish Research Grants EDU2017-88666-R and EDU2015-66395-R (MINECO/FEDER, UE).

• Atkins M. S., Hoagwood K. E., Kutash K., Seidman. E. (2010). Toward the integration of education and mental health in schools . Admin. Pol. Mental Health Mental Health Serv. Res. 37 , 40–47. 10.1007/s10488-010-0299-7 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Atkins M. S., Shernoff E. S., Frazier S. L, Schoenwald S. K., Cappella E., Marinez-Lora A., et al.. (2015). Redesigning community mental health services for urban children: supporting schooling to promote mental health . J. Consult. Clin. Psychol . 83 , 839–52. 10.1037/a0039661 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Bloemraad I., Terriquez V. (2016). Cultures of engagement: the organizational foundations of advancing health in immigrant and low-income communities of color . Soc. Sci. Med. 165 , 214–222. 10.1016/j.socscimed.2016.02.003 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Bradshaw C. P., Zmuda J. H., Kellam S. G., Ialongo N. S. (2009). Longitudinal impact of two universal preventive interventions in first grade on educational outcomes in high school . J. Educ. Psychol . 101 , 926–37. 10.1037/a0016586 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Bronfenbrenner U. (1979). The Ecology of Human Development : Experiments by Nature and Design . Cambridge, MA: Harvard University Press. [ Google Scholar ]
• Cappella E., Hamre B. K., Kim H. Y., Henry D. B., Frazier S. L., Atkins M. S., et al.. (2012). Teacher consultation and coaching within mental health practice: classroom and child effects in urban elementary schools . J. Consult. Clin. Psychol . 80 , 597–610. 10.1037/a0027725 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Cole M. (1996). Cultural Psychology : A Once and Future Discipline. Cambridge, MA: Belknap Press of Harvard University Press. [ Google Scholar ]
• Connell A. M., Dishion T. J. (2008). Reducing Depression among at-risk early adolescents: three-year effects of a family-centered intervention embedded within schools . J. Fam. Psychol. 22 , 574–585. 10.1037/0893-3200.22.3.574 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• de la Barra M F. (2009). Epidemiología de trastornos psiquiátricos en niños y adolescentes: estudios de Prevalencia . Rev. Chil. Neuro Psiquiatr. 47 , 303–314. 10.4067/S0717-92272009000400007 [ CrossRef ] [ Google Scholar ]
• Dowdy E., Ritchey K., Kamphaus R. W. (2010). School-based screening: a population-based approach to inform and monitor children's mental health needs . School Mental Health 2 , 166–176. 10.1007/s12310-010-9036-3 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Durlak J. A., Weissberg R. P., Dymnicki A. B., Taylor R. D., Schellinger K.B. (2011). The impact of enhancing students' social and emotional learning: a meta-analysis of school-based universal interventions . Child Dev . 82 , 405–432. 10.1111/j.1467-8624.2010.01564.x [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Fazel M. (2015). A moment of change: facilitating refugee children's mental health in UK schools . Int. J. Educ. Dev . 41 , 255–261. 10.1016/j.ijedudev.2014.12.006 [ CrossRef ] [ Google Scholar ]
• Fazel M., Hoagwood K., Stephan S., Ford T. (2014). Mental health interventions in schools in high-income countries . Lancet Psychiatry 1 , 377–87. 10.1016/S2215-0366(14)70312-8 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Flecha R., Soler M. (2013). Turning Difficulties into possibilities: engaging roma families and students in school through dialogic learning . Camb. J. Educ. 43 , 451–65. 10.1080/0305764X.2013.819068 [ CrossRef ] [ Google Scholar ]
• García-Carrión R., Molina Roldán S., Roca Campos E. (2018). Interactive learning environments for the educational improvement of students with disabilities in special schools . Front. Psychol . 9 :1744. 10.3389/fpsyg.2018.01744 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Gough D., Oliver S., Thomas J., Hobbs A. (2013). Learning from research: systematic reviews for informing policy decisions a quick guide , in Principal Public Health Adviser NHS Chief Scientist Office Overseas Development Institute Cabinet Office Director of Social Research & Policy , no. December: 1–36. Available online at: www.alliance4usefulevidence.org .
• Green J. G., McLaughlin K. A., Alegría M., Costello E. J., Gruber M. J., Hoagwood K., et al.. (2013). School mental health resources and adolescent mental health service use . J. Am. Acad. Child Adolesc. Psychiatry 52 , 501–510. 10.1016/j.jaac.2013.03.002 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Hennessy S., Rojas-Drummond S., Higham R., Márquez A. M., Maine F., Ríos R. M., et al. (2016). Developing a coding scheme for analysing classroom dialogue across educational contexts . Learn. Culture Soc. Inter. 9 , 16–44. 10.1016/j.lcsi.2015.12.001 [ CrossRef ] [ Google Scholar ]
• Houlston C., Smith P. K., Jessel J. (2011). The relationship between use of school-based peer support initiatives and the social and emotional well-being of bullied and non-bullied students . Child. Soc. 25 , 293–305. 10.1111/j.1099-0860.2011.00376.x [ CrossRef ] [ Google Scholar ]
• Howe C., Abedin M. (2013). Classroom dialogue: a systematic review across four decades of research . Camb. J. Educ . 43 , 325–356. 10.1080/0305764X.2013.786024 [ CrossRef ] [ Google Scholar ]
• Kessler R. C., Berglund P., Demler O., Jin R., Merikangas K. R., Walters E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication . Arch. General Psychiatry 62 , 593–602. 10.1001/archpsyc.62.6.593 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Kia-Keating M., Santacrose D. E., Liu S. R., Adams J. (2017). Using community-based participatory research and human-centered design to address violence-related health disparities among Latino/a youth . Fam. Commun. Health 40 , 160–169. 10.1097/FCH.0000000000000145 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Lockwood C., Munn Z., Porritt K. (2015). Qualitative research synthesis: methodological guidance for systematic reviewers utilizing meta-aggregation . Int. J. Evid. Based Healthcare 13 , 179–187. 10.1097/XEB.0000000000000062 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Manjula M. (2015). Community-based mental health interventions in adolescents , in A Practical Approach to Cognitive Behaviour Therapy for Adolescents , eds Mehta M., Sagar R. (New Delhi: Springer India; ), 43–53. 10.1007/978-81-322-2241-5_3 [ CrossRef ] [ Google Scholar ]
• McWhirter J. J., Herrman D. S., Jefferys K., Quinn M. M. (1997). Tools for violence prevention . Catholic School Stud. 70 , 15–19. [ Google Scholar ]
• McWhirter P. T., McWhirter J. J. (2010). Community and school violence and risk reduction: empirically supported prevention . Group Dynamics 14 , 242–256. 10.1037/a0020056 [ CrossRef ] [ Google Scholar ]
• Mehta N., Croudace T., Davies D. S. C. (2015). Public mental health: evidenced-based priorities . Lancet . 385 , 1472–1475. 10.1016/S0140-6736(14)61400-8 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Mills C., Stephan S. H., Moore E., Weist M. D., Daly B. P., Edwards M. (2006). The President's new freedom commission: capitalizing on opportunities to advance school-based mental health services . Clin. Child Fam. Psychol. Rev . 9 , 149–161. 10.1007/s10567-006-0003-3 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Moher D., Liberati A., Tetzlaff J., Altman D. G., The PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement . PLoS Med . 6 :e1000097 10.1371/journal.pmed.1000097 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Moreira P., Crusellas L., Sa I., Gomes P., Matias C. (2010). Evaluation of a manual-based programme for the promotion of social and emotional skills in elementary school children: results from a 4-year study in Portugal . Health Promotion Int. 25 , 309–317. 10.1093/heapro/daq029 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Ogden T., Halliday-Boykins C. A. (2004). Multisystemic treatment of antisocial adolescents in Norway: replication of clinical outcomes outside of the US . Child Adolesc. Mental Health 9 , 77–83. 10.1111/j.1475-3588.2004.00085.x [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Ohl M., Fox P., Mitchell K. (2013). Strengthening socio-emotional competencies in a school setting: data from the pyramid project . Br. J. Educ. Psychol . 83 , 452–466. 10.1111/j.2044-8279.2012.02074.x [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Osher D., Dwyer K. P., Jimerson S. R., Brown J. A. (2012). Developing safe, supportive, and effective schools: facilitating student success to reduce school violence , in Handbook of School Violence and School Safety , eds Furlong M., Jimerson S., Nickerson A. B., Mayer M. J. (Mahwah, NJ: Lawrence Erlbaum Associates; ). Available online at: https://www.routledgehandbooks.com/doi/10.4324/9780203841372.ch3 (accessed March 10, 2018). [ Google Scholar ]
• Puffer E. S., Green E. P., Sikkema K. J., Broverman S. A., Ogwang-Odhiambo R. A., Pian J. (2016). A church-based intervention for families to promote mental health and prevent HIV among adolescents in rural Kenya: results of a randomized trial . J. Consult. Clin. Psychol . 84 , 511–525. 10.1037/ccp0000076 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Rogoff B. (1990). Apprenticeship in Thinking : Cognitive Development in Social Context . New York, NY: Oxford University Press. [ Google Scholar ]
• Rogoff B. (2003). The Cultural Nature of Human Development . New York, NY: Oxford university press. [ Google Scholar ]
• Seikkula J., Arnkil T. E. (2006). Dialogical Meetings in Social Networks . London:Karnac. [ Google Scholar ]
• Suldo S. M., Gormley M. J., DuPaul G. J., Anderson-Butcher D. (2014). The impact of school mental health on student and school-level academic outcomes: current status of the research and future directions . School Mental Health 6 , 84–98. 10.1007/s12310-013-9116-2 [ CrossRef ] [ Google Scholar ]
• Valls R., Kyriakides L. (2013). The power of interactive groups: how diversity of adults volunteering in classroom groups can promote inclusion and success for children of vulnerable minority ethnic populations . Camb. J. Educ . 43 , 17–33. 10.1080/0305764X.2012.749213 [ CrossRef ] [ Google Scholar ]
• Villardón-Gallego L., García-Carrión R., Yáñez-Marquina L., Estévez A. (2018). Impact of the interactive learning environments in children's prosocial behavior . Sustainability 10 :2138 10.3390/su10072138 [ CrossRef ] [ Google Scholar ]
• Vygotsky L. S. (1978). Mind in Society: The Development of Higher Mental Process . Cambridge, MA: Harvard University Press. [ Google Scholar ]
• Weist M. D., Murray M. (2008). Advancing school mental health promotion globally . Adv. School Mental Health Promotion 1 , 2–12. 10.1080/1754730X.2008.9715740 [ CrossRef ] [ Google Scholar ]
• WHO (2004). Promoting Mental Health: Concepts, Emerging Evidence, Practice: Summary Report. Geneva, World Health Organization. Retrieved . http://www.who.int/mental_health/evidence/en/promoting_mhh.pdf (accessed March 10, 2018).
• WHO (2016). “WHO| Child and Adolescent Mental Health.” WHO . World Health Organization. Available online at: http://www.who.int/mental_health/maternal-child/child_adolescent/en/
• WHO (2017). “WHO| “Depression: Let's Talk” Says WHO, as Depression Tops List of Causes of Ill Health.” WHO. World Health Organization. Available online at: http://www.who.int/mediacentre/news/releases/2017/world-health-day/en/

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Description of the MUSP Cohort

Inclusion criteria for original research publications, quality of supporting literature, predictors: maltreatment types, ethical approval, prevalence and co-occurrence of maltreatment subtypes, cognition and education outcomes, psychological and mental health outcomes, addiction and substance use outcomes, sexual health outcomes, physical health, magnitude of effects, abuse, neglect, and cognitive development, psychological maltreatment: emotional abuse and/or neglect, sexual abuse, physical abuse, limitations, conclusions, long-term cognitive, psychological, and health outcomes associated with child abuse and neglect.

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.

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Lane Strathearn , Michele Giannotti , Ryan Mills , Steve Kisely , Jake Najman , Amanuel Abajobir; Long-term Cognitive, Psychological, and Health Outcomes Associated With Child Abuse and Neglect. Pediatrics October 2020; 146 (4): e20200438. 10.1542/peds.2020-0438

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Video Abstract

Potential long-lasting adverse effects of child maltreatment have been widely reported, although little is known about the distinctive long-term impact of differing types of maltreatment. Our objective for this special article is to integrate findings from the Mater-University of Queensland Study of Pregnancy, a longitudinal prenatal cohort study spanning 2 decades. We compare and contrast the associations of specific types of maltreatment with long-term cognitive, psychological, addiction, sexual health, and physical health outcomes assessed in up to 5200 offspring at 14 and/or 21 years of age. Overall, psychological maltreatment (emotional abuse and/or neglect) was associated with the greatest number of adverse outcomes in almost all areas of assessment. Sexual abuse was associated with early sexual debut and youth pregnancy, attention problems, posttraumatic stress disorder symptoms, and depression, although associations were not specific for sexual abuse. Physical abuse was associated with externalizing behavior problems, delinquency, and drug abuse. Neglect, but not emotional abuse, was associated with having multiple sexual partners, cannabis abuse and/or dependence, and experiencing visual hallucinations. Emotional abuse, but not neglect, revealed increased odds for psychosis, injecting-drug use, experiencing harassment later in life, pregnancy miscarriage, and reporting asthma symptoms. Significant cognitive delays and educational failure were seen for both abuse and neglect during adolescence and adulthood. In conclusion, child maltreatment, particularly emotional abuse and neglect, is associated with a wide range of long-term adverse health and developmental outcomes. A renewed focus on prevention and early intervention strategies, especially related to psychological maltreatment, will be required to address these challenges in the future.

Child maltreatment is a major public health issue worldwide, with serious and often debilitating long-term consequences for psychosocial development as well as physical and mental health. 1   In the United States alone, 3.5 million children are reported for suspected maltreatment each year, with an annual substantiated maltreatment rate of 9.1 per 1000 children. 2   Some of the long-term adverse outcomes associated with maltreatment include cognitive disability, anxiety and depression, psychosis, teen-aged pregnancy, addiction disorders, obesity, and cardiovascular disease. 3   Understanding the distinctive impact of differing types of maltreatment may help medical professionals provide more wholistic care and treatment recommendations as well as identify more specific public health targets for primary prevention.

Unfortunately, however, little is known about the long-term effects of differing types of child maltreatment, which include sexual abuse, physical abuse, emotional abuse, and neglect. 4   According to a meta-analysis review, 5   research on child maltreatment has predominantly been focused on sexual abuse, with far less attention paid to psychological maltreatment (emotional abuse and/or neglect) and the co-occurrence of different types of maltreatment. In addition, most of the current evidence is derived from cross-sectional studies, which may be subject to recall bias, 6 – 8   in which an outcome status (such as depression) may influence recall of the exposure (ie, previous maltreatment). Few previous studies have adequately controlled for confounding variables, such as perinatal risk, socioeconomic adversity, parental psychopathology, and impaired early childhood development, which may predispose to both child maltreatment and later adverse health outcomes.

Longitudinal studies offer evidence that is more robust, but these studies are relatively few in number and have generally been limited to certain sociodemographic groups 9   or to specific types of child maltreatment, such as sexual abuse. 1 , 10   Other longitudinal studies have relied on retrospective recall of maltreatment rather than prospectively collected agency-reported data. 11 – 13   In studies in which prospective data have been collected, 7 , 13 – 17   only a few have compared different types of child maltreatment. 7 , 16 , 17  

In this special article, we review findings from the Mater-University of Queensland Study of Pregnancy (MUSP), a now 40-year longitudinal prenatal cohort study from Brisbane, Australia, involving >7000 women and their children. 18   Unique features of the MUSP include its use of a population-based sample, its use of prospectively substantiated child maltreatment reports, and its consideration of different subtypes of maltreatment. In addition, the study design controlled for a wide range of confounders and covariates, including both maternal and child sociodemographic and mental health variables. This combined body of work, which includes numerous publications over the past decade, has documented a broad range of adverse outcomes associated with child maltreatment, including deficits in cognitive and educational outcomes 19 – 21   ; mental health problems, such as anxiety, depression, posttraumatic stress disorder (PTSD), psychosis, delinquency, and intimate partner violence (IPV) 22 – 25   ; substance abuse and addiction 26 – 30   ; sexual health problems 31   ; physical growth and health deficits 32 – 35   ; and overall decreased quality of life. 36  

Our purpose for this special article is to compare the effects of 4 differing types of maltreatment on long-term cognitive, psychological, addiction, and health outcomes assessed in the offspring at ∼14 and/or 21 years of age. Rather than providing a systematic review or meta-analysis of the current literature, which would include diverse study designs and purposes, we report and compare the findings of individual articles that used a common data set and standard methodology to study a broad array of outcomes. We particularly highlight the long-term impact of emotional abuse and neglect, which has received far less attention in the literature.

Between 1981 and 1983, 8556 consecutive pregnant women who attended their first prenatal clinic visit at the Mater Mothers’ Hospital in Brisbane, Australia, agreed to participate ( Fig 1 ). After excluding mothers who did not deliver a singleton infant at the Mater Mothers’ Hospital or withdrew consent, the MUSP birth cohort consisted of 7223 mother-infant dyads, who were followed over 2 decades: at 3 to 5 days, 6 months, 5 years, 14 years and 21 years. Midway through the study, this rich data set was anonymously linked to state reports of child abuse and neglect, which identified some form of suspected maltreatment in >10% of cases. 37   Notified cases, which had been referred from the community or by general medical practitioners, were investigated by the Queensland government child protection agency. Substantiated maltreatment was determined after a formal investigation when there was “reasonable cause to believe that the child had been, was being, or was likely to be abused or neglected.” 38   Substantiated maltreatment occurred when a notified case was confirmed for (1) sexual abuse, “exposing a child to or involving a child in inappropriate sexual activities”; (2) physical abuse, “any non-accidental physical injury inflicted by a person who had care of the child”; (3) emotional abuse, “any act resulting in a child suffering any kind of emotional deprivation or trauma”; or (4) neglect, “failure to provide conditions that were essential for the healthy physical and emotional development of a child,” which encompassed physical, emotional and medical neglect. 37  

Overview of the MUSP enrollment and testing.

We searched PubMed from inception to April 2020 for published MUSP articles in which agency-reported child maltreatment was evaluated as the predictor of a range of outcomes. Studies needed to meet the following criteria for inclusion in the review: (1) notified or substantiated abuse and neglect was listed as a main predictor variable and (2) outcomes included standardized measurements of cognitive, psychological, behavioral, or health functioning. From ∼340 published MUSP studies, we identified 24 articles dealing with child maltreatment, of which 21 included state-reported maltreatment versus self-reported maltreatment data ( n = 3). Nineteen of the 21 articles met all inclusion criteria and were evaluated in this review ( Fig 2 ). One study was excluded because it only examined outcomes associated with sexual abuse. 8   Another article was excluded because its outcome measures were similar to another included study. 29  

Published studies from the Mater-University of Queensland Study of Pregnancy, linking long-term outcomes with specific maltreatment subtypes (adjusted coefficients or odds ratios ± 95% confidence intervals). CES-D, Center for Epidemiologic Studies–Depression Scale; CI, confidence interval; N , number of offspring in sample; N (Mal) , number of offspring who experienced maltreatment. a In different articles adjusting for co-occurrence of maltreatment subtypes was handled in different ways: (1) statistical adjustment: each maltreatment subtype predictor was statistically adjusted for the other maltreatment subtypes (eg, neglect was adjusted for the occurrence of physical, sexual, and emotional abuse) and is reflected in the table’s odds ratios and coefficients; (2) exclusive categories: different combinations of maltreatment types are included in mutually exclusive groups (eg, physical abuse only, physical abuse and emotional abuse only, physical and emotional abuse and neglect [without sexual abuse], etc; see Table 1 ); (3) nonexclusive categories: maltreatment categories may overlap with other categories (eg, any substantiated abuse [sexual, physical, or emotional] versus any substantiated neglect); and (4) none: no statistical adjustments or combined categories were presented for co-occurring maltreatment subtypes. b Adjusted coefficients (95% CI) were reported as statistical association measures rather than adjusted odds ratios. c Cases of notified (rather than substantiated) maltreatment. In the study by Mills et al, 26   a sensitivity analysis was performed after exclusion of unsubstantiated cases of maltreatment. The associations between any maltreatment and substance use were similar to those seen in the original analysis after full adjustment. d Medium effect size, based on magnitude of the adjusted odds ratio (2 ≤ odds ratio ≤ 4). e Large effect size, based on magnitude of the adjusted odds ratio (odds ratio > 4).

Each of the reviewed articles followed Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for the conduct of cohort studies. 41   The quality of the studies was also evaluated by using a modified version of the Newcastle-Ottawa Scale, which is used to assess the following domains: sample representativeness and size, comparability between respondents and nonrespondents, ascertainment of outcomes, and statistical quality. 42   On the basis of this assessment, all of the MUSP studies were determined to be of low risk of bias, with a score of 4 out of 5 points ( Supplemental Information ).

In all but 2 studies (which used notified maltreatment 21 , 26   ) events were dichotomized and coded as substantiated maltreatment versus no substantiated maltreatment. According to a validated classification of maltreatment types, 43   specific categories and co-occurring forms of childhood maltreatment 44   were used to predict outcomes. In 2 studies, 19 , 20   all types of abuse were combined into 1 category and compared to neglect, whereas in another study, sexual abuse was compared to any combination of nonsexual maltreatment. 21   In 2 other studies, 26 , 40   emotional abuse and neglect (examples of psychological maltreatment) were combined, partly because of overlapping definitional constructs from the government child protection agency (emotional abuse included “emotional deprivation,” and neglect included the failure to provide for “healthy…emotional development”). In all but 2 of the included articles, 25 , 33   co-occurrence of different types of maltreatment was considered, either by examining specific combinations of maltreatment types (in exclusive or nonexclusive overlapping categories) or by statistically adjusting for all remaining types of maltreatment ( Fig 2 ).

All of the odds ratios, mean differences, or coefficients were adjusted for potential confounding variables ( Fig 3 ). All articles adjusted for a variety of sociodemographic variables, such as age, race, education, income, and marital status. Perinatal and/or childhood factors, such as birth weight, gestational age, and breastfeeding status, were used as covariates, particularly in articles in which cognitive and educational outcomes were examined. Psychological and mental health variables (such as internalizing and externalizing behavior problems, maternal depression, chronic stress, or exposure to violence) were primarily included as covariates in mental health outcome studies, especially for psychosis. Addiction studies adjusted for youth and maternal alcohol or tobacco use, among other covariates, and physical health outcome studies adjusted for relevant covariates (such as BMI in a study of dietary fat intake and parental height when studying offspring height). In selected articles, maltreatment subtypes were also statistically adjusted for the other types of maltreatment to determine independent effects.

Covariates used in published articles from the MUSP to adjust for possible confounding. a Race: child’s race, parental race, and maternal or paternal racial origin at pregnancy. b Child age: child age and gestational age. c Maternal age: maternal age at the first visit clinic or at pregnancy. d Maternal education: maternal education (prenatal or at birth). e Family income: annual family income, familial income over the first 5 years or family poverty before birth or over the first 5 years of life, family income before birth, and annual family income. f Maternal marital status and social support: same partner at birth and 14 years and social support at 5 years. g Maternal depression: maternal depression during pregnancy, 3- to 6-month follow-up, or 21-year follow-up; chronic maternal depression. h Maternal alcohol use: maternal alcohol use at 3- to 6-month or 14-year follow-up and binge drinking. i Maternal cigarette use: cigarette use during pregnancy, 6 months postpartum, or at 14-year follow-up. ADHD, attention-deficit/hyperactivity disorder; CES-D, Center for Epidemiologic Studies–Depression Scale; IPV, intimate partner violence. Covariates used in published articles from the MUSP to adjust for possible confounding.

A total of 46 outcomes were assessed at 14 years ( n = 5200) and/or 21 years ( n = 3778) ( Fig 1 ) and were grouped into 5 domains ( Fig 2 ):

Cognition and education outcomes included reading ability and perceptual reasoning measured in adolescence, and, at age 21, receptive verbal intelligence and failure to complete high school or be either enrolled in school or employed; attention problems were measured at both time points.

Psychological and mental health outcomes at 21 years included internalizing and externalizing behavior problems (which were also assessed at 14 years), lifetime anxiety disorder, depressive disorder and symptoms, PTSD, lifetime psychosis diagnosis, psychotic symptoms (such as delusional experience or visual and/or auditory hallucinations), delinquency, experience of IPV or harassment, and overall quality of life.

Addiction and substance use, measured at both time points, included alcohol and cigarette use at 14 and 21 years, and cannabis abuse and/or dependence (including early onset) and injecting-drug use at the 21-year follow-up.

Sexual health was investigated at age 21 in terms of early initiation of sexual experience, having multiple sexual partners, youth pregnancy, and miscarriage or termination.

Physical health outcomes measured at 21 years included symptoms of asthma, high dietary fat intake, poor sleep quality, and height deficits.

The 14-year assessments included a youth questionnaire ( n = 5172) and in-person cognitive testing ( n = 3796). The 21-year visit included an in-person assessment of mental health diagnoses in a subset of the cohort ( n = 2531) with the World Health Organization Composite International Diagnostic Interview (CIDI), which is based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria 45   ( Fig 1 ). All of the questionnaire and interview measures were validated, except for reported frequencies of specific events (ie, pregnancy, number of cigarettes, etc).

Associations were described by using either adjusted odds ratios or mean differences and coefficients, along with the corresponding 95% confidence intervals, and were plotted to visualize and compare the statistical significance of each association across specific outcome categories and types of maltreatment ( Figs 4 – 8 ).

Child maltreatment and cognition and educational outcomes at 14 and 21 years. A, Adjusted coefficients ± 95% confidence intervals. B, Odds ratios ± 95% confidence intervals. * P < .05.

Child maltreatment and psychological and mental health outcomes at 14 and 21 years. A, Adjusted coefficients ± 95% confidence intervals. B, Odds ratios ± 95% confidence intervals. * P < .05.

Child maltreatment and addiction and substance use outcomes at 14 and 21 years (adjusted odds ratio ± 95% confidence interval). * P < .05.

Child maltreatment and sexual health outcomes at 21 years (adjusted odds ratio ± 95% confidence interval). * P < .05.

Child maltreatment and physical health outcomes at 21 years. A, Adjusted odds ratio ± 95% confidence interval. B, Adjusted coefficients ± 95% confidence interval. * P < .05.

The MUSP was approved by the Human Ethics Review Committee of The University of Queensland and the Mater Misericordiae Children’s Hospital. Ethical approval was obtained separately from the Human Ethics Review Committee of The University of Queensland for linking substantiated child maltreatment data to the 21-year follow-up data.

In this cohort of 7214 children ( Fig 1 ), 7.1% ( n = 511 children) experienced at least 1 episode of substantiated maltreatment. Substantiated sexual abuse was reported in 2.0% ( n = 147), physical abuse in 4.0% ( n = 287), emotional abuse in 3.7% ( n = 267), and neglect in 3.7% of cases ( n = 269) ( Table 1 ). Almost 60% of the children with substantiated maltreatment had multiple substantiated episodes (293 children; range: 2–14 episodes per child; median: 3 episodes per child 37   ). Of the 3778 young adults included in the 21-year follow-up, 4.5% ( n = 171) had a history of substantiated maltreatment, 39   including sexual abuse ( n = 53), physical abuse ( n = 60), emotional abuse ( n = 71), and neglect ( n = 89).

More than half of the children who experienced substantiated maltreatment were reported for ≥2 co-occurring maltreatment types ( Table 1 ). Of the substantiated sexual abuse cases, 57.1% of the children experienced ≥1 additional maltreatment types (84 of 147); for physical abuse, this proportion was 79.1% (227 of 287); for emotional abuse, 83.5% (223 of 267); and for neglect, 73.6% (198 of 269). In particular, emotional abuse and neglect co-occurred, with or without other types of maltreatment, in ∼59% of cases. 46  

Nonexclusive and Exclusive Categorization of Child Maltreatment Subtypes (Single and in Combination) Within the MUSP Cohort

Abuse (a combined category) and neglect were both associated with significantly lower cognitive scores at both 14 and 21 years, as well as with negative long-term educational and employment outcomes in young adulthood. 19 , 20   This was after adjusting for factors such as the child’s race, sex, birth weight, breastfeeding exposure, and age; family income; and maternal education and alcohol and/or tobacco use ( Fig 3 ). Specifically, proxy measures of IQ, such as reading ability and perceptual reasoning, at age 14 years were adversely associated with both substantiated abuse and neglect. 19   Sexual abuse was associated with attention problems in adolescence, whereas nonsexual maltreatment was associated with attention problems at both time points. 21   Young adults who experienced substantiated child maltreatment had reduced scores on the Peabody Vocabulary Test at 21 years. In terms of educational outcomes in young adulthood, both abuse and neglect manifested a threefold to fourfold increase in odds of failing to complete high school and a twofold to threefold increase in the likelihood of being unemployed at age 21 years 20   ( Figs 2 and 4 ).

During adolescence, physical abuse, emotional abuse, and neglect were all significantly associated with both internalizing and externalizing behavior problems, although this was not the case for physical abuse notifications without co-occurring emotional abuse or neglect. 22   After adjustment for relevant sociodemographic variables, the associations with emotional abuse and neglect remained significant at 21 years. 39   No statistically significant association was found between sexual abuse and these behavior problems at either time point.

Psychological maltreatment in childhood was associated with all of the other 15 psychological and mental health outcomes in young adulthood, except for delinquency in women. This was true after adjustment for sociodemographic variables and psychological and mental health problems (such as attention-deficit/hyperactivity disorder, aggressive behavior problems, and maternal depression or adverse life events, in the case of psychosis and/or IPV exposure outcomes) ( Fig 3 ). Specifically, both emotional abuse and neglect were significantly associated at 21 years with all of the following outcomes: anxiety, depression, PTSD, psychosis (with some exceptions), delinquency in men, and experiencing IPV and harassment (except for neglect). 22 – 25 , 39   Emotional abuse and neglect were the only maltreatment subtypes associated with a significant decrease in quality-of-life scores. 36  

The only mental health outcomes associated with sexual abuse were clinical depression, lifetime PTSD, and experiencing physical IPV. 8 , 25 , 39   Physical abuse was associated with externalizing behavior problems and delinquency (in men), internalizing behavior problems and depressive symptoms, experience of IPV, and PTSD 22 , 24 , 25 , 39   ( Figs 2 and 5 ).

Overall, emotional abuse and/or neglect were associated with all categories of substance use and addiction at both 14 and 21 years, whereas physical and sexual abuse were associated with surprisingly few substance abuse outcomes. Specifically, childhood emotional abuse and neglect were associated with adolescent substance use at age 14, including alcohol use and smoking. 26   This was after adjustment for sociodemographic factors and youth and maternal drug use. The association with cigarette and alcohol use persisted from adolescence to adulthood. The category of "any cigarette use" was the only addiction outcome associated with all 4 types of maltreatment. 40   At 21 years, emotional abuse and neglect were both associated with the early onset of cannabis abuse after adjustment for maternal stress and cigarette use. Additionally, physical abuse, emotional abuse, and neglect all revealed increased odds of cannabis dependence at age 21, with early onset associated with physical abuse and neglect. 28   In contrast, only emotional abuse significantly predicted injecting-drug use in young adult men, after adjustment for maternal alcohol use and depression, whereas all types of substantiated childhood maltreatment were associated with injecting-drug use in women. 27   Sexual abuse was not associated with any addiction or substance use outcome except for cigarette use at 21 years ( Figs 2 and 6 ).

All forms of maltreatment were significantly associated, at 21 years, with early onset of sexual activity and subsequent youth pregnancy. This was after adjustment for factors such as gestational age, youth psychopathology, and drug use. Neglect was the only type of maltreatment associated with having multiple sexual partners and was the maltreatment type most strongly associated with most other sexual health outcomes, especially youth pregnancy. Pregnancy miscarriage was modestly associated with emotional abuse, whereas termination of pregnancy was not associated with any maltreatment subtype 31   ( Figs 2 and 7 ).

Reduced adult height at 21 years, adjusted for parental height, was associated with all maltreatment subtypes except sexual abuse (which was not associated with any of the physical health outcomes). At 21 years, physical abuse was also associated with high dietary fat intake, a risk factor for obesity (adjusted for BMI), and poor sleep quality in men (adjusted for psychopathology and drug use). Asthma at 21 years revealed a modest association with emotional abuse. The combined category of any maltreatment was also associated with high dietary fat intake ( Figs 2 and 8 ).

To estimate the magnitude of potential effects of child maltreatment on long-term outcomes, other studies have used a number of statistical techniques. In one Australian study that used the MUSP and other data sets, the population attributable risk of child maltreatment causing anxiety disorders in men and women, was estimated to be 21% and 31%, respectively, and 16% and 23% for depressive disorders. 46   Similarly, in the MUSP study on cognitive and educational outcomes of maltreated youth, the population attributable risk of child maltreatment leading to “failure to complete high school” was 13%, and 14% for “failure to be in either education or employment at 21 years.” 20  

Based on one published metric of effect size using the magnitude of the adjusted odds ratio, 47   77% of the statistically significant associations in this review were considered to have a medium to large effect size (odds ratio ≥2), including 10% with a large effect size (odds ratio >4) ( Fig 2 ).

In summary, over the past decade, the MUSP has revealed that child maltreatment is associated with a broad array of adverse outcomes during adolescence and young adulthood, including the following:

deficits in cognitive development, attention, educational attainment, and employment;

serious mental health problems, including anxiety, depression, PTSD, and psychosis, as well as delinquency and the experience of IPV;

substance use and addiction problems;

sexual health problems; and

physical health limitations and risk.

These results were seen after adjustment for a broad range of relevant sociodemographic, perinatal, psychological, and other risk factors ( Fig 3 ). Many of the studies also adjusted for the other subtypes of child maltreatment and demonstrated that specific maltreatment types were closely associated with particular outcomes.

Significant cognitive delays and educational failure were seen for both abuse and neglect across adolescence and adulthood. In another study, the authors concluded that preexisting cognitive impairments at 3 or 5 years may explain this association, rather than maltreatment per se. 16   However, other research has revealed that children neglected over the first 4 years of life show a progressive decline in cognitive functioning, which is associated with a significantly reduced head circumference at 2 and 4 years of age. 48   In rodent models, contingent maternal behavior is linked with infant cognitive development, and possible mechanisms include increases in synaptic connections within the hippocampus 49   and reduced apoptotic cell loss. 50   Prolonged maternal separation, in contrast, is associated with impaired cognitive development in rodent and primate models. 51 , 52  

One of the most striking conclusions from this review was the broad association between emotional abuse and/or neglect and adverse outcomes in almost all areas of assessment ( Fig 2 ). In stark contrast, physical abuse and sexual abuse were associated with far fewer adverse outcomes. Overall, quality of life was lower for those who had experienced emotional abuse and neglect but not for those who had experienced physical or sexual abuse. Although emotional abuse and neglect often co-occur with other types of maltreatment, 46   the associated outcomes were generally robust even after statistical adjustment or separation into differing maltreatment categories ( Fig 2 ).

Emotional abuse and neglect in early childhood may lead to psychopathology via insecure attachment, 53 , 54   which has been associated with externalizing behavior problems 55   and impaired social competence. 56 , 57   Emotional neglect, in particular, may lead to deficits in emotion recognition and regulation, as well as insensitivity to reward, 3   potentially influencing social and emotional development. Neglected children are less able to discriminate facial expressions and emotions, 58   whereas youth who have been emotionally neglected show blunted development of the brain’s reward area, the ventral striatum. 59   Reduced reward activation may predict risk for depression, 59   addiction, 60   and other psychopathologies. 61  

Neglect was also associated with the early onset of sexual activity, multiple sexual partners, and youth pregnancy, even after adjustment for other maltreatment subtypes. This suggests that neglect may result in compensatory efforts to obtain sexual intimacy, consistent with other studies revealing higher rates of unprotected sex 62   and adolescent pregnancy in neglected children. 63   In the animal literature, female rodents that experience maternal deprivation tend to have an earlier onset of puberty and increased sexual receptivity, leading to elevated reproductive activity to help offset an environment of higher offspring risk. 64 , 65  

As observed elsewhere, 66   sexual abuse was associated with early sexual experimentation and youth pregnancy as well as symptoms of PTSD and depression. Risky sexual behaviors were independent of other types of maltreatment but were not specific for sexual abuse. An additional MUSP study comparing self-reported and agency-notified child sexual abuse revealed consistent associations with major depressive disorder, anxiety disorders, and PTSD. 8   The absence of associations with other adverse outcomes, however, may be, in part, due to the lower prevalence of substantiated sexual abuse, especially at the 21-year follow-up.

Outcomes associated with physical abuse differed from those associated with sexual abuse, with increased odds of externalizing behavior problems, and delinquency in men. Jaffee 3   suggests that physical abuse, in particular, may lead to a hypervigilance response to threat, including negative attentional bias, disproportionate to relatively mild threat cues. Studies have revealed that physically abused children show selective attention to anger cues, 67   have difficulty disengaging from them, 58 , 68   and are more likely to misinterpret facial cues as being angry or fearful. 69  

Although these studies demonstrated significant associations between maltreatment and a range of long-term outcomes, association does not equal causality. The causal mechanisms proposed above are tentative and may relate to multiple types of maltreatment.

Other limitations should also be considered. Firstly, selective attrition of socioeconomically disadvantaged and maltreated young people was evident in the MUSP cohort ( Supplemental Information ). However, based on multiple imputation calculations and inverse probability weighting of MUSP data, 18 , 70   differences in the rate of loss to follow-up, for both dependent and independent variables, made little difference to either the estimates or their precision, mirroring findings from other longitudinal studies. 71   In addition, the findings were mostly unchanged when using propensity analysis, which is used to assess the effects of nonrandom sampling variation by analyzing the probability of assignment to a particular category within an observational study given the observed covariates. 72   Specifically, the sample was weighted so that it better resembled sociodemographic characteristics at baseline to minimize bias from differential attrition in those with greater socioeconomic disadvantage.

Secondly, differences in the prevalence of specific maltreatment subtypes might have influenced the statistical power to detect true effects, particularly regarding sexual abuse ( Table 1 ).

Finally, the co-occurrence of different types of maltreatment may have impacted the ability to accurately predict the associations between specific types of maltreatment and outcomes. Other studies have revealed that emotional abuse and neglect, in particular, are more likely to co-occur with each other and with other types of maltreatment. 73   However, even in those articles that statistically adjusted for other co-occurring maltreatment subtypes, the associated outcomes linked with emotional abuse and/or neglect were generally robust. In articles that did not adjust for these co-occurrences, some of the strongest associations were still observed for emotional abuse and/or neglect.

Child maltreatment, particularly psychological maltreatment, is associated with a broad range of negative long-term health and developmental outcomes extending into adolescence and young adulthood. Although these data do not establish causality, neurodevelopmental pathways are likely influenced by stress and early social experience through epigenetic mechanisms, which may affect gene expression and regulation and, ultimately, behavior and development. 3 , 74  

Understanding the developmental roots of these adverse outcomes may motivate physicians to more systematically inquire about early-life trauma and refer patients to more appropriate treatment services. 75 , 76   Even more importantly, early intervention and prevention programs, such as prenatal and infancy nurse home visiting, 77   have demonstrated, in randomized clinical trials, diminished rates of child abuse and neglect. 78 , 79   Long-term benefits to the offspring include decreased childhood internalizing problems, 80   reduced antisocial behavior and substance abuse in adolescence, 81   and improved cognitive skills extending into young adulthood. 80 , 82   Supporting at-risk parents and young children should thus be an urgent priority.

Dr Strathearn conceptualized and designed the original study linking the Mater-University of Queensland Study of Pregnancy data set with substantiated reports of child maltreatment, drafted the special article, and reviewed and revised the manuscript; Dr Giannotti assisted in drafting the manuscript and prepared all tables and figures; Drs Mills, Kisely, and Abajobir conceptualized and wrote the original research articles summarized in this article; Dr Najman was the original principal investigator of the Mater-University of Queensland Study of Pregnancy; and all authors critically reviewed the manuscript for important intellectual content and approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

FUNDING: Partially supported by the US National Institute on Drug Abuse (R01DA026437). The content is solely the responsibility of the authors and does not necessarily represent the official views of this institute or the National Institutes of Health. Funded by the National Institutes of Health (NIH).

Composite International Diagnostic Interview

intimate partner violence

Mater-University of Queensland Study of Pregnancy

posttraumatic stress disorder

Competing Interests

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HANDBOOK OF CHILD PSYCHOLOGY SIXTH EDITION Volume Three: Social, Emotional, and Personality Development Editors-in-Chief

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