This team followed just over 400 premature infants who had abnormal brain ultrasounds taken at birth through to age 16. In the United Kingdom, psychiatrists from the University of Birmingham studied premature/low birth weight infants also looking for possible linkages to mental health disorders in adolescents.

The U.S. study group spoke with the premature infants when they reached their teen years and administered cognitive tests to determine if the brain injuries just prior to or immediately following birth could be linked to psychological disorders presented in and around puberty. Both study groups came to the conclusion that there is a definite connection. The reason for the connection has to do with an increased risk that premature babies face for injury to their brains’ white and grey matter. Injury to the white and grey brain matter affects cortical development and neural connectivity. These perinatal brain injuries appear directly linked to mental health problems in adolescence according to the Columbia Medical Center study.

We are seeing an increasing number of premature births in the United States. British psychologists conducting similar studies point out that as more premature babies survive into adulthood society can expect to see increasing cases of adolescent mental disorders related to premature birth brain injuries. Disorders like obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), tic disorders and major depression appear to be more likely for those who were born prematurely and experienced a non-disabling brain injury.

British research states that psychological disorders such as depression, anxiety and psychosis evidence during the teen years in the general population but their research indicates that the earlier a child is born, the more likely it is that they will suffer from anxiety and mood disorders. The British psychologists caution that there could be other factors but add that it seems likely that trauma experienced in early life (pre-term birth) could significantly affect the way in which a brain responds to stress.

The research is important not only because of the rise in premature births. Heightened awareness of the correlation between brain injuries to premature babies and psychological disorders later in life will hopefully lead to earlier detection and intervention. Pediatricians, psychologists and neurologists now hold information relevant to the causes of mental health disorders. It is to be hoped that future research teams might investigate possible connections between perinatal brain injuries and psychological disorders which tend to present in adulthood such as schizophrenia.

Industry statistics suggest that 80 percent of adult smokers got their start in their teen years. And, while 400,000 deaths occur from smoking each year, teens still light up. On the other hand, those teens who choose not to indulge are more likely to never start smoking.

Studies have found that there is a link between cigarette smoking and deficits in attention and memory in adults. Researchers from UCLA sought to compare brain function in adolescent smokers and non-smokers. Their main focus was on the prefrontal cortex, or the area of the brain that is responsible for guiding those executive functions that include decision-making. In teens, this part of the brain is still developing, both functionally and structurally.

This research team discovered that the greater the addiction the teen had to nicotine, the less active their prefrontal cortex. This finding suggests that smoking can affect brain function for teens, as well as adults.

The tests determined that the more a teen smoked, the lower the levels of activity in the prefrontal cortex. Even with this lower activity, however, the non-smoking and the smoking groups both performed similarly on the Stop-Signal Task. At the same time, teen smokers demonstrated a more difficult time making rational decisions regarding their well-being.

A Science Daily release examined the findings of a new national study that has confirmed the affects disasters can have on children. According to this research, children who are exposed to disasters – fires, earthquakes, flooding – are more likely to experience emotional problems. Even worse, some children may have already been experiencing abuse, peer violence or maltreatment that could exacerbate such issues.

This study found that children who had already been victims of abuse or violence before the disaster struck were more likely to experience more anxiety, depression and aggression than children who only suffered as a result of the disaster. An interesting twist on such scenarios is that when a disaster happens, there are increased opportunities for community organizations and first-responders to interact with these children who may never have had access to help.

The study was completed by a research team at the University of New Hampshire and included an evaluation of data from a sample of 2,030 children. The data included phone interviews with children and parents. Of those children interviewed, 4.1 percent had experienced a disaster in the past year and 13.9 percent had been exposed to a variety of disasters over a lifetime.

The sample produced 70 children who had experienced victimization in the past year, yet only two of those children received counseling for problems related to emotional and behavioral issues. Without proper treatment, these children may seek their own treatment through drugs and alcohol.
 

A recent Science Daily release examined a research abstract that suggests excessive daytime sleepiness presents a higher risk for depression among high school seniors. Results from this research suggest that high school seniors are three times more likely to experience strong symptoms of depression if they also have excessive daytime sleepiness.

Of the 136 study participants, 52 percent experienced excessive daytime sleepiness and 30 percent had strong symptoms of depression. Another 32 percent had some symptoms of depression. These findings suggest treatment needs to focus on depression among these students, as well as potential sleep disorders.

Sleep deprivation was another common factor among high school seniors. In fact, students in the study reported a mean total school night sleep of 6.1 hours. On the weekend that mean increased to 8.2 hours. Such times are considered too low as the American Academy of Sleep Medicine suggests that these students need a little more than nine hours every night to be sufficiently alert during the day.

Studying this impact at the high school level is important. One lead researcher noted that a number of students are performing at sub-optimal levels as far as academic performance is concerned. Depression and sleep deprivation can also affect concentration and memory. Sleep problems and depression could be carrying over past high school, contributing to the decline of U.S. competitiveness in the global market.

What is Violent Behavior?

Violent behavior covers a wide range of activities. These include verbal or physical bullying, extreme temper tantrums, and fights on the playground, cruelty to animals, vandalism, starting fires, verbal abuse, and self-mutilation.

Complex Risk Factors for Teen Violence

Numerous studies have shown interplay of risk factors that, while they cannot be considered causes of violent behavior in adolescents (boys and girls), they can be considered predictive of potential violent behavior. Reports from the U.S. Surgeon General, the American Academy of Child and Adolescent Psychiatry ), and others, mention factors including:

• Previous aggressive or violent behavior
• Being the victim of physical and/or sexual abuse
• Exposure to violence in the home and/or community
• Family heredity or genetic factors
• Exposure to violence in the media (TV, magazines, movies, Internet)
• Use of alcohol and/or drugs
• Firearms present in the home
• Combination of stressful family socioeconomic factors (single parenting, unemployment, marital breakup, loss of support from extended family, poverty, severe deprivation)
• Brain damage from head injury

A report from the U.S. Surgeon General, “Risk Factors for Youth Violence” (http://www.surgeongeneral.gov/library/youthviolence/chapter4/sec1.html), iterates early onset and late onset risk factors for violent behavior and groups them according to individual, family, school, peer group and community. Late onset (age 12 to 14) individual risk factors include psychological conditions such as restlessness, difficulty concentrating and risk-taking; aggression; physical violence; antisocial attitudes and beliefs; crimes against persons; antisocial behavior; low IQ, and substance use.

Late onset family risk factors include poor parent-child relations (harsh, lax discipline, poor monitoring or supervision); low parental involvement; antisocial parents; broken home; low socioeconomic status/poverty; abusive parents, and family conflict.

Late onset school risk factors include poor attitude, performance and academic failure.

Late onset peer group risk factors include weak social ties, antisocial and delinquent peers, and gang membership.

Late onset community risk factors include neighborhood crime, drugs, and disorganization.

The report shows that risk factors tend to appear in clusters, not in isolation. The greater the number of risk factors that a child is exposed to, the greater the likelihood that he or she will become violent. One study (Herrenkohl et al., 2000) showed that a 10-year old exposed to 6 or more risk factors is 10 times as likely to be violent by age 18 as a 10-year old exposed to only one risk factor.

SAMHSA Report Reveals Surprising Facts

A newly-released report, “Violent Behaviors Among Adolescent Females,” from the National Survey on Drug Use and Health (NSDUH), Substance Abuse and Mental Health Services Administration (SAMHSA), reveals some surprising facts about violent behavior in teen girls.

Public perception has long associated teen violence with males. Some of this has to do with societal expectations that teenage males are more aggressive. It has become clear, however, that the problem of violence is pervasive among teenage girls as well. The NSDUH survey group included responses from 33,091 girls aged 12 to 17. The report shows that, among girls in this age group:

• 2.3 million (18.6 percent) got in a serious fight at school or work within the last year
• 1.7 million (14.1 percent) participated in a group-against-group fight
• 700,000 (5.7 percent) attacked others with an intent to seriously hurt them

In addition, the report showed that more than one-quarter (26.7 percent) of girls in this age group engaged in one of these three types of violent behavior within the past year (based on averages for 2006 through 2008).

The report cautions that, despite recent intense media attention to high-profile teen girl violence, the rates of these violent behaviors among adolescent females has remained stable – when comparing combined data from the years 2002 to 2004 with that from 2006 to 2008. Furthermore, participation in group-against-group fighting was lower in the combined 2006 to 2008 data than the combined 2004 to 2006 data.

Comparing this to violent behavior among male teens, combined 2006 to 2008 data show that 25.4 percent got into a serious fight at school or work in the past year, 17.0 percent participated in a group-against-group fight, and 9.3 percent attacked others with the intent to seriously hurt them. A total of 33.6 percent of adolescent males engages in at least one of these violent behaviors in the past year.

Demographic Characteristics of Female Teen Violent Behavior

The NSDUH report shows differences in violent female teen behavior rates according to demographic characteristics. Teen girls aged 14 or 15 were more likely to have engaged in past-year violent behavior (28.9 percent), than teen girls aged 12 or 13 (27.1 percent), and those aged 16 or 17 (24.4 percent). Blacks or African Americans (38.0 percent) were more likely than any other racial/ethnic group – two or more races (30.2 percent), Hispanic (29.0 percent), American Indian or Alaska Native (26.8 percent), white (23.7 percent), or Asian (17.3 percent).

Interestingly, there were no statistically significant differences in girls’ rates of violent behavior across different regions of the country, or between large metropolitan areas, small metropolitan areas, and non-metropolitan areas.

Key Prevalence Factors

The NSDUH findings indicates that the percentages of girls engaging in violent behavior varied by substance use, family income, and school-related characteristics.

• Family Income – Prevalence of past-year violent acts decreased as family income levels increased. Violent behaviors were reported in:

o 36.5 percent of female adolescents who lived in homes with an annual family income level of less than $20,000
o 30.5 percent of those families with annual incomes of $20,000 to $49,999
o 22.8 percent in families whose annual income was $50,000 to $74,999
o 20.7 percent in families with an annual income of $75,000 or more

• Substance Use – Among adolescent females who engaged in any type of violent behavior within the past year, they were more likely than not to indicate past-month:

o Binge alcohol use – 15.1 percent vs. 6.9 percent (Binge alcohol use is defined as having 5 or more drinks on the same occasion, on at least one day in the past 30 days)
o Marijuana use – 11.4 percent vs. 4.1 percent
o Illicit drug use other than marijuana – 9.2 percent vs. 3.2 percent (Includes cocaine and crack cocaine, inhalants, hallucinogens, heroin, or prescription-type drugs used nonmedically)
o The rate of substance use was also higher the more types of violent behaviors the girls engaged in. For example, past-month binge drinking was reported by 6.9 percent of the girls with none of the violent behaviors, 12.6 percent of girls with one type of violent behavior, 17.3 percent with two types, and 27.2 percent of those girls with three types of violent behavior.

• School Attendance – Teen girls who were not currently enrolled or attending school were more likely than those who were in school (34.3 percent vs. 26.7 percent) to engage in one of these types of violent behavior in the past year.

• School Grades – Among the group of teen girls who were in school, rates of violence increased as grades and academic performance decreased. About one-sixth of girls who reported having an “A” average (16.0 percent) engaged in violent behavior in the past year. In comparison, 26.0 percent of those with a “B” average, 38.5 percent of those with a “C” average, and 52.6 percent of those with a “D” average or lower engaged in a past-year violent behavior.
University of Cambridge Research Study Results

Research conducted by the University of Cambridge* shows that teenage girls may be “protected” from displaying or showing antisocial behavior until their teenage years. This study sheds new light on antisocial behavior in girls compared with boys. The research data suggests that, rather than violence and antisocial behavior being the result of poor choices, the brains of people with antisocial behavior may work differently than those who do not present antisocial behavior.

Researchers noted that virtually no studies have been conducted on girls’ antisocial behavior (Conduct Disorder). As a result, little is known about the neuropsychology of girls’ severe antisocial behavior. In the United Kingdom, researchers said, serious violence among female adolescents is sharply increasing (although it is less common than in adolescent males).
The research study group consisted of two groups: 25 girls aged 14 to 18 who had high levels of antisocial and/or violent behavior, and a control group of 30 healthy girls. The study measured the girls’ ability to distinguish and recognize the six primary facial expressions: anger, disgust, fear, happiness, sadness, and surprise. Researchers found that girls with antisocial and/or violent behavior made numerous errors when attempting to identify anger and disgust, but had no difficulty recognizing the other expressions.

Researchers interpreted the findings to suggest that the brains of girls with antisocial behavior work differently than those who do not show antisocial behavior. On some level, they may find it harder to read emotions of others – such as realizing that someone is angry with them and to learn from punishment.

Of particular interest is the fact that, while girls and boys with antisocial behavior had similar difficulties in recognizing the emotions, the girls – whose antisocial behavior began in adolescence – more closely resembled boys whose antisocial behavior began in childhood. The conclusions researchers drew from this is that girls are somehow protected from showing their antisocial behavior until their teenage years, but for reasons researchers do not yet understand. The next phase of the study will utilize brain scans. It is expected that this will be the first functional neuroimaging study ever conducted in girls with severe antisocial behavior.

Among the facts cited in the study is that about 5 percent of youth could be diagnosed with conduct disorder – although it is about 3 to 4 times more common in boys than girls. Factors ranging from childhood physical abuse to Attention-Deficit Hyperactivity Disorder (ADHD) make it more likely that youth will develop Conduct Disorder.

Antisocial/violent behavior is difficult to treat using psychological therapy, and there are currently no drug treatments that are effective. In the U.K., a new type of therapy called Multi-Systemic Therapy is in clinical trials as a potential – and promising – treatment for antisocial behavior.

What Can Be Done About Violent Behavior in Teen Girls?

Since one in four adolescent girls has either perpetrated or participated in a violent act in the last year, the problem of violent behavior among teen girls isn’t going away anytime soon. Just as with their male counterparts, there are many correlates for young girls. These include alcohol and drug use, impoverished family background, poor school performance, and other factors not captured in the NSDUH survey data.

How can these girls be treated? Will prevention measures have any effect if multiple factors already exist within the girls’ family units? Treatment experts recommend that a thorough assessment of all adolescents include the issues of substance use, family background, school performance and other factors, in order that an appropriate mix of therapeutic interventions can be used to address the intersection of substance use and abuse with acts of violence.

Any type of treatment for violent behavior in girls is not likely to be brief in duration. Since it takes years for behavioral patterns to be established, changing attitudes and establishing new patterns of behavior takes time.

SAMHSA officials say that a better job needs to be done to reach at-risk girls and teach them how to resolve their problems without resorting to violence. Prevention efforts should also include limiting adolescents’ exposure to violent video games and television content, in addition to violence available on the Internet. One way to minimize such video game and Internet activity is to move the computer and gaming equipment out of the child’s bedroom and into a more open, family environment where parental supervision is available.

Bottom line: Violent behavior in teen girls may have slightly different origins than that for teen boys, or occur later than in their male counterparts, and girls are catching up to boys in prevalence of violent behavior. Researchers are only now beginning to delve into the neuropsychology of violent behavior in girls to try to better understand these differences. This is particularly important for developing effective means of treatment. For now, intervention, thorough assessment, and a multi-disciplinary approach to treatment appears to be the best therapeutic measures. Preventive measures can be taken by parents, family members, school officials and organizations in the community to help reduce teen girls’ violent behavior before it gets out of hand.

*University of Cambridge (2010 May 13). Violent teenage girls fail to spot anger or disgust in others’ faces. Science Daily. Retrieved May 21, 2010, from (http://www.sciencedaily.com/releases/2010/05/100510150223.htm)

A recent news post highlighted the launch of the KidsMatter early childhood program at Monmia Primary School. The focus of this new program was a shock to Jeff Kennet, chairman of the depression awareness group Beyondblue.

“I can’t express the shock I got when at a board meeting of Beyondblue … our officers said ‘we’re now going to start doing some science among children aged one to seven years of age’,” Mr. Kennett said, in the Australian News. The chairman now admits the program will result in internationally groundbreaking work.

The $18.7 million in federal funding was announced by Federal Health Minister Nicola Roxon. She referred to this program as the government’s efforts to look at the health system at the start instead of at the end.

“What we can do earlier in the system so that instead of picking up the pieces when things get really bad, we’re giving young children and others the tools to manage their lives into the future,” said Roxon.

The KidsMatter program will put mental health in the weekly school curriculum, train teachers and inform parents on how to help children learn to deal with setbacks, talk about them with their children and develop resilience in order to keep depression at bay.

According to Roxon, the program will not focus any of its efforts on screening children for depression or to determine the number of children involved in the program who might have depression-type problems.

If successful, this program could lay the groundwork for similar programs throughout the world.

Research funded in part by the National Institute of Mental Health (NIMH), part of the National Institutes of Health, suggests that Black American teens, especially females, could be at a higher risk for attempting suicide, even if they have never been diagnosed with a mental disorder.

The findings of this research were based on responses from adolescent participants in the National Survey of American Life (NSAL). This survey captured national estimates on suicidal thoughts and behaviors as well as suicide attempts in 13- to 17-year old Black youth in the United States.

As suicide is the third leading cause of death in all teens in the United States, it is important to examine the factors that lead to suicide in an effort to create and execute effective prevention programs. Throughout historical research into the topic, Black teens and young adults have had lower suicide rates than White teens. In recent decades, however, youth suicide rates in Blacks has increased significantly.

Sean Joe, Ph.D., LMSW, University of Michigan, and colleagues evaluated NSAL-A teens’ responses to questions about suicidal thoughts and intentions, as well as nonfatal suicide attempts. Researchers estimate such attempts may take place as much as 10-40 times more often than completed suicides.

Study findings reveal that in a given year, Black teen girls are most likely to attempt suicide. Next in line are Caribbean teen girls, Black teen boys and then Caribbean teen boys. Caribbean females however, reported the highest rates in suicidal thoughts. Caribbean males reported the lowest rates in thoughts and attempts.

Researchers also found that youth from lower income households – or those in the $18,000-$31,999 annually – were the least likely to report attempting suicide. The most likely attempts were among those teens living in homes with modest means – or incomes of $32,000-$54,999.

Links between suicide attempts and mental disorders were identified in study participants. Teens with anxiety disorders appeared to have the highest risk. At the same time, roughly half of those teens who had attempted suicide had never been diagnosed with a mental disorder.

Based on the information gathered in this study, researchers estimate that at some point before reaching the age of 17 years of age, 4 percent of Black teens and more than seven percent of Black teen females will attempt suicide.
 

“Psychological distress does not appear to be caused by teen childbearing, nor does it cause teen childbearing, except apparently among girls from poor households,” said Stefanie Mollborn, Ph.D., an assistant professor of sociology at the Institute of Behavioral Science of the University of Colorado at Boulder, in Science Daily.

The study relied on data from two large long-term U.S. surveys which followed thousands of teen girls and women. Participants responded to such items as how often they found things that did not usually bother them to be bothersome, how easily they could shake off feeling blue or whether they had trouble concentrating.

Within the study, only the combination of poverty and existing distress was a good predictor of teen pregnancy. Within previous studies, researchers found high levels of depression among teen mothers. Nationally however, representative studies had not examined if distress was present before the pregnancy and stresses of young motherhood.

“Psychologically distressed girls are at risk for teen childbearing and vice versa, even if the two things usually do not cause each other,” Mollborn said. “This could help educators and clinicians identify at-risk adolescents.”

Diane Merritt, M.D., director of Pediatric and Adolescent Gynecology at the Washington University School of Medicine in St. Louis, noted looking for symptoms of depression or distress should be part of normal health screening for all teenagers. “Talking to teenagers about their sexuality and responsible behavior is key,” she said.

Mollborn highlighted that high levels of depression have long-term negative consequences for both mothers and children. Higher levels of psychological distress in women who had teenage pregnancies continued well into adulthood.
 

Data collected on youth mental health service utilization from the 2005 and 2006 National Surveys on Drug Use and Health (NSDUH) was presented in a recent NSDUH report. In this report, the organization shared that an annual average of 3.3 million youths aged 12 to 17 – or 13.3 percent – received services for emotional or behavioral problems in a specialty mental health setting in the past year.

The report also revealed roughly 3.0 million youths – or 12.0 percent – received services for emotional or behavioral problems in a school-based setting. Another 752,000 – or 3.0 percent – received these services in a general medical setting. Of all adolescents, females were more likely to receive services for emotional or behavioral problems in a specialty mental health or educational setting than males.

For those youths who received specialty mental health services for emotional or behavioral problems in the 12 months prior to the completion of the survey, 11.9 percent received outpatient mental health services. Private therapists, psychologists, social workers and counselors provided mental health help to 9.9 of youths.

Another 2.7 percent of persons within the adolescent age group received inpatient mental health services. Staying overnight or longer in the hospital was the most commonly used inpatient service for emotional or behavioral problems among 2.1 percent.

Those youth receiving services in a school-based setting numbered 3.0 million, with 9.9 percent receiving mental health services from a school counselor, school psychologist or through regular meetings with a teacher. Another 3.9 percent received special educational services as a result of emotional or behavioral problems while in a regular classroom or when placed in a special classroom or school. Those students receiving services from a pediatrician or other family doctors ranked at 3.0 percent.

Age of the adolescents participating in the survey also played a role in the receipt of mental health services. Those youths aged 14 or 15 were more likely to receive specialty mental health services than youths aged 12 or 13.

At the same time, services delivered in an education setting were more common among 12 to 15 year olds than among 16 or 17 year olds. There was no change in the percentage of youths who received services for emotional or behavioral problems in a general medical setting.

While females were more likely than males to receive specialty mental health services and school-based services for emotional or behavioral problems in the past year, there was no difference between make and female youths in the use of general medical services for such problems.
 

In this study, 2,057 mothers answered questionnaires annually that concerned sleep duration and hyperactivity of their children. This data was collected on the children from birth to five years of age.

A research team from the Université de Montréal, its affiliated Hôpital du Sacré-Cœur de Montréal and Sainte Justine University Hospital Research Center, as well as the Université Laval and the French National Institute for Health and Medical Research (INSERM), analyzed the data.

“Hyperactivity problems may interfere with night-time sleep," said senior author Jacques Montplaisir, a professor in the Université de Montréal Department of Psychiatry and director of the Sleep Disorders Center at Hôpital du Sacré-Cœur de Montréal, in Science Daily. "We found that children who didn’t sleep long were generally hyperactive boys who lived under adverse family conditions."

According to this research team, boys – more than girls – with mothers of a low education, insufficient family income and who were comforted outside the bed or got into bed with mom after awakening at night were considered to be at more risk of having both short sleep duration and high hyperactivity.

"Short or fragmented sleep leads to sleepiness, which could manifest as hyperactivity in boys," explained Dr. Montplaisir. "However, the risk of abbreviated sleep in highly hyperactive children is stronger than the risk of hyperactivity among kids with short sleep duration."