Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK.
Evidence Based Practice Unit, UCL and the Anna Freud Centre, 4-8 Rodney Street, London, N1 9JH, UK.
BMC Public Health. 2019 Nov 6;19(1):1461. doi: 10.1186/s12889-019-7789-7.
Positive mental health may support healthy development in childhood, although few studies have investigated this at a population level. We aimed to construct a measure of mental health competence (MHC), a skills-based assessment of positive mental health, using existing survey items in a representative sample of UK children, and to investigate its overlap with mental health difficulties (MHD), socio-demographic patterning, and relationships with physical health and cognitive development.
We analysed the UK Millennium Cohort Study (MCS) when children were aged 11 years. Maternal (n = 12,082) and teacher (n = 6739) reports of prosocial behaviours (PS) and learning skills (LS) were entered into latent class models to create MHC measures. Using descriptive statistics, we examined relationships between MHC and MHD, and the socio-demographic patterning of MHC. Associations between MHC and physical health and cognitive development were examined with relative risk ratios [RRR] (from multinomial models): BMI status (healthy weight, overweight, obesity); unintentional injuries since age 7 (none, 1, 2+); asthma symptoms (none, 1, 2+); and tertiles of test scores for verbal ability, spatial working memory and risk-taking. Models were adjusted for potential confounding.
Four MHC classes were identified [percentages for maternal and teacher reports, respectively]: high MHC (high PS, high LS) [37%; 39%], high-moderate MHC (high PS, moderate LS) [36%; 26%]; moderate MHC (moderate PS, moderate LS) [19%; 19%]; low MHC (moderate PS, low LS) [8%; 16%]. Higher MHC was less common in socially disadvantaged children. While MHC and MHD were associated, there was sufficient separation to indicate that MHC captures more than the absence of MHD. Compared to children with high MHC, those in other MHC classes tended to have poorer physical health and cognitive development, particularly those with low MHC or high-moderate MHC. For example, children with maternal-report Low MHC were more likely to have experienced 2+ unintentional injuries (RRR: 1.5 [1.1-2.1]) and to have lower verbal ability scores (RRR: 2.5 [1.9-3.2]). Patterns of results were similar for maternal- and teacher-report MHC.
MHC is not simply the inverse of MHD, and high MHC is associated with better physical health and cognitive development. Findings suggest that interventions to improve MHC may support healthy development, although they require replication.
积极的心理健康状况可能有助于儿童的健康成长，但很少有研究在人群层面上对此进行过调查。本研究旨在使用英国儿童代表性样本中的现有调查项目，构建一种心理健康能力（MHC）的衡量标准，即对积极心理健康状况的一种基于技能的评估，并调查其与心理健康障碍（MHD）、社会人口统计学模式以及与身体健康和认知发展的关系。
我们对英国千禧年队列研究（MCS）中的儿童在 11 岁时的数据进行了分析。母亲（n=12082）和教师（n=6739）对亲社会行为（PS）和学习技能（LS）的报告被纳入潜在类别模型，以创建 MHC 衡量标准。使用描述性统计，我们检查了 MHC 与 MHD 之间的关系，以及 MHC 的社会人口统计学模式。使用相对风险比（RRR）（来自多项模型）检查了 MHC 与身体健康和认知发展之间的关系：BMI 状况（健康体重、超重、肥胖）；7 岁后发生的意外伤害（无、1 次、2 次以上）；哮喘症状（无、1 次、2 次以上）；以及口头能力、空间工作记忆和冒险倾向测试分数的三分位数。模型调整了潜在混杂因素。
确定了四个 MHC 类别[分别为母亲和教师报告的百分比]：高 MHC（高 PS，高 LS）[37%；39%]；高-中等 MHC（高 PS，中等 LS）[36%；26%]；中等 MHC（中等 PS，中等 LS）[19%；19%]；低 MHC（中等 PS，低 LS）[8%；16%]。社会劣势儿童中，高 MHC 更为少见。虽然 MHC 和 MHD 相关，但它们之间有足够的差异，可以表明 MHC 不仅仅是没有 MHD。与具有高 MHC 的儿童相比，其他 MHC 类别的儿童的身体健康和认知发展往往较差，特别是那些具有低 MHC 或高-中等 MHC 的儿童。例如，母亲报告的低 MHC 儿童更有可能经历 2 次以上意外伤害（RRR：1.5 [1.1-2.1]），且口头能力得分较低（RRR：2.5 [1.9-3.2]）。母亲和教师报告的 MHC 结果模式相似。
MHC 不仅仅是 MHD 的反面，高 MHC 与更好的身体健康和认知发展有关。研究结果表明，改善 MHC 的干预措施可能有助于健康发展，但需要进一步验证。
