School of Psychological Sciences, College of Engineering, Science and Environment, The University of Newcastle, Callaghan, NSW 2308, Australia.
Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW 2308, Australia.
Int J Environ Res Public Health. 2021 Jul 8;18(14):7315. doi: 10.3390/ijerph18147315.
Internationally, the mental health of children and adolescents is undoubtedly an important construct of theoretical, clinical, and policy level concern. Worldwide, five mental disorders (depression, alcohol misuse, bipolar affective disorder, schizophrenia, and obsessive-compulsive disorder) represent half of the 10 leading causes of disability and premature death; with mental disorders accounting for 15-30% of disability adjusted life years in the first three decades of life. This provides a solid rational founded in implications for population health as to why reducing and preventing mental health problems in children and adolescents deserves attention. Past research has indicated interventions focussed on building resilience through strengthening protective factors may offer the potential to address mental health problems in children and adolescents, and in particular aid in reducing such problems during times of increased risk or adversity. With childhood and adolescence being critical periods of development, there is a need to reflect on the strengths and limitations of resilience-focussed interventions and anticipated future needs of the world's youth. This conceptual analysis identifies a number of future research directions that may meaningfully add to the evidence base and improve implementation, evaluation, and impact of resilience-focussed interventions. These largely relate to refining the understanding of how resilience protective factors relate to mental health problems in children and adolescents. Important issues and potential opportunities to improve the related research field include improved reporting of intervention content; improved measurement of resilience protective factors in intervention trials; continued reporting and review of evidence of association between protective factors and mental health outcomes; and incorporation of mediation analysis within intervention trials. There is a need for further intervention studies in this space to be conducted as rigorous trials of resilience-focussed approaches based on such evidence of association, with clearly posited mechanisms of change, and inclusive of analysis of differential intervention effects. The suggested implications for research made in this conceptual analysis will aid in improving the quality of the evidence base relevant to the fostering of resilience and prevention of mental health problems in children and adolescents.
国际上，儿童和青少年的心理健康无疑是理论、临床和政策层面关注的一个重要结构。在全球范围内，五种精神障碍（抑郁症、酒精滥用、双相情感障碍、精神分裂症和强迫症）占全球十大致残和早逝原因的一半；精神障碍占生命最初三十年伤残调整生命年的 15-30%。这为为什么减少和预防儿童和青少年的心理健康问题值得关注提供了坚实的理由，因为这对人口健康有重要影响。过去的研究表明，通过加强保护因素来培养韧性的干预措施可能有潜力解决儿童和青少年的心理健康问题，特别是在风险或逆境增加时，有助于减少这些问题。由于儿童期和青春期是发展的关键时期，因此需要反思以韧性为重点的干预措施的优势和局限性以及世界青年未来的预期需求。这种概念分析确定了一些未来的研究方向，这些方向可能会为证据基础做出有意义的贡献，并改善以韧性为重点的干预措施的实施、评估和影响。这些主要涉及完善韧性保护因素与儿童和青少年心理健康问题之间关系的理解。提高相关研究领域的重要问题和潜在机会包括：改进干预内容的报告；改善干预试验中对韧性保护因素的测量；继续报告和审查保护因素与心理健康结果之间的关联证据；并在干预试验中纳入中介分析。需要在这一领域进行更多的干预研究，作为基于这种关联证据的以韧性为重点的方法的严格试验，明确提出变化的机制，并包括对干预效果差异的分析。本概念分析中提出的对研究的影响将有助于提高与促进儿童和青少年的韧性和预防心理健康问题相关的证据基础的质量。
