ISSN (Print): 2210-6766
ISSN (Online): 2210-6774
Volume 10, 4 Issues, 2020
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ISSN (Print): 2210-6766
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The prevalence of mental health issues among adolescents, along with the need to build capacity, underscores
the reality that adolescent mental health is a key burden of disease issue for the 21st century.
This issue of Adolescent Psychiatry presents an overview of the status of adolescent mental health promotion
from an international context including considerations for low- and middle-income countries (LMICs)
as well as high-income countries (HICs).
The articles in this special issue present examples of current mental health promotion for adolescents
across nations. They consider strategies to address unmet needs and build capacity with regard to global
adolescent mental health. A range of methods are presented to address global considerations in adolescent
mental health. These include empirical studies, literature reviews, regional case studies, and intervention
models. We highlight the role of stigma and a lack of structured systems to support child and adolescent
mental health (CAMH).
Seven articles make up this special issue (including this introduction). After this first editorial article,
building mental health literacy (MHL) is presented as one strategy to build capacity and address gaps in
mental health services for adolescents (Article 2); then, the status of adolescent mental health services
from a Latin American context are presented (Article 3). From there, a research article presents results of
an intervention study with adolescents from an under-resourced community in Northern England (Article
4); and a theory of change regarding the important role of family/school partnerships on proximal and distal
outcomes is considered in Article 5. The next article uses an intercept recruitment strategy to examine
the experience of bias-motivated victimization among adolescents (Article 6); and the important role of
training professionals in adolescent prevention science is reviewed in the final article (Article 7).
These articles underscore the critically important theme of adolescent mental health promotion, and advantages
of global collaboration in advancing this agenda.
OVERVIEW OF THE ISSUE
Following this introductory article, the second article in this special issue presents an overview of the
status of adolescent mental health from a global perspective. The article, Mental health literacy: A strategy
for global adolescent mental health promotion, discusses the prevalence of adolescent mental health
issues and gaps in service capacity. The experiences of low- and middle-income countries (LMICs) as
well as high-income countries (HICs) are presented. The role of stigma in service delivery, access, and
utilization for adolescents is considered. Mental health literacy (MHL) is presented as a strategic way to
build mental health capacity for adolescents.
The third article in this special issue considers adolescent mental health within a Latin American context.
The article, Community psychiatry in a Latin American context: Perú as a case example, focuses on
the status of community psychiatry in Latin America as it relates to child and adolescent mental health
services (CAMHS). Recent developments in community health centers in Perú are presented. Authors discuss
the importance of community mental health center policies and programs to support the well-being of
Latin American adolescents.
The fourth article in this special issue considers the efficacy of a pilot intervention study conducted
with youth in an economically challenged community in Northern England. The article, Exploration of
psychological well-being, resilience, ethnic identity, and meaningful events among a group of youth in
Northern England: An autobiographical narrative intervention pilot study, examines the use of an autobiographical narrative approach within the context of community-based participatory research (CBPR).
Results of an 8-week autobiographical intervention suggest that the intervention may promote positive
mental health outcomes among adolescents with limited economic resources.
The fifth article in this special issue considers building adolescent mental health capacity through partnerships
between families and educational institutions. The article, Moving towards meaningful and significant
family partnerships in education, begins with a description of developmental transitions from
childhood to adolescence. It then talks about how family/school relationships may vary depending upon
developmental stage. The important role of family/school partnerships is discussed. Best practices for facilitating
school/home connections are presented.
The 6th article, Bias-motivated victimization of immigrant students in schools: Incidence, impact, and
intervention, explores whether immigrant-origin students report greater bias-motivated victimization in
comparison to their non-immigrant origin peers. The study found that approximately 60% of youth in the
entire sample experienced bias-victimization in their lifetime. This rate was basically consistent across
immigrant-origin and nonimmigrant-origin participants. Among participants who reported a minimum of
one lifetime event of bias-victimization, immigrant-origin youth reported a greater likelihood of experiencing
victimization related to their peers’ perceptions of their country of origin or immigrant status, in
comparison to nonimmigrant-origin youth participants.
The final article in this special issue, Preventing child and adolescent mental illness – We got this, presents
international prevalence data for child and adolescent mental health issues. The article discusses how
mental health and substance abuse remain the two main contributors to the global burden of disease and
connects this reality to the adolescent experience. Prevention practices in the psychiatry field are presented.
Such practices differentiate between health promotion/disease prevention and standard mental
health care. The article presents various interventions that are used in different countries to illustrate preventive
mental health interventions for adolescents from diverse country contexts.
Research targeted to reflect the adolescent experience, evidence-based interventions that address adolescent
mental health, and MHL efforts that address community needs can inform policy makers from diverse
LMIC and HIC nations about specific areas to be addressed under the general umbrella of adolescent
mental health. Such specificity, within the context of a cross-sectoral approach, is thought to be the impetus
necessary to promote momentum that is connected to tailored, community-based interventions. This
special issue of Adolescent Psychiatry seeks to address these gaps in the literature.
We are delighted to be Guest Editors for this special issue of Adolescent Psychiatry on Trauma and
Adolescents. During the past thirty years, there has been an increased public awareness of the scope and
serious impact of traumatic stress on the safety and healthy development of children and youth. The articles
assembled represent a range of clinical and research advances from an international group of distinguished
authors. The goals of this publication are to provide the readers an update on developmental psychopathology,
trauma treatment and interventions, and new developments as related to adolescent trauma.
The journal begins with an article on “Complex Trauma and Developmental Trauma Disorder in
Adolescence,” in which Julian Ford describes the phenomena of complex trauma which involves ongoing
or multiple exposures to severe adverse childhood experiences, typically of an interpersonal nature, during
critical periods in individual development. The roadmap Ford provides is likely to advance clinical evaluation
and research with seriously traumatized youth.
We continue to wonder about the impact of early adverse experiences on the lives of our patients with
eating disorders. As a result, we explore the relationship between abuse and eating disorders and discuss
implications for clinical care in our paper, “Eating Disorders and Abuse.”
The article with a focus on resilience by Betty Pfefferbaum, Richard Van Horn and Rose Pfefferbaum
is entitled “Involving Adolescents in Building Community Resilience for Disasters.” They describe working
with established systems of care including the health, mental health, education, law enforcement, child
welfare, juvenile justice, and military family service systems to ensure that there is a comprehensive
trauma informed continuum of accessible care.
The next article is on “The Interplay of Trauma and Bereavement in Adolescence: Pioneering Work
and Recent Advancement,” by Christopher Layne and colleagues. There is greater awareness that trauma
which occurs together with loss and bereavement is very different than trauma alone. The authors describe
therapeutic strategies that address trauma co-occurring with death of loved ones.
In “Academic Achievement in Young Adults with a History of Adolescent Physical Abuse” David Pelcovitz
and colleagues present a follow-up study ten to fourteen years after initial assessment. They document
the lasting effects that physical abuse during adolescence has on educational attainments and occupational
From Quebec, Canada and London, England, Karen Ensink and colleagues report on research with a
community-based sample of adolescents and young adults, using a psychodynamic lens to examine impact
of childhood trauma. In “Pathological Narcissism in Adolescents: Relationships with Childhood Maltreatment
and Internalizing and Externalizing Difficulties” they discuss experiences of childhood maltreatment
in relation to psychosocial difficulties and the negative influence it has on narcissism.
In “A three-tiered Model of School-Based Trauma Services to Address Long-term Impact of a Major
Natural Disaster,” Peter D’Amico and colleagues describe a multi-faceted program to address impact of
community-wide trauma on adolescents. They report on creating trauma-informed, developmentally and
culturally sensitive clinical interventions that included a broad range of effective services, resulting in improved
standard of care in two-highly impacted communities following Super Storm Sandy.
Finally, we end the volume with Michaël Bégin and colleagues who provide a report on their research
on “A Person Centered Approach to understanding the Impact of Childhood Maltreatment.” The authors
explain findings regarding the relationship between the type of abuse experienced during childhood and
the subsequent forms of serious psychopathology.
Several of the papers in this issue involve work by individuals associated with the National Child
Traumatic Stress Network (NCTSN). Established in 2001, NCTSN has ensured that widely shared knowledge
and skills have become a sustainable national resource. NCTSN continues to foster a professional
interdisciplinary community dedicated to improving the lives of traumatized youth.
Note. Finally, we would like to dedicate this issue to the late Sandra Kaplan, MD who devoted her
clinical and academic career to the care of survivors of childhood maltreatment and their families. Dr.
Kaplan headed one of the original NCTSN treatment development programs (focused on the needs of
traumatized adolescents), was a co-investigator with Dr. Pelcovitz in the work he reports here, and influenced
the work of multiple contributors to this volume.