_edited.jpg)
Understanding the Exposome
The Role of Mediator
A mediator is a factor that plays a role between the cause (e.g. social support) and effect (e.g. children’s wellbeing) .
It is an intervening factor, which stands on the causal path between the exposure and the outcome in such a way that it “is caused by” the exposure and in turn “causes” the outcome (VanderWeele 2016). This means that the exposure, mediator, and outcome happen in that specific order over time. The mediator should appear after the exposure but before the outcome (Tate 2015).
The project tested key hypotheses about how sleep, stress/restoration, and self-regulation/coping may influence the link between environmental exposures and mental health and cognitive development.
Why is sleep important?
Sleep is crucial for our body and mind. While we don't fully understand all the details, we know it helps us recover and to be alert during the day. Sleep changes as we grow older, with young children needing the most sleep. Teenagers need enough sleep for their brains and bodies to develop properly.
How can we measure sleep?
We can look at sleep in different ways: how much we sleep, the pattern of our sleep, and how well we sleep. We can measure sleep through surveys, diaries, or more technical methods like polysomnography and actigraphy. Polysomnography records brain activity, eye movements, and muscle activity to indicate the level of sleep, while actigraphy uses movement to estimate sleep.
Sleep quantity and pattern include things like how long it takes to fall asleep, how long we sleep, and how often we wake up. Sleep quality is about how well we sleep and how it affects us during the day. Not getting enough good sleep can lead to problems at school and impact our mood and emotions.
Sleep
What is sleep?
Sleep is a state characterized by diminished mental and physical activity, accompanied by an altered state of consciousness, and a reduction in sensory responsiveness. It involves significantly decreased muscle activity and limited engagement with the surrounding environment.
What are stress and restoration?
Stress and restoration are crucial factors that influence cognitive development and mental health in children.
Stress is a response to perceived internal and external demands that challenge an organism's balance. These demands are also called ‘stressors’. Examples are pollutants, social relations, economic and ecological stressors, critical life events, worries, and occupational stressors (e.g. noise at work or time pressure). The response to these stressors often exceeds adaptive capacities, especially in unpredictable and uncontrollable situations. Responses to stressors can be physiological, like releasing stress-related hormones like cortisol as a reaction to a stressful situation. Chronic stress, resulting from prolonged exposure to demanding situations perceived as harmful, is closely tied to mental well-being and mental illnesses like depression. Stressors are all demanding external and internal challenges.
Restoration is the process of renewing, recovering and the ability to adapt after it has been strained by challenges. It can involve actual recovery or the feeling of being calm and rested.
Stress and Restoration
Why are stress and restoration important?
Stress is functional as it enables us to cope with dangerous, threatening or challenging situations. Chronic stress is closely related to mental (un)well-being and, in the long run, is associated with mental illness such as depression. In consequence, this may mean higher vulnerability or sensitivity to (future) acute demands. There is robust evidence that children exposed to chronic stressors are more likely to develop health problems or diseases, including mental health problems, making it relevant in the scope of the Equal-Life project.
Restoration is important because it involves interactions between a person and their environment, enabling recovery from stress and improving overall well-being. This process is not automatic or guaranteed by simply being in a particular setting; rather, it depends on the environment’s ability to allow for and promote restorative experiences. Restorative environments support behaviours (like outdoor activities, social interactions, and hobbies) and cognitive practices (such as mindfulness) that enhance adaptation and stress coping. For example, environments that reduce stressors (like noise) or encourage relaxed interactions help individuals feel more at ease and empowered, further contributing to their mental and emotional resilience.
How can we measure stress?
Assessing stress in children involves observing their behaviour for signs like irritability, withdrawal, or sleep disturbances and paying attention to their play, which may reflect their emotional state. Older children can provide self-reports through questionnaires or interviews about their feelings and challenges. Parents and teachers play a crucial role by noting changes in mood, routines, or school behaviour. Physiological measures, such as heart rate variability, cortisol levels, or sleep patterns, can also indicate stress. Additionally, children may express their emotions through art or storytelling. Professional assessments using structured tools like the Strengths and Difficulties Questionnaire (SDQ) can provide deeper insights. Combining these approaches helps create a comprehensive understanding of a child's stress and guides appropriate interventions.
Assessing restoration in children involves evaluating their recovery from stress through subjective reports, behavioural observations, and physiological measures. Children can share feelings of relaxation or renewed energy, while improvements in mood, focus, and engagement in play signal recovery. Creative expression, like joyful themes in art or storytelling, can also reflect restoration. Physiological indicators, such as balanced heart rate variability, cortisol levels, or sleep patterns, provide objective evidence for restoration. Feedback from parents and teachers on changes in behaviour and coping abilities further helps to understand their restoration progress. Combining these approaches gives a comprehensive view of their recovery.
What are self-regulation and coping?
Self-regulation is about how we control our thoughts, emotions, and actions to achieve goals. It's important for short-term tasks, like paying attention in class, as well as long-term goals, like doing well in school. Children who are good at self-regulation tend to be happier and do better in school later on. However, there isn't a single definition of self-regulation that everyone agrees on.
Coping is another way we handle stress. It involves efforts to control our emotions, thoughts, behaviour, and even our bodies in response to stress. Kids who face many challenges might lose their confidence in coping, which can lead to negative outcomes. They might see threats everywhere and feel helpless, which makes them use avoidant coping strategies. This can create a cycle where poor coping leads to more challenges.
Self-regulation Coping
Why is self-regulation and coping important?
Self-regulation is essential for short-term goals, like staying focused in class, and long-term goals, like graduating with good grades. Self-regulation shapes how children handle daily challenges and stress, influencing life satisfaction and academic success. Emotion regulation, a key aspect, predicts mental health in childhood and adolescence. Poor emotion regulation is linked to issues such as aggression, anxiety, depression, autism, obesity, substance abuse, and suicide, and impacts the effectiveness of health interventions.
Coping is important because it helps individuals manage and respond to stress effectively, which is essential for psychological and emotional well-being. For example, speaking up or seeking support helps resolve stressors constructively, while managing emotions like frustration reduces their negative impact. Ineffective strategies, like avoidance or disengagement coping, may provide short-term relief but often fail to resolve the underlying issue and can lead to additional problems, such as increased stress, poor mental health, or reliance on unhealthy habits. Thus, coping strategies are crucial for maintaining resilience and adaptive functioning in the face of challenges.
How can we measure self-regulation and coping?
Coping in children is typically assessed using a combination of methods that evaluate their strategies for managing stress and emotions. These methods include self-report questionnaires and surveys (like the Children's Coping Strategies Checklist and KidCOPE), interviews, observations by parents, teachers or researchers, behavioural tasks and experiments. Using multiple methods together provides a more comprehensive understanding of how children cope with stress, as each approach has strengths and limitations.
Similarly, self-regulation in children is assessed using various methods to evaluate their control over emotions, behaviours, and thoughts. Among them are observations and self reports, behavioural tasks (like Marshmallow test), reports from parents and teachers, executive functions test (like Digit Span), track biological markers like heart rate and cortisol or using digital games and application to measure regulatory skills. Combining these methods provides a comprehensive understanding of self-regulation across contexts.