One-year incidence, course, and outcome predictors of frequent headaches among early adolescents

OBJECTIVE: To examine the prevalence rate, course, annual incidence, and predictors of frequent headaches (at least once a week) in a 1-year longitudinal study of a representative school sample of 2355 adolescents aged 12 to 14 years. METHODS: Information was gathered by means of questionnaires administered to the subjects at school. RESULTS: The overall prevalence estimates of frequent headaches, including those subjects reporting another type of frequent pain, were 8.1% and 8.9% at the two assessment points (T(1) and T(2)), and 3.3% to 4% for frequent headaches without other frequent pain complaints. Both forms of frequent headaches were about three times more common among girls than boys. Persistence of frequent headaches (with possible pain comorbidity) was high, in that more than one-third of adolescents reporting frequent headaches continued to have such headaches 1 year later. Persistence also increased with age, in particular among 13- to 14-year-old girls. The overall annual incidence of frequent headaches in the whole sample was 6.5%. While incidence was about twice as high among adolescent girls than boys, there was a steady increase among girls, whereas the rates were stable in boys. The results of multivariate regression analyses showed that frequent headaches at 1-year follow-up could be significantly predicted by frequent headaches at first assessment, impairment (reduced leisure time activities), and high depressive symptom scores, in addition to gender (girls had a worse outcome). CONCLUSIONS: Frequent headaches, among girls in early adolescence in particular, should be carefully evaluated, and treatment offered to those who are impaired in their daily life functioning.     

Gender Differences in the Relationship between Emotional Regulation and Depressive Symptoms

Reports of gender differences in depressive symptoms are one of the most pervasive findings in the literature. In addition, women are frequently reported to be more emotionally sensitive than men. However, the paradox of women being more emotionally responsive and yet at greater risk for psychopathology is still to be unraveled. In the present study we examined emotional regulation as a possible factor in the gender difference in depressive symptom reporting. In a sample of young adults we replicated the frequently reported finding of greater depressive symptom reporting in women. In addition, we found women to report greater attention to emotions. This is consistent with the idea that women tend to think more and ruminate more about their emotions. However, when the variance associated with this greater attention to emotions was statistically controlled, the gender difference in depressive symptoms was no longer significant. Subsequent analyses found that women with low depressive symptoms reported greater attention to emotions without evidencing greater depressive symptoms. However, women with high depressive symptoms exhibited greater attention to emotions, more impaired antirumination emotional repair strategies, and greater reports of depressive symptoms than men with high depressive symptoms. We close by speculating about the neural concomitants of these findings.     

Elevated Self-Standards and Emotional Distress During Adolescence: Emotional Specificity and Gender Differences

This study examined the relation between self-standards and particular forms of emotional distress during adolescence. One hundred fifteen high school subjects completed the Selves Questionnaire, the Multidimensional Perfectionism Scale, the Beck Depression Inventory, and the State-Trait Anxiety Inventory. Actual-ideal discrepancies and self-oriented perfectionism were found to be associated specifically with depressive symptoms after controlling for anxious symptoms, whereas actual-ought discrepancies were associated specifically with anxious symptoms after controlling for depressive symptoms. In contrast, socially prescribed perfectionism was associated with general emotional distress. Compared with boys, girls reported more depressive, but not anxious, symptoms. Importantly, actual-ideal discrepancies partially mediated gender differences in depressive symptoms.     

Comparison of Child Adaptation to Epilepsy and Asthma

Self-concept, home behavior and school behavior of 128 children with epilepsy and 126 children with asthma were measured in order to compare and contrast differences in psychosocial adaptation. Results indicated that children with epilepsy were experiencing significantly poorer psychosocial adaptation ( p <.001) in all three areas. An exploration of gender differences across groups indicated that girls were more at risk for the home behavior problems of depression, somatic complaints, social withdrawal and hyperactivity than boys. Clinical implications for interventions with these two populations are discussed.     

The complexity of symptoms and problems experienced in children with cancer: a review of the literature

To adequately help children with cancer, care providers need to understand the complexity of symptoms and problems associated with the illness that children are experiencing, which can enable them to better tailor patient care individually to each child. In this integrative literature review, we identified the types of symptoms and problems that children with cancer can experience during treatment and rehabilitation; the terms/expressions they use to describe their symptoms and problems; how children's symptoms and problems vary during the course of their illness; and how they vary and co-vary with age, gender or race. Of the 1175 titles identified, 110 articles met the inclusion criteria and were included in the review. Seventy-eight were research-based. A total of 219 distinct symptoms or problems were identified in the literature either as the main problem or a symptom of the main problem. There is significant evidence that children and adolescents experience numerous and complex symptoms, and problems during and after treatment for cancer. Children use many different expressions to talk about their symptom experiences. However, few articles looked at how children's symptoms and problems varied during the course of their illness or the variations in symptom severity and degree of bother, or examined the relationship between children's symptom experience and age, gender, or race. Most instruments that were used to measure symptoms were interviewer-administered questionnaires, often adaptations from adult versions, and in younger children, symptoms were often obtained from adult informants. The insights gained from this review can be helpful to researchers and clinicians who wish to better understand how symptoms and problems are experienced from the children's own perspective. However, more research is needed: to better understand differences in symptom experiences among different age groups; to identify differences among children from distinct cultural, ethnic, or socio-economic backgrounds; to clarify how symptoms and problems interfere with daily life; and to refine assessment methods that allow even younger children to communicate their symptom experiences in an age-adjusted manner.     

Towards understanding gender differences in disordered eating among adolescents

Aims and objectives. The aim of the study was to enhance the detection of disordered eating in adolescents. The objectives were to examine gender differences in the prevalence of eating disorder symptoms, in occurrence of health‐risk factors and susceptibility to these and to investigate associations between health‐risk factors and eating disorder symptoms. Background. Disordered eating has a strong female preponderance. Reasons for the gender discrepancy are not well known. However, to develop effective strategies for eating disorder prevention, we need to understand gender differences in disordered eating and the related factors. Design. This is a school‐based, cross‐sectional cohort study with a natural design. Methods. The SCOFF and the R‐BDI questionnaires were administered to students (14–15 years old) attending the eighth grade of secondary school. Information about health‐risk factors was obtained from the adolescents’ school health‐care records. Results. The results were based on data from 1036 (71% of the sample) students. Self‐reported eating disorder symptoms were prevalent in 24% of the girls and 16% of the boys. Girls reported many of the health‐risk factors studied at a higher rate than boys. However, there were no gender differences in susceptibility to these factors. Dissatisfaction with appearance or weight, use of tobacco, lack of regular meals and poor communication with parents increased the likelihood of eating disorder symptoms in both genders. Conclusions. Gender differences in disordered eating are relatively small in adolescence. To enhance the detection of eating disorder symptoms, both girls and boys should be screened for these problems in secondary school. Relevance to clinical practice. The results can help nurses to use the information obtained from adolescents’ health‐care records, their annual health examinations and their responses to the SCOFF questionnaire to identify those who need further intervention, including adolescent boys.     

Can technology help close the gender gap in literacy achievement? Evidence from boys and girls sharing eBooks

Abstract

Purpose: Digital technologies may offer new solutions to old problems or bring additional complications. In this paper, we address a longstanding and widespread issue, specifically, slower acquisition of literacy skills by boys compared to girls. Electronic books might serve to close this gender gap because it is believed that boys are generally less motivated to read but that boys are especially engaged by technology. However, interactive features in electronic books could further challenge boys’ weak self-regulation skills, thus impeding their literacy achievement. Gender differences in literacy learning and the learning environment were examined in two studies conducted in French-language kindergartens.

Method: Study 1 involved 56 girls and 36 boys, where the relationship between oral language precursors at school entry and literacy outcomes at the end of second grade was assessed. Study 2 included 43 girls and 44 boys, where interactions between children and an adult during shared reading exchanges with electronic books were coded to reveal gender-related differences in the learning environment.

Result: In Study 1, the oral language and emergent literacy screener in first grade significantly predicted second grade spelling, with a significant gender gap in orthographic skills favouring girls in grade two despite similar oral language skills in grade one. In Study 2, adult readers were observed to re-direct boys’ attention or regulate their behaviour more often during shared reading (when compared to girls).

Conclusion: These findings suggest that self-regulation may mediate early reading precursors and different literacy outcomes by gender. Strategies to alleviate stress and improve the learning environment during literacy activities are suggested. Overall, it is clear that technology is neither beneficial nor harmful by itself; rather, synchronised interactions between adult, child and technological features are crucial. Furthermore, the broader social context in which teaching and learning interactions are embedded plays a role.     

Prevalence and Correlates of Depressive Symptoms in Mothers of Young Children

Mothers of young children are at risk for depressive symptoms due to their gender and status as parents. The primary purposes of this study were (1) to assess the prevalence of depressive symptoms in a sample of mothers with young children, (2) to identify sociodemographic correlates of depressive symptoms among the women, and (3) to determine if chronic stress is associated with depressive symptoms independent of other risk factors. In-home interviews were conducted with 196 mothers of 5- and 6-year-old children using the Center for Epidemiologic Studies--Depression (CES-D) Scale and the Everyday Stressors Index (ESI). High depressive symptoms (CES-D greater than or equal to 16) were reported by 49% of the mothers. They were highest among those who had never married, had less than a high school education, were under 25 years of age, were black, and had a low income. The ESI was a strong predictor of high depressive symptoms, controlling for sociodemographic characteristics. In comparison to mothers reporting a low level of everyday stressors (score = 5), those scoring 15 were 3 times more likely to have high depressive symptoms; those scoring 35 were more than 30 times as likely to have high CES-D scores. The results suggest the importance of chronic daily stressors as correlates of depressive symptoms in mothers of young children and also point to the need for multivariate models when examining predictors of those symptoms.     

Content Specificity of Threat Interpretation in Anxious and Non-Clinical Children

This study investigated content specificity of children’s threat interpretations in a group of 40 clinically anxious (18 boys, 22 girls; ages 7–14 years) and a group of 40 non-clinical children (19 boys, 21 girls; ages 8–14 years). Associations between disorder-specific threat interpretations (in response to situations selected by each child) and each of six DSM-IV anxiety and depressive disorder symptom domains were examined for each group of children through multivariate regression analyses. Supporting theories of cognitive content specificity, results showed that for clinically anxious children, symptoms of social phobia and panic disorder were significantly and specifically predicted by threat interpretation in response to situations that corresponded to each disorder, while symptoms of separation anxiety were predicted by threat perception in situations relevant to separation anxiety and panic disorder. There was little evidence of cognitive content specificity within the non-clinical group of children. Implications for theories of development of interpretation biases associated with child anxiety disorders are discussed.     

Emotion Regulation in Children with Emotional Problems

The emotion regulation (ER)-specificity hypothesis assumes that a specific psychological problem is characterized by a specific maladaptive ER strategy. This hypothesis will be investigated for six child-DSM symptom clusters (Study 1) and for depressive symptoms (Study 2). We also investigated whether certain emotion regulation strategies can be detected through different forms of symptom clusters. Study 1 includes 432 school aged non-referred youngsters (60 % girls; age range between 8 and 18 years) and Study 2 includes 128 school aged non-referred youngsters (55 % girls; age range between 10 and 14 years). A self-report questionnaire, FEEL-KJ investigates a wide range of adaptive and maladaptive ER strategies. DSM symptom clusters (affective, anxiety, somatic, conduct, oppositional and ADHD problems) were measured by parent report on the Child Behaviour Checklist; depressive symptoms were measured with the Child Depression Inventory. Youngsters with emotional problems have specifically less adaptive ER strategies. The relation with maladaptive ER strategies can only be detected with self-reported depressive symptoms. ER strategies problem-oriented action and acceptance are transdiagnostically related to both internalizing and externalizing problems. For affective, somatic, conduct and ADHD problems the ER-specificity hypothesis is confirmed. Investigating ER strategies could be of clinical relevance specifically in children with affective, somatic, conduct and ADHD problems. Next, training deficits in the ER strategies Problem-oriented action and Acceptance can be considered as important in the treatment of all children with emotional problems.     

Impact of culture on children's community participation in Israel.

OBJECTIVE: This study compared the participation in activities outside of formal school among Jewish and Druze Israeli children. It also examined the impact of gender and the interaction of culture and gender on participation. METHODS: Participants included 30 Jewish and 30 Druze children ages 8-10 years, who completed the Children's Assessment of Participation and Enjoyment (CAPE). RESULTS: On most of the scales measured, the Jewish children showed a significantly higher participation level than the Druze children, and the Druze children performed more activities alone. The Jewish children demonstrated a higher enjoyment level than the Druze children on half of the scales. Some scales revealed higher participation by girls than by boys as well as a significant cultural group by gender interaction. CONCLUSION: Culture may have an impact on children's level of participation in the community. The CAPE was found to be a sensitive tool in elucidating differences between the Druze and Jewish children in community participation.     

Prevalence of Overweight and Obesity in Children With Intellectual Disabilities in Korea

Background Overweight and obesity in children with intellectual disabilities may be a major health threat. The purpose of this study was to examine the prevalence of overweight and obesity in Korean children with intellectual disabilities aged 7–18 years who did not have specific genetic syndromes or physical disabilities. Materials and methods Participants were 2,404 children with intellectual disabilities aged 7–18 years attending thirteen special schools in Korea. Data from school health records were analysed using SAS (version 9.2). The differences between boys and girls were assessed for children’s height and weight using t‐tests and for children’s age and weight status, such as using Chi‐Square (χ²) test. The relationships between children’s weight status, age and gender were reassessed using Chi‐Square (χ²) test, and strengths of the relationships were measured using Gamma coefficient. Results Approximately one‐quarter of children with intellectual disabilities were either overweight or obese. Children’s gender was significantly associated with their weight status, such that overweight and obesity were more prevalent in girls than in boys, specifically girls aged 15–18 years. There was a positive relationship between age and the prevalence of overweight and obesity in children for both boys and girls. Conclusions The high rates of overweight and obesity in children with intellectual disabilities highlight the need for interventions to help children achieve healthy weight. Before conducting weight management interventions, identifying risk factors that influence weight status in children with intellectual disabilities is an important step.     

Voiding disorders among children and adolescents: surveillance after 'voiding school' treatment

The purpose of this study was to evaluate children's lower urinary tract symptoms (LUTS) and health-related quality of life (HR-QoL) 1–6 years after treatment at voiding school. One to six years after the end of treatment for non-neurogenic voiding disorders, 108 children were contacted (36% girls, current age 8–18 years). The study was conducted in two parts: data were retrospectively collected from the (i) children's medical records to determine their symptoms at the first consultation and (ii) children's current self-report via two different questionnaires, a voiding-related symptom questionnaire and a HR-QoL questionnaire (KINDL^N). Fifty-two children agreed to take part in the study: 17 girls and 35 boys, mean age 12·8 years (SD ± 2·76), median age 13·0 years. At first consultation, 58% of the children suffered from day and night incontinence (DNI), 75% from urgency and 87% from infrequent voiding. Ultrasound showed that 73% had incomplete bladder emptying. No statistically significant sex-based differences were observed, except that girls more often reported urinary tract infections ( P = 0·011). After treatment, 47% of children reported resolution, 39% significant improvement, 12% no improvement and 2% 'don't know'. DNI was reported by 14%, urgency by 18% and infrequent voiding by 45%. There were no statistically significant correlations between the children's degree of current symptoms and their perceived HR-QoL. The children reported fewer symptoms after treatment, indicating that attendance at voiding school might be a successful treatment modality. However, the design of the present study does not allow any conclusion to be drawn regarding cause and effect.     

International survey of self-reported medicine use among adolescents

OBJECTIVE: To examine gender, age, and country variations in adolescents' self-reported medicine use. DESIGN: Cross-sectional school surveys of representative samples of 11- to 15-year-old girls and boys were used. The 1997/1998 Health Behaviour in School-aged Children study was referenced. A standardized questionnaire was completed during school hours. SETTING: Canada, US, Greenland, Israel, and 24 European countries. PARTICIPANTS: 123 227 participants equally distributed by gender and by 3 age groups (mean 11.7, 13.6, 15.6 y). MAIN OUTCOME MEASURES: Self-reported medicine use for headache, stomachache, difficulties in getting to sleep, and nervousness during the past month. RESULTS: The magnitude of the adolescents' medicine use for headache, stomachache, difficulties in getting to sleep, and nervousness varied substantially across countries. In each of the 28 countries, more girls than boys used medicine for pain. Use of medicine for headache increased by age; use of medicine for stomachache increased by age among girls, but decreased among boys; and use of medicine for difficulties in getting to sleep and nervousness decreased from the age of 11 to 15 years. There was an increase in the crude girl versus boy ratios for medicine use by age for all 4 symptoms. Multivariate logistic regression analyses, adjusting for age group and country, revealed the following odds ratios (95% CI) for girls' versus boys' medicine use: headache 1.56 (1.53 to 1.60), stomachache 2.16 (2.10 to 2.22), difficulties in getting to sleep 0.96 (0.91 to 1.00), and nervousness 1.04 (0.99 to 1.08). CONCLUSIONS: Substantial proportions of adolescents used medicine for common health problems. The prevalence of use differed between type of symptom for which the medicine was used, between countries, and between gender and age groups. We suggest that young people's medicine use should be addressed in public health policy.     

葫芦岛市农村汉族儿童身体发育的Heath-Carter体型法评估

背景:研究儿童体质发育及体型的方法很多,其中Heath-Carter体型法是一种综合评价身体形态的方法,该方法从几十项身体测量指标中精选出10项作为评价发育与体型的指标。目的:分析葫芦岛市农村汉族儿童的体型发育规律和特点,为体质人类学补充必要的数据。设计:以正常儿童为调查对象,横断面调查。单位:锦州医学院解剖学教研室。对象:按整群分层抽样法,抽取2001-07/2003-09葫芦岛市绥中县明水乡中心小学7～10岁经学校正常体质检查证明身体健康的汉族学生为检测对象,按性别分两大组,每大组按年龄分4小组,每岁为一组,每小组46～63名,共分8组,搜集完整资料408名(男213名,女195名)。方法:采用Heath-Carter体型法,每项指标测量2次,取平均值,10项指标由专人负责,测试数据按年龄和性别在微机中建立数据库,依次计算出各年龄组的内因子、中因子和外因子,体型图上的X,Y坐标值,身高/体质量1/3,样本中平均体型点到所有体型点空间距离的均数,三维空间中两个体型点间的差异,体脂百分比和各类体型分布频数。主要观察指标:身高、体质量、上臂紧张围、小腿围、肱骨和股骨内外上髁间径、肱三头肌皮褶、肩胛下皮褶、髂前上棘皮褶、腓肠肌皮褶。结果:参加调查408名,均进入结果分析。①7～10岁儿童身高、体质量随年龄的增加而增长,身高/体质量13/指数7,8,10岁女孩>男孩,9岁男孩>女孩,这与八九岁男孩身高增长(5.61cm)比女孩(3.88cm)较多有关。体脂含量女孩>男孩。3个体型值中男孩在3.2～3.9,2.3～2.6,3.0～3.4,女孩在3.5～4.6,1.9～2.6,3.3～3.5,所以男女以内因子、外因子为主,女孩内因子>男孩,说明葫芦岛市农村儿童体内脂肪含量相对较高,身体相对瘦高程度较好,骨骼肌肉欠发达,并且女孩的皮下脂肪更丰富。男女各年龄组间体型比较,7～,8～,9～,10～11岁三维空间中两个体型点间的差异值分别为0.46,0.68,1.03,0.61,除7～岁组外,其余各年龄组男女间体型差异有显著性(P<0.01)。②葫芦岛市农村汉族男孩的平均体型值为3.4-2.5-3.2,属中间型,女孩平均体型值为4.0-2.3-3.4,属偏外胚层的内胚层体型。男孩和女孩的内因子和外因子占优势,中因子值偏低,随着年龄的增长,体型频数不断变化。③与国内外资料相比,葫芦岛市农村汉族儿童内因子偏高,中因子偏低,外因子相差不多。结论:葫芦岛市农村汉族儿童体脂发育较好,身材修长,但骨骼肌肉欠发达,儿童的体型发育随年龄呈多变倾向。     

Anger dysregulation, depressive symptoms, and health in married women and men

BACKGROUND: Anger problems (anger dysregulation) and depressive symptoms have been linked to risk for all causes of mortality, but less is known about the association between anger dysregulation and depressive symptoms within the context of gender differences and health outcomes. OBJECTIVES: The association between anger dysregulation, depressive symptoms, and self-reports of health in married adults was evaluated using an emotion-regulation model. METHODS: Fifty-two married couples completed a series of procedures that included an interview assessing their ability to regulate anger, a questionnaire reporting depressive symptoms (Beck Depression Inventory) and self-reports indicating health. RESULTS: Results provided support for hypothesized links between the variables, but they varied by gender: (a) greater anger dysregulation in the wives, but not the husbands, was predictive of depressive symptoms; (b) anger dysregulation was predictive of the husbands' self-reports of health but was not predictive of the wives' self-reports of health; (c) depressive symptoms were not significantly associated with self-reports of health for either married women or men. DISCUSSION: These results suggest that anger dysregulation may play different roles in the depressive symptoms and self-reports of health for married women and men.     

Gender differences in extrafamilial sexual abuse experiences among young teens.

Extrafamilial sexual abuse experiences of young adolescents (ages 10-14), particularly young teen boys, are not well studied. This retrospective chart review study compared psychosocial correlates and victimization experiences between young adolescent girls (n = 226) and boys (n = 64) referred to a hospital child advocacy center. Several differences in risk behaviors and abuse experiences were found: Girls were more likely to have run away, to be truant from school, to report substance use, to have multiple perpetrators, and to have physical findings from the abuse. Boys were more likely to have a diagnosis of attention deficit disorder and to report anal penetration, and rarely disclosed abuse at the time of the incident. Peers were girls' most common choice for disclosing abuse, whereas boys confided most often in their mothers or other adults. These findings suggest sexually abused young adolescent girls and boys need distinct, developmentally appropriate screening and care in school and health care settings.     

Interpersonal and Achievement Orientations and Specific Stressors Predicting Depressive and Aggressive Symptoms in Children

This prospective study of 486 fifth and sixth grade children examined the contributions of interpersonal (Neediness and Connectedness) and achievement (Self-Criticism and Individualistic-Achievement) orientations, specific stressors, and their interactions to the prediction of depressive symptoms and level of anger/aggression. For both genders, Neediness directly predicted increases in depressive symptoms, whereas Connectedness interacted with social stressors to predict level of anger/aggression. There was a significant main effect of Connectedness for girls and a significant Connectedness × social stressors interaction for boys when predicting depressive symptoms. Neither achievement orientation factor directly predicted or interacted with achievement stressors to predict depressive symptoms. In contrast, the I-Achievement factor interacted with achievement stressors to predict level of anger/aggression for girls, but not boys. Results were consistent with the personality–event congruence hypothesis in that none of the vulnerability factors interacted with noncongruent stressors to predict either depressive symptoms or level of anger/aggression.     

A Test of the Integration of the Hopelessness and Self-Esteem Theories of Depression in Schoolchildren

This prospective study tested the diathesis-stress and symptom components of the integration of the hopelessness and self-esteem theories of depression in a sample of third- and seventh-grade children. The procedure involved an initial assessment of depressive symptoms, self-esteem, and depressogenic inferential styles about causes, consequences, and the self. The procedure also involved a follow-up assessment, 6 weeks later, in which depressive symptoms and the occurrence of negative events were assessed. In line with the integrative theory, depressogenic inferential styles interacted with negative events to predict increases in hopelessness but not nonhopelessness depression symptoms in boys with low but not high self-esteem. At the same time, contrary to the integrative theory, depressogenic inferential styles interacted with negative events to predict increases in hopelessness but not nonhopelessness depression symptoms in girls with high but not low self-esteem.