Emotional and behavioural problems in subgroups of children with chronic illness: results from a large-scale population study

Background   Children with chronic illness are known to have an increased risk of emotional and behavioural problems. In the present population-based study children with asthma, neurological disorders and other chronic illnesses were compared with children without chronic illnesses to assess differences in psychological presentation across illness groups.
Methods   A total of 537 children with parent-reported chronic illness in the Bergen Child Study were categorized into three groups: asthma, neurological disorders and other chronic illnesses. Emotional and behavioural problems were assessed by the Strengths and Difficulties Questionnaire.
Results   All three illness groups had an increased rate of emotional and behavioural problems, as well as increased probability of a psychiatric disorder compared with children without a chronic illness. Most children with asthma and other chronic illnesses did not have emotional and behavioural problems, and effect sizes were small in both groups. In children with neurological disorders the effect sizes ranged from moderate to large, with emotional problems, inattention hyperactivity and peer problems being the most frequent problems.
Conclusions   The increased rate of emotional and behavioural problems in children with chronic illness, especially neurological disorders, emphasizes the importance of early detection of mental health problems in these children.     

Intention of adolescents to seek professional help for emotional and behavioural difficulties

Much is known about adolescent help seeking for severe mental health problems. Little is currently understood about the professionals that adolescents would seek help from for milder emotional and behavioural difficulties. A self-report questionnaire was completed by 968 adolescents (53% male), aged 13-14 years in school year 9, and 15-16 years in school year 11 (64% male), attending a purposive sample of four medium to large secondary schools in Devon, UK, during February 2005. Questionnaires were completed by adolescents during whole class teaching sessions with all in attendance being willing to participate. However, 39 (4%) responses were uncompleted or incorrectly completed and removed from subsequent analysis. Questionnaires contained a series of commonly experienced difficulties and asked adolescents to indicate who they would seek help from first, if anyone, from a list of professionals identified as common providers of support. Logistic regression analyses indicated that intention to seek help varied between a low of 30% for adolescents in Year 11 on the difficulty 'were arguing all the time with your parents' to a high of 95% for females on the difficulty 'had been unfairly treated or spoken to by a teacher' with Year and Sex influencing each difficulty separately. With the exception of the difficulty 'were feeling "down" for a long time' there was a high degree of discrimination regarding the professional group (School vs. Health) that would be approached for help. With respect to specific professionals, the Form tutor featured prominently across several difficulties involving school, friends and family (range 53-65%), but also significantly across several difficulties suggestive of emotional problems (range 49-61%). General practitioners were commonly identified as providing help with difficulties sleeping (76%), and along with the school nurse with problems concerning health advice (range 38-49%). Findings highlight the influence of Year and Sex, and importance of the Form tutor in adolescent help seeking across the range of difficulties. A need is identified for further training of Form tutors in recognition of their role in supporting the interface between adolescents and services aimed at engaging young people and a recognition by health and social care professionals regarding the importance of this role.     

南京市溧水区学龄前儿童睡眠状况及其对情绪与行为问题的影响

目的 探讨南京市溧水区学龄前儿童睡眠质量和情绪与行为的关系。 方法 2020年6—8月基于分层随机抽样,对南京市溧水区6个幼儿园的307名儿童进行研究,通过问卷调查采集儿童的基本信息和睡眠状况;采用长处和困难问卷(Strength and Difficulty Questionnaire, SDQ)了解儿童的情绪和行为问题发生情况,并用多因素logistic回归分析睡眠问题对儿童情绪及行为问题的影响。 结果 307名研究对象中,睡眠障碍者95名(30.94%),起床时间在7:00后、就寝时间在21:00后、夜间睡眠时间<8 h者分别有233名(75.90%)、169名(55.05%)、104名(33.88%);SDQ困难总分(>17分)有29名(9.45%);有睡眠障碍、就寝时间在21:00后及睡眠时间<8 h的学龄前儿童困难总分(>17分)检出率较高,差异有统计学意义(P<0.05)。多因素logistic回归结果显示:睡眠障碍 (OR=3.613, 95%CI:1.217~6.314, P=0.013)、就寝时间晚于21:00(OR=1.611, 95%CI:1.031~2.467, P=0.038)、睡眠时间<8 h (OR=1.238, 95%CI:1.136~2.691, P=0.006)是学龄前儿童发生情绪及行为问题的独立危险因素。 结论 睡眠障碍、就寝时间晚于21:00和夜间睡眠时间<8 h增加儿童情绪行为问题的发生风险,特别是多动的发生,提示家长应为儿童创造良好的睡眠环境与成长环境,对促进儿童身心健康成长具有重要意义。     

Preventing emotional and behavioural problems: the effectiveness of parenting programmes with children less than 3 years of age

BACKGROUND: Emotional and behavioural problems in children under 3 years of age have a high prevalence, and parenting practices have been shown to be strongly associated with their development. A number of recent systematic reviews have shown that group-based parenting programmes can be effective in improving the emotional and behavioural adjustment of older children (aged 3-10 years). The aim of this review was to establish whether there is evidence from controlled trials that group-based parenting programmes are effective in improving the emotional and behavioural adjustment of children less than 3 years of age, and their role in the primary prevention of emotional and behavioural problems. METHODS: English and non-English language articles published between January 1970 and July 2001 were retrieved using a keyword search of a number of electronic databases. RESULTS: Five studies were included and two meta-analyses were conducted, the first combining data from parent reports and the second combining data from independent observations of children's behaviour. The combined parent reports showed a non-significant difference favouring the intervention group, while the combined independent observations showed a significant difference favouring the intervention group. CONCLUSION: It is concluded that this review points to the potential of parenting programmes to improve the emotional and behavioural adjustment of children less than 3 years of age, but that there is insufficient evidence from controlled trials to assess whether the short-term benefit is maintained over time, or the role that such programmes might play in the primary prevention of emotional and behavioural problems. This review points to the need for further primary preventive research on this important public health issue.     

Detection of behavioural and emotional problems in deaf children and adolescents: comparison of two rating scales

The aim of this study was to establish rates of behavioural and emotional problems, and of social maladjustment, In a population of deaf children, particularly in relation to different methods of communication. The parents of 84 children who attended two schools for the deaf took part. They completed the parents'checklist (PCL), a behaviour rating scale for deaf children, and the Child Behaviour Checklist (CBCL), a measure widely used in the general population. The two instruments were significantly correlated on the severity of behavioural and emotional problems, but their previously established cut-off scores detected different rates of possible clinical cases, i.e. children with mental health disorders. According to the CBCL, 40|X% of children were within the clinical range, and 82|X% were socially dysfunctional compared with the general population. The PCL identified a much higher percentage (77|X%of caseness. Behavioural and emotional problems were significantly higher in Asian children. Although all subjects used sign language, the additional use of speech, which may indicate increased hearing ability, had a protective effect for adolescents. The findings are discussed in relation to the validation of the instruments and the development of intervention programmes for deaf children.     

Gender differences in externalising problems among preschool children: implications for early childhood educators

Gender differences in student achievement have been widely studied. Considering the long‐term effects of externalising behaviour problems on children’s later academic performance, it can be conjectured that gender disparities in student achievement may be rooted in developmental characteristics in early childhood. As an effort towards contributing insights to the growing body of knowledge on child development, this study investigated whether variability in externalising behaviour problems among preschool children could be attributed to gender differences. Participants were 110 parents who completed a sociodemographic questionnaire, and rated their child’s behaviour on the Achenbach Child Behaviour Checklist. The children (mean age in months = 45.62 (SD = 10.12)) consisted of 52 boys and 58 girls. This study revealed that boys were reported to exhibit higher rates of externalising problems than girls, and that higher rates of internalising problems also predicted higher rates of externalising problems among these preschool children.     

The association between preschool classroom quality and children's social-emotional problems

This study examined the association between early childhood classroom quality and preschool children's social skills and emotional problems. Teachers completed the Early Childhood Environmental Rating Scale-Revised (ECERS-R) and the Devereux Early Childhood Assessment-Clinical Form (DECA-C). Participants included 141 preschool children from 10 kindergartens and 28 classrooms in Cairo, the capital of Egypt. The study used a mixed-methods approach to explore quantitative and qualitative data. For the qualitative data, focus groups were used to interview a group of female preschool teachers in the schools where observations were conducted. The quantitative results of the study indicated that all the ECERS-R subscales were acceptable expect for the parents and staff subscale. For the DECA-C, the Total Protective Factors (TPF) composite score (including the attachment, self-control, and initiative subscales) was above the mean, which indicates acceptable levels of social functioning. The Total Behavioural Concerns (TBC) composite score (including attention problems, aggression problems, emotional-control problems, and withdrawal/depression problems subscales) was below the mean, which refers to low levels of behavioural problems. The hierarchical multiple regression analyses showed that two subscales of the ECERS-R, namely space and furnishing, and language and reasoning predicted the TPF composite score. Also, two subscales of the ECERS-R, namely activities and interaction, significantly predicted the TBC composite score, while programme structure and parents and staff negatively predicted the TBC composite score.     

学龄前期孤独症谱系障碍儿童情绪行为问题及其与母亲情绪问题的相关性

目的 分析学龄前期孤独症谱系障碍(ASD)儿童情绪行为问题及其与母亲焦虑、抑郁情绪的相关性,以期全面干预ASD儿童及其家庭。方法 选取2018年1—8月于泉州市儿童医院就诊的5~6岁孤独症儿童71名,并同期入组性别、年龄、母亲受教育程度相匹配的正常学龄前期儿童71名;对所有被试进行Achenbach儿童行为量表(CBCL)(4~16岁版)评定,同时由其母亲完成焦虑自评量表(SAS)和抑郁自评量表(SDS)的评定。结果 1)孤独症男童组的CBCL总分、交往不良、多动、违纪、社交退缩和攻击性因子分高于正常对照组(Z值分别为-6.880、-9.417、-5.745、-5.109、-8.869、-3.510,P＜0.001),体诉因子分低于正常对照组(Z=-2.767,P=0.006)。ASD女童组的CBCL总分、多动、残忍、社交退缩、分裂强迫和攻击性因子分均高于正常对照组(Z值分别为-3.726、-3.356、-2.292、-4.339、-2.226、-2.476,P＜0.05)。2)两组ASD儿童母亲的SAS、SDS总分均高于正常对照组(Z值分别为-6.848、-3.126、-6.385、-2.183,P＜0.05)。3)ASD男童母亲的SAS、SDS总分与ASD男童的CBCL总分、多动、违纪、攻击性、体诉、抑郁、强迫因子分均存在正相关关系(P＜0.05);ASD女童母亲的SAS、SDS总分与ASD女童的攻击性因子分存在正相关关系(P＜0.05)。结论 学龄前期ASD儿童存在较多的情绪行为问题,其母亲存在较多的焦虑、抑郁情绪;两者间存在一定相关关系;应对学龄前期ASD儿童的情绪行为问题及其母亲的焦虑抑郁情绪予以关注和干预。     

Externalizing and internalizing problems at school as signs of health-damaging behaviour and incipient marginalization

This study aimed to investigate whether behavioural or emotional problems in adolescents detected by their teachers are signs of a common psychosocial maladjustment and of the beginning of social marginalization. Altogether, 171 pupils (15 years of age) from the eastern part of Finland participated in the survey. Behavioural and emotional problems and academic achievements were assessed separately by two teachers. Pupils filled in a questionnaire about alcohol use, smoking, physical exercise and fitness, self-rated health, psychosomatic symptoms, social relationships and future educational plans. Results showed that poor success at school and the absence of or limited educational plans were associated with both externalizing and internalizing problems. Externalizing problems were associated with health-damaging behaviour and with bullying others. Internalizing problems were associated with poor perceived health and a low level of exercise, with mental symptoms, and with problems in social relationships. Thus, the pupils in both problem groups had a clustering of different risk factors. We conclude that the accumulation in adolescents of self-reported health-damaging behaviour, problems related to school, to future educational plans and to social relationships are already obvious in pupils with externalizing and/ or internalizing problems detected by their teachers at the age of 15 years. The capacity of teachers to identify pupils at risk as early as possible should therefore be utilized. The development of a vicious circle might be prevented through early intervention at school, by offering pupils guidance, counselling and treatment.     

Children of mothers with mental ilness: attachment, emotional and behavioural problems

This study describes the pattern of emotional and behavioural difficulties of children whose mothers have mental illness, and explores the relationship between children's behavioural and emotional difficulties and maternal perceptions of attachment. Thirteen mothers previously admitted to psychiatric hospital for mental illness completed a measure of their own symptoms (Brief Symptom Inventory), their children's emotional and behavioural problems (Strengths and Difficulties Questionnaire (SDQ)), and attachment security (Parent/Child Reunion Inventory) (n = 21). Mean scores for child SDQ profiles were found to be within the 'normal' range, although (on some indices) mothers reported more 'case' scores for their children, than would be expected from standardized norms. It was found that there were significant positive correlations between 'insecurity' scores and all problem scales of the SDQ. Best predictors from the Parent/Child Reunion Inventory factors for each SDQ scale are reported and discussed.     

Children of mothers with mental ilness: attachment,emotional and behavioural problems

This study describes the pattern of emotional and behavioural difficulties of children whose mothers have mental illness, and explores the relationship between children’s behavioural and emotional difficulties and maternal perceptions of attachment. Thirteen mothers previously admitted to psychiatric hospital for mental illness completed a measure of their own symptoms (Brief Symptom Inventory), their children’s emotional and behavioural problems (Strengths and Difficulties Questionnaire (SDQ)), and attachment security (Parent/Child Reunion Inventory) (n?=?21). Mean scores for child SDQ profiles were found to be within the ‘normal’ range, although (on some indices) mothers reported more ‘case’ scores for their children, than would be expected from standardized norms. It was found that there were significant positive correlations between ‘insecurity’ scores and all problem scales of the SDQ. Best predictors from the Parent/Child Reunion Inventory factors for each SDQ scale are reported and discussed.     

儿童情绪问题的早期识别与应对措施

儿童情绪问题发生率较高,包含多种障碍。儿童的情绪症状多样且不典型,常呈现行为异常和躯体症状。儿科医生是识别儿童心理问题的重要资源,早期识别和有效应对是降低情绪问题损害儿童发展的关键。需要在观念、意识、预见性和敏锐性方面做好早期识别的准备。重视高风险儿童、特殊家庭中儿童,重视共患病的诊断,了解警示性症状和早期识别的过程。对儿童情绪障碍的应对措施,采取三级干预模式,从预防开始,家庭、校园、咨询和专业化治疗多方面相介入,综合性治疗。最后,举例解释干预模式,包括健康促进、普适性教育、对情绪问题的指导和情绪障碍的治疗方法。     

晚期早产儿学龄前期行为及情绪问题的研究

目的 探讨晚期早产对儿童学龄前期的行为及情绪的影响。方法 采用儿童行为量表(the Child Behavior Checklist, CBCL)对广东省中山市博爱医院儿童保健科随访的97例学龄前期晚期早产儿童(34周<胎龄<37周)进行评估, 并与107名正常足月儿的结果进行比较。结果 晚期早产组儿童的行为问题总分(25.67±20.07)显著高于正常对照组儿童的行为问题总分(20.85±18.29)(P<0.001), 除焦虑抑郁因子外(P=0.073), 晚期早产组儿童的其他各因子得分也显著高于对照组儿童(P<0.05)。结论 在学龄前期, 具晚期早产史的儿童比正常儿童更多地出现情绪及行为问题。     

学龄前孤独症谱系障碍儿童情绪行为问题与饮食行为问题调查

目的 研究学龄前孤独症谱系障碍(ASD)儿童情绪行为问题与饮食行为问题,并对该群体中两者的关系进行初步探究。方法 2020年8月—2021年4月使用长处和困难问卷(SDQ,父母版)和学龄前儿童饮食行为问卷(PEBQ)对150例学龄前ASD儿童情绪行为问题及饮食行为问题展开评估,利用Logistic回归分析探究两者关系。结果 学龄前ASD儿童常见的情绪行为问题检出率分别为：同伴交往问题(86.0%)、社会行为问题(72.7%)、多动问题(51.3%)。常见的饮食行为问题检出率分别为：主动进食能力不足(83.3%)、挑食(57.3%)、情绪性进食(42.0%)。品行问题是学龄前ASD儿童食物响应问题(OR=3.48, 95%CI:1.04～11.63)和情绪性进食(OR=6.11, 95%CI:1.56～23.86)的危险因素。社会行为问题是学龄前ASD儿童挑食(OR=3.07,95%CI:1.40～6.74)和主动进食不足(OR=5.32,95%CI:1.25～22.70)的危险因素,多动问题是学龄前ASD儿童挑食(OR=3.40,95%CI:1.65～7.00)和不良饮食习惯(OR=4...     

The use of the Piagetian Method of critical exploration in understanding the cognitive development of children with emotional and behavioural difficulties

A Piagetian approach was used to investigate the cognitive development of children who experience emotional and behavioural difficulties (E.B.D.) The method of critical exploration was adopted specifically in the light of the children's difficulties. Cognitive processes and the nature of the children's reasoning were clarified by the method of exploration used. In particular their thinking was characterised by a high degree of uncertainty. The method was shown to be particularly fruitful for providing insight into the cognitive difficulties experienced by this group of children. The findings thus contribute to our understanding of the special educational needs of such children and have major implications for methods and approaches used in teaching.     

Cognitive and behavioural outcomes of former preterm children at a tertiary care centre

There is no current estimation about the impact of prematurity on a child’s development in Lebanon.

This study describes the developmental profile of 82 former preterm-born children aged between 2 and 8 years. The Wechsler Preschool and Primary Scale of Intelligence, third edition (WPPSI-III) and Achenbach Child Behavior Checklist (CBCL for ages 1½–5 [CBCL/1½–5] or CBCL for ages 6–18 [CBCL/6–18]) results were analysed in a prospective cross-sectional study to evaluate the type and extent of cognitive and behavioural impairments amongst these children. Preterm-born children yielded IQ scores approximately 0.5–1 standard deviation below normative parameters. Significant negative associations were found between WPPSI-III composite scores and specific CBCL scales that suggest a relationship between lower intellectual functioning and more reported behavioural problems. While these findings are limited in generalizability due to the limited sample size, they highlight the need for further assessment of cognitive and behavioural impairments among Lebanese preterm-born children.     

上海市区学龄期儿童情绪和行为问题及其影响因素研究

目的 分析上海市区学龄期儿童情绪和行为问题特点及其影响因素,为有针对性地开展学龄期儿童心理健康教育提供借鉴和依据。方法 按照受教育程度分组分层抽样,选取上海市4个区11所小学共2 446名儿童,使用长处与困难问卷(SDQ)父母版和Conners父母症状问卷(PSQ)对其情绪和行为问题进行评定。结果 上海市7～12岁学龄期儿童情绪和行为问题阳性检出率为4.7%～25.9%,其中困难总分检出率为9.6%,男生注意多动不能问题的检出率高于女生(P<0.05),女生同伴交往问题的检出率高于男生(P<0.05),不同年级儿童在SDQ品行问题、多动注意不能、同伴交往和总的困难问题上的检出率差异具有统计学意义(P<0.05),男生在PSQ品行问题、学习问题、冲动-多动和多动指数上得分均高于女生(P<0.001)。除焦虑和身心障碍,各年级儿童在SDQ和PSQ各维度上的得分差异均具有统计学意义(P<0.05)。与儿童情绪和行为问题有关的因素包括性别、年龄、与其他家人关系密切、与父亲关系密切、过分溺爱和粗暴打骂的教养方式。结论 不同性别、年级的儿童存在不同的情绪和行为问题,不同的情绪和行为问题存在不同的影响因素,预防和干预时应加以区别和侧重。