Obesity and coping in childhood

The aim of this study was to investigate everyday coping styles in obese children in comparison to healthy controls in dependence of gender. Furthermore, the correlations of eating behavior with coping styles were examined. In addition, groups with highest and lowest extremal scores in eating behavior were compared. Patients (N = 58) aged from 11 to 13 years, who took part in an in-patient education program, were asked to complete the German Coping Questionnaire for Children and Adolescents (Hampel et al. 2001) and the Dutch Eating Behavior Questionnaire for Children (Franzen u. Florin 1997). Healthy controls were matched by age and gender and were asked to fill out the SVF-KJ. No differences between coping styles of obese children and adolescents and healthy controls were found. In obese children and adolescents, emotional and external eating behavior were positively correlated with maladaptive coping strategies. In comparison to previous findings in chronically ill children, differences in obese children and adolescents and healthy controls on coping styles could not be confirmed in the present study. However, results support that the eating behavior of obese children and adolescents is influenced by coping styles.     

Personality adjustment of children and adolescents with hypopituitarism

Sixteen children and adolescents with extreme short stature secondary to hypopituitarism were compared to a matched group of physically healthy peers on a variety of psychological tests assessing general adjustment, body image, sex role development, sex-related fantasy, and reactions to frustration. With the exception of their reactions to frustrations, the psychological adjustment of children with hypopituitarism compared favorably with that of normal children. Children with hypopituitarism typically perceived less adaptive, mature solutions to frustrating situations than did peers of average stature. Anticipatory guidance for children with extreme short stature might help facilitate more adaptive responses to the difficult and inevitable frustrations imposed by short stature. Evaluations of intervention directed toward the enhancement of coping skills and life adjustment of children with small stature due to hypopituitarism is seen as a focus for future research with this population.     

Are children with epilepsy at greater risk for bullying than their peers?

The primary goal of this study was to determine the prevalence of bullying in children with epilepsy compared with their healthy peers and peers with chronic disease. Children with epilepsy were compared with healthy children and a cohort of children with chronic kidney disease (CKD). The following self-report questionnaires were completed: Revised Olweus Bully/Victim, Piers–Harris Self-Concept Scale, Revised Child Manifest Anxiety Scale, Child Depression Index, and Social Skills Rating System. Children with epilepsy were more frequently victims of bullying (42%) than were healthy controls (21%) or children with CKD (18%) (P = 0.01). Epilepsy factors such as early age at seizure onset, seizure type, and refractory epilepsy were not found to be predictors of victim status. Surprisingly, poor social skills, increased problem behaviors, poor self-concept, depression, and anxiety did not correlate with bully victim status. The relatively high prevalence of bullying behaviors in these children is concerning and, from a clinical standpoint, requires greater research specifically addressing peer relationships and consideration of the implementation of anti-bullying measures and coping strategies for children with epilepsy.     

Répercussions psychologiques de la pandémie de COVID-19 chez les enfants et les adolescents et modalités de prise en charge

Children and adolescents were particularly affected by the psychological consequences of the COVID-19 health crisis. They were faced with multiple stressors such as repeated confinements, the use of masks, the disruption of daily routines, the lack of social interactions following the closure of schools and the cessation of extra-curricular activities. These adversities dramatically weakened their coping strategies and their resources. In this interview with Jean-Pierre Bouchard, Olivier Sorel, Juliane Tortes Saint-Jammes et Sandie Meillerais discuss the changes that have been implemented in their clinical practice for children in the context of the COVID-19 pandemic. Then, they will also identify, by using clinical examples, the procedures specifically used to develop, reinforce or reactivate the resources of children and adolescents during the therapy. Finally, they address the very notion of clinical support, with an emphasis on EMDR therapy and a family-centered approach.     

Effets de la maltraitance sur la régulation émotionnelle des enfants et des adolescents confiés à l’Aide Sociale à l’Enfance

ObjectivesThis research aims to compare coping strategies (strategies developed to cope with stress) and temperamental dimensions used by children and adolescents have not been maltreated and those who have been. The aim of these analyzes is to identify the effects of age as well as vulnerabilities and resources for children and adolescents who have been maltreated.Materials and methodsA total of 232 children and adolescents aged 7 to 16 years participated in this study including 115 who have never been maltreated (control group) and 117 have been maltreated and are living in foster care (placed group). Each young people responded to a scale measuring the frequency of coping strategies (Kidcope) as well as a questionnaire of temperament (questionnaire d’auto- et d’hétéro-évaluation du tempérament en sept facteurs pour l’enfant d’âge scolaire et l’adolescent).ResultsAn analysis of variance (ANOVA) was performed for each coping strategy and temperamental dimension to evaluate the consequence of maltreatment on the emotional regulation, according to the slice of age. The age-based comparison of control and placed groups reveals major differences in the use of certain coping strategies as well as in the temperamental dimensions of maltreated children and adolescents. This confirms that the child's life experience influences his way of understanding his environment and affects his individual resources.ConclusionsThe results show vulnerabilities of emotional regulation for children and adolescents who have been maltreated. These aspects underline the importance to think about supports in order to promote the development of some coping strategies and to reduce the stressors. These points will be discussed with preventive and therapeutic used to improve coping skills and emotional regulation.     

Feasibility and validity of ecological momentary assessment in adolescents with high-functioning autism and Asperger's disorder

Ecological Momentary Assessment (EMA) may increase accuracy of data compared with retrospective questionnaires by assessing behaviours as they occur, hence decreasing recall biases and increasing ecological validity. This study examined the feasibility and concurrent validity of an EMA tool for adolescents with High-Functioning Autism Spectrum Disorders (HFASD). Thirty-one adolescents with HFASD completed a mobile phone EMA application that assessed stressors and coping for two weeks. Parents and adolescents also completed retrospective measures of the adolescent's coping/stressors. Moderate compliance with the EMA tool was achieved and some concurrent validity was established with the retrospective measure of coping. Concordance was found between the types of stressors reported by parents and adolescents but not the quantity. The results suggest adolescents with HFASD are capable of reporting on their stressors and coping via EMA. EMA has the potential to be a valuable research tool in this population.     

Social competence of children and adolescents with epilepsy.

BACKGROUND: This study compared children and adolescents with epilepsy with their healthy peers on measures of social competence. METHODS: Children and adolescents with epilepsy (70 subjects aged 11-18 years; 47.1% girls) and their healthy peers in control group (95 subjects aged 11-18 years; 50.9% girls) were compared on measures of social competence from the Child Competence Checklist (part of Child Behavior Check List). The questionnaires were completed by the parents. All participants were of normal intelligence. RESULTS: The difference of means of total T scores for subscales of sociabilitiy and activities in the epilepsy group and in the control group were statistically significant (p<0.05). The results showed that 5.7% of children and adolescents with epilepsy were in the clinical range compared to 2.1% of subjects in control group. The girls with epilepsy demonstrated greater problems with social competence (45.8+/-8.27) than boys with epilepsy (48.1+/-8.27) and this difference was statistically significant (p<0.05). Multiple analysis of variance of T scores for social competence subscales related to neurobiological variables in the group of participants with epilepsy demonstrated a statistically significant association of reduced sociability with multiple generalized seizure types (F=4,405; d.f.=2; p<0.05). CONCLUSIONS: The study clearly shows that epilepsy is a limiting factor for social competence of children and adolescents.     

Coping and quality of life among children and adolescents with attention deficit/hyperactivity disorder

First studies suggest an impaired emotion regulation especially with negative emotions among children and adolescents with attention deficit/hyperactivity disorder (ADHD), which particularly emerged in the subgroup with comorbid conduct disorder. Moreover, first results have shown that quality of life of children and adolescents with ADHD are negatively affected compared to healthy controls. The present study examined differences in age and subgroup on coping and quality of life among boys with ADHD. Furthermore, coping and quality of life were compared to healthy norms. In total, N=48 boys with ADHD with and without conduct disorder (ages 8 to 12 years) were asked to complete self-report questionnaires on coping and quality of life. Fifth and sixth graders with ADHD reported less distraction than third and fourth graders. The subgroup with ADHD and conduct disorder showed more passive avoidance and resignation compared to the subgroup with ADHD alone. Compared to normative data, especially third and fourth graders with ADHD showed an increased maladaptive coping. Additionally, the subgroup with conduct disorder scored higher on all maladaptive coping strategies than the normative sample. Finally, all domains of quality of life were impaired among children and adolescents with ADHD compared to normative data. These findings support the consideration of emotion regulation and quality of life in the research of ADHD in childhood and adolescence to develop effective programs for prevention and intervention.     

Patterns of children's coping with life stress: implications for clinicians

In a study of children's patterns of coping with daily stressors, boys and girls 9-17 years old were asked to complete a coping checklist in response to one of four types of stressors--school, parents/family, siblings, or peer/interpersonal. Patterns of coping-strategy use were found to be similar across the various stressors, with wishful thinking, problem-solving, and emotional regulation being among those most frequently used. Older adolescents, compared to younger children, tended to use a broader range of coping strategies, regardless of stressor. Implications for clinical practice are discussed.     

Brief report: Coping among Austrian children and adolescents

The study investigated age and gender effects on coping with common stressors among 494 Austrian children and adolescents (age 8-14 years). Participants were subdivided into subgroups of late children comprising third and fourth graders, early adolescents consisting of fifth and sixth graders, and middle adolescents including seventh graders. Middle adolescents showed a maladaptive coping pattern with decreased problem and emotion-focused coping strategies and increased passive avoidance and aggression. Females scored higher on social support and also on the maladaptive coping strategy rumination. Female middle adolescents reported higher resignation than their male contemporaries and female children. Results suggest the application of primary preventive stress management programs in late childhood and early adolescence.     

Posttraumatic stress disorder among Cuban children and adolescents after release from a refugee camp

OBJECTIVE: The authors compared self-reported symptoms of posttraumatic stress disorder (PTSD) in a cohort of Cuban children and adolescents with assessments of internalizing and externalizing behaviors by the children's teachers. METHODS: Eighty-seven children and adolescents who had left Cuba by sea in the summer of 1994 and who had been confined to refugee camps for up to eight months before arriving in the United States were evaluated four to six months later. Self-reported symptoms of PTSD were assessed with the Post-Traumatic Stress Disorder Reactive Index, and internalizing and externalizing behaviors were assessed with the Child Behavioral Check List-Teacher Report Form. RESULTS: A majority of the children reported moderate to severe PTSD symptoms. The most common symptom clusters were avoidance (67 percent), regressive behaviors (64 percent), reexperiencing the traumatic events (60 percent), somatic symptoms (52 percent), and hyperarousal (51 percent). Eighty-six percent of the children reported that the refugee experience had severely affected most of their peers. A statistically significant dose-effect relationship was found between the number of stressors and the severity of self-reported PTSD symptoms. There was a modest relationship between withdrawn behavior and children's feelings that they would die at sea and witnessing violence at the camps. Age and witnessing violence in the camps were moderately associated with PTSD. Teachers' overall ratings of externalizing and internalizing behaviors did not produce any clinically significant findings. CONCLUSIONS: PTSD symptoms among refugee children and adolescents who have been exposed to multiple and prolonged stressors may continue unabated after the stressors are removed. The symptoms are experienced subjectively and may go unnoticed by adults.     

Alexithymia and dissociative tendencies in an adolescent sample from Eastern Turkey

Alexithymia and dissociative reactions are two strategies that have been put forward as coping mechanisms to alleviate painful emotions. Adult studies reveal an association between alexithymia and dissociation. In line with the coping hypothesis, it was predicted that the relationship between alexithymia and dissociative tendencies would be partly mediated by current levels of stress and past traumatic experiences. Dissociation may also be related to enhanced fantasizing, although alexithymia has traditionally been associated with an incapacity to fantasize. This relationship has not been studied well in adolescents. In the present study, 173 randomly selected high school students from Eastern Turkey were assessed with the Adolescent Dissociative Experiences Scale, the Beck Depression and Anxiety inventories, the Rosenberg Self-esteem Scale and the Toronto Alexithymia Scale. Correlation analyses followed by stepwise regression analyses were performed. "Difficulty identifying feelings" subscale of Toronto Alexithymia Scale, anxiety level and the history of physical abuse emerged as predictors of dissociative tendencies. It seems that in this group, dissociation is associated with anxiety and with difficulty in identifying feelings. Physical abuse also contributes to dissociation. The adolescent who is alexithymic may be more prone to dissociation when compared to their non-alexithymic peers. Helping alexithymic adolescents describe their body experiences may decrease their tendency to dissociation by increasing their ability to verbally identify their stressors.     

Coping Strategies of Secondary School Children in Response to Being Bullied

Through a questionnaire survey, the present study investigated the coping strategies of Year 7 (11–12 years old) and Year 9 (13–14 years old) pupils (N = 324) to find out what strategies they have used to overcome the difficulties of being bullied by peers. Fifty-one UK secondary schools, in each of which an anti-bullying peer support system had been in place for at least a year, participated. The coping strategies of those pupils who said that they had told someone (N = 279) about being bullied were compared with those who said that they had not (N = 45). These coping strategies differ, not only according to whether or not they report the bullying, but also according to their age and gender. Implications of the findings for professionals who work with children and adolescents are suggested.     

Cross-situational coping with peer and family stressors in adolescent offspring of depressed parents

Offspring of depressed parents are faced with significant interpersonal stress both within their families and in peer relationships. The present study examined parent and self-reports of adolescents' coping in response to family and peer stressors in 73 adolescent children of parents with a history of depression. Correlational analyses indicated that adolescents were moderately consistent in the coping strategies used with peer stress and family stress. Mean levels of coping were similar across situations, as adolescents reported greater use of secondary control coping (i.e., acceptance, distraction) than primary control coping (i.e., problem solving, emotional expression) or disengagement coping (i.e., avoidance) with both types of stress. Regression analyses indicated that fewer symptoms of self-reported anxiety/depression and aggression were related to using secondary control coping strategies in response to family stress and primary control coping in response to peer stress. Implications for understanding the characteristics of effective coping with stress related to living with a depressed parent are highlighted.     

Coping with stress as a paradigm of the psychopathology in childhood and adolescence

Stress coping can be valid for a paradigm of psychopathology of children and adolescents. This concept is supported by an extensive literature which shows the way of coping from a "footnote to stress theory" (Lazarus) to its central concept. Neither the "objective" stress (stimulus side) nor the specificity of stress reaction (adaptation syndrome) are the important factors, but rather the mediation between stress coping and the individual, the transaction in the sense of an exchange process. Above all, permanent personality attributes have been examined here, most intensively extraversion/introversion and neuroticism, and recently, more and more often coping processes. The research situation also confirms in its approach the concept of Lazarus (1981) in the field of child and adolescent psychiatry. According to Lazarus, stressors are less meaningful as a cause of psychiatric disturbances than cognitive-emotional reaction mediating coping processes. They should be examined preferably under natural conditions; a combination of standard research strategies with individual case analyses is recommended. Therapeutically, it is essential to help children and adolescents to achieve an adequate correlation between their own capabilities and limitations on the one hand, and of conflicts and stress situations on the other hand, whereby the adolescent (young) patient is interested in a quick solution to personal and interpersonal crises. He is not at all interested in its extension in the sense of a 'Sturm-und-Drang'-idea of adolescent age. Hence coping cannot be confined only to coping with a functional crisis; it must rather aspire to achieve a schematisation of the situation in accordance with the truth.     

Anxiety and depression in children with epilepsy and their mothers

OBJECTIVE: Children with epilepsy have high rates of depression and anxiety. The majority of studies concentrate on the children with epilepsy, but the emotional impact of epilepsy on family members is of clinical concern. In this cross-sectional study we aimed to examine the association between epilepsy in childhood and adolescence, and anxiety and depression in these patients and their mothers. METHODS: We studied 35 children and adolescents with seizures (age range, 7-19 years), 35 gender-matched healthy controls (age range, 8-17) who did not have any chronic medical illness, and mothers of these individuals (n=70) in a cross-sectional analysis. We administered the Kovac Child Depression Inventory (CDI) and State-Trait Anxiety Inventory for Children (STAIc) to the children. We administered the Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) to the mothers of these children. Pearson correlations were used to analyze dependence between variables, and Student's t test was used to compare mean values between test scores. RESULTS: Patients with epilepsy had higher CDI scores (mean+/-SD, 12.48+/-6.35) than controls (9.31+/-5.11) (P<0.05), whereas the STAIc scores did not differ between cases (34.03+/-8.29) and controls (35.20+/-6.23) (P<0.05). Mothers of children with epilepsy did not have more depression or anxiety symptoms than mothers of children without epilepsy as measured by BDI and STAI scores (P>0.05). There was no correlation between mothers' scores and patients' or controls' scores. CONCLUSIONS: These results support findings from previous studies that children and adolescents with epilepsy have a higher frequency of depressive but not anxiety symptoms than the general population of healthy children and that this is independent of their mothers' symptoms.     

Importance of developmental perspective for the construction of a diagnostic test battery for children and adolescents (OPD-KJ)

In the following contribution, developmental aspects are highlighted which served as a framework for developing an diagnostic instrument for child and adolescent psychiatry. In operationalizing a psychodynamic instrument for assessing children and adolescent symptomatology, a developmental perspective is critically important. Compared to adult, developmental changes occur on most dimensions measured, for example with respect to coping with the illness and dealing with stressors and conflicts. In addition, relationships with parents and peers changed over time as well as the capacity of self-reflexion and empathy. Two important conceptualizations are presented, which deal with these changes, the concept of developmental lines and the theory of developmental tasks. These conceptualizations, together with the theory of cognitive development, served as a framework for an approach, which distinguish diagnostically between infants, pre-school children, schools aged children and adolescents.     

Coping in children and adolescents with migrant origin

Children and adolescents of migrant origin often have disadvantages regarding education opportunities and health. This paper reports on the extra-curricular "Special Instruction Project for Children and Adolescents of Migrant Origin'", launched by the Stiftung Mercator and administered in Schw?bisch Gmünd. The project aims to improve education opportunities for children and adolescents of migrant origin by providing language and subject support. During the years 2006 to 2008 full-time holiday courses were realized in addition to the weekly subject instructions in German, Mathematics and English. In these holiday schools creative, sportive and health promoting aspects were integrated in language support. In terms of resource promotion and empowerment a module on stress and coping was developed and realized in the holiday courses. This module on stress and coping in context of the language support project is presented and discussed.     

Gender and developmental effects on perceived stress, coping, somatic symptoms and psychological disorders among children and adolescents

The aim of this one-year longitudinal study was to investigate gender and developmental effects on perceived stress related to interpersonal stressors, coping strategies, somatic symptoms and psychological disorders. Additionally, associations of perceived stress and coping styles at the first assessment with psychological problems at the second measurement were examined. In total, N = 169 Austrian children and adolescents (ages 10 to 13 years) participated in this self-report study. Compared to male children and adolescents, female counterparts scored higher on perceived stress related to interpersonal stressors and on social support but evaluated a lower amount of distraction. Moreover, girls reported higher levels of somatic symptoms and anxiety/depression. Boys showed a developmental increase in anger control problems and both genders showed developmental increases in antisocial behavior. Low levels of the emotion-focused coping strategies distraction and minimization were related longitudinally to emotional and behavioral disorders. The results support gender-adjusted stress management programs applied in the primary and secondary prevention.     

Causal links between stressful events, coping style, and adolescent symptomatology

In a longitudinal study, the causal links between different types of stressors, coping styles and adolescent symptomatology were investigated. A total of 94 adolescents and their mothers participated in three annual assessments of critical life events, daily stressors and coping styles. The longitudinal associations between life events, everyday stressors, a dysfunctional coping style and symptomatology were analyzed via a path-analytic model. Critical life events and daily stressors were found to be strongly related over time; however, the type of stressor was not consistently linked with adolescent symptomatology. In contrast, withdrawal, a form of avoidant coping, emerged as a significant predictor of adolescent symptomatology across all times. Further, emotional and behavioral problems led to a time-lagged increase in withdrawal, creating a vicious circle. The results are discussed with reference to the coping-skill deficit model.