Maternal psychosocial factors around delivery,and the behavior of 2‐year‐old children

Background: The objectives of the present study were to explore whether maternal psychosocial factors, mental health and work stress around delivery, are related to the behavior of 2‐year‐old children. Methods: In a prospective cohort study design, pregnant women attending the National Taiwan University Hospital for delivery and post‐partum care from April 2004 to January 2005 were recruited and their children were observed at 24 months. A total of 186 mother–term‐born child dyads completed the measurement. The five‐item Mental Health Index (MHI‐5) self‐report data of maternal psychosocial factors were selected from the Taiwanese version of the short form 36 (SF‐36). The Child Behavior Checklist for age 1½–5 (CBCL/1½‐5) was completed by the parents when the child was 2 years old. Results: The mean score of mental health around delivery was 68.11. The proportion of mothers with work stress seldom and always was 61.8% and 24.7%, respectively. The mean of the total CBCL score, and internalizing, externalizing behavior and sleep problems scores was 45.95, 11.89, 15.59 and 4.23, respectively. After adjusting for the potential confounders, maternal work stress around delivery was found to have a significant effect on the total CBCL and externalizing, attention and aggressive, behavioral problems of 2‐year old children. Maternal mental health around delivery, however, did not show significant effects on child behavior. Conclusions: Work stress around delivery seems to aggravate children's externalizing behavior problems at 2 years old. It is therefore important to improve the psychosocial health and reduce the stress of pregnant women.     

Convergence of the Child Behavior Checklist with Structured Interview-based Psychiatric Diagnoses of ADHD Children with and without Comorbidity

Abstract— We evaluated the convergence of CBCL scales with the diagnosis of ADHD and comorbid disorders in 133 ADHD and 118 normal control boys, aged 6–17 years old. We evaluated the strength of association between each CBCL scale and structured-interview derived diagnoses with Total Predictive Value (TPV) and the odds-ratio (OR). Excellent convergence was found between the GBGL Attention Problems scale with the diagnosis of ADHD, between the Delinquent Behaviour scale and the diagnosis of CD, and between die Anxiety/Depression scale and the diagnoses of Anxiety Disorders. These findings indicate that the CBCL could serve as a rapid and useful screening instrument to identity comoribid and non-comorbid cases of ADHD.     

Correlation of Obesity and Overweight with Emotional-Behavioral Problems in Primary School Age Girls in Tabriz,Iran

Objective

Obesity and overweight have shown an increasing trend in most developing countries. Childhood obesity would impose numerous health-related problems. This study was conducted to determine the correlation of obesity and overweight with emotional-behavioral problems in primary school age girls.

Methods

In a cross-sectional study, 300 primary school girls (aged 7-11 years) were selected using a multi-staged sampling method, including randomized cluster and stratified method. For all students body mass index was measured and then based on BMI for age and sex, from each grade (1-5), 20 students were selected for each group of normal weight, overweight and obese. The emotional-behavioral problems were evaluated using child behavior checklist that consists of 113 items for childhood behavioral problems.

Findings

Total behavioral problems were seen in 17%, 27%, and 2% in obese, overweight, and normal weight children, respectively. Internalizing problems (including Anxious/Depressed, Withdrawn, and Somatic Complaints) were seen in 11%, 15%, and 2% and externalizing problems (including Aggressive and Delinquent Behaviors) were observed in 8%, 17%, and 2% in obese, overweight, and normal weight children, respectively. The mean scores in all scales were higher in obese and overweight children in comparison with normal weight children and the emotional-behavioral problems had significant positive correlation with obesity and overweight (P<0.01).

Conclusion

Despite the cultural differences between east and west, yet there are similarities in the most of the emotional-behavioral problems related to overweight and obesity. Also, it seems that the risk of behavioral-emotional problems in overweight girls is more than in obese girls. Overweight and Obesity prevention may be a primary preventive step for these problems in children.     

The association of reading disability, behavioral disorders, and language impairment among second-grade children

Children with language impairment (LI) have been shown to be at risk for reading disability (RD) and behavior disorder (BD). Previous research has not determined the specific pattern of these conditions associated with LI. This study sought to determine if the behavior disorder and reading problems represented different outcomes or if these conditions occurred together when found with LI. A group of 581 second-grade children, including 164 children with LI, were examined for spoken language, reading, and behavior disorder. The data for each of these areas were examined as dimensional traits and as clinical categorical traits. Reading and spoken language were found to be strongly correlated (r = .68); RD was found in 52 % of the children with LI and in only 9 % of the controls. Scores of parent ratings for BD were also significantly correlated with spoken language scores (r = .29). Clinical levels of BD were found in 29% of the children with LI and 19% of the controls. An examination of the co-occurrence of clinical levels of BD, RD, and LI showed BD in children with LI to be conditioned by the child's reading status. The data indicated that whereas RD was directly associated with BD, the association of LI with BD required the mediation of RD.     

Sleep quality is associated with psychosocial functioning and health‐related quality of life in pediatric transplant recipients

This study examined patient‐reported sleep quality in a single‐center cross‐sectional sample of adolescents with solid organ transplants and evaluated associations between sleep quality, psychosocial functioning (ie, depression/anxiety symptoms), and HRQOL. Health disparities associated with minority race/ethnicity and socioeconomic variables were also examined. Sixty‐nine adolescents (M = 16.51 years; SD = 1.63) who received a solid organ transplant (kidney: n = 25; liver: n = 24; heart: n = 20) completed self‐report measures of sleep quality, psychosocial functioning, and HRQOL. Adolescent transplant recipients endorsed significantly lower levels of sleep quality (ie, falling asleep) compared with previously published norms of healthy peers (t = ?3.60; P ≤ .001). Higher sleep quality was significantly associated with fewer anxiety and depressive symptoms (r = ?.31 to ?.40), and higher physical and psychosocial HRQOL (r = .33‐.43). Adolescents from minority backgrounds had significantly worse sleep quality compared with non‐Hispanic Whites. Adolescent transplant recipients, particularly those from minority backgrounds, may be at increased risk for experiencing poor sleep quality. Suboptimal sleep is a risk factor for higher levels of anxiety and depressive symptoms, as well as lower levels of physical and psychosocial HRQOL. Sleep is an important modifiable factor that, if improved, may contribute to lower anxiety/depressive symptoms and better HRQOL in adolescent transplant recipients.     

Children's perspectives on their relationships with their nonresident fathers: influences, outcomes and implications

BACKGROUND: Children's relationships with their nonresident fathers, and associations between these relationships, children's relationships with mothers and stepfathers, and the children's adjustment were studied in 162 children from single-parent and stepfamilies, selected from a representative community sample in the UK, studied at 2 time points two years apart. METHOD: Children were interviewed about their relationships with their nonresident fathers, mothers and stepfathers; mothers reported on children's adjustment, and other family variables. RESULTS: Positive child-nonresident father relationships were correlated with (a) contact between child and father, (b) the quality of the mother-child relationship, and (c) the frequency of contact between the mother and her former partner. Conflict between child and father was correlated with conflict between child and mother, and child and stepfather. Child-nonresident father contact and relationships were stable over 2 years, and related to children's adjustment; these associations were stronger for children from single-parent families than for those with stepfathers, and for those whose mothers had been first pregnant as teenagers. CONCLUSIONS: Associations between the quality of children's relationships with nonresident fathers and their adjustment need to be considered within the framework of the larger family system; child-father relationships are particularly important for children from 'high risk' families.     

Health-related quality of life and psychosocial adjustment in steroid-sensitive nephrotic syndrome

OBJECTIVES: To evaluate quality of life (QOL) and psychosocial adjustment by standardized tests in well-characterized patients with steroid-sensitive nephrotic syndrome. STUDY DESIGN: Forty-five patients were investigated at a median age of 9.8 years (range, 3.4 to 19.8) and 5.9 years (range, 0.1 to 16.3) since diagnosis. Child- and parent-rated QOL was evaluated by the The Netherlands Organization for Applied Scientific Research Academical Medical Center (TNO-AZL) Child Quality of life Questionnaire. Psychosocial adjustment was assessed by the Child Behavior Checklist and the Teacher Report Form. RESULTS: In patients, only the QOL subscale "social functioning" was impaired compared with that in control subjects, whereas parents rated 4 of a total of 7 subscales as abnormal. Psychosocial adjustment was impaired at home and at school. Steroid dependency and cytotoxic treatment had a significant negative impact on QOL only, whereas family climate, especially maternal distress, negatively affected both QOL and psychosocial adjustment. CONCLUSIONS: QOL and psychosocial adjustment are impaired in steroid-sensitive nephrotic syndrome. Both illness-related variables and family climate play an important role.     

Neuropsychological and psychosocial function in children with a history of snoring or behavioral sleep problems

OBJECTIVES: To compare neuropsychological and psychosocial function in children with a history of snoring, children with a history of behavioral sleep problems (BSP), children with both a history of snoring and BSP, and a group of control subjects. STUDY DESIGN: Families awaiting consultation for "sick" visits in 5 general practice clinics completed the Sleep Disturbance Scale for Children. A subset of children were categorized into groups: Snorers (n = 11), BSP (n = 13), Snorers+BSP (n = 9), and controls (n = 31). Children underwent psychological (Wechsler Abbreviated Scale of Intelligence, Children's Memory Scale; Test of Everyday Attention and Auditory Continuous Performance Test) and psychosocial assessment (Child Behavior Checklist). RESULTS: With analysis of variance, it was revealed that, compared with children in the BSP and control groups, those in the Snorers+BSP and Snorers groups showed reduced intelligence and attention scores. By contrast, compared with children in the Snorers and control groups, children in the Snorers+BSP and BSP groups reported reduced social competency, increased problematic behavior, and reduced memory scores. Children in the combination of Snorers+BSP group showed more deficits than children in all other groups. CONCLUSION: In children, snoring and BSP, separately and together, are associated with impaired neuropsychological and psychosocial functioning. Furthermore, snoring and BSP are related to performance in disparate ways. Snoring was associated with intelligence and attention deficits, whereas BSP was associated with memory and behavioral deficits.     

Parental stress, psychosocial problems and responsiveness in help-seeking parents with small (2–45 months old) children

Experienced parental stress in 75 mothers and 65 fathers seeking help for their young child (M = 14.5 months; SD = 9.4 months) in a Specialist Child Health Centre was examined and related to child problem load, psychosocial problems and parental problems in responding to the child's signals and demands. Maternal stress level was compared with a population-based sample of 1500 mothers with children of similar ages. The measure of parental stress was a revised Swedish version of the American Parenting Stress Index (Parent Domain). Mothers in the clinical sample indicated higher levels of parental stress compared to fathers in the same families and to mothers in the comparison sample. A clear association was found between higher stress and a global clinical assessment of parental unresponsiveness to the child. Child problem load was associated with mothers' overall stress level. A clinical estimate of the parents' psychosocial situation was also associated with mothers' and fathers' stress level, and gave a large unique contribution to the variability in mothers' stress scores. It was concluded that focus in intervention programs should be on the whole family, and that the father should be seen as a resource that might well be more involved in the caretaking of the child. The study also clearly demonstrated the discriminant and construct validity of the parental stress instrument.     

An infant and child feeding index is associated with child nutritional status in rural China

Background

Some researchers have developed child feeding indices to summarize child feeding practices so that they can compare child feeding practices across countries and monitor changes over time within a given country.

Aims

An adapted version of the infant and child feeding index (ICFI) developed by Ruel and Menon was used to examine its association with nutritional status of infants living in a rural community in China.

Methods

A cross-sectional survey of 501 children aged 6-11 mo was conducted with their mothers in 8 townships between May 2006 and March 2007. ICFI was developed based on 24-h dietary recall and food frequency information. The associations between ICFI and anthropometric indices including length-for-age (LAZ), weight-for-age (WAZ), and weight-for-length (WLZ) Z-scores were examined separately. General linear regression models were used to adjust for potential confounders including the children's, parents' and households' sociodemographic characteristics.

Results

The ICFI was associated with both WAZ (adjusted WAZ means: 0.39, 0.47, and 0.54 for the 1st, 2nd, and 3rd tercile, respectively, P < 0.05) and WLZ (adjusted WLZ means: 0.47, 0.74, and 0.79 for the 1st, 2nd, and 3rd tercile, respectively, P < 0.05). But it was not associated with children's LAZ. Among the components of ICFI, dietary diversity, meal frequency and bottlefeeding were positively associated with the children's anthropometric indices.

Conclusions

ICFI and its components could be used to assess effect of complementary feeding practices on child growth.     

Multicultural assessment of child and adolescent psychopathology with ASEBA and SDQ instruments: research findings, applications, and future directions

Around the world, cultural blending and conflict pose challenges for assessment and understanding of psychopathology. Economical, evidence-based, culturally robust assessment is needed for research, for answering public health questions, and for evaluating immigrant, refugee, and minority children. This article applies multicultural perspectives to behavioral, emotional, and social problems assessed on dimensions describing children's functioning, as rated by parents, teachers, children, and others. The development of Achenbach System of Empirically Based Assessment (ASEBA) and Strengths and Difficulties Questionnaire (SDQ) forms and their applications to multicultural research are presented. A primary aim of both questionnaires is to identify children at high risk of psychiatric disorders and who therefore warrant further assessment. The forms are self-administered or administered by lay interviewers. ASEBA problem items are scored on 6 DSM-oriented scales and 3 broader band scales, plus 8 syndromes derived statistically as taxonomic constructs and supported by uniform confirmatory factor analyses of samples from many populations. Comparisons of ASEBA scale scores, psychometrics, and correlates are available for diverse populations. SDQ forms are scored on one broad-band scale and 5 a priori behavioral dimensions supported by data from various populations. For both instruments, factor analyses, psychometrics, and correlates are available for diverse populations. The willingness and ability of hundreds of thousands of respondents from diverse groups to complete ASEBA and SDQ forms support this approach to multicultural assessment. Although particular items and scales may have differential relevance among groups and additional assessment procedures are needed, comparable results are found in many populations. Scale scores vary more within than between populations, and distributions of scores overlap greatly among different populations. Ratings of children's problems thus indicate more heterogeneity within populations than distinctiveness between populations. Norms from multiple populations can be used to compare children's scores with relevant peer groups. Multicultural dimensional research can advance knowledge by diversifying normative data; by comparing immigrant children with nonimmigrant compatriots and with host country children; by identifying outlier findings for elucidation by emic research; and by fostering efforts to dimensionalize DSM-V diagnostic criteria.     

Psychological adjustment in children and adults with congenital adrenal hyperplasia

OBJECTIVE: To determine psychological health in individuals with one form of intersexuality, congenital adrenal hyperplasia (CAH), and its relation to characteristics of the disease and treatment. STUDY DESIGN: Participants (ages 3-31 years) included 72 females and 42 males with CAH, and unaffected relatives (44 females and 69 males). Psychological adjustment was assessed with parent-reports on the Child Behavior Checklist (CBCL) and subject self-reports on the Self-Image Questionnaire for Young Adolescents (SIQYA) or the Multidimensional Personality Questionnaire (MPQ). Information about disease characteristics and genital surgery was obtained from medical records. RESULTS: There were no significant differences between females with CAH and unaffected females on any measure. Psychological adjustment was not significantly associated with genital virilization or age at genital surgery. Males with CAH were not significantly different from unaffected males in childhood, but they showed more negative affect at older ages. CONCLUSIONS: Psychological adjustment is not compromised in females with virilized genitalia who are treated early in life and reared as females. Adjustment does not appear to depend on the characteristics of the disease or its treatment, but sample size and restricted range limit generalizability about adjustment-disease associations.