Birth defects and psychosocial adjustment

A one-year prospective study was conducted to examine the extent to which type of disability, severity, and family functioning serve to predict maladjustment. One hundred forty children, aged 4 to 13 years, born with cardiovascular disorders, cleft lip or palate, or hearing defects were assessed using the Child Behavior Checklist at two points in time. The results suggest that the type of disorder and severity are associated with remaining or becoming maladjusted. Deaf girls and boys with cardiac problems were most likely to be affected, followed by boys with clefts and boys with hearing problems. A direct relationship is found with severity assessed by the Functional Status Measure. Family functioning, however, is not significantly related to maladjustment. These findings provide a framework for better understanding factors contributing to the increased risk of maladjustment for some children with birth defects.     

Short stature--the role of intelligence in psychosocial adjustment

Short children are often described as having psychosocial problems. These reports may be inaccurate as former studies have relied largely on parental report. Psychosocial functioning of short children was assessed with the aim of using them and their peers as informants. Twenty two short (mean (SD) height -2.53 (0.28) SD score) prepubertal children aged between 6 and 11 years were recruited from growth clinics. Comparison children were recruited from each case child's class at school. Cognitive and psychosocial functioning was assessed. Peer relationships were measured using sociometry. There were no significant group differences in terms of peer acceptance, self perception, and social competence. Although cases described themselves as receiving less social support from teachers, no differences were evident in other areas of social support. Little evidence was found to suggest clinic referred prepubertal short children are psychosocially maladjusted. Further analysis revealed cognitive ability was a better predictor than height for most aspects of behavioural and emotional adjustment.     

Changes in psychosocial adjustment after renal transplantation.

The psychological aspects of transplantation were studied in 29 children and adolescents with functioning renal transplants. Most parents rated their child''s physical health as considerably improved after transplantation. They also noted improvements in the child''s behaviour and in the quality of family life. When compared with a sample of children being treated by hospital haemodialysis, children who had received transplants had more favourable parental views of behavioural and emotional adjustment, better parental psychiatric adjustment, and indications of superior child rated mood, self concept, and social functioning. Children who had received transplants did, however, show an increase in minor behavioural symptoms compared with healthy controls, and most parents required continuing psychological and social support as well as attention to physical aspects of the child''s condition. Kidney transplantation is associated with improved psychosocial behaviour in children, but there is a continuing need for support for parents in dealing with minor psychological problems after the transplant.     

Differences between school classes in preschoolers' psychosocial adjustment: evidence for the importance of children's interpersonal relations

We examined differences between school classes with respect to three aspects of psychosocial adjustment at school, namely the extent that children in the class liked to play with each other, the number of teacher-reported behaviour problems, and children's feelings of wellbeing at school. The sample consisted of 1282 4- to 5-year-olds from 94 school classes and 51 schools, but due to nonresponse actual sample sizes were somewhat smaller for most analyses. Multilevel analyses showed that on average 87% of the variance was at the child level, 11% at the class level, and 3% at the school level. This indicated that a non-negligible amount of variance could not be accounted for by factors at the child level. Furthermore, this variance was mainly associated with differences between classes instead of differences between schools. A set of variables that pertained to sociodemographic characteristics of schools, school facilities, organisational aspects of classrooms, and the teacher did not provide an adequate explanation for the differences in adjustment levels. In contrast to these traditional variables, social network indices yielded substantial correlations, showed consistent trends across the different adjustment measures, and fulfilled the necessary requirement that to explain differences between school classes the predictor variables themselves should differ for classes within the same school. These results suggested that aspects of the interpersonal relations of children in the classroom such as proximity, integration, and the amount of contact could be determinants of differences between school classes in psychosocial adjustment.     

The relationship between children's threats of violence and violent behaviors

BACKGROUND: We sought to examine the relationship between students' threats of interpersonal violence and self-reported violent behaviors. METHODS: Anonymous self-report questionnaires were administered to students in grades 3 through 12 in schools located in Colorado, Arizona, and Ohio. A survey of 9487 students from 33 public schools was performed. Ages ranged from 7 to 19 years. Across the 3 samples, the percentage of African Americans ranged from 6% to 35%, whites from 31% to 57%, and Hispanics from 5% to 51%. RESULTS: Multivariate logistic regression analyses revealed that threatening others infrequently or frequently (compared with not threatening others) was significantly associated with violent behaviors. Students who infrequently threatened were about 3 to 4 times more likely to report exhibiting each of the violent behaviors than students who did not threaten others (odds ratio [OR] = 4.08-5.86). The relationship between frequently threatening others and violent behaviors was especially strong (OR = 7.19-24.30) and highest for the most severe forms of violence, knife attacks (OR = 15.39-24.30) and shootings (OR = 18.42). CONCLUSIONS: Findings suggest that students' threats of harm toward others should be taken seriously, and that policies and procedures should be developed to ensure that children who threaten others receive proper assessment and management. Arch Pediatr Adolesc Med. 2000;154:785-790     

Short stature--the role of intelligence in psychosocial adjustment.

Short children are often described as having psychosocial problems. These reports may be inaccurate as former studies have relied largely on parental report. Psychosocial functioning of short children was assessed with the aim of using them and their peers as informants. Twenty two short (mean (SD) height -2.53 (0.28) SD score) prepubertal children aged between 6 and 11 years were recruited from growth clinics. Comparison children were recruited from each case child''s class at school. Cognitive and psychosocial functioning was assessed. Peer relationships were measured using sociometry. There were no significant group differences in terms of peer acceptance, self perception, and social competence. Although cases described themselves as receiving less social support from teachers, no differences were evident in other areas of social support. Little evidence was found to suggest clinic referred prepubertal short children are psychosocially maladjusted. Further analysis revealed cognitive ability was a better predictor than height for most aspects of behavioural and emotional adjustment.     

Peer victimization and psychosocial adjustment in children with type 1 diabetes

This study investigated the frequency and psychosocial correlates of peer victimization in a sample of youths with diabetes. The Social Experience Questionnaire, Children's Depression Inventory, Social Anxiety Scale for Children-Revised, and Asher Loneliness Scale were administered to 32 children diagnosed with type 1 diabetes and 32 control children without a medical diagnosis who were matched for age and gender. Results indicated that children with diabetes reported higher rates of relational victimization and lower levels of prosocial peer support than youths without diabetes. In addition, relational victimization was positively associated with depression, social anxiety, and loneliness for diabetic children. Implications of these findings for clinicians working with this population are discussed.     

Bullying, psychosocial adjustment, and academic performance in elementary school

BACKGROUND: Over the past decade, concerns about bullying and its role in school violence, depression, and health concerns have grown. However, no large studies in the United States have examined the prevalence of bullying during elementary school or its association with objective measures of school attendance and achievement. OBJECTIVE: To determine the prevalence of bullying during elementary school and its association with school attendance, academic achievement, disciplinary actions, and self-reported feelings of sadness, safety, and belonging. DESIGN: Cross-sectional study using 2001-2002 school data. SETTING: Urban, West Coast public school district. PARTICIPANTS: Three thousand five hundred thirty (91.4%) third, fourth, and fifth grade students. MAIN OUTCOME MEASURE: Self-reported involvement in bullying. RESULTS: Twenty-two percent of children surveyed were involved in bullying either as a victim, bully, or both. Victims and bully-victims were more likely to have low achievement than bystanders (odds ratios [ORs], 0.8 [95% confidence interval (CI), 0.7-0.9] and 0.8 [95% CI, 0.6-1.0], respectively). All 3 bullying-involved groups were significantly more likely than bystanders to feel unsafe at school (victims, OR, 2.1 [95% CI, 1.1-4.2]; bullies, OR, 2.5 [95% CI, 1.5-4.1]; bully-victims, OR, 5.0 [95% CI, 1.9-13.6]). Victims and bully-victims were more likely to report feeling that they don't belong at school (ORs, 4.1 [95% CI, 2.6-6.5] and 3.1 [95% CI, 1.3-7.2], respectively). Bullies and victims were more likely than bystanders to feel sad most days (ORs 1.5 [95% CI, 1.2-1.9] and 1.8 [95% CI, 1.2-2.8], respectively). Bullies and bully-victims were more likely to be male (ORs, 1.5 [95% CI, 1.2-1.9] and 3.0 [95% CI, 1.3-7.0], respectively). CONCLUSIONS: The prevalence of frequent bullying among elementary school children is substantial. Associations between bullying involvement and school problems indicate this is a serious issue for elementary schools. The research presented herein demonstrates the need for evidence-based antibullying curricula in the elementary grades.     

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.     

Exposure to violence and psychosocial adjustment among urban school-aged children

This study determines the relationship between psychosocial adjustment in school-aged children and one aspect of exposure to violence, the proximity of exposure, in terms of (1) "physical" proximity and (2) "emotional" proximity to the victims of violence. A convenience sample of 175 children aged 9 to 12 years from a primary care clinic of a large urban hospital were interviewed about their exposure to violence using the Children's Report of Exposure to Violence. Psychosocial adjustment was measured through maternal reports using the Child Behavior Checklist (CBCL) and the Personal Adjustment and Role Skills Scale (PARS III). Children were categorized into three groups according to their closest proximity to exposure to violence ("victim" > "witness" > exposure through other people's "report") and two groups according to emotional proximity (victim was a "familiar person" or "stranger"). All children (23/175) who scored above the CBCL clinical cutoff (T score > 63) were witnesses or victims of violence. The CBCL total T scores (higher score = more maladjustment) showed that the "victims" group (mean 52.4) scored significantly higher than the "witness" group (mean 50.0) and "report" group (mean 47.4). The PARS III total scores (lower scores = more maladjustment) showed that the "victims" group (mean 87.5) scored significantly lower than the "witness" group (mean 93.1) and "report" group (mean 98.2). The relationship of the child to the victim was not associated with significantly different CBCL and PARS III scores. Children exposed to more proximal forms of violence as victims or witnesses exhibited more psychosocial maladjustment.     

Peer victimization and psychosocial adjustment in children: current knowledge and future directions

Childhood peer victimization is the experience of being a target of peers' aggressive behavior. Peer victimization is a common occurrence and has been concurrently and prospectively linked to significant psychological distress. This paper provides a review of the extant literature on the relationship between peer victimization and psychosocial adjustment in nonclinical and pediatric populations. Clinical applications of this literature, as well as directions for future study, are presented.     

上海市中小学生自杀行为及心理社会相关因素的研究

目的 了解上海市中小学生自杀行为的现状，探索自杀行为的相关危险因素。方法 采用分级整群随机抽样方法，选取上海市9所学校：小学5年级、预备初中（预初）、初一、初二、高一和高二年级学生进行匿名自评问卷调查。问卷包括一般情况问卷、流行病学调查中心用抑郁量表、焦虑自评量表、青少年生活事件量表和贝克绝望量表，根据美国疾病控制预防中心（CDC）青少年危险行为调查所采用的方式设置最近12个月的自杀意念、自杀计划和自杀未遂行为调查。自杀行为的年级和性别差异用卡方检验，自杀意念的相关因素分析采用单因素和多因素Logistic回归模型。结果 ①发放问卷2 513份，当场收回有效问卷2 416份，其中男1 190份，女1 226份；调查人群年龄10~17岁；②调查人群中有自杀意念者368名（15.23%，368/2 416），有自杀计划者141名（5.84%，141/2 416），自杀未遂者42名（1.74%，42/2 416）；③自杀行为的性别差异：男生有自杀意念者178名（14.96%,178/1 190），有自杀计划者80名(6.72%，80/1 190)，自杀未遂者24名(2.02%，24/1 190)；女生有自杀意念者190名（15.50%，190/1 226），自杀计划者61名(4.98%，61/1 226)，自杀未遂者18名(1.47%，18/1 226)。男、女生自杀行为差异无统计学意义（P>0.05）；④自杀意念的发生随年级上升而升高（P<0.05）。调查显示高二年级学生自杀未遂的发生率最高（5.17%，6/116）,其次为预初年级（2.52%，13/516）, 小学5年级最低（0.86%，3/347）（P<0.05）。自杀计划的发生率各年级间差异无统计学意义（P>0.05）；⑤小学生自杀意念与所在学校、家庭住房条件显著相关；初中生的自杀意念与同伴关系、父亲文化水平和母子沟通显著相关；高中生的自杀意念与学习成绩、自由支配空余时间和父子沟通显著相关。所有年级学生的自杀意念均与青少年生活事件量表、抑郁量表、焦虑自评量表和贝克绝望量表分呈显著相关。结论 ①上海市中小学生自杀行为状况不容乐观，必须引起高度重视；②不同学习阶段学生的自杀行为影响因素有所不同，干预措施应有所侧重；③应及时发现和积极治疗情绪障碍，努力培养青少年应对不良生活事件的能力，以降低自杀行为发生。     

Relationships between bullying and violence among US youth

OBJECTIVE: To determine the extent to which bullying and being bullied, both in and away from school, is associated with involvement in violent behavior. DESIGN, SETTING, and PARTICIPANTS: A US representative cross-sectional sample of 15 686 students in grades 6 through 10 in public and private schools completed the World Health Organization's Health Behaviour in School-aged Children survey in 1998. MAIN OUTCOME MEASURES: Self-report of weapon carrying, weapon carrying in school, physical fighting, and being injured in a physical fight. RESULTS: Involvement in each of the violence-related behaviors ranged from 13% to 23% of boys and 4% to 11% of girls. Bullying others and being bullied were consistently related to each violence-related behavior for both boys and girls. Greater odds of involvement occurred with bullying others than being bullied, and greater odds of involvement occurred with bullying that took place away from school than that occurring in school. For example, the adjusted odds ratio for weapon carrying associated with being bullied in school weekly was 1.5, for bullying others in school 2.6, for being bullied away from school 4.1, and for bullying others away from school 5.9. CONCLUSION: Bullying should not be considered a normative aspect of youth development, but rather a marker for more serious violent behaviors, including weapon carrying, frequent fighting, and fighting-related injury.     

Mental and motor development and psychosocial adjustment of Chinese children with phenylketonuria

Aim: This study was designed to evaluate mental and motor development, psychosocial adjustment (temperament and behavioural problems) in children with phenylketonuria (PKU). Methods: Twenty‐eight Chinese children aged from three to 36 months with early‐treated PKU were evaluated by Bayley Scales of Infant Development (BSID), Peabody Developmental Motor Scale (PDMS‐II), Toddler Temperament Questionnaire (TTQ) and Achenbach's Child Behavior Checklist (CBCL). The related factors, including blood phenylalanine (Phe) levels, and the socio‐economic status (SES) of the children's family were also explored. Results: In comparison with healthy control, early‐treated PKU children showed no delay in the mental and motor development. However, they presented higher levels on four of the nine temperamental dimensions (higher level in activity, more intense in reaction, more negative mood and more distraction). They also had more behavioural problems in depression, aggression and destructibility. A lower Phe level and a higher SES of children's family showed a positive effect on development index, temperamental characteristics and behavioural problems. Conclusion: Early‐treated PKU children were normal in the mental and motor development. However, they presented higher level on four of the nine temperamental dimensions and had more behavioural problems. Paediatric control combined with psycho‐counselling was suggested for young PKU children.     

Associations between child disciplinary practices and bullying behavior in adolescents

Objectiveto investigate associations between different types of child disciplinary practices and children and adolescents’ bullying behavior in a Brazilian sample.Methodscross-sectional study, with a school-based sample of 10- to 15-year-old children and adolescents. Child disciplinary practices were assessed using two main subtypes: power-assertive and punitive (psychological aggression, corporal punishment, deprivation of privileges, and penalty tasks) and inductive (explaining, rewarding, and monitoring). A modified version of the Olweus Bully Victim Questionnaire was used to measure the frequency of bullying.Results247 children and adolescents were evaluated and 98 (39.7%) were classified as bullies. Power-assertive and punitive discipline by either mother or father was associated with bullying perpetration by their children. Mothers who mostly used this type of discipline were 4.36 (95% CI: 1.87-10.16; p < 0.001) times more likely of having a bully child. Psychological aggression and mild forms of corporal punishment presented the highest odds ratios. Overall inductive discipline was not associated with bullying.Conclusionsbullying was associated to parents’ assertive and punitive discipline. Finding different ways of disciplining children and adolescents might decrease bullying behavior.     

The longitudinal relationship between drug use and risky sexual behaviors among colombian adolescents

OBJECTIVE: To identify the longitudinal relationships between drug use and risky sexual behaviors and early pregnancy in Colombian adolescents. DESIGN: Confidential survey of adolescents, consisting of structured individual interviews, at 2 time points, 2 years apart. A standard self-report questionnaire was adapted to ensure linguistic and cultural relevance. SETTING: Community samples representing differing levels of risky sexual behavior and drug use. Cohorts were drawn from higher- and lower-risk geographic areas and from various self-reported ethnic groups. PARTICIPANTS: Adolescents (N = 2226) randomly selected from 3 major Colombian cities: Bogotá, Medellín, and Barranquilla. MAIN OUTCOME MEASURES: Data were collected concerning adolescent drug use, sexual behaviors, and a history of pregnancy. The youths' drug use included measures of all illegal drugs. RESULTS: By using regression analyses (controlling for demographic variables) a reciprocal longitudinal relationship between risky sexual behaviors and drug use was identified. Those adolescents who reported higher levels of drug use at time 1 also had more sexual partners, had higher frequencies of unprotected sex, and were more likely to have experienced early pregnancy at time 2. The reverse relationship was true as well. The level of violence experienced by the adolescent emerged as a moderator of some of these relationships. CONCLUSIONS: Reducing adolescent drug use may also reduce levels of risky sexual behavior and early pregnancy and vice versa. Furthermore, the importance of addressing violence as a risk factor for both problem behaviors is emphasized.