Prevalence of Emotional and Behavioral Difficulties and Associated Factors Among Adolescents with Divorced or Separated Parents in Vietnam: A cross-sectional study using the SDQ-25

Preschoolers and young children are vulnerable to psychosocial and behavioral disorders linked to lifestyle factors such as screen time and sleep disturbances. Our study examines the relationship between screen time and adherence to recommendations with children's behavioral and emotional difficulties, with a focus on the role of sleep duration. Cross-sectional analyses were conducted within the multicenter prospective Childhood Obesity Risk Assessment Longitudinal Study(CORALS), which included 1420 children aged 3-6years. Screen time (hours/day) and adherence to recommendations (≤ 2hours/day) were assessed. Behavioral and emotional difficulties were measured via the strengths and difficulties questionnaire. Multivariable linear and logistic regression models were used to estimate associations between screen time (continuous and dichotomous) and strengths and difficulties questionnaire scores, adjusting for potential confounders. We also tested the moderating effect of sleep and conducted isotemporal substitution analyses replacing screen time with sleep duration. Higher screen time was associated with higher total strengths and difficulties questionnaire scores [β 95% confidence interval (CI), 0.35 (0.10, 0.61)], emotional symptoms [0.10 (0.01, 0.19)], conduct problems [0.10 (0.01, 0.18)], and greater odds of exceeding the 16-point strengths and difficulties questionnaire cutoff for behavioral and emotional difficulties [odds ratio (OR) (95% CI), 1.21 (1.04, 1.41)]. Children who adhered to screen time recommendations had lower strengths and difficulties questionnaire total scores [β (95% CI), - 0.64 (- 1.19, - 0.10)] and odds of experiencing behavioral and emotional difficulties [OR (95% CI), 0.67 (0.47, 0.95)]. Sleep duration moderated the screen time-strengths and difficulties questionnaire association (P = 0.020). The isotemporal substitution of screen time for sleep duration was associated with lower strengths and difficulties questionnaire scores across all subscales, except for prosocial behavior. Higher screen time was associated with greater emotional and behavioral difficulties, whereas adherence to screen time recommendations and adequate sleep duration were inversely associated. Managing screen time and promoting sleep are crucial for children's well-being.

Parents’ divorce is a phenomenon affecting the further psychosocial functioning of children. It is established that the divorce consequences on children are long-term: adults who have experienced parents’ divorce in childhood are characterized by poorer mental health, also they are having clearer emotional and behavioral difficulties. Researchers argue that not the divorce fact itself is the most important in assessing the consequences for children but rather the circumstances of parents’ divorce. After analysing the most detrimental divorces’ circumstances this study focuses on the child’s negative feelings, experienced during the divorce, the intensity of parents’ conflicts, the child’s involvement in conflicts, and negative changes afterwards.The aim of the study was to determine the relationship between young adults’ behavioral and emotional difficulties and parents’ divorce experienced in childhood or adolescence as well as its circumstances.The study involved 173 young adults. Behavioral and emotional difficulties are assessed by ASEBA (Adult Questionnaire). In order to assess the impact of parents’ divorce and its circumstances, a questionnaire (Viršilaitė, Bukšnytė-Marmienė, 2018) was used. The study found that the child’s negative feelings during parents’ divorce predict young adults’ aggression, rules’ braking, anxiety/depression, self-closure also emotional and behavioral difficulties in general. The intensity of parents’ conflicts during divorce predicts aggression in young adults.

BackgroundSymptoms related to mood and anxiety disorders (emotional disorders) often present in childhood and adolescence. Some of the genetic liability for mental disorders, and emotional and behavioral difficulties seems to be shared. Yet, it is unclear how genetic liability for emotional disorders and related traits influence trajectories of childhood behavioral and emotional difficulties, and if specific developmental patterns are associated with higher genetic liability for these disorders.MethodsThis study uses data from a genotyped sample of children (n = 54,839) from the Norwegian Mother, Father, and Child Cohort Study (MoBa). We use latent growth models (1.5–5 years) and latent profile analyses (1.5–8 years) to quantify childhood trajectories and profiles of emotional and behavioral difficulties and diagnoses. We examine associations between these trajectories and profiles with polygenic scores for bipolar disorder (PGSBD), anxiety (PGSANX), depression (PGSDEP), and neuroticism (PGSNEUR).ResultsAssociations between PGSDEP, PGSANX, and PGSNEUR, and emotional and behavioral difficulties in childhood were more persistent than age‐specific across early childhood (1.5–5 years). Higher PGSANX and PGSDEP were associated with steeper increases in behavioral difficulties across early childhood. Latent profile analyses identified five profiles with different associations with emotional disorder diagnosis. All PGS were associated with the probability of classification into profiles characterized by some form of difficulties (vs. a normative reference profile), but only PGSBD was uniquely associated with a single developmental profile.ConclusionsGenetic risk for mood disorders and related traits contribute to both a higher baseline level of, and a more rapid increase in, emotional and behavioral difficulties across early and middle childhood, with some indications for disorder‐specific profiles. Our findings may inform research on developmental pathways to emotional disorders and the improvement of initiatives for early identification and targeted intervention.

BackgroundSchool bullying is a widespread phenomenon across the world, which involves bystanders who take on various roles. Motivation to defend victims is important to investigate because it helps us devise better, evidence-based, anti-bullying interventions.ObjectiveWe aimed to determine whether students’ behavioral and emotional strengths and difficulties and student–teacher relationships were associated with different types of motivation to defend victims of bullying. The hypotheses were (1) emotional and behavioral difficulties will be associated with less autonomous and introjected motivation to defend and greater extrinsic motivation to defend and (2) close student–teacher relationships will be associated with greater autonomous motivation to defend, and less extrinsic motivation to defend.MethodData were collected from 483 Swedish early adolescents who completed a survey in their classrooms.ResultsResults showed that, among boys and girls, close student–teacher relationships were positively associated with autonomous motivation and negatively associated with extrinsic motivation to defend, while negative expectations concerning teachers were associated with all forms of motivation to defend. Emotional and behavioral difficulties were only associated with introjected motivation to defend among girls. Furthermore, extrinsic motivation to defend was associated with the interactions between individual differences in behavioral and emotional difficulties and negative expectations.ConclusionsAdolescents who are more occupied with wanting to have a better relationship with their teachers might be motivated to be involved in good social relationships with others. The results also indicate that closeness in student–teacher relationships is important for greater autonomous motivation to defend victims during bullying.

This study examines the prevalence and correlates of co-occurring suicidal behavior (i.e., attempted suicide) and violent behavior (i.e., involved in a physical fight) in a nationally representative sample of high school students. Analyses were based on cross-sectional data from the 2003 Youth Risk Behavior Survey (YRBS), which includes a nationally representative sample (n = 15,214) of high school students in 9th through 12th grade in the United States. Multinomial logistic regression analyses were conducted to test the associations between demographic characteristics, potential risk factors, and suicidal and violent behavior for students across urban, suburban, and rural settings. Suicidal and violent behaviors were classified into four mutually exclusive groups: (1) both suicidal and violent behaviors, (2) violent behavior only, (3) suicidal behavior only, and (4) no suicidal behavior and no violent behavior. The prevalence of involvement in suicide attempts and physical fighting were similar across urban (4.5%), suburban (5.0%), and rural (3.9%) settings. Sadness, weapon carrying, binge drinking, drug use, and low academic grades were significantly associated with suicide attempts and physical fighting across settings. However, low academic grades were associated only with suicide attempts and physical fighting among urban students. Risk factors for physical fighting only and for suicide attempt only, varied across settings. Prevention programs are needed to reduce co-occurring suicidal and violent behaviors. These programs need to be implemented across urban, suburban, and rural settings and target those risk factors that appear to exacerbate risk for involvement in both physical fighting and suicide attempts.

BackgroundBehavioural and emotional difficulties might play an important role in the development of body image disturbances, which represent serious risk factors for eating disorders or depression. The present study provides a detailed overview on body image disturbances and several behavioural and emotional difficulties (differences between gender, age, and weight status) and their inter-relations in German children and adolescents.MethodsData on body image disturbances, assessed through a Figure Rating Scale, and on behavioural and emotional difficulties, assessed through Goodman’s Strengths and Difficulties Questionnaire (SDQ), were available for 5255 observations of 1982 German children and adolescents aged 8 to 18 years from the LIFE Child study, based in Leipzig, Germany. Associations were investigated using multiple logistic regression. Each association was checked for interaction with gender, age, and weight status.ResultsBoys reported more behavioural difficulties than girls, while girls reported more emotional difficulties. Gender, age and weight status were related to behavioural and emotional difficulties as well as body image disturbances. Individuals with fewer difficulties were more satisfied with their own body. Children and adolescents who desired to be larger showed more prosocial behaviour problems, conduct and emotional problems and more signs of hyperactivity. Those, who desired to be thinner showed more problems in all SDQ-subscales. A more accurate body size perception was associated with fewer behavioural and emotional difficulties. Children and adolescents who overestimated their body size showed more prosocial behaviour and emotional problems. Underestimation one’s body size was associated with more signs of hyperactivity.ConclusionThe current findings highlight the importance of raising the awareness about the association between behavioural and emotional difficulties and body image disturbances in children and adolescents to prevent negative outcomes.

BackgroundMobile health apps are proving to be an important tool for increasing access to psychological therapies early on, particularly with rising rates of anxiety and depression in young people.ObjectiveWe aimed to assess the usability, acceptability, safety, and effectiveness of a new app, Clear Fear, developed to help young people manage symptoms of anxiety using the principles of cognitive behavioral therapy.MethodsThe Clear Fear app was developed to provide cognitive behavioral strategies to suit anxiety disorders. An uncontrolled pre– and post–follow-up design over a 9-week period was used to assess the app and its effects. This study comprised 3 phases: baseline (stage 1), post–app familiarization phase (stage 2), and follow-up (stage 3). Eligible participants were aged between 16 and 25 years with mild to moderate anxiety but not currently receiving treatment or in contact with specialist mental health services or using other interventions or apps to help monitor or manage their mental health. A community sample was recruited via advertisements, relevant websites, and social media networks. Eligible participants completed standardized self-report tools and questionnaires at each study stage. These measured probable symptoms of anxiety (7-item Generalized Anxiety Disorder scale) and depression (Mood and Feelings Questionnaire); emotional and behavioral difficulties (Strengths and Difficulties Questionnaire); and feedback on the usability, accessibility, and safety of the app. Mean scores at baseline and follow-up were compared using paired 2-tailed t tests or Wilcoxon signed rank tests. Qualitative data derived from open-ended questions were coded and entered into NVivo (version 10) for analysis.ResultsA total of 48 young people entered the study at baseline, with 37 (77%) completing all outcome measures at follow-up. The sample was mostly female (37/48, 77%). The mean age was 20.1 (SD 2.1) years. In total, 48% (23/48) of the participants reached the threshold for probable anxiety disorder, 56% (27/48) had positive scores for probable depression, and 75% (36/48) obtained a total score of “very high” on the Strengths and Difficulties Questionnaire for emotional and behavioral difficulties. The app was well received, offering reassurance, practical and immediate help to manage symptoms, and encouragement to seek help, and was generally found easy to use. A small minority (3/48, 6%) found the app difficult to navigate. The Clear Fear app resulted in statistically significant reductions in probable symptoms of anxiety (t36=2.6, 95% CI 0.41-3.53; P=.01) and depression (z=2.3; P=.02) and behavioral and emotional difficulties (t47=4.5, 95% CI 3.67-9.65; P<.001), representing mostly medium to large standardized effect sizes.ConclusionsThe Clear Fear app was found to be usable, acceptable, safe, and effective in helping manage symptoms of anxiety and depression and emotional and behavioral difficulties.

Resilience and stigma in mothers of children with emotional and behavioural difficulties

A longitudinal study of behavioral, emotional and social difficulties in individuals with a history of specific language impairment (SLI)

This work studies the emotional and behavioural difficulties and the personal wellbeing of adolescents under protective measures. The sample is made up of 151 adolescents in residential care between 11 and 17 years of age. The instruments used were the Strengths and Difficulties Questionnaire (SDQ) and the Personal Wellbeing Index (PWI). The results indicate that a high percentage of adolescents have emotional and behavioural difficulties. We found a greater presence of behavioural rather than emotional problems in the adolescents. Similarly, we also found that females showed more emotional difficulties than the males. As for personal wellbeing, the results indicate that the adolescents are dissatisfied in several areas of their life, they feel insecure and have a pessimistic view of their future and of their achievements. Furthermore, those adolescents who were admitted to residential care due to something other than child abuse have a greater prosocial behaviour. It can be concluded that the more difficulties the adolescents experience (emotional, behavioural and with their peers), the lower the perception of their personal wellbeing will be. This study allows us to design interventions aimed at promoting psychological wellbeing among these adolescents.

Self versus maternal reports of emotional and behavioral difficulties in suicidal and non-suicidal adolescents: An Israeli nationwide survey

Since the initiation of the COVID-19 lockdown, Italian parents have been forced to manage their children at home. The present study aimed at investigating the psychological distress of parents during the lockdown, identifying contributing factors. An online survey was administered to 833 participants from 3 to 15 April 2020. Mediation and moderated mediation models were run to explore the association between parent neuroticism and parent distress, mediated by child hyperactivity–inattention and child emotional symptoms, and the moderating effect of living only with child(ren) on the direct and indirect effects of parent neuroticism on parent distress. For parents living only with child(ren), high levels of psychological distress depended exclusively on their levels of neuroticism. For parents living with at least one other person in addition to child(ren), distress levels were also mediated by child behavioral and emotional difficulties. Motherhood emerged as a significant factor contributing to greater distress. Furthermore, parent psychological distress decreased in line with increased child age. The results confirm that neuroticism is an important risk factor for mental health. Preventive measures should be primarily target multicomponent families with younger children and directed towards parents who are already known to present emotional instability and to parents of children who have received local mental health assistance for behavioral and/or emotional difficulties.

The placenta is a key organ for fetal and brain development. Its epigenome can be regarded as a biochemical record of the prenatal environment and a potential mechanism of its association with the future health of the fetus. We investigated associations between placental DNA methylation levels and child behavioral and emotional difficulties, assessed at 3 years of age using the Strengths and Difficulties Questionnaire (SDQ) in 441 mother-child dyads from the EDEN cohort. Hypothesis-driven and exploratory analyses (on differentially methylated probes (EWAS) and regions (DMR)) were adjusted for confounders, technical factors, and cell composition estimates, corrected for multiple comparisons, and stratified by child sex. Hypothesis-driven analyses showed an association of cg26703534 (AHRR) with emotional symptoms, and exploratory analyses identified two probes, cg09126090 (intergenic region) and cg10305789 (PPP1R16B), as negatively associated with peer relationship problems, as well as 33 DMRs, mostly positively associated with at least one of the SDQ subscales. Among girls, most associations were seen with emotional difficulties, whereas in boys, DMRs were as much associated with emotional than behavioral difficulties. This study provides the first evidence of associations between placental DNA methylation and child behavioral and emotional difficulties. Our results suggest sex-specific associations and might provide new insights into the mechanisms of neurodevelopment.

ABSTRACTChildren and young people with intellectual disabilities are more likely to experience emotional, behavioural, or mental health difficulties, including a combination of these health problems. There are risks that existing interventions may not be accessible or effective for this group. This program evaluation explored the effectiveness of child-centred play therapy, a developmentally appropriate mental health intervention, for a single group of 42 children with intellectual disabilities aged 4 to 16 years with emotional, behavioural, or mental health difficulties. The intervention was provided by seven therapists trained in the same play therapy protocol and procedures. Parents rated children's emotional and behavioural difficulties before and after play therapy using the Strengths and Difficulties Questionnaire. Statistically significant improvement to children's prosocial skills, emotional and behavioural difficulties, and the impact of these difficulties on everyday life was found at the completion of child-centred play therapy. Children with high-priority referral needs were found to have made greater levels of change. However, with increasing severity of difficulties, children required more time in therapy. A higher level of play therapy training predicted greater prosocial skill development for children and a reduced impact of difficulties on their daily life. This evaluation demonstrated that play therapy may be an effective intervention to use with children with intellectual disabilities and emotional and behavioural difficulties, and warrants further consideration for research and practice by the disability and mental health sectors.

Research on adolescents suggests that decision-making styles, emotional experiences, and life satisfaction play a crucial role in emotional and behavioral difficulties and the development of prosocial behaviors. This study analyzed the relationship between decision-making styles, prosociality, and difficulties among adolescent offenders, as well as the mediating role of life satisfaction and emotional experiences in this relationship. A total of 457 adolescents aged from 14 to 19 years (M = 16.23; S.D. = 1.31; 32.2% female) participated in this study. The variables of interest were assessed using self-reports and descriptive, reliability, correlational, predictive, and mediation analyses were performed. A significant association was found between the study variables. Non-rational decision-making styles and negative emotional experiences influenced difficulties, whereas rational decision-making, life satisfaction, and positive emotional experiences influenced prosocial behavior. Furthermore, the results show that the relationship between rational decision-making and prosocial behavior is mediated by life satisfaction, emotional balance, and positive emotional experiences. Similarly, negative emotional experiences mediated the relationship between a hypervigilance decision-making style and emotional and behavioral difficulties. The results of this study indicate the importance of intervening in decision-making styles, emotional management, and life satisfaction in offending adolescents to decrease behavioral and emotional difficulties and favor prosocial behavior.