Anxiety In Children Research Articles

Comparative evaluation of three different behavior management techniques among children aged 6-12 years in dental practice: A single-center, double-blind, randomized controlled trial.

Dental anxiety is characterized by distress in anticipation of dental visits, which may result in a child's refusal to undergo treatment and, ultimately, lead to parents' reluctance towards dental care. The aim of this study was to evaluate and compare the effectiveness of the tell-show-do technique, modeling technique and yogic relaxation technique in the reduction of dental anxiety among children aged 6-12 years. The study was an interventional, parallel-group, single-center, double-blind, randomized controlled trial conducted on 120 children who required restorative treatment without the use of local anesthesia. The participants were selected based on specific inclusion and exclusion criteria and were randomly divided into 3 groups: group 1 - tell-show-do technique; group 2 - modeling technique; group 3 - yogic relaxation technique. The dental anxiety levels were evaluated 4 times using both physiological (oxygen saturation and pulse rate) and behavioral parameters (facial image scale (FIS) and the Face, Legs, Activity, Cry, and Consolability scale (FLACC)). The data was assessed by 2 blinded and calibrated specialists. Statistically significant differences were observed in all 4 parameters among the 3 groups. During both the intraoperative and postoperative periods, the oxygen saturation levels were significantly higher in the yogic relaxation technique group. Moreover, the yogic relaxation technique group exhibited lower pulse rates, FIS and FLACC scores compared to the tell-show-do and modeling technique groups. The practice of yoga has a positive influence on the general health of the individual. Consequently, it can be considered one of the alternative behavioral modification techniques for the reduction of dental anxiety in children.

Adverse Childhood Experiences, Perceived Discrimination, and Mental Health in Sexual and Gender Minoritized Adults: Comparing Stress Accumulation and Stress Sensitization Models.

Purpose: The purpose of this study was to assess the relationship between adverse childhood experiences (ACEs) exposure, perceived discrimination, and anxiety and depressive symptoms in sexual and gender minoritized (SGM) adults in the United States. Methods: Respondents (n = 4445) from a national Qualtrics research panel completed a web-based survey. Guided by the stress proliferation (mediation model) and stress sensitization (moderation model) models, we examined the relationships between ACEs and perceived discrimination and the severity of anxiety and depressive symptoms in adulthood. Results: Cumulative ACEs exposure was positively associated with everyday discrimination scale (EDS) scores. ACEs and EDS scores had a significant direct association with anxiety and depressive symptoms. We found support for EDS as a mediator for anxiety (β = 0.12, p < 0.001) and depressive symptoms (β = 0.14, p < 0.001) and for ACEs as a moderator of the relationship between EDS and anxiety (β = -0.04, p = 0.004) and depressive (β = -0.05, p = 0.001) symptoms. Conclusions: These findings suggest that both stress proliferation and stress sensitization likely contribute to disparities in anxiety and depressive symptoms in SGM adults. This finding supports the integration of social safety and minority stress perspectives regarding health disparities in SGM populations. Exposure to early life adversity likely alters neurodevelopment, which in turn increases awareness of the lack of social safety in adulthood, reduces capacity to cope with minority stress exposure, and ultimately contributes to increased anxiety and depressive symptoms. Prevention efforts should focus on building positive and compensatory childhood experiences.

Mental health among parents and their children with eczema in Hong Kong.

This cross-sectional survey research investigated mental health symptoms and quality of life among Chinese parents and their children with eczema at a paediatric dermatology clinic in Hong Kong from November 2018 to October 2020. Health-related quality of life, eczema severity, and mental health among children with eczema, as well as their parents' mental health, were studied using the Children's Dermatology Life Quality Index (CDLQI), Infants' Dermatitis Quality of Life Index (IDQOL), Nottingham Eczema Severity Score (NESS), Patient-Oriented Eczema Measure (POEM), and the Chinese version of the 21-item Depression, Anxiety, and Stress Scales (DASS-21). In total, 432 children and 380 parents were recruited. Eczema severity (NESS and POEM) and health-related quality of life (CDLQI) were significantly positively associated with parental and child depression, anxiety, and stress levels according to the DASS-21, regardless of sex (children: r=0.28- 0.72, P<0.001 to 0.007; parents: r=0.20-0.52, P<0.001 to 0.034). Maternal depression was marginally positively associated with increased anxiety in boys with eczema (r=0.311; P=0.045). Younger parents had higher risk of developing more anxiety and stress compared with the older parents (adjusted odds ratio [aOR]=-0.342, P=0.014 and aOR=-0.395, P=0.019, respectively). Depression level of parents with primary to secondary education was 58% higher than their counterparts with post-secondary education or above (aOR=-1.579; P=0.007). Depression, anxiety, and stress among children with eczema and their parents were associated with eczema severity and impaired quality of life in those children. These findings regarding impaired mental health in children with eczema and their parents highlight the need to include mental well-being and psychosocial outcomes in future studies and clinical practice.

Childhood violence exposure and anxiety and depression of children and adolescents

BackgroundMental disorders constitute a global public health problem worldwide and occurs in childhood and lasts to adulthood. The purpose of this study was to explore the association between childhood violence exposure and currently diagnosed depression and anxiety in children and adolescents and investigate whether the association differs by sex and age. MethodsThis cross-sectional study used data from 2017 to 2021 National Survey of Children's Health (NSCH). Childhood violence exposure and anxiety or depression of children were reported from caregivers. Logistic regression analyses and subgroup analyses were conducted to assess the association between the childhood violence exposure and anxiety and depression. ResultsThis study included 113,400 participants aged 6 to 17 years (weighted mean [SD] age, 11.5 [3.4] years; 54,539 females [weighted proportions, 48.9 %]). 9603 of them (weighted proportions, 9.0 %) had childhood violence exposure. Childhood violence exposure was associated with higher risks of anxiety (adjusted risk difference: 7.8 %, 95%CI: 6.3–9.3 %; adjusted OR: 2.11, 95%CI: 1.87–2.39) and depression (adjusted risk difference: 6.2 %, 95%CI: 5.1–7.4 %; adjusted OR: 2.94, 95%CI: 2.54–3.41) after full adjustment. Stratified analyses demonstrated that the association appeared to be stronger in younger children and the association between violence exposure and anxiety was stronger in females than in males. ConclusionIn this cross-sectional study, childhood violence exposure was significantly associated with higher risks of anxiety and depression. The associations appeared to be stronger in younger and female children. Differences in sex and age-specific associations highlight the importance of building age-specific and sex-specific patterns of childhood violence prevention and intervention.

Reduction of Dental Anxiety in Children Using Virtual Reality: A Randomised Controlled Trial.

The aim of this research is examining the effectiveness of Virtual Reality (VR) in the reduction of dental anxiety in children with novel methods. The three arm parallel-group randomised clinical study was conducted in children aged 6-10 years. Pulpotomy procedure was performed on randomised 90 selected children (n=30 in each group; AG: group applied active distraction using VR glasses, PG: group applied passive distraction, i.e., watching cartoons on a screen mounted onto a dental unit, CG: control group). Before and after the procedure, children were administered Facial Pain Scale (FIS), Children's Fear Rating Scale (CFSS-DS) and Frankl Behaviour Rating Scale (FBRS). The pulse rate was measured to check the anxiety levels of all treated children at five different time points. Statistical significance was determined as p<0.05. VR has been found to positively contribute to the performance of children in adapting to dental treatment. The VR application aims to create positive attitude in children by providing them a safe atmosphere and becoming a useful tool in the dental profession.

Assessment of dental anxiety in children using different methods

Assessment of dental anxiety in children using different methods

Oops, we missed a spot: Comparing data substitution methods for non-random missing survey data in a longitudinal study

Imputation methods for missing data may not always be applicable, namely, when the data were completely missing for the whole sample. To estimate the missing data, we compared three missing item substitution methods: (1) mean substitution; (2) last observation carried forward (LOCF); and (3) regression-predicted values. A total of 384 parents reported their 8- to 18-year-old children's anxiety level using the 9-item Screen for Child Anxiety Related Disorders at baseline (Time 1) and two later time points, drawing from a larger longitudinal study (Ontario COVID-19 and Kids' Mental Health Study). We predicted a survey item measured one month after baseline (Time 2) using: (1) the mean value of the rest of the test items; (2) the value of the same item measured at baseline; and (3) the predicted value from the linear regression with all other test items as predictors. Within-Subjects ANOVA results showed a main effect of substitution methods on total score at Time 2. Post-hoc analysis indicated that mean substitution was significantly different from the actual data. Regression-predicted values overestimated the median compared to the actual values, while the LOCF estimation produced comparable means and identical medians. Similar results were found while using other indicators and extending the analysis to a larger 4-month time interval (Time 3), suggesting LOCF is more accurate and reliable than mean substitution or regression-prediction. This study proposes when advanced substitution methods are not applicable, a systematic comparison of alternative methods may help researchers to arrive at a more informed decision in data processing.

Assessment of anxiety symptoms in children and adolescents: Italian validation of the short version of the spence children's anxiety scale for parents.

The assessment of anxiety symptoms in children and adolescents requires a valid and reliable single instrument able to detect various anxiety symptoms early and systematically collect data from other informant such as parents. The present study aimed to test the one-factor structure of the SCAS-P-8 and to examine its psychometric properties and invariance across sex and age in an Italian sample of 769 parents of children and adolescents aged 3-18years (50.8% females). Confirmatory factor analysis confirmed the one-factor structure of the SCAS-P-8, which showed good reliability and invariance by sex and age. When examining mean differences by sex and age, results showed that female schoolchildren had higher anxiety scores than males and other age groups. A strong correlation with emotional problems demonstrated convergent validity, while discriminant validity resulted from the weak correlations with externalizing symptoms and relationship problems with peers. Overall, findings support the SCAS-P-8 as a valid brief instrument to assess anxiety symptoms in children and adolescents for clinical and research purposes and demonstrate its invariance across sex and age.

Impact of supplementation with omega-3 fatty acids after maternal dietary deficiency on adolescent anxiety and microglial morphology.

Dietary maternal deficiency in omega-3 polyunsaturated fatty acids (n-3 PUFA) is a potential risk factor for the development of anxiety and other mood disorders in children and adolescents. Here, we used a previously characterized maternal n-3 PUFA dietary deficiency model in rats to determine the impact of postweaning supplementation on adolescent anxiety-like behaviors. We focused on two models of anxiety: innate anxiety tested by the elevated plus maze and a novel operant model of learned anxiety where animals learn that actions may be associated with a variable probability of harm. Given that recent basic and clinical studies have associated anxiety and other adverse effects of n-3 PUFA deficiency on inflammatory processes and microglial structure and function, we also assessed the impact of our dietary deficiency model and supplementation on adolescent microglial morphology in multiple brain regions. We found that the male and female adolescent n-3 PUFA-deficient groups exhibit increased innate anxiety, but only females showed enhanced learned anxiety. Supplementation after weaning did not significantly affect innate anxiety but ameliorated learned anxiety in females. Thus, the beneficial effects of supplementation on adolescent anxiety may be sex-specific and depend on the type of anxiety. We also found that n-3 PUFA deficiency influences microglia function in adolescents in the amygdala and nigrostriatal, but not mesolimbic, brain regions. Collectively, these data suggest that while n-3 PUFA dietary supplementation may be effective in reducing adolescent anxiety, this effect is context-, sex-, and brain network-specific. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Catatonia in autism spectrum disorders: Prevalence, functional impact, and diagnostic insights

The current study aimed to evaluate subtle catatonia behaviors and functionality in adolescents with autism spectrum disorders (ASD). The sample consisted of 48 patients (11 female, 37 male) aged 12–18 (13.77 ± 2.01). DSM-5 catatonia criteria and Bush-Francis Catatonia Rating Scale (BCRS) was utilized to assess catatonia, while the impairment in functionality was appraised using the Global Assessment Scale. Parents fulfilled the Revised Child Anxiety and Depression Scale-Parent version (RCADS-PV) and Repetitive Behavior Scale-Revised (RBS-R). The presence of catatonia was detected in 18 out of 48 (37.5 %) participants according to BCRS, and in 16 cases (35.4 %) according to DSM-5 criteria. A significant association between two diagnostic tools was observed (p < 0.001). In the group with mild impairment in functionality, 2 cases had catatonia (12.5 %), while in the group with more impaired functionality, 16 cases (50 %) had catatonia (p = 0.011) according to BCRS. Major depressive disorder subscale scores of RCADS-PV and stereotypic movements (RBS-R) were correlated with the presence of catatonia (p < 0.05). The findings suggest a higher prevalence of catatonia in ASD, and a potential correlation between the presence of catatonia and functionality. More research is warranted to highlight the presence and course of catatonia beginning from the early years of ASD.

Play therapy: An effective approach to reduce anxiety in children with cancer

Cancer poses a significant challenge to public health worldwide and ranks as the second most common cause of death in children. Approximately 300,000 cases of cancer are diagnosed among children aged 0 to 19 every year [1]. The incidence of childhood cancer is increasing all over the world. A cancer diagnosis can cause serious psychological problems because cancer and admission to the hospital increase the feeling of pain, anxiety, and fear of death [2]. Children diagnosed with cancer often experience severe and persistent anxiety, which can have long-term effects on their well-being. The stress of being hospitalized, coupled with the limited understanding of their illness by medical professionals, the lack of effective coping strategies, and the pain resulting from invasive procedures and treatment regimens, all contribute to the anxiety experienced by these young patients [3].

SPECIFICITY OF CHILDREN'S SOCIALIZATION IN COMPLETE AND PARENT FAMILIES

The article describes the specifics of the socialization process of children in complete and incomplete families. The research is based on the use of various methods: parental surveys and psychological tests. The main goal was to determine the level of anxiety in children and their individual characteristics influencing the socialization process.The study showed that children from incomplete families are characterized by a higher level of anxiety than children from complete families. During the study of personality traits of children according to R. Kettell's questionnaire, it was found that most children living in incomplete families and for various reasons raised by one parent show significant differences in some traits and behaviour, which may result from the fact that they have an incomplete picture of the family environment, unlike children from complete families. Such traits as emotional stability, normative behaviour and self-control are not characteristic of this category of children.The projective technique "My Family" made it possible to assess the specifics of relations between children and members of complete and incomplete families. Analysis of the research results showed that children with behavioural disorders more often appear in the drawings of children who have experienced a divorce of their parents than children in harmonious interpersonal interaction with their parents. The questionnaire "Analysis of family relations" (Eidemiller, Yustyckis) allowed to diagnose dysfunctions in the system of mutual influence of family members on each other and to detect errors in the parenting style chosen by the parents. Analysis of the answers of complete and incomplete families surveyed using this method and their comparison with the description of parenting styles allows to state that in incomplete families the features of excessively dominant care, excessive protection and excessive indulgence, emotional alienation prevail. Parents who raise their children separately or alone most often choose an "indulgent" parenting style.

Effectiveness of Valsalva Maneuver on Pain Intensity and Anxiety in Children Undergoing Hemodialysis

Effectiveness of Valsalva Maneuver on Pain Intensity and Anxiety in Children Undergoing Hemodialysis

Study protocol for a pragmatic randomised multiple baseline trial evaluating Knowledge Insight Tools (KIT), a cognitive behavioural therapy-informed school-based counselling intervention for children and young people in UK secondary schools with low mood and anxiety.

There is a pressing need to offer more accessible, evidence-based psychological interventions to secondary school students who are increasingly reporting difficulties with anxiety and low mood. The aim of this pragmatic randomised multiple baseline trial is to evaluate the efficacy of a school-based counselling intervention called Knowledge Insight Tools (KIT) for reducing anxiety and low mood in UK secondary school students. KIT is a flexible intervention delivered individually and informed by cognitive behavioural therapy (CBT). We will use a randomised multiple baseline design whereby young people will be randomly allocated to a baseline wait period of 3, 4, 5, 6, 7, or 8 weekly measurements, followed by receiving up to 10 weekly sessions of KIT delivered by trained, school-based practitioners. We aim to recruit 60 young people aged 11-18 who are primarily experiencing problems with low mood and/or anxiety from secondary schools across England and Scotland. We will assess child-reported anxiety, mood, and general psychological distress/coping with the Young Person's Clinical Outcomes in Routine Evaluation (YP-CORE), recorded at each session during the baseline and intervention phases. We will also assess child-reported anxiety and low mood with the Revised Children's Anxiety and Depression Scale (RCADS) at the beginning and end of treatment; practitioner-reported treatment fidelity with the KIT Fidelity Checklist; and practitioner-reported feasibility with an end-of-treatment Implementation Survey. We will analyse within-person and between-person change in YP-CORE scores across the baseline and intervention phases using visual analysis and piecewise multilevel growth curve models. We will also analyse pre-post changes in YP-CORE scores using randomisation tests, and reliable and clinically significant change using the RCADS scores. The KIT trial is a pragmatic, randomised multiple baseline trial aimed at evaluating a school-based, individual CBTcounselling intervention for reducing anxiety and low mood in UK secondary school students. Results will directly inform the provision of KIT in school-based counselling services, as well as the growing evidence-base for school-based CBT interventions. ClinicalTrials.gov NCT06188962. Retrospectively registered on 02/01/24.

Effectiveness of Joint Attention Training on Basic Social Communication, Anxiety and Executive Functions of Children with Autism Spectrum

Introduction: The aim of this study was to investigate the effectiveness of joint attention training on basic social communication, anxiety and executive functions of children with autism. Methods: The research design was quasi-experimental and pre-test and post-test with control group. The statistical populations of children with autism spectrum were referred to the psychiatric and psychological centers in Urmia City during the year 2021-2022. 30 individuals (15 ones from the shared attention group and 15 from the control group) were selected as a statistical sample using the available and targeted method. Data via questionnaires of basic social communication (Zabov, 2010), anxiety (Spence, 1999), executive functions of the parents' brief form (Balster Gerard et al., 2000) were collected during the intervention therapy method of joint attention training (Vakilizad and Abedi, 2015) (12 sessions, 3 days a week, each session was an hour and a half, each session was divided into 3 parts of 25 minutes with a 5 minute break for the child). Then the data were analyzed with Software SPSS V. 16 and multivariate analysis of covariance test. Results: The results showed that joint attention training increased basic social communication and executive functions and reduced anxiety in children with autism spectrum. The differences between the investigated groups and the conducted tests were significant (P≤0.01). Conclusion: Interventional treatment methods such as joint attention training should be developed for the treatment of autistic patients, so that with the help of these methods, the individual and collective life of these patients can be improved.

Longitudinal interactions between maternal depression symptoms and familial stressful life events on child anxiety symptoms at 5years of age.

In the current study we identified salient parental factors for child anxiety symptoms by considering the role of stressful life events, maternal anxiety symptoms, maternal depressive symptoms, and maternal neuroticism. Families (N=399) in an urban area in the United States were participants in a longitudinal study beginning in infancy. Mothers completed measures of stressful life events (Revised Life Events Questionnaire at all visits), maternal anxiety and depressive symptoms (State-Trait Anxiety Inventory and Beck Depression Inventory, respectively, at infancy between 5 and 12months, at 2years, and at 3years), maternal neuroticism (NEO Five-Factor Inventory at infancy), and child anxiety symptoms (Child Behavior Checklist 1.5-5 at 5years). Linear mixed models (LMMs) were used in analyses. Maternal depressive symptoms from infancy through 3years were associated with child anxiety symptoms; other main effects modeled (stressful life events, maternal anxiety symptoms, maternal neuroticism) were not associated with child anxiety symptoms. There was a significant interaction effect between stressful life events and maternal depression. Stressful events from infancy through 5years of age increased risk for child anxiety symptoms at 5years if the child's mother had a mild mood disturbance or depression, but not for children with non-depressed mothers.

Childhood Maltreatment Associated with Anxiety and Depression and Complex PTSD Symptoms.

Childhood maltreatment has great impact on physical and mental health. This study was designed to investigate the relationship between childhood maltreatment experience, social support, Anxiety and Depression, and traumatic stress symptoms in adults. There were 113 subjects aged 20-35 recruited. They filled out self-reported questionnaires, including the Childhood Trauma Questionnaire Short Form (CTQ-SF), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-II), International Trauma Questionnaire (ITQ), Chinese version of the PTSD Checklist for DSM-5 (PCL-5), and Multidimensional Scale of Perceived Social Support (MSPSS), to measure symptom severity regarding childhood maltreatment, Anxiety and Depression, post-traumatic stress/complex post-traumatic stress symptoms (PTSD/CPTSD), and social support. The symptom severity was compared between maltreatment and non-maltreatment groups. Regression and mediator analyzes were done to investigate the relationship between maltreatment experience, mental impact severity, and the role of social support. There were 74.3% of participants who had been maltreated as children. Those who experienced maltreatment had more PTSD/CPTSD symptom severity than those who did not. Family support, but not friend support, mediated the relationship between maltreatment and PTSD/CPTSD symptom severity. Childhood maltreatment was associated with Anxiety and Depression and CPTSD symptom severity in young adults. Future prospective studies are warranted to investigate the role of family support in preventing consequences after maltreatment.

The Influence of Temperament, Theory of Mind, Inhibitory Control, and Prosocial Behavior on Child Anxiety Symptoms in the First Five Years of Life.

Anxiety disorders are among the most prevalent of all mental health disorders, often originating in early childhood and extending into later childhood, adolescence, and adulthood. Determining salient risk factors that precede their development is important for prevention and intervention efforts. Towards this end, we examined the role of temperament, theory of mind, inhibitory control, and prosocial behavior on child anxiety symptoms in the first 5years of life. A community sample of children and their parents (N = 399) enrolled in a longitudinal study of emotion processing were assessed when the children were infants and at ages 2years, 3years, and 5years. Linear mixed models and linear regression models revealed that greater anxiety at 5years was associated with greater negative affectivity and behavioral inhibition, lower effortful control, lower theory of mind scores on the "desires" domain, and higher scores on the "intentions" domain (assessed from infancy to 3years of age). These characteristics may be useful to assess in clinical settings to evaluate a patient's risk for developing anxiety. They may also be useful in developinginterventions targeting specific vulnerabilities.

The Effect of Finger Puppet Play on Pain and Anxiety during Peripheral Vascular Opening Attempts in Preschool-age Children during Emergency Room Visits: Randomized Controlled Study

Objective: The pupose of this study is to examine the effect of finger puppet play on pain and anxiety during peripheral vascular access in preschool-age children in the emergency room. Design and methods: The study was conducted in a randomised controlled manner. The study population consisted of children aged 4–6 years who came to the paediatric emergency room of a hospital in Turkey between 25 May and 25 June 2022. The sample consisted of 97 children who met the research criteria between these dates (49 in the control group, 48 in the finger puppet play group). Stratification and block randomisation methods were used to determine the experimental and control groups.The data were collected with the Survey Form, Child Fear and Anxiety Inventory (CFAI) and Wong-Baker Facial Expression Rating Scale (WB-FAS) through interviews conducted by the researchers. Finger puppet play was shown to the experimental group during the procedure. Results: In the experimental and control groups, the child's pain and anxiety were evaluated by the child, parent, and researcher before the procedure, and similar pain and anxiety values were found from each source (p&gt;0.05). During the procedure, the child's pain and anxiety were evaluated by the child, the parent, and the researcher, and it was found that the children in the finger puppet game group experienced significantly less pain and anxiety than the children in the control group (p &lt; 0.05). Results: According to these results, the application of finger puppetry to children aged 4–6 years undergoing peripheral vascular access was effective in reducing pain and anxiety.

Effectiveness of Deep Breathing Relaxation on Anxiety Due to Hospitalization in Preschool Age Children

Hospitalization in preschool children causes them to lose control over their environment, resulting in psychological and physical distress, characterized by panic, phobia, obsessive, compulsive, and generalized anxiety disorders. Objective: This study aims to analyze the effectiveness of Deep Breathing Relaxation. on hospitalization anxiety. Method: This study is a quantitative study with a quasi-experimental design of two groups pre and posttest. The sample of this study was preschool children who underwent hospitalization as many as 32 children. This study used the Preschool Anxiety Scale (PAS) instrument which is of international standard with proven validity (r=0.68) and reliability (0.87). The bivariate data analysis used the Wilcoxon test for the intervention group, the Paired T Test for the control group, and Man Whitney test for comparison of intervention group with control, and N-Gain test to see the effectiveness of the intervention. Result: The results of the study showed that hospitalization anxiety in children before Deep Breathing Relaxation averaged 65.75 with the lowest score of 32 and the highest 79 (SD: 13.394). After the intervention, the children's anxiety score decreased, namely an average score of 53.69, the lowest score of 27 and the highest 66 (SD: 12.877). There was a significant difference between the intervention group and the control group with a p value of 0.038 (&lt;0.05), but the N-Gain results showed that the intervention was in the ineffective category (N-Gain: 20.46%).