Behavioral Problems Research Articles

Toward Compassion in the Assessment and Treatment of Severe Problem Behavior

Toward Compassion in the Assessment and Treatment of Severe Problem Behavior

Gestational phthalate exposure and behavioral problems in preschool-aged children with increased likelihood of autism spectrum disorder

BackgroundExperimental studies have shown associations between gestational phthalate exposure and behavioral problems among offspring; however, epidemiological evidence is still mixed. This study aims to investigate whether gestational phthalate exposure is associated with behavioral problems in preschool-aged children. MethodsParticipants include 178 mother-child pairs from MARBLES (Markers of Autism Risk in Babies – Learning Early Signs), a cohort with high familial likelihood of autism spectrum disorder (ASD). We quantified 14 phthalate metabolites in multiple maternal urine samples collected during the 2nd and 3rd trimesters. Preschool behavior problems were assessed using the Child Behavioral Checklist (CBCL), a standardized instrument for evaluating behavior problems of children aged 1.5–5 years. To examine associations of CBCL scores with both individual phthalate biomarker concentrations and their mixture, we used negative binomial regression and weighted quantile sum regression. ResultsOverall, maternal phthalate biomarker concentrations were not associated with child behavior problems. Monoisobutyl phthalate (MiBP) concentrations were inversely associated with child anxious/depressed symptoms and somatic complaints. Mono-hydroxy-isobutyl phthalate (MHiBP) and monobenzyl phthalate (MBzP) were also inversely associated with somatic complaints. When assessing trimester-specific associations, more behavior problems were associated with the 2nd trimester biomarker concentrations: mono(3-carboxypropyl) phthalate (MCPP) and monocarboxyisononyl phthalate (MCNP) were positively associated with somatic complaints. All associations became non-significant after false discovery rate correction. No association between a mixture of phthalates and CBCL scores was found. ConclusionsOur study observed no clear evidence of gestational phthalate exposure on child behavior problems. However, our findings based on the biomonitoring assessment of multiple samples per participant could improve our understanding of gestational phthalate exposure in association with behavior problems in preschool-aged children.

Exploring the Utility of the Limited Prosocial Emotions Specifier for Subtyping Conduct Problems and Oppositional Defiant Problems: A Multi-informant Study.

This study aimed to assess the clinical utility of the "Limited Prosocial Emotions" (LPE) specifier in subtyping conduct problems (CP) and oppositional defiant problems (ODP) among two samples including 1203 parent-child dyads and 1,937 school-attending youths in Iran. The prevalence of LPE across the entire sample, as well as subsamples of youths with clinically elevated levels of CP and ODP, were examined. CP + LPE individuals scored significantly higher than CP-Only youths on several measures of externalizing psychopathology and depression, although these findings were not fully consistent across informants. Several anticipated differences in measures of aggression and antisocial behavior were not found. Also, no significant group differences were observed between the ODP + LPE and ODP-Only groups concerning externalizing and internalizing psychopathology. In the total sample, youths with LPE scored significantly higher in measures of externalizing and internalizing psychopathology than those without LPE, though the magnitude of these differences was in small ranges. Overall, the findings provide only limited support for the clinical utility of the LPE specifier for CP and none whatsoever for ODP.

The Behavior Problem Inventory-Short Form: Psychometric Properties in a Spanish Sample of Intellectual Disabilities.

Behavioural problems in individuals with intellectual disabilities have a negative impact on them. Limited assessment measures exist in Spain. This study aimed to validate the Behavior Problems Inventory-Short Form (BPI-S) in the Spanish population by examining its psychometric properties and factorial structures. This study included 458 individuals with intellectual disabilities evaluated by 137 professionals. The validity and reliability of the scale were examined. The validity of the measurement tool confirmed a three-factor model. Significant correlations were observed between problem behaviours and maladaptive behaviour indicators, with negative associations found between problem behaviours and adaptive behaviour scores. The Spanish version of the BPI-S demonstrated good internal consistency and convergent and discriminant validities. The most common behaviours were identified, and the scale was refined to 28 items. The three-factor model showed an acceptable fit. Further research is required to establish clinical norms and explore the factorial structures.

Autism in Children

Austic spectrum disorder is a very common presentation where children present with social communication difficulties. They can have behavioural problems and other times anxiety. Every autistic child is different and they may come anywhere in the autistic spectrum, ranging from sensory difficulties, social adjustment to food, sleep and concentration challenges. The main aim of this article to bring awareness about autism to the society and to give Austic children help and support to be able to maintain a safe and healthy lifestyle. It is very important to involve a health care practitioner and get the necessary care and advice from the doctor. It is equally important to organize fun interactive games, activities and book reading for children with Autism to help and support them with their difficulties. All of these things can be done with family support and encouragement, however, it can be very challenging and Children with Autism need professional diagnosis, support in community and teachers to guide them.

Utilization of home-based care and its buffering effects between dementia caregiving intensity and caregiver burden in China.

Home-based care (HBC) services have gained global attention for their potential to reduce caregiver burden among informal caregivers of persons with dementia (PwDs), who experience high caregiving intensity. However, research on HBC and its effects on dementia caregiving in China remains limited. Data were collected from primary caregivers of PwDs in Jiangsu Province, China. Caregiving intensity and HBC utilization were measured using self-developed instruments. Caregiver burden was assessed by The Burden Scale for Family Caregivers-short. Factor analysis was employed to decompose HBC services. Hierarchical multiple regression analysed the moderating effects of HBC on the relationship between caregiving intensity and burden. A community sample of 318 caregiver and PwDs dyads was included. Caregivers averagely aged 62.16 years, with 61% being female, 84% not employed, and 66.2% having low income. PwDs aged 77.45 years averagely, with 52.8% being female and an average behavioural problems score of 42.27. Caregivers averaged 15.19 on response measures. The number and time spent on ADL-based tasks were positively associated with caregiver burden (β = 0.26, p < .001; β = 0.16, p < .01). However, attendance and time of supervision tasks were not significant predictors of burden. HBC services in China comprised four dimensions: Referral service, Household care, Skilled care, and Mental health service. While these did not directly predict caregiver burden, they moderated the associations between ADL-based tasks and caregiver burden (β=-0.25, p < .001; β=-0.24, p < .001; β=-0.23, p < .001; β=-0.20, p < .001), between time of ADL-based tasks and caregiver burden (β=-0.17, p < .001; β=-0.18, p < .001; β=-0.17, p < .001; β=-0.15, p < .01), and between the attendance at supervision tasks and caregiver burden (β=-0.11, p < .05; β=-0.20, p < .001; β=-0.17, p < .001; β=-0.17, p < .001). Only Referral service buffered the relationship between supervision time and caregiver burden (β = -0.13, p < .01). Informal caregivers of PwDs face high caregiving intensity and burden. HBC services may moderate this relationship, with different services playing varying roles. Further research is essential to explore the impact of supervision levels and develop effective strategies to enhance HBC services for dementia caregiving in China.

Service Providers' Perceptions of Psychological, Emotional, and Behavioral Issues Among Children and Adolescents During COVID‐19 in South Korea

ABSTRACTVarious emotional and psychological support services for children and adolescents were implemented in South Korea during the COVID‐19 era. However, little is known about the limitations and future directions of current support services from the perspective of service providers. The purpose of this study was to explore service providers' perspectives on emotional and psychological support services for children and adolescents. The present study purposively recruited 11 clinical practitioners providing support services for children and adolescents to conduct semistructured focus group interviews. Thematic analysis identified four major themes: (a) a noticeable increase in problematic behaviors among children and adolescents (e.g., intrinsic and extrinsic problem behaviors); (b) changes in service use patterns (e.g., increased non‐face‐to‐face services); (c) frustrations with inadequate support systems (e.g., the absence of qualified professionals); and (d) identifying future directions (e.g., improving awareness of support services). The findings highlight the necessity of enhancing awareness of how to access services by reducing stigma. The findings also emphasize the need for improved cooperation between public and private facilities, as well as a greater number of skilled professionals to provide high‐quality programs. The practical and political implications are discussed based on the findings.

Emotional and behavioral problems are associated with hypothalamic development from childhood to adolescence: Findings from a longitudinal cohort study

BackgroundDespite the pivotal role of the hypothalamus in regulating various physiological processes, our understanding of its developmental trajectory and subregional organization during childhood and adolescence remains limited, as well as how emotional and behavioral problems can impact hypothalamic development, potentially leading to neurodevelopmental disorders. MethodsThis population-based longitudinal cohort study utilized data from a representative sample of 702 children, who were followed two to five times. Emotional and behavioral problems were assessed using the Strengths and Difficulties Questionnaire (SDQ). Linear mixed models were employed to delineate developmental trajectories and behavioral regulation. ResultsUsing an automated segmentation technique, we quantified the volumes and asymmetries of the hypothalamus and its subregions in a large longitudinal sample of 702 subjects aged 6–15 years with 1371 MRI scans, and mapped their developmental trajectories. Our findings indicate that while the anterior and posterior regions of the hypothalamus exhibit a tendency toward decline, the tubular region demonstrates a linear increase which is influenced by lateralization, sex, and intracranial volume. Furthermore, emotional and behavioral problems - particularly emotional symptoms and peer relationship problems - are related to faster development in superior tubular and anterior-superior regions. ConclusionsIn this study, we initially delineated the developmental trajectories of the hypothalamus and its subregions from childhood to adolescence based on a longitudinal cohort study. Our findings revealed that the development of hypothalamus followed the pattern of “lateral early to medial late, and dorsomedial early to ventromedial late”, and the emotional and behavioral problems are associated with faster hypothalamic development. This study provides preliminary evidence regarding the impact of emotional and behavioral problems on the dynamic development of the hypothalamus, offering a crucial foundation for future prevention and intervention strategies targeting cognitive and emotional behavioral problems.

The Impact of Maternal Childhood Trauma on Children's Problem Behaviors: The Mediating Role of Maternal Depression and the Moderating Role of Mindful Parenting.

This study investigates the impact of maternal childhood trauma on children's problem behaviors, focusing on the mediating role of maternal depression and the moderating role of mindful parenting. The study used a convenience sampling method to survey 385 mother-child pairs from kindergartens in Jinan, China. Data were collected in two waves, and various validated questionnaires were used to assess maternal childhood trauma, depression, mindful parenting, and children's problem behaviors. Maternal childhood trauma positively predicted children's problem behaviors. Maternal depression was found to mediate this relationship. Mindful parenting moderated the effects of maternal childhood trauma and depression on children's problem behaviors, with high levels of mindful parenting mitigating these adverse effects. Maternal childhood trauma impacts children's problem behaviors both directly and indirectly through maternal depression. Mindful parenting serves as a protective factor, reducing the negative impact of maternal childhood trauma and depression on children's problem behaviors. These findings highlight the importance of interventions aimed at enhancing mindful parenting practices to improve child outcomes.

The effectiveness of group play therapy using sand on social skills and behavioral problems of 5-9-year-old children in Tehran

This research was conducted with the aim of investigating the effectiveness of group play therapy using sand on children's social skills and behavioral problems. The statistical population included all children aged 5 to 9 years in Tehran in 1403, and among them 30 students were selected by available sampling according to the entry criteria and placed in two experimental and control groups. Then, at first, the subjects were measured by Babadi and Meshkani's life skills questionnaire (1389) and Shahim and Yousefi's children's behavioral problems questionnaire (1378) and after receiving group play therapy training using sand according to the protocol, the subjects again They completed the questionnaires. The research findings were analyzed by SPSS software using covariance analysis method and the results indicated the high effectiveness of group play therapy using sand on improving social skills and reducing children's behavioral problems

Changes in Rest-Activity Rhythms in Adolescents as They Age: Associations With Brain and Behavioral Changes in the ABCD Study.

Adolescents with disrupted rest-activity rhythms (RAR) including shorter sleep duration, later sleep timing and low physical activity levels are at a greater risk for mental and behavioral problems. However, it remains unclear whether the same associations can be observed for within-subject changes in RAR. Our longitudinal investigation on RAR used Fitbit data from the Adolescent Brain Cognitive Development (ABCD) Study at the 2-year (FL2: aged 10-13 years) and 4-year follow-up (FL4: aged 13-16 years). 963 youths had good-quality Fitbit data at both time points. In this study we examined changes in RAR from FL2 to FL4, their environmental and demographic contributors as well as brain and behavioral correlates. From FL2 to FL4, adolescents showed decreases in sleep duration and physical activity as well as delayed sleep timing (Cohen's d .44-.75). The contributions of environmental and demographic factors to RAR changes were greatest for sleep timing (explained 10% variance) and least for sleep duration (explained 1% variance). Delays in sleep timing had stronger correlations with behavioral problems including impulsivity and poor academic performance than reductions in sleep duration or physical activity. Additionally, the various brain measures differed in their sensitivity to RAR changes. Reductions in sleep duration were associated with decreased functional connectivity between subcortical regions and sensorimotor and cingulo-opercular networks and with enhanced functional connectivity between sensorimotor, visual and auditory networks. Delays in sleep timing were mainly associated with grey matter changes in subcortical regions. The current findings corroborate the importance of sleep and physical activity in adolescents' brain neurodevelopment and behavioral problems. RAR might serve as biomarkers for monitoring behavioral problems and be potential therapeutic targets for mental disorders in adolescents.

The prevalence of behavior problems in dogs in the United States

Numerous studies have reported the prevalence of various behavior problems in dogs and cats around the world. The actual number of animals included in each varies but is typically less than 1000. The reported prevalence of the behavior problem also varies considerably. It was thought that data from 43,517 dogs enrolled in the Dog Aging Project (DAP), entered by their owners, might provide a more realistic picture of canine behavior problems in the United States. All behavior questions included in the DAP were taken from the C-BARQ and mini C-BARQ questionnaires and included four multi-question categories (i.e., aggression, separation and attachment behaviors, fear and anxiety behaviors, and housesoiling) and seven behaviors asked as single questions. Except for two yes/no questions, all were rated by the owner between 0 (no problem), 2 (moderate) and 4 (serious). Data was analyzed to determine the number of dogs showing moderate (2) to serious (4) levels of behavior appropriate for the question. Overall, 99.12% of dogs showed at least one problem of moderately serious (3) to serious (4) intensity or at least two problems of moderate to serious (2−4) intensity. Within the four multi-question categories, the prevalence of dogs showing moderate (2) to serious (4) behaviors at least twice with the category was 55.6% for aggression, 85.9% for separation and attachment behaviors, 49.9% for fear and anxiety behaviors, and 4.1% for housesoiling.

Identifying childhood pesticide exposure trajectories and critical window associated with behavioral problems at 10 years of age: Findings from SMBCS

BackgroundPesticides may impact children’s neurodevelopment. As children’s metabolic function and neural plasticity change throughout their growth and development, the effects of pesticide exposure may also vary. ObjectivesWe aimed to identify the trajectories of combined pesticide exposure during childhood, and examine the associations of the exposure trajectories with children’s neurobehavior at the age of 10. MethodsWe involved repeated measurements of three pesticide metabolites [Pentachlorophenol (PCP), 3,5,6-Trichloro-2-pyridinol (TCPy), and Carbofuran phenol (CFP)], in urine samples collected from children in a cohort study at ages 1, 2, 3, 6, 7, 8, 9, and 10 years. The group-based multi-trajectory model (GBMT) and latent class analysis (LCA) were separately utilized to describe the distinct trajectories and patterns of pesticide mixture exposure during childhood. Meanwhile, the Strengths and Difficulties Questionnaire (SDQ) and attention deficit hyperactivity disorder (ADHD) Criteria of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) list were applied to assess behavioral disorders in children. The associations between exposure trajectories and behavioral problem scores were then examined. ResultsThe GBMT model delineated three distinct trajectories of combined pesticide exposure among children: consistently low, higher levels in early childhood transitioning to lower levels during pre-school age, and lower levels in early childhood followed by higher levels in the middle childhood. The LCA model identified three similar longitudinal exposure patterns. Further, the children in the second trajectory group identified by GBMT, characterized by higher early childhood exposure levels, exhibited significantly elevated hyperactivity/inattention scores of the SDQ compared to the other two groups (β = 0.46, 95 %CI: 0.11, 0.81; β = 0.44, 95 %CI: 0.02, 0.86). ConclusionsOur study revealed that exposure to pesticides during early childhood (especially before the age of two), rather than other age periods, was linked to hyperactivity/inattention problems in children aged 10 years. We also provided a novel perspective on characterizing the fluctuation in repeated measurements of multiple environmental chemicals and identifying the potential critical windows.

Is exposure to Bisphenol A associated with Attention-Deficit Hyperactivity Disorder (ADHD) and associated executive or behavioral problems in children? A comprehensive systematic review.

Is exposure to Bisphenol A associated with Attention-Deficit Hyperactivity Disorder (ADHD) and associated executive or behavioral problems in children? A comprehensive systematic review.

Gastrointestinal Issues in Depression, Anxiety, and Neurodegenerative Diseases: A Systematic Review on Pathways and Clinical Targets Implications.

Multiple illnesses commonly involve both the Central Nervous System (CNS) and the Gastrointestinal Tract (GI) simultaneously. Consistent evidence suggests that neurological disorders impair GI tract function and worsen the symptomatology and pathophysiology of digestive disorders. On the other hand, it has been proposed that early functional changes in the GI tract contribute to the genesis of several CNS illnesses. Additionally, the role played by the gut in these diseases can be seen as a paradigm for how the gut and the brain interact. We mentioned significant GI symptoms and discussed how the GI tract affects central nervous system illnesses, including depression, anxiety, Alzheimer's disease, and Parkinson's disease in this study. We also explored potential pathophysiological underpinnings and novel targets for the creation of future therapies targeted at gut-brain connections. In this situation, modulating the gut microbiota through the administration of fecal microbiota transplants or probiotics may represent a new therapeutic option for this population, not only to treat GI problems but also behavioral problems, given the role that dysbiosis and leaky gut play in many neurological disorders. Accurate diagnosis and treatment of co-existing illnesses also require coordination between psychiatrists, neurologists, gastroenterologists, and other specialties, as well as a thorough history and thorough physical examination.

Effects of the Tools for Getting Along Curriculum on Teachers’ Reports of Elementary Students’ Executive Functions, Social-Emotional Skills, and Behavior Problems

In this study, we examined the effectiveness of Tools for Getting Along (TFGA) on teachers’ reports of executive functioning (EF), social-emotional, and behavioral skills of upper elementary school students. TFGA is a classroom-level prevention curriculum that teaches students a sequence of empirically based problem-solving steps to apply in emotionally charged situations. We randomly assigned 52 elementary schools in California, Oklahoma, and Kentucky to the treatment (n = 26) or comparison (n = 26) condition, with study participants including 135 grade 4 teachers and their 1,713 students. Multilevel analyses revealed that relative to those in the comparison group, students who participated in TFGA had significantly better social skills (effect size = 0.12) and higher levels of behaviors associated with EFs (effect size = 0.11), as reported by their teachers. Further, students whose teachers reported as having higher internalizing and externalizing behaviors, lower competence, and weaker behaviors associated with EFs at baseline experienced greater improvements in these skills after participating in TFGA than their counterparts with relatively stronger skills in the comparison group. We discuss educational implications of this study to promote and scale evidence-based, social-emotional practices in elementary school classrooms.

Drugs to Treat Behavioral Symptoms and Problems Associated with Neurodevelopmental Disorders.

Drugs to Treat Behavioral Symptoms and Problems Associated with Neurodevelopmental Disorders.

Detecting and Classifying Problematic Behavior: A Method Based on Multi-Dimensional Software Modeling Behavioral Characteristics

Detecting and Classifying Problematic Behavior: A Method Based on Multi-Dimensional Software Modeling Behavioral Characteristics

Protective factors for externalising behaviour problems in children and adolescents living in out-of-home care: A systematic review

Children and young people in out-of-home care (OOHC) often display disproportionate levels of externalising behaviour problems compared to the general population, which are further linked with detrimental outcomes. Yet, despite similar levels of vulnerability, not all young people in OOHC develop these behaviours. The aim of this systematic review was to identify and synthesise knowledge on protective factors for externalising behaviour problems in young people between 0 and 19 years old residing in OOHC. A systematic search was conducted in PubMed, PsycINFO, Embase, CINAHL, and the Proquest Social Abstracts and Social Services databases, with 31 studies meeting inclusion criteria (n = 8310 individual participants across the studies). Results indicated that protective factors associated with fewer and/or lower levels of externalising behaviour problems included: individual (e.g., better self-concept), relationship (e.g., quality relationships with family members and peers), and contextual (e.g., higher neighbourhood income) factors. Given the short and long-term consequences associated with externalising behaviours, professionals working with young people in OOHC should focus on identifying protective factors that can be targeted in prevention and intervention efforts. This review indicated that strengthening individual, relational, and contextual factors may be most beneficial for reducing risk of externalising behaviours.

Harsh parenting, amygdala functional connectivity changes across childhood, and behavioral problems.

Harsh parenting in early childhood is related to offspring's adverse behavioral outcomes. Due to the scarcity of longitudinal neuroimaging data, few studies have explored the neurobiological underpinnings of this association, focusing on within-person variability. This study examined the temporal associations among harsh parenting, later behavioral problems, and the developmental trajectories of amygdala volume and amygdala resting-state functional connectivity (RSFC) profiles, using longitudinal neuroimaging data. The study was embedded in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort. T1-weighted (296 children, 642 scans) and resting-state functional scans (256 children, 509 scans) were collected at ages 4.5, 6, 7.5, and 10.5 years. Amygdala volume and RSFC between the amygdala and six brain regions that have leading roles in emotional regulation were extracted. Harsh parenting at 4.5 years and child behavioral problems at 10.5 years were assessed via parent-report questionnaires. Linear regression and linear mixed models were applied. Harsh parenting was associated with more severe externalizing problems in girls (β = 0.24, 95% CI 0.08-0.40) but not boys (pint = 0.07). In the overall sample, harsh parenting was associated with the developmental trajectories of amygdala-ACC, amygdala-OFC, and amygdala-DLPFC RSFC. In addition, the developmental trajectory of amygdala-ACC RSFC mediated the harsh parenting-externalizing problems association in girls (indirect effect = 0.06, 95% CI 0.01-0.14). Harsh parenting in early childhood was associated with amygdala neurocircuitry development and behavioral problems. The developmental trajectory of amygdala-ACC RSFC is a potential neural mechanism linking harsh parenting and externalizing problems in girls.