Child Behavior Problems Research Articles

Different concepts of neighborhood safety and child internalizing and externalizing behaviors.

Neighborhood safety is defined inconsistently across epidemiologic studies - a conceptual problem that results in incomparable measurements, hampering the design of health interventions. Using child behavior problems (measured via the Child Behavior Checklist) as the outcome of interest, this study directly compared four measures of neighborhood safety: two of experienced safety and two of perceived safety, with each one measured at family and community levels. These included children's direct experience of harm, parental perceptions, community crime statistics, and community perceptions. In a sample of 3291 ten-year-olds from the Generation R cohort (living in municipal Rotterdam, Netherlands, 2013), all four measures were correlated (χ2 ≥ 9.2, P < 0.002 in pairwise chi-square comparisons), but ultimately identified different levels of risk for behavioral health. Direct experiences of harm, parental perceptions, and community crime statistics were all associated with increased child internalizing behaviors (β = 3.12, β = 2.10, and β = 1.77, respectively), while only experiences of harm and parental perceptions were associated with increased externalizing behaviors (β = 2.75 and β = 1.31, respectively). These results provide novel evidence that the conceptual distinctions underlying different measures of neighborhood safety are meaningful for child mental health and should be considered in intervention design.

Association between parental attitudes towards parenting, emotional problems and behavioral problems in children in Sincelejo (Colombia)

Las actitudes parentales hacia la crianza repercuten en la incidencia de problemas emocionales y conductuales en los primero años de vida de un niño. El objetivo del presente estudio es examinar la asociación entre las actitudes parentales hacia la crianza, problemas emocionales y problemas de conducta en niños de 2 a 5 años de Sincelejo, Colombia. Se realizó bajo un enfoque cuantitativo, de alcance correlacional, con una muestra de 352 cuidadores y 352 niños y niñas seleccionados de manera intencionada, a quienes se les aplicaron los siguientes instrumentos: 1. Cuestionario sociodemográfico, 2. El Parents-Child Relationship Inventory (PCRI), 3. Child Behaviour Checklist (CBCL). En los resultados se evidencio que, Los problemas del sueño presentaron una relación negativa con la disciplina y el compromiso, esto quiere decir que a menos disciplina y compromiso, más problemas del sueño presentaban los niños. Y con respeto a los problemas externalizantes se encontró que los problemas de atención, problemas oposicionistas y el comportamiento agresivo se relacionaron con poca disciplina seguida de poco compromiso. Se concluye que los problemas externalizados en niños y niñas se relacionan con el poco compromiso como actitud parental hacia la crianza.

The power of routines: Impact of parent-grandparent coparenting relationship quality on post-lockdown child adjustment over the COVID-19 pandemic in China

Child routines and coparenting relationships are respectively recognized in past literature as valid predictors of child adjustment, representing structured daily living and source of support in children’s lives. Under the difficult times of the COVID-19 pandemic, established family processes were shaken by social and mental challenges, which lacked relevant literature regarding the working mechanism in the Chinese cultural context, where parent-grandparent coparenting families commonly reside. The current longitudinal study explores the role of child routines in the effect of mother-grandmother coparenting relationship quality on child adjustment over the period of the COVID-19 pandemic lockdown. The study collected data from 163 mother-grandmother coparenting families before, during, and after the pandemic lockdown in Beijing, China, in a one-year span. The results showed that the consistency of child routines during the pandemic mediated the effect of mothers’ perceived coparenting relationship quality before the pandemic on child social competence after the lockdown, but not on child behavioral and emotional problems. Grandmother’s perceived coparenting relationship quality before the pandemic negatively predicted behavioral and emotional problems after the lockdown, while no indirect effects were found. The current study reiterates the critical role of routine maintenance in the coparenting context on child social-emotional development, particularly when other parts of daily lives were disturbed. Also, separately examining mothers’ and grandmothers’ perceived coparenting relationship quality validates the idea that caregivers played different roles in the family, resulting in disparities in child development mechanisms.

Wealth at birth and its effect on child academic achievement and behavioral problems

Wealth at birth and its effect on child academic achievement and behavioral problems

Externalizing Behavior Problems in Children Aged 6 to 14 years-old Living Near Coal-Fired Power Plants

Externalizing Behavior Problems in Children Aged 6 to 14 years-old Living Near Coal-Fired Power Plants

Digital Parenting Program: Enhancing Parenting and Reducing Child Behavior Problems.

Digital parenting programs using smartphone apps can support families in positive parenting and require evaluations of their effects, mainly in low- and middle-income countries with caregivers experiencing psychosocial vulnerabilities. The study evaluated the "Born Learning" digital parenting program on improving parenting practices, child prosocial behavior, and reducing the children's externalizing behavior problems. Additionally, participants' satisfaction and engagement with the program were evaluated. Brazilian primary caregivers of 3- to 6-year-old children totaling 91, participated in the "Born Learning" program and pre-, post-intervention, and five-month follow-up evaluations. Most participants received cash transfers (64%) and reported some level of food insecurity (78%). The parenting coercive practices decreased from pre- to post-intervention, with maintenance in follow-up. Satisfaction with the role of parenting increased, and child conduct behavior problems decreased from pre-intervention to follow-up. Most participants found the program content very interesting and engaged adequately with the program strategies, such as messages and videos. The digital parenting program can support caregivers by enhancing parenting and decreasing child behavior problems, highlighting the potential for broader implementation in similar contexts.

The role of functional emotion circuits in distinct dimensions of psychopathology in youth

Several mental disorders emerge during childhood or adolescence and are often characterized by socioemotional difficulties, including alterations in emotion perception. Emotional facial expressions are processed in discrete functional brain modules whose connectivity patterns encode emotion categories, but the involvement of these neural circuits in psychopathology in youth is poorly understood. This study examined the associations between activation and functional connectivity patterns in emotion circuits and psychopathology during development. We used task-based fMRI data from the Philadelphia Neurodevelopmental Cohort (PNC, N = 1221, 8–23 years) and conducted generalized psycho-physiological interaction (gPPI) analyses. Measures of psychopathology were derived from an independent component analysis of questionnaire data. The results showed positive associations between identifying fearful, sad, and angry faces and depressive symptoms, and a negative relationship between sadness recognition and positive psychosis symptoms. We found a positive main effect of depressive symptoms on BOLD activation in regions overlapping with the default mode network, while individuals reporting higher levels of norm-violating behavior exhibited emotion-specific lower functional connectivity within regions of the salience network and between modules that overlapped with the salience and default mode network. Our findings illustrate the relevance of functional connectivity patterns underlying emotion processing for behavioral problems in children and adolescents.

Prenatal Fluoride Exposure Linked to Behavioral Problems in Children

Prenatal Fluoride Exposure Linked to Behavioral Problems in Children

Trauma-related mental health problems among mothers in Taiwan and their relationship with children’s emotional and behavioral problems

ABSTRACT Background: Trauma can give rise to mental health problems and emotional and interpersonal difficulties, which in turn can perpetuate the cycle of trauma and adversity for future generations. However, little is known about the prevalence and potential effects of trauma and trauma-related mental health problems among parents. Objective: The primary goal of this study was to examine childhood and adulthood trauma and trauma-related symptoms among mothers of children aged between 6 and 18. We also conducted exploratory analyses of their potential relationship with children’s emotional and behavioural problems. Method: A total of 817 mothers living with a child aged between 6 and 18 in Taiwan completed standardized self-report assessments of trauma exposure, trauma-related symptoms, and children’s emotional and behavioural problems. A subsample (n = 256) also provided follow-up data after six months. Results: Most surveyed mothers reported at least one childhood traumatic event (74.79%) and one adulthood traumatic event (78.70%); 4.4% met the ICD-11 criteria for PTSD, and 12.1% for complex PTSD; 11.4% reported clinically significant dissociative symptoms. Mothers’ complex PTSD and dissociative symptoms were cross-sectionally correlated with children’s emotional and behavioural problem (rs = .186 to .239, p < .001). After controlling for possible confounding variables and baseline scores, mothers’ childhood non-betrayal trauma reported at baseline was found to be a predictor of children's emotional and behavioural problems reported at follow up. Conclusion: This study is the first to provide data regarding childhood and adulthood trauma and trauma-related disorders, including ICD-11 complex PTSD, among mothers in the community. It calls for more studies to understand the potential effects of intergenerational trauma.

Social Skills and Behavioral Problems in Children with a History of Institutionalization and Foster Care

The aim of the study was to analyze whether there were significant differences in social skills and in externalizing and internalizing behavior problems among three groups of children in Argentina: one group of adopted children with a history of institutional care, another group of adopted children with a history of foster care, and a third group of children with no history of alternative care who have lived with their biological family since birth. A non-experimental, descriptive, cross-sectional study was conducted. The sample consisted of 119 Argentine parents with children between the ages of 3 and 7. Of these, 41 parents had adopted a child with a history of institutional care, 38 had adopted a child with a history of foster care, and 40 were biological parents whose children had no history of alternative care. The Preschool and Kindergarten Behavior Scale (PKBS) by Merrell (2003), adapted in Argentina by Reyna and Brussino (2009), was used to measure the variables studied. Adopted children with a history in institutional care obtained significantly lower scores in the three social skills assessed (social cooperation, social interaction, and social independence) and significantly higher scores in the two behavior problems assessed (internalizing and externalizing) compared to the other two groups. No significant differences were found in social skills and behavioral problems between the group of adopted children with a history of foster care and the group of children without a history of alternative care who have lived with their biological family since birth. Foster care could be considered a protective factor for children at risk.

Psychometric Properties of the Child Behavior Checklist (CBCL) for Ages 6-18 to Identify Autism Spectrum Disorders (ASD) in a Turkish Parent Sample.

The Child Behavior Checklist for ages 6-18 (CBCL/6-18) is broadly used for psycho-educational assessment in identifying children's behavior problems in special education and psychology. However, the usefulness of the CBCL/6-18 in a Turkish sample still needs to be investigated. The current study aimed to investigate the psychometric properties of the measures of the CBCL/6-18 within a sample of Turkish parents. The psychometric evaluation includes item calibration using the Partial Credit Model (PCM). We analyzed data from 548 parents who have children with autism spectrum disorder. According to the PCM calibration, the results suggested that the Internalizing, Externalizing, and Total Problem subscales were unidimensional and showed local independence successfully. All subscales demonstrated adequate reliability, indicating that the scale distinguishes between children with different behavior problems. The subscales had varying item step ordering, meaning that transitions from one category to second by parent ratings are relatively straightforward. Some items with easy-to-define behavior problems, for example, Item 42 (constipated), were more likely to be endorsed by parents. Consequently, the CBCL/6-18 has adequate psychometric properties for accurately assessing problem behaviors in children based on parent ratings.

Combination of taking neuropsychiatric medications and psychological distress in pregnant women, with behavioral problems in children at 2 years of age: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study.

To examine the association of the combination of taking neuropsychiatric medications from the onset of pregnancy to mid-pregnancy and maternal psychological distress at mid-pregnancy, with children's behavioral problems. Neuropsychiatric medication use from the onset of pregnancy to mid-pregnancy was defined by the self-reported name of the neuropsychiatric medication in the questionnaire in early and mid-pregnancy. Maternal psychological distress was defined by the Kessler Psychological Distress Scale (K6) ≥13 on the questionnaire in mid-pregnancy. We classified the participants into four categories based on the combination of taking neuropsychiatric medications and psychological distress: "None," "Medications only," "K6 ≥ 13 only," and "Both." Children's behavioral problems were assessed using the Child Behavior Checklist for Ages 1½-5 (CBCL) at 2 years of age. The clinical ranges of the internalizing and externalizing scales of the CBCL were defined as behavioral problems. We conducted a multivariable logistic regression analysis to examine the associations between the four categories of maternal exposure and children's behavioral problems. Compared with the "None" category (n = 9873), the "K6 ≥ 13 only" category (n = 308) was statistically significantly associated with internalizing and externalizing problems. In contrast, the "Medications only" (n = 93) and "Both" (n = 22) categories were not statistically significantly associated with internalizing and externalizing problems, although the point estimates of the odds ratio in the "Both" category were relatively high (1.58 for the internalizing problem and 2.50 for the externalizing problem). The category of mothers taking neuropsychiatric medications and having no psychological distress during pregnancy was not associated with children's behavioral problems in the present population.

Influence of Brain Gym on children's behavioral problems with autism spectrum disorder: A randomized controlled clinical trial

IntroductionChildren with autism spectrum disorder (ASD) present with a variety of behavioral problems. The aim of this study is to investigate the effectiveness of Brain Gym (BG) on the behavioral problems of children with ASD in Iran. MethodsThis clinical trial was conducted on 36 children with ASD at Kashan and Arak in 2019. Samples were selected using the block randomization method and assigned to the intervention and control groups. The intervention group received ten sessions of BG according to Dennison's protocol. There was no intervention in the control group. The stereotyped behavior, communication, and social interactions of the behavioral problems were assessed at the beginning (T0), the end of the intervention (T1), and two months later (T2). The data were collected using the Demographics, Rutter, GARS-2, and Raven scales. Data from 33 children were analyzed via per-protocol and intention-to-treat analysis using repeated measures analysis of variance. ResultsThe two groups did not differ significantly in demographic variables. The results showed a significant interaction effect of time and intervention on the severity of behavioral problems (p < 0.0001). There was a significant difference in the severity of behavioral disorders between the two groups at T1 and T2 (p < 0.05). A within-group analysis revealed a significant difference in the severity of the behavioral disorder at the three time points between the BG and control groups (p < 0.0001). ConclusionBG can alleviate the behavioral problems of children with ASD. This intervention is recommended as a complementary treatment for affected families with children with ASD. Trial registration numberIRCT20100211003329N5. Date of registration2020-07-16.

Associations of prenatal exposure to PM2.5 and its components with offsprings' neurodevelopmental and behavioral problems: A prospective cohort study from China

Prenatal exposure to fine particulate matter (PM2.5) has been linked with increased neurodevelopmental disorders. However, the most detrimental component of PM2.5 and the most vulnerable exposure time windows remain undetermined, especially in areas with high PM2.5 levels. In a prospective cohort study involving 4494 mother-child dyads, we examined the associations of prenatal exposure to PM2.5 and its four main components with children's neurodevelopmental and behavioral problems (NBPs), separately in three pregnancy trimesters. Poisson regression and generalized additive models were used to depict the linear and nonlinear associations, respectively. Weighted quantile sum and Bayesian kernel machine regression models were applied to examine the effects of exposure to both mixed and individual components. Results showed that exposure to PM2.5 and its components throughout the three trimesters increased the risk of children's NBPs (Risk ratio for PM2.5: 1.16, 95 % confidence interval 1.14–1.18 per μg/m3 in the first trimester; 1.15, 1.12–1.17 in the second trimester; 1.06, 1.04–1.08 in the third trimester), with associations gradually diminishing as pregnancy progressed (P values for trends < 0.05). Among the four main components of PM2.5, exposure to SO42- posed the highest risks on children's NBPs, while organic matter contributed the largest proportion to the overall impacts of PM2.5 exposure. These results underscore the significance of mitigating PM2.5 exposure in pregnant women to reduce the risk of neurodevelopmental disorders in offspring. Our findings would inform risk assessment of PM2.5 exposure and facilitate the development of precision preventive strategies targeting specific components of PM2.5 in similar areas with high levels of exposure.

Adherence to the Mediterranean diet during pregnancy and behavioural problems at 4 years of age.

There is an increasing prevalence of psychological issues in childhood. Lifestyle factors during pregnancy, including maternal nutrition, have been linked to children's behavioural development. This study aims to assess the impact of adherence to the Mediterranean diet during pregnancy on the behavioural problems of children at the age of 4. A total of 231 mother-child pairs were assessed. Maternal adherence to the Mediterranean diet during pregnancy was estimated using a relative Mediterranean Diet Score (rMED). Behavioural outcomes were evaluated through the Child Behaviour Checklist 1½--5, Teacher's Report Form 1½-5, and Behaviour Rating Inventory of Executive Function-Preschool Version questionnaires. The results indicated that a higher rMED score during pregnancy was associated with a reduced probability of obtaining a clinical score for total problems (OR = 0.42; 95%IC from 0.21 to 0.85), including externalising (OR = 0.29; 95%IC from 0.14 to 0.62), attention problems (OR = 0.32; 95%IC from 0.15 to 0.70), attention-deficit/hyperactivity problems (OR = 0.36; 95%IC from 0.15 to 0.87), oppositional defiant problems (OR = 0.06; 95%IC from 0.06 to 0.75), and depressive problems (OR = 0.38; 95%IC from 0.15 to 0.96). This study highlights the importance of maternal diet, especially Mediterranean diet, during gestation for proper child development.

Family and Peer Social Capital and Child Behavioral Outcomes in Japan.

Child problem behaviors have been linked to immediate and long-term negative outcomes. Research has found that family and peer social capital have a strong influence on child behavioral outcomes. However, most research about social capital and child behavior problems has been conducted in Western contexts. Social capital may influence child behavior problems differently in non-Western sociocultural environments due to different family and peer dynamics. Using a sample from the Japan Household Panel Survey and Japan Child Panel Survey (N = 182), we expand this literature on various forms of social capital to the Japanese context with data that were collected between 2009 and 2014. We examine the relationship of family and peer social capital with children internalizing and externalizing problem behaviors using OLS linear regression. Our results differ from what is commonly found in Western contexts. Whereas family and peer social capital are typically associated with both internalizing and externalizing problem behaviors in Western countries, we find that greater family social capital is associated with decreased externalizing problem behaviors but not internalizing problem behaviors in Japan, and peer social capital has no association on either type of problem behaviors. Our findings emphasize the importance of considering social and cultural contexts when exploring how social capital might encourage prosocial child outcomes.

Environmental Risk Factors Associated with Behavioral Problems among Children with Attention Deficit Hyperactivity Disorder: Maternal Perceptions

OBJECTIVE This study aims to identify environmental risk factors associated with behavioral problems in children and adolescents with attention deficit hyperactivity disorder (ADHD). METHODS A case-control study was conducted in children aged 4-15 years comprising 92 children diagnosed with ADHD and 92 controls without ADHD. Stratified sampling was used to select 184 participants residing in Chiang Mai and Lamphun provinces, Thailand. Data were collected from the mothers of the participants using a self-report questionnaire between May and August 2022. The questionnaire consisted of three parts: child characteristics (gender, age, underlying diseases, past illness history), mother’s characteristics (age, income, occupational status, history of cigarette smoking and alcohol drinking), and maternal perceptions about caring for the child and the child’s behavioral problems (exposure to chemicals/toxicants, frequent punishment, excessive use of digital media and games). Data were analyzed using descriptive statistics, chi-squared test, odds ratio (OR) and logistic regression using SPSS version 21. RESULTS Most of participants were males (86.96%) while 13.04% were females. The results showed that the ADHD cases were significantly more likely than the controls to have underlying diseases such as G6PD, allergy, and asthma (p = 0.006). There was also a statistically significant correlation with smoking history in the mothers of ADHD cases (OR = 2.64; 95% CI: 1.36-5.13 p = 0.004). In terms of maternal perceptions, the mothers of ADHD children were significantly more likely than the controls to have frequently punished the child (OR = 6.26; 95% CI: 3.24-12.07; p &lt; 0.001), to have children who were exposed to chemicals (pesticides and fertilizer) or toxicants (passive smoking) (OR = 4.14; 95%CI: 1.76-9.73; p = 0.001), and to have allowed their child to use digital media and play video games excessively (OR = 2.82; 95% CI: 1.55-5.16; p = 0.001). After adjustment for other environmental risk factors, frequent child punishment (ORadj = 4.32; 95% CI: 2.13-8.78; p &lt; 0.001) and exposure of the child to chemicals/toxicants (ORadj = 2.66; 95% CI: 1.00-7.02; p = 0.049) were found to be significantly related with ADHD. CONCLUSIONS Frequent child punishment was the most significant environmental risk factor related to behavioral problems among children with ADHD. This indicates the importance of healthcare providers developing strategies and/or interventions to enhance knowledge and awareness in mothers of ADHD which can improve treatment outcomes. KEYWORDS ADHD, risk factors, behavioral problems, maternal percep- tions

The effects of two types of neighborhood factors on trajectory of internalizing and externalizing symptoms from early childhood to adolescence.

Although a robust body of previous empirical studies investigated the long-term trend of child behavior problems, limited research discussed the influences of various types of neighborhood factors on such trajectory (e.g., neighborhood structural characteristics and collective efficacy). Using a nationally representative longitudinal dataset the Fragile Families and Child Wellbeing Study (FFCWS), with six waves from 1998 to 2017, this study captures the longitudinal effects of two types of early childhood neighborhood factors on the co-development of internalizing and externalizing symptoms. Data was collected at the focal child's age 3, age 5, age 9, age 15 (N = 2,385), and the parallel-process growth curve models were applied. Results suggest that the trajectories of both internalization and externalizing symptoms showed U-shape and bidirectional relationships among internalizing and externalizing problems. The long-term effects of neighborhood social cohesion and economic disadvantages were significantly associated with children's internalizing and externalizing symptoms. The implication of this study was further discussed.

Evaluation of Virtual Enhanced Child Adult Relationship Enhancement in Primary Care Intervention.

Because of COVID-19 pandemic social distancing requirements, the in-person Child Adult Relationship Enhancement in Primary Care (PriCARE) positive parenting intervention was adapted for virtual delivery. Objective was to evaluate the efficacy of the virtual PriCARE program to improve parenting capacity, decrease child behavioral problems, and decrease child maltreatment risk. Caregivers of children 2 to 6 years old recruited from pediatric primary care were randomized to PriCARE (n = 92) or waitlist control (n = 90). Dysfunctional parenting, positive parenting skills, child behaviors, and child maltreatment risk were measured at baseline and 2 to 3 months after intervention using the Parenting Scale (PS), Dyadic Parent-Child Interaction Coding System (DPICS), Eyberg Child Behavior Inventory (ECBI), and Child Abuse Potential Inventory (CAPI). Kruskal-Wallis test compared median change scores from baseline to follow-up by treatment arm. Of 182 enrolled caregivers, 92% (168) were mothers and 67% (122) completed study measures at baseline and follow-up. The median decrease (improvement) in total PS score was greater in the PriCARE group compared with the control group (-0.3 [IQR 0.69] vs -0.1 [IQR 0.56], p = 0.028) as was the median decrease (improvement) in ECBI problem score (-3 [IQR 9] vs -1 [IQR 7], p = 0.045) and ECBI intensity score (-9 [IQR 21] vs 0 [IQR 25], p = 0.006). Improvements in 4 positive parenting skills measured by DPICS were greater in the PriCARE group compared with the control group (all p< 0.003). Median decrease in CAPI abuse score did not differ significantly by study arm ( p = 0.055). The PriCARE virtual adaptation demonstrated promise in promoting positive parenting and decreasing child behavior problems.

Longitudinal relations of prematurity and fetal growth restrictions with hyperactivity/inattention and aggression/delinquency.

It is the aim of this study to analyze the longitudinal relationship between premature birth and low birth weight and the reciprocal influence between hyperactive/inattentive behavior and aggressive/delinquent behavior problems in children from early to late childhood. This study contains data from the German Erlangen-Nuremberg Development and Prevention Study. It applies prospective longitudinal path analyses on data obtained from postnatal pediatric assessments as well as later psychosocial behavior assessments by teachers and parents on N = 667 children, out of which n = 83 children (12.44%) were born preterm/small for gestational age. The results show direct effects of birth complications at the beginning of preschool on hyperactivity/inattentiveness (teacher rating: ß = 0.28; p = 0.017; parent rating: ß = 0.32; p = 0.005), but not on aggression/delinquency (teacher rating: ß = 0.002; p = 0.427; parent rating: ß = 0.12; p = 0.324). Reciprocal effects between aggression/delinquency and hyperactivity/inattentiveness were stable at the end of elementary school, but not at the end of preschool across informants. Our results support a differentiated view on the potential development of behavior problems after birth complications and the demand for early prevention measures. Our results extend to the existing body of research by providing insight into the longitudinal effects of prematurity and fetal growth restrictions on hyperactive and aggressive/delinquent behavioral problems throughout a rather long period of development in childhood. The results show direct effects of birth complications on the development of hyperactivity for boys, but not for girls across informants. No direct effects of birth complications on aggression/delinquency are found. Our findings speak against too simple views on behavioral consequences of birth complications and thus can relieve too anxious parents, however close monitoring of the behavioral development of respective children is indicated.