Behavioral Symptoms In Children Research Articles

The effect of cannabidiol in the treatment of behavioral symptoms in children and adolescents with autism: an integrative review

Objective: to conduct an integrative review which seeks to analyze the effects of cannabidiol in children and adolescents with Autism Spectrum Disorder (ASD). Method: an integrative review was conducted following several methodological steps, including identifying the topic and formulating the research question using the PICO strategy. The guiding question was: "What is the effect of Cannabidiol (CBD) in the treatment of autism spectrum disorder (ASD) in children and adolescents?" Inclusion criteria were defined for selecting relevant articles, followed by the search and selection of articles in scientific databases Portal Capes and PubMed, with no use of search filters. The studies were evaluated and analyzed; the results were then interpreted. Finally, the integrative review consolidated knowledge about the possible effects of CBD as an intervention for ASD. Conclusion: the integrative review highlights the possible effects of cannabidiol (CBD) in the treatment of autism, showing significant improvement of symptoms with minimal side effects. Although still not widely disseminated, CBD appears to be a functional therapy for ASD.

The Effectiveness of Acceptance and Commitment Therapy on Emotion Regulation, Behavioral Symptoms, and Academic Performance of Children with Attention Deficit/Hyperactivity Disorder

Background: Children with attention-deficit/hyperactivity disorder (ADHD) frequently struggle with emotional regulation, behavioral issues, and academic performance, leading to peer rejection and social isolation. Objectives: The present study aimed to investigate the effects of acceptance and commitment therapy (ACT) on emotion regulation, behavioral symptoms, and academic performance of children with ADHD. Methods: A quasi-experimental study was conducted using a pretest-posttest design. The study population consisted of all primary school students with ADHD aged 7 - 11, as well as their mothers, in Amol in 2021. A purposive sample of 30 individuals was selected for the study. Participants were assigned to either the ACT training group (n = 15) or the control group (n = 15) through a simple random allocation. The participants in the study filled out questionnaires on emotion regulation, children's behavioral symptoms, and academic performance. The data was analyzed using an analysis of covariance. Results: In the pretest phase, the scores for adaptive emotion regulation strategies, maladaptive emotion regulation strategies, behavioral symptoms, and academic performance were 43.07 ± 6.05, 65.13 ± 9.27, 91.20 ± 12.58, and 128.47 ± 29.84, respectively; whereas in the posttest phase, they were 61.20 ± 8.01, 52.00 ± 6.00, 67.13 ± 12.73, and 159.73 ± 21.11, respectively. Acceptance and commitment therapy resulted in enhanced emotion regulation strategies and academic performance, as well as a decrease in behavioral symptoms in children with ADHD (P < 0.001). Conclusions: Given the effectiveness of acceptance and commitment therapy training in emotion regulation, behavioral symptoms, and academic performance, this approach may be employed by counselors and psychologists at counseling and psychotherapy centers to help remedy ADHD.

Sleep complaints, suicidal behavior and somatic symptoms in children and adolescents with severe affective disorder

Sleep complaints, suicidal behavior and somatic symptoms in children and adolescents with severe affective disorder

The promotive and protective effects of parents' perceived changes during the COVID-19 pandemic on emotional well-being among U.S. households with young children: an investigation of family resilience processes.

The COVID-19 pandemic may constitute a traumatic event for families with young children due to its acute onset, the unpredictable and ubiquitous nature, and the highly distressing disruptions it caused in family lives. Despite the prevalent challenges such as material hardships, child care disruptions, and social isolation, some families evinced remarkable resilience in the face of this potentially traumatic event. This study examined domains of changes perceived by parents of young children that were consistent with the post-traumatic growth (PTG) model as factors that facilitate family resilience processes. This study drew data from the RAPID project, a large ongoing national study that used frequent online surveys to examine the pandemic impact on U.S. households with young children. A subsample of 669 families was leveraged for the current investigation, including 8.07% Black, 9.57% Latino(a), 74.44% non-Latino(a) White families, and 7.92% households of other racial/ethnic backgrounds. In this subsample, 26.36% were below 200% federal poverty level. Approximately half of the parents reported moderate-to-large degrees of changes during the pandemic, and the most prevalent domain of change was appreciation of life, followed by personal strengths, new possibilities, improved relationships, and spiritual growth. Black and Latino(a) parents reported more changes in all five domains than White parents and more spiritual growth than parents of the other racial/ethnic groups. Moreover, parent-reported improved relationships were found to indirectly reduce young children's overall fussiness/defiance and fear/anxiety symptoms through reducing parents' emotional distress. Perceived changes in the new possibilities, personal strengths, and appreciation of life domains were found to serve as protective factors that buffered the indirect impacts of material hardship mean levels on child behavioral symptoms via mitigating parents' emotional distress. These findings shed light on resilience processes of a family system in a large-scale, disruptive, and stressful socio-historical event such as the COVID-19 pandemic. The five PTG domains could inform therapeutic and intervention practices in the face of future similar events. Importantly, these findings and the evinced family resilience should not negate the urgent needs of policy and program efforts to address material hardships, financial instabilities, and race/ethnicity-based structural inequalities for families of young children.

Long-Term Safety and Sustained Efficacy of ZYN002 Cannabidiol Transdermal Gel in the Treatment of Behavioral Symptoms in Children and Adolescents With Fragile X Syndrome (ZYN2-CL-017)

Long-Term Safety and Sustained Efficacy of ZYN002 Cannabidiol Transdermal Gel in the Treatment of Behavioral Symptoms in Children and Adolescents With Fragile X Syndrome (ZYN2-CL-017)

2.16 Effects of Methylphenidate and Atomoxetine on Emotional and/or Behavioral Symptoms in Children With ADHD

2.16 Effects of Methylphenidate and Atomoxetine on Emotional and/or Behavioral Symptoms in Children With ADHD

The impact of time perception remediation on cold and hot executive functions and behavioral symptoms in children with ADHD

ABSTRACT Children with ADHD struggle with impaired time management, indicating premature and temporally inadequate behavioral style. This study aimed to evaluate the impact of time perception remediation on hot and cold executive functions (EFs) and behavioral symptoms in children with ADHD. In this pilot study, an RCT design was employed to investigate the effects of the intervention on children with ADHD. The participants were assigned to either the control group (n = 15) or the intervention group (n = 13). The intervention group receive 10–12 sessions of program for attentive remediation of time perception (PART). Time perception, N-back, Wisconsin card sorting, Go/No-Go, balloon analog risk, Iowa gambling tasks, and Conner’s parental rating scale were used for the assessment in three baseline, post-intervention, and follow-up sessions. Repeated measures ANOVAs were used for analysis. The results suggest improved time perception and risky decision making in intervention group. Working memory, inhibitory control, and cognitive flexibility did not improve after intervention. The behavioral symptoms ameliorated after intervention. Time perception is trainable in children with ADHD. This training effect transfers to hot EFs and behavioral symptoms, but not cold EFs. A cognitive model has been proposed based on the results of this studies and other cognitive training studies.

Predictor factors affecting emotional and behavioral problems in school-aged (6–12 years) children during the COVID-19 pandemic: a cross-sectional study

ObjectivesThe prolonged outbreak of COVID-19 has caused psychological problems in the community, especially in children. Given that limited studies have been conducted on this vulnerable group in Iran, we conducted this study to determine the predictor factors affecting emotional and behavioral problems in school-aged (6–12 years) children during the COVID-19 pandemic.MethodsWe conducted a cross-sectional study on 322 mothers of elementary school-aged children (6–12 years) from April 21 to June 21, 2021, in Karaj, Alborz, Iran. Sociodemographic checklist, socioeconomic status scale (SES), Depression, Anxiety, and Stress Scale (DASS-21), Corona Disease Anxiety Scale (CDAS), and the Rutter Children's Behavior Questionnaire (RCBQ) were used to evaluate the children's behavioral symptoms, the mental health of their mothers, and sociodemographic factors.ResultsIn total, 17.7% of children (male = 27.0%, female = 11.7%) had behavioral problems. Results showed income (p-value = 0.007, 95%CI (-3.85- -0.607)), and physical activity of the child (p-value = 0.026, 95%CI (-1.03- -0.067)), were indirectly associated with children's behavioral symptoms. Having underlying disease (p-value = 0.00, 95%CI (1.712–5.949)), breastfeeding (p-value = 0.027, 95%CI (0.335–5.61)), corona-related anxiety (p-value = 0.00, 95%CI (0.158–0.318)), and DASS score (p-value = 0.00, 95%CI (0.149–0.334)) in the mothers, as well as male gender (p-value = 0.003, 95%CI (0.724–3.471)) were directly associated with children's behavioral symptoms. The most factors involved in the behavioral symptom score of children were corona-related anxiety (β = .298), DASS (β = 0.273), underlying disease of mothers (β = 0.163), income (β = -0.154), child's gender (β = 0.142) and physical activity (β = -0.101), and breastfeeding (β = 0.099) respectively.ConclusionStudy findings showed that some factors affect the emotional and behavioral problems of school-aged (6–12 years) children during the COVID-19 pandemic. These data may help future researchers and policymakers with early intervention.

The psychological symptoms and behavioral problems of children with mothers working as medical staff in the crisis of Covid-19 outbreak in Hamadan, Iran.

The purpose of this study was to investigate the psychological symptoms and behavioral problems of children with mothers working as medical staff in the crisis of Covid-19 disease in Hamadan. This descriptive causal-comparative study was conducted on all mothers with children aged 6 to 12 years in Hamadan from September 2 to November 29, 2020. In this study, eligible individuals were selected using random sampling and were assigned to two groups of mothers working as the medical staff and the control group. The research instruments included the Child Behavior Checklist (Achenbach) and the Child Symptom Inventory-4 (CSI-4). The results showed that the mean scores of psychological and behavioral symptoms of children in terms of group membership (group of mothers working in the medical staff and control group) had a significant difference. There was a significant difference between the mean scores of depression and aggression in children of the staff group and the control group meaning that for depression and aggression scores of children of the staff group are higher than children of the control group (p < 0.05). There was no significant difference between the mean anxiety scores and there was almost a significant difference between the attention scores of the staff group and the control group (p < 0.05). Children whose mothers worked as medical staff during Covid-19 show more depression, attention, and aggression problems than children whose mothers do not work as medical staff.

Homoeopathy for Reducing Disruptive Behavioural Symptoms in Children with Conduct Disorder-

Background: Conduct disorder (CD) and associated antisocial behaviour is one of the most common behavioural problems in children and young people that lead to considerable burden for the patients themselves, their family and society. There is scarcity of literature for effectiveness of homoeopathic medicines in childhood psychiatric disorders such as CD.&#x0D; Summary of cases: 10 children diagnosed as CD, five each from Child psychiatry OPD and Peripheral camp at a Children’s home were treated with individualized homoeopathic medicines. All the cases were assessed at baseline and successive visits with Conduct Disorder Rating Scale (CDRS)- Parent version and the results are summarized. There was a marked reduction of disruptive behaviour and improvement in the general condition of the children.&#x0D; Conclusion: The analysis of 10 cases generates a preliminary evidence for usefulness of individualized homoeopathic medicines in the management of CDs. Studies with appropriate designs are indispensable to corroborate the evidence.

Meta-analysis of the relationship between bullying and depressive symptoms in children and adolescents

Childhood and adolescence are critical periods for physical and mental development; thus, they are high-risk periods for the occurrence of mental disorders. The purpose of this study was to systematically evaluate the association between bullying and depressive symptoms in children and adolescents. We searched the PubMed, MEDLINE and other databases to identify studies related to bullying behavior and depressive symptoms in children and adolescents. A total of 31 studies were included, with a total sample size of 133,688 people. The results of the meta-analysis showed that the risk of depression in children and adolescents who were bullied was 2.77 times higher than that of those who were not bullied; the risk of depression in bullying individuals was 1.73 times higher than that in nonbullying individuals; and the risk of depression in individuals who bullied and experienced bullying was 3.19 times higher than that in nonbullying-bullied individuals. This study confirmed that depression in children and adolescents was significantly associated with being bullied, bullying, and bullying-bullied behavior. However, these findings are limited by the quantity and quality of the included studies and need to be confirmed by future studies.

Effects of Probiotics on Autism Spectrum Disorder in Children: A Systematic Review and Meta-Analysis of Clinical Trials.

Many studies have explored the efficacy of probiotics on autism spectrum disorder (ASD) in children, but there is no consensus on the curative effect. This systematic review and meta-analysis aimed to comprehensively investigate whether probiotics could improve behavioral symptoms in children with ASD. A systematic database search was conducted and a total of seven studies were included in the meta-analysis. We found a nonsignificant overall effect size of probiotics on behavioral symptoms in children with ASD (SMD = -0.24, 95% CI: -0.60 to 0.11, p = 0.18). However, a significant overall effect size was found in the subgroup of the probiotic blend (SMD = -0.42, 95% CI: -0.83 to -0.02, p = 0.04). Additionally, these studies provided limited evidence for the efficacy of probiotics due to their small sample sizes, a shorter intervention duration, different probiotics used, different scales used, and poor research quality. Thus, randomized, double-blind, and placebo-controlled studies following strict trial guidelines are needed to precisely demonstrate the therapeutic effects of probiotics on ASD in children.

The effect of comprehensive working memory training on executive functions and behavioral symptoms in children with attention deficit-hyperactivity disorder (ADHD).

This study aimed to evaluate the effect of working memory training on executive functions and behavioral symptoms in children with ADHD. Thirty children with ADHD were randomly assigned to active control or Active Memory Intervention (AMIN) group. Executive functions and rating scales were used for assessment in three baseline, post-intervention, and 1-month follow-up sessions. The results show AMIN improves working memory and inhibitory control as well as ameliorates ADHD symptoms at home and school. Working memory training is beneficial and transferable intervention in children with ADHD.

Course of child social-emotional and sleep symptoms, parental distress and pandemic-related stressors during COVID-19.

Research on the longitudinal courses of child social-emotional symptoms and sleep during the COVID-19 pandemic within societies would be of key value for promoting child well-being in global crises. We characterized the course of children's social-emotional and sleep symptoms before and throughout the pandemic in a Finnish longitudinal cohort of 1825 5- to 9-year-old children (46% girls) with four follow-up points during the pandemic from up to 695 participants (spring 2020-summer 2021). Second, we examined the role of parental distress and COVID-related stressful events in child symptoms. Child total and behavioral symptoms increased in spring 2020 but decreased thereafter and remained stable throughout the rest of the follow-up. Sleep symptoms decreased in spring 2020 and remained stable thereafter. Parental distress was linked with higher child social-emotional and sleep symptoms. The cross-sectional associations between COVID-related stressors and child symptoms were partially mediated by parental distress. The findings propose that children can be protected from the long-term adverse influences of the pandemic, and parental well-being likely plays a mediating role between pandemic-related stressors and child well-being. Further research focusing on the societal and resilience factors underlying family and child responses to the pandemic is warranted.

Child and family factors associated with positive outcomes among youth born extremely preterm.

To analyze the relationship of child behavioral and communication disorders, and adverse family events, to later-in-life child health and cognitivefunction among youth born extremely preterm. The study participants were 694 children enrolled in the Extremely Low Gestational Age Newborn Study. At ages 2 and 10, we assessed internalizing and externalizing behaviors, and at age 10, we assessed adverse life events within the family. Associations were evaluated between these child and family factors and positive child health at age 10 years, and global health and cognitive function at age 15 years. Lower T-scores for internalizing or externalizing behaviors at age 2 were associated with more positive health at age 10. The absence of internalizing behaviors at age 10 was associated with better global child health and better cognitive function at age 15. The absence of communication deficits at age 10 was associated with better cognitive function at age 15. The absence of parent job loss was associated with better global child health at age 15. Among individuals born extremely preterm, child health and cognitive outcomes might be improved by timely interventions to address child behavioral symptoms and the impact of adverse life events in the family. The absence of child behavioral and communication disorders, and adverse family events, were associated with more positive health, higher global health, and better cognitive function among youth born extremely preterm. Interventions to address behavioral disorders in early childhood, and to reduce the impact of adverse life events on the family, might promote improved health and developmental outcomes for adolescents born extremely preterm.

The efficacy of cognitive-motor rehabilitation on cognitive functions and behavioral symptoms of attention deficit/hyperactivity disorder (ADHD) children: Specification of near-transfer and far-transfer effects in comparison to medication.

This study aimed to investigate and compare the efficacy of cognitive-motor rehabilitation (CMR) with methylphenidate on cognitive functions and behavioral symptoms of children with attention deficit/hyperactivity disorder (ADHD) and specified the near-transfer and far-transfer effects. The research was semiexperimental with posttest and follow-up assessments, in a single-blind design. Forty-eight boys with ADHD, aged 9-12, were selected conveniently regarding the inclusion/exclusion criteria, matched base on severity and Intelligence quotient (IQ) and were randomly assigned to CMR (n = 16), methylphenidate medication (MED, n = 16), and placebo CMR groups (PCMR, n = 16). CMR and PCMR received 20 3-h training sessions, and the MED group received 20 or 30 mg/day methylphenidate. Tower of London (TOL), Swanson, Nolan, and Pelham, Version IV Scale (SNAP-IV), Wechsler's digit span and mathematic subscales, dictation test, and restricted academic situation scale (RASS) were completed at posttest and follow-up. The data were analyzed by repeated measures multivariate analysis of variance. CMR outperformed PCMR on forward digit span, backward digit span, ToL score at both posttest, and follow-up (P < 0.05). CMR scored lower than MED on ADHD-PI and ADHD-C at both posttest and follow-up (P < 0.05). Moreover, CMR outperformed MED on dictation at both assessment phases (P < 0.01) and RASS at the follow-up phase (P < 0.05). CMR outperformed PCMR on mathematics at post-test (P = 0.038) and also, in dictation and RASS, at both post-test (P < 0.001) and follow-up (P < 0.05). CMR Improves near-transfer cognitive functions and behavior symptoms of ADHD as much as MED, but only CMR has more generalizable and endurable improvement on complex Efs and academic performance (far-transfer effects).

A randomized, controlled trial of ZYN002 cannabidiol transdermal gel in children and adolescents with fragile X syndrome (CONNECT-FX)

BackgroundFragile X syndrome (FXS) is associated with dysregulated endocannabinoid signaling and may therefore respond to cannabidiol therapy.DesignCONNECT-FX was a double-blind, randomized phase 3 trial assessing efficacy and safety of ZYN002, transdermal cannabidiol gel, for the treatment of behavioral symptoms in children and adolescents with FXS.MethodsPatients were randomized to 12 weeks of ZYN002 (250 mg or 500 mg daily [weight-based]) or placebo, as add-on to standard of care. The primary endpoint assessed change in social avoidance (SA) measured by the Aberrant Behavior Checklist–Community Edition FXS (ABC-CFXS) SA subscale in a full cohort of patients with a FXS full mutation, regardless of the FMR1 methylation status. Ad hoc analyses assessed efficacy in patients with ≥ 90% and 100% methylation of the promoter region of the FMR1 gene, in whom FMR1 gene silencing is most likely.ResultsA total of 212 patients, mean age 9.7 years, 75% males, were enrolled. A total of 169 (79.7%) patients presented with ≥ 90% methylation of the FMR1 promoter and full mutation of FMR1. Although statistical significance for the primary endpoint was not achieved in the full cohort, significant improvement was demonstrated in patients with ≥ 90% methylation of FMR1 (nominal P = 0.020). This group also achieved statistically significant improvements in Caregiver Global Impression‐Change in SA and isolation, irritable and disruptive behaviors, and social interactions (nominal P-values: P = 0.038, P = 0.028, and P = 0.002). Similar results were seen in patients with 100% methylation of FMR1. ZYN002 was safe and well tolerated. All treatment-emergent adverse events (TEAEs) were mild or moderate. The most common treatment-related TEAE was application site pain (ZYN002: 6.4%; placebo: 1.0%).ConclusionsIn CONNECT-FX, ZYN002 was well tolerated in patients with FXS and demonstrated evidence of efficacy with a favorable benefit risk relationship in patients with ≥ 90% methylation of the FMR1 gene, in whom gene silencing is most likely, and the impact of FXS is typically most severe.Trial registrationThe CONNECT-FX trial is registered on Clinicaltrials.gov (NCT03614663).

Utilizing Parent-Child Interaction Therapy with Trauma-Directed Interaction in a Young Male in Out of Home Care Who Had Experienced Trauma

Child abuse and neglect in young children can lead to trauma-related stress symptoms that can be challenging to manage. Parent-Child Interaction Therapy (PCIT), a strong evidence-based behavioral parent training program used for young children with behavior issues, has been used in its traditional form with increasing frequency with children and families who have trauma histories, with clinicians tailoring PCIT to use with children who have experienced trauma. Trauma-Directed Interaction (TDI) is a new systematic adaption to the standard PCIT parent training program that has the potential to help treat trauma in younger children. TDI includes several trauma-informed techniques that are added to a course of standard PCIT treatment including psychoeducation regarding trauma, recognition of feelings, and emotional regulation. This case study illustrates the use of a manualized trauma adaptation to PCIT (TDI) with a three-year-old boy who had a history of child maltreatment and his caregiver. This case provides a summary of the progression of this intervention and the results obtained. Results from the case indicated that TDI treatment was effective in not only reducing child trauma and behavioral symptoms but also in reducing mild caregiver mental health concerns. The next steps for TDI treatment and need for further research are discussed.

Association between Gut Microbiota and Emotional-Behavioral Symptoms in Children with Attention-Deficit/Hyperactivity Disorder

Previous studies have explored the role of the microbiome in attention-deficit/hyperactivity disorder (ADHD). However, whether the microbiome is correlated with emotional–behavioral disturbances, the most common comorbid symptom of ADHD, remains unclear. We established a cross-sectional study in which 6- to 18-year-old children with ADHD who were receiving no medication and a healthy control group of children without ADHD were recruited to analyze their microbiome composition. Microbiota of fecal samples were collected and analyzed using a 16s rRNA gene sequencing approach. In comparison with the healthy control group, the gut microbiota in children with ADHD exhibited significantly lower beta diversity. The abundance of the phylum Proteobacteria and the genera Agathobacter, Phascolarctobacterium, Prevotella_2, Acidaminococcus, Roseburia, and Ruminococcus gnavus group was increased in the ADHD group compared with the healthy group. Linear discriminant effect size (LEfSe) analysis was used to highlight specific bacteria phylotypes that were differentially altered between the ADHD and control groups. A regression analysis was performed to investigate the association between microbiota and emotional–behavioral symptoms in children with ADHD. A significant association was noted between withdrawal and depression symptoms and Agathobacter (p = 0.044), and between rule-breaking behavior and the Ruminococcus gnavus group (p = 0.046) after adjusting for sex, age, and the ADHD core symptoms score. This study advances the knowledge of how gut microbiota composition may contribute to emotional–behavioral symptoms in children with ADHD. The detailed mechanisms underlying the role of the gut microbiota in ADHD pathophysiology still require further investigation.

Deficits in Parent Knowledge of Behavior Management Skills is Strongly Associated with CD Symptoms but Not ODD Symptoms.

We conducted secondary analyses of existing data to examine the association between parent scores on the Knowledge of Effective Parenting Test (KEPT) and child symptoms of Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD). Parent knowledge of behavior management skills and child behavior symptoms were assessed in a nationally representative sample of parents/guardians (N = 1,570) of children aged 5-12 from all 50 states. Results showed consistent and robust correlations between parent knowledge of behavior management skills and CD symptoms but not ODD symptoms. These findings suggest that parent knowledge of behavior management may be a greater risk factor for CD than ODD, with implications for taxonomy and understanding the etiology of these two disorders. We also discuss the implications of these findings for the prevention and treatment of these two disorders which are often grouped together in treatment trials.