Childhood Emotional Disorders Research Articles

Parental emotion and emotion regulation: A critical target of study for research and intervention to promote child emotion socialization.

Parents' behaviors-particularly their emotion socialization behaviors (ESBs)-drive children's emotion socialization (Eisenberg, Cumberland, & Spinrad, 1998). We propose that a major next step in the effort to promote healthy emotional development is to improve the field's understanding of the most proximal contributor to parent ESBs: parents' own experience and regulation of emotions in the context of caregiving. As an initial step, this paper integrates Eisenberg and colleagues' model of emotion socialization with theoretical and empirical work on parental emotion. We review the literature on the emotionally evocative nature of parenting, which influences parental ESBs, including parents' expressions of emotions and their responses to children's emotions. However, whereas parental emotions influence behavior, they do not necessarily determine it; parents may regulate their emotions to engage in optimal ESBs. Thus, parental regulation contributes to emotion socialization not only by modeling emotion regulation strategies for children, but also by influencing the quality of parents' ESBs. From a clinical perspective, parental emotion regulation is of utmost importance due to the degree of parental involvement in interventions for childhood emotional and behavioral disorders, which are often aimed at promoting child self-regulation. To illustrate practical applications of Eisenberg's model, we discuss evidence-based practices that include enhancement of parent emotion regulation as a primary target, with the ultimate goal of promoting child emotional development. Ultimately, we aim to spur future theoretical, empirical, and translational work in this area. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Barriers to and facilitators of the identification, management and referral of childhood anxiety disorders in primary care: a survey of general practitioners in England

ObjectivesAlthough anxiety disorders are the most common emotional disorders in childhood and are associated with a broad range of negative outcomes, only a minority of affected children receive professional support....

Increased Risk for Neurodevelopmental Disorders in Children With Orofacial Clefts

Children with orofacial clefts (OFC) may have an increased risk of poor mental health. This study aimed to investigate the risk of psychiatric diagnoses in individuals with OFC, stratified by cleft type. A nationwide register-based cohort of all individuals born with nonsyndromic OFC in Sweden between 1973 and 2012 (n= 7,842) was compared to a matched cohort (n= 78,409) as well as to their unaffected siblings (n= 9,637). The risk of psychiatric diagnoses, suicide attempts, and suicides was examined by crude and adjusted Cox regression models. Effect modification by sex was investigated with interaction terms in the models. Children with cleft lip (CL) had a significantly higher risk of any psychiatric disorder, intellectual disability, and language disorders; children with cleft lip and palate (CLP) had, in addition, an increased risk of autism spectrum disorder (ASD). Children with cleft palate only (CPO) had risk increases for the same diagnoses as children with CL and CLP, but with higher hazard ratios, and also for psychotic disorders, attention-deficit/hyperactivity disorder (ADHD), and other behavioral or emotional disorders in childhood. Sex stratification indicated higher risk increases among females in CL and CLP but not in CPO. Siblings without OFC were less likely to be diagnosed with any psychiatric disorder, intellectual disability, language disorder, ASD, or ADHD compared to their siblings with OFC. Children with nonsyndromic clefts had a significantly higher risk of neurodevelopmental disorders. This risk is unlikely to be explained by familial influences such as inherited genetic or shared environmental factors.

Behavioural and emotional disorders in childhood: A brief overview for paediatricians

Mental health problems in children and adolescents include several types of emotional and behavioural disorders, including disruptive, depression, anxiety and pervasive developmental (autism) disorders, characterized as either internalizing or externalizing problems. Disruptive behavioural problems such as temper tantrums, attention deficit hyperactivity disorder, oppositional, defiant or conduct disorders are the commonest behavioural problems in preschool and school age children. The routine Paediatric clinic or Family Medicine/General Practitioner surgery presents with several desirable characteristics that make them ideal for providing effective mental health services to children and adolescents. DSM-5 and ICD-10 are the universally accepted standard criteria for the classification of mental and behaviour disorders in childhood and adults. The age and gender prevalence estimation of various childhood behavioural disorders are variable and difficult to compare worldwide. A review of relevant published literature was conducted, including published meta-analyses and national guidelines. We searched for articles indexed by Ovid, PubMed, PubMed Medical Central, CINAHL, EMBASE, Database of s and Reviews, and the Cochrane Database of Systematic reviews and other online sources. The searches were conducted using a combination of search expressions including “childhood”, “behaviour”, “disorders” or “problems”. Childhood behaviour and emotional problems with their related disorders have significant negative impacts on the individual, the family and the society. They are commonly associated with poor academic, occupational, and psychosocial functioning. It is important for all healthcare professionals, especially the Paediatricians to be aware of the range of presentation, prevention and management of the common mental health problems in children and adolescents.

GPs' experiences of children with anxiety disorders in primary care: a qualitative study.

BackgroundAnxiety disorders have a median age of onset of 11 years and are the most common emotional disorders in childhood; however, a significant proportion of those affected do not access professional support. In the UK, GPs are often the first medical professional that families see so are in a prime position to support children with anxiety disorders; however, currently there is little research available on GPs’ perspectives on and experiences of supporting children with these disorders.AimTo explore the experiences of GPs in relation to identification, management, and access to specialist services for children (<12 years) with anxiety disorders.Design and settingTwenty semi-structured interviews were conducted with GPs in primary care throughout England.MethodGPs reflected a diverse group in relation to the ethnic and socioeconomic profile of registered patients, GP age, sex, professional status, previous engagement with research, and practice size and location. Purposive sampling was used to recruit GPs until theoretical saturation was reached. Data were analysed using a constant comparative method of thematic analysis.ResultsData from 20 semi-structured interviews were organised into three themes: decision making, responsibility, and emotional response, with an overarching theme of GPs feeling ill equipped. These themes were retrospectively analysed to illustrate their role at different stages in the primary care process (identification, management, and access to specialist services).ConclusionGPs feel ill equipped to manage and support childhood anxiety disorders, demonstrating a need for medical training to include greater emphasis on children’s mental health, as well as potential for greater collaboration between primary and specialist services.

The association between child and adolescent emotional disorder and poor attendance at school: a systematic review protocol

BackgroundAnxiety and depression are common in young people and are associated with a range of adverse outcomes. Research has suggested a relationship between emotional disorder and poor school attendance, and thus poor attendance may serve as a red flag for children at risk of emotional disorder. This systematic review aims to investigate the association between child and adolescent emotional disorder and poor attendance at school.MethodsWe will search electronic databases from a variety of disciplines including medicine, psychology, education and social sciences, as well as sources of grey literature, to identify any quantitative studies that investigate the relationship between emotional disorder and school attendance. Emotional disorder may refer to diagnoses of mood or anxiety disorders using standardised diagnostic measures, or measures of depression, anxiety or “internalising symptoms” using a continuous scale. Definitions for school non-attendance vary, and we aim to include any relevant terminology, including attendance, non-attendance, school refusal, school phobia, absenteeism and truancy. Two independent reviewers will screen identified papers and extract data from included studies. We will assess the risk of bias of included studies using the Newcastle-Ottawa Scale. Random effects meta-analysis will be used to pool quantitative findings when studies use the same measure of association, otherwise a narrative synthesis approach will be used.DiscussionThis systematic review will provide a detailed synthesis of evidence regarding the relationship between childhood emotional disorder and poor attendance at school. Understanding this relationship has the potential to assist in the development of strategies to improve the identification of and intervention for this vulnerable group.Systematic review registrationPROSPERO CRD42016052961

Changing social milieu and emotional disorders of childhood

Changing social milieu and emotional disorders of childhood

The Most Frequent Disorders, at the Department for Child and Adolescent Psychiatry in Sarajevo, Bosnia and Herzegovina in the Period of Four Years

Introduction There is only one Depaartment for Child and adolescent psychiatryin Bosnia and Herzegovina Objectives To determine the structure of psychiatric morbidity, types and prevalence of certain diagnostic entities and sociodemographic characteristics of hospitalized patients at the Department of Child and Adolescent Psychiatry of Psychiatric Clinic in Sarajevo during the period from 2010 to 2014. Material and Methods The study was conducted at the Psychiatric Clinic, Clinical Center of University of Sarajevo as retrospective. It included 394 subjects that were hospitalized at the Department of Child and Adolescent Psychiatry of Psychiatric Clinic during the period of 4 yrs. Data were collected from protocols of hospitalized patients. Results The total number of hospitalized patients in the observed period were 394: 232 or 58,9% were males and 162 or 41,1% were females. The most common were patients in the age group 13-18 years (45,7%). The average hospitalization duration was 44,2±21,4 days. The most common mental disorders were from the diagnostic groups F90-F98 (Behavioural and emotional disorders in childhood and adolescence) and F40-F48 (Neurotic, stress-related and somatoform disorders). Disorders from the diagnostic group F90-F98 were more prevalent in boys, while disorders from the group F40-F48 were more prevalent in girls. Disorders from both diagnostic groups were most common in patients aged 13-18 years. Conclusions There are significant gender and age differences in the distribution of disorders from diagnostic groups F40-F48 and F90-F98.

Gender-age interaction in incidence rates of childhood emotional disorders.

The post-pubertal association of female gender with emotional disorder is a robust finding. However, studies exploring the association of gender and emotional disorders before puberty are few and present diverging results. The aim of this study was to present gender-specific incidence rates of emotional disorders throughout childhood. This is a population-based cohort study of 907,806 Danish 3- to 18-year-olds. The outcome was assignment of an emotional disorder diagnosis based on in-patient and out-patient data from The Danish Psychiatric Central Register. Outcome measures were incidence rates and cumulative incidences for unipolar depressive disorder (ICD-10: F32-F33), anxiety disorders (ICD-10: F40-F42), and emotional disorders with onset specific to childhood (ICD-10: F93). Pre-pubertal incidence rates for depressive and anxiety disorders were higher for boys than girls. At age 12 years the pattern reversed. The cumulative incidence for any emotional disorder (F32-F33, F40-F42, F93) on the 11th birthday was 0.52% (95% CI 0.50-0.55) for boys and 0.31% (95% CI 0.29-0.33) for girls. On the 19th birthday cumulative incidence was 2.33% (95% CI 2.24-2.43) for boys and 3.77% (95% CI 3.64-3.90) for girls. The pre-pubertal male preponderance was also significant for depressive disorders (F32-F33, p = 0.00144) and anxiety disorders (F40-F42, F93, p < 0.00001) separately. Emotional disorders seem to display a male preponderance before the age of 12 years and a female preponderance thereafter. Studies exploring this gender-age interaction are needed. Still, the results question the general assumption that females throughout the lifespan are more at risk for emotional disorders than males.

Parenting interventions for childhood chronic illness

Every day, thousands of children suffer the effects of chronic health conditions and families struggle with illness management and children's behavioural and emotional adjustment. Many parents experience difficulties with their caregiving role and lack confidence in their ability to manage their child's illness and ensure the child's well-being. While there is consistent evidence as to the extent and impact of childhood chronic illness, there is a paucity of evidence-based parenting approaches to help children with chronic health conditions and their families. This paper provides a narrative review of the current literature to examine relationships between chronic childhood illness, emotional and behavioural disorders and parenting. Key guidelines and recommendations for the development of evidence-based parenting programs for parents of children affected by chronic health conditions are provided.

1031 – Risk of psychiatric disorders in hypospadias - a nationwide swedish cohort study

Introduction Even though 0.3-0.8% percent of the male population are born with hypospadias, it is not known if this is associated with an increased risk for psychiatric morbidity later in life. Aims The aim of this study was to assess the association between hypospadias and risk of psychiatric disorders in affected individuals. Methods The association between hypospadias and psychiatric disorders was examined in a population-based cohort study using Swedish registers. Individuals born in Sweden between 1973 and 2009 were included in the study. Among them, 11,156 patients with hypospadias were identified and matched with 1,098,714 distinct controls by year of birth and county. The following outcomes were evaluated: 1- suicide attempt, 2- psychotic, 3- mood, 4-anxiety, 5- eating, 6- personality disorders, 7- disorders due to psychoactive substance use, 8- ADHD, 9- pervasive developmental disorders, 10- intellectual disabilities, and 11- other childhood emotional disorders. Results After adjusting for socio-economic and perinatal factors, malformations and/or genetic syndromes, patients with hypospadias were more likely to be diagnosed with pervasive developmental disorders (OR 1.4; 95% CI 1.1-1.6), intellectual disabilities (OR 1.8; 95% CI 1.6-2.1), ADHD (OR 1.2; 95% CI 1.0-1.4) and other childhood emotional disorders (OR 1.3; 95% CI 1.1-1.4) compared to the controls. No relation between other psychiatric diagnosis and hypospadias was found. Conclusion Hypospadias is associated with an increased risk of neurodevelopmental disorders.

Reported Maternal Postpartum Depression and Risk of Childhood Psychopathology

Childhood emotional and behavioural disorders are prevalent, can cause significant maladaptation and often persist into adulthood. Previous literature investigating the potential influence of postpartum depression (PPD) is inconsistent. The present study examined the association between PPD and childhood behavioural/emotional outcomes, while considering a number of potentially important factors. Data were analyzed prospectively from the National Longitudinal Survey of Children and Youth at two follow-up periods (ages 2-3, N = 1,452 and ages 4-5, N = 1,357). PPD was measured using the diagnostic criteria of the DSM-IV-TR. Four behavioural/emotional outcomes were analyzed at each follow-up. For both age groups, logistic regression models were used to estimate the associations between PPD and each of the behavioural and emotional outcomes adjusting for child, obstetric, environmental and socio-demographic factors. PPD was associated with the Emotional Disorder-Anxiety among 2-3 year olds [OR = 2.38, 95 % CI 1.15, 4.91]. Among 2-3 year olds, hostile/ineffective parenting was associated with Hyperactivity-Inattention [OR = 1.88, 95 % CI 1.14, 3.11] and Physical Aggression-Opposition [OR = 2.95, 95 % CI 1.77, 4.92]. Among 4-5 year olds, hostile/ineffective parenting was associated with Hyperactivity-Inattention [OR = 2.34, 95 % CI 1.22, 4.47], Emotional Disorder-Anxiety [OR = 2.16, 95 % CI 1.00, 4.67], Physical Aggression-Conduct Disorder [OR = 1.96, 95 % CI 1.09, 3.53] and Indirect Aggression [OR = 1.87, 95 % CI 1.09, 3.21]. The findings of the present study do not suggest that PPD is independently associated with any enduring sequelae in the realm of child behavioural/emotional psychology, though the symptoms of PPD may be giving way to other important mediating factors such as parenting style.

Childhood psychological function and obesity risk across the lifecourse: findings from the 1970 British Cohort Study

Psychological comorbidities of obesity are well recognised. However, the role of childhood psychological problems in the aetiology of later obesity has been little studied. Secondary analyses of a national birth cohort (1970 British Cohort Study). Logistic regression models to predict obesity risk at 26, 30 and 34 years related to hypothesised predictors: maternal and teacher reported child psychological function at 5 and 10 years (general behavioural, conduct, emotional or attentional/hyperactivity problems) and maternal psychological function. General behavioural problems at age 5 years increased the risk of obesity at 30 and 34 years. Persistence of these problems through childhood further increased the obesity risk. Inattention/hyperactivity at 10 years similarly increased risk of obesity at 30 years (adjusted odds ratios (AOR) 1.3). Chronic conduct problems at 5 and 10 years also increased the obesity risk at 30 years (AOR 1.6 (1.1, 2.4) P<0.05). Childhood emotional disorders and maternal psychological function were not associated with adult obesity. Children with early and persistent behavioural problems, particularly conduct problems, hyperactivity and inattention in early and mid-childhood are at an increased risk of obesity in adult life. The promotion of child and adolescent mental health and well-being may form an important part of future obesity prevention strategies. The promotion of healthy eating and activity should form part of secondary prevention and management strategies for children with disruptive behaviour disorders.

Supporting children with selective mutism

Selective mutism is a rare childhood emotional disorder. Affected children are unable to speak in certain settings (e.g. in school) but can speak fluently with intimates and in familiar settings (e.g. at home). This article looks at the presentation, possible causes and how school nurses might be able to support children with selective mutism.

Universal Prevention of Anxiety and Depression in a Recreational Camp Setting: An Initial Open Trial.

BACKGROUND: Anxiety and depressive disorders may pose a long-term, deleterious impact on youth, prompting a need for early and effective prevention of such concerns. A growing body of research has examined universal prevention programs targeting these emotional disorders in childhood. While most universal prevention programs are offered within the school setting, there is also a rationale for developing and investigating prevention programs within novel settings, including a recreational context. OBJECTIVE: This initial investigation utilized the Emotion Detectives Prevention Program (EDPP), a universal prevention protocol focusing on anxiety and depression symptoms within a recreational summer camp. The aims of this pilot study were to assess the EDPP's feasibility and participant satisfaction following its initial administration in a camp setting. METHOD: Forty children (ages 7-10 years, 70.7% male) were recruited from an existent recreational sports camp and participated in a non-randomized, open trial of the EDPP. The EDPP, a 15-session program, presents cognitive-behavioral strategies in a manner that emphasizes strategy applicability across a range of emotional experiences. RESULTS: Participating children reported a significant decrease in anxiety symptoms at post-prevention. No significant change in depression symptoms or other emotion regulation indices were reported. Moderate to high participant satisfaction was indicated. CONCLUSIONS: The EDPP appears to be a feasible program for the prevention of child-reported anxiety symptoms in a camp setting. Given the novelty of the prevention context, issues inherent in the conduct of research in a recreational camp setting and future directions for research in this setting are discussed.

The impact of deployment to Iraq or Afghanistan on military children: A review of the literature

The aim of this review is to evaluate what is known about the impact on children of parental deployment to Iraq or Afghanistan. We searched for relevant studies with a minimum sample size of 50 which were published between 2003 and 2010 using Google Scholar, MEDLINE, PubMed, PsycINFO and Web of Science. Bibliographies of retrieved articles were also searched. Nine US-based studies were identified for inclusion in the review, five were cross-sectional, two were longitudinal and two were analyses of routinely collected data. Researchers found an increase in emotional and behavioral problems in children when a parent was deployed. Several mediating factors were identified, such as the family demographics and the number and duration of parental deployments. Parental psychopathology was most consistently identified as a risk factor for childhood emotional and behavioral disorders in the research. Limitations of the current research and subsequent recommendations for future research are also outlined.

Early Resolution of Convergence Spasms Following the Addition of Antipsychotic Medications

We report a case of early resolution of convergence spasms following the addition of antipsychotic medications and present it as a possible alternative to the conventional treatment for convergence spasms. The cessation of atropinization of the eyes and the use of reading glasses was achieved after only 2 months following the initiation of antipsychotic medications for childhood emotional disorder.

Child and maternal psychological function and subsequent adult obesity risk: findings from a national birth cohort

Background The psychological sequelae of obesity have been well studied. There is emerging evidence that childhood psychological function may have implications for subsequent adult obesity. Maternal psychological function has also been implicated. Identification of psychological factors in childhood related to subsequent overweight may contribute to preventing obesity across the life course. Design The authors undertook life-course analyses using the 1970 British birth cohort. Outcomes Obesity at 26, 30 and 34 years. Predictors Maternal- and teacher-reported child psychological function (general behavioural, conduct, emotional or attentional/hyperactivity problems) and maternal psychological function. Analyses Logistic regression models for risk of adult obesity were adjusted for socioeconomic status, parental body mass index (BMI), birth weight, childhood BMI, cognitive ability and adult social class. Results Complete data on childhood psychological function and adult obesity were available on 6768 subjects. Generalised behavioural problems at age 5 years increased the risk of obesity at 30 years (adjusted OR (AOR)=1.5 (95% CI 1.2 to 1.8) p=0.001) and at 34 years (AOR=1.3 (1.0 to 1.6) p=0.03). Persistence of these problems through childhood (ie, also present at 10 years) further increased obesity risk at 30 years (AOR 1.9 (1.3 to 2.7) p=0.001). Chronic conduct problems at 5 and 10 years also increased obesity risk at 30 years (AOR 1.6 (1.1 to 2.4) p=0.01). Inattention/hyperactivity at 10 years similarly increased risk of obesity at 30 years (AOR 1.3 (1.0 to 1.6) p=0.04). Childhood emotional disorders and maternal psychological function were not associated with adult obesity. Conclusion Chronic childhood behavioural problems increase the risk of adult obesity by up to 90% after adjustment for childhood BMI. Risk increases most with early and persistent problems. Adult obesity risk was predominantly related to childhood conduct and attentional/hyperactivity problems. Strategies to prevent or reduce obesity should include a focus on psychological function in childhood, particularly conduct and attentional problems.

Family aggregation of mental disorders in the nationwide Danish three generation study

The study of familial aggregation of major mental disorders in a national population. Within a Danish register-based cohort study, aggregation of mental disorders was analysed in all case-probands with first psychiatric contact before the age of 19 years in the time period between 1 April 1969 and 29 June 2004 followed up until the age of 35 years, their first-degree relatives, and a matched group of control-probands including their first-degree relatives. Hazard rate ratios were significantly elevated for cases as compared to controls for all diagnoses among probands, parents, and siblings. Among children of the probands, these ratios were significantly elevated for neurotic (anxiety) disorders, mental retardation, developmental disorders, behavioural and emotional disorders of childhood and adolescence, and miscellaneous disorders. Family aggregation of any diagnosis was significantly higher in probands with substance use disorder, schizophrenia, affective disorders, neurotic (anxiety) disorders, and miscellaneous disorders. There was specificity of familial transmission for affective and neurotic (anxiety) disorders. This large nationwide study found some differential patterns of familial aggregation of major mental disorders.

Depression in children and adolescents

Among children and adolescents, the prevalence of depressive symptoms is about 15%. Clinically significant depression occurs in 5%. Depression in children overlaps with other childhood emotional and behavioural disorders. Depression in children is multifactorial and includes biological, psychological and social factors. Tricyclic antidepressants such as imipramine are ineffective in children and have limited effect in adolescents. SSRIs are also of limited value. For total health benefit in the treatment of depression, cognitive behaviour therapy (CBT) is found to be more beneficial than SSRIs.