Childhood Psychological Distress Research Articles

A longitudinal investigation of psychological distress in children during COVID-19: the role of socio-emotional vulnerability

ABSTRACT Background Although the COVID-19 pandemic has increased the incidence of distress in youth, some children show increased resilience, emphasizing the need to better understand the predictors of distress in youth. Objective This longitudinal study aimed to assess the combined impact of known socio-emotional predictors of stress-related psychopathology, namely anxiety sensitivity, anxiety trait, intolerance to uncertainty, and rumination, on COVID-related distress in healthy youth. Method A total of 92 parent-child dyads that previously participated in a laboratory-based experiment assessing observational fear learning in families between 2017 and 2019 (T0) were recontacted. Of them, 84 children aged between 9 and 14 agreed to participate. They completed online questionnaires in June 2020 (T1), September 2020 (T2), December 2020 (T3), and March 2021 (T4). Participants were free of mental illness at T0 and T1. To create a socio-emotional composite score (SECS), we measured anxiety sensitivity (Childhood Anxiety Sensitivity Index) at T0, trait anxiety (Trait subscale of the State-Trait Anxiety Inventory for Children (STAI-C)), intolerance to uncertainty (Intolerance of Uncertainty Scale for Children), and trait rumination (Children’s Response Style Scale) at T1 and created a weighted z-score. To assess symptoms of anxiety, post-traumatic stress (PTS), and depression in reaction to COVID-19, participants completed the State subscale of the STAI-C, the Children’s Revised Impact of Event Scale, and the Children’s Depression Inventory at T1–T4. Three general linear models were run with sex, age group (9–11 and 12+ years old), and SECS as predictors. Results Analyses revealed a SECS*Time interaction, with higher SECS predicting elevated anxiety symptoms at T1 and T4, and elevated PTS symptoms at T1 and T2. Conclusion These results suggest that healthy youth endorsing high levels of socio-emotional vulnerability to psychopathology have a higher risk of suffering from anxiety and PTS, but not depressive symptoms, in the year following a major stressor.

Is autonomy-supportive parenting universally beneficial? Combined effect of socially prescribed perfectionism and parental autonomy support on stress in emerging adults in South Korea.

Emerging adulthood is a developmental period marked by numerous life transitions, leading emerging adults to be susceptible to distress and related psychological risks. The current study investigated the effects of socially prescribed perfectionism and parental autonomy support on psychological stress among emerging adults. We implemented a two-wave longitudinal design spanning a six-month period and latent moderation structural equations, based on data collected from 220 South Korean emerging adults (103 males, aged from 21 to 31 years). Our findings indicated that socially prescribed perfectionism predicted longitudinal increases in perceived stress, whereas parental autonomy support did not. Moderation analysis revealed that for those with high socially prescribed perfectionism, more parental autonomy support was related to greater increases in perceived stress. The results suggested that the effect of parental autonomy support may not be universally beneficial to children’s psychological distress. Rather, the effect might vary depending on cultural context and children’s individual differences.

Psychological distress in children and adolescent disaster survivors.

This study aimed to clarify the association between mental and behavioral changes and subsequent psychological distress among children and adolescents living in areas affected by the 2011 Great East Japan Earthquake. We conducted a two-wave study, with waves 1 and 2 occurring in 2011 and 2014, respectively. Data of 462 respondents aged 9-14 years during wave 1 and who participated in both surveys were used in the present analysis. A factor analysis was performed using the mental and behavioral changes reported by respondents in wave 1. Psychological distress was defined as a score of ≥5 on the six-item Kessler Psychological Distress Scale, as measured in wave 2. With the factors generated in this analysis set as independent variables, the odds ratios (OR) (95% confidence intervals, 95% CIs) for psychological distress were calculated using logistic regression, adjusting for age, sex, house damage, living environment, and loss of family or friends. Psychological distress was present in 108 (23.4%) of the respondents. The factor analysis yielded three factors describing mental and behavioral changes: interpersonal issues, brain fog, and anxiety and panic. Of these, interpersonal issues were significantly associated with subsequent psychological distress, with an OR of 2.59 (95% CI 1.58-4.25). This association did not change even when stratified by age and sex. This study suggests that interpersonal issues are a significant predictor of psychological distress in children and adolescents living in areas affected by a large-scale disaster.

Psychological distress in early childhood and the risk of adolescent spinal pain with impact.

Spinal pain (SP), including neck and back pain, is common and often associated with poor mental health and reduced quality of life of adolescents. Contemporary understanding of SP favours a biopsychosocial approach, and emerging evidence suggests the stronger influence of psychological rather than other factors. We aimed to investigate if experiencing psychological distress in early childhood increases the risk of spinal pain with impact during adolescence. 1175 adolescents from a prospective cohort study (Raine Study Gen2) were included. Psychological distress was assessed at ages 2, 5, 8 and 10 using Child Behaviour Check List (CBCL). CBCL total and subscale scores (internalizing and externalizing symptoms) were converted to age-standardized scores and dichotomized according to t-scores (>60=high distress). Life-time spinal pain, including low back, mid back, or neck/shoulder, was measured at age 17. We were interested in adolescent SP with impact (care seeking, medication use, school absenteeism, daily activity interference, leisure activity interference) and defined cases as SP with impact (one or more) or greater impact (two or more) impacts. We investigated the longitudinal associations between childhood psychological distress and adolescent SP using univariate and multivariable logistic regression models. Psychological distress in childhood increased the odds of adolescent SP with impact by 33% (OR 1.33; 95% CI 1.01-1.76), but not spinal pain with greater impact (OR 1.22; 95% 0.83-1.80). Internalizing symptoms were associated with SP with greater impact and externalizing symptoms with SP with impact after adjusting for a range of potential child and family confounders. Psychological distress in childhood increases the risk of SP with impact in adolescence and may be a promising prevention target. Our findings provide evidence that psychological distress early in life is an independent risk factor for spinal pain with impact during adolescence. As psychological distress during childhood is potentially modifiable, it may be a promising target for research on the prevention of consequential spinal pain in adolescence. Identifying and addressing psychological distress in children may be an important component of best practice to reduce consequential spinal pain in adolescents.

Gender Perspective in Research on Interventions in Children with Experiences of Parental Gender-Based Violence: Application of GPIHR Criteria.

The aim of this study was to analyse the inclusion of a gender perspective (GP) in scientific production on interventions for a reduction in psychological distress in children who have experienced parental gender-based violence (CEXPGBV). To achieve this, a review of publications was carried out in the Web of Science, EBSCOhost, ProQuest and Cochrane Library databases. A total of 3418 records were found, and 44 items of research selected. For GP analysis, the questionnaire “Gender perspective in health research” (GPIHR) was applied and relationships with the terminology of violence were analysed, as well as the definition of term used, references to violence by men or received by women and the instruments used to assess these. Generally, the assessed studies do not contain a GP, since 70% of the GPIHR items were answered negatively. Likewise, 89% of research used general terms to refer to violence without referring to gender. These results show the importance of considering instruments such as GPIHR in both the planning and development of future research in order to avoid possible gender bias.

Sleep disturbance and psychological distress among hospitalized children in India: Parental perceptions on pediatric inpatient experiences.

Investigate parental perceptions of children's sleep disturbance and psychological distress associated with an inpatient stay in a low-resource hospital setting. Demographic and validated survey instruments were adapted for administration to parents of children in the medical wards of a tertiary hospital in India. Parents proficient in English, Hindi, Tamil, or Telugu with a child age 4-12 years admitted for at least 48 h were eligible to participate. All respondents completed the Factors Affecting Sleep Disturbance Scale, Sleep Duration Questionnaire, Sleep Disturbance Scale, and Kessler Psychological Distress Scale. Data analysis entailed descriptive statistics, correlations, and multivariate regressions to analyze relationships across responses on demographics, sleep disturbance, and psychological distress. Among 105 parents with hospitalized children, most had children 4-6 years old (54%), including 65% boys and 35% girls. Parents reported that their children slept overnight in the hospital for a mean of 8.3 ± 1.6 h. Children 4-6 year old (relative risk ratio [RRR] = 0.63, p = .004), dyspnea (RRR = 8.73, p = .04), previous hospitalization (RRR = 9.17, p = .03), nighttime procedures (RRR = 2.97, p = .03, and missing home (RRR = 6.78, p < .001) were the factors affecting sleep. Factors affecting psychological distress was nighttime medication administration (RRR = 4.92, p = .01). Sleep disturbances correlated with psychological distress (r = 0.56; p < .01). Sleep disturbance and associated psychological distress in hospitalized children were widely reported by parents queried in this low-resource hospital setting. Nurses can lead efforts in ameliorating sleep in hospitalized children, including partnering with stakeholders on measures to reduce sleep disruption. Child-centered interventions may improve sleep hygiene and decrease psychological distress among children.

Impact of the COVID-19 Lockdown in Malaysia: An Examination of the Psychological Well-Being of Parent-Child Dyads and Child Behavior in Families With Children on the Autism Spectrum.

Background: The COVID-19 pandemic lockdowns have adversely impacted children on the autism spectrum and their families, especially in Malaysia where this population is often marginalized. The current quantitative research aimed to investigate the impact of the Malaysian COVID-19 lockdown on the behavior and psychological distress of children formally diagnosed with an autism spectrum condition (ASC) as well as the psychological distress and well-being of their parents, in comparison with a typically developing (TD) control group.Methods: The children's ages ranged between 5 and 17 years. The sample included 72 ASC parent-child dyads and 62 TD parent-child dyads. The primary caregiver completed an online survey including the following: demographic and diagnostic information; ASC symptoms; children's inattention, hyperactivity/impulsivity, perceived stress, depression, and anxiety; parents' perceived stress, depression, anxiety, and well-being based on their experience pre- and mid-lockdown (March 18th to June 9th 2020) in Malaysia.Results: Among the ASC group, no significant pre- and mid-lockdown change was found in ASC symptoms (p > 0.05). There were no significant gender differences (boys/girls) in all the child scales. The 2 [diagnosis (ASC, TD)] × 2 [lockdown (pre-lockdown, mid-lockdown)] mixed-model ANOVAs revealed main effects of lockdown on children's attention, hyperactivity/impulsivity, anxiety, and parents' perceived stress, depression, and psychological well-being (p < 0.005). There was a main effect of diagnosis in all child and parent variables, except parents' perceived stress (p >0.005). However, there was no significant interaction effect between diagnosis and lockdown (p >0.005). All child behavior (inattention and hyperactivity/impulsivity) and child psychological distress (anxiety, depression, and perceived stress) were significantly correlated in both the ASC and TD groups (p < 0.005). On the other hand, only some of the parent variables were significantly correlated with child variables (p < 0.0045) in the ASC group while none of the parent variables were significantly correlated with the child variables (p > 0.005) in the TD group.Conclusion: The results provide preliminary evidence indicating negative effects of the Malaysian lockdown on both children on the autism spectrum and TD children, as well as their parents. These quantitative results will be triangulated with the qualitative interview data to provide a holistic understanding of the impact of the pandemic, informing translational policy and practice recommendations.

BRINGING FAMILIES TOGETHER IN CRISIS: FAMILY-BASED INTERVENTIONS ACROSS DIFFERENT SETTINGS OF CARE

There is considerable evidence for the clinical utility of family-based interventions (FI) in several domains of childhood psychopathology. Despite the known efficacy of FI, many child and adolescent psychiatry fellowship programs in the United States provide minimal FI training. The goals of this presentation are to highlight the feasibility and relevance of FI across acute care settings and crisis situations, and to provide practical tips on incorporating FI within the scope of daily practice of child and adolescent psychiatry. Presenters from different institutions across the country will discuss the role of FI in treating youth in crisis from inpatient, consultation-liaison, outpatient, and emergency department (ED) perspectives. Using a case-based approach, presenters will give real-life context for the following treatment approaches: brief family therapy for adolescents in the inpatient psychiatric unit, family CBT to treat psychological distress in children on a transplant unit, attachment-based family therapy (ABFT) for high-risk adolescents in the outpatient setting, and emotionally focused family therapy (EFFT) for suicidal adolescents in the ED. The presenters will engage the audience by incorporating a think/pair/share activity to practice problem solving in each treatment setting, and by providing clinical pearls for clinicians to apply FI skills in their practice. Family factors frequently play a significant role in childhood mental health crises. The presenters demonstrate how FI can be effective practical treatment tools for psychiatrists to apply across treatment settings. Family dynamics represent a critical underpinning in understanding both childhood mental distress and well-being. Therefore, it is critical for child and adolescent psychiatrists to understand how family dynamics affect patient distress and to be equipped with skills to intervene with families across treatment settings.

Family resilience and psychological distress in the COVID-19 pandemic: A mixed methods study.

Many changes were thrust upon families by the COVID-19 pandemic, including mandated quarantines, social distancing, transitions to distance learning for children, and remote work. The current study used mixed methods to examine the challenges and resilience of families in the United States during the pandemic (May-July 2020), as well as predictors and moderators of parent/child psychological distress. Our sample included 469 parents (459 mothers) of children aged ∼2-13 years (239 girls, 228 boys, one nonbinary child, one "prefer not to answer" selection), who completed an online survey with closed-ended and open-ended portions. The sample had middle-to-high socioeconomic status and 86% of families were White/non-Hispanic. Qualitative (content and thematic analyses) and quantitative (descriptive statistics and regressions) findings revealed that, even in this relatively privileged sample, parents and families were experiencing struggles in many life domains (e.g., family, school) and shifts in family dynamics and routines, which were related to emotional and mental health. Families experienced many changes in their lives, some positive and some negative, and often exhibited resilience through managing these changes. Our moderation analyses indicated that COVID-19's daily impact was significantly associated with psychological distress for children and parents, and this association was stronger for older versus younger children. Less active/instructive parental media mediation was also related to less child psychological distress. Moving forward, practitioners can focus on preventive efforts including psychoeducation regarding healthy outlets for negative emotions during COVID-19, and practical help troubleshooting childcare and health care challenges impacting many families. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The persistent effects of natural disaster exposure on child and adolescent psychological distress: evidence from a Hurricane Katrina displaced cohort

BACKGROUND AND AIM: This study evaluates the association between exposure to cumulative natural disasters and psychological distress among Gulf Coast children and adolescents. METHODS: We used data from the Gulf Coast Child and Family Health Study, a longitudinal cohort displaced by Hurricane Katrina. The exposure of interest was the number of additional natural disasters the respondent had experienced. Child psychological distress was based on their caregiver endorsing one of the following in the past month: feeling sad or depressed; having problems sleeping; feeling nervous or afraid; or having problems getting along with other children. We conducted bivariate analyses followed by logistic regression, evaluating moderation by race; annual household income; parental educational attainment; household financial constraints; stable housing; family functioning; parental coping; and parental mental component score. RESULTS:Among 141 respondents with children, about 28% reported their children having psychological distress in the past month. Those respondents whose children had psychological distress experienced over twice the number of disasters, on average, than those without psychological distress (0.45 [SD 0.86] vs. 1.10 [SD 1.64]). None of the sociodemographic, vulnerability, or resilience variables significantly moderated the association between additional disaster exposure and child/adolescent psychological distress. Each additional disaster experienced by a respondent was associated with a 90% increase in the odds that his/her child exhibited symptoms of psychological distress (OR 1.90; 95% CI 1.01, 3.55). Those whose caregivers reported coping somewhat or not well at all with parenting responsibilities were over three times more likely to have psychological distress (OR 3.33; 0.11; 0.93) than those whose caregivers were coping very well. Children and adolescents in high functioning families were also significantly less likely than children in low functioning families to exhibit symptoms (OR 0.32; 95% CI 0.11, 0.93). CONCLUSIONS:These results demonstrate the persistent effects of exposure to natural disasters on child/adolescent psychological distress. KEYWORDS: Natural disasters, Children's environmental health, Mental health outcomes

Songwriting intervention for cognitively-impaired children with life-limiting conditions: Study protocol

Investigations evaluating the effectiveness of music-based interventions as a complementary approach to symptom management and health promotion for cognitively-impaired children with life-limiting conditions and their families are needed to minimize the physical and psychological burdens on individuals and their caregivers. Songwriting is one music-based strategy for a remote family-centered complementary approach to improve outcomes for cognitively-impaired children with life-limiting conditions, their parents, and families. The overall purpose of this study is to test the feasibility and preliminary efficacy of a songwriting intervention for cognitively-impaired children (ages 5–17 years) who are receiving palliative or complex care and their parents. Specific aims are to: (1) determine the feasibility of songwriting for cognitively-impaired children with life-limiting conditions and their parents, and (2) examine preliminary efficacy of songwriting for child psychological distress and physical symptoms, parent psychological distress, and family environment. The protocol for this 1-group pre-and post-intervention clinical trial (N = 25) is described.

Identifying Loss of Control Eating within Childhood Obesity: The Importance of Family Environment and Child Psychological Distress.

This study aims to examine the differences in family environment, psychological distress, and disordered eating symptomatology between children classified by weight status with or without loss of control (LOC) eating and to test a model of the role of emotional regulation of LOC eating based on a dysfunctional family environment. A cross-sectional study was conducted among 239 families. The assessment measured family expressed emotion, family adaptability and cohesion, child levels of depression and anxiety, body esteem, and disordered eating attitudes. The assessment was carried out in primary care centers and primary schools. Child body mass index (BMI) was associated with higher expressed emotion, psychological distress, and disordered eating symptomatology. Children with obesity and LOC presented higher BMI, poorer body esteem, and more disordered eating attitudes than children without LOC. Children with overweight/obesity, both with or without LOC, exhibited higher psychological distress and emotional overinvolvement than normal-weight children. A partial mediation of depression or anxiety and disordered eating attitudes between expressed emotion and LOC was found. Findings support that children with overweight/obesity show more family and psychological distress. Body esteem issues and disordered eating attitudes could alert the presence of LOC in children with obesity. The function of LOC might be to cope with psychological distress that may appear in a dysfunctional family environment.

Defensive profile of parents of children with externalizing problems receiving Regulation-Focused Psychotherapy for Children (RFP-C): A pilot study

Background: Implicit emotion regulation, operationalized as psychological defense mechanisms, plays an important role in parenting, especially for parents of children with externalizing behavior problems. Research has highlighted the efficacy of the Regulation Focused Psychotherapy for Children (RFP-C) in reducing psychological distress in children with oppositional defiant disorder (Prout et al., 2019; Prout, 2020). The current, mixed-methods study analyzed the characteristic defensive functioning of parents whose children were treated with RFP-C. Methods: We analyzed 14 video-recorded parent sessions randomly selected from the RFP-C randomized controlled trial examining the efficacy of a novel manualized psychotherapy for children with externalizing behaviors. Defensive functioning was quantitatively and qualitatively analyzed using the Q-sort version of the Defense Mechanisms Rating Scales (DMRS-Q; Di Giuseppe et al., 2014) for parents in the clinical sample and community controls. Results: Adaptive, obsessional, and neurotic defenses were most prevalent, with 10 to 30 defense mechanisms accounting for more than 5% of the overall defensive functioning score. Significantly higher use of affiliation, humor, suppression, and devaluation of other’s image were found among parents of children with oppositional defiant disorder as compared to community controls. Defensive Profile Narratives added a qualitative understanding of the strength and limitations of the caregivers’ emotion regulation. Discussion: Studying parents’ defense mechanisms may provide a better understanding of the parental experience of childhood distress and how parental defensive style may impact children’s externalizing behaviors. Addressing defensive functioning in a clinical setting could enhance psychological adjustment among children with oppositional defiant disorder and improve therapeutic outcomes.

Managing psychological distress in children and adolescents following the COVID-19 epidemic: A cooperative approach.

Children and adolescents are susceptible to the 2019 novel coronavirus (COVID-19) epidemic and tend to show posttraumatic distress. Immediately after an epidemic, governments and social organizations often provide psychological services for children and adolescents to relieve their distress. However, many adolescents report distress even long after a traumatic event because of the unaddressed traumatic atmosphere in schools or families. To advance this issue, this article proposes a cooperative model of psychological services provision for children and adolescents in response to the COVID-19 epidemic. This model suggests that psychological services should simultaneously include social, school, and family systems, which interact and have a synergistic effect. The social system provides direct services not only for children and adolescents but also for their school and family systems; school and family systems cooperate to support adolescents. Psychological work also needs to emphasize the key elements of school and family systems. Attention should be given to teachers' distress, teacher-student relationships, and peer relationships in the school system, as well as to parents' distress, parent-child relationships, and the marital relationship in the family system. In these ways, adolescents can achieve an efficient and sustainable recovery following a disaster. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Talking to children about illness and death of a loved one during the COVID-19 pandemic

Talking to children about illness and death of a loved one during the COVID-19 pandemic

Self-compassion and Fear of Self-compassion: Mechanisms Underlying the Link between Child Maltreatment Severity and Psychological Distress in College Women

Women are at increased risk for depression and anxiety associated with child maltreatment, given higher rates of exposure to childhood maltreatment and a greater sensitivity resulting in maltreatment-related distress. Thus, there is a need to identify mechanisms of resilience among female survivors of child maltreatment. Self-compassion may promote resilience, whereas fear of self-compassion may diminish this protective effect. Moreover, distinct facets of self-compassion (e.g., self-kindness) versus self-coldness (e.g., self-judgment) may differentially explain risk or resilience for child maltreatment outcomes. College women (N = 586) completed anonymous online surveys assessing the severity of different types of child maltreatment, self-compassion, fear of self-compassion, depression, anxiety, and stress. Severity of sexual, physical, and emotional abuse, and emotional and physical neglect, was positively associated with elevated fear of self-compassion and the absence of self-compassion (i.e., self-coldness). In contrast, emotional abuse and neglect severity were the only maltreatment variables negatively associated with self-compassion. Models indicated an indirect relation between increased maltreatment severity and heightened psychological distress via fear of self-compassion and self-coldness (i.e., isolation, overidentification). Statistical patterns indicative of suppression among the positive facets of self-compassion occurred. The centrality of emotional maltreatment, along with fear of self-compassion, isolation, and overidentification, emerged across analyses. Findings suggest the absence of self-compassion (i.e., self-coldness) is associated with specific forms of distress. Additional research with child maltreatment survivors should examine self-compassion components rather than a unidimensional construct.

Grazing in children: associations with child's characteristics and parental feeding practices.

Grazing is a problematic eating behavior linked with poor weight loss outcomes, disordered eating psychopathology, and psychological distress in the adult population. However, no study assessed this behavior in children. Childhood is an important time frame for the development and maintenance of healthy eating habits, which can be influenced by children's psychological state, eating habits, and parental practices. This study investigates the associations between grazing behavior in children and children's psychological variables (anxiety, depression and withdrawn symptoms, body image dissatisfaction), children eating habits, and parental feeding practices. In this cross-sectional study, 330 primary school students (6-10years old) and their parents completed measures assessing children's grazing, anxiety/depression and withdrawn symptoms, body image dissatisfaction, children eating habits and style, and parental feeding practices. The path analysis tested showed that more restrictive parental feeding practices, inappropriate children eating habits, children's anxiety/depression symptoms, and body image dissatisfaction were associated with increased grazing scores (CMIN = 12.679; DF = 11; p = 0.315; RMSEA = 0.025; CFI = 0.990; NFI = 0.935; TLI = 0.982; IFI = 0.991; SRMR = 0.045). Grazing tends to occur in a context of children's psychological distress, inappropriate children eating habits, and restrictive parental feeding practices. These variables should be addressed for the improvement of healthy eating habits and in weight-loss interventions for children. Level V, cross-sectional descriptive study.

Psychological Distress in Early Childhood and the Risk of Adolescent Spinal Pain with Impact: A Longitudinal Cohort Study

Background: Spinal pain (SP), including neck and back pain, is common and often associated with substantial functional interference (e.g. school absenteeism), poor mental health and reduced quality of life of adolescents. Contemporary understanding of SP favours a biopsychosocial approach, and emerging evidence suggests stronger influence of psychological rather than other factors. We aimed to investigate if experiencing psychological distress in early childhood increases the risk of spinal pain with impact during adolescence. Methods: 1175 adolescents from a prospective cohort study (Raine Study Gen2) were included. Psychological distress was assessed at ages 2, 5, 8 and 10 using Child Behaviour Check List (CBCL). CBCL total and subscale scores (internalising and externalising symptoms) were converted to age-standardized scores and dichotomized according to t-scores (>60 = high distress). Spinal pain, including low back, mid back, or neck/shoulder, was measured at age 17. We were interested in adolescent SP with impact (care seeking, medication use, school absenteeism, daily activity interference, leisure activity interference) and defined cases as SP with impact (one or more) or greater impact (two or more) impacts. We investigated the longitudinal associations between childhood psychological distress and adolescent SP using univariate and multivariable logistic regression models. Sex was tested as a moderator and confounders were: child sex, age, body mass index, physical activity, sedentary behaviour, family pain history, income and maternal education. Findings: The prevalence of adolescent SP with impact and greater impact were 49% and 14%, respectively. Psychological distress in childhood increased the odds of adolescent SP with impact by 33% (adjusted OR 1.33; 95% CI 1.01 to 1.76). We found similar, significant associations for internalizing and externalizing symptoms after adjusting for a range of potential child and family confounders. Interpretation: Psychological distress in childhood increases the risk of SP with impact in adolescence and may be a promising prevention target. Funding Statement: The core management of the Raine Study is funded by The University of Western Australia (UWA), Raine Medical Research Foundation; Telethon Kids Institute; Women and Infants Research Foundation; Curtin University; Murdoch University, The University of Notre Dame Australia and Edith Cowan University. The 17 year Raine Study follow up was funded by the National and Medical Research Council (NHMRC) programme grant 353514 and NMHRC project grant 323200. Declaration of Interests: The authors stated: None. Ethics Approval Statement: The authors obtained ethics approval for this study from the Curtin University Human Research Ethics Committee and the Princess Margaret Hospital Human Research Ethics Committee (HR84/2005). Consent was gained from the participants’ guardians.

Psychological Distress in Children with Surgically Corrected Congenital Heart Disease

Purpose/Aim/Objective: The purpose of this study was to investigate the neuropsychological modifications and intellectual functioning parameters (such as predictors of school performance – Intelligence quotient - IQ) of children with surgically corrected congenital heart defects. By investigating these changes, we might be able to develop a screening tool which facilitates the early detection of psychological distress, optimizes psychological therapy. Methods: The study was conducted in the Paediatric Cardiology Clinic of Tirgu Mure?, Romania, between 2016-2018, on 86 children with congenital heart disease (CHD), aged 6 to 17 years old, who have undergone surgical repair - compared to 102 healthy controls, matched by age. The study tested the hypothesis that children with CHD have lower intellectual function than the control group and analysed behavioural outcomes for these patients. Exclusion criteria: children aged less than 6 years old, confirmed genetic syndromes and a family history of psychiatric disorders. Results: 59.3% of children in the eligible group were male, with a median age of 11.1 years ± 3.2 SD. The average IQ of the patients with cyanotic CHD was 84.09, while the control group had an average IQ of 91.10. Analysis of the psychological profile indicated that 33.7% of children with surgically corrected CHD had anxiety, and 11.6% of them had attention deficit disorder. Conclusions: Children with surgically corrected cyanotic CHD had a lower IQ than the control group. Anxiety and attention deficit disorder were more frequent in children with CHD.

Psychological and psychiatric impact of COVID-19 pandemic among children and adolescents.

Background:COVID-19 outbreak and the unprecedent measures imposed by the government, including quarantine and social distancing, cause psychological distress in children and adolescents.Methods:we review literature about mental health effects of COVID-19 pandemic by using the keywords “COVID-19”, “coronavirus”, “pandemic”, “mental health”, “psych*”, “adolescent” and “child”.Results:early evidence show high prevalence of anxiety and depressive symptoms in children and adolescents, due to the pandemic itself, to social isolation and to parents’ stress. High grade students, females and low-income families are at higher risk to develop psychiatric symptoms. Psychological distress can be reduced by maintaining contact with peers through social networks and by accurate updates provided by the government through the mass media. Online resources such as information about mental health education and preventive measure, video-counselling, telemedicine and telepsychiatry services, can be useful to reduce the psychosocial effects of the novel coronavirus.Conclusion:there is urgent need to plan new strategies for early psychological interventions in order to reduce the impact of COVID-19 pandemic on children and adolescents mental health status. (www.actabiomedica.it)