Children's Emotional-behavioral Problems Research Articles

Design and Validation of a Mentalization Promoting Program for Parents of a Child with Type 1 Diabetes and its Effectiveness on Parents' Reflective Functioning and the Child's Emotional-Behavioral Problems: A Single-Subject Study

Aim: This research was conducted with the aim of designing and validating the Mentalization promoting program for parents of a child with type 1 diabetes and investigating its effectiveness on parents' reflective Functioning and emotional-behavioral problems of the child. Methods: A mixed method was used in this research. In the qualitative part, the mentalization problems of 18 children with T1D and 22 of their parents were extracted through the analysis of interviews with the method of transcendental phenomenology, and three general themes,18 main sub-themes and 50 sub-themes were obtained. Then, based on these themes and within the framework of the concepts of mentalization theory, a program to promote the mentalization of parents with a child with type 1 diabetes was designed. After confirming the content validity based on the CVI, with a semi-experimental method and a single-subject design of the type (A-B) with different subjects, 5 parents of children with diabetes who met the criteria for entering the research, were selected with a purposeful sampling method and participated in the program. The effectiveness of this program was assessed in four phases (baseline, during intervention, after intervention and follow-up) using the Child Behavior Checklist (CBCL) and the Parental Reflective Functioning Questionnaire (PRFQ) and indicators of program goals. Then data was checked based on visual analysis indicators. Results: The final outcome of this phenomenological study is the extraction of three general themes, including the underlying factors of breakdowns in mentalizing, types of common mentalizing problems, and the consequences of breakdowns in mentalizing which became the basis for design the program to promote the mentalization of parents with a child with type 1 diabetes The results showed that the designed program, while having sufficient validity, was effective in increasing the parents reflective Functioning and reducing the emotional-behavioral problems of the child, and this effectiveness continued in the follow-up phase. Conclusion: Considering the validity of this program and its effectiveness, it is suggested that this program be widely implemented to help improve the physical and mental health of children with diabetes and their families, and also for children with other chronic diseases should also be adapted.

Prevalence of emotional-behavioral disorders with and without comorbidity in 6-8 year old children: the role of mother's reaction to child's negative emotions

Introduction: In the early years of schooling, factors such as being far from parents for 5 hours, academic and social demands can be stressful for children and provide the conditions for creating or intensify some mental disorders. Therefore, it is important to investigate the prevalence of emotional-behavioral disorders and their related factors at this age. Aim: The purpose of the present study was to investigate the prevalence of emotional-behavioral disorders with and without comorbidity in children aged 6 to 8 years, and also to predict the severity of these disorders based on the mother's reaction to the child's negative emotions. Method: The research method was descriptive-analytical. The population included all the first and second grade primary school students of Malayer city in the academic year 2017-2018, and 454 people were selected by cluster sampling method. In order to collect data, the Child's Behavior Checklist (2002) and the Child's Reaction to Negative Emotions Questionnaire (1990) were used. Data were analyzed through SPSS version 22 software and stepwise linear regression model was employed. Results: The findings of the present study revealed that, the pure prevalence of emotional and behavioral disorders in these children was 8.6% and prevalence with comorbidity of these disorders was 7.3%. In addition, mother's reactions to children's negative emotions could predict the severity of children's emotional-behavioral problems (P=0.001). Conclusion: In the age range of 6 to 8, the comorbidity of emotional and behavioral disorders of these children is high and the mother's supportive or unsupportive reactions to the child's negative emotions play a significant role in it, so it is suggested that child psychologists and psychiatrists pay special attention to these findings in diagnostic interviews and treatment strategies.

Mental health among children with long COVID during the COVID-19 pandemic.

A growing number of studies report that persons of all ages, infected with SARS-CoV-2, may experience long-term persistent symptoms, known as long COVID (LC) or post COVID-19 condition. This is one of the first studies examining the consequences of LC on children's mental health. In this case-control study, we compared select mental health aspects of 103 children diagnosed with LC to a control group of 113 children uninfected with SARS-COV-2; all 4-18years old. Both groups were assessed via parents' questionnaires. In comparison to the control group, children with LC exhibited more memory difficulties. However, no group differences emerged in other functional aspects (connection with friends and engagement in physical activities), problems with concentration, or levels of emotional-behavioral problems (externalizing, internalizing, ADHD, and PTSD symptoms). We also found that children with LC had greater exposure to COVID-19-related stressors. Higher levels of parental worries regarding their children's functioning and economic difficulties at home significantly predicted higher levels of children's emotional-behavioral problems and were better predictors than the child's age, social functioning, or LC diagnosis. Conclusion: LC was associated with impairments in some aspects of children's memory which may relate to academic functioning, but not with higher rates of emotional-behavioral problems, thus warranting interventional programs addressing school functioning and cognitive abilities in this population. Additionally, parents' economic stress and worries regarding their child's emotional adjustment during the pandemic, are important factors affecting pandemic-related emotional-behavioral problems among children, regardless of COVID-19 infection, that should be addressed. What is Known: • Children may have long COVID (LC) after being infected with SARS-COV-2. What is New: • LC may be associated to impairments in some aspects of children's memory, as reported by parents. • Parents' economic stress and worries concerning their children's emotional adjustment during the pandemic are associated with more distress in their children.

Sleep terrors in early childhood and associated emotional-behavioral problems.

While sleep terrors are associated with emotional-behavioral problems in school-aged children and adults, little is known about these associations in early childhood, when sleep terrors prevalence is at its highest. Moreover, studies using a longitudinal design and controlling for confounding variables are scarce. This study's objective was to determine whether the frequency of sleep terrors in toddlers predicts emotional-behavioral problems during the preschool years. Participants (n = 324) were enrolled in the prospective Maternal Adversity Vulnerability and Neurodevelopment cohort study. The frequency of sleep terrors in children was assessed at 12, 18, 24, and 36 months using maternal reports. Children's emotional-behavioral problems were measured at 48 and 60 months using the Child Behavior Checklist. Relevant confounders linked to the child, mother, and environment were also taken into consideration. The frequency of sleep terrors was relatively stable across early childhood (16.7-20.5%). A generalized estimating equation revealed that the frequency of sleep terrors in early childhood was associated with increased emotional-behavioral problems at 4 and 5 years of age, more specifically with internalizing problems (P < .001), after controlling for child's sex, time point, family socioeconomic status, maternal depressive symptoms, and nighttime sleep duration. The frequency of sleep terrors was further associated with the emotionally reactive, anxious/depressed, and somatic complaints scales (P < .01). This longitudinal study provides further support for a high prevalence of sleep terrors in early childhood. Our findings show meaningful associations between higher frequency of sleep terrors and emotional-behavioral problems as early as toddlerhood, especially internalizing problems. Laganière C, Gaudreau H, Pokhvisneva I, etal. Sleep terrors in early childhood and associated emotional-behavioral problems. J Clin Sleep Med. 2022;18(9):2253-2260.

A comparison of the effectiveness of Clark and ACT parenting training on improving the emotional-behavioral problems of the child with divorced single mothers

The main purpose of this study was to compare the effectiveness of Clark and Acceptance and Commitment Therapy parenting training on improving the emotional-behavioral problems of the child with divorced single mothers. The present study was a semi-experimental, pre-test, post-test, and control group. The research population included divorced mothers referred to the psychology and counseling organization centers of the Mashhad, Iran, during May-July 2019. Among them, 66 parents with their children were selected and randomly assigned into two experimental and control groups. Parents with their children in all groups responded to the Achenbach Children's emotional-behavioral problems Questionnaire before intervention (pretest) and immediately after the intervention (posttest). The results showed that there was a significant difference in anxious/depressed and attention problems between parenting skills training based on the Clark approach and Parent-Child Relationship Training based on Acceptance and Commitment approach. The results indicated that training the mothers in two parenting skills training and Parent-Child Relationship Training approaches can improve the emotional-behavioral problems of the child with divorced single mothers. The parenting skills training approach was more effective than control and Parent-Child Relationship Training groups in anxious/depressed and attention problems variables. Finally, it’s possible to conclude that both parenting skills training and Parent-Child Relationship Training are useful interventions in improving the children's negative feelings and beliefs about their parents' divorce and their emotional-behavioral problems, and can also increase positive feelings and attitudes toward parents and their resilience, ultimately leading to increase their compatibility with parental divorce.

A Comparison of Emotional-Behavioral Problems of Siblings at the Age Range of 3-9 Year Old Children with Autism and Down Syndrome.

Children's emotional-behavioral problems will have a huge impact on their future. Such problems are more seen in the siblings of children with special needs. The present study aimed to compare emotional-behavioral problems in the healthy siblings of autistic children with the healthy siblings of children with Down syndrome in order to identify such children in Iran. This descriptive study was carried out in Tehran, Iran in 2016 on 174 healthy children aged between 3 and 9 yr old among whom 58 cases had autistic siblings, 58 cases had siblings with Down syndrome, and 58 cases had typically development siblings. The participants were selected using convenience sampling technique. All volunteer parents filled in SDQ Questionnaire. The study results were calculated using independent sample t-test, two-way ANOVA, and Tukey post hoc test by SPSS. The mean overall score of Strengths and Difficulties Questionnaire was reported as 17.98±6.19 in the autism group, 11.01±6.56 in the Down syndrome group and 4.43±4.34 in the healthy group. There was a significant difference among autism, Down syndrome, and healthy groups. In the group of siblings with Down syndrome, the problems were significantly more in the age range of 3 to 7 yr old (P<0.05). However, no significant difference was observed in the scores of males and females (P>0.05). Siblings with autism or Down syndrome can have especial psychological effects on healthy children in families in the way that such effect will be more with autistic children. Therefore, formulating beneficial strategies for their parents is used to prevent emotional behavioral problems.

Maternal recognition of child mental health problems in two Brazilian cities.

Objective:To identify child behaviors and types of impairment that increase the likelihood of maternal recognition of emotional/behavioral problems (EBP) in children and adolescents.Methods:Maternal-reported data were obtained from two subsamples of 11-to-16-year-olds derived from cross-sectional studies conducted in two Brazilian municipalities: Itaboraí, state of Rio de Janeiro (n=480), and Embu, state of São Paulo (n=217). The Itaboraí study involved a representative sample of 6-to-16-year-olds (n=1,248; response rate = 86.0%) selected from the Family Health Program registry, which covered 85.5% of the municipal population. The Embu study was based on a probabilistic sample of clusters of eligible households (women aged 15-49 years, child < 18 years), with one mother-child pair selected randomly per household (n=813; response rate = 82.4%). The outcome variable was mother’s opinion of whether her child had EBP. Potential correlates included types of child behaviors (hyperactivity/conduct/emotional problems as isolated or combined conditions) and impairment, assessed using the Strengths and Difficulties Questionnaire (SDQ); child’s age and gender; maternal education and anxiety/depression (assessed using the Self-Reporting Questionnaire [SRQ]).Results:Multivariate regression models identified the following correlates of maternal perception of child EBP: comorbidity (co-occurring hyperactivity/conduct/emotional problems), emotional problems alone, and interference of problems with classroom learning and friendships.Conclusion:Comorbidity of different problem types, emotional problems alone, and interference with classroom learning and friendships increase the likelihood of maternal recognition of EBP in children.

Changes in maltreated children’s emotional–behavioral problems following typically provided mental health services.

Child welfare agencies serve as gate keepers for children's mental health services (MHS). Yet, the impact of offered services on behavioral outcomes has not been well studied. Data from the National Survey of Child and Adolescent Well-Being (NSCAW) were examined to measure caregivers' reported change in children's emotional-behavioral problems. Over 600 children in three age groups were matched and problem levels compared across 3 years. Although behavioral problems for the total group improved across time, scores for children who received MHS slightly worsened. Children who received MHS scored 1.4-3.7 points worse than children who did not receive MHS. Additionally, young Black, Hispanic, and other racially identified children had more problems than young White children, regardless of service. Higher behavior problem scores were noted for school-age children and adolescents. Although child welfare appears to rely on a cluster of MHS, including school-based counseling and private practitioner services, future service delivery should expand from improving access to achieving outcomes.

놀이치료를 활용한 부모교육 프로그램에 참여한 부모의 공감능력 및 자녀의 정서행동문제의 변화과정 분석

The study aims at verifying the parents' and children's changing process while using parents' play therapy in parent education program to improve the relationship between parents and their children. The experimental group consisted of 42 mothers who have preschoolers in the age range of 3-5, and was compared with the control group of 42 mothers. They joined together a series of 8 sessions (2 hours? or 16 hours?) once a week and took pre- and post-test. All of the sessions were recorded with a VCR camera. All the changing process the mothers showed was analyzed qualitatively to see what happened to the mothers and their children by the methods of coding, taxonomic analysis, critical events, componential analysis, and casual chain analysis suggested by Spradley(1980). The analyses showed that the mothers who participated in the program come to take more sympathetic, receptive attitudes to their children, while the children get better in the children's emotional behavioral problems in the qualitative analysis as well as the quantitative analysis.

Differential-maternal parenting behavior: estimating within- and between-family effects on children.

This study examined the impact of differential-maternal parenting behavior, evaluated as a family-level experience, on children's emotional-behavioral problems. Data come from 3 child development studies: 2,128 four- to sixteen-year-olds (Ontario Child Health Study), 7,392 four- to eleven-year-olds (National Longitudinal Study of Children and Youth), and 1,992 three- to fourteen-year-olds (National Longitudinal Study of Youth). In 2 of 3 studies, there was consistent evidence that differential-maternal parenting behavior had an adverse impact on all siblings as a group, over and above parenting directed at individual siblings. The strength of association was sensitive to the type of maternal parenting behavior, dimension of child maladjustment, and respondent perspective (stronger for hostile/negative parenting, child externalizing problems, and mother assessments of child emotional-behavioral problems).