Emotional Distress In Children Research Articles

Alterations in Gut Microbiota Composition Are Associated with Changes in Emotional Distress in Children with Obstructive Sleep Apnea

Emerging evidence underscores the pivotal role of the gut microbiota in regulating emotional and behavioral responses via the microbiota–gut–brain axis. This study explores associations between pediatric obstructive sleep apnea (OSA), emotional distress (ED), and gut microbiome alterations before and after OSA treatment. Sixty-six children diagnosed with OSA via polysomnography participated, undergoing adenotonsillectomy alongside routine educational sessions. ED was assessed using the OSA-18 questionnaire, categorizing participants into high ED (scores ≥ 11, 52%) and low ED (scores < 11, 48%) groups. Gut microbiome analysis revealed significant diversity differences, with high ED linked to a reduced Shannon index (p = 0.03) and increased beta diversity (p = 0.01). Three months post-treatment, significant improvements were observed in OSA symptoms, ED scores, and gut microbiome alpha diversity metrics among 55 participants (all p < 0.04). Moreover, changes in the relative abundances of Veillonella, Bifidobacterium, Flavonifractor, and Agathobacter, as well as ultra-low frequency power and low frequency power of sleep heart rate variability, were independently associated with ED score alterations. These findings underscore the gut microbiome’s critical role in the emotional and behavioral symptoms associated with pediatric OSA, suggesting that microbiome-targeted interventions could complement traditional treatments for ED reduction and emphasizing the need for further research.

Measuring Parental Response Styles to Child Stress in Severe Pediatric Illness: A Validation Study.

Pediatric illnesses not only impose physical challenges on affected children, but also profoundly impact their emotional well-being. Understanding how parents respond to their children's psychological distress during medical experiences is crucial for enhancing the overall support provided to these families. This study evaluated the internal structure of the Parental Response Styles Questionnaire (PRSQ), designed to differentiate parental responses to psychological distress in children with pediatric illnesses. A sample of 701 parents of children with medical issues responded to the PRSQ, reporting their different emotional expressions and responses to their children's expressions of distress during the medical experience. Factor analysis confirmed, in three of the five subsamples, an internal scale structure consisting of four factors: apathy and dysphoria, irritability and rejection, overprotectiveness, and perceived maladjustment. The invariance analyses revealed that congenital heart disease and neurological disorders are more similar in function to each other than pediatric cancer. Parents of children with neurological disorders exhibited a notably insecure pattern of parental responsiveness. In pediatric contexts, parental responses to their children's emotional distress are significant factors in the process of adaptation. These responses can be measured, differentiated, and, ideally, managed by nurses and other healthcare professionals. The Parental Response Styles Questionnaire (PRSQ) is a promising tool for assessing parental reactions during their children's treatment, and its structure appears to be particularly robust across diagnoses such as pediatric cancer, congenital heart disease, and neurological disorders.

Parent conversations with young children: Implications for child well-being during the COVID-19 pandemic.

Parent-child conversations may minimize the impact of stressful situations on children's well-being. Parents were encouraged to talk with their children about the coronavirus (COVID-19) pandemic, yet research suggests that parent stress in response to the pandemic was associated with disruptions in parenting and increased child emotional distress. In the present study, 205 parents of children aged 3-6 years (50.7% girls, 56.6% White) reported on conversations about the pandemic and responded to measures of parent stress and child emotional distress in the fall of 2020. Qualitative analysis revealed that talk about mitigation strategies was frequent; most parents offered an explanation for pandemic changes, whereas fewer parents reported communicating support. Guided by the family stress model, we then examined whether different conversation types moderated the association between parent stress and child emotional distress. Only talk about pandemic changes and explanations that COVID-19 was dangerous acted as moderators, suggesting that these conversation types strengthened the association between parent stress and child emotional distress. A main effect of self-protective explanations being associated with lower child emotional distress was also found. We discuss the implications of these findings for future research on parent-child conversations about stressful situations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

COVID-19-Associated Worry and Emotional Distress in Children with CKD

COVID-19-Associated Worry and Emotional Distress in Children with CKD

Life course predictors of child emotional distress during the COVID-19 pandemic: Findings from a prospective intergenerational cohort study.

We examine precursors of child emotional distress during the COVID-19 pandemic in a prospective intergenerational Australian cohort study. Parents (N = 549, 60% mothers) of 934 1-9-year-old children completed a COVID-19 specific module in 2020 and/or 2021. Decades prior, a broad range of individual, relational and contextual factors were assessed during parents' own childhood, adolescence and young adulthood (7-8 to 27-28 years old; 1990-2010) and again when their children were 1 year old (2012-2019). After controlling for pre-pandemic socio-emotional behaviour problems, COVID-19 child emotional distress was associated with a range of pre-pandemic parental life course factors including internalising difficulties, lower conscientiousness, social skills problems, poorer relational health and lower trust and tolerance. Additionally, in the postpartum period, pre-pandemic parental internalising difficulties, lower parental warmth, lower cooperation and fewer behavioural competencies predicted child COVID-19 emotional distress. Findings highlight the importance of taking a larger, intergenerational perspective to better equip young populations for future adversities. This involves not only investing in child, adolescent, and young adult emotional and relational health, but also in parents raising young families.

Maternal alcohol dependence symptoms, maternal insensitivity to children's distress, and young children's blunted emotional reactivity.

Maternal insensitivity to children's emotional distress (e.g., expressions of sadness or fearfulness) is one mechanism through which maternal alcohol dependence may increase children's risk for psychopathology. Although emotion dysregulation is consistently associated with psychopathology, it remains unclear how or why alcohol dependence's effects on caregiving responses to children's distress may impact children's emotion regulation over time, particularly in ways that may engender risks for psychopathology. This study examined longitudinal associations between lifetime maternal alcohol dependence symptoms, mothers' insensitivity to children's emotional distress cues, and children's emotional reactivity among 201 mother-child dyads (Mchild age = 2.14 years; 56% Black; 11% Latino). Structural equation modeling analyses revealed a significant mediational pathway such that maternal alcohol dependence predicted increases in mothers' insensitivity to children's emotional distress across a one-year period (β = .16, p = .013), which subsequently predicted decreases in children's emotional reactivity one year later (β = -.29, p = .009). Results suggest that mothers with alcohol dependence symptoms may struggle to sensitively respond to children's emotional distress, which may prompt children to suppress or hide their emotions as an adaptive, protective strategy. The potential developmental benefits and consequences of early, protective expressive suppression strategies are discussed via developmental psychopathology frameworks.

Gaps in pediatric oncologic end of life care as recounted by the bereaved parents in Isarel

PurposeThis study investigated parents' perception of their needs and those of their children with cancer at the end-of-life period, including unmet needs and their expectations regarding providers. Design and methodsThis cross-sectional study involved 26 parents recruited from three pediatric hematology-oncology wards in Israel who completed demographic and medical questionnaires of the child, and a parental needs questionnaire based on The Needs Assessment of Family Caregivers-Cancer questionnaire, following the death of their child. FindingsParents expressed needs related to medical care, including pain management, decision-making, and finding optimal treatment options for their children. The most prominent unmet needs were financial and psychological factors, of which, paying for medical expenses and helping their child adjust to the end of their life received the highest mean scores. There were notable gaps between desired and actual support from service providers, particularly in relation to emotional aspects. While over half of the parents believed the psychosocial team should assist with their child's emotional distress, this need was not adequately fulfilled. Some parents also expressed a desire for better emotional support during the end-of-life period. ConclusionsThe study emphasizes the importance of understanding parents' needs and perspectives during this challenging time. The identified gaps in support can be attributed to parental roles, the struggle with losing hope, communication barriers between care teams and parents, among others. Practice implicationsBy gaining insight into these needs and perceptions, care teams can enhance the provision of palliative care and optimize the distribution of responsibilities within the team.

Проблема психологического и эмоционального благополучия детей и жизнестойкости их родителей в современных зарубежных исследованиях

<p style="text-align: justify;">The article presents an overview of a number of modern foreign studies on psychological and emotional well-being of children and relationship between their emotional well-being and the resilience of their parents in the interval from 2018 till 2023 which was a difficult life period for many families. An attempt was made to analyze various approaches of foreign researchers to understanding the problem of psychological well-being and its difference from emotional well-being. The article emphasizes similarity in foreign scholars’ understanding of the concept of "emotional well-being" and the concepts of: "socio-emotional well-being", "socio-emotional development", "socio-emotional competence / skills". The practical relevance of the research is described as efficient in the programs for psychoprophylaxis of emotional distress in children. Some studies of the emotional development of children and its disorders in connection with the peculiarities of parenthood, family resilience, with the personal characteristics of parents and their resilience (parental resilience) are presented. The model describes parental resilience developed by in the context of the emotional well-being of children.</p>

Carbohydrate Counting vs. Fixed Meal Plan in Indian Children with Type 1 Diabetes Mellitus: A Randomized Controlled Trial.

To study the impact of carbohydrate counting vs. fixed-meal plan on glycemic control, quality of life (QoL) and diabetes-related emotional distress in children with Type 1 diabetes mellitus (T1DM). Children aged 6-18 y with T1DM of duration >1 y were eligible for the study if they were on multiple daily injections of insulin and regularly monitoring blood glucose. Those with celiac disease, hypothyroidism, any underlying chronic renal/liver/systemic disease or HbA1c >13% were excluded. Both groups received education on diabetes management and healthy diet. In the intervention arm, parents were taught to quantify carbohydrate content and modify insulin doses according to insulin-carbohydrate ratio. The control arm had dietary prescription according to recommended dietary allowance and food exchange list. Standard validated questionnaires were used to assess the QoL and emotional distress related to diabetes. One hundred twenty five patients (61 intervention, 64 controls) were enrolled and 91.8% and 84.3%, respectively, completed 6-mo follow-up. There was a reduction in HbA1c in both the groups, but was not statistically significant within or between groups {Intervention: 8.9 (1.4) to 8.6 (1.5) vs. control: 9.1 (1.6) to 8.8 (1.9), [95% CI 8.3-9.3 vs. 8.3-9.0, intention to treat (ITT), p= 0.63]}. There was a significant reduction in diabetes distress in the intervention group; DAWN Problem Areas in Diabetes Questionnaire (PAID) score with a median (interquartile range) of 21 (11-33) vs. control: 27 (20-40), (p=0.04). Patients in the carbohydrate-counting group demonstrated lower diabetes distress scores and less emotional burnout compared to fixed-meal plan over a 6 mo period though overall glycemic control was comparable between groups.

Pandemic play moderates the relation between caregiver stress and child emotional distress in contexts of economic adversity.

It is well-established that caregiver stress is linked to increased emotional distress among children, and recent evidence highlights similar associations between caregiver and child emotional well-being during the coronavirus (COVID-19) pandemic. Examining protective factors and coping mechanisms that are associated with resiliency in the face of pandemic-related stress can highlight potential strategies that may help children adapt to other unexpected hardships outside of a global pandemic. Previous research found that playing about the pandemic moderated an association between caregiver stress and children's emotional distress. However, few studies have explored "pandemic play" among children from low-income households, where pandemic-related stressors were often exacerbated. In the present study, 72 caregivers of Head Start preschoolers between 3 and 6 years of age were surveyed between late 2020 and early 2021. Results revealed that 32% of children engaged in pandemic play frequently. Caregiver stress was positively associated with child emotional distress, but only among children who did not engage in pandemic play frequently. These findings support the idea that child-directed play may be a developmentally appropriate and accessible coping mechanism to reduce the emotional burden of stressful events on children, regardless of economic context.

Impact of COVID-19 Pandemic on the Development of Childrens Executive Functions Implications for School-Based Interventions

The pandemic of COVID-19 has had a significant impact on children’s lives. Worldwide, there has been evidence of a decline in children's mental health, well-being, and quality of life. Few studies, however, have reported the pandemic's impact on children's cognitive functioning. Executive Functions (EFs) are a set of high-order cognitive functions involved in behavior and emotions self-regulation. EFs are powerful predictors of school performance, child’s well-being and health. During crisis and disaster, EFs are critical resources to cope with unusual and complex situations, and to find novel solutions to problems. Because of EFs’ extensive growth, there are many time periods during which experience has the greatest effect on brain development. Therefore, EFs are among the cognitive systems that are most vulnerable to environmental stress. As a result, children's emotional distress has been related to concentration and memory problems, difficulties managing impulses and emotions, and difficulties in planning ahead. Recent research has found executive dysfunction in children and adolescents during pandemic. Adopting an ecological contextual model, this study aimed to identify factors associated to pandemic that may affect children's performance and development of EFs, as well as, to propose a set of evidence-based strategies for teachers to assist children manage stress and promote EFs during crisis. Peer-reviewed academic articles, books, and web resources published between 2010 and 2023 were chosen for review in this study. As a result, child stress, family stress, school closure, changes in child-teacher interactions, and unhealthy habits are highlighted as potential factors influencing child EF development. In response to the Sustainable Development Goals agenda, a set of strategies was developed that may be easily included into the school curriculum. Creating school-based interventions to develop students' EFs is one approach to improve children's crisis-response resources.

Parental Influence on Child Mental Health Post-Hurricane Harvey

PurposeMany children who face natural disasters experience significant mental health consequences. Parents play a prominent role in the likelihood of child mental health outcomes after a weather-related disaster. This study aimed to examine the relationship between parent risk factors and children’s psychological well-being post Hurricane Harvey.MethodsParents (n = 140) completed a survey that measured hurricane exposure, parental depression and anxiety, parenting behaviors, and assistance given and received during or after Hurricane Harvey. Additionally, parents were asked to complete questionnaires assessing one of their children’s post-disaster psychosocial functioning and distress.ResultsResults indicated that heightened parent anxiety was significantly associated with an increased risk for emotional symptoms, conduct problems, and hyperactivity-inattention symptoms in children. Additionally, inconsistency in parental discipline was significantly associated with an increased risk of child conduct problems. Further, higher numbers of assistance types received by parents—a proxy indicator of resource loss—was associated with higher child emotional distress scores.ConclusionsBroader systems-level interventions that address parents’ physical and emotional needs may help mitigate maladaptive reactions in children and facilitate greater post-disaster psychosocial adjustment.

Monthly correlates of longitudinal child mental health during the COVID-19 pandemic according to children and caregivers.

Multiple reviews identify the broad, pervasive initial impact of the global COVID-19 pandemic on the mental health of children, who may be particularly vulnerable to long-term psychiatric sequelae of the ongoing pandemic. However, limited longitudinal research examines persistence of, or change in, children's distress or psychiatric symptomatology. From June 2020 through December 2021, we enrolled two cohorts of families of children aged 8-13 from Southwestern Ontario into a staggered baseline, longitudinal design that leveraged multi-informant report (N = 317 families). In each family, one child and one parent/guardian completed a baseline assessment, 6monthly follow-up assessments, and one final follow-up assessment 9months post-baseline. At each assessment, the child and parent/guardian completed the CoRonavIruS health Impact Survey and measures of child anxiety, depressive, irritability, and posttraumatic stress syndromes. Children's mental health, indexed by the severity of multiple syndromes, fluctuated over the study period. Elevated local monthly COVID-19 prevalence, hospitalization, and death rates were associated with monthly elevations in children's reported worry about contracting COVID-19 and stress related to stay-at-home orders. In turn, both elevated monthly worry about contracting COVID-19 and stress related to stay-at-home orders were associated with monthly elevations in child- and parent-/guardian-report of children's emotional distress and psychiatric syndromes. This study illustrates the importance of, and informs the potential design of, longitudinal research to track the mental health of children, who may be particularly vulnerable to broad psychosocial sequelae of health crises such as the COVID-19 pandemic.

Comparative efficacy of three different doses of intranasal dexmedetomidine for premedication in children

Preoperative emotional distress in children should be addressed properly for better anesthetic experience. The present study was a Prospective randomized double-blind study to evaluate comparative efficacy of three different doses of intranasal dexmedetomidine for premedication in children. Sixty children were then randomly allocated to one of the three groups of 20 each by a computer generated table. The drug was administered 45 minutes prior to induction of anesthesia intra-nasally. Following intra-nasal drug administration, anxiety was assessed at 0 minutes -baseline, 30 minutes, 45 minutes and at parental separation in the preoperative area just before shifting in operation theater using the mYPAS (modified Yale Preoperative Anxiety Scale). At induction, induction compliance was assessed using the induction compliance checklist and heamodynamic response to definitive airway was assessed.It was observed that intranasal dexmedetomidine in lower doses of 0.5 and 1µg/kg was effective in reducing anxiety from baseline values but was not sufficient for providing anxiolysis at the most stressful time - at parental separation and shifting to OR (Operating room). The dosage of 1.5µg/kg was found to be the most effective dose for allaying preoperative anxiety without any adverse effect. However, this dose was insufficient for optimizing induction as it is mainly anxiolytic and higher doses having additional sedative action may be required to make the child more compliant for induction of anesthesia.Based on our findings, we recommend that intranasal dexmedetomidine in the dose of 1.5µg/kg can be used for allaying preoperative anxiety, without any adverse events.• Question: To evaluate and compare the efficacy of three different doses of intranasal dexmedetomidine for premedication in children for preoperative anxiety using the mYPAS scale. • Findings: Dose of 1.5µg/kg can be used for allaying preoperative anxiety, without any adverse events. • Meaning: Optimum dose of intranasal dexmeditomedine which is efficient to allay preoperative anxiety in children.

Caregivers' everyday moral reasoning predicts young children's aggressive, prosocial, and moral development: Evidence from ambulatory assessment.

Developmental theories have proposed caregiver reactions, in particular caregivers' moral reasoning with their children, as crucial factors in children's developing morality. Yet, empirical evidence is scarce and mainly restricted to laboratory contexts. Here, we used the ambulatory assessment method to investigate how caregiver responses to moral transgressions longitudinally relate to children's emerging moral agency. On the first measurement point, mothers (N=220) reported on nine consecutive evenings on a moral transgression of their 5- to 46-month-olds', their emotional and verbal reactions, and how in turn their child reacted. Five months later, mothers reported on their child's aggressive and prosocial (helping, sharing, comforting) behavior. Our results demonstrated that (1) caregiver reasoning supported children's sharing and comforting behavior and was related to lower levels of children's aggressive behavior half a year later, that (2) caregiver reasoning reactions supported children's negative evaluations of their own transgressions while compliance-based caregiver reactions (e.g., physical interventions, reprimands) were predictive of children's subsequent emotional distress and anger, and that (3) caregiver social conformity and reflective functioning abilities emerged as determinants of caregiver negative moral emotions. Thus, this study uses an innovative methodological approach to uncover key characteristics of caregiver moral reactions supporting the development of morality.

Parent and child adjustment dual trajectories at the beginning of the COVID-19 syndemic.

Children and their families have been significantly impacted by the unfolding of the COVID‐19 syndemic. We sought to identify (1) groups of families with distinct profiles of joint trajectories of parental anxiety and child emotional distress and (2) protective and risk factors associated with these dual‐trajectory profiles. A sample of 488 parents (65% White; 77% mothers) with 3‐ to 8‐year‐old children (M Age = 5.04, SD Age = 1.59) was followed from late March to early July in 2020. Survey data on parent (i.e., anxiety symptoms) and child (i.e., emotional distress) adjustment were collected at three time points. Using multivariate growth mixture modeling, we identified one group with low parental anxiety and child emotional distress (42.7%) and three other distinct groups with varying risk levels among parents and/or children. We also identified protective (e.g., positive parenting) and risk (e.g., child negative affect, negative parenting, perceived stress with racism) factors in predicting parent and child adjustment. It can be concluded that, overall, our sample (mostly middle‐ and high‐socioeconomic status families) demonstrated family resilience amid COVID‐19, consistent with prior disaster coping literature. At the same time, our findings also indicated the need to identify at‐risk families and modifiable factors for post‐disaster public health interventions.

Understanding family life during the COVID-19 shutdown.

ObjectiveOur study investigates how changes in family contexts were associated with child behaviors during Ohio's COVID‐19 shutdown of early 2020.BackgroundThe COVID‐19 pandemic caused major economic and social changes for families. Rapid research was conducted to assess these changes and their potential impacts on child behaviors.MethodUsing a diverse sample of families with children aged birth to 9 years (N = 559), we describe key economic changes and parent‐reported stressors experienced during Ohio's shutdown period. Then, we use regression models to examine how these family conditions were associated with child emotional distress and changes in sleep routines.ResultsWhen parents experienced more total COVID‐19 pandemic‐related stressors, they also reported that their children exhibited more anxious and withdrawn, fearful, acting out, and COVID‐19 pandemic‐related behaviors (p < 0.01).ConclusionFamilies and children living at home in Ohio experienced significant stress during the shutdown. These findings can be used to inform future studies of the social and economic consequences of the COVID‐19 pandemic for parents and children.ImplicationsFamilies and children have experienced multiple stressors during the COVID‐19 pandemic. Researchers and practitioners should continue to monitor and support families and children to mitigate potential lasting consequences.

Acceptability and Outcomes of the Cool Little Kids Parenting Group Program for Culturally and Linguistically Diverse Families Within an Australian Population-Based Study.

This feasibility study explored suitability of a preventive intervention for internalising problems in young children for culturally and linguistically diverse families in Australia. A subsample of 62 families whose main language at home was other than English was selected from a population-based randomised trial of the Cool Little Kids parenting program. The population trial recruited 545 inhibited preschool children. Measures included family demographics, feedback post-intervention and child internalising problems at longitudinal follow-up. Parents of children whose main language at home was not English gave feedback that Cool Little Kids was helpful for managing their inhibited child's emotional distress. Significantly fewer intervention than control children whose main language at home was not English had separation anxiety symptoms after 2 years (M (SD) = 3.00 (3.15) versus 5.95 (3.98), p = 0.041). Further work to expand accessibility of Cool Little Kids to recent immigrant parents who do not speak English could be worthwhile.

Caregivers’ perceived changes in engaged time with preschool-aged children during COVID-19: Familial correlates and relations to children's learning behavior and emotional distress

The COVID-19 pandemic and its resulting containment measures have forced many children and their caregivers around the world to spend unprecedented amounts of time at home. Based on a sample of 764 households with preschool-aged children in Wuhan, China, where the pandemic began, this study examined how primary caregivers perceived changes in the amount of time spent engaging with their children (i.e., engaged time) from the start of the pandemic and whether these changes were associated with children's learning behavior and emotional distress. The results showed that primary caregivers generally perceived increases in the amount of engaged time spent on indoor activities with their children but decreases in the amount of engaged time spent playing with their children outdoors. A bigger family size and greater loss of family income during the pandemic were associated with bigger perceived increases in caregivers’ engaged time spent on indoor activities, whilst a higher level of parental education was associated with bigger perceived decreases in engaged time spent playing with children outdoors. The family's poorer physical health and higher levels of chaos during the pandemic were related to smaller perceived increases in caregivers’ engaged time spent on educational activities. Finally, although bigger perceived increases in caregivers’ indoor engaged time (e.g., time spent on educational activities) were associated with higher levels of positive learning behavior and fewer symptoms of anxiety and withdrawal in the children, bigger perceived decreases in outdoor play time were associated with fewer symptoms of anxiety and withdrawal. These findings offer valuable insights into caregivers’ allocation of engaged time with their preschool-aged children during the COVID-19 pandemic.

Parent time investments in their children's learning during a policy-mandated shutdown: parent, child, and household influences

State-level policies in Ohio during the early months of the COVID-19 pandemic in the United States involved physical school closures and work-from-home requirements when possible. Presumably, these policies and resulting impacts on homes with children would alter parent time investments in their children with respect to home-learning activities. In this study, we assessed parent time investments specific to home-learning activities with their children, and key predictors of these investments. Using data from a comprehensive survey completed by 559 caregivers of children (aged birth to 9 years) during a state-mandated stay-at-home order and widespread school closure, we assessed whether parent time investments in children's learning were associated with: (1) parents’ mental health and social connectedness, (2) children's level of emotional distress, and (3) household characteristics including chaos, social needs, and structure. Results indicate significant negative associations between each of parent loneliness, children's emotional distress, and household chaos with parent time investments in children's learning, controlling for parents’ socio-demographic and economic status. This suggests that parent time investments during the early stages of the pandemic were limited by a number of factors outside of socioeconomic resources. Further research is needed to understand the long-term effects of home environments, including parent time investments in children's learning, on child development during this unprecedented time in world history.