Disturbances In Children Research Articles

Depression, anxiety and quality of life impairment in parents of children with functional lower urinary tract dysfunction

Lower urinary tract dysfunction (LUTD) is a common clinical condition in children, frequently associated with emotional issues both among the patients and their families. The objective of the present study was to measure depressive and anxious symptoms and quality of life (QoL) in parents of LUTD patients. This cross-sectional study applied Beck Depression and Anxiety Inventories and WHOQOL-Bref to 88 caregivers of children with LUTD followed at a tertiary care center. The prevalence of mental disorders in children and adolescents was assessed using the Child Behavior Check List (CBCL 6-18) answered by their caregivers. The association of clinical features and emotional aspects related to the caregivers' quality of life was evaluated through non-parametric correlation (Spearman) and multiple linear regression analysis. Most of the caregivers were mothers (88%), with a mean age of 41.5 (SD 8.7 years), 67% of them married or in a stable union, and 38% had not completed elementary school. Considering 19 as the cutoff point for the Beck scale, 44% of the sample had a clinical score for depressive symptoms and 43% for anxious symptoms. According to the parents' report, 56% of children with LUTD had a clinical score for behavioral problems in CBCL. Parents' QoL was impaired, and the predictors of poor QoL were the age of the patients and presence of depressive/anxious symptoms in caregivers. Parents' depression/anxiety symptoms and poor QoL significantly correlated with behavioral problems in their children. The CBCL total problems score correlated both to depression (r=0.38, p<0.01) and to anxiety in parents (r=0.49, p<0.01) (Figure). These findings indicate a possible emotional impact of LUTD in patients' caregivers. Our study suggests that an approach to the family of LUTD patients' may be an important therapeutic resource for an effective clinical control of this condition.

Maternal antenatal stress and mental and behavioral disorders in their children

BackgroundMaternal antenatal stress, including symptoms of depression, anxiety and perceived stress, is associated with mental and behavioral problems in children. Whether it is associated with child mental and behavioral disorders remains uncertain. We examined if maternal antenatal symptoms of depression, anxiety and perceived stress were associated with mental and behavioral disorders in their children, if the associations varied according to gestational week, stress type, fluctuating or consistently high symptoms, and if they were driven by maternal or paternal lifetime mood or anxiety disorders. Methods3365 mothers participating in the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction (PREDO) study completed the Center for Epidemiologic Studies Depression Scale, the State Anxiety Inventory and the Perceived Stress Scale up to 14 times throughout pregnancy. The Care Register for Health Care provided data on mental and behavioral (including neurodevelopmental) disorders for their children from birth (11/07/2006–07/24/2010) until 12/31/2016 and for parental lifetime mood and anxiety disorders until 12/31/2016. ResultsThe hazard of any childhood mental and behavioral disorder (HR=1.91, 95% CI: 1.39–2.51) was significantly higher for children whose mothers reported consistently high in comparison to consistently low levels of all types of stress throughout pregnancy. The associations remained significant when adjusted for maternal and paternal lifetime mood and anxiety disorders (and their comorbidity and timing and mood disorder type). ConclusionMaternal antenatal stress is associated with higher risk of childhood mental and behavioral disorders. Efforts to reduce maternal antenatal stress should be given a high priority to improve child mental health.

Psychological and social interventions for the prevention of mental disorders in people living in low- and middle-income countries affected by humanitarian crises.

BackgroundPeople living in 'humanitarian settings' in low‐ and middle‐income countries (LMICs) are exposed to a constellation of physical and psychological stressors that make them vulnerable to developing mental disorders. A range of psychological and social interventions have been implemented with the aim to prevent the onset of mental disorders and/or lower psychological distress in populations at risk, and it is not known whether interventions are effective.ObjectivesTo compare the efficacy and acceptability of psychological and social interventions versus control conditions (wait list, treatment as usual, attention placebo, psychological placebo, or no treatment) aimed at preventing the onset of non‐psychotic mental disorders in people living in LMICs affected by humanitarian crises.Search methodsWe searched the Cochrane Common Mental Disorders Controlled Trials Register (CCMD‐CTR), the Cochrane Drugs and Alcohol Review Group (CDAG) Specialized Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (OVID), Embase (OVID), PsycINFO (OVID), and ProQuest PILOTS database with results incorporated from searches to February 2020. We also searched the World Health Organization's (WHO) International Clinical Trials Registry Platform and ClinicalTrials.gov to identify unpublished or ongoing studies. We checked the reference lists of relevant studies and reviews.Selection criteriaAll randomised controlled trials (RCTs) comparing psychological and social interventions versus control conditions to prevent the onset of mental disorders in adults and children living in LMICs affected by humanitarian crises. We excluded studies that enrolled participants based on a positive diagnosis of mental disorder (or based on a proxy of scoring above a cut‐off score on a screening measure).Data collection and analysisWe calculated standardised mean differences for continuous outcomes and risk ratios for dichotomous data, using a random‐effects model. We analysed data at endpoint (zero to four weeks after therapy) and at medium term (one to four months after intervention). No data were available at long term (six months or longer). We used GRADE to assess the quality of evidence.Main resultsIn the present review we included seven RCTs with a total of 2398 participants, coming from both children/adolescents (five RCTs), and adults (two RCTs). Together, the seven RCTs compared six different psychosocial interventions against a control comparator (waiting list in all studies). All the interventions were delivered by paraprofessionals and, with the exception of one study, delivered at a group level.None of the included studies provided data on the efficacy of interventions to prevent the onset of mental disorders (incidence). For the primary outcome of acceptability, there may be no evidence of a difference between psychological and social interventions and control at endpoint for children and adolescents (RR 0.93, 95% CI 0.78 to 1.10; 5 studies, 1372 participants; low‐quality evidence) or adults (RR 0.96, 95% CI 0.61 to 1.50; 2 studies, 767 participants; very low quality evidence). No information on adverse events related to the interventions was available.For children's and adolescents' secondary outcomes of prevention interventions, there may be no evidence of a difference between psychological and social intervention groups and control groups for reducing PTSD symptoms (standardised mean difference (SMD) −0.16, 95% CI −0.50 to 0.18; 3 studies, 590 participants; very low quality evidence), depressive symptoms (SMD −0.01, 95% CI −0.29 to 0.31; 4 RCTs, 746 participants; very low quality evidence) and anxiety symptoms (SMD 0.11, 95% CI −0.09 to 0.31; 3 studies, 632 participants; very low quality evidence) at study endpoint.In adults' secondary outcomes of prevention interventions, psychological counselling may be effective for reducing depressive symptoms (MD −7.50, 95% CI −9.19 to −5.81; 1 study, 258 participants; very low quality evidence) and anxiety symptoms (MD −6.10, 95% CI −7.57 to −4.63; 1 study, 258 participants; very low quality evidence) at endpoint. No data were available for PTSD symptoms in the adult population.Owing to the small number of RCTs included in the present review, it was not possible to carry out neither sensitivity nor subgroup analyses.Authors' conclusionsOf the seven prevention studies included in this review, none assessed whether prevention interventions reduced the incidence of mental disorders and there may be no evidence for any differences in acceptability. Additionally, for both child and adolescent populations and adult populations, a very small number of RCTs with low quality evidence on the review's secondary outcomes (changes in symptomatology at endpoint) did not suggest any beneficial effect for the studied prevention interventions.Confidence in the findings is hampered by the scarcity of prevention studies eligible for inclusion in the review, by risk of bias in the studies, and by substantial levels of heterogeneity. Moreover, it is possible that random error had a role in distorting results, and that a more thorough picture of the efficacy of prevention interventions will be provided by future studies. For this reason, prevention studies are urgently needed to assess the impact of interventions on the incidence of mental disorders in children and adults, with extended periods of follow‐up.

The impact of the family on health inequalities in children – A systematic scoping review

Abstract Background Health inequalities in school-aged children and adolescents were repeatedly reported across Europe but less is known about the contextual and compositional factors of families that might influence and reproduce those health inequalities. In this systematic scoping review we aim to provide a comprehensive overview of the available international literature on the mediating and moderating influence of the family on health inequalities in children and adolescents in Europe and North America. Methods This review follows the PRISMA guidelines for scoping reviews. After defining the research question a search strategy was developed in cooperation with a scientific librarian and the study protocol was registered. A search of three databases (Pubmed, Scopus, PsycINFO) was conducted to identify relevant literature in English or German published between the year 2000 and 2019. A qualitative data charting process was used to extract the relevant data. Results In total 11.838 records were identified through the multi database search (Pubmed n = 6370, PsycINFO n = 3505, Scopus n = 1963). After elimination of duplicates and records from excluded countries, 8862 abstracts were screened by two researchers independently. Different cluster of evidence of family influences on health inequalities were identified: Parental behaviors and children's obesity, parents' smoking and drinking habits and adolescents' risk behaviors, parenting style and children's common mental disorders, parental resources and children's quality of life. Conclusions There are different aspects of family's contextual and compositional characteristics on health inequalities identifiable in the international literature. These characteristics might be new targets for family-focused health promotion strategies. Key messages A systematic scoping review found different family aspects that influence health inequalities in children and adolescents. The identified family traits are promising targets for family-focused health promotion strategies to reduce health inequalities.

Attitude of Student, Teacher Behaviour and Class Management: A Study

Attitude is one of the most important factors in helping to get through the highs and lows of life. Since attitude spells how a person copes, whatever perspective you may hold will invariably have an effect in your performance and the way you and secondary data collected from various secondary sources. In any teaching-learning situation, teacher plays an handle rejection. This study based on both primary and secondary data. Primary data collected from survey method important role in the classroom management. This study focused on the student’s attitude, teacher’s behavior and classroom management. This study showed elements of student’s attitude and socialization is made up of eight stages of psychosocial development. And also mention seven mental disorders of childhood. This research explains some principles and techniques of classroom management and discipline. This study reveals that teacher activities in classroom to maintain well management in classroom. Finally, the research gives some suggestion and recommendation to overcome barriers in classroom management.

Psychometric properties of the screen for child anxiety related emotional disorders (SCARED) among elementary school children in Finland.

Anxiety disorders are the most common mental disorders in children and youth. Effective screening methods are needed to identify children in need of treatment. The Screen for Child Anxiety Related Emotional Disorders (SCARED) questionnaire is a widely used tool to assess childhood anxiety. We aim toevaluate the psychometric properties of the SCARED questionnaire, test the SCARED factor structure, and evaluate the prevalence of anxiety symptoms in a community sample of Finnish elementary school children, based on both a child and parent report. The sample included all pupils (n=1,165) in grades 2 through 6 (ages 8-13) in four elementary schools in the city of Turku, Finland. Children completed a Finnish translation of the SCARED questionnaire at school, with one parent report questionnaire per child completed at home. In total, 663 child-parent dyads (56.9%) completed the questionnaire. Internal consistency was high for both child and parent reports on all subscales (0.71-0.92), except for school avoidance (0.57 child, 0.63 parent report). Inter-rater reliability ranged from poor to fair across subscales (intraclass correlation 0.27-0.47). Self-reported anxiety scores were higher than the parent reported scores. Females had significantly higher total scores than males based on the child reports (p=0.003), but not the parent reports. In the confirmatory factor analysis, hypothesized models did not have a good fit with the data, and modification was needed. The Finnish SCARED questionnaire has good internal consistency. Low child-parent agreement calls for the importance of including both child and parental reports in the assessment of anxiety symptoms.

Greater Nutritional Risk Scores in 2-Year-Old Children Exposed to Gestational Diabetes Mellitus In Utero and Their Relationship to Homeostasis Model Assessment for Insulin Resistance at Age 5 Years

ObjectivesExposure to gestational diabetes mellitus (GDM) in utero may impact nutritional intake and lifestyle habits in early childhood. However, it is unclear whether nutritional status predicts greater risk for metabolic disturbances, such as insulin resistance (IR). The primary objectives were: 1) to determine parent-reported nutritional risk scores in 2-year-old children born to women with and without GDM and 2) to assess whether these scores predict IR in 5-year-old children. MethodsChildren exposed (n=34) and unexposed (n=46) to GDM were screened at 2 years of age using the Toddler version of the Nutrition Screening Tool for Every Preschooler (NutriSTEP). At a 5-year follow up, IR was assessed using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). ResultsTotal NutriSTEP scores ranged from 6 to 33, with higher scores indicating greater risk. After controlling for infant birthweight, sex of the child, child ethnicity, maternal age at time of pregnancy, breastfeeding status and maternal prepregnancy body mass index, average NutriSTEP scores were higher in children exposed to GDM compared with those unexposed (13.8±1.1 vs 11.2±1.1, p=0.03). NutriSTEP scores at 2 years emerged as a positive independent predictor of HOMA-IR at 5 years. For each unit increase in NutriSTEP score, suggesting greater nutritional risk, we saw a 0.48 (95% confidence interval, 0.17 to 0.80; p=0.003) increase in score on the HOMA-IR. ConclusionsParent-reported nutritional risk is greater in GDM-exposed children, and these nutritional behaviours developed during the first years of life may predispose to metabolic disturbance in early childhood.

SOLAR: The Science of Language and Reading

Reading ability is profoundly important, for individuals and for the societies of which they are a part. Research indicates that we should be successfully teaching 95% of children to read, yet, in reality, high rates of reading failure are common in western, industrialized nations. In large part, this reflects a failure to translate into practice knowledge derived from the scientific study of reading and reading instruction and, indeed, to the rejection in some circles of the notion that there is a science of reading, in the same way that there is a science of memory, learning, and cognition. In this article, I suggest the Science of Language and Reading (SOLAR) framework as a way of positioning oral language as a central driver of reading acquisition. The SOLAR framework is illustrated via the Language House schema, which considers the social-emotional contexts for language acquisition and reading instruction, alongside the ongoing development of prosocial interpersonal skills and mastery of sufficient language and reading skills by early adulthood to be able to function as part of the social and economic mainstream. I argue that speech-language therapy has much to offer to the promotion of evidence-based early reading and writing instruction and support, given the linguistic nature of reading and the high comorbidity between language and reading difficulties and social-emotional disturbances in childhood and adolescence.

Associação de Sintomas Psicopatológicos entre Crianças e Responsáveis

Esse estudo teve como objetivo investigar a associacao de sintomas psicopatologicos entre criancas e cuidadores. Este e um estudo quantitativo e transversal. Para a avaliacao, utilizou-se o Child Behavior Checklist (CBCL/6-18) e o Adult Self-Report (ASR), inventarios que avaliam aspectos clinicos e de funcionamento da crianca e dos responsaveis, respectivamente. Participaram 70 adultos que preencheram ambos inventarios. Os dados foram analisados no programa Statistical Package for Social Sciences (SPSS), versao 24.0. Os sintomas avaliados basearam-se nas variaveis dos inventarios. Os resultados apresentam correlacao positiva entre as sintomatologias ansiedade/depressao, isolamento/depressao, problemas somaticos, problemas internalizantes, problemas externalizantes e total de problemas entre responsaveis e criancas. Houve discrepância na classificacao dos escores entre adultos e criancas nas variaveis ansiedade/depressao e total de problemas. Percebe-se que houve correlacao positiva entre a presenca de sintomatologia psicopatologica dos cuidadores e a existencia dos mesmos sintomas nas criancas. Esses achados vao ao encontro de estudos que apontam a importância de estudar o componente familiar como fator de risco para o desenvolvimento de sintomas de transtornos mentais na infância. Frente a isso, torna-se necessario considerar os fatores de protecao e risco ao avaliar e planejar o tratamento para o publico infanto-juvenil.

Possíveis impactos causados pela pandemia da COVID-19 na saúde mental de crianças e o papel dos pais neste cenário

A pandemia causada pelo novo coronavírus tem exigido das pessoas mudanças bruscas em seu cotidiano todo o mundo. Com a suspensão das atividades educacionais presenciais e com a vivência do isolamento social, a saúde mental das crianças também tem sido afetada. Dessa forma, o objetivo deste estudo é denotar, por meio de uma revisão narrativa da literatura, possíveis impactos causados pela pandemia do COVID-19 na saúde mental de crianças, bem como papel dos pais neste cenário. Para o levantamento dos estudos acerca desta temática, foram utilizadas as plataformas Google acadêmico, Pubmed e Lilacs, em que foram selecionados 7 artigos e utilizados apenas 5 na amostra final. Os resultados demonstram a ocorrência de diversos impactos na saúde mental das crianças, a partir de sintomas psicológicos como estresse, ansiedade e irritabilidade. Deste modo, os pais necessitam lançar mão de estratégias para auxiliar os filhos a lidarem com as mudanças causadas pelo isolamento social. Por fim, mesmo com poucos estudos publicados, verifica-se que as crianças sofrem influências devido às mudanças em sua rotina, salientando a importância fundamental dos pais na promoção da saúde mental dos filhos.

CLASSROOM MANAGEMENT TECHNIQUES FOR TEACHING ENGLISH INCLUSIVELY TO ADHD AND ASD PRIMARY STUDENTS IN VIETNAM

Recently included in general education as a compulsory subject since Grade 3, English has established itself in Vietnam as a crucial foreign language for the people to communicate effectively in a globalization era. As a result, English language teaching for primary students has drawn increasing attention from various educators and researchers. However, their studies and teaching practices often overlook students with Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder (ADHD and ASD) - two of the most popular mental disorders in children. In this regard, this mixed-method case study explores the challenges facing, and the solutions the teachers of ADHD and ASD students in Vietnam have been actively drawing on to facilitate their classroom management. After conducting survey questionnaires with 109 English language teachers from 20 cities located in the three regions of Vietnam, the study proceeded with a series of interviews with teachers along with in-class observations. The results indicate that despite these prevailing difficulties, teachers were able to formulate teaching techniques to showcase plenty of innovativeness and versatility in terms of classroom management, despite certain occurrences of potential harmful acts due to the lack of special education training. The discussion could carry useful implications for researchers and teachers working with ADHD and ASD students in Vietnam.

Childhood appendectomy and adult mental disorders: A population-based cohort study.

Recent studies suggest that disruption of the colonic microbiota homeostasis is associated with low-grade systemic inflammation and mental disorders. The cecal appendix may influence the homeostasis of the colonic microbiota. In this large population-based study, we investigated whether early removal of the appendix is associated with an increased risk of mental disorders later in life. All Swedish individuals born between 1973 and 1992 (N = 1,937,488) were included and followed prospectively until December 31, 2016 for any psychiatric International Classification of Disease diagnosis from age 14 or later in life. The main exposure was defined as having a history of appendectomy before age 14 (N = 44,259); the second exposure, appendicitis before age 14 but without appendectomy (N = 1,542), and the third exposure studied was a history of hernia surgery before age 14 (N = 35,523). Control groups for each respective exposure were all unexposed individuals in the study population. Individuals exposed to appendectomy before age 14 had a 19% increased risk of depressive disorder (adjusted hazard ratio [aHR] = 1.19; 95% confidence interval [95% CI]: 1.15-1.23), 27% increased risk of bipolar affective disorder (aHR = 1.27; 95% CI: 1.17-1.37), and a 20% increased risk of an anxiety disorder (aHR = 1.20; 95% CI: 1.16-1.23) compared to individuals unexposed to childhood appendectomy. We found no association between appendectomy and increased risk of obsessive-compulsive disorder and schizophrenia and there was no association between appendicitis without appendectomy and mental disorders. The association between childhood hernia surgery and mental disorders later in life was small but significant. Childhood appendectomy, but not appendicitis without appendectomy, was associated with a significantly increased risk of mood and anxiety disorders in adulthood.

Child Mental Illness and Mental Health Service Use: Role of Family Functioning (Family Functioning and Child Mental Health)

The purpose of this study was to identify which domains of family functioning were associated with odds of internalizing versus externalizing mental health disorder, past-year health professional consultations, hospitalizations, and length of hospital stay in a sample of children with a mental health disorder. One hundred children aged 6–17 years who received mental health services (inpatient or outpatient) and their parents at a large clinical paediatric tertiary care centre in Ontario were recruited in this cross-sectional study. The final recruited and analyzed sample was children aged 8–17 years. Family functioning was measured using the McMaster Family Assessment Device (FAD), child mental health disorder using the Mini International Neuropsychiatric Interview, and mental health service use using items from the 2012 Canadian Community Health Survey (Mental Health). Higher scores on affective involvement and problem solving were associated with greater odds of major depressive disorder [OR = 2.12 (1.01, 4.43)] and social phobia [OR = 1.80 (1.09, 2.98)]. Reports of better communication were correlated with lower odds of generalized anxiety disorder [OR = 0.55 (0.35, 0.84)] and shorter length of stay in hospital [OR = 0.93 (0.89, 0.97)]. Higher scores on behaviour control were associated with lower odds of social phobia and oppositional defiant disorder [OR = 0.48 (0.27, 0.86) and OR = 0.52 (0.32, 0.84)], respectively. Future research should aim to gain an understanding of strategies that ameliorate family functioning to limit the impact and severity of childhood mental health conditions.

A Latent Class Analysis of Perceived Neighborhood Conditions Associated with Mental Disorders Among Children in the United States.

The current study examined the association between perceived neighborhood conditions and common childhood mental disorders in a nationally representative sample of children in the U.S. The datawere derived from the 2017 National Survey of Children's Health, including American children aged 6-17years (N = 15,438). Latent class analysis was used to identify subtypes of perceived neighborhood conditions regarding neighborhood physical environment, social capital, and violence. Three classes were identified: Ideal Neighborhood (55.99%); Insufficient Assets (27.38%), and Broken and Unsafe Neighborhood (16.63%). The effects of latent classes on psychiatric outcomes (i.e. attention deficit hyperactivity disorder, depression, anxiety, conduct problem, and any of these four disorders) were examined. Class membership was differentially associated with the mental disorders after adjustment for demographic variables, food insufficiency, and guardian's mental health. The Broken and Unsafe Neighborhood class was associated with greater odds of all childhood psychiatric disorders than the Ideal Neighborhood and Insufficient Assets class. Insufficient Assets class was associated with greater odds of all childhood psychiatric disorders than the Ideal Neighborhood class. The findings suggest that neighborhood-level interventions to decrease children's mental health burdens are critically needed.

Sociodemographic Correlates of Anxiety Disorders in Children: A Cross-sectional Study in an Indian Outpatient Setting

Background: Anxiety disorders are the most frequent mental disorders in children and contribute to the development of secondary complications such as later risks of anxiety disorders, major depression, and other adverse developmental outcomes. However, very few studies in India have examined childhood anxiety disorders. Aim: This study aimed to understand sociodemographic correlates of childhood anxiety disorders. Method: A total of 84 children aged 8-12, 42 in the anxiety group, and 42 healthy control group were evaluated. Anxiety group consisted of children who met the DSM-5 diagnostic criteria for anxiety disorders. The control group consisted of typically growing children matched on age and gender. Results: The study sample consisted of a large proportion of children coming from a nuclear family, with at least one sibling, parents with graduate education, fathers with skilled jobs, and mothers who were housewives. Anxious children were not characterized by family type, siblings, parental education, or occupation. However, anxious children had a higher proportion of marital discord between parents, parental anxiety, and family history of mental illness. These variables explained 34% of the variance in anxiety disorders. 50% of fathers and 52% of mothers of children with anxiety disorders had anxiety symptoms themselves. Children whose parents had marital discord were 3.4 times more likely to develop anxiety disorders. Children with a family history of mental illness were 6.8 times more likely to develop anxiety disorders. Conclusion: The results highlight the importance of screening and addressing dysfunctional relationships between parents and/or parental anxiety when children present with anxiety disorders.

Sleep Through Toddlerhood: The Distinct Roles of Overall Media Use and Use of Media to Regulate Child Distress.

Excessive media exposure has been associated with various sleep disturbances in early childhood. However, previous research mostly addressed the overall amount of media use while neglecting the role of media use practices. The purpose of this study was to examine whether media use practices (specifically, maternal use of media to regulate child distress) and overall media use predict distinct aspects of children's sleep. We hypothesized that frequent maternal use of media to regulate child distress will predict difficulties in sleep regulation, whereas higher child screen time will predict lower sleep duration. One-hundred fifty-one mothers (predominantly from the United Kingdom) completed anonymous online questionnaires via the Prolific platform that assessed child sleep latency and duration, use of media to regulate child distress, overall child screen time, and demographic covariates at 2 time points: 22 months (T1) and 26 months (T2) of children's age. Maternal use of media to regulate child distress at T1 (but not screen time) predicted longer sleep latency at T2. Conversely, screen time (but not media to regulate distress) at T1 predicted shorter sleep duration at T2. These results were obtained while controlling for multiple covariates and sleep and media use at both time points. Findings suggest that media use practices and overall use have differential effects on sleep. Specifically, the use of media-based regulation strategies may interfere with the development of children's ability to self-soothe and regulate arousal in contexts that require the use of regulatory skills, such as transition to sleep.

Genetic and environmental contributions to psychopathological symptoms in adulthood: Clarifying the role of individual and parental risk factors.

Psychopathology-related suicide attempts and deaths are increasing, and the research focus remains on mental disorder in childhood and adolescence. We examined the genetic and environmental contributions to internalizing, externalizing, and general psychopathological distress to clarify the role of individual/parental risk factors for suicide in young adults. Data from 1206 young adults were obtained from a publicly available dataset from the Human Connectome Project. Heritability estimates were analyzed by twin modelling using OpenMx and data from a subsample of 402 monozygotic and dizygotic twins. The estimated prevalence of psychopathological symptoms ranged from 9 to 16%. The heritability of internalizing, externalizing, and general psychopathological distress reached significance, with estimates ranging from 22 to 46%. Shared (common) environments contributed to aggressive behavior (30 %). Determining factors for psychopathological distress (internalizing, externalizing, general) were evaluated using logistic regression analysis. Household income (<$50,000), childhood conduct problems, and maternal drug or alcohol problems were common risk factors of internalizing, externalizing, and general psychopathological distress. Marijuana dependence and maternal anxiety were additional risk factors of externalizing distress. The presence of alcohol and maternal drug or alcohol problems was linked to general psychopathological distress. The results highlight risk factors associated with psychopathological symptoms that should be considered in the early detection of high-risk groups and implementation of family-based interventions. Providing continuous care and/or follow-up in at-risk children and young adults may improve mental health and well-being.

Body Image and Eating Disturbances in Children: The Role of Self-Objectification

Self-objectification has been implicated in the development of body image disturbances and disordered eating among adults and adolescents. Empirical research exploring these associations among children is limited. Given body image and eating disturbances have been observed in a significant proportion of children, elucidating the factors associated with these disturbances among members of this population segment is important to informing prevention and intervention efforts. Accordingly, we cross-sectionally examined the association between self-objectification and body image and eating disturbances in 219 Australian 6- to 11-year-olds (57% classified as female children; average age = 8.37 years, SD = 1.42). Significant associations were observed between measures of self-objectification and body surveillance; body surveillance and both body shame and weight/shape concern; and weight/shape concern and dietary restraint. Results suggest early interventions targeting poor body image may need to address self-objectification, although further research is needed to firmly establish self-objectification as a risk factor for poor body image in children. Practitioners could utilize resources specifically developed for children, which encourage positive body esteem, build body confidence, support healthy relationships with food and exercise, and promote activities encouraging individuals to be attuned to how their bodies feel rather than how they look.

Child psychiatry in China: Present situation and future prospects.

Child psychiatry in China: Present situation and future prospects.

Guideline adherence in German routine care of children and adolescents with ADHD: an observational study

Although guidelines for the assessment and treatment of mental disorders in childhood and adolescence have been available in Germany for several years, there are barely any data on adherence to guidelines in national routine care. Therefore, the study aimed at a nationwide evaluation of guideline adherence (GA) for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder (ADHD) in German routine care in various groups of health care providers (HCPs). Besides a detailed description of GA, the study focused on examining possible differences between professional groups. Furthermore, data based on global self-reports of clinicians were compared with ratings of documented care in individual patients. Protocols of 73 clinicians regarding their handling of ADHD in routine care for 167 patients were rated according to German guideline recommendations for ADHD care. GA was measured as the proportion of components fulfilled in each individual patient as documented by the HCP. The results were compared to a preceding interview with clinicians regarding their GA. Multilevel models were constructed to detect differences in GA between professional groups. Based on mandatory guideline components, adherence rates of 38.9–72.7% were found and classified as moderate (33.3% < GA ≤ 66.6%) to high (GA > 66.6%). The comparison of the GA between the professional groups generally yielded only small differences. Correlations between GA reported globally by the HCPs and GA documented and rated for individual cases were low. Overall, most rates of GA for ADHD in German routine care lay within a moderate range. Targets for enhancement of GA may be the involvement of teachers and schools in the treatment process, the implementation of psychoeducational methods in general, as well as a careful examination of patients, including monitoring of treatment effects during titration trials. The development of further strategies to monitor the quality of ADHD routine care is needed.