Peer Relationship Problems Research Articles

A Social Emotional Learning Training Programme in a Poor Rural Primary School in Central China: A Pre-Post Intervention Study.

Many universal school-based social and emotional learning (SEL) programmes in the U.S. and Europe have been found to improve social skills and reduce emotional distress and behaviour problems. The aim of this study is to determine whether an adapted version of the SEL can reduce social, emotional, and behavioural difficulties in children in mainland China, using a pre-post intervention design. The study was conducted in a primary school in an economically-disadvantaged rural area in Henan province in central China. The intervention consisted of 16 weekly 90-minunte classroom sessions involving all 190 children in the school. Social and emotional problems were assessed pre- and post- intervention using the Chinese version of the Strengths and Difficulties Questionnaire (SDQ). The results suggest that: (1) the programme can reduce children's peer relationship problems, and that the reduction was sustainable at the two post-intervention assessments; (2) the intervention effects on emotional symptoms or total difficulties in the overall population are very few, but children identified as high risk in the initial assessment benefited from the programme. This is the first published report on the effectiveness of a school-based SEL programme in mainland China. Although the improvement are limited, the programme does benefit some children.

Exploring the association between obesity and problems with peer relationships in children: a nationally representative cross-sectional study

BackgroundThe number of children living with obesity in the UK is increasing, and the rise has been exacerbated by the lockdowns during the COVID-19 pandemic, when school attendance was suspended and leisure activities were curtailed. Whether an association exists between obesity and problems with peer relationships in children has not been definitively answered because few datasets collect these data simultaneously. This study was aimed at exploring the relationship between obesity and peer problems in children after adjustment for multiple confounding factors. MethodsChildren aged 4–15 years participating in the Welsh Health Survey for Children were included. The association between obesity (defined as body-mass index ≥95th centile) and peer relationship problems (as per the standard definitions in the internationally recognised Strengths and Difficulties Questionnaire) was assessed using multivariate logistic regression. Confounding factors included in the analysis were deprivation, meeting the UK Government's physical activity guidelines, and consumption of healthy foods (ie, daily fruit and vegetable consumption). Findings11 279 children were included (5470 [48·5%] girls and 5801 [51·5%] boys). A small but significant association between children living with obesity and peer problems was identified (odds ratio [OR] 1·06 [95% CI 1·04–1·08]; p=0·0001) after accounting for confounding factors. The association was strongest for girls aged 4–10 years (OR 1·12 [95% CI 1·07–1·16]; p=0·0001). InterpretationThis study contributes to the small evidence base on this topic by investigating the association between obesity and peer problems in a large nationally representative sample from Wales, UK, and identifies a small but significant association between obesity and peer problems in children, particularly in younger girls. Existing evidence has established this association in adolescents, but this study is the first nationally representative analysis to identify this association in children. Additional research, ideally using large community datasets, is needed to complement these findings. In the meantime, as a precautionary measure, solutions to reduce bodyweight-based stigma and enhance peer relationships in school-aged children should be developed. FundingNone.

High maternal pre-pregnancy BMI is associated with increased offspring peer-relationship problems at 5 years

BackgroundPeer relationships are an important aspect of child development that are often overlooked. Maternal pre-pregnancy body mass index (BMI) may influence peer relationships through intrauterine mechanisms affecting fetal neurodevelopment or through postnatal mechanisms including social discrimination of the obese mother/child. This study aimed to determine the relationship between maternal pre-pregnancy BMI and child peer-relationship problems around 5 years old, including preterm and term-born children.Methods and findingsMaternal BMI and offspring peer-relationship problems were assessed in participants of three French birth cohorts: EDEN (n = 1,184 children born at term), ELFE (n = 10,889 children born ≥33 weeks of gestation) and EPIPAGE-2 (n = 2,646 children born 23–34 weeks of gestation). Reported or measured pre-pregnancy weight (kg) and height (m) were collected from mothers and used to calculate BMI (kg/m2). Offspring peer-relationship problems were assessed using the Strengths and Difficulties Questionnaire at 5.5 years. Logistic regression was used to estimate odds ratios (OR) of a high peer-relationship problem score (≥3) in EDEN and ELFE, and generalized estimated equations were used in EPIPAGE-2 to account for the large number of multiple births. Paternal BMI was used as a negative control in sensitivity analyses. Maternal pre-pregnancy obesity was associated with increased odds of a high peer-relationship problem score in all three cohorts, independent of confounding factors [adjusted OR 2.27 (1.32, 3.88); 1.52 (1.29, 1.78); 1.44 (1.04, 1.99); for EDEN, ELFE and EPIPAGE-2, respectively]. Additional analysis based on negative controls (i.e., adjusting for paternal BMI) showed the same pattern of associations.ConclusionHigh maternal pre-pregnancy BMI is associated with greater likelihood of a high peer-relationship trouble score in offspring around 5 years of age in both children born preterm and at term.

Positive Attention Bias Trained during the Rethink Therapeutic Online Game and Related Improvements in Children and Adolescents’ Mental Health

Attentional bias towards positive stimuli is considered a resilience factor for mental health and well-being. The aim of the present study was to analyze the effects of an attentional bias training for positive faces in a preventive therapeutic game for children and adolescents. The sample of 54, which consisted of children and adolescents aged between 10-16 years, played the REThink game, which included an attentional bias training level based on the visual search paradigm, where children had the task to quickly find the happy face among other angry faces. We measured mental health, and positive and negative emotions and analyzed their associations between changes in attention bias. Attentional bias indicators demonstrated acceptable reliability and results showed that increases in attentional bias towards positive faces were associated with improvements in children and adolescents' conduct problems, hyperactivity, and peer relationship problems. Overall, our results support the protective role of training attentional bias towards positive faces as part of a preventive therapeutic game for children and adolescents.

Mental health in adults born preterm with very low birth weight at 14 and 26 years of age assessed by the Strengths and Difficulties Questionnaire.

Very low birth weight (VLBW: <1500 g) is associated with risk of adverse long-term outcomes, including mental health problems. We assessed whether self-reported mental health differed between young adults born preterm with VLBW and term-born controls. We also examined changes in mental health from 14 to 26 years. In a prospective cohort study, 61 VLBW and 88 control participants completed the Strengths and Difficulties Questionnaire at 26 years. Group differences were analysed by linear regression with adjustment for sex and parental socioeconomic status. Longitudinal changes from 14 to 26 years were analysed using linear mixed model. Mean total difficulties score was 1.9 (95% CI: 0.5 to 3.5) higher in the VLBW than in the control group. Internalising and its subscale emotional problems as well as externalising and its subscale hyperactivity/inattention symptoms were higher in the VLBW group. From 14 to 26 years, changes in emotional symptoms, peer relationship problems, externalising problems, hyperactivity/inattention, and prosocial behaviour differed between the groups. At 26 years, VLBW participants had more self-reported mental health difficulties than controls. Emotional symptoms increased from 14 to 26 years in the VLBW group, whereas hyperactivity and inattention did not decrease with age as it did in the control group.

The impact of sleep-corrected social jetlag on mental health, behavioral problems, and daytime sleepiness in adolescents

Study objectivesThis study aimed to examine the effect of sleep-corrected social jetlag (SJLsc) on mental health, behavioral problems, and daytime sleepiness in adolescents. MethodsThis was a cross-sectional study which included 4787 adolescents (Mean age: 14.83±1.6y, 56.0% girls) recruited from 15 secondary schools in Hong Kong. SJLsc was defined as the absolute difference between sleep-corrected midsleep on weekdays and weekends, at which the sleep debt has been considered. It was classified into three groups: low-level (“LSJLsc”, <1h), mid-level (“MSJLsc”, ≥1h and <2h), and high-level of SJLsc (“HSJLsc”, ≥2h). Adolescents’ mental health, behavioral problems and daytime sleepiness were measured by the General Health Questionnaire (GHQ-12), the Strengths and Difficulties Questionnaire (SDQ) and the Pediatric Daytime Sleepiness Scale (PDSS). Logistic regression analysis and restricted cubic spline regression (RCS) analysis were applied with consideration of confounders including age, gender, puberty and sleep problems. ResultsNearly half (46.9%) of adolescents had SJLsc for at least 1 h. Greater SJLsc was associated with more behavioral difficulties (MSJLsc: OR: 1.20, p = 0.03; HSJLsc: OR: 1.34, p = 0.02) when controlling for age, sex, puberty, chronotype, insomnia, and time in bed. There was a dose-response relationship in which higher SJLsc had an increased risk of conduct problems and hyperactivity, while only high-level SJLsc was associated with a peer relationship problem. In RCS analysis, SJLsc was associated with a higher likelihood of behavioral difficulties (p = 0.03) but not poor mental health or daytime sleepiness. ConclusionsSleep-corrected social jetlag was a unique risk factor for behavioral problems in adolescents. Our findings highlighted the need for interventions to promote healthy sleep-wake patterns in school adolescents.

Maternal Attachment, Peer Relationship and Behavior Problems among Primary School Children

Behavior problems that occur during childhood often persist into adolescence and they can also lead to various negative outcomes. Since mothers and peers play a significant role in developing children’s behavior, this study aimed to determine the relationship between maternal attachment and peer relationship with behavior problems among children. A total of 440 children aged between 10 to 11 were chosen by using the multistage cluster sampling technique. The data for this study were collected by using a self-administered questionnaire. The result indicated that maternal attachment posed a significantly negative relationship with behavior problems. The result also indicated that peer relationship was significantly and positively correlated with behavior problems. Meanwhile, multiple regression outcomes showed that peer relationships yielded the strongest influence on behavior problems. In conclusion, a good peer relationship is crucial to overcoming behavior problems among primary school children.

Atypical Facial Expressivity in Young Children with Problematic Peer Relationships.

Peer problems are frequently associated with difficulties in recognizing and appraising the emotions of others. It has been argued that facial responsiveness to others' emotions-or motor empathy-is a precursor of emotion processing and affective empathy. Although mimicry impairments have been observed in studies of young people with conduct problems, to our knowledge no study has examined facial responsiveness to others' expressions in young children and examined how this relates to peer relationship problems. Four- to 7-year-old children (n = 91) with or without teacher-reported peer relationship problems (Strength and Difficulties Questionnaire) viewed three dynamic film clips depicting a sad, happy, or scared child, while their spontaneous facial emotional responses were assessed using iMotions software that codes the movement of facial muscles. Children displayed facial expressivity that was congruent with the emotional expressions in the clips. Groups with and without peer problems did not differ in their responses to seeing a happy child. However, children with peer problems exhibited reduced or atypical facial emotional responses to the negative emotional clips. Decreased or atypical facial expressivity to negative emotions was also associated with severity of peer problems; atypical facial responsivity to sadness and reduced facial responsivity to fear predicted peer problems independently of one another. We conclude that reduced or atypical facial expressiveness in response to other children's dynamic facial expressions is associated with problematic peer relations in young children. The implications for early identification and interventions to support prosocial development are discussed.

Expression of CXCR4 on CD4+ T cells predicts body composition parameters in female adolescents with anorexia nervosa.

Anorexia nervosa (AN) is a severe eating disorder characterized by excessive weight loss and lack of recognition of the seriousness of the current low body weight. Individuals with AN frequently exhibit an enhanced inflammatory state and altered blood levels of cytokines and chemokines. However, the expression of chemokine receptors in AN and the association with body composition parameters and treatment effects are still unknown. In this study, we examined the expression of CCR4, CCR6, CXCR3, and CXCR4 on peripheral blood T cells in female adolescents with AN before (T0, n = 24) and after 6 weeks of multimodal therapy (T1, n = 20). We also investigated their value to predict body mass index (BMI) and fat mass index (FMI) at baseline. Using multi-parameter flow cytometry, we found increased expression of CCR4, CXCR3, and CXCR4, but not CCR6, on CD4+ T cells in AN at T0 when compared to healthy controls (HC, n = 20). At T1, CXCR3 and CXCR4 expression decreased in AN. We found a close link between CCR4, CCR6 and CXCR4 expression and the adolescent mental health status in the study cohort as determined by the Strengths and Difficulties Questionnaire (SDQ). Specifically, CXCR4 expression correlated positively with emotional symptoms and peer relationship problems, as well as with the total sum score of the SDQ. In addition, CXCR4 expression on CD4+ T cells was a significant predictor of BMI and FMI in female adolescents. Our findings that CXCR4 expression on T cells is altered in adolescents with AN and predicts body composition parameters in adolescents suggest an impact of this chemokine receptor in the pathogenesis of AN.

Gene-environment interaction using polygenic scores: Do polygenic scores for psychopathology moderate predictions from environmental risk to behavior problems?

The DNA revolution has energized research on interactions between genes and environments (GxE) by creating indices of G (polygenic scores) that are powerful predictors of behavioral traits. Here, we test the extent to which polygenic scores for attention-deficit/hyperactivity disorder and neuroticism moderate associations between parent reports of their children's environmental risk (E) at ages 3 and 4 and teacher ratings of behavior problems (hyperactivity/inattention, conduct problems, emotional symptoms, and peer relationship problems) at ages 7, 9 and 12. The sampling frame included up to 6687 twins from the Twins Early Development Study. Our analyses focused on relative effect sizes of G, E and GxE in predicting behavior problems. G, E and GxE predicted up to 2%, 2% and 0.4%, respectively, of the variance in externalizing behavior problems (hyperactivity/inattention and conduct problems) across ages 7, 9 and 12, with no clear developmental trends. G and E predictions of emotional symptoms and peer relationship problems were weaker. A quarter (12 of 48) of our tests of GxE were nominally significant (p = .05). Increasing the predictive power of G and E would enhance the search for GxE.

Preliminary evaluation of A Home Within psychotherapy with clients with a history of foster care

Children and youth in foster care often experience numerous traumas both in and out of the child welfare system, and as a result many need access to mental health support. Researchers report low utilization rates of mental health services among individuals who have lived in foster care, often attributed to barriers to both access and receipt of consistent mental healthcare. A Home Within is a national nonprofit organization that aims to reduce these barriers to mental healthcare for those with past or current involvement in foster care by facilitating their access to consistent pro bono psychotherapy for “as long as it takes.” Eighty-five A Home Within therapists completed interviews with trained research assistants at two time points. Interviews included 44 closed- and open-ended questions regarding therapist demographics, client demographics, clients’ presenting concerns and mental health status, and treatment description. Repeated measures analysis of variance (ANOVA) models showed significant decreases in all five outcomes from baseline to termination of treatment. The associated effect sizes for length of time in treatment were medium to large for depression, anxiety, conduct disorder, and perpetrating aggression/violence. There was a small to medium associated effect size for peer relationship problems and the effect of time was not significant for cohabitation relationship problems. Findings provide preliminary support for continued development and evaluation of mental health services facilitated through A Home Within among clients currently or previously in foster care.

아동․청소년의 태권도시범단 활동이 교우관계 문제와 자아존중감에 미치는 효과

This study investigated the effects of the Taekwondo Demonstration Team activities on peer relationship problems and self-esteem of children and adolescents. This study considered it necessary to study how the Taekwondo Demonstration Team solves the problems of friendship between children and adolescents and how self-esteem changes. The purpose of this study is to provide basic data to help children and adolescents suffering from interpersonal problems and low self-esteem. The subject of this study was to analyze a total of 50 copies of data from trainees of elementary and middle school students at Taekwondo studios located in the 2 areas of U and G. The experiment period was from February to May 2022, and 25 people in the experimental group and 25 people in the comparison group were compared and analyzed before and after, respectively. Correspondence t-test was performed for data analysis using SPSS 27.0 to verify the effect on friendship problems and self-esteem.As a result of the study, the experimental group had a significant effect on friendship problems and self-esteem after Taekwondo demonstration group activities. As a result, it was found that the activities of the Taekwondo Demonstration Team of children and adolescents improved the problem of friendship and increased self-esteem.

Maternal pre-pregnancy body mass index and mental health problems in early adolescents from the 2004 Pelotas birth cohort

Possible mechanisms by which maternal pre-pregnancy body mass index (BMI) programs offspring mental disorders in late childhood are not fully clarified. To assess the association between maternal BMI and mental health problems at 11 years old, we used data from the 2004 Pelotas birth cohort which comprised 4231 newborns. Maternal pre-pregnancy BMI was analyzed as underweight (< 18.5), normal (18.5–24.9), overweight (25.0–29.9), and obesity (≥ 30.0). Mental health problems were assessed at the child’s age of 11 years by the Strengths and Difficulties Questionnaire, total difficulties score and subscale scores (emotional symptoms, conduct problems, hyperactivity/inattention, and peer relationship problems), dichotomized into normal/borderline and abnormal category. The associations between maternal pre-pregnancy BMI and mental health problems in the whole sample and stratified by sex were estimated using crude and adjusted linear and logistic regression. Both linear and logistic regression showed that pre-pregnancy weight was associated with mental problems in early adolescents. Maternal pre-pregnancy obesity was associated with increased odds of total difficulty score among the whole sample. Boys whose mothers were pre-pregnancy overweight had higher odds of conduct problems (OR = 1.56; 95% CI: 1.13, 1.95), when compared to children of normal pre-pregnancy weight mothers, even after adjustments. Maternal pre-pregnancy obesity was associated with mental health problems in early adolescents; specifically, pre-pregnancy overweight increased the risk for conduct problems in 11 years old boys.

Spotlight on the Adolescent’s Mental Health: Distress and Coping amid the COVID-19 Pandemic

Background: COVID-19 pandemic globally challenged the healthcare sector as well as posed a serious threat to mental health among both young and adults rendering people with a sense of uncertainty and loss. Objective Aim: To assess the psychological burden among the adolescent population during the pandemic and lockdown. Methodology: A cross sectional study was moderated by the research team at the Department of Psychiatry and Behavioral Sciences, Jinnah Postgraduate Medical Center between April 2020 to October 2021. All individuals between the ages of 13 to 17 years were included. The proforma was circulated among residents of the province of Sindh that assessed the emotional symptoms, conduct problems, hyperactivity-inattention, peer relationship problems, and prosocial behaviors among participants. Results: The mean SDQ score was 24.97 with a standard deviation of 6.62. The mean scores for emotional symptoms, conduct problem, hyperactivity, peer problem, and prosocial Scale were 5.47, 6.82, 5.85, 6.82, and 3.02, respectively. A significant relationship was revealed between mental health stability and witnessing a death of a known person due to COVID-19 infection (p=0.003). Furthermore, the study found that Sindhi individuals had significantly higher scores as compared to other ethnic groups (p=0.002). Conclusion: The young population is as equally stressed as adults and may suffer from substantial anxiety during the pandemic. Therefore, parents should be encouraged to create an atmosphere of support and goodwill. Keywords: Adolescent, coping mechanism, covid19, pandemic, psychological distress

Longitudinal Associations of Children’s Hyperactivity/Inattention, Peer Relationship Problems and Mobile Device Use

Children with emotional, behavioral or relationship problems may be more inclined to use mobile touchscreen devices (MTSDs: mobiles and tablets) to regulate their emotions or compensate for the lack of social relationships, which, in turn, may affect their symptoms. Bi-directional longitudinal associations between behavioral difficulties and MTSD use were analyzed. Participants were parents of children aged 4–6 years old at first data collection (n = 173), and 7–9 years old at second data collection (n = 98). They reported on their child’s MTSD use and behavioral difficulties at two time points (T1 and T2). It was analyzed whether T1 MTSD use predicts T2 behavioral difficulties (controlling for demographics and T1 behavioral difficulties); and whether T1 behavioral difficulties predict T2 MTSD use (controlling for demographics and T1 MTSD use). Additionally, cross-sectional associations between behavioral difficulties and MTSD use were analyzed. Children’s T1 hyperactivity/inattention score positively associated with T2 MTSD use, and peer relationship problems and MTSD use positively associated in T2. Pre-schoolers with more hyperactive inattentive symptoms may use MTSDs more to regulate their emotions. The association between peer relationship problems and MTSD use in T2 is consistent with poorer socio-cognitive skills in MTSD user children and may be bi-directional.

Emotional status and problem behavior of pre-school children according to the pandemic period and occupational status of the mother

ABSTRACT The aim was to compare the emotional status and problem behavior of pre-school children according to their mother’s occupational status in two groups before the pandemic and during the pandemic period. Mothers were asked to fill out a survey form containing sociodemographic characteristics, the Emotion Regulation Checklist (ERC) and the Strengths and Difficulties Questionnaire (SDQ) . Total ERC and Emotion Regulation Subscale scores were significantly higher and Lability-Negativity Subscale scores, conduct problems, peer relationship problems, internalising scores and total SDQ scores were significantly lower in the pandemic period group than in the pre-pandemic group. The occupational status of mothers in the PanP and Pre-Pan groups did not significantly differ in ERC scores, peer relationship problems scores, and prosocial behavior, whereas, internalization was lower during PanP and was associated with the mother’s occupational status.

The Psychosocial Well-Being of Young Video-Gamer Children: A Comparison Study.

Objective:In recent years, young children from all socioeconomic conditions found an opportunity to own or access video game devices. The precisely defined effects of video gaming on young children’s behaviors and mental health are unknown. This study aimed to investigate the relationship between the psychosocial well-being and video gaming in preschool children. Materials and Methods:The video gamer (n = 70) and non-gamer (n = 140) children between 2 and 6 years old and their mothers were included in the study. Psychosocial well-being was assessed using the Strengths and Difficulties Questionnaire parent version. Multivariable logistic regressions were used. Results:30% of the video gamers played video games for more than 1 hour per day. Factors associated with video gaming included sex, birth order, age of first screen exposure, daily screen time, and parent(s) video gaming. Being a boy, having a daily screen time of more than 1 hour and parent(s) video gaming increased the probability of video gaming [Odds (95% CI) = 3.00 (1.42-6.31), P = .004; 6.28 (2.86-13.80), P < .001; 6.49 (2.77-15.23), P < .001, respectively]. Not being the first child and having an age of first screen exposure older than 12 months old decreased the probability of video gaming [Odds (95% CI) = 0.29 (0.11-0.76), P = .012; 0.34 (0.13-0.89), P = .027, respectively]. Video gamers and non-gamers had statistically similar Strengths and Difficulties Questionnaire scores. There was no association between video gaming and being borderline or abnormal in emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, prosocial behavior, and total difficulties. Conclusion:This study investigating the relationship between psychosocial well-being and video gaming revealed that video gaming is not associated with psychosocial well-being in preschool age.

Examining socioeconomic disparities in changes in adolescent mental health before and during different phases of the coronavirus disease 2019 pandemic.

This study examined socioeconomic disparities in changes in adolescent mental health between fall 2019 (pre‐COVID‐19), spring 2020 (initial coronavirus disease 2019 (COVID‐19) phase), and fall 2020 (prevailing COVID‐19 phase). Using data from 1429 adolescents (M age = 17.9) from tertiary vocational schools in the Netherlands with n = 386 participating in all three waves, linear and latent basis growth curve models were assessed and multigroup analyses conducted. Results showed a small but significant decrease in life satisfaction and small but significant increases in emotional problems, peer relationship problems, conduct problems, and hyperactivity‐inattention problems. For emotional problems and peer relationship problems, increases between pre‐COVID‐19 and the initial COVID‐19 phase were more pronounced than increases between the initial and prevailing COVID‐19 phase. In contrast, linear decreases were found for life satisfaction and linear increases for conduct problems and hyperactivity‐inattention problems over the course of the study. Mental health patterns were largely comparable for adolescents from families with varying socioeconomic status.

Children and Adolescents' Mental Health Following COVID-19: The Possible Role of Difficulty in Emotional Regulation.

The COVID-19 pandemic has shattered routines throughout the world, creating closures and social isolation. Preliminary studies conducted during the pandemic have shown that children and adolescents are mainly affected by social distancing and the lack of a supportive framework. The purpose of the present study was to compare mental health symptoms of 430 children and adolescents who sought mental health services in the community before vs. during the pandemic. The study examined children's perceived burden of the pandemic, reports of emotional and behavioral problems (SDQ) anxiety (SCARED), depressed moods (SMFQ-C), and difficulty in emotional regulation (DERS), as well as intervening variables such as age and gender. Furthermore, the effect of difficulty in emotional regulation on children's mental health symptoms was explored. Findings indicate an increase in all mental health symptoms excluding anxiety, during the pandemic. Boys reported more difficulty in emotional regulation during the pandemic than before, and girls reported more emotional and behavioral problems. Children reported an increase in emotional and behavioral problems and adolescents in peer relationship problems. Difficulty in emotional regulation predicted all mental health symptoms in both samples, more so in girls and adolescents. These initial findings support the need for further studies to examine the long-term mental health effects of COVID-19 pandemic on children and adolescents.

Self-esteem, emotional and behavioral problems, and psychopathology in children with somatic symptoms and related disorders

ABSTRACT &#x0D; Objective: There are few studies in the literature on somatic symptoms and related disorders (SSRD) in children. The aim of this study is to investigate emotional and behavioral difficulties, self-esteem, psychopathology, and clinical characteristics in children with somatic symptoms.&#x0D; Method: This study included 44 children with recurrent and distressing somatic complaint(s) and 49 healthy children. The diagnosis of SSRD was evaluated in detail according to DSM-5 criteria. Self-esteem, emotional and behavioral difficulties, and somatization were assessed using the Rosenberg Self-Esteem Scale (RSES), Strengths and Difficulties Questionnaire (SDQ), and Children's Somatization Inventory (CSI-24), respectively.&#x0D; Results: Children with somatization had significantly greater rates of having at least one comorbid mental disorder, emotional symptoms scores, and peer relationship problems. On the other hand, these children's prosocial behavior scores (Strengths Score), self-esteem scores, and academic performance were significantly lower than the control group. In addition, children with SSRD had more disadvantaged familial characteristics such as low father education, high family history of psychiatric and medical illness and somatization, high marital problems, and domestic violence.&#x0D; Conclusions: This study revealed that somatization in children is associated with increased emotional, peer, and academic problems and psychopathology rates, and low self-esteem and prosocial behaviors. In clinical practice, it would be advisable to evaluate thoroughly children with SSRD in terms of familial disadvantages, emotional, peer, and academic problems, and psychopathology, rather than focusing solely on somatic symptoms.