Psychosocial Functioning Of Children Research Articles

The impact of a caregiver's chronic illness on childhood psychosocial functioning.

Prolonged activation of the body's stress response from chronic exposure to adverse stressors may have a significant impact on lifelong psychosocial functioning. Screening for the impact of prolonged adversity in childhood has become an integral component of pediatric care. While past research has separately explored the impact of caregiver chronic illness and caregiver toxic stress on children, the relationship between caregiver chronic illness disability burden, caregiver parental toxic stress, and their child's psychosocial functioning is not well understood. This study aimed to investigate how caregiver chronic illness disability burden and caregiver toxic stress impact childhood psychosocial dysfunction (CPD). This pilot study was conducted at two free family medicine clinics in Inland Southern California between August and December 2022. It surveyed caregivers with chronic illness of any age or functional capacity who are full-time caretakers of children aged 4-17 years old. Validated screening tools assessed caregiver disability burden (World Health Organization Disability Assessment Schedule 2.0-12), parental toxic stress (Functional Impact of Toxic Stress for Parents), and pediatric psychosocial functioning (Pediatric Symptom Checklist-17). Regression analysis tested if caregiver scores on these measures predicted CPD. Twenty-nine participants completed the survey. High caregiver chronic illness disability burden and toxic stress together significantly predicted CPD. Caregiver toxic stress alone predicted CPD, whereas chronic illness disability burden alone did not. This study highlights the relationship between caregiver chronic illness disability burden, caregiver toxic stress, and childhood psychosocial dysfunction, and may contribute to providing holistic care to children and their caregivers. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Transition and Aftercare Following a Child's Discharge From ICU to a General Ward: A Qualitative Meta-Synthesis of Parental Experiences.

Transitions from the intensive care unit (ICU) to the general ward cause great impairment of physical and psychosocial functioning in children and their parents. Better understanding of parental experiences during children's ICU-to-ward transitions is required to inform the development of ICU transitional care. To examine the parental experiences during their children's ICU-to-ward transitions through the synthesis of original qualitative studies. This study follows the preferred reporting items for systematic reviews and meta-analyses (PRISMA) and the enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) statements, uses Thomas and Harden's thematic synthesis framework rooted in a critical realist philosophy to present qualitative meta-synthesis. We conducted a systematic review in June 2024 and searched nine electronic databases including Pubmed, Embase, CINAHL, PsycINFO, Cochrane Library, Sinomed, CNKI, Wanfang and VIP. Eligible studies contained parents quotes about their children's ICU-to-ward transitions and published in either English or Chinese since 2005. Systematic searches yielded 2825 identified studies. Two reviewers screened titles, abstracts and full text and reached consensus through critical discussion with a third reviewer. Eighteen studies were finally agreed for inclusion. Data were extracted into a Microsoft Excel spreadsheet and synthesised through line-by-line coding of relevant quotes with the help of NVivo. The qualitative synthesis resulted in four descriptive themes followed later by two analytical themes. Specifically, these were (1) the nature of the parental experience during ICU-to-ward transition (challenging but responded proactively) and (2) factors involved in the ICU-to-ward transition (both facilitators and barriers). This study indicates the nature of parental experiences and factors involved during the critically ill child's ICU-to-ward transition. Healthcare providers serve as the primary support network for parents and should collaborate closely with them to facilitate a smooth transition by providing tailored support. This is a meta-synthesis of previously published qualitative studies. We have registered in the PROSPERO and the number is CRD42023422055.

Associations of sibling relationship quality and emotion regulation with child functioning in families with parental cancer

In families facing parental cancer, children have an increased risk for impaired psychosocial functioning, such as lower quality of life and satisfaction with life, and increased posttraumatic stress symptoms (PTSS). These outcomes are likely affected by both dyadic and individual factors. The aims of the current study were to examine (1) the associations of sibling relationship quality (i.e., warmth and conflict) and emotion regulation problems with child functioning (i.e., quality of life, satisfaction with life, and PTSS) in families facing parental cancer; and (2) whether emotion regulation problems partially or fully mediate these associations. Our sample consisted of 161 children from 82 Dutch families facing parental cancer (84.6% maternal cancer). During home visits, children (mean age 12.1 years; 53.1% girls; 54.4% same-sex sibling pairs) filled out questionnaires about their sibling relationships and their own functioning. Mediation analyses showed no significant direct nor indirect effects of sibling warmth on quality of life, satisfaction with life or PTSS. Significant indirect (but not direct) effects were found for sibling conflict on quality of life and satisfaction with life and on PTSS, through emotion regulation problems. Children experiencing more sibling conflict reported more emotion regulation problems, which were linked to lower quality of life and satisfaction with life and more PTSS. Our study suggests that sibling conflict could be considered a risk factor for child psychosocial functioning in families facing parental cancer. The potentially beneficial effects of sibling warmth were not confirmed by our findings. Limitations and implications of the study and future directions are discussed.

Parent-child discrepancies in reports of child psychosocial functioning in neurofibromatosis type 1.

Children with neurofibromatosis type 1 (NF1) are at an increased risk for social-emotional difficulties. These difficulties, including depression and anxiety, are typically measured through parental report of child functioning in research and rarely have children with NF1 rated their own well-being. Discrepancies between parent proxy- and child self-report of psychosocial functioning in other populations have been shown to relate to socioemotional problems and distress. This study examined the concordance of parent proxy- and child self-report of child behavioral and social-emotional functioning on selected Behavior Assessment System for Children-Second Edition subscales in families of children with NF1 and plexiform neurofibroma tumors (pNFs). We also sought to explore possible child, family, and community factors relating to discrepancies in reporting for youth with NF1 and pNFs. Overall, parents reported higher symptoms across psychosocial domains (anxiety, depression, and atypicality) in comparison to their children. Furthermore, characteristics like child sex, attention-deficit hyperactivity disorder diagnosis, and family functioning significantly predicted differences in ratings of child functioning. These findings indicate that multi-informant studies are crucial to understanding multiple perspectives among family members in symptom-reporting and risk factors for these discrepancies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Psychopathological Correlates and Psychosocial Functioning in Children and Adolescents with Syncope: A Systematic Review.

Syncope is defined as a spontaneous and transient loss of consciousness and postural tone due to brief and reversible cerebral hypoperfusion. This review aimed to summarize the research findings regarding the psychological correlates associated with pediatric syncope. Moreover, the study aimed to deepen the understanding of the relationship between psychological disorders and the onset of syncopal episodes in childhood, focusing on clinical features and different clinical classifications. A systematic review was carried out from inception to January 2023, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, using the CINAHL Plus, APA PsycArticles, APA PsycInfo, MEDLINE, and Psychology and Behavioral Sciences Collection databases. The study search and selection were based on the Population Intervention Comparison Outcome Study Design (PICOS) strategy and the Quality Assessment was carried out using Critical Appraisal Skills Programme (CASP) scales. A combination of keywords related to a) syncope; b) psycho*; and c) child* (Subjects) was used. Studies concerning epilepsy-related syncope were excluded. Overall, 912 records were identified. After excluding non-English, non-original, and duplicate studies, 579 records were selected for the title screening, 88 for the abstract screening, 37 full-text articles were assessed for eligibility and a total of 14 were included. The Risk of Bias in the included studies was assessed and 78,6% of the studies satisfied robustness quality criteria. The findings highlighted that children and adolescents with syncope showed a higher rate of psychopathology as compared to the healthy and clinical controls. Furthermore, patients reported social withdrawal and poor quality of life. The findings suggest that there is a robust relationship between psychopathology and syncope. Children and adolescents with syncope frequently report clinical symptoms related to emotional, relational, and psychosomatic dysregulation. Psychological assessment should be routinely included in the integrated care to identify potential targets for treatment and improve early differential diagnosis.

Protocol for a randomized clinical trial of strength at home parents: A trauma informed parenting intervention for veterans

BackgroundPost-traumatic stress disorder (PTSD) is highly prevalent in veterans and associated with impairments in family functioning, including parenting. There is a bidirectional relationship between PTSD and familial functioning such that impaired functioning is related to increases in trauma-related symptoms, and vice versa. Despite this known bidirectional association, there is currently no trauma-informed parenting intervention available for veterans within the Department of Veterans Affairs (VA). Strength at Home – Parents (SAHP) is an 8-session telehealth delivered psychotherapy group that aims to improve parenting behaviors and overall parent-child and family functioning among U.S. military veterans with PTSD symptoms. This paper describes the methods of an individually randomized group therapy trial to test the efficacy of SAHP compared to a VA treatment as usual control condition.Methods are reported using SPIRIT guidelines. MethodsOne hundred and ninety veterans with elevated PTSD symptoms and parent-child functioning problems will be randomly assigned to the SAHP intervention or a treatment-as-usual control group. Outcomes are measured at 4 timepoints including baseline. The primary outcome is parenting stress. We will also examine changes in parenting behaviors, whether treatment gains are maintained over time, and will conduct an exploratory analysis to examine results separately by gender. Secondary outcomes include symptoms of PTSD and depression, family functioning, and child psychosocial functioning. ConclusionStudy findings will determine the efficacy of SAHP, an intervention developed for ease of use and implementation within the VA to improve parenting stress and parenting behaviors in veterans with elevated PTSD symptoms and parenting difficulties.

Interactive effects of parental support and psychological control on children's emotion regulation.

Parents engage in a variety of behaviors that have important impacts on children's psychosocial functioning, including their ability to effectively regulate emotions. Parental support includes behaviors that convey warmth, love, and acceptance, whereas parental psychological control includes shaming, guilt induction, and love withdrawal. Although the unique effects of these parenting behaviors are most often examined in the literature, it is possible that they may interact with one another to influence child outcomes. The goal of the present study was to examine whether parental psychological control moderated the effect of parental support on children's emotion (dys)regulation over a 6-month period. Participants included 284 third- through fifth-grade students (51.8% boys; 51.1% Hispanic/Latinx) as well as their homeroom teachers. Children completed self-report measures of parental support, psychological control, and emotion (dys)regulation during the fall and spring semesters of an academic year. Teachers also completed measures of emotion (dys)regulation at each time point. Results indicated that parental psychological control moderated the association between parental support and self-reported emotion regulation over time. Specifically, parental support predicted increases in emotion regulation over time among youth reporting lower levels of psychological control; at higher levels, however, parental support was not associated with emotion regulation. Furthermore, psychological control uniquely predicted increases in child-reported emotion dysregulation, whereas parental support predicted decreases in teacher-reported emotion dysregulation. Findings from this study suggest that psychological control may serve as an important target for future parenting interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Family and developmental correlates of adolescent involvement in decision making about screen use

ObjectiveAssess how child involvement in making rules about screen time relates to age, child prosocial functioning, and amount of screen use. MethodsNORC’s AmeriSpeak Panel was used to recruit a nationally representative sample of parents or guardians of school-aged children (age 5–17) in the United States (n = 2084). Parents completed survey that included measures of screen time, child involvement in rule making about screen use, family functioning, and dimensions of child psychosocial functioning. ResultsAcross all age categories, most families had some form of rules about the allowable amount of screen-based digital media for uses other than schoolwork: 86% of elementary school-aged children (ages 5 to 10), 81% of middle school-aged children (ages 11–13), and 61% of high school aged children (ages 14–17). Across all age groups, having rules was associated with fewer hours of screen time (elementary school: B = -1.31, 95% CI = -1.80 to −0.81, p < 0.001; middle school: B = -1.40, 95% CI = -2.20 to −0.59, p < 0.001; high school: B = -0.97, 95% CI = -1.68 to −0.27, p = 0.007). Child involvement in making rules was significantly greater for high school students as compared to elementary school students (ß=0.12, p < 0.001), and not associated with high school- or middle-school aged child screen time. Across all age groups, child involvement in making rules was associated with higher levels of prosocial functioning (elementary school: ß=0.07, p < 0.001; middle school: ß=0.19, p = 0.001; high school: ß=0.21, p < 0.001). ConclusionsChild involvement in making rules about screen use may be an opportunity to strengthen developmentally important competencies, as part of a broader autonomy-supportive approach to parenting.

Caregiver Burden Associated With Pediatric Chronic Pain: A Retrospective Study Using the Pediatric Electronic Persistent Pain Outcomes Collaboration Database.

This retrospective, cross-sectional study investigated the nature and extent of burden experienced by caregivers of children and adolescents with chronic pain, and factors associated with increased caregiver burden. The Pediatric Electronic Persistent Pain Outcomes Collaboration database provided prospectively collected data from 1929 families attending 9 pediatric chronic pain services across Australia and New Zealand. Data included demographic information, responses to child pain and functioning measures, caregiver work impairment, and psychosocial functioning. Caregivers of children with chronic pain reported work impairment associated with their child's pain (mean: 15% ± SD 25 absenteeism; 38% ± SD 29 productivity lost), significantly worse than published international population norms (large-scale community survey data), most other caregiver samples of adults and children with other chronic conditions, and adult samples with various pain conditions. Caregivers reported considerable burden in multiple psychosocial functioning domains, particularly leisure functioning, pain-related catastrophizing, and adverse parenting behaviors (with greater pain-related avoidance). Caregiver psychosocial burden was significantly associated with child psychosocial functioning (β = -0.308, P < 0.01), school absenteeism (β = 0.161, P < 0.01), physical disability (β = 0.096, P < 0.05), and pain duration (β = 0.084, P < 0.05), but not pain intensity. Caregiver work productivity loss was significantly associated with school absenteeism (β = 0.290, P < 0.01), child physical disability (β = 0.148, P < 0.01), child health care utilization (β = 0.118, P < 0.05), and worst pain intensity (β = 0.101, P < 0.05). These results highlight the significant and varied impacts experienced by caregivers of children with chronic pain. This work is novel in reporting significant work impairment and confirms psychosocial burden in a larger sample than previous studies.

Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents.

Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents.

The impact of domestic violence on the mental health and psychosocial functioning of children and adolescents: abroad experience of diagnostics

The article presents an overview of the foreign experience of professional monitoring of children exposed to domestic violence, which is characterized by structured approaches and the wide use of short screening tests-questionnaires for all involved parties - children, parents, teachers, nurses, pediatricians, and mental health specialists. For diagnosis, tools recommended by the international community of specialists in the field of mental health protection of children and adolescents are provided. There are ready-made test-batteries for comprehensive routine assessment of treatment progress that assess indicators of mental health and clinical disorders for adolescents aged 11–18 years and are based on information from adolescents, caregivers and clinicians. They are appropriate for use as screening tools and/or to monitor changes in symptoms over time, assess the outcome of therapy, focus on treatment processes, for example, the therapeutic alliance, treatment expectations. The review pays special attention to a method that gives a global assessment of the psyche, namely the “Pediatric Symptom Checklist” method by M. Jellinek and M. Murphy and colleagues (PSC and Y-PSC versions), which is successfully used to screen for psychosocial problems children This tool has several significant advantages - it has a wide range of action, namely targeting various symptoms of a child’s psychosocial disorders (and not just one: depression or anxiety, or fears, or dissociation, or behavior disorder, etc.); it is very easy and economical in terms of implementation and administration (it takes only 3-5 minutes to execute and the same to process); it clearly distinguishes children who already need additional attention and help from specialists in psychological and psychiatric profiles, and can be used to assess the dynamics of the condition and the effectiveness of assistance. In addition, it conceptually corresponds to the theoretical model of T. M. Achenbach and reveals a violation of the child’s psyche in both ways - internalization and externalization - as a result of adverse developmental conditions. This tool is quite actively used in modern science and clinical practice, it provides important results during the study of psychological problems of children who have experienced domestic or other types of violence, have post-traumatic stress disorder, and experienced displacement from military conflict zones

Caregiver Perceptions of Children's and Adolescents' Psychosocial Functioning During the Stringent COVID-19 Lockdown Restrictions in Shanghai: Cross-sectional Study.

The COVID-19 pandemic represents a global health crisis. The Shanghai municipal government in China implemented strict and comprehensive pandemic control strategies in the first half of 2022 to eliminate a wave of COVID-19 infection. The pandemic and the resulting government responses have led to abrupt changes to families' daily lives, including the mental health of children and adolescents. The aim of this paper is to examine the impact of COVID-19 exposure and the stringent lockdown measures on the daily life and mental health of children and adolescents and to provide suggestions on maintaining their mental health when similar public health emergencies occur in the future. In this cross-sectional study, an anonymous survey was distributed online in May 1-15, 2022, in Shanghai. Individuals were eligible to participate if they were currently the caregiver of a child or adolescent (aged 4-17 years). Outcomes were psychosocial functioning of children and adolescents, as reported by parents, using the Pediatric Symptom Checklist-17. COVID-19 exposure and life changes were also reported. Multivariate logistic regression was used to analyze risk factors for poor psychosocial functioning. In total, 2493 valid questionnaires were analyzed. The rate of positive scores on the global Pediatric Symptom Checklist-17 scale was 16.5% (n=411). Internalizing, attention, and externalizing problem subscale positivity rates were 17.3% (n=431), 10.9% (n=272), and 8.9% (n=221), respectively. Caregivers reported that 64.2% (n=1601) and 20.7% (n=516) of the children's interactions with friends or peers and parents deteriorated, respectively. Compared with male caregivers, female caregivers were less likely to report psychosocial problems in children and adolescents (adjusted odds ratio [aOR] 0.68; 95% CI 0.53-0.88). Older children and those with lower COVID-19 Exposure and Family Impact Scales scores were less likely to have psychological problems (aOR 1.15; 95% CI 1.10-1.21). Compared with children with screen times <1 hour per day for recreation, those using screens for >3 hours had higher odds of psychological distress (aOR 2.09; 95% CI 1.47-1.97). Children who spent 1-2 hours exercising and had better interactions with friends or peers and parents showed a trend toward lower odds of psychological problems. Children and adolescents with worse sleep compared with preclosure were more likely to have psychological problems. The prevalence of psychosocial problems among children and adolescents is relatively high. Being young, having more COVID-19 exposure, and having more screen times (>3 h/day), less exercise time (<30 min), worse sleep, and deteriorated interactions with friends or peers and parents were risk factors for poor psychosocial functioning. It is necessary for governments, communities, schools, and families to take appropriate countermeasures to reduce the negative impact of the stringent control measures on caregivers' parenting and psychosocial functioning of children and adolescents.

Mindfulness Initiatives for Students, Teachers, and Parents: a Review of Literature and Implications for Practice During COVID-19 and Beyond.

The use of mindfulness in schools has greatly expanded over the past 10years. Research has demonstrated positive psychological effects of mindfulness for students as well as teachers (Emerson et al., Mindfulness 8:1136-1149, 2017; Semple et al., Psychology in the Schools 54:29-52, 2017). Similarly, studies focusing on mindfulness interventions for parents of children with disabilities and/or psychosocial difficulties have also yielded a variety of positive outcomes, including reduced parenting stress, increases in quality of life, and improved parent-child interactions (Bögels et al., 2016; Rayan and Ahmad, Research in Developmental Disabilities 55:185-196, 2016). Although there has been a proliferation of mindfulness research, and mindfulness has become a buzzword in popular culture, it has not been systematically examined or applied as an approach to improving psychosocial functioning in children, school personnel, and families during COVID-19 and in online settings. This article provides a preliminary framework for this examination by reviewing relevant research and providing practical strategies and resources for school psychologists.

Mothers’ temperament and psychosocial functioning of children with autism spectrum disorder

Mothers’ temperament and psychosocial functioning of children with autism spectrum disorder

A Prospective Cohort Study of the Association Between Preinjury Psychosocial Function and Postconcussive Symptoms in Pediatric Mild Traumatic Brain Injury: An A-CAP Study.

We evaluated the moderating effect of preinjury psychosocial function on postconcussion symptoms for children with mild traumatic brain injury (mTBI). We conducted a prospective cohort study of children ages 8.0 to 16.9 years with mTBI ( n = 633) or orthopedic injury (OI; n = 334), recruited from 5 pediatric emergency departments from September 2016 to December 2018. Participants completed baseline assessments within 48 hours of injury, and postconcussion symptoms assessments at 7 to 10 days, weekly to 3 months, and biweekly to 6 months post-injury. Preinjury psychosocial function was measured using parent ratings on the Pediatric Quality of Life Inventory (PedsQL) and the Strengths and Difficulties Questionnaire (SDQ), retrospectively evaluating their child's status prior to the injury. Parent and child ratings on the Health and Behavior Inventory (HBI) (cognitive and somatic subscales) and the Post-Concussion Symptom Interview (PCS-I) were used as measures of postconcussion symptoms. We fitted 6 longitudinal regression models, which included 747 to 764 participants, to evaluate potential interactions between preinjury psychosocial function and injury group as predictors of child- and parent-reported postconcussion symptoms. Preinjury psychosocial function moderated group differences in postconcussion symptoms across the first 6 months post-injury. Higher emotional and conduct problems were significantly associated with more severe postconcussion symptoms among children with mTBI compared with OI. Wald's χ 2 for interaction terms (injury group × SDQ subscales) ranged from 6.3 to 10.6 ( P values <.001 to .043) across parent- and child-reported models. In contrast, larger group differences (mTBI > OI) in postconcussion symptoms were associated with milder hyperactivity (Wald's χ 2 : 15.3-43.0, all P < .001), milder peer problems (Wald's χ 2 : 11.51, P = .003), and higher social functioning (Wald's χ 2 : 12.435, P = .002). Preinjury psychosocial function moderates postconcussion symptoms in pediatric mTBI, highlighting the importance of assessing preinjury psychosocial function in children with mTBI.

Diagnostic criteria for temporomandibular disorders-INfORM recommendations: Comprehensive and short-form adaptations for children.

The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) are used worldwide in adults. Until now, no adaptation for use in children has been proposed. The aim of this study was to present comprehensive and short-form adaptations of Axis I and Axis II of the DC/TMD for adults that are appropriate for use with children in clinical and research settings. Global Delphi studies with experts in TMDs and in pain psychology identified ways of adapting the DC/TMD for children. The proposed adaptation is suitable for children aged 6-9 years. Proposed changes in Axis I include (i) adapting the language of the Demographics and the Symptom Questionnaires to be developmentally appropriate for children, (ii) adding a general health questionnaire for children and one for their parents, (iii) replacing the TMD Pain Screener with the 3Q/TMD questionnaire and (iv) modifying the clinical examination protocol. Proposed changes in Axis II include (i) for the Graded Chronic Pain Scale, to be developmentally appropriate for children, (ii) adding anxiety and depression assessments that have been validated in children and (iii) adding three constructs (stress, catastrophising and sleep disorders) to assess psychosocial functioning in children. The recommended DC/TMD, including Axis I and Axis II, for children aged 6-9 years, is appropriate for use in clinical and research settings. This adapted the first version for children includes changes in Axis I and Axis II changes requiring reliability and validity testing in international settings. Official translations to different languages according to INfORM requirements will enable a worldwide dissemination and implementation.

Convergence Between the Child Behavior Checklist Sleep Items, Actigraphy and Other Sleep Measures Among Children of Parents with Alcoholic Disorders and Controls.

The Child Behavior Checklist (CBCL) is a widely used instrument of children psychosocial functioning. CBCL sleep items have been used in both clinical settings and research. To date, few empirical studies have examined the relationships between CBCL sleep items and other sleep measures such as actigraphy and validated sleep questionnaires. This study extends the literature by examining these relationships in a group of children of parents with an alcohol use disorder (COAs) and matched controls. Two hundred and forty-eight children aged 8-12 (48% COAs; 50% girls; Mean age =10.37 (Standard deviation = 1.47)), participated in this study. Data presented here were taken from Time 1 of a larger prospective study designed to understand the relationship between sleep and alcohol use. All participants were naïve to alcohol and other illicit drugs. Parents completed the Achenbach CBCL and the Pediatric Sleep Questionnaire (PSQ). Participants wore an actigraph watch on their non-dominant wrists for one week and filled out the Youth Self-Report (YSR). Multiple regression analyses showed that CBCL sleep items (eg, "trouble sleeping") correlated with related actigraphy (eg, shorter total sleep time and longer sleep onset latency) and Pediatrics Sleep Questionnaire (PSQ) items (eg, sleep difficulties and daytime sleepiness). Logistic regression analyses indicated that CBCL items (eg, "trouble sleeping) predicted similar items in the Youth Self Report (YSR) (eg, trouble sleeping). Structural equation modeling analyses showed that the latent variable "CBCL sleep" correlated significantly with the latent variables of actigraphy (r = -0.54, p < 0.001), PSQ (r = 0.93, p < 0.001) and YSR (r = 0.38, p < 0.01). These associations were largely the same for COAs and controls. CBCL items were significantly associated with actigraphy variables, a validated sleep measure (PSQ) and youth report of sleep for both COAs and non-COAs.

Inclusive education for children with disabilities in a refugee camp.

Children in refugee camps, and particularly those with disabilities, face unique challenges in accessing education and are at high risk of being marginalised. Best practices suggest that main-streaming is the optimal strategy for serving students with disabilities. This study examines the extent to which mainstreaming in a refugee camp helps to promote children's prosocial behaviours, taking into account their emotional and behavioural problems. In Kakuma Refugee Camp, Kenya, researchers collected data from the parents of children currently enrolled in special needs education centres (n=65) and from those formerly enrolled at these facilities who transitioned to mainstream classrooms (n=81). Children in mainstream schools functioned better in terms of prosocial behaviours, but this relationship disappeared when factoring in children's emotional and behavioural difficulties. In the context of a refugee camp, mainstreaming alone is not likely to help children's psychosocial and educational functioning, which requires dedicated supports, appropriate facilities and infrastructure, and a dual focus on disability-specific and disability-inclusive initiatives.

Gender differences in risk factors and psychosocial functioning in children with psychogenic nonepileptic seizures

ObjectiveFemale predominance is evident in childhood-onset psychogenic nonepileptic seizures (PNES). Understanding gender-specific vulnerability to PNES may provide a unique insight into its cause and management. We aimed to investigate gender differences in demographic characteristics, triggering factors and psychosocial functioning in children and youth with PNES. MethodsWe retrospectively reviewed patients who were evaluated in the PNES clinic at Children’s Healthcare of Atlanta from July 2019 to March 2020 and completed questionnaires to assess adverse life events, psychosocial function (Pediatric Symptom Checklist-17 [PSC-17]), and somatic symptoms (Children’s Somatic Symptom Inventory-8, [CSSI-8]). ResultsForty-nine consecutive patients (38 girls, 11 boys) with a median age of 15.0 (9–19) years were included in the study. We performed univariate analysis and evaluated significant variables related to PNES according to sex. Majority of both genders experienced daily to weekly PNES, came from dysfunctional families, scored high on PSC-17, were treated for neuropsychiatric illnesses, and experienced bothersome somatic symptoms. The variables significantly different between genders were suicidal thoughts, history of trauma, and learning disability. Suicidal thoughts and trauma, particularly sexual abuse, were significantly more prevalent in girls (p = 0.03) whereas learning disability was more common in boys (p = 0.03). ConclusionFemales predominated in our PNES clinic (F:M = 3.5:1). Gender differences in predisposing factors were sexual abuse in females and learning disability in males. Our data highlight the gender-specific risk factors and vulnerability to PNES. The awareness of gender difference may guide more targeted intervention for children and youth with PNES.

Psychopathological symptoms associated with psychosocial functioning in children and adolescents with autism spectrum disorders and their typically developing peers

Children and adolescents with autism have increased prevalence of psychosocial disabilities. Studies in autism indicate that key psychosocial factors including adaptive functioning, school absence, special needs education, frequency of peer socialization and participation in organized leisure activities may differ in their relationship with autistic, internalizing and externalizing symptoms, but the findings are so far mixed. Therefore, we examined if these measures of psychosocial functioning displayed specific associations with autistic, internalizing and/or externalizing symptoms in 61 children with autism aged 7–14 years compared to 61 typically developing controls. Multiple linear regression analyses across all participants showed that lower adaptive functioning, frequency of peer socialization and participation in leisure activities were driven by more social communication problems and not internalizing, externalizing or autistic-like symptoms including rigidity, stereotypy and sensory sensitivity. Notably, increased school absence was specifically driven by more internalizing symptoms and not autistic or externalizing symptoms. These associations were observed across all participants, both children with autism and their typically developing peers, and therefore appear to be dimensional and general in nature. Within the autism group, children who received special needs education displayed fewer social communication problems compared to those who attended regular education, while a developmental history of social interaction problems was related to lower adaptive functioning. Our findings suggest that social communication problems are more critical for psychosocial functioning than other autistic-like behaviors, internalizing or externalizing symptoms but that efforts to reduce school absence specifically need to target internalizing symptoms and not autistic-like or externalizing symptoms.