Self-reported Behavioral Problems Research Articles

Self-reported functional health status following interrupted aortic arch repair: A Congenital Heart Surgeons' Society Study

ObjectivesImproved survival after congenital heart surgery has led to interest in functional health status. We sought to identify factors associated with self-reported functional health status in adolescents and young adults with repaired interrupted aortic arch. MethodsFollow-up of survivors (aged 13-24 years) from a 1987 to 1997 inception cohort of neonates included completion of functional health status questionnaires (Child Health Questionnaire-CF87 [age <18 years, n = 51] or the Short Form [SF]-36 [age ≥18 years, n = 66]) and another about 22q11 deletion syndrome (22q11DS) features (n = 141). Factors associated with functional health status domains were determined using multivariable linear regression analysis. ResultsDomain scores of respondents were significantly greater than norms in 2 of 9 Child Health Questionnaire-CF87 and 4 of 10 SF-36 domains and only lower in the physical functioning domain of the SF-36. Factors most commonly associated with lower scores included those suggestive of 22q11DS (low calcium levels, recurrent childhood infections, genetic testing/diagnosis, abnormal facial features, hearing deficits), the presence of self-reported behavioral and mental health problems, and a greater number of procedures. Factors explained between 10% and 70% of domain score variability (R2 = 0.10-0.70, adj-R2 = 0.09-0.66). Of note, morphology and repair type had a minor contribution. ConclusionsMorbidities associated with 22q11DS, psychosocial issues, and recurrent medical issues affect functional health status more than initial morphology and repair in this population. Nonetheless, these patients largely perceive themselves as better than their peers. This demonstrates the chronic nature of interrupted aortic arch and suggests the need for strategies to decrease reinterventions and for evaluation of mental health and genetic issues to manage associated deteriorations.

Caregiver and youth self-reported emotional and behavioural problems in Ugandan HIV-infected children and adolescents

IntroductionWe determined the prevalence of, and factors associated with, self-rated emotional and behavioural problems (EBPs) and assessed the agreement between self-rated and caregiver-rated EBPs in the ‘Mental health among HIV-infected Children and Adolescents (CA-HIV) in Kampala and Masaka, Uganda’ (CHAKA) study. Existing literature demonstrates that CA-HIV face increased mental health challenges related to a broad range of biological and psychosocial factors. There is scarce data on self-reported EBPs in CA-HIV.MethodsIn a cross-sectional sample, caregiver-reported EBPs were assessed with the Child and Adolescent Symptom Inventory-5 (CASI-5), and self-reported problems were evaluated with the Youth Inventory-4 (YI-4) in 469 adolescents aged 12–17 years and the Child Inventory-4 (CI-4) in 493 children aged 8–11 years. Logistic regression models were utilised to determine factors related to self-reported EBPs.ResultsSelf-reported emotional problems (EPs) were present in 28.8% of the adolescents and were associated with caregivers being separated and having a lower level of education. Among adolescents, 14.5% had self-reported behavioural problems (BPs), and these were associated with caregiver unemployment and food insecurity. Self-reported EPs were reported by 36.9% of children and were associated with rural study sites, having missed school and caregivers having a lower level of education. There was only modest agreement (maximum r = 0.29) between caregiver- and CA-HIV-reported EBPS, with caregivers reporting more EPs and adolescents reporting more BPs.ConclusionSelf-reported EBPs are frequently endorsed by CA-HIV, and these problems are related to unique psychosocial factors. Including CA-HIV, self-report measures can assist in identifying problems that caregivers may not be aware of, particularly BPs.

Social perspective taking is associated with self-reported prosocial behavior and regional cortical thickness across adolescence.

Basic perspective taking and mentalizing abilities develop in childhood, but recent studies indicate that the use of social perspective taking to guide decisions and actions has a prolonged development that continues throughout adolescence. Here, we aimed to replicate this research and investigate the hypotheses that individual differences in social perspective taking in adolescence are associated with real-life prosocial and antisocial behavior and differences in brain structure. We used an experimental approach and a large cross-sectional sample (n = 293) of participants aged 7–26 years old to assess age-related improvement in social perspective taking usage during performance of a version of the director task. In subsamples, we then tested how individual differences in social perspective taking were related to self-reported prosocial behavior and peer relationship problems on the Strengths and Difficulties Questionnaire (n = 184) and to MRI measures of regional cortical thickness and surface area (n = 226). The pattern of results in the director task replicated previous findings by demonstrating continued improvement in use of social perspective taking across adolescence. The study also showed that better social perspective taking usage is associated with more self-reported prosocial behavior, as well as to thinner cerebral cortex in regions in the left hemisphere encompassing parts of the caudal middle frontal and precentral gyri and lateral parietal regions. These associations were observed independently of age and might partly reflect individual developmental variability. The relevance of cortical development was additionally supported by indirect effects of age on social perspective taking usage via cortical thickness.

School-based mindfulness intervention supports adolescent resiliency: A randomized controlled pilot study

ABSTRACTThis research evaluated the effects of a seven-session mindfulness intervention, Learning to BREATHE, on an ethnically diverse at-risk high school student sample. Two classrooms were randomly assigned to intervention or normal health-education programming. Results indicated significant effects to self-reported psychosocial resilience, with students receiving the intervention reporting stable levels of resilience over time and students in the control condition reporting significant reductions. Intervention groups did not evidence change to self-reported psychosocial problem behavior, school attendance, and quarterly academic grades. Findings suggest that MBI may offer an effective strategy for enhancing student dispositional resilience, and suggestions for further research are offered.

Associations Between Sleep Hygiene and Sleep Problems in Adolescents With ADHD: A Cross-Sectional Study

Objective: To determine whether self-reported sleep hygiene practices are associated with self- and parent-reported behavioral sleep problems in adolescents with ADHD. Method: Participants included 79 adolescents with ADHD (13-17 years) and their parents. Adolescents were asked to report on their sleep hygiene (Adolescent Sleep Hygiene Scale) and sleep (Adolescent Sleep Wake Scale). Parents also reported on their adolescent’s sleep (Sleep Disturbance Scale for Children). Results: Poorer sleep hygiene was associated with higher total self-reported behavioral sleep problems and most self-reported sleep problems: falling asleep, reinitiating sleep, and returning to wakefulness. The association was also apparent for total parent-reported behavioral sleep problems, problems with initiating and maintaining sleep, and excessive somnolence. Conclusion: This study demonstrates small-to-moderate relationships between poor sleep hygiene practices and sleep problems in adolescents with ADHD, by both self- and parent-report.

Changes in Emotional and Behavioral Problems Between 2000 and 2011 Among 16-Year-Old Polish Children: A Cross-Sectional Study

Since after the second world war there has been an increasing number of studies investigating secular changes in adolescent mental health. Although no general trends could be outlined, the majority of studies show at least partial deterioration of psychological wellbeing from year 2000 on. Our study adds to this knowledge by exploring changes in self-declared emotional and behavioral problems in Poland, which is a part of post-communist Europe. In this paper, we compared responses on the Youth Self-Report by Polish 16-year-olds from 2000 and those from 2011. Two independent samples consisted of 259 (year 2000) and 185 (year 2011) 16-year-olds of both genders, drawn from randomized, normative, school-based groups. We analyzed linear, ordinal and binary logistic regression models. The results revealed that teenagers from 2011 reported more self-rated internalizing and total problems. Social and thought problems also rose significantly. Gender related time trends hint at a male increase in externalizing, aggressive behaviors and anxiety/depression. Caseness rose significantly in most scales with female gender being an additional risk factor for internalizing and total problems. No reduction in self-reported emotional and behavioral problems was detected.

Behavioral Problems Reported by Adolescents and Parents from HIV Affected Families in China.

This study examined the influence of various factors on the behavioral problems of adolescents affected by HIV while considering the agreement between adolescent and parent reports on problem behaviors. A total of 136 families each with one parent living with HIV (PLH) and one child aged 13-18 were included. Structural equation modeling was used to explore relationships between selected family measures and adolescent's problem behaviors. The correlation between the PLH and adolescent-reported behavioral problem measures was low (β = 0.11). PLH-reported adolescent problem behaviors were negatively related to PLH-reported parental bonding (β = -0.39), family routines (β = -0.26), and positively associated with family conflict (β = 0.21). Adolescent-reported family participation was associated with self-reported problem behaviors (β = -0.35). Our study reported discrete perceptions of adolescent problem behaviors from parents' and adolescents' points of view. Future intervention efforts should emphasize family contextual factors to improve behavioral outcomes in adolescents affected by HIV.

Daily Fantasy Football and Self-Reported Problem Behavior in the United States.

Traditional, season-long fantasy sport participation has grown considerably since the late 1990s, and in an attempt to capitalize on this growing demand, daily fantasy sports (DFS) providers have created a new game where money changes hands instantly. This change has led some legal commentators and state agencies to believe the game is a form of Internet gambling similar to online poker, blackjack, and sports wagering, and thus, it requires increased regulation or even prohibition. Little is known, however, about the gambling behavior associated with DFS participation. Thus, the purpose of the current study was to examine problem gambling severity in conjunction with DFS participant motives, perceptions, and consumption behavior. Over 500 DFS participants were surveyed, and the results suggest DFS participants behave similarly with participants in other forms of gambling activities. In addition, the findings suggest additional consumer protections may be needed to prevent further problem behavior such as chasing.

Self-reported problem behavior in young children with and without a DSM-disorder in the general population

BackgroundProblem behavior of young children is generally not assessed with structured child interviews. This paper examined how information about problem behavior, obtained by structured interviews with six-year-old children, relates to DSM-disorders obtained from parents and to treatment referral. MethodsIn a population-based cohort, caregivers of 1084 young children (mean age 6.7 years) were interviewed with the DSM-based Diagnostic Interview Schedule-Young Child version (DISC-YC), and they scored the Child Behavior Checklist (CBCL). Children themselves were interviewed about problem behavior using the semi-structured Berkeley Puppet Interview (BPI). Information regarding treatment referral to mental health services was obtained by parent-reported questionnaire when children were on average eight years old. ResultsDSM-disorders and CBCL problems in the clinical range were cross-sectionally associated with higher levels of child self-reported problems. Associations were strongest in the externalizing domain (e.g. DISC-YC externalizing disorders with BPI externalizing scores: F(1, 416)=19.39, P<0.001; DISC-YC internalizing disorders with BPI internalizing scores: F(1, 312)=3.75, P=0.054). Moreover, higher BPI internalizing and externalizing problem scores predicted treatment referral two years later. ConclusionsWe conclude that systematically interviewing preschool and young elementary school-aged children should be an integral part of child assessment. This approach may contribute to a better understanding of child development and may predict future problems.

Assessing Diabetes Self-Management with the Diabetes Self-Management Questionnaire (DSMQ) Can Help Analyse Behavioural Problems Related to Reduced Glycaemic Control.

AimTo appraise the Diabetes Self-Management Questionnaire (DSMQ)’s measurement of diabetes self-management as a statistical predictor of glycaemic control relative to the widely used SDSCA.Methods248 patients with type 1 diabetes and 182 patients with type 2 diabetes were cross-sectionally assessed using the two self-report measures of diabetes self-management DSMQ and SDSCA; the scales were used as competing predictors of HbA1c. We developed a structural equation model of self-management as measured by the DSMQ and analysed the amount of variation explained in HbA1c; an analogue model was developed for the SDSCA.ResultsThe structural equation models of self-management and glycaemic control showed very good fit to the data. The DSMQ’s measurement of self-management showed associations with HbA1c of –0.53 for type 1 and –0.46 for type 2 diabetes (both P < 0.001), explaining 21% and 28% of variation in glycaemic control, respectively. The SDSCA’s measurement showed associations with HbA1c of –0.14 (P = 0.030) for type 1 and –0.31 (P = 0.003) for type 2 diabetes, explaining 2% and 10% of glycaemic variation. Predictive power for glycaemic control was significantly higher for the DSMQ (P < 0.001).ConclusionsThis study supports the DSMQ as the preferred tool when analysing self-reported behavioural problems related to reduced glycaemic control. The scale may be useful for clinical assessments of patients with suboptimal diabetes outcomes or research on factors affecting associations between self-management behaviours and glycaemic control.

The Comorbid and Individual Impacts of Maternal Depression and Substance Dependence on Parenting and Child Behavior Problems.

Maternal depression, substance dependence, and the comorbidity of these conditions are highly prevalent risk factors among families involved with Child Protective Services (CPS). Data from the National Survey of Child and Adolescent Well-Being I (NSCAW I) were analyzed to examine the influence of maternal substance dependence, depression, and comorbidity on parenting and child behavior over 36-months among children reported to CPS who remained in the home at all waves. Although neglect and child behavior problems were highest for mothers with comorbidity at baseline, mothers with substance dependence had the poorest self-reported parenting and child behavior problems over time. Results indicate a need for intensive targeted services to address the complex needs of CPS-involved mothers with substance dependence and their in-home children.

Self-Reported Emotional and Behavioral Problems, Family Functioning and Parental Bonding Among Psychiatric Outpatient Adolescent Offspring of Croatian Male Veterans with Partial PTSD

Background Posttraumatic stress disorder (PTSD) in male veterans has been linked with impaired family relationships and psychopathology in their children. Less is known about symptoms in children of veterans with partial PTSD.

Co-occurring Self-Reported Behavioral Problems in a Substance Use Disorder Treatment Population: Treatment Perspective

Research and clinical experience indicate that individuals with substance use disorders (SUD) may also experience problems with excessive food intake, sexual activity, exercise, and gambling. Such behavioral problems cause individual suffering and might also complicate substance abuse treatment. In clinical practice, however, behavioral problems seem to escape identification. Through the use of a questionnaire, this study investigated whether patients in substance abuse treatment considered themselves having experienced behavioral problems, and whether behavioral problems had been acknowledged during treatment. Sixty-nine individuals in substance abuse treatment answered the questionnaire. Sixty-seven percent of the participants reported behavioral problems, predominantly two or more behaviors. Forty percent of the participants reported that their behavioral problems had been acknowledged in treatment. Based on these findings, it is suggested that treatment units should be prepared to identify behavioral problems and meet the treatment needs of patients who experience one or several behavioral problems.

Life after Adolescent and Adult Moderate and Severe Traumatic Brain Injury: Self-Reported Executive, Emotional, and Behavioural Function 2-5 Years after Injury.

Survivors of moderate-severe Traumatic Brain Injury (TBI) are at risk for long-term cognitive, emotional, and behavioural problems. This prospective cohort study investigated self-reported executive, emotional, and behavioural problems in the late chronic phase of moderate and severe TBI, if demographic characteristics (i.e., age, years of education), injury characteristics (Glasgow Coma Scale score, MRI findings such as traumatic axonal injury (TAI), or duration of posttraumatic amnesia), symptoms of depression, or neuropsychological variables in the first year after injury predicted long-term self-reported function. Self-reported executive, emotional, and behavioural functioning were assessed among individuals with moderate and severe TBI (N = 67, age range 15–65 years at time of injury) 2–5 years after TBI, compared to a healthy matched control group (N = 72). Results revealed significantly more attentional, emotional regulation, and psychological difficulties in the TBI group than controls. Demographic and early clinical variables were associated with poorer cognitive and emotional outcome. Fewer years of education and depressive symptoms predicted greater executive dysfunction. Younger age at injury predicted more aggressive and rule-breaking behaviour. TAI and depressive symptoms predicted Internalizing problems and greater executive dysfunction. In conclusion, age, education, TAI, and depression appear to elevate risk for poor long-term outcome, emphasising the need for long-term follow-up of patients presenting with risk factors.

Ten-year trends in adolescents’ self-reported emotional and behavioral problems in the Netherlands

Changes in social, cultural, economic, and governmental systems over time may affect adolescents' development. The present study examined 10-year trends in self-reported emotional and behavioral problems among 11- to 16-year-old adolescents in the Netherlands. In addition, gender (girls versus boys), ethnic (Dutch versus non western) and educational (vocational versus academic) differences in these trends were examined. By means of the Strengths and Difficulties Questionnaire, trends in emotional and behavioral problems were studied in adolescents belonging to one of five independent population representative samples (2003: n=6,904; 2005: n=5,183; 2007: n=6,228; 2009: n=5,559; 2013: n=5,478). Structural equation models indicated rather stable levels of emotional and behavioral problems over time. Whereas some small changes were found between different time points, these changes did not represent consistent changes in problem levels. Similarly, gender, ethnic and educational differences in self-reported problems on each time point were highly comparable, indicating stable mental health inequalities between groups of adolescents over time. Future internationally comparative studies using multiple measurement moments are needed to monitor whether these persistent mental health inequalities hold over extended periods of time and in different countries.

Prevalence of emotional and behavioral symptomatology in Spanish adolescents

IntroductionThe main purpose of this study was to examine the prevalence of symptoms of an emotional and behavioral nature, as well as prosocial type capabilities, measured using the Strengths and Difficulties Questionnaire, in non-clinical adolescents. MethodThe final sample was composed of a total of 508 students, 208 male (40.9%). The age of participants ranged from 11 to 18 years (M=13.91 years; SD=1.71). ResultsThe results show that a significant number of adolescents self-reported emotional and behavioral problems. The mean scores of the Strengths and Difficulties Questionnaire subscales varied according the gender and age of the adolescents. ConclusionsIn the present study, the prevalence of psychological difficulties among adolescents was similar to that reported in other national and international studies. In view of these results, there is a need to develop programs for the early detection of these types of problems in schools in children and adolescents ages.

Perceived Parental Rearing Practices, Supportive School Environment, and Self-Reported Emotional and Behavioral Problems among Lithuanian Secondary School Students

Previous research rarely addressed parental rearing practices, perceived safety at school, teachers’ support and school climate in the same study. Most often those two contexts-home environment and school context-are analyzed separately. Several authors have advocated the need for incorporating those two contexts in the study of emotional and behavioral problems (Suldo et al., 2012). Thus, the main purpose of the study was to investigate the relationship between the perceived parental practices (parents’ reactions to adolescents’ behavior, i.e., guilt induction and emotional warmth) and supportive school environment (school attachment, school climate, perceived teacher support, and feelings of safety at school) with adolescents’ emotional and behavioral problems. The data used is from an ongoing longitudinal Positive Youth Development study (POSIDEV) that examines the mechanisms and processes through which young people develop their competences. The sample comprised 2625 Lithuanian students (1146 boys and 1479 girls, age 14-20 (M = 16.69; SD = 1.17)) from the ninth, tenth, eleventh and twelfth grades of 8 upper secondary schools. The results showed that parents’ emotional warmth was negatively, and psychological control was positively related to students’ depressive symptoms and delinquent behavior. Furthermore, perceived teacher support, feelings of safety at school were negatively associated with adolescents’ depressive symptoms and delinquent behavior, when students’ perceptions of negative school climate were positively associated with adolescents’ depressive symptoms and delinquent behavior. After entering school context variables in the regression, demographic characteristics and mother’s guilt induction practice remained significant, but mother’s emotional warmth was no longer significant. This suggests the possibility that school context acts as a mediator between emotional warmth by mother and delinquent behavior. This finding has important practical implications in terms of shedding some insight on how multiple systems might be interlinked in influencing wellbeing in adolescents and confirms the importance of intervening at the double platform of both the family and the school system.

Socio-ecological correlates of mental health among ethnic minorities in areas of political conflict: A study of Druze adolescents in Israel

Children and youths living in areas of political conflict are at increased risk of mental health problems, but little is known about psychosocial adjustment among ethnic minorities living in war-afflicted settings. This cross-sectional study used an ecological approach to investigate the unique contributions of child, family/social, and minority related factors as well as traumatic exposure and perceived discrimination to the mental health of 167 Druze adolescents in Northern Israel. Outcome measures included participants' self-reported posttraumatic stress disorder symptoms, psychological distress, and emotional and behavioral problems. Adolescents reported high indirect exposure, moderate discrimination, strong ethnic identity and high religious involvement. Regression analyses showed that female gender, number of traumatic events, and perceived discrimination were associated with more severe mental health outcomes. In addition, low social support and high religious involvement predicted increased PTSD symptom severity, while stronger ethnic identity was associated with less emotional and behavioral problems. Findings are discussed in terms of the cultural characteristics of the Druze community and highlight the need to consider additional stressors, such as discrimination, when working with ethnic minority youth in conflict zones.

Exploring gender differences in constellations of problem behaviors and associated health-related factors during adolescence

Using data from the National Longitudinal Study of Adolescent Health (Add Health), this study expands on previous research on adolescent problem behavior by (1) examining gender differences in patterns or ‘subgroups’ of adolescents based on self-reported problem behaviors and (2) identifying differences in health-related factors including service utilization, physical and mental health, and violent victimization across the identified gender-specific subgroups. The data used in this study were taken from Wave 2 of the National Longitudinal Study of Adolescent Health (Add Health) data and includes respondents under the age of 18 (n = 10,360). Based on 16 problem behavior items measuring delinquency, substance use, risky sexual practices, and status offending, latent class analyses identified a 4-class model for the male subsample and a 3-class model for the female subsample. Important differences in health-related factors were observed across the latent classes. However, these differences were fairly consistent for boys and girls. Implications for prevention and intervention strategies, specifically focusing on the intersection of juvenile justice and public health services, are discussed.

Young children’s self-reported emotional, behavioral, and peer problems: The Berkeley Puppet Interview.

Adult observers are typically the only informants on emotional and behavioral problems in young children. Although additional information can be provided by child self-report, few validated, structured instruments are available to obtain self-report from young children. The Berkeley Puppet Interview (BPI) has been developed to obtain structured self-reports on multiple domains of mental health and social well-being. This study was the 1st to evaluate the psychometric properties of the BPI in a large sample. We studied 8 a priori scales of the interview in a Dutch community sample of 6,375 children ages 5-7 years. Using confirmatory factor analysis, we demonstrated adequate fit (Tucker-Lewis index = .90; comparative fit index = .90; root-mean-square error of approximation = .03) of a multidimensional model with 50 items loading on 8 latent factors (Depression, Separation Anxiety, Overanxious, Oppositional Defiant, Overt Hostility, Conduct Problems, Bullied by Peers, and Peer Acceptance/Rejection). This model was invariant across gender. Children reported anxiety-related problems more frequently than depressive problems, behavioral problems, or difficulties in peer relations. Reliability analyses showed that 3 broadband scales designated as Internalizing, Externalizing, and Peer Relations were homogeneous constructs (αs = .68-.79). Higher scores on most BPI scales were associated with lower maternal education, lower family income, and non-Western ethnicity. Boys reported more behavioral and peer relation problems, whereas girls reported more emotional problems. The findings indicate that young children from socioeconomically and demographically diverse backgrounds are capable of providing valid, multidimensional information on their emotional, behavioral, and peer relation problems using the BPI. Young children's self-report is a promising addition to existing assessment tools.