Self-reported Behavioral Problems Research Articles

Five-year follow-up of the iBerry Study: screening in early adolescence to identify those at risk of psychopathology in emerging adulthood.

The iBerry Study, a Dutch population-based high-risk cohort (n = 1022) examines the transition from subclinical symptoms to psychiatric disorders in adolescents. Here, we present the first follow-up measurement, approximately 3years after baseline assessment and 5years after the screening based on self-reported emotional and behavioral problems (SDQ-Y). We give an update on the data collection, details on the (non)response, and the results on psychopathology outcomes. The first follow-up (2019-2022) had a response rate of 79% (n = 807). Our results at baseline (mean age 15.0years) have shown the effectiveness of using the SDQ-Y to select a cohort oversampled for the risk of psychopathology. At first follow-up (mean age 18.1years), the previously administered SDQ-Y remains predictive for selecting adolescents at risk. At follow-up, 47% of the high-risk adolescents showed significant mental health problems based on self- and parent reports and 46% of the high-risk adolescents met the criteria for multiple DSM-5 diagnoses.Compared to low-risk adolescents, high-risk adolescents had a sevenfold higher odds of significant emotional and behavioral problems at follow-up. Comprehensive assessment on psychopathology, substance abuse, psychotic symptoms, suicidality, nonsuicidal self-injury, addiction to social media and/or video gaming, and delinquency, as well as social development, and the utilization of healthcare and social services were conducted. This wave, as well as the ones to follow, track these adolescents into their young adulthood to identify risk factors, elucidate causal mechanisms, and discern pathways leading to both common and severe mental disorders. Results from the iBerry Study will provide leads for preventive interventions.

Self-reported emotional and behavioural problems among adolescents with migrant parents in Lithuania

Abstract Background The mental health effects of parental emigration on adolescents who stayed behind in Eastern European countries are not fully understood. This study examines the emotional and behavioural difficulties of stay-behind adolescents in Lithuania. Methods The data collection took place January 2022-April 2023 from adolescents between the ages of 12 and 17 who attended 25 schools from 15 regions in Lithuania. This cross-sectional study was approved by the Biomedical Research Ethics Committee, No. 2021/11-1378-861. Parents and adolescents provided informed consent to participate in the study. Self-reported Strengths and Difficulties Questionnaire (Goodman, 2005) and a questionnaire on demographics and health status, were collected. Descriptive statistics and t-tests were calculated by using Stata (version 15.1). Results The sample consisted of 728 adolescents (response rate 52,6%), with a mean age of 14.5 years (SD 1.63), 43.4% males and 54.7% females. Of the total sample, 35,7% lived in rural areas, 84,8% had siblings and, 15.7% had at least one migrant parent. Most staying behind adolescents had migrant fathers (83.3%), and (90,6%) maintained regular online communication with their emigrated parents. Compared to peers living with parents, staying behind adolescents obtained significantly higher emotional and behavioural problems total score (12.3, SD 5.5 vs 10.7, SD 5.5, respectively), with a p-value of 0.006. In addition, adolescents with migrant parents had significantly higher scores than their peers living with parents on the emotional subscale (3.2, SD 2.5 vs 2.5, SD 2.4) and problems subscale (2.9, SD 1.7 vs 2.5, SD 1.7), with a p-value of 0.02 for both subscales. Conclusions This study found higher emotional and behavioural problems among stay-behind adolescents compared to those living with parents in their home country. The findings emphasize the need to implement supportive interventions and increase awareness of these issues in society. Key messages • Stay-behind adolescents in Lithuania experience higher emotional and behavioural problems than their peers living with parents in home country. • Greater focus should be given to the emotional health of stay-behind children and adolescents in migrant-sending countries.

Associations between the urban environment and psychotic experiences in adolescents.

In 2050 two-thirds of the world's population is predicted to live in cities, which asks for a better understanding of how the urban environment affects mental health. Urbanicity has repeatedly been found to be a risk factor, in particular for psychosis. Here, we explored what factors of the urban exposome underlie the association between urban characteristics and psychotic experiences (PE) in adolescents. Participants were 815 adolescents (mean age 14.84years, SD 0.78) from an at-risk cohort (greater Rotterdam area, the Netherlands) oversampled on their self-reported emotional and behavioral problems. We used linear regression analysis to examine the association with detailed geodata on urbanicity (surrounding address density), green space density (high and low vegetation), and mixed noise levels (road, rail, air, industry, and wind power) with PE in adolescents. Analyses were adjusted for multiple socio-economic and parental confounders. Furthermore, we explored sex-interaction effects. Higher surrounding address density and low greenspace density were each independently associated with more PE (B=0.18, 95% CI 0.02; 0.34 and B=0.17, 95% CI 0.01; 0.32, respectively). High mixed noise levels were only associated with more PE in boys (B=0.23, 95% CI 0.01; 0.46). A sex-interaction effect was found for high urbanicity (B=-0.46, 95% CI -0.77; -0.14) and low greenspace density (B=-0.49, 95% CI -0.73; -0.11), illustrating that these associations with PE were specific for boys. Multiple characteristics of living in an urban area are associated with more PE in adolescent boys. Our observations provide leads for prevention of mental health problems via urban designing.

Self-reported emotional and behavioral problems among school-going adolescents in Nepal-A cross-sectional study.

Studies on self-reported emotional and behavioral problems (EBPs) among adolescents are still sparse in many low- and middle-income countries. In Nepal, no such studies have been performed on a larger scale, and little is known about self-reported EBPs in the adolescent population. This cross-sectional, school-based study on EBPs included 1904 adolescents aged 11-18 years, enrolled in government and private schools located in 16 districts in Nepal. The Nepali version of the Youth Self Report form was used to assess self-reported EBPs, and the Teacher Report Form was used to assess academic performance. Analysis of variance (ANOVA) was used for gender comparisons on adolescents' EBPs and on academic competence. Multiple regression analysis was done to explore correlates of self-reported EBPs. The overall prevalence of self-reported EBPs was 14.2%; 15.6% in boys and 12.9% in girls. The mean Total Problems score was 39.27 (standard deviation = 24.16); no gender differences were observed. Boys scored higher on Externalizing Problems and girls scored higher on Internalizing Problems. The effect sizes for gender comparisons were small with Hedges' g ranging from -0.29 to 0.28. Physical illness and negative/traumatic life events were positively correlated with self-reported EBPs, whereas academic performance was negatively correlated. However, the effect sizes were small (η2 < 0.02). This study helps to narrow the knowledge gap on the prevalence, magnitude, and types of self-reported EBPs in Nepali adolescents. It demonstrated an association between self-reported EBPs and academic performance and linked self-reported EBPs to other factors such as negative/traumatic life events and physical illness. The findings might assist health authorities in the planning of mental health services and may also provide valuable background information to clinicians dealing with adolescent mental health problems.

The good, the bad, and the ugly: a comprehensive study of temperament and personality traits as correlates of self-reported disruptive behavior problems in male and female adolescents

PurposeThe aim of the present study was to provide a comprehensive picture of temperament and personality traits as correlates of self-reported disruptive behavior problems in male and female adolescents.MethodsTwo-hundred-and-sixty-three non-clinical adolescents aged 12–18 years completed a survey containing standardized scales to measure the HEXACO personality traits, impulsivity, effortful control, Dark Triad traits, and symptoms of oppositional-defiant disorder (ODD) and conduct disorder (CD).ResultsThe results showed that good traits (in particular, honesty-humility, agreeableness, and the regulative trait of effortful control) were negatively associated, while bad and ugly traits (especially impulsivity and the Dark Triad traits of psychopathy and Machiavellianism) were positively associated with symptoms of ODD and CD. In addition, regression analyses indicated that both types of disruptive behavior problems were associated with a unique set of temperament and personality correlates, and that specific correlates also differed for both genders.ConclusionsIt is concluded that research on the role of temperament and personality should adopt a broad perspective, taking good, bad, and ugly traits from various theoretical models as well as gender differences into account.

Changes in self-reported emotional and behavioral problems of Polish adolescents in 2000 and 2013.

This study assesses 13-year changes in self-reported emotional and behavioral problems of Polish adolescents. Even though we already assessed time-related changes in emotional problems of Polish 16-year-olds, a comparison covering more age groups has been lacking. Youth Self Report (YSR) questionnaire was used to assess emotional and behavioral problems. We compared median scores and ran regression models to see whether age and gender influenced the observed changes. We ran a logistic regression analysis for deviant scores. We found that median scores on most scales were higher after 13 years albeit the differences were quite small. We found that gender moderated the effect of age on scale scores. Score on the deviant range in attention problems and thought problems were 1.5 more frequent in the 2013 group. We did not detect significant differences in self-reported emotional and behavioral problems of Polish adolescents between 2000 and 2013. We detected different coping strategies for boys and girls: boys reported more problems with delinquency and more externalizing behaviors whereas girls reported more problems on each scale.

The gender gap in adolescents’ emotional and behavioural problems in Georgia: a cross-sectional study using Achenbach’s Youth Self Report

BackgroundAdolescents, particularly girls, are vulnerable to mental health disorders. Knowledge about young people’s mental health in Eastern European countries is limited. This study is the first to investigate adolescents’ self-reported emotional and behavioural problems in Georgia from a public mental health perspective.MethodsThis study utilized Achenbach’s Youth Self-Reported syndrome scales among 933 adolescents studying from grades 7–12 in 18 public schools in Georgia. We compared the gender-specific results with each other and with the Achenbach’s Normative Sample using two-sample t-tests. Linear regression was used to assess associations between internalizing and externalizing problems and individual as well as demographic characteristics such as parental migration experience (being ‘left-behind’ or ‘staying behind’).ResultsThe study found that girls obtained higher scores than boys in Youth Self-Reported empirical syndrome scales and the internalizing broadband scale. Rule-breaking behaviour was the only syndrome scale where boys scored higher. Compared to Achenbach’s Normative Sample, adolescents in Georgia scored higher on all scales. Regression analyses showed that illnesses, having fewer than three close friends, problems at school, and worse relationships with peers/siblings/parents (compared to peers) were associated with higher internalizing and externalizing problems scores in both genders. Performing household chores, living with only one parent, or having a migrant parent showed no associations in either gender.ConclusionEmotional and behavioural difficulties of adolescents in Georgia, especially girls, require attention. Having close friends, developing strong relationships with family members, and a supportive school environment could help mitigate emotional and behavioural problems among adolescents in Georgia.

Subclinical binge eating symptoms in early adolescence and its preceding and concurrent factors: a population-based study

ObjectiveBinge eating, loss of control eating and overeating often develop during late childhood or early adolescence. Understanding the presentation of binge eating as early as symptoms manifest and its preceding and concurrent factors is essential to hamper the development of eating disorders. This study examined the prevalence, concurrent and preceding factors (e.g. compensatory behaviors, emotional and behavioral problems) of subclinical binge eating symptoms in early adolescence.MethodsData from the population-based Generation R Study were used (n = 3595). At 10 years and 14 years, preceding and concurrent factors including eating behaviors, body dissatisfaction, emotional and behavioral problems and body composition were assessed. At 14 years, 3595 adolescents self-reported on binge eating symptoms in the past 3 months and were categorized into four groups: no symptoms (n = 3143, 87.4%), overeating only (n = 121, 3.4%), loss of control (LOC) eating only (n = 252, 7.0%) or binge eating (i.e. both, n = 79, 2.2%).ResultsIn total, 452 (12.6%) young adolescents reported subclinical binge eating symptoms. Those who reported LOC eating and binge eating showed most compensatory behaviors (e.g. hide or throw away food, skipping meals). Concurrent emotional and behavioral problems, body dissatisfaction, more emotional-, restrained- and uncontrolled eating, and a higher BMI were associated with subclinical binge eating symptoms. Preceding self-reported emotional and behavioral problems, body dissatisfaction, more restrained eating and higher BMI (both fat mass and fat-free mass) at 10 years were associated with LOC eating and binge eating, but not with overeating.DiscussionAmong young adolescents, subclinical binge eating symptoms were common. Considering the high prevalence of LOC eating, and the overlapping preceding and concurrent factors of LOC eating and binge eating compared to overeating, LOC eating seems to be a key symptom of binge eating in early adolescence.

Association between Parent-Reported Executive Functions and Self-Reported Emotional Problems among Adolescent Offspring of Fathers with Alcohol-Dependence

Objectives To compare the executive functions in adolescents of fathers with alcohol dependence (AOFADs) with a control group of adolescents without a paternal history of alcohol dependence and examine the association between executive functioning problems and behavioral and emotional problems. Materials and Methods The study included 39 AOFADs and 45 adolescent offspring of fathers without a history of alcohol-use disorders, who were matched for age and sex. They were assessed using standardized measures of executive functions and emotional and behavioral problems. Statistical Analysis A comparison was made between the two groups about the parental report of adolescents' executive functions and adolescents' self-reported emotional and behavioral problems. ANCOVA was performed to understand the covariance of educational and socio-economic status on executive functions. Correlation between executive functions, emotional and behavioral problems, and the duration of father's alcohol dependence was examined with Spearman's rho. Results AOFAD group showed significant impairment on all subdomains of executive functions and emotional and behavioral disturbances ( p < 0.01) but not on the prosocial behavioral dimension ( p < 0.01). The group differences were independent of child's education and family income. Executive functional impairments positively correlated with psychopathology ( p < 0.01). Problems with executive functions and psychopathology correlated with the duration of the father's alcohol dependence. Conclusions AOFADs are at risk for executive function impairments which in turn are strongly associated with emotional and behavioral problems. The association is independent of child's education and family economic status. The duration of alcohol dependence in fathers is associated with these problems. It has implications for targeted interventions for both adolescents and families.

Children with Congenital Heart Disease Show Increased Behavioral Problems Compared to Healthy Peers: A Systematic Review and Meta-Analysis.

Millions of children and adults are living with congenital heart disease (CHD). Their risk for behavioral problems has not been the subject of a meta-analysis. We performed a systematic review and meta-analysis of measures of behavioral problems in people born with CHD compared to peers without CHD. We searched Pubmed, CINAHL, Embase, PsycInfo, and the Cochrane Library from January 1, 1986 to November 15, 2021. We included studies that reported a measure of behavioral problems in patients with CHD in children and adults older than 3years of age. We screened 26,343 search results, and 24 studies met inclusion criteria. The quality of evidence was generally low. Subjects with CHD had a small increase in internalizing problems [standardized mean difference (SMD): 0.198, p = 0.02] and total behavior problems (SMD: 0.287, p = 0.013), but no difference in externalizing behavioral problems. There was significant heterogeneity in all three domains of behavior problems analyzed, and it could not be explained by variables such as age, severity, assessor, or assessment tool. There are small increases in parent- and self-reported overall behavioral problems and internalizing problems in patients with CHD compared to healthy controls. Wide confidence intervals in the meta-analyses leave open the possibility that certain factors may increase the risk of behavioral problems in this group, and future studies with important attention paid to potential confounders may help identify risk factors.

Youth with hearing loss: Emotional and behavioral problems and quality of life

ObjectivesTo compare parent- and self-reported emotional and behavioral problems and quality of life (QoL) among youth with hearing loss (HL) to norms, and to investigate possible associations between emotional and behavioral problems and QoL among youth with HL. MethodsWe used the Strengths and Difficulties questionnaire (SDQ) and the Inventory of Life Quality in Children and Adolescents (ILC) to measure emotional and behavioral problems and QoL in youth with HL (n = 317, ages 6–18), where 78% had bilateral HL, 22% unilateral HL, 16% had cochlear implants, and 59% conventional hearing aids. ResultsThe youth with HL had significantly more parent-reported (but not self-reported) emotional and behavioral problems and poorer parent- and self-reported QoL than hearing youth. SDQ and ILC total scores were significantly correlated (−0.47 to −0.63). Conclusion Emotional and behavioral problems and poor QoL appear closely related in youth with HL, suggesting that attending to these problems may improve QoL.

The iBerry study: a longitudinal cohort study of adolescents at high risk of psychopathology

The iBerry study is a population-based cohort study designed to investigate the transition from subclinical symptoms to a psychiatric disorder. Adolescents were selected based on their self-reported emotional and/or behavioral problems assessed by completing the strengths and difficulties questionnaire-youth (SDQ-Y) in their first year of high school. A total of 16,736 SDQ-Y questionnaires completed in the academic years 2014–2015 and 2015–2016 by students in the greater Rotterdam area in the Netherlands were screened. A high-risk group of adolescents was then selected based on the 15% highest-scoring adolescents, and a low-risk group was randomly selected from the 85% lowest-scoring adolescents, with a 2.5:1 ratio between the number of high-risk and low-risk adolescents. These adolescents were invited to come with one parent for a baseline visit consisting of interviews, questionnaires, neuropsychological tests, and biological measurements to assess determinants of psychopathology. A total of 1022 high-risk and low-risk adolescents (mean age at the first visit: 15.0 years) enrolled in the study. The goal of the iBerry study is to follow these adolescents for a 10-year period in order to monitor any changes in their symptoms. Here, we present the study design, response rate, inclusion criteria, and the characteristics of the cohort; in addition, we discuss possible selection effects. We report that the oversampling procedure was successful at selecting a cohort of adolescents with a high rate of psychiatric problems based on comprehensive multi-informant measurements. The future results obtained from the iBerry Study will provide new insights into the way in which the mental health of high-risk adolescents changes as they transition to adulthood. These findings will therefore facilitate the development of strategies designed to optimize mental healthcare and prevent psychopathology.

Self-rated child maltreatment, behavioural problems, and contacts with welfare and police authorities – longitudinal community data

ABSTRACT This study examines how children report abuse, neglect and behavioural problems and what authorities they claim to have had contact with that are legally mandated to report to the Child Welfare Services, e.g. health services and police. It draws data from a longitudinal research programme, LoRDIA, in which four data collections followed adolescents’ development from 12 to 15 years (n = 1884). A total of 61 indicators of self-reported child abuse, neglect and behavioural problems were constructed to identify children with severe exposure so that each indicator would have prompted referral. The main finding is that 445 (25.3%) of the study population reported severe exposure of this magnitude. Among these self-reported severely exposed children (SSE), boys reported higher rates of child neglect and of overall behavioural problems, specifically criminal and other socially destructive behaviour. Poverty and living in single-parent households significantly increase the risk of abuse, neglect, and behavioural problems. Increased risk of neglect and criminal behaviour were found for children studying Swedish as second language. The SSE children more than other children report contact with all authorities with mandatory reporting. Odds ratios of contact were higher in the case of behavioural problems compared to the odds ratios for abuse and neglect.

A quasi-experimental pilot study to the effects of Responsive Aggression Regulation Therapy (Re-ART) Outpatient for young adults.

It is important to provide treatment for juvenile and young adult violent offenders, since no or (too) late treatment increases the risk of recidivism and persistent aggressive behavior in adulthood. In this study, we investigated the efficacy of the intervention Responsive Aggression Regulation Therapy (Re-ART) Outpatient, which has been developed for adolescents and young adults between 16 and 24years old with severe aggression problems. This quasi-experimental (pilot) study compared the effects of Re-ART Outpatient (n=47) with a control group (n=29) receiving treatment as usual on measures regarding risk of violent recidivism, impulsivity, emotional/personal functioning, family functioning, motivation, handling anger, self-reported problem behavior, coping skills, and cognitive distortions. Re-ART showed significantly better results than the control group on risk of violent recidivism, impulsivity, emotional/personal functioning, motivation, handling anger, certain coping skills, and certain cognitive distortions. Family functioning and self-reported rule-breaking behavior did not differ significantly between the groups. The results implicate that Re-ART is a promising outpatient intervention for young adults with severe aggressive behavior. The results can be explained by the fact that Re-ART treats both systemically and individually and pays specific attention to stress reduction and the improvement of executive functions.

'Too many BeEPs in our teens!' Behavioral and emotional problems in a large group of Italian adolescents.

One in six adolescents suffers from mental health problems. Despite the presence of general information on Italian adolescents' mental health, researches conducted with standardized assessment tools are scarce in the literature. We evaluated the prevalence of self-reported behavioral and emotional problems in a group of Italian adolescents and examined their relation to socio-demographical variables. This population-based sampling survey was conducted on high school students aged 14-18 from urban areas of Rome and Latina. Participants completed Youth Self-Report (YSR) and a socio-demographic schedule to collect information on age, gender, type of school attended, socio-economic status, urbanicity. Final sample consisted of 1400 adolescents (38.61% male, mean age 16 years, s.d. 1.42). Prevalence of Internalizing Problems, Externalizing Problems and Total Problems was 29.55%, 18.34% and 24.13%. In our multivariable model, Internalizing Symptoms were not explained by sociodemographic variables while Externalizing Symptoms were explained by Male Gender [OR = 1.53 (1.14-2.06)], older age [OR = 2.06 (1.52-2.79)] and attending a Technical and Professional Institute [OR = 2.15 (1.53-3.02)], with an adjusted R2 = 4.32%. Total Problems were explained by School Type [Technical and Professional Institutes and Art and Humanities v. Grammar and Science School; OR respectively 1.93 (1.40-2.67) and 1.64 (1.08-2.47)], adjusted R2 = 1.94. The study provides, for the first time, evidence of a great prevalence of self-reported behavioral and emotional problems in a large sample of Italian adolescents, highlighting the role of different socio-demographic variables as risk factors for externalizing behaviors. Our results emphasize the urgent need for implementing prevention programs on mental health in adolescence.

Borderline personality disorder and attention deficit/hyperactivity disorder in adolescence: overlap and differences in a clinical setting

BackgroundWith increased consensus regarding the validity and reliability of diagnosing Borderline Personality Disorder (BPD) in adolescents, clinicians express concern over the distinction between BPD and Attention-Deficit/Hyperactivity Disorder (ADHD), and its co-morbidity in clinical settings. The goal of this study was to evaluate differences between BPD, ADHD and BPD + ADHD in terms of co-morbid psychiatric disorders and a range of self-reported behavioral problems in adolescents.MethodsOur sample consisted of N = 550 inpatient adolescents with behavioral and emotional disorders that have not responded to prior intervention. We took a person-centered approach (for increase clinical relevance) and compared adolescents with ADHD, BPD and ADHD+BPD in terms of co-occurring psychiatric disorders and behavioral problems. We performed a regression analysis to test whether BPD symptoms make an incremental contribution to the prediction of psychiatric symptoms over ADHD symptoms.ResultsThe severity of almost all co-occurring disorders, aggression, self-harm, suicidal thoughts, and substance use, were higher in the ADHD+BPD group. Borderline symptoms made an incremental contribution to the prediction of psychiatric symptoms beyond the contribution of ADHD.ConclusionSeverity and co-morbidity may be helpful factors in distinguishing between ADHD and BPD in clinical practice and the co-morbidity of these two disorders may indicate a worse clinical outcome.

Trauma Systems Therapy for Refugees (TST-R) in a multi-ethnic refugee population in Maine, USA: early findings from a programme evaluation project with children and adolescents

BackgroundTrauma Systems Therapy for Refugees (TST-R) is a multi-tiered, behavioural health intervention that directly targets barriers to care for refugee children and families. Informed by a population-based approach, TST-R encompasses three levels of practice (individual/family, community, and systems), aiming to address not only individual behaviour, but also social or structural factors, or both, that contribute to distress. Services are delivered by a clinician and a cultural broker (a community member who shares the client's ethnic background) who work in partnership to provide psychoeducation on mental health, reduce acculturative stress, enhance the safety and stability of the child's social environment, and improve the child's regulatory capacities. Here, we describe components of TST-R and report early findings from an ongoing, multi-site programme evaluation. MethodsTST-R services began in Lewiston, ME, USA, in September, 2016; since then, two additional TST-R programmes have started in neighbouring communities (Biddeford in September, 2017, and Portland in September, 2018). These three communities have high proportions of refugees from various countries of origin. Each TST-R programme is comprised of clinicians, cultural brokers, and site supervisors; these teams received an initial TST-R training followed by subsequent consultation to ensure model fidelity. We used the strengths and difficulties questionnaire (SDQ) to measure the effect of clinical services on clients' emotional and behavioural symptoms and functioning over time (the parent-report version of the SDQ was used if the child was aged 10 years or younger). This measure was administered at intake and repeated at 6-month intervals until discharge. The impact of cultural brokering on treatment outcomes was also assessed, as cultural brokers were not available on the TST-R team for every ethnic group served by TST-R programming. FindingsBetween April 1, 2017, and April 1, 2020, 103 clients, or parents of clients, completed the SDQ at intake; 44 clients, 20 clients, 10 clients, and 5 clients completed the measure at the 6-month, 12-month, 18-month, and 24-month timepoints, respectively. Clients were aged 3–19 years (median 11 years), mostly male (n=63, 64%), and from 17 different countries, with most refugee clients born in the Democratic Republic of Congo (n=20, 20%) or Somalia (n=10, 10%). When cultural brokers were included in treatment, there was a marked decrease in clients' self-reported emotional and behavioural problems 6 months into service delivery (intake M=0·56; 6 months M=0·46); this decrease was not evident for refugee clients whose mental health services were supported instead through the use of the language line, an interpreter, or clinician intervention alone. Mixed design ANOVA showed a significant interaction effect between timepoint (intake and 6-months) and the inclusion of cultural brokering services in treatment: F(1,42)=7·42, p=0·009, r=0·39. InterpretationOur findings underscore TST-R's potential as a promising intervention for refugee children and adolescents experiencing both acculturative hassles and traumatic stress. In addition, results support the inclusion of cultural brokers into outpatient treatment teams as a strategy for providing linguistically appropriate, culturally responsive mental health services to multi-ethnic, refugee populations. FundingSubstance Abuse & Mental Health Services Administration, US Department of Health & Human Services

Dopamine-related receptors, substance dependence, behavioral problems and personality among juvenile delinquents

The objective was two-fold: to examine possible associations between dopamine-related genetic polymorphisms and (1) substance dependence; and (2) self-reported psychiatric disturbances, behavioral problems, and personality. Genotyping of single nucleotide polymorphisms (SNP: s) in COMT, DAT and DRD4 was conducted in 174 Russian male juvenile inmates (14–18 years of age) subdivided into having a diagnosis of substance dependence or not, as assessed by using K-SADS-PL. The inmates completed several self-reports assessing psychiatric symptoms (CPTS-RI, BDI), behavioral problems (YSR), and personality traits (TCI). Results revealed that juveniles meeting the criteria for substance dependence differed significantly from their counterparts in four polymorphisms, namely COMT rs737865, DAT rs6347, DRD4 C_1611535 and DRD4 exon III; and exact binary regression analysis indicated a highly significant association between the DRD4 C_1611535 GG genotype and substance dependence. One-way ANOVA tests further showed this gene polymorphism variant to be significantly associated with higher levels of posttraumatic stress, thought problems, aggressive behavior, and personality traits indicating antisocial personality disturbances, as compared with the other gene polymorphism variants. In conclusion, the results underscore the role of the DRD4 polymorphism C_1611535 GG genotype for substance dependence, and suggest its associations with different self-reported phenotype characteristics.

Self-Reported Emotional and Behavioral Problems of Left-behind Children in Lithuania

The migration makes an influence on children’s mental health and behaviors. However, the majority of studies investigate the families and people in migration rather than left-behind groups in their home countries. OBJECTIVE: to assess the possible impact of parents’ migration on emotional and behavioral problems of their left-behind children. The study comprised 10–19-year-old adolescents from five urban secondary schools (n = 1292). The cross-sectional study was conducted in Kaunas city (Lithuania). Main measures were self-reported scales – Strengths and Difficulties Questionnaire (SDQ) and Child Behavior Checklist (CBCL) as well as items on subjective perceptions and feelings towards the change of relationship with a missing parent due to migration or divorce. Findings show that left-behind children report more risky behaviors and emotional problems, they tend more to feel unloved (OR = 2.34, p < 0.05), longing for missing parent (OR = 4.72, p < 0.05), contemplating suicide or self-injuring behavior (OR = 3.92, p < 0.05). Emotional and behavioral problems are more prevalent among 15–19-year-old male adolescents (OR = 1.71, p < 0.05). The left-behind children report more emotional and behavioral problems compared to the children from divorced families. The findings suggest that parental migration has specific negative effects on left-behind children’s emotional state and behaviors.

Agreement and Discrepancy on Emotional and Behavioral Problems Between Caregivers and HIV-Infected Children and Adolescents From Uganda.

Background: HIV-infected children and adolescents (CA-HIV) face significant mental health challenges related to a broad range of biological and psychosocial factors. Data are scarce on the agreement and discrepancy between caregivers and CA-HIV regarding emotional and behavioral problems (EBPs) in CA-HIV. Objectives: We determined agreement between self- versus caregiver- reported EBPs and describe factors associated with informant discrepancy among caregiver–youth dyads who participated in the “Mental health among HIV-infected CHildren and Adolescents in KAmpala and Masaka, Uganda” (CHAKA) study. Methods: In 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. Adolescents were questioned about experiences of HIV stigma. Caregiver psychological distress was assessed with the Self-Reporting Questionnaire (SRQ-20). Linear regression models were applied to identify variables associated with discrepancy scores. Results: Self-reported emotional problems (EPs) were present in 28.8% of adolescents and 36.9% of children, and 14.5% of adolescents self-reported behavioral problems (BPs). There was only a modest correlation (r ≤ 0.29) between caregiver- and CA-HIV-reported EBPs, with caregivers reporting more EPs whereas adolescents reported more BPs. Informant discrepancy between adolescents and caregivers for BPs was associated with adolescent age and caregiver’s employment and HIV status. Among adolescents, EP discrepancy scores were associated with adolescent’s WHO HIV clinical stage, caregiver level of education, and caregivers caring for other children. Among children, EP discrepancy scores were associated with child and caregiver age, caregiver level of education, and caregiver self-rated health status. HIV stigma and caregiver psychological distress were also associated with discrepancy, such that adolescents who experienced HIV stigma rated their EPs as more severe than their caregivers did and caregivers with increased psychological distress rated EBPs as more severe than CA-HIV self-rated. Conclusions: EBPs are frequently endorsed by CA-HIV, and agreement between informants is modest. Informant discrepancy is related to unique psychosocial and HIV-related factors. Multi-informant reports enhance the evaluation of CA-HIV and informant discrepancies can provide additional insights into the mental health of CA-HIV.