Social-emotional Problems Research Articles

Intersectional inequalities in child social-emotional health: a case for proportionate universalism

Abstract Background Social-emotional difficulties in early childhood are associated with a range of outcomes across the life course and are related to socioeconomic factors. The aim of this study was to examine intersectional inequalities in social-emotional problems in preschool children relating to their parents’ income, education and country of birth in addition to investigating the public health implications. Methods This population-based study with a repeated cross-sectional design in the Västerbotten County of Sweden used the Ages and Stages Questionnaires: Social-Emotional (ASQ:SE) for children aged 3 in child health care services over the years of 2014-2018 and socio-economic information from national population registers. The effective sample of 8,823 individuals was analyzed using additive binomial regression in combination with an analysis of individual heterogeneity and discriminatory accuracy (AIHDA) approach to estimate risk differences for social-emotional problems across 27 intersectional groups and discriminatory accuracy. Results Average risk differences generally increased in the groups where multiple dimensions of social inequality intersected, with risk differences as high as 18% (95% CI 8 to 28%) and 25% (95% CI 14 to 37%) compared to the most advantaged category. The discriminatory accuracy of all three included regression models was estimated as moderate, but improved in a slight but statistically significant way with the addition of social inequalities. Conclusions This study increases our understanding of intersectional and social inequalities in social-emotional problems in preschool children. It supports the need for universal public health policies in addition to policies targeting more vulnerable groups when addressing this issue, consistent with the concept of proportionate universalism. An intersectional research perspective including discriminatory accuracy could increase our knowledge of health inequities and improve public health effectiveness. Key messages • Intersecting dimensions of social inequalities are associated with an increased risk of social-emotional problems in children aged 3. • Universal public health policies are needed in addition to policies targeting vulnerable population groups with regards to social-emotional problems in young children.

Cost-effectiveness analysis of screening three-year old for social-emotional problems

Abstract Aim To assesses the long-term cost-effectiveness of a population-based screening to detect social-emotional problems at 3-years-old combined with an evidence-based intervention to prevent mental health problems. Methods A decision-analytic Markov model compares two alternatives 1) all 3-years-old get screened for social-emotional problems, and parents for children at a high risk receive a generic targeting parenting intervention 2) no screening and no intervention. The cohort of 3-year-old is modeled until they are 19 years old. The screening test is the ASQ:SE and the intervention was given to children with scores that suggest social-emotional problems. The model considered development of anxiety, conduct problems, and ADHD, over the 16 years. The analyses were done from a societal and healthcare perspectives. Health outcomes were assessed with DALYs averted. Results Results suggest that the probability of population-based screening for social-emotional problems combined with the parenting intervention to high risk-children being cost-effective is high, adopting a societal and healthcare perspective, 98% and 97% each. From a societal perspective, the likelihood of cost saving is high, 85 %. The combination of screening and intervention strongly dominated the comparator. Conclusions The findings align with previous research; prevention aimed at children’s mental health disorders will likely yield high investment returns. Successful implementation of population-based screening for social-emotional problems combined with an effective evidence-based parenting intervention might be an important way to contribute to sustainable and efficient mental health care. Key messages • The impact of combining population-based screening with intervention is encouraging when considering a long-term view. • Prevention aimed at children’s mental health will likely yield high investment return.

The associations of social isolation with depression and anxiety among adults aged 65 years and older in Ningbo, China

Social isolation was associated with emotional problems (depression and anxiety) among older adults, however, little is known in China. Thus, we conducted a cross-sectional study including 6,664 ≥ 65 years older adults in Ningbo, China. We collected data on social isolation, depression, and anxiety by specific scales. The relationship between social isolation and emotional problems was estimated by multivariate-adjusted logistic regression models. The population–attributable risk percentage (PAR%) was used to explore the contribution of social isolation to emotional problems. Overall, the percentage of participants who had experienced social isolation, depression, and anxiety was 12.67%, 4.83%, and 2.63%. Compared with the elderly without social isolation, the adjusted odds ratios (95% confidence interval) of depression and anxiety with social isolation were 1.77 (1.25–2.51) and 1.66 (1.05–2.63), respectively. The PAR analysis showed that 10.66% of depression and 9.03% of anxiety could be attributable to social isolation. In the gender subgroup, ORs and PAR% were only significantly observed in female participants. In Chinese older adults, social isolation has been linked to depression and anxiety, suggesting the importance of taking effective and feasible interventions to reduce social isolation and emotional problems, especially among females.

Trait mindfulness during pregnancy and maternal-infant bonding: Longitudinal associations with infant temperament and social-emotional development

Maternal love and caregiving are pillars for optimal child development and may affect infant outcomes from pregnancy onwards. The present study aimed to examine whether maternal trait mindfulness during pregnancy and pre- and postnatal maternal-infant bonding were associated with maternal perceptions of infant temperament and social-emotional development. In total, 408 Dutch women (Mage = 31.33, SD = 3.59) participated in a prospective perinatal cohort study and completed questionnaires on trait mindfulness, prenatal bonding, postnatal bonding, infant temperament, and infant social-emotional development at 20 and 28 weeks of gestation, and 10 weeks, 6 and 12 months postpartum, respectively. Path analyses demonstrated that higher levels of the trait mindfulness facet non-judging (i.e., refraining from judgments about own feelings and thoughts) were associated with more pre- and postnatal maternal bonding and fewer social-emotional problems as perceived by the mother. Adopting an accepting and non-judgmental attitude may promote positive feelings of bonding and benefit the infant in terms of having fewer social-emotional problems in the first year of life. Mindfulness interventions may be offered to pregnant women in order to enhance maternal bonding and improve infant outcomes after birth.

Social-emotional problems in 3-to 5-year-old children: a cross-sectional study of highly educated migrants in a Chinese urban area.

Previous research has primarily examined the mental well-being of children from labor migrant families, yet there is a lack of understanding regarding the mental well-being of children from highly educated migrant backgrounds. This study investigated the social-emotional problems of 3-5-year-olds from highly educated migrant families residing in an urban area of China, as well as explored potential differences in demographic variables. A cross-sectional study was conducted in Qiantang District, Hangzhou, China, with 1,494 (53.3% boys) children selected via a convenient sampling method. The Ages & Stages Questionnaires: social-Emotional, Second Edition (ASQ:SE-2) was used to measure social-emotional problems. The results showed that 23.6% of the children were at risk for social-emotional problems. More boys (26.7%) than girls (20.1%) had scores above the cut-off. Additionally, more children in the low socioeconomic status (29.9%) had scores above the cut-off than those in the high socioeconomic status (18.9%). There were three common issues among all age groups: "being more active than others," "excessive attachment to parents," and "being overly friendly with strangers. The social-emotional development of children from highly educated migrant families is a significant aspect that deserves recognition, contributing valuable insights to the existing literature on this topic.

Children’s Social-Emotional Development During the COVID-19 Pandemic: Protective Effects of the Quality of Children’s Home and Preschool Learning Environments

ABSTRACT Research Findings: The study examined the development of children’s social-emotional problems between 2019 (T1) and winter 2021/22 (T2) during the COVID-19 pandemic, as well as the role of children’s home and preschool learning environments. The sample included 228 German children ages 3–7 years at T1 (M Age = 5.13, SD = 0.79, 46% female). Results showed an increase in emotional problems between T1 and T2, which was more pronounced among already disadvantaged groups of children from families with lower income and lower educational background. Peer problems increased only among children from families with lower educational backgrounds. The emotional climate of the family and the quality of children’s preschool learning environment were identified as protective influences for the development of children’s peer problems, but not for children’s emotional problems. Practice or Policy: The policy restrictions implemented to slow the spread of the COVID-19 virus had longer-lasting consequences for (some) children’s emotional functioning. Efforts should be undertaken to mitigate such detrimental effects by supporting disadvantaged groups of children. In addition, based on the findings regarding the importance of high-quality interactions to prevent the development of social problems among children, policy should establish the conditions for preschool staff to provide high-quality interactions in childcare.

A follow-up study of peer relationships in autistic and non-autistic youths: Mediating effects from autistic, emotional and behavioral symptoms

BackgroundLittle is known about how clinical features prospectively influence peer relationships in autistic populations. AimsThis study investigated the clinical symptoms mediating the link between autism spectrum disorder (ASD) diagnosis and peer relationships at follow-up, i.e. the second time evaluation of this study. MethodsThe sample consisted of 366 autistic youths and 134 non-autistic comparisons. The autistic traits and emotional/behavioral problems were measured at baseline by Social Responsiveness Scale (SRS) and Child Behavior Checklist (CBCL). The interactions and problems with peers were assessed by the Social Adjustment Inventory for Children and Adolescents (SAICA) at follow-up. ResultsEach subscore of SRS and CBCL showed significant mediation effects. Multiple mediation analyses showed atypical social communication, social awareness problems, and delinquent behaviors mediated the link from ASD to less active peer interactions after controlling for sex, age, and IQ. Moreover, atypical social communication, social-emotional problems, and attention difficulties predicted problems with peers. After considering these mediation effects, the diagnosis of ASD still demonstrated a significantly direct effect on peer relationships at follow-up. Conclusions and implicationsOur findings support that social-related autistic features, attention problems, and delinquent behaviors mediated a link between ASD and peer relationships. These mediators are potential measures for improving interactions and decreasing difficulties with peers in the autistic population.

Social Anxiety in Students with Specific Learning Disorders Based on Emotion Regulation and Emotional Intelligence: The Mediating Role of Perceived Self-Efficacy

Background: One of the basic challenges faced by children with specific learning disorders (SLD) is social-emotional problems. Objectives: Considering the importance of social anxiety in interacting with others and its negative consequences in the family, society, and academic life of students with specific learning disabilities, the present study aims to develop a causal model of social anxiety in these students based on emotion regulation and emotional intelligence, taking into account the mediating role of perceived self-efficacy. Methods: The research employed a descriptive approach and utilized path analysis. The statistical population of this research comprised all the students with SLD who were referred to the student counseling centers and LD centers affiliated with the education organization of Sanandaj city in the academic year 2022 - 2023. The research sample consisted of 360 students aged between 8 and 12 years old with SLD, selected from the statistical population through purposeful sampling. In this research, the self-report version of Leibovitz's Social Anxiety Scale for children and adolescents by Masia-Warner et al., Shields and Cicchetti's emotion regulation inventory, Trait Emotional Intelligence Questionnaire by Mavroveli et al., and Muris' Children's Self-Efficacy Questionnaire were utilized. The fit indices of the model were also confirmed. Results: The variables of emotion regulation, perceived self-efficacy, and emotional intelligence directly affected the social anxiety of students with SLD. Additionally, the social anxiety of students with SLD was significantly related to the mediation of perceived self-efficacy with emotion regulation and emotional intelligence (P < 0.01). Conclusions: Therefore, to reduce the social anxiety of students with SLD, it is recommended that educators and experts develop educational programs to increase adaptive emotion regulation strategies, enhance perceived self-efficacy, and strengthen emotional intelligence.

Maternal perinatal social support and infant social-emotional problems and competencies: a longitudinal cross-cohort replication study.

Maternal perinatal social support is theorised to promote offspring social-emotional development, yet few studies have prospectively examined this relationship. Findings may inform preventative intervention efforts, to support a healthy start to emotional life. This study examined whether maternal social support perinatally predicts infant social-emotional development at 12 months of age in two longitudinal cohort studies:The Australian Temperament Project (ATP) (n = 1,052 mother-infant dyads [653 mothers, M age_at_birth = 32.03, 88% Australian-born; 1,052 infants, 52% girls]) and TheTriple B Pregnancy Cohort Study (Triple B) (n = 1,537 dyads [1,498 mothers, M age_at_birth = 32.53, 56% Australian-born; 1,537 infants, 49% girls]). Social support was assessed at pregnancy (third trimester) and eight-weeks post-birth. Infant social-emotional competencies (ATP: Brief Infant and Toddler Social and Emotional Assessment (BITSEA), Competencies Scale; Triple B: Bayley Scales of Infant and Toddler Development-Social Emotional Scale) and problems (ATP: BITSEA, Problems Scale; Triple B: Ages and Stages Questionnaires: Social-Emotional Scale), were assessed at 12-months of age. In ATP, social support was associated with lower offspring problems (pregnancy: β = -0.15; post-birth: β = -0.12) and greater competencies (pregnancy: β = 0.12; post-birth: β = 0.16) at 12 months. In Triple B, social support alsopredicted lower offspring problems (pregnancy: β = -0.11; post-birth: β = -0.07) and greater competencies (pregnancy: β = 0.07) at 12 months. Findings did not indicate an association between support at eight-weeks post-birth and subsequent competencies (β = 0.06). Evidence suggests that perinatal social support promotes healthy infant social and emotional development. These results underscore the critical importance of social support for mothers transitioning into parenthood.

Predicting preschool problems

Being able to predict which children will develop social-emotional problems is important for targeting interventions and efficiently allocating resources to preschools. We used the Strengths and Difficulties Questionnaire (SDQ) and preschool teachers’ assessments of 908 children aged 2–7 in 16 preschools in one Danish municipality, data from administrative registers, and a range of prediction models to examine how well social-emotional problems in preschool be can predicted. Although machine learning models typically make better predictions than linear or logistic regression, no model predicted either child or preschool-level social-emotional problems well. However, using the best-performing machine learning model, we obtained a predicted rank of preschools close to the observed rank (Spearman’s r = 0.69), which improved upon predictions based on income and earlier SDQ measures. Our results indicate that although using register data to target interventions to individual children is difficult, prediction models can improve the identification of preschools in need of extra resources.

Executive Functions and Social-Emotional Problems in Toddlerhood: Nature, Persistence, and Direction of Associations.

Social-emotional problems can emerge as early as the first years of life and are associated with a broad range of negative outcomes throughout the lifespan. There is convincing evidence that poorer executive functions (EF) are associated with more social-emotionalproblems during childhood and adolescence. However, the nature, persistence, and direction of the associations between different components of EF and social-emotionalproblems in toddlerhood remain unclear. Using two complementary statistical approaches, the present study aimed to (a) identify the role of EF components (inhibitory control, cognitive flexibility, and working memory) in the emergence and maintenance of social-emotional problems during toddlerhood, and (b) explore potential bidirectional associations between toddlers' EF and social-emotional problems. EF and social-emotional problems were assessed around 13, 19, and 28 months of age in a sample of 133 typically developing toddlers (51% boys) from mostly White middle-class families. At each time point, EF were measured with three behavioral tasks and social-emotional problems with a well-validated questionnaire completed by mothers. Multilevel growth models revealed a significant increase in social-emotional problems across toddlerhood and a negative association between inhibitory control and social-emotional problems that persisted across time. Controlling for stability across time, cross-lagged panel models indicated that child inhibitory control at 19 months negatively predicted child social-emotional problems at 28 months, but not the reverse. This study highlights that toddlerhood is a period of significant increase in social-emotional problems andprovides evidence for the protective role of early inhibitory control skills against the development of social-emotional problems during toddlerhood.

Mother-Infant Interaction and Maternal Postnatal Psychological Distress Associate with Child's Social-Emotional Development During Early Childhood: A FinnBrain Birth Cohort Study.

We studied the effects of mother-infant interaction and maternal pre- and postnatal psychological distress on children's social-emotional problems and competences, as well as whether interaction quality moderates the association between distress and children's outcomes. Maternal pre- and postnatal psychological distress were measured using the SCL and EPDS questionnaires, whereas mother-infant interaction was measured when the child was 8months old using the EA Scales. Children's social-emotional development was measured using the BITSEA questionnaire at 2years old and using the SDQ questionnaire at 4years old, where higher maternal structuring was associated with fewer social-emotional problems in children and higher maternal sensitivity was associated with greater social-emotional competence in children at 2years old. Further, higher postnatal distress was found associated with greater social-emotional problems at 2years old, though neither these effects nor moderating effects at 4years old were observed after multiple-comparison corrections. Our findings support direct associations of both mother-infant interaction and maternal postnatal psychological distress with children's social-emotional development during toddlerhood.

Effects of Gender and Social Network Use on High School Students’ Emotional Well-Being during COVID-19

Various studies conducted during the COVID-19 pandemic have confirmed changes in online behaviour, with young people increasingly using social networks. This trend appears to correlate with a heightened risk of various psychological and emotional problems. The main aim of this study is to explore the patterns of social network use among high school students amidst the pandemic, particularly focusing on the presence of specific emotional problems and potential gender differences. In addition, this study aims to contribute to the existing body of knowledge on the influence of lockdown measures on adolescents. A probabilistic sample of N = 825 students from 20 high schools in Zagreb participated in this study. Alongside basic sociodemographic variables, this study assessed social network habits and emotional problems using the Depression Anxiety Stress Scales 21 (DASS-21). The findings indicate intensive social media engagement during the pandemic. The results of the MANOVA analysis (gender x daily time on social media) show significant effects of both the time spent on social networks and gender on mental health, while no interaction effect was observed. Female students and those who spend more time on social media have higher levels of depression, anxiety, and stress symptoms. These findings underscore the need for addressing emotional problems and habits in the virtual environment of high school students and implementing appropriate preventive and treatment interventions.

Facial emotion recognition and social-emotional problems in middle childhood: Assessment of directional effects

Research has consistently shown that difficulties in facial emotion recognition (FER) are associated with peer problems and internalizing symptoms during middle childhood. However, no longitudinal research has investigated the direction of effects, that is, how these constructs influence each other across time. In this preregistered three-wave panel study, we tested the directional effects between FER, peer problems, and internalizing symptoms among Finnish school-aged children (n = 3,607; Mage = 8.20, SDage = 0.86; 51% female). The results of random-intercept cross-lagged panel models showed that a low FER accuracy and high biases toward happiness and sadness correlated with higher levels of peer problems and internalizing symptoms at the between-person level. However, we found no evidence of directional effects at the within-person level. Overall, our findings suggest that these constructs might be associated because of shared underlying causes, rather than mutually influencing one another in middle childhood.

Maternal parenting stress and social-emotional problems of Chinese preschoolers: The role of the mother-child relationship and maternal adverse childhood experiences

BackgroundPrevious research suggests that maternal parenting stress is a significant predictor of social-emotional problems in children. However, little is known regarding the mother-child relationship and the effect of maternal adverse childhood experiences (ACEs) on this association. MethodsThree waves of longitudinal panel data were collected from 2893 Chinese preschoolers with a follow-up interval of 6 months. The mothers of preschoolers were asked to complete anonymous questionnaires concerning demographic variables, maternal ACEs and parenting stress in Wave 1, mother-child relationships in Wave 2, and children's social-emotional problems in Wave 3. The parallel mediation model was conducted to analyze the mediating role of three dimensions of mother-child relationships, and the moderation model was conducted to examine the moderating role of maternal ACEs. ResultsThe results showed that maternal parenting stress predicted children's social-emotional problems directly or indirectly through the mother-child relationship, with an intimate mother-child relationship mediating this main effect negatively but a conflicted and dependent mother-child relationship mediating this main effect positively. In addition, moderating results indicated that the main effect of maternal parenting stress on children's social-emotional problems was more marked among participants with at least one maternal ACEs than those without maternal ACEs. Furthermore, the moderating effect was only detected in children whose mothers had a high school education or less. LimitationsThe subjectivity of mothers' reports may somewhat reduce the credibility due to the possible overestimation or underestimation of children's social-emotional problems. ConclusionThese findings provide new evidence for the effects of maternal parenting stress on children's social-emotional development and highlight the need for more attention to children with mothers having ACE exposure, lower educational level and poor parent-child relationships.

Caregiver report of social-emotional functioning in infants and young children after inflicted traumatic brain injury

ABSTRACT Social-emotional difficulties are common sequelae of traumatic brain injury (TBI). Children who have experienced inflicted TBI (iTBI) may be at increased risk for social-emotional problems due to the risk factors associated with both early neurologic injury and with child maltreatment. We characterized the associations among injury severity, caregiver type (i.e., biological parents, non-kinship, kinship), and child social-emotional functioning in 41 infants and young children who had sustained iTBI and were seen in a large, regional children’s hospital. This study was a retrospective analysis, utilizing data collected from the medical record as part of routine clinical care. Social-emotional functioning was assessed with the Bayley Scales of Infant and Toddler Development-Third Edition. Children with more severe injuries were rated as having worse social-emotional functioning. Caregiver type was associated with child social-emotional scores, above and beyond injury and demographic predictors. Biological parents were more likely to report better social-emotional skills than non-kinship caregivers, with the pattern of results suggesting that rater bias plays a role in this difference. In order to ensure that children are accurately identified for supports, these relationships should be considered when interpreting caregiver report of social-emotional skills.

The Role of Self-Esteem and Social Support on Emotional Behavioral Problems Among Grade 12 Students

The study investigated how self-esteem and social support influence emotional behavioral problems in Grade 12 students, involving 212 participants in a quantitative-correlational design. Results indicated generally high levels of self-esteem and social support, especially in domains such as social acceptance, school satisfaction, and self-assessment for self-esteem, as well as support from various sources including parents, relatives, adults, siblings, and peers. Emotional behavioral problems were largely low, encompassing factors like anxiousness, academic issues, aggression, social withdrawal, feelings of rejection, and psychosomatic problems. Surprisingly, no significant correlation was found between self-esteem and emotional behavioral problems with the influence of 1.9%, but a notable link existed with social support with the influence of 16.4%, highlighting its importance in fostering a positive environment. Limitations include potential biases in self-report measures, limited generalizability, and the absence of qualitative data. Future research should delve into underlying factors and develop interventions to enhance social support systems in educational settings for better mental health outcomes among students.

Social Emotional Well-Being, Psychological Resilience and Behavioural Problems in Preschool Children: The Mediating Role of Emotion Regulation

Social Emotional Well-Being, Psychological Resilience and Behavioural Problems in Preschool Children: The Mediating Role of Emotion Regulation

Age, Gender and Children Opinion with Social-Emotional Development among Preschool Children in Flood-Prone Areas

Background: Preschool children are at a risk of social-emotional problems at 58.8%, with 72.2% of post-flood disaster children experiencing emotional behavior problems. In flood-affected areas, the self-concept of preschool children shows poor self-image (53.4%), low self-esteem (56.8%), and a negative self-role (52.3%).Purpose: To understand the overview and factors correlation to the social-emotional development of preschool children in flood-prone areas.Methods: This research was designed as a descriptive cross-sectional study. A total of 125 preschool children living in flood-prone areas were the research subjects. The ASQ-SE questionnaire was used to measure the social-emotional development of children. Spearman tests were conducted to determine the correlation between respondent characteristics and social-emotional development.Result: This study shows 88% of preschool children living in flood-prone areas are at risk of experiencing social-emotional problems. The questions with the highest scores in the 36-month, 48-month, and 60-month questionnaires were related to children intentionally hurting themselves. Gender is significantly correlated with the social-emotional development of children in flood-prone areas (p 0.05).Conclusion: Preschool children in flood-prone areas are more likely to experience social-emotional problems. Gender plays a role in the social-emotional development of children. The results provide insight for pediatric nurses in developing interventions to prevent social-emotional problems in children with a family-centered care approach.

Prospective Associations Between Family-Based Social Capital, Wellbeing, and Emotional and Behavioral Problems Amongst People with Mild Intellectual Disabilities: A Two-Wave Study

ABSTRACT Introduction Family members are often the main provider of informal support to people with mild intellectual disabilities. In the current study, we explored whether their family-based social capital is prospectively associated with their wellbeing and emotional and behavioral problems. Methods Sixty-nine participants with mild intellectual disabilities and key (proxy reporting) staff members participated in two waves of data collection (T1, T2). Data were collected about family-based social capital (FNM-ID), subjective wellbeing (PWI-ID), and emotional and behavioral problems (ABCL, BPI-01). Results People who reported less support provision to family members and more reciprocal family support relationships at T1 experienced higher levels of internalizing behavior problems at T2, after accounting for T1 levels of internalizing behavior problems. No other associations were found between earlier family-based social capital dimensions and psychological outcomes at T2. Conclusion Our study provides initial insights regarding the prospective associations between the family-based social capital of people with mild intellectual disabilities and their wellbeing and emotional and behavioral problems. Future studies should include larger samples to investigate if our preliminary results are replicated.