Our longitudinal study contributes to the body of literature on depression in childhood by examining potential protective factors. We investigated the influence of maternal depressive symptoms on child depressive symptoms at early school age and its gender-specific moderation by children’s narrative representations of the maternal figure, over and above children’s own depressive symptoms at preschool age. Children’s narrative representations were assessed using the MacArthur Story Stem Battery in 170 preschool children (92 girls; 54.1 %) oversampled for internalizing symptoms. Children’s depressive symptoms were assessed at preschool age (Time 1; 4-6 years) and at early school age (Time 2; 6-8 years) by maternal report; mothers’ depressive symptoms were assessed at Time 1. The results showed that for boys, only their own depressive symptoms at Time 1 predicted their depressive symptoms at Time 2. For girls, maternal depressive symptoms were a significant risk factor for their own depressive symptoms at Time 2. Regarding this association, we also found a moderation effect: girls with more positive narrative representations of the maternal figure showed a reduced negative impact of maternal depressive symptoms on their own depressive symptoms at Time 2. This implies that clinical practice should screen a child for early depressive symptoms, especially if the mother displays depressive symptoms. Clinicians might also assess children’s inner working models, which can serve as a protective factor.
Keywords: Childhood depression; Maternal depression; Narrative representations; Preschool/school age; Gender differences
Background/Aim: Children born preterm are at risk of neonatal complications but the long-term consequences for everyday functioning is not well known. The study aimed to identify patterns of everyday functioning in preschool children born preterm and at term in relation to perinatal data, neonatal risk factors, behaviour, and socioeconomic status. Registry data and data from parent rated questionnaires were collected for 331 children. Method: A person-oriented approach with a cluster analysis was used. Results: A seven cluster solution explained 65.91% of the variance. Most children (n = 232) showed patterns of strong everyday functioning. A minority of the children (n = 99), showed diverse patterns of weak everyday functioning. Perinatal characteristics, neonatal risk factors and socio-economics did not predict cluster group membership. Children born preterm were represented in all clusters. Conclusion, implications: Most preschool children are perceived by their parents with strong everyday functioning despite being born preterm. However small groups of children are, for various reasons, perceived with weak functioning, but preterm birth is not the sole contributor to patterns of weak everyday functioning. More critical for all children’s everyday functioning is probably the interaction between individual factors, behavioural factors and contextual factors. To gain a broader understanding of children’s everyday functioning. Child Health Services need to systematically consider aspects of body function, activity and in addition participation and environmental aspects.
Keywords: Everyday functioning; Children born preterm; Child development; Person-oriented research; Cluster analysis
BACKGROUND: While talking about traumatic experiences is considered central to psychological recovery, little is known about how these conversations occur in daily life. OBJECTIVE: We investigated spontaneous injury talk among parents and children in the aftermath of a child’s hospitalisation due to physical trauma, and its relationship with children’s socioemotional functioning. METHODS: In a prospective naturalistic observation study, we audio-sampled the daily life of 71 families with the Electronically Activated Recorder after their child (3-16 years old) was discharged from hospital. We collected close to 20 000 snippets of audio information, which were double-coded for conversation characteristics, and measured children’s socioemotional functioning with the Strengths and Difficulties Questionnaire (SDQ) at 6 weeks and 3 months postinjury. FINDINGS: The children were involved in injury talk for, on average, 46 min/day, 9 min of which referred to emotions. Children had significantly more injury conversations with their mothers than with their fathers. The tone of injury conversations was significantly more positive than that of non-injury conversations. More direct injury talk was associated with fewer problems on the emotion subscale of the SDQ at 3 months. Other associations between aspects of injury talk and children’s socioemotional functioning were mostly non-significant, although they appeared to be stronger at 3 months than at 6 weeks. CONCLUSIONS: Families spontaneously talked about the injury and associated issues for about the same amount of time per day as a therapist might within a session (a ‘therapy hour’). CLINICAL IMPLICATIONS: Making full use of naturally occurring injury talk may be a valuable direction for parent and family-focused postinjury interventions. However, the study design prevents causal inference, and further exploration is warranted.
BACKGROUND: One of every five children and adolescents in the European Union suffers from behavioural, and emotional disturbances. OBJECTIVES: To compare factors associated with the quality of life and mental health of immigrant and Spanish children aged 4-14years both during the years 2006 and 2012 and to evaluate changes over this time period. DESIGN AND METHODS: An epidemiologic age and sex matched case-control study (1:2) was conducted. The study group were 677 immigrant children and 1354 matched Spanish children (controls). This study was conducted using data obtained from the Spanish National Health Surveys done in 2006 and 2012. We used the Strengths and Difficulties Questionnaire to obtain the score for variables derived from mental health and the Kidscreen-10 questionnaire to score the Health-Related Quality of Life. RESULTS: Spanish girls scored higher in conduct problems (2.04+/-0.1) and better in problems with peers (1.21+/-0.08) regarding immigrant girls (1.82+/-0.12-1.92+/-0.13 respectively). Concerning total scores, immigrant children obtained significantly lower scores in quality of life (81.29+/-0.76) and in problems with peers (2.04+/-0.09) than their matched Spanish children (84.4+/-0.45 and 1.26+/-0.06) in 2006. Immigrant children had lower total scores in prosocial behaviour (8.62+/-0.11) compared to the matched Spanish children (8.92+/-0.06) in 2012. The total average scores of immigrant children in terms of quality of life, emotional symptoms, behavioural problems, hyperactivity and problems with peers were significantly better in 2012 (86.58; 1.84; 1.46; 3.77 and 1.48 respectively) than in 2006 (81.29; 2.15; 1.90; 4.58 and2.04). CONCLUSIONS: Immigrant children had a poorer quality of life and mental health than matched Spanish children in 2006.
Keywords: Behaviour problems; Conduct disorder; Immigrant; Mental health; Quality of life; School children
Although universal screening for mental health difficulties is increasingly recognized as a way to identify children who are at risk and provide early intervention, little research exists to inform decisions about screening, such as the choice of informants and the type of information collected. The present study examined the incremental validity of teacher- and parent-rated (primarily mothers) symptoms and impairment in a non-referred sample of early elementary school children (n = 320, 49 % boys, ages 6 to 9) in terms of predicting impairment as rated by a different teacher 1 year later. Teacher-rated symptoms and impairment and parent-rated impairment were each unique predictors of later impairment; however, parent-rated symptoms did not contribute to the prediction of later impairment above and beyond these other indicators. The results indicate that, when screening for mental health difficulties in the school system, impairment ratings collected across settings add useful information, but it may not be necessary to use parent symptom ratings when teacher symptom ratings are available.
Keywords: Incremental validity; Multiple informants; Symptoms; Impairment; Screening
Background: Discrepancies between multiple informants often create considerable uncertainties in delivering services to youth. The present study assessed the ability of the parent and youth scales of the Strength and Difficulties Questionnaire (SDQ) to predict mental health problems/disorders across several mental health domains as validated against two contrasting indices of validity for psychopathology derived from the Development and Well Being Assessment (DAWBA): (1) an empirically derived computer algorithm and (2) expert based ICD-10 diagnoses. Methods: Ordinal and logistic regressions were used to predict any problems/disorders, emotional problems/disorders and behavioural problems/disorders in a community sample (n = 252) and in a clinic sample (n = 95). Results: The findings were strikingly similar in both samples. Parent and youth SDQ scales were related to any problem/disorder. Youth SDQ symptom and impact had the strongest association with emotional problems/disorder and parent SDQ symptom score were most strongly related to behavioural problems/disorders. Both the SDQ total and the impact scores significantly predicted emotional problems/disorders in males whereas this was the case only for the total SDQ score in females. Conclusion: The present study confirms and expands previous findings on parent and youth informant validity. Clinicians should include both parent and youth for identifying any mental health problems/disorders, youth information for detecting emotional problems/disorders, and parent information to detect behavioural problems/disorders. Not only symptom scores but also impact measures may be useful to detect emotional problems/disorders, particularly in male youth.
Keywords: Adolescent psychopathology; Emotional problems; Behavioural problems; Multi-informants; SDQ; DAWBA
Background: Exposure to trauma was found to increase later violent behaviours in youth but the underlying psychopathological mechanisms are unclear. This study aimed to test whether posttraumatic stress disorder (PTSD) is related to violent behaviours and whether PTSD symptoms mediate the relationship between the number of trauma experiences and violent behaviours in adolescents. Method: The present study is based on a nationally representative sample of 9th grade students with 3434 boys (mean age = 15.5 years) and 3194 girls (mean age = 15.5 years) in Switzerland. Lifetime exposure to traumatic events and current PTSD were assessed by the use of the University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index (UCLA-RI). Logistic regression was used to assess associations between PTSD and violent behaviours, and structural equation modelling (SEM) was used to examine the meditation effects of PTSD. Results: PTSD (boys: OR = 7.9; girls: OR = 5.5) was strongly related to violent behaviours. PTSD symptoms partially mediated the association between trauma exposure and violent behaviours in boys but not in girls. PTSD symptoms of dysphoric arousal were positively related to violent behaviours in both genders. Anxious arousal symptoms were negatively related to violent behaviours in boys but not in girls. Conclusions: In addition to trauma, posttraumatic stress is related to violent outcomes. However, specific symptom clusters of PTSD seem differently related to violent behaviours and they do not fully explain a trauma-violence link. Specific interventions to improve emotion regulation skills may be useful particularly in boys with elevated PTSD dysphoric arousal in order to break up the cycle of violence.
Keywords: Trauma; Aggression; PTSD; Dysphoric arousal; Anxious arousal; Numbing
Objective: Early temperamental characteristics may influence children’s developmental pathways and predict future psychopathology. However, the environmental context may also shape or interact with infant temperament and indirectly contribute to increased vulnerability to adverse developmental outcomes. The aim of the present study is to explore the long-term contribution of temperamental traits at twelve months of age to the presence of emotional and behavioral problems later in childhood, and whether this association varies with the child’s sex, parental separation, family socioeconomic status and maternal depression. Method: 1184 mother-child pairs from the EDEN mother-child birth cohort study based in France (2003 +/- 2011), were followed from 24 +/- 28 weeks of pregnancy to the child’s fifth birthday. Infant temperament at 12 months was assessed with the Emotionality Activity and Sociability (EAS) questionnaire and behavior at 5.5 years was assessed with the Strengths and Difficulties Questionnaire (SDQ). Results: Emotional temperament in infancy predicts children’s overall behavioral scores (beta = 1.16, p < 0.001), emotional difficulties (beta = 0.30, p < 0.001), conduct problems (beta = 0.51, p < 0.001) and symptoms of hyperactivity/inattention (beta = 0.31, p = 0.01) at 5.5 years. Infants' active temperament predicts later conduct problems (beta = 0.30, p = 0.02), while shyness predicts later emotional problems (beta = 0.22, p = 0.04). The association between the child's temperament in infancy and later behavior did not vary with children's own or family characteristics. Conclusion: An emotional temperament in infancy is associated with higher levels of emotional and behavioral difficulties at the age of 5.5 years. Children who show high emotionality early on may require early prevention and intervention efforts to divert possible adverse developmental pathways.
Introduction: Anxiety disorders in primary school-aged children negatively affect their mental health and psychological development. Available non-medical treatments for these conditions are time-consuming and expensive. In this context, eclectic therapy is a therapeutic approach that incorporates some therapeutic techniques and philosophies to create the ideal treatment. In this study, eclectic therapy consisted of art therapy and cognitive-behavioral therapy designed for children suffering from high level of anxiety in their middle childhood years. The therapy also included group guidance sessions for their mothers. The effectiveness of this intervention was examined in the study. Methods: 61 students aged 9-12 years with high levels of anxiety participated in the study. Intervention A (n = 20) consisted of 9-hour eclectic therapy for children with 3-hour group guidance sessions for their mothers. Intervention B (n = 20) consisted of 9-hour eclectic therapy for children. There was also a control group (n = 21). Results: Teacher ratings of children’s mental health difficulties and self-report ratings of anxiety disorders indicated a significant difference from pretest to posttest, revealing a large effect size between the two interventions. Higher levels of pretest scores significantly predicted higher posttest scores for all domains of anxiety and mental health difficulties. Furthermore, age, gender, mothers working a 15-hour day, mother’s educational level, parental divorce rates, parental death, and family monthly income predicted therapy outcomes. Conclusion: Results provide support for the effectiveness of eclectic art and CBT to improve children’s mental health and reduce anxiety through changing thoughts, beliefs, emotions, and behaviors that may cause fear and anxiety. Abstract (Portuguese) Introducao: Transtornos de ansiedade em escolares afetam sua saude mental e seu desenvolvimento psicologico. Tratamentos alternativos disponiveis consomem tempo e sao dispendiosos. Nesse contexto, a terapia ecletica e uma abordagem terapeutica que incorpora algumas tecnicas e filosofias terapeuticas para criar o tratamento ideal. Neste estudo, terapia ecletica consistiu de terapia artistica e terapia cognitivo-comportamental (TCC) planejada para escolares com altos niveis de ansiedade. A terapia tambem incluiu sessoes de orientacao em grupo para as maes. A eficacia da intervencao foi examinada. Metodos: 61 escolares com idade de 9-12 anos e altos niveis de ansiedade participaram do estudo. A intervencao A (n = 20) consistiu de 9 horas de terapia ecletica para criancas com sessoes de 3 horas de orientacao em grupo para as maes. A intervencao B (n = 20) consistiu de 9 horas de terapia ecletica para criancas. Houve tambem um grupo controle (n = 21). Resultados: Escores atribuidos pelos professores as dificuldades de saude mental das criancas e escores de ansiedade autoaplicados indicaram diferencas significativas entre resultados pre-teste e pos-teste, revelando grande tamanho de efeito entre as duas intervencoes. Escores pre-teste maiores foram preditores significativos de escores pos-teste mais altos para todos os dominios de ansiedade e dificuldades de saude mental. Idade, genero, maes trabalhando 15 horas/dia, nivel educacional da mae, indice de divorcio, morte de um dos pais e renda familiar mensal foram preditores de desfechos da terapia. Conclusao: Os resultados sugerem a eficacia de arte ecletica e TCC para melhorar a saude mental de criancas e reduzir a ansiedade atraves de mudanca em pensamentos, crencas, emocoes e comportamentos que possam causar medo e ansiedade.
Keywords: Anxiety disorders; children; Spence Children’s Anxiety Scale; eclectic therapy; SDQ; CBT
Improving children’s learning and development in conflict-affected countries is critically important for breaking the intergenerational transmission of violence and poverty. Yet there is currently a stunning lack of rigorous evidence as to whether and how programs to improve learning and development in conflict-affected countries actually work to bolster children’s academic learning and socioemotional development. This study tests a theory of change derived from the fields of developmental psychopathology and social ecology about how a school-based universal socioemotional learning program, the International Rescue Committee’s Learning to Read in a Healing Classroom (LRHC), impacts children’s learning and development. The study was implemented in three conflict-affected provinces of the Democratic Republic of the Congo and employed a cluster-randomized waitlist control design to estimate impact. Using multilevel structural equation modeling techniques, we found support for the central pathways in the LRHC theory of change. Specifically, we found that LRHC differentially impacted dimensions of the quality of the school and classroom environment at the end of the first year of the intervention, and that in turn these dimensions of quality were differentially associated with child academic and socioemotional outcomes. Future implications and directions are discussed.