Daily Activities in European Children and Adolescents During COVID-19 School Closure: A Longitudinal Study Exploring Physical Activity, Use of Screens, and Sleep Patterns.

This longitudinal study aimed to analyze the evolution of patterns of daily activities (physical activity time, screen usage time, and sleep hours) in European youth during school closure due to the COVID-19 health crisis. Participants were 624 caregivers of children and adolescents aged 3-18 from Italy, Spain, and Portugal. Evaluations were online, and four time-points were considered: retrospective measurement of daily activities before confinement (T1), and two (T2), five (T3), and eight (T4) weeks after starting the lockdown. Generally accepted international guidelines on physical activity time, screen usage time, and hours of sleep by age group were used to determine whether the pattern might increase the risk for ill health or not. To estimate the evolution of daily activities, generalized estimating equations (GEE) were used. The percentage of children who practiced less than 60 min of daily exercise increased significantly from before home confinement (47.8%) to T2 (86.4%); it slightly decreased at T3 (79.8%), and remained stable at T4 (76.1%). The percentage of children who made excessive use of screens (according to their age group) significantly increased from T1 to T2 and remained stable and high in the rest of the evaluations. The percentage of children who slept fewer or more hours than recommended for their age group remained stable between T1 and T4, although there was a significant increase at T3. In general, results found unhealthier behaviors as confinement was extended. Results are discussed in order to find strategies for promoting healthy daily activities for future pandemics.

Treating Emotional Disorders in Spanish Children: A Controlled Randomized Trial in a Clinical Setting.

Super Skills for Life (SSL) is a CBT-transdiagnostic group intervention currently being translated and validated in multiple countries. In Spanish children, it has shown a positive impact on anxious and depressive symptoms, as well as other variables such as self-concept, prosocial behaviors, or behavioral problems. However, the effectiveness of the program to treat internalizing symptoms in children with a mental disorder in a clinical setting has not been examined so far. The aim of this study was to evaluate the effectiveness of SSL in a Spanish sample of children with a major internalizing disorder. Participants aged 8-12 years (71.6% boys) were randomly allocated to the SSL group (n = 43) or the waiting list control (WLC) group (n = 43). All children and their parents completed a series of measures before the first session and after the last session or at about the same time in the WLC group. The effectiveness of the intervention was assessed using generalized estimating equations. Significant reductions from pretest to posttest across multiple outcomes were found in children who participated in SSL group compared to those in the WLC group, including anxiety symptoms (SCAS, p = .02), anxiety interference (CALIS, p = .002), depressive symptoms (CDI, p = .033) and remission from diagnosis (K-SADS, p < .001). This study provides initial support for SSL as an effective treatment for children with emotional disorders in clinical settings. Future studies are needed to analyze long-term effects and broader benefits of the program in clinical contexts.

Benefits of Super Skills for Life in a randomized controlled trial in clinical settings for Spanish children with comorbid conditions.

Emotional disorders in children are often associated with low self-concept and problems with peers, and in many cases externalizing symptoms. Super Skills for Life (SSL) is a transdiagnostic treatment for emotional problems in children that has also shown benefits in other comorbid symptoms. This study aimed to examine, for the first time, the effect of SSL on a clinical sample of Spanish children aged 8-12 years with a major emotional disorder and comorbid externalizing symptoms and low self-concept. A quasi-experimental design with two groups, pretest and posttest, was carried out. Thirty-eight children received the SSL intervention, and 36 children were assigned to a wait-list control (WLC) group. Children in SSL showed statistically fewer posttest emotional symptoms (p < .001), peer problems (p = .002), and overall internalizing and externalizing difficulties (p = .005) compared to children in WLC, in addition to higher posttest self-concept (p = .002). There were no differences in the postinterventional changes between boys and girls in internalizing and externalizing symptoms. However, significant differences were found in some facets of self-concept. The results of this study suggest that the SSL protocol may be useful in Spanish clinical contexts. Still, more research is needed to overcome some of the inherent limitations.

Effectiveness of a transdiagnostic computerized self-applied program targeting children with emotional problems: A randomized controlled trial.

BACKGROUND: Super Skills for Life (SSL) is an eight-session transdiagnostic program based on cognitive-behavioral therapy (CBT), aimed at the indicated prevention of childhood emotional problems, which has been implemented with positive short- and long-term results. The present study aimed to examine the effects of a self-applied computerized program based on SSL that maintains the same objectives and contents as the face-to-face program. METHODS: In this randomized controlled study, 75 children (49.3 % female) aged 8-12 years (Mage = 9.45, SD = 1.31), selected for exhibiting emotional symptoms, were randomly assigned to either the intervention (n = 35) or the waiting list control (WLC) group (n = 40). Pre- and post-intervention data were collected through self-reports and the report of parents who completed parallel versions of the same measures of emotional and behavioral problems. RESULTS: Overall, compared to the WLC group, the intervention group showed positive effects on targeted emotional symptomatology in the short term. Based on parents' reports, a significant reduction was found in outcomes such as anxiety, depression, emotional symptoms, and internalizing problems, while self-reported results were similar except for anxiety. In addition, a positive impact was found on symptoms related to other types of difficulties (e.g., externalizing problems and general difficulties measured). LIMITATIONS: Small sample size, non-inclusion of follow-up assessment and other informants (e.g., teachers). CONCLUSIONS: In conclusion, this research provides novel and promising data on the self-applied computerized adapted version of the SSL program, within a multi-informant approach, suggesting that it may be a useful tool for the indicated prevention of childhood emotional problems.

Stressful Life Events in Children Aged 3 to 15 Years During the COVID-19 Pandemic: A Latent Class Analysis.

BACKGROUND: Although several studies have reported an increase in psychological problems during the COVID-19 pandemic, the impact of stressful life events on Spanish children and adolescents using a person-oriented statistical approach and the relationships between the profiles and emotional and behavioral symptoms have not yet been examined. The present study aims to identify profiles of Spanish children and adolescents, considering life-threatening stressful events during the COVID-19 pandemic. METHOD: Participants were 252 parents of children aged 3 to 15 years old who completed an online structured questionnaire that collected information about stressful life events related to the pandemic and its impact on their children's welfare. RESULTS: Through Latent Class Analysis (LCA), four profiles of children and adolescents were found according to the stressful events experienced: "COVID infection, social confinement", "economic loss", "reduced social contact" and "parental stress", with no significant age or gender differences. Reduction in social contact was the most prevalent stressor. Comparisons of psychological symptoms across latent classes were analyzed. CONCLUSIONS: The findings increase our understanding of how stressful life events during the COVID-19 situation impacted young people's psychological welfare and highlight the need to promote strategies to prevent emotional problems during a pandemic considering the identified profiles.

Examining academic self-concept as a mediator of the relationship between anxiety and depression: A longitudinal study.

BACKGROUND: Self-concept plays a role as a mediator in the development and maintenance of internalizing symptoms but mechanisms through which the early presence of anxiety symptoms is associated with the subsequent development of depression is unknown. The aim of this longitudinal study was to analyze the mediating role of different areas of self-concept in the relationship between the early development of anxiety symptoms and the later appearance of depressive symptoms. METHODS: A longitudinal study with 3 time-points was conducted, including baseline, 2 months and 12 months from the baseline assessment. A total of 217 children aged 8-12 years participated. Mediation analyses were conducted using PROCESS Macro for SPSS. RESULTS: Academic self-concept (Time 2) mediated the relationship between Anxiety (Time 1) and Depression (Time 3) when controlling for children's sex and, age, baseline value of the mediator, anxiety (at Times 2 and 3), and depression (at Times 1 and 2). Children with self-reports of higher anxiety symptoms (Time 1) presented lower Academic self-concept (Time 2). Children who reported lower levels of Academic self-concept and Family self-concept (Time 2) were more likely to develop depressive symptoms (Time 3). CONCLUSIONS: Feeling competent in the school environment may be considered a protective factor against the development of depression in childhood. The identification of risk factors facilitates the development and implementation of preventive programs.

Colombian adolescents fail in knowledge regarding HIV and other sexually transmitted infections / Adolescentes colombianos fracasan en conocimientos sobre VIH y otras infecciones de transmisión sexual

Abstract Introduction/objective: Sexually transmitted infections (STIs) -HIV included- are a major problem in Latin America, mainly in Colombia. In 2021, 17647 cases were reported, which compared to the previous year showed an increase of 29.7%. The main aim of this study was to assess the knowledge regarding HIV and other STIs among the adolescent population in Colombia. Method: A total of 2012 Colombian adolescents between 12-19 years of age participated in this study. The HIV and Other Sexually Transmitted Infections Knowledge Scale (KSI), a self-report measure, was administered. Results: The results showed moderate to low general knowledge (M = 9.90, SD = 4.64) regarding HIV and other STIs. Adolescents did not know if a tongue-kiss led to an HIV infection (75%), or whether both the vaginal ring and the IUD were effective methods for preventing HIV/AIDS (82%). Results showed better scores in knowledge regarding HIV transmission (84%), HIV testing (66%), and condom use to prevent HIV infection (71%). Conclusions: Significant differences were observed in HIV/STIs knowledge between both sexes, but the effect magnitudes were small. Thus, these differences were neglected. This study contributes to understanding the state of knowledge and strengthening prevention strategies of professionals linked to the field of quality of life, education, and sexual healthcare in Colombia.

Resumen Introducción/objetivo: Las infecciones de transmisión sexual (ITS) y el VIH son un gran desafío en América Latina, principalmente en Colombia. Para el 2021 se reportaron 17 647 casos, que comparados con el 2019 muestran un incremento del 29.7 %. El objetivo principal de este artículo fue evaluar el conocimiento sobre el VIH y otras ITS en la población adolescente de Colombia. Método: En este estudio participaron un total de 2012 adolescentes colombianos con edades entre los 12 y los 19 años. Se administró la Escala de Conocimientos sobre el VIH y otras infecciones de transmisión sexual (KSI) y una medida de autoinforme. Resultados: Los resultados mostraron un conocimiento general de moderado a bajo (M = 9.90, SD = 4.64) sobre el VIH y otras ITS. Las adolescentes no sabían si un beso con lengua conducía a una infección por el VIH (75 %) o si tanto el anillo vaginal como el DIU eran métodos efectivos para prevenir el VIH/SIDA (82 %). Los resultados mostraron mejores puntuaciones en conocimientos sobre la transmisión del VIH (84 %), pruebas de detección del VIH (66 %) y uso de preservativos para prevenir la infección por el VIH (71 %). Conclusiones: Se observaron diferencias significativas en el conocimiento del VIH/ ITS entre ambos sexos, pero los tamaños del efecto fueron pequeños. Por tanto, estas diferencias fueron despreciadas. Este estudio contribuye a comprender el estado del conocimiento y a fortalecer las estrategias de prevención que realizan los profesionales vinculados al campo de la calidad de vida, la educación y la salud sexual en Colombia.

Spanish Validation of the Short Mood and Feelings Questionnaire (SMFQ) in Children Aged 8-12.

BACKGROUND: The Short Mood and Feelings Questionnaire (SMFQ) is one of the few well-established available measures designed to assess childhood depression. The objective of the present study was to assess the psychometric properties and explore the differential item functioning (DIF) of the SMFQ in a community sample of Spanish children. Gender and age differences in SMFQ scores were also analyzed. METHOD: The sample included 824 students aged 8-12 years (Mage = 9.64, SD = 1.2) recruited from four public and private schools in urban areas in the southeast of Spain. RESULTS: Findings from factor analysis and Polytomous Rasch analysis supported a unidimensional interpretation of the SMFQ, thereby replicating findings across cultures and languages. The SMFQ had good reliability, and test-retest analysis indicated fair to good temporal stability. Evidence of construct validity was provided by a path diagram of the SMFQ and SDQ subscales. No age or gender differences in the SMFQ scores were observed. However, two items (3 and 11) exhibited gender-related DIF. CONCLUSIONS: The use of SMFQ sum-scores as a continuous measure of the severity of depressive symptoms can be supported. The measure shows promise as brief, reliable, valid instrument for the assessment of depressive symptoms in Spanish children.

Nighttime coping response in children: Development and validation of a new scale.

Coping strategies can play an important role in dealing with nighttime fears and related anxiety problems in school-aged children, but well-established self-reporting tools are lacking, and research in this area is limited. The aim of this study was to develop a new self-report instrument assessing coping strategies in school-aged children when facing nighttime fears, the Nighttime Coping Response Scale (NCRS), and to examine its psychometric properties. Participants were 786 children (48.7% boys) aged 8-12 years, who completed the NCRS and other measures related to anxiety and behavioral problems. The construction of the NCRS was based on relevant prior literature and experts' criteria. Exploratory and confirmatory analyses supported a three-factor structure, comprising 15 items measuring coping strategies related to self-control, social support seeking, and avoidance. The NCRS was shown to have good internal consistency, test-retest reliability, and convergent and divergent validity. This research found preliminary support for the use of the NCRS, suggesting the potential suitability of this brief tool to be used by clinicians and researchers to identify and address the use of children's maladaptive coping strategies when dealing with nighttime fears. The NCRS could also be important to enable the development of further research in this field.

Early detection of anxiety problems in childhood: Spanish validation of the brief Spence Children's Anxiety Scale for parents.

The small percentage of children with anxiety problems who receive psychological treatment, and the negative psychological consequences associated with these problems highlight the need for early detection. Although assessment instruments with appropriate measurement properties exist, they tend to be extensive, making it difficult to apply them in clinical settings, schools, or primary care practices. This study aimed to adapt the Spanish brief version for parents of the Spence Children's Anxiety Scale (SCAS-P-8). For this purpose, information on 215 children between 8 and 12 years of age was reported by 163 parents. The Spanish version of the SCAS-P-8 adequately fit a one-factor structure, χ2 = 44.25; df = 19; comparative fit index = .97; Tucker-Lewis index = .96; root mean square error of approximation: .07 (.04, .09); standardized root mean squared residual = .08. Evidence of internal consistency of the total SCAS-P-8 score was good (α = 0.82), and the direct correlations obtained between the SCAS-P-8 and internalizing problems showed evidence of convergent validity. Moreover, the appropriate measurement properties of the SCAS-P-8 were shown to be independent of gender. Differences in sociodemographic variables and SDQ-P between children with anxiety symptoms and those without anxiety symptoms were also discussed. Information reported by parents can help the clinician carry out an accurate diagnosis. A brief assessment scale can be easily applied in schools or primary care settings.

COVID-19: Psychological symptoms and coping strategies in preschoolers, schoolchildren, and adolescents.

The present study aimed to compare psychological symptoms and coping strategies in 1480 preschoolers, schoolchildren, and adolescents during home confinement due to COVID-19. We enrolled parents from Italy, Portugal, and Spain who completed a survey between the second and fourth week of lockdown. The results showed that preschoolers displayed more sleeping difficulties, temper tantrums, and dependency while adolescents' reactions were more related to COVID-19 worries and uncertainty. Schoolchildren showed more difficulty in concentrating. Adolescent girls showed higher anxiety levels than schoolchildren boys. Schoolchildren relied more on emotion-oriented strategies, which were linked to increased internalizing and externalizing symptoms in all ages. Task-oriented strategies, regardless of the child's age, work best to cope with stress. Our findings provide information for professionals and parents about children's most common and adaptive coping strategies according to age. Furthermore, they contribute to the early detection of long-term psychological maladjustment in children.

Effects of a Sexual Risk-Reduction Intervention for Teenagers: A Cluster-Randomized Control Trial.

This study evaluated the efficacy of the COMPAS program in the short term and 6 months after its application. For the initial sample, 2047 teenagers aged 14-19 years from 14 schools in 11 Colombian cities participated; eight schools were randomly assigned to the experimental condition and six to the control group. The participants completed self-report assessments that evaluated several variables theoretically associated with protective sexual behaviors. In the short term, the experimental group showed increased knowledge about HIV and other STIs, sexual assertiveness, self-efficacy, greater behavioral intention toward condom use, and more favorable attitudes toward HIV and condom use than the control group. After 6 months, most psychological and health variables also showed a significant positive change. In conclusion, the COMPAS program is the first school-based sexuality education program that has been shown to be effective in reducing mediating and behavioral variables associated with sexual risk reduction in Colombia.

RESUMEN: Este estudio evaluó la eficacia del programa COMPAS a corto plazo y a 6 meses después de la aplicación. Para la muestra inicial participaron 2.047 adolescentes de 14 a 19 años provenientes de 12 escuelas en 11 ciudades colombianas; 8 escuelas fueron aleatoriamente asignadas a la condición experimental y 6 al grupo control. Los participantes completaron autoinformes sobre variables teóricamente asociadas con comportamientos sexuales de protección. A corto plazo, el grupo experimental mostró un mayor conocimiento sobre ITS, asertividad sexual, autoeficacia e intención conductual hacia el uso del condón y actitudes más favorables hacia el VIH que el grupo de control. Después de seis meses, la mayoría de las variables psicológicas y de salud también mostraron un cambio positivo. En conclusión, el programa COMPAS es el primer programa de educación sexual que ha demostrado ser efectivo para reducir las variables mediadoras y conductuales asociadas con la reducción del riesgo sexual en Colombia.

Psychological Symptoms in Italian, Spanish and Portuguese Youth During the COVID-19 Health Crisis: A Longitudinal Study.

Aiming to slow down the spread of the COVID-19, a lockdown was declared in the first term of 2020 in many European countries, applying different restrictions measures. Although the psychological effects of home confinement in children have been described, there is a lack of longitudinal research examining the impact of the confinement over time. The present study analyzes the evolution of the psychological wellbeing of children and adolescents from three European countries with different restrictions. Parents of 624 Italian, Spanish, and Portuguese children and adolescents aged 3 to 18 years old completed the "Impact Scale of COVID-19 and Home Confinement on Children and Adolescents" two, five, and eight weeks after the lockdown. Results show a different pattern for each country. Children from Italy, the first European country that applied a lockdown, were better adapted than Spanish and Portuguese children the first two weeks after confinement but they were more psychologically impacted by home confinement at the eight-week assessment. Portuguese children, who followed a general duty of home confinement, were the best adapted to the situation, with no significant differences over time. A significant change was found in anxiety symptoms in Spanish children, with a decrease at the last assessment. Findings suggest that long confinements and hard restrictions affect children, so prevention measures should be applied during confinements to prevent psychological problems in children.

Improving Social Performance Through Video-feedback with Cognitive Preparation in Children with Emotional Problems.

Anxious children report a more negative perception of their social performance and increased nervous behaviors. The video-feedback with cognitive preparation allows children to contrast and modify their negative social self-image, increasing their self-confidence and decreasing anxiety behaviors. This study aimed to examine the effectiveness of the Super Skills for Life (SSL) program in improving social performance in a sample of children with emotional symptoms. Results indicated that both objective and subjective evaluation showed positive effects of the SSL program on the children's social performance, enhancing their social skills and reducing anxiety behaviors in social situations, both during the program and in the last session. Girls felt more comfortable and showed better speech and social performance than boys. Our findings increase the evidence about the short-term effects of the video-feedback with cognitive preparation of the SSL program and provide a useful transdiagnostic protocol for application in the clinical setting.

Validation and Adaptation of the Brief Self-Control Scale With Spanish Adolescents: Factorial Structure and Evidences of Reliability, Validity, and Factor Invariance Across Gender and Age.

During adolescence, the difficulty to control impulses is especially notable. The Brief Self-Control Scale has been used in different countries for years to study associations between self-control and other variables. However, its factor structure is not completely clear, and it is necessary to have a scale with psychometric assurances that evaluates self-control in adolescents. The aim of this study was to examine the factorial structure of the Brief Self-Control Scale and to provide evidences of reliability, validity, and factor invariance across gender and age in a sample of Spanish adolescents. Participants were 693 adolescents from Southeastern Spain, aged 13 to 18 years. Data supported an excellent fit to a two-dimensional model and evidences of reliability, validity and factor invariance across gender and age were obtained. This study provides new data on the two-dimensionality of self-control. The need of this tool becomes increasingly relevant to the susceptibility of new emerging addictions, such as mobile phones or internet.

Who benefits most from an evidence-based program to reduce anxiety and depression in children? A latent profile analysis.

Comorbidity between anxiety and depression symptoms is often high in children. Person-oriented statistical approaches are useful to detect heterogeneity of individuals and diverse patterns of response to treatment. This study aimed to explore the different profiles in a sample of Spanish children who received the Super Skills for Life (SSL) transdiagnostic program, to identify which profile of individuals benefited most from the intervention and the likelihood of transition of symptom patterns over time. Participants were 119 children (42.9% were female) aged 8-12 years old (M = 9.39; SD = 1.26). Children completed anxiety and depression measures at the baseline, postintervention, and 12-months follow-up. Results from latent transition analysis (LTA) revealed two groups depending on the severity of the anxiety and depression symptoms: low symptoms (LS) and high symptoms (HS). LS group remained stable and HS decreased by 25%, switching to the LS group. Children with greater social anxiety benefited most from the program over time. Furthermore, older children were more likely to improve rapidly one year after the intervention compared to younger children. This study provides information to consider when implementing preventive interventions for schoolchildren and to tailor them according to the target population characteristics to increase their effectiveness.

Validation of the brief version of the Spence Children's Anxiety Scale for Spanish children (SCAS-C-8).

OBJECTIVE: This study aimed to validate the self-reported brief version of the Spence Children's Anxiety Scale-Children (SCAS-C-8) in pre-adolescent Spanish children. METHOD: Participants were 824 children aged 8-12 from a community sample. The results revealed a good fit to the one-factor structure, adequate internal consistency (α = 0.75), and evidence of test-retest reliability (α = 0.77). RESULTS: The strong relationship between the SCAS-C-8 and emotional problems provided evidence of convergent validity. Also, the results showed factorial gender invariance. CONCLUSION: The SCAS-C-8 is a suitable instrument for pre-adolescent Spanish children. The brevity and simplicity of this scale may facilitate early detection and help to narrow the existent gap between the presence of anxiety problems and psychological assistance-seeking.

Corrigendum: Coping Behaviors and Psychological Disturbances in Youth Affected by the COVID-19 Health Crisis.

[This corrects the article DOI: 10.3389/fpsyg.2021.565657.].

Effects as a function of implementation fidelity of a transdiagnostic prevention program in young school-aged children.

Super Skills for Life (SSL) is a transdiagnostic prevention program for school-aged children with internalizing problems. The current study aimed to examine the short- and long-term (12-month follow-up) effectiveness of SSL, depending on implementation fidelity. Participants were 123 Spanish-speaking children aged 6-8 years with internalizing symptoms and their parents. High (n = 41) and low fidelity (n = 26) groups were established and compared with a control group (CG) (n = 56). Compared to CG, the high-fidelity group (HFG) achieved better outcomes than the low-fidelity group (LFG) at short and long term, including symptoms of anxiety, depression, and internalizing problems, and also externalizing problems at long-term. The LFG improved key symptoms at short term (depression) and long term (anxiety and depression). Findings suggest that SSL is beneficial even if not delivered at maximum fidelity, although considering the influence of implementation fidelity is critical because the high-fidelity implementation yielded the greatest effects when compared to the CG. This research provides valuable data, analyzing for the first time the influence of fidelity on SSL outcomes in young school-aged children exhibiting internalizing symptoms, while there is still a lack of studies of these characteristics concerning transdiagnostic prevention programs targeting childhood anxiety and depression.

Animal Welfare Attitudes: Effects of Gender and Diet in University Samples from 22 Countries.

Animal Welfare Attitudes (AWA) are defined as human attitudes towards the welfare of animals in different dimensions and settings. Demographic factors, such as age and gender are associated with AWA. The aim of this study was to assess gender differences among university students in a large convenience sample from twenty-two nations in AWA. A total of 7914 people participated in the study (5155 women, 2711 men, 48 diverse). Participants completed a questionnaire that collected demographic data, typical diet and responses to the Composite Respect for Animals Scale Short version (CRAS-S). In addition, we used a measure of gender empowerment from the Human Development Report. The largest variance in AWA was explained by diet, followed by country and gender. In terms of diet, 6385 participants reported to be omnivores, 296 as pescatarian, 637 ate a vegetarian diet and 434 were vegans (n = 162 without answer). Diet was related with CRAS-S scores; people with a vegan diet scored higher in AWA than omnivores. Women scored significantly higher on AWA than men. Furthermore, gender differences in AWA increased as gender inequality decreased.