ABSTRACT
OBJECTIVE: To evaluate the prevalence, trends, and factors associated with psychotropic medication use and polypharmacy among children and adolescents initiating intensive behavioral therapy for severe challenging behavior over a 10-year period. STUDY DESIGN: In this retrospective observational study, we examined data from caregiver interviews and patient medical records on the number and types of psychotropic medications prescribed to patients initiating intensive behavioral therapy between January 1, 2013, and December 31, 2022. Trends in medication use and polypharmacy across the 10-year period were analyzed using regression analysis, while differences in demographics and clinical factors for patients with use and polypharmacy were analyzed using nonparametric statistical analysis with odds ratios presented for significant factors. RESULTS: Data from all 302 pediatric patients initiating intensive behavioral therapy across the 10-year period were analyzed. Among all patients and all years, 83.8% were taking at least 1 psychotropic medication and 68.2% experienced polypharmacy. There were no changes in the prevalence of use, mean number of medications taken, or polypharmacy across the 10-year period. Patients diagnosed with attention-deficit/hyperactivity disorder or anxiety disorder, as well as those exhibiting self-injurious behavior had higher use of psychotropic medication and polypharmacy and were taking more medications overall. CONCLUSIONS: Psychotropic medication use and polypharmacy were extremely high for children and adolescents with severe challenging behavior, but use and polypharmacy did not change over the 10-year period of data collection. Further research is needed to establish the generality of these findings to other regions of the US.
Subject(s)
Behavior Therapy , Polypharmacy , Psychotropic Drugs , Humans , Female , Male , Child , Psychotropic Drugs/therapeutic use , Retrospective Studies , Adolescent , Behavior Therapy/methods , Problem Behavior , Child, Preschool , Attention Deficit Disorder with Hyperactivity/drug therapyABSTRACT
OBJECTIVES: To assess the prevalence and pattern of behavioral problems in children and adolescents with atopic dermatitis (AD) and to study their associations with clinical data and severity. METHODS: This was a single-center, cross-sectional study of patients (6-17 years) with AD. Assessment of competencies and syndrome scale scores of behavioral problems was performed by applying the Child Behavior Checklist 6-18 (CBCL 6-18) and AD severity using the Eczema Area Severity Index (EASI) score. RESULTS: Of the 100 patients with AD, 56% were male, with a mean age of 11±3 years, and 43% had moderate/severe AD. Borderline or abnormal values were found in 75% of the patients for total social competence, 57% for internalization, 27% for externalization, and 18% for aggressive behavior. A higher prevalence of aggressive behavior (27.9% vs. 10.5%; p = 0.02) and sleep disorders (32.6% vs. 15.8%; p = 0.04) was observed in patients with moderate/severe AD than in those with mild AD. Children with current or previous use of immunosuppressants/immunobiological tests had a lower frequency of normal social competence (53% vs. 83%, p = 0.012). Regarding the critical questions, 8% responded affirmatively to suicidal ideation. CONCLUSION: A high prevalence of behavioral problems was observed among children and adolescents with AD, with a predominance of internalizing profiles, mainly anxiety and depression. Children with moderate/severe AD have a higher prevalence of aggressive behaviors and sleep disorders. These findings highlight the importance of multidisciplinary teams, including mental health professionals, in caring for patients with AD.
Subject(s)
Dermatitis, Atopic , Problem Behavior , Sleep Wake Disorders , Child , Humans , Male , Adolescent , Female , Dermatitis, Atopic/epidemiology , Cross-Sectional Studies , Anxiety/epidemiology , Sleep Wake Disorders/etiology , Sleep Wake Disorders/complications , Severity of Illness IndexABSTRACT
Esta pesquisa teve como objetivo investigar as perspectivas dos psicólogos dos Centros de Referência da Assistência Social (CRAS) que compõem a equipe de Proteção e Atenção Integral à Família (PAIF) a respeito do seu trabalho no Acompanhamento Familiar oferecido para famílias com membros com transtornos mentais. Oito psicólogos que atuavam nos CRAS de um município no interior de Minas Gerais participaram do estudo. O instrumento utilizado foi um roteiro de entrevista semiestruturada, com a subsequente análise de conteúdo temática. As categorias temáticas foram analisadas à luz da literatura específica da área. De maneira geral, os resultados indicaram que os psicólogos se sentem despreparados para o exercício de sua função no CRAS, uma vez que a formação específica e continuada em Psicologia não ofereceu subsídios adequados para o conhecimento da atuação no campo da Assistência Social. A natureza (psico)terapêutica do trabalho é discutida, assim como a necessidade de formações continuadas para a atuação. Ressalta-se a necessidade de mais pesquisas que abordem a formação em Psicologia e suas relações com a Assistência Social, bem como os impactos desse despreparo na prática dos profissionais, de maneira a fomentar maior satisfação pessoal/profissional e, consequentemente, aprimorar a assistência oferecida à comunidade.(AU)
This study aims to investigate the views of psychologists who worked at Social Assistance Reference Centers (CRAS) associated with the Comprehensive Family Care Program (PAIF) on their work with the aforementioned program. Overall, eight psychologists who worked at CRAS units in small municipalities in Minas Gerais for at least one year participated in this research. The instrument used was a semi-structured interview script, and the data were analyzed under the content analysis (thematic) method. Thematic categories were analyzed based on the specific literature. Results indicate that the psychologists generally felt unprepared to work at CRAS since their degree in Psychology provided inadequate knowledge to deal with Social Assistance issues. This study discusses the (psycho)therapeutic nature of their practice and the need for ongoing training for their proper performance. This study highlights the need for further research that addresses the links between education in Psychology and Social Assistance and the impacts of said unpreparedness on the performance of those professionals. Such research might provide more professional/personal satisfaction and, in turn, improve the quality of the offered service.(AU)
Este estudio tuvo la intención de conocer las perspectivas de los psicólogos de los Centros de Referencia de Asistencia Social (CRAS) que forman parte de los equipos del Protección y Atención Integral a la Familia (PAIF) acerca del seguimiento de familias con miembros portadores de trastornos mentales. Ocho psicólogos que actuaban en los CRAS de un municipio del interior del estado de Minas Gerais (Brasil) participaron en el estudio. El instrumento utilizado fue un guion de entrevistas semiestructuradas; y, para análisis de datos, se utilizó el análisis de contenido temático. Las categorías temáticas se analizaron a la luz de la literatura específica del campo. De modo general, los resultados indicaron que los psicólogos no se sienten preparados para desempeñar la función en el CRAS, puesto que la formación en Psicología no ofreció conocimientos adecuados para actuar en el campo de la asistencia social. Se discuten la naturaleza (psico)terapéutica del trabajo y la necesidad de formación continua para esta actuación. Se destaca la necesidad de más investigaciones que tratan de la formación en Psicología y sus relaciones con la asistencia social, y los impactos de esta falta de preparo en la práctica de los profesionales, de modo a promover una satisfacción personal/profesional y, consecuentemente, optimizar la asistencia ofrecida a la comunidad.(AU)
Subject(s)
Humans , Male , Female , Psychology , Psychology, Social , Social Support , Acting Out , Anxiety , Orientation , Patient Escort Service , Pensions , Personal Satisfaction , Poverty , Prejudice , Psychomotor Agitation , Public Policy , Quality of Life , Rural Population , Self Care , Self Mutilation , Social Behavior , Social Change , Social Identification , Social Problems , Social Responsibility , Social Sciences , Social Security , Social Welfare , Social Work , Socioeconomic Factors , Suicide , Behavioral Sciences , Health Policy, Planning and Management , Adaptation, Psychological , Family , Patient Acceptance of Health Care , Child Development , Residence Characteristics , Hygiene , Mental Health , Rural Health , Occupational Health , Treatment Refusal , Health Strategies , Self-Injurious Behavior , Patient Satisfaction , Negotiating , Family Planning Policy , Health Personnel , Disabled Persons , Domestic Violence , Comprehensive Health Care , Constitution and Bylaws , Community Networks , Continuity of Patient Care , Program , Persons with Mental Disabilities , Health Management , Creativity , Crisis Intervention , Personal Autonomy , State , Delivery of Health Care , Aggression , Depression , Diagnosis , Education , Ego , Emotions , Workforce , Humanization of Assistance , User Embracement , Health Care Facilities, Manpower, and Services , Family Conflict , Family Relations , Resilience, Psychological , Protective Factors , Sociological Factors , Problem Behavior , Work Performance , Psychosocial Support Systems , Treatment Adherence and Compliance , Work Engagement , Social Construction of Ethnic Identity , Adverse Childhood Experiences , Family Separation , Leadership and Governance Capacity , Solidarity , Social Protection in Health , Health Sector Stewardship and Governance , Indigenous Peoples , Empowerment , Psychosocial Intervention , Social Inclusion , Community Support , Social Vulnerability , Belonging , Diversity, Equity, Inclusion , Psychological Well-Being , Working Conditions , Workforce Diversity , Health Policy , Health Promotion , Health Resources , Health Services Accessibility , Human Rights , Interpersonal Relations , Object AttachmentABSTRACT
El Comportamiento Sexual Inadecuado del Paciente es una conducta que viene en continuo crecimiento y afecta en gran medida a los profesionales de la salud y el deporte, por ello, el propósito de este trabajo es describir la incidencia sobre los demás aspectos psicosociales con el fin de proponer estrategias que permitan comprender técnicas y habilidades para afrontar el acoso sexual, establecer límites saludables, fomentar el respeto y lograr un equilibrio adecuado entre el trabajo y la vida personal.
Subject(s)
Problem Behavior , Sports , Humans , Incidence , Sexual BehaviorABSTRACT
This study had as general objective to characterize and associate social skills, behavior problems, and academic competence of students with intellectual disabilities in school inclusion and; as specific objectives to verify predictive values for social skills and differences between groups diagnosed with intellectual disability and other associated diagnoses. This was a quantitative, cross-sectional, descriptive, correlational, predictive, and comparative study. Forty-four students with intellectual disability participated (11 of them presented other associated diagnoses), who were evaluated by 42 guardians and 34 teachers. The instruments used were Social Skills Rating System (SSRS-BR) and the Parental Educative Social Skills Interview Script (RE-HSE-P). The evaluation from guardians and teachers were different. Social skills were negatively associated with behavior problems and positively associated with academic competence; behavior problems and diagnosis were negative predictors to social skills. There were significant differences in the groups. The results highlight the importance of intervention programs to develop social skills.(AU)
O estudo teve como objetivo geral caracterizar e associar habilidades sociais, problemas de comportamento e competência acadêmica de alunos com deficiência intelectual em inclusão educacional e; como objetivos específicos verificar valores preditivos para habilidades sociais e diferenças entre grupos com diagnóstico de deficiência intelectual somente e com outros diagnósticos associados. Trata-se de um estudo quantitativo, transversal, descritivo, correlacional, preditivo e comparativo. Participaram 44 alunos com deficiência (11 apresentavam outros diagnósticos associados), que foram avaliados por 42 responsáveis e 34 professoras. Os instrumentos utilizados foram Social Skills Rating System (SSRS-BR) e Roteiro de Entrevista de Habilidades Sociais Educativas Parentais (RE-HSE-P). A avaliação de responsáveis e professores foi diferente. Habilidades sociais foram negativamente associadas aos problemas de comportamento e positivamente associadas a competência acadêmica; problemas de comportamento e diagnósticos associados foram preditores negativos de habilidades sociais. Houve diferença significativa entre grupos. Resultados evidenciam a importância de programas para promoção de habilidades sociais.(AU)
Este estudio tuvo como objetivo general caracterizar y asociar las habilidades sociales, los problemas de conducta y la competencia académica de estudiantes con discapacidad intelectual en la inclusión escolar; y como objetivos específicos verificar los valores predictivos de las habilidades sociales y las diferencias entre grupos diagnosticados con discapacidad intelectual y otros diagnósticos asociados. Se trató de un estudio cuantitativo, transversal, descriptivo, correlacional, predictivo y comparativo. Participaron 44 estudiantes con discapacidad intelectual (11 de ellos presentaban otros diagnósticos asociados), quienes fueron evaluados por 42 tutores y 34 docentes. Los instrumentos utilizados fueron el Sistema de Evaluación de Habilidades Sociales (SSRS-BR) y el Guion de Entrevista de Habilidades Sociales para Educación de los Padres (RE-HSE-P). Las evaluaciones de los tutores y docentes fueron diferentes. Las habilidades sociales se asociaron negativamente con problemas de conducta y positivamente con la competencia académica; los problemas de conducta y el diagnóstico fueron predictores negativos de las habilidades sociales. Hubo diferencias significativas entre los grupos. Los resultados destacan la importancia de los programas de intervención para desarrollar habilidades sociales con la población estudiada.(AU)
Subject(s)
Humans , Male , Female , Child , Adult , Social Skills , Problem Behavior/psychology , Academic Performance/psychology , Intellectual Disability/psychology , Mainstreaming, Education , Cross-Sectional Studies , Interviews as Topic , Predictive Value of Tests , Data Interpretation, Statistical , Correlation of Data , Sociodemographic FactorsABSTRACT
Punishing, minimizing, ignoring, or becoming distressed when dealing with children's negative emotions may favor the emergence or worsen behavior problems during childhood. This study examined the effects of the intervention program Vivendo Emoções [Experiencing Emotions] on maternal reactions to children's emotions and children's internalizing and externalizing problems. Thirty-two mothers of children aged between three and eight participated and were assigned to an intervention (n = 16) or a comparison (n = 16) group. The intervention was implemented in eight sessions intended to promote the mothers' strategies to identify and regulate their children's negative emotions and enable the children to improve emotional competence. The mothers completed the CCNES to report their reactions to children's emotional expressions and the CBCL to report internalizing and externalizing problems on pretest and posttest. The results reveal that mothers in the intervention group reported fewer unsupportive reactions on posttest than mothers in the comparison group. This finding shows the potential of such interventions to decrease unsupportive maternal reactions. Additionally, children in the intervention group presented more frequent somatic complaints than those in the comparison group on posttest. A potential explanation is that the mothers were more prepared to encourage their children to report negative emotions associated with bodily sensations.
Castigar, minimizar, ignorar o manifestar malestar ante la expresión de emociones negativas de los niños puede favorecer la aparición o el empeoramiento de problemas de comportamiento en la infancia. Este estudio examinó los efectos del programa de intervención Viviendo Emociones, focado en la socialización emocional de los niños, en las reacciones maternas a las emociones y en los problemas internalizantes y externalizantes de los niños. Participaron 32 madres de niños entre tres y ocho años, divididas en los grupos intervención (n = 16) y comparación (n = 16). El Viviendo Emociones se realizó en ocho sesiones y busca promover estrategias para identificar y regular las emociones negativas expresadas por los niños para que ellos amplíen su competencia emocional. En el pre-test y post-test, las madres respondieron el CCNES para reportar sus reacciones ante las expresiones emocionales de sus hijos y el CBCL para reportar problemas internalizantes y externalizantes. Los resultados revelaron que las madres en el grupo de intervención reportaron menos reacciones de no apoyo que las madres en el grupo comparación en el post-test. Ese hallazgo resalta el potencial de intervenciones de esta naturaleza para reducir las reacciones maternas de no apoyo. Adicionalmente, los niños del grupo intervención presentaron más quejas somáticas que los niños del grupo comparación en el post-test. Una explicación potencial es que las madres estaban más preparadas para alentar a los niños a reportar emociones negativas asociadas a sensaciones corporales.
Punir, minimizar, ignorar ou manifestar desconforto diante da expressão de emoções negativas dos filhos pode favorecer o surgimento ou agravamento dos problemas de comportamento na infância. Este estudo examinou os efeitos do programa de intervenção, Vivendo Emoções, com foco na socialização emocional infantil, sobre as reações maternas às emoções dos filhos e os problemas internalizantes e externalizantes das crianças. Participaram 32 mães de crianças entre três e oito anos, divididas em grupo intervenção (n = 16) e comparação (n = 16). O Vivendo Emoções foi realizado em oito sessões e busca promover estratégias para identificação e regulação das emoções negativas expressas pelos filhos de forma que a criança amplie sua competência emocional. No pré-teste e no pós-teste, as mães responderam a CCNES para informar suas reações às expressões emocionais nos filhos e o CBCL para relatar problemas internalizantes e externalizantes. Os resultados revelaram que as mães do grupo intervenção relataram menos reações não apoiadoras do que as mães do grupo comparação no pós-teste. Esse achado evidencia o potencial de intervenções dessa natureza para reduzir reações maternas não apoiadoras. Adicionalmente, as crianças do grupo intervenção apresentaram mais queixas somáticas do que as crianças do grupo comparação no pós-teste. Uma explicação potencial é que as mães estivessem mais preparadas para encorajar as crianças a relatar emoções negativas associadas a sensações corporais.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Socialization , Child Behavior/psychology , Emotions/physiology , Problem Behavior/psychology , Mothers/psychology , Parent-Child Relations , Psychotherapy/methods , Checklist , Sociodemographic Factors , Maternal Behavior/physiologyABSTRACT
Research has demonstrated a negative association between social support and symptoms of posttraumatic stress disorder (PTSD). This has been interpreted as a protective influence of social support against the development of posttraumatic stress symptoms (PTSS). Research on the opposite association is more limited, but findings suggest that PTSS have a negative impact on social support. There is conflicting evidence that these effects are moderated by gender. Few studies have assessed both associations and gender moderation in a postdisaster context. We examined the longitudinal and bidirectional effects of emotional support and PTSS and whether gender moderates these effects among U.S. survivors of the 2017-2018 season. Participants (N = 1,347) were assessed at four time points over 1 year. Bidirectional effects were assessed using cross-lagged, autoregressive analyses with the combined sample (Model 1) and grouped by gender (Model 2) to assess gender moderation. The results supported small bidirectional negative effects of social support and PTSS on one another from one assessment point (e.g. Wave 1) to the subsequent point (e.g., Wave 2) for all waves, ßs = -.07-.15, p < .001-p = .040. Multigroup analyses suggested the effects were not significantly different by gender. Overall, the results suggest that social support and PTSS may mutually diminish one another. Such effects may result in a positive or negative cascade wherein high PTSS may lead to lower social support and, therefore, even higher PTSS and vice versa. These findings support the importance of including social support in interventions to promote PTSS prevention and recovery.
Subject(s)
Disasters , Problem Behavior , Stress Disorders, Post-Traumatic , Male , Humans , Female , Stress Disorders, Post-Traumatic/psychology , Social Support , Survivors/psychologyABSTRACT
Este artigo pretende verificar a quantidade de pesquisas publicadas no mundo nos últimos cinco anos e sua predição para com o comportamento humano. Foram encontrados 75 artigos nas bases de dados Scielo, Medline e Lilacs, a través de uma busca utilizando descritores em português e na língua inglesa no Portal Periódicos.capes. Os resultados apontaramque os estudos encontrados tiveram relação aos transtornos da personalidade, referindode forma direta a comportamentos relacionados aos esquemas desadaptativos como preditores dos transtornos da personalidade. Outros temas considerados foram o suicídio, o divórcio, a violência conjugal, patologias orgânicas e/ou dor crônica, a parentalidade,comportamentos erráticos, saúde e validação de escalas. Conclui-se que esta revisão tem sua importância na análise criteriosa dos estudos sobre os EIDs e sua relação com a personalidade, já que a teoria cognitiva traz a priori que os comportamentos disfuncionais estão relacionados com os Esquemas Iniciais Desadaptativos AU
Este artículo tiene como objetivo verificar la cantidad de investigaciones publicadas en el mundo en los últimos cinco años y su predicción para el comportamiento humano. Se encontraron un total de 75 artículos en las bases de datos Scielo, Medline y Lilacs, a través de una búsqueda con descriptores en portugués e inglés en el Portal Periódicos.capes. Los resultados mostraron que los estudios encontrados estaban relacionados con los trastornos de personalidad, refiriéndose directamente a conductas relacionadas con esquemas desadaptativos como predictores de trastornos de personalidad. Otros temas considerados fueron suicidio, divorcio, violencia conyugal, patologías orgánicas y/o dolor crónico, crianza, comportamiento errático, salud y validación de escalas. Se concluye que esta revisión es importante en el análisis cuidadoso de los estudios sobre las EID y su relación con la personalidad, ya que la teoría cognitiva muestra a priori que las conductas disfuncionales están relacionadas con los Esquemas Desadaptativos Iniciales AU
This article aims to verify the amount of research published in the world in the last five years and its prediction for human behavior. A total of 75 articles were found in the Scielo, Medline and Lilacs databases, through a search using descriptors in Portuguese and English on the Portal Periódicos.capes. The results showed that the studies found were related topersonality disorders, referring directly to behaviors related to maladaptive schemas as predictors of personality disorders. Other topics considered were suicide, divorce, marital violence, organic pathologies and/or chronic pain, parenting, erratic behavior, health and validation of scales. It is concluded that this review is important in the careful analysis of studies on EIDs and their relationship with personality, since the cognitive theory shows a priori that dysfunctional behaviors arerelated to Initial Maladaptive Schemas AU
Subject(s)
Humans , Male , Female , Personality Disorders/psychology , Suicide , Adjustment Disorders/psychology , Problem Behavior/psychology , Cognitive Behavioral Therapy , Adverse Childhood ExperiencesABSTRACT
OBJECTIVES: To predict behavioral disruptions in middle childhood, we identified latent classes of prenatal substance use. STUDY DESIGN: As part of the Environmental influences on Child Health Outcomes Program, we harmonized prenatal substance use data and child behavior outcomes from 2195 women and their 6- to 11-year-old children across 10 cohorts in the US and used latent class-adjusted regression models to predict parent-rated child behavior. RESULTS: Three latent classes fit the data: low use (90.5%; n = 1986), primarily using no substances; licit use (6.6%; n = 145), mainly using nicotine with a moderate likelihood of using alcohol and marijuana; and illicit use (2.9%; n = 64), predominantly using illicit substances along with a moderate likelihood of using licit substances. Children exposed to primarily licit substances in utero had greater levels of externalizing behavior than children exposed to low or no substances (P = .001, d = .64). Children exposed to illicit substances in utero showed small but significant elevations in internalizing behavior than children exposed to low or no substances (P < .001, d = .16). CONCLUSIONS: The differences in prenatal polysubstance use may increase risk for specific childhood problem behaviors; however, child outcomes appeared comparably adverse for both licit and illicit polysubstance exposure. We highlight the need for similar multicohort, large-scale studies to examine childhood outcomes based on prenatal substance use profiles.
Subject(s)
Child Behavior Disorders , Prenatal Exposure Delayed Effects , Problem Behavior , Substance-Related Disorders , Pregnancy , Humans , Child , Female , Latent Class Analysis , Substance-Related Disorders/epidemiology , Child Behavior , Child Behavior Disorders/epidemiology , Child Behavior Disorders/etiology , Prenatal Exposure Delayed Effects/epidemiologyABSTRACT
AIMS: Previous epidemiological evidence identified a concerning increase in behavioural problems among young children from 1997 to 2008 in Brazil. However, it is unclear whether behavioural problems have continued to increase, if secular changes vary between sociodemographic groups and what might explain changes over time. We aimed to monitor changes in child behavioural problems over a 22-year period from 1997 to 2019, examine changing social inequalities and explore potential explanations for recent changes in behavioural problems between 2008 and 2019. METHODS: The Child Behaviour Checklist was used to compare parent-reported behavioural problems in 4-year-old children across three Brazilian birth cohorts assessed in 1997 (1993 cohort, n = 633), 2008 (2004 cohort, n = 3750) and 2019 (2015 cohort, n = 577). Response rates across all three population-based cohorts were over 90%. Moderation analyses tested if cross-cohort changes differed by social inequalities (demographic and socioeconomic position), while explanatory models explored whether changes in hypothesized risk and protective factors in prenatal development (e.g., smoking during pregnancy) and family life (e.g., maternal depression and harsh parenting) accounted for changes in child behavioural problems from 2008 to 2019. RESULTS: Initial increases in child behavioural problems from 1997 to 2008 were followed by declines in conduct problems (mean change = -2.75; 95% confidence interval [CI]: -3.56, -1.94; P < 0.001), aggression (mean change = -1.84; 95% CI: -2.51, -1.17; P < 0.001) and rule-breaking behaviour (mean change = -0.91; 95% CI: -1.13, -0.69 P < 0.001) from 2008 to 2019. Sex differences in rule-breaking behaviour diminished during this 22-year period, whereas socioeconomic inequalities in behavioural problems emerged in 2008 and then remained relatively stable. Consequently, children from poorer and less educated families had higher behavioural problems, compared to more socially advantaged children, in the two more recent cohorts. Changes in measured risk and protective factors partly explained the reduction in behavioural problems from 2008 to 2019. CONCLUSIONS: Following a rise in child behavioural problems, there was a subsequent reduction in behavioural problems from 2008 to 2019. However, social inequalities increased and remained high. Continued monitoring of behavioural problems by subgroups is critical for closing the gap between socially advantaged and disadvantaged children and achieving health equity for the next generation.
Subject(s)
Problem Behavior , Pregnancy , Humans , Male , Female , Child, Preschool , Brazil/epidemiology , Cohort Studies , Socioeconomic Factors , ParentingABSTRACT
Using models of risk and resilience as a guide, this study examined the mediating role of constructive conflict behaviors on the associations between maternal depressive symptoms, intimate partner violence (IPV), and child behavior problems. The nature of the mediation pathways was also examined for two groups of families, one experiencing high and another experiencing low levels of partner social support. Participants included 196 mothers and their preschool-aged children from diverse ethnic and socioeconomic backgrounds in Guyana. Constructive conflict behaviors partially mediated the link between maternal depressive symptoms and children's externalizing behaviors. Maternal depressive symptoms and physical intimate partner violence were directly related to children's internalizing behaviors. Constructive conflict behaviors were not a mediator of the association between risk factors and children's behavioral outcomes for families experiencing high or low levels of partner social support. In the context of families experiencing high partner social support, constructive conflict behaviors appeared to be more effective in reducing children's externalizing problem behaviors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Subject(s)
Intimate Partner Violence , Problem Behavior , Child, Preschool , Female , Humans , Child , Guyana , Depression , MothersABSTRACT
OBJECTIVE: The current study assesses whether the association between diagnosis of Bipolar Disorder (BD) in mothers and emotional and behavioral problems (EBP) in their offspring is mediated by a disruption in the offspring's biological rhythms. METHODS: A probabilistic sample of 492 public school children (ages 7-8, 48 % female) were assessed for biological rhythms disruption and EBP using the Biological Rhythms Interview for Assessment in Neuropsychiatry for Kids and the Strengths and Difficulties Questionnaire, respectively. Mothers' mental health (BD = 64) was evaluated using a standardized clinical interview. A mediation analysis was conducted to assess the effect of the mother's diagnosis of BD on the EBP of their offspring in relation to the offspring's biological rhythms disruptions. RESULTS: When compared to offspring of mothers without BD, offspring of mothers with BD showed greater difficulty in maintaining biological rhythms and higher prevalence of EBP. Using the presence of EBP as the outcome, 75 % of the effect of mother's BD diagnosis was mediated by offspring's biological rhythms disruption. CONCLUSIONS: Biological rhythms disruption in children fully mediates the effect of the mother's diagnosis of BD on the child's EBP. These data encourage the development of further studies to find effective strategies to prevent and treat biological rhythms disruption in offspring of mothers with BD.
Subject(s)
Bipolar Disorder , Problem Behavior , Child , Humans , Female , Male , Mothers , Emotions , PeriodicityABSTRACT
BACKGROUND: Chlordecone is a highly persistent organochlorine insecticide that was intensively used in banana fields in the French West Indies, resulting in a widespread contamination. Neurotoxicity of acute exposures in adults is well recognized, and empirical data suggests that prenatal exposure affects visual and fine motor developments during infancy and childhood, with greater susceptibility in boys. OBJECTIVE: To assess the associations between pre- and postnatal exposures to chlordecone and cognitive and behavioral functions in school-aged children from Guadeloupe. METHODS: We examined 576 children from the TIMOUN mother-child cohort in Guadeloupe at 7 years of age. Concentrations of chlordecone and other environmental contaminants were measured in cord- and children's blood at age 7 years. Cognitive abilities of children were assessed with the Wechsler Intelligence Scale for Children-IV (WISC-IV), and externalizing and internalizing problem behaviors documented with the Strengths and Difficulties Questionnaire (SDQ) completed by the child's mother. We estimated covariate-adjusted associations between cord- and 7-years chlordecone concentrations and child outcomes using structural equations modeling, and tested effect modification by sex. RESULTS: Geometric means of blood chlordecone concentrations were 0.13 µg/L in cord blood and 0.06 µg/L in children's blood at age 7 years. A twofold increase in cord blood concentrations was associated with 0.05 standard deviation (SD) (95% Confidence Interval [CI]: 0.0, 0.10) higher internalizing problem scores, whereas 7-years chlordecone concentrations were associated with lower Full-Scale IQ scores (FSIQ) and greater externalized behavioral problem scores. A twofold increase in 7-year chlordecone concentrations was associated with a decrease of 0.67 point (95% CI: -1.13, -0.22) on FSIQ and an increase of 0.04 SD (95% CI: 0.0, 0.07) on externalizing problems. These associations with Cognitive abilities were driven by decreases in perceptive reasoning, working memory and verbal comprehension. Associations between 7-year exposure and perceptive reasoning, working memory, and the FSIQ were stronger in boys, whereas cord blood and child blood associations with internalizing problems were stronger in girls. CONCLUSIONS: These results suggests that cognitive abilities and externalizing behavior problems at school age are impaired by childhood, but not in utero, exposure to chlordecone, and that prenatal exposure is related to greater internalizing behavioral problems.
Subject(s)
Chlordecone , Prenatal Exposure Delayed Effects , Problem Behavior , Child , Adult , Male , Pregnancy , Female , Humans , Chlordecone/analysis , Chlordecone/toxicity , Guadeloupe/epidemiology , Prenatal Exposure Delayed Effects/chemically induced , Prenatal Exposure Delayed Effects/epidemiology , Cognition , Mother-Child RelationsABSTRACT
BACKGROUND: Externalizing problems are commonly associated with alcohol outcomes in adolescence. Nevertheless, findings regarding internalizing problems are mixed, and fewer longitudinal studies have considered the both problems concomitantly and the role of gender. We examined the role of externalizing and internalizing problems in predicting adolescent alcohol-related harm and binge drinking, taking into account the gender differences. We also evaluated if externalizing problems could moderate the association between internalizing problems and alcohol outcomes. METHOD: We used longitudinal data from 2368 8th grade students across 37 public schools in three Brazilian cities. Linear and logistic regressions were performed to analyze the association between alcohol outcomes and the independent variables (externalization and internalization scores, and sociodemographic variables) according to gender. We also tested the same model with an interaction term between externalizing*internalizing. RESULTS: Our results suggest that externalizing problems predict adolescents' binge drinking in both genders; it also may predict adolescents' alcohol-related harms, but only in boys. Internalizing problems seem to be a gender-specific risk factor for binge drinking among girls. All findings are independent of comorbid problems and sociodemographic variables. LIMITATION: The findings should be considered taking into account the short follow-up period from risk factors to the outcomes. CONCLUSION: Our results highlight the contribution of internalizing and externalizing problems to the development of alcohol-related harm and binge drinking in early adolescence and the need for interventions to prevent early behavioral problems that consider the role played by gender.
Subject(s)
Binge Drinking , Problem Behavior , Humans , Male , Adolescent , Female , Risk Factors , Longitudinal Studies , Sex FactorsABSTRACT
Executive functions allow the regulation of behavior and emotions. This study aimed to analyze the association of executive functions with externalizing and internalizing behaviors in 30 Mexican preschoolers with typical development (age M = 53.63 months; SD = 7.83 months; 40% girls) from homes of middle-low socioeconomic status. Behavioral and cognitive measures were used to assess executive functions and analyzed them using robust statistical methods. We found that executive functions are related to externalizing and internalizing behaviors at the behavioral level. Only Forward Digit Span predicts attentional problems. Individual differences in children's cognitive development in a Mexican context were adressed, and they have clinical and educational implications.
Subject(s)
Executive Function , Problem Behavior , Child , Female , Humans , Child, Preschool , Male , Emotions , Problem Behavior/psychologyABSTRACT
The aim of the present longitudinal study was to examine the effect of preterm childbirth, acute neonatal stress, and child behavior at 18-36 months of age on later behavior outcomes in 4-5-year-old children. The sample comprised of 70 children who were born preterm. The neonatal characteristics of children were assessed during hospitalization by reviewing their medical records and utilizing the Neonatal Infant Stressor Scale. Behavior problems were evaluated by the maternal-report in the Child Behavior Checklist 1½-5 years. A multiple linear regression analysis was conducted. Also, the repeated measures analysis of variance and the McNemar test for paired samples were performed. Daily exposure of the infants to high neonatal acute stress during NICU hospitalization and more behavior problems at 18-36 months of age was associated with more total and externalizing behavior problems at 4-5 years of age. Lower gestational age at childbirth and more internalizing behavior problems at 18-36 months was associated with more internalizing problems at 4-5 years old. The present study showed the combination of predictors of neonatal conditions and behavioral problems at childhood, highlighting the relevance of the implementation of developmental care in the NICU and follow-up the preterm infants after discharge programs.
Subject(s)
Infant, Premature , Problem Behavior , Infant , Female , Child , Infant, Newborn , Humans , Child, Preschool , Longitudinal Studies , Child Behavior , Patient DischargeABSTRACT
The causal link between variants in the SCAF4 gene and a syndromic form of intellectual disability (ID) was established in 2020 by Fliedner et al. Since then, no additional cases have been reported. We performed exome sequencing in a 16-year-old Brazilian male presenting with ID, epilepsy, behavioral problems, speech impairment, facial dysmorphisms, heart malformations, and obesity. A de novo pathogenic variant [SCAF4(NM_020706.2):c.374_375dup(p.Glu126LeufsTer20)] was identified. This is the second study reporting the involvement of SCAF4 in syndromic ID, and the description of the patient's clinical features contributes to defining the phenotypic spectrum of this recently described Mendelian disorder.
Subject(s)
Epilepsy , Intellectual Disability , Problem Behavior , Humans , Male , Adolescent , Intellectual Disability/diagnosis , Intellectual Disability/genetics , Intellectual Disability/pathology , Epilepsy/genetics , Exome Sequencing , Syndrome , Phenotype , Serine-Arginine Splicing Factors/geneticsABSTRACT
Pouco se sabe sobre a atuação do psicólogo no Brasil junto a pessoas com Diabetes Mellitus. O objetivo desta pesquisa foi identificar os psicólogos brasileiros que trabalham com essa população e suas ações. Foram convidados a responder a um questionário online psicólogos que atuam ou atuaram junto a pessoas com diabetes. Participaram 79 psicólogos, principalmente da região Sudeste (59,5%). Todos declararam que haviam cursado pósgraduação. Na amostra, predominou o gênero feminino (89,9%), com idade entre 26 e 40 anos (46,8%). A maioria dos que atuam com diabetes declarou-se autônoma ou voluntária, e quase metade trabalhava menos do que 10 horas semanais. Entre aqueles que deixaram de trabalhar com diabetes, apenas uma minoria tinha vínculo empregatício. Além do trabalho com pessoas com diabetes, a maior parte declarou exercer outras atividades profissionais, como atendimentos clínicos em consultórios particulares, sugerindo que esta não é a atividade principal. Majoritariamente, os respondentes declararam não ter conhecimentos suficientes para o atendimento específico às pessoas com diabetes. Discute-se a qualidade da formação profissional dos psicólogos no Brasil, a necessidade de aprimoramento em relação à atuação com pessoas com diabetes e as condições de trabalho.(AU)
Little is known about the practice of psychologists in Brazil caring for people with Diabetes Mellitus. The aim of this research was to identify the Brazilian psychologists who work with this population and describe their actions. Psychologists who work or have worked with people diagnosed with diabetes were invited to answer an online questionnaire. The 79 participants lived mainly in the Southeast Region (59.5%). All of them declared to have a graduate degree, most were female (89.9%), aged 26 to 40 years (46.8%). Most of those working with diabetes declared to be autonomous or voluntary, and almost half had a workload of less than 10 hours a week. Among those who stopped working with diabetes, only a minority had a formal employment contract. In addition, most of them stated that they had other professional activities related to clinical care in private offices, suggesting that working with diabetes is not their main activity. Mostly, respondents stated that they did not have enough knowledge to care for people with diabetes. The quality of professional education of psychologists in Brazil, the need for specific improvement in labor relations and conditions were discussed.(AU)
Son escasas las informaciones del trabajo de los psicólogos en Brasil con las personas con Diabetes Mellitus. El objetivo de este estudio fue identificar los psicólogos brasileños que trabajan con esta población y describir sus acciones. Se invitó a psicólogos que trabajan o hayan trabajado con personas con diabetes a responder un cuestionario en línea. Participaron 79 psicólogos, principalmente de la región Sureste de Brasil (59,5%). Todos declararon tener posgrado. En la muestra hubo una mayor prevalencia del género femenino (89,9%), de edades de entre 26 y 40 años (46,8%). La mayoría de los que trabajan con personas con diabetes se declararon autónomos o voluntarios, y casi la mitad trabajaba menos de 10 horas a la semana. Entre los que dejaron de trabajar con las personas con diabetes, solo una minoría tenía una relación laboral. Además de trabajar con personas con diabetes, la mayoría afirmó tener otras actividades profesionales, como la atención clínica en consultorios privados, lo que sugiere que esta no es su actividad principal. La mayoría de los encuestados afirmaron que no tenían los conocimientos suficientes para atender específicamente a las personas con diabetes. Se discuten la calidad de la formación profesional de los psicólogos en Brasil, la necesidad de mejora en relación con el trabajo con personas con diabetes y las condiciones laborales.(AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Psychology , Acting Out , Diabetes Mellitus , Professional Training , Anxiety , Pain , Patient Care Team , Primary Health Care , Public Policy , Quality of Life , Research Personnel , Self Care , Self-Care Units , Self Concept , Social Sciences , Autoimmune Diseases , Specialization , Stress, Psychological , Therapeutics , Transplantation , Volunteers , Wound Healing , Behavior , Body Composition , Adaptation, Psychological , Pharmaceutical Preparations , Exercise , Weight Loss , Family , Patient Acceptance of Health Care , Blindness , Cholesterol , Mental Health , Disease Outbreaks , Episode of Care , Diabetic Ketoacidosis , Cost of Illness , Continuity of Patient Care , Counseling , Universal Access to Health Care Services , Crisis Intervention , Health Law , Death , Diabetes Complications , Depression , Diabetes Mellitus, Type 1 , Diabetes Mellitus, Type 2 , Diabetic Angiopathies , Diagnosis , Dialysis , Emergencies , Disease Prevention , Bariatric Surgery , Fear , Binge-Eating Disorder , Epidemics , Chronic Pain , Insulins , Cognitive Dysfunction , Problem Behavior , Diet, Healthy , Global Burden of Disease , Treatment Adherence and Compliance , Access to Essential Medicines and Health Technologies , Burnout, Psychological , Self-Neglect , Sadness , Diabulimia , Psychological Distress , Transtheoretical Model , Psychosocial Intervention , Glycemic Control , Sociodemographic Factors , Psychological Well-Being , Food, Processed , Health Promotion , Health Services Accessibility , Amputation, Surgical , Hospitalization , Hyperglycemia , Hypoglycemia , Kidney Failure, Chronic , Life Style , Mental Disorders , Metabolism , Nutritional and Metabolic Diseases , ObesityABSTRACT
A Comissão Consultiva em Avaliação Psicológica (CCAP), atrelada ao Sistema de Avaliação de Testes Psicológicos (SATEPSI) do Conselho Federal de Psicologia (CFP), tem como objetivos emitir pareceres acerca de solicitações advindas da avaliação psicológica(AP), elaborar e propor atualizações de documentos técnicos e normativos do CFP relativos à AP, elaborar e propor diretrizes para o ensino e formação continuada em AP, conduzir o processo de avaliação dos instrumentos submetidos ao SATEPSI e discutir temas e propor ações no âmbito da AP. Nos últimos 20 anos, a CCAP vem buscando atender a esses objetivos, indicando novos caminhos para a área. Nesse sentido, este artigo tem como objetivo apresentar as principais atualidades e movimentos da CCAP, indicando caminhos possíveis e perspectivas futuras para a área de AP. São discutidas as ações atuais que vêm sendo desenvolvidas pela CCAP, bem como as ações futuras delineadas que buscam promover uma AP cada vez mais democrática. Concluímos que a AP é uma prática do(a) psicólogo(a) que deve ser operacionalizada com compromisso ético, atrelada aos direitos humanos e à justiça, com embasamento científico e alinhada às mudanças sociais.(AU)
The Consultative Commission on Psychological Assessment (CCAP), affiliated with the Psychological Test Evaluation System under the Federal Council of Psychology (CFP), has the following objectives: to provide expert opinions on requests stemming from psychological assessments (PA), to draft and propose updates to the CFP technical and normative documents pertaining to PA, to formulate and recommend guidelines for education and ongoing professional development in PA, to oversee the evaluation process of instruments submitted to SATEPSI, and to engage in discussions and propose initiatives within the PA. Over the past two decades, CCAP has diligently worked to achieve these goals, charting new avenues in the field. In this context, this study aims to describe the most current developments and initiatives of CCAP and outline prospective directions and future outlooks for the PA. This study delves into the current initiatives undertaken by CCAP and the prospective actions delineated to foster a progressively more inclusive PA. Thus, we claim that PA is a practice inherent to psychologists that demands ethical commitment, alignment with human rights and justice, a solid scientific foundation, and adaptation to evolving social dynamics.(AU)
La Comisión Consultiva en Evaluación Psicológica (CCAP), vinculada al Sistema de Evaluación de Pruebas Psicológicas (SATEPSI) del Consejo Federal de Psicología (CFP), tiene como objetivo emitir opinión técnica sobre solicitudes derivadas de la evaluación psicológica (EP), elaborar y proponer actualizaciones de documentos técnicos y normativos del CFP relacionados con EP, desarrollar y proponer lineamientos para la enseñanza y la formación continua en EP, conducir el proceso de evaluación de los instrumentos presentados al SATEPSI y discutir temas y proponer acciones en el ámbito de EP. Durante los últimos veinte años, la CCAP ha buscado alcanzar estos objetivos indicando nuevos caminos para el área. En este sentido, este artículo tiene como objetivo presentar las principales actualidades y movimientos de la CCAP indicando posibles caminos y perspectivas de futuro para el área de EP. Se discuten las acciones actuales que ha desarrollado la CCAP, así como las acciones futuras perfiladas que buscan promover una EP cada vez más democrática. Se concluye que la EP es una práctica del psicólogo que debe ponerse en práctica con compromiso ético, vinculada a los derechos humanos y la justicia, con base científica y alineada con los cambios sociales.(AU)