Children with Autism Spectrum Disorder in Times of COVID-19: Examining Emotional and Behavioral Problems, Parental Well-Being, and Resilience.

This longitudinal study assessed the impact of the COVID-19 pandemic on children with autism spectrum disorder (ASD; n = 62; Mage = 13 years) by measuring emotional and behavioral problems before and during the pandemic, and by comparing this change to a matched sample of children without ASD (n = 213; Mage = 16 years). Moreover, we examined whether indicators of parental well-being promoted resilience of children with ASD. Results showed that the mean change in problems did not differ between children with and without ASD. Importantly, some children showed an increase in problems, while others showed resilience. Parental well-being indicators were not related to resilience among children with ASD. The interindividual variability in responses, particularly among children with ASD, highlights the need for personalized support.

Associations of parents' use of food as reward with children's eating behaviour and BMI in a population-based cohort.

BACKGROUND: Parents' use of food as reward has been linked to children's dietary intake, but the association with children's eating behaviour and overweight risk is less clear. OBJECTIVES: To examine the temporal association of using food as reward with eating behaviour, body mass index (BMI) and weight status of children. METHODS: Participants were 3642 children of the population-based Generation R Study in the Netherlands (8.3% overweight/obese). Repeated assessments were collected at child ages 4 and 9 years, including measured anthropometrics and parent reports on feeding practises and eating behaviour. RESULTS: Linear regressions and cross-lagged models indicated that parents' use of food as reward at child age 4 years predicted Emotional Overeating and Picky Eating at age 9 years. Reversely, higher Emotional Overeating and Food Responsiveness scores were associated with more use of food as reward over time. Using food as reward was not associated with children's satiety response, BMI or overweight risk. CONCLUSIONS: A vicious cycle may appear in which children who display food approach behaviour are rewarded with food by their parents, which in turn might contribute to the development of unhealthy eating habits (emotional eating, fussiness). These findings warrant further research, to facilitate evidence-based recommendations for parents.

Development of regulation disorders into specific psychopathology.

Underlying deficits in self-regulation and sensory processing are seen in children with regulation disorders (RD) and might lead to emotional and behavioral problems as the child develops. However, little is known about the specific developmental course of RD. This follow-up study was conducted to investigate the development of a clinical sample of RD children, diagnosed by means of the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Revised (DC:0-3R; ZERO TO THREE, 1994), toward specific psychopathology 4 to 10 years later based on parent- and teacher-reports on the Child Behavior Checklist (T.M. Achenbach & L.A. Rescorla, 2007). Parental reports showed that 39 to 69% of children with RD had internalizing, externalizing, and total problems above borderline cutoffs, as compared to norm group data (16%). In addition, higher rates of affective, anxiety, attention deficit/hyperactivity, oppositional defiant, and conduct problems were reported. Analyses between RD subtypes showed significant differences on future attention problems and rule-breaking behavior, wherein less favorable results were found for the Hypersensitive subtype Type A (fearful/cautious) in comparison to the sensory stimulation-seeking/impulsive subtype. The current results indicate persistence of emotional and behavioral problems into middle childhood and adolescence in children with preschool RD diagnoses. More attention should be paid to differentiation of psychopathology in these children since developmental outcomes may differ between RD subtypes.

Current subjective state of health, and longitudinal psychological well-being over a period of 10 years, in a cohort of adults with congenital cardiac disease.

OBJECTIVE: To examine the current subjective state of health, and the longitudinal course of psychological well-being, in adult patients with congenital cardiac malformations. METHODS: Our study concerns the second follow-up of a cohort of patients with congenital cardiac malformations. We examined 362 consecutive patients, aged from 20 to 46 years, who underwent surgical procedures for treatment of congenital cardiac disease between 1968 and 1980, specifically for treatment of atrial and ventricular septal defects, tetralogy of Fallot, transposition, and pulmonary stenosis. The patients were submitted to extensive medical and psychological examination. During psychological examination, in which all patients were seen by the same psychologist (EvR), patients filled in questionnaires concerning their current subjective state of health, using the 36-item Short Form Health Survey (SF-36), and psychological well-being, answering the Heart Patients Psychological Questionnaire. The data we acquired at their first follow-up was used to measure the longitudinal course of psychological well-being over the intervening period of 10 years. RESULTS: When compared to a reference group, the patients assessed their state of health less favourably concerning physical functioning, but more favourable with regard to social functioning, bodily pain, and limitations of role due to emotional problems. Younger female patients reported more limitations of role due to physical functioning than did the female patients who were older. Patients with transposition showed a negative trend for their subjective state of health, but reported the least bodily pain. Within the overall group of patients, displeasure had increased, while social inhibition had decreased, over the intervening period of 10 years. CONCLUSION: Extra attention should be paid to the subjective experiences of young female patients with congenital cardiac disease. The patients with transposed arterial trunks seem overall to experience poorer physical health.

Longitudinal development of psychopathology in an adult congenital heart disease cohort.

BACKGROUND: Little is known about the development of psychopathology in patients with congenital heart disease (ConHD) from adolescence into adulthood. In this study, the course of psychopathology in a cohort of ConHD adults, who received their first heart surgery in childhood, was determined longitudinally over a 10-year-period. METHODS: At both the first (1989-1991) and second (2000-2001) follow-up, patients (n=251, aged 20-32 years) completed questionnaires during a psychological examination. Parallel instruments were used to measure psychopathology in adolescence and adulthood. RESULTS: Young ConHD female patients showed higher levels of psychopathology compared to the reference group. Larger differences in psychopathology were found between younger (20-27 years) and older (28-32 years) patients compared to the reference group; the younger patients showed more psychopathology than the older patients. Also, larger differences in psychopathology were found between male and female patients compared to the reference group; female patients showed more psychopathology than male patients. Parents and partners of patients evaluated the patients' behavior as more deviant from the norm than patients themselves. There was a stronger decline of psychopathology in ConHD patients with increasing age compared to reference groups. Female and younger patients showed more variability in trajectories of psychopathology than did male and older patients. CONCLUSIONS: Assessment and treatment of psychopathology at a younger age is highly desirable in ConHD patients. Young adult ConHD female patients deserve special attention since they might be hampered by disease-specific uncertainties.

Styles of coping and social support in a cohort of adults with congenital heart disease.

OBJECTIVE: To determine styles of coping, that is personal ways of dealing with problems, and social support, or support from the social environment, in a cohort of adults with congenital heart disease. METHODS: We subjected 362 patients with congenital heart disease, aged from 20 to 46 years, belonging to five diagnostic groups, to extensive medical and psychological examination from 20 to 33 years after their first open heart surgical procedure. During psychological examination, 342 patients filled in questionnaires concerning styles of coping, specifically the Utrecht Coping List, and social support, using the Social Support List. RESULTS: Overall, styles of coping in the total sample are comparable to those of peers in the general population, except for lower active problem solving, which can be attributed to female patients. Males with congenital heart disease showed more favourable styles of coping compared to their peers, such as higher seeking of social support, lower passive reaction patterns, and lower expression of negative emotions. Compared to the reference group, the total cohort of patients reported to receive less social support, but also to experience less discrepancies between desired and received social support, indicating feelings of independence in these adults. Females with congenital heart disease were found to seek and receive more social support compared to their male counterparts. CONCLUSION: Overall, few differences in styles of coping were found between the patients and their reference groups. Perceived social support in the sample of patients was favourable.