[Sex as a moderating variable of internalizing and externalizing symptomatology in childhood]. / Sexo como variable moderadora de la sintomatología internalizante y externalizante en la infancia.

OBJECTIVE: One in one hundred minors has some mental health problem. Symptomatology varies according to gender. Most research has been conducted with the general population. The objective of this paper was to analyze the moderating role of sex in the presence of internalizing (emotional disorders, anxiety and depression) and externalizing symptomatology (behavioral disorders and hyperactivity) in childhood, as well as to compare the general population with the clinical population. METHODS: A descriptive cross-sectional study was conducted with 552 boys and girls between ten and twelve years of age, 94 mental health patients and 458 schoolchildren. Participants completed self-report measures: Strengths and Difficulties Questionnaire (SDQ-Cas), Modified Depression Scale (MDS) and a sociodemographic information questionnaire. For data analysis, descriptive statistics and multivariate and univariate mean comparisons were performed by parametric and re-sampling procedures. RESULTS: Statistically significant differences were observed between clinical and school population groups in externalizing, internalizing and depressive symptomatology (p<0.001). No sex differences were found in externalizing and depressive symptomatology. Sex differences were found in internalizing symptoms (p<0.001, pboot<0.001) as well as group interaction effects (p=0.016), girls had higher scores than boys, with greater differences in the clinical group (p<0.001, pboot=0.003). CONCLUSIONS: Research with mental health patients is essential to verify the existence or not of differences with the general population as well as differences by sex, which will allow adapting preventive and intervention strategies to each case.

OBJETIVO: Uno de cada cien menores tiene algún problema de salud mental. La sintomatología varía según el sexo. La mayoría de las investigaciones son realizadas con población general. El objetivo de este estudio fue analizar el papel moderador del sexo en la presencia de sintomatología internalizante (alteraciones emocionales, ansiedad y depresión) y externalizante (alteraciones comportamentales e hiperactividad) en la infancia, así como comparar población general con población clínica. METODOS: Se realizó un estudio descriptivo transversal con 552 niños y niñas entre diez y doce años, 94 pacientes de salud mental y 458 escolares. Los participantes cumplimentaron medidas de autoinforme: Cuestionario de capacidades y dificultades (Strengths and Difficulties Questionnaire, SDQ-Cas), Escala de depresión modificada (Modified Depression Scale, MDS) y un cuestionario de información sociodemográfica. Para el análisis de datos se realizaron los estadísticos descriptivos y comparaciones de medias multivariantes y univariantes, por procedimientos paramétricos y de remuestreo. RESULTADOS: Se observaron diferencias estadísticamente significativas entre los grupos clínico y de la población escolar en sintomatología externalizante, internalizante y depresiva (p<0,001). No se hallaron diferencias de sexo en sintomatología externalizante ni depresiva. En los síntomas internalizantes se encontraron diferencias de sexo (p<0,001, pboot<0,001), así como efectos de interacción con el grupo (p=0,016). Las niñas tuvieron puntuaciones más altas que los niños, con mayores diferencias en el grupo clínico (p<0,001, pboot=0,003). CONCLUSIONES: Las investigaciones con pacientes de salud mental son fundamentales para verificar la existencia o no de diferencias con la población general, así como las diferencias por sexo, lo que permitirá adaptar las estrategias preventivas y de intervención a cada caso.

Sexo como variable moderadora de la sintomatología internalizante y externalizante en la infancia / Sex as a moderating variable of internalizing and externalizing symptomatology in childhood

Fundamentos: Uno de cada cien menores tiene algún problema de salud mental. La sintomatología varía según el sexo. Lamayoría de las investigaciones son realizadas con población general. El objetivo de este estudio fue analizar el papel moderador delsexo en la presencia de sintomatología internalizante (alteraciones emocionales, ansiedad y depresión) y externalizante (alteracionescomportamentales e hiperactividad) en la infancia, así como comparar población general con población clínica. Métodos: Se realizó un estudio descriptivo transversal con 552 niños y niñas entre diez y doce años, 94 pacientes de salud mentaly 458 escolares. Los participantes cumplimentaron medidas de autoinforme:Cuestionario de capacidades y dificultades (Strengthsand Difficulties Questionnaire, SDQ-Cas),Escala de depresión modificada (Modified Depression Scale, MDS) y un cuestionario deinformación sociodemográfica. Para el análisis de datos se realizaron los estadísticos descriptivos y comparaciones de medias multivariantes y univariantes, por procedimientos paramétricos y de remuestreo. Resultados: Se observaron diferencias estadísticamente significativas entre los grupos clínico y de la población escolar ensintomatología externalizante, internalizante y depresiva (p<0,001). No se hallaron diferencias de sexo en sintomatología externalizante ni depresiva. En los síntomas internalizantes se encontraron diferencias de sexo (p<0,001, pboot<0,001), así como efectos deinteracción con el grupo (p=0,016). Las niñas tuvieron puntuaciones más altas que los niños, con mayores diferencias en el grupoclínico (p<0,001, pboot=0,003). Conclusiones: Las investigaciones con pacientes de salud mental son fundamentales para verificar la existencia o no dediferencias con la población general, así como las diferencias por sexo, lo que permitirá adaptar las estrategias preventivas y deintervención a cada caso.(AU)

Background: One in one hundred minors has some mental health problem. Symptomatology varies according to gender. Mostresearch has been conducted with the general population. The objective of this paper was to analyze the moderating role of sex inthe presence of internalizing (emotional disorders, anxiety and depression) and externalizing symptomatology (behavioral disordersand hyperactivity) in childhood, as well as to compare the general population with the clinical population. Methods: A descriptive cross-sectional study was conducted with 552 boys and girls between ten and twelve years of age, 94 mentalhealth patients and 458 schoolchildren. Participants completed self-report measures:Strengths and Difficulties Questionnaire (SDQ-Cas),Modified Depression Scale (MDS) and a sociodemographic information questionnaire. For data analysis, descriptive statistics andmultivariate and univariate mean comparisons were performed by parametric and re-sampling procedures. Results: Statistically significant differences were observed between clinical and school population groups in externalizing, internalizing and depressive symptomatology (p<0.001). No sex differences were found in externalizing and depressive symptomatology.Sex differences were found in internalizing symptoms (p<0.001, pboot <0.001) as well as group interaction effects (p=0.016), girls hadhigher scores than boys, with greater differences in the clinical group (p<0.001, pboot=0.003). Conclusions: Research with mental health patients is essential to verify the existence or not of differences with the generalpopulation as well as differences by sex, which will allow adapting preventive and intervention strategies to each case.(AU)

Mental health among adolescents living with HIV in Namibia: the role of poverty, orphanhood and social support.

The mental health needs of children and adolescents living with HIV (ALHIV) in Namibia are poorly understood, despite the dramatic improvement in their survival. ALHIV in resource poor contexts face particular risk factors, such as poverty, orphanhood, and poor social support. This study examines the mental health of ALHIV in Namibia, and the factors that contribute to mental health problems. A case-control design assessed emotional and behavioural symptoms of distress, risk and protective factors among adolescents aged 12-18 years. Case participants were 99 HIV-positive adolescents. Case controls were 159 adolescents from the same community who were not known to be HIV seropositive at the time of the study. Control group participants were selected from schools using a stratified random sampling. A larger proportion of HIV-positive adolescents were orphaned (62.6% vs. 20.8%, p < .001); the groups showed no differences in poverty factors. HIV-positive adolescents scored lower than the control group on total perceived social support (p < .05) and caregiver support (p < .05), but no differences in perceived friend support and support from a self-selected person were present. HIV-positive adolescents reported significantly more total emotional and behavioural difficulties (p = .027) and conduct problems (p = .025), even after controlling for socio-demographic factors. However, after controlling for the effects of orphanhood, group differences in mental health outcomes were no longer significant. Furthermore, mediation analysis suggested that social support completely mediated the relationship between HIV status and mental health (standardised pathway coefficients = .05, p = .021). Policies and programmes that aim to strengthen social support and take orphanhood status into consideration may improve the mental health of adolescents living with HIV.

Situaciones estresantes cotidianas en la infancia y su relación con la sintomatología y la adaptación / Daily hassles in childhood and their relationship with symptomatology and adaptation

En este trabajo se analizó la relación entre las situaciones estresantes cotidianas (SEC) y la sintomatología psicológica, exteriorizada e interiorizada, y la adaptación escolar, social y familiar en la infancia. El número de participantes fue de 552 (53,4% niños y 46,6% niñas), de entre 10 y 12 años (M= 10,91). Se comparó un grupo clínico de salud mental con un grupo comunitario. Se administraron autoinformes: "Escala de situaciones estresantes cotidianas en la infancia" (Children’s Hassles Scale, CHS), "Cuestionario de capacidades y dificultades" (Strengths and Difficulties Questionnaire, SDQ-Cas), "Escala de depresión modificada" (Modified Depression Scale, MDS), "Cuestionario de adaptación escolar" y "Cuestionario de adaptación familiar". Se registra una media de 11 SEC y seis vividas con malestar. Las SEC se relacionan con la presencia de sintomatología y una menor adaptación (p< 0,01), siendo mayor la asociación con los síntomas depresivos en el grupo clínico. Las SEC explican del 21 al 39% de la varianza de la sintomatología y entre el 5 y el 41% de la adaptación. Las SEC son relevantes para planificar estrategias de prevención e intervención en la infancia

This study analyzed the relationship between daily hassles and psychological symptoms (externalizing and internalizing symptomatology) and school, social and family adaptation in childhood. The participants were 552 (53.4% boys and 46.6% girls), aged between 10-12 years (M= 10.91). Patients receiving treatment in mental health services and a community group were compared. Self-report questionnaires were administered: Children's Hassles Scale (CHS), Strengths and Difficulties Questionnaire (SDQ-Cas), Modified Depression Scale (MDS), School Adaptation Scale and Family Adaptation Scale. The average of daily hassles was 11, with six of them experiencing distress. Daily hassles were related to an increased presence of symptoms and lower levels of adaptation (p< .01). The association between daily hassles and depressive symptoms were stronger in the clinical group than in the community one. Daily hassles explain from 21 to 39 percent of variance in symptomatology and from 5 to 41 percent in adaptation. Daily hassles are relevant for planning prevention and intervention strategies in Childhood

Los acontecimientos vitales estresantes, la sintomatología y la adaptación en la infancia: estudio comparativo con pacientes de salud mental y escolares / Stressful life events, symptomatology, and adaptation in childhood: A comparative study between mental health patients and students

La investigación analizó la relación de los acontecimientos vitales estresantes (AVE) con la sintomatología, externalizante e internalizante, y la adaptación escolar y familiar en la infancia. El número de participantes fue 552, 53.4% niños y 46.6% niñas, de 10 a 12 años. Se comparó un grupo clínico de salud mental con un grupo comunitario. Al menos un AVE ha sido experimentado por el 88.2% de los participantes en los dos últimos años. Los AVE registrados son significativamente superiores en el grupo clínico. Los AVE se relacionan con presencia de sintomatología y menor adaptación, siendo mayor la asociación entre los AVE de tipo familiar y los síntomas de hiperactividad en el grupo clínico. El haber experimentado AVE y el ser paciente predicen tanto la sintomatología como la adaptación

This paper studied the relationship between stressful life events (SLE) and psychological symptoms (externalizing and internalizing symptomatology) and school and family adaptation in childhood. Participants were 552, 53.4% boys and 46.6% girls, aged between 10-12 years. Patients receiving treatment in mental health services and a community group were compared. At least one SLE in the past two years is experienced by 88.2% of children. SLE were significantly higher in the clinical group than in the community group. SLE are related to the increased presence of symptoms and lower levels of adaptation. The association between family SLE and hyperactivity symptoms is stronger in the clinical group than in the community group. Having experienced SLE and being a patient predict both symptomatology and adaptation

Predictors of mental health problems in adolescents living with HIV in Namibia.

BACKGROUND: Little research in sub-Saharan Africa has looked at factors that predict mental health problems in adolescents living with HIV (ALHIV). This study examines the psychological impact of HIV in adolescents in Namibia, including risk and protective factors associated with mental health. METHODS: Ninety-nine fully disclosed ALHIV between the ages of 12 and 18 were interviewed at a State Hospital in Windhoek. A structured questionnaire assessed mental health, using the SDQ (Goodman, 1997), sociodemographic factors, poverty, social support, adherence and stigma. RESULTS: Mean age was 14.3 years, 52.5% were female and most were healthy. Twelve percent scored in the clinical range for total mental health difficulties and 22% for emotional symptoms. Poverty was associated with more total mental health difficulties, t(96) = -2.63, p = .010, and more emotional symptoms, t(96) = -3.45, p = .001, whereas better social support was a protective factor, particularly caregiver support (r = -.337, p = .001). Adherence problems, HIV-related stigma and disclosing one's own HIV status to others were also associated with more total mental health difficulties. Poverty (ß = -.231, p = .023) and stigma (ß = .268, p = .009) were the best predictors for total mental health difficulties, whereas stigma (ß = .314, p = .002) predicted emotional symptoms. Social support had a protective effect on peer problems (p = .001, ß = -.349). CONCLUSIONS: Several contextual factors associated with poorer mental health in ALHIV are identified.