Compulsive Internet Use Scale for assessment of self-reported problematic internet use in primary school-aged children.

Introduction: The tremendous growth of internet use during past few decades has been primarily led by young people. Despite a plenitude of studies reporting the pros and cons of excessive internet use by adolescents, the internet use of primary school-aged children is under-researched. First, there is lack of reliable and valid cultural invariant self-report instruments for children younger than 11-years-old. Secondly, there is no consensus on whether primary school-aged children can reliably report on their internet use. This study aimed to examine the psychometric properties of the Compulsive Internet Use Scale (CIUS) as reported by primary school-aged children in three different countries/regions. Methods: Paper-pencil format CIUS questionnaires were completed by a total of 691 children aged 8 to 10 years old, 236 of them Latvian, 207 Lithuanian, and 248 Taiwanese, as well as by one of their parents, at two-time points, separated by a one-year interval. The parents also reported on the child's emotional and behavioral difficulties. Methods: Confirmatory factor analysis indicated that for the child self-report, a 10-item CIUS showed the best fit and good psychometric properties: solid structural validity; very good internal consistency; appropriate stability and predictive validity after 1 year; as well as sound sensitivity and specificity when compared to the 14-item CIUS parent-report form. Child self-report CIUS ratings correlated with time online reported by the child and parent and with emotional and behavioral problems reported by the parent. Discussion: This study indicates that children as young as 8-10 years old can reliably and consistently provide valuable information on their problematic use of the internet.

The Predictors of Psychological Well-Being in Lithuanian Adolescents after the Second Prolonged Lockdown Due to COVID-19 Pandemic.

Recent research highlights the impact of prolonged pandemics and lockdown on the mental health of youngsters. The second wave of COVID-19 brought an increase in mental health problems among young people. Therefore, this study aims to analyze the main factors arising from intra-individual, inter-individual, and environmental contexts that predict good psychological well-being in a group of adolescents after a second prolonged period of social restrictions and distance education. The study included 1483 school students from 11 to 19 years old. The survey assessed self-reported students' psychological well-being (WHO-5 index), physical activity, sedentary behavior, school social capital, communication with peers and relationships with parents, existing emotional and behavioral problems. The results indicated that 58% of adolescents were of good psychological well-being in spring 2021, after half a year in lockdown. Almost 19% of adolescents had depression risk. The study revealed that during a period of prolonged isolation, male gender, better relationships between young people and their parents, the absence of serious emotional and behavioral problems, less sedentary behavior, and higher school social capital were found to be significant factors predicting adolescents' psychological well-being. Lower physical activity is an important contributor to students' poor well-being. Finally, the lack of face-to-face communication with peers was revealed as a specific factor in predicting adolescents with depression risk.

Sedentary Behavior among 6-14-Year-Old Children during the COVID-19 Lockdown and Its Relation to Physical and Mental Health.

As a result of the outbreak of SARS-CoV-2 and consequent restrictions in spring 2020, children in many countries might be engaged in more sedentary behavior and have limited possibilities to access the necessary level of physical activity to maintain their physical and mental health. The aim of this study was to explore the relationships between child sedentary behavior, physical activity, mental and physical health, and parental distress in a sample of Lithuanian children aged 6-14 years during the COVID-19 pandemic lockdown in March-June 2020. Parents of 306 children (52.9% female) completed an online survey in May-June 2020 and reported on their children's screen time for educational and recreational (leisure) purposes, the level of physical activity and time outdoors, somatic symptoms, and emotional well-being and behavior. Parents also reported on stressful life events in the family and personal distress. The results revealed that 57.5% of children exceeded the recommended maximum of 2 h of recreational screen time per day, and 33.6% of the children did not meet the recommended guidelines of 60 min of physical activity per day. Longer screen time for educational purposes and parental distress significantly predicted a higher prevalence of somatic symptoms in children and parental distress also served as a significant predictor of children's decreased emotional well-being and behavior. These results highlight the importance of psychosocial support interventions for parents who experience distress when raising children at a stressful time, such as during a pandemic.

Children's Internet Use Profiles in Relation to Behavioral Problems in Lithuania, Latvia, and Taiwan.

This study explored the profiles of elementary-school-aged children's Internet use in relation to their emotional and behavioral problems. Participating in this cross-sectional study were 877 child-parent dyads from Latvia, Lithuania, and Taiwan. Children (8-10 years old) provided information on three variables: the amount of time they spent online, frequency of online activities, and knowledge of how to do things online. Latent profile analysis including these three variables provided a four-class solution for child Internet use. A comparison between Latvia, Lithuania, and Taiwan on the percentage of the sample distribution in each class showed that there was no difference between sites for the high class (high ratings on all three variables). The largest differences were for the low and average classes (low and average ratings on all three variables, namely, time online, frequency, and knowledge): the Lithuanian and Taiwanese samples were similar in that a higher percentage of each sample was in the low class, whereas the Latvian sample had children equally distributed between the low class and the average class. Analysis of the data from the entire sample for differences in parent-reported child behavioral difficulties suggested that children in the high class had an elevated level of behavioral problems and compulsive Internet use.

Screen Use During Meals Among Young Children: Exploration of Associated Variables.

Background and Objectives: There is evidence that eating meals or snacks while watching TV is an obesogenic factor. Moreover, the patterns of TV and other screen use during meals begin early and persist. However, there are only a few studies to date which address the prevalence and predictors of young children's exposure to screen during mealtimes. Thus, the present study aimed to investigate the prevalence and the associated factors of screen use during meals in early childhood. Materials and Methods: A cross sectional survey was conducted in Lithuania. Data of 847 children aged 2 to 5 years old (51.5% boys) were analyzed in this study. Parents completed the Child Behavior Checklist (CBCL/1½-5) and reported their children's daily screen time, exposure to background TV, screen use during child's meals, child and parental height and weight, and sociodemographic data. Results: More than half of children were exposed to screen during meals: 33.7% occasionally, several times per week or per month, and 22%-daily or during every meal. Overall daily screen time, background TV, consumption of junk food, child age, and emotional and behavioral problems were related to mealtime screen use (all associations significant at p < 0.01). Longer daily screen time (OR 1.01; 95% CI 1.00-1.01), more background TV (OR 1.26; 95% CI 1.10-1.45), and elder child age (OR 1.02; 95% CI 1.00-1.03) were significant predictors of occasional use of screen during meals. Also, longer daily screen time (OR 0.99; 95% CI 0.98-0.99), background TV (OR 0.78; 95% CI 0.66-0.91) together with no siblings' status of a child (OR 0.42; 95% CI 0.25-0.69) increased the probability that children were fed in front of screens daily. Conclusions: This study confirmed the unfavorable associations among screen use during meals, daily screen time and junk food consumption in early childhood. In addition, first-time parents should get particular health providers' attention as they are more likely to use screens during child's mealtime.

PREDICTORS OF EMOTIONAL AND BEHAVIORAL PROBLEMS IN 1-YEAR-OLD CHILDREN: A LONGITUDINAL PERSPECTIVE.

Emotional and behavioral problems at an early age can reasonably be considered a high-risk factor for later mental health disorders. The aim of the article is to reveal predictive factors of 1½-year-old children's emotional and behavioral problems. The study was a part of a prospective birth-cohort study. The study sample consisted of 172 full-term infants (born during Gestational Weeks 37-42) and their mothers. Emotional and behavioral problems at the age of 1½ years were measured using the Child Behavior Checklist for Ages 1½-5 (T. Achenbach & L. Rescorla, 2000), which was completed by mothers. Emotional and behavioral problems at age of 1½ years were more prevalent in infants born via cesarean section, as compared to infants born vaginally without administration of medication. Newborns' suboptimal functioning after birth, complicated emotional acceptance of pregnancy, a couple's nonsatisfactory relationship during pregnancy, maternal distress during pregnancy and in the first months after childbirth, and inflexible and parent-oriented attitudes toward infant-rearing also predicted children's emotional and behavioral problems independent of sociodemographic factors. Results suggest that biomedical and psychosocial factors which manifest themselves in the prenatal and perinatal periods can have associations with later infant and child mental health.

Smoking during pregnancy in association with maternal emotional well-being.

OBJECTIVE: The aim of the study was to investigate psychosocial predictors of smoking during pregnancy. MATERIALS AND METHODS: It was a cross-sectional analysis of a prospective birth-cohort study. The participants were 514 mothers of full-term infants. Women completed questionnaires during hospital stay after delivery. Questionnaire included items on sociodemographic characteristics, planning and emotional acceptance of pregnancy, reproductive history, health-related behavior, emotional well-being, and relationships with a partner. RESULTS: Smoking during pregnancy was reported by 14.8% of the participants. Prenatal smoking was associated with secondary or lower education, maternal age less than 20 years, childbirth outside of marriage, history of elective abortion, unplanned pregnancy, lack of positive emotional acceptance of pregnancy by mother and father, emotional distress and alcohol consumption during pregnancy. Smoking during pregnancy remained significantly associated with prenatal alcohol consumption, previous elective abortion, and lack of positive emotional acceptance of pregnancy by mother even after adjustment for maternal age, education, and family structure. CONCLUSIONS: Results support an idea of complexity of the relationships among smoking, alcohol use, and emotional well-being. Lack of positive emotional acceptance of pregnancy by mother and history of elective abortions can be considered as possible associates of smoking during pregnancy and suggest that strengthening of positive attitudes toward motherhood could add to lower smoking rates among pregnant women.

Developmental trajectories of mother reported regulatory problems from toddlerhood to preschool age.

Developmental trajectories of mother-reported regulatory problems of typically developing children from age one and a half to four years old and possible predictors of various trajectories are analyzed in this study. Participants were 281 children born as full-term babies and their mothers. The attention and behavior regulation (ABR) problems and emotion regulation (ER) problems scales derived from maternal ratings on CBCL/1½-5 were used. Also, data on the neonate's functioning, problem behaviors in infancy, maternal postpartum depressiveness, SES, maternal self-efficacy, and parenting practices were gathered prospectively at different time points and were analyzed as factors of regulatory problems. The latent class analysis for ABR problems over time suggested a 4-class solution: 35% of children were classified as having stable low, 27.6% - stable medium, 22.6% - decreasing and 14.1% - stable high levels of problems. Analysis of ER problems suggested a 3-class solution: 65% showed stable low, 25.1% - decreasing and 9.2% - increasing level of problems. Results showed the significance of maternal self-efficacy in predicting mother-rated emotional and behavioral regulation problems. Young maternal age and non-marital status resulted as risk factors for ABR problems, and lower maternal education differentiated the increasing from decreasing ER problems trajectories. Maternal depressiveness was found to be an additional risk factor for stable high ABR problems as opposed to decreasing trajectory, and lower scores of supportive responses predicted increasing vs. decreasing ER problems. Apgar scores were added only for high vs. medium ABR problems, and behavior problems in infancy for increasing vs. low ER problems trajectory in the study sample. Female gender was a stable predictor for a trajectory of low ABR problems. Early risk factors related with high ABR problems or increasing ER problems trajectories that may be important targets for intervention practices as well as further research are discussed.

Infant difficult behaviors in the context of perinatal biomedical conditions and early child environment.

BACKGROUND: Problems experienced within the first year of an infant's life can be precursors of later mental health conditions. The purpose of this study was to examine the frequency and continuity of difficult behaviors in infants at 3 and 6 months of age and the associations of these difficulties with biomedical and psychosocial factors. METHODS: This study was a part of an ongoing prospective birth-cohort study. Study participants were 189 uniparous mothers and their full-term newborns. The index of infant difficult behavior was constructed. This index was then associated with the following factors: delivery mode, newborn function after birth, maternal emotional well-being, risk behavior, subjective evaluation of the quality of the relationship of the couple, and attitudes toward infant-rearing. RESULTS: Common difficult behaviors, including crying, sleeping and eating problems, were characteristic for 30.2% of 3 month old and for 22.2% of 6 month old full-term infants. The expression of infant difficult behaviors at the age of 3 months increased the likelihood of the expression of these difficulties at 6 months by more than 5 times. Factors including younger maternal age, poor prenatal and postnatal emotional well-being, prenatal alcohol consumption, low satisfaction with the couple's relationship before pregnancy, and deficiency of infant-centered maternal attitudes towards infant-rearing increased the likelihood of difficult behaviors in infants at the age of 3 months. Low maternal satisfaction with the relationship of the couple before pregnancy, negative emotional reactions of both parents toward pregnancy (as reported by the mother) and the deficiency of an infant-centered maternal attitude towards infant-rearing increased the likelihood of infant difficult behaviors continuing between the ages of 3 to 6 months. Perinatal biomedical conditions were not related to the difficult behaviors in infants. CONCLUSIONS: Our study suggests that early onset of difficult behavior highly increases the risk for the continuation of difficult behavior during infancy. In general, the impact of prenatal psychosocial environment on infant behavior decreases from the ages of 3 to 6 months; however, some prenatal and preconceptional psychosocial factors have direct associations with the continuity of difficult behaviors through the first half-year of an infant's life.

Behavioral/Emotional Problems of Preschoolers: Caregiver/Teacher Reports From 15 Societies.

This study tested societal effects on caregiver/teacher ratings of behavioral/emotional problems for 10,521 preschoolers from 15 societies. Many societies had problem scale scores within a relatively narrow range, despite differences in language, culture, and other characteristics. The small age and gender effects were quite similar across societies. The rank orders of mean item ratings were similar across diverse societies. For 7,380 children from 13 societies, ratings were also obtained from a parent. In all 13 societies, mean Total Problems scores derived from parent ratings were significantly higher than mean Total Problems scores derived from caregiver/teacher ratings, although the size of the difference varied somewhat across societies. Mean cross-informant agreement for problem scale scores varied across societies. Societies were very similar with respect to which problem items, on average, received high versus low ratings from parents and caregivers/teachers. Within every society, cross-informant agreement for item ratings varied widely across children. In most respects, results were quite similar across 15 very diverse societies.

International comparisons of behavioral and emotional problems in preschool children: parents' reports from 24 societies.

International comparisons were conducted of preschool children's behavioral and emotional problems as reported on the Child Behavior Checklist for Ages 1½-5 by parents in 24 societies (N = 19,850). Item ratings were aggregated into scores on syndromes; Diagnostic and Statistical Manual of Mental Disorders-oriented scales; a Stress Problems scale; and Internalizing, Externalizing, and Total Problems scales. Effect sizes for scale score differences among the 24 societies ranged from small to medium (3-12%). Although societies differed greatly in language, culture, and other characteristics, Total Problems scores for 18 of the 24 societies were within 7.1 points of the omnicultural mean of 33.3 (on a scale of 0-198). Gender and age differences, as well as gender and age interactions with society, were all very small (effect sizes < 1%). Across all pairs of societies, correlations between mean item ratings averaged .78, and correlations between internal consistency alphas for the scales averaged .92, indicating that the rank orders of mean item ratings and internal consistencies of scales were very similar across diverse societies.

Preschool psychopathology reported by parents in 23 societies: testing the seven-syndrome model of the child behavior checklist for ages 1.5-5.

OBJECTIVE: To test the fit of a seven-syndrome model to ratings of preschoolers' problems by parents in very diverse societies. METHOD: Parents of 19,106 children 18 to 71 months of age from 23 societies in Asia, Australasia, Europe, the Middle East, and South America completed the Child Behavior Checklist for Ages 1.5-5 (CBCL/1.5-5). Confirmatory factor analyses were used to test the seven-syndrome model separately for each society. RESULTS: The primary model fit index, the root mean square error of approximation (RMSEA), indicated acceptable to good fit for each society. Although a six-syndrome model combining the Emotionally Reactive and Anxious/Depressed syndromes also fit the data for nine societies, it fit less well than the seven-syndrome model for seven of the nine societies. Other fit indices yielded less consistent results than the RMSEA. CONCLUSIONS: The seven-syndrome model provides one way to capture patterns of children's problems that are manifested in ratings by parents from many societies. Clinicians working with preschoolers from these societies can thus assess and describe parents' ratings of behavioral, emotional, and social problems in terms of the seven syndromes. The results illustrate possibilities for culture-general taxonomic constructs of preschool psychopathology. Problems not captured by the CBCL/1.5-5 may form additional syndromes, and other syndrome models may also fit the data.

[Attention-deficit/hyperactivity disorder: possibilities of early diagnostics]. / Ankstyvosios vaiku aktyvumo ir demesio sutrikimo diagnostikos galimybes.

The present study aimed at analyzing the possibilities of early diagnostics of attention-deficit/hyperactivity disorder in toddlers and preschool children. Parents and caregivers from children day care centers provided information about 863 children (mean age, 47.18 months; 410 girls and 453 boys). The methods used in the study were as follows: Child Behavior Checklist/1(1/2)-5 (CBCL), Caregiver-Teacher Report Form (C-TRF), and clinical questionnaire for evaluation of attention-deficit/hyperactivity disorder symptoms. The study consisted of two stages: 1) screening of the emotional and behavioral problems of children based on parental and caregiver-teachers' reports; 2) clinical interview with parents of children at risk for attention-deficit/hyperactivity disorder as measured by empirical ratings of attention hyperactivity symptoms. Results revealed that according to parental ratings, attention and hyperactivity problems are related to children's age. According to caregiver-teachers' ratings, boys were rated as having more problems of attention and hyperactivity than girls. Based on the results from the first stage, children at risk for attention-deficit/hyperactivity disorder were analyzed further. Case study analysis showed attention-deficit/hyperactivity disorder symptoms in these children to be a part of overall pattern characterized by behavioral, emotional, and other problems. The quantitative as well as qualitative analysis provides the evidence for a high comorbidity of attention-deficit/hyperactivity disorder and other emotional and behavioral problems in early childhood. Study showed that comprehensive clinical assessment is necessary for early diagnostics of ADHD.

Psychological adjustment of children with congenital hypothyroidism and phenylketonuria as related to parental psychological adjustment.

Phenylketonuria and congenital hypothyroidism are the inherited metabolic diseases that can be diagnosed and successfully treated early from birth. Nevertheless, children with phenylketonuria and congenital hypothyroidism are found to be in the risk for psychological maladjustment. Parental adjustment - as significant condition for child's psychological adjustment--and related factors are explored in this study. Parents of 63 children with congenital hypothyroidism and phenylketonuria (age 2 to 14 years) answered the Child Behavior Checklist, Coping Strategies Questionnaire and the questionnaire on reactions to child's disease, relations with a sick child, with the spouse and other people. Severity of the disease and child's age are considered as well. Results of the study show that parental emotional (maladaptive) coping and indulgence of a sick child account for the higher rates of internalizing problems of children with phenylketonuria and congenital hypothyroidism. In addition, the higher rates of children's psychological problems are related to parental feelings of guilt as a reaction to child's disease.

Familial variables as predictors of psychological maladjustment in Lithuanian children with phenylketonuria.

BACKGROUND: Children with phenylketonuria of early onset under continuous treatment are considered at higher risk for psychological maladjustment than children without other chronic diseases. The aim of the present study was to evaluate the psychological adjustment of Lithuanian children with treated phenylketonuria and analyze it in the context of the psychological adjustment of their parents. MATERIAL/METHODS: The parents of 37 early-treated children (age 4-14 years old) with phenylketonuria and of 37 matched controls were asked to fill out the Child Behavior Checklist and questionnaire on stress coping strategies. Parents of children with phenylketonuria answered a questionnaire on reactions to the child's disease and its impact on the family. RESULTS: Lithuanian children with treated phenylketonuria have significantly more emotional and behavioral problems than healthy controls. They are more withdrawn, anxious/depressed, have more social and attention problems. The higher rates of internalizing and total problems are related to parental maladjustment (feelings of guilt and anger) together with maladaptive (emotional) everyday stress coping strategies. These last two factors promote overindulging the child, which is also a predictor of psychological maladjustment in children with phenylketonuria. CONCLUSIONS: The already existing organic vulnerability may account for the greater susceptibility of children with phenylketonuria to psychological risk factors, as for example parental inability to cope adequately with everyday stress related to the demands of disease and its treatment.

[Psychological adjustment of children with phenylketonuria]. / Fenilketonurija serganciu vaiku psichine sveikata.

INTRODUCTION: Phenylketonuria is an inherited disorder, which prevents the normal use of protein food and causes changes in body chemistry, which, if left uncontrolled can lead to severe learning disabilities. By following a strict low protein diet early from birth phenylketonuria children can avoid mental retardation, other somatic as well as psychiatric disorders. However, early treated children with phenylketonuria are found to have more emotional and behavioral problems. Because of the lack of correlation between elevated phenylalanine (Phe) levels and psychological adjustment recent studies strongly indicate a psychological perspective for the development of emotional and behavioral problems in phenylketonuria patients. THE AIM OF PRESENT STUDY: To evaluate psychological adjustment of Lithuanian phenylketonuria children and to find out possible reasons for psychological problems of phenylketonuria children. METHODS: Parents of 45 phenylketonuria children and 45 normal controls aged 2 to 14 years old were asked to fill in Lithuanian version of Child Behavior Checklist (CBCL, Achenbach, 1991) and a questionnaire on reactions to child's disease. The mean Phe level and IQ of some phenylketonuria children were considered as well. RESULTS AND CONCLUSIONS: Older phenylketonuria children have significantly more psychological problems than healthy peers. There were no such considerable differences found in younger groups. Parental maladjustment to child's chronic illness is related to higher levels of internalizing and other problems of phenylketonuria children.