Associations between Sociodemographic and Behavioral Variables and Educational Practices on Mother-Child Dyads

The association between the sociodemographic variables of children with behavior problems and mothers with maternal depression is widely acknowledged in the literature. However, there is a lack of studies addressing the association of these variables with maternal parenting practices in typical samples, i.e., children without behavior problems and mothers without current depression indicators. The aim of this study was to identify associations between the sociodemographic variables of children and mothers with the mothers' parenting practices and children's behavioral indicators (resources and problems) in a sample of children without behavior problems and mothers without current depression indicators. This quantitative, cross-sectional, descriptive, and correlational study addressed 46 biological mothers (married or in a stable relationship) and their children. A sociodemographic questionnaire and validated instruments addressing child behavior, maternal mental health, and parenting practices were applied. Findings showed that the mothers did not present mental health problems (e.g., behavior problems or maternal depression), but a) they presented deficits of positive practices and an excess of negative practices, and the children displayed deficits in social skills and behavior problems; b) there was an association between positive practices and the children's social skills and between negative practices and children's behavior problems; c) the frequency of positive and negative practices was equivalent among boys and girls, and d) boys more frequently presented behavior problems while school-aged children more frequently presented social skills deficits. The results indicate that even non-clinical samples may present harmful parenting practices, excess negative practices, and deficits in positive practices. Hence, there is a need for timely interventions to prevent behavior problems among children and maternal depression arising from conflicting interactions in the parenthood sphere.

Las asociaciones de variables sociodemográficas de madres con depresión materna y de sus hijos con problemas comportamentales son ampliamente reconocidas en la literatura. Por otro lado, en muestras típicas existe un vacío de estudios que traten de las asociaciones de esas variables con las prácticas parentales maternas; o sea, en niños de corta edad sin problemas comportamentales y en madres sin indicadores de depresión actual. Considerando lo anterior, el objetivo de este estudio fue verificar las asociaciones entre las variables sociodemográficas de hijos y de las prácticas parentales de sus madres con los indicadores comportamentales de recursos y problemas de los hijos. Se utilizó una muestra de hijos sin problemas comporta-mentales y de madres sin indicadores de depresión actual. Se trata de un estudio cuantitativo, transversal, descriptivo y correlacional. Participaron 46 madres biológicas que vivían con su pareja y sus hijos. Las participantes respondieron al cuestionario sobre variables sociodemográficas y a los instrumentos calibrados sobre comportamientos infantiles, salud mental materna y prácticas educativas. Se identificó que: (a) a pesar de no presentar problemas de salud mental (problemas de comportamiento y depresión materna), las madres evidenciaron un déficit de prácticas positivas y un exceso de prácticas negativas; a su vez, los hijos presentaron déficit de habilidades sociales y hubo quejas comportamentales; (b) se encontró asociación entre las prácticas positivas y las habilidades sociales; también se encontró asociación entre las prácticas negativas y las quejas comportamentales; (c) las prácticas positivas y negativas ocurrieron de manera equivalente entre niños y niñas; y (d) los niños tuvieron más quejas comportamentales; además, los hijos, en edad escolar, tuvieron más déficits de habilidades sociales. Los datos indican que inclusive en muestras no clínicas existen variables de riesgo en lo que se refiere a la parentalidad, a excesos de prácticas negativas y a déficits de prácticas positivas. Lo encontrado sugiere la necesidad de intervenir precozmente, para evitar el surgimiento de problemas de comportamiento infantil y también de la depresión materna, cuando esta proviene de interacciones de conflictos en el ambiente de la parentalidad.

Progression of the COVID-19 pandemic, Brazilian healthcare workers' emotional burden and the effects on professional fulfillment at the end of the third wave: a longitudinal study.

Introduction: Even though the long-term effects of the COVID-19 pandemic on healthcare workers' mental health remain unknown, such effects might negatively impact health services and patient safety, especially in countries like Brazil, where there is little investment in public health policies. Objectives: To assess how the mental health indicators of Brazilian healthcare workers progressed between the beginning and 2 years after the pandemic (at the end of the third wave when there was a significant decrease in the number of new cases and deaths). Methods: The sample comprised healthcare workers whose mental health indicators have been monitored since the beginning of the pandemic in Brazil. The potential participants were addressed via social media and contacted through class councils and health institutions across Brazil. A total of 165 participants answered instruments at the baseline and 2 years after the pandemic. Data were collected online using the Redcap platform and addressed symptoms of anxiety, depression, post-traumatic stress, insomnia, and burnout (emotional exhaustion, depersonalization, and professional fulfillment). Results: Brazilian healthcare workers faced three periods of intensified incidence of new cases and deaths due to COVID-19 for 2 years. Approximately one-third of the sample still experiences high levels of anxiety, depression, and post-traumatic stress. Insomnia indicators remained the most prevalent compared to the baseline assessment, while post-traumatic stress symptoms (p = 0.04) and professional fulfillment (p = 0.005) decreased. Conclusion: The lack of positive changes in mental health indicators coupled with decreased professional fulfillment over time highlights the pandemic's chronic effects and the need for organizations to monitor these workers' mental health, especially in developing countries like Brazil, where there is a high demand for health services and public policies are poorly structured and unstable.

Mental health trajectories of Brazilian health workers during two waves of the COVID-19 pandemic (2020-2021).

This study aimed to: (a) monitor the progression of symptoms of mental health burden among frontline workers caring for COVID-19 patients in Brazil during the two waves of the pandemic, considering the number of new cases and deaths, and; (b) to verify the different mental health outcomes and potential associations with current burnout symptoms. A non-probabilistic sample of health professionals was assessed as the pandemic progressed in Brazil (May/2020 August/2021). Standardized instruments focusing on anxiety, depression, insomnia, post-traumatic stress, and burnout symptoms were applied online. The results indicate a decrease in anxiety levels, what was related to when the number of new cases declined (end 1th-wave); symptoms returned to higher levels later. Emotional exhaustion increased when there was a higher incidence of cases, returning to the baseline levels at the end of the second wave. Depersonalization symptoms increased in this phase, characterized by a further decrease in new cases, while professional accomplishment decreased during the follow-up. The highest number of new cases was associated with a higher frequency of anxiety (OR = 1.467;95%CI = 1.109-1.941; p = 0.007) and professional accomplishment (OR = 1.490;95%CI = 1.098-2.023; p = 0.011). The subjects with trajectory of resilience against anxiety presented the lowest level of emotional exhaustion and depersonalization (p < 0.05). The conclusion is that the pressure experienced by healthcare professionals throughout the pandemic caused different impacts on their mental health, emphasizing the dynamic nature of this condition and the need for constant monitoring and care. This finding directly affects mental health prevention and intervention measures, which remain a priority and require continuous reinforcement, especially among the most vulnerable groups.

Práticas educativas de professores, comportamento e dificuldades de desempenho acadêmico: comparações de grupos / Teachers' practices and students' academic and behavioral difficulties: a comparison of groups / Prácticas educativas de los maestros, comportamiento y dificultades de desempeño escolar: comparaciones de grupos

Constitui-se em lacuna do conhecimento as práticas educativas dos professores frente às crianças que apresentam dificuldades múltiplas ou específicas. Objetivou-se caracterizar e comparar as práticas educativas positivas e negativas de professores para três grupos diferenciados de crianças, considerando-se uma amostra não clínica, sem problemas comportamentais e de desempenho acadêmico (G1) e duas amostras clínicas, uma de crianças com problemas múltiplos, comportamentais e de desempenho acadêmico (G2) e outra de crianças com problemas específicos, comportamentais (G3). Participaram 102 meninos e suas professoras, as quais responderam a instrumentos sobre práticas educativas, habilidades sociais e problemas comportamentais. Verificou-se que, comparativamente, crianças com problemas de desempenho e de comportamento associados apresentaram mais problemas de comportamento, menos habilidades sociais e seus professores relataram mais déficits de práticas educativas positivas e uso mais frequente de práticas negativas. Conclui-se sobre a relevância de estudar riscos combinados e de promover intervenções com professores e crianças

There is a gap in the knowledge concerning the teaching of children with multiple or specific difficulties. The objective was to characterize and compare positive and negative teaching practices among three groups of children: a non-clinical sample, without problem behaviors and typical academic performance (G1), and two clinical samples: a group with multiple behavioral and academic performance problems (G2) and a group with specific problem behaviors (G3). A total of 102 boys and their respective teachers participated in the study. The teachers answered instruments addressing teaching practices, social skills, and problem behaviors. A comparison between the groups showed that children with associated performance and behavioral problems presented more problem behaviors and fewer social skills, while their teachers reported a higher deficit of positive teaching practices and more frequently used negative practices. The results revealed the importance of studying cumulative risks and promoting interventions among teachers and children

Las prácticas educativas de los docentes en relación con los niños que presentan dificultades múltiples o específicas constituyen un vacío de conocimiento. El objetivo fue caracterizar y comparar las prácticas educativas positivas y negativas de los docentes para tres grupos diferentes de niños, considerando una muestra no clínica sin problemas conductuales y de desempeño escolar (G1) y dos muestras clínicas, una de niños con múltiples problemas. rendimiento escolar y conductual (G2) y otro de niños con problemas conductuales específicos (G3). Participaron 102 niños y sus profesores, quienes respondieron a instrumentos sobre prácticas educativas, habilidades sociales y problemas de conducta. Se encontró que, comparativamente, los niños con problemas asociados de desempeño y conducta tenían más problemas de conducta, menos habilidades sociales y sus maestros reportaron más deficiencias en las prácticas educativas positivas y un uso más frecuente de prácticas negativas. Concluye sobre la relevancia de estudiar riesgos combinados y promover intervenciones con docentes y niños

Parenting Practices, Maternal Depression and Behavior Problems: Associations, Prediction and Moderation / Práticas Parentais, Depressão Materna e Problemas Comportamentais: Associações, Predição e Moderação / Prácticas de Crianza, Depresión Materna y Problemas de Conducta: Asociaciones, Predicción y Moderación

Abstract There are gaps in the ways in which maternal depression, educational practices and children's behavior problems are associated. The objective was to verify: (a) associations between maternal depression, parenting practices and behavior problems in this sample; (b) the isolated and combined predictive effect of maternal depression and both positive and negative parenting practices on behavior problems; and (c) the possible moderating effect of positive parenting practices in the relation between maternal depression and behavior problems. Participants were 101 biological mothers who responded to validated self-report instruments. Data were treated by univariate and multivariate regression analyses, and moderation analyses were conducted. Associations were found between negative parenting, current maternal depression and behavior problems. And the moderation of positive practices in reducing the negative impact of depression on children's behaviors was identified. Teaching positive practices is suggested to minimize risk factors for behavioral problems.

Resumo Constituem lacunas os modos como se associam depressão materna, práticas educativas e problemas comportamentais infantis. O objetivo do estudo foi verificar: (a) associações entre depressão materna, práticas parentais e problemas de comportamento nesta amostra; (b) efeito preditivo isolado e combinado da depressão materna e das práticas parentais positivas e negativas para os problemas de comportamento; e (c) possível efeito moderador das práticas positivas para a relação entre depressão materna e problemas de comportamento. Participaram 101 mães biológicas de crianças que responderam a instrumentos de autorrelato validados. Os dados foram tratados por análises de regressão uni e multivariada, sendo conduzidas análises de moderação. Verificaram-se associações entre parentalidade negativa, depressão materna e problemas comportamentais; com moderação das práticas positivas na redução do impacto negativo da depressão. Sugere-se o ensino de práticas positivas para minimizar fatores de risco para problemas comportamentais.

Resumen Las formas en que se asocian depresión materna, prácticas educativas y problemas de conducta de niños son lagunas. El objetivo fue verificar: (a) asociaciones entre depresión materna, prácticas de los padres y problemas de conducta en esta muestra; (b) efecto predictivo aislado y combinado de depresión materna y prácticas parentales positivas y negativas para los problemas de conducta; y (c) posible efecto moderador de las prácticas positivas para la relación entre la depresión materna y los problemas de conducta. Participaron 101 madres biológicas de niños que respondieron a instrumentos de autoinforme validados. Los datos fueron tratados mediante análisis de regresión univariante y multivariante, realizándose análisis de moderación. Se verificaron asociaciones entre prácticas educativas negativas, depresión materna y problemas de conducta; con moderación de prácticas positivas para reducir el impacto negativo de la depresión. Se sugiere enseñar prácticas positivas para minimizar los factores de riesgo para problemas de conducta.

Maintained anxiolytic effects of cannabidiol after treatment discontinuation in healthcare workers during the COVID-19 pandemic.

Objective: To assess whether the effects of oral administration of 300 mg of Cannabidiol (CBD) for 28 days on mental health are maintained for a period after the medication discontinuation. Methods: This is a 3-month follow-up observational and clinical trial study. The data were obtained from two studies performed simultaneously by the same team in the same period and region with Brazilian frontline healthcare workers during the COVID-19 pandemic. Scales to assess emotional symptoms were applied weekly, in the first month, and at weeks eight and 12. Results: The primary outcome was that, compared to the control group, a significant reduction in General Anxiety Disorder-7 Questionnaire (GAD-7) from baseline values was observed in the CBD group on weeks two, four, and eight (Within-Subjects Contrasts, time-group interactions: F1-125 = 7.67; p = 0.006; ηp 2 = 0.06; F1-125 = 6.58; p = 0.01; ηp 2 = 0.05; F1-125 = 4.28; p = 0.04; ηp 2 = 0.03, respectively) after the end of the treatment. Conclusions: The anxiolytic effects of CBD in frontline health care professionals during the COVID-19 pandemic were maintained up to 1 month after the treatment discontinuation, suggesting a persistent decrease in anxiety in this group in the real world. Future double-blind placebo-controlled clinical trials are needed to confirm the present findings and weigh the benefits of CBD therapy against potential undesired or adverse effects.

Workplace Protections and Burnout Among Brazilian Frontline Health Care Professionals During the COVID-19 Pandemic.

Health care workers from low- and middle-income countries have been playing a critical role in overcoming the challenges related to the COVID-19 pandemic; yet little is known about the relationship between workplace protections and wellbeing of Brazilian health care workers during the pandemic. This study aimed to evaluate whether Brazilian health care workers were satisfied with their workplace measures to protect their physical and mental health during the pandemic, and to assess the associations of such levels of satisfaction with indicators of burnout. Licensed Brazilian health care professionals were recruited via popular media between 5/19/2020 and 8/23/2020 to complete an online survey including questions about their demographic/professional characteristics, satisfaction with their workplace protective measures during the pandemic, and validated questionnaires assessing neuroticism, resilient coping, and symptoms of burnout. Most participants reported being dissatisfied with their workplace measures to protect their physical (516, 56.3%) and mental health (756, 82.5%). In multivariable analysis adjusted for personal and environmental factors, dissatisfaction with workplace physical health protections was significantly associated with higher levels of emotional exhaustion (B = 1.08, 95% CI = 0.47-1.69) and depersonalization (B = 0.61, 95% CI = 0.10-1.12), and dissatisfaction with workplace mental health protections significantly associated with higher levels emotional exhaustion (B = 1.17, 95% CI = 0.40-1.95). Efforts to improve both physical and mental health protective measures are critical to guarantee that health care workers continue to provide care at their maximum capacity.

Cannabidiol for COVID-19 Patients with Mild to Moderate Symptoms (CANDIDATE Study): A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

Importance: Owing to its anti-inflammatory properties and antiviral "in vitro" effect against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), cannabidiol (CBD) has been proposed as a potential treatment for coronavirus disease 2019 (COVID-19). Objective: To investigate the safety and efficacy of CBD for treating patients with mild to moderate COVID-19. Design: Randomized, parallel-group, double-blind, placebo-controlled clinical trial conducted between July 7 and October 16, 2020, in two sites in Brazil. Setting: Patients were recruited in an emergency room. Participants: Block randomized patients (1:1 allocation ratio-by a researcher not directly involved in data collection) with mild and moderate COVID-19 living in Ribeirão Preto, Brazil, seeking medical consultation, and those who voluntarily agreed to participate in the study. Interventions: Patients received 300 mg of CBD or placebo added to standard symptomatic care during 14 days. Main Outcome and Measure: The primary outcome was reduction or prevention of the deterioration in clinical status from mild/moderate to severe/critical measured with the COVID-19 Scale or the natural course of the resolution of typical clinical symptoms. Primary study outcome was assessed on days 14, 21, and 28 after enrollment. Results: A total of 321 patients were recruited and assessed for eligibility, and 105 were randomly allocated either in CBD (n=49) or in placebo (n=42) group. Ninety-one participants were included in the analysis of efficacy. There were no baseline between-group differences regarding disease severity (χ2=0.025, p=0.988) and median time to symptom resolution (12 days [95% confidence interval, CI, 6.5-17.5] in the CBD group, 9 days [95% CI, 4.8-13.2] in the placebo group [χ2=1.6, p=0.205 by log-rank test]). By day 28, 83.3% in the CBD group and 90.2% in the placebo group had resolved symptoms. There were no between-group differences on secondary measures. CBD was well tolerated, producing mostly mild and transient side effects (e.g., somnolence, fatigue, changes in appetite, lethargy, nausea, diarrhea, and fever), with no significant differences between CBD and placebo treatment groups. Conclusions and Relevance: Daily administration of 300 mg CBD for 14 days failed to alter the clinical evolution of COVID-19. Further trials should explore the therapeutic effect of CBD in patients with severe COVID-19, possibly trying higher doses than the used in our study. Trial Registration: ClinicalTrials.gov identifier NCT04467918 (date of registration: July 13, 2020).

Risk and Protective Factors for the Mental Health of Brazilian Healthcare Workers in the Frontline of COVID-19 Pandemic.

The objective was to compare the mental health indicators of health workers providing care to individuals with COVID-19 in Brazil, considering sociodemographic and occupational variables and the risk perception of contamination by the Sars-CoV-2 of workers from different professions, identifying risk and protective factors. A sample of 916 health workers was assessed: physicians, nursing workers, and workers from other professions (psychologists, physical therapists, nutritionists, speech therapists, occupational therapists, dentists, pharmacists, and social workers). REDCAP software was used to collect data online, using standardized instruments to assess anxiety, depression, posttraumatic stress, and insomnia, and one questionnaire addressed risk and protective variables. Statistical techniques for comparing groups were used along with logistic regression analysis. The results revealed that all the groups presented indicators of significant mental health problems (>36%), especially the nursing group. A larger percentage of participants, regardless of the profession, presented a high rate of insomnia disorders, while posttraumatic stress was the least expressive. Occupational variables stand out as risk factors for mental health, with specificities among the different groups. A protective factor for all the groups was having positive professional prospects. The protective factors for the physicians group included support provided by co-workers, being older and a man, while being satisfied with physical protective measures implemented by the employing institution was a protective factor for the groups composed of nursing workers and other professionals. These findings are relevant for devising mental health care strategies.

Efficacy and Safety of Cannabidiol Plus Standard Care vs Standard Care Alone for the Treatment of Emotional Exhaustion and Burnout Among Frontline Health Care Workers During the COVID-19 Pandemic: A Randomized Clinical Trial.

Importance: Frontline health care professionals who work with patients with COVID-19 have an increased incidence of burnout symptoms. Cannabidiol (CBD) has anxiolytic and antidepressant properties and may be capable of reducing emotional exhaustion and burnout symptoms. Objective: To investigate the safety and efficacy of CBD therapy for the reduction of emotional exhaustion and burnout symptoms among frontline health care professionals working with patients with COVID-19. Design, Setting, and Participants: This prospective open-label single-site randomized clinical trial used a 1:1 block randomization design to examine emotional exhaustion and burnout symptoms among frontline health care professionals (physicians, nurses, and physical therapists) working with patients with COVID-19 at the Ribeirão Preto Medical School University Hospital in São Paulo, Brazil. Participants were enrolled between June 12 and November 12, 2020. A total of 214 health care professionals were recruited and assessed for eligibility, and 120 participants were randomized in a 1:1 ratio by a researcher who was not directly involved with data collection. Interventions: Cannabidiol, 300 mg (150 mg twice per day), plus standard care or standard care alone for 28 days. Main Outcomes and Measures: The primary outcome was emotional exhaustion and burnout symptoms, which were assessed for 28 days using the emotional exhaustion subscale of the Brazilian version of the Maslach Burnout Inventory-Human Services Survey for Medical Personnel. Results: A total of 120 participants were randomized to receive either CBD, 300 mg, plus standard care (treatment arm; n = 61) or standard care alone (control arm; n = 59) for 28 days. Of those, 118 participants (59 participants in each arm; 79 women [66.9%]; mean age, 33.6 years [95% CI, 32.3-34.9 years]) received the intervention and were included in the efficacy analysis. In the treatment arm, scores on the emotional exhaustion subscale of the Maslach Burnout Inventory significantly decreased at day 14 (mean difference, 4.14 points; 95% CI, 1.47-6.80 points; partial eta squared [ηp2] = 0.08), day 21 (mean difference, 4.34 points; 95% CI, 0.94-7.73 points; ηp2 = 0.05), and day 28 (mean difference, 4.01 points; 95% CI, 0.43-7.59 points; ηp2 = 0.04). However, 5 participants, all of whom were in the treatment group, experienced serious adverse events: 4 cases of elevated liver enzymes (1 critical and 3 mild, with the mild elevations reported at the final 28-day assessment) and 1 case of severe pharmacodermia. In 2 of those cases (1 with critical elevation of liver enzymes and 1 with severe pharmacodermia), CBD therapy was discontinued, and the participants had a full recovery. Conclusions and Relevance: In this study, CBD therapy reduced symptoms of burnout and emotional exhaustion among health care professionals working with patients during the COVID-19 pandemic. However, it is necessary to balance the benefits of CBD therapy with potential undesired or adverse effects. Future double-blind placebo-controlled clinical trials are needed to confirm the present findings. Trial Registration: ClinicalTrials.gov Identifier: NCT04504877.

Maternal Depression, Parental Practices and Child Sex: Prediction of Children's Behavior / Depressão Materna, Práticas Parentais e Sexo das Crianças: Predição de Comportamentos Infantis / Depresión Materna, Prácticas Parentales y Sexo de los Niños: Predicción de Comportamientos Infantiles

Abstract Exposure to maternal depressive symptoms and negative parenting practices during childhood configures a vulnerability factor associated with behavior problems among children. This study aims to verify the predictive effects of maternal depression (main factor) on behavioral outcomes and maternal parenting practices, considering the sex of the children (covariate factor); and the predictive effect of maternal depression, parenting practices, and child's sex on behavioral outcomes. The sample was composed of a community sample of 101 mother-child pairs. Mothers answered to: Structured Clinical Interview for DSM Disorders, Parenting Styles Inventory, and Strengths and Difficulties Questionnaire. The covariance and multiple linear regressions analysis showed that being a boy, and specific practices of neglect, physical abuse, and permissive discipline were the main predictors of behavioral problems among children exposed to negative practices and maternal depression. These findings underline the role of the child's sex in the interactions between variables, which could contribute to interventions in mental health.

Resumo Na infância, a exposição a sintomas depressivos maternos e práticas parentais negativas configura-se como vulnerabilidade, associando-se a problemas comportamentais. Este estudo teve por objetivos: verificar o efeito da depressão materna (fator principal) para os indicadores comportamentais e práticas parentais, considerando-se o efeito do sexo dos filhos (fator covariável); e verificar os efeitos preditivos da depressão materna, práticas parentais maternas e sexo das crianças para os indicadores comportamentais. Incluída amostra da comunidade de 101 díades de mães-crianças. As mães responderam: Entrevista Clínica Estruturada para o DSM-IV, Inventário de Estilos Parentais e Questionário de Capacidades e Dificuldades da Criança. Análises de covariância e regressão linear multivariada evidenciaram o sexo masculino e práticas de negligência, abuso físico e disciplina relaxada como principais preditores de problemas comportamentais de crianças expostas a práticas negativas e depressão materna. Tais resultados evidenciam o papel do sexo nas interações entre as variáveis, podendo nortear intervenções em saúde-mental.

Resumen La exposición a depresión materna y prácticas parentales negativas en la infancia se configuran como factor de vulnerabilidad relacionado con problemas comportamentales. Este estudio tuvo por objetivo verificar el efecto de la depresión materna (factor principal) en los indicadores comportamentales y prácticas parentales, considerando el efecto del sexo de los hijos (factor covariable); así como identificar los efectos predictivos de la depresión, las prácticas parentales maternas y el sexo de los niños en los indicadores comportamentales. Se compuso la muestra comunitaria con 101 díadas madres-hijos. Las madres respondieron a la Entrevista Clínica Estructurada para el DSM-IV, al Inventario de Estilos Parentales y al Cuestionario de Capacidades y Dificultades. Los análisis de covariancia y de regresión lineal multivariada evidenciaron el sexo masculino y las prácticas de negligencia, abuso físico y disciplina relajada como los principales predictores de problemas comportamentales de niños expuestos a prácticas negativas y a depresión materna. Tales resultados evidencian el papel del sexo en las interacciones entre las variables, favoreciendo las intervenciones en salud mental.

Educational Practices and Child Behaviors: Mothers' and Teachers' Evaluation / Práticas Educativas e Comportamentos Infantis: Avaliações de Mães e Professores

Abstract The objective of this study was to describe and compare mothers' and teachers' reports concerning their educational social skills and negative practices and children's behavioral problems and social skills. The mothers and teachers of 81 children participated in this study. The children were assigned to four groups depending on whether they presented problems exclusively at home, school, in both, or none of these contexts. Valid instruments measured educational practices and child behavior. The results show that: (a) mothers and teachers agreed that children with problems in both contexts presented the highest level of impairment; (b) the mothers more frequently reported skills such as affection, adopted negative practices, and identified problem behaviors; (c) the teachers reported more skills such as limit setting. The conclusion is that teachers' and mothers' practices differ, and such information can guide preventive programs and interventions.

Resumo Objetivou-se descrever e comparar avaliações de mães e professores quanto às suas habilidades sociais educativas, práticas negativas e problemas de comportamento e de habilidades sociais das crianças. Participaram mães e professores de 81 crianças, distribuídas em 4 subgrupos quanto à presença/ausência de dificuldades na família e na escola. Aplicou-se instrumentos validados para mensurar práticas educativas e comportamentos infantis. Verificou-se que: (a) crianças com problemas nos dois ambientes apresentaram mais comprometimento para mães e professores; (b) as mães referiram mais habilidades (afeto), usaram mais práticas negativas e identificaram mais problemas de comportamento; (c) os professores referiram mais habilidades para estabelecer limites. Conclui-se que práticas de mães e professores diferem e tais dados podem nortear programas de prevenção e intervenção.

Behavioral problems and their relationship to maternal depression, marital relationships, social skills and parenting.

Behavioral problems have been associated with multiple variables; however, studies simultaneously investigating parenting practices, marital relationships in bi-parental families, maternal depression, and child behavior remain a gap in the literature. The objective was to verify associations between positive and negative parenting practices, marital relationships, social skills, and behavioral problems among children from bi-parental families with and those without maternal depression; to identify the predictive effect of positive and negative parenting practices, marital relationships, children's social skills, and maternal depression, for internalizing, externalizing behavior problems and internalizing and externalizing comorbidities. A case-control study with a cross-sectional design was adopted to ensure the groups were homogeneous in regard to the children's, mothers', and families' sociodemographic characteristics. A total of 35 mothers currently with depression and 35 without depression indicators participated in the study, while the children were 25 preschoolers and 23 school-aged children. The mothers responded to instruments addressing depression, child behavior, parenting practices, and marital relationships. The results reveal maternal depression associated with marital relationships, positive parenting, and context variables. Maternal depression and marital relationship were found to influence externalizing problems; maternal depression, child-rearing practices, marital relationships, and the children's behavioral repertoires influence internalizing and externalizing comorbidities; and none of the independent variables influenced the occurrence of internalizing problems.

Intact nuclear families: associations between parental styles and school children's behavior / Famílias nucleares intactas: associações entre estilos parentais e comportamento de escolares / Familias nucleares intactas: asociaciones entre estilos parentales y comportamiento de escolares

Regardless of family configurations, few studies address the concomitant assessment of mothers and fathers regarding their children's behaviors and parenting practices. The objective was to compare and correlate the assessment of biological mothers and fathers of intact nuclear families on their parental practices and behavioral problems of their school-aged children. Fourth-two intact nuclear families answered to the following instruments: General Questionnaire, Parenting Style Inventory, Strengths and Difficulties Questionnaire and Raven Progressive Matrices Test - Special Scale. The quantitative analysis showed that mothers and fathers presented similar assessments regarding the behavior of their children, though mothers reported more positive practices than fathers. Negative parenting styles were positively correlated with child behavioral problems. These findings contribute to the planning of preventive strategies and interventions directed to families. (AU)

Independente da configuração familiar, poucos estudos têm abordado as avaliações concomitantes de mães e pais sobre os comportamentos e práticas educativas adotadas com seus filhos. Objetivou-se comparar e correlacionar a avaliação de mães e pais biológicos, de famílias nucleares intactas, sobre suas práticas educativas e problemas comportamentais de seus filhos, em idade escolar. Foram avaliadas 42 famílias nucleares intactas, que responderam aos seguintes instrumentos: Questionário Geral, Inventário de Estilos Parentais, Questionário de Capacidades e Dificuldades da Criança e Teste das Matrizes Progressivas de Raven - Escala Especial. Por meio de análise quantitativa, verificou-se que mães e pais apresentaram semelhanças quanto às avaliações sobre o comportamento dos filhos e que mães referiram mais práticas positivas do que pais. As práticas parentais negativas correlacionaram-se positivamente com os problemas de comportamento. Tais achados contribuem para o planejamento de estratégias de prevenção e intervenção com famílias. (AU)

Independiente de la configuración familiar, pocos estudios han abordado las evaluaciones concomitantes de madres y padres sobre los comportamientos y prácticas educativas adoptadas con sus hijos. Se tuvo como objetivo comparar y correlacionar la evaluación de madres y padres biológicos, de familias nucleares intactas, sobre las prácticas educativas y problemas comportamentales de sus hijos en edad escolar. Fueron evaluadas 42 familias nucleares intactas, que respondieron a los siguientes instrumentos: Cuestionario General, Inventario de Estilos Parentales, Cuestionario de Capacidades y Dificultades del Niño y Test de las Matrices Progresivas de Raven - Escala Especial. Por medio de un análisis cuantitativo, se verificó que madres y padres presentaron semejanzas con relación a las evaluaciones sobre el comportamiento de los hijos y que las madres mencionaron más prácticas positivas que los padres. Las prácticas parentales negativas se correlacionan positivamente con los problemas de comportamiento. Estos resultados contribuyen para la planificación de estrategias de prevención e intervención con las familias. (AU)

Evidence of validity for Socially Skillful Responses Questionnaires - SSRQ-Teachers and SSRQ-Parents / Evidências de validade para os Questionários de Respostas Socialmente Habilidosas - QRSH-Pr e QRSH-Pais / Evidencias de validez para los Cuestionarios de Respuestas Socialmente Habilidosas - QRSH-Pr y QRSH-Pais

There is a lack of free-of-charge validated instruments whereby parents and teachers may be respondents to assess child social skills. Social skills are known to prevent behavioral problems among preschool and school-aged children. This study fills in this gap, the objective of which is to assess the internal consistency and construct and discriminant validity of the Questionários de Respostas Socialmente Habilidosas [Socially Skillful Responses Questionnaire] - teachers' version - SSRQ-Teachers and parents' version - SSRQ-Parents. A total of 134 primary school and preschool teachers and 183 mothers/fathers/caregivers of 88 school-aged children and 95 preschoolers of both sexes participated in the study. In addition to the SSRQ teachers' and parents' versions, the participants completed an additional instrument: the teachers completed the Teacher Report Form - TRF and the parents completed the Child Behavior Checklist (CBCL). The results obtained in the exploratory factor analysis and ROC curve analysis, along with alpha values, indicate good psychometric properties. Thus, the SSRQ-Teachers and SSRQ-Parents presented in this paper are appropriate for assessing both preschool and school-aged children. (AU)

Verifica-se uma carência de instrumentos validados, de uso livre, tendo pais e professores como respondentes, que avaliem as habilidades sociais infantis, reconhecidas por prevenirem problemas de comportamento de pré-escolares e escolares. O estudo se insere nessa lacuna, tendo por objetivo avaliar a consistência interna, e as evidências de validade de construto e discriminante, relativas aos Questionários de Respostas Socialmente Habilidosas Versão para Professores - QRSH-Pr e para Pais - QRSH-Pais. Participaram 134 professores de crianças escolares e pré-escolares e 183 mães/pais/cuidadores de 88 escolares e de 95 pré-escolares, incluindo meninos e meninas, que além dos respectivos questionários responderam aos professores aos Inventários de Comportamentos da Infância e Adolescência - TRF (Teacher's Report Form) e os pais ao CBCL (Child Behavior Checklist). Os resultados indicaram boas propriedades psicométricas, tendo por suporte os valores do alfa, da análise fatorial exploratória e das análises de Curvas Roc. Considera-se que os instrumentos QRSH-Pr e QRSH-Pais, disponibilizados no artigo, mostraram-se adequados para a avaliação de pré-escolares e escolares. (AU)

Se verifica una falta de instrumentos validados, de uso gratuito, con padres y profesores como encuestados, que evalúan las habilidades sociales infantiles, reconocidas por prevenir problemas de comportamiento de preescolares y escolares. El estudio cae dentro de esta brecha, teniendo como objetivo evaluar la consistencia interna, y las evidencias de validez de constructo y discriminante, relativas a los Cuestionarios de Respuestas Socialmente Habilidosas Versión para Profesores (QRSH-Pr) y para Padres (QRSH-Pais). Participaron 134 profesores de niños escolares y preescolares y 183 madres / padres / cuidadores de 88 escolares y de 95 preescolares, incluyendo niños y niñas, que además de los respectivos cuestionarios los profesores respondieron a los Inventarios de Comportamientos de la Infancia y Adolescencia - TRF (Teacher's Report Form) y los padres al CBCL (Child Behavior Checklist). Los resultados indicaron buenas propiedades psicométricas, teniendo por soporte los valores del alfa, del análisis factorial exploratorio y los análisis de Curvas Roc. Se considera que los instrumentos QRSH-PR y QRSH-Pais, disponibles en el artículo, se mostraron adecuados para la evaluación de preescolares y escolares. (AU)

Associations between maternal depressive symptoms, childrens behavioral problems and perceptions regarding family interactions / Associações entre sintomas depressivos maternos, problemas comportamentais infantis e percepções sobre as interações familiares

The aim of this study was to verify possible associations between maternal depressive symptoms, children's behavioral problems and perceptions regarding the family interactions, considering the reports of mothers and children. A total of 60 mothers and their school-age children were divided into two equal groups, according to the presence or absence of maternal depression indicators, and evaluated using the following instruments: Sociodemographic Questionnaire, Patient Health Questionnaire-9, Strengths and Difficulties Questionnaire, and scales of family interaction (Escalas de Qualidade nas Interações Familiares). The results indicate that maternal depressive symptoms were associated with children's behavioral problems and with family interactions reported by mothers and children. Maternal depression and positive family interactions reported by the mothers predicted behavioral problems in children. Positive family interactions reported by the mothers also mediated the association between maternal depression and children's behavioral problems, highlighting the relevance of interventions with mothers with depression indicators that have school-age children.

Objetivou-se verificar as possíveis associações entre os sintomas depressivos maternos, os problemas de comportamento infantil e as percepções sobre as interações familiares, considerando-se os relatos das mães e das crianças. Avaliaram-se 60 mães e seus filhos escolares, divididos, conforme a presença ou ausência de indicadores depressivos maternos, em dois grupos de mesmo tamanho amostral pelos instrumentos Questionário Sociodemográfico, Questionário sobre a Saúde do Paciente-9, Questionário de Capacidades e Dificuldades, e Escalas de Qualidade nas Interações Familiares. Os sintomas depressivos maternos se associaram aos problemas comportamentais infantis e às interações familiares relatadas por mães e crianças. A depressão materna e as interações familiares positivas referidas pelas mães foram preditoras de problemas de comportamento. As interações familiares positivas descritas pelas mães mediaram a associação entre depressão materna e problemas comportamentais infantis, evidenciando a relevância de intervenções voltadas para mães com indicadores de depressão com filhos em idade escolar.

Problemas de comportamiento y recurso prosocial en la evaluación de madres y profesoras / BEHAVIOR PROBLEMS AND PROSOCIAL RESOURCaE IN THE EVALUATION OF MOTHER AND TEACHERS / Problemas de comportamento e recurso pró-social na avaliação de mães e professoras

Os problemas de comportamento das crianças podem ser internalizantes ou externalizantes, sendo os últimos mais comumente mencionados pelos pais e professores como fator de incômodo. Tem-se como objetivo comparar a avaliação de indicadores de problemas de comportamento e de recurso pró-social de escolares, a partir do relato de mães e professoras, considerando como variáveis o sexo e a escolaridade. Participaram do estudo 100 professoras, 200 alunos e 200 mães. Para a coleta de dados utilizou-se um questionário de caracterização e o Questionário de Capacidades e Dificuldades - (SDQ). Verificaram-se diferenças estatísticas significativas na avaliação dos recursos adaptativos e problemas de comportamento, por mães e professoras, em todas as escalas e escore total do SDQ. As mães identificaram mais problemas que as professoras, para os meninos, mais recursos de socialização para meninas, e mais sintomas emocionais nos anos iniciais de escolarização. A avaliação simultânea de recursos adaptativos e problemas favorece práticas preventivas.

Los problemas de comportamiento de los niños pueden ser internalizantes o externalizantes, los últimos, más comúnmente mencionados por los padres y profesores como factor de incómodo. Se tiene como objetivo comparar la evaluación de indicadores de problemas de comportamiento y de recurso prosocial de escolares, a partir de relato de madres y profesoras, considerando como variables el sexo y la escolaridad. Participaron del estudio 100 profesoras, 200 alumnos y 200 madres. Para la recolecta de datos se utilizó un cuestionario de caracterización y el Cuestionario de Capacidades y Dificultades - (SDQ). Se evidenció diferencias estadísticas significativas en la evaluación de los recursos adaptativos y problemas de comportamiento, por madres y profesoras, en todas las escalas y escore total del SDQ. Las madres identificaron más problemas que las profesoras, para los niños, más recursos de socialización para niñas, y más síntomas emocionales en los curos iniciales de escolarización. La evaluación simultánea de recursos adaptativos y problemas favorecen prácticas preventivas.

Children's behavior problems can be internalizing or externalizing, with the latter being most commonly mentioned by parents and teachers as a nuisance factor. The aim is to compare assessments on indicators of behavior problems and prosocial resources in schoolchildren, based on the report of mothers and teachers, considering sex and level of school education as variables. In the present study, 100 teachers, 200 students and 200 mothers participated. For data collection, a characterization questionnaire and the Strengths and Difficulties Questionnaire - (SDQ) were used. Mothers and teachers found significant statistical differences in the assessment of prosocial resources and behavior problems in all scales and in the total SDQ score. Mothers surpassed teachers in the identification of problems for boys, of more prosocial resources for girls, and of more emotional symptoms in the early years of schooling. The simultaneous assessment of prosocial resources and problems leads to preventive practices.

Behavioral problems and their relationship to maternal depression, marital relationships, social skills and parenting

Abstract Behavioral problems have been associated with multiple variables; however, studies simultaneously investigating parenting practices, marital relationships in bi-parental families, maternal depression, and child behavior remain a gap in the literature. The objective was to verify associations between positive and negative parenting practices, marital relationships, social skills, and behavioral problems among children from bi-parental families with and those without maternal depression; to identify the predictive effect of positive and negative parenting practices, marital relationships, children's social skills, and maternal depression, for internalizing, externalizing behavior problems and internalizing and externalizing comorbidities. A case-control study with a cross-sectional design was adopted to ensure the groups were homogeneous in regard to the children's, mothers', and families' sociodemographic characteristics. A total of 35 mothers currently with depression and 35 without depression indicators participated in the study, while the children were 25 preschoolers and 23 school-aged children. The mothers responded to instruments addressing depression, child behavior, parenting practices, and marital relationships. The results reveal maternal depression associated with marital relationships, positive parenting, and context variables. Maternal depression and marital relationship were found to influence externalizing problems; maternal depression, childrearing practices, marital relationships, and the children's behavioral repertoires influence internalizing and externalizing comorbidities; and none of the independent variables influenced the occurrence of internalizing problems.

Protection and Risk for Different School Stress Trajectories / Proteção e Risco para Diferentes Trajetórias de Estresse de Escolares / Protección y Riesgo en Diferentes Trayectorias de Estrés de Escolares

Abstract The study of chronic stress, potentially harmful to development, resents the focus of research on modal trends, not discriminating individual trajectories of chronicity. This study aimed to associate groups differentiated by the trajectory of stress, in children from the 1st to the 3rd year of Elementary School - Without Stress, Acute Stress and Chronic Stress, to the variables of protection or risk of the child and the school itself. One hundred and eleven students (56 boys) participated in the Child Stress Scale, Provinha Brasil, School Stressors Inventory and Social Skills Rating System - Teachers. Early childhood education, the Basic Education Index and the location of the school were considered. Comparison and prediction analyses were performed. Results indicated worse performance and greater perception of stressors in the group with chronic stress. Externalizing behavior, performance stressors and less permanence in Early Childhood Education contribute to chronicity. The focus on trajectories highlighted the vulnerability of chronically stressed children.

Resumo O estudo do estresse crônico, potencialmente prejudicial ao desenvolvimento, ressente-se do foco das pesquisas em tendências modais, não discriminando trajetórias individuais de cronicidade. O presente estudo teve como objetivo associar grupos diferenciados pela trajetória de estresse, de crianças do 1º ao 3º ano do Ensino Fundamental - Sem Estresse, Estresse Pontual e Estresse Crônico, à variáveis de proteção ou de risco da própria criança e da escola. Participaram 111 alunos (56 meninos) avaliados pela Escala de Estresse Infantil, Provinha Brasil, Inventário de Estressores Escolares e Social Skills Rating System - Professores. A Educação Infantil, o Índice da Educação Básica e a localização da escola foram considerados. Análises de comparação e de predição foram realizadas. Os resultados indicaram pior desempenho e maior percepção de estressores no grupo com estresse crônico. Comportamento externalizante, estressores do desempenho e menor permanência na Educação Infantil contribuem para a cronicidade. O foco nas trajetórias ressaltou a vulnerabilidade das crianças cronicamente estressadas.

Resumen Los estudios acerca del estrés crónico potencialmente dañino para el desarrollo se basan en investigaciones enfocadas en tendencias modales, sin discriminar las trayectorias individuales de la cronicidad. El presente estudio tuvo como objetivo asociar los grupos diferenciados por la trayectoria de estrés en niños del 1.° al 3.° grado de la primaria - Sin estrés, Estrés puntual y Estrés crónico, con las variables de protección o de riesgo del niño y de la escuela. Se evaluaron a 111 alumnos (56 chicos) utilizando la Escala de Estrés Infantil, la Provinha Brasil, el Sistema de Inventario de Estrés de Escolares y el Social Skills Rating System, Maestros. Se consideraron la Educación de la primera infancia, el Índice de educación básica y la ubicación de la escuela. Se hizo el análisis de comparación y de predicción. Los resultados indicaron un peor rendimiento y una mayor percepción de estresores en el grupo con estrés crónico. El comportamiento externo, los factores estresantes del rendimiento y la menor permanencia en la educación de la primera infancia contribuyen a la cronicidad. El enfoque en las trayectorias destaca la vulnerabilidad de los niños con estrés crónico.

Clinical validity and intrarater and test-retest reliability of the Structured Clinical Interview for DSM-5 - Clinician Version (SCID-5-CV).

AIM: The Structured Clinical Interview for the DSM is one of the most used diagnostic instruments in clinical research worldwide. The current Clinician Version of the instrument (SCID-5-CV) has not yet been assessed in respect to its psychometric qualities. We aimed to assess the clinical validity and different reliability indicators (interrater test-retest, joint interview, face-to-face vs telephone application) of the SCID-5-CV in a large sample of 180 non-prototypical and psychiatric patients based on interviews conducted by raters with different levels of clinical experience. METHODS: The SCID-5-CV was administered face-to-face and by telephone by 12 psychiatrists/psychologists who took turns as raters and observers. Clinical diagnoses were established according to DSM-5 criteria and the longitudinal, expert, all data (LEAD) procedure. We calculated the percentage of agreement, diagnostic sensitivity and specificity, and the level of agreement (kappa) for diagnostic categories and specific diagnoses. RESULTS: The percentage of positive agreement between the interview and clinical diagnoses ranged between 73% and 97% and the diagnostic sensitivity/specificity were >0.70. In the joint interview, the levels of positive agreement were high (>75%) and kappa levels were >0.70 for most diagnoses. The values were less expressive, but still adequate, for interrater test-retest interviews. CONCLUSION: The SCID-5-CV presented excellent reliability and high specificity as assessed with different methods. The clinical validity of the instrument was also confirmed, which supports its use in daily clinical practice. We highlight the adequacy of the instrument to be used via telephone and the need for careful use by professionals with little experience in psychiatric clinical practice.