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1.
Prax Kinderpsychol Kinderpsychiatr ; 69(1): 3-21, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31918650

RESUMO

Parents' and Childcare Teachers' Agreement on Mental Health Problems, Psychosocial Ressources and Need for Action Young Children with mental health problems rarely receive professional help. Recognising a problem is one key factor for mental health care utilisation in kindergarten age. In this study psychosocial problems and ressources of 255 children (age 3,0-6,6 years) were assessed by parents and childcare teachers with the instrument "Verhaltensskalen für das Kindergartenalter" (VSK, Koglin u. Petermann, 2016). Subjective need for action was also measured. Teachers announced a need for action in 19.8 % of the children, while parents did so for 17.3 % of the children, but they agreed only for 18.9 % of these children. So agreement on need for action was low (κ = .16). Agreement was also low for psychosocial problems (Median ICC = .32), and very low with respect to the borderline/clinical range (κ = .13). No agreement was found for psychosocial ressources. Results underline the importance for Early Education and Care professionals to cooperate with institutions like social-pediatric centers to avoid blind spots in the identification of mental health problems in preschool age.


Assuntos
Transtornos do Comportamento Infantil , Saúde Mental , Professores Escolares , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/terapia , Pré-Escolar , Humanos , Pais
2.
Arch Dis Child Fetal Neonatal Ed ; 105(1): 8-13, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31036702

RESUMO

OBJECTIVE: Since therapeutic hypothermia became standard care for neonatal hypoxic-ischaemic encephalopathy (HIE), even fewer infants die or have disability at 18-month assessment than in the clinical trials. However, longer term follow-up of apparently unimpaired children is lacking. We investigated the cognitive, motor and behavioural performances of survivors without cerebral palsy (CP) cooled for HIE, in comparison with matched non-HIE control children at 6-8 years. DESIGN: Case-control study. PARTICIPANTS: 29 case children without CP, cooled in 2008-2010 and 20 age-matched, sex-matched and social class-matched term-born controls. MEASURES: Wechsler Intelligence Scales for Children, Fourth UK Edition, Movement Assessment Battery for Children, Second Edition (MABC-2) and Strengths and Difficulties Questionnaire. RESULTS: Cases compared with controls had significantly lower mean (SD) full-scale IQ (91 [10.37]vs105[13.41]; mean difference (MD): -13.62, 95% CI -20.53 to -6.71) and total MABC-2 scores (7.9 [3.26]vs10.2[2.86]; MD: -2.12, 95% CI -3.93 to -0.3). Mean differences were significant between cases and controls for verbal comprehension (-8.8, 95% CI -14.25 to -3.34), perceptual reasoning (-13.9, 95% CI-20.78 to -7.09), working memory (-8.2, 95% CI-16.29 to -0.17), processing speed (-11.6, 95% CI-20.69 to -2.47), aiming and catching (-1.6, 95% CI-3.26 to -0.10) and manual dexterity (-2.8, 95% CI-4.64 to -0.85). The case group reported significantly higher median (IQR) total (12 [6.5-13.5] vs 6 [2.25-10], p=0.005) and emotional behavioural difficulties (2 [1-4.5] vs 0.5 [0-2.75], p=0.03) and more case children needed extra support in school (34%vs5%, p=0.02) than the control group. CONCLUSIONS: School-age children without CP cooled for HIE still have reduced cognitive and motor performance and more emotional difficulties than their peers, strongly supporting the need for school-age assessments.


Assuntos
Hipotermia Induzida , Hipóxia-Isquemia Encefálica/terapia , Transtornos do Neurodesenvolvimento/diagnóstico , Estudos de Casos e Controles , Criança , Transtornos do Comportamento Infantil/diagnóstico , Compreensão , Feminino , Seguimentos , Humanos , Recém-Nascido , Masculino , Memória de Curto Prazo , Destreza Motora , Testes Neuropsicológicos , Estudos Prospectivos , Desempenho Psicomotor , Reino Unido , Escalas de Wechsler
3.
Dan Med J ; 66(6)2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31256773

RESUMO

INTRODUCTION: The Strengths and Difficulties Ques-tion-naire (SDQ) is a brief well-validated psychometric instrument for assessment of developmental, behavioural and emo-tional problems in children and adolescents. Versions of the questionnaire covering the 2-17-year age range are an-swered by parents and by pedagogues or teachers. Also, a self-report version can be used from the age of 11 years. The SDQ is well-accepted by informants and is increasingly preferred both internationally and in Denmark for research and evaluation purposes. The questionnaire is also well-suited for clinical use, especially in the primary sector. However, no comprehensive set of Danish norms has been available before this study. METHODS: Data from an extensive survey in a Danish municipality was used to generate national norms for SDQ scores. These norms were compared with British and Nordic population data. RESULTS: Across informants, threshold values show some variation with age and often differ between sexes. Therefore, norms are provided both with and without gender stratification. Similarities as well as differences were found between the Danish norms and materials from other countries. The differences may, to some extent, be attributable to methodological issues. CONCLUSION: We expect that the availability of Danish SDQ norms will further stimulate the use of the instrument. FUNDING: TrygFonden provided financial support for the development of Danish SDQ norms. TRIAL REGISTRATION: not relevant.


Assuntos
Sintomas Afetivos/diagnóstico , Sintomas Afetivos/epidemiologia , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/epidemiologia , Psicometria/estatística & dados numéricos , Inquéritos e Questionários , Adolescente , Sintomas Afetivos/psicologia , Criança , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Dinamarca , Feminino , Humanos , Masculino , Valores de Referência , Autorrelato
4.
Pediatrics ; 144(1)2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31186366

RESUMO

BACKGROUND AND OBJECTIVES: In the context of protracted shortages of pediatric behavioral health (BH) specialists, BH integration in pediatric primary care can increase access to BH services. The objectives of this study were to assess the structure and process of pediatric BH integration and outcomes in patient experience (access and quality), cost, and provider satisfaction. METHODS: In 2013, we launched a multicomponent, transdiagnostic integrated BH model (Behavioral Health Integration Program [BHIP]) in a large pediatric primary care network in Massachusetts. Study participants comprised the first 13 practices to enroll in BHIP (Phase-1). Phase-1 practices are distributed across Greater Boston, with ∼105 primary care practitioners serving ∼114 000 patients. Intervention components comprised in-depth BH education, on-demand psychiatric consultation, operational support for integrated practice transformation, and on-site clinical BH service. RESULTS: Over 5 years, BHIP was associated with increased practice-level BH integration (P < .001), psychotherapy (P < .001), and medical (P = .04) BH visits and guideline-congruent medication prescriptions for anxiety and depression (P = .05) and attention-deficit/hyperactivity disorder (P = .05). Total ambulatory BH spending increased by 8% in constant dollars over 5 years, mainly attributable to task-shifting from specialty to primary care. Although an initial decline in emergency BH visits from BHIP practices was not sustained, total emergency BH spending decreased by 19%. BHIP providers reported high BH self-efficacy and professional satisfaction from BHIP participation. CONCLUSIONS: Findings from this study suggest that integrating BH in the pediatric setting can increase access to quality BH services while engendering provider confidence and satisfaction and averting substantial increases in cost.


Assuntos
Serviços de Saúde da Criança/organização & administração , Serviços de Saúde Mental/organização & administração , Atenção Primária à Saúde/organização & administração , Atitude do Pessoal de Saúde , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/terapia , Educação Médica Continuada , Acesso aos Serviços de Saúde , Humanos , Massachusetts , Satisfação do Paciente , Avaliação de Programas e Projetos de Saúde , Psicoterapia , Encaminhamento e Consulta
5.
Scand J Psychol ; 60(5): 430-439, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31099031

RESUMO

Assessment of behavioral disorders is one of the most commonly encountered tasks in child psychiatry. The Eyberg Child Behavior Inventory (ECBI) is a widespread measurement tool used for assessing conduct problems, though the psychometric properties of the tool have varied in different samples. In this study, the ECBI was evaluated in a Finnish population based sample of children aged 4 to 12 years (n = 1,715). Factor structure and internal consistency of the ECBI and associates of behavioral problems in Finnish children were evaluated. The results showed that a unidimensional one-factor solution for the ECBI intensity scale was the best fit for the data. The ECBI mean scores were considerably higher in our sample compared to other Nordic countries. Boys scored higher than girls on both ECBI scales, and the mean scores decreased with child's age. Socioeconomic status (SES) was weakly connected to the ECBI scores. Our results highlight the need for country specific reference norms in order to improve the clinical utility of evidence-based measures for assessing conduct problems.


Assuntos
Transtornos do Comportamento Infantil/diagnóstico , Comportamento Problema , Criança , Transtornos do Comportamento Infantil/economia , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Interpretação Estatística de Dados , Análise Fatorial , Feminino , Finlândia/epidemiologia , Humanos , Masculino , Comportamento Problema/psicologia , Psicometria , Valores de Referência , Países Escandinavos e Nórdicos , Classe Social
6.
Rev Chil Pediatr ; 90(2): 157-165, 2019 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-31095232

RESUMO

INTRODUCTION: The dysregulation profile (DP) is a relevant clinical entity in the children and ado lescent area since its association with future psychopathology. DP is defined by the Child Behavior Checklist (CBCL), combining internalizing symptoms (anxiety/depression) and externalizing ones (aggressiveness, attention problems). OBJECTIVES: To study the frequency of CBCL-DP in a sample of Chilean preschoolers. PATIENTS AND METHOD: A sociodemographic survey and CBCL 1.5-5 was applied to caregivers of children aged 30 to 48 months in a national representative sample of public health system users. Frequency was estimated using the Kim et al. method and an explanatory model was made using binary logistic regression of DP using the child, caregiver, and contextual variables. RESULTS: The sample size was n = 1,429 preschool children and their caregivers. The frequency of DP was 11.6% (95% CI 9.9-13.5%). The variables that allow to classify DP in 88.6% of cases were: current depressive symptoms in the main caregiver (OR: 2.24; 95% CI 1.37-3.67); number of stressful events experienced by the main caregiver (p = 0.005); number of available elements for child development stimulation in the home (p = 0.001); number of chronic diseases of the child (p = 0.006). Conclu sions: DP has a high frequency in preschoolers, which implies a relevant mental health burden. This finding points to the need for interventions in this area and also longitudinal monitoring of this subgroup.


Assuntos
Transtornos do Comportamento Infantil/diagnóstico , Escalas de Graduação Psiquiátrica , Cuidadores/psicologia , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Chile/epidemiologia , Efeitos Psicossociais da Doença , Feminino , Humanos , Modelos Logísticos , Masculino , Modelos Psicológicos
9.
Eur J Pediatr ; 178(7): 995-1003, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31030258

RESUMO

Primary ciliary dyskinesia (PCD) causes a broad spectrum of disease. This study aims to explore the developmental, behavioral, and social-emotional aspects of preschool-aged children with PCD. Fourteen PCD, 17 cystic fibrosis (CF) patients and 15 healthy subjects were enrolled. Developmental features of the participants were evaluated with Ages and Stages Questionnaire. Parents of participants filled out the Child Behavior Checklist (CBCL). The number of children screened positive for developmental delay was statistically higher in the PCD group. Higher numbers of children with PCD were screened positive for developmental delay in communication and problem-solving domains. Delay in fine motor skill domain was more common in children with PCD and CF compared to healthy subjects. There was no difference among the three groups in terms of gross motor and personal-social development. None of the children in all three groups was shown to have social-emotional problems. In CBCL, patients with CF had higher internalizing problem scores. Externalizing and total problem scores did not differ between the three groups. However, among PCD patients, children with developmental delay on more than one domain had higher externalizing and total problem scores.Conclusion: The current study revealed that positive screening for developmental delay is more common in preschool-aged PCD patients compared to patients with CF and healthy children. What is Known: • Intelligence scores of school-aged PCD patients are similar to healthy subjects despite their higher internalizing problem scores on Child Behavior Checklist (CBCL). • School-aged PCD patients exhibit higher hyperactivity and inattention findings. What is New: • Positive screening for developmental delay in communication, problem-solving and fine motor skills is more common in preschool-aged PCD patients. • Preschool-aged PCD patients screened positive for developmental delay in more than one domain have higher externalizing and total problem scores on CBCL.


Assuntos
Transtornos do Comportamento Infantil/etiologia , Transtornos da Motilidade Ciliar/complicações , Deficiências do Desenvolvimento/etiologia , Escala de Avaliação Comportamental , Estudos de Casos e Controles , Transtornos do Comportamento Infantil/diagnóstico , Pré-Escolar , Transtornos da Motilidade Ciliar/fisiopatologia , Transtornos da Motilidade Ciliar/psicologia , Estudos de Coortes , Deficiências do Desenvolvimento/diagnóstico , Feminino , Humanos , Masculino , Fatores de Risco
10.
Behav Ther ; 50(3): 608-620, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31030877

RESUMO

Limited research has examined sleep-related problems (SRPs) among children and adolescents with obsessive-compulsive disorder (OCD). The present study addresses this gap by investigating preliminary associations between SRPs, demographic factors (gender and age), family variables (family accommodation and parental stress), and clinical factors (medication status, internalizing and externalizing symptoms, OCD severity, OCD-related impairment), and treatment outcomes in a sample of 103 youth (aged 7 to 17 years; 53% female) with a primary diagnosis of OCD. Clinician, parent, and child measures were used to assess demographic, family, and clinical predictors. SRPs were assessed using an 8-item measure comprising items of the Child Behaviour Checklist, Child Depression Inventory, and Multidimensional Anxiety Scale for Children as used in previous studies. Results showed that SRPs were highly prevalent among this sample and that more SRPs were associated with younger age, internalizing problems, and functional impairment. However, SRPs were not an independent predictor of OCD severity, impairment, or treatment response. Preliminary findings suggest that SRPs among youth with OCD may be more strongly associated with broader internalizing symptoms than with OCD itself. Future longitudinal research is warranted to further explore the complexity of SRPs when co-occurring with pediatric OCD.


Assuntos
Terapia Implosiva/métodos , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno Obsessivo-Compulsivo/terapia , Transtornos do Sono-Vigília/psicologia , Transtornos do Sono-Vigília/terapia , Adolescente , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/psicologia , Transtornos do Comportamento Infantil/terapia , Feminino , Seguimentos , Humanos , Intenção , Masculino , Transtorno Obsessivo-Compulsivo/diagnóstico , Pais/psicologia , Transtornos do Sono-Vigília/diagnóstico , Resultado do Tratamento
11.
BMC Psychiatry ; 19(1): 112, 2019 04 11.
Artigo em Inglês | MEDLINE | ID: mdl-30975129

RESUMO

BACKGROUND: Parenthood is a life transition that can be especially demanding for vulnerable individuals. Young maternal age and maternal single status have been reported to increase the risk for adverse outcomes for both mother and child. The aim of this study was to investigate the effect of young maternal age and maternal single status on maternal and child mental health and child development at age 3. METHODS: A birth-cohort of 1723 mothers and their children were followed from birth to age 3. Sixty-one mothers (3.5%) were age 20 or younger, and 65 (4.0%) reported single status at childbirth. The mothers filled out standardized instruments and medical information was retrieved from the standardized clinical assessment of the children at Child Welfare Centers, (CWC). RESULTS: Young maternal age was associated with symptoms of postpartum depression whereas single status was not. Young mothers were more prone to report internalizing and externalizing problems in their children, while there was no association between single status and child behavioral problems. No differences were seen on child development (CWC scores). School drop-out was, however, a more influential factor on depressive symptoms postpartum than maternal age. CONCLUSION: Young mothers are at increased risk for symptoms of postpartum depression which indicates the need for attention in pre- and postnatal health care programs. Single mothers and their children were not found to be at increased risk for adverse outcomes. The importance of schooling was demonstrated, indicating the need for societal support to encourage adolescents to remain in school.


Assuntos
Comportamento Infantil/psicologia , Depressão Pós-Parto/psicologia , Saúde Mental/tendências , Relações Mãe-Filho/psicologia , Mães/psicologia , Pais Solteiros/psicologia , Adolescente , Adulto , Fatores Etários , Comportamento Infantil/fisiologia , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/psicologia , Desenvolvimento Infantil/fisiologia , Pré-Escolar , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Gravidez , Apoio Social , Suécia/epidemiologia , Adulto Jovem
12.
Issues Ment Health Nurs ; 40(6): 486-492, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30917053

RESUMO

Over 5 million American children are estimated to be exposed to intimate partner violence (IPV) annually. The past decade has seen a surge in research, assessment, and related interventions regarding children and violence. Contemporary practice guidelines continue to expand relative to the wide range of violence that a child might be exposed to, particularly noting that children who have experienced one type of violence, such as physical abuse, are at great risk for also experiencing other forms of violence. Effects on children exposed to IPV are potentially catastrophic and can be influenced, by not only the number of exposures, but also the protective factors that are available to a child when violence is encountered. Treatment should be individualized and appropriate for the developmental level of the child. It is also essential to identify and include the child's non-abusive parent into the process to support the child and related treatment.


Assuntos
Experiências Adversas da Infância , Maus-Tratos Infantis/psicologia , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/terapia , Violência por Parceiro Íntimo/psicologia , Pais/psicologia , Adulto , Criança , Transtornos do Comportamento Infantil/etiologia , Humanos
13.
Atten Defic Hyperact Disord ; 11(1): 113-122, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30927236

RESUMO

This longitudinal study focused on early behavioural problems and autistic traits. In a stratified, population-derived sample of 119 children, mothers reported through questionnaires on externalizing, internalizing, and social-communicative characteristics of their child in infancy (14 months) and toddlerhood (37 months), and on autistic traits at preschool age (4-5 years). Children with consistently normal behaviour from infancy to toddlerhood showed lower autistic traits at preschool age than children with deviant behaviour on one or both time points. High autistic traits at preschool age were predominantly preceded by problems in interaction, communication, language, play, and affect in infancy and/or toddlerhood, but also by inattention in toddlerhood. Adequate support and specific interventions in these domains are needed in an attempt to diminish further derailment of the child's behaviour and development, and to prevent the full manifestation of ASD or related disorders such as ADHD.


Assuntos
Atenção , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/psicologia , Transtornos do Comportamento Infantil/diagnóstico , Comunicação , Sintomas Prodrômicos , Comportamento Social , Adulto , Pré-Escolar , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Pais , Inquéritos e Questionários
14.
PLoS One ; 14(2): e0212667, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30817752

RESUMO

BACKGROUND: The present study conducted secondary analyses of a randomized controlled trial to examine the transgenerational relationship between cognitive-behavioral therapy for child Separation Anxiety Disorder (SepAD) and the mental health of parents. Symptoms of anxiety and depression were compared before and after child treatment between parents of children treated for SepAD and parents of healthy children, who did not receive any treatment. METHODS: One hundred and seven children aged 4-14 years with SepAD received one of two cognitive behavioral treatment programs for SepAD (TAFF; TrennungsAngstprogramm Für Familien; English: Separation Anxiety Family Therapy or CC; Coping Cat). Their parents (N = 189; 101 mothers and 88 fathers) were assessed at baseline and post-treatment for symptoms of separation anxiety, general anxiety, and depression. A comparison group of parents (N = 74; 42 mothers and 32 fathers) of 45 children without SepAD, who did not receive any treatment, were also assessed. RESULTS: Results indicated a significant interaction effect between group and time on mothers' depression and separation anxiety, indicating that maternal symptoms of depression and separation anxiety improved in the child treatment condition in comparison to mothers of healthy children. There was no significant improvement in parental pathology levels among fathers of children treated for SepAD. CONCLUSIONS: Treatment for child SepAD may have subsequent positive effects on mothers' own levels of separation anxiety and depression, though the mechanisms are yet unknown. Future studies are needed that test the transgenerational effect of child SepAD treatment on parental mental health as the primary research question.


Assuntos
Ansiedade de Separação/terapia , Transtornos do Comportamento Infantil/terapia , Terapia Cognitivo-Comportamental , Depressão/diagnóstico , Pai/psicologia , Mães/psicologia , Adolescente , Adulto , Ansiedade de Separação/diagnóstico , Ansiedade de Separação/psicologia , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Depressão/psicologia , Pai/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mães/estatística & dados numéricos , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Autorrelato/estatística & dados numéricos , Índice de Gravidade de Doença , Fatores Sexuais , Resultado do Tratamento
15.
Arch Pediatr ; 26(4): 220-225, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30885603

RESUMO

Detecting an abnormal developmental trajectory in very preterm infants remains challenging. The objective of this study was to determine the correlation between the Draw-a-Man test (DAMT) and behavioral and cognitive disabilities in very preterm infants. From the school-age follow-up of the Premag study, which evaluated the neuroprotective effect of prenatal magnesium sulfate before 33 weeks of gestation, 281 human figure drawings were assessed (mean age, 11 years). Behavioral and cognitive disabilities were associated with delayed DAMTs but test performance indicators were insufficient to use DAMT as a screening or a diagnostic test.


Assuntos
Arte , Transtornos do Comportamento Infantil/diagnóstico , Transtornos Cognitivos/diagnóstico , Testes Neuropsicológicos , Adolescente , Paralisia Cerebral/prevenção & controle , Criança , Feminino , Seguimentos , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Sulfato de Magnésio/uso terapêutico , Masculino , Fármacos Neuroprotetores/uso terapêutico , Cuidado Pré-Natal , Inquéritos e Questionários
16.
Pediatrics ; 143(3)2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30737245

RESUMO

: media-1vid110.1542/5984232215001PEDS-VA_2018-0977Video Abstract OBJECTIVES: To examine profiles of infant regulatory behaviors and associated family characteristics in a community sample of 12-month-old infants and mental health difficulties at 5 and 11 years of age. METHODS: Items relating to demographic characteristics, maternal distress, and infant regulation were completed by 1759 mothers when their infants were 8 to 12 months old. The Strengths and Difficulties Questionnaire was completed by mothers at child ages 5 (n = 1002) and 11 (n = 871) years. RESULTS: Analyses revealed 5 profiles ranging from the most settled infants (36.8%) to those with mainly sleep problems (25.4%), isolated mild-to-moderate tantrums (21.3%), complex regulatory difficulties (13.2%), and complex and severe regulatory difficulties (3.4%). Compared with those in the settled profile, children in the moderately unsettled profile were more likely to score in the clinical range for total difficulties at 11 years of age (odds ratio [OR] 2.85; 95% confidence interval [CI]: 1.28 to 6.36; P < .01), and children in the severely unsettled profile were more likely to score in the clinical range at 5 (OR 9.35; 95% CI: 2.49 to 35.11; P < .01) and 11 years of age (OR 10.37; 95% CI: 3.74 to 28.70; P < .01). CONCLUSIONS: Infants with multiple moderate-to-severe regulatory problems experience substantially heightened odds of clinically significant mental health concerns during childhood, and these symptoms appear to worsen over time. Clinicians must inquire about the extent, complexity, and severity of infant regulatory problems to identify those in the most urgent need of intervention and support.


Assuntos
Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/epidemiologia , Comportamento do Lactente/fisiologia , Saúde Mental/tendências , Adulto , Criança , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Estudos de Coortes , Humanos , Lactente , Comportamento do Lactente/psicologia , Estudos Longitudinais , Vitória/epidemiologia
17.
EBioMedicine ; 40: 655-662, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30709768

RESUMO

BACKGROUND: Behaviour problems are prevalent among children born very preterm (≤ 32 weeks gestation), and have been associated with morphine exposure. Morphine accumulation in the brain is determined by genetic variations related to morphine biotransformation. The objective of the study was to investigate whether morphine-biotransformation genotypes contribute to individual differences in long-term effects of morphine on behaviour at 18 months corrected age (CA). METHODS: 198 children born very preterm (24-32 weeks gestation) were followed from birth and seen at 18 months CA. Relationships between child behavior (Internalizing, Externalizing on the Child Behavior Checklist), morphine exposure, neonatal clinical variables, and morphine biotransformation gene variants in ABCB1, UGT1A9, UGT 2B7*2, ABCC2, ABCC3, SLCO1B1, CYP3A4, COMT were examined. FINDINGS: Neonatal clinical predictors and genotypes accounted for 39% of the overall variance in behaviour. In children with the minor allele of UGT1A9 rs17863783 (marker of UGT1A6*4, UDP-glucuronosyltransferase), greater morphine exposure (p = ·0011) was associated with more Internalizing behaviour. More Externalizing behaviour was predicted by greater morphine exposure in children with the COMT rs4680 Met/Met genotype (p = ·0006). INTERPRETATION: Genetic variations that affect relative accumulation of morphine in the brain, together with neonatal clinical factors, are differentially related to anxiety and depressive symptoms (internalizing) and to acting out (externalizing) behaviours at 18 months CA in children born very preterm. FUND: NIH/NICHD HD039783 (REG); CIHR MOP86489 (REG), MOP68898 (SPM), MOP79262 (SPM, REG).


Assuntos
Transtornos do Comportamento Infantil/etiologia , Transtornos do Comportamento Infantil/psicologia , Inativação Metabólica/genética , Lactente Extremamente Prematuro/psicologia , Morfina/metabolismo , Fatores Etários , Alelos , Transtornos do Comportamento Infantil/diagnóstico , Suscetibilidade a Doenças , Feminino , Estudos de Associação Genética , Genótipo , Humanos , Lactente , Recém-Nascido , Masculino , Redes e Vias Metabólicas/genética , Morfina/administração & dosagem , Prognóstico , Psicometria/métodos
18.
PLoS One ; 14(1): e0211427, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30703154

RESUMO

OBJECTIVES: Moderately and late preterm children (MLPs, 32.0-36.9 weeks gestational age) have a greater risk of poorer growth. This seems to be associated with poorer neuropsychological functioning. Evidence is limited on whether this also holds for emotional and behavioral (EB) problems. Therefore, we assessed whether longitudinal growth from birth until age 7 was associated with EB problems at age 7 in MLPs. STUDY DESIGN: This study was part of the Longitudinal Preterm Outcome Project, a prospective cohort study. Data on growth (height, weight, head circumference, and extent of catch-up growth) were obtained from assessments from birth until age 7. EB problems were assessed at age 7 with the Child Behavior Checklist. We assessed whether growth and EB problems were associated using logistic regression analyses, adjusting for multiple birth, parity, and socioeconomic status. RESULTS: We included 248 MLPs. Median gestational age was 34 weeks (interquartile range: 33-35 weeks). Mean birth weight was 2.2 kg (standard deviation: 0.5 kg). Postnatal growth measures were below the Dutch reference norm. EB problems were more prevalent in MLPs than in the general Dutch population. Generally, we found no associations between growth and EB problems; odds ratios ranged from 0.20 to 2.72. CONCLUSIONS: In MLPs, postnatal growth from birth until age 7 was not associated with EB problems at age 7. Poorer growth thus seems to relate to neuropsychological problems, but not to EB problems. This suggests that the etiologies of these problems differ at least partially.


Assuntos
Transtornos do Comportamento Infantil/etiologia , Desenvolvimento Infantil , Emoções/fisiologia , Cabeça/crescimento & desenvolvimento , Doenças do Prematuro/etiologia , Recém-Nascido Prematuro/crescimento & desenvolvimento , Recém-Nascido Prematuro/psicologia , Criança , Transtornos do Comportamento Infantil/diagnóstico , Pré-Escolar , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Doenças do Prematuro/diagnóstico , Estudos Longitudinais , Masculino , Testes Neuropsicológicos , Gravidez , Nascimento Prematuro , Estudos Prospectivos , Fatores de Risco
19.
J Clin Child Adolesc Psychol ; 48(1): 1-15, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30640522

RESUMO

The controlled evaluation of treatments for early childhood anxiety and related problems has been a relatively recent area of investigation, and accordingly, trials examining early childhood anxiety treatment have not been well represented in existing systematic reviews of youth anxiety treatments. This Evidence Base Update provides the first systematic review of evidence supporting interventions specifically for the treatment of early childhood anxiety and related problems. Thirty articles testing 38 treatments in samples with mean age < 7.9 years (N = 2,228 children) met inclusion criteria. We applied Southam-Gerow and Prinstein's (2014) review criteria, which classifies families of treatments according to one of five levels of empirical support-Well-Established, Probably Efficacious, Possibly Efficacious, Experimental, and of Questionable Efficacy. We found family-based cognitive-behavioral therapy (CBT) to be a Well-Established treatment, and Group Parent CBT and Group Parent CBT + Group Child CBT to both be Probably Efficacious treatments. In contrast, play therapy and attachment-based therapy are still only Experimental treatments for early childhood anxiety, relaxation training has Questionable Efficacy, and there is no evidence to date to speak to the efficacy of individual child CBT and/or medication in younger anxious children. All 3 currently supported interventions for early childhood anxiety entail exposure-based CBT with significant parental involvement. This conclusion meaningfully differs from conclusions for treating anxiety in older childhood that highlight the well-established efficacy of individual child CBT and/or medication and that question whether parental involvement in treatment enhances outcomes.


Assuntos
Ansiedade/psicologia , Ansiedade/terapia , Transtornos do Comportamento Infantil/psicologia , Transtornos do Comportamento Infantil/terapia , Medicina Baseada em Evidências/métodos , Idoso , Ansiedade/diagnóstico , Criança , Transtornos do Comportamento Infantil/diagnóstico , Pré-Escolar , Terapia Cognitivo-Comportamental/métodos , Terapia Cognitivo-Comportamental/tendências , Medicina Baseada em Evidências/tendências , Feminino , Humanos , Masculino , Pais/psicologia , Psicoterapia de Grupo/métodos , Psicoterapia de Grupo/tendências , Resultado do Tratamento
20.
Eur Child Adolesc Psychiatry ; 28(9): 1169-1181, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30684088

RESUMO

Selective mutism (SM) is classified under the category of anxiety disorders in DSM-5 [1], although concrete fears that underlie the condition are not specified contrary to all other anxiety disorders. Given the lack of studies systematically investigating fears in SM, content and frequency of concrete fears as well as related cognitions have remained unclear so far. One hundred and twenty-four participants [M = 13.25 years (SD = 3.24), range 8-18 years] with SM (n = 65), social phobia (SP n = 18) or with typical development (TD n = 51) took part in an online survey. Participants with SM (n = 65) answered an open-ended question concerning fears that might cause the consistent failure to speak in select situations. Additionally, participants with SM, SP and TD completed a survey containing 34 fear-related cognitions that might occur in speech-demanding situations. Open text answers were systematically evaluated by extracting higher-order categories using a Qualitative Content Analysis. Single item scores of the survey were compared between the three groups. 59% of all spontaneously reported fears were assigned to the cluster of social fears. Other reported fears represented the categories fear of mistakes (28%), language-related fears (8%) and voice-related fears (5%). The SM- and SP group only differed regarding the cognition that one's own voice might sound funny (SM > SP). Social fears and the fear of mistakes account for the majority of fears in SM. Therefore, future interventions should consider specifically targeting these types of fears.


Assuntos
Transtornos de Ansiedade/psicologia , Transtornos do Comportamento Infantil/diagnóstico , Cognição/fisiologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Medo/psicologia , Mutismo/diagnóstico , Fobia Social/psicologia , Adolescente , Criança , Transtornos do Comportamento Infantil/patologia , Feminino , Humanos , Masculino , Mutismo/patologia
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