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1.
J Consult Clin Psychol ; 87(11): 1056-1067, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31556651

RESUMO

OBJECTIVE: We evaluated whether initiating the Family Check-Up (FCU) during early childhood prevented a severe form of psychopathology in adolescence-co-occurring internalizing and externalizing problems-and whether effects operated indirectly through early childhood maternal depression and parents' positive behavior support. METHOD: Participants were drawn from a randomized controlled trial of the FCU (50.2% FCU; 49.5% girls; 46.6% Caucasian, and 27.6% Black; 13.4% Hispanic/Latino). At Ages 2 and 3, mothers self-reported depression, and primary caregivers' (PCs') positive behavior support was coded by trained observers. PCs, alternate caregivers (ACs), and teachers reported on 14-year-olds' problem behaviors. Latent profile analyses (LPAs) identified problem behavior groups for each reporter, which were outcomes in multinomial logistic regressions (PC, n = 672; AC, n = 652; teacher, n = 667). RESULTS: LPAs identified a low-problem, internalizing-only, externalizing-only, and co-occurring-problem group for each reporter. For PC- and AC-reported outcomes, the FCU predicted a lower likelihood that adolescents belonged to the co-occurring group relative to the low-problem, externalizing-only (p < .05), and internalizing-only (p < .05 for PC, p < 0.10 for AC) groups; these effects operated through maternal depression (p < .05). For teacher-reported outcomes, the FCU predicted a lower likelihood that adolescents belonged to the co-occurring group relative to the low-problem, internalizing-only, and externalizing-only (p < 0.05) groups; effects operated through positive behavior support (p < 0.05). CONCLUSIONS: Early delivery of the FCU indirectly prevented adolescents' co-occurring internalizing/externalizing problems in both home and school contexts by improving the quality of the early home environment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Comportamento do Adolescente/psicologia , Transtornos do Comportamento Infantil/prevenção & controle , Transtornos do Comportamento Infantil/psicologia , Transtorno Depressivo/psicologia , Terapia Familiar/métodos , Pais/psicologia , Adolescente , Pré-Escolar , Feminino , Humanos , Masculino , Mães/psicologia , Autorrelato
2.
Psychiatr Pol ; 53(2): 399-417, 2019 Apr 30.
Artigo em Inglês, Polonês | MEDLINE | ID: mdl-31317966

RESUMO

OBJECTIVES: The aim of the research was to verify whether a child's "difficult" temperamental traits: low flexibility, low perseverance, low good mood and high bad mood are related to parental discrepancy (defined as the distance between parental goals, i.e. the features that parents want to shape in the child and the level of child development in terms of the shaped features) and the difficulties parents experience in their relationship with child (parental stress). METHODS: The study hypothesized that the child's "difficult" temperamental traits are related to parenting discrepancies and the experienced parental stress. The study involved 319 parents of children aged 3-6 years old (144 girls and 175 boys). A Generalized k-Means Cluser Analysis conducted by data mining algorithms was used for the analysis. RESULTS: The study revealed, that: (a) higher parental stress is related to the negative mood of the children and the higher temperamental flexibility, (b) the lower parental stress is related to the higher positive mood in children. This relation occurs both in the group of parents raising boys and girls. CONCLUSIONS: Parental stress is associated with the temperamental feature of mood. The lower the positive mood of the child, the more the parent experiences stress in relationship with their child.


Assuntos
Transtornos do Comportamento Infantil/psicologia , Relações Pais-Filho , Poder Familiar/psicologia , Pais/psicologia , Adulto , Sintomas Afetivos/psicologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Temperamento
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
5.
J Fam Psychol ; 33(7): 753-763, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31045402

RESUMO

This study examined the prospective associations among maternal substance use, depressive symptoms, and children's behavioral problems in a family systems therapy (ecologically based family therapy [EBFT]) condition and an individual treatment condition. Participants included 183 mothers with a substance use disorder who had at least 1 biological child in their care. Mothers were randomly assigned to the EBFT condition (n = 123) or an individual treatment condition (n = 60). Maternal substance use, depressive symptoms, and child behavioral problems were assessed at baseline and at 3, 6, and 12 months postbaseline. Autoregressive cross-lagged models were estimated to compare whether the cross-lagged paths among the 3 variables differed from zero in each treatment condition. Findings revealed that for individual treatment, strong reciprocal relationships were observed between maternal substance use and maternal depressive symptoms, and between maternal substance use and child behavioral problems. Conversely, in the EBFT group, fewer reciprocal relationships were observed, and instead, maternal depressive symptoms predicted more future child behavioral problems. These findings suggest an interruption in the dysfunctional reciprocal transmission of problem behaviors between mothers and children over time in the family therapy condition. The findings provide evidence for the effectiveness of family systems therapy, EBFT, in interrupting the dysfunctional family dynamics that contribute to maternal substance using behaviors and child behavioral problems. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Transtornos do Comportamento Infantil/terapia , Transtorno Depressivo/terapia , Terapia Familiar/métodos , Relações Mãe-Filho/psicologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Adolescente , Adulto , Criança , Transtornos do Comportamento Infantil/complicações , Transtornos do Comportamento Infantil/psicologia , Transtorno Depressivo/complicações , Transtorno Depressivo/psicologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos , Mães/psicologia , Estudos Prospectivos , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/psicologia , Resultado do Tratamento , Adulto Jovem
6.
J Consult Clin Psychol ; 87(7): 603-616, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31070387

RESUMO

OBJECTIVE: This study investigated therapeutic alliance (TA) trajectories, their demographic and symptomatic predictors, and associations with outcome in psychodynamic child psychotherapy. METHOD: The sample included 89 Turkish children (Mage = 6.87, SD = 2.11, 46% girls) with internalizing (37.11%), externalizing (21.14%), and comorbid (38.20%) problems; 12% of the children were in the nonclinical range. Independent raters coded 328 sessions from different phases of treatment using the Therapy Process Observational Coding System-Alliance Scale. Outcome measures were collected at intake and termination (Children's Behavior Checklist and Teacher Rating Form). RESULTS: Multilevel growth curve modeling indicated that TA showed a quadratic trend (high-low-high) over the course of treatment. The shape-of-change methodology indicated three subgroups following a stable pattern, a slow and an accelerated quadratic TA trajectory. Externalizing problems (teacher report) negatively predicted average TA strength. Boys and children with internalizing problems showed a declining TA trajectory, whereas children with externalizing problems (teacher report) showed an upward TA trajectory. Multivariate multiple regression analyses showed that the average TA (i.e., intercept) and the positive quadratic slope (the high-low-high pattern) positively predicted changes in internalizing and externalizing problems (teacher report). DISCUSSION: This study was the first to show the course of TA development in psychodynamic child psychotherapy, identify a number of child characteristics that facilitate and impede TA. Investigating both the strength and patterns of TA development when examining associations with outcome is important. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Transtornos do Comportamento Infantil/terapia , Psicoterapia Psicodinâmica , Aliança Terapêutica , Criança , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Feminino , Humanos , Masculino
7.
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
8.
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
9.
Issues Ment Health Nurs ; 40(6): 466-475, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30958077

RESUMO

Few studies have examined the effects of parental incarceration (PI) on outcomes above and beyond other risk and adverse childhood experiences (ACEs). The objectives of this study were to (1) the associations between PI and mental health problems (attention, externalizing, internalizing, and total behavioral problems) and (2) the mediating role of current socioeconomic status and cumulative ACEs. An observational and cross-sectional design was employed. Analyses included hierarchical multivariable linear regression modeling. The analytic sample included 613 adolescents (11-17 years). On average, youth exposed to PI experienced three times as many ACEs compared with youth unexposed. Youth exposed to PI were more likely to have behavioral problems than their unexposed peers. The main effect for all models was attenuated by current economic hardship as well as exposure to increasing numbers of ACEs. Exposure to PI can be viewed as a marker of accumulative risk for intervention since youth impacted by PI are more likely to experience behavioral difficulties and associated adverse childhood experiences. Due to the associated adversity that impact youth exposed to PI, mental health providers need to be able to identify and screen for symptoms associated with trauma.


Assuntos
Experiências Adversas da Infância , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/psicologia , Acontecimentos que Mudam a Vida , Pais , Prisioneiros , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Modelos Lineares , Masculino , Fatores Socioeconômicos
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.
J Fam Psychol ; 33(6): 730-741, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30973254

RESUMO

Intimate partner violence (IPV) between parents can have a serious impact on children's health, well-being, and development. This study aimed to investigate the longitudinal associations between exposure to IPV in the first year postpartum and children's emotional-behavioral well-being at age 10 years, where maternal depressive symptoms and involvement in home learning activities at 4 years mediate this relationship. A second aim was to test for the moderating effects of child gender and economic disadvantage. Data were drawn from 1,385 Australian mothers and children participating in the Maternal Health Study; a prospective longitudinal study of women's health after childbirth. Results revealed that IPV in the first year postpartum was associated with higher maternal depressive symptoms at 4 years postpartum, which was, in turn, associated with children's emotional-behavioral difficulties at age 10 years. These associations remained significant after adjusting for concurrent exposure to IPV and maternal depressive symptoms at 10 years. There was no evidence of moderation by child gender, but there was for economic disadvantage. The associations between early life exposure to IPV, maternal depressive symptoms, and children's emotional-behavioral difficulties were stronger for families experiencing economic disadvantage, while the associations between IPV, maternal involvement, and children's emotional-behavioral difficulties were stronger for those not experiencing disadvantage. These findings can inform prevention and early intervention practices and policies aimed at providing adequate mental health support to women experiencing IPV to minimize the negative impact on children. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Sintomas Afetivos/epidemiologia , Sintomas Afetivos/psicologia , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/psicologia , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Austrália/epidemiologia , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Estudos Longitudinais , Masculino , Estudos Prospectivos , Adulto Jovem
12.
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
13.
Lang Speech Hear Serv Sch ; 50(1): 1-15, 2019 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-30950772

RESUMO

Purpose Positive behavioral interventions and supports (PBIS) provide a framework for behavioral expectations in school systems for children with and without disabilities. Speech-language pathologists who work in school settings should be familiar with this framework as part of their role in improving the outcomes for children. The purpose of this tutorial is to discuss PBIS and its use in school settings. Method The authors provide an overview of the PBIS framework and focus on its applicability in classroom-based settings. The process of implementing PBIS in classrooms and other settings such as speech-language therapy is discussed. Conclusions This tutorial provides speech-language pathologists with an overview of PBIS and may facilitate their understanding of how to implement PBIS in nonclassroom settings.


Assuntos
Terapia Comportamental/métodos , Transtornos do Comportamento Infantil/terapia , Serviços de Saúde Escolar , Criança , Comportamento Infantil , Transtornos do Comportamento Infantil/complicações , Transtornos do Comportamento Infantil/psicologia , Transtornos da Comunicação/complicações , Transtornos da Comunicação/psicologia , Transtornos da Comunicação/terapia , Humanos , Patologia da Fala e Linguagem
14.
Behav Ther ; 50(2): 340-352, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30824250

RESUMO

The purpose of this study was to test whether Parent-Child Interaction Therapy (PCIT), a widely used effective therapy for children's externalizing behaviors and parenting problems, was associated with improvements in parents' emotion regulation and reflective functioning. We also investigated whether these improvements had unique associations with children's improvements in externalizing and internalizing symptoms. Participants were 139 Australian children aged 29 to 83 months and their caregivers; all were referred for child externalizing behavior problems coupled with parenting skill deficits or high parent stress. All data were gathered via a questionnaire completed prior to and after completion of PCIT. Significant improvements were found in parents' self-reported emotion dysregulation and capacity to use cognitive reappraisal for emotion regulation. There was also improvement in parents' self-report of children's symptoms, parenting practices, and reflective functioning in the form of prementalizing, which measured a low capacity to understand the emotional world of the child. Multiple regression showed that improvements in cognitive reappraisal, prementalizing, and negative parenting practices were associated with improvement in children's symptoms. The findings extend the existing evidence for PCIT as an effective parenting intervention, adding parents' perceived emotion regulation and reflective functioning to the list of positive outcomes from PCIT. Improved emotion regulation and reflective functioning, unique from changes in parenting practices, could be mechanisms that help explain why PCIT has been associated with improvements in children's externalizing behaviors.


Assuntos
Comportamento Infantil/psicologia , Emoções , Terapia Familiar/métodos , Relações Pais-Filho , Pais/psicologia , Percepção , Austrália/epidemiologia , Criança , Comportamento Infantil/fisiologia , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/psicologia , Transtornos do Comportamento Infantil/terapia , Educação Infantil/psicologia , Educação Infantil/tendências , Pré-Escolar , Emoções/fisiologia , Terapia Familiar/tendências , Feminino , Humanos , Masculino , Poder Familiar/psicologia , Poder Familiar/tendências , Percepção/fisiologia , Inquéritos e Questionários , Resultado do Tratamento
15.
J Affect Disord ; 251: 141-148, 2019 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-30921598

RESUMO

BACKGROUND: High rates of comorbidity among children and adolescents with anxiety disorders are widely documented. To date the question of what happens to comorbid disorders upon treatment of the primary anxiety disorder has received little attention and the optimal treatment strategy for cases with comorbidity remains to be determined. OBJECTIVES: This review examines the literature on the impact of disorder-specific CBT on comorbid mood and behavioral disorders in young people with a primary anxiety disorder. SEARCH METHODS: PsycINFO, EMBASE, MEDLINE and the Cochrane Library were systematically searched using predefined selection criteria. Two reviewers independently assessed the relevance of studies, obtained data using a data extraction form and undertook methodological quality analysis. RESULTS: Ten studies (1647 children in total) were included in the review. All studies demonstrated positive outcomes for CBT focused on the primary anxiety disorder on untargeted comorbid mood and/or externalising disorders. CONCLUSIONS: Findings suggest CBT focused on the primary anxiety disorder successfully reduces comorbid mood and/or behavioral diagnoses and symptoms of these co-occurring clinical diagnoses. Therefore, the implementation of disorder-specific CBT for the primary disorder is a valid alternative to transdiagnostic interventions and is recommended in cases of comorbidity in children and adolescents with a primary anxiety disorder.


Assuntos
Transtornos de Ansiedade/terapia , Transtornos do Comportamento Infantil/fisiopatologia , Terapia Cognitivo-Comportamental , Transtornos do Humor/fisiopatologia , Adolescente , Ansiedade , Transtornos de Ansiedade/fisiopatologia , Transtornos de Ansiedade/psicologia , Criança , Transtornos do Comportamento Infantil/psicologia , Comorbidade , Humanos , Transtornos do Humor/psicologia , Comportamento Problema
16.
J Affect Disord ; 251: 42-51, 2019 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-30903988

RESUMO

BACKGROUND: Previous research on the hormone-symptom relationship in children suggests that certain hormone patterns may be associated with symptoms, but only under certain circumstances. Having a parent with a history of depression may be one circumstance under which dysregulated hormone patterns are especially associated with emotional and behavioral symptoms in children. The current study sought to explore these relationships in a community sample of 389 9-year-old children. METHODS: Children's salivary cortisol and testosterone levels were collected at home over three consecutive days; parental psychiatric histories were assessed using semi-structured diagnostic interviews; and children's internalizing and externalizing symptoms were rated by the child's mother. RESULTS: Having two parents with a history of depression moderated the associations of reduced total daily cortisol output with higher externalizing scores, as well as the association of reduced testosterone with higher internalizing scores. A maternal history of depression, on the other hand, moderated the relationship between higher cortisol awakening response and higher internalizing scores. Furthermore, lower daily cortisol output was associated with higher internalizing scores among girls, but not boys, with two parents with a history depression. LIMITATIONS: Limitations include the cross-sectional nature of the current analyses, as well as the limited racial, ethnic, and geographical diversity of the sample. CONCLUSIONS: Taken together, the current results suggest that the relationship between hormones and internalizing and externalizing symptoms in children may vary as a function of parental depression and child sex, knowledge that may inform intervention efforts aimed at preventing psychopathology in children whose parents have a history of depression.


Assuntos
Transtornos do Comportamento Infantil/psicologia , Transtorno Depressivo/psicologia , Hidrocortisona/metabolismo , Pais/psicologia , Testosterona/metabolismo , Adulto , Criança , Transtornos do Comportamento Infantil/metabolismo , Filho de Pais Incapacitados , Estudos Transversais , Transtorno Depressivo/metabolismo , Grupos Étnicos , Feminino , Fluorimunoensaio , Humanos , Técnicas Imunoenzimáticas , Masculino , Pessoa de Meia-Idade , Relações Pais-Filho , Saliva/química , Estresse Psicológico
17.
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
18.
J Fam Psychol ; 33(2): 203-214, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30702308

RESUMO

The coparenting subsystem is important for the psychosocial development of young children. In this article, we used cross-lagged structural equation modeling to assess the bidirectional relations between unmarried parents' cooperative coparenting and their children's behavioral problems. Using a subsample of 788 dyads of poor, unmarried parents and their children from the Fragile Families and Child Wellbeing data, we examined trends in coparenting and behavioral problems over time (in children ages 1, 3, 5, and 9 years) and the reciprocal effects between these 2 variables. All pathways from coparenting at 1 time point to the children's behavioral problems at the following time point were significant, indicating that cooperative coparenting at earlier time points is likely to result in fewer behavioral problems in children at later time points. A cross-lagged path from behavioral problems to coparenting in the preschool years was also statistically significant. Implications for interventions and next steps for further research are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Transtornos do Comportamento Infantil/psicologia , Ilegitimidade/estatística & dados numéricos , Poder Familiar/psicologia , Adulto , Criança , Transtornos do Comportamento Infantil/etiologia , Pré-Escolar , Comportamento Cooperativo , Características da Família , Feminino , Humanos , Ilegitimidade/psicologia , Lactente , Estudos Longitudinais , Masculino , Relações Pais-Filho , Pobreza , Pais Solteiros
19.
BMC Psychiatry ; 19(1): 60, 2019 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-30736758

RESUMO

BACKGROUND: Approximately 84,000 children under the age of 15 years are living with HIV in Malawi. Although the survival rate of children living with HIV in Malawi has improved due to the increased availability of antiretroviral medications, these children continue to experience numerous challenges negatively impacting on their mental health. The aim of this study was to investigate the prevalence of, and factors associated with, emotional and behavioural difficulties in children aged between 6 and 12 years living with HIV in Malawi. METHODS: A random sample of 429 primary caregivers of children living with HIV drawn from the three main administrative regions of Malawi was recruited in a cross-sectional study. They completed a questionnaire about family socio-demographic characteristics, HIV disclosure, and child demographic and clinical characteristics, as well as the Strengths and Difficulties Questionnaire, Life Stress Scale, Support Function Scale, and Impact on Family Scale which were pre-tested and translated into the local Chichewa language. Data were analysed using descriptive statistics and logistic regression. FINDINGS: Using the newer band categorisations of the Strengths and Difficulties Questionnaire, parent version, 31% of primary caregivers reported that their child had a slightly raised to very high level of total difficulties. Factors that were associated with difficulties were: primary caregivers' young age (adjusted odds ratio [aOR] 3.6; 95% confidence interval [CI]: 1.4-9.5); low level of education (aOR 2.6; 95% CI: 1.2-5.7); lack of employment (aOR 2.7; 95% CI: 1.2-5.9); the report of a substantial impact of the child's illness on the family (3.1; 95% CI: 1.5-6.5); and a low level of family functional support (aOR 2.0; 95% CI: 1.1-4.1). Neither non-disclosure of HIV status nor any of the child demographic or clinical factors were significant in multivariate analysis (p > .0.05). CONCLUSION: Close to one-third of children living with HIV in this study had high scores indicative of emotional and behavioural difficulties. Emotional and behavioural difficulties in children living with HIV were associated with family demographic and psychosocial factors, but not HIV disclosure. Effective policies and programs that promote the mental wellbeing of children living with HIV in Malawi are indicated.


Assuntos
Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/psicologia , Emoções , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Saúde Mental , Adolescente , Cuidadores/psicologia , Criança , Pré-Escolar , Estudos Transversais , Emoções/fisiologia , Feminino , Humanos , Malaui/epidemiologia , Masculino , Prevalência , Distribuição Aleatória , Inquéritos e Questionários
20.
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
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