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1.
Riv Psichiatr ; 56(4): 205-210, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34310578

RESUMO

BACKGROUND: The SARS-CoV-2 pandemic forced parents and children to modify their habits with a radical change in the family routine and consequent increase in psychological stress. Children with a neurodevelopmental disorder (NDDs) are particularly vulnerable to new and unexpected situations; moreover, the parents of these children generally show high levels of psychological stress due to the greater commitment that this condition imposes on them. The aim of this study is to evaluate the disease status of NDDs children before and during SARS-CoV-2 pandemic and to evaluate the psychological effects related to measures of social distancing on these children and their families. MATERIALS AND METHODS: Seventy-one children with NDDs, were enrolled in this study and followed up at the Child Neuropsychiatry Unit of the University Hospital Consortium Corporation Polyclinic of Bari (Italy) along with their parents. Parents were evaluated before national lockdown (baseline) and recontacted during the SARS-CoV-2 emergency almost after a year. The changes in emotional/behavioral problems of children and parenting stress before and during the SARS-CoV-2 pandemic were assessed with Child Behaviour CheckList (CBCL) and Parent Stress Index - short form (PSI). RESULTS: The analysis of the emotional and behavioral problems of children with NDDs did not show statistically significant differences between the before and during the SARS-CoV-2 pandemic period. The evaluations conducted on parents highlights an increase in parental stress during the pandemic. Significant differences (p<0.05) were found in three subscales: Parenting Distress (PD) scale, Dysfunctional Interaction Parent-Child (P-CDI) scale and Defensive responding scale (DF). CONCLUSIONS: This study highlights the increase in parental stress and a more difficult parent-child interaction with NDDs in the period of lockdown due to the pandemic; identification of these risk targets can be useful for interventions in similar situations. Therefore, it is necessary to provide caregivers information to manage and overcome challenges experienced during a pandemic and providing psychological support for caregivers of children with NDDs.


Assuntos
COVID-19/psicologia , Transtornos do Neurodesenvolvimento/psicologia , Pandemias , Pais/psicologia , SARS-CoV-2 , Adolescente , Cuidadores/psicologia , Criança , Comportamento Infantil , Transtornos do Comportamento Infantil/etiologia , Transtornos do Comportamento Infantil/psicologia , Emoções , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Itália/epidemiologia , Masculino , Relações Pais-Filho , Sistemas de Apoio Psicossocial , Quarentena , Índice de Gravidade de Doença , Isolamento Social , Estresse Psicológico/etiologia
2.
Int J Psychol ; 56(5): 739-744, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33754361

RESUMO

The present study aimed at exploring the relationship between parenting stress and children's problematic behaviour in the families of 99 children aged 8-11 years. Parenting stress was assessed by parents, using the Parenting Stress Index, and children's problematic behaviour was assessed by teachers, using the Strengths and Difficulties Questionnaire. A moderation regression analysis showed a conditioning effect of paternal parenting stress in the relationship between maternal parenting stress and children's problematic behaviour. In the presence of high levels of paternal parenting stress, the relationship between maternal parenting stress and children's problematic behaviour was significant and strong (p = .01). When paternal parenting stress levels were low, the relationship between maternal parenting stress and children's problematic behaviour was not significant (p = .49). The results underlined that paternal parenting stress may buffer the relationship between maternal parenting stress and children's problematic behaviour. Clinical implications are discussed.


Assuntos
Comportamento Infantil , Pai/psicologia , Mães/psicologia , Poder Familiar/psicologia , Comportamento Problema , Estresse Psicológico , Adulto , Criança , Transtornos do Comportamento Infantil/etiologia , Transtornos do Comportamento Infantil/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
3.
J Consult Clin Psychol ; 89(2): 96-109, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33705166

RESUMO

OBJECTIVE: This study is the first to investigate the effect of psychodynamic technique (PT), therapeutic alliance, and their interactions with outcome in psychodynamic child psychotherapy. METHOD: The sample comprised 79 Turkish children (mean age = 6.86 years, 38% girls) with discrete internalizing (22%), discrete externalizing (11%) and comorbid internalizing and externalizing (67%) problems. Independent raters coded 359 sessions from different phases of treatment using the Child Psychotherapy Process Q-Sort for PT and Therapy Process Observational Coding System-Alliance Scale. Problem-assessment measures were collected at intake and every 10th session in treatment using the Children's Behavior Checklist and Brief Problem Monitor. RESULTS: Multilevel modeling analyses indicated that the PT and therapeutic alliance interacted such that more use of the PT in the context of high therapeutic alliance predicted less problem behaviors, whereas in the context of low therapeutic alliance PT predicted more problem behaviors. This relationship was moderated by problem comorbidity such that for children with comorbid problems, though a strong therapeutic alliance was indicated, an increase in PT use did not have a significant effect. CONCLUSION: Findings suggest that the use of psychodynamic interventions is indicated in the context of a strong therapeutic alliance, especially for children with noncomorbid problems. Psychodynamic interventions may have an adverse effect if a therapeutic alliance is not established. For children with comorbid problems, keeping the relationship strong is important. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Transtornos do Comportamento Infantil/terapia , Comportamento Problema/psicologia , Psicoterapia Psicodinâmica/métodos , Aliança Terapêutica , Criança , Transtornos do Comportamento Infantil/psicologia , Família , Feminino , Humanos , Masculino , Resultado do Tratamento
4.
Medicine (Baltimore) ; 100(4): e23894, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33530185

RESUMO

BACKGROUND: We aimed to evaluate the effect of music-based intervention on the aggressive behavior in children and adolescents, and made a comparison of music medicine and music therapy. METHODS: We searched PubMed (MEDLINE), Ovid-Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) to identify relevant studies. Standardized mean differences (SMDs) were estimated with random-effect model. RESULTS: We included 10 studies and found a significant decrease of aggressive behavior (SMD = -0.99; 95% CI = -1.42 to -0.56) and a significant increase of self-control (SMD = 0.56; 95% CI: 0.19 to 0.93) in the music-based intervention group compared with the control group. The aggressive behavior was significantly decreased in the music therapy group compared with the control group (SMD = -1.79; 95% CI = -3.23 to -0.35); while, no difference was observed between music medicine group and control group. Sub-group analyses exhibited a more efficacious in reducing aggressive behavior in the children received ≥2 sessions per week, the children with a mean age > 10 years, the children whose behavior were reported by teachers, and the children with aggressive behavior before intervention. Sensitivity analyses yielded similar results. CONCLUSION: Music-based intervention seemed to be more efficacious for reducing aggression and increasing self-control in children and adolescents, especially music therapy.


Assuntos
Comportamento do Adolescente , Agressão , Transtornos do Comportamento Infantil/terapia , Musicoterapia , Adolescente , Comportamento do Adolescente/psicologia , Criança , Transtornos do Comportamento Infantil/psicologia , Humanos , Autocontrole
5.
Child Dev ; 92(2): 502-516, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33528841

RESUMO

This meta-analysis synthesizes the empirical data on problem behaviors among foreign- (G1) and U.S-born (G2+) youth and explores the effects of immigrant status on youth internalizing and externalizing problems. A random effects meta-regression with robust variance estimates summarized effect sizes for internalizing and externalizing problems across 91 studies (N = 179,315, Mage  = 13.98). Results indicated that G1 youth reported significantly more internalizing problems (g = .06), and fewer externalizing problems than G2+ youth (g = -.06). Gender and sample type moderated the effects. The findings provide a first-step toward reconciling mixed support for the immigrant paradox by identifying for whom and under what conditions the immigrant experience serves as a risk or protective factor for youth.


Assuntos
Comportamento do Adolescente/etnologia , Transtornos do Comportamento Infantil/etnologia , Emigrantes e Imigrantes/psicologia , Comportamento Problema/psicologia , Adolescente , Comportamento do Adolescente/psicologia , Criança , Transtornos do Comportamento Infantil/psicologia , Humanos , Masculino , Estados Unidos
6.
Prev Sci ; 22(3): 269-283, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33586056

RESUMO

Health agencies call for the immediate mobilization of existing interventions in response to numerous child and family mental health concerns that have arisen as result of the COVID-19 pandemic. Answering this call, this pilot study describes the rapid, full-scale change from a primarily clinic-based Parent-Child Interaction Therapy (PCIT) model to a virtual service model (i.e., I-PCIT) in an academic and community-based program in Miami, Florida. First, we describe the virtual service training model our program developed and its implementation with 17 therapists (MAge = 32.35, 88.2% female, 47.1% Hispanic) to enable our clinic to shift from providing virtual services to a small portion of the families served (29.1%) to all of the families served. Second, we examine the effect of I-PCIT on child and caregiver outcomes during the 2-month stay-at-home period between March 16, 2020, and May 16, 2020, in 86 families (MChildAge = 4.75, 71% Hispanic). Due to the rapid nature of the current study, all active participants were transferred to virtual services, and therefore there was no comparison or control group, and outcomes represent the most recently available scores and not treatment completion. Results reveal that I-PCIT reduced child externalizing and internalizing problems and caregiver stress, and increased parenting skills and child compliance with medium to large effects even in the midst of the COVID-19 pandemic. Finally, the study examined components of our virtual service training model associated with the greatest improvements in child and caregiver outcomes. Preliminary findings revealed that locally and collaboratively developed strategies (e.g., online communities of practice, training videos and guides) had the strongest association with child and caregiver outcomes. Implications for virtual service delivery, implementation, and practice in the midst of the COVID-19 pandemic are discussed.


Assuntos
Terapia Comportamental/métodos , COVID-19/epidemiologia , Transtornos do Comportamento Infantil/psicologia , Transtornos do Comportamento Infantil/terapia , Relações Pais-Filho , Telemedicina , Adulto , Criança , Feminino , Florida , Humanos , Masculino , Pandemias , Projetos Piloto , SARS-CoV-2
7.
Psychiatry Res ; 296: 113692, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33421841

RESUMO

The current study examined the impact of the lockdown due to the Covid-19 disease on mood state and behaviours of children and adolescents with ADHD. Nine hundred ninety-two parents of children and adolescents with ADHD filled out an anonymous online survey through the ADHD family association website. The survey investigated the degree of severity of six emotional and mood states (sadness, boredom, little enjoyment/interest, irritability, temper tantrums, anxiety) and five disrupted behaviours (verbal and physical aggression, argument, opposition, restlessness) based on their frequency/week (absent; low: 1-2 days/week; moderate: 3-4 days/week; severe: 5-7 days/week) before and during the lockdown. Important fluctuations were found in all dimensions during the lockdown independently by the severity degree. Subjects with previous low severity degree of these behaviors significantly worsened in almost all dimensions during the lockdown. On the contrary, ADHD patients with moderate and severe degree showed important improvement during the lockdown. Little enjoyment/interests and boredom resulted the dimensions more strongly affected by the condition of restriction, overall in children. Children vs. adolescents showed substantially similar trend but the former resulted significantly more vulnerable to emotive changes. The results provided both the individuation of domains affected, and the indirect benefits produced by restriction condition.


Assuntos
Sintomas Afetivos/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , COVID-19/psicologia , Transtornos do Comportamento Infantil/psicologia , Isolamento Social , Adolescente , Agressão/psicologia , Ansiedade/diagnóstico , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Tédio , Criança , Feminino , Humanos , Humor Irritável , Masculino , Fatores de Risco , Inquéritos e Questionários
8.
Anesth Analg ; 133(3): 595-605, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-33497062

RESUMO

BACKGROUND: Exposure to surgery and anesthesia in early childhood has been found to be associated with an increased risk of behavioral deficits. While the US Food and Drug Administration (FDA) has warned against prenatal exposure to anesthetic drugs, little clinical evidence exists to support this recommendation. This study evaluates the association between prenatal exposure to general anesthesia due to maternal procedures during pregnancy and neuropsychological and behavioral outcome scores at age 10. METHODS: This is an observational cohort study of children born in Perth, Western Australia, with 2 generations of participants contributing data to the Raine Study. In the Raine Study, the first generation (Gen1) are mothers enrolled during pregnancy, and the second generation (Gen2) are the children born to these mothers from 1989 to 1992 with neuropsychological and behavioral tests at age 10 (n=2024). In the primary analysis, 6 neuropsychological and behavioral tests were evaluated at age 10: Raven's Colored Progressive Matrices (CPM), McCarron Assessment of Neuromuscular Development (MAND), Peabody Picture Vocabulary Test (PPVT), Symbol Digit Modality Test (SDMT) with written and oral scores, Clinical Evaluation of Language Fundamentals (CELF) with Expressive, Receptive, and Total language scores, and Child Behavior Checklist (CBCL) with Internalizing, Externalizing, and Total behavior scores. Outcome scores of children prenatally exposed to general anesthesia were compared to children without prenatal exposure using multivariable linear regression models adjusting for demographic and clinical covariates (sex, race, income, and maternal education, alcohol or tobacco use, and clinical diagnoses: diabetes, epilepsy, hypertension, psychiatric disorders, or thyroid dysfunction). Bonferroni adjustment was used for the 6 independent tests in the primary analysis, so a corrected P value <.0083 (P = .05 divided by 6 tests, or a 99.17% confidence interval [CI]) was required for statistical significance. RESULTS: Among 2024 children with available outcome scores, 22 (1.1%) were prenatally exposed to general anesthesia. Prenatally exposed children had higher CBCL Externalizing behavioral scores (score difference of 6.1 [99.17% CI, 0.2-12.0]; P = .006) than unexposed children. Of 6 tests including 11 scores and subscores, only CBCL Externalizing behavioral scores remained significant after multiple comparisons adjustment with no significant differences found in any other score. CONCLUSIONS: Prenatal exposure to general anesthetics is associated with increased externalizing behavioral problems in childhood. However, given the limitations of this study and that avoiding necessary surgery during pregnancy can have significant detrimental effects on the mother and the child, further studies are needed before changes to clinical practice are made.


Assuntos
Anestesia Geral/efeitos adversos , Anestésicos Gerais/efeitos adversos , Transtornos do Comportamento Infantil/induzido quimicamente , Comportamento Infantil/efeitos dos fármacos , Desenvolvimento Infantil/efeitos dos fármacos , Sistema Nervoso/efeitos dos fármacos , Efeitos Tardios da Exposição Pré-Natal , Fatores Etários , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/fisiopatologia , Transtornos do Comportamento Infantil/psicologia , Feminino , Humanos , Masculino , Sistema Nervoso/crescimento & desenvolvimento , Gravidez , Medição de Risco , Fatores de Risco , Austrália Ocidental
9.
Eur Child Adolesc Psychiatry ; 30(2): 233-241, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32172341

RESUMO

Improving the mental health of children and adolescents is a critical priority in China. However, only minimal information is available concerning the prevalence of mental disorders. In the present study, a two-stage national survey has been completed in five regions of China. In the first stage, data from the Achenbach Child Behavior Checklist (CBCL) were collected for each participant to identify the prevalence of the behavioral and emotional problems in China. A multistage cluster stratified random sampling design was used, and a total of 71,929 individuals aged 6-16 years were collected. In this large cohort, 36,893 (49.86%) were males, and 49,015 (66.24%) were living in urban communities. Overall, 17.6% (90% confidence interval 17.4%, 17.9%) of the children and adolescents were identified as having behavioral and emotional problems. Moreover, age and sex effect was found for the CBCL scores. The boys' cohort had a higher prevalence of behavioral and emotional problems than girls (18.6% versus 16.6%). In the older cohort aged 12-16, the prevalence was higher than for the younger cohort aged 6-11 (19.0% versus 15.9%). Notably, it seems that the prevalence of the behavioral and emotional problems for children and adolescents had a rise in the past 30 years, but the scarcity of pediatric psychiatrists in China needs to be addressed. To reduce the behavioral and emotional problems, the whole society, including mental health providers, educators, and parents, needs to focus on and pay more attention to it. It will have long-term benefits for China.


Assuntos
Sintomas Afetivos/psicologia , Transtornos do Comportamento Infantil/psicologia , Criança , China , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Prevalência , Inquéritos e Questionários
10.
J Behav Health Serv Res ; 48(1): 120-132, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32700177

RESUMO

Understanding caretaker attitudes towards the prevention of pediatric behavioral disorders is important for the effective delivery of prevention services. Caretakers of children ages 0-18 (N = 385) read a description of pediatric prevention services in an integrated primary care setting. Attitudes towards these services were assessed. The majority of participants (80%) agreed that prevention is important, 87% reported interest in learning their child's risk for a behavioral disorder, 84% were interested in learning the results of a screen for behavioral disorders, and 88% were interested in learning parenting strategies. Participants endorsed similarly positive attitudes towards prevention in integrated care. Perceived risks outweighing perceived benefits, younger caregiver age, and identifying as non-Hispanic White predicted less favorable attitudes towards prevention. Other socio-demographic characteristics (e.g., caretaker education) were associated with disorder-specific beliefs about the importance of prevention, but not general attitudes. Findings suggest generally positive attitudes towards preventing behavioral disorders in an integrated care setting.


Assuntos
Cuidadores/psicologia , Transtornos do Comportamento Infantil/prevenção & controle , Prestação Integrada de Cuidados de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Serviços Preventivos de Saúde , Comportamento Problema/psicologia , Adolescente , Criança , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Masculino , Pediatria , Atenção Primária à Saúde/organização & administração
11.
Am J Med Genet A ; 185(1): 83-89, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33043996

RESUMO

Prader-Willi syndrome (PWS) is a neurodevelopmental disorder characterized by multiple endocrine, metabolic, respiratory, cognitive, and behavioral/psychiatric symptoms that may lead to severe emotional strain in their caregivers. In this study, we evaluated parenting stress by the Parenting Stress Index-short form (PSI/SF) and parent-reported behavioral symptoms by the Child Behavior Checklist (CBCL/6-18) in families of children with PWS. Sixty-seven home-resident PWS patients and their families were recruited in this study. The patients' mean age was 14.9 ± 8.3 years, and 33 (50.8%) were male. High parenting stress was reported by 41.5% families, as determined by high total stress scores of PSI/SF. The patients in high stress families were significantly older than those in low stress families (18.2 ± 8.0 vs. 12.6 ± 7.8 years, p = .007). CBCL/6-18 was used to evaluate the somatic and neuropsychiatric symptoms of PWS patients aged between 6 and 18 in the subgroup of the 35 families. In this subgroup, 37.1% of families reported high parenting stress. High stress families reported a higher T-score in anxiety/depression, withdrawn behavior, somatic complaints, thought problems, attention problems, and delinquent and aggressive behavior of their children with PWS. After multivariate stepwise logistic regression analysis, the T-score of somatic complaints was the only factor related to high parenting stress, with an odds ratio of 1.279. Our data demonstrated the high care burden of families with PWS and highlighted the importance of having dedicated medical care for both somatic and neuropsychiatric symptoms.


Assuntos
Ansiedade/psicologia , Poder Familiar/psicologia , Síndrome de Prader-Willi/psicologia , Estresse Psicológico/psicologia , Adolescente , Adulto , Ansiedade/epidemiologia , Ansiedade/fisiopatologia , Cuidadores/psicologia , Criança , Comportamento Infantil/fisiologia , Comportamento Infantil/psicologia , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/fisiopatologia , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Depressão/epidemiologia , Depressão/fisiopatologia , Depressão/psicologia , Feminino , Humanos , Masculino , Síndrome de Prader-Willi/epidemiologia , Síndrome de Prader-Willi/patologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/fisiopatologia , Adulto Jovem
12.
Child Dev ; 92(1): 291-307, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32845015

RESUMO

Parental psychopathology can affect child functioning, and vice versa. We examined bidirectional associations between parent and offspring psychopathology in 5,536 children and their parents. We asked three questions: (a) are parent-to-child associations stronger than child-to-parent associations? (b) are mother-to-child associations stronger than father-to-child associations? and (c) do within- and between-person effects contribute to bidirectional associations between parent and offspring psychopathology? Our findings suggest that only within-rater bidirectional associations of parent and offspring psychopathology can be consistently detected, with no difference between mothers and fathers. Child psychopathology was hardly associated with parental psychopathology. No evidence for cross-rater child-to-parent associations was found suggesting that the within-rater child-to-parent associations reflect shared method variance. Moreover, within-person change accounted for a part of the variance observed.


Assuntos
Comportamento Infantil/psicologia , Filho de Pais Incapacitados/psicologia , Relações Pai-Filho , Transtornos Mentais/psicologia , Relações Mãe-Filho , Adulto , Criança , Comportamento Infantil/etnologia , Transtornos do Comportamento Infantil/etnologia , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Relações Pai-Filho/etnologia , Pai/psicologia , Feminino , Humanos , Masculino , Transtornos Mentais/etnologia , Relações Mãe-Filho/etnologia , Mães/psicologia , Relações Pais-Filho/etnologia , Psicopatologia
13.
Arch Dis Child ; 106(4): 355-360, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33168523

RESUMO

OBJECTIVE: Shorter breastfeeding duration has been linked to a range of difficulties in children. However, evidence linking shorter breastfeeding duration to child behavioural problems has been inconclusive. Owing to an almost exclusive focus on early childhood in previous research, little is known about breastfeeding effects on behaviour throughout childhood and adolescence. This study examines the longitudinal effect of breast feeding on parent-reported behaviour in children aged 3-14. DESIGN: Data come from the Millennium Cohort Study, a large, prospective, UK birth cohort study. PARTICIPANTS: 11 148 children, their parents and teachers. METHODS: This study maps the effect of breastfeeding duration on parent-reported child behaviour longitudinally, using latent growth curve modelling and on teacher-reported child behaviour using multiple regression analyses. Breastfeeding duration was assessed through parent interviews when the child was 9 months old. Children's behavioural development was measured using parent-reported Strengths and Difficulties Questionnaires (SDQ) at 3, 5, 7, 11 and 14 years and teacher-reported SDQs at 7 and 11 years. RESULTS: Breast feeding was associated with fewer parent-reported behavioural difficulties at all ages even after adjusting for potential confounders (<2 months: B=-0.22, 95% CI -0.39 to -0.04; 2-4 months: B=-0.53, 95% CI -0.75 to -0.32; 4-6 months: B=-1.07, 95% CI -1.33 to -0.81; >6 months: B=-1.24, 95% CI -1.44 to -1.04; B=adjusted mean difference of raw SDQ scores at age 3, reference: never breast fed). CONCLUSION: This study provides further evidence supporting links between breastfeeding duration and children's socioemotional behavioural development. Potential implications include intervention strategies encouraging breast feeding.


Assuntos
Aleitamento Materno/psicologia , Transtornos do Comportamento Infantil/psicologia , Comportamento Infantil/psicologia , Pais/psicologia , Adolescente , Aleitamento Materno/estatística & dados numéricos , Criança , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/etiologia , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Masculino , Estudos Prospectivos , Fatores de Tempo , Reino Unido/epidemiologia
14.
J Autism Dev Disord ; 51(8): 2800-2811, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33057858

RESUMO

Some research suggests that GI symptoms seen in children with ASD may relate to behavior problems. The objective of this pilot study was to assess the effect of the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet on GI and behavioral problems in children with ASD. At follow-up, the low FODMAP diet group had significant relief in some GI problems compared with both baseline in the group and control group. At baseline and at follow-up, there were no significant differences in behavioral problems between the low FODMAP diet group and the control group. Randomized controlled studies including larger sample sizes are needed to confirm the effects of low FODMAP diets in children with autism who have gastrointestinal problems.


Assuntos
Transtorno do Espectro Autista/dietoterapia , Transtornos do Comportamento Infantil/dietoterapia , Ingestão de Alimentos/fisiologia , Ingestão de Energia/fisiologia , Fermentação/fisiologia , Gastroenteropatias/dietoterapia , Adolescente , Transtorno do Espectro Autista/fisiopatologia , Transtorno do Espectro Autista/psicologia , Criança , Transtornos do Comportamento Infantil/fisiopatologia , Transtornos do Comportamento Infantil/psicologia , Dissacarídeos/administração & dosagem , Ingestão de Alimentos/psicologia , Feminino , Gastroenteropatias/fisiopatologia , Gastroenteropatias/psicologia , Humanos , Masculino , Monossacarídeos/administração & dosagem , Oligossacarídeos/administração & dosagem , Projetos Piloto , Polímeros/administração & dosagem , Resultado do Tratamento
15.
Scand J Psychol ; 62(2): 141-149, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32920860

RESUMO

The present study compared mothers' stress and the behavioral/emotional problems of children with attention deficit hyperactivity disorder (ADHD) and children with typical development (TD). Furthermore, the relationships among the mothers' stress, the children's behavioral/emotional problems, and the mothers' coping strategies in both groups were identified. The contribution of behavioral/emotional problems to parenting stress in children with ADHD was also studied through mediation effects of the mothers' coping strategies. The parenting stress, coping orientation to problems, and strengths and difficulties questionnaires were administered to 72 mothers of children from 7 to 11 years old: 35 with a clinical diagnosis of ADHD and 37 with typical development. The comparison analyses showed that the mothers' stress and the behavioral/emotional problems of their children were significantly higher in the group with ADHD than in the group without ADHD. Correlation analyses revealed different correlation patterns in the two groups, with behavioral/emotional problems significantly associated with parenting stress and with the disengagement and cognitive reframing coping reported by the mothers of children with ADHD. In addition, the disengagement coping strategy was a significant mediator in the relationship between behavioral/emotional problems and mothers' stress, according to the mediation analysis. The findings illustrate the need to include training in both behavioral strategies and coping strategies in counseling in order to help mothers buffer the impact of stress. This work is supported by the project PSI2016-78109 (AEI/FEDER, UE) and by University of Valencia UV-INV-PREDOC15-265889.


Assuntos
Adaptação Psicológica , Sintomas Afetivos/complicações , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtornos do Comportamento Infantil/complicações , Mães/psicologia , Estresse Psicológico/psicologia , Adulto , Sintomas Afetivos/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Criança , Transtornos do Comportamento Infantil/psicologia , Feminino , Humanos , Masculino , Relações Mãe-Filho , Poder Familiar/psicologia
16.
Am J Epidemiol ; 190(6): 1009-1020, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33230558

RESUMO

Several studies have reported associations between prenatal acetaminophen exposure and behavioral outcomes in young children. We aimed to evaluate the associations of prenatal and postnatal exposures to acetaminophen with behavioral problems in children at age 11 years, using behavioral measures reported by parents and children. We studied 40,934 mother-child pairs from the Danish National Birth Cohort enrolled during 1996-2002. Parent-reported and child-reported Strengths and Difficulties Questionnaire (SDQ) responses were collected during the 11-year follow-up. We estimated risk ratios for behavioral problems including total difficulties as well as internalizing or externalizing behaviors following prenatal (during pregnancy) or postnatal (within the first 18 months after birth) acetaminophen exposure. Parent-reported and child-reported SDQ scores were moderately correlated; higher for externalizing (r = 0.59) than internalizing (r = 0.49) behaviors. Prenatal acetaminophen exposure was associated with 10%-40% higher risks for total difficulties and internalizing and externalizing problems based on parent- or child-reported SDQ, with the association being stronger for greater cumulative weeks of acetaminophen use. Postnatal exposure was associated with 16%-19% higher risks for parent-reported internalizing behaviors, but the associations were weak or null for child-reported scores except for prosocial behavior. Our study corroborates published associations between prenatal exposures to acetaminophen and behavioral problems and extends the literature to early adolescence.


Assuntos
Acetaminofen/efeitos adversos , Analgésicos não Narcóticos/efeitos adversos , Transtornos do Comportamento Infantil/induzido quimicamente , Comportamento Infantil/efeitos dos fármacos , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Criança , Transtornos do Comportamento Infantil/psicologia , Estudos de Coortes , Dinamarca , Feminino , Humanos , Pais , Medidas de Resultados Relatados pelo Paciente , Gravidez , Efeitos Tardios da Exposição Pré-Natal/psicologia
17.
J Abnorm Psychol ; 130(1): 60-77, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33211504

RESUMO

Hundreds of studies have documented an association between depression in mothers and behavior problems in children. Theory and empirical findings suggest this association may be confounded by other factors, but little attention has been paid to this issue. We used propensity score methods in a sample of 731 low-income families assessed repeatedly from child age 2 through 14 years to produce a weighted sample of families that were similar at child age 3 years except for mothers' depression. Depressive symptomatology was measured via self-report rating scale. Mothers were categorized as having clinically-elevated versus non-clinically-elevated scores based on an established threshold. Mothers with elevated versus nonelevated scores were equated on 89 other relevant characteristics (e.g., SES, child behavior, marital conflict). We then compared the equated groups on mother, secondary caregiver, and teacher ratings of child externalizing and internalizing behavior from child ages 4 to 14 years. Prior to equating, the mean prima facie effect of exposure to clinically-elevated mothers' depression scores at child age 3 years was d = 0.45 per mothers, d = 0.26 per secondary caregivers, and d = 0.13 per teachers. After equating, the mean adjusted effect was d = 0.07 per mothers, d = 0.01 per secondary caregivers, and d = 0.03 per teachers. Findings suggest that a substantial portion of the prima facie association between mothers' depression and later child behavior problems is accounted for by confounding variables rather than a causal effect of depressive symptoms per se. To fully understand why children of depressed mothers exhibit more behavior problems, a multicausal theory is needed that jointly considers the cluster of co-occurring clinical features that often accompany maternal depression. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Transtornos do Comportamento Infantil/psicologia , Filho de Pais Incapacitados/psicologia , Transtorno Depressivo/psicologia , Mães/psicologia , Adolescente , Adulto , Criança , Comportamento Infantil/psicologia , Filho de Pais Incapacitados/estatística & dados numéricos , Pré-Escolar , Feminino , Humanos , Masculino , Autorrelato
18.
Br J Anaesth ; 126(2): 433-444, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33250180

RESUMO

BACKGROUND: Whether exposure to a single general anaesthetic (GA) in early childhood causes long-term neurodevelopmental problems remains unclear. METHODS: PubMed/MEDLINE, Embase, CINAHL, Web of Science, and the Cochrane Library were searched from inception to October 2019. Studies evaluating neurodevelopmental outcomes and prospectively enrolling children exposed to a single GA procedure compared with unexposed children were identified. Outcomes common to at least three studies were evaluated using random-effects meta-analyses. RESULTS: Full-scale intelligence quotient (FSIQ); the parentally reported Child Behavior Checklist (CBCL) total, externalising, and internalising problems scores; and Behavior Rating Inventory of Executive Function (BRIEF) scores were assessed. Of 1644 children identified, 841 who had a single exposure to GA were evaluated. The CBCL problem scores were significantly higher (i.e. worse) in exposed children: mean score difference (CBCL total: 2.3 [95% confidence interval {CI}: 1.0-3.7], P=0.001; CBCL externalising: 1.9 [95% CI: 0.7-3.1], P=0.003; and CBCL internalising problems: 2.2 [95% CI: 0.9-3.5], P=0.001). Differences in BRIEF were not significant after multiple comparison adjustment. Full-scale intelligence quotient was not affected by GA exposure. Secondary analyses evaluating the risk of these scores exceeding predetermined clinical thresholds found that GA exposure was associated with increased risk of CBCL internalising behavioural deficit (risk ratio [RR]: 1.47; 95% CI: 1.08-2.02; P=0.016) and impaired BRIEF executive function (RR: 1.68; 95% CI: 1.23-2.30; P=0.001). CONCLUSIONS: Combining results of studies utilising prospectively collected outcomes showed that a single GA exposure was associated with statistically significant increases in parent reports of behavioural problems with no difference in general intelligence.


Assuntos
Anestésicos Gerais/efeitos adversos , Transtornos do Comportamento Infantil/induzido quimicamente , Comportamento Infantil , Desenvolvimento Infantil , Função Executiva/efeitos dos fármacos , Inteligência/efeitos dos fármacos , Sistema Nervoso/efeitos dos fármacos , Síndromes Neurotóxicas/etiologia , Fatores Etários , Transtornos do Comportamento Infantil/fisiopatologia , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Humanos , Sistema Nervoso/crescimento & desenvolvimento , Síndromes Neurotóxicas/fisiopatologia , Síndromes Neurotóxicas/psicologia , Medição de Risco , Fatores de Risco
19.
Epilepsy Behav ; 115: 107519, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33257293

RESUMO

OBJECTIVE: The objective of this study was to evaluate care needs, emotional and behavioral changes, and parental stress indices in a cohort of pediatric patients with epilepsy with neurocognitive and emotional comorbidities at the time of the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This is a prospective observational study involving pediatric patients with epilepsy with neurocognitive and emotional comorbidities. Included patients were admitted to our hospital between August 2019 and February 2020 for epilepsy and neuropsychiatric assessment, and Child Behavior Checklist (CBCL) questionnaires were filled in by parents. Those patients and their families accepted to participate in a phone follow-up visit in April-May 2020 and to refill CBCL and Parenting Stress Index-Short Form (PSI-SF) questionnaires. Descriptive statistics for demographic and clinical data, CBCL questionnaire scores before and during the COVID-19 pandemic, and PSI-SF scores have been computed. Moreover, results of a short phone survey on the psychological burden during COVID lockdown have been reported. RESULTS: This study provides the parental-proxy report of emotional and behavioral profile changes of 23 pediatric patients with epilepsy and neurocognitive and emotional comorbidities during the COVID-19 pandemic. Concerns for therapy monitoring at the time of lockdown emerged in 43% of families, and 30% of patients showed worries for an altered contact with the referring medical team. Patients with neurocognitive comorbidities were more likely to exhibit behavioral problems, especially externalizing problems compared with patients with a diagnosis of anxiety/depression. CONCLUSION: Our data suggest the importance to monitor disease trajectory and behavior and affective symptoms with telehealth strategies to provide effective care to patients and their families.


Assuntos
COVID-19/prevenção & controle , Transtornos do Comportamento Infantil/psicologia , Epilepsia/psicologia , Transtornos Mentais/psicologia , Telemedicina/métodos , Adolescente , COVID-19/epidemiologia , Criança , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/terapia , Estudos de Coortes , Controle de Doenças Transmissíveis/métodos , Epilepsia/epidemiologia , Epilepsia/terapia , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Pais/psicologia , Estudos Prospectivos , Inquéritos e Questionários
20.
J Autism Dev Disord ; 51(1): 323-333, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32415533

RESUMO

Parent-mediated interventions can reduce behavioral and emotional problems in children with ASD. This report discusses the development of the first group parent intervention targeting behaviors and anxiety in children with ASD, across the spectrum of cognitive and language ability. 'Predictive Parenting' was developed from the clinical observation (and emerging evidence base) that children with ASD struggle with 'prediction' and anticipating change. It integrates well-established parenting strategies within an ASD-specific framework. The concept was co-created with patient and public involvement panels of parents and adults with ASD. A feasibility study found the programme is acceptable and accessible. Qualitative feedback from participants was largely positive, and critiques were used to inform a larger, pilot randomized controlled trial of the intervention.


Assuntos
Sintomas Afetivos/psicologia , Transtorno do Espectro Autista/psicologia , Transtornos do Comportamento Infantil/psicologia , Poder Familiar/psicologia , Pais/psicologia , Adulto , Sintomas Afetivos/diagnóstico , Sintomas Afetivos/terapia , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/terapia , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/terapia , Pré-Escolar , Estudos de Viabilidade , Feminino , Previsões , Humanos , Masculino
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