Gender associated developmental trajectories of SDQ-dysregulation profile and its predictors in children

Longitudinal associations between socioeconomic status and psychosocial problems in preschool children

Socioeconomic status (SES) at different points in a child's lifetime may have different effects on health outcomes. This study aimed to examine longitudinal associations between SES and psychosocial problems in preschool children (n = 2509, Mage = 24.2 ± 1.3 months). The psychosocial problems of children were assessed using the Brief Infant-Toddler Social and Emotional Assessment at age 2 years and age 3 years and categorized as having yes/no psychosocial problems. Four groups of pattern of presence/absence of psychosocial problems between age 2 and 3 years were classified: (1) 'no problems', (2) 'problems at age two', (3) 'problems at age three', and (4) 'continuing problems'. Five indicators of SES (i.e., maternal education level, single-parent family, unemployment, financial problems, and neighborhood SES) were evaluated. Results showed around one-fifth (2Y = 20.0%, 3Y = 16.0%) of children had psychosocial problems. Multinomial logistic regression models revealed low and middle maternal education levels were associated with 'problems at age two'; low maternal education level and financial problems were associated with 'problems at age three'; low and middle maternal education level, single-parent family, and unemployment were associated with 'continuing problems'. No associations were observed between neighborhood SES and any pattern. Results suggest children in a lower SES, indicated by maternal education, single-parent family, and financial stress, had higher odds of developing and continuously having psychosocial problems in early childhood. These findings call for optimally timing interventions to reduce the impact of disadvantaged SES in early childhood on psychosocial health.

Investigating associations between emotional and behavioral problems, self-esteem, and parental attachment among adolescents: A cross-sectional study in Indonesia

Background

Emotional and Behavioral Problems (EBPs) are prevalent among adolescents, and adolescents' capacity for adaptation can be influenced by their interactions with their parents, environment, and self-esteem. This link has not been systematically examined among adolescents in West Sumatra, Indonesia. This study aimed to assess the association of parental attachment and self-esteem with EBPs in adolescents.

Methods

A cross-sectional study was conducted from July to November 2022 in Padang West Sumatra, Indonesia. In total, 854 students from public senior high school 4 Padang were involved in this study and completed questionnaires on demographics, EBPs, parental attachment, and self-esteem. There was a total of five subscales for EBPs, which included emotional problems, conduct problems, hyperactivity, peer problems and prosocial. Additionally, there were three subscales for parental attachment, which included the mother's attachment, father's attachment, and peer attachment. Spearman's correlation, independent-sample t-tests, ANOVA and multiple linear regression analysis were employed to examine factors associated with EBPs.

Results

This study showed that father's attachment (r = -0.191, p < 0.001), mother's attachment (r = -0.241, p < 0.001), and self-esteem (r = -0.437, p < 0.001) were negatively correlated with EBPs. The linear regression analysis showed EBPs was associated with father's education, father's communication, father's alienation, mother's alienation, and self-esteem. All predictors of overall EBPs among adolescents were able to explain 31 % of the variance in EBPs.

Conclusion

High self-esteem and a strong parental attachment have positive outcomes in terms of mental health in adolescents. Thus, increasing adolescent self-esteem and establishing a warm parent attachment can be the main target in providing interventions for Indonesian adolescents with EBPs.

Do Parents' Internal Processes and Feelings Contribute to the way they Report Their Children's Mental Difficulties on the Strength and Difficulties Questionnaire (SDQ)?

The way parents report their child's emotional and behavioral difficulties is important both for identifying the child's needs, diagnosis, and prevention. This study examined to what extent parents' internal processes predict the way in which parents report their child's emotional and behavioral difficulties on the SDQ, as mediated by parental feelings. Parents of children who were referred to a community mental health clinic completed a self-report questionnaire including the following scales: adulthood attachment style, self-regulation difficulty, personal well-being, self-compassion parental feelings, and their child's emotional-behavioral difficulties. Study findings indicated that parents' internal processes do not directly predict parents' report of their children's mental difficulties on the SDQ, only when mediated by parental feelings. These findings highlight the significance of parental feelings in reporting children's behavioral and emotional difficulties. It also contributes to the body of knowledge concerning the importance of caring for parents' needs and feelings and overall parenthood.

Management of Emotion Dysregulation and Outbursts in Children and Adolescents

PURPOSE OF REVIEW

Emotion dysregulation and outbursts are very common reasons for referral to child and adolescent mental health services and a frequent cause of admission to hospitals and residential programs. Symptoms of emotion dysregulation and outburst are transdiagnostic, associated with many disorders, have the potential to cause severe impairment and their management presents a major challenge in clinical practice.

RECENT FINDINGS

There are an increasing number of psychosocial interventions that demonstrate promise in improving emotion dysregulation and outbursts. Acute care systems to manage the most severely ill patients have limited best practice guidelines but program advancements indicate opportunities to improve care models. Pharmacotherapy may be of assistance to psychosocial interventions but must be used with caution due to potential adverse effects. Much remains to be discovered however evidence informed, targeted treatments for specific populations show potential for future improvements in outcomes.

Psychometric Properties of the Strengths and Difficulties Questionnaire-Dysregulation Profile in Italian Early Adolescents

Emotional dysregulation is of great cause for concern because it is associated with severe outcomes. Currently, the identification of youths with signs of emotional and behavioral dysregulation is obtained through the assessment of a Dysregulation Profile (DP), including the Strengths and Difficulties Questionnaire-DP (SDQ-DP). Despite its increasingly frequent use in research, studies exploring the SDQ-DP properties are still limited, and no study with Italian samples is currently available. The current study aimed to explore the psychometric properties of the SDQ-DP parent-report and its association with difficulties in the school context in a sample of 332 Italian early adolescents. Results showed that the SDQ-DP parent-report is a single-factor measure with good internal consistency. Also, in both males and females, the SDQ-DP parent-report was associated with higher teacher-reported Internalizing (e.g., anxious symptoms) and Externalizing Problems (e.g., hyperactivity, conduct problems) and lower Prosocial Behavior. This study added further evidence about the utility of the SDQ-DP in the assessment, prevention, and treatment of emotional dysregulation.

Greek Validation of the Factor Structure and Longitudinal Measurement Invariance of the Strengths and Difficulties Questionnaire-Self Report (SDQ-SR): Exploratory Structural Equation Modelling

The study examined the factor structure and longitudinal measurement invariance over three time points (1-year apart) of the Strengths and Difficulties Questionnaire-Self Report (SDQ-SR) for ratings provided by adolescents in Greece. It used exploratory structural equation modelling (ESEM) to achieve these two goals. At time point one, a total of 968 adolescents (males = 508, and females = 460) between 12 and 17.9 years completed the SDQ-SR. In relation to factor structure, ESEM tested the fit of one- to five-factor models. The findings were interpreted as indicating most support for the ESEM model with three factors (the factors being dysregulation, peer problems, and prosocial behaviour). This model showed support for configural invariance and full metric invariance across the three time points. Except for two thresholds, all other thresholds were also invariant across the three time points. Thus, there was good support for longitudinal measurement invariance. The implications of the findings for use of the SDQ-SR are discussed.

Associations of circadian factors with insomnia symptoms and emotional and behavioral problems among school-age children

STUDY OBJECTIVES

To examine the associations of circadian characteristics (ie, chronotype and social jetlag) with insomnia symptoms and emotional and behavioral problems among school-age children.

METHODS

A total of 620 primary school children (median_age = 10.06, standard deviation = 1.16, 58.7% boys) were recruited and assessed by a set of parent-report questionnaires, including Children's Sleep Habit Questionnaire for measuring sleep-wake patterns and insomnia symptoms (bedtime resistance, sleep onset delay, and night waking), Children's Chronotype Questionnaire for assessing the child's chronotype preference, and Strength and Difficulties Questionnaire for assessing emotional and behavioral problems. Linear regression models were applied to examine the associations of chronotype and social jetlag with insomnia symptoms and mental health outcomes, in which age, sex, family income, and average sleep duration were entered as covariates.

RESULTS

Evening chronotype was significantly associated with bedtime resistance and sleep onset delay, while social jetlag was not related to insomnia symptoms. Evening chronotype was also significantly associated with externalizing symptoms after controlling for potential confounders.

CONCLUSIONS

Evening chronotype, but not social jetlag, was the risk factor for insomnia symptoms, and evening chronotype was further associated with increased behavioral problems in school-age children. Our findings underscored the roles of circadian factors in relation to sleep and mental health problems in this young population.

CITATION

Sun W, Kwok NTT, Chan NY, et al. Associations of circadian factors with insomnia symptoms and emotional and behavioral problems among school-age children. J Clin Sleep Med. 2021;17(10):2107-2114.

Measurement of Dysregulation in Children and Adolescents

This article highlights the breadth of measures available for measuring emotion dysregulation, or facets thereof, in children and adolescents, and reviews in detail a subset of these measures. We describe broadband measures and measures that are specific to emotion dysregulation, including observational tools, clinical interviews, and rating scales. Furthermore, we discuss the strengths, weaknesses, and psychometric properties of each approach and specific contexts or populations in which certain methods may be particularly useful. Finally, recommendations for thorough assessment of emotion dysregulation in future studies are provided.

The Association between Low Blood Pressure and Attention-Deficit Hyperactivity Disorder (ADHD) Observed in Children/Adolescents Does Not Persist into Young Adulthood. A Population-Based Ten-Year Follow-Up Study

Background: Attention-deficit hyperactivity disorder (ADHD) is one of the most common behavioral disorders in childhood and adolescence associated with relevant psychosocial impairments. The basic pathophysiology of ADHD may be related, at least partly, to a deficit in autonomic arousal processes, which not only influence core symptoms of the disorder, but may also lead to blood pressure (BP) deviations due to altered arousal regulation. Objectives: This study examined long-term changes in BP in children and adolescents with ADHD up to young adulthood. Methods: In children and adolescents aged between 7 and 17 years at baseline, we compared BP recordings in subjects with (n = 1219, 11.1%) and without (n = 9741, 88.9%) ADHD over a 10-year follow-up using data from the nationwide German Health Survey for Children and Adolescents (KiGGS). Propensity score matching was used to improve the comparability between children in the ADHD and control groups with now n = 1.190 in each group. Results: The results of these matched samples revealed that study participants with ADHD showed significantly lower systolic BP (107.6 ± 10.7 mmHg vs. 109.5 ± 10.9 mmHg, p < 0.001, Cohen’s d = 0.17) and diastolic BP (64.6 ± 7.5 mmHg vs. 65.8 ± 7.4 mmHg, p < 0.001, Cohen’s d = 0.16) at baseline. In a sensitivity analysis with a smaller (n = 272) and more stringently diagnosed ADHD group, the significant differences remained stable with somewhat higher Cohen’s d; i.e., 0.25 and 0.27, respectively. However, these differences did not persist after 10-year follow-up in a smaller matched longitudinal sub-group (ADHD n = 273; control n = 323), as subjects with and without ADHD had similar levels of systolic (123.4 ± 10.65 vs. 123.78 ± 11.1 mmHg, p = 0.675, Cohen’s d = 0.15) and diastolic BP (71.86 ± 6.84 vs. 71.85 ± 7.06 mmHg, p = 0.992, Cohen’s d = 0.16). Conclusions: At baseline, children and adolescents with ADHD had significantly lower BP (of small effect sizes) compared to the non-ADHD group, whereas this difference was no longer detectable at follow-up ten years later. These developmental alterations in BP from adolescence to early adulthood may reflect changes in the state of autonomic arousal, probably modulating the pathophysiology of ADHD.

Predictors and outcomes of self-reported dysregulation profiles in youth from age 11 to 21 years

Understanding the dysregulation profile (DP) consisting of high scores in aggression, attention problems, and anxious/depressed problems is still limited. The aims of the present study were threefold: (a) to analyze developmental trajectories of DP (b) to identify predictors of these trajectories, and (c) to study the outcome of DP in terms of mental disorders and criminal offenses in young adulthood. A sample of 402 individuals aged 11-14 years at baseline was followed up during adolescence and young adulthood. Latent class growth analysis was used to identify DP based on the youth self-report and the young adult self-report. Self-related cognitions, perceived parental behavior, life events and coping served as predictors, psychiatric diagnoses and criminal convictions in young adulthood as outcomes. There were three developmental trajectories representing high, moderate, and low DP subgroups with 9.2% of participants represented by the high DP subgroup. Among predictors, self-esteem (negative), self-awareness (positive), and high numbers of life events had the most consistent effect on high DP. Affective and anxiety disorders and any mental disorder were significant outcomes of the high DP subgroup in both sexes at the time of young adulthood. This first report on DP based on longitudinal self-reports shows that DP is stable for a sizeable proportion of youth during adolescence and young adulthood. The predictors for DP share some similarity with those predicting psychopathology in general. However, so far there seems to be no heightened risk for the development of crime in the concerned individuals.

Effects of neurofeedback on the dysregulation profile in children with ADHD: SCP NF meets SDQ-DP - a retrospective analysis

BACKGROUND

As children with attention-deficit/hyperactivity disorder (ADHD) usually show psychopathological signs beyond their core symptoms (e.g. elevated scores of the dysregulation profile (DP) in 30-40%), treatments with a broader approach to self-regulation skills may be supportive. Neurofeedback (NF) may reflect such an option. Aim of the present analysis was to compare the effects of slow cortical potential (SCP) NF and θ/β NF on the DP using data from a previous trial.

METHODS

Thirty children with ADHD (aged 8-12 years) and a DP score in the Strengths and Difficulties Questionnaire (SDQ-DP) ⩾ 3 were included. NF treatment consisted of one block of SCP NF and one block of θ/β NF (18 units per block) allowing an intraindividual comparison. Effects of the NF protocols were also contrasted to a control group (n = 18) that completed an attention skills training (between-group analysis).

RESULTS

Regarding the SDQ-DP, SCP NF was superior to θ/β NF and the control condition. Effects of SCP NF and θ/β NF on ADHD symptom severity were not significantly different. The SDQ-DP score did not correlate with EEG-related measures previously found to be predictors for SCP NF on ADHD symptoms.

CONCLUSIONS

SCP NF may reflect a more general approach to improve cognitive, emotional and behavioral self-regulation skills. If confirmed in a larger sample, the SDQ-DP score could be used as an indication criterion and contribute to the individualization of NF in ADHD. Overall, the differential effect provides further evidence for the specificity of NF effects.

REAC neuromodulation treatments in subjects with severe socioeconomic and cultural hardship in the Brazilian state of Pará: a family observational pilot study

PURPOSE

The purpose of this preliminary observational study was to evaluate the usefulness of a humanitarian initiative, aimed at improving the neuropsychological and behavioral attitude of children with severe socioeconomic and cultural hardship, in the Brazilian state of Pará. This humanitarian initiative was realized through the administration of two neuromodulation protocols, with radioelectric asymmetric conveyor (REAC) technology. During several years of clinical use, the REAC neuromodulation protocols have already proved to be effective in countering the effects of environmental stress on neuropsycho-physical functions.

PATIENTS AND METHODS

After the preliminary medical examination, all subjects were investigated with the Strengths and Difficulties Questionnaire (SDQ), including the impact supplement with teacher's report. After the SDQ, they received the neuromodulation treatment with REAC technology named neuro postural optimization (NPO), to evaluate their responsiveness. Subsequently, every 3 months all subjects underwent a treatment cycle of neuropsycho-physical optimization (NPPO) with REAC technology, for a total of three cycles. At the end of the last REAC-NPPO treatment cycle, all subjects were investigated once again with the SDQ. For the adequacy of the data, the Wilcoxon and the Signs tests were used. For the subdivision into clusters, the Kruskal-Wallis test was applied for the adequacy of the procedure. For all the applied tests, a statistical significance of p<0.5 was found.

RESULTS

The results showed that the REAC-NPO and REAC-NPPO neuromodulation protocols are able to improve the quality of life, the scholastic and socialization skills, and the overall state of physical and mental health in children of a family with severe socioeconomic and cultural hardship.

CONCLUSION

The REAC-NPO and REAC-NPPO neuromodulation protocols, due to their non-invasive characteristics, painlessness, and speed of administration, can be hypothesized as a treatment to improve the overall state of physical and mental health in a large number of people with socioeconomic and cultural discomfort.