Behavioural problems among preschool age children in Shanghai: analysis of 3,000 cases

Brainstem tumors may increase the impairment of behavioral emotional cognition in children

PURPOSE

It remains unclear as to whether patients with brainstem tumor experience complex neuropsychiatric problems. In this cohort study, we specifically investigated behavioral, emotional and cognitive symptoms in pediatric patients with brainstem glioma and healthy individuals.

METHODS

A total of 146 patients with pediatric brainstem tumors (aged 4-18 years old) and 46 age-matched healthy children were recruited to assess their behaviors and emotions examined by the Child Behavior Checklist. A variety of clinical factors were also analyzed.

RESULTS

There were significant differences in most behavioral and emotional symptoms between pediatric patients and healthy subjects. Moreover, patients with pons tumors exhibited significantly higher scores than patients with medulla oblongata tumors (p = 0.012), particularly in concerning the syndrome categories of Withdrawn (p = 0.043), Anxious/depressed symptoms (p = 0.046), Thought Problems (p = 0.004), Attention deficits (p = 0.008), Externalizing problems (p = 0.013), and Aggressive behavior (p = 0.004). A tumor body located in the pontine (p = 0.01, OR = 4.5, 95% CI = 1.4-14.059) or DIPG in the midbrain (p = 0.002, OR = 3.818, 95% CI = 1.629-8.948) appears to act as a risk factor that is associated with more problems in patients with neuropsychiatric symptoms.

CONCLUSIONS

Pediatric patients with brainstem tumors exhibit severe behavioral and emotional problems. Tumor invades the pontine and midbrain act a risk factor with more problems. It suggests that structural and functional abnormalities in the brainstem will cause prolonged behavioral problems and emotional-cognitive dysfunctions in young children.

Affective modulation of executive control in early childhood: Evidence from ERPs and a Go/Nogo task

Modulation of adaptive executive control is particularly demanded in a pre- and early-school period. Therefore, in the present study, we investigated whether affective information can influence executive control in preschool children. We have recorded EEG during a Go/Nogo task where gender of a face served as a Go/Nogo cue and emotional expressions (positive, negative, neutral) were task irrelevant. Negative emotions modulated the magnitude of the conflict effect (Nogo vs. Go) in the N200 relative to neutral control, indicating enhanced cognitive control for negative emotions. Moreover, interpersonal characteristics (e.g., aggressive behavior) correlated with the emotion facilitated inhibitory control as indicated by N200. In addition, Go/Nogo conflict modulated neural responses in children already 100 ms after stimulus onset when paired with socially relevant emotional stimuli. These results show that emotions affect cognitive control in this age group in a valence specific manner.

Child Psychiatry and the Developing World: Recent Developments

ABSIRACT: The authors examine the growth and role of child psychiatry in the developing world over the last 25 years. They review national epidemiologi cal studies of the prevalence of child psychiatric disorders, culture-specific symptoms of maladjustment and the evidence for culture-specific parenting patterns. They consider the impact of social change on psychiatric disorders in the Third World, identify ing specific protective factors (e.g. gender, intelli gence, special schooling, social skills) and vulner ability factors (e.g. poor diet). The authors then examine the role of culturally sensitive intervention strategies. Training programs for child psychiatrists in the developing world must encompass both medical and public health models. The review closes with a brief discussion of urgent research questions and a summary of the most pressing clinical requirements for child psychiatry in the developing world.

Agreement between parent and teacher reports on behavioral problems among chinese children

Research has consistently shown low to moderate correlations between parent and teacher reports on children's behavioral problems in Western samples. Little is known about the agreement between parent and teacher reports on behavioral problems among Chinese children. The authors examined the agreement on behavioral and emotional problems in a community sample of 2836 Chinese children aged 6 to 11 years from Mainland China. Children's behavioral problems were assessed by the Child Behavior Checklist (CBCL) and Teacher Report Form (TRF). Consistent with most previous studies in Western samples, our results indicated that parent-teacher agreement was low to moderate for attention, externalizing, and internalizing problems. Parent-teacher agreement was higher for attention and externalizing problems than for internalizing problems and decreased with increased behavioral problems. Child's gender, age, and academic performance and father's age were correlated with parent-teacher agreement on ratings of behavioral problems.

The symptom experience of hospitalised Chinese children and adolescents and relationship to pre-hospital factors and behaviour problems

PURPOSE

To describe the symptom experience of hospitalised Chinese children and adolescents and examine the relationship of symptoms to pre-hospital factors and child behaviour.

METHODS

Data were collected at two hospital sites in Hong Kong (HK) and at five hospitals in the Chinese Mainland (CM). A total of 307 hospitalised children and adolescents (ages 2-18) and their primary caregiver (e.g., mother, father or grandparent) participated in the study. Children and adolescents completed an age-appropriate symptom diary on one evening and subsequent morning early in their hospital stay. Parents completed the diary for the children less than 6 years of age. Parents also completed an age-appropriate Chinese version of the Child Behaviour Checklist.

RESULTS

Over 50% of the children and adolescents reported some degree of pain, 75% of them reported evening tiredness, and 21% reported gastrointestinal symptoms. The intensity of symptoms varied by age and region and symptoms often co-occurred. Greater symptom burden was predicted by previous surgery, higher level of worst pain prior to hospitalisation, parent report of child behaviour problems, and co-occurrence of other symptoms.

CONCLUSIONS

Hospitalised Chinese children manifest symptoms of pain, tiredness, and gastrointestinal distress that vary based on pre-hospital factors and are associated with child behaviour problems. Further research is needed to identify causes and treatments for children's symptoms.

Behavioural, emotional and family functioning of hospitalized children in China and Hong Kong

PURPOSE

This study examined behavioural and emotional problems, social competence and family functioning of hospitalized Chinese children in Hong Kong and the Chinese Mainland.

METHOD

A sample of 210 hospitalized children (ages 2-11 years) and their families participated in the study. The families were from a cross-section of geographical areas in Hong Kong (two hospitals) and the Chinese Mainland (five hospitals). Parents completed an age-appropriate Chinese version of the Child Behaviour Checklist and the Family Assessment Device. Multiple regression models were used to examine predictors of children's behaviour problems.

RESULTS

Behavioural patterns appeared to be specific to the developmental stage. Children had greater problems when their families demonstrated poorer affective involvement. Hospitalized children on the Chinese Mainland experienced more internalizing and externalizing behaviour problems than those in Hong Kong. Sick children, according to their parents, however, demonstrate some resiliency based on social and academic competency factors.

CONCLUSIONS

Hospitalized Chinese children manifest behavioural, emotional and family problems that vary by region, the child's development and gender. Problems predominantly of an internalizing nature characterized this group. The findings support the need for culturally appropriate behavioural assessments and interventions with hospitalized children.

Culturally Appropriate Family Assessment: Analysis of the Family Assessment Device in a Pediatric Chinese Population

As part of a larger study, we investigated the adaptation of the Family Assessment Device (FAD) to a Chinese population of hospitalized children (N = 313) compared to a sample of families with healthy children (N = 29) in Hong Kong and Chinese Mainland. Confirmatory factor analysis and exploratory factor analysis (EFA) were performed to examine the FAD structure. The results supported the notion of cultural variations in measuring family functioning. Eight factors were found to explain 30.34% of the variance in family functioning. The Cronbach’s alphas of families with hospitalized children ranged from 0.29 to 0.74. Similar reliability scores were found in nonhospitalized families. This study indicates that the Chinese FAD has a different factor structure, reliabilities, and mean scores in several subscales compared to U.S. studies. The psychometric properties of the Chinese FAD may be influenced by the fact that the sample was focused on children rather than adults.

Child behavior problems: prevalence and correlates in rural minority areas of China

BACKGROUND

Ethnicity may possibly associate with different maternal child-rearing practices and child developmental problems. The aim of this study was to better understand epidemiological features and correlates of child behavior problems in a large sample of children in economically disadvantaged rural minority areas of China and to provide reference data for subsequent intervention of child developmental problems.

METHODS

A total of 1222 rural mother-child pairs belonging to Hani, Yi, Hui, Miao and Han were drawn from four economically disadvantaged minority counties in Yunnan Province of China. Well-trained investigators completed child physical examination and measurements (height and weight) in village clinics and interviews of mothers at respondents' homes using a structured questionnaire.

RESULTS

Child behavior problems were prevalent in children aged 2-6 years: 71.4% for temper tantrums; 48.2% for swearing; 36.0% for nocturnal bed-wetting; 29.9% for disobedience; 29.5% for difficulty initiating sleep; and 17.0% for picky eating. Child behavior problems significantly differed across Hani, Yi, Hui, Miao and Han ethnic groups. Logistic regression indicated that ethnicity of Hui compared with Han, younger children, prenatal risk factors, being a twin, ineffective child-rearing behaviors such as pampering, corporal punishment, swaddling, family disagreement among child-rearing contributed independently to the risk for child behavior problems.

CONCLUSIONS

The child behavior problems were prevalent in children aged 2-6 years in rural minority children of China. Ineffective family child-rearing practices increase risk for child behavior problems.

Behavioral and emotional problems in Chinese children of divorced parents

OBJECTIVE

This study examined the behavioral problems in Chinese children of divorced parents.

METHOD

A total of 58 children of divorce and 116 gender-, age-, and school class-matched controls were ascertained from a general population sample of children aged 6 through 15 years. Parents completed the Child Behavior Checklist (CBCL), and teachers completed the Teacher's Report Form (TRF) and Conners Hyperkinesis Index.

RESULTS

Parent-reported problem scores on the CBCL total scale and each subscale, and prevalence of all CBCL syndromes except for Somatic Complaints, were significantly higher in children of divorce than in controls. Teacher-reported problem scores on the TRF total scale and Social and Attention Problems and prevalence of Attention Problems were significantly different for the 2 groups of children. Social competence was rated significantly lower in children of divorce than in controls. Discriminant function analysis showed that behavioral problems in children of divorce were characterized by aggressive behavior, withdrawal, and social problems.

CONCLUSIONS

The findings emanating from China provide the first evidence of the link between parental divorce and children's psychopathology and clarify the psychopathological dimensions in Chinese children of divorced parents.

Competence and behavioral/emotional problems among Taiwanese adolescents as reported by parents and teachers

OBJECTIVE

To investigate competence and behavioral/emotional problems among nonreferred adolescents in Taiwan, using a Chinese version of the Child Behavior Checklist (CBCL-C) and the Teacher's Report Form (TRF-C). The psychometric properties of these instruments and cross-cultural differences were also examined.

METHOD

Parents of 854 junior high school students aged 12 to 16 years in Taipei, Taiwan, were asked to complete the CBCL-C. Among these students, 162 had their teachers' ratings of the TRF-C.

RESULTS

The internal consistency and 1-month test-retest reliability were satisfactory for both the CBCL-C and TRF-C, which were moderately correlated. Both exploratory and confirmatory factor analysis provided some support for the validity of Achenbach's cross-informant model. Parents' reports showed that compared with their American counterparts, Taiwanese adolescents tended to have lower scores on most competence scales, higher scores on scales that reflect covert behavior problems, and lower scores on scales that reflect more overt behavior problems. However, teachers' reports showed no significant differences on most competence and behavior problem scales.

CONCLUSION

The CBCL-C and TRF-C are useful tools for assessing the mental health status of Taiwanese adolescents. The cross-cultural differences in adolescent behavior problems are discussed.

Prevalence and risk factors of behavioral and emotional problems among Chinese children aged 6 through 11 years

OBJECTIVE

To examine the prevalence and risk factors of behavioral and emotional problems in Chinese children.

METHOD

A sample of 2,940 children aged 6 through 11 years was randomly drawn from household registers in Shandong Province of China. Parents completed the Child Behavior Checklist (CBCL) and a structured self-rating questionnaire.

RESULTS

The mean CBCL Total Problems score was 16.1 (SD = 14.0). There was no significant age effect on the Total Problems score; boys scored significantly higher than girls (17.2 versus 15.0; F = 24.94, p < .01). The overall prevalence rates of behavioral problems were 12.5% for boys and 8.3% for girls (chi 2 = 14.23, p < .01). Logistic regression analysis showed that a number of parental, prenatal, perinatal, and postnatal factors were significantly associated with increased risk of children's behavioral problems.

CONCLUSIONS

The prevalence of parent-reported behavioral problems in Chinese children is lower than those found in other countries. Of multiple psychosocial and biological factors associated with children's behavioral problems, separation or divorce of parents is the most significant factor.

Behavioral and emotional problems among Chinese and American children: parent and teacher reports for ages 6 to 13

This study compared behavioral and emotional problems reported by parents and teachers in Chinese urban and rural samples and demographically similar American samples. Parents of 469 6-to-13-year-old children of each nationality completed the Child Behavior Checklist (CBCL). Teachers completed the Teacher's Report Form (TRF). Cross-cultural differences were generally modest in magnitude. Chinese children scored higher on TRF Delinquent Behavior and Anxious/Depressed syndromes, and on Internalizing. American children scored higher on CBCL Aggressive Behavior and TRF Attention Problems syndromes. Boys exhibited more externalizing behaviors across both cultures. The mean correlation between parent and teacher ratings was .36 in the Chinese sample and .29 in the American sample, a nonsignificant difference. Findings indicate considerable similarity between problems reported for children in very different societies.