Agreement between parents and adolescents on emotional and behavioral problems and its associated factors among Chinese school adolescents: a cross-sectional study

Depressive Symptoms and Behavioral Manifestations in Children and Adolescents with Cerebral Palsy: A Parent-Child Perspective Study

Individuals with cerebral palsy (CP) often exhibit mental health problems, including depressive symptoms. This study investigated self-reported depressive symptoms in children and adolescents with and without CP and associated factors. Herein, 52 and 38 children and adolescents with and without CP were enrolled in the CP and typically developing (TD) groups. Depressive symptoms were assessed using the Birleson Depression Self-Rating Scale for Children. Parents of the participants completed the Strengths and Difficulties Questionnaire. Self-reported depressive symptoms were more severe in the CP group than in the TD group, which was primarily attributed to declining activities and enjoyment in daily life. Depressive symptoms in the CP group were not correlated with age, the severity of CP, or parent-reported behavioral features. However, in the overall cohort, the cluster with high levels of depressive symptoms had significantly higher proportions of individuals with CP and participants with conduct, emotional, and peer problems. Multivariate analyses revealed that only peer problems were associated with increased depressive symptoms. Furthermore, peer problems fully mediated the relationship between the presence of CP and depressive symptoms. Our study suggests that providing opportunities for activities involving social interactions with peers and offering support to enable the enjoyment of such activities from an early age are imperative to prevent an increase in depressive symptoms in children with CP.

Pediatric SARS-CoV-2 infection and development of anxiety and depression

Objective

It remains unclear whether emerging mental health concerns in children infected with SARS-CoV-2 are a direct result of the infection or due to the indirect effects of the pandemic. Therefore, we sought to assess the frequency of new diagnoses of anxiety and/or depression among children diagnosed with and without SARS-CoV-2 infection who were tested in pediatric emergency departments.

Methods

A prospective cohort study with 6- and 12-month follow-ups was conducted across 14 Canadian tertiary-care pediatric emergency departments of the Pediatric Emergency Research Canada (PERC) network. The study included children aged <18 years who were tested for SARS-CoV-2 infection between August 2020 and February 2022. The primary outcome was the diagnosis of anxiety and/or depression reported during follow-up. The surveys incorporated a modified version of the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) Long-COVID Pediatric Questionnaire.

Results

Among the participants who were eligible for 6- and 12-month follow-ups, 64.7% (268/414) of SARS-CoV-2-positive and 71.9% (743/1,033) of SARS-CoV-2-negative participants completed follow-up at these time points, respectively. The median age was 7.0 [inter-quartile range (IQR): 5.0-11.0] years, and 54.2% (548/1,011) were male. New diagnoses of anxiety and/or depression reported on either survey did not differ significantly between test-positive (4.1%, 11/268) and test-negative (2.8%; 21/743) participants [difference = 1.3% (95% CI: -1.3 to 4.2)]. There was a higher prevalence of new diagnoses of anxiety and/or depression among SARS-CoV-2-negative participants aged ≥12 years relative to those aged <12 years [8.7% (13/149) vs. 1.3% (8/594); difference = 7.4%; 95% CI of the difference = 3.0-12.5], but not among SARS-CoV-2-positive participants [4.4% (2/45) vs. 4.0% (9/223); difference = 0.4%; 95% CI of the difference = -5.6 to 9.4]. At 6 or 12 months, SARS-CoV-2-positive participants were more likely to experience confusion and/or lack of concentration, abdominal pain, and insomnia.

Conclusions

Although no association was found between SARS-CoV-2 infection and new diagnoses of anxiety and/or depression, SARS-CoV-2-positive participants were more likely to experience confusion/lack of concentration, abdominal pain, and insomnia. This finding, in the context of an increased prevalence of new diagnoses of anxiety and depression, underscores the impacts of societal changes on the mental health of children. Our finding that some non-specific symptoms were more frequently reported by SARS-CoV-2-positive participants emphasizes the need for further investigation of the underlying pathophysiologic mechanisms.

Internalizing Symptoms among Kosovar Adolescents: Pubertal Correlates in Boys and Girls

Pubertal status/stage of maturation and pubertal timing have been linked with emotional symptoms of problems among youth, particularly in vulnerable developmental contexts at risk for stress exposure. The present study tested the extent to which pubertal status/stage of maturation and pubertal timing were associated with anxious/depressed, withdrawn/depressed, and somatic complaint symptoms in Kosovar adolescents. It also tested whether sex moderated these relationships. Data were collected from N = 1,342 Kosovar adolescents (665 girls; M age = 13.26 years, SD = 1.27; 677 boys M age = 13.19 years, SD = 1.31). Regression analyses provided evidence that pubertal status/stage was positively associated with rates of anxious/depressed, withdrawn/depressed, and somatic complaint symptoms in girls, but only with withdrawn/depressed symptoms in boys. Additionally, pubertal timing was positively associated with anxious/depressed, and somatic complaint symptoms in girls; no significant links were found for boys. The present study provided evidence that advanced pubertal status/stage as well as timing is positively associated with internalizing symptoms in girls; however, only pubertal status/stage was positively associated with withdrawn/depressed symptoms in boys. The study highlights the importance of pubertal development for internalizing symptoms in a developmental context known for high stress exposure, particularly for girls.

Cross-informant ratings on emotional and behavioral problems in Nepali adolescents: A comparison of adolescents' self-reports with parents' and teachers' reports

BACKGROUND

Studies on cross-informant agreement on adolescents' emotional and behavioral problems (EBPs) are sparse in low- and middle-income countries. This study aimed to assess parent-adolescent and teacher-adolescent agreement on EBPs and associated factors in Nepal.

METHODS

This cross-sectional survey included 1904 school-going adolescents aged 11-18, enrolled in government and private schools located in sixteen districts of Nepal. The Nepali versions of the Youth Self Report, Child Behavior Checklist, and Teacher's Report Form were administered to assess EBPs reported by adolescents, their parents, and teachers, respectively. Repeated measures analysis of variance (ANOVA) was done to assess mean differences in problem scores. Pearson's correlation was used to assess cross-informant agreement. Linear regression analysis was used to explore factors associated with cross-informant discrepancies in EBPs.

RESULTS

Adolescents reported significantly more problems than their parents and teachers. Mean Total Problem scores for the 90 common items in the adolescents' self-reports, parent reports, and teacher reports were 34.5 (standard deviation [SD]: 21.4), 24.1 (SD = 19.2), and 20.2 (SD = 17.5) respectively. Parent-adolescent agreement on Total Problems was moderate, whereas teacher-adolescent agreement was low. The parent-adolescent agreement was moderate to low for the two broadband scales and all syndrome scales, whereas the teacher-adolescent agreement was low for all scales. Female gender and ethnic minority status impacted both parent-adolescent and teacher-adolescent discrepancies. Family stress/conflicts impacted parent-adolescent discrepancies, while academic performance impacted teacher-adolescent discrepancies.

CONCLUSIONS

Nepali adolescents reported more EBPs than their parents and teachers. The agreement between adolescents' self-reports and reports by their parents and teachers was moderate to low. Gender, caste/ethnicity, family stress/conflicts, and academic performance were associated with cross-informant discrepancies. It is crucial to collect information from different sources, consider context-specific needs, and discern factors influencing cross-informant discrepancies to accurately assess adolescents' EBPs and develop personalized approaches to treatment planning.

The effect of family capital on psychological adjustment of Chinese children with autism spectrum disorder in the transition from kindergarten to primary school

Purpose: The present study aimed to investigate how different forms of family capital might affect psychological adjustment in children with autism spectrum disorder (ASD) in the transition from kindergarten to primary school. Methods: Participants (n = 221) were recruited using convenience sampling from Beijing, Xiamen, Chongqing, and Lanzhou in China. With the Chinese version of different measurements such as Strengths and Difficulties Questionnaire, Family Economic Capital Scale, Family Cultural Capital Scale, Social Capital Scale, and the Questionnaire of Parental Involvement in Transition from Kindergarten to Primary School, the hierarchical linear regression was performed to examine the effect of family capital on psychological adjustment of Chinese children with ASD. Results: The results indicated that monthly household income (B = -0.04, SE = 0.03, p < 0.05), parental educational expectations (B= - 0.07, SE = 0.02, p < 0.01), and parental involvement (B= -0.11, SE = -0.04, p < 0.05) have significantly negative effect on emotional symptoms of children with ASD; monthly household income (B= -0.05, SE = 0.01, p < 0.05) and the strength of social ties (B=-0.09, SE =0.03, p < 0.01) were negatively associated with conduct problems; monthly household income negatively predicted hyperactivity/inattention (B=-0.05, SE = 0.02, p < 0.05); social network ties were negatively correlated with peer problems (B=-0.10, SE = 0.03, p < 0.01); the monthly household income (B = 0.04, SE = 0.02, p < 0.05), parental educational expectations (B = 0.07, SE = 0.03, p < 0.05), parental involvement (B = 0.27, SE = 0.04, p < 0.01), and strength of social ties (B = 0.10, SE = 0.05, p < 0.05) positively affected the prosocial behavior. Conclusion: The present study, from a cross-cultural perspective, revealed the negative associations between family capital variables, including family economic, cultural, and social capital, and the difficult domains of psychological adjustment, as well as the positive associations with prosocial behavior. These contribute to the applicability of the family capital theory to explain psychological adjustment of children with ASD.

Unintentional injury and its associated factors among left-behind children: a cross-sectional study

BACKGROUND

Unintentional injuries among children and adolescents are a major public health problem worldwide. These injuries not only have negative effects on children's physiology and psychology, but also bring huge economic losses and social burdens to families and society. Unintentional injuries are the leading cause of disability and death among Chinese adolescents, and left-behind children (LBC) are more prone to experience unintentional injury. The purpose of this study was to evaluate the type and incidence of unintentional injury among Chinese children and adolescents and explore the influences of personal and environmental factors by comparing the differences between LBC and not left-behind children (NLBC).

METHODS

This cross-sectional study was conducted in January and February 2019. Additionally, 2786 children and adolescents from 10 to 19 years old in Liaoning Province in China were collected in the form of self-filled questionnaires, including Unintentional Injury Investigation, Unintentional Injury Perception Questionnaire, Multidimensional Subhealth Questionnaire of Adolescent (MSQA), Negative life events, "My Class" questionnaire and Bullying/victim Questionnaire. Multiple logistic regression analysis was used to explore the factors associated with unintentional injury among children and adolescents. Binary logistic regression analysis was used to explore the factors affecting unintentional injuries between LBC and NLBC.

RESULTS

The top three unintentional injuries were falling injuries (29.7%), sprains (27.2%) and burns and scalds (20.3%) in our study population. The incidence of unintentional injuries in LBC was higher than that in NLBC. Burn and scalds, cutting injury and animal bites in LBC were higher than those in NLBC. The results show that junior high school students (odds ratio (OR) = 1.296, CI = 1.066-1.574) were more likely to report multiple unintentional injuries than primary school students. Girls (OR = 1.252, CI = 1.042-1.504) had higher odds of reporting multiple unintentional injuries. The odds of multiple injuries in children and adolescents with low levels of unintentional injury perception were higher than those in children and adolescents with high levels of unintentional injury perception (OR = 1.321, C = 1.013-1.568). Children and adolescents with a higher levels of mental health symptoms (OR = 1.442, CI = 1.193-1.744) had higher odds of reporting multiple unintentional injuries. Compared with teenagers who had never experienced negative life events, teenagers who had experienced negative life events many times (OR = 2.724, CI = 2.121-3.499) were more likely to suffer unintentional injuries many times. Low-level discipline and order (OR = 1.277, CI = 1.036-1.574) had higher odds of reporting multiple unintentional injuries. In-school adolescents who were bullied were more likely to report being injured multiple times than their counterparts who were not bullied (OR = 2.340, CI = 1.925-2.845). Low levels of unintentional injury perception, experienced negative life events and bullying had greater impacts on LBC than on NLBC.

CONCLUSION

The survey found that the incidence of at least one unintentional injury was 64.8%. School level, sex, unintentional injury perception, subhealth, negative life events, discipline and order and bullying were associated with incidents of unintentional injury. Compared with NLBC, LBC had a higher incidence of unintentional injury, and special attention should be given to this group.

School adaptation and adolescent immigrant mental health: Mediation of positive academic emotions and conduct problems

Introduction

Immigrant adolescents must adapt their physical and mental attitudes to attain healthy development due to dramatic changes in their living and learning environments after relocation. From the perspective of positive psychology, this study explored the specific influence of school adaptation on mental health among immigrant adolescents, mainly focusing on the mediating effects of positive academic emotions and conduct problems.

Methods

We selected primary and secondary school students from five relocated resettlement schools in Qianxinan Buyi and Miao Autonomous Prefecture, which has the largest population of relocated people in Guizhou Province, China. Using cluster sampling, 550 relocated students in Grades 5-12 from the five schools were recruited to complete a battery of questionnaires, including the Immigrant Adolescents' School Adaptation Scale, the General Health Scale, and the Positive Academic Emotions Questionnaire, and the Adolescents' Behavioral Tendency Questionnaire. In addition, this study used the bias-corrected bootstrap method to explore the chain-mediating effect of positive academic emotions and conduct problems between school adaptation and mental health.

Results

The results showed that immigrant adolescents had significant gender differences only in conduct problems. However, significant learning stage differences existed in school adaptation, mental health, positive academic emotions, and conduct problems. School adaptation, positive academic emotions, and mental health were significantly positively correlated. In contrast, conduct problems were significantly negatively correlated with mental health. School adaptation influenced mental health through the mediation effects of positive academic emotions and conduct problems. These effects contained three paths: the separate mediation effects of positive academic emotions and conduct problems and the chain mediation effect of positive academic emotions and conduct problems.

Children’s Mental Health: Discrepancy between Child Self-Reporting and Parental Reporting

(1) Background: Discrepancies between children’s self-reports and their parents’ reports on mental health indicators are associated with measurement errors or informant bias. However, they are a valuable tool in understanding the course of child psychopathology. This study aims to determine the level of discrepancies between parents’ perceptions and children’s self-reports in mental health indicators in Northern Chile. (2) Methods: A System of Evaluation of Children and Adolescents self-report (Sistema de Evaluación de Niños y Adolescentes, SENA) was responded to by 408 students between 8 and 13 years old and their parents. (3) Results: Children reported a significantly higher frequency of emotional problems, defiant behavior, and executive functions as compared to their parents’ responses. (4) Conclusions: There is a disjunction between the report of parents and children, which could originate in poor family communication.

Associations of parent-adolescent relationship and self-esteem with emotional and behavioral problems among Chinese adolescents

BACKGROUND

This study aimed at exploring the associations of parent-adolescent relationship and self-esteem with emotional and behavioral problems (EBPs) among Chinese adolescents using a large-scale nationally questionnaire survey data from China.

METHODS

Obtained from China Family Panel Studies (CFPS) 2018, the research data involved 2400 adolescents aged 10-15. Multiple linear regression analysis and the PROCESS macro were used for examining the mediating effect of self-esteem on the associations of parent-adolescent relationship with EBPs.

RESULTS

After controlling the potential confounding factors, parent-adolescent relationship and self-esteem were significantly associated with EBPs (P < 0.01). Correlation analysis results showed that parent-adolescent relationship (r = -0.116, P < 0.01) and self-esteem (r = -0.209, P < 0.01) were negatively correlated with EBPs. Self-esteem partially mediated the associations of parent-adolescent relationship with EBPs among Chinese adolescents.

LIMITATIONS

The cross-sectional design limited the ability to make causal inferences.

CONCLUSIONS

Positive parent-adolescent relationship and high self-esteem contributed to fewer EBPs of adolescents. Parent-adolescent relationship predicted EBPs partially mediated by self-esteem. Establishing positive parent-adolescent relationship and improving individual self-esteem may thus be promising targets for intervention in adolescents with EBPs.

The Reliability and Validity of the Korean Version of the Mood and Feelings Questionnaire for Depression in Youth: A Cross-Cultural Perspective

We aimed to assess cross-cultural differences in depressive symptoms and the validity of the Korean version of the Mood and Feelings Questionnaire (MFQ). Four hundred and sixty-four children and adolescents (aged 7-19, 278 girls) with any psychiatric diagnosis, 290 of whom had major depressive disorder, were included. The levels of depressive symptoms in children and adolescents were evaluated by children/adolescents and their parents. We conducted Pearson's r and Cronbach's α, confirmative factor analysis and item response theory tests. The Korean version of the MFQ demonstrated excellent criterion validity and discriminant validity. There were no cultural differences in the clinical manifestations of depression in youth from Western countries and Korea. Korean youths with depression were more likely to complain of cognitive and emotional symptoms than somatic symptoms. The Korean version of the MFQ demonstrated promising psychometric properties in a clinical sample of children and adolescents.

Parent-Adolescent Agreement on Adolescents' Emotional and Behavioral Problems Assessed by the Strengths and Difficulties Questionnaire

Objective. The perception of emotion and behavior is different between adolescents and their parents. Parent-adolescent agreement on emotional and behavioral problems has not been well researched. The aim of this study was to explore and compare how well the information from themselves matches with the judgments by their parents in terms of emotional and behavioral problems. Methods. The cross-sectional study was conducted using the self-report and parent-report Strengths and Difficulties Questionnaire (SDQ). A total of 1254 Japanese school adolescents aged 12 to 18 and their parents were assessed almost the same time. The results were analyzed using the paired t-test and 2-way analysis of variance for the discrepancies of parent-adolescent agreements in each age and gender groups. Results. Adolescents obtained higher total difficulty and all subscales scores of SDQ than their parents. The effect of grade on the self/parent discrepancy scores were significantly observed on the conduct problems (P < .001), hyperactivity (P = .009), and prosocial behavior (P < .001). The effect of gender was shown significantly on the emotional problems (P < .001), conduct problems (P < .001), and peer problems (P = .002). Conclusion. Adolescents reported more problems than their parents did. For comprehensive evaluation of adolescents' mental health, it is necessary to draw information from both the adolescents themselves and their parents, and pay attention to the gap between adolescents and their parents' perception.

Adolescent psychiatric outpatients and their caregivers: Comparing the Strengths and Difficulties Questionnaire

Background

The use of the SDQs as a screening tool to monitor new or ongoing problems in adolescent psychiatric outpatients is needed to improve clinical outcomes. Discrepancies between parent and adolescent reports on the Strengths and Difficulties Questionnaire (SDQ), reflects the degree of emotional and behavioural symptoms. This may affect their ability to work together to reach therapeutic goals.

Aim

The level of SDQ (dis)agreements between adolescent-parental self-reports in adolescent psychiatric outpatients was examined.

Setting

Weskoppies Child and Adolescent outpatients.

Methods

This two-group cross-sectional comparative study obtained SDQ responses from 74 psychiatrically diagnosed adolescents and their parents (148 completed SDQ questionnaires). Adolescent outpatients aged between 11 and 18 years following up at the outpatients between July 2017 and November 2017 were included. Adolescent and parent rating scores were compared using a paired sample t-test, and patterns of agreement were measured by using Pearson’s correlation coefficient and Cohen’s kappa.

Results

Parents reported more difficulties than adolescents, although differences were non-significant (p > 0.58). Caregivers and adolescents agreed on the conduct domain and on emotional symptoms (0.21 ≤ kappa ≤ 0.40, p < 0.05). Caregivers and adolescents agreed on the presentation of internalising and externalising disorders (R = 0.48, p < 0.001).

Conclusions

The SDQ confirmed fair agreement between parents and adolescents. Parental perceptions of adolescent behavioural difficulties could influence parent– adolescent relations and communication. Using the SDQ as a screening tool in South Africa, requires further validation for it to be integrated as part of a multi-informant best-practice approach.

Factors associated with the resilience of Tibetan adolescent survivors five years after the 2010 Yushu earthquake

Resilience contributes to the recovery of disaster victims. The resilience of Tibetan adolescents after the Yushu earthquake has not been properly studied. This study aimed to examine the current resilience and associated factors in Tibetan adolescent survivors in the hardest-hit area 5 years after the Yushu earthquake. This cross-sectional survey was conducted in the area hit the hardest by the Yushu earthquake. Data were collected from 4681 respondents in October and November 2015. Measurements included the participant characteristics, traumatic earthquake experience, the Connor-Davidson resilience scale (CD-RISC), and the social support appraisals (SS-A) scale. The individual datasets were randomized as 80% for the training set and 20% for the validation set. The mean resilience score of the Tibetan adolescent survivors was 55.0±12.3. Thirteen variables were entered into the regression equation. The three dimensions of social support (from family, from friends, from others than family/friends) were positively associated with resilience (all P<0.05), among which support from others than family/friends was the strongest (r = 0.388, P<0.001). Academic performance, activeness of participation in school activities, harmonious relationship with teachers/classmates, health over the last year, and regular physical exercise were positively associated with resilience (all P<0.05). Being female and being extremely worried about their own lives were negatively associated with resilience (both P<0.05). In conclusion, among Tibetan adolescent survivors to the Yushu earthquake of 2010, support from others than family/friends was the strongest positive factor associated with resilience, while being female and extreme worry about their own lives were negative factors. These results expand our knowledge regarding resilience in Tibetan adolescent disaster survivors.

Emotional/Behavioral Indicators in Children and Adolescents With and Without Vocal Problems: Self-Evaluation and Parental Evaluation

OBJECTIVES

To verify the relationships between voice, behavior, and social skills in children and adolescents with and without voice disorders based on their self-reports and their parents/guardians' reports.

METHODS

The study comprised 575 individuals, with 347 parents/guardians of children and adolescents aged 6-18 years who responded the parent version of the Strengths and Difficulties Questionnaire and 228 children and adolescents aged 11-18 years, who responded its report version.

RESULTS

Children and adolescents with vocal problem scored higher on hyperactivity/inattention, emotional symptoms, peer relationship, and conduct problems domains; and in the internalization, externalization, and difficulties scales. Children with vocal problem scored lower on the skills scale in the self-report. Parents/guardians in the group with vocal problem reported peer relationship problems not perceived by their children. Parents/guardians in the group without vocal problem did not perceive the signs of hyperactivity/inattention reported in their children and adolescents' self-reports.

CONCLUSIONS

The presence of vocal problems in the pediatric and adolescent population may be a risk factor for mental health due to the higher scores on behavior problems scales, both in their internalization and externalization aspects.

Factors Affecting Social Health from Young Adults' Perspective: A Qualitative Study

BACKGROUND

Factors affecting social health, especially in young adults, are among the most important research priorities. Knowledge of social factors affecting young adults' health will lead to understand them in the social context. The present study is aimed to explain the perspective of young adults on social factors affecting health.

METHODS

In the present qualitative content analysis study, semi-structured open interviews were conducted through targeted sampling of young volunteers aged 18-30 who were selected from Tehran Province. Interviews were recorded, transcribed, and analyzed. The inclusion criteria for participants were willingness to participate in the study and ability to express their personal experiences. Twenty-one data were collected through collection was done with individual in-depth interviews.

RESULTS

Using this qualitative approach, the present study was conducted to identify factors affecting social health from the perspective of young adults. The analysis led to the extraction of three main categories, each with two or three subcategories: expectations regarding the community, expectations regarding the family, and expectations regarding infrastructures.

CONCLUSIONS

Our findings shown that social support considered as effective elements in providing social health of young adults. The evidence on controlling factors should be considered in promoting the social health of specific target groups. The results of the present study could be used for better planning of interventions in youth social health domains.

A Comparative Study of Behavior Problems among Left-Behind Children, Migrant Children and Local Children

This study aims to estimate the prevalence of behavioral problems among left-behind children, migrant children and local children in China, and to compare the risks of behavioral problems among the three types of children. Data on 4479 children aged 6–16 used in this study were from a survey conducted in China in 2017. The school-age version of the Children Behavior Checklist was used to measure children’s behavioral problems. Descriptive analysis, correlation analysis, and logistic regressions were conducted. The prevalence of behavioral problems was 18.80% and 13.59% for left-behind children and migrant children, respectively, both of which were higher than that of local children. Logistic regression analysis showed that after adjustments for individual and environmental variables, the likelihood of total, internalizing and externalizing behavior problems for left-behind children and migrant children were higher than those for local children; left-behind children had a higher likelihood of internalizing problems than externalizing problems, while migrant children had a higher prevalence of externalizing problems. Left-behind children had a higher prevalence of each specific syndrome than migrant and local children. Both individual and environmental factors were associated with child behavioral problems, and family migration may contribute to the increased risks. Left-behind and migrant children were more vulnerable than local children to behavioral problems.

Parent-child discrepancies in the report of adolescent emotional and behavioral problems in Taiwan

The majority of studies on parent-child discrepancies in the assessment of adolescent emotional and behavioral problems have been conducted in Western countries. It is believed that parent-adolescent agreement would be higher in societies with a strong culture of familism. We examined whether parent-adolescent discrepancies in the rating of adolescent emotional and behavioral problems are related to parental and family factors in Taiwan. Participants included 1,421 child-parent pairs of 7^th-grade students from 12 middle schools in Northern Taiwan and their parents. We calculated Pearson’s correlation coefficients to assess the relationship between parental (Child Behavior Checklist, CBCL) and adolescent (Youth Self Report, YSR) report of emotional/behavioral problem syndromes. Regression models were used to assess parent-adolescent differences in relation to parental psychopathology and family factors. We found that parent-adolescent agreement was moderate (r = 0.37). Adolescents reported higher symptom scores than their parents (Mean Total Problem Score: CBCL: 20.79, YSR: 33.14). Parental psychopathology was related to higher parental ratings and better informant agreement. Parents with higher socioeconomic status (SES) tended to report lower scores for adolescent problem syndromes, resulting in higher levels of disagreement. Greater maternal care was related to higher parent-adolescent agreement. Based on our study findings, we conclude that familism values do not seem to improve parent-child agreement in the assessment of adolescent problem syndromes. The finding that higher SES was related to increased discrepancies speaks to the need to explore the culture-specific mechanisms giving rise to informant discrepancies.

Menarche, menstrual problems and suicidal behavior in Chinese adolescents

BACKGROUND

Menarche is the first menstrual cycle. Menstrual problems, such as dysmenorrheal menorrhagia, oligomenorrhea, and irregular cycle are common in female adolescents. This research aims to examine the associations between age at menarche and menstrual problems and suicidal behavior among Chinese female adolescents.

METHODS

An epidemiological survey of 5831 female adolescents from eight high schools of three counties of Shandong province, China, was conducted. A self-administered paper-and-pencil questionnaire was used to collect information. Logistic regression analyses were used to examine the association between menstruation and suicidality.

RESULTS

The mean age of the sample was 15.02 (SD=1.44) years. Of the sample, 5,231 (90.0%) had experienced their first menstrual cycle, and 23.2%, 10.4%, and 4.5% of the sample reported having had suicidal ideation, plan and attempt, respectively. In multivariate models, menarche at ≤11 years was associated with increased risk of suicidal ideation (OR=1.41, 95%CI: 1.10-1.81) and menarche at 12 years was associated with suicide plan (OR=1.23, 95%CI: 1.00-1.51). Irregular menstrual cycle was significantly associated with increased risk of suicidal ideation (OR=1.40, 95%CI: 1.05-1.86) and menstrual period less than or equal to 4 days was significantly associated with increased risk of suicide plan (OR=1.32, 95%CI: 1.06-1.66).

LIMITATIONS

This cross-sectional study cannot establish the causal directions between menstrual problems and suicidality in adolescents.

CONCLUSIONS

Our study suggests that earlier menarche, irregular menstrual cycle and short menstrual period are associated with suicidal behavior in female adolescents. Further research is warranted to examine the causal relationship between menstrual problems and suicidal behavior in adolescents.