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Barrett ES, Sullivan A, Workman T, Zhang Y, Loftus CT, Szpiro AA, Paquette A, MacDonald JW, Coccia M, Smith R, Bowman M, Smith A, Derefinko K, Nguyen RHN, Zhao Q, Sathyanarayana S, Karr C, LeWinn KZ, Bush NR. Sex-specific associations between placental corticotropin releasing hormone and problem behaviors in childhood. Psychoneuroendocrinology 2024; 163:106994. [PMID: 38387218 DOI: 10.1016/j.psyneuen.2024.106994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 02/24/2024]
Abstract
Placental corticotropin-releasing hormone (pCRH) is a neuroactive peptide produced in high concentrations in mid-late pregnancy, during key periods of fetal brain development. Some evidence suggests that higher pCRH exposure during gestation is associated with adverse neurodevelopment, particularly in female offspring. In 858 mother-child dyads from the sociodemographically diverse CANDLE cohort (Memphis, TN), we examined: (1) the slope of pCRH rise in mid-late pregnancy and (2) estimated pCRH at delivery as a measure of cumulative prenatal exposure. When children were 4 years-old, mothers reported on problem behaviors using the Child Behavior Checklist (CBCL) and cognitive performance was assessed by trained psychologists using the Stanford-Binet Intelligence Scales. We fitted linear regression models examining pCRH in relation to behavioral and cognitive performance measures, adjusting for covariates. Using interaction models, we evaluated whether associations differed by fetal sex, breastfeeding, and postnatal neighborhood opportunity. In the full cohort, log-transformed pCRH measures were not associated with outcomes; however, we observed sex differences in some models (interaction p-values≤0.01). In male offspring, an interquartile (IQR) increase in pCRH slope (but not estimated pCRH at delivery), was positively associated with raw Total (β=3.06, 95%CI: 0.40, 5.72), Internalizing (β=0.89, 95%CI: 0.03, 1.76), and Externalizing (β=1.25, 95%CI: 0.27, 2.22) Problem scores, whereas, in females, all associations were negative (Total Problems: β=-1.99, 95%CI: -3.89, -0.09; Internalizing: β=-0.82, 95%CI: -1.42, -0.23; Externalizing: β=-0.56, 95%CI: -1.34, 0.22). No associations with cognitive performance were observed nor did we observe moderation by breastfeeding or postnatal neighborhood opportunity. Our results provide further evidence that prenatal pCRH exposure may impact subsequent child behavior in sex-specific ways, however in contrast to prior studies suggesting adverse impacts in females, steeper mid-gestation pCRH rise was associated with more problem behaviors in males, but fewer in females.
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Affiliation(s)
- Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA; Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, USA.
| | - Alexandra Sullivan
- Center for Health and Community, University of California, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Tomomi Workman
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Yuhong Zhang
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Christine T Loftus
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Adam A Szpiro
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Alison Paquette
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA; Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - James W MacDonald
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Michael Coccia
- Center for Health and Community, University of California, San Francisco, CA, USA
| | - Roger Smith
- Mothers and Babies Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - Maria Bowman
- Mothers and Babies Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - Alicia Smith
- Department of Gynecology and Obstetrics, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, USA
| | - Karen Derefinko
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Ruby H N Nguyen
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Qi Zhao
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Sheela Sathyanarayana
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA; Department of Pediatrics, University of Washington, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Catherine Karr
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA; Department of Pediatrics, University of Washington, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Nicole R Bush
- Center for Health and Community, University of California, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA; Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
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McAloon J, Armstrong SM. The Effects of Online Behavioral Parenting Interventions on Child Outcomes, Parenting Ability and Parent Outcomes: A Systematic Review and Meta-analysis. Clin Child Fam Psychol Rev 2024:10.1007/s10567-024-00477-4. [PMID: 38613631 DOI: 10.1007/s10567-024-00477-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2024] [Indexed: 04/15/2024]
Abstract
The twenty-first century has seen the development and delivery of online programs of behavioral family intervention for disruptive child behavior. Typically, programs evaluate outcomes in terms of change in child functioning and change in parenting ability. Existing research has also articulated the importance of parent-child relational capacity and its role in facilitating change in child functioning, and the importance of parent emotion regulation in the interests of ensuring optimal child development. These factors were explored in a meta-analysis of k = 14 prospective longitudinal research studies of online parenting interventions for disruptive child behavior. Peer reviewed randomized controlled trials with inactive control groups that were published in English between 2000 and 2022 were included in the review if they were delivered online; offered parent self-directed treatment; included as participants families who were screened as having child behavioral difficulties on validated psychometric assessment measures; and assessed child treatment outcomes, parenting ability and parent treatment outcomes. The protocol for this study was pre-registered with PROSPERO (CRD42020215947). Statistical analyses employed random effects models and reported pooled effect sizes (Hedge's g) within and between groups. Results emphasize the importance of child outcomes and parenting ability in program assessment, however, suggest that parents' capacity to develop optimal parent-child relationships and regulate emotion may not be sufficiently reflected in program content. Identified continuous and categorical moderators of treatment outcome were also assessed. Results of the review are discussed in terms of their potential to influence the future development of online programs of behavioral family intervention and, therefore, child development.
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Affiliation(s)
- John McAloon
- UTS: Family Child Behavior Clinic, Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Level 5 Building 20, 100 Broadway, Ultimo, NSW, 2007, Australia.
| | - Simone Mastrillo Armstrong
- UTS: Family Child Behavior Clinic, Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Level 5 Building 20, 100 Broadway, Ultimo, NSW, 2007, Australia
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Ma T, Tellegen CL, Sanders MR. The role of parenting self-efficacy on teacher-child relationships and parent-teacher communication: Evidence from an Australian national longitudinal study. J Sch Psychol 2024; 103:101296. [PMID: 38432724 DOI: 10.1016/j.jsp.2024.101296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 07/27/2023] [Accepted: 02/05/2024] [Indexed: 03/05/2024]
Abstract
High-quality teacher-child relationships and parent-teacher communications have substantial benefits to children's well-being and school functioning. However, more research is needed to understand how parenting self-efficacy influences these relationships. This cross-sequential study investigated the direct associations of parenting self-efficacy with the teacher-child relationship and parent-teacher communication, as well as potential mediation pathways. The present study included a sample of 8152 children who participated in the Longitudinal Study of Australian Children (LSAC), a large study with a nationally representative sample of children from two cohorts who were 4 years apart. We used data collected in three waves when participating children were ages 6 years, 8 years, and 10 years. Structural equation modeling was used to test a panel model with parent-reported parenting self-efficacy and parent-teacher communication quality, as well as teacher-reported teacher-child relationship, child behavior difficulties, and child prosocial behaviors at school. Cross-lagged regressions demonstrated that baseline parenting self-efficacy directly and positively linked with the quality of teacher-child relationship and parent-teacher communication 2 years later. Child behavior at school was identified as a mediation pathway between parenting self-efficacy and teacher-child relationship. The same patterns were identified in two waves (Waves 6-8 and Waves 8-10). Limited child gender, parent gender, or cohort differences were observed. The current findings provide initial support that parenting self-efficacy may have spillover effects on school-related factors. The findings have implications both for parenting and school researchers and for child mental health practitioners because one important way to promote parenting self-efficacy is through evidence-based parenting programs.
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Affiliation(s)
- Tianyi Ma
- Parenting and Family Support Centre, The University of Queensland, 13 Upland Road, St Lucia 4072, Australia.
| | - Cassandra L Tellegen
- Parenting and Family Support Centre, The University of Queensland, 13 Upland Road, St Lucia 4072, Australia
| | - Matthew R Sanders
- Parenting and Family Support Centre, The University of Queensland, 13 Upland Road, St Lucia 4072, Australia
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Lewer D, Gilbody S, Lewis G, Pryce J, Santorelli G, Wadman R, Watmuff A, Wright J. How do schools influence the emotional and behavioural health of their pupils? A multi-level analysis of 135 schools in the Born in Bradford inner city multi-ethnic birth cohort. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-023-02608-8. [PMID: 38195962 DOI: 10.1007/s00127-023-02608-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 12/11/2023] [Indexed: 01/11/2024]
Abstract
PURPOSE To estimate variation in emotional and behavioural problems between primary schools in Bradford, an ethnically diverse and relatively deprived city in the UK. METHODS We did a cross-sectional analysis of data collected from 2017 to 2021 as part of the 'Born In Bradford' birth cohort study. We used multilevel linear regression in which the dependent variable was the Strengths and Difficulties Questionnaire (SDQ) total score, with a random intercept for schools. We adjusted for pupil-level characteristics including age, ethnicity, socioeconomic status, and parental mental health. RESULTS The study included 5,036 participants from 135 schools. Participants were aged 7-11 years and 56% were of Pakistani heritage. The mean SDQ score was 8.84 out of a maximum 40. We estimated that the standard deviation in school-level scores was 1.41 (95% CI 1.11-1.74) and 5.49% (95% CI 3.19-9.37%) of variation was explained at school level. After adjusting for pupil characteristics, the standard deviation of school-level scores was 1.04 (95% CI 0.76-1.32) and 3.51% (95% CI 1.75-6.18%) of variation was explained at school level. Simulation suggested that a primary school with 396 pupils at the middle of the distribution has 63 pupils (95% CI 49-78) with a 'raised' SDQ score of 15 + /40; and shifting a school from the lower to the upper quartile would prevent 26 cases (95% CI 5-46). CONCLUSION The prevalence of emotional and behavioural problems varies between schools. This is partially explained by pupil characteristics; though residual variation in adjusted scores may suggest that schools have a differential impact on mental wellbeing.
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Affiliation(s)
- Dan Lewer
- Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
- Department for Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Simon Gilbody
- Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
- Department of Health Sciences, University of York, York, YO10 5DD, UK
- Hull York Medical School, University of York, York, YO10 5DD, UK
| | - Gemma Lewis
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Joseph Pryce
- Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Gillian Santorelli
- Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Ruth Wadman
- Department of Health Sciences, University of York, York, YO10 5DD, UK.
| | - Aidan Watmuff
- Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
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Barrett ES, Day DB, Szpiro A, Peng J, Loftus CT, Ziausyte U, Kannan K, Trasande L, Zhao Q, Nguyen RHN, Swan S, Karr CJ, LeWinn KZ, Sathyanarayana S, Bush NR. Prenatal exposures to phthalates and life events stressors in relation to child behavior at age 4-6: A combined cohort analysis. Environ Int 2024; 183:108425. [PMID: 38199129 PMCID: PMC10863744 DOI: 10.1016/j.envint.2024.108425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/31/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
Prenatal exposures to chemical and psychosocial stressors can impact the developing brain, but few studies have examined their joint effects. We examined associations between prenatal phthalate exposures and child behavior, hypothesizing that prenatal stressful life events (PSLEs) may exacerbate risks. To do so, we harmonized data from three U.S. pregnancy cohorts comprising the ECHO-PATHWAYS consortium. Phthalate metabolites were measured in single mid-pregnancy urine samples. When children were ages 4-6 years, mothers completed the Child Behavior Checklist (CBCL), from which a Total Problems score was calculated. Mothers additionally provided recall on their exposure to 14 PSLEs during pregnancy. Primary models examined problem behaviors in relation to: (1) phthalate mixtures calculated through weighted quantile sums regression with permutation test-derived p-values; and (2) joint exposure to phthalate mixtures and PSLEs (counts) using interaction terms. We subsequently refitted models stratified by child sex. Secondarily, we fit linear and logistic regression models examining individual phthalate metabolites. In our main, fully adjusted models (n = 1536 mother-child dyads), we observed some evidence of weak main effects of phthalate mixtures on problem behaviors in the full cohort and stratified by child sex. Interaction models revealed unexpected relationships whereby greater gestational exposure to PSLEs predicted reduced associations between some phthalates (e.g., the metabolites of di-2-ethylhexyl phthalate, di-n-octyl phthalate, di-iso-nonyl phthalate) and problem behaviors, particularly in males. Few associations were observed in females. Additional research is needed to replicate results and examine potential mechanisms.
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Affiliation(s)
- Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA; Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ 08854, USA.
| | - Drew B Day
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA 98101, USA
| | - Adam Szpiro
- Department of Biostatistics, University of Washington, Seattle, WA 98195, USA
| | - James Peng
- Department of Biostatistics, University of Washington, Seattle, WA 98195, USA
| | - Christine T Loftus
- Department of Occupational and Environmental Health, University of Washington, Seattle, WA 98195, USA
| | - Ugne Ziausyte
- Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
| | | | - Leonardo Trasande
- Department of Pediatrics, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Qi Zhao
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN 38163, USA
| | - Ruby H N Nguyen
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55454, USA
| | - Shanna Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Catherine J Karr
- Department of Occupational and Environmental Health, University of Washington, Seattle, WA 98195, USA; Department of Epidemiology, University of Washington, Seattle, WA 98195, USA; Department of Pediatrics, University of Washington, Seattle, WA 98104, USA
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Sheela Sathyanarayana
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA 98101, USA; Department of Occupational and Environmental Health, University of Washington, Seattle, WA 98195, USA; Department of Epidemiology, University of Washington, Seattle, WA 98195, USA; Department of Pediatrics, University of Washington, Seattle, WA 98104, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA; Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
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Canfield CF, Miller EB, Taraban L, Aviles AI, Rosas J, Mendelsohn AL, Morris P, Shaw D. Impacts of a tiered intervention on child internalizing and externalizing behavior in the context of maternal depression. Dev Psychopathol 2023:1-11. [PMID: 38093598 DOI: 10.1017/s0954579423001475] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
Greater maternal depressive symptoms are consistently associated with higher levels of behavioral difficulties in children, emerging in early childhood and with long-lasting consequences for children's development. Interventions promoting early relational health have been shown to have benefits for children's behavior; however, these impacts are not always realized in the context of maternal depression. This study examined whether tiered programs could address this limitation by focusing on both parenting, through universal primary prevention, and psychosocial stressors and parent mental health, through tailored secondary prevention. Analysis of a randomized controlled trial (RCT) of the Smart Beginnings (SB) intervention was conducted to determine whether SB attenuated the association between maternal depression and early childhood internalizing and externalizing behaviors. Maternal depression significantly predicted both internalizing and externalizing behaviors in linear regression models. Further, there was a significant interaction between maternal depression and treatment group, such that among mothers with higher depressive symptoms, the SB treatment attenuated the magnitude of the association between depression and child behavior. Findings suggest that while parenting support is important for all families, it may be particularly critical for those with higher levels of depression and underscores the need to consider multidimensional family processes in both research and clinical practice.
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Affiliation(s)
| | | | | | - Ashleigh I Aviles
- Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA
| | - Johana Rosas
- NYU Grossman School of Medicine, New York, NY, USA
| | | | - Pamela Morris
- Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA
| | - Daniel Shaw
- University of Pittsburgh, Pittsburgh, PA, USA
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Dosman C, Koscielnuk D, Gallagher S. Pearls of wisdom: Updated skill-specific parenting strategies in the first 6 years. Paediatr Child Health 2023; 28:470-479. [PMID: 38638543 PMCID: PMC11022867 DOI: 10.1093/pch/pxac081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 07/25/2022] [Indexed: 04/20/2024] Open
Abstract
This article provides knowledge translation on up-to-date parenting strategies (pearls of wisdom). These pearls support the development of specific skills in children from birth through 5 years of age. Paediatricians have indicated that they feel inadequately trained in providing parenting guidance. This article could be used by family physicians, community health nurses, nurse practitioners, and paediatricians as an office reference when providing anticipatory parenting guidance and when there are parent or clinician concerns that relate to various developmental stages. Included are general tips for guiding parents and pearls that support self-regulation, attachment, perspective taking, and developing the child's sense of self. The present review links pearls to specific reference sources in the literature which cite developmental standards and advice. Evidence-based parenting programs are cited for children with more complex presentations due to developmental, regulatory, or behavioural disorders, temperament individual differences, or limited parenting support. Website links for parents are recommended, and Parenting Pearls handouts provided, to solidify understanding and follow through.
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Affiliation(s)
- Cara Dosman
- Division of Developmental Pediatrics, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | | | - Sheila Gallagher
- Division of Developmental Pediatrics, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
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Fux-Noy A, Zeineh R, Shmueli A, Halperson E, Ram D, Moskovitz M. Anxiety during the dental care of children aged 4 to 6 years over three consecutive visits. J Clin Pediatr Dent 2023; 47:100-105. [PMID: 37997241 DOI: 10.22514/jocpd.2023.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 06/20/2023] [Indexed: 11/25/2023] Open
Abstract
Managing the anxiety of children during dental care is a major aspect of a pediatric dentist's work. Only a sparse body of literature is available regarding anxiety during dental care over consecutive visits. The purpose of the study was to investigate anxiety over three consecutive visits for pediatric dental treatment using an electrodermal activity (EDA) device. We also investigated how patient age, gender, the type of dental care performed and previous dental experience, exerted effect on anxiety.This was an observational cohort study. Anxiety was assessed during treatment, using an EDA device. We also recorded Frankl's behavior rating, previous dental experience, behavior guidance technique, heart rate and the type of dental care. Our cohort included 30 healthy children aged 4-6 years who needed dental care over at least three visits. Frankl scale scores, EDA values and heart rate did not differ significantly between visits. Behavior and anxiety during treatment did not differ significantly according to gender and age. At the second visit, the Frankl score was higher in children who received pulp treatments and crowns than those who received restorations (p = 0.012). At the third visit, children who received pulp treatments and crowns had higher heart rates than those who received restorations (p = 0.011). Heart rate was significantly higher in children who had negative dental experiences when compared to those with positive experiences (p = 0.030). The levels of anxiety in children aged 4-6 years did not change significantly over three consecutive dental treatments. Therefore, varied and meticulous behavior management methods should be maintained throughout consecutive visits.
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Affiliation(s)
- Avia Fux-Noy
- Department of Pediatric Dentistry, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, 9112102 Jerusalem, Israel
| | - Raneen Zeineh
- Department of Pediatric Dentistry, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, 9112102 Jerusalem, Israel
| | - Aviv Shmueli
- Department of Pediatric Dentistry, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, 9112102 Jerusalem, Israel
| | - Elinor Halperson
- Department of Pediatric Dentistry, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, 9112102 Jerusalem, Israel
| | - Diana Ram
- Department of Pediatric Dentistry, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, 9112102 Jerusalem, Israel
| | - Moti Moskovitz
- Department of Pediatric Dentistry, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, 9112102 Jerusalem, Israel
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YanYing P, ShenLing L, XiaoHan P, YunBo X, Xin T, GuoYan L, Yan C, Lei H. Incidence and risk factors associated with negative postoperative behavioral changes in children undergoing painless gastroscopy. BMC Pediatr 2023; 23:371. [PMID: 37474961 PMCID: PMC10360286 DOI: 10.1186/s12887-023-04187-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 07/13/2023] [Indexed: 07/22/2023] Open
Abstract
OBJECTIVE To investigate the incidence of and risk factors associated with negative postoperative behavioral changes (NPOBCs) in children undergoing painless gastroscopy. METHODS Inclusion criteria: ASA I-II and outpatients aged 6-12 years undergoing painless gastroscopy. EXCLUSION CRITERIA history of surgery or anesthesia, children with developmental or intellectual abnormalities, refusal to participate, preoperative abdominal pain score > 3 points, history of chronic abdominal pain of > 3 months duration, and serious intraoperative complications. On the 1st, 14th, and 30th day after the gastroscopy, the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery (PHBQ-AS) was used to assess NPOBCs in children. RESULTS A total of 1,670 children were included in this prospective observational cohort study. The incidence rates of NPOBCs were 14.13%, 4.55%, and 2.14% on the 1st, 14th, and 30th day after gastroscopy, respectively. The risk factors for the first day were female sex (OR 1.34, 95% CI 1.00-1.79), parental anxiety (OR 2.23, 95% CI 1.75-3.12), and severe anxiety in children (OR 2.83, 95% CI 1.96-4.07). The risk factors on the 14th day were parental anxiety (OR 3.71, 95% CI 2.19-6.29), a parental educational level above high school (OR 1.65, 95% CI 1.00-2.70), and severe anxiety in children (OR 11.87, 95% CI 5.85-24.07). The risk factors on the 30th day were female sex (OR 2.99, 95% CI 1.41-6.34), being an only child (OR 4.42, 95% CI 2.18-8.95), a parental educational level above high school (OR 2.66, 95% CI 1.27 NPOBCs 5.56), and severe anxiety in children (OR 6.84, 95% CI 2.84-16.49). CONCLUSION In children undergoing painless gastroscopy, the incidence rates of NPOBCs on the 1st, 14th, and 30th day were 14.13%, 4.55%, and 2.14%, respectively. The risk factors for NPOBCs were severe anxiety in children, female sex, parental anxiety, and a parental educational level above high school. In particular, severe preoperative anxiety in children was a persistent risk factor for NPOBCs within 30 days.
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Affiliation(s)
- Pu YanYing
- Sedation and Analgesia Center, Kunming Children's Hospital, Kunming, China
| | - Liu ShenLing
- Sedation and Analgesia Center, Kunming Children's Hospital, Kunming, China
| | - Peng XiaoHan
- Sedation and Analgesia Center, Kunming Children's Hospital, Kunming, China
| | - Xu YunBo
- Sedation and Analgesia Center, Kunming Children's Hospital, Kunming, China
| | - Tan Xin
- Sedation and Analgesia Center, Kunming Children's Hospital, Kunming, China
| | - Li GuoYan
- Sedation and Analgesia Center, Kunming Children's Hospital, Kunming, China
| | - Cheng Yan
- Sedation and Analgesia Center, Kunming Children's Hospital, Kunming, China
| | - Huang Lei
- Sedation and Analgesia Center, Kunming Children's Hospital, Kunming, China.
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Scheiber F, Nelson PM, Momany A, Ryckman KK, Ece Demir-Lira Ö. Parent mental health and child behavior during the COVID-19 pandemic. Child Youth Serv Rev 2023; 148:106888. [PMID: 36846210 PMCID: PMC9943737 DOI: 10.1016/j.childyouth.2023.106888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/06/2023] [Accepted: 02/18/2023] [Indexed: 05/07/2023]
Abstract
Objective Child behavior, which encompasses both internalizing and externalizing behaviors, is associated with many outcomes, including concurrent and future mental health, academic success, and social well-being. Thus, understanding sources of variability in child behavior is crucial for developing strategies aimed at equipping children with necessary resources. Parental mental health (PMH) difficulties and preterm birth may be risk factors for child behavior (CB) problems. Moreover, not only are PMH difficulties more common among parents of preterm children, but preterm children might also be more sensitive than full-term children to environmental stressors. In this study, we examined how PMH and CB changed during the COVID-19 pandemic, how change in PMH related to change in CB, and whether preterm children were more susceptible than full-term children to change in PMH. Methods Parents that participated in a study prior to the pandemic were invited to complete follow-up questionnaires during the pandemic about PMH and CB. Forty-eight parents completed follow-up questionnaires. Results Our results suggested that parental depression symptoms, children's internalizing symptoms, and children's externalizing symptoms significantly increased, and parental well-being significantly decreased during the pandemic. Change in parental depression symptoms, but not change in parental anxiety symptoms or parental well-being, was associated with change in children's internalizing and externalizing symptoms. Prematurity did not moderate change in PMH, change in CB, or the effect of change in PMH on change in CB. Conclusion Our findings have the potential to inform efforts aimed at equipping children with behavioral resources.
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Affiliation(s)
- Francesca Scheiber
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, United States
| | - Paige M Nelson
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, United States
| | - Allison Momany
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, United States
| | - Kelli K Ryckman
- Department of Epidemiology, University of Iowa, Iowa City, IA, United States
| | - Ö Ece Demir-Lira
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, United States
- DeLTA Center, University of Iowa, Iowa City, IA, United States
- Iowa Neuroscience Institute, University of Iowa, Iowa City, IA, United States
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11
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Araújo MFM, Silva EP, Ludermir AB. Maternal educational practices and mental health disorders of school-age children. J Pediatr (Rio J) 2023; 99:193-202. [PMID: 36341894 PMCID: PMC10031371 DOI: 10.1016/j.jped.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To investigate the association between emotional and behavioral difficulties in schoolchildren and maternal educational practices. METHODS Participants and Setting: 631 mother-child pairs were evaluated in a poor urban district in Recife, northeastern Brazil. Cross-sectional study carried out between 2013 and 2014. It integrates a prospective cohort study designed to investigate the consequences of intimate partner violence that occurred during pregnancy, postpartum, and seven years after birth for the physical and mental health of women and their children. Maternal educational practices were assessed using the Parent-Child Conflict Tactics Scale (CTSPC - mother-child version) and the child's behavioral and emotional disorders through the Strengths and Difficulties Questionnaire (SDQ) mother-version. The association was estimated through crude and adjusted prevalence ratios, using Poisson regression considering the 95% confidence interval. RESULTS The prevalence of violent maternal educational practices was 91.8% (572/631) being 89.7% (566/631) of psychological aggression and 75.6% of physical aggression, subdivided into corporal punishment (73.5%), physical maltreatment (35.8%) and severe physical maltreatment (1.7%). Corporal punishment (Adjusted PR 1.5; CI 95%: 1.1-2.1; p = 0.010) and severe physical maltreatment (Adjusted PR 1.9; CI 95%: 1.3-2.8; p = 0.002) were associated with emotional and behavioral difficulties in schoolchildren. CONCLUSION The high prevalence of violent maternal educational practices, especially corporal punishment and severe physical maltreatment is associated with emotional and behavioral disorders in children. Therefore, it is necessary to interventions that promote parental support and effective use of non-violent discipline in conducting the educational process to establish healthier family relationships and to prevent/mitigate the impact of emotional and behavioral problems in children.
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Affiliation(s)
- Maria Fernanda Muniz Araújo
- Universidade Federal de Pernambuco, Pós-graduação em Saúde Coletiva do Centro de Ciências Médicas, Recife, PE, Brazil.
| | - Elisabete Pereira Silva
- Universidade Federal de Pernambuco, Pós-graduação em Saúde da Criança e do Adolescente do Centro de Ciências Médicas, Recife, PE, Brazil
| | - Ana Bernarda Ludermir
- Universidade Federal de Pernambuco, Pós-graduação em Saúde Coletiva do Centro de Ciências Médicas, Recife, PE, Brazil
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Shalini K, Uloopi KS, Vinay C, Ratnaditya A, RojaRamya KS, Chaitanya P. Impact of Parenting Style on Child's Behavior and Caries Experience in 3-6-year-old Children: A Cross-sectional Study. Int J Clin Pediatr Dent 2023; 16:276-279. [PMID: 37519952 PMCID: PMC10373772 DOI: 10.5005/jp-journals-10005-2517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
Abstract
Aim The aim of the study is to evaluate the impact of parenting style on a child's behavior and caries experience in 3-6-year-old children. Materials and methods This cross-sectional study included 1,216 parent-child pairs of 3-6-year-old preschool children. Parenting style was determined using Parenting Style and Dimensions Questionnaire (PSDQ). Child behavior was assessed using Frankl's behavior rating scale, and caries experience was recorded using the decayed, extracted and filled deciduous teeth surfaces index. Results Out of the 1,216 parents, the authoritative parenting style is seen in 70%, authoritarian in 20%, and permissive parenting style in 9.5%. Children with a permissive type of parenting style have shown more negative behavior. Children of authoritative parents had 4.1 times higher odds of exhibiting definitely positive behavior, which is statistically significant (p = 0.004). Children of positive child behavior had 2.4 times higher odds of avoiding caries which is statistically significant (p = 0.0001). Children of authoritarian parents had 1.45 times higher odds of exhibiting caries than children of permissive parents; however, this difference is not statistically significant. Conclusion Children of authoritative parents demonstrated low caries experience and desirable behavior in the dental office. On the contrary, children of permissive parents exhibited undesirable dental behavior, and children of authoritarian parents had high caries experience. Clinical significance Twenty-first-century parents are less controlling and are more permissive leading to problematic child behavior in the dental office. Parenting styles have an impact on the effectiveness of behavior management as well as dental treatment. Pediatric dentists should identify different parenting styles and anticipate the child's behavior. This study emphasizes the effect of different parenting styles on a child's behavior and dental caries experience. How to cite this article Shalini K, Uloopi KS, Vinay C, et al. Impact of Parenting Style on Child's Behavior and Caries Experience in 3-6-year-old Children: A Cross-sectional Study. Int J Clin Pediatr Dent 2023;16(2):276-279.
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Affiliation(s)
- Kodati Shalini
- Department of Pedodontics and Preventive Dentistry, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
| | - KS Uloopi
- Department of Pedodontics and Preventive Dentistry, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
| | - C Vinay
- Department of Pedodontics and Preventive Dentistry, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
| | - A Ratnaditya
- Department of Pedodontics and Preventive Dentistry, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
| | - Kakarla Sri RojaRamya
- Department of Pedodontics and Preventive Dentistry, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
| | - Penmatsa Chaitanya
- Department of Pedodontics and Preventive Dentistry, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
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de Castro Peraza ME, Lorenzo Rocha ND, García Acosta JM, Díez Fernández O, Rodríguez Novo N, Pérez Ramos A, Perdomo Hernández AM, Castro Molina J. [Benefits of early social transition in transgender minors. Family perspectives: qualitative study.]. Rev Esp Salud Publica 2023; 97:e202301007. [PMID: 36705053 PMCID: PMC10541254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/29/2022] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE The term trans brings together all transgender identities. The early social transition towards the affirmed gender has benefits in the child's development. For families, transit is a period of great uncertainty, requiring support aimed at families of trans minors. The aim of this paper was to explore the needs and experiencies of parents and close-relatives who supported the social transition of their children. METHODS We worked with focus groups of functional families of transgender minors who had begun the transition (n=14), with a medium-high educational level and who belonged to urban areas of Tenerife. Through a semi-structured interview, they commented on their experiences in the process of supporting the social transition of their children. The data was recorded in a video recording and processed through content analysis and categorization. RESULTS Early social transition had positive and immediate benefits on child development as well as in the reduction of anxiety. There was a general improvement in mood, self-esteem, and social and family relationships. The accompaniment of specialists and associations helped in the different social situations and favoured resilience. CONCLUSIONS Early social transition is positive in the personal and socio-family sphere of the minor. To improve their resilience, families demand accompaniment in this process, as well as meeting other trans people who serve as transpositive references. In addition, they point out the need for specific training in health professionals.
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Affiliation(s)
- M. Elisa de Castro Peraza
- Escuela de Enfermería N. S. Candelaria, Servicio Canario de la Salud, Universidad de La LagunaUniversidad de La LagunaSanta Cruz de TenerifeSpain
| | - Nieves-Doria Lorenzo Rocha
- Escuela de Enfermería N. S. Candelaria, Servicio Canario de la Salud, Universidad de La LagunaUniversidad de La LagunaSanta Cruz de TenerifeSpain
| | - Jesús M. García Acosta
- Escuela de Enfermería N. S. Candelaria, Servicio Canario de la Salud, Universidad de La LagunaUniversidad de La LagunaSanta Cruz de TenerifeSpain
| | - Olga Díez Fernández
- Centro de Educación a Distancia Santa Cruz de Tenerife Mercedes Pinto, Consejería de Educación, Universidades, Cultura y Deportes del Gobierno de Canarias.Consejería de Educación, Universidades, Cultura y Deportes del Gobierno de CanariasSanta Cruz de TenerifeSpain
| | - Natalia Rodríguez Novo
- Sección Enfermería, Facultad de Ciencias de la Salud, Universidad de La LagunaUniversidad de La LagunaSanta Cruz de TenerifeSpain
| | | | - Ana M. Perdomo Hernández
- Escuela de Enfermería N. S. Candelaria, Servicio Canario de la Salud, Universidad de La LagunaUniversidad de La LagunaSanta Cruz de TenerifeSpain
| | - Javier Castro Molina
- Escuela de Enfermería N. S. Candelaria, Servicio Canario de la Salud, Universidad de La LagunaUniversidad de La LagunaSanta Cruz de TenerifeSpain
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Sousa TMD, Ferreira LA, Osanan GC, Santos LCD. Does antenatal supplementation with omega-3 affect child development and behavior during the first six months of life? A randomized double-blind placebo-controlled trial. Early Hum Dev 2023; 176:105713. [PMID: 36682094 DOI: 10.1016/j.earlhumdev.2023.105713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/19/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023]
Abstract
BACKGROUND Omega-3 fatty acids, especially docosahexaenoic acid (DHA), are found in different cell membranes, but more concentrated in the brain, playing an important role in child's behavior and development. AIMS To evaluate the effect of antenatal omega-3 supplementation on child development and behavior during the first six months of life. STUDY DESIGN Randomized double-blind placebo-controlled trial. SUBJECTS Low-risk pregnant women with gestational age between 22 and 24 weeks were randomized in placebo (olive oil; n = 30) or omega-3 (fish oil; 1440 mg/day of DHA; n = 30) groups and supplemented until childbirth. OUTCOME MEASURES Child development was assessed using the Survey of Well-being of Young Children in the first, fourth and sixth month of life. RESULTS The comparison between groups showed no differences in the Developmental Milestones score at any time, but when compared to the first month, the omega-3 group showed an increase at the fourth and sixth month. Such increase was not observed in the placebo group. No differences were found between groups for Irritability and Inflexibility scores, however, higher scores for Difficulty with Routine were observed in the placebo group when compared to omega-3 at first, fourth and sixth month. CONCLUSION There were no differences between groups for child development, but the omega-3 group showed an increase in this score over time. The placebo group had greater difficulty with routine than the omega-3 group, indicating a beneficial effect of antenatal supplementation on child behavior. TRIAL REGISTRATION ReBec U1111-1215-7952 (June 16th 2018).
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Affiliation(s)
- Taciana Maia de Sousa
- Universidade Federal de Minas Gerais, Nutrition Department, Belo Horizonte, Minas Gerais, Brazil.
| | - Leydiane Andrade Ferreira
- Universidade Federal de Minas Gerais, Jenny de Andrade Faria Institute, Belo Horizonte, Minas Gerais, Brazil
| | - Gabriel Costa Osanan
- Universidade Federal de Minas Gerais, Gynecology and Obstetrics Department, Belo Horizonte, Minas Gerais, Brazil
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López-Fernández G, Barrios M, Gómez-Benito J. Breastfeeding and maternal attachment: The moderating roles of maternal stress and child behavior. J Pediatr Nurs 2022; 69:e80-e87. [PMID: 36529595 DOI: 10.1016/j.pedn.2022.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 10/08/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE This study examined the effect of breastfeeding on maternal attachment, and explored the moderating role of maternal stress and child behavior in this relationship, in a sample of Spanish mothers with children aged between 2 and 7 years. DESIGN AND METHODS A total of 432 mothers participated in a cross-sectional online survey. A three-way interaction model was used to test the moderating role of maternal stress and child behavioral problems in the relationship between breastfeeding and maternal attachment. RESULTS The full model accounted for 19% of the variance of maternal attachment. Breastfeeding was significantly associated with mother-rated attachment, and the moderated moderation analysis confirmed the moderating effects of maternal stress and child behavior on the relationship between breastfeeding and maternal attachment. CONCLUSIONS This study adds to the existing literature that supports the contribution that breastfeeding makes in enhancing maternal attachment, and may help to clarify the role of breastfeeding in shaping maternal attachment. Our findings suggest that breastfeeding is a factor in enhancing maternal attachment, and also identify maternal stress and child behavior as moderators of this relationship. PRACTICE IMPLICATIONS Understanding the mechanisms by which breastfeeding affects maternal attachment will help generate recommendations to improve breastfeeding and maternal attachment.
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Affiliation(s)
- Gemma López-Fernández
- Department of gynecology and obstetrics, Corporació Sanitaria Parc Taulí, Sabadell, Barcelona, Spain; Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain.
| | - Maite Barrios
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain; Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
| | - Juana Gómez-Benito
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain; Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
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Donovan MO, Briscoe-Hough K, Barkus E, Herbert JS, Miller L, Konza G, Pickard JA. Mindfulness and Imagery Enhanced Behavioral Parenting: Effectiveness Pilot of the Confident Carers Cooperative Kids Program. J Child Fam Stud 2022; 32:1504-1518. [PMID: 36530565 PMCID: PMC9748389 DOI: 10.1007/s10826-022-02502-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/23/2022] [Indexed: 05/28/2023]
Abstract
Mindfulness is increasingly offered to parents of children presenting with behavioral problems, either as a stand-alone intervention, or integrated within existing behavioral parenting interventions. There is relatively modest support for mindful parenting, with small to medium effect size improvements demonstrated across child and parent outcome measures. Here we introduce a mindfulness and imagery enhanced behavioral parenting program. We argue blending mindfulness, imagery and behavioral skills could produce improved parenting engagement and perseverance, leading to stronger outcomes. Pilot data is presented from two contrasting real world clinical settings. Parents attending the 8-week Confident Carers Cooperative Kids (CCCK) group program in a university clinic setting were invited to be included in the study (n = 20). Permission was also gained to use archival data from a community organisation offering CCCK groups to parents who were at risk of child welfare involvement (n = 14). Pre- and post-intervention measures were completed across both groups on parent-reported child behavior, parent wellbeing, adaptive parenting, and mindful parenting. Parents from both groups achieved significant pre- to post-intervention improvements in child behavior problems, parent wellbeing, adaptive parenting, and mindful parenting, with large effect sizes. Larger improvements in child behavior problems were reported by parents from the community group compared with the university group. The CCCK intervention appears beneficial across child and parent outcomes, including for families most in need. A larger sample is required to replicate and extend these promising findings.
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Affiliation(s)
- Mark O. Donovan
- School of Psychology, University of Wollongong, Keiraville, NSW 2522 Australia
| | | | - Emma Barkus
- Department of Psychology, Northumbria University, Newcastle-upon-Tyne, NE7 7YT UK
| | - Jane S. Herbert
- School of Psychology, University of Wollongong, Keiraville, NSW 2522 Australia
| | - Leonie Miller
- School of Psychology, University of Wollongong, Keiraville, NSW 2522 Australia
| | - Greg Konza
- Private Practice, Figtree, NSW 2525 Australia
| | - Judy A. Pickard
- School of Psychology, University of Wollongong, Keiraville, NSW 2522 Australia
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17
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Bemanalizadeh M, Badihian N, Khoshhali M, Badihian S, Hosseini N, Purpirali M, Abadian M, Yaghini O, Daniali SS, Kelishadi R. Effect of parenting intervention through "Care for Child Development Guideline" on early child development and behaviors: a randomized controlled trial. BMC Pediatr 2022; 22:690. [PMID: 36461019 DOI: 10.1186/s12887-022-03752-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 11/14/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Several studies showed that parenting intervention programs play a core component in early child development. Considering the limited healthcare resources in developing countries, group-session intervention based on care for child development (CCD) guideline might be cost-effective. METHODS This randomized controlled trial was conducted at an outpatient public Pediatrics clinic in Isfahan, Iran. We included 210 pregnant women aged 18-45 years in their third trimester and followed their children for 18 months. The intervention group underwent 5 educational group sessions, each lasting for almost 45 minutes. The main outcomes were the children's development and socio-emotional behavior problems based on Bayley Scales of Infant and Toddler Development-III (BSID-III) at 12 months and the Children Behavior Checklist (CBCL) at 18 months. RESULTS Overall, data of 181 children were included in the current study, including 80 in the intervention group and 101 controls. The adjusted median/mean differences between intervention and control groups using median/linear regression were not significant for all BSID-III domains except for median differences for cognitive score based on BSID-III (β (SE): - 4.98(2.31), p:0.032) and mean differences for anxiety/depression score based on CBCL (β (SE): - 2.54(1.27), p:0.046). CONCLUSION In this study, parenting interventions through CCD group sessions were significantly effective on just one subscale of children's socio-emotional behavior domains based on CBCL and one domain of children's development based on BSID-III. There might be a ceiling or floor effects for the BSID-III and CBCL assessment, respectively, leaving little room for improvement as almost all children have achieved their full developmental potential in our study. TRIAL REGISTRATION IRCT20190128042533N2, Date of registration: 16/01/2020, www.irct.ir.
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Stein CR, Wu H, Bellinger DC, Smith DR, Wolff MS, Savitz DA. Exposure to metal mixtures and neuropsychological functioning in middle childhood. Neurotoxicology 2022; 93:84-91. [PMID: 36122627 PMCID: PMC10513744 DOI: 10.1016/j.neuro.2022.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 09/05/2022] [Accepted: 09/15/2022] [Indexed: 01/09/2023]
Abstract
Elevated exposure to multiple trace metals can be neurotoxic even at relatively low levels. These findings are primarily evident from adult occupational studies as well as in children exposed prenatally or in early childhood. Less research has focused on the neurodevelopmental impacts of exposure to metals among school-aged children. We examined associations between exposure to a mixture of four metals (arsenic, cadmium, manganese, lead) measured in hair and markers of cognition, attention, and behavior among 222 6-12 year old children who participated in a 2009-2010 neurodevelopmental follow-up to the C8 Health Project. Using quantile-based g-computation we estimated the adjusted overall metal mixture effect ψ (95 % CI) as the change in outcome per decile increase in all metals in the mixture. Hair metal levels varied by metal, with cadmium being lowest (median 0.007, interquartile range (IQR) 0.013 μg/g) and lead the highest concentration (median 0.152, IQR 0.252 μg/g). Children's cognitive skills and development, attention/impulsivity, and behavior were all close to standardized population means. Each decile increase in all metals was associated with a Full Scale IQ reduction of 1.01 points (95 % confidence interval (CI) -1.88, -0.15) and Verbal IQ reduction of 1.11 points (95 % CI -1.97, -0.25), adjusted for child age, sex, secondhand smoke exposure, HOME score, maternal education, maternal IQ, and examiner. Maternal report of ADHD-like behaviors and executive functioning also showed adverse associations with the metal mixture. Our findings suggest that similar to exposure during prenatal and early childhood periods, recent exposure to metals during middle childhood is associated with adverse neurodevelopmental consequences. Middle childhood may also be a developmental window of susceptibility to the negative consequences of exposure to environmental neurotoxicants.
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Affiliation(s)
- Cheryl R Stein
- Hassenfeld Children's Hospital at NYU Langone, Department of Child and Adolescent Psychiatry, Child Study Center, One Park Avenue, 7th Floor, New York, NY 10016, USA.
| | - Haotian Wu
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168th St, New York, NY 10032, USA.
| | - David C Bellinger
- Department of Neurology, Boston Children's Hospital, Farley Basement Box 127, 300 Longwood Ave, Boston, MA 02115, USA.
| | - Donald R Smith
- Department of Microbiology and Environmental Toxicology, University of California, 442 Physical Sciences Building, Santa Cruz, CA 95064, USA.
| | - Mary S Wolff
- Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, 17 East 102 Street, New York, NY 10029, USA.
| | - David A Savitz
- Department of Epidemiology, Brown University School of Public Health, 121 S. Main Street, Box G-S-121-2, Providence, RI 02912, USA.
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Cioffredi LA, Anderson H, Loso H, East J, Nguyen P, Garavan H, Potter A. Prenatal cannabis exposure predicts attention problems, without changes on fMRI in adolescents. Neurotoxicol Teratol 2022; 91:107089. [PMID: 35314358 PMCID: PMC9136933 DOI: 10.1016/j.ntt.2022.107089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 03/12/2022] [Accepted: 03/15/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES We hypothesized that prenatal cannabis exposure (PCE) would be associated with increased attention problems and altered neurocognition in young adolescents. METHODS Data were obtained from the Adolescent Brain Cognitive Development (ABCD study®), a cohort of approximately 12,000 children. Presence or absence of PCE after knowledge of pregnancy was measured by caregiver report. All participants with PCE (N = 224) were included and compared to two control groups; those matched on tobacco and alcohol exposure and those without prenatal tobacco or alcohol exposures. Outcomes were measured with the ABCD baseline assessment when participants were 9-10 years old and included attention, internalizing, externalizing and total problems scales on the Child Behavior Checklist (CBCL). Teacher reports were used when available. Mixed effects modeling assessed the association between PCE and outcomes controlling for parental psychopathology, prematurity and socioeconomic status. For participants with available data, patterns of brain activity during three fMRI tasks (the Stop Signal Task measuring response inhibition, the Monetary Incentive Delay (MID) task measuring reward processing and the EN-Back task measuring working memory) were analyzed using Permutation Analyses of the Linear Model. RESULTS Compared to both control groups, participants with PCE had significantly higher attention problems, externalizing, and total problem scores. PCE did not impact cognitive performance or patterns of brain activation during fMRI tasks. CONCLUSIONS There are long-term associations between PCE and early adolescent attention and behavioral problems. These are not reflected in cognitive performance or task fMRI measures, a finding that is consistent with reports that fewer than half of children with ADHD have any specific cognitive deficit (Nigg et al., 2005; Willcutt et al., 2005). The young age of the sample may also relate to this finding and future investigation of neurodevelopmental trajectories of youth with PCE is warranted.
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Affiliation(s)
- Leigh-Anne Cioffredi
- Larner College of Medicine at the University of Vermont, Department of Pediatrics, USA.
| | - Hillary Anderson
- Larner College of Medicine at the University of Vermont, Department of Pediatrics, USA
| | - Hannah Loso
- Larner College of Medicine at the University of Vermont, Department of Psychiatry, USA
| | - James East
- Larner College of Medicine at the University of Vermont, Department of Radiology, USA
| | - Philip Nguyen
- Larner College of Medicine at the University of Vermont, Department of Psychiatry, USA
| | - Hugh Garavan
- Larner College of Medicine at the University of Vermont, Department of Psychiatry, USA
| | - Alexandra Potter
- Larner College of Medicine at the University of Vermont, Department of Psychiatry, USA
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Liu J, Portnoy J, Raine A, Gladieux M, McGarry P, Chen A. Blood lead levels mediate the relationship between social adversity and child externalizing behavior. Environ Res 2022; 204:112396. [PMID: 34801542 PMCID: PMC10117419 DOI: 10.1016/j.envres.2021.112396] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/12/2021] [Accepted: 11/13/2021] [Indexed: 06/01/2023]
Abstract
BACKGROUND/AIMS The association between social adversity and externalizing behavioral problems in children is well-documented. What is much less researched are biological mechanisms that may mediate such relationships. This study examines the hypothesis that low blood lead mediates the relationship between social adversity and child externalizing behavior problems. METHODS In this cross-sectional study, participants were 131 children aged 11-12 years (mean = 11.90) from Philadelphia, US. A venous fasting blood sample was taken and analyzed for blood lead levels. A social adversity index was calculated based on 10 total indicators derived from a psychosocial interview of the parent and official neighborhood data, while child behavior outcomes (internalizing and externalizing behavior) were assessed using both parent-report and child self-report. RESULTS The mean blood lead level was 2.20 μg/dL. Both relatively higher blood lead levels and higher social adversity scores were associated with higher levels of parent-reported and child self-reported externalizing behaviors. Additionally, blood lead mediated the relationship between social adversity and child-reported externalizing behavior (Indirect effect: B = 0.03, 95% CI: 0.004, 0.09) and partially mediated the relationship between social adversity and parent-reported externalizing behavior (Indirect Effect: B = 0.03, 95% CI: 0.01, 0.07). CONCLUSION To our knowledge, this study is the first to suggest that blood lead levels play a mediating role in the relationship between externalizing behavior problems and social adversity. Findings have potentially important implications for public health and environmental regulation as well as understanding biological mechanisms that link social inequality with health outcomes, especially in youth from low-income, urban areas.
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Affiliation(s)
- Jianghong Liu
- University of Pennsylvania, School of Nursing 418 Curie Blvd., Claire M. Fagin Hall, Philadelphia, PA, 19104, USA.
| | - Jill Portnoy
- University of Massachusetts Lowell, School of Criminology and Justice Studies, 113 Wilder Street, Lowell, MA, 01854, USA.
| | - Adrian Raine
- University of Pennsylvania, Departments of Criminology, Psychiatry, and Psychology, 3718 Locust Walk, McNeil Building, Philadelphia, PA, 19104, USA.
| | - Margaret Gladieux
- University of Pennsylvania, School of Nursing 418 Curie Blvd., Claire M. Fagin Hall, Philadelphia, PA, 19104, USA.
| | - Presley McGarry
- University of Massachusetts Lowell, School of Criminology and Justice Studies, 113 Wilder Street, Lowell, MA, 01854, USA.
| | - Aimin Chen
- University of Pennsylvania, Department of Biostatistics, Epidemiology and Informatics, 423 Guardian Drive, Blockley Hall, Philadelphia, PA, 19104, USA.
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21
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Loomis AM, Freed S, Coffey R. Inhibitory Control, Student-Teacher Relationships, and Expulsion Risk in Preschools: An Indirect Effects Path Analysis. Early Child Educ J 2022; 51:179-188. [PMID: 35018090 PMCID: PMC8736288 DOI: 10.1007/s10643-021-01287-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/18/2021] [Indexed: 06/14/2023]
Abstract
Identifying factors related to expulsion risk is of great need due to the high and disparate rates of young children routinely excluded from preschool classrooms. This study aimed to explore the pathways to expulsion risk among a sample of 88 preschool children from 22 Head Start classrooms. Data were collected on children's inhibitory control using the Child Behavior Questionnaire, the closeness subscale of the Student-Teacher Relationship Scale, and on children's overall expulsion risk using the Preschool Expulsion Risk Measure. Direct pathways from children's inhibitory control and student-teacher closeness to expulsion risk were significant. Results indicated that student-teacher closeness mediated the relationship between children's inhibitory control and expulsion risk, indicating the importance of supporting positive relationships in preschool classrooms to disrupt pathways to expulsion. Implications for practices and future research to prevent expulsion are discussed.
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Affiliation(s)
- Alysse M. Loomis
- College of Social Work, University of Utah, 395 South 1500 East #111, Salt Lake City, UT 84112 USA
| | - Sasha Freed
- College of Social Work, University of Utah, 395 South 1500 East #111, Salt Lake City, UT 84112 USA
| | - Rachel Coffey
- College of Social Work, University of Utah, 395 South 1500 East #111, Salt Lake City, UT 84112 USA
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22
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Linhares MBM, Altafim ERP, Gaspardo CM, de Oliveira RC. A Personalized Remote Video-Feedback Universal Parenting Program: A Randomized Controlled Trial. Interv Psicosoc 2022; 31:21-32. [PMID: 37362619 PMCID: PMC10268541 DOI: 10.5093/pi2021a9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 08/09/2021] [Indexed: 06/28/2023]
Abstract
The randomized controlled trial examined the efficacy of a personalized remote video feedback parenting program to improve parenting and child behavior outcomes. Ninety-two mothers of 2-6-year-old children were randomly allocated into the intervention group (n = 50) and waiting-list control group (n = 42). The Strengthening Bonds preventive program was performed to improve positive parenting. The mothers participated in one in-person group session. During six weeks, the mothers received, via smartphone, remote personalized video feedback about their mother-child interactions in a play situation. Parenting was the primary outcome, and child behavior was the secondary one. Pre- and post-intervention assessments were performed. The generalized estimating equation analysis showed no significant results in the intention-to-treat (ITT). In the treatment-on-the-treated (TOT), there were statistically significant effects of the intervention decreasing mothers' coercive parenting practices and child behavior problems. The structural equation model analysis showed that the intervention-induced reductions in children's behavior problems were mediated by improvements in coercive practices. There was a direct effect of the intervention to improve the parental sense of competence. Despite the null findings in the ITT analysis, the TOT analysis showed promising results to strengthen positive parenting behaviors and beliefs and reduce child behavior problems.
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23
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Familiar I, Majumder A, Sikorskii A, Boivin M, Nakasujja N, Bass J. Longitudinal Dyadic Interdependence in Depression Symptoms of Caregivers Living with HIV in Uganda and Their Dependent Children's Neurodevelopment and Executive Behavior Outcomes. AIDS Behav 2021; 25:3828-3835. [PMID: 33606133 DOI: 10.1007/s10461-021-03192-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2021] [Indexed: 11/29/2022]
Abstract
We tested a model of dyadic interdependence in depression symptoms experienced by female caregivers living with HIV in Uganda (n = 288) and behavioral problems of their HIV-infected (n = 92) and perinatally HIV-exposed uninfected (HEU) children (n = 196). Three repeated measures of caregiver depression symptoms and child neurodevelopment and behavioral outcomes were related to their own outcomes at a previous time point (actor effects), and the outcomes of the other member of the dyad (partner effects). Caregiver depression and child behavioral problem were interdependent over the 24 months of observation. Caregiver depression at Tn predicted child's behavioral problems at Tn+1 (coefficient = 0.1220, SE = 0.0313, p < 0.01); child behavioral problems at Tn predicted maternal depression at Tn+1 (coefficient = 0.0984, SE = 0.0253, p < 0.01). Results suggest the importance of services addressing behavioral needs of affected children and mental health of their mothers.
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Affiliation(s)
- Itziar Familiar
- Department of Psychiatry, Michigan State University, 909 Wilson Rd. A322, East Lansing, MI, USA.
| | | | - Alla Sikorskii
- Departments of Psychiatry and Statistics, Michigan State University, East Lansing, MI, USA
| | - Michael Boivin
- Departments of Psychiatry and Neurology, Michigan State University, East Lansing, MI, USA
| | - Noeline Nakasujja
- Department of Psychiatry College of Health Sciences, Makerere University, Kampala, Uganda
| | - Judith Bass
- Mental Health Department, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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24
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Guilbert A, Rolland M, Pin I, Thomsen C, Sakhi AK, Sabaredzovic A, Slama R, Guichardet K, Philippat C. Associations between a mixture of phenols and phthalates and child behaviour in a French mother-child cohort with repeated assessment of exposure. Environ Int 2021; 156:106697. [PMID: 34147998 DOI: 10.1016/j.envint.2021.106697] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/10/2021] [Accepted: 06/04/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Synthetic phenols and phthalates can interfere with biological pathways involved in brain development. Despite the high within-subject temporal variability of urinary concentrations observed for their metabolites, studies investigating effects of phenols and phthalates on child behaviour often relied on a limited number of spot biospecimens to assess exposure. Besides, the majority did not consider mixture effects. OBJECTIVES To study the combined effect of prenatal exposure to synthetic phenols and phthalates on child behaviour using repeated exposure measurements. METHODS We assessed concentrations of 12 phenols, 13 phthalate and 2 non-phthalate plasticizer metabolites in within-subject pools of multiple urine samples (median = 21 samples per individual pool) collected at two distinct time points during pregnancy in 416 mother-child pairs from the French SEPAGES cohort. Child behaviour was evaluated at two years using the Child Behaviour Checklist 1.5-5 (CBCL). Associations between a mixture of biomarkers of exposure and externalizing and internalizing behaviour scores were studied using adjusted Weighted Quantile Sum (WQS) regressions with a repeated holdout validation (100 repetitions). RESULTS The positive WQS indexes were associated with both the externalizing and internalizing behaviour scores in the whole population, indicating greater risk of behavioural problems. Stratification for child sex suggested stronger associations in girls than boys. On average, girls externalizing and internalizing scores increased by 3.67 points (95% CI: 1.24, 6.10) and 2.47 points (95 %CI: 0.60, 4.33) respectively, for an increase of one tertile in the WQS index, compared with 1.70 points (95 %CI: -0.42, 3.81) and 1.17 points (95 %CI: -0.50, 2.84) in boys. Main contributors for the associations observed in girls were bisphenol A (weight of 18%), triclosan (17%) and monoethyl phthalate (MEP, 15%) for the externalizing score and MEP (19%), mono-benzyl phthalate (MBzP, 19%) and mono-n-butyl phthalate (MnBP, 16%) for the internalizing score. DISCUSSION Our results suggest adverse associations between in utero exposure to a mixture of phenols and phthalates and child behaviour, mainly in girls. Public health consequences may be substantial due to the widespread exposure of the population to these compounds.
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Affiliation(s)
- Ariane Guilbert
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences (IAB), Grenoble Alpes University, Inserm, CNRS, 38700 La Tronche, France.
| | - Matthieu Rolland
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences (IAB), Grenoble Alpes University, Inserm, CNRS, 38700 La Tronche, France.
| | - Isabelle Pin
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences (IAB), Grenoble Alpes University, Inserm, CNRS, 38700 La Tronche, France; Pediatric Department, Grenoble Alpes University Hospital, 38700 La Tronche, France.
| | | | | | | | - Rémy Slama
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences (IAB), Grenoble Alpes University, Inserm, CNRS, 38700 La Tronche, France.
| | - Karine Guichardet
- Pediatric Department, Grenoble Alpes University Hospital, 38700 La Tronche, France.
| | - Claire Philippat
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences (IAB), Grenoble Alpes University, Inserm, CNRS, 38700 La Tronche, France.
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Day JJ, Baker S, Dittman CK, Franke N, Hinton S, Love S, Sanders MR, Turner KMT. Predicting positive outcomes and successful completion in an online parenting program for parents of children with disruptive behavior: An integrated data analysis. Behav Res Ther 2021; 146:103951. [PMID: 34507006 DOI: 10.1016/j.brat.2021.103951] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 06/17/2021] [Accepted: 08/26/2021] [Indexed: 10/20/2022]
Abstract
Online delivery of parenting support is steadily increasing, yet the factors that influence program engagement and efficacy are still understudied. This study used an integrated data analysis approach to identify family and program-related factors that influence outcomes. We combined individual data from seven published efficacy trials of the web-based version of the Triple P-Positive Parenting Program. Data were analyzed for 985 families with children aged between 2 and 12 years (M = 4.87; SD = 2.14) using a Latent Change Score approach. At post-intervention, sociodemographic factors were not predictive of changes in child behavior problems, while parents of boys and those with higher education showed greater improvements in dysfunctional parenting. Parents who were initially more confident in their parenting showed more overall gains while parents with more initial adjustment difficulties showed less improvement. Only the effect of baseline child behavior problems on changes in dysfunctional parenting was moderated by treatment condition. At follow-up, program variant and completion were the primary outcome predictors, with completion found to be related to initial parenting confidence, internet usage and program variant. The implications of these findings for reaching and retaining parents in online programs across all phases of the engagement process are discussed.
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Affiliation(s)
- Jamin J Day
- The University of Queensland, Australia; The University of Newcastle, Australia.
| | - Sabine Baker
- The University of Queensland, Australia; Queensland University of Technology, Australia
| | - Cassandra K Dittman
- The University of Queensland, Australia; Central Queensland University, Australia
| | | | | | - Susan Love
- California State University, Northridge, USA
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26
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Cardoso SG, Paixão Argollo B, Nascimento Martinelli Braga AA, Barroso U. Urgency in children with overactive bladder or voiding postponement: What's the difference? J Pediatr Urol 2021; 17:448.e1-448.e8. [PMID: 33839033 DOI: 10.1016/j.jpurol.2021.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 02/02/2021] [Accepted: 03/06/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Overactive bladder (OAB) and voiding postponement (VP) can share the same symptom of urgency, but with different pathophysiology, including the cerebral interpretation of bladder filling. The objective of the present study was to compare the clinical, psychological and sociodemographic features of children with urgency for OAB with those who presented urgency for VP (UrVP). METHODS A retrospective cross-sectional study with an analytical component was conducted with patients of 5-14 years of age with urinary urgency between January, 2014, and January, 2019. Urinary symptoms were evaluated using the Dysfunctional Voiding Scoring System (DVSS) questionnaire, constipation using the Rome IV criteria and psychological symptoms using the Strengths and Difficulties Questionnaire (SDQ). All the patients had bell-shaped or tower-shaped curves at uroflowmetry and no significant post-void residual volume at ultrasonography. Patients were classified as having OAB or UrVP depending on whether they voided >3 or ≤3 times/day, respectively. RESULTS Median age of the 101 children/adolescents included was 9 years, with no significant difference between the groups. The prevalence of OAB was 60.4%. Girls constituted 57.4% of the sample but 67.5% of the postponement group, although no independent association was found between sex and diagnosis. The prevalence of constipation was 75.2%, with no difference between the groups. The children with OAB had higher behavioral hyperactivity scores and more intense externalizing symptoms, although there was no significant difference between the groups for the SDQ total difficulties score. In the multivariate analysis, the independent clinical factors associated with a diagnosis of OAB were behavioral hyperactivity (OR = 5.134), urge incontinence (OR = 4.694) and MVV/EBC (%) (OR = 0.983). CONCLUSION More behavioral problems, particularly hyperactivity, were found in children with OAB compared to those with UrVP. No statistically significant difference was found between the groups evaluated insofar as their sociodemographic characteristics are concerned. Furthermore, as expected, there was a strong association between the symptom of urge incontinence and lower MVV/EBC in the children and adolescents with OAB compared to those with voiding postponement.
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Affiliation(s)
- Samuel Gomes Cardoso
- Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil.
| | - Beatriz Paixão Argollo
- Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil.
| | | | - Ubirajara Barroso
- Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil.
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Abstract
Recent decades have seen increases in the variability of family income, tepid income growth rates for all but the richest families, and widening income inequality. These trends are concerning for child well-being, given the importance of income to parental investments and parenting practices. Growing evidence suggests that a high level of change is disruptive to family processes and that chronic stress affects physiology as well as psychology. This study used the Panel Study of Income Dynamics Child Development Supplement to estimate associations between three dimensions of childhood income dynamics-level, variability, and trend-and child achievement and behavior. After income level was controlled for, income variability during childhood was not associated with child achievement or behavior, but an increasing five-year trend in income-to-needs was modestly beneficial to behavior measures. Subgroup analysis suggests some adverse effects of income variability and trend on reading and behavior for non-White children but no clear patterns by child's age or family income or wealth levels.
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Affiliation(s)
- Heather D Hill
- Daniel J. Evans School of Public Policy & Governance, University of Washington, Seattle, WA, USA
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28
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Stormshak EA, DeGarmo D, Garbacz SA, McIntyre LL, Caruthers A. Using Motivational Interviewing to Improve Parenting Skills and Prevent Problem Behavior During the Transition to Kindergarten. Prev Sci 2021; 22:747-757. [PMID: 32036553 PMCID: PMC8318938 DOI: 10.1007/s11121-020-01102-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
In this study, we examined the efficacy of a version of the Family Check-Up (FCU) adapted for kindergarten school entry with regard to parenting skills during the transition to school. We also examined whether improvements in parenting skills would mediate improvements in parent- and teacher-rated child behavior problems from kindergarten to second grade. The FCU is a motivational interviewing (MI) intervention designed to engage parents in treatment to improve parenting skills. Participants were parents of 365 children enrolled in one of five elementary schools in the Pacific Northwestern United States. Main and indirect effects were tested with structural equation path modeling using an intent-to-treat approach. The FCU was associated with improved change in parenting skills, and changes in parenting skills, in turn, predicted reductions in child behavior problems. Implications for embedding MI in family-centered interventions at kindergarten school entry are discussed. Trial registration: NCT02289092.
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Affiliation(s)
| | - David DeGarmo
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
| | | | - Laura Lee McIntyre
- College of Education, University of Oregon, 5251, Eugene, OR, 97403, USA
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Hasegawa C, Takahashi T, Ikeda T, Yoshimura Y, Hiraishi H, Nobukawa S, Saito DN, Kumazaki H, Yaoi K, Hirata M, Asada M, Kikuchi M. Effects of familiarity on child brain networks when listening to a storybook reading: A magneto-encephalographic study. Neuroimage 2021; 241:118389. [PMID: 34265420 DOI: 10.1016/j.neuroimage.2021.118389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/23/2021] [Accepted: 07/10/2021] [Indexed: 10/20/2022] Open
Abstract
Parent-child book reading is important for fostering the development of various lifelong cognitive and social abilities in young children. Despite numerous reports describing the effects of familiarity on shared reading for children, the exact neural basis of the functional network architecture remains unclear. We conducted Magnet-Encephalographic (MEG) experiments using graph theory to elucidate the role of familiarity in shared reading in a child's brain network and to measure the connectivity dynamics of a child while Listening to Storybook Reading (LSBR), which represents the daily activity of shared book reading between the child and caregiver. The LSBR task was performed with normally developing preschool- and school-age children (N = 15) under two conditions: reading by their own mother (familiar condition) vs. an experimenter (unfamiliar condition). We used the phase lag index (PLI), which captures synchronization of MEG signals, to estimate functional connectivity. For the whole brain network topology, an undirected weighted graph was produced using 68 brain regions as nodes and interregional PLI values as edges for five frequency bands. Behavioral data (i.e., the degree of attention and facial expressions) were evaluated from video images of the child's face during the two conditions. Our results showed enhanced widespread functional connectivity in the alpha band during the mother condition. In the mother condition, the whole brain network in the alpha band exhibited topographically high local segregation with high global integration, indicating an increased small-world property. Results of the behavioral analysis revealed that children were more attentive and showed more positive facial expressions in the mother condition than in the experimenter condition. Behavioral data were significantly correlated with graph metrics in the mother condition but not in the experimenter condition. In this study, we identified the neural correlates of a familiarity effect in children's brain connectivity dynamics during LSBR. Furthermore, these familiarity-related brain dynamics were closely linked to the child's behavior. Graph theory applied to MEG data may provide useful insight into the familiarity-related child brain response in a naturalistic setting and its relevance to child attitudes.
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Affiliation(s)
- Chiaki Hasegawa
- Research Center for Child Mental Development, Kanazawa University, Kanazawa 920-8640, Japan; JSPS Oversea Research Fellow RRA, Visiting Fellow, Department of Cognitive Science, Macquarie University, Tokyo 102-0083, Japan.
| | - Tetsuya Takahashi
- Research Center for Child Mental Development, Kanazawa University, Kanazawa 920-8640, Japan; Uozu Shinkei Sanatorium, Uozu 937-0017, Japan; Department of Neuropsychiatry, University of Fukui, Fukui 910-1193, Japan.
| | - Takashi Ikeda
- Research Center for Child Mental Development, Kanazawa University, Kanazawa 920-8640, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka/Kanazawa/Hamamatsu/Chiba/Fukui, Japan.
| | - Yuko Yoshimura
- Research Center for Child Mental Development, Kanazawa University, Kanazawa 920-8640, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka/Kanazawa/Hamamatsu/Chiba/Fukui, Japan; Institute of Human and Social Sciences, Kanazawa University, Kanazawa 921-1192, Japan.
| | - Hirotoshi Hiraishi
- Department of Biofunctional Imaging, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan.
| | - Sou Nobukawa
- Department of Computer Science, Chiba Institute of Technology, Narashino 275-0016, Japan.
| | - Daisuke N Saito
- Research Center for Child Mental Development, Kanazawa University, Kanazawa 920-8640, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka/Kanazawa/Hamamatsu/Chiba/Fukui, Japan; Department of Psychology, Faculty of Psychology, Yasuda Woman's University, Hiroshima 731-0153, Japan.
| | - Hirokazu Kumazaki
- National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553, Japan.
| | - Ken Yaoi
- Research Center for Child Mental Development, Kanazawa University, Kanazawa 920-8640, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka/Kanazawa/Hamamatsu/Chiba/Fukui, Japan.
| | - Masayuki Hirata
- Department of Neurological Diagnosis and Restoration, Osaka University Graduate School of Medicine, Suita 565-0871, Japan; Endowed Research Department of Clinical Neuroengineering Global Center for Medical Engineering and Informatics, Osaka University, Suita 565-0871, Japan.
| | - Minoru Asada
- International Professional University of Technology in Osaka, Kita-ku 530-0001, Japan; Symbiotic Intelligent System Research Center, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita 565-0871, Japan.
| | - Mitsuru Kikuchi
- Research Center for Child Mental Development, Kanazawa University, Kanazawa 920-8640, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka/Kanazawa/Hamamatsu/Chiba/Fukui, Japan; Department of Psychiatry and Neurobiology, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8641, Japan.
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Yang S, Charters T, Weinstock D, Nandi A. Impacts of universal childcare on early behavioral development: evidence from a birth cohort in Québec, Canada. Ann Epidemiol 2021; 62:92-9. [PMID: 34146708 DOI: 10.1016/j.annepidem.2021.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 05/28/2021] [Accepted: 06/06/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE To examine associations between universal pre-school childcare use and later behaviors among children at age 6 years. METHODS Using annual follow-up data of a birth cohort (N=1450), we estimated differences in behavioral scores by primary childcare arrangement between ages 2-5 years - universal subsidized childcare program (CPE care), non-CPE childcare, and parental or family care (no regular care) - using propensity score inverse probability weights. RESULTS Teachers reported slightly higher levels of hyperactivity (0.73, 95% CI: 0.32, 1.1) and indirect aggression (0.58, 95%CI: 0.24, 0.91) among children who attended a CPE than children in non-CPE care. However, these patterns were not observed from either maternal or paternal reports. Similarly, teachers' assessments of slightly higher physical aggression (0.50, 95% CI: 0.11, 0.88) and opposition (0.63, 95% CI: 0.21, 1.05) scores among children in CPE care than children who did not have a regular childcare were not observed in parental assessments. Behavioral scores by childcare arrangement were similar between girls and boys and across family socioeconomic position. CONCLUSIONS Universal pre-school childcare does not appear to have substantial impacts on child behaviors at early school age, however teachers rated externalizing behaviors to be slightly higher among children who attended universal childcare.
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Frndak S, Gallo Y, Queirolo EI, Barg G, Mañay N, Kordas K. A mixed methods study examining neighborhood disadvantage and childhood behavior problems in Montevideo, Uruguay. Int J Hyg Environ Health 2021; 235:113753. [PMID: 33915423 PMCID: PMC10916338 DOI: 10.1016/j.ijheh.2021.113753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 03/13/2021] [Accepted: 04/12/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Neighborhood disadvantage (ND) is a risk factor for child behavior problems (CBPs), but is understudied outside the United States and Europe. Our mixed methods study aims to (1) create a culturally meaningful measure of ND, (2) test cross-sectional associations between ND and CBPs and (3) qualitatively explore life in the neighborhoods of families participating in the Salud Ambiental Montevideo (SAM) study. METHODS The quantitative study (Study 1) comprised 272, ~7-year-old children with geolocation and complete data on twelve behavioral outcomes (Conner's Teachers Rating Scale - Revised Short Form: CTRS-R:S and Behavioral Rating Inventory of Executive Functioning: BRIEF). A ND factor was created at the census segment level (1,055 segments) with 19 potential indicators of ND downloaded from the Municipality of Montevideo Geographic Services. Children were assigned ND scores based on the location of their household within a census segment. Multilevel models tested associations between ND and all CBP scales, controlling for confounders at the individual level. The qualitative study (Study 2) comprised 10 SAM caregivers. Photovoice alongside semi-structured interviews in Spanish were used to foster conversations about neighborhood quality, activities, and raising children. Thematic analysis with inductive coding was used to summarize qualitative study findings. RESULTS The ND factor consisted of 12 census-based indicators related to education, employment, ethnicity, housing quality, and age characteristics, but unrelated to home ownership and some ethnicity variables. In multivariable models, ND was associated with greater conduct problems (β = 1.37, p < .05), poor shifting (β = 1.56, p < .01) and emotional control problems (β = 2.36, p < .001). Photovoice and semi-structured interviews yielded four themes: physical disorder, recreation, safety and crime, and community resources. Residents discussed improving waste management and transportation, updating playgrounds, and ensuring neighborhood safety. CONCLUSIONS ND in Montevideo comprised a unique set of census indicators. ND was primarily related to behavioral regulation problems. Hypothesized pathways whereby ND affects CBPs are discussed.
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Affiliation(s)
- Seth Frndak
- Department of Epidemiology and Environmental Health: University at Buffalo, The State University of New York, United States.
| | - Yanina Gallo
- Department of Neurocognition, Catholic University of Uruguay, Montevideo, Uruguay
| | - Elena I Queirolo
- Department of Neurocognition, Catholic University of Uruguay, Montevideo, Uruguay
| | - Gabriel Barg
- Department of Neurocognition, Catholic University of Uruguay, Montevideo, Uruguay
| | - Nelly Mañay
- Faculty of Chemistry, University of the Republic of Uruguay (UDELAR), Montevideo, Uruguay
| | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health: University at Buffalo, The State University of New York, United States
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Phu T, Miles E, Dominguez A, Hustedt J, Watamura SE. Characterizing Family Contextual Factors and Relationships with Child Behavior and Sleep Across the Buffering Toxic Stress Consortium. Prev Sci 2021:10.1007/s11121-021-01243-6. [PMID: 34036462 DOI: 10.1007/s11121-021-01243-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2021] [Indexed: 10/21/2022]
Abstract
The Buffering Toxic Stress (BTS) consortium included six sites in locations that varied widely in racial/ethnic composition and population density. Each site tested a promising parent-child intervention designed to supplement Early Head Start (EHS) services and prevent "toxic stress." To better understand family risk in a large and diverse EHS sample, studies gathered extensive data on family risk exposure, including demographic risk factors (single mother, unemployed, less than high school education or its equivalent, and neighborhood safety), income-to-needs ratio, household resource constraints, perceptions of economic hardship and pressure, caregiver mental health, and caregiver-reported dysfunctional parent-child interactions. Results presented here for all six sites offer context for the more targeted studies in this special issue. Average levels of family characteristics and child behavior varied by site. We also characterized associations between family characteristics, observer-rated child temperament, and child outcomes (i.e., caregiver-reported child behavior problems and behavioral sleep quality), controlling for child age; these relationships were similar across sites. Demographic risk and caregiver mental health problems were positively associated with child behavior problems, with low income-to-needs ratio and increased financial strain relating to behavioral problems in infancy and toddlerhood. Caregiver mental health problems, financial strain, and social and affect temperament dimensions were related to increased behavioral sleep problems. Dysfunctional parent-child interactions and household resource constraints did not demonstrate statistically significant associations. Findings suggest helpful targets to increase effectiveness of parent-child interventions in early childhood on behavior and sleep outcomes.
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Affiliation(s)
- Tiffany Phu
- Department of Psychology, University of Denver, Denver, CO, USA
| | - Elly Miles
- Department of Psychology, University of Denver, Denver, CO, USA
| | - Amy Dominguez
- Department of Psychology, University of Denver, Denver, CO, USA
| | - Jason Hustedt
- Department of Human Development and Family Sciences, University of Delaware, Newark, DE, USA
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da Silva GS, Anabuki AA, Viana KA, Corrêa-Faria P, Moterane MM, Tedesco TK, Costa PS, Hosey MT, Raggio DP, Costa LR. Sedation versus protective stabilization for dental treatment of children with caries and challenging behavior at the dentist (CHOOSE): a study protocol for a non-randomized clinical trial. BMC Oral Health 2021; 21:256. [PMID: 33980232 PMCID: PMC8115863 DOI: 10.1186/s12903-021-01594-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a lack of evidence on the effectiveness of moderate sedation in pediatric dentistry, compared to protective stabilization, which remains routinely used in Brazil despite moral questions. This prospective non-randomized clinical trial's objective is to evaluate the effectiveness of moderate sedation, compared to the protective stabilization, in the dental care of children with dental behavior management problems. METHODS Participants will be 152 children under seven years of age with early childhood caries (ECC) who need specialized dental treatment due to a history of challenging behavior during dental care. The interventions to be compared are moderate sedation with oral administration of ketamine and midazolam and protective stabilization. The primary endpoint will be the child's behavior during treatment assessed using the Ohio State University Behavioral Rating Scale (OSUBRS). The secondary outcomes are (A) child's - behavior according to the visual analogue scale, anxiety, pain, and physiological stress; (B) parent's - satisfaction and anxiety; (C) family and child - impact on oral health-related quality of life (OHRQoL); (D) dentist's - satisfaction and stress; (E) procedure - adverse events of the intervention and dental treatment longevity. A cost-effectiveness analysis will be performed from the perspective of the Brazilian Unified Health System (SUS). DISCUSSION Considering the primary outcome, this study hypothesis is that sedated children have better behavior during dental treatment than children whose behavior was managed by protective stabilization without sedation. Additionally, at the end of 12 months, we expect to identify participants' reported outcomes and objective measures related to dental behavior in early childhood. Trial registration Clinicaltrials.gov registration NCT04119180 on October 8th, 2019. https://clinicaltrials.gov/ct2/show/NCT04119180.
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Affiliation(s)
- Gabriela Seabra da Silva
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Anna Alice Anabuki
- Dentistry Graduate Program, Universidade Federal de Goias, Goiânia, GO, Brazil
| | | | | | | | | | | | - Marie Therese Hosey
- Pediatric Dentistry, Centre for Oral Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Daniela Prócida Raggio
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Luciane Rezende Costa
- Faculty of Dentistry, Universidade Federal de Goias, Primeira Avenida, s/n, Goiânia, GO, CEP 74605-220, Brazil.
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Maslowski A, Abbas H, Abrams K, Taraman S, Garberson F, Segar S. Project Rosetta: a childhood social, emotional, and behavioral developmental feature mapping. J Biomed Semantics 2021; 12:8. [PMID: 33858495 PMCID: PMC8051063 DOI: 10.1186/s13326-021-00242-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 03/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A wide array of existing instruments are commonly used to assess childhood behavior and development for the evaluation of social, emotional and behavioral disorders such as Autism Spectrum Disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and anxiety. Many of these instruments either focus on one diagnostic category or encompass a broad set of childhood behaviors. We analyze a wide range of standardized behavioral instruments and identify a comprehensive, structured semantic hierarchical grouping of child behavioral observational features. We use the hierarchy to create Rosetta: a new set of behavioral assessment questions, designed to be minimal yet comprehensive in its coverage of clinically relevant behaviors. We maintain a full mapping from every functional feature in every covered instrument to a corresponding question in Rosetta. RESULTS In all, 209 Rosetta questions are shown to cover all the behavioral concepts targeted in the eight existing standardized instruments. CONCLUSION The resulting hierarchy can be used to create more concise instruments across various ages and conditions, as well as create more robust overlapping datasets for both clinical and research use.
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Pouliquen A, Boyer E, Sixou JL, Fong SB, Marie-Cousin A, Meuric V. Oral sedation in dentistry: evaluation of professional practice of oral hydroxyzine in the University Hospital of Rennes, France. Eur Arch Paediatr Dent 2021; 22:801-811. [PMID: 33840073 DOI: 10.1007/s40368-021-00620-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 03/29/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Management of a child's anxiety early in their treatment is essential in dentistry. Sedative medications are used to overcome increased anxiety from previous appointments and to promote the cooperation of children during treatment. Hydroxyzine is currently prescribed to young patients as part of the first level of conscious sedation. The main objective was to evaluate the professional practice of oral hydroxyzine, when prescribed for children presenting anxiety during dental treatment procedure performed by students and senior practitioners. METHODS A retrospective study of dental records and questionnaires was conducted at the Dental Care Centre of the University Hospital of Rennes, France. Parameters related to the prescription of hydroxyzine in children were evaluated as potential predictors of the dental session success, with adjustments on potential confounders. RESULTS The therapeutic outcome was very encouraging with 78.3% of success during dental sessions under sedation with oral hydroxyzine. Anxiety levels before the dental procedure and the medication compliance of the child were the main predictors of success. On the other hand, lower age (< 6 years old) and longer treatments (such as pulpotomy) worsened the outcome. CONCLUSIONS Careful analysis of the literature and results of this work showed the safety of hydroxyzine within the maximum dose authorized without adverse effects, compared to other molecules described and commonly used in dentistry. No adverse effects during dental procedure were noted. This allows for minimal sedation with efficiency for the great majority of pediatric treatment. This solution should be the first step in sedation to help practicing clinicians.
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Affiliation(s)
- A Pouliquen
- Paediatric Dentistry Department, Univ Rennes 1, CHU de Rennes, Rennes, France
| | - E Boyer
- Paediatric Dentistry Department, Univ Rennes 1, CHU de Rennes, Rennes, France. .,INSERM, INRAE, Univ Rennes 1, CHU de Rennes, Nutrition Metabolisms and Cancer, Rennes, France.
| | - J-L Sixou
- Paediatric Dentistry Department, Univ Rennes 1, CHU de Rennes, Rennes, France
| | - S B Fong
- University of Rennes 1, Rennes, France
| | - A Marie-Cousin
- Paediatric Dentistry Department, Univ Rennes 1, CHU de Rennes, Rennes, France
| | - V Meuric
- Paediatric Dentistry Department, Univ Rennes 1, CHU de Rennes, Rennes, France.,INSERM, INRAE, Univ Rennes 1, CHU de Rennes, Nutrition Metabolisms and Cancer, Rennes, France
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Baakdah RA, Turkistani JM, Al-Qarni AM, Al-Abdali AN, Alharbi HA, Bafaqih JA, Alshehri ZS. Pediatric dental treatments with pharmacological and non-pharmacological interventions: a cross-sectional study. BMC Oral Health 2021; 21:186. [PMID: 33845835 PMCID: PMC8040197 DOI: 10.1186/s12903-021-01555-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/24/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives Behaviour management strategies involving pharmacological or non-pharmacological interventions during dental procedures should be considered to attain safe and successful treatment outcomes. This study compared the frequencies of use and the completeness of treatment with these interventions. Methods A total of 1725 dental records of patients up to 18 years old, who were treated in the King Abdulaziz Medical City in Jeddah City from October 2018 to June 2019, were used in this retrospective, cross-sectional study. Inferential analysis, Chi-square test, Kruskal–Wallis test, and regression model were used in the data analysis. Results About two-thirds of the patients were treated with attendant non-pharmacological interventions, while one-third, with pharmacological interventions. The application of General Anesthesia (GA) was the most frequently used intervention. Restorative procedures and extractions were done in higher frequencies with pharmacological interventions. Treatments with space maintainers and orthodontic appliances were carried out in higher frequencies with non-pharmacological strategies. The choice of intervention was significantly influenced by the systemic conditions of the patients. Patients treated with non-pharmacological intervention comprised the dominant type of patients, because they required treatments with less pain. Those treated with GA needed restorative treatments and extractions, or treatments that involve pain, but these treatments had higher frequencies of being completed. Conclusions The treatments with pharmacological intervention through GA have higher frequencies of being completed, compared to those with non-pharmacological interventions. Factors, such as age, potential to complete the treatment, and the type of dental treatment applied, influence the choice of treatment intervention.
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Affiliation(s)
- Rania A Baakdah
- King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Jihan M Turkistani
- King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Saudi Arabia.
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Rasnick E, Ryan PH, Bailer AJ, Fisher T, Parsons PJ, Yolton K, Newman NC, Lanphear BP, Brokamp C. Identifying sensitive windows of airborne lead exposure associated with behavioral outcomes at age 12. Environ Epidemiol 2021; 5:e144. [PMID: 33870016 PMCID: PMC8043737 DOI: 10.1097/ee9.0000000000000144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 02/12/2021] [Indexed: 11/25/2022] Open
Abstract
Despite the precipitous decline of airborne lead concentrations following the removal of lead in gasoline, lead is still detectable in ambient air in most urban areas. Few studies, however, have examined the health effects of contemporary airborne lead concentrations in children. METHODS We estimated monthly air lead exposure among 263 children (Cincinnati Childhood Allergy and Air Pollution Study; Cincinnati, OH; 2001-2005) using temporally scaled predictions from a validated land use model and assessed neurobehavioral outcomes at age 12 years using the parent-completed Behavioral Assessment System for Children, 2nd edition. We used distributed lag models to estimate the effect of airborne lead exposure on behavioral outcomes while adjusting for potential confounding by maternal education, community-level deprivation, blood lead concentrations, greenspace, and traffic related air pollution. RESULTS We identified sensitive windows during mid- and late childhood for increased anxiety and atypicality scores, whereas sensitive windows for increased aggression and attention problems were identified immediately following birth. The strongest effect was at age 12, where a 1 ng/m3 increase in airborne lead exposure was associated with a 3.1-point (95% confidence interval: 0.4, 5.7) increase in anxiety scores. No sensitive windows were identified for depression, somatization, conduct problems, hyperactivity, or withdrawal behaviors. CONCLUSIONS We observed associations between exposure to airborne lead concentrations and poor behavioral outcomes at concentrations 10 times lower than the National Ambient Air Quality Standards set by the US Environmental Protection Agency.
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Affiliation(s)
- Erika Rasnick
- Department of Statistics, Miami University, Oxford
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center
| | - Patrick H. Ryan
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio
| | | | | | - Patrick J. Parsons
- Division of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Albany
- Department of Environmental Health Sciences, School of Public Health, University at Albany, Rensselaer, New York
| | - Kimberly Yolton
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center
| | - Nicholas C. Newman
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio
- Division of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Albany
- Department of Environmental and Public Health Sciences, University of Cincinnati, Cincinnati, Ohio
| | - Bruce P. Lanphear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Cole Brokamp
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio
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Janeshin A, Habibi M. The relationship between temperament and behavior in 3-7-year-old children during dental treatment. Dent Res J (Isfahan) 2021; 18:12. [PMID: 34104359 PMCID: PMC8174457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 01/26/2020] [Accepted: 09/19/2020] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Various factors affect child behavior in different situations such as in a dental clinic. The purpose of this study was to investigate the relationship between temperament and child behavior during routine dental treatment. MATERIALS AND METHODS The present study is a descriptive-analytic study that included 199 children aged 3-7-years from patients referred to a dental clinic of Guilan University of Medical Sciences in 2017-2018. The Children's Behavior Questionnaire, which is specific to children aged 3-7 years, was used to assess children's dental temperament. Children's behaviors during dental treatment were recorded using Frankl scale. Finally, the data were analyzed by the SPSS-16 statistical software. RESULTS About 47.9% of the samples were female, with a mean temperament score of 4.79 which was significantly higher than males (P < 0.05). Almost 2.4% of children had completely negative behaviors and 2.8% had a completely positive behavior. The mean scores of fear (P = 0.008) and anger (P = 0.004) in children with completely negative behavior were higher than those with completely positive behavior. Moreover, the average scores of inhibitory control (P = 0.003) and perceptual sensitivity (P = 0.001) in completely positive children were higher than completely negative children. CONCLUSION The results of the present study showed that girls had a better mean score of temperament than boys. The inhibitory control and perceptual sensitivity in completely positive children were significantly higher than negative children. In addition, a higher mean score of fear and anger was observed in completely negative children.
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Affiliation(s)
- Atousa Janeshin
- Dental Sciences Research Center, Department of Pediatric Dentistry, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran,Address for correspondence: Dr. Atousa Janeshin, Dental Sciences Research Center, Department of Pediatric Dentistry, School of Dentistry, Guilan University of Medical Sciences, Rasht Iran. E-mail:
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Day DB, Collett BR, Barrett ES, Bush NR, Swan SH, Nguyen RHN, Szpiro AA, Sathyanarayana S. Phthalate mixtures in pregnancy, autistic traits, and adverse childhood behavioral outcomes. Environ Int 2021; 147:106330. [PMID: 33418196 PMCID: PMC9291724 DOI: 10.1016/j.envint.2020.106330] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/28/2020] [Accepted: 12/07/2020] [Indexed: 05/22/2023]
Abstract
BACKGROUND Prenatal exposure to multiple phthalates is ubiquitous, and yet few studies have evaluated these exposures as a mixture in relation to child autistic traits and behavioral problems. OBJECTIVES To assess cumulative associations between prenatal phthalate mixtures and child behaviors, including effect modification by exposure timing and child sex. METHODS Analyses included 501 mother/child pairs from the multicenter pregnancy cohort The Infant Development and Environment Study (TIDES). Nine maternal urinary phthalate metabolites were measured in early and late pregnancy, and behavior was assessed at ages 4-5 years using composite T scores for the Behavioral Assessment System for Children (BASC-2), which measures several dimensions of child behavior, and the Social Responsiveness Scale (SRS-2), which measures social impairment consistent with autistic traits. We utilized weighted quantile sum (WQS) regressions to examine pregnancy period-specific associations between phthalate mixtures and behavioral outcomes. Full-sample 95% WQS confidence intervals are known to be anti-conservative, so we calculated a confirmatory p-value using a permutation test. Effect modification by sex was examined with stratified analyses. RESULTS A one-quintile increase in the early pregnancy phthalate mixture was associated with increased SRS-2 total score (coefficient = 1.0, confirmatory p = 0.01) and worse adaptive skills (coefficient = -1.0, confirmatory p = 0.06) in both sexes. In sex-stratified analyses, the early pregnancy phthalate mixture was associated with increased SRS-2 total score in boys (coefficient = 1.2, confirmatory p = 0.04) and girls (coefficient = 1.0, confirmatory p = 0.10) and worse BASC-2 adaptive skills score in girls (coefficient = -1.5, confirmatory p = 0.06), while the late pregnancy phthalate mixture was associated with increased BASC-2 externalizing score in boys (coefficient = 1.3, confirmatory p = 0.03). CONCLUSION Our results suggest cumulative adverse associations between prenatal phthalate mixtures and multiple facets of childhood behavior.
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Affiliation(s)
- Drew B Day
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA 98101, USA.
| | - Brent R Collett
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA 98101, USA; Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USA.
| | - Emily S Barrett
- Department of Epidemiology, Environmental and Occupational Health Sciences Institute, Rutgers School of Public Health, 170 Frelinghuysen Road, Piscataway, NJ 08854, USA.
| | - Nicole R Bush
- Center for Health and Community, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, Department of Pediatrics, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, USA.
| | - Shanna H Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 17 E. 102nd Street, CAM Building, 3 West, One Gustave L. Levy Place, New York, NY 10029, USA.
| | - Ruby H N Nguyen
- Department of Epidemiology and Community Health, University of Minnesota, 420 Delaware Street Southeast, Minneapolis, MN 55455, USA.
| | - Adam A Szpiro
- Department of Biostatistics, University of Washington, 1705 Northeast Pacific Street, Seattle, WA 98195, USA.
| | - Sheela Sathyanarayana
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA 98101, USA; Department of Pediatrics, University of Washington, 1959 Northeast Pacific Street, Seattle, WA 98195, USA.
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Gissandaner TD, Schmidt AT, Mastergeorge A, Gette JA, Littlefield AK. Does Stress Mediate the Relation between Caregivers' Victimization and Child Behavioral Outcomes? A Prospective Examination. Child Psychiatry Hum Dev 2021; 52:154-65. [PMID: 32372376 DOI: 10.1007/s10578-020-01000-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Children with internalizing and externalizing difficulties are at risk for long-term negative effects in adulthood and are impacted by several caregiver factors. Findings of the present study are consistent with previous studies that found direct associations between caregiver victimization history (e.g., physical and sexual abuse) and child behavior problems. Examination of potential mechanisms revealed that caregiver everyday stress related to relationships/responsibilities (RR) served as a mediator between caregiver victimization history and increased children's internalizing symptoms. Though there may be other pathways that contribute to this relation, there does seem to be clinical and policy utility of this knowledge, particularly for at-risk families that are faced with high levels of everyday RR stress. Attenuation of this impact may be accomplished through connection to community resources such as access to family counseling to mitigate relational stress and policy addressing disparities.
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Mitchell EJ, Frisbie SH, Roudeau S, Carmona A, Ortega R. Estimating daily intakes of manganese due to breast milk, infant formulas, or young child nutritional beverages in the United States and France: Comparison to sufficiency and toxicity thresholds. J Trace Elem Med Biol 2020; 62:126607. [PMID: 32683229 DOI: 10.1016/j.jtemb.2020.126607] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/16/2020] [Accepted: 06/30/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Although manganese (Mn) is an essential nutrient, recent research has revealed that excess Mn in early childhood may have adverse effects on neurodevelopment. METHODS We estimated daily total Mn intake due to breast milk at average body weights by reviewing reported concentrations of breast milk Mn and measurements of body weight and breast milk intake at 3 weeks, 4.25 months, 7 months, and 18 months. We compared these figures to the Mn content measured in 44 infant, follow-up, and toddler formulas purchased in the United States and France. We calculated Mn content of formula products made with ultra-trace elemental analysis grade water (0 μg Mn/L) and with water containing 250 μg Mn/L, a concentration which is relatively high but less than the World Health Organization Health-based value of 400 μg Mn/L or the United States Environmental Protection Agency Health Advisory of 350 μg Mn/L. RESULTS Estimated mean daily Mn intake from breast milk ranged from 1.2 μg Mn/kg/day (3 weeks) to 0.16 μg Mn/kg/day (18 months), with the highest intakes at the youngest age stage we considered, 3 weeks. Estimated daily Mn intake from formula products reconstituted with 0 μg Mn/L water ranged from 130 μg Mn/kg/day (3 weeks) to 4.8 μg Mn/kg/day (18 months) with the highest intakes at 3 weeks. Formula products provided 28-520 times greater than the mean daily intake of Mn from breast milk for the 4 age stages that we considered. Estimated daily Mn intake from formula products reconstituted with water containing 250 μg Mn/L ranged from 12 μg Mn/kg/day to 170 μg Mn/kg/day, which exceeds the United States Environmental Protection Agency Reference Dose of 140 μg Mn/kg/day for adults. CONCLUSIONS Mn deficiency is highly unlikely with exclusive breast milk or infant formula feeding, but established tolerable daily intake levels for Mn may be surpassed by some of these products when following labeled instructions.
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Affiliation(s)
- Erika J Mitchell
- Better Life Laboratories, Inc., 293 George Road, East Calais, VT, USA.
| | - Seth H Frisbie
- Department of Chemistry and Biochemistry, Norwich University, Northfield, VT, USA.
| | - Stéphane Roudeau
- University of Bordeaux, Centre d'Etudes Nucléaires de Bordeaux Gradignan (CENBG), UMR 5797, F-33170 Gradignan, France; Centre National de la Recherche Scientifique (CNRS), CENBG, UMR 5797, F-33170 Gradignan, France.
| | - Asuncion Carmona
- University of Bordeaux, Centre d'Etudes Nucléaires de Bordeaux Gradignan (CENBG), UMR 5797, F-33170 Gradignan, France; Centre National de la Recherche Scientifique (CNRS), CENBG, UMR 5797, F-33170 Gradignan, France.
| | - Richard Ortega
- University of Bordeaux, Centre d'Etudes Nucléaires de Bordeaux Gradignan (CENBG), UMR 5797, F-33170 Gradignan, France; Centre National de la Recherche Scientifique (CNRS), CENBG, UMR 5797, F-33170 Gradignan, France.
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Sobral da Silva PF, Eickmann SH, Arraes de Alencar Ximenes R, Ramos Montarroyos U, de Carvalho Lima M, Turchi Martelli CM, Velho Barreto de Araújo T, Brickley EB, Cunha Rodrigues L, Lima da Silva Pastich Gonçalves FC, Costa Gomes Carvalho MD, Vieira de Souza W, de Barros Miranda-Filho D. Pediatric neurodevelopment by prenatal Zika virus exposure: a cross-sectional study of the Microcephaly Epidemic Research Group Cohort. BMC Pediatr 2020; 20:472. [PMID: 33038931 PMCID: PMC7547521 DOI: 10.1186/s12887-020-02331-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 09/07/2020] [Indexed: 01/29/2023] Open
Abstract
Background The implications of congenital Zika Virus (ZIKV) infections for pediatric neurodevelopment and behavior remain inadequately studied. The aim of this study is to investigate patterns of neurodevelopment and behavior in groups of children with differening severities of ZIKV-related microcephaly and children with prenatal ZIKV exposure in the absence of microcephaly. Methods We conducted a cross-sectional study, nested in a cohort, of 274 children (aged 10–45 months) who were born during the peak and decline of the microcephaly epidemic in Northeast Brazil. Participants were evaluated between February 2017 and August 2019 at two tertiary care hospitals in Recife, Pernambuco, Brazil. We analyzed the children in four groups assigned based on clinical and laboratory criteria: Group 1 had severe microcephaly; Group 2 had moderate microcephaly; Group 3 had prenatal ZIKVexposure confirmed by maternal RT-PCR testing but no microcephaly; and Group 4 was a neurotypical control group. Groups were evaluated clinically for neurological abnormalities and compared using the Survey of Wellbeing of Young Children (SWYC), a neurodevelopment and behavior screening instrument validated for use in Brazil. Children with severe delays underwent further evaluation with an adapted version of the SWYC. Results Based on the SWYC screening, we observed differences between the groups for developmental milestones but not behavior. Among the 114 children with severe microcephaly of whom 98.2% presented with neurological abnormalities, 99.1% were ‘at risk of development delay’ according to the SWYC instrument. Among the 20 children with moderate microcephaly of whom 60% presented with neurological abnormalities, 65% were ‘at risk of development delay’. For children without microcephaly, the percentages found to be ‘at risk of developmental delay’ were markedly lower and did not differ by prenatal ZIKV exposure status: Group 3 (N = 94), 13.8%; Group 4 (N = 46), 21.7%. Conclusions Among children with prenatal ZIKV exposure, we found a gradient of risk of development delay according to head circumference. Children with severe microcephaly were at highest risk for delays, while normocephalic ZIKV-exposed children had similar risks to unexposed control children. We propose that ZIKV-exposed children should undergo first-line screening for neurodevelopment and behavior using the SWYC instrument. Early assessment and follow-up will enable at-risk children to be referred to a more comprehensive developmental evaluation and to multidisciplinary care management.
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Schenck-Fontaine A, Panico L. Many Kinds of Poverty: Three Dimensions of Economic Hardship, Their Combinations, and Children's Behavior Problems. Demography 2020; 56:2279-2305. [PMID: 31808103 DOI: 10.1007/s13524-019-00833-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Income poverty, material deprivation, and subjective financial stress are three distinct dimensions of economic hardship. The majority of the theoretical and empirical literature on the effects of economic hardship on children has treated material deprivation and subjective financial stress as only mediators of the effects of income poverty, not considering the independent effects of each dimension or the effects of their combinations. Using nationally representative, longitudinal data from the Millennium Cohort Study on more than 18,000 families in the United Kingdom, we propose seven distinct experiences of economic hardship, based on the possible combinations of income poverty, material deprivation, and subjective financial stress. We use mixed- and fixed-effects linear regression models to identify whether these different economic hardship combinations are differentially associated with children's behavior problems between ages 3 and 7. We find that all economic hardship combinations, including those without income poverty, are associated with higher levels of children's behavior problems. The combination of material deprivation and subjective financial stress and the combination of all three dimensions of economic hardship are associated with the highest levels of behavior problems. Based on these findings, we argue that income poverty is an important but insufficient measure of economic hardship for children and that theory and research on the effects of economic hardship on children should consider the multidimensional nature of economic stressors for families.
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Affiliation(s)
- Anika Schenck-Fontaine
- Leibniz Institute for Educational Trajectories, Wilhelmsplatz 3, 96047, Bamberg, Germany.
| | - Lidia Panico
- Institut National d'Études Démographiques, 133 Boulevard Davout, 75020, Paris, France
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Park YA, Im YJ. The Effects of a Continuous Olfactory Stimulation Using Breast Milk (COSB) on Behavioral State and Physiological Responses in Korean Premature Infants. J Pediatr Nurs 2020; 53:e114-20. [PMID: 32147276 DOI: 10.1016/j.pedn.2020.02.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 02/25/2020] [Accepted: 02/25/2020] [Indexed: 11/23/2022]
Abstract
PURPOSE This study aimed to evaluate the effects of continuous olfactory stimulation with breast milk (COSB) on behavioral and physiologic states of Korean premature infants. DESIGN AND METHODS We examined the COSB effects on the behavioral states and physiological responses, including heart rate and oxygen saturation, in 30 premature infants using a non-equivalent control group pre- and post-test design. Sterile 2 cm × 2 cm gauzes wet with 2 cc breast milk were placed 10 cm away from the infants' nostrils 8 times per day for 3 consecutive days. We obtained five measurements each of the behavioral state, heart rate, and oxygen saturation of the premature infants in the neonatal intensive care unit (NICU). Statistical analysis was conducted using descriptive statistics and two-way repeated-measures ANOVA. RESULTS The experiment group presented significantly reduced heart rate variations (p = .039). There were significant differences in the heart rate at all time-points in the control group (p < .001) but not in the experimental group, indicating more stable (p > .089) heart rates in the latter group. There were positive COSB effects on the behavioral states of premature infants at some time points. CONCLUSIONS COSB can be a useful intervention program for high-risk infants for partial behavioral state stabilization and significant heart rate stabilization. PRACTICE IMPLICATIONS COSB might enable NICU nurses to provide a useful and safe developmental care plan for the premature infants hospitalized in the NICU to improve their physiologic and behavioral condition.
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Oh Y, Choi J, Song YM, Jhung K, Lee YR, Yoo NH, Kim Y. Defining Subtypes in Children with Nail Biting: A Latent Profile Analysis of Personality. Psychiatry Investig 2020; 17:517-525. [PMID: 32450625 PMCID: PMC7324728 DOI: 10.30773/pi.2019.0015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 01/07/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study aimed to examine personality profiles and behavioral problems of children with nail biting (NB) to gain insight into the developmental trajectory of pathological NB. METHODS 681 elementary school students were divided into non NB (n=436), occasional NB (n=173) and frequent NB group (n=72) depending on the frequency of NB reported in Child Behavioral Checklist (CBCL). Children's personality was assessed using the Junior Temperament and Character Inventory (JTCI), and behavioral problems were assessed using the CBCL. Latent Profile Analysis (LPA) was performed using JTCI profiles to classify personalities of the children with NB (belonging to frequent and occasional NB group, n=245). RESULTS For subscale scores of CBCL, the total, internalizing, externalizing, anxious/depressed withdrawn/depressed, depression, thought, rule-breaking, and aggressive behavior problems, were most severe in the frequent NB group followed by occasional NB and non NB group. LPA of personality profile in children with NB revealed four classes ('adaptiveness,' 'high reward dependence,' 'low self-directedness,' and 'maldaptiveness'). The four personality classes demonstrated significant group differences in all of the CBCL subscales. Children who showed low self-directedness and cooperativeness and high novelty seeking and harm avoidance personality profiles demonstrated highest tendency for problematic behavior irrespective of the frequency of NB. CONCLUSION Children with NB reported significantly more problematic behaviors compared to children without NB. Children with specific personality profile demonstrated higher tendency for problematic behavior irrespective of the frequency of NB. Therefore, accompanying personality profiles should be considered when assessing behavioral problems in children with NB.
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Affiliation(s)
- Yunhye Oh
- Department of Child and Adolescent Psychiatry, National Center for Mental Health, Seoul, Republic of Korea.,Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jungwon Choi
- Department of Child and Adolescent Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Yul-Mai Song
- Department of Nursing, Honam University, Gwangju, Republic of Korea
| | - Kyungun Jhung
- Department of Psychiatry, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
| | - Young-Ryeol Lee
- Incorporated Korea Family Association for the Mentally Disabled, Sejong, Republic of Korea
| | - Nam-Hee Yoo
- Department of Child and Adolescent Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Yeni Kim
- Department of Psychiatry, Dongguk University International Hospital, Institute of Clinical Psychopharmacology, Dongguk University School of Medicine, Goyang, Republic of Korea
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Yoo SJ, Joo H, Kim D, Lim MH, Kim E, Ha M, Kwon HJ, Paik KC, Kim KM. Associations between Exposure to Bisphenol A and Behavioral and Cognitive Function in Children with Attention-deficit/Hyperactivity Disorder: A Case-control Study. Clin Psychopharmacol Neurosci 2020; 18:261-269. [PMID: 32329307 PMCID: PMC7242102 DOI: 10.9758/cpn.2020.18.2.261] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/10/2019] [Accepted: 11/11/2019] [Indexed: 12/23/2022]
Abstract
Objective Bisphenol A (BPA) is a widely produced synthetic chemical used to manufacture polycarbonate plastics and epoxy resins. We aimed to investigate the association between exposure to BPA and behavioral and cognitive function in children with attention-deficit/hyperactivity disorder (ADHD) and healthy controls. Methods The study included 444 children aged from 6 to 10 years. The ADHD and control groups included 195 and 249 children, respectively. BPA levels were assessed via urinalysis, while behavior was assessed using the Korean version of the ADHD Rating Scale (K-ARS) and the Behavior Assessment System for Children (BASC-2). Cognitive function was assessed using the Continuous Performance Test (i.e., ADHD Diagnostic System [ADS]). Participants were categorized into tertile groups based on urinary BPA concentration. Results Scores on the K-ARS and the hyperactivity, aggression, anxiety, and depression subscales of the BASC-2 were significantly different among tertile groups for urinary BPA levels. Scores on visual omission error, commission error, response time variability, and auditory commission error of the ADS were significantly different among three BPA groups. Subgroup analysis revealed that these differences of behavior and cognition among three BPA groups were observed in only boys and normal controls. Conclusion Exposure to BPA was associated with unfavorable behavioral and cognitive outcomes. Our study extends the findings of previous studies regarding the association between BPA exposure and behavior/cognitive function by including children with ADHD. Further studies are required to determine the mechanisms underlying sex- and group-based differences in these associations.
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Affiliation(s)
- Seung-Jin Yoo
- Environmental Health Center, Dankook University Medical Center
| | - Hyunjoo Joo
- Department of Preventive Medicine, Dankook University College of Medicine
| | - Dohyun Kim
- Department of Psychiatry, Dankook University Hospital
| | - Myung Ho Lim
- Environmental Health Center, Dankook University Medical Center.,Department of Psychology, College of Public Human Resources, Dankook University
| | - Eunjung Kim
- Environmental Health Center, Dankook University Medical Center
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine
| | - Ho-Jang Kwon
- Environmental Health Center, Dankook University Medical Center.,Department of Preventive Medicine, Dankook University College of Medicine
| | - Ki Chung Paik
- Environmental Health Center, Dankook University Medical Center.,Department of Psychiatry, Dankook University College of Medicine, Cheonan, Korea
| | - Kyoung Min Kim
- Environmental Health Center, Dankook University Medical Center.,Department of Psychiatry, Dankook University College of Medicine, Cheonan, Korea
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Jeong J, Li Z. The Association Between Fathers' Depression and Children's Socioemotional Development: Evidence from a Longitudinal Household Survey in China. Prev Sci 2020; 21:672-80. [PMID: 32266642 DOI: 10.1007/s11121-020-01117-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Depression is highly prevalent among parents around the world. Although there has been substantial research on maternal depression, few studies have additionally considered paternal depression and examined the independent and potentially interactive influence between paternal and maternal depression on children's development. The objectives of this study were to investigate the unique association between paternal depression and children's later socioemotional development, and explore whether this association was moderated by maternal depression. We used data from the 2012 and 2014 waves of the China Family Panel Studies. We used multivariable linear regression models to examine the association between paternal depression, as measured using the Center for Epidemiological Studies-Depression Scale, and children's socioemotional development, as measured using the Positive Behaviors Scale. We also explored whether there was effect modification by maternal depression. The sample comprised of 1615 children (Mage = 7.38 years; 48.5% female) and their parents. Twenty-four percent of fathers and 33% of mothers were depressed. We found that paternal depression was negatively associated with children's socioemotional development (β = - 0.18; 95% CI - 0.31, - 0.03), controlling for maternal depression and other sociodemographic covariates. Moreover, we found that the association was moderated by maternal depression, whereby the negative association was stronger when mothers were not depressed (β = - 0.30; 95% CI - 0.52, - 0.08) versus null when mothers were depressed (β = - 0.02; 95% CI - 0.24, 0.20). Parenting interventions should promote the mental health of fathers, in addition to mothers, as a more holistic and family-based approach for improving both the wellbeing of parents and behavioral development of children.
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Gába A, Pedišić Ž, Štefelová N, Dygrýn J, Hron K, Dumuid D, Tremblay M. Sedentary behavior patterns and adiposity in children: a study based on compositional data analysis. BMC Pediatr 2020; 20:147. [PMID: 32241269 PMCID: PMC7114780 DOI: 10.1186/s12887-020-02036-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 03/13/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Between-person differences in sedentary patterns should be considered to understand the role of sedentary behavior (SB) in the development of childhood obesity. This study took a novel approach based on compositional data analysis to examine associations between SB patterns and adiposity and investigate differences in adiposity associated with time reallocation between time spent in sedentary bouts of different duration and physical activity. METHODS An analysis of cross-sectional data was performed in 425 children aged 7-12 years (58% girls). Waking behaviors were assessed using ActiGraph GT3X accelerometer for seven consecutive days. Multi-frequency bioimpedance measurement was used to determine adiposity. Compositional regression models with robust estimators were used to analyze associations between sedentary patterns and adiposity markers. To examine differences in adiposity associated with time reallocation, we used the compositional isotemporal substitution model. RESULTS Significantly higher fat mass percentage (FM%; βilr1 = 0.18; 95% CI: 0.01, 0.34; p = 0.040) and visceral adipose tissue (VAT; βilr1 = 0.37; 95% CI: 0.03, 0.71; p = 0.034) were associated with time spent in middle sedentary bouts in duration of 10-29 min (relative to remaining behaviors). No significant associations were found for short (< 10 min) and long sedentary bouts (≥30 min). Substituting the time spent in total SB with moderate-to-vigorous physical activity (MVPA) was associated with a decrease in VAT. Substituting 1 h/week of the time spent in middle sedentary bouts with MVPA was associated with 2.9% (95% CI: 1.2, 4.6), 3.4% (95% CI: 1.2, 5.5), and 6.1% (95% CI: 2.9, 9.2) lower FM%, fat mass index, and VAT, respectively. Moreover, substituting 2 h/week of time spent in middle sedentary bouts with short sedentary bouts was associated with 3.5% (95% CI: 0.02, 6.9) lower FM%. CONCLUSIONS Our findings suggest that adiposity status could be improved by increasing MVPA at the expense of time spent in middle sedentary bouts. Some benefits to adiposity may also be expected from replacing middle sedentary bouts with short sedentary bouts, that is, by taking standing or activity breaks more often. These findings may help design more effective interventions to prevent and control childhood obesity.
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Affiliation(s)
- Aleš Gába
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic.
| | - Željko Pedišić
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Nikola Štefelová
- Faculty of Science, Palacký University Olomouc, Olomouc, Czech Republic
| | - Jan Dygrýn
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Karel Hron
- Faculty of Science, Palacký University Olomouc, Olomouc, Czech Republic
| | - Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Mark Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario, Ottawa, Canada
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Day DB, Collett BR, Barrett ES, Bush NR, Swan SH, Wang C, Sathyanarayana S. Prenatal sex hormones and behavioral outcomes in children. Psychoneuroendocrinology 2020; 113:104547. [PMID: 31901731 PMCID: PMC7759302 DOI: 10.1016/j.psyneuen.2019.104547] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/12/2019] [Accepted: 12/12/2019] [Indexed: 01/07/2023]
Abstract
Abnormal sex hormone levels in utero have been associated with child behavioral problems, but it is unclear if normal variation in prenatal sex hormones is associated with subsequent behavior in childhood. We assessed maternal sex hormones, including serum estrone (E1), estradiol (E2), estriol (E3), free testosterone (FT), and total testosterone (TT), during early pregnancy (gestational week 6-21 (mean = 11.1)) and evaluated child behavior at ages 4-5 using the Behavioral Assessment System for Children (BASC-2) and Social Responsiveness Scale (SRS-2) in 404 mother/child pairs (211 girls, 193 boys) within The Infant Development and Environment Study, a multi-site pregnancy cohort study. Associations between hormones and composite scores were evaluated using multiple linear regressions in both sexes combined, and separate models assessed effect modification by sex with the addition of interaction terms. A 10-fold increase in maternal FT or TT was associated in both sexes with a 4.3-point (95 % CI: 0.5, 8.2) or 4.4-point (0.8, 8.0) higher BASC-2 internalizing composite T score, respectively. In addition, a 10-fold increase in FT or TT was associated with a 3.8-point (0.04, 7.5) or 4.0-point (0.5, 7.5) higher behavioral symptoms index composite score. In models evaluating effect modification by sex, a 10-fold increase in E1 was associated with a 4.3-point (1.2, 7.4) decrease in adaptive skills composite score in girls only (interaction p = 0.04). We observed associations between testosterone and internalizing behaviors and behavioral symptoms index in both sexes, as well as a female-specific association between E1 and adaptive skills. Sex hormones during pregnancy may play a key role in influencing later-life behavior, and additional studies should further examine different periods of susceptibility to hormonal signals.
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Affiliation(s)
- Drew B Day
- Seattle Children's Research Institute, Seattle, WA, United States.
| | - Brent R Collett
- Seattle Children’s Research Institute, Seattle, WA,University of Washington, Seattle, WA
| | | | - Nicole R Bush
- University of California, San Francisco, San Francisco, CA
| | - Shanna H Swan
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - Christina Wang
- Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA
| | - Sheela Sathyanarayana
- Seattle Children’s Research Institute, Seattle, WA,University of Washington, Seattle, WA
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Di Benedetto MG, Bottanelli C, Cattaneo A, Pariante CM, Borsini A. Nutritional and immunological factors in breast milk: A role in the intergenerational transmission from maternal psychopathology to child development. Brain Behav Immun 2020; 85:57-68. [PMID: 31129231 DOI: 10.1016/j.bbi.2019.05.032] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 04/15/2019] [Accepted: 05/22/2019] [Indexed: 10/26/2022] Open
Abstract
Perinatal psychopathologies affect more than 25% of women during and after their gestational period. These psychiatric disorders can potentially determine important biological variations in their organisms, affecting many different physiological and metabolic pathways. Of relevance, any of these changes occurring in the mother can alter the normal composition of breast milk, particularly the concentration of nutritional and inflammatory components, which play a role in child brain functioning and development. Indeed, there is evidence showing that changes in milk composition can contribute to cognitive impairments and alterations in mental abilities in children. This review aims to shed light on the unique intergenerational role played by breast milk composition, from maternal psychopathologies to child development.
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Affiliation(s)
- Maria Grazia Di Benedetto
- Section of Stress, Psychiatry and Immunology & Perinatal Psychiatry, King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychological Medicine, London, UK.
| | - Chiara Bottanelli
- Section of Stress, Psychiatry and Immunology & Perinatal Psychiatry, King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychological Medicine, London, UK.
| | - Annamaria Cattaneo
- Section of Stress, Psychiatry and Immunology & Perinatal Psychiatry, King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychological Medicine, London, UK; Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio, Fatebenefratelli, Brescia, Italy.
| | - Carmine Maria Pariante
- Section of Stress, Psychiatry and Immunology & Perinatal Psychiatry, King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychological Medicine, London, UK; Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio, Fatebenefratelli, Brescia, Italy.
| | - Alessandra Borsini
- Section of Stress, Psychiatry and Immunology & Perinatal Psychiatry, King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychological Medicine, London, UK.
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