Background: Psychiatric problems are common in autism spectrum disorders (ASDs), but the reasons are poorly understood. We use a longitudinal population‐representative cohort to examine for the ...first time the persistence of psychiatric problems and to identify risk factors for their occurrence and stability.
Methods: Eighty‐one 16‐year olds (75 male, six female), initially seen at 12 years, were re‐assessed using the parent‐report Strengths and Difficulties Questionnaire (SDQ). Child, family and contextual characteristics from age 12 were tested as risk factors for psychopathology.
Results: Prevalence rates varied depending on whether general population or ASD‐specific SDQ cut‐offs were used. While the former suggested a decrease in psychiatric problems over time, the ASD‐specific cut‐offs showed no significant differences. With the exception of ADHD, the ASD‐specific cut‐offs identified a smaller proportion of individuals as ‘affected’ than did the general population cut‐offs. There was longitudinal domain specificity, with parent correlations ranging from 0.50 to 0.58 and teacher SDQ reports at age 12 correlating 0.33–0.53 with parent reports at 16 years. In examining the role of risk factors, lower IQ and adaptive functioning predicted higher hyperactivity and total difficulties scores. Greater emotional problems at 16 were predicted by poorer maternal mental health, family‐based deprivation and lower social class. Improvement from 12 to 16 years in conduct problems was predicted by greater neighbourhood deprivation and special school attendance.
Conclusions: This is the first longitudinal study of other psychiatric symptoms in ASD. Additional psychiatric problems in ASD are persistent and domain‐specific from childhood to adolescence. The finding that age‐related reduction in SDQ symptoms does not apply when ASD‐specific cut‐offs are used requires further evaluation using diagnostic measures. Only a few of the expected risk factor‐psychopathology predictions expected from general population studies were found, raising the possibility that the causes of psychopathology in ASD differ from those in the general population.
Introduction
Across the globe, children born with perinatal HIV infection (PHIV) are reaching adolescence and young adulthood in large numbers. The majority of research has focused on biomedical ...outcomes yet there is increasing awareness that long‐term survivors with PHIV are at high risk for mental health problems, given genetic, biomedical, familial and environmental risk. This article presents a review of the literature on the mental health functioning of perinatally HIV‐infected (PHIV+) adolescents, corresponding risk and protective factors, treatment modalities and critical needs for future interventions and research.
Methods
An extensive review of online databases was conducted. Articles including: (1) PHIV+ youth; (2) age 10 and older; (3) mental health outcomes; and (4) mental health treatment were reviewed. Of 93 articles identified, 38 met inclusion criteria, the vast majority from the United States and Europe.
Results
These studies suggest that PHIV+ youth experience emotional and behavioural problems, including psychiatric disorders, at higher than expected rates, often exceeding those of the general population and other high‐risk groups. Yet, the specific role of HIV per se remains unclear, as uninfected youth with HIV exposure or those living in HIV‐affected households displayed similar prevalence rates in some studies, higher rates in others and lower rates in still others. Although studies are limited with mixed findings, this review indicates that child‐health status, cognitive function, parental health and mental health, stressful life events and neighbourhood disorder have been associated with worse mental health outcomes, while parent–child involvement and communication, and peer, parent and teacher social support have been associated with better function. Few evidence‐based interventions exist; CHAMP+, a mental health programme for PHIV+ youth, shows promise across cultures.
Conclusions
This review highlights research limitations that preclude both conclusions and full understanding of aetiology. Conversely, these limitations present opportunities for future research. Many PHIV+ youth experience adequate mental health despite vulnerabilities. However, the focus of research to date highlights the identification of risks rather than positive attributes, which could inform preventive interventions. Development and evaluation of mental health interventions and preventions are urgently needed to optimize mental health, particularly for PHIV+ youth growing up in low‐and‐middle income countries.
The impact of parental characteristics on mental health outcomes of early adolescents have been robustly examined in the West. However, the extent to which two salient parental characteristics, ...specifically parental self-efficacy (PSE) and parenting behaviours (PB) influence early adolescents’ mental health particularly emotional-behavioural problems and competence are scarcely explored among Asian households. Hence, this study examined the linkages between PSE, PB (i.e., warmth, monitoring, harsh discipline, and indigenous), and early adolescents’ mental health (i.e., emotional-behavioural problems and competence) from the perspective of Malaysian parents. The mediating role of PB on the relationships between PSE and early adolescents’ mental health was also examined. Sample comprised 478 Malaysian parents of children aged between 10 and 14 years old. Parents completed a self-report online survey regarding their PSE and PB as well as child’s mental health. Structural equation modelling (SEM) analysis indicated that PSE was positively related to parental warmth, monitoring, and indigenous parenting which predicted better early adolescents’ mental health, but negatively related to parental harsh discipline that predicted poorer early adolescents’ mental health. Results also show that high PSE is related to less emotional-behavioural problems and more competence among early adolescents. Finally, the role of warmth, monitoring, and harsh discipline parenting was established as the mediators between the relationships between PSE and early adolescents’ mental health. The findings imply that parents’ belief in their ability to perform their parenting roles and the way they behave in their parenting could have a direct and indirect impact on their offspring’s mental health.
BackgroundChildhood asthma is associated with emotional and behavioural problems. The prevalence and factors associated with psychological problems in childhood asthma have not been studied in Sri ...Lanka. AimsThe aim of this study was to describe the prevalence and factors associated with development of emotional and behavioural problems among children with asthma, presenting to outpatient follow up clinics. MethodsThis was a hospital based cross sectional descriptive study using systematic random sampling (n=250). The parents completed the Strengths and Difficulties Questionnaire (Sinhala version) and children with borderline or abnormal scores were assessed further using a structured interview, based on the International Classification for Disease-10 research criteria. ResultsThe mean age of participants was 8.1 years and 141 (56.4%) were males. The mean duration of asthma and age at diagnosis was 4.4 years and 3.6 years respectively. In 62% of participants, the asthma was well controlled. The prevalence of mental health problems was 8%. Borderline or abnormal scores in at least one scale of the SDQ was found in 18.4%, and 2.8% had abnormal or borderline impact scores. The level of asthma control was significantly associated with emotional problems score (OR 8.23, p=0.41). ConclusionsThe prevalence of mental health problems among children with asthma was comparable to the general population. Asthma control was significantly associated with emotional problems and this carries implications for management.
The present study aimed to explore the association between academic achievement and emotional and behavioural problems and the moderation role of gender in this association. 1350 Portuguese ...school-aged children and adolescents from first to ninth grade (6–15-year-old), part of a national representative sample, were assessed by teachers and parents with questionnaires from the Achenbach System of Empirically Based Assessment (ASEBA). Results show that academic achievement significantly predicts child and adolescent’s internalizing, externalizing, and total problems. Gender moderates the association between academic achievement and child and adolescent’s externalizing and total problems, both at school and in the family context. The results underscore the relevance of academic achievement in children and adolescent’s emotional and behavioural problems, and particularly in boys.
The type, frequency and inter-relationships of emotional and behavioural problems in 863 children with autism spectrum disorder (ASD) were investigated using the population-based Database of children ...with ASD living in the North East of England (Dasl
n
e). A high rate of problems was reported, with 53 % of children having 4 or more types of problems frequently. Sleep, toileting and eating problems, hyperactivity, self injury and sensory difficulties were greater in children with lower language level and in special schooling. However, anxiety, tantrums and aggression towards others were frequent regardless of age, ability or schooling. The frequency of co-existing conditions, including such emotional and behavioural problems, in children with ASD has implications for designing appropriate support services for children and families.
The relationship between parental age at pregnancy and offspring development in low- and middle-income countries remains unclear. We aimed to examine the associations of parental age at pregnancy ...with adolescent development in rural China.
We conducted a prospective birth cohort study of offspring born to pregnant women who participated in an antenatal micronutrient supplementation trial in rural Western China. Adolescent cognitive development and emotional and behavioural problems were assessed by using the Wechsler Intelligence Scale for Children-IV and the Youth Self-Report-2001, respectively. After accounting for the possible nonlinear relationships, we examined the linear associations between parental age (in years) at pregnancy and scores of adolescent cognitive development and emotional and behavioural problems by performing generalized estimating equations.
Among 1897 adolescents followed from birth to early adolescence, 59.5% were male with a mean age of 11.8 (standard deviation (SD): 0.8) years. The mean ages of mothers and fathers at pregnancy were 24.6 (SD: 4.4) and 27.9 (SD: 4.1) years old, respectively. All the P values of the nonlinear terms between parental age and adolescent development in all domains were greater than 0.05. Each one-year increase in maternal age at pregnancy was associated with a 0.29-point (95% confidence interval (CI) 0.06, 0.52) increase in the full-scale intelligence quotient in early adolescence. After parental age was categorized into quartiles, the total behavioural problem scores of adolescents with fathers with an age in the fourth quartile (Q4) were 6.71 (95% CI 0.86, 12.57) points higher than those of adolescents with fathers with an age in the first quartile (Q1), with a linear trend P value of 0.01. Similarly, higher scores (worse behavioural problems) were observed for internalizing behavioural problems and other emotional and behavioural symptoms related to anxiety, withdrawal, social problems, thought problems and aggressive behaviour.
At conception, older maternal age was independently linked to better adolescent cognitive development, whereas advanced paternal age was independently associated with a greater risk of adolescent emotional and behavioral problems. These findings suggest that public health policies targeting an optimal parental age at pregnancy should be developed in the context of offspring developmental consequences.
Although there is extensive literature on the risks faced by families dealing with cumulative challenges, including the emotional and behavioural problems of the child, limited research exists on the ...potential resilience of these families. Additionally, there are a lot of ambiguities in family resilience research with respect to indicators of good outcomes while facing risks. Therefore, this study aimed to answer the following research questions: 1) What risks do family members recognise that they are facing?; and 2) How do family members perceive good outcomes in the context of the risks that they are facing? To answer these research questions, we conducted group interviews with 8 families whose children, aged 12 to 18 years, manifest emotional and/or behavioural problems. Data were analysed using thematic analysis. For the first question, the results highlight one theme - Families with complex needs: multiple risks at different levels. Four themes contribute to answering the second research question: Survival, Not giving up and asking for help, Positive change, and Wish for togetherness and good communication. The families reported three indicators of good family outcomes, while striving for the fourth (Wish for togetherness and good communication), suggesting that outcome indicators can be distributed on a “continuum”. However, family members also reported that as they cope with and resolve the challenges they face, new risks emerge that may take the family back to an earlier stage, emphasising the circular rather than linear nature of this continuum. All participating families stressed that togetherness can be achieved with more professional help and time. The findings of this study address the importance of strength-based approaches in practice that will provide a space for fostering resilience in families facing chronic and cumulative risks.
A significant number of breast cancer survivors are living with their minor children. In this review we investigated the impact of maternal breast cancer on children. A literature search conducted ...through PubMed, Scopus, Cochrane Library and CINAHL yielded 26 relevant studies, which documented a variety of effects. Evidence has been presented that dealing with maternal breast cancer can cause uncertainty, anxiety and depression in children, but may also lead to enhanced social and academic performance. The risk of problems in these children is reported to be associated with both low parental affective responsiveness and excessive parental involvement. Internalising child problems were shown to be linked with maternal depression and family dysfunction, and externalising problems with family dysfunction and communication problems. Some of these problems may be modified by interventions for supporting these families, which should be designed to include both parents and children, and also the healthcare personnel.
Sleep problems are common in adolescence with a negative impact on the mental health and functioning of adolescents. However, the roles of different sleep problems in relation to emotional and ...behavioural problems (EBPs), classified according to the 10th version of the International Classification of Diseases as emotional, conduct, hyperactivity and social functioning disorders, are not clear. The first aim of the study was to investigate the association between difficulties in getting to sleep and EBPs in adolescents. The second aim was to explore the role of sleep duration in this association. We used data from the Health Behaviour in School-aged Children (HBSC) study conducted in 2018 in Slovakia. Presented are results for specific age groups of 13-year-old (N = 1909) and 15-year-old (N = 1293) adolescents. Subjective measures of sleep variables were used. Binary logistic regression models adjusted for age and gender were used to assess associations between difficulties in getting to sleep, sleep duration and EBPs measured using the Strengths and Difficulties Questionnaire. Modification of the association between difficulties in getting to sleep and EBPs by sleep duration was also explored. We found that difficulties in getting to sleep at least once a week as well as insufficient sleep (less than 8 h) increased the probability of EBPs. Interactions of sleep duration with difficulties in getting to sleep on EBPs were found to be non-significant. The results suggest that caregivers and clinicians should screen and intervene for both sleep quality and quantity problems in adolescents as they might indicate and promote EBPs.
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