Emotions and self-esteem as indicators of somatic complaints in children

Somatic and Depressive Symptoms Among Children From Latin America and the English-Speaking Caribbean

BACKGROUND

The extent to which depression is associated with somatic complaints in children from the English-speaking Caribbean and Latin America is not well established.

OBJECTIVE

We sought to explore the association between depressive and somatic symptoms among children from the English-speaking Caribbean and Latin America, while accounting for age, sex, socioeconomic status, cultural background, and anxiety score.

METHOD

1541 elementary school children, ages 9-12 years, from the English-speaking Caribbean and Latin America completed the Adolescent Depression Rating Scale (ARDS), the Numeric 0-10 Anxiety Self-Report Scale and the Children's Somatic Symptom Inventory-24 (CSSI-24). T-tests and ANOVA's were used to compare CSSI-24 and ARDS scores among countries, and the CSSI-24 scores of children with (ARDS ≥ 4) and without likely clinically significant depression. Regression analyses assessed possible predictors of CSSI-24 score.

RESULTS

Depressive and somatic symptom scores were highest among the Jamaican children and lowest among the Colombian children (p < .001). Children with likely clinically significant depression exhibited higher mean somatic symptom scores (p < .001). Depressive symptom scores predicted somatic symptom scores (p < .001).

CONCLUSIONS

Depressive symptoms were a strong predictor of reporting somatic symptoms. Knowledge of this association may facilitate better recognition of depression among youth.

Paranormal belief and well-being: The moderating roles of transliminality and psychopathology-related facets

Evaluation of prior research suggests that belief in the paranormal is more likely to be associated with negative psychological functioning, when presented alongside cognitive-perceptual factors that askew thinking and insight. The current study examined this notion using a sample of 3,084 participants (1,382 males, 1,693 females, nine non-binary). Respondents completed self-report measures assessing Paranormal Belief, Transliminality, psychopathology-related characteristics (Schizotypy and Manic-Depressive Experience), and well-being (Perceived Stress and Somatic Complaints). Responses were analysed via correlations and moderation. Paranormal Belief correlated positively with Transliminality, psychopathology-related measures, Perceived Stress, and Somatic Complaints. Moderation analyses revealed that Transliminality and psychopathology-related variables (i.e., the Unusual Experiences and Cognitive Disorganisation subscales of schizotypy, and Manic-Depressive Experience) interacted with Paranormal Belief in complex ways and were allied to higher scores on negative well-being outcomes. This indicated that within paranormal believers, Transliminality and specific psychopathology-related variables in combination predicted susceptibility to negative well-being outcomes.

The Long-Term Effects of Bullying, Victimization, and Bystander Behavior on Emotion Regulation and Its Physiological Correlates

Bullying at school is a serious social problem that influences the wellbeing of everyone involved, that is, victims, perpetrators, and bystanders. Among the many health and psychological problems that these individuals may develop, emotion dysregulation appears to be a common marker. To date, however, it remains unclear whether bullying experienced during the school years is associated with emotion dysregulation also in adulthood. In this study, by adopting a retrospective approach, we investigated whether involvement in bullying at school-either as a bully, victim, or bystander-could put these individuals at risk of presenting deficits in emotion regulation in adulthood, as assessed with behavioral (explicit) and physiological (implicit) indexes (i.e., skin conductance), and whether the association between the involvement in bullying and emotion regulation was direct or mediated by other factors, such as somatic complaints and sensation seeking. A total of 58 young adults were asked to control their emotional reactions in front of images with strong emotional content, and to explicitly evaluate them with ratings, while their arousal was measured through skin conductance. They also responded to questionnaires about retrospective involvement in bullying, somatic complaints, and sensation seeking. Results revealed that victimization and bystander behavior were directly and negatively associated with emotion regulation as assessed with skin conductance, whereas bullying was positively associated with implicit emotion regulation through the mediation of sensation seeking. Interestingly, emotion regulation as assessed with explicit ratings was not associated with any of the characteristics of the participants. Our study suggests that being directly (as victim) but also indirectly (as bystander) involved in bullying at school time is associated with difficulties in emotional wellbeing in adulthood. Furthermore, it reveals that behavioral and physiological indexes associated with emotion regulation dissociate, suggesting that subtle physiological changes may remain hidden from explicit behavior.

Cross-cultural validation of the Mood Questionnaire in three Spanish-speaking countries Argentina, Ecuador, and Spain

This study validates the Mood Questionnaire for adults in three Spanish-speaking countries: Argentina, Ecuador, and Spain. It then analyzes the influence of gender and cultural differences on mood, and whether there is a relationship between mood, emotional intelligence, and the Avoidance of Responsibility. A convenience sample of 1048 adults, with a middle-class socioeconomic background, was selected from three Spanish-speaking countries (Spain, Argentina, and Ecuador). The psychometric properties of the Mood Questionnaire are adequate, which is particularly interesting given the need for transcultural tools to evaluate moods. Moreover, the mood was associated with avoidance of responsibility and emotional intelligence. In addition, differences in mood were observed according to country and gender. These findings are interesting because the Spanish version of the Mood Questionnaire has been validated for children but not for adults, and it compares three Spanish-speaking countries. The use of this diagnostic tool with Spanish adults can be justified according to these results.

Feasibility of Ecological Momentary Assessment of Negative Emotion in Girls With ADHD: A Pilot Study

This study explores the feasibility of using mobile phone ecological momentary assessment to evaluate negative emotion in adolescent girls with attention-deficit/hyperactivity disorder (ADHD). A total of 13 girls with ADHD, ages 12-16 years old (38.5% with comorbid depression), and their mothers completed several daily surveys assessing the intensity and variability of youth negative emotion using mobile phone-based ecological momentary assessment for approximately one week. The rate of response to survey prompts by youth and maternal reports was examined. In addition, associations between girls' and mothers' ratings of negative emotion were calculated. Finally, the severity and fluctuation in negative emotion were compared between girls with and without depression. Girls and their mothers demonstrated a high level of compliance with assessment procedures, and maternal and youth ratings were significantly correlated. In addition, girls with comorbid depression and their mothers endorsed significantly more intense and variable negative emotion compared to girls with ADHD alone. These preliminary findings show that ecological momentary assessment is a feasible and valid method for collecting information on emotion regulation among girls with ADHD and their mothers that can be applied to future work aimed at collecting ecologically valid assessments of functioning in girls with ADHD.

Emotional Competence and Anxiety in Childhood and Adolescence: A Meta-Analytic Review

Anxiety is conceptualized as a state of negative emotional arousal that is accompanied by concern about future threat. The purpose of this meta-analytic review was to evaluate the evidence of associations between emotional competence and anxiety by examining how specific emotional competence domains (emotion recognition, emotion expression, emotion awareness, emotion understanding, acceptance of emotion, emotional self-efficacy, sympathetic/empathic responses to others' emotions, recognition of how emotion communication and self-presentation affect relationships, and emotion regulatory processes) relate to anxiety in childhood and adolescence. A total of 185 studies were included in a series of meta-analyses (N's ranged from 573 to 25,711). Results showed that anxious youth are less effective at expressing (r = -0.15) and understanding emotions (r = -0.20), less aware of (r = -0.28) and less accepting of their own emotions (r = -0.49), and report less emotional self-efficacy (r = -0.36). More anxious children use more support-seeking coping strategies (r = 0.07) and are more likely to use less adaptive coping strategies including avoidant coping (r = 0.18), externalizing (r = 0.18), and maladaptive cognitive coping (r = 0.34). Emotion acceptance and awareness, emotional self-efficacy, and maladaptive cognitive coping yielded the largest effect sizes. Some effects varied with children's age. The findings inform intervention and treatment programs of anxiety in youth and identify several areas for future research.

Medical and Behavioral Correlates of Depression History in Children and Adolescents With Autism Spectrum Disorder

BACKGROUND AND OBJECTIVES

Depression is commonly associated with autism spectrum disorder (ASD) across the life span. We sought to identify medical and behavioral problems associated with a history of a parent-reported diagnosis of depression in a large sample of school-aged children and adolescents with ASD.

METHODS

A sample of 1272 participants (aged 6-17 years; mean [SD]: 9.56 [2.79] years) from the Autism Speaks Autism Treatment Network consortium were divided into "ever-depressed" (n = 89) and "nondepressed" (n = 1183) groups on the basis of caregiver endorsement of children's current or previous diagnoses of depression.

RESULTS

In total, 7.0% of children with ASD (4.8% of those aged 6-12 years and 20.2% of those aged 13-17 years) were reported to have a history of a depression diagnosis. Positive depression history was associated with greater chronological age, higher IQ, and Asperger disorder diagnosis. After controlling for age, IQ, and within-spectrum categorical diagnosis, the ever-depressed group exhibited significantly greater rates of seizure disorders (odds ratio = 2.64) and gastrointestinal problems (odds ratio = 2.59) and trend-level differences in aggression, somatic complaints, and social impairments. The groups did not differ in autism severity, repetitive behaviors, sleep problems, eating problems, self-injurious behavior, or current intervention use.

CONCLUSIONS

Co-occurring depression is a particularly common problem in higher-functioning older children within the Autism Treatment Network. Our findings indicate that children with ASD and a history of a depression diagnosis are more likely to also have co-occurring medical problems, although the presence and direction of causality is unclear.

Somatic symptoms, peer and school stress, and family and community violence exposure among urban elementary school children

Somatic symptoms are a common physical response to stress and illness in childhood. This study assessed 409, primarily African American (85.6 %), urban elementary school children to examine the association between: (1) somatic symptoms and potential external stressors (school and peer stress, family conflict, and community violence) and (2) parent and child agreement on children's self-report of somatic symptoms. The odds of self-report of somatic complaints were significantly associated with family conflict, school and peer stress, and community violence exposure (OR = 1.26, 95 % CI: 1.05-1.50; OR = 1.18, 95 % CI 1.08-1.28; and OR = 1.02, 95 % CI: 1.00-1.05, respectively). Identifying the associations between social, family, and community based stress and somatic symptoms may improve the quality of life for children living in urban environments through early identification and treatment.

Clinical status in adolescents: is its impact on oral health-related quality of life influenced by psychological characteristics?

The objective of this study was to examine, using structural equation modelling, the relationships among clinical characteristics (such as caries experience and malocclusion), oral health-related quality of life (OHRQoL), and psychological characteristics (mental health, self-esteem, somatisation, and social perception of body image) in adolescents in New Zealand. Adolescents were examined for malocclusion using the Dental Aesthetic Index (DAI) and for dental caries. Among the 353 (58.8%) 12- and 13-yr-old adolescents who took part in this cross-sectional study, the overall mean ± SD decayed, missing, or filled surfaces (DMFS) value was 1.6 ± 3.0, with slightly more than 50% of being caries-free; the mean ± SD DAI was 31.5 ± 7.6, with one-quarter of subjects having a 'handicapping' malocclusion. The structural equation modelling analysis showed that the structural model was a good fit to the data. As hypothesized, the DAI score significantly predicted OHRQoL. There was no direct relationship between caries experience (DMFS) and OHRQoL, but there was an indirect effect of DMFS on OHRQoL mediated through psychological characteristics. The amount of OHRQoL variance accounted for in the model was substantial, at 62%. It appears that investigating OHRQoL in adolescents is not straightforward; while malocclusion directly affects OHRQoL, the influence of dental caries experience is less direct.

Crying in Middle Childhood: A Report on Gender Differences

The aims of this study were (1) to confirm gender differences in crying in middle childhood and (2) to identify factors that may explain why girls cry more than boys in a Dutch sample (North Holland and Utrecht). We examined 186 children’s (age: 9–13 years) self-reports on crying, catharsis, seeking support for feelings, and internalizing feelings. Girls reported a greater crying frequency and crying proneness, and more emotional and physical catharsis after crying. In addition, they more frequently sought support for feelings and more often experienced sadness and somatic complaints than boys. Seeking help for negative feelings and the experience of sadness and somatic complaints were positively associated with crying frequency and crying proneness. Emotional catharsis was positively linked to crying proneness. Support was found for the potential mediating role of sadness and somatic complaints with respect to the gender difference in crying frequency and for the potential mediating role of emotional catharsis and somatic complaints for crying proneness. This study demonstrates that gender differences in crying frequency already exist in middle childhood and the findings suggest a linkage between these gender differences in crying and psychosocial factors.

The longitudinal relationship between emotion awareness and internalising symptoms during late childhood

Emotion awareness, the ability to reflect upon the own emotions, is assumed to contribute to better mental health. However, empirical support for this relationship has only been cross-sectional. In this study we examined the extent to which individual differences in changes in emotion awareness over time can explain individual differences in changes in symptoms of internalising problems (depression, fear, worrying and ruminative thoughts). Children and young teenagers (368 boys and 295 girls) were asked four times to fill out self-report questionnaires, with a 6-month time interval between each time. The mean age was 10 years during the first data collection. Longitudinal multilevel analyses showed that the variance in emotion awareness trends was highly predictive for the variance in trends for internalizing problems over time. The ability to differentiate discrete emotions was a strong predictor and negatively contributed to all internalising symptoms. In addition, a diminished tendency to address and value emotions contributed to more depressive symptoms; whereas hiding the own emotions contributed to more worrying and ruminative thoughts. The outcomes show that individual differences in emotion awareness over time make a strong, and, above all, negative contribution to the prediction of the individual differences in various internalizing symptoms. The fact that several aspects of emotional (dys)functioning are uniquely related to different kinds of internalizing problems gives valuable and useful information not only theoretically but also clinically about the distinctive nature of these problems.

Pathways underlying somatic complaints in children and adolescents who are deaf or hard of hearing

Frequent somatic complaints are not only a problem in themselves but also related to other difficulties. So far, no conclusive findings have been reported about the prevalence of and factors underlying these complaints in children and adolescents who are deaf or hard of hearing (DHH). Such information would be valuable for prevention and intervention. Therefore, the aim of this study was to examine the prevalence of somatic complaints and their relation with emotional functioning in DHH youngsters, as compared with hearing youngsters. This was established by assessing how somatic complaints, mood states, and sense of coherence were experienced by 186 Dutch participants (mean age = 11;07 years). DHH and hearing groups were compared using multivariate analysis of variance and structural equation modeling. The results showed that somatic complaints were reported equally often for both groups, but that the pathways leading to these complaints were partly different. Only in DHH participants were feelings of fear associated with more somatic complaints. The results suggest that DHH children and adolescents would benefit from support in the regulation of fear and its causes. Other aspects affecting adjustment outcomes of DHH youngsters were education type and communication mode.

The Relation Between Anger Coping Strategies, Anger Mood and Somatic Complaints in Children and Adolescents

Attempts to explain the experience of somatic complaints among children and adolescents suggest that they may in part result from the influence of particular strategies for coping with anger on the longevity of negative emotions. To explore these relationships British (n = 393) and Dutch (n = 299) children completed a modified version of the Behavioral Anger Response Questionnaire (BARQ), and two additional questionnaires assessing anger mood and somatic complaints. A hierarchical regression analysis showed that for both the UK and Dutch samples two coping styles, Social support-seeking and Rumination, made a significant contribution to somatic complaints, over and above the variance explained by anger mood. A tendency to repeatedly think or talk about an angering event as a way of coping seems to underlie the observed negative health effects. In addition, tentative support is given for a broader range of strategies to cope with anger than just the traditionally studied anger-out and anger-in styles.