1
|
Dominguez-Viera ME, de Vries Mecheva M, Nguyen T, van den Berg M. Relaxed minds for healthier food choice at school: A field experiment in southern Mexico. Appetite 2024; 200:107529. [PMID: 38801995 DOI: 10.1016/j.appet.2024.107529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/12/2024] [Accepted: 05/24/2024] [Indexed: 05/29/2024]
Abstract
Stress leads to unhealthy food choices since the school-age stage. Yet, there is limited evidence particularly in low- and middle-income countries regarding the impact of stress-reduction strategies on school-age children's food choices. Such aspects were crucial during the recent COVID-19 pandemic, which exacerbated psychological distress and unhealthier food choices among children. Two years after the pandemic began, we conducted a field experiment in southern Mexico to assess the impact of stress-reduction strategies on the food choices of over 1400 children aged 9-12. Half of the school-classes in the sample were randomly assigned to a stress reduction strategy namely meditation, which comprised six audios with basic relaxation techniques and intuitive messages to guide food choices. Additionally, all participants received information signalling that an amaranth snack was nutritious (i.e., the healthy snack), which was paired with a chocolate bar (i.e., the unhealthy snack) as part of a snack choice experiment. Students that practiced meditation were slightly more likely to choose the healthy snack than those in the control group, but the effect was not statistically significant. Upon collecting their snack, students had the chance to exchange their original choice for the other snack. Students that meditated were more likely to exchange their originally chosen "unhealthy snack" towards the healthy snack than students in the control group. The meditation program effectively reduced chronic stress among treated children. The effect was larger among students attending schools in lower-income areas. Our study sheds some light on the challenges to translate an improved psychological well-being into healthier food choices at school.
Collapse
Affiliation(s)
- Marcos E Dominguez-Viera
- Development Economics Group, Wageningen University & Research, Droevendaalsesteeg 4, 6708 PB, Wageningen, Netherlands.
| | - Margarita de Vries Mecheva
- The International Institute of Social Studies, Erasmus University Rotterdam, Kortenaerkade 12, 2518 AX, Den Haag, Netherlands
| | - Trang Nguyen
- Development Economics Group, Wageningen University & Research, Droevendaalsesteeg 4, 6708 PB, Wageningen, Netherlands
| | - Marrit van den Berg
- Development Economics Group, Wageningen University & Research, Droevendaalsesteeg 4, 6708 PB, Wageningen, Netherlands
| |
Collapse
|
2
|
McAlister KL, Zink J, Huh J, Yang CH, Dunton GF, Dieli-Conwright CM, Page KA, Belcher BR. Perceived stress and associations between physical activity, sedentary time, and interstitial glucose in healthy adolescents. Physiol Behav 2024; 283:114617. [PMID: 38889810 PMCID: PMC11246823 DOI: 10.1016/j.physbeh.2024.114617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 05/09/2024] [Accepted: 06/15/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Less moderate to vigorous physical activity (MVPA), more sedentary time (ST), and higher perceived stress are related to type 2 diabetes mellitus (T2DM) occurrence, but observational evidence addressing the interaction of these factors is lacking in youth. This pilot study investigated momentary stress as a moderator in the acute associations of MVPA and ST with subsequent glucose in healthy adolescents. METHODS Participants (N=15, Mage=13.1±1.0 years, 10 girls, 5 with overweight/obesity) simultaneously wore a continuous glucose monitor (CGM), thigh-mounted accelerometer, and reported momentary stress via random ecological momentary assessments (EMA; Time T) for 7-14 days. MVPA and ST (min) were calculated for 60- and 120-minute time windows before each EMA prompt (Time T-1). Mean CGM-measured interstitial glucose (mg/dL) was calculated after each prompt (Mmin=120.0±25.4; Time T+1). Multilevel models assessed whether within-subject MVPA and ST (Time T-1) predicted mean glucose (Time T+1), with momentary stress as a moderator (Time T). RESULTS There were 513 time-matched EMA reports of stress, accelerometer, and CGM data. Momentary stress moderated the effects of MVPA 60 (β=-0.22, p=.001) and 120 min (β=-0.08, p=.02) before the prompt on subsequent glucose levels. When youth spent more time in MVPA than their average and when momentary stress was higher than their average, subsequent glucose was lower. Stress did not moderate associations of ST with glucose (p>.05). CONCLUSIONS Higher momentary stress may interact with higher MVPA to lower subsequent glucose in youth. Accelerometers, EMA, and CGMs can be integrated in future studies to further understand these associations in free-living environments.
Collapse
Affiliation(s)
- Kelsey L McAlister
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Jennifer Zink
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Jimi Huh
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Chih-Hsiang Yang
- Department of Exercise Science/TecHealth, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Genevieve F Dunton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Department of Psychology, Dornsife College of Letters, Arts, and Sciences, University of Southern California, Los Angeles, CA, USA
| | - Christina M Dieli-Conwright
- Department of Medical Oncology, Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Kathleen A Page
- Department of Medicine, Division of Endocrinology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Britni R Belcher
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
3
|
Lundin Remnélius K, Bölte S. Camouflaging in Autism: Age Effects and Cross-Cultural Validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q). J Autism Dev Disord 2024; 54:1749-1764. [PMID: 36757540 PMCID: PMC11136743 DOI: 10.1007/s10803-023-05909-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2023] [Indexed: 02/10/2023]
Abstract
Given that camouflaging has been suggested to contribute to delayed diagnosis and mental health problems among autistic people, validated measures of the construct are needed. This study describes the psychometric evaluation of the Swedish adaptation of the self-reported Camouflaging Autistic Traits Questionnaire (CAT-Q) in autistic (n = 100) and general population (n = 539) samples aged 10 to 83 years. Analyses indicated good-to-excellent internal consistency and test-retest reliability. Construct validity was supported by autistic participants scoring higher than non-autistic, and autistic females scoring higher than autistic males on the measure. Also as expected, camouflaging was associated with theoretically linked traits, including autistic behaviors and depressive symptoms. On the other hand, the factor structure of the original CAT-Q did not provide a good fit in the Swedish data set, and validity issues were found, particularly in children younger than 15 years, warranting further investigation of the construct validity of the scale. Different age trajectories were observed, where camouflaging behaviors decreased during adulthood in non-autistic people but remained at an elevated level among autistic people.
Collapse
Affiliation(s)
- Karl Lundin Remnélius
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Gävlegatan 22B, 113 30, Stockholm, Sweden.
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Gävlegatan 22B, 113 30, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| |
Collapse
|
4
|
Hale GE, Colquhoun L, Lancastle D, Lewis N, Tyson PJ. Physical activity interventions for the mental health of children: A systematic review. Child Care Health Dev 2023; 49:211-229. [PMID: 35995884 DOI: 10.1111/cch.13048] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 08/08/2022] [Accepted: 08/14/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This systematic review explored the effectiveness of using physical activity (PA) interventions to enhance psychological well-being and reduce psychological ill-being (e.g., anxiety and depression) in children aged six to 11 years old from the general population. METHODS Electronic databases were searched for studies published between January 2005 and June 2020: Web of Science, ProQuest Psychology Journals, PsycINFO, Pub Med, ASSIA, CINHAL PLUS, SPORTDiscus, EMBASE and Wiley Online Library. Search terms included 'physical activity intervention', 'psychological well-being' and 'child*'. After removing duplicates, 11 390 studies were independently screened by two authors based on inclusion/exclusion criteria and assessed for risk of bias. RESULTS A total of 23 studies were narratively synthesized and categorized into four domains: Quality of Life (QOL), body image, self-esteem and psychological ill-being. Evidence was provided for the impact of PA interventions in improving QOL, body image and self-esteem. Despite the positive effect on psychological well-being, evidence for a reduction in the frequency and severity of symptoms associated with psychological ill-being in children is less clear. CONCLUSIONS Reviewed studies support the use of PA interventions in enhancing the psychological well-being of children in school and community settings. More research is warranted to understand the impact of PA interventions on reducing psychological ill-being in children from the general population.
Collapse
Affiliation(s)
- Gabrielle E Hale
- School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd, UK
| | - Luke Colquhoun
- School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd, UK
| | - Deborah Lancastle
- School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd, UK
| | - Nicky Lewis
- School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd, UK
| | - Philip J Tyson
- School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd, UK
| |
Collapse
|
5
|
Davis C, Turner-Cobb JM. The Perceived Stress Scale for Kids (PeSSKi): Initial development of a brief measure for children aged 7-11 years. Stress Health 2023; 39:125-136. [PMID: 35688796 PMCID: PMC10084385 DOI: 10.1002/smi.3174] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/31/2022] [Accepted: 06/07/2022] [Indexed: 02/05/2023]
Abstract
Perceived stress, a known risk factor for poor health, has been extensively assessed in adult populations. Yet an equivalent assessment tool for measurement of global perceived stress in children is lacking. This study aimed to develop and provide initial validation of a scale to measure perceived stress in children aged 7-11 years. Using a two-phase design, we conducted semi-structured interviews with thirteen child-parent dyads for development of items. In a sample of 123 children (age range 7-11 years, Mage = 9 years 7 months, 54.5% male) we administered the resulting Perceived Stress Scale for Kids (PeSSKi). Exploratory factor analysis of the 10-item PeSSKi yielded support for both a one-factor and a two-factor solution (negative, positive item wording). The PeSSKi was associated positively with the Penn-State Worry Questionnaire for Children (r = 0.748, p < 0.001) and negatively with the Students' Life Satisfaction Scale (r = 0.381, p < 0.001) indicating strong convergent/divergent validity respectively. Girls showed higher scores on the PeSSKi than boys with no effects observed by age. Initial psychometrics suggest the PeSSKi provides a robust scale for assessment of perceived stress in children. Further validation is needed across different child populations, over time and with physical measures of stress and health outcomes.
Collapse
|
6
|
Connelly M, Dilts J, Boorigie M, Gerson T. A Prospective Evaluation of the Effects of the COVID-19 Pandemic on Youth with Primary Headache Disorders. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020184. [PMID: 36832313 PMCID: PMC9954271 DOI: 10.3390/children10020184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/22/2022] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
Alterations in certain academic and social/family routines during the COVID-19 pandemic have been speculated to be either a risk factor or buffer for poor health outcomes for youth with stress-sensitive health conditions such as primary headache disorders. The current study evaluated patterns and moderators of pandemic impacts on youth with primary headache disorders, with an aim of extending our understanding of the relationship between stress, resilience, and outcomes in this population. Children recruited from a headache clinic in the midwestern United States reported on their headaches, schooling, routines, psychological stress, and coping at four timepoints ranging from within a few months of the pandemic onset to a long-term follow-up 2 years later. Changes in headache characteristics over time were analyzed for association with demographics, school status, altered routines, and stress, and coping. At baseline, 41% and 58% of participants reported no change in headache frequency or intensity, respectively, relative to pre-pandemic levels, with the remainder almost equally divided between reporting an improvement or worsening. The results of multilevel growth model analyses indicated that headache intensity remained more elevated over time since the start of the pandemic for respondents whose stress scores were relatively higher (b = 0.18, t = -2.70, p = 0.01), and headache-related disability remained more elevated over time for older respondents (b = 0.01, t = -2.12, p = 0.03). The study results suggest, overall, that the outcomes of primary headache disorders in youth were not systematically altered by the COVID-19 pandemic.
Collapse
Affiliation(s)
- Mark Connelly
- Children’s Mercy Kansas City, Kansas City, MO 64108, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
- Correspondence:
| | - Jennifer Dilts
- Children’s Mercy Kansas City, Kansas City, MO 64108, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
| | | | - Trevor Gerson
- Children’s Mercy Kansas City, Kansas City, MO 64108, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
| |
Collapse
|
7
|
Castilla-Earls A, Ronderos J, Fitton L. Can Bilingual Children Self-Report Their Bilingual Experience and Proficiency? The Houston Questionnaire. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:3835-3853. [PMID: 36167064 PMCID: PMC9927622 DOI: 10.1044/2022_jslhr-21-00675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/24/2022] [Accepted: 06/20/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE The aim of this study was to develop a child self-report questionnaire measuring bilingual experience and self-perceptions of Spanish and English proficiency and establish preliminary evidence of validity and reliability for the questionnaire. METHOD Participants included 113 Spanish-English bilingual children with and without developmental language disorders ranging in age from 4 to 8 years. All children completed the questionnaire in Spanish and participated in behavioral assessment of their language skills in both Spanish and English. RESULTS Using confirmatory factor analysis, a model with three correlated factors (self-perception of proficiency in Spanish, self-perception of proficiency in English, and bilingual experience) emerged with the best global fit, reasonableness, consistency with theory, and model parsimony, suggesting that the questionnaire has good internal reliability. The scaled results of the questionnaires significantly correlated with behavioral measures of both Spanish and English, supporting the convergent validity of the measure. CONCLUSIONS The Houston Questionnaire is an assessment tool for the assessment of bilingual experience and self-perception of proficiency in Spanish and English bilingual children between the ages of 4 and 8 years. The results provide foundational evidence supporting the reliability and convergent validity of this tool. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21158887.
Collapse
Affiliation(s)
- Anny Castilla-Earls
- Department of Communication Disorders and Sciences, University of Houston, TX
| | - Juliana Ronderos
- Department of Communication Disorders and Sciences, University of Houston, TX
| | - Lisa Fitton
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia
| |
Collapse
|
8
|
Lynch T, Davis SL, Johnson AH, Gray L, Coleman E, Phillips SR, Soistmann HC, Rice M. Definitions, theories, and measurement of stress in children. J Pediatr Nurs 2022; 66:202-212. [PMID: 35868219 PMCID: PMC10085063 DOI: 10.1016/j.pedn.2022.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 06/30/2022] [Accepted: 07/08/2022] [Indexed: 11/28/2022]
Abstract
PROBLEM Stress in children remains a complex concept to examine due to the inherent subjectivity and lack of specific manifestations, as well as the multiple ways stress can be defined and measured in children. Because stress is multifactorial,is experienced daily by children, and undergirds adolescent health and early mental illness, it is crucial to have a clear understanding of stress and the effects of stress in children from infancy through age twelve years. ELIGIBILITY CRITERIA To be included in this review, literature must pertain to and highlight theories, definitions/classifications, and measurements of stress in children from infancy to 12 years of age. SAMPLE The most pertinent articles identified through database searches (PubMed, Scopus, PsycINFO, CINAHL, Google Scholar), gray literature sources (e.g., child health websites), and reference lists of identified articles were included in this narrative overview. RESULTS The results of this review are organized by themes and include: classifications and definitions of stress, stress-related theories, and tools to measure stress in children. CONCLUSIONS Research addressing stressors and stress in children is limited, and there is wide variation in how researchers define and classify stress in children. Existing measures of stress in children younger than 12 address physiological, psychological, and observational components, but may be inconsistent and threaten validity of otherwise well-designed and well-executed studies. IMPLICATIONS Improving the understanding and accurate measurement of stress in children enables researchers and clinicians to curtail undesirable health outcomes.
Collapse
Affiliation(s)
- Thuy Lynch
- University of Alabama in Huntsville, 301 Sparkman Drive, Huntsville, AL 35899, USA.
| | - Sara L Davis
- University of South Alabama, 5721 USA Drive, N., Mobile, AL 36688, USA.
| | - Ann Hammack Johnson
- Harris College of Nursing and Health Sciences, Texas Christian University, 2800 S. University Drive, Fort Worth, TX 76109, USA.
| | - Laura Gray
- Gordon E. Inman College of Health Sciences and Nursing, Belmont University, 1900 Belmont Boulevard, Nashville, TN 37212, USA.
| | - Elizabeth Coleman
- University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, AL 35294, USA.
| | | | - Heather C Soistmann
- Penn State Health Children's Hospital, 500 University Drive, Hershey, PA 17033, USA.
| | - Marti Rice
- University of Alabama at Birmingham, 1701 University Boulevard, Birmingham, AL 35294, USA.
| |
Collapse
|
9
|
Reading Skills, Social Competence, and Physiological Stress in the First Grade. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-021-09487-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AbstractAn awareness of school-related antecedents of children’s physiological stress at the beginning of school helps educators to prevent and mitigate children’s stress, the one of the major obstacles to their well-being and academic progress. We aimed to study the effect of reading skills and social competence on first-grade students’ salivary cortisol levels in natural settings. Based on previous results of the effects of everyday situations on children’s stress according to gender, we expected that both academic and social skills would affect girls’ physiological stress more, compared to boys. Our sample consisted of 277 students (7–8 years old, 50.2% girls). We used the highest salivary cortisol level of three morning samples and a cortisol level from the middle of the school day as physiological stress indicators. Reading skills were assessed by group-administered tests and social competence by teacher ratings. We found that lower reading comprehension skills and lower disruptiveness were related to higher cortisol levels for girls but not for boys. Higher empathy and lower disruptiveness moderated the effect of better reading comprehension on higher psychological stress in the middle of the school day only for girls. By recognizing the antecedents of children’s stress and supporting their academic and social skills, children’s, especially girls’, physiological self-regulation and coping skills in the primary grades will benefit.
Collapse
|
10
|
Panagiotou M, Charalampopoulou M, Bacopoulou F, Velegraki IM, Kokka I, Vlachakis D, Chrousos GP, Darviri C. Reliability and validity of the Peer Relation Questionnaire in a sample of Greek school children and adolescents. ACTA ACUST UNITED AC 2021; 26. [PMID: 34621634 DOI: 10.14806/ej.26.1.974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Bullying among children and adolescents can have detrimental effects on their physical and mental health. The first step in the identification of bullying is the detection of relevant signs and behaviours, with the use of appropriate instruments. The widely used Peer Relation Questionnaire (PRQ)has been developed to measure bullying behaviour in children and adolescents. The aim of this study was to translate and validate this instrument in the Greek language in a school sample of children and adolescents. A sample of 193 students (mean age ± SD 11.44 ± 1.26 years, girls 49.7%), was recruited from elementary and junior high schools of the public and private sector, in the capital of Athens, Greece. Along with the Peer Relation Questionnaire, the Stress in Children questionnaire and a structured inquiry regarding satisfaction from various aspects of life were used to assess the criterion validity of the Peer Relation Questionnaire. Results revealed good psychometric properties of the questionnaire in the Greek language. The principal component analysis resulted in two subscales that demonstrated an adequate internal consistency and a significant correlation with stress and satisfaction parameters, suggesting satisfying criterion validity. Meaningful associations between demographic characteristics and the subscales were also found. The Greek version of the Peer Relation Questionnaire-short form can be used as a valid tool to measure bullying behaviour in children and adolescents.
Collapse
Affiliation(s)
- Marilena Panagiotou
- Postgraduate Course of Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Charalampopoulou
- Postgraduate Course of Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Flora Bacopoulou
- University Research Institute of Maternal and Child Health & Precision Medicine and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Ioanna Maria Velegraki
- Postgraduate Course of Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioulia Kokka
- Postgraduate Course of Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Vlachakis
- University Research Institute of Maternal and Child Health & Precision Medicine and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece.,Laboratory of Genetics, Department of Biotechnology, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece.,Lab of Molecular Endocrinology, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - George P Chrousos
- University Research Institute of Maternal and Child Health & Precision Medicine and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Christina Darviri
- Postgraduate Course of Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
11
|
Sofianopoulou K, Bacopoulou F, Vlachakis D, Kokka I, Alexopoulos E, Varvogli L, Chrousos GP, Darviri C. Stress Management in Elementary School Students: a Pilot Randomised Controlled Trial. ACTA ACUST UNITED AC 2021; 26. [PMID: 34621631 PMCID: PMC8494420 DOI: 10.14806/ej.26.1.976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Research has shown that stress experiences begin in early stages of life. Stress management techniques have appeared to be beneficial for the development or enhancement of stress coping skills. The aim of this pilot randomised controlled trial was to assess the effect of a 12-week intervention, comprising training in diaphragmatic breathing and progressive muscular relaxation, on elementary school students’ stress levels. Outcomes on the quality of life and behavioural aspects of the students were also assessed. Standardised questionnaires were administered at baseline and after the 12-week intervention program. Fifty-two children aged 10 to 11 years were randomly assigned to intervention (n=24) and control groups (n=28). Children of the intervention group demonstrated lower levels of stress (in all three subscales of lack of well-being, distress, and lack of social support) and improved aspects of quality of life (physical, emotional, and school functioning). No significant differences were observed regarding the examined behavioural dimensions, in the intervention group. Larger randomised controlled trials with follow-up evaluations are needed to ascertain the positive outcomes of such programs on elementary school children.
Collapse
Affiliation(s)
- Katerina Sofianopoulou
- Postgraduate Course of Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Flora Bacopoulou
- University Research Institute of Maternal and Child Health & Precision Medicine and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Dimitrios Vlachakis
- University Research Institute of Maternal and Child Health & Precision Medicine and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece.,Laboratory of Genetics, Department of Biotechnology, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece.,Lab of Molecular Endocrinology, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Ioulia Kokka
- Postgraduate Course of Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Evaggelos Alexopoulos
- Postgraduate Course of Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Liza Varvogli
- Postgraduate Course of Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - George P Chrousos
- University Research Institute of Maternal and Child Health & Precision Medicine and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Christina Darviri
- Postgraduate Course of Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
12
|
A Systematic Review of Self-Reported Stress Questionnaires in People on the Autism Spectrum. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021; 10:295-318. [PMID: 34603935 PMCID: PMC8475841 DOI: 10.1007/s40489-021-00293-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 09/08/2021] [Indexed: 10/26/2022]
Abstract
Background The goal of this systematic review was to provide an overview of self-report measures of stress in populations on the autism spectrum. In addition, information regarding psychometric properties was discussed as well. Methods Four databases were systematically searched following the PRISMA guidelines and using strict eligibility criteria. Risk of bias assessment was performed using the COSMIN checklist. Results Eight questionnaires were previously used in populations on the autism spectrum, reported over 31 studies. Discussion Future research should focus more on examining psychometric properties of these self-report measures in this population as current evidence is scarce. In addition, it is important to consider which concept of stress one aims to measure as not all questionnaires cover the same aspects of stress. Supplementary Information The online version contains supplementary material available at 10.1007/s40489-021-00293-4.
Collapse
|
13
|
Do B, Mason TB, Yi L, Yang CH, Dunton GF. Momentary associations between stress and physical activity among children using ecological momentary assessment. PSYCHOLOGY OF SPORT AND EXERCISE 2021; 55:101935. [PMID: 33841048 PMCID: PMC8031470 DOI: 10.1016/j.psychsport.2021.101935] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Chronic and acute stress may have a detrimental effect on children's physical activity. Research on stress as a predictor of children's physical activity has mostly focused on stress between children, rather than how children's within-day variation in stress may predict physical activity. The current study assessed the within- and between-effects of stress on subsequent physical activity in three different time windows using ecological momentary assessment (EMA) and accelerometry. Children (N = 190; MBaseline Age =10.1±0.9, 53% female, 56% self-identified Hispanic/Latino) completed six semi-annual assessment bursts across three years. During each burst, participants responded to up to seven (weekend) or three (weekday) randomly prompted EMA surveys on smartphones for seven days and wore a waist-worn accelerometer. Multi-level structural equation modeling examined within- and between-subjects effects of stress as a predictor of children's subsequent moderate-to-vigorous physical activity (MVPA) in the 15, 30, and 60 minutes following the EMA prompt. Latent variables were created for within- and between-subjects stress were comprised of three EMA stress items. Higher than average levels of stress (within-subjects) significantly predicted lower MVPA in the subsequent 15, 30 and 60 minutes (ps < .05). Between-subjects stress was not significantly associated with subsequent MVPA (ps > .05). Results indicate that elevated momentary stress predicts less subsequent MVPA. These findings suggest that within-day fluctuations in stress may be a barrier for children engaging in physical activity. Childhood physical activity promotion and interventions should consider the role of children's stress, aim to reduce the stress children experience throughout the day, and incorporate stress coping strategies.
Collapse
Affiliation(s)
- Bridgette Do
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Tyler B. Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Li Yi
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA, 90089 USA
| | - Chih-Hsiang Yang
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA
| | - Genevieve F. Dunton
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90032, USA
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
| |
Collapse
|
14
|
Naya CH, Zink J, Huh J, Dunton GF, Belcher BR. Examining the same-day relationship between morning cortisol after awakening, perceived stress in the morning, and physical activity in youth. Stress 2021; 24:338-347. [PMID: 32840163 PMCID: PMC7904965 DOI: 10.1080/10253890.2020.1804852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Most children in the United States currently do not meet physical activity (PA) guidelines, and perceived stress is a known barrier against PA. However, most studies have solely focused on the between-subject (BS) association of stress and PA, whereas the within-subject (WS) relationship remains under-studied in children. This limits our understanding of day-level psychosocial factors that influence children's PA engagement. This study assessed the same-day associations of the Morning Cortisol after Awakening (MCA) and morning perceived stress with moderate-to-vigorous physical activity (MVPA) in children using Ecological Momentary Assessment (EMA) methodologies. The analytic sample consisted of 143 children from Los Angeles in the Mothers and Their Children's Health (MATCH) study. Children collected four saliva samples and wore accelerometers to assess MVPA minutes across four days (two weekdays and two weekend days) during each data collection wave. On weekend days, they also answered a mobile phone EMA survey on perceived stress within 1 h of awakening. Data from four assessment waves, each approximately six months apart, were combined and analyzed cross-sectionally. Multilevel modeling, which adjusts for the nested data structure, was used to test the same-day associations of MCA and weekend morning perceived stress with MVPA. On weekend days when morning perceived stress was higher than usual, participants engaged in more MVPA on the same day (β = 0.79, SE = 0.32, p = 0.02), but no association was found between MCA and MVPA. These findings elucidate same-day factors that predict MVPA in children and inform future WS studies on stress and PA.HighlightIt is unknown how stress influences children's daily activity levels. We tested if two types of stress (self-reported and saliva-measured) are related to children's daily activity. We found that self-reported stress is associated with physical activity, but saliva-measured stress is not.
Collapse
Affiliation(s)
- Christine H. Naya
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA
| | - Jennifer Zink
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA
| | - Jimi Huh
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA
| | - Genevieve F. Dunton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA
- Department of Psychology, University of Southern California, SGM 501, 3620 S. McClintock Ave., Los Angeles, CA 90089, USA
| | - Britni R. Belcher
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA
| |
Collapse
|
15
|
Dunton GF, Chu D, Naya CH, Belcher BR, Mason TB. Associations of Mothers' and Children's Stress With Children's Device-Measured Physical Activity and Sedentary Behavior Trajectories Across 3 Years. J Phys Act Health 2021; 18:477-487. [PMID: 33785655 DOI: 10.1123/jpah.2020-0558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/02/2020] [Accepted: 01/04/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Psychological stress has adverse effects on health-related behaviors, yet longitudinal research is lacking. Research examined how children's and mothers' perceived stress are associated with children's physical activity and sedentary behavior trajectories across 3 years. METHODS Mothers and their children (N = 186 dyads; 8-12 y at baseline, 57% Hispanic) completed 6 assessments across 3 years. Children and mothers self-reported perceived stress using the Stress in Children Scale and Perceived Stress Scale, respectively. Children's moderate to vigorous physical activity (MVPA) and sedentary behavior were assessed using accelerometers. Mixed models examined interactions of mothers' and children's perceived stress by time elapsed in the study on children's MVPA and sedentary behavior. RESULTS The perceived stress × time elapsed interactions were significant for children's MVPA and sedentary behavior (Ps < .05). Higher average perceived stress in mothers was associated with greater decreases in children's MVPA and increases in children's sedentary behavior. The child stress × time elapsed interactions was significant for children's MVPA (P < .05) but not sedentary behavior. Higher average perceived stress in children was associated with smaller decreases in children's MVPA. CONCLUSION Interventions to promote physical activity and reduce screen time in children should mitigate the effects of psychological stress, especially among mothers, on these behaviors.
Collapse
|
16
|
Abstract
Studies suggest that the relationship between psychosocial well-being and type 1 diabetes (T1D) is bidirectional, with T1D typically having a negative influence on psychological functioning, which in turn negatively affects the course of T1D. Here, we investigate the potential role of the capacity for mentalizing, or reflective functioning, in children and their mothers in diabetes control. We tested differences in mentalizing as assessed by the Reflective Functioning Scale in two groups of mother-son dyads with good (GDC) versus poor (PDC) diabetes control. Fifty-five boys (8-12 years old) and their mothers were recruited from the Juvenile Diabetes Foundation in Santiago, Chile. The mothers were interviewed with the Parental Development Interview and the children with the Child Attachment Interview, and both were scored for reflective functioning by using the Reflective Functioning Scale. Self-report measures of stress and diabetes outcomes were completed by the mothers and children, and levels of glycated hemoglobin (HbA1c) were assessed as an index of diabetes control. The results showed that both maternal and child reflective functioning were higher in the GDC than the PDC group and were negatively correlated with HbA1c in the total sample. Our findings suggest an important role for mentalizing in diabetes outcomes, but further prospective research is needed.
Collapse
|
17
|
Dunton GF, Chu D, Naya CH, Belcher BR, Mason TB. Longitudinal associations of maternal stress and child stress with child body mass index trajectory. Pediatr Obes 2021; 16:e12724. [PMID: 32881324 DOI: 10.1111/ijpo.12724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 08/10/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Although exposure to stress is common among children and their parents, longitudinal research on the effects of perceived stress on child obesity risk is lacking. This study examined the 3-year longitudinal associations of children and mothers' perceived stress with children's body mass index (BMI). METHODS A sample of 199 mothers and their children (8-12 years at baseline, 56% Hispanic) completed six semi-annual assessments across 3 years with questionnaire-based self-report measures of perceived stress and measured height/weight. Parallel process latent growth curve modelling specified regressions of latent intercept and slope of children's BMI on latent intercepts and slopes for mothers' and children's perceived stress. RESULTS Greater child self-reported perceived stress at baseline predicted greater increase in children's BMI across the six assessments whereas mother self-reported perceived stress at baseline was unrelated to change in child BMI. Baseline child BMI was unrelated to change in children or mothers' perceived stress across the six assessment waves. CONCLUSION Children's own perceptions of stress may play a larger contributing role in BMI progression during middle childhood than their mother's perceived stress levels. These findings underscore the importance of focusing on children's stress-coping strategies for promoting a healthy weight.
Collapse
Affiliation(s)
- Genevieve F Dunton
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
- Department of Psychology, University of Southern California, Los Angeles, California, USA
| | - Daniel Chu
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Christine H Naya
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Britni R Belcher
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Tyler B Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| |
Collapse
|
18
|
Thomas EM, Centeio EE. The Benefits of Yoga in the Classroom: A Mixed-Methods Approach to the Effects of Poses and Breathing and Relaxation Techniques. Int J Yoga 2020; 13:250-254. [PMID: 33343157 PMCID: PMC7735498 DOI: 10.4103/ijoy.ijoy_76_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 03/12/2020] [Accepted: 04/07/2020] [Indexed: 11/04/2022] Open
Abstract
Background Disadvantaged youth in the United States are disproportionately likely to be more sedentary and obese and experience more stress than their counterparts with higher socioeconomic status. Yoga and breathing and relaxation techniques have positive effects on stress levels, physical activity levels, and behavior of school-aged children. Aims Using social cognitive theory to examine behavioral, personal, and environmental factors, the purpose of this pilot study was to examine the multilevel influences of a yoga-based classroom intervention on urban youth. Methods Using a mixed methodological quasi-experimental design, this pilot study included the third grade students (n = 40) at one urban elementary school. A survey contained stress, yoga behavior, and aggression scales. In addition, individual student interviews, a teacher interview, and classroom observations were conducted. Results Paired and independent sample t-tests showed pre/post differences in yoga participation both in and out of school for the intervention participants (P < 0.01). Qualitative analysis revealed three main themes: (1) increased use and enjoyment of yoga techniques, (2) behavioral changes both in/out of school, and (3) impact on personal factors. Conclusions Findings suggest that urban classrooms should include yoga and mindfulness training as it contributes to daily student PA and also can be stress relieving, fun, calming, and easy to perform outside of school.
Collapse
Affiliation(s)
- Erica M Thomas
- Department of Education and Wellness, Elon University, Elon, NC, USA
| | - Erin E Centeio
- Department of Kinesiology and Rehabilitation Science, The University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| |
Collapse
|
19
|
Does transcranial direct current stimulation affect selective visual attention in children with left-sided infantile hemiplegia? A randomized, controlled pilot study. BRAIN IMPAIR 2020. [DOI: 10.1017/brimp.2020.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:Infantile hemiplegia due to brain injury is associated with poor attention span, which critically affects the learning and acquisition of new skills, especially among children with left-sided infantile hemiplegia (LSIH). This study aimed to improve the selective visual attention (SVA) of children with LSIH through transcranial direct current stimulation (tDCS).Methods:A total of 15 children participated in this randomized, double-blinded, pilot study; of them, 10 experienced LSIH, and the remaining 5 were healthy age-matched controls. All the children performed the Computerized Stroop Color-Word Test (CSCWT) at baseline, during the 5th and 10th treatment sessions, and at follow-up. The experimental (n = 5) and control groups (n = 5) received tDCS, while the sham group (n = 5) received placebo tDCS. All three groups received cognitive training on alternate days, for 3 weeks, with the aim to improve SVA.Results:Two-way repeated measures analysis of variance (ANOVA) showed a statistically significant change in the mean scores of CSCWT between time points (baseline, 5th and 10th sessions, and follow-up) within-subject factor, group (experimental, sham) between-subject factor and interaction (time points X group) (p < 0.005). Furthermore, a one-way repeated measures ANOVA showed significant differences between time point (p < 0.005) for the experimental and control group but not the sham group.Conclusion:These pilot results suggest that future research should be conducted with adequate samples to enable conclusions to be drawn.
Collapse
|
20
|
Hoare J, Stein DJ, Heany SJ, Fouche JP, Phillips N, Er S, Myer L, Zar HJ, Horvath S, Levine AJ. Accelerated epigenetic aging in adolescents from low-income households is associated with altered development of brain structures. Metab Brain Dis 2020; 35:1287-1298. [PMID: 32671535 PMCID: PMC7606536 DOI: 10.1007/s11011-020-00589-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 06/23/2020] [Indexed: 10/23/2022]
Abstract
The relationship between cognitive performance, macro and microstructural brain anatomy and accelerated aging as measured by a highly accurate epigenetic biomarker of aging known as the epigenetic clock in healthy adolescents has not been studied. Healthy adolescents enrolled in the Cape Town Adolescent Antiretroviral Cohort Study were studied cross sectionally. The Illumina Infinium Methylation EPIC array was used to generate DNA methylation data from the blood samples of 44 adolescents aged 9 to 12 years old. The epigenetic clock software and method was used to estimate two measures, epigenetic age acceleration residual (AAR) and extrinsic epigenetic age acceleration (EEAA). Each participant underwent neurocognitive testing, T1 structural magnetic resonance imaging (MRI), and diffusion tensor imaging (DTI). Correlation tests were run between the two epigenetic aging measures and 10 cognitive functioning domains, to assess for differences in cognitive performance as epigenetic aging increases. In order to investigate the associations of epigenetic age acceleration on brain structure, we developed stepwise multiple regression models in R (version 3.4.3, 2017) including grey and white matter volumes, cortical thickness, and cortical surface area, as well as DTI measures of white matter microstructural integrity. In addition to negatively affecting two cognitive domains, visual memory (p = .026) and visual spatial acuity (p = .02), epigenetic age acceleration was associated with alterations of brain volumes, cortical thickness, cortical surface areas and abnormalities in neuronal microstructure in a range of regions. Stress was a significant predictor (p = .029) of AAR. Understanding the drivers of epigenetic age acceleration in adolescents could lead to valuable insights into the development of neurocognitive impairment in adolescents.
Collapse
Affiliation(s)
- Jacqueline Hoare
- Department of Psychiatry and Mental Health, University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town, 7925, South Africa.
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town, 7925, South Africa
- SA MRC Unit on Risk & Resilience in Mental Disorders, Cape Town, South Africa
| | - Sarah J Heany
- Department of Psychiatry and Mental Health, University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town, 7925, South Africa
| | - Jean-Paul Fouche
- Department of Psychiatry and Mental Health, University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town, 7925, South Africa
| | - Nicole Phillips
- Department of Psychiatry and Mental Health, University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town, 7925, South Africa
| | - Sebnem Er
- Department of Statistics, University of Cape Town, Rondebosch, Cape Town, South Africa
| | - Landon Myer
- Centre for Infectious Disease Epidemiology and Research, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
- SA Medical Research Council Unit on Child and Adolescent Health, Cape Town, South Africa
| | - Steve Horvath
- Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, 90095, USA
- Biostatistics, School of Public Health, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Andrew J Levine
- SA MRC Unit on Risk & Resilience in Mental Disorders, Cape Town, South Africa
- Department of Neurology, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| |
Collapse
|
21
|
Duberg A, Jutengren G, Hagberg L, Möller M. The effects of a dance intervention on somatic symptoms and emotional distress in adolescent girls: A randomized controlled trial. J Int Med Res 2020; 48:300060520902610. [PMID: 32019389 PMCID: PMC7111017 DOI: 10.1177/0300060520902610] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Objective To investigate whether a dance intervention for adolescent girls reduces stress-related symptoms. Methods This was a randomized controlled trial of an after-school intervention. Participants were 112 girls aged 13 to 18 years with stress-related somatic symptoms and emotional distress. The intervention comprised twice-weekly dance sessions for 8 months with a focus on enjoyment and socialization. A questionnaire was administered at baseline and after 8, 12 and 20 months. Participants rated the frequency with which they had experienced somatic symptoms and emotional distress during the previous 3 months. Results After the intervention, there was a significantly greater reduction in somatic symptoms and emotional distress in the dance intervention group than in the control group. The difference in the mean score change on a 5-point scale was 0.26 (95% confidence interval [CI]: 0.04 to 0.47) for somatic symptoms and 0.30 (95% CI: 0.04 to 0.58) for emotional distress. Conclusion Dance interventions may reduce somatic symptoms and emotional distress in adolescent girls, and may constitute a nonpharmacological complement to school health services. However, continued participation is needed for long-term sustainable results. Additional randomized studies are required to further evaluate the effect of this type of intervention in different settings. This study was registered with ClinicalTrials.gov. Study name: ‘Influencing Adolescent Girls With Creative Dance Twice Weekly’. URL: http: //clinicaltrials.gov/ct2/show/study/NCT01523561. Trial registration number: NCT01523561.
Collapse
Affiliation(s)
- Anna Duberg
- University Health Care Research Center, Region Örebro County, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Göran Jutengren
- School of Health Sciences, University of Borås, Borås, Sweden
| | - Lars Hagberg
- University Health Care Research Center, Region Örebro County, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Margareta Möller
- University Health Care Research Center, Region Örebro County, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| |
Collapse
|
22
|
Effect of a Game-Based Physical Education Program on Physical Fitness and Mental Health in Elementary School Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134883. [PMID: 32645840 PMCID: PMC7370186 DOI: 10.3390/ijerph17134883] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/01/2020] [Accepted: 07/04/2020] [Indexed: 12/19/2022]
Abstract
Promotion of healthy active behaviors should start from early ages, as behaviors learned in youth are more likely to endure. A fundamental body of research in this field focuses on the implementation of programs within physical education (PE), thanks to its favorable characteristics. However, traditional PE based on exercise training and controlling styles seems to have weaker association with students' health benefits. For this reason, the aim of this study was to assess the effects of a game-based PE program on physical fitness and psychological health in schoolchildren aged 10 to 12 years old. A total of 252 students were distributed in experimental (EG, games-centered activities) and control (CG, traditional exercise training activities) groups. The program lasted 6 months. Health-related physical fitness components, psychological wellbeing, self-esteem, stress, and anxiety were assessed before and after the treatment. Both groups increased physical fitness at post-test; however, cardiorespiratory fitness did not improve. No differences were found between the groups at post-test. Our results show that games may be as effective as traditional training methods; yet, they suggest that PE alone may be insufficient for obtaining substantive benefits in cardiorespiratory fitness, regardless of the type of task presented.
Collapse
|
23
|
O’Connor SG, Huh J, Schembre SM, Lopez NV, Dunton GF. The Association of Maternal Perceived Stress With Changes in Their Children's Healthy Eating Index (HEI-2010) Scores Over Time. Ann Behav Med 2019; 53:877-885. [PMID: 30649162 PMCID: PMC6735897 DOI: 10.1093/abm/kay095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Few studies have examined the role of maternal stress in relation to their children's dietary quality and its trajectory over time. PURPOSE The objective of this longitudinal study was to examine the effect of baseline maternal stress on the change in their 8- to 12-year-old children's dietary quality over 1 year. METHODS Mother-child dyads (N = 189) from the greater Los Angeles area participating in the Mothers' and their Children's Health (MATCH) study in 2014-2016 completed assessments at baseline, 6 months, and 12 months. At baseline, mothers (mean age = 41.0 years, standard deviation [SD] = 6.1) completed the 10-item Cohen's Perceived Stress Scale (PSS). At each time point, children (51% female, mean age = 9.6 years, SD = 0.9) completed up to two 24-hr dietary recalls. Dietary data were used to calculate each child's Healthy Eating Index 2010 (HEI-2010) score at each time point. Multilevel models examined the effect of time on the patterns of change in children's HEI-2010 scores over 1 year and the cross-level interaction between baseline maternal PSS score and time on the change in children's HEI-2010 scores. RESULTS On average, there was no significant linear change in child HEI-2010 across 1 year (b = -0.410, p = .586). Controlling for covariates, the rate of change in HEI-2010 differed depending on mother's baseline PSS (i.e., significant cross-level interaction effect) (b = -0.235, p = .035). CONCLUSIONS Our results showed that higher-than-average maternal stress at baseline was associated with greater decline in children's dietary quality over 1 year. Family-based dietary interventions that incorporate maternal stress reduction could have positive effects on children's dietary quality.
Collapse
Affiliation(s)
- Sydney G O’Connor
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Jimi Huh
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Susan M Schembre
- Department of Family and Community Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ
| | - Nanette V Lopez
- Department of Health Sciences, School of Public Health, Northern Arizona University, Flagstaff, AZ
| | - Genevieve F Dunton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| |
Collapse
|
24
|
Forsell C, Gronowitz E, Larsson Y, Kjellberg BM, Friberg P, Mårild S. Four-year outcome of randomly assigned lifestyle treatments in primary care of children with obesity. Acta Paediatr 2019; 108:718-724. [PMID: 30230026 DOI: 10.1111/apa.14583] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 08/28/2018] [Accepted: 09/14/2018] [Indexed: 12/12/2022]
Abstract
AIM To assess the four-year outcome in children with obesity randomised to one of two 12-month lifestyle treatment programmes in primary care. METHODS At baseline, 64 children with obesity aged 8.0-13.0 years were randomised to a treatment programme managed either by a nurse, dietician and physiotherapist (n = 32) or by a nurse and dietician (n = 32). RESULTS From baseline to follow-up, the mean body mass standard deviation score (BMISDS) had decreased by -0.50 [standard deviation (SD) 0.73], p = 0.002, in the nurse, dietician and physiotherapist group (n = 27), by -0.26 (SD 0.73), p = 0.057 in the other group (n = 29); adjusted mean difference was -0.22, 95% confidence interval -0.59; 0.16, p = 0.25. Changes in weight categories did not differ between the groups: both had a change from obesity to normal weight in 1 and to overweight in 6; in the physiotherapist group 1 case of severe obesity changed to obesity. The combined treatment groups (n = 56) had a mean reduction in BMISDS of -0.37 (SD 0.73) and an improved distribution in weight categories, p = 0.015. CONCLUSION After four years, there was no difference in outcome between the treatment options. In the treatment groups combined the number of children with obesity and their adiposity measures were significantly lower.
Collapse
Affiliation(s)
- Christer Forsell
- Paediatric Department; Alingsås Hospital; Västra Götaland Region Sweden
| | - Eva Gronowitz
- Department of Paediatrics; Sahlgrenska Academy at Gothenburg University; Gothenburg Sweden
| | - Yvonne Larsson
- Paediatric Department; Alingsås Hospital; Västra Götaland Region Sweden
| | | | - Peter Friberg
- Department of Physiology; Sahlgrenska Academy at Gothenburg University; Gothenburg Sweden
| | - Staffan Mårild
- Department of Paediatrics; Sahlgrenska Academy at Gothenburg University; Gothenburg Sweden
| |
Collapse
|
25
|
Pryor L, Strandberg-Larsen K, Nybo Andersen AM, Hulvej Rod N, Melchior M. Trajectories of family poverty and children's mental health: Results from the Danish National Birth Cohort. Soc Sci Med 2019; 220:371-378. [DOI: 10.1016/j.socscimed.2018.10.023] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/12/2018] [Accepted: 10/25/2018] [Indexed: 01/20/2023]
|
26
|
Jonsson U, Olsson NC, Coco C, Görling A, Flygare O, Råde A, Chen Q, Berggren S, Tammimies K, Bölte S. Long-term social skills group training for children and adolescents with autism spectrum disorder: a randomized controlled trial. Eur Child Adolesc Psychiatry 2019; 28:189-201. [PMID: 29748736 PMCID: PMC6510850 DOI: 10.1007/s00787-018-1161-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 04/27/2018] [Indexed: 11/14/2022]
Abstract
Social skills group training (SSGT) is widely used for intellectually able children and adolescents with autism spectrum disorder (ASD). Previous studies indicate small to moderate effects on social communication capacities. The duration of most available programs is relatively short, and extended training might lead to further improvement. This randomized controlled trial compared an extended 24-week version of the SSGT program KONTAKT with standard care. The weekly sessions gradually shifted in content from acquisition of new skills to real-world application of the acquired skills. A total of 50 participants with ASD (15 females; 35 males) aged 8-17 years were included. The study was conducted at two child and adolescent psychiatry outpatient units in Sweden. The primary outcome was the Social Responsiveness Scale-Second Edition (SRS-2) rated by parents and blinded teachers. Secondary outcomes included parent- and teacher-rated adaptive behaviors, trainer-rated global functioning and clinical severity, and self-reported child and caregiver stress. Assessments were made at baseline, posttreatment, and at 3-months follow-up. Parent-rated SRS-2 scores indicated large effects posttreatment [- 19.2; 95% CI - 29.9 to - 8.5; p < .001, effect size (ES) = 0.76], which were maintained at follow-up (- 20.7; 95% CI - 31.7 to - 9.7; p < .0001, ES = 0.82). These estimates indicate substantially larger improvement than previously reported for shorter SSGT. However, the effects on teacher-rated SRS-2 and most secondary outcomes did not reach statistical significance. Our results suggest added benefits of extended SSGT training, implying that service providers might reach better results by optimizing the delivery of SSGT.
Collapse
Affiliation(s)
- Ulf Jonsson
- 0000 0004 1937 0626grid.4714.6Pediatric Neuropsychiatry Unit, Department of Women’s and Children’s Health, Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Gävlegatan 22B, SE-11330 Stockholm, Sweden ,0000 0001 2326 2191grid.425979.4Child and Adolescent Psychiatry, BUP-KIND, Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden ,0000 0004 1936 9457grid.8993.bDepartment of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Nora Choque Olsson
- 0000 0004 1937 0626grid.4714.6Pediatric Neuropsychiatry Unit, Department of Women’s and Children’s Health, Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Gävlegatan 22B, SE-11330 Stockholm, Sweden ,0000 0001 2326 2191grid.425979.4Child and Adolescent Psychiatry, BUP-KIND, Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Christina Coco
- 0000 0004 1937 0626grid.4714.6Pediatric Neuropsychiatry Unit, Department of Women’s and Children’s Health, Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Gävlegatan 22B, SE-11330 Stockholm, Sweden ,0000 0001 2326 2191grid.425979.4Child and Adolescent Psychiatry, BUP-KIND, Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Anders Görling
- 0000 0001 2326 2191grid.425979.4Child and Adolescent Psychiatry, BUP-KIND, Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Oskar Flygare
- 0000 0004 1937 0626grid.4714.6Pediatric Neuropsychiatry Unit, Department of Women’s and Children’s Health, Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Gävlegatan 22B, SE-11330 Stockholm, Sweden ,0000 0001 2326 2191grid.425979.4Child and Adolescent Psychiatry, BUP-KIND, Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Anna Råde
- 0000 0004 1937 0626grid.4714.6Pediatric Neuropsychiatry Unit, Department of Women’s and Children’s Health, Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Gävlegatan 22B, SE-11330 Stockholm, Sweden ,0000 0001 2326 2191grid.425979.4Child and Adolescent Psychiatry, BUP-KIND, Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Qi Chen
- 0000 0004 1937 0626grid.4714.6Pediatric Neuropsychiatry Unit, Department of Women’s and Children’s Health, Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Gävlegatan 22B, SE-11330 Stockholm, Sweden ,0000 0004 1937 0626grid.4714.6Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Steve Berggren
- 0000 0004 1937 0626grid.4714.6Pediatric Neuropsychiatry Unit, Department of Women’s and Children’s Health, Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Gävlegatan 22B, SE-11330 Stockholm, Sweden ,0000 0001 2326 2191grid.425979.4Child and Adolescent Psychiatry, BUP-KIND, Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Kristiina Tammimies
- 0000 0004 1937 0626grid.4714.6Pediatric Neuropsychiatry Unit, Department of Women’s and Children’s Health, Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Gävlegatan 22B, SE-11330 Stockholm, Sweden ,0000 0001 2326 2191grid.425979.4Child and Adolescent Psychiatry, BUP-KIND, Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Sven Bölte
- Pediatric Neuropsychiatry Unit, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Gävlegatan 22B, SE-11330, Stockholm, Sweden. .,Child and Adolescent Psychiatry, BUP-KIND, Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden.
| |
Collapse
|
27
|
Wen CKF, Liao Y, Maher JP, Huh J, Belcher BR, Dzubur E, Dunton GF. Relationships among affective states, physical activity, and sedentary behavior in children: Moderation by perceived stress. Health Psychol 2018; 37:904-914. [PMID: 30234349 DOI: 10.1037/hea0000639] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE We examined the acute bidirectional relationships between affective states and moderate-to-vigorous physical activity (MVPA) or sedentary behavior (SB) in children, and whether perceived stress moderates these associations. METHOD A total of 180 children (mean age = 9.6 years, 51.7% female, 53.9% Hispanic) completed a 7-day ecological momentary assessment (EMA) study, where they received 3-7 random prompts per day asking about their current affective states. MVPA and SB during this period were measured by waist-worn accelerometers. Children's and mothers' perceived stress were measured by paper questionnaires. Multilevel models tested the within-person (WP) and between-person (BP) associations of (a) MVPA and SB 30 and 60 min before an EMA prompt with subsequent affective states at the prompt, and (b) affective states at the prompt with MVPA and SB in the subsequent 30 and 60 min after the prompt. Interaction terms were used to assess whether children's and mothers' perceived stress moderated these associations. RESULTS Children reported a higher positive affect after engaging in more MVPA than usual (WP; β = 0.04, SE = 0.02, p < .05) and a lower positive affect after spending more SB than usual (WP; β = -0.02, SE = 0.01, p < .05) in the previous 30 min. Children's affective states were unrelated to time in MVPA and SB within the subsequent 30 min. Parent's perceived stress level attenuated the relationship between children's time spent in MVPA 60 min before a prompt and self-reported positive affect at that prompt (β = -0.01, SE = 0.01, p < .05). CONCLUSIONS MVPA and SB acutely impacted children's psychological well-being, with the benefits of MVPA on positive affect across longer intervals attenuated among children whose mothers had higher perceived stress. (PsycINFO Database Record
Collapse
Affiliation(s)
- Cheng K Fred Wen
- Department or Preventive Medicine, University of Southern California
| | - Yue Liao
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center
| | - Jaclyn P Maher
- Department of Kinesiology, University of North Carolina at Greensboro
| | - Jimi Huh
- Department or Preventive Medicine, University of Southern California
| | - Britni R Belcher
- Department or Preventive Medicine, University of Southern California
| | - Eldin Dzubur
- Center for Outcomes Research and Education, Cedars-Sinai Medical Center
| | | |
Collapse
|
28
|
Emmanouil CC, Pervanidou P, Charmandari E, Darviri C, Chrousos GP. The effectiveness of a health promotion and stress-management intervention program in a sample of obese children and adolescents. Hormones (Athens) 2018; 17:405-413. [PMID: 30099726 DOI: 10.1007/s42000-018-0052-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 05/26/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Our study aimed to evaluate the effectiveness of an 8-week stress management intervention program that included progressive muscle relaxation, diaphragmatic breathing, guided imagery, and cognitive restructuring in obese Greek children and adolescents. DESIGN Thirty-six patients were prospectively recruited to participate in this randomized controlled study. Of these, 16 participants formed the intervention group and 20 participants the control group. Anthropometric measurements and salivary cortisol, determined serially 3 times a day, were assessed at the beginning and at the end of the study. Participants also completed the state-trait anxiety in children questionnaire (STAIC), the stress in children questionnaire (SiC), and the child behavior checklist (CBCL). RESULTS The intervention resulted in a significant reduction of waist-hip ratio (p = 0.008) in the intervention group compared with the control group. Moreover, school performance was improved in the intervention group (p = 0.025), while both the intervention and the control group adopted healthier daily habits (p = 0.020 and 0.011, respectively). However, there was no statistically significant difference between body mass index (BMI) z-score, stress, anxiety, and diurnal patterns in salivary cortisol. CONCLUSIONS The present study supports the effectiveness of stress management intervention programs on waist-hip ratio reduction. Further research is required to investigate biomarkers able to predict and evaluate the effectiveness of stress management intervention programs.
Collapse
Affiliation(s)
- Chrysoula-Christina Emmanouil
- Postgraduate Course Stress Management and Health Promotion, University of Athens Medical School, 4 Soranou Ephessiou Str., GR-115-27, Athens, Greece
| | - Panagiota Pervanidou
- First Department of Pediatrics, University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Evangelia Charmandari
- First Department of Pediatrics, University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Christina Darviri
- Postgraduate Course Stress Management and Health Promotion, University of Athens Medical School, 4 Soranou Ephessiou Str., GR-115-27, Athens, Greece.
| | - George P Chrousos
- Postgraduate Course Stress Management and Health Promotion, University of Athens Medical School, 4 Soranou Ephessiou Str., GR-115-27, Athens, Greece
- First Department of Pediatrics, University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| |
Collapse
|
29
|
Dissing AS, Dich N, Andersen AMN, Lund R, Rod NH. Parental break-ups and stress: roles of age & family structure in 44 509 pre-adolescent children. Eur J Public Health 2018; 27:829-834. [PMID: 28449034 DOI: 10.1093/eurpub/ckx040] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Parental break-up is wide spread, and the effects of parental break-up on children's well-being are known. The evidence regarding child age at break-up and subsequent family arrangements is inconclusive. Aim: to estimate the effects of parental break-up on stress in pre-adolescent children with a specific focus on age at break-up and post-breakup family arrangements. Methods We used data from the Danish National Birth Cohort. Participants included 44 509 children followed from birth to age 11. Stress was self-reported by children at age 11, when the children also reported on parental break-up and post break-up family arrangements. Results Twenty-one percent of the children had experienced a parental break-up at age 11, and those who had experienced parental break-up showed a higher risk of stress (OR:1.72, 95%CI:1.55;1.91) regardless of the child's age at break-up. Children living in a new family with stepparents (OR = 1.63, 95%CI:1.38;1.92), or shared between the parents (OR = 1.48, 95%CI:1.26;1.75) reported higher stress than children of intact families. Single parent families reported markedly higher stress levels than children in intact families (OR = 2.18, 95%CI:1.90;2.50) and all other family types. Children who were satisfied with their living arrangements post-break-up reported the same stress level as children living in intact families (OR = 1.01, 95%CI:0.86;1.18). Conclusion Children who experience parental break-up have higher stress levels, also many years after the break-up, and those living in a single parent household post break-up seem to be most vulnerable. Living arrangements post-breakup should be further investigated as a potential protective factor.
Collapse
Affiliation(s)
- Agnete S Dissing
- The department of Public Health, The University of Copenhagen, Copenhagen, Denmark
| | - Nadya Dich
- The department of Public Health, The University of Copenhagen, Copenhagen, Denmark
| | | | - Rikke Lund
- The department of Public Health, The University of Copenhagen, Copenhagen, Denmark.,Center for Healthy Ageing, The University of Copenhagen, Copenhagen, Denmark.,Danish Aging Research Center, University of Southern Denmark, Aarhus University, Aarhus, Denmark
| | - Naja H Rod
- The department of Public Health, The University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
30
|
Isler B, Mineau M, Hunter B, Callahan S, Gelfman N, Bustos Y, Dovale I, Peterson A, Jason LA. Relationship Themes Present between Parents and Children in Recovery Homes. ALCOHOLISM TREATMENT QUARTERLY 2017; 35:200-212. [PMID: 28839346 DOI: 10.1080/07347324.2017.1317483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Approximately 12.5% of children have a parent with a substance use disorder. These children are likely to experience developmental delays, especially if they are placed into foster care. Oxford House recovery homes provide a useful setting that allows children to live with their parents after treatment for substance use. A sample of parents and their children who lived in Oxford Houses were interviewed, using mixed methods, and the outcomes suggest that Oxford Houses may provide a stable and supportive setting for parents and their children.
Collapse
Affiliation(s)
- Brandon Isler
- Center for Community Research, DePaul University, Chicago, Illinois, USA
| | - Megan Mineau
- Center for Community Research, DePaul University, Chicago, Illinois, USA
| | - Bronwyn Hunter
- Department of Psychology, University of Maryland, Baltimore, Maryland, USA
| | - Sarah Callahan
- Center for Community Research, DePaul University, Chicago, Illinois, USA
| | - Noah Gelfman
- Center for Community Research, DePaul University, Chicago, Illinois, USA
| | - Yvita Bustos
- Center for Community Research, DePaul University, Chicago, Illinois, USA
| | - Isabel Dovale
- Center for Community Research, DePaul University, Chicago, Illinois, USA
| | - Andrew Peterson
- Center for Community Research, DePaul University, Chicago, Illinois, USA
| | - Leonard A Jason
- Center for Community Research, DePaul University, Chicago, Illinois, USA
| |
Collapse
|
31
|
Abstract
BACKGROUND In adults, hypothalamus-pituitary-adrenal (HPA) axis activity shows sexual dimorphism, and this is thought to be a mechanism underlying sex-specific disease incidence. Evidence is scarce on whether these sex differences are also present in childhood. In a meta-analysis, we recently found that basal (non-stimulated) cortisol in saliva and free cortisol in 24-h urine follow sex-specific patterns. We explored whether these findings could be extended with sex differences in HPA axis reactivity. METHODS From inception to January 2016, PubMed and EMBASE.com were searched for studies that assessed HPA axis reactivity in healthy girls and boys aged ≤18 years. Articles were systematically assessed and reported in the categories: (1) diurnal rhythm, (2) cortisol awakening response (CAR), (3) protocolled social stress tests similar or equal to the Trier Social Stress Test for children (TSST-C), (4) pharmacological (ACTH and CRH) stress tests, and (5) miscellaneous stress tests. RESULTS Two independent assessors selected 109 out of 6158 records for full-text screening, of which 81 studies (with a total of 14,591 subjects) were included. Studies showed that girls had a tendency towards a more variable diurnal rhythm (12 out of 29 studies), a higher CAR (8 out of 18 studies), and a stronger cortisol response to social stress tests (9 out of 21 studies). We found no evidence for sex differences in cortisol response after a pharmacological challenge or to miscellaneous stress tests. DISCUSSION Sex differences in HPA axis reactivity appear to be present in childhood, although evidence is not unequivocal. For a better evaluation of sex differences in HPA axis reactivity, standardization of protocols and reports of stress tests is warranted.
Collapse
|
32
|
Choque Olsson N, Flygare O, Coco C, Görling A, Råde A, Chen Q, Lindstedt K, Berggren S, Serlachius E, Jonsson U, Tammimies K, Kjellin L, Bölte S. Social Skills Training for Children and Adolescents With Autism Spectrum Disorder: A Randomized Controlled Trial. J Am Acad Child Adolesc Psychiatry 2017. [PMID: 28647010 DOI: 10.1016/j.jaac.2017.05.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Social skills group training (SSGT) for children and adolescents with autism spectrum disorder (ASD) is widely applied, but effectiveness in real-world practice has not yet been properly evaluated. This study sought to bridge this gap. METHOD This 12-week pragmatic randomized controlled trial of SSGT compared to standard care alone was conducted at 13 child and adolescent psychiatry outpatient units in Sweden. Twelve sessions of manualized SSGT ("KONTAKT") were delivered by regular clinical staff. Participants (N = 296; 88 females and 208 males) were children (n = 172) and adolescents (n = 124) aged 8 to 17 years with ASD without intellectual disability. The primary outcome was the Social Responsiveness Scale rating by parents and blinded teachers. Secondary outcomes included parent- and teacher-rated adaptive behaviors, trainer-rated global functioning and clinical severity, and self-reported child and caregiver stress. Assessments were made at baseline, posttreatment, and 3-month follow-up. Moderator analyses were conducted for age and gender. RESULTS Significant treatment effects on the primary outcome were limited to parent ratings for the adolescent subgroup (posttreatment: -8.3; 95% CI = -14.2 to -1.9; p = .012, effect size [ES] = 0.32; follow-up: -8.6; 95% CI = -15.4 to -1.8; p = .015, ES = 0.33) and females (posttreatment: -8.9; 95% CI = -16.2 to -1.6; p = .019, ES = 0.40). Secondary outcomes indicated moderate effects on adaptive functioning and clinical severity. CONCLUSION SSGT for children and adolescents with ASD in regular mental health services is feasible and safe. However, the modest and inconsistent effects underscore the importance of continued efforts to improve SSGT beyond current standards. CLINICAL TRIAL REGISTRATION INFORMATION Social Skills Group Training ("KONTAKT") for Children and Adolescent With High-functioning Autism Spectrum Disorders; https://clinicaltrials.gov/; NCT01854346.
Collapse
Affiliation(s)
- Nora Choque Olsson
- Center of Neurodevelopmental Disorders (KIND), Neuropsychiatry Unit, Karolinska Institutet, Stockholm, and Child and Adolescent Psychiatry, Center for Psychiatry Research, Stockholm County Council, Stockholm
| | - Oskar Flygare
- Center of Neurodevelopmental Disorders (KIND), Neuropsychiatry Unit, Karolinska Institutet, Stockholm, and Child and Adolescent Psychiatry, Center for Psychiatry Research, Stockholm County Council, Stockholm
| | - Christina Coco
- Center of Neurodevelopmental Disorders (KIND), Neuropsychiatry Unit, Karolinska Institutet, Stockholm, and Child and Adolescent Psychiatry, Center for Psychiatry Research, Stockholm County Council, Stockholm
| | - Anders Görling
- Center of Neurodevelopmental Disorders (KIND), Neuropsychiatry Unit, Karolinska Institutet, Stockholm, and Child and Adolescent Psychiatry, Center for Psychiatry Research, Stockholm County Council, Stockholm
| | - Anna Råde
- Center of Neurodevelopmental Disorders (KIND), Neuropsychiatry Unit, Karolinska Institutet, Stockholm, and Child and Adolescent Psychiatry, Center for Psychiatry Research, Stockholm County Council, Stockholm
| | | | - Katarina Lindstedt
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Steve Berggren
- Center of Neurodevelopmental Disorders (KIND), Neuropsychiatry Unit, Karolinska Institutet, Stockholm, and Child and Adolescent Psychiatry, Center for Psychiatry Research, Stockholm County Council, Stockholm
| | - Eva Serlachius
- Child and Adolescent Psychiatry, Center for Psychiatry Research
| | - Ulf Jonsson
- Center of Neurodevelopmental Disorders (KIND), Neuropsychiatry Unit, Karolinska Institutet, Stockholm, and Child and Adolescent Psychiatry, Center for Psychiatry Research, Stockholm County Council, Stockholm
| | - Kristiina Tammimies
- Center of Neurodevelopmental Disorders (KIND), Neuropsychiatry Unit, Karolinska Institutet, Stockholm, and Child and Adolescent Psychiatry, Center for Psychiatry Research, Stockholm County Council, Stockholm
| | - Lars Kjellin
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Neuropsychiatry Unit, Karolinska Institutet, Stockholm, and Child and Adolescent Psychiatry, Center for Psychiatry Research, Stockholm County Council, Stockholm.
| |
Collapse
|
33
|
Spinal pain and co-occurrence with stress and general well-being among young adolescents: a study within the Danish National Birth Cohort. Eur J Pediatr 2017; 176:807-814. [PMID: 28470441 DOI: 10.1007/s00431-017-2915-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 04/12/2017] [Accepted: 04/20/2017] [Indexed: 12/28/2022]
Abstract
UNLABELLED This study aims to describe the patterns in low back, mid back, and neck pain complaints in young adolescents from the Danish National Birth Cohort (DNBC) and to investigate the co-occurrence of spinal pain and stress and general well-being, respectively. Cross-sectional data from the 11-year follow-up of DNBC were used. As part of a web-based survey, a total of 45,371 young adolescents between 10 and 14 years old completed the Young Spine Questionnaire, the Stress in Children Questionnaire, and a one-item question on general well-being. Associations between spinal pain and, respectively, stress and general well-being were estimated by means of multiple logistic regression models. Almost one fifth of boys and one quarter of girls reported spinal pain. Compared with adolescents who reported no stress, adolescents reporting medium and high values of stress had odds ratios (OR) of 2.19 (95% CI 2.08-2.30) and 4.73 (95% CI 4.28-5.23), respectively, of reporting spinal pain (adjusted for age, gender, and maternal education). Adolescents who reported poor general well-being had an OR of 2.50 (95% CI 2.31-2.72) for reporting spinal pain compared to adolescents with good general well-being. CONCLUSION Spinal pain is a common complaint among young adolescents and co-occurs with stress and poor general well-being. The mutual dependency between the factors remained to be explained. What is Known: • The prevalence of spinal pain increases rapidly during childhood and adolescence, but different measurement instruments result in great variation in the estimates of spinal pain in children and adolescents. • Some studies have shown that different psychosocial measures are associated with spinal pain in children and adolescents. What is New: • Spinal pain, as measured by the newly developed and validated Young Spine Questionnaire, is a common complaint in young adolescents aged 10-14 years. • Spinal pain in young adolescents co-occurs with stress and poor general well-being.
Collapse
|
34
|
Lindfors P, Folkesson Hellstadius L, Östberg V. Perceived stress, recurrent pain, and aggregate salivary cortisol measures in mid-adolescent girls and boys. Scand J Psychol 2017; 58:36-42. [PMID: 28054380 DOI: 10.1111/sjop.12347] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 10/17/2016] [Indexed: 12/16/2022]
Abstract
Measures of perceived stress have been criticized for theoretical inconsistency. However, the validated pressure activation stress scale has been suggested as a theoretically sound alternative. But it is unclear how pressure and activation stress relate to objective and subjective measures including commonly used aggregate cortisol measures and health complaints respectively. Specifically, this study aimed at investigating how pressure and activation stress were related to aggregate salivary cortisol measures and recurrent pain in mid-adolescent girls and boys. Mid-adolescents (119 girls and 56 boys) provided self-reports in questionnaires on activation and pressure stress and recurrent pain (headache, stomach ache, neck/shoulder and back pain). Additionally, adolescents sampled saliva during an ordinary school day: (1) immediately at awakening; (2) 30 minutes after waking up; (3) 60 minutes after waking up, and (4) at 8 p.m. These samples were analyzed for cortisol. Hierarchical regressions showed no statistically significant associations between activation and pressure stress and cortisol, neither for girls nor for boys. However, activation and pressure stress were significantly associated with recurrent pain but only for girls. The findings may relate to subjective and objective measures reflecting distinct aspects of stress-related functioning. However, the study participants included mid-adolescents whose bodily systems are flexible and still relatively unaffected by the strain of their daily stress perceptions. To conclude, the non-significant relationships between activation and pressure stress and commonly used aggregate measures of cortisol adds to the understanding of how perceived stress may relate to physiological functioning in the daily life of adolescents when using such aggregate measures.
Collapse
Affiliation(s)
| | | | - Viveca Östberg
- Stockholm University/Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
35
|
Chen Y, Osika W, Dangardt F, Friberg P. Impact of psychological health on peripheral endothelial function and the HPA-axis activity in healthy adolescents. Atherosclerosis 2017; 261:131-137. [PMID: 28298251 DOI: 10.1016/j.atherosclerosis.2017.03.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 02/09/2017] [Accepted: 03/08/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND AIMS The development of adolescence psychological health over a 3-year period and its relationship to peripheral endothelial function and the hypothalamic-pituitary-adrenal (HPA)-axis activity were examined in a cohort of healthy adolescents in a longitudinal study. METHODS A total of 162 adolescents (94 females) participated in both baseline (mean age 14.5 ± 1 years) and three-year follow-up studies. Psychological health was evaluated by self-report using the Beck Youth Inventories of Emotional and Social Impairment and the psychosomatic problem scale. Peripheral endothelial function was assessed using a peripheral artery tonometry device. The HPA-axis activity measured as cortisol awakening response (CAR) was assessed only at follow-up by collecting two saliva samples, immediately after awakening and 15 min later. Physical activity, smoking and parental education were assessed by questionnaires. RESULTS Adolescents reported increased depression and decreased anger over three years, while only females reported increased psychosomatic complaints. Reduced peripheral endothelial function was associated with high level of anger (β = -0.332, p = 0.018) and disruptive behaviour (β = -0.390, p = 0.006) over three years in males, but not in females, after adjusting for covariates. Blunted cortisol awakening response was associated with high level of anxiety (β = -0.235, p = 0.017), depression (β = -0.203, p = 0.038), anger (β = -0.185, p = 0.048), and low level of self-concept (β = 0.289, p = 0.002) after adjusting for covariates. CONCLUSIONS High level of negative emotions during adolescence may have adverse effects on peripheral endothelial function and the regulation of the HPA-axis activity, while high level of self-concept might be protective.
Collapse
Affiliation(s)
- Yun Chen
- Department of Molecular and Clinical Medicine/Clinical Physiology, The Sahlgrenska Academy and University Hospital, University of Gothenburg, SE 41345 Gothenburg, Sweden.
| | - Walter Osika
- Department of Clinical Neuroscience, Karolinska Institute, SE 17177 Stockholm, Sweden
| | - Frida Dangardt
- Department of Molecular and Clinical Medicine/Clinical Physiology, The Sahlgrenska Academy and University Hospital, University of Gothenburg, SE 41345 Gothenburg, Sweden
| | - Peter Friberg
- Department of Molecular and Clinical Medicine/Clinical Physiology, The Sahlgrenska Academy and University Hospital, University of Gothenburg, SE 41345 Gothenburg, Sweden
| |
Collapse
|
36
|
Centeio EE, Whalen L, Thomas E, Kulik N, McCaughtry N. Using Yoga to Reduce Stress and Bullying Behaviors among Urban Youth. Health (London) 2017. [DOI: 10.4236/health.2017.93029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
37
|
Olsson NC, Tammimies K, Bölte S. Manualized social skills group training for children and adolescents with higher functioning autism spectrum disorder: protocol of a naturalistic multicenter, randomized controlled trial. ACTA ACUST UNITED AC 2015. [DOI: 10.3402/tdp.v3.29825] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
38
|
Dunton GF, Liao Y, Dzubur E, Leventhal AM, Huh J, Gruenewald T, Margolin G, Koprowski C, Tate E, Intille S. Investigating within-day and longitudinal effects of maternal stress on children's physical activity, dietary intake, and body composition: Protocol for the MATCH study. Contemp Clin Trials 2015; 43:142-54. [PMID: 25987483 PMCID: PMC4861058 DOI: 10.1016/j.cct.2015.05.007] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 05/11/2015] [Accepted: 05/13/2015] [Indexed: 10/23/2022]
Abstract
Parental stress is an understudied factor that may compromise parenting practices related to children's dietary intake, physical activity, and obesity. However, studies examining these associations have been subject to methodological limitations, including cross-sectional designs, retrospective measures, a lack of stress biomarkers, and the tendency to overlook momentary etiologic processes occurring within each day. This paper describes the recruitment, data collection, and data analytic protocols for the MATCH (Mothers And Their Children's Health) study, a longitudinal investigation using novel real-time data capture strategies to examine within-day associations of maternal stress with children's physical activity and dietary intake, and how these effects contribute to children's obesity risk. In the MATCH study, 200 mothers and their 8 to 12 year-old children are participating in 6 semi-annual assessment waves across 3 years. At each wave, measures for mother-child dyads include: (a) real-time Ecological Momentary Assessment (EMA) of self-reported daily psychosocial stressors (e.g., work at a job, family demands), feeling stressed, perceived stress, parenting practices, dietary intake, and physical activity with time and location stamps; (b) diurnal salivary cortisol patterns, accelerometer-monitored physical activity, and 24-hour dietary recalls; (c) retrospective questionnaires of sociodemographic, cultural, family, and neighborhood covariates; and (d) height, weight, and waist circumference. Putative within-day and longitudinal effects of maternal stress on children's dietary intake, physical activity, and body composition will be tested through multilevel modeling and latent growth curve models, respectively. The results will inform interventions that help mothers reduce the negative effects of stress on weight-related parenting practices and children's obesity risk.
Collapse
Affiliation(s)
- Genevieve F Dunton
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, 3rd floor, Rm 302E, MC 9239, Los Angeles, CA 90033-9045, USA.
| | - Yue Liao
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, 3rd floor, Rm 302E, MC 9239, Los Angeles, CA 90033-9045, USA
| | - Eldin Dzubur
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, 3rd floor, Rm 302E, MC 9239, Los Angeles, CA 90033-9045, USA
| | - Adam M Leventhal
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, 3rd floor, Rm 302E, MC 9239, Los Angeles, CA 90033-9045, USA
| | - Jimi Huh
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, 3rd floor, Rm 302E, MC 9239, Los Angeles, CA 90033-9045, USA
| | - Tara Gruenewald
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, 3rd floor, Rm 302E, MC 9239, Los Angeles, CA 90033-9045, USA
| | - Gayla Margolin
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, 3rd floor, Rm 302E, MC 9239, Los Angeles, CA 90033-9045, USA
| | - Carol Koprowski
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, 3rd floor, Rm 302E, MC 9239, Los Angeles, CA 90033-9045, USA
| | - Eleanor Tate
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, 3rd floor, Rm 302E, MC 9239, Los Angeles, CA 90033-9045, USA
| | - Stephen Intille
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, 3rd floor, Rm 302E, MC 9239, Los Angeles, CA 90033-9045, USA
| |
Collapse
|
39
|
Cohort Profile: Swedish Twin Study on Prediction and Prevention of Asthma (STOPPA). Twin Res Hum Genet 2015; 18:273-80. [PMID: 25900604 DOI: 10.1017/thg.2015.17] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Asthma is a common childhood disease and several risk factors have been identified; however, the impact of genes and environment is not fully understood. The aim of the Swedish Twin study On Prediction and Prevention of Asthma (STOPPA) is to identify environmental (birth characteristics and early life) and genetic (including epigenetic) factors as determinants for asthmatic disease. Based on the Child and Adolescent Twin Study in Sweden (CATSS) (parental interview at 9 or 12 years, N ~23,900) and an asthma and/or wheezing algorithm, we identified a sample of monozygotic (MZ) and dizygotic (DZ) same-sexed twin pairs. The twin pairs were classified as asthma concordant (ACC), asthma discordant (ADC) and healthy concordant (HCC). A sample of 9- to 14-year-old twins and their parents were invited to participate in a clinical examination. Background characteristics were collected in questionnaires and obtained from the National Health Registers. A clinical examination was performed to test lung function and capacity (spirometry with reversibility test and exhaled nitric oxide) and collect blood (serology and DNA), urine (metabolites), feces (microbiota), and saliva (cortisol). In total, 376 twin pairs (752 individual twins) completed the study, response rate 52%. All participating twins answered the questionnaire and >90% participated in lung function testing, blood-, and saliva sampling. This article describes the design, recruitment, data collection, measures, and background characteristics, as well as ongoing and planned analyses in STOPPA. Potential gains of the study include the identification of biomarkers, the emergence of candidates for drug development, and new leads for prevention of asthma and allergic disease.
Collapse
|
40
|
The Pressure-Activation-Stress scale in relation to ADHD and cortisol. Eur Child Adolesc Psychiatry 2015; 24:153-61. [PMID: 24737123 DOI: 10.1007/s00787-014-0544-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 03/29/2014] [Indexed: 10/25/2022]
Abstract
The Pressure-Activation-Stress (PAS) scale is a self-report questionnaire for children concerning perceived stress. To explore behavioral and physiological correlates, we investigated if scores discriminate between a group prone to perceive high levels of stress [children with attention-deficit/hyperactivity disorder (ADHD)] and a healthy school sample, and if they are associated with diurnal cortisol levels. The PAS scale was filled in at home by children (11-17 years) with clinically confirmed ADHD (n = 102) and non-affected comparisons (n = 146). Saliva samples were collected four times during a regular school day for radioimmunoassay analysis of cortisol. Subtypes and severity of ADHD symptoms were determined using parental rating scales. Children with ADHD scored higher on the PAS scale than a school sample. The PAS scores were similar over ages in the ADHD group while they increased with age in the healthy group. Female sex was associated with higher stress in both groups but no gender interaction was found. No association was found between PAS scores and cortisol levels in neither group. Children in the ADHD group had a lower ratio of cortisol levels/perceived stress on all sampling occasions, built up both by the higher PAS scores and the lower cortisol levels in children with ADHD. The higher PAS scores in children with ADHD support the validity of the scale. The lack of association between PAS scores and diurnal cortisol levels is intriguing and illustrates the complexity of the stress concept. Stress-related fragility seems to accompany ADHD during childhood.
Collapse
|
41
|
Caqueo-Urízar A, Urzúa A, De Munter K. Mental health of indigenous school children in Northern Chile. BMC Psychiatry 2014; 14:11. [PMID: 24438210 PMCID: PMC3898225 DOI: 10.1186/1471-244x-14-11] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 01/15/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anxiety and depressive disorders occur in all stages of life and are the most common childhood disorders. However, only recently has attention been paid to mental health problems in indigenous children and studies of anxiety and depressive disorders in these children are still scarce. This study compares the prevalence of anxiety and depressive symptoms in Aymara and non-Aymara children. Among the Aymara children, the study examines the relations between these symptoms and the degree of involvement with Aymara culture. METHODS We recruited 748 children aged 9 to 15 years from nine schools serving low socioeconomic classes in the city of Arica, in northern Chile. The children were equally divided between boys and girls and 37% of the children were Aymara. To evaluate anxiety and depressive symptoms we used the Stress in Children (SiC) instrument and the Children Depression Inventory-Short version (CDI-S), and used an instrument we developed to assess level of involvement in the Aymara culture. RESULTS There was no significant difference between Aymara and non-Aymara children on any of the instrument scales. Dividing the Aymara children into high-involvement (n = 89) and low-involvement (n = 186) groups, the low-involvement group had significantly higher scores on the Hopelessness subscale of the CDI-S (p = 0.02) and scores of marginally higher significance in overall Anxiety on the SiC (p = 0.06). CONCLUSIONS Although Aymara children have migrated from the high Andean plateau to the city, this migration has not resulted in a greater presence of anxiety and depressive symptoms. Greater involvement with the Aymara culture may be a protective factor against anxiety and depressive symptoms in Aymara children. This point to an additional benefit of maintaining cultural traditions within this population.
Collapse
Affiliation(s)
- Alejandra Caqueo-Urízar
- Departamento de Filosofía y Psicología, Universidad de Tarapacá, Avenida 18 de Septiembre #2222, Arica, Chile
| | - Alfonso Urzúa
- Escuela de Psicología, Universidad Católica del Norte, Avenida Angamos, 0610 Antofagasta, Chile
| | - Koen De Munter
- Departamento de Antropología, Universidad Alberto Hurtado, Cienfuegos 41, Santiago, Chile
| |
Collapse
|
42
|
Child Drawings and Salivary Cortisol in Children Undergoing Preoperative Procedures Associated With Day Surgery. J Perianesth Nurs 2013; 28:361-7. [DOI: 10.1016/j.jopan.2013.05.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 03/25/2013] [Accepted: 05/15/2013] [Indexed: 11/24/2022]
|
43
|
Kaufman-Shriqui V, Werbeloff N, Faroy M, Meiri G, Shahar DR, Fraser D, Novack Y, Bilenko N, Vardi H, Elhadad N, Pietrzak RH, Harpaz-Rotem I. Posttraumatic stress disorder among preschoolers exposed to ongoing missile attacks in the Gaza war. Depress Anxiety 2013; 30:425-31. [PMID: 23620192 DOI: 10.1002/da.22121] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 02/28/2013] [Accepted: 03/17/2013] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The prevalence and manifestation of posttraumatic stress symptoms in young children may differ from that observed in adults. This study examined sociodemographic, familial, and psychosomatic correlates of posttraumatic stress disorder (PTSD) among preschool children and their mothers who had been exposed to ongoing missile attacks in the Gaza war. METHODS One hundred and sixty-seven mothers of preschoolers (aged 4.0-6.5 years) were interviewed regarding PTSD and psychosomatic symptomatology of their children, as well as their own reactions to trauma. RESULTS Fourteen mothers (8.4%) and 35 children (21.0%) screened positive for PTSD. Sociodemographic characteristics were not associated with PTSD among mothers or children. Among children, the only significant risk factor was having a mother with PTSD (OR = 12.22, 95% CI 2.75-54.28). Compared to children who did not screen positive for PTSD, those who did screen positive displayed significantly higher rates of psychosomatic reactions to trauma, most notably constipation or diarrhea (OR = 4.36, 95% CI 1.64-11.60) and headaches (OR = 2.91, 95% CI 1.07-7.94). CONCLUSIONS Results of this study add to the burgeoning literature on child PTSD, emphasizing the important role of maternal anxiety and the psychosomatic reactions associated with exposure to ongoing traumatic experiences in young children.
Collapse
Affiliation(s)
- Vered Kaufman-Shriqui
- Faculty of Health Sciences, Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Michels N, Sioen I, Huybrechts I, Bammann K, Vanaelst B, De Vriendt T, Iacoviello L, Konstabel K, Ahrens W, De Henauw S. Negative life events, emotions and psychological difficulties as determinants of salivary cortisol in Belgian primary school children. Psychoneuroendocrinology 2012; 37:1506-15. [PMID: 22385686 DOI: 10.1016/j.psyneuen.2012.02.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Revised: 01/17/2012] [Accepted: 02/06/2012] [Indexed: 11/18/2022]
Abstract
PURPOSE This paper describes whether children's life events, emotions and psychological difficulties are related to their salivary cortisol patterns and whether this is different between sexes. METHODS In 385 children (5-10 years old) participating in the ChiBS study, salivary cortisol samples were collected when waking up, 30 min and 60 min after wake up and in the evening on two consecutive weekdays. Moreover, data on children's life events, emotions and difficulties were collected. Statistical analysis was done separately for boys and girls by multilevel growth curve modelling with adjustments for age, body mass index, socio-economic status and wake up time. RESULTS In boys and girls with more negative life events during the last three months, the diurnal cortisol slope was steeper (more decline). Boys with higher self-reported happiness showed lower overall, morning and evening cortisol levels. In contrast, the diurnal slope was steeper (more decline) in boys with emotional problems due to higher morning values. In girls, peer problems were associated with lower overall and morning cortisol levels. CONCLUSIONS Children's salivary cortisol patterns were related to some negative life events, emotions and difficulties, although differently in boys and girls. As such, sex-differences in HPA functioning are already present in young children. Most findings support the upregulation of the cortisol response to stress, although lower morning values were found in the presence of peer problems in girls. Future studies should focus on sex differences, positive emotions and the diurnal cortisol slope.
Collapse
Affiliation(s)
- Nathalie Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, B-9000 Ghent, Belgium.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Vanaelst B, De Vriendt T, Huybrechts I, Rinaldi S, De Henauw S. Epidemiological approaches to measure childhood stress. Paediatr Perinat Epidemiol 2012; 26:280-97. [PMID: 22471688 DOI: 10.1111/j.1365-3016.2012.01258.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The prevalence of childhood stress has repeatedly been shown to be high, with 'parental separation' and 'being bullied at school' as the most frequently reported stressors in the child's everyday life. This is quite alarming as children are most vulnerable to the adverse psychological and physiological health consequences of chronic stress exposure. Despite growing research interest in this field over the last years, literature falls short in providing an overview of methods to adequately assess stress in elementary school children (6-12 years old). This review describes questionnaires and interviews, as well as laboratory measurements of cortisol in biological samples (serum, urine, saliva and hair) as stress assessment methods in children, with the emphasis on epidemiological research settings. Major characteristics, strengths and limitations of these methods are established, examples of child-specific stressor questionnaires and interviews are provided and specific recommendations with respect to epidemiological research are formulated. In addition, hair cortisol as a potential biomarker for chronic stress (in children) is discussed more thoroughly. This review is meant to serve as a preliminary guide for health researchers new to this research area by reflecting on theoretical and methodological aspects in childhood stress assessment.
Collapse
Affiliation(s)
- Barbara Vanaelst
- Department of Public Health, Ghent University, University Hospital, De Pintelaan 185, Ghent, Belgium.
| | | | | | | | | |
Collapse
|
46
|
Wennström B, Törnhage CJ, Nasic S, Hedelin H, Bergh I. The perioperative dialogue reduces postoperative stress in children undergoing day surgery as confirmed by salivary cortisol. Paediatr Anaesth 2011; 21:1058-65. [PMID: 21771174 DOI: 10.1111/j.1460-9592.2011.03656.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To evaluate the efficacy of 'the perioperative dialogue (PD)' by analyzing salivary cortisol, in 5- to 11-year-old children undergoing day surgery. BACKGROUND To deal with anxiety prior to investigations and/or procedures, children need to be confident and informed about what is going to happen. Therefore, intervention strategies should be initiated before admission to hospital. METHODS AND MATERIALS Children (n = 93), 79 boys and 14 girls, scheduled for elective day surgery requiring general anesthesia were randomly recruited into three groups: (i) standard perioperative care (n = 31), (ii) standard perioperative care including preoperative information (n = 31), and (iii) the PD (n = 31). Saliva was sampled for cortisol analysis at specific time points during the pre- and perioperative procedures. RESULTS The children who received the PD had significantly lower (P = 0.003) salivary cortisol concentrations postoperatively. Moreover, it continuously decreased during the day of surgery compared with the other two groups (P < 0.01). Among the children who received analgesics, the PD group received significantly less morphine (P = 0.014) related to bodyweight: the mean dose was 0.1 mg·kg(-1) (n = 9) in the control group vs 0.04 mg·kg(-1) (n = 6) in the PD group. Irrespective of group, there was a positive correlation between the children's morphine consumption and salivary cortisol concentration (r = 0.56; P = 0.038). The W-B scale score was higher in the group that received morphine (median = 3 vs median=1; P = 0.001). CONCLUSIONS The PD's caring, continuity, and on-going dialogues were associated with low concentrations of salivary cortisol postoperatively and reduced morphine consumption and thus appears to be a valuable complement to standard perioperative care in children undergoing day surgery.
Collapse
|
47
|
Adam EK, Kumari M. Assessing salivary cortisol in large-scale, epidemiological research. Psychoneuroendocrinology 2009; 34:1423-36. [PMID: 19647372 DOI: 10.1016/j.psyneuen.2009.06.011] [Citation(s) in RCA: 620] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2008] [Revised: 06/01/2009] [Accepted: 06/17/2009] [Indexed: 10/20/2022]
Abstract
Salivary cortisol measures are increasingly being incorporated into large-scale, population-based, or epidemiological research, in which participants are selected to be representative of particular communities or populations of interest, and sample sizes are in the order of hundreds to tens of thousands of participants. These approaches to studying salivary cortisol provide important advantages but pose a set of challenges. The representative nature of sampling, and large samples sizes associated with population-based research offer high generalizability and power, and the ability to examine cortisol functioning in relation to: (a) a wide range of social environments; (b) a diverse array individuals and groups; and (c) a broad set of pre-disease and disease outcomes. The greater importance of high response rates (to maintain generalizability) and higher costs associated with this type of large-scale research, however, requires special adaptations of existing ambulatory cortisol protocols. These include: using the most efficient sample collection protocol possible that still adequately address the specific cortisol-related questions at hand, and ensuring the highest possible response and compliance rates among those individuals invited to participate. Examples of choices made, response rates obtained, and examples of results obtained from existing epidemiological cortisol studies are offered, as are suggestions for the modeling and interpretation of salivary cortisol data obtained in large-scale epidemiological research.
Collapse
Affiliation(s)
- Emma K Adam
- School of Education and Social Policy and Institute for Policy Research, Northwestern University, United States
| | | |
Collapse
|
48
|
Abstract
AIM To develop a new stress scale and use it for investigating impact of ethnicity on perception of stress. SUBJECTS AND METHODS One thousand one hundred and twenty-four students (grades 6-9) from 14 schools filled in a questionnaire at school with questions about age, sex, use of language at home (proxy for cultural background), stress and stressors. Factor analysis and analysis of variance were used to analyze the data. RESULTS Two-stress dimensions were identified, 'pressure'(7 items, Cronbach's alpha 0.862) and 'activation'(4 items, Cronbach's alpha 0.767). Scores on the two scales and a separate 'stress' item were higher in girls and increased with grade. Use of another language than Swedish at home showed a significant effect only for activation, with lower scores in girls. The interaction effect between sex and language was significant for all variables and was due mainly to lower stress in girls using another language than Swedish at home. CONCLUSION This new stress scale has some promising qualities like a condensed format, basis in a specific stress concept and formulated to be as age and culture independent as possible. Immigrant girls seem to perceive less stress than Swedish born girls, which opens up for questions about protective mechanisms.
Collapse
Affiliation(s)
- F Lindblad
- Stress Research Institute, Stockholm University, Stockholm, Sweden.
| | | | | |
Collapse
|