Parental Stress of Preschool Children With Generalized Anxiety or Oppositional Defiant Disorder

Behaviour Concerns in Preschool Cardiac Surgery Survivors

Background

Behaviour concerns (BC) are reported in survivors of complex cardiac surgery (CCSx) with inconsistent evidence about health and demographic variables that impact outcomes.

Methods

A prospective inception-cohort study of infants (without known chromosomal abnormalities) after CCSx from 2001 to 2017 determined Behaviour Assessment System for Children (BASC-II/III) parent rating scales at 4.5 years. T scores ≥60 for externalizing, internalizing, and the Behavioural Symptoms Index and ≤40 for adaptive behaviour defined BC. Potential predictive variables included demographic, acute care, and health factors after initial CCSx. Multiple logistic regression using the purposeful selection method gave odds ratios (ORs) with 95% confidence intervals (CIs).

Results

Survivors (n = 585; 61% boys, 40% single ventricle) were assessed at a median age of 55 months (interquartile range: 53, 57 months). Independent predictors were noncardiac hospitalizations (OR: 1.10, 95% CI: 1.02, 1.19; P = 0.015) for externalizing; noncardiac hospitalizations (OR: 1.14, 95% CI: 1.05, 1.24; P = 0.003), female sex (OR: 1.62, 95% CI: 1.04, 2.52; P = 0.031), and single ventricle (OR: 1.82, 95% CI: 1.04, 3.17; P = 0.035) for internalizing; noncardiac hospitalizations (OR: 1.10, 95% CI: 1.02, 1.19; P = 0.017), socioeconomic status (SES) (OR: 0.98, 95% CI: 0.96, 0.10; P = 0.031), and years of maternal schooling (OR: 0.91, 95% CI: 0.84, 0.10; P = 0.04) for adaptive; and extracorporeal life-saving support (OR: 2.03, 95% CI: 1.01, 3.96; P = 0.041) for the Behavioural Symptoms Index, indicating more pervasive behaviours.

Conclusions

The number of noncardiac hospitalizations predicted increased odds of BC and requires further attention. Improving inpatient trauma-informed care experiences and optimizing access to primary care to prevent noncardiac hospitalization may be modifiable.

Association of Affiliate Stigma with Parenting Stress and Its Moderators among Caregivers of Children with Attention-Deficit/Hyperactivity Disorder

Caring for children with attention-deficit/hyperactivity disorder (CADHD) is stressful for caregivers. Identifying factors related to parenting stress in caregivers of CADHD can facilitate the development of intervention programs. This study aimed to examine the associations between affiliate stigma and various domains of parenting stress among caregivers of CADHD. This study also analyzed the moderating effects of demographic characteristics and the symptoms of childhood ADHD and oppositional defiant disorder (ODD) on the associations between affiliate stigma and parenting stress. In total, 213 caregivers of CADHD participated in this study. Parenting stress was assessed using the Parenting Stress Index, Fourth Edition Short Form (PSI-4-SF). Affiliate stigma was assessed using the Affiliate Stigma Scale. ADHD and ODD symptoms were assessed using the Parent Form of the Swanson, Nolan, and Pelham Scale, Version IV. The results indicated that higher affiliate stigma was significantly associated with greater parenting stress in all three domains of the PSI-4-SF. ODD symptoms increased the magnitude of parenting stress in two domains of parenting stress among caregivers with affiliate stigma. Intervention programs for relieving parenting stress among caregivers of CADHD should take affiliate stigma and child ODD symptoms into consideration.

Mood and Emotional Changes After PEERS® Program in Parents of Young Adults With Autism Spectrum Disorder

Objectives

This study examined the changes in anxiety and depressive symptoms in the parents of Korean adults with autism spectrum disorder (ASD) after participating in the Korean version of the Program for the Education and Enrichment of Relational Skills for Young Adults (PEERS^®-YA-K).

Methods

Forty-six parents were enrolled (mean age 54.7 years; 22 fathers and 24 mothers), of whom 27 participated in the PEERS^®- YA-K as social coaches. Participants completed self-report scales, including the Test of Young Adult Social Skills Knowledge (TYASSK), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Symptom Check-List-90-R (SCL-90-R). The scales were administered three times: before and after the 16-week program and 4 months after the program ended. Differences between participant variables at pretreatment, post-treatment, and follow-up were analyzed using paired-sample t-tests.

Results

Participants showed a significant improvement in their social skills knowledge (TYASSK) (p<0.01). There was a significant improvement in the BAI and BDI scores of parents with severe depressive and anxiety symptoms at the baseline (p<0.05). Paternal paranoia and maternal hostility results also significantly improved on the SCL-90-R.

Conclusion

This study suggests that PEERS^®-YA-K can reduce parental anxiety and depressive symptoms. To the best of our knowledge, this is the first to compare the degree of depression and anxiety after PEERS^®-YA-K in parents of adults with ASD.

Unraveling the Relationship between Sleep Problems, Emotional Behavior Disorders, and Stressful Life Events in Preschool Children

Objectives: The aims of this study were to: (1) explore sleep problems in preschool children with generalized anxiety disorder (GAD), selective mutism (SM), and oppositional defiant disorder (ODD) and (2) examine the relationship between stressful life events, sleep problems, and emotional behavior disorders in preschoolers. Methods: The parents of 213 preschool children with SM, GAD, ODD, and TD (typical development, age range 2–6 years) completed the Children’s Sleep Habits Questionnaire (CSHQ), the Coddington Life Events Scale, preschool version (CLES-P), and the CBCL 1½–5. Results: Eighty-three subjects reported sleep problems before the age of 2 years. Seventy-five children (86.14%) with a clinical diagnosis and eight children with TD (8.4%) exceeded the threshold level on the CSHQ. For the bedtime resistance (p = 0.042) and sleep duration subscales (p = 0.038), the SM group had significantly higher scores in comparison to the ODD group. The same pattern was also true for the sleep onset (p = 0.024) and sleep anxiety subscales (p = 0.019). The linear regression analysis model showed that the impact of stressful life events and internalizing problems could predict sleep habits in children. Conclusions: Emotional behavior disorders and stress factors should be regularly investigated in children who are referred to clinics for sleep problems. Clinicians should consider how these symptoms may exacerbate sleep problems and/or interfere with treatment.

Behavioral gender differences across Pre-School Children with Autism Spectrum Disorders: a cross-sectional study

There is increasing literature showing that the presentation of Autism Spectrum Disorder (ASD) could be different according to the sex of the patient. Through the analysis of the Autism Diagnostic Interview Revised interview results of a study group consisting of 56 preschool children diagnosed with ASD potential differences in the presentation of ASD were searched. Variables investigated were verbal abilities, the presence/absence of unusual sensory interests, as well as of echolalia. The results showed significant differences between gender in restricted and repetitive behavior (p < 0.01), in particular for those children who have no unusual sensory interest (p < 0.05) and with minimal verbal ability (p < 0.05). The findings contribute providing evidences on phenotypical differences in preschool children with a diagnosis of Autism Spectrum Disorder.

Association Between Family Structure and Anxiety Disorder Among Pre-schoolers: A Cross-Sectional Study in Urban Chongqing, China

Objective: This study explores the current situation of anxiety disorder of pre-schoolers and assesses the association between family structure and anxiety disorder (AD) among pre-schoolers in Chongqing, China. Methods: This is a cross-sectional study of 499 main fosterers of children aged 3-6 years who completed the 28-item Chinese version of the Spence Pre-school Anxiety Scale (PAS). Multinomial logistic regression with three models was used to assess the association of the family structure with the different AD. Results: The prevalence of AD was 31.46%, whose score of PAS were more than 48. Among the five different PAS sub-scales, the prevalence of obsessive-compulsive disorder (OCD) was the highest (50.10%), followed by separation anxiety disorder (SAD, 39.28%), fear of physical harm (FPH, 37.68%), generalized anxiety disorder (GAD, 33.47%), and social phobia (SP, 25.85%). Pre-schoolers from inter-generational families were more probably have AD than those from nuclear families (OR = 3.73, p < 0.05). The participants from inter-generational families were more likely to have SAD (OR = 3.39, p < 0.05), FPM (OR = 2.80, p < 0.05), or OCD (OR = 2.40, p < 0.05), in comparison with participants from other family structures. Conclusion: Anxiety disorder among pre-schoolers aged 3-6 in Chongqing is widespread. Pre-schoolers from inter-generational families were more probably have AD, SAD, FPM, and OR and pre-schoolers from stem families may be less likely to have SAD compared with those from nuclear families. Relieving the anxiety of pre-schoolers may be possible with additional interventional efforts in inter-generational families.

Criterion Validity and Reliability of SF-12 Health Survey Version 2 (SF-12v2) in a Student Population during COVID-19 Pandemic: A Cross-Sectional Study

OBJECTIVE

The novel coronavirus SARS-CoV-2, responsible for the COVID-19 pandemic, led to strict domestic quarantine, social isolation policies, and consequently significant psycho-emotional and lifestyle changes. The individual and societal fear and anxiety cause significant stress affecting health-related quality of life (HRQOL). There is evidence of the psychological and mental health effects of the current pandemic on students, who are known to be a vulnerable population. A decrease in physical activity was reported among students, and it is known to contribute to stress levels, which is strongly associated with HRQOL. This study is aimed at evaluating the validity and reliability of SF-12 Health Survey version 2 (SF-12v2) in the assessment of self-perceived quality of life of Italian students following lifestyle changes due to the outbreak of COVID-19.

METHODS

A cross-sectional study was conducted with university students attending the faculty of Medicine and Surgery or Health Professions. The Physical Component Summary (PCS12) and the Mental Component Summary (MCS12) of SF-12v2 were compared to the Perceived Stress Scale (PSS). Internal consistency was examined using Cronbach's Alpha Coefficient. Concurrent validity was evaluated comparing SF-12v2 values to PSS scores, and the Pearson Correlation Coefficient (PCC) was calculated. Cross-cultural validity was investigated through several analyses for correlations between SF-12v2 scores and the gender of participants, University of Italy, body mass index (BMI), and time spent sitting and exercising.

RESULTS

The SF-12v2 questionnaire was administered to 583 medical and health professionals' students in July 2020. Cronbach's Alpha showed acceptable reliability for PCS12 and MCS12. In line with expectations, PCS12 scores differed by BMI groups, while the MCS12 was associated with PSS score and showed differences between genders, BMI groups, time spent sitting, and time spent exercising.

CONCLUSION

The Italian version of SF-12v2 is a valid and reliable instrument to assess health-related quality of life among medical and health professionals' students.