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

Research Review: Grandparental care and child mental health - a systematic review and meta-analysis

BACKGROUND

The number of children residing in grandfamilies is growing worldwide, leading to more research attention on grandparental care over the past decades. Grandparental care can influence child well-being in various forms and the effects vary across contexts. In this systematic review and meta-analysis, we synthesize the evidence on the relation between grandparental care and children's mental health status.

METHODS

We identified 5,745 records from seven databases, among which 38 articles were included for review. Random effects meta-analyses were used to synthesize evidence from eligible studies. We also examined the variability across study and participant characteristics, including study design, recruitment method, child age, child gender, study region, family type, comparison group, and outcome rater.

RESULTS

The meta-analysis consisted of 344,860 children from the included studies, whose average age was 10.29, and of which 51.39% were female. Compared with their counterparts, children being cared for by their grandparents had worse mental health status, including more internalizing problems (d = -0.20, 95% CI [-0.31, -0.09], p = .001), externalizing problems (d = -0.11, 95% CI [-0.21, -0.01], p = .03), overall mental problems (d = -0.37, 95% CI [-0.70, -0.04], p = .03), and poorer socioemotional well-being (d = -0.26, 95% CI [-0.49, -0.03], p = .03). The effects varied by study design and child gender.

CONCLUSIONS

The findings highlight that grandparental care is negatively associated with child mental health outcomes with trivial-to-small effect sizes. More supportive programs and interventions should be delivered to grandfamilies, especially in disadvantaged communities.

Relationship between bedtime, nighttime sleep duration, and anxiety symptoms in preschoolers in China

Background

Sleep problems in preschoolers are becoming increasingly prominent, and the association between sleep status and anxiety symptoms has attracted growing attention. However, studies investigating the relationship between bedtime and nighttime sleep duration in preschoolers and their anxiety symptoms remain scant. We used the large sample data from the Longhua Cohort Study of Children in Shenzhen, China (LCCS) to analyze the association between bedtime and sleep in preschoolers and their anxiety symptoms.

Methods

A cross-sectional study of 69,138 preschoolers in Longhua District, Shenzhen, China was conducted in 2022. Data on sociodemographic characteristics of families, bedtime, nighttime sleep duration of preschoolers, and their anxiety symptoms (measured by the Spence Preschool Children Anxiety Scale) were collected through a structured questionnaire completed by the parents. Using binary logistic regression models, the relationship between bedtime, nighttime sleep duration, and childhood anxiety symptoms was examined.

Results

The bedtimes of preschoolers were concentrated between 21:01-22:00 (52.41%). Among the preschoolers, 38.70% had bedtimes later than 22:00, and 75.49% had insufficient nighttime sleep duration. The positive screening rate for anxiety symptoms among preschoolers was 3.50%. After adjusting for confounding factors using binary logistic regression models, compared with preschoolers with bedtime ≤21:00, The OR (95%CI) values of anxiety in preschoolers with bedtime ≥23:01, 22:01-23:00 and 21:01-22:00 were 2.86 (2.21-3.69), 1.51 (1.27-1.79) and 1.48 (1.26-1.76), respectively. Compared with those with sufficient nighttime sleep duration, the OR (95%CI) of children with nighttime sleep duration less than 9 h was 1.36 (1.23-1.51).

Conclusion

An association exists between bedtime and nighttime sleep duration in preschoolers and their anxiety symptoms. Preschoolers with 21:00 for bedtime and a nighttime sleep duration of 10 h may have lower anxiety symptoms. These findings support the importance of adequate sleep for preventing anxiety symptoms in children.

The relationships between sleep disturbances, resilience and anxiety among preschool children: A three-wave longitudinal study

OBJECTIVE

This study, based on a three-wave longitudinal study, aimed to examine bidirectional relationships between sleep disturbances, resilience and anxiety symptoms among preschool children.

METHODS

In total, 1169 children in the junior class of preschools were investigated three times with an interval of one year, in Anhui Province, China. Children's sleep disturbances, resilience and anxiety symptoms were all assessed in the three-wave surveys. Then, 906 children at baseline (T1), 788 children in the first follow-up study (T2), and 656 children in the second follow-up study (T3) were included in the analysis. Autoregressive cross-lagged modeling analyses were performed to examine bidirectional relationships between sleep disturbances, resilience and anxiety symptoms using Mplus 8.3.

RESULTS

The mean age of the children was 3.6 ± 0.4 years at T1, 4.6 ± 0.4 years at T2, and 5.6 ± 0.4 years at T3, respectively. The results indicated that sleep disturbances at T1 significantly predicted anxiety symptoms at T2 (β = 0.111, P = 0.001); and sleep disturbances at T2 significantly predicted anxiety symptoms at T3 (β = 0.108, P = 0.008). Resilience only at T2 significantly predicted anxiety symptoms at T3 (β = -0.120, P = 0.002). Anxiety symptoms did not significantly predict the two variables (sleep disturbances and resilience) at any wave.

CONCLUSION

This study suggests that more sleep disturbances are longitudinally associated with subsequent high anxiety symptoms; inversely, high resilience will alleviate subsequent anxiety symptoms. These findings highlight the importance that early screening for sleep disturbances and anxiety, and strengthening resilience are beneficial to prevent preschool children from developing higher anxiety symptoms.

Comparison Between High School Youth and College Freshmen Toward Their Psychological Disorders Under the Influence of Sleep Hygiene During COVID-19 Pandemic

OBJECTIVE

Adolescents experience the critical period for physical and psychological growth. Few studies focus on the influence of sleep hygiene on the psychological health of adolescence aging from high school to freshmen year. Also, the influence from the COVID-19 pandemic has a public health significance.

METHODS

A total of 698 students from high schools and colleges were included in the manuscript, and a cross-sectional procedure was conducted, objective to make an epidemiological comparison of the social phobia/depression prevalence, and discuss the effects of potential determinants.

RESULTS

Psychological problems including social phobia and depression were prevalent especially among the high school students, with the female gender showing higher possibilities. Current results also indicated that the association between sleep status and the occurrence of social phobia is most obvious among high school students, while relatively higher MMR risks was found both for high school students showing symptoms of social phobia and college freshmen with depressive symptoms. Moreover, the interaction between social phobia and depression was obvious for both populations.

CONCLUSIONS

Psychological problems including social phobia symptoms and depression are more prevalent among the high school females when compared with their male and freshemen peers. Sgnificant influencial factors for the risk of psychological problems among 2 populations are different, but media multitasking status should be paid attention to for both.