Individual, Prenatal, Perinatal, and Family Factors for Anxiety Symptoms Among Preschool Children

A parent-report measure of children's anxiety: psychometric properties of the Macquarie Anxiety Behavioural Scale (MABS) in a Chinese sample of preschool children

OBJECTIVE

The Macquarie Anxiety Behavioural Scale (MABS) is a newly developed scale to assess anxiety in children and teenagers. The present study aimed to evaluate the reliability and validity of the Chinese version of the MABS, as well as the measurement invariance across different age groups in a preschool-aged sample.

METHODS

A total of 1007 parents with children aged 3-6 years participated in the study. Internal consistency was assessed by calculating Cronbach's alpha, McDonald's omega and average inter-item correlation values. Confirmatory factor analysis (CFA) was conducted to examine the five-factor model. Multi-group CFA was conducted to test the measurement equivalence across different age groups (3- and 4-year-olds and 5- and 6-year-olds). Convergent, divergent, and criterion-related validity were assessed with Pearson correlation coefficients.

RESULTS

Internal consistency for the MABS total score was good and that of the subscales was acceptable. The CFA results showed that the five-factor structure of the MABS was supported in preschoolers (e.g., CFI = 0.929, TLI = 0.914, RMSEA = 0.050). In addition, scalar invariance of the MABS was supported across different age groups (e.g., ΔCFI = - 0.003, ΔTLI = 0, ΔRMSEA = 0). Furthermore, the MABS showed good convergent and divergent validity as well as criterion-related validity.

CONCLUSION

The Chinese version of the MABS demonstrated satisfactory psychometric properties and appeared to be a valid and reliable instrument for measuring anxiety in preschool children.

Patterns of pediatric and adolescent female genital inflammation in China: an eight-year retrospective study of 49,175 patients in China

Background

Genital inflammation is one of the most frequent clinical complaints among girls, which was easily overlooked by the general public. This study aimed to investigate the patterns and epidemiological characteristics of pediatric and adolescent female genital inflammation in China.

Methods

A retrospective observational study (2011 to 2018) was conducted among all female patients under the age of 0-18 years at the Department of Pediatric and Adolescent Gynecology of The Children's Hospital, Zhejiang University School of Medicine. Data were collected from the electronic medical records. The abnormal vaginal discharge of patient was collected for microbiological investigation by bacterial and fungal culture. Descriptive analysis was conducted to evaluate the genital inflammation pattern and epidemiological characteristics, including age, season, and type of infected pathogens.

Results

A total of 49,175 patients met the eligibility criteria of genital inflammation and 16,320 patients later came to the hospital for follow-up over the study period. The number of first-visit increased gradually from 3,769 in 2011 to 10,155 in 2018. The peak age of the first visit was 0-6 years old. Non-specific vulvovaginitis, lichen sclerosis, and labial adhesion were the top three genital inflammation. Among the top five potential common pathogens of vaginal infection, the prevalence of Haemophilus influenzae cases was the highest (31.42%, 203/646), followed by Streptococcus pyogenes (27.74%, 176/646), Candida albicans (14.09%, 91/646), Escherichia coli (8.51%, 55/646), and Staphylococcus aureus (6.35%, 41/636). The specific disease categories and pathogens of genital inflammation vary by age groups and season.

Conclusion

Our study summarizes the pattern of pediatric and adolescent female genital inflammation over an 8-year period in China, emphasizing the need for more public awareness, healthcare services and research in this field.

Development of psychological resilience and associations with emotional and behavioral health among preschool left-behind children

PURPOSE

This study aimed to explore the development of psychological resilience and its associations with emotional and behavioral health among preschool left-behind children (LBC).

METHODS

LBC in 26 preschools of Fuyang City, Hefei City, and Maanshan City of Anhui Province were included at baseline survey; and baseline children in the junior and middle classes of preschools as targeted samples were recruited for the 1-year follow-up. Multivariable linear regression models were performed to examine associations of psychological resilience with emotional and behavioral health.

RESULTS

In total, 1463 LBC were included at baseline and 568 of the 905 targeted LBC completed the 1-year follow-up. Change patterns of psychological resilience were identified as the stable-high pattern (19.0%), increasing pattern (18.3%), declining pattern (15.9%), and stable-low pattern (46.8%). The results showed that psychological resilience at baseline was positively associated with later dietary behavior habits and prosocial behaviors, and negatively associated with later problematic behaviors and sleep problems. In addition, children with the declining pattern had more problematic behaviors and sleep problems, and fewer prosocial behaviors at follow-up. Children with the increasing pattern and stable-high pattern had more prosocial behaviors, better dietary behavior habits, and fewer problematic behaviors and sleep problems at follow-up.

CONCLUSIONS

The majority of preschool LBC had lower psychological resilience and its level among some LBC changed during the follow-up. Higher psychological resilience was a protective factor for emotional and behavioral health. Timely assessing psychological resilience and then strengthening it are needed to promote the emotional and behavioral health of preschool LBC.

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.