Search Results (86)

Background: Late preterm delivery accounts for approximately 5% of all births. Although there is a growing body of literature recognizing that children born late preterm are at risk for mild neurodevelopmental issues, these children are often excluded from follow-up programs. From a preventive perspective, it could be useful to promote protective factors for child development. Among these, human milk feeding is highly recommended due to its advantages for child health and development. However, there is limited research on the complex interactions between late preterm birth, human milk feeding, and subsequent cognitive and emotional development. This paper aims to explore these interactions. Methods: This study focuses on late preterm children aged 8 to 12 years who are attending school. A trained psychologist conducted assessments of cognitive development using the Wechsler Intelligence Scale for Children-III (WISC-III). Additionally, the family pediatrician gathered neonatal and current growth data, while parents completed the Child Behavior Checklist 6–18 (CBCL) regarding their child’s emotional and behavioral profile. Results: A significant impact of early nutrition on children’s cognitive development was observed, with those fed human or formula milk scoring higher than those in the mixed milk group. Additionally, early feeding, high maternal and low paternal perception of externalizing difficulties significantly predicted children’s cognitive development. Conclusions: The study suggests the potential role of early nutrition and externalizing difficulties in the cognitive development of late preterm children at school age. Therefore, the inclusion of protective factors such as breastfeeding should be encouraged in future research. Full article

Background: The general psychopathology factor (p factor) is central to understanding the shared variance across mental disorders, offering a dimensional alternative to traditional diagnostic models. The early identification of this factor in childhood is key for improving prevention and intervention strategies. This study evaluated the Strengths and Difficulties Questionnaire (SDQ) as a brief measure to assess p factor in children. Methods: A community sample of 284 children, ages 6 to 12, was assessed using parent-reported SDQ and the Child Behavior Checklist (CBCL). Confirmatory Factor Analyses compared two models of psychopathology: a higher-order model and a first-order bifactor model. Results: Results showed that the bifactor model provided a better fit for both instruments, with the SDQ showing particularly strong fit indices. Moreover, SDQ-derived p factor scores were strongly correlated with key CBCL scales, particularly attention and externalizing problems, supporting its concurrent validity. Conclusions: These findings suggest that the SDQ, due to its brevity and psychometric robustness, is a valid alternative to the CBCL for assessing general psychopathology in children. Full article

Recently, cognitive training programs using digital content with visuoperceptual stimulation have been developed and commercialized. In particular, digital intervention content for children with attention deficit hyperactivity disorder (ADHD) has been developed as games, enhancing motivation and accessibility for the target population. Active stimulation is required to elicit positive effects on self-regulation training, including attention control and impulse inhibition, through task-based content. Common forms of stimulation include emotional stimuli, such as praise and encouragement, and economic stimuli based on a self-directed token economy system. Economic stimulation can serve as active reinforcement because the child directly engages as the primary agent within the task content. This study applied and validated a token economy intervention using digital therapeutic content in children with ADHD. Behavioral assessments were conducted using the Comprehensive Attention Test (CAT) and the Korean version of the Child Behavior Checklist (K-CBCL). The developed digital intervention content implemented a user-centered token economy based on points within the program. In the CAT Flanker Task, the experimental group (0.84 ± 0.40) showed significantly higher sensitivity factor scores than the control group (0.72 ± 0.59) after 4 weeks, with a large effect size (F = 4.76, p = 0.038, partial η² = 0.150). Additionally, the rate of change in externalizing behavior scores on the K-CBCL showed a significant difference between the two groups (t = 2.35, p = 0.026, Cohen’s d = 0.860), demonstrating greater improvement in externalizing symptoms in the experimental group than in the control group. Therefore, this study suggests that the participant-centered implementation model using token economy mechanisms in digital intervention content may serve as a novel and effective therapeutic approach for children with ADHD. Full article

Background/Objectives: Emerging evidence suggests the critical role of diet in shaping mental health outcomes, which are increasingly prevalent among children and adolescents worldwide. This study aims to investigate whether the dietary habits of children in the Italian multicenter Piccolipiù birth cohort at four years of age were associated with anxiety and depression symptoms. This analysis was conducted within the framework of the Global burden of disease Lifestyle And mental Disorder (GLAD) Project (DERR2-10.2196/65576). Methods: Data from 1726 children were analyzed. Emotional symptoms were assessed with the Child Behavior Checklist (CBCL), and diet was assessed using a food frequency questionnaire. Sociodemographic data, including per capita income, were also collected. Associations between food intake (grams per day) and clinical anxiety/depression (T-scores > 70) or total symptom scores were examined using univariate and multivariable logistic and robust linear regressions adjusted for sex and income. Results: In 1726 children (median age 4.4 years; 50% female), 3% exhibited clinical anxiety and 2% clinical depression. Higher grain intake was associated with increased odds of clinical anxiety (OR = 1.004; 95% CI: 1.001–1.007), while greater fish consumption reduced odds of clinical depression (OR = 0.946; 95% CI: 0.903–0.992). Vegetable intake was associated with lower anxiety and depression scores. Multivariable analyses confirmed that grain intake is positively associated with anxiety, while fish consumption is inversely associated with depression. Conclusions: Higher intake of vegetables, fruits, and fish may be associated with better emotional health in preschoolers, although effect sizes were modest. Early dietary interventions may offer a practical approach to improving children’s long-term mental health. Longitudinal studies are needed to confirm these associations and clarify underlying mechanisms. Full article

Background: The fetal period is critical for neurodevelopment, with maternal diet emerging as a key environmental factor influencing long-term child health. This study investigated the associations between maternal dietary patterns during pregnancy and neurocognitive and behavioral outcomes in 4-year-old children, with a particular focus on sex-related differences. Methods: We used data from the Piccolipiù Italian birth cohort, including 2006 mother/child pairs. Maternal dietary intake during pregnancy was assessed via a questionnaire and categorized into distinct patterns using Principal Component Analysis (PCA). Child neurodevelopment was evaluated at age 4 using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) and the Child Behavior Checklist (CBCL 1.5–5). Linear and logistic regression models were employed, adjusting for potential confounders and stratifying by child sex. Results: Two major maternal dietary patterns were identified: “Processed and high-fat foods” and “Fresh foods and fish”. Higher maternal adherence to the “Processed and high-fat foods” pattern was associated with increased externalizing behaviors in offspring (β = 0.88; 95%CI 0.28–1.49; p = 0.004). In males, this pattern was associated with an increased clinical risk of Attention Deficit Hyperactivity Disorder (ADHD) (OR (Odds Ratio) = 1.13; 95%CI: 1.02–1.26; p = 0.021). Conclusions: Our findings indicate that maternal consumption of a diet rich in processed and high-fat foods during pregnancy is associated with increased behavioral problems in children, with sex-specific vulnerabilities: slightly higher externalizing behaviors in girls and an increased risk of ADHD in boys. These results underscore the importance of promoting healthy maternal dietary patterns during pregnancy as a targeted early prevention strategy for supporting child neurodevelopment. Full article

This cross-sectional study aims to identify clusters of internalizing and externalizing traits during adolescence using a bottom-up approach. The second aim is to investigate whether the different clusters differ by environmental risk factors and specific epigenetic profiles. A total of 205 adolescents, who had been referred for psychopathology in childhood, were recruited. Behavioral problems were assessed using the Child Behavior Checklist/6–18 (CBCL). Different clusters of psychopathological profiles were analyzed using a Finite mixture model. Differences in environmental risk factors and epigenetic profiles were tested with χ²-tests and Bonferroni-corrected t-tests. Two clusters were identified: a LOW cluster (51% of the sample), characterized by the presence of subclinical mean scores in both internalizing and externalizing problems, and a HIGH cluster (49% of the sample), characterized by high mean scores in both domains. The HIGH cluster had a significantly greater number of perinatal complications and changes in methylation of specific CpG sites of Brain-derived neurotrophic factor, Insulin-like growth factor-2, and Oxytocin receptor, whereas no difference was found for FK506-binding protein 5. Our results confirm the existence of a strong association between early adverse events, DNA methylation, and the presence of behavioral problems and psychopathological traits in adolescence. Full article

Background: Developmental dyslexia (DD) affects reading ability and exacerbates mental health challenges among children. This study examines the relationships between reading ability, depressive symptoms, and internalizing and externalizing behavior problems in Chinese school-age children, focusing on potential mediating effects. Methods: A case–control study was conducted with 44 dyslexic children and 81 controls from Shantou, China. Assessments included phonological processing tasks for reading ability, the Depression Self-Rating Scale for Children (DSRS) for depressive symptoms, and the Child Behavior Checklist/6–18 (CBCL/6–18) for behavior problems. Mediation analyses were performed using the PROCESS macro 4.1 for SPSS. Results: Dyslexic children showed significantly poorer reading ability (all phonological tasks, p < 0.001), higher prevalence of depressive symptoms (40.9% vs. 17.3%, p < 0.01), and greater behavior problems (internalizing and externalizing, both p < 0.001) compared to controls. Both depressive symptoms and behavior problems significantly mediated the effects of reading ability on each other, forming a feedback loop that further impairs reading skills. Externalizing behavior problems showed the strongest mediation effect, explaining up to 33.53% of the relationship between depressive symptoms and reading ability. Conclusions: The study reveals a complex interaction between reading ability, depressive symptoms, and internalizing and externalizing behavior problems in Chinese school-age children, suggesting the need for integrated interventions targeting educational and psychological aspects. Further longitudinal research is needed to clarify causal relationships and refine intervention strategies. Full article

Background/Objectives: Children with above-average cognitive functioning often present complex developmental profiles, combining high cognitive potential with heterogeneous socio-emotional and learning trajectories. Although the cognitive and behavioral characteristics of giftedness have been widely studied in Anglophone countries, evidence remains limited in Southern Europe. This study aimed to investigate the cognitive, academic, and emotional–behavioral profiles of Italian children and adolescents with above-average cognitive functioning, using an inclusive, dimensional approach (IQ > 114). Methods: We analyzed a cross-sectional sample of 331 children and adolescents (ages 2.11–16.5 years), referred for clinical cognitive or behavioral evaluations. Participants were assessed using the WPPSI-III or WISC-IV for cognitive functioning, the MT battery for academic achievement, and the Child Behavior Checklist (CBCL) for emotional and behavioral symptoms. Comparative and correlational analyses were performed across age, gender, and functional domains. A correction for multiple testing was applied using the Benjamini–Hochberg procedure. Results: Gifted participants showed strong verbal comprehension (mean VCI: preschoolers = 118; school-aged = 121) and relative weaknesses in working memory (WM = 106) and processing speed (PS = 109). Males outperformed females in perceptual reasoning (PR = 121 vs. 118; p = 0.032), while females scored higher in processing speed (112 vs. 106; p = 0.021). Difficulties in writing and arithmetic were observed in 47.3% and 41.8% of school-aged participants, respectively. Subclinical internalizing problems were common in preschool and school-aged groups (mean CBCL T = 56.2–56.7). Working memory negatively correlated with total behavioral problems (r = −0.13, p = 0.046). Conclusions: These findings confirm the heterogeneity of gifted profiles and underscore the need for personalized educational and psychological interventions to support both strengths and vulnerabilities in gifted children. Caution is warranted when interpreting these associations, given their modest effect sizes and the exploratory nature of the study. Full article

Objective: This study aimed to investigate the relationship between social media use (SMU) in children diagnosed with major depression (MD) or attention deficit hyperactivity disorder (ADHD) and various psychosocial factors, including familial functioning, parental SMU, and parent-reported internalizing and externalizing symptoms. A healthy control group was included for comparison. Methods: The study included 121 children and adolescents aged 10–18 years (36 with MD, 41 with ADHD, and 44 healthy controls). The Social Media Addiction Scale—Short Form (SMDS) was administered to all participants, while mothers completed the McMaster Family Assessment Scale (FAS), the Social Media Addiction Scale—Adult Form (SMAS-AF), and the Child Behavior Checklist (CBCL). Psychiatric diagnoses were made using the K-SADS-PL DSM-5-T. Correlation and linear regression analyses were used to assess associations among variables. Results: SMU scores were significantly higher in the ADHD group compared to both the depression and control groups. Parental SMU was also higher in the ADHD group. In the depression group, child SMU was significantly associated with internalizing symptoms and impaired family communication. In the ADHD group, child SMU was predicted by poor family problem-solving and communication. Regression analyses showed that internalizing symptoms and family communication predicted SMU in the depression group (R² = 0.335), while family problem-solving and communication predicted SMU in the ADHD group (R² = 0.709). Conclusion: The findings suggest that social media use in children with depression and ADHD is associated with different psychosocial factors. While internalizing symptoms and family communication are more prominent in depressed children, family functioning—particularly problem-solving and communication—plays a larger role in children with ADHD. These results emphasize the need for targeted family-based interventions to mitigate problematic SMU in clinical populations. Full article

Objective: This cross-sectional study examined assumptions about the role of parenting qualities in predicting child problems. Background: Children with ADHD often experience distress, partially linked to less adaptive parenting practices. Our working assumptions are that: parental mindfulness, insecure parent attachment styles, and parental child rejection have a significant impact upon the severity of child problems and therefore should be addressed in parental training. Methods: A total of 122 Israeli parents (55 fathers (Mage = 43.8; SD = 4.01) and 67 mothers (Mage = 41.6; SD = 4.59)) of 75 children with attention deficit hyperactivity disorder (ADHD) (Mage = 8.4; SD = 1.56) completed self-report measures: the Experience of Close Relationships scale (ECR), the Mindfulness Attention Awareness Scale (MAAS), the Parental Acceptance–Rejection Questionnaire (PARQ), and Achenbach Child Behavior Checklist (CBCL). Data were analyzed using descriptive statistics, Pearson correlations, and structural equation modeling (SEM). Results: The key finding was that a latent ‘parental rejection/non-warmth’ factor mediated the relationship between (a) parents’ anxious attachment and child behavior problems, and (b) parental mindfulness and child problems. Parental rejection emerged as the strongest predictor of child difficulties. Conclusions: Parental training for parents of children with ADHD should prioritize reducing rejection while also addressing mindfulness and anxious attachment style to promote child well-being. Clinical Trial Registration: Group training for parents whose children suffer from ADHD and comorbidity using a behavioral-dynamic approach (SPBT). Registered at Veeva Vault. Full article

Background: Schizotypal traits are considered to be clinical and cognitive features of Schizotypal Disorder in children (SDc). These traits are also seen in children and adolescents with high-functioning Autism Spectrum Disorder (ASD). This study examines the influence of schizotypal traits (and their severity) on the capacity of children with ASD to manage emotions, develop relationships with others, and adapt in school and family life. Methods: The Schizotypal traits of 63 children (6–12 years old) with High Functioning ASD were measured by the Melbourne Assessment of Schizotypy in Kids (MASK). Parents and teachers of the participating children completed the Child Behavior Checklist (CBCL) and Teachers’ Report Form (TRF) from the Achenbach System of Empirically Based Assessment and the Aberrant Behavior Checklist (ABC). Results: Overall, the results indicated correlations between the MASK scores and problems recorded by teachers, such as Internalizing problems (i.e., Anxious/Depressed, Withdrawn/Depressed, and Other problems score) according to TRF and Inappropriate speech scores, according to teacher’s ABC scales. Schizotypal traits impact the social, emotional, and behavioral functioning of children with ASD at home and school environments. Conclusions: The assessment of schizotypal traits in children with ASD provides critical information about a child’s functionality and cognitive development, also leading to the identification of potential cognitive-neuropsychological endophenotypes within ASD with characteristics of both Autism and Schizophrenia spectra. Τhe development of a valid assessment tool is required, as well as the design of targeted interventions to prevent the loss of functionality. Full article

In Colombia and Mexico, an increase in emotional, behavioral, and eating problems in adolescents has been documented after the pandemic. The objective was to characterize the relationship between internalizing and externalizing behaviors in adolescents with eating disorders in Colombia and Mexico according to the adolescents’ self-report and the parents’ report. In Colombia, 17 adolescents between 12 and 18 years old (M = 15.4; SD = 1.8) and one of their parents (n = 17); in Mexico, 8 adolescents between 12 and 17 years old (M = 14.6; SD = 1.6) and one of their parents (n = 8) were evaluated. The parents completed the Child Behavior Checklist (CBCL), and the adolescents completed the self-report (YSR) and the EAT-26. The analyses showed a statistically significant correlation between eating problems and anxiety/depression of the YSR (r = 0.39; p = 0.031). Statistically significant differences (p < 0.05) were found in the CBCL scores for externalizing problems, somatic complaints, and rule-breaking behavior; all scores were higher in the Colombian sample. The findings provided partial support for differences between adolescents with eating disorders and parental reports. A higher percentage of clinical levels was reported by adolescents compared to their parents, except for the anxious/depressive and aggressive behavior subscales. Full article

This cross-sectional study investigates the association between the behavior of children aged 8–12 years old and key factors such as body mass index (BMI), sleep quality, and emotional intelligence (EI). It aims to explore how these variables interrelate and impact children’s overall behavior during a crucial developmental stage. A sample of children was assessed using standardized measures for BMI, sleep quality, and emotional intelligence (EI), while their behaviors were evaluated using behavioral scales. Statistical analyses were conducted to determine significant associations between these factors. For the data collection, we used sociodemographic questionnaire and the family affluence scale (FAS), and for the evaluation of sleep quality, we used the Children’s Sleep Habits Questionnaire (CSHQ). Moreover, the Trait Emotional Intelligence Questionnaire—Child Short Form (TEIQue-CSF) and Child Behavior Checklist (CBCL) were used for the evaluation of emotional intelligence and behavior. The findings reveal noteworthy correlations between high BMI, poor sleep quality, and lower emotional intelligence with certain behavioral challenges, including emotional regulation and social interaction difficulties. The study underscores the importance of addressing these factors to support the healthy psychological and physical development of children. Further research is suggested to explore potential interventions. Full article

Background: This study aimed to investigate the effects of allogeneic hematopoietic stem cell transplantation (HSCT) on quality of life and behavioral problems in children diagnosed with leukemia and β-thalassemia major, with a focus on post-transplant diagnosis-specific differences in psychosocial adjustment. Method: This study included 112 children (63 children with acute leukemia, 49 children with β-thalassemia major) aged 6–18 years, along with a control group of 30 healthy children within the same age range. The Pediatric Quality of Life Inventory (PedsQL) and the Child Behavior Checklist for Ages 6–18 (CBCL) were administered. Participants were categorized into five groups, and the outcomes were compared accordingly. Results: The emotional functioning subscale scores of the PedsQL were significantly lower in children with leukemia and those who had undergone HSCT for leukemia, when compared to children with thalassemia (p < 0.05). The social functioning subscale scores were also significantly lower in children with leukemia who underwent HSCT compared to those with thalassemia (p < 0.05). The CBCL internalizing scores were higher in children with leukemia and post-HSCT leukemia patients than in their healthy peers (p < 0.05). Over time, both diagnostic groups showed improvements, with total PedsQL scores increasing and total CBCL scores decreasing after HSCT. Conclusions: This study demonstrates that quality of life improved and behavioral problems diminished over time following HSCT. However, the psychosocial impact of HSCT varied depending on the underlying disease, with children diagnosed with leukemia being slightly more adversely affected. These findings suggest that interventions aimed at improving quality of life and addressing behavioral issues should be tailored to the specific diagnosis. Full article

Background/Objectives: Internalizing and externalizing problems have been associated with sensory processing (SP) alteration, where severe alterations are equivalent to sensory processing disorder (SPD). This study aims to examine the relationship between childhood problems and the degree of SP alteration in children referred to a child mental health center (CMHC). Methods: The study included sixty-four children (44 boys and 20 girls), aged 6 to 8 years, referred to a CMHC in Gipuzkoa, Spain. Parents completed the Child Behavior Checklist (CBCL/6–18) and the Child Sensory Profile (CSP-2). Analyses of variance and qualitative analyses were conducted to compare T-scores of childhood problems across SP alteration groups (no alteration, mild, moderate, and severe). Results: Of the participants, 31.3% (n = 20) exhibited a severe SP alteration and obtained significantly higher scores than those without SP alteration on the Withdrawn/Depressed and Attention, Social, and Thought Problems syndrome scales, as well as on the Internalizing Problems and Total Problems scales. Furthermore, children with severe SP alteration scored within the clinical range on the Anxious/Depressed and Attention Problems scales. Mean scores for Internalizing, Externalizing and Total Problems reached the clinical threshold when the SP alteration was classified as moderate or severe. These findings indicate that SP alteration is associated with increased internalizing and externalizing problems in children referred to the CMHC, with clinical levels observed particularly in cases of moderate to severe SP alteration. Conclusions: This study highlights the importance of including SP assessment in the diagnostic evaluation of childhood mental health problems. Full article