Search Results (262)

The location of mental health services in schools increases access for children and youth. This may be especially important in rural communities, where youth have more significant mental health needs and less access to services. Yet, few studies exist that explore the outcomes of student participation in school-based services. The present study evaluates student behavioral health needs and outcomes, as measured by the strengths and difficulties questionnaire (SDQ), of students (N = 43) participating in therapeutic mental health services (Tier 3) provided in three rural Midwest communities in the United States. At baseline, SDQ scores indicated that over half of students’ total difficulties scores fell in the Borderline or Abnormal categories, and over 40% of students demonstrated high needs related to emotional problems and hyperactivity. At the conclusion of services, students experienced statistically significant improvements in mean scores (compared to baseline) in total difficulties, externalizing problems, and internalizing problems, and on subscales measuring emotional problems, conduct problems, and hyperactivity. Significant differences were not found in the subscales measuring peer problems and prosocial behavior. High levels of satisfaction with services were also reported. Limitations and conclusions are discussed. Full article

Background: Probiotic supplementation for very preterm infants is a common practice in many neonatal units. Assessing the effects of early postnatal exposure to probiotics on long-term neurodevelopment, growth, and atopy-related outcomes is important. Extremely preterm (EP: <28 weeks) infants enrolled in our previously reported randomized trial (SiMPro) comparing short-term effects of single (SS: B. breve M-16V) versus triple-strain (TS: B. breve M-16V, B. longum subsp. infantis-M63, B. longum subsp. longum-BB536) probiotic provided a unique opportunity to study this issue. Methods: This follow-up study assessed the five-year outcomes of SiMPro trial infants, including neurodevelopment (cognition (Full Scale Intelligence Quotient/ FSIQ using WPPSI-IV), behavior (Strengths and Difficulties Questionnaire), executive function (BRIEF–P)), growth (anthropometry) and blood pressure (BP). Atopy-related outcomes were evaluated at six to seven years using the ISAAC questionnaire. A linear mixed model was used for longitudinal outcomes. Impairment indicators were modeled using logistic regression and adjusted for Socio-Economic Indexes for Areas (SEIFA) centiles. Results: Follow-up rates (SS: 89.2% versus TS: 95%), neurodevelopmental outcomes [severe impairment (FSIQ < 70): SS: 7.4% versus TS: 4.3%; p = 0.68], growth, BMI, and BP were comparable between the SS and TS groups. The total difficulty score or BRIEF–P executive indices, disability rates (none: 66.7% versus 55.4%), and atopy-related outcomes were comparable between groups. Conclusions: Both TS and SS Bifidobacterium probiotic formulations were safe, with comparable neurodevelopmental, growth, and atopy-related outcomes at school age. Full article

Background: Foster children exhibit higher rates of psychiatric and physical disorders than children living with their biological families. This places a high burden on the parenting skills of foster parents and potentially increases the risk of placement failure. One possibility to increase foster carers’ parenting skills and to reduce child problems is through parent training. In this study, the feasibility and effectiveness of the German-translated version of Fostering Changes, a parent training programme for foster parents, was investigated. The aims of Fostering Changes are the reduction in child behavioural problems, supporting children’s affect regulation, and improving the quality of the foster parent–child relationship through the promotion of foster parents’ sensitivity and parenting skills. Methods: We conducted six Fostering Changes courses in 2022 and 2023, with a total of 33 foster carers (i.e., foster parents) participating. Child behavioural problems (Carer-Defined Problems Scale; primary outcome), child psychopathology (Strengths and Difficulties Questionnaire), carer–child relationship quality (Child Relationship Behavior Inventory, Quality of Attachment Relationship Questionnaire), foster carers’ stress (Parental Stress Scale), and foster carers’ parenting strategies (Parenting Scale) were assessed at the start (t0) and end of each course (t1) and three months after course completion (t2). To examine the effect of training participation, mixed linear models and generalised estimating equations were applied. Additionally, effect sizes (Cohen’s d) were calculated. Results: When comparing t0 with t1 scores, there was a significant reduction in child behavioural problems (d = 1.87) and child psychopathology (d = 0.70), and improvement in foster carers’ parenting skills (d = 0.76) and the quality of the foster parent–child relationship (CRBI: d = 0.77, QUARQ: d = 0.72). Effect sizes for changes in the abovementioned variables between t0 and t2 were also moderate to large, with the exception of child psychopathology (d = 0.44). Conclusions: The results of this feasibility study, which is the first trial of Fostering Changes outside the UK, suggest that the German version of Fostering Changes could be an effective intervention for foster families. The largely comparable results for the periods t0–t1 and t0–t2 suggest constancy of the observed changes three months after course completion. Trial registration: DRKS-ID: DRKS00029014; date of registration: 23 May 2022. Full article

Background/Objectives: Emotional and behavioral difficulties are common during adolescence and have lasting implications for well-being. Although several psychological resources—such as self-efficacy, mindfulness, and reflective functioning—have been individually linked to better adjustment, less is known about how these strengths jointly relate to perceived stress, difficulties, and health-related quality of life (HRQoL). This study aimed to develop and test an integrative structural model capturing the interplay of these factors during early and mid-adolescence. Methods: A cross-sectional online survey was conducted among 395 adolescents (222 girls, 173 boys; aged 10–16 years) who completed self-report questionnaires assessing HRQoL (KIDSCREEN-10), emotional–behavioral difficulties (SDQ), perceived stress (PSS), self-efficacy (GSE), mindfulness (CAMM), and reflective functioning (RFQY-5). After descriptive analyses and correlation testing, the structural path model using observed variables examined how these variables were interrelated. Multi-group analyses assessed whether structural pathways were invariant across gender and age groups. Results: Mindfulness, self-efficacy, and reflective functioning were each indirectly associated with better HRQoL, mainly through lower perceived stress and fewer emotional–behavioral difficulties. Perceived stress showed a strong positive association with difficulties, and both constructs uniquely predicted lower HRQoL. The overall pattern of associations was fully consistent across age and broadly comparable across gender. Conclusions: The findings highlight the interconnected role of psychological resources, stress, and emotional–behavioral difficulties in adolescents’ well-being. However, the cross-sectional design, convenience sampling, reliance on self-report measures, and single-country sample limit the generalizability and causal interpretation of the results. The robustness of these pathways across age and their broad comparability across gender underscore their developmental relevance and suggest that programs aimed at strengthening socio-emotional competences may be meaningfully applied to support adolescents’ well-being already from early adolescence. Full article

Young people in residential care settings tend to present a heightened risk of emotional and behavioral problems. This study intended to explore connections between Dark Triad personality traits and psychological adjustment and to investigate potential sex and age differences in psychological adjustment and the expression of Dark Triad traits. Primary data were collected from a sample of 511 youth (279 girls and 232 boys) aged between 12 and 24 years, living in 46 Portuguese residential care institutions. Self-report questionnaires (Strengths and Difficulties Questionnaire, Short Dark Triad) were used to collect the primary data. Statistical methods were used such as analysis of variance, multivariate analysis of variance, and hierarchical regression analysis. Results showed that boys scored higher in all Dark Triad traits and in behavioral problems. Younger participants scored higher in Machiavellianism and Psychopathy, in emotional and behavioral problems, and in hyperactivity/inattention difficulties. These results could help institutional professionals and social policies assess and delineate individual programs. Full article

The current investigation examines pathways linking individual risk factors, namely maladaptive emotion regulation, behavior problems, and drinking motives, with adolescents’ alcohol consumption. In a cross-sectional design, 243 adolescents attending secondary school in Germany completed questionnaires. The Cognitive Emotion Regulation Questionnaire was used to assess maladaptive emotion regulation, the Strengths and Difficulties Questionnaire for assessing internalizing and externalizing behaviors, and the Drinking Motives Questionnaire Revised for assessing the four drinking motives, namely social, enhancement, coping, and conformity motives. Adolescents also reported their daily and problematic alcohol consumption. The path analysis revealed that maladaptive emotion regulation was positively associated with both internalizing and externalizing problems, and all four drinking motives. Externalizing problems were positively associated with adolescents’ enhancement and coping motives, and their alcohol consumption. Internalizing problems were only negatively associated with enhancement motives. Only coping motives were positively associated with alcohol consumption. Moreover, maladaptive emotion regulation had an indirect effect on alcohol consumption, via externalizing problems and coping motives. The findings emphasize the interactions between the risk factors in contributing to adolescent alcohol consumption, underscoring the importance of targeting emotion regulation and coping motives in substance use prevention efforts prior and during adolescence. Full article

Young people in residential care settings hold distinct preferences regarding their relationships with key adults, including caseworkers and caregivers. However, their perspectives are not consistently assessed or effectively integrated into case planning. Evaluating this integration is essential for fostering positive adjustment and placement stability. Given that residential care represents the predominant child welfare intervention in Portugal, this study adapts and validates an existing instrument for use with youth in residential care institutions, providing evidence of its validity and reliability. Self-report questionnaires—the Positive Residential Care Integration (PRCI) scale (an adapted Positive Home Integration scale) and Strengths and Difficulties Questionnaire—were administered to 511 youth (279 girls and 232 boys), aged 12 to 24 years, across 46 Portuguese residential care institutions. The study examined the face validity, discriminant validity, and reliability of the PRCI scale. Confirmatory factor analysis indicated good model fit, supporting a unidimensional six-item structure. Correlation analyses demonstrated associations with psychological adjustment and sociodemographic variables. The PRCI scale showed satisfactory psychometric properties, confirming its reliability for assessing youth integration in residential care. Cross-gender measurement invariance was also confirmed. These findings underscore the instrument’s relevance and validity for evaluating integration within residential settings and provide valuable guidance for caregivers, professionals, and caseworkers in child welfare services. Full article

Background/Objectives: The beliefs about a disease and its treatment determine how patients and caregivers manage and adapt to the illness. The study aimed to explore the QoL and mental health of children with food allergy (FA), and parental illness perception, analyzing influences of sociodemographic and clinical factors and associations between constructs. Methods: This cross-sectional study involved 79 parents of children (3–12 years) with FA, who completed the Food Allergy Quality of Life Questionnaire—Parent Form (FAQLQ_PF), Strengths and Difficulties Questionnaire (SDQ), and Brief Illness Perception Questionnaire (B-IPQ). Pearson correlation coefficient and multiple linear regressions were performed. Results: FAQLQ score was positively associated (0.28) with SDQ score, particularly internalizing problems (0.33), and with B-IPQ score (0.64), consequences for the child and parents (0.66), timeline (0.43), and emotional representation (0.63). SDQ score was negatively associated with parental control (−0.27) and coherence (−0.24), while internalizing problems were negatively associated with parental control (−0.23) and positively associated with timeline (0.24). A greater number of allergens was associated with a worse QoL (p < 0.05). Previous anaphylaxis was associated with higher illness identity (p < 0.05). An age between 7 and 12 years was associated with lower control and coherence. In the final model, higher scores on internalizing problems, timeline, and emotional representation were associated with poorer child QoL (p < 0.001). Conclusions: It is crucial to understand and explore illness perception, as well as focus on psychosocial–emotional aspects of FA in both children and parents. A multidisciplinary approach addressing medical and psychological aspects of FA should be implemented to ensure optimal QoL. Full article

Social-emotional and behavioural difficulties are among the most common developmental problems in childhood and adolescence and present substantial challenges for teachers and schools. Universal social and emotional learning (SEL) programmes combined with standardised diagnostic procedures have been proposed as a promising approach to addressing these issues. The present study evaluated the first implementation of a process-based diagnostic and support concept (StaFF) in everyday school practice in the Canton of Basel-Landschaft, Switzerland. Over the course of one school term, teachers (N = 173 at T1; N = 83 at T2) and pupils (N = 1072 at T1; N = 339 at T2) from kindergarten to the lower secondary level (approximately ages 4 to 16) were assessed using standardised questionnaires. Teacher outcomes included emotional exhaustion, occupational self-efficacy, subjective personal accomplishment, and attitudes towards inclusion. Pupil behaviour was assessed with the Strengths and Difficulties Questionnaire (SDQ). Data analyses comprised descriptive statistics, paired t-tests, and effect size estimates. The results indicated stable values for emotional exhaustion and attitudes towards inclusion, while occupational self-efficacy and perceived accomplishment significantly increased with medium to large effect sizes. At T1, more than one-third of pupils displayed at least one abnormal score; at T2, about one-third of these pupils no longer showed abnormal scores. The findings suggest that structured diagnostics combined with universal SEL measures can strengthen teachers’ professional agency and contribute to improvements in pupil outcomes while highlighting the need for long-term and multi-tiered implementation research. Full article

Introduction: Trace metals can negatively impact biological functions and brain development. Cognitive and neurobehavioral disorders in children are poorly documented in Haut-Katanga Province, an area with significant and multiple exposures to trace metals that can lead to the exacerbation of cognitive and behavioral disorders. Objective: This study aimed to characterize the behavior of schoolchildren linked to their cognitive performance in urban and rural environments. Methods: A cross-sectional pilot study was conducted on 52 schoolchildren aged 6 to 11 (22 from rural areas presumed less exposed to metals and 30 from Lubumbashi, DRC). This study employed NEPSY-II tests, the Strengths and Difficulties Questionnaire (SDQ-Tutor), ENA 2020 software and trace metal spectrometry assays. Statistical tests were carried out with SPSS-20 and Stata-18. Results: Our findings revealed a correlation between children’s malnutrition and low mother’s education. The “total difficulties score” was more prevalent in rural areas (73%) compared to urban settings (37%) p < 0.05), in contrast to the “negative impact of difficulties” (59% versus 57%, p > 0.05). Urban children demonstrated superior cognitive performance, particularly in “facial affect recognition” (8 versus 4, p = 0.013) and “inhibitory control” (6.5 versus 3, p = 0.032). As-U(urine), Cd-B(blood), Hg-B, Mo-U, Ni-U, Pb-U, Pb-B and Sb-U were elevated compared to references. In general, urban areas had higher metal levels than rural areas. Blood and urine metals showed a complex and significant relationship with behavioral difficulties or cognitive performance. Conclusions: The observed behavioral issues, cognitive performance deficits and their association with nutritional deficiencies and trace metal exposure suggest a multifactorial neurodevelopmental origin. These findings highlight the need for further research in the region. Full article

High-quality early care and education (ECE) programs, characterized by safe environments, emotionally supportive communication, proactive behavior supports, and teacher self-care practices, play a pivotal role in healthy child development. Early Childhood Mental Health Consultation (ECMHC) is an evidence-based approach designed to strengthen these environments and support young children’s social–emotional outcomes. However, the long-term impacts of ECMHC models remain understudied. Grounded in ECMHC, the purpose of this study is to evaluate the effectiveness of Jump Start Plus COVID Support (JS+CS) in supporting child psychosocial outcomes (prosocial behaviors and reduced externalizing/internalizing behaviors) over two school years. In a cluster-randomized trial, 12 ECE centers received the 14-week JS+CS intervention, and 12 attention control centers received a 14-week obesity prevention program. Children were followed over two school years to determine long-term impacts on behavior, measured by the Devereux Early Childhood Assessment (DECA) and the Strengths and Difficulties Questionnaire (SDQ). Over two school years, significant time-by-group interactions emerged for primary child outcomes. The JS+CS group showed greater improvements in DECA Initiative and Self-Regulation (p = 0.01 and p = 0.02, respectively) compared to controls. JS+CS significantly enhanced child psychosocial functioning, supporting its potential as an effective model for a scalable mental health consultation in ECE settings. Full article

The health crisis caused by COVID-19 led to a series of restrictive measures worldwide. Amongst them, a period of lockdown that resulted in a decrease in social contact, which had a series of effects at the emotional, educational, and social levels, the greatest concern being the mental health effects in minors. The aim of this study is to analyse mental health disorders affecting Primary Education students before and during the pandemic, at emotional, social and behavioural levels. A total of 1045 students from different educational centres, in 5th and 6th year of Primary Education, of both sexes and aged between 10 and 12 years old, took part in the study. The instrument used was the “Strengths and Difficulties Questionnaire, SDQ”, which measures mental health disorders in minors. The results indicate that during the pandemic there was an increase in emotional problems among minors, alongside a decrease in hyperactivity, conduct problems, and peer-related problems. Social distancing during the pandemic may have acted as a key mediating variable in the observed outcomes. It is concluded that these results are important in preventing psychological effects on the mental health of minors in crisis situations. Full article

Following natural disasters, children and adolescents are particularly vulnerable to the onset and persistence of post-traumatic stress symptoms, which can significantly affect developmental trajectories and mental health. Although PTSD networks have been extensively studied in adults, less is known about youth, and no previous studies have examined how PTSD clusters relate to social, emotional, and behavioral difficulties (SEBD). This study applied network analysis to examine how PTSD clusters relate to psychosocial problems in a large sample of trauma-exposed youth. A total of 635 Italian children and adolescents (M_age = 11.19 years, SD = 1.43; 51.5% male), exposed to the 2012 Emilia-Romagna earthquake, completed the UCLA PTSD-RI and the Strengths and Difficulties Questionnaire. Network estimation and centrality indices were computed for the overall sample. Network Comparison Tests assessed differences by gender, age group, and proximity to the epicenter. Emotional problems and Increased Arousal emerged as the most central nodes, whereas Peer Problems were consistently peripheral. Gender differences were significant, whereas no differences were detected by age; moreover, youth living closer to the epicenter exhibited a more densely connected network. Despite its limitations, the study identifies co-occurrence patterns between PTSD clusters and specific SEBD, outlining clinical implications that warrant further investigation. Full article

To ensure the success of early childhood education and further studies and to formulate interventions, the early diagnosis of childhood socioemotional and behavioral problems is essential. In this study, we analyzed socioemotional and behavioral difficulties in a sample of 501 Hungarian minority children (primary school children from Grades 1, 2, 3, and 4) residing in five administrative regions of Slovakia. Teachers’ and parents’ ratings on the Strengths and Difficulties Questionnaire (SDQ) were used for the assessment, and teacher–parent agreement (ICCs) from a total of 501 parents and 107 teachers were calculated to validate cross-informant convergence. The SDQ assessment tool includes a total of 25 items, which are divided into five subscales: emotional symptoms, conduct problems, hyperactivity, peer problems, and prosocial behavior. Hyperactivity was the problem most frequently reported by teachers, showing abnormal scores, while emotional symptoms were most frequently reported by parents. Demographic information, such as school grade, GPA (grade point average), and maternal education, was significantly related to the children’s SDQ scores. GPA showed a significant negative correlation with difficulties and a positive correlation with prosocial behavior. Significant differences in socioemotional and behavioral problems were also found across different grades. Inter-rater reliability analysis using intraclass correlation coefficients (ICCs) revealed fair-to-good agreement between teachers and parents (ICC range: 0.45–0.61). These findings reveal the importance of incorporating multiple informants in behavioral assessments, highlighting the need for early diagnosis and family-informed interventions to address socioemotional and behavioral problems within culturally diverse educational settings. Full article

Background/Objectives: The prison environment presents a unique context for examining the impact of addiction on physical and psychological functioning. Individuals with substance use disorders (SUDs) are overrepresented in correctional facilities and often experience greater emotional difficulties and impaired physical capacity. This study aimed to conduct a comparative analysis of psychological and functional profiles between addicted and non-addicted male inmates in a semi-open correctional facility. Methods: The study included 47 male prisoners (19 addicted, 28 non-addicted). Physical performance was assessed using the Countermovement Jump (CMJ), handgrip strength, the Functional Movement Screen (FMS), and the FitLight reaction time test. Psychological functioning was evaluated using six standardized questionnaires: problem-focused, emotion-focused, and avoidant coping strategies, depression (PHQ-9), perceived stress (PSS-10), and self-compassion (SCS). Results: No statistically significant differences (p > 0.05) were found between addicted and non-addicted inmates in physical performance parameters. Addicted individuals demonstrated slightly higher handgrip strength with lower variability, while non-addicted inmates showed slightly better lower-body power in the CMJ test. Functional movement quality and reaction speed were similar between groups. Psychological assessments also revealed no significant differences between the groups. Coping styles, depressive symptoms, perceived stress levels, and self-criticism scores were comparable in both populations. In the addicted group, deeper squats correlated with lower stress (rho = −0.46, p = 0.047), and better hurdle step performance correlated with emotion-focused coping (rho = 0.46, p = 0.048). Conclusions: Although no statistically significant differences were found between addicted and non-addicted male inmates in the assessed physical and psychological outcomes, the limited sample size and context-specific nature of this pilot study suggest that these findings should be viewed as preliminary and interpreted with caution. Nonetheless, the observed associations between physical performance and psychological variables indicate subtle interconnections between motor capacity, stress perception, and coping mechanisms that merit further investigation in larger, longitudinal studies. Full article