Search Results (552)

Background and Objectives: Although survival after congenital cardiac malformations (CCM) has improved, little is known about Romanian children’s own perceptions of health-related quality of life (HRQoL) or their emotional burden. We compared HRQoL, depressive symptoms, and anxiety across lesion severity strata and explored clinical predictors of impaired HRQoL. Methods: In this cross-sectional study (1 May 2023–30 April 2025), 72 children (mean age 7.9 ± 3.0 years, 52.8% male) attending a tertiary cardiology clinic completed the Romanian-validated Pediatric Quality of Life Inventory (PedsQL), Children’s Depression Inventory (CDI) and the Screen for Child Anxiety-Related Emotional Disorders questionnaire (SCARED-C, child version). Lesions were classified as mild (n = 22), moderate (n = 34), or severe (n = 16). Left-ventricular ejection fraction (LVEF) and unplanned cardiac hospitalisations over the preceding 12 months were extracted from electronic records. Results: Mean PedsQL total scores declined stepwise by severity (mild 80.9 ± 7.3; moderate 71.2 ± 8.4; severe 63.1 ± 5.4; p < 0.001). CDI and SCARED-C scores rose correspondingly (CDI: 9.5 ± 3.0, 13.6 ± 4.0, 18.0 ± 2.7; anxiety: 15.2 ± 3.3, 17.2 ± 3.8, 24.0 ± 3.4; both p < 0.001). PedsQL correlated positively with LVEF (r = 0.51, p < 0.001) and negatively with hospitalisations (r = −0.39, p = 0.001), depression (r = −0.44, p < 0.001), and anxiety (r = −0.47, p < 0.001). In multivariable analysis, anatomical severity remained the sole independent predictor of lower HRQoL (β = −8.4 points per severity tier, p < 0.001; model R² = 0.45). Children with ≥ 1 hospitalisation (n = 42) reported poorer HRQoL (69.6 ± 8.0 vs. 76.1 ± 11.1; p = 0.005) and higher depressive scores (p < 0.001). Conclusions: HRQoL and internalising symptoms in Romanian children with CCM worsen with increasing anatomical complexity and recent hospital utilisation. The severity tier outweighed functional markers as the main determinant of HRQoL, suggesting that psychosocial screening and support should be scaled to lesion complexity. Integrating the routine use of the Romanian-validated PedsQL, CDI, and SCARED-C questionnaire into cardiology follow-up may help identify vulnerable patients early and guide targeted interventions. Full article

Background/Objectives: Despite the importance of parent mental health for child health, there are no global prevalence data on parental mental health symptoms when children are hospitalized. We aimed to describe depression and anxiety symptom prevalence and associated factors among parents of hospitalized children. Methods: We conducted this 14-country prospective cohort survey with parents/primary caregivers staying at a nearby Ronald McDonald House^® during their child’s hospital treatment. We used the Hospital Anxiety and Depression Scale to measure depression and anxiety symptoms and validated scales and theory-based questions to measure parent, family, and child covariates. We calculated the prevalence of clinically significant or concerning symptoms of depression and anxiety, and used multivariable regression analyses to examine associations between covariates and outcomes. Results: Among 3350 participants, 1789 (49.7%) reported depression symptoms and 2286 (69.0%) reported anxiety symptoms. Worry about housing and poorer ratings of their child’s health were associated with increased risk of depression symptoms. Poorer rating of the child’s health, living with a partner, and discrimination in daily life were associated with increased risk of anxiety symptoms. Higher levels of self-care, hospital family-centered care, and social support were associated with reduced risk of depression symptoms. Higher levels of self-care and social support were associated with reduced risk of anxiety symptoms. Conclusions: Clinically significant or concerning depression and anxiety symptoms are common among parents of hospitalized children globally. Hospitals should consider offering routine mental health symptom screening and preventative mental health and support services to all parents. Full article

Background/Objectives: Social worry may appear in preadolescence, causing it to persist in the future, such that adolescents become more avoidant of situations in which they are evaluated by others. Many previous studies have shown that approximately 4% of preadolescent children suffer from high levels of social worry, which may lead to other problems in the future. It is important to take necessary precautions to explore this worry and take the necessary measures to address it. This study aimed to do so by extracting the psychometric properties of the Social Worries Questionnaire (SWQ) for preadolescence in Arab countries. Methods: The sample consisted of 269 children aged 8–12 years. The SWQ, Spence Child Anxiety Scale (SCAS), Child Abuse Self-Reporting Scale (CASRS-12), and Arabic version of the Children’s Depression Inventory (AVCDI) were administered via various social media. Results: Confirmatory factor analysis was used, and the one-factor model showed that the scale consists of 14 items. The results also indicated evidence of discriminant validity, and that the internal consistency was acceptable. For reliability, the test–retest results showed that the value was appropriate. Conclusions: This scale could be valuable in detecting worry in preadolescent children and providing them with therapeutic and psychological services. Full article

Background/Objectives: Communication disorders in childhood, including expressive, receptive, pragmatic, and fluency impairments, have been consistently linked to mental health challenges such as anxiety, depression, and behavioural difficulties. However, existing research remains fragmented across diagnostic categories and developmental stages. This scoping review aimed to synthesise empirical evidence on the relationship between communication disorders and mental health outcomes in children and adolescents and to identify key patterns and implications for practice and policy. Methods: Following the PRISMA Extension for Scoping Reviews (PRISMA-ScR) and Arksey and O’Malley’s framework, this review included empirical studies published in English between 2000 and 2024. Five databases were searched, and ten studies met the inclusion criteria. Data were charted and thematically analysed to explore associations across communication profiles and emotional–behavioural outcomes. Results: Four interconnected themes were identified: (1) emotional and behavioural manifestations of communication disorders; (2) social burden linked to pragmatic and expressive difficulties; (3) family and environmental stressors exacerbating child-level challenges; and (4) a lack of integrated care models addressing both communication and mental health needs. The findings highlight that communication disorders frequently co-occur with emotional difficulties, often embedded within broader social and systemic contexts. Conclusions: This review underscores the need for developmentally informed, culturally responsive, and interdisciplinary service models that address both communication and mental health in children. Early identification, family-centred care, and policy reforms are critical to reducing inequities and improving outcomes for this underserved population. Full article

Maternal mental illness significantly impacts caregiving, influencing both mothers and their children. This narrative review examines the challenges faced by mothers with conditions such as depression, anxiety, bipolar disorder, and schizophrenia, which often disrupt caregiving routines, emotional stability, and social integration. These difficulties can hinder secure attachments and contribute to adverse developmental outcomes in children, including heightened risks of anxiety, depression, behavioral issues, and cognitive impairments. Children of mothers with mental illnesses are 1.8 times more likely to develop emotional or behavioral problems and face a 2.7 times higher risk of suicidal ideation during adolescence. Intergenerational transmission of mental illness is also prevalent, with affected children showing a 2.5 times greater likelihood of developing mental illnesses in adulthood. Effective interventions include cognitive behavioral therapy (CBT), family-based approaches, and community programs integrating parenting education and mental health resources. These strategies have demonstrated improvements in maternal well-being and child resilience. The review highlights the need for comprehensive policies addressing maternal mental health, early intervention for children, and culturally sensitive support systems to break cycles of intergenerational mental illness. Future research should prioritize evaluating long-term intervention effectiveness and exploring innovative tools like digital mental illnesses solutions to support affected families. Full article

Background/Objectives: Dental anxiety in children is a common issue that can hinder the delivery of effective dental care. Traditional approaches to managing this are often insufficient or involve pharmacological interventions. This study shows the potential of virtual reality (VR) to aid in reducing anxiety in children undergoing simple dental procedures. By immersing children in relaxing VR environments (such as beaches, forests, mountains, or underwater scenes with calm music), the objective is to assess VR’s effectiveness in calming pediatrics patients during these procedures. Methods: Children scheduled for minor dental treatments wore a wearable device that monitored pulse, perspiration, and stress levels. Each child’s baseline data was collected without the VR headset, followed by data collection during VR exposure before and during dental procedures. VR scenarios ranged from soothing nature scenes to animated cartoons, designed to foster relaxation. Results: The data collected showed a reduction in physiological indicators of stress, such as lower heart rate and reduced perspiration, when the VR headset was used. Children appeared more relaxed, with a calmer response during the procedure itself, compared to baseline levels without VR. Conclusions: This study provides preliminary evidence supporting VR as an effective tool for reducing anxiety and stress in pediatric dental patients. By offering an engaging, immersive experience, VR can serve as an alternative or complementary approach to traditional anxiety management strategies in pediatric dentistry, potentially improving patient comfort and cooperation during dental procedures. Further research could determine if VR may serve as an alternative to local anesthesia for non-intrusive pediatric dental procedures. Full article

Background Objectives: Parental anxiety and depression demonstrate bidirectional connections with child developmental outcomes (e.g., disruptive behavior). Directly targeting child development through behavioral parent training (BPT) has potential for reversing this cycle. Parent–Child Interaction Therapy (PCIT), a BPT with robust research evidence for decreasing child disruptive behaviors, has demonstrated promise in also decreasing caregiver anxiety and depression. However, the mechanisms that explain this relationship are less understood. Methods: The current study examined whether caregivers (N = 840) completing time-limited PCIT experienced significant reductions in depression and anxiety symptoms and improvements in child disruptive behaviors at each time point. Generalized estimate equation analyses assessed whether caregiver anxiety and depression moderated changes in child disruptive behavior. Mediation analyses explored the extent that changes in caregiver–child interactions over time explained changes in family outcomes. Results: Child disruptive behavior and caregiver depression and anxiety symptoms improved significantly at each time point of PCIT. Change in child behavioral outcomes was significantly moderated by caregiver race. Caregivers with higher anxiety reported fewer improvements in child disruptive behavior compared to other caregivers. Changes in caregiver anxiety and depression over the course of treatment were partially mediated by improvement in caregiver–child interaction skills. Changes in child disruptive behavior were not mediated by improvement in caregiver–child interaction skills. Conclusions: Results demonstrate that time-limited PCIT could significantly improve caregiver anxiety and depression, and some PCIT-taught parenting skills are direct drivers of this process. Further research is needed to understand other mechanisms underlying the relationship between PCIT and improved family outcomes. Full article

Background/Objectives: The Mediterranean diet (MD) is well-studied for its health-promoting effects, while the factors influencing adherence in children remain an important research focus. This study examines the sociodemographic, maternal, perinatal, and lifestyle determinants associated with MD adherence among children aged 6–9 years in an effort to identify key predictors and their impact on long-term nutritional habits. Methods: This study recruited 4851 children from diverse Greek rural and urban regions. The mothers of the enrolled children completed relevant questionnaires on their children’s sociodemographics, perinatal outcomes, anthropometric parameters, breastfeeding practices, and physical activity status. The enrolled children completed the Children’s Depression Inventory (CDI) and the State–Trait Anxiety Inventory for Children—State (STAIC-S) form to assess the presence of depression and anxiety symptoms, respectively. The KIDMED score was used to assess the MD compliance of the enrolled children. Results: The outcomes demonstrated that higher maternal education and family economic status gravitated toward increased MD adherence (p = 0.0071, p ˂ 0.0001), while exclusive breastfeeding (p ˂ 0.0001) and higher physical activity levels (p = 0.0101) were strong predictive factors for MD adherence, highlighting the role of early-life interventions in shaping dietary habits. In contrast, cesarean delivery (p = 0.0173) and higher birth weight (p ˂ 0.0001) were linked to lower MD adherence, indicating potential metabolic and behavioral predispositions. Notably, higher MD adherence correlated with lower prevalence of depressive and anxiety symptoms (p ˂ 0.0001, p = 0.0001), underscoring its potential protective role in mental health. Conclusions: Our findings highlight a complex interplay between early-life and dietary behaviors, while further longitudinal studies are needed to establish causality and optimize evidence-based nutritional strategies and education for childhood health and well-being. Full article

Background: A growing body of literature suggests that there are two variants of callous–unemotional (CU) traits—primary (with low anxiety) and secondary (with high anxiety)—although whether these traits differ in emotional regulation is unknown. The present study aimed to further our understanding of these variants by comparing the two variant groups (high CU/low anxiety and high CU/high anxiety) with two control groups (low CU/low anxiety and low CU/high anxiety) on emotional regulation, along with a variety of psychosocial and externalizing behavioral measures. Methods: A community sample of children aged 8 to 10 years (N = 340) from the northeast United States and their main caregivers participated in this study. Children completed an emotional regulation task while their sympathetic and parasympathetic nervous system activities were recorded. Prenatal and postnatal adversity and externalizing behaviors of the children were assessed using caregiver and child reports. Results: It was found that children with high CU/high anxiety were characterized by elevated parasympathetic activities during the emotional regulation task, along with more adversity and externalizing behaviors. Conclusions: These findings extend our knowledge on CU by highlighting the emotional dysregulation and more severe clinical picture that were associated with more psychosocial adversity in the high CU/high anxiety variants. Full article

The increasing incidence of autism spectrum disorder (ASD) increases the urgency of establishing the mechanism of its development for effective prevention and treatment. ASD’s etiology includes genetic predisposition and environmental triggers, both of which can play a role in the changed microbiota. Recent research has proved the impact of maternal microbiota on the neurodevelopment of the child. To investigate the co-play of genetic and microbiota factors in ASD development, we performed fecal microbiota transplantation (FMT) from children with ASD to female Shank3b^+/− mice and studied the autism-like symptoms in the male Shank3b^−/− and wild-type (WT) offspring. WT animals with prenatal exposure to ASD microbiota had delayed neurodevelopment and impaired food intake behavior, but also elevated plasma leptin concentration and body weight. Shank3b^−/− mice after FMT ASD exhibited impaired learning and exacerbated anxiety-like behavior in adulthood. Interestingly, FMT ASD improved learning in adolescent Shank3b^−/− mice. Prenatal exposure to ASD microbiota decreased the activity of hypocretin neurons of the lateral hypothalamic area in both genotypes. The combination of genetic predisposition and FMT ASD led to an increased colon permeability, evaluated by zonula occludens (ZO1, ZO3) and claudin factors. These results suggest the effect of parental FMT exposure on shaping offspring behavior in Shank3b^−/− mice and the potential of microbiota in the modulation of ASD. Full article

Background/Objectives: Children and adolescents with cerebral palsy (CP) often experience associated functional limitations, diseases, or impairments. Included in these associated concerns are mental health symptoms/disorders and academic concerns. There has been an increasing research focus on the mental health of youth with CP over the past 5 years, and there is a need to synthesize this research. This review aims to synthesize the most recent research on the mental and behavioral health of youth with CP. Methods: A literature search on research focused on mental health, academic functioning, and mental and behavioral treatment for youth with CP was conducted in August of 2024 and limited to the last 5 years to highlight the most recent developments in this area of research. Four hundred and forty-eight articles were screened, and thirty-eight articles were included in this review. Results: Based on this literature review, children with CP have high rates of mental health diagnoses across multiple diagnostic areas, including autism spectrum disorder, attention-deficit hyperactivity disorder, intellectual developmental disorder, anxiety, and depression. Academic concerns are common for children with CP. Intervention studies have focused on both child and parent interventions. Conclusions: Research over the past 5 years has added to prevalence estimates of mental health disorders in the pediatric CP population. Considering the high rates of mental health symptoms found in children with CP, future research should focus further on mental health interventions for this population. Full article

Introduction: Nonbinary individuals who do not identify as exclusively male or female often face unique emotional challenges due to societal cisheteronormativity and limited recognition of their identities. While existing research has primarily focused on anxiety, depression, and pathways to parenthood among nonbinary people, little attention has been paid to their comprehensive emotional experiences as parents. This study aims to explore the emotional universe of two nonbinary parents from Spain and the United States. Design: Hermeneutic study. Materials and Methods: We implemented purposive sampling, conducted semi-structured virtual interviews, and followed Ricoeur’s theory of interpretation for data analysis. We used the Universe of Emotions affective taxonomy as a starting category in this analysis. Our sample consisted of a 32-year-old white Spanish nurse (she/they/them), assigned female at birth and parent of two one-year-old toddlers, and a 34-year-old white North American physiotherapist (he/they/them) assigned female at birth and parent of a ten-year-old child. Results: Through its four themes (A story of misunderstanding: “What are you, a combat helicopter?”; Clearly, you don’t fit, so…; But (a new) family is there; No monster here: I’m, at the core, a human being), this study reveals the complex emotional journey experienced by two nonbinary parents. Conclusions: Central to this journey are three key emotions: strangeness, belonging, and acceptance. The participants describe an initial stage marked by body and social dysphoria, confusion, and rejection, followed by a transformative process in which parenthood becomes a catalyst for emotional and identity integration. This transition—from alienation to connection—reflects a broader movement from dehumanization to humanization, where the experience of parenting fosters emotional resilience, social recognition, and a renewed sense of self. Implications for the profession and/or patient care: Analyzing their emotions (both negative and positive ones), we obtained robust insights into these parents’ personal and social contexts. Therefore, we can facilitate understanding of the emotional complexity of nonbinary parents by the trans and cisgender communities. Through this understanding, nurses and the organizations they work for can improve their competence in their holistic care. Acceptance from nonbinary parents’ social contexts, of which nursing is a part, is a critical factor in their health and emotional wellbeing. Full article

Hispanic youth have one of the highest rates of unmet physical and mental health needs. This study aims to examine how child and adolescent healthcare access creates pathways to behavioral/mental health among a national sample of 1711 U.S. Hispanic youth. Using psychometric network analysis, unique pathways in which child healthcare access (i.e., transportation and health service-related factors) and behavioral/mental health were identified. Findings indicate relationships among depression, anxiety, school settings, and friendships. These associations offer a starting point for interventionists and policymakers to ensure that interventions are not targeted individually but from an ecological systems framework. This study may raise awareness of Hispanic youth’s barriers and better equip scientists to plan and implement approaches to address identified barriers. Full article

Background: Music therapy and music-based interventions are increasingly recognized as valuable adjuncts in pediatric neurorehabilitation, leveraging rhythm, singing, instrument playing, and improvisation to support children with neurological disabilities. Objective/Method: This narrative review synthesizes evidence from studies published between 2000 and 2025, focusing on children aged 3 to 18 years receiving neurorehabilitation. Results: The literature demonstrates that music therapy and music-based interventions can improve motor function—particularly gait and upper limb coordination—as well as speech production, while also reducing anxiety and enhancing participation. Techniques such as rhythmic auditory stimulation and melodic intonation therapy have shown promise in targeting movement and communication deficits. Music therapy is further associated with positive effects on vital signs and emotional well-being, supporting its role in holistic care. Neurobiological findings suggest that music-based interventions may promote neuroplasticity and strengthen brain connectivity, though high-quality mechanistic studies remain limited. Conclusions: Despite methodological heterogeneity and small sample sizes in the current literature, the overall evidence supports music therapy and music-based interventions as accessible, cost-effective, and child-centered complements to standard neurorehabilitation. Future research should prioritize rigorous clinical trials and neurobiological investigations to clarify mechanisms and optimize therapeutic protocols. 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