Search Results (107)

Background/Objectives: Juvenile idiopathic arthritis (JIA) and inflammatory bowel disease (IBD) are chronic autoimmune conditions that impact the physical and psychological well-being of pediatric patients. While previous studies have shown a high prevalence of mental health challenges among youth with chronic conditions, the prevalence of mental health issues in Canadian pediatric patients with JIA and IBD remains unclear. We aimed to estimate the prevalence of documented mental health disorders and related medication use of youth with JIA or IBD at a tertiary care centre. Methods: We conducted a retrospective chart review of youths aged 12–17 diagnosed with JIA or IBD at McMaster Children’s Hospital (MCH) to understand the prevalence of generalized anxiety disorder (GAD), separation anxiety disorder, social anxiety disorder (SAD), obsessive–compulsive disorders (OCD), eating disorders, major depressive disorder (MDD), adolescent adjustment disorder, suicide attempt/suicide ideation, self-harm behaviour, substance use disorder, and attention deficit disorders (ADD). Results: We reviewed 429 patient charts, including 303 patients with IBD and 126 with JIA. Our findings identified 90 IBD patients and 20 JIA patients who had one or more documented mental health conditions. Proportionately, there was a higher prevalence of mental health conditions among IBD patients (30%) compared to JIA patients (16%). The most frequently observed conditions in both IBD and JIA patients were GAD (63%, 50%), ADD (33%, 35%), and MDD (29%, 15%). Conclusions: These findings highlight the critical need for early mental health screening and integrated care approaches that address both medical and psychosocial needs in adolescents with chronic illnesses. Future research should incorporate prospective study designs, include diverse geographic and demographic populations, and explore targeted interventions to improve mental and physical health outcomes in this vulnerable group. Full article

Introduction: Divergent theories exist concerning the constructs of adaptation and acceptance for chronic conditions. Understanding these processes is essential to improving care. The aim of this study is to describe these concepts from the perspective of people living with type 1 diabetes. Methods: A secondary analysis was conducted on data from a qualitative study, including interviews with 101 people in 13 countries across all continents, with participants of varying ages, genders, and diabetes durations as well as participants who were parents with children with type 1 diabetes. The initial study included a topic guide with open questions and interviews were analyzed using grounded theory resulting in a pyramid of needs for type 1 diabetes. This pyramid included the concepts of adaptation and acceptance. This study explores these themes in more depth. Results: Adaptation and acceptance processes vary from one person to another. Adaptation includes both adjustment to daily care and a change in perspective. Acceptance is explained as a process relying on adaptation, with no defined standardized stages. Diabetes acceptance positively impacts health, daily life, and relationships. The study identifies several factors that help acceptance, such as medical supplies, a caring healthcare environment, family and peer support, parental acceptance of diabetes, and diabetes camps. Discussion: Some of the elements required for adaptation and acceptance can be provided directly by the healthcare system, such as medical supplies, while others outside the healthcare system still need to be considered by caregivers, such as the individual’s social environment. The psychological well-being of people with type 1 diabetes and parents should be investigated as often as possible with the provision of adaptative, integrated, and holistic care. Full article

Parental school involvement (PSI) is a multidimensional construct that significantly influences children’s academic adjustment and overall development. However, inconsistencies persist in its definition and measurement, with researchers operationalizing PSI through a varied of parental activities. This study aimed to (1) identify PSI instruments and their theoretical models and (2) evaluate their psychometric properties. Following PRISMA guidelines (PROSPERO ID CRD42023451091, registered August 2023), this systematic review examined six databases (Web of Science, ERIC, MEDLINE, Psychology and Behavioral Sciences Collection, PsycArticles, and PsycInfo), analyzing quantitative studies from 2000 to 2024. Inclusion criteria encompassed instruments designed for parents, teachers, or children aged 6–15 and published in peer-reviewed journals in English, Portuguese, Spanish, or French. From an initial pool of 490 records, 38 studies were included, yielding 43 instruments: 23 for parents, 15 for children, and 5 for teachers. Seven instruments followed Epstein’s model, while nine followed the Hoover-Dempsey and Sandler framework, underscoring the prominence of these theoretical approaches. The study quality, assessed with MMAT, was generally moderate to high. Despite an exhaustive search effort, it is possible that some relevant instruments were not identified. Nevertheless, this review advances the understanding of PSI operationalization, promotes more consistent and replicable assessments, enhances alignment between instruments and study objectives, and strengths the validity of findings derived from these tools. Full article

Objectives: Feeding and eating disorders (FED) represent a major public health issue and are the second leading cause of death among psychiatric conditions in children and adolescents. Psychopathological comorbidities play a significant role in the onset and persistence of FED, yet research on their underlying structure remains limited. This study explores the psychiatric comorbidities associated with FED, focusing on common etiopathogenetic factors and their clinical implications. Methods: Data were retrospectively collected from the Italian Regional Center for FED in the Emilia-Romagna Region between June 2023 and April 2024. Diagnoses were assigned following DSM-5 criteria using the Italian version of the semi-structured K-SADS-PL diagnostic interview. Principal component analysis (PCA) was performed to identify latent psychological dimensions underlying FED psychopathology, retaining five components based on the scree plot. Additionally, an analysis of covariance (ANCOVA) was conducted to examine differences in factor scores across FED subtypes, while adjusting for potential confounders. Results: Seventy-two participants were included (mean age: 14.6 years; mean BMI: 18.3 kg/m²; male-to-female ratio: 1:8). Diagnoses were distributed as follows: 63.9% anorexia nervosa (AN), 13.9% other specified feeding and eating disorder (OSFED), 6.9% avoidant restrictive food intake disorder (ARFID), 4.2% binge eating disorder (BED), 4.2% unspecified feeding and eating disorder (UFED), and 2.7% bulimia nervosa (BN). All participants met the criteria for at least one psychiatric comorbidity. Identified psychopathological clusters include the following: (1) mood disorders (66.5%); (2) anxiety disorders (87.5%); (3) obsessive–compulsive and related disorders (47.2%); (4) neurodevelopmental disorders, i.e., attention-deficit/hyperactivity disorder (ADHD) (30.5%); (5) disruptive and impulse-control disorders (13.9%); and (6) psychotic symptoms (40.3%). No instances of tic or elimination disorders were detected. Conduct disorder was more prevalent among UFED, BED, and BN patients compared to other FED (p = 0.005), and moderate/severe ADHD was associated with higher body mass index (BMI) (p = 0.035). PCA revealed distinct psychological dimensions underlying FED, while ANCOVA indicated significant differences in factor scores across FED subtypes, supporting the presence of shared transdiagnostic mechanisms. Conclusions: This study highlights the complex interplay between FED and psychiatric comorbidities, emphasizing the need for early intervention and personalized treatment approaches. The dimensional structure identified through PCA suggests that common psychopathological factors may drive FED development, and ANCOVA findings support their differential expression across FED types. Future research should further investigate these transdiagnostic mechanisms to optimize clinical care. Full article

This study investigates the impact of family environments on the psychological well-being of children and adolescents in rural China, focusing on loneliness, depression, and internet addiction. Using a cross-sectional design, data were collected from 652 families in rural Hunan province to examine the role of family communication, caregiver psychological states, and parenting styles. Structural equation modeling revealed that family economic conditions influenced children’s mental health through primary caregivers’ emotional well-being, hostile parenting styles, and family communication. Notably, hostile parenting and poor family communication were the strongest mediators across all three psychological outcomes, consistently exhibiting significant associations with loneliness, depression, and internet addiction. The findings highlight the crucial role of parenting styles and poor family communication in shaping children’s psychological health, emphasizing the need for interventions that enhance family communication and promote supportive parenting. Addressing caregiver emotional well-being and adjusting parental expectations may serve as effective strategies for improving mental health outcomes among rural youth. Full article

(1) Background: This study investigates the relationship between the moral maturity levels of individuals who have experienced parental divorce or loss and their adjustment to the divorce process, considering various factors. (2) Methods: A total of 319 participants, aged between 10 and 18, who had either divorced parents or had experienced parental loss, were included in the study. Data were collected using the Adaptation to Divorce Inventory for Children and the Moral Maturity Scale. (3) Results: The results revealed that individuals who had experienced parental loss exhibited higher-than-average moral maturity levels. (4) Conclusions: A moderate, positive correlation was found between moral maturity and divorce adjustment, specifically in the areas of conflict resolution and depression–anxiety subscales. Additionally, substance use was associated with lower levels of moral maturity, while gender and educational level were significant predictors of moral maturity. These findings suggest that professional support, guidance programs, and family communication strategies are essential to promote the psychological adjustment of children affected by parental divorce or loss. Full article

The economic and health context in recent years has led to an increase in return migration of Romanians and an increased propensity to settle down in their country of origin. Remigration can be lived as a life experience with an extremely high vulnerabilising potential, with obvious consequences in terms of adaptation and psychological consequences, and a negative impact especially on children and adolescents. The present study is based on an online survey conducted between July 2023 and February 2024 among teachers in the North-East Region of Romania and had the overall objective of assessing the effects of return migration on Romanian remigrant pupils. This phenomenon was analysed on the basis of teachers’ perceptions of the behaviour of pupils who have experienced emigration, followed by remigration, equivalence of studies and integration or reintegration into the Romanian education system. Our study is exploratory and could be followed by the analysis of the same phenomenon from other perspectives (children, parents). The results of the study show that after remigration, some children and adolescents are faced with many educational and social adjustment problems for which they were not prepared. Remigration increases stress, and educational integration is in most cases a difficult process. The negative impact translates into limited opportunities for emotional, social, and intellectual development, or even behavioural disorders, which affect the quality of life of remigrant pupils and their long-term quality of life. Positive aspects of children’s remigration have also been identified. Full article

This study aimed to explore the dynamic adjustment mechanisms of the families of school-aged children with autism spectrum disorder (ASD) in China in coping with challenges, focusing on the roles of belief systems, organizational processes, and communication strategies, as well as the influence of the China-specific cultural and policy contexts. Based on Walsh’s family resilience theory, a qualitative research methodology was used, with semi-structured interviews to collect experience data from these families, and thematic analysis was used to summarize the main challenges and coping processes. The study found that the families mainly faced the following challenges: difficulties in family care, parenting burnout, educational plights, and inadequate community support systems. Regarding belief systems, families enhanced their resilience through emotional acceptance and redefined expectations; regarding organizational processes, families optimized their internal operations through the flexible division of labor and decision-making patterns and actively mobilized external resources; and, regarding communication, reflection and sharing fostered emotional connection within the family, while compromise and patience enhanced the ability to integrate external resources. In addition, the traditional Chinese culture and inadequate policy support had a significant impact on the formation of family resilience. This study validates the cross-cultural applicability of family resilience theory and suggests enhancing family resilience through psychological support, policy optimization, and social advocacy. Full article

Much attention has been given to the predictive role of callous–unemotional (CU) traits in children’s social and peer functioning. As an important dimension of social adaptation, early social withdrawal in preschool left-behind children (LBC) might be the outcome of psychological factors and growth environments. This study explored the predictive effect of CU traits on social withdrawal among preschool LBC, including the indirect effect of emotion regulation and teacher–child relationship quality. Data from 513 Chinese preschool LBC (257 boys and 256 girls) were reported by their teachers in rural areas, including assessments of CU traits, emotion regulation, social withdrawal, and teacher–child relationship quality. Path analyses showed that the CU traits of young LBC could significantly positively predict the prevalence of social withdrawal, and emotion regulation played a key mediating role in this effect path. Notably, teacher–child relationship quality moderated the indirect effect of emotion regulation on CU traits and withdrawal behaviors. Therefore, the moderated mediation model was supported. The findings expanded the recognition of LBC with CU traits and further suggested that the association of some personality traits and growing environments in the early left-behind childhood can significantly make a difference in peer functioning and social adjustment. Full article

Background/Objectives: Burnout is a critical concern among healthcare professionals, particularly during crises such as the COVID-19 pandemic. This study investigated burnout levels among forensic medicine and pathology personnel at three distinct phases: the early pandemic period (Phase 1—September 2020), the peak of the pandemic (Phase 2—October 2021), and the post-pandemic period (Phase 3—October 2024). Methods: A total of 37 participants employed in forensic medicine and pathology departments completed the Maslach Burnout Inventory (MBI). A one-way repeated measures ANOVA was conducted to assess within-subject differences over time. Normality and sphericity were tested using the Shapiro–Wilk test and Mauchly’s test, with the Greenhouse-Geisser correction. Post hoc Bonferroni-adjusted comparisons identified significant differences, and partial eta squared (η²) was reported for effect sizes. Results: Results showed significant fluctuations in burnout levels across the three phases. Emotional exhaustion and low personal accomplishment peaked during Phase 2, with slight reductions observed in Phase 3. Gender differences were evident, with females reporting higher EE levels and males exhibiting higher depersonalization across all phases. Marital and parental status also influenced burnout levels, with unmarried individuals and those without children showing higher burnout scores. Medical doctors experienced the highest burnout levels among professional roles, while auxiliary staff showed significant challenges in the PA subscale. Conclusions: The COVID-19 pandemic was pivotal in exacerbating burnout levels due to increased workload, crisis decision-making, and emotional toll. Although the sample size is limited, these findings underscore the importance of implementing targeted interventions to mitigate burnout among forensic and pathology personnel, especially during healthcare emergencies. Gender-based differences in burnout suggest the necessity of specific workplace well-being strategies, while the protective role of family status demonstrates the importance of work-life balance policies. The persistence of psychological distress after a medical crisis calls for long-term monitoring and support programs. There is a need for improved workload distribution, peer support networks, and mental health training to build resilience among forensic and pathology personnel. Full article

Background: Evidence indicates that pediatric burns are a significant form of trauma. They affect not only children but also their parents, who often experience short- and long-term psychopathological symptoms. The body of knowledge on the impact of hospitalization on parents has expanded; however, there is a dearth of evidence on the dynamics of parental relationships, parental experiences, and how these experiences affect their parenting. Objectives: This study aims to map and summarize the available literature on the repercussions of trauma associated with pediatric burns and hospitalization on parental and family dynamics. Methods: A scoping review will be carried out in accordance with the JBI methodology, based on the PCC. Studies involving hospitalized children (up to the age of 18) who have suffered accidental burns and their parents or caregivers will be included. The literature study will examine the effects of pediatric burn-related trauma on family and parental dynamics, emphasizing interventions and adjustment strategies that support children and families affected by this injury. Studies related to hospital settings and returning home will be included and analyzed by two independent reviewers using a standardized form developed for this study. The databases consulted will be Academic Search Complete, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed/Medline, Collection of Psychology and Behavioral Sciences (via EB-SCO), PsycInfo, Cochrane Library, Embase, and Web of Science (Clarivate). Results: The results will be summarized narratively, presented in tables or diagrams, to highlight key findings related to parental experiences with burned children, the trauma associated with this episode, and its impact on parenting. In addition, strategies developed within the framework of the care partnership will be highlighted. Conclusions: Understanding how family dynamics change after a child suffers a burn injury and goes through the hospitalization process is crucial for nurses to improve their practice. We hope that this review will promote partnership-oriented, family-centered nursing practice in the care of child burn victims and their families, as well as assist in the identification of knowledge gaps in the literature and potential areas for future research and development. Full article

Background. T1DM is a significant chronic condition that necessitates regular medical monitoring, dietary and physical activity supervision, and daily blood glucose monitoring and insulin therapy. The management of this disease and the transition to adolescence often have a significant psychosocial impact on the individual and their family. Objective. The objective of this correlational study was to examine the reciprocal influence between adolescents and their caregivers, with a particular focus on the beneficial effect of receiving psychological support sessions from family members and adolescents with T1DM in a pilot study. Methods. An indicator variable was developed to facilitate an analysis of changes occurring prior to, as well as following, the administration of the treatment in question. Family caregivers received two therapy sessions, and we analyzed their perceived caregiver stress. Adolescents had five sessions, and the reduction in emotional distress was studied in them. Results. The sample comprised 15 adolescent–family caregiver dyads. All parents were mothers of adolescents, with a mean age of 47.67 and 13.47 years, respectively. Descriptive statistics and Spearman correlations were conducted. Following the completion of the psychological counseling sessions, the data revealed a significant positive correlation between the perceived reduction in global stress experienced by the caregiver and the adolescent’s emotional distress, with correlation coefficients of 0.74 and 0.61, respectively. Furthermore, a positive relationship was observed between the reduction in existing difficulties in family role adjustment and the reduction in emotional distress among diabetic youth, with correlation coefficients of 0.72 and 0.57. The frequency of emotional distress of the caregiver also correlated with adolescent emotional distress, with a coefficient of 0.60. Conclusions. The findings of this study provide evidence for the circularity of family systems change. A positive emotional contagion effect is observed in the improvements in stress and emotional distress experienced during adolescence and in the family’s adjustment to T1DM, as reported by caregivers and their children who received psychological support sessions. Full article

Background/Objectives: Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer, with intense treatments affecting both children and their families. Limited information is available on parental distress and psychological well-being during the first treatment year, with most studies focusing on individuals rather than the family system. This study explores longitudinal changes in parental distress (psychological morbidity and traumatic stress symptoms), coping strategies, family resilience and functioning, and psychological well-being. The study also examines the mediating roles of family resilience, family functioning, and coping strategies in the relationships between parental distress and psychological well-being. Methods: A prospective study was conducted with 46 parents of children newly diagnosed with ALL, assessing parental distress, family functioning and resilience, coping, and psychological well-being across three treatment phases: consolidation (T0), delayed intensification (T1), and maintenance (T2). Results: Parental distress and family resilience significantly decreased from T0 to T2, while parental coping improved over time. Family functioning deteriorated from T0 to T1, stabilizing thereafter. Psychological well-being followed a non-linear trajectory, initially declining from T0 to T1 and improving from T1 to T2. Mediation analyses revealed that family resilience and family functioning partially mediated the relationships between parental distress and psychological well-being. Parental coping did not emerge as a mediator. Conclusions: Parental psychological adjustment in the context of ALL is dynamic and influenced by individual and family factors. Interventions that strengthen family functioning and resilience are crucial for supporting parental psychological well-being during treatment. A family-centered approach in healthcare delivery is essential to address individual and systemic challenges. Full article

Background/Objectives: the aim of the current cross-sectional study is to explore and compare the emotional and behavioural conditions of children and adolescents with short stature (i.e., familial short stature and constitutional delay of growth), idiopathic growth hormone deficiency (GHD), and normal height. Methods: Twenty-nine participants (15 males, 14 females; mean age ± standard deviation (SD) = 11.2 ± 1.96 years) with short stature (height standard deviation score (SDS): −2.10 ± 0.57), 10 age-matched participants (4 males, 6 females; mean age ± SD = 10.9 ± 2.35 years) with growth hormone deficiency (GHD; height SDS: −2.44 ± 0.29), and 36 age-matched participants (19 males, 17 females; mean age ± SD = 11.3 ± 1.93 years) with normal stature (height SDS: 0.56 ± 0.78) were admitted to this study. Psychological distress was evaluated using the Depression Anxiety and Stress Scale (DASS-21), and emotional and behavioural problems using the Child Behaviour Checklist for Children (CBCL) and the Strengths and Difficulties Questionnaire (SDQ). Results: Participants with GHD exhibited higher levels of the “withdrawn/depressed subscale” score of CBCL (H = 7.794, df = 2, p = 0.020), compared to their peers with normal height, while no significant differences were observed between participants with short stature and those with normal stature. Normal-statured participants reported higher levels of the “conduct problems” subscale score (H = 10.421, df = 2, p = 0.005) and the “rule-breaking behaviour” subscale score of CBCL (H = 10.358, df = 2, p = 0.006) compared to both short-statured groups. No significant differences among the three subgroups were found in the DASS-21 and SDQ scores questionnaires, suggesting the lack of short stature-dependent effects on psychological distress and emotional and behavioural adjustment. Conclusions: Although participants with GHD exhibited higher levels of the “withdrawn/depressed subscale” score of CBCL (H = 7.794, df = 2, p = 0.020) compared to their peers with normal height, participants with short stature did not experience the same problems. Although short-statured participants had lower levels of “conduct problems” and “rule-breaking behaviours” scores than their normal-statured peers, the psychological distress and emotional and behavioural adjustment were not affected by short stature, being comparable to those recorded in normal-statured participants. Full article

Objective: This study aimed to assess the psychological health status of children aged 3–7 years in Wuxi and analyze the correlation between dietary behaviors, lifestyle, and psychological problems. Methods: Using a stratified cluster random sampling method, 3–7-year-old children from 18 kindergartens across Wuxi were selected as the survey subjects. An online survey was conducted to collect demographic information about children and their parents, dietary information, lifestyle data, and family backgrounds. Psychological assessments were conducted using the Strengths and Difficulties Questionnaire (SDQ). Results: A total of 3727 preschool children were included. The average SDQ score was 16.12 ± 4.00, with an abnormal rate of 40.81% (1521/3727). After adjusting for various confounding factors, logistic regression analysis indicated that low dietary diversity (OR = 1.299, 95% CI: 1.131–1.492), daily consumption of ultra-processed foods (OR = 1.202, 95% CI: 1.051–1.376), picky eating behavior or ideas occurring more than twice per week (OR = 1.405, 95% CI: 1.227–1.608), engaging in other activities while eating (such as watching TV or playing with toys) more than twice per week (OR = 1.742, 95% CI: 1.510–2.011), lack of a fixed dining position (OR = 1.222, 95% CI: 1.012–1.476), daily screen time exceeding 1 h (OR = 1.353, 95% CI: 1.152–1.590), and daily sleep duration of less than 9 h or more than 13 h (OR = 1.535, 95% CI: 1.262–1.866) were risk factors for psychological problems. Conclusions: The findings highlight the urgent need for targeted interventions addressing insufficient dietary diversity, distracted eating, excessive screen time, and unhealthy sleep habits to improve the psychological well-being of preschool children. Future studies should explore the effectiveness of tailored health and lifestyle interventions for children and their families to mitigate these risks. Full article