Search Results (573)

Introduction: Sex-specific differences in psychopharmacological treatment have gained increasing attention in adults, with studies showing that women often have higher serum concentrations of psychotropic drugs due to biological differences. However, despite recognition of these differences in adults, reference ranges for therapeutic drug monitoring (TDM) in general, but even more sex-specific therapeutic windows for psychotropic drugs, are lacking in children and adolescents, who may metabolize and respond to medications differently. Aim: The study aimed to investigate sex-specific differences in antidepressant (AD) and antipsychotic (AP) -treatment outcomes, and pharmacokinetics in childhood/adolescence. In particular, we examined differences in AD and AP serum levels and clinical effects, including adverse drug effects (ADEs) and therapeutic effectiveness. Methods: This study is part of the multicenter “TDM-VIGIL” pharmacovigilance project, which prospectively followed patients aged 6–18 years treated with AD and AP across 18 child psychiatric centers in German-speaking countries from 2014 to 2018. Clinical data, including drug concentrations (AD: fluoxetine, mirtazapine, (es)citalopram, sertraline; AP: aripiprazole, quetiapine, olanzapine, risperidone), were collected using an internet-based registry, and treatment outcomes and ADEs were assessed during routine visits. Statistical analyses were performed to examine sex differences in pharmacokinetics and clinical responses, adjusting for age, weight, and other confounders. Results: A total of 705 patients (66.5% girls, 24.7% <14 years, mean age of 14.6 years) were included. Female patients were slightly older, had lower body weight, and were more often diagnosed with depression and anorexia nervosa, while boys were more frequently diagnosed with hyperkinetic disorders and atypical autism. We found no sex differences in the serum concentrations of investigated drugs when adjusted for age and weight. In fluoxetine treatment in patients diagnosed with mood (affective) disorders, female sex was associated with the probability for very good therapy response (p = 0.04), as well as with moderate treatment response (p = 0.02) compared to no treatment response. Discussion: Our findings suggest that sex may not affect serum levels of investigated AD and AP in children/adolescents. However, treatment outcome of fluoxetine was associated with sex, with higher probability for a better outcome in female patients diagnosed with mood (affective) disorders. Full article

Background/Objectives: Growing pains are a common cause of recurrent limb pain in children, but their etiology remains unclear. Physical activity and nutrition are important factors for musculoskeletal health, but their specific relationship with growing pains has not been well established in young athletes. This study aimed to assess the prevalence of growing pains in child and adolescent athletes and evaluate their adherence to the Mediterranean Diet. Methods: A cross-sectional study was conducted with 916 athletes aged 8–17 years from sports academies in Alicante, Spain. Data were collected via an online survey assessing demographics, pain types, and adherence to the Mediterranean diet. Results: Self-reported pain was highly prevalent, affecting 78.5% of children and 93.5% of adolescents. Musculoskeletal and nocturnal pain increased with age, with nocturnal pain significantly more frequent in girls among children (p < 0.001). Additionally, 32.6% of children and 51.9% of adolescents had received a formal diagnosis of growing pains. Despite this, only 13.7% reported using analgesics, with no significant gender differences. Adherence to the Mediterranean diet was mostly moderate, with children reporting higher fruit and vegetable intake than adolescents, while adolescents consumed more healthy fats and carbohydrates, and participants without pain showed overall healthier dietary patterns. Conclusions: Idiopathic musculoskeletal pain is highly prevalent among young athletes, and their adherence to a healthy diet is suboptimal, challenging the assumption that physically active children maintain well-balanced diets. This underscores the importance of early nutritional education as a strategy to support musculoskeletal health and reduce pain in physically active youth. Full article

Background: This longitudinal study aims to explore the stability and changes in child temperament dimensions between the ages of three and six, analyzing their relationship with emotional and behavioral problems, differentiated by gender. Method: This study involved 24 boys and 25 girls from various early childhood education centers in Málaga, Spain. To assess temperament, the Spanish adaptation of the Children’s Behavior Questionnaire was used, while emotional and behavioral problems were evaluated using the SPECI Screening for Emotional and Behavioral Problems in Children. Results: Findings indicate that 9 out of the 15 temperament dimensions remained stable, while 4—anger/frustration, attentional focusing, perceptual sensitivity, and sadness—showed significant changes in the total sample. The gender-specific analysis revealed different developmental patterns for boys and girls. Girls exhibited changes in attentional focusing, fear, and perceptual sensitivity, while boys showed changes in anger/frustration and attentional focusing. In addition, girls scored higher in discomfort and fear, whereas boys stood out in activity levels. Regarding behavioral problems, girls’ externalizing symptoms were significantly associated with attentional focusing and smiling/laughter, while internalizing symptoms were linked to low-intensity pleasure and perceptual sensitivity. Conclusions: These findings highlight the importance of addressing temperament from a gender-differentiated perspective when designing educational and family interventions aimed at promoting socioemotional development. Full article

Background: Adolescent girls and young women (AGYW) who engage in alcohol and substance abuse face more significant health and social consequences compared to the general population. This study evaluated the prevalence and associated factors of alcohol abuse and substance use among AGYW in Namibia. Methods: We conducted a retrospective analysis of programmatic data from AGYW aged 10–24 who participated in the Determined, Resilient, Empowered AIDS-free, Mentored, and Safe (DREAMS) component of the Reducing HIV Vulnerability: Integrated Child and Youth Health (REACH) Project HOPE Namibia from March to December 2024. Data analysis was conducted employing chi-squared tests alongside binomial and multinomial logistic regression. Results: Among the 19,662 participants included in this analysis, 2068 (10.5%) abused alcohol and/or substances in the previous six months. Participants who were HIV-negative or did not know their status (AOR = 1.57, 95% CI (1.15–2.14), and AOR = 1.50, 95% CI (109–2.07), respectively), from outside Windhoek, those who had failed or repeated school in the previous year (COR = 1.77, 95% CI (1.54–2.05)), those not disabled (AOR = 1.27, 95% CI (1.06–1.52)), those who had dropped out of school or had completed their studies, and those with no adult emotional support (AOR = 1.25, 95% CI (1.11–1.40)), were more likely to have abused alcohol and/or substances recently. In contrast, participants who were not depressed were less likely to have recently abused alcohol and substances. Conclusions: The prioritization of strategies to identify AGYW experiencing depression and to provide them with treatment is essential. Moreover, it is important to encourage parents and guardians to provide emotional support to AGYW, as it prevents them from abusing alcohol and substances. Full article

This study explores the associations between parental playfulness and various aspects of parenting, specifically role overload, parenting behaviors, and the quality of coparenting. In addition, we explore the relation between parental playfulness and child playfulness, as well as the differences in playfulness between mothers and fathers. This cross-sectional, questionnaire-based study relied on a sample of 348 parents (84.7% mothers) of children aged 3–8 years old (52.9% girls). Significant associations were found between parental playfulness and cognitive aspects of child playfulness (e.g., sense of humor). Certain dimensions of coparenting (e.g., support) and other parenting behaviors (e.g., challenging and warmth) were also correlated with parental playfulness. There was no association found between parental playfulness and parental role overload. However, a significant moderation effect of parental gender was found only for the association between parental playfulness and role overload. This analysis showed that parental playfulness was positively associated with role overload for fathers but was negatively associated for mothers. Lastly, we did not identify differences between mothers’ and fathers’ self-reported playfulness. These results provide important information about an understudied parental behavior, which may inform interventions promoting positive parenting. Full article

Background/Objectives: School bullying is a significant issue that negatively impacts children’s well-being, emphasizing the need to identify family-related factors contributing to bullying victimization. This study explored the potential link between parental marital quality and school bullying victimization by employing a moderated mediation model. Methods: Parent–child attachment, measured separately as father–child and mother–child attachment, was tested as a mediator, with child gender included as a moderator. Data were collected from both children and their mothers, comprising 358 mother–child pairs recruited from three primary schools in suburban Beijing, China. Results: Results revealed that greater parental marital quality was associated with a lower risk of bullying victimization, with father–child attachment mediating this relationship. Furthermore, child gender moderated the mediating effect of father–child attachment, such that the indirect pathway from parental marital quality to bullying victimization through father–child attachment was statistically significant for girls but not for boys. Conclusions: These findings highlight the importance of father–child attachment in preventing bullying victimization and suggest that gender-sensitive implications may be necessary. Full article

Background. Emotions are a crucial part of our human nature. The recognition of emotions is an essential component of our social and emotional skills. Facial expressions serve as a key element in discerning others’ emotions. Different databases of images of facial emotion expressions exist worldwide; however, most of them are limited to only adult faces and include only the six basic emotions, as well as neutral faces, ignoring more complex emotional expressions. Here, we present the Children’s Emotions Database (CED), a novel repository featuring both basic and complex facial expressions captured from preschool-aged children. The CED is one of the first databases to include complex emotional expressions in preschoolers. Our aim was to develop such a database that can be used further for research and applied purposes. Methods. Three 6-year-old children (one female) were photographed while showing different facial emotional expressions. The photos were taken under standardized conditions. The children were instructed to express each of the following basic emotions: happiness, pleasant surprise, sadness, fear, anger, disgust; a neutral face; and four complex emotions: pride, guilt, compassion, and shame; this resulted in a total of eleven expressions for each child. Two photos per child were reviewed and selected for validation. The photo validation was performed with a sample of 104 adult raters (94 females; aged 19–70 years; M = 29.9; SD = 11.40) and a limited sample of 32 children at preschool age (17 girls; aged 4–7 years; M = 6.5; SD = 0.81). The validation consisted of two tasks—free emotion labeling and emotion recognition (with predefined labels). Recognition accuracy for each expression was calculated. Results and Conclusions. While basic emotions and neutral expressions were recognized with high accuracy, complex emotions were less accurately identified, consistent with the existing literature on the developmental challenges in recognizing such emotions. The current work is a promising new database of preschoolers’ facial expressions consisting of both basic and complex emotions. This database offers a valuable resource for advancing research in emotional development, educational interventions, and clinical applications tailored to early childhood. Full article

Youth exposed to early-life adversity (ELA) are at greater risk for poorer physical and mental health outcomes in adolescence and adulthood. Although the biological mechanisms underlying these associations remain elusive, DNA methylation (DNAm) has emerged as a potential pathway. DNAm-based measures of epigenetic age have been associated with ELA, indicating accelerated aging. According to the stress sensitization hypothesis, prenatal adversity may further heighten sensitivity to subsequent stressors in childhood and adolescence. This study examined the associations between ELA and six epigenetic aging measures, considering both the timing of adversity and the participant’s sex. Data were drawn from the Quebec Longitudinal Study of Child Development, with two cumulative indices of ELA derived from prospectively collected data: the Perinatal Adversity and the Child and Adolescent Adversity indices. Higher Perinatal Adversity scores were associated with accelerated DunedinPACE scores. No significant associations were found between ELA and the other epigenetic clocks, nor did we find support for the stress sensitization hypothesis—though a sex-specific trend emerged among girls. The findings suggest that DunedinPACE may be more sensitive to variations in ELA than other clocks. Future research should systematically investigate sex-dimorphic associations between ELA and epigenetic aging, with particular attention to the impact of perinatal adversity. Full article

Cross-sectional research suggests associations between enrichment and cognitive skills in toddlerhood. There are no prospectively designed longitudinal studies that investigate the link between early home literacy activities and subsequent mechanisms that explain the putative cognitive benefits. This study tests long-term associations between toddler literacy enrichment and later student engagement across key academic transitions, from kindergarten to the end of high school. Using the Quebec Longitudinal Study of Child Development (QLSCD) population-based birth cohort data, we examined whether parent-reported experiences of shared reading, looking at picture books or illustrated stories, and pretend writing at age 2 years predict later teacher- and self-reported student engagement at ages 6, 12, and 17 years. The results from multiple regression models, stratified by sex and adjusted for pre-existing and concurrent child and family characteristics, revealed significant associations between early literacy enrichment and later engagement. For boys and girls, literacy enrichment in toddlerhood predicted increases in classroom engagement from kindergarten to the end of high school. These findings highlight the lasting influence of early literacy exposure on subsequent learning-related behaviors, both in and beyond the classroom. They underscore the importance of promoting enrichment in early childhood as a family strategy toward individual readiness to learn, a cornerstone of crystalized intelligence. Full article

Background/Objectives: Child undernutrition remains a critical public health issue in Nepal, especially in the rural district of Solukhumbu. This study aimed to assess the prevalence and clinical characteristics of undernutrition, dietary patterns, and related health indicators in school-aged children from the Shree Saraswoti Basic School in Phuleli. Methods: A descriptive, cross-sectional study was conducted between July and August 2022. Fifty-four children (51.8% boys; mean age 9.4 ± 2.1 years) were evaluated using anthropometry, clinical examination, hemoglobin measurement, and three-day 24 h dietary recall. Data were analyzed using descriptive and inferential statistics. Results: BMI z-scores indicated that 39% of children were at risk of acute undernutrition, and 2% were at risk of moderate acute undernutrition. After adjusting for altitude, 87% were classified as anemic. Diets were dominated by cereals and vegetables, with a very low intake of fruits and proteins and no dairy consumption. Dental caries affected 59% of participants. Girls presented slightly higher subcutaneous fat percentages; however, 14.8% of the children exceeded the recommended thresholds. A dietary assessment revealed poor eating habits, including excessive intake of simple carbohydrates and insufficient nutrient diversity. Although socioeconomic data were not directly collected, the findings reflect the typical context of the vulnerability of isolated mountain communities. Undernutrition indicators (BMI, clinical signs, anemia) were associated with poorer health outcomes. An unexpected moderate inverse correlation was found between BMI and both systolic (r = −0.601) and diastolic (r = −0.550) blood pressure. Conclusions: The findings reveal a high burden of undernutrition and anemia among children in Solukhumbu, linked to poor diet and structural vulnerability. Urgent, community-based interventions—including nutrition education, agricultural diversification, and improved healthcare access—are needed. Longitudinal monitoring is essential to track progress and design sustainable, multisectoral solutions. Full article

Problem behaviors and the risk of learning disorders in early childhood carry significant implications for children’s future development. Understanding the relationship between parenting stress and these developmental outcomes may inform the design of effective interventions to promote healthy child development. The present longitudinal study investigated the association between parenting stress and preschoolers’ risk of learning disorders, specifically focusing on the mediating role of problem behaviors. Data were collected at two time points, approximately 6 months apart, from 284 preschool-aged children and their parents (mean age of children at Time 1 = 56.64 months; 53.17% of them were girls). Parents completed standardized assessments of parenting stress, children’s problem behaviors, and the risk of learning disorders. An autoregressive cross-lagged panel model within a half-longitudinal framework was employed to test the hypothesized mediation model. Results revealed that parenting stress had a direct effect on both children’s problem behaviors and their risk of learning disorders. Moreover, children’s problem behaviors partially mediated the longitudinal association between parenting stress and learning disorder risk. Specifically, the indirect effect size was statistically significant (β = 0.022, p = 0.025), indicating that increased parenting stress contributed to approximately a 2.2% increase in the risk of learning disorders through elevated problem behaviors. Theoretically, these findings underscore the critical role of child behavioral adjustment as a mechanism through which parenting stress may influence developmental risk. The results highlight the potential benefits of reducing parenting stress and addressing children’s behavioral difficulties to prevent early learning problems. However, the study relied exclusively on parent-reported data, which may introduce shared method variance and reporting bias; future research should incorporate multiple informants and objective behavioral assessments. Full article

Background/Objectives: Head lice is an ever-present public health issue, especially among the child population. The diagnosis of head lice infestation should be based on direct examination of the scalp, but, in practice, this standard is often not followed, giving way to indirect methods, such as questionnaires or sales reports of delousing shampoos. In Poland, there is no national pediculosis capitis control strategy; therefore, the aim of this study was to determine the prevalence and associated factors of head lice infestation in schools and kindergartens in the years 2021–2023. Methods: Children aged from 3 to 14 years old were directly examined by certified nurses. The same educational institutions were examined across 2021–2023. No personal data of the children were gathered. Results: The prevalence of head lice infestation among children ranged from 8% to 13%, with significantly higher intensity and prevalence observed in girls compared to boys. Conclusions: The prevalence of pediculosis capitis among children in Poland remains persistent and relatively stable over the monitored period. Gender emerged as a significant factor, showing a strong association with both the intensity and extent of head lice infestation. Full article

Background/objectives: Early childhood is marked by rapid physical and cognitive development, underscoring the critical influence of parental choices in shaping habits, pastimes, and traditions. The World Health Organization highlights habits of physical activity, sleep, and screen use as modulators of healthy development and well-being in young children. As a first, this birth cohort study investigates the relationship between movement behaviors in toddlerhood and subsequent sport participation during middle childhood. Methods: Participants are 930 boys and 926 girls from the Quebec Longitudinal Study of Child Development. Using a population-based analytical approach, we examined the relationship between parent-reported active leisure, sleep, and sedentary screen time at age 2 years and trajectory of sport participation between ages 6 and 10 years using sex-stratified linear regressions that account for a range of pre-existing individual and family confounding factors. Results: Many child and family characteristics predicted early childhood movement behaviors, distinctly for boys and girls. Moreover, parental regulation of screen time during early childhood significantly influenced their decisions to enroll and encourage sport participation in sons during school age. Specifically, boys who spent more than 1 h/day on screens had 10% fewer chances of consistently participating in sport throughout middle childhood, even after accounting for adherence to other lifestyle habits. Conclusions: Our findings suggest that parental values regarding early childhood screen exposure are an effective potential target for intervention fostering healthy and active development. Future research should focus on parent and child motivations for sport involvement in the long-term. Full article

Objectives: Our aim was to study whether the Modified Dental Anxiety Scale (MDAS) is reliable and valid for use in children aged 9 to 12 years. Methods: The study population was a convenient sample of Finnish comprehensive school pupils in the third and sixth grades (N = 57 and N = 69, respectively). Dental fear and anxiety (DFA) were measured with the Finnish validated adult version of MDAS, the modified Child Fear Survey Schedule—Dental Subscale (CFSS-DS-M), and a single question. Reliability was evaluated using Cronbach’s alpha. The criterion validity of MDAS was assessed using Spearman rank correlation coefficients against CFSS-DS-M and the single question. Construct validity was assessed by examining the ability of MDAS to find differences according to gender and treatment procedures using the chi-square test for categorized and the Mann–Whitney and Jonckheere–Terpstra tests for continuous variables. Results: The Cronbach alphas were 0.841, 0.708, and 0.778 for MDAS total, anticipatory, and treatment-related DFA, respectively. Correlations between MDAS and CFSS-DS-M total and subscale scores were moderate to strong (ρ = 0.559–0.794), supporting criterion validity. Girls in third grade had lower mean MDAS anticipatory DFA (3.4, SD = 1.44) than boys (4.5, SD = 2.21, p = 0.051). In sixth graders, girls had higher mean MDAS treatment-related DFA (8.4, SD = 3.17) than boys (6.9, SD = 2.61, p = 0.067). Children reporting orthodontic treatment had lower anticipatory DFA (mean = 3.4, SD = 2.13) than children not reporting (mean = 4.0, SD = 1.83; p = 0.009), supporting construct validity. Conclusions: The Finnish version of the MDAS showed good reliability, good criterion validity, and acceptable construct validity, supporting its use in children aged 9–12 years. 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