Conductas internalizantes y externalizantes en jóvenes universitarios peruanos afectados por violencia familiar / Internalizing and externalizing behaviors in young peruvian university students affected by family violence / Comportamentos internalizando e externalizando em jovens universitários peruanos afetados pela violência familiar

Debido al aislamiento social que se vivió gracias a la pandemia por Covid-19, las horas de convivencia familiar aumentaron en cada hogar, convirtiéndose en un potencial peligro cuando el entorno familiar más cercano está lleno de violencia; esto puede traer diversos problemas a la salud física, psicológica y emocional. Por ello, se buscó identificar los principales tipos de violencia familiar que han experimentado los jóvenes universitarios, distinguir entre las conductas externalizantes e internalizantes como consecuencia de estos eventos adversos, así como conocer la relación estadística entre las variables de estudio. La investigación tuvo un enfoque cuantitativo, alcance correlacional y con diseño no experimental transversal; la muestra final estuvo constituida por 374 estudiantes de tres universidades de Lima, Perú. Según los hallazgos, la violencia psicológica es la que se presenta con mayor frecuencia, la ansiedad-depresión y el retraimiento son las dos conductas más comunes y los índices de correlación entre las variables son positivos y significativos. Las mujeres presentan más puntaje en las conductas internalizantes, mientras que los varones en las externalizantes; así mismo, se encontró que los más jóvenes presentan más conductas externalizantes. Finalmente, se evidenció la existencia de violencia familiar en los hogares de los jóvenes universitarios, lo cual se ha traducido en diversos tipos de conducta que podrían afectar su salud y también su rendimiento académico.

Due to the social isolation that was experienced thanks to the Covid-19 pandemic, the hours of family life increased in each home, becoming a potential danger when the closest family environment is full of violence; this can bring various problems to physical, psychological and emotional health. Therefore, we sought to identify the main types of family violence that university students have experienced, distinguish between externalizing and internalizing behaviors as a consequence of these adverse events, as well as knowing the statistical relationship between the study variables. The research was a quantitative, correlational and a non-experimental cross-sectional design; the sample consisted of 374 students from three universities in Lima, Peru. According to the findings, psychological violence is the one that occurs most frequently, anxiety-depression and withdrawal are the two most common behaviors and the correlation rates between the variables are positive and significant. Women present higher scores in internalizing behaviors, while men in externalizing ones; Likewise, it was found that the youngest present more externalizing behaviors. The existence of family violence in the homes of university students was evidenced, which has resulted in various types of behavior that could affect their health and also their academic performance.

Effect of parent-child cohesion on internalizing problems of junior high school students: the mediating role of self-esteem and the moderating role of sibling relationships / 中华行为医学与脑科学杂志

Objective:To explore the effect of self-esteem and sibling relationships on the links of parental cohesion and internalizing problems in junior high school students based on the family system theory.Methods:A total of 565 junior high school students were investigated with the sibling relationship questionnaire, parent-child cohesion questionnaire, self-esteem scale and internalizing problems questionnaire from April to June 2021.SPSS 26.0 was used for descriptive statistics and Pearson correlation analysis.PROCESS was used to examine the mediating and moderating effect.Results:Maternal-child cohesion was positively correlated with self-esteem and sibling warmth ( r=0.36, 0.58, both P<0.01), while it was negatively correlated with internalizing problems and sibling conflict ( r=-0.29, -0.25, both P<0.01). Similarly, paternal-child cohesion was positively correlated with self-esteem and sibling warmth ( r=0.37, 0.51, both P<0.01), and it was negatively correlated with internalizing problems and sibling conflict ( r=-0.36, -0.21, both P<0.01). The self-esteem played a partial mediating role between maternal-child cohesion and internalizing problems ( β=-0.09, 95% CI=-0.14--0.05), and the mediating value was 30.13%.The self-esteem also played a partial mediating role between paternal-child cohesion and internalizing problems ( β=-0.07, 95% CI=-0.11--0.04), and the mediating value was 25.36%.Sibling warmth could improve the positive effect of maternal-child cohesion on self-esteem ( β=0.06, 95% CI=0.01-0.11), while could offset the negative effects of low level of maternal-child cohesion against the internalizing problems ( β=0.10, 95% CI=0.04-0.16). But sibling conflict did not significantly predict the effects of maternal-child cohesion on self-esteem and internalizing problems.Similarly, sibling warmth could improve the positive effect of paternal-child cohesion on self-esteem ( β=0.05, 95% CI=0.01-0.09), while could offset the negative effects of low level of paternal-child cohesion against the internalizing problems ( β=0.09, 95% CI=0.03-0.15). But sibling conflict could reduce the positive impact of paternal-child cohesion and self-esteem ( β=-0.05, 95% CI=-0.09--0.01), while had no effect on the impact of paternal-child cohesion and internalizing problems. Conclusion:Parent-child cohesion not only directly affects the internalizing problems, but also indirectly affects the internalizing problems through the self-esteem.Positive parent-child cohesion and sibling warmth relationships can improve the individual's self-esteem level and reduce the internalizing problems.

Adverse childhood experiences and psychopathology in adolescents from northern Chile: the moderating role of the attachment style

Abstract Background Identifying the underlying mechanisms through which adverse childhood experiences affect (ACEs) the mental health of adolescents is of paramount importance for disease prevention in later stages of life. Objective The present study examines the relationship between ACEs and psychopathology in adolescents from northern Chile and how attachment style (abandonment anxiety and intimacy avoidance) may moderate this relationship. A total of 154 schooled adolescents aged 12 to 17 (M = 15.08, SD = 1.64) completed a series of self-report questionnaires including the Adverse Childhood Experience Questionnaire (ACEs), Experiences in Close Relationships-Relationship Structures (ECR-RS), and Youth Self Report (YSR-18). Results The data analysis was carried out using SPSS version 25, which included descriptive analysis, one-way ANOVA, and Spearman correlation analysis. To address moderation analysis, the PROCESS macro extension version 4.1 was employed. In this process, the bootstrap method was applied to construct confidence intervals, and the pick-a-point approach was used to define the levels of the moderating variable. According to the results, 80.3% of the sample experienced one or more ACEs, and 16.4% reported experiencing at least three. Furthermore, the variables under study exhibited significant correlations with each other, except for intimacy avoidance, which showed no correlation with ACEs (rho = −0.10; p = 0.273). When considering abandonment anxiety as a moderating variable, the direct effect of ACEs on externalizing symptoms showed statistically significant changes (β = 0.60, p = 0.03). No other moderating effects were found according to the proposed models. Conclusion In childhood, the accumulation of ACEs is associated with the development of psychopathology in adolescents from northern Chile, specifically with the presence of internalizing and externalizing symptoms. These findings suggest that lower levels of abandonment anxiety could mitigate the effects of ACEs on adolescent psychopathology, while higher levels of abandonment anxiety could exacerbate these effects on psychopathology.

Cross-cultural adaptation, validity, and reliability of the Child and Adolescent Behavior Inventory (CABI) for use in Brazil

Abstract Objective The Child and Adolescent Behavior Inventory (CABI) is a cost-free 75 question-questionnaire developed by an Italian group to collect information from parents on the behavior of children and adolescents aged 6 to 18 years. It assesses different areas of children's behavior and psychopathology, including internalizing and externalizing symptoms, and can be used to identify children at risk of mental disorders both in clinical and epidemiological settings. In this study, the authors present a Brazilian-Portuguese adaptation of the CABI and its psychometric properties. Methods First, the authors conducted a rigorous transcultural adaptation of CABI's questions and instructions for the Brazilian context. In an online sample of 598 parents, the authors found high reliability (internal consistency) for the CABI's main subscales. Results Validity was supported by exploratory factor analysis (the authors found 6 factors representing several aspects of psychopathology both according to the DSM and HiTop models) and significant differences in most CABI's subscales between children with parent-reported psychopathology and typically developing ones. The present study suggests that the adapted version of CABI is a valid and reliable measure that can be used in Brazil. Conclusions The CABI can be useful to the pediatrician to get fast but wide information from parents on the behavioral condition of their children or adolescents, and also to decide whether it is appropriate to consult a mental health professional.

Hábitos de sono e relação com indicadores de saúde mental na infância / Sleep habits and relationship with mental health indicators in childhood / Hábitos de sueño y relación con indicadores de salud mental en la infancia

Este estudo investigou a relação entre hábitos de sono e indicadores de saúde mental na infância relatados por cuidadores, além de buscar evidências de validade e precisão da adaptação para o Brasil do Children's Sleep Habits Questionnaire (CSHQ). Participaram 60 crianças, entre 4 e 10 anos, de uma escola pública da região central de São Paulo, em 2019. A média geral no CSHQ-BR foi 49,08. Não houve diferenças de sexo nos escores do CSHQ e do Strengths and Difficulties Questionnaire (SDQ). Houve correlações positivas e significativas entre o CSHQ e o SDQ, especificamente entre dificuldades, parassonias e distúrbios respiratórios do sono com problemas emocionais e hiperatividade. Hábitos de sono explicaram 23% da variância no SDQ. O coeficiente alfa de Cronbach do CSHQ-BR foi 0,75, indicando consistência interna adequada. Esses achados apontam evidências de validade e precisão do CSHQ-BR. Hábitos de sono estão associados a indicadores de problemas emocionais e comportamentais.

This study investigated the relationship between sleep habits and mental health indicators in childhood reported by caregivers, in addition to seeking evidence of validity and reliability of the Children Sleep Habits Questionnaire (CSHQ), Brazilian version (CSHQ-BR). Sixty children participated, between 4 and 10 years old, from a public school in the central region of São Paulo, in 2019. The overall mean of the CSHQ-BR score was 49.08. There were no differences between sex in the CSHQ and the Strengths and Difficulties Questionnaire (SDQ) scores. Positive and significant correlations were observed between the CSHQ and the SDQ, specifically between difficulties, parasomnias, sleep-disordered breathing with emotional problems, and hyperactivity. Sleep problems explain 23% of the variance of the SDQ scores. The Cronbach's Alpha Coefficient was 0.75, indicating adequate internal consistency. These findings point to evidence of the validity and accuracy of the CSHQ-BR. Sleep habits are associated with indi-cators of emotional and behavioral problems

Se investigó la relación entre hábitos de sueño y indicadores de salud mental infantil reportados por cuidadores, además de buscar evidencia de validez y precisión de la adaptación del Cuestionario de Hábitos de Sueño Infantil (CSHQ) para Brasil. En 2019 participaron 60 niños de 4 a 10 años de una escuela pública de la región central de São Paulo. El promedio general en el CSHQ-BR fue 49,08. No hubo diferencias de género en las puntuaciones del CSHQ y del Cuestionario de Fortalezas y Dificultades (SDQ). Hubo correlaciones positivas y significativas entre CSHQ y SDQ, específicamente entre dificultades, parasomnias y trastornos respiratorios del sueño con problemas emocionales e hiperactividad. Hábitos de sueño explicaron 23% de la variación en el SDQ. El coeficiente alfa de Cronbach de CSHQ-BR fue 0,75, indicando una consistencia interna adecuada. Estos hallazgos apuntan evidencia de validez y precisión del CSHQ-BR. Hábitos de sueño están asociados con indicadores de problemas emocionales y de comportamiento.

Relationships between coparental triangulation, parent-adolescent conflicts and adolescent adjustment: Differences between fathers and mothers / Relações entre triangulação coparental, conflitos pais-filhos e ajustamento de adolescentes: Diferenças entre pais e mães / Relaciones entre la triangulación coparental, los conflictos padre/madre-hijos y el ajuste del adolescente: Diferencias entre padres y madres

The involvement of the adolescent in coparental conflict through triangulation impacts the development of emotional and behavioral symptoms. This article researched direct and indirect impacts of coparental triangulation relations and conflicts between parents and their adolescent children on internalizing and externalizing problems, controlling gender and age variables. As a quantitative, cross-sectional and explanatory study, it included 238 adolescents, aged 14 to 18 years old, and used structural equation modeling analysis. As a result, internalizing and externalizing problems were associated with father, mother, and coparental dyad triangulation, mediated by conflicts between father-adolescent conflict and mother-adolescent conflict. Father triangulation had direct and indirect connections with adolescents' externalizing problems. Mother triangulation was associated with adolescents' anxiety and depression, mediated by father-adolescent conflicts. There were no distinctions for gender and age regarding the level of impact between variables. The data provide greater depth and precision in understanding these relationships for practical applications looking for a healthy development of the offspring and their families

O envolvimento de adolescentes nos conflitos coparentais por meio da triangulação impacta no desenvolvimento de sintomas emocionais e comportamentais. Este artigo investigou os impactos diretos e indiretos das relações de triangulação coparental e conflitos entre pais e filhos em problemas internalizantes e externalizantes dos adolescentes, controlando variáveis de gênero e idade. De caráter quantitativo, transversal e explicativo, incluiu 238 adolescentes de 14 a 18 anos e foi utilizada análise de modelagem de equações estruturais. Problemas internalizantes e externalizantes associaram-se à triangulação do pai, da mãe e da díade coparental, mediados por conflitos entre pai e filho e conflitos entre mãe e filho. Triangulação paterna teve relação direta e indireta com problemas externalizantes dos adolescentes. Triangulação materna associou-se à ansiedade e depressão dos adolescentes, mediada por conflitos entre pai e filho. Não houve distinções no modelo para gênero e idade quanto ao nível de impacto entre as variáveis. Os dados possibilitam maior precisão na compreensão dessas relações para aplicações práticas visando o desenvolvimento saudável da prole e suas famílias.

La participación de adolescentes en conflictos coparentales a través de la triangulación impacta en el desarrollo de síntomas emocionales y conductuales. Este artículo investigó los impactos directos e indirectos de las relaciones de triangulación coparental, y los conflictos entre padres e hijos, en los problemas de internalización y externalización de adolescentes, controlando las variables de género y edad. Siendo de carácter cuantitativo, transversal y explicativo, incluyó 238 adolescentes de 14 a 18 años y utilizó análisis de modelos de ecuaciones estructurales. Los problemas de internalización y externalización se asociaron con la triangulación de padre, madre y díada coparental, mediada por conflictos entre padre e hijo y madre e hijo. La triangulación paterna se relacionó directa e indirectamente con problemas de externalización de los adolescentes. La triangulación materna se asoció con ansiedad y depresión de los adolescentes, mediada por conflictos entre padre e hijo. No hubo distinciones en el modelo por género y edad en cuanto al nivel de impacto entre las variables. Los datos permiten una mayor precisión en la comprensión de estas relaciones para aplicaciones prácticas dirigidas al desarrollo saludable de la prole y sus familias.

Conductas internalizantes y externalizantes en jóvenes universitarios peruanos afectados por violencia familiar

Debido al aislamiento social que se vivió gracias a la pandemia por Covid-19, las horas de convivencia familiar aumentaron en cada hogar, convirtiéndose en un potencial peligro cuando el entorno familiar más cercano está lleno de violencia; esto puede traer diversos problemas a la salud física, psicológica y emocional. Por ello, se buscó identificar los principales tipos de violencia familiar que han experimentado los jóvenes universitarios, distinguir entre las conductas externalizantes e internalizantes como consecuencia de estos eventos adversos, así como conocer la relación estadística entre las variables de estudio. La investigación tuvo un enfoque cuantitativo, alcance correlacional y con diseño no experimental transversal; la muestra final estuvo constituida por 374 estudiantes de tres universidades de Lima, Perú. Según los hallazgos, la violencia psicológica es la que se presenta con mayor frecuencia, la ansiedad-depresión y el retraimiento son las dos conductas más comunes y los índices de correlación entre las variables son positivos y significativos. Las mujeres presentan más puntaje en las conductas internalizantes, mientras que los varones en las externalizantes; así mismo, se encontró que los más jóvenes presentan más conductas externalizantes. Finalmente, se evidenció la existencia de violencia familiar en los hogares de los jóvenes universitarios, lo cual se ha traducido en diversos tipos de conducta que podrían afectar su salud y también su rendimiento académico.

Due to the social isolation that was experienced thanks to the Covid-19 pandemic, the hours of family life increased in each home, becoming a potential danger when the closest family environment is full of violence; this can bring various problems to physical, psychological and emotional health. Therefore, we sought to identify the main types of family violence that university students have experienced, distinguish between externalizing and internalizing behaviors as a consequence of these adverse events, as well as knowing the statistical relationship between the study variables. The research was a quantitative, correlational and a non-experimental cross-sectional design; the sample consisted of 374 students from three universities in Lima, Peru. According to the findings, psychological violence is the one that occurs most frequently, anxiety-depression and withdrawal are the two most common behaviors and the correlation rates between the variables are positive and significant. Women present higher scores in internalizing behaviors, while men in externalizing ones; Likewise, it was found that the youngest present more externalizing behaviors. The existence of family violence in the homes of university students was evidenced, which has resulted in various types of behavior that could affect their health and also their academic performance.

Devido ao isolamento social vivido graças à pandemia de Covid-19, as horas de convívio em família aumentaram em cada casa, tornando-se um perigo potencial quando o ambiente familiar mais próximo está repleto de violência; isso pode trazer diversos problemas para a saúde física, psicológica e emocional. Assim, buscou-se identificar os principais tipos de violência familiar vivenciados por estudantes universitários, distinguir entre comportamentos externalizantes e internalizantes decorrentes desses eventos adversos, bem como conhecer a relação estatística entre as variáveis ​​do estudo. A pesquisa teve abordagem quantitativa, escopo correlacional e delineamento transversal não experimental; a amostra final foi composta por 374 estudantes de três universidades de Lima, Peru. De acordo com os achados, a violência psicológica é a que ocorre com maior frequência, ansiedade-depressão e retraimento são os dois comportamentos mais comuns e os índices de correlação entre as variáveis ​​são positivos e significativos. As mulheres têm pontuações mais altas nos comportamentos internalizantes, enquanto os homens nos externalizantes; Da mesma forma, verificou-se que os mais jovens apresentam mais comportamentos externalizantes. Por fim, evidenciou-se a existência de violência familiar nas residências de estudantes universitários, o que resultou em diversos tipos de comportamento que podem afetar sua saúde e também seu desempenho acadêmico.

Effect of play-based communication and behavior intervention on improving internalizing and externalizing behaviors in children with autism spectrum disorder / 中华行为医学与脑科学杂志

Objective:To explore the effect of play-based communication and behavior intervention (PCBI) on internalizing and externalizing behaviors in children with autism spectrum disorder (ASD).Methods:From November 2018 to November 2021, 90 ASD children aged 8-30 months who registered in the Child Mental Health Research Center of the Affiliated Brain Hospital of Nanjing Medical University for PCBI ultra-early intervention training were selected and randomly assigned to the intervention group( n=60) and the waiting group( n=30) according to the ratio of 2∶1.Behavioral videos of free play between children and caregivers were collected before and after the 12-week intervention and the behavioral observation and analysis system (Observer XT) was used to code the parent-child interaction status and children's internalizing and externalizing behaviors.SPSS 23.0 statistical software were used and the data were analyzed by t-test, chi-square test, Pearson correlation analysis and multiple linear stepwise regression analysis. Results:After the intervention, the children in the intervention group had improved internalizing and externalizing behaviors (2.43±2.22, 1.88±1.91) compared with those before the intervention (4.82±3.37, 3.68±5.68), and the difference was statistically significant ( t=4.66, 2.60, both P<0.05). The children in the waiting group had no significant difference in internalizing and externalizing behaviors before (4.23±2.47, 4.00±2.18) and after intervention (4.37±2.57, 4.67±3.72) ( t=-0.23, -0.83, both P>0.05). After intervention, the children in the intervention group had fewer internalizing and externalizing behaviors than those in the waiting group, and the difference was statistically significant ( t=-3.70, -4.71, both P<0.05). The differences in internalizing behaviors (2.38±3.96, 1.80±5.37) and externalizing behaviors (1.80±5.37, -0.67±4.38) between the two groups before and after the intervention were statistically significant ( t=3.03, 2.18, both P<0.05). The results of multiple linear stepwise regression showed that the negative interaction of caregivers ( β=0.29, P<0.01) was a risk factor for internalizing behaviors.The negative interaction of children ( β=0.45, P<0.01) was a risk factor for externalizing behaviors, and the child's object status ( β=-0.30, P<0.01) and binary interaction ( β=-0.39, P<0.01) were protective factors for externalizing behaviors.In the intervention group, active child interaction, active caregiver interaction, and binary interaction increased after the intervention ( t=-6.77, -4.58, -7.72, all P<0.05), while the child's object status and the caregiver's negative interaction decreased ( t=3.37, 4.30, both P<0.05). Conclusion:The PCBI ultra-early intervention can effectively improve the internalizing and externalizing behaviors of ASD children.Improvements in internalizing behaviors may work by reducing negative caregiver interactions, and improvements in externalizing behaviors may work by increasing parent-child binary interactions.

Problemas internalizantes e externalizantes de crianças e adolescentes com fibrose cística / Internalizing and externalizing problems of children and adolescents with cystic fibrosis / Problemas de internalización y externalización de niños y adolescentes con fibrosis quística

A fibrose cística é uma doença genética, ainda sem cura, provocada por mutações cromossômicas, que pode afetar vários sistemas, dentre os quais o respiratório e o digestivo são os mais comumente atingidos. O adoecimento crônico traz alterações psicológicas para os pacientes e seus cuidadores. Com o objetivo de avaliar problemas internalizantes e externalizantes, e também competências de crianças e adolescentes com fibrose cística, foram entrevistados 31 cuidadores familiares, majoritariamente mães de pacientes na faixa etária de 6 a 18 anos, em salas de espera de três centros de referência no tratamento da doença na cidade de São Paulo. Os instrumentos utilizados foram: Inventário de Comportamentos da Infância e da Adolescência e diário de campo. Os resultados apontaram a prevalência de problemas internalizantes em adolescentes com fibrose cística. A análise do diário de campo indicou dificuldades na adesão ao tratamento e demandas de atendimento psicológico não assistidas em pacientes e seus cuidadores familiares. A ausência de profissional de Psicologia nas equipes multiprofissionais configurou-se como um prejuízo frente as condições psicológicas dos pacientes de fibrose cística e seus cuidadores familiares.(AU)

Cystic fibrosis is a genetic disease, still without cure, caused by chromosomal mutations that can affect various systems, the respiratory and digestive systems being the most common. Chronic illness brings psychological changes to patients and their caregivers. Aiming to evaluate internalizing and externalizing problems, and competences of children and adolescents with cystic fibrosis, we interviewed 31 family caregivers, mostly mothers, of patients aged 6 to 18 years in waiting rooms of three Reference Centers in the treatment of the disease in the municipality of São Paulo, state of São Paulo. The instruments used were: Child behavior checklist and Field Diary. The results pointed out the prevalence of internalizing problems in patients with cystic fibrosis in adolescence. Field diary analysis indicated difficulties in adherence to treatment and unassisted demands for psychological care in patients and their family caregivers. The absence of a Psychology professional in the multiprofessional teams showed to be prejudicial to the psychological conditions of cystic fibrosis patients and their family caregivers.(AU)

La fibrosis quística es una enfermedad genética, aún sin cura, causada por mutaciones cromosómicas y que puede afectar varios sistemas, entre ellos los sistemas respiratorio y digestivo son los más comunes. La enfermedad crónica trae cambios psicológicos a los pacientes y sus cuidadores. Para evaluar los problemas de internalización y externalización, así como las competencias de niños y adolescentes con fibrosis quística, se entrevistó a 31 cuidadores familiares, en su mayoría madres de pacientes de 6 a 18 años de edad, en salas de espera de tres centros de referencia en el tratamiento de la enfermedad en la ciudad de São Paulo. Los instrumentos utilizados fueron: Inventario del Comportamiento de Niños y Adolescentes y diario de campo. Los resultados mostraron la prevalencia de problemas de internalización en pacientes con fibrosis quística en la adolescencia. El análisis del diario de campo indicó dificultades en la adherencia al tratamiento y demandas de asistencia psicológica no asistida en pacientes y sus cuidadores familiares. Se hace necesario un profesional de psicología en los equipos multiprofesionales ante las condiciones psicológicas de los pacientes con fibrosis quística y sus cuidadores familiares.(AU)

Internalized and externalized behavioral problems in children with leukemia and influencing factors / 中华实用儿科临床杂志

Objective:To investigate internalized and externalized behavioral problems in children with leukemia and to analyze the influencing factors.Methods:A total of 121 children match the inclusion and exclusion criteria with leukemia hospitalized in Hematology and Oncology Department of 3 hospitals in Zhengzhou city from November 2021 to March 2022 were recruited through a cluster sampling method.The general information questionnaire, Strengths and Difficulties Questionnaire (parent version), Psychological Adaptation Scale, Perceived Social Support Questionnaire and Zarit Burden Interview were used for investigation.Multiple linear regression was used to analyze the influencing factors of internalized and externalized behavioral problems in children with leukemia.Results:Among 121 children with leukemia, there were 72 males and 49 females, with the age of (7.16 ± 3.18) years.The total score of interna-lized and externalized behavioral problems in 121 children with leukemia was (6.12±3.13) points and (5.49±2.92) points, respectively.Multiple linear regression analysis showed that burden of care ( β=0.412, P<0.001), family support ( β=-0.242, P=0.003) and monthly household income per capita ( β=-0.167, P=0.036) were the influencing factors of internalized behavioral problems in children with leukemia.Burden of care ( β=0.360, P<0.001), social integration ( β=-0.223, P=0.008) and caregiver age ( β=-0.176, P=0.035) were the influencing factors of externalized behavioral problems in children with leukemia. Conclusions:Children with leukemia suffer severe internalized and externalized behavioral problems.Burden of care of the caregiver, family support and social integration are predictors of adverse emotional and behavioral problems in children.

Empatia e problemas emocionais e de comportamento infantil / Empathy and child emotional and behavioral problems / Empatia y problemas emocionales y de conducta infantil

Empatia é uma resposta emocional que se assemelha à emoção sentida pelo outro. Baixos níveis de empatia repercutem nas relações sociais, associando-se a problemas emocionais e de comportamento. Objetivou-se comparar grupos de crianças com e sem indicadores clínicos de problemas internalizantes, externalizantes e escalas sindrômicas relacionadas quanto a empatia. Participaram do estudo 106 crianças matriculadas do 1° ao 3° anos do ensino fundamental e seus responsáveis, que responderam aos instrumentos: Escala de Empatia Infanto-juvenil, Questionário de Dados Sociodemográficos e Inventário dos Comportamentos de Crianças e Adolescentes. Testes de comparação (tstudent e Mann-Whitney) indicaram que crianças com problemas externalizantes apresentaram maior média de preocupação com o outro, crianças com comportamentos de quebrar as regras e sintomas internalizantes exibiram índices mais altos de envolvimento emocional com o outro. Os resultados sugerem que altos níveis de empatia afetiva podem aumentar a vulnerabilidade ao desenvolvimento de problemas emocionais e de comportamento neste período de desenvolvimento da criança (AU).

Problemas internalizantes em adultos / Internalizing problems in adults

RESUMO são escassas as investigações sobre problemas internalizantes em adultos brasileiros. Estudos epidemiológicos apontam que ansiedade e depressão são mais comuns em mulheres. Este estudo apresenta uma investigação com 240 adultos de diferentes municípios da Região Metropolitana da Baixada Santista, com uso do Adult Self Report . Dados foram analisados por estatística descritiva e inferencial, considerando a variável sexo. Não foram encontradas diferenças significativas entre homens e mulheres da amostra em termos de problemas internalizantes, ansiedade/depressão, retraimento e queixas somáticas. Resultados são discutidos à luz de dados epidemiológicos sobre transtornos mentais em outros recortes populacionais brasileiros. Ficam sugeridos novos estudos com ampliação de amostra.

ABSTRACT investigations on internalizing problems in Brazilian adults are scarce. Epidemiological studies indicate that anxiety and depression are more common among women. This study presents an investigation with 240 adults from different municipalities in the Baixada Santista Metropolitan Region, using the Adult Self Report. The data was analyzed using descriptive and inferential statistics, considering as variable the gender. No significant differences were found between men and women in the sample in terms of internalizing problems, anxiety/depression, withdrawal and somatic complaints. Results are discussed in the light of epidemiological data on mental disorders in other Brazilian population segments. New studies with sample expansion are suggested.

Sentimientos de soledad y problemas internalizantes frente al distanciamiento social y confinamiento preventivo por el coronavirus COVID-19 / Feelings of Loneliness and Internalizing Problems as a Result of Preventive Social Distancing and Lockdown due to the Coronavirus COVID-19

El objetivo de este estudio es analizar la relación entre sentimientos de soledad y problemas internalizantes producto del distanciamiento social y el confinamiento, para comprender el impacto psicológico en la población. Metodología: estudio de diseño mixto descriptivo-correlacional de alcance temporal transversal. Instrumentos: Perceptions of the Adult US Population regarding the Novel Coronavirus, Three-Item Loneliness Scale y el Adult Self Report. Muestra: 653 casos respondieron una encuesta online en marzo 2020. Resultados: mayores niveles de soledad y problemas internalizantes en sujetos jóvenes convivientes con sus padres y en adultos que viven solos. Hay correlaciones significativas entre sentimientos de soledad y problemas internalizantes: ansiedad-depresión (r =,636, p<.001) y quejas somáticas (r=,422, p<.001). Prevalencia de problemas internalizantes: preocupación general, inquietud por el futuro y trastornos del sueño. Discusión: los resultados del estudio identificaron dos grupos de riesgo: los jóvenes convivientes con sus padres y los adultos que viven solos(AU)

The objective of this study is to analyze the relationship between feelings of loneliness and internalizing problems as a result of social distancing and lockdown, in order to understand the psychological impact on the population. Methodology: mixed descriptive-correlational design study with a transversal temporal scope. Instruments: Perceptions of the Adult US Population regarding the Novel Coronavirus, Three-Item Loneliness Scale and the Adult Self Report. Sample: 653 individuals answered an online survey in March 2020. Results: higher levels of loneliness and internalizing problems in young adults living with their parents and in adults living alone. There are significant correlations between feelings of loneliness and internalizing problems: anxiety-depression (r = .636, p = .000) and somatic complaints (r = .422, p = .000). Prevalence of internalizing problems: general concern, concern about the future and sleep disorders. Discussion: the study identified two groups at risk: young people living with their parents and adults living alone(AU)

An epidemiological study of childhood development in an urban setting in Brazil

Objective: Mental illness is an important public health concern, often starting early in life and particularly impacting children from low-and middle-income countries. Our aims were to 1) determine, in a representative sample of public preschool 4- to 5-year old children in Brazil, the prevalence of internalizing and externalizing disorders and socioemotional development delays; and 2) to identify modifiable risk factors associated with mental, behavioral, or developmental disorders (MBDD), such as microsystem (i.e., parent-child relationship), mesosystem (social support), and macrosystem contextual factors (neighborhood disadvantage). Methods: A random sample of public preschool children was recruited in the city of Embu das Artes (São Paulo metropolitan area) (n=1,292 from 30 public preschools). Six-month prevalence of MBDD was measured using the Child Behavior Checklist (CBCL) and the Ages and Stages Questionnaires: Social-Emotional (ASQ:SE). Results: Six-month prevalence estimates were 25.4% for internalizing disorders, 12.1% for externalizing disorders, and 30.3% for socioemotional development delays. MBDD prevalence estimates were higher in families with stressful relationships and parental depression or anxiety, and in families with lower social capital. Conclusion: At least 25% of preschool children living in an urban area in Brazil presented a mental health disorder. These mental disorder were associated with modifiable factors such as stressful family relationships and lower social capital. Prevention and intervention measures such as family therapy are needed to decrease such high prevalence.

Behavior Problems in Four-Year-Old Children from a Brazilian Birth Cohort / Problemas de Comportamento em Crianças Brasileiras de Quatro Anos de Idade

Abstract This study aimed to investigate the occurrence of behavior problems in 3750 four years old children from a birth cohort. Children were followed from birth to four years old through home visits, and questionnaires on child health and development and the Child Behavior Checklist 4-18/CBCL were applied. Prevalence rates were high (total problems 35.6%), particularly externalizing problems, which occurred in 44.4 % of children (48.3% girls; 40.6% boys; p < 0.001). Internalizing problems were less prevalent, occurring in 15.5 % of children (19.1% boys; 11.6% girls; p < 0.001). Regardless of sex, there was a higher prevalence of behavioral problems in children with younger siblings, whose mothers had less education and had no partner.

Resumo Este estudo objetivou investigar a ocorrência de problemas de comportamento em 3750 crianças pertencentes a uma coorte de nascimentos. As crianças foram acompanhadas do nascimento aos quatro anos de idade, por meio de visitas domiciliares, tendo sido aplicados instrumentos sobre saúde e desenvolvimento infantil e o Child Behavior Checklist 4-18/CBCL. As prevalências encontradas foram altas (total de problemas de comportamento: 35,6%), com destaque para problemas de externalização, que ocorreram em 44,4% das crianças (48,3% meninas; 40,6% meninos; p < 0,001). Problemas de internalização foram menos prevalentes, ocorrendo em 15,5% das crianças (19,1% meninos; 11,6% meninas; p < 0,001). Independente do sexo, houve maior prevalência de problemas de comportamento em crianças com maior número de irmãos mais novos, cujas mães tinham menor escolaridade e não tinham companheiro.

El papel de las competencias emocionales parentales en las conductas internalizantes y el autoconcepto de los niños / The role of emotional parental competencies in children's internalizing behaviors and self-concept

Resumen Introducción: Las competencias emocionales de los padres se constituyen en un factor protector para el fortalecimiento del autoconcepto en los niños; sin embargo, cuando no se expresan adecuadamente pueden generar en los hijos problemas internalizantes. La evidencia empírica en Colombia sobre la relación entre dichas variables no ha sido suficiente por lo cual es fundamental continuar su estudio. Objetivo: Identificar la relación entre competencias emocionales de los padres, el nivel de autoconcepto y las conductas internalizantes en niños de 8 a 12 años. Método: En esta investigación correlacional se aplicó el Cuestionario de Evaluación de Estilos Educativos de Padres (CEEP), la Lista de Chequeo de la Conducta Infantil (CBCL) formato para padres; y la Escala de autoconcepto de Piers-Harris a los niños. Los participantes fueron 364, conformados por 182 diadas (padres e hijos de 8 a 12 años) de colegios públicos y privados de Bogotá, seleccionados bajo un muestreo no probabilístico por conveniencia. Resultados: Se encontró una relación positiva estadísticamente significativa entre la impulsividad en padres y los síntomas ansioso/depresivo (Rho= 0,213; p= 0,04) y aislado/depresivo (Rho= 0,210; p= 0,004) en los niños. Se hallaron relaciones inversas entre el manejo emocional y el componente intelectual del autoconcepto (Rho= -0,148; p= 0,046), entre los síntomas ansioso/depresivo y los componentes conductual (Rho= -0,240; p= 0,001), físico (Rho= -0,182; p= 0,014) y falta de ansiedad del autoconcepto (Rho= -0,213; p= 0,004). Conclusiones: Las relaciones encontradas entre impulsividad y síntomas internalizantes en los niños, evidencian que los enfados excesivos e injustificados de los padres, pueden asociarse con preocupación excesiva y aislamiento social en los hijos. Estos hallazgos permiten sugerir para futuros estudios, evaluar el efecto de programas para prevenir problemas de ansiedad y depresión en los niños a través del entrenamiento en regulación emocional a los padres.

Abstract Introduction: The emotional competences of the parents are a protective factor for strengthening the self-concept in children; However, when they aren't expressed properly, they can generate internalizing problems in the children. The empirical evidence in Colombia on the relationship between these variables hasn't been sufficient, so it is essential to continue its study. Objective: To identify the relationship between parents' emotional competences, the level of self-concept and internalizing behaviors such as anxiety, depression and somatic complaints in children. Method: In this correlational research, the Parent Educational Style Assessment Questionnaire (CEEP), the Child Behavior Check List (CBCL)parent format and the Piers-Harris Self-Concept Scale were applied to children. The participants were 364 made up of 182 dyads (parents and children from 8 to 12 years old) from public and private schools in Bogotá, selected under a non-probabilistic sampling for convenience. Results: A statistically significant positive relationship was found between impulsiveness in parents and anxious/depressive symptoms (Rho = 0,213; p= 0,04) and isolated/depressive (Rho= 0,210; p= 0,004) in children. Inverse relationships were found between emotional management and the intellectual component of self-concept (Rho=-0,148; p= 0,046), between anxious/depressive symptoms and behavioral components (Rho = -0,240; p= 0,001), physical (Rho = -0,182; p= 0,014) and lack of self-concept anxiety (Rho=-0,213; p= 0,004). Conclusions: The relationships found between impulsivity and internalizing symptoms in children show that excessive and unjustified anger of parents can be associated with excessive concern and social isolation in children. These findings allow us to suggest for future studies, to evaluate the effect of programs to prevent anxiety and depression problems in children through training in emotional regulation for parents.

Rumiación cognitiva y afecto negativo como predictores diferenciales de los síntomas psicopatológicos internalizantes / Cognitive rumination and negative affect as differential predictors of internalizing psychopathological symptoms

Resumen Los modelos transdiagnósticos para los problemas de ansiedad, depresión y somatización han tenido evidencia para variables como la rumiación cognitiva y el afecto negativo; sin embargo, las asociaciones diferenciales entre estas dos variables en la explicación psicopatológica requiere aún ser investigada. El objetivo fue analizar la relación entre la rumiación cognitiva según las dimensiones de la rumiación: reproche y reflexión, con el afecto negativo y los síntomas psicopatológicos internalizantes depresivos, ansiosos y psicosomáticos en adultos colombianos. Se llevó a cabo una investigación cuantitativa con un diseño transversal explicativo, en el que se definió una red estructural de relaciones entre constructos mediante un diagrama de senderos y ecuaciones estructurales. Se contó con una muestra final de 640 personas, con una edad media de 31.07 años (DE = 11.27). Los resultados indicaron correlaciones significativas parciales y de orden cero entre las variables transdiagnósticas y las sintomáticas internalizantes, mediante un modelo ajustado que permitió explicar en un 74 % estas problemáticas a partir de la rumiación cognitiva y la función mediadora parcial del afecto negativo. En los síntomas depresivos y ansiosos se obtuvo que están mediados parcialmente por el afecto negativo, mientras que la medida de somatización obtuvo un coeficiente de regresión significativo con el afecto negativo como predictor independiente. Estos resultados aportan a la comprensión de la interacción de la rumiación y el afecto en la aparición de los síntomas internalizantes de manera diferencial. Se recomendó contar con una muestra clínica que ayudaría a identificar con mayor precisión la varianza explicada del modelo obtenido, lo que favorecerá los actuales tratamientos transdiagnósticos disponibles.

Abstract The transdiagnostic models of anxiety, depression and somatization problems have had evidence for variables such as cognitive rumination and negative affect, however, the differential associations between these two variables in the psychopathological explanation, still need to be investigated. The aim was to analyze the relationship between cognitive rumination according to the two dimensions: brooding and reflection, with negative affect and depressive, anxious, and psychosomatic internalizing psychopathological symptoms. A quantitative research was carried out with an explanatory cross-sectional design in which a structural network of relationships between constructs was defined by a path diagram and structural equations. There was a final sample of 640 people with a mean age of 31.07 years (SD = 11.27). The results indicated significant partial and zero-order correlations between transdiagnostic and internalizing symptomatic variables, using an adjusted model that allowed explaining these problems in 74% from cognitive rumination, and the partial mediating function of negative affect. In depressive and anxious symptoms, they were partially mediated by the negative affect, while the somatization measure obtained a significant regression coefficient with the negative affect as an independent predictor. These results contribute to the understanding of the interaction of rumination and affect in the appearance of differential internalizing symptoms. It was recommended to have a clinical sample that would help to more accurately identify the explained variance of the obtained model, as well as favor the current and available transdiagnostic treatments.

O processo psicoterapêutico psicodinâmico de um menino com sintomas internalizantes: uma análise com base no Child Psychotherapy Q-Set / The psychodynamic psychotherapeutic process of a boy with internalizing symptoms: an analysis based on the Child Psychotherapy Q-Set / El proceso psicoterapéutico psicodinámico de un niño con síntomas de internalización: un análisis con base en el Child Psychotherapy Q-Set

Problemas internalizantes são frequentes em crianças, mas os ingredientes ativos que tornam uma psicoterapia efetiva são ainda pobremente compreendidos. O objetivo deste estudo foi analisar o processo terapêutico psicodinâmico de um menino em idade escolar que apresentava sintomas internalizantes, cujo tratamento foi interrompido após 22 meses. Os participantes foram o paciente e sua terapeuta. O Child Psychotherapy Q-Set foi utilizado para analisar o processo terapêutico. Os resultados mostraram as características da relação terapeuta-paciente e suas transformações. Fatores como conflitos familiares, aliança terapêutica com os pais, limitação da capacidade de mentalização do menino, contratransferência, habilidades e ajustamento da terapeuta ao paciente tiveram impacto no processo terapêutico, contribuindo para o desfecho observado. Para elucidar questões em aberto acerca da efetividade e mecanismos de mudança da psicoterapia psicodinâmica, e para estabelecimento de uma base de evidências consistente, é imprescindível que se conheça, de fato, o que ocorre e como ocorre no setting clínico.

Internalizing problems are frequent in children, but the active ingredients that make a psychotherapy effective are still poorly understood. This study aimed to analyze the psychodynamic therapeutic process of a school-age boy who presented internalizing symptoms, whose treatment was interrupted after 22 months. Participants were the patient and the therapist. The Child Psychotherapy Q-Set was used to analyze the therapeutic process. The results showed the characteristics of the therapist-patient relationship and its transformations. Factors such as family conflicts, therapeutic alliance with the parents, limitation to the ability to mentor the boy, countertransference, skills, and adjustment of the therapist to the patient impacted the therapeutic process, contributing to the observed outcome. In order to clarify the questions about the effectiveness and mechanisms of change in psychodynamic psychotherapy, and for the establishment of a consistent base of evidence, it is essential to know, in fact, what happens and how it happens in the clinical setting.

Problemas de internalización son frecuentes en niños, pero los ingredientes activos que hacen que una psicoterapia sea efectiva todavía son pobremente comprendidos. El objetivo de este estudio fue analizar el proceso terapéutico psicodinámico de un niño en edad escolar que presentaba síntomas de internalización y cuyo tratamiento fue interrumpido después de 22 meses. Los participantes fueron el paciente y su terapeuta. El Child Psychotherapy Q-Set fue utilizado para analizar el proceso terapéutico. Los resultados mostraron las características de la relación terapeuta-paciente y sus transformaciones. Factores como conflictos familiares, alianza terapéutica con los padres, limitación de la capacidad de mentalización del niño, contratransferencia, habilidades y ajustamiento de la terapeuta al paciente tuvieron impacto en el proceso terapéutico, contribuyendo para el desenlace observado. Para elucidar cuestiones en abierto acerca de la efectividad y de los mecanismos de cambio de la psicoterapia psicodinámica, y para el establecimiento de una base de evidencias consistente, es imprescindible que se sepa, de hecho, qué ocurre y cómo ocurre el setting clínico.

Role of parenting styles in internalizing, externalizing, and adjustment problems in children / Papel de los estilos parentales sobre los problemas internalizantes, externalizantes y de adaptación en niños

Abstract Introduction Different studies have reported the relationship of parenting styles with adjustment problems in children. However, it has not been specified which aspects of parenting styles play a central role in the manifestation of such psychological problems. Objective To increase the knowledge about the role of which parental educational styles are associated with internalizing, externalizing, and adjustment problems in Colombian children. Method Through structural equations, the fit of the proposed model was verified. Participants were 422 parents and children aged between 8 and 12 years, enrolled in public schools in Bogota, Colombia. The Parental Educational Styles Questionnaire, the Child Behavior Checklist, and the Parent Format and Self-assessment Multifactorial Adjustment test were applied. Results Family dynamics and parental practices have effects on internalizing, externalizing, and general maladjustment problems. Parental roles and practices show indirect effects on general maladjustment through externalizing problems. Discussion and conclusion The models tested show that conflicts at home, parental overload, impulsivity, permissive, ambiguous/non-consistent styles, and dysfunctional reaction to disobedience play a role in the manifestation of internalizing, externalizing, and adjustment problems in children.

Resumen Introducción Diferentes estudios han reportado la relación de los estilos de crianza con problemas de adaptación en niños. Sin embargo, no se ha especificado qué aspectos de los estilos de crianza desempeñan un papel central en la manifestación de tales problemas psicológicos. Objetivo Incrementar el conocimiento acerca del papel de qué estilos educativos parentales se asocian con los problemas internalizantes, externalizantes y de adaptación en niños colombianos. Método Por medio de ecuaciones estructurales se probó el ajuste al modelo. Los participantes fueron 422 padres con hijos de entre 8 y 12 años, matriculados en colegios públicos en Bogotá, Colombia. Se aplicó el Cuestionario de Estilos Educativos de los Padres, la Lista de Chequeo del Comportamiento Infantil, el Formato para padres y el Test Autoevaluativo Multifactorial de adaptación. Resultados Las dinámicas familiares y las prácticas parentales tienen efectos sobre los problemas internalizantes, externalizantes y de adaptación general. Los roles y las prácticas parentales muestran efectos indirectos sobre la desadaptación general a través de problemas externalizantes. Discusión y conclusión Los modelos probados muestran que los conflictos en el hogar, la sobrecarga de los padres, la impulsividad, los estilos permisivos, ambiguos/no consistentes y la reacción disfuncional a la desobediencia desempeñan un papel en la manifestación de los problemas internalizantes, externalizantes y de adaptación en los niños.

Salud mental infantil: una prioridad a considerar / Children's mental health: a priority to consider

Resumen: Objetivo: Identificar posibles cambios en la frecuencia de manifestaciones sindromáticas sugerentes de problemas de salud mental en población infantil mexicana empleando el Cuestionario Breve de Tamizaje y Diagnóstico (CBTD), a lo largo de 15 años. Material y métodos: Se analiza información de diferentes estudios en población general, escuelas y práctica médica. La estimación obtenida en la Ciudad de México fue utilizada como población de referencia para comparación. Resultados: Se apreciaron incrementos notables respecto a la prevalencia de síndromes como el déficit de atención e hiperactividad, y conducta oposicionista y explosiva, así como manifestaciones de ansiedad y depresivas. Estas últimas resultaron más frecuentes en la edad escolar tardía. Las alteraciones en el lenguaje y la epilepsia también mostraron incremento en diferentes grupos de edad. Conclusiones: Se discuten los hallazgos a la luz de estudios longitudinales en la literatura, así como de reportes de población adolescente en nuestro país.

Abstract: Objective: To identify possible changes in the frequency of psychopathological syndromes in Mexican children population over a 15-year period using the Brief Screening and Diagnostic Questionnaire (CBTD in Spanish). Materials and methods: Information gathered from different studies on the general population, schools and medical general practice are analyzed. Results from the Mexico City study were used as base rates for comparisons. Results: Higher prevalence of externalizing syndromes such as attention deficit and hyperactivity, oppositional and explosive conduct were very evident. Also, anxiety and depressive syndromes showed a notable increase. Prevalence of abnormal language and probable epilepsy were also increased on different age-groups. Conclusions: Findings are discussed in light of longitudinal reports in the literature as well as on reports in adolescent population in Mexico.