Efeitos de uma intervenção com foco na socialização emocional infantil / Efectos de una intervención centrada en la socialización emocional infantil / Effects of an intervention focused on child emotion socialization

Punishing, minimizing, ignoring, or becoming distressed when dealing with children's negative emotions may favor the emergence or worsen behavior problems during childhood. This study examined the effects of the intervention program Vivendo Emoções [Experiencing Emotions] on maternal reactions to children's emotions and children's internalizing and externalizing problems. Thirty-two mothers of children aged between three and eight participated and were assigned to an intervention (n = 16) or a comparison (n = 16) group. The intervention was implemented in eight sessions intended to promote the mothers' strategies to identify and regulate their children's negative emotions and enable the children to improve emotional competence. The mothers completed the CCNES to report their reactions to children's emotional expressions and the CBCL to report internalizing and externalizing problems on pretest and posttest. The results reveal that mothers in the intervention group reported fewer unsupportive reactions on posttest than mothers in the comparison group. This finding shows the potential of such interventions to decrease unsupportive maternal reactions. Additionally, children in the intervention group presented more frequent somatic complaints than those in the comparison group on posttest. A potential explanation is that the mothers were more prepared to encourage their children to report negative emotions associated with bodily sensations.

Castigar, minimizar, ignorar o manifestar malestar ante la expresión de emociones negativas de los niños puede favorecer la aparición o el empeoramiento de problemas de comportamiento en la infancia. Este estudio examinó los efectos del programa de intervención Viviendo Emociones, focado en la socialización emocional de los niños, en las reacciones maternas a las emociones y en los problemas internalizantes y externalizantes de los niños. Participaron 32 madres de niños entre tres y ocho años, divididas en los grupos intervención (n = 16) y comparación (n = 16). El Viviendo Emociones se realizó en ocho sesiones y busca promover estrategias para identificar y regular las emociones negativas expresadas por los niños para que ellos amplíen su competencia emocional. En el pre-test y post-test, las madres respondieron el CCNES para reportar sus reacciones ante las expresiones emocionales de sus hijos y el CBCL para reportar problemas internalizantes y externalizantes. Los resultados revelaron que las madres en el grupo de intervención reportaron menos reacciones de no apoyo que las madres en el grupo comparación en el post-test. Ese hallazgo resalta el potencial de intervenciones de esta naturaleza para reducir las reacciones maternas de no apoyo. Adicionalmente, los niños del grupo intervención presentaron más quejas somáticas que los niños del grupo comparación en el post-test. Una explicación potencial es que las madres estaban más preparadas para alentar a los niños a reportar emociones negativas asociadas a sensaciones corporales.

Punir, minimizar, ignorar ou manifestar desconforto diante da expressão de emoções negativas dos filhos pode favorecer o surgimento ou agravamento dos problemas de comportamento na infância. Este estudo examinou os efeitos do programa de intervenção, Vivendo Emoções, com foco na socialização emocional infantil, sobre as reações maternas às emoções dos filhos e os problemas internalizantes e externalizantes das crianças. Participaram 32 mães de crianças entre três e oito anos, divididas em grupo intervenção (n = 16) e comparação (n = 16). O Vivendo Emoções foi realizado em oito sessões e busca promover estratégias para identificação e regulação das emoções negativas expressas pelos filhos de forma que a criança amplie sua competência emocional. No pré-teste e no pós-teste, as mães responderam a CCNES para informar suas reações às expressões emocionais nos filhos e o CBCL para relatar problemas internalizantes e externalizantes. Os resultados revelaram que as mães do grupo intervenção relataram menos reações não apoiadoras do que as mães do grupo comparação no pós-teste. Esse achado evidencia o potencial de intervenções dessa natureza para reduzir reações maternas não apoiadoras. Adicionalmente, as crianças do grupo intervenção apresentaram mais queixas somáticas do que as crianças do grupo comparação no pós-teste. Uma explicação potencial é que as mães estivessem mais preparadas para encorajar as crianças a relatar emoções negativas associadas a sensações corporais.

Internal consistency of the Strengths and Difficulties Questionnaire in Amazonian children / Consistência interna do Questionário de Capacidades e Dificuldades em crianças amazônicas

ABSTRACT OBJECTIVE: To describe the frequency of behavioral problems and the internal consistency of the parent version of the Strengths and Difficulties Questionnaire (SDQ-P) in Amazonian preschool children during the covid-19 pandemic. METHODS: Data from the Maternal and Child Health and Nutrition in Acre (MINA-Brazil) study, a population-based birth cohort in the Western Brazilian Amazon, were used. The SDQ-P was applied in 2021 at the five-year follow-up visit to parents or caregivers of 695 children (49.4% of which were girls). This instrument is a short behavioral screening questionnaire composed of 25 items reorganized into five subscales: emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. Cases of behavioral problems were defined according to the original SDQ cut-offs based on United Kingdom norms. Moreover, cut off points were estimated based on the SDQ-P percentile results of our study sample. Internal consistency was assessed by calculating Cronbach's alpha coefficient and McDonald's omega for each scale. RESULTS: According to the cut-offs based on our studied population distribution, 10% of all children had high or very high total difficulty scores, whereas it was almost twice when the original SDQ cut-offs based on United Kingdom norms, were applied (18%). Differences were also observed in the other scales. Compared to girls, boys showed higher means of externalizing problem and lower means of prosocial behavior. The five-factor model showed a moderate internal consistency of the items for all scales (0.60 ≤ α ≤ 0.40), except for total difficulty scores, which it considered substantial (α > 0.61). CONCLUSIONS: Our results support the usefulness of SDQ in our study population and reinforce the need for strategies and policy development for mental health care in early life in the Amazon.

RESUMO OBJETIVO: Descrever a frequência de problemas de comportamento e a consistência interna da versão para os pais do Questionário de Capacidades e Dificuldades (SDQ-P) em crianças pré-escolares da Amazônia durante a pandemia de covid-19. MÉTODOS: Foram utilizados dados do estudo de saúde e nutrição Materno-Infantil no Acre (MINA-Brasil), uma coorte de nascimentos de base populacional na Amazônia Ocidental Brasileira. O SDQ-P foi aplicado aos pais e cuidadores em 2021 na visita de acompanhamento de cinco anos de 695 crianças (49,4% das quais eram meninas). Esse instrumento é um breve questionário de rastreamento comportamental composto por 25 itens reorganizados em cinco subescalas: sintomas emocionais, problemas de conduta, hiperatividade/desatenção, problemas de relacionamento com colegas e comportamento pró-social. Os casos de problemas de comportamento foram definidos de acordo com os pontos de corte originais do SDQ, baseados nas normas do Reino Unido. Além disso, os pontos de corte foram estimados com base nos percentis dos resultados do SDQ-P da amostra do nosso estudo. A consistência interna foi avaliada pelo cálculo do coeficiente alfa de Cronbach e ômega de McDonald para cada escala. RESULTADOS: De acordo com os pontos de corte baseados na distribuição da população estudada, 10% de todas as crianças apresentaram escores totais de dificuldade elevados ou muito elevados, o que quase dobrou quando os pontos de corte originais do SDQ, baseados nas normas do Reino Unido, foram utilizados (18%). Este estudo também encontrou diferenças nas demais escalas. Comparados às meninas, os meninos apresentaram maiores médias de problemas de externalização e menores médias de comportamento pró-social. O modelo de cinco fatores apresentou consistência interna dos itens moderada para todas as escalas (0,60 ≤ α ≤ 0,40), exceto para a escala de pontuação total de dificuldades, a qual foi considerada substancial (α > 0,61). CONCLUSÕES: Nossos resultados apoiam a utilidade do SDQ em nossa população de estudo e reforçam a necessidade de estratégias e desenvolvimento de políticas para o cuidado em saúde mental no início da vida na Amazônia.

Relación de problemas disciplinarios y de rendimiento académico con el consumo de sustancias psicoactivas en escolares colombianos / Disciplinary and Academic Issues Related with Psychoactive Substances Consumption, in Colombian Scholars / Relação entre problemas disciplinares e desempenho académico e o uso de substâncias psicoativas em crianças colombianas em idade escolar

Introducción: El consumo de sustancias psicoactivas en jóvenes colombianos es considerado un problema de salud pública, debido a su prevalencia ascendente. Los estudios al respecto han indicado la existencia de una asociación con patrones conductuales que llevan a la alteración del rendimiento académico y el surgimiento de problemas disciplinarios. Objetivos: Identificar la asociación entre el consumo de sustancias psicoactivas y la presencia de problemas disciplinarios y de rendimiento académico en adolescentes colombianos. Materiales y métodos: Estudio transversal analítico. Se incluyeron 80.018 adolescentes escolares. Se indagó sobre la presencia de problemas disciplinarios y de rendimiento académico, así como consumo de sustancias psicoactivas durante los últimos 12 meses. Se describieron las frecuencias de los problemas académicos o disciplinarios con el consumo de cada una de las sustancias psicoactivas. Se estimaron asociaciones por medio de modelos de regresión logística binaria, y todos los análisis fueron ajustados por el factor de expansión. Resultados: Se registró que el 44% de los adolescentes reportaron problemas académicos, y el 20%, problemas disciplinarios. Entre las sustancias con mayor fuerza de asociación, frente a problemas disciplinarios, se mencionaron: cocaína (OR=3,18; IC95%=2,75- 3,69); marihuana (OR=2,93; IC95%=2,68-3,20); inhalables (OR=2,80; IC95%=2,40-3,28). Frente a problemas académicos, mostraron asociación la marihuana (OR=2,39; IC95%=2,18-2,61), el dick (OR=2,24; IC95%=1,88- 2,66) y los inhalables (OR=2,11; IC95%=1,80-2,48). Conclusiones: El consumo de sustancias psicoactivas estuvo relacionado con la presencia de problemas académicos y disciplinarios.

Introduction: The consumption of psychoactive substances in Colombian youth is considered a public health problem, due to its prevalence and rising characteristics. Studies of the prevalence of drug use in this population indicate the presence of an association with behavioral patterns that lead to an alteration in academic performance and disciplinary problems. Objective: To identify the association between the consumption of psychoactive substances and the presence of academic or disciplinary problems in Colombian adolescents. Materials and methods: This is an analytical cross-sectional study. 80,018 adolescents enrolled in school were included. It was investigated whether the adolescent had academic or disciplinary per- formance problems, as well as consumption of psychoactive substances during the last 12 months. A description was made of the frequencies of academic or disciplinary problems with the consumption of each of these psychoactive substances. Associations were estimated using binary logistic regression models, and all analyzes were adjusted for the expansion factor. Results: There was a prevalence of 44% for academic problems and 20% for disciplinary problems. Among the substances with the greatest strength of association with disciplinary problems was cocaine (OR=3,18; IC95%=2.75-3.69), marihuana (OR=2,93; IC95%=2.68-3.20) and inhalants (OR=2,80; IC95%=2,40-3.28) and related to academic problems was marijuana (OR=2,39; IC95=2,18-2.61). dick (OR=2,24; IC95%=1.88-2.66) e inhalants (OR=2,11; IC95%=1,80-2.48). Conclusions: The use of psychoactive substances is related to the presence of academic and disciplinary problems.

Introdução: O uso de substâncias psicoativas em jovens colombianos é considerado um problema de saúde pública, devido à sua crescente prevalência. Estudos indicaram a existência de uma associação com padrões de comportamento que levam à alteração do desempenho académico e ao surgimento de problemas disciplinares. Objetivos: Identificar a associação entre o consumo de substâncias psicoativas e a presença de problemas disciplinares e de desempenho académico em adolescentes colombianos. Materiais e métodos: Estudo analítico de corte transversal. Foi incluído um total de 80.018 adolescentes em idade escolar. Inquirimos sobre a presença de problemas disciplinares e de desempenho académico, bem como o consumo de substâncias psicoativas durante os últimos 12 meses. Foram descritas as frequências dos problemas académicos ou disciplinares com a utilização de cada uma das substâncias psicoativas. As associações foram estimadas utilizando modelos de regressão logística binária, e todas as análises foram ajustadas para o fator de expansão. Resultados: 44% dos adolescentes relataram problemas académicos e 20% relataram problemas dis ciplinares. Entre as substâncias com maior associação a problemas disciplinares estavam: cocaína (OR= 3,18; IC95% = 2,75-3,69); canábis (OR = 2,93; IC95% = 2,68-3,20); inalantes (OR = 2,80; IC95%CI= 2,40-3,28). Para problemas académicos, o canábis (OR = 2,39, IC95% = 2,18-2,61), o Dick (OR =2,24, IC95% = 1,88-2,66) e inalantes (OR = 2,11, IC95% = 1,80-2,48) foram associados. Conclusões: O uso de substâncias psicoativas estava relacionado com a presença de problemas académicos e disciplinares.

Protective effects of breastfeeding on behavior at four years old in children exposed to maternal gestational diabetes mellitus: a birth cohort study / 中华围产医学杂志

Objective:To explore the protective effects of breastfeeding on behavioral problems at 4 years in children born to mothers with gestational diabetes mellitus (GDM).Methods:Based on the Ma' anshan Birth Cohort (MABC) study, 305 GDM women and their children were recruited in this study from Ma' anshan Maternal and Child Health Care Hospital from May 2013 to September 2014. Total breastfeeding duration was followed up at 42 d, 3, 6, 12, and 18 months postpartum as well as the breastfeeding intensity within 6 months. All the subjects were divided into breastfeeding group ( n=256, including exclusive breastfeeding and mixed feeding) or bottle feeding group ( n=49). Internalizing and externalizing behavioral problems at age 4 were assessed using Achenbach Child Behavior Checklist (CBCL/1.5~5) and their association with breastfeeding were analyzed using robust Poisson regression. Controlling false discovery rate was applied for multiple test correction. Results:Compared with bottle feeding, breastfeeding was a protective factor for depression in children ( RR=0.23, 95% CI: 0.05-0.98, q=0.048) when the duration was 4-5 months; for somatic complaints ( RR=0.36, 95% CI: 0.14-0.95, q=0.047) and anxiety ( RR=0.19, 95% CI: 0.06-0.62, q=0.010) with a breastfeeding duration of 6-11 months; and for depression ( RR=0.46, 95% CI: 0.25-0.83, q=0.039) and anxiety ( RR=0.12, 95% CI: 0.03-0.49, q=0.006) with a breastfeeding duration of 12 months and above. Compared with bottle feeding within 6 months, mixed feeding had a protective effect on somatic complaints ( RR=0.29, 95% CI: 0.13-0.64, q=0.026) and anxiety ( RR=0.18, 95% CI:0.07-0.52, q=0.002). Conclusions:The findings suggested that breastfeeding had a protective effect on behavioral problems at age 4 in children exposed to GDM. Women with GDM should be encouraged to breastfeed.

Maternal subclinical hypothyroidism and behavioral problems in preschoolers: A cohort study / 中华内分泌代谢杂志

Objective:To investigate the effects of maternal subclinical hypothyroidism (SCH) on preschoolers′ behavioral problems.Methods:Based on the Ma′ anshan Birth Cohort, pregnant women who had their first antenatal checkup in Maternal and Child Health Center in Ma′ anshan were recruited from May 2013 to September 2014. Data on demographic, obstetric information, and maternal exposure were collected. Women′s fasting venous blood in the first, second, and third trimesters of pregnancy was collected. The levels of thyroid hormones [thyrotropin (TSH), free thyroxine (FT 4)] and thyroid autoantibodies [thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb)] in maternal blood were retrospectively detected by electrochemiluminescence immunoassay. Preschoolers′ behavioral problems were assessed by Achenbach Child Behavior Checklist (CBCL/1.5-5). Poisson regression models were adopted to examine the effect of maternal SCH on preschoolers′ internalizing and externalizing problems and the critical period. Results:In this study, the reference of maternal thyroid indexes was established (between 2.5 th and 97.5 th percentile). The reference of TSH in the first, second, and third trimester of pregnancy was 0.04-4.90 μIU/mL, 0.75-6.08 μIU/mL, and 0.58-5.59 μIU/mL respectively; and the reference of FT 4 was 13.19-23.27 pmol/L, 9.14-15.32 pmol/L, and 9.53-17.45 pmol/L respectively. In the first, second, and third trimester of pregnancy, the prevalence of SCH was found to be 2.0% (25/1 224), 1.6% (19/1 218), and 1.7% (21/1 220), respectively. After adjusting for confounding factors, maternal SCH in the first trimester was associated with the risk of anxiety and depression in preschool children ( OR=3.06, 95% CI 1.05-8.98). Maternal SCH in the second trimester was found to be associated with the risk of overreaction in preschool children ( OR=2.65, 95% CI 1.13-6.21). Conclusions:The establishment of thyroid hormones reference range for pregnant women in Ma′ anshan area is beneficial to the screening, diagnosis, and treatment of thyroid diseases during pregnancy in this area. Maternal SCH during pregnancy is associated with increased risk of behavioral problems in preschool children. In the first trimester, maternal SCH was associated with preschoolers′ anxiety and depression, and in the second trimester, maternal SCH was associated with preschoolers′ emotional reactivity.

Applicability of the Disruptions in Surgery Index in the Cardiovascular Management Scenarios - A Marker for Developing Functionally Efficient Teams

Abstract Introduction: To support the development of practices and guidelines that might help to reduce adverse events related to human factors, we aimed to study the response and perception by members of a cardiovascular surgery team of various error-driven or adverse features that might arise in the operating room (OR). Methods: A previously validated Disruptions in Surgery Index (DiSI) questionnaire was completed by individuals working together in a cardiovascular surgical unit. Results were submitted to reliability analysis by calculating the Cronbach's alpha coefficient. Non-parametric Kruskal-Wallis test and Dunn's post-test were performed to estimate differences in perceptions of adverse events or outcomes between the groups (surgeons, nurses, anesthesiologists, and technicians). P<0.05 was considered statistically significant. Results: Cronbach's alpha reliability coefficients showed consistency within the recommended range for all disruption types assessed in DiSI: an individual's skill (0.85), OR environment (0.88), communication (0.81), situational awareness (0.92), patient-related disruption (0.89), team cohesion (0.83), and organizational disruption (0.83). Nurses (27.4%) demonstrated significantly higher perception of disruptions than surgeons (25.4%), anesthetists (23.3%), and technicians (23.0%) (P=0.005). Study participants were more observant of their colleagues' disruptive behaviors than their own (P=0.0001). Conclusion: Our results revealed that there is a tendency among participants to hold a positive self-perception position. DiSI appears to be a reliable and useful tool to assess surgical disruptions in cardiovascular OR teams, identifying negative features that might imperil teamwork and safety in the OR. And human factors training interventions are available to develop team skills and improve safety and efficiency in the cardiovascular OR.

Development of language and arithmetic skills: risk and protective factors. Comparative cross-sectional study

ABSTRACT BACKGROUND: In a literate society, linguistic/arithmetic performance is highly valued. Based on defined risk factors, strategies for promotion of better performance can be developed. OBJECTIVE: To ascertain the risk and protective factors relating to development of language and arithmetic. DESIGN AND SETTING: Observational comparative cross-sectional study at a public elementary school in Ribeirão Preto (SP), Brazil. METHODS: A total of 66 children (41% females) attending first to fifth grades participated in this study. They were divided into two groups: G1, children classified as presenting language or arithmetic deficits; G2, average performance. Language (oral and written) and arithmetic skills were assessed through standardized tests. Variables relating to social skills, home environment resources and behavioral problems were assessed through standardized scales. Data on other variables (pre, peri and postnatal complications, maternal variables and others) were collected through interviews. The logistic regression technique with LASSO was used (α = 0.05). RESULTS: Teenage pregnancy and consumption of psychoactive substances during pregnancy or complications during pregnancy were risk factors for performance regarding arithmetic and language. Higher schooling level for the mother was a protective factor in the development of arithmetic and language. Being female and having a history of otitis were risk factors for language. Altered social skills (responsibility and civility) and complaints of inattention were risk factor for arithmetic. Adequate linguistic development was a protective factor for the development of arithmetic. CONCLUSION: The risk/protective factors included variables relating to the gestational period, mother's age when pregnant, mother's schooling, social skills, behavior and development issues.

Educational Practices and Child Behaviors: Mothers' and Teachers' Evaluation / Práticas Educativas e Comportamentos Infantis: Avaliações de Mães e Professores

Abstract The objective of this study was to describe and compare mothers' and teachers' reports concerning their educational social skills and negative practices and children's behavioral problems and social skills. The mothers and teachers of 81 children participated in this study. The children were assigned to four groups depending on whether they presented problems exclusively at home, school, in both, or none of these contexts. Valid instruments measured educational practices and child behavior. The results show that: (a) mothers and teachers agreed that children with problems in both contexts presented the highest level of impairment; (b) the mothers more frequently reported skills such as affection, adopted negative practices, and identified problem behaviors; (c) the teachers reported more skills such as limit setting. The conclusion is that teachers' and mothers' practices differ, and such information can guide preventive programs and interventions.

Resumo Objetivou-se descrever e comparar avaliações de mães e professores quanto às suas habilidades sociais educativas, práticas negativas e problemas de comportamento e de habilidades sociais das crianças. Participaram mães e professores de 81 crianças, distribuídas em 4 subgrupos quanto à presença/ausência de dificuldades na família e na escola. Aplicou-se instrumentos validados para mensurar práticas educativas e comportamentos infantis. Verificou-se que: (a) crianças com problemas nos dois ambientes apresentaram mais comprometimento para mães e professores; (b) as mães referiram mais habilidades (afeto), usaram mais práticas negativas e identificaram mais problemas de comportamento; (c) os professores referiram mais habilidades para estabelecer limites. Conclui-se que práticas de mães e professores diferem e tais dados podem nortear programas de prevenção e intervenção.

Association between Environmental Factors in Home and Behavioral Problems in Children with Allergic Diseases: Based on 2015 Panel Study of Korean Children Survey

PURPOSE: This study aimed to investigate the association between indoor environmental exposures and behavioral problems in children with allergic diseases.METHODS: We used data from 2015 Panel Study of Korean Children (PSKC). The subjects of this study included 825 children aged 7 years with asthma, allergic rhinitis, or atopic dermatitis. The data was analyzed using hierarchical multiple regression.RESULTS: Factors influencing behavioral problems in children with allergic diseases were passive smoking (β=.15, p < .001), painting from 1year after birth until 1 year ago (β=.13, p < .001), using of linoleum as floor materials (β=.09, p < .001), change of wallpaper From 2 years before pregnancy until 1year after birth (β=.08, p < .001), change of wallpaper from 1year after birth until 1 year ago (β=.07, p < .001), keeping hot food or water in plastic container (β=.06, p < .001), remodeling from 1 year after birth until 1year ago (β=.04, p < .001), using of plastic container (β=.03, p < .001), and change of floor materials from 1 year after birth until 1year ago (β=.01, p=.006) which explained about 10% of behavioral problems.CONCLUSION: This study showed that indoor environmental exposures were associated with behavioral problems in children with allergic diseases. Based on the findings of this study, programs focusing on controlling of indoor environmental exposures may help to prevent and reduce behavioral problems in children with allergic diseases.

Childhood emotional and behavior problems and their associations with cesarean delivery

Objective: To determine the prevalence of childhood emotional and behavioral problems and examine their associations with cesarean delivery. Methods: Our sample consisted of 8,900 preschoolers from 35 kindergartens in four cities in East China. Parents completed the Strengths and Difficulties Questionnaire (SDQ) and provided other information. Children's emotional and behavioral problems were assessed using five subscales of the SDQ. Mode of delivery was classified as vaginal or cesarean section (CS); in sub-analyses, we divided CS into elective or emergency delivery. Logistic regression was used to examine associations. Results: A total of 1,209 (13.6%) children had a total SDQ score within abnormal range; 25.5% had peer problems within abnormal range, 9.0% had abnormal emotional symptoms, 13.9% had abnormal conduct problems, 18.9% had abnormal hyperactivity problems, and 16.2% were rated abnormal in pro-social behavior. Overall, 67.3% of the children who participated were delivered by CS. In fully adjusted analysis, CS was significantly associated with abnormal total SDQ score (OR = 1.27; 95%CI 1.10-1.46; p < 0.05) and pro-social behavior (OR = 1.27; 95%CI 1.12-1.45; p < 0.0001). No significant association was found between CS and risk of having conduct problems (OR 1.13; 95%CI 0.98-1.29), peer problems (OR 1.11; 95%CI 0.99-1.24), hyperactivity (OR 1.02; 95%CI 0.91-1.15), or emotional problems (OR 1.06; 95%CI 0.90-1.24). Conclusion: In this sample, CS was associated with risk of behavioral problems, but not with emotional problems. Further research is needed to better understand these associations.

Environmental Tobacco Smoke Exposure at Home and Attributable Problem Behaviors in Korean Children and Adolescents for 2012–2014 in a Nationally Representative Survey

BACKGROUND: This study aimed to examine the environmental tobacco smoke (ETS) exposure at home and associated problem behaviors in Korean children and adolescents. METHODS: Approximately 2,167 children aged 3–18 years were included in the study after excluding 163 active smokers from the Korean Environmental Health Survey in Children and Adolescents (2012–2014). ETS data were obtained using a questionnaire; problem behaviors were measured using the Child Behavior Checklist administered to parents. The relationship between ETS exposure and problem behavior was evaluated using a survey regression model adjusted for region, age, sex, income, and father's education. The population-attributable fraction (PAF%) was calculated based on problem behaviors related to ETS exposure at home. RESULTS: The rates of ETS exposure at home were 20%, 28%, and 39% in children aged 3–5, 6–11, and 12–18 years, respectively; ETS exposure at home was associated with behavioral problems: the exposed group having higher total behavioral problem score (95% confidence interval [CI]) than the non-exposed by 2.46 (0.60–4.32) and 2.74 (0.74–4.74) in children aged 6–11 and 12–18 years, respectively, with no significant association in those aged 3–5 years. The PAF% (95% CI) of total problem behaviors for ETS exposure at home were 2.68 (−10.11–17.78), 10.66 (3.25–17.55), and 11.62 (3.03–18.96) in children aged 3–5, 6–11, and 12–18 years, respectively. Children with externalizing problems had higher PAF% than those with internalizing problems. CONCLUSION: In Korea, ETS exposure at home is associated with problem behaviors in children and adolescents with about more than 10% population attributable fraction.

Validity and Reliability of Korean Version of Behavior Problems Inventory in Autism Spectrum Disorder and/or Intellectual Developmental Disorder

OBJECTIVES: Problem behaviors pose a great obstacle to daily functioning in children with neurodevelopmental deficits and are an important target for treatment. In this study, we translated the Behavior Problems Inventory (BPI)-01 into Korean language and tested its psychometric properties. METHODS: We attained the approval of the BPI author and performed standard translation-back translation. Then, professional caregivers examined appropriateness according to cultural and situational contexts in order to make necessary modifications of the Korean version of the BPI. RESULTS: The BPI-01, Korea-Scales of Independent Behavior-Revised (K-SIB-R), and Child Behavior Checklist were completed for 98 autistic spectrum disorder or intellectual development disorder participants (mean age=28.3, standard deviation=7.3, range=10.1–51.7). The inter-rater reliability of the BPI-01 was found to be high (r=0.992–1.000). As for the results for concurrent validity for subscale items of BPI-01 and scales of SIB, correlations between SIB and BPI-01 subscales were statistically significant (r=0.357–0.672). CONCLUSION: The Korean version of the BPI-01 showed good psychometric properties with high reliability and sufficient convergent validity. Further examination of the validity of BPI-01 should be carried out with inclusion of younger aged children and a closer look at less frequently occurring symptoms.

Effects of Intervention Using PARO on the Cognition, Emotion, Problem Behavior, and Social Interaction of Elderly People with Dementia

PURPOSE: This study aims to investigate the effects of intervention using the therapeutic robot, PARO, on the cognition, emotion, problem behavior, and social interaction of elderly people with dementia. METHODS: A nonequivalent control group pretest-posttest design was used. A total of 33 elderly people with dementia living in a nursing home facility participated in the study, with 17 in the experimental group and 16 in the control group. The intervention program with PARO was administered twice a week for 6 weeks, for a total of 12 sessions. Data were collected before and after intervention, using a questionnaire, direct observation, and video recording. RESULTS: There were statistically significant differences in positive emotions and problem behaviors between the groups. The experimental group demonstrated a significant improvement in social interaction. CONCLUSION: PARO intervention can be utilized as an effective nursing intervention to increase positive emotions and social interaction, as well as decrease problem behaviors, in elderly people with dementia living in nursing home facilities.

Factors Influencing Parenting Stress in Mothers of Preschoolers Born Prematurely

PURPOSE: This study was conducted to describe parenting stress in mothers of preschoolers who were born prematurely and to determine factors affecting parenting stress in child's problem behavior, mother-child interaction and parenting alliance. METHODS: An exploratory survey study was conducted with 66 mothers of preschool children (5~6 years) with preterm births (PTB). Data were collected using Parenting Stress Index (PSI), Child Behavior Checklist (CBCL), Mother-Preschool Child Interaction Scale (MPIS), and Parenting Alliance Inventory (PAI). RESULTS: Of the 66 mothers, 8(12.1%) showed high scores that were more than borderline for the PSI total score. In the multiple linear regression analysis, lower scores on the PAI (β=−.41, p<.001), higher scores on the externalizing problem behavior of the CBCL (β=.40, p=.001), and lower scores on the MPIS (β=−.21, p=.043) were statistically significant contributors to maternal parenting stress. CONCLUSION: Findings indicate that mothers of PTB preschool children are at risk for parenting stress. Child's externalizing problem behavior, poor maternal-child interaction and parenting alliance were independent factors raising maternal parenting stress. More attention is needed on paternal parenting support, child's behavioral development, interaction with children for effective prevention and management of maternal parenting stress of PTB young children.

Factors Affecting Contraceptive Use among Adolescent Girls in South Korea

PURPOSE: This study was done to identify contraceptive practices in adolescent girls in South Korea and predictors of contraceptive practices. METHODS: The study sample included 743 girls who had experienced sexual activity. Using statistics from the 12th (2016) Korea Youth Risk Behavior Web-based Survey, hierarchical logistic regression analysis was conducted. RESULTS: The contraceptive practice rate for adolescent girls was 34%. Contraceptive practice was associated with ‘age at first intercourse’ and ‘sexual intercourse after drinking’. For adolescent girls who had early sexual initiation and drank alcohol before sexual intercourse there was a tendency to reduce the practice of contraception. CONCLUSION: It is necessary to provide practical sex education to improve the practice of contraception in these adolescents. In addition, adolescent girls should be encourage to delay their first intercourse. The results of this study can also be used to develop education interventions regarding healthy sexuality behaviour including the practice of contraception.

Effect of Sexual Maturation, Parenting Attitude and Maturity Fear on Emotional and Behavioral Problems in Elementary School Girls

PURPOSE: This study was conducted to identify the sexual maturation, parenting attitude, maturity fear and emotional and behavioral problems of girls in elementary school, and to examine the relation between these variables and factors that influence emotional and behavioral problems. METHODS: Participants were 128 second, third and fourth year students from 3 elementary schools. Data were analyzed using t-test, ANOVA and Scheffé test, Pearson correlation coefficients, and stepwise multiple regression with SPSS/WIN 21.0. RESULTS: Emotional and behavioral problems were related to eating rate, eating breakfast, frequency of late-night snacks and main communicator on pubertal development. Emotional and behavioral problems showed a positive correlation with maturity fear and father's parenting attitude (strictness) and a negative correlation with parenting attitude and father's parenting attitude (intimacy). Maturity fear, father's parenting attitude, eating breakfast, and main communicator on pubertal development had significant influence on emotional and behavioral problems of girls in elementary school. CONCLUSION: Findings show that for effective management of emotional and behavioral problems in elementary school girls, programs including coping with maturity fear, supportive parenting of father, diet education, and functional communication with mother on pubertal development should be developed.

Validation Study of Behavior Problems Inventory-01 among Korean Children and Adolescents

OBJECTIVES: The purpose of this study was to examine the reliability and validity of the Korean version of the Behavior Problems Inventory (BPI-01) among children and adolescents aged between 3 and 18. METHODS: The control group consisting of one hundred children and adolescents was recruited from schools and the patient group consisting of forty one children and adolescents with autism spectrum disorder were recruited from a hospital. We compared the measurements of both groups. To assess the concurrent validity of the BPI-01, we compared the problem behavior index of the Korean Scale of Independent Behavior-Revised (K-SIB-R) and, to assess the discriminant validity, we compared the Korean version of the Child Behavior Checklist (K-CBCL). The Cronbach's alpha of the BPI-01 was measured to assess its reliability. Correlation analyses between the BPI-01 and the other scale were carried out to examine the former's concurrent and discriminant validity. RESULTS: The patient group showed a significantly higher score for all three subscales of the BPI than the control group. The Cronbach's alpha was 0.92 for the total severity score of the BPI and ranged between 0.67–0.89 for each subscale in the patient group. All subscales of the BPI-01's, i.e., self injurious behavior, stereotyped behavior and aggressive/destructive behavior, were significantly correlated with the corresponding subscales of the K-SIB-R. The BPI-01 generally did not demonstrate any significant correlation with emotional items such as anxiety/depression in the K-CBCL. Especially, the BPI-01's stereotyped behavior subscale showed little correlation with externalizing behaviors such as social problems and aggressive behaviors. CONCLUSION: This study found that the Korean version of BPI-01 is a reliable and valid behavior rating instrument for problem behavior in developmental disabilities among children and adolescents.

The Relationship between Smoking and Unhealthy Weight Control Behaviors among Korean Adolescents: The Tenth Korea Youth Risk Behavior Web-Based Survey, 2014 / 가정의학회지

BACKGROUND: Adolescent smoking is positively related to weight control attempts, especially by unhealthy methods. The co-occurrence of smoking and unhealthy weight control behaviors may cause serious health problems in adolescents. This study examined the relationship of smoking with unhealthy weight control behaviors among Korean adolescents. METHODS: This cross-sectional study involved 31,090 students of grades 7 to 12, who had tried to reduce or maintain their weight during the 30 days prior to The Tenth Korea Youth Risk Behavior Web-based Survey, 2014. Data on height, weight, weight control methods, smoking, alcohol intake, living with one's family, and perceived economic status were obtained through self-report questionnaires. ‘Unhealthy weight control behaviors’ were subcategorized into ‘extreme weight control behaviors’ and ‘less extreme weight control behaviors.’ RESULTS: The smoking rates were 13.3%±0.4% in boys and 3.8%±0.2% in girls. Current smokers were more likely to engage in extreme weight control behaviors (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.09 to 2.00 in boys, and OR, 2.05; 95% CI, 1.59 to 2.65 in girls) and less extreme weight control behaviors (OR, 1.23; 95% CI, 1.07 to 1.40 in boys, and OR, 1.47; 95% CI, 1.22 to 1.76 in girls) compared to non-smokers among both boys and girls. CONCLUSION: Current smoking is independently related to a high likelihood of engaging in unhealthy weight control behaviors among Korean adolescents. This relationship is stronger for girls than for boys. Extreme weight control behaviors have a stronger relationship with current smoking than less extreme weight control behaviors.

Factors Affecting Emotional · Behavioral Problems in Early Adolescence: A Multilevel Model Study

PURPOSE: This study aims to investigate the individual and environmental factors related to emotional/behavioral problems to early adolescence in Korea by applying multilevel modeling. METHODS: From the database of the 2014 Korean Child and Youth Panel Survey (KCYPS), the researchers selected 1,977 adolescents who are in the second year of middle school. Multilevel model analysis was performed to estimate the impact of relevant factors at the individual and environmental levels. RESULTS: At the individual level, the significant factors associated with emotional/behavioral problems included BMI and study tendency in boys, and drinking, study tendency and economic levels in girls. At the environmental level, the significant factor associated with emotional/behavioral problems included relationship with the teacher. CONCLUSION: The emotional/behavioral problems of early adolescence are influenced not only by the individual factors but also by the environment factor. Therefore, the environment surrounding the adolescents should also be considered to prevent emotional/behavioral problems.

Mediating Effects of Cognitive Emotion Regulation on Influences of Self-differentiation and Family Function in High School Students' Problem Behavior / 정신간호학회지

PURPOSE: This study was done to investigate the mediation effects of cognitive emotion regulation on influences of self-differentiation and family function in high school students' problem behavior. METHODS: Study design was a cross-sectional descriptive analysis of causal research. A survey was conducted with 194 students in a C city high school. Data were analyzed using SPSS 21.0 and AMOS 21.0. RESULTS: There were direct effects of self-differentiation (β= -.39, p<.001), adaptive cognitive emotion regulation strategies (β=-.16, p=.004) and maladaptive cognitive emotion regulation strategies (β=.34, p<.001) on problem behavior in these students. A mediator effect was found for self-differentiation, as it had a direct impact on the maladaptive cognitive emotion regulation strategy (β=-.15, p=.014), which then had a direct impact on problem behavior. However, family function had no direct impact on both the maladaptive cognitive emotion regulation strategy and the adaptive cognitive emotion regulation strategy and on problem behavior, no mediator effect was observed. Explanatory power of these variables for problem behavior was 48.0%. CONCLUSION: Study findings suggest that to intervene for problem behavior in high school students, there is a need to develop and utilize programs that not only intervene for self-differentiation but also decrease high school students' use of non-adaptive cognitive emotion regulation.