Childhood Maltreatment and Toxic Stress: What We Have Learned From the COVID-19 Pandemic Era.

Stress is a natural state that emerges due to the dynamics of an individual's life. Children must learn how to effectively manage stress as part of their growth and development. Resolution is possible when children are exposed to stress and receive adequate support from their families. However, when stress is intense, frequent, protracted, or traumatic, as in cases of childhood abuse, it can become toxic and interfere with the development of the child's brain and body. This results in vulnerability, which can have detrimental effects on the child's overall physical, mental, and emotional health. This perspective discusses the impact of childhood maltreatment and toxic stress, drawing on insights gained during the COVID-19 pandemic. We aimed to shed light on the lessons learned from this unique and challenging period and how they inform our understanding of the effects of stress on children's well-being.

Relationship between Parenting Style and Risk of Attention Deficit Hyperactivity Disorder in Elementary School Children.

Background: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder in a child with three symptoms, which include inattention, hyperactivity and impulsiveness that may persist into adulthood for some conditions. Parenting style is thought to be one part that determines the risk of ADHD in children. This study aims to analyse the relationship between parenting styles and the risk of ADHD in children. Methods: Employing a cross-sectional design, this study was conducted in Surabaya from November 2020 to January 2021. The respondents of the study were parents who had children at risk of ADHD with a total of 55 samples recruited using the purposive sampling technique. The questionnaires used are the demographic questionnaire, Abbreviated Conners Rating Scale (ACRS), and the Parenting Style Questionnaire for Children and Adolescents (KPAA), which were filled out online by the respondents. The data were processed and analysed using the bivariate analysis test, Pearson's chi-squared test, which has a significant value if the P-value < 0.05. Results: The majority of the parents used the authoritative style (94.5%). There was a significant relationship between parenting style and the risk of ADHD in children with P < 0.001 for authoritarian and permissive styles and P = 0.005 for an authoritative style. Conclusion: There is a significant relationship between parenting style and the risk of ADHD in children. This indicates the importance of early diagnosis of ADHD and treating the children with ADHD in the context of family environment, especially from parenting style.

Internet gaming disorder in an adolescent during the COVID-19 pandemic: a case report.

The internet has become an indispensable tool in people´s daily lives during the COVID-19 pandemic. Internet and video game use are experiencing rapid growth in the youth and adult populations as a major source of entertainment. However, excessive gaming may cause addiction and negatively impact mental health, entailing low psychosocial well-being, poor social skills, and decreased academic achievement. We report the case of a 16-year-old student with a "typical" pattern of internet gaming disorder (IGD) developed during the pandemic, which improved after weeks of treatment with pharmacotherapy and psychosocial interventions. This case highlights that it is essential for the mental health professionals to know the psychopathology of IGD and multimodal approaches to treat it.

Effects of Playing Angklung and Practicing Silence on Emotion, Cognition and Oxytocin Levels in Children: A Preliminary Study.

BACKGROUND: Playing angklung, an Indonesian traditional musical instrument and practicing silence have been shown to exert beneficial effects on emotion and cognition; the mechanism of such an effect possibly involve oxytocin. To date, only a few clinical and biomolecular studies have investigated the effects of playing angklung and practicing silence. This study aimed to examine the effects of playing angklung and practicing silence on human emotion and cognition and on oxytocin levels. METHODS: This experimental study involved 61 Fourth Grade students from Surabaya, East Java, Indonesia. The participants were divided into two groups: the angklung intervention group and silence intervention group. The two interventions were performed for 15 min before the morning classes for 2 months. The control group attended their classes as usual. Clinical parameters, namely, emotion and cognition, as well as the saliva oxytocin levels were measured. RESULTS: No significant differences were observed among the three groups in terms of concentration and cognitive flexibility. However, changes in oxytocin levels significantly differed among the three groups (P < 0.001) and the oxytocin levels were highest in the silence intervention group. CONCLUSION: Practicing silence significantly increased the oxytocin levels, but it did not elicit changes in cognitive function and emotion of the students.

Systematic review of gut microbiota and attention-deficit hyperactivity disorder (ADHD).

BACKGROUND: Gut-brain axis (GBA) is a system widely studied nowadays, especially in the neuropsychiatry field. It is postulated to correlate with many psychiatric conditions, one of them being attention-deficit hyperactivity disorder (ADHD). ADHD is a disorder that affects many aspects of life, including but not limited to financial, psychosocial, and cultural aspects. Multiple studies have made a comparison of the gut microbiota between ADHD and healthy controls. Our aims were to review the existing studies analyzing the gut microbiota between human samples in ADHD and healthy individuals. METHODS: The literature was obtained using Google Scholar, Pubmed, and Science Direct search engine. The keywords used were "ADHD", "gut microbiota", "stool", "gut", and "microbiota". The selected studies were all case-control studies, which identify the gut microbiota between ADHD and healthy individuals. RESULT: We found six studies which were eligible for review. The model and methods of each study is different. Forty-nine bacterial taxa were found, yet none of them can explain the precise relationship between ADHD and the gut microbiota. Bifidobacterium was found in higher amount in ADHD patients, but other study stated that the abundance of this genus was lower in ADHD with post-micronutrient treatment. This may suggest that micronutrient can modulate the population of Bifidobacterium and improve the behavior of ADHD patients. Other notable findings include a significantly lower population of Dialister in unmedicated ADHD, which rose after patients were medicated. A smaller amount of Faecalibacterium were also found in ADHD patients. This may explain the pathogenesis of ADHD, as Faecalibacterium is known for its anti-inflammatory products. It is possible the scarcity of this genera could induce overproduction of pro-inflammatory cytokines, which is in accordance with the high level of pro-inflammatory cytokines found in children with ADHD. CONCLUSION: There were no studies that examined which bacterial taxa correlated most to ADHD. This might occur due to the different model and methods in each study. Further study is needed to identify the correlation between gut microbiota and ADHD.

Anxiety and Resilience of Healthcare Workers During COVID-19 Pandemic in Indonesia.

INTRODUCTION: The COVID-19 pandemic has an impact on the physical health and mental health of the community, including healthcare workers. Several studies have shown symptoms of depression, anxiety, and sleep disorders in healthcare workers during this pandemic. However, not many studies have examined the resilience of healthcare workers during this pandemic. Resilience is a person's ability to rise and adapt when times are difficult and is considered to have a protective effect on mental problems. PURPOSE: This study aims to determine the correlation between resilience and anxiety in healthcare workers during COVID-19 pandemic. MATERIALS AND METHODS: This research was a cross-sectional study with observational analytic methods. The respondents were healthcare workers at Dr. Soetomo Hospital as the COVID-19 referral hospital in Surabaya, East Java, Indonesia. Data were collected from 10 to 16 June 2020 by distributing online questionnaires through the Google form application. There were three questionnaires used: demographic data, the State-Trait Anxiety Inventory (STAI) questionnaire, and the Connor-Davidson Resilience Scale (CR-RISC) questionnaire. RESULTS: The 227 respondents had filled out the questionnaire online with 33% had high state anxiety and 26.9% had high trait anxiety. The mean score of the respondents' resilience was 69 ± 15.823. The Spearman correlation test showed a significant relationship between anxiety and resilience (p <0.05), both S-Anxiety and T-Anxiety. CONCLUSION: A significant correlation was found between the level of resilience and anxiety experienced by healthcare workers during the COVID-19 pandemic. The lower the resilience, the higher the anxiety experienced.

Relationship between Paternal and Maternal Parenting Style with Internet Addiction Level of Adolescents.

Objective: Internet addiction has become a major problem worldwide, especially for adolescents. Adolescents are considered vulnerable and at risk of internet addiction due to the immature self-control, easy access, and flexible schedule. Parenting style has a significant influence on the incidence of internet addiction in adolescents. This study aimed to analyze the relationship between paternal and maternal parenting style toward internet addiction level of adolescents at one of junior high Schools in Surabaya, Indonesia. Method : In this cross-sectional study, a total of 114 adolescents (44 boys and 70 girls) aged ranging from 12 to 15 in a junior high school in Surabaya, Indonesia, were recruited by stratified random sampling method in November 2019. The Internet Addiction Test (IAT) and Parental Authority Questionnaire (PAQ) were used to measure internet addiction level, and maternal and paternal parenting style of adolescents. The data were analyzed using Pearson correlation and multiple regression tests with IBM SPSS Statistics 25 to adjust the relationship between paternal and maternal parenting style toward internet addiction level of adolescents. Results: a total of 77.2% of adolescents were internet addicts and the majority experienced 'mild' internet addiction level (52.60%). Furthermore, the Pearson correlation results indicated that paternal permissive and authoritarian parenting styles were positively correlated with internet addiction level of adolescents. The multiple regression analysis results indicated that paternal permissive parenting style significantly predicted adolescents' internet addiction level. Conclusion: This study highlighted the significant role of paternal permissive and authoritarian parenting styles among adolescents' internet addiction.