Comparing immigrant children with native Greek in self-reported-Quality of Life.

UNLABELLED: Research on an international and national context regarding immigrant children and adolescents' quality of life (QoL) is rather scarce. Few international studies have been conducted investigating the presence of psychopathology and providing evidence of behavioural and psychological problems in immigrant adolescents. Regarding immigrant quality of life, thus far investigation was directed mainly to adult immigrant individuals and not to their children. The aim of the present study was to investigate the quality of life (QoL) of immigrant children and young adolescents who live in the greater Athens area, and to compare them with their native Greek peers living in the same communities and attending the same schools. METHOD: Sixty three immigrant children, from Albanian and Eastern European origin (mean age 11.9 years) and 489 native children (mean age 11.33 years) were administered a QoL instrument specifically developed for children and adolescents: the Kid-KINDL® Questionnaire for 8-12 years old and the Kiddo-KINDL® Questionnaire for 13-16 years old. The dimensions examined in the KINDL® questionnaire refer to: physical wellbeing, emotional well-being, self- esteem, friends, family life and everyday life (school life). The Greek version is reported to show satisfactory values of validity and reliability. Administration of questionnaires was conducted at school after parent consent. Analysis included student's t-test, chi-square test, and multivariate linear regression analysis, as to investigate the relationship between KINDL® QoL dimensions' scores and nationality status, after controlling for gender and age. The results indicated that self-reported QoL scores of immigrant children were significantly poorer in comparison to native children in the domains of self-esteem and family life, as well as in the total QoL scores. In the rest of the QoL domains, similar scores were reported in both immigrant and their native classmates, that is in the dimensions of physical well-being, emotional well-being, friends and school. Investigating the effect of gender in KINDL® QoL parameters, after controlling for nationality and age, no evidence was found for differences between male and female children. Regarding the effect of age, older compared to younger in age children scored significantly lower in emotional well-being, self-esteem, and friends, school and total QoL. The results provide evidence of QoL deficits in self-esteem and family life in immigrant children. QoL deficits seem to increase in more areas as immigrant children grow older. Dimensions regarding self-perception and family may be interrelated, mutually influencing one another. It may be suggested that immigrant children seem to experience reduced self-esteem and distressful feelings within family interpersonal relations. As they grow older, distress seems to become more evident in emotional and social areas of QoL. Mental health interventions should take into account the multilevel impact of family interpersonal experiences on child's psychosocial development, as to design and deliver appropriate interventions supporting parenting for immigrant groups of individuals. Also, specialized mental health promotion programs need to be provided for adolescent immigrant individuals.

Predictors and characteristics of anxiety among adolescent students: a Greek sample.

In the Greek society, there is a strong cultural tendency to overestimate the value of University studies. So students are under high emotional pressure during the long lasting period of the preparation for the university entrance exams. The aim of the present study was to evaluate the level of anxiety in a general adolescent population of senior high school students in Athens, Greece. Also to examine the association between the anxiety's severity with various demographic and socio-cultural factors, as well as with academic performance, extracurricular activities, sleep duration and presence of somatic problems. The sample consisted of 696 adolescent students of three Senior High Schools (SHS) (391 girls and 305 boys). Two of the schools were general education institutions (GE1 and GE2, N=450), while the third was a technical one (TE, N=246). The school sample was selected to reflect the proportion between the two different types of SHSs in Athens as well as other major urban areas in Greece. The State-Trait Anxiety Inventory was administered and personal data were also collected. Statistical significance was set at p<0.05 and analyses were conducted using STATA 7.0. 567 adolescents lived with both parents and 121 with one or none of them. Father's educational level was low for 138, middle for 154, high for 195 and mother's was low for 135, middle for 417, high for 140. The average sleep duration was 7.5 hours per day (SD=1.3). The average time per week spent in school related activities was 7.94 hours (SD=7.56) and in extracurricular activities was 9.02 hours (SD=12.44). 107 adolescents reported somatic complaints in the last year The academic achievement was poor for 233, good for 264, excellent for 196 students. Adolescents with extracurricular activities for more than 11 hours per week had lower scores, both on State and Trait scales. More hours in school-related activities were associated with greater levels of Trait anxiety. Adolescents whose father had a high educational level had lower scores on State anxiety compared to those whose father had a low educational level. Adolescents who reported the presence of somatic problems had a higher score in Trait anxiety. A significant negative correlation was found between sleep duration and both State (r=-0.14, p<0.001) and Trait anxiety (r=-0.10, p=0.008) scores. Stepwise linear regression analyses confirmed the association of gender and of father's educational level with both State and Trait subscale scores. The association of somatic problems with Trait anxiety was greater for girls compared to boys. The hypothesis that there is exam-related anxiety in our sample was not confirmed. There were no differences between school years and GE and TE schools. Also there was not an association of anxiety level with academic achievement and the number of parents the adolescent was living with. This study shows that girls, especially those reporting somatic problems, and adolescents coming from families with low parental education, are particularly prone to higher level of anxiety and that extracurricular activities are linked to lower level of anxiety. These findings could contribute to the planning of preventive measures for student's anxiety.

[Specific developmental disorder of speech and language in adulthood].

Specific developmental disorder of speech and language is part of a more general category of neurodevelopmental disorders, which is encountered in 7-10% of the childhood population. These children exhibit a significant impairment in speech and language development, which cannot be justified by hearing impairment, cognitive impairment, neuromuscular or orofacial disorders, as well as by emotional or environmental factors. Specific developmental disorders of speech and language are often comorbid with other neurodevelopmental disorders, such as motor coordination disorder and ADHD. These disorders are usually detected in early childhood and commonly treated during the preschool and school years. Despite this fact clinical and empirical evidence suggest that often these disorders persist beyond the school years, even though the symptomatology may be differentiated. In this literature review, we address the question of whether specific developmental language disorders are encountered only during childhood, and, if they persist, how they are manifested in adulthood. Finally, possible factors which may lead to these manifestations are analyzed. A considerable body of research has shown that even though the symptoms of children with specific developmental language disorders are resolved before the end of childhood, a significant part of this population continues to have persisting difficulties through adolescence and into adulthood. The continuity of this disorder may sometimes be directly linked to language disorder, as in the case of learning impairments or, on the other hand, symptoms may be related with those of conduct disorders, social adjustment disorder, emotional and psychiatric disorders in adolescence and adulthood. It therefore appears that specific developmental language disorder is often an early symptom of other disorders in the future. Even though the precise mechanisms which are responsible for these disorders are not yet known, it is possible that a fragile neurobiological substratum in these disorders may explain why early symptoms are usually manifested as language disorders and later develop into other disorders over time. However, these symptom changes may be linked to other parameters, such as the increasing social and emotional demands made on these individuals with increasing age, which may be a contributing environmental parameter to an already vulnerable system. Despite all of the limitations in the longterm study of these children, it is suggested that in some way, and not in all cases, pathology may continue into adulthood, although with a different symptomatology, which is linked to behavioural and social adjustment, as well as with more pervasive psychiatric disorders. In conclusion, it is suggested that a continuum of services may be necessary for these cases into adulthood.

Does the subjective quality of life of children with specific learning disabilities (SpLD) agree with their parents' proxy reports?

PURPOSE: The aim of the present study was to investigate agreement between child-parent proxy reports on quality of life (QoL) in children with specific learning disabilities (SpLD) and in a control group of typically developing children. METHODS: One hundred and sixteen children aged 8-14 years with SpLD, and 312 same age typically developing children with their parents (one or both), respectively, completed the child and parent versions of the KINDL(R) questionnaire. Values were analyzed with ANOVA and intra-class correlation coefficient (ICC). RESULTS: Significant mean differences were found between children with SpLD and their mother's proxy ratings. So, mothers reported significantly lower scores in the dimension of everyday functioning in school, but significantly higher scores regarding the child's physical and emotional well-being. For typically developing children, significant differences between children and parents' proxy ratings were found in physical well-being and self-esteem with both parents reporting higher scores. Concerning ICC, correlations were few and low in the SpLD group but more robust in the typically developing child-parent proxy ratings with values ranging from 0.22 to 0.46. CONCLUSION: In the case of SpLD, the child's problem area, which is reflected in the KINDL(R) dimension of everyday functioning in school, seems to be an issue of controversial value that may be differentially perceived by children and their mothers. Further, it can be argued that as mothers seemed to perceive in a more negative way the child's QoL at school, they were at the same time attempting to counterbalance their reactions by overestimating the child's physical and emotional well-being. Besides differences, there is a tendency even low for mothers and children with SpLD to converge toward similar perceptions regarding the child's physical and emotional well-being and satisfaction with friends that is showing some rather common understanding of the child's overall well-being and his/her relationships with peers. In the control group, agreement between children and parents seems to be more even and evident. Proxy assessments in children with SpLD and their parents may be useful for planning targeted support interventions for these families.

Increased frequency and service delivery for children with pervasive developmental disorders.

Many investigators have reported the increasing incidence of pervasive developmental disorders (PDD), noting that this is probably due to more precise diagnoses, as a result of professionals' increased awareness and knowledge, as well as increased publicawareness. Child mental health services are usually the first to examine these patients and consequently are required to deal with this increase on a practical basis. The aim of this study is to investigate the factors which may be responsible for this increase in PDD cases in a communitymental health centre over a ten year period and to examine whether this has led to a differentiation in service delivery. Consequently, two sets of factors are investigated: factors pertaining to the children themselves, as well as their families and factors related to service provision and delivery.48 children, aged between 2 and 6 years (Mean: 3,5 yrs) with pervasive developmental disorder, as well as their families are divided into two groups according to year of intake. Data collected from patient files included prenatal and perinatal information; medical the and developmental history;family functioning; and hereditary factors. Data from the Service included professionals involved in each case; number of diagnostic sessions; referral for further examinations; patient's symptoms and level of functioning; cognitive functioning; recommendations and outcome. There was no significantdifference in age at intake between groups. The number of cases with pervasive developmental disorder has doubled over a ten year period at our Service. There was no significant difference between groups, with regard to conception, perinatal, developmental and medical histories. Thereis a trend for increased non-medical referrals. Service delivery has not differentiated over the ten year period. In conclusion, no specific factors were identified to justify the increase in PDD cases at our Service over a ten year period, however the trend for more non-medical referrals seems toimply a rise in public awareness of these disorders. Despite augmented patient intake without the complementary increase in staff, service provision at our setting has remained stable, delivered according to a multidisciplinary model and designed according to individual patient needs.

Behaviour assessment and reading ability in second grade greek school children.

Studies on ADHD show high comorbidity with behavioural and learning disorders. However, the specific association of behavioural and attention factors with learning disorders is not clear. The aim of this study is to examine the relationships between hyperactivity, inattentionand reading ability in a non-referred sample in Greece. Data were collected from 201 pupils attending second grade in public school in an Athens district. The CBCL was administrated to parents in order to evaluate behavioural disorders, inattention and hyperactivity. Teachers completedthe CBCL and the Conner's scale. Reading ability was assessed by a reading test appropriate for second grade. Attention difficulties reported by the teacher were associated with lower readingskills, but hyperactivity and behaviour disorders were not. Correlations of reading skills with CBCL scores were very low, especially through parental ratings. Girls showed better reading skills and less"hyperactivity" than boys. There was consistency in teachers' ratings between the Conner's and the CBCL. Teacher-parent concordance on CBCL was very low or absent. Report of hyperactivity without report of attention problems was not associated with reading difficulties in a non-referred Greek sample of second grade schoolchildren. This observation must be considered when therapeutic and/or educational planning is undertaken.

[The psychopathology of bilingual children in a sample of a Community Mental Health Center].

Thoughts and views of one's internal self can be materialized via verbal symbols. Therefore literal people can use these verbal symbols as a means of recording their ideas and experiences in order for them to be passed on and read by others. Evidently the abovementioned mental operations can be reflected in speech and language. It is not yet known whether bilingualism is the sum of two monolingual situations or whether they coexist. The way each language is organized is also not known, neither are the psychological operations that may influence the organization of each language, memory and the relationship with each language. During childhood and adolescence, language is a very important tool via which one communicates, materializes emotional behavior and organizes oneself. Linguistic development and identity formation both follow a parallel and connected line in view of the internal psychological organization. However, in the bilingual person, this relationship is influenced both by the two different cultural stimuli and by the two different linguistic stimuli (i.e. language). However, in the case where children grow up in a bilingual environment there are some particularities and special issues affecting these children. Under such circumstances, the accomplishment of the feeling of coherence and stability of the self becomes an even more difficult task for the child. Nowadays, in Greek reality, the phenomenon of bilingualism tends to be associated with economic immigration. In the sample used, five fourths of children consist of children coming from families of economic immigrants. The composition of the student population in Greece is characterized by linguistic and cultural polymorphism. The presence and existence of a large number of immigrants has changed the setting in Greece in many regions of the country and in turn, the composition of the school population. Any public school allover in Greece consists, among others, of children coming from families of economic immigrants, including thus a random number of children speaking different languages. Without doubt, immigration affects the immigrating person as much as it affects the new group. Also, immigration adjustment and formation depends on the pre-existing characteristics of the immigrants as much as it does on the characteristics of the welcoming society. Research dealing with the issues of economic immigrants in Greece are limited and mainly come from schools. The focus of interest is aimed firstly on the psychopathology that can be linked to the phenomenon of immigration and secondly on the social consequences of the phenomenon. The formation of psychopathology is associated with immigration and the importance of psychological trauma and its consequences. However, the association between the creation of psychopathology, which is formulated in childhood/adolescence, and the bilingual environment together with identity formation, is not yet clear. The aim of this paper was to study the effect of the dual language environment on psychopathology formation among children and adolescents as it appears in everyday clinical practice and as it has been recorded at the Child and Adolescent Mental Health Unit of the Community Mental Health Centre of Byron and Kaissariani, Psychiatric Hospital, Athens University. Data deriving from the database of the Community Mental Health Centre were extracted from the files of 62 bilingual children, aged 0 to 18 years, who had visited the CMHC of Byron and Kaissariani in the period 2000 to 2005. The data selected concerned the sex, age, maternal language, diagnosis and the existence of economic immigration. Means deriving from the sample of bilingual children were compared to the means of the rest of the sample. (Pearson chi,2 Fishers exact test) Based on the results, four fifths of the sample was composed of children belonging to families of economic immigrants. The occurrence of Pervasive Developmental Disorders was triple among the sample of bilingual children compared to the sample of monolingual children. Among school-aged children the majority of diagnoses concerned Specific Language, Movement and Learning Disorders. On the contrary, during adolescence, there was a two-fold increase of psychiatric illness among bilingual adolescents compared to monolingual adolescents with conduct disorders being more prominent among males and mood disorders more prominent among females. Based on the extent and importance of the influence of the dual linguistic environment on children and adolescents as well as on the originality of the new situation in Greek society, further exploration of this area is believed to be necessary.

Factors affecting compliance with treatment in an outpatient child psychiatric practice: A retrospective study in a community mental health centre in Athens.

BACKGROUND: The literature review shows that treatment compliance in child psychiatric practice is a multifactorial issue that includes parameters such as the type of problem presented by the child, the family's functioning and the therapeutic team's organization and functioning. METHODS: In order to examine these parameters and their inter-relationship, epidemiological data from the files of 455 cases, representing the total number of cases admitted to our Centre between 1990-1994, were collected. We noted that the majority of patients (58.6%) failed to comply with treatment. RESULTS: The statistical analysis shows that the sex and age of the child, the socio-economic status of the family, the family's size, the parents' educational background as well as the referral source are unrelated to compliance. On the contrary, the type of problem presented by the child, the type of recommended treatment, the number of sessions attended and the season of admission are correlated with treatment compliance. CONCLUSIONS: Certain aspects of our team's techniques concerning the admission procedure, therapeutic contract and parental counselling have been re-examined and improved.