Parents/primary caregivers' perspectives on the well-being, and home-based learning of children with neurodevelopmental disorders during COVID-19 in Bangladesh.

Background and Aims: The coronavirus pandemic (CP) leading to prolonged lockdown, and restriction of movement for almost two years in Bangladesh severely affected not only the well-being (physical and mental health) of both children and adults but also their access to home-based learning. The present study aimed to explore the mental, and physical health problems of children with neurodevelopmental disorders (NDDs), their use of telehealth services, and the status of their home-based learning by asking questions to their parents/primary caregivers (N = 149) during the second year of lockdown (November and December 2021). Methodology: The present study was a cross-sectional self-reported survey covering as many parents/primary caregivers as possible within Bangladesh. The survey questions were selected from a larger study by Masi et al. named 'COVID-19 impact survey' with permission. A total of 149 parents/primary caregivers with one or more children (mean age = 5.54) having any of the NDDs took part in the survey. Data were collected via physical sitting, telephone interview, and anonymous Google form. Results: Almost one-third of parents/caregivers felt that the NDD symptoms of their children were worsening with time, and half of them reported that their children's health and well-being were negatively impacted. More than 90% of the caregivers felt that their children are facing challenges following the rules of social distancing. Whereas more than 80% of parents agreed that their children's learning was disrupted during covid-19, and they were not getting enough online/offline support from the authorities. Conclusions: The outcome of this study suggested that CP had a significant impact on the wellbeing and home-based learning of children with NDDs and their families in Bangladesh. Most of the caregivers reported that the NDDs symptoms of their children are worsening with disrupted routine, facing problems following social distancing and maintaining fruitful relationships. In terms of home-based learning, most caregivers reported insufficient support from school authorities. The parents recommended the development of an adequate system for telehealth services and policies to help the vulnerable individuals in the future.

A Digital Microintervention Supporting Evidence-Based Parenting Skills: Development Study Using the Agile Scrum Methodology.

BACKGROUND: Conduct disorder increases risks of educational dropout, future mental illness, and incarceration if untreated. First-line treatment of conduct disorder involves evidence-based parenting skills programs. Time-outs, a frequent tool in these programs, can be effective at improving behavior, and recent apps have been developed to aid this process. However, these apps promote the use of time-outs in inconsistent or developmentally inappropriate ways, potentially worsening behavior problems. Digital microinterventions like these apps could guide parents through high-quality time-outs in the moment, but current time-out apps lack features promoting adherence to the evidence-based best practice. Agile scrum is a respected approach in the software development industry. OBJECTIVE: We aimed to explore the feasibility of using the agile scrum approach to build a digital microintervention to help parents deliver an evidence-based time-out. METHODS: The agile scrum methodology was used. Four sprints were conducted. Figma software was used for app design and wireframing. Insights from 42 expert stakeholders were used during 3 sprint reviews. We consulted experts who were identified from councils around the Midlands region of the United Kingdom and charities through personal contacts and a snowballing approach. RESULTS: Over 4 development sprints from August 2022 to March 2023, the app was iteratively designed and refined based on consultation with a diverse group of 42 experts who shared their knowledge about the content of common parenting programs and the challenges parents commonly face. Modifications made throughout the process resulted in significant app enhancements, including tailored timer algorithms and enhanced readability, as well as an onboarding zone, mindfulness module, and pictorial information to increase inclusivity. By the end of the fourth sprint, the app was deemed ready for home use by stakeholders, demonstrating the effectiveness of our agile scrum development approach. CONCLUSIONS: We developed an app to support parents to use the evidence-based time-out technique. We recommend the agile scrum approach to create mobile health apps. Our experience highlights the valuable role that frontline health and social care professionals, particularly those working with vulnerable families, can play as experts in scrum reviews. There is a need for research to both evaluate the impact of digital microinterventions on child behavioral change and also create digital microinterventions that cater to non-English speakers and individuals who participate in parenting programs in settings outside the United Kingdom.

First evaluation of Eyberg Child Behavior Inventory for foster children in Japan.

BACKGROUND: Behavioral problems of foster children are an important issue for the maintenance of the foster care system, but they have not been adequately studied in Japan. We used the Eyberg Child Behavior Inventory (ECBI) to investigate behavioral problems among foster children and to examine associated factors. METHODS: Twenty-nine foster children and their foster parents and 479 non-foster children and parents were recruited for the foster and control groups, respectively. Both groups underwent statistical comparative analyses using data from their ECBI assessments. The ECBI has two scales: the Intensity Scale quantifies the severity of child behavioral problems, and the Problem Scale captures the caregiver's perceived difficulties handling each behavior. We conducted a retrospective investigation of the background of the foster parent-child pairs to explore potential causal relationships with behavioral problems. RESULTS: The mean intensity score for the foster group was significantly higher than that for the control group (p = 0.001). The mean problem scores for the foster group and the control group were not significantly different (p = 0.79). In the foster group, the retrospective investigation revealed two children with neurological or neurodevelopmental disorders, 17 with histories of abuse, and 10 with other issues. CONCLUSION: Intensity scores showed severe behavioral problems among foster children, perhaps caused by neurological disorders, abuse, parental mental health, or economic hardship. Problem scores showed no significant differences between groups. It can therefore be posited that foster parents might exhibit a more lenient parenting style when dealing with children who have a history of abuse by their biological parents.

Early Childhood Caries and Its Association With Behavior in Preschool Children.

Background and aim Early childhood caries (ECC) is a profoundly impactful multifactorial condition that not only influences a child's overall well-being but also diminishes their quality of life. Given the limited availability of literature on the relationship between children's behavior and ECC, the present study utilized a standardized assessment tool to assess the association between ECC and behavioral changes in preschool children. Methodology Our study cohort consisted of 120 healthy preschool children, aged 18-60 months, evenly divided into two groups: caries-free (group I) and caries active (group II). Clinical features of ECC were meticulously inspected in each child, and the parents or caregivers completed the Child Behavior Checklist (CBCL), which comprises 100 questions related to a child's daily behavior. The total scores, the narrow-band subscales, and raw scores were obtained. Accordingly, for each raw score, t-scores were obtained using the graphic display. These scores were then subjected to various statistical analyses including the Kolmogorov-Smirnov test, Mann-Whitney U test, and Spearman's rank correlation method. Results Results of the present study revealed that there were no significant differences in behavior based on demographic factors such as gender and age. However notable differences were observed in several aspects of behavior between the two groups. Conclusion Caries-active children exhibited significantly higher levels of behavioral problems compared to their caries-free counterparts.

Family Functioning and Internalizing and Externalizing Problems in Gifted Children.

INTRODUCTION: Although gifted children can express high cognitive skills, they can also show socioemotional difficulties. Drawing from Olson's circumplex model, the present paper assessed the role of family functioning in internalizing and externalizing problems in gifted children. MATERIALS AND METHODS: 362 mothers and their 362 gifted children were included. The unbalanced subscales of the FACES IV-disengagement, enmeshment, rigidity, and chaos-and the CBCL were administered to mothers. The children completed the WISC-IV. RESULTS: The model predicting internalizing problems was significant and explained 5.6% of the variance. Only rigidity had an independent and positive effect on internalizing problems in gifted children over and above sociodemographic variables and QI, whereas disengagement, enmeshment, and chaos were not associated with internalizing problems. The model predicting externalizing problems was significant and explained 10% of the variance. Again, rigidity was the only variable that had an independent and positive effect on externalizing problems in gifted children over and above sociodemographic variables and QI, whereas disengagement, enmeshment, and chaos were not associated with externalizing problems in this population. DISCUSSION: Rigid families with a low ability to change in conditions that require readjustment appear to increase the risk of both internalizing and externalizing problems in gifted children. Although further studies are needed to support these preliminary findings, parental support interventions aimed at increasing flexibility appear to be useful.

Treatment Effects of Introducing the Neurosequential Model of Therapeutics in a Norwegian Residential Treatment Facility for Children Aged 7-13.

This study investigates the impact of the Neurosequential Model of Therapeutics (NMT) in child and adolescent psychiatric care, addressing a gap in current clinical methodologies that tend to focus on single problems rather than the interconnected nature of many real-life mental health issues. The study was conducted in a residential setting over an extended period, including children aged 7-13, to observe the effects of implementing NMT. The children presented with complex symptoms and multiple diagnoses. The methods incorporated the NMT approach, emphasizing individualized treatment plans based on each child's unique brain development, and aimed at addressing multiple, interconnected problems simultaneously. Results from multilevel model analyses of behavioral difficulties, measured using the Child Behavior Checklist (CBCL), revealed substantial improvements in treatment effectiveness post-NMT implementation. Despite the limitations, such as a non-randomized participant selection and limited sample size, the findings strongly suggest that NMT enhances care effectiveness in real-world clinical settings, particularly for children with complex mental health issues. The study concludes that relationally oriented milieu therapy, and specifically the NMT approach, holds great promise for advancing pediatric psychiatric care, advocating for its broader application and further research to refine and substantiate its efficacy.

Maternal concentrations of environmental phenols during early pregnancy and behavioral problems in children aged 4 years from the Shanghai Birth Cohort.

BACKGROUND: Prenatal exposure to environmental phenols such as bisphenol (BPs), paraben (PBs), benzophenone (BzPs), and triclosan (TCS) is ubiquitous and occurs in mixtures. Although some of them have been suspected to impact child behavioral development, evidence is still insufficient, and their mixed effects remain unclear. OBJECTIVES: To explore the association of prenatal exposure to multiple phenols with child behavioral problems. METHOD: In a sample of 600 mother-child pairs from the Shanghai Birth Cohort, we quantified 18 phenols (6 PBs, 7 BPs, 4 BzPs, and TCS) in urine samples collected during early pregnancy. Parent-reported Strengths and Difficulties Questionnaires were utilized to evaluate child behavioral difficulties across four subscales, namely conduct, hyperactivity/inattention, emotion, and peer relationship problems, at 4 years of age. Multivariable linear regression was conducted to estimate the relationships between single phenolic compounds and behavioral problems. Additionally, weighted quantile sum (WQS) regression was employed to examine the overall effects of the phenol mixture. Sex-stratified analyses were also performed. RESULTS: Our population was extensively exposed to 10 phenols (direction rates >50 %), with low median concentrations (1.00 × 10-3-6.89 ng/mL). Among them, single chemical analyses revealed that 2,4-dihydroxy benzophenone (BP1), TCS, and methyl 4-hydroxybenzoate (MeP) were associated with increased behavior problems, including hyperactivity/inattention (BP1: ß = 0.16; 95 % confidence interval [CI]: 0.04, 0.30), emotional problems (BP1: ß = 0.11; 95 % CI: 0.02, 0.20; TCS: ß = 0.08; 95 % CI: 0.02, 0.14), and peer problems (MeP: ß = 0.10; 95 % CI: 0.02, 0.18); however, we did not identify any significant association with conduct problems. Further phenol mixture analyses in the WQS model yielded similar results. Stratification for child sex showed stronger positive associations in boys. CONCLUSION: Our findings indicated that maternal phenol levels during early pregnancy, specifically BP1, TCS, and MeP, are associated with high behavioral problem scores in 4-year-old children.

Household chaos and child problem behaviors: A cross-cultural examination of the mediating and moderating role of mindful parenting.

Household chaos has been shown to adversely associate with children's behavioral adjustment. However, the mechanism underlying the relationship between household chaos and children's behaviors is not yet fully understood. The current study proposes mindful parenting as an important mediating and moderating factor in the relationship between household chaos and child problem behaviors. This study also examines cultural influences in this process, comparing the UK and Türkiye, considering both mothers' and children's perspectives on mindful parenting. Cross-sectional questionnaires were administered to mothers and their children aged 11-16 years in the UK (n = 90; 53.3% girl) and Türkiye (n = 154; 54.5% girl) in 2021. Mother reports of the Confusion, Hubbub, and Order Scale and the Strengths and Difficulties Questionnaire, as well as mother and child reports of Mindful Parenting Inventories for Parents (MPIP) and Children (MPIC), were used to assess household chaos, child problem behaviors, and mindful parenting, respectively. Multiple-group path analysis revealed that household chaos was a significant indirect predictor of child problem behaviors via mindful parenting in both countries. Furthermore, simple slopes analysis showed that mindful parenting moderated the link between household chaos and child problem behaviors in the UK. Overall, our study sheds light on the importance of micro- and macro-environmental factors and their interactions in children's adjustment.

Cheating in childhood: Exploring the link between parental reports of problem behaviors and dishonesty on simulated academic tests.

This study investigated the relationship between parental reports of children's behavioral problems and their cheating behaviors on simulated academic tests, addressing a significant gap in understanding early childhood academic cheating and its potential links to broader behavioral issues. We hypothesized that children's early problem behaviors would be predictive of their academic cheating. To test these hypotheses, children aged 4 to 12 years took part in six unmonitored academic tests that measured their cheating behaviors while their parents completed the Child Behavior Checklist and the Strengths and Difficulties Questionnaire elsewhere. Separate hierarchical linear regressions revealed that children's problem behaviors, as reported by parents, overall significantly predict children's cheating behaviors even after accounting for demographic variables such as age, gender, ethnicity, and parental religiosity. Specifically, the Conduct Problems subscale of the Strengths and Difficulties Questionnaire showed a significant and unique association with children's cheating behaviors above and beyond the common contributions of all predictors. However, the Child Behavior Checklist scores and the scores on the other Strengths and Difficulties subscales were not significantly or uniquely related to cheating. These findings offer new insight into simulated childhood academic cheating and its relation to problem behaviors observed by parents.

The Role of Parental Emotional Health and Parenting Practices in Offspring Mental Health.

In the family social environment, children can experience and observe stressful situations, involving mental health and parental practices. The review by Mendes-Sousa et al. examines the relation between family stress, child development, and offspring mental health. Of the main results, we highlight the relationship between maternal depression with developmental delays and child internalizing and externalizing symptoms. Furthermore, negative parenting practices were also related to children's emotional and behavioral problems, while positive practices were beneficial to the socio-emotional development of offspring. The review warns about preventing socio-emotional problems in offspring, through promoting parental mental health, positive parenting practices, and cohesive family environments. Finally, we envision a significant path for subsequent research on maternal emotional overload and the central role of mothers in caring for their offspring, exploring shared care for children and potential public policies aimed at mothers' mental health and social inclusion.

The Effects of Online Behavioral Parenting Interventions on Child Outcomes, Parenting Ability and Parent Outcomes: A Systematic Review and Meta-analysis.

The twenty-first century has seen the development and delivery of online programs of behavioral family intervention for disruptive child behavior. Typically, programs evaluate outcomes in terms of change in child functioning and change in parenting ability. Existing research has also articulated the importance of parent-child relational capacity and its role in facilitating change in child functioning, and the importance of parent emotion regulation in the interests of ensuring optimal child development. These factors were explored in a meta-analysis of k = 14 prospective longitudinal research studies of online parenting interventions for disruptive child behavior. Peer reviewed randomized controlled trials with inactive control groups that were published in English between 2000 and 2022 were included in the review if they were delivered online; offered parent self-directed treatment; included as participants families who were screened as having child behavioral difficulties on validated psychometric assessment measures; and assessed child treatment outcomes, parenting ability and parent treatment outcomes. The protocol for this study was pre-registered with PROSPERO (CRD42020215947). Statistical analyses employed random effects models and reported pooled effect sizes (Hedge's g) within and between groups. Results emphasize the importance of child outcomes and parenting ability in program assessment, however, suggest that parents' capacity to develop optimal parent-child relationships and regulate emotion may not be sufficiently reflected in program content. Identified continuous and categorical moderators of treatment outcome were also assessed. Results of the review are discussed in terms of their potential to influence the future development of online programs of behavioral family intervention and, therefore, child development.

Child behavior problems and parental psychological distress in Chinese families of children with autism: The putative moderating role of parental social support and cultural values.

The wellbeing of parents of children with autism residing in mainland China remains understudied. We aimed to examine whether and how parental perceived social support, individualism, and collectivism acted together to moderate the relationships between child behavior problems and parental psychological distress in Chinese parents of children with autism. With convenience and snowball sampling, data on 268 primary caregiver parents of children with autism were collected from an online cross-sectional survey. Linear regression analysis indicated that child behavior problems were significantly associated with increased psychological distress in Chinese parents of children with autism. There was no evidence to support the stress-buffering model of social support in moderation analysis of the association between child behavior problems and parental psychological distress. Nonetheless, increased social support was associated with lower levels of parental psychological distress. Moderated moderation analyses did not support a role for individualism or collectivism as a moderator of the putative buffering role of social support. However, there was evidence that parental individualism was associated with increased parental psychological distress. Our findings highlight that child behavior problems are a robust correlate of parental psychological distress, and parental social support may act as a compensatory factor promoting less psychological distress rather than having a protective role. The role of social support and cultural values in the wellbeing of parents of children with autism in China requires additional exploration, including longitudinal research designs.

Associations between Atopic Dermatitis and Behavior Difficulties in Children.

Background and Objectives: There has been increasing evidence that atopic dermatitis (AD) is associated with behavioral difficulties (BDs). There is currently a lack of evidence of how the severity of the disease determines BDs and what additional factors may contribute to their manifestation. The aim is to determine what kind of BDs occur in children with AD compared to healthy children and to find out what additional factors may contribute to the development of BDs in AD patients. Materials and Methods: This is a cross-sectional, prospective study with the application of a risk assessment instrument for behavior difficulties (Child Behavior Checklist, CBCL 6/18) in pediatric patients with AD and healthy controls (6-17 years) between 1 January 2020 and 31 December 2022. For statistical comparison, mainly Wilcoxon-Mann-Whitney and Student's t-test were used, considering a significance level of 5%. Results: This study included a total of 101 children: 48% with AD, 52% non-AD. The mean age was 10 ± 2.7 years for AD, and10.5 ± 3.1 years for the control patients. AD patients had higher internal behavior scale scores and T-scores (6.6 ± 6.4 vs. 9.6 ± 6.9 and 47.9 ± 9.5 vs. 52.3 ± 10.2, p = 0.01), anxiety/depression scale score and T-score (2.8 ± 2.7 vs. 4.3 ± 3.5 and 47.7 ± 8.4 vs. 52.5 ± 11, p = 0.02), and somatic problems scale score and T-score (2.1 ± 2.3 vs. 3.5 ± 3 and 47.6 ± 8.5 vs. 52.7 ± 10.9, p = 0.005). Patients with severe AD had sleep disturbance and itching scores higher than those with mild-moderate AD (5.4 ± 2.6 vs. 2.4 ± 2.2, p = 0.000 and 6.6 ± 2.4 vs. 4 ± 2.8, p = 0.001). The mean morning serum cortisol concentration was lower in AD patients compared to controls (252.91 ± 304.34 vs. 351.55 ± 126.09 nmol/L, p = 0.047). Conclusions: Children with AD present a higher risk of BDs than healthy controls. Patients with severe AD experience more sleep disturbances and a greater intensity of itching compared to mild-moderate AD. The occurrence of BDs was not related to serum cortisol levels. The cortisol level, severity, age, gender, duration of illness, intensity of pruritus, and sleep disturbance did not affect the development of BDs.

Knowledge and Attitude Toward Child Safety Seat Use in Saudi Arabia: A Cross-Sectional Study.

Background Car safety seats (CSS) are a well-established strategy to reduce injuries and fatalities among children involved in road traffic accidents. However, the use of CSS is generally low globally due to limited knowledge of its benefits. This study assessed parents' knowledge and attitudes toward CSS in Saudi Arabia. Methods This cross-sectional study used an online self-administered survey distributed among residents in different regions of Saudi Arabia to assess their knowledge and attitude toward CSS. Data were analyzed using the statistical package for the social sciences (SPSS) version 23.0 (IBM Corp., Armonk, NY). Results A total of 383 Saudi residents participated in the study. The mean age was 37.14 ±9.10 years, with a female predominance (62.1%, n=238). One-third of the participants were from the western region of Saudi Arabia (30.3%, n=109). Non-use of CSS was reported by 25.8% of the participants, while 11.7% reported that they rarely used CSS. The mean total knowledge score was 2.15 (range 0 -3). A lower knowledge score was significantly associated with a lower educational level (p=0.008), not having information regarding CSS (p=0.005), none or rare use of CSS by the parent (p<0.001), and the use of media or self-education as a source of information regarding CSS (p=0.002). The mean attitude score was 12.52 (range 4 -20). The attitude score was significantly associated with gender (p=0.002), education (p=0.014), number of children (p=0.005), monthly family income (p=0.028), use of CSS by people other than the parent (p<0.001), information about CSS use in the car (p<0.002), source of information (p<0.001), and use of CSS by the parent (p<0.001). Conclusions The knowledge and attitude of the Suadi population toward CSS use are inadequate, highlighting the need to enhance awareness and understanding of the importance of CSS use.

The role of parenting self-efficacy on teacher-child relationships and parent-teacher communication: Evidence from an Australian national longitudinal study.

High-quality teacher-child relationships and parent-teacher communications have substantial benefits to children's well-being and school functioning. However, more research is needed to understand how parenting self-efficacy influences these relationships. This cross-sequential study investigated the direct associations of parenting self-efficacy with the teacher-child relationship and parent-teacher communication, as well as potential mediation pathways. The present study included a sample of 8152 children who participated in the Longitudinal Study of Australian Children (LSAC), a large study with a nationally representative sample of children from two cohorts who were 4 years apart. We used data collected in three waves when participating children were ages 6 years, 8 years, and 10 years. Structural equation modeling was used to test a panel model with parent-reported parenting self-efficacy and parent-teacher communication quality, as well as teacher-reported teacher-child relationship, child behavior difficulties, and child prosocial behaviors at school. Cross-lagged regressions demonstrated that baseline parenting self-efficacy directly and positively linked with the quality of teacher-child relationship and parent-teacher communication 2 years later. Child behavior at school was identified as a mediation pathway between parenting self-efficacy and teacher-child relationship. The same patterns were identified in two waves (Waves 6-8 and Waves 8-10). Limited child gender, parent gender, or cohort differences were observed. The current findings provide initial support that parenting self-efficacy may have spillover effects on school-related factors. The findings have implications both for parenting and school researchers and for child mental health practitioners because one important way to promote parenting self-efficacy is through evidence-based parenting programs.

Neonatal Nucleus Accumbens Microstructure Modulates Individual Susceptibility to Preconception Maternal Stress in Relation to Externalizing Behaviors.

OBJECTIVE: Maternal stress influences in utero brain development and is a modifiable risk factor for offspring psychopathologies. Reward circuitry dysfunction underlies various internalizing and externalizing psychopathologies. This study examined (1) the association between maternal stress and microstructural characteristics of the neonatal nucleus accumbens (NAcc), a major node of the reward circuitry, and (2) whether neonatal NAcc microstructure modulates individual susceptibility to maternal stress in relation to childhood behavioral problems. METHOD: K-means longitudinal cluster analysis was performed to determine trajectories of maternal stress measures (Perceived Stress Scale [PSS], hair cortisol) from preconception to the third trimester. Neonatal NAcc microstructural measures (orientation density index [ODI] and intracellular volume fraction [ICVF]) were compared across trajectories. We then examined the interaction between maternal stress and neonatal NAcc microstructure on child internalizing and externalizing behaviors, assessed between ages 3 and 4 years. RESULTS: Two trajectories of maternal stress magnitude ("low"/"high") were identified for both PSS (n = 287) and hair cortisol (n = 336). Right neonatal NAcc ODI (rNAcc-ODI) was significantly lower in "low" relative to "high" PSS trajectories (n = 77, p = .04). PSS at preconception had the strongest association with rNAcc-ODI (r = 0.293, p = .029). No differences in NAcc microstructure were found between hair cortisol trajectories. A significant interaction between preconception PSS and rNAcc-ODI on externalizing behavior was observed (n = 47, p = .047). CONCLUSION: Our study showed that the preconception period contributes to in utero NAcc development, and that NAcc microstructure modulates individual susceptibility to preconception maternal stress in relation to externalizing problems.

The Child Behavior Check List Usefulness in Screening for Severe Psychopathology in Youth: A Narrative Literature Review.

OBJECTIVE: This article will review the use of the CBCL to diagnose youth with psychopathological disorders focusing on: ADHD, Mood Disorders, Autism Spectrum disorders, and Disruptive Disorders. METHOD: Using a narrative review approach, we investigate the usefulness of the CBCL as a screening tool to detect childhood onset psychopathology across different diagnostic syndromes. RESULTS: The available literature supports the use of the CBCL for ADHD screening and as a measure of ADHD severity. While some studies support a specific profile linked with childhood bipolar disorder, replication studies for this profile found mixed results. The CBCL was also found to be useful in screening for patients presenting with Autism Spectrum Disorders, Conduct Disorder, and Childhood Bipolar Disorder all of which presents with more severely impaired scores. CONCLUSION: The CBCL holds promise as a screening tool for childhood psychopathology.

Sex-specific associations between placental corticotropin releasing hormone and problem behaviors in childhood.

Placental corticotropin-releasing hormone (pCRH) is a neuroactive peptide produced in high concentrations in mid-late pregnancy, during key periods of fetal brain development. Some evidence suggests that higher pCRH exposure during gestation is associated with adverse neurodevelopment, particularly in female offspring. In 858 mother-child dyads from the sociodemographically diverse CANDLE cohort (Memphis, TN), we examined: (1) the slope of pCRH rise in mid-late pregnancy and (2) estimated pCRH at delivery as a measure of cumulative prenatal exposure. When children were 4 years-old, mothers reported on problem behaviors using the Child Behavior Checklist (CBCL) and cognitive performance was assessed by trained psychologists using the Stanford-Binet Intelligence Scales. We fitted linear regression models examining pCRH in relation to behavioral and cognitive performance measures, adjusting for covariates. Using interaction models, we evaluated whether associations differed by fetal sex, breastfeeding, and postnatal neighborhood opportunity. In the full cohort, log-transformed pCRH measures were not associated with outcomes; however, we observed sex differences in some models (interaction p-values≤0.01). In male offspring, an interquartile (IQR) increase in pCRH slope (but not estimated pCRH at delivery), was positively associated with raw Total (ß=3.06, 95%CI: 0.40, 5.72), Internalizing (ß=0.89, 95%CI: 0.03, 1.76), and Externalizing (ß=1.25, 95%CI: 0.27, 2.22) Problem scores, whereas, in females, all associations were negative (Total Problems: ß=-1.99, 95%CI: -3.89, -0.09; Internalizing: ß=-0.82, 95%CI: -1.42, -0.23; Externalizing: ß=-0.56, 95%CI: -1.34, 0.22). No associations with cognitive performance were observed nor did we observe moderation by breastfeeding or postnatal neighborhood opportunity. Our results provide further evidence that prenatal pCRH exposure may impact subsequent child behavior in sex-specific ways, however in contrast to prior studies suggesting adverse impacts in females, steeper mid-gestation pCRH rise was associated with more problem behaviors in males, but fewer in females.

Validación psicométrica de la escala Yale Food Addiction Scale for Children (YFAS-C) al idioma español en población mexicana / Psychometric validation of the Yale Food Addiction Scale for Children (YFAS-C) in Spanish in a Mexican population

Introducción: México es uno de los países con mayor prevalencia de obesidad infantil a nivel mundial. El aumento de comportamientos adictivosa temprana edad es una posible causa de su desarrollo. La escala de adicción a los alimentos para niños Yale Food Addiction Scale for Children(YFAS-C) permite identificar a los niños con conductas adictivas.Objetivo: validar la escala YFAS-C en español en una muestra de niñas/niños y adolescentes mexicanos.Material y métodos: se realizó un análisis factorial exploratorio y confirmatorio, con una muestra de estudio conformada por 448 niños de sietea 14 años de edad. En la primera etapa se realizó la traducción al español; en la segunda etapa, la solución de preguntas con discrepancias;posteriormente, una traducción inversa al idioma original y una revisión por expertos en el tema de trastornos alimenticios en población pediátrica;y en la última etapa, una prueba piloto con el fin de adaptar culturalmente el instrumento y la evaluación de las propiedades psicométricas.Resultados: utilizando el método de extracción de componentes principales, se identificaron cuatro componentes que explicaron el 47,1 % dela varianza muestral. En el análisis factorial confirmatorio se encontró que los índices de bondad de ajuste cumplieron con los valores requeridos(CFI = 0,906; GFI = 0,932; AGFI = 0,915; SRMS = 0,007; RMSEA = 0,043).Conclusiones: se obtuvo una versión validada al español de la escala YFAS-C para niñas/niños y adolescentes mexicanos que permitirá evaluarla adicción a la comida.(AU)

Introduction: Mexico is one of the countries with the highest prevalence of childhood obesity worldwide. The increase of addictive behaviorsat an early age is a possible cause of its development. The Yale Food Addiction Scale for Children (YFAS-C) allows identifying children with foodaddictive behaviors.Objective: to validate the YFAS-C scale in Spanish in a population sample of Mexican children and adolescents.Material and methods: an exploratory and confirmatory factor analysis was performed. The study sample consisted of 448 children from sevento 14 years of age. The first stage involved translation into Spanish; a second stage involved the solution of questions with discrepancies; then, areverse translation into the original language and a review by experts on the subject of eating disorders in pediatric population were performed;and in the last stage, a pilot test in order to culturally adapt the instrument and the evaluation of the psychometric properties was carried out.Results: using the principal component extraction method, four components were identified that explained 47.1 % of the sample variance. Inthe confirmatory factor analysis, it was found that the goodness-of-fit indices met the required values (CFI = 0.906: GFI = 0.932; AGFI = 0.915,SRMS = 0.007 and RMSEA = 0.043).Conclusions: a validated Spanish version of the YFAS-C scale was obtained for Mexican children and adolescents to assess food addiction.(AU)