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Daughter and mother report of individual symptoms on the Children's Depression Inventory.

PURPOSE: To examine differences between early adolescent girls' and their mothers' perceptions of girls' depressive symptoms. METHODS: 313 daughter-mother dyads completed the Children's Depression Inventory. RESULTS: Low to modest agreement was found for most symptoms, although higher agreement was found for symptoms relating to school performance. The hypothesis that girls would report more ideational symptoms and mothers more behavioral symptoms of depression was tested; girls generally reported more ideational and behavioral symptoms when differences occurred. However, several specific ideational symptoms (feeling like crying; feeling sad; guilt; worrying) tended to be more frequently endorsed by girls and had particularly poor daughter-mother agreement. Examining third variables associated with daughter-mother agreement, girls scoring high on social desirability tended to have smaller daughter-minus-mother difference scores for ideational, but not for behavioral items; therefore, social desirability may be associated with girls underreporting ideational symptoms. CONCLUSIONS: Mothers appear to be reliable raters of symptoms related to school functioning, but may be less aware of certain covert depressive symptoms in their early adolescent daughters.

Adolescent↗

The correlates of depressed mood in adolescents in Hong Kong.

PURPOSE: Most studies of depressed mood and its correlates in adolescents have been conducted in Western countries. This study examined the relationship between a broad range of stressors and depressed mood in a community sample of Hong Kong adolescents. METHODS: Secondary school students (n = 996) completed the Chinese Beck Depression Inventory (C-BDI), provided demographic information, and indicated their perceptions of family and peer relationships, school function and pressures, and subjective health, and some measures salient to the Hong Kong environment: triad gang pressure, religiosity, and intent to emigrate. The correlation between C-BDI and these variables was assessed in bivariate and multivariate analyses. RESULTS: Hong Kong adolescents reported higher levels of depressive symptoms than a comparison group of Western teenagers. Girls showed more symptoms than boys. All stressors correlated in bivariate analyses with C-BDI, indicating similar influences on depressed mood in Western and Hong Kong teenagers. In multivariate analyses, the stressors contributed cumulatively to the C-BDI score. Perceptions of a lack of parental understanding and peer acceptance appeared as the strongest variables in predicting depressed mood. CONCLUSIONS: Depressed mood is highly prevalent among Hong Kong teenagers. Stressors play a cumulative role in their relationship to mood. Our findings point to the importance of broad screening of this vulnerable population.

Adolescent↗

Neuroimpairments, activity performance, and participation in children with cerebral palsy mainstreamed in elementary schools.

Participation and activity performance (motor and cognitive or behavioural) were examined in 148 children with cerebral palsy (CP; 87 males, 61 females; mean age 9y 8mo, SD 1y 11mo; range 6y 1mo to 13y 7mo), mainstreamed in fully inclusive (n=100) and in self-contained classes (n=48) within general schools in Israel, using the School Function Assessment. Differences in participation within these groups were analyzed in relation to the type of CP (mainly spastic hemiplegia, spastic diplegia, and spastic tetraplegia), the level of impairment according to the Gross Motor Function Classification System (GMFCS; level II 55%, level III 37%, and level IV 8%), and additional neuroimpairments. Univariate analyses of variance revealed significant differences in levels of participation and levels of activity performance between different types of CP and GMFCS levels. With regard to additional neuroimpairments, significant differences in participation were found for fully included children with speech and language impairments and those with learning disability within the self-contained group. Physical activity performance partly accounted for differences in participation between children with different types of CP and different levels of motor impairment. These findings suggest that within the mainstreamed environment, participation and activity performance increase as motor disability and/or additional neuroimpairments (speech and language impairments and learning disability) decrease.

Activities of Daily Living↗

Month of birth, socioeconomic background and development in Swedish men.

Season of birth has been shown to correlate with many aspects of somatic and mental disorders, development and social adaptation (so-called 'birth-date effects'). In a sample of young Swedish men, corresponding roughly to a one-year birth cohort, the results of intelligence tests, psychologists' ratings of psychological function, school achievement, body height, weight and self-reported health during childhood, were found to be correlated with month of birth, and--more strongly--father's socioeconomic status. The results were more favourable for men who were born during March-May (the period of highest birth rate), and whose fathers were of higher socioeconomic status, than for those born in November and December (the period of lowest birth rate), and whose fathers were in the lower socioeconomic group. It seems reasonable to conclude, from this study and previously reported findings, that these so-called 'birth-date effects' are determined by varying and often interacting biological and psychosocial factors. Among these factors, the light-induced entrainment of circadian and annual rhythms in the fetus and/or infant seems to be of pivotal importance. The organization of children into one-year age classes therefore produces an unfair lack of equality of possibilities.

Anthropometry↗

Prevalence and impact of premenstrual syndrome in adolescent schoolgirls in the United Arab Emirates.

BACKGROUND: Our objective was to determine the prevalence, sociodemographics, and impact of premenstrual syndrome in adolescent schoolgirls in the United Arab Emirates, as there are no national data on this subject. METHODS: Adolescent girls aged 12-18 years who were at least 1 year postmenarchal were selected from five private and five public schools (n=70 x 10 = 700) in Al-Ain city using a multistage stratified cluster-sampling technique. Subjects were interviewed about cyclic and recurrent behavioral and somatic premenstrual symptoms during the last 3 months based on the American College of Obstetricians and Gynecologists' criteria and their impact on quality of life using a structured and validated questionnaire. RESULTS: The prevalence of premenstrual syndrome was 16.4% (n=115). On logistic regression analysis, premenstrual syndrome was significantly associated with Emirati nationality (p=0.001), presence of the condition in sister(s) (p=0.002), and dysmenorrhea (p<0.001). Only 52 affected subjects (45.2%) were currently taking treatment for premenstrual syndrome and the majority (60%) used pharmacological therapy. Premenstrual syndrome had a moderate but significant negative impact (p<0.001) on the quality of life of affected girls, particularly school performance, social interactions, lifestyle, and emotional well-being. Difficulty in performing school functions and decrease in stigma were the two most adversely affected parameters. CONCLUSION: Premenstrual syndrome is a prevalent, yet undertreated, disorder in adolescent schoolgirls in the United Arab Emirates, which adversely affects their emotional well-being and educational performance, representing a significant public health problem. Premenstrual syndrome is significantly associated with ethnicity, family history, and dysmenorrhea in this group.

Adaptation, Psychological↗

Effects of early childhood supplementation with and without stimulation on later development in stunted Jamaican children.

It is not known whether nutritional supplementation in early childhood has long-term benefits on stunted children's mental development. We followed up 127 7-8-y old children who had been stunted in early childhood and received supplementation, stimulation, or both. At 9-24 mo of age, the children had been randomly assigned to four treatment groups: nutritional supplementation, stimulation, both treatments, and control. After 2 y, supplementation and stimulation had independent benefits on the children's development and the effects were additive. The group receiving both treatments caught up to a matched group of 32 nonstunted children. Four years after the end of the 2-y intervention 97% of the children were given a battery of cognitive function, school achievement, and fine motor tests. An additional 52 nonstunted children were included. Factor analyses of the test scores produced three factors: general cognitive, perceptual-motor, and memory. One, the perceptual-motor factor, showed a significant benefit from stimulation, and supplementation benefited only those children whose mothers had higher verbal intelligence quotients. However, each intervention group had higher scores than the control subjects on more tests than would be expected by chance (supplemented and both groups on 14 of 15 tests, P = 0.002; stimulated group in 13 of 15 tests, P = 0.01), suggesting a very small global benefit. There was no longer an additive effect of combined treatments at the end of the intervention. The stunted control group had significantly lower scores than the nonstunted children on most tests. Stunted children's heights and head circumferences on enrollment significantly predicted intelligence quotient at follow-up.

Anthropometry↗

Teachers' perceptions of and responses to adolescents with chronic pain syndromes.

OBJECTIVE: To examine factors that influence teachers' perceptions of and responses to chronic pain in students. METHODS: Two-hundred and sixty classroom teachers responded to a vignette describing a student with limb pain. The 2 x 2 x 2 factorial design included conditions that varied by (a) the presence or absence of documented organic evidence for the pain, (b) cooperative vs. confrontational parent-teacher interactions, and (c) the presence or absence of communication from the medical team. Teachers rated pain severity and impairment, relief from classroom responsibilities, extent of accommodations the student would require in school, and sympathy for the student and family. RESULTS: Documented medical evidence supporting the pain was the most influential factor affecting teachers' responses to pain. Parental attitude also influenced responses. Communication from the medical team influenced teachers' decisions about relief from responsibilities but did not affect other reactions. CONCLUSIONS: Teachers' responses to students with pain are influenced by situational factors. Efforts to increase school functioning in youth with chronic pain should incorporate attempts to help teachers respond to pain adaptively.

Adolescent↗

Six-year predictors of problems in a national sample: IV. Young adult signs of disturbance.

OBJECTIVE: To identify adolescent predictors of young adult signs of disturbance. METHOD: Family variables and parent- and self-reported syndromes, competencies, and stressful experiences were tested as predictors of school dropout, unwed pregnancy, substance use, mental health services, suicidal behavior, police contacts, and being fired from jobs. RESULTS: Most signs were predictable with considerable accuracy, especially suicidal behavior and being fired from jobs among females. The Delinquent Behavior syndrome and poor school functioning predicted the most poor outcomes. Concurrent scores on young adult syndromes were significantly associated with most signs. CONCLUSIONS: Across the diversity of a national sample, young adult signs of disturbance were predictable from risk and protective factors assessed in adolescence. The predictors can help to identify youth at risk for particular signs. Parents are important contributors to assessment of young adults' problems.

Adolescent↗

Phenomenology, psychosocial correlates, and treatment seeking in major depression and dysthymia of adolescence.

OBJECTIVE: To compare phenomenology, psychosocial correlates, and treatment seeking in DSM-Itt-R major depression and dysthymia among adolescents diagnosed as cases in a community-based study. METHOD: A self-report questionnaire, including psychosocial data, life events, eating behaviors, depressive symptoms, substance use, pathological behaviors, and family and school functioning was administered to a nonselected sample (N = 3,287, 93.2% of targeted population) of adolescents aged 11 to 20 years from several Haute-Marne communities in France in 1988-1989. Subgroups of subjects (n = 205, 84.7% of eligible subjects) were interviewed with a structured diagnostic schedule, and adolescents with major depression (n = 49), dysthymia (n = 21) and controls (n = 135) were compared. RESULTS: Nearly 30% of controls had at least one current symptom of depression. Patterns of affective symptoms were similar in major depression and dysthymia, but significant differences emerged in comorbid conditions (more anxiety disorders, suicidal behaviors, and alcohol intoxications associated with major depression) and stressor at onset (more severe in major depression). Experiences of loss during the prior 12 months were associated with both forms of affective disorder, while poor family relationships were specific correlates of dysthymia. In contrast, peer relationships and pathological behaviors did not differ between depressed subjects and controls. Although psychosocial functioning was significantly impaired in both groups of depressed adolescents, treatment seeking was limited to 34.7% for major depressive subjects and 23.8% for dysthymic subjects. CONCLUSION: The results provide evidence that major depression and dysthymia in adolescence are equally severe but may have distinct patterns in associated factors. Despite free access to health care, the rate of treatment seeking for mood disorders in France is similar to that reported in U.S. studies.

Adolescent↗

Quality of life in children with psychiatric disorders: self-, parent, and clinician report.

OBJECTIVE: To study the relationship between child psychiatric disorders and quality of life (QoL). METHOD: In a sample of 310 children (ages 6-18 years) referred for psychiatric problems, children, parents, and clinicians reported on psychopathology and subjective and objective QoL indicators. RESULTS: Six diagnostic categories were distinguished: attention-deficit and disruptive behavior disorders, anxiety disorders, pervasive developmental disorders, mood disorders, other disorders, and no diagnosis. In overall QoL, no differences were found between the diagnostic categories, except in clinician's ratings, who rated children with pervasive developmental disorder as having a poorer QoL than children with other diagnoses. In each diagnostic category specific QoL subdomains were affected: for children with attention-deficit and disruptive behavior disorder, school functioning and social functioning; for children with anxiety disorder, emotional functioning; for children with pervasive developmental disorder, social functioning; and for children with mood disorder, emotional functioning. CONCLUSIONS: Across multiple raters, the distinguished child psychiatric disorders had a different impact on QoL. Knowledge about domains of QoL that are affected in specific child psychiatric disorders can help clinicians to focus on particular QoL domains during the diagnostic process and to define adequate treatment goals.

Adolescent↗

Gender differences among children with DSM-IV ADHD in Australia.

OBJECTIVE: To examine gender differences among children meeting symptom criteria for DSM-IV attention-deficit/hyperactivity disorder (ADHD) identified in a nationally representative sample of Australian children. METHOD: From 2,404 children aged 6 to 13 years, 225 boys and 99 girls with ADHD symptoms were identified using the parent version of the Diagnostic Interview Schedule for Children and compared on parent reports of children's behavioral problems and impairment. RESULTS: When ADHD types were collapsed into a single group, boys and girls did not differ on core symptoms, comorbidity, and impairment with the exception that girls rated higher on somatic complaints and boys had poorer school functioning. However, gender patterns were found to vary across ADHD type on impairment measures of social problems, schoolwork difficulties, and self-esteem, with boys being generally rated as more impaired in the combined and hyperactive-impulsive groups but equally or less impaired in the inattentive group. CONCLUSIONS: The findings suggest the possibility of gender-specific risks associated with high levels of inattentive and hyperactive-impulsive symptoms indicating that ADHD subtype membership should be considered when conducting ADHD gender comparisons.

Adolescent↗

Concordance of maternal and teacher ratings of school and behavior problems in children of varying birth weights.

To examine the concordance of mother and teacher ratings of children born at different birth weights on measures of school functioning, behavioral problems, and social competencies, we used a prospective cohort study involving children in two previously studied multisite birth cohorts whom we recontacted at 8 to 10 years of age. This provided a multisite sample of 784 low birth weight children and 334 normal birth weight children. Teacher reports of children's behaviors were obtained from 80% of the 1400 teachers contacted. We found that birth weight and neonatal health were associated with both maternal and teacher reports; that maternal characteristics, e.g., low levels of education and poor mental health, were associated with the greatest discrepancies in reports; and that although mothers' reports of objective measures were accurate, their assessments of behavioral problems and social competence often differed from those of teachers.

Achievement↗

Children with haemophilia: same or different?

Haemophilic children's perceptions of their own social and school function and their concerns about illness and expectations for the future were compared with those of diabetic and healthy children of the same age and social background. All three groups had similar anticipations about making friends, getting married, finding satisfactory employment and having children. Haemophilic and diabetic children were no more concerned than healthy children about being ill in the future and worried less about passing an illness on to others. Haemophilic, but not diabetic, children felt they were less able to run and play than others. The small sub-group of HIV-positive haemophiliacs differed only in that none of them envisaged having children.

Adolescent↗

Quality of life in paediatric migraine: characterization of age-related effects using PedsQL 4.0.

The aim of this study was to measure quality of life (QOL) across a broad age range of paediatric migraine patients. Children and adolescents (n=686) with migraine completed the Pediatric Quality of Life Inventory, version 4.0 (PedsQL 4.0) and a standardized headache assessment at an initial clinic visit. The sample size for each PedsQL age group was: age 2-4=21, age 5-7=86, age 8-12=298, and age 13-18=281. Mean total score was 72.7 +/- 14.8, significantly less than healthy norms (P<0.01). Teens reported lower School Functioning than older and young children (P<0.05) and young children reported lower Social Functioning than older children and teens (P<0.001). A moderate relation was found between self and parent report. Age-related effects on QOL have implications for the evaluation and management of migraine in paediatric practice. The self and parent report forms of the PedsQL can be used in a practice setting.

Adolescent↗

Psychological aspects of the Canadian randomized controlled trial of human growth hormone and low-dose ethinyl oestradiol in children with Turner syndrome. The Canadian Growth Hormone Advisory Group.

Preliminary results are presented after 2 years of the Canadian long-term multicentre study on the impact of hormone therapy on the final height, sexual development and psychological status of girls with Turner syndrome. Girls entering the study were randomized either to be treated with recombinant human growth hormone or to act as controls. Both groups received oestrogen replacement therapy in the same dose and format at the age of 13 years. However, for the purposes of the psychological study at this time, children receiving oestrogen were excluded from analysis. Girls treated with GH for a period of 2 years showed a significant increase in growth rate, which declined with continued treatment, while the growth rate in the control group remained constant throughout. There was a correlation between the higher growth rate and the girls' perceptions of themselves as more intelligent, more attractive, having more friends, greater popularity and experiencing less teasing than the untreated group. Growth rate was not correlated with family or school functioning.

Analysis of Variance↗

Maternal affective disorders, illness, and stress: risk for children's psychopathology.

Stressful circumstances that covary with maternal affective disorder may account for some of the risk to children for psychological dysfunction. Children (ages 8-16) of mothers with unipolar or bipolar disorders were compared with children of mothers who had chronic medical illness and children of normal mothers. Comparisons included Kiddie-SADS (Schedule for Affective Disorders and Schizophrenia) diagnoses and evaluations of behavior problems, school functioning, and social competence. Compared to the other groups, children of mothers with affective disorder (especially unipolar) had high rates of diagnosis. With the effects of chronic stress statistically controlled, psychosocial outcome variables showed fewer differences between groups but indicated particular impairment for children of unipolar mothers.

Adolescent↗

Phenomenology and outcome of subjects with early- and adult-onset psychotic mania.

OBJECTIVE: This study examined clinical differences between subjects with early-onset and adult-onset psychotic mania. METHOD: Subjects were from an epidemiologically derived, hospitalized sample who met criteria for definite bipolar disorder after 24 months of follow-up and whose index episode had been manic. Information collected regarding demographic characteristics, psychotic and depressive symptoms, childhood behavior problems and school functioning, substance/alcohol use disorders, and episode recurrence for two subgroups were compared: those whose illness first emerged before age 21 (early onset) (N=23) and those whose first episode occurred after age 30 (adult onset) (N=30). RESULTS: A larger proportion of the early-onset subjects were male, had childhood behavior disorders, had substance abuse comorbidity, exhibited paranoia, and experienced complete episode remission less frequently during 24-month follow-up than the adult-onset subjects. CONCLUSIONS: These data add to the body of evidence that has suggested that many subjects with early-onset psychotic mania have a more severe and developmentally complicated subtype of bipolar disorder.

Achievement↗

Goodness of fit in the home: its relationship to school behavior and achievement in children with learning disabilities.

This study examined whether a "goodness of fit" theoretical model, applied to families with and without children with learning disabilities, would be valuable in understanding the children's performance in school. A home interview was conducted with 63 families with a child with learning disabilities and 53 families with a comparable child without learning disabilities. The mothers were asked to rate how their own child fit into the family's expectations for children. It was found that, for both groups of families, children who were rated as a "poor fit" in the home demonstrated less positive behavior in the classroom and poorer achievement over the elementary school years. There was some evidence that poor fit in the home was even more negatively related to outcomes for children with learning disabilities. Discussion is centered on the importance of this theoretical model for understanding the importance of the home on successful school function.

Achievement↗