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Global Burden and New Trends in Emotional, Behavioral and Relational Problems of Children, Adolescents and Young Adults

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (20 June 2024) | Viewed by 21422

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Special Issue Editors

Prof. Dr. Lucia Margari

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Guest Editor

Child and Adolescent Neuropsychiatry Unit, University of Bari “Aldo Moro”, 70124 Bari, Italy
Interests: neurodevelopmental disorders; autism spectrum disorder; child and adolescent neuropsychiatry; psychopathology; mental illness; psychopharmacology
Special Issues, Collections and Topics in MDPI journals

Dr. Maria Giuseppina Petruzzelli

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Guest Editor

Child and Adolescent Neuropsychiatry Unit, University of Bari “Aldo Moro”, 70124 Bari, Italy
Interests: psychopathology; clinical psychiatry; psychopharmacology; child and adolescent psychiatry; adolescent psychiatry; psychoneuroendocrinology

Special Issue Information

Dear Colleagues,

We are pleased to announce a Special Issue which aims to explore the global burden and new trends in the emotional, behavioural, and relationship disorders of children, adolescents, and young adults.

During the last decade, we have experienced many changes in global society, and these are reflected in changing patterns of psychopathology. Recently, in addition to the coronavirus pandemic, there has been a significant increase in mental illness, with a significant burden worldwide. There has been an increase in self-harming behaviours, suicide attempts, emotional and behavioural disorders, eating and sleeping disorders, alcohol and drug addiction, and disorders related to excessive involvement in online activities (e.g., video games, social media use, and shopping).

The alarming increase in the incidence and prevalence of different emotional, behavioural, and relationship disorders from early development until young adult age, the high degree of overlap, and the great heterogeneity in clinical characteristics and therapeutic responses has inspired researchers to attempt to better characterize and investigate clinical phenotypes and underlying pathophysiology in order to develop more effective and targeted treatments.

We welcome observational and intervention studies, as well as review articles (systematic reviews and meta-analyses) that address the ongoing global mental health burden during developmental to young adult age, focusing on:

Risk and protective factors;
Advances in etiopathogenetic mechanisms;
Differences in clinical phenotypes;
Changes in diagnosis and treatment.

Prof. Dr. Lucia Margari
Dr. Maria Giuseppina Petruzzelli
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

emotional
behavioural
relationship disorders
psychopathology
mental illness

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Published Papers (11 papers)

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11 pages, 266 KiB

Open AccessArticle

Mental Disorders, Social Media Addiction, and Academic Performance in Romanian Undergraduate Nursing Students

by Liliana David, Abdulrahman Ismaiel, Paul Foucambert, Daniel Corneliu Leucuta, Stefan-Lucian Popa, Mihaela Fadgyas Stanculete and Dan L. Dumitrascu

J. Clin. Med. 2024, 13(15), 4475; https://doi.org/10.3390/jcm13154475 - 31 Jul 2024

Cited by 1 | Viewed by 1384

Abstract

Introduction: We aimed to evaluate social media addiction in Romanian undergraduate nursing students and its association with academic performance, depression, and anxiety. Methods: We used a cross-sectional online survey to collect data among nursing undergraduate students enrolled at the University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania. The Social Media Addiction Scale-Student Form (SMAS-SF), Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAI) were used to assess social media addiction, depression, and anxiety, respectively. Results: A total of 90 nursing students participated in the study, of which 82 (91.1%) were females and 81 (90%) were of Romanian ethnicity. The median age of participants was 21 years (18–40). Males showed higher BDI total scores, SMAS-SF total scores, and STAI scale A state anxiety compared to females, and females showed higher STAI scale A trait anxiety compared to males, although these results were not statistically significant. Also, we found no significant difference in these variables between participants from different study years. Participants with no or mild depression had a significantly higher academic performance (p-value = 0.001), lower SMAS-SF (p-value = 0.004), and lower STAI scores (p-value < 0.001) compared to participants with borderline, moderate, or severe depression after performing multivariate regression analysis. Conclusions: Our study demonstrated that depression was significantly associated with social media addiction, anxiety, and lower academic performance in Romanian undergraduate nursing students. Full article

(This article belongs to the Special Issue Global Burden and New Trends in Emotional, Behavioral and Relational Problems of Children, Adolescents and Young Adults)

15 pages, 292 KiB

Open AccessArticle

Identity Formation in Individuals between 16 and 25 Years Old with Borderline Personality Disorder

by Anaïs Mungo, Marie Delhaye, Camille Blondiau and Matthieu Hein

J. Clin. Med. 2024, 13(11), 3221; https://doi.org/10.3390/jcm13113221 - 30 May 2024

Viewed by 1054

Abstract

Background/Objectives: Identity disruption is a key feature of borderline personality disorder (BPD), characterized by disturbances in self-image. This study aimed to use the Dimensions of Identity Development Scale (DIDS) in a population aged 16–25, to assess differences in identity status and correlations with BPD features as well as whether a correlation exists between the BPD features, the scores obtained on the DIDS and the scores of the different dimensions of this disorder. Methods: We analyzed data from 132 individuals: 44 with BPD using the Diagnostic Interview for Borderline—Revised (DIB-R). Statistical analyses included quantile regression to determine the differences in the DIDS after adjusting for confounding factors identified during group comparisons and Spearman correlation between the DIDS, the BPD features and the DIB-R. Results: Results indicated significantly lower DIDS scores in the BPD group, particularly in commitment making, exploration breadth (EB), identity with commitment (IM) and ruminative exploration (RE). After adjusting, only EB differs significantly between the two groups. All dimensions of the DIDS except for the exploration in depth (ED) are correlated with BPD features. Significant correlations could be demonstrated between cognitive dimension and ED, between the total DIDS and the number of suicide attempt (SA) and between the IM and the number of SA. Conclusions: Our clinical sample showed distinct identity formation compared to controls, with a lower EB associated with BPD. RE correlated with BPD, suggesting that the individuals engage in repetitive exploratory processes. SA was negatively associated with overall identity development and commitment, indicating impulsive behaviors in BPD intersect with identity struggles. Full article

(This article belongs to the Special Issue Global Burden and New Trends in Emotional, Behavioral and Relational Problems of Children, Adolescents and Young Adults)

18 pages, 1667 KiB

Open AccessArticle

Self-Perceived Stress in Association with Emotional Experiences Following Patient Death and Coping Adequacy among Clinical Nurses in Lithuania: A Cross-Sectional Study

by Marius Baranauskas, Marius Kalpokas, Ingrida Kupčiūnaitė, Jurgita Lieponienė and Rimantas Stukas

J. Clin. Med. 2024, 13(9), 2533; https://doi.org/10.3390/jcm13092533 - 25 Apr 2024

Viewed by 1408

Abstract

(1) Background: Stress is defined as a psychological sensation related to a change in both human physiology and behavior in response to a threat or challenge. As the prevalence of stress is increasing globally, nurses represent a risk group for exposure to stress-related psychological alterations. The aim of this study was to explore how clinical nurses in Lithuania cope with the perceived chronic stress in relation to additional emotional experiences following the death of a patient. (2) Methods: During a four-week period of October 2023, a total of 283 female nurses, aged between 20 and 70 years old, were enrolled in a single cross-sectional study. The PSS-10 (perceived stress scale) and the Brief-COPE (Coping Orientation to Problems Experienced) questionnaires were applied to assess the level of self-perceived stress and the use of coping styles along with the adequate strategies. Furthermore, the nurses’ emotions, evoked following patient death, were classified depending on their valence. Both the multiple linear and logistic regression statistical analyses were conducted to examine the associations between dependent and independent variables. (3) Results: The study identified that more than half of the nurses experienced patient death several times a month. A moderate-to-high level of the symptoms of mental chronic stress were suffered by 76% of caregivers. The psychological arousal following the death of a patient may induce the occurrence of emotional complexity that refers to competitive feelings, namely, helplessness (adjusted odd ratio (AOR) 1.7, 95% confidence interval (95% CI) 1.1; 2.9), disappointment (AOR 1.9, 95% CI 1.1; 3.5), anxiety (AOR 1.9, 95% CI 1.2; 4.2), and guilt (OR_adj 4.7, 95% CI 1.4; 5.7), and can serve as a potential trigger for chronic stress development in clinical nurses. In terms of emotion-focused stress control (β 0.1, 95% CI −0.1; −0.2, R² = 0.12), Lithuanian nurses had low control of the perceived chronic stress. The use of problem-focused coping (β −0.2, 95% CI −0.3; −0.1, R² = 0.09) was also not addressed to an appropriate extent. The use of the avoidance coping style was associated with moderate–high levels of chronic stress perceived by nurses (β 0.5, 95% CI 0.4; 0.7, R² = 0.24). Furthermore, the avoidant coping strategy related to behavioral disengagement was significantly related to resilience to chronic stress in an adverse way. The cognitive process of self-blame was considered as a meaningful maladaptive behavior component for magnifying chronic stress in nurses. (4) Conclusions: The study highlights the need to implement the recommendations for boosting the nurses’ mental health. Hospitals should contribute to psychological assistance along with providing necessary training on stress-coping strategies for clinical nurses. In order to promote the sustainability of mental health through additional social support interventions, it would be useful to upgrade the clinical nurses’ daily routines with mindfulness-based trainings. Full article

(This article belongs to the Special Issue Global Burden and New Trends in Emotional, Behavioral and Relational Problems of Children, Adolescents and Young Adults)

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11 pages, 234 KiB

Open AccessArticle

Parental Competences and Stress Levels in Mothers of Children with Autism Spectrum Disorders and Children Developing Neurotypically

by Beata Tyszkiewicz-Gromisz, Joanna Burdzicka-Wołowik, Piotr Tymosiewicz and Wilhelm Gromisz

J. Clin. Med. 2024, 13(4), 1119; https://doi.org/10.3390/jcm13041119 - 16 Feb 2024

Viewed by 2008

Abstract

(1) Background: the aim of this study was to explore parental competences and stress levels in the mothers of children with autism in relation to the mothers of neurotypical children. (2) Methods: the study used the Parental Competence Test and the PSS-10 scale to assess the intensity of stress related to one’s own life situation over the past month. Forty mothers of children with ASD (n = 20) and neurotypical children (n = 20) participated in the study. (3) Results: the mothers of children with ASD showed higher levels of stress (p = 0.0002). The mothers of neurotypical children achieved higher scores in parental competences (r = −0.49). The competence of mothers of children with ASD was correlated with rigour (r = 0.50), permissiveness (r = −0.60), overprotectiveness (r = 0.71), and helplessness (r = −0.77). (4) Conclusions: mothers of children with autism demonstrate lower parental competences than mothers of neurotypical children. Mothers of children with autism are less rigorous but more permissive, overprotective, and helpless. They tend to become heavily involved with their child. An overprotective attitude and greater tolerance for antisocial behaviours among parents of children with ASDs protect them from excessive stress. Full article

(This article belongs to the Special Issue Global Burden and New Trends in Emotional, Behavioral and Relational Problems of Children, Adolescents and Young Adults)

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13 pages, 264 KiB

Open AccessArticle

Well-Being, Self-Esteem and Temporal Perspective in Incels: An Italian Study

by Costanza Scaffidi Abbate, Federica Rapacciuolo and Silvana Miceli

J. Clin. Med. 2024, 13(2), 358; https://doi.org/10.3390/jcm13020358 - 9 Jan 2024

Viewed by 1660

Abstract

The global scholarly attention has shifted toward the phenomenon of inceldom (involuntary celibacy) due to violent incidents involving self-identified incels. There is a growing number of platforms promoting the proliferation of these ideologies, and cases of violence are becoming increasingly severe. This research constitutes one of the limited empirical investigations within an Italian context. This study aims to examine the mental well-being and its associations with self-esteem and temporal perspectives among individuals identifying as incels. Fifty-eighth male subjects aged between 18 and 45 years old participated in the study. Participants, recruited through online communication channels, completed three questionnaires focused on assessing mental well-being, self-esteem, and temporal orientation. The results reveal that incel subjects exhibit low self-esteem and are inclined toward a hedonistic present-focused perspective aimed at immediate gratification rather than future planning. Of note are the data related to the future temporal perspective, which does not show any predictive value on the well-being of incel subjects. Their ability to plan for the long term, defer immediate gratification, and control behavior through the anticipation and evaluation of possible consequences appears diminished. This study discusses the implications of developing targeted intervention programs, given that the incel phenomenon is becoming increasingly widespread. It is, therefore, crucial not to underestimate the potential threat that inceldom could pose in the future. Full article

(This article belongs to the Special Issue Global Burden and New Trends in Emotional, Behavioral and Relational Problems of Children, Adolescents and Young Adults)

14 pages, 863 KiB

Open AccessArticle

Stress Dynamics in Families with Children with Neuropsychiatric Disorders during the COVID-19 Pandemic: A Three-Year Longitudinal Assessment

by Ada Claudia Silvana Gruescu, Calin Popoiu, Mihaela Codrina Levai, Sonia Roxana Burtic, Isabella Ionela Sanda, Oana Neda-Stepan, Ovidiu Rosca, Roxana Manuela Fericean, Catalin Dumitru and Lavinia Stelea

J. Clin. Med. 2023, 12(22), 7170; https://doi.org/10.3390/jcm12227170 - 18 Nov 2023

Viewed by 1346

Abstract

Background and Objectives: This study explores the impact of the COVID-19 pandemic on families with children diagnosed with neuropsychiatric disorders, focusing on stress dynamics and quality of life. Materials and Methods: A longitudinal survey was conducted over three years (2020–2022) involving 168 families. The survey included data on demographics, diagnosed conditions, access to therapies, mental well-being, and perceived challenges. Results: The study involved 62, 51, and 55 families in 2020, 2021, and 2022, respectively. ADHD emerged as the most prevalent condition, diagnosed in approximately 32% of the children. The pandemic significantly affected therapy access, with parents reporting a decrease from an average score of 8.1 in 2020 to 6.5 in 2022 (p = 0.029). Parents also reported increased feelings of being overwhelmed, peaking at 8.0 in 2021 before declining to 6.3 in 2022 (p = 0.017). Despite these challenges, there was a positive trend in family mental well-being, with scores increasing from 5.1 in 2020 to 6.7 in 2022 (p = 0.031). The Parental Stress Index (PSI) indicated decreasing trends in Emotional Stress and Parent–Child Communication Difficulties (p < 0.001), and Behavioral Challenges in children showed a significant reduction across the years (p < 0.001). The Hospital Anxiety and Depression Scale (HADS) reflected a moderate reduction in anxiety levels from 7.6 in 2020 to 6.0 in 2022 (p = 0.038), although depression scores did not show a significant change. Conclusions: The COVID-19 pandemic introduced notable challenges for families with neuropsychiatrically diagnosed children, particularly in therapy access and increased parental stress. However, the study also reveals a general improvement in family dynamics, mental well-being, and a decrease in behavioral challenges over time. The necessity of this study stems from the critical need to examine the impact of the COVID-19 pandemic on families with neuropsychiatrically diagnosed children, focusing on their resilience and adaptation in navigating therapy access, parental stress, and overall mental well-being. Full article

(This article belongs to the Special Issue Global Burden and New Trends in Emotional, Behavioral and Relational Problems of Children, Adolescents and Young Adults)

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13 pages, 272 KiB

Open AccessArticle

A Neuropsychiatric Assessment of Children with Previous SARS-CoV-2 Infection

by Veronica Scarselli, Dario Calderoni, Arianna Terrinoni, Chiara Davico, Giulia Pruccoli, Marco Denina, Chiara Carducci, Andrea Smarrazzo, Melania Martucci, Mariaelena Presicce, Daniele Marcotulli, Luca Arletti, Mauro Ferrara, Silvia Garazzino, Rosanna Mariani, Andrea Campana and Benedetto Vitiello

J. Clin. Med. 2023, 12(12), 3917; https://doi.org/10.3390/jcm12123917 - 8 Jun 2023

Cited by 2 | Viewed by 1555

Abstract

Aim: Concerns have been raised about possible neuropsychiatric sequelae of COVID-19. The objective of this study was to examine the plausibility of long-term mental health consequences of COVID-19 by assessing a sample of children after the resolution of the acute SARS-CoV-2 infection. Method: As part of a systematic follow-up assessment of pediatric patients with COVID-19 conducted at two university children’s hospitals, 50 children (56% males) aged 8 to 17 years (median 11.5), 26% with previous multisystem inflammatory syndrome in children (MIS-C), without a prior history of neuropsychiatric disorders, received a battery of clinical neuropsychiatric and neuropsychological rating scales that included the Pediatric Migraine Disability Assessment (PedMIDAS), Sleep Disturbance Scale for Children (SDSC), Multidimensional Anxiety Scale for Children (MASC-2), Child Depression Inventory (CDI-2), Child Behavior Checklist (CBCL), and the NEPSY II (Neuropsychological Assessment, Second Edition). The assessments were conducted between 1 and 18 months (median 8 months) after the acute infection. Results: The CBCL internalizing symptoms score was in the clinical range for 40% of the participants (vs. a population expected rate of about 10%, p < 0.001). A sleep disturbance was detected in 28%, clinically significant anxiety in 48%, and depressive symptoms in 16%. The NEPSY II scores showed impairment in attention and other executive functions in 52%, and memory deficits in 40% of the children. Conclusions: These data from direct assessment of a sample of children who had SARS-CoV-2 infection show higher than expected rates of neuropsychiatric symptoms, thus supporting the possibility that COVID-19 may have mental health sequelae long after the resolution of the acute infection. Full article

(This article belongs to the Special Issue Global Burden and New Trends in Emotional, Behavioral and Relational Problems of Children, Adolescents and Young Adults)

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10 pages, 267 KiB

Open AccessArticle

Social Introversion Personality Trait as Predictor of Internalizing Symptoms in Female Adolescents with Gender Dysphoria

by Flora Furente, Emilia Matera, Lucia Margari, Elisabetta Lavorato, Federica Annecchini, Francesca Scarascia Mugnozza, Giuseppe Colacicco, Alessandra Gabellone and Maria Giuseppina Petruzzelli

J. Clin. Med. 2023, 12(9), 3236; https://doi.org/10.3390/jcm12093236 - 30 Apr 2023

Cited by 3 | Viewed by 2065

Abstract

The personality trait of social introversion refers to the individual inclination toward the inner/outer world. Moreover, adolescents who experience Gender Dysphoria (GD) can be involved in relationship conflicts with family, peers, and friends and experience stigmatization and rejection from society. This leads higher distress in females which are more sensitive to this kind of feelings. This leads in them frequently developing a negative sense of well-being and low self-esteem which increases their risk of internalizing symptoms. So, the aims of this study were: (1) to investigate the presence of significant differences in Social Introversion (SI) dimensions between an assigned-female at birth (AFAB) GD group and a cisgender female group both diagnosed with a depressive disorder, (2) to verify whether the two clinical groups may be characterized by different profiles of internalizing symptoms, (3) to investigate if the SI dimensions could promote the internalizing symptomatology. Our results confirmed the presence of significantly higher score in GD sample for MMPI-SI scale and subscales and showed no significant difference in depressive profiles. Lastly, SI could promote internalizing symptomatology in AFAB underlying a link between SI and depression in this condition which should be further investigated. Full article

(This article belongs to the Special Issue Global Burden and New Trends in Emotional, Behavioral and Relational Problems of Children, Adolescents and Young Adults)

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18 pages, 943 KiB

Open AccessArticle

Examining the Indirect Effect of Online Gaming on Depression via Sleep Inequality and Anxiety—A Serial and Parallel Mediation Analysis

by Tahani Alshammari, Sarah Alseraye, Aleksandra Rogowska, Nouf Alrasheed and Musaad Alshammari

J. Clin. Med. 2022, 11(24), 7293; https://doi.org/10.3390/jcm11247293 - 8 Dec 2022

Cited by 3 | Viewed by 3586

Abstract

Stress-related disorders are highly prevalent among first-year college students. Gaming disorder (GD) is an emerging disorder linked to physical and psychological consequences. We aimed to investigate the mechanism linking GD with anxiety, depression, and sleep disorders among first-year undergraduate students. Four hundred fifty-seven participants were recruited, and the survey included the Internet Gaming Disorder Scale Short-Form (IGDS9-SF), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Pittsburgh Sleep Quality Index (PSQI). Our results showed that female students scored significantly higher than males in anxiety and depression. Furthermore, we found that depression is positively and strongly correlated to anxiety, and both are moderately associated with sleep quality. Gaming is positively related to depression, anxiety, and sleep quality. Interestingly, the health sciences tracks showed lower sleep quality than undergraduates from other tracks. There was a 64% variance in depression explained by many predictors, including anxiety, sleep quality, gaming, painkiller use, and gender. In addition, the mediation models showed that the association between gaming and depression is mediated indirectly by sleep quality, and sleep quality may be mediated directly by anxiety. The first year in college occurs at a critical developmental and professional stage, and our results highlight the need to establish support programs and conduct mental health educational workshops. Full article

(This article belongs to the Special Issue Global Burden and New Trends in Emotional, Behavioral and Relational Problems of Children, Adolescents and Young Adults)

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11 pages, 758 KiB

Open AccessArticle

Implication of COVID-19 Pandemic on Adolescent Mental Health: An Analysis of the Psychiatric Counseling from the Emergency Room of an Italian University Hospital in the Years 2019–2021

by Maria Giuseppina Petruzzelli, Flora Furente, Giuseppe Colacicco, Federica Annecchini, Anna Margari, Alessandra Gabellone, Lucia Margari and Emilia Matera

J. Clin. Med. 2022, 11(20), 6177; https://doi.org/10.3390/jcm11206177 - 19 Oct 2022

Cited by 15 | Viewed by 2343

Abstract

Introduction: Although the COVID-19 pandemic had profound consequences on youths’ mental health, few data are available about its longitudinal implications. Method: In this study, from 655 counseling requests by the Emergency Room (ER) of the University Hospital of Bari, we retrospectively examined 380 requests for psychiatric counseling of pediatric subjects, during the pre-pandemic, the first pandemic, and the second pandemic wave of COVID-19. Results: We found a significant upward trend between 2019 and 2021 for the counseling requests for acute psychopathological symptoms (p = 1.469 × 10⁻⁵), patients in adolescent age (p = 0.022), females (p = 0.004), and those taking psychotropic medications (p = 2.28 × 10⁻⁵). Moreover, a significant difference in the proportions of depression (p = 0.003), post traumatic (p = 0.047), somatic (p = 0.007) and psychotic symptoms (p = 0.048), and self-injuring behaviors (p = 0.044) was observed. The proportion of counseling for psychotic symptoms (p = 0.014) and self-injuring behaviors (p = 0.035) also showed an increasing trend over time, with self-harming behaviors becoming more severe and diversified in modalities. Discussion: The pandemic’s persistence over time may have had an impact on youth’s psychopathology, influencing the frequency, type, and complexity of mental health problems; as a result, it is vital to implement timely integrated interventions and find strategies to prevent self-harm, in particular with the identification of vulnerable categories of patients. Full article

(This article belongs to the Special Issue Global Burden and New Trends in Emotional, Behavioral and Relational Problems of Children, Adolescents and Young Adults)

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12 pages, 265 KiB

Open AccessArticle

Unraveling the Relationship between Sleep Problems, Emotional Behavior Disorders, and Stressful Life Events in Preschool Children

by Filippo Manti, Federica Giovannone, Franca Aceti, Nicoletta Giacchetti, Francesca Fioriello, Andrea Maugeri and Carla Sogos

J. Clin. Med. 2022, 11(18), 5419; https://doi.org/10.3390/jcm11185419 - 15 Sep 2022

Cited by 2 | Viewed by 1782

Abstract

Objectives: The aims of this study were to: (1) explore sleep problems in preschool children with generalized anxiety disorder (GAD), selective mutism (SM), and oppositional defiant disorder (ODD) and (2) examine the relationship between stressful life events, sleep problems, and emotional behavior disorders in preschoolers. Methods: The parents of 213 preschool children with SM, GAD, ODD, and TD (typical development, age range 2–6 years) completed the Children’s Sleep Habits Questionnaire (CSHQ), the Coddington Life Events Scale, preschool version (CLES-P), and the CBCL 1½–5. Results: Eighty-three subjects reported sleep problems before the age of 2 years. Seventy-five children (86.14%) with a clinical diagnosis and eight children with TD (8.4%) exceeded the threshold level on the CSHQ. For the bedtime resistance (p = 0.042) and sleep duration subscales (p = 0.038), the SM group had significantly higher scores in comparison to the ODD group. The same pattern was also true for the sleep onset (p = 0.024) and sleep anxiety subscales (p = 0.019). The linear regression analysis model showed that the impact of stressful life events and internalizing problems could predict sleep habits in children. Conclusions: Emotional behavior disorders and stress factors should be regularly investigated in children who are referred to clinics for sleep problems. Clinicians should consider how these symptoms may exacerbate sleep problems and/or interfere with treatment. Full article

(This article belongs to the Special Issue Global Burden and New Trends in Emotional, Behavioral and Relational Problems of Children, Adolescents and Young Adults)

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