Prevalencia y caracter??sticas de los s??ntomas externalizantes en la infancia : diferencias de g??nero

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Problemas de conducta de los adolescentes en acogimiento preadoptivo, residencial y con familia extensa

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Conflictos entre padres y conducta agresiva y delictiva en los hijos

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Mental health of internally displaced preschool children: a cross-sectional study conducted in Bogotá, Colombia

A causa de los conflictos armados, como el de Colombia, se han desplazado por la fuerza a millones de personas, entre ellas una importante parte de la población infantil. Este estudio tuvo como objetivo evaluar la salud mental de los niños desplazados internos en edad preescolar en Bogotá Colombia, e identificar los determinantes de la salud mental en estos niños. Métodos: Estudio transversal realizado entre 279 niños que asisten a cuatro jardines infantiles en un barrio marginal de Bogotá. La salud mental infantil se evaluó con el instrumento validado de Comportamiento Infantil (CBCL) 1,5-5 años, aplicados a padres y cuidadores. Se realizo un análisis univariado y multivariado de regresión logística para evaluar la asociación entre el desplazamiento y la salud mental de los niños y para identificar las relaciones con la salud mental en los niños desplazados. Resultados: los Niños desplazados (n = 90) se identificaron con más frecuencia sobre los puntos de corte límite para las escalas CBCL que los no desplazados (n = 189) (por ejemplo, problemas totales 46,7 vs 22,8%;p \ 0,001). La asociación entre el desplazamiento y la presencia de problemas CBCL totales se mantuvo después del ajuste por factores socio-demográficos (OR Ajustado 3.3 del 95%: 1,5; 6,9). Donde la salud mental del cuidador explica en parte la asociación. En los niños desplazados, la salud mental del cuidador (p \ 0,01) y el funcionamiento familiar (p \ 0,01) se asociaron independientemente con la salud mental de los niños. La exposición a eventos traumáticos y el apoyo social también se asociaron con la salud mental del niño, sin embargo, las asociaciones no fueron independientes. Conclusión: En este barrio marginal de Bogotá, los niños en edad preescolar registrados como desplazados internos presentan peor salud mental que los no desplazados. El funcionamiento familiar y la salud mental del cuidador fueron fuerte e independientemente asociados con la salud mental de los niños y niñas desplazados.

Evaluación de un programa de expresión corporal en niños de 4 a 5 años de edad.

Comprobar si un programa de educación psicomotriz de intervención temprana basado en técnicas de expresión corporal optimiza la maduración del niño preescolar. 108 sujetos de entre 4 y 5 años: 53 niños y 55 niñas de un nivel sociocultural bajo. En total forman un grupo control con 60 sujetos y un grupo experimental con 48 sujetos. Describe el marco teórico y revisa las distintas tendencias y concepciones de la psicomotricidad, la relación entre aprendizaje y educación psicomotriz, el concepto de maduración y la intervención temprana, así como la expresion corporal, su metodología y recursos necesarios. Variable independiente: programa de intervención de expresión corporal. Variable dependiente: distintos niveles de maduración del niño preescolar (verbal, memoria, motricidad, etc.). Plantea un diseño de grupo control y experimental, aplicando a este último el programa de expresión corporal. Para obtener los datos realiza una evaluación test-retest mediante tests estandarizados de psicomotricidad y desarrollo de las variables independientes antes y después del tratamiento. Lleva a cabo un análisis estadístico descriptivo para cada factor de desarrollo del niño y un análisis de variancia para calcular la significatividad entre grupos y centros. Expone el programa de técnicas de expresión corporal. Escalas McCarthy de aptitudes y psicomotricidad para niños (MSCA). Sociograma. Child Behavior Checklist (CBCL) de Achenbach. Programa de técnicas de expresión corporal ad hoc. Estadística descriptiva, ANOVA, gráficas y SPSS. El test retest muestra que los sujetos del grupo experimental han incrementado las puntuaciones en: maduración motriz, maduración perceptivo-manipulativa, maduración numérica y maduración cognitivo general. No ha habido cambios, o ha sido por el paso del tiempo, en maduración verbal y memoria. La intervención con técnicas de expresión corporal es más eficaz en los factores estrictamente motores que en los verbales, y es más eficaz si se aplica a grupos pequeños que en grupos grandes.

Conducta y desarrollo psicológico de un grupo de niños preescolares con déficit ponderal.

Estudiar y comparar el desarrollo de la conducta de los niños con DPPT en edad preescolar en relación a niños normales. La población es de 3000-6000 niños de primero de Preescolar de edades comprendidas entre 3 años y 10 meses y 5 años y cuatro meses, de nivel socioeconómico diverso, que acudieron al examen de salud que ofrece el Servicio de Medicina Preventiva del Ayuntamiento de Barcelona. La muestra 1 la componían 30 individuos, 11 varones y 19 mujeres cuyo peso estuviese por debajo del percentil 3 usando las tablas Tanner. La muestra 2, grupo de control, lo componían 32 individuos, 13 varones y 19 mujeres. El autor realiza una aproximación teórica a los conceptos de desarrollo psicológico y crecimiento físico, así como a los conceptos de malnutrición y de los efectos psicológicos del déficit nutricional. En el segundo bloque de la investigación se analiza el perfil conductual y el desarrollo psicológico en base a las hipótesis: 1) los niños que presentan un peso por debajo de dos desviaciones standard en relación a la edad estatural presentan un retraso global en el desarrollo psicomotor; 2) los niños que presentan un peso por debajo de dos desviaciones standard en relación a su edad estatural, presentan aspectos de comportamiento diferente. Se aplicó la escala McCarthy de aptitudes y psicomotricidad para niños. Escala Child Behavior Checklist. SPSS. Los individuos del grupo muestra presentan un desarrollo psicomotor similar al del grupo de control. No se advierten diferencias estadísticamente significativas pero se observa la posibilidad de que una muestra mayor, sí las mostrara. El déficit de peso para la talla puede ser considerado como factor predisponente para problemas de desarrollo y conducta. Si se une a factores desfavorables como antecedentes patológicos orgánicos o apetitos alternados, pueden dar lugar a desarrollo anómalo.

Conducta antisocial en adolescentes.

Estudiar la posible influencia de ciertas variables ambientales, como la asociación con compañeros marginales y otros factores familiares y de variables individuales.Y estudiar la posible manifestación de la conducta antisocial en presencia de alto grado de sintomatomatología depresiva y/o la conducta hiperactiva con déficit de atención.. 151 sujetos pertenecientes a 2 escuelas públicas de Badia (Vallès Occidental).86 sujetos de 7õ de E.G.B y 1õ de Enseñanza Secundaria. 85 sujetos de 8õ de E.G.B. y 2õ de Enseñanza Secundaria.. Realiza una revisión bibliográfica y basa el estudio en la Teoría Interaccionista de la conducta antisocial para la identificación de variables tanto socio-ambientales como individuales. Plantea la siguiente hipótesis:'Los sujetos del mismo sexo que presenten una mayor necesidad de estimulación y alta susceptabilidad a la recompensa, junto con una baja susceptibilidad al castigo y un alto grado de asociación con compañeros marginales, seran los que tendran mayor probabilidad de manifestar una conducta antisocial'. Aplica los instrumentos de investigación (cuestionarios), realiza un análisis estadístico de las varibles (herencia, sexo, inteligencia, personalidad, rendimiento académico, hiperactividad, estimulación, circunstancias socioeconómico, asociación con compañeros marginales, ...) y elabora conclusiones.. Cuestionarios: Child Behavior Checkist, escala de susceptibilidad al castigo y susceptibilidad a la recompensa, escala de búsqueda de sensaciones, autoinforme de conducta antisocial, .... Programa estadístico SPSS+, comparación de medias de Student-Fisher(t), correlaciones, modelo lineal de regresión.. Los datos confirman plenamente la hipotesis principal. Las diferencias sexuales de conducta y personalidad se hacen patentes en el estudio. La variable rendimiento escolar es significativamente predictoria. El resto de variables presentan una capacidad de predicción baja.. Los varones presentan mayor conducta delictiva y tienden a asociarse más con compañeros marginales. Las chicas son más sensibles a las señales de castigo y desarrollan un rendimiento académico más elevado. En ambos sexos la conducta antisocial se puede predecir a partir de diversas variables. A partir de este tipo de estudios se pueden crear programas de tratamiento y prevención de la conducta antisocial..

Maternal antenatal anxiety, postnatal stroking and emotional problems in children: outcomes predicted from pre and postnatal programming hypotheses

Background Mothers' self-reported stroking of their infants over the first weeks of life modifies the association between prenatal depression and physiological and emotional reactivity at 7 months, consistent with animal studies of the effects of tactile stimulation. We now investigate whether the effects of maternal stroking persist to 2.5 years. Given animal and human evidence for sex differences in the effects of prenatal stress we compare associations in boys and girls. Method From a general population sample of 1233 first-time mothers recruited at 20 weeks gestation we drew a random sample of 316 for assessment at 32 weeks, stratified by reported inter-partner psychological abuse, a risk indicator for child development. Of these mothers, 243 reported at 5 and 9 weeks how often they stroked their infants, and completed the Child Behavior Checklist (CBCL) at 2.5 years post-delivery. Results There was a significant interaction between prenatal anxiety and maternal stroking in the prediction of CBCL internalizing (p = 0.001) and anxious/depressed scores (p < 0.001). The effects were stronger in females than males, and the three-way interaction prenatal anxiety × maternal stroking × sex of infant was significant for internalizing symptoms (p = 0.003). The interactions arose from an association between prenatal anxiety and internalizing symptoms only in the presence of low maternal stroking. Conclusions The findings are consistent with stable epigenetic effects, many sex specific, reported in animal studies. While epigenetic mechanisms may be underlying the associations, it remains to be established whether stroking affects gene expression in humans.

Rural parents, teenagers and alcohol: what are parents thinking?

INTRODUCTION: The fundamental role of alcohol in the lives of young Australians is mirrored in the level of drinking by adolescents. In 2001, more than one in four Australian adolescents aged 14-19 years consumed alcohol weekly. Teenagers in rural areas are more likely to consume alcohol than their metropolitan counterparts. Parents are key 'gatekeepers' of adolescent behaviour and as such are a salient group to consider in relation to adolescent alcohol use. The aim of this study was to explore parents' attitudes, beliefs, concerns and receptiveness to harm minimisation strategies with respect to teenage use of alcohol.

METHODS: A convenience sample of parents with adolescent children attended a series of focus groups across the north and north-western area of the State of Victoria, Australia. Schools were approached to advertise the project and invite parents to participate. Snowball sampling was used to enhance recruitment.

RESULTS: Parents described patterns of alcohol use such as 'drinking to get drunk' and the influence of both parents and peers on the consumption of alcohol by adolescents. Few parents were concerned about the long-term risks of alcohol use by teenagers; rather they were more concerned about the short-term harms, for example, road trauma and other accidents and risky behaviours such as binge drinking. Parents indicated that they perceived alcohol to be less harmful than other drugs and many indicated that alcohol was often not perceived to be a drug. A number of strategies were adopted by parents to negotiate teenagers' drinking and to minimise the risks associated with alcohol use. These included transporting teenagers to parties, providing teenagers with a mobile phone, setting clear guidelines about alcohol use and/or providing teenagers with a small amount of alcohol. These were seen by parents as strategies for reducing the risks associated with alcohol consumption. Many parents reported that they do not feel well informed about alcohol use and how and when to use harm reduction strategies.

CONCLUSIONS: Rural parents are unsure how to respond to teenagers' alcohol use and drunkenness. While some parental strategies for harm reduction (such as supplying adolescents with a small amount of alcohol) may have good face validity in reducing alcohol consumption among adolescents, these strategies are not supported by previous research findings.

Social control, self-control and psychosocial problems in adolescent males

‘Psychosocial problems’ are psychological problems that are regarded as resulting from the interaction between the adaptive capacities of individuals and the demands of their physical and social environments. Many different factors have been theoretically proposed, and empirically established, as predictors of a range of psychosocial problems in adolescents. However, a problem exists in that this literature appears to lack an integrative framework that has validity across the range of problems that are observed. The purpose of the current research is to propose and test a model that draws together three clusters of factors that are useful in predicting the incidence of adolescent psychosocial problems. These are family structural background factors, family functioning variables and control beliefs. Data were collected from 155 adolescent males aged between 12 and 19 by a single concurrent and retrospective self-report questionnaire. This included data about the respondent (age, involvements with mental health or juvenile justice agencies) and family structural background factors (days per week worked by mother/father, occupational status for mother/father, residential mobility, number of persons in the family home). The questionnaire also incorporated the Parental Bonding Instrument (Parker, Tupling & Brown, 1979) to quantify the levels of perceived parental care and overprotection, and an adaptation of the Parental Discipline Style Scale (Shaw & Scott, 1991), to assess punitive, love withdrawing and inductive discipline practices. In addition, the (Low) Self-control Scale (Grasmick, Tittle, Bursick & Arneklev, 1993) and the Locus of Control of Behaviour Scale (Craig, Franklin, & Andrews, 1984) were used to collect data concerning adolescents’ perceived behavioural self-control and locus of control. Finally, selected sub-scales of the Child Behavior Checklist Youth Self-Report (Achenbach, 1991b) were used to collect data on the incidence of social withdrawal, somatisation, anxiety and depression, aggression and delinquency among the respondents, and in aggregated form, the incidence of ‘total problems’ and internalising and externalising behaviours. Results indicated family structural background factors, family functioning variables and control beliefs possess limited predicted validity and that the usefulness of the proposed model varies between specific psychosocial problems. Family functioning variables were generally stronger predictors than family structural background factors, particularly for internalising behaviours. Of these, levels of parental care and overprotection were generally the strongest predictors. Perceived self-control and locus of control were also generally strong predictors, but were particularly powerful with respect to externalising behaviours. The strength of predictive relationships was observed to vary between specific internalising and externalising behaviours, suggesting that individual difference variables not assessed in the current research were differentially influential. Finally, the parental and individual characteristics that predicted maximal levels of adjustment (defined in terms of minimal levels of internalising and externalising behaviours) were explored and the correlates of various parenting style typologies (Parker et al., 1979) were investigated. These results strongly confirmed the importance of family functioning and control beliefs with respect to the prediction of internalising, externalising and well-adjusted behaviours. In all analyses, substantial proportions of the variance in the incidence of problem behaviours remain unexplained. The findings are examined in relation to previous research focused on (familial) social control and (individual) self-control with respect to psychosocial problems in adolescents. In addition, methodological considerations are discussed and the implications of the findings for clinical and community interventions to address problem behaviours, and for further study, are explored.

Outcomes of population based language promotion for slow to talk toddlers at ages 2 and 3 years: let’s learn language cluster randomised controlled trial

Objective To determine the benefits of a low intensity parent-toddler language promotion programme delivered to toddlers identified as slow to talk on screening in universal services.
Design Cluster randomised trial nested in a population based survey.
Setting Three local government areas in Melbourne, Australia.
Participants Parents attending 12 month well child checks over a six month period completed a baseline questionnaire. At 18 months, children at or below the 20th centile on an expressive vocabulary checklist entered the trial.
Intervention Maternal and child health centres (clusters) were randomly allocated to intervention (modified “You Make the Difference” programme over six weekly sessions) or control (“usual care”) arms.
Main outcome measures The primary outcome was expressive language (Preschool Language Scale-4) at 2 and 3 years; secondary outcomes were receptive language at 2 and 3 years, vocabulary checklist raw score at 2 and 3 years, Expressive Vocabulary Test at 3 years, and Child Behavior Checklist/1.5-5 raw score at 2 and 3 years.
Results 1217 parents completed the baseline survey; 1138 (93.5%) completed the 18 month checklist, when 301 (26.4%) children had vocabulary scores at or below the 20th centile and were randomised (158 intervention, 143 control). 115 (73%) intervention parents attended at least one session (mean 4.5 sessions), and most reported high satisfaction with the programme. Interim outcomes at age 2 years were similar in the two groups. Similarly, at age 3 years, adjusted mean differences (intervention−control) were −2.4 (95% confidence interval −6.2 to 1.4; P=0.21) for expressive language; −0.3 (−4.2 to 3.7; P=0.90) for receptive language; 4.1 (−2.3 to 10.6; P=0.21) for vocabulary checklist; −0.5 (−4.4 to 3.4; P=0.80) for Expressive Vocabulary Test; −0.1 (−1.6 to 1.4; P=0.86) for externalising behaviour problems; and −0.1 (−1.3 to 1.2; P=0. 92) for internalising behaviour problems.
Conclusion This community based programme targeting slow to talk toddlers was feasible and acceptable, but little evidence was found that it improved language or behaviour either immediately or at age 3 years.

The association between parental personality patterns and internalising and externalising behaviour problems in children and adolescents

Background:  This study investigated the relationship between parental personality patterns and internalising and externalising behaviour problems in a clinically referred sample of children (aged 4–8) and adolescents (aged 12–18).

Methods:  Data from families involved in two clinical trials in Victoria, Australia were analysed (n = 59). Families were administered the Millons Clinical Multiaxial Inventory—III (MCMI-III) which reports personality patterns consistent with Axis II disorder and an Achenbach measure of mental health as appropriate to child's age (Child Behavior Checklist (CBCL), Youth Self-Report (YSR), or Adult Self-Report (ASR)). Relationships between internalising and externalising behaviour problems, and parental personality patterns were examined via correlation and regression analyses.

Results:  The study found a positive correlation between parental borderline, paranoid, and avoidant personality patterns, and child and adolescent externalising behaviour problems. The relationships were generally stronger for adolescents than for children. However, no relationship was observed between parental personality patterns and internalising behaviour problems.

Conclusions:  These findings underline the importance of clinical assessment of the family ecology as a whole—including the interaction between parental personality patterns and child and adolescent behaviour and emotional problems. These findings contribute to the understanding of developmental risk factors for child and adolescent mental health and the transmission of psychopathology across generations.

What factors are associated with adolescents' school break time physical activity and sedentary time?

Purpose Adolescents' physical activity levels during school break time are low and understanding correlates of physical activity and sedentary time in this context is important. This study investigated cross-sectional and longitudinal associations between a range of individual, behavioural, social and policy/organisational correlates and objectively measured school break time physical activity and sedentary time.

Methods In 2006, 146 adolescents (50% males; mean age = 14.1±0.6 years) completed a questionnaire and wore an accelerometer for ≥3 school days. Time spent engaged in sedentary, light (LPA) and moderate-to-vigorous physical activity (MVPA) during school break times (recess and lunchtime) were calculated using existing cut-points. Measures were repeated in 2008 among 111 adolescents. Multilevel models examined cross-sectional and longitudinal associations.

Results Bringing in equipment was cross-sectionally associated with 3.2% more MVPA during break times. Females engaged in 5.1% more sedentary time than males, whilst older adolescents engaged in less MVPA than younger adolescents. Few longitudinal associations were observed. Adolescents who brought sports equipment to school engaged in 7.2% less LPA during break times two years later compared to those who did not bring equipment to school.

Conclusion These data suggest that providing equipment and reducing restrictions on bringing in sports equipment to school may promote physical activity during school recess. Strategies targeting females' and older adolescents', in particular, are warranted.

Children impacted by parental substance abuse: an evaluation of the supporting kids and their environment program

The deleterious impact of parental substance abuse on child development and family functioning is well established. However, evaluations of interventions designed to ameliorate such impacts are very limited. This paper presents the results of a service evaluation using a pre-post design of the Supporting Kids And Their Environment (SKATE) program; a child-focused group program run by Glastonbury Community Services from 2006 to 2010 in the Geelong region of Victoria, Australia. The intervention was an 8-week psycho-educative model that used family-based techniques. Outcomes are reported for child behavior problems, assessed on the Child Behavior Checklist, and family functioning, assessed on the Family Support Scale. A total of 89 children and families within 13 intervention groups were recruited via adult Drug and Alcohol Services (Mean age = 10.4 years; SD = 2.4). Results suggest reductions in emotional and behavioral problems in children as well as improving family functioning with small to moderate effect sizes after children’s participation in the SKATE program compared to pre-test. These preliminary findings suggest that children whose parents are substance abusing are a high-risk group but they may benefit from targeted intervention programs that are well integrated with the adult drug treatment system. Such interventions warrant further development and evaluation.

Estudo das propriedades psicométricas do perfil psicoeducacional PEP-R : elaboração da versão brasileira

O presente estudo investigou as propriedades psicométricas do Perfil Psicoeducacional Revisado (Psychoeducational Profile Revised - PEP-R), criado para avaliar a idade de desenvolvimento em crianças com autismo ou com transtornos correlatos da comunicação. Após tradução feita por dois tradutores bilíngües, vários itens (como imagens e letras do alfabeto) foram substituídos para tornar o material mais atrativo e apropriado à nossa cultura. Um estudo piloto composto por 20 crianças com desenvolvimento típico foi realizado para avaliar a adequação das mudanças realizadas nas imagens do instrumento. A validade relacionada a critério das dimensões da escala de Desenvolvimento e Comportamento foi avaliada administrando-se o PEP-R em 20 crianças autistas, 20 crianças com Síndrome de Down e 40 crianças com desenvolvimento típico. As crianças tinham idade entre 4 e 9 anos e também responderam ao teste de Matrizes Coloridas de Raven e à versão brasileira do CBCL (Child Behavior Checklist). As correlações entre o PEP-R e essas medidas foram de 0,54 e 0,39, respectivamente. A fidedignidade entre os avaliadores (coeficiente de W-Kendall) mostrou resultados variando entre 0,80 e 0,87. Os índices de consistência interna do PEP-R variaram entre 0,80 e 0,97. A comparação dos escores brutos finais da escala de Comportamento do PEP-R, nos três grupos, confirmou a validade discriminante do instrumento, uma vez que o grupo com autismo apresentou maior comprometimento que os demais grupos, nas dimensões investigadas