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Aim: Left-behind children (LBC) now account for more than 1 in 5 Chinese children, and they often suffer from behavioural problems when their parents leave their rural homes to seek work in urban areas. The primary aim of this meta-analysis was to compare the incidence rates and factor scores of behavioural problems in LBC, who now account for more than one-fifth of Chinese children, and non-LBC.Methods: This systematic review and meta-analysis explored the children's characteristic behavioural problems using the Achenbach Child Behaviour Check List. A subgroup analysis was conducted to compare the different behavioural problems of LBC with different characteristics. The meta-analysis assessed 1405 papers and analysed 13 papers from 2007 to 2015, covering 10 264 LBC and 8909 non-LBC from 2 to 19 years of age.Results: The incidence rates of behavioural problems were higher in LBC than non-LBC. The highest risks were noted in boys aged between 6 and 11 years of age, who were more likely to be withdrawn and be affected by somatic complaints, schizophreniform disorder, compulsive behaviour and depression.Conclusion: Interventions and policies are urgently needed to tackle behavioural issues among LBC, especially high-risk males aged 6-11 years. [ABSTRACT FROM AUTHOR]

Investigations have found maternal adverse childhood experiences (ACEs) cause an intergenerational danger to their children's health. However, no study has investigated the effects of maternal ACEs on behavioral problems of preschool children in China and gender differences on these effects. This paper aims to investigate the role of maternal ACEs on behavioral problems of preschool children in China and explore gender differences as related to these behavioral problems. Stratified cluster sampling method was used to select 7318 preschool children from 12 districts in Hefei city, China. A questionnaire survey was conducted to collect information on maternal exposure to ACEs and Conners' Parent Rating Scales. Logistic regression was used to analyze the relationship between maternal ACEs and children's behavioral problems. The prevalence of behavioral problems in preschool children was 16.0%, while it was higher among girls (18.4%) than boys (13.92%) (χ2 = 27.979, p < 0.001). The rate of behavioral problems in children in the group of mothers with ACEs was higher than those without ACEs (all p < 0.05). Maternal ACEs were associated with increased risk of the behavior problems in preschool children (adjusted OR 2.91, 95% CI 2.45–3.45), and no gender difference (in girls 3.01, 2.38–3.81, in boys 2.79, 2.17–3.58, respectively) was found. Maternal ACEs were associated with increased risk of each type of the behavioral problems of preschool children, except that maternal emotional neglect was not associated with psycho-physical problems, impulse-activities, and anxiety. The only gender differences found were higher conduct problems related to maternal emotional abuse and ACEs and higher anxiety related to maternal physical abuse and community violence in girls compared with boys. Mothers exposured to ACEs are more likely to have children with behavioral health problems in preschool period. Further research is needed to explore the mechanisms by which maternal ACEs influence children's behavioral problems. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to investigate impact of coronavirus COVID-19 on children's mental health specifically emotional and behavioral disorders. It aims at identifying the main disorders faced by children during epidemics and suggests recommendations to nurture resilience among children and involving them in various positive activities. Design/methodology/approach: This study is based on review of literature focused on COVID-19. Recent articles related to coronavirus or COVID-19 and psychological distress among children were included to draw conclusion and impact of COVID-19 on mental health of children. Due to the limited availability of studies on CONID-19 impact on mental health of children, studies focused on recent pandemic were focused. Findings: The identified literature reports a negative impact of COVID-19 on individual's mental health. Relatives' health, poor appetite, fear of asking questions about epidemics, agitation, clinginess, physical discomfort, nightmares and poor sleep, inattention and separation issues were among the major psychological conditions analyzed. Personal attributes such as resilience, should be nurtured so that children will be empowered to manage difficult situations such as traumas and disappointments. Several measures were suggested by pediatricians in China to family members and parents such as playing games with children to reduce feeling of loneliness, increased communication to address their concerns and fears, promoting and encouraging physical activities and involving in musical activities to reduce fear, worry and stress among children. Originality/value: Coronavirus is new pandemic and growing rapidly. most of the research studies are focused on physical health of individuals, but mental health concept has bene overlooked. This study helps to broaden the scope of research on children's mental health by examining the impact of COVID-19. [ABSTRACT FROM AUTHOR]

Purpose: Parenting for Lifelong Health for Young Children (PLH-YC) is a program to prevent child maltreatment. This study aimed to examine the feasibility, acceptability and preliminary effects of the adapted program for Chinese parents. Methods: A pre–post single-arm pilot trial was conducted with 21 Chinese parents. A mixed-method design was utilized to collect questionnaire-based quantitative data and qualitative data of interviews and focus group discussions. Results: Program implementation was feasible, with overall high recruitment, enrollment, attendance, acceptability and fidelity. Quantitative results demonstrated reductions in general child maltreatment, physical and emotional abuse, child behavioral problems, and improvements in positive parenting. Thematic analyses identified reduced violent discipline, psychological aggression, and child behavioral problems, strengthened parent–child bonds, increased parenting confidence, and decreased family conflict. Conclusion: The adapted PLH-YC program for Chinese parents has shown good feasibility and acceptability, and exhibited a significant association with reduced child maltreatment. Further randomized controlled trials are required. [ABSTRACT FROM AUTHOR]

The study aims to explore the protection effect of grit as a personal quality and social support as an environmental factor in the association between left-behind children's discrimination perception and problem behavior. A total of 457 left-behind children in China were recruited to complete the Discrimination Perception questionnaire, Social Support Scale, Short Grit Scale, and Problem Behavior Questionnaire. It found discrimination perception could positively associate with the problem behaviors of left-behind children. Grit played a mediating role in the relationship of left-behind children's discrimination perception on problem behaviors. Social support played a mediating role in the association of left-behind children's discrimination perception on problem behaviors. The higher the left-behind children's discrimination perception, the lower their grit level, and the less social support led to the more prone to problem behaviors. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to analyze how authoritative parenting affects behavioral problems among primary, junior high, and secondary high school students. Today, parental educational anxiety and parent–child relationship conflicts are common in China and are resulting in a high incidence of child behavioral problems. High-quality family education is becoming increasingly important in China. This study sought to provide a reference for developing responsive family education services. Methods: A total of 10,441 parents in Hubei Province, including urban and rural areas, were evaluated using the Parents’ Education Anxiety Questionnaire, Parental Authority Parenting Questionnaire, Parent–Child Relationship Scale, and Self-Made Behavior Problem Scale to determine the internal mechanisms of child behavioral problems in the family system. To make the sample more representative, this study collected data from primary and secondary schools representative of the southeast, northwest, and center of Hubei Province; further, the number of parents involved in each school was controlled at approximately 300 to ensure that the final sample had analytical value. Results: Educational anxiety directly affected children’s behavioral problems and indirectly affected them through the conflicts between parent and child. This conflict partially mediated educational anxiety and child behavioral problems, and authoritative parenting played a significant regulatory role in this relationship. Discussion: Higher levels of educational anxiety among parents increased the likelihood of a depressed family environment. This can lead to deteriorating parent–child relationships, which can result in children’s problem behaviors. Parents can address these problems by changing their approach to education and adjusting their emotions accordingly. [ABSTRACT FROM AUTHOR]

Purpose -- An increasing number of people are migrating within the borders of China. Some migrants have to leave their children behind, and 58,000,000 children are estimated to be living as left-behind children. Earlier studies have found severe mental problems in left-behind children, but different factors could influence their mental health. The purpose of this paper is to investigate the mental health of these left-behind children and to determine possible influencing factors. Design/methodology/approach -- Data for this study were collected in one province of the People's Republic of China with a validated instrument, the Strengths and Difficulties Questionnaire (SDQ), to investigate behavior in 13-to-15-year old children. Findings -- No significant difference was found in total difficulty score and in any subscale score of SDQ when left-behind children were compared with children who were not left behind. A significant difference in emotional difficulty subscale score was found between girls who were left behind and girls who were not. Some socio-economic factors such as poor family economy and living with relatives, friends or grandparents, were identified as risk factors. Originality/value -- When strategies for support of the mental health in left-behind children are developed, they will need to be individualized according to the gender, social and economic situation and focused on emotional and conduct problems. [ABSTRACT FROM AUTHOR]

Please cite this paper as: Li H-T, Ye R, Achenbach T, Ren A, Pei L, Zheng X, Liu J-M. Caesarean delivery on maternal request and childhood psychopathology: a retrospective cohort study in China. BJOG 2011;118:42-48. To prospectively examine the association between mode of delivery and childhood psychopathology. Retrospective cohort study. Eighteen counties and three cities in China. A total of 4190 preschool children whose mothers were registered in a perinatal surveillance programme were assessed with the Child Behaviour Checklist (CBCL), an instrument to assess child emotional (internalising) and behavioural (externalising) problems. Differences in CBCL problem scores were analysed both quantitatively and categorically among children born by caesarean delivery on maternal request (CDMR), assisted vaginal delivery (AVD), and spontaneous vaginal delivery (SVD). The CBCL total, externalising, and internalising scores. There were significant differences in the mean scores of total (20.9, 23.0, and 25.0), externalising (7.6, 8.4, and 9.1), and internalising (4.7, 5.2, and 5.6) problems among children born by CDMR, SVD, and AVD, after adjusting for potential confounding factors ( P = 0.007, 0.014, and 0.031). Children born by AVD were more likely than those born by SVD to have total (OR 1.43; 95% CI 1.10-1.86), externalising (OR 1.46; 95% CI 1.11-1.92), and internalising (OR 1.41; 95% CI 1.08-1.84) scores in the highest quartile, whereas children born by CDMR were less likely to have externalising scores in the highest quartile (OR 0.64; 95% CI 0.42-0.97). Furthermore, there were significant increasing linear trends on all problem scores, and in the odds of being in the highest quartile, from children born by CDMR to those born by SVD and AVD. The likelihood of childhood psychopathological problems may be the lowest in children born by CDMR, followed by those born by SVD, whereas the highest probability was observed in those born by AVD. [ABSTRACT FROM AUTHOR]

Background: Sleep plays a critical role in normal development and the effects of culture upon sleep are especially important in young children. The purpose of the present paper was to determine the sleep times and the prevalence of sleep problems and co-sleeping in children from Shanghai. Methods: A cross-sectional design incorporating parental self-report was used to investigate the sleep-related habits of 1129 children, 1–23 months of age, randomly selected from the five districts of Shanghai, China. Results: The total sleep time (TST) of Chinese young children was less than that reported in Western populations, and the prevalence of sleep problems (65.97%) was higher than that for Western children. The sleep problems of children were significantly related to perinatal factors and certain behavior problems. The rate of bed sharing did not differ between boys and girls but significantly increased with age from 44.07% in 1-month-olds to 71.51% in 23-month-olds. Conclusions: Sleep problems that cross cultures result from a variety of behavioral and health problems. Nevertheless, it is speculated that reduced TST in Chinese children may be related to factors unique to China, such as co-sleeping and child-rearing practices. [ABSTRACT FROM AUTHOR]

It is well known that aggressive parenting is associated with behavioral problems among Western children in their early childhood, but this has rarely been examined among Chinese preschoolers. The purpose of this study is to explore the relationship between aggressive parenting, callous–unemotional traits (CU traits), and behavioral problems among a large Chinese preschool sample. Data were collected in Wuhu city, China, from 1879 preschoolers (54% of whom were male) with a mean age of 65.66 months (standard deviation = 9.41). Parents provided information about the frequency of aggressive parenting, children's behaviors, and demographic characteristics via an online questionnaire. Mediation models were applied to analyze the associations between aggressive parenting, CU traits, and behavioral problems. Preschoolers' age, gender, and family socioeconomic status were considered as covariates. The findings of our study revealed that higher frequencies of parental psychological and physical aggression were associated with high levels of CU traits, which were related to increased levels of preschoolers' behavioral problems. This study extends previous studies by revealing a positive relationship between aggressive parenting and behavioral problems among Chinese preschoolers via CU traits and highlights the risks of aggressive parenting. Interventions for improving parenting strategies and lessening callous–unemotional traits should be developed to help reduce behavioral problems. [ABSTRACT FROM AUTHOR]

Background: Previous studies have not clearly demonstrated the impact of behavioral and emotional problems (BEDs) on treatment outcomes among HIV-infected children on antiretroviral therapy (ART). This study aimed to describe the prevalence of BEDs among this population and identify the factors associated with HIV treatment outcomes. Methods: This cross-sectional study was conducted in Guangxi, China, between July and August 2021. HIV-infected children answered questionnaires about BEDs, physical health, social support, and whether they have missed doses in the past month. BEDs were assessed using the Chinese version of the self-reported Strengths and Difficulties Questionnaire (SDQ-C). The self-reported survey data were linked to participants' HIV care information that was obtained from the national surveillance database. Univariate and multivariate logistic regression models were used to identify factors that were associated with missed doses in the past month and virological failure. Results: The study sample was 325 HIV-infected children. HIV-infected children had a higher proportion of abnormal scores on SDQ-C total difficulties compared to their peers in the general population (16.9 vs 10.0%; P = 0.002). An abnormal SDQ-C total difficulties score (AOR = 2.06, 95%CI: 1.10–3.88) and infrequency of receiving assistance and support from parents over the past 3 months (AOR = 1.85, 95%CI: 1.12–3.06) were significantly associated with missed doses in the past month. Between the ages of 14–17 years (AOR = 2.66, 95% CI: 1.37–5.16), female (AOR = 2.21, 95% CI: 1.20–4.08), and suboptimal adherence (AOR = 2.45, 95% CI: 1.32–4.57) were significantly associated with virological failure. Conclusions: Children's mental health plays a role in HIV treatment outcomes. Psychological interventions should be promoted in pediatric HIV care clinics to improve children's mental health status and HIV treatment outcomes. [ABSTRACT FROM AUTHOR]

Behavior problems of children with autism spectrum disorder (ASD) bring many difficulties and stress to their parents, thus increasing their risk of depression. Recent studies have shown that the mindfulness and perceived social support may play significant roles in improving the depression of these parents as well as relieve their boundary of stress. However, related research conducted under the context of Mainland China is still limited, and no studies have yet explored the mediating effect of mindfulness and perceived social support on the relationship between behavior of children with ASD and depressive symptoms of parents in Mainland China. The present study aimed to examine the relationship between behavior problems of children with ASD and parents' depressive symptoms in Mainland China and focused on whether mindfulness and perceived social support may act as mediators in the association between child behavior problems and parents' depressive symptoms. Participants were 286 Chinese parents of children with ASD. The Strengths and Difficulties Questionnaire (SDQ), the Center for Epidemiological Studies–Depression Scale (CES-D), the Cognitive and Affective Mindfulness Scale-Revised (CAMS-R), and the Interpersonal Support Evaluation List-12 (ISEL-12) were adopted to assess: child behavior problems, parental depressive symptoms, individual differences in mindfulness and perceived social support. The direct effects of child behavior problems on parental depressive symptoms was statistically significant (direct effect = 0.137, SE = 0.043, p =.002). Child behavior problems also showed a significant indirect effect on parental depressive symptoms through mindfulness (indirect effect = 0.097, SE = 0.025, p <.001) and perceived social support (indirect effect = 0.088, SE = 0.023, p <.001). Two variables, mindfulness and perceived social support both played a mediating role in the influence of child behavior problems on parents' depressive symptoms. Parental depressive symptoms were significantly related to child behavior problems. Consistent with previous studies across diverse cultural backgrounds, the results of this study showed that the relationship between child behavior problems and parents' depressive symptoms was, in part, mediated by mindfulness and perceived social support of parents. Mindfulness interventions and effective social support for parents of children with ASD may be needed to help parents raise their children and relieve depressive symptoms. [ABSTRACT FROM AUTHOR]

The present study explored the role of parenting styles as mediating mechanisms in the link between marital conflict and Chinese children's internalizing problems. Participants were N = 1269 families (mothers, fathers, and children) from Shanghai, P. R. China. Multisource assessments were employed at three time points. Mothers and fathers reported their marital conflict and parenting styles (authoritative, authoritarian) and teachers and children reported on children's internalizing problems. Results from the Actor–Partner Interdependence Model (APIM) showed significant actor and partner effects for associations between marital conflict and parenting styles. After controlling for internalizing problems at Time 1, only maternal authoritarian parenting continued to mediate the relations between mothers' reported marital conflict and change in children's internalizing problems over time. This research provides valuable information about how important aspects of parenting influence the relations between marital conflict and internalizing problems among Chinese children. [ABSTRACT FROM AUTHOR]

A growing body of research has documented that childhood maltreatment is associated with increased risk of child aggression. However, little is known about the mediating and moderating mechanisms underlying the relationships between childhood maltreatment and reactive and proactive functions of aggression. Therefore, the present study examined whether callousunemotional traits mediated the relationships between childhood maltreatment and two subtypes of aggression and whether these mediating processes were moderated by friendship quality. A cross-sectional study was conducted among 2407 adolescents between 11 and 16 years (M age = 12.75, SD = .58) in Shanxi province, China. Participants filled out questionnaires regarding childhood maltreatment, callous-unemotional traits, aggression, and friendship quality. The results indicated that childhood maltreatment was significantly and positively associated with proactive and reactive aggression, and these relationships were partially mediated by callous-unemotional traits after controlling for demographic variables. Friendship quality moderated the relationship between childhood maltreatment and proactive aggression as well as callous-unemotional traits and proactive aggression. These relationships became weaker for adolescents with high levels of friendship quality. Friendship quality did not moderate the effects of childhood maltreatment and callous-unemotional traits on reactive aggression. [ABSTRACT FROM AUTHOR]

Fei Xiaotong proposed a grade structure to explain that interpersonal relationships in China are self-centered and gradually move outward through kinship. As a clue to connecting a family, how does this kinship affect the growth of individuals, especially children? This study examined the roles of different kinship supports in left-behind children's behavioral problems based on cognitive behavior therapy. According to their current family structure, the participants were divided into left-behind and non-left-behind children. Data from 852 participants indicated that for left-behind children, the support of parents and grandparents could affect internal aggression/external aggression through depression/anxiety, and the help of other relatives could also directly and positively affect external aggression, whereas for non-left-behind children, only parental support affected children's internal aggressive behavior by affecting depression. The results revealed the internal mechanism of kinship support on children's aggressive behavior from the perspective of cognitive behavior theory. [ABSTRACT FROM AUTHOR]

The coparenting between grandparents and parents is increasingly prevalent in Chinese society. Based on the family system theory and the differential susceptibility model, the current study examined (a) the relative associations of maternal and grandparental psychological control with children's behavioral problems; (b) the interactive effects of maternal and grandparental psychological control on children's behavioral problems; and (c) the moderation role of children's temperamental reactivity. The sample included 241 Chinese multigenerational families with preschool children (130 boys, Mage = 4.88 years, SD = 1.04). Mothers and grandparents reported their psychological control and children's behavioral problems. Mothers also rated children's temperamental reactivity. The results showed that only maternal psychological control was uniquely associated with more children's behavioral problems. There was no interaction between maternal and grandparental psychological control. However, children's temperamental reactivity moderated associations between grandparental psychological control and children's behavioral problems. Specifically, grandparental psychological control was positively linked to children's behavioral problems only for highly reactive children. This finding highlighted the susceptibility of children with high reactivity to grandparental psychological control, raising the possibility of targeted interventions to facilitate children's development. Highlights: In Chinese multigenerational families, maternal psychological control played a more significant role in preschool children's behavioral problems than grandparental psychological control. There was no interaction between maternal and grandparental psychological control. High reactive children were more susceptible to grandparental psychological control. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study is to investigate the influence of perceived discrimination on children's depression and behavioral problems via the mediator of integration among Chinese migrant children. Rural‐urban differences in the proposed relationships are also examined. Methods: The sample included 484 migrant children (Mean age = 11.65 years; 52.9% girls), which was collected through multi‐stage cluster random sampling in Kunming, Southwest China. Structural equation modelling (SEM) was adopted for data analysis. Results: Results indicate that perceived discrimination reduces the integration of Chinese migrant children, which in turn, leads to their higher levels of depression and more behavioral problems. The multi‐group analysis on rural‐urban differences reveals that the effects of discrimination on depression and behavioral problems are significant among rural‐urban migrants but not among urban–urban ones. Conclusions: This study contributes to current knowledge by revealing the mechanisms among perceived discrimination, integration, depression and behavioral problems of Chinese migrant children. The migration pattern differences in terms of their depression and behavioral problems are also highlighted. [ABSTRACT FROM AUTHOR]

The aim of the present study was to examine the relationships between ACEs and behavioral problems of children in their early adolescence in Chinese society. Results from bivariate analyses of 2,910 Chinese children in early adolescence indicated that children begin to exhibit behavioral problems being related to the exposure of adverse childhood experiences (ACEs). Compared to those with 0 ACEs, children with 4 or more ACEs were 4.45 times (p < 0.001), 4.44 times (p < 0.001), 7.80 times (p < 0.001), 4.49 times (p < 0.001), and 6.63 times (p<0.001)more likely to demonstrate hyperactivity, peer communication problems, pro-social problems, emotional problems and conduct problems, respectively. Rural children, children of mothers with low education, and boys were particularly likely to have been exposed to multiple categories of ACE. This study evidenced that there was a strong association between exposure to ACEs and behavioral problems in early adolescence in China. [ABSTRACT FROM AUTHOR]

The public has always been concerned about the problem behaviors of children and teenagers (such as cigarette and alcohol use), especially among disadvantaged groups (e.g., left-behind children in China); in the current information era, left-behind children's use of social media also has increasingly expanded, which has diverse effects on their adaptation. Accordingly, the present study examined the association between exposure to relevant content on social media and left-behind children's tobacco and alcohol use, as well as the underlying mechanisms—the mediating effect of deviant peer affiliation and the moderating effect of parent–child contact, the gender differences were also investigated. A sample of 515 Chinese left-behind children (Mage = 13.39 ± 2.52 years, 45.0% girls) was recruited to complete a set of questionnaires assessing the main variables. The results show that social media exposure was positively associated with tobacco and alcohol use and that deviant peer affiliation significantly mediated this relationship. Furthermore, parent–child interaction attenuated the link between social media exposure and cigarette and alcohol use among left-behind girls, but this moderating effect was not statistically significant among left-behind boys. The moderating role of parent–child contact in the association between deviant peer affiliation and tobacco and alcohol use was insignificant in both boys and girls. These findings may have significance in several ways—theoretically, they not only deepen our understanding of the risk factors and mechanism of tobacco and alcohol use among left-behind children in the current information era and the influences of social media use; practically, they provide direction for the health improvement of left-behind children of different genders. [ABSTRACT FROM AUTHOR]

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Background: To date, no national‐scale psychiatric epidemiological survey for children and adolescents has been conducted in China. In order to inform government officials and policymakers and to develop a comprehensive plan for service providers, there was a clear need to conduct an up‐to‐date systematic nationwide psychiatric epidemiological survey. Methods: We conducted a two‐stage large‐scale psychiatric point prevalence survey. Multistage cluster stratified random sampling was used as the sampling strategy. Five provinces were selected by comprehensively considering geographical partition, economic development, and rural/urban factors. In Stage 1, the Child Behavior Checklist was used as the screening tool. In Stage 2, Mini‐International Neuropsychiatric Interview for Children and Adolescents and a diagnostic process based on the Diagnostic and Statistical Manual were used to make the diagnoses. Sampling weights and poststratification weights were employed to match the population distributions. Exploratory analyses were also performed using socio‐demographic factors. Prevalence in socio‐demographic factor subgroups and overall were estimated. Rao‐Scott adjusted chi‐square tests were utilized to determine if between‐group differences were present. Factor interactions were checked by logistic regression analyses. Results: A total of 73,992 participants aged 6–16 years of age were selected in Stage 1. In Stage 2, 17,524 individuals were screened and diagnosed. The weighted prevalence of any disorder was 17.5% (95% CI: 17.2–18.0). Statistically significant differences in prevalence of any psychiatric disorder were observed between sexes [χ2(1, N = 71,929) = 223.0, p <.001], age groups [χ2(1, N = 71,929) = 18.6, p <.001] and developed vs. developing areas [χ2(1, N = 71,929) = 2,129.6, p <.001], while no difference was found between rural and urban areas [χ2(1, N = 71,929) = 1.4, p =.239]. Male, younger individuals, children, and adolescents from developed areas had higher prevalence of any psychiatric disorder. The prevalence of any psychiatric disorder was found to decrease with the age in the male group, while the female group increased with the age. Individuals diagnosed with attention‐deficit hyperactivity disorder, oppositional defiant disorder, a tic disorder, conduct disorder, and major depression disorder had the highest rates of comorbidity. Conclusions: The prevalence of any psychiatric disorder we found is the highest ever reported in China. These results urgently need to be addressed by public mental health service providers and policymakers in order to provide access to the necessary treatments and to reduce the long‐term negative impact of these conditions on families and the society as a whole. [ABSTRACT FROM AUTHOR]

The sizable prevalence of autism spectrum disorder (ASD) in China has recently emerged as an urgent public health issue; however, studies investigating parenting stress in Chinese parents of children with ASD lack clarity in identifying the potential factors of stress. The aim of this systematic review was to identify and categorize the potential factors of stress based on findings in the literature. An extensive search of articles in online databases, including PubMed, Web of Science, and EBSCOhost (ERIC, MEDLINE and PsycINFO), was conducted, as a result of which 24 eligible articles published from 2007 to 2019 were identified. Four key categories of potential factors of parental stress—cultural factors, parents' psychopathological symptoms, problem behaviors in ASD children, and caregiver burden—were identified. The impact of these potential factors on parental coping strategies and on the quality of life in affected families were also discussed. [ABSTRACT FROM AUTHOR]

While the harmful effects of peer victimization have been well documented, there is limited research on the parental behaviors as potential moderators of victimization and child mental health outcomes. The current study examined the moderating effects of parental warmth, parental rejection, and child gender on the relation between peer victimization and child mental health difficulties, i.e., emotional and behavioral difficulties. Participants included 425 Chinese elementary school children in grades 3 to 6 (Mage = 10.59, SDage = 1.11), who self-reported on peer victimization experiences, perceived parental warmth and rejection, and mental health difficulties. Data were collected at two-time points, six months apart. Victimization and parental rejection positively predicted child emotional and behavioral difficulties, while parental warmth negatively predicted child emotional and behavioral difficulties at both time points. Victimization significantly predicted emotional difficulties (at time 1) and behavioral difficulties (at time 2) for girls, but not boys. In addition, gender moderated the interaction of victimization and parental rejection in predicting child behavioral difficulties at time 1, i.e., parental rejection exacerbated the effects of peer victimization on behavioral difficulties for girls only. Findings highlight the need to target bullying prevention efforts, and underscore the importance of evaluating peer and parental factors while working with children with emotional and behavioral issues. Highlights: The study examined if parental warmth, parental rejection, and child gender moderated the effects of peer victimization on child mental health difficulties. Peer victimization is associated with mental health difficulties, both emotional and behavioral. Parental warmth is beneficial, and parental rejection is detrimental for children's mental health. Peer victimization affects girls more negatively compared to boys. Parental rejection exacerbated effects of peer victimization on behavioral difficulties for girls. [ABSTRACT FROM AUTHOR]

This study aimed to determine how pathological Internet use and emotional intelligence affect the relationship between perceived personal discrimination and problem behavior of left behind children. Data were collected from 406 left-behind students from 6 rural primary and secondary schools in Mainland China. Results indicated that perceived personal discrimination could be a predictor of left-behind children's pathological Internet use, and further cause their problem behavior. Pathological Internet use had a partial mediating effect on the relation between perceived personal discrimination and problem behavior. In addition, emotional intelligence played a moderating role in the relationship between perceived personal discrimination and problem behavior, as well as between pathological Internet use and problem behavior. Emotional intelligence could alleviate the negative impact of perceived personal discrimination on problem behavior, as well as the negative impact of pathological Internet use on problem behavior. [ABSTRACT FROM AUTHOR]

Parenting young children could be stressful at times and parenting stress could have an impact on parenting styles and child behavior problems which could lead to difficulties in later life. Therefore, the relationship among these three factors is worthy of examination. In this study we aim to examine the direct relationship between parenting stress, parenting styles, and perceived child behavior problems; and to investigate a model that illustrates the mediating role of negative (authoritarian and permissive) parenting styles on the relationship between parenting stress and perceived child behavior problems in China. A total of 371 parents with preschool age children (3 to 7 years old) were recruited. The results showed higher level of parenting stress was associated with higher level of reported child behavior problems. Parenting stress was positively related to negative parenting styles, and negative parenting styles partially mediated the relationship between parenting stress and child behavior problems. Findings from this study suggested that reducing parenting stress, improving parenting behaviors such as parenting styles, and enhancing parent-child relationship through early support (e.g., parenting skills training) are of vital importance and mutual benefits to the parents, children, and family relationships at large. Highlights: This study examines the relationships of parenting styles with parenting stress and child behavior problems in Chinese context. Parenting stress was positively associated with child behavior problems. Parenting stress was positively related to negative parenting styles. Negative parenting styles partially mediated the relationship between parenting stress and child behavior problems. [ABSTRACT FROM AUTHOR]

• The gender disparities in DCM vary among different maltreatment subtypes. • DCM's negative effect was more severe for girls than for boys. • Gender heterogeneity is less evident than gender homogeneity in the risk factors. Currently, gender disparities in domestic child maltreatment (DCM) have become an important and highly controversial issue worldwide. This study aims to provide panoramic evidence from China on this issue. Data were derived from a survey of 4,308 children (M age = 12.13, 48.7% were boys) conducted in seven provinces in rural China from June to December 2019. This study used multistage cluster sampling to select respondents, and modified versions of the JVQ Scale and the DSM-5 Scale (11–17 years old) were adopted. This study reached three significant conclusions. First, the gender disparities in DCM vary among different maltreatment subtypes. Compared with girls, boys are more likely to experience physical abuse. A higher prevalence of neglect is observed among girls than among boys. Second, although DCM significantly increased the likelihood of posttraumatic depression for all children, its negative effect was more severe for girls than for boys. Third, gender heterogeneity is less evident than gender homogeneity in the risk factors for DCM. In rural China, children's problematic behaviours, family structure, parents' experiences of childhood violence and family relationships are common predictors of maltreatment for all children. This paper highlights gender differences in the risk of DCM among children in rural China, reveals the Confucian culture behind DCM and gender, and provides Chinese evidence for building an international dialogue. [ABSTRACT FROM AUTHOR]

Objectives: Sleep disturbances are often associated with emotional/behavioral problems in young children, but whether the association differs among Asian countries remains unknown. This study aimed to investigate the association between sleep disturbances and emotional/behavioral problems in Chinese and Japanese preschoolers and to explore potential differences. Methods: Participants were 1,020 Chinese preschoolers from 10 cities and 438 Japanese preschoolers from 1 city aged 4 to 5 years. Parents filled out the Children's Sleep Habits Questionnaire (CSHQ) and the Strengths and Difficulties Questionnaire (SDQ). Results: Chinese children with sleep disturbances (defined as total CSHQ score >41) demonstrated more peer problems than children without, while there was no such difference in Japanese preschoolers. Domains of sleep disturbances associated with emotional/behavioral problems in Chinese children were sleep disordered breathing and daytime sleepiness, yet in Japanese children were sleep anxiety and night wakings. Children with a higher score of sleep anxiety showed more emotional problems in Japan, but fewer conduct problems in China. Conclusions: Sleep disturbances were associated with emotional/behavioral problems in preschoolers with differences between China and Japan, indicating subcultural differences in preschoolers' sleep within Asian countries. Abbreviations: CSHQ: Children's Sleep Habits Questionnaire; SDQ: Strengths and Difficulties Questionnaire; ANCOVA: analysis of covariance; SD: standard deviation; CI: confidence interval. [ABSTRACT FROM AUTHOR]

This study investigated the association between perceived material deprivation, children's behavior problems, and parents' disciplinary practices. The sample included 1,418 8- to 12-year-old children and their parents in China, Colombia, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the United States. Multilevel mixed- and fixed-effects regression models found that, even when income remained stable, perceived material deprivation was associated with children's externalizing behavior problems and parents' psychological aggression. Parents' disciplinary practices mediated a small share of the association between perceived material deprivation and children's behavior problems. There were no differences in these associations between mothers and fathers or between high- and low- and middle-income countries. These results suggest that material deprivation likely influences children's outcomes at any income level. [ABSTRACT FROM AUTHOR]

The relationship between three types of child maltreatment, including physical abuse, emotional abuse and neglect, and childhood behavior problems in Mainland China, has not been systematically examined. This meta-analysis reviewed findings from 42 studies conducted in 98,749 children in Mainland China and analyzed the pooled effect sizes of the associations between child maltreatment and childhood behavior problems, heterogeneity in study findings, and publication bias. In addition, this study explored cross-study similarities/differences by comparing the pooled estimates with findings from five existing meta-analyses. Equivalent small-to-moderate effect sizes emerged in the relationships between the three types of maltreatment and child externalizing and internalizing behaviors, except that emotional abuse related more to internalizing than externalizing behaviors. Considerable heterogeneity exists among the 42 studies. Weak evidence suggests that child gender and reporter of emotional abuse may moderate the strengths of the relationships between child maltreatment and behavior problems. No indication of publication bias emerged. Cross-study comparisons show that the pooled effect sizes in this meta-analysis are about equal to those reported in the five meta-analyses conducted in child and adult populations across the world. Findings urge relevant agencies in Mainland China to build an effective child protection system to prevent child maltreatment. [ABSTRACT FROM AUTHOR]

While emotional and behaviorial problems increase risks to youth development, resilience helps youth adapt and overcome adversity. Research has discussed factors related to youth resilience, emotional problems, and behaviorial problems; however, existing literature excludes non‐western sociocultural contexts and has not explored the potential relations among mindfulness and life skills. This study examines the effects of mindfulness and life skills on resilience, emotional problems, and behaviorial problems of adolescents in China. Our data come from a group‐administered survey among 60 adolescents from a school for behaviourally delinquent students in Beijing, China, in 2017. The regression results indicate that mindfulness is associated with reduced adolescent emotional and behaviorial problems, whereas life skills are associated with increased resilience. The findings suggest the importance of adolescent interventions that incorporate concepts from both mindfulness and life skills training. [ABSTRACT FROM AUTHOR]

The problem behaviors exhibited by left-behind children occur within multiple contexts, and are influenced by cumulative risk, including family, peer, and school characteristics; however, little is known about the mediating and moderating mechanisms underlying the relationship between such problem behaviors and cumulative risk. A total of 1,313 Chinese left-behind children were recruited to complete anonymous questionnaires measuring cumulative risk, deviant peer affiliation, effortful control, and delinquent behavior. After controlling demographic covariates, cumulative risk is positively associated with problem behaviors. Furthermore, deviant peer affiliation was found to partially mediate the association between cumulative risk and problem behaviors. Both the direct association between cumulative risk and delinquent behaviors and the indirect effect of deviant peer affiliation were moderated by effortful control, specifically; the effects were stronger for left-behind children with low levels of effortful control. These results highlight the significance of the cumulative ecological model for understanding and developing intervention programs to reduce left-behind children's problem behaviors. [ABSTRACT FROM AUTHOR]

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Background: Childhood injury is a major public health problem around the world and those injuries have negative impacts on children and their families. The purpose of this study was to compare the behavioral characteristics between Chinese school-age children (6 to 11 years of age) with and without unintentional injuries and to identify behavioral risk factors for school-age children with unintentional injury.Methods: This cross-sectional predictive study was conducted in five elementary schools in Daqing, China. The Achenbach Child Behavior Checklist (CBCL) was used to assess the children's behavioral characteristics. A total of 725 school-age children were screened. Of these, 116 children who had experienced unintentional injury in the past year were recruited as the study group, and 123 children who had not experienced an unintentional injury were randomly selected and assigned to the control group.Results: The total scores of CBCL in the study group children were significantly higher than those in the control group. The significant behavior disorder predictors for unintentional injury in boys were schizoid behavior problem (OR = 2.43), anxiety/depression (OR = 2.76) and hyperactive (OR = 2.42). The predictors for unintentional injury in girls were anxiety/depression (OR = 2.12) and delinquent behavior (OR = 2.81).Conclusions: Children with behavior disorders are more likely to suffer from unintentional injuries. Teachers and pediatricians should identify the behavior disorders and assist parents to help children, thereby reducing the rate and severity of injuries. [ABSTRACT FROM AUTHOR]

Background.Converging evidence has revealed both functional and structural abnormalities in adolescents with early-onset conduct disorder (EO-CD). The neurological abnormalities underlying EO-CD may be different from that of adolescent-onset conduct disorder (AO-CD) patients. However, the cortical structure in AO-CD patients remains largely unknown. The aim of the present study was to investigate the cortical alterations in AO-CD patients.Method.We investigated T1-weighted brain images from AO-CD patients and age-, gender- and intelligence quotient-matched controls. Cortical structures including thickness, folding and surface area were measured using the surface-based morphometric method. Furthermore, we assessed impulsivity and antisocial symptoms using the Barratt Impulsiveness Scale (BIS) and the Antisocial Process Screening Device (APSD).Results.Compared with the controls, we found significant cortical thinning in the paralimbic system in AO-CD patients. For the first time, we observed cortical thinning in the precuneus/posterior cingulate cortex (PCC) in AO-CD patients which has not been reported in EO-CD patients. Prominent folding abnormalities were found in the paralimbic structures and frontal cortex while diminished surface areas were shown in the precentral and inferior temporal cortex. Furthermore, cortical thickness of the paralimbic structures was found to be negatively correlated with impulsivity and antisocial behaviors measured by the BIS and APSD, respectively.Conclusions.The present study indicates that AO-CD is characterized by cortical structural abnormalities in the paralimbic system, and, in particular, we highlight the potential role of deficient structures including the precuneus and PCC in the etiology of AO-CD. [ABSTRACT FROM PUBLISHER]

This study examined Chinese American immigrant couples' marriage conflict, and the relations among socioeconomic incorporation, marital conflict, and their school-age children's behavior problems. A total of 230 parents (81 % mothers, 19 % fathers) as the participating parent provided demographic and background information, rated their own marital conflict and their children's behavioral problems. Findings indicated that: (a) the score of Chinese American immigrant couples' marital conflict was low, child exposure to conflict was much lower than frequency of marital conflict; (b) marital conflict mediated the relation between socioeconomic incorporation and children's behavioral problems. We found that frequency of marital conflict partially mediated the relationship between maternal education level and children's internalizing problems; it also totally mediated the relationship between maternal education level and children's externalizing problems; child exposure to conflict totally mediated the relationship between family estimated per capita income and children's internalizing and externalizing problems. The results promote understanding of family processes that influence the relationships between family socioeconomic incorporation, marital conflict, and children's behavioral problems among Chinese American immigrant families. [ABSTRACT FROM AUTHOR]

Parenting has been conceptualized to mediate or moderate children's adaptation to family stress. Our study expanded the literature to determine, within the adoptive context, how non-child-related family stress (NCR-family stress; e.g., parent's problems at work) and parenting styles were related to internalizing and externalizing problems in school-age girls adopted from China. Using data from the third wave of a longitudinal study, 651 school-age girls were identified for the current analysis. On average, the girls were 9.3 years old ( SD = 2.7) and were adopted at 15.6 months ( SD = 13.8). Data on NCR-family stress, parenting styles and child behavior problems were collected from the adoptive mothers using the social problem questionnaire, parenting styles and dimensions questions, and Child Behavior Checklist (CBCL/6-18), respectively. After controlling for age at adoption, age, the adoptive mother's education level, household income, and the girls' corresponding behavior problems from the second wave of data (2 years prior), we found that that the association between NCR-family stress and the adopted Chinese girls' internalizing problems and externalizing problems was mediated by authoritarian parenting and moderated by authoritative parenting. [ABSTRACT FROM AUTHOR]

The current study examines the relationships of several psychosocial correlates and mediating factors with problem behaviors among children (6-18 years of age) affected by parental HIV/AIDS in rural China. Cross-sectional data were collected from 755 children orphaned by AIDS ('orphans') and 466 children living with HIV-positive parents ('vulnerable children') during 2006-2007 in central rural China. The structural equation modeling analyses revealed that HIV-related stigma had a positive direct effect on problem behaviors of vulnerable children, while HIV-related stigma and low education aspiration had direct negative effects on school adjustment among both orphans and vulnerable children. Measures of future orientation and perceived social support mediated the effect of HIV-related stigma and low education aspiration on school adjustment, which in turn was negatively associated with problem behaviors of both groups. The data also showed that school adjustment mediated the effect of low education aspiration and HIV-related stigma on problem behaviors of both orphans and vulnerable children. Future prevention intervention efforts aiming to reduce problem behaviors and improve school adjustment among these children should target multiple factors at individual, community, and societal levels such as enhancing the children's future expectation, increasing the social support from family, school, and community, and reducing HIV-related stigma against children and families affected by HIV. [ABSTRACT FROM AUTHOR]

This study examined how child temperament moderated the effect of family conflict on behavior problems and social competence in a longitudinal sample of 118 Chinese children. Social competence and internalizing and externalizing problems were assessed first at three months after nursery entry (T1) and then at the end of the nursery year (T2). Temperament and physical and psychological modes of family conflict were assessed at T1. The results showed that temperament moderated the effect of physical conflict on externalizing problems at both T1 and T2, as well as the effect of psychological conflict on social competence and internalizing problems at T2. Children with difficult temperament were more susceptible to the negative influence of physical conflict (i.e., showing more externalizing and more rank-order increases in externalizing when exposed to more physically expressed conflict) and the positive influence of psychological conflict (i.e., showing more rank-order decreases in internalizing and increases in social competence when exposed to more openly and verbally expressed conflict). In contrast, children with easy temperament were less susceptible to the influence of physical conflict but more susceptible to the negative influence of psychological conflict (i.e., showing more rank-order decreases in social competence when exposed to more openly and verbally expressed conflict). [ABSTRACT FROM AUTHOR]

Maternal expressed emotion (EE), including maternal criticism and emotional over-involvement, is considered an index of family emotional climate that is critical for children's psychological well-being. Limited research investigates how each element of EE differentially contributes to child behavior problems, or explores the mechanisms, such as child emotion dysregulation, through which parental EE influences child psychosocial outcomes. This study examined maternal EE, child emotion dysregulation, and child behavior problems among 60 mother-child dyads from a community sample, utilizing multi-method and multi-reporter assessment. Findings indicated that maternal expressed criticism toward the child was positively associated with child externalizing symptoms through its relation to increased child emotion dysregulation, whereas maternal emotional over-involvement was negatively associated with child externalizing symptoms through its negative relation to child emotion dysregulation. These results provided increased support for a model in which maternal criticism remains negatively associated with child psychosocial outcomes, but the construct of emotional over-involvement is not necessarily associated with youth psychosocial problems. This study also illustrated one pathway through which maternal EE influence child psychosocial functioning, thus placing EE research in the broader context of research on family emotion socialization. [ABSTRACT FROM AUTHOR]

The article discusses a study to investigate the early problem behaviors of children in grades 4–6 while examining the potential demographic, parental, and socioeconomic factors related to these behaviors in the rural Hunan province of China. It was found that the prevalence of children with problem behaviors was higher in the rural areas of Hunan, China, than in China as a whole, partly due to the phenomenon of left-behind children, whose parents work away from home.

Background: Psychosocial functioning is poor in patients with pectus excavatum (PE). However, a comprehensive understanding of this issue does not exist. The aim of this study was to assess the severity of psychosocial problems as associated with PE, as well as to identify its risk factors.Methods: A comparative study was performed at the Sichuan Academy of Medical Sciences/Sichuan Provincial People's Hospital in Chengdu, China. Patients age 6 to 16 who admitted to the outpatient department for the evaluation or treatment for PE were included in the study. In addition to parental reports of child psychosocial problems on the Achenbach Child Behavior Checklist (CBCL), parents also filled in other structured questionnaires, including socio-demographic variables, patients' medical and psychological characteristics. The severity of malformation was assessed by CT scan. For comparison, an age- and gender- matched control group was recruited from the general population. The socio-demographic and scores on CBCL were compared between patients and control subjects. Univariate and multivariate analysis were performed to examine risk factors for psychosocial problems in patients.Results: No statistically significant differences were found with respect to social-demographic variables between children with PE and control subjects. Compared with control subjects, children with PE displayed higher prevalence of psychosocial problems in the different scales of the CBCL questionnaire such as 'withdraw', 'anxious-depressed', 'social problems' and 'total problems'. Both univariate and multivariate analyses suggested that age, severity of malformation, and being teased about PE were significantly associated with patients' psychosocial problems.Conclusions: The information derived from this study supports the opinion that children with PE have more psychosocial problems than children from the general population. Multiple medical and psychosocial factors were associated with patients' impairment of psychosocial functioning. [ABSTRACT FROM AUTHOR]

The provision of services under Part C of the Individuals With Disabilities Education Act is built on a premise that children benefit from early intervention. This article presents findings from a study of children adopted from China. Given information obtained from a survey, the researchers grouped children as (a) those who received early intervention, (b) those who did not receive early intervention and whose parents had concerns about their behavior and development, and (c) those who did not receive early intervention and whose parents had no concerns about their behavior and development. Results showed that parental judgments of their children's behavior at the time of adoption best explained differences between the parents whose children received early intervention and parents who had no concerns about their children's behavior and who did not receive early intervention. The behavioral markers that differentiated the groups from one another were as follows: child affect, poor attention, eating and feeding difficulties, problems communicating, poor physical health, and social interaction problems. Findings indicate that parents' appraisals can be an important source of information for eligibility determination for this population of children. [ABSTRACT FROM AUTHOR]

TOPIC: Filial therapy as a therapeutic intervention to promote parent–child interaction and improve child's behavior across culture. PURPOSE: To review the state of the science of filial therapy and explore whether filial therapy would be an effective parenting program in China. SOURCES: Four research articles related to the impact of filial therapy, used with Chinese immigrants, Koreans, and Native Americans, were located in a search of nursing, medical, psychological, and social science literature. CONCLUSIONS: The findings indicated that filial therapy is a culturally sensitive and effective intervention. The overall limitations, some recommendations for future research, and the discussion of efficacy of filial therapy in China were provided. [ABSTRACT FROM AUTHOR]

The present study evaluated the effectiveness of the Positive Parenting Program (Triple P) with a sample of Chinese parents of children with early onset conduct-related problems in Hong Kong. The participants consisted of 91 parents whose children attended maternal and child health centers and child assessment centers for service, and were between three to seven years old. Participants were randomly assigned to the intervention (TP) and a waitlist control group (WL). There was no significant difference in pre-intervention measures between the two groups. However, at post intervention, participants in the TP group reported significantly lower levels of child behavior problems, lower dysfunctional parenting styles, and higher parent sense of competence, compared to the WL group. Implications of these findings for the use of Triple P with families of Chinese descent are discussed. [ABSTRACT FROM AUTHOR]

A sample of Chinese children in Grade 4(155 boys and 135 girls with an average age 10.3 years) completed Olweus' Aggression Inventory, an instrument developed for the assessment of aggressive and aggression controlling behavior tendencies in a Western culture. Results indicated that the questionnaire gave quite meaningful Information when used with the Chinese children. Two interpretable factors, general aggression and aggression control, were derived; the pattern of factor loadings was essentially the same for boys and girls. The internal consistency reliabilities of the two factor scales were In the .80s and .70s, respectively. Overall, the findings indicated that there were distinct measurable individual differences among Chinese children in the domain of aggression--in spite of strong societal pressures against aggressive behavior and towards aggression control. However, some results suggested that aggression was a somewhat more global. or less differentiated, phenomenon for the Chinese as compared with the Swedish children. The two main factor scales were related meaningfully to other self report dimensions such as positive attitude to school and negative relations with parents. In all probability, the pattern of findings gave a valid picture of the behavior and attitudes of the Chinese children: By and large they were nonabrasive, well-behaved, ambitious, friendly, prosocial, and exerted strong control over aggressive feelings and behavior tendencies. In possible conflicts with adults, they were likely to take a humble and submissive attitude. These findings agree well with the impressions of Western observers and with what can be expected on the basis of the typical socialization patterns found in the People's Republic of China. [ABSTRACT FROM AUTHOR]