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Parental influence and children's anxiety have a complex interaction. Robust findings revealed that parenting styles and practices, modeling, and parent-child emotion socialization play a role in a child's anxiety. However, research has focused on global behavioral and emotional tendencies derived from quantitative studies with large samples, neglecting their link to parental cognitive factors and the heterogeneity of the family's distinctive experiences. Our study aimed to broaden this knowledge, capture what parents think, feel, and behave during anxiety-enhancing childhood experiences, and identify distinct parental profiles based on these complementary elements. The present study adopted a cross-sectional qualitative design. Semi-structured interviews were conducted with 65 parents of children with anxiety disorders (9–12 years old). A content analysis was first performed, and then representations of the associations between the emergent categories obtained from the content analysis, and latent constructs that can work as major determinants in parents' responses to the child's anxiety, were assessed by a multiple correspondence analysis (MCA) combined with a hierarchical clustering algorithm. Parental cognitions, emotions, and behaviors are first derived into two distinct dimensions: capacity to respond and emotional reactivity. Three typological profiles of parents were derived from these dimensions: (a) Reactive and ineffective; (b) Unreactive and moderately effective, and (c) Anxious and effective. The qualitative exploration of parental cognitions, emotions, and behaviors in a child's anxiety context contributes to engrossing the current literature. Our results have essential implications and the need to adjust treatments in clinical settings according to parents' profiles. Highlights: Parental reactions to children's anxiety were based on their response capability and emotional reactivity. These characteristics resulted in three typological profiles of parents: reactive and ineffective; unreactive and somewhat effective; and anxious and effective. There are different parental patterns in how parents perceive and respond to their child's anxiety, highlighting significant consequences and the need to tailor interventions in clinical settings. [ABSTRACT FROM AUTHOR]

Children and adolescents (henceforth "children") with both attention-deficit/hyperactivity disorder (ADHD) and anxiety experience greater difficulties than children with either alone, though qualitative methodologies are yet to be used to understand the challenges this population experiences. We aimed to explore parent-reported daily impacts of co-occurring anxiety in children with ADHD (ages 8–13 years). Participants were enrolled in an Australian trial evaluating an adapted anxiety intervention and were eligible if their child met diagnostic criteria for ADHD plus separation, social, and/or generalized anxiety disorder. A baseline measure of life impacts associated with child anxiety captured situations parents reported were difficult, due to their child's anxiety. Reflexive thematic analysis of free-text responses (N = 203) facilitated new insights via inductively generating key themes. Three overarching themes highlighted (1) child difficulties with everyday situations and processes due to their anxiety; (2) the nature of the child's anxiety being pervasive and unrelenting; and (3) the strain placed on the child's family system. This study enhances understanding of daily impacts associated with co-occurring anxiety and ADHD and may contribute to an improved understanding of support needs. Results reiterate the need to identify co-occurring difficulties in children with ADHD and support both children and their families. [ABSTRACT FROM AUTHOR]

This study examined the level of social communication problems (SCP), social anxiety (SA), and mood problems (MP) among children with ASD (age 4–13 years) enrolled in special classes (n = 74) and regular classes (n = 73) and grade level (kindergarten, 1st–3rd, 4th–6th) from teachers' perspective in schools of Palestinian Arabs in Israel. Teachers responded to three questionnaires about (1) SCP, (2) SA and (3) MP; the teachers' responses to the questionnaires were used to answer the research questions. Results: SCP, SA and MP were of medium rates for students with ASD enrolled in regular and special classes. No significant differences in the level of SCP could be attributed to class type (Regular, Special) or the grade level (kindergarten, 1st–3rd, 4th–6th). There were significant differences in SA levels that could be attributed to grade level in favor of the 4th–6th grades but there were no significant differences according to class type (Regular, Special). There were statistically significant differences in MP levels that could be attributed to the class type in favor of special classes, and the effect of grade level was not significant. There was a direct significant relationship between SCP, SA, and MP. Conclusion: SCP may be an important risk factor for the development of SA and MP among students with ASD, which lead us to incorporating social skills interventions by educational staff to alleviate or even prevent symptoms of SA and MP among students with ASD, which supports the view of inclusion [ABSTRACT FROM AUTHOR]

Although exposure-based practices are effective in treating selective mutism, difficulties arise when the child refuses to visit a clinical center. In this situation, it is important to intervene using remote technology and to support parents who have children with selective mutism. In this patient report, an exposure-based intervention using online technology was implemented for an 8-year-old girl with selective mutism. In addition, her mother was also experiencing increased parenting stress. Therefore, the mother received behavioral parent training specifically designed for parents of children with selective mutism. As a result, the child's nervousness decreased during the intervention, and the frequency of their speech, facial expression, and body motion improved. Initially, the child refused to visit our clinical center. However, they eventually agreed and managed to communicate non-verbally with the primary author in our clinical center. Behavioral parent training for selective mutism improved her mother's understanding of the condition, the way she interacts with her child, and reduced her parenting stress. Implementing Internet-based interventions is highly beneficial because it significantly reduces the fear of clinic or hospital visits among children with selective mutism. Furthermore, behavioral parent training tailored to selective mutism to improve parental stress and interaction can be a valuable support option for parents of children with selective mutism. [ABSTRACT FROM AUTHOR]

Children with dyslexia (CwD) often report poor psychological well‐being. We examined (i) whether anxiety, self‐concept and reading motivation in CwD differed from those of typically developing children (TDC; case–control design, Study 1a) and (ii) whether these differences mirrored the linear relationships that these variables present with reading ability in the TDC group (dimensional approach, Study 1b). In Study 1a, 34 CwD were compared with 191 TDC in grades 4–8 on anxiety, self‐concept, reading motivation and reading strategy using self‐reports (controlling for sex, intelligence and math ability scores). In Study 1b, the differences that emerged in Study 1a were compared with the results obtained from a simulation procedure that generated dyslexia observations under the assumptions of a dimensional hypothesis. The CwD group presented small‐to‐moderate difficulties, which partially mirrored the predictions in the TDC group. However, violations of predictions based on the population without dyslexia were found for reading self‐concept, social anxiety and reading competitiveness. In sum, children's diagnoses affect their self‐perception as readers and social anxiety in a way that cannot be inferred from linear relationships. CwD need support to preserve an adequate image of themselves as readers and cope with social anxiety. [ABSTRACT FROM AUTHOR]

Objective • There have been studies shown the efficacy of psychological interventions in reducing preoperative anxiety in children undergoing surgery. We constructed an intervention strategy, based on the concept of co-design, for perioperative anxiety behavior in children’s outpatient surgery and conducted a prospective randomized controlled research to confirm its effectiveness. Method • This research comprised a total of 100 kids who received surgery in our outpatient clinic between January 2019 and January 2020. According to the random number table approach, all kids were divided into observation as well as control categories, each of which had 50 instances. The behavioral intervention tactics included cognitive intervention before behavioral intervention and behavioral interventions in the environment. The observation cohort was offered behavioral intervention tactics before anesthesia, whereas the control category had surgery under standard anesthesia. The two categories’ preoperative visit (T1) mean arterial pressure (MAP) & heart rates (HR) in the anesthesia preparation room (T2), during induction of anesthesia (T3) and 1 hour after surgery (T4) were compared, and the two groups’ modified facial expression score (FLACC) at T1 and T4 was compared as well; At T3, the children’ degree of cooperation and anxiety were evaluated with Induction Cooperation Scale (ICC) and modified Yale Perioperative Anxiety Scale (mYPAS). The satisfaction degree of the children’s family with the surgery was collected 7d after the operation with a Satisfaction Rating Scale prepared by our hospital. Results •The MAP in the observation group was 58.49±6.35 at T1 time, which was not a significant diference from that of the control group (60.12±7.03). Also, the HR in the observation group was 100.27±12.38 at T1 time, with no difference from that in control group. MAP and HR at T2-T4 were remarkably higher in both groups than at T1 (P < .05); & During T2-T4, the group being observed appeared to have lower MAP & HR compared to the group acting as a control (P < .05). At T3, the observation category’s ICC & mYPAS scores were significantly poorer than those of the control category (P < .05). On the seventh day following surgery, the satisfaction level of the observation category’s family with the procedure was greater than that of the control category. (P < .05). Conclusion • The behavioral intervention strategy help children undergoing outpatient surgery maintain stable hemodynamic indicators during the perioperative period, reduce their anxiety and improve their cooperation for surgery. In future, the apply of the behavioral intervention strategy will effectively improve the satisfaction of children’s family members with surgery. [ABSTRACT FROM AUTHOR]

The study was conducted with 330 children and their mothers waiting in line for examination in pediatric outpatient clinics. Child and Mother Information Forms, State-Trait Anxiety Inventory for Children, and State-Trait Anxiety Inventory were used as data collection tools. The study revealed that both children and their mothers experience moderate anxiety during the waiting period in the outpatient clinic and that there is a positive relationship between state and trait anxiety levels of children and mothers. The study observed that the state anxiety levels of children and their mothers were higher in children with previous hospitalization experience. Both state and trait anxiety levels were lower in children informed about visiting the hospital. It was concluded that prolonging the outpatient clinic waiting period increases anxiety levels in children and their mothers. [ABSTRACT FROM AUTHOR]

Education policies align with evolving needs and changes in education. Two years ago, the double reduction policy was widely welcomed. But new challenges have emerged now, it is necessary to examine whether it still meets parental expectations, and whether adjustments in details are needed. We investigated parents' perception of policy implementation intensity; and its relationship with parents' perception of educational involution; and parents' educational anxiety, as well as the roles played by gender. Findings highlight parents who perceive a stronger policy implementation intensity experience higher levels of educational anxiety and are more likely to feel educational involution; education anxiety acts as a mediator, while gender plays a moderating role. We highlighted policy's advantages while emphasizing the necessity to avoid policy rigidity and one‐size‐fits‐all. We recommend establishing a flexible, real‐time parental feedback mechanism and promoting continuous monitoring and evaluation. This approach would enable it to meet the changing demands of education. [ABSTRACT FROM AUTHOR]

Introduction. Identifying mental health problems in children is essential to preventing psychopathological problems in adolescence or adulthood and ensuring optimal development. It is important to take measures in this regard to support younger children, especially during the pandemic, which may result in emotional and behavioral problems. To this end, it is necessary to identify children's current disorders. Objective. To identify and compare the emotional and behavioral profiles of Mexican preschoolers assessed in 2006 with those assessed in 2021 (during the pandemic), under the hypothesis that those evaluated in 2021 will present with greater depression, anxiety, sleep problems and inattention than those evaluated in 2006. Method. Total sample of 608 preschoolers, including the 2006 subsample consisting of 327 children and the 2021 subsample of 281. A descriptive cross-sectional design was used, together with The Child Behavior Checklist (CBCL 1.5-5; Achenbach & Rescorla, 2000). Results. Significant differences were found between the two groups. Preschoolers evaluated in 2021 (during the pandemic) showed an increase in sleep, attention, and anxiety problems. Moreover, significant changes were observed at the item level, in which the presence of certain indicators increased during the pandemic. These included: overeating, showing little interest in their surroundings, refusing to sleep alone, being nervous or tense, having nightmares, being anxious or scared, being afraid to try new things, problems speaking or pronouncing words, an inability to concentrate or pay attention for a long time, or sit still, and shifting quickly from one activity to another. Discussion and conclusion. Increases in sleep, attention, and anxiety problems were confirmed preschoolers assess in 2021 compare to 2006 group, a group that has barely been studied in terms of mental health effects during the pandemic. It is important to conduct epidemiological studies to evaluate the change in symptomatology in preschoolers and to measure the historical biases of an event such as COVID-19. [ABSTRACT FROM AUTHOR]

Researchers continue to count the short‐ and longer‐term mental health costs for children and adolescents of the COVID‐19 pandemic and the associated exceptional restrictions imposed by governments on their lives in an attempt to control the pandemic and its impacts. Despite being at low risk of serious physical illness from COVID‐19 themselves, some studies have reported a decline in the mental health of many young people during the pandemic. Some have suggested that this could even create a risk for long‐term morbidity. In this commentary, we reflect on the excellent article by Rask and colleagues on paediatric health anxiety and consider key research gaps for the field in general and for the specific challenges and questions posed by the COVID‐19 pandemic and its legacy. [ABSTRACT FROM AUTHOR]

Health anxiety involves excessive worries about one's health along with beliefs one has an illness or may contract a serious disease. Concerning evidence suggests that health anxiety is on the rise in society, possibly further fueled by the COVID‐19 pandemic. Recent classification systems acknowledge that impairing health‐related worries and beliefs can emerge in early childhood with significant levels of symptoms persisting throughout childhood, and possibly continuous with diagnostic considerations in adulthood. This narrative review summarizes recent research advances in health anxiety in children and adolescents, focusing on various developmental aspects of health anxiety and related concepts in youths. Findings suggest that health anxiety symptoms in young age groups are associated with impairment, distress, and increased healthcare use, as well as substantial comorbidity with mainly other emotional problems and disorders. Furthermore, longitudinal studies suggest that childhood health anxiety can persist across adolescence, perhaps with links to chronic courses in adulthood. The growing literature was further reviewed, thus extending our understanding of early risk factors, including the potential role of exposure to serious illness and transgenerational transmission of health anxiety. Learning more about developmental trajectories will be highly relevant to inform strategies for early detection and prevention. While modified cognitive behavioral therapies in adults are successful in treating health anxiety, specific interventions have not yet been tested in youths. Given substantial overlaps with other psychopathology, it could be important to develop and explore more transdiagnostic and scalable approaches that take advantage of common factors in psychotherapy, while also including a wider perspective on potential familiar maladaptive illness cognitions and behaviors. [ABSTRACT FROM AUTHOR]

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Intramuscular injections, which children frequently experience during hospitalization, are one of the most significant causes of pain. Pain control is an important part of care. Therefore, it is necessary to provide practical methods in the field of nursing care to reduce injection-related pain. This study aimed to determine the effect of the Helfer skin tap technique on pain, anxiety, and fear in children undergoing intramuscular injection. This randomized controlled clinical study (NCT05250804) was conducted in a pediatric emergency department between January and July 2022. A total of 64 children aged 4–10 years were randomly divided into two groups: 32 children in the Helfer skin tap group (HG), and 32 children in the control group (CG). Data were collected using the Wong–Baker FACES Pain Rating Scale, the Child Anxiety Scale–State, and the Child Fear Scale. After the intramuscular injection, children in the HG had significantly lower levels of pain, anxiety, and fear than those in the CG, with mean scores of 3.25±1.50 versus 5.18±1.51, 5.87±1.56, versus 6.23±1.46, and 1.68±0.53 versus 3.15±0.76, respectively (p <0.001 for all scores). The Helfer skin tap technique has positive effects on pain, anxiety, and fear in children during intramuscular injection. This technique can be used by nurses to reduce the pain, anxiety, and fear felt by children receiving an intramuscular injection. [ABSTRACT FROM AUTHOR]

The goals of this study were to investigate (a) the dyadic relations of mothers' and children's perceptions of children's anxiety symptoms across development, (b) whether maternal perceptions of children's anxiety serve as a mediator of the association between maternal anxiety and child anxiety, and (c) whether sensitive/structured parenting moderates these processes. Participants were 180 mother–child dyads (96 female) recruited from Quebec, Canada, and assessed in preschool, middle childhood, and early adolescence. Mothers and children completed questionnaires on children's anxiety, and mothers additionally completed a questionnaire on their own anxiety. Maternal sensitivity/structuring was assessed from an observed interaction task. Results from an actor–partner interdependence model suggest (a) maternal perceptions of children's anxiety in middle childhood predict children's self-perceptions in adolescence, but not vice versa; (b) maternal perceptions in middle childhood mediate the link between maternal anxiety in early childhood and child self-perceptions of anxiety in adolescence; and (c) the indirect effect of maternal perceptions is moderated by maternal sensitivity/structuring such that mothers who perceived more anxiety in their children and who were observed to show lower levels of sensitivity/structuring in middle childhood tended to have children who perceived more anxiety in adolescence. Findings suggest that maternal awareness of children's anxiety may be one mechanism, in the presence of relationships characterized by lower levels of sensitivity, through which anxiety risk is transferred from parent to child over time. Public Significance Statement: This study suggests that a mother's awareness of their child's anxiety predicts how their child comes to see their anxiety across time, but not vice versa. Anxious mothers see more anxiety in their children and, when they are less sensitive and supportive, have children who perceive experiencing more anxiety. This highlights the importance of targeting parent–child communication about emotions when seeking to understand and intervene in children's anxiety. [ABSTRACT FROM AUTHOR]

Background and Objectives: The essence of Problem-based Learning (PBL) is to find a prêt-à-porter solution to a problem, which is also known as scenario. Several features differentiate this teaching methodology from other typical approaches in language teaching contexts. In order to reinforce the association between learners' construction of the required knowledge to solve an ill-structured problem when assessing different possible solutions and attempting to find an acceptable solution, learners need to collect necessary information mostly on their own with the help of a teacher as a facilitator. PBL can also be considered as a potentially useful approach to language teaching and learning, especially with regard to productive skills in which leaners practice more fluently if they experience more involvement in the learning process. The PBL also contributes to learners and learning psychological aspects. Despite the generally acknowledged benefits of PBL, it has not been commonly used, especially in foreign language learning contexts. One reason for this may have been concerns about how the method might affect foreign language learners' feeling of anxiety, self-efficacy and willingness to communicate. The major objective of this study was to bridge the gap in our understanding of how the implementation of the PBL approach affects English as a Foreign Language (EFL) learners' psychological factors of willingness to communicate, self-efficacy, and classroom anxiety. Materials and Methods: Ninety pre-intermediate EFL students were selected according to the Oxford Placement Test (OPT) and purposeful sampling method. They were randomly assigned into 3 groups of online PBL, face-to-face PBL, and control group with 30 learners in each. Students in both online PBL and face-to-face PBL classes embarked on a 10-session speaking course according to the framework of the PBL approach. Meanwhile, the control group received speaking instruction based on a conventional method other than the PBL. Three questionnaires of Willingness to Communicate (WTC), English selfefficacy, and foreign language classroom anxiety scale were administered before and after the course to all participants. Analysis of covariance (ANCOVA) was employed to analyze the data. Findings: Results showed that EFL learners in the online and face-to-face PBL classes outperformed those in the control group in their WTC and self-efficacy. In addition, learners in the online and face-to-face PBL groups meaningfully experienced a lower level of classroom anxiety compared with the control group. Conclusions: The findings of the present study suggest that the PBL approach efficiently motivates learners to communicate and interact within the classroom context. In addition, learners in the online and conventional PBL groups felt more self-determining and responsible for their learning as a result of feeling more comfortable in the learning environment. Results also shed light on the idea that due to the experiential aspect of PBL, when learners explore the solutions to the problem/scenario and discuss them with others, that forms an environment with a minimized classroom speaking anxiety. Implications are also discussed at the end of the study. [ABSTRACT FROM AUTHOR]

Although nature is recognized as a setting that stimulates children's joy and wonder, few studies have examined the negative emotions that children experience in nature. This qualitative study explored 4–5-year-old Alaskan children's emotional, behavioural, and cognitive expressions of fear and anxiety during an outdoor excursion. Data was collected through sensory tours, in which children were equipped with wearable cameras while they explored. Findings revealed that half of the 20 children expressed fear and anxiety. Four themes (physical discomfort, trouble navigating, imagined danger, feeling scared and lost) characterized children's fearful encounters. Children created fearful situations by imaging monsters, snakes, and alligators. Encountering dark and fallen limbs, navigating the tall grass and a slippery boardwalk provoked feeling lost and scared. Children self-regulated their fearful experiences through self-talk and staying close to one another. By paying attention to children's fearful emotions, adults can better support children's formative experiences in the natural world. [ABSTRACT FROM AUTHOR]

Background: Preoperative anxiety (PA) in children is a common phenomenon associated with various negative patient outcomes. Allaying PA is accepted as a standard of care, but its use is not universal and often overlooked. This survey is designed to evaluate the nationwide current practice patterns and attitudes of anesthesiologists toward the practice of allaying PA in children. Materials and Methods: A questionnaire of 25 questions, including information on methods of relieving PA in children, reasons for noncompliance, and associated complications, was framed. It was circulated among members of the Indian Society of Anaesthesiologists through an online survey of Google Forms and manually. Results: Four hundred and fifty anesthesiologists were surveyed. Responses were predominantly from anesthesiologists practicing in medical colleges across the country. Although 97% of the surveyed respondents practiced anxiety-relieving strategies, only 37% used it consistently. Seventy-three percent of anesthesiologists practiced both pharmacological and nonpharmacological techniques. The most common reason for avoiding premedication was an anticipated difficult airway (88%). Inadequate sedation was a commonly reported problem. Ninety-five percent of participants felt that PA-relieving strategies should be integral to pediatric anesthesia practice. The most common reason for not following these practices was an inadequate hospital infrastructure (67%). Ninety-seven percent of the participants believed that more awareness is required on this crucial perioperative issue. Conclusion: Only 37% of the surveyed anesthesiologists consistently used some form of PA-relieving strategy and the practice varied widely. Further improvement and team approach involving anesthesiologists, surgeons, and nurses is required to ensure the quality of pediatric PA-relieving services and establish it as a standard of care. [ABSTRACT FROM AUTHOR]

Alopecia areata (AA) is a non-scarring alopecia due to an immune-mediated damage to the hair follicles. Trichotillomania (TT) is a psychodermatologic disorder characterized by repetitive hair removal. AA and TT are common causes of hair loss in children and can be triggered by anxiety and distressful events. The simultaneous onset of AA and TT in children is rarely reported in the literature. We describe the case of a 9-year-old male child with a 3-month history of hair loss. The clinical history associated with a detailed trichoscopy led to the diagnosis of concomitant AA and TT. [ABSTRACT FROM AUTHOR]

Background: Children with intellectual disability are at greater risk of developing anxiety than the general population. Limited research has examined the challenges associated with recognising and responding to anxiety in children with intellectual disability, and its perceived impact. Aim: This study aimed to explore anxiety in children with intellectual disability, from the child and parent perspective to better understand how parents and children recognise and respond to anxiety. Method and Procedures: Six children with an intellectual disability (age range: 12–17, four boys) and their mothers participated in a semi‐structured interview online. Interviews were transcribed verbatim and interpreted using thematic analysis. Outcome and Results: Mothers elaborated on the difficulties with recognising signs of anxiety due to the impact of the child's primary diagnosis and the overlap of symptoms with co‐occurring conditions. Mothers and children discussed the 'contagious' effect of anxiety within the household and how this influenced mothers' approaches to managing their child's anxiety. They reported that anxiety limited the meaningful activities in which children and families could engage. Conclusions and Implications: These findings highlight the importance of supporting mothers to recognise their children's anxiety and to assist them with strategies on how best to respond and cope. These findings have implications for future research, and practitioners working in this field. [ABSTRACT FROM AUTHOR]

Aim: This participative, creative research aimed to explore the meaning of 'safe space' at school, defined as areas which children could access when emotionally dysregulated. This study aimed to answer the research question -- how do children and teachers understand the meaning of safe space at school? Rationale: Safe space is an overused and conceptually confused term, which has been described as the second-most popular strategy for supporting children's anxiety in UK schools. However, the scarce research literature documents adult views of the benefits of safe space, with little reference to children's perceptions. Method: A Mosaic-based approach, which offers child-centred, multi-modal methods for exploring views, was used to enable seven children and their three teachers to construct their understanding of safe space in school. Children designated as users of safe space led the researcher on a school tour and took photos of a puppet in their chosen safe spaces. Teachers participated in a semi-structured interview. Visual data was categorised using content analysis and combined with inductive, reflexive thematic analysis of verbal data to identify themes. Findings: Children's multiple, dynamic understandings of safe space generated themes of liberated places, safe bases and belonging, contrasting with teachers' differing understanding of a static, boundaried, restricted space. The value of psychological safety in school alongside giving children agency to self-regulate according to context and need is emphasised when considering safe space. Implications: Discussing the 'dilemmas of difference' regarding teachers' operationalising of a safe space in school leads to consideration of the potential implications for educational policy and practice. The value of deconstructing dominant adult discourses through visibly listening to children using a humanistic, empowering psychological framework is highlighted. Limitations: Children's words, photographs and actions were filtered and interpreted by the researcher which could be conceived as constraining child voice and furthering adult-child power imbalances. The full Mosaic approach where a platform for communication between adults and children is facilitated did not take place due to school closures because of the pandemic. Conclusions: This research extends, and to a degree challenges previous UK literature which suggests that safe space is a beneficial strategy for managing anxiety, as child participants had a more dynamic and flexible understanding of safe space than their teachers. Concerns were raised about the understanding and awareness teachers have regarding wellbeing interventions and how these have the potential to become stigmatising within a behaviourist-dominated school perspective. [ABSTRACT FROM AUTHOR]

Objective: Distraction is a highly acceptable technique for diverting a patient's attention from what may be perceived as an unpleasant procedure, reducing anxiety and helping the patient relax. The objective of the present study was to evaluate the effect of watching television during dental treatment on pediatric patients' anxiety and cooperation compared to the commonly used conventional Tell-Show-Do (TSD) behavioral management method. Method and materials: Sixty-nine children (mean age 6.8 years) scheduled to undergo restorative dental treatment were randomly divided into two intervention groups: a group that was managed by television distraction and a control group that was managed by TSD. During treatment, anxiety was assessed by the Facial Image Scale and cooperative behavior was assessed by the Frankl scale. Pulse rate and oxygen saturation were also measured during the treatment. Results: Compared to TSD, television distraction significantly reduced anxiety by 1.27 (95% confidence interval [CI] 0.798 to 1.744, adjusted P < .001), decreased pulse rate by 6.44 beats per minute (bpm) (95% CI 4.60 to 8.28, adjusted P < .001), and significantly increased cooperation by 1.17 (95% CI -1.318 to -1.020, adjusted P < .001). A greater effect of television distraction on reduced anxiety and increased cooperation was observed during administration of the anesthetic injection. No effect of television distraction on saturation levels was noted. Conclusions: Television distraction is an effective method for reducing anxiety and improving cooperative behavior in children during dental treatments. [ABSTRACT FROM AUTHOR]

Background: Procedural pain is very important in clinical children care. We aimed to evaluate the effects of active versus passive distraction for reducing procedural pain and anxiety in children. Methods: Two researchers searched the Web of Science, PubMed, EMBASE, Cochrane, SinoMed, Wanfang, China National Knowledge Infrastructure, Weipu databases for the randomized controlled trials(RCTs) on the active versus passive distraction affecting procedural pain and anxiety in children until May 18, 2023. The literature screening and data extraction were carried out by two researchers independently. Review Manager 5.3 software was used for data analysis. Results: 13 RCTs were finally included. 553 children received active distraction intervention and 551 children received passive distraction intervention. There were no significant differences in the children self-reported procedural pain betweent active and passive distraction. The parent-reported procedural pain, medical staff-reported procedural pain, children-reported procedural anxiety, parent-reported procedural anxiety, medical staff-reported procedural anxiety in the active distraction were significant less than that of active distraction. Egger regression analysis showed that there was no publication bias in the results. Conclusions: Existing evidence suggests that active distraction may be more effective in reducing operational pain and anxiety in children than passive distraction. More studies on the effects of active distraction versus passive distraction in children with larger sample size are needed in the future. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has created a crisis in students' career development. Online learning activities could not have been optimal during the pandemic due to the poor quality of the internet network. Meanwhile, more than 1.2 million individuals had their employment terminated, resulting in their job loss. The pandemic contributes to students' career anxiety and mismatches in determining future careers. Our study explored the dynamics of student career anxiety that emerged during the COVID-19 pandemic through a phenomenological approach. Data was collected using semistructured interviews by teleconference Zoom meeting. The interviews focused on 1) how the participants experience career anxiety and 2) how it affects their career planning. Fifteen students participated through purposive sampling with criteria: 19-25 years old and undergraduate students. Interpretative Phenomenological Analysis (IPA) is applied as an analysis framework. We synthesized phenomenological themes identified as students' career anxiety: doubts about career plans, limited job opportunities due to the pandemic, and social comparison. The analysis also found that engaging in career-relevant communities was relevant to career readiness and deepening knowledge of career paths. This study encourages improving student skills by adjusting educational materials, training, or internships relevant to the student's potential and career needs during this critical time. [ABSTRACT FROM AUTHOR]

Introduction: The present study was conducted with the aim of the effectiveness of philial therapy on social acceptability and anxiety sensitivity of children with symptoms of selfdestructive mood disorder. Methods: It was a semi-experimental study with a pre-test-post-test design with a control group and a follow-up period. The statistical population included 9-12-year-old children with symptoms of suicidal mood disorder in Isfahan city. 30 children with symptoms of self-inflicted mood disorder and their mothers were selected by purposive sampling and randomly assigned to experimental and control groups. The experimental group received Filial Landreth play therapy intervention (2013) during two months in 8 sessions of 60 minutes. Research tools included Ford and Robin's (1970) social acceptability questionnaire and Tsao et al.'s (2006) anxiety sensitivity questionnaire. The data obtained from the research was analyzed by the method of variance analysis with repeated measurements using SPSS-29 statistical software. Results: The results showed that the filial therapy intervention had a significant effect on the social acceptability and anxiety sensitivity of children with symptoms of self-destructive mood disorder (P<0.001). In this way, this intervention was able to lead to the improvement of social acceptability and the reduction of anxiety sensitivity of these children. Conclusions: Based on the findings, it can be concluded that philial therapy using techniques such as lectures, discussion, role playing, group processes and supervision can be an effective treatment to improve social acceptability and reduce anxiety sensitivity of children with the symptoms of self-inflicted mood disorder should be used. [ABSTRACT FROM AUTHOR]

The aim of this study was to describe and compare routines and behaviors in a sample of children from three countries during the mandatory quarantine of the COVID-19 pandemic and to analyze their connections to anxiety. A total of 335 children aged 3 to 7 years from Spain, Argentina and the United States participated in the study. The instruments used were the Routine and Behavior Scale (RBS) and the Preschool Anxiety Scale (PAS). Using network sampling through online questionnaires in Spanish and English, the results showed differences in routines and behaviors patterns in participants from countries under confinement, as well as higher anxiety scores. The negative repercussions of confinement may affect a child’s welfare. It is therefore necessary to carry out cross-cultural studies in order to enable the early detection of psychopathological symptoms and promote prevention and intervention programs. [ABSTRACT FROM AUTHOR]

Background: Children of caregivers with problematic substance use are at an increased risk for adverse childhood experiences, such as neglect, intentional and unintentional abuse, and household dysfunction. These experiences can contribute to anxiety, which is the most common mental health concern for children. Anxiety has multiple short- and long-term adverse effects. Aim: To describe the anxiety-provoking experiences of children living with caregivers who experience problematic substance use. Methods: Secondary analysis using exploratory, inductive thematic analysis was conducted on 16 interviews of individuals affected by substance use disorder in the Prince Albert, Saskatchewan area. The focus of the analysis is to describe anxiety-provoking experiences of children living in homes affected by a caregiver's substance use. Results: Three main themes were identified and included experiencing trauma, living in an unstable home environment, and resiliency in adulthood. Conclusion: Children who lived with caregivers with problematic substance use faced anxiety while living in an unstable home environment and experiencing traumatic events. This anxiety continued into adulthood. These children demonstrated resiliency despite the hardships they faced. This research contributes to understanding childhood anxiety in the context of living with caregivers with problematic substance use and the importance of using a trauma-informed approach when working with children. [ABSTRACT FROM AUTHOR]

Shyness can manifest on behavioral, affective, and physiological levels, but little is known about how these components cluster. We coded behavioral expressions of avoidance/inhibition, collected self‐reported nervousness, and measured cardiac vagal withdrawal in 152 children (Mage = 7.82 years, 73 girls, 82% White) to a speech task in 2018–2021. A latent profile analysis using these behavioral, affective, and physiological indicators revealed four profiles: average reactive (43%), lower affective reactive (20%), higher affective reactive (26%), and consistently higher reactive (11%). Membership in the higher reactive profile predicted higher parent‐reported temperamental shyness across 2 years. Findings provide empirical support for the long‐theorized idea that shyness might exist as an emotional state but also represents a distinct temperamental quality for some children. [ABSTRACT FROM AUTHOR]

This study investigated emotion transmission among peers during middle childhood. Participants included 202 children (111 males; race: 58% African American, 20% European American, 16% Mixed race, 1% Asian American, and 5% Other; ethnicity: 23% Latino(a) and 77% Not Latino(a); Mincome = $42,183, SDincome = $43,889; Mage = 9.49; English‐speaking; from urban and suburban areas of a mid‐Atlantic state in the United States). Groups of four same‐sex children interacted in round‐robin dyads in 5‐min tasks during 2015–2017. Emotions (happy, sad, angry, anxious, and neutral) were coded and represented as percentages of 30‐s intervals. Analyses assessed whether children's emotion expression in one interval predicted change in partners' emotion expression in the next interval. Findings suggested: (a) escalation of positive and negative emotion [children's positive (negative) emotion predicts an increase in partners' positive (negative) emotion], and (b) de‐escalation of positive and negative emotion (children's neutral emotion predicts a decrease in partners' positive or negative emotion). Importantly, de‐escalation involved children's display of neutral emotion and not oppositely valenced emotion. [ABSTRACT FROM AUTHOR]

Background: Dental anxiety is defined as the apprehension and fear of terrible events occurring during dental treatment, coupled with a sense of losing control. There are numerous individual and environmental factors causing dental anxiety in children, with the most significant environmental factor being the family environment in which the child is raised. Purpose: To break a possible cycle of dental anxiety within families, it may be necessary to assess and particularly address the level of dental anxiety in parents, especially mothers. In eliminating dental anxiety, providing parents with information to reduce their dental worries and teaching them coping strategies will be a significant step in minimizing the impact of these anxieties on their children. Reviews: The fears related to dental treatments of parents and/or siblings can induce dental anxiety in children. Studies have found that children with odontophobic parents are more likely to develop odontophobia. Additionally, research results indicate that dental anxiety can be transmitted among family members through modeling. Conclusion: Our literature review indicates that dental anxiety is significantly widespread among both children and adults in society. The observation that children with parents who suffer from dental anxiety tend to have a higher level of dental anxiety themselves suggests that resolving this issue should begin with the parents. [ABSTRACT FROM AUTHOR]

Background: Considering the heterogenous evidence, a systematic review of the change in anxiety in European children and adolescents associated with the COVID-19 pandemic is lacking. We therefore assessed the change compared with pre-pandemic baselines stratified by gender and age as well as evaluated the impact of country-specific restriction policies. Methods: A registration on the 'International Prospective Register of Systematic Reviews' (PROSPERO) occurred and an a priori protocol was published. We searched six databases (PubMed, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, WHO COVID-19) using a peer-reviewed search string with citation tracking and grey literature screening. Primary outcomes were: (1) general anxiety symptoms; and (2) clinically relevant anxiety rates. We used the Oxford COVID-19 Stringency Index as an indicator of pandemic-related restrictions. Screening of title/abstract and full text as well as assessing risk of bias (using the 'Risk of Bias in Non-randomized Studies of Exposure' [ROBINS-E]) and certainty of evidence (using the 'Grading of Recommendations Assessment, Development and Evaluation' [GRADE]) was done in duplicate. We pooled data using a random effects model. Reporting is in accordance with the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) statement. Results: Of 7,422 non-duplicate records, 18 studies with data from 752,532 pre-pandemic and 763,582 pandemic participants met full inclusion criteria. For general anxiety symptoms the total change effect estimate yielded a standardised mean difference (SMD) of 0.34 (95% confidence interval [CI], 0.17–0.51) and for clinically relevant anxiety rates we observed an odds ratio of 1.08 (95%-CI, 0.98–1.19). Increase in general anxiety symptoms was highest in the 11–15 years age group. Effect estimates were higher when pandemic-related restrictions were more stringent (Oxford Stringency Index > 60: SMD, 0.52 [95%-CI, 0.30–0.73]) and when school closures (School Closure Index ≥ 2: SMD, 0.44 [95%-CI, 0.23–0.65]) occurred. Conclusion: General anxiety symptoms among children and adolescents in Europe increased in a pre/during comparison of the COVID-19 pandemic; particularly for males aged 11–15 years. In periods of stringent pandemic-related restrictions and/or school closures a considerable increase in general anxiety symptoms could be documented. PROSPERO registration: CRD42022303714. [ABSTRACT FROM AUTHOR]

Background: Gray matter morphometry studies have lent seminal insights into the etiology of mental illness. Existing research has primarily focused on adults and then, typically on a single disorder. Examining brain characteristics in late childhood, when the brain is preparing to undergo significant adolescent reorganization and various forms of serious psychopathology are just first emerging, may allow for a unique and highly important perspective of overlapping and unique pathogenesis. Methods: A total of 8645 youth were recruited as part of the Adolescent Brain and Cognitive Development study. Magnetic resonance imaging scans were collected, and psychotic-like experiences (PLEs), depressive, and anxiety symptoms were assessed three times over a 2-year period. Cortical thickness, surface area, and subcortical volume were used to predict baseline symptomatology and symptom progression over time. Results: Some features could possibly signal common vulnerability, predicting progression across forms of psychopathology (e.g. superior frontal and middle temporal regions). However, there was a specific predictive value for emerging PLEs (lateral occipital and precentral thickness), anxiety (parietal thickness/area and cingulate), and depression (e.g. parahippocampal and inferior temporal). Conclusion: Findings indicate common and distinct patterns of vulnerability for varying forms of psychopathology are present during late childhood, before the adolescent reorganization, and have direct relevance for informing novel conceptual models along with early prevention and intervention efforts. [ABSTRACT FROM AUTHOR]

Children and adolescents are at a significantly high risk of mental health problems during their lifetime, among which are depression and anxiety, which are the most common. Life skills education is one of the intervention programmes designed to improve mental wellbeing and strengthen their ability to cope with the daily stresses of life. This review aimed to identify and evaluate the effect of life skills intervention on the reduction of depression, anxiety and stress among children and adolescents. Following the Population, Intervention, Comparison and Outcome (PICO) model and the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2009 checklist, eight databases (Academic Search Complete, CINAHL, Cochrane, MEDLINE, Psychology and Behavioural Sciences Collection, PubMed, Scopus and Web of Science) were systematically reviewed from 2012 to 2020. The search was limited to English papers only. It included published experimental and quasi-experimental studies addressing the effect of life skills interventions on the reduction of at least one of the following mental health disorders: depression, anxiety and stress among children and adolescents (from the age of 5 years old to 18 years old). We used the Joanna Briggs Institute checklist for experimental and quasi-experimental studies to evaluate the quality of the included studies. This study was registered in PROSPERO [CRD42021256603]. The search identified only 10 studies (three experimental and seven quasi-experimental) from 2,160 articles. The number of the participants was 6,714 aged between 10 years old and 19 years old. Three studies in this review focused on depression and anxiety, whereas one study investigated depression and the other anxiety. Three studies targeted only stress and two examined the three outcomes, namely, depression, anxiety and stress. Almost in all studies, the life skills intervention positively impacted mental disorders, considering the differences among males and females. The overall methodological quality of the findings was deemed to be moderate to high. Our results clearly indicated the advantages of life skills programmes among adolescents in different settings and contexts. Nonetheless, the results highlight some important policy implications by emphasising the crucial roles of developers and policymakers in the implementation of appropriate modules and activities. Further research examining life skills intervention with a cultural, gender perspective, age-appropriate and long-term effect is recommended. [ABSTRACT FROM AUTHOR]

We aimed to assess anxiety of children with primary ciliary dyskinesia (PCD) and their primary caregivers at the beginning of Coronavirus disease-2019 (COVID-19) pandemic and change in levels of anxiety in first year with prolongation of pandemic. This was a two-step study; first step was questionnaire-based, conducted via teleconference. In first step, 29 patients and 105 healthy children and their mothers were participated; 25 children with PCD and their mothers were in second step. Demographic characteristics, clinical informations were recorded. Children's and mothers' state and trait anxiety levels were assessed and compared. Anxiety levels of mothers of patients were assessed according to clinical characteristics of children. Mothers' knowledge of COVID-19 and effect of teleconference on their anxiety was evaluated. State anxiety levels in the first year of pandemic of children with PCD and their mothers were also compared. Compared to control group, state anxiety of children in 13-18 age group and trait anxiety of their mothers were lower (p<0.05). In both groups, trait and state anxiety of 13-18 years old children and mothers positively correlated. Trait anxiety of mothers of patients negatively correlated with patients' FEV1 and MEF25-75. Patients' mothers reported feeling less anxiety at the end of teleconference. Anxiety of mothers of patients (especially under 9 years old) had increased as pandemic continued. At the beginning of pandemic, children with PCD were less anxious than healthy children, and their mothers had lower trait anxiety than mothers of healthy children. Being followed for chronic disease and obtaining information about COVID-19 may have reduced anxiety of children with PCD and their mothers. However, as pandemic continues, need to protect their children with PCD from infection, especially of mothers with younger children, may have raised their concerns. [ABSTRACT FROM AUTHOR]

Two experiments investigated perceived and physiological changes in anxiety in children (7–11 years; N = 222; 98 female) in a performance situation after they observed another child in a similar situation with a negative or neutral outcome. The sample's London, United Kingdom, school catchment areas ranged from low to high socioeconomic statuses with 31% to 49% of children from ethnic minority backgrounds. In Study 1, participants watched one of two films of a child playing a simple musical instrument (a kazoo). In one film, an audience of peers responds negatively to the performance. In the other film, the audience response was neutral. Participants were then filmed playing the instrument themselves and measures of perceived and actual heart rate were taken along with individual differences in trait social anxiety, anxiety sensitivity, and effortful control. To better understand findings from Study 1, Study 2 replicated Study 1 but added a manipulation check and measures of effortful control and self-reported anxiety. Multiple regression analyses found watching a negative performance film, compared with a neutral one, was associated with a blunted heart rate response for children with low effortful control (Study 1 and 2). These findings suggest that children who are low in effortful control may disengage during performance tasks if the situation's social threat is elevated. Hierarchical regression analyses found that, compared to the neutral film, the negative performance film elevated children's self-report anxiety (Study 2). Overall, the findings indicated that anxiety in performance situations can be elevated after observing peers' negative experiences. Public Significance Statement: These studies show that children's own feelings of performance-related anxiety are influenced by observing peers' experiences and poor self-regulation may alter how increased social threat is processed. Findings suggest negative experiences of peers in social contexts could contribute to children's anxiety development. [ABSTRACT FROM AUTHOR]

En pédopsychiatrie, le modèle classique de prise en charge, les consultations thérapeutiques, implique la continuité du suivi par le même thérapeute dès le premier entretien. Ce modèle nécessite toutefois des ressources en personnel qui ne sont souvent plus disponibles dans nos systèmes de soins. Selon le lieu, les enfants attendent plusieurs mois à plusieurs années avant d'obtenir un premier rendez-vous avec un spécialiste. À Genève, une unité pédopsychiatrique ambulatoire pour enfants d'âge préscolaire propose depuis plusieurs années une approche différente dans laquelle les familles sont d'abord vues par un pédopsychiatre expérimenté lors d'une consultation unique (CU), avec pour objectifs de réduire le temps d'attente avant le premier rendez-vous, soulager l'anxiété parentale, donner un premier conseil et/ou avis et orienter si nécessaire les familles vers un autre thérapeute au sein de la même unité ou vers une autre structure. À travers une étude observationnelle menée entre mars 2019 et février 2020 auprès de 79 familles ayant bénéficié de ce modèle, nous avons cherché à évaluer sa pertinence, son acceptation par les familles et les thérapeutes ainsi que ses avantages et inconvénients. Les données ont été collectées dans une unité de pédopsychiatrie ambulatoire pour enfants d'âge préscolaire, la Guidance infantile, qui fait partie des Hôpitaux Universitaires de Genève. Les résultats de cette étude ont montré la pertinence de ce modèle et son acceptabilité par les familles nécessitant une aide psychiatrique pour leurs enfants en âge préscolaire. La majorité des familles apprécie la rapidité de la prise en charge, plus importante à leurs yeux que la continuité des soins par le même thérapeute. Les cliniciens, qui au début émettaient des réserves quant au changement de thérapeute, sont eux aussi satisfaits par ce modèle, soulignant notamment l'apport positif de la CU à l'établissement de l'alliance thérapeutique. Ce modèle devrait cependant pouvoir être utilisé avec une certaine flexibilité. Il semble en effet opportun que le thérapeute de la CU puisse dans certains cas prévoir une deuxième séance afin d'approfondir l'évaluation initiale, et également qu'il puisse continuer lui-même le suivi s'il estime lors de la CU que la famille est à risque de rupture de soins en cas de changement de thérapeute ou de délai d'attente supplémentaire. In child psychiatry, the classic model of care, which is the therapeutic consultations, implies a continuity of care by the same therapist from the first session. The strong emotional charge which emerges from this first consultation favours the therapeutic alliance. This model requires staff resources which are often no longer available in our care systems. Depending on the area, children have to wait several months to several years to get a first appointment with a specialist. A Geneva outpatient child psychiatric unit for preschool children has experimented a different approach in which families are first seen by an experienced child psychiatrist for a single consultation (SC) with the following objectives: to reduce the waiting time before the first appointment, to relieve parental anxiety, to give initial advice and to refer families to care with another therapist if needed, either within the same unit or to another structure. In this article, we examine, through an observational study, the relevance of this model, its acceptance by families and therapists, as well as its advantages and limitations. An observational study was conducted between March 2019 and February 2020 among 79 families who benefited from this model. The data were collected in an outpatient child psychiatry unit for preschool children, the Guidance infantile, which is part of the Geneva University Hospitals. Exclusion criteria were: no French speaking, the presence of a legal third party during the session (minor protection service, lawyer), or a known clinical contraindication to a change of therapist. Four questionnaires were distributed along the study. The first and second were respectively completed by the family and the therapist immediately after the SC. The third was filled out by the family by telephone two months after the SC and the fourth was completed by the second therapist in charge of the therapy after the SC, if therapy took place in the same unit. At the end of the 79 SCs, 41 indications for continuation of care in the Guidance were made, 26 of them also including a parallel referral to an outpatient care structure. 24 patients were referred only to outpatient care, and for 14 patients no further care was indicated or desired by the parents. The SCs lasted between 60 and 90 minutes. Regarding their concern about their child, 65% of families noticed a reduction of anxiety immediately after the SC and 51% two months after the SC. 75% answered that the SC helped them to better tolerate the wait before the rest of the treatment. However, this waiting time was still perceived as too long by 22% of families. Most parents (51% after the SC and also after 2 months) perceived the change of therapist as "not problematic at all". When the patient was redirected toward a junior therapist inside the same care unit, the written report and oral transmissions facilitated the follow-up. All of the second therapists considered that the change of clinician had no negative impact on the establishment of a therapeutic alliance. On the contrary, 63% of them noted that the SC had favored the alliance. Good clinical practice requires the development of therapeutic models that take into account their quality, effectiveness and cost effectiveness. The lack of child psychiatrists, together with the increase in needs, pushes us to think about new modes of care which take into account the particularity of child psychiatric care in which the therapeutic alliance constitutes a major stake. The results of this observational study show the relevance and acceptability of this model in a population of families seeking psychiatric help for preschool children. The families noted fare more advantages than inconveniences with this new practice. The majority of them appreciated the rapid management of care, which was more important to them than the continuity of care by the same therapist. The clinicians, who were mainly doubtful about this model, gave a positive evaluation, in particular by realizing that the therapeutic alliance was not negatively impacted by the change of therapist. However, this model should be applied with some flexibility by allowing a second session when clinically useful to improve the evaluation or the referral and by allowing the SC's therapist to continue the assessment and the treatment with families who are at risk of disruption of care if there is a change of therapist or an additional waiting period. [ABSTRACT FROM AUTHOR]

Parenting communication and parenting style, including expressions of fear, worry, and threat, may contribute to children's anxiety and apprehension. This study examined the degree to which perceptions of parental communication (both verbal and nonverbal) and parenting style are linked with childhood anxiety. This is among the first studies to investigate these relationships in a Saudi Arabian context. We employed a sample of 121 Saudi adults who completed questionnaires measuring perceptions of 2 parenting styles (authoritative and authoritarian), parental anxiety, and childhood anxiety. Parental communication elements such as shouting, criticism, facial expression, and body expressions were included among assessments of perceived parental anxiety, authoritative style, and authoritarian style. The results indicated that perceptions of childhood anxiety were positively associated with parental anxiety but not consistently associated with other assessed variables. This research addressed perceptions of parental communication and parenting style in the development of childhood anxiety, extending upon previous research on Western samples to a Middle Eastern sample residing in Saudi Arabia. [ABSTRACT FROM AUTHOR]

In a growing body of literature, poor sleep quality has been associated with externalizing problems. In adults, anxiety was found to mediate the relationship, and callous-unemotional (CU) traits were found to moderate it. We sought to examine these relationships in a child population. We examined these relationships in 239 clinic-referred youth (age 6–17) in Singapore with externalizing behavior problems. Parent- but not child-rated sleep problems were associated with increased parent-rated externalizing problems. This association was partially mediated by anxiety. Unlike in adults, CU traits did not moderate the relationship. Sleep problems were associated with externalizing problems regardless of the level of CU traits. It is possible externalizing behaviors may lead children to internalize experiences, leading to anxiety about their behaviors. Another possibility is externalizing behaviors may lead to more stressful life experiences due to negative reactions children with externalizing behaviors receive from parents, teachers, or peers. Regardless, the partial mediation found indicates anxiety may be an important factor to consider in future interventions focused on improving sleep as a means to reduce externalizing problems. [ABSTRACT FROM AUTHOR]

In this study, I measured and evaluated the levels of assertiveness, anxiety, and retention in children. For this purpose, I recruited a total of 135 healthy children (with parental consent) aged 8-9 years, both boys and girls, studying in the third grade of a primary school. I employed "the Assertiveness Inventory for Children", "Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV)", and "Benton Visual Retention Test (BVRT)" to measure and evaluate the data. I calculated frequency and percentage distributions for gender distribution, mean, standard deviation, minimum and maximum values for assertiveness, anxiety and retention levels as descriptive statistics during statistical evaluations of all data. On the other hand, as inferential statistics, Mann Whitney U-Test was performed for the differences between the means according to gender for assertiveness, anxiety and retention tests, and Spearman Rank-Order Correlation Tests were performed for the relationship between assertiveness, anxiety and retention levels. Based on the evaluations, it was determined that the assertiveness, anxiety and retention scores of the children were 31.45, 35.11, and 11.11, respectively. Similarly, the mean assertiveness, anxiety and retention scores of boys and girls were 31.81 and 31.02, 34.03 and 36.53, 10.75 and 11.56, respectively, and there was no statistically significant difference between the mean scores of boys and girls (P>0.05, P>0.01). However, the anxiety scores of children decreased significantly (P<0.01) as their assertiveness scores increased. The findings revealed that there was no difference between the assertiveness, anxiety and retention levels of 8-9 years old children according to gender, but the level of assertiveness may affect the level of anxiety in boys and girls. [ABSTRACT FROM AUTHOR]

Objective: This study determined whether children have sleep disorders during the Coronavirus disease-2019 (COVID-19) pandemic restriction process, and if they do, to determine in which areas they have problems with sleep, as well as to examine the relationship of sleep disorder with chronotype and coronavirus anxiety. Materials and Methods: In April-November 2020, 98 patients attending Kocaeli University Child Psychiatry clinics and attending primary school 1-4th grade were recruited. "Sociodemographic Form", "Child Sleep Habits Questionnaire", and "Children's Chronotype Questionnaire" were applied to the parents. The short form of the "Coronavirus Anxiety Scale" and the information form about the pandemic process were applied to the children. Results: According to the sleep habits questionnaire, 70.4% of the group had clinically significant sleep problems. The most common sleep disorders observed in our study; are bedtime resistance, delayed falling asleep, and nighttime awakenings. A significant relationship was found between physical illness in the family (p=0.019), smoking (p=0.032), sleep pattern change during the pandemic (p=0.002), sleep change of the mother (p=0.006) and/or father (p=0.035), change in appetite (p=0.010), and sleep disorder. According to the chronotype scale, 66 children were morning and children's anxiety toward coronavirus was low. Conclusion: Our study shows that sleep disturbance in children is marked during the pandemic period, but this is due to changes in sleep patterns and parents' sleep rather than problems related to anxiety or chronotype associated with the pandemic. It will be useful to question these factors and make arrangements in this direction when evaluating the sleep-related problems of patients who apply to outpatient clinics. [ABSTRACT FROM AUTHOR]

Introduction There are approximately 1.5 million U.S. military-dependent children. However, little is known about mental health referrals for these youths. This study sought to examine the type of mental health treatment referrals made by primary care providers for child military-dependent beneficiaries receiving care in the direct (within Military Treatment Facilities) and private care (civilian-fee-for service facilities) sectors of the Military Health System. Materials and Methods A between-subjects, cross-sectional study was performed on children aged 5–18 years old in fiscal years 2011–2015 and enrolled in TRICARE Prime. Study analyses examined specialty ("talk therapy") mental health care and psychotropic medication referrals from TRICARE Prime (the Defense Health Agency-managed health care program) providers for beneficiary children diagnosed with attention-, mood-, anxiety-, or behavior-related disorders in direct versus private sector care. Results Of 1,533,630 children enrolled in TRICARE Prime (50.03% female), 8.6% (n  = 131,393) were diagnosed with a psychological disorder during FY 2011–2015. Most were attention-related (5.2%, n  = 79,770), followed by mood (1.7%, n  = 25,314), anxiety (1.1%, n  = 16,155), and conduct-related diagnoses (0.7%, n  = 10,154). Adjusting for age, sex, and sponsor rank, children within direct care diagnosed with attention-related disorders were 1.7 times more likely to receive a prescription for psychotropic medication than those in private sector care, odds ratio (OR) = 1.72, 95% confidence interval (CI): [1.66, 1.77]. Children diagnosed with mood-related disorders in direct care were 2.1 times more likely to receive a prescription for psychotropic medication than those in private sector care, OR = 2.08, 95% CI: [1.96, 2.21]. Across disorders, children who received private sector care were more likely to have a referral specialty mental health ("talk therapy") follow-up (ps  < 0.0001). Conclusions For attention- and mood-related disorders, but not anxiety- or conduct-related disorders, direct care providers were more likely than private sector care providers to prescribe psychotropic medications. Inconsistencies of provider referrals within and outside of the Military Health System should be elucidated to determine the impact on outcomes. [ABSTRACT FROM AUTHOR]

The study investigated Peer Victimisation and Mental Health of Primary School Pupils. Respondents comprised 235 primary school pupils selected from nine primary schools across three Local Government Areas in Ekiti State, Nigeria. The participants were between 6 and 11 years and were stratified into lower and upper primary classes. The Multidimensional Peer-Victimisation Scale, Children's Depression Inventory-Short, and Multidimensional Anxiety Scale for Children were used to elicit information for the study. The results indicated that respondents reported largely high levels of peer victimisation with verbal victimisation as the most common form of peer victimisation. There were significant differences between male and female respondents on verbal and social forms of peer victimisation. Also, the study established that feeling unhappy and nervousness were forms of depression and anxiety experienced as a result of peer victimisation. The study brings into attention the need to encourage a consistent checking of victimisation rates and identify pupils that are at risk. [ABSTRACT FROM AUTHOR]

The aim of this study was to review the research which focused on ‘Reading Anxiety’ in Turkish language systematically. According to the questions derived from the aim, 16 papers were re-examined based on the rules of systematic review method. These papers were analysed in terms of their aims, designs, sampling and results. In addition to this, similarities and differences of the reviewed papers were discovered. It was seen that these studies were conducted with primary and middle school students. It was also found that the methodology of these reviewed studies was designed with quantitative approaches. The results of the review indicates that reading anxiety is related with reading comprehension, reading habit, reading fluency and reading motivation. Such factors as gender, parents‟ income, having books and place of residence have relation with reading anxiety. The results gathered from reviewed papers suggest that studies designed with qualitative and mixed-method are needed. Additionally, focusing on various topics related with „reading anxiety‟ with different participant groups are needed. In conclusion, it is believed that this systematic review study can provide fruitful information for the area and new perspectives for the further studies. [ABSTRACT FROM AUTHOR]