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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]

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]

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]

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]

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]

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]

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]

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 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]

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: 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]

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: 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]

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]

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]

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]

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]

This article explores the influence of nursing uniforms on pediatric patient anxiety and caregiver perception. With health care institutions adopting standardized uniforms, questions arise regarding their effects on patient comfort and caregiver trust. While pediatric patients often prefer colorful and playful uniforms, caregivers lean toward standardized attire for ease of identification. Nurses demonstrate a willingness to adapt uniforms based on patient preferences, highlighting patientcentered care. Conflicting findings underscore the need for further research to inform uniform policies. Balancing patient comfort with caregiver preferences is essential for fostering a supportive care environment. [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]

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 aim of the current investigation was to compare the association between attachment and behaviour problems in children attending regular schools and children attending special education schools with a focus on emotional and social development. We draw upon data collected from 169 children attending regular schools (Mage = 9.66), and 91 children attending special education schools (Mage= 10.52). The children completed the Experiences in Close Relationships Scale-Revised (ECR-RC), which assess their maternal attachment-related anxiety and avoidance. Parents completed the Child Behaviour Checklist (CBCL/6-18 R) which captures their child's internalising and externalising problems. Special education children showed higher levels of attachment-related anxiety and avoidance, than regular education children. Furthermore, regular and special education children showed different associations between attachment and internalising and externalising problems. Our results have implications for the transferability of previous research findings from children without to children with special needs and highlight the importance of considering maternal attachment for children attending special education schools. [ABSTRACT FROM AUTHOR]

Objective: Some children experience a significant deal of anxiety during the outbreak of COVID-19. Behavioral dimensions of the executive function appear to link to situational anxiety experience. Therefore, the primary aim of the present study is to investigate the relationship between self-related skills of executive functions and the level of anxiety in children (8-12-years-old) during the outbreak of COVID-19. Also, the secondary goal of this study is to predict the level of anxiety based on self-related skills of executive functions. Method: Parents of 300 children filled out the Barkley Deficits in Executive Functioning Scale (BDEFS) and the COVID- 19 anxiety scale. Data were analyzed using correlation and path analysis. A significance level of less than 0.05 was set for all tests. Data were analyzed using SPSS 22 software. Results: Results demonstrated that self-related skills of executive functions can predict 28% of COVID-19 anxiety. The subscales of self-management (P < 0.015, t = 5.56), self-regulation (P < 0.011, t = 6.37), self-restraint (P < 0.035, t = 4.29) and emotional self-organization (P < 0.042, P = 0.222) predicted coronavirus anxiety, but self-motivation (P < 0.05, P = 0.894) did not. Conclusion: Given that most subscales of executive function predict anxiety tied to critical situations such as the prevalence of the corona virus, it seems that greater attention should be allocated to the fostering and development of children's executive functions by teaching such skills at home by families. [ABSTRACT FROM AUTHOR]

Background: A growing body of evidence supports the efficacy of measurement-based care (MBC) for children and adolescents experiencing mental health concerns, particularly anxiety and depression. In recent years, MBC has increasingly transitioned to web-based spaces in the form of digital mental health interventions (DMHIs), which render high-quality mental health care more accessible nationwide. Although extant research is promising, the emergence of MBC DMHIs means that much is unknown regarding their effectiveness as a treatment for anxiety and depression, particularly among children and adolescents. Objective: This study uses preliminary data from children and adolescents participating in an MBC DMHI administered by Bend Health Inc, a mental health care provider that uses a collaborative care model to assess changes in anxiety and depressive symptoms during participation in the MBC DMHI. Methods: Caregivers of children and adolescents participating in Bend Health Inc for anxiety or depressive symptoms reported measures of their children's symptoms every 30 days throughout the duration of participation in Bend Health Inc. Data from 114 children (age 6-12 years) and adolescents (age 13-17 years) were used for the analyses (anxiety symptom group: n=98, depressive symptom group: n=61). Results: Among children and adolescents participating in care with Bend Health Inc, 73% (72/98) exhibited improvements in anxiety symptoms and 73% (44/61) exhibited improvement in depressive symptoms, as indicated by either a decrease in symptom severity or screening out of completing the complete assessment. Among those with complete assessment data, group-level anxiety symptom T-scores exhibited a moderate decrease of 4.69 points (P=.002) from the first to the last assessment. However, members' depressive symptom T-scores remained largely stable throughout their involvement. Conclusions: As increasing numbers of young people and families seek DMHIs over traditional mental health treatments due to their accessibility and affordability, this study offers promising early evidence that youth anxiety symptoms decrease during involvement in an MBC DMHI such as Bend Health Inc. However, further analyses with enhanced longitudinal symptom measures are necessary to determine whether depressive symptoms show similar improvements among those involved in Bend Health Inc. [ABSTRACT FROM AUTHOR]

Objective: Depression and anxiety are common in children and a major cause of many illnesses and disabilities in this age group; Moreover, parents have the greatest impact on shaping the mental health and well-being of their children and there is a vast literature describing the importance of parenting factors in the development of depression and anxiety in children. Methods: We used the experimental research design in this study. The sample consisted of 34 children with depression and anxiety who were randomly allocated into ACT on parenting (intervention) and control groups via the randomization method. The intervention group received eight 2-h sessions weekly. The revised child anxiety and depression scale, parent short versions and the self-compassion scale were administered in both groups. The analyses of covariance (ANCOVA) and the repeated measures of analysis of variance (ANOVA) were employed to determine the difference between the intervention and control groups on depression, anxiety, and self-compassion. Results: ANCOVA and repeated measures ANOVA results showed clinically significant changes in depression and anxiety in children and self-compassion in parents in the intervention group (P<0.001). The Mean±SD of depression in the intervention group was 16.50±0.89 at baseline, which significantly decreased to 2.94±3.27 at post-measure and 2.25±3.35 at followup (P<0.001). The Mean±SD of anxiety was 18.19±1.87, which significantly decreased to 7.63±4.34 at post-measure and 7.06±4.52 at follow-up (P<0.001). Additionally, the mean and SD score of self-compassion was 56.43±3.14 in pre-intervention, which significantly improved to 97.18±3.72 in post-intervention and 98.25±4.76 at follow-up (P<0.001). Conclusion: The results show that ACT-based parenting is an effective treatment for depression and anxiety in children. This method also improves self-compassion in parents. [ABSTRACT FROM AUTHOR]

This study examines the relationship between religious and spiritual (R/S) struggle and religiosity with depression and anxiety in adolescents admitted to inpatient psychiatric units of a pediatric hospital in the Midwest of the United States. We administered four self-reported scales to 71 adolescents (ages 13–17) to assess religiosity, R/S struggle, depression, and anxiety. The prevalence of R/S struggle among this population was high (88.73%). Significant associations were found between R/S struggle and depression and anxiety, linking greater R/S struggles with more severe depression or anxiety. However, no significant associations between religiosity and depression and anxiety were noted. By examining the prevalence of R/S struggle among this population and its relationship to depression and anxiety, this study contributes to the expanding research on the impact of religion and spirituality on the psychological well-being of adolescents. [ABSTRACT FROM AUTHOR]

Screening for adverse childhood experiences (ACEs) can help prevent and reduce adverse outcomes on child development, including increased risk for anxiety disorders. Emerging studies strongly support the inclusion of community-level adversities in ACE screeners to consider diverse contexts and populations. Recent studies suggest that community violence exposure (CVE) may have a distinct impact on youth mental health. Although recent studies have examined the association between ACEs, CVE, and mental health in primary care settings, this association has not been examined on treatment-seeking children in urban mental health settings. The present study employs a mediation model using the PROCESS macro to examine community violence exposure mediating the effect on the association between ACEs and somatic symptoms (SS) on a sample of anxious treatment-seeking children. A total of 98 participants (Mage = 11.7, SD = 3.79, 51.6% males, 54.1% ethnic minority children) who sought services at a specialized anxiety clinic completed self-report measures. Results indicated that exposure to ACEs is associated with endorsement of somatic symptoms as a result of reporting hearing, witnessing, or experiencing CVE. Evidence of mediation was found in a statistically significant indirect effect of ACEs on SS through CREV (Effect =.17, 95% CI =.069–.294). These findings support recent evidence that CVE is a distinct ACE as it contributes to toxic stress similar to individual-level ACEs. The use of a comprehensive ACE screening that includes CVE is warranted, particularly when working with culturally and socioeconomically diverse populations, as it would better capture a broader range of adversities across demographic groups. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 crisis influenced the lives of families and preschoolers, worldwide. School closures and restriction measures introduced distance learning for preschoolers and remote working for parents. Social distancing narrowed opportunities to meet with peers and enjoy leisure activities. Additionally, social and mental services closures limited young children's accessibility to mental, speech and occupational health services. The aim of the current study was to investigate how home confinement during the third wave of the COVID‐19 pandemic affected parenting self‐efficacy and preschoolers' anxiety. Method: An online survey based on a convenience sample took place on April 2021 to evaluate how home confinement to halt the third wave of COVID‐19 pandemic influenced children's anxiety and parenting self‐efficacy (PSE). Parents of 146 children (65 girls [44.5%] and 81 boys [55.5%]; aged 2–6 years old) were enrolled and completed a demographics form, the Preschool Anxiety Scale (PAS) and the Tool to Measure Parenting Self‐efficacy (TOPSE). Results: Most of the participants reported that the relationship with their child was positively affected from staying at home. TOPSE mean scores reflected average parenting self‐efficacy. PSE was negatively correlated with children's anxiety. COVID‐19‐related variables 'Parent's vaccine hesitancy' and 'Death of a loved one' had a clear effect on preschoolers' anxiety, whereas the latter also on PSE. Conclusion: Findings highlight the necessity of implementing public health strategies to strengthen families and support parents and their children during the ongoing health crisis. [ABSTRACT FROM AUTHOR]

The present study examined the moderating effects of both parents' warmth in the relations between parental harsh discipline (psychological aggression and corporal punishment) and migrant children's anxiety and parent and child gender differences in the moderating mechanism in Chinese society. This study used a sample of 477 elementary school-age children and both their parents in Chinese migrant families. We constructed a Structural Equation Model to explore the relation between parental harsh discipline (psychological aggression and corporal punishment) and migrant children's anxiety and the moderating role of parental warmth. Our findings revealed that maternal but not paternal psychological aggression was found to significantly predict boys' anxiety. Moreover, maternal warmth exacerbated the relations between paternal corporal punishment and girls' anxiety. The findings provide partial support for the "healthy context paradox" and highlight the importance of considering how the broader family emotional context may interact with parental harsh discipline to influence child adjustment. [ABSTRACT FROM AUTHOR]

We present findings from the first cohort of third- and fourth-grade students with reading difficulties (128 students from 31 classrooms) who participated in a 2-year intervention examining the effects of a reading intervention with and without anxiety management. Using a randomized controlled trial, students were assigned to one of three conditions: (a) small-group reading intervention with anxiety management instruction (RANX), (b) small-group reading intervention with math fact practice (RMATH), and (c) business-as-usual (BAU) comparison condition (no researcher provided treatment). Personnel from the research team provided participants in the RANX and RMATH the same reading intervention with the variation in the two treatments being whether the same amount of time per lesson was allocated to anxiety management (RANX) or practicing math facts (RMATH). Students in the RANX significantly outperformed students in the BAU on reading comprehension (effect size [ES] = 1.22) and students in the RMATH outperformed BAU on reading comprehension (ES = 0.77). Groups did not differ significantly on other reading outcomes. Reading anxiety moderated the main effect of the RANX intervention on the Test of Word Reading Efficiency (TOWRE) word reading when contrasted against the BAU group, indicating a significant difference favoring RANX where treatment's effect decreased by 0.94 units (about 1 point on the outcome) on word reading for each additional point increase in reading anxiety. [ABSTRACT FROM AUTHOR]

Background: Children with learning disabilities (LD) are more likely to have health conditions that require hospital attendance than children without LD. Like all children, they can experience fear and distress related to procedural anxiety. Parents play a key role in managing procedural anxiety in children with LD. No previous published qualitative studies have explored parental experiences of caring for a child with LD and procedural anxiety in hospital. Objectives: To explore how parents experienced caring for their child with LD and procedural anxiety in hospital. Methods: A purposive sample of six participants were recruited through a Facebook group for parents of children with LD. Remote semi‐structured interviews were conducted via telephone, Microsoft Teams or Whatsapp. Interviews were transcribed verbatim and analysed using interpretative phenomenological analysis. Results: Five key themes were generated: (1) Emotional toll: parents characterized their experiences as highly emotional; reporting feeling stressed, anxious and worried. (2) Restraint and holding: parents spoke of their experiences of restraint which was largely viewed as negative and sometimes inappropriate. (3) Advocacy: parents articulated their responsibility as advocates for their children. (4) Going it alone: parents were extremely proactive in managing their child's anxieties but some also felt highly‐pressurized and isolated. (5) Inconsistency and uncertainty: parents experienced inconsistency and uncertainty in their children's care from healthcare professionals which led to anxiety and frustration. Conclusion: Parents of children with both LD and procedural anxiety experienced many challenges. Parents' expertise must be utilized by clinicians when caring for children with LD and procedural anxiety whilst ensuring appropriate support for parents. Nurses require specific training in psychosocial interventions to enhance care for children with LD and procedural anxiety. Further research identifying effective nursing strategies to enhance parental experiences would be beneficial to improve care to this patient group. [ABSTRACT FROM AUTHOR]

A correction is presented to the article "Anxiety in children with CFS/ME" published in a previous issue of the periodical.

We utilized a community detection approach to longitudinally (a) identify distinct groups of children with common temperament profiles in infancy and at 2 and 3 years of age and (b) determine whether co‐occurrence of certain temperament traits may be early predictors of internalizing problems at 5 years of age. Seven hundred and seventy‐four infants (360 girls; 88.6% White, 9.8% Hispanic, and 1.6% other races) were recruited from the Boston area. Data collection spanned from 2012 to 2021. The analysis yielded three distinct groups of children with different temperament traits and was associated with significant variation in levels of internalizing symptoms and anxiety diagnosis rate. Our findings suggest that stable temperament "communities" can be detected in early childhood and may predict risk for psychopathology later in life. [ABSTRACT FROM AUTHOR]

This study investigated discrete achievement emotions (enjoyment, pride, boredom, and anxiety) as simultaneous mediators between achievement goals (mastery goals, performance-approach goals, and performance-avoidance goals) and academic engagement (cognitive engagement, effort withdrawal, and novelty avoidance). The data were collected using an online questionnaire with a sample of secondary school students (n = 1939) in Singapore. With gender, stream, and grade controlled, we conducted structural equation modelling to test the hypothesised mediation model. We found that achievement goals had a differential relationship with the four achievement emotions, which in turn showed a distinct association with engagement variables. Achievement emotions as mediators partly explained the differential relationship between achievement goals and academic engagement. In particular, the findings highlight the complex meaning of enjoyment and anxiety and the adaptive role of mastery goals in student learning. [ABSTRACT FROM AUTHOR]

Background: Although some meta-analyses have identified potential moderators associated with treatment outcomes for pediatric obsessive-compulsive disorder (OCD), there is as yet no consensus regarding the influence of anxiety and depression symptoms on the recovery from pediatric OCD. A meta-analysis was conducted to investigate the effects of depression and anxiety symptoms and their comorbidities on the efficacy of CBT in pediatric OCD, as well as other potential moderators that may be associated with outcomes. Method: An exhaustive literature search from 1983 to March 2021 located 22 published articles that applied cognitive-behavioral therapy (CBT) to pediatric OCD, producing a total of 26 treatment groups. Some of the moderator variables analyzed included age, gender, comorbidity baseline in anxiety, depression and obsession, and methodological quality. Results: Results showed that the psychological treatment of OCD achieves clinically significant effectiveness, both for measures of obsessions and compulsions (d+ = 2.030), and for anxiety (d+ = 0.613) and depression (d+ = 0.451). An explanatory model for the CY-BOCS effect sizes showed that three moderator variables were statistically related: the mean of the CY-BOCS (Children's Yale Brown Obsessive Compulsive Scale) in pretest, the effect size for anxiety, and the mean age of the sample. Conclusions: CBT reduced obsessive-compulsive symptoms and, to a lesser extent, anxiety and depression symptoms. Since anxiety symptoms are reduced with the same therapy, resources would be saved compared to other treatments. [ABSTRACT FROM AUTHOR]

Aggressive behaviour is one of the most disruptive problems in children with autism. It generates anxiety in the parents and the child, who does not know what to do, and the family's quality of life is significantly reduced. In this scenario, using narrative practices may help promote the sense of agency in children with autism spectrum disorder (ASD) and help them find solutions based on self‐knowledge. This article explores different narrative practices to help deal with challenging behaviour in children with ASD. We discuss several examples using two techniques: a therapist's imaginary friend and using a magic coin as ways of externalising the problem and playing with metaphors. We present the procedures applied during the interventions with three children. These narrative practices can help to externalise the problem, think about possible solutions, and facilitate the development of imagination and abstract thinking in children with ASD. [ABSTRACT FROM AUTHOR]

BACKGROUND: Researchers have found a relationship between having food allergies and anxiety in children. Anxiety may relate to others' lack of food allergy knowledge. This study investigated the relationship between having a food allergy and self‐reported anxiety among children. Furthermore, knowledge of food allergies among children without food allergies and teachers was explored. METHODS: Children with food allergies and their parents each completed a perceived food allergy severity questionnaire. Children without food allergies completed a food allergy knowledge measure. All children completed a self‐reported anxiety measure. Teachers completed a questionnaire investigating knowledge, attitudes, and beliefs about food allergies. Correlational analyses and analyses of variance were conducted. RESULTS: Overall anxiety was significantly higher in children with food allergies than in children without food allergies. When controlling for the effects of sex and age, children with food allergies had significantly higher social phobia and school phobia. Teachers correctly answered 69.7% of knowledge‐based questions about food allergies; children without food allergies correctly answered 62.7%. CONCLUSIONS: Findings highlight the need for an integrated approach in which families, school personnel, psychologists and other mental health professionals, and medical professionals work together to increase awareness about the multifaceted needs of children with food allergies. [ABSTRACT FROM AUTHOR]

Identifying non-invasive methods for anxiolysis is becoming increasingly important in the pediatric emergency department (ED). Few studies have examined the use of intranasal (IN) ketamine for procedural anxiolysis. We aim to evaluate if IN ketamine provides satisfactory anxiolysis for patients undergoing laceration repair based on anxiety and sedation scoring. We also evaluated the feasibility of using IN ketamine in future trials based on its tolerability and side-effects. A pilot study evaluating IN ketamine in the treatment of procedural anxiety for patients, 2 years and older, weighing 40 kg or less, presenting to the pediatric ED with lacerations. The need for anxiolysis was defined by an elevated modified-Yale Preoperative Anxiety Scale—Short Form (mYPAS-SF) score. Patients received 5 mg/kg of IN ketamine in addition to topical anesthesia, mYPAS-SF scoring before and during the procedure, sedation scoring, adverse events, vital signs, age, weight, laceration size and location, and satisfaction surveys were recorded. Twenty-five patients were enrolled, with mean age of 61 ± 29.2 months and mean weight of 21 ± 6.4 kg. Lacerations were located on the face, extremities, and groin with mean size of 2.1 cm. A decrease in anxiety levels was observed, from median m-YPAS-SF score of 66.7 (62.50–80.2) to 33.3 (27.09–52.00), p < 0.001. Among the patients, 92% (n = 23) were less anxious during the procedure. IN ketamine appears to be safe and well-tolerated with a positive impact on procedural anxiety. A dosage of 5 mg/kg is a reasonable starting point, as 80% of patients had appropriate anxiolysis. [ABSTRACT FROM AUTHOR]

Anxiety disorders are among the most common forms of psychopathology in childhood and represent a particularly concerning issue for Latinx children. Research on adults and children with anxiety suggests that the effective regulation of emotion is associated with fewer symptoms. The current study used data from 78 Latinx (predominantly Mexican American) 8- to 11-year-old children (M = 9.91; SD = 1.14; 50% girls) and one caregiver to explore regulatory processes that may characterize emerging psychopathology in Latinx families. Caregivers reported on their use of reappraisal and their child's anxiety symptoms. Children completed a cognitive flexibility task and self-reported their anxiety symptoms. More extensive caregiver use of reappraisal was associated with fewer child anxiety symptoms (an average of caregiver- and child-report). As expected, this effect was qualified by children's cognitive flexibility. Caregiver reappraisal was associated with anxiety symptoms only for children with greater cognitive flexibility, highlighting the importance of individual differences in cognitive skills underlying children's mastery of sophisticated cognitive strategies. Findings suggest the importance of considering both caregiver and child regulatory processes to improve understanding of anxiety symptoms among Latinx children. Highlights: This study investigated whether caregiver and child regulatory processes jointly predict Latinx children's anxiety symptoms. Greater use of reappraisal by a caregiver was associated with fewer symptoms for Latinx children high in cognitive flexibility. Findings suggest the importance of considering caregiver and child processes to understand anxiety symptoms among Latinx children. [ABSTRACT FROM AUTHOR]

Bedtime routines have "strong" support for addressing bedtime behavior problems and sleep; however, little research has examined factors associated with bedtime routines and sleep quality. Parents of 155 children ages 3 to 5 were surveyed about their children's bedtime routines, bedtime anxiety, compliance, and sleep quality. Regression models supported a simple indirect effect of bedtime routine consistency on sleep quality through bedtime anxiety, but not through compliance at bedtime. In a serial model, consistent bedtime routines were related to sleep quality through first bedtime anxiety and then compliance near bedtime. Clinically, results suggest that if parents can alleviate child anxiety around bedtime through routines, compliance around bedtime, and a good night sleep may follow. [ABSTRACT FROM AUTHOR]

Emotionally based school non-attendance (EBSNA) needs are complex, with a distinctive combination of risk factors affecting each individual. This study presents an exploration of the perceived facilitators to successful returns to school for two primary-aged children who had previously experienced anxiety around school attendance. The perspectives of parents, school staff, and educational psychologists were gathered using semi-structured interviews to identify effective support. A reflexive thematic analysis was conducted to generate themes. Findings demonstrate that the support in each case was highly individualised. Key facilitators considered to achieve this included: effective home-school communication; taking a functional approach; engaging other professional support; cultivating positive relationships; and practitioners regularly reflecting on their practice. The significant overlap between themes supports an interactionist, ecological model of early identification and intervention for EBSNA difficulties. Implications for practitioners include the need to ensure a reflective, individualised approach, and the importance of facilitating the home-school relationship. [ABSTRACT FROM AUTHOR]

Knowing the age at which the sexual orientation disparity in depression and anxiety symptoms first emerges and the early determinants of this disparity can suggest optimal timing and targets of supportive interventions. This prospective cohort study of children ages 3 to 15 (n = 417; 10.6% same-sex-attracted; 47.2% assigned female at birth) and their parents sought to determine the age at which the sexual orientation disparity in depression and anxiety symptoms first emerges and whether peer victimization and poor parental relationships mediate this disparity. Same-sex-attracted youth first demonstrated significantly higher depression symptoms at age 12 and anxiety symptoms at age 15 than exclusively other-sex-attracted youth. Age 12 peer victimization mediated the sexual orientation disparity in age 15 depression symptoms. Age 12 poor mother–child relationship mediated the sexual orientation disparity in age 15 anxiety symptoms. The findings are discussed in terms of implications for developmentally appropriate interventions against social stress during early development. [ABSTRACT FROM AUTHOR]