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Contains fulltext : 297920.pdf (Publisher’s version ) (Closed access), Background and objectives: To examine the prevalence of two ISAAC (International Study of Asthma and Allergies in Childhood) asthma indicators in 7 European countries and their relationship with mental health disorders in children 6-12 years. Methods: A cross-sectional survey of 5712 school children aged 6-12 years using a video Self-administered instrument: Dominic Interactive and the Strengths and Difficulties Questionnaire (SDQ) for parents and teachers. Asthma indicators were 12 month "Wheezing or whistling in the chest" (WWC) and "Severe Asthma" (SA) based on number of attacks of wheezing, sleep disturbance due to wheezing, and limits to speech. Results: On average 7.31% of the children had WWC, from 15.09% in Turkey to 1.32% in Italy; SA 2.22% on average ranged from 4.78% in Turkey to 0% in Italy. Generalized Anxiety Disorder (GAD) from child self-reports was significantly associated with WWC and SA even after adjustment for covariates. Based on parent and teacher combined reports, emotional problems were found to have significant associations with 12-month WWC after adjustment, as well as "any problems" which summarized externalizing and internalizing disorders Emotional, hyperactivity, conduct disorders were not associated with SA. Conclusion: Asthma indicators very much differ across countries. Asthma indicators are associated with childhood GAD. Childhood self-reported mental health seems more related to Asthma indicators than parents/teachers combined reports., 9 p.

Item does not contain fulltext, Background: Bullying involvement is associated with suicidal ideation among adolescents, yet there are no studies examining this issue among younger children. Methods: The School Children Mental Health in Europe study was conducted in seven countries in 2010 using similar methods to collect cross-sectional data from children, parents, and teachers. Suicidal ideation and thoughts of death were assessed using the Dominic Interactive among children. Parent and teacher reports were used to determine bullying involvement. The sample comprised n=5,183 children ages 6 to 11 identified as bullies (n=740, 14.3%), victims (n=945, 18.2%), bully-victims (n=984, 18.2%) and not involved in bullying (n=2,514, 48.5%). Multivariate logistic regressions were used to assess the association of bullying involvement with suicidal ideation and thoughts of death. Results: Suicidal ideation was reported by 13.3% of those not involved in bullying, 17.1% of victims, 19.6% of bullies and 24.4% of bully-victims. Similarly, thoughts of death were reported by 19.0% of victims, 24.3% of bullies, and 25.0% of bully-victims. Children identified as being involved were more likely than those not involved to report suicidal ideation in bivariate analyses. When controlling for psychopathology and for maternal distress among other factors, the association remained significant for bullies (AOR=1.30, 95%CI=1.01-1.66), bully-victims (AOR=1.54, 95%CI=1.22-1.94), but not for victims (AOR=1.02, 95%CI=.80-1.30). Limitations The study is cross-sectional. The assessment of bullying may have underestimated victimization. Conclusions: The association of bullying involvement and child suicidal ideation is present among elementary school children across Europe, using multiple informants to avoid shared variance biases, and adjusting for key factors.

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Contains fulltext : 219595.pdf (Publisher’s version ) (Closed access), The objective of the study is to investigate the role of mental health in the relationship between moderately low birthweight MLBW (>= 1500 g & <=2500) and academic achievement in a large cross-country study. Data were drawn from the School Children Mental Health in Europe study (n = 4305). Achievement in mathematics and reading was categorized by teachers as being below average, average or above average. Parents reported birthweight, and both parents and teachers evaluated mental health status using the Strengths and difficulties Questionnaire. When controlling for child age, number of children in the household, maternal age, education, employment status and psychological distress and country of residence, MLBW was associated with lower odds of above average performance in mathematics and reading. Once mental health was added into the model, MLBW remained significant but mental health problems largely surpassed its influence: conduct disorders decreased the probability to perform above average in mathematics RRR = 0.37 and increased the risk of performing below average RRR = 4.45 as did ADHD and emotional disorders. A similar trend was found for reading achievement except for ADHD which decreased the probability of above average performance RRR = 0.13 and did not have a significant effect on below average performance. A path analysis highlights the prominent role of mental health. Among children attending regular education settings, MLBW is associated with academic performance but mental health has much stronger effects. Teachers and parents should be sensitized to child mental health problems and be informed of the special needs of MLBW children in order to help children overcome potential academic difficulties and to adapt their teaching taking into account mental health problems.

Item does not contain fulltext, Fears are common in the general population and particularly among children. The number of fear subtypes (animals, natural environment, situational, blood–injection–injury or other type) has been shown to be associated with psychopathology. Furthermore, there is evidence suggesting that some subtypes may be more often associated with mental disorders than others. The present study uses data from a large cross sectional survey, the School Children Mental Health in Europe (SCMHE) study, conducted in eight European countries on children ages 6 through 13-years-old attending elementary school (n = 9613). Fear subtypes and self-reported mental health were assessed using the Dominic Interactive (DI), a self-administered computerized image-based questionnaire. The findings show that the number of fear subtypes is strongly associated with self-reported internalizing and externalizing problems. In addition, adjusting for the number of subtypes, fear of animals was less likely than other fears to be associated with psychopathology. The findings support the notion that children who report excessive and generalized fear should be targeted for prevention, consistent with research identifying childhood onset generalized specific phobia as a probable precursor to subsequent psychopathology.

Contains fulltext : 221878.pdf (Publisher’s version ) (Closed access), Purpose: The present study seeks to examine gender differences in internalizing and externalizing problems either parent/teacher or self-reported and to investigate the influence of country-level gender gap on children's mental health problems across countries with high and low gender gap across Europe. Methods: The School Children's Mental Health in Europe (SCMHE) survey collected data on primary school children living in six European countries, using self-reports (SR) from children (Dominic Interactive), as well as combination of parent- and teacherreports (P/T C) (Strengths and Difficulties Questionnaire) to assess internalizing and externalizing mental health problems. The World Economic Forum's (WEF's) Global Gender Gap report’s Gender Gap Index (GGI) was used to categorize countries with high and low gender gap. Results: Boys had greater odds of externalizing problems (OR = 2.6 P/T C, 1.95 SR), and lower odds of internalizing problems (OR = 0.85 P/T C, 0.63 SR). The gender gap's association with mental health problems was different depending on the informant used to identify these problems. A small gap was a risk factor based on reports from adults for externalizing (OR = 1.53) and internalizing problems (OR = 1.42) while it was a protective factor for SR internalizing problems (OR = 0.72). For these problems the gender gap impacted boys and girls differently: a small gender gap was protective for boys but not for girls, including when controlling for key confounding variables. Conclusions: The differential impact of country-level gender gap observed between self-reported and parent- or teacher-reported mental health is complex but nevertheless present trough mechanisms that are worthwhile to study in depth, with a special attention to the informants and the type of problems examined.

14 juni 2021, Item does not contain fulltext, Fears are common in the general population and particularly among children. The number of fear subtypes (animals, natural environment, situational, blood–injection–injury or other type) has been shown to be associated with psychopathology. Furthermore, there is evidence suggesting that some subtypes may be more often associated with mental disorders than others. The present study uses data from a large cross sectional survey, the School Children Mental Health in Europe (SCMHE) study, conducted in eight European countries on children ages 6 through 13-years-old attending elementary school (n = 9613). Fear subtypes and self-reported mental health were assessed using the Dominic Interactive (DI), a self-administered computerized image-based questionnaire. The findings show that the number of fear subtypes is strongly associated with self-reported internalizing and externalizing problems. In addition, adjusting for the number of subtypes, fear of animals was less likely than other fears to be associated with psychopathology. The findings support the notion that children who report excessive and generalized fear should be targeted for prevention, consistent with research identifying childhood onset generalized specific phobia as a probable precursor to subsequent psychopathology.

22 mei 2020, Contains fulltext : 219595.pdf (Publisher’s version ) (Closed access), The objective of the study is to investigate the role of mental health in the relationship between moderately low birthweight MLBW (>= 1500 g & <=2500) and academic achievement in a large cross-country study. Data were drawn from the School Children Mental Health in Europe study (n = 4305). Achievement in mathematics and reading was categorized by teachers as being below average, average or above average. Parents reported birthweight, and both parents and teachers evaluated mental health status using the Strengths and difficulties Questionnaire. When controlling for child age, number of children in the household, maternal age, education, employment status and psychological distress and country of residence, MLBW was associated with lower odds of above average performance in mathematics and reading. Once mental health was added into the model, MLBW remained significant but mental health problems largely surpassed its influence: conduct disorders decreased the probability to perform above average in mathematics RRR = 0.37 and increased the risk of performing below average RRR = 4.45 as did ADHD and emotional disorders. A similar trend was found for reading achievement except for ADHD which decreased the probability of above average performance RRR = 0.13 and did not have a significant effect on below average performance. A path analysis highlights the prominent role of mental health. Among children attending regular education settings, MLBW is associated with academic performance but mental health has much stronger effects. Teachers and parents should be sensitized to child mental health problems and be informed of the special needs of MLBW children in order to help children overcome potential academic difficulties and to adapt their teaching taking into account mental health problems.

Contains fulltext : 217513.pdf (Publisher’s version ) (Closed access), The Strengths and Difficulties Questionnaire (SDQ) has been used extensively to screen for possible mental disorders in epidemiological studies around the world. The present study aimed to compare the internal consistency of both the parent- and teacher-SDQ across seven European countries: Italy, Germany, the Netherlands, Lithuania, Bulgaria, Romania, and Turkey, and to determine the ability of the SDQ to discriminate cases from non-cases of disorders against the well-established Development and Well-Being Assessment (DAWBA). The sample included 541 assessments of children aged 5-12 years. Internal consistency ranged from .74 to .85 for the teacher-SDQ, and .60 to .85 for the parent-SDQ with significant between-country differences. The SDQ further proved to be an adequate screening instrument for the detection of any mental disorder (area under the receiving operator characteristic [AUROC] = .74, 95% CI: .69-.78), and for externalizing disorders in particular (AUROC = .80, 95% CI: .76-.84). There were no differences in AUROC between countries (p = .09), yet sample sizes were limited thus restricting our ability to detect between-country differences in AUROCs. The results reinforce existing research on the SDQ and support its use in detecting probable cases of psychiatric disorders in children across Europe.

Contains fulltext : 219924.pdf (Publisher’s version ) (Closed access), Background: Bullying behavior is recognized internationally as a serious issue associated with mental health and functioning problems among children. Objective: The present study sought to determine the associations between bullying involvement and self-reported mental health among elementary school children across seven European countries. Participants and setting: The School Children Mental Health in Europe study was conducted in Bulgaria, Germany, Italy, Lithuania, the Netherlands, Romania and Turkey in 2010 using similar methodology to collect cross-sectional data from children, parents, and teachers. Methods: The study focused on children who had completed the Dominic Interactive and whose mother and/or teacher had completed the Strengths and Difficulties Questionnaire (n = 5,183). Results: Overall 14.3 % of children were identified as bullies, 18.2 % as victims and, 19.0 % as both bullies and victims. Despite the low threshold for defining bullying status, children identified as being involved were highly likely to present with self-reported mental health problems: 31.6 % of bully-victims reported any disorder, while 25.4 % of bullies and 23.1 % of victims did. Adjusting for key factors, bullies and bully-victims were significantly more likely to present with any externalizing disorder, while victims were not. Additionally, bully-victim status was associated with significantly greater odds of presenting with each internalizing disorder: phobia (AOR = 1.48, 95 %CI = 1.01-2.19), GAD (AOR = 2.54, 95 %CI = 1.67-3.87), separation anxiety (AOR = 1.88, 95 %CI = 1.43-2.47) and depression (AOR = 2.52, 95 %CI = 1.61-3.93). However, victim status was only associated with GAD (AOR = 1.63, 95 %CI = 1.07-2.48) and bully status with separation anxiety (AOR = 1.44, 95 %CI = 1.07-1.93). Conclusions: The results highlight the association of bullying involvement and child mental health in elementary school children across Europe.

Contains fulltext : 219404.pdf (Publisher’s version ) (Closed access), The study examines the associations of specific self-reported internalizing and externalizing problems and performance in mathematics and reading in school-aged children across Europe. Data were drawn from 5,842 children between 6 and 13 years of age participating in the School Children Mental Health in Europe study and a large cross-sectional survey in France. Self-reported child mental health was assessed using the Dominic Interactive, academic performance was reported by teachers. Across Europe, controlling for key sociodemographic factors associated with achievement including maternal education, performance in mathematics was more often associated with the presence of externalizing and internalizing problems as compared to performance in reading. In addition, the findings point to significant sex differences in the associations of internalizing problems and academic achievement. Considering the impact of early academic difficulties in terms of later internalizing and externalizing problems and academic attainment, school-based interventions interrupting the cycle as early as possible are warranted.

Contains fulltext : 219531.pdf (Publisher’s version ) (Closed access), The present study investigates the relationship between birth rank and academic achievement of children in a cross-country study to examine whether firstborn children perform better in primary school than later-born children when controlling for individual, social and parental characteristics. Data were drawn from the School Children Mental Health in Europe (SCMHE) study, which included samples from Bulgaria, Germany, Italy, Netherlands, Lithuania, Romania and Turkey (n = 7,518). Children's academic performance in reading and mathematics was evaluated by teachers and parents reported sociodemographic variables including birth rank and parental attitudes. Controlling for individual, sociodemographic variables and parental attitudes in multinomial regressions, first- or second-born children displayed greater performance in mathematics and in reading as compared to children whose birth rank was third or above. Children from large families, especially when they are not first- or second-born appear to be at greater risk for academic difficulties and should benefit from targeted prevention efforts.

Item does not contain fulltext, Purpose: To evaluate the associations between the presence of a grand parent at home that is three-generation household, with children mental health in diverse countries whether this situation is frequent or not. Methods: Data from the School Children Mental Health in Europe cross-sectional survey in six countries (n = 4582) were used to examine the association between three-generation households and child mental health across Europe. The parent and teacher Strengths and Difficulties Questionnaire was combined to assess child mental clinical problems. Results: Overall, 25.13% of European families live with at least one grandparent: 5.46% in Western and 29.70% in Eastern Europe. Controlling for key sociodemographic variables and for country of residence, the presence of a grandparent is associated with an increased risk for child mental health problems in the total sample (OR 1.37, p = 0.002). In two-parent homes, the effect of the presence of a grandparent is significant (OR 1.40, p = 0.026), while it is not in single-parent homes. In each country, the presence of a grandparent is a risk for either externalizing or internalizing problems. Conclusions: Programs may be developed to educate elderly people to better respect their children’s role as parents so having a grandparent in the home can become an asset for family members rather than a burden.

Item does not contain fulltext, Assessments of child psychopathology are often derived from parental and teacher reports, yet there is substantial disagreement. This study utilized data from 7 European countries to examine parent–teacher agreement and possible explanatory factors for parent-teacher disagreement such as child and family characteristics, parenting dimensions, and maternal distress were explored. Parent–teacher agreement of the Strengths and Difficulties Questionnaire were assessed using a cross-sectional survey of 4,894 school aged children 6-11 from the School Children Mental Health Europe Project. Parent-teacher agreement was low to moderate (Pearson correlation ranging from .24 (Prosocial) to .48 (Hyperactivity) for the 5 subscales across 7 countries); kappa coefficient ranged from .01 (Turkey) to .44 (Italy) for internalizing problems and .19(Romania) to .44(Italy) for externalizing problems. Child's gender and age, mother's employment status, single parent home, number of children in household, and selected parenting dimension were found to be explanatory of informant disagreement. This study not only serves to advance our understanding of parent-teacher agreement of the Strengths and Difficulties Questionnaire in 7 European countries but provides a novel approach to examining the factors that contribute to informant disagreement.

Item does not contain fulltext, Worldwide, approximately one in eight children or adolescents suffers from a mental disorder. The present study was designed to determine the self-reported prevalence of mental health problems in children aged 6-11 years across eight European countries including Italy, France, Germany, the Netherlands, Lithuania, Bulgaria, Romania, and Turkey. Data were drawn from 6245 children participating in the School Children Mental Health in Europe (SCHME) study and a large cross-sectional survey in France. Self-reported child mental health was assessed using the Dominique Interactive (DI). Overall, 22.0% of children were identified per their own evaluation as having at least one mental disorder, ranging from 16.4% in the Netherlands to 27.9% in Bulgaria. The prevalence of internalizing disorders was 18.4% across countries and ranged from 11.8% in the Netherlands to 24.3% in Turkey. The prevalence of externalizing disorders was lower with an average of 7.8%, ranging from 3.5% in Turkey to 10.5% in Bulgaria. Combining samples across European countries, 1 in 5 children reported internalizing problems and 1 in 12 children externalizing problems. The net completion rates of 4.1-74.3% preclude conclusions about national differences in prevalence rates.

Contains fulltext : 175342.pdf (publisher's version ) (Open Access), Children's fear of a car accident occurring to parents or themselves has been used as a concrete example to illustrate one of the symptoms of anxiety disorders such as separation anxiety and generalized anxiety. However, its usage across countries may be questionable where the prevalence of this specific type of injury differs. This cross-sectional study compares samples from seven diverse European countries (Bulgaria, Germany, Italy, Lithuania, Netherlands, Romania, Turkey) to see if an environmental exposure, car accident death rate per 100,000 people (country-wide from WHO data), is associated with children's self-report of car accident fears. In this study, 6-11 year-old children were surveyed by a diagnostic instrument (Dominic Interactive) about several situations and asked if they believed they were similar to a fictional child depicted in said situations. Mothers were surveyed for additional sociodemographic information. Multivariable logistic regression was used to adjust for covariates including mother's age, mother's education, single parenting, and mother's professional inactivity. We report a monotonic relationship between higher car accident death rates and the prevalence of children reporting fear of parent's or own accident. Relative to a reference of 3.9 deaths per 100,000 people, children's odds of reporting fear of parent's accident ranged from 1.99 (95% CI 1.51-2.61) times to 4.84 (95% CI 3.68-6.37) times as the risk of death by car accident increased across countries. A similar result arose from fear of child's own accident, with significant ORs ranging from 1.91 (95% CI 1.53-2.40) to 2.68 (95% CI 2.07-3.47) alongside increased death rates. Given that reporting of these fears accompanies correspondingly high accident death rates, the pertinence of using fear of car accidents as an illustration for some diagnostic item for mental disorders cross-nationally appears to be an issue.

Item does not contain fulltext, Background: Offspring of individuals with alcohol use disorders have been shown to have elevated risk for mental health problems. Objectives: To examine the association between maternal problem drinking and child mental health as assessed by three informants in three European countries. Methods: Data were drawn from the School Child Mental Health in Europe study. Maternal alcohol use was assessed using the alcohol use disorders identification test. Child mental health was assessed using the mother and teacher versions of the strengths and difficulties questionnaire, and the child self-reported Dominic interactive. Analyses were performed on 2,678 individuals, 6-11 year olds. Results: Adjusting for variables associated with maternal drinking, among children eight years old or younger, excessive drinking was not significantly associated with mental health problems, whether reported by the mother, teacher or by the child. However, among girls eight years old and above, problem drinking was associated with conduct problems as reported by the mother (OR = 4.19), teacher reported total difficulties (OR = 4.69), and peer relationship problems (OR = 8.86). It was also associated with the presence of any child-reported disorder (OR = 3.88), externalizing (OR = 5.55) and internalizing disorders (OR = 4.42). Conclusions/Importance: Adjusting for sociodemographic variables and for psychological distress, maternal problem drinking was not significantly associated with child mental health problems in boys or in girls ages six to eight. The association was only present among girls ages 8-11. Examining relationships between mothers and their daughters in the peripubertal period may be a critical window for the development of effective intervention strategies.

Item does not contain fulltext, Objective:The aim of this study was to examine the determinants of use of mental health services for children across Europe, with a specific focus on differences in the availability of mental health resources. Methods: Data were drawn from the School Children Mental Health in Europe Project. Parent- and teacher-reported child mental health status was based on the Strengths and Difficulties Questionnaire. Sociodemographic characteristics of parents and children, as well as academic performance and use of mental health services in the previous 12 months, were collected. Countries were categorized as having high versus low mental health resources. The sample comprised 4,894 schoolchildren in seven countries. Results: Across Europe, only 25.6% of children with a mental disorder had received mental health services in the previous 12 months, including 31.5% in high-resources countries and 18.9% in low-resources countries (p=.001) (N=4,867). The presence of any mental disorder, maternal psychological distress, gender, living in a single-parent home, and low academic performance were determinants of service use. The effect of resources group on the likelihood of receiving services remained significant when the analyses controlled for all predictors (odds ratio=1.41, p<.01). Determinants differed between groups - maternal psychological distress was associated with service use in high-resources countries, and gender was associated with service use in low-resources countries. Conclusions:The findings point to a substantial portion of unmet need across Europe and to major differences in access to care in low- versus high-resources countries. Efforts are needed to address unmet need among children with mental disorders, especially in low-resources countries.

Item does not contain fulltext, Background: Worldwide, approximately one in eight children or adolescents suffer from a mental disorder. The present study was designed to determine the cross-national prevalence of mental health problems in children aged 6-11 across seven European countries including Italy, Germany, the Netherlands, Lithuania, Bulgaria, Romania, and Turkey. Methods: Data were collected on 7682 children for whom either parent- or teacher SDQ were completed. Results: The present study provides country-specific normative banding for both parent- and teacher SDQ scores. Overall, 12.8 % of children have any probable disorder, with rates ranging from 15.5 % in Lithuania to 7.8 % in Italy, 3.8 % of children have a probable emotional disorder, 8.4 % probable conduct disorder, and 2.0 % probable hyperactivity/inattention. However, when adjusting for key sociodemographic variables and parental psychological distress, country of residence did not predict the odds of having any disorder. For specific disorders, however, country of residence does have an effect on the odds of presenting with mental health problems. Conclusions: As normative data are key in the comparison of mental health status on an international level, the present data considerably advance the possibilities of future research. Furthermore, the findings underline the importance of controlling for a number of sociodemographic and parental variables when conducting international comparisons of child mental health. In addition, the findings suggest that efforts are needed locally to assist in the detection and prevention of parental psychological distress.

Item does not contain fulltext, Video games are one of the favourite leisure activities of children; the influence on child health is usually perceived to be negative. The present study assessed the association between the amount of time spent playing video games and children mental health as well as cognitive and social skills.

Item does not contain fulltext, Large-scale international surveys are important to globally evaluate, monitor, and promote children's mental health. However, use of young children's self-reports in these studies is still controversial. The Dominic Interactive, a computerized DSM-IV–based child mental health self-report questionnaire, has unique characteristics that may make it preeminently appropriate for usage in cross-country comparisons. This study aimed to determine scale score reliabilities (omega) of the Dominic Interactive in a sample of 8,135 primary school children, ages 6–11 years old, in 7 European countries, to confirm the proposed 7-scale factor structure, and to test for measurement invariance of scale and item scores across countries. Omega reliability values for scale scores were good to high in every country, and the factor structure was confirmed for all countries. A thorough examination of measurement invariance provided evidence for cross-country test score comparability of 5 of the 7 scales and partial scale score invariance of 2 anxiety scales. Possible explanations for this partial invariance include cross-country differences in conceptualizing items and defining what is socially and culturally acceptable anxiety. The convincing evidence for validity of score interpretation makes the Dominic Interactive an indispensable tool for cross-country screening purposes.

Item does not contain fulltext, In utero exposure to tobacco smoke is associated with adverse neonatal outcomes; the association with later childhood mental health outcomes remains controversial. We used a strategy involving comparison of maternal and paternal smoking reports in a sample pooling data from six diverse European countries. Data were drawn from mother (N = 4,517) and teacher (N = 4,611) reported attention deficit and hyperactivity disorder (ADHD) symptoms in school children aged 6-11 in Turkey, Romania, Bulgaria, Lithuania, Germany, and the Netherlands, surveyed in 2010. Mothers report on self and husband's smoking patterns during the pregnancy period. Logistic regression used with control covariates including demographics, maternal distress, live births, region, and post-pregnancy smoking. In unadjusted models, maternal prenatal smoking was associated with probable ADHD based on mother [Odds Ratio (OR) = 1.82, 95 % Confidence Interval (CI) 1.45-2.29], teacher (OR = 1.69, 95 % CI 1.33-2.14) and mother plus teacher (OR = 1.49, 95 % CI 1.03-2.17) report. Paternal prenatal smoking was similarly associated with probable ADHD in unadjusted models. When controlled for relevant confounders, maternal prenatal smoking remained a risk factor for offspring probable ADHD based on mother report (OR = 1.44, 95 % CI 1.06-1.96), whereas the effect of paternal prenatal smoking diminished (e.g., mother report: OR = 1.17, 95 % CI 0.92-1.49). Drawing on data from a diverse set of countries across Europe, we document that the association between maternal smoking and offspring ADHD is stronger than that of paternal smoking during the pregnancy period and offspring ADHD. To the extent that confounding is shared between parents, these results reflect a potential intrauterine influence of smoking on ADHD in children.

Contains fulltext : 131681.pdf (Publisher’s version ) (Closed access), Objective. Unintentional injury is the leading cause of death for schoolchildren. We assessed the association between externalizing psychopathology, parenting style, and unintentional injury in European children in the community. Methods. Data were drawn from the School Children Mental Health in Europe project and included 4517 schoolchildren across seven diverse European regions. Past-year injuries serious enough to seek medical attention were reported by mothers. Child mental health problems were assessed using validated measures and reported by the mothers, teachers, and children. Parenting styles were based on The Parenting Scale and the Parent Behaviors and Attitudes Questionnaire. Results. Children with attention-deficit/hyperactivity symptoms and oppositional defiant symptoms had a higher risk of injury compared to other children whether based on parent report (OR = 1.47,95% C.I. 12-1.9), teacher report (OR = 136,95% C.I. 1.1-1.7), or parent and teacher report combined (OR = 1.53, 95% C.I. 1.1-2.1). Children who self-reported oppositional symptoms also had higher risk of injury (OR = 1.6,95% C.I. 1.1-2.4). Low-caring behavior of parents increased the risk of injury (OR = 1.4,95% C.I. 1.1-1.9). Conclusion. Unintentional injury is a potential adverse health consequence of child externalizing problems. Interventions to improve parent-child relationships and prevention as well as focused treatment for externalizing problems may reduce the burden of injury.

Contains fulltext : 116601.pdf (publisher's version ) (Open Access), Objective: To ascertain patterns of parental smoking in the vicinity of children in Eastern and Western Europe and their relation to Tobacco Control Scale (TCS) scores. Methods: Data on parental smoking patterns were obtained from the School Child Mental Health Europe (SCMHE), a 2010 cross-sectional survey of 5141 school children aged 6 to 11 years and their parents in six countries: Germany, Netherlands, Lithuania, Romania, Bulgaria and Turkey ranked by TCS into three level categories toward tobacco control policies. Results: A slightly higher proportion of Eastern compared to Western European mothers (42.4 vs. 35.1%) were currently smoking in but the difference was not statistically significant after adjusting for maternal age and maternal educational attainment. About a fifth (19.3%) and a tenth (10.0%) of Eastern and Western European mothers, respectively, smoked in the vicinity of their children, and the difference was significant even after adjustment for potential confounders (p<0.001). Parents with the highest educational attainment were significantly less likely to smoke in the vicinity of their children than those with the lowest attainment. After control of these covariates lax tobacco control policies, compared to intermediate policies, were associated with a 50% increase in the likelihood of maternal smoking in the vicinity of children adjusted odds ratio (AOR) = 1.52 and 1.64. Among fathers, however, the relationship with paternal smoking and TCS seems more complex since strict policy increases the risk as well AOR = 1,40. Only one country, however belongs to the strict group. Significance: Tobacco control policies seem to have influenced maternal smoking behaviors overall to a limited degree and smoking in the vicinity of children to a much greater degree. Children living in European countries with lax tobacco control policies are more likely to be exposed to second hand smoking from maternal and paternal smoking.