RESUMO

Self-harm is a prevalent adolescence behavior, indicated as a public health problem. The objective was to understand how adolescents perceive and explain this behavior, considering family and school characteristics. It's a multiple case study, in which five self-harming adolescents participated, enrolled in a public school in Novo Hamburgo-RS, participated in the study. They answered the following instruments: Sociodemographic Data Sheet, Semi-Structured Interview, Family Support Perception Inventory, Youth Self-Reporting and Delaware School Climate Survey-Student. Each case was individually analyzed and cross-case synthesis was performed. Self-harm was indicated as a strategy to relief suffering and regulate emotions. Low familial support, lack of skills, and presence of internalizing and externalizing problems were evidenced, as well as negative evaluation of peer relations and student engagement. When faced with a complex phenomenon, it is important to contemplate individual and relational issues in interventions. (AU)

A autolesão é prevalente na adolescência e indicada como um problema de saúde pública. Objetivou-se compreender como adolescentes percebem e explicam esse comportamento, considerando características de seu contexto familiar e escolar. Trata-se de um estudo de casos múltiplos, do qual participaram cinco adolescentes que se autolesionavam, matriculados em uma escola pública de Novo Hamburgo-RS, que responderam aos instrumentos: Ficha de Dados Sociodemográficos, Entrevista Semiestruturada, Inventário de Percepção de Suporte Familiar, Inventário de Comportamentos Autorreferidos para Jovens de 11 a 18 Anos e Delaware School Climate Survey-Student. Analisou-se individualmente cada caso e realizou-se a síntese de casos cruzados. A autolesão foi indicada como uma estratégia para aliviar sofrimento. Evidenciou-se baixo suporte familiar, carência de competências e presença de indicadores de problemas internalizantes e externalizantes, assim como avaliação negativa das relações entre pares e do engajamento estudantil. Frente a um fenômeno complexo, faz-se importante contemplar questões individuais e relacionais nas intervenções. (AU)

La autolesión es frecuente en adolescencia y se indica como un problema de salud pública. El objetivo era comprender cómo adolescentes perciben y explican este comportamiento, considerando características de su contexto familiar y escolar. Es un estudio de caso múltiple, en el participaron cinco adolescentes con autolesión, matriculados en escuela pública en Novo Hamburgo-RS, que respondieron a los instrumentos: Hoja de Datos Sociodemográficos, Entrevista Semiestructurada, Inventario de Percepción de Apoyo Familiar, Auto informe para Jóvenes de 11 a 18 años y Delaware School Climate Survey-Student. Cada caso se analizó individualmente y se realizó una síntesis cruzada de casos. La autolesión se indicó como estrategia para aliviar el sufrimiento. Se evidenció poco apoyo familiar, falta de habilidades y presencia de indicadores de problemas de internalización y externalización, así como una evaluación negativa de las relaciones con los compañeros y la participación de los estudiantes. Ante un fenómeno complejo, es importante contemplar problemas individuales y relacionales en las intervenciones. (AU)

Assuntos

RESUMO

Abstract Introduction Mental health assessment in childhood needs to be carried out within a broader context that includes different factors. Objective To assess the prevalence of emotional and behavioral problems in schoolchildren and associated factors. Method A cross-sectional study was conducted with a school-based sample at 20 schools selected by systematic random sampling. Participants consisted of children aged 7-8 year old and their parents or primary caregivers. The Strengths and Difficulties Questionnaire (SDQ) was used to screen for the presence of emotional and behavioral problems in children. Results A total of 596 dyads were evaluated. The prevalence of emotional and behavioral problems was 30.0% among boys and 28.2% among girls. Hyperactivity/inattention were more prevalent among boys (p=0.015). Belonging to economically disadvantaged strata increased the likelihood of emotional and behavioral problems among schoolchildren by 71% (p=0.001), while having parents or caregivers with mental disorder increased by 2.2 times that probability (p<0.001). Conclusion: Our findings showed a high prevalence of emotional and behavioral problems among schoolchildren, as well as the influence of economic conditions and of the mental health of parents and caregivers on child mental health.

Resumo Introdução A avaliação da saúde mental na infância necessita ser realizada dentro de um contexto amplo que considere os diferentes fatores envolvidos. Objetivo Verificar a prevalência de problemas emocionais e comportamentais em escolares, bem como fatores associados. Método Estudo transversal, com amostra de base escolar em que foram selecionadas 20 escolas por amostragem aleatória sistemática. Participaram crianças com 7-8 anos e seus pais ou principais cuidadores. A presença de problemas emocionais e comportamentais nas crianças foi rastreada pelo Strengths and Difficulties Questionnaire (SDQ). Resultados Foram avaliadas 596 díades. A prevalência de problemas emocionais e comportamentais foi de 30,0% entre os meninos e 28,2% entre as meninas. Sintomas de hiperatividade/desatenção foram mais prevalentes entre meninos (p=0,015). Pertencer a camadas menos favorecidas economicamente aumentou em 71% a probabilidade de problemas emocionais e comportamentais entre os escolares (p=0,001), enquanto ter pais ou cuidadores com transtorno mental aumentou 2,2 vezes tal probabilidade (p<0,001). Conclusões: Nossos achados demonstram a elevada prevalência de problemas emocionais e comportamentais entre escolares, bem como a influência das condições econômicas e da saúde mental de pais e cuidadores sobre a saúde mental infantil.

Assuntos

RESUMO

BACKGROUND: Children exposed to substance use in their families are vulnerable to multiple risk factors in their development and at increased risk for emotional and behavioral problems. The aims of the study were as follows 1) estimate the prevalence of emotional and behavioral problems among children aged 6-11 years old, living with addicted family members in a low-income urban community of São Paulo, Southeastern Brazil; 2) evaluate the children's exposure to family psychosocial stressors and substance use; and 3) investigate the factors related to the increased risk of emotional and behavioral problems and substance use. METHODS: A cross-sectional study was conducted among 101 children aged 6-11 years old (M = 9.16 years, SD = 1.61). The instruments used were a sociodemographic questionnaire, the Child Behavior Checklist (CBCL) and the Psychosocial Stress Factors (PSF). RESULTS: High prevalence of problems was found for this sample: the CBCL showed 26.7% of clinical scores for Internalizing Problems, 40.6% for Externalizing Problems, and 40.6% for Total Problems. Exposure to family psychosocial stressors was also high, including severe disease (33%), physical aggression (28.9%), death (27.8%), psychiatric hospitalization (16.7%), suicide attempts (15.5%), and suicide (9.3%). Exposure to these family stressors was associated with an increase of two to four times in the prevalence of internalizing and externalizing problems. CONCLUSIONS: Children exposed to substance abusers have more mental health problems than general population, even when compared to peers living in similar low-income areas. This is a group that should be target of a selective preventive intervention.

Assuntos

RESUMO

Emotional and behavioral problems have been considered an indicative of mental disorder in children. Mental health problems affect 10-20% of children and adolescents living in low-income and middle-income countries. Evidence suggests that disruptions in the biological rhythm may be a primary cause of emotional and behavioral changes, which affects several psychological functions and moods. Thus, this study aimed at verifying the association between biological rhythm and emotional and behavioral problems in schoolchildren living in Southern Brazil. This is a cross-sectional study with a school-based sample conducted between August 2015 and November 2016. The presence of emotional and behavioral problems in children was verified by the Strengths and Difficulties Questionnaire (SDQ), parents' version. This is a 25-item assessment questionnaire used to screen mental health problems in children and adolescents (from 4 to 17 years of age) in the last 6 months. The Biological Rhythm Interview of Assessment in Neuropsychiatry-Kids (BRIAN-K) was used to measure the degree of biological rhythm disruption. The BRIAN-K consists of 20 items; from among these, 17 items are added to generate a quantitative measure, with greater scores indicating more biological rhythm disruption. The final score can also be divided into four subscales: sleep, social rhythm, eating pattern and overall activities. A total of 609 children responded to the assessment instruments. With regard to parents or primary caregiver, 596 completed the assessment and 13 (2%) were not located or refused to participate in the study. Thus, 596 dyads were included in the analysis. Children with emotional and behavioral problems presented higher scores in all domains of BRIAN-K: sleep, social, activity, eating pattern and total score (p < 0.001). The following variables remained associated with emotional and behavioral problems after adjusted analysis: BRIAN-K total score (p < 0.001) and all subscales sleep (p < 0.001), social (p < 0.001), activity (p < 0.001) and eating pattern (p < 0.001). Children with emotional and behavioral problems presented higher biological rhythm disruption when compared with children without emotional and behavioral problems. Our study emphasizes the importance of biological rhythm and its influence on emotional and behavioral problems in schoolchildren. Early detection of any biological rhythm disruption may enhance further assessment of any eventual emotional and behavioral problem and even a psychopathology.

Assuntos

RESUMO

El objetivo de este trabajo fue explorar la estabilidad del ser víctima y ser agresor en tres puntos en el tiempo y la direccionalidad de la causalidad entre la victimización y los problemas emocionales, por un lado, y entre la agresión y los problemas de conducta en adolescentes, por el otro. Se constituyó una muestra intencional de 485 alumnos de dos escuelas secundarias de Paraná, Entre Ríos. Un 42% correspondió a alumnos varones; la media de edad fue de 13.6 años. Los participantes contestaron un cuestionario sociodemográfico, el Cuestionario de Agresores/Víctimas de Olweus (que mide bullying verbal, físico, relacional y cyberbullying), el Inventario de Depresión de Kovacs, la Escala de Síntomas Psicosomáticos de Rosenberg para ansiedad y las escalas de conducta antisocial y agresividad del ASEBA de Achenbach y Rescorla (2001). Los resultados indicaron que un porcentaje similar era víctima en cada uno de los tres tiempos (15%, 16% y 18%). Con respecto al ser agresor, también se hallaba un porcentaje similar en los tres tiempos (9% 10% y 9%). Considerando el grupo que era victimizado en el tiempo 1, un 39% lo era también en los tiempos 2 y 3, mientras que dentro del 9% que era agresor en el tiempo 1, un 57% lo era en los dos tiempos subsiguientes. Un modelo autoregressive cross-lagged indicó que existían efectos bidireccionales entre la victimización y la depresión. También se hallaron efectos bidireccionales para el bullying y la agresividad. Estos resultados indican estabilidad, pero también cambio en el ser victimizado y ser agresor. En la discusión se analizan estos hallazgos a partir de diversos aportes teóricos para explicar tanto la estabilidad como el cambio. Finalmente, se proveen limitaciones y sugerencias para futuros estudios.

Bullying is an important risk factor for mental health of children and adolescents. Bullying is a subset of aggressive behavior, generally defined as an act intended to inflict injury or discomfort upon another student. There is considerable evidence for emotional problems (such as, depression, anxiety, and low self-esteem) among children and young people who experience bullying or peer victimization, and between bullying and behavioral problems (aggression, antisocial behavior, and substance use), but cross-sectional studies cannot explore the direction of the relationship. Besides, longitudinal studies are crucial to explore stability of being victim and being aggressor. There are no many studies that has attempted to do this. In Latin American countries, such as Argentina, longitudinal studies are very scarce in this respect. Exploring the direction of the link between victimization and emotional problems is vital to identify targets of victimization in adolescents and reducing cost of victimization. So, the purpose of this research was examining stability of victims and aggressor in three-time points and determine the direction of the relationship between emotional problems (depression and anxiety) and victimization, on one hand, and between behavioral problems (antisocial behavior and aggression), on the other hand. To this end, data were obtained from a sample of 485 students from two secondary schools attending first course, second and third in Parana, Entre Rios. A 58% was female and 42% was males; Mage = 13.6. They were examined in May (Time 1, T1), August (Time 2, T2), and November (Time 3, T3). To measure victimization, they completed Olweus Bully/ Victim Questionnaire (tapping verbal, physical, relational, and cybervictimization and these kind of bullying), Kovacs Child Depression Inventory for depression, Rosenberg Psychosomatic Symptom Scale for anxiety, and aggressive behavior and antisocial behavior from Achebanch and Rescorla ASEBA (2001), and some sociodemographic questions. Confidentiality and anonymity were ensured. Date was set up with Statistical Package for Social Sciences version 22 and AMOS 16 to set up structural equation modeling (SEM). Results suggested that 15%,16%, and 18% were victims in T1, T2, and T3. As regarding being aggressor, the percentages were 9%, 10%, and 9%. With respect to stability of victim status in each of the three times, a 39% was victim in the three times; as regarding aggressor status, a 57% was aggressor in the three times. An autoregressive cross-lagged with index of victimization, scores on depression and anxiety in T1, T2, and T3 indicated an adequate model fit: CFI = .99, TLI = .96 and RMSEA =.08. Victimization at T1 predicted victimization at T2 and T3. Regarding the links between victimization and emotional problems, this relationship was reciprocal with respect to depression: victimization predicted depression at T2 and T3 and depression predicted victimization in both times, as well. The links between victimization and anxiety was non-significant. Reciprocal links between depression and anxiety were found. With respect to bullying, antisocial behavioral and aggression model, results indicated a good model fit: CFI = .99, TLI = .96, and RMSEA = .06. Findings suggested reciprocal links between bullying and aggression. Links between bullying and antisocial behavioral were non-significant. These results suggested stability in victim status and aggressor status, but also change in only a period of six month. Besides, results showed that the link between victimization and depression was reciprocal: depression was an antecedent but a consequence of victimization, as well; the same happened for bullying and aggression. So, these results are in line with a vast literature suggesting reciprocal effects. In the discussion, we provided further explanation of the results, considering domination theory among others. Finally, limitations and suggestion for carrying out future studies are provided.

RESUMO

The present study investigated Beck's cognitive diathesis-stress theory (1967, 1987) for the prediction of emotional and behavioral problems in childhood. The study included 218 participants aged 10 to 16 years (M = 12.38, SD = 1.16) who underwent two evaluations with an interval of 8.4 months between them. In the first evaluation, sample was divided according to the participants' cognitive vulnerability (vulnerable, moderate, resilient) and in the second, by their experience of stressful events in recent months (low risk, moderate risk, high risk). The groups were compared by variation in the intensity of the symptoms over time. Results showed that high-risk cognitively vulnerable children had increased externalizing symptoms and children with moderate and high cognitive vulnerability had increased internalizing symptoms at Time 2. These results suggest the importance of considering dysfunctional cognitions and the existence of a certain level of stressful events for the development of psychopathology in childhood.

RESUMO

Esse estudo investigou a relação entre clima familiar e problemas emocionais e comportamentais na infância. Participaram 237 mães, pais ou cuidadores de crianças matriculadas em escolas do ensino fundamental da cidade do Rio de Janeiro. Os dados foram coletados por meio do Inventário de Clima Familiar e do Child Behavior Checklist (CBCL 618). Correlações de Pearson e regressões lineares múltiplas indicaram associação negativa entre apoio e coesão familiar e problemas emocionais/comportamentais infantis. Além disso, conflito e hierarquia relacionaram-se positivamente com estes problemas. Os resultados apontaram para a importância dos processos proximais, em especial do clima familiar, como fatores de proteção para o desenvolvimento infantil.

This study investigated the relationship between family climate and emotional/behavioral problems in childhood. A total of 237 mothers, parents or caregivers of children enrolled in elementary schools in Rio de Janeiro participated in the study. Data were collected through the Family-Climate Inventory and the Child Behavior Checklist (CBCL 6/18). Pearson's correlations and multiple linear regressions indicated a negative association between family support and cohesion and children's emotional/behavioral problems. Thus, conflict and family hierarchy were positively associated with these problems. The results showed the importance of the proximal processes, and especially the family climate, as an important source of protection for children's development.

Este estudio investigó la relación entre el clima familiar y los problemas emocionales/comportamentales en la infancia. Participaran 237 madres, padres o cuidadores de niños matriculados en escuelas del sistema educativo fundamental de Río de Janeiro. Los datos fueron recogidos por medio del Inventario de Clima Familiar y el Child Behavior Checklist (CBCL 6/18). Correlaciones de Pearson y regresiones lineares múltiples indicaran asociación negativa entre apoyo y cohesión familiar y los problemas emocionales y de comportamiento de los niños. Además conflicto y jerarquía presentaran relación positiva con estos problemas. Los resultados indican que los procesos proximales, específicamente el clima familiar, son una importante fuente de protección para el desarrollo de los niños.

Assuntos

RESUMO

A adolescência é um período do desenvolvimento suscetível ao estresse e aodesenvolvimento de problemas emocionais e de comportamento. Esta pesquisa analisa afunção do estresse, como variável preditora, no desenvolvimento de problemas emocionaise de comportamento nos adolescentes. A amostra é de 83 adolescentes, entre os 12 e os15 anos de idade, que cursam o 8º e o 9º Ano do Ensino Fundamental, em uma escolapública de uma cidade de médio porte do Estado de São Paulo. Em grupo, é aplicado oYouth Self-Report(YSR), a AdolescentPerceivedEventsScale (APES) e a Escala deEstresse para Adolescentes (ESA). A análise de regressão logística univariada indicaque os participantes com maior risco para a ocorrência dos problemas emocionais e decomportamento, incluindo os problemas internalizantes e externalizantes, são aquelesexpostos a um maior número de estressores e com maior frequência de sintomas deestresse. Tanto o número de estressores, quanto a frequência de sintomas de estressesão identificados como fatores de risco para a ocorrência dos problemas emocionais ede comportamento. A compreensão dos processos envolvidos no desenvolvimento dapsicopatologia, nos adolescentes, favorece a prevenção e a elaboração de intervençõesmais eficazes para esta população(AU)

Adolescence is a period of the development susceptible to stress and thedevelopment of emotional and behavioral problems. This research analyzes the functionof stress as a predictor variable in the development of emotional and behavioral problemsin adolescents. The sample is from 83 adolescents (67.47% girls), aged between 12and 15 years old; who attend the 7th grade and the 8th grade of a public school in amedium-sized city in the state of São Paulo, Brazil. For the group, the Youth SelfReport(YSR); the Adolescent Perceived Events Scale (APES); and the Stress Scale for Adolescents (Escala de Estresse para Adolescentes – ESA) were applied. Theunivariate logistic regression analysis indicates that participants with higher risk forthe occurrence of emotional and behavioral problems, including internalizing andexternalizing problems are those exposed to more stressors and greater frequency ofsymptoms of stress. Both the number of stressors, as the frequency of stress symptomsare identified as risk factors for the occurrence of emotional and behavioral problems.Understanding of the processes involved in developing the psychopathology inadolescents, promotes the prevention and the development of more effectiveinterventions for this population(AU)

La adolescencia es un período de desenvolvimiento susceptible al estrés yde desarrollo de problemas emocionales y de comportamiento. Esta investigaciónanaliza el papel del estrés como una variable predictiva en el desarrollo de problemasemocionales y de comportamiento en los adolescentes. La muestra de 83 adolescentesde entre 12 y 15 años, que cursan octao y noveno año de una escuela pública en unaciudad de tamaño medio del Estado de São Paulo. Les es aplicado el Youth SelfReport(YSR),la AdolescentPerceivedEventsScale (APES) y la Escala de Estrés paraAdolescentes (ESA). El análisis de regresión logística univariable indica que losparticipantes con mayor riesgo para la aparición de problemas emocionales y deconducta, incluyendo problemas de internalización y externalización, son los másexpuestos a un mayor número de estresores y una mayor frecuencia de los síntomasde estrés. Tanto el número de estresores, como la frecuencia de los síntomas deestrés son identificados como factores de riesgo para la aparición de problemasemocionales y de comportamiento. La comprensión de los procesos involucrados enel desarrollo de la psicopatología en adolescentes, promueve la prevención y el desarrollode intervenciones más eficaces para esta población(AU)

RESUMO

Los estudios de prevalencia en salud mental en edades tempranas (primeros 5 años de vida) han sido insuficientes y escasos. Dado que la evidencia neurobiológica, económica, psicológica y social ha demostrado que intervenir durante los primeros años de vida es altamente efectivo para disminuir los problemas psicosociales, es que es urgente obtener datos nacionales sobre problemas afectivos y conductuales en la temprana infancia y edad preescolar. El presente trabajo tuvo como objetivo validar un instrumento de reporte parental denominado Inventario de Conductas Infantiles para niños de entre 1½-5 años (CBCL 1½-5). El test fue validado a través de un proceso de jueces expertos, para posteriormente obtener indicadores de confiabilidad y validez en una muestra de 418 niños pertenecientes a la Región Metropolitana. Los resultados obtenidos en la muestra chilena son coherentes con el modelo bifactorial propuesto por los autores del instrumento, la dimensión Internalización da cuenta de los problemas ansioso-depresivos, quejas somáticas y retraimiento en los niños/as y la Externalización, de los aspectos atencionales y la conducta agresiva. Se concluye que el CBCL 1½-5 es un instrumento válido y confiable para ser aplicado a la realidad nacional, permitiendo ser utilizado para obtener indicadores de diversos trastornos de salud mental en la temprana infancia y edad preescolar.

Prevalence studies in infant and preschool mental health have been scarce and insufficient. Considering the ample neurobiological, psychological, economical and social evidence that has demonstrated that intervening in early years may be a highly effective strategy for lowering the rates of mental health problems, is urgent to find prevalence data about early emotional and behavioral problems. To validate an instrument called Child Behavior Checklist for ages 1.5-5 (CBCL 1-5-5). The study was made through a process with expert judges, and subsequently, reliability and validation results were obtained in a sample of 418 children from Region Metropolitana. Data from a Chilean sample confirmed the bi-factorial model originally proposed by the authors who create the instrument. Internalizing dimension account for anxious-depression symptoms', somatic complaints, and withdrawal in children, and Externalizing dimension account for atentional and behavioral problems. The CBCL 1.5-5 is a valid and reliable instrument and can be apply to Chilean reality, obtaining good signs of emotional and behavioral problems in infancy and preschool ages.

Assuntos

RESUMO

Este artigo discute algumas diretrizes para a implementação e avaliação de programas de prevenção a problemas emocionais e comportamentais em crianças e adolescentes, visando a transformação da tecnologia de pesquisa em serviços comunitários. Abordar-se-á uma estrutura conceitual de intervenções preventivas em saúde mental, a fundamentação dos programas preventivos em teoria, a avaliação de necessidades e o envolvimento da comunidade durante o planejamento e implementação do programa, a replicação de programas preventivos cuja efetividade foi empiricamente verificada e a avaliação de processo e resultados destes programas. Como conclusão, será discutida uma agenda de pesquisa para o avanço da área no Brasil.

This paper presents some directives for implementing and evaluating emotional and behavioral problem programs for children and adolescents, aiming at the transformation of research technology into community services. The following are discussed: the conceptual framework of preventive interventions in mental healthcare, the theoretical bases of preventive programs, the assessment of needs and community participation during the planning and implementation of the program, the replication of preventive programs that were empirically supported, and the assessment of the process and long-term results of these programs. As a conclusion, a research agenda for the advancement of this field in Brazil is provided.

Assuntos