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BACKGROUND: Adverse Childhood Experiences (ACEs) are potentially traumatic events that affect children and adolescents, increasing the risk for negative outcomes in several developmental domains. The literature suggests that ACEs affect boys and girls differently, and that protective factors such as social and emotional skills may favor resilience processes and promote Psychosocial Adjustment. OBJECTIVE: The present study aimed to verify gender differences in relation to ACEs and Empathy, and to identify whether the effect of ACEs on Psychosocial Adjustment is moderated by Empathy. PARTICIPANTS AND SETTING: A total of 1229 boys and girls aged 14 to 17 years from public schools in regions considered to be of high social vulnerability in two cities of Brazil participated in this study. METHODS: Comparisons between genders were carried out using a logistic regression model. We then fitted multiple regression models predicting Psychosocial Adjustment, where ACEs, Empathy, and an interaction term between ACEs and Empathy were employed as independent variables, controlled by gender. RESULTS: Logistic regression analysis showed that girls experience ACEs more often than boys (d = 0.26, p = 0.02; d = 0.36; p < 0.001), and score higher on the Empathy scale (d = 0.43, p < 0.001). The genders do not differ in Community Violence Exposure nor Psychosocial Adjustment levels. Interaction analysis showed that Empathy moderates the effect of ACEs on adolescents' level of Psychosocial Adjustment. In the context of close relationships, Empathy may counteract the effect of ACEs, while in cases involving domestic violence and/or psychological abuse, it may amplify the impact of ACEs. CONCLUSIONS: The results show the relevance of considering gender specificities and that the role played by Empathy is more complex and needs further investigation. We emphasize that programs and policies aiming to prevent ACEs and their harmful effects should consider its types, in addition to the diversity and the specificities of the target population.

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OBJECTIVE: To evaluate the influence of filling material and timing of surgery on radiograph outcomes of alveolar grafting with premaxillary osteotomy. The null hypothesis was that radiographic outcomes would be similar with both rhBMP-2 (rhBMP-2G) and cancellous bone from the iliac crest (IG), regardless of the timing of surgery. DESIGN: Cross-sectional study with consecutive sampling of 56 periapical or occlusal radiographs taken 12 months after surgery. SETTING: A single tertiary craniofacial center. PATIENTS/PARTICIPANTS: Twenty-eight patients with complete bilateral cleft lip and palate and mean age of 13 years. The individuals underwent bilateral alveolar grafting associated with premaxillary osteotomy (AG + PO) with rhBMP-2 or cancellous bone from the iliac crest. INTERVENTIONS: Experienced maxillofacial surgeons used the same surgical technique in both groups. AG + PO were assigned as success or failure by 3 blinded raters based on modified Bergland and SWAG scales. MAIN OUTCOME MEASURES: The influence of filling materials and timing of surgery on radiographic outcomes was verified by Fisher's exact test and chi-square test (P < .05). RESULTS: There was no significance variation between the mean age of participants in the rhBMP-2G and IG (P = .471). Scales showed almost perfect reliability (agreement rate = 96.4%; K = 0.85). rhBMP-2G and IG had similar success rates with modified Bergland scale (85.7% and 82.1%) and SWAG scale (92.9% and 82.1%), respectively. However, only modified Bergland scale found influence of age on radiographic outcomes (P = .025). CONCLUSIONS: AG + PO performed with rhBMP-2 and iliac crest bone showed similar radiographic success rates, regardless of the timing of surgery.

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OBJECTIVE: The aim of this study was to describe coping strategies used by parents of children with cleft palate with or without a cleft (CP ± L) during the early development of their children in El Salvador. DESIGN: Qualitative interviews were completed with 16 parents of children born with CP ± L who were 6 months to 6 years old. Parents were questioned about their emotions and coping during eight time periods: prenatal, birth, social interaction before the first surgery, the beginning of surgeries, social interaction after the first surgery, early childhood education (ECE), speech-language therapy, and formal education. Thematic analysis (TA) was used to identify coping strategies as conceptualized by Lazarus and Folkman (1984). RESULTS: Four major themes emerged: (a) experienced emotions related to diagnosis, (b) interpretations related to the birth of a child with a cleft, (c) seeking and experiencing cleft treatment, and (d) social interaction of the children. During prenatal and birth stages, parents used emotion-focused strategies. A few hours to a week after birth, they used problem-focused strategies, which led them in search of treatment. Some parents used avoidance strategies during periods of social interaction before surgery, ECE, and formal education. Socioeconomic challenges impacted access to speech-language therapy. Sociocultural factors, such as discrimination, religion, and folk beliefs, appeared to influence some of the coping strategies used by parents. CONCLUSIONS: Problem-focused strategies appear to be helpful in seeking surgical treatments. The emotion-focused strategy of avoidance seemed to have adverse effects in minimizing opportunities for social interaction prior to surgery and early education.

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This study focused on early adolescents' stress of language brokering and examined the moderating role of family cumulative risk in the relation of language brokering to adjustment problems. Data came from self-reports of 604 low-income Mexican American adolescent language brokers (54% female; X ¯ age = 12.4 ; SD = 0.97; 75% born in the United States) and their parents (99% foreign-born) in central Texas. Path analyses revealed that brokering stress, but not frequency, was positively associated with adolescents' adjustment problems, including depressive symptoms, anxiety, and delinquency. We also found that the relation between stress of brokering for mothers and adolescents' depressive symptoms was stronger among families with a high cumulative risk. Further, with a high cumulative risk, adolescents exhibited delinquent behaviors regardless of the levels of stress from translating for fathers. Current findings underscore the importance of examining family contexts in assessing the consequences of language brokering for Mexican American early adolescents' well-being.

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El objetivo de esta investigación es analizar el ajuste psicosocial en los adolescentes víctimas de violencia de pareja, considerando posibles diferencias en función de la frecuencia de la victimización y del sexo de los adolescentes. Los indicadores del ajuste psicológico y social analizados son el ánimo depresivo, los sentimientos de soledad, el autoconcepto, la satisfacción con la vida y la calidad de la comunicación con el padre y la madre. Participaron 672 adolescentes españoles (325 chicas, 347 chicos), entre 12 y 19 años (M = 14.45; DT = 1.62). Los resultados indicaron que los adolescentes, chicos y chicas, en situación frecuente de victimización presentan menor autoconcepto familiar, más problemas de comunicación con la madre, mayor ánimo depresivo y sentimientos de soledad y menor satisfacción con la vida que los adolescentes cuya victimización es ocasional. Estos resultados muestran la necesidad de diferenciar entre ambos grupos de adolescentes víctimas de la violencia de pareja.

The objective of this research is to analyze the psychosocial adjustment on adolescent victims of dating violence, considering possible differences in terms of the frequency of victimization and sex of adolescents. The analyzed indicators of psychological and social adjustment are depressed mood, feelings of loneliness, self-concept, satisfaction with life and quality of communication with father and mother. 672 Spanish adolescents (325 girls, 347 boys), aged 12 to 19 years (M=14.45, SD=1.62) participated. The results indicated that adolescents, boys and girls, frequently victimized have less family self-concept, more communication problems with the mother, more depressive mood and feelings of loneliness and less satisfaction with life, than adolescents whose victimization is occasional. These results show the need to differentiate between both groups of adolescent victims of dating violence.

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O reduzido envolvimento social, aspeto central na definição da solidão social, foi analisado numa amostra de 337 crianças portuguesas (171 rapazes), com idades compreendidas entre os três e os cinco anos. Com base em metodologias de observação, realizadas em contexto de Jardim de infância, verificou-se que níveis reduzidos de envolvimento social estão negativamente associados a baixos níveis de competência social, de resiliência e de um elevado ego-controle. A aceitação pelos pares, o impacto e a preferência social, analisados com base nas medidas sociométricas, encontram-se, também, negativamente associados com os níveis de baixo envolvimento social. Os resultados refletem as dificuldades de ajustamento psicossocial destas crianças e enfatizam o seu potencial risco para o desenvolvimento saudável.

Low social engagement, a central feature of the definition of solitude, was examined in a sample of 337 Portuguese children (171 boys), ages ranging between 3 and 5 years. Based on observation measures, collected in school settings, Low Social Engagement was negatively associated with a broad range of adaptive outcomes, including social competence, ego-resilience as well as higher levels of ego-undercontrol. Negative associations were also found with sociometric measures of peer acceptance, social impact and preference. The results reflect these children's difficulties in the social domain and stress the potential risk factor of social solitude for their healthy development.

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O reduzido envolvimento social, aspeto central na definição da solidão social, foi analisado numa amostra de 337 crianças portuguesas (171 rapazes), com idades compreendidas entre os três e os cinco anos. Com base em metodologias de observação, realizadas em contexto de Jardim de infância, verificou-se que níveis reduzidos de envolvimento social estão negativamente associados a baixos níveis de competência social, de resiliência e de um elevado ego-controle. A aceitação pelos pares, o impacto e a preferência social, analisados com base nas medidas sociométricas, encontram-se, também, negativamente associados com os níveis de baixo envolvimento social. Os resultados refletem as dificuldades de ajustamento psicossocial destas crianças e enfatizam o seu potencial risco para o desenvolvimento saudável.(AU)

Low social engagement, a central feature of the definition of solitude, was examined in a sample of 337 Portuguese children (171 boys), ages ranging between 3 and 5 years. Based on observation measures, collected in school settings, Low Social Engagement was negatively associated with a broad range of adaptive outcomes, including social competence, ego-resilience as well as higher levels of ego-undercontrol. Negative associations were also found with sociometric measures of peer acceptance, social impact and preference. The results reflect these children's difficulties in the social domain and stress the potential risk factor of social solitude for their healthy development.(AU)

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OBJECTIVE: To describe patterns of psychosocial adjustment and psychological attributes in preadolescent children as a function of headache status in univariate and adjusted analyses. METHODS: Target sample of children (n = 8599) was representative of Brazil by demographics. Parents were interviewed using validated headache questionnaires and the "Strengths and Difficulties Questionnaire," which measures behavior in 5 domains. One-year prevalence estimates of headaches were derived by demographics. Relative risk of abnormal Strengths and Difficulties Questionnaire scores were separately modeled in children with episodic migraine and episodic tension-type headache using logistic regression. RESULTS: Sample consisted of 5671 children (65.9% of the target sample), from 5 to 12 years old (49.3% girls). Prevalence estimates in children were 20.6% for "no headache," 9% for episodic migraine, and 12.8% for episodic tension-type headache. Abnormal scores in psychosocial adjustment were significantly more likely in children with episodic migraine, relative to children without headaches and children with episodic tension-type headache, and was significantly influenced by frequency of headache attacks, nausea, school performance, prenatal exposure to tobacco, as well as by phonophobia and photophobia. CONCLUSIONS: Children with migraine are at an increased risk of having impairment in psychosocial adjustment, and the factors associated with this impairment have been mapped. Future studies should address the directionality of the association and putative mechanisms to explain it.

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The current study examined how parental ethnic socialization informed adolescents' ethnic identity development and, in turn, youths' psychosocial functioning (i.e., mental health, social competence, academic efficacy, externalizing behaviors) among 749 Mexican-origin families. In addition, school ethnic composition was examined as a moderator of these associations. Findings indicated that mothers' and fathers' ethnic socialization were significant longitudinal predictors of adolescents' ethnic identity, although fathers' ethnic socialization interacted significantly with youths' school ethnic composition in 5th grade to influence ethnic identity in 7th grade. Furthermore, adolescents' ethnic identity was significantly associated with increased academic self-efficacy and social competence, and decreased depressive symptoms and externalizing behaviors. Findings support theoretical predictions regarding the central role parents play in Mexican-origin adolescents' normative developmental processes and adjustment and, importantly, underscore the need to consider variability that is introduced into these processes by features of the social context such as school ethnic composition.

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In our days, more than 90% of children with congenital heart disease (CHD) reach adolescence and adult life, and therapeutic procedures are performed with late quality of life (QOL) in mind. Rates of success are now assessed at long range by sequels, residues and adaptation of the individuals to normality. The attempt to identify factors to avoid psychopathological sequels in this group of "new" cardiac patients is one of the most important aspects of studies on late outcome of congenital heart disease. This fact remains valid in the current era and is in consonance with the attitude to more and more value child-adolescent and adolescent-adult transitions in patients with CHD submitted or not to surgical or percutaneous intervention in childhood. Resilience and ability to adapt could also be improved by a multiprofessional approach of attitudes, abilities and psychological characteristics, aiming to prevent the psychopathologic effects of the disease.

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Introducción: El trastorno afectivo bipolar (TAP) está asociado con un significativo deterioro en el funcionamiento social, laboral y familiar, incluso en períodos de estabilidad clínica, y ello podría explicarse por un déficit de la cognición social. Objetivo: Revisar los principales hallazgos sobre la cognición social de los pacientes bipolares, a través de sus principales dimensiones y a través de las distintas fases de la enfermedad. Método: Búsqueda en la literatura biomédica en Medline, OVID, Proquest y EMBASE, cruzando los términos MeSH cognición social, teoría de la mente, reconocimiento de emociones, empatía y procesamiento emocional con trastorno bipolar, delimitando los resultados a los estudios clínicos con calidad metodológica media/alta, en español o inglés, y publicados en los últimos 20 años en la población infantil y adulta. Resultados: Se seleccionaron 83 artículos que se referían al tema, aunque sólo 16 evalúan específicamente la cognición social en población bipolar. La mayoría de estudios muestran un déficit tanto en las fases de descompensación como en estado de eutimia. Discusión: Desde una perspectiva neurocognitiva se plantean diversas explicaciones a estas alteraciones cognitivas, asociadas con la existencia de sintomatología subsindrómica afectiva. Finalmente, se revisan las estrategias rehabilitadoras que podrían ser de utilidad para revertir este déficit que conlleva importantes repercusiones funcionales...

Introduction: Bipolar disorder (BD) is associated with significant impairment in social, work, and family functioning, even in euthymic state. This could be explained by a social cognition deficit. Objective: To review the findings on social cognition in bipolar patients through its main dimensions, and through the various stages of the illness. Method: We searched the biomedical literature on Medline, OVID, Proquest, and EMBASE for articles matching the MeSH terms “social cognition”, “theory of mind”, “emotion recognition”, “empathy”, and “emotional processing” to “bipolar disorder”, limiting the results to clinical studies with medium/high methodological quality, in Spanish or English and published in the last 20 years, in children and adults. Results: We selected 83 items referring to this topic but only 24 specifically assessed social cognition in bipolar population. Most studies showed a deficit in both the phases of relapse as well as in euthymic state. Discussion: From a neurocognitive perspective a number of explanations arise for this cognitive impairment, associated with the existence of subsyndromal affective symptoms. Finally, we review the rehabilitation strategies that could be useful to reverse this deficit that carries important functional implications...

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