Depression, Anxiety and Stress in Children and Adolescents

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Child and Adolescent Psychiatry".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 25047

Special Issue Editors


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Guest Editor
Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University Cluj-Napoca, Cluj-Napoca 400015, Romania
Interests: cognitive behavioral therapy; digital mental health promotion; clinical psychology; psychopathology; parenting; cognitive science; psychometrics; psychotherapy
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Guest Editor
Department of Psychology, Psitec Laboratory-ULR 4072, University of Lille, Rue du Barreau, BP 60149, 59653 Villeneuve d'Ascq, France
Interests: parenting; emotions; attachment; well-being; socio-emotional development; digital use; adversity; social support

Special Issue Information

Dear Colleagues,

There is currently global concern regarding the mental and emotional health of youths. Emotional disorders that have early onset come with high lifetime persistence as well as immense personal and societal consequences.

The aim of this Special Issue is to stimulate urgently needed research on the mechanisms and innovative interventions for addressing Depression, Anxiety and Stress in Children and Adolescents. We welcome original research studies (e.g., experimental, randomized controlled trials, mixed methods) and meta-analyses on the topic. It is encouraged that the focus of the research be to either validate innovative assessment systems for youth stress, anxiety and depression; investigate understudied mechanisms and risk factors connected to current world changes and stressors for such conditions; or to evaluate accessible (e.g., digital) interventions aiming to prevent or reduce depression, anxiety and stress in children and adolescents.

We look forward to receiving your contributions.

Dr. Oana A. David
Dr. Marie Danet
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • depression
  • anxiety
  • stress
  • children and adolescents
  • digital interventions
  • emotion regulation

Published Papers (12 papers)

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Research

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10 pages, 577 KiB  
Article
The Mediating Role of Parenting Style in the Relationship between Parents’ Openness to Different Ways of Thinking and Child Anxiety
by Adele Zeevi-Cousin and Osnat Lavenda
Children 2023, 10(9), 1564; https://doi.org/10.3390/children10091564 - 17 Sep 2023
Viewed by 1968
Abstract
The quality of parent–child relationships plays a significant role in the development of child anxiety, especially regarding aspects of parental control, intrusive behavior, and a lack of warmth. Nevertheless, the underlying mechanisms of these parenting behaviors that are associated with the risk of [...] Read more.
The quality of parent–child relationships plays a significant role in the development of child anxiety, especially regarding aspects of parental control, intrusive behavior, and a lack of warmth. Nevertheless, the underlying mechanisms of these parenting behaviors that are associated with the risk of child anxiety have yet to be revealed. The present study aims to examine the contribution of a cognitive aspect of parenting, i.e., openness to different ways of thinking, to the development of child anxiety through its impact on parenting style. A sample of 300 Israeli parents (72% women) over the age of 18 (M = 38.8, SD = 6.2), with at least one child over the age of 6 (M = 13.3, SD = 5.5 of oldest child), was recruited through social media platforms. Participants provided demographic information and filled out self-reported questionnaires dealing with child anxiety (using the Child Behavior Checklist), openness to different ways of thinking (using the Interpersonal Reactivity Index), and parenting style (using the Parental Behavior Inventory). The analysis confirmed the mediation role of hostile/coercive parenting style in the association between parental openness to different ways of thinking and child anxiety. However, the association between supportive/engaged parenting and child anxiety was non-significant. Apparently, openness to different ways of thinking allows for parents to consolidate parenting that does not resort to coercive and hostile behaviors, control, obedience, and severe strictness. As a result, the child develops self-regulation and coping mechanisms that reduce the risk for developing anxiety. Full article
(This article belongs to the Special Issue Depression, Anxiety and Stress in Children and Adolescents)
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16 pages, 627 KiB  
Article
Stress and Anxiety among High School Adolescents: Correlations between Physiological and Psychological Indicators in a Longitudinal Follow-Up Study
by Gábor Pál Stromájer, Melinda Csima, Réka Iváncsik, Bernadett Varga, Krisztina Takács and Tímea Stromájer-Rácz
Children 2023, 10(9), 1548; https://doi.org/10.3390/children10091548 - 14 Sep 2023
Cited by 1 | Viewed by 2127
Abstract
Mental and psychological disorders are serious health problems worldwide. Anxiety among high school students can affect school performance, relationships, and family life. Objective: Our aim is to understand the anxiety levels and associated factors among high school students and compare the results of [...] Read more.
Mental and psychological disorders are serious health problems worldwide. Anxiety among high school students can affect school performance, relationships, and family life. Objective: Our aim is to understand the anxiety levels and associated factors among high school students and compare the results of psychological tests measuring anxiety with the cortisol levels obtained from biological sampling. Method: In our longitudinal follow-up study, we involved 125 individuals in May 2019. Validated measurement tools were used during questionnaire data collection, including the State–Trait Anxiety Inventory, Clear Communication Scale, Multiple Social Perceived Support Scale, and related HBSC questions. As objective data, we collected hair samples for cortisol level measurement. Results: At the end of the school year, the anxiety levels measured by psychological tests were significantly higher (p = 0.001) compared to the anxiety levels at the beginning of the next school year. Anxiety levels were higher among girls and were influenced by the type of school and parental expectations. Both state anxiety and trait anxiety showed a strong correlation with psychosomatic symptoms (p < 0.001) and anxiety arising from school expectations (p < 0.05). The changes in cortisol levels did not follow the changes in psychological tests. Cortisol level increased (p = 0.01) in the second sample. Full article
(This article belongs to the Special Issue Depression, Anxiety and Stress in Children and Adolescents)
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12 pages, 523 KiB  
Article
Depression Disorders in Mexican Adolescents: A Predictive Model
by Gilda Gómez-Peresmitré and Romana Silvia Platas-Acevedo
Children 2023, 10(7), 1264; https://doi.org/10.3390/children10071264 - 22 Jul 2023
Cited by 1 | Viewed by 974
Abstract
Depression is a type of mood disorder that can impact individuals of any age. A variety of factors, including biological, psychological, and environmental factors, can contribute to the likelihood of developing depression. If the environment in which a person exists does not support [...] Read more.
Depression is a type of mood disorder that can impact individuals of any age. A variety of factors, including biological, psychological, and environmental factors, can contribute to the likelihood of developing depression. If the environment in which a person exists does not support its occurrence, the disorder may not manifest. The current research follows a retrospective, correlational approach, utilizing a non-probability sample of 557 high school students from public schools in Mexico City. This sample includes 181 males and 376 females, aged between 15 and 18 years, with an average age of 15.66 and a standard deviation of 0.68. The main objective of this research is to identify the variables that serve as risk factors for the development of depressive disorders in Mexican adolescents in high school. The data show that 78% of the adolescents in the total sample were at risk of depression, which is consistent with what has been reported by other researchers. The regression model shows that alcohol and drug consumption is associated with and influences the emergence and presence of depressive symptomatology and major depressive disorder. Adolescents with different sexual orientations than heterosexuals are twice as likely to suffer depression and emotional dysregulation. It was confirmed that the developmental stage and adolescence contributes as a context that favors the evolution of such a symptomatology. Full article
(This article belongs to the Special Issue Depression, Anxiety and Stress in Children and Adolescents)
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14 pages, 298 KiB  
Article
Self-Compassion and Anxiety in Adolescents with and without Anxiety Disorder
by Edibe Tali, Eva S. Potharst, Esther I. de Bruin and Elisabeth M. W. J. Utens
Children 2023, 10(7), 1181; https://doi.org/10.3390/children10071181 - 07 Jul 2023
Cited by 2 | Viewed by 1572
Abstract
Previous studies have linked self-compassion to mental health, specifically anxiety, in non-clinical adolescents, suggesting that self-compassion can be a protective factor against anxiety. This study compared the overall level of self-compassion and (un)compassionate self-responding in adolescents with and without an anxiety disorder and [...] Read more.
Previous studies have linked self-compassion to mental health, specifically anxiety, in non-clinical adolescents, suggesting that self-compassion can be a protective factor against anxiety. This study compared the overall level of self-compassion and (un)compassionate self-responding in adolescents with and without an anxiety disorder and assessed the association between self-compassion and anxiety. This cross-sectional study included adolescents (12–19 years) with an anxiety disorder (N = 23) and a reference group (N = 28). Participants completed the Self-Compassion Scale (SCS) and State Trait Anxiety Inventory (STAI). Results showed that overall self-compassion and uncompassionate self-responding were significantly lower and higher in the clinical than the reference group, respectively, while compassionate self-responding did not differ between groups. In the clinical group, only uncompassionate self-responding was significantly associated with higher anxiety. In the reference group, uncompassionate self-responding showed a significant positive association with anxiety, and compassionate self-responding showed a significant negative association with anxiety. Although the results suggest that low uncompassionate self-responding may buffer against anxiety, the role of compassionate and uncompassionate self-responding remains unclear. An alternative explanation is that the uncompassionate self-responding items measure the presence of psychopathology in adolescents with an anxiety disorder. More research on the construct validity of the SCS uncompassionate self-responding scale is needed. Full article
(This article belongs to the Special Issue Depression, Anxiety and Stress in Children and Adolescents)
16 pages, 880 KiB  
Article
Structural and Intermediary Social Determinants of Health and the Emotional and Behavioral Health of US Children
by Ngozi V. Enelamah, Margaret Lombe, Mansoo Yu, Melissa L. Villodas, Andrew Foell, Chrisann Newransky, Lisa C. Smith and Von Nebbitt
Children 2023, 10(7), 1100; https://doi.org/10.3390/children10071100 - 22 Jun 2023
Viewed by 1291
Abstract
Children grow up in homes where varying environmental and socioeconomic contexts have a bearing on their emotional and behavioral health (EBH). This study used data from a representative sample of the child supplement of the US National Health Information Survey (NHIS) and applied [...] Read more.
Children grow up in homes where varying environmental and socioeconomic contexts have a bearing on their emotional and behavioral health (EBH). This study used data from a representative sample of the child supplement of the US National Health Information Survey (NHIS) and applied the social determinants of health (SDoH) framework to explore factors associated with child EBH. We conducted a path analysis of the child’s EBH measured by the strengths and difficulties questionnaire (SDQ) from their macro and socioeconomic contexts, e.g., policy, household, and other health system risk factors. For children in the sample, aged 4 to 17 years old (n = 9205), most path relationships to child SDQ scores were statistically significant. The total effects from a child’s visit to a mental health specialist (0.28) and child’s age (0.22) had the highest coefficients to child SDQ scores. A modified model showed a better fit with X2 (4) = 22.124, RMSEA = 0.021, and 90% CI [0.013–0.03], CFI = 0.98. Findings indicate that child factors such as being older, the use of mental healthcare services, and family socioeconomic status were significantly associated with EBH, calling attention to the need for more responsive policy and behavioral health interventions that address household/familial and child-level factors, critical determinants of child wellbeing. Full article
(This article belongs to the Special Issue Depression, Anxiety and Stress in Children and Adolescents)
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13 pages, 1800 KiB  
Article
Sadness and Loneliness in Adolescents with Physical, Sensory or Health Problems in Low/Middle-Income Countries
by Angel Denche-Zamorano, María Ángeles García-Gil, María Mendoza-Muñoz and Sabina Barrios-Fernandez
Children 2023, 10(6), 996; https://doi.org/10.3390/children10060996 - 01 Jun 2023
Viewed by 1433
Abstract
Feelings of loneliness and sadness are increasing among the global youth, especially in disadvantaged settings. Young people with disabilities from low-income countries may be at greater risk of experiencing such emotions. This study aims to assess the dependence between difficulties/disability and sadness, loneliness [...] Read more.
Feelings of loneliness and sadness are increasing among the global youth, especially in disadvantaged settings. Young people with disabilities from low-income countries may be at greater risk of experiencing such emotions. This study aims to assess the dependence between difficulties/disability and sadness, loneliness and crying for no reason in young people from low- to middle-income countries and to test the risk of experiencing these emotions in young people with different disabilities versus the overall population. A cross-sectional study was conducted based on the Programme for International Student Assessment for Development survey, with 34,604 participants aged 15 years from seven countries: Cambodia, Ecuador, Guatemala, Honduras, Paraguay, Senegal, and Zambia. Dependent relationships were found between difficulties/disabilities and loneliness, sadness and crying. People with disabilities had a higher prevalence of these emotions. The probability of experiencing sadness, loneliness and crying was higher among people with difficulties/disabilities. Young people with disabilities in low-income countries are at a higher risk of experiencing feelings of loneliness, sadness and crying compared to the general population of the same age. Full article
(This article belongs to the Special Issue Depression, Anxiety and Stress in Children and Adolescents)
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12 pages, 1324 KiB  
Article
Beyond Screen Time: The Different Longitudinal Relations between Adolescents’ Smartphone Use Content and Their Mental Health
by Shunsen Huang, Xiaoxiong Lai, Yajun Li, Yang Cui and Yun Wang
Children 2023, 10(5), 770; https://doi.org/10.3390/children10050770 - 24 Apr 2023
Cited by 1 | Viewed by 2057
Abstract
Purpose: Previous studies focusing on the relationship between adolescents’ screen time and mental health have uncovered contradictory results. By focusing on smartphone use content (SUC), this study uses specification curve analysis to explore the different effects of SUCs on mental health-based on [...] Read more.
Purpose: Previous studies focusing on the relationship between adolescents’ screen time and mental health have uncovered contradictory results. By focusing on smartphone use content (SUC), this study uses specification curve analysis to explore the different effects of SUCs on mental health-based on longitudinal data. Methods: A total of 2552 adolescents were surveyed in the first (July 2020) and second year (April 2021). A total of 2049 eligible participants (average age = 14.39 ± 2.27, female = 1062) are included in the analysis. Participants reported 20 types of content used by them during smartphone use and their mental health (depression, anxiety, and somatization). Specification curve analysis was used to examine the longitudinal relationship between SUCs and their mental health. Results: Smartphone use for listening to music (median β = 0.18, p < 0.001, NSRPD = 25/27, p < 0.05), chatting online (median β = 0.15, p < 0.001, NSRPD = 24/27, p < 0.05), watching TV (median β = 0.14, p < 0.001, NSRPD = 24/27, p < 0.05), and playing games (median β = 0.09, p < 0.001, NSRPD = 19/27, p < 0.05) produce high to medium negative effects on subsequent mental health. Only using smartphones for online courses exerts no effect on their subsequent mental health (median β = 0.01, p > 0.05, NSRPD = 0/27, p > 0.05). The left 15 types of smartphone content showed unstable effects on future mental health. Depending on the types of content used, these effects ranged from high, medium, and small to none. The relatively descending order of effect on mental health is listening to music, chatting online, watching TV, playing games, and types of content (e.g., browsing social media, making payments, reading online novels) with high but unstable effects, types of content with medium (e.g., browsing news and posting/sharing) but unstable effects, types of content (e.g., using the camera, obtaining life information, and making calls) with small but unstable effects, such as finishing homework and taking online courses. Conclusions: This study enlightens researchers and policymakers to update their understanding of adolescents’ technology use, especially to adopt a differentiated attitude towards different media use content. As nutritionists often do, a “nutritionally balanced” digital diet for young people should be recommended to the public, rather than just suggesting limits on the amount of time they can spend using digital media. Full article
(This article belongs to the Special Issue Depression, Anxiety and Stress in Children and Adolescents)
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12 pages, 1567 KiB  
Article
The Role of Emotion Regulation and Executive Functioning in the Intervention Outcome of Children with Emotional and Behavioural Problems
by Blossom Fernandes, Mark Wright and Cecilia A. Essau
Children 2023, 10(1), 139; https://doi.org/10.3390/children10010139 - 11 Jan 2023
Cited by 4 | Viewed by 3448
Abstract
Emotional and behavioural problems are closely associated with impairments in regulating emotions and in executive functions (EF). To examine this further, the aim of the present study was to determine whether EF and emotion regulation at baseline would predict emotional and behavioural problem [...] Read more.
Emotional and behavioural problems are closely associated with impairments in regulating emotions and in executive functions (EF). To examine this further, the aim of the present study was to determine whether EF and emotion regulation at baseline would predict emotional and behavioural problem scores post-intervention, and further explore the extent to which emotion regulation mediates these outcomes. Participants were 41 primary school children who exhibited emotional and/or behavioural problems, aged 8 to 11 years. All the children completed measures of emotional and behavioural problems, cognitive emotion regulation, anxiety symptoms, and performed two experimental tasks to measure working memory and response inhibition before and after participating in a transdiagnostic Cognitive Behaviour Therapy-based programme, “Super Skills for Life” (SSL), and at 3-months follow-up. Results revealed significant reduction in the use of maladaptive emotion regulation strategy catastrophising and other blame following the intervention. Additionally, EF and emotion regulation was associated with outcomes for emotional problems and conduct problems. More specifically maladaptive emotion regulation strategy such as catastrophising and other blame was closely related with self-reports of emotional problems, likewise other blame, was also linked with scores of conduct problems. This study provides preliminary empirical support for EF and emotion regulation in predicting outcomes of emotional and behavioural problems in children following intervention. Full article
(This article belongs to the Special Issue Depression, Anxiety and Stress in Children and Adolescents)
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14 pages, 281 KiB  
Article
Self-Compassion Correlates of Anxiety and Depression Symptoms in Youth: A Comparison of Two Self-Compassion Measures
by Peter Muris, Kris Bongers, Claudia Schenning, Cor Meesters and Henry Otgaar
Children 2022, 9(12), 1930; https://doi.org/10.3390/children9121930 - 08 Dec 2022
Cited by 3 | Viewed by 1347
Abstract
Background and purpose: Self-compassion is considered as a protective psychological construct that would shield against the development of emotional problems. The aim of the present study was to compare the ‘protective nature’ of two measures of self-compassion: the Self-Compassion Scale for Youth (SCS-Y) [...] Read more.
Background and purpose: Self-compassion is considered as a protective psychological construct that would shield against the development of emotional problems. The aim of the present study was to compare the ‘protective nature’ of two measures of self-compassion: the Self-Compassion Scale for Youth (SCS-Y) and the Sussex-Oxford Compassion for the Self Scale (SOCS-S). Methods: Eighty-seven adolescents aged 12 to 18 years completed both self-compassion measures as well as scales of anxiety and depression symptoms. Results: SCS-Y and SOCS-S scores were positively correlated, and for both measures it was generally found that higher levels of self-compassion were associated with lower levels of emotional symptoms. However, the uncompassionate self-responding scales of the SCS-Y correlated positively with anxiety and depression symptoms and hence can better be seen as indices of vulnerability. Regression analyses suggested that a positive attitude toward oneself, as measured by the self-kindness scale of the SCS or its SOCS-S equivalent ‘feeling for the person suffering’ is particularly relevant as a buffer against emotional problems. Conclusion: The protective nature of self-compassion can be established by both measures. Caution is advised with the use of the uncompassionate self-responding scales included in the SCS-Y as they appear to measure vulnerability rather than protection. Full article
(This article belongs to the Special Issue Depression, Anxiety and Stress in Children and Adolescents)
9 pages, 634 KiB  
Article
Positive Attention Bias Trained during the Rethink Therapeutic Online Game and Related Improvements in Children and Adolescents’ Mental Health
by Oana A. David and Silvia Magurean
Children 2022, 9(11), 1600; https://doi.org/10.3390/children9111600 - 22 Oct 2022
Cited by 3 | Viewed by 1634
Abstract
Attentional bias towards positive stimuli is considered a resilience factor for mental health and well-being. The aim of the present study was to analyze the effects of an attentional bias training for positive faces in a preventive therapeutic game for children and adolescents. [...] Read more.
Attentional bias towards positive stimuli is considered a resilience factor for mental health and well-being. The aim of the present study was to analyze the effects of an attentional bias training for positive faces in a preventive therapeutic game for children and adolescents. The sample of 54, which consisted of children and adolescents aged between 10–16 years, played the REThink game, which included an attentional bias training level based on the visual search paradigm, where children had the task to quickly find the happy face among other angry faces. We measured mental health, and positive and negative emotions and analyzed their associations between changes in attention bias. Attentional bias indicators demonstrated acceptable reliability and results showed that increases in attentional bias towards positive faces were associated with improvements in children and adolescents’ conduct problems, hyperactivity, and peer relationship problems. Overall, our results support the protective role of training attentional bias towards positive faces as part of a preventive therapeutic game for children and adolescents. Full article
(This article belongs to the Special Issue Depression, Anxiety and Stress in Children and Adolescents)
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Review

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32 pages, 1344 KiB  
Review
School Mindfulness-Based Interventions for Youth, and Considerations for Anxiety, Depression, and a Positive School Climate—A Systematic Literature Review
by Jessica Monsillion, Rafika Zebdi and Lucia Romo-Desprez
Children 2023, 10(5), 861; https://doi.org/10.3390/children10050861 - 11 May 2023
Cited by 4 | Viewed by 3181
Abstract
Mindfulness-based interventions (MBIs) are growing in popularity, with research concerning their efficacy with youth populations. Following a preliminary analysis of the existing literature, and given the positive effects of such programs, we felt it relevant to assess whether research has considered the implications [...] Read more.
Mindfulness-based interventions (MBIs) are growing in popularity, with research concerning their efficacy with youth populations. Following a preliminary analysis of the existing literature, and given the positive effects of such programs, we felt it relevant to assess whether research has considered the implications for MBIs on children and adolescents, with regard to depression, anxiety, and school climate. Objectives: We aim to estimate the effect of MBIs as innovative interventions addressing youths in school settings, with special consideration for anxiety, depression, and school climate outcomes. Method: This review investigates the existing literature in the field of mindfulness, using quasi-experimental and randomized control trial (RCT) models, targeted at youth (5–18 years) in school settings. A search was carried out in four databases—WebofScience, Google Scholar, PubMed, and PsycARTICLES. This resulted in 39 articles, which were sorted based on predetermined inclusion criteria; 12 articles qualified. Results: The results show discrepancies in terms of methodological and implementation variables, types of interventions, instructor trainings, assessment measures, and choice of practices and exercises, which make the effects of existing school MBIs difficult to compare. Consistencies were observed in emotional and behavioral regulation, prosocial behaviors, and reducing stress and anxiety in students. The results of this systematic review also suggest that MBIs could be potential mediators in improving student well-being and environmental factors, such as school and class climates. Specifically, children’s sense of safety and community can be improved by an improved quality of relationships between students, their peers, and teachers. Future research should consider incorporating school climate perspectives, such as implementing whole-school MBI approaches and using replicable and comparable study designs and methods, whilst considering the capacities and limitations of the academic and institutional context. Full article
(This article belongs to the Special Issue Depression, Anxiety and Stress in Children and Adolescents)
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Other

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10 pages, 412 KiB  
Systematic Review
Influence of Child’s Temperament on Behaviour Management Problems in the Dental Office: A Literature Review
by Nhat Minh Do, François Clauss, Margot Schmitt and Marie-Cécile Manière
Children 2023, 10(1), 90; https://doi.org/10.3390/children10010090 - 02 Jan 2023
Cited by 1 | Viewed by 1740
Abstract
Background: A child’s temperament could have an influence on his/her behaviour in the dental environment. This review aims to present the main temperament surveys and their clinical use and to discuss the relationship between certain temperament dimensions and Dental Behaviour Management Problems (DBMP). [...] Read more.
Background: A child’s temperament could have an influence on his/her behaviour in the dental environment. This review aims to present the main temperament surveys and their clinical use and to discuss the relationship between certain temperament dimensions and Dental Behaviour Management Problems (DBMP). Methods: A literature search was conducted in Medline/PubMed, ScienceDirect, Wiley Online Library and Cochrane library electronic databases for publications, up to June 2022, investigating the link between child’s temperament and DBMP. Results: From 733 potentially eligible studies, 12 were included in qualitative synthesis. Conclusion: According to studies using the Child Behaviour Questionnaire (CBQ) scale, the most impactful dimensions are activity, extraversion and surgency, high-intensity pleasure and attention control. For those using the Emotionality–Activity–Sociability (EAS) scale, emotionality and shyness have a statistically significant positive linear correlation with dental anxiety and DBMP. It has yet to be determined whether the use and interpretation of these questionnaires can be carried out in a daily clinical situation as an aid to sharpen the indications for the several levels of sedation. Full article
(This article belongs to the Special Issue Depression, Anxiety and Stress in Children and Adolescents)
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