Global Burden and New Trends in Emotional, Behavioral and Relational Problems of Children, Adolescents and Young Adults

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: 20 June 2024 | Viewed by 12912

Special Issue Editors


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Guest Editor
Child and Adolescent Neuropsychiatry Unit, University of Bari “Aldo Moro”, 70124 Bari, Italy
Interests: neurodevelopmental disorders; autism spectrum disorder; child and adolescent neuropsychiatry; psychopathology; mental illness; psychopharmacology
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Child and Adolescent Neuropsychiatry Unit, University of Bari “Aldo Moro”, 70124 Bari, Italy
Interests: psychopathology; clinical psychiatry; psychopharmacology; child and adolescent psychiatry; adolescent psychiatry; psychoneuroendocrinology

Special Issue Information

Dear Colleagues,

We are pleased to announce a Special Issue which aims to explore the global burden and new trends in the emotional, behavioural, and relationship disorders of children, adolescents, and young adults.

During the last decade, we have experienced many changes in global society, and these are reflected in changing patterns of psychopathology. Recently, in addition to the coronavirus pandemic, there has been a significant increase in mental illness, with a significant burden worldwide. There has been an increase in self-harming behaviours, suicide attempts, emotional and behavioural disorders, eating and sleeping disorders, alcohol and drug addiction, and disorders related to excessive involvement in online activities (e.g., video games, social media use, and shopping).

The alarming increase in the incidence and prevalence of different emotional, behavioural, and relationship disorders from early development until young adult age, the high degree of overlap, and the great heterogeneity in clinical characteristics and therapeutic responses has inspired researchers to attempt to better characterize and investigate clinical phenotypes and underlying pathophysiology in order to develop more effective and targeted treatments.

We welcome observational and intervention studies, as well as review articles (systematic reviews and meta-analyses) that address the ongoing global mental health burden during developmental to young adult age, focusing on:

  • Risk and protective factors;
  • Advances in etiopathogenetic mechanisms;
  • Differences in clinical phenotypes;
  • Changes in diagnosis and treatment.

Prof. Dr. Lucia Margari
Dr. Maria Giuseppina Petruzzelli
Guest Editors

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Keywords

  • emotional
  • behavioural
  • relationship disorders
  • psychopathology
  • mental illness

Published Papers (9 papers)

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Research

11 pages, 234 KiB  
Article
Parental Competences and Stress Levels in Mothers of Children with Autism Spectrum Disorders and Children Developing Neurotypically
by Beata Tyszkiewicz-Gromisz, Joanna Burdzicka-Wołowik, Piotr Tymosiewicz and Wilhelm Gromisz
J. Clin. Med. 2024, 13(4), 1119; https://doi.org/10.3390/jcm13041119 - 16 Feb 2024
Viewed by 700
Abstract
(1) Background: the aim of this study was to explore parental competences and stress levels in the mothers of children with autism in relation to the mothers of neurotypical children. (2) Methods: the study used the Parental Competence Test and the [...] Read more.
(1) Background: the aim of this study was to explore parental competences and stress levels in the mothers of children with autism in relation to the mothers of neurotypical children. (2) Methods: the study used the Parental Competence Test and the PSS-10 scale to assess the intensity of stress related to one’s own life situation over the past month. Forty mothers of children with ASD (n = 20) and neurotypical children (n = 20) participated in the study. (3) Results: the mothers of children with ASD showed higher levels of stress (p = 0.0002). The mothers of neurotypical children achieved higher scores in parental competences (r = −0.49). The competence of mothers of children with ASD was correlated with rigour (r = 0.50), permissiveness (r = −0.60), overprotectiveness (r = 0.71), and helplessness (r = −0.77). (4) Conclusions: mothers of children with autism demonstrate lower parental competences than mothers of neurotypical children. Mothers of children with autism are less rigorous but more permissive, overprotective, and helpless. They tend to become heavily involved with their child. An overprotective attitude and greater tolerance for antisocial behaviours among parents of children with ASDs protect them from excessive stress. Full article
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13 pages, 264 KiB  
Article
Well-Being, Self-Esteem and Temporal Perspective in Incels: An Italian Study
by Costanza Scaffidi Abbate, Federica Rapacciuolo and Silvana Miceli
J. Clin. Med. 2024, 13(2), 358; https://doi.org/10.3390/jcm13020358 - 09 Jan 2024
Viewed by 984
Abstract
The global scholarly attention has shifted toward the phenomenon of inceldom (involuntary celibacy) due to violent incidents involving self-identified incels. There is a growing number of platforms promoting the proliferation of these ideologies, and cases of violence are becoming increasingly severe. This research [...] Read more.
The global scholarly attention has shifted toward the phenomenon of inceldom (involuntary celibacy) due to violent incidents involving self-identified incels. There is a growing number of platforms promoting the proliferation of these ideologies, and cases of violence are becoming increasingly severe. This research constitutes one of the limited empirical investigations within an Italian context. This study aims to examine the mental well-being and its associations with self-esteem and temporal perspectives among individuals identifying as incels. Fifty-eighth male subjects aged between 18 and 45 years old participated in the study. Participants, recruited through online communication channels, completed three questionnaires focused on assessing mental well-being, self-esteem, and temporal orientation. The results reveal that incel subjects exhibit low self-esteem and are inclined toward a hedonistic present-focused perspective aimed at immediate gratification rather than future planning. Of note are the data related to the future temporal perspective, which does not show any predictive value on the well-being of incel subjects. Their ability to plan for the long term, defer immediate gratification, and control behavior through the anticipation and evaluation of possible consequences appears diminished. This study discusses the implications of developing targeted intervention programs, given that the incel phenomenon is becoming increasingly widespread. It is, therefore, crucial not to underestimate the potential threat that inceldom could pose in the future. Full article
14 pages, 863 KiB  
Article
Stress Dynamics in Families with Children with Neuropsychiatric Disorders during the COVID-19 Pandemic: A Three-Year Longitudinal Assessment
by Ada Claudia Silvana Gruescu, Calin Popoiu, Mihaela Codrina Levai, Sonia Roxana Burtic, Isabella Ionela Sanda, Oana Neda-Stepan, Ovidiu Rosca, Roxana Manuela Fericean, Catalin Dumitru and Lavinia Stelea
J. Clin. Med. 2023, 12(22), 7170; https://doi.org/10.3390/jcm12227170 - 18 Nov 2023
Viewed by 876
Abstract
Background and Objectives: This study explores the impact of the COVID-19 pandemic on families with children diagnosed with neuropsychiatric disorders, focusing on stress dynamics and quality of life. Materials and Methods: A longitudinal survey was conducted over three years (2020–2022) involving 168 families. [...] Read more.
Background and Objectives: This study explores the impact of the COVID-19 pandemic on families with children diagnosed with neuropsychiatric disorders, focusing on stress dynamics and quality of life. Materials and Methods: A longitudinal survey was conducted over three years (2020–2022) involving 168 families. The survey included data on demographics, diagnosed conditions, access to therapies, mental well-being, and perceived challenges. Results: The study involved 62, 51, and 55 families in 2020, 2021, and 2022, respectively. ADHD emerged as the most prevalent condition, diagnosed in approximately 32% of the children. The pandemic significantly affected therapy access, with parents reporting a decrease from an average score of 8.1 in 2020 to 6.5 in 2022 (p = 0.029). Parents also reported increased feelings of being overwhelmed, peaking at 8.0 in 2021 before declining to 6.3 in 2022 (p = 0.017). Despite these challenges, there was a positive trend in family mental well-being, with scores increasing from 5.1 in 2020 to 6.7 in 2022 (p = 0.031). The Parental Stress Index (PSI) indicated decreasing trends in Emotional Stress and Parent–Child Communication Difficulties (p < 0.001), and Behavioral Challenges in children showed a significant reduction across the years (p < 0.001). The Hospital Anxiety and Depression Scale (HADS) reflected a moderate reduction in anxiety levels from 7.6 in 2020 to 6.0 in 2022 (p = 0.038), although depression scores did not show a significant change. Conclusions: The COVID-19 pandemic introduced notable challenges for families with neuropsychiatrically diagnosed children, particularly in therapy access and increased parental stress. However, the study also reveals a general improvement in family dynamics, mental well-being, and a decrease in behavioral challenges over time. The necessity of this study stems from the critical need to examine the impact of the COVID-19 pandemic on families with neuropsychiatrically diagnosed children, focusing on their resilience and adaptation in navigating therapy access, parental stress, and overall mental well-being. Full article
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13 pages, 272 KiB  
Article
A Neuropsychiatric Assessment of Children with Previous SARS-CoV-2 Infection
by Veronica Scarselli, Dario Calderoni, Arianna Terrinoni, Chiara Davico, Giulia Pruccoli, Marco Denina, Chiara Carducci, Andrea Smarrazzo, Melania Martucci, Mariaelena Presicce, Daniele Marcotulli, Luca Arletti, Mauro Ferrara, Silvia Garazzino, Rosanna Mariani, Andrea Campana and Benedetto Vitiello
J. Clin. Med. 2023, 12(12), 3917; https://doi.org/10.3390/jcm12123917 - 08 Jun 2023
Viewed by 1066
Abstract
Aim: Concerns have been raised about possible neuropsychiatric sequelae of COVID-19. The objective of this study was to examine the plausibility of long-term mental health consequences of COVID-19 by assessing a sample of children after the resolution of the acute SARS-CoV-2 infection. Method: [...] Read more.
Aim: Concerns have been raised about possible neuropsychiatric sequelae of COVID-19. The objective of this study was to examine the plausibility of long-term mental health consequences of COVID-19 by assessing a sample of children after the resolution of the acute SARS-CoV-2 infection. Method: As part of a systematic follow-up assessment of pediatric patients with COVID-19 conducted at two university children’s hospitals, 50 children (56% males) aged 8 to 17 years (median 11.5), 26% with previous multisystem inflammatory syndrome in children (MIS-C), without a prior history of neuropsychiatric disorders, received a battery of clinical neuropsychiatric and neuropsychological rating scales that included the Pediatric Migraine Disability Assessment (PedMIDAS), Sleep Disturbance Scale for Children (SDSC), Multidimensional Anxiety Scale for Children (MASC-2), Child Depression Inventory (CDI-2), Child Behavior Checklist (CBCL), and the NEPSY II (Neuropsychological Assessment, Second Edition). The assessments were conducted between 1 and 18 months (median 8 months) after the acute infection. Results: The CBCL internalizing symptoms score was in the clinical range for 40% of the participants (vs. a population expected rate of about 10%, p < 0.001). A sleep disturbance was detected in 28%, clinically significant anxiety in 48%, and depressive symptoms in 16%. The NEPSY II scores showed impairment in attention and other executive functions in 52%, and memory deficits in 40% of the children. Conclusions: These data from direct assessment of a sample of children who had SARS-CoV-2 infection show higher than expected rates of neuropsychiatric symptoms, thus supporting the possibility that COVID-19 may have mental health sequelae long after the resolution of the acute infection. Full article
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10 pages, 267 KiB  
Article
Social Introversion Personality Trait as Predictor of Internalizing Symptoms in Female Adolescents with Gender Dysphoria
by Flora Furente, Emilia Matera, Lucia Margari, Elisabetta Lavorato, Federica Annecchini, Francesca Scarascia Mugnozza, Giuseppe Colacicco, Alessandra Gabellone and Maria Giuseppina Petruzzelli
J. Clin. Med. 2023, 12(9), 3236; https://doi.org/10.3390/jcm12093236 - 30 Apr 2023
Cited by 2 | Viewed by 1413
Abstract
The personality trait of social introversion refers to the individual inclination toward the inner/outer world. Moreover, adolescents who experience Gender Dysphoria (GD) can be involved in relationship conflicts with family, peers, and friends and experience stigmatization and rejection from society. This leads higher [...] Read more.
The personality trait of social introversion refers to the individual inclination toward the inner/outer world. Moreover, adolescents who experience Gender Dysphoria (GD) can be involved in relationship conflicts with family, peers, and friends and experience stigmatization and rejection from society. This leads higher distress in females which are more sensitive to this kind of feelings. This leads in them frequently developing a negative sense of well-being and low self-esteem which increases their risk of internalizing symptoms. So, the aims of this study were: (1) to investigate the presence of significant differences in Social Introversion (SI) dimensions between an assigned-female at birth (AFAB) GD group and a cisgender female group both diagnosed with a depressive disorder, (2) to verify whether the two clinical groups may be characterized by different profiles of internalizing symptoms, (3) to investigate if the SI dimensions could promote the internalizing symptomatology. Our results confirmed the presence of significantly higher score in GD sample for MMPI-SI scale and subscales and showed no significant difference in depressive profiles. Lastly, SI could promote internalizing symptomatology in AFAB underlying a link between SI and depression in this condition which should be further investigated. Full article
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12 pages, 619 KiB  
Article
Do Cortisol and Dehydroepiandrosterone Influence Motivational Factors for Non-Suicidal Self-Injury in Female Adolescents?
by Francesco Maria Piarulli, Anna Margari, Francesco Margari, Emilia Matera, Federica Croce, Flora Furente, Alessandra Gabellone and Maria Giuseppina Petruzzelli
J. Clin. Med. 2023, 12(5), 1924; https://doi.org/10.3390/jcm12051924 - 28 Feb 2023
Viewed by 1457
Abstract
Non-suicidal self-injury (NSSI) is a significant public health issue that particularly affects female adolescents usually emerging during puberty, with a subsequent reduction and even remission in the phenomenon later in life. The dysregulation of the hormonal stress response, particularly cortisol and dehydroepiandrosterone sulfate [...] Read more.
Non-suicidal self-injury (NSSI) is a significant public health issue that particularly affects female adolescents usually emerging during puberty, with a subsequent reduction and even remission in the phenomenon later in life. The dysregulation of the hormonal stress response, particularly cortisol and dehydroepiandrosterone sulfate (DHEA-S), whose levels increase markedly during pubertal adrenarche, has been associated with the development and maintenance of a wide range of emotional disorders. Our study aims to investigate whether different cortisol-DHEA-S response patterns could be associated with the main motivational moderators to engage NSSI as well as with urgency and motivation to stop NSSI in a sample of female adolescents. We found significant correlations between stress hormones and several factors that support and sustain NSSI, specifically: cortisol levels and distressing/upsetting urge (r = 0.39 and a p = 8.94 × 10−3) and sensation seeking (r = −0.32 and a p = 0.04), as well as cortisol/DHEA-s ratio and external emotion regulation (r = 0.40 and a p = 0.01) and desire to stop NSSI (r = 0.40 and a p = 0.01). Cortisol and DHEA-S may play a role in NSSI through the regulation of stress responses and affective states. Such results could have implications for the development of new and improved treatment and prevention plans for NSSI. Full article
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18 pages, 943 KiB  
Article
Examining the Indirect Effect of Online Gaming on Depression via Sleep Inequality and Anxiety—A Serial and Parallel Mediation Analysis
by Tahani Alshammari, Sarah Alseraye, Aleksandra Rogowska, Nouf Alrasheed and Musaad Alshammari
J. Clin. Med. 2022, 11(24), 7293; https://doi.org/10.3390/jcm11247293 - 08 Dec 2022
Cited by 1 | Viewed by 2452
Abstract
Stress-related disorders are highly prevalent among first-year college students. Gaming disorder (GD) is an emerging disorder linked to physical and psychological consequences. We aimed to investigate the mechanism linking GD with anxiety, depression, and sleep disorders among first-year undergraduate students. Four hundred fifty-seven [...] Read more.
Stress-related disorders are highly prevalent among first-year college students. Gaming disorder (GD) is an emerging disorder linked to physical and psychological consequences. We aimed to investigate the mechanism linking GD with anxiety, depression, and sleep disorders among first-year undergraduate students. Four hundred fifty-seven participants were recruited, and the survey included the Internet Gaming Disorder Scale Short-Form (IGDS9-SF), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Pittsburgh Sleep Quality Index (PSQI). Our results showed that female students scored significantly higher than males in anxiety and depression. Furthermore, we found that depression is positively and strongly correlated to anxiety, and both are moderately associated with sleep quality. Gaming is positively related to depression, anxiety, and sleep quality. Interestingly, the health sciences tracks showed lower sleep quality than undergraduates from other tracks. There was a 64% variance in depression explained by many predictors, including anxiety, sleep quality, gaming, painkiller use, and gender. In addition, the mediation models showed that the association between gaming and depression is mediated indirectly by sleep quality, and sleep quality may be mediated directly by anxiety. The first year in college occurs at a critical developmental and professional stage, and our results highlight the need to establish support programs and conduct mental health educational workshops. Full article
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11 pages, 758 KiB  
Article
Implication of COVID-19 Pandemic on Adolescent Mental Health: An Analysis of the Psychiatric Counseling from the Emergency Room of an Italian University Hospital in the Years 2019–2021
by Maria Giuseppina Petruzzelli, Flora Furente, Giuseppe Colacicco, Federica Annecchini, Anna Margari, Alessandra Gabellone, Lucia Margari and Emilia Matera
J. Clin. Med. 2022, 11(20), 6177; https://doi.org/10.3390/jcm11206177 - 19 Oct 2022
Cited by 12 | Viewed by 1845
Abstract
Introduction: Although the COVID-19 pandemic had profound consequences on youths’ mental health, few data are available about its longitudinal implications. Method: In this study, from 655 counseling requests by the Emergency Room (ER) of the University Hospital of Bari, we retrospectively examined 380 [...] Read more.
Introduction: Although the COVID-19 pandemic had profound consequences on youths’ mental health, few data are available about its longitudinal implications. Method: In this study, from 655 counseling requests by the Emergency Room (ER) of the University Hospital of Bari, we retrospectively examined 380 requests for psychiatric counseling of pediatric subjects, during the pre-pandemic, the first pandemic, and the second pandemic wave of COVID-19. Results: We found a significant upward trend between 2019 and 2021 for the counseling requests for acute psychopathological symptoms (p = 1.469 × 10−5), patients in adolescent age (p = 0.022), females (p = 0.004), and those taking psychotropic medications (p = 2.28 × 10−5). Moreover, a significant difference in the proportions of depression (p = 0.003), post traumatic (p = 0.047), somatic (p = 0.007) and psychotic symptoms (p = 0.048), and self-injuring behaviors (p = 0.044) was observed. The proportion of counseling for psychotic symptoms (p = 0.014) and self-injuring behaviors (p = 0.035) also showed an increasing trend over time, with self-harming behaviors becoming more severe and diversified in modalities. Discussion: The pandemic’s persistence over time may have had an impact on youth’s psychopathology, influencing the frequency, type, and complexity of mental health problems; as a result, it is vital to implement timely integrated interventions and find strategies to prevent self-harm, in particular with the identification of vulnerable categories of patients. Full article
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12 pages, 265 KiB  
Article
Unraveling the Relationship between Sleep Problems, Emotional Behavior Disorders, and Stressful Life Events in Preschool Children
by Filippo Manti, Federica Giovannone, Franca Aceti, Nicoletta Giacchetti, Francesca Fioriello, Andrea Maugeri and Carla Sogos
J. Clin. Med. 2022, 11(18), 5419; https://doi.org/10.3390/jcm11185419 - 15 Sep 2022
Cited by 2 | Viewed by 1256
Abstract
Objectives: The aims of this study were to: (1) explore sleep problems in preschool children with generalized anxiety disorder (GAD), selective mutism (SM), and oppositional defiant disorder (ODD) and (2) examine the relationship between stressful life events, sleep problems, and emotional behavior [...] Read more.
Objectives: The aims of this study were to: (1) explore sleep problems in preschool children with generalized anxiety disorder (GAD), selective mutism (SM), and oppositional defiant disorder (ODD) and (2) examine the relationship between stressful life events, sleep problems, and emotional behavior disorders in preschoolers. Methods: The parents of 213 preschool children with SM, GAD, ODD, and TD (typical development, age range 2–6 years) completed the Children’s Sleep Habits Questionnaire (CSHQ), the Coddington Life Events Scale, preschool version (CLES-P), and the CBCL 1½–5. Results: Eighty-three subjects reported sleep problems before the age of 2 years. Seventy-five children (86.14%) with a clinical diagnosis and eight children with TD (8.4%) exceeded the threshold level on the CSHQ. For the bedtime resistance (p = 0.042) and sleep duration subscales (p = 0.038), the SM group had significantly higher scores in comparison to the ODD group. The same pattern was also true for the sleep onset (p = 0.024) and sleep anxiety subscales (p = 0.019). The linear regression analysis model showed that the impact of stressful life events and internalizing problems could predict sleep habits in children. Conclusions: Emotional behavior disorders and stress factors should be regularly investigated in children who are referred to clinics for sleep problems. Clinicians should consider how these symptoms may exacerbate sleep problems and/or interfere with treatment. Full article
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