Childrens Health

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Toddlers who take a long time to fall asleep or wake up many times during the night have put many a desperate mom and dad to the test. Tired parents are often told that night waking is part of toddlerhood, and that it will soon pass on its own, but this is not the case for everyone.

Researchers at NTNU’s Department of Psychology have conducted a comprehensive survey of nearly 1,000 toddlers that shows that serious sleep disorders in young children can have long-term consequences.

The study shows that four-year-olds with sleep disorders have a higher risk of developing symptoms of psychiatric problems as six-year-olds, compared with children who sleep soundly.

At the same time, four-year-olds with psychiatric symptoms have a greater risk of developing a sleep disorder as six-year-olds, compared with children who do not have these kind of symptoms.

Reciprocal relationship

“It is common for children to have periods when they sleep poorly, but for some children, the problems are so extensive that they constitute a sleep disorder. Our research shows that it is important to identify children with sleep disorders, so that remedial measures can be taken. Sleeping badly or too little affects a child’s day-to-day functioning, but we are seeing that there are also long term repercussions,” says Silje Steinsbekk, an Associate Professor and Psychologist in NTNU’s Department of Psychology.

Her previous research on the relationship between sleep disorders and psychological problems in children has shown that four-year-olds with sleep disorders often also show symptoms of psychiatric problems.

The new study, which was recently published in the respected Journal of Developmental & Behavioral Pediatrics, shows that the correlation between sleep disorders and psychiatric disorders is also found over time and that the relationship is reciprocal.

Thorough interviews and diagnoses

We know that 20-40 per cent of young children struggle with sleep in one way or another, but we lack data on how many of them are suffering from a diagnosable sleep disorder.

NTNU researchers conducted diagnostic interviews with the parents of the children participating in the study. The interview was based on the DSM-IV diagnostic manual, which contains the official diagnostic criteria for mental disorders.

One thousand four-year-olds participated in the study. Parents of around 800 of these children were interviewed again two years later. The comprehensive study is part of a longitudinal study in Trondheim that examines the incidence, progression and risk factors for the development of mental health problems in children. The project conducts follow-up visits with the children and their parents every other year.

“Previous studies of sleep problems in children have mainly used a questionnaire format, with questions like, “Does your child have trouble sleeping?” But what parents define as sleep problems will vary. In the diagnostic interview we ask parents questions until we are confident that we have enough information to assess whether a symptom is present or not. The information we’ve collected is more reliable than information obtained from the questionnaire,” says Steinsbekk.

What comes first?

Can we say that poor sleep causes psychiatric problems – or do psychiatric problems cause poor sleep? The findings from the study suggest that the relationship goes both ways.

One possible explanation for this reciprocity may be that both conditions are biologically determined, by common underlying genetics, for example.

Another explanation may be that insufficient sleep creates general functional impairment, and that the risk of other problems therefore increases – in the same way that psychiatric symptoms often result in poorer everyday functioning, which in turn may negatively affect sleep.

Vicious cycle

Perhaps sleep disorders and mental health issues share the same risk factors. A child who shows signs of anxiety or a behavioural disorder may easily end up in a vicious cycle, where conflict with adults triggers anxiety and in turn leads to trouble falling asleep.

It may also be that difficult and negative thoughts steal both energy and sleep and make us restless and depressed if we fail to gain control over them.

“Given that so many children suffer from insomnia, and only just over half ‘outgrow it,’ it is critical for us to be able to provide thorough identification and good treatment. Perhaps early treatment of mental health problems can also prevent the development of sleep disorders, since psychiatric symptoms increase the risk of developing insomnia,” says Steinsbekk, stressing that this is something that must be examined in further research.

Insomnia is most prevalent
The study shows that insomnia is the most prevalent sleep disorder. Children who suffer from insomnia struggle with falling asleep and frequent waking. Insomnia was diagnosed in 16.6 per cent of the four-year-olds surveyed, and 43 per cent of these still had insomnia as six- year olds.

Insomnia in four-year olds increases the risk for symptoms of anxiety, depression, ADHD and behavioural problems as six-year-olds. After the researchers had taken into account the children’s psychiatric symptoms at age four, the relationship between insomnia and ADHD disappeared.

Similarly, children who show symptoms of anxiety, depression, ADHD and behavioural disturbances as four-year-olds have a greater risk of developing insomnia as six-year-olds. When symptoms of insomnia at age four were adjusted for, the relationship between insomnia and anxiety disappeared.

Examples of other types of sleep disorders are hypersomnia, i.e. an extreme urge to sleep, and various cases of parasomnia, such as nightmares, night terrors and sleepwalking. These conditions are uncommon, and the study also shows that, with the exception of sleepwalking, they are shorter-lived.

http://gemini.no/en/2015/04/childrens-sleep-and-mental-health-are-interrelated/

Silje Steinsbekk and Lars Wichstrøm (2015) Stability of Sleep Disorders From Preschool to First grade and Their Bidirectional Relationship With Psychiatric Symptoms. Journal of Developmental & Behavioral Pediatrics: May 2015 – Volume 36 – Issue 4 – p 243–251 doi: 10.1097/DBP.0000000000000134

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Sexual abuse of children and adolescents can have serious health consequences for victims. Early studies have revealed that child sexual abuse is associated with an increased risk of later mental and physical health problems and risk-taking behavior. The Institute of Social and Preventive Medicine at the University of Zurich, the Psychosomatics and Psychiatry Department at Zurich’s University Children’s Hospital and the Department of Psychiatry and Psychotherapy at University Hospital Zurich discovered that sexual abuse is alarmingly widespread in a representative sample of more than 6,000 9th grade students in Switzerland.

Sexual harassment via the Internet is mentioned most frequently

Among the study participants, mainly between 15 and 17 years old, roughly 40 percent of girls and 17 percent of boys reported they had experienced at least one type of child sexual abuse. Relative to boys, sexual abuse without physical contact was reported twice as often in girls and sexual abuse with physical contact without penetration three times more often. Both genders reported “sexual harassment via the Internet” as the most frequent form of abuse. This form of sexual abuse was experienced by roughly 28 percent of girls over the course of their lifetimes and by almost 10 percent of boys. At just under 15 percent for girls versus 5 percent for boys, “molested verbally or by e-mail/text message” was the second most common form of abuse. Just under 12 percent of the surveyed girls and 4 percent of the surveyed boys reported having been kissed or touched against their will. Approximately 2.5 percent of the girls had already experienced sexual abuse with penetration (vaginal, oral, anal or other); among boys, this figure was 0.6 percent.

The results of the Zurich study are comparable to those of an earlier Swiss study which was conducted in Geneva between 1995 and 1996 in a similar age group asked similar questions. The prevalence of sexual abuse with physical contact is almost unchanged today. However, sexual abuse without physical contact occurs far more frequently. “We believe that this difference can be attributed to harassment via the Internet, e-mail, or text messaging. This type of sexual abuse was not surveyed back then”, explains Dr. Meichun Mohler-Kuo, senior research scientist at the Institute of Social and Preventive Medicine at the University of Zurich.

The majority were victimized by juvenile perpetrators

Just over half of the female victims and more than 70 percent of the male victims reported that they had been abused by a juvenile perpetrator. Furthermore, most of the victims of sexual abuse with physical contact knew the perpetrator – for instance, they were partners, peers, or acquaintances. “This new trend towards the majority being juvenile perpetrators, and being peers and acquaintances, is in contrast to the Geneva study, and might indicate increased violent behavior among adolescents”, explains Dr. Ulrich Schnyder, Head of the Department of Psychiatry and Psychotherapy at University Hospital Zurich. And he adds: “Our results also differ considerably from official police reports, according to which perpetrators are usually adult, male relatives.” This would seem to indicate significant under-reporting of abuse to officials.

The majority did not disclose sexual abuse

Only about half of victimized girls and less than one-third of victimized boys disclosed their sexual abuse experiences. The disclosure rate is even lower with more severe forms of sexual abuse. Most victimswho do disclose, do so to their peers; less than 20 percent to their families. Fewer than 10 percent of victims reported the sexual abuse to police. “Compared to similar studies from other countries, the disclosure figures in the Swiss study are low. The reluctance in reporting incidents of this kind to family members or authorities makes timely intervention more difficult,” concludes Dr. Schnyder.

http://www.mediadesk.uzh.ch

sleepless toddler
Irregular bedtimes may disrupt healthy brain development in young children, according to a study of intelligence and sleeping habits.

Going to bed at a different time each night affected girls more than boys, but both fared worse on mental tasks than children who had a set bedtime, researchers found.

Little is known about the links between the time that young children go to bed and their cognitive development. This research paper, sought to examine whether bedtimes in early childhood are related to cognitive test scores in 7-year-olds.

The findings on sleep patterns and brain power come from a UK study of more than 11,000 seven-year-olds.The findings are published in the Journal of Epidemiology and Community Health.

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Children and adolescents who watch a lot of television are more likely to manifest antisocial and criminal behaviour when they become adults, according to a new University of Otago study published online in the US journal Pediatrics.

 
The study followed a group of around 1000 children born in Dunedin in 1972-73. Every two years between the ages of 5 and 15, they were asked how much television they watched. Those who watched more television were more likely to have a criminal conviction and were also more likely to have antisocial personality traits in adulthood.

Study co-author Associate Professor Bob Hancox of the University’s Department of Preventive and Social Medicine says he and colleagues found that the risk of having a criminal conviction by early adulthood increased by about 30% with every hour that children spent watching TV on an average weeknight.

The study also found that watching more television in childhood was associated, in adulthood, with aggressive personality traits, an increased tendency to experience negative emotions, and an increased risk of antisocial personality disorder; a psychiatric disorder characterised by persistent patterns of aggressive and antisocial behaviour.

The researchers found that the relationship between TV viewing and antisocial behaviour was not explained by socio-economic status, aggressive or antisocial behaviour in early childhood, or parenting factors.

A study co-author, Lindsay Robertson, says it is not that children who were already antisocial watched more television. “Rather, children who watched a lot of television were likely to go on to manifest antisocial behaviour and personality traits.”

Other studies have suggested a link between television viewing and antisocial behaviour, though very few have been able to demonstrate a cause-and-effect sequence. This is the first ‘real-life’ study that has asked about TV viewing throughout the whole childhood period, and has looked at a range of antisocial outcomes in adulthood. As an observational study, it cannot prove that watching too much television caused the antisocial outcomes, but the findings are consistent with most of the research and provides further evidence that excessive television can have long-term consequences for behaviour.

“Antisocial behaviour is a major problem for society. While we’re not saying that television causes all antisocial behaviour, our findings do suggest that reducing TV viewing could go some way towards reducing rates of antisocial behaviour in society,” says Associate Professor Hancox.

The American Academy of Pediatrics recommends that children should watch no more than 1 to 2 hours of quality television programming each day. The researchers say their findings support the idea that parents should try to limit their children’s television use.

This research emerges from the Dunedin Multidisciplinary Health and Development Study. The Study is run by the Dunedin Multidisciplinary Health and Development Research Unit, which is supported by the Health Research Council of New Zealand.

University of Otag