Stress und seine Bedeutung in der Kindheit: die Messung von frühen Stressoren und möglichen Folgen auf die psychische Gesundheit von Vorschulkindern

Early adversities such as critical live events or cumulative everyday challenges might exceed individual coping strategies or resources and thus lead to pathological changes in the long term. Maladaptive physiological and psychological processes as a consequence of dysfunctional stress response are the basis of these changes. Preschool age plays an important role in this context, since the developing brain still underlies a certain plasticity and thus behavior patterns and physiological processes are consolidating. Understanding the child`s normative stress response, it’s triggers and consequences, form the basis for counteracting maladaptive or pathological changes through prevention or intervention. Publication 1 presents the physiological stress reaction to an age-adapted stress task in two to six-year-olds. In addition, assessment of socio-economic, child- and task-related characteristics should provide information about the possible influences on preschooler’s stress response. Results revealed no overall response of the hypothalamic-pituitary-adrenal axis but a short-term response of the autonomic nervous system. The daily release of salivary-alpha-amylase, test lengths and movement further influenced the stress response. An anticipatory effect might have prevented further cortisol release during the stress test. However, the lack of additional cortisol release in combination with the activation of the autonomic nervous system might as well reflect the response of a predominantly healthy sample. The results of publication 2 support this assumption by changes in the self-reported affect and children’s facial expressions. Children were less likely to choose the positive image and also displayed less positive connotated facial expressions under stress. This coherence in the two measurements has been rarely detected in previous studies. Publication 3 supplemented the results of the first two publications with current prevalences of behavioral problems in Swiss preschool children and the influence of parenting style on their occurrence. Even in a predominantly healthy sample with only about seven percent of the children above the critical value for behavioral problems, parenting style plays an important role. Dysfunctional parenting had an influence on the occurrence of behavioral problems in both testing years. Finally, the results are placed in the existing literature and the clinical implications and treatment options that result out of the presented findings are discussed.Stressoren, wie einschneidende Lebensereignisse oder sich kumulierende alltägliche Herausforderungen können die individuellen Ressourcen eines Individuums überschreiten und so langfristig zu pathologischen Veränderungen führen. Maladaptive physiologische und psychologische Prozesse als Konsequenzen einer dysfunktionalen Stressreaktion liegen diesen Veränderungen zugrunde. Besonders das Vorschulalter spielt in diesem Kontext eine wichtige Rolle, da das sich entwickelnde Gehirn noch einer gewissen Plastizität unterliegt und sich Verhaltensmuster und auch physiologische Prozesse konsolidieren. Das Verständnis der kindlichen Stressreaktion, ihrer Auslöser und Konsequenzen bildet somit die Basis, um maladaptiven oder pathologischen Veränderungen mit Präventions- oder Interventionsmassnahmen entgegenzuwirken. Publikation 1 stellt in diesem Kontext die physiologische Stressreaktion auf einen altersangepassten Stresstest bei Zwei- bis Sechsjährigen dar. Ausserdem soll die Erfassung sozioökonomischer, kind- und testbezogener Parameter Aufschluss über die möglichen Einflussgrössen auf die Stressreaktion im Vorschulalter liefern. In der Gesamtstichprobe zeigte sich keine Reaktion der Hypothalamus-Hypophysen-Nebennierenrindenachse, jedoch eine kurzfristige Reaktion des autonomen Nervensystems. Die tägliche Ausschüttung der Speichel-Alpha-Amylase, die Testlänge und die Bewegung beeinflussten die Stressreaktion zusätzlich. Die Kinder zeigten möglicherweise einen Antizipationseffekt, der eine weitere Kortisolausschüttung während dem Stresstest verhinderte. Allerdings spiegelt die fehlende zusätzliche Kortisolausschüttung in Kombination mit der Aktivierung des autonomen Nervensystems möglicherweise auch eine adaptive Reaktion der untersuchten Stichprobe wider. Die Ergebnisse aus Publikation 2 stützten diese Annahme, denn im selbstberichteten Affekt wie auch den Gesichtsausdrücken der Kinder waren Veränderungen beobachtbar. Die Kinder wählten unter Stress weniger wahrscheinlich das positive Bild und zeigten auch weniger positiv konnotierte Gesichtsausdrücke. Diese Kohärenz in den beiden Massen liess sich in früheren Studien nur selten aufzeigen. Publikation 3 ergänzte die bisherigen Befunde durch aktuelle Prävalenzen für Verhaltensauffälligkeiten bei Schweizer Vorschulkindern und den Einfluss des elterlichen Erziehungsstils auf Selbige. Auch in einer überwiegend gesunden Stichprobe mit nur circa sieben Prozent der Kinder über dem kritischen Wert für klinische Auffälligkeiten spielte das Erziehungsverhalten eine tragende Rolle. Dysfunktionales Erziehungsverhalten hatte dabei einen Einfluss auf das Auftreten der Verhaltensauffälligkeiten. Schliesslich folgt im Rahmen der Diskussion die Einordnung der Befunde in die bestehende Literatur und die Betrachtung der klinischen Implikationen sowie Behandlungsmöglichkeiten, die sich aus den dargestellten Ergebnissen ableiten lassen

Regional sociocultural differences as important correlate of physical activity and sedentary behaviour in Swiss preschool children

Regional differences in physical activity in school-aged children and adults even within one country with the same political and health care system have been observed and could not be explained by sociodemographic or individual variables. We analysed whether such differences were already present in preschool children.; Swiss children from 84 childcare centres in five cantons (Aargau, Bern, Fribourg, Vaud, Zurich) comprising about 50% of the population of the country participated. Physical activity was quantified with accelerometers (ActiGraph, wGT3X-BT) and potential correlates were assessed with measurements at the childcare centre or questionnaires. Mixed regression models were used to test associations between potential correlates of total physical activity (TPA), moderate-to-vigorous physical activity (MVPA), light physical activity (LPA) or sedentary behaviour with a special focus on regional differences.; 394 of 476 children (83%) provided valid physical activity data (at least 2 weekdays and 1 weekend day with 10 h recording; mean age 3.9 ± 0.7 years, 54% boys) with 26% and 74% living in the French- and German-speaking parts of Switzerland, respectively. Days consisted of (mean ± standard deviation) 1.5 ± 0.5 h MVPA, 5.0 ± 0.6 h LPA, and 6.3 ± 0.8 h sedentary behaviour with an average of 624 ± 150 counts/min TPA. TPA and MVPA (but not sedentary behaviour or LPA) increased with age, were higher in boys and children with better motor skills. Despite controlling for individual characteristics, familial factors and childcare exposure, children from the French-speaking part of Switzerland showed 13% less TPA, 14% less MVPA, 6% less LPA and 8% more sedentary behaviour than German-speaking children.; Beside motor skills and non-modifiable individual factors, the regional sociocultural difference was the most important correlate of phyical activity and sedentary behaviour. Therefore, regionally adapted public health strategies may be needed

Construction and validation of a test of oral direction in junior high school mathematics; discovering the degree of intelligence and achievement contained therein

Thesis (Ed.M.)--Boston Universit

The relationship of parenting style and eating behavior in preschool children

Background: Eating behavior represents individual appetitive traits which are related to the individual's regulation of food intake. Eating behavior develops at an early age. There is some evidence that parenting styles might impact on the child's eating behavior. The aim of this study was to investigate the relationship of different dimensions of positive and negative parenting styles with the child's eating behavior at a critical age period of the child's early development. Methods: Parents of 511 preschool children (aged 2-6 years) completed the Children Eating Behavior Questionnaire and the Alabama Parenting Questionnaire. Results: Analyses revealed that different dimensions of negative parenting styles were associated with eating behavior of the child. In details, inconsistent parenting showed a consistent association with eating behavior of a child (i.e. higher emotional eating, higher food responsiveness, higher food fussiness, higher satiety responsiveness and more enjoyment of food), whereas corporal punishment was associated with more emotional overeating and more food responsiveness but less satiety responsiveness. Further, powerful implementation was related to higher food responsiveness and less enjoyment of food and low monitoring was associated with higher emotional overeating and more slowness in eating. There was no such consistent association of positive parenting and eating behavior. Conclusions: More negative parenting styles were associated with eating behavior which is more often related to potential weight problems in a long term, whereas positive parenting did not show such a consistent relationship with eating behavior. Negative parenting should be in the focus of prevention and treatment of eating behavior problems in young children. Trial registration: ISRCTN41045021 (06/05/2014). Keywords: Eating behavior; Parenting style; Preschool; SPLASH

The Swiss Preschoolers’ health study (SPLASHY): objectives and design of a prospective multi-site cohort study assessing psychological and physiological health in young children

Background: Children’s psychological and physiological health can be summarized as the child’s thinking, feeling, behaving, eating, growing, and moving. Children’s psychological and physiological health conditions are influenced by today’s life challenges: Thus, stress exposure and lack of physical activity represent important health challenges in older children. However, corresponding evidence for young children is scarce. The aim of Swiss Preschoolers’ Health Study (SPLASHY) is to examine the role of stress and physical activity on children’s psychological and physiological health, particularly on cognitive functioning, psychological well-being, adiposity and motor skills in children at an early stage of childhood. We will also assess the role of child and environmental characteristics and aim to define sensitive time points. Methods/design: In a total of 84 child care centers, children at preschool age (2–6 years) are recruited and are assessed immediately and one year later. Assessments include direct measurements of the children in the child care centers and at home as well as assessments of children’s behavior and environmental factors through informants (parents and child care educators). Discussion: SPLASHY is one of the first studies in early childhood aiming to investigate the influence of stress and physical activity on children’s psychological and physiological health in a community-based longitudinal design

Prevalence and Predictors of Behavioral Problems in Healthy Swiss Preschool Children Over a One Year Period

Behavioral problems impair children's health but prevalence rates are scarce and persistence rates vary due to divergence in age ranges, assessment methods and varying environmental factors. The aim of this study was to assess prevalence rates of behavioral problems, their persistence over a 1-year period, and the impact of child- and parent-related factors on behavioral problems. 555 2-6-year-old healthy preschool children were assessed at baseline and 382 of the initial sample at 1-year follow-up. Assessment included questionnaires concerning behavioral problems and their potential predictors (e.g. socio-economic status or parenting style). Altogether, nearly 7% of these children showed clinically relevant behavioral problems, and 3% showed persistent symptoms. Low SES, inconsistent parenting and corporal punishment were positively associated with behavioral problems. The prevalence rates of behavioral problems in Swiss preschoolers are similar to other European countries, but persistence is still rather low within preschool age. These findings need further confirmation in longitudinal studies

Regional sociocultural differences as important correlate of physical activity and sedentary behaviour in Swiss preschool children

QUESTION: Regional differences in physical activity in school-aged children and adults even within one country with the same political and health care system have been observed and could not be explained by sociodemographic or individual variables. We analysed whether such differences were already present in preschool children. METHODS: Swiss children from 84 childcare centres in five cantons (Aargau, Bern, Fribourg, Vaud, Zurich) comprising about 50% of the population of the country participated. Physical activity was quantified with accelerometers (ActiGraph, wGT3X-BT) and potential correlates were assessed with measurements at the childcare centre or questionnaires. Mixed regression models were used to test associations between potential correlates of total physical activity (TPA), moderate-to-vigorous physical activity (MVPA), light physical activity (LPA) or sedentary behaviour with a special focus on regional differences. RESULTS: 394 of 476 children (83%) provided valid physical activity data (at least 2 weekdays and 1 weekend day with 10 h recording; mean age 3.9 ± 0.7 years, 54% boys) with 26% and 74% living in the French- and German-speaking parts of Switzerland, respectively. Days consisted of (mean ± standard deviation) 1.5 ± 0.5 h MVPA, 5.0 ± 0.6 h LPA, and 6.3 ± 0.8 h sedentary behaviour with an average of 624 ± 150 counts/min TPA. TPA and MVPA (but not sedentary behaviour or LPA) increased with age, were higher in boys and children with better motor skills. Despite controlling for individual characteristics, familial factors and childcare exposure, children from the French-speaking part of Switzerland showed 13% less TPA, 14% less MVPA, 6% less LPA and 8% more sedentary behaviour than German-speaking children. CONCLUSION: Beside motor skills and non-modifiable individual factors, the regional sociocultural difference was the most important correlate of phyical activity and sedentary behaviour. Therefore, regionally adapted public health strategies may be needed

The Swiss Preschoolers’ health study (SPLASHY): objectives and design of a prospective multi-site cohort study assessing psychological and physiological health in young children

Background: Children’s psychological and physiological health can be summarized as the child’s thinking, feeling, behaving, eating, growing, and moving. Children’s psychological and physiological health conditions are influenced by today’s life challenges: Thus, stress exposure and lack of physical activity represent important health challenges in older children. However, corresponding evidence for young children is scarce. The aim of Swiss Preschoolers’ Health Study (SPLASHY) is to examine the role of stress and physical activity on children’s psychological and physiological health, particularly on cognitive functioning, psychological well-being, adiposity and motor skills in children at an early stage of childhood. We will also assess the role of child and environmental characteristics and aim to define sensitive time points. Methods/design: In a total of 84 child care centers, children at preschool age (2–6 years) are recruited and are assessed immediately and one year later. Assessments include direct measurements of the children in the child care centers and at home as well as assessments of children’s behavior and environmental factors through informants (parents and child care educators). Discussion: SPLASHY is one of the first studies in early childhood aiming to investigate the influence of stress and physical activity on children’s psychological and physiological health in a community- based longitudinal design

Physical activity and sedentary behavior in preschoolers: a longitudinal assessment of trajectories and determinants

Background : Despite physical activity (PA) being recognized as a critically important factor for good physical and mental health already early in life and throughout the life course, prospective data on activity behavior during the preschool years remains scarce. This study examined trajectories and determinants of levels and change in total PA (TPA), moderate-to-vigorous PA (MVPA) and sedentary behavior (SB) in a representative sample of Swiss preschoolers. Methods : Data were drawn from the Swiss Preschoolers’ Health Study (SPLASHY), a multi-site prospective cohort study including 555 children (53% boys) aged 2-to-6 years at baseline. A follow-up was conducted after 12 months. Activity behavior was measured using accelerometers. Information on 35 potential determinants from different socio-ecological domains was either directly measured or parent-reported. Trajectories of TPA, MVPA and SB over time were described for boys and girls. Linear mixed models were used to investigate factors that predicted levels and change in TPA, MVPA and SB. Results: All children were sufficiently physically active according to published recommendations for preschoolers. Trajectory profiles revealed a marked increase in TPA and MVPA in boys and girls whereas SB remained fairly stable over time. Mixed modeling demonstrated that variables most relevant to determining PA levels were sex, age and activity temperament (all positively associated). Together with gross motor skills, birth weight, family structure (only for TPA) and season (only for MVPA), these factors accounted for 26 and 32% of total variance explained in TPA and MVPA, respectively. Activity temperament emerged as the strongest determinant of SB (negative association) and explained with sex, season and family structure 20% of total variance in SB. The presence of older siblings was the only factor that predicted change in PA over time. Conclusions : In this healthy physically active cohort of preschoolers, non-modifiable individual-level factors had the greatest influence on PA. The limited success of this and previous studies to identify modifiable determinants and the finding that most preschoolers were sufficiently active suggest that future attempts should provide insights into how preschoolers’ activity levels can be maintained and fostered to prevent subsequent harmful declines attributable, amongst others, to educational transitions. Thus, good-quality longitudinal studies are needed