Suicide probability in adolescents with a history of childhood maltreatment: The role of non-suicidal self-injury, emotion regulation difficulties, and forms of self-criticism

Background: Suicidal attempt and non-suicidal self-injury are very common in adolescents with a history of childhoodmaltreatment. By identifying correlates of these kinds of high-risk behaviors, it is possible to prevent and decrease completed suicide. Objectives: The aims of this study were: 1) to compare adolescents with a history of childhood maltreatment with non-suicidal self injury (NSSI) or past suicidal attempt in terms of suicide probability, and 2) to investigate the association between NSSI, forms of self-criticism, emotion regulation difficulties, and suicide probability. Patients and Methods: Participants were 169 adolescents living in Iranian social welfare centers who had a history of childhood maltreatment. The Suicide Probability Scale, Difficulties in Emotion Regulation Scale, Forms of Self-criticism, and the Non-Suicidal Self injury (NSSI) checklist were used for assessment. Results: Adolescents with NSSI and suicidal attempts had higher rates of suicide ideation than adolescents with NSSI-only (P < 0.05). Feelings of inadequacy, self-hatred, difficulty with impulse control, and frequency of NSSI can predict 50 variance of suicide probability (P < 0.001). Conclusions: Adolescents with histories of suicidal attempts and NSSI, compared with adolescents with NSSI-only, weremoreprone to suicide. Self-criticism, poor impulse control, and the frequency of NSSI were the main risk factors associated with suicide probability in adolescents with a history of childhood maltreatment. © 2016, Zahedan University of Medical Sciences

The effect of a parental education program on the mental health of parents and behavioral problems of their children with autism spectrum disorder

Objectives Early interventions can play an important role in alleviating or eliminating many of the major symptoms of Autism Spectrum Disorder (ASD) and enhancing new skills. Parental education can reduce the parents� depression and stress and increase their empowerment. This study aimed to evaluate the effect of a parental education program the mental health of parents, behavioral problems of their children with ASD. Methods A group of 30 parents of children with ASD in Tehran, Iran were selected by a convenience sampling and were randomly divided into intervention and control groups. The parents in the intervention group received psychoeducational program according to Tonge et al.�s (2006) method in 10 sessions each for 90 min in Tehran Psychiatric Institute. Data collection tools were the Family Assessment Device, the Childhood Autism Rating Scale, Billings and Mouse�s Coping Strategies Scale, and 28-item General Health Questionnaire. All participants were evaluated at three stages of pretest, posttest, and 3-month follow-up. Results The effect of parental education program on the clinical symptoms and its dimensions was significant at three measurement phases. In the 3-month follow-up duration, the results remained unchanged. There were a significant difference between the two study groups in general health, family function, coping strategies, and child behavior (F=4.859, P=0.023). Conclusion Parental education can improve the mental health of parents and reduce the behavioral problems of their ASD children. © 2020, Iran University of Medical Sciences. All rights reserved

Internalizing and externalizing problems, empathy quotient, and systemizing quotient in 4 to 11 years-old siblings of children with autistic spectrum disorder compared to control group

Objective: This study was conducted to recognize the problems of living with a sibling with Autistic Spectrum Disorder (ASD) to improve their quality of life. Method: A total of 30 participants were selected among the 4-to11- year-old siblings of children who had referred to Tehran Psychiatric Institute due to autism spectrum disorder. For the control group, 30 children aged 4 to11years old who were the siblings of patients with chronic diseases referring to Pediatric Clinic of Rasoul-e Akram (PBUH) hospital were selected. Gilliam Autism Rating Scale-Second Edition (GARS-2) was filled out for patients and siblings participating in the study and Child Behavior Checklist was completed by their parents. Results: The mean age of the patients in this study was 4.46 ± 9.66 years (range: 1.5-22 years), and the mean age in the healthy children was 2.54 ± 8.18 years (range: 4-11 years). The mean scores of anxiety/depression, withdrawn/depressed, somatic complaints, social problems, thought problems, attention problems, and rule-breaking behavior subscale of CBCL (Child Behavior Checklist) were not significantly different between groups. Aggressive behavior was the only subscale that showed such difference (p = 0.008). Externalizing problems in children who had siblings with ASD was higher than children who had siblings with physical illness. In a group in which a sibling had ASD, sisters were more anxious/ depressed than brothers. Conclusion: Due to various psychological and social problems that siblings of children with ASD experience throughout their life, studying their psychological problems to improve their quality of life seems to be of paramount importance. © 2018 Tehran University of Medical Sciences

Internalizing and externalizing problems, empathy quotient, and systemizing quotient in 4 to 11 years-old siblings of children with autistic spectrum disorder compared to control group

Objective: This study was conducted to recognize the problems of living with a sibling with Autistic Spectrum Disorder (ASD) to improve their quality of life. Method: A total of 30 participants were selected among the 4-to11- year-old siblings of children who had referred to Tehran Psychiatric Institute due to autism spectrum disorder. For the control group, 30 children aged 4 to11years old who were the siblings of patients with chronic diseases referring to Pediatric Clinic of Rasoul-e Akram (PBUH) hospital were selected. Gilliam Autism Rating Scale-Second Edition (GARS-2) was filled out for patients and siblings participating in the study and Child Behavior Checklist was completed by their parents. Results: The mean age of the patients in this study was 4.46 ± 9.66 years (range: 1.5-22 years), and the mean age in the healthy children was 2.54 ± 8.18 years (range: 4-11 years). The mean scores of anxiety/depression, withdrawn/depressed, somatic complaints, social problems, thought problems, attention problems, and rule-breaking behavior subscale of CBCL (Child Behavior Checklist) were not significantly different between groups. Aggressive behavior was the only subscale that showed such difference (p = 0.008). Externalizing problems in children who had siblings with ASD was higher than children who had siblings with physical illness. In a group in which a sibling had ASD, sisters were more anxious/ depressed than brothers. Conclusion: Due to various psychological and social problems that siblings of children with ASD experience throughout their life, studying their psychological problems to improve their quality of life seems to be of paramount importance. © 2018 Tehran University of Medical Sciences

The impact of a sleep hygiene intervention on sleep habits in children with attention deficit/hyperactivity disorder

Background Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders of childhood. Up to 50 of these children suffer from at least one comorbid sleep disorder. Considering the deleterious effects of sleep problems on all aspects of children's life, this study was designed to investigate the impact of a sleep hygiene intervention on sleep habits in children with ADHD and comorbid sleep disorders. Materials and Methods This randomized controlled trial, was conducted on 62 children aged 7 to13 years with diagnosis of ADHD and comorbid sleep disorders. Children's Sleep Habits Questionnaire (CSHQ) was completed by children's mothers and then the participants allocated randomly into experimental (n=28) and control (n=28) groups. Mothers of the children in experimental group received a sleep hygiene educational intervention which was delivered through a training session and a booklet followed by two telephone calls and educational text messages. Participants in the control group received usual clinical care. The post-test was performed two months after intervention. Results 56 children (case and control groups) completed the survey (mean age 8.62 � 1.57 years). Data analysis showed that, compared with control children, experimental children had a significant- reduction in mean scores of Bedtime resistance (P < 0.05), Sleep onset delay (P < 0.05), Sleep duration (P < 0.05), Sleep anxiety (P < 0.05), Daytime sleepiness (P < 0.05) and total score of CSHQ (P < 0.05), after controlling pre-test. Conclusion The sleep hygiene intervention improved sleep problems in a sample of children with ADHD by parent report. The findings of this study support the design, implementation and evaluation of educational programs on good sleep-hygiene practices for children and adolescents

Impact of coping skills training on the quality of life among the daughters of mothers with breast cancer

Background: Cancer affects the quality of life (QoL) of patients and their families. The purpose of this study was to determine the effect of coping skills training on the QoL among daughters of mothers with breast cancer. Methods: In this quasi-experimental pre-test/post-test design, data were collected from 70 participants (35 in each of the control and education groups) from January 2016 to July 2017 in Imam Khomeini and Rasole-e-Akram Hospitals in Tehran. The education group participated in a workshop and group discussion (groups of 5 to 8 participants) with the presence of a pediatric psychiatrist and two pediatric nurses, and then a follow up program was performed. The Pediatric Quality of Life Inventory version 4.0 was used in this study in two stages of pre-test (before education) and post-test (four weeks later). Data were analyzed through SPSS, version 21 using independent t-test and paired t-test for comparison of the mean scores of the two groups, with the significance level of 0.05. Results: After the education, there were significantly improved scores of the QoL in the dimensions of physical functioning (P<0.001), emotional functioning (P<0.001), and school functioning (P<0.001) in the study group compared to the control group. The social functioning did not show a significant change (P<0.083). Conclusion: The findings of the study confirm that coping skills training can lead to the improvement of QoL in adolescent daughters of mothers with breast cancer. Healthcare professionals must provide the mothers and daughters with information about breast cancer and instruments to handle their situation to promote the daughters� QoL. © 2020, Shriaz University of Medical Sciences. All rights reserved

Palmitoylethanolamide as adjunctive therapy for autism: Efficacy and safety results from a randomized controlled trial

Inflammation as well as glutamate excitotoxicity have been proposed to participate in the propagation of autism. Palmitoylethanolamide (PEA) is an endocannabinoid proven to prevent glutamatergic toxicity and inhibit inflammatory responses simultaneously. The present randomized, parallel group, double-blind placebo-controlled trial is the first study depicted to probe the efficacy of co-treatment with risperidone and PEA over 10 weeks in children with autism. Seventy children (aged 4�12 years) with autism and moderate to severe symptoms of irritability were randomly assigned to two treatment regimens. The study outcomes were measured using the Aberrant Behavior Checklist-Community Edition (ABC-C). At trial endpoint (week 10), combination of PEA and risperidone had superior efficacy in ameliorating the ABC-irritability and hyperactivity/noncompliance symptoms (Cohen's d, 95 confidence interval (CI) = 0.94, 0.41 to 1.46, p = 0.001) compared with a risperidone plus placebo regimen. Interestingly, effect of combination treatment on hyperactivity symptoms was also observed at trial midpoint (week 5) but with a smaller effect size (d = 0.53, p = 0.04) than that at the endpoint (d = 0.94, p = 0.001). Meanwhile, there was a trend toward significance for superior effect of risperidone plus PEA over risperidone plus placebo on inappropriate speech at trial endpoint (d = 0.51, p = 0.051). No significant differences existed between the two treatment groups for the other two ABC-C subscales (lethargy/social withdrawal and stereotypic behavior). The findings suggest that PEA may augment therapeutic effects of risperidone on autism-related irritability and hyperactivity. Future studies are warranted to investigate whether PEA can serve as a stand-alone treatment for autism. © 2018 Elsevier Lt