Background: The experience of childhood maltreatment of women has been identified as an important predictor for the occurrence of health-related and psychosocial risk factors during pregnancy that might increase the risk for mental health problems in offspring. Little is known yet about how different types of maternal childhood maltreatment contribute to the occurrence of these health-related and psychosocial risk factors during pregnancy.Objective: The aim of this study was to investigate how specific types of childhood maltreatment (emotional, physical and sexual abuse, and emotional and physical neglect) relate to the occurrence of health-related and psychosocial risk factors during pregnancy.Method: A sample of N = 305 pregnant women in their second or third trimester, drawn from the general German-speaking population, completed an online survey assessing childhood maltreatment and a range of health-related (e.g. medical complications) and psychosocial (e.g. maternal antenatal depression) factors. Multiple linear regression analyses were performed to examine the specific predictive effect of each type of childhood maltreatment on different health-related and psychosocial risk factors during pregnancy.Results: The regression analyses indicated that the combined predictor emotional abuse/neglect predicted health-related and psychosocial factors during pregnancy, including perceived stress, antenatal depression, relationship quality and psychiatric symptoms. Sleep problems were predicted by sexual abuse. Sensitivity analyses with emotional abuse and emotional neglect as separate predictors revealed emotional abuse as the only significant predictor of perceived stress, antenatal depression and psychiatric symptoms.Conclusions: Future research should focus on the underlying mechanisms linking emotional abuse and neglect to health-related and psychosocial risk factors during pregnancy. Routine screening for childhood maltreatment and early interventions for women who experienced emotional abuse and neglect in childhood may substantially reduce the occurrence of health-related and psychosocial risk factors during pregnancy that might affect children's mental health, thereby promoting healthy psychological development in offspring.

BACKGROUND:Prenatal alcohol exposure (PAE) is a major preventable cause of neurodevelopmental impairment. Little is known about its impact on real-life child/adolescent academic outcomes, which are key functional indicators of long-term social participation. METHODS:PAE was assessed in a sample of 156 participants via (1) meconium ethyl glucuronide (EtG) concentration (≥10 ng/g; EtG-positive, n = 36) and (2) third-trimester maternal self-report (SR-positive, n = 40). At primary school (6-10 years, t1) and secondary school ages (12-14 years, t2), exposed and non-exposed children were compared regarding primary school grades (t1) and secondary track placement (t2). RESULTS:At t1, EtG-positive children exhibited lower school report grades by trend (n = 15, p = 0.068-0.085) with a moderate effect size (r = 0.36-0.39). SR-positive children demonstrated significantly lower school report grades (n = 15, p = 0.016) with strong effect (r = 0.56). At t2, both exposure groups had increased trend-significant odds of attending lower educational tracks (EtG-positive/-negative: n = 153, OR = 1.84, p = 0.059; SR-positive/-negative: n = 153, OR = 1.78, p = 0.066). CONCLUSIONS:PAE is associated with reduced real-life academic outcomes across development. School performance represents a sensitive functional outcome of neurodevelopmental vulnerability following PAE. Meconium EtG may contribute to postnatal identification of affected children.

Callous-unemotional (CU) traits are associated with specific cognitive and emotional deficits, which help explain their severe aggressive behavior. In the ICD-11/DSM-5, CU traits have been added to the diagnostic criteria for disruptive behavior disorder (DBD) as the "limited prosocial emotions" (LPE) specifier. The semi-structured Clinical Assessment of Prosocial Emotions (CAPE) interview is a new method to identify LPE. This study protocol describes the German translation of the semi-structured CAPE and the planned evaluation of its construct validity in a clinical sample of children diagnosed with DBD in Germany. Given that individuals with elevated CU traits can be categorized into primary (less anxiety, with less experience of abuse) and secondary (high anxiety, with more experience of abuse) variants, this study protocol will outline the planned exploratory analysis of these variants in a German clinical sample. The research questions will be examined in a multicenter, cross-sectional, clinical observational study using a case-control design. The study will include children and adolescents aged 8-18 and their primary caregivers. Multivariable general linear models will be used to assess the construct validity of CAPE and to explore differences between CU trait variants. Validating a German version of CAPE could provide clinicians and researchers with a standardized tool to assess LPE, enabling treatment tailored to CU trait variants. Trial Registration: German Clinical Trials Register, DRKS00035428, registered on 5 November 2024. Ethical approval was obtained from the Friedrich-Alexander Universität Erlangen-Nürnberg (reference number: 24-112-S) on 28 May 2024. Trial status: Recruiting ongoing.

Abstract Background This study investigates the effects of surgery-related variables on child neurodevelopment, internalizing symptoms, health-related quality of life (HRQoL), and maternal psychopathology following early child surgical Ventricular Septal Defect (VSD) repair. Methods 24 children (54.2% females) who underwent VSD surgery (age at surgery: Range 1.38 to 33.18 months) and their mothers were examined from child primary school-age (T1; M = 7.3 years, SD = 0.99) to early adolescence (T2; M = 12.4 years, SD = 0.93). Surgery-related variables (age at surgery, duration of surgery, cardiopulmonary bypass time, post-surgical hospital stay) were retrospectively reviewed, surgical scar characteristics were measured at T2. Child neurodevelopment, mother-reported internalizing symptoms and HRQoL were assessed at both time points, with adolescents also rating their internalizing symptoms and HRQoL at T2. Data were analyzed using repeated measures analyses of covariance (T1-T2). Results An older age at surgery was linked to lower child long-term HRQoL. Time-based surgery-related variables (duration of surgery, cardiopulmonary bypass time) were associated with higher HRQoL at T1, while a longer duration of surgery affected maternal psychopathology at T2. A prolonged post-surgical hospital stay was negatively related to child neurodevelopment, and negatively predicted internalizing symptoms and child-rated HRQoL at T2. Longer surgical scars were correlated with higher child anxiety at T1 and lower long-term HRQoL, while wider scars were associated with increased depressive symptoms and lower HRQoL over time, and higher maternal psychopathology at T1. Conclusions In sum, surgery-related variables primarily influenced child long-term psychosocial adjustment, with less impact on neurodevelopment. Postoperative variables have demonstrated greater relevance compared to time-based surgery-related variables. Effective management during all surgical phases is therefore crucial for both somatic and psychosocial recovery.

BACKGROUND:Recent advances in natural language processing (NLP), particularly in language processing methods, have opened new avenues in semantic data analysis. A promising application of NLP is data harmonization in questionnaire-based cohort studies, where it can be used as an additional method, specifically when only different instruments are available for one construct as well as for the evaluation of potentially new construct-constellations. The present article therefore explores embedding models' potential to detect opportunities for semantic harmonization. METHODS:Using models like SBERT and OpenAI's ADA, we developed a prototype application ("Semantic Search Helper") to facilitate the harmonization process of detecting semantically similar items within extensive health-related datasets. The approach's feasibility and applicability were evaluated through a use case analysis involving data from four large cohort studies with heterogeneous data obtained with a different set of instruments for common constructs. RESULTS:With the prototype, we effectively identified potential harmonization pairs, which significantly reduced manual evaluation efforts. Expert ratings of semantic similarity candidates showed high agreement with model-generated pairs, confirming the validity of our approach. CONCLUSIONS:This study demonstrates the potential of embeddings in matching semantic similarity as a promising add-on tool to assist harmonization processes of multiplex data sets and instruments but with similar content, within and across studies.

Background and Aims:Internet gaming disorder (IGD) is a relevant psychiatric disorder during adolescence. Excessive digital gaming has been associated with youth mental health problems. Prospective studies combining psychological and biological outcomes in childhood and adolescence are rare. Methods:A sample of n = 178 children was studied at primary school age (M = 7.7 years, t1) and during adolescence (M = 13.3 years, t2). Data was collected in mother- (t1, t2) and self-reports (t2) on screen time, gaming behavior, emotional/behavioral symptoms and biological/psychological stress. Adolescent gamers and nongamers were compared using sex-controlled (co)variance analyses and correlations with the gaming scores were carried out. Results:At t1, there were no differences between adolescent gamers versus nongamers. At t2, self-reports indicated elevated psychological stress (p = 0.01) and an increase in behavioral symptoms (p = 0.01) in both sexes. Furthermore, gaming girls exhibited a higher prevalence of self-reported emotional symptoms (p = 0.05); no differences were observed in mother-reports or hair cortisol concentrations. In the gaming group, more DSM-5 internet gaming disorder (IGD) symptoms at t2 were associated with higher mother-rated total symptoms and digital gaming screen time at t1 in boys (p = 0.03/0.04), higher self-rated psychological stress and more emotional/behavioral/total symptoms in boys (p = 0.002-0.02) and lower hair cortisol concentrations in girls (p = 0.003) at t2. Conclusion:The phenomenon of online gaming in adolescence had no precursors in childhood, while it was associated with current mental health and stress parameters. The extent of gaming, as defined by the DSM-5 IGD symptoms, was found to be associated with screen time and mental health issues in childhood and adolescence. Consequently, it can be hypothesized that adolescent online gaming is a symptom of earlier as well as a risk factor for current mental health problems during adolescence, with specific consequences for boys and girls.

Prenatal alcohol exposure (PAE) and maternal depressive symptoms are associated with hypothalamic-pituitary-adrenal (HPA) axis alterations in the offspring. The present study investigated long-term associations of both risk factors on the offspring’s hair cortisol concentration (HCC) in childhood and adolescence. The HCC of n = 94 children was assessed at primary school age (T1, M = 7.7 years, SD = 0.81) and in early adolescence (T2, M = 13.3 years, SD = 0.30). PAE was operationalized by maternal self-report and the meconium alcohol metabolite ethyl glucuronide (EtG), applying two cut-off values, EtG ≥ 10 ng/g (EtG10+: n = 18) and EtG ≥ 154 ng/g (EtG154+: n = 9). The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for prenatal maternal depressive symptoms (EPDS ≥ 10: n = 24). The clinical relevance of the results was assessed by correlating the HCC with children’s emotional and behavioral problems as measured by the Strengths and Difficulties Questionnaire (SDQ). The EtG10+ and the EtG154+ group showed lower HCC at T1 than the respective control groups, with a significant difference observed for the EtG154 risk group (p = .032). This difference was attenuated at T2. Children and adolescents whose mothers reported prenatal depressive symptoms did not show any significant differences in HCC at any time. The present study provides further evidence of long-term effects of alcohol consumption during pregnancy on the HPA axis development of the child, as manifested in distinct trajectories of HCC from primary school age to early adolescence. Not applicable.

IntroductionMany studies have investigated the impact of congenital heart defects (CHD) on child development. However, because CHD not only affects the child and his or her development but, also the entire family, family functioning after pediatric cardiac surgery is of increasing research interest. This prospective childhood-adolescence case-control study aimed to examine differences and changes in parenting behavior and mother-child relationship quality after early surgical repair of an isolated ventricular septum defect (VSD) compared to non-affected controls.Patients and methods39 affected children (M = 7.3 years) with surgically repaired VSD and their mothers were compared with a matched, non-affected control group of 39 mother-child-dyads (M = 7.3 years) during primary school age (t1). At child early adolescence, 24 affected children (M = 12.4 years) and 24 children of the control group (M = 13.2 years) were examined again (t2). Parenting behavior characteristics (t1: mother report; t2: mother- and child report) and mother-child relationship quality (t2: child report) were measured by standardized questionnaires.ResultsThe mother-rated parenting behavior dimensions Involvement (p < .001, η2p = .37), Parental Monitoring (p = .014, η2p = .17) and Corporal Punishment (p < .001, η2p = .57) significantly decreased from t1 to t2 in both cohorts. Responsible Parenting Behavior tended to decrease from t1 to t2 in the control group, while remaining stable in the VSD-group (p = .088, η2p = .09). Independent of the group, higher mother-child relationship quality was associated with more Positive Parenting Behavior (p < .001, η2p = .34), more Involvement (p = .003, η2p = .22) and fewer Inconsistency (p < .001, η2p = .31) in the child-rating; and more Positive Parenting Behavior in the mother-rating (p = .039, η2p = .10).ConclusionVSD affected mother-child-dyads were mostly comparable in their parenting behavior characteristics and mother-child relationship quality to non-affected controls. The absence of a decrease in maternal Responsible Parenting Behavior in the VSD group may indicate challenges during the developmental task of autonomy in adolescence. Nevertheless, adaptive family functioning after early pediatric surgical VSD repair seems possible.