Browsing by Author "Seppälä, Vilja"

Objective. Childhood stress is a risk factor for psychiatric disorders. Selective mutism (SM) is an anxiety disorder, which is characterized by consistent difficulties to speak in certain situations, without difficulties in speech development. It is suggested that children with anxiety disorders have higher amount of stress than children with externalizing disorders. However, the literature is scarce and there are also contradicting results. Stress in children with SM have not been previously studied in comparison to other psychiatric disorders. The aim of the current study is to examine self-reported, parent-reported and physiological stress among children with a diagnosis of selective mutism in comparison to child psychiatric patients with mainly externalizing symptoms. The study aims to enlighten the role of stress in different patient groups. It might make a difference when choosing interventions for child psychiatric patients. Methods. The participants were 21 6 – 12 year-old children with a diagnosis of SM (F94.0). The children were currently receiving treatment in a child psychiatry outpatient clinic. The control group consisted of 25 children who had been referred to child psychiatric evaluation and treatment for externalizing symptoms. Parents filled out questionnaires of the child’s symptoms (Child Behavior Checklist; Frankfurt Scale of Selective Mutism) and answered to a question concerning the child’s daily stress. The children filled out a questionnaire about daily stress (Perceived Stress Scale), in addition to which the child’s heart rate variability (HRV) was measured. Analysis of variance and linear regression analysis were used to examine level of stress in the two groups. Results and discussion. A higher amount of physiological childhood stress (i.e. lower HRV) was observed in children with selective mutism than in children with mainly externalizing symptoms. No difference in the children’s self- or parent-reported stress was found between the groups. The current study suggests there might be differences in physiological stress between different pediatric patient groups and emphasizes the importance of combining questionnaire-based and physiological measures in future studies as they may lead to different results. There was no association between the severity of selective mutism and the child’s stress. The results are preliminary, thus future studies should focus on selective mutism and childhood stress as it might result implications for the etiology and treatment of selective mutism.