OKUL ÖNCESİ ÇOCUKLARDA PSİKOSOSYAL ÖZELLİKLER İLE DEHB İLE İLİŞKİLİ YIKICI DAVRANIŞLAR VE ANKSİYETE BOZUKLUĞU BELİRTİLERİ ARASINDAKİ İLİŞKİ

Öz

Amaç: Bu araştırmanın amacı, okul öncesi çocuklarda dikkat eksikliği hiperaktivite bozukluğu ile ilişkili yıkıcı davranışlar ve anksiyete bozukluğu belirtilerinin; aile işlevselliği, uyku düzeni, fiziksel aktivite ve ekran süresi gibi psikososyal faktörlerle ilişkisini incelemektir.

Gereç ve Yöntemler: Mart-Mayıs 2025 tarihleri arasında Zonguldak il merkezinde yer alan bir anaokulunda yürütülen kesitsel çalışmaya, 3-6 yaş aralığında 84 çocuk ve ebeveynleri katılmıştır. Veriler, sosyodemografik formun yanı sıra Ercan Okul Öncesi Yıkıcı Davranış Bozuklukları Ölçeği, Aile Değerlendirme Ölçeği, Çocuk Uyku Alışkanlıkları Anketi ve Okul Öncesi Çocuklarda Anksiyete Ölçeği aracılığıyla toplanmıştır. İstatistiksel analizler SPSS 29.0 programı kullanılarak gerçekleştirilmiştir.

Bulgular: Erkek çocuklarda sosyal ve yaygın anksiyete düzeylerinin kız çocuklara kıyasla daha yüksek olduğu bulunmuştur (p<0,05). Boşanmış ebeveynlere sahip çocukların ayrılık anksiyetesi puanları anlamlı düzeyde yüksek bulunmuştur (p<0,05). Annesinde psikiyatrik hastalık öyküsü bulunan çocuklarda hem toplam anksiyete düzeyi hem de fiziksel yaralanma korkusu puanları anlamlı şekilde daha yüksek saptanmıştır (p<0,05). Fiziksel aktivite düzeyi düşük olan çocukların yaygın anksiyete puanları anlamlı şekilde daha yüksek bulunmuştur (p<0,05). Artan ekran süresi, yatma zamanı direnci ile pozitif yönde ilişkili bulunmuş; ekran süresi ile anksiyete belirtileri arasında ise anlamlı bir ilişki saptanmamıştır.

Sonuç: Bulgular, okul öncesi dönemde görülen psikiyatrik belirtilerin bireysel etmenlerin yanı sıra ailevi, çevresel ve yaşam tarzı değişkenleriyle ilişkili olabileceğine işaret etmektedir. Özellikle uyku kalitesi ve fiziksel aktivite düzeyi gibi modifiye edilebilir değişkenlerin erken dönemde değerlendirilmesi ve müdahale planlarına dahil edilmesi önerilmektedir.

Anahtar Kelimeler

• Okul Öncesi
• Dikkat Eksikliği Hiperaktivite Bozukluğu
• Anksiyete
• Uyku
• Aile İşlevselliği
• Ekran Süresi
• Fiziksel Aktivite

The Relationship Between Psychosocial Characteristics and ADHD-Related Disruptive Behaviors and Anxiety Disorder Symptoms in Preschool Children

Öz

Objective: This study aimed to investigate the associations between disruptive behaviors associated with attention-deficit/hyperactivity disorder  and anxiety symptoms and various psychosocial factors-including family functioning, sleep patterns, physical activity, and screen time-in preschool children.

Material and Methods: A cross-sectional study was conducted between March and May 2025 in a preschool located in Zonguldak, Türkiye. The study sample included 84 children aged 3-6 years. Data were collected using the Sociodemographic Form, Ercan Preschool Disruptive Behavior Scale, Family Assessment Device (FAD), Children’s Sleep Habits Questionnaire, and Preschool Anxiety Scale. Statistical analyses were conducted using SPSS 29.0.

Results: Male children exhibited significantly higher levels of social and generalized anxiety compared to females (p<0.05). Children with divorced parents had elevated separation anxiety scores (p<0.05), and those whose mothers had a psychiatric history demonstrated significantly higher total anxiety and physical injury fear scores (p<0.05). Lower physical activity levels were associated with higher generalized anxiety scores (p<0.05). Screen time was positively correlated with bedtime resistance; however, it was not significantly associated with anxiety symptoms.

Conclusion: These findings suggest that early childhood psychopathology may be associated with a range of  modifiable psychosocial and environmental factors. Assessing and addressing variables such as sleep quality  and physical activity in early interventions may contribute to improved developmental and emotional  outcomes in preschool-aged children.

Anahtar Kelimeler

• Preschool
• Attention-De icit Hyperactivity Disorder
• Anxiety
• Sleep
• Family Functioning
• Screen Time
• Physical Activity

Kaynakça

1. 1. Conti-Ramsden G, Durkin K. Language development and assessment in the preschool period. Neuropsychol Rev. 2012;22(4):384-401.
2. 2. Garon N, Bryson SE, Smith IM. Executive function in preschoolers: a review using an integrative framework. Psychol Bull. 2008;134(1):31-60.
3. 3. Melhuish EC. Preschool matters. Science. 2011;333(6040):299-300.
4. 4. Kohlberg L. Early education: a cognitive developmental view. Child Dev. 1968;39(4):1013-62.
5. 5. Muetzel RL, Blanken LME, van der Ende J, El Marroun H, Shaw P, Sudre G, et al. Tracking brain development and dimensional psychiatric symptoms in children: a longitudinal population based neuroimaging study. Am J Psychiatry. 2018;175(1):54-62.
6. 6. Hughes DE, Kunitoki K, Elyounssi S, Luo M, Bazer OM, Hopkinson CE, et al. Genetic patterning for child psychopathology is distinct from that for adults and implicates fetal cerebellar development. Nat Neurosci. 2023;26(6):959-69.
7. 7. Egger HL, Angold A. Common emotional and behavioral disorders in preschool children: presentation, nosology, and epidemiology. J Child Psychol Psychiatry. 2006;47(3- 4):313-37.
8. 8. Finsaas MC, Bufferd SJ, Dougherty LR, Carlson GA, Klein DN. Preschool psychiatric disorders: homotypic and heterotypic continuity through middle childhood and early adolescence. Psychol Med. 2018;48(13):2159-68.

9. 9. Bufferd SJ, Dougherty LR, Carlson GA, Rose S, Klein DN. Psychiatric disorders in preschoolers: continuity from ages 3 to 6. Am J Psychiatry. 2012;169(11):1157-64.
10. 10. Palmer M, Scott S. Social determinants of child psychopathology. In: Bhugra D, Moussaoui D, Craig TJ (eds). Oxford Textbook of Social Psychiatry. Oxford University Press; 2022;403-12.
11. 11. Franzoi D, Bockting CL, Bennett KF, Odom A, Lucassen PJ, Pathania A, et al. Which individual, social, and urban factors in early childhood predict psychopathology in later childhood, adolescence and young adulthood? A systematic review. SSM - Population Health. 2023;25:101575.
12. 12. Cussen A, Sciberras E, Ukoumunne OC, Efron D. Relationship between symptoms of attention deficit/hyperactivity disorder and family functioning: a community-based study. Eur J Pediatr. 2012;171(2):271-80.
13. 13. Wang SS, Chen TJ, Ji CY. A twin study of genetic and environmental influences on relationship between attention deficit and anxiety/depression in children and adolescents. Chin J Epidemiol. 2017;38(9):1183-6.
14. 14. Hansen BH, Skirbekk B, Oerbeck B, Wentzel Larsen T, Kristensen H. Associations between sleep problems and attentional and behavioral functioning in children with anxiety disorders and ADHD. Behav Sleep Med. 2014;12(1):53-68.
15. 15. Ercan ES, Somer O, Amado S, Thompson D. Parental recall of pre-school behavior related to ADHD and disruptive behavior disorder. Child Psychiatry Hum Dev. 2005;35(4):299-313.
16. 16. Epstein NB, Baldwin LM, Bishop DS. The McMaster Family Assessment Device. J Marital Fam Ther. 1983;9(2):171-80.
17. 17. Bulut I. Aile Değerlendirme Ölçeği (ADÖ) El Kitabı Özgüzeliş Matbaası; 1990. p. 1-38.
18. 18. Owens JA, Spirito A, McGuinn M. The Children's Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep. 2000;23(8):1043-51.
19. 19. Fiş NP, Arman A, Ay P, Topuzoğlu A, Güler AS, Gökçe İmren S, ve ark. Çocuk Uyku Alışkanlıkları Anketi'nin Türkçe geçerliği ve güvenilirliği. Anadolu Psikiyatri Derg. 2010;11(2):151-60.
20. 20. Spence SH, Rapee RM, McDonald C, Ingram M. The structure of anxiety symptoms among preschoolers. Behav Res Ther. 2001;39(11):1293-316.
21. 21. Şahin H. Study of adaptation of the Preschool Anxiety's Scale in children to Turkish. Int Educ Stud. 2020;13(9):82-95.
22. 22. Erermiş S, Bellibaş E, Özbaran B, Büküşoğlu ND, Altıntoprak E, Bildik T, et al. Temperamental Characteristics of Mothers of Preschool Children With Separation Anxiety Disorder. Turk Psikiyatri Derg. 2009;20(1):14-21.
23. 23. Apata OE, Falana OE, Hanson U, Oderhohwo E, Oyewole PO. Exploring the effects of divorce on children's psychological and physiological wellbeing. Asian J Educ Soc Stud. 2023;49(4):124-33.
24. 24. Dicu A. The family environment of children with divorced parents and their emotional disturbances. Anthropol Res Stud. 2024;14(1):438-51.
25. 25. Mahler MS, Pine F, Bergman A. The psychological birth of the human infant: symbiosis and individuation. Basic Books, 1975. p. 65-90.
26. 26. Kardaş B, Kardaş Ö. Çocuğun ekran maruziyeti ve annenin akıllı telefon kullanım düzeyi dil gelişimini etkiler mi? Acta Med Nicomedia. 2024;7(2):202-7.
27. 27. Xu Q, Wang JH, Zhou B, Jin CH, Zhang LL, Li N, et al. Effects of screen exposure on language skills in children. Zhonghua Er Ke Za Zhi. 2023;61(4):328-32.
28. 28. Liu H, Zhu X, Ge B, Huang M, Li X. The association between screen exposure and autism spectrum disorder in children: meta-analysis. Rev Environ Health. 2024;40(2):437-44.
29. 29. Jannesar N, Davenport TE, Gietzen L. Effects of screen time on children's brain development: a scoping review. Pac J Health. 2023;6(1):14.
30. 30. Hale L, Hartstein LE, Robbins R, Grandner MA, LeBourgeois MK, Garrison MM, et al. What do we know about the link between screens and sleep health? In: Handbook of Children and Screens: Digital Media, Development, and Well-Being. Springer Nature; 2024;101-7.
31. 31. Khan A, Werner-Seidler A, Hidajat T, Feng J, Huang WY, Rosenbaum S. Association between sports participation and psychosocial wellbeing of Australian children: an 8-year longitudinal study. J Adolesc Health. 2023;73(6):1117-24.
32. 32. Şenışık S, Kayış H. Spora katılımın ergenlik dönemindeki depresyon ve kaygı düzeylerine etkisi. Ege Tip Derg. 2021;60(3):210-8.
33. 33. Moeijes J, van Busschbach JT, Bosscher RJ, Twisk JWR. Sports participation and psychosocial health: a longitudinal observational study in children. BMC Public Health. 2018;18(1):702.
34. 34. Guerlich K, Avraam D, Cadman T, Calas L, Charles MA, Elhakeem A, et al. Sleep duration in preschool age and later behavioral and cognitive outcomes: an individual participant data meta-analysis in five European cohorts. Eur Child Adolesc Psychiatry. 2024;33(1):167-77.
35. 35. Hoyniak CP, Bates JE, McQuillan ME, Staples AD, Petersen IT, Rudasill KM, et al. Sleep across early childhood: implications for internalizing and externalizing problems, socioemotional skills, and cognitive and academic abilities in preschool. J Child Psychol Psychiatry. 2020;61(10):1080-91.
36. 36. Zhao T, Xuan K, Liu H, Chen X, Sun L, Chen M, et al. The association between family function and sleep disturbances of preschool children in rural areas of China: a cross-sectional study. Psychol Health Med. 2023;28(4):895-907.
37. 37. Ayano G, Betts K, Maravilla JC, Alati R. The risk of anxiety disorders in children of parents with severe psychiatric disorders: a systematic review and meta-analysis. J Affect Disord. 2021;282:472-87.
38. 38. Lawrence PJ, Murayama K, Creswell C. Systematic review and meta-analysis: anxiety and depressive disorders in offspring of parents with anxiety disorders. J Am Acad Child Adolesc Psychiatry. 2019;58(1):46- 60.
39. 39. Franz L, Angold A, Copeland W, Costello EJ, Towe-Goodman N, Egger HL. Preschool anxiety disorders in pediatric primary care: prevalence and comorbidity. J Am Acad Child Adolesc Psychiatry. 2013;52(12):1294-303.