DOI: 10.5061/dryad.80gb5mkz8
title: Behavioral problems in preadolescence: Does nutritional status have a role?

description: Malnutrition in children and adolescents is a global issue, particularly
 in low- and middle-income countries, while behavioral problems are
 becoming a growing public health concern in the area of child and
 adolescent mental health, with very few studies examining their
 association in preadolescence. This study aimed to assess the
 epidemiological relationship between malnutrition and behavioral problems
 in preadolescence. A school-based, cross-sectional survey was
 conducted in Pakistan. A total of 660, 11-12-year-old preadolescents were
 selected from a middle-class, co-educational school chain.
 Socio-demographic questionnaires and an officially adapted version of the
 Youth Self Report Form (YSR), which is the child and adolescent reported
 version of the Child Behavior Checklist (CBCL), were used to collect data,
 along with anthropometric assessments following the WHO protocol. Thin and
 stunted preadolescents had significantly higher odds of internalizing
 problems (AOR= 2.05, P= 0.003 and AOR= 2.09, P= 0.039, respectively) than
 normal ones. Over-nutrition was not associated with any behavioral issues.
 According to the composite index of anthropometric failure, 40% of
 preadolescents had at least one type of malnutrition, and among them,
 about 3% had co-occurring malnutrition (stunted and thin or overweight).
 They had a higher risk of being associated with internalizing problems
 (AOR 2.92, P = 0.027). The effect was considerably higher than
 that associated with stunted or thin only, highlighting the cumulative
 impact of the co-occurring malnutrition on the internalizing problems. Our
 study concludes that over- and under-nutrition are prevalent in
 preadolescents, with a significant association of under-nutrition with
 internalizing problems. Moreover, our study is the first that report that
 the co-occurrence of malnutrition is significantly associated with
 increased risk of internalizing problems. This study highlights the
 importance of the link between physical and mental health and emphasizes
 the need for holistic interventions and programs for addressing
 preadolescents' issues.
description: Data were collected by trained enumerators using standard
 instruments on paper-based forms under the supervision of the principal
 investigator. Data were entered into a pre-designed software and later
 analysed in SPSS software.
description: # Behavioural Problems in Preadolescence: Does Nutritional Status Have a
 Role? Dryad DOI:
 [https://doi.org/10.5061/dryad.80gb5mkz8](https://doi.org/10.5061/dryad.80gb5mkz8) Description of the Data: Data were collected from 660, 11-12-year-old preadolescents who were studying in middle-class coeducational schools in Pakistan. Instruments for assessment: Anthropometric assessment was done to assess nutritional status, whereas the Youth Self Report Form of CBCL was used to assess Behavioral problems. Author details: [bushra.khan@uok.edu.pk](mailto:bushra.khan@uok.edu.pk) We have shared limited data in compliance with the Dryad policies to ensure participants' safety and confidentiality. Variable definitions: UniqueID | Participants' Unique ID Age | Age of the participants | 0. 11 years; 1. 12 years Gender | Gender of the participants | 0. Girl; 1. Boy SES | Socioecnomic status/index | 1. 1st poorest; 2. 2nd; 3. 3rd; 4. 4th; 5. 5th Richest Nutrition_status | Nutritional status (Index of anthropometric failure) | 0. Normal; 1. Stunted only; 2. Thin; 3. Overweight only; 4. Stunted and Thin/overweight OverallProb | Overall behavioural problems | 1. normal; 2. deviant Externalizing | Externalizing problems | 1. normal; 2. deviant Internalizing | Internalizing problems | 1. normal; 2. deviant ## Code Recommended Software for Data Analysis: SPSS or JASP ## Human subjects data We confirm that we have received consent from our study participants to publish the de-identified data in the public domain. Several measures are taken to de-identified the data that includes: a) Assigning a unique participant ID (a numeric serial number) b) No personal identifier are kept in the data such as participant name or parents' characteristics c) Variables has been categories in a way that unique values of each participant is lumped into a broader category