Association between short stature and behavioral and emotional difficulties among children in Jordan: a cross-sectional study

BackgroundShort stature is associated with psychological and emotional challenges, yet its impact on children’s behavioral well-being in Jordan remains underexplored. This study examines the association between short stature and behavioral and emotional difficulties in Jordanian children.MethodsA cr...

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Main Authors: Tamara Kufoof, Randa K. Saad, Redab Al-Ghawanmeh, Seri Sawaqed, Zaid Hamdan, Zaid Qolaghasi, Adnan Alswiti, Layan Sharkas, Osama Sharkas
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1630919/full
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author Tamara Kufoof
Randa K. Saad
Redab Al-Ghawanmeh
Seri Sawaqed
Zaid Hamdan
Zaid Qolaghasi
Adnan Alswiti
Layan Sharkas
Osama Sharkas
author_facet Tamara Kufoof
Randa K. Saad
Redab Al-Ghawanmeh
Seri Sawaqed
Zaid Hamdan
Zaid Qolaghasi
Adnan Alswiti
Layan Sharkas
Osama Sharkas
author_sort Tamara Kufoof
collection DOAJ
description BackgroundShort stature is associated with psychological and emotional challenges, yet its impact on children’s behavioral well-being in Jordan remains underexplored. This study examines the association between short stature and behavioral and emotional difficulties in Jordanian children.MethodsA cross-sectional study was conducted at Prince Hamza Hospital, Amman (2023–2024). We recruited eighty-three children aged 4–14 years with a height percentile ≤3%. The Strengths and Difficulties Questionnaire (SDQ) assessed behavioral and emotional difficulties. Differences in SDQ scores by gender, age group, and growth hormone (GH) therapy status were analyzed.ResultsThe mean total difficulties score was 13.7 ± 6.1, with 30.1% of participants classified in the “high” or “very high” category. Emotional difficulties (31.3%), peer problems (31.3%), and conduct issues (34.9%) were notably prevalent. Boys exhibited significantly higher conduct problems (p < 0.001), hyperactivity (p = 0.002), and total difficulties scores (p = 0.010), while girls showed stronger prosocial behaviors (p = 0.004). No significant differences were observed between younger (3–10 years) and older (11–14 years) children. Children receiving GH therapy reported significantly higher emotional problems (p = 0.029), though other SDQ scores did not differ significantly between treated and untreated groups.ConclusionShort stature in Jordanian children is associated with significant behavioral and emotional challenges, particularly among boys. GH therapy was not associated with improved scores in this sample. A multidisciplinary approach integrating psychological support and public health initiatives is needed to address stigma and improve well-being.
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spelling doaj-art-46a4fe088a8b4fc5900c1a269acc60cb2025-08-25T04:10:27ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-08-011610.3389/fendo.2025.16309191630919Association between short stature and behavioral and emotional difficulties among children in Jordan: a cross-sectional studyTamara Kufoof0Randa K. Saad1Redab Al-Ghawanmeh2Seri Sawaqed3Zaid Hamdan4Zaid Qolaghasi5Adnan Alswiti6Layan Sharkas7Osama Sharkas8Department of Pediatrics, Faculty of Medicine, The Hashemite University, Zarqa, JordanResearch and Policy, Eastern Mediterranean Public Health Network (EMPHNET), Amman, JordanDepartment of Pediatrics, Faculty of Medicine, The Hashemite University, Zarqa, JordanDepartment of Internal Medicine, Faculty of Medicine, The Hashemite University, Zarqa, JordanDepartment of Pediatrics, Faculty of Medicine, The Hashemite University, Zarqa, JordanDepartment of Pediatrics, Faculty of Medicine, The Hashemite University, Zarqa, JordanDepartment of Pediatrics, Faculty of Medicine, The Hashemite University, Zarqa, JordanDepartment of Pediatrics, Faculty of Medicine, The Hashemite University, Zarqa, JordanDepartment of Pediatrics, Faculty of Medicine, The Hashemite University, Zarqa, JordanBackgroundShort stature is associated with psychological and emotional challenges, yet its impact on children’s behavioral well-being in Jordan remains underexplored. This study examines the association between short stature and behavioral and emotional difficulties in Jordanian children.MethodsA cross-sectional study was conducted at Prince Hamza Hospital, Amman (2023–2024). We recruited eighty-three children aged 4–14 years with a height percentile ≤3%. The Strengths and Difficulties Questionnaire (SDQ) assessed behavioral and emotional difficulties. Differences in SDQ scores by gender, age group, and growth hormone (GH) therapy status were analyzed.ResultsThe mean total difficulties score was 13.7 ± 6.1, with 30.1% of participants classified in the “high” or “very high” category. Emotional difficulties (31.3%), peer problems (31.3%), and conduct issues (34.9%) were notably prevalent. Boys exhibited significantly higher conduct problems (p < 0.001), hyperactivity (p = 0.002), and total difficulties scores (p = 0.010), while girls showed stronger prosocial behaviors (p = 0.004). No significant differences were observed between younger (3–10 years) and older (11–14 years) children. Children receiving GH therapy reported significantly higher emotional problems (p = 0.029), though other SDQ scores did not differ significantly between treated and untreated groups.ConclusionShort stature in Jordanian children is associated with significant behavioral and emotional challenges, particularly among boys. GH therapy was not associated with improved scores in this sample. A multidisciplinary approach integrating psychological support and public health initiatives is needed to address stigma and improve well-being.https://www.frontiersin.org/articles/10.3389/fendo.2025.1630919/fullshort statureJordanbehavioral difficultiesemotional difficultiesStrengths and Difficulties Questionnaire (SDQ)
spellingShingle Tamara Kufoof
Randa K. Saad
Redab Al-Ghawanmeh
Seri Sawaqed
Zaid Hamdan
Zaid Qolaghasi
Adnan Alswiti
Layan Sharkas
Osama Sharkas
Association between short stature and behavioral and emotional difficulties among children in Jordan: a cross-sectional study
Frontiers in Endocrinology
short stature
Jordan
behavioral difficulties
emotional difficulties
Strengths and Difficulties Questionnaire (SDQ)
title Association between short stature and behavioral and emotional difficulties among children in Jordan: a cross-sectional study
title_full Association between short stature and behavioral and emotional difficulties among children in Jordan: a cross-sectional study
title_fullStr Association between short stature and behavioral and emotional difficulties among children in Jordan: a cross-sectional study
title_full_unstemmed Association between short stature and behavioral and emotional difficulties among children in Jordan: a cross-sectional study
title_short Association between short stature and behavioral and emotional difficulties among children in Jordan: a cross-sectional study
title_sort association between short stature and behavioral and emotional difficulties among children in jordan a cross sectional study
topic short stature
Jordan
behavioral difficulties
emotional difficulties
Strengths and Difficulties Questionnaire (SDQ)
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1630919/full
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