{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T05:44:49Z","timestamp":1793166289273,"version":"4.5.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Short stature is associated with psychological and emotional challenges, yet its impact on children\u2019s behavioral well-being in Jordan remains underexplored. This study examines the association between short stature and behavioral and emotional difficulties in Jordanian children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross-sectional study was conducted at Prince Hamza Hospital, Amman (2023\u20132024). We recruited eighty-three children aged 4\u201314 years with a height percentile \u22643%. 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean total difficulties score was 13.7 \u00b1 6.1, with 30.1% of participants classified in the \u201chigh\u201d or \u201cvery high\u201d category. Emotional difficulties (31.3%), peer problems (31.3%), and conduct issues (34.9%) were notably prevalent. Boys exhibited significantly higher conduct problems (p &amp;lt; 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\u201310 years) and older (11\u201314 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Short 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.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1630919","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T04:10:43Z","timestamp":1756095043000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Association between short stature and behavioral and emotional difficulties among children in Jordan: a cross-sectional study"],"prefix":"10.3389","volume":"16","author":[{"given":"Tamara","family":"Kufoof","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randa K.","family":"Saad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Redab","family":"Al-Ghawanmeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seri","family":"Sawaqed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaid","family":"Hamdan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaid","family":"Qolaghasi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adnan","family":"Alswiti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Layan","family":"Sharkas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama","family":"Sharkas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-0509","article-title":"Consensus statement on the diagnosis and treatment of children with idiopathic short stature: a summary of the Growth Hormone Research Society, the Lawson Wilkins Pediatric Endocrine Society, and the European Society for Paediatric Endocrinology Workshop","volume":"93","author":"Cohen","year":"2008","journal-title":"J Clin Endocrinol Metab"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2013-304829","article-title":"Investigation and management of short stature","volume":"99","author":"Cheetham","year":"2014","journal-title":"Arch Dis Child"},{"key":"B3","doi-asserted-by":"publisher","first-page":"101392","DOI":"10.1016\/j.ghir.2021.101392","article-title":"Impact of short stature on quality of life: A systematic literature review","author":"Backeljauw","year":"2021","journal-title":"Growth Horm IGF Res"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e0153953","DOI":"10.1371\/journal.pone.0153953","article-title":"Associations between psychological problems and quality of life in pediatric short stature from patients\u2019 and parents\u2019 Perspectives","volume":"11","author":"Quitmann","year":"2016","journal-title":"PloS One"},{"key":"B5","doi-asserted-by":"publisher","first-page":"6558","DOI":"10.3390\/ijerph20166558","article-title":"Health-related quality of life, stress, caregiving burden and special needs of parents caring for a short-statured child\u2014review and recommendations for future research","volume":"20","author":"Lackner","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1396","DOI":"10.3390\/healthcare12141396","article-title":"Body perceptions and psychological well-being: A review of the impact of social media and physical measurements on self-esteem and mental health with a focus on body image satisfaction and its relationship with cultural and gender factors","volume":"12","author":"Merino","year":"2024","journal-title":"Healthcare (Basel)"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp23X732309","article-title":"Inequalities in the assessment of childhood short stature","volume":"73","author":"Davies","year":"2023","journal-title":"Br J Gen Pract"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.17458\/per.vol14.2017.lm.childrenshortstature","article-title":"Children with short stature and growth failure: heightism, gender and racial disparities","volume":"14","author":"Lipman","year":"2017","journal-title":"Pediatr Endocrinol Rev"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1093983","article-title":"Caregiving burden and special needs of parents in the care of their short-statured children \u2013 a qualitative approach","volume":"14","author":"Lackner","year":"2023","journal-title":"Front Endocrinol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"104579","DOI":"10.1016\/j.actpsy.2024.104579","article-title":"Overparenting and adolescent\u2019s trait anxiety: Unraveling the roles of basic psychological needs frustration and emotion dysregulation","volume":"251","author":"Sadoughi","year":"2024","journal-title":"Acta Psychol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"74","DOI":"10.29303\/prospek.v6i1.1225","article-title":"Overprotective parenting patterns and its influence on children\u2019s mental health","volume":"6","author":"Choirunnisa","year":"2025","journal-title":"Progres Pendidikan"},{"key":"B12","volume-title":"Short Stature. StatPearls","author":"Rani","year":"2025"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1186\/s12889-016-3687-4","article-title":"Prevalence of short stature, underweight, overweight, and obesity among school children in Jordan","volume":"16","author":"Zayed","year":"2016","journal-title":"BMC Public Health"},{"key":"B14","unstructured":"Growth charts national center for health statistics: US centers for disease control and prevention"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7610.1997.tb01545.x","article-title":"The Strengths and Difficulties Questionnaire: a research note","volume":"38","author":"Goodman","year":"1997","journal-title":"J Child Psychol Psychiatry"},{"key":"B16","unstructured":"What is the SDQ"},{"key":"B17","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1186\/s43045-023-00380-8","article-title":"Validation of the Arabic strengths and difficulties questionnaire in Qatar","volume":"30","author":"Gilstrap","year":"2023","journal-title":"Middle East Curr Psychiatry"},{"key":"B18","unstructured":"Scoring the SDQ"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.18502\/ijps.v16i2.5822","article-title":"The global prevalence of conduct disorder: A systematic review and meta-analysis","volume":"16","author":"Mohammadi","year":"2021","journal-title":"Iran J Psychiatry"},{"key":"B20","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1007\/s12020-024-03938-6","article-title":"A comprehensive systematic review of health-related quality of life measures in short stature paediatric patients","volume":"86","author":"Adedeji","year":"2024","journal-title":"Endocrine"},{"key":"B21","doi-asserted-by":"publisher","first-page":"200395","DOI":"10.1016\/j.mhp.2025.200395","article-title":"Social connection as a key target for youth mental health","volume":"37","author":"Birrell","year":"2025","journal-title":"Ment Health Prev"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1037\/a0030737","article-title":"Gender differences in emotion expression in children: a meta-analytic review","volume":"139","author":"Chaplin","year":"2013","journal-title":"Psychol Bull"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1080\/03004430802041011","article-title":"Gender differences in externalising problems among preschool children: implications for early childhood educators","volume":"180","author":"Chen","year":"2010","journal-title":"Early Child Dev Care"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1007\/s10826-024-02999-5","article-title":"Gender differences in the development of children\u2019s conduct problems: A four-year longitudinal study","volume":"34","author":"\u00c1lvarez-Voces","year":"2025","journal-title":"J Child Fam Stud"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/S0191-8869(99)00110-5","article-title":"Testosterone, intelligence and behavior disorders in young boys","volume":"28","author":"Chance","year":"2000","journal-title":"Pers Individ Differ"},{"key":"B26","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1159\/000322937","article-title":"Improvements in behaviour and self-esteem following growth hormone treatment in short prepubertal children","volume":"75","author":"Chaplin","year":"2011","journal-title":"Hormone Res Paediatr"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1159\/000086593","article-title":"Growth hormone treatment of short stature: status of the quality of life rationale","volume":"63","author":"Sandberg","year":"2005","journal-title":"Horm Res"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1159\/000092455","article-title":"The effects of growth hormone treatment on health-related quality of life in children","volume":"65","author":"Sheppard","year":"2006","journal-title":"Horm Res"},{"key":"B29","article-title":"Growth hormone treatment for children may exacerbate feelings of depression","volume-title":"ScienceDaily","year":"2014"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.23736\/S0026-4946.20.05821-1","article-title":"Dilemmas of growth hormone treatment for GH deficiency and idiopathic short stature: defining, distinguishing, and deciding","volume":"72","author":"Halas","year":"2020","journal-title":"Minerva Pediatr"},{"key":"B31","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1159\/000330151","article-title":"Short stature: psychosocial interventions","volume":"76","author":"Sandberg","year":"2011","journal-title":"Hormone Res Paediatr"},{"key":"B32","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1016\/j.dr.2018.02.001","article-title":"Stigma-based bullying interventions: A systematic review","volume":"48","author":"Earnshaw","year":"2018","journal-title":"Dev Rev"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1630919\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T04:10:44Z","timestamp":1756095044000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1630919\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,25]]},"references-count":32,"alternative-id":["10.3389\/fendo.2025.1630919"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1630919","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,25]]},"article-number":"1630919"}}