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Li Y, Ye Y, Zhou X. Parent-child relationship, parenting behaviors, and adolescents' depressive symptoms after an earthquake: unraveling within-adolescent associations from between-adolescent differences. Eur Child Adolesc Psychiatry 2024; 33:2301-2318. [PMID: 37924379 DOI: 10.1007/s00787-023-02319-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/15/2023] [Indexed: 11/06/2023]
Abstract
This study assessed temporal associations between parent-child relationship, parenting behaviors (i.e., warmth, rejection, and overprotection), and adolescents' depressive symptoms after trauma, using random-intercept cross-lagged panel models to distinguish between- and within-adolescent differences. We surveyed Chinese adolescents 12 (Aug 2018; T1), 21 (May 2019; T2), 27 (Nov 2019; T3) months after the Jiuzhaigou earthquake that occurred in August 2017. Of the 585 adolescents who participated in at least two waves of the study, mean age at T1 was 15.50 years old (SD = 1.58 years) and 57.8% were girls. Controlling adolescents' gender, age, ethnicity, trauma exposure at T1, and parents' marital status, between-adolescent results showed that parent-child relationship and parenting behaviors, parent-child relationship and depressive symptoms were correlated across models of parental warmth, rejection, and overprotection, whereas depressive symptoms were only correlated with parental rejection and overprotection. Within-adolescent results indicated that parent-child relationship and adolescents' depressive symptoms had bidirectional associations via the mediation of parental warmth from T1 to T3. Over the longer term following the earthquake, we found that parental rejection was bidirectionally associated with adolescents' depressive symptoms, whereas parental overprotection was unidirectionally influenced by adolescents' depressive symptoms from T2 to T3. In addition, more depressive symptoms in adolescents were associated with worsening parent-child relationship from T2 to T3. In conclusion, shortly after trauma, interventions should focus on improving parent-child relationship and relieving adolescents' depressive symptoms. Over the longer term after trauma, relieving adolescents' depressive symptoms should be prioritized to avoid its eroding effects on parent-child relationship and parenting behaviors, and to break the "vicious cycle".
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Affiliation(s)
- Yifan Li
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, 310028, China
| | - Yingying Ye
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, 310028, China
| | - Xiao Zhou
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, 310028, China.
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Daundasekara SS, Marshall AN, Schuler BR, Testa A, Hernandez DC. Lower Perceived Neighborhood Collective Efficacy Indirectly Influences the Association Between Perceived Maternal Exposure to Community Violence and Household Food Insecurity. FAMILY & COMMUNITY HEALTH 2024; 47:117-129. [PMID: 38372329 PMCID: PMC10878717 DOI: 10.1097/fch.0000000000000399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
BACKGROUND AND OBJECTIVES Individuals of color and of low socioeconomic status are at greater risk of experiencing community violence and food insecurity, which are both influenced by neighborhood conditions. We evaluated neighborhood collective efficacy as a linkage between community violence exposure and household food insecurity. METHODS Mothers from the Future of Families and Child Wellbeing Study who completed phone surveys when the child was 3 (time 1, T1) and 5 years old (time 2, T2) were included (n = 2068). A covariate-adjusted structural equation model estimated direct and indirect effects of community violence exposure on household food insecurity. A covariate-adjusted multiple mediator model estimated the indirect effects of the 2 neighborhood collective efficacy subscales (informal social control; social cohesion and trust). RESULTS At T1, 40% of mothers reported community violence exposure; 15% experienced food insecurity at T2. Mean neighborhood collective efficacy (range 1-5) at T1 was 2.44 (SD = 0.94). Neighborhood collective efficacy indirectly influenced the association between community violence exposure and food insecurity (indirect effect = 0.022, 95% CI = 0.007 to 0.040). Only social cohesion and trust contributed independent variance to the indirect effect model (indirect effect = 0.028, 95% CI = 0.001 to 0.056). CONCLUSIONS Community-based efforts to reduce household food insecurity should emphasize building social cohesion and trust in communities experiencing violence.
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Affiliation(s)
- Sajeevika S Daundasekara
- Department of Food Science & Technology, Faculty of Agriculture, University of Peradeniya, Peradeniya, Sri Lanka (Dr Daundasekara); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana (Dr Marshall); School of Social Work, Temple University, Philadelphia, Pennsylvania (Dr Schuler); Department of Management, Policy, & Community Health, School of Public Health San Antonio, The University of Texas Health Science Center at Houston, San Antonio (Dr Testa); and Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston (Dr Hernandez)
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Gee DG, Cohodes EM. Leveraging the developmental neuroscience of caregiving to promote resilience among youth exposed to adversity. Dev Psychopathol 2023; 35:2168-2185. [PMID: 37929292 PMCID: PMC10872788 DOI: 10.1017/s0954579423001128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Early adversity is a major risk factor for the emergence of psychopathology across development. Identifying mechanisms that support resilience, or favorable mental health outcomes despite exposure to adversity, is critical for informing clinical intervention and guiding policy to promote youth mental health. Here we propose that caregivers play a central role in fostering resilience among children exposed to adversity via caregiving influences on children's corticolimbic circuitry and emotional functioning. We first delineate the numerous ways that caregivers support youth emotional learning and regulation and describe how early attachment lays the foundation for optimal caregiver support of youth emotional functioning in a developmental stage-specific manner. Second, we outline neural mechanisms by which caregivers foster resilience-namely, by modulating offspring corticolimbic circuitry to support emotion regulation and buffer stress reactivity. Next, we highlight the importance of developmental timing and sensitive periods in understanding caregiving-related mechanisms of resilience. Finally, we discuss clinical implications of this line of research and how findings can be translated to guide policy that promotes the well-being of youth and families.
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Suomi A, Bolton A, Pasalich D. The Prevalence of Post-Traumatic Stress Disorder in Birth Parents in Child Protection Services: Systematic Review and Meta-analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:1032-1046. [PMID: 34736361 DOI: 10.1177/15248380211048444] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Birth parents of children in the statutory child protection system have disproportionally high rates of trauma exposure and mental health problems, however, little is known about the extent to which this population display symptoms of Post-Traumatic Stress Disorder (PTSD) or Complex PTSD. This study provides a systematic review and meta-analysis of the PTSD rates in parent samples involved in the child protection services. METHOD Articles were identified by searching PSYCINFO, Medline, CINAHL, and PILOTS. The search included terminology pertaining to parents, trauma, and child protective services and we included all peer-reviewed articles that reported a valid measure of PTSD and child protection service involvement. RESULTS Fifteen studies were included in the review with a combined prevalence estimate for PTSD based on 11 studies (n = 4871) was 26.0% (95% CI 20.0-32.0%) for mothers, and estimate based on three studies (n = 2606) was 13.0% (95% CI 7.0%-18.0%) for fathers and 23.0% (95% CI 17.0-29.0) for all parents based on 7848 responses. Four studies that did not report prevalence rates, reported sample mean scores for PTSD that were consistently higher than in general population. Factors associated with parents' PTSD symptoms included mental health co-morbidities, victimization of physical and sexual violence, and perpetration of child abuse. CONCLUSION There are high rates of PTSD in parents involved in the protective system, thus more targeted efforts are needed to identify and adequately address trauma symptoms of parents as part of child protection interventions.
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Affiliation(s)
- Aino Suomi
- Institute of Child Protection Studies, 95359Australian Catholic University, Canberra, VIC, Australia
- Research School of Population Health, 2219Australian National University, Canberra, ACT, Australia
| | - Annalese Bolton
- Matilda Centre, University of Sydney, Sydney, NSW, Australia
- Forensic Psychology Clinic, 7800University of New South Wales, Sydney, NSW, Australia
| | - Dave Pasalich
- Research School of Psychology, 2219Australian National University, Canberra, ACT, Australia
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Beebe B, Crown CL, Jasnow M, Sossin KM, Kaitz M, Margolis A, Lee SH. The vocal dialogue in 9/11 pregnant widows and their infants: Specificities of co-regulation. Infant Behav Dev 2023; 70:101803. [PMID: 36565493 DOI: 10.1016/j.infbeh.2022.101803] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 11/08/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022]
Abstract
Mothers who were pregnant and widowed on September 11, 2001, and their 4-6-month infants (in utero on 9/11) were filmed during face-to-face interaction and their vocal dialogues were examined via microanalysis. Mothers were White, well-educated, mean age 34.3 years, and far from the World Trade Center site on 9/11; infants were 4-6 months, half female. We examined the bi-directional, moment-by-moment co-regulation of the timing of vocal dialogue, and particularly turn taking, in mother-infant and stranger-infant interactions, with time-series models. We analyzed the contingent coordination of durations of (1) vocalizations of the turn-holder, and (2) switching-pauses at the moment of the turn exchange. The switching pause is an aspect of the rhythm of the turn-holder who, after taking a turn, yields the floor to the partner through the switching pause. Turn taking is the lynchpin of dialogue, and the bi-directional contingent coordination of the switching-pause regulates the turn exchange. Both partners showed signs of risk and resilience. The 9/11 mothers did not coordinate the timing of turn taking with their infants, a highly unusual finding. In contrast, the 9/11 infants did coordinate the timing of turn taking with their mothers, and with the "stranger," forms of resilience. We propose that the 9/11 mother's difficulty coordinating with the infant's turn taking rhythm is a mode of transmission of her trauma to the infant. This work expands our knowledge of the specificities of co-regulation in the context of the 9/11 trauma.
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Affiliation(s)
- Beatrice Beebe
- Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA.
| | | | | | - K Mark Sossin
- Department of Psychology, Pace University, New York, NY, USA.
| | - Marsha Kaitz
- Department of Psychology, Hebrew University, Jerusalem, Israel.
| | - Amy Margolis
- Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA.
| | - Sang Han Lee
- The Nathan Kline Institute, Orangeburg, NY, USA.
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Rowell T, Neal-Barnett A. A Systematic Review of the Effect of Parental Adverse Childhood Experiences on Parenting and Child Psychopathology. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:167-180. [PMID: 35222782 PMCID: PMC8837768 DOI: 10.1007/s40653-021-00400-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 05/22/2023]
Abstract
Adverse childhood experiences (ACEs) are defined as early exposure to maltreatment and household dysfunction. Researchers have demonstrated the link between ACEs and negative psychological, behavioral, interpersonal, and health outcomes. A growing area of interest in the ACE literature concerns the relationship between ACEs, parenting, and child psychopathology due to the intergenerational effect of ACEs. Emotional availability and discipline strategies are two domains of parenting that can increase understanding of the associations between ACEs, parenting, and child psychopathology from an attachment framework because they are both salient during early childhood and directly influence a child's later behavior. This paper utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to elucidate the relationships between parental ACEs, parents' emotional availability and discipline strategies, and children's psychopathology. PubMed, PSYCINFO, and Psychology and Behavioral Sciences Collection were used to access the literature on June 16, 2020, and 26 studies met the inclusion criteria. Results from this review suggested that there is a direct association between ACEs and parental emotional availability and discipline techniques. Depression and dissociation were identified as potential mediators. There was support for the direct association between parental ACEs and children's internalizing and externalizing difficulties. Maternal anxiety and depressive symptoms, emotional availability, attachment, and children's maltreatment experiences were found to be possible mediators. Recommendations are proposed to address limitations within the literature to further expand upon the research of ACEs, parenting, and child psychopathology.
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Affiliation(s)
- Tiffany Rowell
- Department of Psychological Sciences, Kent State University, 600 Hilltop Drive, Kent, OH 44240 USA
| | - Angela Neal-Barnett
- Department of Psychological Sciences, Kent State University, 600 Hilltop Drive, Kent, OH 44240 USA
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Canale CA, Hayes AM, Yasinski C, Grasso DJ, Webb C, Deblinger E. Caregiver Behaviors and Child Distress in Trauma Narration and Processing Sessions of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Behav Ther 2022; 53:64-79. [PMID: 35027159 PMCID: PMC8765780 DOI: 10.1016/j.beth.2021.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 01/03/2023]
Abstract
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an effective treatment for children impacted by trauma, and non-offending caregivers play an important role in this treatment. This study aims to identify correlates of four caregiver variables that have been identified as predictors of child outcomes in TF-CBT: support, cognitive-emotional processing, avoidance, and blame/criticism. Audio recorded sessions were coded from a community effectiveness trial of TF-CBT that included 71 child-caregiver dyads participating in the trauma narration and processing phase of treatment. Regression analyses were conducted to examine caregiver trauma history and child baseline symptoms (internalizing, externalizing, and posttraumatic stress disorder [PTSD] symptoms) as predictors of caregiver behavior during the trauma processing sessions. Caregivers who reported exposure to more trauma types exhibited more in-session avoidance and also processing during the trauma processing phase of treatment. Child symptoms at baseline did not predict caregiver in-session behaviors. Bivariate correlations were used to investigate concurrent associations between mean levels of in-session caregiver behaviors and in-session child distress (negative emotion, hopelessness, negative behaviors). More caregiver blame/criticism was associated with more in-session child distress on all three measures. Caregiver avoidance was associated with more child negative emotion and hopelessness. Findings may help identify therapeutic targets when working with caregivers to promote change and enhance TF-CBT outcomes.
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Affiliation(s)
| | - Adele M. Hayes
- University of Delaware, Department of Psychological and Brain Sciences
| | | | - Damion J. Grasso
- University of Connecticut School of Medicine, Department of Psychiatry
| | - Charles Webb
- State of Delaware Division of Prevention and Behavioral Health Services
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Costa MSA, Vilhena E, Leite Â, Almeida AC, Pereira MG. Quality of Life in Caregivers of Type 2 Diabetes Patients After Patient's Surgery: a Path Analysis. Int J Behav Med 2021; 29:438-447. [PMID: 34608592 DOI: 10.1007/s12529-021-10028-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Type 2 diabetes Mellitus is a chronic disease, and one of its complications may result in amputation. The goal of this study was to evaluate the impact of psychosocial variables, over time, on quality of life (QoL) of caregivers of patients (N = 110) who had undergone a recent amputation. METHOD A longitudinal design was employed: (T1) 1 month after the patient's surgery; (T2) 7 months after; and (T3) 10 months after. Burden Assessment Scale, Family Assessment Device, Revised Impact of Events Scale, Family Disruption from Illness Scale, and Short Form Health Survey were used. A path analysis model was tested. RESULTS Burden, perception of family functioning, and traumatic symptoms at T1 showed a positive impact on the perception of family functioning, at T2. Traumatic symptoms, at T1, predicted traumatic symptoms at T2 being also a mediator between those symptoms (T1) and physical QoL (T3). Physical and traumatic symptoms, at T1 predicted physical symptoms, at T2 affecting both mental and physical QoL (T3), being also a mediator in these relationships. Burden (T1) also had a direct effect on mental QoL (T3) and at T2 had an impact on physical QoL (T3) mediating also the relationship between burden/physical symptoms at T1 and physical QoL, at T3. CONCLUSION Intervention should focus on physical and traumatic symptoms as well as burden since they were both mediators regarding mental and physical QoL.
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Affiliation(s)
- M Suely Alves Costa
- Research Center in Psychology (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, 4710-245, Braga, Portugal
| | - Estela Vilhena
- 2Ai School of Technology, IPCA, 4750-810, Barcelos, Portugal
| | - Ângela Leite
- Research Center in Psychology (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, 4710-245, Braga, Portugal
| | - Ana C Almeida
- Research Center in Psychology (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, 4710-245, Braga, Portugal
| | - M Graça Pereira
- Research Center in Psychology (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, 4710-245, Braga, Portugal.
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Brown S, Resko S, Dayton CJ, Barron C. Trauma Symptoms and Social Support Mediate the Impact of Violence Exposure on Parenting Competence Among Substance-Dependent Mothers. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:4570-4592. [PMID: 30079793 DOI: 10.1177/0886260518791234] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Women with substance use disorders (SUDs) experience high rates of violence exposure and posttraumatic stress disorder (PTSD), which are associated with parenting anxiety and lower parenting satisfaction among mothers. Although social support may buffer the impact of violence and PTSD on parenting, violence exposure and PTSD may impair mothers' ability to create, perceive, and utilize social support. We examined the impact of violence exposure, trauma symptoms, and interpersonal support on parenting competence among 291 mothers with substance dependence, using ordinary least squares regression and path analysis. Greater violence exposure and trauma symptoms were associated with lower parenting competence. Greater interpersonal support was associated with greater parenting competence. Trauma symptoms and interpersonal support sequentially mediated the impact of violence exposure on parenting competence, suggesting one pathway through which violence exposure may affect parenting among substance-dependent mothers. Implications for practice include the need to utilize trauma-informed interventions that modify social support.
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Affiliation(s)
| | - Stella Resko
- Wayne State University, Detroit, MI, USA
- Merrill Palmer Skillman Institute, Detroit, MI, USA
| | - Carolyn J Dayton
- Wayne State University, Detroit, MI, USA
- Merrill Palmer Skillman Institute, Detroit, MI, USA
| | - Carla Barron
- Wayne State University, Detroit, MI, USA
- Merrill Palmer Skillman Institute, Detroit, MI, USA
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Ascienzo S, Sprang G, Eslinger J. Disseminating TF-CBT: A Mixed Methods Investigation of Clinician Perspectives and the Impact of Training Format and Formalized Problem-Solving Approaches on Implementation Outcomes. J Eval Clin Pract 2020; 26:1657-1668. [PMID: 31989728 DOI: 10.1111/jep.13351] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 12/21/2019] [Accepted: 12/27/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Trauma Focused-Cognitive Behavioural Therapy (TF-CBT) has been established as an evidence-based treatment for youth with traumatic stress symptoms. The versatility of TF-CBT in conjunction with its established effectiveness has led to its widespread dissemination. However, dissemination efforts have not always translated into sustainability, which has prompted a more thorough investigation into those factors that impact implementation and encouraged the development of strategies that promote sustainability. Toward this end, the aims of this study were to: (1) determine which components of TF-CBT clinicians found the most difficult to implement; (2) explore clinicians' perceptions as to why these components were challenging; and (3) examine whether the use of formalized problem-solving approaches (FPSAs) or training format was associated with implementation outcomes. METHODS A mixed methods design was utilized to analyse survey data from mental health professionals (N = 85) who received TF-CBT training. Thematic analysis explored responses to questions concerning those TF-CBT components respondents found most difficult to implement, while bivariate analyses helped determine whether training format or the use of FPSAs was associated with training engagement, confidence in delivering TF-CBT, fidelity or sustainability. RESULTS Clinicians perceived the same three components of TF-CBT as most difficult regardless of the type of training they received, and provider, youth, caregiver, and organizational-related themes emerged from thematic analysis. Bivariate analyses indicated more extended training formats and the use of FPSAs were associated with greater implementation success. CONCLUSION Findings suggest that perceived difficulty of TF-CBT components did not vary by training format, but more extended formats and the use of FPSAs were associated with more favourable implementation outcomes. Implementers should consider ways to utilize FPSAs within training programs, as well as focus on content identified by clinicians as difficult, as this may assist clinicians in developing skills and managing implementation barriers.
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Affiliation(s)
- Sarah Ascienzo
- University of Kentucky Center on Trauma and Children.,College of Humanities and Social Sciences, Department of Social Work, Sarah Ascienzo is now at North Carolina State University
| | - Ginny Sprang
- University of Kentucky Center on Trauma and Children.,Department of Psychiatry, University of Kentucky College of Medicine
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Beebe B, Hoven CW, Kaitz M, Steele M, Musa G, Margolis A, Ewing J, Sossin KM, Lee SH. Urgent engagement in 9/11 pregnant widows and their infants: Transmission of trauma. INFANCY 2020; 25:165-189. [PMID: 32749044 DOI: 10.1111/infa.12323] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 10/22/2019] [Accepted: 12/19/2019] [Indexed: 11/30/2022]
Abstract
The potential effects of maternal trauma on mother-infant interaction remain insufficiently studied empirically. This study examined the effects of the September 11, 2001, trauma on mother-infant interaction in mothers who were pregnant and widowed on 9/11, and their infants aged 4-6 months. Split-screen videotaped interaction was coded on a one-second basis for infant gaze, facial affect, and vocal affect; and mother gaze, facial affect, and touch. We examined the temporal dynamics of communication: self-contingency and interactive contingency of behavior by time-series methods. We documented heightened maternal and infant efforts at engagement in the 9/11 (vs. control) dyads. Both partners had difficulty tolerating moments of looking away as well as moments of negative behavior patterns. Heightened efforts to maintain a positive visual engagement may be adaptive and a potential source of resilience, but these patterns may also carry risk: working too hard to make it work. A vigilant, hyper-contingent, high-arousal engagement was the central mode of the interpersonal transmission of the trauma to these infants, with implications for intervention.
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Affiliation(s)
- Beatrice Beebe
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York
| | - Christina W Hoven
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York
| | - Marsha Kaitz
- Department of Psychology, Hebrew University, Jerusalem, Israel
| | - Miriam Steele
- Department of Psychology, The New School for Social Research, New York, New York
| | - George Musa
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York
| | - Amy Margolis
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York
| | - Julie Ewing
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York
| | - K Mark Sossin
- Department of Psychology, Pace University, New York, New York
| | - Sang Han Lee
- The Nathan Kline Institute, Orangeburg, New York
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Dekel B, Andipatin M, Abrahams N. Exploring adversities among parents convicted of killing their children. PLoS One 2020; 15:e0235812. [PMID: 32697774 PMCID: PMC7375607 DOI: 10.1371/journal.pone.0235812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 06/24/2020] [Indexed: 11/19/2022] Open
Abstract
Experiencing adversities has been associated with the use of violence but this has not been explored with filicide offenders in South Africa. Individual, semi-structured interviews were conducted with 22 parents/stepparents/caregivers convicted of child homicide in South Africa, resulting in 49 in-depth interviews. Data were analyzed by means of grounded theory. Using an ecological framework, this study alludes to the widespread and cumulative nature of violence and trauma experiences within multiple domains of the participants' lives. The study highlighted the absence of support in the aftermath of experiencing trauma, possibly resulting in these parents lacking resources to mitigate the sequelae of adverse experiences. This study calls for trauma related, mental health components to be integrated into violence interventions and for these to address the impact of trauma at the individual, family, and societal levels, to prevent the transition from victim to offender.
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Affiliation(s)
- Bianca Dekel
- Gender and Health Research Unit, The South African Medical Research Council, Cape Town, Western Cape, South Africa
- Psychology Department, University of the Western Cape, Cape Town, Western Cape, South Africa
- * E-mail:
| | - Michelle Andipatin
- Psychology Department, University of the Western Cape, Cape Town, Western Cape, South Africa
| | - Naeemah Abrahams
- Gender and Health Research Unit, The South African Medical Research Council, Cape Town, Western Cape, South Africa
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Combat Experience and Posttraumatic Stress Symptoms among Military-Serving Parents: a Meta-Analytic Examination of Associated Offspring and Family Outcomes. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:131-148. [PMID: 29687429 DOI: 10.1007/s10802-018-0427-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
In this meta-analysis, we review findings on the relationships between parental combat exposure and PTSD/PTSS in military-serving families and (1) parenting problems, (2) family maladjustment, and (3) offspring problems. We systematically searched for studies in PsycInfo, PsychArticles, Psychology and Behavior Sciences Collection, Published International Literature on Traumatic Stress (PILOTS), and PubMed/Medline as well as conducted manual searches. Search procedures identified 22 eligible studies, including 20 studies examining relationships between parental PTSD/PTSS and parenting, family, and/or offspring outcomes and 8 studies examining relationships between parental combat exposure and parenting, family, and/or offspring outcomes. Random effects meta-analytic models estimated omnibus associations between parental combat exposure/PTSD and pooled Family Difficulties, as well as individual relationships between parental combat exposure and PTSD/PTSS and parenting, family adjustment, and offspring outcomes. Small-to-moderate effect sizes were observed in the omnibus meta-analysis examining relationships between parental PTSD/PTSS and pooled Family Difficulties, and in the meta-analysis examining relationships between parental PTSD/PTSS and parenting problems, between parental PTSD/PTSS and poor family functioning, and between parental PTSD/PTSS and offspring problems. Associations between parental combat exposure and pooled Family Difficulties, as well as between parental combat exposure and parenting problems were smaller in magnitude. PTSD/PTSS among military-serving parents is associated with increased problems in the family environment, including parenting problems, family maladjustment, and offspring problems, whereas combat exposure alone is not as strongly associated with such family difficulties. Moderator analyses are presented and discussed as well. When military-serving parents show psychological symptoms, professionals should consider allocating resources to target broader family issues.
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Li Y, Shi X, McReynolds LS, Tang H, Chen H, Wang T, Zhang Y, Geng F, Fan F, Hoven CW. Depressive symptoms between parent and adolescent survivors: A longitudinal actor-partner interdependence model. J Affect Disord 2020; 265:139-145. [PMID: 32090735 DOI: 10.1016/j.jad.2020.01.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 12/04/2019] [Accepted: 01/11/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The association between parent-child depression following disasters has been well documented. However, longitudinal studies of posttraumatic depression using parent-child dyadic are scarce. This study aimed to investigate inter-related effects between parent and child depression, as well as predictors of depressive symptoms, in a large sample of Wenchuan earthquake survivors. METHODS Data are from the Wenchuan Earthquake Adolescent Health Cohort (WEAHC) Study that included 685 parent-child dyads exposed to the earthquake. Depression was assessed with the Self-Rating Depression Scale (for parents) and Depression Self-Rating Scale for Children, at 12 (T12m) and 18 months (T18m) post-earthquake. Longitudinal actor-partner interdependence models (APIMs) were employed to examine depression within dyads. Predictors of depressive symptoms were assessed by the cart algorithm throughout the 6-month follow-up. RESULTS Adjusting for earthquake exposure and previous depressive symptoms, parents' depression at 12 months predicted children's depressive symptoms at 18 months, and vice versa (β = 0.14 for parents and β = 0.12 for children). Psychomotor retardation in parents, and dysphoria/social isolation and positive affect in children were identified as crucial screening indicators identifying parents and children at increased risk for depression. CONCLUSION A bidirectional association was found between parent and child depression following a mass disaster. Both parent and child depression status should be examined when implementing interventions to identify and treat depression in earthquake survivors.
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Affiliation(s)
- Yuanyuan Li
- School of Psychology, Center for Studies of Psychological Application, and Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Shipai Road, Guangdong 510631, China
| | - Xuliang Shi
- College of education, Hebei University, Baoding, China
| | - Larkin S McReynolds
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, USA
| | - Huilan Tang
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, USA
| | - Huilin Chen
- Department of Psychology, University of Bath, Bath, Somerset, UK
| | - Tong Wang
- School of Psychology, Center for Studies of Psychological Application, and Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Shipai Road, Guangdong 510631, China
| | - Yuechu Zhang
- School of Psychology, Center for Studies of Psychological Application, and Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Shipai Road, Guangdong 510631, China
| | - Fulei Geng
- School of Psychology, Center for Studies of Psychological Application, and Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Shipai Road, Guangdong 510631, China
| | - Fang Fan
- School of Psychology, Center for Studies of Psychological Application, and Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Shipai Road, Guangdong 510631, China.
| | - C W Hoven
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, USA
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de Wit M, Leijten P, van der Put C, Asscher J, Bouwmeester-Landweer M, Deković M. Study protocol: randomized controlled trial of manualized components in home visitation to reduce mothers' risk for child maltreatment. BMC Public Health 2020; 20:136. [PMID: 32000744 PMCID: PMC6993430 DOI: 10.1186/s12889-020-8237-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 01/17/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND This study tests whether home visitation to prevent child maltreatment can be improved by adding manualized program components, targeting four key risk factors for child maltreatment: low parental self-efficacy, high levels of perceived stress, parental anger, and post-traumatic stress symptoms. Home visitation is widely implemented, but effects on child maltreatment risk tend to be modest at best. Home visitation tends to be rather flexible (i.e., professionals decide how to support each family). We will test whether adding manualized program components increases program effectiveness, by ensuring that key risk factors are addressed, while maintaining flexibility. In addition, we will test whether any component effects on reduced child maltreatment risk can be explained (i.e., is mediated) by ameliorated risk factors. Lastly, we will test whether the components are more effective for some mothers (e.g., those at highest child maltreatment risk) than for others. METHODS We will conduct a randomized controlled trial among 398 mothers enrolled in a Dutch home visiting program targeting families at risk for child maltreatment. Mothers in the experimental group will receive the manualized components in two consecutive home visits, while mothers in the control group will receive regular home visits (care as usual). Mothers will fill out questionnaires at four time points: before and after each of the two home visits. Outcome variables include the four targeted risk factors parental self-efficacy, perceived stress, parental anger, and (recognition of) post-traumatic stress symptoms, as well as parenting practices (e.g., rejection and affection), and risk for child maltreatment. DISCUSSION This study aims to determine whether adding manualized program components to a flexible home visiting program increases program effectiveness on risk for child maltreatment. In addition, our test of whether the effects of the components on risk for child maltreatment is explained (i.e., mediated) by amelioration of the targeted risk factors, may contribute to our understanding of the role of these risk factors in child maltreatment. Our tests of which mothers benefit most from adding the components may help move the field towards evidence-based personalized family support. TRIAL REGISTRATION This trial has been retrospectively registered in the Netherlands Trial Register (NL8005).
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Affiliation(s)
- Merel de Wit
- Research Institute of Child Development and Education, University of Amsterdam, PO Box 15780, 1001, NG, Amsterdam, the Netherlands.
| | - Patty Leijten
- Research Institute of Child Development and Education, University of Amsterdam, PO Box 15780, 1001, NG, Amsterdam, the Netherlands
| | - Claudia van der Put
- Research Institute of Child Development and Education, University of Amsterdam, PO Box 15780, 1001, NG, Amsterdam, the Netherlands
| | - Jessica Asscher
- Research Institute of Child Development and Education, University of Amsterdam, PO Box 15780, 1001, NG, Amsterdam, the Netherlands
- Clinical Child and Family Studies, Utrecht University, PO Box 80125, 3508, TC, Utrecht, the Netherlands
| | - Merian Bouwmeester-Landweer
- The Netherlands Center for Preventive Youth Health (NCJ), Churchilllaan 11, 3527, GV, Utrecht, the Netherlands
| | - Maja Deković
- Clinical Child and Family Studies, Utrecht University, PO Box 80125, 3508, TC, Utrecht, the Netherlands
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16
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Tedgård E, Råstam M, Wirtberg I. An upbringing with substance-abusing parents: Experiences of parentification and dysfunctional communication. NORDIC STUDIES ON ALCOHOL AND DRUGS 2018; 36:223-247. [PMID: 32934562 PMCID: PMC7434158 DOI: 10.1177/1455072518814308] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 10/17/2018] [Indexed: 11/15/2022] Open
Abstract
Aim To increase understanding of the consequences of growing up with substance-abusing parents, including how this can influence the experience of becoming a parent. Methods In-depth interviews were conducted with 19 parents who had participated in an Infant and Toddler Psychiatry Unit intervention programme and who had experienced substance-abusing parents in their family of origin. Directed qualitative content analysis was used to analyse the data. Results Analysis of the interview material revealed both a high incidence of parentification and a conspiracy of silence concerning the substance abuse that helped generate symptoms of cognitive dissonance in the children. As parents they experience a high degree of inadequacy, incompetence and stress. Conclusion A majority of the children who had grown up with substance-abusing parents responded by taking a parenting role for themselves, their siblings and their parents. These children, often well-behaved and seemingly competent, need to be identified and offered support as they risk developing significant psychological and emotional difficulties that can extend into adulthood. They form an extra sensitive group who may need special support up to and including the time when they become parents themselves. This finding underlines the importance of further research on parenting among those who have grown up with abusive parents.
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Affiliation(s)
- Eva Tedgård
- Lund University, Sweden Offices for Healthcare "Sund", Child and Adolescent Psychiatry, Infant and Toddler Unit, Malmö, Sweden
| | - Maria Råstam
- Lund University, Sweden University of Gothenburg, Sweden
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17
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Affrunti NW, Suárez L, Simpson D. Community violence and posttraumatic stress disorder symptoms in urban youth: The moderating influence of friend and parent support. JOURNAL OF COMMUNITY PSYCHOLOGY 2018; 46:636-650. [PMID: 31682288 DOI: 10.1002/jcop.21963] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 01/22/2018] [Accepted: 01/23/2018] [Indexed: 06/10/2023]
Abstract
Separate lines of research have demonstrated that community violence predicts posttraumatic stress disorder (PTSD) symptoms in youth and that social support is one protective factor against the development of PTSD symptoms. The current study sought to examine the associations between primary and secondary exposure to community violence and the moderating role of parent and friend support on these relations. Participants were 96 urban youths (aged 6-17 years; 58.4% racial/ethnic minority; 51% female) and a caregiver recruited from a university mental health clinic. Results indicated that both primary and secondary exposure to community violence predicted PTSD symptoms. Friend support, but not parent support, moderated the association between primary, but not secondary, exposure to community violence and PTSD symptoms. The findings suggest that friend support is a salient protective factor for urban youth who may be at risk of PTSD symptoms due to exposure to community violence.
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18
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Schilpzand EJ, Conroy R, Anderson V, Alisic E. Development and Evaluation of the Thinking About Recovery Scale: Measure of Parent Posttraumatic Cognitions Following Children's Exposure to Trauma. J Trauma Stress 2018; 31:71-78. [PMID: 29384234 DOI: 10.1002/jts.22258] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 10/17/2017] [Accepted: 10/27/2017] [Indexed: 11/10/2022]
Abstract
Researchers have recently suggested that parent posttraumatic appraisals potentially contribute to the development of posttraumatic stress in both parents and children following children's exposure to trauma. However, a single-instrument, multidimensional measure of parent posttraumatic cognitions as they relate to their child's recovery has yet to be operationalized. This study described the development and evaluation of a parent-report questionnaire of parent posttraumatic cognitions, designed to be used after a child's exposure to trauma. We generated an initial pool of items in reference to existing theories and subjected this list to an iterative process of item writing and revision. Items were subjected to expert review to maximize construct validity. The 33-item Thinking About Recovery Scale (TARS), which measures three domains (My child has been permanently damaged; The world is dangerous for my child; Parents should always promote avoidance) demonstrated good internal consistency (Cronbach's α = .74-88) and convergent validity (r 2 range = .08-.40) when piloted in a sample of 116 parents of children who had been exposed to a serious accidental injury. The TARS augments the available literature by providing a brief measure of parent posttraumatic cognitions, an area which is currently understudied in childhood posttraumatic stress and could have broad clinical and research use.
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Affiliation(s)
- Elizabeth J Schilpzand
- Child Neuropsychology, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rowena Conroy
- Child Neuropsychology, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Mental Health, The Royal Children's Hospital, Melbourne, Victoria, Australia.,School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Vicki Anderson
- Child Neuropsychology, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Mental Health, The Royal Children's Hospital, Melbourne, Victoria, Australia.,School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Eva Alisic
- Child Neuropsychology, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Monash University Accident Research Centre, Monash University, Melbourne, Victoria, Australia.,Department of Psychosomatics and Psychiatry, University Children's Hospital Zürich, Zürich, Switzerland
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19
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Cummings JA. Transformational change in parenting practices after child interpersonal trauma: A grounded theory examination of parental response. CHILD ABUSE & NEGLECT 2018; 76:117-128. [PMID: 29101832 DOI: 10.1016/j.chiabu.2017.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 10/05/2017] [Accepted: 10/10/2017] [Indexed: 06/07/2023]
Abstract
Child interpersonal trauma is associated with a host of negative outcomes, both concurrently and in adulthood. Parental responses following trauma can play an important role in modulating child responses, symptoms, and post-trauma functioning. However, parents themselves are also impacted after their child experiences trauma, reporting distress, psychopathology, concerns about the child's safety, changes in discipline and protectiveness, and feelings of blame. Most of this previous research, however, suffers from methodological limitations such as focusing on description and correlations, providing static "one shot" assessments of parenting after trauma, and relying mainly on results related to child sexual abuse. This project developed a comprehensive, explanatory theory of the dynamic process by which parenting changes in response to a range of child trauma, using a sample of parents whose children had experienced a range of interpersonal trauma types. Grounded theory analyses revealed a three-phase dynamic model of discontinuous transformation, in which parents experienced destabilization, recalibration, and re-stabilization of parenting practices in response to child trauma. Parents were focused on Protecting and Healing the child victim, often at the expense of their own needs. Most parents reached a phase of posttraumatic growth, labelled Thriving Recovery, but processes that hindered this recovery are also discussed. This study provides the first evidence that dynamic systems of change as well as vicarious posttraumatic growth can apply to parents of child trauma victims. Generating an explanatory theory provides important avenues for future research as well as interventions and services aimed at families who have experienced child trauma.
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Affiliation(s)
- Jorden A Cummings
- Department of Psychology, University of Saskatchewan, 9 Campus Drive, Saskatoon, SK, Canada.
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20
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Hogwood J, Mushashi C, Jones S, Auerbach C. “I Learned Who I Am”: Young People Born From Genocide Rape in Rwanda and Their Experiences of Disclosure. JOURNAL OF ADOLESCENT RESEARCH 2017. [DOI: 10.1177/0743558417713302] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sexual violence was systematically used to terrorize thousands of Tutsi women and girls during the 1994 Rwandan genocide, infecting many with HIV and resulting in thousands of children born as a result of rape. Now these children are young adults; they are asking questions about their parentage and are often faced with challenging parent–child relationships, discrimination, stigmatization, and identity issues. As a result, there is a need for them to understand more about their birth histories. Through community counseling groups, mothers of these young people have been supported to disclose to their child about their birth histories. This study aims to understand how the young people experienced the disclosure and how this affected their sense of identity. Semistructured interviews were conducted with 10 young people and analyzed using interpretative phenomenological analysis. Three subordinate themes and eight subthemes begin to describe the complex and difficult process of learning about a new identity, the process of reconstructing a positive identity, and reworking family relationships as a result of the knowledge acquired. The young people appreciated knowing about their birth histories despite the painful emotions. Recommendations are made as to how these young people and their families can be better supported.
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21
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Observed Parenting in Families Exposed to Homelessness: Child and Parent Characteristics as Predictors of Response to the Early Risers Intervention. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/978-3-319-50886-3_3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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22
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Utržan DS, Piehler TF, Gewirtz AH, August GJ. Stressful life events and perceived parental control in formerly homeless families: Impact on child-internalizing symptoms. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2016; 87:317-325. [PMID: 27991820 PMCID: PMC5647151 DOI: 10.1037/ort0000236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Research has neglected the potential role of perceived parental control as a moderator between stressful life events (SLEs) and child-internalizing symptoms. Using secondary data from the Early Risers "Skills for Success" Program (August, Realmuto, Hektner, & Bloomquist, 2001), this study examined the impact of perceived parental control on the association between SLEs and child internalizing symptoms in formerly homeless families. The sample consisted of 137 families with 223 children between 4 and 12 years of age (M = 8.1, SD = 2.3) living in supportive housing sites in Minneapolis, Minnesota. Participants completed measures assessing the number of SLEs experienced (e.g., unemployment of parent, death of loved one, serious illness, homelessness), perceived parental control, and child-internalizing symptoms. In this sample, 65% of children (n = 144) experienced at least 1 SLE with an average experience of 2 SLEs (M = 2.0, SD = 1.9, range = 0-7). A regression analysis found that experiencing more SLEs and a perceived absence of parental control over child behavior were positively associated with child-internalizing symptoms. A significant interaction between SLEs and perceived absence of parental control over child behavior in predicting child internalizing symptoms was also found. These findings suggest that children of parents who model appropriate control are more likely to experience fewer internalizing symptoms in response to SLEs. (PsycINFO Database Record
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Affiliation(s)
- Damir S Utržan
- Department of Family Social Science, University of Minnesota, Twin Cities
| | - Timothy F Piehler
- Department of Family Social Science, University of Minnesota, Twin Cities
| | - Abigail H Gewirtz
- Department of Family Social Science, University of Minnesota, Twin Cities
| | - Gerald J August
- Department of Family Social Science, University of Minnesota, Twin Cities
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23
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Hultmann O, Broberg AG. Family Violence and Other Potentially Traumatic Interpersonal Events Among 9- to 17-Year-Old Children Attending an Outpatient Psychiatric Clinic. JOURNAL OF INTERPERSONAL VIOLENCE 2016; 31:2958-2986. [PMID: 25917005 DOI: 10.1177/0886260515584335] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Among children visiting child and adolescent mental health care (CAM), the prevalence of exposure to family violence (FV) is reported to exceed prevalence in community samples, as are potentially traumatic interpersonal events (IPE) outside the family. The aim of the study was to relate CAM patients' self-reported experiences of violence exposure to their current psychiatric symptoms and to compare patients exposed to violence with patients who reported no exposure. We asked 305 consecutive 9- to 17-year-old patients in CAM about their current and previous exposure to violence in and outside of the family. Prevalence of exposure to any kind of violence was 67%. Reported exposures were 19% to IPE, 21% to FV, and 27% to both. Children exposed to both FV and IPE were more negatively affected by the events than children exposed to FV or IPE only. Children in the FV + IPE group reported more mental health symptoms than those in the no violence (33%) group. In general, IPE was related to the outcome measures only in combination with FV. Degree of violence exposure seemed to have a dose-response relationship with the diagnosis of post-traumatic stress disorder.
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24
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Post-Disaster Mental Health Among Parent-Child Dyads After a Major Earthquake in Indonesia. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2016; 43:1309-18. [PMID: 25851238 DOI: 10.1007/s10802-015-0009-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The interdependent adjustment of children and their parents following disasters has been well documented. We used the Actor-Partner Interdependence Model (APIM) to provide an appropriate analytical framework for examining how family members may contribute to each other's post-disaster mental health. Independent self-reports were collected from parent-child dyads (n = 397) residing in a rural community in Indonesia that was devastated by a major earthquake. Elementary school children (M = 10 years; 51 % female) and one of their parents (M = 41 years; 73 % female) each reported on their disaster exposure, posttraumatic stress (PTS) symptoms, and general distress. The APIM was used to examine mental health within dyads and moderation by gender across dyads. Children reported lower disaster exposure and fewer PTS symptoms, but similar general distress levels, as their parents. Children's and parents' disaster-specific PTS symptoms were the strongest predictor of their own general distress. Parents' PTS symptoms were associated with children's general distress (b = 0.14, p < 0.001), but children's PTS symptoms were not associated with parents' general distress (b = -0.02, p > 0.05). Findings were not moderated by parents' or children's gender. Although children and parents may respond differently to natural disasters, they may be best understood as a dyad. APIM analyses provide new evidence suggesting a unidirectional path of influence from parents' disaster-related symptomatology to children's general mental health. Dyadic approaches to understanding mental health and treating symptoms of distress among disaster survivors and their families following trauma are encouraged.
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25
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Betancourt TS, McBain RK, Newnham EA, Brennan RT. The intergenerational impact of war: longitudinal relationships between caregiver and child mental health in postconflict Sierra Leone. J Child Psychol Psychiatry 2015; 56:1101-7. [PMID: 25665018 DOI: 10.1111/jcpp.12389] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/30/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Trauma from witnessing events such as bombings and killings as well as direct victimization or participation in violence has been associated with psychosocial distress and poor mental health among war-exposed children and adolescents. This study examines the relationship between caregiver mental health and child internalizing (anxiety and depression) symptoms over a 4-year period in postconflict Sierra Leone. METHODS The sample included 118 adolescent Sierra Leonean youth (73% male; mean age = 16.5 years at Time 1) and their caregivers (40% male; mean age = 39.0 at Time 1). To measure depression and anxiety symptoms, the Hopkins Symptom Checklist-25 was used with adults and the Oxford Measure of Psychosocial Adjustment - previously validated for use with children and adolescents in the region - was used to assess youth. A multivariate hierarchical linear model (HLM) for studying change within dyads was implemented to study covariation in internalizing symptoms among caregivers and youth over time; these models also included covariates at the individual, family and community levels. The relationship of caregiver mental health to child's internalizing was tested in a latent variable extension of the HLM. RESULTS The latent variable extension estimated that a one standard deviation (SD) change in caregiver anxiety/depression was associated with a .43 SD change in youth internalizing (p < .01) over the 4-year period. Family acceptance was negatively related to youth internalizing (p < .001), while community stigma was positively associated (p < .001). CONCLUSIONS The findings highlight an important interplay between caregiver and child mental health within the postconflict setting and the need for psychosocial interventions to extend beyond the individual to account for family dynamics.
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Affiliation(s)
- Theresa S Betancourt
- Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA.,François-Xavier Bagnoud Center for Health and Human Rights, Harvard School of Public Health, Boston, MA, USA
| | - Ryan K McBain
- Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA
| | - Elizabeth A Newnham
- François-Xavier Bagnoud Center for Health and Human Rights, Harvard School of Public Health, Boston, MA, USA.,School of Psychology, The University of Western Australia, Perth, WA, Australia
| | - Robert T Brennan
- François-Xavier Bagnoud Center for Health and Human Rights, Harvard School of Public Health, Boston, MA, USA
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26
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Landolt MA, Ystrom E, Stene-Larsen K, Holmstrøm H, Vollrath ME. Exploring causal pathways of child behavior and maternal mental health in families with a child with congenital heart disease: a longitudinal study. Psychol Med 2014; 44:3421-3433. [PMID: 24286537 DOI: 10.1017/s0033291713002894] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND A congenital heart defect (CHD) can increase the risk of mental health problems in affected children and their parents. The extent to which risk factors for these problems are shared in families or are specific to the individual family member is unclear. METHOD Prospective data from the Norwegian Mother and Child Cohort Study (MoBa; n = 93,009) were linked with a nationwide CHD registry, and 408 children with CHD were identified. Mothers' reports on child internalizing problems and their own distress were assessed by questionnaires at child ages 6, 18 and 36 months. A structural model was applied to distinguish between familial (shared) factors and individual-specific factors for mental health problems. RESULTS CHD was a substantial risk factor for problems in children and their mothers at all time points. CHD contributed on average 31% and 39% to the variance in children's and mothers' problems respectively. Both shared familial and individual-specific factors unique to CHD families contributed to risk for mental health problems. Whereas individual-specific risk factors contributed to the stability of problems in mothers, the effect of these factors lasted only a short time in children. Mutual influences over time were found between the mother's and the child's mental health at 18 and 36 months. CONCLUSIONS The burden of CHD in a child is shared between family members but is also specific to the individual. This study points to a need for both an individual and a family-based approach to provide psychological support to children with CHD and their parents.
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Affiliation(s)
- M A Landolt
- Department of Psychosomatics and Psychiatry,University Children's Hospital,Zurich,Switzerland
| | - E Ystrom
- Division of Mental Health,Norwegian Institute of Public Health,Oslo,Norway
| | - K Stene-Larsen
- Division of Mental Health,Norwegian Institute of Public Health,Oslo,Norway
| | - H Holmstrøm
- Department of Pediatrics,Oslo University Hospital,Norway
| | - M E Vollrath
- Division of Mental Health,Norwegian Institute of Public Health,Oslo,Norway
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27
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Erolin KS, Wieling E, Parra REA. Family violence exposure and associated risk factors for child PTSD in a Mexican sample. CHILD ABUSE & NEGLECT 2014; 38:1011-1022. [PMID: 24854428 DOI: 10.1016/j.chiabu.2014.04.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 04/20/2014] [Accepted: 04/22/2014] [Indexed: 06/03/2023]
Abstract
This study was undertaken in an effort to help illuminate the deleterious effects of traumatic stress on children and families in Mexico. Rates of exposure to traumatic events, family and community violence, and posttraumatic stress disorder (PTSD) were investigated in 87 school-age children and their mothers. Binary logistic regression analysis was performed to examine potential family and ecological risk factors for the presence of child PTSD. A total of 51 children (58.6%) reported an event that met the DSM-IV A criteria, and 36 children (41.4%; 20 boys and 16 girls) met criteria for full PTSD. Traumatic exposure in this sample was considerable, particularly intense, and chronic as a result of interpersonal violence in the home and community. Results support the need for preventive systemic interventions targeting the individual level, parent-child dyadic level, and the larger cultural and community context.
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Affiliation(s)
- Kara S Erolin
- Department of Family Social Science, University of Minnesota, 290 McNeal Hall, 1985 Buford Circle, St. Paul, MN 55108, USA
| | - Elizabeth Wieling
- Department of Family Social Science, University of Minnesota, 290 McNeal Hall, 1985 Buford Circle, St. Paul, MN 55108, USA
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Martinez-Torteya C, Dayton CJ, Beeghly M, Seng JS, McGinnis E, Broderick A, Rosenblum K, Muzik M. Maternal parenting predicts infant biobehavioral regulation among women with a history of childhood maltreatment. Dev Psychopathol 2014; 26:379-92. [PMID: 24621516 PMCID: PMC4326256 DOI: 10.1017/s0954579414000017] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Early biobehavioral regulation, a major influence of later adaptation, develops through dyadic interactions with caregivers. Thus, identification of maternal characteristics that can ameliorate or exacerbate infants' innate vulnerabilities is key for infant well-being and long-term healthy development. The present study evaluated the influence of maternal parenting, postpartum psychopathology, history of childhood maltreatment, and demographic risk on infant behavioral and physiological (i.e., salivary cortisol) regulation using the still-face paradigm. Our sample included 153 women with high rates of childhood maltreatment experiences. Mother-infant dyads completed a multimethod assessment at 7 months of age. Structural equation modeling showed that maternal positive (i.e., sensitive, warm, engaged, and joyful) and negative (i.e., overcontrolling and hostile) behaviors during interactions were associated with concurrent maternal depressive symptoms, single parent status, and low family income. In turn, positive parenting predicted improved infant behavioral regulation (i.e., positive affect and social behaviors following the stressor) and decreased cortisol reactivity (i.e., posttask levels that were similar to or lower than baseline cortisol). These findings suggest increased risk for those women experiencing high levels of depressive symptoms postpartum and highlight the importance of maternal positive interactive behaviors during the first year for children's neurodevelopment.
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Cobham VE, McDermott B. Perceived parenting change and child posttraumatic stress following a natural disaster. J Child Adolesc Psychopharmacol 2014; 24:18-23. [PMID: 24494740 DOI: 10.1089/cap.2013.0051] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Recent research suggests that not only parental psychopathology, but also parenting practices, have a role to play in the development of child posttraumatic stress symptoms (PTSS) following a natural disaster. The current study aimed to investigate the relationship between parents' perceptions of their parenting in the aftermath of a natural disaster, and child PTSS. METHODS A cross-sectional design was used to explore the associations among child PTSS, parents' perceptions of altered (more anxious) parenting, and parental disaster-related distress (altered cognitions and behaviors) in 874 elementary school children (ages 8-12 years) and their parents following a severe storm of cyclonic proportions. With parental consent, school-based screening was conducted in impacted communities 3 months after the storm. Children completed a screening questionnaire consisting of the Child Trauma Screening Questionnaire (CTSQ; used for identifying children at risk for posttraumatic stress disorder [PTSD]), as well as a range of questions assessing disaster exposure and threat perception. Parents completed questions relating to their perceptions of changes in their parenting since the storm, as well as two items relating to their own disaster-related distress. RESULTS Independent of other significant associations with child PTSS (such as age, gender, and disaster exposure), a high level of parent-perceived altered parenting appeared to put children at increased risk for PTSS 3 months after the disaster. However, when the sample was stratified for the presence or absence of altered parent cognitions and behaviors following the storm, altered parenting was found to have a unique relationship with child PTSS only when parents reported altered disaster-related cognitions and behaviors. CONCLUSIONS When parents report disaster-related cognitions and behaviors, their perception of altered parenting practices (becoming more protective, less granting of autonomy, and communicating a sense of current danger) is associated with child PTSS. Although it is not possible to draw conclusions about the direction of these relationships, this study identifies parenting practices that may constitute important targets for intervention.
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Affiliation(s)
- Vanessa E Cobham
- 1 School of Psychology, University of Queensland , Brisbane, Queensland, Australia
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Leen-Feldner EW, Feldner MT, Knapp A, Bunaciu L, Blumenthal H, Amstadter AB. Offspring psychological and biological correlates of parental posttraumatic stress: review of the literature and research agenda. Clin Psychol Rev 2013; 33:1106-33. [PMID: 24100080 DOI: 10.1016/j.cpr.2013.09.001] [Citation(s) in RCA: 135] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 09/06/2013] [Accepted: 09/06/2013] [Indexed: 11/16/2022]
Abstract
Millions of individuals with posttraumatic stress disorder (PTSD) are parents. A burgeoning literature suggests that offspring of parents with this condition may be at increased risk for psychological problems. The current paper provides an integrative and comprehensive review of the diverse research literature examining the sequelae of parental posttraumatic stress among offspring. Over 100 studies that evaluated psychological and/or biological variables among children of parents with PTSD are reviewed. Findings suggest parental symptoms of posttraumatic stress are uniquely related to an array of offspring outcomes, including internalizing-type problems, general behavioral problems, and altered hypothalamic-pituitary-adrenal axis functioning. Although very little work has directly evaluated mechanisms of transmission, there is increasing support for genetic and epigenetic effects as well as parenting behaviors. These and other mechanisms are discussed; drawing upon findings from other literatures to consider how parental PTSD may impart psychobiological vulnerability upon offspring. We conclude with a detailed discussion of the methodological strengths and challenges of the extant research, along with a recommended agenda for future research in this important area of study.
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Douglas-Siegel JA, Ryan JP. The effect of recovery coaches for substance-involved mothers in child welfare: impact on juvenile delinquency. J Subst Abuse Treat 2013; 45:381-7. [PMID: 23856594 DOI: 10.1016/j.jsat.2013.05.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Revised: 05/20/2013] [Accepted: 05/30/2013] [Indexed: 10/26/2022]
Abstract
Despite the documented relationship between parental substance abuse and youth delinquency, the effects of parental interventions on delinquency outcomes are unknown. Such interventions are particularly vital for families in the child welfare system who are at heightened risk for both parental substance involvement and youth delinquency. The current study tested the impact of intensive case management in the form of a recovery coach for substance-involved mothers on youth delinquency outcomes among a randomized sample of 453 families involved in a Title IV-E experimental waiver demonstration in Cook County, Illinois. In comparison to control group participants, families enrolled in the Alcohol and Other Drug Abuse (AODA) waiver demonstration experienced a lower rate of juvenile arrest, net of factors such as demographic characteristics, primary drug of choice, and time spent in substitute care. Findings support efforts to curb delinquency among child-welfare involved youth by providing recovery coaches to their substance abusing or dependent parents.
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Affiliation(s)
- Jonah A Douglas-Siegel
- University of Michigan, School of Social Work and Department of Sociology, 1080 South University Ave, Ann Arbor, MI 48109, USA.
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Jordan B, Franich-Ray C, Anderson V, Northam E, Albert N, Cochrane A, Menahem S. Maternal Report of Infant Emotional Well-Being Following Their Infant's Hospitalization for Neonatal Cardiac Surgery. Infant Ment Health J 2013. [DOI: 10.1002/imhj.21388] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Brigid Jordan
- Murdoch Childrens Research Institute; Royal Children's Hospital; Melbourne; Australia
| | - Candice Franich-Ray
- Murdoch Childrens Research Institute; Royal Children's Hospital; Melbourne; Australia
| | - Vicki Anderson
- Murdoch Childrens Research Institute; The University of Melbourne; Melbourne; Australia
| | - Elisabeth Northam
- Murdoch Childrens Research Institute; The University of Melbourne; Melbourne; Australia
| | - Nadia Albert
- Murdoch Childrens Research Institute; Melbourne; Australia
| | - Andrew Cochrane
- Monash Medical Centre; Monash University; Clayton; Australia
| | - Samuel Menahem
- Monash Medical Centre; Monash University; Clayton; Australia
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Kanewischer EJW. Do You Ever Feel That Way? A Story and Activities About Families and Feelings. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2013. [DOI: 10.1080/15401383.2013.763686] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Betancourt TS, Yudron M, Wheaton W, Smith-Fawzi MC. Caregiver and adolescent mental health in Ethiopian Kunama refugees participating in an emergency education program. J Adolesc Health 2012; 51:357-65. [PMID: 22999836 DOI: 10.1016/j.jadohealth.2012.01.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Revised: 12/29/2011] [Accepted: 01/03/2012] [Indexed: 01/30/2023]
Abstract
PURPOSE To examine the role of caregiver mental health and risk and protective factors in influencing levels of internalizing and externalizing emotional and behavioral symptoms over time among a sample of refugee adolescents. METHODS Prospective study of 153 Kunama refugee adolescents receiving an emergency education intervention while living in a camp in Ethiopia. Surveys were collected in 2001 (T1) and 2002 (T2). Adolescent and caregiver mental health were assessed using a Kunamenga adaptation of the Youth Self Report; caregiver mental health was assessed using the Hopkins Symptom Checklist-25. Attitudes toward education, satisfaction with education programming, socioeconomic status, and perceptions of access to services were also explored as variables potentially influencing adolescent mental health at follow-up. RESULTS Caregiver distress was significantly associated with youth externalizing behavior symptoms (β = 8.34, p < .001) and internalizing symptoms (β = 4.02, p < .05). Caregiver perceived access to services had a protective effect on externalizing behaviors (β = -7.54, p < .05) and internalizing behaviors (β = -13.67, p < .001). Higher socioeconomic status (β = -1.47, p < .05) had a protective effect on internalizing symptoms. In terms of modifying effects, among youth with distressed caregivers, those who were satisfied with the International Rescue Committee education intervention had a lower internalizing score (β = -6.34, p < .001) compared with those who were not satisfied with the program. CONCLUSIONS This study presents a rare prospective investigation of caregiver-adolescent mental health during an active refugee displacement. Results suggest that programs targeting mental health in refugee children should consider children within the larger family system, including caregiver influence on child and adolescent mental health adjustment over time.
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Affiliation(s)
- Theresa S Betancourt
- Department of Global Health and Population, Research Program on Children and Global Adversity, François-Xavier Bagnoud Center for Health and Human Rights at the Harvard School of Public Health, Boston, Massachusetts 02115, USA.
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Kearney JA, Cushing E. A multi-modal pilot intervention with violence-exposed mothers in a child psychiatric trauma-focused treatment program. Issues Ment Health Nurs 2012; 33:544-52. [PMID: 22849782 DOI: 10.3109/01612840.2012.688254] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This multi-method pilot study implemented a relationally-based intervention with mothers of school-aged children receiving treatment for exposure to domestic violence. Grounded in psychodynamic and attachment theories, the short-term intervention consisted of targeted individual and group sessions. Quantitative as well as qualitative data were examined for trends and exemplars of important process outcomes. Improvements were evidenced in a number of key areas including psychiatric symptoms, isolation, defensive avoidance, coping skills, attributional style, and reflective functioning. Results converged to portray improved functioning in critical areas of dysfunction often displayed by these mothers.
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Affiliation(s)
- Joan A Kearney
- Columbia University School of Nursing, 617 West 168th St., New York, NY 10032, USA.
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Landolt MA, Ystrom E, Sennhauser FH, Gnehm HE, Vollrath ME. The mutual prospective influence of child and parental post-traumatic stress symptoms in pediatric patients. J Child Psychol Psychiatry 2012; 53:767-74. [PMID: 22211718 DOI: 10.1111/j.1469-7610.2011.02520.x] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Previous studies found notable rates of post-traumatic stress symptoms (PTSS) and post-traumatic stress disorder (PTSD) in pediatric patients and their parents and suggest a significant association between child and parent PTSS. However, little is known about mutual influences between child and parental PTSS over time. This study prospectively examined the presence of PTSS and PTSD and the mutual influence of child and parental PTSS in a large sample of pediatric patients with different medical conditions. METHODS A total of 287 children (aged 6.5-16 years) and their mothers (n = 239) and fathers (n = 221) were assessed at 5-6 weeks and 1 year after an accident or a new diagnosis of cancer or diabetes mellitus type 1 in the child. RESULTS At the first assessment 11.1% and at the second assessment 10.2% of the children had moderate to severe PTSS. At 5-6 weeks 29.3% of mothers and 18.6% of fathers met criteria for PTSD. At 1 year the rates were 14.6% for mothers and 7.9% for fathers. There were considerable differences of PTSS among different medical diagnostic groups in children and parents. Mothers were more vulnerable than fathers. Structural equation analysis revealed that initially high PTSS in mothers and fathers were longitudinally related to poorer recovery from PTSS in the child. Cross-lagged effects from the child to the parents and from one parent to the other were not significant. CONCLUSIONS This study highlights the long-term influence of parental PTSS on the child's recovery after trauma and calls for a family systems approach and for early interventions in the treatment of traumatized pediatric patients.
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Affiliation(s)
- Markus A Landolt
- University Children's Hospital Zurich and Children's Research Center, Steinwiesstrasse 75, Zurich, Switzerland.
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37
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Voisin DR, Hong JS. A Meditational Model Linking Witnessing Intimate Partner Violence and Bullying Behaviors and Victimization Among Youth. EDUCATIONAL PSYCHOLOGY REVIEW 2012. [DOI: 10.1007/s10648-012-9197-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Jordan B. Therapeutic play within infant-parent psychotherapy and the treatment of infant feeding disorders. Infant Ment Health J 2012; 33:307-313. [DOI: 10.1002/imhj.21321] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Alisic E, Boeije HR, Jongmans MJ, Kleber RJ. Supporting children after single- incident trauma: parents' views. Clin Pediatr (Phila) 2012; 51:274-82. [PMID: 21946253 DOI: 10.1177/0009922811423309] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To strengthen trauma-informed health care by exploring parents' experiences of assisting their child after single-incident trauma (eg, violence, accidents, and sudden loss). METHOD Semistructured interviews with parents (N = 33) of 25 exposed children (8-12 years). RESULTS Responsive parenting after trauma emerged as a core theme, consisting of (a) being aware of a child's needs and (b) acting on these needs. The authors identified 14 strategies, such as comparing behavior with siblings' behavior and providing opportunities to talk. Parents felt that their capacity to be responsive was influenced by their own level of distress. CONCLUSION The authors propose a model of Relational PTSD (posttraumatic stress disorder) and Recovery to assist health care professionals working with children exposed to trauma. The results also point to the need to recognize the challenge that parents face when supporting a child after traumatic exposure and to align more with parents about procedures that may cause the child to be reminded of the event.
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Affiliation(s)
- Eva Alisic
- Psychotrauma Center for Children and Youth, University Medical Center Utrecht, Utrecht, Netherlands.
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Polusny MA, Ries BJ, Meis LA, DeGarmo D, McCormick-Deaton CM, Thuras P, Erbes CR. Effects of parents' experiential avoidance and PTSD on adolescent disaster-related posttraumatic stress symptomatology. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2011; 25:220-229. [PMID: 21480702 PMCID: PMC6791530 DOI: 10.1037/a0022945] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Despite the importance of family context to adolescents' reactions following disaster, little research has examined the role of parents' functioning on adolescents' disaster-related posttraumatic stress disorder (PTSD) symptoms. Using data from 288 adolescents (ages 12 to 19 years) and 288 parents exposed to a series of severe tornadoes in a rural Midwestern community, this study tested a conceptual model of the interrelationships between individual and parental risk factors on adolescents' disaster-related PTSD symptoms using structural equation modeling. Results showed that the psychological process of experiential avoidance mediated the relationship between family disaster exposure and PTSD for both adolescents and their parents. Parents' PTSD symptoms independently predicted adolescents' PTSD symptoms. Further, parents' postdisaster functioning amplified the effects of adolescent experiential avoidance on adolescents' disaster-related PTSD symptoms. Findings highlight the importance of family context in understanding adolescents' postdisaster reactions. Clinical implications are discussed.
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Affiliation(s)
- Melissa A Polusny
- Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN 55417, USA.
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42
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Chemtob CM, Nomura Y, Rajendran K, Yehuda R, Schwartz D, Abramovitz R. Impact of maternal posttraumatic stress disorder and depression following exposure to the September 11 attacks on preschool children's behavior. Child Dev 2010; 81:1129-41. [PMID: 20636686 DOI: 10.1111/j.1467-8624.2010.01458.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To evaluate whether conjoined maternal posttraumatic stress disorder (PTSD) and depression are associated with increased behavioral problems among terrorism-exposed preschool children (N = 116; 18-54 months), this study compared clinically significant child behavioral problem rates among the preschool children of mothers with PTSD and depression, depression alone, and neither disorder. Behavioral problems were independently rated by mothers and preschool teachers. Maternal depression and PTSD, relative to maternal depression alone, and to neither disorder, were associated with substantially increased child problems. Notably, maternal depression and PTSD were associated with increased emotional reactivity (relative risk [RR] = 5.9 by mother's and 3.4 by teacher's reports) and aggressive behavior problems (RR = 11.0 by mother's and RR = 5.9 by teacher's reports). This was corroborated by teacher ratings. Implications for intervening with terrorism-exposed preschool children are discussed.
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Paris R, DeVoe ER, Ross AM, Acker ML. When a parent goes to war: effects of parental deployment on very young children and implications for intervention. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2010; 80:610-618. [PMID: 20950302 DOI: 10.1111/j.1939-0025.2010.01066.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Young children (birth through 5 years of age) are disproportionately represented in U.S. military families with a deployed parent. Because of their developmental capacity to deal with prolonged separation, young children can be especially vulnerable to stressors of parental deployment. Despite the resiliency of many military families, this type of separation can constitute a developmental crisis for a young child. Thus, the experience may compromise optimal child growth and development. This article reviews what is known about the effects of the military deployment cycle on young children, including attachment patterns, intense emotions, and behavioral changes and suggests an ecological approach for supporting military families with infants, toddlers, and preschoolers. Specifically, home-based family focused interventions seem to warrant the most serious consideration.
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Kerig PK, Sink HE, Cuellar RE, Vanderzee KL, Elfstrom JL. Implementing trauma-focused CBT with fidelity and flexibility: a family case study. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2010; 39:713-22. [PMID: 20706923 DOI: 10.1080/15374416.2010.501291] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Effective approaches for the treatment of childhood posttraumatic stress disorder and traumatic grief are needed given the prevalence of trauma and its impact on children's lives. To effectively treat posttraumatic stress disorder in children, evidence-based practices should be implemented with flexibility and responsiveness to culture, developmental level, and the specific needs of the family. This case study illustrates flexibility with fidelity in the use of a manualized treatment, describing the implementation of Trauma Focused-Cognitive Behavior Therapy with three traumatized family members-a caregiver and two children. Particular attention is paid to the use of creative strategies to tailor interventions to the individual clients while maintaining fidelity to the principles and components of this evidence-based treatment.
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45
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Peek L, Stough LM. Children With Disabilities in the Context of Disaster: A Social Vulnerability Perspective. Child Dev 2010; 81:1260-70. [PMID: 20636694 DOI: 10.1111/j.1467-8624.2010.01466.x] [Citation(s) in RCA: 184] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Lori Peek
- Department of Sociology, Colorado State University, B-237 Clark Building, Fort Collins, CO 80523-1784, USA.
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46
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Kearney JA. Women and children exposed to domestic violence: themes in maternal interviews about their children's psychiatric diagnoses. Issues Ment Health Nurs 2010; 31:74-81. [PMID: 20070220 DOI: 10.3109/01612840903308515] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Twelve mothers who had experienced domestic violence and whose children had received psychiatric diagnoses before school age were interviewed. An attachment based tool, the Reaction to Diagnosis Interview, was employed as it accesses maternal representational content. Using psychodynamic and attachment based models as a theoretical framework, content analysis was performed and four thematic categories emerged from the data: intense negative emotionality and suffering; diminished cognitive coping and dysregulation; preoccupation with trauma related material; and constricted causal attributions. Thematic categories as well as inter-relationships among themes are described and discussed in terms of current literature.
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Affiliation(s)
- Joan A Kearney
- Columbia University, School of Nursing, 630 West 168th St., New York, NY 10032, USA.
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Kaitz M, Levy M, Ebstein R, Faraone SV, Mankuta D. The intergenerational effects of trauma from terror: A real possibility. Infant Ment Health J 2009. [PMID: 28636178 DOI: 10.1002/imhj.20209] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The goals of this article are to discuss the potential risk of children whose parents were traumatized by terror, to present literature on parenting in the context of terror, and to consider factors that may mediate the transmission of trauma-effects from parents to children. Mediators considered are parents' traumatic distress, disturbed parent-child interactions, trauma-related disturbances in parents' thinking, and effects of stress on children's neural functioning. Also discussed are genetic and environmental factors that may moderate the transmission of intergenerational effects and promote children's risk and resilience. Points raised during the discussion are illustrated with segments from interviews of women who were pregnant or gave birth some time after direct exposure to a terror attack. The authors conclude that empirical studies are needed to learn more about the intergenerational transmission of trauma-effects and processes that underlie it. The authors join others in the call to improve evaluation, treatment, and support of trauma victims and their children to stymie the transmission of problems from one generation to the next.
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Affiliation(s)
| | | | | | | | - David Mankuta
- Hadassah Hospital and Hebrew University Medical School
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48
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Klein TP, Devoe ER, Miranda-Julian C, Linas K. Young children's responses to September 11th: The New York City experience. Infant Ment Health J 2009. [PMID: 28636121 DOI: 10.1002/imhj.20200] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Although the knowledge base regarding very young children's responses to trauma has been expanding, descriptions of their responses to terrorism remain sparse. Yet, their vulnerability makes this an important group to study. Recent events in the United States (9/11, Hurricane Katrina) make this question highly relevant. This study aims to provide extensive descriptions of how children 5 years or younger on September 11th who were living in close proximity to Ground Zero responded that day and in the following months. Sixty-seven New York City parents (with 104 children) participated in focus groups between November 2001 and May 2002. Focus groups also provided a foundation for an in-depth study examining young children's adaptation following 9/11 and changes in parenting behaviors after the disaster. Findings on children's behavioral and emotional reactions on 9/11 and in the 8 months after as well as their need to return to normalcy are reported. Consistent with current understanding of trauma symptoms in young children, parents reported behaviors including chronic sleep disruptions, fearful reactions, development of new fears, and increased clinginess and separation anxiety following the disaster. On the actual day, children's responses were described as ranging from calm and cooperative to difficult and panicky. Implications for working with parents and young children affected by terrorism or community-level trauma and directions for future research are discussed.
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Affiliation(s)
- Tovah P Klein
- Barnard College Center for Toddler Development and Department of Psychology
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49
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Berz JB, Taft CT, Watkins LE, Monson CM. Associations Between PTSD Symptoms and Parenting Satisfaction in a Female Veteran Sample. ACTA ACUST UNITED AC 2008. [DOI: 10.1080/19322880802125969] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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50
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Spell AW, Kelley ML, Wang J, Self-Brown S, Davidson KL, Pellegrin A, Palcic JL, Meyer K, Paasch V, Baumeister A. The Moderating Effects of Maternal Psychopathology on Children's Adjustment Post–Hurricane Katrina. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2008; 37:553-63. [DOI: 10.1080/15374410802148210] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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