What Role for Parental Attributions in Parenting Interventions for Child Conduct Problems? Advances from Research into Practice

Parents' illness representations of their child with anorexia nervosa: A systematic review of qualitative studies using the common-sense model

OBJECTIVE

Research indicates that parents experience distress while caring for a child with anorexia nervosa. Applying the Common Sense Model of Self-Regulation (CSM), a framework to describe responses to illness may help to understand the antecedents of parental distress, which could inform how to support parents in treatment. The aim of this systematic review was to synthesize outcomes from qualitative research in relation to parents' experiences of caring for a child with anorexia nervosa using the CSM.

METHOD

Systematic search of four electronic databases (psychINFO, MEDLINE, EMBASE, ProQuest Dissertation, and Theses Database) alongside a two-way screening process was used to identify eligible studies. Qualitative themes were synthesized using a "best fit" framework analysis and reported according to CSM dimensions of cognitive and emotional illness representations.

RESULTS

A total of 32 studies published between 1970 and 2023 were eligible for inclusion for review. Parents perceived their child's anorexia nervosa as a major health threat observable by illness representations that anorexia nervosa was uncontrollable, incomprehensible, chronic, and associated with negative consequences. The themes also suggested parents take responsibility for causing anorexia nervosa. These illness representations were linked with emotional representations of fear, anxiety, shame, guilt, loneliness, and depression.

CONCLUSIONS

The findings provide evidence of the utility of using the CSM to understand the antecedents of parents' distress and negative impacts of caring for a child with anorexia nervosa. Recommendations for future research and clinical practice are discussed emphasizing the need to understand parents' perceptions of their child's illness to putatively maximize treatment benefits for families.

PUBLIC SIGNIFICANCE

This review emphasizes the salience of understanding parents distress while caring for a child with anorexia nervosa. The findings present opportunities to best support parents in treatment, with a focus on addressing their cognitive and emotional representations of their child's illness. A multicomponent treatment regimen may be required to support parents if they present with illness representations that negatively affect their well-being and ability to cope with distress.

The Ws of Parental Help-Seeking: When, Where, and for What Do Parents Seek Help for Child Mental Health

Parental help-seeking preferences may help explain the treatment gap in child mental health. This study examined mothers' and fathers' help-seeking behaviors for child mental health to further understand their individual preferences for treatment. A total of 394 mothers and fathers completed questionnaires assessing the types of help sought for mental health concerns for a target child (age 3-7 years), as well as measures representing illness profile, predisposing characteristics, and barriers/facilitators proposed to influence help-seeking. Parents often sought informal rather than professional help. Regression modelling indicated mothers' different help-seeking behaviors were significantly associated with illness profile (marital quality, child mental health, parental education), predisposing factors (parental attributions, child age), and family income, while fathers' different help-seeking behaviors were significantly associated with child demographics (age, gender). The results support expanding treatments into nonclinical settings and improving child mental health literacy to improve appropriate parental help-seeking for child mental health concerns.

Dimensions of Warm Parenting Attributions Differentiate Conduct Problem Subtypes in Young Children

Understanding the developmental psychopathology of child conduct problems (CP) has been advanced by differentiating subtypes based on levels of internalizing problems (INT) and/or callous-unemotional (CU) traits (i.e., low empathy/guilt, poor motivation, shallow/deficient affect). The current study sought to elucidate prior inconsistencies in the role of warm/positive and harsh/negative parenting subcomponents in CP by differentiating subtypes on the basis of INT and CU traits. Parents of 135 young children (M age = 4.21 years, SD = 1.29) referred to specialty clinics for the treatment of CP completed pre-treatment measures of parenting and rated their child's levels of CP, INT, and CU traits. Results of planned comparisons revealed that mothers of children classified as secondary CU variants (high CU/ high INT) reported fewer overall warm attributions toward their child, compared with CP-only (low CU) children. They also reported a more negative dyadic relationship characterized by feelings of anger/hostility, active avoidance and/or a desire to do harm to their child relative to primary CU variants (high CU/ low INT). Mothers of primary CU variants attributed fewer good and altruistic intentions towards others in their child, relative to CP-only children. Subtypes were undifferentiated on observed positive and negative parenting behaviors, indicative of a disconnect between parenting behaviors and cognitions for mothers of children high on CU traits. Findings are discussed in relation to their theoretical and practice implications, and in guiding future research.

Treatment of childhood disruptive behavior disorders and callous-unemotional traits: a systematic review and two multilevel meta-analyses

BACKGROUND

Children with callous-unemotional (CU) traits are at high lifetime risk of antisocial behavior. It is unknown if treatments for disruptive behavior disorders are as effective for children with CU traits (DBD+CU) as those without (DBD-only), nor if treatments directly reduce CU traits. Separate multilevel meta-analyses were conducted to compare treatment effects on DBD symptoms for DBD+CU versus DBD-only children and evaluate direct treatment-related reductions in CU traits, as well as to examine moderating factors for both questions.

METHODS

We systematically searched PsycINFO, PubMed, Cochran Library (Trials), EMBASE, MEDLINE, APA PsycNet, Scopus, and Web of Science. Eligible studies were randomized controlled trials, controlled trials, and uncontrolled studies evaluating child-focused, parenting-focused, pharmacological, family-focused, or multimodal treatments.

RESULTS

Sixty studies with 9,405 participants were included (Mage  = 10.04, SDage  = 3.89 years, 25.09% female, 44.10% racial/ethnic minority). First, treatment was associated with similar reductions in DBD symptoms for DBD+CU (SMD = 1.08, 95% CI = 0.45, 1.72) and DBD-only (SMD = 1.01, 95% CI = 0.38, 1.64). However, DBD+CU started (SMD = 1.18, 95% CI = 0.57, 1.80) and ended (SMD = 0.73, p < .001; 95% CI = 0.43, 1.04) treatment with more DBD symptoms. Second, although there was no overall direct effect of treatment on CU traits (SMD = .09, 95% CI = -0.02, 0.20), there were moderating factors. Significant treatment-related reductions in CU traits were found for studies testing parenting-focused components (SMD = 0.21, 95% CI = 0.06, 0.35), using parent-reported measures (SMD = 0.16, 95% CI = 0.04, 0.28), rated as higher quality (SMD = 0.26, 95% CI = 0.13, 0.39), conducted outside the United States (SMD = 0.19, 95% CI = 0.05, 0.32), and with less than half the sample from a racial/ethnic minority group (SMD = 0.15, 95% CI = 0.002, 0.30).

CONCLUSIONS

DBD+CU children improve with treatment, but their greater DBD symptom severity requires specialized treatment modules that could be implemented alongside parenting programs. Conclusions are tempered by heterogeneity across studies and scant evidence from randomized controlled trials.

Conception and Development of the Warmth/Affection Coding System (WACS): A Novel Hybrid Behavioral Observational Tool for Assessing Parent-to-Child Warmth

A vast body of research and theory underscores the importance of parental warmth/affection (hereby 'warmth' and 'warmth/affection' are used interchangeably) as a distinct relational process that is fundamental to core developmental processes including parent-child attachment, socialization, emotion recognition and responsivity, and empathic development. The increasing focus on parental warmth as a viable transdiagnostic and specific treatment target for Callous-Unemotional (CU) traits highlights the critical need for a reliable and valid tool for measuring this construct within clinical contexts. However, existing assessment methods have limitations in their ecological validity, clinical utility, and the comprehensiveness of their coverage of core warmth subcomponents. In response to this clinical and research need, the observational Warmth/Affection Coding System (WACS) was developed to comprehensively measure parent-to-child warmth/affection. This paper chronicles the conception and development of the WACS, which adopts a hybrid approach of utilizing both microsocial and macro-observational coding methods to capture key verbal and non-verbal subcomponents of warmth that are currently underrepresented or poorly captured by existing assessment tools. Recommendations for implementation and future directions are also discussed.

Multiple needs and multiple treatments. What's a clinician to do? Update on the psychosocial treatment of disruptive behaviours in childhood

PURPOSE OF REVIEW

There are a wide range of psychosocial treatment options, delivered in different modalities, for children with disruptive behaviour. However, clinicians face many challenges in ensuring the empirically supported treatments (ESTs) they select will be effective for their patient. This has prompted studies to generate knowledge on how to improve treatment outcomes for children with disruptive behaviour. This review identifies the major challenges in treatment selection as well as emerging research seeking to improve outcomes.

RECENT FINDINGS

This review emphasizes the salience of the research-practice gap associated with establishing ESTs using narrow definitions of clinical problems. Recent research is reviewed considering the complex determinants of disruptive behaviours, including parent and family factors that influence outcomes. The review subsequently outlines recent advances in research and clinical practice guidelines aiming to surmount these challenges. Key advances discussed include examining the most impactful components of ESTs, personalizing interventions by targeting core dysfunction underlying behaviour, and addressing parent factors including mental health and cultural relevance to improve outcomes.

SUMMARY

Thorough assessment of patients' needs, combined with knowledge of treatment response predictors, are recommended to determine the most suitable treatment plan. Recent advances have focused on developing and designing interventions that meet needs in a way that is flexible and tailored.

Parent Training Adapted to the Needs of Children With Callous-Unemotional Traits: A Randomized Controlled Trial

Callous-unemotional (CU) traits designate a distinct subgroup of children with early-starting, stable, and aggressive conduct problems. Critically, traditional parenting interventions often fail to normalize conduct problems among this subgroup. The aim of this study was to test whether parent-child interaction therapy (PCIT) adapted to target distinct deficits associated with CU traits (PCIT-CU) produced superior outcomes relative to standard PCIT. In this proof-of-concept trial, 43 families with a 3- to 7-year-old child (M age = 4.84 years, SD = 1.12, 84% male) with clinically significant conduct problems and elevated CU traits were randomized to receive standard PCIT (n = 21) or PCIT-CU (n = 22) at an urban university-based research clinic. Families completed five assessments measuring child conduct problems, CU traits, and empathy. Parents in both conditions reported good treatment acceptability and significantly improved conduct problems and CU traits during active treatment, with no between-group differences. However, linear mixed-effects models showed treatment gains in conduct problems deteriorated for children in standard PCIT relative to those in PCIT-CU during the 3-month follow-up period (ds = 0.4-0.7). PCIT-CU shows promise for sustaining improvements in conduct problems for young children with conduct problems and CU traits, but requires continued follow-up and refinement.

Predictors and Moderators Two Treatments of Oppositional Defiant Disorder in Children

OBJECTIVE

The aim of this study was to examine predictors and moderators of behavioral improvement in children with Oppositional Defiant Disorder (ODD) following treatment with Parent Management Training (PMT) and Collaborative and Proactive Solutions (CPS). Initial problem severity, inconsistent discipline, parental attributions of child misbehavior, and child lagging cognitive skills were examined.

METHOD

One hundred and forty-five children aged between 7 and 14 (103 males, M = 8.88 years, ethnicity representative of the wider Australian population) were randomly assigned to PMT and CPS. Assessment was conducted at baseline, post-intervention, and at 6-month follow-up, using independently rated semi-structured diagnostic interviews and parent-ratings of ODD symptoms. Using an intent-to-treat sample in this secondary analysis (Murrihy et al., 2022), linear regressions and PROCESS (Hayes, 2017) were used to examine these predictors and possible moderators of treatment.

RESULTS

Higher pre-treatment levels of conduct problems, lagging skills, and inconsistent discipline predicted poorer behavioral outcomes following both treatments. The only characteristic that moderated treatment outcome was child-responsible attributions - mothers who were more likely to attribute their child's problematic behaviors to factors in the child had significantly poorer outcomes in PMT than CPS at 6-month follow-up.

CONCLUSIONS

CPS may be a more beneficial treatment than PMT for families who have been identified as having higher levels of child-responsible attributions before commencing treatment for ODD. While tentative, this provides promising insights as to how treatment outcomes for children with ODD may be improved.

Parents' early representations of their children moderate socialization processes: Evidence from two studies

Difficult infants are commonly considered at risk for maladaptive developmental cascades, but evidence is mixed, prompting efforts to elucidate moderators of effects of difficulty. We examined features of parents' representations of their infants - adaptive (appropriate mind-mindedness, MM) and dysfunctional (low reflective functioning, RF, hostile attributions) - as potential moderators. In Family Study (N = 102), we tested parents' appropriate MM comments to their infants as moderating a path from infants' observed difficulty (negative affect, unresponsiveness) to parents' observed power assertion at ages 2-4.5 to children's observed and parent-rated (dis)regard for conduct rules at age 5.5. In father-child relationships, MM moderated that path: for fathers with low MM, the infants' increasing difficulty was associated with fathers' greater power assertion, which in turn was associated with children's more disregard for rules. The path was absent for fathers with average or high MM. In Children and Parents Study (N = 200), dysfunctional representations (low RF, hostile attributions) moderated the link between child objective difficulty, observed as anger in laboratory episodes, and difficulty as described by the parent. Reports of mothers with highly dysfunctional representations were unrelated to children's observed anger. Reports of mothers with average or low dysfunctional representations aligned with laboratory observations.

Mindfulness, Parental Attributions, and Parenting: the Moderating Role of Child Mental Health

Objectives

Research interest in mindfulness, the capacity for present-oriented, nonjudgmental attention and awareness, and its relation to parenting has been growing in recent years. However, factors facilitating the association between mindfulness and parenting are not yet well understood. In the present study, we examined whether parents’ biased causal thinking about children’s misbehaviors, i.e., parental attributions, may mediate the link between parents’ dispositional mindfulness and parenting. Given that parents of children with clinically elevated mental health difficulties tend to report more biased parental attributions, we further examined whether the proposed mediation may differ across parents of children with and without clinical diagnoses or referrals for mental health difficulties.

Methods

Parents (59.8% mothers) of 8- to 12-year-old children with (n = 157) and without (n = 99) clinical diagnoses or referrals for mental health difficulties participated in online surveys assessing their mindfulness, parental attributions, and negative parenting behaviors.

Results

More mindful parents reported less negative parenting, with the link significantly mediated by less biased parent-directed attributions, but not child-directed attributions. The mediating effect via parent-directed attributions was significantly moderated by the child’s clinical status: the effect was retained only for parents of children with clinical diagnoses or referrals for mental health difficulties. No significant moderation effect emerged for child-directed attributions.

Conclusions

The results provide initial support for the links among parents’ mindfulness, parental attributions, and parenting. The present findings suggest that parental mindfulness may be important for less biased parental attributions, with implications for parenting behaviors at least in the context of children’s mental health disorders.

Parenting in the Context of the Child: Genetic and Social Processes

The focus on the role of parenting in child development has a long-standing history. When measures of parenting precede changes in child development, researchers typically infer a causal role of parenting practices and attitudes on child development. However, this research is usually conducted with parents raising their own biological offspring. Such research designs cannot account for the effects of genes that are common to parents and children, nor for genetically influenced traits in children that influence how they are parented and how parenting affects them. The aim of this monograph is to provide a clearer view of parenting by synthesizing findings from the Early Growth and Development Study (EGDS). EGDS is a longitudinal study of adopted children, their birth parents, and their rearing parents studied across infancy and childhood. Families (N = 561) were recruited in the United States through adoption agencies between 2000 and 2010. Data collection began when adoptees were 9 months old (males = 57.2%; White 54.5%, Black 13.2%, Hispanic/Latinx 13.4%, Multiracial 17.8%, other 1.1%). The median child age at adoption placement was 2 days (M = 5.58, SD = 11.32). Adoptive parents were predominantly in their 30s, White, and coming from upper-middle- or upper-class backgrounds with high educational attainment (a mode at 4-year college or graduate degree). Most adoptive parents were heterosexual couples, and were married at the beginning of the project. The birth parent sample was more racially and ethnically diverse, but the majority (70%) were White. At the beginning of the study, most birth mothers and fathers were in their 20s, with a mode of educational attainment at high school degree, and few of them were married. We have been following these family members over time, assessing their genetic influences, prenatal environment, rearing environment, and child development. Controlling for effects of genes common to parents and children, we confirmed some previously reported associations between parenting, parent psychopathology, and marital adjustment in relation to child problematic and prosocial behavior. We also observed effects of children's heritable characteristics, characteristics thought to be transmitted from parent to child by genetic means, on their parents and how those effects contributed to subsequent child development. For example, we found that genetically influenced child impulsivity and social withdrawal both elicited harsh parenting, whereas a genetically influenced sunny disposition elicited parental warmth. We found numerous instances of children's genetically influenced characteristics that enhanced positive parental influences on child development or that protected them from harsh parenting. Integrating our findings, we propose a new, genetically informed process model of parenting. We posit that parents implicitly or explicitly detect genetically influenced liabilities and assets in their children. We also suggest future research into factors such as marital adjustment, that favor parents responding with appropriate protection or enhancement. Our findings illustrate a productive use of genetic information in prevention research: helping parents respond effectively to a profile of child strengths and challenges rather than using genetic information simply to identify some children unresponsive to current preventive interventions.

Review of barriers and interventions to promote treatment engagement for pediatric attention deficit hyperactivity disorder care

Attention deficit hyperactivity disorder (ADHD) is a common and impairing behavioral health disorder, impacting over 5% of children worldwide. There are multiple evidence-based pharmacological and psychosocial treatments for ADHD, and greater service utilization is associated with improved acute and long-term outcomes. However, long-term outcomes are suboptimal as multimodal treatments are often not accessed and most care ends prematurely. This narrative review discusses barriers to engagement for children and adolescents with ADHD and their families as well as interventions to overcome these barriers. Families face a variety of structural and attitudinal barriers, ranging from cost and access to stigma and low self-efficacy to successfully implement change. There are multiple interventions that may enhance engagement with ADHD care including psychoeducation, integration of behavioral services in general medical settings, telehealth as well as specific adaptations to existing ADHD treatments, such as the use of motivational interviewing or shared decision making. Integration of behavioral health into general medical settings and telehealth have been found in controlled studies to increase access by reducing both structural and attitudinal barriers. Adding motivational interviewing, shared decision making and other engagement interventions to evidence-based ADHD treatments has been found to reduce attitudinal barriers that translates into improved participation and satisfaction while enhancing outcomes. However, little is known about how to promote extended engagement with ADHD services even though a chronic care model for ADHD is recommended.

Expressed Emotion and Attributions in Parents With Schizophrenia

We examined expressed emotion (EE) and attributions in parents with schizophrenia and compared them to parents without serious mental illness (SMI) in order to better understand the emotional climate of families in which a parent has schizophrenia. Parenting practices and parental reports of child behavior were also compared between the two groups. The relationship of EE to attributions was examined in each group separately. Relationships between parental mental health, EE, and attributions were explored in the parents with schizophrenia only. The Camberwell Family Interview was used to determine both EE and attributions in 20 parents with schizophrenia and 20 parents without SMI. We found that more parents with schizophrenia were rated as high EE than those without (60 and 35%, respectively) although this was not a statistically significant difference. Parents with schizophrenia demonstrated significantly more hostility and criticism toward their children than those without SMI and made more child-blaming attributions. Blame was associated with increased hostility, less warmth, and fewer positive remarks. Parental warmth was related to greater parenting self-efficacy, less harsh parenting practices, better child behavior, and a more positive parent-child relationship. We conclude that EE and attributions are potential explanatory variables to be considered in the development of preventative and early intervention strategies for families with a parent with schizophrenia or other psychotic disorder. Blame and warmth are modifiable factors that could be targeted within family and parenting interventions.

The Ecology of Youth Psychological Wellbeing in the COVID-19 Pandemic

The consequences of profound disruption to everyday life caused by the COVID-19 pandemic will only emerge over time. Guided by ecological systems (Pitchik et al., 2021) and developmental psychopathology (Masten & Cicchetti, 2010) frameworks, I review evidence that points to parents at home with children as particularly vulnerable to increased psychological difficulties, particularly in contexts of poverty. Resultant compromised parenting may reduce children's opportunities for the kinds of everyday interactions that promote cognitive and socioemotional development and expose them to increases in coercive, avoidant, and other problematic caregiving behaviours. I discuss three evidence-based strategies that parents could adopt to buffer their child's mental health: building positive discipline strategies, talking with the child about the pandemic and its consequences, and conversing about the past. I conclude, however, that approaches to supporting parents and their children at this time must also address multisystem factors that compromise caregivers' ability to provide nurturing care.

Practitioner Review: Parenting interventions for child conduct problems: reconceptualising resistance to change

Parenting interventions based on social learning theory have received extensive empirical support in the treatment of child conduct problems; yet, they fail to produce lasting gains in as many as a third of cases. Perspectives on these poor outcomes have been informed by numerous lines of research, and practitioner recommendations for improving such outcomes have often emphasized processes related to clinical engagement. In this Practitioner Review, we examine recent theory and evidence pertaining to these processes, including emerging research into the therapeutic relationship across face-to-face and eHealth treatment modalities, and the clinical engagement of both mothers and fathers. The concept of resistance to change is examined in light of these developments, and it is argued that the process of overcoming such resistance can be characterized as one of reflective practice. A novel process model based on this perspective is presented, comprising practical clinical strategies that are designed to be initiated from the earliest contacts with a family and build on one another across treatment.

Parental Attributions in Ethnocultural Minority, Immigrant, and Country of Origin Parents: A Scoping Review and Call for Research

OBJECTIVE

Maladaptive parental attributions for their children's behavior have been linked to poorer parenting skills, heightened child internalizing and externalizing difficulties, and parents' less willingness to engage in treatment. Although most parental attributions research has been focused on White or European-origin parents, attention has recently turned to ethnic and cultural groups that are underrepresented literature. The present scoping review synthesized existing work on parental attributions among ethnocultural minority and immigrant parents in an adopted country and parents residing in their native non-Western country of origin.

METHOD

A systematic search of five databases was conducted for literature published up to and including the last week of December 2020. Title and abstract screening, then full-text screening, identified 18 records for inclusion in the review.

RESULTS

Although descriptive, single-culture studies showed that maladaptive parental attributions were associated with poorer parenting and child outcomes across cultures, studies comparing ethnocultural groups demonstrated differences in parental attributions across groups.

CONCLUSIONS

Despite the rise in and importance of literature on parental attributions, these results point to a limited scope in understanding parental attributions of ethnocultural minority, immigrant, and country of origin parents. Gaps identified in the literature point to promising future research directions, and a call is made for culturally sensitive parental attribution measures.

Transdiagnostic Associations Among Parental Causal Locus Attributions, Child Behavior and Psychosocial Treatment Outcomes: A Systematic Review

Parents' interpretations of the cause of their children's behavior, i.e., parental attributions, are linked to parenting behavior and child development. However, it is not yet known whether parental attributions are systematically associated with children's internalizing and externalizing symptoms and behavior or psychosocial treatment engagement and outcomes across diagnostic categories. This systematic review aimed to fill this knowledge gap using a transdiagnostic perspective to synthesize the literature on the associations between parent-causal and child-responsible attributions and children's internalizing and externalizing behavior, treatment engagement, and treatment outcomes for parents and children. A total of 67 studies were identified. Overall, biased child-responsible attributions were associated with elevated child internalizing and externalizing symptoms and behavior across diagnoses, while findings on the association between parent-causal attributions and child behavior were inconsistent. The link between parental attributions and treatment engagement was also mixed, varying across treatment type, child diagnosis, and focus of attributions. Regarding treatment outcomes, less biased parent-causal and child-responsible attributions were linked to post-treatment improvements in children's behaviors, while mixed findings were reported on post-treatment improvements in parental attributions. Findings are discussed with a focus on approaches to enhance the effectiveness of assessment and psychosocial treatment approaches across diagnostic categories with consideration of parental attributions.

Psychometric Properties of the Parent Cognition Scale in a Clinical Sample of Parents of Children With Disruptive Behavior

The Parent Cognition Scale (PCS; Snarr, Slep, & Grande, 2009) is a self-report measure of parental attributions of child behavior that has demonstrated validity in community samples. However, its psychometric properties have not been examined in a clinical sample of parents of children with disruptive behavior. Examining the psychometric properties of the PCS in this population is important given research linking parent attribution with childhood disruptive behavior. The present study aimed to: (a) examine the psychometric properties of the PCS in a sample of parents whose children were clinic-referred for disruptive behavior problems; and (b) investigate the concurrent validity of the PCS and its factors using correlations with parent reports of children's emotional and behavioral difficulties, and parenting skills (i.e., discipline, supervision). A confirmatory factor analysis was run on 225 parents' responses on the PCS, and revealed that a two-factor structure of the PCS fit the data well. Significant correlations were found between Parent Causal Attributions (Factor 1) and parent-reported parenting difficulties. Child Responsible Attributions (Factor 2) were correlated with elevations in children's emotion, attention, and conduct difficulties. The results provide information on the utility of the PCS for parents of children with disruptive behavior and its potential clinical relevance.

Childhood adaptation: Perception of the parenting style and the anxious-depressive symptomatology

OBJECTIVES

Childhood adaptation is essential for proper social-emotional development. Children growing up in a family context where they feel supported and protected are less vulnerable in the presence of psychopathology. The aim of this study is analysing the impact of parenting styles and the anxious-depressive symptoms on child adaptation.

DESIGN AND SETTING

A total of 367 children between the ages of 10 and 12, following a similar distribution by sex. The children completed self-reports assessing parenting styles, child adaptation, and depressive-anxiety symptomatology.

METHODS

The data were analysed using two complementary methodologies: linear regressions and fuzzy-set qualitative comparative analysis (fsQCA).

RESULTS

Both methodologies indicated that the main predictors explaining child adaptation were depression and an authoritative parenting style. The fsQCA models explained a greater amount of variance and included more variables in their prediction than the regression models.

CONCLUSION

Identifying family and emotional aspects when working with children may help professionals to improve childhood adaptation. Consequently, well-adapted children are less likely to suffer the negative consequences of emotional symptoms in later evolutionary stages.

Effectiveness of a trauma-informed care psychoeducational program for foster carers - Evaluation of the Fostering Connections Program

BACKGROUND

The need to improve the quality of foster care training has been highlighted and evidenced-based programs that aim to support foster carers in the care of children who have experienced trauma are warranted.

OBJECTIVE

This study aimed to evaluate the effectiveness of the Fostering Connections program, a newly developed trauma-informed care program within the national child welfare agency in Ireland.

PARTICIPANTS AND SETTING

The study included 79 foster carers. The Fostering Connections group-based experiential intervention was delivered over a period of 6-weeks in a community-based setting to intervention group participants.

METHODS

A quasi-experimental design was used to compare the results of the intervention group (n = 49), to a control group (n = 30,) who received usual care. Standardized assessment measures were used at baseline, 6-weeks on completion, 16 weeks and 15 months post-intervention. Foster carers' knowledge of trauma-informed fostering, tolerance of misbehavior and fostering efficacy, and children's emotional and behavioral difficulties were assessed.

RESULTS

Significant improvements were found in foster carers' knowledge of trauma-informed fostering (p < 0.001), tolerance of child misbehavior (p = 0.007) and fostering efficacy (p < 0.001), with effect sizes ranging from medium to large and sustained over fifteen months (ES = 0.07-0.14). Significant improvement was also found in children's emotional and behavioral difficulties at fifteen months (p = 0.019), with a small effect size (ES = 0.05).

CONCLUSION

Preliminary evidence suggests that Fostering Connections is potentially an effective intervention in increasing foster carer's capacity to provide children with trauma-informed care.

How Do Mothers' Parental Attributions Affect Child Outcomes from a Positive Parenting Intervention? A Mediation Study

Problematic parental attributions refer to negative causal explanations for child problem behaviour and are known to predict parenting intervention outcomes. This study examines alternative accounts of how mothers' problematic parental attributions, operationalised as negative pre-treatment and change resistant parental attributions during treatment, may affect child behaviour outcomes from a parenting intervention program. Putative mediators included parental feelings about the child and use of harsh discipline. Participants were 163 families with children aged from 3 to 16 referred to specialist clinics for the treatment of conduct problems. Measures were collected as part of pre-treatment, post-treatment, and 3-month follow-up assessments. Mothers' pre-treatment and change resistant parental attributions were associated with smaller improvements in parental feelings at the end of treatment which in turn were associated with greater use of harsh discipline. Greater use of harsh discipline was associated with greater conduct problems overall. Smaller improvements in parental feelings mediated the effects of pre-treatment and change resistant parental attributions on outcomes in mothers' use of harsh discipline and mediated the effects of change resistant parental attributions on outcomes in child conduct problems. Smaller improvements in parental feelings about the child may act as a mechanism that explains the impact of problematic parental attributions on treatment outcomes.

Why is this Happening? A Brief Measure of Parental Attributions Assessing Parents' Intentionality, Permanence, and Dispositional Attributions of Their Child with Conduct Problems

We present and evaluate a new self-report measure of parental attributions developed for assessing child causal and dispositional attributions in parenting interventions. The Parent Attribution Measure (PAM) ascribes attributions along first-order dimensions of intentionality, permanence, likeability, and disposition, and a higher-order Total Scale. The psychometric analyses involved participants drawn from populations of clinical (n = 318) and community-based families (n = 214) who completed questionnaires assessing parental attributions, parenting behaviours, parental depression, parental feelings about the child, and child behavioural problems. Confirmatory factor analysis indicated that a 3-factor hierarchical structure provided a close fitting model. The model with intentionality, permanence, and disposition (consolidating likeability and disposition) dimensions as first-order factors grouped under a higher-order general factor was validated in independent samples and demonstrated sound psychometric properties. The PAM presents as a brief measure of parental attributions assessing parents' intentionality, permanence, and dispositional attributions of their child with conduct problems.

Parents' Spontaneous Attributions about their Problem Child: Associations with Parental Mental Health and Child Conduct Problems

Parents' attributions about their child's personality and behaviour are known to predict the quality of parent-child interactions and outcomes for the child, including those from parenting interventions. Nothing is known, however, about the quantity and quality of attributions parents use during free speech about their children referred for treatment of behavioural and emotional problems. We tested hypotheses about the types of attributions and associations among parental attributions, parental psychopathology and child conduct problems, using 504 five-minute speech samples (FMSS) coded using the Parent Attribution Speech Sample (PASS) coding system. Both mothers and fathers talked about their thoughts and feelings regarding their children with disruptive behaviour problems (N = 295; 74% male; 3-8 years old). The assessment of spontaneous parental attributions via the PASS coding system was shown to be valid and reliable. Mothers made more negative, dispositional attributions than fathers, however, parents of either gender made, on average, more positive than negative attributions about their children. Parents' natural attributions about these children with emotional and behavioural problems were rather independent from parents' own mental health, but were consistently related to child factors. Specifically, across parent gender and across all attribution dimensions, levels of callous-unemotional traits were associated with spontaneous parental attributions above and beyond other child and parent factors. Overall, the results show that parents' spontaneous speech about referred children contains important information about their causal attributions, and that these are associated with child temperament rather than specific referral symptoms.

The role of parental attributions in predicting parenting intervention outcomes in the treatment of child conduct problems

BACKGROUND

Parent attributions about the causes of their children's behaviour problems are a known predictor of problematic parenting and ongoing child problems. However, their importance in parenting interventions remains unknown as research has not addressed whether parental attributions predict outcomes associated with parenting training. The current study examined whether problematic pre-treatment and change resistant parental attributions during treatment uniquely predict child behaviour outcomes.

METHOD

Participants were 250 families with children aged from 3 to 16 referred to specialist clinics for the treatment of conduct problems. Measures of family demographic information, parental attributions, and severity of child conduct problems were collected as part of pre-treatment, post-treatment, and 3-month follow-up assessments.

RESULTS

Linear regression showed that mothers' pre-treatment parental attributions uniquely predicted severity of conduct problems at the post-treatment and 3-month follow-up assessments. Fathers' pre-treatment parental attributions uniquely predicted severity of conduct problems at the 3-month follow-up assessment. Reductions in problematic pre-treatment parental attributions were recorded at post-treatment for both parents. However, smaller reductions or increases in mothers' problematic attributions uniquely predicted worse child behaviour outcomes, a result not replicated for fathers.

CONCLUSIONS

Findings that pre-treatment and change resistant parental attributions predict poorer child behaviour outcomes after controlling for other predictors and treatment effects recommend that parental attributions should be assessed prior to and after treatment and possibly included in treatment to maximise treatment gains for children with conduct problems.

Confirmatory factor analyses of the Parent Attributions Questionnaire among Asian immigrant mothers

The present study examined the factor structure of maternal attributions regarding their caregiving experiences, measured by the Parent Attributions Questionnaire, among Asian immigrant mothers. Chinese and Korean immigrant mothers ( N = 333, mean age ( Mage) = 36.79 years, standard deviation ( SD) = 4.79) with preschool children ( Mage = 4.43 years, SD = 1.31) reported their attributions regarding the reasons for their success and failure at seven daily caregiving tasks, and demographic information. Three structure models were tested: the unidimensional structure model; the internal–external structure model; and the controllable–uncontrollable structure model. Results revealed that the controllability-based structure fitted the data better than the unidimensional or locus-based structure of parental attributions. Metric and partial scalar invariance of the controllability-based model were established between Chinese and Korean immigrant mothers. Asian immigrant mothers focused on whether the causes for the parenting outcomes were controllable or uncontrollable when attributing the causes of their caregiving experiences. The superiority of the controllable–uncontrollable over the internal–external structure model in this sample may reflect Asian immigrant mothers’ Confucian-based heritage cultural emphasis on their responsibility for creating optimal childrearing for their children.