Parental Meta-Emotion Philosophy and Emotion Coaching in Families of Children and Adolescents with an Anxiety Disorder

Transgenerational transmission of psychopathology: when are adaptive emotion regulation strategies protective in children?

BACKGROUND

Children of parents with a mental illness (COPMI) have multiple psychological and developmental risks, including an increased lifetime risk of developing a mental illness themselves. Emotion regulation (ER) has been identified as a potential underlying mechanism of the transgenerational transmission of mental disorders. This study compares ER strategies in parents with and without a mental illness and their children. Further, it aims to examine the relationship between parents and children's psychopathology with a focus on the role of parental and child ER.

METHODS

Participants were 96 COPMI (77% female) and 99 children of parents without mental illness (COPWMI, 83% female) aged 4-16 years and their parents. Psychopathology and ER strategies of parents and children were assessed with a series of questionnaires.

RESULTS

Both COPMI and their parents showed significantly more psychopathology and more maladaptive and adaptive ER strategies in comparison with COPWMI and their parents. Parent and child adaptive ER strategies mediated the relationship between the psychopathology of parents and children only when child maladaptive ER strategies were low.

CONCLUSIONS

The findings further our understanding of the processes by which parental psychopathology affects child outcomes. Our findings highlight the importance of implementing preventive programs that specifically target the reduction of maladaptive ER in children to interrupt the transgenerational transmission of psychopathological symptoms.

Emotion-focused skills training for parents with anxious children. A pilot study

Anxiety disorders are common among children and adolescents. Effective treatments exist, but meta-analyses indicate that 40% of children continue to have significant symptoms posttreatment. Alternative therapeutic interventions are needed. Emotion-focused parental interventions have been found to be effective in targeting children's internalizing difficulties, but no research has examined remission. In this pilot trial, we examined whether Emotion Focused Skills Training (EFST) was associated with remission of diagnosis in children with anxiety. Nine 8-14-year-olds diagnosed with anxiety were recruited at a mental health clinic in Norway. Both parents of each child attended a 2-day EFST program followed by five 1-hour weekly sessions. Pre- and posttreatment diagnosis and severity were evaluated using a multiinformant approach using the Spence Children's Anxiety Scale and the Anxiety Disorders Interview Schedule. After treatment, 33% no longer met criteria for any anxiety diagnosis, 66% obtained remission from their primary anxiety diagnosis, and 89% from at least one.

Brief emotion-focused family therapy: A 12-month follow-up study

This study provides a 12-month follow-up evaluation of caregivers after participating in a 2-day Emotion-focused family therapy (EFFT) intensive, a brief intervention for caregivers of youth struggling with mental health difficulties. Caregivers (N = 498) of children (N = 337) completed measures of caregiver self-efficacy and child mental health difficulties 1 week before the intervention, immediately after the intervention, and at 4, 8, and 12-month follow-ups. Piecewise latent trajectory models revealed that parental self-efficacy showed a large immediate increase following the intervention, β = 1.61 (1.32, 2.14), and although this effect was attenuated by 4 months, β = -0.77 (-1.31, -0.52), it did not change further by 12 months. Reductions in child mental health difficulties were observed by 4 months, β = -0.54 (-0.77, -0.37), and remained stable through the 12-month follow-up. Caregivers reporting more increases in self-efficacy also reported greater reductions in their children's symptoms at 4 and 12 months.

The Influence of Parents on Emotion Regulation in Middle Childhood: A Systematic Review

Emotion regulation (ER) has been identified as a transdiagnostic risk factor for psychopathology, making it an ideal target for prevention and treatment. This study explores how parents can nurture the development of child ER. In April 2022, a systematic review was executed focusing on malleable factors in the parental emotion-socialization process during middle childhood. Papers in PubMed, Web of Science and Medline were screened on content-related and methodological criteria. Their methodological quality was assessed. Knowledge was assembled using a summarizing framework encompassing four factors involved in emotion socialization. Fifty papers shed light on modifiable factors at the level of parental meta-emotion philosophy, emotion-related socialization behaviors, the ER skills of parents and the emotional climate of the family. Adaptive socialization appears to be context- and child-specific, thereby taxing parents' ER skills and their ability to put them into practice flexibly. The four changeable factors in the emotion-socialization process are highly intertwined, resulting in four possible entries for parent-directed interventions. Importantly, time should be devoted to the ER capacities of parents and their ability to attune to the situation and their child. Regarding the latter, replication studies are necessary. Recommendations for clinical interventions are provided.

Profiles of Emotion Socialization Across Development and Longitudinal Associations with Youth Psychopathology

Although there is relative consensus in the literature regarding associations between certain emotion socialization (ES) strategies and youth behavioral health, there is very limited research from a person-centered perspective. To address this gap, the current study examined patterns of ES strategies in families and explored predictors and youth outcomes associated with those patterns. An economically-diverse sample of 229 predominately White mothers and fathers of youth aged 3-12 years was recruited online for a longitudinal study. Latent profile analysis was used to determine the optimal number of family clusters with similar ES profiles. Model fit supported a four-class model, which consisted of an Emotion Coaching profile, characterized by the lowest levels of putatively labeled unsupportive ES practices and the highest levels of putatively labeled supportive ES practices, a Moderate profile characterized by moderate levels of both unsupportive and supportive ES practices, a Limited Engagement profile characterized by low levels of both unsupportive and supportive ES practices, and an Emotion Dismissing profile characterized by the highest levels of unsupportive ES practices and the lowest levels of supportive ES practices. Cross-sectional and longitudinal differences were observed across the ES profiles with regard to demographic and parent emotional competence predictors and youth outcomes. The current study extends the literature on ES by providing evidence on how distinct ES profiles differentially predict youth behavioral health outcomes. Findings also underscore the importance of examining parent emotional competence as a catalyst for adaptive change in the family system.

Emotion Coaching Intervention for Chinese Mothers of Preschoolers: A Randomized Controlled Trial

Preschoolers' emotional development typically hinges on the family emotional climate and their interactions with caregivers. This study used a randomized controlled trial to examine the treatment efficacy of an emotion coaching parenting intervention culturally adapted from the Tuning in to Kids^® (TIK) program in enhancing Chinese mothers' emotional responsiveness in parenting. A total of eighty-nine mothers with preschoolers were randomly assigned to either the intervention or waitlist control group. The TIK group received six weekly sessions of intervention on emotion coaching parenting training. The training significantly improved participating mothers' positive involvement and the use of emotion coaching in their parenting practices. More expressive encouragement and emotion-focused reactions to children's emotion expression, and less punitive parenting and emotional dismissing were also found in the mothers after training. Our findings provided the first evidence in a non-Western sample to support the effectiveness of such program in enhancing parents' efficacy in facilitating their children's emotional development.

Profiles of Emotion Socialization Across Development and Longitudinal Associations with Youth Psychopathology

Although there is relative consensus in the literature regarding associations between certain emotion socialization (ES) strategies and youth behavioral health, there is very limited research from a person-centered perspective. To address this gap, the current study examined patterns of ES strategies in families and explored predictors and youth outcomes associated with those patterns. An economically-diverse sample of 229 predominately White mothers and fathers of youth aged 3-12 years was recruited online for a longitudinal study. Latent profile analysis was used to determine the optimal number of family clusters with similar ES profiles. Model fit supported a four-class model, which consisted of an Emotion Coaching profile, characterized by the lowest levels of putatively labeled unsupportive ES practices and the highest levels of putatively labeled supportive ES practices, a Moderate profile characterized by moderate levels of both unsupportive and supportive ES practices, a Limited Engagement profile characterized by low levels of both unsupportive and supportive ES practices, and an Emotion Dismissing profile characterized by the highest levels of unsupportive ES practices and the lowest levels of supportive ES practices. Cross-sectional and longitudinal differences were observed across the ES profiles with regard to demographic and parent emotional competence predictors and youth outcomes. The current study extends the literature on ES by providing evidence on how distinct ES profiles differentially predict youth behavioral health outcomes. Findings also underscore the importance of examining parent emotional competence as a catalyst for adaptive change in the family system.

Academic performance under COVID-19: The role of online learning readiness and emotional competence

The COVID-19 pandemic caused school closures and social isolation, which created both learning and emotional challenges for adolescents. Schools worked hard to move classes online, but less attention was paid to whether students were cognitively and emotionally ready to learn effectively in a virtual environment. This study focused on online learning readiness and emotional competence as key constructs to investigate their implications for students' academic performance during the COVID-19 period. Two groups of students participated in this study, with 1,316 high school students (Mean age = 16.32, SD = 0.63) representing adolescents and 668 college students (Mean age = 20.20, SD = 1.43) representing young adults. Structural equation modeling was conducted to explore the associations among online learning readiness, emotional competence, and online academic performance during COVID-19 after controlling for pre-COVID-19 academic performance. The results showed that, for high school students, both online learning readiness and emotional competence were positively associated with online academic performance during COVID-19. However, for college students, only online learning readiness showed a significant positive relationship with online academic performance during COVID-19. These results demonstrated that being ready to study online and having high emotional competence could make adolescents more resilient toward COVID-19-related challenges and help them learn more effectively online. This study also highlighted different patterns of associations among cognitive factors, emotional factors, and online academic performance during COVID-19 in adolescence and young adulthood. Developmental implications were also discussed.

Childhood maltreatment and emotional distress: The role of beliefs about emotion and psychological inflexibility

The current study aimed to investigate the mediating role of negative beliefs about emotion and psychological inflexibility on the relationship between childhood maltreatment and emotional distress. A total of 519 participants completed the Childhood Trauma Questionnaire (CTQ), Depression Anxiety Stress Scale-21 (DASS-21), the Leahy Emotional Schema Scale II (LESS-II), and the Acceptance and Action Questionnaire-II (AAQ-II). All scales were significantly correlated. Two mediation analyses were tested. In the first model negative beliefs about emotion and psychological inflexibility mediated the relationship between childhood maltreatment and emotional distress measured by DASS-21 total score. In the second model, negative beliefs about emotion and psychological inflexibility mediated the relationship between childhood maltreatment and depression, anxiety, and stress measured by the subscales of DASS-21. Results suggest that maltreatment in childhood is associated with the individuals' approaches, plans and strategies in response to emotions, and psychological inflexibility which together further determine emotional distress.

Evaluating the Effect of Parent-Child Interactive Groups in a School-Based Parent Training Program: Parenting Behavior, Parenting Stress and Sense of Competence

The Exploring Together program is a group-based parent training program that comprises separate parent, child, and teacher components, and a combined parent-child interactive component. A cluster-randomized trial design was used to compare the Exploring Together program with (Exploring Together; ET) and without (Exploring Together-Adapted; ET-Adapted) the parent-child interactive component. One hundred and thirty-six parents and their children (aged 5-10 years) with externalizing and/or internalizing problems participated in the trial, recruited from primary schools. There was a significant reduction in negative parenting behavior across both treatment groups (ET and ET-Adapted) but no significant improvement in positive parenting behaviors. Parenting self-efficacy improved significantly across both treatment groups however there was no significant change in parenting satisfaction or parenting stress. There was no consistent evidence of superiority of one version of the Exploring Together program over the other. Further investigation regarding treatment dosage and mastery of parenting skills associated with the program is warranted.

Emotion Socialization and Internalizing Problems in Late Adolescence and Emerging Adulthood: Coping Styles as Mediators

This study examined coping strategies as mediators of the relationship between parental emotion socialization and internalizing problems in late adolescence and emerging adulthood, and whether these relationships varied by gender or ethnicity. Participants were 1,087 individuals (Mage = 19.35 years; 50% male; 61% African American, 36% European American). Results from structural equation modeling indicated that parental supportive responses to sadness and fear were associated with less emotional distress, and this relationship was partly mediated by greater use of task-oriented coping and lower use of emotion-oriented coping. Parental unsupportive responses were related to greater emotional distress, and this relationship was fully mediated by greater use of emotion-oriented coping. Gender and ethnic differences emerged in the links between parental responses and several coping strategies. The findings suggest that parental emotion socialization may contribute to emotional functioning by fostering specific coping strategies, with some differences across gender and ethnicity.

Mothers' negative emotional expression and preschoolers' negative emotional regulation strategies in Beijing, China: The moderating effect of maternal educational attainment

The relationship between mothers' negative emotional expression and preschoolers' negative emotional regulation has been a topic of debate. Studies have confirmed the unique effect of maternal education on children's emotional regulation. Further understanding of the role of maternal educational attainment in the relationship between mothers' emotional expression and children's emotional regulation strategies will help us better explain the possible reasons for the differences in children's emotional regulation abilities. In this study, 503 Chinese mother-child dyads were recruited. The Chinese version of the Self-Expressiveness in the Family Questionnaire (SEFQ) was used to measure the mothers' negative emotional expression, and the Emotional Regulatory Strategy Questionnaire (ERQ) was used to measure the children's negative emotional regulation strategies. The results indicated that mothers' negative emotional expression was positively related to children's negative emotional regulation strategies. Moreover, maternal educational attainment moderated this relationship. The findings of the current study demonstrate the importance of mothers' educational background, providing an important supplement to and extension of previous research on family emotions.

Maternal Attributions of Infant Behavior and Parenting in Toddlerhood Predict Teacher-Rated Internalizing Problems in Childhood

Social-information-processing theories of parenting posit that parents' beliefs and attributions about their children's behaviors contribute to how parents interact with their children. The purpose of this study was to examine the associations between negative parenting attributions in infancy, harsh-intrusive parenting in toddlerhood, and children's internalizing problems (IPs) in early childhood. Using data from a diverse longitudinal study (n = 206), the current study used a structural equation modeling approach to test if mothers' negative attributions measured at 6 months predicted teacher ratings of children's IPs in 1st grade, as well as the extent to which observed harsh-intrusive parenting behaviors measured at ages 1, 2, and 3 years mediated this link. Maternal negative attributions in infancy predict more IPs in 1st grade, but this link becomes nonsignificant when observed harsh-intrusive parenting is included as a mediator. A significant indirect effect suggests that harsh-intrusive parenting mediates the association between early negative attributions and eventual IPs. Findings from this study identify harsh-intrusive parenting behaviors as one potential mechanism through which the effects of early attributions are carried forward to influence children's IPs. The developmental and clinical implications of these findings are discussed.

Influence of maternal negative emotion reactivity and cognitive reappraisal on child anxiety disorder

BACKGROUND

Anxiety disorders are among the most common psychopathologies in childhood. Two underlying contributors to child anxiety disorders (ADs) are negative emotional hyper-reactivity and deficits in reappraisal, a cognitive strategy of emotion regulation. Given that emotion regulation develops in the context of parent-child interaction, the aim of this study was to fill a research gap regarding the association between maternal negative emotional reactivity (NER) and reappraisal and child anxiety by examining (a) whether mothers of children with ADs display abnormalities in emotional reactivity and reappraisal compared to mothers of children without ADs; (b) whether maternal NER and reappraisal are associated with child anxiety; and (c) whether maternal reactivity and reappraisal significantly explain the variance in the level of child anxiety beyond the level of maternal anxiety.

METHOD

Forty-nine mothers and their AD children (aged 10-17) were assessed at admission to an anxiety disorder clinic and were compared to a control group of 42 mothers and their non-anxious (NA) children. Child and maternal anxiety were assessed, as well as maternal NER and reappraisal.

RESULTS

Mothers of AD children showed a higher NER as well as reappraisal deficits compared to the control group. Self-rated child anxiety was associated with maternal deficits in reappraisal. The variance in child anxiety was significantly explained by the level of maternal anxiety as well as maternal reappraisal deficits.

CONCLUSIONS

This study suggests that maternal NER and reappraisal play an important role in child anxiety and should be considered in prevention and intervention of childhood ADs.

Adapting to the changing needs of adolescents: parenting practices and challenges to sensitive attunement

Changes in adolescents' motivations and capabilities pose unique challenges to parents who play a continuing role in ensuring the youth's safety and well-being. We describe sensitively attuned parenting as an optimal response to this challenge and summarize practices of positive engagement, supervision/guidance and open communication that support sensitive attunement and facilitate the continuing development of the adolescent's self-confidence, autonomous decision-making, and communication skills. We then consider factors that require parents to adapt their practices to the particular needs and developmental level of the adolescent. Individual differences that may challenge parent's effectiveness in implementing these practices include: biological vulnerabilities, differential sensitivity to parenting, relationship history and temperament. Clinical interventions that seek to improve parenting offer an opportunity to test sensitive attunement as a mechanism for reducing adolescents' symptoms and problem behaviors.