Associations between maternal and paternal parenting behaviors, anxiety and its precursors in early childhood: A meta-analysis

Supporting parents to reduce children's anxiety: A meta-analysis of interventions and their theoretical components

Parent-focused interventions hold promise for reducing child anxiety, but their content varies greatly, and little is known on the intervention content. We estimated the effects of parent-focused interventions on child anxiety and the most effective combinations of theoretical components. We searched PsycINFO, Medline, and Web of Science in October 2022 for randomized trials on parent-focused interventions to reduce children's anxiety. We used robust variance estimation to estimate main effects and differential effects by individual theoretical components, and network meta-analysis to estimate the effects of clusters of components (preregistration: PROSPERO CRD42022362983). We identified 26 studies (k = 157, N = 4098). Parent-focused interventions had a significant medium effect on children's anxiety (d = -0.59; 95% CI [-0.92, -0.26]). Interventions used seven theoretically distinct components. No significant differential effects were found, but all clusters of components that produced significant effects contained a behavioral component. Adding cognitive and emotional components to behavioral components seemed beneficial. This meta-analysis highlights the potential of parent-focused interventions for children's anxiety, and of behavioral components in particular, but is limited by the very low certainty of evidence. More high-quality research is needed to understand the exact potential of parent-focused interventions on children's anxiety, and their most effective components.

Family-centered profiles of mindful parenting: Longitudinal associations with negative parenting and youth emotional and behavioral problems

There has been great interest in analyzing the potential of mindful parenting in promoting family well-being. Studies indicated that there is a lack of research on the predictive relationship between parenting practice and youth emotional and behavioral problems analyzed from a multi-informant perspective. This study evaluates the family-centered profiles of mothers and fathers' mindful parenting and negative parenting and youth problems associated with those profiles. A total of 441 youths (aged 9-14 years), along with their parents, answered self-report questionnaires in a three-wave longitudinal study conducted over 1 year. A latent profile analysis was performed to examine the mindful parenting profiles and to identify their associations with youth emotional and behavioral problems and negative parenting as outcomes. The results of latent profile analyses supported a three-profile solution: low mindful parenting family (35%), high maternal mindful parenting family (24%), and average mindful parenting family (41%). The low mindful parenting family profile showed the highest scores on negative parenting and youth emotional and behavioral problems. The high maternal mindful parenting family profile had the lowest scores on youth negative outcomes but demonstrated similar levels to those of the average mindful parenting family profile regarding negative parenting. Our findings highlight the importance of analyzing specific family profiles that help to develop personalized interventions with optimized treatments regarding family cohesion and environment.

A Psychometric Evaluation of the Parenting Anxious Kids Rating Scale (PAKRS-PR) in a Sample of Families with Clinically Anxious Children

The Parenting Anxious Kids Rating Scale-Parent Report (PAKRS-PR) measures five types of anxiogenic parenting. The present study aimed to extend the previous psychometric evaluation of the PAKRS-PR to a treatment-seeking sample and examine sensitivity to change over 15 sessions of cognitive behavioral therapy. The sample included 383 parent-child dyads presenting to treatment at a specialty outpatient clinic. Cronbach's α was acceptable for the PAKRS-PR Total scale and several subscales, although the Accommodation/Beliefs and Warmth/Support subscales were in the unacceptable/questionable range. Convergent validity was found to be mixed with the closest relationship between anxiety severity and the Accommodation/Beliefs, Warmth/Support, and Conflict PAKRS-PR subscales. Additionally, the PAKRS-PR Total score and subscales changed significantly throughout treatment, but were not associated with treatment response or child- or clinician-rated treatment outcome measures. Overall, the current findings demonstrate some support for the psychometric properties of the PAKRS-PR; however, further refinement of the PAKRS-PR at the item-level is recommended to further strengthen the measure.

Maternal and paternal harsh parenting and anxiety symptoms in Chinese adolescents: examining a multiple mediation model

BACKGROUND

Harsh parenting has been recognized as a risk factor for adolescent anxiety; however, the underlying mechanisms of this relationship remain unclear, and it is unknown whether this relationship is influenced by different parental roles and living arrangements. This study aimed to investigate the mediating mechanisms between harsh parenting and adolescent anxiety symptoms using a multiple mediation model and to further compare specific roles of harsh parenting and distinguish between the living arrangements.

METHODS

A total of 3505 adolescents completed this survey, and 3295 adolescents (54.7% girls, Mage = 14.97 years) were included in the study. Participants completed self-assessments measuring harsh parenting, self-efficacy, school connectedness, Internet addiction, sleep problems, and anxiety. They were categorized into three groups based on living arrangements: living with both parents, only with the mother, or only with the father.

RESULTS

Correlational analyses revealed that both maternal and paternal harsh parenting were associated with increased anxiety symptoms. Structural equation modeling (SEM) mediation analyses and multigroup analyses showed that the independent mediating effects of school connectedness, Internet addiction, and sleep problems, as well as the sequential mediating pathways involving self-efficacy → school connectedness, self-efficacy → Internet addiction, and self-efficacy → sleep problems, vary across the adolescents' living arrangements in the association between maternal and paternal harsh parenting and adolescent anxiety symptoms.

CONCLUSIONS

This study elucidated the mechanisms linking harsh parenting to adolescent anxiety symptoms and validated the effects of different parental roles and living arrangements. The findings provide important insights for developing targeted interventions to address anxiety symptoms in adolescents exposed to harsh parenting.

Anxiety Symptom Trajectories Predict Depression Symptom Trajectories up to Four Years After CBT for Youth Anxiety Disorders

Long-term data on depression symptoms after cognitive behavioral therapy (CBT) for youth anxiety disorders are scant. We examined depression symptoms up to four years post CBT for anxiety addressing youth age and gender, family social class, and parent mental health as predictors. The sample comprised 179 youth (M age at pre-treatment = 11.5 years; SD = 2.1) in a randomized controlled trial. Clinically assessed anxiety diagnoses and youth and parent-reported anxiety and depression symptoms were measured before, after, and one and four years after CBT. Parent self-reported mental health was measured before CBT. We used regression analyses to determine whether full diagnostic recovery at post-CBT predicted depression trajectories across the four-year assessment period. We used growth curve models to determine whether anxiety trajectories predicted depression trajectories across the four-year assessment period. Youth who lost their anxiety diagnoses after CBT had significantly lower parent-reported depression levels over time, but not lower youth self-reported depression levels. The anxiety symptom trajectory predicted the depression symptom trajectory up to four years post-treatment. There was more explained variance for within-informant (youth-youth; parent-parent) than cross-informants. Being older, female, having lower socio-economic status and parents with poorer mental health were associated with more youth-rated depression over time. However, these demographic predictors were not significant when anxiety symptoms trajectories were added to the models. Successful CBT for anxiety in children is associated with less depression symptoms for as long as four years. Anxiety symptom improvement appears to be a stronger predictor that demographic variables and parent mental health.

Parental Overprotection and Locus of Control as the Mechanisms Explaining the Relationship Between Parent and Child Anxiety: A Multiple Mediation Model

The study probes the role played by parenting control practices and parental locus of control in the relationship between parent and child anxiety. The study particularly aims at probing these matters in light of the parental gender-specific role, striving to improve our understanding of the differential etiological contribution of mothers' and fathers' anxiety and parental practices to child's anxiety. The study consisted of 316 parents (159 mothers and 157 fathers) who reported their own and their child's anxiety using valid instruments. The general path model used in the study exhibited an adequate fit to the data, generally confirming our theory regarding the direct and indirect associations between parent-child anxiety. Using SEM multiple group analysis for parental gender, a strong-direct unique association was found between parent and child anxiety. For mothers, this association was partially mediated by maternal overprotection. Finally, maternal external locus of control was positively associated with child anxiety, after accounting for the effects of all other maternal variables. The study's findings and limitations are profoundly discussed in light of parental gender differences.

Psychometric Properties of the Japanese Translation of the Parent Overprotection Measure for Mother and Father Reports

The Parent Overprotection Measure (POM) is a promising scale to measure parent overprotection toward a child from the parent's perspective. However, no Japanese translation of the scale has been developed, and whether the POM can be applied to a Japanese population is unknown. This study translated the POM into Japanese and examined its psychometric properties. Parents of 380 children aged 4 to 7 years (including 190 mothers and 190 fathers) completed online questionnaires. Exploratory and confirmatory factor analyses (CFA) indicated that the Japanese translation of the POM has a bi-factor structure, including one general factor (general overprotection) and two specific factors (care/attention and control/prevention). The measurement invariance of reports from mothers' and fathers' perspectives was confirmed by multiple group CFA. The McDonald's Omega was acceptable for all factors, but the general overprotection factor explained most scale variance. Pearson's correlation coefficients were more than .20 between the control/prevention factor and child anxiety symptoms in both mother and father reports. The correlation between the control/prevention factor and parent anxiety according to fathers' reports also exceeded .20. These results provided the factor structure and supported the reliability of the POM among a Japanese population; however, further investigation of the validity of the scale is needed.

Is parental overcontrol a specific form of child maltreatment? Insights from a resting state EEG connectivity study

INTRODUCTION

Recent studies suggest that parental overcontrol could be considered a specific form of childhood trauma (CT). Although previous research has shown that CT alters the functional and structural architecture of large-scale networks in the brain, the neural basis associated with parental overcontrol has not been sufficiently explored. Therefore, the main aim of the current study was to investigate the relationship between parental overcontrol and electroencephalography (EEG) triple network (TN) functional connectivity during the resting state (RS) condition in a non-clinical sample (N = 71; 39 females, mean age 23.94 ± 5.89 SD).

METHODS

EEG was recorded during 5 min of RS with eyes closed. All participants were asked to self-report maternal and paternal overcontrol, CT and general psychopathology. All EEG analyses were performed using the exact low-resolution electromagnetic tomography software (eLORETA).

RESULTS

Our results showed a significant positive correlation between maternal overcontrol and theta connectivity between the salience network and the central executive network. This connectivity pattern was independently associated with maternal overcontrol even when controlling for relevant confounding variables, including the severity of CT and the general level of psychopathology. This neurophysiological pattern may reflect a predisposition to detect and respond to potentially threatening stimuli in the environment, which is typically associated with excessive overcontrol.

CONCLUSIONS

Our findings support the hypothesis that parental overcontrol should be considered a form of CT in all respects independent of the forms traditionally studied in the literature (i.e., emotional abuse, physical abuse, sexual abuse, and physical and emotional neglect).

Childhood maltreatment, parenting style and anxiety in Chinese youths: A case-control study

BACKGROUND

Although evidence in supporting the associations between childhood maltreatment (CM), parenting style and anxiety in children and adolescents exists, few high-quality analytical epidemiological studies which focusing on clinically diagnosed anxiety disorders (AD) had been published.

OBJECTIVE

The aim of this study was to further corroborate the associations between CM, parenting style, and AD in a large representative sample of Chinese children and adolescents.

PARTICIPANTS AND SETTING

Study subjects were derived from the Mental Health Survey for Children and Adolescents in Yunnan (MHSCAY), a population-based cross-sectional program.

METHODS

Individually matched case-control study design was adopted. Univariate and multivariate conditional binary logistic regression models were used to estimate the associations between CM, parenting style and AD. Dose-response trends were estimated using the Cochran-Armitage Chi-square test. A series of stratified analyses were conducted to explore effect modification on exposure-outcome association by some important features.

RESULTS

Totally we screened out 202 cases and 404 matched controls, with an age mean of 14.43 years. Conditional logistic regression models revealed that EA and a higher level of parental over-protection were significantly associated with increased risk of AD, with adjusted ORs of 3.39 (95 % CI: 2.07-5.56) and 1.93 (95 % CI: 1.28-2.90). Stratified analysis identified noticeable effect modification by sex, age, and whether the only child in the family.

CONCLUSIONS

Major findings of this study suggested that children and adolescents who had experienced EA or raised up by over-protective parents are at increased risk of AD. Targeted intervention measures should be developed and implemented for these high-risk youths.

Assessing anxiety problems in a community sample during toddlerhood: The impact of child temperament and maternal intrusiveness

Previous research indicates that child temperament and maternal behaviors are related to internalizing behaviors in children. We assessed whether maternal intrusiveness (MI) observed at 10-months would moderate the impact of temperamental fear and the impact of inhibitory control (IC) at 24 months on anxiety problems at 36 months. A mother-child interaction task was coded for MI. Behavioral tasks were given to assess children's IC. Parents completed questionnaires about their children's temperamental fear and anxiety problems. Results showed that greater temperamental fear reported at 24 months predicted greater anxiety problems reported at 36 months, regardless of MI levels. Lower levels of IC at 24 months predicted more anxiety problems reported at 36 months when children experienced greater MI. These findings illustrate the importance of examining both intrinsic and extrinsic factors, independently and interactively, that contribute to children's anxiety problems in toddlerhood.

Associations between challenging parenting behavior and creative tendencies of children: the chain mediating roles of positive emotion and creative self-efficacy

Background

Parenting behavior has been reported to be closely associated with children's creativity, yet the association between challenging parenting behavior and children's creative tendencies, as well as the potential mechanisms connecting the two, remains ambiguous. Based on the Social Cognitive Theory and the Self-efficacy Theory, this study aims to examine the correlation between Chinese parents' challenging parenting behaviors and their children's creative tendencies, as well as the chain mediating role of children's positive emotions and creative self-efficacy.

Methods

In total, 2,647 families were surveyed with questionnaires completed by parents on the Challenging Parenting Behaviors Scale and by children on the Positive/Negative Emotions Scale, the Creative Self-efficacy Scale, and the Williams Creative Tendency Test Scale, and analyzed using structural equation modeling (SEM) in SPSS 22.0 and Mplus 8.3.

Results

The findings indicate that challenging parenting behavior has a positive correlation with children's positive emotions, creative self-efficacy, and creative tendencies. Through positive emotions, creative self-efficacy, and a chain mediated pathway between these two variables, challenging parenting behaviors increase children's creative tendencies.

Conclusion

The favorable impacts of challenging parenting behaviors on children's creative tendencies, with the mediating effects of children's positive emotions and creative self-efficacy, may help Chinese parents better grasp the mechanisms underlying this association.

Intergenerational relations in childhood anxiety: A network approach

OBJECTIVE

Family factors are assumed to play a central role in the development of childhood anxiety disorders. How child and parental anxiety symptoms are intertwined on a symptom and family level has not yet been examined. Such knowledge may lead to a more detailed understanding of the intergenerational relation in anxiety problems. The current study investigated the relation between anxiety in children and their parents at a symptom level using a network approach.

METHOD

Parents of 1,452 clinically referred children in the Netherlands completed questionnaires on anxiety about their children and themselves. We examined relations on a symptom level both within persons and between parents and children. In addition, we also compared the relations between parental and child anxiety symptoms in families with children with an anxiety disorder (n = 350) versus families with children who displayed other psychiatric diagnoses (n = 1,102).

RESULTS

Anxiety symptom relations within persons were more intertwined than the symptom relations between family members. Between-person relations were found among similar anxiety symptoms, suggesting specific intergenerational relations. The feeling of being fearful was found to be a central and connecting symptom in all family members (fathers, mothers, and children). The relations between parental and child anxiety symptoms were more specific (i.e., among similar symptoms) in families with children with an anxiety disorder than in families with children with other types of psychopathologies.

CONCLUSIONS

This study found that anxiety symptom associations are present within the family on a detailed (symptom) level. This stresses the importance of future studies to examine factors responsible for this family-anxiety transmission.

Longitudinal effects of maternal depressive and anxious symptomatology on child hair cortisol and cortisone from pregnancy to 5-years: The EDEN mother-child cohort

Exposure to maternal depressive and anxious symptomatology in utero and after birth can affect child outcomes. One proposed mechanism is through changes in child stress hormone levels, however current studies present inconsistent findings, and further research is needed to better understand the impact of maternal mental health on child stress response. This study aims to add to the limited literature by analysing longitudinal data ranging from 24 weeks amenorrhea to 5 years postpartum among 281 mother-child pairs from the French EDEN mother-child birth cohort. Hair cortisol and cortisone data were collected from children at four time points: birth, 1, 3, and 5 years. Mothers reported depressive symptomatology via the Center for Epidemiologic Studies Depression Scale (CES-D) (at 24-weeks amenorrhea, 3-, and 5-year follow-up), and the Edinburgh Postnatal Depression Scale (EPDS) (at 4, 8 and 12 months postpartum). Prenatal anxiety symptomatology was measured via the State Anxiety Inventory (STAI) at 24 weeks amenorrhea. Group-based trajectory modelling indicated a 1-cluster classification of longitudinal child hair cortisol, cortisone and cortisol-to-cortisone ratio, as analyses did not reveal a classification by subgroups representing different child profiles. After inverse probability weighting, small effects showed prenatal depressive symptomatology was significantly associated to higher levels of child hair cortisone at one year. Prenatal anxiety symptomatology was significantly linked to higher levels of child cortisol measured at birth and cortisone at birth and at 1 year. Postpartum depressive symptomatology at 8 months was related to higher levels of cortisone among 3-year-olds. These effects were not moderated by child sex or maternal socio-economic status. Further research is needed to understand why there are associations at some time points and not others to determine any potential buffering factors.

Lower maternal emotional availability is related to increased attention toward fearful faces during infancy

It has been suggested that infants' age-typical attention biases for faces and facial expressions have an inherent connection with the parent-infant interaction. However, only a few previous studies have addressed this topic. To investigate the association between maternal caregiving behaviors and an infant's attention for emotional faces, 149 mother-infant dyads were assessed when the infants were 8 months. Caregiving behaviors were observed during free-play interactions and coded using the Emotional Availability Scales. The composite score of four parental dimensions, that are sensitivity, structuring, non-intrusiveness, and non-hostility, was used in the analyses. Attention disengagement from faces was measured using eye tracking and face-distractor paradigm with neutral, happy, and fearful faces and scrambled-face control pictures as stimuli. The main finding was that lower maternal emotional availability was related to an infant's higher attention to fearful faces (p = .042), when infant sex and maternal age, education, and concurrent depressive and anxiety symptoms were controlled. This finding indicates that low maternal emotional availability may sensitize infants' emotion processing system for the signals of fear at least during this specific age around 8 months. The significance of the increased attention toward fearful faces during infancy is an important topic for future research.

Effects of parenting style on depressive symptoms, anxiety symptoms, and their comorbidity during the COVID-19 pandemic lockdown among 3117 Chinese junior high school students

INTRODUCTION

Depressive symptoms, anxiety symptoms, and comorbidity increased in junior high school students due to the outbreak of COVID-19. The objective of this study was to measure the impacts of parenting style on depressive symptoms, anxiety symptoms, and their comorbidity in Chinese junior high school students during the COVID-19 pandemic lockdown period.

METHODS

An online survey was conducted in June 2020 among 3117 junior high school students from Shandong Province, China. The Egna Minnen av Barndoms Uppfostran scale was used to measure parenting styles. The 9-item Patient Health Questionnaire scale and the 7-item Generalized Anxiety Disorder scale were used to measure depressive symptoms and anxiety symptoms, respectively. Multinomial logistic regression was conducted with SPSS 25.0 Version.

RESULTS

3117 junior school students enrolled in this study. The prevalence of depressive symptoms only, anxiety symptoms only, and comorbidity among junior high school students was 11.55 %, 5.29 %, and 22.97 %. Paternal over-protection was a risk factor not only for depressive symptoms only (OR = 1.075, 95 % CI = 1.020-1.134) but for anxiety symptoms only (OR = 1.090, 95 % CI = 1.016-1.170) and comorbidity (OR = 1.098, 95 % CI = 1.050-1.148). Paternal over-interference was a protective factor for depressive symptoms only (OR = 0.947, 95 % CI = 0.908-0.987) and comorbidity (OR = 0.953, 95 % CI = 0.921-0.986). However, maternal over-interference and over-protection were risk factors for depressive symptoms only (OR = 1.039, 95 % CI = 1.011-1.068).

LIMITATIONS

This was a cross-sectional study and the causal inferences could not be conducted.

CONCLUSIONS

Junior high school students with poorer family environmental factors were more likely to suffer from the comorbidity of anxiety symptoms and depressive symptoms during the COVID-19 pandemic lockdown. Decision-makers from the government, educational, and healthcare institutions should pay more attention to junior high school students at higher risk of mental disorders due to poor parenting styles. We should discuss family interventions in the future to prevent mental disorders in junior high school students.

Hospital quality of life for children: development of a new measurement tool for hospitalised children

Background

Hospitalisation affects children's quality of life (QoL) regardless of illness, treatment and care.

Aims

The objective of this study was to create an instrument for evaluating QoL of hospitalised children aged 7 to 18 years.

Methods

Initially, 46 items for the preliminary Hospital Quality of Life for Children Scale (HQL-children) were developed through a combination of literature reviews and individual interviews. The study was conducted with 230 participants from a general paediatric ward of a hospital. Exploratory and confirmatory factor analyses were conducted to examine the construct, convergent and discriminant validities of the measure. Criterion validity was assessed by confirming split-half reliability, whereas reliability was established using Cronbach's alpha coefficient.

Results

The HQL-child scale consists of 17 items and the total variance is 51.14%. The scale is categorised into five sub-dimensions: illness, fear, activity, hospital and perception. The scale demonstrated construct, convergent and divergent validity, discriminant and split-half reliability, with Cronbach's alpha coefficient 0.75.

Conclusions

The scale is a promising instrument to determine children's perception by capturing their experiences on hospitalisation. Assessing the QoL in hospitalised children is crucial for enhancing patient satisfaction and facilitating the development of health policies based on patient self-reporting in Turkey.

Systematic Review and Meta-Analysis: Early Irritability as a Transdiagnostic Neurodevelopmental Vulnerability to Later Mental Health Problems

OBJECTIVE

Irritability is a transdiagnostic indicator of child and adolescent internalizing and externalizing problems that is measurable from early life. The objective of this systematic review was to determine the strength of the association between irritability measured from 0 to 5 years and later internalizing and externalizing problems, to identify mediators and moderators of these relationships, and to explore whether the strength of the association varied according to irritability operationalization.

METHOD

Relevant studies published in peer-reviewed, English-language journals between the years 2000 and 2021 were sought from EMBASE, PsycINFO, MEDLINE, CINAHL, and ERIC. We synthesized studies that included a measure of irritability within the first 5 years of life and reported associations with later internalizing and/or externalizing problems. Methodological quality was assessed using the JBI-SUMARI Critical Appraisal Checklist.

RESULTS

Of 29,818 identified studies, 98 met inclusion criteria, with a total number of 932,229 participants. Meta-analysis was conducted on 70 studies (n = 831,913). Small, pooled associations were observed between infant irritability (0-12 months) and later internalizing (r = 0.14, 95% CI = 0.09, 0.20) and externalizing symptoms (r = 0.16, 95% CI = 0.11, 0.21) symptoms. For toddler/preschool irritability (13-60 months), small-to-moderate pooled associations were observed for internalizing (r = 0.21, 95% CI = 0.14, 0.28) and externalizing (r = 0.24, 95% CI = 0.18, 0.29) symptoms. These associations were not moderated by the lag between irritability and outcome assessment, although the strength of the associations varied according to irritability operationalization.

CONCLUSION

Early irritability is a consistent transdiagnostic predictor of internalizing and externalizing symptoms in childhood and adolescence. More work is required to understand how to accurately characterize irritability across this developmental period, and to understand mechanisms underlying the relationship between early irritability and later mental health problems.

DIVERSITY & INCLUSION STATEMENT

One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as living with a disability. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group.

STUDY PREREGISTRATION INFORMATION

Early irritability as a transdiagnostic neurodevelopmental vulnerability to early onset mental health problems: A systematic review; https://www.crd.york.ac.uk/prospero/; CRD42020214658.

Preschoolers and anxiety: The effect of parental characteristics

PROBLEM

Anxiety is a common phenomenon among children that can lead to adverse developmental outcomes. A challenging parent-child relationship and its characteristics may negatively impact the development of a child's internalizing problems. However, theoretical models on children's anxiety have not fully emphasized the contribution of parenting and environmental factors. Therefore, the aim of this study is to explore the possible correlations between parenting styles and other parental characteristics with children's anxiety.

METHODS

The sample consisted of 443 parents of preschool children who completed the Parenting Styles and Dimension Questionnaire and the Child Behavior Checklist 1.5-5. The univariate analysis included differences between demographic groups, assessed with independent sample t-tests. Associations between demographic evidence and child anxiety were estimated using χ2 tests. Binomial logistic regression analysis assessed the most important parenting characteristics contributing to a child's anxiety.

FINDINGS

A total of 24.6% of the children had borderline or clinical symptoms of anxiety. Parents whose children were anxious were more permissive than parents of nonanxious children (p < 0.001). Mothers were more authoritative compared to fathers. In addition, permissive parenting style increased the probability of a child's anxiety and maternal permissive style emerged as a significant predictor of anxiety in preschoolers (p < 0.003).

CONCLUSIONS

This study revealed that the permissive parenting style is associated with anxiety in preschool children. Furthermore, the maternal permissive style was identified as a predictor of anxiety. Future research may address its causal effect on anxiety and other behavioral problems, focusing on multiple perspective relationships and cultural dimensions.

Relations among parenting, academic performance, and psychopathology: An investigation of developmental cascades and their interplay with maternal and paternal parenting

Little effort has been made to integrate developmental cascades with maternal/paternal parenting in a single investigation. The present study seeks to test cascading effects among academic and internalizing/externalizing symptoms and their associations with maternal/paternal parenting across three time points from 8 to 10 years. Data for this investigation came from a nationally representative prospective cohort study of children born in April through July of 2008 in South Korea who were followed up annually. The sample included 1,598 families (48.5% girls). Parents rated their parenting and teachers rated children's internalizing/externalizing problems and academic performance. Structural equation modeling showed that externalizing problems were negatively related to academic performance. Academic performance was negatively related to internalizing problems and positively related to maternal/paternal authoritative parenting, which in turn led to children's higher academic performance. Bidirectional relations were found between academic performance and externalizing problems and between paternal authoritative parenting and children's internalizing problems. Findings suggested cascading effects and their associations with parenting were not attributable to child gender, intelligence, or socioeconomic differences. These findings lend support to adjustment erosion and academic incompetence models and underscore the need for greater attention to the role that fathering may play in children's development and mothering.

Compulsive digital use among school-age children and association with escapism and feeling of loneliness: A call for action

PURPOSE

This study aimed to investigate the relationship between Compulsive Digital Use (CDU), escapism, and loneliness among school-age children.

DESIGN AND METHODS

A quantitative, non-experimental, descriptive correlational study was conducted at 16 governmental preparatory schools affiliated with the Ministry of Education in Alexandria, Egypt. A simple random sampling of 300 school-age children participated in the study after obtaining the informed consent from the parents/guardians and assent from children.

RESULTS

The main study findings showed that 74% of school-age children had a subthreshold level of CDU, and 21.7% demonstrated a pathological/ addictive level. Compulsive digital use showed a significant positive correlation with both total escapism and loneliness scores (r = 0.689, p < 0.001 and r = 0.329, p = 0.005, respectively).

CONCLUSION

Children spend more than the recommended daily duration online. They reported having sleeping problems, especially insomnia, and poor academic achievement due to internet overuse. Most children had subthreshold level of CDU and one-quarter of them reached the addictive level. They reported that internet use helped them escape from the world of reality, unpleasant and worrisome things, as well as problems and pressures. Children reported loneliness and felt that people were around but not with them. Female gender and the employment of both parents were significantly associated with developing CDU. Escapism and loneliness among children were positively correlated with CDU.

PRACTICAL IMPLICATIONS

Awareness-raising campaigns regarding internet usage should be launched for school-age children and their parents to address its emerging psychosocial risks and challenges.

Associations between paternal versus maternal parenting behaviors and child and adolescent internalizing problems: A systematic review and meta-analysis

There is a large evidence base supporting an important role of parenting behavior in influencing youth mental health; however, this literature often fails to capture the potentially unique and interactive role of mothers and fathers. This systematic review and meta-analysis aimed to investigate the role of maternal and paternal parenting behaviors in relation to child and adolescent internalizing problems. Following PRISMA (2020) guidelines, 88 studies were identified. Of these, 47 studies and upward of 65 parent-behavior and child-outcome combinations were examined. Findings indicated a unique role of maternal overprotection in the prediction of child anxiety symptoms. For other parenting behaviors, largely similar associations were found for maternal and paternal parenting behaviors with child and adolescent anxiety, depressive symptoms and broader internalizing problems. There was preliminary support for the interaction of maternal and paternal parenting being important in predicting youth symptoms. Although findings did not strongly substantiate differences in the effects of maternal and paternal parenting practices, with only one significant difference identified, further research would benefit from stronger representation of fathers, to enable a more rigorous and comprehensive understanding of each parent's role, and their interactive influence on internalizing outcomes of their children.

Bidirectional spillover between maladaptive parenting and peer victimization and the mediating roles of internalizing and externalizing problems: A within-person analysis among Chinese early adolescents

Parenting practices and relationships with peers are crucial aspects of youth socialization. Although theoretically expected reciprocal associations between changes in maladaptive parenting and adolescent peer victimization exist, there is a lack of studies that examine this link and address the mediating mechanisms at the within-person level. This longitudinal study examined reciprocal relations between peer victimization and two types of maladaptive parenting including harsh punishment and psychological control, and the potential mediating roles of internalizing and externalizing problems within these relations, by disentangling between- and within-person effects. A total of 4,731 Chinese early adolescents (44.9% girls; M age = 10.91 years, SD = 0.72) participated in a four-wave longitudinal study with 6-month intervals. The results of random intercept cross-lagged panel modeling showed: (a) harsh punishment did not directly predict peer victimization, and vice versa; (b) psychological control directly predicted peer victimization, and vice versa; (c) psychological control indirectly predicted peer victimization via internalizing problems, and peer victimization also indirectly predicted psychological control via internalizing problems. These findings provide evidence of a bidirectional spillover effect between psychological control and peer victimization at the within-person level, suggesting Chinese early adolescents may become caught in a vicious cycle directly or indirectly via their internalizing problems.

Anxiety disorders in children and adolescents: A summary and overview of the literature

Considerable work has advanced understanding of the nature, causes, management, and prevention of anxiety disorders in children and adolescents over the past 30 years. Prior to this time the primary focus was on school refusal and specific phobias. It is now recognised that children and adolescents experience the full gamut of anxiety disorders in very similar ways to adults and that anxiety disorders in the paediatric years can predict a lifelong mental-health struggle. Given the vast array of specific studies in this field, the current review summarises current knowledge about these high prevalence disorders, points to overarching limitations, and suggests potentially important future directions. Following a brief historical overview, the review summarises knowledge about demographic and epidemiological characteristics, distal and proximal risk factors, current treatment directions, and prevention. There is still a great deal to learn about the causes and treatments of child and adolescent anxiety disorders. By amalgamating our current knowledge, this review provides a window to the research directions that are likely to lead to future advances.

Parenting and Chinese Adolescents' Multidimensional Prosocial Behaviors: The Moderating Role of Sympathy

In this study, the prediction of maternal and paternal parenting behaviors to 1527 (59.27% female, age ranged between 11 and 18 years old) Chinese adolescents' multidimensional prosocial behaviors, and the moderating role of adolescents' sympathy were examined. Data were collected in 2019. Adolescents reported their perceived parenting practices, their own sympathy and prosocial tendencies using online questionnaires. Results from path models in Mplus indicated care and autonomy granting of both parents were uniquely and positively associated with adolescents' various prosocial behaviors. Paternal control was also positively associated with adolescents' public prosocial behaviors. Further, adolescents' sympathy moderated the association between paternal autonomy granting to adolescents' altruistic prosocial behaviors, as well as between paternal control and adolescents' compliant and emotional prosocial behaviors. Our study contributed novel information regarding the roles of maternal and paternal parenting and sympathy in Chinese adolescents' diverse prosocial behaviors. Replications with longitudinal design are needed.

The Mediating Role of Mindful Parenting in the Relationship Between Parental Anxiety and Youth's Emotional and Behavioral Difficulties

One of the central questions in the theory of the intergenerational transmission of psychological symptoms is to identify whether parenting practices explain the transmission of psychological symptoms from parents to youth. This study examined the mediating mechanism of mindful parenting in the relationship between parental anxiety and youth's emotional and behavioral difficulties. In three waves separated by six months, longitudinal data were collected from 692 Spanish youth (54% girls) aged between 9 and 15 years (Mage = 12.84 years, SD = 1.22 years at Wave 1) and their parents. Path analysis showed that maternal mindful parenting mediated the relationship between maternal anxiety and the youth's emotional and behavioral difficulties. No mediating effect was found concerning fathers; however, marginal bidirectional relationships were obtained between paternal mindful parenting and youth's emotional and behavioral difficulties. This study addresses one of the main concerns about the theory of intergenerational transmission using a multi-informant and longitudinal study design, concluding that maternal anxiety predicts less mindful parenting practices and these in turn predict youth's emotional and behavioral difficulties.

Parental Worry About COVID-19 in Preschool Children's Mothers During the Pandemic Waves: The Role of Maternal Negative Feelings and Parenting Styles

This cross-sectional study explores the relationship between maternal feelings, maternal parenting styles, and mothers' worry about COVID-19's detrimental consequences on preschool children's health and well-being. The study is among the first to concentrate on this reference specific group, whose characteristics might be particularly vulnerable to COVID-19's adversities. One hundred and four mothers of at least one preschool-age child completed an online questionnaire battery, which included the Parental Feelings Inventory, the Parenting Styles and Dimensions Questionnaire (PSDQ), and the parental worry about COVID-19 scale. Negative maternal feelings (i.e., anger, anxiety/sadness) were associated with authoritarian and indulgent parenting practices, especially verbal hostility, while maternal happiness was associated with more authoritative practices, especially warmth and support. The hierarchical multiple regression model explained about 42% of variance of the overall maternal worry about COVID-19 from maternal negative feelings and parenting styles, with maternal authoritative parenting and maternal anxiety/sadness as the significant predictors that uniquely explain maternal worry about COVID-19. These results are discussed in terms of positive and negative maternal worry, which partially reflect the differences between overprotective and authoritative parenting in early childhood.

Elucidating the Roles of Maternal Overcontrol and Warmth in the Development of Childhood Anxiety and Depression: A Moderated Mediation Framework

Studies have linked childhood anxiety and depression with parenting characterized by high control and low warmth. However, few studies have examined how control and warmth may work together to influence internalizing symptoms in children. Therefore, the goal of this study was to examine the moderating effect of warmth on the relationship between overcontrol and anxiety and depressive symptoms, as well as whether negative thoughts serve as a mediator of these pathways. A total of 182 fourth and fifth grade children completed measures of maternal parenting behavior, negative thoughts, and anxiety and depressive symptoms. Results showed an interaction between overcontrol and warmth for depressive but not anxiety symptoms. Furthermore, low warmth increased the strength of the mediating relationship between overcontrol and depression via thoughts of personal failure. Findings may signal a need for early interventions to address parenting behaviors, such as controlling behaviors, in parents of children at risk for internalizing difficulties.

Construct Validation for Toddler-Solicited Maternal Comforting Behavior as Relevant to Family Accommodation and Child Anxiety Risk

Reciprocal parent-child interactions are theorized to play a crucial role in child anxiety development and maintenance. The current study tested whether toddler-solicited maternal comforting behavior in low-threat (mildly challenging and novel) situations may be a unique, early indicator of anxiety-relevant interactions. Controlling for other types of maternal comforting behavior, a path model tested solicited comforting behavior in a low-threat context in relation to both family accommodation (FA) and child anxiety symptoms, which may subsequently continue to predict each other over time. Identifying the emergence of this cycle in early childhood could bolster anxiety development theory and preventative interventions. Mother-child dyads (n = 166) of predominantly non-Hispanic/Latinx European American and socioeconomically diverse backgrounds were assessed at child ages 2, 4, and school-age via laboratory observation and maternal report. A longitudinal path model showed that solicited comforting observed in a low-threat situation at age 2 predicted mother-reported FA and child anxiety symptoms at age 4, above and beyond unsolicited comforting behavior and comforting behavior in a high-threat context. Furthermore, FA and child anxiety were bidirectionally related between age 4 and school-age assessments. Results suggest that toddler-solicited comforting in low-threat situations may be a unique indicator of child-directed anxiogenic family processes. The current study also expands the FA literature by providing empirical evidence for a bi-directional relation between anxiety and accommodation in young children.

The effects of goldfish on anxiety, fear, psychological and emotional well-being of hospitalized children: A randomized controlled study

AIM

This study aimed to determine the effect of goldfish intervention on anxiety, fear, psychological and emotional well-being of hospitalized children.

MATERIALS AND METHODS

Between November 2020 and August 2021, an open-label, single-center randomized controlled experimental study was conducted in Türkiye's Eastern Anatolia region. The study included 112 children aged 8 to 10 years old (56 in the study group and 56 in the control group). The study and control groups were randomly assigned to strata using a table of random numbers. The children in the study group observed after goldfish intervention for three days. As data collection tools, the State-Trait Anxiety Inventory for Children, Child Fear Scale, and the Stirling Children's Well-being Scale were used.

RESULTS

The mean state anxiety scores of the children in the study group who looked after goldfish intervention decreased significantly compared to the control group. When the two groups were compared, the difference between the post-test measurements were significant (p < 0.05). The mean score of the fear scale in the post-test measurements of the study group children was significantly lower than the control group (p < 0.05). Finally, the emotional, and psychological well-being post-test scale mean scores of the study group children were higher than the control group (p < 0.01).

CONCLUSION

Goldfish intervention was found to be effective in decreasing the state anxiety and fear levels and increasing the psychological and emotional well-being levels of the children in the study group.

Lifetime psychopathology in the offspring of parents with anxiety disorders: A systematic review

BACKGROUND

The offspring of parents with Anxiety Disorders (AD) are at high risk for different types of psychopathology, including AD. However, little is known about how parental anxiety during pregnancy and/or the postnatal period might result in alterations in behavior or neurodevelopmental changes in offspring. To examine the effect of parental AD on offspring behavior and neurodevelopment, we conducted a systematic review.

METHODS

Following PRISMA guidelines, we searched the Web of Science, PubMed, and PsycINFO databases.

RESULTS

Forty-seven articles met the inclusion criteria for the systematic review. Prenatal maternal anxiety is related to negative temperament, increased attention to fearful vocalizations, decreased alertness, and impaired psychomotor and cognitive development in early and middle childhood. AD during the postnatal period is associated with greater negative temperament, internalizing symptoms, and anxiety symptoms in early childhood, middle childhood, and adolescence.

CONCLUSION

Our review is the first to demonstrate that prenatal and postnatal AD symptoms impact offspring. Future research should explore the mediating and moderating factors leading to the development of psychopathology in the offspring of parents with AD.

Parental Overprotection and Sleep Problems in Young Children

Poor sleep in children predicts mental and physical disorders later in life. Identifying and changing modifiable factors associated with sleep problems in young children may improve their health trajectory. Our aim was to establish whether overprotective parenting was associated with problems sleeping in children. Parents of children aged 2-6 years completed questionnaires about their own anxiety, parenting style, and about their children's sleep. We obtained 307 reports on 197 children from 240 parents. Using mixed-effects linear regression, we found that maternal (beta = 0.26, 95% CI 0.11 to 0.41, p = 0.001) and paternal (beta = 0.35, 95% CI 0.17 to 0.53, p < 0.001) overprotection were associated with impaired sleep in children. This relationship remained unchanged when controlling for parental anxiety. Decreasing parents' overprotection may improve children's sleep, and reduce the risk of physical and mental disorders later in their life.

Associations between parent posttraumatic stress symptoms (PTSS) and later child PTSS: Results from an international data archive

The extant literature indicates that parent and child posttraumatic stress symptoms (PTSS) are associated. However, the magnitude of this association at different time points and in the context of covariates has been difficult to quantify due to the methodological limitations of past studies, including small sample sizes. Using data from the Prospective studies of Acute Child Trauma and Recovery Data Archive, we harmonized participant-level parent and child data from 16 studies (N = 1,775 parent-child dyads) that included prospective assessment of PTSS during both the acute and later posttrauma periods (i.e., 1-30 days and 3-12 months after exposure to a potentially traumatic event, respectively). Parent and child PTSS demonstrated small-to-moderate cross-sectional, ρs = .22-.27, 95% CI [.16, .32], and longitudinal associations, ρ = .30, CI [.23, .36]. Analyses using actor-partner interdependence models revealed that parent PTSS during the acute trauma period predicted later child PTSS. Regression analyses demonstrated that parent gender did not moderate the association between parent and child PTSS. The findings suggest that parent PTSS during the acute and later posttrauma periods may be one of a constellation of risk factors and indicators for child PTSS.

A prospective study of associations between early fearfulness and perceptual sensitivity and later restricted and repetitive behaviours in infants with typical and elevated likelihood of autism

LAY ABSTRACT

Restricted interests and repetitive behaviours are central to the diagnosis of autism and can have profound effects on daily activities and quality of life. These challenges are also linked to other co-occurring conditions such as anxiety and sensory sensitivities. Here, we looked at whether early emerging signs of anxiety and sensory problems appear before symptoms of autism by studying infants with a family history of autism, as these infants are more likely to develop autism themselves. Studying infant siblings provides an opportunity for researchers to focus on early developmental markers of autism as these infants can be followed from birth. This study found that early infant signs of anxiety (e.g. fear/shyness) predicted later perceptual sensitivity, and those infants who scored higher on fear/shyness and sensitivity were more likely to experience more persistent repetitive behaviours, but also social and communication difficulties in toddlerhood. Early signs of anxiety and perceptual sensitivity may thus relate to both later social difficulties and repetitive behaviours. These findings support the importance of further research exploring the causal links between these domains in relation to autism, resulting in increased understanding of children who go onto develop autism in the future and guiding early interventions and supports.

The impact of children's temperament on recurrent unintentional injuries: the role of paternal parenting styles as a mediator

Background

Unintentional injuries (UIs) pose a threat to the health of children all over the world and are a major global health problem. The recurrence of UIs are influenced by the host itself or environmental factors. Children's temperament and paternal parenting styles (PPS) are important potential factors for poor health outcomes, including recurrent unintentional injuries (recurrent UIs). Therefore, exploring the relationship among these variables may help reduce the likelihood of recurrent UIs in children.

Purpose

To elucidate the mediating effect of PPS in the relationship of children's temperament characteristics and recurrent UIs among children.

Methods

By multistage random cluster sampling method, a total of 2,850 pupils in grades four and five from 10 different schools were included. The survey included the characteristics of UIs in the past year, parenting styles, and children's temperament. Structural equation modeling (SEM) was used to examine the possible mediating effect of PPS between children's temperament and recurrent UIs.

Results

In this study, the incidence rate of recurrent UIs was 3.8%. In temperament, children with recurrent UIs had higher mean scores than the non-recurrent UIs group (t = -3.40, -3.52, -3.45, respectively; p < 0.001) in the activity, predictability, persistence. Meanwhile, the scores of negative PPS (punishing, over-interference, rejection, and overprotection) were higher in the recurrent UIs group than in the non-recurrent UIs group (t = -5.78, -5.05, -5.56, and -3.29; p < 0.001, < 0.001, < 0.001, < 0.001, respectively). Using a stepwise binary logistic regression model, grade (OR = 0.23, 95% CI [0.12-0.41], p < 0.001), activity (OR = 1.61, 95% CI [1.14-2.26], p = 0.007) and over-interference (OR = 2.28, 95% CI [1.37-3.80], p = 0.002) had a significant independent relationship with recurrent UIs. The SEM results indicated that children's temperament was significantly related to negative PPS (β = 0.26, p < 0.001) and recurrent UIs (β = 0.11, p = 0.029). The results of the bootstrap test confirmed the significance of the mediating effect of PPS (β = 0.06, p < 0.001) between children's temperament and recurrent UIs.

Conclusions

These results suggest that negative PPS plays an important role in mediating children's temperament and recurrent UIs. It is essential to consider PPS when creating tailored intervention programs to reduce children's recurrent UIs.

Frequency and Correlates of Fathers' Accommodation in Pediatric Anxiety Disorders

Previous studies investigating family accommodation (FA) in pediatric anxiety disorders have primarily relied on mothers' reports, while data on FA by fathers remains scarce. We examined the frequency and correlates of fathers' FA of anxious children and compared fathers' and mothers' reports of FA. Participants were 69 parents of treatment-seeking children and adolescents with a primary anxiety disorder. FA was highly prevalent amongst fathers, with the majority of fathers participating in symptom-related behaviors and modifying family routines due to child anxiety. Fathers' accommodation levels were significantly correlated with fathers' reports of child internalizing symptoms, child externalizing symptoms, and fathers' own anxiety symptoms. Fathers' and mothers' reports of FA were moderately correlated, whereas their reports of their respective distress related to the need to accommodate were only weakly correlated. Fathers reported a significantly lower frequency of FA than did mothers. These findings highlight the importance of obtaining reports from both fathers and mothers when assessing FA. Results are particularly relevant to family-focused and parent-based interventions designed to address and reduce FA amongst parents of clinically anxious children.

Anxious parents show higher physiological synchrony with their infants

BACKGROUND

Interpersonal processes influence our physiological states and associated affect. Physiological arousal dysregulation, a core feature of anxiety disorders, has been identified in children of parents with elevated anxiety. However, little is understood about how parent-infant interpersonal regulatory processes differ when the dyad includes a more anxious parent.

METHODS

We investigated moment-to-moment fluctuations in arousal within parent-infant dyads using miniaturised microphones and autonomic monitors. We continually recorded arousal and vocalisations in infants and parents in naturalistic home settings across day-long data segments.

RESULTS

Our results indicated that physiological synchrony across the day was stronger in dyads including more rather than less anxious mothers. Across the whole recording epoch, less anxious mothers showed responsivity that was limited to 'peak' moments in their child's arousal. In contrast, more anxious mothers showed greater reactivity to small-scale fluctuations. Less anxious mothers also showed behaviours akin to 'stress buffering' - downregulating their arousal when the overall arousal level of the dyad was high. These behaviours were absent in more anxious mothers.

CONCLUSION

Our findings have implications for understanding the differential processes of physiological co-regulation in partnerships where a partner is anxious, and for the use of this understanding in informing intervention strategies for dyads needing support for elevated levels of anxiety.

Infant Effortful Control Mediates Relations Between Nondirective Parenting and Internalising-Related Child Behaviours in an Autism-Enriched Infant Cohort

Internalising problems are common within Autism Spectrum Disorder (ASD); early intervention to support those with emerging signs may be warranted. One promising signal lies in how individual differences in temperament are shaped by parenting. Our longitudinal study of infants with and without an older sibling with ASD investigated how parenting associates with infant behavioural inhibition (8-14 months) and later effortful control (24 months) in relation to 3-year internalising symptoms. Mediation analyses suggest nondirective parenting (8 months) was related to fewer internalising problems through an increase in effortful control. Parenting did not moderate the stable predictive relation of behavioural inhibition on later internalising. We discuss the potential for parenting to strengthen protective factors against internalising in infants from an ASD-enriched cohort.

Intergenerational Transmission of Social Anxiety in Childhood Through Fear of Negative Child Evaluation and Parenting

Background

Parents’ fear of negative evaluation (FNE) has been proposed to play a role in the intergenerational transmission of social anxiety. We investigated whether (1) parents’ own FNE, a core belief of social anxiety, extends to their child’s environment resulting in fear of negative child evaluation (FNCE); and (2) parents’ FNCE mediates the association between parents’ social anxiety, parenting behavior and children’s social anxiety.

Methods

In this cross-sectional study, fathers (n = 84) and mothers (n = 92) from 99 Caucasian families completed questionnaires on social anxiety, FNE, FNCE, and parenting (intrusiveness, negative parenting and encouragement of social daring) when their child was 7.5 years old. Child social anxiety was measured by questionnaires (child and parent report).

Results

For both parents, FNE mediated the association between their social anxiety and FNCE. Furthermore, FNCE mediated the relation between both parents’ social anxiety and intrusiveness and the relation between mothers’ social anxiety and negative parenting. In addition, FNCE mediated the relation between fathers’ social anxiety and children’s social anxiety (parents’ report only) directly and through intrusive parenting.

Conclusions

Our study suggests that parents’ FNE extends to their children’s environment and provides support for the role of FNCE in various pathways of intergenerational transmission of social anxiety during middle childhood.

Parents' Adherence to Childhood Screening Tests and Referrals: A Retrospective Cohort Study with Randomized Sampling

Routine timely examinations of well-child health are important for achieving children's good health outcomes. Nevertheless, there is evidence of low compliance with well-child visit recommendations. The aim of the study was to examine potential factors associated with parents' nonadherence to routine childhood screening tests and their acting on further referrals following unusual findings. A retrospective cohort study was conducted among 14,348 children born in 2016-2017 and registered at mother-child health clinics in a large city in Israel. A sample of 844 children was randomly selected. Screening tests at the age of two months and nine months were examined. A multiple logistic regression examined potential factors associated with nonadherence to screening tests and to further referral for evaluation. Lower adherence to screening tests was found among parents of nine-month-old children, but adherence was higher for nurses' screening tests than for those of physicians. Children born in a complex delivery process, older mothers with a higher number of children, and Israeli citizens were at risk of not undergoing screening tests. Fewer children in the family and initial physician's findings were the only explanation for acting to referrals. In order to promote children's health outcomes and public health, health policymakers should conduct campaigns to convince parents of the importance of screening tests and of adherence to referrals with the aim of ensuring their children's wellbeing throughout the life cycle.

Same Behaviors, Different Outcomes: Mothers' and Fathers' Observed Challenging Behaviors Measured Using a New Coding System Relate Differentially to Children's Social-Emotional Development

This study used a newly developed coding system for measuring the quality of parenting behavior to examine associations with children’s social-emotional development. The Risky Interaction Support and Challenge Scale (RISCS) measures the extent to which parents engage in behaviors that present physical and regulatory challenges to children, as well as parents’ tendency to allow children to pursue action goals autonomously. These behaviors were observed while parents (n = 57 fathers; n = 55 mothers; n = 50 pairs) interacted with their 1-year-olds who played on a structure that included a slide, a small climbing wall, and a tunnel. Trained raters reliably used the RISCS to measure several dimensions of parent behaviors related to children’s exploration, and all but one of the dimensions captured adequate variability in parent behavior. Although mothers and fathers did not differ in any of the dimensions, the associations between parent behavior and children’s social-emotional development did not overlap. Fathers who engaged in greater autonomy allowance and lower overprotection had toddlers with lower levels of internalizing behavior, whereas mothers who challenged children’s regulatory competence had toddlers with lower levels of externalizing behavior and greater competence. We discuss the implications of the findings for the literature on attachment theory and father-child relationships.

Exploring the Effect of Parental Styles on Social Skills: The Mediating Role of Affects

Parental educational styles have a significant effect in personal development. These styles (authoritative, democratic, permissive and neglectful) can be related to affects and social skills at the individual level. The study presented here, which comprised 456 participants (151 men; 33.11%), with an average age of 22.01 years (s.d. = 2.80), aimed to analyse the relationship between parental styles, affects and social skills, as well as the role played by affects in the relationship between parental style and social skills. The results suggest that the constructs under study are closely related. The most common parental style is democratic. By gender, permissive styles were more often applied to women and authoritative styles to men. No significant gender differences were found in the application of democratic and neglectful parental styles. In terms of emotional support, women were found to have higher negative affect scores and men higher emotional support scores. People with parents that use democratic and permissive styles scored higher in all variables related to affects and social skills, which challenges the notion that democratic styles are the best parental styles in terms of socialisation of children. The results of the affect and social skills scales were analysed in relation to parenting styles, indicating that children educated under a democratic parental regime tend to yield higher scores in terms of social skills than children educated under any other form of parental regime and medium scores in terms of affects. Finally, it was found that parenting styles have a direct influence on social skills, which tend to improve when affects play a mediating role between these two constructs. These results suggest that parenting styles are closely related to affects and social skills. In addition, they also suggest that affects play a mediating role in the relationship between parenting styles and social skills. Finally, owing to the impact that parenting styles have on affects and social skills, more research is needed to address this issue.

Fluoride exposure during early adolescence and its association with internalizing symptoms

BACKGROUND

Early, chronic, low-level fluoride exposure has been linked to attention-deficit hyperactivity disorder (ADHD) and learning deficits in children. Rodent studies suggest a link between fluoride exposure and internalizing behaviors. No human studies have examined the impact of fluoride on internalizing behaviors during adolescence.

OBJECTIVE

Evaluate the relationship between urinary fluoride and early adolescent internalizing symptoms in the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS).

METHODS

Participants in CCAAPS provided non-fasting spot urine samples at age 12 years (n = 286). Urine samples were analyzed using a microdiffusion method to determine childhood urinary fluoride (CUF) concentrations and were log-transformed for analyses. Caregivers of CCAAPS participants completed the Behavior Assessment System for Children-2 (BASC-2) at the age 12 study visit to assess internalizing symptoms (e.g., anxiety, depression, somatization), and a composite score of the three domains; T-scores ≥ 60 were used to identify adolescents in a clinically "at-risk" range. Race, age of the adolescent, household income, maternal age at birth, caregiver depression, caregiver-child relationships, and age 12-year serum cotinine concentrations were considered covariates in regression models. Sex-specific effects of fluoride exposures were investigated through the inclusion of interaction terms.

RESULTS

Higher CUF concentrations were significantly associated with increased somatization (β = 3.64, 95% CI 0.49, 6.81) and internalizing composite T-scores in a clinically "at-risk" range (OR = 2.9, 95% CI 1.24, 6.9). Compared to females, males with higher CUF concentrations had more internalizing (pinteraction = 0.04) and somatization symptoms (pinteraction = 0.02) and were nearly seven times more likely to exhibit "at-risk" internalizing symptomology. CUF concentrations were not significantly associated with depression or anxiety symptoms.

CONCLUSIONS

This is the first study to link fluoride exposure and internalizing symptoms, specifically somatization. Somatization represents an interface of physical and psychological health. Continued follow-up will help shed light on the sex-specific relationship between fluoride and mental health and the role of somatization.

Vocalization and physiological hyperarousal in infant-caregiver dyads where the caregiver has elevated anxiety

Co-regulation of physiological arousal within the caregiver-child dyad precedes later self-regulation within the individual. Despite the importance of unimpaired self-regulatory development for later adjustment outcomes, little is understood about how early co-regulatory processes can become dysregulated during early life. Aspects of caregiver behavior, such as patterns of anxious speech, may be one factor influencing infant arousal dysregulation. To address this, we made day-long, naturalistic biobehavioral recordings in home settings in caregiver-infant dyads using wearable autonomic devices and miniature microphones. We examined the association between arousal, vocalization intensity, and caregiver anxiety. We found that moments of high physiological arousal in infants were more likely to be accompanied by high caregiver arousal when caregivers had high self-reported trait anxiety. Anxious caregivers were also more likely to vocalize intensely at states of high arousal and produce intense vocalizations that occurred in clusters. High-intensity vocalizations were associated with more sustained increases in autonomic arousal for both anxious caregivers and their infants. Findings indicate that caregiver vocal behavior differs in anxious parents, cooccurs with dyadic arousal dysregulation, and could contribute to physiological arousal transmission. Implications for caregiver vocalization as an intervention target are discussed.

Development and validation of the Modeling of Parental Anxiety Questionnaire

Parental anxious modeling is assumed to be a risk factor for child anxiety. Until now there has been no self-assessment scale available that measures parental modeling of anxiety in a comprehensive way. Our aim with this study was to bridge this gap by developing the Modeling of Parental Anxiety Questionnaire (MPAQ). To do this, we generated an item pool containing 51 statements covering different aspects of parental modeling of anxious and non-anxious behaviors. A sample of Swedish parents (N = 1092) of children aged 4-12, answered an online survey comprising the generated item pool, the Parental Overprotection Scale (OP) and the PROMIS Anxiety short forms (the adult version and the parent proxy report scale). A factor analysis of the items of parental modeling indicated a structure with four separate factors. These factors formed the final four subscales of MPAQ; (1) being curios and content, (2) being on guard, (3) displaying anxiety and avoidance, and (4) displaying stress. The Cronbach's alpha coefficients of the subscale scores ranged from moderate to good. Linear regression analysis showed that the displaying anxiety and avoidance-subscale had the strongest association with child anxiety symptoms. These findings show that MPAQ demonstrates adequate psychometric properties and has potential for being used in research and clinical settings, for example to identify potential targets for parenting interventions and to measure mediation effects.

Exploring the Link Between Transdiagnostic Cognitive Risk Factors, Anxiogenic Parenting Behaviors, and Child Anxiety

Theoretical models suggest parent anxiety leads to increased anxiogenic parenting, an important etiological factor for child anxiety disorders. Evidence suggests that parents engage in anxiogenic parenting to reduce distress in response to their child's anxiety; however, further study of this mechanism is needed. Cognitive risk factors, including distress intolerance, anxiety sensitivity, emotion-related impulsivity, and repetitive negative thinking are promising to examine as they impact emotion regulation. This study examined whether an indirect association between parent anxiety and anxiogenic parenting via these risk factors exists, and if child anxiety moderated this effect. Findings demonstrated evidence for an indirect association via distress intolerance in mothers at high levels of child anxiety, but not low levels. An unmoderated indirect effect via emotion-related impulsivity was found. Anxiety sensitivity and repetitive negative thinking did not demonstrate significant indirect effects. These findings suggest distress intolerance and emotional-related impulsivity may be targets for parent-focused child anxiety treatments.

The role of parenting behaviors in the bidirectional and intergenerational transmission of depression and anxiety between parents and early adolescent youth

BACKGROUND

Parenting is a modifiable factor proposed to underpin the transmission of anxiety and depression from parents to children. This study examined the role of parenting in the intergenerational transmission of anxiety and depression across pre- and early adolescence.

METHOD

Participants were 531 youth (M_age  = 11.18, SD = 0.56; 50.85% boys) and their parent. Child and parent anxiety and depression, and parental rejection, warmth and overprotection were assessed annually over 3 years. Bidirectional relationships between parent and child anxiety and depression, and the mediating role of parenting behaviors, were examined using cross-lagged panel models.

RESULTS

Results suggest bidirectional associations over time between parent and child depression, and parental rejection and child depression. Parental rejection and low warmth were associated with increases in child depression, but did not mediate depression transmission. Parental anxiety was associated with increases in child anxiety and depression, but there was no bidirectional association from child psychopathology to parental anxiety. There was little evidence that parenting predicted changes in child anxiety over time. Child anxiety and depression were associated with subsequent increases in parental depression.

CONCLUSION

Parental depression, rejection and low warmth are independent risk factors for child depression. Parental rejection may also be a consequence of parenting a depressed youth. Parenting did not account for the apparent transmission of parental anxiety to increased child anxiety and depression. Child psychopathology increases risk of parental depression. Parental rejection may be an important modifiable risk factor for youth depression in early adolescence, and may also reduce later risk of parent depression.

A Narrative Review of Methodological Considerations in Magnetic Resonance Imaging of Offspring Brain Development and the Influence of Parenting

Parenting has been robustly associated with offspring psychosocial development, and these effects are likely reflected in brain development. This hypothesis is being tested with increasingly rigorous methods and the use of magnetic resonance imaging, a powerful tool for characterizing human brain structure and function. The objective of this narrative review was to examine methodological issues in this field that impact the conclusions that can be drawn and to identify future directions in this field. Studies included were those that examined associations between parenting and offspring brain structure or function. Results show four thematic features in this literature that impact the hypotheses that can be tested, and the conclusions drawn. The first theme is a limited body of studies including repeated sampling of offspring brain structure and function, and therefore an over-reliance on cross-sectional or retrospective associations. The second involves a focus on extremes in early life caregiving, limiting generalizability. The third involves the nature of parenting assessment, predominantly parent- or child-report instead of observational measures which may be more ecologically valid measures of parenting. A closely related fourth consideration is the examination of detrimental versus positive parenting behaviors. While studies with one or more of these thematic limitations provide valuable information, future study design should consider addressing these limitations to determine how parenting shapes offspring brain development.