Emotion socialization parenting interventions targeting emotional competence in young children: A systematic review and meta-analysis of randomized controlled trials

Family and parenting factors are associated with emotion regulation neural function in early adolescent girls with elevated internalizing symptoms

A prominent tripartite model proposes that parent role modeling of emotion regulation, emotion socialization behaviors, and the emotional climate of the family are important for young people's emotional development. However, limited research has examined the neural mechanisms at play. Here, we examined the associations between family and parenting factors, the neural correlates of emotional reactivity and regulation, and internalizing symptoms in early adolescent girls. Sixty-four female adolescents aged 10-12 years with elevated internalizing symptoms completed emotional reactivity, implicit (affect labeling) and explicit (cognitive reappraisal) emotion regulation tasks during functional magnetic resonance imaging. Positive family emotional climate was associated with greater activation in the anterior cingulate and middle temporal cortices during emotional reactivity. Maternal emotion regulation difficulties were associated with increased frontal pole and supramarginal gyrus activation during affect labeling, whereas supportive maternal emotion socialization and positive family emotional climate were associated with activation in prefrontal regions, including inferior frontal and superior frontal gyri, respectively, during cognitive reappraisal. No mediating effects of brain function were observed in the associations between family/parenting factors and adolescent symptoms. These findings highlight the role of family and parenting behaviors in adolescent emotion regulation neurobiology, and contribute to prominent models of adolescent emotional development.

Study protocol for a randomized controlled trial of supportive parents - coping kids (SPARCK)-a transdiagnostic and personalized parent training intervention to prevent childhood mental health problems

BACKGROUND

To meet the scientific and political call for effective prevention of child and youth mental health problems and associated long-term consequences, we have co-created, tested, and optimized a transdiagnostic preventive parent-training intervention, Supportive parents - coping kids (SPARCK), together with and for the municipal preventive frontline services. The target group of SPARCK is parents of children between 4 and 12 years who display symptoms of anxiety, depression, and/or behavioral problems, that is, indicated prevention. The intervention consists of components from various empirically supported interventions representing different theorical models on parent-child interactions and child behavior and psychopathology (i.e., behavioral management interventions, attachment theory, emotion socialization theory, cognitive-behavioral therapy, and family accommodation intervention). The content and target strategies of SPARCK are tailored to the needs of the families and children, and the manual suggests how the target strategies may be personalized and combined throughout the maximum 12 sessions of the intervention. The aim of this project is to investigate the effectiveness of SPARCK on child symptoms, parenting practices, and parent and child stress hormone levels, in addition to later use of specialized services compared with usual care (UC; eg. active comparison group).

METHODS

We describe a randomized controlled effectiveness trial in the frontline services of child welfare, health, school health and school psychological counselling services in 24 Norwegian municipalities. It is a two-armed parallel group randomized controlled effectiveness and superiority trial with 252 families randomly allocated to SPARCK or UC. Assessment of key variables will be conducted at pre-, post-, and six-month follow-up.

DISCUSSION

The current study will contribute with knowledge on potential effects of a preventive transdiagnostic parent-training intervention when compared with UC. Our primary objective is to innovate frontline services with a usable, flexible, and effective intervention for prevention of childhood mental health problems to promote equity in access to care for families and children across a heterogeneous service landscape characterized by variations in available resources, personnel, and end user symptomatology.

TRIAL REGISTRATION

ClinicalTrials.gov ID: NTCT05800522.

The Tuning in to Kids parenting program delivered online improves emotion socialization and child behavior in a first randomized controlled trial

Emotion-focused parenting interventions have only rarely been evaluated systematically in Europe. This study investigates the effectiveness of "Tuning in to Kids" (TIK) from Australia delivered online in a randomized controlled trial. TIK is a six-week emotion-focused group parenting program that has shown to improve many aspects of parent emotion socialization as well as child problem behavior in several different countries across cultures. Parents (N = 141) of children between 3 and 6 years of age were included in the study and randomly assigned to an intervention and wait-list control group. The intervention was delivered online due to the worldwide COVID-19 pandemic in spring 2021 (intervention group) and one year later (control group) in Switzerland. Parents' beliefs about emotions, their reported reactions to the child's negative emotions, family emotional climate, and child behavior (internalizing and externalizing) improved after the intervention and stayed better until the 6 months follow-up in the intervention group, but not in the wait-list controls. Adherence to the program was very high. This study shows that parent emotion socialization practice is changeable with small effects even on child behavior and even after online delivery. This possibly makes Tuning in to Kids a promising emotion-focused parenting intervention when delivered online as an interactive group webinar.

Associations Between Adult Attachment, Maternal Emotion Socialization and Child Behavior

BACKGROUND

Attachment theories suggest that the adult attachment styles of mothers may influence behavior problems among their children; however, empirical studies examining the direct role of maternal adult attachment styles and the mechanisms through emotion-related parenting are scarce.

OBJECTIVE

This study examined the influence of maternal adult attachment styles and emotion-related parenting on child internalizing and externalizing problems.

METHODS

The participants were 409 mothers with children aged 4-5 years. A questionnaire survey was conducted to obtain their adult attachment styles to their mothers, maternal emotion socialization, and their children's behavior problems.

RESULTS

The results of structural equation modelling (SEM) analyses revealed that maternal adult attachment influenced child behavior problems directly and indirectly through maternal emotion socialization. (1) Maternal attachment anxiety directly affected child externalizing problems, and indirectly affected them via mothers' higher unsupportive emotion socialization (dismissing and dysfunction). Moreover, attachment anxiety influenced child internalizing problems directly, and indirectly via mothers' higher unsupportive emotion socialization (dysfunction). (2) Furthermore, attachment avoidance indirectly impacted child externalizing problems via mothers' lower supportive emotion socialization (coaching).

CONCLUSIONS

These results suggested that maternal adult attachment styles and emotion-related parenting have important implications for the development of child behaviors. Future interventions should target parental factors to mitigate the risk of behavior problems among preschoolers.

Interventions for Young Children's Mental Health: A Review of Reviews

To determine the efficacy of intervention programs for young children (4-9 years) with emerging mental health needs, we conducted a review of meta-analytic and systematic reviews of the intervention literature. Of 41,061 abstracts identified and 15,076 screened, 152 review articles met the inclusion criteria. We reviewed interventions across multiple disciplines targeting: (1) general mental health concerns; (2) internalizing symptoms; (3) externalizing symptoms; (4) anxiety; (5) depression; (6) trauma; (7) symptoms of attention-deficit/hyperactivity disorder; and (8) mental health concerns associated with autism spectrum disorder. Substantial evidence was found for the efficacy of behavioral and cognitive behavioral interventions for general mental health concerns, externalizing symptoms (generally, as well as ADHD, conduct, and other behavioral symptoms) and internalizing symptoms (generally, as well as anxiety) aged 4-9 years. Emerging evidence was identified for interventions targeting trauma symptoms, depression symptoms, and social, emotional and behavioral symptoms in autism spectrum disorder in children aged 4-9 years. Currently there is only limited emerging evidence regarding non-behavioral or non-cognitive behavioral interventions for programs targeting children ages 4-9 years where the aim is to deliver an evidence-based program to improve child social, emotional and/or behavioral functioning. Given the recent rises in mental health needs reported in children, targeted behavioral-and/or cognitive behavior therapy-based interventions should be made widely available to children (and their families) who experience elevated symptoms.

Effects of emotionally oriented parental interventions: a systematic review and meta-analysis

Objective

This systematic review and meta-analysis investigates the effects of emotionally oriented parental interventions.

Background

Several emotionally oriented parental interventions have been developed during the last decade. Some of these have gained popularity and spread across several continents. The literature is growing and consists of qualitative studies; intervention only, quasi-experimental, case-control studies; and randomized controlled trials. They indicate effects for parents and children. However, no systematic review or meta-analysis has, to our knowledge, summarized the results.

Method

Using several search engines, we located 8,272 studies. After abstract and full-text screening, 33 studies were assessed for bias and included in the study. Outcomes for parents and children were extracted and combined into three constructs for parents and two for children. Meta-analyses were conducted for each construct to estimate the effect of the interventions using a robust Bayes meta-analysis.

Results

The results indicate the presence of a small to medium effect on parents' mental health, behavior, and use of emotionally oriented parenting, as well as on children's internalizing and externalizing difficulties. Most participants were recruited from the general population, and clinical settings were rare. The results show little evidence of publication bias.

Conclusion

There is evidence of a small to medium effect of emotionally oriented interventions on parents and children.

Systematic review registration

https://osf.io/un3q4/.