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Bloss C, Brown S, Sawrikar V. Does behavioural parent training reduce internalising symptoms (or not) among children with externalising problems? Systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2024; 33:2485-2501. [PMID: 36527525 PMCID: PMC11272747 DOI: 10.1007/s00787-022-02122-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
Behaviour parent training (BPT) is known to effectively reduce child externalising problems. However, evidence for BPT to have secondary benefits for reducing internalising symptoms remains unclear. To address this, electronic databases (PsycINFO, MEDLINE, EMBASE, CINAHL, and SCOPUS) were systematically searched for studies examining internalising outcomes from BPT among children aged 2-12 years with clinically elevated externalizing problems. Outcomes for internalising problems following BPT were analysed by meta-analysis. Of 9105 studies identified, 24 studies met the eligibility criteria. Results from meta-analysis demonstrated a significant small treatment effect size (g = - 0.41) for reducing internalising symptoms immediately after treatment. Studies showed moderate heterogeneity (I2 = 44%). Moderation analyses indicated that the overall treatment effect was robust against variations in treatment and study design characteristics. However, a review of individual study methods indicate that these results are limited by significant heterogeneity and limitations in clinical assessment. Overall, the results suggest that BPT programmes for reducing externalising problems have the potential to improve internalising outcomes, but that there is limited information to determine the reliability of these effects, highlighting the need for further investigation.
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Affiliation(s)
- Christy Bloss
- Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Sophie Brown
- Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Vilas Sawrikar
- Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK.
- Centre of Applied Developmental Psychology, University of Edinburgh, Edinburgh, UK.
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2
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Ribas LH, Montezano BB, Nieves M, Kampmann LB, Jansen K. The role of parental stress on emotional and behavioral problems in offspring: a systematic review with meta-analysis. J Pediatr (Rio J) 2024:S0021-7557(24)00040-8. [PMID: 38636551 DOI: 10.1016/j.jped.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 04/20/2024] Open
Abstract
OBJECTIVE Empirical evidence underscores an association between parental stress and emotional and behavioral problems in offspring. However, a comprehensive systematic review or meta-analysis on this topic is lacking. Thus, this study aims to address the scientific inquiry: Is there a relationship between parental stress and emotional/behavioral problems in children? SOURCES This systematic review with a meta-analysis surveyed PubMed, PsycINFO, and the Biblioteca Virtual em Saúde between August and September 2021. The present search combined terms (school-age children) AND (parental stress OR parenting stress OR family stress) AND (emotional and behavioral problems OR internalizing and externalizing problems). Eligibility criteria encompassed cross-sectional, cohort, and case-control studies published within the last five years, exploring the association between parental stress (stressful life events and parenthood-related stress disorders) and emotional/behavioral problems in school-age children. PROSPERO ID CRD42022274034. SUMMARY OF THE FINDINGS Of the 24 studies meeting all inclusion criteria (n = 31,183) for the systematic review, nine were eligible for inclusion in the meta-analysis. The meta-analysis revealed an association between parental stress and emotional problems (COR: 0.46 [95 % CI: 0.27 - 0.61], p < 0.001, Heterogeneity = 89 %) as well as behavioral problems (COR: 0.37 [95 % CI: 0.27 - 0.46], p < 0.001, Heterogeneity = 76 %). CONCLUSIONS These findings indicate that parental stress predicts emotional/behavioral problems in school-age children. Since these problems are related to long-term negative effects in adulthood, these results are crucial for preventing mental health problems in offspring and for screening and managing parental stress.
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Affiliation(s)
| | | | - Maria Nieves
- Universidade Católica de Pelotas, Pelotas, RS, Brazil
| | | | - Karen Jansen
- Universidade Católica de Pelotas, Pelotas, RS, Brazil
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3
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Pezzoli P, Pingault JB, Malanchini M, Voronin I, McCrory E, Fearon P, Viding E. Reciprocal Effects Between Negative Parenting and Children's Callous-Unemotional Traits From Mid to Late Childhood. Am J Psychiatry 2024; 181:310-321. [PMID: 38476045 DOI: 10.1176/appi.ajp.20230208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
OBJECTIVE The role of negative parenting in the development of callous-unemotional (CU) traits remains unclear. Both negative parenting and CU traits are influenced by genetic and environmental factors. The authors used genetically informed longitudinal cross-lagged models to examine the extent to which reciprocal effects between negative parenting and children's CU traits in mid-to-late childhood are genetic versus environmental in origin. METHODS In 9,260 twin pairs from the Twins Early Development Study, the authors estimated cross-lagged effects between negative parenting (discipline and feelings) and children's CU traits in mid (ages 7-9) and late (ages 9-12) childhood. RESULTS CU traits were strongly heritable and stable. Stability was explained largely by genetic factors. The influence of negative parenting on the development of CU traits was small and driven mostly by genetic and shared environmental factors. In mid childhood, the influence of children's CU traits on subsequent negative parenting (i.e., evoked by children's CU traits) was also small and mostly genetic in origin. In late childhood, CU traits showed no effects on negative parental discipline and small effects on negative parental feelings, which reflected mostly shared environmental factors. CONCLUSIONS In mid-to-late childhood, genetic factors strongly influenced the development of CU traits, whereas environmental effects of negative parenting were small. Negative parenting was also relatively unaffected by CU traits. The small reciprocal effects originated mostly from genetic and shared environmental factors. Therefore, repeated intensive interventions addressing multiple risk factors rather than negative parenting alone may be best positioned to support families of children with CU traits across development.
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Affiliation(s)
- Patrizia Pezzoli
- Division of Psychology and Language Sciences, University College London (Pezzoli, Pingault, McCrory, Fearon, Viding); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Pingault, Malanchini); School of Biological and Behavioural Sciences, Queen Mary University of London, London (Malanchini); École de Psychologie, Université Laval, Quebec City, Quebec (Voronin); Department of Psychology, University of Cambridge, Cambridge, U.K. (Fearon)
| | - Jean-Baptiste Pingault
- Division of Psychology and Language Sciences, University College London (Pezzoli, Pingault, McCrory, Fearon, Viding); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Pingault, Malanchini); School of Biological and Behavioural Sciences, Queen Mary University of London, London (Malanchini); École de Psychologie, Université Laval, Quebec City, Quebec (Voronin); Department of Psychology, University of Cambridge, Cambridge, U.K. (Fearon)
| | - Margherita Malanchini
- Division of Psychology and Language Sciences, University College London (Pezzoli, Pingault, McCrory, Fearon, Viding); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Pingault, Malanchini); School of Biological and Behavioural Sciences, Queen Mary University of London, London (Malanchini); École de Psychologie, Université Laval, Quebec City, Quebec (Voronin); Department of Psychology, University of Cambridge, Cambridge, U.K. (Fearon)
| | - Ivan Voronin
- Division of Psychology and Language Sciences, University College London (Pezzoli, Pingault, McCrory, Fearon, Viding); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Pingault, Malanchini); School of Biological and Behavioural Sciences, Queen Mary University of London, London (Malanchini); École de Psychologie, Université Laval, Quebec City, Quebec (Voronin); Department of Psychology, University of Cambridge, Cambridge, U.K. (Fearon)
| | - Eamon McCrory
- Division of Psychology and Language Sciences, University College London (Pezzoli, Pingault, McCrory, Fearon, Viding); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Pingault, Malanchini); School of Biological and Behavioural Sciences, Queen Mary University of London, London (Malanchini); École de Psychologie, Université Laval, Quebec City, Quebec (Voronin); Department of Psychology, University of Cambridge, Cambridge, U.K. (Fearon)
| | - Pasco Fearon
- Division of Psychology and Language Sciences, University College London (Pezzoli, Pingault, McCrory, Fearon, Viding); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Pingault, Malanchini); School of Biological and Behavioural Sciences, Queen Mary University of London, London (Malanchini); École de Psychologie, Université Laval, Quebec City, Quebec (Voronin); Department of Psychology, University of Cambridge, Cambridge, U.K. (Fearon)
| | - Essi Viding
- Division of Psychology and Language Sciences, University College London (Pezzoli, Pingault, McCrory, Fearon, Viding); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Pingault, Malanchini); School of Biological and Behavioural Sciences, Queen Mary University of London, London (Malanchini); École de Psychologie, Université Laval, Quebec City, Quebec (Voronin); Department of Psychology, University of Cambridge, Cambridge, U.K. (Fearon)
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4
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Lo RF, Schumacher A, LaForge-Mackenzie K, Cost KT, Crosbie J, Charach A, Anagnostou E, Birken CS, Monga S, Korczak DJ. Evaluation of an automated matching system of children and families to virtual mental health resources during COVID-19. Child Adolesc Psychiatry Ment Health 2024; 18:24. [PMID: 38336708 PMCID: PMC10858567 DOI: 10.1186/s13034-024-00716-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Children and their families often face obstacles in accessing mental health (MH) services. The purpose of this study was to develop and pilot test an electronic matching process to match children with virtual MH resources and increase access to treatment for children and their families during COVID-19. METHODS Within a large observational child cohort, a random sample of 292 families with children ages 6-12 years were invited to participate. Latent profile analysis indicated five MH profiles using parent-reported symptom scores from validated depression, anxiety, hyperactivity, and inattention measures: (1) Average Symptoms, (2) Low Symptoms, (3) High Symptoms, (4) Internalizing, and (5) Externalizing. Children were matched with virtual MH resources according to their profile; parents received surveys at Time 1 (matching process explanation), Time 2 (match delivery) and Time 3 (resource uptake). Data on demographics, parent MH history, and process interest were collected. RESULTS 128/292 families (44%) completed surveys at Time 1, 80/128 families (63%) at Time 2, and a final 67/80 families (84%) at Time 3, yielding an overall uptake of 67/292 (23%). Families of European-descent and those with children assigned to the Low Symptoms profile were most likely to express interest in the process. No other factors were associated with continued interest or uptake of the electronic matching process. Most participating parents were satisfied with the process. CONCLUSIONS The electronic matching process delivered virtual MH resources to families in a time-efficient manner. Further research examining the effectiveness of electronically matched resources in improving children's MH symptoms is needed.
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Affiliation(s)
- Ronda F Lo
- Department of Psychiatry, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Anett Schumacher
- Department of Psychiatry, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Kaitlyn LaForge-Mackenzie
- Department of Psychiatry, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Katherine Tombeau Cost
- Department of Psychiatry, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
| | - Alice Charach
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | | | - Catherine S Birken
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Paediatric Medicine, Hospital for Sick Children, Toronto, ON, Canada
| | - Suneeta Monga
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Daphne J Korczak
- Department of Psychiatry, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
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Nonweiler J, Torrecilla P, Kwapil TR, Ballespí S, Barrantes-Vidal N. I don't understand how I feel: mediating role of impaired self-mentalizing in the relationship between childhood adversity and psychosis spectrum experiences. Front Psychiatry 2023; 14:1268247. [PMID: 38098634 PMCID: PMC10719857 DOI: 10.3389/fpsyt.2023.1268247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/13/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction Childhood adversity is associated with the severity of multiple dimensions of psychosis, but the mechanisms underpinning the close link between the two constructs is unclear. Mentalization may underlie this relationship, as impaired mentalizing is found in various stages of the psychosis continuum. Nonetheless, the differential roles of self- and other-mentalizing in psychosis are not well understood. Methods Parallel multiple mediation was conducted for the relationship between a diverse range of childhood adversity types, including intentional and nonintentional harm, and schizotypy (positive, negative, disorganized), psychotic-like experiences (PLE) and paranoia via self-mentalizing (attention to emotions and emotional clarity) and other-mentalizing in n = 1,156 nonclinically ascertained young adults. Results Significant parallel multiple mediation models were found for all psychotic outcomes except negative schizotypy. The associations between intentionally harmful childhood adversity and psychotic outcomes were significantly mediated by increased attention to emotions for most models and decreased emotional clarity for some models. No significant mediation was found for parental loss. Paternal abuse was only mediated by attention to emotions whereas the effects of maternal abuse were mediated by attention to emotions and emotional clarity. Other-mentalizing only showed mediating effects on one of thirty models tested. Conclusion Results highlight the mediating role of impaired self-mentalizing in the association between childhood adversity and psychosis. This is consistent with disturbances of self-concept and self-boundary characterizing, in particular, the positive dimension of psychosis. Maternal versus paternal figures may contribute differentially to the development of mentalizing. These results could inform future preventative interventions, focusing on the development and maintenance of self-mentalizing.
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Affiliation(s)
- Jacqueline Nonweiler
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pilar Torrecilla
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Thomas R. Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Sergi Ballespí
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
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6
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Scaini S, Caputi M, Giani L. Parent and Child Predictors of Internalizing and Externalizing Symptomatology during COVID-19. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1625. [PMID: 37892288 PMCID: PMC10605653 DOI: 10.3390/children10101625] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/18/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023]
Abstract
The COVID-19 emergency has fostered an increasing risk of experiencing distress and negative emotions in parents that turned into heightened stress for children. In this study, we aim to evaluate the effects of parental stress, children's resilience, and previous adversities on the development of internalizing and externalizing symptoms in children. A series of questionnaires were completed by 158 Italian parents (148 mothers, 10 fathers, mean age = 41 years) concerning them and their school-aged children (N = 158, 76 boys, mean age = 7.4 years) at two critical time points (June 2020 and December 2020). Regression analyses showed that internalizing problems were predicted only by concurrent children's resilience, whereas externalizing problems were predicted by concurrent parental flooding, children's resilience, and early parental satisfaction. Therefore, internalizing and externalizing symptoms trajectories follow different routes and are predicted by both common and distinct factors. Supporting positive parenting attitudes and behavior should be recommended to prevent the worsening of children's externalizing behaviors. At the same time, nurturing resilience in pediatric systems might be useful in preventing or reducing children's internalizing symptoms.
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Affiliation(s)
- Simona Scaini
- Department of Psychology, Sigmund Freud University, Ripa di Porta Ticinese 77, 20143 Milan, Italy; (S.S.); (L.G.)
- Child and Adolescent Unit, Italian Psychotherapy Clinics, Corso San Gottardo 5, 20136 Milan, Italy
| | - Marcella Caputi
- Department of Life Sciences, University of Trieste, Via E. Weiss 21, 34128 Trieste, Italy
| | - Ludovica Giani
- Department of Psychology, Sigmund Freud University, Ripa di Porta Ticinese 77, 20143 Milan, Italy; (S.S.); (L.G.)
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7
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Loh AHY, Ong LL, Yong FSH, Chen HY. Improving mother-infant bonding in postnatal depression - The SURE MUMS study. Asian J Psychiatr 2023; 81:103457. [PMID: 36638754 DOI: 10.1016/j.ajp.2023.103457] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 01/05/2023] [Accepted: 01/07/2023] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To study the effectiveness of the Sure Mums intervention in improving mother-baby bonding in a group of new mothers in Singapore. METHODS Over a period of 2 years from 2017 to 2019, thirty-two mothers were identified from our clinic population seeking treatment for postnatal mental health difficulties - these included depressive or anxiety symptoms, together with bonding difficulties. They received home-based mother-infant therapy sessions, and scores for the Postpartum Bonding Questionnaire (PBQ), Global Assessment of Functioning (GAF), and Edinburgh Postnatal Depression Scale (EPDS) were taken pre- and post-intervention. RESULTS In all, twenty-five mothers completed measures for baseline characteristics, pretreatment scores and post-treatment scores. Paired sample t-tests were conducted for the 4 subscales of the PBQ, the GAF rating score, and the EPDS score. Postintervention scores noted a reduction in the mean of all of the 4 PBQ subscales, and 3 of the 4 scores had differences that were shown to be statistically significant improvement. The EPDS pre-intervention mean score was 17.72, while mean postintervention EPDS score was 9.2. Total GAF scores showed an mean uptrend by 12-14 points, likely indicating significant improvement in the mothers' functioning post intervention. CONCLUSIONS The results of this programme shows promising evidence of its effectiveness in improving the quality of bonding in mothers with postnatal mental health difficulties. For future direction, we hope to offer the SURE MUMS programme to more mothers who are struggling to bond with their baby amidst the challenges of becoming a parent.
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Affiliation(s)
- Abigail Hong Yan Loh
- Ministry of Health Holdings Pte Ltd, 1 Maritime Square, #11-25 Harbour Front Centre, 099253, Singapore.
| | - Li Lian Ong
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore.
| | - Flora Su Hui Yong
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore.
| | - Helen Yu Chen
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore; Duke-National University of Singapore, Singapore.
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8
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Berry V, Mitchell SB, Blower S, Whittaker K, Wilkinson K, McGilloway S, Mason-Jones A, Carr RM, Bywater T. Barriers and facilitators in the delivery of a proportionate universal parenting program model (E-SEE Steps) in community family services. PLoS One 2022; 17:e0265946. [PMID: 35696375 PMCID: PMC9191704 DOI: 10.1371/journal.pone.0265946] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 03/10/2022] [Indexed: 11/19/2022] Open
Abstract
Background A proportionate universal (PU) approach to early years’ service provision has been advocated to improve children’s health and development and to reduce health inequality, by ensuring that services provide timely and high-quality parenting support commensurate with need. Process-oriented research is critical to examine the factors that contribute to, or hinder, the effective delivery/implementation of such a model in community-based family services. This study aimed to assess the delivery, acceptability and feasibility of a new PU parenting intervention model (called E-SEE Steps), using the Incredible Years® (IY) parent program, when delivered by trained health/family service staff in three “steps”—one universal step (the IY Babies Book), and two targeted steps (group-based IY Infant and Toddler programs). Methods An embedded mixed-methods process evaluation within a pragmatic parallel two-arm, assessor blinded, randomized controlled trial was conducted in community services in four local authorities in England. The process evaluation used qualitative data gathered via interviews and focus groups with intervention arm parents who were offered the targeted steps (n = 29), practitioners (n = 50), service managers (n = 7) and IY program mentors (n = 3). This was supplemented by quantitative data collected using group leader pre-training (n = 50) and post-delivery (n = 39) questionnaires, and research notes of service design decisions. Results The E-SEE Steps model was acceptable to most parents, particularly when it was accompanied by engagement strategies that supported attendance, such as providing childcare. Practitioners also highlighted the positive development opportunities provided by the IY training and supervision. However, participant views did not support the provision of the IY Babies book as a standalone universal component, and there were barriers to eligible parents—particularly those with low mood—taking up the targeted programs. Service providers struggled to align the PU model with their commissioned service contracts and with their staff capacity to engage appropriate parents, including tackling common barriers to attendance. Conclusions Despite general enthusiasm and support for delivering high-quality parenting programs in community services in the England, several barriers exist to successfully delivering IY in a proportionate universal model within current services/systems.
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Affiliation(s)
- Vashti Berry
- College of Medicine and Health, University of Exeter, Exeter, Devon, United Kingdom
- * E-mail:
| | - Siobhan B. Mitchell
- College of Medicine and Health, University of Exeter, Exeter, Devon, United Kingdom
| | - Sarah Blower
- Department of Health Sciences, University of York, York, North Yorkshire, United Kingdom
| | - Karen Whittaker
- School of Nursing, University of Central Lancashire, Preston, Lancashire, United Kingdom
| | - Kath Wilkinson
- College of Medicine and Health, University of Exeter, Exeter, Devon, United Kingdom
| | - Sinead McGilloway
- Centre for Mental Health and Community Research, Department of Psychology and Social Sciences Institute, Maynooth University, Maynooth, Co Kildare, Republic of Ireland
| | - Amanda Mason-Jones
- Department of Health Sciences, University of York, York, North Yorkshire, United Kingdom
| | - Rachel Margaret Carr
- Department of Health Sciences, University of York, York, North Yorkshire, United Kingdom
| | - Tracey Bywater
- Department of Health Sciences, University of York, York, North Yorkshire, United Kingdom
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9
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Havighurst SS, Chainey C, Doyle FL, Higgins DJ, Mathews B, Mazzucchelli TG, Zimmer-Gembeck M, Andriessen K, Cobham VE, Cross D, Dadds MR, Dawe S, Gray KM, Guastella AJ, Harnett P, Haslam DM, Middeldorp CM, Morawska A, Ohan JL, Sanders MR, Stallman HM, Tonge BJ, Toumbourou JW, Turner KMT, Williams KE, Yap MBH, Nicholson JM. A review of Australian Government funding of parenting intervention research. Aust N Z J Public Health 2022; 46:262-268. [PMID: 35436026 DOI: 10.1111/1753-6405.13235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/01/2021] [Accepted: 02/01/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Parenting is central to children's optimal development and accounts for a substantial proportion of the variance in child outcomes, including up to 40% of child mental health. Parenting is also one of the most modifiable, proximal, and direct factors for preventing and treating a range of children's problems and enhancing wellbeing. To determine the effectiveness of new approaches to parenting intervention, and to evaluate how to optimise reach and uptake, sufficient funding must be allocated for high quality research. METHOD We reviewed funding awarded by the National Health and Medical Research Council (NHMRC) and Australian Research Council (ARC) for parenting intervention research during 2011-2020. RESULTS Parenting intervention research received 0.25% of the NHMRC and ARC research budgets. CONCLUSIONS There is a substantial mismatch between the funding of parenting intervention research and the impact of improved parenting on short- and long-term child outcomes. To rectify this, it is critical that Australian Government funding schemes include parenting interventions as priority areas for funding. IMPLICATIONS FOR PUBLIC HEALTH Changes in allocation of funding to parenting research will support the establishment of evidence for the effective development, implementation and dissemination of parenting interventions to maximise health outcomes for children and their families.
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Affiliation(s)
- Sophie S Havighurst
- Mindful: Centre for Training and Research in Developmental Health, The University of Melbourne, Melbourne, Victoria
| | - Carys Chainey
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland
| | - Frances L Doyle
- School of Psychology, MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Penrith, New South Wales
| | - Daryl J Higgins
- Institute of Child Protection Studies, Australian Catholic University, Melbourne, Victoria
| | - Ben Mathews
- Faculty of Law, Queensland University of Technology, Brisbane, Queensland
| | - Trevor G Mazzucchelli
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland.,Division of Psychology, School of Population Health, Curtin University, Perth, Western Australia
| | - Melanie Zimmer-Gembeck
- School of Applied Psychology & Menzies Health Institute of Queensland, Griffith University, Gold Coast, Queensland
| | - Karl Andriessen
- Centre for Mental Health, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria
| | - Vanessa E Cobham
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland
| | - Donna Cross
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia
| | - Mark R Dadds
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales
| | - Sharon Dawe
- School of Applied Psychology & Applied Health Institute of Queensland, Griffith University, Brisbane, Queensland
| | - Kylie M Gray
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK.,Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, Victoria
| | - Adam J Guastella
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales
| | - Paul Harnett
- School of Criminology and Criminal Justice, Griffith University, Brisbane, Queensland
| | - Divna M Haslam
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland.,Faculty of Law, Queensland University of Technology, Brisbane, Queensland
| | - Christel M Middeldorp
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland
| | - Alina Morawska
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland
| | - Jeneva L Ohan
- School of Psychological Science, The University of Western Australia, Perth, Western Australia
| | - Matthew R Sanders
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland
| | - Helen M Stallman
- Thompson Institute, University of the Sunshine Coast, Sunshine Coast, Queensland
| | - Bruce J Tonge
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, Victoria
| | - John W Toumbourou
- School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria
| | - Karen M T Turner
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Queensland
| | - Kate E Williams
- Centre for Child and Family Studies, Queensland University of Technology, Brisbane, Queensland
| | - Marie B H Yap
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria.,School of Population and Global Health, University of Melbourne, Melbourne, Victoria
| | - Jan M Nicholson
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria
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10
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Paleari FG, Celsi L, Galati D, Pivetti M. Gender Differences in the Associations Between Perceived Parenting Styles and Young Adults' Cyber Dating Abuse. Front Psychol 2022; 13:818607. [PMID: 35401302 PMCID: PMC8987230 DOI: 10.3389/fpsyg.2022.818607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/10/2022] [Indexed: 11/25/2022] Open
Abstract
Existing literature indicates that parenting styles affect the development of cyber aggression in offspring differently, depending on the gender of children. The present study investigates whether mothers' and fathers' parenting styles show similar gender differences in their associations with a new form of dating violence, i.e., cyber dating abuse (CDA). The limited evidence on the issue focuses on the relation that each parenting style has with CDA perpetration, without considering CDA victimization and the joint effects of fathers' and mothers' parenting styles. The present study contributes to the research on gender differences in parenting by examining whether young adults' perceptions of maternal and paternal parenting styles during childhood were independently and/or jointly related to their perpetrated and suffered CDA and whether these relations differed across young adults' gender. In total, 351 young adults (50.7% men), age between 18 and 35 years and having a romantic relationship, completed online self-reports of the variables of interest that include a bidimensional measure of perpetrated/suffered CDA that assess aggression and control. Results showed that maternal authoritarian parenting was uniquely and positively associated to their children's perpetration and victimization of cyber dating control, whereas maternal permissive parenting was uniquely and positively related to their children's perpetration of cyber dating aggression and victimization of cyber dating control. For daughters, these associations were stronger when the father's style was similar to the mother's one or when a maternal authoritarian style combined with a paternal permissive style, thus indicating that the two parents' parenting styles interact in relating to their daughters' CDA.
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Affiliation(s)
- F. Giorgia Paleari
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
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11
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Borelli JL, Russo LN, Arreola J, Cervantes BR, Marquez CM, Montiel G, Avalos V, Carballo J, Garcia J, Bhatt I, Torres G, Leal F, Guerra N. Saving a seat at the table for community members: co-creating an attachment-based intervention for low-income Latin parent-youth dyads using a promotor/a model. RESEARCH IN PSYCHOTHERAPY: PSYCHOPATHOLOGY, PROCESS AND OUTCOME 2022; 25. [PMID: 35373959 PMCID: PMC9153758 DOI: 10.4081/ripppo.2022.598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 12/15/2021] [Indexed: 11/23/2022]
Abstract
Evidence for the effectiveness of attachment-based interventions in improving youth’s socioemotional health increases each year, yet potential for scalability of existing programs is limited. Available programs may have lower acceptability within low-income immigrant communities. Co-designing and implementing interventions with trained community workers (Promotors) offers an appealing solution to multiple challenges, but community workers must have high investment in the program for this to be a workable solution. This study examines the experiences of promotors involved in the co-creation and delivery of an attachmentbased intervention program for low-income Latinx youth (ages 8 to 17) and their mothers. Promotors (N=8) completed surveys, reporting on the experiences of each therapy group in terms of group dynamic (e.g., promotors’ connectedness to each group, perceived program relevance). Following the completion of the intervention study, promotors participated in interviews in which they described their experiences in co-creating the intervention, delivering the intervention to the community, and their recommendations for improving the intervention. Overall, promotors perceived group dynamics as positive, though the mother groups were evaluated as significantly higher in quality (e.g., lower conflict) than the youth groups. Interviews revealed that promotors enjoyed the cocreation process and identified important areas for improvements for the intervention (incorporation of more visuals, creation of agelimited groups, reducing number of youth sessions) and evaluation (reduction in length, modification of language). Integrating input from promotors in the process of co-creating and implementing an intervention can benefit every member of the community from the program participants to the providers themselves.
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12
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The Infant Health Study - Promoting mental health and healthy weight through sensitive parenting to infants with cognitive, emotional, and regulatory vulnerabilities: protocol for a stepped-wedge cluster-randomized trial and a process evaluation within municipality settings. BMC Public Health 2022; 22:194. [PMID: 35090411 PMCID: PMC8796192 DOI: 10.1186/s12889-022-12551-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 01/07/2022] [Indexed: 11/24/2022] Open
Abstract
Background Child mental health problems are a major public health concern associated with poor mental and physical health later in development. The study evaluates a new community-based intervention to promote sensitive parenting and reduce enduring mental health problems and unhealthy weight among vulnerable infants aged 9-24 months. Methods We use a step-wedge cluster randomized controlled trial design conducted within a home visiting program offered by community health nurses to infant families in Denmark. Sixteen municipalities are randomly allocated to implement the intervention starting at three successive time points from May 1, 2022 to January 1, 2023. A total of 900-1000 families will be included. A standardized program, Psykisk Udvikling og Funktion (PUF), is used to identify infants with major problems of eating, sleep, emotional or behavioral regulation or developmental problems. The intervention builds on the Video-Feedback Intervention to Promote Positive Parenting (VIPP) program, adapted to the PUF-context and named the VIPP-PUF. Children will be followed up at ages 18 and 24 months. Primary outcome measure is the Strengths and Difficulties Questionnaire (SDQ) at child age 24 months. The other outcome measures include body mass index z-scores, the Ages and Stages Questionnaire Social-Emotional (ASQ:SE2); the Child Behavior Checklist (CBCL 1½ -5); Eating behavior Questionnaires; the Being a Mother-questionnaire (BaM13); the Parental Stress Scale (PSS); and the WHO-5 well-being index (WHO-5). Data on child and family factors are obtained from National registries and the Child Health Database. Quantitative measures are applied to examine the effectiveness of the VIPP-PUF intervention and the implementation process. Qualitative measures include interviews with CHNs, parents and municipality stakeholders to explore factors that may influence the adherence and effectiveness of the intervention. Discussion The study examines a service-setting based intervention building on the promotion of sensitive parenting to vulnerable infants. We use a mixed methods approach to evaluate the intervention, taking into account the influences of COVID-19 pandemic running since March 2020. Overall, the study has potential to add to the knowledge on the possibilities of prevention within the municipality child health care to reduce the risk of mental health problems and unhealthy weight in early childhood. Trial registration www.ClinicalTrials.gov; IDNCT04601779; Protocol ID 95-110-21307. Registered 25 June 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12551-z.
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El-Deen GMS, Yousef AM, Mohamed AE, Ibrahim AS. Socio-demographic and clinical correlates of parenting style among parents having ADHD children: a cross-section study. MIDDLE EAST CURRENT PSYCHIATRY 2021. [DOI: 10.1186/s43045-021-00151-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
ADHD affects 7.8% of the school-aged population, making it one of the most common childhood brain illnesses. It is characterized by abnormally high levels of inattention, activity, and impulsivity at a young age. Being a parent of a child with ADHD is a real challenge, as the parents tend to be more disapproving, critical, and provide more impulse control directions; such parenting style can have an impact on the illnesses course, accentuate its signs and symptoms, and lead to secondary development of co-morbid psychiatric and behavioral problems. This makes the parent-child effect a matter of clinical importance that needs to be carefully assessed and managed. We aimed to estimate the sociodemographic and clinical correlates of parenting attitudes among parents having ADHD children. This cross-sectional study included 48 ADHD children from both sexes, aged from 6 to 12 years old, and their parents. In our study, we applied the Stanford-Binet Intelligence Scale 5th edition, the Conner’s Parent Rating Scale-revised, the parenting style as perceived by children questionnaire, and the Fahmy and El-Sherbini questionnaire for the measurement of socioeconomic status.
Results
Mothers of ADHD children had significantly lower scores of over-protections parenting style than the fathers; the current study showed a significant increase in total parenting scores and warmth/support in mild ADHD cases than in moderate and severe ones, and there is a significant increase in the mother’s positive parenting style toward ADHD children with lower levels of social problems, mild cases, and older age. There is a significant increase of positive parenting style toward ADHD children exerted by post graduated, professionally working, and high social class fathers and by working mothers among rural residents and high social class mothers. There is a positive correlation between IQ and a mother’s warmth/support.
Conclusion
ADHD children with mild symptoms, higher social functioning of the child, high socioeconomic level of the family, better education, and professional occupations of parents were associated with positive parenting style.
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Khoury JE, Kaur H, Gonzalez A. Parental Mental Health and Hostility Are Associated With Longitudinal Increases in Child Internalizing and Externalizing Problems During COVID-19. Front Psychol 2021; 12:706168. [PMID: 34393943 PMCID: PMC8357980 DOI: 10.3389/fpsyg.2021.706168] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/02/2021] [Indexed: 12/03/2022] Open
Abstract
Children are at high risk for negative COVID-19 related outcomes. The present longitudinal study assessed (1) changes in child internalizing and externalizing problems from before to during the pandemic and (2) whether parent mental health (depression, anxiety, stress) or parenting behavior during COVID-19 were associated with changes in child mental health problems. Sixty eight mother-child dyads participated in this study. Children were approximately five years-old at the time of enrollment and were between the ages of 7–9 years old at the time of the follow-up survey. Parenting behavior, parental depression, anxiety, perceived stress and child internalizing and externalizing problems were measured using validated questionnaires. Children experienced greater internalizing (t = 6.46, p < 0.001) and externalizing (t = 6.13, p < 0.001) problems during the pandemic compared to before the pandemic. After taking into account child gender and COVID-related stressors, parental hostility was uniquely associated with greater changes in externalizing problems (β = 0.355, SE = 0.178, p < 0.05), while maternal anxiety was associated with greater increases in internalizing problems (β = 0.513, SE = 0.208, p < 0.05). Findings highlight the need for mental health supports for families to limit the impact of the COVID-19 pandemic on child and parent mental health.
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Affiliation(s)
- Jennifer E Khoury
- Department of Psychology, Mount Saint Vincent University, Halifax, NS, Canada
| | - Hargun Kaur
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
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15
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Iranpour A. How to "Immunize" Children against Drug and Alcohol Abuse. ADDICTION & HEALTH 2021; 13:205-206. [PMID: 35047130 PMCID: PMC8730446 DOI: 10.22122/ahj.v13i3.308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 05/01/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Abedin Iranpour
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran,Correspondence to: Abedin Iranpour; HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran;
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Abdelrahman M, Al-Adwan D, Hasan Y. Impact of Social Distancing on the Mental Health of Parents and Children in Qatar. Int J Ment Health Addict 2021; 20:2894-2905. [PMID: 34121959 PMCID: PMC8183319 DOI: 10.1007/s11469-021-00555-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/24/2021] [Indexed: 12/23/2022] Open
Abstract
This study investigated the effects of COVID-19-related social distancing practices on parents and children’s mental health and explored joint parent-child activities and coping strategies among Arab families in Qatar. The sample of 308 parents answered self-reported questionnaires regarding their mental health, coping strategies, activities with their children, social distancing practices, and their children’s mental health. Pearson’s correlation coefficient and structural equation modeling were carried out. The results showed a significant positive correlation between social distancing and parents’ activities with their children and their coping strategies, as well as between parents’ mental health, activities with their children, children’s mental health, and parents’ coping strategies. Path analysis showed that social distancing practices influence both parents’ and children’s mental health through parents’ activities with children and their coping strategies. Our findings revealed how living under stressful conditions, such as COVID-19, could enhance the mental health of family members.
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Affiliation(s)
- Mohamed Abdelrahman
- Mokhtass for Consultations and Research, Ahmed Bin Mohamed Bin Thani, Doha, Qatar
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17
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A phenomenological exploration of parenting after birth trauma: Mothers perceptions of the first year. Women Birth 2021; 34:278-287. [DOI: 10.1016/j.wombi.2020.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 03/05/2020] [Accepted: 03/06/2020] [Indexed: 11/24/2022]
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O'Farrelly C, Barker B, Watt H, Babalis D, Bakermans-Kranenburg M, Byford S, Ganguli P, Grimås E, Iles J, Mattock H, McGinley J, Phillips C, Ryan R, Scott S, Smith J, Stein A, Stevens E, van IJzendoorn M, Warwick J, Ramchandani P. A video-feedback parenting intervention to prevent enduring behaviour problems in at-risk children aged 12-36 months: the Healthy Start, Happy Start RCT. Health Technol Assess 2021; 25:1-84. [PMID: 34018919 PMCID: PMC8182442 DOI: 10.3310/hta25290] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Behaviour problems emerge early in childhood and place children at risk for later psychopathology. OBJECTIVES To evaluate the clinical effectiveness and cost-effectiveness of a parenting intervention to prevent enduring behaviour problems in young children. DESIGN A pragmatic, assessor-blinded, multisite, two-arm, parallel-group randomised controlled trial. SETTING Health visiting services in six NHS trusts in England. PARTICIPANTS A total of 300 at-risk children aged 12-36 months and their parents/caregivers. INTERVENTIONS Families were allocated in a 1 : 1 ratio to six sessions of Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) plus usual care or usual care alone. MAIN OUTCOME MEASURES The primary outcome was the Preschool Parental Account of Children's Symptoms, which is a structured interview of behaviour symptoms. Secondary outcomes included caregiver-reported total problems on the Child Behaviour Checklist and the Strengths and Difficulties Questionnaire. The intervention effect was estimated using linear regression. Health and social care service use was recorded using the Child and Adolescent Service Use Schedule and cost-effectiveness was explored using the Preschool Parental Account of Children's Symptoms. RESULTS In total, 300 families were randomised: 151 to VIPP-SD plus usual care and 149 to usual care alone. Follow-up data were available for 286 (VIPP-SD, n = 140; usual care, n = 146) participants and 282 (VIPP-SD, n = 140; usual care, n = 142) participants at 5 and 24 months, respectively. At the post-treatment (primary outcome) follow-up, a group difference of 2.03 on Preschool Parental Account of Children's Symptoms (95% confidence interval 0.06 to 4.01; p = 0.04) indicated a positive treatment effect on behaviour problems (Cohen's d = 0.20, 95% confidence interval 0.01 to 0.40). The effect was strongest for children's conduct [1.61, 95% confidence interval 0.44 to 2.78; p = 0.007 (d = 0.30, 95% confidence interval 0.08 to 0.51)] versus attention deficit hyperactivity disorder symptoms [0.29, 95% confidence interval -1.06 to 1.65; p = 0.67 (d = 0.05, 95% confidence interval -0.17 to 0.27)]. The Child Behaviour Checklist [3.24, 95% confidence interval -0.06 to 6.54; p = 0.05 (d = 0.15, 95% confidence interval 0.00 to 0.31)] and the Strengths and Difficulties Questionnaire [0.93, 95% confidence interval -0.03 to 1.9; p = 0.06 (d = 0.18, 95% confidence interval -0.01 to 0.36)] demonstrated similar positive treatment effects to those found for the Preschool Parental Account of Children's Symptoms. At 24 months, the group difference on the Preschool Parental Account of Children's Symptoms was 1.73 [95% confidence interval -0.24 to 3.71; p = 0.08 (d = 0.17, 95% confidence interval -0.02 to 0.37)]; the effect remained strongest for conduct [1.07, 95% confidence interval -0.06 to 2.20; p = 0.06 (d = 0.20, 95% confidence interval -0.01 to 0.42)] versus attention deficit hyperactivity disorder symptoms [0.62, 95% confidence interval -0.60 to 1.84; p = 0.32 (d = 0.10, 95% confidence interval -0.10 to 0.30)], with little evidence of an effect on the Child Behaviour Checklist and the Strengths and Difficulties Questionnaire. The primary economic analysis showed better outcomes in the VIPP-SD group at 24 months, but also higher costs than the usual-care group (adjusted mean difference £1450, 95% confidence interval £619 to £2281). No treatment- or trial-related adverse events were reported. The probability of VIPP-SD being cost-effective compared with usual care at the 24-month follow-up increased as willingness to pay for improvements on the Preschool Parental Account of Children's Symptoms increased, with VIPP-SD having the higher probability of being cost-effective at willingness-to-pay values above £800 per 1-point improvement on the Preschool Parental Account of Children's Symptoms. LIMITATIONS The proportion of participants with graduate-level qualifications was higher than among the general public. CONCLUSIONS VIPP-SD is effective in reducing behaviour problems in young children when delivered by health visiting teams. Most of the effect of VIPP-SD appears to be retained over 24 months. However, we can be less certain about its value for money. TRIAL REGISTRATION Current Controlled Trials ISRCTN58327365. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 29. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Christine O'Farrelly
- Division of Psychiatry, Imperial College London, London, UK
- Centre for Research on Play in Education, Development, and Learning, Faculty of Education, University of Cambridge, Cambridge, UK
| | - Beth Barker
- Division of Psychiatry, Imperial College London, London, UK
- Centre for Research on Play in Education, Development, and Learning, Faculty of Education, University of Cambridge, Cambridge, UK
| | - Hilary Watt
- School of Public Health, Imperial College London, London, UK
| | - Daphne Babalis
- Imperial Clinical Trials Unit, Imperial College London, London, UK
| | - Marian Bakermans-Kranenburg
- Clinical Child and Family Studies, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Sarah Byford
- Institute of Psychology, Psychiatry, and Neuroscience, King's College London, London, UK
| | - Poushali Ganguli
- Institute of Psychology, Psychiatry, and Neuroscience, King's College London, London, UK
| | - Ellen Grimås
- Division of Psychiatry, Imperial College London, London, UK
| | - Jane Iles
- Division of Psychiatry, Imperial College London, London, UK
- School of Psychology, University of Surrey, Guildford, UK
| | - Holly Mattock
- Division of Psychiatry, Imperial College London, London, UK
| | | | | | - Rachael Ryan
- Division of Psychiatry, Imperial College London, London, UK
| | - Stephen Scott
- Institute of Psychology, Psychiatry, and Neuroscience, King's College London, London, UK
| | - Jessica Smith
- Division of Psychiatry, Imperial College London, London, UK
- Imperial Clinical Trials Unit, Imperial College London, London, UK
| | - Alan Stein
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Eloise Stevens
- Division of Psychiatry, Imperial College London, London, UK
- Centre for Research on Play in Education, Development, and Learning, Faculty of Education, University of Cambridge, Cambridge, UK
| | - Marinus van IJzendoorn
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Jane Warwick
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - Paul Ramchandani
- Division of Psychiatry, Imperial College London, London, UK
- Centre for Research on Play in Education, Development, and Learning, Faculty of Education, University of Cambridge, Cambridge, UK
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Herbell K, Bloom T. A Qualitative Metasynthesis of Mothers' Adverse Childhood Experiences and Parenting Practices. J Pediatr Health Care 2020; 34:409-417. [PMID: 32674884 DOI: 10.1016/j.pedhc.2020.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/03/2020] [Accepted: 03/20/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Despite the known prevalence and detrimental health outcomes associated with adverse childhood experiences (ACEs), extant literature has rarely focused on the impact of ACEs on mothers' parenting practices. The purpose of this metasynthesis was to synthesize qualitative studies to understand how mothers with a history of ACEs parent their children. METHOD A systematic search was conducted across five databases with 11 studies meeting eligibilty criteria. Relevant data were extracted and analyzed with qualitative description. RESULTS Six subthemes and three themes emerged from the data. Themes included breaking the cycle, parent and child well-being, and supporting mothers. All mothers described strategies to protect their children, with some describing hypervigilant parenting practices. Mothers discussed worries about appropriate discipline and a pervasive fear of community-based services for fear of removal of the child. Across studies, mothers described their current support system and offered several suggestions for formal support services. DISCUSSION This metasynthesis provides the synthesized perspectives of traumatized mothers' parenting practices, which may inform future interventions.
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Children's Dental Anxiety during the COVID-19 Pandemic: Polish Experience. J Clin Med 2020; 9:jcm9092751. [PMID: 32854401 PMCID: PMC7564251 DOI: 10.3390/jcm9092751] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/17/2020] [Accepted: 08/25/2020] [Indexed: 12/18/2022] Open
Abstract
Dental fear and anxiety is a significant issue that affects pediatric patients and creates challenges in oral health management. Considering that the coronavirus disease 2019 (COVID-19) pandemic, along with its associated sanitary regime, social distancing measures and nationwide quarantines, could itself induce public fears, including in children, it is of great interest to explore whether this situation and the necessity of reorganizing dental care could potentially affect the emotional state of pediatric patients facing a need for urgent dental intervention. The present study assessed the emotional state of children ≤ seven years old (n = 25) requiring dental healthcare during a nationwide quarantine in Poland, as well as the anxiety levels of their caregivers. The Faces Anxiety Scale was adopted, and the evaluation was independently performed by the dentist, caregivers and children themselves. The level of anxiety in caregivers was also measured. As demonstrated, children requiring dental intervention during the nationwide quarantine did not reveal a significantly higher anxiety level as compared to the age- and indication-matched pre-pandemic control group (n = 20), regardless of whether their emotional state was evaluated by the dentist, caregivers, or by themselves. However, the share of children scoring the lowest anxiety level in all assessments was smaller in the pandemic group. Boys in the pandemic group had a higher anxiety level, as indicated by a caregiver assessment, and displayed a negative correlation with age in all three types of evaluation. Moreover, caregiver anxiety levels were higher in the pandemic group as compared to the pre-pandemic subset and revealed stronger correlations with the dental anxiety in children. The results suggest that the reorganization of oral healthcare under the pandemic scenario did not have a profound effect on children’s dental anxiety. Nevertheless, findings in young boys highlight that they may be more vulnerable and require special care to mitigate their anxiety and decrease the risk of dentophobia in the future—these observations must be, however, treated with caution due to the small sample size and require further confirmation. Moreover, it is important to reassure caregivers of the safety of the dental visit during the pandemic to minimize the effect of their own anxiety on dental fears in children.
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Blower SL, Gridley N, Dunn A, Bywater T, Hindson Z, Bryant M. Psychometric Properties of Parent Outcome Measures Used in RCTs of Antenatal and Early Years Parent Programs: A Systematic Review. Clin Child Fam Psychol Rev 2019; 22:367-387. [PMID: 30796674 PMCID: PMC6669247 DOI: 10.1007/s10567-019-00276-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Parenting programs are effective in the early intervention and treatment of children's social, emotional and behavioural difficulties. However, inconsistency in the use of outcome measures limits the comparability of programs and creates challenges for practitioners seeking to monitor progress of families in their care. A systematic review was conducted to identify measures, appraise their psychometric properties and ease of implementation, with the overall objective of recommending a small battery of measures for use by researchers and practitioners. This article provides an overview of the most commonly used measures in experimental evaluations of parenting programs delivered to parents of children up to, and including, the age of 5 years (including antenatal programs). An in-depth appraisal of the psychometric properties and ease of implementation of parent outcome measures is also presented (findings in relation to child and dyadic outcome measures are presented elsewhere). Following a systematic search, 64 measures were identified as being used in three or more of 279 included evaluation studies. Data on the psychometric properties of 18 parent outcome measures were synthesised from 87 development and validation studies. Whilst it was not possible to identify a definitive battery of recommended measures, we are able to recommend specific measures that could be prioritised in further research and development and hold promise for those seeking to monitor the outcomes of parents and children in receipt of parenting programs.
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Affiliation(s)
- Sarah L Blower
- Department of Health Sciences, University of York, York, YO10 5DD, UK.
| | - Nicole Gridley
- Department of Health Sciences, University of York, York, YO10 5DD, UK
- Carnegie School of Education, Leeds Beckett University, Leeds, UK
| | - Abby Dunn
- Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - Tracey Bywater
- Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - Zoe Hindson
- Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - Maria Bryant
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
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Abstract
Poor mental health has profound economic consequences. Given the burden of poor mental health, the economic case for preventing mental illness and promoting better mental health may be very strong, but too often prevention attracts little attention and few resources. This article describes the potential role that can be played by economic evidence alongside experimental trials and observational studies, or through modeling, to substantiate the need for increased investment in prevention. It illustrates areas of action across the life course where there is already a good economic case. It also suggests some further areas of substantive public health concern, with promising effectiveness evidence, that may benefit from economic analysis. Financial and economic barriers to implementation are then presented, and strategies to address the barriers and increase investment in the prevention of mental illness are suggested.
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Affiliation(s)
- David McDaid
- Personal Social Services Research Unit, Department of Health Policy, London School of Economics and Political Science, London WC2A 2AE, United Kingdom; ,
| | - A-La Park
- Personal Social Services Research Unit, Department of Health Policy, London School of Economics and Political Science, London WC2A 2AE, United Kingdom; ,
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McKenzie-Edwards E. Are we enabling the next generation to thrive? LONDON JOURNAL OF PRIMARY CARE 2017; 9:81-82. [PMID: 29181089 PMCID: PMC5694792 DOI: 10.1080/17571472.2017.1402496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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