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Ruggiero CF, Trexberg KM, Moore AM, Savage JS. Applying the Family Stress Model to responsive feeding and early obesity prevention. Appetite 2024; 200:107515. [PMID: 38797237 PMCID: PMC11227407 DOI: 10.1016/j.appet.2024.107515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 05/13/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024]
Abstract
Rapid weight gain during infancy and obesity during early childhood may lead to adverse health outcomes during later childhood and into adulthood, especially in families experiencing economic hardship. Families experiencing economic hardship may also experience food insecurity, which can impact child development and responsive feeding, an important target for obesity prevention in early life. The Family Stress Model suggests that stress, particularly economic hardship, can negatively impact parents' mental health, parenting, and quality of family relationships. This review proposes a conceptual model that expands upon the original Family Stress Model by including parent-child dyadic interactions during feeding (i.e., responsive feeding) as well as the coparenting relationship around feeding. Our conceptual model integrates responsive feeding into the Family Stress Model and includes the impact of food insecurity on feeding and child health outcomes. Such models that consider multiple influences on child development have implications for the design of effective interventions to promote healthy growth for entire families. Future directions in this research will empirically test the model and explore early intervention strategies that aim to promote responsive feeding, nutrition security, and health within families. Continuing interdisciplinary research between the fields of nutrition and family development will be key to addressing the complex interplay of family stressors, parent responsiveness, and childhood obesity.
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Affiliation(s)
- Cara F Ruggiero
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA; Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA
| | - Kaitlin M Trexberg
- Department of Human Development and Family Studies, The Pennsylvania State University, 119 Health and Human Development Building, University Park, PA, 16802, USA.
| | - Amy M Moore
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA.
| | - Jennifer S Savage
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA; Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA.
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2
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Isobel S. Trauma and the perinatal period: A review of the theory and practice of trauma-sensitive interactions for nurses and midwives. Nurs Open 2023; 10:7585-7595. [PMID: 37775971 PMCID: PMC10643851 DOI: 10.1002/nop2.2017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/30/2023] [Accepted: 09/17/2023] [Indexed: 10/01/2023] Open
Abstract
AIM With high rates of trauma in the population, known links between trauma and perinatal distress, and the intimate and close nature of the nursing and midwifery roles, ensuring awareness and understandings of trauma is crucial for guiding practice. This paper aims to explore the relationship of trauma to the perinatal period, based on theory and practice, to consider on how nurses and midwives can deliver trauma-sensitive interactions. DESIGN AND METHODS This discursive discussion draws on relevant research from the fields of trauma therapy, attachment theory and nursing and midwifery practice to consider elements of trauma-sensitive practice in the perinatal period. RESULTS Nurses and midwives can foster safety for people who have experienced trauma through noticing and responding to triggers, supporting awareness of attachment and its relationships to trauma, undertaking psychosocial screening with care, supporting linearity and cohesion in narratives and developing collaborative care plans that maximise safety and agency. For nurses and midwives, understandings of the relationship between trauma, pregnancy, birth, early parenting and distress is crucial for effective care delivery. Delivering perinatal nursing or midwifery care of any kind, without universal trauma precautions risks reinforcing, misinterpreting or re-enacting dynamics of trauma. To be trauma-sensitive in this period requires nurses and midwives to have awareness of the dynamics of trauma in relation to pregnancy, birth and attachment. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE This paper fills a gap in the translation of theory to practice for trauma-sensitive care in the perinatal period, with a focus on the therapeutic relationship formed by nurses and midwives. The findings highlight that nurses and midwives can foster safety for people who have experienced trauma within their practice, when they hold a robust understanding of the relationship between trauma, pregnancy, birth, early parenting and distress. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Sophie Isobel
- University of SydneySydneyNew South WalesAustralia
- Perinatal Mental Health, Sydney Local Health DistrictSydneyNew South WalesAustralia
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3
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Belanger K, Gennis H, Ottenbreit N, Racine N. Enhancing attachment-based aspects of PCIT for young children with a history of maltreatment. Front Psychol 2023; 14:1229109. [PMID: 38023060 PMCID: PMC10655231 DOI: 10.3389/fpsyg.2023.1229109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Disruptive behavior difficulties, such as aggression, non-compliance, and emotional outbursts, are common among children exposed to maltreatment. Parent-Child Interaction Therapy (PCIT) is an effective parenting intervention for addressing child behavior difficulties, however, treatment retention and engagement among parents remain a concern in the clinical setting. This paper describes how the delivery of an intervention that teaches attachment theory concepts (Circle of Security-Parenting, COS-P) prior to PCIT can increase engagement and retention among parents of maltreated children and inform new coaching practices. A detailed description of how to extend and integrate COS-P concepts with PCIT for maltreated families using specific strategies is provided. Recommendations, limitations, and next steps for research are presented.
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Affiliation(s)
- Kristine Belanger
- Child Abuse Service, Alberta Children’s Hospital, Calgary, AB, Canada
- Luna Child and Youth Advocacy Centre, Calgary, AB, Canada
| | | | - Nicole Ottenbreit
- Child Abuse Service, Alberta Children’s Hospital, Calgary, AB, Canada
- Luna Child and Youth Advocacy Centre, Calgary, AB, Canada
| | - Nicole Racine
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
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Sabancı Baransel E, Uçar T. The effect of an attachment-based intervention program on attachment, expectation, and stress in pregnant women: A randomized controlled study. Jpn J Nurs Sci 2023; 20:e12549. [PMID: 37380333 DOI: 10.1111/jjns.12549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/20/2023] [Accepted: 06/04/2023] [Indexed: 06/30/2023]
Abstract
AIM This study aimed to determine the effect of an attachment-based intervention program (ABIP) on attachment, prenatal expectation and stress levels in pregnant women. METHODS This randomized controlled study was conducted in the pregnant outpatient clinics of a public hospital in Turkey. The study sample consisted of a total of 154 pregnant women (77 experimental, 77 control) at 28-38 weeks of gestation. The ABIP was applied to the pregnant women in the experimental group for 5-7 days. The ABIP included five interventions: (1) perceiving/counting fetal movements; (2) music therapy; (3) preparation for the baby; (4) writing notes/letters to the baby; and (5) watching images of the fetus/pregnancy. RESULTS After the ABIP, pregnant women in the experimental group had higher prenatal maternal attachment and prenatal positive expectation mean scores than those in the control group, and the difference between them was statistically significant in favor of those in the experimental group (P < .001). In addition, pregnant women in the experimental group had lower prenatal negative expectation and prenatal distress mean scores than those in the control group, and the difference between them was statistically significant in favor of those in the experimental group (P < .001). CONCLUSIONS The results of this study suggest that ABIP is a unique and pioneering program to increase maternal-antenatal attachment and prenatal positive expectations and reducing prenatal negative expectations and distress through diverse interventions. However, further research is required to assess the effectiveness of ABIP on maternal-fetal attachment, prenatal maternal expectations, and prenatal distress.
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Affiliation(s)
- Esra Sabancı Baransel
- Department of Midwifery, Faculty of Health Sciences, İnönü University, Malatya, Türkiye
| | - Tuba Uçar
- Department of Midwifery, Faculty of Health Sciences, İnönü University, Malatya, Türkiye
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5
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Hippman C, Mah JWT, MacFadden M. Virtual Delivery of Parent Coaching Interventions in Early Childhood Mental Health: A Scoping Review. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01597-8. [PMID: 37740798 DOI: 10.1007/s10578-023-01597-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2023] [Indexed: 09/25/2023]
Abstract
Parent-coaching interventions positively impact child development. Virtual delivery of such interventions is supported by literature reviews and a practice guideline, however, none of these focused on children under age six. A scoping review of virtually-delivered parent-coaching interventions for disruptive behaviour, anxiety, and parent-child relationship concerns in children under age six was conducted between Dec. 15, 2020 and April 22, 2021. Iterative searches of the databases PubMed, CINAHL, and PsycINFO were complemented by reference list searches and clinician expert review (N = 1146). After relevance screening and duplicate removal, collaboratively-developed inclusion criteria were applied to records, followed by data extraction from eligible articles (n = 30). Most literature documented behavioural-based interventions targeting disruptive behaviour which were delivered individually, by therapists, to White, non-Hispanic parents. Evidence supports feasibility and efficacy of virtually-delivered parent-coaching interventions to improve child disruptive behaviour (strong), anxiety (moderate), and parent-child relationship (weak). There is a significant gap in the literature regarding the virtual delivery of attachment-based parent-coaching interventions. In sum, virtual parent coaching can be an efficacious approach for children under age six, particularly for behavioural challenges.
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Affiliation(s)
- Catriona Hippman
- BC Children's Hospital, University of British Columbia (UBC), 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada.
| | - Janet W T Mah
- BC Children's Hospital, University of British Columbia (UBC), 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
| | - Megan MacFadden
- BC Children's Hospital, University of British Columbia (UBC), 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
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6
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Pace CS, Muzi S, Morganti W, Steele H. Attachment Stability and Longitudinal Prediction of Psychotic-like Symptoms in Community Adolescents over Four Months of COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6562. [PMID: 37623148 PMCID: PMC10454594 DOI: 10.3390/ijerph20166562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/26/2023] [Accepted: 08/03/2023] [Indexed: 08/26/2023]
Abstract
Background: The Friends and Family Interview (FFI) is assumed to be a valid method to study attachment stability and attachment-related psychopathological processes in adolescence, but no studies have yet tested the test-retest reliability of this interview or the longitudinal association of attachment patterns in response to the FFI from adolescents with symptoms such as psychotic-like experiences (e.g., hallucinations, bizarre behavior, dissociation, self-harm) that are known to have increased during the COVID-19 pandemic. Methods: This study involved 102 community adolescents (M = 14.64, SD = 1.63, 46% males) assessed twice: during a severe COVID-19-related lockdown (in Italy) (T1) and four months later (T2). Measures were the FFI (assessing attachment patterns: secure-autonomous, insecure-dismissing, insecure-preoccupied, and insecure-disorganized) and the thought problems scale of the Youth Self-Report to assess psychotic-like symptoms. Results: revealed high stability of four-way attachment classifications over four months (93.5%), with a modest yet significant link between higher disorganization at T1 and higher scores of thought problems at T2, p = 0.010. Conclusions: The FFI shows high test-retest reliability and can be a valid, age-adapted option to assess adolescents' attachment. Attachment disorganization should be further investigated as possibly related to psychotic-like experiences in community adolescents.
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Affiliation(s)
- Cecilia Serena Pace
- Department of Educational Sciences, University of Genoa, 16128 Genoa, Italy; (S.M.); (W.M.)
| | - Stefania Muzi
- Department of Educational Sciences, University of Genoa, 16128 Genoa, Italy; (S.M.); (W.M.)
| | - Wanda Morganti
- Department of Educational Sciences, University of Genoa, 16128 Genoa, Italy; (S.M.); (W.M.)
| | - Howard Steele
- Center for Attachment Research, New School for Social Research, New York, NY 10011, USA;
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Li M, Lan R, Ma P, Gong H. The effect of positive parenting on adolescent life satisfaction: the mediating role of parent-adolescent attachment. Front Psychol 2023; 14:1183546. [PMID: 37465493 PMCID: PMC10351537 DOI: 10.3389/fpsyg.2023.1183546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 06/15/2023] [Indexed: 07/20/2023] Open
Abstract
This study explores the impact of positive parenting on adolescents' life satisfaction and the mediating role of parent-adolescent attachment, based on the family systems theory and attachment theory. The sample included 5,047 adolescents (2,353 males, 2,694 females) with a mean age of 16.65 (SD = 1.21) from Henan Province, China. This study used the Positive Parenting Scale, the Inventory of Parent and Peer Attachment and the Satisfaction with Life Scale to survey 5,047 adolescents. The results showed that: (1) father's positive parenting positively predicted adolescent life satisfaction, while mother's positive parenting did not significantly predict adolescent life satisfaction; (2) Father-adolescent attachment and mother-adolescent attachment play a mediating role in the relationship between fathers' positive parenting, mothers' positive parenting, and adolescent life satisfaction, respectively; (3) Differences in the mechanisms of father's positive parenting and mother's positive parenting on adolescent life satisfaction. Among them, mothers' positive parenting positively predicts mother-adolescent attachment, which in turn affects adolescent life satisfaction. On the other hand, fathers' positive parenting can influence adolescent life satisfaction through two pathways: by positively predicting father-adolescent attachment and by positively predicting mother-adolescent attachment. The research findings indicate that father's and mother's positive parenting have different direct effects on adolescent's life satisfaction, and both can indirectly influence adolescent life satisfaction through the mediating variables of father-adolescent and mother-adolescent attachment. These findings have important theoretical and practical implications for promoting family education and adolescent psychological well-being.
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Affiliation(s)
- Mengge Li
- School of Psychology, South China Normal University, Guangzhou, Guangdong, China
| | - Ruiming Lan
- School of Psychology, Fujian Normal University, Fuzhou, Fujian, China
| | - Peng Ma
- School of Psychology, South China Normal University, Guangzhou, Guangdong, China
| | - Huoliang Gong
- School of Psychology, Henan University, Kaifeng, Henan, China
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8
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Hayre RS, Sierra Hernandez C, Goulter N, Moretti MM. Attachment & School Connectedness: Associations with Substance Use, Depression, & Suicidality Among at-Risk Adolescents. CHILD & YOUTH CARE FORUM 2023. [DOI: 10.1007/s10566-023-09743-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
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9
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Maggard BL, Gies LM, Sidol CA, Moscato EL, Schmidt M, Landry SH, Makoroff KL, Rhine TD, Wade SL. Online Intervention for Caregivers of Children with Early Traumatic Brain Injury: Pilot Trial. J Pediatr Psychol 2023; 48:205-215. [PMID: 36240452 PMCID: PMC9619775 DOI: 10.1093/jpepsy/jsac080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To assess the feasibility and acceptability of an online parenting-skills program for caregivers of young children with traumatic brain injury (TBI). Positive parenting contributes to recovery following early TBI and social and emotional development in typically developing children. Yet, few interventions have been designed to support psychosocial recovery and subsequent development after early TBI. METHODS This study protocol was registered with clinicaltrials.gov (NCT05160194). We utilized an academic hospital's Trauma Registry to recruit caregivers of children, ages 0-4 years, previously hospitalized for TBI. The GROW intervention integrated six online learning modules with videoconference meetings with a coach to review and practice skills while receiving in vivo coaching and feedback. Interactive modules addressed strategies for responsive parenting, stimulating cognition, and managing parenting stress. Enrollment and retention rates served as feasibility metrics and satisfaction surveys assessed acceptability. RESULTS 18 of 72 families contacted (25%) consented, and 11 of 18 (61%) completed the intervention and follow-up assessments. All participants rated the intervention as helpful and indicated that they would recommend the intervention to others. All endorsed a better understanding of brain injury and how to optimize their child's recovery and development. Both coaches rated intervention delivery as comparable to traditional face-to-face treatment. CONCLUSIONS Low levels of uptake and initial engagement underscore the challenges of intervening with caregivers following early TBI, which likely were exacerbated due to the COVID-19 pandemic. High levels of acceptability and perceived benefit support the potential utility of GROW while highlighting the need to improve accessibility and early engagement.
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Affiliation(s)
- Brianna L Maggard
- All correspondence concerning this article should be addressed to Brianna L. Maggard, BA, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA. E-mail:
| | - Lisa M Gies
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Psychology, University of Cincinnati College of Arts and Science, Cincinnati, OH, USA
| | - Craig A Sidol
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Psychology, University of Cincinnati College of Arts and Science, Cincinnati, OH, USA
| | - Emily L Moscato
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Psychology, University of Cincinnati College of Arts and Science, Cincinnati, OH, USA
| | - Matthew Schmidt
- College of Education, University of Florida, Gainesville, FL, USA
| | - Susan H Landry
- Children’s Learning Institute, University of Texas Health, Houston, TX, USA
| | - Kathi L Makoroff
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Mayerson Center for Safe and Healthy Children, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Tara D Rhine
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Shari L Wade
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Psychology, University of Cincinnati College of Arts and Science, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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10
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Salvá CP. Peligro y circularidad en las relaciones diádicas tempranas: un estudio de caso. CLÍNICA CONTEMPORÁNEA 2022. [DOI: 10.5093/cc2022a16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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11
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Kidd T, Dferevine SL, Walker SC. Affective Touch and Regulation of Stress Responses. Health Psychol Rev 2022; 17:60-77. [PMID: 36346350 DOI: 10.1080/17437199.2022.2143854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Much has been documented on the association between stress and health. Both direct and indirect pathways have been identified and explored extensively, helping us understand trajectories from healthy individuals to reductions in well-being, and development of preclinical and disease states. Some of these pathways are well established within the field; physiology, affect regulation, and social relationships. The purpose of this review is to push beyond what is known separately about these pathways and provide a means to integrate them using one common mechanism. We propose that social touch, specifically affective touch, may be the missing active ingredient fundamental to our understanding of how close relationships contribute to stress and health. We provide empirical evidence detailing how affective touch is fundamental to the development of our stress systems, critical to the development of attachment bonds and subsequent social relationships across the life course. We will also explore how we can use this in applied contexts and incorporate it into existing interventions.
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Affiliation(s)
- Tara Kidd
- School of Psychology, Liverpool John Moore University, Liverpool, U.K
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Henry A, Allain P, Potard C. Relationships between Theory of Mind and Attachment Styles in Emerging Adulthood. JOURNAL OF ADULT DEVELOPMENT 2022. [DOI: 10.1007/s10804-022-09399-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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13
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Kaminski JW, Robinson LR, Hutchins HJ, Newsome KB, Barry CM. Evidence base review of couple- and family-based psychosocial interventions to promote infant and early childhood mental health, 2010-2019. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:23-55. [PMID: 34783041 PMCID: PMC10995740 DOI: 10.1111/jmft.12570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 10/23/2021] [Indexed: 06/13/2023]
Abstract
Infant and early childhood mental health (IECMH) has been defined as the capacity of infants and young children to regulate their emotions, form secure relationships, and explore their environments. For this special issue, we conducted a review of IECMH outcomes from evaluations of couple- and family-based psychosocial interventions not explicitly designed for trauma exposure published from 2010 through 2019, following Evidence Base Update criteria and the current convention of classifying general categories of intervention approaches rather than the former practice of evaluating specific brand-name packaged programs. Full-text review of 695 articles resulted in 39 articles eligible for categorization into intervention approaches, taking into consideration the theoretical orientation of the treatment, the population served, the intervention participants, the target outcomes, the treatment theory of change, and the degree to which the intervention was standardized across participants. Four intervention approaches were identified in this review as Probably Efficacious: Behavioral Interventions to Support Parents of Toddlers, Interventions to Support Adolescent Mothers, Tiered Interventions to Provide Support Based on Assessed Risk, and Home Visiting Interventions to Provide Individualized Support to Parents. Other intervention approaches were classified as Possibly Efficacious, Experimental, or did not have sufficient evidence in this time period to classify under these criteria. Further research could explore how to ensure that all families who need support can receive it, such as by increasing the reach of effective programs and by decreasing the number of families needing additional support.
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Affiliation(s)
- Jennifer W. Kaminski
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control & Prevention, Atlanta, Georgia, USA
| | - Lara R. Robinson
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control & Prevention, Atlanta, Georgia, USA
| | - Helena J. Hutchins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control & Prevention, Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education, Centers for Disease Control and Prevention Research Participation Programs, Oak Ridge, Tennessee, USA
| | - Kimberly B. Newsome
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control & Prevention, Atlanta, Georgia, USA
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