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Lotto CR, Altafim ERP, Linhares MBM. Maternal Emotional and Behavioral Regulation/Dysregulation and Parenting Practices: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380241253036. [PMID: 38804703 DOI: 10.1177/15248380241253036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Emotional and behavioral regulations are crucial for the development of perceptive, responsive, and flexible parenting. Moreover, maternal emotional dysregulation constitutes a risk for maltreatment behaviors. The present study aimed to conduct a systematic review of empirical studies on the associations between mothers' emotional and behavioral regulations and parenting practices with their children or adolescents. A systematic review was conducted, including papers that addressed these variables, analyzing the direct effects, and moderation or mediation effects of maternal emotional and behavioral regulation on parenting practices, targeting child and adolescent samples. We identified 35 studies for analysis. Most of the studies (86%) showed significant associations between maternal emotional and behavioral regulation and parenting practices. Mothers' emotional dysregulation was related to a high risk of maltreatment and negative parenting, such as unsupportive reactions and harsh discipline. High maternal emotional dysregulation and negative parenting, in turn, were associated with children's aggressive behaviors. Conversely, when mothers exhibited high emotional regulation, they engaged in more positive and supportive parenting. Additionally, maternal behavioral regulation with inhibitory control and effortful control led to supportive and warm parenting. Individual and contextual factors, such as maternal victimization history and symptoms of inattention and hyperactivity, had effects on maternal emotional dysregulation, which, in turn, impacted their parenting practices. Consequently, emotional and behavioral regulation played a crucial role in mothers' parenting practices with their children and adolescents. The findings of the current review could contribute to planning parenting interventions, including maternal emotional and behavioral regulation skills, aimed at preventing maltreatment of their children.
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Affiliation(s)
- Camila Regina Lotto
- Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto, Brazil
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Adams-Clark AA, Lee AH, Everett Y, Zarosinski A, Martin CG, Zalewski M. Direct and indirect associations among mothers' invalidating childhood environment, emotion regulation difficulties, and parental apology. Borderline Personal Disord Emot Dysregul 2022; 9:21. [PMID: 35978371 PMCID: PMC9387053 DOI: 10.1186/s40479-022-00191-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/19/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Effective emotion regulation abilities are essential for engaging in positive, validating parenting practices. Yet, many parents report difficulties with both emotion regulation and positive parenting, and these difficulties may in part be the result of parents' own childhood experiences of invalidation. Building upon prior literature documenting the intergenerational transmission of invalidation and emotion dysregulation, the present study examined the associations between these constructs and a specific parenting practice - parental apology - that can be conceptualized as a type of validating parenting practice. METHODS Using a sample of 186 community mothers, we tested direct and indirect relationships via correlational and path analysis between participants' retrospective reports of parental invalidation during childhood, difficulties with emotion regulation, and two aspects of parental apology - proclivity (i.e., participants' self-reported propensity to apologize to their child) and effectiveness (i.e., participants' inclusion of specific apology content when prompted to write a child-directed apology). Parental invalidation, difficulties with emotion regulation, and parental apology proclivity were measured via self-report questionnaires. Apology effectiveness was measured by coding written responses to a hypothetical vignette. RESULTS There was a significant negative bivariate relationship between difficulties with emotion regulation and parental apology proclivity and effectiveness. Parents' own childhood experiences of invalidation were linked to parental apology indirectly via emotion regulation difficulties. CONCLUSIONS Results suggest that mothers with greater difficulties regulating emotions may be less able to or have a lower proclivity to apologize to their child when appropriate. Thus, parent apology may be an important addition to current calls for parent validation training.
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Affiliation(s)
- Alexis A Adams-Clark
- Department of Psychology, University of Oregon, 1227 University St., Eugene, OR, 97401, USA.
| | - Angela H Lee
- Department of Psychology, University of Oregon, 1227 University St., Eugene, OR, 97401, USA
| | - Yoel Everett
- Department of Psychology, University of Oregon, 1227 University St., Eugene, OR, 97401, USA
| | - Arianna Zarosinski
- Department of Psychology, University of Oregon, 1227 University St., Eugene, OR, 97401, USA
| | | | - Maureen Zalewski
- Department of Psychology, University of Oregon, 1227 University St., Eugene, OR, 97401, USA
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Vettori G, Ruffini C, Andreini M, Megli G, Fabbri E, Labate I, Bianchi S, Pecini C. Investigating Children's Ability to Express Internal States through Narratives and Drawings: Two Longitudinal Studies during Pandemic. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1165. [PMID: 36010055 PMCID: PMC9406709 DOI: 10.3390/children9081165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 11/16/2022]
Abstract
The COVID-19 pandemic emergency has challenged children's socio-affective and cognitive development. It is essential to capture the modulation of their emotional experience through ecological and children-friendly tasks, such as written narratives and drawings. This contribution investigates the impact of pandemic experience (2020-2021 waves) on the internal states and emotions of the primary school age children, according to a longitudinal research approach through narratives (study 1 n = 21) and drawing tasks (study 2 n = 117). 138 Italian children were examined during COVID-19 three (study 1) or two waves (study 2). Children's written narratives were codified on the basis of narrative competence and psychological lexicon. Children's drawings were codified based on social/emotional, physical, and environmental elements. Results of narrative texts showed a lower psychological lexicon relating to positive emotions and a greater psychological lexicon relating to negative emotions only in the study sample group during the first lockdown compared to the previous and subsequent periods. Children's drawings of themselves showed a decrease of negative emotions during the third pandemic wave in comparison to the first pandemic wave. Results inform mental health services, school practitioners, and parents about the importance of written narratives and drawings for promoting well-being in the developmental age.
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Affiliation(s)
- Giulia Vettori
- Department of Education, Languages, Intercultures, Literatures and Psychology, University of Florence, 12 Via di San Salvi, Building 26 (Psychology Section), 50135 Florence, Italy; (C.R.); (M.A.); (G.M.); (E.F.); (I.L.); (S.B.); (C.P.)
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Cabecinha-Alati S, Montreuil TC, Langevin R. The role of maternal child maltreatment history and unsupportive emotion socialization in the intergenerational transmission of emotion regulation difficulties. CHILD ABUSE & NEGLECT 2022; 129:105661. [PMID: 35550482 DOI: 10.1016/j.chiabu.2022.105661] [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: 11/18/2021] [Revised: 04/21/2022] [Accepted: 05/01/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Maternal mental health problems and poor parenting are thought to account for the intergenerational transmission of poor outcomes to offspring of mothers who have experienced child maltreatment. OBJECTIVE Given that emotion regulation (ER) difficulties have been linked to adult psychopathology and maladaptive parenting, the goal of the present study was to examine the mechanisms through which a maternal history of child maltreatment, and subsequent difficulties with ER, might contribute to unsupportive emotion socialization and the intergenerational transmission of ER difficulties. PARTICIPANTS AND SETTING Mothers and their young adult children (aged 18-25) were recruited from across Canada to participate in an online study (N = 185 dyads). METHODS Mothers responded to questionnaires assessing their child maltreatment histories and ER difficulties. Young adults retrospectively reported on their mothers' emotion socialization behaviours in adolescence as well as their own difficulties with ER. RESULTS A moderated mediation analysis revealed that mothers who endorsed more types of child maltreatment were described as using more unsupportive contingencies, but only in the context of high levels of maternal ER difficulties. The indirect effect of maternal child maltreatment on young adults' ER difficulties was only significant for mothers with high levels of ER difficulties. More specifically, maternal difficulties with impulse control and emotional clarity contributed to more unsupportive contingencies. CONCLUSIONS Mothers who have experienced multiple forms of child maltreatment may be more likely to struggle with ER and engage in unsupportive emotion socialization behaviours, which may increase the risk of emotional difficulties in their children. Survivors of child maltreatment should have access to interventions that promote ER skills to improve their own well-being and to prevent the transmission of ER difficulties to future generations.
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Affiliation(s)
- Sarah Cabecinha-Alati
- Department of Educational and Counselling Psychology, McGill University, 3700 McTavish Street, Room 614, Montreal, QC H3A 1Y2, Canada
| | - Tina C Montreuil
- Department of Educational and Counselling Psychology, McGill University, 3700 McTavish Street, Room 614, Montreal, QC H3A 1Y2, Canada; Department of Psychiatry, Faculty of Medicine, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada
| | - Rachel Langevin
- Department of Educational and Counselling Psychology, McGill University, 3700 McTavish Street, Room 614, Montreal, QC H3A 1Y2, Canada.
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Overbeek MM, Koren-Karie N, de Schipper JC, van Delft I, Schuengel C. Quality of Mother-child Dialogue About Emotional Events, Coping and Posttraumatic Stress Symptoms Among Children Exposed to Interpersonal Trauma. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:201-208. [PMID: 35600532 PMCID: PMC9120269 DOI: 10.1007/s40653-021-00381-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/24/2021] [Indexed: 06/15/2023]
Abstract
Children exposed to traumatic events are at increased risk for developing symptoms of a Post-Traumatic Stress Disorder. Children often discuss emotional, and therefore also traumatic, events in their lives with their parents, and the quality of these discussions can facilitate coping and further development. The study aim was 1) to explore whether the association between the quality of dialogue between mothers and children about emotional events and children's posttraumatic stress symptoms (PTSS) might be indirectly linked through children's adaptive coping skills, and 2) whether this association differed when discussing different negative emotions. 169 mother-child dyads with interpersonal trauma-exposure (86% domestic violence, 14% mother and/or child sexually abused) participated in the Autobiographical Emotional Events Dialogue (AEED). Quality of mother-child emotion dialogue, captured in maternal sensitive guidance and child cooperation, and approach-oriented coping were coded from transcripts. PTSS was measured with the Child Behavior Checklist. Lower quality of mother-child emotion dialogue was associated with less approach-oriented coping and more symptoms of posttraumatic stress. There was an indirect effect of approach-oriented coping with angry feelings linking quality of mother-child emotion dialogue and child PTSS. Children's symptoms of posttraumatic stress were reflected in the quality of mother-child dialogues about traumatic and other emotional events. Findings support that dialogues about emotional events may be a promising target for intervention with children exposed to trauma.
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Affiliation(s)
- Mathilde M. Overbeek
- Section of Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | | | - J. Clasien de Schipper
- Section of Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Ivanka van Delft
- Section of Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Carlo Schuengel
- Section of Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Canale CA, Hayes AM, Yasinski C, Grasso DJ, Webb C, Deblinger E. Caregiver Behaviors and Child Distress in Trauma Narration and Processing Sessions of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Behav Ther 2022; 53:64-79. [PMID: 35027159 PMCID: PMC8765780 DOI: 10.1016/j.beth.2021.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 01/03/2023]
Abstract
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an effective treatment for children impacted by trauma, and non-offending caregivers play an important role in this treatment. This study aims to identify correlates of four caregiver variables that have been identified as predictors of child outcomes in TF-CBT: support, cognitive-emotional processing, avoidance, and blame/criticism. Audio recorded sessions were coded from a community effectiveness trial of TF-CBT that included 71 child-caregiver dyads participating in the trauma narration and processing phase of treatment. Regression analyses were conducted to examine caregiver trauma history and child baseline symptoms (internalizing, externalizing, and posttraumatic stress disorder [PTSD] symptoms) as predictors of caregiver behavior during the trauma processing sessions. Caregivers who reported exposure to more trauma types exhibited more in-session avoidance and also processing during the trauma processing phase of treatment. Child symptoms at baseline did not predict caregiver in-session behaviors. Bivariate correlations were used to investigate concurrent associations between mean levels of in-session caregiver behaviors and in-session child distress (negative emotion, hopelessness, negative behaviors). More caregiver blame/criticism was associated with more in-session child distress on all three measures. Caregiver avoidance was associated with more child negative emotion and hopelessness. Findings may help identify therapeutic targets when working with caregivers to promote change and enhance TF-CBT outcomes.
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Affiliation(s)
| | - Adele M. Hayes
- University of Delaware, Department of Psychological and Brain Sciences
| | | | - Damion J. Grasso
- University of Connecticut School of Medicine, Department of Psychiatry
| | - Charles Webb
- State of Delaware Division of Prevention and Behavioral Health Services
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Brown EJ, Cohen JA, Mannarino AP. Trauma-Focused Cognitive-Behavioral Therapy: The role of caregivers. J Affect Disord 2020; 277:39-45. [PMID: 32791391 DOI: 10.1016/j.jad.2020.07.123] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/06/2020] [Accepted: 07/27/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Childhood trauma exposure is unfortunately common and is associated with the development of posttraumatic stress disorder (PTSD) as well as a number of other serious medical and mental and health disorders. After experiencing trauma, children depend on their non-offending parents to believe and support them, reframe the meaning of the trauma, and to keep them safe from future harm. Parents are often negatively impacted by their child's trauma which may contribute to the child's risk for developing PTSD and related problems. Including parents in treatment may enhance child outcomes. METHODS Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is an evidence-based child and adolescent trauma treatment model that integrally includes non-offending parents or caregivers throughout treatment (hereafter referred to as "caregivers"). This article describes TF-CBT's underlying concepts, principles and core components, as well as the role of caregiver inclusion in this model, and evaluates the extant evidence for caregiver factors in predicting TF-CBT outcomes. RESULTS Several studies suggest that inclusion of non-offending caregivers is associated with TF-CBT outcomes, and that this may occur through enhancing caregiver support of the child and/or reducing caregivers' trauma-related maladaptive cognitions. LIMITATIONS Few studies have evaluated whether caregiver factors served as formal treatment mediators. CONCLUSIONS Including non-offending caregivers in TF-CBT can improve youth outcomes.
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Affiliation(s)
- Elissa J Brown
- Professor of Psychology, St. John's University, 8000 Utopia Parkway, Queens, NY 11439, United States.
| | - Judith A Cohen
- Professor of Psychiatry, Drexel University College of Medicine, Allegheny Health Network/Allegheny General Hospital, 4 Allegheny Center, 8th Floor, Pittsburgh, PA 15212, United States.
| | - Anthony P Mannarino
- Professor and Vice ChairDepartment of Psychiatry, Allegheny General Hospital, Allegheny Health Network, Drexel University College of Medicine, 4 Allegheny Center, 8th Floor, Pittsburgh, PA 15212, United States.
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Martin CG, Everett Y, Skowron EA, Zalewski M. The Role of Caregiver Psychopathology in the Treatment of Childhood Trauma with Trauma-Focused Cognitive Behavioral Therapy: A Systematic Review. Clin Child Fam Psychol Rev 2020; 22:273-289. [PMID: 30796672 DOI: 10.1007/s10567-019-00290-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Trauma-focused cognitive behavioral therapy (TF-CBT) is regarded as one of the most effective treatments for children who have experienced trauma and is rapidly being disseminated. To best ensure efficacy, even among treatment refractory symptoms, a better understanding of the factors that lead TF-CBT to be more or less effective for some children is warranted. One major factor that has not been systematically considered is the role of caregiver psychopathology. Therefore, this systematic review of 18 empirical studies examined how TF-CBT has incorporated caregiver psychopathology into the treatment of childhood trauma and how it is related to treatment outcomes. The results of this review provide preliminary support for TF-CBT decreasing caregiver psychopathology, in terms of symptoms of depression, PTSD, and emotional distress related to the child's experience of trauma, as well as partial support for caregiver depression, rather than caregiver PTSD or distress, influencing child treatment outcomes. It also illuminates the strong need for future TF-CBT studies to routinely measure caregiver psychopathology. Several recommendations are provided to ensure that the emerging research base can inform clinical practice guidelines on how to incorporate caregivers who exhibit psychopathology and potentially develop modifications to the existing treatment to address trauma and symptoms in both members of the caregiver-child dyad, when needed.
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Affiliation(s)
| | - Yoel Everett
- Department of Psychology, 1227 University of Oregon, Eugene, OR, 97403, USA
| | - Elizabeth A Skowron
- Department of Counseling Psychology & Human Services, 5251 University of Oregon, Eugene, OR, 97403, USA
| | - Maureen Zalewski
- Department of Psychology, 1227 University of Oregon, Eugene, OR, 97403, USA
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Lebow JL. Editorial: The Systemic in Couple and Family Research and Couple and Family Therapy. FAMILY PROCESS 2020; 59:3-9. [PMID: 32119753 DOI: 10.1111/famp.12529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Affiliation(s)
- Jay L Lebow
- Family Institute at Northwestern, Evanston, IL
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10
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Lebow JL. Editorial: Focusing on Intergenerational Processes and Problems of Family Life in Family Therapy. FAMILY PROCESS 2019; 58:793-795. [PMID: 31823363 DOI: 10.1111/famp.12508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Jay L Lebow
- Family Institute at Northwestern, Evanston, IL
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