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Gao Q, Niu L, Wang W, Zhao S, Xiao J, Lin D. Developmental Trajectories of Mental Health in Chinese Early Adolescents: School Climate and Future Orientation as Predictors. Res Child Adolesc Psychopathol 2024; 52:1303-1317. [PMID: 38625459 DOI: 10.1007/s10802-024-01195-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2024] [Indexed: 04/17/2024]
Abstract
There is growing support for the dual-continua model of mental health, which emphasizes psychopathology and well-being as related but distinct dimensions. Yet, little is known about how these dimensions co-develop from childhood to early adolescence and what factors predict their different trajectories. The current study aimed to identify distinct patterns of mental health in Chinese early adolescents, focusing on both psychopathological symptoms (i.e., depressive symptoms and self-harm behaviors) and subjective well-being (i.e., life satisfaction and affect balance). This study also examined the contributions of school climate and future orientation to these trajectories. A total of 1,057 students (Mage = 11.88, SDage = 1.67; 62.1% boys) completed four assessments over two years, with six-month intervals. Using parallel-process latent class growth modeling, we identified four groups: Flourishing (32.5%), Languishing (43.8%), Troubled with Stable Depressive Symptoms (16.1%), and Troubled with Increasing Self-Harm Risk (7.6%). Furthermore, school climate and future orientation contributed to adolescents' membership in these trajectories, either independently or jointly. Specifically, higher levels of future orientation combined with higher school climate were associated with a lower likelihood of belonging to the Troubled with Increasing Self-Harm Risk trajectory, compared to the Flourishing group. Our findings identified four distinct mental health trajectories consistent with the dual-continua model, and demonstrated that the development of psychopathology and well-being were not always inversely related (e.g., the Languishing group). Adolescents with unique developmental profiles may benefit from tailored intervention strategies that build on the personal and environmental assets of the adolescent.
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Affiliation(s)
- Qianqian Gao
- Institute of Developmental Psychology, Beijing Normal University, Beijing, 100875, China
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Li Niu
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Wei Wang
- Institute of Developmental Psychology, Beijing Normal University, Beijing, 100875, China
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Shan Zhao
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiale Xiao
- Institute of Developmental Psychology, Beijing Normal University, Beijing, 100875, China
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Danhua Lin
- Institute of Developmental Psychology, Beijing Normal University, Beijing, 100875, China.
- Faculty of Psychology, Beijing Normal University, Beijing, China.
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Bilgin A, Morales-Muñoz I, Winsper C, Wolke D. Associations between bed-sharing in infancy and childhood internalizing and externalizing symptoms. Attach Hum Dev 2024:1-20. [PMID: 39033345 DOI: 10.1080/14616734.2024.2380427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 07/11/2024] [Indexed: 07/23/2024]
Abstract
Bed-sharing is a controversial but common parenting practice with claimed benefits for emotional and behavioral development. Using data from the UK Millennium Cohort Study (N = 16,599), this prospective study investigated whether bed-sharing at 9 months is associated with childhood internalizing and externalizing symptom trajectories. Children were grouped by their patterns of co-developing internalizing and externalizing symptoms from 3 to 11 years of age using a parallel process latent class growth analysis. There were no associations between bed-sharing at 9 months of age and internalizing and externalizing symptom trajectories across childhood. This finding suggests that bed-sharing at 9 months has no positive or negative influence on the development of internalizing and externalizing symptoms across childhood. Clinicians should inform parents that bed-sharing during the second half of the first year is unlikely to have an impact on the later emotional and behavioral development of the children.
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Affiliation(s)
- Ayten Bilgin
- Department of Psychology, University of Essex, Colchester, UK
| | - Isabel Morales-Muñoz
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Catherine Winsper
- Coventry and Warwickshire Partnership NHS Trust, Research and Innovation, Coventry, UK
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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3
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Bilgin A, Heinonen K, Girchenko P, Kajantie E, Wolke D, Räikkönen K. Early childhood multiple or persistent regulatory problems and diurnal salivary cortisol in young adulthood. Psychoneuroendocrinology 2024; 161:106940. [PMID: 38171041 DOI: 10.1016/j.psyneuen.2023.106940] [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: 08/05/2023] [Revised: 11/15/2023] [Accepted: 12/15/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Early childhood multiple or persistent regulatory problems (RPs; crying, sleeping, or feeding problems) have been associated with a risk of behavioural problems in young adulthood. It has been suggested that this may be due to the possible influence of early RPs on the functioning of the hypothalamic-pituitary-adrenal (HPA) axis. However, associations between early RPs and HPA-axis activity in young adulthood remain unexplored. Thus, the aim of the current study was to investigate whether early childhood multiple or persistent RPs are associated with diurnal salivary cortisol in young adulthood. METHODS At the ages of 5, 20 and 56 months, RPs of 308 children from the Arvo Ylppö Longitudinal Study were assessed via standardized parental interviews and neurological assessments. Multiple RPs were defined as two or three RPs at the age of 5 months and persistent RPs as at least one RP at 5, 20 and 56 months. At the mean age of 25.4 years (SD= 0.6), the participants donated saliva samples for cortisol at awakening, 15 and 30 min thereafter, 10:30 am, at noon, 5:30 pm, and at bedtime during one day. We used mixed model regressions, and generalized linear models for testing the associations, controlling for important covariates. RESULTS Of the 308 children, 61 (19.8%) had multiple or persistent RPs in early childhood: 38 had multiple, and 27 had persistent RPs. Persistent RPs were associated with significantly higher cortisol peak and output in the waking period, and cortisol awakening response. On the other hand, multiple RPs were not associated with salivary cortisol. CONCLUSION Children displaying persistent RPs throughout early childhood show, over two decades later, increased HPA axis activity in response to awakening stress. This may be one physiological mechanism linking early childhood RPs to adulthood behavioural outcomes.
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Affiliation(s)
- Ayten Bilgin
- Department of Psychology, University of Essex, Colchester, United Kingdom.
| | - Kati Heinonen
- Department of Psychology & Logopedics, University of Helsinki, Helsinki, Finland; Psychology/Welfare Sciences, Faculty of Social Sciences, Tampere University, Finland
| | - Polina Girchenko
- Department of Psychology & Logopedics, University of Helsinki, Helsinki, Finland; Research Unit of Clinical Medicine, University of Oulu, Finland
| | - Eero Kajantie
- Finnish Institute for Health and Welfare, Helsinki, Finland; PEDEGO Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Katri Räikkönen
- Department of Psychology & Logopedics, University of Helsinki, Helsinki, Finland
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Harskamp-van Ginkel MW, Imkamp NLE, van Houtum L, Vrijkotte TGM, Ben Haddi-Toutouh Y, Chinapaw MJM. Parental Discontent with Infant Sleep During the First Two Years of Life. Behav Sleep Med 2023; 21:727-740. [PMID: 36625550 DOI: 10.1080/15402002.2022.2156867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Problematic sleep in infants can have a high impact on families. We examined parental discontent with infant sleep in the first six months of life and parent-perceived problematic sleep during the second year of life. METHODS We used Sarphati Cohort data of 1471 children. During periodic youth health care visits in the first six months of life, professionals registered parental discontent with infant sleep. In the second year of life, parents filled out the Brief Infant Sleep Questionnaire (BISQ), from which we defined parent-perceived problematic sleep and BISQ-defined problematic sleep. We examined the association of parental discontent with infant sleep during the first six months with both BISQ-derived outcomes up to age two, using multivariable logistic regression analysis. RESULTS 26% of parents were discontented with infant sleep during the first six months of life. During the second year of life, 27% of the parents perceived their child's sleep as problematic, and 9% of the infants had BISQ-defined problematic sleep. Early parental discontent with infant sleep was associated with parent-perceived problematic sleep [adjusted OR 2.50 (95% CI 1.91-3.28)], and BISQ-defined problematic sleep [adjusted OR 1.88 (1.11-3.17)]. CONCLUSIONS Early registered parental discontent with infant sleep was a predictor of parent-perceived problematic sleep in early toddlerhood. Registering parental discontent during infancy might enable professionals to identify a group of infants at risk for later problematic sleep. We recommend screening and parental support for sleep difficulties in an early stage.
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Affiliation(s)
- Margreet W Harskamp-van Ginkel
- Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - Nicola L E Imkamp
- Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - Lieke van Houtum
- Sarphati Amsterdam, Public Health Service (GGD), Amsterdam, The Netherlands
| | - Tanja G M Vrijkotte
- Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Mai J M Chinapaw
- Amsterdam Public Health Research Institute, Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan The Netherlands
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Georg AK, Moessner M, Taubner S. Stability of improvements: follow-up data on focused parent-infant psychotherapy (fPIP) for treating regulatory disorders in infancy. Eur Child Adolesc Psychiatry 2023; 32:2379-2383. [PMID: 36006477 PMCID: PMC10576718 DOI: 10.1007/s00787-022-02057-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/25/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Anna Katharina Georg
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Bergheimer Straße 54, 69115, Heidelberg, Germany.
| | - Markus Moessner
- Center for Psychotherapy Research, University Hospital Heidelberg, Voßstr. 2, 69115, Heidelberg, Germany
| | - Svenja Taubner
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Bergheimer Straße 54, 69115, Heidelberg, Germany
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Asmussen J, Davidsen KA, Olsen AL, Skovgaard AM, Bilenberg N. The longitudinal association of combined regulatory problems in infancy and mental health outcome in early childhood: a systematic review. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02262-0. [PMID: 37493835 DOI: 10.1007/s00787-023-02262-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 07/07/2023] [Indexed: 07/27/2023]
Abstract
Co-occurring regulatory problems in infancy, RPs, including excessive crying, feeding-eating and sleeping, have been found associated with mental health problems in school ages. Still, an overview is needed on trajectories of co-occurring or combined RPs, and mental health problems in early childhood. The aim of this review is to systematically review the literature on longitudinal community-based studies of combined RPs measuring mental health outcomes in early childhood. Following the PRISMA guideline, we systematically reviewed the literature published 2000-2020, in which combined RPs are assessed in infancy, and mental health is examined using standardised measures at ages 1-7 years. The search was performed in four databases MEDLINE, EMBASE, PsycINFO and Scopus. A protocol is published on PROSPERO. Based on 1978 screened articles, 42 papers were screened for eligibility, of which six were included, comprising data on two or more RPs investigated among a total of 20,675 children. Assessment of risk of bias in the studies showed overall good quality in five of the six papers. The literature reviewed suggests that combined RPs in infancy are early markers of mental health problems during early childhood, and highlights that community studies exploring the longitudinal associations of combined RP and mental health problems in preschool and early school age are still scarce. Overall, the review points to the need of research into preventive intervention targeting early manifestations of childhood dysregulation, such as RPs.
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Affiliation(s)
- Jette Asmussen
- Department of Clinical Research, Research Unit of Child and Adolescent Mental Health, University of Southern Denmark, J.B Winsløws Vej 16, 5000, Odense C, Denmark.
| | - Kirstine Agnete Davidsen
- Department of Psychology, University of Southern Denmark, Mental Health Services, Region of Southern Denmark, Research Unit &, Odense, Denmark
| | - Anne Lise Olsen
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Copenhagen, Denmark
| | - Anne Mette Skovgaard
- Faculty of Health Sciences, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Niels Bilenberg
- Research Unit of Child and Adolescent Psychiatry Odense, Odense, Denmark
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Ziegler M, Wollwerth de Chuquisengo R, Mall V, Licata-Dandel M. [Early childhood mental disorders: excessive crying, sleep and feeding disorders, and interventions using the "Munich model" as an example]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023:10.1007/s00103-023-03717-0. [PMID: 37401977 DOI: 10.1007/s00103-023-03717-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/09/2023] [Indexed: 07/05/2023]
Abstract
About 20% of all healthy infants and toddlers show problems in the area of mental health during their first years of life such as inconsolable crying (so-called cry-babies), sleeping problems, and feeding problems. The prevalence of enduring feeding problems and sleeping problems is distinctly higher in premature children and in children with neuropediatric disorders. These problems present a higher risk for the development of internalizing and externalizing disorders of mental health in later childhood. The parent-child relationship is often strained. Parents report experiencing severe exhaustion, extreme uncertainty, and helplessness.Pediatricians and midwives are the first points of contact for families. Outpatient clinics for cry-babies such as the "Munich Consultation for Cry-Babies," founded by Mechthild Papoušek in 1991 at the kbo-Children's Center Munich, provide a low-threshold service for the highly stressed families. They can contribute to the prevention of neglect, maltreatment, and psychological secondary disorders of the child. Intervention strategies are based on parent-infant and attachment research and integrate child- and parent-oriented approaches.During the COVID-19 pandemic, psychosocial stress factors in families increased. This development was also observable in the outpatient clinics for cry-babies.
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Affiliation(s)
- Margret Ziegler
- Sozialpädiatrisches Zentrum und Klinik für Sozialpädiatrie, Kbo-Kinderzentrum München, Heiglhofstr. 65, 81377, München, Deutschland
| | - Ruth Wollwerth de Chuquisengo
- Technische Universität München, München, Deutschland.
- Sozialpädiatrisches Zentrum und Klinik für Sozialpädiatrie, Kbo-Kinderzentrum München, Heiglhofstr. 65, 81377, München, Deutschland.
| | - Volker Mall
- Sozialpädiatrisches Zentrum und Klinik für Sozialpädiatrie, Kbo-Kinderzentrum München, Heiglhofstr. 65, 81377, München, Deutschland
| | - Maria Licata-Dandel
- Sozialpädiatrisches Zentrum und Klinik für Sozialpädiatrie, Kbo-Kinderzentrum München, Heiglhofstr. 65, 81377, München, Deutschland
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Speranza AM, Liotti M, Spoletini I, Fortunato A. Heterotypic and homotypic continuity in psychopathology: a narrative review. Front Psychol 2023; 14:1194249. [PMID: 37397301 PMCID: PMC10307982 DOI: 10.3389/fpsyg.2023.1194249] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 05/16/2023] [Indexed: 07/04/2023] Open
Abstract
Psychopathology is a process: it unfolds over time and involves several different factors. To extend our knowledge of such process, it is vital to understand the trajectories that lead to developing and maintaining a specific disorder. The construct of continuity appears very useful to this aim. It refers to the consistency, similarity, and predictability of behaviors or internal states across different developmental phases. This paper aims to present a narrative review of the literature on homotypic and heterotypic continuity of psychopathology across the lifespan. A detailed search of the published literature was conducted using the PsycINFO Record and Medline (PubMed) databases. Articles were included in the review based on the following criteria: (1) publication dates ranging from January 1970 to October 2022; and (2) articles being written in the English language. To ensure a thorough investigation, multiple combinations of keywords such as "continuity," "psychopathology," "infancy," "childhood," "adolescence," "adulthood," "homotypic," and "heterotypic" were used. Articles were excluded if exclusively focused on epidemiologic data and if not specifically addressing the topic of psychopathology continuity. The literature yielded a total of 36 longitudinal studies and an additional 190 articles, spanning the research published between 1970 and 2022. Studies on continuity focus on the etiology of different forms of mental disorders and may represent a fundamental resource from both a theoretical and clinical perspective. Enhancing our understanding of the different trajectories beneath psychopathology may allow clinicians to implement more effective strategies, focusing both on prevention and intervention. Since literature highlights the importance of early detection of clinical signs of psychopathology, future research should focus more on infancy and pre-scholar age.
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Affiliation(s)
- Anna Maria Speranza
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Marianna Liotti
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Ilaria Spoletini
- Department of Medical Sciences, IRCCS San Raffaele Pisana, Rome, Italy
| | - Alexandro Fortunato
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
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Jaekel J, Heinonen K, Baumann N, Bilgin A, Pyhälä R, Sorg C, Räikkönen K, Wolke D. Associations of crying, sleeping, and feeding problems in early childhood and perceived social support with emotional disorders in adulthood. BMC Psychiatry 2023; 23:394. [PMID: 37268881 DOI: 10.1186/s12888-023-04854-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/07/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Multiple or persistent crying, sleeping, or feeding problems in early childhood (regulatory problems) are associated with increased internalizing symptoms in adulthood. Unknown is whether early regulatory problems are associated with emotional disorders in adulthood, and what psychosocial factors may provide protection. We tested whether early childhood multiple or persistent regulatory problems are associated with a higher risk of (a) any mood and anxiety disorder in adulthood; (b) perceiving no social support in adulthood; and (c) whether social support provides protection from mood and anxiety disorders among participants who had multiple/persistent regulatory problems and those who never had regulatory problems. METHODS Data from two prospective longitudinal studies in Germany (n = 297) and Finland (n = 342) was included (N = 639). Regulatory problems were assessed at 5, 20, and 56 months with the same standardized parental interviews and neurological examinations. In adulthood (24-30 years), emotional disorders were assessed with diagnostic interviews and social support with questionnaires. RESULTS Children with multiple/persistent regulatory problems (n = 132) had a higher risk of any mood disorder (odds ratio (OR) = 1.81 [95% confidence interval = 1.01-3.23]) and of not having any social support from peers and friends (OR = 1.67 [1.07-2.58]) in adulthood than children who never had regulatory problems. Social support from peers and friends provided protection from mood disorders, but only among adults who never had regulatory problems (OR = 4.03 [2.16-7.94]; p = .039 for regulatory problems x social support interaction). CONCLUSIONS Children with multiple/persistent regulatory problems are at increased risk of mood disorders in young adulthood. Social support from peers and friends may, however, only provide protection from mood disorders in individuals who never had regulatory problems.
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Affiliation(s)
- Julia Jaekel
- Psychology, University of Oulu, Oulu, Finland.
- Department of Psychology, University of Warwick, Coventry, UK.
- Department of Population Health Sciences, University of Leicester, Leicester, UK.
| | - Kati Heinonen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
- Psychology/Welfare Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Nicole Baumann
- Department of Psychology, University of Warwick, Coventry, UK
- Department of Population Health Sciences, University of Leicester, Leicester, UK
- Turner Institute for Brain and Mental Health, School of Psychology Sciences, Monash University, Melbourne, Australia
| | - Ayten Bilgin
- Department of Psychology, University of Essex, Colchester, UK
| | - Riikka Pyhälä
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Christian Sorg
- Department of Neuroradiology and Klinikum rechts der Isar, Technische Universität München, München, Germany
- Department of Psychiatry, Klinikum rechts der Isar, Technische Universität München, München, Germany
- TUM-NIC Neuroimaging Center Technische Universität München, München, Germany
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
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Augustin M, Licata-Dandel M, Breeman LD, Harrer M, Bilgin A, Wolke D, Mall V, Ziegler M, Ebert DD, Friedmann A. Effects of a Mobile-Based Intervention for Parents of Children With Crying, Sleeping, and Feeding Problems: Randomized Controlled Trial. JMIR Mhealth Uhealth 2023; 11:e41804. [PMID: 36897641 PMCID: PMC10039405 DOI: 10.2196/41804] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/16/2022] [Accepted: 01/13/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Excessive crying, sleeping, and feeding problems in early childhood are major stressors that can result in parents feeling socially isolated and having low self-efficacy. Affected children are a risk group for being maltreated and developing emotional and behavioral problems. Thus, the development of an innovative and interactive psychoeducational app for parents of children with crying, sleeping, and feeding problems may provide low-threshold access to scientifically based information and reduce negative outcomes in parents and children. OBJECTIVE We aimed to investigate whether following the use of a newly developed psychoeducational app, the parents of children with crying, sleeping, or feeding problems experienced less parenting stress; gained more knowledge about crying, sleeping, and feeding problems; and perceived themselves as more self-effective and as better socially supported and whether their children's symptoms decreased more than those of the parents who did not use the app. METHODS Our clinical sample consisted of 136 parents of children (aged 0-24 months) who contacted a cry baby outpatient clinic in Bavaria (Southern Germany) for an initial consultation. Using a randomized controlled design, families were randomly allocated to either an intervention group (IG; 73/136, 53.7%) or a waitlist control group (WCG; 63/136, 46.3%) during the usual waiting time until consultation. The IG was given a psychoeducational app that included evidence-based information via text and videos, a child behavior diary function, a parent chat forum and experience report, tips on relaxation, an emergency plan, and a regional directory of specialized counseling centers. Outcome variables were assessed using validated questionnaires at baseline test and posttest. Both groups were compared at posttest regarding changes in parenting stress (primary outcome) and secondary outcomes, namely knowledge about crying, sleeping, and feeding problems; perceived self-efficacy; perceived social support; and child symptoms. RESULTS The mean individual study duration was 23.41 (SD 10.42) days. The IG reported significantly lower levels of parenting stress (mean 83.18, SD 19.94) after app use compared with the WCG (mean 87.46, SD 16.67; P=.03; Cohen d=0.23). Furthermore, parents in the IG reported a higher level of knowledge about crying, sleeping, and feeding (mean 62.91, SD 4.30) than those in the WCG (mean 61.15, SD 4.46; P<.001; Cohen d=0.38). No differences at posttest were found between groups in terms of parental efficacy (P=.34; Cohen d=0.05), perceived social support (P=.66; Cohen d=0.04), and child symptoms (P=.35; Cohen d=0.10). CONCLUSIONS This study provides initial evidence of the efficacy of a psychoeducational app for parents with child crying, sleeping, and feeding problems. By reducing parental stress and increasing knowledge of children's symptoms, the app has the potential to serve as an effective secondary preventive measure. Additional large-scale studies are needed to investigate long-term benefits. TRIAL REGISTRATION German Clinical Trials Register DRKS00019001; https://drks.de/search/en/trial/DRKS00019001.
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Affiliation(s)
- Michaela Augustin
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Maria Licata-Dandel
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
- kbo-Kinderzentrum Munich, Munich, Germany
| | - Linda D Breeman
- Health, Medical, and Neuropsychology Unit, Leiden University, Leiden, Netherlands
| | - Mathias Harrer
- Psychology & Digital Mental Health Care, Department of Sports and Health Sciences, Technical University of Munich, Munich, Germany
- Clinical Psychology and Psychotherapy, Institute for Psychology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Ayten Bilgin
- School of Psychology, University of Kent, Canterbury, United Kingdom
| | - Dieter Wolke
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Volker Mall
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
- kbo-Kinderzentrum Munich, Munich, Germany
| | | | - David Daniel Ebert
- Psychology & Digital Mental Health Care, Department of Sports and Health Sciences, Technical University of Munich, Munich, Germany
| | - Anna Friedmann
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
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11
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Commisso M, Temcheff C, Orri M, Poirier M, Lau M, Côté S, Vitaro F, Turecki G, Tremblay R, Geoffroy MC. Childhood externalizing, internalizing and comorbid problems: distinguishing young adults who think about suicide from those who attempt suicide. Psychol Med 2023; 53:1030-1037. [PMID: 34183077 DOI: 10.1017/s0033291721002464] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND While childhood externalizing, internalizing and comorbid problems have been associated with suicidal risk, little is known about their specific associations with suicidal ideation and attempts. We examined associations between childhood externalizing, internalizing and comorbid problems and suicidal ideation (without attempts) and attempts by early adulthood, in males and females. METHOD Participants were from the Quebec Longitudinal Study of Kindergarten Children, a population-based study of kindergarteners in Quebec from 1986 to 1988 and followed-up until 2005. We captured the co-development of teacher-rated externalizing and internalizing problems at age 6-12 using multitrajectories. Using the Diagnostic Interview Schedule administered at age 15 and 22, we identified individuals (1) who never experienced suicidal ideation/attempts, (2) experienced suicidal ideation but never attempted suicide and (3) attempted suicide. RESULTS The identified profiles were no/low problems (45%), externalizing (29%), internalizing (11%) and comorbid problems (13%). After adjusting for socioeconomic and familial characteristics, children with externalizing (OR 2.00, CI 1.39-2.88), internalizing (OR 2.34, CI 1.51-3.64) and comorbid (OR 3.29, CI 2.05-5.29) problems were at higher risk of attempting suicide (v. non-suicidal) by age 22 than those with low/no problems. Females with comorbid problems were at higher risk of attempting suicide than females with one problem. Childhood problems were not associated with suicidal ideation. Externalizing (OR 2.01, CI 1.29-3.12) and comorbid problems (OR 2.28, CI 1.29-4.03) distinguished individuals who attempted suicide from those who thought about suicide without attempting. CONCLUSION Childhood externalizing problems alone or combined with internalizing problems were associated with suicide attempts, but not ideation (without attempts), suggesting that these problems confer a specific risk for suicide attempts.
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Affiliation(s)
- Melissa Commisso
- Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Caroline Temcheff
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Massimiliano Orri
- Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Bordeaux Population Health Research Centre, INSERM U1219, University of Bordeaux, France
| | - Martine Poirier
- Department of Education, University of Rimouski, Quebec, Canada
| | - Marianne Lau
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Sylvana Côté
- Bordeaux Population Health Research Centre, INSERM U1219, University of Bordeaux, France
- Department of Social and Preventive Medicine, University of Montreal, Quebec, Canada
- CHU Ste-Justine Research Centre, Montreal, QC, Canada
- INSERM 1219 Bordeaux Population Health, France
| | - Frank Vitaro
- Department of Psychoeducation, University of Montreal
| | - Gustavo Turecki
- Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Richard Tremblay
- CHU Ste-Justine Research Centre, Montreal, QC, Canada
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
| | - Marie-Claude Geoffroy
- Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
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12
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Wolke D, Baumann N, Jaekel J, Pyhälä R, Heinonen K, Räikkönen K, Sorg C, Bilgin A. The association of early regulatory problems with behavioral problems and cognitive functioning in adulthood: two cohorts in two countries. J Child Psychol Psychiatry 2023; 64:876-885. [PMID: 36601777 DOI: 10.1111/jcpp.13742] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/07/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Regulatory problems (RPs; excessive crying, sleeping, or feeding difficulties) that co-occur (i.e., multiple) or are persistent have been associated with cognitive and behavioral problems in childhood. However, it remains unknown if multiple or persistent RPs are associated with cognitive and behavioral problems in adulthood. METHODS This large prospective longitudinal study (N = 759) was conducted in two cohorts in Germany (N = 342) and Finland (N = 417). RPs were assessed at 5, 20, and 56 months via the same standardized parental interviews and neurological examinations. In young adulthood, questionnaires were used to assess behavioral problems. Cognitive functioning was assessed with IQ tests. We examined the effects of multiple or persistent RPs on the outcomes via analysis of covariance tests and logistic regression controlled for the influence of cohort. RESULTS Of 163 participants with RPs, 89 had multiple and 77 had persistent RPs. Adults who had early multiple or persistent RPs (N = 151) reported more internalizing (p = .001), externalizing (p = .020), and total behavioral problems (p = .001), and, specifically, more depressive (p = .012), somatic (p = .005), avoidant personality (p < .001), and antisocial personality problems (p = .006) than those who never had RPs (N = 596). Participants with multiple or persistent RPs were more likely to receive any ADHD diagnoses (p = .017), particularly of hyperactive/impulsive subtype (p = .032). In contrast, there were no associations between multiple or persistent RPs and IQ scores in young adulthood. CONCLUSIONS The results indicate long-lasting associations between multiple or persistent RPs and behavioral problems. Thus, screening for early RPs could help to identify children who are at risk for later behavioral problems.
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Affiliation(s)
- Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK.,Warwick Medical School, University of Warwick, Coventry, UK
| | - Nicole Baumann
- Department of Health Sciences, University of Leicester, Leicester, UK.,Turner Institute for Brain and Mental Health, School of Psychology Sciences, Monash University, Melbourne, Victoria, Australia
| | - Julia Jaekel
- Department of Psychology, University of Warwick, Coventry, UK.,Psychology, University of Oulu, Oulu, Finland
| | - Riikka Pyhälä
- Maternity and Child Health Clinics, City of Helsinki, Helsinki, Finland
| | - Kati Heinonen
- Psychology/Welfare Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Christian Sorg
- Department of Neuroradiology and Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,Department of Psychiatry, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.,TUM-NIC Neuroimaging Center Technische Universität München, Munich, Germany
| | - Ayten Bilgin
- Department of Psychology, University of Warwick, Coventry, UK.,School of Psychology, University of Kent, Canterbury, UK
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13
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Evers O, Georg AK, Wegener C, Sidor A, Taubner S. Transactional Relations between Child Functioning and Parenting Stress in the First Years of Life: A Longitudinal Study among Psychosocially Burdened Families. Psychopathology 2023; 56:29-40. [PMID: 35537443 DOI: 10.1159/000524101] [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] [Received: 08/31/2021] [Accepted: 03/13/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Previous research reported transactional relations between child functioning and parenting stress. There is limited evidence whether a transactional developmental model also fits children below the age of 12 months, especially in psychosocially burdened families. This study aims to test the fit of a transactional model during the first 3 years of life and examines whether the model differs between families with low and high psychosocial burden. METHODS A total of 302 psychosocially burdened families were observed over 3 years at age 4, 12, 24, and 36 months. Child behavioral problems and parenting stress were assessed via self-report while psychosocial burden was assessed via external rating at baseline. Cross-lagged panel analysis was used to investigate the fit of a transactional model. RESULTS A transactional model fitted the data significantly better (Δχ2 = 81.87, p < 0.001) than an autoregressive model reaching acceptable to good fit indices (CFI = 0.96, RMSEA = 0.09). The model indicated moderate stability within and reciprocal effects between child behavioral problems and parenting stress from age 12 to 36 months. From age 4 to 12 months, parenting stress predicted child behavioral problems but not vice-versa. Model fit indices and transactional relations did not substantially differ between families with low and high psychosocial burden, except for child effects on parenting stress during the first year of life, which were only evident in higher burdened families. CONCLUSION Transactional relations among child and parent variables are evident in the first 3 years of life. Child effects in the first year of life may be restricted to highly psychosocially burdened families. Future research may focus on potential mediating variables such as parental sensitivity or contextual variables like significant life events. Targeted prevention strategies should be adapted to the level of psychosocial burden to account for the differing transactional relations.
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Affiliation(s)
- Oliver Evers
- Institute for Psychosocial Prevention, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Anna Katharina Georg
- Institute for Psychosocial Prevention, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Charlotte Wegener
- Institute for Psychosocial Prevention, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Anna Sidor
- Social Pediatric Centre Frankfurt, Frankfurt, Germany
| | - Svenja Taubner
- Institute for Psychosocial Prevention, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
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14
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Schnatschmidt M, Lollies F, Schlarb AA. A single-arm pilot study: can a parental sleep intervention for sleep-disturbed young children in individual settings improve children's sleep, crying, eating, and parental distress in mothers and fathers? BMC Pediatr 2022; 22:578. [PMID: 36207683 PMCID: PMC9541003 DOI: 10.1186/s12887-022-03631-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/23/2022] [Indexed: 11/10/2022] Open
Abstract
Background Early sleep problems co-occur with crying, eating problems, and parental distress. This study investigates the impact of a parent-focused intervention to improve child sleep with the following aims: (1) To assess the impact on child sleep (sleep onset latency, frequency and duration of nighttime awakenings, frequency of bed-sharing, and nighttime food intake, total nighttime sleep duration, and sleep efficiency), child crying (frequency of crying episodes, of unexplained and unsoothable crying and of crying out of defiance), child eating difficulties, and parental distress of mothers and fathers. (2) To assess the maintenance of any changes in these areas longitudinally, at 3-month, 6-month, and 12-month follow-ups. (3) To explore at the within-subjects level, how children’s sleep, crying, eating, and parental distress changed together across all study measurement points. Methods In this single-arm pilot study, the parents of 60 children participated in six individual sessions of a parent-focused multimodal age-adjusted cognitive-behavioral intervention to improve child sleep. Parents of 39 children (46% girls, age in months M = 22.41, SD = 12.43) completed pre- and at least one measure after the intervention. Sleep diary, questionnaire for crying, feeding, sleeping, and parental stress index (short-form) were assessed pre, post, three, six, and 12 months after the intervention. Results Significantly, sleep (decreased sleep onset latency, frequency, duration of nighttime awakenings, bed-sharing, nighttime food intake; increased total nighttime sleep duration, sleep efficiency), crying (reduced frequency of crying episodes, unexplained and unsoothable crying), and parental distress (reduced) changed, which remained partially stable over follow-up. The frequency of crying episodes decreased with fewer nighttime awakenings; morning crying with increased nighttime feeding; unexplained and unsoothable crying with higher sleep efficiency; crying due to defiance with more nighttime awakenings, sleep efficiency, and bed-sharing. Eating problems decreased with shorter night awakenings and time; maternal distress with fewer nighttime awakenings, paternal with less child’s nighttime feeding, unexplained and unsoothable crying, and time. Conclusions A parental sleep intervention for sleep-disturbed young children could be promising to reduce children’s sleep problems, crying, eating problems and parental distress. Future studies should consider more personal contact during the follow-up to reduce the drop-out rate and a randomized-controlled design. Trial registration The study was retrospectively registered at the German Clinical Trials Register (ID: DRKS00028578, registration date: 21.03.2022). Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03631-5.
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Affiliation(s)
- Marisa Schnatschmidt
- Faculty of Psychology and Sports Science, Department of Psychology, Clinical Psychology and Psychotherapy of Childhood and Adolescence, Bielefeld University, P.O.P. 10 01 31, DE-33501, Bielefeld, Germany.
| | - Friederike Lollies
- Faculty of Psychology and Sports Science, Department of Psychology, Clinical Psychology and Psychotherapy of Childhood and Adolescence, Bielefeld University, P.O.P. 10 01 31, DE-33501, Bielefeld, Germany
| | - Angelika A Schlarb
- Faculty of Psychology and Sports Science, Department of Psychology, Clinical Psychology and Psychotherapy of Childhood and Adolescence, Bielefeld University, P.O.P. 10 01 31, DE-33501, Bielefeld, Germany
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15
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Georg AK, Bark C, Wiehmann J, Taubner S. Frühkindliche Regulationsstörungen: Störungsbilder und Behandlungskonzepte. PSYCHOTHERAPEUT 2022. [DOI: 10.1007/s00278-022-00594-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Asmussen J, Skovgaard AM, Bilenberg N. Trajectories of dysregulation in preschool age. Eur Child Adolesc Psychiatry 2022; 31:313-324. [PMID: 33386524 DOI: 10.1007/s00787-020-01689-z] [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: 06/02/2020] [Accepted: 11/18/2020] [Indexed: 02/06/2023]
Abstract
Dysregulation of emotions, behaviour and attention is involved in several areas of childhood psychopathology, but knowledge about early developmental trajectories remains scarce. This study aims to explore continuity and associations of dysregulation in preschool age. Dysregulation was measured at age 2½ years and again at 5 years in a community-based birth cohort of 1099 children using the Child Behavior Checklist, preschool version (CBCL1½-5), answered by mothers. Based on the Dysregulation Profile (CBCL-DP) score, we defined four trajectory groups, using the 75th percentile from the Danish norm material as a cut-off. Associations between the four CBCL-DP trajectory groups and potential covariates, including child, parental and family factors, were analysed using univariate and multiple multinomial logistic regression. Nearly half (54%) of the children showed persistent low scores of CBCL-DP, 17% displayed continuing dysregulation problems, 13% had problems that increased from 2½ years to 5 years, whereas 16% of the children showed reduced problems across preschool age. Persistent dysregulation was associated with maternal postpartum depressive symptoms RRR = 2.20 (95% CI 1.29-3.75), low maternal educational level RRR = 1.69 (95% CI 1.08-2.66), and mothers' smoking during pregnancy RRR = 2.87 (95% CI 1.09-7.55). Persistent problems of emotional, behavioural and attention regulation in children aged 2½ years to 5 years is influenced by maternal educational level and post-partum depression symptoms. The study draws clinical attention to early symptoms of dysregulation and to the importance of addressing the specific needs of mentally vulnerable parents in intervention planning.
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Affiliation(s)
- Jette Asmussen
- Research Unit of Child and Adolescent Mental Health, Department of Clinical Research, University of Southern Denmark, J.B Winsløws Vej 16, indgang 228, 5000, Odense C, Denmark.
| | - Anne Mette Skovgaard
- Faculty of Health Sciences, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Niels Bilenberg
- Research Unit of Child and Adolescent Psychiatry Odense, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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17
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Georg AK, Dewett P, Taubner S. Learning from mothers who received focused parent-infant psychotherapy for the treatment of their child's regulatory disorders. Psychother Res 2022; 32:805-819. [PMID: 35021957 DOI: 10.1080/10503307.2021.2023778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE Gaining a deeper understanding of how focused parent-infant psychotherapy (fPIP) works by asking mothers about their experiences. METHOD Purposeful sampling was used to select participants who before had participated in an RCT on fPIP. Nine mothers of infants with early regulatory disorders who had received fPIP were interviewed. Eight cases received full-protocol treatment, one case was a treatment drop-out. Semi-structured interviews were audio-recorded, transcribed verbatim and analyzed applying grounded theory methodology. RESULTS Seven major categories evolved: (1) engaging in therapy while maintaining autonomy, (2) relating to an emotionally responsive therapist and resolving ruptures, (3) involvement of partners in therapy facilitates multiple perspectives, (4) understanding the meaning of the child's signals and increasing acceptance of difficult behaviors, (5) feeling supported by advice that is attuned to the families' needs, (6) insight into parental contributions to the child's problems and (7) feeling strengthened as a mother and recognizing one's own needs. CONCLUSION Findings highlight which aspects of fPIP mothers find most helpful and most challenging. Aspects that compromised the change process seemed related to the specific needs of this population and therapeutic setting. The results may guide therapists and inspire future development in interventions for treating infant regulatory disorders.
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Affiliation(s)
- Anna Katharina Georg
- Centre for Psychosocial Medicine, University Hospital Heidelberg, Institute for Psychosocial Prevention, Heidelberg, Germany
| | - Priya Dewett
- Centre for Psychosocial Medicine, University Hospital Heidelberg, Institute for Psychosocial Prevention, Heidelberg, Germany
| | - Svenja Taubner
- Centre for Psychosocial Medicine, University Hospital Heidelberg, Institute for Psychosocial Prevention, Heidelberg, Germany
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18
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Guilé JM, Zavaglia E, Berthiaume C, Bergeron L. Prevalence and comorbidity of borderline personality traits in the Quebec general population aged 12-14 years. Soc Psychiatry Psychiatr Epidemiol 2021; 56:2053-2062. [PMID: 33745001 DOI: 10.1007/s00127-021-02067-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 03/10/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The early identification of borderline personality traits (BPT) in adolescents helps to prevent their progression. Data are available for the clinical population, but little has been published on the general population, especially regarding age and sex distribution in adolescence. Even less is known about the comorbidity of BPT with other mental disorders. METHODS We estimated the prevalence of BPT, by sex, age, and comorbidity, in a sample of adolescents aged 12-14 years (n = 799) from the Quebec Mental Health Survey. A complex sampling design was used to ensure representativeness. BPT was assessed with the abbreviated-diagnostic interview for borderlines-revised, with the adolescent as an informant. Reliability coefficients were above 0.80. Several levels of severity were explored using an independent criterion, defined by impairment according to the Columbia impairment scale. RESULTS The overall prevalence of BPT was 6.3%. Prevalence estimates for the most impaired were 3.2% for the entire sample and 1.3% for 12-year-olds. Prevalence increased significantly with age for most impairment levels but did not differ significantly between the sexes. In adolescents, BPT displayed moderate-to-strong comorbidity with anxiety (AD) and insomnia disorders, and very strong comorbidity with depressive (DD), attention deficit hyperactivity (ADHD), and oppositional defiant/conduct disorders (ODD/CD). CONCLUSION We, therefore, make two clinical recommendations for child psychiatry practice: (1) with respect to the lower rate of male adolescents attending BPT Health Programs, increase BPT screening in male adolescents; (2) evaluate BPT when children with ADHD or ODD/CD develop AD or DD during adolescence.
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Affiliation(s)
- Jean Marc Guilé
- Child and Adolescent Psychiatry Services, Amiens-Picardie University Medical Centre , Amiens, France. .,Psychiatry Residency Program, Department of Psychiatry, University of Picardie-Jules Verne, Amiens, France. .,Department of Psychiatry, McGill University, Montreal, QC, Canada.
| | - Elissa Zavaglia
- Department of Psychology, Montreal University, Montreal, QC, Canada.,Research Centre, Hôpital en Santé Mentale Rivières-Des-Prairies, CIUSSS du Nord-de-L'Île-de-Montréal, Montréal, Québec, Canada
| | - Claude Berthiaume
- Research Centre, Hôpital en Santé Mentale Rivières-Des-Prairies, CIUSSS du Nord-de-L'Île-de-Montréal, Montréal, Québec, Canada
| | - Lise Bergeron
- Department of Psychology, Montreal University, Montreal, QC, Canada
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19
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Early regulatory problems and parenting: life-long risk, vulnerability or susceptibility for attention, internalizing and externalizing outcomes? Eur Child Adolesc Psychiatry 2021; 30:1523-1531. [PMID: 32888096 DOI: 10.1007/s00787-020-01632-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/24/2020] [Indexed: 12/13/2022]
Abstract
Multiple or persistent crying, sleeping, or feeding problems in early childhood (regulatory problems, RPs) predict increased risk for self-regulation difficulties. Sensitive parenting may protect children from trajectories of dysregulation. Considering self-regulation from a life-course perspective, are children with early multiple and/or persistent RPs affected similarly by parenting as those without (main effects model, ME), or are they more vulnerable (diathesis-stress, DIA-S), or more susceptible (differential susceptibility theory, DST) to variations in sensitive parenting at age 6 years? Participants (N = 302) were studied prospectively from birth to 28 years. RPs were assessed from 5 to 56 months. Sensitive parenting was observed at 6 years. Attention regulation was observed at 8 and 28 years. Internalizing and externalizing problems were rated by parents at 8 years, and by adults at 28 years. Confirmatory-comparative modelling tested whether associations of sensitive parenting with outcomes at 8 and 28 years among individuals with early multiple and/or persistent RPs (n = 74) versus those without (n = 228) were best explained by ME, DIA-S, or DST models. Best fitting models differed according to age at assessment. For childhood attention regulation, the statistically parsimonious DIA-S provided the best fit to the data. At age 28, two additive main effects (ME, RP group and sensitive parenting) fit best. DIA-S and ME explained internalizing and externalizing problems. Using a comprehensive life-span approach, DIA-S and ME models but not DST explained how early RPs and sensitive parenting predicted attention, internalizing, and externalizing outcomes. Individuals with early RPs are vulnerable to insensitive parenting.
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20
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Sibling Bullying: A Prospective Longitudinal Study of Associations with Positive and Negative Mental Health during Adolescence. J Youth Adolesc 2021; 51:940-955. [PMID: 34590196 PMCID: PMC8993709 DOI: 10.1007/s10964-021-01495-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/27/2021] [Indexed: 11/01/2022]
Abstract
Sibling bullying is associated with poor mental health outcomes, but the relevance of specific bullying roles remains unclear. Data from a population-based study (n = 17,157, 48% female) focusing on early (11 years), middle (14 years), and late (17 years) adolescence were analyzed. Associations between sibling bullying roles in early adolescence and positive and negative mental health outcomes in late adolescence were investigated. Generally, bullying, irrespective of role, was associated with poorer mental health outcomes in late adolescence. As the frequency of bullying victimization increased between early and middle adolescence so did the severity of mental health outcomes in late adolescence. The developmental trajectories of externalizing problems were influenced by bullying in early adolescence. Sibling bullying, irrespective of role, is associated with poor mental health outcomes.
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21
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Cook F, Conway L, Omerovic E, Cahir P, Giallo R, Hiscock H, Mensah F, Bretherton L, Bavin E, Eadie P, Brown S, Reilly S. Infant Regulation: Associations with Child Language Development in a Longitudinal Cohort. J Pediatr 2021; 233:90-97.e2. [PMID: 33549551 DOI: 10.1016/j.jpeds.2021.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 01/31/2021] [Accepted: 02/01/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To determine whether infants who have regulatory problems (eg, sleeping, crying, and feeding problems) at 1 year of age are at increased risk of experiencing language difficulties at ages 5 and 11 years, compared with settled infants. STUDY DESIGN Parent survey and child assessment data (n = 1131) were drawn from a longitudinal community cohort study. Latent Class Analysis identified 5 profiles of infant regulation including those who were settled (37%), had tantrums (21%), had sleep problems (25%), were moderately unsettled (13%), and severely unsettled (3%) at 12 months of age. Adjusted regression analyses examined associations between infant regulatory profiles and language ability (Clinical Evaluation of Language Fundamentals-fourth edition) at ages 5 and 11 years. RESULTS Infants who were moderately unsettled had lower language scores at age 5 (adjusted mean difference, -3.89; 95% CI, -6.92 to -0.86) and were more likely to have language difficulties (aOR, 2.71; 95% CI, 1.28-5.75), than infants who were settled. Infants who were severely unsettled at 12 months of age, had lower language scores at ages 5 (adjusted mean difference, -7.71; 95% CI, -13.07 to -2.36) and 11 (adjusted mean difference, -6.50; 95% CI, -11.60 to -1.39), than infants who were settled. Severely unsettled infants were 5 times more likely to have language difficulties at age 5 than their settled counterparts (aOR, 5.01; 95% CI, 1.72-14.63). CONCLUSIONS Children at 1 year of age with multiple regulatory problems are at an increased risk for poorer language skills at ages 5 and 11 years.
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Affiliation(s)
- Fallon Cook
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia.
| | - Laura Conway
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Emina Omerovic
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Petrea Cahir
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Rebecca Giallo
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Harriet Hiscock
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Royal Children's Hospital, Melbourne, Australia
| | - Fiona Mensah
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Royal Children's Hospital, Melbourne, Australia
| | - Lesley Bretherton
- Murdoch Children's Research Institute, Melbourne, Australia; La Trobe University, Melbourne, Australia
| | - Edith Bavin
- Murdoch Children's Research Institute, Melbourne, Australia; La Trobe University, Melbourne, Australia
| | - Patricia Eadie
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, Australia
| | - Stephanie Brown
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Department of General Practice, University of Melbourne, Melbourne, Australia
| | - Sheena Reilly
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Menzies Health Institute Queensland, Griffith University, Queensland, Australia
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22
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Ford JD, Courtois CA. Complex PTSD and borderline personality disorder. Borderline Personal Disord Emot Dysregul 2021; 8:16. [PMID: 33958001 PMCID: PMC8103648 DOI: 10.1186/s40479-021-00155-9] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/09/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND This article builds on a previous review (Ford and Courtois, Borderline Personal Disord Emot Dysregul 1:9, 2014) which concluded that complex posttraumatic stress disorder (cPTSD) could not be conceptualized as a sub-type of either PTSD or BPD. Recent research is reviewed that extends and clarifies the still nascent understanding of the relationship between cPTSD and BPD. MAIN BODY The circumscribed formulation of adult cPTSD that has been developed, validated, and included in the 11th Edition of the International Classification of Diseases has spurred research aimed at differentiating cPTSD and BPD both descriptively and empirically. A newly validated Developmental Trauma Disorder (DTD) syndrome for children and adolescents provides a basis for systematic research on the developmental course and origins of adult cPTSD and BPD. This review summarizes recent empirical findings regarding BPD, PTSD, and cPTSD in terms of: (1) prevalence and comorbidity; (2) clinical phenomenology; (3) traumatic antecedents; (4) psychobiology; (5) emotion dysregulation; (6) dissociation; and (7) empirically supported approaches to clinical assessment and psychotherapeutic treatment. CONCLUSION The evidence suggests that PTSD, cPTSD, and BPD are potentially comorbid but distinct syndromes. A hypothesis is advanced to stimulate scientific research and clinical innovation defining and differentiating the disorders, positing that they may represent a continuum paralleling the classic conceptualization of the stress response, with dissociation potentially involved in each disorder.
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Affiliation(s)
- Julian D Ford
- University of Connecticut Health Center MC1410, 263 Farmington Avenue, Farmington, CT, 06030-1410, USA.
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Emotion Dysregulation within the CBT-E Model of Eating Disorders: A Narrative Review. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-021-10225-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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24
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Johnson BN, Vanwoerden S. Future directions in personality pathology development research from a trainee perspective: Suggestions for theory, methodology, and practice. Curr Opin Psychol 2021; 37:66-71. [PMID: 32891979 PMCID: PMC7895861 DOI: 10.1016/j.copsyc.2020.08.006] [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: 07/23/2020] [Revised: 08/02/2020] [Accepted: 08/09/2020] [Indexed: 11/28/2022]
Abstract
Research on personality disorder (PD) development has received increased attention in the last two decades, spurring reconceptualization in theoretical models of etiology, use of advanced methods, and development of effective treatments. The current manuscript briefly reviews the state of the field and proposes avenues of new research on the development of personality pathology in theoretical, methodological, and clinical veins. We identify the need to adopt a unifying and comprehensive theory to describe PD development across the lifespan, novel statistical methods to complement traditional methods relied on thus far, and the adoption of developmentally sensitive interventions that are disseminated to professionals and trainees alike. These directions for future research aim to augment prevention efforts to reduce the burden of PDs earlier in life.
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Affiliation(s)
- Benjamin N Johnson
- The Pennsylvania State University, Mount Sinai Beth Israel, United States
| | - Salome Vanwoerden
- University of Pittsburgh Medical Center, Western Psychiatric Hospital, United States
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25
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Morales-Muñoz I, Durdurak BB, Bilgin A, Marwaha S, Winsper C. Understanding the Relationship Between Sleep Problems in Early Childhood and Borderline Personality Disorder: A Narrative Review. Nat Sci Sleep 2021; 13:2175-2202. [PMID: 34984039 PMCID: PMC8709557 DOI: 10.2147/nss.s311672] [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: 08/23/2021] [Accepted: 12/06/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Recent research indicates that sleep problems in childhood precede the development of borderline personality disorder (BPD) symptoms, but the mechanisms by which sleep problems associate with BPD are still unknown. This narrative review aims to provide some potential explanations for how early sleep problems might associate with BPD. METHODS We used the biosocial developmental model of BPD as a framework to discuss how sleep problems may associate with BPD. Articles were identified via PubMed and Embase, and papers published between January 1991 and April 2021 were extracted. Authors made a series of literature searches using the following keywords: Sleep problems, Insomnia, Nightmares, Hypothalamic-Pituitary-Adrenal Axis (HPA), Prefrontal Cortex, Family Psychopathology, Disrupted Attachment, Child Maltreatment, Impulsivity, Emotion Regulation, Internalizing, Externalizing, Rumination, Childhood, Adolescence, Young people. The inclusion criteria were published in peer-reviewed journals; human studies or reviews; published in English. The exclusion criteria were commentaries; abstracts from conferences; studies with animal samples. A total of 96 articles were included for the purpose of this review. RESULTS The evidence from this review suggests that some biological factors and core features of BPD act as potential mechanisms mediating the associations between early sleep and subsequent BPD, while some family-related factors might constitute common risk factors for sleep problems and BPD. CONCLUSION The biosocial developmental model of BPD provides a plausible characterization of how sleep disruption might lead to subsequent BPD. Further research on new developmental and early intervention approaches to understand how sleep in early stages associates with BPD could have significant clinical impact on these patients and could inform targeted therapeutic interventions.
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Affiliation(s)
- Isabel Morales-Muñoz
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK.,Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Buse Beril Durdurak
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Ayten Bilgin
- School of Psychology, University of Kent, Canterbury, UK
| | - Steven Marwaha
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK.,The Barberry National Centre for Mental Health, Birmingham and Solihull Mental Health Trust, Birmingham, UK
| | - Catherine Winsper
- Coventry and Warwickshire Partnership NHS Trust, Research and Innovation, Coventry, UK
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Shan H, Li F, Zhang J, Wang H, Li J. Feeding and Eating Disorder and Risk of Subsequent Neurodevelopmental Disorders: A Population-Based Cohort Study. Front Pediatr 2021; 9:671631. [PMID: 34552897 PMCID: PMC8451269 DOI: 10.3389/fped.2021.671631] [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] [Received: 02/24/2021] [Accepted: 08/03/2021] [Indexed: 11/30/2022] Open
Abstract
Background: There are limited data concerning the long-term mental health of children with feeding and eating disorder (FED). We aimed to investigate whether children with FED are at greater risks of developing emotional/behavioral disorders with onset usually during childhood, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and intellectual disability (ID). Methods: We conducted a population-based cohort study, including all singleton births in Denmark from January 1, 1995, to December 31, 2015. For each child diagnosed with FED, 10 age- and sex-matched controls who did not meet the criteria for FED were randomly selected from the general population. Associations were estimated with Cox regression modes adjusting for other perinatal and maternal factors, and sibling analyses were performed for controlling potential confounding by shared familial (genetic or environmental) factors. Results: Of the 1,256,989 individuals in the cohort, there were 1967 (53.4% girls) children diagnosed with FED. Children with FED had higher risks for clinically diagnosed emotional/behavioral disorders with onset usually in childhood (hazard ratio [HR], 2.78; 95% CI, 2.34-3.31), ADHD (HR, 1.74; 95% CI, 1.33-2.26), ASD (HR, 3.05; 95% CI, 2.36-3.94), and ID (HR, 6.38; 95% CI, 4.48-9.11), compared with matched controls. Girls with FED are at greater risks for emotional/behavioral disorders and ID, but not ADHD and ASD. Alike, in sibling analysis, increased rates are also observed for other neurodevelopmental disorders, but not for ADHD. Conclusion: Children with FED are associated with substantially increased risks of emotional/behavioral disorders, ADHD, ASD, and ID. This study highlights the importance of carefully monitoring neurodevelopmental disorders in children with FED.
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Affiliation(s)
- Hongyun Shan
- Ministry of Education -Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Fei Li
- Department of Developmental and Behavioral Pediatric & Child Primary Care, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Zhang
- Ministry of Education -Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Wang
- Ministry of Education -Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiong Li
- Ministry of Education -Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
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Georg AK, Schröder-Pfeifer P, Cierpka M, Taubner S. Maternal Parenting Stress in the Face of Early Regulatory Disorders in Infancy: A Machine Learning Approach to Identify What Matters Most. Front Psychiatry 2021; 12:663285. [PMID: 34408674 PMCID: PMC8365191 DOI: 10.3389/fpsyt.2021.663285] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 06/08/2021] [Indexed: 11/25/2022] Open
Abstract
Objective: Early regulatory disorders (ERD) in infancy are typically associated with high parenting stress (PS). Theoretical and empirical literature suggests a wide range of factors that may contribute to PS related to ERD. The aim of this study was to identify key predictors of maternal PS within a large predictor data set in a sample of N = 135 mothers of infants diagnosed with ERD. Methods: We used machine learning to identify relevant predictors. Maternal PS was assessed with the Parenting Stress Index. The multivariate dataset assessed cross-sectionally consisted of 464 self-reported and clinically rated variables covering mother-reported psychological distress, maternal self-efficacy, parental reflective functioning, socio-demographics, each parent's history of illness, recent significant life events, former miscarriage/abortion, pregnancy, obstetric history, infants' medical history, development, and social environment. Variables were drawn from behavioral diaries on regulatory symptoms and parental co-regulative behavior as well as a clinical interview which was utilized to diagnose ERD and to assess clinically rated regulatory symptoms, quality of parent-infant relationship, organic/biological and psychosocial risks, and social-emotional functioning. Results: The final prediction model identified 11 important variables summing up to the areas maternal self-efficacy, psychological distress (particularly depression and anger-hostility), infant regulatory symptoms (particularly duration of fussing/crying), and age-appropriate physical development. The RMSE (i.e., prediction accuracy) of the final model applied to the test set was 21.72 (R 2 = 0.58). Conclusions: This study suggests that among behavioral, environmental, developmental, parent-infant relationship, and mental health variables, a mother's higher self-efficacy, psychological distress symptoms particularly depression and anger symptoms, symptoms in the child particularly fussing/crying symptoms, and age-inappropriate physical development are associated with higher maternal PS. With these factors identified, clinicians may more efficiently assess a mother's PS related to ERD in a low-risk help-seeking sample.
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Affiliation(s)
- Anna K Georg
- Institute for Psychosocial Prevention, Centre for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Paul Schröder-Pfeifer
- Institute for Psychosocial Prevention, Centre for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany.,Psychological Institute, University Heidelberg, Heidelberg, Germany
| | - Manfred Cierpka
- Institute for Psychosocial Prevention, Centre for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Svenja Taubner
- Institute for Psychosocial Prevention, Centre for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
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Usta MB, KarabekİroĞlu K. Does the Psychopathology of the Parents Predict the Developmental-Emotional Problems of the Toddlers? ACTA ACUST UNITED AC 2020; 57:265-269. [PMID: 33354115 DOI: 10.29399/npa.25074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 05/15/2020] [Indexed: 11/07/2022]
Abstract
Introduction Parental psychopathology has been defined in respect of psychopathological development in early childhood. This study aimed to investigate the effects of parental psychopathologies on social and emotional problems in the age range of 1-3 years and to determine children at risk. Methods The study data were obtained from the 2009 Early Childhood Mental Health Profile taking population distribution into consideration with the properties representing Turkey. The primary caregiver of the child completed the Psychiatric Evaluation Form for 1-3 years, the Brief Infant-Toddler Social Emotional Assessment (BITSEA), the Ages and Stages Questionnaire (ASQ), and the Brief Symptom Inventory (BSI) for themselves. Machine learning models used for prediction. The performance of prediction models was evaluated with the ten-fold cross-validation method. Area Under Curve (AUC) values were calculated with Receiver Operating Characteristic (ROC) curves to evaluate the performance of each model. Results The evaluation was made of the data of 2775 children, comprising 1507 (54.3%) males and 1268 (45.7%) females with a mean age of 26.19±9.11 months (range, 10-48 months). A total of 106 children were identified as at risk, as they were above the clinical cut-off point (1.5 standard deviations) of the BITSEA points and below the cut-off points of any one of the developmental areas of the ASQ. Modeling was applied to the data of these 106 children. The Support Vector Machines (SVM) model was selected for prediction with the automatically optimized highest AUC value. Weighting for the SVM algorithm showed mothers' BSI scores, fathers' education and health problems, duration of breastfeeding, unplanned pregnancy are significant for predicting BITSEA-problem scores in the model. Conclusion To be able to understand the complex relationship with parental psychopathology and behavioral problems, machine learning methods were used successfully in this study. Further studies with more massive data sets, more extended follow-up periods, and stronger algorithms will be able to identify risk groups earlier and allow early interventions to be implemented.
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Affiliation(s)
- Miraç Barış Usta
- Department of Child and Adolescent Psychiatry, Ondokuz Mayıs University, School of Medicine, Samsun, Turkey
| | - Koray KarabekİroĞlu
- Department of Child and Adolescent Psychiatry, Ondokuz Mayıs University, School of Medicine, Samsun, Turkey
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Schnider B, Disselhoff V, Held U, Latal B, Hagmann CF, Wehrle FM. Executive function deficits mediate the association between very preterm birth and behavioral problems at school-age. Early Hum Dev 2020; 146:105076. [PMID: 32470766 DOI: 10.1016/j.earlhumdev.2020.105076] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/11/2020] [Accepted: 05/15/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND & AIMS Children and adolescents born very preterm are at increased risk to develop executive function deficits and to suffer from social, emotional and attentional problems. This study investigated whether executive function deficits contribute to behavioral problems in children and adolescents born very preterm at school-age. STUDY DESIGN Thirty-eight children and adolescents born very preterm and 41 age-matched term-born peers were assessed at a mean age of 12.9 (±1.8) years with a comprehensive battery of executive function tests, including working memory, planning, cognitive flexibility, and verbal fluency. A composite score was calculated to reflect overall executive function abilities. To assess behavioral problems, parents completed the Strengths and Difficulties Questionnaire (SDQ). Mediation analysis was applied to quantify the effect of preterm birth on behavioral problems with executive function abilities as a mediating variable. RESULTS Executive function abilities were poorer in the very preterm compared to the term-born group (d = 0.62, p = .005) and the parents of very preterm children reported more behavioral problems on the SDQ Total Difficulties Score (d = 0.54, p = .01). The effect of birth status on behavioral problems was significantly mediated by executive function abilities while adjusting for age at assessment, sex, and socioeconomic status (F(2, 76) = 6.42, p = .002, R2 = 0.14). CONCLUSION Results from this study suggest that the increase in behavioral symptoms in very preterm children at school-age compared to term-born peers may partly be explained by their executive function deficits. These findings highlight the importance of continuously monitoring the development of children born very preterm to provide optimal care as they grow up.
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Affiliation(s)
- Barbara Schnider
- University Children's Hospital Zurich, Department of Neonatology and Pediatric Intensive Care, Zurich, Switzerland; University Children's Hospital Zurich, Children's Research Center, Zurich, Switzerland
| | - Vera Disselhoff
- University Children's Hospital Zurich, Department of Neonatology and Pediatric Intensive Care, Zurich, Switzerland; University Children's Hospital Zurich, Children's Research Center, Zurich, Switzerland
| | - Ulrike Held
- University of Zurich, Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
| | - Beatrice Latal
- University Children's Hospital Zurich, Children's Research Center, Zurich, Switzerland; Child Development Center, University Children's Hospital Zurich, Switzerland
| | - Cornelia F Hagmann
- University Children's Hospital Zurich, Department of Neonatology and Pediatric Intensive Care, Zurich, Switzerland; University Children's Hospital Zurich, Children's Research Center, Zurich, Switzerland
| | - Flavia M Wehrle
- University Children's Hospital Zurich, Department of Neonatology and Pediatric Intensive Care, Zurich, Switzerland; University Children's Hospital Zurich, Children's Research Center, Zurich, Switzerland; Child Development Center, University Children's Hospital Zurich, Switzerland.
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