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Cosgrove JA, Rao N, George P, Hoey T, Taylor J, Marshall T, Ghose SS, Patel NA. Social and Emotional Learning Interventions for Preadolescents and Adolescents: Assessing the Evidence Base. Psychiatr Serv 2024:appips20240040. [PMID: 39118573 DOI: 10.1176/appi.ps.20240040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
OBJECTIVE The social and emotional learning (SEL) framework is widely recognized as being effective for developing social and emotional competencies among students of all ages. However, the evidence for specific intervention models with older student populations is less established. The objective of this systematic review was to rate the evidence supporting the effectiveness of SEL interventions aimed at improving mental health outcomes among preadolescents and adolescents. METHODS A search of major databases, gray literature, and evidence base registries was conducted to identify studies published from 2008 to 2022 that assessed the effects of SEL interventions on mental health outcomes among students ages 10-19 years. The authors rated the evidence for SEL interventions as high, moderate, or low based on established rating criteria. RESULTS In total, 25 articles reporting on 17 original research studies were reviewed. Sixteen intervention models were assessed, with 11 resulting in improved mental health symptoms; however, no intervention was evaluated in a large enough number of studies to surpass a low evidence rating. Some studies reported cost benefits and high effectiveness of an intervention with students from diverse racial-ethnic or low socioeconomic backgrounds. CONCLUSIONS SEL interventions can improve mental health outcomes among preadolescents and adolescents. Additional research is needed to strengthen the evidence base for specific intervention models.
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Affiliation(s)
- John A Cosgrove
- Westat (Cosgrove, Rao, George, Hoey, Taylor, Marshall, Ghose) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland
| | - Neha Rao
- Westat (Cosgrove, Rao, George, Hoey, Taylor, Marshall, Ghose) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland
| | - Preethy George
- Westat (Cosgrove, Rao, George, Hoey, Taylor, Marshall, Ghose) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland
| | - Tabitha Hoey
- Westat (Cosgrove, Rao, George, Hoey, Taylor, Marshall, Ghose) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland
| | - Jeffrey Taylor
- Westat (Cosgrove, Rao, George, Hoey, Taylor, Marshall, Ghose) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland
| | - Tina Marshall
- Westat (Cosgrove, Rao, George, Hoey, Taylor, Marshall, Ghose) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland
| | - Sushmita Shoma Ghose
- Westat (Cosgrove, Rao, George, Hoey, Taylor, Marshall, Ghose) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland
| | - Nikhil A Patel
- Westat (Cosgrove, Rao, George, Hoey, Taylor, Marshall, Ghose) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland
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Yang Y(S, Law M, Vaghri Z. New Brunswick's mental health action plan: A quantitative exploration of program efficacy in children and youth using the Canadian Community Health Survey. PLoS One 2024; 19:e0301008. [PMID: 38848408 PMCID: PMC11161078 DOI: 10.1371/journal.pone.0301008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/09/2024] [Indexed: 06/09/2024] Open
Abstract
In 2011, the New Brunswick government released the New Brunswick Mental Health Action Plan 2011-2018 (Action Plan). Following the release of the Action Plan in 2011, two progress reports were released in 2013 and 2015, highlighting the implementation status of the Action Plan. While vague in their language, these reports indicated considerable progress in implementing the Action Plan, as various initiatives were undertaken to raise awareness and provide additional resources to facilitate early prevention and intervention in children and youth. However, whether these initiatives have yielded measurable improvements in population-level mental health outcomes in children and youth remains unclear. The current study explored the impact of the Action Plan by visualizing the trend in psychosocial outcomes and service utilization of vulnerable populations in New Brunswick before and after the implementation of the Action Plan using multiple datasets from the Canadian Community Health Survey. Survey-weighted ordinary least square regression analyses were performed to investigate measurable improvements in available mental health outcomes. The result revealed a declining trend in the mental wellness of vulnerable youth despite them consistently reporting higher frequencies of mental health service use. This study highlights the need for a concerted effort in providing effective mental health services to New Brunswick youth and, more broadly, Canadian youth, as well as ensuring rigorous routine outcome monitoring and evaluation plans are consistently implemented for future mental health strategies at the time of their initiation.
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Affiliation(s)
- Yuzhi (Stanford) Yang
- Department of Psychology, Faculty of Science, Applied Science, and Engineering, University of New Brunswick, Saint John, New Brunswick, Canada
| | - Moira Law
- Department of Psychology, Faculty of Science, St. Mary’s University, Halifax, Nova Scotia, Canada
| | - Ziba Vaghri
- Global Child Program, Integrated Health Initiative, Faculty of Business, University of New Brunswick, Saint John, New Brunswick, Canada
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Vaillant-Coindard E, Briet G, Lespiau F, Gisclard B, Charbonnier E. Effects of three prophylactic interventions on French middle-schoolers' mental health: protocol for a randomized controlled trial. BMC Psychol 2024; 12:204. [PMID: 38615007 PMCID: PMC11016224 DOI: 10.1186/s40359-024-01723-8] [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] [Received: 03/21/2024] [Accepted: 04/09/2024] [Indexed: 04/15/2024] Open
Abstract
Adolescence is a strategic developmental stage in terms of preventing later difficulties and ensuring good mental health. Prophylactic interventions, which are conducted before the onset, prolongation, or worsening of difficulties, and aim to prevent or reduce symptoms or to promote wellbeing, therefore appear particularly appropriate for adolescents. However, existing prophylactic interventions conducted with adolescents have several weaknesses, including sparse theoretical frameworks, ambivalent evidence of their efficacy, and implementation and dissemination difficulties. In addition, no data are currently available on the effectiveness of such interventions in France. To fill this gap, a four-arm randomized controlled trial will be performed to assess the effectiveness of three prophylactic interventions targeting reactive, proactive and interpersonal adaptation in fourth-grade middle-school students, together with participants' experience and perception of the interventions. Based on existing knowledge about adolescents, their learning mechanisms, and field constraints, these three interventions have been designed to promote their learning and receptiveness to interventions. Compared with baseline (i.e., before the intervention), we expect to observe a significant decrease in the level of distress (anxiety and depressive symptoms, functional impairment, and psychosocial difficulties) and a significant increase in the level of wellbeing after the intervention, across the three intervention groups, but not in the control group. In addition, we expect to observe post-intervention improvements in the processes targeted by the reactive adaptation intervention (operationalized as coping strategy use and flexibility), those targeted by the proactive adaptation intervention (operationalized as the tendency to engage in committed actions and general self-efficacy), and those targeted by the interpersonal adaptation intervention (operationalized as assertiveness in interactions), but only in the corresponding groups, with no change in any of these processes in the control group. The results of this research will not only enrich our knowledge of the processes involved in adolescents' distress and wellbeing, but also provide clues as to the best targets for intervention. Moreover, the material for these interventions will be freely available in French on request to the corresponding author, providing access to innovative and fully assessed interventions aimed at promoting adolescents' mental health in France.This clinical trial is currently being registered under no. 2023-A01973-42 on https://ansm.sante.fr/ . This is the first version of the protocol.
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Affiliation(s)
| | - Gaëtan Briet
- UNIV. NIMES, APSY-V, F-30021, Nîmes Cedex 1, France
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Duagi D, Carter B, Farrelly M, Lisk S, Shearer J, Byford S, James K, Brown JS. Long-term effects of psychosocial interventions for adolescents on depression and anxiety: a systematic review and meta-analysis. EClinicalMedicine 2024; 68:102382. [PMID: 38273890 PMCID: PMC10809118 DOI: 10.1016/j.eclinm.2023.102382] [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: 07/06/2023] [Revised: 11/28/2023] [Accepted: 12/01/2023] [Indexed: 01/27/2024] Open
Abstract
Background Adolescence represents a distinctive phase of development, and variables linked to this developmental period could affect the efficiency of prevention and treatment for depression and anxiety, as well as the long-term prognosis. The objectives of this study were to investigate the long-term effectiveness of psychosocial interventions for adolescents on depression and anxiety symptoms and to assess the influence of different intervention parameters on the long-term effects. Methods In this systematic review and meta-analysis, we searched five databases (Cochrane Library, Embase, Medline, PsychInfo, Web of Science) and trial registers for relevant papers published between database inception and Aug 11, 2022, with no restrictions on the language or region in which the study was conducted. An updated search was performed on Oct 3, 2023. Randomised controlled trials of psychosocial interventions targeting specifically adolescents were included if they assessed outcomes at 1-year post-intervention or more. The risk of bias in the results was assessed using the Cochrane RoB 2.0. Between-study heterogeneity was estimated using the I2 statistic. The primary outcome was depression and studies were pooled using a standardised mean difference, with associated 95% confidence interval, p-value and I2. The study protocol was pre-registered on PROSPERO (CRD42022348668). Findings 57 reports (n = 46,678 participants) were included in the review. Psychosocial interventions led to small reductions in depressive symptoms, with standardised mean difference (SMD) at 1-year of -0.08 (95% CI: -0.20 to -0.03, p = 0.002, I2 = 72%), 18-months SMD = -0.12, 95% CI: -0.22 to -0.01, p = 0.03, I2 = 63%) and 2-years SMD = -0.12 (95% CI: -0.20 to -0.03, p = 0.01, I2 = 68%). Sub-group analyses indicated that targeted interventions produced stronger effects, particularly when delivered by trained mental health professionals (K = 18, SMD = -0.24, 95% CI: -0.38 to -0.10, p = 0.001, I2 = 60%). No effects were detected for anxiety at any assessment. Interpretation Psychosocial interventions specifically targeting adolescents were shown to have small but positive effects on depression symptoms but not anxiety symptoms, which were sustained up to 2 years. These findings highlight the potential population-level preventive effects if such psychosocial interventions become widely implemented in accessible settings, such as schools. Future trials should include a longer term-follow-up at least at 12 months, in order to determine whether the intervention effects improve, stay the same or wear off over time. Funding UKRIMedical Research Council.
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Affiliation(s)
- Denis Duagi
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
| | - Ben Carter
- Department of Biostatistics and Health Informatics, Institute of Psychology, Psychiatry and Neuroscience (IoPPN), King's College London, London, UK
| | - Maria Farrelly
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
| | - Stephen Lisk
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
| | - James Shearer
- Health Service and Population Research Department, Institute of Psychology, Psychiatry and Neuroscience (IoPPN), King's College London, London, UK
| | - Sarah Byford
- Health Service and Population Research Department, Institute of Psychology, Psychiatry and Neuroscience (IoPPN), King's College London, London, UK
| | - Kirsty James
- Department of Biostatistics and Health Informatics, Institute of Psychology, Psychiatry and Neuroscience (IoPPN), King's College London, London, UK
| | - June S.L. Brown
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
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Surendran G, Sarkar S, Kandasamy P, Rehman T, Eliyas S, Sakthivel M. Effect of life skills education on socio-emotional functioning of adolescents in urban Puducherry, India: A mixed-methods study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:250. [PMID: 37727404 PMCID: PMC10506769 DOI: 10.4103/jehp.jehp_434_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 12/19/2022] [Indexed: 09/21/2023]
Abstract
BACKGROUND We wanted to assess the effect of life skills education (LSE) and regular curriculum on the self-esteem, self-efficacy, adjustment, and psychosocial functioning of students from co-educational government schools, compared to those receiving only the regular curriculum. The secondary objectives were to study the feasibility of such sessions and identify the factors affecting the effectiveness of the sessions. MATERIALS AND METHODS We conducted a mixed-methods study in government schools of urban Puducherry, India in 2018-2019. The quantitative component was a cluster-randomized trial with activity-based learning methods delivered over 10 sessions in the intervention arm (IA). Differences in outcome variables (self-esteem, self-efficacy, adjustment, psychosocial behavior) between baseline and after intervention in each of the groups were calculated, and the difference-in-differences (DID) technique was applied to account for any natural change in scores over time. Qualitative data were collected through focused group discussions (FGDs) among students and teachers. Analysis was founded on a positivist paradigm with inducto-deductive methodology. RESULTS The mean (SD) age of 258 participants was 13 (1) years in both arms. The mean (SD) difference between baseline and end-line for IA and control arm (CA) was 0.3 (4.4) and - 0.1 (4.0), for self-esteem (P = 0.38), 0.03 (6.0) and - 1.1 (6.1) for self-efficacy (P = 0.12), and - 0.04 (3.5) and - 0.05 (4.3) for adjustment (P = 0.73), respectively. Similarly, the median (interquartile range [IQR]) difference in the conduct problems scale of the Strengths and Difficulties Questionnaire was - 1 (-2, 1) and 0 (-1, 1) (P < 0.01). Five FGDs revealed multiple positive effects on anger management, conduct, self-awareness, and responsible behavior. All 10 teachers viewed life skills education (LSE) positively. CONCLUSIONS LSE positively affects adolescents' socio-emotional functioning, but more extended periods of exposure are needed to demonstrate discernible change. The feasibility of implementation depends on the syllabus and based on health policies.
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Affiliation(s)
| | - Sonali Sarkar
- Department of Preventive and Social Medicine, JIPMER, Puducherry, India
| | | | - Tanveer Rehman
- ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Salin Eliyas
- Department of Preventive and Social Medicine, JIPMER, Puducherry, India
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Components Related to Long-Term Effects in the Intra- and Interpersonal Domains: A Meta-Analysis of Universal School-Based Interventions. Clin Child Fam Psychol Rev 2022; 25:627-645. [PMID: 35908266 PMCID: PMC9622567 DOI: 10.1007/s10567-022-00406-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 11/17/2022]
Abstract
The aims of the present meta-analysis were to (1) examine long-term effects of universal secondary school-based interventions on a broad range of competencies and problems and (2) analyze which intervention components were related to stronger or weaker intervention effects at follow-up. Fifty-four studies of controlled evaluations (283 effect sizes) reporting on 52 unique interventions were included. Long-term intervention effects were significant but small; effect sizes ranged from .08 to .23 in the intrapersonal domain (i.e., subjective psychological functioning) and from .10 to .19 in the interpersonal domain (i.e., social functioning). Intervention components were generally related to effects on specific outcomes. Some components (e.g., group discussions) were even related to both stronger and weaker effects depending on the assessed outcome. Moreover, components associated with long-term effects differed from those associated with short-term effects. Our findings underscore the importance of carefully selecting components to foster long-term development on specific outcomes. PROSPERO registration number: CRD42019137981.
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Jiang M, Zhang Z, Kang L, Liao J, Wang S, Lv Y, Zhou X, Hou X. Textual Features and Risk Preference Effects on Mental Health Education Among Teenager Students in Chongqing, China. Front Psychol 2022; 13:911955. [PMID: 35693487 PMCID: PMC9181320 DOI: 10.3389/fpsyg.2022.911955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 05/03/2022] [Indexed: 11/13/2022] Open
Abstract
Background Mental health is a public health problem of great concern. Previous studies show that textual features and individual psychological characteristics can influence the effect of receiving information. Purpose This study explores whether textual features influence the persuasiveness of teenager students’ mental health education while considering the influence of risk preference. Methods From November to December 2021, a cross-sectional study was conducted among 1,869 teenager students in grade 7–12 in Chongqing, China. Wilcoxon signed-rank test, multiple logistic regression, and subgroup analysis were used to analyze the data. Results Among the four textual features mentioned in this study, a significant difference was reported in the persuasive effects of information with and without numerical features (p < 0.001), and such information tended to include digital features. The result for the symbolic features (p < 0.001) was consistent with the numerical features. The persuasive effects of positive and negative emotional information significantly differed (p < 0.001), with the former showing a better performance. No significant differences were observed between the persuasive effects of information with and without emotional conflicts (p > 0.05). Combined with those from the risk preference analysis, results showed that the regulatory effect of risk preference was only reflected in emotional conflicts. Students who prefer having no emotional conflict in the text showed the characteristics of risk avoidance, or lower grades, or rural or school accommodation. Most teenager students are also risk averse, especially females (or = 2.223, 95%CI:1.755–2.815) and juniors (or = 1.533, 95%CI: 1.198–1.963). Conclusion The numbers, symbols, and positive emotions in the text generate an active effect on teenager students receiving mental health education. Students avoiding risk are inclined to read texts without emotional conflicts. The probability of male choosing texts with positive emotional polarity is 33.5% lower than that of female. Female students and those from lower grades also demonstrate a higher inclination to risk avoidance compared with their male and higher grade counterparts. Therefore, educational materials with different text characteristics should be developed for teenager students with varying characteristics.
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Affiliation(s)
- Mengyao Jiang
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, China
- Chongqing Engineering Research Center for Clinical Big Data and Drug Evaluation, Chongqing, China
| | - Zuyue Zhang
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, China
- Chongqing Engineering Research Center for Clinical Big Data and Drug Evaluation, Chongqing, China
| | - Li Kang
- Chongqing Tianjiabing Middle School, Chongqing, China
| | - Jing Liao
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, China
- Chongqing Engineering Research Center for Clinical Big Data and Drug Evaluation, Chongqing, China
| | - Shumin Wang
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Yalan Lv
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, China
- Chongqing Engineering Research Center for Clinical Big Data and Drug Evaluation, Chongqing, China
| | - Xiaoyu Zhou
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Xiaorong Hou
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, China
- Chongqing Engineering Research Center for Clinical Big Data and Drug Evaluation, Chongqing, China
- *Correspondence: Xiaorong Hou,
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Martínez-García A. Contributions of universal school-based mental health promotion to the wellbeing of adolescents and preadolescents: a systematic review of educational interventions. HEALTH EDUCATION 2022. [DOI: 10.1108/he-07-2021-0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe study aims to determine the contributions of universal school-based educational programs to the current and future worldwide youth mental health condition.Design/methodology/approachA systematic search was conducted in accordance with the PRISMA 2020 guidelines. Academic education and health databases including ERIC, Education Database, APA PsycInfo, APA PsycArticles, Psychology Database, and PubMed were used. Characteristics and outcomes of educational interventions developed in school settings and education potential for mental health promotion were examined.FindingsUniversal school-based mental health educational programs positively affect preadolescents and adolescents. The study review provided further insight into educational programs' characteristics and identified two primary curricula foci: mental health education and development of resiliency traits and skills.Originality/valueResearch on mental health promotion using a pedagogical approach is rare as most studies focus on mental health symptomatology and psychotherapy techniques training.
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Salavera C, Usán P, Quilez-Robres A. Exploring the Effect of Parental Styles on Social Skills: The Mediating Role of Affects. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063295. [PMID: 35328983 PMCID: PMC8953939 DOI: 10.3390/ijerph19063295] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/21/2022] [Accepted: 02/25/2022] [Indexed: 11/29/2022]
Abstract
Parental educational styles have a significant effect in personal development. These styles (authoritative, democratic, permissive and neglectful) can be related to affects and social skills at the individual level. The study presented here, which comprised 456 participants (151 men; 33.11%), with an average age of 22.01 years (s.d. = 2.80), aimed to analyse the relationship between parental styles, affects and social skills, as well as the role played by affects in the relationship between parental style and social skills. The results suggest that the constructs under study are closely related. The most common parental style is democratic. By gender, permissive styles were more often applied to women and authoritative styles to men. No significant gender differences were found in the application of democratic and neglectful parental styles. In terms of emotional support, women were found to have higher negative affect scores and men higher emotional support scores. People with parents that use democratic and permissive styles scored higher in all variables related to affects and social skills, which challenges the notion that democratic styles are the best parental styles in terms of socialisation of children. The results of the affect and social skills scales were analysed in relation to parenting styles, indicating that children educated under a democratic parental regime tend to yield higher scores in terms of social skills than children educated under any other form of parental regime and medium scores in terms of affects. Finally, it was found that parenting styles have a direct influence on social skills, which tend to improve when affects play a mediating role between these two constructs. These results suggest that parenting styles are closely related to affects and social skills. In addition, they also suggest that affects play a mediating role in the relationship between parenting styles and social skills. Finally, owing to the impact that parenting styles have on affects and social skills, more research is needed to address this issue.
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Affiliation(s)
| | - Pablo Usán
- Correspondence: (C.S.); (P.U.); (A.Q.-R.)
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Developing Self-concept, Coping Skills, and Social Support in Grades 3–12: A Cluster-Randomized Trial of a Combined Mental Health Literacy and Dialectical Behavior Therapy Skills Program. SCHOOL MENTAL HEALTH 2019. [DOI: 10.1007/s12310-019-09353-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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