Disorder Type and Severity as Predictors of Mental Health in Siblings of Children with Chronic Disorders

Siblings of children with chronic disorders are at risk of developing mental health problems. Studies are inconclusive about whether sibling mental health is best predicted by the specific diagnoses of the child with disorder or by transdiagnostic factors. The aims of the present study were (1) to examine if specific diagnoses predicted sibling mental health, and (2) to examine if disorder severity in the child with the chronic disorder predicted sibling mental health. Baseline data from a randomized controlled trial were used. Siblings (aged 8 - 16 years) of children with chronic disorders and their parents were recruited from eight municipality and hospital clinics (N = 288). The children with chronic disorders were placed in ICD-10 diagnostic categories based on combined parent report and clinical records. Regression analyses with the most frequent primary diagnoses (ADHD, Asperger syndrome, autism, down syndrome, rare disorders) and a measure of disorder severity as predictors of sibling mental health were run. Father-reported disorder severity predicted sibling-reported internalizing problems and father-reported internalizing and externalizing problems in siblings. Mother-reported disorder severity predicted mother-reported sibling internalizing problems. No single primary diagnosis predicted sibling internalizing or externalizing problems. Disorder severity does to an extent predict sibling mental health, whereas single diagnostic categories do not. Disorder severity may be used to identify siblings at risk and/or in need of interventions. Fathers should be included in assessment and health care for siblings as their reports seem to predict sibling mental health better than the mothers.

Mother and Child Emotion Regulation: A Moderated Mediation Model

The relationship between mother and child emotion regulation (ER) is widely researched, but fewer studies have investigated explanatory variables or those affecting the strength of this link.

BACKGROUND/OBJECTIVES

The present study focused on maternal play behavior, considered as an explanatory mechanism between mother and child ER. In addition, the study explored the moderating role of paternal empathy in the association between maternal emotion regulation (ER) and maternal play behavior.

METHODS

This present cross-sectional study involves 103 mothers and their husbands (the children's fathers), with at least one child between the ages of 3 and 6 who is typically developed.

RESULTS

Our findings show that maternal play behavior mediates the relationship between maternal cognitive reappraisal (CR), expressive suppression (ES), and child ER. Regarding the moderating role of paternal empathy, lower levels moderate the association between ER and maternal play behavior.

CONCLUSIONS

Our findings highlight the importance of maternal play behavior as an explanatory variable between maternal and child outcomes and, concomitantly, of paternal variables, such as empathy, in supporting maternal play behavior when it comes to achieving better child outcomes.

Engagement With an Internet-Administered, Guided, Low-Intensity Cognitive Behavioral Therapy Intervention for Parents of Children Treated for Cancer: Analysis of Log-Data From the ENGAGE Feasibility Trial

BACKGROUND

Parents of children treated for cancer may experience psychological difficulties including depression, anxiety, and posttraumatic stress. Digital interventions, such as internet-administered cognitive behavioral therapy, offer an accessible and flexible means to support parents. However, engagement with and adherence to digital interventions remain a significant challenge, potentially limiting efficacy. Understanding factors influencing user engagement and adherence is crucial for enhancing the acceptability, feasibility, and efficacy of these interventions. We developed an internet-administered, guided, low-intensity cognitive behavioral therapy (LICBT)-based self-help intervention for parents of children treated for cancer, (EJDeR [internetbaserad självhjälp för föräldrar till barn som avslutat en behandling mot cancer or internet-based self-help for parents of children who have completed cancer treatment]). EJDeR included 2 LICBT techniques-behavioral activation and worry management. Subsequently, we conducted the ENGAGE feasibility trial and EJDeR was found to be acceptable and feasible. However, intervention adherence rates were marginally under progression criteria.

OBJECTIVE

This study aimed to (1) describe user engagement with the EJDeR intervention and examine whether (2) sociodemographic characteristics differed between adherers and nonadherers, (3) depression and anxiety scores differed between adherers and nonadherers at baseline, (4) user engagement differed between adherers and nonadherers, and (5) user engagement differed between fathers and mothers.

METHODS

We performed a secondary analysis of ENGAGE data, including 71 participants. User engagement data were collected through log-data tracking, for example, communication with e-therapists, homework submissions, log-ins, minutes working with EJDeR, and modules completed. Chi-square tests examined differences between adherers and nonadherers and fathers and mothers concerning categorical data. Independent-samples t tests examined differences regarding continuous variables.

RESULTS

Module completion rates were higher among those who worked with behavioral activation as their first LICBT module versus worry management. Of the 20 nonadherers who opened the first LICBT module allocated, 30% (n=6) opened behavioral activation and 70% (n=14) opened worry management. No significant differences in sociodemographic characteristics were found. Nonadherers who opened behavioral activation as the first LICBT module allocated had a significantly higher level of depression symptoms at baseline than adherers. No other differences in depression and anxiety scores between adherers and nonadherers were found. Minutes working with EJDeR, number of log-ins, days using EJDeR, number of written messages sent to e-therapists, number of written messages sent to participants, and total number of homework exercises submitted were significantly higher among adherers than among nonadherers. There were no significant differences between fathers and mothers regarding user engagement variables.

CONCLUSIONS

Straightforward techniques, such as behavioral activation, may be well-suited for digital delivery, and more complex techniques, such as worry management, may require modifications to improve user engagement. User engagement was measured behaviorally, for example, through log-data tracking, and future research should measure emotional and cognitive components of engagement.

TRIAL REGISTRATION

ISRCTN Registry 57233429; https://doi.org/10.1186/ISRCTN57233429.

Complex Health Needs in Hurricane-Affected Youth and Their Families: Barriers, Vulnerabilities, and Mental Health Outcomes

Youth with complex health needs (CHNs; e.g., requiring daily assistance or equipment for care) and their parents face heightened vulnerabilities during natural disasters, potentially leading to poorer mental health outcomes compared to those without CHNs. However, limited research has focused on this group's disaster-related experiences and their impact on mental health outcomes. This study aimed to investigate the disaster experiences, perceptions, and mental health outcomes of youth with CHNs and their parents' post-hurricane and to evaluate the unique influence of CHN- and disaster-related factors on their psychological functioning. Parents (N = 142) of youth with CHNs (n = 48) and without CHNs (n = 94) who experienced a hurricane reported on their youth's and their own psychological functioning, disaster perceptions, experiences, and CHN-related information. Youth with CHNs exhibited greater perceived life threat compared to youth without CHNs. Families of youth with CHNs were more likely to evacuate and faced greater evacuation barriers. They also exhibited greater PTS, depressive, and anxiety symptom severity compared to those without CHNs. Financial healthcare concerns were not associated with youth with CHNs or their parents' mental health symptomatology. Hurricane-impeded access to healthcare necessities was associated with youth and parent PTS and depressive symptom severity and youth anxiety symptom severity. These findings underscore the vulnerabilities of youth with CHNs and their parents' post-hurricane, emphasizing the need for tailored mental health services and improved disaster planning resources to support this population effectively.

Bidirectional Associations Between Parent-Child Conflict and Child and Adolescent Mental Health

OBJECTIVE

To estimate the longitudinal bidirectional association between parent-child conflict and child externalizing and internalizing symptoms from the preschool years through adolescence.

METHOD

A nationally representative longitudinal study recruited 11,134 children at birth and followed them from December 2010 through June 2022. Primary caregivers completed validated measures at each follow-up, yielding data on parent-child conflict and child symptoms at ages 3, 5, 7, 9, and 13 years. Data were analyzed using a random-intercepts cross-lagged panel model.

RESULTS

A total of 9,793 children were assessed at age 3 years, 9,001 at age 5 years, 5,344 at age 7 years, 8,032 at age 9 years, and 6,655 at age 13 years (50% girls). Externalizing symptoms at ages 3, 5, and 7 years were prospectively associated with parent-child conflict at ages 5, 7, and 9 years. The opposite associations were not observed, indicating a unidirectional link between child externalizing symptoms and later parent-child conflict during childhood. However, parent-child conflict at age 9 years was prospectively associated with child externalizing symptoms at age 13 years. The opposite prospective association was not observed, indicating a reversal in the direction of the association between externalizing symptoms and parent-child conflict during early adolescence. Prospective associations between parent-reported internalizing symptoms and parent-child conflict were not observed in either direction.

CONCLUSION

Findings underscore the importance of both the timing and targeted nature of interventions for children's mental health. Supporting children's early self-regulation skills could be an effective intervention for preventing parent-child conflict later in development.

Modelling the associations between parental depressive symptoms, hypomanic traits, and infant socio-emotional development: The mediating role of parental reflective functioning

BACKGROUND

Although understanding of maternal hypomania in the postpartum period is gradually improving, the intergenerational pathways of risk associated with hypomania in the context of postpartum depression remain unknown. It is also unclear whether distinct or shared pathways of risk exist for infants exposed to different parental mood characteristics and whether these pathways are mediated by parental reflective functioning.

METHODS

An online survey was administered to 1788 parents (89 % mothers, 50 % White) who were primary caregivers of a child under 2. Structural equation modelling techniques were employed to model direct and indirect associations between parental depressive symptoms, hypomanic traits and infant socio-emotional development, investigating the mediating role of parental reflective functioning.

RESULTS

Elevated levels of parental depressive symptoms, in the presence of hypomanic personality traits, were directly associated with infant socio-emotional challenges, without affecting parental reflective functioning. However, higher levels of parental hypomanic traits in the postnatal period displayed a fully mediated pathway of risk transmission to infants' socio-emotional development via their negative association with parental reflective functioning.

LIMITATIONS

Results should be interpreted with caution as the reliance on self-and-parent-reported scales may have introduced biases influenced by individual perceptions and situational factors. Additionally, the cross-sectional design of this study inhibits establishing cause-and-effect relationships.

CONCLUSIONS

Overall, these results highlight the critical role of both parental depressive symptoms and hypomanic traits on infant socio-emotional development, suggesting that supporting parental mood regulation and mentalizing abilities in the postnatal period could reduce the risk of early maladaptive socio-emotional trajectories in children.

The Indirect Effects of Fathers' Parenting Style and Parent Emotion Regulation on the Relationship Between Father Self-Efficacy and Children's Mental Health Difficulties

Improving parental self-efficacy has been linked with reductions in child mental health difficulties; however, underlying mechanisms remain unclear, especially for fathers. This study investigated whether father self-efficacy influences child mental health difficulties indirectly through parenting style and parent-facilitated regulation of children's negative emotions. A community sample of American fathers (N = 350, M = 39.45 years old) completed self-reports on father self-efficacy, parenting styles, parent-facilitated emotion regulation, and their children's mental health difficulties (aged 4-12). Path analysis was used to test a cross-sectional, parallel-sequential indirect effect model. Father self-efficacy had a significant indirect effect on child mental health difficulties via three significant pathways of permissive parenting, authoritative parenting-acceptance of child's negative emotions, and authoritarian parenting-avoidance of child's negative emotions. Our model explained a moderate amount of variance in child mental health difficulties. The findings support promoting father self-efficacy through parenting interventions and highlight parenting beliefs as important for clinicians providing child mental health care.

Regulation Strategies, Contextual Problems, Addictive and Suicidal Behaviors: A Network Perspective with Adolescents

Adolescence is a period marked by challenges, including problems that appear in the adolescent's context. To manage these, adolescents use a series of emotional regulation skills that can be more or less adaptive. Less adaptive regulation is related to problem behaviors such as alcohol abuse, substance addiction, problematic internet use, and/or suicidal behavior. This study employs psychometric networks to analyze the association between these problem behaviors, the existence of contextual problems, and the use of cognitive emotional regulation strategies. We performed this analysis for the total sample: the male sample and the female sample. The total sample consists of 758 participants; 424 females (55.4%) and 341 males (44.6%) between the ages of 12 and 21 years (M age = 15.85; SD = 2311). The results show that less adaptive regulation strategies are the most central node, exhibiting a positive relationship with problem behaviors and contextual problems. In contrast, adaptive regulation strategies are a less influential node. Finally, problem behaviors are related to each other. Differences emerged between the male sample and the female sample. These findings contribute to improving our understanding of the phenomenon as well as to the construction of preventive interventions.

Parental Distress and Parenting Behavior in Families of Preschool Children with and Without ASD: Spillover and Buffering

Parents of children with autism spectrum disorder (ASD) report increased distress relative to parents of children with neurotypical development. Parent well-being is generally considered a key determinant of parenting behavior, thus increased distress may spill over into less optimal parenting in families of children with ASD. However, evidence is mixed regarding the degree to which parenting is actually compromised in this population, suggesting the possibility of buffering, wherein the parenting of children with ASD may be robust against spillover from increased parental distress. The current study tested competing spillover and buffering models with regard to relations among child ASD status, parental distress, and parenting behavior. Parents of preschoolers with (n = 73) and without (n = 55) ASD completed self-report measures of parenting stress, depressive symptoms, and emotion dysregulation, as well as of positive and negative parenting behaviors. Families of preschoolers with ASD reported higher distress and negative parenting, and lower positive parenting than did their counterparts. Findings supported the spillover model for negative parenting such that increased parental distress accounted for status-group differences in negative parenting. In contrast, potential buffering was observed for positive parenting in that an inverse association between distress and parenting was observed for parents of children with neurotypical development only. Findings highlight the potential benefit of intervention to reduce parental distress in families of children with ASD, but also suggest some existing ability of these families to buffer certain parenting behaviors from deleterious effects of parent distress.

[From generation to generation: mechanisms of risk transmission of parental mental illness in early childhood]

Growing up with a mentally ill parent is associated with multiple and far-reaching developmental risks for children. The intergenerational transmission of parental mental disorders is influenced by a variety of risk and protective factors as well as mediating mechanisms both on the part of the parents and children and in the social environment. The influence of parental psychopathology is particularly strong in the first years of life, but also affects development in childhood and adolescence and can have a lifelong negative impact on mental health. Due to the diverse and long-term effects on child development, the identification of transmission factors and the development of prevention and intervention strategies as early as possible are highly relevant in order to reduce the far-reaching negative consequences for the development of the offspring. Possible starting points for this include identified risk and protective factors as well as mediating mechanisms between parental psychopathology and child development. These factors and their effects on early child development are presented in this narrative review based on the current state of research. In addition, research gaps are identified and implications for the development of early interventions are discussed.

Emotion dysregulation in autism: Severity and correlates in early childhood

Emotion dysregulation (ED) is common and severe in older autistic youth, but is rarely the focus of early autism screening or intervention. Moreover, research characterizing ED in the preschool years (when autism is typically diagnosed) is limited. This study aimed to characterize ED in autistic children by examining (1) prevalence and severity of ED as compared to children without an autism diagnosis; and (2) correlates of ED in autistic children. A sample of 1864 parents (Mean child age = 4.21 years, SD = 1.16 years; 37% female) of 2-5 year-old children with (1) autism; (2) developmental concerns, but no autism; and (3) no developmental concerns or autism completed measures via an online questionnaire. ED was measured using the Emotion Dysregulation Inventory-Young Child, a parent report measure characterizing ED across two dimensions: Reactivity (fast, intense emotional reactions) and dysphoria (low positive affect, sadness, unease). Autistic preschoolers, compared to peers without developmental concerns, had more severe ED (+1.12 SD for reactivity; +0.60 SD for dysphoria) and were nearly four and three times more likely to have clinically significant reactivity and dysphoria, respectively. Autistic traits, sleep problems, speaking ability, and parent depression were the strongest correlates of ED in the autism sample. While more work is needed to establish the prevalence, severity, and correlates of ED in young autistic children, this study represents an important first step. Results highlight a critical need for more high-quality research in this area as well as the potential value of screening and intervention for ED in young autistic children.

The process in-between: Parents' perceptions about how practitioners promote the outcomes of the Incredible Years Basic program

Practitioners are recognized as one of the key components that make parenting interventions meaningful and helpful to families, and the impact of practitioners' skills on the outcomes of parenting interventions has been consistently recognized in research. However, the mechanisms and ongoing processes through which the practitioners' actions and skills may impact parental engagement and other outcomes remain unknown. This qualitative study explored parents' perceptions about the processes through which specific practitioners' skills contribute to the outcomes of the Incredible Years Basic Parent Program (IYPP). Twenty-four Portuguese parents who had completed the IYPP were interviewed in four focus groups, and the data were analyzed through thematic analysis. Practitioners' skills were perceived by parents as having an impact on their engagement in the program, their process of change, and their interpersonal relationships. Practitioners were perceived to demonstrate their influence in the intervention process through six different roles: the roles of a confidant, a positive coach, a partner, a maestro, a tailor, and a congruent person. This study reinforces the prominent role of practitioners in enabling parental outcomes of an evidence-based parenting program and suggests that more attention should be paid to continuing supervision and other professional development processes.

Maternal Emotional and Behavioral Regulation/Dysregulation and Parenting Practices: A Systematic Review

Emotional and behavioral regulations are crucial for the development of perceptive, responsive, and flexible parenting. Moreover, maternal emotional dysregulation constitutes a risk for maltreatment behaviors. The present study aimed to conduct a systematic review of empirical studies on the associations between mothers' emotional and behavioral regulations and parenting practices with their children or adolescents. A systematic review was conducted, including papers that addressed these variables, analyzing the direct effects, and moderation or mediation effects of maternal emotional and behavioral regulation on parenting practices, targeting child and adolescent samples. We identified 35 studies for analysis. Most of the studies (86%) showed significant associations between maternal emotional and behavioral regulation and parenting practices. Mothers' emotional dysregulation was related to a high risk of maltreatment and negative parenting, such as unsupportive reactions and harsh discipline. High maternal emotional dysregulation and negative parenting, in turn, were associated with children's aggressive behaviors. Conversely, when mothers exhibited high emotional regulation, they engaged in more positive and supportive parenting. Additionally, maternal behavioral regulation with inhibitory control and effortful control led to supportive and warm parenting. Individual and contextual factors, such as maternal victimization history and symptoms of inattention and hyperactivity, had effects on maternal emotional dysregulation, which, in turn, impacted their parenting practices. Consequently, emotional and behavioral regulation played a crucial role in mothers' parenting practices with their children and adolescents. The findings of the current review could contribute to planning parenting interventions, including maternal emotional and behavioral regulation skills, aimed at preventing maltreatment of their children.

Effects of Parent Involvement in Homework on Students' Negative Emotions in Chinese Students: Moderating Role of Parent-Child Communication and Mediating Role of Family Responsibility

Chinese parents' involvement in children's homework has become a hot topic, which not only affects students' learning but also leads to mental health problems. This study aimed to examine how parent involvement in homework affects students' negative emotions, focusing on the mediating role of family responsibility and the moderating role of parent-child communication in it. The study uses data from the CFPS 2020 database by Peking University, with a sample size of 6906, resulting in 494 valid observations after data cleaning. Data were analyzed using SPSS 26.0 and SPSS Macro PROCESS, which examined the correlation coefficients, mediation effects, and moderated mediation among the variables. The results found that parent involvement in homework had a significant effect on students' negative emotions. Family responsibility played a partial mediating role between parent involvement in homework and students' negative emotions. Parent-child communication played a significant moderating role in the relationship between parent involvement in homework and family responsibility on students' negative emotions. The results are consistent with the Family Systems Theory, and help to reduce the negative emotions of students and promote the physical and mental health of children.

Social Support and Postpartum Depressive Symptoms in Portuguese Women: The Mediating Role of Emotion Regulation Difficulties

Background/Objectives: Postpartum depression (PPD) is a prevalent mental health issue affecting 14% of mothers worldwide, with long-term implications for both maternal and child well-being. Understanding the factors contributing to PPD is essential for developing effective interventions. This study aimed to investigate the relationship between social support and postpartum depression symptoms, with a focus on the mediating role of emotion regulation difficulties. Methods: A sample of 160 postpartum women (M age = 33.57, SD = 4.94) participated in the study. Participants were assessed on their levels of perceived social support, difficulties in emotion regulation, and symptoms of PPD. Results: The results indicated that lower levels of social support were significantly associated with greater difficulties in emotion regulation (effects ranging from -0.10 to 0.07). These difficulties in turn were linked to higher levels of postpartum depression symptoms (effects ranging from -0.29 to 0.78), suggesting a partial mediation effect from emotional awareness (95% CI -0.05, -0.00), non-acceptance of emotions (95% CI -0.04, -0.00), difficulty in goal-directed behavior (95% CI -0.04, -0.00), and limited access to strategies (95% CI -0.12, -0.04). Conclusions: These findings underscore the critical role of both social support and emotion regulation in the development of PPD symptoms. Enhancing emotion regulation skills, particularly for women with limited social support, could be a key target for interventions aimed at reducing the risk and severity of PPD.

Caregiver Involvement in Psychotherapy for Young People With Borderline Personality Disorder and Borderline Personality Disorder Features: A Systematic Review

Caregivers of young people with borderline personality disorder (BPD) or BPD features experience significant burden and distress and often lack effective coping strategies. A family environment of pervasive invalidation can contribute to the disorder and work against effective coping. Consequently, some psychotherapy interventions for young people with BPD or BPD features aim to incorporate caregivers in treatment to varying degrees. This review synthesised results of existing studies that included caregivers in psychotherapy alongside their young person and that examined caregiver outcomes using quantitative measures. The review and literature search were conducted in accordance with PRISMA guidelines. Searches of five databases returned a total of 2988 articles, of which 10 met inclusion criteria and only two of which were RCTs. Seven used a dialectical behaviour therapy approach, two used brief psychoeducation, and one was an online social group. Articles examined changes in caregivers regarding treatment feasibility and satisfaction, emotion communication, perceived knowledge of BPD and caregiver mental health, burden and stress. Although there are few studies and results are limited by considerable methodological limitations, results suggest that including caregivers in treatment alongside young people, even in a brief capacity, may improve caregiver outcomes on several measures. Inclusion of caregivers is conceptually particularly pertinent for BPD for young people, and this review reveals important clinical implications and clear future research directions.

Preliminary report: Sleep duration during late pregnancy predicts postpartum emotional responses among parents at risk for postpartum depression

Introduction

Sleep loss is common during the perinatal period; however, few studies have assessed potential consequences of insufficient sleep for postnatal emotional responding, a key contributor to parenting behaviors with implications for parent-infant bonding and mental health. To generate hypotheses for future work assessing perinatal sleep and emotion-related outcomes, this pilot study explored whether prenatal sleep duration predicted postnatal emotional responding in a sample at risk for postpartum depression.

Methods

Participants were nine birthing parents with a prior mood disorder who were not in a current episode at enrollment. We estimated sleep with actigraphy collected for 1 week at 33 weeks' gestation and at 2 and 6 weeks postpartum. Following each week, participants completed an emotional evaluation task, rating the valence and arousal of standardized images from the International Affective Picture System. We tested whether average prenatal (33 weeks) nighttime sleep duration predicted concurrent and future responsiveness to emotional images, quantified by participants' reaction times and arousal/valence ratings.

Results

Shorter prenatal sleep duration predicted faster reaction times, both concurrently and at 2 weeks postpartum (ps ≤ .05), as well as lower arousal ratings for negative images at 2 and 6 weeks postpartum (ps ≤ .043).

Conclusions

In this small sample of birthing parents at risk for postpartum depression, shorter prenatal sleep duration predicted faster reactions to emotional stimuli and blunted arousal responses to negative images. Although preliminary, these findings justify further study of the role of prenatal sleep in postpartum emotional responses and how these factors may impact parent-infant outcomes.

Parent Facilitation of Child Emotion Regulation in ASD: An Ecological Momentary Assessment Study

Parents play a substantial role in their children's emotion regulation (ER) abilities. Children with autism spectrum disorder (ASD) often have difficulties regulating their emotions, which can manifest as externalizing behavioral issues. Parents of children with ASD facilitate their children's ER development in response to unique challenges and stressors, often developing resiliency but other times contributing to their children's dysregulation and behavioral challenges. It is unclear how much momentary stress attenuates parents' emotional facilitation of child ER and its effect on child behavioral functioning. Using an ecological momentary assessment approach, the current study explores this process by considering how parents of children with ASD facilitate child ER through (1) parent ER ability, (2) emotion socialization style, and (3) expressed emotion. Multilevel models explored the relative influences of parent ER facilitation on the association between momentary parent stress and behavioral intensity. Results suggest that parent ER abilities and specific emotion socialization styles interact with momentary parent stress and child behavior, whereas emotional climate of the home impacts child behavior more directly. The role of parent ER facilitation in the context of parent stress and children with ASD and behavioral problems is complex and multifaceted. Implications for further supporting children's emotional development via parent involvement are discussed.

Prospective Associations of Maternal Depressive Symptoms and Emotion Dysregulation with Children's Internalizing Problems: The Moderating Role of Fathers

Parents, including fathers, contribute to the early development of internalizing symptoms, which is observable and prevalent among young children. This longitudinal study examined the moderating role of paternal depressive symptoms/emotion dysregulation in the prospective associations between maternal depressive symptoms/emotion dysregulation and children's internalizing problems (depressive and anxiety symptoms). Ninety-four preschoolers and their mothers and fathers participated. Parents completed online questionnaires when their children were four years old and one year later. Results indicated that higher paternal depressive symptoms were associated with an increase, while lower paternal symptoms were associated with a decrease, in the negative impact of maternal emotion dysregulation on children's later depressive, but not anxiety, symptoms. We also tested the moderating role of paternal emotion dysregulation, these pathways were not significant. The findings enhance our understanding of the interaction between maternal and paternal psychological characteristics in contributing to children's anxiety and depressive symptoms.

A common neural response to perceiving but not implicitly regulating infant and adult affect in postpartum mothers

The transition to parenthood requires parents develop caregiving behaviors, such as the ability to identify their infant's emotions and regulate their own emotional response. Research has identified patterns of neural activation in parenting contexts that are interpreted as socioemotional processing. However, no prior research has directly tested whether mothers' neural responses to their infant's affect are the same as those involved in emotion perception/experience and regulation in other contexts. We employed conjunction analyses to clarify which components of mothers' neural response to viewing their infant's affect are shared with passively viewing and labeling adult affective faces (emotion perception/experience and implicit emotion regulation, respectively) in 24 mothers three months postpartum. Our results support a common neural response to viewing infant and adult affect in regions associated with emotion perception/experience (bilateral hippocampi, amygdalae, thalami, orbitofrontal cortex, and ventrolateral prefrontal cortex), but no areas of common response to viewing negative infant affect and implicitly regulating negative adult affect outside of the occipital lobe and cerebellum. This study provides corroborating evidence for shared neural patterns being involved in perceiving/experiencing infant and adult affect but not implicit regulation of infant and adult negative affect.

Parent Emotion Regulation, Mindful Parenting, and Youth Attachment: Direct and Indirect Associations with Internalizing and Externalizing Problems

The direct associations between two dimensions of parent emotion regulation within the parent-youth relationship (dysregulation; suppression), mindful parenting, and youth internalizing and externalizing problems were examined among 759 parents of youth with significant behavioural or emotional problems. The indirect associations of parent emotion regulation and mindful parenting with youth functioning through youth attachment anxiety and avoidance were also investigated. Parent dysregulation was associated with internalizing symptoms both directly and through attachment anxiety, and with externalizing symptoms directly and through attachment anxiety and avoidance. Parent suppression was associated with internalizing symptoms through attachment anxiety, and with externalizing symptoms through attachment anxiety and avoidance. Mindful parenting was associated with lower internalizing symptoms through attachment anxiety and with lower externalizing symptoms through attachment anxiety and avoidance. Emotion regulation within parent-child relationships and mindful parenting may be critical components of parenting programs aimed at promoting youth attachment security and mental health.

"Trying to remain calm…but I do reach my limit sometimes": An exploration of the meaning of gentle parenting

Raising young children has always been hard, but evidence suggests that it may be getting harder. The isolation of the pandemic, the pressures to fulfill exacting parenting standards, and the explosion of "expert" parenting advice on social media have fueled the rise of "gentle parenting," an approach that pivots away from older, discipline-heavy parenting typologies and which promises the development of happier, healthier children. Despite the popularity of gentle parenting, it has received no empirical scrutiny. The current study represents the first systematic investigation of what gentle parenting entails. Data were gathered from a sample (N = 100) of parents of at least one child between the ages of 2 and 7 from the Midwest, Southeast, and Southwest. Approximately half (n = 49) of the sample identified as "gentle parents." Inductive analyses identified this approach as one that emphasizes high levels of parental affection and parents' and children's emotion regulation. Gentle parenting appears to be distinct from other established measures of parenting approaches in its emphasis on boundaries, yet the enactment of those boundaries is not uniform. Overall, gentle parents reported high levels of parenting satisfaction and efficacy, but a subset of gentle parents who were highly critical of themselves reported significantly lower levels of efficacy than the rest of the sample. Statements of parenting uncertainty and burnout were present in over one-third of the gentle parent sample. Implications are discussed for future research and increased support for those who identify as gentle parents.

The central role of mindful parenting in child's emotional regulation and human flourishing: a blueprint perspective

This article provides an innovative perspective of emotional-regulation and human flourishing which acknowledges the fundamental role of early parent-child experiences in shaping brain structure and functioning involved in emotional regulation and the central role of mindful parenting in facilitating emotional regulation in both parent and child (co-regulation). In this perspective paper the author underlines not only the central role of emotions and emotional regulation in human development and flourishing, but also the importance of maternal mental health, mindfulness, and a connected supportive community during pregnancy and postnatally in facilitating emotional regulation in both the caregiver and the infant and thus promoting secure attachment. The role of alloparenting and how we evolved to share childrearing is introduced, and emotional regulation is described not as an individual phenomenon but a relational embodied process. The associations between right brain functioning, mindfulness and secure attachment, all leading to emotional regulation, wellbeing, and resilience are described. Sharing findings and perspectives offer an opportunity for insights and reflection upon what strategies could be created to promote relational emotional regulation and wellbeing in early life, thus human flourishing leading to a peaceful society.

Testing a Biobehavioral Model of Chronic Stress and Weight Gain in Young Children (Family Stress Study): Protocol and Baseline Demographics for a Prospective Observational Study

BACKGROUND

Chronic stress is an important risk factor in the development of obesity. While research suggests chronic stress is linked to excess weight gain in children, the biological or behavioral mechanisms are poorly understood.

OBJECTIVE

The objectives of the Family Stress Study are to examine behavioral and biological pathways through which chronic stress exposure (including stress from COVID-19) may be associated with adiposity in young children, and to determine if factors such as child sex, caregiver-child relationship quality, caregiver education, and caregiver self-regulation moderate the association between chronic stress and child adiposity.

METHODS

The Family Stress Study is a prospective cohort study of families recruited from 2 Canadian sites: the University of Guelph in Guelph, Ontario, and McMaster University in Hamilton, Ontario. Participants will be observed for 2 years and were eligible to participate if they had at least one child (aged 2-6 years) and no plans to move from the area within the next 3 years. Study questionnaires and measures were completed remotely at baseline and will be assessed using the same methods at 1- and 2-year follow-ups. At each time point, caregivers measure and report their child's height, weight, and waist circumference, collect a hair sample for cortisol analysis, and fit their child with an activity monitor to assess the child's physical activity and sleep. Caregivers also complete a web-based health and behaviors survey with questions about family demographics, family stress, their own weight-related behaviors, and their child's mental health, as well as a 1-day dietary assessment for their child.

RESULTS

Enrollment for this study was completed in December 2021. The final second-year follow-up was completed in April 2024. This study's sample includes 359 families (359 children, 359 female caregivers, and 179 male caregivers). The children's mean (SD) age is 3.9 years (1.2 years) and 51% (n=182) are female. Approximately 74% (n=263) of children and 80% (n=431) of caregivers identify as White. Approximately 34% (n=184) of caregivers have a college diploma or less and nearly 93% (n=499) are married or cohabiting with a partner. Nearly half (n=172, 47%) of the families have an annual household income ≥CAD $100,000 (an average exchange rate of 1 CAD=0.737626 USD applies). Data cleaning and analysis are ongoing as of manuscript publication.

CONCLUSIONS

Despite public health restrictions from COVID-19, the Family Stress Study was successful in recruiting and using remote data collection to successfully engage families in this study. The results from this study will help identify the direction and relative contributions of the biological and behavioral pathways linking chronic stress and adiposity. These findings will aid in the development of effective interventions designed to modify these pathways and reduce obesity risk in children.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05534711; https://clinicaltrials.gov/study/NCT05534711.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/48549.

Effect of partner presence on emotion regulation during parent-child interactions

Having people around, especially if they provide social support, often leads to positive outcomes both physically and mentally. Mere social presence is especially beneficial when it comes from a loved one or romantic partner. In these studies, we aim to expand the understanding of how the presence of one's romantic partner affects emotion regulation in parental situations. Specifically, we examined how partner presence influences the parent's emotional intensity, emotion regulation, and interpretation of their child's emotion regulation. We examined these questions in parents of both non-autistic children (Study 1) as well as autistic children (Study 2), which we hypothesize leads to more intense emotional interactions. The parents of autistic children were better able to regulate their emotions when their partners were present compared to when they were absent. Furthermore, in both studies, parents' ratings of their children's ability to regulate their emotions were higher when their parent's partner was present compared to when the partner was absent. However, in both studies, we found no significant difference in the parents' emotional intensity when their partners were present compared to when their partners were absent during the emotionally charged interaction with their child. Our findings help highlight the impact of partner presence on parent and child emotion regulation.

Exploring the Relationship between Turkish Mothers' Parenting and Psychological Well-Being in Early Childhood: The Role of Child Emotion Regulation and Dysregulation

Although the importance of psychological well-being in early childhood is emphasized, the number of studies conducted with children and adolescents in this field is less than those carried out with adults. The present study aimed to explore the role of child emotion regulation in the relationship between parenting and psychological well-being among a sample of Turkish preschoolers aged 5-6. It further examines the mediating role of emotion regulation. The sample consisted of 416 mothers with children aged 5-6 (Mage = 5.38, SD = 0.48; 50% girls-boys). We collected the data using the Multidimensional Assessment of Parenting Scale (MAPS), the Emotion Regulation Checklist (ERC), and the Psychological Well-Being Scale for Children (PWBS-C). The findings revealed significant relationships among parenting practices (positive/negative), the child's emotion regulation/dysregulation, and the child's psychological well-being. Moreover, the findings revealed that positive parenting, directly and indirectly, affects children's psychological well-being through children's emotion regulation. On the other hand, findings disclosed that negative parenting has both a direct and indirect impact on children's psychological well-being through children's emotion regulation. Overall, the study may shed light on a possible process in which positive parenting boosts a child's emotional regulation and psychological well-being among preschoolers.

Current perspectives on perinatal mental health and neurobehavioral development: focus on regulation, coregulation and self-regulation

PURPOSE OF REVIEW

Perinatal mental health research provides an important perspective on neurobehavioral development. Here, we aim to review the association of maternal perinatal health with offspring neurodevelopment, providing an update on (self-)regulation problems, hypothesized mechanistic pathways, progress and challenges, and implications for mental health.

RECENT FINDINGS

(1) Meta-analyses confirm that maternal perinatal mental distress is associated with (self-)regulation problems which constitute cognitive, behavioral, and affective social-emotional problems, while exposure to positive parental mental health has a positive impact. However, effect sizes are small. (2) Hypothesized mechanistic pathways underlying this association are complex. Interactive and compensatory mechanisms across developmental time are neglected topics. (3) Progress has been made in multiexposure studies. However, challenges remain and these are shared by clinical, translational and public health sciences. (4) From a mental healthcare perspective, a multidisciplinary and system level approach employing developmentally-sensitive measures and timely treatment of (self-)regulation and coregulation problems in a dyadic caregiver-child and family level approach seems needed. The existing evidence-base is sparse.

SUMMARY

During the perinatal period, addressing vulnerable contexts and building resilient systems may promote neurobehavioral development. A pluralistic approach to research, taking a multidisciplinary approach to theoretical models and empirical investigation needs to be fostered.

Prospective Associations of Maternal Depressive Symptoms and Emotion Dysregulation with Children's Internalizing Problems: The Moderating Role of Fathers

The occurrence of internalizing symptoms is prevalent among young children and can be observed as early as preschool years. Using a longitudinal approach, this study examined the moderating role of paternal depressive symptoms/emotion dysregulation in the prospective associations between maternal depressive symptoms/emotion dysregulation and children's internalizing problems (depressive and anxiety symptoms). Ninety-four preschoolers and their mothers and fathers participated in the study. Mothers and fathers completed online questionnaires for all variables when their children were 4 years old and one year later. The results indicated that paternal depressive symptoms moderated the association between maternal emotion dysregulation and children's later depressive, but not anxiety, symptoms. Specifically, higher levels of depressive symptoms in fathers exacerbated the negative influence of maternal emotion dysregulation on children's later depressive symptoms, whereas fathers with low levels of depressive symptoms served a protective role. The findings enhance our understanding of the interaction between maternal and paternal psychological characteristics in contributing to children's anxiety and depressive symptoms.

Initial Effects of a Brief Transdiagnostic Intervention on Parent Emotion Management During COVID-19

Parents are a vulnerable group to increased distress resulting from the COVID-19 pandemic. In this study, 80 parents with at least mildly elevated internalizing symptoms were randomized to receive a four session, transdiagnostic intervention via telehealth during the height of the COVID-19 pandemic based on the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders (UP-Caregiver), immediately or 6-weeks after receipt of psychoeducational materials. Results showed no between-condition differences in slopes of primary outcome measures; however, significant group differences in intercepts indicated that those receiving UP-Caregiver immediately had greater improvements in distress tolerance and intolerance of uncertainty than those in the delayed condition. Analyses also suggested within-condition improvements in emotional functioning and high satisfaction with UP-Caregiver. Results suggest that psychoeducation and symptom monitoring may be helpful to some distressed parents. Future investigations should utilize a larger sample to identify which parents might benefit the most from interventions like UP-Caregiver during crises.

Research Review: Child emotion regulation mediates the association between family factors and internalizing symptoms in children and adolescents - a meta-analysis

BACKGROUND

Parental influence on children's internalizing symptoms has been well established; however, little is known about the underlying mechanisms. One possible mechanism is child emotion regulation given evidence (a) of its associations with internalizing symptoms and (b) that the development of emotion regulation during childhood and adolescence is influenced by aspects of the family environment. This meta-analysis aimed to systematically investigate the mediating role of child emotion regulation in the relationship between various family factors and internalizing symptoms in children and adolescents.

METHODS

We searched Medline, Embase, PsychInfo, and Web of Science for English articles up until November 2022. We included studies that examined child emotion regulation as a mediator between a family factor and child/adolescent internalizing symptoms. Random-effects models were used to calculate pooled indirect effects and total effects for nine family factors. Heterogeneity and mediation ratio were also calculated.

RESULTS

Of 49 studies with 24,524 participants in this meta-analysis, family factors for which emotion regulation mediated the association with child/adolescent internalizing symptoms included: unsupportive emotion socialization, psychological control, secure attachment, aversiveness, family conflict, parent emotion regulation and parent psychopathology, but not supportive emotion socialization and behavioral control.

CONCLUSIONS

Various family factors impact children's emotion regulation development, and in turn, contribute to the risk of internalizing symptoms in young people. Findings from this study highlight the need for interventions targeting modifiable parenting behaviors to promote healthy emotion regulation and better mental health in children and adolescents.

Emotion Regulation, Parenting, and Psychopathology: A Systematic Review

The presence of a parental mental disorder can lead to adverse outcomes for children. Difficulties in emotion regulation are observed across a range of mental health problems and may play a crucial role in this context. Following PRISMA guidelines, we systematically searched Medline, PsycINFO, Embase, and Web of Science for studies examining the association between emotion regulation in parents with psychopathology at a clinical or subclinical level and their parenting. The protocol was registered with the PROSPERO international prospective register of systematic reviews (CRD42021224954; January 2021). A total of 23 studies were included in the qualitative synthesis. Emotion regulation was predominantly assessed using self-report on the general ability (e.g., Difficulties in Emotion Regulation Scale). The assessment of parenting encompassed a broad range of aspects and operationalizations. Across psychopathology in parents, several aspects of difficulties in emotion regulation were associated with unfavorable emotion socialization, more negative parenting, and partially with less positive parenting. Slightly different effects were observed for posttraumatic stress disorder and anxiety disorders. For parents with depressive disorders, specific emotion regulation strategies (suppression, reappraisal) seem to buffer against negative parenting. Since the majority of studies refer only to mothers, generalization to fathers is limited. Furthermore, conclusions are limited due to study heterogeneity and lack of prospective studies. Nevertheless, findings suggest that interventions should target the improvement of emotion regulation in parents with psychopathology.

Roles of physical functioning and comorbid mental illness of chronically ill parents and their spouses' health status in adolescent functioning

INTRODUCTION

Emerging research suggests that physically ill parents' psychological adjustment to illness and emotional well-being may affect adolescents' psychosocial functioning. As people with chronic medical conditions often develop mental disorders, it is important to examine the influence of comorbidity of parental physical and mental health conditions on adolescents' functioning. In addition, the physical and mental health status of the spouses/partners of chronically ill parents needs to be explored to further understand the potential impact of parental chronic illness on adolescents' psychological distress and academic performance.

METHODS

Cross-sectional data from 164 parent-adolescent pairs were collected through online surveys in the United States between 2018 and 2019. Parent participants (Mage  = 42.69, SD = 5.96) included parents who had been diagnosed with a chronic physical illness (e.g., multiple sclerosis, diabetes, chronic pain, cancer). Adolescent participants were middle- and high-school-aged children who lived with their physically ill parents (Mage  = 14.34, SD = 2.07).

RESULTS

Hierarchical regression analyses indicated that comorbid mental illness of parental chronic illness and spousal mental health status were associated with adolescents' distress. The level of physical functioning of chronically ill parents was related to adolescents' academic performance.

CONCLUSION

Parental chronic illness appears to affect adolescents' psychological and academic outcomes through distinct pathways. It is important to examine the comorbid mental health status of chronically ill parents and their spouses'/partners' mental health conditions to better understand the impact of parental chronic illness on adolescents' psychological adjustment.

Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents

BACKGROUND

Emotional and behavioural difficulties (EBD) in children are common, characterised by externalising or internalising behaviours that can be highly stable over time. EBD are an important cause of functional disability in childhood, and predictive of poorer psychosocial, academic, and occupational functioning into adolescence and adulthood. The prevalence, stability, and long-term consequences of EBD highlight the importance of intervening in childhood when behavioural patterns are more easily modified. Multiple factors contribute to the aetiology of EBD in children, and parenting plays an important role. The relationship between parenting and EBD has been described as bidirectional, with parents and children shaping one another's behaviour. One consequence of bidirectionality is that parents with insufficient parenting skills may become involved in increasingly negative behaviours when dealing with non-compliance in children. This can have a cyclical effect, exacerbating child behavioural difficulties and further increasing parental distress. Behavioural or skills-based parenting training can be highly effective in addressing EBD in children. However, emotional dysregulation may intercept some parents' ability to implement parenting skills, and there is recognition that skills-based interventions may benefit from adjunct components that better target parental emotional responses. Mindful parenting interventions have demonstrated some efficacy in improving child outcomes via improvements in parental emotion regulation, and there is potential for mindfulness training to enhance the effectiveness of standard parent training programmes.

OBJECTIVES

To assess the effectiveness of mindfulness-enhanced parent training programmes on the psychosocial functioning of children (aged 0 to 18 years) and their parents.

SEARCH METHODS

We searched the following databases up to April 2023: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL Plus, PsycINFO, Sociological Abstracts, Social Sciences Citation Index, Conference Proceedings Citation Index - Social Science & Humanities, AMED, ERIC, ProQuest Dissertations & Theses, Cochrane Database of Systematic Reviews, Campbell Collaboration Library of Systematic Reviews, as well as the following trials registers: ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP). We also contacted organisations/experts in the field.

SELECTION CRITERIA

We included randomised and quasi-randomised trials. Participants were parents or caregivers of children under the age of 18. The intervention was mindfulness-enhanced parent training programmes compared with a no-intervention, waitlist, or attentional control, or a parent training programme with no mindfulness component. The intervention must have combined mindfulness parent training with behavioural or skills-based parent training. We defined parent training programmes in terms of the delivery of a standardised and manualised intervention over a specified and limited period, on a one-to-one or group-basis, with a well-defined mindfulness component. The mindfulness component must have included mindfulness training (breath, visualisation, listening, or other sensory focus) and an explicit focus on present-focused attention and non-judgemental acceptance.

DATA COLLECTION AND ANALYSIS

We followed standard Cochrane procedures.

MAIN RESULTS

Eleven studies met our inclusion criteria, including one ongoing study. The studies compared a mindfulness-enhanced parent training programme with a no-treatment, waitlist, or attentional control (2 studies); a parent training programme with no mindfulness component (5 studies); both a no-treatment, waitlist, or attentional control and a parent training programme with no mindfulness component (4 studies). We assessed all studies as being at an unclear or high risk of bias across multiple domains. We pooled child and parent outcome data from 2118 participants to produce effect estimates. No study explicitly reported on self-compassion, and no adverse effects were reported in any of the studies. Mindfulness-enhanced parent training programmes compared to a no-treatment, waitlist, or attentional control Very low certainty evidence suggests there may be a small to moderate postintervention improvement in child emotional and behavioural adjustment (standardised mean difference (SMD) -0.46, 95% confidence interval (CI) -0.96 to 0.03; P = 0.06, I2 = 62%; 3 studies, 270 participants); a small improvement in parenting skills (SMD 0.22, 95% CI 0.06 to 0.39; P = 0.008, I2 = 0%; 3 studies, 587 participants); and a moderate decrease in parental depression or anxiety (SMD -0.50, 95% CI -0.96 to -0.04; P = 0.03; 1 study, 75 participants). There may also be a moderate to large decrease in parenting stress (SMD -0.79, 95% CI -1.80 to 0.23; P = 0.13, I2 = 82%; 2 studies, 112 participants) and a small improvement in parent mindfulness (SMD 0.21, 95% CI -0.14 to 0.56; P = 0.24, I2 = 69%; 3 studies, 515 participants), but we were not able to exclude little to no effect for these outcomes. Mindfulness-enhanced parent training programmes compared to parent training with no mindfulness component Very low certainty evidence suggests there may be little to no difference postintervention in child emotional and behavioural adjustment (SMD -0.09, 95% CI -0.58 to 0.40; P = 0.71, I2 = 64%; 5 studies, 203 participants); parenting skills (SMD 0.13, 95% CI -0.16 to 0.42; P = 0.37, I2 = 16%; 3 studies, 319 participants); and parent mindfulness (SMD 0.11, 95% CI -0.19 to 0.41; P = 0.48, I2 = 44%; 4 studies, 412 participants). There may be a slight decrease in parental depression or anxiety (SMD -0.24, 95% CI -0.83 to 0.34; P = 0.41; 1 study, 45 participants; very low certainty evidence), though we cannot exclude little to no effect, and a moderate decrease in parenting stress (SMD -0.51, 95% CI -0.84 to -0.18; P = 0.002, I2 = 2%; 3 studies, 150 participants; low certainty evidence).

AUTHORS' CONCLUSIONS

Mindfulness-enhanced parenting training may improve some parent and child outcomes, with no studies reporting adverse effects. Evidence for the added value of mindfulness training to skills-based parenting training programmes is suggestive at present, with moderate reductions in parenting stress. Given the very low to low certainty evidence reviewed here, these estimates will likely change as more high-quality studies are produced.

The Effectiveness of Parenting Programs in Preventing Abusive Head Trauma: A Systematic Review and Meta-Analysis

Parenting programs are the most common intervention for preventing the lethal form of child maltreatment, abusive head trauma (AHT). However, certain results of the effects of these programs have not yet been compared across studies. A systematic review with meta-analysis is warranted to quantitively synthesize the available evidence to identify effective elements and strategies of the programs for preventing AHT. This review aims to estimate AHT preventive parenting programs' pooled effect on the reduction of AHT incidence, the improvement of parental knowledge, and the increased use of safe strategies in response to infants' inconsolable crying. Studies published in English and Mandarin were searched and retained if they were randomized control trials (RCTs) or with a quasi-experimental design, included an AHT preventive parenting program, and provided data that quantified targeted outcomes. Eighteen studies were included in this review. AHT preventive parenting programs had a pooled effect on improving parents' knowledge and increasing the use of safe coping strategies in response to inconsolable crying but not on the incidence of AHT and parents' emotional self-regulation. Subgroup analyses showed that the intervention effects were mostly present across study designs or measurements and emerged in the reduction of AHT incidence compared with historical controls. The findings suggest that AHT preventive parenting programs enhance parenting knowledge and skills to provide safe care for infants. Further efforts to evaluate AHT parenting programs on the reduction of AHT incidence are necessary for decision-making on allocating and disseminating interventions.

Examining the whole plate: The role of the family context in the understanding of children's food refusal behaviors

INTRODUCTION

In the context of understanding children's food refusal behaviors, such as food fussiness and food neophobia, research has predominantly focused on the role of parental feeding strategies. However, little is known about which general family context variables add to the understanding of children's food refusal behaviors. The purpose of this study was to examine the relation between 1) parents' own use of maladaptive emotion regulation strategies when they are anxious, 2) parents' reactions towards their children's emotions in stressful situations, and 3) parenting styles on the one hand, and children's food refusal behaviors on the other.

METHODS

Mothers and fathers (N = 157) of young children (M = 4.64, SD = 1.7) completed a series of self- and parent-report questionnaires.

RESULTS

The model examining the role of parenting styles was found to be significantly related to food refusal behaviors in children. More specifically, the current findings demonstrate that higher levels of a coercive parenting style were associated with higher levels of both food fussiness and food neophobia in children. Furthermore, higher levels of a chaotic parenting styles were associated with higher levels of food neophobia in children. The models examining parents' maladjusted emotion regulation strategies when anxious and parents' reactions towards their children's emotions during stressful situations were not found to be significant.

CONCLUSIONS

Factors related to the parenting style appear to be important for understanding food refusal behaviors in children. Replication of the findings using longitudinal and observational designs is needed.

A Scale of Parent-to-Child Emotions (SPCE): Development and validation of a short form

Aim

Parents' emotions towards a child are extremely important. The Scale of Parent-to-Child Emotions (SPCE) consists of five basic and four self-conscious emotion domains for assessment of parental emotional states. Abridgement of the SPCE is needed for research and clinical settings.

Methods

Our previous investigational data for SPCE development were used in this study. The sample of 2336 fathers and 2264 mothers, whose eldest child's age was up to 12 years old, was analyzed. Total information for each pair (form) of items corresponding to a latent trait (θ) was calculated. The form with the greatest amount of total information was selected as the best for each domain. In addition, relative efficiency for each form and correlations of raw sum scores in classical test theory (CTT) for short forms with factor scores in item response theory (IRT) were calculated.

Results

The SPCE was shortened to 18 items by selecting two items each for nine domains. Correlations of raw sum scores in CTT for short forms with factor scores in IRT were correlated strongly and significantly.

Conclusion

This abridged form of the scale, the SPCE-18, may be applicable in a busy clinical setting or research works to investigate the trajectory of parent-to-child emotions across a long span of time.

The experiences of parents in an early-intervention program for young people with borderline personality disorder features

Previous research demonstrates that parents' communication skills may contribute to the development and maintenance of their young person's borderline personality disorder (BPD). Carers of people with BPD also experience their own psychosocial stressors and feel unsupported. Consequently, Dialectical Behavior Therapy for adolescents (DBT-A) invites parents to partake in group therapy alongside their young person. Despite this involvement, little research exists examining parents' perspective of engaging in a DBT-A program, and specifically whether they experience their own benefits and changes from being part of the program. To examine this, the current study interviews 34 parents who engaged in an early intervention DBT-A program. Thematic analysis resulted in seven key themes and 16 subthemes beginning with parents' expectations of the program, followed by the key elements of the program that facilitated change, and the actual changes and benefits attributed to these elements. Overall, parents were surprised by their own gains from the program, and how the skills they learned facilitated personal development that improved family communication and functioning with their young person and more broadly. This study addresses the gap in understanding the parent perspective with clinical implications for the benefits of involving parents in therapy more generally.

Neonatal Intensive Care Unit Latent Profiles of Maternal Distress: Associations With 5-Year Maternal and Child Mental Health Outcomes

OBJECTIVE

To examine profiles of distress of mothers of preterm infants in the neonatal intensive care unit (NICU) and relate profiles to maternal and child outcomes at child age 5 years.

METHOD

A racially and economically diverse sample of mothers (n = 94; 39% African American, 52% White) of preterm infants (≤30 weeks of gestation) completed validated questionnaires assessing depression, anxiety (state and trait), NICU stress, and life stress at NICU discharge of their infant. Mothers reported on their own and their children's symptomatology at child age 5. A latent profile analysis was conducted to categorize maternal symptomatology.

RESULTS

Latent profile analysis yielded 4 distinct maternal profiles: low symptomatology, high NICU stress, high depression and anxiety, and high state anxiety. Social determinants of health factors including age, education, neighborhood deprivation, and infant clinical risk distinguished the profiles. Mothers in the high depression and anxiety profile reported more anxiety and life stress at follow-up and reported their children experienced more anxious/depressed symptoms.

CONCLUSION

Existing literature has gaps related to examining multiple dimensions of NICU distress and understanding how patterns of mood/affective symptoms, life stressors, and related social determinants of health factors vary across mothers. In this study, one specific profile of maternal NICU distress demonstrated enduring risks for poorer maternal and child mental health outcomes. This new knowledge underscores sources of disparate health outcomes for mothers of preterm infants and the infants themselves. Universal screening is needed to identify at-risk dyads for poor health outcomes in need of individualized interventions that address both maternal and child well-being.

DIVERSITY & INCLUSION STATEMENT

We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list.

Maternal invalidation and child RSA reactivity to frustration interact to predict teacher-reported aggression among at-risk preschoolers

BACKGROUND

Aggression is a transdiagnostic indicator of risk and represents one of the most common reasons children are referred for mental health treatment. Theory and research highlight the impact of maternal invalidation on child aggression and suggest that its influence may vary based on differences in child physiological reactivity. Moreover, the interaction between these risk factors may be particularly pronounced among children of mothers with emotion regulation (ER) difficulties. The current study examined the independent and interactive effects of maternal invalidation and child physiological reactivity to frustration on teacher-reported aggression in an at-risk sample of preschool children.

METHOD

Participants included 77 mothers (Mage = 33.17 years, s.d. = 4.83; 35% racial/ethnic minority) and their children (Mage = 42.48 months; s.d. = 3.78; 56% female; 47% racial/ethnic minority). Groups of mothers with and without clinician-rated ER difficulties reported on maternal invalidation, and child respiratory sinus arrhythmia (RSA) was assessed continuously during a frustration task as an indicator of physiological reactivity. Teachers or daycare providers reported on child aggression.

RESULTS

Results demonstrated positive associations between maternal ER difficulties and both maternal invalidation and child RSA reactivity to frustration. As expected, the interaction between maternal invalidation and child RSA reactivity was significant, such that higher maternal invalidation and greater child RSA reactivity to frustration predicted more aggression in a daycare or preschool setting. Importantly, this effect was demonstrated while controlling for demographic covariates and baseline RSA.

CONCLUSIONS

Findings are in line with diathesis-stress and biosocial models of risk and point to multiple targets for prevention and early intervention.

Do Emotion Regulation Strategies Mediate the Relationship of Parental Emotion Socialization with Adolescent and Emerging Adult Psychological Distress?

A child's ability to cope with stress is shaped by experiences in a parent-child relationship. In this study, the direct effect of a parent's response to anger and happiness in childhood on adolescents' and emerging adults' psychological distress and the indirect effect through the mediating role of emotion regulation strategies-specifically, cognitive reappraisal and emotional suppression-were measured. To achieve our research aim, we tested four parallel mediation models using the bootstrapping method. A group of 497 participants aged between 14 and 35 years (M = 18.62; SD = 3.32), 66% female (n = 332) and 34% male (n = 165), completed a questionnaire comprising self-reporting measures. The results indicate direct effects between emotion socialization and distress for seven independent variables. The mother's and father's positive responses to anger and happiness are significant negative predictors of distress; the negative responses of both parents to happiness, and the mother's negative response to anger-but not the father's-are significant positive predictors of distress. The findings also provide support for the mediating role of expressive suppression and cognitive reappraisal for the mother's positive response to both anger and happiness, as well as for the mother's negative response to the child's expression of happiness. None of the father's responses-positive or negative, in relation to anger or happiness-are mediated by emotion regulation strategies in relation to distress. Our findings have practical implication for a preventative intervention program focused on the psychological growth of adolescents by adaptative emotional responses.

Profiles of parents' emotion socialization within a multinational sample of parents

Introduction

Seminal emotion socialization theories classify parents according to two patterns of parent emotion socialization processes: 'emotion coaching' (i.e., parents validate and teach children about emotions) versus 'emotion dismissing' parenting (i.e., parents minimize and dismiss their children's emotions). However, empirical evidence supporting this binary distinction of parents remains limited. Our objective was to investigate whether parents can be differentiated by distinct patterns in their (1) beliefs about children's emotions, (2) emotion regulation, and (3) emotion-related parenting practices.

Method

Participants were parents of children aged 4-10 years from the Child and Parent Emotion Study (N = 869) (https://bmjopen.bmj.com/content/10/10/e038124). Parents completed self-reported measures of emotion socialization processes via an online survey, which took 20-30 min to complete. Data included in the current study were collected May-August 2019. We conducted a latent profile analysis of parents' emotion socialization (13 indicators). To assess reliability of the profiles, we examined stability of the profiles across (1) parents of children in early versus middle childhood, and (2) fathers versus mothers, via measurement invariance testing. Further, to assess for construct validity of the profiles, we examined concurrent associations between six criterion constructs and parents' emotion socialization profiles.

Results

A three-profile model emerged characterizing parents by: (1) emotion coaching; (2) emotion dismissing; (3) emotion disengaged. There was strong support for construct validity and reliability.

Discussion

Our study provides empirical support for distinct differentiated classifications of emotion coaching and emotion dismissing parenting, aligned with emotion socialization theories. We further extend on extant theory and suggest a third 'emotion disengaged' classification, describing parents with moderate levels of emotion dismissing parenting and low levels of emotion coaching parenting. It should be noted that the profiles were derived with self-report data, therefore, data may have been biased by contextual factors. Furthermore, the study sample consisted of Western families from affluent backgrounds. The field should focus efforts on conducting person-centered studies with more diverse samples in future.

Evidence-Based Treatment in Practice: PCIT Research on Addressing Individual Differences and Diversity Through the Lens of 20 Years of Service

Parent-Child Interaction Therapy (PCIT) is an intensive parent support program for caregivers and their children who exhibit difficult-to-manage disruptive behaviors. After more than four decades of research supporting its efficacy for reducing children's disruptive behaviors and improving parent-child relationships, PCIT has become one of the most popular and widely disseminated parenting support programs in the world. The evidence for the efficacy of PCIT can be found in many reviews of randomized clinical trials and other rigorous studies. To add to those reviews, our aim was to provide practical guidance on how PCIT can be part of an evidence-based program for families that depends on practitioner expertise, as well as attention to families' diverse needs. To do this, we describe the evolution of PCIT as practiced in a university-community partnership that has continued for over 20 years, alongside a narrative description of selected and recent findings on PCIT and its use in specific client presentations across four themes. These themes include studies of 1) whether the standard manualized form of PCIT is efficacious across a selection of diverse family situations and child diagnoses, 2) the mechanisms of change that explain why some parents and some children might benefit more or less from PCIT, 3) whether treatment content modifications make PCIT more feasible to implement or acceptable to some families, at the same time as achieving the same or better outcomes, and 4) whether PCIT with structural modifications to the delivery, such as online or intensive delivery, yields similar outcomes as standard PCIT. Finally, we discuss how these directions in research have influenced research and practice, and end with a summary of how the growing attention on parent and child emotion regulation and parents' responses to (and coaching of) their children's emotions has become important to PCIT theory and our practice.

Self-Compassion for Caregivers of Children in Parentally Bereaved Families: A Theoretical Model and Intervention Example

Family-based bereavement interventions have shown promises to prevent problem outcomes and promote resilience in parentally bereaved children. Evidence of the broad range of mental and physical health problems following the death of a parent supports the need for a transdiagnostic approach that promotes adaptation and reduces multiple problem outcomes for parentally bereaved families. We discuss self-compassion as a promising framework for a transdiagnostic approach. We argue that three elements of self-compassion-mindfulness (vs. over-identification), self-kindness (vs. self-judgment), and common humanity (vs. isolation)-can facilitate loss-oriented coping, restoration-oriented coping, and the oscillation process between the two. This sets the foundation for individual and family processes that support bereavement adjustment. To explain how self-compassion promotes adjustment outcomes in parentally bereaved families, we review the extant literature with a focus on parental emotion regulation and effective parenting and propose a conceptual model with testable hypotheses to guide more research in this area. The model suggests that caregivers' self-compassion is a resilience resource for multiple adaptive outcomes for themselves and for their child through its positive impacts on emotion regulation and effective parenting. We illustrate the utility of the framework with an example of a family-based bereavement prevention program that integrated self-compassion training. Future directions for research are discussed.

Adolescents' Coping and Internalizing Symptoms: Role of Maternal Socialization of Coping and Depression Symptoms

Parental emotion socialization, including processes of the socialization of coping and emotion regulation, is a key factor in shaping children's adjustment in response to acute and chronic stress. Given well-established links between parental depression and youth psychopathology, levels of parental depression symptoms are an important factor for understanding emotion socialization and regulation processes. The present study examined associations among maternal coping and depression symptoms with their adolescents' coping and internalizing problems. A sample of 120 adolescents (45% female, M = 12.27, SD = 1.90) and their mothers participated in a cross-sectional, multi-informant study. Mothers' depression symptoms and adolescents' coping were significantly related to adolescents' internalizing problems. Adolescents' coping moderated the association between maternal depression symptoms and adolescents' internalizing problems, where at low and moderate levels of primary control coping, maternal depression predicted greater internalizing symptoms in adolescents. Further, this study expanded on prior work, demonstrating that the relationship between adolescents' coping and internalizing symptoms was associated with the degree to which mothers model coping. Taken together, results suggest that maternal coping and adolescent coping serve as salient risk and protective factors in the context of family stress. Findings emphasize a need for researchers to further clarify the role of emotion socialization processes in adolescents' development of coping in the context of family stress.

Assessing the effectiveness and the mechanisms of the Social-Emotional Prevention Program for Preschoolers: Findings from a universal school-based intervention

The Social-Emotional Prevention Program (SEP) encompasses a multifaceted approach (classroom curriculum, with teacher and parent training) intended to increase preschool children's social adjustment, as well as to reduce risk of emotional and behavioral problems. The present study's focus was on implementing the technology-assisted SEP version and was aimed at (a) investigating the program's effectiveness on children's social-emotional competencies and parental practices, as well as (b) testing the program's conceptual framework, with an emphasis on children's emotion regulation (ER) skills and parental emotion socialization practices as explanatory intervention mechanisms. A randomized-controlled trial (RCT) was conducted with five schools assigned to either the intervention or to a comparison condition (wait-list control). Structural equation models (SEM) and complier average causal effects (CACE) were conducted to evaluate SEP effectiveness on teacher- and parent-rated child outcomes (primary outcomes) and parenting behaviors (secondary outcomes). Findings from the present study indicated that (a) SEP fosters increased social-emotional competencies and increased use of adaptive ER strategies, with teacher and parent ratings converging to support these outcomes; (b) parental participation in the program increased the use of reappraisal and emotion coaching strategies; and (c) children's ER mediated the intervention's effect on social competence, whereas parental coaching and parental ER mediated SEP effects on children's ER. This study's findings suggest that the SEP may be an effective universal intervention for promoting preschoolers' social-emotional competence and may provide emerging evidence to support the program's hypothesized mechanisms of change.

How does parental emotion regulation influence Chinese migrant children's resilience? The chain mediating role of self-efficacy and hope

To examine the chain mediating role of self-efficacy and hope in the relationship between parental emotion regulation and migrant children's resilience, the study investigated 745 migrant children (mean age = 12.9, SD = 1.5, 371 boys) from four schools and their parents in Guiyang City, Guizhou Province, China. All children were asked to complete the Adolescent Resilience Scale, the General Self-Efficacy Scale, and the Children's Hope Scale. Their parents completed the Parental Emotion Regulation Questionnaire. Structural equation modeling showed that parental emotion regulation could not only directly influence children's resilience but also indirectly influence it through two paths: the independent mediating role of self-efficacy and the chain mediating role of self-efficacy and hope. These findings contribute to a deeper understanding of how parental emotion regulation influences migrant children's resilience and provide important practical guidance for enhancing migrant children's resilience.

Child internalizing and externalizing behaviors: Interplay between maternal depressive symptoms and child inhibitory control

Maternal depression is a risk factor for child internalizing and externalizing behaviors. Aiming to investigate the moderating role of child inhibitory control on this relationship, we invited a sub-sample of dyads from the Norwegian Mother, Father, and Child Cohort study (MoBa) for a lab-based assessment (N = 92, M age = 68 months, Range = 59-80, 50% girls). Maternal depression was assessed using the Beck Depression Inventory (BDI-II), while child behaviors were measured using the Child Behavior Check List, and inhibitory control using a child friendly version of the Flanker-task. As expected, higher levels of concurrent maternal depressive symptoms predicted higher levels of child internalizing and externalizing behaviors. Importantly, and in line with our predictions, child inhibitory control moderated the association. Lower levels of inhibitory control predicted a stronger association between concurrent maternal depressive symptoms and child behavioral outcomes. The results support prior research suggesting that concurrent maternal depression poses a risk for child development, and highlight that children with lower levels of inhibitory control are more vulnerable to negative environmental influences. These findings contribute to our understanding of the complexity of parental mental health issues on child development and suggest avenues for personalized treatment programs for families and children at risk.