Video-feedback promotes sensitive limit-setting in parents of twin preschoolers: a randomized controlled trial

Development of social feedback processing and responses in childhood: an fMRI test-replication design in two age cohorts

This study investigated behavioral and neural correlates underlying social feedback processing and subsequent aggressive behaviors in childhood in two age cohorts (test sample: n = 509/n = 385 and replication sample: n = 354/n = 195, 7-9 years old). Using a previously validated Social Network Aggression Task, we showed that negative social feedback resulted in most behavioral aggression, followed by less aggression after neutral and least aggression after positive feedback. Receiving positive and negative social feedback was associated with increased activity in the insula, medial prefrontal cortex and ventrolateral prefrontal cortex. Responding to feedback was associated with additional activation in the dorsolateral prefrontal cortex (DLPFC) following positive feedback. This DLPFC activation correlated negatively with aggression. Furthermore, age analyses showed that older children showed larger reductions in aggression following positive feedback and more neural activation in the DLPFC when responding to positive feedback compared to younger children. To assess the robustness of our results, we examined these processes in two independent behavioral/functional magnetic resonance imaging samples using equivalence testing, thereby contributing to replicable reports. Together, these findings demonstrate an important role of social saliency and regulatory processes where regulation of aggression rapidly develops between the ages of 7 and 9 years.

Improving parenting, child attachment, and externalizing behaviors: Meta-analysis of the first 25 randomized controlled trials on the effects of Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline

Improving parenting, child attachment, and externalizing behaviors: Meta-analysis of the first 25 randomized controlled trials on the effects of Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD). VIPP-SD combines support of parental sensitive responsiveness with coaching parents in sensitive limit setting. Here, we present meta-analyses of 25 RCTs conducted with more than 2,000 parents and caregivers. Parents or children had various risks. We examined its effectiveness in promoting parental cognitions and behavior regarding sensitive parenting and limit setting, in promoting secure child-parent attachment, and reducing externalizing child behavior. Web of Science, MEDLINE, PubMed, and recent reviews were searched for relevant trials (until May 10, 2021). Multilevel meta-analysis with META, METAFOR, and DMETAR in R took account of the 3-level structure of the datasets (studies, participants, measures). The meta-analyses showed substantial combined effect sizes for parenting behavior (r = .18) and attitudes (r = .16), and for child attachment security (r = .23), but not for child externalizing behavior (r = .07). In the subset of studies examining effects on both parenting and attachment, the association between effect sizes for parenting and for attachment amounted to r = .48. We consider the way in which VIPP-SD uses video-feedback an active intervention component. Whether VIPP-SD indeed stimulates secure attachment through enhanced positive parenting remains an outstanding question for further experimental study and individual participant data meta-analysis.

A randomized wait-list controlled trial to investigate the role of cognitive mechanisms in parenting interventions on mothers with substance use disorder

Background

Maternal substance use disorder (SUD) represents a risk condition for quality of parenting and child development. The current literature highlights the need to identify interventions that effectively enhance the quality of parenting and to better understand which mechanisms are involved in the process of change. The present study protocol describes a randomized wait-list controlled trial that aims to examine (1) the efficacy of the Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) in improving the quality of parenting (i.e., sensitive parenting and sensitive discipline) in mothers with SUD, (2) whether the intervention affects parental cognitive mechanisms (i.e., attentional disengagement to infant negative emotions, inhibitory control confronted with children’s affective expression, and parental reflective functioning), and (3) whether changes in these processes act as mechanisms of change, mediating the effect of the VIPP-SD program on quality of parenting. Moreover, the study aims (4) to explore whether the VIPP-SD has an effect on parenting stress and (5) to compare mothers with SUD to low-risk mothers on the outcome measures.

Methods

The study will involve 40 mothers with SUD and 20 low-risk mothers of children aged between 14 months and 6 years old. Mothers in the SUD group will be randomly divided into two groups, one receiving the intervention (SUD experimental group) and one undergoing treatment as usual (SUD control group). All the mothers will be assessed pre-test and post-test. Quality of parenting will be assessed through observed parenting behaviors, whereas parental cognitive mechanisms will be assessed through neuropsychological tasks and self-report measures.

Discussion

The results of the study will reveal whether an intervention that has been proven effective in other at-risk samples is also effective in improving parenting behaviors in the context of SUD. The results will also provide insight into potential cognitive mechanisms involved in the process of change.

Trial registration

ISRCTN registry ISRCTN63070968. Registered on 25 June 2021. Retrospectively registered

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-022-06420-8.

Conduct Problems and Hair Cortisol Concentrations Decrease in School-Aged Children after VIPP-SD: A Randomized Controlled Trial in Two Twin Cohorts

The Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) is effective in increasing parental sensitivity and sensitive discipline, and aims to decrease child behavior problems. Changes in quality of parenting may be accompanied by effects on child stress levels. However, studies of VIPP-SD effects on child behavior problems have shown mixed results and there are no studies to date of the effect of the intervention on children's stress levels, as measured by hair cortisol concentration (HCC). Furthermore, differences in intervention effectiveness may be explained by differential susceptibility factors. We hypothesized that the effects of the VIPP-SD on child behavior problems might be moderated by currently available child polygenic scores of differential susceptibility (PGS-DS). In the current pre-registered trial, we randomly assigned 40% of n = 445 families with school-aged twin children to the intervention group. The VIPP-SD was successful in decreasing both children's conduct problems and HCC. Effects were not moderated by available child PGS-DS. We conclude that a brief, home-based video-feedback parenting intervention can decrease child behavior problems and affect the child's stress-related neuroendocrine system as assessed with hair cortisol. In future studies, more specific PGS-DS for externalizing behaviors should be used as well as parental PGS-DS.

A Learning Theory Approach to Attachment Theory: Exploring Clinical Applications

Although clinicians typically acknowledge the importance of insecure attachment as one factor that can contribute to children's psychopathology, translating attachment theory into clinical practice has proved a challenge. By specifying some of the mechanisms through which the child's attachment develops and changes, learning theory can enhance attachment based approaches to therapy. Specifically, interventions building on operant (parent management training) and classical (exposure therapy) learning can be used to stimulate new learning that increases the child's security and confidence in the parent's availability and responsiveness. To explore the clinical application and utility of a Learning Theory of Attachment (LTA), we focus on two attachment-focused interventions: Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) and Middle Childhood Attachment-based Family Therapy (MCAT). VIPP-SD is an evidence-based parent management training designed to promote sensitive parenting and secure attachment in early childhood. MCAT is a recently developed intervention that uses exposure to stimulate secure attachment in middle childhood. LTA sheds light on the mechanisms set in train by VIPP-SD and MCAT facilitating the induction of professionals in clinical applications.