Parental Internalizing Psychopathology and PTSD in Offspring after the 2012 Earthquake in Italy

Parent-Child Communication About Potentially Traumatic Events: A Systematic Review

Social support plays an important role in children's well-being after experiencing a potentially traumatic event (PTE). One such source of support is the parent-child relationship, specifically by discussing the event. However, current literature provides no consensus on whether parents and children communicate about PTEs, in what way they might communicate and how this affects the child. Hence the goal of the current study is threefold, to explore: (a) whether parents and children communicate about PTEs, (b) what this communication looks like, and (c) how this affects children's well-being. These questions are answered by means of a systematic literature review. Articles were eligible for inclusion if it was an empirical study on communication between parents and children about a PTE that the child (under 18 years) had experienced. Initial searches in electronic databases provided 31,233 articles, of which 26 were deemed eligible for inclusion. Results show that most parents and children have discussed PTEs, but that this may depend on cultural background. What the parent-child communication looks like depends on various factors such as, age of the child, tone, and child's initiation of discussion. Parental post-traumatic stress symptoms seem to negatively impact communication. The results of the impact of communication are less clear-cut, but it seems to have a predominantly positive effect on the child's well-being, depending on parental sensitivity. Clinicians should be watchful for parental symptoms of post-traumatic stress disorder and can focus on promoting parental sensitivity and responsiveness when discussing PTEs with their child or on creating a joint narrative within families.

A Systematic Review and Meta-analysis: Paternal Anxiety and the Emotional and Behavioral Outcomes in Their Offspring

OBJECTIVE

Anxiety disorders are highly prevalent worldwide; however, the literature lacks a meta-analytic quantification of the risk posed by fathers' anxiety for offspring development. This systematic review and meta-analysis aimed to provide a comprehensive estimate of the magnitude of the association between paternal anxiety and emotional and behavioral problems of offspring.

METHOD

In February 2022, Web of Science, Ovid (Embase, MEDLINE, PsycINFO), Trip Database, and ProQuest were searched to identify all quantitative studies that measured anxiety in fathers and emotional and/or behavioral outcomes in offspring. No limits were set for offspring age, publication language, or publication year. Summary estimates were extracted from the primary studies. Meta-analytic random-effects 3-level models were used to calculate correlation coefficients. Quality was assessed using the Newcastle-Ottawa Scale. The study protocol was preregistered with PROSPERO (CRD42022311501) and adhered to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) reporting guidelines.

RESULTS

Of 11,746 records identified, 98 were included in the meta-analysis. Small but significant associations were found between paternal anxiety and offspring emotional and behavioral problems overall (r = 0.16, 95% CI [0.13, 0.19]) and behavioral (r = 0.19, 95% CI [0.13, 0.24]), emotional (r = 0.15, 95% CI [0.12, 0.18]), anxiety (r = 0.13, 95% CI [0.11, 0.16]), and depression (r = 0.13, 95% CI [0.03, 0.23]) problems. Some significant moderators were identified.

CONCLUSION

Paternal mental health is associated with offspring development, and the offspring of fathers with anxiety symptoms or disorders are at increased risk of negative emotional and behavioral outcomes, in line with the principles of multifinality and pleiotropy. The substantial heterogeneity among studies and the overrepresentation of White European American groups in this literature highlight the need for further research.

DIVERSITY & INCLUSION STATEMENT

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.

The association between posttraumatic stress disorder and mental health of adolescents who exposed to the worst disaster of the century: Extensive data from southeast Turkey

PROBLEMS

This study was conducted to examine the association between posttraumatic stress disorder and mental health status of adolescents exposed to the worst disaster of the century.

METHODS

This study was descriptive, cross-sectional, and correlational. This research was conducted between March 31 and July 1, 2023. The study was conducted with earthquake survivors who migrated from Kahramanmaraş, the epicenter of the earthquake, and Adıyaman and Hatay, the other two cities where it was most effective, to Şanlıurfa. The study was conducted with a total of 947 adolescents. "Personal Information Form," "Child Posttraumatic Stress Reaction Index," and "Symptom Distress Check List- (SCL-90)" were used to collect data. Linear regression method was used in the analysis of the research. Path analysis was performed using PATH analysis.

FINDINGS

The mean age of the adolescents participating in the study was 16.69 ± 1.41 years. It was found that the Global Severity Index (GSI) of the adolescents was at the pathological level with a mean of 2.36 ± 0.68. Posttraumatic stress reactions of the adolescents who experienced the earthquake was found to explain 97.2% of their mental symptoms (anxiety, depression, somatization, anger-hostility, obsession-compulsion, interpersonal sensitivity, phobic anxiety, paranoid ideation, psychotic symptoms, other problems, and GSI) (p < 0.001). It was found that the age of the adolescents, total number of losses in the earthquake, the time they stayed under the rubble, the time they waited for siblings to be pulled from under the rubble and the state of having loss due to the earthquake explained 74.4% of the posttraumatic stress reactions (p < 0.001).

CONCLUSIONS

As a conclusion, it was found that the adolescents who experienced the earthquake experienced severe posttraumatic stress symptoms. It was also found that adolescents who experienced high levels of trauma symptoms showed pathological mental symptoms. After the earthquake, adolescents should be evaluated periodically in terms of posttraumatic stress symptoms. In the evaluations to be made, it is important to determine how adolescents are affected especially mentally. In this context, interventions should be implemented for the identified mental symptoms (anxiety, depression, somatization, etc.).

Trajectories of parental posttraumatic stress disorder and children's mental health following Super Typhoon Lekima: The mediating role of feeling of safety

INTRODUCTION

Several studies have examined the impact of parents' posttraumatic stress disorder (PTSD) on their children's mental health, but few have evaluated the role of parents' specific PTSD trajectories. The aim of this study was to assess the mechanisms underlying distinct trajectories of parental PTSD that affect children's PTSD and depression through the feeling of safety.

METHODS

The final sample comprised 242 dyads of parents and their children who experienced Super Typhoon Lekima in 2019. All participants were surveyed at three time points after the typhoon: 3 months (T1), 15 months (T2), and 27 months (T3). Parental PTSD symptoms at three time points and children's PTSD, depression, and feeling of safety at T3 were analyzed.

RESULTS

Four parental PTSD trajectories were identified: recovery, resilience, delayed, and coping. Compared with the resilient group, children of parents with delayed PTSD trajectories reported higher levels of depression at T3, while children of parents in the coping group were more likely to experience severe PTSD at T3. Children of parents in the recovery group, with a reduced feeling of safety, exhibited more severe depression and PTSD at T3, whereas children of parents in the delayed group were at an increased risk of PTSD at T3.

CONCLUSIONS

These findings highlight the heterogeneity of parental PTSD trajectories following natural disasters and their distinct effects on children's PTSD and depression. Furthermore, feeling of safety emerges as a crucial mechanism in this process.

Parent and Child Predictors of Internalizing and Externalizing Symptomatology during COVID-19

The COVID-19 emergency has fostered an increasing risk of experiencing distress and negative emotions in parents that turned into heightened stress for children. In this study, we aim to evaluate the effects of parental stress, children's resilience, and previous adversities on the development of internalizing and externalizing symptoms in children. A series of questionnaires were completed by 158 Italian parents (148 mothers, 10 fathers, mean age = 41 years) concerning them and their school-aged children (N = 158, 76 boys, mean age = 7.4 years) at two critical time points (June 2020 and December 2020). Regression analyses showed that internalizing problems were predicted only by concurrent children's resilience, whereas externalizing problems were predicted by concurrent parental flooding, children's resilience, and early parental satisfaction. Therefore, internalizing and externalizing symptoms trajectories follow different routes and are predicted by both common and distinct factors. Supporting positive parenting attitudes and behavior should be recommended to prevent the worsening of children's externalizing behaviors. At the same time, nurturing resilience in pediatric systems might be useful in preventing or reducing children's internalizing symptoms.

The Mediation of Care and Overprotection between Parent-Adolescent Conflicts and Adolescents' Psychological Difficulties during the COVID-19 Pandemic: Which Role for Fathers?

BACKGROUND

There is evidence of a significant raise in youths' emotional and behavioral difficulties during the pandemic. Only a few studies have addressed parent-adolescent conflict, and none investigated the possible mediating effect of parenting in the association between conflicts with parents and adolescents' symptoms. This study aimed at investigating youths' psychological symptoms during the pandemic, focusing on the predicting effect of parent-adolescent conflict. The mediating role of care and overprotection was also explored, considering whether adolescent gender moderated this mediation.

METHODS

195 adolescents aged 14-18 years participated in an online longitudinal study. Perceived conflict with parents and parenting dimensions (Parental Bonding Instrument; PBI) were assessed at baseline (2021). Self-reported psychological difficulties (Strengths and Difficulties Questionnaire; SDQ) were collected at baseline and after one year (2022).

RESULTS

A significantly severer symptomatology was found in adolescents having a conflictual relationship with one or both parents. Major conflicts with parents correlated with lower care and greater overprotection in mothers and fathers. However, parental overprotection and maternal care were not mediators of the relationship between conflict and youths' difficulties. The only exception was represented by paternal care that fully mediated this relationship in both adolescent males and females.

CONCLUSIONS

Although further investigations are needed to overcome limitations due to the small sample, findings extend our insight into the impact of parent-adolescent conflict, highlighting the role of fathers' care and the need to maximize their involvement in clinical interventions.

Recent Advances in Child and Adolescent Psychiatry

The field of child and adolescent psychiatry is receiving growing attention, although a number of local differences still exist in terms of academic curricula, board certifications and even definitions of what is to be considered part of this field or not [...]