Can a low-intensity evidence-based parenting seminar series promote the mental health and wellbeing of children and families? A cluster randomised trial.

Internalising symptoms and disorders often emerge in childhood and are associated with negative health outcomes into adulthood. Studies have shown neighbourhood characteristics (e.g. socio-economic composition, greenspace exposure) to be associated with depression and anxiety symptoms in adults; however, research that explores these relationships longitudinally in children is lacking. This study examined cross-sectional and longitudinal associations of neighbourhood characteristics with developmental trajectories of internalising symptoms in 202 children (ages 8-12) from the Mothers' and Their Children's Health (MATCH) Study. The MATCH Study is a Los Angeles-based longitudinal observational investigation of children's health outcomes with six semi-annual assessment waves across 3 years. Latent growth curve modelling was used to examine cross-sectional and longitudinal associations between child's self-reported anxiety or depressive symptoms and their neighbourhood's park coverage, greenness exposure and median household income. All models included the following as covariates: child's age, sex, ethnicity, family household income and mother's mental health measures. Cross-sectionally, results indicated that neighbourhood median household income was negatively associated with children's depressive symptoms at baseline. Longitudinally, neighbourhood median household income was associated with steeper increases in children's depressive symptoms. Neither greenness exposure nor park coverage was associated with children's depressive or anxiety symptoms cross-sectionally or longitudinally. Childhood plays a key factor in setting the foundations for healthy mental, social, physical and cognitive growth. Our study suggests future mental health prevention programmes in youth should cater to a multilevel approach that integrates individual, familial and neighbourhood interventions and pay special attention to their neighbourhood SES levels.

BackgroundParental emotional adjustment refers to the degree of distress associated with the parenting role and can be correlated with increased use of negative parenting practices. Parenting programs are a critical strategy globally to help ensure children reach their full developmental potential; however, their effects on parental mental health outcomes are inconsistent.MethodsCross-sectional self-report survey data from mothers, fathers, and caregivers (e.g., grandmother) from Afghanistan, Indonesia, Kyrgyzstan, Malaysia, and Uzbekistan were analysed to explore: (1) the relative contributions of parental adjustment on parenting practices as measured by the Parenting and Family Adjustment Scales, and (2) differences in parenting practices across diverse contexts. Descriptive statistics were used to characterise the sample. Multiple logistic regression was used to explore the relationship between parental adjustment and parenting generally and parental consistency, coercive parenting, positive encouragement, and behaviours supporting the parent-child relationship specifically.ResultsA total of 642 participants (mean age = 33.2 years; 79% female; 89.9% partnered) from Afghanistan (n = 111), Indonesia (n = 157), Kyrgyzstan (n = 118), Malaysia (n = 103), and Uzbekistan (n = 153) completed the survey. Results showed that parental adjustment was significantly positively associated with parenting practices, explaining 5.9% of the unique variance. Specifically, better parental adjustment was significantly positively associated with the use of positive parenting practices, including praise, attention, affection, and displays of pride, but not significantly associated with negative parenting practices such as spanking, shouting, and getting angry with children. Finally, significant differences in parental consistency, coercive parenting, positive encouragement, and parenting practices supporting the parent-child relationship were found across the five LMICs.ConclusionsA robust literature demonstrates the importance of supporting parents’ mental health and emotional adjustment to improve both parent and child outcomes. Our results highlight that better emotional adjustment is associated with more positive parenting practices, suggesting that interventions that support a parent’s ability to cope with the parenting role will increase the use of responsive and nurturing childrearing practices. However, further research is now required to understand how best to integrate mental health-related content with other key intervention material (e.g., training in responsive caregiving), including with regards to the optimal ‘dose’ of each component, to optimise effectiveness.

Parents play an important role in children's illness management, in promoting child adjustment and reducing behavior problems. Little research has focused on the evaluation of parenting interventions in the context of childhood chronic illness. The aim of this study was to test the efficacy of a brief, group parenting intervention (Healthy Living Triple P) in improving parenting skills and parent adjustment, and reducing child behavioral and emotional difficulties in the context of childhood asthma and eczema. One hundred seven parents of children with a diagnosis of asthma and/or eczema were randomly assigned to intervention (n = 52) or care as usual (CAU; n = 55). Parents completed self-report measures of their child's behavioral and emotional adjustment, their own parenting, and their own level of adjustment at pre- and postintervention and at 6-month follow-up. Parent-child interactions were observed and coded at each time point. The intervention consisted of 2 group sessions of 2 hr each delivered by trained, accredited practitioners. Attrition was low, with T2 and T3 assessment completed by 84.6% and 80.8% of intervention families and 92.7% and 81.8% of CAU families, respectively. Intention-to-treat analyses indicated that overall parent-reported ineffective parenting as well as parental overreactivity reduced as a result of intervention. Parent report of child behavior problems also decreased, but there were no changes in children's emotional adjustment. No changes in observed parent or child behavior were found. Stress reduced for parents in the intervention group compared to the CAU group, but there were no changes in parental anxiety or depression. Effects showed evidence of reliable and clinical change and were maintained at 6-month follow-up. The intervention shows promise as an addition to clinical services for children with asthma and eczema and may have broader application to other chronic health conditions. (PsycINFO Database Record

BackgroundChildren orphaned by parental AIDS or those of parents with HIV infection demonstrate many negative mental health outcomes. Different types of psychosocial interventions have been conducted to improve the psychological well-being of these children. The efficacy of these psychosocial interventions has been reviewed and synthesized recently (Skeena et al., Vulnerable Child Youth Stud 12:91-116, 2017), but not quantified.MethodThis study therefore adopted meta-analytic approach to quantify the efficacy of the existing psychosocial interventions on depressive and anxiety symptoms in children affected by parental HIV/AIDS. Eight intervention studies—four randomized controlled trials (RCT) and four pre–post intervention trials—were included.ResultIn general, psychosocial interventions could effectively reduce anxiety or depressive symptoms in children of parents with HIV/AIDS. The overall intervention effect size (Cohen’s d) was 1.298 and 1.100 for depressive and anxiety symptoms, respectively. Publication bias and exploratory moderating effects of study design (RCT vs. pre–post intervention trials), study location, and intervention levels were also analyzed.ConclusionFuture studies reporting the detailed outcome data, which could be used for research integration, are warranted. Further research should also focus on the implementation of evidence-based interventions sensitive to the target population in a developmentally appropriate manner.

The purpose of this study was to investigate whether there are elevated symptoms of anxiety or depression in children and adolescents (aged 2-18 years) who stutter, and to identify potential moderators of increased symptom severity. We conducted a preregistered systematic review of databases and gray literature; 13 articles met criteria for inclusion. A meta-analysis using robust variance estimation was conducted with 11 cohort studies comparing symptoms of anxiety in children and adolescents who do and do not stutter. Twenty-six effect sizes from 11 studies contributed to the summary effect size for anxiety symptoms (851 participants). Meta-analysis of depression outcomes was not possible due to the small number of studies. The summary effect size indicates that children and adolescents who stutter present with increased anxiety symptoms (g = 0.42) compared with nonstuttering peers. There were insufficient studies to robustly analyze depression symptoms, and qualitative review is provided. No significant between-groups differences were reported in any of the depression studies. Preliminary evidence indicates elevated symptoms of anxiety in some children and adolescents who stutter relative to peers. There was a tendency toward higher depression scores in this population, although reported between-groups differences did not reach statistical significance. These findings require replication in larger, preferably longitudinal studies that consider factors that may moderate risk. Nevertheless, our findings highlight a need for careful monitoring of mental health and well-being in young people who stutter. Supplemental Materials: http://osf.io/5m6zv.

Adolescent substance use is comorbid with internalizing problems (e.g., anxious and depressive symptoms) and externalizing problems (EPs). Developmental researchers have linked early anxious and depressive symptoms to later substance use behaviours via an "internalizing pathway". Support for this pathway exists among young adults; however, evidence from prospective studies of adolescents has been inconsistent. Given the paucity of prospective studies in this area, the current study used a developmental framework to examine childhood anxiety and depression symptom trajectories as predictors of adolescent substance use and whether these relationships depend on sex and EPs. Children with and without EPs participated annually in an ongoing longitudinal study (N = 744; Time 1 age = 6.3-10.6). Youth completed self-report measures of anxiety and depression symptoms (Times 3-6) and substance use (Times 7-8). Parents and teachers completed measures of children's EPs (Time 0). Parallel process growth models showed that changes over time in childhood depression symptoms were significantly positively associated with adolescent alcohol/cannabis use, substance-related consequences, and total score of problematic substance use. Changes over time in childhood anxiety symptoms were significantly negatively associated with adolescent alcohol/cannabis use. These results were invariant by EPs and sex. Research implications of this study emphasize the importance of isolating the respective pathways of anxious and depressive symptoms to later substance use outcomes, while clinical implications focus on targets for early identification and prevention of problematic substance use in adolescence.

USING STRUCTURAL EQUATION MODELING TO UNDERSTAND THE ROLE OF THE FAMILY IN PEDIATRIC ASTHMA CONTEXTS By Nour Al Ghriwati, B.A. A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science at Virginia Commonwealth University. Virginia Commonwealth University, 2015. Virginia Commonwealth University, 2015 Major Director: Marcia Winter, PhD. Assistant Professor Department of Psychology Family factors have long been associated with the psychosocial adjustment of children with chronic illnesses, such as asthma (Minuchin, 1975; Rapee, 1997). Research indicates that negative family factors may also contribute to child disease severity, via bio-behavioral mechanisms of effect (Wood et al., 2006); however, these pathways have yet to be examined with a comprehensive focus on more positive family factors. This study sought to examine whether factors such as family cohesion, problem solving abilities, and communication influence asthma symptom severity in children via their effects on child depression and anxiety symptoms. Using structural equation modeling, we identified significant indirect associations between family factors and child asthma severity via child depressive symptoms; however, these associations were not present in models mediated by child anxiety symptoms. Results highlight the importance of families in pediatric asthma settings. Findings suggest differential roles for anxiety and depression in their associations with child asthma severity.

Using data collected from two provinces in China through an online survey, the current study aimed to investigate left‐behind children's emotional and academic adjustment during the COVID‐19 pandemic in China. The participants included 1780 left‐behind (960 boys) and 1500 non‐left‐behind (811 boys) children in elementary and junior high school with a mean age of 11.23. Self‐reported questionnaires concerning children's depression, loneliness, anxiety, and academic adjustment, and parents' coping with children's negative emotions were completed. The results suggested that compared with non‐left‐behind children, left‐behind children's depression and anxiety symptoms were more severe and their academic adjustment was poorer. However, left‐behind children had lower levels of loneliness than non‐left‐behind children. Additionally, supportive coping types, especially emotion‐focused and problem‐focused reactions, were significantly negatively correlated with children's depression and anxiety. Unsupportive coping types, especially distress and punitive reactions, were significantly positively correlated with children's depression and anxiety symptoms. Moreover, the relationships between punitive reactions and depression, ignoring and loneliness and problem‐focused reactions and academic adjustment were significantly stronger in left‐behind children. Hence, during the pandemic, left‐behind children were still at a disadvantage even with their parents' company. However, parents' coping style towards left‐behind children's negative emotions played a significant role in their adjustment.

The impact of parental substance use on the emotional and behavioral adjustment of their adolescent children was examined over 5 years. A representative sample of 220 parents with HIV (PWH) and 330 adolescent children in New York City were repeatedly assessed. Some parents never used marijuana or hard drugs over the 5 years (nonusers). Among those who were users, substance use varied over time. PWH who used substances during a specific 3-month period were classified as active users and those who abstained from substance use were classified as inactive users. Longitudinal regression analyses were used to analyze the impact of variations in patterns of substance use over time on their adolescent children's emotional adjustment and behavioral problems. PWH relapse exacerbated adolescent substance use, trouble with peers, and adolescent emotional distress. Even time-limited reductions in parents' substance abuse can have a significant positive impact on their adolescent children's emotional and behavioral adjustment. Interventions that address parental substance use among PWH should be developed to ameliorate the impact of substance use relapse on their adolescents.

Due to the unprecedented nature of COVID-19, more studies are needed to examine how parents and children are impacted by the pandemic, and more specifically the role of parental Emotional Intelligence (EI) in the link between COVID-19 stressors and child mental health outcomes. This cross-sectional study investigated the relationships between COVID-19 stressors, parental EI, and child anxiety and depression outcomes. Fifty parents (mean age = 41.98 years; 88% mothers) of children between the ages of 8-11 years old (mean age = 9.46 years; 74% boys) completed online questionnaires assessing COVID-19 stress, parental EI, and child anxiety and depression symptoms. Although no significant results were found between parent COVID-19 stress, parent EI, and child depression symptoms, the results suggest that parental COVID-19 stress was related to child anxiety. Exploratory analyses were conducted examining specific domains of COVID-19 stress, parental EI, and child anxiety and depression symptoms. Findings indicate the resilience of child mood and parental EI to COVID-19 stress among this sample, as well as child anxiety being a potential area of risk during the pandemic. Knowledge of these associations gives insight into areas to prioritize for mental health clinicians in assessment and intervention.
 
 Public significance statement: There is a need for more research on parent and child psychological outcomes during COVID-19. This study suggests an association specifically between parental COVID-19 stress and child anxiety, and not with child depressive symptoms. Findings help with better understanding the experiences of families during COVID-19.

A growing body of literature asserts the importance of friendships for a child's emotional wellbeing, behavioural adjustment and developmental attainment. However, few studies have examined friendships in the twin situation. This paper examines the literature on friendships among children who are twins and asks two questions: (1) What are the implications of the twin situation for friendship formation? (2) How can the twin situation inform theoretical knowledge concerning friendship formation in the general population? The discussion examines the implications of the twin situation for the size and nature of twin children's friendship pool and questions whether children who are twins are more likely to be adaptive or maladaptive in their social behaviour. The paper argues for the need to study the process and mechanisms in friendship formation among twin children because the findings might inform not only studies of friendship but also behavioural genetic research.

A growing body of literature asserts the importance of friendships for a child's emotional wellbeing, behavioural adjustment and developmental attainment. However, few studies have examined friendships in the twin situation. This paper examines the literature on friendships among children who are twins and asks two questions: (1) What are the implications of the twin situation for friendship formation? (2) How can the twin situation inform theoretical knowledge concerning friendship formation in the general population? The discussion examines the implications of the twin situation for the size and nature of twin children's friendship pool and questions whether children who are twins are more likely to be adaptive or maladaptive in their social behaviour. The paper argues for the need to study the process and mechanisms in friendship formation among twin children because the findings might inform not only studies of friendship but also behavioural genetic research.

Since Amato and Gilbreth's (1999) meta-analysis of nonresident father involvement and child well-being, nonmarital childbirths and nonresident father involvement both have increased. The unknown implications of such changes motivated the present study, a meta-analytic review of 52 studies of nonresident father involvement and child well-being. Consistent with Amato and Gilbreth, we found that positive forms of involvement were associated with benefits for children, with a small but statistically significant effect size. Amounts of father-child contact and financial provision, however, were not associated with child well-being. Going beyond Amato and Gilbreth, we analyzed the associations between different types of fathering and overall child well-being, and between overall father involvement and different types of child well-being. We found that nonresident father involvement was most strongly associated with children's social well-being and also was associated with children's emotional well-being, academic achievement, and behavioral adjustment. The forms of father involvement most strongly associated with child well-being were involvement in child-related activities, having positive father-child relationships, and engaging in multiple forms of involvement. Moderator analyses demonstrated variation in effect sizes based on both study characteristics and demographic variables. We discuss the implications of these findings for policy and practice.

Teacher characteristics, social classroom relationships, and children's social, emotional, and behavioral classroom adjustment in special education

Parental factors such as parental symptomatology, family functioning, and parental practices are linked to child anxiety and depression. While most research focuses on clinical groups, this study examines these associations in an indicated sample, before and after a preventive intervention and at 12-month follow-up. Participants included 1043 parents of 650 children (8-12 years old) from the ECHO trial, aimed at optimizing a preventive program for anxious and sad children. Using cross-lagged panel models, we modelled the relationship between parent-reported children's anxiety and depression symptoms and parental factors. Parental factors were parents' symptoms of anxiety and depression, family functioning and parental practices (managing emotions, setting goals & dealing with problems, and dealing with negative emotions). All variables were measured by parent-report questionnaires at baseline, post-intervention and 12-month follow-up. Positive associations were found between child anxiety and depressive symptoms, and parental anxiety and depressive symptoms and poorer family functioning. There were smaller, negative associations between children's symptoms and positive parental practices. Parental factors were significantly associated with child anxiety and depression over time, with stronger links to parents' anxiety and depressive symptoms and family functioning, than parental practices.