Prevention of familial transmission of depression: EFFEKT-E, a selective program for emotionally burdened families

The aim of the present study was to evaluate whether a short parent-training program (PT) reduces risk factors related to development of childhood socio-emotional and behavior problems in a non-clinical community sample. Data were obtained from parents in a randomized controlled trial (RCT) on PT for children aged 2 to 8 years (N=186) at pre-intervention, post-intervention and one-year-follow up. There were significant differences in the changes in the two groups, with reductions in harsh parenting and child behavior problems, an enhancement of positive parenting and of the parents' sense of competence in the intervention group. The effects on parenting and parents' satisfaction all lasted through one-year follow up. Our findings suggests that a shortened version of a well-structured parenting intervention, The Incredible Years program, implemented in primary care at community level, reduces harsh parenting and strengthens positive parenting and parents' sense of competence, as reported by the parents. Issues related to a public health approach to promote positive parenting are discussed.

The present study aimed to determine whether religious coping mediates the relationship between parenting sense of competence (PSOC) and post-traumatic growth (PTG). Cross-sectional research design was used. A sample of 74 mothers (age range; 20-45 years) of CP children (age range; 2-9 years) was collected through purposive sampling from different physiotherapy centres and special education schools of Lahore. PSOC scale, brief RCOPE and PTG inventory were used. Positive religious coping partially mediated (β = 0.190, 95% CI [0.026, 0.374], p < 0.05) between PSOC and PTG. Partial mediation exists between PSOC and appreciation of life through pathway of positive religious coping (β = 0.040, 95% CI [0.007, 0.075], p < 05). Full mediation exists between PSOC and personal strength through pathway of positive religious coping (β = 0.041, 95% CI [0.001, 0.081], p < 0.05) and through negative religious coping (β = 0.034, 95% CI [0.002, 0.066], p < 0.05). Positive religious coping fully mediated (β = 0.029, 95% CI [0.007, 0.058], p < 0.05) between PSOC and spiritual change. Moreover, indirect effect of PSOC on relating to others and new possibilities through positive and negative religious coping was non-significant, indicating no mediation. Positive religious coping affected the association between PSOC and PTG, that is, mothers of CP children having high parenting competence are more likely to use positive religious coping strategies that results in more PTG.

We investigated the relationship between mothers’ perceptions of their children’s emotional behaviour problems and their parenting sense of competence, as well as the mediating effect of maternal meta-emotion philosophy in this connection. Participants were 349 mothers of 4- to 17-year-old children (female children = 40.7%, mean age = 8.24 years, SD = 2.95 years). The mothers completed the Strengths and Difficulties Questionnaire, the Parental Meta-Emotion Philosophy Scale, and the Parenting Sense of Competence Scale. Structural equation modelling and simple mediation analyses results showed that mothers’ perceptions of their children’s problem behaviours were linked to higher emotion dimissing and lower parenting sense of competence. Specifically, emotion dimissing mediated the relationship between children’s problem behaviours and parenting sense of competence by the mothers. Furthermore, mothers’ perceptions of their children’s prosocial behaviours were associated with both higher emotion coaching and parenting sense of competence. Emotion coaching mediated the relationship between children’s prosocial behaviours and parenting sense of competence for higher sense of competence by the mothers. Our findings suggest that mothers’ perceptions of children’s emotional behaviour problems may explain their parenting sense of competence through their parenting philosophy. By prioritising their maternal meta-emotion philosophy when dealing with their children’s emotional behaviour problems, mothers can enhance their parenting sense of competence.

Behavioural problems in young children can be detrimental to the psychological well-being of their parents. The present study examined the effectiveness of a newly developed intervention in improving parental stress and parenting sense of competence for parents of young children with a developmental delay (DD), presenting with behavioural problems. The sample comprised 15 parents and 1 grandparent of children, aged between 2 and 5 years, with DD. Parents completed a questionnaire package at pre-intervention and post-intervention, including measures to assess parent stress and sense of competence. Paired sample t-tests revealed a significant decline at post-intervention in the total frequency of hassles associated with raising a child with DD, as well as reductions in stress associated with parents' needs. General stress and parenting sense of competence showed no significant post-intervention improvements. Correlation analyses revealed a negative relationship between parent stress and sense of competence, at pre-intervention and post-intervention. It was concluded that the intervention was useful for reducing the overall frequency of stress and the stress associated with the needs of parents raising a young child with DD. Findings have implications for the development of parental supports by early childhood intervention practitioners. Due to a number of methodological limitations, suggestions were made for future research.

Le sentiment de compétence parentale des mères victimes d’abus sexuel(s) infantile(s) : un modèle structural

Prevention of Depression in Children and Adolescents

Parenting programs can enhance positive parenting, reduce harsh parenting, and positively impact children's development. This two-arm randomized controlled trial examined the effectiveness of the parenting program, the ACT Action Program - Raising Safe Kids, on parenting practices (primary outcomes), parental sense of competence, stimulation activities, and children's behaviors (secondary outcomes) in low-income families. The sample consisted of 1,310 caregivers and their 0-to-6-year-old children from 17 municipalities in a Brazilian state, with the majority receiving cash transfers (governmental monetary support for families facing vulnerabilities). The caregivers were randomly allocated into the intervention (IG, n = 639) or waitlist control (CG, n = 671) groups. The IG participated in the ACT Program during an 8-week-in-person group session to strengthen positive parenting, and the CG in the usual care. The caregivers answered the questionnaires administered by the facilitators in the pre-intervention (after the randomization) and the post-intervention (at the end of the program), using the following tools: ACT Scale, Parenting and Family Adjustment, Parental Sense of Competence, UNICEF's Multiple Indicator Cluster Survey, home stimulation activities, and the Strengths and Difficulties Questionnaire. The analysis used the MANOVA followed by the two-way mixed ANOVA for repeated measures. Results showed that compared to GC, the IG significantly increased emotional and behavioral regulation practices, parental sense of competence, and caregivers' home stimulation and decreased parental inconsistency, coercive practices, and children's behavior problems in the post-intervention. The program was effective in improving positive parenting and decreasing child behavior problems when implemented at a large scale in a policy system.

Assessing the Toxic Levels in Parenting Behavior and Coping Strategies Implemented During the COVID-19 Pandemic

A critical issue in devising effective interventions for the treatment of children's behavioral and emotional problems identifying genuine family environmental factors that place children at risk. In most twin and family studies, environmental factors are confounded with both direct genetic risk from parents and the indirect effect of genes influencing parents' ability to provide an optimal rearing environment. The present study was undertaken to determine whether parental psychopathology, specifically parental antisocial behavior (ASP), is a genuine environmental risk factor for juvenile conduct disturbance, depression and hyperactivity, or whether the association between parental ASP and children's behavioral and emotional problems can be explained as a secondary consequence of the intergenerational transmission of genetic factors. An extended children of twins design comprised of data collected on 2,674 adult female and male twins, their spouses, and 2,454 of their children was used to test whether genetic and/or family environmental factors best accounted for the association between parental antisocial behavior and children's behavioral problems. An age-matched sample of 2,826 juvenile twin pairs from the Virginia Twin Study of Adolescent Behavioral Development was also included to examine developmental differences in gene expression by partitioning child-specific transmissible effects from those effects that persist into adulthood. The fit of alternative models was evaluated using the statistical program Mx. We found distinct patterns of transmission between parental antisocial behavior and juvenile conduct, depression and hyperactivity. Genetic and family environmental factors accounted for the resemblance between parents' ASP and children's conduct disturbance. Family environmental factors alone explained the association between child depression and parental ASP, and the impact of parental ASP on hyperactivity was entirely genetic. These findings underscore differences in the contribution of genetic and environmental factors on the patterns of association between parental antisocial behavior and juvenile psychopathology, having important clinical implications for the prevention and amelioration of child behavioral and emotional problems.

Objective To evaluate the effectiveness on informational support of the parenting sense of competence and parenting stress in primiparas. Methods Ninety-five primiparas in the First Affiliated Hospital of Zhengzhou University were recruited from November 2017 to April 2018, mothers of premature infants discharged from hospital from November 2017 to January 2018 were divided into the control group,and which discharged from February 2018 to April 2018 were divided into the experimental group conveniently.Seven cases in the control group and 5 cases in the experimental group dropped out. The control group received routine nursing care, 4 times of informational support were implemented to the mothers of premature infants at the first 4 months after discharged in the experimental group,included team teaching, live demonstration, set up a wechat group, et al. All primiparas were investigated using the Chinese version of Parenting Sense of Competence Scale(C-PSOC) and the Parenting Stress Index-Short Form(PSI-SF) at the 1th,3th,6th month postpartum. Results At the 6th month postpartum, total scores of the Chinese version of Parenting Sense of Competence Scale and subscale scores of self-efficacy, satisfaction of the mothers of premature infants were 82.60±4.45, 39.19±3.25, 43.40±3.47, respectively in the experimental group,and the scores were 76.83±7.88, 36.90±4.82, 39.93±5.16, respectively in the control group, the difference between the two groups was statistically significant(t=4.117, 2.541, 3.613, P<0.05). At the 6th month postpartum,total scores of the Parenting Stress Index-Short Form and subscale scores of parenting distress,parent-child dysfunctional interaction,difficult child of the mothers of premature infants were 80.31±9.50, 28.62±4.54, 23.98±4.91, 26.14±5.15, respectively in the experimental group,and the scores were 87.36±8.58, 32.55±4.88, 25.95±4.15, 28.84±4.88, respectively in the control group,the difference between the two groups was statistically significant(t=-3.568-3.823, P<0.05). Conclusions Informational support can effectively improve the parenting sense of competence and relieve the parenting stress in primiparas. Key words: Informational support; Primipara; Parenting sense of competence; Parenting stress

This study evaluated the effect on infant sleep of a novel intervention (Play2Sleep) that combined infant sleep information with self-modeled video feedback on parent-infant interactions. An explanatory sequential mixed-methods design consisting of a randomized controlled trial with 63 mother-father-infant triads randomized to Play2Sleep or comparison home visit interventions was used. We used repeated measures analysis of covariance to detect changes in infant night wakings, nocturnal wakefulness, and sleep durations and Wilcoxon signed rank test to evaluate changes in perception of infant sleep problems. Family interviews (n = 20) were used to explain the quantitative findings and analyzed qualitatively using thematic analysis. Play2Sleep was effective in reducing maternal-reported infant wakefulness, F(1,55) = 5.33, P = .03, partial η2 = .09, and the number of paternal-reported naps, F(1,58) = 4.90, P = .03, partial η2 = .08. Parents in the Play2Sleep group reported significant improvements in problematic infant sleep that were not observed in the comparison group; however, Play2Sleep was not effective in reducing the number of parent-reported night wakings. Information overwhelm, learning infant cues, and working together with a subtheme of father involvement were key qualitative themes developed to explain the quantitative results. Unplanned exploratory analyses revealed a significant improvement in maternal depression symptoms in the Play2Sleep group. This study suggests Play2Sleep could improve infant sleep by promoting parental awareness of infant cues and father involvement and improving maternal depression. Additional research is needed to determine the optimal number and timing of sessions. Registry: ClinicalTrials.gov; Name: Play2Sleep: Using Play to Improve Sleep; URL: https://clinicaltrials.gov/ct2/show/NCT02742155; Identifier: NCT02742155. Keys EM, Benzies KM, Kirk VG, Duffett-Leger L. Effect of Play2Sleep on mother-reported and father-reported infant sleep: a sequential explanatory mixed-methods study of a randomized controlled trial. J Clin Sleep Med. 2022;18(2):439-452.

This study compared behavior problems of children of mothers with elevated depressive symptoms and children of mothers with non-elevated depressive symptoms, using the same measure for mothers and teachers. Participants included 914 mother–teacher dyads of low-income children (M age of child = 62.9 months, SD = 4.0) who participated in the Early Head Start Research and Evaluation Project. Mothers completed a shortened version of CES-D to evaluate their own depressive symptoms. Teachers and mothers completed the Family and Child Experiences Survey Interviews (FACES) to assess children’s behavior problems. The results showed that children of mothers with elevated depressive symptoms-higher than the cut-off score for possible depression- showed higher aggressive and hyperactive behaviors than did children of mothers with non-elevated depressive symptoms according to the mothers’ rating; however, teachers rated the children no differently. Both mothers and teachers reported higher internalizing behaviors in children of mothers with elevated depressive symptoms than did those of mothers with non-elevated depressive symptoms. Maternal depressive symptoms moderated the relations between informants (mothers and teachers) and externalizing behaviours (aggressive and hyperactive) of children. These findings underscore the need for research in different settings such as at home and at school, to measure children’s behavior problems in order to gain a more comprehensive perspective on child functioning. Results suggest an emphasis on intervention or prevention programs targeting internalizing behavior problems, specifically for children of depressed mothers in low-income families.

Parents and adolescents often have conflict. Previous research has been inconsistent regarding the association between some parent behaviors during this conflict and adolescent symptoms. This study examines parents' behaviors during a conflict resolution discussion in a clinical sample, and the relationship between parents' behaviors and adolescents' depression and anxiety symptoms. Depression and anxiety symptoms were self-reported by 22 adolescents of ages 13-17 who were diagnosed with depression. They also participated in an observed conflict resolution task with one parent. Using observationally coded data, we utilized two linear multiple regressions to assess how parent and adolescent emotion-related behaviors related to adolescents' depression and anxiety symptoms. Adolescents' conflict behaviors were not associated with their psychopathology symptoms. Parent conflict behaviors of support and withdrawal were both negatively associated with adolescent depression and anxiety, with parent contempt marginally associated with adolescent depression. In this clinical sample, parents of adolescents with low mood or anxiety demonstrated some reduced negative parenting behaviors (i.e., contempt and withdrawal), but also reduced positive parenting behavior (i.e., support). The results suggest that when some negative parenting behaviors are reduced, this may inadvertently reinforce depressive behaviors. The results also indicate the importance of increasing supportive parent behaviors.

Abstracts

Many models of psychological development are based on the assumption that parent’s actions are linked to, or the cause of, a child’s behavior. Information about childhood experiences, particularly parental rearing behaviour, is of importance in the clinical investigation of adjustment problems in adolescence. It has been well documented that adolescents run a heightened risk for emotional and behavioral problems when they feel rejected or overprotected by their parents and that parental rejection and overprotection has different effects for gender in developing emotional and behavioral problems. In general, the perceptions of early negative parental behavior are found to be connected to maladjustment and problem behaviors with internalizing as well as externalizing symptoms in adolescence. High perceived parental overinvolvment, rejection, and low emotional warmth correlates with low adjustment and low selfesteem, externalizing disorders, childhood depression, obsession-compulsion, and psychosomatic complaints, and parental control and absence of autonomy is connected with anxiety disorders. Adolescent delinquents perceived their parents as more rejecting, overprotecting, and less emotionally warm than normal adolescents. The perceptions of parental rejection and overprotection in the group of adolescent delinquents also correlated with attention and social problems and somatic complaints. Whether personality in combination with gender plays a role in the association between parental rejection and overprotection and emotional and behavioral problems has not yet received much attention. This study focuses on assessment of personality and parental rearing practices as predictors of adolescent emotional and behavioral problems and gender differences in predictive accuracy of emotional and behavioral problems. Data is used from longitudinal study on development of adjustment problems from childhood to adolescence. A total of 467 adolescent (251 girls and 216 boys), ages 16–17, completed questionnaires about parental rearing practices EMBU (The Egna Minnen Betraffande Uppfostran for Children, Arrindell et al., 1999). EMBU is a short 34-item questionnaire that intends to measure children and adolescents’ perception of three main aspects of parental rearing behaviour: Emotional Warmth, Rejection and Overprotection. Adolescents also completed questionnaires about their emotional and behavioral problems (YSR 11/18, Achenbach, 1991), and personality traits (NEO-FFI, Costa and McCrae, 1992). Girls scored higher on emotional problems (but not on behavioral problems) than boys. Parental behavior was more strongly associated with girls’ emotional and behavioral problems, in comparison to boys. Regression analysis revealed that parental rearing behavior is less significant predictors of emotional and behavioral problems in adolescence, than personality traits. Furthermore, parental rearing behavior and personality traits (namely, neuroticizm) were stronger predictors of emotional and behavioral problems for girls in comparison to boys. Overall, parental rearing practices and personality traits of adolescents are better predictors for emotional and behavioral problems of girls in comparison to boys.