Child Psychopathology Symptoms Research Articles

Atypical child-parent neural synchrony is linked to negative family emotional climate and children's psychopathological symptoms.

[Correction Notice: An Erratum for this article was reported in Vol 79(2) of American Psychologist (see record 2024-62662-005). In the article "Atypical Child-Parent Neural Synchrony Is Linked to Negative Family Emotional Climate and Children's Psychopathological Symptoms," by Haowen Su, Christina B. Young, Zhuo Rachel Han, Jianjie Xu, Bingsen Xiong, Zisen Zhou, Jingyi Wang, Lei Hao, Zhi Yang, Gang Chen, and Shaozheng Qin (American Psychologist, 2024, Vol. 79, No. 2, pp. 210-224, https://doi.org/10.1037/amp0001173), Figure 2 and its caption were corrected to fix a mismatch between the r coefficients and scatterplots. The caption was changed from "(c) Child-parent hippocampal activity concordance was significantly higher for boundary than nonboundary event time series (Z = 2.30, p = .01). (d) Child-parent vmPFC activity concordance was marginally significantly higher for boundary than nonboundary time series (Z = -1.39, p = .08)" to "(c) Child-parent vmPFC activity concordance was marginally significantly lower for boundary than nonboundary time series (Z = -1.39, p = .08). (d) Child- parent hippocampal activity concordance was significantly higher for boundary than nonboundary event time series (Z = 2.30, p = .01)." In addition, in the second sentence of the second paragraph of the "Reduced Child-Parent vmPFC Connectivity With the Hippocampus Links to Negative Family Emotional Climate and Children's Internalizing Symptoms" section, "anxious/depressed" and "internalizing" were switched. All versions of this article have been corrected.] Family emotional climate is fundamental to children's well-being and mental health. Family environments filled with negative emotions may lead to increased psychopathological symptoms in the child through dysfunctional child-parent interactions. Single-brain paradigms have uncovered changes in brain systems and networks related to negative family environments, but how the neurobiological reciprocity between child and parent brains is associated with children's psychopathological symptoms remains unknown. Here, we first investigated the relation between family emotional climate and children's psychopathological symptoms in 395 child-parent dyads. Using a naturalistic movie-watching functional magnetic resonance imaging technique in a subsample of 50 child-parent dyads, we further investigated the neurobiological underpinnings of how family emotional climates are associated with children's psychopathological symptoms through child-parent neural synchrony. Children from negative family emotional climate experienced significantly more severe psychopathological symptoms. In comparison to child-stranger dyads, child-parent dyads exhibited higher intersubject correlations in the dorsal and ventral portions of the medial prefrontal cortex (mPFC), and greater concordance of activity with widespread regions critical for socioemotional skills. Critically, negative family emotional climate was associated with decreased intersubject functional correlation between the ventral-mPFC and the hippocampus during movie watching in child-parent dyads, which further accounted for higher children's internalizing symptoms. Together, our findings provide insights into the neurobiological mechanisms that negative family environments can cause and maintain psychopathological symptoms in children through atypical child-parent neural synchrony. This has important implications for a better understanding of how child-parent connections may mediate the relation between environmental risks and developmental outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Early maladaptive schemas and symptoms of psychopathology in children in residential care.

According to schema theory, early maladaptive schemas (EMS) contribute to the onset and development of psychopathology. Given that research on EMS in children is limited, the contribution of the present study is that it investigates the role of EMS in psychopathology in children living in residential care. Participants of the present study were children who lived in residential care and were referred for assessment to the Day Center "The House of the Child" run by the Organisation "The Smile of the Child". The study sample comprised of 75 children (35 boys, 40 girls), mean age 12.7 years old. The Greek version of the Achenbach Child Behavior Checklist was completed by the child's caregiver, whereas the Greek version of the Schema Questionnaire for Children was administered to children. The research questions were explored by implementing both variable-focused (multiple regression) as well as person-focused (cluster analysis) techniques. The Confirmatory Factor Analysis conducted in the Schema Questionnaire for Children showed acceptable goodness of fit indices. The Vulnerability schema was found to be the highest scoring schema. Social isolation was a strong predictor for most indicators of psychopathology (internalizing and externalizing). Strong predictor for the Symptoms of Withdrawal, Anxiety/Depression, Social Problems and Thought Problems was the EMS of Failure. Hierarchical cluster analysis on schemas revealed two strong clusters, one with low scores and one with high scores in most EMS. In the cluster with high levels of EMS, Emotional deprivation, Failure, Defectiveness, Social isolation and Abandonment showed the highest scores. In this cluster, children presented statistically significant burdened indicators in externalizing psychopathology. Our hypotheses that EMS and, especially, schemas related to the domains of Disconnection/Rejection and Impaired Autonomy/Performance would be predictive indicators of psychopathology were confirmed. Cluster analysis confirmed the above findings and highlighted the role of schemas Emotional deprivation and Defectiveness in the emergence of psychopathology symptoms. The results of the current study highlight the importance of assessing EMS in children who live in residential care and could inform the development of appropriate intervention programs in this population to prevent the establishment of psychopathology.

Observational measures of early irritability predict children's psychopathology risk.

Irritability is a transdiagnostic feature of diverse forms of psychopathology and a rapidly growing literature implicates the construct in child maladaptation. However, most irritability measures currently used are drawn from parent-report questionnaires not designed to measure irritability per se; furthermore, parent report methods have several important limitations. We therefore examined the utility of observational ratings of children's irritability in predicting later psychopathology symptoms. Four-hundred and nine 3-year-old children (208 girls) completed observational tasks tapping temperamental emotionality and parents completed questionnaires assessing child irritability and anger. Parent-reported child psychopathology symptoms were assessed concurrently to the irritability assessment and when children were 5 and 8 years old. Children's irritability observed during tasks that did not typically elicit anger predicted their later depressive and hyperactivity symptoms, above and beyond parent-reported irritability and context-appropriate observed anger. Our findings support the use of observational indices of irritability and have implications for the development of observational paradigms designed to assess this construct in childhood.

Caregiver Strain Questionnaire-Short Form 11 (CGSQ-SF11): A Validation Study.

Caregiver strain is associated with caregiver and child well-being and clinical outcomes. The present study examined the psychometric properties of a revised 11-item measure of caregiver strain, the Caregiver Strain Questionnaire-Short Form 11 (CGSQ-SF11). In a sample of 962 caregivers, we found support for a three-factor model of the CGSQ-SF11, consisting of objective (e.g., financial impact), subjective internalized (e.g., sadness about the child's problems), and subjective externalized (e.g., anger directed toward the child) strain factors. Measurement invariance was supported across multiple demographic and clinical groups, and all three subscales displayed high internal consistency. Convergent validity was also supported through positive correlations with measures of child psychopathology symptoms and psychosocial impairment. Moreover, caregiver strain was associated with number of child disorders as well as breadth of child symptoms across both internalizing and externalizing domains. Findings provide initial validation of the CGSQ-SF11 as a comprehensive yet brief measure of caregiver strain.

The Developmental Trajectory of Empathy and Its Association with Early Symptoms of Psychopathology in Children with and without Hearing Loss

Empathy enables people to share, understand, and show concern for others’ emotions. However, this capacity may be more difficult to acquire for children with hearing loss, due to limited social access, and the effect of hearing on empathic maturation has been unexplored. This four-wave longitudinal study investigated the development of empathy in children with and without hearing loss, and how this development is associated with early symptoms of psychopathology. Seventy-one children with hearing loss and cochlear implants (CI), and 272 typically-hearing (TH) children, participated (aged 1–5 years at Time 1). Parents rated their children’s empathic skills (affective empathy, attention to others’ emotions, prosocial actions, and emotion acknowledgment) and psychopathological symptoms (internalizing and externalizing behaviors). Children with CI and TH children were rated similarly on most of the empathic skills. Yet, fewer prosocial actions were reported in children with CI than in TH children. In both groups, affective empathy decreased with age, while prosocial actions and emotion acknowledgment increased with age and stabilized when children entered primary schools. Attention to emotions increased with age in children with CI, yet remained stable in TH children. Moreover, higher levels of affective empathy, lower levels of emotion acknowledgment, and a larger increase in attention to emotions over time were associated with more psychopathological symptoms in both groups. These findings highlight the importance of social access from which children with CI can learn to process others’ emotions more adaptively. Notably, interventions for psychopathology that tackle empathic responses may be beneficial for both groups, alike.

Psychometric properties of the Chinese version of the Multidimensional Assessment of Parenting Scale.

Parenting practices have been linked to a wide range of issues related to children's psychological adjustment; however, more research is warranted to further understand not only cultural variations of parenting norms, but also how such variations might differentially influence child outcomes. The current study examined the psychometric properties of a Chinese translation of the Multidimensional Assessment of Parenting Scale (MAPS) in order to: (a) assess both positive and negative dimensions of parenting in Chinese-speaking societies and (b) to explore the association between these practices and children's psychopathological symptoms. A total of 2,237 parents with children between 6 and 12 years old completed the MAPS, Interpersonal Mindfulness in Parenting Scale (IM-P), adapted Parental Bonding Instrument (PBI), and other measures related to children's psychosocial functioning. Exploratory and confirmatory factor analyses (CFA) revealed a clear six-factor structure. Strong to strict measurement invariance for child gender, parent gender, and child age were found. The results demonstrated adequate psychometric properties in terms of internal consistency and test-retest reliability. MAPS subscales also showed concurrent and convergent validity with mindful parenting, parent-child bonding, and children's psychopathology outcomes. The Chinese version of the MAPS will help facilitate multidimensional parenting research in Chinese-speaking societies and promote future cross-cultural studies examining the effect of positive and negative parenting on children's psychopathological adjustment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Exposure to Bullying and General Psychopathology: A Prospective, Longitudinal Study

Although there is mounting evidence that the experience of being bullied associates with both internalizing and externalizing symptoms, it is not known yet whether the identified associations are specific to these symptoms, or shared between them. The primary focus of this study is to assess the prospective associations of bullying exposure with both general and specific (i.e., internalizing, externalizing) factors of psychopathology. This study included data from 6,210 children participating in the Avon Longitudinal Study of Parents and Children (ALSPAC). Child bullying was measured by self-report at ages 8 and 10 years. Child psychopathology symptoms were assessed by parent-interview, using the Development and Well-being Assessment (DAWBA) at ages 7 and 13 years. Bullying exposure significantly associated with the general psychopathology factor in early adolescence. In particular, chronically victimized youth exposed to multiple forms of bullying (i.e., both overt and relational) showed higher levels of general psychopathology. Bullying exposure also associated with both internalizing and externalizing factors from the correlated-factors model. However, the effect estimates for these factors decreased considerably in size and dropped to insignificant for the internalizing factor after extracting the shared variance that belongs to the general factor of psychopathology. Using an integrative longitudinal model, we found that higher levels of general psychopathology at age 7 also associated with bullying exposure at age 8 which, in turn, associated with general psychopathology at age 13 through its two-year continuity. Findings suggest that exposure to bullying is a risk factor for a more general vulnerability to psychopathology.

Relationship between parenting measures and parents and child psychopathological symptoms: a cross-sectional study

BackgroundIncreasing evidence suggests a complex role of family influences, such as the exposure to parent psychopathology through parenting behavior, in parent-to-child psychopathology transmission. Parenting behaviour could represent a relevant target of psychoeducative intervention. Given these premises, we aimed to evaluate homotypic and heterotypic relationships between parent and child psychopathology, mediated by parenting behaviours, taking into account the constructs of parent and offspring internalizing and externalizing psychopathology.MethodsInternalizing and externalizing symptoms in 272 clinically-referred subjects (mean age = 14.5 ± 2.3; F = 23.5%) and their parents (mothers n = 272, fathers n = 242) were assessed through the Child Behavior Checklist and the Adult Self Report; four areas of parenting behaviours were investigated through the Family Life Questionnaire. Multiple mediation models were built, considering mother and father psychopathology scales as independent variables, parenting measures and family functioning as mediators (Affirmation, Rules, Discipline and Special Allowances), child psychopathology scales as dependent variables and demographic variables as covariates.ResultsRegression models showed a significant effect of maternal internalizing symptomatology on child externalizing behavioral problems; high levels of maternal pathology predicted high levels of children’s psychopathology. A total mediating effect of parenting measures was found: high levels of internalizing symptoms in mothers predicted low levels of affirmation, which in turn predicted high levels of externalizing psychopathology in children.ConclusionsOur study results confirmed the existence of interdependent links between mothers’ psychiatric symptomatology, parenting behaviour and offspring outcomes, specifically in an Italian context. On a clinical and rehabilitation basis, this work offers suggestions about parenting practices, specifically maternal, involved in the maintenance of child psychopathology.

Mother and father repertoires of emotion socialization practices in middle childhood

This study identified profiles of parental responses to children's positive and negative emotion expression using latent profile analysis and examined socio-cultural, family, parent, and child correlates of these profiles. Parents (N = 870) of children aged 8–12 completed self-report measures of their responses to children's positive and negative emotion expression, ethnicity, income, family expressivity, parent and child emotion regulation and psychopathology. Four profiles of parental emotion socialization emerged: the teach and problem-focused parent, supportive parent, balanced parent, and hyper-engaged parent. These profiles significantly differed by income, ethnicity, family expressivity, parent and child emotion dysregulation and psychopathology symtoms. Parents in the supportive and teach and problem-focused profiles reported enhanced child emotion regulation and fewer child psychopathology symptoms compared to the balanced and hyper-engaged parents. Findings highlight the importance of considering constellations of parent responses to children's broad range of emotions, and socio-cultural, family, parent, and child correlates of these patterns.

Maternal depression and preadolescent symptoms: An examination of dyad-level moderators in an economically impoverished sample.

This cross-sectional study examined behavioral and physiological indicators of the parent-child relationship as moderators of the link between maternal depressive and child psychopathology symptoms. Ninety-seven mothers (M age = 35.38 years) and their 9- to 12-year-old children (M age = 10.32 years, 53.7% girls, 78.1% African American) from economically impoverished backgrounds participated. Mothers reported on their own depressive symptoms using the Beck Depression Inventory-2 (BDI-2) and their child's emotional and behavioral problems using the Child Behavior Checklist (CBCL). Physiological activity (i.e., respiratory sinus arrhythmia) of both mother and child was collected during a dyadic conflict discussion task, and interactions were coded independently for mother and child positivity, negativity, and engagement. Physiological synchrony was computed using multilevel modeling, and dyad-level behavioral indicators (i.e., dyadic positivity, negativity, and engagement) were created by averaging individual mother and child behavioral codes. Moderation analyses indicated that the link between mother and child symptoms was exacerbated for dyads who displayed low levels of positivity and low levels of engagement, as well as in the context of positive physiological synchrony. In contrast, high levels of positivity and engagement and negative physiological synchrony buffered the link between symptoms. Findings have implications for conceptual models of intergenerational risk for psychopathology and for clinical prevention and intervention efforts that target the parent-child relationship. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Maternal Depressive Symptoms Predict General Liability in Child Psychopathology

ABSTRACT Objective: The current study examines how maternal depressive symptoms relate to child psychopathology when structured via the latent bifactor model of psychopathology, a new organizational structure of psychopathological symptoms consisting of a general common psychopathology factor (p-factor) and internalizing- and externalizing-specific risk. Method: Maternal report of depressive symptoms (Beck Depression Inventory – II) and child psychopathological symptoms (Child Behavior Checklist and Children’s Behavior Questionnaire) were provided by 554 mother-child pairs. Children in the sample were 7.7 years old on average (SD = 1.35, range = 5–11 years), and were 49.8% female, 46% Latinx, and 67% White, 6% Black, 5% Asian/Pacific Islander, and 21% multiracial. Results: Maternal depressive symptoms were positively associated with the child p-factor but not with the internalizing- or externalizing-specific factors. We did not find evidence of sex/gender or race/ethnicity moderation when using latent factors of psychopathology. Consistent with past research, maternal depressive symptoms were positively associated with internalizing and externalizing composite scores on the Child Behavior Checklist. Conclusions: Findings suggest that maternal depressive symptoms are associated with transdiagnostic risk for broad child psychopathology (p-factor). Whereas the traditional Achenbach-style approach of psychopathological assessment suggests that maternal depressive symptoms are associated with both child internalizing and externalizing problems, the latent bifactor model suggests that these associations may be accounted for by risk pathways related to the p-factor rather than internalizing or externalizing specific risk. We discuss clinical and research implications of using a latent bifactor structure of psychopathology to understand how maternal depression may impact children’s mental health.

Genetic moderation of the effects of the Family Check-Up intervention on children's internalizing symptoms: A longitudinal study with a racially/ethnically diverse sample.

Development involves synergistic interplay among genotypes and the physical and cultural environments, and integrating genetics into experimental designs that manipulate the environment can improve understanding of developmental psychopathology and intervention efficacy. Consistent with differential susceptibility theory, individuals can vary in their sensitivity to environmental conditions including intervention for reasons including their genotype. As a consequence, understanding genetic influences on intervention response is critical. Empirically, we tested an interaction between a genetic index representing sensitivity to the environment and the Family Check-Up intervention. Participants were drawn from the Early Steps Multisite randomized prevention trial that included a low-income and racially/ethnically diverse sample of children and their families followed longitudinally (n = 515). As hypothesized, polygenic sensitivity to the environment moderated the effects of the intervention on 10-year-old children's symptoms of internalizing psychopathology, such that children who were genetically sensitive and were randomly assigned to the intervention had fewer symptoms of child psychopathology than genetically sensitive children assigned to the control condition. A significant difference in internalizing symptoms assessed with a clinical interview emerged between the intervention and control groups for those 0.493 SD above the mean on polygenic sensitivity, or 25% of the sample. Similar to personalized medicine, it is time to understand individual and sociocultural differences in treatment response and individualize psychosocial interventions to reduce the burden of child psychopathology and maximize well-being for children growing up in a wide range of physical environments and cultures.

Parental Emotion Socialization and Child Psychological Adjustment among Chinese Urban Families: Mediation through Child Emotion Regulation and Moderation through Dyadic Collaboration.

The theoretical model of emotion regulation and many empirical findings have suggested that children’s emotion regulation may mediate the association between parents’ emotion socialization and children’s psychological adjustment. However, limited research has been conducted on moderators of these relations, despite the argument that the associations between parenting practices and children’s psychological adjustment are probabilistic rather than deterministic. This study examined the mediating role of children’s emotion regulation in linking parents’ emotion socialization and children’s psychological adjustment, and whether dyadic collaboration could moderate the proposed mediation model in a sample of Chinese parents and their children in their middle childhood. Participants were 150 Chinese children (87 boys and 63 girls, Mage = 8.54, SD = 1.67) and their parents (Mage = 39.22, SD = 4.07). Parent–child dyadic collaboration was videotaped and coded from an interaction task. Parents reported on their emotion socialization, children’s emotion regulation and psychopathological symptoms. Results indicated that child emotion regulation mediated the links between parental emotion socialization and child’s psychopathological symptoms. Evidence of moderated mediation was also found: supportive emotion socialization and child emotion regulation were positively correlated only at high and medium levels of dyadic collaboration, with child’s psychopathological symptoms as the dependent variables. Our findings suggested that higher-level parent–child collaboration might further potentiate the protective effect of parental supportive emotion socialization practices against child psychopathological symptoms.

Parental Reports of Prodromal Psychopathology in Pediatric Bipolar Disorder.

: Objectives: Early psychopathology in children diagnosed with Bipolar Disorder (BD) remains poorly characterized. Parental retrospective reports provide helpful details on the earliest manifestations and their evolution over time. These symptoms occur early in the course of BD, often before a formal diagnosis is made and/or treatment is implemented, and are of great importance to early recognition and prevention.Methods: Parents of pre-pubertal children and adolescents with DSM-IV diagnoses of BD attending an outpatient mood disorders clinic provided retrospective ratings of 37 symptoms of child psychopathology. Stability and comorbidity of diagnoses were evaluated, and severity of symptoms for each subject was assessed by identifying the earliest occurrence of the reported symptoms causing impairment.Results: Severe mood instability, temper tantrums, anxiety symptoms, sleep disturbances and aggression were among the most common signs of psychopathology reported in children diagnosed with BD before puberty. Symptoms were already apparent in the first three years in 28%, and formal diagnoses were made before the age of 8 y in the majority of cases.Conclusions: Retrospective parental reports of early symptoms of psychopathology in pre-pubertal children with BD revealed a very early occurrence of affective precursors (irritability and mood dysregulation) and clinical risk factors like impulsive aggression and anxiety that can precede the syndromal onset of mania by several years. These findings support previous reports suggesting a progression of symptoms from abnormal, non-specific presentations to sub-threshold and finally syndromal BD. The importance of early identification and intervention is discussed.

Serum copeptin in children exposed to maltreatment

Childhood maltreatment (CM) has been related to a persistent reprograming of stress-response. Copeptin is a marker of hypothalamic-pituitary-adrenal axis activation; however, few studies have examined copeptin levels in children exposed to CM. The aim of this study was to compare serum copeptin levels in children reporting child abuse and/or neglect and children with no history of CM. This study included 65 children with a positive history of moderate to severe CM, as reported by themselves and their parent(s) during a clinical interview, and 71 children with no history of CM as a comparison group. CM was considered moderate to severe based on the child-reported frequency of being exposed to events related to sexual abuse, physical abuse, emotional abuse, emotional neglect, and/or physical neglect. Child psychopathology symptoms were assessed using the Child Behavior Checklist (CBCL). We measured serum copeptin concentration using enzyme-linked immunosorbent assay. Children exposed to CM exhibited higher levels of serum copeptin compared to children without CM when controlling for sex, age, and psychiatric morbidity. The CBCL total score, including internalizing and externalizing symptoms, was higher in children with CM. We found no correlation between copeptin and CBCL scores for internalizing symptoms and externalizing symptoms. CM is associated with copeptin serum levels independently of age, sex, and symptom severity. Copeptin is a promising new biomarker for children with a history of abuse and/or neglect.

Parent and child psychopathological symptoms: the mediating role of parental emotion dysregulation.

Parental psychopathological symptoms have been associated with a number of child psychological problems, yet little research has examined the role of parental emotion dysregulation on the intergenerational transmission of psychopathological symptoms. This study aims to examine the relationship between parents' and children's psychopathological symptoms with a focus on the mediating mechanism of parental emotion dysregulation on these relationships. Eighty-nine Chinese parents and their school-age children between the ages of 7 and 12 (49 males, M age=8.79, SD=1.81) participated in the study. In the initial phase of the study, parents filled out a series of questionnaires reporting their own psychopathological symptoms via SCL-90 and difficulties with emotion regulation via Difficulties in Emotion Regulation Scale. After 9months, the parents reported their children's internalizing and externalizing problems via Child Behavior Checklist, and the children self-reported anxiety symptoms via Screen for Child Anxiety Related Emotional Disorders in the second phase of the study. The results showed that parental emotion dysregulation played an important role as a mediator of the relationship between parental psychopathological symptoms and child internalizing problems and separation anxiety, which indicates that parents' mental health problems were significantly associated with their difficulties with emotion regulation, which in turn led to more internalizing problems and separation anxiety in their children. However, we did not find a mediating effect of parental emotion dysregulation on the links between parent psychopathology and child externalizing problems or other types of self-reported anxiety symptoms. Our findings highlighted the importance of implementing more psycho-education programs that specifically target parents' emotion regulation abilities in both community and clinical settings to ameliorate the intergenerational transmission of psychopathological symptoms between generations.

Emotion regulation and psychopathological symptoms of Chinese school‐age children: A person‐centred and multi‐informant approach

Emotion regulation (ER) is a critical component of children's development. Many previous studies have utilised a single-assessment method to reflect child ER, which might result in losing important information regarding the unique contribution of each informant. With a person-centred approach and multi-informant reports (mother, teacher and child), the current study examined 196 children's (age M = 9.21, SD = 1.10, range = 7-11 years; 51% girls) ER patterns and their associations with psychopathological symptoms in a Chinese sample. A model-based clustering procedure resulted in 3 ER groups: the poor family ER group (n = 36), poor school ER group (n = 120), and overall good ER group (n = 40). Significant differences were found among ER clusters on teacher-reported child psychopathological symptoms compared on the levels of withdrawn depression, somatic complain, thought problems and attention problems. No significant differences were found on the mother-reported psychopathological symptoms. Compared with children in the poor school or poor family ER clusters, children in the overall good ER group demonstrated fewer psychopathological symptoms at school. Our results confirmed the advantage of adopting multi-informant assessments to fully capture children's emotional profiles and linked these profiles with children's emotional and behavioural functioning at school.

Children of the postwar years: A two-generational multilevel risk assessment of child psychopathology in northern Uganda.

In postconflict settings risk factors at multiple levels of the social ecology, including community, family, and relationship factors, potentially affect children's mental health. In addition, intergenerational risk factors such as guardians' history of childhood family violence, war exposure, and psychopathology may contribute to children's psychopathological symptoms. In this study, we aimed to identify risk constellations that predict child internalizing and externalizing behavior problems, depression, and posttraumatic stress symptoms in the postconflict setting of northern Uganda. In a cross-sectional epidemiological study, 513 second-grade students and their female guardians were interviewed using standardized clinical questionnaires. A higher exposure to traumatic events, more witnessed or experienced violence within the family, and lower child-reported care from female guardians independently predicted psychopathological symptoms in children. While controlling for intergenerational risk factors in female guardians, serial mediation modeling revealed that the effect of trauma exposure on children's psychopathological symptoms was partially mediated by higher exposure to family violence and lower child-perceived care from female guardians. The mediation appeared to be stronger for children's depression symptoms and internalizing and externalizing behavior problems than for posttraumatic stress symptoms. The current findings support the need for targeted interventions at the individual and family system levels that are matched to children's psychopathological symptoms.

Symptoms of Psychopathology in Hearing-Impaired Children.

Objectives:Children with hearing loss are at risk of developing psychopathology, which has detrimental consequences for academic and psychosocial functioning later in life. Yet, the causes of the extensive variability in outcomes are not fully understood. Therefore, the authors wanted to objectify symptoms of psychopathology in children with cochlear implants or hearing aids, and in normally hearing peers, and to identify various risk and protective factors.Design:The large sample (mean age = 11.8 years) included three subgroups with comparable age, gender, socioeconomic status, and nonverbal intelligence: 57 with cochlear implants, 75 with conventional hearing aids, and 129 children who were normally hearing. Psychopathology was assessed by means of self- and parent-report measures.Results:Children with cochlear implants showed similar levels of symptoms of psychopathology when compared with their normally hearing peers, but children with hearing aids had significantly higher levels of psychopathological symptoms, while their hearing losses were approximately 43 dB lower than those of children with implants. Type of device was related with internalizing symptoms but not with externalizing symptoms. Furthermore, lower age and sufficient language and communication skills predicted less psychopathological symptoms.Conclusions:Children who are deaf or profoundly hearing impaired and have cochlear implants have lower levels of psychopathological symptoms than children with moderate or severe hearing loss who have hearing aids. Most likely, it is not the type of hearing device but rather the intensity of the rehabilitation program that can account for this difference. This outcome has major consequences for the next generation of children with hearing loss because children with profound hearing impairment still have the potential to have levels of psychopathology that are comparable to children who are normally hearing.

Study protocol for a randomised controlled trial of a cognitive-behavioural prevention programme for the children of parents with depression: the PRODO trial.

BackgroundDepression is one of the most common psychiatric illnesses worldwide, but is nevertheless preventable. Since the children of parents who have depression are at greatest risk of developing depression themselves, prevention programmes for this population are a major public health priority. Here we report the study protocol of a randomised controlled trial of a group-based psychological intervention for families with i) at least one parent who suffers (or has suffered) from depression and ii) at least one child who has no current or previous psychiatric diagnosis.Methods/DesignEligible families will be randomly allocated to receive either a German adaptation of the 12-session cognitive-behavioural Raising Healthy Children intervention (Gesund und glücklich aufwachsen; N = 50), or no intervention (usual care; N = 50). The primary outcome (child diagnosis of an episode of depression) will be assessed at 15-month follow-up. The secondary outcomes (child psychopathological symptoms) will be assessed immediately following completion of the intervention (6-months), as well as at 9- and 15-month follow-up. We hypothesise that children in the intervention condition, compared with those who do not receive the intervention, will show fewer symptoms of psychopathology, and be less likely to meet diagnostic criteria for a depressive episode, at follow-up.DiscussionDespite their elevated risk of developing depression, there is little formal support available for the children of parents with depression. This study provides an important step in the development of more effective depression prevention measures, which are needed if the personal, social and economic burden of depression is to be reduced.Trial registrationClinical Trials NCT02115880. Registered April 7 2014.