Family Psychosocial Factors Research Articles

Intergenerational trauma transmission through family psychosocial factors in adult children of Rwandan survivors of the 1994 genocide against the Tutsi

Thirty years after the 1994 genocide against the Tutsi in Rwanda, children of survivors are being increasingly documented to be at higher risk compared to their peers for adverse mental health outcomes. However, no studies in Rwanda have empirically explored family psychosocial factors underlying this intergenerational transmission of trauma. We investigated family psychosocial factors that could underlie this transmission in 251 adult Rwandan children of survivors (mean age = 23.31, SD = 2.40; 50.2% female) who completed a cross-sectional online survey. For participants with survivor mothers (n = 187), we found that both offspring-reported maternal trauma exposure and maternal PTSD were indirectly associated with children's PTSD via maternal trauma communication (specifically, nonverbal and guilt-inducing communication), and that maternal PTSD was indirectly associated with children's PTSD, anxiety, and depression symptoms through family communication styles. For participants with survivor fathers (n = 170), we found that paternal PTSD symptoms were indirectly associated with children's anxiety and depression symptoms via paternal parenting styles (specifically, abusive and indifferent parenting). Although replication is needed in longitudinal research with parent-child dyads, these results reaffirm the importance of looking at mass trauma in a family context and suggest that intergenerational trauma interventions should focus on addressing family communication, trauma communication, and parenting.

The Moderating Effect of Parental Feeding Style in Relation to Familial Psychosocial Risk Factors and Childhood Obesity

Background: The prevalence of obesity in children is increasing in the world and it has become one of the major health problems. Parents are the first people who have the opportunity to shape child's eating experiences and habits, including food preferences, attitudes, and eating patterns. This study was conducted to determine the moderating role of parental feeding styles in relation to family psychosocial and social risk factors and childhood obesity in primary school children in 2018-2019 academic year in Shiraz, Iran. Methods: In this study, 298 children aged 6 to 11 years from primary schools in Shiraz were selected using multistage cluster sampling method. Their parents completed the stress-anxiety-depression scale tool and parenting feeding styles questionnaire. The data were analyzed using simultaneous multiple regression analysis, cluster analysis, and two-way analysis of variance (ANOVA). Results: The results showed that there was a statistically significant correlation between the identified risk factors and child's body mass index (BMI), as well as the variable effect of feeding styles on the child's BMI. The interaction of risk factors on feeding styles indicated that the effect of adjusting feeding styles on childhood obesity was significant due to risk factors. Conclusion: These findings support the moderating role of parental feeding styles in the development or prevention of childhood obesity.

Psychosocial Moderators and Outcomes of a Randomized Effectiveness Trial for Child Asthma.

Psychosocial factors play a role in child asthma morbidity and disparities, but their impact on asthma intervention effectiveness is less understood. This study examined how child, parent, and family psychosocial factors moderated asthma response to, and changed in response to, 2 community asthma interventions among urban minority youth. Asthma Action at Erie was a randomized comparative effectiveness trial examining a community health worker (CHW) home intervention versus certified asthma educator (AE-C) services for children aged 5-16 with uncontrolled asthma (N = 223; mean age = 9.37, SD = 3.02; 85.2% Hispanic). Asthma control was assessed via the Asthma Control Test (ACT)/childhood ACT and activity limitation. Baseline child/parent depression and posttraumatic stress disorder (PTSD) symptoms, family chaos, and social support were examined as treatment moderators. We also tested intervention effects on psychosocial outcomes. For parents with higher baseline depression symptoms, youth in the CHW group had greater ACT improvement by 24 months (7.49 points) versus AE-C (4.76 points) and 51% reduction in days of limitation by 6 months versus AE-C (ß = -0.118; p = .0145). For higher parent PTSD symptoms, youth in CHW had 68% fewer days of limitation at 24 months versus AE-C (ß = -0.091; p = .0102). Psychosocial outcomes did not vary by group, but parent depression, parent and child PTSD symptoms, and social support improved for all. CHW intervention was associated with improved asthma control among families with higher parent strain. Findings have implications for utilizing tailored CHW home interventions to optimize asthma outcomes in at-risk families.

Modern treatment of retinoblastoma: A 2020 review

Retinoblastoma management remains complex, requiring individualized treatment based on International Classification of Retinoblastoma (ICRB) staging, germline mutation status, family psychosocial factors and cultural beliefs, and available institutional resources. For this 2020 retinoblastoma review, PubMed was searched for articles dated as early as 1931, with an emphasis on articles from 1990 to the present day, using keywords of retinoblastoma, chemotherapy, intravenous chemotherapy, chemoreduction, intra-arterial chemotherapy, ophthalmic artery chemosurgery, intravitreal chemotherapy, intracameral chemotherapy, cryotherapy, transpupillary thermotherapy, laser, radiation, external beam radiotherapy, plaque radiotherapy, brachytherapy, and enucleation. We discuss current treatment modalities as used in the year 2020, including intravenous chemotherapy (IVC), intra-arterial chemotherapy (IAC), intravitreal chemotherapy (IvitC), intracameral chemotherapy (IcamC), consolidation therapies (cryotherapy and transpupillary thermotherapy [TTT]), radiation-based therapies (external beam radiotherapy [EBRT] and plaque radiotherapy), and enucleation. Additionally, we present a consensus treatment algorithm based on the agreement of three North American retinoblastoma treatment centers, and encourage further collaboration amongst the world's most expert retinoblastoma treatment centers in order to develop consensus management plans and continue advancement in the identification and treatment of this childhood cancer.

EMPERICAL ANALYSIS OF THE FAMILY RESPONSIBILITIES FOR PSYCHOLOGICAL SERVICES IN UZBEKISTAN

The role of family psychological service in ensuring family stability is to identify the solutions to the problems associated with the establishment of family psychosocial factors, to study the motivation of marriage in the neighborhood, which is to establish active positive relationships between parents and children, husband and wife, mother-in-law and daughter-in-law.

Mothers’ Oral Health Literacy and children’s oral health: study in the department of Pikine, Senegal

Abstract Background Several studies have shown that social conditions in which children are raised and family psychosocial factors affect their oral health. Oral health literacy (OHL) has been shown to be associated with prevalence of dental caries, access to care and prevention of oral diseases. No studies have addressed this issue in Senegal. Objective: To study the characteristics of the mothers’ OHL and its association with children’s dental health. Methods Cross- sectional study in the district of Pikine, a suburb of Dakar including 16 municipalities. Two-stage cluster sampling and a sample comprising 315 children from 3 to 9 years old and their mothers. Data on oral health status were collected from clinical examinations, sociodemographic and OHL (Sistani et al’ OHL-AQ) data were collected during face-to-face interview. Results More than half of the mothers (56.5%) had a low OHL, but 68.9% had an adequate score for the communication/interactive dimension. The level of OHL increased significantly with education level, household wealth and dynamism of the social support. Prevalence of dental caries was 64.8%, following a social gradient and significantly associated with the mothers’ OHL level (OR = 5.2) CI[2.2-14.1]. The oral health behaviour of families was significantly associated with the level of OHL and children’s dental health. A structural equation model showed the OHL was a mediating factor between social characteristics and oral health behaviours. Conclusions The OHL of mothers is an important variable to be included in the study of social inequalities in oral health. The communication/interactive dimension seems to be decisive in the African context of an oral culture and dynamic social support which makes it possible to provide better knowledge and preventive behaviour. Key messages High maternal OHL should be reinforced to lessen oral health inequalities among Senegalese children. The communication/interactive dimension seems to be decisive in the African context of an oral culture and dynamic social to enhance OHL.

Prevalence and factors associated with emotional and behavioural difficulties among children living with HIV in Malawi: a cross-sectional study

BackgroundApproximately 84,000 children under the age of 15 years are living with HIV in Malawi. Although the survival rate of children living with HIV in Malawi has improved due to the increased availability of antiretroviral medications, these children continue to experience numerous challenges negatively impacting on their mental health. The aim of this study was to investigate the prevalence of, and factors associated with, emotional and behavioural difficulties in children aged between 6 and 12 years living with HIV in Malawi.MethodsA random sample of 429 primary caregivers of children living with HIV drawn from the three main administrative regions of Malawi was recruited in a cross-sectional study. They completed a questionnaire about family socio-demographic characteristics, HIV disclosure, and child demographic and clinical characteristics, as well as the Strengths and Difficulties Questionnaire, Life Stress Scale, Support Function Scale, and Impact on Family Scale which were pre-tested and translated into the local Chichewa language. Data were analysed using descriptive statistics and logistic regression.FindingsUsing the newer band categorisations of the Strengths and Difficulties Questionnaire, parent version, 31% of primary caregivers reported that their child had a slightly raised to very high level of total difficulties. Factors that were associated with difficulties were: primary caregivers’ young age (adjusted odds ratio [aOR] 3.6; 95% confidence interval [CI]: 1.4–9.5); low level of education (aOR 2.6; 95% CI: 1.2–5.7); lack of employment (aOR 2.7; 95% CI: 1.2–5.9); the report of a substantial impact of the child’s illness on the family (3.1; 95% CI: 1.5–6.5); and a low level of family functional support (aOR 2.0; 95% CI: 1.1–4.1). Neither non-disclosure of HIV status nor any of the child demographic or clinical factors were significant in multivariate analysis (p > .0.05).ConclusionClose to one-third of children living with HIV in this study had high scores indicative of emotional and behavioural difficulties. Emotional and behavioural difficulties in children living with HIV were associated with family demographic and psychosocial factors, but not HIV disclosure. Effective policies and programs that promote the mental wellbeing of children living with HIV in Malawi are indicated.

Psychosocial assessment of the family in the clinical setting

Children develop in the context of the family. Family functioning prominently shapes the psychosocial adaptation and mental health of the child. Several family psychosocial risk factors have been shown to increase the risk of behavioral problems in children. Early identification of families with psychosocial profiles associated with a higher risk of having children with behavioral problems may be valuable for targeting these children for prevention and early intervention services.MethodsWe developed the Family Health Questionnaire (FHQ) for the purpose of evaluating families’ psychosocial risk profiles in the primary care setting. The questionnaire included 10 formative indicators that have been shown to influence children’s behavioral health. We aimed to establish a correlation between the family risk factors on the FHQ and child behavioral health. In addition, we examined the properties of the questionnaire as a screening tool for use in primary care.Families of 313 of children 4–6 years of age presenting for well child examinations at two primary care clinics completed both the FHQ and the Pediatric Symptom Checklist 17 (PSC-17), a validated screening instrument for pediatric behavioral problems.ResultsWe found that the FHQ was positively and significantly correlated with the PSC score (r = .50, p < .05).ConclusionsThe FHQ may be a valuable screening tool for identifying families with psychosocial risk profiles associated with increased risk of childhood behavioral problems.

Commercial Sexual Exploitation of Children: Health Care Use and Case Characteristics

ObjectiveThe purpose of this study was to describe pediatric health care utilization, familial psychosocial factors, child sexual abuse case characteristics, and patient demographic characteristics of adolescents prior to or at the time of their most recent identification as a victim of commercialized sexual exploitation of children (CSEC). MethodsA retrospective chart review was conducted for the above detailed information of all adolescents presenting to the Emergency Department (ED) or Child Advocacy Center (CAC) of a pediatric hospital with concerns of suspected CSEC. ResultsSixty-three adolescents were referred to the ED or CAC for CSEC concerns in the eighteen-month period. Nearly all (52, 82.5%) adolescents identified as potential CSEC victims received care at the pediatric hospital within one year of the CSEC concern being identified. ConclusionsPediatric health care providers, including pediatric nurse practitioners, need to be more skilled in the prevention and identification of CSEC.

Provider Perspectives of High-Quality Pediatric Hospital-to-Home Transitions for Children and Youth With Chronic Disease.

The objective of this study was to describe health care providers' and hospital administrators' perspectives on how to improve pediatric hospital-to-home transitions for children and youth with chronic disease (CYCD). Focus groups and key informant interviews of inpatient attending physicians, primary care physicians, pediatric residents, nurses, care coordinators, and social workers were conducted at a tertiary care children's hospital. Key informant interviews were performed with hospital administrators. Semistructured questions were used to elicit perceptions of transitional care quality and to identify key structures and processes needed to improve transitional care outcomes. Transcripts of discussions were coded to identify emergent themes. Participants (N = 22) reported that key structures needed to enhance transitional care were a multidisciplinary team, inpatient provider-patient continuity, hospital resource availability, an interoperative electronic health record, and availability of community resources. Key processes needed to achieve high-quality transitional care included setting individualized transition goals, involving parents in care planning, establishing parental competency with home care tasks, and consistently communicating with primary care physicians. Providers identified a lack of reliable roles and processes, insufficient assessment of patient and/or family psychosocial factors, and consistent 2-way communication with community providers as elements to target to improve transitional care outcomes for CYCD. Many key structures and processes of care perceived as important to achieving high-quality transitional care outcomes for CYCD have the opportunity for improvement at the institution studied. Engaging key stakeholders in designing quality improvement interventions to address these deficits in the current care model may improve transitional care outcomes for this vulnerable population.

Child Sexual Abuse Revictimization: Child Demographics, Familial Psychosocial Factors, and Sexual Abuse Case Characteristics.

The purposes of this study were to describe child demographics, familial psychosocial factors, and sexual abuse case characteristics in children experiencing sexual abuse revictimization before the age of 18 years, and to compare them with children not identified as experiencing revictimization. A retrospective chart review was conducted from both the revictimization group and the one-assessment group and reviewed for child sexual abuse case characteristics, familial psychosocial characteristics, and child demographic information. Children in the revictimization group were younger and more likely to possess a developmental delay and mental health diagnosis when compared with children in the one-assessment group. Higher proportions of parents in the one-assessment group were supportive and believed their child's sexual abuse allegation when compared with parents of the revictimization group. Families in the revictimization group were more likely to report multiple psychosocial risk factors when compared with the one-assessment group, including domestic violence, substance abuse concerns, mental health, parental history of sexual abuse, and financial concerns. This study suggests that children most at risk for sexual abuse revictimization often present with multiple familial psychosocial concerns and have parents/caregivers who are not supportive of them or their sexual abuse allegations.

OC21 - Psychosocial functioning of parents of infants diagnosed with complex congenital heart defect.

Theme: Parenting/parenthood. The diagnosis of complex CHD impacts the psychosocial status of parents and their functioning. A critical evaluation of the literature concerning the psychosocial parental response to their infant's diagnosis of complex CHD. Systematic review of 18 articles published after 2000 in PubMed and CINAHL. The impact of an infant's CHD on the family functioning is determined both by child's medical condition and family's psychosocial factors. The majority of parents experience intense loss and numerous stressors. Nurses and physicians need to be sensitive to the needs, thoughts and experiences of the parents when discussing treatment options. Families with poor social support networks may have the greatest need for professional interventions. Appropriate interventions assist the majority of parents to adapt to the diagnosis of complex CHD. However, there are a number of parents with an increased psychosocial risk associated with higher rates of emotional distress.

Is the Use of Physical Discipline Associated with Aggressive Behaviors in Young Children?

ObjectiveTo determine the association between use of physical discipline and parental report of physically aggressive child behaviors in a cohort of young children who were without indicators of current or past physical abuse. MethodsThe data for this study were analyzed from an initial cohort of patients enrolled in a prospective, observational, multicenter pediatric emergency department-based study investigating bruising and familial psychosocial characteristics of children younger than 4 years of age. Over a 7-month period, structured parental interviews were conducted regarding disciplinary practices, reported child behaviors, and familial psychosocial risk factors. Children with suspected physical abuse were excluded from this study. Trained study staff collected data using standardized questions. Consistent with grounded theory, qualitative coding by 2 independent individuals was performed using domains rooted in the data. Inter-rater reliability of the coding process was evaluated using the kappa statistic. Descriptive statistics were calculated and multiple logistic regression modeling was performed. ResultsThree hundred seventy-two parental interviews were conducted. Parents who reported using physical discipline were 2.8 (95% confidence interval [CI], 1.7–4.5) times more likely to report aggressive child behaviors of hitting/kicking and throwing. Physical discipline was used on 38% of children overall, and was 2.4 (95% CI, 1.4–4.1) times more likely to be used in families with any of the psychosocial risk factors examined. ConclusionsOur findings indicated that the use of physical discipline was associated with higher rates of reported physically aggressive behaviors in early childhood as well as with the presence of familial psychosocial risk factors.

High Emotional Intelligence: Family Psychosocial Factors

Since a family plays a significant role in the development of a personality in the childhood, it is very important to find out, what are the exact social and psychological family factors that are the most essential for the development of emotional intelligence (EI). In the study, data from 1,430 subjects was collected in various regions of Lithuania. The average subject age was 19.7 years (SD=3.29). 43.2 per cent men and 55.5 per cent women (1.3 per cent of participants have not specified their gender) participated in the research. The majority of subjects were high school (56.7 per cent) and university (35.2 per cent) students. EI-DARL methodology (Antiniene & Lekaviciene, 2014) was used to assess EI. It was established that EI level is statistically significantly related to some family factors: psychological climate in the family, strength of subject relations with their mother/ father, subjective perception of family financial status, etc.

Brief approaches to developmental-behavioral promotion in primary care: updates on methods and technology.

Well-child visits are a critical opportunity to promote learning and development, encourage positive parenting practices, help children acquire behavioral self-control, enhance the development and well-being of children and their families, identify problems not amenable to brief in-office counseling, and refer for services when needed. This article outlines the communication skills, instructional methods, and resource options that enable clinicians to best assist families. Also covered is how to monitor progress and outcomes. A total of 239 articles and 52 Web sites on parent/patient education were reviewed for this study. Providers require a veritable armamentarium of instructional methods. Skills in nonverbal and verbal communication are needed to elicit the parent/patient agenda, winnow topics to a manageable subset, and create the "teachable moment." Verbal suggestions, with or without standardized spoken instructions, are useful for conveying simple messages. However, for complex issues, such as discipline, it is necessary to use a combination of verbal advice, written information, and "teach-back," aided by role-playing/modeling or multimedia approaches. Selecting the approaches most likely to be effective depends on the topic and family characteristics (eg, parental literacy and language skills, family psychosocial risk and resilience factors, children's developmental-behavioral status). When providers collaborate well (with parents, patients, and other service providers) and select appropriate educational methods, families are better able to act on advice, leading to improvements in children's well-being, health, and developmental-behavioral outcomes. Provided are descriptions of methods, links to parenting resources such as cell phone applications, Web sites (in multiple languages), interactive technology, and parent training courses.

The Impact of an Infant's Severe Congenital Heart Disease on the Family: A Prospective Cohort Study

The aim of this article is to investigate the impact of a child's severe congenital heart disease on the family and to prospectively examine the influence of disease specific and psychosocial factors on the family. A prospective cohort study. Parents of 104 infants who had undergone cardiopulmonary bypass surgery before the age of 12 months for congenital heart disease were included. None. Parents completed the generic Impact on Family scale and a social support questionnaire; a large number of medical data were extracted from the patients' hospital records. Parents most frequently reported that they were thinking about not having more children and living on a "roller coaster." No difference was found in the total Impact on Family scale score between fathers and mothers. The presence of a genetic disorder in the child and lower levels of perceived social support was significantly associated with a greater impact on the family. The impact of an infant's congenital heart disease on the family is determined both by child's medical condition and family's psychosocial factors. Families with poorer social support network may have the greatest need for professional interventions, especially if their child has an underlying genetic disorder.

What's for dinner? Types of food served at family dinner differ across parent and family characteristics

To examine the types of food served at family dinner in the homes of adolescents and correlations with parent and family sociodemographic characteristics, psychosocial factors and meal-specific variables. A cross-sectional population-based survey completed by mail or telephone by parents participating in Project F-EAT (Families and Eating and Activity in Teens) in 2009-2010. Homes of families with adolescents in Minneapolis/St. Paul urban area, MN, USA. Participants included 1923 parents/guardians (90·8% female; 68·5% from ethnic/racial minorities) of adolescents who participated in EAT 2010. Less than a third (28%) of parents reported serving a green salad at family dinner on a regular basis, but 70% reported regularly serving vegetables (other than potatoes). About one-fifth (21%) of families had fast food at family dinners two or more times per week. Variables from within the sociodemographic domain (low educational attainment) psychosocial domain (high work-life stress, depressive symptoms, low family functioning) and meal-specific domain (low value of family meals, low enjoyment of cooking, low meal planning, high food purchasing barriers and fewer hours in food preparation) were associated with lower healthfulness of foods served at family dinners, in analyses adjusted for sociodemographic characteristics. There is a need for interventions to improve the healthfulness of food served at family meals. Interventions need to be suitable for parents with low levels of education; take parent and family psychosocial factors into account; promote more positive attitudes toward family meals; and provide skills to make it easier to plan and prepare healthful family meals.

Relação entre variáveis psicossociais familiares e desempenho em leitura/escrita em crianças

Este artigo analisa a relação entre fatores psicossociais familiares e o desempenho em leitura e escrita a partir de um estudo comparativo realizado através de entrevista semiestruturada com 29 familiares de dois grupos de alunos de 2ª série do ensino fundamental. Por meio de avaliação neuropsicológica, os estudantes foram caracterizados em: com dificuldade de leitura e escrita e leitores e escritores competentes. As análises estatísticas evidenciaram associação significativa entre o grupo com dificuldade em leitura e escrita e as variáveis presença de transporte próprio na família, percepção dos familiares de que a criança teve dificuldades para aprender a ler e no desempenho da leitura, maior índice de repetência escolar e história familiar de dificuldade na leitura. Os resultados demonstram a importância da análise de fatores psicossociais familiares para a compreensão da complexidade que envolve o desenvolvimento de habilidades de leitura e escrita em crianças.

Family psychosocial characteristics influencing criminal behaviour and mortality--possible mediating factors: a longitudinal study of male and female subjects in the Stockholm Birth Cohort.

BackgroundFamily psychosocial characteristics in childhood have been associated with children's development into criminal behaviour and mortality. This study explored these possible relationships and examined alcohol and/or drug use and mental problems as possible mediating factors, highlighting gender-specific patterns.MethodsData from Swedish subjects born in 1953 (n = 14,294) from the Stockholm Birth Cohort study were examined. Several indicators of adverse family factors and individual problems were included in the present study. The information was derived from various data sources, covering different periods. Gender-specific associations with incidence of criminality (1966-1980) and mortality (1981-2009) were analysed using logistic regression. Furthermore, the population attributable fraction (PAF) was calculated for all variables in the fully adjusted models which were positively related to the outcome.ResultsOverall incidence of criminality and mortality was (m/f 32.3/6.6) and (m/f 6.1/3.5), respectively. The results showed that all aspects of family psychosocial and individual problems studied were associated with criminality for both genders. Among males, individual problems seemed to partly mediate these relations, but the associations remained statistically significant. Interestingly, the PAF analysis revealed a reduction in criminality of 17.5% when individual problems with alcohol and/or drug use were considered. Among females, a significant impact of alcohol and/or drug use on the association between family psychosocial characteristics and subsequent criminality was obtained. Inclusion of father's occupational class only somewhat reduced the estimates for the genders. Concerning male mortality, father's alcohol abuse was significantly related to an increased risk. When individual criminality was accounted for, the association was substantially reduced but remained statistically significant. Among females, when adjusting for family psychosocial factors, only the association between parents' mental problems and females' mortality was significant. None of the individual problem variables managed to explain this association.ConclusionsFamily psychosocial characteristics were associated with both subsequent criminal behaviour and mortality. These connections were partly explained by individual risk factors, especially by alcohol and/or drug use. The practical implications of the findings point to the importance of addressing the individual's alcohol and/or drug use in reducing criminal behaviour, which would also lower the mortality rates.

The Effect of Family Structures and Psycho-Social Factors on Suicidal Ideation of Senior Citizens

The Effect of Family Structures and Psycho-Social Factors on Suicidal Ideation of Senior Citizens