Negative Child Outcomes Research Articles

Impacts of women's work and childcare on child illness among Bangladeshi Shodagor communities

For decades, women's employment has been seen as crucial for achieving greater autonomy and empowerment for women, and for promoting better health and nutrition outcomes for children, particularly in low- and middle-income countries (LMIC). However, numerous empirical studies of the relationship between women's work and child outcomes have shown mixed results. Our study tests the assumptions of a model that suggests loss of maternal care during working hours may produce negative health outcomes for children. We use longitudinal data collected from traditionally semi-nomadic, boat-dwelling Shodagor families in Matlab, Bangladesh to determine the importance of maternal care as a mechanism influencing the relationship between women's work and child illness. We use Bayesian linear mixed models to assess the influence of occupation and amount of care on average days of child illness per month, and also to examine the role that allomothers play in buffering against potential negative impacts of lost maternal care on child illness. Results show that children who receive more care from mothers experience fewer days of illness, and that availability of high-quality alloparents mediates the relationship between maternal work and child health. These results indicate that both the care and resources provided by mothers influence children's biological outcomes. This has important implications for policy and aid interventions in LMIC, which have been developed to capitalize on an assumed positive relationship between maternal work and child health and nutrition.

The effect of parental separation on educational achievement: An instrumental variable analysis

Parental separation is associated with a range of negative outcomes for children experiencing it, and there is ongoing scholarly and public interest in whether these associations reflect causal effects of parental separation. We estimate the effect of parental separation on children's educational achievement in Sweden using the proportion of male colleagues at the maternal workplace as an instrumental variable for parental separation. We discuss our instrumental variable approach in the context of the literature on the heterogeneous effects of parental separation. In the empirical analysis, we use population register data on 387,411 Swedish children born between 1990 and 1996 and measure educational achievement through their grade point averages in the final year of compulsory schooling. We find that parental separation does not have a negative effect on educational achievement and that this result is robust across a range of specifications. We argue that our results are informative of the effects of a large share of parental separations, in which parents dissolve relatively well-functioning unions.

Effectiveness of a Behavioral Activation Intervention for Peripartum Women with Opioid Use Disorder.

Pregnant women with opioid use disorder show elevated rates of comorbid mental health problems, both of which are associated with negative health outcomes for mothers and children. There is substantial evidence supporting the benefits of treatment of perinatal opioid use disorder, as well as perinatal depression and anxiety, but there are gaps in knowledge about the effectiveness of perinatal behavioral health interventions in the context of co-occurring substance use disorder. The current study seeks to address this gap by examining outcomes of a behavioral activation treatment in a group of peripartum women with opioid use disorder (N = 68). Behavioral activation has shown promise in treating co-occurring depression and substance use problems. The intervention was delivered as part of an integrated care treatment model, in which patients received co-located obstetric, substance use, and mental health care in a hospital-based clinic. Hierarchical linear modeling was used to assess change in symptoms over time. Results suggest that the group behavioral activation intervention was associated with reduced depression and anxiety symptoms, demonstrated by significant reductions in PHQ-9 and GAD-7 scores over the course of treatment. Moreover, there were indications that increased attendance was associated with further reductions in depressive symptoms. Results contribute to understanding the effectiveness of behavioral activation in the context of peripartum opioid use disorder. Findings also add to the evidence supporting integrated care models and offer a potential blueprint for improving outcomes and reducing barriers to care in this population.

A Qualitative Analysis of the Effects of COVID-19 on Home Visiting Service Provision.

Home visiting programs have been found to improve parenting practices and to reduce negative child outcomes. The 2019 coronavirus disease (COVID-19) resulted in an abrupt transition to telehealth services for many home visiting services. Limited research has examined the impacts of delivering home visiting services via telehealth, and the effects of this abrupt transition during COVID-19 is understudied as well. This study examined the impact of the abrupt transition to telehealth as a result of COVID-19 on home visiting service provision in one mid-sized midwestern community from the perspective of clients and providers. We conducted semi-structured interviews with both home visiting clients and providers (N = 26) in prevention-focused home visiting services. Although some benefits to telehealth were reported, providers discussed challenges with regard to engaging clients in services and difficulties in completing important home visiting tasks (i.e., assessment of child development, teaching parent-child interaction). Providers and clients also noted that they missed face-to-face interactions. Effective use of telehealth in home visiting requires provision of devices that allow for video-chatting as well as development of effective methods to engage in observation and teaching tasks.

Does parental use of harsh discipline and punishment in response to ambiguous child situations vary by child physical abuse risk?

Background/objectivesThe present study investigated the extent to which fathers and mothers at high-risk and low-risk for child physical abuse (CPA) differed in their use of harsh discipline and punishment when presented ambiguous child situations (situations where differences in positive and negative valences are close to zero). Participants/methodsHigh-risk for CPA parents (N = 74: fathers, n = 41; mothers, n = 33) and low-risk parents (N = 178: fathers, n = 91; mothers, n = 87) were asked to indicate their likelihood of using harsh verbal discipline (HVD), harsh physical discipline (HPD), and punishment (i.e., retributive harm separate from HVD and HPD) after viewing each of eighteen ambiguous child situations. ResultsAs expected, high-risk, compared to low-risk, for CPA parents were significantly (ps < 0.001) more likely to use HVD (d = 0.546), HPD (d = 0.595), and punishment (d = 0.564). Overall, fathers, relative to mothers, were significantly more likely to use HVD (d = 0.261) and HPD (d = 0.238). For punishment, however, there was no significant parental role (father, mother) difference (d = 0.136). ConclusionsSince in everyday living situations many child behaviors are ambiguous, the findings that parents, especially high-risk for CPA parents, use harsh discipline and punishment when encountering ambiguous child situations suggest that non-contingent harsh child-related parental behaviors may be frequent in the lives of some children. The findings that parents may use non-contingent discipline and punishment suggest the need to explore whether, when these parenting behaviors occur, they increase the likelihood of negative child outcomes.

Examining parental stress and its link to hair cortisol and DHEA levels in kindergartners

Background Parental work-family conflict (WFC) and parental household income have been linked to negative outcomes for children. So far, no study has associated these two stressors with the hair concentration of cortisol (HCC) and dehydroepiandrosterone (DHEA) in kindergarteners as a measurement of their objective stress. Methods and measures 44 children (40.91% female) with a mean age of 5.16 years and their parents participated in this cross-sectional study. Children’s cortisol and DHEA measurements reflected the hormones produced over the past two months. Parents filled out questionnaires concerning their WFC and parenting behavior. Results Higher maternal WFC and a lower parental net household income were negatively associated with the DHEA and positively with HCC/DHEA ratio of their children. No significant associations were found between HCC and any included variables. Paternal WFC had no impact on the stress hormones and negatively affected parenting behavior of both parents. Levels of stress hormones were not correlated with parenting behavior. Conclusion The present results indicated a higher stress exposure in children of mothers with a higher WFC and lower net household income. Conceivably, this may have led to an accumulation of allostatic load. Potential influences of demographic variables on the children’s hormones are discussed.

Direct and indirect predictors of postpartum depression symptoms among indigenous Bedouin mothers in Israel.

Postpartum depression (PPD) is a common and complex phenomenon with negative outcomes for children, womenand their families. This study set out to identify both direct and indirect predictors of PPD symptoms among indigenous Bedouin mothers in Israel. The study included 305 women, 18 to 45 years of age, who were interviewed while pregnant and again, 2 to 4 months postpartum. Interviews were conducted in Arabic and included the Edinburgh Postnatal Depression Scale, administered at both points of measurement. Using path analyses, we identified four significant, direct predictors of PPD symptoms. The strongest was depressive symptoms when pregnant, followed by low relative income, low hemoglobin, and number of prior miscarriages. The latter was significantly associated with consanguinity, meaning that women married to a first cousin experienced more miscarriages which, in turn, increased PPD risk. Low relative income was the only variable that had both a direct and indirect effect upon PPD symptoms (via symptoms of depression when pregnant and hemoglobin). Education and polygamy also emerged as indirect predictors of PPD via depressive symptoms reported during pregnancy. Results suggest a high rate of PPD in this perinatal sample of indigenous women. Our findings underscore the need for tailored interventions to reduce PPD, especially for low-income Bedouin women, faced with many barriers and insufficient access to healthcare services.

Identification of depression and anxiety during pregnancy: Asystematic review and meta-analysis of test accuracy.

Depression and anxiety are significant contributors to maternal perinatal morbidity and a range of negative child outcomes. This systematic review and meta-analysis aimed to review and assess the diagnostic test accuracy of selected screening tools (Edinburgh Postnatal Depression Scale [EPDS], EPDS-3A, Patient Health Questionnaire [PHQ-9]-, PHQ-2, Matthey Generic Mood Question [MGMQ], Generalized Anxiety Disorder scale [GAD-7], GAD-2, and the Whooley questions) used to identify women with antenatal depression or anxiety in Western countries. On January 16, 2023, we searched 10 databases (CINAHL, Cochrane Library, CRD Database, Embase, Epistemonikos, International HTA Database, KSR Evidence, Ovid MEDLINE, PROSPERO and PsycINFO); the references of included studies were also screened. We included studies of any design that compared case-identification with a relevant screening tool to the outcome of a diagnostic interview based on the Diagnostic and Statistical Manual of Mental Disorders, fourth or fifth edition (DSM-IV or DSM-5), or the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10). Diagnoses of interest were major depressive disorder and anxiety disorders. Two authors independently screened abstracts and full-texts for relevance and evaluated the risk of bias using QUADAS-2. Data extraction was performed by one person and checked by another team member for accuracy. For synthesis, a bivariate model was used. The certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). PROSPERO CRD42021236333. We screened 8276 records for eligibility and included 16 original articles reporting on diagnostic test accuracy: 12 for the EPDS, one article each for the GAD-2, MGMQ, PHQ-9, PHQ-2, and Whooley questions, and no articles for the EPDS-3A or GAD-7. Most of the studies had moderate to high risk of bias. Ten of the EPDS articles provided data for synthesis at cutoffs ≥10 to ≥14 for diagnosing major depressive disorder. Cutoff ≥10 gave the optimal combined sensitivity (0.84, 95% confidence interval [CI]: 0.75-0.90) and specificity (0.87, 95% CI: 0.79-0.92). Findings from the meta-analysis suggest that the EPDS alone is not perfectly suitable for detection of major depressive disorder during pregnancy. Few studies have evaluated the other instruments, therefore, their usefulness for identification of women with depression and anxiety during pregnancy remains very uncertain. At present, case-identification with any tool may best serve as a complement to a broader dialogue between healthcare professionals and their patients.

A test of the instability hypothesis in low- and middle-income countries.

The instability hypothesis proposes that family structure transitions lead to negative child outcomes through the pathway of stress. However, in many cases, family structure transitions are not associated with stress or negative child outcomes, suggesting that there are specific circumstances under which transitions are more or less stressful. Using five rounds of data (ages 1-15) from the Young Lives study (N = 8,062) which follows children and their caregivers in Ethiopia, India, Peru, and Vietnam, we had two aims: (a) to test the instability hypothesis, and (b) to examine the specific circumstances under which family structure transitions lead to stress and worsened child physical health. First, we used multilevel mediation to assess whether financial stress mediated the link between family structure transitions and children's physical health. We then added household size, multigenerational household, and horizontally extended kin household as moderators to the family structure transition-financial stress relationship. We found that financial stress did not mediate the link between family structure transitions and children's physical health in any of the Young Lives countries. We found some moderated mediation effects for household size and multigenerational households in Peru and Vietnam, but effect sizes were small. These findings highlight the need to further unpack the instability hypothesis to understand the specific circumstances under which family structure transitions lead to stress and worsened child outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Depression, parenting and the COVID-19 pandemic in Canada: results from three nationally representative cross-sectional surveys

ObjectivesDepression is associated with problems in functioning in many aspects of life, including parenting. COVID-19 has increased risk factors for depression. We investigated the prevalence of depression among parents during...

The Employee Turnover Phenomenon in Saudi Arabia’s Private Schools: Case Study

This article represent an investigation of the causes behind high turnover of teachers in Saudi Arabian private schools and recommends ways and means to reduce its incidence. It is widely acknowledged that school teachers play a critical role in providing high quality education, so inadequacy, unavailability, or high turnover among teachers can radically affect the quality of education provided by schools and furthermore have negative outcomes for children. This research makes use of an elaborate literature review on various aspects of labour turnover, with specific regard to turnover among teachers, and follows the case study method for researching the subject issue. The study focuses on the Private Education Group, which runs a number of private schools in Saudi Arabia. The research makes use of qualitative analysis and the administration of semi- structured interviews. The research reveals low salaries to be the most important reason for staff turnover among the teachers and the existence of significant differences in attitudes between employees and officials. And finally, the researcher has made a number of recommendations for improving retention of teachers in private schools in Saudi Arabia.

Parenting While Depressed: The Influence of Interpersonal Supports and Community Resources for Mothers

Maternal depression may have a significant impact on multiple aspects of parenting throughout childhood, leading to negative outcomes for children. However, the impact of depression on parenting perceptions, practices, and involvement may differ among mothers, particularly when protective factors are present. Using data from the Fragile Families and Child Wellbeing Study, we compared three aspects of parenting (perceptions, practices, and involvement) between depressed and non-depressed mothers, and then investigated the influence of interpersonal supports and community resources on these aspects of the parenting, specifically for depressed mothers. Findings indicated that mothers with depression were equally involved with the child at home, but were more likely to hold negative perceptions of parenting. Furthermore, interpersonal supports and community resources had an indirect impact on parenting practices and involvement through perceptions of parenting, highlighting the importance of interventions for mothers with depression that address the appraisal and expectations of parenting stress and competencies.

Think of the children!: Relationships between nudity‐related experiences in childhood, body image, self‐esteem and adjustment

AbstractThere are widespread, strongly held beliefs that naturism has a negative impact on children. However, naturist groups advocate for including children and prior research has not clearly investigated how naturism affects children. Two pre‐registered, cross‐sectional studies (N1 = 411, N2 = 250) investigated how nudity‐related experiences in childhood predicted overall adjustment. In Study 1, adults reported their recalled experiences of nudity in childhood as well as their current levels of body appreciation, self‐esteem and overall adjustment. In Study 2, mothers reported on their children's current experiences of nudity and the children themselves reported on their current levels of body appreciation, self‐esteem and overall adjustment. Results for both studies were similar (though in Study 2, some associations only approached statistical significance): Experiences of naturism were associated with positive, not negative outcomes. These findings suggest that, despite the concerns some people express, naturism does not generally lead to negative outcomes for children.

The parent's and the child's internal working models of each other moderate cascades from child difficulty to socialization outcomes: Preliminary evidence for dual moderation?

Infants' difficulty, typically characterized as proneness to negative emotionality, is commonly considered a risk for future maladaptive developmental trajectories, mostly because it often foreshadows increased parental power assertion, typically linked to future negative child outcomes. However, growing evidence of divergent developmental paths that unfold from infant difficulty has invigorated research on causes of such multifinality. Kochanska et al. (2019) proposed that parent and child Internal Working Models (IWMs) of each other are key, with the parent's IWM of the child moderating the link between child difficulty and parental power assertion, and the child's IWM of the parent moderating the link between power assertion and child outcomes. In Children and Parents Study (200 community mothers, fathers, and children), child difficulty was observed at 8 months, parents' power assertion at 16 months, and children's outcomes rated by parents at age 3. Parents' IWMs were assessed with a mentalization measure at 8 months and children's IWMs were coded from semi-projective narratives at age 3. The cascade from infant difficulty to maternal power assertion to negative child outcomes was present only when both the mother's and the child's IWMs of each other were negative. We did not support the model for father-child dyads.

Protocol for the effectiveness evaluation of an antenatal, universally offered, and remotely delivered parenting programme ‘Baby Steps’ on maternal outcomes: a Born in Bradford’s Better Start (BiBBS) study

BackgroundPoor perinatal mental health and maternal sensitivity towards a child in the early years can carry a long-term cost to individuals and to society, and result in negative child outcomes such as poor mental health and social emotional issues. Despite the recognition of early intervention and prevention, there is mixed evidence regarding antenatal parenting interventions that aim to enhance perinatal mental health and maternal sensitivity to prevent negative child outcomes. ‘Baby Steps’ is a relationship-based antenatal and postnatal parenting programme. The service evaluated in this study is delivered in a low-income and ethnically diverse community via Better Start Bradford.This study aims to assess whether the universally, and remotely delivered Baby Steps programme is effective in improving postnatal maternal sensitivity (primary outcome) and postnatal maternal mental health (secondary outcome) when compared to services as usual 6–10 weeks post-birth. It will also assess differences in birth outcomes, and differences in the prevalence of poor perinatal mental ill health through routine data. The feasibility of collecting cost and health related resource use data for a future economic evaluation will be explored.MethodsThe study is a quasi-experimental evaluation in a single centre. All participants are drawn from Born in Bradford’s Better Start (BiBBS) interventional family cohort study. Intervention participants will be matched to a demographically comparable control group using propensity score matching. The required minimum sample is n = 130 (ratio 1:1) to detect a medium effect (± 2.35, d = .50) on the primary outcome—maternal-child sensitivity, using the Mothers Object Relations Scale Short Form (MORS-SF). Secondary outcomes include the Patient Health Questionnaire (PHQ-8), Generalised Anxiety Disorder assessment 7 (GAD-7), identification of poor perinatal mental health through routine data, and birth outcomes (delivery method, gestation period, low birth weight). Service delivery costs and health resource use will be gathered from routine data.DiscussionThis study will evaluate the effectiveness of Baby Steps for enhancing maternal-child sensitivity and maternal mental health when delivered universally and remotely. The findings regarding programme effectiveness, process, and costs will be relevant for researchers, service commissioners, and service staff.Trial registrationThis study was prospectively registered with ISRCTN (22/04/2022, ISRCTN12196131).

Associations of Symptom Severity of Mentally Ill Parents on Family Functioning and Children’s Mental Health

Background: Parental mental illness has a negative impact on children’s mental health. Often, the entire family structure suffers from the consequences of parental illness. Purpose: For future interventions, it is important to examine the impact of specific factors such as parental symptom severity on children’s mental health and family functioning. Method: The sample of this study included N = 203 parents with mental illness with a total of N = 309 children. Parents completed questionnaires on symptom severity. Children’s mental health symptoms were rated by parents and children and family functioning was assessed from the children’s perspective. Results: Mixed linear models showed a significant impact of parental symptom severity on children’s mental health from both parents’ and children’s perspectives. No significant impact of symptom severity on perceived family functioning from the children’s perspective was found. Conclusion: Results underline the importance of personalized interventions in terms of parental symptom severity to minimize negative outcomes for children and the whole family.

Mothering Ideology: A Qualitative Exploration of Mothers' Perceptions of Navigating Motherhood Pressures and Partner Relationships.

The online version contains supplementary material available at 10.1007/s11199-022-01345-7.

Gendered Associations between Single Parenthood and Child Behavior Problems in the United Kingdom.

Internalizing and externalizing behavior problems are associated with a variety of negative child outcomes, but these conclusions have been drawn from research that usually compares children in families with two biological, married parents to all other family types. We compare behavior problems across two-parent, single-mother, and single-father families, which allows us to explore competing gender theories as possible explanations for why child behavior outcomes may be different across these three categories. Results from analyses of the UK Millennium Cohort Study suggest that while children in both single-mother and single-father families initially look like they experience more behavior problems than those in two-parent families, controlling for physical and, especially, social resources explains potential differences. Similarly, when single mothers and single fathers occupy similar family environments in terms of physical and social resources, their children report similar behavior. In contrast to findings from the US, children of single mothers who occupy similar family environments as children in two-parent families in terms of resources perform slightly better in terms of externalizing behavior problems than their two-parent counterparts. We conclude that constructivist theories more accurately explain gendered parenting behavior and its consequences for child behavior problems. Environmental factors such as income, parental closeness, and participation in extracurricular activities have a significant effect on child behavior problems.

Prevalence and Determinants of Unintended Pregnancy among Married Women Seeking Antenatal Care at Bwaila District Hospital in Lilongwe, Malawi

In many countries, women fall pregnant much sooner than desired and have more pregnancies and bear more children than they want. Pregnancies are usually associated with an array of negative health, economic, social and psychological outcomes for women and children. Preventing unintended pregnancies through family planning is an integral component in limiting associated consequences and population growth. However, despite widely available contraceptives, the demand for family planning among married women is still high. A quantitative study was conducted to explore the prevalence and determinants of unintended pregnancy among married women seeking antenatal care at Bwaila District Hospital in Lilongwe, Malawi. Permission was granted by the relevant authorities to conduct the study. Between July and August 2019, 413 married pregnant women were interviewed. The women gave written consent before joining the study and all the completed questionnaires were personally collected daily. Descriptive statistics were used to analyse the data while nonparametric tests were used to explore associations amongst the variables. The mean age of the participants was 23 years and 43.1% of the participants reported that their most recent pregnancy was unintended. Multivariate analysis revealed that young age (18–25 years), low education level and preference for the sex of the child were significant determinants of unintended pregnancy. Inconsistent use of family planning methods increased the risk of unintended pregnancy. Unintended pregnancy among married women indicates the need for improving education among women to delay marriage to the universal minimum of 18 years, and increasing access to long-term family planning methods to avoid failure and discontinuation of contraceptives.

Evaluation of subclinical atherosclerosis and cardiac functions in children of mothers with gestational diabetes and maternal obesity.

We aimed to evaluate the effects of maternal obesity or gestational diabetes on body composition, lipid, and glucose metabolism, arterial morphology, and functions in children, and to investigate these effects in terms of cardiometabolic diseases. The study group was composed of 48 children who had a history of gestational diabetes or maternal obesity, and the control group was composed of 33 children. Echocardiographic assessments were performed. Socio-economic status and education level of mothers were obtained. In the study group, carotid intima-media thickness, epicardial adipose tissue thickness, and arterial stiffness values were found to be significantly higher compared to the control group (p < 0.001, p < 0.001, p = 0.003, respectively), while arterial distensibility and arterial strain values were found to be significantly lower (p = 0.003, p = 0.008, respectively). Among the children who had similar body mass index in both groups, children in the study group had higher carotid intima-media thickness and epicardial adipose tissue thickness values. Arterial stiffness values were significantly reduced (p = 0.028) and arterial distensibility and strain values were significantly increased (p = 0.039, p = 0.033, respectively) in the children whose mothers had gestational diabetes and high socio-economic status. Left ventricular mass and left ventricular end-diastolic internal thickness were found to be significantly increased in the children who had obese and unemployed mothers (p = 0.04, p = 0.03, respectively). Low socio-economic status was found to be associated with increased maternal obesity and gestational diabetes. Poor socio-economic status, poor glycaemic control and being overweight during pregnancy indicate negative cardiometabolic outcomes for children in the long term.