Parental Health Research Articles

Parent–child interaction frequency: associations with age, sibling presence, and child health

Abstract Objectives Parent-child interaction plays a crucial role in child development. This study investigated associations between the frequency of parent-child-interactions and sociodemographic characteristics (age, sex, socio-economic status, family structure, number and age of siblings), physical and psychological symptoms in children, and mental health of parents. Methods The frequencies of 11 different parent-child interactions (shared reading, singing, moving, painting, building, puzzle, playing ball, role games, language games, number games and talking about problems) were assessed in 739 children aged 2–6.5 years-old using a standardised parental questionnaire, within a population-based cohort study in Leipzig, Germany. Physical and psychological symptoms were investigated using the HBSC Symptom-Checklist and parental depression symptoms using the Patient Health Questionnaire. We applied regression analyses to assess associations between variables. Results Shared reading was the parent-child interaction reported most frequently, with an average occurrence of several times a week. Number games were reported least frequently, with an average occurrency of every two weeks. Fewer parent-child interactions were significantly associated with higher child age, higher number of siblings, presence of older siblings and a lower level of physical and psychological symptoms. The other variables (sex, SES, living situation, presence of younger siblings or both (younger and older), depression symptoms of parents) were not significantly associated with the frequency of parent-child interactions. Conclusion The findings show that age of children and number as well as age of siblings at home may shape the frequency of parent-child interaction in preschool children. In addition, the findings suggest that parent-child interaction might be related to the health of children rather than the (mental) health of parents. Impact This study assessed the associations between the frequency of different types of parent-child interactions and sociodemographic as well as health-related parameters in a large sample of children. There still exist sex-specific differences in the frequency of parent-child interactions related to traditional role models of girls and boys. A higher frequency of parent-child interactions is associated with more physical and psychological symptoms in children. Parent-child interactions are less frequent in families with more children, especially when older siblings are present.

“There is a Mental Resistance”: Experiences of Involving Refugee Parents in a Youth Trauma Recovery Program from the Perspective of Participating Youth, Parents and Facilitators

AbstractScalable light-touch programs that align with the Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) approach is becoming an established intervention model for refugee youth with symptoms of post-traumatic stress. Teaching Recovery Techniques (TRT) is one example and, as TF-CBT guidelines state, parent sessions are included as the model relies on parents to provide support and instigate the techniques. In addition to traumatic stress, refugee families are often subjected to acculturative, isolation and resettlement stress. This study sought to understand how refugee parental involvement in TRT functions in practice and how it is perceived by participating youth, parents, and facilitators in Sweden. Thirty semi-structured interviews (11 youth, 8 parents, and 11 TRT facilitators) were conducted by phone or videoconference, transcribed, and analyzed using Thematic Network Analysis. A global theme ‘Parental engagement in trauma recovery requires dedicated attention’ emerged. Three organizing themes sat within this global theme: (i) Shifting roles when adapting differently to a new context; (ii) Tendency to keep parents at a distance; and (iii) Parent sessions don’t just happen. Whilst the potential for refugee parent involvement was recognized, a number of factors preventing their participation were identified. Cultural adaptations within TRT facilitators’ training are recommended, including: raising awareness about contextual factors and changes in family dynamics with regard to trauma and migration; adopting culturally responsive ways to present parental involvement to youth and parents; adding positive parenting skills; addressing parental mental health and readiness; and preparing facilitators to redirect parents to adequate services, when needed.

The Impact of Parental Depressive, Anxiety, and Stress Symptoms on Adolescents’ Mental Health and Quality of Life: The Moderating Role of Parental Rejection

Background/Objectives: Parental internalizing issues, particularly maternal mental health, can significantly influence adolescents’ mental health by altering parenting behaviors and roles. This study explores the role of parental rejection in moderating the relationship between parental depressive, anxiety, and stress symptoms and adolescents’ mental health and quality of life. Methods: One hundred thirty eight mothers (mean age: 47.96, SD = 5.06 years) and 68 fathers (mean age: 51.07, SD = 5.53 years) of adolescents aged 12–18 completed measures on mental health, parental rejection, and adolescent well-being. Results: Maternal rejection was found to moderate the relationship between maternal anxiety symptoms and adolescents’ quality of life, as well as between maternal anxiety symptoms and adolescents’ mental health problems. Paternal rejection moderated the relationship between paternal stress symptoms and adolescents’ mental health. However, parental rejection did not moderate the relationship between parental depression and adolescents’ quality of life or mental health. Conclusions: These findings highlight the distinct roles of maternal and paternal rejection in adolescent development and suggest that parental mental health, particularly anxiety and stress, has a significant impact on adolescent well-being. Future studies should consider the influence of both parents and focus on longitudinal effects. These results emphasize the need for interventions addressing parental rejection to improve adolescent outcomes.

Parental obesity, health determinants, and cardiometabolic risk according to sleep duration in schoolchildren: analysis through structural equations

Backgroundthe independent association between parental obesity, sleep and lifestyle habits with cardiometabolic risk factors in children and adolescents has been widely explored in the literature. Our study represents a novel approach to comprehensively investigate a complex model encompassing various aspects associated with cardiometabolic risk in youth. Thus, the aim of the present study was to verify the relationship between parental obesity and cardiometabolic risk in children and adolescents, considering the mediator role of health indicators according to sleep time.MethodsThis cross-sectional study was conducted on 3,973 children and adolescents aged 6 to 17 years attending public and private schools in a city located in Southern Brazil. Sleep duration, lifestyle, physical activity, natural food consumption, and parental obesity were evaluated through self-reported questionnaires. Physical fitness was evaluated according to the protocols of Projeto Esporte Brasil. The body fat percentage was evaluated through the measures of tricipital and subscapular folds, and the body mass index was calculated. The clustered metabolic risk score (cMetS) considered the summing z-scores of waist circumference, systolic blood pressure, triglycerides, total cholesterol/high-density lipoprotein cholesterol ratio, and fasting glucose, divided by five. A structural equation model was applied for statistical analysis. Results: The relationship between parental obesity and cardiometabolic risk was observed in children and adolescents with adequate sleep, being significant (p < 0.05) mediated by physical activity, natural food, physical fitness, and lifestyle. This was also observed when parental education was included in the inadequate sleep cluster model. Conclusion: Present findings underscore the importance of sufficient sleep duration as a critical factor in understanding the complex interplay between parental obesity and cardiometabolic risk in children and adolescents.

The Role of Informal Social Networks in Supporting Parents With Learning Disabilities: A Systematic Review

ABSTRACTBackgroundParents with learning disabilities are often assessed as lacking the capacity to parent effectively; however, ecological models of parenting indicate that support from informal social networks (ISNs) can help them successfully maintain family life. This systematic review examined evidence regarding (1) parent and child outcomes associated with support from ISNs and (2) perceptions of the roles of ISNs for parents with learning disabilities.MethodsPeer‐reviewed quantitative and qualitative literature was identified through a search of six databases, and a narrative synthesis was subsequently conducted.ResultsTwenty‐six articles were included in the review. Findings of the quantitative synthesis provided preliminary evidence for a positive relationship between support from ISNs and parental mental health, positive parenting practices and child wellbeing. The qualitative synthesis indicated that parents benefited from ISNs through their provision of practical and emotional support and learning skills. Network characteristics that divided supportive from unsupportive members were also identified.ConclusionParents with learning disabilities receive the same positive outcomes from ISNs as other parents, although unique contextual and social challenges may affect their experiences. Future research should explore interventions to build ISNs of parents with learning disabilities that acknowledge their existing strengths as parents and community members.

Examining the Effect of Parental COVID-19 Vaccination Prior to Birth and the Association Between COVID-19 and Cancer in Children Under Six.

The biology of COVID-19 has intricate links to childhood cancer, exacerbated by pandemic disturbances. This research aims to explore the association between childhood cancer in children under 6 years old and COVID-19 immunisation, in addition to the effects of vaccination on parents before delivery. The study employs a case-control approach, gathering informed consent and matching factors like age, marital status, and socioeconomic status between cases and controls. A survey was distributed, culminating in 191 children under six, with data from 136 diagnosed cancer cases collected in 2023, adhering to methodological standards in epidemiological research. The analysis utilised SPSS28, employing chi-square testing and logistic regression. Chi-square testing confirmed a significant rise in childhood cancer rates post-COVID-19 pandemic compared to pre-pandemic rates. Key factors influencing cancer incidence include the mother's age at childbirth, parental vaccination history before pregnancy, maternal vaccination details during pregnancy, the child's COVID-19 infection status, and maternal marriage age. Notably, younger mothers faced higher COVID-19 infection risks, but vaccination appears to mitigate paediatric cancer risk. The post-pandemic surge in childhood cancer underscores a complex interplay of early exposures and maternal viral infections. Emphasising vaccination's protective effects before and during pregnancy, the study advocates integrating vaccination into maternal health programs. Public health measures should promote immunisation and address socioeconomic inequalities to lower paediatric cancer risk, aligning with previous studies linking parental health behaviours to childhood cancer incidence.

Psychosis Spectrum Symptoms Before and After Adolescent Cannabis Use Initiation

Adolescent cannabis use has been consistently posited to contribute to the onset and progression of psychosis. However, alternative causal models may account for observed associations between cannabis use and psychosis risk, including shared vulnerability for both cannabis use and psychosis or efforts to self-medicate distress from psychosis spectrum symptomology. To test 3 hypotheses that may explain cannabis-psychosis risk associations by modeling psychosis spectrum symptom trajectories prior to and after cannabis initiation across adolescent development (approximately 10-15 years of age). This cohort study used data from 5 waves across 4 years of follow-up from the Adolescent Brain Cognitive Development (ABCD) Study. The ABCD study is an ongoing large-scale, longitudinal study of brain development and mental and physical health of children in the US launched in June 2016. Data are collected from 21 research sites. The study included data from 11 868 adolescents aged 9 to 10 years at baseline. Three participants were excluded from the present analysis owing to missing data. Data analysis was performed from September 2023 to July 2024. Discontinuous growth curve modeling was used to assess trajectories of psychosis spectrum symptoms before and after cannabis initiation. Control variables considered for this investigation were age, sex, internalizing and externalizing symptoms, socioeconomic status, parental mental health, and other substance use. Among the 11 858 participants at wave 1, the mean (SD) age was 9.5 (0.5) years; 6182 (52%) participants were male. Consistent with a shared vulnerability hypothesis, adolescents who used cannabis at any point during the study period reported a greater number of psychosis spectrum symptoms (B, 0.86; 95% CI, 0.68-1.04) and more distress (B, 1.17; 95% CI, 0.96-1.39) from psychosis spectrum symptoms relative to those who never used cannabis. Additionally, consistent with a self-medication hypothesis, the number of psychosis spectrum symptoms (B, 0.16; 95% CI, 0.12-0.20) and distress (B, 0.23; 95% CI, 0.21-0.26) from psychosis spectrum symptoms increased in the time leading up to cannabis initiation. We observed mixed evidence for an increase in psychosis symptoms after cannabis initiation (ie, contributing risk hypothesis). The findings underscore the importance of accounting for shared vulnerability and self-medication effects when modeling cannabis-psychosis risk associations.

Mental health of parents with infants in NICU receiving cooling therapy for hypoxic-ischaemic encephalopathy

ABSTRACT Background Parents cuddling their babies during intensive care to promote parent-infant bonding is usual practice in the neonatal intensive care unit (NICU). However, babies undergoing cooling therapy and intensive care are not routinely offered parent-infant cuddles due to concerns of impacting the cooling process or intensive care. We developed the CoolCuddle intervention to enable parents to cuddle babies safely during cooling therapy. We investigated whether CoolCuddle impacted parent-infant bonding and parent’s mental health. Methods We conducted parental interviews and compared mental health and bonding measures in two cohorts of parents; one with access to CoolCuddle and the other where CoolCuddle was not available. Results Ten tertiary NICUs in England and Wales from 2019 to 2023 were involved and 107 families. There were high levels of post-delivery depression amongst all parents. However, at discharge mothers in the CoolCuddle group had significantly less depression, lower EPDS scores, and higher MIBS scores (consistent with better mother-infant bonding) than those where CoolCuddle was not available. All measures appeared similar when re-measured at 8 weeks. Parents reported they were not ready to access psychological support or information whilst on NICU and stressed the need of mental health support following discharge, which was not offered or available. Conclusion The CoolCuddle intervention was associated with a lower prevalence of depression and enhanced bonding scores for mothers at discharge compared to those who did not cuddle their babies. Parents highlighted increased levels of postnatal depression following the sudden and traumatic admission of their infant to NICU after birth asphyxia.

Associations between parental psychopathology and youth functional emotion regulation brain networks

Parental mental health is associated with children’s emotion regulation (ER) and risk for psychopathology. The relationship between parental psychopathology and children’s functional ER networks and whether connectivity patterns mediate the relationship between parent and youth psychopathology remains unexplored. Using resting-state functional magnetic resonance imaging data from the Adolescent Brain Cognitive Development Study (N = 4202, mean age = 10.0) and a multilevel approach, we analyzed the relationship between self-reported parental psychopathology and their offsprings’ connectivity of four ER networks, as well as associations with self-reported youth psychopathology at a 3-year follow-up. Parental internalizing and total problems were associated with 1) higher connectivity between a subcortical-cortical integrative and ventrolateral prefrontal cortical (PFC) network, 2) lower connectivity between dorsolateral and ventrolateral PFC networks involved in cognitive aspects of ER, and 3) lower connectivity within a subcortical ER network (β = -0.05-0.04). Parental externalizing and total problems were associated with lower connectivity within the integrative network (βext = -0.05; βtot = -0.04). Mediation analyses yielded direct effects of parental to youth psychopathology, but no mediation effect of ER network connectivity. Overall, our results show that ER network connectivity in youth is related to parental psychopathology, yet do not explain intergenerational transmission of psychopathology.

Quality of Life in Children With Chronic Health Conditions and Its Contribution to Unmet Supportive Care Needs of Families.

While theoretical models have established the bidirectional relationship between health and wellbeing of parents and children with chronic health conditions (CHCs), previous work has predominantly emphasised the impact of parent functioning on child outcomes. This study examines how quality of life (QoL) domains in children with CHCs are associated with unmet supportive care needs (SCN) of their parents and explores whether these associations vary by health condition. Parents of children with congenital heart disease (CHD), type 1 diabetes (T1D) and cancer diagnosed before the age of 12 years and receiving treatment within the last 5 years were eligible. Parents recruited through charity organisations and social media platforms completed a secure, online survey via Qualtrics. The PedsQL examined child QoL across four dimensions: physical, emotional, social and school functioning. A 34-item survey assessed parents' unmet SCN in the previous month across six need domains (e.g., care and informational). Linear regressions examined associations between child QoL and unmet SCN domains and moderation analyses determined whether associations varied as a function of CHC. The study included 186 parents (age range 25-56 years) of children diagnosed with various CHCs (52% CHD; 27% T1D, 21% cancer). The child's emotional functioning was inversely related to all unmet SCN domains, social functioning was inversely related to three domains (physical and social; support; financial), school functioning was inversely related to two domains (physical and social; care), and child's physical functioning was not associated with any SCN domains. Only the association between child school functioning and unmet care needs was significantly moderated by CHC type (p < 0.05). Poorer emotional functioning in children with a CHC is a key factor in determining parents unmet SCN. Larger studies are required to replicate these findings and inform design of interventions addressing QoL and unmet SCN in families of children with common CHCs.

Preconception care.

Preconception care (PCC) entails a comprehensive suite of interventions to improve the health of potential parents, their babies and future generations. PCC is not limited to a first pregnancy, and addressing health and wellbeing is equally important in the interconception period. The aims of this paper are to discuss the evidence for and components of PCC, as well as the role of the general practitioner in the delivery of PCC. It is estimated that 90% of women and over 50% of men have preconception health issues to address. Although all people stand to benefit from PCC, certain population groups experience increased risk of adverse outcomes and require more targeted attention. Although most do not present for a dedicated PCC consultation, asking about pregnancy intention can start the conversation. Evidence shows that interventions delivered in primary care can improve preconception health knowledge and reduce preconception risk factors.

Emotional awareness, child maltreatment and child exposed to intimate partner violence: A systematic review of their relationship with symptoms and protective factors

AbstractThis systematic review studies the emotional awareness (EA) in children exposed to intimate partner violence (IPV) and other child maltreatment (CM), and their relationship with externalizing and internalizing symptoms and protective factors. The search was performed using the PubMed, PsycINFO and Google Scholar databases. The search was based on scientific studies using the follow terms: (“emotional awareness” OR “emotional intelligence”) AND (child OR adolescent OR children OR teenager) AND (abuse OR neglect OR maltreatment OR “presence of domestic violence” OR “domestic violence” OR “intimate partner violence”). Seventeen empirical studies were included, presenting a low risk of bias (82%). Four studies have explored the relationship between EA and exposition to IPV, four with sexual abuse, five with neglect, five with psychological abuse and three with physical abuse. A total of 13 articles have assessed the relationship between EA and externalizing and internalizing symptoms: three with suicidal ideation (SI), three with post‐traumatic stress symptoms (PTSD), two focused on addictions, three on affective symptoms, one with total externalizing symptoms, one with borderline personality disorder (BDP), one with non‐suicidal self‐injury (NSSI) and one with disordered eating behaviours and attitudes (DEBA). Studies show that abused children have lower EA and that the lower EA, the greater the presence of symptoms. A total of 10 articles have assessed the relationship between EA and protective factors such as mental health in parents, six with coping skills, one with self‐stem and one with quality of life. The main results suggest that EA could be a mediator between children exposed to IPV and other CM and internalizing and externalizing symptoms as well as protective factors.

Online interventions for the mental health and well-being of parents of children with additional needs: Systematic review and meta-analysis.

Parents of children with additional needs experience compromised physical and mental health and higher stress, and their ability to engage in meaningful occupations is impacted by their additional caregiving tasks. Online interventions targeting mental health, stress, and well-being for parents of children with additional needs have potential to increase supports alongside occupational therapy direct services. The aims of this review are to systematically identify and synthesise evidence of effectiveness of online interventions aimed at improving mental health, stress, and well-being of parents of children with additional needs. Eight databases were searched up to July 2024 to identify online interventions for parents of children with additional needs. Studies were appraised for methodological quality. Standardised effect sizes were calculated, and meta-analyses of randomised control trials (RCTs) were conducted on outcomes of mental health, well-being, and stress. There was no consumer or community involvement. Systematic screening identified 30 papers that met inclusion criteria. Most were RCTs or controlled clinical trials (CCTs) with 'moderate' quality ratings: Three were designed by occupational therapists. There was substantial variation in intervention types, methods of delivery, outcomes, and outcome measures used. The pooled standardised effect size estimates (ES) and the lower and upper confidence intervals (CI) of online interventions from RCTs post-interventions were significant for mental health ES = 0.47, 95% CI (0.18, 0.77), p = 0.002; stress ES = 1.27, 95% CI (0.56, 1.98), p = 0.000; and well-being ES = 0.65, 95% CI (1.2, 0.06), p = 0.03, respectively. The online interventions that aimed to improve mental health, stress, and well-being included in this meta-analysis were effective. Occupational therapists supporting families play an important role in guiding parents of children with additional needs to evidence-based interventions to support them with addressing their own mental health and well-being needs.

Influence of maternal and infant technology use and other family factors on infant development

BackgroundDigital technology is ubiquitous in the lives of many children and parents. To better understand any influence of technology use by infants, and mothers, on child development, technology use should be considered within the broader family system context in which children develop. This study aimed to investigate associations between infant and maternal technology use and infant 12-month development, taking into consideration other family factors.MethodsThis cross-sectional study used data from ORIGINS participants, collected at 12-months of age: maternal and child technology use (TechU-Q), sociodemographic factors (e.g. child sex, household income), parental mental health (DASS-21), and child development (Ages and Stages Questionnaire). Linear regression was used for analyses.ResultsWhen family factors were considered, higher infant mobile touchscreen device (MTSD) use was associated with poorer infant development for gross motor, problem-solving, and total ASQ-3 scores. In contrast there were no associations between infant television (TV) watching or maternal technology use and total ASQ-3 scores. Higher maternal technology use was associated with higher infant technology use. Poorer maternal and paternal mental health were associated with poorer infant development. Poorer maternal mental health was also associated with higher infant TV watching and higher maternal MTSD use.ConclusionThere is a complex relationship between technology use, parental mental health and other family factors that together influence infant development. To improve infant development outcomes, less focus should be on infant or maternal technology use, and more on supporting the family as a whole, and parental mental health in particular.

Key Determinants of Family-Centered Care for Children with Leukemia

This study examines the relationship between health status, parental knowledge, and parental attitudes with the application of family-centered care (FCC) for children with leukemia at Abdul Moelok Regional Hospital, Lampung Province. Using a quantitative approach with a cross-sectional design, 92 respondents were selected from a population of 1,200 leukemia patients treated between 2021 and 2022. Data were collected through a validated questionnaire that measured parental knowledge, attitudes, and health status, with analysis conducted using the gamma correlation test. The results indicate significant relationships between health status, parental knowledge, and parental attitudes with the implementation of FCC. Factors such as age, education, income, caregiving duration, and disease length influenced the health status and FCC application. The study also reveals that caregivers face challenges in providing care, particularly due to financial burdens and physical strain, impacting their quality of life. Additionally, cultural factors affect how parents communicate the diagnosis to children, with some families delaying disclosure based on cultural norms.

Roles of Psychological Flexibility, Parenting Competence, and Asthma Management Self-Efficacy in the Functioning Outcomes of Parents of Children with Asthma Co-Occurring with Attention-Deficit/Hyperactivity Disorder

Asthma and ADHD represent prevalent pediatric conditions, with the former being a physical disorder and the latter being a neurodevelopmental disorder. This study examined the influence of parental psychological flexibility (PF)—the ability to adapt to evolving situational demands, shift perspectives, and balance competing priorities—alongside parenting competence and asthma management self-efficacy on family functioning and parental psychological adjustment in families with children exhibiting concurrent asthma and ADHD symptoms. Baseline data were analyzed from 130 parents (mean age = 40.3 years, SD = 5.5; 88.9% mothers) of children diagnosed with both asthma and ADHD (mean age = 8.0 years, SD = 2.2; 74.6% boys), who were participating in a randomized controlled trial evaluating an Acceptance and Commitment Therapy (ACT)-based parenting intervention. An adjusted structural equation model revealed that greater parental psychological inflexibility was significantly associated with poorer family functioning (β = −0.61, 95% CI [−0.74, −0.33], p &lt; 0.001) and increased psychological maladjustment (β = 0.48, 95% CI [0.32, 0.63], p &lt; 0.001), accounting for intercorrelations with parenting competence and parental asthma management self-efficacy. Additionally, parental psychological flexibility was found to mediate the relationship between parenting competence and both family functioning and psychological adjustment. These findings underscore the importance of targeting parental psychological inflexibility and enhancing parenting competence in interventions to improve family dynamics and parental mental health and thereby suggest a shift from the traditional focus on self-efficacy in symptom management for pediatric asthma and ADHD.

Risk and protective factors for mental health problems in children and adolescents during the COVID-19 pandemic: results of the longitudinal COPSY study

AbstractThe COVID-19 pandemic has had profound effects on the mental health of children and adolescents worldwide, exacerbating existing challenges and introducing new stressors. This paper explores the impact of risk and protective factors on the mental well-being of young individuals during the pandemic. Using data from the German nationwide, population-based, longitudinal COPSY study (n = 2,471, girls: 50.0%, age 7–17 years) spanning nearly three years, this study investigates how factors such as gender, age, parental education, parental depressive symptoms, family cohesion, and social support influence mental health. Mental health problems were assessed using the Strengths and Difficulties Questionnaire (SDQ). Latent growth analysis and structural equation modeling were employed to analyze cross-sectional and longitudinal data collected at five measurement points (initial response rate: 46.8%). Findings revealed that boys and younger children are at a higher risk for mental health problems. Additionally, low parental education, single parenthood, parental burden due to the pandemic and parental depressive symptoms were significantly linked with mental health problems in children. Conversely, personal resources, family cohesion, and social support were associated with less symptoms. Family cohesion additionally buffered against the negative impact of parental depressive symptoms. The study underscores the importance of multi-level interventions that consider individual, familial, and societal factors in promoting positive mental health outcomes among children and adolescents during challenging times. Continued research and collaborative efforts are needed to develop evidence-based strategies for supporting the resilience of young individuals in the face of future adversities.

An intergenerational study of mental health among parents and adolescents

Abstract Background The aim of this study was to examine the association between parents’ mental disorders and adolescents’ self-rated health, using both subjective and objective assessment of parents’ mental health status. Methods This cohort study was based on the Danish Future Occupation of Children and Adolescents cohort. Study population 25,891parents (biological parents or registered guardians) linked to 13,067 adolescents. Survey data were merged with register data on parent mental health, and logistic regression was used to analyse association between the register- and self-report data on parents mental health, and self-rated global health among their offspring. Results Adolescents’ self-rated health was associated with their parents’ mental disorders, showing an unadjusted OR of 1.5 (95% CI 1.4-1.6) when assessing parental mental disorders using ICD-10 diagnoses and an unadjusted OR of 2.0 (95% CI 1.8-2.2) when using the adolescents’ self-reported measure on the parental mental disorder. Adjustment for adolescents’ sex, adolescents’ mental disorders during childhood, parental education, and parental labour market attachment led to a decreased association between parents’ mental disorders and adolescents’ self-rated health in both analyses with an adjusted OR of 1.2 (95% CI 1.1-1.4) when assessing parents’ mental disorders using ICD-10 diagnoses and an adjusted OR of 1.8 (95% CI 1.6-2.0) when using the adolescents’ self-reported measure on parental mental disorder. Conclusions This study documents a clear pattern in mental disorders across generations and that parental labour market attachment as well as mental disorders in earlier life phases are risk factors for developing mental disorders in adolescence. The results point to the importance of public health interventions aimed at the more vulnerable group of adolescents, where mental health problems are observed over two generations. Key messages • There is a clear pattern in mental disorders across generations. • Parental labour market attachment are risk factors for developing mental disorders among their offspring.

Parental Health and Flourishing Among Young US Children

This cross-sectional study investigates the association between parental health and flourishing among children aged 6 months to 5 years in the US.

Parents' experiences of psychotherapeutic support on the neonatal unit: A mixed methods systematic review to inform intervention development for a multicultural population.

Parents of infants admitted to neonatal intensive care require support to minimize the impact on their mental health and to encourage engagement with their infants to support infant neurodevelopment. Many interventions aim to address this need, but there is a lack of research considering the accessibility of these for a multicultural population. To systematically identify sources of psychotherapeutic support available for parents with infants admitted to neonatal care (NNU, neonatal intensive care unit [NICU] and special care units), assess their accessibility and acceptability and identify challenges and facilitators. Six electronic databases with no restrictions on language or date were used to identify relevant studies following Preferred Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Publications were included in the review if they reviewed parent experience of an intervention actively in place to support parent experience during the neonatal unit stay. Any studies where the intervention's primary aim was infant focused, such as developmental care, were excluded. All publications were quality-assessed using quality appraisal tools appropriate for their design type. Data were extracted line by line using Sekhon et al.'s theoretical acceptability framework and questionnaire. A total of 3309 studies were found, of which 36 studies met the inclusion criteria. Included studies were published worldwide between 2000 and 2023 and explored 15 different interventions. Challenges for parental engagement were due to preconceived ideas about intervention requirements and parents' ability to participate in them. Timely information and providers' experience in delivering the intervention were reported to support engagement and as being valuable for enhancing participant knowledge. The emotional content of interventions was found to be challenging by parents across most studies. This was prominent in interventions designed to be carried out in a group format and where keepsakes were created. However, the value of these interventions was in reducing parents' feelings of isolation through increased social support and providing a starting point for conversations with wider family and friends about the family's neonatal experience. Participant demographics were poorly reported, with only two studies taking into consideration the ethicality of the intervention. Poor reporting of participant demographics, and a focus on mothers as participants, means findings are not transferrable to the wider population of parents in neonatal units. Future studies should consider how to ensure that research and interventions are accessible to multicultural populations to improve the understanding of the acceptability of interventions. Better knowledge of neonates and the NNU setting amongst intervention providers could increase the accessibility of psychotherapeutic support for parents. Training for providers on how to manage sensitive conversations may also be beneficial to support parents during interventions. The impact of neonatal admission on parental mental health is increasingly recognized and reported. Interventions have been developed to reduce the negative impact on the mental health of parents. There continue to be significant health inequalities as a result of many services not taking into account the acceptability and accessibility of interventions in this setting for their multicultural populations. This review highlights the need for better reporting of participant demographics in research and the inclusion of those seldom heard to ensure interventions are culturally, religiously and linguistically appropriate for multicultural populations.