Positive Psychosocial Outcomes Research Articles

Behavior Change Techniques Involved in Physical Activity Interventions for Children With Chronic Conditions: A Systematic Review.

Behavior change techniques (BCTs) have been extensively used in physical activity interventions for children, however, no systematic reviews have synthesized their effects. The present review aimed to identify the most promising BCTs used in physical activity interventions associated with (i) increased physical activity behavior and (ii) positive psychosocial outcomes in children with chronic conditions. A systematic search of 6 databases identified 61 articles as eligible for inclusion. Data, including BCTs, were extracted from these studies and analyzed descriptively. Due to the heterogeneity of interventions, chronic conditions, and outcome measures, a meta-analysis was not conducted. Social support (unspecified), graded tasks, generalization of target behavior, and credible source were the most commonly reported and most promising (i.e., present in 2+ studies evidencing significant effects) BCTs across all studies. These BCTs were found to be especially relevant to improving psychosocial outcomes in the short- and long-term and improving physical activity behaviors in the long-term. Meanwhile, to improve short-term physical activity behaviors, in addition to social support (unspecified), action planning, goal setting (behavior), and problem solving were found to be promising BCTs. The BCTs identified in this review may be relevant to incorporate when planning future interventions to support physical activity and psychosocial outcomes for children with chronic conditions.

Level of perceived social support, and associated factors, in combat-exposed (ex-)military personnel: a systematic review and meta-analysis.

Combat deployment increases exposure to potentially traumatic events. Perceived social support (PSS) may promote health and recovery from combat trauma. This systematic review and meta-analysis aimed to synthesize studies investigating the level of PSS and associated factors among (ex-)military personnel who served in the Iraq/Afghanistan conflicts. Five electronic databases were searched in August 2023 and searches were restricted to the beginning of the Iraq/Afghanistan conflicts in 2001. The search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A quality assessment was carried out, and a meta-analysis and narrative synthesis were performed. In total, 35 papers consisting of 19,073 participants were included. Of these, 31 studies were conducted in the United States (US) and 23 were cross-sectional. The pooled mean PSS score was 54.40 (95% CI: 51.78 to 57.01). Samples with probable post-traumatic stress disorder had a lower mean PSS score (44.40, 95% CI: 39.10 to 49.70). Approximately half of the included studies (n = 19) investigated mental health in relation to PSS, whilst only four explored physical health. The most frequently reported risk factors for low PSS included post-traumatic stress disorder, depression and anxiety, whilst post-traumatic growth and unit support were protective factors. Higher levels of PSS were generally associated with more positive psychosocial and mental health-related outcomes following deployment. PSS should be targeted in psychosocial interventions and education programmes. Future research should investigate PSS in (ex-)military personnel across other countries and cultures, based on the lack of studies that focused on PSS in countries outside of the US.

Healthcare communication satisfaction and psychosocial outcomes in adolescents and young adults with differences of sex development

ObjectivesWe examined: (1) healthcare communication satisfaction and psychosocial outcomes (resilience, QoL, and psychological adjustment) in adolescents and young adults (AYA) with differences of sex development (DSD), (2) differences in psychosocial outcomes between those who were highly satisfied and those who were less satisfied, and (3) group differences between adolescents (ages 12–17) and young adults (ages 18–26) regarding associations with healthcare communication and psychosocial outcomes. MethodsAYA with DSD across four study sites reported on satisfaction with healthcare communication and psychosocial outcomes. Analyses included descriptive statistics (aim 1), independent samples t-tests (aim 2), and Pearson’s correlations (aim 3). ResultsParticipants reported high levels of satisfaction with healthcare communication. Higher healthcare communication satisfaction was associated with greater resilience (p = .01), better QoL (p = .02), and fewer internalizing problems (p = .04). For adolescents, higher healthcare communication satisfaction was associated with better psychosocial outcomes (p values ranging from.01–.04). No significant associations were found in the young adult group. ConclusionsSatisfaction with healthcare communication is related to positive psychosocial outcomes in adolescents with DSD. Practice ImplicationsThese data underscore the importance of optimizing communication with families, engaging AYA in early and ongoing discussions about their care, and including psychosocial providers in DSD care.

Impact of Meditation Versus Exercise on Psychological Characteristics, Paranormal Experiences, and Beliefs: Randomized Trial

Background: Research indicates that meditation increases mindfulness and paranormal experiences of precognition, telepathy, clairvoyance, and synchronicities. There is limited knowledge about the prevalence or impact of these experiences on meditators and the general population. Aims: To compare self-reported well-being, mindfulness, connectedness, personality, paranormal experiences, beliefs, and performance on psi tasks in a meditation group versus an exercise control group. Method: This is a randomized trial that explored changes, including well-being, mindfulness, connectedness, psi, extraordinary experiences, beliefs, and ability to impact a random number generator in the participants, comparing a meditation vs. exercise control group. We collected data at baseline, “Mid” or halfway through the intervention (week 4), post 1, which is at the end of intervention (week 9), and post 2, which is two months post-intervention. Data was collected securely online with IRB approval. Results: Data from 72 participants (N=45 meditation/N=27 exercise) demonstrated improvement in some well-being measures (anxiety and general health). The study examined the effects of meditation versus exercise on various psychosocial measures and paranormal experiences. The meditation group displayed higher scores in openness and extroversion compared to the exercise group, which was unexpected and required further investigation. The meditation cohort also reported more paranormal experiences, with about half of them considering these experiences important or meaningful. However, the experiment exploring psychic abilities did not yield significant results. While the study had limitations, such as a predominantly non-diverse sample, it adds to the existing body of evidence linking meditation and exercise to positive psychosocial outcomes. Conclusions: The randomly selected meditation naïve cohort trained in brief structured meditation demonstrated increases over time in mindfulness, connectedness, extraversion, and paranormal experiences and beliefs compared to an exercise cohort. Performance on the psi tasks did not improve in either group over time, and these tasks may not be sensitive enough to detect significant changes.

Positive impacts of psychological pain treatments: Supplementary analyses of a randomized clinical trial.

Clinical trials often focus on symptom reduction as a primary outcome, overlooking positive psychology factors of potential importance although many individuals can and do live well with pain. The Patient-Reported Outcomes Measurement Information System (PROMIS) Psychosocial Illness Impact-Positive (PIIP) scale assesses perceptions of adaptive psychosocial functioning (e.g., coping and meaning-making) after illness onset. This study evaluated the effects of hypnosis (HYP), mindfulness meditation (MM), and pain psychoeducation (ED) on PIIP scores, using data from a completed randomized clinical trial (RCT) of complementary and integrative chronic pain interventions. We hypothesized that treatment effects on PIIP would mirror the RCT's primary pain intensity outcome, such that HYP and MM, relative to ED, would lead to greater improvements in PIIP during trial follow-up. Our sample included 262 Veterans who completed the PROMIS PIIP Short-Form 8a at pre- and posttreatment and at 3- and 6-month follow-up. Linear regression was used to test between-group differences in PIIP at each time point, controlling for baseline PIIP, average pain intensity, and baseline perceptions of prepain psychosocial functioning. There were no significant between-group differences in PIIP at posttreatment or 3-month follow-up. However, group differences emerged at 6-month follow-up: individuals randomized to MM and HYP showed improved PIIP relative to those randomized to ED. Positive psychosocial outcomes are a mostly untapped territory in clinical trials of pain interventions. The present work highlights the potential benefits of including positive psychology concepts in both research and clinical contexts, emphasizing the importance of understanding human flourishing in the presence of illness and disability. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The relationship between social media use and psychosocial outcomes in older adults: A systematic review.

Social isolation and loneliness are prevalent in older adults and are detrimental to physical and mental health. Social media use has been shown to be effective in maintaining social connections and improving older adults' psychosocial outcomes. This study aimed to systematically review and synthesize current research on this topic. Searches were conducted in November 2021 (and updated in October 2023) in PsycINFO, PubMed, and CINAHL. Inclusion criteria: (1) participants ≥ 65 years (mean, median, or minimum age) and (2) reported impact of social media use on psychosocial outcomes (including loneliness, depression, anxiety, social connectedness, wellbeing, life satisfaction, and quality of life). Quality appraisal tools were utilized, and results were synthesized using narrative synthesis. Sixty-four papers met inclusion criteria, including cross-sectional (n = 38), observational longitudinal (n = 6), interventional (n = 9), mixed-methods (n = 4), and qualitative (n = 7) studies. Participant numbers ranged from 6 to 16,925. While associations between social media use and positive psychosocial outcomes were generally reported in cross-sectional studies, the impact of social media use over time from longitudinal studies was mixed and inconclusive. While social media use is associated with positive psychosocial outcomes, casual conclusions cannot be drawn. Few longitudinal and randomized controlled trial studies existed, and these reported mixed findings. Large variations in study methodology including participants, measurement of social media use, and outcome measures contributed to the inconsistencies of findings. Addressing this heterogeneity through standardized approaches and more rigorous research may enhance understanding.

Life Satisfaction among Unaccompanied Refugee Minors: Associations with Traumatic Events and Daily Hassles

While there is a growing literature about mental health problems among unaccompanied asylum-seeking and refugee minors (URMs), far less is known about their wellbeing. Such information is important as a subjective sense of wellbeing is associated with a variety of positive health and psychosocial outcomes. The aim of this study was to examine life satisfaction and the association with traumatic events, daily hassles, and asylum status among URMs in Norway. We collected self-report questionnaire data from URMs living in Norway (n = 173, 90.80% male, 71.1% from Afghanistan). Mean age was 16.62 (SD = 1.74) years, and they reported clinically relevant post-traumatic stress symptoms. We explored variation in life satisfaction, URM-specific daily hassles and traumatic events. We also investigated a mediation model, in which we assumed that daily hassles mediated the association between traumatic events and life satisfaction. The participants reported low life satisfaction (M = 4.28, SD = 2.90, 0–10 scale). A negative outcome of the asylum process and URM-specific daily hassles were associated with reduced life satisfaction. URM-specific daily hassles accounted for the relation between traumatic events and life satisfaction. The youth had been exposed to several traumatic events yet the effect of these on life satisfaction appeared indirect, via an increase in URM-specific daily hassles. Reducing the number of, or help URM cope with, URM-specific daily hassles may increase their life satisfaction.

Piloting building early sentences therapy for pre-school children with low language abilities: An examination of efficacy and the role of sign as an active ingredient.

Early intervention is recommended for pre-school children with low language. However, few robustly evaluated language interventions for young children exist. Furthermore, in many interventions the theoretical underpinnings are underspecified and the 'active ingredients' of the interventions not tested. This paper presents a quasi-experimental study to test the efficacy and examine the active ingredients of Building Early Sentences Therapy (BEST): an intervention based on usage-based theory designed to support young children to understand and produce two-, three- and four-clause element sentences. BEST manipulates the input children hear to support them to harness the cognitive mechanisms hypothesized in usage-based theories to promote the development of abstract linguistic representations. One such input manipulation is the use of signing alongside verbal input signalling both content and morphology of target sentences. To examine whether (1) BEST is more efficacious than treatment as usual (TAU); and (2) signing of content and morphology is an active ingredient of the intervention. A quasi-experimental study recruited children aged 3;5-4;5 years from 13 schools. Schools were assigned to receive either BEST with sign, BEST without sign or TAU. The TAU group received their usual classroom provision. Across arms schools were matched with respect to classroom oral language environment and indices of deprivation. Participants were 48 children (28 boys) with expressive and/or receptive language abilities ≤ 16th centile measured using the New Reynell Developmental Language Scales (NRDLS). Outcomes gathered by researchers blind to treatment arm were NRDLS production and comprehension standard scores and measures of production of targeted sentence structures. Primary outcomes indicate that BEST with sign was significantly more efficacious than TAU with respect to NRDLS production standard score, but not comprehension. The advantage for production was maintained at follow-up. BEST without sign was significantly more efficacious than TAU on measures of targeted vocabulary, sentence structure and morphology. The results from this quasi-experimental study provide evidence for the efficacy of a usage-based intervention on expressive language outcomes for preschool children with low language abilities. There is also evidence to support the inclusion of sign as an active ingredient, and so efforts to train interventionists in its use are worthwhile. Patterns of findings across outcomes suggest signing of content and morphology may support the development of abstract linguistic representations and accelerate language learning. Given these positive results and the scale of this study, a fully powered randomized controlled trial is warranted. What is already known on the subject Robust language skills are crucial for positive social, emotional, academic and economic outcomes across the lifespan. There is a paucity of robustly evaluated interventions for preschool children with language difficulties. The development of such interventions is crucial for ameliorating language difficulties and promoting positive educational and psychosocial outcomes. What this study adds to the existing knowledge This paper evaluates BEST, a novel usage-based language intervention targeting children with language difficulties in the early years. Findings indicate that a usage-based intervention is efficacious for treating language difficulties. In particular, BEST benefited expressive language development, bringing benefits to both treated and untreated language structures and improving standard scores. The role of sign as an active ingredient is also supported. Further evaluation is warranted. What are the practical and clinical implications of this work? Findings suggest that BEST may be effective for targeting children who have been identified as having language difficulties. In particular, expressive language may be improved when the intervention is delivered as it was originally manualized, including a signing system to represent content and grammatical morphology. More broadly, these findings also provide preliminary evidence that the use of a signing system does not hinder oral language development in children with language difficulties and may conversely support their expressive language. Future research exploring the role and underpinning mechanisms of sign in language intervention is warranted.

Protective factors for psychosocial outcomes following cumulative childhood adversity: systematic review.

The long-term cumulative impact of exposure to childhood adversity is well documented. There is an increasing body of literature examining protective factors following childhood adversity. However, no known reviews have summarised studies examining protective factors for broad psychosocial outcomes following childhood adversity. To summarise the current evidence from longitudinal studies of protective factors for adult psychosocial outcomes following cumulative exposure to childhood adversity. We conducted a formal systematic review of studies that were longitudinal; were published in a peer-reviewed journal; examined social, environmental or psychological factors that were measured following a cumulative measure of childhood adversity; and resulted in more positive adult psychosocial outcomes. A total of 28 studies from 23 cohorts were included. Because of significant heterogeneity and conceptual differences in the final sample of articles, a meta-analysis was not conducted. The narrative review identified that social support is a protective factor specifically for mental health outcomes following childhood adversity. Findings also suggest that aspects of education are protective factors to adult socioeconomic, mental health and social outcomes following childhood adversity. Personality factors were protective for a variety of outcomes, particularly mental health. The personality factors were too various to summarise into meaningful combined effects. Overall GRADE quality assessments were low and very low, although these scores mostly reflect that all observational studies are low quality by default. These findings support strategies that improve connection and access to education following childhood adversity exposure. Further research is needed for the roles of personality and dispositional factors, romantic relationship factors and the combined influences of multiple protective factors.

Self-directed online learning in support of students’ mental health to promote positive psychosocial outcomes in public schools

Negative mental health among students is currently categorized as a global crisis, and those at both ends of the academic achievements are considered at greatest risk. Public schooling, reproducing accepted psychosocial beliefs through standardized learning, has traditionally evolved independently of the imperative to address student mental health. Unlike standardized learning, self-directed learning in public schools aims to establish relevant support structures for student mental health, thereby promoting positive psychosocial outcomes. The detachment of public schooling from mental health and self-directed learning was first acknowledged – and lamented – by John Dewey over 100 years ago, who anticipated the ubiquity of the present-day mental health crisis. However, as a response to the challenges posed by COVID-19 restrictions, self-directed learning became an acknowledged learning method in public schools, potentially able to be regularly accommodated by them in support of mental health through the use of online technology. This review investigates the results of self-directed online learning in public schools during the COVID-19 pandemic through a Google Scholar search of peer-reviewed studies on self-directed learning, online learning, mental health, and public schools during COVID-19. The findings suggest that, for self-directed online learning to continue and positively impact public school students’ mental health post-COVID-19, it should be embraced without bias, supported by stable internet connections, and self-initiated with relaxed parental expectations regarding standardized learning.

Impact of patient age on the functional and psychosocial outcomes of orthognathic treatment

Orthognathic treatment has been demonstrated to enhance oral function and quality of life. In the UK, prior approval criteria have been trialled to govern the provision of orthognathic surgery within the National Health Service (NHS). These include the patient’s age and presence of functional concerns. The purpose of this paper was to examine the outcomes of orthognathic treatment with respect to patient age at the start of treatment. This was a retrospective evaluation of a single surgeon’s experience of patients treated for dentofacial deformity over a 17-year period. A total of 118 patients completed pre-treatment and post-treatment questionnaires. There were significant improvements (p < 0.001) in reported functional problems, and in Body Satisfaction Scale (BSS), General Health Questionnaire (GHQ-12), and in Anxiety questionnaire scores. There was no difference in outcome when younger and older patients were compared. Orthognathic treatment produced positive functional and psychosocial outcomes irrespective of the patient’s age at the start of treatment.

Should I Stay or Should I Go? Examining Persistence Factors Among Rural First-Year Community College Students

ABSTRACT College completion is an important focus for policy and practice and is impacted by student academic and non-academic factors. Participation in non-classroom activities is well documented to extend positive intellectual, social, and psychosocial outcomes associated with college completion, yet this association is understudied for community college students. The purpose of this study was to determine whether rural community college full-time first-year students who participate in non-classroom activities differ from nonparticipants. An adapted form of the College Persistence Questionnaire Version 2 (CPQ-V2) was utilized to examine five factors previously demonstrated to influence student persistence including academic integration, social integration, degree commitment, collegiate stress, and institutional commitment. The CPQ-V2 was administered using an electronic instrument during the Fall 2021 semester wherein respondents provided details about their pre-college background and involvement in non-classroom activities. Data analysis consisted of the chi-square test of independence and one-way ANOVA to identify significant associations or relationships between variables. Results demonstrated variation among student groups in non-classroom involvement and the outcomes correlated to such involvement. The findings offer insights for community colleges considering supports to increase persistence (and completion) through student engagement and recommendations for monitoring the effectiveness of non-classroom opportunities to meet residential and nonresidential students’ needs.

Scoping Review of Self-Directed Online Learning, Public School Students’ Mental Health, and COVID-19 in Noting Positive Psychosocial Outcomes with Self-Initiated Learning

During COVID-19, self-directed learning, contrasted with standardized learning, became a necessary and promoted learning method in public schools—one potentially supportive of mental health regularly in public schools through the use of online learning. This is important because negative mental health has been classified as a global crisis, with the highest and lowest student achievers recognized as at greatest risk. Therefore, the conditions under which public school students’ mental health has been improved, leading to positive psychosocial outcomes, are relevant. Studies have identified that positive psychosocial outcomes in this regard require self-initiation of students’ self-directed learning. Also necessary is a reduction in the standardized expectations of parents to lead to positive psychosocial outcomes. Unknown is what research identifies the relevance of both self-initiated self-directed online learning and a reduction in parental expectations of standardization. To investigate this, self-directed learning, online learning, mental health, public schools, and COVID-19 were keywords searched following PRISMA guidelines for scoping reviews. The result: few returns considered either factor and those that did reinforce the need for both. The conclusion: self-initiated self-directed online learning supported by public schools and parents should be central in the aim of reducing the mental health crisis in students post COVID-19.

Are international students relatively resilient? Comparing international and domestic students’ levels of self-compassion, mental health and wellbeing

ABSTRACT Because international students encounter unique stressors in addition to those experienced by all higher education students they are often assumed to be at heightened risk for experiencing mental health difficulties. However, empirical studies have consistently found that international students report comparable or lower rates of depression and anxiety than their domestic counterparts. The present study investigates one possible explanation for these unexpected results: are international students relatively resilient? More particularly, we investigate self-compassion (SC) – an emotion-regulation strategy known to buffer the impact of stressors on mental health. While SC has been associated with positive psycho-social outcomes in the higher education context, existing studies have not disaggregated international and domestic students. The present study addresses that gap by comparing the levels and estimating the effects of SC among international and domestic students. Analyses found that international students on average reported significantly higher SC than their domestic counterparts. Without the protection afforded by those higher levels of SC, we estimated that international students would report higher psychological distress and lower psychological wellbeing than domestic students. Implications for fostering and supporting the mental health and wellbeing of all higher education students are discussed.

Associations between older adults' social media use behaviors and psychosocial well-being.

Research examining associations between social media use behaviors and psychosocial well-being among older adults are limited. To explore associations between older adults' social media (social networking services and instant messaging applications) use behaviors and psychosocial well-being. This was a secondary data analysis. All data were retrieved from the Taiwan Communication Survey database, an annual survey that examines trends in Taiwanese residents' communication behaviors and social media use. The original investigation was conducted in Taiwan from September to December 2019. Data from 647 older adults aged over 60 years were extracted for the analyses. Social media use behaviors (users/non-users and time spent using), positive psychosocial outcomes (life satisfaction, self-determination, subjective well-being, and happiness), negative psychosocial outcomes (loneliness, depression, and anxiety), and demographic variables were included. Social media users had significantly higher levels of subjective well-being and lower levels of depression, anxiety, and loneliness compared with non-users. Time spent on social networking services was significantly and positively correlated with negative psychosocial outcomes (β = 0.103, p = 0.044, f2 = 0.011), and it was significantly and inversely correlated with positive psychosocial outcomes (β = -0.063, p = 0.049, f2 = 0.004). Time spent using an instant messaging application was significantly positively associated with positive psychosocial outcomes (β = 0.068, p = 0.031, f2 = 0.005). The proposed path model had an acceptable model fit. Study results indicated that older adults' social media use behaviors were associated with their psychosocial well-being. Older adults are recommended to use social media for appropriate time periods as an important way to promote social engagement for their psychosocial well-being.

“It’s a big trauma for the family”: A qualitative insight into the psychological trauma of paediatric burns from the perspective of mothers

BackgroundDespite the medical and surgical improvements of paediatric burn injuries, burn injuries can be a painful and traumatic experience for the child and their family. It is therefore important to explore the experiences of caregivers who support their child throughout the burn journey. Thus, the purpose of this study was to explore the traumatic nature of paediatric burns on the family from a caregiver’s perspective. MethodsThis study used a descriptive qualitative approach to conduct online semi-structured interviews with caregivers (18 years and older) of children (aged four to 17 years) that had previously been admitted with an unintentional acute burn injury to a paediatric burns unit in Western Australia. Interviews explored the child’s and caregiver’s experiences throughout the burn journey from the perspective of the caregiver and were digitally recorded and transcribed verbatim. Transcripts were analysed using Braun and Clarke’s six stages of reflexive thematic analysis. ResultsEleven mothers participated in the interviews and identified a range of poor psychological and psychosocial outcomes that themselves and their child experienced. Three overarching themes were elaborated from the interviews: Child and caregiver mental health difficulties during and after the burn (including medical trauma, mental health outcomes and caregiver guilt); Lifestyle and physical changes following the burn (including disruptions to routine, appearance concerns and puberty); and factors supporting or inhibiting the recovery journey (including personality factors, coping strategies, family dynamics and support). Final considerationsThis study has presented the difficulties that children, young people, and their family face throughout a paediatric burn injury, which makes the implementation of timely and effective family centred interventions imperative. Meeting the needs and supporting these families with their mental health throughout this traumatic recovery journey, can ensure positive psychosocial outcomes and adaptive coping strategies are adopted early on.

Disclosing the obvious: Psychosocial implications of (not) explaining facial differences

Although the disclosure of invisible stigmatized identities has been frequently researched, little work has examined disclosure of facial differences (FD), in which stigma is often highly visible. People with FD are frequently expected by others to disclose or explain their condition. Qualitative work indicates that people with FD have a range of disclosure approaches from agentic disclosure (feeling obliged to disclose), autonomous nondisclosure (choosing not to disclose or to disclose only to certain people), and autonomous disclosure (choosing to openly disclose). The purpose of the present study was to validate these disclosure approaches in a large international sample, examine their frequency of use, and test their relationship to psychosocial outcomes using validated measures. English-speaking participants (n = 288) with 33 different types of FD completed an online survey of disclosure approaches and psychosocial outcomes (i.e. anxiety, depression, self-esteem, stigma, job satisfaction, and relationship self-concept). Participants disclosed to 59 % of the people they knew. Selective and indiscriminate disclosure were the most frequently used and recommended approaches. As predicted, autonomous disclosure was associated with more positive psychosocial outcomes than agentic (non)disclosure and autonomous nondisclosure. Findings from this study can support disclosure autonomy, and thus positive psychosocial outcomes, among people with FD.

Resilience to Maltreatment in Early Adulthood Does Not Predict Low Allostatic Load at Midlife.

Although childhood maltreatment is associated with a host of poor health and social outcomes in adulthood, many individuals manifest resilience. We tested competing predictions about whether achieving positive psychosocial outcomes in young adulthood would be differentially predictive of allostatic load at midlife for those with and without a childhood history of maltreatment. The sample included 808 individuals, 57% of whom had court-documented records of childhood abuse or neglect between 1967 and 1971, and demographically matched controls without those histories. Participants provided information on socioeconomic, mental health, and behavioral outcomes in interviews conducted between 1989 and 1995 (mean age = 29.2 years). Indicators of allostatic load were measured between 2003 and 2005 (mean age = 41.2 years). The relationship between positive life outcomes in young adulthood and allostatic load in middle adulthood varied depending on childhood maltreatment status (b = .16, 95% CI: .03; .28); for adults who did not experience childhood maltreatment, more positive life outcomes predicted lower allostatic load (b = -.12, 95% CI: -.23; -.01), whereas the relationship was not significant for adults with a childhood history of maltreatment (b = .04, 95% CI: -.06; .13). There were no differences in the results predicting allostatic load for African-American and White respondents. Childhood maltreatment may have enduring effects on physiological functioning that are manifest in elevated allostatic load scores in middle age. Alternatively, resilience to maltreatment-as manifest in positive functioning in socioeconomic and behavioral domains-may not be sufficiently stable over adulthood to buffer individuals from the physiological consequences of stressful environments.

Single Room Maternity Care Versus Traditional Maternity Care: A Cross-Sectional Study Examining Differences in Mothers' Perceptions of Readiness for Discharge and Satisfaction and Health Outcomes.

Single room maternity care (SRMC) includes all aspects of the birth process (labour, delivery, postpartum) in a single room with a consistent team of healthcare providers. Traditional maternity care (TMC) involves having mothers labouring and delivering their baby in one room and then transferring to a room on another unit, which also means a transition in providers. Although many hospitals have transitioned to SRMC, there has been limited evidence to support their development. This study was conducted in two large hospitals (one offering SRMC, the other TMC) in Western Canada. A cross-sectional between-subjects design was used to compare differences between SRMC and TMC. New mothers were asked to complete validated questionnaires. Health information was collected from administrative and health databases. The main outcomes included readiness for hospital discharge, mothers' satisfaction, newborn length of stay, and mother length of stay. Several covariates were examined. In total, 506 (292 SRMC; 214 TMC) mothers participated. Readiness for discharge and maternal satisfaction were significantly higher in SRMC. Although newborn and mother length of stay were significantly reduced in SRMC compared to TMC for univariate tests, mother length of stay was not significantly different when adjusting for other variables. There are positive health and psychosocial outcomes for mothers and newborns in the SRMC model of care compared to TMC. Since readiness for discharge and satisfaction are associated with positive maternal-infant interactions and transitions to community, SRMC could be the better approach. Further research should examine healthcare provider outcomes and implementation costs.

Effectiveness of Trauma-Focused Cognitive Behavioral Therapy Among Maltreated Children: A Meta-Analysis

Objectives: To assess the effects of trauma-focused cognitive behavioral therapy (TF-CBT) among maltreated children, and to examine the role of potential moderators. Methods: A search of eight databases was conducted. Eighteen studies involving 11 randomized and quasi-randomized controlled trials with 965 maltreated children were included, and the effect sizes were pooled using random-effect models. Results: There were large effect sizes for posttraumatic growth and emotional management. Moderate to large effects were evident for PTSD and depression, while small effects were found for anxiety, internalizing behavior, sexualized behavior, and parenting practice. Effects were maintained at 3–12 months for some outcome domains. The effectiveness of TF-CBT was better when delivered to older children, and versions of TF-CBT, delivery format, sessions, and treatment length will not affect effectiveness. Conclusions: TF-CBT effectively reduces abuse-related symptoms and improves positive psychosocial outcomes among maltreated children.