Parental Separation Research Articles

A comparison of midazolam, dexmedetomidine 2µg/kg and dexmedetomidine 4µg/kg as oral premedication in children, a randomized double-blinded clinical triall

Background: The objective of this study was to analyze an oral administration of midazolam with two different doses of dexmedetomidine for premedication in paediatric patients. Methods: A prospective, randomized, double blind study. Three hundred patients, aged 1-7 years, undergoing elective surgery under general anesthesia were recruited for the study. Patients were randomized into three groups to receive oral midazolam 0.5mg/kg (group M), oral dexmedetomidine 2 µg/kg (group D2) and oral dexmedetomidine 4 µg/kg (group D4) for premedication. An observer blinded to the patient group allocation assessed level of sedation at 30 minutes after giving the premedication, ease of parental separation was assessed while shifting the patients to the operating room, mask acceptance during induction and postoperative agitation scores in post anesthesia care unit. Results: The sedation score of group D4 was significantly higher than group D2 and group M [ group D4- 4 (4,3), group D2- 2(2,2) and group M -2(3,2), H statistics = 80.4718, p < 0.00001]. The parental separation score, mask acceptance score and postoperative was also significantly better for group D4 compared to the other two group. Conclusion: These results suggest that oral dexmedetomidine 4 µg/kg is more effective than oral midazolam 0.5mg/kg and oral dexmedetomidine 2 µg/kg for premedication in children.

Heterogeneity in effects of parent-child separation on young-adult substance use disorder.

A large body of literature suggests that parent-child separation predicts child maladjustment. However, further advancement in methodology is needed to account for heterogeneity in types of separation. Additionally, given a lack of research examining different types of separation as predictors of offspring substance use, further research into this topic is warranted. The present study tested the relation between parent-child separation and young-adult substance use disorder (SUD), capturing heterogeneity in these effects based on group differences and measurement of separation. In a sample of 427 young adults from a larger longitudinal study oversampled for parental alcohol use disorder (AUD), effects of number and type of separations on SUD diagnosis were tested. Further, we explored whether these associations were moderated by gender, ethnicity, or parental AUD. Two underlying types of separation were found: parental health-related separation (i.e., parental death, hospitalization) and nonhealth-related separation (i.e., divorce, arrest). A higher sum of separations and greater nonhealth-related separation predicted higher odds of SUD. Greater health-related separation predicted lower odds of SUD. However, these effects were qualified by interactions with ethnicity and parental AUD. Although the vast majority of studies measure cumulative parent-child separation with sum scores, the present study demonstrates that measuring underlying "types" of cumulative separation also reveals important effects. Moreover, childhood separation is a significant risk factor for SUD. Future research on separation should implement methods to capture separation types and further account for potential effects of selection into separation types. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Abstract No.: ABS2768: Comparison of pre-emptive ketamine nebulisation with intravenous ketamine for post-operative analgesia in children undergoing tonsillectomy: A randomised controlled trial

Background and Aims:Nebulised ketamine is a painless route of drug administration in children.This study aimed to compare the effectiveness of ketamine nebulisation as opposed to intravenous ketamine as premedication in childrenMethods:64 children aged 5-10 years, undergoing tonsillectomy were randomly allocated into 2 groups.Both groups received glycopyrrolate 5mcg/kg. First group received ketamine nebulisation (1mg/kg) 20minutes prior to the surgery and other group received intravenous ketamine (1mg/kg) just before shifting to operating room. Children were anaesthetised by standard technique using fentanyl 1 µg/kg, propofol 2mg/kg, atracurium 0.5mg/kg and sevoflurane. Postoperatively, pain score using verbal rating scale(VRS) was assessed immediately after shifting to post anaesthesia care unit (PACU)and after one hour and the time of first rescue analgesic requirement was noted. Children were also assessed for parental separation scores and levels of sedation using 5-point sedation scale preoperatively.Results:There was no difference in VRS pain score immediately after shifting to PACU but there was significant difference in the VRS pain score at one hour postoperatively (p<0.05).The mean time for rescue analgesia was significantly prolonged in ketamine nebulisation group (300±26.40min) in contrast to intravenous ketamine group (237.19±34.38min) (p<0.05). Nebulised and intravenous ketamine produced similar levels of sedation (score-2) and acceptable parental separation scores (score1,2) (table 1).Conclusion:Ketamine nebulisation (1mg/kg) administered before tonsillectomy significantly prolonged postoperative analgesia as opposed to intravenous ketamine with similar parental separation scores and sedation scores. Hence nebulisation can be used as an alternative route for administering ketamine.

Abstract No. : ABS0107 : Ultrasound guided lower thoracic erector spinae plane block for postoperative analgesia following gynaecologic oncology surgery - A randomised controlled trial

Background and Aims:Erector spinae plane (ESP) block is a relatively novel block which provides local and visceral analgesia for abdominal surgery. The present study is aimed to assess the efficacy of ESP block for postoperative analgesia following major open gynaecologic oncology surgery.Methods:Sixty female patients posted for elective open gynaecologic oncology surgeries were enroled in this prospective, double blind study and randomised to B and C group. Group B patients received general anaesthesia plus ultrasound guided bilateral ESP block at T9 level at the end of surgery while group C patients received general anaesthesia only. Primary outcome was postoperative visual analogue scale (VAS) scores. Secondary outcomes were time to first rescue analgesic, 24 hours tramadol consumption, and side effects. Chi square and student t tests were used and P < 0.05 was considered significant.Results:Postoperative pain scores were lower in B group compared to C group at rest and on movement . Time to first rescue analgesic was prolonged in B group (8.10 ± 1.48 hours) as compared to C group (0.7 ± 0.38 hours) [P < 0.0001]. Total 24 hours tramadol consumption was less in B group (68 ± 48.55 mg) than C group (210 ± 52.65 mg)(table 1) [P < 0.0001].Conclusion:Ultrasound guided ESP block with general anaesthesia provides superior postoperative analgesia compared to general anaesthesia alone following major gynaecologic oncology surgeries without any side effects. It can be used as an alternative to epidural analgesia.Table 1Comparison of variables in different routes of ketamine administrationVariableGroup intravenous-ketamineGroup nebulised-ketamine P Age mean (years)7.56±1.277.41±1.14>0.05Weight mean (kg)25.34±4.7125.09±2.97>0.05Parental Separation scores (median)11>0.05Sedation (median) 5-point sedation score22>0.05Verbal rating scale pain score (median) Immediate00>0.05 1 h- post-operatively210.04Time for 1st rescue analgesic (min)237.19±34.38 min300±26.396 minP<0.001

Effects of family disintegration on children later depression

Studies examining the effects of marital dissolution on children's welfare have repeatedly found that children of separated parents perform worse on several well-being parameters than those from intact households. Depression is highly represented in the health care system among children and older offspring of divorced parents. This study utilizes the double ABCX model to examine the relationship between divorce and depression. The goal of the study was to see if divorce is a sound predictor of depression. Divorce was shown to only explain a modest portion of the variation in depression (r^2= .04). This level of variation suggests that other than divorce, various additional variables have a role in depression. The study closes with the indication that if additional moderating variables such as the child's maturity and availability of household resources before and after dissolution were encompassed in the analysis, divorce would become a stronger risk factor for depression. Family disharmony may be linked to a higher incidence of severe depressive illness in children of divorced parents.

Evolution of Emergency Department Characteristics in Child and Adolescent Psychiatry: A Retrospective Review over Two Decades

Evolution of Emergency Department Characteristics in Child and Adolescent Psychiatry: A Retrospective Review over Two Decades Abstract. Objective: Emergency inpatient admissions to child and adolescent psychiatric hospitals because of a mental health crisis represent a substantial proportion of all inpatient admissions and have increased substantially over time. This study examines changes in the characteristics of this patient group at a university care clinic over two decades. Method: We evaluated the emergency admissions from 1996, 2002, 2008, and 2014 of the Child and Adolescent Psychiatry Clinic in Tübingen retrospectively using sociodemographic data, psychosocial circumstances, and diagnoses. Results: We evaluated a total of N = 403 emergency admissions. The emergency admissions in the periods mentioned increased by 405 %. Especially patients from families with separated parents and with multiple diagnoses increased over time. Conclusions: From 1996 to 2014, there was a significant increase in emergency admissions. The results also indicate that more complex disease situations and less favorable psychosocial conditions are occurring. The findings underscore the need to improve the clinical care of children and adolescents during acute mental health crises and work toward their prevention. There is also a need to focus broad societal discussion on improving overall mental health during childhood development. There is an urgent need for prospective studies to identify the factors leading to the increase in emergency admissions among children and adolescents.

A comparative study of intranasal dexmedetomidine and intranasal midazolam for premedication - A prospective randomized double-blind study in children posted for tonsillectomy

Preanesthetic medication in paediatric patients is well known to be a challenge for anaesthesiologists. Premedication in paediatric population helps to produce a relaxed state with reduced anxiety and increased compliance as well as to ease separation from parent and allowing the patient to tolerate and co-operate with the necessary procedure. Our aim is to do a comparation of dexmedetomidine and midazolam given via intranasal route in children posted for tonsillectomy as premedication.This study was conducted in 100 patients of 6 to 12 years posted for tonsillectomy. Patients were randomly allocated into Group M and D. Patient in group M (50) received 0.2mg/kg of midazolam administered intranasally as nasal drop using 1ml insulin syringe and similarly group D (50) received 1µg/kg of dexmedetomidine administered intranasally as nasal drops using 1ml insulin syringe. Sedation score, Anxiolysis score, mask induction score, post-operative agitation score was assessed.Satisfactory sedation was achieved by 86% and 68% of patient in dexmedetomidine and midazolam respectively p (0.03). Satisfactory mask induction was achieved by 84% and 70% of patient in dexmedetomidine and midazolam respectively p (0.09). In terms of post op agitation score there is no difference in both the group p (0.30). During the time between administration of pre op drugs and initiation of anaesthesia, no patient seems to develop hypotension, hypoxia or any other life-threatening complicationIn our study we concluded that in terms of decreasing anxiety at parental separation both dexmedetomidine and midazolam were found to be equally effective. However, Intranasal dexmedetomidine produced superior sedation scores at separation and induction compared to oral midazolam in paediatric patients.

Exploring the intersection of adverse childhood experiences, pediatric chronic pain, and rheumatic disease

BackgroundWhile the general relationship between ACEs and the development of chronic pain has become increasingly clear, how ACEs may shape a child’s clinical presentation with regards to chronic pain has yet to be fully expounded. We aimed to determine the association between ACEs and clinical manifestations of pediatric chronic pain and explore the interaction of ACEs and pediatric rheumatic disease among youth with chronic pain on health-related outcomes.MethodsWe conducted a cross-sectional cohort study of patients aged ≤18 years with chronic pain seen in a pediatric rheumatology amplified pain clinic between August 2018 and July 2020. We stratified subjects into three groups: no ACEs, one ACE, and ≥ 2 ACEs. We assessed clinical signs and symptoms associated with the presence of ACEs using Chi-square or Wilcoxon-rank test. The association between ACEs as well as other variables of interest with functional impairment was tested using simple and multivariable linear regression.ResultsOf the 412 patients included, more than 75% of patients reported at least one ACE. Most frequent included history of mental illness in a first degree relative (56%) and parental divorce or separation (20%). Those with ≥2 ACEs had more somatic symptoms, worse functional disability, and a higher proportion of mental health conditions. There appeared to be a dose dependent interaction between ACEs and functional disability from co-morbid rheumatologic disease. In multivariable regression, higher verbal pain score, symptom severity score (SSS), and presence of autonomic changes were associated with estimated average increase in FDI score (β = 1.05, 1.95 and 4.76 respectively; all p < 0.01).ConclusionChildren with chronic pain and/or rheumatologic diseases who are exposed to ACEs are at increased risk of greater symptomatology, functional disability, and somatization of symptoms. Our findings indicate an ongoing need for systemic evaluation of ACEs in children with chronic pain and/or rheumatic disease and incorporation of trauma-based care.

High precision 26Al-26Mg chronology of chondrules in unequilibrated ordinary chondrites: Evidence for restricted formation ages

Chondrules in ordinary chondrites are considered to form in high density environments, likely related to the evolution of protoplanets and large planetesimals. In order to determine the timing of their formation at high time resolution (≤0.1 Ma), we conducted high precision Al-Mg chronology of 17 porphyritic chondrules from 6 different unequilibrated ordinary chondrites (UOCs) of low petrologic subtypes (3.00–3.05). Detailed petrology, mineralogy, and oxygen isotope ratios of individual chondrules were also obtained that include 10 additional chondrules without Al-Mg ages. Seventeen chondrules for Al-Mg chronology consist of 14 chondrules with plagioclase (An1-An87) and three chondrules with Na-rich glassy mesostasis, all of which have high 27Al/24Mg ratios (30–3000). The inferred initial (26Al/27Al)0 ratios range between (6.5 ± 0.6) × 10–6 to (9.5 ± 1.0) × 10–6, corresponding to chondrule formation ages of 1.74 ± 0.12/0.11 Ma to 2.13 ± 0.09 Ma after CAIs, which have a canonical (26Al/27Al)0 ratio of 5.25 × 10–5. Six albite-bearing chondrules (An<30) show a much more restricted ages range, spanning between 2.00 ± 0.11/0.10 Ma and 2.07 ± 0.11/0.10 Ma. Including 14 anorthite-bearing chondrules studied previously, chondrules in ordinary chondrites have a restricted range of formation ages from 1.8 Ma to 2.2. Ma after CAIs.Based on the newly acquired oxygen isotope data and previous high precision studies, chondrules in L and LL chondrites do not show systematic difference in their δ18O and δ17O signatures. Majority of plagioclase-bearing chondrules studied for Al-Mg chronology show similar oxygen isotope ratios to those of glass-bearing chondrules. There is no obvious difference in Al-Mg ages of chondrules between L and LL chondrites. Thus, chondrules in L and LL chondrites would have formed in common environments and processes, though they accreted to two separate parent bodies by 2.2 Ma after CAIs, which timing is consistent with the proposed thermal model for ordinary chondrite parent bodies. Onset of chondrule formation at 1.8 Ma after CAIs may be caused by the delay of Jupiter formation or the formation of protoplanets in ordinary chondrite chondrule forming regions if chondrules formed by large scale disk shock or impact jetting of protoplanets. Alternatively, early formed chondrules would not be preserved before 1.8 Ma if chondrules formed by the impacts of molten planetesimals.

The relation of childhood adversity and antisociality to suicide attempts in men admitted to forensic psychiatric hospital.

Suicide is a leading cause of death in custody. Although previous studies with prison inmates suggest a strong relation between childhood adversity and suicidal behavior, as well as between childhood adversity and antisociality, this has not been explored in the forensic psychiatric system. We compared 211 men admitted to a forensic hospital having a lifetime history of suicide attempts with 275 men with no suicide history in the same institution. Data were retrospectively coded from information gathered during their assessment and medical records. We examined associations of adverse childhood events and antisociality with suicide attempt history in a series of regression analyses. Childhood adversity was present in majority of individuals and significantly more common for individuals with a history of suicide attempts (76.8%) than those with no suicide attempts (63.3%). The suicide attempt group also experienced a greater number of adverse childhood events. Physical abuse, parental separation, and parental psychiatric history during childhood were associated with suicide attempts. Men with a suicide attempt history had higher antisociality scores than the comparison group and adult antisocial behavior partially mediated the relationship between adverse childhood experiences and suicide attempts. Men in forensic hospital who have suffered multiple experiences of childhood adversity are at increased risk for exhibiting antisocial behavior and engaging in suicidal attempts. Early interventions targeted toward antisociality and trauma-informed care in the forensic hospital are needed to support the mental health of the forensic population.

Comparative evaluation of intranasal midazolam, dexmedetomidine, ketamine for their sedative effect and to facilitate venous cannulation in pediatric patients: A prospective randomized study

ABSTRACT Background Sedative premedication has a great role to overcome fear and anxiety and to facilitate easy separation of children from their parents. The current study was designed to compare the effectiveness of intranasal midazolam, dexmedetomidine, and ketamine as sedatives to facilitate the intravenous cannulation before surgery in children. Methods The patients were classified into three groups. M group (midazolam), D group (dexmedetomidine), and K group (ketamine), each group received the intranasal drug 30 min before the procedure. The degree of sedation was documented using Modified Observer’s Assessment of Alertness/Sedation scale (MOAA/S) at baseline and every 10 min till induction of anesthesia. The onset of sedation was documented when reaching MOAA/S of 5. Easiness of venipuncture and the degree of anxiety during parental separation were recorded using 4-point scales (Venipuncture score and Parental Separation Anxiety Scale, respectively). Results The cannula insertion was tolerated in the three groups, but the percent of patients in group D showed better conditions for cannula insertion as scored in venipuncture score. Group D showed better sedation level in MOAA/S. The time taken to reach MOAA/S of 4 (venipuncture time) was less in group D. Conclusion The study showed that using intranasal midazolam, dexmedetomidine, and ketamine facilitates the cannula insertion at the preoperative period, and they are safe and easy methods for sedation. The three drugs provided a satisfactory child–parent separation. However, intranasal dexmedetomidine provides statistically significant better conditions facilitating cannula insertion.

Review of the book Implementation of the principle of the best interests of the child in mediation in matters concerning the exercise of parental authority and contacts, edited by Joanna Mucha

The monograph Implementation of the principle of the best interests of the child in mediation in matters concerning the exercise of parental authority and contacts, edited by Joanna Mucha is based on the thesis that in court proceedings in matters relating to a child and mediation in matters concerning the exercise of parental rights and contact with a child, the primary value to be protected should be the best interests of the child. The analysis and research allowed the researchers to determine the extent to which the applicable regulations and mediation practice implement this principle and what instruments adopted in legal regulations and used in mediation serve to respect it. The authors emphasised that in many acts of international law and the provision of Art. 72 of the Constitution of the Republic of Poland, the order to protect the best interests of the child is a fundamental and overriding principle of the Polish system of family law. All regulations in the sphere of relations between parents and children are subordinated to this principle. It signifies the primacy of the child’s best interests over the interests of other people, especially parents, and is the purpose of exercising parental authority and contacts. This analysis was supplemented with positions based on other legal systems – Ukraine and Italy. In both cases, the importance of the best interests of the child was confirmed in the procedures for resolving conflicts related to the separation of parents.

The Effects of Distraction on Preoperative Anxiety in Preschool and School-Age Children: A Literature Review

Children experience high levels of anxiety before surgery. Preoperative anxiety interferes with anesthesia induction compliance and is associated with many short and long-term postoperative complications The aim of this integrative review was to evaluate the impact of distraction methods on preoperative anxiety in preschool and school-age children compared to standard of care or conventional methods. A systematic search of literature was conducted using PubMed and CINHAL databases. We found 15 full-text articles in English published, between the years 2015-2019 on preschool and school-age children on PubMed, CINHAL, and keyword search according to inclusion criteria. The tools used to measure the children’s anxiety included a personal information from, separation scoring, index of clinical stress score, modified Yale preoperative assessment scale, the state-trait anxiety inventory for children, post hospitalization behavior questionnaire, Hamilton anxiety rating scale, and vital signs. Medical clowns, integrated art therapy, therapeutic play, “Play-doh”, computer games, books, and music, video games, toys, music, books, virtual reality, smartphone, relaxation-guided imagery, and iPads were used for creating distraction to reduce anxiety levels during parental separation and the preoperative period. Distraction is a safe, timely, and cost-effective non-pharmacological anxiolytic intervention that can be performed by nurses. Keywords: distraction, therapy, art, anxiety, play, surgery

A Comparison of Intranasal Dexmedetomidine, Esketamine or a Dexmedetomidine-Esketamine Combination for Induction of Anaesthesia in Children: A Randomized Controlled Double-Blind Trial.

Objective: To compare the efficacy of dexmedetomidine, esketamine or combined intranasal administration on the induction of inhalation anaesthesia in children. Methods: Ninety children aged 1–6 years were randomly allocated into three equal groups to be premedicated with either intranasal dexmedetomidine 2 μg/kg (Group D), esketamine 1 mg/kg (Group S), or dexmedetomidine 1 μg/kg combined with esketamine 0.5 mg/kg (Group DS). The primary endpoint was the Induction Compliance Checklist (ICC) Scale. Secondary outcomes included the sedation success rate; the modified Yale Preoperative Anxiety Scale score; the time of reaching up to two points on the University of Michigan Sedation Scale (UMSS); Parental Separation Anxiety Scale; anaesthesiologist satisfaction with induction based on the visual analogue scale; emergence agitation scale score; and adverse effects. Results: The children in the DS group showed a high degree of cooperation with inhalation anaesthesia induction, and their ICC score was significantly lower than that of the D and S groups (p = 0.001), but there was no difference between the D and S groups. The success rate of sedation was higher in Group DS (90%) than in Group D (70%) and Group S (53.3%) (p = 0.007). Anaesthesiologist satisfaction with induction was significantly higher in Group DS than in Groups D and S (p = 0.001). The incidence of emergence agitation and the Paediatric Anaesthesia Emergence Delirium (PAED) score in the DS group were lower than those in the D and S groups. Conclusions: Preoperative intranasal administration of dexmedetomidine combined with esketamine can significantly improve the cooperation of children with inhalation anaesthesia masks. It is a sedation method that has a high success rate and reduces the incidence and degree of emergence agitation.

Childhood Separation From Parents and Self-Harm in Adolescence: A Cross-Sectional Study in Mainland China.

As the prevalence of self-harm among adolescents in Chinese escalates, finding out the potential risk factors associated with self-harm behaviors has aroused much attention. This study aims to explore the association between parent-child separation and series of self-harm (SH) subtypes among Chinese adolescents. We survey a total of 4,928 middle school students aged from 12 to 18 years at school. Parent-child separation was investigated from four dimensions—occurrence of parental separation, separation status, age at first separation and duration of separation. Self-harm series are deemed as five subtypes—highly lethal self-harm, less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, self-harmful behaviors with latent damage and psychological self-harm. Multivariate logistic regression is used to explore the associations between parent-child separation and different subtypes of self-harm among adolescents. Paternal separation is associated with each type of self-harm whilst maternal separation is not correlated with highly lethal self-harm. Except for highly lethal self-harm, the other four subtypes of self-harm demonstrate a relation with both length of paternal separation and maternal separation with aOR ranging from 1.02 to 1.06. Individuals who suffer parental separation prior to the age of three were at a higher risk for four types of less-lethal self-harm. The association of parent-child separation with self-harm deserves our attention, and future research is needed to identify the underlying mechanisms.

Is adult separation anxiety associated with offspring risk for internalizing psychiatric problems?

Awareness of adult separation anxiety (ASA) is growing, but there is a dearth of knowledge about how separation anxiety aggregates in families. We examined the intergenerational associations of separation anxiety and other forms of internalizing problems in an American community sample of 515 predominantly white children and their parents. Children's separation anxiety (CSA), depression, and other anxiety disorders were modeled as latent factors using diagnoses from interviews and symptom scores from questionnaires completed by mothers, fathers, and children when children were 9 years old and again 3 years later. Parents' separation anxiety was assessed via a questionnaire and parents' other anxiety, depressive, and substance use disorders were assessed with a diagnostic interview when children were nine. Relationships between parents' and children's psychopathology were modeled using s.e.m. Mothers' and fathers' ASA were related to all three psychopathology factors in offspring, over and above other parental disorders, in concurrent and prospective analyses. CSA was also related to maternal depression concurrently and prospectively and to maternal anxiety prospectively. Of all paternal psychopathology variables, only ASA was significantly related to children's psychopathology in either model. Results indicate that parental separation anxiety is an important, but non-specific, risk factor for children's psychopathology. The pathway by which this risk is transmitted may be genetic or environmental, and the observed statistical associations likely also encompass child-to-parent effects.

Effects of an asynchronous, fully web‐based parenting‐after‐divorce program to reduce interparental conflict, increase quality of parenting and reduce children's post‐divorce behavior problems

AbstractThis study is a randomized controlled trial of an asynchronous, fully web‐based program for divorced and separated parents, the electronic New Beginnings Program (eNBP). This program is an adaptation of a group, in‐person program for divorced parents, the New Beginnings Program (NBP), which has been shown in randomized trials to reduce a wide range of offspring problems and improve a wide range of competencies up to 15 years after participation. The 10‐module, 5‐h program uses evidence‐based, highly interactive strategies to teach skills designed to strengthen parenting after divorce and reduce interparental conflict. Participants were 131 parents (63% mothers) and 102 adolescent offspring. Parents were randomly assigned to the eNBP or a wait‐list control condition. Parents and their children completed pre‐ and post‐tests. Analyses showed that at post‐test, parents and children in the eNBP reported significantly higher parent–child relationship quality, more effective discipline, lower interparental conflict and lower child mental health problems than did those in the wait‐list control condition. These are the strongest findings in the literature on the effects of web‐based programs to reduce interparental conflict, strengthen positive parenting and reduce children's post‐divorce mental health problems. Given that parental divorce has significant individual and societal costs, widespread implementation of this program could have significant public health implications.

First-time parents' personal growth: Role of parental separation anxiety.

The transition to parenthood is both a joyful and a stress‐evoking event and thus may lead to the experience of personal growth. Parental separation anxiety is a potential source for stress, not yet examined in this context. The study aimed to examine new parents’ personal growth, exploring the contribution of parental separation anxiety, and to investigate the contribution of the personal resources of self‐mastery and emotional intelligence. In a cross‐sectional study, Israeli parents (n = 315) whose first child was up to 24 months old completed self‐report questionnaires. Results show that higher personal growth was associated with greater separation anxiety among both parents, but more strongly among fathers. Higher personal growth was also associated with higher self‐mastery for mothers, and lower emotional intelligence for both parents. The results indicate that parental separation anxiety is related to the personal growth of new parents, and highlight the importance of understanding the transition to parenthood as a differential experience for mothers and fathers. It is recommended that research among fathers be expanded, and that professionals discuss potential separation issues with new parents, and encourage their recognition of inner strengths to enhance their potential to experience personal growth in this demanding period in their lives.

“And all Hell Broke Loose”: How Child Maintenance Regulations Contribute to Re-actualizing Intimate Partner Violence between Separated Parents in Sweden

This study examines recent changes in Swedish regulations for child maintenance in relation to post-separation families with experiences of either intimate partner violence (IPV) or conflict. The reform limited the possibility to rely on the state for maintenance in cases of cooperation difficulties. For IPV cases, the Swedish Social Insurance Agency (SSIA) can function as an intermediary between parents, but such exceptions are made upon assessment and require disclosure of IPV. This study investigates consequences of the maintenance reform and the ways in which it may re-actualize conflict and IPV between separated parents. Data consist of 649 recorded phone calls (~ 55 h) to the SSIA concerning maintenance. Disclosures of post-separation conflict or IPV were found in 132 of these calls; these calls were analyzed using thematic analysis. The maintenance reform’s requirement to reinstate contact with a former partner can re-actualize experiences of parental conflict as well as IPV by (a) re-surfacing physical or psychological abuse; (b) continued or accelerated cooperative difficulties; (c) renewed financial control; and (d) ‘paper abuse’ and new possibilities to display diligence or exert camouflaged control. This can take the form of explicit acts of abuse, anxiety or concern caused by the renewed contact, or being forced to deal with difficult memories. We argue that the Swedish maintenance reform ignores the reality of parental conflicts and IPV by re-actualizing such experiences in a range of ways.

Preventive Group Training Improves Children\u2019s Outcomes after Divorce: A Dutch Quasi-experimental Study

Worldwide, many children experience parental separation and divorce. This has a significant impact on their well-being, and emotional and behavioral functioning, and calls for prevention. To assess the effects of the Children of Divorce Intervention Program in the Netherlands (CODIP-NL) on 6- to 8-year-olds, we performed a quasi-experimental effect study. The study compared children receiving CODIP-NL (intervention: I, n = 104), children not receiving CODIP-NL but having divorced parents (divorced control: DC, n = 37), and children belonging to non-divorced families (non-divorced control: NDC, n = 138). Outcomes pertained to children’s positive functioning, emotional and behavioral problems, and well-being. We assessed pre- to post-test differences in change in mother-reported outcomes between the intervention and control groups, and pre- to post-test differences in group leader reports. The intervention led to increases in mother-reported positive functioning (d = 0.97 I vs. DC; d = 1.04 I vs. NDC), and well-being (d = 1.00 I vs. DC; d = 0.84 I vs. NDC). Mother-reported child emotional and behavioral problems decreased after participation (total difficulties, d = 0.73 I vs. DC; d = 0.49 I vs. NDC). Group leader-reported pre- to post-test differences (p ≤ 0.001) pointed in the same directions. Findings support further implementation of CODIP to support children’s positive functioning and well-being, and to decrease emotional and behavioral problems after their parents’ divorce.