Political violence and mental health of Bedouin children in the West Bank, Palestine: a cross-sectional study.

The Bedouin population is among the most vulnerable in Palestine, subject to forced relocation and lacking basic necessities, including water and electricity. To our knowledge, there are no studies on the mental health of Palestinian Bedouin children. A cross-sectional household survey was conducted examining exposures to traumatic events and mental health among 455 refugee children between the ages of 5-16 years old, and randomly selected from 18 Bedouin communities throughout the West Bank, including East Jerusalem. Mental health status was measured using the Strength and Difficulties Questionnaire. Based on reports by mothers, teachers and children, 44% of the participants in the study had a probable psychiatric disorder. Exposure to traumatic events, fair/poor maternal self-rated mental health, and younger age were positively associated with child mental health problems. The findings highlight the importance of maternal mental health as a contributing factor affecting children's vulnerability. Bedouin mothers and their children need immediate psychosocial intervention, as well as the protection of their basic human rights.

Supporting bereaved parents: a phenomenological study of a telephone intervention programme in a paediatric oncology unit.

AIMS AND OBJECTIVES: This study sought to discover bereaved parents' perspectives and experiences of a nurse-led, ward-based, telephone support programme in a children's oncology unit. BACKGROUND: Parental grief is especially intense and long-lasting, and many parents can experience serious psychological problems. The oncology team learned that some parents felt 'forgotten' or 'abandoned' following their child's death and addressed this concern by initiating and subsequently evaluating a telephone bereavement support programme. DESIGN: An interpretive phenomenological investigation of the experiences of six parents who participated in the programme. METHODS: Parents shared their experiences and perceptions of the programme in individual interviews. Interpretive phenomenology and thematic analysis guided the interviews' interpretation to ascertain both the parents' experiences of the programme and their understandings of everyday clinical terms such as 'support' or 'reassurance'. RESULTS: Parents found the programme supportive, especially valuing ongoing contact with a nurse who 'knew them'. Telephone contact was preferred to visiting the hospital, which brought back painful memories. Calls were important elements in helping parents create meaning and memory around their deceased child. CONCLUSIONS: Regular telephone contact over an agreed period from a familiar member of the child's treating team can create a more positive and supportive bereavement experience for parents in the year following their child's death. The specific findings are discussed in the context of the death of a child as a crisis of meaning. RELEVANCE TO CLINICAL PRACTICE: Clinical nurses are ideally placed to use existing close relationships to extend care and support to bereaved parents. This study shows how nurses can identify service gaps, work with interdisciplinary team colleagues to initiate appropriate actions and participate in the essential evaluation subsequently required.

Diathesis-stress or differential susceptibility? Comparing the theories when determining the outcomes for children born before 33 weeks' gestation.

Infants born preterm (less than 37 weeks completed gestation) have a higher risk of suboptimal cognitive and behavioral outcomes when compared with their term-born counterparts. The risk and severity of poor outcome increases as gestational age at birth decreases; however, not all children born preterm will develop deficits, and environmental influences post birth may have a role in shaping developmental outcomes. Whilst early preterm birth is not preventable, it may be possible to intervene after birth via the environment in order to improve outcomes. The diathesis-stress theory hypothesizes that vulnerable individuals will have worse outcomes after a negative environmental exposure, whereas the differential susceptibility theory posits that vulnerable (or plastic) individuals can be both adversely and positively affected by environmental factors. These two theories were compared in 535 children born <33 weeks' gestation. The interaction between the degree of prematurity and the home environment (as measured by the Home Screening Questionnaire) at 18 months on cognition (Intelligence Quotient from the Wechsler Abbreviated Scale of Intelligence) and behavior (Total Difficulties Score from the Strengths and Difficulties Questionnaire) at 7 years was explored. Evidence was not found for either theory, although a supportive/stimulating home environment appeared to contribute to a decrease in the risk or severity of suboptimal scores. Future research is needed to establish stronger evidence in order to inform interventions to improve the home environment of children born preterm.

Living with a craniofacial condition: development of the Craniofacial Experiences Questionnaire (CFEQ) for adolescents and their parents.

OBJECTIVE: To develop a new instrument (the Craniofacial Experiences Questionnaire, CFEQ) to measure both stressors and positive aspects of living with a craniofacial condition from adolescent and parent perspectives, and to examine its validity and reliability. A secondary aim was to explore experiences reported according to age, gender, and diagnosis. DESIGN: Self-report and parent report questionnaires (CFEQ, Youth Self Report [YSR], Child Behavior Checklist [CBCL], Behavioral and Emotional Rating Scale [BERS]) were completed by adolescents with congenital craniofacial conditions and their parents. PARTICIPANTS: Fifty adolescents with craniofacial conditions and 55 of their parents. RESULTS: Internal reliability of the stressor and positive aspects scales was acceptable (.81 to .92) but was lower for some stressor subscales (.50-.86). Higher stressor scale scores were related to poorer adjustment (CBCL r = .55, YSR r = .37). There were no consistent differences in the stressful or positive experiences of young people with craniofacial conditions according to gender or age. There were no differences in stressors reported according to diagnosis. CONCLUSIONS: The CFEQ shows promise as a clinical and research tool for investigating the stressors and positive experiences of young people with craniofacial conditions. Consistent with the literature on chronic pediatric conditions, there were few differences in experiences of young people according to diagnosis. Furthermore, the lack of gender or age differences supports the need for clinicians to comprehensively assess the experiences of young people regardless of demographic variables.

A Test in the High School Context of Berdahl's Status Theory of Sex-Based Harassment.

This study, carried out in the high school context, is the first direct test of Berdahl's status theory of sex-based harassment. The theory covers not just male harassment of females, but female harassment of males and same-sex harassment. Participants were 771 males and 679 females, from Years 8 to 10, in five co-educational lower socioeconomic status (SES) Australian city schools, participating in a wider study of peer victimization. They indicated on a 5-point scale (from never to almost every day) how frequently they had experienced each of six sex-based harassment behaviors over the previous year, from same-sex and from opposite-sex peers, and responded to a question about sense of safety at school. Nonparametric analyses supported five of seven hypotheses derived from the theory: boys harassed others most often, girls were harassed most often, boy-to-girl harassment was the most frequent, girls harassed girls more than they did boys, and girl-to-boy harassment was the least frequent. However, contrary to the theory, boys' same-sex harassment was no more frequent than that between girls, and girl-to-girl harassment was just as threatening to victims' sense of safety as boy-to-boy harassment. The study largely supports Berdahl's theory. The unexpected results can be understood in terms of the intimate nature of adolescent girls' groups in high schools and their centrality for identity formation. In this context, girls are highly motivated to defend their status in terms of stereotypically feminine standards regarding appearance, sexual activity, and access to high-status boys. The theory implies that structural changes to reduce the salience of sex differences and sex stereotyping will be crucial to efforts to address sex-based harassment.

The relationship of recalled adverse parenting styles with maladaptive schemas, trait anger, and symptoms of depression and anxiety.

BACKGROUND: Young's contention that early maladaptive schemas mediate the relationship between adverse parenting and later emotional difficulties has been lrttle tested. Also, most relevant research focuses only on depression, and on maternal parenting. METHODS: One hundred and fifty-five non-clinical adults completed the Young Parenting Inventory (YPI) regarding both their mothers and fathers, Young's Schema Questionnaire (YSQ), the State/Trait Anger Scale (STAS) and the Depression Anxiety Stress Scale-21 (DASS-21). RESULTS: Young's suggested 17-factor YPI structure was not supported. Rather, participants differentiated between recalled paternal and maternal parenting, with rejecting and controlling components emerging for each parent. There was an indirect effect of rejecting fathering on symptoms of depression, via the social isolation schema, in support of Young's theory. However, despite some significant relationships between parenting and schemas, and schemas and emotions, most effects of parenting on emotions were direct. Rejecting fathering had a direct positive effect on trait anger, and controlling mothering on symptoms of depression and anxiety. Controlling fathering had a negative effect on anxiety symptoms. LIMITATIONS: The study was cross-sectional, limited to participants in a single city, and had a preponderance of female respondents. CONCLUSIONS: Most effects of adverse parenting seem to be direct rather than operating through schemas. Prevention through early parenting programs, and adult cognitive therapies that draw on a broad range of schemas, seem to be called for.

Teacher responses to bullying in relation to moral orientation and seriousness of bullying.

BACKGROUND: Little research has focused on factors influencing teachers' decisions about whether and how to intervene in bullying incidents. Such factors have the potential to influence the role of teachers as agents in counteracting bullying. AIMS: To examine: (a) whether moral orientation predicts teachers' responses to bullying, (b) the role of perceived seriousness of an incident in moderating responses to bullying and (c) factors that are important to teachers when deciding whether to intervene. SAMPLE: Primary, middle and high school teachers (N=127) were recruited during staff meetings at five schools. METHODS: Moral orientation was measured using a modified version of Caputo's (2000) Sanctioning Voice Index (SVI); other questionnaires were specifically designed for this study. Correlational and hierarchical multiple regression analyses examining how moral orientation and seriousness predict teachers' responses to bullying were performed. RESULTS: As anticipated, care moral orientation predicted a problem-solving response, while justice orientation predicted a rules-sanctions response. Care and justice orientations also interacted to predict rules-sanctions, but not problem-solving responses. However, seriousness of an incident accounted for the majority of variance (46% for rules-sanctions and 40% for problem-solving responses). Seriousness did not moderate the relationship between moral orientation and responses to bullying. CONCLUSIONS: While teachers' moral orientation does impact upon the kinds of responses to bullying they choose, seriousness of the incident is more important. However, seriousness as perceived by teachers may not be consistent with impact on students. Implications for teacher education and policy are discussed.

'We are dealing with it the best we can': Exploring parents' attributions regarding their child's physical disability using the 'Four Ws' framework.

BACKGROUND: When a child has a disability, parents' adaptation has traditionally been viewed in negative terms (e.g. grief and stress). However, recent research suggests that parents' adaptation is determined by their appraisals of their situation, both positive and negative. It would be valuable for clinicians to have a conceptual framework for exploring such cognitions. AIMS: This study aimed, first, to devise an attribution theory-based framework for understanding parental cognitions and, second, to examine its usefulness for analysing the appraisals of parents through a qualitative study. METHODS: A wide-ranging review of literature on cognitions, particularly attribution theory, was used to devise the 'Four Ws' framework: What is the problem? Who is to blame? Why did it happen? When? This was used as a scaffold to organise the data from semi-structured interviews with 36 parents of young children with physical disabilities. RESULTS: The framework proved robust, with a range of subthemes emerging through thematic analysis. Additional themes also emerged, for example, about emotions. CONCLUSION: The Four Ws framework provides a potential tool for clinicians working with parents of children with disabilities, both to guide general conversations when the child's needs are the main focus and for more in-depth clinical work with struggling parents.

Adolescents with chronic illnesses: school absenteeism, perceived peer aggression, and loneliness.

Frequent school absence is often cited as a risk factor for peer relationship problems in youngsters with chronic illnesses, but this assumption has not been subjected to quantitative empirical examination. This issue was examined in the present study by exploring the relationship between school absenteeism, peer aggression, and loneliness in adolescents with chronic illnesses. Forty-one adolescents with chronic illnesses completed a modified version of the Direct and Indirect Aggression Scale and the Asher Loneliness Scale. Details of school absences and hospitalizations were obtained from parents and school and hospital records. No evidence was found to support the notion that peer aggression and loneliness are related to absenteeism, but social aggression (for both boys and girls) and verbal aggression (more markedly for girls) were associated with loneliness. Of the group, 19% reported experiencing verbal aggression and 12% social aggression at least weekly; informal qualitative data suggesting that such aggression is often related to limited sporting ability and appearance. Interventions at both the individual and school community level are warranted.

A self-categorization theory perspective on adolescent boys' sexual bullying of girls.

This preliminary study applied Self-Categorization Theory (SCT) to the sexual bullying of high school girls by boys. Seventy-five Year 9 boys responded to vignettes portraying sexual bullying in which gender was a more or a less salient feature of the social context described. As predicted, boys were more likely to engage in sexual bullying when gender was more salient. Masculine sex role was not correlated with engagement in sexual bullying. Controlling for social desirability, pro-bullying attitude was predictive of such engagement, but only when the social context rendered gender less salient. This suggests the power of the perceived social context for determining which individual characteristics will gain expression. It is concluded that SCT is a promising avenue for advancing understanding of bullying, a field of research that has previously largely lacked a theoretical focus.

Children's experience of living with a craniofacial condition: perspectives of children and parents.

This is the first study to examine the range of experiences of children living with a wide range of craniofacial anomalies (CFAs), from the perspectives of children and parents. We interviewed 26 young people and 28 parents about both stressors and positive aspects for young people of living with a CFA. Thematic analysis revealed four major stress-related themes (self-acceptance, responses of others, disabilities and impairments, and treatment). Positive themes included personal qualities and support. Psychological theories often applied to those with CFAs relate to attractiveness, stigma and teasing, but the present findings suggest that these are not as useful as the conceptualization of CFAs as chronic conditions which influence adaptive tasks. Implications for clinical practice are discussed.

Parental and child perspectives on adaptation to childhood chronic illness: a qualitative study.

This qualitative study aimed to gain an in-depth understanding of the adaptation of children and families to childhood chronic illness. Considering ecological theories and child empowerment, we departed from the usual practice of relying solely on parental report by also soliciting children's views. Eighteen children aged 7-14 with cancer, chronic renal failure or type 1 diabetes, and 21 of their parents, participated. The inclusion of several conditions enabled the examination of data from a categorical versus non-categorical perspective. Focus groups supplemented by individual interviews explored participants' views about challenges and the processes they considered important in enhancing adaptation to a chronic illness. Children, as well as parents, provided rich material. Thematic analysis revealed 11 main themes. Six concerned the impact of the illness on various aspects of life. The other main themes were the meaning of disease, stress-processing, social support, future concerns and psychosocial interventions. There were many similarities and some differences between parent and child reports. Many issues were common across illness groups, consistent with a non-categorical approach, though there were some illness-specific issues, especially for those with cancer. Positive as well as negative material emerged. Implications for clinical services are discussed.