Protective factors enhancing resilience in children of parents with a mental illness: a systematic review.

Objectives: A systematic review was conducted to (1) investigate protective factors enhancing resilience in children of parents with a mental illness (COPMI), and (2) examine theoretical and methodological issues in the existing literature. Method: Following guidelines for systematic reviews, searches were performed using Web of Science, Pubmed and Embase. After screening 5,073 articles 37 fulfilled inclusion criteria and were extracted for review. Results of the present review indicate that there are several ways to help build resilience in COPMI. More specifically, five protective factors emerged from the reviewed literature: Information, Support, Family functioning and Connectedness, Child coping, and Parenting. Discussion: Research on protective factors in children confronted with parental mental illness is still scarce and for some factors no clear conclusions can be drawn based on the available evidence. To further our understanding of the building blocks and underlying mechanisms of resilience in COPMI, additional rigorously designed studies are needed.

The Interplay of Parent and Child Coping Responses in Understanding Child Functioning in the Context of Living With a Parent With or Without Chronic Pain.

OBJECTIVES: Pain disorders tend to run in families, and children of individuals with chronic pain have been found to report lower functioning. Drawing upon a social learning perspective, the current study examined how diverse maternal pain coping responses (ie, pain catastrophizing and distraction) may, via corresponding child pain coping responses, act as a vulnerability or protective factor for child functioning in the context of parental chronic pain (CP). METHODS: A cross-sectional study was conducted in mothers with CP and their pain-free child (N=100) and mothers without CP and their pain-free child (N=74). Moderated mediation analyses were performed to test whether associations between maternal coping responses and child functioning (ie, somatic symptoms, physical functioning, and psychosocial health) were mediated by corresponding child coping responses and whether these associations were moderated by the presence or absence of maternal CP. RESULTS: Maternal pain catastrophizing was indirectly related to more somatic symptoms, lower physical functioning, and lower psychosocial health in their child via child pain catastrophizing. Relationships were moderated by the presence or absence of maternal CP, such that mediated relationships were only found in mothers without CP and their child. No (in)direct relationships between maternal distraction, child distraction, and child functioning were observed. DISCUSSION: The current findings demonstrated that child functioning was associated with maternal and child pain catastrophizing, but only in children of mothers without CP. No evidence was found in support of maternal pain coping responses as vulnerability or protective factors in the context of parental CP.

Learning to fear pain after observing another's pain: An experimental study in schoolchildren.

BACKGROUND: Children of individuals with chronic pain have an increased vulnerability to experience pain problems, possibly through observation of pain in their parents. As pain-related fear (PRF) is a critical factor in the development and maintenance of chronic pain, the current experimental study examined the acquisition of PRF through observational learning and subsequent extinction after first-hand experience of the feared stimulus. METHODS: Healthy children (8-16 years) observed either their mother or a stranger performing two cold pressor tasks (CPT) filled with coloured water. In a differential conditioning procedure, one colour (CS+) was combined with genuine painful facial expressions and the other colour (CS-) with neutral facial expressions. Following this observation phase, children performed both CPTs (10°C) themselves. RESULTS: Children expected the CS+ to be more painful than the CS- and they reported being more afraid and hesitant to immerse in the CS+ compared to the CS-. Moreover, this fear was reflected in children's level of arousal in anticipation of CPT performance. This learned association extinguished after performing both CPTs. Effects were not moderated by whether the child observed their mother or a stranger, by the child's pain catastrophizing, trait PRF or trait anxiety. Remarkably, learning effects increased when the child perceived a larger difference between the model's painful and neutral facial expressions. CONCLUSIONS: This study provides evidence for observational learning of PRF and subsequent extinction in schoolchildren. This acquisition of PRF by observing parental pain may contribute to vulnerabilities in children of parents with chronic pain. SIGNIFICANCE: Children may acquire pain-related fear by observing pain in others and this learned fear can diminish after first-hand experience. Remarkably, observational learning did not depend on the children's relationship with the model, but it did depend on the intensity of pain that is perceived. A better understanding of the impact of observing (parental) pain may help clarify the intergenerational transmission of risk for pain and inform the development of preventive programs.

Comparing conscious and unconscious conflict adaptation.

Recently, researchers have been trying to unravel the function of consciousness by exploring whether unconscious information is (in)capable of exerting cognitive control. Theoretically, cognitive control functions, such as conflict adaptation, have often been assumed to require consciousness. However, empirical evidence on conscious versus unconscious conflict adaptation is highly contradictory and hitherto, only one study reliably demonstrated adaptation to unconscious conflict. Therefore, the current study wanted to shed further light on this debated issue. A masked and unmasked version of the priming paradigm were used to create unconscious and conscious conflict trials (i.e., when prime and target trigger opposite responses). In contrast to previous studies, the Stimulus Onset Asynchrony was kept constant in both conditions and neutral trials were added to the design in order to investigate the origin of the adaptation and to investigate the specific adaptation effects. Our results showed robust conflict adaptation effects following conscious and unconscious conflict. Furthermore, our results suggest that the adaptation elicited by the conflict, is mainly an adaptation of interference, not of facilitation. We can conclude that conflict adaptation can occur after unconscious conflict, which indicates that this expression of cognitive control is most likely not an exclusive function of consciousness.