The Enduring Effects of Parental Alcohol, Tobacco, and Drug Use on Child Well-being: A Multilevel Meta-Analysis.

The effects of psychoactive substance abuse are not limited to the user, but extend to the entire family system, with children of substance abusers being particularly at risk. This meta-analysis attempted to quantify the longitudinal relationship between parental alcohol, tobacco, and drug use and child well-being, investigating variation across a range of substance and well-being indices and other potential moderators. We performed a literature search of peer-reviewed, English language, longitudinal observational studies that reported outcomes for children aged 0 to 18 years. In total, 56 studies, yielding 220 dependent effect sizes, met inclusion criteria. A multilevel random-effects model revealed a statistically significant, small detriment to child well-being for parental substance abuse over time (r = .15). Moderator analyses demonstrated that the effect was more pronounced for parental drug use (r = .25), compared with alcohol use (r = .13), tobacco use (r = .13), and alcohol use disorder (r = .14). Results highlight a need for future studies that better capture the effect of parental psychoactive substance abuse on the full breadth of childhood well-being outcomes and to integrate substance abuse into models that specify the precise conditions under which parental behavior determines child well-being.Registration: PROSPERO CRD42017076088.

Evaluating the psychometric properties of the mental health continuum-short form (MHC-SF) in Dutch adolescents.

BACKGROUND: Mental health is increasingly viewed as the presence of various aspects of well-being rather than just the absence of mental illness. The Mental Health Continuum-Short Form (MHC-SF) is a 14-item instrument that assesses mental health, focusing on emotional, psychological, and social well-being. The present study examined for the first time the psychometric properties of the Dutch version of the MHC-SF among adolescents, focusing on its factor structure, internal consistency, construct validity, and gender and age factorial invariance. METHODS: Data were collected from a school-based sample of 1175 adolescents (53.4% girls) aged 11-17 years (M = 13.7; SD = 1.1). Participants completed an online questionnaire in the classroom during regular school hours. Statistical analyses to evaluate the factor structure, internal consistency, construct validity, and gender and age factorial invariance were performed in SPSS and R. RESULTS: Using confirmatory factor analyses, a satisfactory-to-good fit was obtained for the three-factor model (emotional, psychological, and social well-being). The MHC-SF scores showed good internal consistency (Cronbach's alpha = .91) and results supported convergent and divergent validity. Finally, the MHC-SF showed gender and age factorial invariance. CONCLUSION: The current psychometric evaluation indicates the MHC-SF is a reliable and valid instrument to assess multiple dimensions of well-being among Dutch adolescents. The instrument can be applied for research purposes and in clinical practice.

Amelioration of Child Depression Through Behavioral Parent Training: A Preliminary Study.

Child depression is an impairing condition for which tested treatments have shown relatively modest mean effects. One possible explanation is that the treatments have generally adopted an individual child focus, without addressing the dysfunctional parent-child interactions that often accompany child depression. The present study provides preliminary evidence bearing on this hypothesis, using data from a treatment outcome study in which clinically referred children with a depression diagnosis could receive individual cognitive behavioral therapy (CBT) focusing on the depression or behavioral parent training (BPT) focusing on comorbid conduct problems. Among children in the study who met criteria for Diagnostic and Statistical Manual of Mental Disorders (4th ed.) depressive disorders, we identified two groups, matched on gender and age: 15 who received only CBT focused on child depression and 15 who received only BPT focused on child conduct problems. Children were 7 to 13, 20 of whom were male, and race included Caucasian (17), Latino (5), African American (2), and multirace (6). Measures assessed depressive diagnoses and symptoms, as well as parenting stress. Analyses focused on whether BPT alone might lead to reduced depression, and if so how that reduction would compare to the depression reduction achieved through CBT that focused on depression. Both groups showed significant reductions from pre- to post-treatment in depressive diagnoses and depression symptoms, and there were no BPT versus CBT group differences at post-treatment. BPT that focuses on child conduct problems, with no emphasis on depression treatment, may produce significant depression reduction in comorbid children who meet criteria for depressive disorders.

Measuring quantitative autism traits in families: informant effect or intergenerational transmission?

Autism spectrum disorders (ASD) have a high degree of heritability, but there is still much debate about specific causal genes and pathways. To gain insight into patterns of transmission, research has focused on the relatedness of quantitative autism traits (QAT) between family members, mostly using questionnaires. Yet, different kinds of bias may influence research results. In this paper, we focus on possible informant effects and, taking these into account, on possible intergenerational transmission of QAT. This study used multiple informant data retrieved via the Social Responsiveness Scale from 170 families with at least one member with ASD. Using intraclass correlations (ICCs) and mixed model analyses, we investigated inter-informant agreement and differences between parent and teacher reports on children and between self- and other-reports on adults. Using structural equation modelling (SEM), we investigated the relatedness of QAT between family members in ASD families. Parent-teacher agreement about social responsiveness was poor, especially for children with ASD, though agreement between parents was moderate to strong for affected and unaffected children. Agreement between self- and other-report in adult men was good, but only moderate in women. Agreement did not differ between adults with and without ASD. While accounting for informant effects, our SEM results corroborated the assortative mating theory and the intergenerational transmission of QAT from both fathers and mothers to their offspring.

Autism spectrum disorders in children with functional defecation disorders.

OBJECTIVE: To prospectively assess the prevalence of autism spectrum disorder (ASD) symptoms in children presenting with functional defecation disorders. STUDY DESIGN: Children (age 4-12 years) with functional constipation or functional non-retentive fecal incontinence according to the Rome III criteria referred to a specialized outpatient clinic were included. Parents completed 2 validated ASD screening questionnaires about their child; the Social Responsiveness Scale (SRS) and the Social Communication Questionnaire-Lifetime (SCQ-L). A total SRS score of ≥ 51 is a strong indicator for the presence of ASD. On the SCQ-L, a score of ≥ 15 is suggestive for ASD. RESULTS: In total, 242 patients (130 males, median age 7.9 years) were included. Of these, 91% were diagnosed with functional constipation and 9% with functional non-retentive fecal incontinence. Thirteen children (5.4%) had previously been diagnosed with ASD. Twenty-six children (11%) had both SRS and SCQ-L scores at or above cutoff points, strongly suggestive for the presence of ASD. Solely high SRS were present in 42 children (17%), whereas two children (1%) only had high SCQ-L scores. Altogether, 29% had ASD symptoms, indicated by SRS and/or SCQ-L scores at or above the cutoff values. These children were older than children without ASD symptoms and presented with a longer duration of symptoms. CONCLUSIONS: A substantial number of children (29%) presenting with a functional defecation disorder at a tertiary hospital has concomitant ASD symptoms. Clinicians should be aware of ASD symptoms in children with functional defecation disorders.

A few thoughts on evidence in social work.

Social work practitioners must act every working day in the face of uncertainty. This uncertainty arises in part because knowledge is often difficult to locate or sometimes lacking regarding: the systems context the population being served; the particular client system; the set of problems the client system is experiencing; as well as the various interventions that could be selected. It seems reasonable to explore ways to reduce the experience of uncertainty, and narrow, if not eliminate, the knowledge gaps that arise in such situations. The generic idea of evidence-based practice has been advanced for some time as an approach to support practitioners in their day-to-day work. This article has two foci. First, it will briefly and selectively review attempts to make social work practice more evidence based. Second, it will describe one stage in the evolution of a Web-based service (information for practice [IP]). IP is a long-term project with the mission of keeping practitioners informed about news and new scholarship in the field, so that they can more easily make their practice more evidenced based.

Sequential meta-analysis of single-case experimental data.

In this article, sequential meta-analysis is presented as a method for determining the sufficiency of cumulative knowledge in single-case research synthesis. Sufficiency addresses the question of whether there is enough cumulative knowledge on a topic to yield convincing statistical evidence. The method combines cumulative meta-analysis of single-case experimental data with formal sequential testing. After describing the underlying statistical techniques, a strategy for conducting a sequential single-case meta-analysis is illustrated using a real meta-analytic database. The sequential methodology may serve as a valuable tool for behavioral researchers to guide them in making optimal use of limited resources.

Meta-Analysis: 13-Year Follow-up of Psychotherapy Effects on Youth Depression.

OBJECTIVE: Youth depression is a debilitating condition that constitutes a major public health concern. A 2006 meta-analysis found modest benefits for psychotherapy versus control. Has 13 more years of research improved that picture? We sought to find out. METHOD: We searched PubMed, PsychINFO, and Dissertation Abstracts International for 1960 to 2017, identifying 655 randomized, English-language psychotherapy trials for individuals aged 4 to 18 years. Of these, 55 assessed psychotherapy versus control for youth depression with outcome measures administered to both treatment and control conditions at post (κ = 53) and/or follow-up (κ = 32). Twelve study and outcome characteristics were extracted, and effect sizes were calculated for all psychotherapy versus control comparisons. Using a three-level random-effects model, we obtained an overall estimate of the psychotherapy versus control difference while accounting for the dependency among effect sizes. We then fitted a three-level mixed-effects model to identify moderators that might explain variation in effect size within and between studies. RESULTS: The overall effect size (g) was 0.36 at posttreatment and 0.21 at follow-up (averaging 42 weeks after posttreatment). Three moderator effects were identified: effects were significantly larger for interpersonal therapy than for cognitive behavioral therapy, for youth self-reported outcomes than parent-reports, and for comparisons with inactive control conditions (eg, waitlist) than active controls (eg, usual care). Effects showed specificity, with significantly smaller effects for anxiety and externalizing behavior outcomes than for depression measures. CONCLUSION: Youth depression psychotherapy effects are modest, with no significant change over the past 13 years. The findings highlight the need for treatment development and research to improve both immediate and longer-term benefits.

Relations between parental psychological control and childhood relational aggression: reciprocal in nature?

Using a cross-lagged panel design, this study examined the directionality of relations between parental psychological control and child relational aggression. Data were collected from a proportionally stratified sample of 600 Flemish 8- to 10-year-old children at 3 measurement points with 1-year intervals. Reciprocal effects were evident in mother-child dyads. Maternal psychological control was positively related to child relational aggression 1 year later, and child relational aggression was positively related to maternal psychological control 1 year later. The father-child dyads were best represented by unidirectional parent effects. Paternal psychological control was positively related to child relational aggression 1 year later. Surprisingly, these effects emerged only for relational aggression as indexed by mother and father reports and not for relational aggression as indexed by teacher and peer measures.

Associations between parental control and children's overt and relational aggression.

The present study examined specialized associations between parental control and child aggression in a sample of 600 8- to 10-years old children. Parental control dimensions and aggression subtypes were assessed using multiple informants (i.e. children, mothers, fathers, peers, and teachers). In line with expectations, parental physical punishment was positively associated with overt aggression, whereas parental psychological control was positively associated with relational aggression in both girls and boys. In addition, this study demonstrated that if both parents employed similar parenting strategies, it appeared to have a cumulative effect on child aggressive behaviour. Associations involving overt aggression were more pronounced for boys than girls, whereas associations involving relational aggression were not moderated by gender. Overall, the present study contributes to an emerging research field by supporting the hypothesis of specialized associations between parental control and child aggression.

Parenting Styles: A Closer Look at a Well-Known Concept.

Although parenting styles constitute a well-known concept in parenting research, two issues have largely been overlooked in existing studies. In particular, the psychological control dimension has rarely been explicitly modelled and there is limited insight into joint parenting styles that simultaneously characterize maternal and paternal practices and their impact on child development. Using data from a sample of 600 Flemish families raising an 8-to-10 year old child, we identified naturally occurring joint parenting styles. A cluster analysis based on two parenting dimensions (parental support and behavioral control) revealed four congruent parenting styles: an authoritative, positive authoritative, authoritarian and uninvolved parenting style. A subsequent cluster analysis comprising three parenting dimensions (parental support, behavioral and psychological control) yielded similar cluster profiles for the congruent (positive) authoritative and authoritarian parenting styles, while the fourth parenting style was relabeled as a congruent intrusive parenting style. ANOVAs demonstrated that having (positive) authoritative parents associated with the most favorable outcomes, while having authoritarian parents coincided with the least favorable outcomes. Although less pronounced than for the authoritarian style, having intrusive parents also associated with poorer child outcomes. Results demonstrated that accounting for parental psychological control did not yield additional parenting styles, but enhanced our understanding of the pattern among the three parenting dimensions within each parenting style and their association with child outcomes. More similarities than dissimilarities in the parenting of both parents emerged, although adding psychological control slightly enlarged the differences between the scores of mothers and fathers.

Because you had a bad day: General and daily relations between reactive temperament, emotion regulation, and depressive symptoms in youth.

Negative emotionality (NE) and positive emotionality (PE) have repeatedly shown to act as vulnerability factors for youth depression. Less research examined the mechanisms through which these reactive temperament traits may differently confer vulnerability to depression. Based on recent integrated models of depression proposing emotion regulation as a key underlying mechanism, the current study aimed to clarify the general and day-to-day relations among temperament, emotion regulation strategies, and depressive symptoms in Dutch-speaking youth (35% boys; Mage = 13.27 years, SD = 1.98) using a cross-sectional (n = 495) and a 7-day daily diary design (n = 469). Self-reported temperament, trait rumination, trait positive refocusing, and depressive symptoms were measured at baseline. State rumination, state positive refocusing, and depressive symptoms were further assessed daily. Whereas results revealed that NE and PE interacted in predicting baseline and daily depressive symptoms, the cross-sectional analyses provide preliminary evidence for the hypothesis that NE and PE each provide unique pathways for understanding vulnerability to depression. Additional analyses in the daily diary study showed NE to be significantly related to trajectories of state rumination. Results contribute to a more nuanced understanding of the associations between temperament, emotion regulation strategies, and depressive symptoms in youth.

Are Psychotherapies for Young People Growing Stronger? Tracking Trends Over Time for Youth Anxiety, Depression, Attention-Deficit/Hyperactivity Disorder, and Conduct Problems.

With the development of empirically supported treatments over the decades, have youth psychotherapies grown stronger? To investigate, we examined changes over time in treatment effects for four frequently treated youth mental-health problems: anxiety, depression, attention-deficit hyperactivity disorder (ADHD), and conduct disorders. We used PubMed and PsycINFO to search for randomized controlled trials (RCTs) that were published between January 1960 and May 2017 involving youths between the ages of 4 and 18 years. We also searched reviews and meta-analyses of youth psychotherapy research, followed reference trails in the reports we identified, and obtained additional studies identified by therapy researchers whom we contacted. We identified 453 RCTs (31,933 participants) spanning 53 years (1963-2016). Effect sizes for the problem-relevant outcome measures were synthesized via multilevel meta-analysis. We tracked temporal trends for each problem domain and then examined multiple study characteristics that might moderate those trends. Mean effect size increased nonsignificantly for anxiety, decreased nonsignificantly for ADHD, and decreased significantly for depression and conduct problems. Moderator analyses involving multiple study subgroups showed only a few exceptions to these surprising patterns. The findings suggest that new approaches to treatment design and intervention science may be needed, especially for depression and conduct problems. We suggest intensifying the search for mechanisms of change, making treatments more transdiagnostic and personalizable, embedding treatments within youth ecosystems, adapting treatments to the social and technological changes that alter youth dysfunction and treatment needs, and resisting old habits that can make treatments unduly skeuomorphic.

Family-based treatments for serious juvenile offenders: A multilevel meta-analysis.

OBJECTIVE: Researchers have identified several family-based treatments that hold considerable promise in reducing serious juvenile offending; however, these treatments remain underutilized by youth service systems. In the present study, we used meta-analysis to summarize the findings of research on family-based treatments for serious juvenile offenders. METHOD: We conducted a multilevel meta-analysis that modeled dependencies between multiple effect sizes from the same study. The meta-analysis synthesized 324 effect sizes from 28 studies that met inclusion criteria. Potential moderators (e.g., characteristics of samples, treatments, methods, and measures) were entered as fixed effects in the meta-analytic model. RESULTS: Across studies, family-based treatments produced modest, yet long-lasting, treatment effects (mean d = 0.25 for antisocial behavior, 0.24 overall) relative to comparison conditions. Furthermore, certain characteristics moderated the magnitude of treatment effects; for example, measures of substance use showed the largest effects and measures of peer relationships showed the smallest effects. CONCLUSIONS: Policymakers, administrators, and treatment providers may find it useful to consider the effects of family-based treatments for serious juvenile offenders in their selection of treatments for this population. In addition, investigators who seek to develop and study such treatments may wish to consider the current findings in their future research efforts. (PsycINFO Database Record

What five decades of research tells us about the effects of youth psychological therapy: A multilevel meta-analysis and implications for science and practice.

Across 5 decades, hundreds of randomized trials have tested psychological therapies for youth internalizing (anxiety, depression) and externalizing (misconduct, attention deficit and hyperactivity disorder) disorders and problems. Since the last broad-based youth meta-analysis in 1995, the number of trials has almost tripled and data-analytic methods have been refined. We applied these methods to the expanded study pool (447 studies; 30,431 youths), synthesizing 50 years of findings and identifying implications for research and practice. We assessed overall effect size (ES) and moderator effects using multilevel modeling to address ES dependency that is common, but typically not modeled, in meta-analyses. Mean posttreatment ES was 0.46; the probability that a youth in the treatment condition would fare better than a youth in the control condition was 63%. Effects varied according to multiple moderators, including the problem targeted in treatment: Mean ES at posttreatment was strongest for anxiety (0.61), weakest for depression (0.29), and nonsignificant for multiproblem treatment (0.15). ESs differed across control conditions, with "usual care" emerging as a potent comparison condition, and across informants, highlighting the need to obtain and integrate multiple perspectives on outcome. Effects of therapy type varied by informant; only youth-focused behavioral therapies (including cognitive-behavioral therapy) showed similar and robust effects across youth, parent, and teacher reports. Effects did not differ for Caucasian versus minority samples, but more diverse samples are needed. The findings underscore the benefits of psychological treatments as well as the need for improved therapies and more representative, informative, and rigorous intervention science. (PsycINFO Database Record

Associations between parental psychological control and relational aggression in children and adolescents: a multilevel and sequential meta-analysis.

Youth aggression has been associated with negative parenting practices, but previous research about this association has mainly focused on physical and verbal aggression. Because more subtle forms of aggression are considered at least as harmful as their physical and verbal counterparts, there is a growing scientific interest in parenting practices that are linked with relational aggression. Guided by social learning theory, a link between youth relational aggression and parental psychological control has been postulated, but the empirical evidence is inconsistent. The present meta-analysis provides a multilevel and sequential quantitative synthesis of 165 dependent effect sizes (23 studies) encompassing 8,958 youths. Across studies, a positive, albeit weak, association between parental psychological control and relational aggression was found. The sequential analysis demonstrated that sufficient cumulative knowledge was attained to yield convincing evidence on this overall association. Moderator analyses revealed that developmental period and assessment method were associated with differences in research findings. Overall, however, results suggest that clarifying the precise role of psychological control in the development and maintenance of relational aggression requires more targeted primary research, which in turn would allow additional and more complex synthesis efforts with potentially more nuanced conclusions.

Both trust and self-control are necessary to prevent intrusive behaviors: evidence from a longitudinal study of married couples.

Many people engage in intrusive behaviors in close relationships. Existing research links intrusive behaviors to a lack of trust and an imbalance between self- and partner-interest. The authors tested the novel hypothesis that people need self-control to regulate intrusive behaviors. Self-control enables people to forgo their self-interests (reassurance or closeness) for the sake of their partner or the relationship. Specifically, we predicted that people need both trust and self-control to refrain from intrusive behavior. One-hundred-eighty-nine couples participated in a prospective longitudinal study with three waves. Consistent with predictions, multilevel analyses revealed an interaction between trust and self-control on intrusive behaviors cross-sectionally as well as longitudinally (albeit marginally). These results provide support for our hypothesis that neither trust in the partner nor self-control is sufficient to forestall intrusive behaviors, but rather both are necessary to refrain from intruding into one's partner's privacy.

Performance of evidence-based youth psychotherapies compared with usual clinical care: a multilevel meta-analysis.

IMPORTANCE: Research across more than 4 decades has produced numerous empirically tested evidence-based psychotherapies (EBPs) for psychopathology in children and adolescents. The EBPs were developed to improve on usual clinical interventions. Advocates argue that the EBPs should replace usual care, but this assumes that EBPs produce better outcomes than usual care. OBJECTIVE: To determine whether EBPs do in fact produce better outcomes than usual care in youth psychotherapy. We performed a meta-analysis of 52 randomized trials directly comparing EBPs with usual care. Analyses assessed the overall effect of EBPs vs usual care and candidate moderators; we used multilevel analysis to address the dependency among effect sizes (ES) that is common but typically unaddressed in psychotherapy syntheses. DATA SOURCES: We searched the PubMed, PsychINFO, and Dissertation Abstracts International databases for studies from January 1, 1960, through December 31, 2010. STUDY SELECTION: We identified 507 randomized youth psychotherapy trials. Of these, the 52 studies that compared EBPs with usual care were included in the meta-analysis. DATA EXTRACTION AND SYNTHESIS: Sixteen variables (participant, treatment, outcome, and study characteristics) were extracted from studies, and ESs were calculated for all comparisons of EBP vs usual care. We used an extension of the commonly used random-effects meta-analytic model to obtain an overall estimate of the difference between EBP and usual care while accounting for the dependency among ESs. We then fitted a 3-level mixed-effects model to identify moderators that might explain variation in ESs within and between studies by adding study or ES characteristics as fixed predictors. MAIN OUTCOMES AND MEASURES: Primary outcomes of our meta-analysis were mean ES estimates across all studies and for levels of candidate moderators. These ES values were based on measures of symptoms, functioning, and other outcomes assessed within the 52 randomized trials. RESULTS: Evidence-based psychotherapies outperformed usual care. Mean ES was 0.29; the probability was 58% that a randomly selected youth would have a better outcome after EBP than a randomly selected youth after receiving usual care. The following 3 variables moderated treatment benefit: ESs decreased for studies conducted outside North America, for studies in which all participants were impaired enough to qualify for diagnoses, and for outcomes reported by informants other than the youths and parents in therapy. For certain key groups (eg, studies of clinically referred samples and youths with diagnoses), significant EBP effects were not demonstrated. CONCLUSIONS AND RELEVANCE: Evidence-based psychotherapies outperform usual care, but the EBP advantage is modest and moderated by youth, location, and assessment characteristics. The EBPs have room for improvement in the magnitude and range of their benefit relative to usual clinical care.

The role of teachers' expectations in the association between children's SES and performance in kindergarten: a moderated mediation analysis.

This study examines the role of teachers' expectations in the association between children's socio-economic background and achievement outcomes. Furthermore, the role of children's ethnicity in moderating this mediated relation is investigated. In the present study, 3,948 children from kindergarten are examined. Data are analysed by means of structural equation modeling. First, results show that teachers' expectations mediate the relation between children's SES and their later language and math achievement, after controlling for children's ethnicity, prior achievement and gender. This result indicates that teachers may exacerbate individual differences between children. Second, children's ethnicity moderates the mediation effect of teachers' expectations with respect to math outcomes. The role of teachers' expectations in mediating the relation between SES and math outcomes is stronger for majority children than for minority children.

Psychometric evaluation of the Dutch version of the Mood, Interest and Pleasure Questionnaire (MIPQ).

Recently, several instruments have been developed to measure the subjective component of the quality of life (QOL) of people with profound intellectual and multiple disabilities (PIMD). A next step, however, must be the further validation of these instruments. The present study aimed at evaluating the psychometric properties of one of these instruments, the Dutch version of the Mood, Interest and Pleasure Questionnaire (MIPQ). The MIPQ is a 25-item Likert scale questionnaire with two subscales (Mood and Interest and Pleasure). The MIPQ and the Aberrant Behavior Checklist were completed on 360 participants with severe or profound intellectual disabilities. About 27% of these participants were included in an examination of test-retest of and the inter-rater reliability of the MIPQ. The results suggest that the proposed two-factor structure did not show an adequate fit to our data. An exploratory factor analysis revealed a three-factor structure with positive mood, negative mood and interest as three correlated but distinct subscales. These results are in concurrence with the literature on positive emotions. High internal consistency (α ≥ .80), high inter-rater (r ≥ .69) and high test-retest reliability (r ≥ .86) were found, which indicates the reliable use of the MIPQ in the population of people with PIMD. Strong negative correlations between the MIPQ total score and the Aberant Behavior Checklist's 'lethargy, social withdrawal' subscale provides some evidence of the construct validity of the MIPQ. However, further validation of the MIPQ including other measures of subjective well-being is warranted.