Parent and child experience of skin conditions: relevance for the provision of mindfulness-based interventions.

BACKGROUND: Managing a skin condition can be difficult, and there is a lack of psychological support for children and their families. OBJECTIVES: To identify issues surrounding caring for a child with a skin condition, investigate experiences of current psychological support to gain a sense of what is needed, and determine the relevance of offering mindfulness-based interventions for children and families. MATERIALS AND METHODS: This study employed a mixed inductive and deductive form of qualitative inquiry to understand the experiences and needs of children and families. Twenty-three participants (12 parents/carers: 11 females, 1 male; 11 children: 6 females, 5 males, aged 8-11 years) were recruited with an advert posted on social media. In-depth data were collected from semi-structured interviews. Interviews were recorded, transcribed and analysed with a descriptive form of thematic analysis. RESULTS: Systematic analysis of the data led to five themes being developed: (i) caregiver burden of childhood skin conditions; (ii) skin condition overshadowing childhood; (iii) battling for recognition and lack of support; (iv) naturalistic use and understanding of mindfulness in everyday coping: and (v) openness and relevance of offering mindfulness-based interventions. CONCLUSIONS: Living with a skin condition was reported as being associated with mood disturbance, with impacts on schooling, sleep and daily life. Parents and children expressed a desire for short/accessible interventions that could fit with daily routines and might provide the opportunity to connect with other families. The findings indicate that mindfulness-based interventions may be likely to be accepted, as many participants had experience of using mindful techniques in school, and described that they were naturalistically using 'mindfulness' to manage itch and stress. However, the findings indicate that a number of misconceptions exist about the fundamental nature and aims of mindfulness. Addressing misconceptions related to mindfulness needs to be considered when planning both future studies and service delivery.

Living With Physical Health Conditions: A Systematic Review of Mindfulness-Based Interventions for Children, Adolescents, and Their Parents.

OBJECTIVES: This systematic review aimed to identify and appraise studies investigating the efficacy of mindfulness-based interventions (MBIs) for improving depression, anxiety and parental stress in families affected by childhood physical illnesses, as well as feasibility and acceptability. METHODS: Embase, PsycINFO, Scopus, Medline, and PubMed were searched between February 2 and 17, 2021, and updated on August 5, 2022. Studies investigating MBIs with children and adolescents (<18 years) with physical health conditions were included, and results are presented with narrative synthesis. RESULTS: Eighteen studies met eligibility criteria. Studies included children and adolescents with chronic pain, headaches, cancer, heart conditions, esophageal atresia, inflammatory bowel disease, and polycystic ovary syndrome. Most studies reported mindfulness was feasible and acceptable, although findings for different health conditions were mixed. Some studies encountered difficulties with attrition, resulting in findings being underpowered. CONCLUSIONS: MBIs show promise for improving anxiety and depression in children with physical health conditions, but there is limited support for reducing stress in the family unit. A potential direction for future research might be the inclusion of parents. However, because of the heterogeneity of studies included in this review, findings must be cautiously interpreted.

Overlapping brain correlates of superior cognition among children at genetic risk for Alzheimer's disease and/or major depressive disorder.

Early life adversity (ELA) tends to accelerate neurobiological ageing, which, in turn, is thought to heighten vulnerability to both major depressive disorder (MDD) and Alzheimer's disease (AD). The two conditions are putatively related, with MDD representing either a risk factor or early symptom of AD. Given the substantial environmental susceptibility of both disorders, timely identification of their neurocognitive markers could facilitate interventions to prevent clinical onset. To this end, we analysed multimodal data from the Adolescent Brain and Cognitive Development study (ages 9-10 years). To disentangle genetic from correlated genetic-environmental influences, while also probing gene-adversity interactions, we compared adoptees, a group generally exposed to substantial ELA, with children raised by their biological families via genetic risk scores (GRS) from genome-wide association studies. AD and MDD GRSs predicted overlapping and widespread neurodevelopmental alterations associated with superior fluid cognition. Specifically, among adoptees only, greater AD GRS were related to accelerated structural maturation (i.e., cortical thinning) and higher MDD GRS were linked to delayed functional neurodevelopment, as reflected in compensatory brain activation on an inhibitory control task. Our study identifies compensatory mechanisms linked to MDD risk and highlights the potential cognitive benefits of accelerated maturation linked to AD vulnerability in late childhood.

Facial emotion recognition in adopted children.

Children adopted from public care are more likely to experience emotional and behavioural problems. We investigated two aspects of emotion recognition that may be associated with these outcomes, including discrimination accuracy of emotions and response bias, in a mixed-method, multi-informant study of 4-to-8-year old children adopted from local authority care in the UK (N = 42). We compared adopted children's emotion recognition performance to that of a comparison group of children living with their birth families, who were matched by age, sex, and teacher-rated total difficulties on the Strengths and Difficulties Questionnaire (SDQ, N = 42). We also examined relationships between adopted children's emotion recognition skills and their pre-adoptive histories of early adversity (indexed by cumulative adverse childhood experiences), their parent- and teacher-rated emotional and behavioural problems, and their parents' coded warmth during a Five Minute Speech Sample. Adopted children showed significantly worse facial emotion discrimination accuracy of sad and angry faces than non-adopted children. Adopted children's discrimination accuracy of scared and neutral faces was negatively associated with parent-reported behavioural problems, and discrimination accuracy of angry and scared faces was associated with parent- and teacher-reported emotional problems. Contrary to expectations, children who experienced more recorded pre-adoptive early adversity were more accurate in identifying negative emotions. Warm adoptive parenting was associated with fewer behavioural problems, and a lower tendency for children to incorrectly identify faces as angry. Study limitations and implications for intervention strategies to support adopted children's emotion recognition and psychological adjustment are discussed.

Adoptive parents' finances and employment status: a 5-year longitudinal study.

We investigated risk and facilitating factors related to families' change in finances and employment over 5 years following adoption of a child from local authority care in a prospective, longitudinal study of children placed for adoption between 2014 and 2015 (N = 96). Parents completed questionnaires at approximately 5, 21, 36, 48 and 60 months post-placement. We used time series analysis to examine the impact of child (e.g. pre-placement experiences, mental health), family structure (e.g. number of siblings, parent relationship status), and parent (e.g. mental health) factors on change in household income and parent employment status after adoption. We also examined the tendency for parents to comment on employment and finances and the emotional valence of their comments to gauge their concern about their circumstances. Children's mental health problems were associated with primary caregivers reducing their time spent in employment and parents' tendency to comment on their financial and work circumstances. Children who experienced more moves in care were more likely to have a primary caregiver not in full-time work, as were children with higher prosocial behaviour scores. Being in full-time work was associated with parents' symptoms of anxiety. We also detected associations between structural features of the family and changes in income and employment. This study represents one of the first empirical investigations of factors associated with the socioeconomic features of adoptive families' lives and informs ongoing discussion regarding the support needs of families and the timing, nature, and delivery of post-adoption professional services.

Maternal childhood maltreatment and perinatal outcomes: A systematic review.

BACKGROUND: Maternal childhood maltreatment (MCM) is linked to poor perinatal outcomes but the evidence base lacks cohesion. We explore the impact of MCM on four perinatal outcome domains: pregnancy and obstetric; maternal mental health; infant; and the quality of the care-giving environment. Mechanisms identified in the included studies are discussed in relation to the maternal programming hypothesis and directions for future research. METHOD: We completed a comprehensive literature search of eight electronic databases. Independent quality assessments were conducted and PRISMA protocols applied to data extraction. RESULTS: Inclusion criteria was met by N = 49 studies. MCM was consistently associated with difficulties in maternal and infant emotional regulation and with disturbances in the mother-infant relationship. Directly observed and maternal-reported difficulties in the mother-infant relationship were often mediated by mothers' current symptoms of psychopathology. Direct and mediated associations between MCM and adverse pregnancy and obstetric outcomes were suggested by a limited number of studies. Emotional and sexual abuse were the most consistent MCM subtype significantly associated with adverse perinatal outcomes. LIMITATIONS: A meta-analysis was not possible due to inconsistent reporting and the generally small number of studies for most perinatal outcomes. CONCLUSIONS: MCM is associated with adverse perinatal outcomes for mothers' and infants. Evidence suggests these associations are mediated by disruptions to maternal emotional functioning. Future research should explore biological and psychosocial mechanisms underpinning observed associations between specific subtypes of MCM and adverse perinatal outcomes. Services have a unique opportunity to screen for MCM and detect women and infants at risk of adverse outcomes during the perinatal period.

Negative parental emotional environment increases the association between childhood behavioral problems and impaired recognition of negative facial expressions.

Impaired facial emotion recognition is a transdiagnostic risk factor for a range of psychiatric disorders. Childhood behavioral difficulties and parental emotional environment have been independently associated with impaired emotion recognition; however, no study has examined the contribution of these factors in conjunction. We measured recognition of negative (sad, fear, anger), neutral, and happy facial expressions in 135 children aged 5-7 years referred by their teachers for behavioral problems. Parental emotional environment was assessed for parental expressed emotion (EE) - characterized by negative comments, reduced positive comments, low warmth, and negativity towards their child - using the 5-minute speech sample. Child behavioral problems were measured using the teacher-informant Strengths and Difficulties Questionnaire (SDQ). Child behavioral problems and parental EE were independently associated with impaired recognition of negative facial expressions specifically. An interactive effect revealed that the combination of both factors was associated with the greatest risk for impaired recognition of negative faces, and in particular sad facial expressions. No relationships emerged for the identification of happy facial expressions. This study furthers our understanding of multidimensional processes associated with the development of facial emotion recognition and supports the importance of early interventions that target this domain.

'Grounding a PIE in the sky': Laying empirical foundations for a psychologically informed environment (PIE) to enhance well-being and practice in a homeless organisation.

While psychologically informed environments (PIEs) are gaining in prominence in efforts to improve well-being and practice in the homeless sector, their empirical foundations remain tenuous. We present a unique scoping needs analysis of staff and client well-being, staff attitudes and the social-therapeutic climate in a UK-based homeless prevention organisation (prior to PIE implementation). Our aims were: (a) to apply a robust framework to pinpoint need and target forthcoming PIE initiatives and (b) to establish a validated needs baseline that informs and measures efficacy of PIE for its future development. Four established personal and practice well-being measures were administered to 134 (predominantly 'frontline') staff and 50 clients. Staff completed the: Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), Professional Quality of Life Scale (measuring compassion satisfaction [CS], burnout [BO] and secondary traumatic stress [STS]), Attitudes related to Trauma-informed Care Scale (ARTIC-10; measuring practice attitudes towards trauma-informed values) and the Essen Climate Evaluation Schema (EssenCES; measuring perceptions of client cohesion, safety and practitioner relationships in housing projects). Clients completed the WEMWBS and EssenCES. Vulnerability to STS was evident in nearly two-thirds of frontline staff and it was a statistically significant predictor of BO. It was not, however, associated with lesser levels of CS. We discuss this complex dynamic in relation to highlighted strategic recommendations for the PIE framework, and the identified potential challenges in implementing trauma-informed and reflective practice in the organisation. We conclude with a critique of the value and the lessons learnt from our efforts to integrate stronger empirical substance into the PIE approach.

Early adversity predicts adoptees' enduring emotional and behavioral problems in childhood.

Children adopted from the public care system are likely to experience a cluster of inter-related risk factors that may place them on a trajectory of mental health problems that persist across the life course. However, the specific effects of putative risk factors on children's mental health post-placement are not well understood. We conducted a prospective, longitudinal study of children placed for adoption between 2014 and 2015 (N = 96). Adoptive parents completed questionnaires at approximately 5, 21, 36, and 48 months post-placement. We used time series analysis to examine the impact of pre-adoptive risk factors [adverse childhood experiences [ACEs], number of moves, days with birth parents and in care] on children's internalizing and externalizing problems, and prosocial behavior over 4 years post-placement. Adoptees' internalizing and externalizing problems remained consistently high over the 4-year study period, but more ACEs predicted increases in internalizing and externalizing problems. Contrary to expectations, more pre-placement moves and time in care predicted fewer problems over time, but exploratory analyses of interactive effects revealed this was only the case in rare circumstances. We identify pre- and post-removal factors that may incur benefits or have a deleterious impact on adoptees' outcomes in post-adoptive family life. Our findings provide knowledge for front-line professionals in the support of adoptive families and underscore the vital need for effective early intervention.

The neurocognitive profiles of children adopted from care and their emotional and behavioral problems at home and school.

Adoptees' mental health problems in childhood and later life are well described, but little attention has been paid to domestically adopted children's emotional and behavioral problems and neurocognitive profiles. The aim of this study was to describe the neurocognitive profiles of domestically adopted children in the UK and their parent- and teacher-rated emotional and behavioral problems. Forty-five children (M age = 75.96 months, SD = 12.98; 51.1% female) who were placed for adoption from public care at a M age of 22.14 months (SD = 14.21) completed a battery of age standardized neurocognitive tests, and adoptive parents and school teachers rated their emotional and behavioral problems. Children had more emotional and behavioral problems than the general population and over a fifth scored low (> 1 SD below the expected range for their age) in 5/6 neurocognitive tasks. Children who scored low on the non-verbal reasoning task were more likely to have more parent- and teacher-rated behavioral problems, and children's performance on the inhibitory control and cognitive flexibility tasks were associated with parent-rated behavioral problems. Children's verbal reasoning scores were positively associated with both parent- and teacher-rated emotional problems. Children who were adopted later in childhood scored significantly lower in non-verbal reasoning. Although longitudinal studies are needed to clarify the nature of neurocognitive functioning as a marker for later mental health problems, our findings underscore the importance of using comprehensive assessments to better recognize adopted children's difficulties and inform appropriate intervention initiatives.

Charting the trajectories of adopted children's emotional and behavioral problems: The impact of early adversity and postadoptive parental warmth.

Children who are adopted from care are more likely to experience enduring emotional and behavioral problems across development; however, adoptees' trajectories of mental health problems and factors that impact their trajectories are poorly understood. Therefore, we used multilevel growth analyses to chart adoptees' internalizing and externalizing problems across childhood, and examined the associations between preadoptive risk and postadoptive protective factors on their trajectories. This was investigated in a prospective longitudinal study of case file records (N = 374) and questionnaire-based follow-ups (N = 96) at approximately 5, 21, and 36 months postadoptive placement. Preadoptive adversity (indexed by age at placement, days in care, and number of adverse childhood experiences) was associated with higher internalizing and externalizing scores; the decrease in internalizing scores over childhood was accelerated for those exposed to lower levels of preadoptive risk. Warm adoptive parenting was associated with a marked reduction in children's internalizing and externalizing problems over time. Although potentially limited by shared methods variance and lack of variability in parental warmth scores, these findings demonstrate the deleterious impact of preadoptive risk and the positive role of exceptionally warm adoptive parenting on children's trajectories of mental health problems and have relevance for prevention and intervention strategies.

Executive functions in homeless young people: Working memory impacts on short-term housing outcomes.

Most homeless young people have experienced multiple adversities, with potential implications for the development of Executive Functions (EFs), higher-order cognitive processes important for adaptation. EFs have been identified as putative contributors to the capacity to exit homelessness, however, little research has investigated EFs in homeless young people. To address gaps in current knowledge, this study compared executive function performance between homeless and housed young people. Relationships between EFs and short-term housing outcomes were also explored. Sixty-eight homeless young people (16-19 years) and 37 age-matched housed young people participated in this study. Computerized EF tasks spanned the domains of working memory, set shifting/flexibility, planning, impulsivity/risky decision making, selective attention/inhibition, and verbal fluency. Homeless young people demonstrated worse performance than housed youth on several EF tasks, particularly working memory and impulsivity/risky decision making. Working memory predicted progression into more independent accommodation; those with longer working memory spans were twice as likely to have progressed to more independent housing rather than maintained their current housing status after six months. Poorer EFs are associated with youth homelessness and also with an individual's ability to progress towards independence. As such, EFs should not continue to be overlooked by researchers and service providers. Emerging adulthood, as a sensitive period for EF development, is an opportune time for intervention to increase the likelihood of positive housing outcomes in homeless young people.

Depression and Anxiety Symptoms of British Adoptive Parents: A Prospective Four-Wave Longitudinal Study.

The mental health of birth parents has gained attention due to the serious negative consequences for personal, family, and child outcomes, but depression and anxiety in adoptive parents remains under-recognized. Using a prospective, longitudinal design, we investigated anxiety and depression symptoms in 96 British adoptive parents over four time points in the first four years of an adoptive placement. Depression and anxiety symptom scores were relatively stable across time. Growth curve analysis showed that higher child internalizing scores and lower parental sense of competency at five months post-placement were associated with higher initial levels of parental depressive symptoms. Lower parental sense of competency was also associated with higher initial levels of parental anxiety symptoms. Parents of older children and those with higher levels of parental anxiety and sense of competency at five months post-placement had a steeper decrease in depressive symptoms over time. Support for adoptive families primarily focuses on child adjustment. Our findings suggest that professional awareness of parental mental health post-placement may be necessary, and interventions aimed at improving parents' sense of competency may be beneficial.

Adverse Childhood Experiences of Children Adopted from Care: The Importance of Adoptive Parental Warmth for Future Child Adjustment.

We investigated the relationship between adverse childhood experiences (ACEs) and children's internalising symptoms and externalising problems in the Wales Adoption Cohort Study, a prospective longitudinal study that used case file records (n = 374) for a sample of British children adopted from care (M = 2 years, 55% male). Parents (n = 96) completed questionnaires at 3-5 months, 15-17 months, and 31-33 months post-placement. We hypothesised that: (1) children adopted from care would have experienced more ACEs than children in the general population; (2) the number of ACEs would be associated with higher internalising symptom and externalising problem scores; and (3) adoptive parental warmth would moderate the relationship between ACEs and post-placement internalising symptoms and externalising problems. Nearly half (42%) of the children experienced four or more ACEs. Internalising symptoms and externalising problems were significantly higher than the UK general population. The number of ACEs was associated with internalising symptoms 3 years post-adoptive placement but this relationship was moderated by adoptive parental warmth. This study profiles the experiences and characteristics of a national sample of adopted children and highlights the potential importance of parent warmth as a factor that ameliorates the impact of ACEs on poor child outcomes.

'Best friends forever'? Friendship stability across school transition and associations with mental health and educational attainment.

BACKGROUND: Friendships have been linked to mental health and school attainment in children. The effects of friendlessness and friendship quality have been well researched, but less is known about the role of friendship stability (i.e., maintaining the same friend over time), an aspect of friendship which is often interrupted by the transition between phases of schooling. Many children report concerns about the secondary school transition which introduces a number of new social and academic challenges for children. AIMS: To explore rates of friendship stability and whether maintaining a stable best friend across the primary to secondary school transition provided benefits to children's adjustment during this period. SAMPLE: Data were from 593 children (M age = 11 years 2 months). METHODS: This study used longitudinal data from children transitioning into 10 UK secondary schools and explored the association between self-reported friendship stability and three outcomes: academic attainment, emotional problems and conduct problems. Analyses controlled for friendship quality and pre-transition psychological adjustment or attainment as appropriate. RESULTS: Rates of friendship stability were relatively low during this period. Children who kept the same best friend had higher academic attainment and lower levels of conduct problems. Exploratory analyses indicated that secondary school policies that group children based on friendships may support friendship stability. CONCLUSIONS: Helping maintain children's best friendships during the transition to secondary school may contribute to higher academic performance and better mental health.

Maternal depressive symptoms and adolescent academic attainment: Testing pathways via parenting and self-control.

Maternal depression is associated with reduced academic attainment in children, however, it is not clear how this association comes about. Depressive symptoms are associated with impairment in social roles including parenting. Children's self-control is an important contributor to academic attainment and is influenced by parenting. We therefore hypothesised that impaired parenting and children's self-control may mediate links between maternal depression and children's academic attainment. Data were from a brief longitudinal study (3 waves) of UK children aged 11-12 years and their mothers. Higher maternal depressive symptoms at baseline were associated with lower academic attainment in children assessed one year later. There was evidence to support an indirect effect of maternal depressive symptoms on children's academic attainment through the mother-child and the father-child relationship which, in turn, reduced children's self-control. These influences were independent of socio-economic deprivation. A direct effect of maternal depression on children's academic attainment was also observed.

An investigation of changes in children's mental health in Wales between 2007/2008 and 2012/2013.

Improving children's mental wellbeing is a recognised public health priority, but evidence on recent trends is lacking. This study updates evidence on differences in child mental health since 2008 by comparing two nationally representative cohorts in Wales, UK. Parents of 4- to 12-year-old children completed the Strengths and Difficulties Questionnaire (SDQ). No significant differences were seen for younger girls between 2007/2008 and 2012/2013. There was a decrease in conduct, hyperactivity and total difficulties symptom scores and an increase in prosocial scores for boys and older girls. These findings suggest that rates of child mental health problems are stable or falling.

A systematic review of cognitive functioning among young people who have experienced homelessness, foster care, or poverty.

Young people who have experienced homelessness, foster care, or poverty are among the most disadvantaged in society. This review examines whether young people who have these experiences differ from their non-disadvantaged peers with respect to their cognitive skills and abilities, and whether cognitive profiles differ between these three groups. Three electronic databases were systematically searched for articles published between 1 January 1995 and 1 February 2015 on cognitive functioning among young people aged 15 to 24 years who have experienced homelessness, foster care, or poverty. Articles were screened using pre-determined inclusion criteria, then the data were extracted, and its quality assessed. A total of 31 studies were included. Compared to non-disadvantaged youth or published norms, cognitive performance was generally found to be impaired in young people who had experienced homelessness, foster care, or poverty. A common area of difficulty across all groups is working memory. General cognitive functioning, attention, and executive function deficits are shared by the homeless and poverty groups. Creativity emerges as a potential strength for homeless young people. The cognitive functioning of young people with experiences of impermanent housing and poverty has been relatively neglected and more research is needed to further establish cognitive profiles and replicate the findings reviewed here. As some aspects of cognitive functioning may show improvement with training, these could represent a target for intervention.

A longitudinal study of self-control at the transition to secondary school: Considering the role of pubertal status and parenting.

Higher self-control in children and adolescents is associated with a range of positive outcomes in adulthood. However, little is known about the naturalistic development of self-control during early adolescence and the factors that affect this. We examined the role of puberty and parenting style as theoretically important influences on stability and change in self-control. A longitudinal (3 waves), multiple-informant dataset of children entering early adolescence (M = 11 years) was used to explore longitudinal change in self-control using latent growth curve modelling. Children's self-control declined during the one-year study period and declines were associated with children's behavioural and social functioning. Associations with self-control were found for pubertal status and parental warmth and hostility, but not for parental discipline. The findings suggest that during early adolescence, when children make the transition to secondary school, self-control declines. This is particularly the case for those experiencing puberty earlier than their peers. Parent warmth influences the trajectory of self-control during this period.