"I remember most of my family seeing it": The presence of others during child physical abuse, as conveyed in forensic interviews with Israeli children.

Child physical abuse is often perceived as a crime perpetrated within the family and out of sight. However, recent studies have indicated the presence of others during incidents of physical abuse. The current study was designed to examine the experiences and perceptions of children who were physically abused in their families concerning the presence of others, as conveyed during their forensic interviews. A thematic analysis of 26 forensic interviews was conducted with Israeli children aged 5-13. Three main themes were identified: (1) Patterns, roles, and coping mechanisms: The multifaceted spectrum of familial abuse; (2) The echoes of family reactions: Shaping children's abuse experiences; and (3) Navigating the storm together: Sibling bonds amidst familial abuse. The children's narratives highlighted their distress and pointed to the abusive and chaotic daily routine in which they lived. In spotlighting their encounters with physical abuse, the children focused on their need to be seen and gain certainty in their daily routines. The discussion highlights the unique and elusive dynamics of families in which child physical abuse occurs and challenges the social perception that physical abuse occurs secretly. The characteristics of such abuse highlight the urgent need for policymakers and professionals to treat the phenomenon of physical abuse within the family as a visible phenomenon.

Expanding the food environment framework to include family dynamics: A systematic synthesis of qualitative evidence using HIV as a case study.

Food environment changes in low- and middle-income countries are increasing diet-related noncommunicable diseases (NCDs). This paper synthesizes the qualitative evidence about how family dynamics shape food choices within the context of HIV (Prospero: CRD42021226283). Guided by structuration theory and food environment framework, we used best-fit framework analysis to develop the Family Dynamics Food Environment Framework (FDF) comprising three interacting dimensions (resources, characteristics, and action orientation). Findings show how the three food environment domains (personal, family, external) interact to affect food choices within families affected by HIV. Given the growing prevalence of noncommunicable and chronic diseases, the FDF can be applied beyond the context of HIV to guide effective and optimal nutritional policies for the whole family.

Perceived Impact of Sensory Integration Therapy on the Family.

BACKGROUND: Many children with sensory processing differences receive occupational therapy services using sensory integration therapy (SIT). Studies exist to demonstrate the effects of this intervention on the child receiving the service. However, children exist as part of a family unit. There is limited research to examine the effect of SIT on the family. OBJECTIVES: The purpose of this study was to explore the perceptions and experiences of caregivers as to the impact on families of children who received SIT. METHODOLOGY: Qualitative, phenomenological methodology was utilized. RESULTS: Results revealed four themes: family routines, parent response/reaction to sensory, modified participation in family activities needs, and improved regulation leading to increased family participation outside the home. CONCLUSION: This study indicates that parents perceive positive effects on participation of the family unit and for the child receiving SIT therapy.

Perceived Impact of Sensory Integration Therapy on the FamilyThis study provides information on how occupational therapy using a sensory integration approach impacts more than just the child who receives the service and extends to the family, positively impacting participation in daily life.

Family Dynamics, Socioeconomic Hardships, and Health Risk Behaviours of Bulgarian Adolescents during the COVID-19 Pandemic.

BACKGROUND/OBJECTIVES: This study aims to explore family dynamics and the economic hardships experienced by families during the COVID-19 pandemic and their associations with adolescents' health risk behaviours (HRBs). METHODS: Based on a representative study of adolescents aged 11-16 conducted in Bulgaria during the COVID-19 pandemic and HBSC data from the pre-pandemic period, logistic regression models were applied, assessing cigarette smoking, vaping, alcohol use, drunkenness, and cannabis use. The independent variables included demographics, Family Affluence Scale (FAS III), family structure, ease of communication with parents, and the authors' developed questions on parents' income and economic status change, family conflicts, and missing contact with extended family due to the pandemic. RESULTS: Material status of the family showed increasing differentials in adolescents' HRBs during the pandemic. Parental unemployment, income reduction, and temporary lay-offs were associated with a higher risk of substance use. Family conflicts, missing contact with extended family, and difficulties in communication with the mother were related to a higher risk of substance use. Communication with the father was significantly associated with alcohol use and drunkenness. Boys had lower odds of vaping and higher odds of alcohol use, drunkenness, and cannabis use. Higher age and minority status were associated with an increase in adolescents' HRBs. CONCLUSIONS: This study highlights the need for special family-focused interventions in times of health and economic crises.

Siblings at home: Moderating influence of sibling presence and composition on the relation between problem behaviors and Theory of Mind in early childhood.

Despite the prevalence of internalizing and externalizing difficulties in children, the impact of these problem behaviors on the development of important social cognitive skills, such as Theory of Mind (ToM), is not well-understood. Indeed, many studies that have explored relations between problem behaviors and ToM report inconsistent findings. A possible reason for these disparities may be a lack of accounting for social protective factors within the home, such as the presence and number of siblings. Here, we explored the moderating influence of sibling presence and number on the relation between problem behaviors (i.e., internalizing and externalizing) and ToM. A total of 184 children (88 boys; Mage = 64.6 months, SD = 10.39) completed six well-validated ToM tasks while mothers reported on their children's externalizing and internalizing behaviors. Children who had siblings living in the same home exhibited higher ToM than children without siblings. In addition, both sibling presence and number of siblings moderated the relation between children's externalizing behaviors and ToM, such that in children without siblings externalizing behaviors were negatively associated with ToM. In contrast, children with siblings had similar ToM regardless of externalizing behaviors. As well, children with relatively fewer siblings and higher externalizing behaviors displayed lower ToM than children with relatively more siblings and higher externalizing behaviors. We did not detect a moderating effect of sibling presence or number on the relation between internalizing behaviors and ToM. These findings provide support for siblings' protective utility within the context of children's social cognition.

Patterns of Family Conflict and Accusations of Abuse in Dementia Family Caregivers: A Latent Class Analysis.

BACKGROUND AND OBJECTIVES: Family conflict is a stressor for dementia family caregivers, yet its impact may differ based on the relationship between caregivers and their recipients. This study's objectives were to categorize caregivers into groups based on family conflict, examine whether the relationship to the recipient influences group membership, and determine whether these groups are associated with engaging in abusive and neglectful behaviors. RESEARCH DESIGN AND METHODS: This national, cross-sectional study of 453 dementia family caregivers used latent class analysis to generate groups based on family conflict and abuse accusations. A multinomial logistic regression determined if relationship type (i.e., being a spouse, child, or grandchild to the care recipient or having a nontraditional relationship) predicted group membership. Groups were examined as predictors of abusive and neglectful behaviors using analysis of variance. RESULTS: A 4-class solution emerged as the best fit: 3 groups with varying probabilities of family conflict and 1 group with elevated probabilities of abuse and neglect accusations. Relationship typed predicted membership in these classes. Group membership predicted abusive and neglectful behaviors. DISCUSSION AND IMPLICATIONS: Adult children were more likely to experience high amounts of family conflict, whereas nontraditional caregivers were less likely to experience abuse and neglect accusations. Membership in the accusations group was a unique risk factor for abusive and neglectful behaviors. These findings support the need for continued investigation of family conflict in dementia caregivers. They also call to examine how family relationship types, including nontraditional family structures, influence caregiving outcomes.

Assessing family relationships through drawing: the Family Life Space.

The Family Life Space (FLS) is a graphic instrument that may aid the relational assessment of families. This interactive instrument involves all members of the family in a joint task, that of collectively making a drawing of their own family system and it allows the gathering of information related to the overall family organization. The FLS was originally conceived by Danuta Mostwin in the early 70s and used as an instrument for clinical intervention. After having been applied to several contexts, the present contribution aims at presenting the key indicators to use the instrument as a tool for assessing family relations. Specifically, the characteristics of the instrument that allow the gathering of relevant information at the individual, relational, and family level will be outlined. For each of these levels, the data regarding the quantity and quality of the elements in the drawing that define the family space (i.e., the number and graphic quality of the actual elements in the drawing) as well the quantity and quality of the relationships among family members and with their community at large (i.e., the number and type of lines connecting the various elements in the drawing) will be presented. The instrument can therefore provide useful insights on the following constructs: quality of life, power dynamics within the family, feelings of belonging, closeness and/or distance as well as conflict or acknowledgement between family members and the overall attitude family members have toward their context and the critical events they had to face. The application and complete potential of the instrument are further elaborated upon through the presentation of a clinical case. This case not only aids in comprehending the tool's usage but also enables the collection of psychological information about the family and provides a clinical interpretation of family relationships.

Exploring the role of pain on physical activity among youth with acute lymphoblastic leukemia using the biopsychosocial model.

BACKGROUND: Engaging in physical activity (PA) throughout cancer treatment offers many benefits, but may be challenging due to cancer-related pain. Pain research in pediatric cancer has primarily focused on procedural pain, with fewer studies exploring how pain affects PA. The current study qualitatively investigated the impact of pain on PA in youth with acute lymphoblastic leukemia (ALL) using a biopsychosocial framework. PROCEDURE: As part of a larger study, caregivers (N = 17) of a child diagnosed with ALL and on treatment for less than 1 year completed a semi-structured interview about perceptions of their child's health behaviors during ALL treatment. This secondary analysis focused specifically on discussions about pain and its impact on PA. We followed Braun and Clarke's (2006) six-step thematic analysis framework to identify themes of pain-related barriers to PA. RESULTS: Key pain-related barriers endorsed by caregivers included: interactions among pain and treatment effects, caregiver distress around seeing their child in pain, and fear of interfering with medical equipment. Despite these barriers, caregivers found creative solutions to adapt activities for their child. Caregivers were reassured by PA advice from their medical team; however, advice varied between teams. CONCLUSION: The relationship between pain and PA during ALL treatment is influenced by an intricate system of biological (e.g., treatment effects), psychological (e.g., parental distress), and social (e.g., communication among families and medical teams) factors. Future directions include identifying evidence-based PA recommendations and exploring family-team communication dynamics. This study also highlights a need to prioritize ALL pain management and involve caregivers in behavioral treatment protocols to improve PA.

Exploring Sibling Relationship Quality among Latinx Siblings: A Systematic Review.

This systematic review addresses the gap in the literature regarding sibling relationship quality among Latinx families, a topic that has not been comprehensively examined to date. This study aimed to synthesize current research on sibling relationship quality in Latinx families, focusing on the influence of cultural factors, identifying key variables associated with sibling relationship quality, and evaluating the methodological approaches used. This paper is a systematic review based on a recently published evidence and gap map (EGM) that identified and visually presented all published studies investigating sibling relationship quality. Additional inclusion criteria were applied to select articles that specifically examined sibling relationship quality in the United States samples with at least 50% Latinx participants. The review included 12 articles representing 6 distinct studies, revealing significant findings on the roles of familism, simpatía, and gender in shaping sibling dynamics. Results indicated that cultural values such as familism and simpatía positively influence sibling intimacy and warmth, while gender dynamics further moderate these relationships. Methodologically, the articles employed longitudinal and cross-sectional designs, utilizing various quantitative measures. The findings underscore the importance of culturally sensitive approaches in studying sibling relationships and highlight the need for further research to explore these dynamics in diverse Latinx subgroups.

Understanding the Dynamics: A Comprehensive Review of Family Therapy's Impact on Expressed Emotions in Schizophrenia Patients.

This comprehensive review examines the impact of family therapy on expressed emotions (EE) within the context of psychiatric disorders. EE, characterized by high levels of criticism, hostility, or emotional over-involvement, have been consistently linked to poorer treatment outcomes and increased severity of psychiatric symptoms. The review explores various family therapy approaches and their effectiveness in reducing high EE levels in families of psychiatric patients. It synthesizes existing literature to highlight the mechanisms underlying the changes in EE, such as modifying communication patterns and enhancing family cohesion. Additionally, the review discusses the implications for clinical practice, emphasizing the importance of integrating family therapy into psychiatric treatment plans and providing psychoeducation to empower families to manage emotions effectively. Future research directions are also outlined, including investigating the long-term sustainability of changes brought about by family therapy and exploring cultural considerations in therapeutic approaches. Overall, the review underscores the pivotal role of family therapy in addressing EE and promoting recovery and resilience in psychiatric patients and their families.

Childhood Environmental Instabilities and Their Behavioral Implications: A Machine Learning Approach to Studying Adverse Childhood Experiences.

Adverse childhood experiences (ACEs) include a range of abusive, neglectful, and dysfunctional household behaviors that are strongly associated with long-term health problems, mental health conditions, and societal difficulties. The study aims to uncover significant factors influencing ACEs in children aged 0-17 years and to propose a predictive model that can be used to forecast the likelihood of ACEs in children. Machine learning models are applied to identify and analyze the relationships between several predictors and the occurrence of ACEs. Key performance metrics such as AUC, F1 score, recall, and precision are used to evaluate the predictive strength of different factors on ACEs. Family structures, especially non-traditional forms such as single parenting, and the frequency of relocating to a new address are determined as key predictors of ACEs. The final model, a neural network, achieved an AUC of 0.788, a precision score of 0.683, and a recall of 0.707, indicating its effectiveness in accurately identifying ACE cases. The model's ROC and PR curves showed a high true positive rate for detecting children with two or more ACEs while also pointing to difficulties in classifying single ACE instances accurately. Furthermore, our analysis revealed the intricate relationship between the frequency of relocation and other predictive factors. The findings highlight the importance of familial and residential stability in children's lives, with substantial implications for child welfare policies and interventions. The study emphasizes the need for targeted educational and healthcare support to promote the well-being and resilience of at-risk children.

Lifestyle Dimensions of Public Safety Personnel Families: There's No Life Like It.

PURPOSE: The nature and cumulative occupational demands imposed on families of public safety personnel (PSP) are substantial, in many cases non-negotiable, and distinct from the general population accentuating risk factors for family well-being. Despite this reality, the contributions of PSP families are not well understood, and a conceptual framework is needed. The aim of this paper is to summarize contextual factors (lifestyle dimensions) that shape the lives of PSP families; factors supported in the existing, albeit limited, body of research. METHODS: Grounded in the interpretive/constructivist paradigm, a synthesis was central to understanding the lived experiences of PSP families. An interdisciplinary research team engaged in an iterative process of framework analysis to capture the variability and complexity of PSP family life and distilled the overarching lifestyle dimensions. RESULTS: Three lifestyle dimensions-logistics, risks, and identities-emerged from contextual factors and represent distinct aspects of PSP family life. PSP families play a crucial role in that their capacity to accommodate the lifestyle dimensions (i.e., logistics, risks, and identities), without which the PSP could not meet the demands of the profession. CONCLUSION: Promoting awareness of these dimensions and their consequent demands underscores the cumulative demands that put PSP families at risk. Responses from governments, public safety organizations, and communities are required to help PSP families manage non-negotiable elements of the public safety occupation that spill over into family life over which they have no control.

Association Between Egalitarian Gender Attitudes and Attitudes Toward Same-Sex Marriage: Findings from a National Representative Survey.

Egalitarian gender attitudes are linked to increased support for same-sex marriage, with previous studies mainly focusing on Western countries. Limited existing research from Asian countries often relied on non-representative, convenient samples. Taiwan, the first Asian country to legalize same-sex marriage in 2019, offers a valuable context. Since surveys before 2020 lacked questions on attitudes toward same-sex marriage, we utilized the 2020 PSFD data for a cross-sectional analysis. Logistic regression analyses were conducted to explore the relationship between gender attitudes (assessed through six questions) and attitudes toward same-sex marriage, along with examining the moderation effects of socio-demographic variables. The results revealed significant associations between embracing egalitarian gender attitudes and increased support for same-sex marriage (adjusted odds ratio [aOR] ranged from 1.34 to 2.08, 95% CI = [1.15, 2.45]). Moderation analysis indicated that this connection appeared to be more pronounced among younger individuals, those who were not currently married, and those with higher educational attainment. Individuals who are older, less educated, or married and hold negative views on gender equality should be targeted for efforts to enhance their support for same-sex marriage. Advocating for gender equality aligns with principles of equality, nondiscrimination, and recognizing fundamental rights for all, irrespective of sexual orientation.

Systematic review of family and pediatric constipation: An overlooked piece of the puzzle.

The objective of this review is to summarize pertinent literature looking at family dynamics and/or adherence to treatment in pediatric functional constipation. A structured systematic literature search was conducted on MEDLINE, Embase, and Web of Science core collection libraries from the years 2000 to 2023 using specific search terms: constipation, treatment adherence, family dynamics, parenting style, and pediatrics. Seventy-one publications were identified and included for review. After screening based on alignment to the review, 20 publications remained. These publications were placed into three categories depending on their intent and findings: (1) recommendations to further increase adherence, (2) studies analyzing factors of adherence, and (3) studies stating a need for a better understanding of family factors. A future area of research is identifying the associations between family factors on adherence to constipation treatment regimens. Results from such studies would increase the amount of positive treatment outcomes and decrease unnecessary healthcare costs.

Parenting Amid Shadows: Exploring the Child-Rearing Experiences of Wives of Individuals With Alcohol Use Disorder.

INTRODUCTION: The pervasive impact of alcohol use disorder (AUD) within families, particularly on parenting roles in Kerala, India, necessitates an in-depth exploration. This study aims to uncover the unique challenges and coping strategies employed by wives of individuals with AUD against a backdrop of societal stigma and economic hardship. METHODOLOGY: This study, employing a qualitative narrative research design, delves into the experiences of 30 wives of men with AUD in Kerala. The study delves into the complexities of navigating parenting responsibilities amid challenges related to AUD, employing in-depth interviews with the aid of a semi-structured interview guide conducted in Malayalam.​​​​​ The researchers used narrative analysis to extract the themes related to coping mechanisms, resilience, and the impact on children's psychological health. RESULTS: The study highlights significant emotional and social burdens on wives, including solo parenting, financial strain, and social stigma. Despite these challenges, the resilience and adaptive strategies of these women stand out, with extended family support, community resources, and personal beliefs playing crucial roles in their coping mechanisms. The study points out variations in coping strategies across different socio-economic and educational backgrounds. IMPLICATIONS: The findings underscore the necessity for comprehensive support systems sensitive to the socio-demographic differences among families affected by AUD. Tailored interventions that enhance access to professional support, foster community solidarity, and provide economic assistance are critical. Moreover, efforts to reduce stigma and promote understanding are essential for improving the psychological health and overall quality of life of these families.

Parenting styles and psychological effects on children with alopecia areata: exploring family dynamics, anxiety, and depression.

Alopecia areata (AA) is an autoimmune disease that develops due to inflammation and causes sudden hair loss. Ithas been observed that family circumstances may contribute to the development of AA. This study aims to assessthe relationship between the development of alopecia areata in children, family functions, and depression andanxiety levels in their parents.Thirty-nine participants diagnosed with AA and 41 healthy controls (HC), agedbetween 8 and 18 years, and their parents participated in the study. The assessment of the children included thecompletion of a socio-demographic data form, the Parenting Style Scale (PSS), and the Revised Children's Anxietyand Depression Scale (RCADS). The parents provided information on a sociodemographic form, the BeckDepression Inventory (BDI), and the Beck Anxiety Inventory (BAI). The children in the control group scoredsignificantly higher on the PSS acceptance/ involvement subscale than those with AA. In the AA group, the numberof authoritative and indulgent (PSS) families was statistically significantly lower than that of the families in the HC,and the number of neglectful families was statistically significantly higher than those of the control group. Totalanxiety and depression t scores (RCADS) were statistically significantly higher in the AA children than in theHC. Our study demonstrates the importance of considering familial factors and parental mental health tounderstand and address alopecia areata in children. Our findings support the psychosomatic component of AA.Implementing comprehensive treatment strategies that target psychological well-being and family dynamics couldprove crucial.

The Impact of Recurrent Epistaxis on the Quality of Life of Children and the Functioning of Their Families.

Introduction Epistaxis, or nosebleeds, is a common pediatric emergency, impacting their quality of life (QoL). Existing research on epistaxis has predominantly focused on clinical aspects, overlooking its broader impact on the quality of life of affected children and the functioning of their families. This study seeks to fill that gap by assessing the impact of recurrent epistaxis on children's QoL, family dynamics, and parental stress in Saudi Arabia's Eastern region. Methods A survey was conducted involving 168 parents of children with recurrent epistaxis, using the Pediatric Quality of Life InventoryTM (PedsQL 4.0TM) Short Form (SF) for QoL assessment across different age groups, the PedsQL 2.0 Family Impact Module to evaluate the effect of the child's health on family dynamics, and a custom questionnaire for gathering sociodemographic and health-related information. Better QoL and family functioning were indicated by higher scores. Results Recurrent epistaxis was more frequent (>4 times per year) in 58.9% of cases, with unknown causes in 72%. A total of 116 (69%) of the children never needed medical intervention for epistaxis and 52 (31%) visited ER 1-2 times. The lowest scores for both children and parents were in the emotional functioning domains (77.9 and 78.2, respectively). In the study, both parents and children who had no history of ER visits exhibited significantly higher quality of life (QoL) scores compared to those who did, with parents reporting 83.7% versus 77.2% (P=.022), and children showing 84.6% versus 79.9% (P=.049), respectively. Parents of older children, ages 13-18 years, reported a higher Quality of Life (QoL) at 83.9%, compared to those with younger children, ages 2-4 years, who reported a QoL of 57.3% (P=.003). Conclusion The overall QoL scores of families of children with recurrent epistaxis were relatively high, indicating a variable and limited general impact. Significantly higher QoL was observed in families of older children and those without ER visits.

The association between family dynamics and Positive Youth Development in secondary education students.

INTRODUCTION: The Positive Youth Development (PYD) framework is a strengths-based approach to adolescence that states that adolescents will thrive if nurtured by the right developmental assets. The family is one of the most important developmental assets, but studies about the relationship between family dynamics and the overall PYD of adolescents are scarce. OBJECTIVE: The present study aims to examine the associations between five family dynamics indicators and PYD, while taking into account the role of gender. METHODS: A cross-sectional study was carried out with a representative sample of adolescents from the city of Huelva, Spain (n = 1,036). Data were collected in 14 randomly selected secondary education schools. A Structural Equation Model (SEM) was tested to determine the effect of family dynamics on PYD, both for the whole sample and within each gender. RESULTS: The SEM for the whole sample showed a positive effect of the family dynamics factor on the PYD factor, explaining 51.8% of its variance. The indicators of satisfaction with the relationship with the mother, satisfaction with the relationship with the father, frequency of engaging in joint family activities on weekends, and frequency of sharing daily occurrences at home showed factor loadings over 0.50, while the indicator of frequency of contribution to household chores had the lowest loading. The family dynamics factor in the model with the subsample of girls explained 54.8% of the variance in PYD, while in the SEM with the subsample of boys this factor explained 47.6% of it. Additionally, among girls, the relative influence of satisfaction in the relationship with the parents, as well as of frequently discussing the day at home, is higher than among boys. CONCLUSION: These results highlight a strong association between family dynamics indicators and PYD among adolescents and indicate that this relationship is stronger for girls than for boys. Intersectoral policies enhancing improvements in family dynamics (e.g., facilitating the practice of joint family activities on weekends) may have a relevant impact on PYD.

Childcare sharing and family happiness: analyzing parental and child well-being in the actor-partner interdependence model.

Introduction: The exploration of the relationship between parental and child happiness, particularly in the context of shared childcare responsibilities, has not been examined in Korean families. Methods: Using a two-wave longitudinal design and data from 1,403 families from the Panel Study on Korean Children, this study employed the actor-partner interdependence model to examine the dynamics of childcare sharing between mothers and fathers in South Korea. Results: Mothers' childcare sharing was found to have no significant impact on their own and their partner's happiness, reflecting traditional gender norms that undervalue mothers' contributions. In contrast, fathers' childcare sharing had a positive impact on their own and their spouse's happiness, suggesting a growing recognition of fathers' involvement. Furthermore, fathers' active participation in childcare was found to promote their children's happiness through their own happiness. Discussion: This study reflects the complexity of evolving family roles and the covert persistence of traditional gender roles in modern Korean parenting. It suggests the importance of work and family policies that support changes in family dynamics by providing a more nuanced understanding of how changing family roles and responsibilities can enhance overall family well-being.

Grandparent Caregivers Lived Experiences and Resource Needs/Use During the COVID-19 Pandemic.

This project examined the impacts of the COVID-19 pandemic on grandparent caregivers, grandchildren, family dynamics, and resources to mitigate and navigate crises. Phone interviews were conducted with 24 grandparent caregivers using a semi-structured interview guide. Caregivers explained that the pandemic had impacted them and their grandchildren by increasing emotional distress, social isolation, financial difficulties, and challenges with education. Helpful resources consisted of financial support, respite care, and support for grandchildren. Thus, there is a need to provide grandparent caregivers with the same resources that foster care providers receive - particularly when faced with challenges such as the COVID-19 pandemic.