Social media and ADHD: implications for clinical assessment and treatment.

The interaction between social media use and mental health is complicated. The mental health information shared on these platforms is frequently of poor quality but has the potential to exert powerful influence on users. Social media trend peaks in some mental disorders have led to increases in illness behaviour through social contagion. There has been a marked upsurge in online interest in attention deficit hyperactivity disorder (ADHD) over the last number of years, which has been particularly noticeable since the onset of the COVID-19 pandemic. The exponential increase in online ADHD interest has the potential to contribute to overloading mental health services with referrals. Mental health professionals and organisations need to consider strategies to ensure that quality health information is disseminated to younger audiences.

Contextualizing Children's Caregiving Responses to Interparental Conflict: Advancing Assessment of Parentification.

Parentification is a parent-child dynamic in which children assume caregiving responsibilities while parents fail to support and reciprocate children's roles. There is a gap between empirical research, which typically operationalizes parentification as the occurrence of children's caregiving behaviors, and theory, which emphasizes consideration of the family context in which children engage in caregiving as well as adjustment. The present study (N=235) considered multiple operationalizations of the construct by assessing kindergarten-aged children's caregiving reactions to interparental conflict in a standardized paradigm and additionally contextualizing caregiving reactions within family context and child adjustment over time through mixture modeling approaches. Although 88% of children endorsed caregiving, contextualizing caregiving resulted in lower estimates of this phenomenon (conservatively, 30%). Moreover, contextualizing children's caregiving at the family level (i.e., within parent-child relationships) proved most informative in identifying between-family differences in within-family experiences of parentification. Despite identifying a pattern of parentification at the family level (high children's caregiving reactions in conjunction with poor parental caregiving competence and poor autonomy support), children's adjustment (externalizing, internalizing, prosocial behavior) remained in the normative range of functioning over two years, potentially suggesting child resilience to this family risk context. As such, these findings demonstrate an advancement in measuring parentification by contextualizing young children's caregiving within parent-child relationships.

Youth in Northern Ireland: Linking Violence Exposure, Emotional Insecurity, and the Political Macrosystem.

Growing up in the aftermath of armed conflict puts youth at a higher risk for psychopathology-particularly in societies like Northern Ireland which continue to be characterized by intergroup tension and cyclical violence. This risk may be heightened during adolescence, when youth are beginning to explore their identities and are becoming more aware of intergroup dynamics in both their immediate communities and the broader society. It is also during this stage when youth increasingly witness or engage in antisocial behavior and sectarian activities. A series of studies in Belfast conducted by Cummings et al. (2014, Child Dev Perspect, 12(1), 16-38; 2019, J Clin Child Adolesc Psychol, 48(2), 296-305) showed that adolescents' exposure to sectarian violence resulted in heightened emotional insecurity about the community and subsequent adjustment problems. Though the impact of direct exposure to violence is well documented, few studies have accounted for the influence of sectarianism that occurs outside of one's immediate environment. These influences may include the general climate surrounding events that are not experienced firsthand but are nonetheless salient, such as the overarching levels of tension between groups or societal discourse that is threatening to one's identity. These higher-level influences, often referred to collectively as the macrosystem, are a necessary component to consider for adequately assessing one's socio-developmental environment. Yet, measurement at this level of the social ecology has proven elusive in past work. The current study advances research in this area by using newspaper coding as a method of measuring the political macrosystem in Northern Ireland and assessing whether a tense or threatening climate serves as an added risk factor for youth living in Belfast. In the current study, we measured sectarian violence at the level of the macrosystem by systematically collecting and coding newspaper articles from Northern Ireland that were published between 2006 and 2011 (N = 2,797). Each article was coded according to its level of overall political tension between Catholics and Protestants, threat to Catholics, and threat to Protestants. When aggregated, these assessments reflected the overarching trends in Catholic-Protestant relations during this period. In order to assess the association between these sociopolitical trends and the direct experiences of adolescents, the newspaper coding was linked with five waves of survey data from families (N = 999) in socioeconomically disadvantaged areas of Belfast. Using a series of multilevel moderation analyses, we then tested whether intergroup tension and ingroup threat moderated the relation between adolescents' direct exposure to violence and their emotional insecurity. These analyses were followed by a thematic analysis of the coded newspaper articles in order to provide further context to the findings. The results indicated that adolescents' response to direct exposure to sectarian violence varied based on the political climate at the time of their interview. Overall, the adolescents' emotional insecurity about the community increased with exposure to sectarian violence. During periods when the sociopolitical climate was characterized by high levels of intergroup political tension, this relation was slightly weaker-regardless of the adolescents' ingroup (i.e., Protestant vs. Catholic). During periods when the sociopolitical climate was coded as threatening, this relation was weaker for Catholic adolescents. That is, high levels of macro-level threat-particularly events coded as threatening for Protestants-seemed to be a protective factor for Catholic adolescents. Group differences were also found based on the adolescents' cumulative amount of exposure to sectarian violence. As threat in the macrosystem increased, Catholic adolescents who were directly exposed to higher than average levels of sectarian violence became more emotionally secure, while Catholics with little to no exposure to violence became more insecure. Contrastingly, Protestant adolescents directly exposed to higher than average levels of sectarian violence were more insecure than Protestants with little to no violence exposure. A thematic analysis of the newspaper articles revealed the categories of events that were viewed by coders as politically tense and threatening. Five primary themes emerged: ineffective policing and justice, family and community unrest, memories of violence, destabilized leadership, and organized paramilitary activity. Many of the articles coded as most threatening reported on a spike in attacks organized by dissident republican groups-that is, members of the Catholic community with, particularly hardline views. This may be pertinent to the finding that associations between sectarian violence exposure and emotional insecurity were exacerbated during this time for Protestants but not for Catholics. Findings from the thematic analysis provide a deeper examination of the context of events taking place during the study period, as well as their potential bearing on interpretation of the macro-level effects. In conclusion, these findings illustrate how one's response to the immediate environment can vary based on shifts in the political macrosystem. The current study thus contributes conceptually, empirically, and methodologically to the understanding of process relations between multiple levels of the social ecology and adolescent functioning. These results may further inform the design of future interventions and policies meant to lessen the impact of political violence. The methods used here may also be useful for the study of other contexts in which macrosystem effects are likely to have a salient impact on individual wellbeing.

Empowerment, Digital Literacy and Shared Digital Health Records: The Value of 'nothing about me without me'.

People with complex chronic conditions (CCCs), particularly those living in rural locations, experience numerous challenges in engaging with quality integrated healthcare services. The deployment of shared digital health records (SDHRs) has been promoted to lessen these issues. However, the implementation of them has actually exacerbated the problems and inhibited SDHR adoption and use with this cohort as well as amongst rural health professionals. Based on a larger study conducted with a rural community, supported to adopt and use their SDHR, this paper highlights one finding, an empowerment gap. This needs to be overcome if vulnerable healthcare users and health professionals are to be able adopt and use SDHRs and realise some of their promised benefits. Critically, the finding highlights the importance of these users being empowered as active participants in SDHR adoption and use including by overcoming the digital literacy challenges faced. The research demonstrates that traditionally marginalised people living with CCCs in rural communities can be empowered and benefit more from an SDHR in ways comparable with users from less vulnerable groups.

Distinguishing Attachment and Affiliation in Early Adolescents' Narrative Descriptions of Their Best Friendship.

This study was designed to test for specificity in the relationship between individual friendship provisions and adjustment across early adolescence. Using a narrative procedure, attachment (i.e., accessing care) and affiliation (i.e., forming cooperative partnerships) were found to be distinct functional themes organizing 293 adolescents' (Mage  = 13) internal representations of their best friendship across three annual measurement occasions. Longitudinal, cross-lag analyses revealed a unique transactional relationship between friendship affiliation and greater social competence over time, controlling for friendship stability, maternal relationship quality, socioeconomic status, and gender. By contrast, friendship attachment predicted fewer subsequent internalizing symptoms from ages 14 to 15. Together, findings point to the importance of understanding individual differences in the content of adolescents' internal representations of friendship.

Conducting longitudinal, process-oriented research with conflict-affected youth: Solving the inevitable challenges.

The reader might get the impression that the four projects described in this Special Section proceeded in a systematic and predictable way. Of course, those of us engaged in each research project encountered pitfalls and challenges along the way. A main goal of this Special Section is to provide pathways and encouragement for those who may be interested in advancing high-quality research on this topic. In this paper, we describe a set of practical and ethical challenges that we encountered in conducting our longitudinal, process-oriented, and translational research with conflict-affected youth, and we illustrate how problems can be solved with the goal of maintaining the internal and external validity of the research designs. We are hopeful that by describing the challenges of our work, and how we overcame them, which are seldom treated in this or any other literature on research on child development in high-risk contexts, we can offer a realistic and encouraging picture of conducting methodologically sound research in conflict-affected contexts.

The developmental costs and benefits of children's involvement in interparental conflict.

Building on empirical documentation of children's involvement in interparental conflicts as a weak predictor of psychopathology, we tested the hypothesis that involvement in conflict more consistently serves as a moderator of associations between children's emotional reactivity to interparental conflict and their psychological problems. In Study 1, 263 early adolescents (M age = 12.62 years), mothers, and fathers completed surveys of family and child functioning at 2 measurement occasions spaced 2 years apart. In Study 2, 243 preschool children (M age = 4.60 years) participated in a multimethod (i.e., observations, structured interview, surveys) measurement battery to assess family functioning, children's reactivity to interparental conflict, and their psychological adjustment. Across both studies, latent difference score analyses revealed that involvement moderated associations between emotional reactivity and children's increases in psychological (i.e., internalizing and externalizing) problems. Children's emotional reactivity to interparental conflict was a significantly stronger predictor of their psychological maladjustment when they were highly involved in the conflicts. In addition, the developmental benefits and costs of involvement varied as a function of emotional reactivity. Involvement in interparental conflict predicted increases in psychological problems for children experiencing high emotional reactivity and decreases in psychological problems when they exhibited low emotional reactivity. We interpret the results in the context of the new formulation of emotional security theory (e.g., Davies & Martin, 2013) and family systems models of children's parentification (e.g., Byng-Hall, 2002).

Political violence and child adjustment in Northern Ireland: Testing pathways in a social-ecological model including single-and two-parent families.

Moving beyond simply documenting that political violence negatively impacts children, we tested a social-ecological hypothesis for relations between political violence and child outcomes. Participants were 700 mother-child (M = 12.1 years, SD = 1.8) dyads from 18 working-class, socially deprived areas in Belfast, Northern Ireland, including single- and two-parent families. Sectarian community violence was associated with elevated family conflict and children's reduced security about multiple aspects of their social environment (i.e., family, parent-child relations, and community), with links to child adjustment problems and reductions in prosocial behavior. By comparison, and consistent with expectations, links with negative family processes, child regulatory problems, and child outcomes were less consistent for nonsectarian community violence. Support was found for a social-ecological model for relations between political violence and child outcomes among both single- and two-parent families, with evidence that emotional security and adjustment problems were more negatively affected in single-parent families. The implications for understanding social ecologies of political violence and children's functioning are discussed.

Harsh parenting and child externalizing behavior: skin conductance level reactivity as a moderator.

Skin conductance level reactivity (SCLR) was examined as a moderator of the association between harsh parenting and child externalizing behavior. Participants were 251 boys and girls (8-9 years). Mothers and fathers provided reports of harsh parenting and their children's externalizing behavior; children also provided reports of harsh parenting. SCLR was assessed in response to a socioemotional stress task and a problem-solving challenge task. Regression analyses revealed that the association between harsh parenting and externalizing behavior was stronger among children with lower SCLR, as compared to children with higher SCLR. SCLR may be a more robust moderator among boys compared to girls. Results are discussed with regard to theories on antisocial behavior and multiple-domain models of child development.

Marital psychological and physical aggression and children's mental and physical health: direct, mediated, and moderated effects.

Relations between marital aggression (psychological and physical) and children's health were examined. Children's emotional insecurity was assessed as a mediator of these relations, with distinctions made between marital aggression against mothers and fathers and ethnicity (African American or European American), socioeconomic status, and child gender examined as moderators of effects. Participants were 251 community-recruited families, with multiple reporters of each construct. Aggression against either parent yielded similar effects for children. Children's emotional insecurity mediated the relation between marital aggression and children's internalizing, externalizing, and posttraumatic stress disorder symptoms. No differences were found in these pathways for African American and European American families or as a function of socioeconomic status or child gender.

Towards a family process model of maternal and paternal depressive symptoms: exploring multiple relations with child and family functioning.

BACKGROUND: Research has focused on maternal dysphoria and child adjustment. However, family process models indicate gaps in the study of paternal dysphoria, broader family functioning, and diverse child outcomes. METHOD: A community sample of 235 mothers and fathers of kindergarten children completed measures of depressive symptoms, family functioning and child adjustment. Teachers also provided measures of child adjustment. RESULTS: Supportive of pervasive effects even in a community sample, increased parental depressive symptomatology was related to increased marital conflict, insecure marital attachment, less parental warmth, more psychological control in parenting, and multiple child problems. Child gender moderated child outcomes differently for paternal and maternal dysphoria. Marital relations, but not parenting, mediated child outcomes. CONCLUSIONS: Marital problems may be especially reactive to parental depressive symptomatology, so that mediational processes affecting child functioning become evident even in family contexts of relatively low risk.

Pathways between profiles of family functioning, child security in the interparental subsystem, and child psychological problems.

This study was designed to delineate pathways between systems profiles of family functioning, children's emotional insecurity in the interparental relationship, and their psychological adjustment in a sample of 221 children and their parents. Consistent with family systems theory, cluster analyses conducted with assessments of marital, coparental, and parent-child functioning indicated that families fit into one of four profiles: (a) cohesive families, characterized by warmth, affection, and flexible well-defined boundaries in family relationships; (b) disengaged families, reflected in high levels of adversity and low levels of support across family subsystems; (c) enmeshed families, evidenced by high levels of discord and weak maintenance of relationship boundaries in the family unit; and (d) adequate families, defined by elevated parental psychological control within a larger family context of low discord and high warmth. In comparison to children in cohesive families, children in enmeshed and disengaged families exhibited greater signs of insecurity in the interparental relationship concurrently and internalizing and externalizing symptoms both concurrently and 1 year later. Structural equation models revealed that a latent, multimethod measure of insecurity in the interparental relationship partially mediated associations between family enmeshment and disengagement and children's psychological symptoms 1 year later. Results are discussed in relation to how they inform and refine a family-wide model of the emotional security hypothesis.

Assessment of orientation: relationship between informant report and direct measures.

Although informant reports of everyday functioning are often used in dementia assessments, the actual correspondence between such indirect reports of functioning and actual performance has not been examined. Orientation results on the Dementia Questionnaire for Mentally Retarded Persons were compared to those obtained in direct assessment of orientation of 138 adults with mental retardation. Fair to good agreement was found between informant report and direct assessment. However, for some orientation items, nonverbal IQ, cause of mental retardation, and age affected the level of agreement. Thus, both informant report and direct measures of orientation are necessary in dementia assessments, and further work is needed on informant scale validation.

Medical and health care needs of families providing in-home care for relatives with developmental disabilities.

The purpose of this investigation was to attempt to describe the health care needs of families providing in-home care to members with developmental disabilities as well as the characteristics and demographics of families providing in-home care. The survey included 761 families who participated in a federal demonstration project in rural southern Georgia. The results indicated that impoverished families need increased assistance to provide adequate medical and health care when providing in-home care to relatives experiencing developmental disabilities. Implications for administration of programs and development of policies are discussed.