Parental sensitivity and child behavioral problems: A meta-analytic review.

Meta-analytic associations between observed parental sensitivity and child behavioral problems were examined (children aged 0-17 years). Studies (k = 108, N = 28,114) contained sociodemographically diverse samples, primarily from North America and Europe, reporting on parent-child dyads (95% mothers; 54% boys). Sensitivity significantly related to internalizing (k = 69 studies; N = 14,729; r = -.08, 95% CI [-.12, -.05]) and externalizing (k = 94; N = 25,418; r = -.14, 95% CI [-.17, -.11]) problems, with stronger associations found for externalizing. For internalizing problems, associations were significantly stronger among samples with low socioeconomic status (SES) versus mid-high SES, in peer-reviewed versus unpublished dissertations, and in studies using composite versus single scale sensitivity measures. No other moderators emerged as significant.

Adverse childhood experiences and maternal anxiety and depression: a meta-analysis.

BACKGROUND: It has been proposed that adverse childhood experiences (ACEs) can put women at risk for mental illness in the pregnancy and postpartum periods. While some studies have found strong support for this proposition, others have found weak or no support. This study is a meta-analysis of the association between ACEs and maternal mental health to resolve between-study discrepancies, and to examine potential moderators of associations. METHODS: Three electronic databases (i.e., MEDLINE, Embase, and PsycINFO) were searched up to November 2018 by a health sciences librarian. A hand search was conducted in January 2020 and relevant studies were added. Included studies reported on associations between ACEs and maternal depression and/or anxiety in the perinatal period (pregnancy to 1-year postpartum). Pregnancy and postpartum outcomes were examined separately for both depression and anxiety. Random-effect meta-analyses were conducted. Moderator analyses were conducted using meta-regression. Study quality was evaluated using a 15-point scale. RESULTS: The initial search yielded 4646 non-duplicate records and full text review occurred for 196 articles. A total of 15 studies (N = 7788) were included in the meta-analyses, of which 2 were also described narratively. Publication year ranged from 1998 to 2019. Mothers were approximately 28.93 years of age when they retrospectively reported on their ACEs. All studies had maternal self-report questionnaires for the mental health outcomes. Study quality ranged from 7 to 12. The pooled effect sizes between ACEs and prenatal (N = 12; r = .19; 95% CI= .13, .24) and postpartum (N = 7; r = .23; 95% CI = .06 to .39) depressive symptoms were significant. The pooled effect size between ACEs and prenatal anxiety was also significant (N = 5; r = .14; 95% CI= .07, .21). Moderator analyses indicated that timing of depressive and anxiety symptoms may be important for understanding associations. CONCLUSIONS: ACEs confer risk to maternal mental health, albeit effect sizes are small to moderate in magnitude. Trauma-informed approaches, as well as increased mental health support during and after pregnancy, may help to offset the relative risk of ACEs on maternal mental health.

Feasibility of training service providers on the AMBIANCE-Brief measure for use in community settings.

The Atypical Maternal Behavior Instrument for Assessment and Classification-Brief (AMBIANCE-Brief) was developed to provide a clinically useful and psychometrically sound assessment of disrupted parenting behavior for community practitioners. With prior evidence of this tool's reliability and validity in laboratory settings, this study aimed to determine whether providers from family service agencies could become reliable in the use of the level of disrupted communication following a brief training. Providers (N = 46) from three agency sites participated in a 2-day AMBIANCE-Brief training and, at the end of the training, coded eight videotaped mother-child interactions. Novice participant coding was compared to expert consensus ratings using intraclass correlations. On average, participants' interrater agreement was good (ICCmean  = .84, SD = 0.10), with 89% meeting the reliability standards of ICC ≥ .70. In response to queries, 100% of participants indicated that they would recommend the AMBIANCE-Brief training to their colleagues, 85% reported that the AMBIANCE-Brief measure would be useful or very useful for their clinical practice, and 56% of participant clinicians believed that parents would find the measure acceptable or very acceptable for integration into intervention or support planning. Altogether, these findings speak to the feasibility of using the AMBIANCE-Brief in community settings. Future studies are needed in diverse clinical and community contexts to evaluate whether use of this assessment tool can inform more targeted interventions tailored to the specific needs of families.

El Instrumento Abreviado para Evaluación y Clasificación de la Conducta Materna Atípica (AMBIANCE-Abreviado; Madigan, Bronfman, Haltigan y Lyons-Ruth, 2018) se desarrolló para ofrecer a quienes practican en la comunidad una evaluación clínicamente útil y sicométricamente acertada de la conducta de crianza trastornada. Con la anterior evidencia de la confiabilidad y validez de esta herramienta en el marco de los laboratorios (Cooke, Eirich, Racine, Lyons-Ruth y Madigan, 2020), este estudio se propuso determinar si se podría confiar en quienes proveen el servicio como parte de las agencias de servicio a las familias después de un breve entrenamiento. Los proveedores (N = 46) de tres lugares de agencias participaron en un entrenamiento de dos días sobre AMBAIANCE-Abreviado y, al final del entrenamiento, codificaron ocho interacciones madre-niño grabadas en video. Se comparó la forma de codificar de los novatos con el puntaje consenso de los expertos usando correlaciones dentro de clases. El acuerdo entre los evaluadores fue bueno (ICC media = .84, SD = 0.10), con un 89% de los participantes que lograron el estándar de confiabilidad de ICC > .70. En respuesta a preguntas, el 100% de los participantes indicó que ellos recomendarían el entrenamiento de AMBIANCE-Abreviado a sus colegas, 85% reportó que la medida AMBIANCE-Abreviado sería útil o muy útil en su práctica clínica, y 56% creían que los progenitores encontrarían la medida aceptable o muy aceptable para ser integrada en la intervención o el planeamiento de apoyo. En conjunto, estos resultados hablan de la factibilidad de usar AMBIANCE-Abreviado en el marco comunitario.

L'Instrument d'Evaluation et de Classification-Brève du Comportement Maternel Atypique (AMBIANCE-Bref; Madigan, Bronfman, Haltigan, & Lyons-Ruth, 2018) a été développé afin d'offrir une évaluation du comportement de parentage perturbé, cliniquement utile et saine du point de vue psychométrique, pour les acteurs communautaires. Avec des preuves préalables de la fiabilité et de la validité de cet outil en laboratoire (Cooke, Eirich, Racine, Lyons-Ruth, & Madigan, 2020), cette étude s'est donné pour but de déterminer si les prestataires des agences de service à la famille pouvaient devenir fiables pour son utilisation après une formation courte. Des prestataires (N = 46) de trois sites d'agence ont participé à une formation AMBIANCE-Bref de deux jours et à la fin de la formation ont codé huit interactions mère-enfant filmées. Le codage du participant débutant a été comparé aux évaluations par consensus d'expertes en utilisant des corrélations intraclasses. Le coefficient d'objectivité était bon (moyenne des coefficient de corrélation intraclasse [ICC] = 84, SD = 0,10), avec 89% des participants remplissant les standards de fiabilité d'ICC ICC ³,70. En répondant aux questions, 100% des participants ont indiqué qu'ils ou elles recommanderaient la formation AMBIANCE-bref à leurs collègues, 85% ont indiqué que la mesure AMBIANCE-bref serait utile ou très utile pour leur pratique clinique, et 56% ont déclaré qu'ils ou elles croyaient que les parents trouveraient cette mesure acceptable ou très acceptable pour une intégration à une intervention ou le plan de soutien. Au total, ces résultats parlent de la viabilité de l'utilisation de l'AMBIANCE-bref dans des contextes communautaires.

The Prevalence of Sexting Behaviors Among Emerging Adults: A Meta-Analysis.

Sexting is the sharing of sexually explicit images, videos, and/or messages via electronic devices. Prevalence estimates of sexting have varied substantially, potentially due to broad age ranges being examined. The current study sought to synthesize relevant findings examining the prevalence of consensual and non-consensual sexting in a specific developmental period, emerging adulthood (≥ 18-< 29), to try to explain discrepancies in the literature. Searches were conducted in electronic databases for articles published up to April 2018. Relevant data from 50 studies with 18,122 emerging adults were extracted. The prevalence of sexting behaviors were: sending 38.3% (k = 41; CI 32.0-44.6), receiving 41.5% (k = 19; CI 31.9-51.2), and reciprocal sexting 47.7% (k = 16; CI 37.6-57.8). Thus, sexting is a common behavior among emerging adults. The prevalence of non-consensual forwarding of sexts was also frequent in emerging adults at 15.0% (k = 7; CI 6.9-23.2). Educational awareness initiatives on digital citizenship and psychological consequences of the non-consensual forwarding of sexts should be targeted to youth and emerging adults with the hopes of mitigating this potentially damaging and illegal behavior.

Validation of the AMBIANCE-brief: An observational screening instrument for disrupted caregiving.

Resulting from a community-identified need for a well-validated indicator of caregiving difficulties for use in practice settings, a brief form of the Atypical Maternal Behavior Instrument for Assessment and Classification System (AMBIANCE) was developed for use as a screening instrument. Prior to its dissemination, this study aimed to assess the feasibility, reliability, and validity of the AMBIANCE-Brief. Adolescent mother-infant dyads (N = 69) participated in the Strange Situation Procedure, as well as play sessions with and without toys. Maternal disrupted caregiving was coded from the play sessions using the AMBIANCE and AMBIANCE-Brief. The AMBIANCE-Brief demonstrated convergent validity with the AMBIANCE in the play session with toys (r = .65, p < .001) and without toys (r = .61, p < .001). Concurrent validity of the AMBIANCE-Brief was also demonstrated in relation to infant attachment disorganization in the play session with toys (r = .36, p < .05) and without toys (r = .32, p < .01). These findings suggest a shorter protocol for assessing disrupted caregiving may be feasible and valid for use in community settings. Future studies are in progress to train community practitioners in the use of the AMBIANCE-Brief and to evaluate their reliability.

Como resultado de una necesidad identificada por la comunidad para un indicador bien validado de dificultades en la prestación de cuidado para uso en escenarios prácticos, se desarrolló una forma breve del Sistema del Instrumento de Conducta Materna Atípica para la Evaluación y Clasificación (AMBIANCE) para ser usado como instrumento de detección. Antes de ser diseminado, la meta de este estudio fue de evaluar la posibilidad, confiabilidad y validez de AMBIANCE-Abreviado. Las díadas de madres adolescentes e infantes (N = 69) participaron en el Procedimiento de la Situación Extraña, así como en sesiones de juego con y sin juguetes. La interrumpida prestación de cuidado materna fue codificada a partir de las sesiones de juego usando AMBIANCE y AMBIANCE-Abreviado. El AMBIANCE-Abreviado demostró una validez convergente con AMBIANCE en la sesión de juego con juguetes (r = .65, p < .001) y sin juguetes (r = .61, p < .001). También se demostró la validez concurrente de AMBIANCE-Abreviado en relación con la desorganización de la afectividad del infante en la sesión de juegos con juguetes (r = .36, p < .05) y sin juguetes (r = .32, p <.01). Estos resultados sugieren que un protocolo más corto para evaluar la interrumpida prestación de cuidado pudiera ser posible y válido para uso en escenarios comunitarios. Hay estudios futuros en progreso para entrenar al personal de la práctica comunitaria en el uso de AMBIANCE-Abreviado y para evaluar su confiabilidad.

Résultat d'un besoin identifié au niveau communautaire d'un indicateur bien validé de difficultés dans les soins pour une utilisation dans des contextes de pratique, une forme écourtée ("brève", ci-dessous) de l'Instrument d'Evaluation et du Système de Classification du Comportement Maternel Atypique (abrégé AMBIANCE en anglais, nous gardons ici l'abréviation anglaise) a été développée pour une utilisation à des fins d'outil de dépistage. Avant sa dissémination, cette étude s'était donnée pour but d'évaluer la faisabilité, la fiabilité et la validité de l'AMBIANCE-Brève. Des dyades adolescentes mères-nourrissons (N = 69) ont participé à la Procédure de Situation Etrange, ainsi qu'à des séances de jeu avec et sans jouets. Les soins maternels perturbés ont été codés à partir des séances de jeu en utilisant l'AMBIANCE et l'AMBIANCE-Brève. L'AMBIENCE-Brève a fait preuve de validité de convergence avec l'AMBIENCE dans les séances de jeu avec des jouets (r = ,65, p <,001) et sans jouets (r = ,61, p <,001). La validité concurrente de l'AMBIENCE-Brève a aussi été démontrée pour ce qui concerne la désorganisation de l'attachement du bébé dans la séance avec les jouets (r = ,36, p <,05) et sans jouets (r = ,32, p <,01). Ces résultats suggèrent qu'un protocole écourté pour l'évaluation de soin perturbé peut s'avérer plus fiable et valide pour l'utilisation en contexte communautaire. Des études supplémentaires sont en cours afin de former les praticiens communautaires à l'utilisation de l'AMBIENCE-Brève et afin d'évaluer leur fiabilité.

The Impact of Parent-Child Closeness and Romantic Attachment on Dating Violence Perpetration in Adolescence.

Past research has demonstrated that romantic attachment insecurity is a risk factor for dating violence in adolescence. However, few studies to date have longitudinally examined whether earlier relational experience, such as perceived closeness with parents, may serve as an antecedent of this relationship. To examine longitudinal associations among youths' perceived closeness with parents, romantic attachment insecurity, and perpetration of dating violence in adolescence. Adolescents (N = 1016) were recruited from seven public high schools in south Texas and reported on their perceived closeness with parents, romantic attachment styles, and perpetration of physical and psychological dating violence at three assessments between 2010 and 2014. Data were analyzed using structural equation modeling. Adolescents' romantic attachment anxiety, but not attachment avoidance, significantly mediated the relationship between low perceived closeness with parents and the perpetration of physical and psychological dating violence in late adolescence. Multi-group analyses showed the mediation model only held for females but not males, and for Hispanic youth but not for Non-Hispanic White, African American, and youth of other races and ethnicities. Through its link to romantic attachment anxiety, perceived closeness with parents could play an important role in the perpetration of dating violence in adolescence, especially for girls and Hispanic youth. Findings suggest that dating violence interventions may benefit from targeting aspects of parent-child relationships.

Maternal Adverse Childhood Experiences and Child Behavior Problems: A Systematic Review.

CONTEXT: A growing body of research has examined the role of maternal adverse childhood experiences (ACEs) on child behavior problems. OBJECTIVE: To summarize the literature examining the association between maternal ACEs and child behavior problems via a systematic review. DATA SOURCES: Electronic searches were conducted in Medline, PsycINFO, and Embase (1998-June 2020). Reference lists were reviewed. In total, 3048 records were screened. STUDY SELECTION: Studies were included if an association between maternal ACEs and child externalizing (eg, aggression) and/or internalizing (eg, anxiety) problems was reported. In total, 139 full-text articles were reviewed for inclusion. DATA EXTRACTION: Data from 16 studies met full inclusion criteria. Studies were synthesized by child externalizing and internalizing outcomes. RESULTS: Maternal ACEs were significantly associated with child externalizing problems across all studies (number of studies synthesized per outcome [k] = 11). Significant associations were also found for inattention, hyperactivity, and impulsivity (k = 4), and aggression (k = 2). For internalizing problems (k = 11), significant associations were identified across 8 studies and nonsignificant associations were reported for 3 studies. Maternal ACEs were consistently associated with child anxiety and depression (k = 5). However, inconsistent findings were reported for somatization (k = 2). LIMITATIONS: Results are limited to mother-child dyads and questionnaire measures of behavior problems in primarily North American countries. CONCLUSIONS: Mothers' ACEs demonstrated largely consistent associations with children's behavior problems. Future research is needed to determine if specific types of maternal ACEs (eg, household dysfunction) are more strongly associated with child behavior problems.

Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19: A Meta-analysis.

Importance: Emerging research suggests that the global prevalence of child and adolescent mental illness has increased considerably during COVID-19. However, substantial variability in prevalence rates have been reported across the literature. Objective: To ascertain more precise estimates of the global prevalence of child and adolescent clinically elevated depression and anxiety symptoms during COVID-19; to compare these rates with prepandemic estimates; and to examine whether demographic (eg, age, sex), geographical (ie, global region), or methodological (eg, pandemic data collection time point, informant of mental illness, study quality) factors explained variation in prevalence rates across studies. Data Sources: Four databases were searched (PsycInfo, Embase, MEDLINE, and Cochrane Central Register of Controlled Trials) from January 1, 2020, to February 16, 2021, and unpublished studies were searched in PsycArXiv on March 8, 2021, for studies reporting on child/adolescent depression and anxiety symptoms. The search strategy combined search terms from 3 themes: (1) mental illness (including depression and anxiety), (2) COVID-19, and (3) children and adolescents (age ≤18 years). For PsycArXiv, the key terms COVID-19, mental health, and child/adolescent were used. Study Selection: Studies were included if they were published in English, had quantitative data, and reported prevalence of clinically elevated depression or anxiety in youth (age ≤18 years). Data Extraction and Synthesis: A total of 3094 nonduplicate titles/abstracts were retrieved, and 136 full-text articles were reviewed. Data were analyzed from March 8 to 22, 2021. Main Outcomes and Measures: Prevalence rates of clinically elevated depression and anxiety symptoms in youth. Results: Random-effect meta-analyses were conducted. Twenty-nine studies including 80 879 participants met full inclusion criteria. Pooled prevalence estimates of clinically elevated depression and anxiety symptoms were 25.2% (95% CI, 21.2%-29.7%) and 20.5% (95% CI, 17.2%-24.4%), respectively. Moderator analyses revealed that the prevalence of clinically elevated depression and anxiety symptoms were higher in studies collected later in the pandemic and in girls. Depression symptoms were higher in older children. Conclusions and Relevance: Pooled estimates obtained in the first year of the COVID-19 pandemic suggest that 1 in 4 youth globally are experiencing clinically elevated depression symptoms, while 1 in 5 youth are experiencing clinically elevated anxiety symptoms. These pooled estimates, which increased over time, are double of prepandemic estimates. An influx of mental health care utilization is expected, and allocation of resources to address child and adolescent mental health concerns are essential.

Prevalence of posttraumatic and general psychological stress during COVID-19: A rapid review and meta-analysis.

Emerging evidence suggests rates of posttraumatic stress and psychological stress in the general population are elevated due to COVID-19. However, a meta-analysis is needed to attain more precise prevalence estimates due to between-study variability. Thus, we performed a rapid review and meta-analysis of posttraumatic stress and general psychological stress symptoms during COVID-19. Electronic searches were conducted up to May 26th, 2020 using key terms: mental illness and COVID-19. A total of k = 14 non-overlapping studies were identified for inclusion. Random effects meta-analyses indicated that the pooled prevalence of posttraumatic stress symptoms and psychological stress in the general population was 23.88% and 24.84%, respectively. In both meta-analyses, the prevalence of stress symptoms was higher in unpublished compared to peer-reviewed studies. Overall, nearly one-in-four adults experienced significant stress due to the COVID-19 pandemic. Psychological resources and services must be allocated to help address the mental health burden of COVID-19. High quality, longitudinal research on the long-term mental health effects of the pandemic is greatly needed.

Maternal adverse childhood experiences, attachment style, and mental health: Pathways of transmission to child behavior problems.

BACKGROUND: Investigations have found mothers' adverse childhood experiences (ACEs) confer an intergenerational risk to their children's outcomes. However, mechanisms underlying this transmission have only been partially explained by maternal mental health. Adult attachment insecurity has been shown to mediate the association of ACEs and mental health outcomes, yet an extension of this research to children's behavioral problems has not been examined. OBJECTIVE: To examine the cascade from maternal ACEs to risk for child behavioral problems at five years of age, via mothers' attachment insecurity and mental health. PARTICIPANTS AND SETTING: Participants in the current study were 1994 mother-child dyads from a prospective longitudinal cohort collected from January 2011 to October 2014. METHODS: Mothers retrospectively reported their ACEs when children were 36 months of age. When children were 60 months of age, mothers completed measures of their attachment style, depression and anxiety symptoms, and their children's behavior problems. RESULTS: Path analysis demonstrated maternal ACEs were associated with children's internalizing problems indirectly via maternal attachment avoidance, attachment anxiety, and depression symptoms, but not directly (ß = .05, 95% CI [-.001, .10]). Maternal ACEs indirectly predicted children's externalizing problems via maternal attachment avoidance, attachment anxiety, and depression. A direct effect was also observed from maternal ACEs to child externalizing problems (ß = .06, 95% CI [.01, .11]). CONCLUSIONS: Maternal ACEs influenced children's risk for poor behavioral outcomes via direct and indirect intermediary pathways. Addressing maternal insecure attachment style and depression symptoms as intervention targets for mothers with histories of ACEs may help to mitigate the intergenerational transmission of risk.

Parent-child attachment and children's experience and regulation of emotion: A meta-analytic review.

Attachment relationships serve as contexts within which children develop emotional capacities. This meta-analytic review assessed the strength of associations of parent-child attachment patterns with the experience and regulation of emotion in children under age 18 years. In a series of meta-analyses (k = 72 studies, N's ranged from 87 to 9,167), we examined children's positive and negative affective experiences (assessed either globally or elicited in specific contexts), emotion regulation ability, and coping strategies. More securely attached children experienced more global positive affect and less global negative affect, expressed less elicited negative affect, were better able to regulate emotions, and more often used cognitive and social support coping strategies. More avoidantly attached children experienced less global positive affect, were less able to regulate emotions, and were less likely to use cognitive or social support coping strategies. By contrast, more ambivalently attached children experienced more global and more elicited negative affect, and were less able to regulate emotions. More disorganized children experienced less global positive affect and more global negative affect. These robust findings provide evidence that attachments to parents have implications for children's emotional development, although more research is needed on whether insecure attachment patterns are associated with distinct emotion profiles. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A Meta-Analysis of Maternal Prenatal Depression and Anxiety on Child Socioemotional Development.

OBJECTIVE: Observed associations between maternal prenatal stress and children's socioemotional development have varied widely in the literature. The objective of the current study was to provide a synthesis of studies examining maternal prenatal anxiety and depression and the socioemotional development of their children. METHOD: Eligible studies through to February 2018 were identified using a comprehensive search strategy. Included studies examined the association between maternal prenatal depression or anxiety and the future development of their children's socioemotional development (eg, difficult temperament, behavioral dysregulation) up to 18 years later. Two independent coders extracted all relevant data. Random-effects meta-analyses were used to derive mean effect sizes and test for potential moderators. RESULTS: A total of 71 studies met full inclusion criteria for data analysis. The weighted average effect size for the association between prenatal stress and child socioemotional problems was as follows: odds ratio (OR) = 1.66 (95% CI = 1.54-1.79). Effect sizes were stronger for depression (OR = 1.79; 95% CI = 1.61-1.99) compared to anxiety (OR = 1.50; 95% CI = 1.36-1.64). Moderator analyses indicated that effect sizes were stronger when depression was more severe and when socio-demographic risk was heightened. CONCLUSION: Findings suggest that maternal prenatal stress is associated with offspring socioemotional development, with the effect size for prenatal depression being more robust than for anxiety. Mitigating stress and mental health difficulties in mothers during pregnancy may be an effective strategy for reducing offspring behavioral difficulties, especially in groups with social disadvantage and greater severity of mental health difficulties.

Children's emotion understanding and mother-child attachment: A meta-analysis.

Understanding emotions serves as a critical foundation for several aspects of children's social development. Secure attachment relationships, which allow for open emotion communication between the parent and child, are hypothesized to foster emotion understanding. The goal of the current meta-analysis was to determine the strength of the relationship between emotion understanding and attachment security. We conducted an electronic search using PsycINFO and identified 10 studies (N = 564 children) examining this association in children younger than 18 years of age. The meta-analysis yielded a medium and significant overall effect size of r = .33 with no significant moderators. Thus, our results demonstrated that the association between emotion understanding and security of attachment is quite robust. (PsycINFO Database Record