Narrating hope and resistance: A critical analysis of sources of agency among Palestinian children living under military violence.

BACKGROUND: In light of critical and socioconstructionist theories, the aim of our research was to analyze source of agency, psychological adjustment to trauma as protective factors against political violence in children living in three different refugee camps in Palestine, as well as exploring the risks to which these children are exposed. METHODS: Thematic content analysis was applied to children's written and drawn productions in order to extract the main categories and themes. RESULTS: Four main domains of agency emerged from the analysis: personal growth, political well-being, social relationships, and geographical context. For each domain, specific dimensions are discussed. CONCLUSIONS: The results of this preliminary exploration of children's agency suggest that the children's living environment plays a key role in shaping their suffering and reactions to war and ongoing violence. Furthermore, the social nature of the children affected by war-related suffering forces practitioners and policymakers to question the effectiveness of intervention programs that are predominantly focused on symptoms.

[The mental health of only children and of siblings with cancer - first results of a multicenter study in Germany]. / Psychische Gesundheit von Einzelkindern und Kindern mit Geschwistern, deren Eltern an Krebs erkrankt sind. Ergebnisse einer multizentrischen Studie in Deutschland.

BACKGROUND: Children of parents with cancer are at risk of developing mental disorders. RESULTS from divorce research also reveal that sibling relationships can protect the mental health of children in difficult times. OBJECTIVE: Does having a sibling help to cope with an oncological disease of a parent and thus act as a protective factor? METHODS: A group of 271 children were examined in a multicenter study. 54 % made use of the offered psychosocial support. Only children (N = 89) and children with siblings (N = 182) were compared with respect to their mental health (Strength and Difficulties Questionnaire, SDQ, parental and self-assessment). RESULTS: The group comparison between only children and siblings showed no significant differences in the SDQ (assessed by healthy/ill parent). In the self-assessment 2 % of the only children and 9 % of the siblings showed significant results on the SDQ. The group comparison between only children and children with siblings failed to reveal any important differences in mental health. The study indicates that a negative relationship quality (Sibling Relationship Questionnaire, SRQ) is associated with increased problems in the peer group. CONCLUSIONS: The existence of a sibling is not per se a protective factor. Only children do not show more signs of emotional stress than children with siblings.

[The influence of unreconciled grief in the family on the functioning and development of a child]. / Wplyw nieprzezytej zaloby w rodzinie na funkcjonowanie i rozwój dziecka.

The aim of the work is to present the influence of unreconciled grief in a family for functioning and growth of a child. The paper is based on some examples of clinical work from the field of family therapy, where developmental problems of children followed their carer's inability to cope with death and bereavement. Presented cases from family therapy serve as examples of possible therapeutic interventions in such situations. They show examples of developmental disturbances and psychopathology of the child who stays in relationship with deeply bereaved intimates.

[How children who's siblings are diagnosed with cancer experience and regulate the disease]. / Wie Geschwister krebskranker Kinder die Erkrankung erleben und verarbeiten.

The aim of this study is to investigate behaviour problems and emotional regulation of children who's siblings are diagnosed with cancer. Participants were assessed with the Strengths and Difficulties Questionnaire (SDQ) and the MacArthur Story Stem Battery (MSSB). Both instruments were administered twice (shortly after diagnosis and at the end of treatment). Brothers and sisters of 14 children suffering from cancer were compared with 18 siblings of healthy individuals. In the SDQ no differences between the two groups were found. At time 1 the MSSB showed significant differences in number and quality of displayed contents, representation of parents and the way of performing the narrative. At time 2 narratives changed particularly in the treatment group, but some differences still remained. Overall siblings of children suffering from cancer showed more intrapsychic reaction to the disease than became obvious in their behaviour. This fosters the conclusion that there may be a need for specific support for siblings of children with cancer in order to prevent them from psychic disorders and pathological mourning reactions.

["I do not worry about ...!" How the Berkeley Puppet Interview may reveal self-report of psychological symptoms of 4 to 8 years old children exposed to parental cancer]. / "Ich mach mir keine Sorgen ...!" Wie 4- bis 8-jährige Kinder krebskranker Eltern im Berkeley Puppet Interview psychische Symptome selbst einschätzen.

The Berkeley Puppet Interview (BPI) enables us to investigate psychological symptoms of children aged four to eight years under a multi-informant perspective by the means of self and parent report measures. 45 families with one parent suffering from cancer have been examined with regard to internalizing and externalizing symptoms of the children. Results have been compared to two different age-appropriate samples (Swiss preschool study of Basel and German KiGGS study). A small, highly selective sample of twelve children aged four to eight years could have been examined both from the self and parent perspective. Our results show, that four to eight year old children of cancer patients do not differ from other children of the same age in the way they express emotional symptoms in the BPI, but they are judged more emotionally burdened than other children by their parents (SDQ). Self and parent report do not significantly correlate. It seems as if parents in families struck by a cancer disease see their children's emotional symptoms more pronounced than the children themselves do express in the puppet interview. Implications for clinical and research practice will be discussed.

[Reactive changes in psychological condition and behaviour in children of parents with cancer--results of an epidemiological survey]. / Reaktive Veränderungen in Befinden und Verhalten von Kindern bei elterlicher Krebserkrankung--Ergebnisse einer epidemiologischen Patientenbefragung.

Children of cancer patients are at risk for developing psychological symptoms. The parental appraisal of the child's psychological condition is a key variable for the utilization of child-centred psychosocial services. This study aimed at the systematic analysis of parental appraisals of changes in the emotional condition or behaviour of their children. We conducted an epidemiologic survey with a sample size of 1,809 patients with different cancer diagnoses, giving information about 2,581 children aged 21 years or younger at time of diagnosis. Quantitative information on children's distress during the disease and on changes in psychological condition or behaviour and qualitative information on the kind of changes were analysed. About half of the children were considered to be psychologically strongly affected during the disease. For about 25 % negative changes in psychological condition or behaviour are reported, positive changes are reported for 20 % of the children. Negative changes are most frequently described in young children (up to five years), positive changes are most frequently described in young adults (18 to 21 years). The results indicate that from the cancer parent's view many children are substantially distressed. Thus, the implementation of additional preventive psychosocial services seems reasonable and necessary.

Protecting children from the consequences of divorce: a longitudinal study of the effects of parenting on children's coping processes.

This study examines whether intervention-induced changes in mother-child relationship quality and discipline led to short-term (6 months) and long-term (6 years) changes in children's coping processes in a sample of 240 youth aged 9-12 years when assessed initially. Data were from a randomized, experimental trial of a parenting-focused preventive intervention designed to improve children's postdivorce adjustment. Three-wave prospective mediational analyses revealed that intervention-induced improvements in relationship quality led to increases in coping efficacy at 6 months and to increases in coping efficacy and active coping at 6 years. Tests of the mediated effects were significant for all 3 indirect paths. Results are discussed in terms of pathways to adaptive coping and implications for the implementation of preventive interventions targeting coping.

Attachment style in parents of children with chronic gastrointestinal disease.

Attachment is a point of interest in psychosomatic research since it influences a wide array of biopsychosocial phenomena. Data from literature highlights the role of this concept in the context of Inflammatory Bowel disease (IBD), still, there is a lack of data regarding attachment among parents of children with chronic gastrointestinal diseases. The main hypothesis for the current study is that parents of children with IBD will have a more insecure attachment than parents of children with celiac disease (CD) and parents of healthy children. The second hypothesis is that insecure attachment among parents of sick children will be associated with lower parental quality of life (QoL). 46 parents of children with IBD, 42 parents of children with CD and 43 parents of healthy children completed the validated modification of the Brennan's Experiences in Close Relationship Inventory. Results were categorized as secure and insecure attachment. In order to assess parental QoL, the WHOQOL-BREF questionnaire was used. The Total QoL was calculated as a sum of all domain items. Secure attachment was found in 45.7% parents of children with IBD, in 35.7% parents of children with CD and in 32.6% parents of healthy children. Surprisingly, the lowest rate of secure attachment was found in parents of healthy children. However, significant differences among groups do not exist. For all groups of parents the attachment style is associated with Total QoL, although only among parents of children with IBD, the secure attachment independently and significantly predicts higher parental Total QoL. According to results, we might say that parental attachment style does not have a role that exclusively belongs in the context of paediatric chronic gastrointestinal diseases. However, parents of children with IBD who have insecure attachment represent target group for psychosocial support in order to improve their QoL.

[Trauma among children and parents within the context of international adoption]. / Trauma des enfants et des parents dans un contexte d'adoption internationale.

Although the large majority of international adoptions are problem free, some of them involve a certain degree of suffering as much for the children as for the adoptive parents. These stumbling blocks in the relationship need to be studied taking into account the trauma experienced by each of the protagonists.

Bullying victimization in youths and mental health problems: 'much ado about nothing'?

Bullying victimization is a topic of concern for youths, parents, school staff and mental health practitioners. Children and adolescents who are victimized by bullies show signs of distress and adjustment problems. However, it is not clear whether bullying is the source of these difficulties. This paper reviews empirical evidence to determine whether bullying victimization is a significant risk factor for psychopathology and should be the target of intervention and prevention strategies. Research indicates that being the victim of bullying (1) is not a random event and can be predicted by individual characteristics and family factors; (2) can be stable across ages; (3) is associated with severe symptoms of mental health problems, including self-harm, violent behaviour and psychotic symptoms; (4) has long-lasting effects that can persist until late adolescence; and (5) contributes independently to children's mental health problems. This body of evidence suggests that efforts aimed at reducing bullying victimization in childhood and adolescence should be strongly supported. In addition, research on explanatory mechanisms involved in the development of mental health problems in bullied youths is needed.

Psychosocial adjustment of siblings of children with cancer: a systematic review.

OBJECTIVES: To promote a broader understanding of the psychosocial impact of childhood cancer on siblings, a systematic review was undertaken. Directions for future research are proposed and clinical strategies are suggested for addressing the needs of these children. METHODS: Searches of Medline, PsycINFO and CINAHL revealed 65 relevant qualitative, quantitative, or mixed methods' papers published between 1997 and 2008. These papers were rated for scientific merit and findings were extracted for summary. RESULTS: Siblings of children with cancer do not experience elevated mean rates of psychiatric disorders, but a significant subset experiences post-traumatic stress symptoms, negative emotional reactions (e.g. shock, fear, worry, sadness, helplessness, anger, and guilt), and poor quality of life in emotional, family, and social domains. In general, distress is greater closer to time of diagnosis. School difficulties are also evident within 2 years of diagnosis. Qualitative studies reveal family-level themes such as loss of attention and status as well as positive outcomes including increased sibling maturity and empathy. CONCLUSIONS: Research regarding siblings of children with cancer continues to be methodologically limited. The conclusions of qualitative and quantitative studies differ considerably. We propose a research agenda to propel this field forward including greater attention to alterations in normative development (as opposed to psychiatric conditions), development of more appropriate quantitative measures, examination of potential moderators of adaptation, and use of prospective longitudinal designs. Siblings of children with cancer are a psychosocially at-risk group and should be provided with appropriate supportive services.

Assessing resilience in preschool children exposed to intimate partner violence.

This study examined why some preschool-age children exposed to intimate partner violence (IPV) showed deleterious outcomes and others appeared more resilient. Resilience, conceptualized as strengths in emotion regulation and prosocial skills, was evaluated using the Social Competence Scale developed by the Conduct Problem Prevention Research Group. The sample consisted of 56 mothers and their 4- to 6-year-old children exposed to IPV within the past 2 years. After controlling for relevant demographic factors, hierarchical regression analyses indicated that better parenting performance, fewer maternal mental health problems, and less severe violence exposure predicted better emotion regulation and prosocial skill scores, which in turn were negatively correlated with maladaptive child behaviors. These findings can be used to inform and enhance clinical services for children exposed to IPV.

Psychological interventions with siblings of pediatric cancer patients: a systematic review.

OBJECTIVE: Siblings of pediatric cancer patients have been shown to be at risk for developing emotional, behavioral, and social problems. There is a need for psychological interventions in this population. Several researchers have previously documented and evaluated their interventions with siblings. This paper aimed at reviewing the existing reports of evaluated psychological interventions with siblings of pediatric cancer patients and at outlining future directions. METHODS: Research was conducted on several online bibliographic databases. Articles were selected on the basis of predefined criteria. If possible, effect sizes (ES) were calculated. RESULTS: Fourteen studies representing 11 different sibling interventions met criteria for inclusion. One individual intervention, three camps, and seven groups were found. Objectives of interventions concentrated mainly on enhancing siblings' coping and improving their medical knowledge. In terms of outcome measures, most of the studies focused on psychological adjustment variables. Findings showed significant improvements in siblings' depression symptomatology, medical knowledge, and health-related quality of life. Findings were inconsistent with regard to anxiety, behavioral problems, social adjustment, self-esteem, and posttraumatic stress symptoms. Depending on the outcome variables, small to large ES were found. Satisfaction with the intervention was high in both siblings and parents. CONCLUSION: There is tentative evidence that psychological interventions with siblings of childhood cancer patients can effectively reduce psychological maladjustment and improve medical knowledge about cancer. However, the number of studies is small, and several methodological shortcomings have to be noted. In future, more randomized controlled trials need to be conducted in larger samples to extend the evidence base.

Impact of a technological disaster on young children: a five-year postdisaster multiinformant study.

Children exposed to a technological disaster during an understudied part of the lifespan, preschool age and early middle childhood, were assessed in a 5-year follow-up regarding mental health problems, anxiety disorder symptoms, depressive symptoms, physical symptoms, and posttraumatic stress symptoms. Exposed children and their parents (n = 264) reported significantly more problems than controls (n = 515). The differences were greater for conduct problems (including hyperactivity) and physical symptoms, than for anxiety and depression. The long-term effects of a technological disaster on children of pre-school age at exposure appear to differ from those in children, who were victimized at a later age. This may reflect interference with completion of specific developmental tasks.

Impact of life events on child mental health before school entry at age six.

The study examined the association between life events and early child mental health prior to school entry. The impact of single life events and the cumulative effect of multiple life events on child mental health were examined. In a northern German city, the complete 1-year intake of preschool children at the primary school entry assessment was included. In 1,887 children, life events and psychiatric symptoms were recorded by means of standardized parent questionnaires. Included were all life events between child's birth and school entry. For more than 80 percent of all children, at least one life event was reported. The number of life events was independent of any demographic variable; the mean was 2.2. The number of life events had a highly significant effect on the prevalence of child mental health problems. Six family-change-factors, especially coherent in content, could be identified by factor analysis. The study provides important data on the epidemiology and clinical impact of life events and psychopathology in early childhood. For child mental health, the cumulative effect of multiple life events was found to be much more important than the effect of specific single life events.

Fathering by partner-abusive men: attitudes on children's exposure to interparental conflict and risk factors for child abuse.

A substantial body of research concludes that children in homes marked by intimate partner violence (IPV) and conflict are at increased risk for maladjustment. Although studies often attribute these difficulties to the aggressive acts witnessed, other research and theoretical work suggests that disrupted parenting and co-occurring child maltreatment play an equally critical role in the onset of the children's psychological and behavioral problems. Despite the clear importance of parenting in the context of IPV, relatively little scholarship has been devoted to the topic, particularly when it comes to examining fathers. The current study sought to better understand the paternal relationships of men arrested for spouse/partner abuse, to examine their beliefs about children's exposure to interparental conflict and to identify the specific factors that may place their children at risk for maltreatment. The data consisted of questionnaires administered to 3,824 men attending a court-ordered evaluation after they were convicted of assaulting an intimate partner. Analyses revealed that most of the men had some type of fathering role with underage children (n = 2,508; 65.6%) and in most cases these relationships continued following their arrest. Although the majority of the men acknowledged that their children had been exposed to interparental conflicts, few perceived that their children had been affected by the arguing. Also of concern was the fact that risk factors for child maltreatment were highly prevalent in this population. Implications of these findings and suggestions for those working with domestic offenders are discussed.

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.

Evaluation of a resilience-based intervention for children of parents with mental illness.

OBJECTIVE: The purpose of the present study was to evaluate the effectiveness of a group psychosocial intervention for children (aged 12-18) of a parent with mental illness (copmi). METHOD: A treatment and waitlist-control design study with pre- and post-treatment, and 8 week follow up, was carried out. The treatment (n=27) and control (n=17) groups were compared on three groups of dependent variables: intervention targets (mental health literacy, connectedness, coping strategies), adjustment (depression, life satisfaction, prosocial behaviour, emotional/behavioural difficulties), and caregiving experiences. RESULTS: Group comparisons failed to show statistically significant intervention effects, but reliable clinical change analyses suggested that compared to the control group, more intervention participants had clinically significant improvements in mental health literacy, depression, and life satisfaction. These treatment gains were maintained 8 weeks after treatment. Participant satisfaction data supported these treatment gains. CONCLUSIONS: Given study limitations and the modest support for intervention effectiveness it is important that this and other similar interventions should continue to be revised and undergo rigorous evaluation.

Peer rejection and physical health problems in early adolescence.

OBJECTIVE: Rejection from the peer group may constitute an important source of stress that may weaken children's immune system and leave them vulnerable to infection and physical illness. Controlling for family adversity and depressed mood, this study examined the predictive link between peer rejection and physical health problems, as well as the putative moderating effect of adolescents' reactivity/emotional negativity in this context. METHOD: A total of 122 high school students (50% girls) were assessed over two consecutive years in grades 7 (time [T] 1) and 8 (time [T] 2). More than 90% of the participants were white and French speaking and were from average socioeconomic backgrounds. Physical health problems at T1 and T2 as well as depression symptoms at T1 were assessed using adolescent self-reports. Peer rejection at T1 was assessed through peer nominations. Reactivity/negative emotionality at T1 was assessed via teacher ratings. Family adversity at T1 was assessed via mother reports. RESULTS: Peer rejection at T1 predicted an increase in physical health problems from T1 to T2, even when controlling for physical health problems and depression symptoms at T1. This result, however, was only true for girls with moderate or high levels of reactivity/negative emotionality. For boys, peer rejection was unrelated to change in physical health problems. CONCLUSIONS: The present findings are in line with the diathesis stress model of disease and emphasize the need for health education programs that specifically target girls and that foster problem-solving skills to help vulnerable adolescents cope more effectively with peer conflict.

Child and adolescent mental health research in the context of Hurricane Katrina: an ecological needs-based perspective and introduction to the special section.

This article introduces the special section on child and adolescent mental health research in the context of Hurricane Katrina. We outline the purpose and intent of the special section and present an integrative perspective based on broad contextual theories of human development with which to think about the impact of disasters like Katrina. The perspective emphasizes multiple levels of influence on mental health and normal development through the impairment of multiple human needs. The perspective helps show the interconnections among the diverse theoretical and methodological paradigms that are utilized to understand the impact of disasters on youth and may help to guide future research.