Risky Alcohol Use and Romantic Relationships Among College Students: A Longitudinal Study.

BACKGROUND: Risky alcohol use is frequent among college students and can be associated with functional outcomes. Bidirectional associations have been shown between alcohol use and the stability of romantic relationships, though little is known about the longitudinal association between risky alcohol use and romantic relationships in college and about college students' perceived stress regarding one's love life. Objectives: The present study aims to explore these relationships both cross-sectionally and at one-year follow-up. METHOD: Data were drawn, from the French portion of the World Mental Health International College Student Survey initiative (WMH-ICS). First-year college students who completed an online survey (n = 1,624) and a second survey at one-year follow-up (n = 727) were included. Current romantic relationship status and stress regarding one's love life, past-year risky alcohol use, lifetime presence of DSM-5 mental health disorders and sociodemographic correlates were assessed. RESULTS: Risky alcohol use was cross-sectionally associated with dating in multivariate models adjusting for lifetime mental disorders (aOR = 1.70, 95%CI = 1.31-2.20), and in particular with unsteady relationships (aOR = 2.87, 95%CI = 2.01-4.10), but was no longer associated with both one year later. Risky alcohol use was, however, not associated with severe perceived stress regarding one's love life in multivariate models adjusting for lifetime mental disorders in both cross-sectional and longitudinal analyses, while it was associated in bivariate models for both analyses. CONCLUSIONS: These findings extend our understanding of the association between excessive drinking and romantic relationship patterns among college students underlying the importance of comorbid disorders.

Childhood adversities and mental disorders in first-year college students: results from the World Mental Health International College Student Initiative.

BACKGROUND: This study investigates associations of several dimensions of childhood adversities (CAs) with lifetime mental disorders, 12-month disorder persistence, and impairment among incoming college students. METHODS: Data come from the World Mental Health International College Student Initiative (WMH-ICS). Web-based surveys conducted in nine countries (n = 20 427) assessed lifetime and 12-month mental disorders, 12-month role impairment, and seven types of CAs occurring before the age of 18: parental psychopathology, emotional, physical, and sexual abuse, neglect, bullying victimization, and dating violence. Poisson regressions estimated associations using three dimensions of CA exposure: type, number, and frequency. RESULTS: Overall, 75.8% of students reported exposure to at least one CA. In multivariate regression models, lifetime onset and 12-month mood, anxiety, and substance use disorders were all associated with either the type, number, or frequency of CAs. In contrast, none of these associations was significant when predicting disorder persistence. Of the three CA dimensions examined, only frequency was associated with severe role impairment among students with 12-month disorders. Population-attributable risk simulations suggest that 18.7-57.5% of 12-month disorders and 16.3% of severe role impairment among those with disorders were associated with these CAs. CONCLUSION: CAs are associated with an elevated risk of onset and impairment among 12-month cases of diverse mental disorders but are not involved in disorder persistence. Future research on the associations of CAs with psychopathology should include fine-grained assessments of CA exposure and attempt to trace out modifiable intervention targets linked to mechanisms of associations with lifetime psychopathology and burden of 12-month mental disorders.

The contribution of childhood adversities to the persistence of severe role impairment among college students: a follow-up study.

PURPOSE: While the association between childhood adversities (CAs) and negative mental health outcomes is robustly supported throughout the epidemiological literature, little is known about their contribution to the persistence of role impairment. The present study aims to investigate the association of three facets of CAs with the persistence of severe role impairment among college students using a follow-up design. METHODS: Data were drawn from the French portion of the World Mental Health International College Student Initiative. Students who completed both the baseline and 1-year follow-up surveys were included (n = 1,188). Exposure to 12 types of CAs before the age of 18 was assessed at baseline, and 12-month role impairment and 12-month mental disorders were assessed at baseline and follow-up. Logistic regressions estimated associations by jointly using types, number of types, and cumulative frequency of exposure to CAs as predictors. RESULTS: At baseline, 27.6% of students reported any severe role impairment. Among them, 47.5% reported the persistence of any impairment at one year. In models adjusted for 12-month mental disorders, only the frequency of CAs was associated with the persistence of impairment, namely college-related and other work impairment (aOR = 1.17, 95% CI [1.01, 1.35]). CONCLUSION: Role impairment is prevalent among college students, and studies are needed to better understand its persistence. Beyond the primary prevention of early stressors, screening for and treating mental health problems during college may help reduce the impact of CAs on the persistence of role impairment.

Self-reported fears and mental health in elementary school children across Europe.

Fears are common in the general population and particularly among children. The number of fear subtypes (animals, natural environment, situational, blood-injection-injury or other type) has been shown to be associated with psychopathology. Furthermore, there is evidence suggesting that some subtypes may be more often associated with mental disorders than others. The present study uses data from a large cross sectional survey, the School Children Mental Health in Europe (SCMHE) study, conducted in eight European countries on children ages 6 through 13-years-old attending elementary school (n = 9613). Fear subtypes and self-reported mental health were assessed using the Dominic Interactive (DI), a self-administered computerized image-based questionnaire. The findings show that the number of fear subtypes is strongly associated with self-reported internalizing and externalizing problems. In addition, adjusting for the number of subtypes, fear of animals was less likely than other fears to be associated with psychopathology. The findings support the notion that children who report excessive and generalized fear should be targeted for prevention, consistent with research identifying childhood onset generalized specific phobia as a probable precursor to subsequent psychopathology.

Prior depression predicts greater stress during Covid-19 mandatory lockdown among college students in France.

BACKGROUND: The Covid-19 pandemic and its related public health measures such as mandatory lockdowns have been shown to have an impact on mental health. A key question is the role of pre-existing psychiatric disorders in how such measures are experienced. METHODS: During the first country-wide lockdown imposed in France, a Covid-19 module was added to the French portion of the ongoing World Mental Health International college student survey. The present study focuses on respondents who completed the survey during that time frame (n = 291). RESULTS: Students with prior depression endorsed greater increases in anxiety (72.2% vs 50.9%) and stress (72.2% vs 49.4%), as well as greater decreases in concentration (87.0% vs 72.9%) during lockdown as compared to those without depression history. In multivariate analyses, prior depression was associated with overall stress (AOR = 5.50), financial stress (AOR = 1.95), family stress (AOR = 2.47), work related stress (AOR = 5.15), and stress related to loved ones (AOR = 2.21). Prior depression was also associated with greater probability experiencing increased anxiety (AOR = 2.61) and stress (AOR = 2.55) during lockdown. CONCLUSIONS: The findings indicate that the best predictor of experiencing stress and anxiety during the first Covid-19 lockdown was a history of depression prior to the pandemic outbreak. Implementing public health measures such as mandatory national lockdowns should be accompanied by strategies for reaching out to those who are vulnerable due to a history of mental illness.

Sexual and Nonsexual Interpersonal Violence, Psychiatric Disorders, and Mental Health Service Use.

Exposure to potentially traumatic events (PTEs) increases an individual's risk of suffering from psychiatric disorders. However, only a small proportion of individuals exposed to PTEs use health care services (HCS). Few studies have examined how exposure to different types of PTEs affect the odds an individual will suffer from a psychiatric disorder and access HCS. The present study aimed to examine the associations among lifetime exposure to sexual and nonsexual violence, psychiatric disorder presence, and utilization of HCS. Data were drawn from a large cross-sectional survey (N = 19,958) representative of four regions of France. Lifetime occurrence of traumatic events, past-year DSM-IV Axis I psychiatric disorders, and past-year use of HCS were assessed using the CIDI-SF. Lifetime exposure to violence, particularly sexual violence, was associated with significantly higher odds of suffering from common psychiatric disorders in the past year, including major depression, aOR = 1.70, 95%CI [1.34, 2.17], which was present among 36.9% of participants who reported sexual violence exposure, 20.9% of those who reported exposure to nonsexual violence, and 7.1% of those exposed to neither. Compared to participants who were not exposed to sexual violence, victims of sexual violence were more likely to have contacted health care professionals due to a mental health problem and to have received psychotropic medication. However, a significant portion of individuals with psychiatric disorders did not report receiving potentially beneficial HCS. The present findings highlight the need to identify victims of violence and improve access to appropriate services for this population.

Gender, the gender gap, and their interaction; analysis of relationships with children's mental health problems.

PURPOSE: The present study seeks to examine gender differences in internalizing and externalizing problems either parent/teacher or self-reported and to investigate the influence of country-level gender gap on children's mental health problems across countries with high and low gender gap across Europe. METHODS: The School Children's Mental Health in Europe (SCMHE) survey collected data on primary school children living in six European countries, using self-reports (SR) from children (Dominic Interactive), as well as combination of parent- and teacherreports (P/T C) (Strengths and Difficulties Questionnaire) to assess internalizing and externalizing mental health problems. The World Economic Forum's (WEF's) Global Gender Gap report's Gender Gap Index (GGI) was used to categorize countries with high and low gender gap. RESULTS: Boys had greater odds of externalizing problems (OR = 2.6 P/T C, 1.95 SR), and lower odds of internalizing problems (OR = 0.85 P/T C, 0.63 SR). The gender gap's association with mental health problems was different depending on the informant used to identify these problems. A small gap was a risk factor based on reports from adults for externalizing (OR = 1.53) and internalizing problems (OR = 1.42) while it was a protective factor for SR internalizing problems (OR = 0.72). For these problems the gender gap impacted boys and girls differently: a small gender gap was protective for boys but not for girls, including when controlling for key confounding variables. CONCLUSIONS: The differential impact of country-level gender gap observed between self-reported and parent- or teacher-reported mental health is complex but nevertheless present trough mechanisms that are worthwhile to study in depth, with a special attention to the informants and the type of problems examined.

Feasibility and validity of Ecological Momentary Assessment in patients with acute coronary syndrome.

BACKGROUND: In recent years, Ecological Momentary Assessment (EMA) has expanded rapidly in healthcare research but its application specifically to the field of cardiology has been limited. This study presents essential information concerning the feasibility and validity of EMA in patients with acute coronary syndrome. METHODS: Four months after a first-ever acute coronary syndrome, 47 patients completed EMA five times a day for seven consecutive days concerning their current activities, mood and perceived negativity or positivity of daily events. RESULTS: Compliance with the repeated electronic assessments was high, and no evidence was found for time-dependent biases such as fatigue or practice effects. The resulting EMA data were found to have high internal validity, high reliability when considering average scores, and low reliability when considering within-person variance. CONCLUSIONS: We found evidence for the feasibility and intrinsic validity of EMA in patients with acute coronary syndrome. Research examining daily life experiences, symptoms and therapeutic adherence in this population can be reinforced through the use of mobile technologies.

Stress and anxiety among university students in France during Covid-19 mandatory confinement.

While necessary from a public health standpoint, Covid-19 confinement strategies are often contrary to evidence-based therapies used to treat mental disorders. University students may be particularly vulnerable to mental health problems, but recent studies have indicated only a negligible impact of confinement strategies. French respondents to a World Mental Health survey of university students completed questions concerning Covid-19 confinement. The sample experienced increased anxiety as well as moderate to severe stress during confinement. Respondents who did not relocate to live with parents were disproportionately affected. Knowledge of confinement effects may be used to reduce its negative impact in vulnerable populations.

Principal Component Analysis of the Well-Being at Work and Respect for Human Rights Questionnaire (WWRRR) in the Mediterranean Region.

BACKGROUND: The Well-Being at Work and Respect for human Rights Questionnaire (WWRR) was conceived based on the hypothesis that the perception of respect for users' rights is an essential element of well-being in the workplace in healthcare. The objective of the study is to examine the principal components of the WWRR. METHODS: A random sample representative of a set of professionals working in three different healthcare networks in Tunisia, North-Macedonia, and Italy was enrolled (n=426). Each professional completed a questionnaire on sociodemographic data and the WWRR. The WWRR consists of six items on beliefs about: satisfaction at work, users' satisfaction, organization at work, respect of users' and staff human rights, adequacy of resources. A seventh item assesses the perceived needs of personnel. Correlation between the items was evaluated by analysing the principal components with Varimax rotation and Kaiser normalization (which included all components with an Eigen value> 1). RESULTS: A single factor covered over 50% of the variance, all the items of the questionnaire were closely related and compose a single factor. Tunisia presented some differences regarding the item about the human rights of staff. CONCLUSION: Satisfaction with the respect for the rights of users is strongly correlated with the other factors that are part of the concept of the organizational well-being of health care providers. The WWRR provides a means of measuring this important and often neglected dimension.

Birth-sex cohort alcohol use transitions in the general population: the cross-sectional PEGASUS-Murcia project. / Las transiciones en el uso de alcohol en una cohorte de nacimiento-sexo en la población general: el proyecto transversal PEGASUS-Murcia.

To examine the potential impact of prevalence of alcohol use in a birth-sex cohort on subsequent initiation and progression of alcohol use in the PEGASUS-Murcia project, a cross-sectional survey of a representative sample of non-institutionalized adults in Murcia (Spain). Data on lifetime history of alcohol use, DSM-IV use disorders, and remission were collected from 1,459 adults using face-to-face interviewers based on the Composite International Diagnostic Interview (CIDI 3.0). Life-table estimates based on survival functions for alcohol use age-of-onset and remission were used as time-varying predictors of subsequent individual-level alcohol use in discrete-time survival models. Nearly nine out of ten adults had a lifetime alcohol use history at time of interview. Of these lifetime users, 84.3% became regular users (>12 drinks a year) and 5.5-1.6% went on to meet criteria for DSM-IV alcohol abuse or dependence, respectively. By the age of 18, 70.9% of respondents had used alcohol, and one half (50.2%) had used regularly. Regular use sharply increased during early adulthood to reach 90.8% by age 22. Birth-sex cohort alcohol use was significantly and positively associated with increased odds of all subsequent transitions examined except for the transition from use to abuse. The findings highlight sensitive periods with rapid transitions to higher levels of alcohol use and emphasize the importance of cohort experiences in the full spectrum of stages of alcohol use. These results may contribute to predicting population-levels trends in alcohol-related problems in Spain.

Examinar el impacto potencial de la prevalencia de uso de alcohol en una cohorte de nacimiento-sexo en el inicio y progresión del uso de alcohol en el proyecto PEGASUS-Murcia, encuesta transversal en una muestra representativa de adultos no institucionalizados de Murcia (España). Se entrevistaron personalmente a 1.459 adultos sobre consumo de alcohol a lo largo de la vida, trastornos por uso de alcohol (criterios DSM-IV) y remisión utilizando la Entrevista Diagnóstica Internacional Compuesta (CIDI 3.0). Se calcularon estimaciones de tablas de vida basadas en las funciones de supervivencia para la edad de inicio en el uso de alcohol y su remisión en modelos de supervivencia de tiempo discreto. Casi nueve de cada diez adultos tuvieron una historia de uso de alcohol a lo largo de la vida. Entre ellos, 84,3% desarrolló un uso regular (>12 bebidas por año) y 5,5% y 1,6% cumplieron criterios DSM-IV de Abuso y Dependencia de alcohol, respectivamente. A los 18 años, 70,9% había usado alcohol, 50,2% de forma regular, con un aumento brusco en adultos jóvenes (90,8% a los 22 años). El uso de alcohol de la cohorte de nacimiento-sexo se asoció significativamente con mayores probabilidades para todas las transiciones examinadas, excepto en la transición uso-abuso. Se detectan períodos sensibles con transiciones rápidas a niveles más altos de uso de alcohol. Las experiencias de cohortes en todas las etapas del consumo de alcohol son importantes. Estos resultados podrían contribuir a la predicción de las tendencias poblacionales de los problemas con el alcohol en España.

Three-generation households and child mental health in European countries.

PURPOSE: To evaluate the associations between the presence of a grand parent at home that is three-generation household, with children mental health in diverse countries whether this situation is frequent or not. METHODS: Data from the School Children Mental Health in Europe cross-sectional survey in six countries (n = 4582) were used to examine the association between three-generation households and child mental health across Europe. The parent and teacher Strengths and Difficulties Questionnaire was combined to assess child mental clinical problems. RESULTS: Overall, 25.13% of European families live with at least one grandparent: 5.46% in Western and 29.70% in Eastern Europe. Controlling for key sociodemographic variables and for country of residence, the presence of a grandparent is associated with an increased risk for child mental health problems in the total sample (OR 1.37, p = 0.002). In two-parent homes, the effect of the presence of a grandparent is significant (OR 1.40, p = 0.026), while it is not in single-parent homes. In each country, the presence of a grandparent is a risk for either externalizing or internalizing problems. CONCLUSIONS: Programs may be developed to educate elderly people to better respect their children's role as parents so having a grandparent in the home can become an asset for family members rather than a burden.

Chronic back pain and its association with quality of life in a large French population survey.

BACKGROUND: Chronic back pain is associated with significant burden, yet few epidemiological studies have provided data on chronic back pain, its predictors and correlates in France. METHODS: Data were drawn from a cross-sectional survey conducted in France (n = 17,249) using computer-assisted telephone interviews. Sample age ranges from 18 to 98 with a mean of 46.39 years (SD = 17.44), and was 56.7% female. Medical conditions were assessed using the CIDI, quality of life was assessed using both the physical and mental component scores of the SF-36. RESULTS: Overall, 38.3% of adults reported chronic back pain. Female gender, older age, lower education, manual labor occupation, and population density were significantly associated with the distribution of chronic back pain. Chronic back pain was associated with lower scores on all SF-36 mean scores and on the Physical Composite Score and Mental Composite Score controlling for comorbid medical conditions including other types of chronic pain. CONCLUSION: The study highlights the burden of chronic back pain in the general population and underscores its correlation with quality of life. Such data contribute to raise awareness among clinicians and health policy makers on the necessity of prevention, early diagnosis, proper management and rehabilitation policies in order to minimize the burden associated with chronic pain.

Gender differences in psychiatric and medical comorbidity with post-traumatic stress disorder.

BACKGROUND: Post-traumatic stress disorder (PTSD) is associated with significant personal and societal burden. The present study examines the gender-specific differences in this burden in terms of the co-occurrence of psychiatric disorders and medical conditions with PTSD in the general population of France. METHODS: The study is based on a cross-sectional general population survey of 21,879 adults. Trained interviewers used a computer-assisted telephone interviewing system to administer the Composite International Diagnostic Interview-Short Form to screen for psychiatric disorders and medical conditions in the previous 12 months. RESULTS: One third of those with moderately severe PTSD (35.3%) and half of those with severe PTSD (54.2%) suffered from comorbid depression. The prevalence of anxiety disorders and substance use disorders was also greater among severe cases of PTSD. Chronic back or neck problems, frequent or severe headaches, arthritis or rheumatism and hypertension were highly prevalent among adults with PTSD. Adjusting for gender, age, education, employment and marital status, moderately severe and severe PTSD diagnoses were associated with significantly greater odds of comorbid psychiatric disorders and medical conditions. With few exceptions, the pattern of gender differences in psychiatric and medical morbidity among those with moderate or severe PTSD were similar to differences observed among those without PTSD. CONCLUSIONS: The findings highlight the burden of co-occurring psychiatric and medical conditions among PTSD sufferers in France and suggest the need for careful consideration of comorbidity in the assessment and service planning for PTSD.

Self-reported mental health in children ages 6-12 years across eight European countries.

Worldwide, approximately one in eight children or adolescents suffers from a mental disorder. The present study was designed to determine the self-reported prevalence of mental health problems in children aged 6-11 years across eight European countries including Italy, France, Germany, the Netherlands, Lithuania, Bulgaria, Romania, and Turkey. Data were drawn from 6245 children participating in the School Children Mental Health in Europe (SCHME) study and a large cross-sectional survey in France. Self-reported child mental health was assessed using the Dominique Interactive (DI). Overall, 22.0% of children were identified per their own evaluation as having at least one mental disorder, ranging from 16.4% in the Netherlands to 27.9% in Bulgaria. The prevalence of internalizing disorders was 18.4% across countries and ranged from 11.8% in the Netherlands to 24.3% in Turkey. The prevalence of externalizing disorders was lower with an average of 7.8%, ranging from 3.5% in Turkey to 10.5% in Bulgaria. Combining samples across European countries, 1 in 5 children reported internalizing problems and 1 in 12 children externalizing problems. The net completion rates of 4.1-74.3% preclude conclusions about national differences in prevalence rates.

Factors Associated with Parent-Child Discrepancies in Reports of Mental Health Disorders in Young Children.

The study compares parent and child reports of child mental health to determine the relationship between parent-child disagreement and parental psychological and attitudinal factors, and to determine how parent-child disagreement is associated with the use of specialized services. A cross-sectional study was conducted with 1268 children aged 6-11 years using the Dominic Interactive and the Strengths and Difficulties Questionnaire. Psychological distress and negative parental attitudes were associated with greater reporting of mental health problems, leading to greater parent-child agreement on symptom presence, and to parental over-reporting of symptoms. Parent/child agreement was associated with 43.83% of contact with a mental health provider for externalizing and 33.73% for internalizing problems. The contribution of key parental psychological and attitudinal factors in parent-child disagreement on child mental health status may prove helpful in improving the identification of children in need of specialized services.

Risk factors for child mental health problems in Lithuania: The role of parental nationality.

BACKGROUND: We compare the mental health status of children who reside in Lithuania with parents who are either Lithuanian nationals or non-Lithuanian nationals. METHOD: Data were drawn from the School Child Mental Health Europe survey (SCMHE), a cross-sectional survey of school children aged 6-11years. A total of 1152 Lithuanian children participated, among them 11.7% from a non-Lithuanian family. Child mental health was assessed using the Dominique Interactive (DI) and the parent- and teacher Strength and Difficulties Questionnaire (SDQ). Parental attitudes were evaluated, and socio-demographics were collected. RESULTS: Overall 26.7% of non-Lithuanian versus 17.2% of Lithuanian children reported having an internalizing disorder (p=0.01) mainly due to separation anxiety (16.4% versus 10.2%, p=0.04). Odds ratio (OR) for child-reported internalizing disorders was 1.86 (95% CI=1.17-2.96) once adjusted for other factors including being a girl, to be younger, parental unemployment and low caring and low autonomy parental attitudes which were associated with greater odds of internalizing disorders. In addition, 31.9% of non-Lithuanian reported suicidal thoughts versus 22.0% of Lithuanian children p=.02); OR=1.60 (95% CI=1.04-2.46) once adjusted for single parent, parental unemployment, parental alcohol problems and overreactivity attitude. CONCLUSIONS: Being a non-national minority in Lithuania is a risk factor for child mental health. These findings suggest that further studies are needed to inform local policy-makers on targeted prevention and intervention programs in these children.

Maternal Problem Drinking and Child Mental Health.

BACKGROUND: Offspring of individuals with alcohol use disorders have been shown to have elevated risk for mental health problems. OBJECTIVES: To examine the association between maternal problem drinking and child mental health as assessed by three informants in three European countries. METHODS: Data were drawn from the School Child Mental Health in Europe study. Maternal alcohol use was assessed using the alcohol use disorders identification test. Child mental health was assessed using the mother and teacher versions of the strengths and difficulties questionnaire, and the child self-reported Dominic interactive. Analyses were performed on 2,678 individuals, 6-11 year olds. RESULTS: Adjusting for variables associated with maternal drinking, among children eight years old or younger, excessive drinking was not significantly associated with mental health problems, whether reported by the mother, teacher or by the child. However, among girls eight years old and above, problem drinking was associated with conduct problems as reported by the mother (OR = 4.19), teacher reported total difficulties (OR = 4.69), and peer relationship problems (OR = 8.86). It was also associated with the presence of any child-reported disorder (OR = 3.88), externalizing (OR = 5.55) and internalizing disorders (OR = 4.42). Conclusions/Importance: Adjusting for sociodemographic variables and for psychological distress, maternal problem drinking was not significantly associated with child mental health problems in boys or in girls ages six to eight. The association was only present among girls ages 8-11. Examining relationships between mothers and their daughters in the peripubertal period may be a critical window for the development of effective intervention strategies.

Differential impact of parental region of birth on negative parenting behavior and its effects on child mental health: Results from a large sample of 6 to 11 year old school children in France.

BACKGROUND: In France, one in 10 residents has immigrated mainly from North Africa, West Africa or the Caribbean including the French West Indies. However little is known about how parents from these regions behave when they migrate to countries that have different cultural norms. It is therefore important to determine how ethno-cultural background affects parental behavior and subsequent child mental health in the context of immigration. The objectives are: 1) to compare negative parenting behaviors of French residents from diverse ethno-cultural backgrounds 2) to examine the relationship between parental region of origin and child mental health, and 3) to investigate the extent to which ethno-cultural context moderates the effect of parenting styles on child mental health. METHODS: A cross-sectional study was conducted in 2005 in 100 schools in South-East France. The Dominic Interactive and the parent-reported Strengths and Difficulties Questionnaire were used to assess child psychopathology. The Parent Behavior and Attitude Questionnaire was used to assess parenting styles. The final sample included data on 1,106 mother and child dyads. RESULTS: Caring and punitive attitudes were significantly different across mothers as a function of region of origin. This association was stronger for punitive attitudes with the highest prevalence in the Caribbean/African group, while mothers from Maghreb were more similar to French natives. Differences in caring behaviors were similar though less pronounced. Among children of Maghrebian descent, punitive parenting was associated with an increased risk of internalizing disorders while this association was weaker among children of African and Afro-Caribbean descent. CONCLUSIONS: Parental region of origin is an important component of both parenting styles and their effect on child mental health. Interventions on parenting should consider both the region of origin and the differential impact of origin on the effect of parenting styles, thus allowing for a finer-grained focus on high-risk groups.