ABSTRACT
This study examined the associations between maternal depression and oxytocin in pregnancy, caregiving sensitivity and adult attachment style, and infant temperament. One hundred and six women recruited from a public hospital antenatal clinic in Australia, and their infants completed assessments at three time points (Time 1: pregnancy; Time 2: 3-month postpartum; Time 3: 12-month postpartum). Mothers completed self-report questionnaires assessing maternal depression symptom severity at Time 1-3, adult attachment style at Time 2, and infant temperament at Time 3. At Time 1, they also provided a blood sample to assess peripheral oxytocin levels, and at Time 2, participated in a parent-child interaction session, which was later coded for caregiving behavior (sensitivity). Neither maternal depression nor lower levels of oxytocin during pregnancy predicted difficult infant temperament; rather, it was predicted by non-Caucasian ethnicity. When all other variables were free to vary, adult attachment avoidance mediated an association between maternal depression during pregnancy and difficult infant temperament. Results highlight the potential value of interventions focusing on adult attachment insecurity for pregnant women and raise questions about associations between culture/ethnicity and infant temperament.
Cette étude a examiné les liens entre la dépression maternelle et l'oxytocine durant la grossesse, la sensibilité de la personne prenant soin de l'enfant, le style d'attachement adulte et le tempérament du nourrisson. Cent six femmes recrutées dans une clinique prénatale d'un hôpital public et leurs nourrissons ont rempli des évaluations à trois moments (Moment 1 : la grossesse; Moment 2 : 3 mois postpartum; Moment 3 12 mois postpartum). Les mères ont rempli des questionnaires d'autoévaluation évaluant la sévérité du symptôme de dépression maternelle aux Moments 1, 2, et 3, le style d'attachement adulte au Moment 2, et le tempérament du nourrisson au Moment 3. Au Moment 1 elles ont aussi donné un échantillon de sang afin d'évaluer les niveaux périphériques d'oxytocine, et au Moment 2 elles ont participé à une séance d'interaction parentenfant qui fut plus tard codée pour le comportement de soin (sensibilité). Ni la dépression maternelle ni des niveaux plus bas d'oxytocine durant la grossesse ont prédit un tempérament difficile du nourrisson. En fait ce dernier s'est avéré prédit par une ethnicité non blanche. Lorsque toutes les autres variables étaient libres de varier le fait d'éviter l'attachement adulte a servi de médiation dans le lien entre la dépression maternelle durant la grossesse et le tempérament difficile du nourrisson. Les résultats mettent en lumière la valeur potentielle des interventions qui mettent l'accent sur l'insécurité de l'attachement adulte pour les femmes enceintes et soulèvent des questions quant aux liens entre la culture/l'ethnicité et le tempérament du nourrisson.
Este estudio examinó las asociaciones entre depresión materna y oxitocina en el embarazo, la sensibilidad acerca de la prestación de cuidado y el estilo de afectividad adulta, así como el temperamento del infante. Ciento seis mujeres, reclutadas de la clínica antenatal de un hospital público, y sus infantes, completaron un instrumento evaluativo en 3 momentos (Momento 1: embarazo; Momento 2: 23 meses después del parto; Momento 3: 12 meses después del parto). Las madres completaron cuestionarios de autoinforme en los que evaluaban la severidad de los síntomas de depresión materna en los Momentos 1, 2 y 3, el estilo de afectividad adulta al Momento 2, así como el temperamento del infante al Momento 3. Al Momento 1, ellas también aportaron una muestra de sangre para evaluar los niveles perimetrales de oxitocina, y al Momento 2, participaron en una sesión de interacción progenitorinfante que luego fue codificada en cuanto al comportamiento de prestación de cuidado (sensibilidad). Ni la depresión materna ni los bajos niveles de oxitocina durante el embarazo predijeron el temperamento difícil del infante; más bien, eso lo predijo la etnicidad no caucásica. Cuando todas las otras variables estaban libres para variar, la evasión de la afectividad adulta sirvió de mediadora en una asociación entre depresión materna durante el embarazo y temperamento difícil del infante. Los resultados subrayan el valor potencial de intervenciones que se enfoquen en la inseguridad de la afectividad adulta para mujeres embarazadas y plantean preguntas acerca de las asociaciones entre cultura/etnicidad y el temperamento del infante.
ABSTRACT
Childhood represents a critical window for the emergence and treatment of mental health disorders, yet many are not being identified, or are identified too late to receive adequate intervention. This systematic review (Prospero registration: CRD42022299560) aimed to determine the effectiveness and acceptability of parent reported universal mental health screening (UMHS) to improve the early identification of children at-risk of mental health difficulties, and to identify barriers and enablers that may influence parental engagement. Six databases were searched in February 2022 for peer-reviewed, primary research. Studies conducted in targeted populations, evaluating psychometric properties, or focused on screening non-psychological problems were excluded. Ten studies examined parent reported (n = 3,464 parents) UMHS for children from birth to 18 years, suggesting an overall scarcity of research. Findings are presented in a table of study characteristics and a narrative summary of acceptability, effectiveness, barriers, and enablers. Quantitative findings indicated that parents generally support and accept UMHS. Research assessing effectiveness was limited, although two studies indicated increased referrals and referral adherence following positive screens. Confidentiality and stigma were commonly identified barriers. Quality assessment using the Mixed Methods Appraisal Tool indicated that studies varied in quality, meeting four to seven of the seven quality criteria. Understanding and addressing parent attitudes to UMHS across settings is necessary for the successful implementation of screening and improvement of child mental health outcomes. More high-quality research studies, including randomized controlled trials are therefore needed to examine the acceptability and effectiveness of UMHS for parents and their children.
Subject(s)
Mass Screening , Parents , Humans , Child , Parents/psychology , Mental Disorders/diagnosis , Mental Disorders/prevention & control , Adolescent , Child, Preschool , Mental HealthABSTRACT
Time-out (TO) is a widely utilised parental discipline technique with a strong evidence-base that nonetheless has attracted controversy regarding potential adverse effects on mental health in developing children. Associations between TO implementation and mental health outcomes have rarely been investigated, especially through the eyes of children who grew up experiencing TO. This study recruited 407 university students (Study 1) and a community sample of 535 young adults (Study 2); both samples aged 18-30 years. Young adults were surveyed on their retrospective reports of childhood TO experience, childhood experiences of adversity, perceived parenting style and parental attachment, and their current mental health outcomes (attachment style, emotion regulation and mental health). In Study 1, 334 (82.1%) young adults reported experiencing TO in childhood, but with widely varied implementation that differed considerably from its evidence-based ideal. Reports of more TO appropriate implementation were associated with less avoidant attachment, better mental health, and emotion regulation, over and above the effects associated with authoritative parenting and secure attachment in childhood. While exposure to childhood adversity was associated with poorer adulthood outcomes, TO implementation did not moderate the association. Study 2 replicated most findings from Study 1, except that appropriate TO implementation displayed a positive association with mental health and no associations with anxious and avoidant attachment and emotion regulation. These findings suggest the safety of TO use with young children, including those who experienced childhood adversity, and highlight the importance of disseminating sufficient parenting information on TO in the community.
ABSTRACT
Parental self-efficacy predicts outcomes for parenting interventions for child behaviour problems, but there is a need for a brief measure that can be repeated over treatment and applies to a wide age range. The present study describes the development of such a measure, the Brief Parental Self-Efficacy Scale (BPSES). The psychometrics of the BPSES is presented across a wide age range from preschool to late adolescent in a sample comprised of four different intervention contexts. Evidence for structural validity, internal consistency, content validity, configural measurement invariance (equivalent factor structure) and test-retest reliability is presented alongside convergent validity against measures of parental self-efficacy, child behaviour problems, as well as self-report and observed parenting styles. Finally, lower levels of BPSES at baseline predicted increased disengagement from an intensive, individualised family therapy intervention for antisocial youth, while higher baseline levels predicted increased response to a group parenting programme for primary school aged children. The BPSES shows promise as a measure that can be used across a wide age-range, for a variety of parenting interventions for disruptive behaviour problems and which is sufficiently brief to be used as a routine outcome measurement during treatment.
ABSTRACT
Oppositional defiant disorder (ODD) is a disruptive behaviour disorder involving an ongoing pattern of angry/irritable mood, argumentative/defiant behaviour and vindictiveness. Onset is typically before 8 years of age, although ODD can be diagnosed in both children and adults. This disorder is associated with substantial social and economic burden, and childhood ODD is one of the most common precursors of other mental health problems that can arise across the lifespan. The population prevalence of ODD is ~3 to 5%. A higher prevalence in males than females has been reported, particularly before adolescence. No single risk factor accounts for ODD. The development of this disorder seems to arise from the interaction of genetic and environmental factors, and mechanisms embedded in social relationships are understood to contribute to its maintenance. The treatment of ODD is often successful, and relatively brief parenting interventions produce large sized treatment effects in early childhood. Accordingly, ODD represents an important focus for research, practice and policy concerning early intervention and prevention in mental health.
Subject(s)
Attention Deficit and Disruptive Behavior Disorders , Irritable Mood , Male , Child , Adult , Female , Adolescent , Humans , Child, Preschool , Attention Deficit and Disruptive Behavior Disorders/diagnosis , Attention Deficit and Disruptive Behavior Disorders/epidemiology , Attention Deficit and Disruptive Behavior Disorders/therapyABSTRACT
This study investigated maternal oxytocin, caregiving sensitivity and mother-to-infant bonding at 3-months postpartum as predictors of child behavior and psychological outcomes in the preschool years, when controlling for concurrent maternal negative emotional symptoms and adult attachment state-of-mind. Forty-five mother-child dyads were assessed at 3-months and 3.5 years postpartum using mix of questionnaires, observational, interview and biological methods. Results showed that lower levels of maternal baseline oxytocin at 3-months postpartum significantly predicted emotional reactivity in the child at 3.5 years. When maternal adult attachment state-of-mind and negative emotional symptoms were included, lower levels of maternal baseline oxytocin at 3-months postpartum significantly predicted withdrawn child behavior. In addition, unresolved adult attachment and maternal negative emotional symptoms were significantly associated child behavioral disturbance in a range of areas. Findings highlight maternal postnatal oxytocin as a potential indicator of children who may be more likely to show emotional reactivity and withdrawn behavior in the preschool years.
ABSTRACT
Many fields of medicine have benefitted from the formation of clinical trials networks, whereby researchers come together on a large scale to identify high-priority questions and implement coordinated clinical trials. Clinical trials networks in the field of mental health, however, have been rare and largely absent from the Australian context. Here, we present an overview of the newly formed Growing Minds Australia Clinical Trials Network, which represents the first comprehensive clinical trials network in child and youth mental health in Australia. The 60 principal members of the Growing Minds Australia Clinical Trials Network represent teams across 19 diverse areas related to specific forms of psychopathology (e.g. internalising, externalising, neurodevelopmental disorders, early psychosis, substance use), specific research methods and processes (e.g. health economics, eHealth, implementation science) and specialised areas of practice (e.g. school-based systems, parenting interventions, Indigenous mental health, refugee families). Core functions of the Growing Minds Australia Clinical Trials Network include collaborative trial protocol development; peer review, prioritisation and endorsement of proposed trials; training; development of clinical guidelines; and consumer representation. The research by the clinical trials network will encompass the populations typically accessing youth mental health services, while placing a key emphasis on the early periods of life, and the role of parents and caregivers as critical partners in the co-design of research and the delivery of intervention and prevention strategies. The structures and processes built into the network are designed to coordinate collaboration between diverse stakeholders and ensure that provisions for translation are integrated into research from the outset. In this paper, we examine the potential for a dedicated clinical trials network to initiate fundamental improvement in child and youth mental health systems, and discuss the unique and complex challenges associated with establishing such an initiative.
Subject(s)
Mental Health Services , Psychotic Disorders , Substance-Related Disorders , Humans , Child , Adolescent , Mental Health , AustraliaABSTRACT
Global access to practitioner training in the clinical engagement of fathers in family-based interventions is limited. The current study evaluated the feasibility of training practitioners in Canada and UK using online training developed in Australia by examining improvements in practitioner confidence and competence in father engagement, training satisfaction, qualitative feedback, and benchmarking results to those from an Australian sample. Practitioners were recruited to participate in a 2-h online training program through health services and charity organisations. The online program required practitioners to watch a video and complete self-reflection exercises in a digital workbook. Pre- and post-training measures were collected immediately before and after the online training program. The results indicated significantly large improvements in self-reported confidence and competence in engaging fathers following training, with levels of improvement similar to those found in Australia. Training satisfaction was high and qualitative feedback suggested providing local resources and increasing representation of social diversity could improve training relevance in local contexts. The findings suggest online training in father engagement can contribute to global workforce development in improving practitioners' skills in engaging fathers in family-based interventions.
Subject(s)
Fathers , Humans , Male , Feasibility Studies , Australia , Self Report , WorkforceABSTRACT
BACKGROUND: Time-out (TO) is a widely used parental discipline strategy with strong research support in programmes that promote positive child development. Concerns have been raised, however, regarding adverse impact on child mental health (CMH) in part driven by evidence of widespread variability in appropriate implementation. There are no existing measures of TO. We present the first measure of procedural implementation of TO in a community sample of parents of children aged 6-8 years. METHODS: A nationally representative sample (N = 474) of parents completed a survey on the implementation of TO, parent-child relationships, and emotional and behavioural difficulties. The scale of TO use was used to test the convergent validity between TO implementation and parenting practices/family adjustment and CMH. RESULTS: Consistent with international research, >70% of parents have used TO with their children. There was high variability in the levels of appropriate implementation of TO. Scale reliability (Cronbach's alpha) was acceptable and tests of convergent validity indicated that as expected, less appropriate implementation of TO was associated with worse CMH and poorer parenting and family adjustment. CONCLUSIONS: The current findings suggest that the scale is a psychometrically sound instrument for measuring the appropriate procedural implementation of TO with young children.
Subject(s)
Child Rearing , Parenting , Humans , Child , Child, Preschool , Reproducibility of Results , Child Development , Parents/psychologyABSTRACT
Contemporary theories of early development and emerging child psychopathology all posit a major, if not central role for physiological responsiveness. To understand infants' potential risk for emergent psychopathology, consideration is needed to both autonomic reactivity and environmental contexts (e.g., parent-child interactions). The current study maps infants' arousal during the face-to-face still-face paradigm using skin conductance (n = 255 ethnically-diverse mother-infant dyads; 52.5% girls, mean infant age = 7.4 months; SD = 0.9 months). A novel statistical approach was designed to model the potential build-up of nonlinear counter electromotive force over the course of the task. Results showed a significant increase in infants' skin conductance between the Baseline Free-play and the Still-Face phase, and a significant decrease in skin conductance during the Reunion Play when compared to the Still-Face phase. Skin conductance during the Reunion Play phase remained significantly higher than during the Baseline Play phase; indicating that infants had not fully recovered from the mild social stressor. These results further our understanding of infant arousal during dyadic interactions, and the role of caregivers in the development of emotion regulation during infancy.
Subject(s)
Facial Expression , Mother-Child Relations , Infant , Female , Humans , Male , Mother-Child Relations/psychology , Mothers/psychology , Parent-Child Relations , Sympathetic Nervous System , Infant Behavior/psychologyABSTRACT
Children with conduct problems and high callous-unemotional (CP+CU) traits are characterized by dampened emotional responding, limiting their ability for affective empathy and impacting the development of prosocial behaviors. However, research documenting this dampening in young children is sparse and findings vary, with attachment-related stimuli hypothesized to ameliorate deficits in emotional responding. Here we test emotional responsiveness across various emotion-eliciting stimuli using multiple measures of emotional responsiveness (behavioral, physiological, self-reported) and attention, in young children aged 2-8 years (M age = 5.37), with CP+CU traits (CP+CU; n = 36), CPs and low CU traits (CP-CU; n = 82) and a community control sample (CC; n = 27). We found no evidence that attachment-related stimulus ameliorated deficits in emotional responding. Rather, at a group level we found a consistent pattern of reduced responding across all independent measures of responsiveness for children with CP+CU compared to the CC group. Few differences were found between CP+CU and CP-CU groups. When independent measures were standardized and included in a regression model predicting to CU trait score, higher CU traits were associated with reduced emotional responding, demonstrating the importance of multimodal measurement of emotional responsiveness when investigating the impact of CU traits in young children.
Subject(s)
Conduct Disorder , Problem Behavior , Child , Humans , Child, Preschool , Conduct Disorder/psychology , Emotions/physiology , Problem Behavior/psychology , EmpathyABSTRACT
Maternal-infant bonding is important for children's positive development. Poor maternal-infant bonding is a risk factor for negative mother and infant outcomes. Although researchers have examined individual predictors of maternal-infant bonding, studies typically do not examine several concurrent and longitudinal predictors within the same model. This study aimed to evaluate the unique and combined predictive power of cross-sectional and longitudinal predictors of maternal-infant bonding. Participants were 372 pregnant women recruited from an Australian hospital. Data were collected from mothers at antenatal appointments (T0), following their child's birth (T1), and at a laboratory assessment when their child was 5-11-months-old (T2). Poorer bonding at T2 was predicted at T0 by younger maternal age, higher education, and higher antenatal depressive symptoms. Poorer bonding at T2 was predicted at T1 by younger maternal age, higher education, and higher postnatal depressive symptoms. Poorer bonding at T2 was predicted at T2 by younger maternal age, higher education, higher postnatal depression symptoms, higher concurrent perceived social support, and more difficult infant temperament, when controlling for child age at T2. To promote positive maternal-infant bonding, global and targeted interventions in the perinatal period may benefit from targeting maternal psychopathology, perceived lack of social support, and coping with difficult infant temperament.
Subject(s)
Depression, Postpartum , Mother-Child Relations , Child , Female , Infant , Pregnancy , Humans , Child, Preschool , Cross-Sectional Studies , Australia , Depression, Postpartum/diagnosis , Depression, Postpartum/prevention & control , Mothers , Object AttachmentABSTRACT
Importance: Exposure to adverse childhood experiences substantially increases the risk of chronic health problems. Originally designed to treat child conduct problems, parent management training programs have been shown to be effective in preventing children from being exposed to further adversity and supporting children's recovery from adversity; however, there are increasing concerns that a core component of these programs, the discipline strategy time-out, may be harmful for children with a history of exposure to adversity. Objective: To investigate the comparative benefits and potential harms to children exposed to adversity that are associated with parenting programs that include time-out. Design, Setting, and Participants: This nonrandomized waiting list-controlled clinical study was conducted at a specialist clinic for the treatment of conduct problems in Sydney, Australia. The self-referred sample included children with conduct problems and their caregivers. Eligibility was confirmed through clinician-administered interviews. Data were collected between February 14, 2018, and February 1, 2021. Interventions: Caregivers participated in a 10-session, social learning-based parent management training program. Caregivers were provided with parenting strategies aimed at encouraging desired behaviors through effective reinforcement and managing misbehavior through consistent limit setting, including the use of time-outs. Main Outcomes and Measures: The primary outcome was the parent-reported Strengths and Difficulties Questionnaire score, and secondary outcomes included subscale scores from the clinician-administered Diagnostic Interview Schedule for Children, Adolescents, and Parents. Multi-informant measures of child adversity were collected using the parent-reported Adverse Life Experiences Scale and the clinician-rated Maltreatment Index. Results: A total of 205 children were included in analysis (156 in the full intervention and 49 in the control condition; 158 boys [77.1%]; mean [SD] age, 5.6 [1.8] years [range, 2-9 years]). Compared with children with low adversity exposure, children with high adversity exposure showed greater reductions in the Strengths and Difficulties Questionnaire score from baseline (mean difference, 3.46 [95% CI, 1.51-5.41]; P < .001) to after treatment (mean difference, 1.49 [95% CI, -0.46 to 3.44]; P = .13) and in the internalizing symptom subscale score (baseline mean difference, 1.00 [95% CI, -2,00 to 0.00]; P = .50; posttreatment mean difference, 0.06 [95% CI, -0.82 to 0.94]; P = .90). No significant differences in the externalizing symptom subscale score were found. Conclusions and Relevance: In this nonrandomized clinical study, children with high exposure to adversity experienced equivalent, if not greater, benefits associated with parenting programs that include time-out compared with children with low exposure to adversity. Results suggest that time-out was an effective component of parenting programs for children exposed to adversity. Trial Registration: anzctr.org.au Identifier: ACTRN12617001472369.
Subject(s)
Parenting , Parents , Adolescent , Australia/epidemiology , Caregivers , Child , Child, Preschool , Humans , Male , Parents/educationABSTRACT
OBJECTIVES: Parenting is central to children's optimal development and accounts for a substantial proportion of the variance in child outcomes, including up to 40% of child mental health. Parenting is also one of the most modifiable, proximal, and direct factors for preventing and treating a range of children's problems and enhancing wellbeing. To determine the effectiveness of new approaches to parenting intervention, and to evaluate how to optimise reach and uptake, sufficient funding must be allocated for high quality research. METHOD: We reviewed funding awarded by the National Health and Medical Research Council (NHMRC) and Australian Research Council (ARC) for parenting intervention research during 2011-2020. RESULTS: Parenting intervention research received 0.25% of the NHMRC and ARC research budgets. CONCLUSIONS: There is a substantial mismatch between the funding of parenting intervention research and the impact of improved parenting on short- and long-term child outcomes. To rectify this, it is critical that Australian Government funding schemes include parenting interventions as priority areas for funding. IMPLICATIONS FOR PUBLIC HEALTH: Changes in allocation of funding to parenting research will support the establishment of evidence for the effective development, implementation and dissemination of parenting interventions to maximise health outcomes for children and their families.
Subject(s)
Parenting , Parents , Australia , Child , Government , Humans , Parenting/psychology , Parents/psychologyABSTRACT
There is tentative evidence that infants can learn preferences through evaluative conditioning to socioemotional stimuli. However, the early development of evaluative conditioning and the factors that may explain infants' capacity to learn through evaluative conditioning are not well understood. Infants (N = 319; 50.2% boys) participated in a longitudinal study where an evaluative conditioning paradigm using socioemotional stimuli was conducted on two occasions (when infants were 7 and 14 months old, on average). We tested whether repeatedly pairing neutral stimuli (triangular and square shapes) with affective stimuli (angry and happy faces) affects infants' preferences for these shapes. At both timepoints, the majority of infants did not choose the shape that was paired with happy faces, indicating that, in general, learning through evaluative conditioning was not present. However, as expected, individual differences were evident such that infants who spent more time fixating on faces compared to shapes (face-preferrers) during the conditioning trials were significantly more likely than non-face-preferrers to choose the shape paired with happy faces, and this effect strengthened with increasing age.
Subject(s)
Conditioning, Classical , Learning , Anger , Female , Humans , Infant , Longitudinal Studies , MaleABSTRACT
BACKGROUND: Longitudinal studies are needed to examine the association between maternal depression, trauma and childhood mental health in conflict-affected settings. AIMS: To examine maternal depressive symptoms, trauma-related adversities and child mental health by using a longitudinal path model in conflict-affected Timor-Leste. METHOD: Women were recruited in pregnancy. At wave 1, 1672 of 1740 eligible women were interviewed (96% response rate). The final sample comprised 1118 women with complete data at all three time points. Women were followed up when the index child was aged 18 months (wave 2) and 36 months (wave 3). Measures included the Edinburgh Postnatal Depression Scale, lifetime traumatic events and the Child Behaviour Checklist. A longitudinal path analysis examined associations cross-sectionally and in a cross-lagged manner across time. RESULTS: Maternal depressive symptom score was associated with child mental health (cross-sectional association at wave 2, ß = 0.35, P < 0.001; cross-sectional association at wave 3, ß = 0.33, P < 0.001). The maternal depressive symptom score at wave 1 was associated with child mental health at wave 2 (ß = 0.12, P < 0.001), and the maternal depressive symptom score at wave 2 showed an indirect association with child mental health at wave 3 (indirect standardised coefficient 0.23, P < 0.001). There was a time-lagged relationship between child mental health at wave 2 and maternal depression at wave 3 (ß = 0.08, P = 0.02). CONCLUSIONS: Maternal depressive symptoms are longitudinally associated with child mental health, and traumatic events play a role. Maternal depression symptoms are also affected by child mental health. Findings suggest the need for skilled assessment for depression, trauma-informed maternity care and parenting support in a post-conflict country such as Timor-Leste.
ABSTRACT
The Diagnostic Interview Schedule for Children Adolescents and Parents (DISCAP) is a semi-structured diagnostic interview for assessing psychiatric disorders in children and adolescents. Changes to diagnostic criteria introduced in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) required the DISCAP to be revised accordingly. The aim of this study was to evaluate the reliability and validity of the updated DISCAP-5 in clinic-referred children. The DISCAP-5 was administered to parents of n=60 clinic-referred children aged 2-9 years with externalizing problems and a range of comorbid disorders. Inter-rater reliability data were collected using independent ratings of video-recorded DISCAP-5 interviews, and concurrent and discriminant validity were indexed against mother and father reports on the Strengths and Difficulties Questionnaire. Inter-rater reliability agreement was high for the presence and absence of any diagnosis, common externalizing (e.g., oppositional defiant disorder, conduct disorder) and internalizing disorders (separation anxiety disorder, generalized anxiety disorder), and severity of primary and secondary diagnoses. Rating scale data supported the concurrent and discriminant validity of diagnoses based on the DISCAP-5. The DISCAP-5 appears to provide valid and reliable data in the diagnostic assessment of clinic-referred children with behavioral and emotional difficulties across broad ranges of severity and complexity.
Subject(s)
Attention Deficit and Disruptive Behavior Disorders , Parents , Adolescent , Attention Deficit and Disruptive Behavior Disorders/diagnosis , Child , Diagnostic and Statistical Manual of Mental Disorders , Humans , Parents/psychology , Psychiatric Status Rating Scales , Psychometrics , Reproducibility of ResultsABSTRACT
There is a significant gap between the need for child mental health services and use of these services by families. Parental attributions may play a role in this. This study examined whether mothers' attributions about their child's problems influence professional help-seeking intentions in a general sample of community mothers. Secondary analysis re-examined this hypothesis in a subgroup of mothers of children with clinically elevated mental health symptoms. Cross-sectional survey data were collected from mothers (N = 184) of children aged between 2 and 12 years recruited from the community. Mothers completed self-report questionnaires measuring parental attributions: child-responsible attributions and parental self-efficacy; professional help-seeking intentions; and psychosocial covariates: child mental health, mothers' anxiety and depression, child age, gender, marital status, education, and professional help-seeking experience. Hierarchical regression modelling indicated that parental attributions explained professional help-seeking intentions after controlling for covariates in both the general sample (ΔF = 6.07; p = .003) and subgroup analysis (ΔF = 10.22, p = .000). Professional help-seeking intentions were positively associated with child-responsible attributions (ß = .19, p = .002) but not parental self-efficacy (ß = - .01, p = .865) in the general sample, while positively associated with child-responsible attributions (ß = .20, p = .009) and negatively associated with parental self-efficacy (ß = - .16, p = .034) in the subgroup analysis. Findings were independent of the presence of clinically elevated symptoms, problem type, and severity. Overall, the findings support models suggesting that parental attributions have a role in professional help-seeking for child mental health problems.
Subject(s)
Intention , Mothers , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Mental Health , Parents , Patient Acceptance of Health CareABSTRACT
This study investigated links between maternal postnatal oxytocin, maternal sensitivity, and infant attachment security. At 3-months postpartum, participants (n=88) took part in a structured parent-infant interaction. Maternal oxytocin levels were assessed via blood, before and after the interaction. At 12-months postpartum, mother-child dyads completed the Strange Situation Procedure. Neither baseline oxytocin, oxytocin response, or maternal sensitivity were identified as significant independent predictors of infant attachment security or organisation. However, an interaction effect was identified, with higher maternal sensitivity being associated with secure infant attachment for mothers who showed an increase in oxytocin during parent-child interaction. Results indicate that maternal sensitivity, when accompanied by an increase in maternal oxytocin during parent-child interaction, is associated with the establishment of a positive early parent-child attachment relationship. This adds to the growing body of evidence highlighting maternal oxytocin response as a key adaptive process in the postpartum period.
Subject(s)
Mother-Child Relations , Oxytocin , Female , Humans , Infant , Mothers , Object Attachment , Postpartum PeriodABSTRACT
An attentional bias toward threat has been theorized to be a normative aspect of infants' threat and safety learning, and an indicator of risk for internalizing psychopathology in older populations. To date, only four studies have examined this bias using the dot-probe task in infancy and the findings are mixed. We extended the literature by examining patterns of attention to threat in a culturally and linguistically diverse sample of infants aged 5-11 months old (N = 151) using all measures previously employed in the infant dot-probe literature. Given that an attentional bias toward threat is associated with higher risk of developing anxiety disorders later in life, we also examined how negative affect-an early correlate of later anxiety disorders-is related to attentional bias toward threat in infancy. This study was the first to use a consistent measure of negative affect across the whole sample. An eye-tracking dot-probe task was used to examine attentional bias toward threat (i.e., angry faces) relative to positive (i.e., happy faces) stimuli. Results showed that an attention bias to threat was not characteristic of infants at this age, and negative affect did not moderate the putative relationship between attention and emotional faces (angry, happy). These findings therefore suggest that attention biases to socio-emotional threat may not have emerged by 11 months old.