Procedural Fairness in Physician-Patient Communication: A Predictor of Health Outcomes in a Cohort of Adults with Overweight or Obesity.

BACKGROUND: This study aimed to explore whether patients' perception of procedural fairness in physicians' communication was associated with willingness to follow doctor's recommendations, self-efficacy beliefs, dietary behaviors, and body mass index. METHODS: This was a secondary analysis of baseline data from 489 primary care patients with a BMI ≥ 25 kg/m2 (43.6% Black, 40.7% Hispanic/Latino, 55.8% female, mean age = 50 years), who enrolled in a weight management study in two New York City healthcare institutions. We conducted ordinary least squares path analyses with bootstrapping to explore direct and indirect associations among procedural fairness, willingness to follow recommendations, self-efficacy, dietary behaviors, and body mass index, while controlling for age and gender. RESULTS: Serial, multiple mediator models indicated that higher procedural fairness was associated with an increased willingness to follow recommendations which, in turn, was associated with healthier dietary behaviors and a lower BMI (indirect effect = - .02, SE = .01; 95% CI [- .04 to - .01]). Additionally, higher procedural fairness was associated with elevated dietary self-efficacy, which was, in turn, was associated with healthier dietary behaviors and lower BMI (indirect effect = - .01, SE = .003; 95% CI [- .02 to - .002]). CONCLUSIONS: These findings highlight the importance of incorporating procedural fairness in physician-patient communication concerning weight management in diverse primary care patients.

From co-regulation to self-regulation: Maternal soothing strategies and self-efficacy in relation to maternal reports of infant regulation at 3 and 7 months.

This study, conducted in Germany, examines the role of maternal soothing strategies to explain the association of maternal self-efficacy with infant regulation (crying and sleeping behavior). Questionnaire data of 150 mothers, living in Germany, with mixed ethnic and educational backgrounds were collected when infants were 3 and 7 months old. Two types of maternal soothing strategies were distinguished: close soothing, involving close physical and emotional contact, and distant soothing, involving physical and emotional distancing from the infant. A cross-sectional SEM at 3 months indicated that maternal self-efficacy is associated with reported infant regulation through distant soothing strategies. Low maternal self-efficacy was associated with frequent maternal use of distant soothing, which in turn was related to reported infant regulation problems, that is, non-soothability and greater crying frequency. Frequent use of close soothing was associated with reported infant sleeping behavior, that is, frequent night-time awakenings. A longitudinal SEM further indicated that the effects of close soothing persisted at least until the infants' age of 7 months. The study showed how low maternal self-efficacy, increased use of distant soothing, and reported early infant regulation problems are intertwined and that, due to their persisting positive effect on infant soothability, close soothing better supports infant development.

Este estudio examina el papel de las estrategias calmantes maternas para explicar la asociación entre auto efectividad materna y la regulación del infante (comportamiento de llanto y de dormir). Información de cuestionario de N = 150 madres de trasfondos étnicos y educativos mixtos se recogió cuando los infantes tenían tres y siete meses de nacidos. Dos tipos de estrategias calmantes maternas se identificaron: estrategia calmante cercana, la cual trata del contacto físico y emocional cercano, y estrategia calmante distante, la cual trata del distanciamiento físico y emocional con el infante. Un estudio de Modelo de Ecuación Estructural (SEM) transversal a los tres meses indicó que la auto efectividad materna se asocia con la reportada regulación del infante a través de estrategias calmantes distantes. La baja auto efectividad materna se asoció con el frecuente uso materno de estrategias calmantes distantes, lo cual a su vez se relacionó con los reportados problemas de regulación del infante, tales como el no calmarse y la mayor frecuencia del llanto. El uso frecuente de estrategias calmante cercanas se asoció con el reportado comportamiento de dormir del infante, tal como el frecuente despertar nocturno. Un estudio de tipo SEM longitudinal indicó más allá que los efectos de las estrategias calmantes cercanas persistían por lo menos hasta que los infantes tenían siete meses de edad. El estudio mostró cómo la baja auto efectividad materna, el uso incrementado de estrategias calmantes distantes, así como los reportados tempranos problemas de regulación del infante están entremezclados y que, debido a su persistente efecto positivo en calmar al infante, las estrategias calmantes cercanas apoyan mejor el desarrollo del infante.

Cette étude examine le rôle des stratégies maternelles d'apaisement pour expliquer le lien de l'auto-efficacité maternelle avec la régulation du nourrisson (pleurs et comportement du sommeil). Des données d'une questionnaire de N = 150 mères issues de milieux ethniques et éducationnels différents ont été recueillies quand les nourrissons avaient trois et sept mois. Deux types de stratégies maternelles d'apaisement ont été distingués: l'apaisement proche, avec un contact physique et émotionnel proche, et l'apaisement distant, avec une distanciation physique et émotionnelle du nourrisson. Une coupe transversale SEM à trois mois a indiqué que l'auto-efficacité maternelle est liée à la régulation infantile signalée au travers de stratégies d'apaisement distantes. Une auto-efficacité maternelle faible était liée à l'utilisation maternelle fréquente de stratégies d'apaisement, qui à son tour était liée aux problèmes signalés de régulation du nourrisson, comme par exemple le fait de ne pas pouvoir être apaisé ou une fréquence de pleurs plus grande. L'utilisation fréquente de stratégies d'apaisement proche était liée au comportement de sommeil du nourrisson signalé, comme par exemple des réveils nocturnes fréquents. Un SEM longitudinal a de surcroit indiqué que les effets de stratégies d'apaisement proches persistaient au moins jusqu'à l'âge de sept mois des nourrissons. L'étude a montré comment l'auto-efficacité maternelle faible, une utilisation accrue de stratégies d'apaisement distant et les problèmes signalés de régulation précoce des nourrissons sont imbriqués et que, du fait de leur effet positif persistant sur l'apaisement du nourrisson, les stratégies d'apaisement proches soutiennent mieux le développement du nourrisson.

A unified approach to demographic data collection for research with young children across diverse cultures.

Culture is a key determinant of children's development both in its own right and as a measure of generalizability of developmental phenomena. Studying the role of culture in development requires information about participants' demographic backgrounds. However, both reporting and treatment of demographic data are limited and inconsistent in child development research. A barrier to reporting demographic data in a consistent fashion is that no standardized tool currently exists to collect these data. Variation in cultural expectations, family structures, and life circumstances across communities make the creation of a unifying instrument challenging. Here, we present a framework to standardize demographic reporting for early child development (birth to 3 years of age), focusing on six core sociodemographic construct categories: biological information, gestational status, health status, community of descent, caregiving environment, and socioeconomic status. For each category, we discuss potential constructs and measurement items and provide guidance for their use and adaptation to diverse contexts. These items are stored in an open repository of context-adapted questionnaires that provide a consistent approach to obtaining and reporting demographic information so that these data can be archived and shared in a more standardized format. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Behavioural outcomes of children born with intrauterine growth restriction: protocol for a systematic review and meta-analysis.

INTRODUCTION: Intrauterine growth restriction (IUGR) is a pregnancy condition, which is associated with poor perinatal outcomes and long-term neurodevelopmental impairment. Several studies also investigated the impact of IUGR on child behaviour (eg, internalising and externalising behaviour, social competencies). However, so far, no systematic review or meta-analysis has been conducted that summarises these effects while considering relevant third variables such as type of IUGR diagnosis and control group, or concurrent cognitive abilities. The objective of this study is to summarise the current evidence regarding the relationship between IUGR and behavioural outcomes from early childhood to young adulthood. Additionally, to explore how third variables such as type of control group, or cognitive abilities, relate to this association. METHODS: Search strategy: The following electronic databases will be searched-Web of Science, Medline Ovid, PsycInfo, Cochrane Library, Scopus and Embase. INCLUSION CRITERIA: observational (eg, cohort studies and case-control studies) and intervention studies (if standard care is used and norm values are reported for the control group) will be included if they quantitatively compare children with and without IUGR from the age of 2 to 18 years. The main outcomes are internalising and externalising behaviour, and social competencies. ETHICS AND DISSEMINATION: No ethics approval was necessary for this protocol. Dissemination of findings will be done by publishing the results in peer-reviewed journals. The results of this systematic review will provide guidance for practice and counselling for clinicians and therapists facing patients affected by IUGR and their families. PROSPERO REGISTRATION NUMBER: CRD42022347467.

Infant regulation during the pandemic: Associations with maternal response to the COVID-19 pandemic, well-being, and socio-emotional investment.

In the transition to parenthood, the COVID-19 pandemic poses an additional strain on parental well-being. Confirmed infections or having to quarantine, as well as public health measures negatively affect parents and infants. Contrary to previous studies mainly focusing on the well-being of school-aged children and their parents during lockdown periods, the present study investigated how mothers of infants respond to the COVID-19 pandemic and whether this is related to maternal well-being, maternal socio-emotional investment, and infant regulation. Between April and June 2021, 206 mothers of infants (Mage  = 7.14 months, SDage  = 3.75 months) reported on COVID-19 infections, their response to the COVID-19 pandemic, their well-being, socio-emotional investment, and their infant's regulation. Exploratory factor analyses yielded five dimensions of maternal response to the COVID-19 pandemic: social distancing, worrying about the child, birth anxiety, distancing from the child, and information on COVID-19-related parenting behavior and support. These dimensions were related to mother-reported infant regulatory problems. Path analyses revealed paths via reduced maternal well-being and maternal socio-emotional investment. Maternal perceptions of infant regulatory problems are related to how the mothers respond to the COVID-19 pandemic. Better information about COVID-19-related parenting behavior and support might buffer against these effects.

Effect of Early High-Dose Recombinant Human Erythropoietin on Behavior and Quality of Life in Children Aged 5 Years Born Very Preterm: Secondary Analysis of a Randomized Clinical Trial.

Importance: In light of the promising neuroprotective properties of recombinant human erythropoietin (RHEpo), the Swiss EPO Neuroprotection Trial was started to investigate its effect on neurodevelopment in very preterm infants. The results of the primary and secondary outcome analysis did not show any effect of RHEpo on cognitive performance, neuromotor outcomes, or somatic growth of the study participants at ages 2 or 5 years. Objective: To investigate whether early high-dose RHEpo improves behavioral outcomes and health-related quality of life (HRQoL) at age 5 years. Design, Setting, and Participants: This was a prespecified secondary analysis of the double-blind, placebo-controlled, multicenter Swiss EPO Neuroprotection randomized clinical trial, which was conducted at 5 level-III perinatal centers in Switzerland. Infants born between 26 weeks 0 days' and 31 weeks 6 days' gestation were recruited between 2005 and 2012 and followed-up until age 5 years (last follow-up in 2018). Data were analyzed from January 6 to December 31, 2021. Interventions: Infants were assigned to receive either RHEpo (3000 IU/kg) or placebo (saline, 0.9%) intravenously 3 times within the first 42 hours after birth. Main Outcomes and Measures: The prespecified parent-reported measures of behavioral outcomes and health-related quality of life (HRQoL) of their children at the age of 5 years were assessed by two standardized questionnaires: the Strengths and Difficulties Questionnaire (behavioral outcomes) and the KIDSCREEN-27 (HRQoL). Results: Among 448 randomized infants, 228 infants were assigned to the RHEpo group and 220 infants were assigned to the placebo group. Questionnaire data were available for 317 children (71%) at a mean (SD) age of 5.8 (0.4) years (mean [SD] gestational age at birth, 29.3 [1.6] weeks; mean [SD] birth weight 1220 [340] grams; 128 [40%] female infants). At the age 5 years follow-up, the mean (SD) total difficulties score in the RHEpo group (8.41 [5.60] points) was similar to that of the placebo group (7.76 [4.81]) (P = .37). There were no statistically significant differences between the groups in any other outcome measures. Conclusions and Relevance: This secondary analysis of a randomized clinical trial showed no evidence for an effect of early high-dose RHEpo administration on behavioral outcomes or HRQoL in children born very preterm at early school age. Trial Registration: ClinicalTrials.gov Identifier: NCT00413946.

Maternal self-efficacy development from pregnancy to 3 months after birth.

The present study uses a prospective longitudinal study design to investigate the development of maternal self-efficacy in the transition phase to parenthood, drawing on a large sample of socially and/or culturally disadvantaged families (N = 292). Parity, maternal education, migration, informal and formal social support are considered as potential predictors. Results indicate that previous birth experience, being born abroad, and higher levels of formal and informal social support during pregnancy jointly predict higher levels of maternal self-efficacy three months after birth. First-time mothers and mothers born in Germany (where the study was conducted) benefit more from formal support than mothers with previous experience and mothers born outside of Germany. Overall, maternal self-efficacy increases significantly. Implications for prenatal maternal care are discussed.

El presente estudio usa un diseño de estudio longitudinal potencial para investigar el desarrollo de la auto efectividad materna en la fase de transición a ser madre. Usando una muestra grande de familias desfavorecidas social y/o culturalmente (N = 292). Se consideran como potenciales factores de predicción la paridad, la educación materna, la migración, y el apoyo social informal y formal. Los resultados indican que una previa experiencia de dar a luz, el haber nacido en el extranjero, así como altos niveles de apoyo social formal e informal durante el embarazo predicen en conjunto altos niveles de auto efectividad materna tres meses después del parto. Las madres primerizas y las madres nacidas en Alemania (donde se llevó a cabo el estudio) se beneficiaron más del apoyo formal que las madres con experiencia previa y las madres nacidas fuera de Alemania. En general, la auto efectividad materna aumentó significativamente. Se discuten las implicaciones para el cuidado materno prenatal.

Cette étude utilise un plan d'étude prospectif longitudinal pour se pencher sur le développement de l'auto-efficacité maternelle dans la phase de transition à la parenté, en utilisant un grand échantillon de familles socialement et/ou culturellement défavorisées (n = 292). La parité, l'éducation maternelle, la migration, le soutien social informel et formel sont considérés comme des prédicteurs potentiels. Les résultats indiquent qu'une expérience de la naissance antérieure, le fait d'être née à l'étranger et des hauts niveaux de soutien social formel et informel durant la grossesse prédisent ensemble des niveaux élevés d'auto-efficacité maternelle après la naissance. Les mères étant mères pour la première fois et les mères nées en Allemagne (où l'étude a été faite) ont plus bénéficié d'un soutien formel que les mères ayant déjà donné naissance à un enfant et que les mères nées en dehors de l'Allemagne. Dans l'ensemble l'auto-efficacité maternelle a augmenté de manière importante. Les implications pour le soin maternel prénatal sont discutées.

Testing Go/No-Go training effects on implicit evaluations of unhealthy and healthy snack foods.

OBJECTIVE: Despite intending to eat healthy foods, people often yield to temptation. In environments rife with unhealthy food options, a positive implicit evaluation of unhealthy foods may inadvertently influence unhealthy choices. This study investigates if and under which conditions implicit evaluations of unhealthy and healthy foods can be influenced by a computer-based Go/No-Go (GNG) training. DESIGN: Undergraduate student participants (N = 161 participants; 117 females, 44 males; Mage = 19 years, SD = 2 years) completed a GNG training with two healthy (grape and nut) and two unhealthy (potato chip and cookie) stimuli. Participants were either instructed to inhibit their responses to the potato chip (No-Go Chips/Go Grape) or to a grape (No-Go Grape/Go Chips). MAIN OUTCOME MEASURE: Implicit evaluations of chips and grapes were assessed using the Extrinsic Affective Simon Task. RESULTS: This GNG training impacted implicit evaluations of chips, but not grapes. GNG training effects were stronger for participants with lower sensitivity for behavioural inhibition measured with the Behavioural Inhibition System scale. CONCLUSION: GNG training might help people change implicit food evaluations. More research is needed to understand how individual and training characteristics affect outcomes with the goal of tailoring and optimising the GNG training to produce the strongest effect.

Polytraumatization in young male refugees from the Middle East and its association with internalizing and externalizing symptoms.

BACKGROUND: Young Middle Eastern male refugees are currently among the most vulnerable groups in Europe. Most of them have experienced potentially traumatic events (PTEs) such as rape, torture, or violent assaults. Compared to their peers, young refugees suffer more from internalizing and externalizing symptoms, especially when unaccompanied. Little is known about the cumulative impact of experiencing different types of PTEs on mental health outcomes (polytraumatization) of young male refugees from the Middle East. We investigated (1) whether there is a dose-response relationship between multiple PTE types experienced and mental health outcomes, (2) whether individual types of PTEs are particularly important, and (3) to what extent these are differentially associated with mental health outcomes among unaccompanied or accompanied peers. METHODS: In total, 151 young Middle Eastern male refugees in Germany (Mage = 16.81 years, SDage = 2.01) answered questionnaires on PTEs, mental health, and post-migration stress. RESULTS: Hierarchical regression analyses revealed, while controlling for age, duration of stay, unaccompanied status, and post-migration stress, (1) a dose-effect between PTE types on both internalizing and externalizing symptoms. Moreover, (2) regarding internalizing symptoms, violent family separation and experiencing life-threatening medical problems were particularly crucial. The latter was driven by unaccompanied refugees, who also reported higher levels of substance use. CONCLUSIONS: The results extend findings from the literature and suggest that not only may greater polytraumatization be related to greater depression among refugees, but also to a range of other mental health outcomes from the internalizing and externalizing symptom domains. Furthermore, the results highlight the mental health risks that unaccompanied and accompanied refugee adolescents face after exposure to PTEs, and provide information for practitioners as well as researchers about event types that may be particularly relevant.

Research review: A meta-analysis of the international prevalence and comorbidity of mental disorders in children between 1 and 7 years.

BACKGROUND: Children younger than 7 years can develop mental disorders that might manifest differently than in older children or adolescents. However, little is known about the prevalence of mental disorders at this early age. METHODS: We systematically searched the literature in the databases Web of Science, PsycINFO, PSYNDEX, MEDLINE, and Embase to identify epidemiological studies of community samples published between 2006 and 2020. A series of meta-analyses was conducted to estimate the pooled worldwide prevalence of mental disorders in general, specific mental disorders, and comorbidity in young children. RESULTS: A total of ten epidemiological studies reporting data on N = 18,282 children (12-83 months old) from eight countries met the inclusion criteria. The pooled prevalence of mental disorders in general was 20.1%, 95% CI [15.7, 25.4]. Most common disorders were oppositional defiant disorder (4.9%, 95% CI [2.5, 9.5]) and attention-deficit hyperactivity disorder (4.3%, 95% CI [2.5, 7.2]). The prevalence of any anxiety disorders was 8.5%, 95% CI [5.2, 13.5], and of any depressive disorders was 1.1%, 95% CI [0.8, 1.6]. Comorbidity was estimated at 6.4%, 95% CI [1.3, 54.0]. CONCLUSIONS: The literature search reveals that the epidemiology of mental disorders in children younger than 7 years is still a neglected area of research. The findings also indicate that there are a significant number of young children suffering from mental disorders who need appropriate age-adapted treatment.

Systematic review showed that low and moderate prenatal alcohol and nicotine exposure affected early child development.

AIM: We systematically reviewed the literature on the influence of low and moderate amounts of prenatal alcohol and nicotine exposure on early child development. This paper also suggests possible directions for future research in order to tackle the controversial findings identified. METHODS: The PubMed and Web of Science electronic databases were searched together with the reference lists of the selected papers. Empirical studies were included if they focused on the effects of low or moderate exposure, reported outcomes on child development within the first 2 years of life and were published in English between January 2009 and December 2019. The eligibility of the included studies was based on three authors reading the full text. RESULTS: The final sample comprised 17 papers. Of these, 13 focused on the effects of prenatal alcohol exposure and they reported decreased sensory sensibility, smaller body sizes and increased cognitive capacities. The other four looked at prenatal nicotine exposure, and they primarily found impairments in children's orienting, communication and motor skills. CONCLUSION: Any amount of prenatal alcohol and nicotine exposure appeared to risk healthy child development. There were many reasons for consumption and numerous effects on the child, but representative data from interdisciplinary research were missing.

Emotion regulation strategies predict weight loss during an inpatient obesity treatment for adolescents.

OBJECTIVE: Weight loss during an inpatient obesity treatment is an important predictor of subsequent weight maintenance. However, psychological factors influencing weight loss are not well established. Psychological models suggest some importance of executive functioning and emotion regulation strategies. Therefore, this study investigated whether these factors predict weight loss during an inpatient obesity treatment and whether this effect holds after controlling for general personal and treatment characteristics. METHOD: A total of 158 adolescents with diagnosed obesity underwent inpatient obesity treatment at a German rehabilitation clinic. Psychological factors (executive functioning and emotion regulation) were measured at admission and used to predict BMI reduction after treatment completion. RESULTS: More frequent use of reappraisal as an emotion regulation strategy, but not suppression or executive functioning, predicted weight loss at the end of the obesity treatment, even after controlling for age, gender, treatment duration, and BMI at admission. CONCLUSION: Functional emotion regulation strategies, like reappraisal, might offer an additional target for obesity treatment programmes, complementary to the more traditional components of psychoeducation, physical activity, and caloric restriction.

Influence of executive functions on the self-reported health-related quality of life of children with ADHD.

PURPOSE: ADHD is regarded as a neurodevelopmental disorder associated with deficits in executive functions (EF). The presence of these deficits is associated with increased symptom severity. However, so far there is little knowledge, whether deficits in EFs relate to a reduced health-related quality of life (HRQoL) in children with ADHD. METHODS: Hence, n = 100 children with a confirmed ADHD diagnosis were compared with a non-cases group (n = 100) with regard to their HRQoL (6-12 years old). The clinical group was divided into ADHD-specific drug treatment intake (drug treatment: n = 42; no drug treatment: n = 58) or deficits in EF (n = 29; no deficits in EF: n = 71). RESULTS: Children with ADHD (without medication) reported a significantly worse HRQoL than healthy children (d = .72), when controlled for age and sex. Even if they were treated with drug treatment, they reported a lower HRQoL than the non-case group in the area Family (d = .53). Drug treatment of ADHD leads to a significant difference in HRQoL in school area (d = .39). Children with ADHD and EF problems reported impairments in the social context of HRQoL compared to healthy children (d = .51 to .70). In addition, a significant negative association between set-shifting and HRQoL in children with ADHD (without drug treatment) was demonstrated (r = - .27 to r = - .35). CONCLUSIONS: By assessing the HRQoL, an impairment in the functioning of children with ADHD can be detected, which is essential for the diagnosis. Furthermore, executive problems have an influence on the social sphere, which should be clarified and improved in therapy with the involvement of parents.

The interplay of delay aversion, timing skills, and impulsivity in children experiencing attention-deficit/hyperactivity disorder (ADHD) symptoms.

Impulsive behaviours occurring as a central deficit in connection with attention-deficit/hyperactivity disorder (ADHD) are associated with social and academic impairment in children. Whereas impulsivity was shown to be related to both delay aversion and deficient timing skills, the mutual relation between the latter two has hardly been investigated. The present study therefore examined the interplay of delay aversion, timing skills, and impulsivity in a sample of eighty-eight children aged between seven and fourteen, twenty-one of them diagnosed with ADHD. Children participated in a delay aversion and a tapping task, while parents reported about their impulsiveness. The results showed that both delay aversion and deficient timing skills were related to impulsivity. Contrasting prior assumptions, delay aversion and timing skills were also shown to be related, even when controlling for impulsivity. Implications for interventions aiming to reduce children's impulsivity as well as methodological considerations regarding whether to view ADHD as a category or a continuum are discussed.

Examining the Relationship Between Children's ADHD Symptomatology and Inadequate Parenting: The Role of Household Chaos.

OBJECTIVE: This study examines the interrelations of parenting practices, emotional climate, and household chaos in families with children with and without ADHD. In particular, indirect pathways from children's ADHD symptomatology to inadequate parenting and negative emotional climate via household chaos were investigated. METHOD: Parenting, emotional climate, and household chaos were assessed using questionnaires and a speech sample of parents of 31 children with and 53 without ADHD, aged 7 to 13 years. RESULTS: Group differences were found for certain parenting dimensions, the parent-child relationship, critical comments, and household chaos. While we found significant indirect effects between children's ADHD and certain parenting dimensions through household chaos, no effects were found for any aspect of emotional climate. CONCLUSION: Children's ADHD symptoms translate into inadequate parenting through household chaos, which underlines the need for interventions to improve household organization skills in parents of children with ADHD.

A Brief Introduction to the Multidimensional Intercultural Training Acculturation Model (MITA) for Middle Eastern Adolescent Refugees.

The large number of adolescent refugees around the world constitutes a great challenge for societies. However, current models of acculturation have been developed for migrants, but not specifically for adolescent refugees. Crucial factors to describe adolescent refugee acculturation, such as intentions to return to their homeland, especially with respect to adolescent refugees with temporary residency and experiences of potentially traumatic events, are missing. Hence, the Multidimensional Intercultural Training Acculturation (MITA) model is introduced. The model proposes that two major concerns for adolescent refugees, which are socio-cultural adjustment and mental health, are predicted by intercultural and social⁻emotional competence, intentions to return to their homeland, and experiences of traumatic events. Moreover, the effects of three modes of acculturation are also proposed in the model. It is expected that these variables mediate the effects of intercultural competence, social⁻emotional competence, intentions to return to the homeland, and experiences of traumatic events on socio-cultural adjustment as well as mental health. Finally, it is also expected that in-group social support and out-group social support moderate the direct connection between the experiences of traumatic events and mental health.

Promoting Mental Health in Unaccompanied Refugee Minors: Recommendations for Primary Support Programs.

During the last years, the number of refugees around the world increased to about 22.5 million. The mental health of refugees, especially of unaccompanied minors (70% between the ages of 16 and 18 years) who have been exposed to traumatic events (e.g., war), is generally impaired with symptoms of post-traumatic stress disorder, depression, and anxiety. Several studies revealed (1) a huge variation among the prevalence rates of these mental problems, and (2) that post-migration stressors (e.g., language barriers, cultural differences) might be at least as detrimental to mental health as the traumatic events in pre- and peri-flight. As psychotherapy is a limited resource that should be reserved for severe cases and as language trainings are often publicly offered for refugees, we recommend focusing on intercultural competence, emotion regulation, and goal setting and goal striving in primary support programs: Intercultural competence fosters adaptation by giving knowledge about cultural differences in values and norms. Emotion regulation regarding empathy, positive reappraisal, and cultural differences in emotion expression fosters both adaptation and mental health. Finally, supporting unaccompanied refugee minors in their goal setting and goal striving is necessary, as they carry many unrealistic wishes and unattainable goals, which can be threatening to their mental health. Building on these three psychological processes, we provide recommendations for primary support programs for unaccompanied refugee minors that are aged 16 to 18 years.

A framework of psychological compensation in attention deficit hyperactivity disorder.

The term compensation is widely used in the context of attention deficit hyperactivity disorder (ADHD), yet, it is neither defined nor theory driven. Adapting a model of psychological compensation (Bäckman and Dixon, 1992) to fit ADHD research is the aim of this review: we will (1) introduce the existing theoretical framework of psychological compensation, (2) discuss its applicability to ADHD and adapt the model to fit ADHD research, and (3) set up requirements for research on psychological compensation in ADHD. According to the framework psychological compensation can be inferred if a deficit (i.e., a mismatch between skill and environmental demand) is counterbalanced by the investment of more effort, the utilization of latent skills, or the acquisition of new skills. The framework has to be adapted because ADHD deficits are developmental and in individuals with ADHD compensation can appear independent of awareness of the deficit. A better understanding of psychological compensation in ADHD could foster diagnosis and interventions. Therefore, we suggest that future studies should follow a research design incorporating independent measures of deficit, compensation, and outcome as well as include individuals who compensate for their ADHD related deficits.