Parental anxiety symptoms, parenting confidence, and family functioning following a youth's hospitalization for suicide risk.

The posthospitalization period following a youth's psychiatric emergency is characterized by marked risk for suicide attempts and rehospitalization. Parental anxiety and uncertainty about parenting strategies may become particularly salient during this period due to fear of youth relapse. These parental factors, then, may negatively impact family functioning, a factor known to mitigate suicide risk. The present study tested a theoretical model to elucidate the relationship between parenting factors and family functioning during this transition period, specifically, whether parental anxiety symptoms and parenting confidence are related and contribute to family functioning longitudinally following youth psychiatric hospitalization. The sample included 147 adolescents and a primary caregiver enrolled in a clinical trial. At baseline (BL) and 6 months (M6), caregivers completed measures of global anxiety symptoms (Brief Symptom Inventory) and parenting confidence (Parenting Relationship Questionnaire). Observer-rated family problem solving and limit setting were assessed (Family Assessment Task) at BL and 12 months (M12). These two measures of family functioning were included in separate path analyses that examined the temporal relations between constructs. After accounting for demographics, BL levels of parenting variables, BL youth functioning, and the presence or absence of youth suicide attempts during follow-up, BL parenting confidence negatively predicted M6 parent anxiety in both models. Additionally, M6 parenting confidence positively predicted M12 problem solving and limit setting. Bidirectional relations between parenting confidence and global anxiety were not supported, nor did global anxiety predict family functioning. Findings suggest that specifically addressing parenting confidence in youth treatment may be beneficial to support family adjustment, particularly following crises. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Facets of social problem-solving as moderators of the real-time relation between social rejection and negative affect in an at-risk sample.

Social rejection predicts negative affect, and theoretical work suggests that problem-solving deficits strengthen this relation in real-time. Nevertheless, few studies have explicitly tested this relation, particularly in samples at risk for suicide. This may be particularly important as social rejection and negative affect are significant predictors of suicide. The aim of the current study was to examine whether cognitive (i.e., perceiving problems as threats) and behavioral (i.e., avoidance) facets of problem-solving deficits moderated the real-time relation between social rejection and negative affect. The sample consisted of 49 young adults with past-month suicidal ideation. Demographic information, social problem-solving deficits, as well as depressive/anxiety symptoms and stress levels were assessed at baseline. Social rejection and negative affect were assessed using ecological momentary assessment over the following 28 days. Dynamic structural equation modeling was used to assess relations among study variables. After accounting for depressive/anxiety symptoms, stress levels, sex, and age, only avoidance of problems bolstered the real-time positive relation between social rejection severity and negative affect (b = 0.04, 95% credibility interval [0.003, 0.072]). Individuals with suicidal ideation who possess an avoidant problem-solving style may be particularly likely to experience heightened negative affect following social rejection and may benefit from instruction in problem-solving skills.

Revisiting caregiver satisfaction with children's mental health services in the United States.

Nearly four decades ago, Unclaimed Children documented the gaps in the United States between mental health programs and caregivers' perspectives about those services for their children. This absence of attention to parent or caregiver perspectives, including their satisfaction with these services, was a key finding of the report, which detailed system failure in caring for youth with mental health needs. Since then, the focus on caregiver satisfaction with children's mental health services has been largely overlooked in research, and when examined has been mostly included as an indicator of the feasibility of program implementation. In striking contrast, overall healthcare system reforms have highlighted the importance of improving consumer's direct experience of care. However, caregiver satisfaction remains largely disconnected to these overall health system reforms, even as reforms focus increasingly on value-based, coordinated and integrated care. In this paper, we review literature from 2010 to 2020, revisit the measurement of caregiver satisfaction, identify how and when it is being measured, and delineate a research agenda to both realign it with health system improvements, refine its focus on expectancies and appropriateness, and root it more firmly in the principles of user experience (UX) and human-centered design (HCD).