A systematic review of callous-unemotional traits and attachment in children and adolescents.

METHODS: The systematic review and meta-analysis included 17 research articles from 1994 to 2022. Results were summarized by developmental periods. RESULTS: Attachment insecurity was associated with CU traits across development (r = .17). This association was marginally stronger for high-risk samples (e.g., clinical, justice) and for continuous attachment measures versus coding schemes. From early to middle childhood, attachment disorganization was associated with CU traits (r = .17). IMPLICATIONS: Research on attachment and CU traits in childhood is still in its infancy. Changes in attachment measures from childhood to adolescence make developmental comparisons difficult. Results suggest attachment as a potential developmental mechanism for youth with CU traits, however, the area requires more research.

A Systematic Review of Neurodevelopmental Assessments in Infancy and Early Childhood: Developing a Conceptual Framework, Repository of Measures, and Clinical Recommendations.

The first 6 years of life are when 90% of brain development occurs, setting the foundation for lifelong neurodevelopment. The field of infant and early childhood neurodevelopment has made marginal advancements since introduced in 1988. There remains a gap in knowledge around early neurodevelopmental domains and trajectories given that there are few established assessment procedures for infants and young children and controversies around reserving assessments until school age. Throughout this systematic review, we (1) identified neurodevelopmental assessment measures employed in the literature by domain and age of assessment, (2) compiled a repository of 608 domain-specific neurodevelopmental assessment measures, and (3) established a preliminary conceptual framework for cross-domain neurodevelopmental assessments across infancy and early childhood. This review adhered to PRISMA guidelines and spanned three databases (PsycINFO, MEDLINE, PubMed). Articles were reviewed for (1) infancy and early childhood (0-6 years), (2) neurodevelopmental measures, and (3) English language. This systematic review spanned 795 articles from 1978 to 2020 with international representation. Advancements in assessment methods (e.g. measures, domains, frameworks) are essential for the evaluation of early neurodevelopmental profiles to inform early interventions, thus harnessing the neuroplasticity and dynamic development notable during early childhood. We hope this work catalyzes future research and clinical guidelines around early assessments methods.

A comparative effectiveness study of the breaking the cycle and Maxxine Wright intervention programs for substance-involved mothers and their children: study protocol.

BACKGROUND: Children of substance-involved mothers are at especially high risk for exposure to adverse childhood experiences (ACEs) and poor mental health and development. Early interventions that support mothers, children, and the mother-child relationship have the greatest potential to reduce exposure to early adversity and the mental health problems associated with these exposures. Currently, there is a lack of evidence from the real-world setting demonstrating effectiveness and return on investment for intervention programs that focus on the mother-child relationship in children of substance-involved mothers. METHODS: One hundred substance-involved pregnant and/or parenting women with children between the ages of 0-6 years old will be recruited through the Breaking the Cycle and Maxxine Wright intervention programs, in Toronto, Ontario, Canada and Surrey, British Columbia, Canada, respectively. Children's socioemotional development and exposure to risk and protective factors, mothers' mental health and history of ACEs, and mother-child relationship quality will be assessed in both intervention programs. Assessments will occur at three time points: pre-intervention, 12-, and 24-months after engagement in the intervention program. DISCUSSION: There is a pressing need to identify interventions that promote the mental health of infants and young children exposed to early adversity. Bringing together an inter-disciplinary research team and community partners, this study aligns with national strategies to establish strong evidence for infant mental health interventions that reduce child exposure to ACEs and support the mother-child relationship. This study was registered with clinicaltrials.gov (NCT05768815) on March 14, 2023.

Adherence to and Motivations for Complying With Public Health Measures Among Adolescents During the Coronavirus Disease (COVID-19) Pandemic in Canada.

Background: Public health measures (e.g., minimizing social interactions, social distancing, and mask wearing) have been implemented in Canada to reduce the transmission of COVID-19. Given that adolescents may be a high-risk demographic for spreading COVID-19, this study investigated adherence to and motivations for complying with public health measures among Canadian youth at two points of the COVID-19 pandemic. Methods: Adolescents (N = 1,484, 53% girls, Mage = 15.73 [SD = 1.41]) completed an online survey in either Summer 2020 (Cohort 1 [C1]; n = 809, 56% girls) or Winter 2020/2021 (Cohort 2 [C2]; n = 675, 50% girls). We investigated differences in adherence across cohorts using independent sample t-tests and predictors of adherence using a path analysis. Results: Youth engaged in similar levels of social interaction in C1 and C2. Relative to adolescents in C1, adolescents in C2 reported more mask wearing, but less social distancing. Social responsibility was associated with adherence to almost all public health measures across both cohorts, with one exception: it did not predict minimizing social interactions in C2. Not wanting to get sick predicted minimizing social interactions and mask wearing. Concern with population health predicted adherence to all public health measures in C1 and all but mask wearing in C2. Maintaining social ties was negatively associated with minimizing social interactions in both cohorts, and with social distancing in C1. Conclusions: Youth engaged in more mask wearing but less social distancing as the pandemic progressed. Social responsibility and not wanting to get sick were consistent predictors of adherence to most public health measures throughout the pandemic. Youth shifted away from adhering to mask wearing measures due to concern with population health over the course of the pandemic. These results can inform targeted campaigns to bolster compliance with public health measures among adolescents.

Bullying before and during the COVID-19 pandemic.

The rates of bullying during the COVID-19 pandemic, a time of unprecedented public health and social restrictions, were compared to earlier times when students attended school in person. Several studies indicated a notable decrease in the prevalence of bullying victimization and perpetration during the pandemic, particularly when online learning was implemented. But studies from countries with fewer social restrictions indicated increases in rates of bullying during the pandemic. Mixed results regarding prevalence rates for some bullying forms (e.g., cyberbullying) were also found. Racialized youth and LGBTQ+ youth reliably reported higher rates of bullying victimization during the pandemic, consistent with pre-pandemic patterns. Reasons for the inconsistencies in findings likely relate to diverse methods, timeframes, and sampling techniques, as well as different experiences with pandemic social restrictions. More longitudinal studies are needed to assess whether bullying involvement did in fact "change" during, compared to before, the pandemic. The findings point to the importance of peer relationships and hint at the potential of increased teacher supervision as a bullying prevention strategy.

Cumulative Risk, Protection, and Early Intervention: Neurodevelopment in Sibling Groups Exposed Prenatally to Substances.

Mothercraft's Breaking the Cycle is an early intervention program for substance-exposed children with neurodevelopmental vulnerabilities. Within three substance-exposed sibling groups (N = 8; 0-6 years), we 1) described longitudinal neurodevelopmental trajectories, 2) explored the balance of cross-domain cumulative risk and protection on neurodevelopment, and 3) generated hypotheses on how cumulative risk, protection, and early intervention impact neurodevelopment. Neurodevelopment is potentially shaped by the balance of risk and protection. Postnatal risk (birth/postnatal, child, parent-child interaction) and relational protection (family, parent-child interaction) appear to have the most salient impact on neurodevelopment. Early intervention is thought to be important as soon as possible and before age 3 years.

School bullying before and during COVID-19: Results from a population-based randomized design.

We examined the impact of COVID-19 on bullying prevalence rates in a sample of 6578 Canadian students in Grades 4 to 12. To account for school changes associated with the pandemic, students were randomized at the school level into two conditions: (1) the pre-COVID-19 condition, assessing bullying prevalence rates retrospectively before the pandemic, and (2) the current condition, assessing rates during the pandemic. Results indicated that students reported far higher rates of bullying involvement before the pandemic than during the pandemic across all forms of bullying (general, physical, verbal, and social), except for cyber bullying, where differences in rates were less pronounced. Despite anti-Asian rhetoric during the pandemic, no difference was found between East Asian Canadian and White students on bullying victimization. Finally, our validity checks largely confirmed previous published patterns in both conditions: (1) girls were more likely to report being bullied than boys, (2) boys were more likely to report bullying others than girls, (3) elementary school students reported higher bullying involvement than secondary school students, and (4) gender diverse and LGTBQ + students reported being bullied at higher rates than students who identified as gender binary or heterosexual. These results highlight that the pandemic may have mitigated bullying rates, prompting the need to consider retaining some of the educational reforms used to reduce the spread of the virus that could foster caring interpersonal relationships at school such as reduced class sizes, increased supervision, and blended learning.

A Systematic Review of the Prospective Relationship Between Bullying Victimization and Pain.

OBJECTIVE: This systematic review synthesized evidence about the relationship between childhood bullying victimization and chronic pain, with a focus on the temporal nature of the relationship and moderating factors, such as the type and intensity of victimization. METHOD: We included prospective cohort studies that examined the relationship between childhood bullying victimization and pain measured at least three months later. We conducted electronic searches of Medline, EMBASE, PsycINFO, and CINAHL up to June 30, 2019. Standard methodological procedures consistent with Cochrane reviews of prognosis studies were used (PROSPERO record ID 133146). RESULTS: We included four longitudinal studies (6275 participants) in this review. The mean age of participants at baseline ranged from 10 to 14 years and the follow-up periods ranged from 6 months to 12 years. Two of the four studies were judged as having high risk of bias. Meta-analysis of results from four studies revealed increased risk of pain among victimized compared to non-victimized youth (adjusted OR [95% CI] = 1.45 [1.06-1.97], but the effect size was small and not clinically important. Only one study examined the inverse association (ie, from pain to victimization), and there was not enough evidence to conduct a meaningful analysis of the proposed moderators. CONCLUSIONS: Study findings were limited by few prospective studies. Meta-analytic findings suggested that victimization may incur some risk for later pain, although the evidence was judged to be very low quality. High-quality studies that measure and report the nuances of bullying victimization are needed to test the proposed moderator models.

Looking Beyond Assumptions to Understand Relationship Dynamics in Bullying.

To account for the complex relationships and processes that constitute the phenomenon of bullying, it is critical to understand how students and their parents and teachers conceptualize traditional and cyberbullying. Qualitative data were drawn from a mixed methods longitudinal study on cyberbullying. Semi-structured interviews were held with Canadian students in grades 4, 7, and 10 in a large urban school board, and their parents and teachers. To account for the complexity and interactions of different systems of relationships, the purpose of the current article is to examine how students and their matched parents and teachers understand traditional and cyberbullying. Central to participants' understanding of traditional and cyberbullying was whether they considered bullying to represent harmful relationship dynamics. Three main assumptions emerged as shaping participants' understanding of bullying and appeared to obscure the deep relationship processes in bullying: (a) assumptions of gender in bullying, (b) type of bullying-comparing traditional and cyberbullying, and (c) physical bullying as disconnected from relationship dynamics. It is essential that assessment, education, and prevention and intervention strategies in traditional and cyberbullying be informed by the inherent relationships in bullying and be implemented at multiple levels of relationships and broader social systems.

The Mediational Effect of Affect Dysregulation on the Association Between Attachment to Parents and Oppositional Defiant Disorder Symptoms in Adolescents.

Oppositional defiant disorder (ODD) is a childhood disorder, commonly occurring in early school aged children with some symptoms becoming normative in adolescence (e.g., irritability, disagreeing). Affect dysregulation is a risk factor in the development of ODD. Affect regulation is nurtured within parent-child relationships, thus disruptions to attachment may derail children's capacity to develop adaptive affect regulation, increasing the risk for ODD. Using a high-risk sample of adolescents, we investigated the association between attachment anxiety and attachment avoidance with ODD through affect dysregulation. Attachment anxiety, but not avoidance, was associated with affect dysregulation and ODD. Affect dysregulation was found to fully mediate the relationship between attachment anxiety and ODD concurrently and prospectively. Similar findings have been demonstrated among children; results show that attachment anxiety, and its effects on affect dysregulation, are associated with ODD symptoms well into adolescence.

A national implementation of a community-based intervention for mothers experiencing violence in relationships.

Interpersonal violence is a significant concern for families; thus interventions to support vulnerable mothers and children experiencing violence are essential. The purpose of this study was to present preliminary evaluation results from the national dissemination of an interpersonal violence intervention for mothers delivered in community-based programs across Canada. In 18 communities, 184 mothers participated in the intervention. Mothers reported on measures related to the self, relationships, parenting, and knowledge of community services, both before and after the intervention. Mothers comprised a high-risk, vulnerable population. Results indicated feasibility and acceptability, based on a high proportion of intervention completers and high levels of satisfaction. Women reported improvements in self-esteem, self-efficacy, relationship capacity, parenting stress, knowledge of community services, and understanding of relevant concepts compared to before the intervention (with small to medium effects). Additional analyses supported some of these findings as particularly robust. We discuss the importance of community-based projects in reaching diverse families, sustaining engagement with high levels of satisfaction, and supporting mothers in making changes relating to themselves, their relationships, and their parenting. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A dyadic perspective on aggressive behavior between friends.

Youth are sometimes victimized by their friends, but we know little about the nature of these relationships. Taking a dyadic approach, we studied relationships characterized by both friendship and aggression. Participants (952 middle schoolers; 50% female; 44% Latinx) nominated friends and aggressive perpetrators and victims. Using two analytic samples of friend dyads (N = 6971) and aggressive dyads (N = 4662), results indicated that aggression by a friend was somewhat common. Compared with friend dyads without aggression, aggressive friend dyads were stronger (i.e., reciprocal) and longer lasting, though victimized youth were less satisfied with the friendship. Aggressive dyads who were friends more often had reciprocal aggression than aggressive dyads who were not friends. Results provide insight into the dynamics of aggression in close peer relationships.

Trauma-informed and relational approaches to service provision: building community-based project capacity to respond to interpersonal violence through a national initiative.

BACKGROUND: Community services that engage and service marginalized families can act as an important entry point for mothers and children experiencing interpersonal violence. The purpose of this study was to use an initiative that included training, implementation, and evaluation of an interpersonal violence intervention to understand changes in the capacity of service providers in community-based organizations to use trauma-informed and relational approaches to support mothers and children experiencing violence in relationships. METHODS: Participants (N = 27) were service providers from 14 community-based organizations across Canada, who had been trained to implement an interpersonal violence intervention with mothers in their communities. Using a phenomenological approach, participants engaged in an open-ended interview in which they were encouraged to reflect on their experiences in the intervention initiative, with prompts relating to the ways in which their work and their organization may have changed as a result of their participation. RESULTS: Findings indicated that participants were able to identify changes in four key areas related to trauma-informed practice: awareness (e.g., attitudes toward interpersonal violence), competency (e.g., application of trauma-informed knowledge), collaboration (e.g., working with other organizations to provide services to children and families), and safety (e.g., organizational policies to ensure safe, welcoming spaces). Further, participants identified these areas of change at the level of themselves as facilitators of the interpersonal violence intervention, their organizations, and their communities. CONCLUSIONS: Results indicate that, through training, implementation, and evaluation of an interpersonal violence intervention, service providers in community-based projects were able to extend trauma-informed and relational principles not only to the intervention itself, but also to their own work, as well as that of their organizations and communities. With some additional support, leveraging the existing capacities within community-based projects may be an effective means to support mothers and children experiencing interpersonal violence and other challenges.

ADHD and Exposure to Maltreatment in Children and Youth: a Systematic Review of the Past 10 Years.

PURPOSE OF THE REVIEW: The purpose of the current paper was to review and summarize the literature on ADHD and maltreatment over the past 10 years. RECENT FINDINGS: The majority of research on ADHD and exposure to maltreatment focuses on the high rates of comorbidity, including international studies from Asia, South America, North America, and Europe. Longitudinal studies showed that early exposure to maltreatment is a risk factor for ADHD symptoms later in development; however, this finding was not consistent. There were some preliminary studies on the neurological and genetic mechanisms underlying the link between ADHD and exposure to maltreatment. Finally, ADHD and exposure to maltreatment were found to have an additive effect on clinically salient outcomes (e.g., aggression, suicide attempts). Results from the review have direct clinical and future implications, including the need to understand the effect of comorbid ADHD and exposure to maltreatment in treatment studies.

Cumulative risk and protection measures data.

These data include clinically and theoretically grounded, cross-domain cumulative risk and protection measures. These measures were established for use with three sibling groups at Mothercraft's Breaking the Cycle (BTC), a child maltreatment prevention and early intervention program for substance using mothers and their children. These measures were established using archival data obtained from clients' charts. The cumulative risk factor measure encompasses: 1) items from a cumulative risk measure utilized in prior BTC research, 2) clinical measures assessing maternal mental health, addiction, and parenting capacity, 3) a measure utilized in studies on adverse childhood experiences, and 4) the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (Axis IV: Psychosocial Stressors) [1-3]. The cumulative protection factor measure encompasses: 1) existing early intervention components of services at BTC, 2) clinical measures assessing maternal mental health, addiction, and parenting capacity, and 3) known protective factors outlined in the literature. Both measures were theoretically grounded using the Developmental Model of Transgenerational Transmission of Psychopathology [4], which enabled salient domains of risk and protection to be delineated for children exposed prenatally to substances and accessing child maltreatment prevention and early intervention services. For a description of the process of establishing these measures, the total and cross-domain cumulative risk and protection percentages for the sample, as well as a qualitative interpretation of the balance between domains of risk and protection, see [5]. These measures can contribute to improved future understanding around cumulative risk and cumulative protection in vulnerable populations, salient domains of risk and protection, and the unique interaction that occurs between risk and protective processes in the context of child maltreatment prevention and early intervention.

Establishing clinically and theoretically grounded cross-domain cumulative risk and protection scores in sibling groups exposed prenatally to substances.

BACKGROUND: Prenatal substance exposure is associated with neurodevelopmental deficits. Deficits are exacerbated by cumulative risks yet attenuated by cumulative protective factors. Cross-domain relative to intra-domain risk exposure presents more neurodevelopmental challenges. Cumulative risk and protection scores must be clinically and theoretically grounded, with cross-domain considerations. OBJECTIVES: 1) Create clinically and theoretically grounded, cross-domain cumulative risk and protection scores; 2) Describe the benefits of our methodological approach. PARTICIPANTS & SETTING: This study included three sibling groups (N = 8) at Mothercraft's Breaking the Cycle, a child maltreatment prevention and early intervention program for substance using mothers and their children. METHOD: We outlined the process of establishing clinically and theoretically grounded, cross-domain cumulative risk and protection scores. Total and cross-domain cumulative risk and protection percentages, and the balance between domains of risk and protection, were explored. RESULTS: Clinically and theoretically grounded, cross-domain cumulative risk and protection scores were established. Total percentages were reported. Cross-domain profiles of cumulative risk and protection, and the number of significant domains of risk relative to protection, were reported. The cross-domain profiles facilitated consideration of intra- and inter-domain risk and protection within and between sibling groups. CONCLUSIONS: Emerging patterns indicate the importance of establishing cumulative risk and protection scores that are: 1) clinically and theoretically grounded, 2) cross-domain, and 3) encompass cumulative protection and risk. In understanding profiles of risk and protection, we can inform evidence-based early interventions that address: 1) high-risk children, 2) the full range of risks, 3) vulnerable domains, and 4) protective factors.

Developing and testing a readiness tool for interpersonal violence prevention partnerships with community-based projects.

Community-based projects that serve vulnerable families have the opportunity to identify and respond to interpersonal violence (IPV). We developed a readiness assessment tool to support selection of projects to participate in an initiative that involved implementing a community-based IPV intervention for mothers. The overarching aim of the current study was to describe the development of this tool and examine the reliability of coding, validity, and utility of the tool. After developing and refining the tool, 41 community-based projects completed the tool. Responses were coded and scored; scores were used to select projects for the initiative. Preliminary validation for the tool included (a) expert opinion, (b) uptake/implementation of the intervention, and (c) feedback and responses from service providers in terms of the usefulness and importance of the tool. This tool can be used by both researchers and service providers to assess community project readiness and capacity to provide trauma-informed services for vulnerable families.

Peer victimization through a trauma lens: Identifying who is at risk for negative outcomes.

Peer victimization is a chronic stressor that occurs within the context of peer interactions and has been robustly associated with numerous negative psychological and social adjustment problems. Although increased frequency of peer victimization has been linked to psychosocial problems, few researchers have studied the role of duration and pervasiveness of victimization (i.e., number of places it occurs). The objective of this study was to examine how frequency, duration, and pervasiveness of peer victimization are associated with youth adjustment. Canadian adolescents (N = 879), ages 12-18 completed an online survey about experiences with peer victimization. Youth also answered questions about internalizing problems, distress, relationship quality with family, friends, and adults in their school and community, as well as academic functioning. Data were analyzed using multinomial logistic regression modeling. Both duration and pervasiveness of peer victimization were predictive of increased internalizing problems, distress, relationship problems, and academic difficulties. Duration and pervasiveness of peer victimization were identified as important factors to consider when predicting youth psychosocial adjustment. By asking questions about these situational factors, parents, teachers, and healthcare providers may more effectively identify youth who are at risk for experiencing mental health problems associated with peer victimization.

Using a Developmental-Relational Approach to Understand the Impact of Interpersonal Violence in Women Who Struggle with Substance Use.

Substance use among women is a major public health concern. This review article takes a developmental-relational approach to examine processes through which early relational trauma and violence in relationships may lead to substance use. We examine how early exposure to violence in relationships can impact neurological development, specifically through interference with physiological mechanisms (e.g., the hypothalamic-pituitary-adrenal axis), brain structure and functioning (e.g., the hippocampus and prefrontal cortex), and neuropsychological development (e.g., executive functioning and emotion regulation) across the lifespan. Further, we discuss the impact of exposure to violence on the development of relational capacity, including attachment, internal working models, and subsequent interpersonal relationships across the lifespan, and how these developmental pathways can lead to continued problematic substance use in women.

Addressing the Impact of Interpersonal Violence in Women Who Struggle with Substance Use Through Developmental-Relational Strategies in a Community Program.

From a developmental-relational framework, substance use in women can be understood as relating to early experiences of violence in relationships and across development. This article uses a developmental-relational approach to outline specific strategies that can be used by service providers and to guide interventions for women with substance use issues. By reviewing research and clinical work with women attending a community-based prevention and early intervention program, we describe how specific components of programming can target the developmental and intergenerational pathway between experiences of violence in relationships and substance use. We include the voices of women who attended the program to support the strategies discussed. Specifically, these strategies address the impact of interpersonal violence on substance use by promoting the process of repair and reintegration for women whose neurological development, sense of self, and capacity to form relationships have been significantly impacted by experiences of violence in relationships.