The efficacy of group delivered mentalization-based parenting interventions: A systematic review of the literature.

Mentalization refers to the capacity to understand and interpret one's own and others mental states. There is good evidence for individualised treatments aimed at increasing this capacity with children and adolescents. However, there has been no focused synthesis of the literature concerning specifically group delivered mentalization-based parenting interventions. The current study aimed to systematically review the literature in relation to group delivered mentalization-based parenting interventions. Three databases were searched to identify N=515 studies that were screened and reported according to PRISMA guidelines. Inclusion criteria were met by N=10 studies. Interventions varied in terms of content, but often included psychoeducation, experiential group exercises and homework tasks. The length and setting of interventions did not appear to influence outcomes. Significant improvements in parental reflective functioning were found in eight of the ten studies. There was mixed evidence for the efficacy in terms of other parental and child outcomes. This may be due to the lack of high quality studies and the absence of longer-term follow-ups. There is a need for future research to conduct high quality studies with greater diversity in participating parents and long-term follow-up.

A systematic review and meta-synthesis of qualitative studies that investigate the emotional experiences of staff working in homeless settings.

Homelessness is a pervasive issue in society, and government policies have highlighted the need to focus on the experience of front-line staff in homelessness settings. The aim of this meta-synthesis was to draw together the available research to further understanding of the experiences of staff working with homeless people. A systematic search was conducted across four electronic databases (ASSIA, PsycInfo, Sociological Abstracts and Web of Science) from the date of their inception. Qualitative research exploring the emotional experiences of staff working in homeless settings was identified. Identified studies were subject to quality assessment, and the data were synthesised using meta-ethnography. Ten studies were included in the synthesis following screening of 228 titles, 92 abstracts and 33 full texts. The concepts that were obtained from the analysis were building quality relationships, negotiating boundaries, carrying the emotional burden (self and others), accessing care and support (self-care and from others), individual advancement, advocating and contextual helplessness. An overarching theoretical construction of the internal experiences of support staff in managing the demands of the role along with their own needs was developed. This theory may provide the basis for testable hypotheses in future research and inform the development of support and training opportunities for staff working within homelessness settings.

Childhood Antisocial Behavior: A Neurodevelopmental Problem.

Early-onset disruptive, aggressive, and antisocial behavior is persistent, can become increasingly serious as children grow older, and is difficult to change. In 2007, our group proposed a theoretical model highlighting the interplay between neurobiological deficits and cognitive and emotional functioning as mediators of the link between genetic influences and early social adversity, on the one hand, and antisocial behavioral problems in childhood, on the other. In this article, we review the post-2007 evidence relevant to this model. We discuss research on genetics/epigenetics, stress/arousal regulation, and emotion and executive functioning in support of the argument that antisocial children, especially those who persist in engaging in antisocial behavior as they grow older, have a range of neuropsychological characteristics that are important in explaining individual differences in the severity and persistence of antisocial behavior. Current clinical practice tends not to acknowledge these individual neuropsychological risk factors or to target them for intervention. We argue that aggressive and disruptive behavior in childhood should be regarded as a neurodevelopmental problem and that intervening at the level of mediating neuropsychological processes represents a promising way forward in tackling these serious behavioral problems.

'Grounding a PIE in the sky': Laying empirical foundations for a psychologically informed environment (PIE) to enhance well-being and practice in a homeless organisation.

While psychologically informed environments (PIEs) are gaining in prominence in efforts to improve well-being and practice in the homeless sector, their empirical foundations remain tenuous. We present a unique scoping needs analysis of staff and client well-being, staff attitudes and the social-therapeutic climate in a UK-based homeless prevention organisation (prior to PIE implementation). Our aims were: (a) to apply a robust framework to pinpoint need and target forthcoming PIE initiatives and (b) to establish a validated needs baseline that informs and measures efficacy of PIE for its future development. Four established personal and practice well-being measures were administered to 134 (predominantly 'frontline') staff and 50 clients. Staff completed the: Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), Professional Quality of Life Scale (measuring compassion satisfaction [CS], burnout [BO] and secondary traumatic stress [STS]), Attitudes related to Trauma-informed Care Scale (ARTIC-10; measuring practice attitudes towards trauma-informed values) and the Essen Climate Evaluation Schema (EssenCES; measuring perceptions of client cohesion, safety and practitioner relationships in housing projects). Clients completed the WEMWBS and EssenCES. Vulnerability to STS was evident in nearly two-thirds of frontline staff and it was a statistically significant predictor of BO. It was not, however, associated with lesser levels of CS. We discuss this complex dynamic in relation to highlighted strategic recommendations for the PIE framework, and the identified potential challenges in implementing trauma-informed and reflective practice in the organisation. We conclude with a critique of the value and the lessons learnt from our efforts to integrate stronger empirical substance into the PIE approach.

Negative parental emotional environment increases the association between childhood behavioral problems and impaired recognition of negative facial expressions.

Impaired facial emotion recognition is a transdiagnostic risk factor for a range of psychiatric disorders. Childhood behavioral difficulties and parental emotional environment have been independently associated with impaired emotion recognition; however, no study has examined the contribution of these factors in conjunction. We measured recognition of negative (sad, fear, anger), neutral, and happy facial expressions in 135 children aged 5-7 years referred by their teachers for behavioral problems. Parental emotional environment was assessed for parental expressed emotion (EE) - characterized by negative comments, reduced positive comments, low warmth, and negativity towards their child - using the 5-minute speech sample. Child behavioral problems were measured using the teacher-informant Strengths and Difficulties Questionnaire (SDQ). Child behavioral problems and parental EE were independently associated with impaired recognition of negative facial expressions specifically. An interactive effect revealed that the combination of both factors was associated with the greatest risk for impaired recognition of negative faces, and in particular sad facial expressions. No relationships emerged for the identification of happy facial expressions. This study furthers our understanding of multidimensional processes associated with the development of facial emotion recognition and supports the importance of early interventions that target this domain.

A Systematic Review of Longitudinal Studies Investigating the Association Between Early Life Maternal Depression and Offspring ADHD.

OBJECTIVE: The systematic review sought to understand the relationship between maternal depression and later ADHD in children. METHOD: Three databases were used to identify the studies (Medline, Web of Science and PsychInfo) resulting in 1,223 studies being screened and 14 articles being included in the review. RESULTS: The majority of studies (N = 11) reported a significant relationship between maternal depression (across both prenatal and postnatal periods) and ADHD symptoms in children. This relationship remained significant when temperament, or past ADHD symptoms were controlled for. Several methodological issues were identified including; overreliance on maternal report and parental ADHD not being accounted for in most studies. CONCLUSION: The review adds to the literature regarding the temporal relationship between maternal depression and the development of ADHD in children, and thus supports the case for improving access to mental health services for mothers as a preventative strategy in the development of child psychopathology.

Facial emotion recognition in children with externalising behaviours: A systematic review.

Difficulties in facial emotion recognition (FER) are associated with a range of mental health and antisocial presentations in adolescents and adults. Externalising behaviours in children are often one of the earliest signs of risk for the development of such difficulties. This article systematically reviews the evidence (from both group and correlational studies) for whether there is a relationship between FER and externalising behaviours in pre-adolescent children (aged 12 and under), both across and within externalising behaviour domains (hyperactivity, conduct problems, callous-unemotional traits, and aggression). Four electronic databases were searched producing 1,296 articles. Articles were included if they used validated measures of FER and externalising behaviours. Sixteen articles met criteria for inclusion in the review. Overall, the results suggested FER problems are present in ADHD, CP and callous-unemotional presentations, and in samples of children with higher levels of externalising problems rather than in community samples. However, there was no consistent evidence for specific emotions being implicated in the studies reviewed. Clinically, the findings suggest that FER difficulties are commonly associated with externalising behaviours, and hence this review offers some support that FER deficits could be a relevant target of intervention for externalising behaviours. However, more longitudinal studies are required, that control for other variables that might underlie FER difficulties (e.g. IQ or basic Theory of Mind abilities), to inform our knowledge of whether FER difficulties are a causal factor in externalising behaviours.

Investigation of cool and hot executive function in ODD/CD independently of ADHD.

BACKGROUND: Children with oppositional defiant disorder/conduct disorder (ODD/CD) have shown deficits in 'cool' abstract-cognitive, and 'hot' reward-related executive function (EF) tasks. However, it is currently unclear to what extent ODD/CD is associated with neuropsychological deficits, independently of attention deficit hyperactivity disorder (ADHD). METHODS: Fifty-nine adolescents with a history of early-onset oppositional problems, 28 with pure ODD/CD symptoms and 31 with ADHD with or without ODD/CD, and 34 healthy controls were administered a task battery measuring motor response inhibition, sustained attention, cognitive flexibility and reward-related decision-making. Findings were analysed using dimensional and group analyses. RESULTS: In group analyses both groups with and without ADHD were impaired in EF measures. Dimensional analyses, however, showed that ODD/CD but not ADHD was related to hot EF based on increased risky decision-making in the Iowa Gambling Task. ODD/CD was also independently related to aspects of cool EF independently of ADHD, namely slower speeds of inhibitory responding and increased intra-subject variability. CONCLUSIONS: These findings show EF deficits associated with ODD/CD independently of ADHD, and implicate reward-related abnormalities in theories of antisocial behaviour development.