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Childhood mental health problems are a leading cause of disability and frequently go untreated. Barriers to children receiving the most effective care available include shortfalls in three areas: identification, referral to specialists, and delivery of evidence-based treatment (EBT). The current paper details an effort to develop a digital health intervention, the Mental Health Advisor (MHA), to increase the number of children with mental health problems who receive optimal care through identification, specialty referral, and fidelity to EBT. We present this pilot as a case example to help guide other efforts to improve mental health care through technology.
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Transtornos Mentais , Serviços de Saúde Mental , Humanos , Criança , Transtornos Mentais/terapia , Telemedicina , Projetos PilotoRESUMO
BACKGROUND: When creating resources, such as psychoeducational materials, for children and families, it is essential to consult all stakeholders. By asking service users what they would find helpful, we can ensure that psychoeducational materials developed are directly addressing a need. This report summarises the process of co-developing a psychoeducational video with young people for the adults in their lives. METHODS AND RESULTS: The idea for a psychoeducational video originated from discussions within a Youth Advisory Group in a South London Child and Adolescent Mental Health Service. The group shared that they wanted a way of letting the adults in their lives know what is and is not helpful to hear when they are experiencing mental health distress. A workshop was held with young people to gather ideas for the content and style of a psychoeducational video resource. Through co-design methods, themes were identified including prioritising the young person's lived experience, the importance of listening, respecting and validating, adults not making assumptions about a diagnosis, and actively involving young people in care planning. A script and accompanying video were produced over several co-design sessions and shared via multiple online mass communication channels. CONCLUSIONS: This project was co-produced at all stages by young people with lived experience of mental health difficulties to develop a digital resource that they considered necessary and meaningful. Centring the voices of young people when producing materials concerning their mental health results in valuable resources and can bring autonomy to those involved.
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Introduction: The benefits of physical activity for mental health and well-being and the associations between parental mental health and children's mental health have been well established. These important issues tend to be examined separately however, and there is limited research on the associations between parent and child physical activity and mental health when all considered together. While family focused practice is recommended to provide support for parents who have mental health problems and their families and includes various components (such as psychoeducation, support for mental health and parenting), promoting physical activity for parents and children is not usually a core component of these interventions. Methods: The Northern Ireland Youth Wellbeing Survey aimed to provide estimates of the prevalence of mental health problems among children and young people. The survey also included questions about parental physical activity, parental mental health, and children's physical activity (for those aged 11-19 years). The main aim of the analysis reported in this article was to explore possible bivariate associations between parent and child physical activity and mental health and also explore these associations when all considered together. Participants were included in the analysis where there were completed interviews for the young person and one of their parents, and both young person and parent provided responses in relation to questions on weekly physical activity (n = 882). Results: The findings highlight the positive associations between parental physical activity and parental mental health, and between children's physical activity and children's mental health. They also explore some of the more complex interactions between these four variables, which suggest that gender may also be an important consideration. There were significant associations between father's physical activity and son's mental health, and son's physical activity and father's mental health. Discussions: These findings suggest that including support for parental physical activity and children's physical activity should be a routine component of family focused mental health interventions. It is important to acknowledge that there may be additional barriers to engaging in physical activity for families where a parent is experiencing mental health problems, and these should also be explored and addressed.
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Transtornos Mentais , Esportes , Humanos , Criança , Adolescente , Saúde Mental/estatística & dados numéricosRESUMO
Objective: This study investigated changes in the emotional availability of the parent and the child in the dyadic relationship, parental reflective functioning, and parental perception of the relationship with their child following treatment with an integrated family approach in adult and child mental health care services. The aim of the study was to investigate if an integrated family approach in treatment contributes to good practice in mental health care. Background: Children of parents with a mental disorder are at increased risk for developing mental health problems themselves during lifetime. Infants are extremely vulnerable for environmental influences. Parents with mental disorders are at risk for mis-attuned behavior and non-optimal emotional availability. This increases the risk of adverse cascading effects on the parent-child relationship and child development. A secure parent-child relationship is an important protective factor against the intergenerational transmission of mental disorders. Although treatment of the parental mental disorder is important, it does not automatically change undesirable patterns in the parent-child relationship. Therefore, an integrated family approach to mental health treatment is recommended. Methods: This study involved a mixed methods design using questionnaires, an observation instrument and semi-structured interviews. The variables examined were the quality of the parent-child interaction, the parental perspective on their relationship with the child, their problems with child upbringing, and on their parental reflective functioning. The clinical sample consisted of 50 patients with a variety of mental disorders and their young children. Results: After finishing the integrated treatment the quality of the parent-child interaction had improved significantly. Likewise, we found a significant improvement in parental perception regarding the relationship with the child and the parental role. The majority of the parents interviewed showed that they were better able to mentalize about themselves, their child and their relationship with the child, but the data from the questionnaire showed mixed results regarding parents' reflective functioning. Conclusion: Treatment with an integrated family approach to mental health care in which the parental role of the patient, the young child, and the parent-child relationship are integrated in treatment, can be a valuable addition to the current practice of mental health care in which patients are commonly perceived as individuals.
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Maternal experience of child maltreatment (CM) has been associated with maternal and child mental health. However, evidence about the course of child mental health and maternal CM is scarce. Therefore, this study aims to compare trajectories of mental health in children according to maternal CM exposure and maternal mental health. We included 327 mothers and their singleton child from the Ulm SPATZ Health Study, a prospective birth cohort study. Child mental health was determined by the Strength and Difficulties Questionnaire (SDQ) at the age of 4, 5, 6, and 7 years and maternal CM by the Childhood Trauma Questionnaire (CTQ). Results display that maternal CM is associated with more behavioural and emotional difficulties in children, a trend that tends to increase with older child age. The sum of maternal mental health problems across this time course mediates this association. Male child sex is associated with more mental health problems in the child and the mother. These results provide an important first insight into the relevance of maternal CM on the trajectories of mental health in the offspring and highlight the importance of chronicity and severity of maternal mental health. Further prospective research in cohorts with longer follow-ups up into adolescence and adulthood is needed.
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Maternal childhood maltreatment (CM) represents an important factor in the transmission of trauma that may lead to impaired child mental health. Apart from childhood maltreatment insecure attachment has been identified as a risk factor for insensitive caregiving behavior, which may affect child's mental health. The aim of this study is to identify the working mechanisms in the relationship between maternal CM and child mental health, considering maternal attachment representation, mother-child-interaction und maternal helplessness and fear. N = 103 mother-child-dyads from a longitudinal cohort study were examined at four different measuring points. Data was assessed using self and external report questionnaires as well as the AMBIANCE scales during the Strange Situation Procedure and the Adult Attachment Projective Picture System (AAP). Maternal CM experience did not predict an insecure attachment representation (OR = 2.46 [0.98, 6.53], p = .060). Maternal insecure attachment was associated with higher AMBIANCE scores (F(8, 94) = 11.46, p < .001), which indicates more disrupted communication between mother and child. AMBIANCE scores in turn predicted higher self-perceived helplessness (F(9, 93) = 8.62, p < .001) and fear (F(9, 93) = 7.40, p < .001) in mothers. Helplessness and fear both were associated with higher SDQ-scores, indicating more mental health problems in children (F(10, 92) = 3.98, p < .001; F(10, 92) = 3.87, p < .001). The results of this study highlight how even insecure attachment in a low-risk sample has a long-term impact on parenting behavior and child mental health, therefore underlining the need of early intervention programs in affected and at-risk families.
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Saúde Mental , Relações Mãe-Filho , Apego ao Objeto , Humanos , Feminino , Relações Mãe-Filho/psicologia , Adulto , Fatores de Risco , Masculino , Estudos Longitudinais , Criança , Mães/psicologia , Pré-Escolar , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricosRESUMO
BACKGROUND: Research suggests that maternal ACEs have intergenerational consequences for offspring mental health. However, very few studies have investigated moderators of this association. OBJECTIVES: The objective of this longitudinal study was to examine whether child resilience factors moderated the association between maternal ACEs prior to age 18, and child-reported symptoms of anxiety, depression, hyperactivity, and inattention. PARTICIPANTS AND SETTING: The current study used data from 910 mother-child dyads. Participants were recruited in pregnancy from 2008 to 2010 as part of a longitudinal cohort study. METHODS: Mothers had previously completed an ACEs questionnaire and reported on their child's resilience factors at child age 8-years. Children completed questionnaires about their mental health problems (symptoms of anxiety, depression, hyperactivity, and attention problems) at ages 10 and 10.5 years. Four moderation models were performed in total. RESULTS: Results revealed that maternal ACEs predicted child-reported symptoms of anxiety (ß = 0.174, p = .02) and depression (ß = 0.37, p = .004). However, both these associations were moderated by higher levels of perceived child resilience factors (ß = -0.29, p = .02, ß = -0.33, p = .008, respectively). Specifically, there was no association between maternal ACEs and child mental health problems in the context of moderate and high levels of child resilience factors. CONCLUSIONS: Children who have the ability to solicit support from internal and external sources (e.g., being creative, setting realistic goals, making friends easily) may be buffered against the consequences of maternal ACEs on anxiety and depression. Thus, the effects of maternal ACEs on child mental health problems are not deterministic.
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Experiências Adversas da Infância , Mães , Resiliência Psicológica , Humanos , Feminino , Criança , Estudos Longitudinais , Experiências Adversas da Infância/estatística & dados numéricos , Experiências Adversas da Infância/psicologia , Masculino , Adulto , Mães/psicologia , Relações Mãe-Filho/psicologia , Ansiedade/psicologia , Inquéritos e Questionários , Depressão/psicologia , Transtornos Mentais/psicologia , Transtornos Mentais/epidemiologiaRESUMO
AIM: There is limited research on the impact of preschool attendance on socio-emotional problems. This study aimed to investigate the association between not attending preschool and emotional and behavioural problems among children aged 3-5 years in Sweden. METHODS: We analysed cross-sectional data from 9395 children, rated by both parents or by one parent. The dependent variable, emotional and behavioural problems, was measured using the Strengths and Difficulties Questionnaire (SDQ). Preschool attendance served as the independent variable. Single and multiple logistic regression analyses were conducted. RESULTS: Only 1.2% of children did not attend preschool. Single logistic regression models, using SDQ subscales with scores at or above the cut-off point as outcomes, showed that not attending preschool was associated with peer relationship problems, rated by mothers, and with peer relationship problems and overall difficulties, rated by fathers. These associations remained significant when controlling for covariates. Children with parents born outside Sweden or with lower educational levels had higher odds of experiencing peer relationship problems and overall difficulties. CONCLUSION: Children who do not attend preschool are at heightened risk of experiencing peer relationship problems. It is important to ensure that children who may benefit most from preschool education receive adequate support.
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BACKGROUND: While research has described the profile of children with poor mental health, little is known about whether this profile and their needs have changed over time. Our aim was to investigate whether levels of difficulties and functional impact faced by children with a psychiatric disorder have changed over time, and whether sociodemographic and family correlates have changed. METHODS: Samples were three national probability surveys undertaken in England in 1999, 2004 and 2017 including children aged 5-15 years. Psychiatric disorders were assessed using the Development and Well-Being Assessment (DAWBA), a standardised multi-informant diagnostic tool based on the tenth International Classification of Diseases (ICD-10). The impact and difficulties of having a disorder (emotional, behavioural or hyperkinetic) were compared over time using total difficulty and impact scores from the Strengths and Difficulties Questionnaire (SDQ). Analyses explored the impact of having any disorder, as well as for each disorder separately. Regression analyses compared associations between disorders and sociodemographic factors over time. RESULTS: Parent- and adolescent-reported total SDQ difficulty and impact scores increased between 1999 and 2017 for children and adolescents with disorders. No differences were noted when using teacher ratings. No differences in total SDQ difficulty score were found for children without a disorder. Comparison of sociodemographic correlates across the surveys over time revealed that ethnic minority status, living in rented accommodation and being in the lowest income quintile had a weaker association with disorder in 2017 compared to 1999. CONCLUSIONS: Our study reveals a concerning trend; children with a disorder in 2017 experienced more severe difficulties and greater impact on functioning at school, home and in their daily lives, compared to children with a disorder in earlier decades. Research is needed to identify and understand factors that may explain the changing nature and level of need among children with a disorder.
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Background: This systematic review addresses how adolescent-rated parent-child communication (PCC) quality is related to adolescent mental health. Methods: We performed a systematic literature search in Medline and APA PsycInfo, including peer-reviewed quantitative studies examining associations between adolescent-rated dyadic PCC quality and general as well as specific measures of adolescent mental health. Qualitative and case studies were excluded, as were studies reporting only parent-rated communication quality or instruments assessing other constructs than dyadic PCC. We screened 5314 articles, of which 37 were included in the review. We assessed study quality with the Mixed Methods Appraisal Tool. Results: We synthesized the findings in a table and narratively, reporting the main outcomes organized according to mental health constructs. The included studies were mainly cross-sectional. The results showed that adolescent-rated PCC quality is negatively associated with mental health constructs, demonstrating small to large effects across different mental health constructs and populations. The associations were found for general mental health and specific domains, including depression, anxiety, psychosis, suicidal ideation, post-traumatic stress symptoms, and addictive internet use/gaming. Conclusions: The findings demonstrate that PCC is a relevant variable to consider in assessing adolescent mental health and preventive efforts. Limitations include the exclusive focus on adolescent-reported PCC questionnaires since parent- and observer-rated instruments may lead to different results. Also, PCC is related to other constructs, such as dyadic relationships, that were not included in this review. We conclude that PCC is a relevant variable to consider in mental health research. Our findings suggest that PCC may be considered in mental health practice, both in terms of assessing its quality and potentially by tailoring interventions to enhance PCC. These may represent a mean to promote adolescent mental health.
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Comorbidity between post-traumatic stress disorder (PTSD) and substance use disorder may be explained by a prospective trauma risk conferred by both conditions. The current study modeled concurrent and prospective associations of trauma, PTSD symptoms, and substance use (SU) behavior among trauma exposed youth (ages 8-20). Clinical interviews assessed trauma exposure, PTSD symptom severity, and SU behavior at baseline and at six- and 12-month follow up study visits (N = 2,069). Structural equation models assessed the associations of trauma, PTSD symptoms, and SU behavior. Lifetime trauma was associated with more severe PTSD symptoms and SU behaviors, whereas trauma exposure during the study was only associated with PTSD symptoms. PTSD symptom severity was prospectively associated with trauma exposure. PTSD symptom severity and SU behavior at follow-up study visits were prospectively associated. These results highlight the dynamic interplay between trauma, PTSD symptoms, and SU behavior during youth, a developmental period during which complex psychiatric presentations can have longstanding consequences for health.
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Transtornos de Estresse Pós-Traumáticos , Transtornos Relacionados ao Uso de Substâncias , Humanos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Masculino , Feminino , Adolescente , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Criança , Adulto Jovem , Comorbidade , Estudos Prospectivos , Adulto , Índice de Gravidade de Doença , Seguimentos , RecidivaRESUMO
Background: In many countries, health care professionals are legally obliged to share information from electronic health records with patients. However, concerns have been raised regarding the sharing of notes with adolescents in mental health care, and health care professionals have called for recommendations to guide this practice. Objective: The aim was to reach a consensus among authors of scientific papers on recommendations for health care professionals' digital sharing of notes with adolescents in mental health care and to investigate whether staff at child and adolescent specialist mental health care clinics agreed with the recommendations. Methods: A Delphi study was conducted with authors of scientific papers to reach a consensus on recommendations. The process of making the recommendations involved three steps. First, scientific papers meeting the eligibility criteria were identified through a PubMed search where the references were screened. Second, the results from the included papers were coded and transformed into recommendations in an iterative process. Third, the authors of the included papers were asked to provide feedback and consider their agreement with each of the suggested recommendations in two rounds. After the Delphi process, a cross-sectional study was conducted among staff at specialist child and adolescent mental health care clinics to assess whether they agreed with the recommendations that reached a consensus. Results: Of the 84 invited authors, 27 responded. A consensus was reached on 17 recommendations on areas related to digital sharing of notes with adolescents in mental health care. The recommendations considered how to introduce digital access to notes, write notes, and support health care professionals, and when to withhold notes. Of the 41 staff members at child and adolescent specialist mental health care clinics, 60% or more agreed with the 17 recommendations. No consensus was reached regarding the age at which adolescents should receive digital access to their notes and the timing of digitally sharing notes with parents. Conclusions: A total of 17 recommendations related to key aspects of health care professionals' digital sharing of notes with adolescents in mental health care achieved consensus. Health care professionals can use these recommendations to guide their practice of sharing notes with adolescents in mental health care. However, the effects and experiences of following these recommendations should be tested in clinical practice.
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Técnica Delphi , Serviços de Saúde Mental , Humanos , Adolescente , Serviços de Saúde Mental/normas , Registros Eletrônicos de Saúde , Consenso , Estudos Transversais , Feminino , MasculinoRESUMO
To reduce child mental health disparities, it is imperative to improve the precision of targets and to expand our vision of social determinants of health as modifiable. Advancements in clinical research informatics and please state accurate measurement of child mental health service use and quality. Participatory action research promotes representation of underserved groups in informatics research and practice and may improve the effectiveness of interventions by informing research across all stages, including the identification of key variables, risk and protective factors, and data interpretation.
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Equidade em Saúde , Serviços de Saúde Mental , Humanos , Criança , Serviços de Saúde Mental/organização & administração , Informática Médica , Pesquisa Biomédica , Disparidades em Assistência à Saúde , Serviços de Saúde da CriançaRESUMO
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.
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Programas de Rastreamento , Pais , Humanos , Criança , Pais/psicologia , Transtornos Mentais/diagnóstico , Transtornos Mentais/prevenção & controle , Adolescente , Pré-Escolar , Saúde MentalRESUMO
BACKGROUND: To meet the scientific and political call for effective prevention of child and youth mental health problems and associated long-term consequences, we have co-created, tested, and optimized a transdiagnostic preventive parent-training intervention, Supportive parents - coping kids (SPARCK), together with and for the municipal preventive frontline services. The target group of SPARCK is parents of children between 4 and 12 years who display symptoms of anxiety, depression, and/or behavioral problems, that is, indicated prevention. The intervention consists of components from various empirically supported interventions representing different theorical models on parent-child interactions and child behavior and psychopathology (i.e., behavioral management interventions, attachment theory, emotion socialization theory, cognitive-behavioral therapy, and family accommodation intervention). The content and target strategies of SPARCK are tailored to the needs of the families and children, and the manual suggests how the target strategies may be personalized and combined throughout the maximum 12 sessions of the intervention. The aim of this project is to investigate the effectiveness of SPARCK on child symptoms, parenting practices, and parent and child stress hormone levels, in addition to later use of specialized services compared with usual care (UC; eg. active comparison group). METHODS: We describe a randomized controlled effectiveness trial in the frontline services of child welfare, health, school health and school psychological counselling services in 24 Norwegian municipalities. It is a two-armed parallel group randomized controlled effectiveness and superiority trial with 252 families randomly allocated to SPARCK or UC. Assessment of key variables will be conducted at pre-, post-, and six-month follow-up. DISCUSSION: The current study will contribute with knowledge on potential effects of a preventive transdiagnostic parent-training intervention when compared with UC. Our primary objective is to innovate frontline services with a usable, flexible, and effective intervention for prevention of childhood mental health problems to promote equity in access to care for families and children across a heterogeneous service landscape characterized by variations in available resources, personnel, and end user symptomatology. TRIAL REGISTRATION: ClinicalTrials.gov ID: NTCT05800522.
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Adaptação Psicológica , Relações Pais-Filho , Pais , Humanos , Criança , Pais/psicologia , Pais/educação , Pré-Escolar , Masculino , Feminino , Depressão/prevenção & controle , Poder Familiar/psicologia , Ansiedade/prevenção & controle , AdultoRESUMO
BACKGROUND: Adverse childhood experiences (ACEs) of mothers have been shown to be associated with children's mental health and behavior problems. It is important to identify effective intervention points to prevent negative consequences among children. This study aimed to investigate whether mothers' education is protective against children's depressive symptoms in families with mothers who experienced parental divorce in childhood. METHODS: Data from a cross-sectional study of 5th and 8th grade children and their caregivers in a prefecture in Japan were used. Final analytic sample consisted of 9666 child-caregiver pairs. Mediation analyses using inverse odds weighting were performed where the exposure was maternal experience of parental divorce in childhood, outcome was child depressive symptoms, and potential mediators were maternal education beyond high school, maternal mental health, and household income. RESULTS: Maternal experience of parental divorce was associated with an elevated risk of child depressive symptoms (risk ratio: 1.22, 95 % confidence interval (CI): 1.07-1.39). Mediation analyses indicated that the combination of maternal education, maternal depression and household income mediated about half of the total effect. In the model where maternal education was the sole mediator, maternal education mediated nearly half of the total effect (risk ratio: 1.10, 95 % CI: 1.01-1.20). LIMITATIONS: Results should be cautiously interpreted given observational and cross-sectional nature of the data. CONCLUSIONS: Maternal education beyond high school may be protective against negative mental health consequences among children due to mothers' experience of parental divorce. Further studies are needed regarding potential mechanisms and the roles of other potential mediators.
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Depressão , Divórcio , Escolaridade , Mães , Humanos , Divórcio/psicologia , Feminino , Mães/psicologia , Mães/estatística & dados numéricos , Estudos Transversais , Criança , Masculino , Depressão/psicologia , Depressão/epidemiologia , Adulto , Japão , Adolescente , Saúde Mental , Experiências Adversas da Infância/estatística & dados numéricosRESUMO
BACKGROUND: Naturalistic Developmental Behavioral Interventions (NDBIs) for young children with autism spectrum disorder commonly involve caregiver-mediated approaches. However, to date, there is limited research on how caregivers' skills change, and, in turn, impact child outcomes. METHODS: We evaluated the NDBI strategy use of 191 caregivers prior to participation in NDBIs (or control groups) across multiple randomized controlled trials, using the Measure of NDBI Strategy Implementation, Caregiver Change (MONSI-CC). Clustering analyses were used to examine caregiver variability in NDBI strategy use at intervention entry. Generalized Linear Mixed Models were used to examine changes in caregiver strategy use over the course of intervention and its impact on changes in children's social communication. RESULTS: Using clustering analysis, we found that caregivers' baseline skills fit four profiles: limited, emerging, variable, and consistent/high, with few demographic factors distinguishing these groups. Caregivers starting with limited or emerging skills improved in their strategy use with intervention. Caregivers starting with more skills (consistent/high or variable) maintained higher skills over intervention. Children of caregivers in these groups who received target NDBIs improved in their social communication skills. CONCLUSIONS: Results suggested that caregiver skills improve through participation in NDBIs and may directly contribute to their children's outcomes, although more research on mediating factors is needed. Individualized approaches for caregivers and their children starting with differing skill profiles at intervention entry may be warranted.
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BACKGROUND: The significance of socioeconomic status (SES) in child mental health is well-established in Western populations; however, there is little evidence on this topic in Chinese populations. The possibility that Chinese families with different SES elicit different parenting practices that cause positive or negative child mental health outcomes warrants further investigation. METHODS: This study examined the associations of SES, parenting practices, and child mental health among 1401 Chinese school children and their parents residing in Shanghai. SES was measured by a composed index of parental education levels, occupations, and household incomes. The Alabama parenting questionnaire (APQ; child version) and the strengths and difficulties questionnaire (SDQ; parent version) were used to assess parenting practices and child mental health. We also explored the underlying mechanisms between parental SES and the mental health of children by testing different parenting practices as mediators of the relationships. RESULTS: The results showed that a higher SES is positively associated with better mental health in children. Positive involvement and deficient monitoring can mediate the relationship between SES and child mental health outcomes. Negative discipline did not significantly mediate the above relationship. CONCLUSIONS: The results highlight the significance of positive involvement and sufficient monitoring in promoting children's mental health and provide evidence for designing effective programs to improve parenting skills.
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Saúde Mental , Poder Familiar , Pais , Classe Social , Humanos , Criança , Masculino , Feminino , China , Pais/psicologia , Adulto , Inquéritos e Questionários , Relações Pais-Filho , População do Leste AsiáticoRESUMO
The Child and Adolescent Mental Health Initiative (CAMHI) aims to enhance mental health care capacity for children and adolescents across Greece. Considering the need for evidence-based policy, the program developed an open-resource dataset for researching the field within the country. A comprehensive, mixed-method, community-based research was conducted in 2022/2023 assessing the current state, needs, barriers, and opportunities according to multiple viewpoints. We surveyed geographically distributed samples of 1,756 caregivers, 1,201 children/adolescents, 404 schoolteachers, and 475 health professionals using validated instruments to assess mental health symptoms, mental health needs, literacy and stigma, service use and access, professional practices, training background, and training needs and preferences. Fourteen focus groups were conducted with informants from diverse populations (including underrepresented minorities) to reach an in-depth understanding of those topics. A dataset with quantitative and qualitative findings is now available for researchers, policymakers, and society [ https://osf.io/crz6h/ and https://rpubs.com/camhi/sdashboard ]. This resource offers valuable data for assessing the needs and priorities for child and adolescent mental health care in Greece. It is now freely available to consult, and is expected to inform upcoming research and evidence-based professional training. This initiative may inspire similar ones in other countries, informing methodological strategies for researching mental health needs.