The role of sleep in prospective associations between parent reported youth screen media activity and behavioral health.

BACKGROUND: Screen media activity (SMA) can negatively affect youth behavioral health. Sleep may mediate this association but has not been previously explored. We examined whether sleep mediated the association between SMA and youth behavioral health among a community sample. METHOD: Parents completed questions about their child (N = 564) ages 3-17 at Wave 1, Wave 2 (4-8 months later), and Wave 3 (12 months later). Path analyses were conducted to examine links between Wave 1 SMA and Wave 3 behavioral health problems (i.e., internalizing, externalizing, attention, peer problems) through Wave 2 sleep disturbance and duration. RESULTS: SMA was significantly associated with greater sleep disturbance, ß = .11, 95% CI [.01, .21] and shorter sleep duration, ß = -.16 [-.25, -.06], and greater sleep disturbance was associated with worse youth behavioral health across internalizing, ß = .14 [.04, .24], externalizing, B = .23 [.12, .33], attention, ß = .24 [.15, .34], and peer problems, ß = .25 [.15, .35]. Longer sleep duration was associated with more externalizing, ß = .13 [.04, .21], and attention problems, ß = .12 [.02, .22], and fewer peer problems, ß = -.09 [-.17, -.01], but not with internalizing problems. Lastly, there was a direct effect of SMA on peer problems, ß = -.15 [-.23, -.06] such that higher SMA that does not impact sleep may have a positive impact on reducing peer problems. CONCLUSIONS: Sleep (i.e., disturbances and shorter duration) may partially account for the small associations observed between SMA and worse behavioral health in youth. To continue expanding our understanding, future research should utilize more diverse representative samples, use objective measures of SMA and sleep, and examine other relevant aspects of SMA, including content, device type, and timing of use.

Parent-Child Role Confusion: Exploring the Role of Family Processes in the Context of Parental Depression.

OBJECTIVE: Parent-child role confusion has been shown to influence developmental outcomes for children whose parents have a history of depression; however, more research is needed to understand the pathways by which parental depression increases risk of role confusion. The current study aimed to extend previous literature by evaluating how different family processes (e.g., interparental conflict, guilt induction, family cohesion, and positive parenting practices) contribute to the development of emotional role confusion in families with a history of parental depression. METHOD: The sample was comprised of 90 parent-child dyads (parent Mage = 42, 90% female, 83.3% White; child Mage = 11.51, 51.1% female, 75.6% White) participating in the control group of a randomized controlled trial. All parents had a history of depression. A longitudinal path analysis was conducted to evaluate prospective associations in the multiple mediator model. RESULTS: Findings from the current study suggest that parental depressive symptoms are not directly related to the development of parent-child emotional role confusion, but are instead indirectly related through increased interparental conflict observed by youth. Although not identified as significant mediators, guilt induction and positive parenting practices emerged as predictors of emotional role confusion. Lastly, family cohesion did not appear to influence the development of role confusion. CONCLUSION: Findings suggest that parenting behaviors and coparenting relationship quality play important roles in the development of parent-child emotional role confusion, with interparental conflict emerging as the strongest predictor in families with a history of parental depression.

Keeping your coparent in mind: A longitudinal investigation of mindfulness in the family system.

Recent studies have increasingly focused on mindfulness as it relates to interpersonal processes. In particular, cross-sectional research has shown that parents' dispositional mindfulness is associated with increased mindful parenting and coparenting, as well as improved coparenting relationship quality. The current study replicates and extends such work, representing the first longitudinal investigation of mindful coparenting. A sample of 449 parents (60% mothers) of children between the ages of 3 and 17 years were recruited online through Amazon's Mechanical Turk (MTurk) as part of a larger study on the assessment of parenting. Parents reported on their dispositional mindfulness, mindful coparenting, and coparenting relationship quality at three time points across an 8-month period. Results from a cross-lagged panel model using maximum likelihood estimation suggested that higher levels of parental mindfulness at baseline were related with higher levels of mindful coparenting at 4 months, which, in turn, were related to higher quality coparenting relationship at 8 months. Support for this model was found for both mothers and fathers and across all examined child age groups (i.e., early childhood, middle childhood, and adolescence), highlighting the robust nature of these effects. Overall, findings suggest that increasing mindfulness at an individual level can promote meaningful change within a family system, specifically through improvements in coparenting and parent-child interactions.

Los estudios recientes se han centrado cada vez más en la conciencia plena en relación con los procesos interpersonales. En particular, las investigaciones transversales han demostrado que la conciencia plena disposicional de los padres está asociada con una crianza y una cocrianza más conscientes, así como con una mejor calidad de la relación de cocrianza. El presente estudio reproduce y amplía dicho trabajo, y representa la primera investigación longitudinal de cocrianza consciente. Se reunió virtualmente una muestra de 449 padres (el 60 % madres) de niños de entre 3 y 17 años mediante Amazon's Mechanical Turk (MTurk) como parte de un estudio más extenso sobre la evaluación de la crianza. Los padres informaron sobre su conciencia plena disposicional, la cocrianza consciente y la calidad de la relación de cocrianza en tres intervalos de tiempo durante un periodo de ocho meses. Los resultados de un modelo de panel de retardo cruzado utilizando la estimación por máxima verosimilitud indicaron que los niveles más altos de conciencia plena de los padres en el momento basal estuvieron relacionados con niveles más altos de cocrianza consciente a los cuatro meses, los cuales, a su vez, estuvieron relacionados con una relación de cocrianza de mayor calidad a los ocho meses. Se encontró respaldo para este modelo tanto en el caso de las madres como en el de los padres y entre todos los grupos etarios de los niños analizados (p. ej.: primera infancia, segunda infancia, adolescencia). Asimismo, se destacó la índole sólida de estos efectos. En general, los resultados indican que aumentar la conciencia plena a nivel individual puede promover un cambio significativo dentro de un sistema familiar, específicamente mediante mejoras en la cocrianza y en las interacciones entre padres e hijos.

COVID-19 and the Acceleration of Behavioral Parent Training Telehealth: Current Status and Future Directions.

The SARS-COV-2 (COVID-19) pandemic and associated social distancing guidelines have accelerated the telehealth transition in mental health. For those providing Behavioral Parent Training (BPT), this transition has called for moving sessions that are traditionally clinic-based, active, and directive to engaging, supporting, and treating families of children with behavior disorders remotely in their homes. Whereas many difficulties accompany this transition, the lessons learned during the current public health crisis have the potential to transform BPT service delivery on a large scale in ways that address many of its long-standing limitations. We describe both challenges and opportunities and consider the possibilities inherent in a large scale BPT service delivery model capable of increasing the reach and impact of evidence-based treatment for all families.

Development of the Nighttime Parenting Scale: Differentiating nighttime versus general parenting practices and their impact on youth sleep health.

OBJECTIVES: The current study provides a novel method of assessing the impact of nighttime parenting practices on youth sleep health during the sensitive transition from childhood to adolescence (ie., peri-puberty). Specifically, we aimed to advance the measurement of nighttime parenting by developing a conceptually driven questionnaire for use in research and clinical settings. METHOD: A total of 625 parents (67.9% mothers) of peripubertal youth (age M=11.6, SD=1.31) were recruited online and completed self-report questionnaires. The sample was primarily White (67.4%), followed by 16.5% Black, 13.1% Latinx, and 9.6% Asian. Factor structure was examined through four empirically-driven stages (ie, exploratory factor analyses, confirmatory factor analyses, examining internal and test-retest reliability, and indices of validity). Furthermore, the current study sought to validate nighttime parenting as a unique construct by exploring associations with peripubertal youth sleep health. RESULTS: A factor structure consisting of six dimensions of nighttime parenting was established (ie, nighttime supportiveness, hostility, physical control, limit-setting, media monitoring, and co-sleeping behaviors). Furthermore, the current measure demonstrated strong psychometric properties. Finally, the established dimensions were cross-sectionally associated with youth sleep health indices. CONCLUSIONS: This study extends previous research by examining the influence of distinct domains of parenting practices that specifically occur at nighttime and how these differentially relate to youth sleep health. Results suggest that intervention and/or prevention programs targeting sleep should place emphasis on fostering positive parenting at nighttime as a strategy for creating an evening environment that is conducive to optimizing youth sleep health.

Assessing parenting in racially and ethnically diverse families: A lack of measurement equivalence.

The present study explored measurement invariance of the Multidimensional Assessment of Parenting Scale (MAPS; Parent & Forehand, 2017) across White, Hispanic, Black, and Asian American parents. Participants included 2,734 parents, 58% of whom were mothers. On average, parents were 36.32 years old (SD = 9.54); the parent sample was 66.9% White non-Hispanic, 10.1% Black, 5.3% Asian, and 17.7% Hispanic regardless of race. Child ages ranged from 3 to 17 years (M = 9.84, SD = 3.71), and 58% were identified as male. Parents completed a demographics questionnaire about themselves and their target child, and the 34-item MAPS. We explored measurement equivalence of the MAPS Broadband Positive and Negative parenting scales using item response theory to identify differential item functioning (DIF). Univariate analyses for Positive and Negative Parenting showed reliability was excellent. Twelve items assessing negative aspects of parenting exhibited bias by race/ethnicity. Specifically, when comparing racial and ethnic groups, three items had nonuniform DIF comparing Black and Asian participants, two items had nonuniform DIF comparing Black and Hispanic participants, and one item showed nonuniform DIF comparing Asian and Hispanic participants. When looking at Positive Parenting, no items showed evidence of DIF. Results from the present study suggest broadband Positive Parenting can be compared across ethnoracial groups, while findings raise concern about assessing Negative Parenting items when examining invariance across race and ethnicity. Findings from the present study imply that racial and ethnic comparisons are potentially invalid. These findings offer guidance for improving parenting assessment for racially/ethnically diverse populations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

An 18-week model of Parent-Child Interaction Therapy: clinical approaches, treatment formats, and predictors of success for predominantly minoritized families.

Introduction: Disruptive behavior disorders are among the most prevalent pediatric mental health referrals for young children. However, families from historically minoritized social identities have experienced disparities in treatment access, retention, and outcomes. Evidence-based interventions such as Parent-Child Interaction Therapy (PCIT) have been found to be effective in reducing children's disruptive behaviors in minoritized families. However, variable treatment length as a result of skill-based graduation criteria (e.g., observed caregiver verbalizations) may slow and/or hinder treatment progress, particularly for families where expected treatment verbalizations are less linguistically relative (e.g., no exact English to Spanish translations) and/or culturally familiar. Time-limited PCIT has been proposed as a strategy for promoting equity in treatment completion and outcomes amongst minoritized families, because treatment progression and/ or completion is not contingent upon caregiver linguistic skill demonstration. Methods: The current study evaluated the overall effectiveness of an 18-week model of PCIT and examined predictors of retention and treatment outcomes. Participants (N = 488 dyads) included predominantly racially, ethnically, linguistically, and socioeconomically diverse children aged two to eight years, and their caregivers. Results: Overall findings indicate that the 18-week PCIT model is an effective intervention for reducing children's externalizing and internalizing behaviors and improving caregiver parenting skills for most treatment completers. Despite advances in treatment completion, some caregiver social identities and PCIT treatment characteristics were predictive of lower completion rates and/or less optimal treatment outcomes. Discussion: Overall, this study provides strong support for widely disseminating use of the 18-week model of PCIT for most families served. Clinical implications and considerations for continued treatment inequity are discussed.

Profiles of Emotion Socialization Across Development and Longitudinal Associations with Youth Psychopathology.

Although there is relative consensus in the literature regarding associations between certain emotion socialization (ES) strategies and youth behavioral health, there is very limited research from a person-centered perspective. To address this gap, the current study examined patterns of ES strategies in families and explored predictors and youth outcomes associated with those patterns. An economically-diverse sample of 229 predominately White mothers and fathers of youth aged 3-12 years was recruited online for a longitudinal study. Latent profile analysis was used to determine the optimal number of family clusters with similar ES profiles. Model fit supported a four-class model, which consisted of an Emotion Coaching profile, characterized by the lowest levels of putatively labeled unsupportive ES practices and the highest levels of putatively labeled supportive ES practices, a Moderate profile characterized by moderate levels of both unsupportive and supportive ES practices, a Limited Engagement profile characterized by low levels of both unsupportive and supportive ES practices, and an Emotion Dismissing profile characterized by the highest levels of unsupportive ES practices and the lowest levels of supportive ES practices. Cross-sectional and longitudinal differences were observed across the ES profiles with regard to demographic and parent emotional competence predictors and youth outcomes. The current study extends the literature on ES by providing evidence on how distinct ES profiles differentially predict youth behavioral health outcomes. Findings also underscore the importance of examining parent emotional competence as a catalyst for adaptive change in the family system.

Longitudinal Associations Between Parenting Practices and Youth Sleep Problems.

OBJECTIVE: Sleep problems among youth are highly prevalent and associated with adjustment difficulties. When considering influences on youth's sleep, bidirectional links between youth's sleep health and family functioning have been suggested. Parenting practices are among the many familial factors that could be transactionally related to poor sleep in youth; however, research is lacking on potential longitudinal associations between parenting practices and sleep problems in youth. In addition, sensitive periods for this link are mostly unknown. The current study examined longitudinal relations between constellations of parenting practices and youth sleep health to identify profiles of parenting practices that are predictive of sleep problems in youth across different developmental stages. METHOD: Participants were 292 parents (M = 36.51, SD = 7.3) of children between the ages of 3 and 14 years (M = 8.4, SD = 3.6). A person-centered approach was used to create profiles across traditionally labeled positive and negative parenting practices, as well as supportive and unsupportive parental emotion socialization strategies. Parenting profiles were then examined as longitudinal predictors of youth sleep problems. RESULTS: Findings revealed 3 distinct parenting profiles, which were differentially associated with sleep problems in youth, with the first profile predicting the lowest levels of sleep problems and the third profile predicting the highest levels of sleep problems, particularly among peripubertal youth. CONCLUSION: This study extends previous findings by elucidating distinct constellations of parenting practices that are differentially predictive of youth sleep problems and highlighting parenting among the various family processes that can longitudinally contribute to youth's sleep health.

Parent-Child Interaction Therapy for Children with Developmental Delay: The Role of Sleep Problems.

OBJECTIVE: Sleep problems are common and associated with externalizing behavior problems in young children, particularly among young children with developmental delay (DD). The aims of the current study, which was a secondary data analysis of 2 previously conducted randomized controlled trials, were to assess whether parent-child interaction therapy (PCIT) led to decreases in child sleep problems and whether initial sleep problems moderated the effect of PCIT on child behavior. METHODS: The study participants were 44 children (M = 49.19 months, SD = 13.1) with DD or borderline DD and with co-occurring clinically significant levels of externalizing behavior problems and their mothers (M = 35.9 years, SD = 7.3). These participants were randomly assigned to either an immediate treatment group or a waitlist control group. RESULTS: Findings revealed a significant direct effect of PCIT on decreases in sleep problems. Additionally, moderation analyses revealed that lower levels of child sleep problems at pretreatment were associated with greater improvements in observed child compliance compared with higher levels of child sleep problems at pretreatment. CONCLUSION: This study extends previous findings by providing support for the preliminary efficacy of PCIT in reducing sleep problems in children with DD and borderline DD and highlighting the role of sleep problems as a factor associated with differential treatment effects in behavioral parenting intervention research.

Épulis congénito: reporte de un caso clínico / Congenital epulis: clinical case study / Epúlide congênita: relato de caso clínico

El épulis congénito es una patología neonatal muy rara. Se trata de un tumor benigno pediculado de la mucosa de los maxilares, más frecuentemente localizado en maxilar superior en relación 2-3/1. Se describe el caso de un recién nacido de sexo femenino, de término, adecuado, vigoroso. Se constata al nacimiento la presencia de un épulis congénito que causa alteraciones de la succión. Se realiza intervención quirúrgica temprana, con resolución de la patología sin complicaciones.

Congenital epulis is a very rare neonatal pathology. It is a benign pedunculated tumor of the jaw mucosa, most frequently located in the upper jaw in a 2-3 / 1 ratio. The case of a newborn, female, term, adequate, vigorous is described. Noting at birth a congenital Epulis that causes suction alterations. Early surgical intervention is perfomed with resolution of the pathology without complications.

A epúlide congênita é uma patologia neonatal muito rara. É um tumor pedunculado benigno da mucosa dos maxilares, mais frequentemente localizado no maxilar superior na proporção de 2-3/1. Descreve-se o caso de um recém-nascido, do sexo feminino, a termo, adequado, vigoroso. Verificando ao nascimento uma Epúlide congênita que causa alterações na sucção. A intervenção cirúrgica precoce é realizada com resolução da patologia sem complicações.

Infecciones intrahospitalarias por estafilococo coagulasa negativo en una unidad de neonatología / Coagulase negative streptococci nosocomial infections at a neonatal intensive care unit / Infecções intra-hospitalares por estafilococo coagulasa negativa numa unidade de neonatologia

Introducción: la sepsis tardía por estafilococo coagulasa negativo (SCoN) es una causa común de morbimortalidad en la unidad neonatal. Los SCoN son los microorganismos más frecuentemente involucrados con aproximadamente el 50% de los casos. El objetivo de este estudio es analizar la incidencia y las características de los neonatos portadores de sepsis tardía por SCoN. Materiales y métodos: se realizó un estudio descriptivo, longitudinal, retrospectivo. Se utilizaron las bases de datos del laboratorio de microbiología del hospital y las historias clínicas electrónicas para obtener la información. El período de estudio analizado fueron los años 2018 y 2019 en la unidad de cuidados intensivos e intermedios de recién nacidos del Centro Hospitalario Pereira Rossell. Resultados: obtuvimos una incidencia de 2,5% de los ingresos a cuidados intensivos e intermedios (25 pacientes). La edad gestacional al nacer fue de 28 semanas (25,0-35,0) y la mediana del peso fue de 1.070 g (730,0-2.365,0). La media de edad gestacional posmenstrual al momento del diagnóstico fue de 32,92±7,921 semanas. Por sospecha de sepsis precoz, 17 pacientes habían recibido un curso de antibióticos previo. El signo clínico más frecuentemente observado fue el deterioro del estado general, en 11 pacientes, seguido de distensión abdominal en 6 y fiebre en 5. Dentro de los SCoN, el más frecuentemente aislado fue el Staphylococcus epidermidis (13 pacientes); 22 pacientes recibieron tratamiento, 18 de ellos con vancomicina-meropenem y 4 con monoterapia con vancomicina. Conclusión: estos patógenos representan una causa importante de morbimortalidad en la unidad neonatal, particularmente en pacientes que presentan mayor gravedad y mayor necesidad de soporte vital. Se necesitan pautas claras de interpretación del rol de estos microorganismos y de abordaje de pacientes con riesgo de sepsis tardía, incluyendo el tratamiento antibiótico empírico.

Introduction: Coagulase Negative Staphylococci (CoNS) late onset sepsis is a common cause of morbidity and mortality in the neonatal intensive care unit (NICU). CoNS are the most frequently isolated microorganisms and total 50% of cases. The objective of this study is to analyze the incidence and characteristics of newborns carriers of late onset CoNS. Materials and methods: we performed a descriptive, retrospective, longitudinal study. Data was obtained from the hospital's microbiology laboratory database and electronic medical records. Patients included were those admitted to NICU during the period between 2018 and 2019. Results: we obtained an incidence of 2.5% of patients admitted to the NICU (25 patients). Median gestational age at birth was 28 weeks 25.0-35.0 and median birth weight was 1.070 g 730.0-2365.0. Mean gestational age at the time of diagnosis was 32.92±7.921 weeks. 17 patients had received an antibiotics course at birth because of early onset sepsis suspicion. The most frequently observed clinical symptom was deterioration of general condition, 11 patients, followed by abdominal distention in 6 and fever in 5. Among CoNS, the most frequently isolated pathogen was Staphylococcus epidermidis (13 patients). 22 patients received treatment, 18 a combination of vancomycin and meropenem and 4 received vancomycin monotherapy. Conclusion: these pathogens are a common cause of morbidity and mortality in the newborn intensive care unit, particularly in patients with more serious conditions and in those who require more advanced life support measures. Clearer interpretation of their role is needed as well as to determine a proper approach to patients at risk of late onset sepsis, including empiric antibiotic treatment.

Sepse tardia para Staphylococcus coagulase negativa (SCoN) é uma causa comum de morbidade e mortalidade na unidade neonatal. SCoNs são os microrganismos mais frequentemente envolvidos e representam aproximadamente 50% dos casos. O objetivo deste estudo é analisar a incidência e as características de neonatos com sepse tardia por SCoN. Materiais e métodos: foi realizado um estudo descritivo, longitudinal e retrospectivo. Usamos os bancos de dados do laboratório de microbiologia e prontuários médicos eletrônicos de nosso hospital para obter as informações. O período de estudo analisado foi de 2018 e 2019 na unidade de terapia intensiva e intermediária para recém-nascidos do Centro Hospitalar Pereira Rossell. Resultados: obtivemos uma incidência de 2,5% de internações em Terapia Intensiva e Intermediária (25 pacientes). A idade gestacional ao nascer foi de 28 semanas 25,0-35,0 e o peso médio foi de 1070g 730,0-2365,0. A média da idade gestacional pós-menstrual no momento do diagnóstico foi de 32,92 ± 7,921 semanas. 17 pacientes haviam recebido um curso anterior de antibióticos por suspeita de sepse precoce. O sinal clínico mais frequentemente observado foi deterioração do estado geral em 11 pacientes, seguido por distensão abdominal em 6 e febre em 5. Dentre os SCoN, o mais isolado foi o Staphylococcus Epidermidis (13 pacientes). 22 pacientes receberam tratamento, 18 deles com Vancomicina-Meropenem e 4 com Vancomicina em monoterapia. Conclusão: esses patógenos representam uma importante causa de morbimortalidade na unidade neonatal, principalmente em pacientes com maior gravidade e maior necessidade de suporte de vida. Orientações claras são necessárias para interpretar o papel desses microrganismos e para abordar pacientes com risco de sepse tardia, incluindo tratamento com antibióticos.

Acute Stress Dysregulates the LPP ERP Response to Emotional Pictures and Impairs Sustained Attention: Time-Sensitive Effects.

Stress can increase emotional vigilance at the cost of a decrease in attention towards non-emotional stimuli. However, the time-dependent effects of acute stress on emotion processing are uncertain. We tested the effects of acute stress on subsequent emotion processing up to 40 min following an acute stressor. Our measure of emotion processing was the late positive potential (LPP) component of the visual event-related potential (ERP), and our measure of non-emotional attention was the sustained attention to response task (SART). We also measured cortisol levels before and after the socially evaluated cold pressor test (SECPT) induction. We found that the effects of stress on the LPP ERP emotion measure were time sensitive. Specifically, the LPP ERP was only altered in the late time-point (30-40 min post-stress) when cortisol was at its highest level. Here, the LPP no longer discriminated between the emotional and non-emotional picture categories, most likely because neutral pictures were perceived as emotional. Moreover, compared to the non-stress condition, the stress-condition showed impaired performance on the SART. Our results support the idea that a limit in attention resources after an emotional stressor is associated with the brain incorrectly processing non-emotional stimuli as emotional and interferes with sustained attention.