The Relationships Between Family Financial Stress,Mental Health Problems,Child Rearing Practice,and School Involvement Among Taiwanese Parents with School-Aged Children

This study examined the relationships between family financial stress, mental health problems, child rearing practice, and school involvement using a sample of 431 parents with children in grades 1–4 from one elementary school in a rural area of Taiwan. Financial stress was hypothesized to be associated with parental mental health problems, which in turn were expected to be linked to poorer child rearing practice and less parental involvement in school. Structural equation models were constructed and tested in a stepwise manner. Results showed that financial stress was significantly associated with higher mental health problems, poorer child rearing effort, and decreased parental school involvement while parents’ mental health problems were not significantly associated with their child rearing efforts or involvement in school. These findings suggest that the impact of family financial stress on Taiwanese parents’ child rearing practice is largely direct rather than mediated through their mental health problems.     

Parents’ postnatal depressive symptoms and their children's academic attainment at 16 years: Pathways of risk transmission

The aim of the study was to examine whether parents’ increased postnatal depressive symptoms predicted children's academic attainment over time and whether the parent–child relationship, children's prior academic attainment, and mental health mediated this association. We conducted secondary analyses on the Avon Longitudinal Study of Parents and Children data (12,607 mothers, 9,456 fathers). Each parent completed the Edinburgh-Postnatal Depression Scale at 8 weeks after the child's birth (predictor) and a questionnaire about the mother–child and father–child relationship at 7 years and 1 month (mediator). The children's mental health problems were assessed with the teacher version of the Strengths and Difficulties Questionnaire at 10–11 years (mediator). We used data on the children's academic attainment on UK Key Stage 1 (5–7 years; mediator) and Key Stage 4 (General Certificate of Secondary Education 16 years) (outcome). We adjusted for the parents’ education, and child gender and cognitive ability. The results revealed that parents’ depressive symptoms at 8 weeks predicted lower academic performance in children at 16 years. Mothers’ postnatal depressive symptoms had an indirect effect through children's mental health problems on academic outcomes at 16 years via negative mother–child relationship, and prior academic attainment. There was a significant negative indirect effect of fathers’ postnatal depressive symptoms on academic attainment at 16 years via negative father–child relationship on child mental health. The findings suggest that the family environment (parental mental health and parent–child relationship) and children's mental health should be potential targets for support programmes for children of depressed parents.     

Depressive Symptoms among Children with ODD: Contributions of Parent and Child Risk Factors in a Chinese Sample

Oppositional Defiant Disorder (ODD) is a developmental disorder characterized by serious and persistent social impairment, especially stressful interactions with parents. Although previous studies demonstrated associations between parent mental health and children’s ODD symptoms, less attention has been paid to integrating both parent and child risk factors. The purpose of the current study was to investigate the associations among parent emotion regulation, child emotion regulation, parental depression, and child depression in Chinese children with ODD. A total of 234 children with ODD ranging in age from 6 to 13 years, along with their fathers or mothers, completed questionnaires. Results indicated that: (1) Parent emotion regulation, parental depression and child emotion regulation were significantly correlated with children’s depressive symptoms. (2) Parent emotion regulation was related to children’s depression indirectly through parental depression and child emotion regulation. (3) Child emotion regulation fully mediated the relationship between parent emotion regulation and child depression, and also fully mediated the relationship between parental and child depression. These findings highlight the need to improve parent emotion regulation and pay attention to parental mental health, because both risk factors may exacerbate their children’s emotion regulation difficulties and further associate the high level of depressive symptoms among children with ODD.     

Relationships Among Emerging Adult Psychological Problems,Maltreatment, and Parental Psychopathology: Moderation by Parent–Child Relationship Quality

Current research supports clear relationships between parental psychopathology, parental maltreatment, and emerging adult child psychopathology. Less research has examined how the role of the parent–child relationship influences these existing associations. The current study tested two models that examined the moderating effect of parent–child relationship quality on parental psychopathology and emerging adult mental health as well as the effect on parental maltreatment and emerging adult mental health. It was expected that high parent–child relationship quality would buffer against the negative effects of parental psychopathology and maltreatment while enhancing the effects of functional parenting characteristics. Participants included 1,452 emerging adults, predominantly Caucasian (73.3%) college students who completed surveys on their mental health, recent experienced maltreatment, and their parents’ mental health problems. Results suggested lowest rates of mental health problems for emerging adults were associated with higher parent–child relationship quality and lower parental psychological problems, whereas negative outcomes were associated with higher parental psychopathology, regardless of parent–child relationship quality. Additionally, physical maltreatment was associated with lower rates of mental health concerns in the context of higher mother-daughter relationship quality. Results emphasize the continuing impact of the parent–child relationship, particularly the mother-daughter relationship, on emerging adults’ mental health. Moreover, the current study demonstrates the continuing influence of parents on their emerging adult children.     

The Impact of Parent Empowerment in Children’s Mental Health Services on Parenting Stress

Emotional and behavioral (EB) problems in children are associated with increased perceptions of strain in parenting. Among children receiving services, parenting stress has been linked to initiating services for their children, and may strain the relationship between parent and child. In contrast, parental engagement and empowerment in services is an important quality indicator for positive treatment outcomes. However, no known studies have examined the association between parent empowerment in their child’s services and their perceptions of stress related to parenting a child with significant mental health needs. Further, no studies have explored whether empowerment moderates the relationship between the child’s symptoms and parental perceptions of stress. The current study examined the impact of child EB problems and parent empowerment on parenting stress. Among a sample of 525 parents of children receiving school-based services for disruptive behavior disorders, child EB problems significantly predicted parenting stress. Parent empowerment also correlated with lower parenting stress, as hypothesized. Although parent empowerment was not found to moderate the relationship between child symptomatology and parenting stress, the relationship between parent empowerment and parenting stress differed based on child gender and age. Parent empowerment was associated with lower parenting stress more for parents of females and younger children than for parents of males and older children.     

How Can I Help You? Dimensional versus Categorical Distinctions in the Assessment for Child Analysis and Child Psychotherapy

ABSTRACT

This paper describes the process of a psychoanalytically-informed or a psychodynamic diagnostic assessment with children, contrasting it with a DSM-like diagnostic process. The importance of understanding and sensitively addressing the experience of parents when they bring their child to a professional for help is highlighted. The promotion of a psychoanalytic atmosphere, the unique contribution of a child analyst or psychodynamic clinician to the general mental health field, is an approach which promotes the development of a therapeutic alliance. This allows both parents and children to express their underlying issues as openly as possible. In addition to the basic assumptions of psychoanalysis (the ubiquity of unconscious mental activity and the impact of the past on the present/the developmental perspective), several factors are crucial to bear in mind: the importance of understanding the nature of the child’s (and the parent’s) emotions, emotion regulation, development of mental representations of self and other, and their conflicts and defense mechanisms. Potential therapeutic approaches are highlighted, including stressing the need to empirically study how decisions are made by a mental health provider when moving from assessment to treatment recommendation.     

Ethical Considerations for Assessing Parent Mental Health during Child Assessment Services

Parents play an integral role in the mental health service provision of children and adolescents, and they can have significant effects on the outcomes of youth. A growing body of research has linked parents’ own mental health status to numerous outcomes for their children, and recent guidelines have emerged recommending the assessment of parent psychopathology when treating child patients. However, these recommendations present a range of ethical considerations. Mental health professionals must determine if the assessment of a parent is empirically supported and that an assessment procedure appropriate for parents can be feasibly implemented. They must also respect the autonomy and confidentiality of parents while ensuring that assessment findings can be translated to meaningful benefits for child patients. This article details and discusses each of these concerns within the context of the relevant principles and standards of the 2016 American Psychological Association’s Code of Ethics. Further, it provides guidelines, relevant clinical examples, and an applied model for mental health professionals to consider the ethical implications of assessing parent mental health when serving child patients.     

Understanding Barriers to Initial Treatment Engagement among Underserved Families Seeking Mental Health Services

This mixed method study examined factors associated with parents not attending their child’s mental health treatment after initially seeking help for their 2–5 year old child. It was part of a larger study comparing two evidence-based treatments among low-income racial/ethnic minority families seeking child mental health services. Of 123 parents who initiated mental health treatment (71?% African American or multi-racial; 97.6?% low-income), 36 (29.3?%) never attended their child’s first treatment session. Socio-demographic characteristics, parenting stress, depression, severity of child behavior problems, and length of treatment delay from intake to first scheduled treatment session were compared for families who did and did not attend their first treatment session. Parents who never attended their child’s first treatment session were more likely to live with more than four adults and children (p?=?.007) and have more depressive symptoms (p?=?.003). Median length of treatment delay was 80 days (IQR?=?55) for those who attended and 85 days (IQR?=?67.5) for those who did not attend their child’s first treatment session (p?=?.142). Three themes emerged from caregiver interviews: (a) expectations about the treatment, (b) delays in getting help, and (c) ambivalence about research participation. Findings suggest the need to develop better strategies for addressing risk factors early in the treatment process and reducing the length of time families with adverse psychosocial circumstances must wait for child mental health treatment.     

Children’s Influence on Their Parent’s Adult Development: Mothers’ and Fathers’ Receptivity to Children’s Requests for Change

This mixed-method study examined parents’ experiences of their children’s influence on parent’s continuing adult development. Mothers and fathers from 30 families were separately interviewed regarding two of their children who were between 8 and 14 years old. Parents reported on recent events when their younger and older child successfully requested that parents change their preferences, attitudes, and personal behaviors. Mothers reported more direct child influence than fathers, and both parents reported that they were more receptive to influence from their older children. Thematic analyses revealed that parents were generally comfortable with child influence and constructed their children as actors and agents. Parents attributed their receptivity to agentic qualities of children’s requests, goals for empowering children, and maintaining their mutual relationship. The findings provided insight into the transactional and relational nature of children’s influence and the direct and indirect impact of children on the adult development of parents.     

家庭氛围、子女生活满意度与心理健康代际传递的关系：亲子性别和子女年龄的差异

为探讨家庭环境（家庭氛围）、认知过程（生活满意度）和个人因素（亲子性别和子女年龄）对心理健康代际传递的影响,对591户家庭亲子被试进行调查。结果显示：（1）父母心理健康均正向预测子女心理健康,家庭氛围和子女生活满意度在其中起了重要中介作用;（2）较之于父亲,母亲心理健康对家庭氛围的预测效应更显著,母亲能以家庭氛围和生活满意度为链式多重中介预测子女心理健康,父亲心理健康仅以生活满意度为中介预测子女心理健康;（3）母亲心理健康仅能直接预测女儿的生活满意度和心理健康,父子间代际传递效应高于父女,以及母亲对子女的影响效应随子女年龄增长而提高,父亲的影响效应却在下降。研究结果有助于揭示心理健康代际传递的作用机制,且可丰富心理健康领域的研究。     

Parents’ Intelligence Mindsets Relate to Child Internalizing Problems: Moderation Through Child Gender

Parental belief systems can strongly influence children’s affect, behavior, and mental health. However, associations between specific kinds of parental beliefs and children’s mental health have not been thoroughly explored. One relevant belief system is parental intelligence mindset: beliefs about the malleability of intelligence. Children of parents who view intelligence as static (known as a fixed intelligence mindset), rather than malleable through effort (known as a growth intelligence mindset), experience more academic, self-regulatory, and motivational difficulty. However, associations between parental intelligence mindset and child mental health problems are unclear. Accordingly, we tested whether parents’ intelligence mindsets related to internalizing problems in their children (N?=?131, ages 5–8). Overall, parents with stronger fixed intelligence mindsets had children with greater internalizing problems, particularly social anxiety (characterized by fear of negative evaluation). Results further revealed that parents’ fixed intelligence mindsets were associated with overall internalizing problems and depressive symptoms in boys, but not girls. Results are the first to suggest and parse direct links between parents’ intelligence mindsets and youth internalizing problems.     

Youth Mental Illness and the Family: Parents’ Loss and Grief

Parents and family members whose adult child or relative has a mental illness endure significant losses, to which they respond with grief. Such grief may negatively affect family members’ physical and psychological health and also the relationship with their relative. Yet, research in this field is sparse. Very few studies have examined parents’ loss and grief in the context of the patient being a child or teen. It is not clear the extent to which parents’ loss and grief in response to their child or adolescent’s mental illness is similar or different to the accounts of older parents and family members caring for an adult relative with major psychopathology (e.g., Schizophrenia, Bipolar disorder). Parental loss and grief is not often addressed in child and adolescent mental health services’ provision of care; alarmingly, little is known about how best to support parents who access these services. The present study aimed to bridge this knowledge gap and identify the therapeutic needs of this younger parent population. Comprehensive interviews were conducted with 14 parents and one custodial grandparent of a youth aged 18 years or younger who was currently attending a child and adolescent mental health service. An inductive thematic analysis identified six themes; parents’ narrative of finding out, profound and pervasive loss, complex grief, waning support, the challenges of caregiving and a call for assistance. It can be inferred from these results that youth mental illness can constitute a source of loss and grief for parents. Participants’ loss and grief was largely consistent with the experience of families caring for an adult relative with major psychopathology. Opportunities for mental health practitioners to support families’ loss and grief were identified. Further studies are needed to enhance understanding of this complex and, to a large extent, ignored familial experience. Results do underscore the importance of clinicians acknowledging parents’ loss and grief and working directly with this experience over the course of youths’ treatment, perhaps in conjunction with family psychoeducation approaches.     

The Effect of Praise, Positive Nonverbal Response, Reprimand, and Negative Nonverbal Response on Child Compliance: A Systematic Review

Lack of compliance has both short- and long-term costs and is a leading reason why parents seek mental health services for children. What parents do to help children comply with directives or rules is an important part of child socialization. The current review examines the relationship between a variety of parenting discipline behaviors (i.e., praise, positive nonverbal response, reprimand, negative nonverbal response) and child compliance. Forty-one studies of children ranging in age from 1? to 11?years were reviewed. Reprimand and negative nonverbal responses consistently resulted in greater compliance. Praise and positive nonverbal responses resulted in mixed child outcomes. The findings are discussed based on theory and populations studied. The authors propose a mechanism that may increase children’s sensitivity to both positive and negative behavioral contingencies.     

Parents’ experience of child contact within entrenched conflict families following separation and divorce: a qualitative study

Child contact arrangements with parents following separation and divorce are strongly endorsed for children in both public policy and law where safe, but can be difficult to sustain. Entrenched high-conflict post-separation relationships between parents can cause substantial emotional risks to children as well as impacting severely on parents’ mental health. This paper describes a qualitative study, aimed at examining parents’ experiences of contact arrangements post-separation, undertaken within a mixed methods random allocation study of therapeutic outcomes for parents in entrenched conflict over their children. Two established semi-structured interviews with 22 parents were jointly subjected to thematic analyses. A thematic analysis across interviews revealed three main themes: ‘Dealing with contact evokes extreme states of mind’ for parents; when speaking of contact, the child is ‘everywhere and nowhere’ in the parents’ minds; ‘the hardest thing about contact is dealing with my ex-partner’. These findings indicate the immense strain children and parents are under and shed much light on the desperate states of mind for parents, particularly the anxieties driving relentless child contact disputes. This paper may contribute to the understanding of parents’ experiences of contact arrangements post-separation, potentially providing important information which can inform best practice for professionals working with this population.     

Family Impact and Parenting Styles in Families of Children with ADHD

Attention deficit hyperactivity disorder (ADHD) begins in childhood and is characterized by attention deficits, hyperactivity, or impulsiveness that is inconsistent with a child’s developmental level. The effects of ADHD are not limited to the child alone but can affect their familial context, particularly parenting styles. Using data from 68 parents of 6–11-year-old ADHD-diagnosed children, we attempted to identify the predictive variables of two parenting styles: criticism-rejection and permissiveness-indulgence. We analyzed two complex predictive models using structural equation modeling. We hypothesized that family impact variables would mediate the relation between the child’s behavior and parenting. The data showed that the child’s ADHD was only indirectly related to parenting styles, whereas child’s behavior problems had a direct relationship. The results stressed the central role of the child’s behavior on family social life, parents’ marital relationship, and parents’ feelings about their children. These variables mediated the relationship between the children’s disorders and parenting styles. On the other hand, perceived social support had an inverse relationship with this negative family impact, and it even had relevant indirect effects on criticism and permissiveness.     

Delivering Diagnoses: Parents as Translators and Withholders of Children’s Mental Health Diagnoses

There is a lack of research on how mental health diagnoses are delivered and explained to children and the effectiveness of these strategies. This qualitative study examines how emerging adults recall the delivery of mental health diagnoses in childhood and how they suggest these diagnoses should be delivered to children. Semi-structured interviews were conducted with 42 emerging adults (aged 18–22) who were diagnosed with attention deficit hyperactivity disorder (ADHD), depressive disorders, generalized anxiety disorder (GAD), and/or bipolar disorder in childhood. Findings reveal that parents, rather than mental health professionals, often inform children of their diagnoses. The data suggest that parents often act as translators of diagnostic information, acting as liaisons between mental health professionals and their children. The paper explores ways in which parents and mental health professionals withhold diagnoses from children, and how this affects children’s experiences. Drawing on their own experiences, participants offer suggestions regarding the best ways to deliver diagnoses to children. Findings suggest that adults should share mental health diagnoses openly with children. Implications for social workers and other allied health professionals who support families when children are diagnosed are discussed.     

The Parental Reflective Functioning Questionnaire in Mothers and Fathers of School-Aged Children

Research on parental reflective functioning (PRF)—defined as parents’ capacity to comprehend the developing mind of their child, reflect upon it, and hold in mind the inner life of the child—has mostly involved mothers of infants and young children, and rarely fathers and parents of school-aged children. The present study sought to extend research on PRF by examining aspects of the construct that are still scarcely explored, such as the role of gender and attachment; to investigate whether there were differences between mothers’ and fathers’ PRF and whether there were differences in PRF related to the gender and age of the child; and, finally, to assess the association between PRF and each parent’s attachment style. The Parental Reflective Functioning Questionnaire (PRFQ) and the Attachment Style Questionnaire (ASQ) were administered to a community sample of mothers and fathers of 385 children aged 3–10 years. A multi-group factor analysis supported the hypothesized three-factor model among both fathers and mothers. Univariate and multivariate analyses of variance showed that mothers had higher levels of interest and curiosity in their children’s mental states than fathers. Parents of daughters showed higher pre-mentalizing modes than parents of sons. Parents of preschool children showed less nonmentalizing modes than parents of children aged 8–10. Correlations between PRFQ and ASQ showed that both mothers’ and fathers’ interest in thinking about their child’s internal experience and in taking the child’s perspective were correlated with higher levels of secure attachment style. Research implications are discussed.     

Perinatal maternal mental health and infant socio-emotional development: A growth curve analysis using the MPEWS cohort

Pregnancy and the early post partum period are widely understood as a critical period for the infant’s emotional development and the earliest influence shaping social interaction. The present study aims to understand the potential influence of both antenatal and postnatal maternal anxiety and depressive symptoms on socio-emotional outcomes in offspring aged 12 months. The study used longitudinal data from a prospective cohort study on Australian pregnant women and their children. Data were available for 282 mothers and their children. Maternal depressive and anxiety symptoms were measured in early pregnancy, trimester three of pregnancy, six and 12 months postpartum. Social and emotional development in children was measured using the Brief Infant and Toddler Social Emotional Assessment (BITSEA) at 12 months. Using growth curve analysis of 4 waves of repeated measurement to examine intercept and slope, we found that both initial maternal depression and anxiety symptom levels, and the growth of these symptoms over time, predicted more problems with children’s social and emotional development. In the final model anxiety accounted for 19% of the variance in child socio-emotional problems and depression 23% of variance. The results emphasise the importance of perinatal maternal mental health as a potential risk factor for child development. This carries important implications for policy development, such as the need to build early identification and early intervention models in to the current clinical practice for perinatal care, specifically, to develop targeted screening, assessment and interventions to address maternal mental health issues for at-risk parents during pregnancy, and continuing monitoring of young children whose mothers have experienced perinatal mental health difficulties.     

Dyadic Mental State Talk and Sophistication of Symbolic Play between Parents and Children with Behavioral Problems

Parents’ ability to recognize children’s mental states and use mental state language in their interactions are associated with children’s mentalization, affect regulation, and symbolization in play. However, the relations among these constructs have not been investigated in school-age children with behavioral problems. This study examined the association between 53 Turkish mother-child and 40 father-child dyads’ mental state talk, children’s play characteristics, and behavioral problems at the beginning of psychotherapy. Results indicated that parents’ and children’s play-related mental state talk was associated with children’s interactive role-play, and mothers’ mental state talk was associated with children’s affect regulation in play. Moreover, mental state talk through pretend play was linked with fewer internalizing symptoms; yet a direct focus on children’s mental states out-of-pretend play was correlated with more behavioral problems, highlighting the multidimensional nature of the mentalization construct. These results are discussed taking into account the socio-cultural variations of the Turkish culture highlighting the unique characteristics of the parent-child play in context. The clinical implications point to the importance of parental and child mentalization within pretend play, that provide opportunities for affect processing, which could promote symptomatic improvement.