L’attachement chez les enfants institutionnalisés : une recension narrative et méta-analytique des études sur les facteurs de risque

IntroductionInstitutional conditions are deleterious for child development (Browne, 2009). In particular, at a socioemotional level, a high proportion of institutionalized children develop an insecure-disorganized attachment (van IJzendoorn & Bakermans-Kranenburg, 2009). However, little is known about the risk factors associated with the development of disorganized attachment behavior among children living in institutions.ObjectiveA narrative and meta-analytic review is conducted to identify such risk factors.MethodAll studies reporting valid attachment scores of institutionalized children during infancy (between the ages of 1 and 5) were selected. A total of 16 published studies, out of 9 different research projects, conducted in various countries were found.ResultsOverall results show that structural factors are associated to higher levels of disorganized attachment. The accumulation of risk factors or their interaction are suggested as potential processes explaining insecure attachments in institutional settings.ConclusionResearch questions are suggested for future work.     

Medication beliefs and structural barriers to treatment adherence among people living with HIV infection

Background: People living in poverty face multiple structural challenges to medication adherence including lack of transportation, inadequate housing and food insecurity. The degree to which individuals’ motivations to remain adherent may overcome structural barriers has received limited attention.

Purpose: To examine whether medication necessity and concerns beliefs predict antiretroviral therapy (ART) adherence over and above structural adherence barriers associated with poverty.

Methods: People living with HIV in a southern US city (N = 942) completed computerised interviews, an objective measure of adherence and HIV viral suppression obtained from medical records. Hierarchical logistic regression models were constructed to examine demographic and illness characteristics, structural barriers, mental health, substance use and medication necessity and concerns beliefs as predictors of ART adherence.

Results: In multivariable models, current drug use and medication necessity and concerns beliefs predicted treatment adherence over and above demographic, health, mental health and structural factors.

Conclusions: Medication beliefs are proximal and powerful motivating factors that predict adherence. Adherence interventions should directly address medication beliefs in developing strategies to manage barriers facing people with HIV living in poverty.     

Development of a coping with stress scale for a non-western population of children and adolescents

Background and objectives: In the related literature numerous instruments have been developed to measure children and adolescents’ coping with stress. Considering the cultural differences in individuals’ choice for coping strategies, along with the limitations of the existing measures of coping for children and adolescents (e.g., being derived from coping measures developed for adults; unrepresentative samples with limited age range, etc.), the current study aimed to construct a self-report coping scale for a non-western population of children and adolescents.

Design and methods: The study design included both qualitative and quantitative methodology. Three consecutive studies were conducted for the development and validation of the Children and Adolescents’ Coping with Stress Scale (CACSS), a self-report measure assessing coping strategies of children and adolescents aged from 9 to 18 in response to self-identified stressors.

Results: Exploratory and confirmatory factor analyses resulted in a 61-item CACSS with 10 factors. The scale appears to have a clear factor structure; sufficient temporal stability; and good convergent, discriminant, and construct validity.

Conclusions: By addressing limitations of existing coping scales, CACSS is believed to contribute to the literature as a developmentally appropriate and multidimensional tool.     

Neighborhood Types and Externalizing Behavior in Urban School-Age Children: Tests of Direct, Mediated, and Moderated Effects

We evaluated the association of neighborhood types and externalizing behavior problems in 99 predominately African-American urban children (M = 10.7 years), and the extent to which qualities of the family environment mediated or moderated these associations. Three distinct neighborhood types were identified using cluster analysis of census and crime data. Results showed that children living in very poor neighborhoods with moderate crime levels had more behavior problems than children living in relatively low crime, low poverty areas. Family stress mediated the association between neighborhood type and behavior problems. Family cohesion moderated the association of neighborhood type and adjustment: children living in the most impoverished neighborhoods with high levels of family cohesion demonstrated fewer behavior problems relative to their peers in low-cohesive households in the same area, and similar levels of behavior problems relative to children in highly cohesive homes in low crime, low poverty areas.     

Mentalization-Based Interventions in Child Psychiatry and Youth Protection Services I: Objectives,Setting, General Principles and Strategies

ABSTRACT

Many of the children who receive services in child psychiatry or are in the care of Youth Protection Services present with complex, multiple and often severe problems. Classic psychodynamic psychotherapy seems to be of little benefit to them. The majority of these children tend to not use symbolic play as a means of expressing their intrapsychic conflicts or relational difficulties and they do not verbally communicate much with clinicians. They are more likely to display an imaginative poverty that translates into boredom, motor discharge, and an inability to use the material put at their disposal for therapeutic purposes. The systematic and rigorous observations of these children in Quebec revealed that the majority of them present with severe mentalizing difficulties. They often show attitudes and behaviors linked to the prementalizing modes of psychic functioning. This article presents a mentalization-based intervention adapted to these children’s difficulties. The objectives, adaptation of the work setting, and general principles underlying this intervention are discussed. In addition, general intervention strategies are also covered. These interventions are considered as preparatory work whose principal purpose is to enable children to benefit later on from psychodynamic psychotherapy. The authors also recommend specific intervention strategies adapted to children’s predominant mode of psychic functioning. The details of these strategies will be shared in a separate article.     

Consumer decision making in low‐income families: The case of conflict avoidance

• This paper explores consumer decision making in low‐income families. The focus is on the issue of conflict avoidance within the family when making consumption choices. Whereas previous studies have focused on conflict resolution strategies, this paper considers the ways in which families prevent conflict from arising in the first instance. These include individual control in purchasing and budgeting decisions, giving in to the requests of children and ensuring open communication about the family's financial situation. Importantly, the connections between the poverty narrative and the family decision making narrative are considered as the decision making strategies employed are not only aimed at avoiding conflict but also making experiences of poverty more manageable.

Copyright © 2009 John Wiley & Sons, Ltd.     

Secondary traumatization among former prisoners of wars' adult children: the mediating role of parental bonding

Background and Objectives: The aversive impact of combat and parents' combat-induced posttraumatic stress disorder (PTSD) on young children has been examined in a few studies. However, the long-term toll of war captivity on secondary traumatization (ST) and the parental bonding of adult children remain unknown. This study examined ST symptoms and parental bonding among adult children of former prisoners of war (ex-POWs' children) that were compared to adult children of comparable veterans (controls' children). Furthermore, we examined the mediating role of parental bonding and exposure to stress in the association between group and ST symptoms. Design: A correlative, cross-sectional study. Methods: Participants were Israeli ex-POWs' children (N = 98) and controls' children (N = 90), whose fathers fought in the 1973 Yom Kippur War. All participants completed a battery of self-reported questionnaires. Results: Ex-POWs' children reported a higher number of ST symptoms and lower levels of fathers' care, as compared to controls' children. Importantly, exposure to stress stemming from fathers' behaviors and fathers' care was found to mediate the association between research group and ST. Conclusions: Forty years after the war ended, the experience of living with ex-POWs is associated with ex-POWs' children psychological outcome.     

Children with Disabilities

Abstract

Children in out-of-home care due to abuse and neglect are at disproportionately high risk for disabling conditions. The reasons for the over-representation of children with disabilities in the child welfare system are reviewed and discussed in this chapter. Factors discussed include impact of abuse and neglect, the impact risk factors such as exposure to community and domestic violence and poverty, risk of abuse or neglect associated with disability, and child welfare system factors. In addition, the need for greater efficacy in identification of disability, identification of service needs, and linkage with and delivery of services to serve the needs of children with disabilities in out-of-home care is addressed. Recommendations for policy review at State and Federal levels are offered along with direction for future research.     

A meta-ethnography of parents’ experiences of their children’s life-limiting conditions

ABSTRACT

As many children’s life-limiting illnesses (LLCs) are now often viewed as curable, there is an inevitable tension between providing good treatment and addressing patients and their families’ needs. For health care providers to provide optimal care, they must understand parents’ experiences of illness. Therefore, this article provides a meta-ethnography of parents’ experiences of their children’s LLCs by examining the findings of existing interpretative phenomenological analysis studies. Seventeen studies were included, which allowed the development of a conceptual model. Two multifaceted concepts emerged from the data, namely living in a bounded and polarised space and living in a collapsed time, and these are discussed with reference to their subconcepts. Recommendations for future research and practice are provided.     

Pandémie de COVID-19 : attachement,anxiété, régulation émotionnelle et stratégies de coping chez les enfants d’âge scolaire

IntroductionAn impact of the COVID-19 pandemic on the emotions and behaviors of children has been found in several studies. However, this impact is not found in all studies. Attachment could be linked to different reactions and levels of anxiety.ObjectiveThe main aim of this study was to analyze the links between children's insecure attachment and variables related to anxiety, emotional and behavioral management of children during the pandemic.MethodStudy participants (n = 83 parents and their child aged 6 to 12) completed anonymously online questionnaires assessing attachment insecurity, state-anxiety, coping strategies and emotional regulation. They also answered socio-demographic questions related to their context of life and experience of the pandemic.ResultsState-anxiety is significantly related to children's emotional dysregulation but not to emotion-oriented coping strategy. Significant links were observed between attachment insecurity on the one hand, and children's state-anxiety, emotion-oriented coping strategy and children's emotional dysregulation on the other hand. Emotional dysregulation mediates the link between disorganized attachment and state anxiety.ConclusionThe links between attachment insecurity and children's state-anxiety on the one hand, and the emotion-oriented coping strategy on the other hand highlight the importance of taking individual and interactional factors into account in children's socio-emotional manifestations during the COVID-19 pandemic.     

Uncovering Multidimensional Poverty Experiences in Shaping Children’s Socioemotional Trajectories during the First 6 Years of Schooling

The extant literature has attested to the importance of poverty on child well-being generally using a unidimensional approach. Researchers have yet to establish solid evidence on how multiple dimensions of poverty (e.g., depth, volatility, and spells of exposure) might be associated with children’s socioemotional well-being during their early school years. Building upon Bronfenbrenner’s bioecological systems theory, this study used latent class analysis to identify poverty patterns by incorporating multiple dimensions of poverty and investigated the relationship between multidimensional poverty patterns and children’s socioemotional trajectories from kindergarten through fifth grade. Using the Early Childhood Longitudinal Study, Kindergarten Class of 1998–1999 (ECLS-K), a longitudinal dataset featuring a nationally representative cohort of children in the United States (N ≈ 20,090), the analysis identified seven poverty groups. Each group exhibited a unique poverty or economic pattern that incorporates the three poverty dimensions. Growth-curve results indicate that multidimensional poverty patterns were significantly associated with externalizing and internalizing behaviors both at kindergarten and over time by fifth grade. Children with the acutest form of economic deprivation—extreme poverty, volatile income, and multiple spells of poverty exposure—were reported to have the worst outcomes. The significant variations in children’s socioemotional trajectories due to different poverty patterns highlight the importance of poverty reduction and prevention strategies corresponding to those patterns for optimal effect. This study suggests a focus not just on helping families exit poverty temporarily, but on improving their economic security as a way to nurture children’s socioemotional well-being.     

8~15岁儿童贫富观的发展特点及其与成人的比较

儿童贫富观是其价值观的重要体现,贫富观形成是儿童社会化进程中的重要方面,然而目前国内尚缺乏中国儿童贫富观的系统研究。本研究以8~9岁、11~12岁、14~15岁以及成人(主要为大学生,年龄为20.7±1.32岁)为研究对象(N=186),结合开放性问题和结构化问卷,考察他们对于贫富的感知、公平判断、归因以及对于缓解贫困对策的认识。结果发现:控制社会经济地位之后,(1)8~9岁儿童对贫富的认识局限于表面特征,11~12岁更关注心理特征,而成人提及系统特征的比例更高;(2)8~9岁儿童较其他年龄组更倾向于对贫富做不公平的判断;(3)在贫富的归因和缓解贫困的对策上,儿童和成人都认可个人因素的重要性,但成人更多关注国家政策和社会的影响,并且认为消除贫困是不可能的。中国儿童贫富观的发展与西方已有研究相比,既有共性也有文化特异性。     

Incidence of Behavior Problems in Toddlers and Preschool Children from Families Living in Poverty

Few studies have examined the incidence of behavior problems in toddlers and preschool children from families living in poverty. The available research suggests behavior problems occur at higher rates in children living in poverty and may have long-term negative outcomes if not identified and properly treated. This study included an ethnically representative sample of 357 children, five years of age and younger, from a diverse, low-income, urban area. All families’ incomes met the federal threshold for living in poverty. Behavior problems were assessed by parent report through a questionnaire specifically designed for low-income families. Boys and younger children were reported as demonstrating a higher rate of externalizing behaviors than girls and older children. The overall rate of children scoring at least one standard deviation above the sample's mean for challenging behaviors was 17.4% and was not related to the child's gender, age or ethnicity. This study also sampled children's positive behaviors, which is unique in studies of behavior problems. Gender and age were not related to the frequency of reported positive behaviors. Ethnicity did influence scores on the positive scale. African American children appeared to present their parents more difficulty on items reflecting cooperative behaviors than Caucasian or Latino children. The implications of the study are discussed based on the recognized need for universal screening of behavior problems in young children and the small number professional training programs targeting the identification and treatment of early childhood behavior problems, despite the availability of evidence-based treatment programs tailored to young children in low-income families.     

Hair sampling for cortisol analysis with mother-toddler dyads living in low-income homes

BackgroundA first step to advance stress science research in young children is understanding the relationship between chronic stress in a mother and chronic stress in her child. One non-invasive measure of chronic stress is hair cortisol. However, little is known about strategies for hair sampling in mother-toddler dyads living in low-income homes in the U.S. To address prior limitations, the purpose of this study was to understand the feasibility of sampling hair for cortisol analysis in mother-toddler dyads living in low-income homes in the U.S. We examined feasibility related to participation, eligibility, and gathering an adequate hair sample weight.MethodsWe approached 142 low-income, racially diverse, urban-dwelling mothers who were participating in an ongoing longitudinal birth cohort study for informed consent to cut approximately 150 hairs from the posterior vertex of their scalp and their toddlers’ (20–24 months) scalp. We demonstrated the process of sampling hair with a hairstyling doll during home visits to the mother and toddler using rounded-end thinning shears.ResultsOverall, 94 of 142 mother-toddler dyads (66 %) participated in hair sampling. The most common reason for participation refusal was related to hairstyle. All but three hair samples were of adequate weight for cortisol extraction.DiscussionThe findings from this study can help researchers address sampling feasibility concerns in hair for cortisol analysis research in mother-toddler dyads living in low-income homes in the U.S.     

Coping et odontologie pédiatrique : construction d’un questionnaire français

ObjectiveThe purpose of this study was to build a tool of evaluation of the strategies the children use during a dental care.MethodThirty children (from six to 15 years old), 15 parents and 10 dentists participated in semidirective conversations and in observations.ResultsAn analysis of thematic contents of the conversations and the observations allowed to kick away five categories of strategies and to classify them according to the moment of the meeting.Conclusion and perspectivesQuestionnaires (behaviour, relation, cognition, emotion and somatic) were built. Once validated, these tools should allow to assess the strategies used by the child during a dental care.     

The impact of contextual family risks on prisoners' children's behavioural outcomes and the potential protective role of family functioning moderators

Abstract

Research suggests that children of prisoners have an increased risk for behavioural and emotional problems. However, in a resilience approach, one should expect heterogeneous outcomes and thus apply a contextualized perspective. As this is rarely acknowledged in empirical research, the present study sought to fill this gap using data from the Fragile Families and Child Wellbeing study on 801 children of imprisoned fathers. We explored the extent to which cumulative family risks measured during the first year of life (e.g., poverty and mental health problems) predicted behavioural outcomes at age 9 and whether potentially protective aspects of family functioning moderated the impact of these risk factors. Cumulative risk significantly predicted behavioural outcomes, but the associations were weak. No strong evidence of moderation was found. At low risk, mother–child closeness moderated behavioural outcomes. There was also some evidence of moderation by accumulated protective factors. Potential implications for policy and practice and challenges for further research are discussed.     

Children coping with uncontrollable stressors

Many of the negative events in children's lives cannot be controlled by them. Three strategies that children can be taught for coping adaptively with many uncontrollable events are presented: (a) reconstruing the event in more positive ways, (b) using positive imagery to dampen fear and frustration, and (c) developing reasonable proximal goals. How these strategies may be used in working with children living in poverty is discussed.     

Using simulation to assess the ability of youth to safely operate tractors

BackgroundOperating farm tractors is dangerous for children. Recent studies document mismatches between children and physical requirements for operating tractors. The role of cognition has not been studied, because such research conducted in real-life situations places youth at risk. The objective of this study was to evaluate the feasibility and psychometric properties of a simulated virtual tractor environment to examine how children’s age and development impacts safe tractor operations.MethodsFifty-five male youth ages 10–17 living/working on farms with experience driving tractors tested the virtual environment and simulation modules. Six adult male farmers were recruited as a reference group to compare youth performance with adults.ResultsThe simulation had adequate face validity with realism scores reported between “somewhat” and “quite” realistic. Internal reliability of the simulation was excellent, as demonstrated by highly significant intraclass correlations for key indicators of performance (speeds and hazard clearances). While there was some evidence for construct validity, as indicated by trends in performance across the age groups, findings were mixed.ConclusionStudy findings support using simulation for assessing the abilities of children to safely operate tractors.     

Do process simulations during episodic future thinking enhance the reduction of delay discounting for middle income participants and those living in poverty?

Two studies examined whether episodic future thinking (EFT; pre‐experiencing future events) reduces discounting of future rewards (DD). No studies have investigated whether process simulations (i.e., simulating the process of executing a future event) amplify EFT's reduction of DD. Study 1 examined the effect of incorporating process simulations into EFT (N = 42, M_age = 43.27; 91% female, family income = $75,976) using a 2 × 2 factorial design with type of episodic thinking (process, nonprocess/general) and temporal perspective (EFT, episodic recent thinking) as between‐subjects factors. Study 2 replicated Study 1 in a sample of adults living in poverty (N = 36; M_age = 38.44, 88% female; family income = $25,625). The results of both studies showed EFT reduced DD, but process‐oriented EFT did not amplify the effect of EFT. Our findings suggest the key ingredient in EFT's effect on DD is self‐projection into the future. This was also the first study to show EFT improves DD in a sample living in poverty.