Interplay between Attachment to Peers and Parents in Korean Adolescents’ Behavior Problems

The present study investigated the relative contribution of style of peer attachment (secure, anxious, avoidant) and quality of attachment to parents on behavior problems in Korean adolescents. In addition, we examined the role of paternal and maternal attachment separately as a potential moderator in the relationship between style of peer attachment and internalizing and externalizing behavior problems. Middle school students (245 males, 209 females) completed the Korean version of the Adolescent Friendship Attachment Scale, Inventory of Parental and Peer Attachment-Revised, and Youth Self-Report. Attachment to peers and parents as predictors of behavior problems were tested via hierarchical multiple regression analyses. Results revealed that anxious peer attachment remained the strongest predictor of behavior problems among adolescents (internalizing behavior problems β?=?.18, p?<?.01; externalizing behavior problems β?=?.21, p? <?.001), indicating the relative importance of peer relationship compared to attachment to parents. Paternal attachment significantly moderated the relationship between avoidant peer attachment and externalizing behavior problems (β?=?.15, p?<?.05), even when the main effect of avoidant peer attachment on externalizing behavior problems was not significant. Results highlight the role of both attachments to peers and parents on adolescents’ psychological adjustment.     

Emotion Regulation in Families of Children with Behavior Problems and Nonclinical Comparisons

The current study compared parents’ emotion regulation (ER) in clinical (those with a child with externalizing behavioral problems) and low-risk comparison families. Additionally, mediation models were explored with parent ER predicting child behavior problems through child ER. Participants were 60 families with children (71.7% boys; 73% Caucasian) ages 2 through 8 years (M?=?4.62; SD?=?1.69) from a rural population in the United States: 34 clinical families referred for parent training and 26 nonclinical families. A blocking design was used to balance the two groups on key demographic characteristics. Parents’ and children’s ER was assessed using parent-report surveys and structured behavioral observations. Analyses indicated higher rates of parental emotion dysregulation (specifically, more difficulty when upset with achieving goal-directed behaviors, p?=?.01, d?=?0.67; controlling impulses, p?=?.01, d?=?0.64; limited use of ER strategies, p?=?.02, d?=?0.62; and more negative verbalizations to their child during the observed task, p?<?.01, d?=?0.73) and child emotion dysregulation (specifically, more difficulty as reported by parents, p?<?.01, d?=??2.42) in the clinical group. Mediational analyses indicated there were indirect paths from parental ER to children’s behavioral problems through child ER. Findings from this research suggest a need to measure and target ER in both parents and their children when working with families who are referred for treatment of child behavior problems.     

Differential Effects of Mother’s and Father’s Parenting on Prosocial and Antisocial Behavior: Child Sex Moderating

The current study examined the differential effects of maternal and paternal parenting on prosocial and antisocial behavior during middle childhood, and the moderating role of child sex. Parents of 96 boys and 107 girls (mean age?=?92.42?months, SD?=?3.52) completed different questionnaires to assess parenting and child behavior. All participants were Caucasian from south of Spain. Multiple hierarchical regressions (enter method) were performed to determine significant predictors of prosocial and antisocial behavior. The results showed that maternal and paternal hostility predicted an increase of externalizing problems in boys and girls (p?<?.001 in both sex groups). As well, Warmth/Induction of both parents predicted an increase in adaptive skills in boys and girls (p?<?.001 in both sex groups). On the other hand, differential effects of fathers’ and mothers’ parenting were found: both for boys and girls, maternal inconsistency positively predicted externalizing problems and negatively adaptive skills (p?<?.001 in both sex groups) and paternal overprotection positively predicted externalizing problems and negatively adaptive skills (p?<?.05 in both sex groups). Finally, maternal coercion negatively predicted adaptive skills in boys and girls (p?<?.05 in both sex groups); however, it increased externalizing problems only in girls (p?<?.05), whereas maternal permissiveness only increased these problems in boys (p?<?.01 in both cases). The discussion highlighted the importance of considering both parents’ and children’s sex to further knowledge of parenting styles affecting children’s behaviors.     

Childhood Cancer and Brain Tumor Late Effects: Relationships with Family Burden and Survivor Psychological Outcomes

This study examines illness-specific family burden as a mediator of the association between late effects of childhood cancer and survivors’ emotional and behavioral outcomes. Childhood cancer survivors (n?=?65; ages 10–17) two or more years off-treatment completed measures assessing internalizing and PTSD symptoms. Parents reported on illness-specific family burden, late effects severity, and survivor internalizing/externalizing problems. Providers documented the number of late effects. Illness-specific family burden was correlated with provider-reported late effects (r?=?.29, p?<?.05) and parent report of severe late effects (r?=?.56, p?<?.01). Results supported an indirect effect of illness-specific family burden on number of late effects and parent-reported survivor internalizing problems, p?<?.05. Indirect effects were not found in models predicting PTSD and externalizing problems. Illness-specific family burden is an important intervention target for reducing internalizing problems in childhood cancer survivors with late effects.     

Relationship between Disabilities and Adoption Outcomes in African American Children

Although many children adopted from the public child welfare system have special needs, little is known about the experiences of African American adopted children with disabilities and their families. The purpose of this study is to explore different categories of disabilities, including chronic health issues; emotional, mental, or behavioral (EMB) disorders; and intellectual or developmental disabilities (IDDs) on adoption outcomes in a sample of African American children. Data were from the Post-Permanency Round II Survey collected in 2008. A random sample of 412 adoptive parents or legal guardians self-reported their children’s disability diagnoses and family caregiving experiences. Hierarchical regression modelling was used to investigate the relationship between child disability and child and parental outcomes. Results indicated that chronic health issues (β?=?.10, p?<?.05), EMB disorders (β?=?.16, p?<?.01), and IDDs (β?=?.12, p?<?.05) were positively associated with parental burden. In addition, asthma (β?=?.10, p?<?.05), from the larger physical health issue category, was also associated with parental burden. However, none of the disability categories was significantly related with caregiver commitment or adoption dissolution. Future research should disentangle the definitions of special needs or disabilities.     

Mother-Child Interactions and Preschoolers’ Emotion Regulation Outcomes: Nurturing Autonomous Emotion Regulation

Emotion regulation is a complex process that begins in infancy and continues through childhood with parents’ support. Early parent-child interactions shape the way children learn emotion management. We took a sociocultural and social learning approach to exploring the specific components of mother-child interactions that are related to mothers’ perceptions of her child’s regulatory ability and the child’s observed emotion regulation. Thirty mothers and their preschool children were recruited from two New England urban areas: one community sample and one head start sample. Dyads engaged in a free play session, children completed an observed compliance task, and mothers completed a set of questionnaires assessing their perceptions of their child’s regulation. Regression analyses revealed that maternal behaviors during free play predicted child’s observed hostility (F _(2,29)?=?3.137, p?<?.05) and mothers’ perceptions of her child’s regulatory ability predicted observed child compliance (F _{(2, 17)}?=?4.990, p?<?.05). Child behaviors during play significantly predicted child’s compliance (F _(3,20)?=?4.722, p?<?.05) and child’s hostility (F _{(1, 26)}?=?9.220, p?<?.001). Maternal modeling and intentional scaffolding as well as perceptions of her child’s regulatory capacity have a powerful impact on her child’s observed regulation. Results indicate that it is particularly important for mothers of preschoolers to support autonomy while guiding socially appropriate behavior. Interventions that target improving mothers’ negative perceptions of their children, educating on appropriate preschool expectations, and facilitating preschoolers’ mature play may help mothers interact with their children in the ways that foster children’s autonomous emotion regulation.     

Maternal Depression in Families of Children with ADHD: A Meta-Analysis

Although research has demonstrated a relationship between maternal depression and child attention deficit/hyperactivity disorder (ADHD); the strength of the relationship is currently unclear. The results of some studies have found a strong association between maternal depression and child ADHD, while other studies have found little or no association. A meta-analysis was conducted to clarify the strength of the association between maternal depression and child ADHD. The current study included 51 published and unpublished studies that included a quantitative comparison between maternal depression and child ADHD. Mothers of children with ADHD had significantly higher levels of depressive symptoms than mothers of children without ADHD (d?=?0.58; 95% CI [0.43, 0.74]; p?<?.001; k?=?18). The relationship between maternal depressive symptoms and child ADHD symptoms was moderate (r?=?.22; 95% CI [.17, .28]; p?<?.001; k?=?21). 17.11% of mothers of children with ADHD currently met criteria for a depressive disorder (95% CI [11.95, 23.89], p?<?.001, k?=?19). The DSM version used to evaluate child ADHD status was the only moderator that was statistically significant (p?=?.021, k?=?15). Specifically, studies that used the DSM-III or DSM-III-R were associated with larger effect sizes than studies that used the DSM-IV or DSM-IV-TR. The results suggest that clinicians should screen for the possible co-occurrence of maternal depression when working with families of children with ADHD.     

Language Delay and Externalizing Problems in Preschool Age: A Prospective Cohort Study

This study sought to examine the direction of causation between language delay and two externalizing problems; inattention and aggression. Autoregressive fixed effects models were fitted to data from 25,474 children (age 1.5 to 5 years; 50.8% boys) in the population-based longitudinal Norwegian Mother and Child Cohort Study (MoBa), to model the direction of causality for language delay and inattention and aggression, respectively. The most parsimonious model for the relationship between language delay and inattention was one where both common factors and reciprocal causation were estimated. Adjusted for common factors, language delay was estimated to have a non-significant effect on inattention by b?=?0.12 (p?=?0.06), and inattention to have a significant effect on language delay by b?=?0.19 (p?=?0.03). The most parsimonious model for the direction of causality for language delay and aggression was one where the entire association could be explained by language delay having effect on aggression b?=?0.12 (p?<?0.02). It appears that while language delay can best be conceptualized as an epiphenomenon of inattention partly related to both common factors and causal processes, aggression can best be conceptualized as caused by language delay. This illumination of the hypothetical causal links between two common problem domains in preschool-aged children has clear implications on where to implement interventions to prevent co-occurrence of language delay and externalizing problems.     

Antisocial Process Screening Device Subscales Predict Recidivism in an Australian Juvenile Offender Sample

The present study is the first to examine the psychometric properties of the self-report Antisocial Process Screening Device (APSD-SR), and the predictive utility of its subscales for reoffending, among Australian juvenile offenders (N?= 308, M age = 17.00, SD?=?1.49). Exploratory factor analysis supported a modified three-factor structure in which four items loaded differently to prior studies. Total APSD-SR and modified subscale scores were positively associated with criminal history and mental health problems (e.g., internalizing and externalizing problems, alcohol and substance abuse/dependence). Survival analyses indicated that youth scoring high on the APSD-SR total score were faster to reoffend nonviolently (Hazard Ratio [HR]?= 1.31, p?=?.0003) and violently (HR?=?1.42, p?=?.0003) than those scoring low. Whereas the modified grandiose-manipulative subscale predicted faster time to nonviolent recidivism (HR?=?1.18, p?=?.026) as a single predictor, when all subscales were simultaneously entered into the model only callous-unemotional (CU) traits and impulsivity predicted nonviolent recidivism (HR?=?1.19, p?=?.026 and 1.22, p?=?.015, respectively), and only impulsivity predicted violent recidivism (HR?=?1.26, p?=?.014). Findings inform current understanding of the relative contribution of adolescent psychopathy dimensions to designating a particularly high-risk group of Australian youth in custody.     

Exploring the Relationships Between Maternal Mental Health Symptoms and Young Children’s Functioning in a Low-Income,Minority Sample

Poor maternal mental health, including depression and high stress levels, can negatively impact many domains of child development, particularly among low-income, ethnic minority families experiencing multiple stressors. Low-income minority mothers, particularly Hispanic mothers, are also at increased risk of experiencing exposure to community violence and other types of trauma. However, studies exploring the additional impact of maternal trauma symptoms on children’s functioning are rare. This study aims to address this gap by examining the impact of maternal trauma symptoms on young children’s functioning in a low-income, predominantly Hispanic sample through the mechanisms of maternal depressive symptoms, and mother’s experiences of parenting stress and strain. The sample consisted of 158 biological mothers (58% Hispanic, 13% African American, 5.7% White American) who were participating in community-based mental health treatment for their children (M_AGE?=?3.7, SD?=?1.2). Mothers completed questionnaires providing information on their children’s behaviors and their own mental health and stress levels at intake. Path analysis indicated that there was a significant indirect effect of maternal trauma symptoms on children’s behavior problems through maternal depressive symptoms and maternal stress in the parent-child relationship (β?=?0.09, p?<?0.01). In addition, there was a direct effect of maternal trauma symptoms on children’s behavior problems (β?=?0.32, p?<?0.001). The results suggest that maternal trauma symptoms, in addition to maternal depressive symptoms, contribute to poor maternal and child functioning.     

Prioritizing Parental Worry Associated with Duchenne Muscular Dystrophy Using Best-Worst Scaling

Duchenne muscular dystrophy (DMD) is a progressive, fatal pediatric disorder with significant burden on parents. Assessing disease impact can inform clinical interventions. Best-worst scaling (BWS) was used to elicit parental priorities among 16 short-term, DMD-related worries identified through community engagement. Respondents viewed 16 subsets of worries, identified using a balanced, incomplete block design, and identified the most and least worrying items. Priorities were assessed using best-worst scores (spanning +1 to ?1) representing the relative number of times items were endorsed as most and least worrying. Independent-sample t-tests compared prioritization of parents with ambulatory and non-ambulatory children. Participants (n?=?119) most prioritized worries about weakness progression (BW score?=?0.64) and getting the right care over time (BW?=?0.25). Compared to parents of non-ambulatory children, parents of ambulatory children more highly prioritized missing treatments (BW?=?0.31 vs. 0.13, p?<?0.001) and being a good enough parent (BW?=?0.06 vs. ?0.08, p?=?0.010), and less prioritized child feeling like a burden (BW?=??0.24 vs. ?0.07, p?<?0.001). Regardless of child’s disease stage, caregiver interventions should address the emotional impact of caring for a child with a progressive, fatal disease. We demonstrate an accessible, clinically-relevant approach to prioritize disease impact using BWS, which offers an alternative to the use of traditional rating/ranking scales.     

Mindfulness Among Genetic Counselors Is Associated with Increased Empathy and Work Engagement and Decreased Burnout and Compassion Fatigue

Genetic counselors experience high rates of compassion fatigue and an elevated risk for burnout, both of which can negatively impact patient care and retention in the profession. In other healthcare professions, mindfulness training has been successfully used to address similar negative psychological sequelae and to bolster empathy, which is the foundation of our counseling work. We aimed to assess associations between mindfulness and key professional variables, including burnout, compassion fatigue, work engagement, and empathy. Data were collected via an anonymous, online survey that included validated measures of mindfulness and these key professional variables. The survey was completed by 441 genetic counselors involved in direct patient care. Half of the respondents (50.1%) reported engaging in yoga, meditation, and/or breathing exercises. Mindfulness was positively correlated with work engagement (r?=?0.24, p?<?0.001) and empathy (as measured through four subscales: perspective taking (r?=?0.15, p?=?0.002), empathic concern (r?=?0.11, p?=?0.03), fantasy (r?=???0.11, p?=?0.03) and personal distress (r?=???0.15, p?=?0.001)). Mindfulness was negatively correlated with compassion fatigue (r?=???0.48, p?<?0.001) and burnout (r?=???0.50, p?<?0.001). Given these findings, mindfulness training may be a valuable addition to graduate and continuing education for genetic counselors. The integration of mindfulness into the genetic counseling field will likely improve professional morale and well-being, while promoting workforce retention and bolstering the relational and counseling aspects of our clinical work.     

Early Feeding,Child Behaviour and Parenting as Correlates of Problem Eating

Mealtimes are a common source of stress for families. Examining factors related to problem eating may provide markers by which to identify families requiring assistance and salient targets for treatment. The current study investigated parenting practices and cognitions, generalisation of child behavioural issues, and early feeding history as they relate to problem eating in typically developing young children. We compared a community sample of 105 parents of 1.5–6-year-old children via survey and observation with 96 parents seeking treatment for their child’s problem eating. History of problems with breastfeeding, χ²(1)?=?3.88, p?=?.049, and the transition to solids, χ²(1)?=?7.27, p?=?.007, were more common among problem eaters than comparisons. Problem eaters had a greater number of problem behaviours outside of mealtimes, F(1181)?=?10.88, p?=?.001, though not more frequently than comparisons and not to clinical levels, F(1181)?=?1.81, p?=?.181. Parents of problem eaters reported more unhelpful mealtime parenting strategies, F(1155)?=?22.59, p?<?.001, yet general parenting style was similar by group, F(1187)?=?0.42, p?=?.527. Parents’ cognitions about mealtimes, F(1155)?=?119.81, p?<?.001, including mealtime-specific self-efficacy, F(1155)?=?171.30, p?<?.001, were poorer amongst problem eaters, and were the only factors to predict problem eating in the total sample. General parenting self-efficacy was poorer in parents of problem eaters (Behaviour: F(1187)?=?42.36, p?<?.001; Setting: F(1187)?=?10.64, p?=?.001). Evidence of feeding issues in infancy may support early detection of and intervention for later problem eating. The significance of broader child behaviour is less clear. Parent factors, particularly those specific to mealtimes, and cognitive in nature (including mealtime parenting self-efficacy) clearly differentiated the groups, and represent important targets for intervention.     

Family Exploration: The Contribution of Stability and Change Processes

Building upon the redefinition of exploration as a family process, this study analyses how the processes of family stability and change may favour exploration by members of multiple family relational contexts. Sixty non-clinical family triads (mother, father, child) participated in an experimental observational study and were video-recorded while playing in different interactive configurations. The children (37 females and 23 males) were 4–5 years old (M?=?55 months). The mothers’ ages ranged from 29 to 45 (M?=?38) and the fathers’ ages ranged from 29 to 46 (M?=?39). All the parents were employed and were living together. All participants were Caucasians of Italian nationality. Using the Triadic Interactions Analytical Procedure (TIAP), the family morphostatic processes and the family morphogenetic processes were analysed in relation to the family members’ exploration. Data analyses showed that family stability continual construction (morphostasis) and family change (morphogenesis) involve different interactive and relational dynamics (χ²(8)?=?13.84, p?>?.05; CFI?=?.97, TLI?=?.94, SRMR?=?.06), even if they are intertwined processes (p?<?.001). Both morphostatic and morphogenetic processes were correlated to the level of exploration showed by family members (respectively r?=?.32, p?<?.05, and r?=?.59, p?<?.001), even if the morphogenetic processes had a stronger relation with family exploration (z?=?1.85, p _one-tailed ?<?.05).     

General and Domain-Specific Effectiveness of Cognitive Remediation after Stroke: Systematic Literature Review and Meta-Analysis

Cognitive remediation (CR) has been shown to improve cognitive abilities following a stroke. However, an updated quantitative literature review is needed to synthesize recent research and build understanding of factors that may optimize training parameters and treatment effects. Randomized controlled trials of CR were retrieved from seven electronic databases. Studies specific to adult stroke populations were included. Treatment effects were estimated using a random effects model, with immediate and longer-term follow-up outcomes, and moderator effects, examined for both overall and domain-specific functioning. Twenty-two studies were identified yielding 1098 patients (583 in CR groups). CR produced a small overall effect (g?=?0.48, 95% CI 0.35–0.60, p?<?0.01) compared with control conditions. This effect was moderated by recovery stage (p?<?0.01), study quality (p?=?0.04), and dose (p?=?0.04), but not CR approach (p?=?0.63). Significant small to medium (g?=?0.25–0.75) post-intervention gains were evident within each individual outcome domain examined. A small overall effect (g?=?0.27, 95% CI 0.04–0.51, p?=?0.02) of CR persisted at follow-up (range 2–52 weeks). CR is effective and efficient at improving cognitive performance after stroke. The degree of efficacy varies across cognitive domains, and further high-quality research is required to enhance and sustain the immediate effects. Increased emphasis on early intervention approaches, brain-behavior relationships, and evaluation of activity and participation outcomes is also recommended.     

Associations of Quality of Life,Physical Activity and Mood States in Women with Breast Cancer Treated with Curative Intent

This study aims to investigate the associations between quality of life, physical activity and mood states in women with breast cancer. A total of 354 women (mean age, 51.74?±?8.63 years; body mass index (BMI), 28?±?5.67 kg/m²) completed the Baecke Physical Activity Questionnaire, Profile of Mood States (POMS), European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) and European Organisation for Research and Treatment of Cancer Breast Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-BR23). Pearson’s correlation and multiple linear regressions were used to verify the relations between outcomes and independent variables. Correlations between scores on POMS, Baecke Physical Activity Questionnaire and global health status/quality of life subscale of EORTC QLQ-C30 found associations (p?<?0.01) between physical activity (r?=?0.191), vigour (r?=?0.333) and fatigue (r?=??0.433). Multiple linear regression analysis of the global health status/quality of life subscale of the EORTC QLQ-C30 showed significant differences for vigour (p?<?0.001), social function (p?=?0.003), side effects of systemic therapy (p?=?0.019), arm and breast symptoms (p?<?0.001) and Baecke physical activity score (p?=?0.006). Physical activity is an independent factor related to the quality of life in women with breast cancer. Understanding these variables may influence clinical decisions during treatment and allow positive interventions regarding symptoms, functions and lifestyle.     

Childhood Adversity and Children’s Academic Functioning: Roles of Parenting Stress and Neighborhood Support

Existing research has shown that adverse childhood experiences from family instability and lack of safety increase children’s risk for poor academic functioning. A recent conceptual framework, however, has emphasized the need to investigate how parenting might mediate while community context might moderate the association between childhood adversity and children’s cognitive development. In the current study, we tested the roles of parenting stress and neighborhood support in the association between cumulative childhood adversity and children’s current academic functioning. We conducted a secondary data analysis on the subsample of school-aged children (i.e., 6–17 years old; N?=?65,680) from the 2011–2012 United States National Survey of Children’s Health (NSCH). The parent provided telephone survey data on six types of adversity (e.g., parent’s divorce) that the target child experienced, parenting stress, neighborhood support, as well as the child’s academic functioning. Controlling for the child’s age, gender, ethnicity, and the parent’s education level, structural equation modeling (SEM) revealed a significant moderated mediating effect: parenting stress partially mediated the association between history of childhood adversity and children’s current academic functioning (β?=??1.760, p?<?0.001), while neighborhood support moderated the association between parenting stress (β?=?0.492, p?<?0.001) and academic functioning.     

A Psychometric Evaluation of the Behavioral Inhibition Questionnaire in a Non-Clinical Sample of Israeli Children and Adolescents

This study examined the psychometric properties of a Hebrew version of the Behavioral Inhibition Questionnaire (BIQ) in a non-clinical sample of Israeli children and adolescents. We produced a Hebrew translation of the BIQ and collected 227 responses to it from parents of children aged 4–15. Some respondents in the larger sample also completed the Screen for Child Anxiety Related Emotional Disorders (SCARED) questionnaire (n?=?91) and the Conners’ Abbreviated Parent-Teacher (CONNERS) questionnaire (n?=?39), in addition to the BIQ. Lastly, 21 children of BIQ respondents (aged 8–14) completed a self-report version of the questionnaire. Confirmatory factor analysis (CFA) was performed to assess how well the established six correlated factor model of the BIQ applied to the sample data. The Hebrew BIQ demonstrated good internal consistency (Chronbach’s α?=?.94, n?=?227) and 3 month test–retest reliability, (r?=?.95, p?<?.001, n?=?21). It also showed both convergent validity, as scores on the BIQ were correlated with the SCARED (r?=?.66, p?<?.01. n?=?91), and discriminant validity, as BIQ scores were not correlated with the CONNERS (r?=?.24, n?=?39). Finally, mother reports of BI were significantly correlated to child reports of BI via the BIQ (r?=?.60, p?<?.01, n?=?21). Thus, through this preliminary study we demonstrated that the Hebrew version of the BIQ is an effective tool for screening for BI among Israeli children, making it a useful instrument for future research.