Cognitive behavior therapy in treatment-naive children and adolescents with obsessive-compulsive disorder: an open trial

This work aims is to evaluate the therapeutic efficacy of cognitive behavior therapy (CBT) in pediatric patients with obsessive-compulsive disorder (OCD) who had not previously been treated with either pharmacotherapy or psychotherapy and who remained medication-free during CBT. Sixteen OCD outpatients, 8-17 years of age, were treated in a 12-week open trial with manualized CBT. Target symptoms were rated at two-week intervals with the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), the National Institute of Mental Health Global Obsessive-Compulsive Scale (NIMH Global), the Clinical Global Impression Scale (CGI), and the Hamilton Anxiety Rating Scale (Ham-A). Statistical analyses showed a significant benefit for treatment. Ten patients experienced at least a 50% reduction in symptoms on the CY-BOCS; seven were asymptomatic on the NIMH Global. These results build on previous reports that CBT may be effective in the acute treatment of pediatric OCD. Further, the results of this study suggest that CBT can be efficacious in alleviating OCD symptoms in the absence of pharmacotherapy. These results must be considered preliminary, given the small sample size and open administration of treatment.     

Measurement Structure of the Turkish Translation of the Child Behavior Checklist Using Confirmatory Factor Analytic Approaches to Validation of Syndromal Constructs

The new correlated 8-factor measurement structure of the Child Behavior Checklist for ages 6-18 (CBCL/6-18; T. M. Achenbach & L. A. Rescorla, 2001) derived from an American sample was used as a benchmark to evaluate its generalizability to Turkish general population (N = 5,195) and clinical (N = 963) samples. Item-level confirmatory factor analysis (CFA) was used to evaluate the adequacy of the correlated 8-factor model across 3 sample conditions (general population, clinical, and combined sample whose Total Problems scores were above the Turkish national median). The results supported the generalizability of the overall measurement structure of the CBCL to the Turkish population.     

Demographic characteristics,social competence,and behavior problems in children with gender identity disorder: a cross-national,cross-clinic comparative analysis

This study examined demographic characteristics, social competence, and behavior problems in clinic-referred children with gender identity problems in Toronto, Canada (N = 358), and Utrecht, The Netherlands (N = 130). The Toronto sample was, on average, about a year younger than the Utrecht sample at referral, had a higher percentage of boys, had a higher mean IQ, and was less likely to be living with both parents. On the Child Behavior Checklist (CBCL), both groups showed, on average, clinical range scores in both social competence and behavior problems. A CBCL-derived measure of poor peer relations showed that boys in both clinics had worse ratings than did the girls. A multiple regression analysis showed that poor peer relations were the strongest predictor of behavior problems in both samples. This study—the first cross-national, cross-clinic comparative analysis of children with gender identity disorder—found far more similarities than differences in both social competence and behavior problems. The most salient demographic difference was age at referral. Cross-national differences in factors that might influence referral patterns are discussed.     

Reducing reactive aggression in schoolchildren through child,parent, and conjoint parent‐child group interventions: An efficacy study of longitudinal outcomes

This study was the first to evaluate the effectiveness of three different group interventions to reduce children's reactive aggression based on the social information processing (SIP) model. In the first stage of screening, 3,734 children of Grades 4–6 completed the Reactive–Proactive Aggression Questionnaire (RPQ) to assess their reactive and proactive aggression. Respondents with a total score of z ≥ 1 on the RPQ were shortlisted for the second stage of screening by qualitative interview. Interviews with 475 children were conducted to select those who showed reactive aggression featuring a hostile attributional bias. Finally, 126 children (97 males and 29 females) aged 8 to 14 (M = 9.71, SD = 1.23) were selected and randomly assigned to one of the three groups: a child group, a parent group, and a parent–child group. A significant Time × Intervention effect was found for general and reactive aggression. The parent–child group and child group showed a significant drop in general aggression and reactive aggression from posttest to 6‐month follow‐up, after controlling for baseline scores, sex, and age. However, the parent group showed no treatment effect: reactive aggression scores were significantly higher than those in the child group at 6‐month follow‐up. This study has provided strong evidence that children with reactive aggression need direct and specific treatment to reconstruct the steps of the SIP involving the selection and interpretation of cues. The intervention could help to prevent severe violent crimes at the later stage of a reactive aggressor.     

Parent–Child Attunement Moderates the Prospective Link between Parental Overcontrol and Adolescent Adjustment

Parental overcontrol (OC), behavior that intrusively or dominantly restricts child autonomy, has been identified as a transdiagnostic risk factor for youth. However, it is as yet unknown whether the association between parental OC and child maladjustment remains even when OC is exerted infrequently or by attuned parents. Rather, the selective use of OC might steer children away from danger. Taking a developmental psychopathology approach, this study focuses on the larger parent–child relationship context, testing whether either the dose at which parents demonstrate OC or the degree to which children perceive their parents as attuned determines whether OC is risky or protective for adolescents’ adjustment. Among a community sample of 114 families of children followed from the ages of 12–18, we examine whether OC, behaviorally coded from triadic mother–father–child discussions in middle childhood, is associated with later risky behavior and anxiety symptoms in adolescence. Overcontrol exerted by either mothers or fathers had a curvilinear effect on adolescent risky behaviors, and this effect was moderated by children's perceived attunement. Although OC generally was associated with increased risky behaviors, low doses of OC or OC exerted by highly attuned parents protected against engagement in risky behaviors. No main effect of OC was observed on adolescent anxiety; however, mothers’ OC interacted with perceived parental attunement, such that OC exerted by less attuned parents predicted greater anxiety. Results underscore that the effect of parenting behaviors depends on the larger parent–child relationship context.     

The Development of Family Alliance From Pregnancy to Toddlerhood and Child Outcomes at 5 Years

This article presents a longitudinal study of the development of “family alliance” from pregnancy to toddlerhood in a community sample, as well as its links with the emotional and cognitive development of the child at age 5 years. Family alliance is defined as the quality of the interactive coordination between family members. We consider that the alliance constitutes a context for the child to learn emotion regulation and to develop an understanding of inner states. Family interactions (N = 38) were observed at the 5th month of pregnancy and at 3, 9, and 18 months after birth in a standardized situation of observation (Lausanne Trilogue Play). Marital satisfaction and child temperament were assessed through self‐reported questionnaires. Several outcomes of the child at age 5 years were measured: theory of mind performances, predominant emotional themes in pretend play, internalized and externalized symptoms. Results show that (a) three patterns of evolution of family alliance occur: “high stable” (n = 19), “high to low” (n = 10), and “low stable” (n = 9); (b) a high stable alliance is predictive of better outcomes in children at age 5 years, especially regarding theory of mind; (c) the temperament of the child is predictive of child outcomes; and (d) an interaction effect occurs between family alliance and temperament. These results highlight the importance of both family‐level and individual‐level variables for understanding individual differences in the social and cognitive development of children.     

Australian parents’ willingness to use a rideshare vehicle to transport their unaccompanied children

This study aimed to identify the key factors associated with Australian parents' willingness to use a rideshare vehicle to transport their unaccompanied child(ren). Six hundred and thirty-one participants completed an online survey (M = 39.2 years, SD = 10.5, Range = 18.0–70.0 years; Female: 63.4%). Most participants (62.1%) reported that they would 'never' use a rideshare vehicle to transport their unaccompanied child(ren). The results of a logistic regression model showed that participants': previous use of a rideshare vehicle with their child, annual mileage, propensity for technology adoption, aberrant driving behaviours, as well their requirements for vehicle features were significantly associated with their willingness to use a rideshare vehicle to transport their unaccompanied child, χ2(7) = 159.59, p < 0.001. Overall, the findings suggest that Australian parents are mostly ‘unwilling’ to use a rideshare vehicle to transport their unaccompanied children. Understanding the views of parents towards emerging transportation modes for their children is crucial for urban planning, traffic engineering, economic and social mobility and ultimately, on supporting safe modes of transportation.     

Toward Relationship‐Directed Parenting: An Example of North American Born Second‐Generation Korean‐American Mothers and their Partners

Historically, parenting has been constructed hierarchically; however, contemporary parenting models frequently emphasize parenting as relationship (Siegel & Hartzell [2004] Parenting from the inside out: How a deeper self‐understanding can help you raise children who thrive; Tuttle, Knudson‐Martin, & Kim [2012] Family Process, 51, 73–89). Drawing on interviews with 20 North American born second‐generation Korean–American mothers and their partners, and sensitized by TP‐CRO, a social constructionist framework for conceptualizing parent–child relational orientations, this grounded theory analysis identified three main processes that facilitate relational connection as a parenting orientation rather than the rule‐directed approach historically associated with first‐generation immigrant Asian families. These include: (a) emphasizing dominant culture values; (b) inviting open communication; and (c) promoting mutuality. Results also show how parents integrate collectivist cultural values of their first generation immigrant parents' traditional culture into North American parenting ideals with which they primarily identify. The study demonstrates the usefulness of the TP‐CRO for understanding parent–child relationships within multicultural parenting contexts and offers suggestions for working with second‐generation Korean families.     

Maternal and paternal infant representations: A comparison between parents of term and preterm infants

Objective

Research on parental attachment representations after preterm birth is limited and inconclusive. The present study is the first in which maternal and paternal attachment representations after term, moderately and very preterm birth are compared. In addition, special attention was directed toward disrupted attachment representations.

Method

Mothers and fathers of term infants (≥37 weeks of gestational age, n = 71), moderately preterm infants (≥32–37 weeks of gestational age, n = 62) and very preterm infants (<32 weeks of gestational age, n = 56) participated in the present study. Attachment representations (balanced, disengaged, distorted) about their infants were evaluated with the Working Model of the Child Interview (WMCI). To asses disrupted representations the coding of the WMCI was extended with the disrupted scale (WMCI-D).

Results

The three main classifications of attachment representations were not affected by preterm birth. In addition, there were no gender differences in the rate of balanced representations. In case of non-balanced representations however, maternal representations were more often distorted, whereas fathers showed more often disengaged representations. Results further revealed that maternal disrupted attachment representations were marked by role/boundary confusion or disorientation, whereas paternal disrupted attachment representations were characterized by withdrawal.

Conclusion

Given the gender differences it is essential to tailor interventions according to the attachment representations of the parent, in order to be able to alter their non-balanced and/or disrupted attachment representations.     

Effects of personality traits and characteristics of child sexual abuse on maternal reactions and support

Objective

This study aimed to examine the relationship between maternal and contextual factors including maternal personality traits, the quality of mother–child relationship, the characteristics of sexual abuse and maternal outcomes: (1) maternal reactions including feelings of anger and responsibility, anger and perceptions of responsibility of the child, and (2) maternal support provided to the child following the disclosure of sexual abuse.