A ansiedade infantil : vulnerabilidades da criança e influência dos pais

Tese de Doutoramento em Psicologia na área de especialidade Psicologia Clínica

Causal factors of anxiety symptoms in children

Aim: The present work aimed to investigate the impact of the child’s cognitions associated with ambiguous stimuli that refer to anxiety, both parents’ fears and anxiety, and parents’ attributions to the child’s interpretations of ambiguous stimuli on child anxiety. The influence of parental modelling on child’s cognitions was also analyzed. Method: The final sample was composed of 111 children (62 boys; 49 girls) with ages between 10 and 11 years (M = 10.6, SD = 0.5) from a community population, and both their parents. The variables identified as most significant were included in a predictive model of anxiety. Results: Results revealed the children’s thoughts (positive and negative) related to ambiguous stimuli that describe anxiety situations. Parents’ fears and mothers’ anxiety significantly predict children’s anxiety. Those variables explain 29% of the variance in children general anxiety. No evidence was found for a direct parental modeling of child cognitions. Conclusion: Children’s positive thoughts seem to be cognitive aspects that buffer against anxiety. Negative thoughts are vulnerability factors for the development of child anxiety. Parents’ fears and anxiety should be analyzed in separate as they have distinct influences over children’s anxiety. Mothers’ fears contribute to children’s anxiety by reducing it, revealing a possible protective effect. It is suggested that the contribution of both parents’ fears to children’s anxiety may be interpreted acknowledging the existence of “psychological and/or behavioral filters”. Mothers’ filters seem to be well developed while fathers’ filters seem to be compromised. The contribution of mothers’ anxiety (but not fathers’ anxiety) to children’s anxiety is also understood in light of the possible existence of a “proximity space” between the child and parents, which is wider with mothers than with fathers.

A Feminist Affective Turn for Public Relations: Mothers, Passionate Publics, and the Childhood Vaccine Debate

This project proposes a feminist intervention in how affect and publics are theorized in public relations research. Drawing from extant literature, I argue that public relations theories of affect and publics have been apolitical and lack depth and context (Leitch & Motion, 2010a). Using the context of the online childhood vaccine debate, I illustrate several theories and concepts of the new feminist affective turn, as well as postmodern theories of affect, relevant to public relations research: (a) Public Feelings, “ugly” feelings, agency, and community (Cvetkovich, 2012; Ngai, 2007); (b) passionate politics (Mouffe, 2014); (c) postmodern assemblages, biopower, and body politics (Deleuze & Guattari, 1988; Foucault, 1984); (d) affective facts and logics of future threats (Massumi, 2010); and (e) affective ethics (Bertleson & Murphie, 2010). Scholarship in the areas of public relations, risk, feminist and postmodern affect theory, and the vaccine debate provided theoretical grounding for this project. My research questions asked: How is feminist affect theory embodied by mothers in the vaccine debate? How do mothers understand risks as affective facts in the vaccine debate (if at all)? What affective logics are used by mothers in the vaccine debate (if any)? And, What are sources of knowledge for mothers in the vaccine debate? Multi-sited online ethnographic methods were used to explore how feminist affect theory contributes to public relations research, including 29 one-on-one in-depth interviews with mothers of young children and participant observation of 15 online discussions about vaccines on parenting websites BabyCenter.com, TheBump.com, and WhatToExpect.com. I used snowball sampling to recruit interview participants and grounded theory (Glaser & Strauss, 1967) to analyze interview and online data. Results show that feminist affect theory contributes to theoretical and practical knowledge in public relations by politicizing and contextualizing understandings of publics and elucidating how affective facts and logics inform publics’ knowledge and choices, specifically in the context of risk. I also found evidence of suppression of dissent (Martin, 2015) and academic bias in vaccine debate research, which resulted in cultures of silence. Further areas of study included how specific contexts such as motherhood and issues of privilege and access affect publics’ experiences, knowledges, and choices.

Cortisol Reactivity and Observed Parenting among Mothers of Children with and without ADHD

Parenting is a robust predictor of developmental outcomes among children with ADHD. Early parenting predicts the persistence and course of ADHD and comorbid problems above and beyond risk associated with shared genetic effects. Yet, on average, mothers of children with ADHD are less positive and more negative in their parent-child interactions compared to mothers of non-disordered children. Little is known about psychobiological markers which may be associated with individual variations in maternal parenting in families of children with ADHD. Neurobiological models of parenting suggest that maternal cortisol levels following a stressor may be positively associated with hostile and intrusive parenting; however, to date no studies have examined maternal cortisol reactivity and parenting in school-age, or clinical samples of, children. Mothers’ regulation of physiological stress responses may be particularly important for families of children with ADHD, as parenting a child with chronically challenging behaviors represents a persistent environmental stressor. The current study sought to extend the existing literature by providing an empirical examination of the relationship between maternal cortisol reactivity following two laboratory stressors and parenting among mothers of children with and without ADHD. It was hypothesized that child ADHD group would moderate the relationship between cortisol reactivity and self-reported and observed parenting. Greater total cortisol output and greater increase in cortisol during the TSST were associated with decreased positive parenting and increased negative and directive parenting, with the exception of parental involvement, which was associated with increased cortisol output during the TSST. Conversely, cortisol output during the PCI was associated with increased positive parenting, increased parental involvement, and decreased negative parenting. In contrast to the TSST, a greater decrease in cortisol during the PCI indicated more positive parenting and parental involvement. These associations were specific to mothers of children with ADHD, with the exception of maternal directiveness, which was specific to comparison mothers. Findings add to our understanding of physiological processes associated with maternal parenting and contribute to an integrative biological, psychological, and cognitive process model of parenting in families of children with ADHD.

Inequities in energy-balance related behaviours and family environmental determinants in European children: baseline results of the prospective EPHE evaluation study

BACKGROUND:Tackling inequalities in overweight, obesity and related determinants has become a top priority for the European research and policy agendas. Although it has been established that such inequalities accumulate from early childhood onward, they have not been studied extensively in children. The current article discusses the results of an explorative analysis for the identification of inequalities in behaviours and their determinants between groups with high and low socio-economic status. METHODS: This study is part of the Epode for the Promotion of Health Equity (EPHE) evaluation study, the overall aim of which is to assess the impact and sustainability of EPODE methodology to diminish inequalities in childhood obesity and overweight. Seven community-based programmes from different European countries (Belgium, Bulgaria, France, Greece, Portugal, Romania, The Netherlands) participate in the EPHE study. In each of the communities, children aged 6-8 years participated, resulting in a total sample of 1266 children and their families. A parental self-administrated questionnaire was disseminated in order to assess the socio-economic status of the household, selected energy balance-related behaviours (1. fruit and vegetable consumption; 2. soft drink/ fruit juices and water consumption; 3. screen time and 4. sleep duration) of the children and associated family environmental determinants. The Mann-Whitney U test and Pearson's chi-square test were used to test differences between the low and high education groups. The country-specific median was chosen as the cut-off point to determine the educational level, given the different average educational level in every country. RESULTS: Children with mothers of relatively high educational level consumed fruits and vegetables more frequently than their peers of low socio-economic status. The latter group of children had a higher intake of fruit juices and/or soft drinks and had higher screen time. Parental rules and home availability were consistently different between the two socio-economic groups in our study in all countries. However we did not find a common pattern for all behaviours and the variability across the countries was large. CONCLUSIONS: Our findings are indicative of socio-economic inequalities in our samples, although the variability across the countries was large. The effectiveness of interventions aimed at chancing parental rules and behaviour on health inequalities should be studied.

The Effect of Stress Management Program Using Cognitive Behavior Approach on Mental Health of the Mothers of the Children With Attention Deficit Hyperactivity Disorder

Background: Attention deficit hyperactivity disorder is one of the most common psychiatric disorders in children. Objectives: The study aimed to evaluate the effectiveness of stress management program using cognitive behavior approach on mental health of the mothers of the children with attention deficit hyperactivity disorder. Patients and Methods: In this interventional study, 90 mothers of the children with attention deficit hyperactivity disorder were randomly allocated into three intervention, placebo, and control groups. The general health questionnaire was used to measure mental health. Besides, stress was assessed through the depression-anxiety-stress scale. The two instruments were completed at baseline, immediately after, and one month after the intervention by the mothers. Afterwards, within group comparisons were made using one-sample repeated measurement ANOVA. One-way ANOVA was used for inter group comparisons. Mothers in the placebo group only participated in meetings to talk and express feelings without receiving any interventions. Results: At the baseline, no significant difference was found among the three groups regarding the means of stress, anxiety, depression, and mental health. However, a significant difference was observed in the mean score of stress immediately after the intervention (P = 0.033). The results also showed a significant difference among the three groups regarding the mean score of mental health (P < 0.001). One month after the intervention, the mean difference of mental health score remained significant only in the intervention group (P < 0.001). Conclusions: The study findings confirmed the effectiveness of stress management program utilizing cognitive behavior approach in mental health of the mothers of the children with attention deficit hyperactivity disorder.

Estrategias que los padres cuencanos utilizan para criar a sus hijos

El presente estudio corresponde a una investigación cuantitativa realizada en la ciudad de Cuenca, Ecuador, cuyo objetivo fue determinar las prácticas parentales en la función de socialización de la familia. Se trabajó con una muestra de 445 padres con hijos en segundo año de educación básica, a quienes se aplicó el cuestionario “Estudio socioeducativo de hábitos y tendencias de comportamiento en familias de niños de segundo año de educación básica” (Torio, 2001). Luego del procesamiento de la información se encontró que: a) El cuidado de los hijos y administración de recursos para el hogar son actividades que los padres realizan de manera conjunta; las actividades escolares y preparación de alimentos recae generalmente en las madres; b) la participación de los padres en los juegos es diferente según el tipo de juego: los padres tienden a involucrarse en juegos que demandan actividad física y las madres en juegos didácticos; c) la verdad, la solidaridad y la responsabilidad son los valores que los padres/madres mencionan transmitir y los que consideran de mayor importancia; d) los besos, abrazos y caricias son estrategias que los padres/madres utilizan para premiar a sus hijos, en tanto que la prohibición de cosas lo utilizan como castigo, en consecuencia los padres/madres cuencanos son más expresivos que instrumentales.

Individual Child Cognitive Behavioral Treatment versus Child-Parent Cognitive Behavioral Treatments for Anxiety Disorders in Children and Adolescents: Comparative Outcomes

Anxiety disorders; such as separation anxiety disorder, generalized anxiety disorder, social phobia and specific phobia, are widespread in children and adolescents. Cognitive behavioral therapy (CBT) has been shown to be effective in reducing excessive fears and anxieties in children and adolescents. Research has produced equivocal findings that involving parents in treatment of child anxiety enhances effects over individual CBT (ICBT). The present dissertation study examined whether parental involvement can enhance individual treatment effect if the parent conditions are streamlined by targeting specific parental variables. The first parent condition, Parent Reinforcement Skills Training (RFST), involved increasing mothers’ use of positive reinforcement and decreasing use of negative reinforcement. The second parent condition, Parent Relationship Skill Training (RLST), involved increasing maternal child acceptance and decreasing maternal control (or increasing autonomy granting). Results of the present dissertation findings support the use of all three treatment conditions (ICBT, RLST, RFST) for child anxiety; that is, significant reductions in anxiety were found in each of the three treatment conditions. No significant differences were found between treatment conditions with respect to diagnostic recovery rate, clinician rating, and parent rating of child anxiety. Significant differences between conditions were found on child self rating of anxiety, with some evidence to support the superiority of RLST and RFST to ICBT. These findings support the efficacy of individual, as well as parent involved CBT, and provide mixed evidence with respect to the superiority of parent involved CBT over ICBT. The conceptual, empirical, and clinical implications of the findings are discussed.

Qualidade das vivências parentais em três famílias homoparentais portuguesas

Dissertação de Mestrado apresentada no ISPA – Instituto Universitário para obtenção do grau de Mestre na especialidade de Psicologia Clinica

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