Cortisol levels in relation to maternal interaction and child internalizing behavior in preterm and full-term children at 18 months corrected age

Cortisol levels were compared in children born preterm at extremely low gestational age (ELGA; 24-28 weeks), very low gestational age (VGLA; 29-32 weeks), and full-term in response to cognitive assessment at 18 months corrected age (CA). Further, we investigated the relationship between maternal interactive behaviors and child internalizing behaviors (rated by the mother) in relation to child cortisol levels. EGLA children had higher "pretest" cortisol levels and a different pattern of cortisol response to cognitive assessment compared to VGLA and full-terms. Higher cortisol levels in ELGA, but not full-term, children were associated with less optimal mother interactive behavior. Moreover, the pattern of cortisol change was related to internalizing behaviors among ELGA, and to a lesser degree VLGA children. In conclusion, our findings suggest altered programming of the hypothalamic-pituitary-adrenal (HPA) axis in preterm children, as well as their greater sensitivity to environmental context such as maternal interactive behavior.

Socially anxious mothers’ narratives to their children, and their relation to child representations and adjustment

Anxious mothers’ parenting, particularly transfer of threat information, has been considered important in their children’s risk for social anxiety disorder (SAnxD), and maternal narratives concerning potential social threat could elucidate this contribution. Maternal narratives to their pre-school 4-5 year-old children, via a picture book about starting school, were assessed in socially anxious (N=73), and non-anxious (N=63) mothers. Child representations of school were assessed via Doll Play (DP). After one school term, mothers (CBCL) and teachers (TRF) reported on child internalizing problems, and child SAnxD was assessed via maternal interview. Relations between these variables, infant behavioral inhibition, and attachment, were examined. Socially anxious mothers showed more negative (higher threat attribution), and less supportive (lower encouragement) narratives, than controls, and their children’s DP representations, SAnxD and CBCL scores were more adverse. High narrative threat predicted child SAnxD; lower encouragement predicted negative child CBCL scores and, particularly for behaviorally inhibited children, TRF scores and DP representations. In securely attached children, CBCL scores and risk for SAnxD were affected by maternal anxiety and threat attributions, respectively. Low encouragement mediated the effects of maternal anxiety on child DP representations, and CBCL scores. Maternal narratives are affected by social anxiety, and contribute to adverse child outcome.

Ecología nutricional del lactante y del niño en edad preescolar: problemas de nutrición en América Latina = The nutritional ecology of the infant and pre-school child: nutritional problems in Latin America

Incluye Bibliografía

Assessment of the effects of a parental intervention with mothers of children with internalizing problems

The present study assesses the effects of a semi-structured intervention held exclusively with mothers and its effects on internalizing problems, social skills of children, and positive and negative parenting practices. The single subject experimental design with three participants was adopted. The three mothers had, in baseline, children diagnosed with internalizing and externalizing problems. The instruments used were CBCL, RE-HSE-P, QRSH-Pais and PHQ-9, they were performed in baseline, pre-test, post-test, and follow-up assessments. The intervention held is characterized as semi-structured for it promotes the development of parental practices that are considered positive by the literature on behavior problems, however, contingently to the difficulties and demands of each case. The number of sessions performed for each case was 14, 15 and 17, which lasted about two hours each. The data were analyzed according to the instruments' norms and under the perspective of each singular case. The results found include remission of internalizing problems, increase in frequency of the children's social skills, increase in frequency of positive parental practices, and decrease in variability of negative parental practices. All the improvements were maintained on the six months follow-up, with the exception of variability on the negative parental practices of one client. Results are discussed in a context of mental health promotion and indicate the need for strategies to prevent internalizing problems in children.

The normal child; some problems of the first five years and their treatment.

Includes bibliography.

The ecocultural context and child behavior problems: A qualitative analysis in rural Nepal.

Commonly used paradigms for studying child psychopathology emphasize individual-level factors and often neglect the role of context in shaping risk and protective factors among children, families, and communities. To address this gap, we evaluated influences of ecocultural contextual factors on definitions, development of, and responses to child behavior problems and examined how contextual knowledge can inform culturally responsive interventions. We drew on Super and Harkness' "developmental niche" framework to evaluate the influences of physical and social settings, childcare customs and practices, and parental ethnotheories on the definitions, development of, and responses to child behavior problems in a community in rural Nepal. Data were collected between February and October 2014 through in-depth interviews with a purposive sampling strategy targeting parents (N = 10), teachers (N = 6), and community leaders (N = 8) familiar with child-rearing. Results were supplemented by focus group discussions with children (N = 9) and teachers (N = 8), pile-sort interviews with mothers (N = 8) of school-aged children, and direct observations in homes, schools, and community spaces. Behavior problems were largely defined in light of parents' socialization goals and role expectations for children. Certain physical settings and times were seen to carry greater risk for problematic behavior when children were unsupervised. Parents and other adults attempted to mitigate behavior problems by supervising them and their social interactions, providing for their physical needs, educating them, and through a shared verbal reminding strategy (samjhaune). The findings of our study illustrate the transactional nature of behavior problem development that involves context-specific goals, roles, and concerns that are likely to affect adults' interpretations and responses to children's behavior. Ultimately, employing a developmental niche framework will elucidate setting-specific risk and protective factors for culturally compelling intervention strategies.

Parenting, self-regulation and childhood anxiety : A Self-Determination Theory perspective

Le contrôle psychologique parental est un facteur de risque réputé pour les problèmes intériorisés des enfants (p. ex., Affrunti & Ginsburg, 2011; McLeod, Wood & Weisz, 2007). Selon la Théorie de l'auto-détermination, le contrôle psychologique mène aux problèmes intériorisés (Ryan, Deci, Grolnick, & La Guardia, 2006) car il brime le besoin fondamental d'autonomie. En effet, recevoir de la pression afin de penser, se comporter et se sentir d’une certaine façon (Ryan, 1982) semble favoriser une régulation trop rigide et surcontrôlée (Ryan et al., 2006). Suite aux travaux de Soenens et Vansteenkiste (2010), la distinction conceptuelle entre deux formes de contrôle psychologique, soit manifestes (p. ex., les menaces, forcer physiquement) et dissimulées (p. ex., la surprotection, le marchandage), ont été utilisées pour évaluer le style parental (Étude 1) et les pratiques disciplinaires (Étude 2). Le contrôle psychologique parental et le soutien de l'autonomie (Étude 2) ont été mesurés durant la petite enfance puisque (1) les problèmes intériorisés émergent tôt, (2) le développement du sentiment d'autonomie est central au cours de cette période, et (3) attire probablement plus de contrôle psychologique parental. Avec ses deux articles, la présente thèse vise à clarifier la façon dont le contrôle psychologique manifeste et dissimulé est lié au développement précoce de problèmes intériorisés. L'étude 1 est une étude populationnelle examinant l'impact relatif du style parental sur des trajectoires développementales d'anxiété (N = 2 120 enfants; de 2,5 à 8 ans) avec de nombreux facteurs de risque potentiels provenant de l'enfant, de la mère et de la famille, tous mesurés au cours de la petite enfance. Les résultats ont montré qu'en plus de la timidité des enfants, de la dépression maternelle et du dysfonctionnement familial, le contrôle psychologique manifeste (c.-à-d., coercitif) et dissimulé (c.-à-d., la surprotection) augmentent le risque, pour les enfants, de suivre une trajectoire d'anxiété élevée. Une interaction entre la dépression maternelle et le contrôle dissimulé a été trouvée, ce qui indique que la surprotection augmente l'anxiété des enfants seulement lorsque la dépression maternelle est élevée. Enfin, le contrôle dissimulé prédit également l'anxiété telle que rapportée par les enseignants de deuxième année. Le deuxième article est une étude observationnelle qui examine comment l'autorégulation (AR) des bambins est liée au développement précoce des symptômes intériorisés, tout en explorant comment les pratiques disciplinaires parentales (contrôle et soutien de l'autonomie) y sont associées. Les pratiques parentales ont été codifiées lors d'une requête de rangement à 2 ans (contexte "Do", N = 102), tandis que l'AR des bambins a été codifiée à la fois durant la tâche de rangement ("Do") et durant une tâche d'interdiction (ne pas toucher à des jouets attrayants; contexte «Don't » ), à 2 ans puis à 3 ans. Les symptômes d'anxiété / dépression des enfants ont été évalués par leurs parents à 4,5 ans. Les résultats ont révélé que l'AR aux interdictions à 3 ans diminue la probabilité des enfants à manifester des taux élevés de symptômes d'anxiété / dépression. Les analyses ont aussi révélé que le parentage soutenant l'autonomie était lié à l'AR des enfants aux requêtes, un an plus tard. En revanche, le contrôle psychologique manifeste et dissimulé ont eu des effets délétères sur l'AR. Enfin, seul le contrôle dissimulé a augmenté les probabilités de présenter des niveaux plus élevés de problèmes intériorisés et ce, au-delà de l’effet protecteur de l'AR des bambins. Des résultats mitigés sont issus de cette thèse concernant les effets respectifs des deux formes de contrôle sur les problèmes intériorisés, dépendamment de l'informateur (mère c. enseignant) et de la méthodologie (questionnaires c. données observationnelles). Toutefois, le contrôle psychologique dissimulé était lié à ce problème affectif dans les deux études. Enfin, le soutien à l'autonomie s’est révélé être un facteur de protection potentiel et mériterait d'être étudié davantage.

Longitudinal Pathways Between Political Violence and Child Adjustment: The Role of Emotional Security about the Community in Northern Ireland

Links between political violence and children's adjustment problems are well-documented. However, the mechanisms by which political tension and sectarian violence relate to children's well-being and development are little understood. This study longitudinally examined children's emotional security about community violence as a possible regulatory process in relations between community discord and children's adjustment problems. Families were selected from 18 working class neighborhoods in Belfast, Northern Ireland. Participants (695 mothers and children, M=12.17, SD=1.82) were interviewed in their homes over three consecutive years. Findings supported the notion that politically-motivated community violence has distinctive effects on children's externalizing and internalizing problems through the mechanism of increasing children's emotional insecurity about community. Implications are considered for understanding relations between political violence and child adjustment from a social ecological perspective.

The Caregiver–Child Relationship, Youth Mental Health, and Placement Stability in a Child Welfare Sample

Objective: Healthy relationships between adolescents and their caregivers have been robustly associated with better youth outcomes in a variety of domains. Youth in contact with the child welfare system are at higher risk for worse outcomes including mental health problems and home placement instability. A growing body of literature points to youth mental health problems as both a predictor and a consequence of home placement instability in this population; the present study aimed to expand our understanding of these phenomena by examining the interplay among the caregiver-child relationship, youth mental health symptoms, and placement change over time. Method: The sample consisted of 1,179 youths aged 11-16, from the National Survey of Child and Adolescent Well-Being, a nationally representative sample of children in contact with the child welfare system. We used bivariate correlations and autoregressive cross-lagged path analysis to examine how youths’ reports of their externalizing and internalizing symptoms, their relationship with their caregivers, and placement changes reciprocally influenced one another over three time points. Results: In the overall models, early internalizing symptoms significantly negatively predicted the quality of the caregiver-child relationship at the next time point, and early externalizing symptoms predicted subsequent placement change. In addition, later externalizing symptoms negatively predicted subsequent reports of relationship quality, and later placement changes predicted subsequent externalizing problems; these relationships were significant only at the trend level (p < .10). The quality of the relationship was significantly negatively correlated with externalizing and internalizing problems at all time points, and all variables demonstrated autoregressive stability over time. Conclusions: Our findings support the importance of comprehensive interventions for youth in contact with the child welfare system, which target not only youth symptoms in isolation, but also the caregiver-child relationship, as a way to improve social-emotional outcomes in this high-risk population.

Problems of child welfare,

Includes bibliographical references.

Child parent dyadic treatment for anxiety disorders in youths

There is evidence for the efficacy of treatments for childhood anxiety disorders; however, less is known about whether including parents in the child's treatment enhances child treatment response. There also are few studies that have examined predictors of treatment completion/non-completion and success/failure. In this dissertation, a child focused individual treatment was compared to a dyadic child-parent treatment. In dyadic, parent anxiety symptoms and child-parent relationships were targeted. Based on the Transfer of Control Model proposed by Silverman and Kurtines (1996a, b, 2005), it was hypothesized that treatment changes in parent anxiety symptoms and child-parent relationships would be related to positive child treatment response. ^ Participants were 119 youths (ages 6 to 16 years, M = 9.93 SD = 2.75; 68 girls) and their parents. All youth were born in the U.S. but had various backgrounds; 40 were European American, 73 were Latinos/as, 6 were of other ethnic backgrounds or did not report their ethnicity. Participants signed informed consent (assent for youths) and completed a pretreatment assessment. Participants were randomized to a child individual treatment or dyadic treatment, were assessed immediately after treatment and one year post treatment. Findings showed that treated youths improved across all measures over time. Comparison of treatment conditions across all measures showed no statistically significant differences between the child individual and dyadic treatment. Reductions in parent anxiety symptoms and improvements in child-parent relationships were significantly related to child treatment change at posttreatment and at one year follow-up across treatments. No factors differentiated completers from non-completers and only parent reported child internalizing behavior problems were significantly negatively related to child treatment response. ^ The study findings support a premise of the Transfer of Control Model that changes in parent anxiety symptoms and child-parent relationships are related to child treatment response. The study findings show that children can be successfully treated when parents are included as co-clients in dyadic treatment, thereby supporting the utility of this approach in practice. ^

Maternal anxiety and attention problems in children at 5 and 14 years

Objective: This study examines the association between maternal anxiety from pregnancy to 5 years and child attention problems at 5 and 14 years. Method: Birth cohort of 3,982 individuals born in Brisbane between 1981 and 1983 are assessed. Self-reported measures of maternal anxiety are assessed at four time points. Maternal reports of child attention problems using Achenbach’s Child Behavior Checklist are assessed at 5 and 14 years. Results: Children of mothers experiencing anxiety during or after pregnancy are at greater risk of experiencing attention problems at 5 and 14 years. After adjusting for maternal age and child’s gender, antenatal anxiety is strongly associated with persistent attention problems (OR = 3.65, 95% CI = 2.19, 6.07). Children with chronically anxious mothers are 5.67 (95% CI = 3.56, 9.03) times more likely to have persistent attention problems. These associations remain consistent after adjusting for potential confounders. Conclusions: Maternal anxiety appears to increase the rate of child attention problems and identifies a need for treatment programs to have a dual focus—the mother and her child. (J. of Att. Dis. 2009; XX(X) 1-XX)

Vulnerability factors for disaster-induced child post-traumatic stress disorder : the case for low family resilience and previous mental illness

Objective: The aim of the present study was to investigate whether parent report of family resilience predicted children’s disaster-induced post-traumatic stress disorder (PTSD) and general emotional symptoms, independent of a broad range of variables including event-related factors, previous child mental illness and social connectedness. ---------- Methods: A total of 568 children (mean age = 10.2 years, SD = 1.3) who attended public primary schools, were screened 3 months after Cyclone Larry devastated the Innisfail region of North Queensland. Measures included parent report on the Family Resilience Measure and Strengths and Difficulties Questionnaire (SDQ)–emotional subscale and child report on the PTSD Reaction Index, measures of event exposure and social connectedness. ---------- Results: Sixty-four students (11.3%) were in the severe–very severe PTSD category and 53 families (28.6%) scored in the poor family resilience range. A lower family resilience score was associated with child emotional problems on the SDQ and longer duration of previous child mental health difficulties, but not disaster-induced child PTSD or child threat perception on either bivariate analysis, or as a main or moderator variable on multivariate analysis (main effect: adjusted odds ratio (ORadj) = 0.57, 95% confidence interval (CI) = 0.13–2.44). Similarly, previous mental illness was not a significant predictor of child PTSD in the multivariate model (ORadj = 0.75, 95%CI = 0.16–3.61). ---------- Conclusion: In this post-disaster sample children with existing mental health problems and those of low-resilience families were not at elevated risk of PTSD. The possibility that the aetiological model of disaster-induced child PTSD may differ from usual child and adolescent conceptualizations is discussed.