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Adverse childhood experiences (ACEs) of mothers have been shown to be associated with children's mental health and behavior problems. It is important to identify effective intervention points to prevent negative consequences among children. This study aimed to investigate whether mothers' education is protective against children's depressive symptoms in families with mothers who experienced parental divorce in childhood. Data from a cross-sectional study of 5th and 8th grade children and their caregivers in a prefecture in Japan were used. Final analytic sample consisted of 9666 child-caregiver pairs. Mediation analyses using inverse odds weighting were performed where the exposure was maternal experience of parental divorce in childhood, outcome was child depressive symptoms, and potential mediators were maternal education beyond high school, maternal mental health, and household income. Maternal experience of parental divorce was associated with an elevated risk of child depressive symptoms (risk ratio: 1.22, 95 % confidence interval (CI): 1.07–1.39). Mediation analyses indicated that the combination of maternal education, maternal depression and household income mediated about half of the total effect. In the model where maternal education was the sole mediator, maternal education mediated nearly half of the total effect (risk ratio: 1.10, 95 % CI: 1.01–1.20). Results should be cautiously interpreted given observational and cross-sectional nature of the data. Maternal education beyond high school may be protective against negative mental health consequences among children due to mothers' experience of parental divorce. Further studies are needed regarding potential mechanisms and the roles of other potential mediators. • Maternal experience of parental divorce was associated with an elevated risk of their children's depressive symptoms. • Maternal education mediated the link between maternal experience of parental divorce and their children's mental health. • Maternal education may be protective against children's depressive symptoms due to mothers' experience of parental divorce. [ABSTRACT FROM AUTHOR]

We aimed to explore the difference between rural and urban children's mental health and quality of life after the pandemic. A total of 200 parents and their 11- to 15-year-old children were interviewed face to face in October 2022. This study measures child mental health and quality of life using the Strengths and Difficulties Questionnaire and Child Health Utility 9 Dimensions tools. The unadjusted effect sizes on health outcomes among demographic groups are calculated using Cohen's d. The school-specific fixed effects linear regression model with bootstrapped standard errors is applied. Rural children have significantly higher mean internalizing behavior scores than urban children (emotional problems, Cohen's d score = 0.38; peer difficulties, Cohen's d score = 0.39; P <.05). Although children living in urban areas who had COVID-19 had significantly higher peer problem scores (Cohen's d score = 0.82, P <.05), the result was not found in those residing in rural areas. After controlling all variables, the econometrics method confirms that infection status significantly affects children's peer problems, obviously in the urban sample. Children may experience the consequences of the pandemic on their mental health related to peer difficulties, differently between urban and rural areas. Further research is required to investigate the different impacts of COVID-19 on health in urban and rural areas. • The COVID-19 pandemic might have significant effects on the mental health of children; however, few studies focus on social-geographic disparity analysis. Moreover, there is a gap in the literature regarding children's mental health after the pandemic. • Based on Cohen's d approach, rural children have significantly worse mental health in internalizing behavior scores than their urban counterparts. COVID-19-infected urban children have significantly worse peer difficulties-related mental disorders than those not infected; meanwhile, the reverse results are found in the rural sample. After controlling for covariates, the effects disappear. The econometrics method shows that infected children were at a higher risk of mental disorders in peer problems, obviously in the urban sample. • Policies and programs may consider regional factors for improving children's mental health, focusing on rural areas with more support related to healthcare services. There is a need for tailored support for infected children, particularly in urban areas, which have witnessed tight social distancing with a rapidly increasing number of infections during COVID-19. This is appropriate for Vietnam, which has neither an explicit mental health law nor specific legislation on mental healthcare for children. [ABSTRACT FROM AUTHOR]

There is a large body of evidence suggesting that maternal prenatal depression significantly predicts mental health problems in children. However, little is known about the role of maternal childhood trauma within this effect. The current study utilized a sample of 187 mother-child dyads (51.3 % boys) from the Shanghai Sleep Birth Cohort (SSBC), a six-year prospective longitudinal study. The effects of maternal depression at late pregnancy (Center for Epidemiological Survey-Depression Scale) on the child mental health at six years old (Strengths and Difficulties Questionnaire) were analyzed, with different types of maternal childhood trauma (Childhood Trauma Questionnaire) being examined as moderators. The results showed that maternal prenatal depression positively predicted child mental health problems (β = 0.13, p <.05) and there was a significant moderating effect of maternal childhood emotional abuse (β = −0.05, p <.05); that is, in mothers with high childhood emotional abuse, child mental health problems remained high regardless of maternal prenatal depression (β = −0.02, p =.78), while in mothers with low childhood emotional abuse, maternal prenatal depression significantly predicted child behavioral and emotional problems (β = 0.20, p <.05). Relatively high socio-economic status samples, retrospective reports of maternal childhood trauma and the single reporter were the limitations of this study. The findings provided new insights into the impact of maternal prenatal depression on child mental health, highlighting the importance of intervention efforts targeting mothers with prenatal depression and childhood trauma history. • Child mental health was associated with maternal prenatal depression and childhood trauma. • Maternal prenatal depression was associated with a history of childhood trauma. • Only maternal childhood emotional abuse moderated the effect of prenatal depression on children. [ABSTRACT FROM AUTHOR]

Parental burnout is an underrecognized condition with adverse consequences for parents and children. The objective of this study was to determine the psychometric properties of a new scale, the Working Parent Burnout Scale, and a concurrent one-item assessment. A cross-sectional survey was conducted. The sample included parents (N = 1,285) living with children < 18 years. Content, face, construct, and predictive validity and reliability were established. Cronbach α was 0.90 with the elimination of item four on the scale. All factor loadings were > 0.40. The one-factor model was supported by confirmatory factor analysis. The Pearson r correlation was 0.59 for the total score on the original 10-item burnout scale (item 4 excluded) and the one-item assessment. These are the first known scales to measure working parent burnout. By better identifying parental burnout, preventive and interventional approaches can be initiated to enhance parent and child outcomes. [ABSTRACT FROM AUTHOR]

Individuals with intellectual disability (ID) are more vulnerable to traumatic and stressful events, increasing their risk of developing post-traumatic stress disorder (PTSD). This study aimed to investigate differences in psychopathology, post-traumatic symptoms, and adaptive functioning in a sample of Italian children and adolescents with and without ID. It also sought to determine whether the type of interpersonal trauma was associated with distinct psychopathological outcomes. Sixty-six children and adolescents exposed to interpersonal trauma (physical/sexual abuse, domestic violence, and neglect), were selected and divided into two groups based on the presence or absence of ID. Assessment consisted of structured parent interviews and parent-reported questionnaires. For each scale, comparisons between subtests were performed. Children and adolescents with ID were more likely to exhibit more severe post-traumatic symptoms, anxiety issues, social problems, and poorer adaptive functioning, with the exception of the practical domain, which appeared to be equally impaired in both groups. In terms of interpersonal trauma typology, exposure to physical/sexual abuse and domestic violence led to greater post-traumatic symptoms compared to neglect. Interpersonal trauma significantly affects children and adolescents, with or without ID, highlighting the need for tailored treatments for both groups. • Trauma impacts psychopathological and adaptive functioning from childhood. • Children with and without Intellectual Disabilities exhibit similar psychopathology. • Early and tailored trauma interventions must be implemented. [ABSTRACT FROM AUTHOR]

Few studies have examined the role of selenium in anxiety. This study aimed to evaluate the association between serum selenium concentrations and anxiety disorders and symptoms in children. This study utilized data from 831 children participating in the China Jintan Child Cohort Study (mean age = 12.67 years; 46.1% female). Serum selenium samples were collected and anxiety was assessed using the Chinese version of the Screen for Child Anxiety Related Disorders. Six types of anxiety scores were calculated, including total anxiety, panic/somatic, generalized anxiety, separation anxiety, social anxiety, and school phobia. Controlling for covariates, children with lower serum selenium concentrations were more likely to meet clinical cutoffs for total anxiety (OR = 0.992, p < 0.01), panic/somatic disorder (OR = 0.993, p < 0.05), generalized anxiety disorder (OR = 0.990, p < 0.05), social anxiety disorder (OR = 0.991, p < 0.01), and school phobia (OR = 0.989, p < 0.01), but not separation anxiety (OR = 1.000, p > 0.05). Controlling for covariates, lower serum selenium concentrations were also associated with higher continuous total anxiety, generalized anxiety, and school phobia scores (p < 0.05). Lower serum selenium concentrations were associated with higher anxiety. To our knowledge, this was the first study to examine the relationship between serum selenium and anxiety disorders in a sample of children. Results indicate an association between children's micronutrient levels and anxiety disorders. Improving child nutrition may be a promising strategy to help reduce childhood anxiety. • Children with lower serum selenium concentrations had higher levels of anxiety. • Prior research into selenium and anxiety has largely focused on adults. • Improving nutrition may be a promising strategy to help reduce childhood anxiety. [ABSTRACT FROM AUTHOR]

Research suggests that maternal ACEs have intergenerational consequences for offspring mental health. However, very few studies have investigated moderators of this association. The objective of this longitudinal study was to examine whether child resilience factors moderated the association between maternal ACEs prior to age 18, and child-reported symptoms of anxiety, depression, hyperactivity, and inattention. The current study used data from 910 mother-child dyads. Participants were recruited in pregnancy from 2008 to 2010 as part of a longitudinal cohort study. Mothers had previously completed an ACEs questionnaire and reported on their child's resilience factors at child age 8-years. Children completed questionnaires about their mental health problems (symptoms of anxiety, depression, hyperactivity, and attention problems) at ages 10 and 10.5 years. Four moderation models were performed in total. Results revealed that maternal ACEs predicted child-reported symptoms of anxiety (β = 0.174, p =.02) and depression (β = 0.37, p =.004). However, both these associations were moderated by higher levels of perceived child resilience factors (β = −0.29, p =.02, β = −0.33, p =.008, respectively). Specifically, there was no association between maternal ACEs and child mental health problems in the context of moderate and high levels of child resilience factors. Children who have the ability to solicit support from internal and external sources (e.g., being creative, setting realistic goals, making friends easily) may be buffered against the consequences of maternal ACEs on anxiety and depression. Thus, the effects of maternal ACEs on child mental health problems are not deterministic. [ABSTRACT FROM AUTHOR]

Background: There are increasing concerns that the coronavirus disease (COVID-19) pandemic will disproportionately affect socioeconomically disadvantaged children. However, there lacks empirical evidence on socioeconomic inequalities in child mental health and associated factors.Methods: We conducted a population-based online survey in 21,526 children in China, when children were confined at home for nearly two months during the pandemic. We assessed child mental health problems with the Strengths and Difficulties Questionnaire (SDQ). Parental education level and provincial gross domestic product (GDP) per capita were treated as proxies for individual- and population-level socioeconomic status (SES), respectively. Lifestyle and family environment factors included sleep disturbances, physical activity, screen time, primary caregiver, parental mental health, and harsh parenting.Results: Of the children, 32.31% demonstrated mental health problems. Parental education from the highest (undergraduate and above) to the lowest (middle school and below) increased the adjusted odds ratio(aOR) for child mental health problems by 42% (aOR, 1.42; 95% CI, 1.29-1.57); provincial GDP per capita (RMB) from the highest (>¥100K) to the lowest (≤¥70K) increased aOR by 41% (aOR, 1.41; 95% CI%, 1.28-1.55). Sleep disturbances, physical activity <1 h/day, media exposure ≥2 h/day, non-parental care, poor parental mental health, and harsh parenting were independently associated with increased child mental health problems, regardless of SES.Limitations: The potential sampling bias, subjective measures, and the cross-sectional design are the main limitations.Conclusion: The first evidence from China suggests socioeconomic inequality in child mental health during the pandemic. As unhealthy lifestyle and unfavorable family environment are contributory factors, prioritized interventions are needed to reduce socioeconomic inequality in child mental health problems. [ABSTRACT FROM AUTHOR]

• Online parenting support seems non-inferior to in-person support for parent and child well-being. • Video calling is an effective format in treatment settings. • Websites that included guidance by professionals are an effective format in prevention settings. • The added value of online support elements to in-person support seems limited. Parenting support to enhance parent and child mental health is increasingly offered on websites, apps, and through videocall. This development raises the question of how online parenting support compares to traditional in-person parenting support. Is online support non-inferior to traditional in-person support? Or should online support be used as a supplement to in-person support? In the COST Action EurofamNet (CA18123), we sought to answer these questions by systematically searching for randomized trials comparing online to in-person parenting support (Study 1) and trials comparing in-person parenting support augmented with online support elements to in-person parenting support only (Study 2). We registered our review in PROSPERO (CRD42022354393) and searched PsycINFO, MEDLINE, Web of Science, and Cochrane in May 2022. Our outcomes of interests were children's mental health, parenting practices, parental mental health, and parents' satisfaction with the program. For Study 1, multilevel meta -analysis of seven eligible randomized trials (101 effect sizes; N = 957) showed consistent non-inferiority of online support and a trend that parents were more satisfied with online support. For Study 2, narrative synthesis of two eligible trials (N = 279) suggests that adding online support elements to in-person support can improve program satisfaction and short-term benefits, but does not contribute significantly to program benefits above and beyond in-person support. Our findings suggest that, provided appropriate online formats and sufficient guidance from professionals, online parenting support is non-inferior to in-person support. The additive value of online support elements to in-person support seems limited, but may still be meaningful. Future research should identify the circumstances under which parents prefer, and benefit more from, in-person versus online parenting support. [ABSTRACT FROM AUTHOR]

Childhood emotional maltreatment can be associated with long-term consequences on mental health. In addition, transgenerational transmission of adverse childhood experiences to the next generation can occur and thus have an impact on the mental health of one's own children. The purpose of this study was to examine the role of stress on the association between childhood emotional maltreatment and parental load what is referred to in this study as limitations in parental functioning that affect the resources available to parents to cope with the demands of raising, caring for, and providing for their child. Furthermore the effect of parental load on the mental health of one's own children will be examined. N = 237 mother-child dyads (age mother M = 33.76, SD = 4.07 years; age child M = 11.91 months, SD = 0.89 months) from a longitudinal cohort study were examined at two different measuring points. Emotional abuse, perceived stress, parental load and child mental health were assessed using self and external report questionnaires. The calculation of a mediation showed that the association of emotional abuse and parental load was completely mediated by perceived stress (indirect effect ab = 0.44, 95 %-CI [0.17, 0.78]). In addition, effects of parental load on the child's mental health (β = 0.13, 95%CI [0.07;0.20]), mainly hyperactivity (β = 0.06, 95%CI [0.03;0.11]) and prosocial behavior (β = −0.04, 95%CI [−0.07; −0.01]), were evident. The results of this study provide evidence that the mental health of children can be influenced in the long term by increased parental load. [ABSTRACT FROM AUTHOR]

Abstract Of the children and adolescents with mental health concerns who receive treatment, most do so in outpatient community mental health service sites, systems of care which have largely failed to produce significant clinical outcomes. Suggested strategies to improve care in child mental health treatment include improving families' access to services, increasing use of evidence-based practices (EBPs), and holding service sites accountable for demonstrating outcomes. Producing a workforce to implement these strategies will require cultivating providers who have developed specific competencies within a range of agencies that naturally interface with the daily lives of families and their children. The authors report on a recently developed interprofessional child community fellowship for psychiatry residents and psychiatric mental health nurse practitioners aimed at training providers to deliver child mental health services in a variety of community settings. Activities that focus the fellowship are outlined along with the development of the related competencies: EBP translation, collaboration skills, and outcome measurement. Evaluation strategies for fellows' competency development are discussed. Highlights • The child mental health system is faltering, fraught with access and quality issues • Workforce training is key to improving service delivery and outcomes • Interprofessional training of MDs and Psychiatric Nurse Practitioners is critical to effective mental health care. • To build a system that is prevention oriented and strength based will demand training in the community. [ABSTRACT FROM AUTHOR]

[Display omitted] Prenatal exposures to chemical and psychosocial stressors can impact the developing brain, but few studies have examined their joint effects. We examined associations between prenatal phthalate exposures and child behavior, hypothesizing that prenatal stressful life events (PSLEs) may exacerbate risks. To do so, we harmonized data from three U.S. pregnancy cohorts comprising the ECHO-PATHWAYS consortium. Phthalate metabolites were measured in single mid-pregnancy urine samples. When children were ages 4–6 years, mothers completed the Child Behavior Checklist (CBCL), from which a Total Problems score was calculated. Mothers additionally provided recall on their exposure to 14 PSLEs during pregnancy. Primary models examined problem behaviors in relation to: (1) phthalate mixtures calculated through weighted quantile sums regression with permutation test-derived p-values; and (2) joint exposure to phthalate mixtures and PSLEs (counts) using interaction terms. We subsequently refitted models stratified by child sex. Secondarily, we fit linear and logistic regression models examining individual phthalate metabolites. In our main, fully adjusted models (n = 1536 mother–child dyads), we observed some evidence of weak main effects of phthalate mixtures on problem behaviors in the full cohort and stratified by child sex. Interaction models revealed unexpected relationships whereby greater gestational exposure to PSLEs predicted reduced associations between some phthalates (e.g., the metabolites of di-2-ethylhexyl phthalate, di-n-octyl phthalate, di- iso -nonyl phthalate) and problem behaviors, particularly in males. Few associations were observed in females. Additional research is needed to replicate results and examine potential mechanisms. [ABSTRACT FROM AUTHOR]

The article focuses on Medical-Legal Partnerships foster equity and address social determinants of health through the integration of legal advocacy into clinical care. Topics include integrating psychologists into these partnerships provides an innovative to mitigate psychosocial factors that contribute to child health inequities, and Cincinnati Child Health-Law Partnership being collaboration between Cincinnati Children's Hospital Medical Center and the Legal Aid Society of Greater Cincinnati.

Abstract Background Children in out-of-home care are consistently found to have poor mental health compared to children in the general population. However, UK research has so far failed to disentangle the impact of the care system on children's mental health outcomes from the effects of the adverse circumstances that led to their admission to care. Objective This research investigated the association between care placement and the presence of child mental health problems after controlling for children's pre-care experiences. It also identified factors associated with mental health problems among children in care. Participants and Setting The sample comprised three groups of children involved with child welfare services due to maltreatment, including children in out-of-home care (n = 122), reunified children (n = 82) and those who had never been in care (n = 159). Methods The mental health of the children in the three groups was compared, using information collected from their parents/foster carers and social workers. Results The odds of a child in out-of-home care having a mental health problem were not significantly higher than those of a child who had never been in care (AOR = 1.24; p = 0.462). However, the odds of a child in out-of-home care having reactive attachment disorder (RAD) were significantly higher than those of a child who had never been in care (AOR=1.92; p = 0.032). Conclusions These findings make an important contribution to international debates about whether placing children in care is beneficial or detrimental to their wellbeing, and highlight a range of inter-linking factors associated with the mental health of children in out-of-home care. [ABSTRACT FROM AUTHOR]

Abstract Children who live in conditions of poverty are at high risk for developmental and emotional difficulties. This study compared the psychological distress of migrant workers in Israel and their children with the psychological distress of low socioeconomic Israeli mothers and their children. We hypothesized that migrant working mothers and their children would show higher levels of distress than Israeli mothers and their children, and that single mothers and their children would show higher levels of distress than married mothers and their children. Three hundred and twenty-three mothers aged 25–59 and their children aged 6–12 participated in the study. One hundred and sixty-seven mothers were migrant workers, mostly from the Philippines, and 156 were Israeli working mothers of low socioeconomic status. One hundred and fifty-seven of the mothers were married and 143 were single. The mothers completed a measure of psychological distress and measures of their children's behavioral problems, psychological functioning, and satisfaction with life. The children completed measures of negative life events, subjective competence and psychological functioning. Overall, hypotheses were confirmed for children but not mothers, although migrant mothers reported higher levels of depressive symptoms than Israeli mothers. Levels of psychological distress were similar in single versus married mothers. In contrast, children whose mothers were migrant workers or single working mothers were at significantly higher psychological risk than children of Israeli mothers or married mothers respectively. This study contributes to an understanding of problem domains that should be addressed in welfare, and points to the need for psychological interventions for migrant and single-mother families that foster positive mother-child communication and interaction. Highlights • Risk for depression is greater in migrant than in non-migrant mothers. • Levels of psychological distress are similar in single and married working mothers. • Children of migrant workers in Israel are more distressed than local children. • Children of single mothers are more distressed than children of married mothers. • Psychological interventions for migrant and single-mother families are needed. [ABSTRACT FROM AUTHOR]

Objective: To examine the relationship between body composition-specifically fat mass (FM) and fat-free mass (FFM)-in early infancy, and mental health outcomes in early childhood.Study Design: In the Infant Anthropometry and Body Composition birth cohort study from Ethiopia, body composition was measured at birth and 1.5, 2.5, 3.5, 4.5, and 6 months of age. Mental health was assessed at 5 years of age using the approved Amharic version of the Strengths and Difficulties Questionnaire (SDQ), a parent report scale covering 4 different domains providing a total difficulties score. The associations of FM or FFM at birth as well as during early infancy, with SDQ score at 5 years of age were examined using multiple linear regression analyses.Results: At 5 years of age, the mean ± SD for SDQ score was 10.4 ± 5.8. FM at birth was positively and FFM negatively associated with SDQ score. For each kg increase in FM at birth, the SDQ score at 5 years was 5.7 points higher (β = 5.7; 95% CI, 1.4-10.0). In contrast, for each kilogram increase in FFM at birth, the SDQ score was 3.9 points lower (β = -3.9; 95% CI, -7.0 to -0.8). Neither FM nor FFM accretion rate during early infancy were associated with SDQ score at 5 years of age.Conclusions: Fetal rather than infant body composition was associated with SDQ score at 5 years of age. Greater FFM accretion during fetal life may have contributed to more optimal neurobehavioral development during early life. However, the potential mechanisms underlying the observed associations need further investigation. [ABSTRACT FROM AUTHOR]

While a growing body of literature documents adverse outcomes among prostituting women, very little research has focused on their parenting practices or the unique risk factors their children experience. This is of particular interest as majority of prostituting women have children, that are vulnerable to experiencing adverse outcomes. Among the general population, the positive impact of effective parenting styles on children's mental health has been well-documented; however, there is a paucity of information on the relationship between parenting practices and mental health outcomes for children of prostituting mothers. The current study examined the parenting practices of prostituting mothers and their effects on child mental health outcomes utilizing data from a larger randomized clinical trial. Mothers and their children were recruited through a local substance use treatment facility. Results indicated that children of prostituting mothers reported experiencing less parental monitoring and worse mental health functioning compared to other children. The joint influences of parental monitoring and psychological autonomy on children's mental health outcomes were different among these children, compared to those of non-prostituting mothers. Specifically, as support for children's psychological autonomy increased, so did children's mental health functioning, but only for those that experienced low to moderate levels of parental monitoring. This combination of low monitoring and increased psychological autonomy likely fostered independence and may have allowed these children to distance themselves from potential hazards and avoid experiences of abuse. To our knowledge, this is the first study to quantitatively examine parenting practices and child mental health outcomes among this population. [ABSTRACT FROM AUTHOR]

The purpose of this systematic review is to compare the associations of kinship care and non-kinship care with children's mental health and to examine the factors associated with children's mental health in kinship care and non-kinship foster care. A comprehensive search was conducted in nine databases, and 237 articles were identified yielding eight studies that met criteria. Study designs, sample characteristics, methodologies, and results were collected and entered into data matrices and data was analyzed narratively. This review found that children in kinship care exhibited better mental health outcomes than children in non-kinship care in the univariate and bivariate comparisons. However, the associations between kinship care and children's mental health in regression models were mixed across studies. The associations depended on research designs (cross-sectional or prospective longitudinal design) and whether statistical models addressed selection bias and controlled for confounders. This review also identified that child maltreatment related factors, placement related factors, child level factors, foster caregiver level factors, foster family environmental level factors, and neighborhood level factors were associated with foster children's mental health. Some implications for practice and research were discussed. [ABSTRACT FROM AUTHOR]

• Youth behavioral and mental health improved between admission and discharge. • Youth perception of caring, fair staff and safety at admission predicted improved behavioral and mental health at discharge. • Results suggest prioritizing trusting staff-youth relationships and including youth in staff and quality of care assessments. Child mental health practitioners and advocates have raised concerns about the use of group homes for youth with mental and behavioral health concerns. However, little is known about what factors contribute to the tremendous variation in youth outcomes following group home care. The current study draws from a large-scale, quasi-experimental, NIMH-funded study of group homes in a southeastern state. This study uses data from interviews with guardians, youth, and group home staff to understand the experiences of 554 diverse youth staying in 44 group homes across 14 agencies. Pre- and post-behavioral and mental health outcomes were measured using the Strengths and Difficulties Questionnaire. Youth were asked to assess staff caring, fairness, pleasantness, and teaching as well as overall group home safety. Youth behavioral and mental health improved between admission and discharge. Most youth felt that staff were certainly fair, caring, pleasant, and teaching them things. A small but meaningful portion of children reported feeling unsafe. Youth perception of the staff as caring and fair and the group home as safe in their first interview significantly predicted improved behavioral and mental health at discharge. To date this is the only study examining youth's prospective assessment of group home treatment quality on their later treatment outcomes. Along with the broader literature, these findings imply that building trusting, safe relationships with youth should be a top priority and suggests youth perspectives should be a valuable part of staff and safety assessments. [ABSTRACT FROM AUTHOR]

On 11 March 2011, the Great East Japan Earthquake and subsequent tsunami hit East Japan. We aim to investigate the impact of trauma experiences related to the earthquake on suicide risk among young children, stratified by child sex. Participants at baseline were children who were exposed to the 2011 disaster at preschool age (affected area, n=198; unaffected area, n=82, total n=280). From July 2013 to May 2014, suicide risk was assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) in a follow-up interview conducted by a child psychiatrist or psychologist (N=210, follow-up rate: 75%). Among young girls in the affected area, 12 out of 65 (18.5%) showed suicidal ideation, which is significantly higher than girls in the unaffected area (4.7%, p for chi-square=0.036). In the multivariate model adjusted for potential confounders and mediators, the odds ratio for 4 or more trauma experiences related to the earthquake was 5.74 (95% confidence interval: 0.83–39.6, p=0.076) compared to no trauma experience related to the earthquake. Among young boys, trauma exposure was not associated with suicidal ideation. Our findings showed that young girls who experienced earthquake-related trauma at preschool age had a higher suicidal ideation 3 years after the earthquake. [ABSTRACT FROM AUTHOR]

• Children and parents are relieved to reunite after years of institutional placement. • Children return home from institutions exhibiting signs of complex developmental trauma. • Parents struggle to understand and manage children's behavioral problems. • Parents sometimes misinterpret children's traumatic reactions as disobedience and poor behavior. • Parents struggle to re-establish boundaries and authority, especially with boys. Family reunification is one of the main deinstitutionalization strategies in the Post-Soviet countries, replacing institutional childcare systems. While the family offers a better environment for children, little is known about the challenges and opportunities that children and parents face upon reunification and how multiple traumatic experiences that occurred prior to and during separation affect the family reintegration process. This qualitative study explores the emotional and interpersonal experiences and difficulties that families experience when they reunite with children following institutional placement. Participants and Setting: Children ages 8–16 with a history of institutionalization and their caregivers (N = 47) were recruited through five child institutions in Azerbaijan. Semi-structured interviews included questions about children's and caregiver's experiences during readjustment to the family environment following deinstitutionalization. Four coders thematically coded the interviews. Children and parents were pleased to reunite and return home. At times, upon reunification, children manifested both internalizing and externalizing behavioral problems (i.e., social withdrawal, emotional dysregulation, and overtly aggressive behaviors toward family members). Narratives pointed to relational desires and challenges associated with transition from institutional care to the family environment, including building a better sense of trust and communication, as well as managing role conflict and disparate conceptions of authority in the child-caregiver relationship dynamic, particularly affecting boys. To improve emotional and psychosocial well-being of reunifying children and their caregivers, deinstitutionalization strategies should incorporate culturally-responsive trauma-informed and attachment-based interventions to heal relational traumas and further equip children and caregivers with coping, stress management and emotional regulation skills. [ABSTRACT FROM AUTHOR]

Objective: Despite progress in the development of evidence-based interventions for youth psychiatric problems, up to 75% of youths with mental health needs never receive services, and early dropout is common among those who do. If effective, then single-session interventions (SSIs) for youth psychiatric problems could increase the accessibility, scalability, completion rates, and cost-effectiveness of youth mental health services. This study assessed the effects of SSIs for youth psychiatric problems.Method: Using robust variance estimation to address effect size (ES) dependency, findings from 50 randomized-controlled trials (10,508 youths) were synthesized.Results: Mean postintervention ES showed a Hedges g value equal to 0.32; the probability that a youth receiving SSI would fare better than a control-group youth was 58%. Effects varied by several moderators, including target problem: ESs were largest for anxiety (0.56) and conduct problems (0.54) and weakest for substance abuse (0.08; targeted in >33% of studies). Other problems yielded numerically promising but nonsignificant ESs (e.g., 0.21 for depression), potentially from low representation across trials. ESs differed across control conditions, with larger ESs for studies with no treatment (0.41) versus active controls (0.14); developmental periods, with greater ESs for children (0.42) than adolescents (0.19); intervention types, with largest ESs for youth-focused cognitive-behavioral approaches (0.74); and follow-up lengths, with smaller ESs for follow-ups exceeding 13 weeks. ESs did not differ for self- versus therapist-administered interventions or for youths with diagnosable versus subclinical problems.Conclusion: Findings support the promise of SSIs for certain youth psychiatric problems and the need to clarify how, to what degree, and for whom SSIs effect lasting change. [ABSTRACT FROM AUTHOR]

Objective: The objective was to identify how children's knowledge positions were negotiated in child mental health assessments and how this was managed by the different parties.Methods: The child psychiatry data consisted of 28 video-recorded assessments. A conversation analysis was undertaken to examine the interactional detail between the children, parents, and practitioners.Results: The findings indicated that claims to knowledge were managed in three ways. First, practitioners positioned children as 'experts' on their own health and this was sometimes accepted. Second, some children resisted this epistemic position, claiming not to have the relevant knowledge. Third, some children's claims to knowledge were negotiated and sometimes contested by adult parties who questioned their competence to share relevant information about their lives in accordance with the assessment agenda.Conclusion: Through question design, the practitioner was able to position the child as holding relevant knowledge regarding their situation. The child was able to take up this position or resist it in various ways.Practice Implications: This has important implications for debates regarding children's competence to contribute to mental health interventions. Children are often treated as agents with limited knowledge, yet in the mental health assessment they are directly questioned about their own lives. [ABSTRACT FROM AUTHOR]

Men are increasingly the heads of single parent households, yet are often excluded from child welfare research and practice. To better serve all families in the child welfare system, it is necessary to understand the impact of primary caregiving men on children's wellbeing. In this study we investigated the longitudinal effects of primary caregiving fathers' mental health and substance use on child mental health, and examined possible differences by child age and gender. Regression analyses were conducted with the sample of 322 youth living with a male primary caregiver at the first wave of data collection from the National Survey of Child and Adolescent Wellbeing-II (NSCAW-II). We found that father depression at baseline consistently predicted child mental health outcomes three years later, even after accounting for demographics and baseline child mental health. Surprisingly, fathers' substance use did not predict child mental health, and interactions with child age and gender were not significant. Our findings are consistent with a small but growing literature suggesting that efforts to improve engagement of and attention to fathers within research, clinical and policy efforts are likely to be worthwhile. [ABSTRACT FROM AUTHOR]

Background More than 40% of children in military families are <6 years old, a period when children are most dependent on their parents' physical and emotional availability. Purpose This systematic review describes the impact of deployment since 9/11 on the mental health of military families with young children, evaluates evidence-based interventions for military parents with young children, and identifies gaps in the science limiting our ability to support the needs of these families. Methods Databases were reviewed from 2001 to 2014 using preferred reporting items for systematic reviews and meta-analyses approach; 26 studies met review criteria. Results Deployment was associated with increased parent stress, child behavior problems, health care utilization, and child maltreatment. Few studies tested interventions or focused on racial/ethnic minority or veteran families. A number of methodological limitations are noted. Conclusions More research using multiple methods, stronger designs, and more diverse samples is needed to understand and address the needs of military families with young children. [ABSTRACT FROM AUTHOR]

Objective Children are at risk for adverse outcomes during parental military deployments. We aim to determine the impact of parental deployment and combat injury on young children's postdeployment mental health, injuries, and maltreatment. Method This is a population-based, retrospective cohort study of young children of active duty military parents during fiscal years (FY) 2006 to 2007, a high deployment period. A total of 487,460 children, 3 to 8 years of age, who received Military Health System care, were included. The relative rates of mental health, injury, and child maltreatment visits of children whose parents deployed and children of combat-injured parents were compared to children unexposed to parental deployment. Results Of the included children, 58,479 (12%) had a parent deploy, and 5,405 (1%) had a parent injured during deployment. Relative to children whose parents did not deploy, children of deployed and combat-injured parents, respectively, had additional visits for mental health diagnoses (incidence rate ratio [IRR] = 1.09 [95% CI = 1.02-1.17], IRR = 1.67 [95% CI = 1.47-1.89]), injuries (IRR = 1.07 [95% CI = 1.04-1.09], IRR = 1.24 [95% CI = 1.17-1.32]), and child maltreatment (IRR = 1.21 [95% CI = 1.11-1.32], IRR 2.30 = [95% CI 2.02-2.61]) postdeployment. Conclusion Young children of deployed and combat-injured military parents have more postdeployment visits for mental health, injuries, and child maltreatment. Mental health problems, injuries, and maltreatment after a parent's return from deployment are amplified in children of combat-injured parents. Increased preventive and intervention services are needed for young children as parents return from deployments. Child health and mental health providers are crucial to effective identification of these at-risk children to ensure effective care provision. [ABSTRACT FROM AUTHOR]

The intersection of parenting stress and maltreatment underscores the importance of understanding the factors associated with parenting stress among child welfare involved families. This study takes advantage of a statewide survey of child welfare involved families to examine parent and child characteristics and concrete resources, in relation to parenting stress. Separate multivariate analyses were conducted by placement status given the difference in day-to-day parenting responsibilities for families receiving in-home supervision compared to those whose children are in out-of-home care. Across both groups, parenting stress was predicted by child mental health, a finding with critical implications for intervention to this vulnerable group of families. Parent mental health also predicted parenting stress for the in-home group and food insecurity predicted parenting stress in the out-of-home group. Findings confirm that stress varies by context and that a multi-dimensional framework, considering both psychosocial and concrete resources, is required to capture contributors to parenting stress. [ABSTRACT FROM AUTHOR]

Background Disasters are associated with myriad negative outcomes in youth, including posttraumatic stress disorder and related psychopathology. Prior work suggests links between caregiver distress and child mental health outcomes following community traumas, but the extent to which caregiver distress is directly linked to post-disaster child functioning, or whether such associations may simply be due to shared traumatic exposure, remains unclear. Methods The current study examined relationships among caregiver distress, caregiver-child shared traumatic exposure, and child outcomes in Boston-area families ( N =460) during the six months following the 2013 Boston Marathon bombing. Parents completed surveys about their and their child׳s potentially traumatic experiences during the bombing and subsequent manhunt. Post-attack caregiver distress and child psychological functioning were also assessed. Results After accounting for caregiver-child shared traumatic exposure, significant associations were retained between caregiver distress and child functioning across several domains. Furthermore, after accounting for caregiver traumatic exposure, caregiver distress moderated relationships between child traumatic exposure and child posttraumatic stress and conduct problems, such that associations between child traumatic exposure and child posttraumatic stress and conduct problems were particularly strong among children of highly distressed caregivers. Limitations The cross-sectional design did not permit evaluations across time, and population-based methods were not applied. Conclusions Findings clarify links between caregiver distress and child psychopathology in the aftermath of disaster and can inform optimal allocation of clinical resources targeting disaster-affected youth and their families. [ABSTRACT FROM AUTHOR]

Abstract: Estimates suggest that most children placed in state custody have mental or behavioral health problems. Many of these children are difficult to place with foster families and ultimately are referred for residential care. Residential care is expensive relative to other alternatives and the effects on child outcomes do not seem to justify the expense. This study identifies systemic factors contributing to the residential placement of young children and opportunities for service improvement in a rural state. Key informant interviews and surveys were used to synthesize a broad array of professional perspectives. Remarkable consensus across multiple groups suggests that young children are best served in a family setting. Strategies to reduce residential placement and improve outcomes of young children are discussed. [Copyright &y& Elsevier]

Highlights: [•] Changes in clinical presentation of autism in Taiwan from 1987 to 1995 are reported. [•] Decreasing first visit age and increasing assessment age across the nine years are noted. [•] Lessening autism symptom and increasing developmental quotients across the nine years are also observed. [•] Improved diagnostic criteria, government policy, and increased awareness are attributed. [Copyright &y& Elsevier]

Abstract: Prevailing child psychopathology paradigms focus on caregiving in isolation from market work. Yet most children's caregivers — mothers and fathers — are also employed. Although policy and academic debate has voiced concerns that employment could hamper mothers' capacity to care, less emphasis is given to the benefits generated by mothers' jobs. By contrast, theories of child mental health often view fathers' employment as beneficial, indeed necessary, for children's wellbeing, and few problematise fathers' capacity to combine work and care. This paper aims to integrate these seemingly contradictory concerns. We consider whether mothers' and fathers' rewards from combining employment with childcare may be protective for children's mental health, and whether their conflicts and dilemmas generate risks. Analyses use cross-sectional data from a representative survey of families with 4–5 year old children (Growing Up in Australia Study). We restricted our sample to employed parents (N = 2809 mothers; 3982 fathers), using data gathered in 2004. While a majority of parents reported benefits and rewards from working (work-family facilitation), more than one third also reported difficulties and conflicts (work-family conflict). When mothers or fathers experienced conflict we found elevations in young children's emotional and behavioural symptoms, with the risks compounding if both parents experienced conflict between work and family. Associations persisted after adjusting for family socioeconomic circumstances and composition, and they were not offset by work-family facilitation. We did not find evidence for heightened vulnerability to work-family conflict in families with few socioeconomic resources. However, among these disadvantaged families we observed stronger protective associations with children's mental health when parents had rewarding and supportive jobs. Our study extends current paradigms of child mental health by considering the interplay between care environments and market work. Jobs which help mothers and fathers to combine employment with caregiving could yield health benefits across generations. [Copyright &y& Elsevier]

Abstract: Using structural equation modeling, this study examined the relationship of caregiver network support on caregiver and child mental health need, as well as child mental health service use among 1075 8-year-old children participating in the LONGSCAN study. The final model showed acceptable fit (Χ 2 =301.476, df=136, p<0.001; RMSEA=0.052; CFI=0.95). Caregiver and child mental health needs were positively related. As predicted, caregiver network support exerted a protective effect, with greater levels of caregiver network support predictive of lower caregiver and child need. Contrary to prediction, however, caregiver network support was not directly related to child service use. Higher child need was directly related to child service use, especially among children whose caregivers had mental health problems. The findings appear to indicate that lower levels of caregiver network support may exert its impact on child service use indirectly by increasing caregiver and child need, rather than by directly increasing the likelihood of receiving services, especially for African American children. [Copyright &y& Elsevier]

Abstract: We present data on predictors of treatment outcome for 3200 consecutive referrals to a child and adolescent psychiatry clinic. Using Reliable Change Index (RCI) methodology, we divided children into those who, between intake and discharge, improved, stayed the same, or got worse according to clinician-rated impairment. Most predictors of improvement were related to parent variables (marital status, maternal anxiety, and ethnicity), while those associated with deterioration were tied to child status (extent of psychiatric comorbidity, history of placement in a self-contained classroom, and a prior trial of psychotropic medications). The implications of these findings for data-driven program development, clinic management, treatment planning, and systems of care are discussed. [Copyright &y& Elsevier]

Abstract: Deliberate firesetting is a significant social problem that causes millions of dollars of property damage each year. Of particular concern is that a high proportion of these arson offences are committed by children and adolescents. Youth firesetters are a unique and diverse group, variant in their motivations, needs and behavior and distinct from their adult counterparts. The study of firesetting has been approached in a number of ways and thus the existing body of research lacks a coherent, consistent and comprehensive set of empirical findings. In synthesizing the literature on child and adolescent firesetting, this review considers the potential relationships between firesetting typologies, risk factors, development and treatment. It considers the extent to which firesetting can be considered within the framework of antisocial behavior and what implications such a relationship may have for clinical practice. The review concludes that despite a number of risk factors being repeatedly identified, an understanding of the etiology behind firesetting behavior and potential developmental trajectories remain theoretically rather than empirically based. Existing typological theories do not take sufficient account of the complexities of firesetting behavior and there is not yet a typology and accompanying assessment that has undergone thorough empirical testing and is of significant clinical utility. Despite indications that the relationship between firesetting and antisocial behavior is of a serious nature, there has been a general lack of attention to this in literature and practice. Attention to this relationship is necessary not just in the area of firesetting research and practice but also amongst those working with youth with behavioral difficulties and conduct problems as for these individuals firesetting is likely to indicate particularly high risk for severity of behavior and future offending. Because of this relationship and the diversity of firesetting populations there is a need for collaborative intervention for firesetters that includes thorough assessment and provides an individualized, and developmentally appropriate approach best suited to the needs of the individual. This review reflects on the methodological limitations as well as clinical implications of existing studies and suggests necessary directions for future research. [Copyright &y& Elsevier]

Abstract: This study examines relations between children''s salivary interleukin-6 (IL-6) and secretory immunoglobulin A (SIgA) and mental health. Child sex was considered as a moderator of relations. Data were from 329 normally developing children (M age=9.85years; SD=.98years); 67% of children were European American and 33% were African American. Saliva samples were obtained during the afternoon and assayed for SIgA and IL-6. Parents completed questionnaire measures of child internalizing and externalizing symptoms, and children completed self-report measures of anxiety and depression. Structural equation models were fit to the data, and indicated that greater levels of salivary IL-6 and SIgA were associated with adjustment problems more strongly for girls than for boys. [Copyright &y& Elsevier]

The article presents a study which examines the trends in health care expenditures in children with autism spectrum disorders (ASDs) in Medicaid in the U.S. The study compared inflation-adjusted expenditures and Medicaid reimbursements from inpatient, outpatient, long-term care, and prescription drugs in 42 states from 2000 to 2003. Results show slight growth of per patient expenditures and large increase in treated prevalence due to the rise of total ASD-associated health care expenditures.

Abstract: This study builds upon existing research by examining whether risk indices for child psychological well-being behave in the same way in different types of neighborhoods. Specifically, we sought to determine if neighborhood characteristics acted to exacerbate or, alternatively, to buffer risk factors at the family and/or child level. Families with a child entering first grade in Fall 2002 were recruited from Baltimore City neighborhoods, defined as census block groups. This study included 405 children, and data came from an interview with the primary caregiver and an assessment of the first grader. The dependent variables were externalizing behavior and internalizing problems. A family risk index consisting of 13 measures, and a child risk index consisting of three measures were the main independent variables of interest. We examined the effects of these indices on child psychological well-being and behavior across two neighborhood characteristics: neighborhood potential for community involvement with children and neighborhood negative social climate. Results of multivariate analyses indicated that cumulative family risk was associated with an increase in both internalizing and externalizing behavior problems. Perceived negative social climate moderated the effect of family risks on behavior problems such that more risk was associated with a larger increment in both externalizing behavior problems and psychological problems for children living in high versus low risk neighborhoods. These findings further emphasize the importance of considering neighborhood context in the study of child psychological well-being. [ABSTRACT FROM AUTHOR]

Abstract: A pilot study using a prospective design examined the impact of a collaboratively developed training model, called the Parent Empowerment Program (PEP), for professionally-employed family peer advocates who work with caregivers of children with mental health needs. This training used a combination of didactic, practice exercises, and group discussion. It targeted specific mental health knowledge content and collaborative skills to facilitate the work of family peer advocates in empowering caregivers. Co-delivered by a family peer advocate and clinician, the training consisted of a 40-hour face-to-face training, followed by six monthly face-to-face booster sessions. A total of 15 advocates participated in assessments conducted at baseline and post-training. This group of experienced family peer advocates showed no significant increase in knowledge about mental health content, but post-training assessments indicated increased collaborative skills and mental health services self-efficacy. This initial evaluation has implications for expanding training and support for the emergent workforce of professionally-employed family peer advocates in children''s mental health. [Copyright &y& Elsevier]

The article presents a study on serious emotional disturbance (SED) among youths who are exposed to hurricane Katrina. It says that more than 1,000 persons were killed by the hurricane and caused property damage of 100 billion dollars. It states that 80% of individuals in hurricane-affected areas are experiencing psychological problems effect among children and adolescents. It mentions that traumatic stress disorder and aggressive behavior among children and adolescents were found.

Abstract: In the context of high and rising rates of parental employment in Australia, we investigated whether poor quality jobs (without security, control, flexibility or paid family leave) could pose a health risk to employed parents’ children. We examined the extent to which both mothers’ and fathers’ jobs matter, and whether disadvantaged children are more vulnerable than others. Multiple regression modelling was used to analyse cross-sectional data for 2004 from the Growing Up in Australia study, a nationally representative sample of 4–5 year old children and their families (N = 2373 employed mothers; 3026 employed fathers). Results revealed that when parents held poor quality jobs their children showed more emotional and behavioural difficulties. The associations with child difficulties were independent of income, parent education, family structure and work hours, and were evident for both mothers’ and fathers’ jobs. Further, the associations tended to be stronger for children in low-income households and lone-mother families. Thus job quality may be another mechanism underlying the intergenerational transmission of health inequality. Our findings also support the argument that a truly family-friendly job must not erode children’s health. [Copyright &y& Elsevier]

The article presents a study which assesses the prevalence of serious emotional disturbance (SED) among youths who were exposed to Hurricane Katrina. In this study, a survey among the residents of areas affected by the hurricane was conducted to assess hurricane-related stressors, the lifetime history of psychopathology of the respondents as well as the SED in their children. Results reveal a 14.9% prevalence rate of SED among youths exposed to Hurricane Katrina.

Abstract: This study examined how one of the oldest and most widely distributed child welfare practice journals addressed children''s mental health issues over a 25-year period. The content of 478 articles was coded. Logistic regression findings indicate that mental health issues were discussed less frequently over the first half of the period examined, and then more frequently over the last decade. Residential treatment was discussed less frequently over time, but other community-based alternatives to residential treatment were rarely discussed at any point, so that overall the content related to treatment of mental health issues decreased as discussion of residential treatment decreased. These findings suggest that although the child welfare literature has recently focused more on children''s mental health, dissemination of specific concepts from the mental health to the child welfare literature does not naturally occur over time. Efforts targeted at dissemination of effective community-based mental health interventions for foster children may be needed to support this process. [Copyright &y& Elsevier]

Abstract: Objective: This observational study explores pathways towards any past year use of child mental health services. Methods: Data from the 2002 National Survey of American Families were used to explore the relationship between past month maternal mental health and past year child mental health services use. Observations were limited to the 8072 most knowledgeable adults who were the mothers of target children aged 6–11. Logistic regressions were performed to determine the odds of any child mental health service use followed by path analyses using Maximum Likelihood estimation with robust standard errors. Results: Multiple factors were associated with odds of any child mental health service use. In the path analytic model poor past month maternal mental health was associated with increased aggravation which in turn was associated with increased use of mental health visits. Negative child behaviors as reported by the mother were also associated with increased maternal aggravation and increased service use. Conclusions: Parental perception of child behaviors influences treatment seeking, both directly and indirectly through parental aggravation. Parental mental health influences tolerance for child behaviors. Findings are consistent with other studies. Interventions should address the entire family and their psychosocial circumstances through collaboration between multiple service sectors. [Copyright &y& Elsevier]

Abstract: Objective: To assess whether differences between individual Preventive Child Health Care (PCH) professionals in the percentage of children they identify as having psychosocial problems are larger than expected based on chance and whether such differences can be explained by differences in parent-reported problems or risk indicators. Study Design: We used data from three community-based studies among 3,170 Dutch children aged 8 till 12 years, invited for a routine health examination. Parents filled in the Child Behavior Checklist (CBCL) and questions on demographic characteristics. After the examination, PCH professionals registered whether they had identified any psychosocial problem in the child. We examined differences between professionals in the rate of identified children. We used multilevel logistic regression analysis to assess whether such differences could be explained by parent-reported problems or risk indicators. Results: Significant differences between PCH professionals were found (P <0.001). These differences could not be explained by parent-reported problems or risk indicators. The differences were largest for children with a score above the CBCL clinical cut-off point. Conclusion: Some PCH professionals are more likely to identify psychosocial problems than others, independently from parent-reported problems or other risk indicators. [Copyright &y& Elsevier]

Abstract: This paper describes scales available to assess the mental health of children and adolescents. These have generally been designed for research purposes but they can also be used clinically to document the quantity and quality of symptomatology, provided that undue emphasis is not placed on suggested cut-off scores. We outline general screening measures for psychiatric disorder, for emotional and externalizing disorders, for eating disorders, autism and for self-esteem. We also describe instruments used to document outcomes of contact with mental health services and case complexity. There are many scales that may be useful adjuncts to clinicians working within and outside child and adolescent mental health services. This contribution has discussed only a small proportion of those available. While these should not serve as a substitute for the clinical interview, they may inform diagnostic assessment and the monitoring of treatment response. [Copyright &y& Elsevier]

Summary: This past century has seen a 15-fold decrease in child mortality and a 56% increase in life expectancy in the United States of America. A shift has occurred in morbidity and mortality from infectious diseases to that from unintentional injuries. New morbidities such as obesity, atopic disease and mental health dominate public health discussion. This article reviews factors contributing to these shifts: (1) new patterns in sociodemographic trends for children and families; (2) paradigm shifts in the financing and delivery of child health services; (3) new morbidity and mortality from changing disease patterns; (4) challenges and promise of genetic therapy and (5) E-health. In addition, we speculate on future directions in US child health and the new role of paediatricians in this century. [Copyright &y& Elsevier]

Summary: This article describes a study conducted in England as part of the preparation work for the Children’s Taskforce, looking at the training needs of specialist Child and Adolescent Mental Health Service (CAMHS) staff, and of primary care staff who work with children and young people. A survey of existing service provision and of training opportunities was conducted, and as a result a series of recommendations for future training needs within CAMHS are made. It includes the needs of the developing role of Primary Mental Health Workers (PMHWs) within this area in their crucial link position between primary and secondary services. The study is multi-disciplinary in nature, given that all CAMHS teams are provided by multi-professional workers. Since this work was undertaken the workforce development plans for future CAMHS have progressed under the Children’s Taskforce, with the National Service Framework for Children being published in October 2004. [Copyright &y& Elsevier]

Public health researchers have provided a growing body of evidence on the salutary effects of social capital for individual well being. The importance of these findings for social epidemiology, however, may have precluded so far a full examination of the complex association between neighborhood social processes and the well being of individual residents, including the often acknowledged potential “downside” of social capital. In this study, we examine the association between attachment to community, an indicator of social capital, in a sample of African American parents, and the presence of behavior problems in their preschool children. Participants were recruited from a socioeconomically diverse set of neighborhoods. Attachment to community was assessed using a multi-item scale comprised of two subscales, general sense of community and how well one knew one''s neighbors. Results indicated that the association between how well a parent knew her neighbors and the presence of child behavior problems differed depending on the degree of economic impoverishment of the neighborhood. In wealthy neighborhoods, children whose parent reported knowing few of the neighbors had higher levels of internalizing problems such as anxiety and depression compared to those who knew many of their neighbors. In contrast, in poor neighborhoods, children whose parent reported knowing few of the neighbors had lower levels of internalizing problems compared to those who knew many of their neighbors. These results are discussed in terms of furthering the study of the contextual nature of the social capital in explaining community inequalities in mental health among children. [Copyright &y& Elsevier]

This study uses Children of the National Longitudinal Survey of Youth to test for evidence of a causal relationship between maternal alcohol, marijuana, and cocaine use, and children's behavior problems. Ordinary least squares (OLS) results provide strong evidence that substance use is associated with behavior problems. However, OLS estimation fails to account for unobserved factors that may be correlated with substance use and child behavior. To account for this problem, mother-child and family fixed-effects models are tested. The results suggest that maternal illicit drug use is positively associated with children's behavior problems, while alcohol use has a less consistent impact. [ABSTRACT FROM AUTHOR]