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Migration can put an important psychological stress on families. The aim of this study was to assess the mental health of migrant children and their parents followed at the Children’s Hospital of Lausanne (HEL) in Switzerland to emphasize potential areas for intervention. We conducted an exploratory study at the Policlinic of HEL from March 2021 to December 2022. Questionnaires included the Strengths & Difficulties Questionnaire (SDQ) addressed to children aged 4–17 years old, the World Health Organisation-Five Well-Being Index (WHO-5) filled in by their parents and socio-demographic questions related to migration. Forty-two children of 33 families (26 mothers, 7 fathers) were included. A raised total difficulties score was observed in 19% of children, emotional problems in 26%, conduct problems in 24% and peer problems in 21% of them. Longer stay in Switzerland correlated with higher total difficulties (p = 0.001), emotional problems (p = 0.0099) and conduct problems (p = 0.0080). Children with insecure legal status and those in single-parent families had higher total difficulties scores (p = 0.041 and p = 0.018, respectively). Thirty percent of parents had a WHO-5 score ≤ 50, indicating poor well-being (n = 30), which was associated with increased emotional problems(p = 0.049) and lower prosocial scores (p = 0.006) in children. While many migrant children exhibit resilience, this study emphasizes their susceptibility to multiple chronic stressors in the post-migration phase. [ABSTRACT FROM AUTHOR]

There is evidence of an overall decline in women's mental health, particularly those with young children, in the wake of the COVID-19 pandemic. However, research has also found heterogeneity in women's mental health responses. This longitudinal study sampled low-income women with young children by recruiting from the government's child care financial subsidy waitlist. To examine heterogeneity in women's mental health responses to COVID-19, a latent transition analysis was employed to identify profiles of anxiety, depression, and stress among 289 low-income mothers. Using these identified profiles, we examined the transitional patterns between profiles before and during COVID-19 and the sociodemographic and familial factors related to these profiles. A three-profile solution was identified prior to COVID-19 and a four-profile solution during COVID-19, with some profiles exhibiting qualitatively different defining characteristics. Latent transition analyses found diverse patterns of mental health changes after the onset of COVID-19. Mothers with better mental health prior to COVID-19 tended to have the most stable mental health during COVID-19. In contrast, mothers who were highly stressed prior to COVID-19 were equally likely to improve or decline after the onset of the pandemic. In addition, the relationships between race, parenting practices, child temperament, and child mental health were significantly related to mothers' mental health profiles. These findings describe mothers' experiences and areas where policymakers and practitioners can tailor support to low-income women with young children. Significance: What is already known on this subject?: There is a bidirectional relationship between maternal and child mental health. Child and maternal mental health challenges increased, on average, during the COVID-19 pandemic. What this study adds?: A person-centred longitudinal approach is an effective tool for identifying maternal mental health profiles over time. It provides a more nuanced understanding of how mothers' mental health is impacted. Low-income mothers' responses to the pandemic were heterogeneous and did not uniformly decline as previously (majorly) reported. In addition, poor maternal and child mental health and difficult child temperament pre-COVID-19 were risk factors for poor mental health trajectories in mothers from low-income families. [ABSTRACT FROM AUTHOR]

Specific pregnancy complications, socioeconomic position and sex have all been independently associated with child mental health outcomes, but their combined effects remain unclear. We examined whether total number of complications experienced in the pregnancy associated with mental health at 5 and 9-years, and whether this varied by sex or adverse social circumstances. Pregnancy complications were self-reported at 9-months post-natally from a list of 16 complications. Parents completed the Strengths and Difficulties Questionnaire (SDQ) when their child was 5 and 9-years. The primary outcome was the SDQ-total and scoring in the clinical range (> 16) was a secondary outcome. We applied generalized linear mixed models to a large nationally representative Irish cohort (GUI; n = 11,134). Analyses were adjusted for sex, adverse social circumstances (at 9-months), and gestational smoking. We included an interaction term between pregnancy complications and each variable respectively in separate models to examine if associations varied by sex or adverse circumstances. After controlling for covariates, total complications associated with mental health at 5 and 9-years. Each additional pregnancy complication conferred a 10% higher total-SDQ score (exponentiated co-efficient 1.10 [95%CI 1.06–1.14], 1.20 [1.15–1.26], 1.20 [1.12–1.29] and 1.34 [1.21–1.48] for 1, 2, 3 and 4 + complications respectively). For the dichotomised outcome, generally increasing odds for clinical levels of mental health difficulties were observed (OR 1complication = 1.89, 95%CI [1.37–2.59]; OR 2complications = 2.31, 95%CI [1.53–3.50]; OR 3complications = 1.77, 95%CI [0.89–3.52]; OR 4 + complications = 6.88, 95%CI [3.29–14.40]). Females had significantly lower odds of exhibiting clinically significant mental health difficulties than males (OR = 0.43, 95%CI[0.32–0.57]). There was no evidence that the association between pregnancy complications and child's mental health varied by sex or social circumstances at 5 or 9-years. Males exposed to numerous pregnancy complications in the context of adverse social circumstances had the highest predicted probability of having mental health difficulties in middle childhood. [ABSTRACT FROM AUTHOR]

Background/Objectives: Most studies have linked mandatory homeschooling during COVID-19 to mental health harm in parents and children, while a minority have found non-significant or beneficial effects. Past studies have not measured mandatory homeschooling continuously over an extended period; consequently, they could not capture compounding mental health effects, which may explain conflicting results. We asked whether children's cumulative time spent homeschooled during COVID-19 school closure mandates caused compounding harm for parent and child mental health, and whether parent employment, child internet access and educational support from schools (live and pre-recorded online classes, home learning packs) impacted this relationship. We aimed to identify the families at greatest risk of mental health harm during mandatory homeschooling and the educational support that may have mitigated this risk. Methods: Couples completed retrospective, cross-sectional survey questionnaires assessing parent depression, anxiety and stress, child internalizing and externalizing symptoms, and the family's homeschooling experience. Data were analyzed using mediation analysis total effects, ordinary least squares regression and simple slopes analysis. Results: Both parents and children experienced compounding mental health harm during mandatory homeschooling. Live online classes protected parents and children, while home learning packs protected children. Unexpectedly, reliable internet access and the employment of both parents placed children at greater risk. Conclusions: Findings suggest that long-term mandatory homeschooling during COVID-19 placed families at greater risk of mental health harm. To protect family mental health during homeschooling mandates, schools should provide children with evidence-based educational support. [ABSTRACT FROM AUTHOR]

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]

Instability in early childhood education and care (ECEC) arrangements may have detrimental consequences on children's mental health. This study examined ECEC trajectories in the first 30 months of life for 373 children from low-income families in Toronto. We provide information about patterns of instability and reasons for instability. We also tested whether instability in ECEC was related to children's mental health using the Strengths and Difficulties Questionnaire. Five main profiles of ECEC stability were identified: (1) 8% in Home-Only, (2) 56.3% in Home-Center, (3) 8.0% in Home-Center-Home, (4) 5.9% in In-and-Out, and (5) 20.9% in Home-Multiple-Centers. Frequently mentioned reasons for change were a new baby in the family, availability of grandparents, quality of ECEC and family relocation. Families in these different profiles had similar demographic characteristics. Of the five profiles, children in the Home-Center-Home profile had a significantly higher likelihood of experiencing mental health problems compared to the Home-Center and Home-Multiple-Centers groups. These findings have important implications for future research, policy and practice related to ECEC availability. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions While research has described the profile of children with poor mental health, little is known about whether this profile and their needs have changed over time. Our aim was to investigate whether levels of difficulties and functional impact faced by children with a psychiatric disorder have changed over time, and whether sociodemographic and family correlates have changed.Samples were three national probability surveys undertaken in England in 1999, 2004 and 2017 including children aged 5–15 years. Psychiatric disorders were assessed using the Development and Well‐Being Assessment (DAWBA), a standardised multi‐informant diagnostic tool based on the tenth International Classification of Diseases (ICD‐10). The impact and difficulties of having a disorder (emotional, behavioural or hyperkinetic) were compared over time using total difficulty and impact scores from the Strengths and Difficulties Questionnaire (SDQ). Analyses explored the impact of having any disorder, as well as for each disorder separately. Regression analyses compared associations between disorders and sociodemographic factors over time.Parent‐ and adolescent‐reported total SDQ difficulty and impact scores increased between 1999 and 2017 for children and adolescents with disorders. No differences were noted when using teacher ratings. No differences in total SDQ difficulty score were found for children without a disorder. Comparison of sociodemographic correlates across the surveys over time revealed that ethnic minority status, living in rented accommodation and being in the lowest income quintile had a weaker association with disorder in 2017 compared to 1999.Our study reveals a concerning trend; children with a disorder in 2017 experienced more severe difficulties and greater impact on functioning at school, home and in their daily lives, compared to children with a disorder in earlier decades. Research is needed to identify and understand factors that may explain the changing nature and level of need among children with a disorder. [ABSTRACT FROM AUTHOR]

Introduction: The benefits of physical activity for mental health and well-being and the associations between parental mental health and children's mental health have been well established. These important issues tend to be examined separately however, and there is limited research on the associations between parent and child physical activity and mental health when all considered together. While family focused practice is recommended to provide support for parents who have mental health problems and their families and includes various components (such as psychoeducation, support for mental health and parenting), promoting physical activity for parents and children is not usually a core component of these interventions. Methods: The Northern Ireland Youth Wellbeing Survey aimed to provide estimates of the prevalence of mental health problems among children and young people. The survey also included questions about parental physical activity, parental mental health, and children's physical activity (for those aged 11-19 years). The main aim of the analysis reported in this article was to explore possible bivariate associations between parent and child physical activity and mental health and also explore these associations when all considered together. Participants were included in the analysis where there were completed interviews for the young person and one of their parents, and both young person and parent provided responses in relation to questions on weekly physical activity (n = 882). Results: The findings highlight the positive associations between parental physical activity and parental mental health, and between children's physical activity and children's mental health. They also explore some of the more complex interactions between these four variables, which suggest that gender may also be an important consideration. There were significant associations between father's physical activity and son's mental health, and son's physical activity and father's mental health. Discussions: These findings suggest that including support for parental physical activity and children's physical activity should be a routine component of family focused mental health interventions. It is important to acknowledge that there may be additional barriers to engaging in physical activity for families where a parent is experiencing mental health problems, and these should also be explored and addressed. [ABSTRACT FROM AUTHOR]

Maternal childhood maltreatment (CM) represents an important factor in the transmission of trauma that may lead to impaired child mental health. Apart from childhood maltreatment insecure attachment has been identified as a risk factor for insensitive caregiving behavior, which may affect child's mental health. The aim of this study is to identify the working mechanisms in the relationship between maternal CM and child mental health, considering maternal attachment representation, mother–child-interaction und maternal helplessness and fear. N = 103 mother–child-dyads from a longitudinal cohort study were examined at four different measuring points. Data was assessed using self and external report questionnaires as well as the AMBIANCE scales during the Strange Situation Procedure and the Adult Attachment Projective Picture System (AAP). Maternal CM experience did not predict an insecure attachment representation (OR = 2.46 [0.98, 6.53], p =.060). Maternal insecure attachment was associated with higher AMBIANCE scores (F(8, 94) = 11.46, p <.001), which indicates more disrupted communication between mother and child. AMBIANCE scores in turn predicted higher self-perceived helplessness (F(9, 93) = 8.62, p <.001) and fear (F(9, 93) = 7.40, p <.001) in mothers. Helplessness and fear both were associated with higher SDQ-scores, indicating more mental health problems in children (F(10, 92) = 3.98, p <.001; F(10, 92) = 3.87, p <.001). The results of this study highlight how even insecure attachment in a low-risk sample has a long-term impact on parenting behavior and child mental health, therefore underlining the need of early intervention programs in affected and at-risk families. [ABSTRACT FROM AUTHOR]

How Black Americans in the United States (U.S.) make sense of a sociopolitical climate marked by racist imagery, tensions, and police violence is important to understand given the numerously documented detrimental effects of racism‐related stress on the well‐being of Black parents and children. Informed by Racism‐Related Stress Theory, the current study employed a convergent parallel mixed methods design to better understand the ways racism‐related stressors in the sociopolitical climate impacted the daily lives and mental health of a sample of Black families with low income. Seventy‐eight Black American preadolescents (Mage = 11.0; 43.6% girls) and their parents (79% mothers; 76% living below the U.S. federal poverty level [FPL]) from the southwestern U.S. reported their symptoms of depression and how they had been affected by racial stressors in the sociopolitical climate between Fall 2018 and Summer 2019. A nested sample of 10 parents (80% mothers; 80% living below the FPL) from the quantitative sample also participated in a semi‐structured interview. Meta‐inferences across methods were drawn pertaining to the influence of child gender on parents' interpretation of effects for children, the toll racism‐related stress in the sociopolitical climate takes on Black families, and the transferal of effects on parents to children through parenting and parental depressive symptoms. Findings spotlight the need for policies and family‐centered programming that address the racism‐related stress faced by many Black youth and their families. Providing families with opportunities and tools that can potentially mitigate harmful effects and foster empowerment could promote positive and lasting change. [ABSTRACT FROM AUTHOR]

The Gaza Strip is a notoriously high-conflict area, but few large-scale studies have examined the rates of psychiatric distress and emotional/behavioral problems among Gaza youth, and there are few trauma-informed, scaleable intervention options. Studies in existence have used smaller samples or have examined focal problems such as posttraumatic stress disorder (PTSD) or aggression. Here, we examine the mental health burden of young individuals (ages 8-13) in Gaza across a broad range of symptoms, and demonstrate the impact of a community-based, trauma-informed program, Eye to the Future. At the outset of this supportive youth program, over 2000 children and adolescent youth and their parents reported on child well-being using standardized measures with established global norms (the Child Behavior Checklist and Youth Self Report). These measures examine symptoms broadly (e.g. anxiety, depression, social problems, attention problems, aggression, etc.). Relative to U.S. population estimates, children in Gaza had between 2.5- and 17-times higher point prevalence of clinical mental health problems. The most significant clinical concern was anxiety, but overall, their symptoms were not confined to posttraumatic stress as a disorder and were instead broadly dispersed. However, these concerns were responsive to intervention: over the course of a six-month community psychosocial program, symptoms ameliorated, with approximately 50–70% showing reliable improvement at post-program (varying by measure). These gains were maintained in a 9-month follow-up. Future work should consider the broader mental health impact, beyond PTSD and aggression, and incorporate community supports into addressing mental health among children in the region. [ABSTRACT FROM AUTHOR]

The popularity of mobile gaming is increasing globally, fueled by technological advancements, high-quality smartphones with gaming features, and widespread internet access. A large number of young people and also children are mainly involved in different types of mobile gaming, primarily online mobile gaming, which is a matter of concern for society. This addiction leads to various psychological issues, including mental health problems, loneliness, introversion, insomnia, and a lack of self-control. Bangladesh's lack of public mental health facilities exacerbates this challenge, particularly in rural areas. To address this issue, we have developed a machine learning model to predict the level of mental health issues faced by Bangladeshi urban children due to gaming addiction. A total of 1996 data were collected from urban parents about their children's gaming activities and categorized them as 'Serious,' 'Partial,' and 'Normal.' The dataset was then split into a 70:30 ratio for training and testing purposes. K-Nearest Neighbors (KNN), Support Vector Machine (SVM), Multinomial Naïve Bayes, & Random Forest were applied as the machine learning approaches for prediction. Here, the Support Vector Machine gives good accuracy (92.75%), and other classifiers have different accuracy. The research highlights the significance of addressing gaming addiction in children and the potential of machine learning technology in predicting mental health issues, particularly in the absence of public mental health services. The study concludes by proposing the expansion of the research to include smartphone and mobile gaming addiction among Bangladeshi rural children and ensure a holistic approach to tackling the broader issue of technology-related addiction. [ABSTRACT FROM AUTHOR]

Objectives: This study describes the prevalence, associated factors and child mental health outcomes related to symptoms of maternal depression and anxiety within 5 years after childbirth in a rural district in Nepal. This association is not well‐understood in rural, community‐based settings in low‐ and middle‐income countries (LMIC). Methods: A sample of 347 women with children under 5 years was recruited in September 2019 for a cross‐sectional study in the rural Saptari district in Nepal. Multivariable logistic regression was used to investigate the association between maternal depressive or anxiety symptoms and children's experience and impact of emotional and behavioural difficulties. Results: In total, 144 women (41.5%) had moderate or severe depression symptoms and 118 (34%) had anxiety symptoms. Mothers with a lower income were more likely to have anxiety symptoms than the highest income group (OR: 1.8, 95% CI: 1.1–3.0). An association existed between maternal depressive symptoms and the impact of emotional or behavioural difficulties in children (OR: 2.44, 95% CI: 1.02–5.84). In contrast, there was no association between maternal anxiety and child outcomes. Conclusions: Our findings suggest that the prevalence of probable maternal anxiety and depression symptoms was relatively high in this rural, low‐resourced and community‐based setting in Nepal. Maternal depressive symptoms were associated with the degree of impact on children's mental health post‐infancy, emphasising the importance of improving maternal mental health in the early years of a child's life. [ABSTRACT FROM AUTHOR]

Child and Adolescent Mental Health Services (CAMHS) have been under recent increased demand, with increasingly limited resources, contributing to longer waiting lists, and a growing proportion of rejected referrals due to limited capacity and increasing thresholds. Child and Wellbeing Practitioners (CWPs) provide an opportunity to meet the needs of rejected referrals. We aimed to determine the feasibility of a new and direct referral route within a South London CAMHS. All referrals rejected to the local CAMHS in one year were assessed for inclusion to an embedded child and youth wellbeing in schools team (CYWS), and data collected on reasons for rejection, demographics and eligibility for the CYWS team. Of the 1,322 referrals made to CAMHS in this period, 317 were rejected. The most common reason for referral rejection was not meeting the severity threshold. One third of rejected referrals were judged to be eligible for inclusion to the CYWS team. Therefore, a significant number of children and young people (CYP) being rejected by CAMHS would be eligible for assessment and possible treatment under the CYWS team, making a new referral route potentially feasible, allowing more CYP to access mental health support and have a positive impact on waiting times. [ABSTRACT FROM AUTHOR]

Background: Family is one of the most influential social institutions and caregivers act as the main protective factors for children's mental health and resilience skills. Family skills programmes support caregivers to be better parents and strengthen positive age-specific and age-appropriate family functioning and interactions. We developed a universal, brief and light programme for implementation in low-resource settings, the Family UNited (FU) programme, and conducted a pilot study to show feasibility of implementation, replicability and effectiveness in improving family functioning, child behaviour and resilience. Methods: We recruited caregivers with children aged 8–14 years through schools in East Java, Indonesia and Dhaka, Bangladesh to the FU programme. Demographic data, emotional and behavioural difficulties of children, child resilience and parental skills and family adjustment measures were collected from children and caregivers before, 2 and 6 weeks after the intervention. Outcome was assessed through the SDQ (Strengths and Difficulties Questionnaire), PAFAS (Parenting and Family Adjustment Scales) and CYRM-R (Child and Youth Resilience Measure). Results: We enrolled 29 families in Bangladesh and allocated 37 families to the intervention and 33 to the control group in Indonesia. Overall, there was no effect over time in the control group on any of the PAFAS subscales, whereas significant reductions in scores were found on six of the seven subscales in either country in the intervention group, most prominently in caregivers with higher scores at baseline. We found highly significant reductions in total SDQ scores in the intervention group in both countries, whereas there was no effect over time in the control group in Indonesia. Boys in the intervention group in Indonesia and in Bangladesh seemed to have benefitted significantly on the SDQ as well as the total resilience scale. Overall, on the CYRM-R, particularly children below the 33rd percentile at pre-test benefitted substantially from the programme. Conclusions: The implementation of a brief family skills programme was seemingly effective and feasible in resource-limited settings and positively improved child mental health, resilience and parenting practices and family adjustment skills. These results suggest the value of such a programme and call for further validation through other methods of impact assessment and outcome evaluation. Trial registration: Clinical Trial Registration: ISRCTN99645405, retrospectively registered, 22 September, 2022. [ABSTRACT FROM AUTHOR]

It is theorised that adventurous play offers learning opportunities that help to prevent mental health problems in children. In this study, data from two samples is used to examine associations between the time that children aged 5–11 years spent playing adventurously and their mental health. For comparison, time spent playing unadventurously and time spent playing outdoors are also examined. Study 1 includes a sample of 417 parents, Study 2 includes data from a nationally representative sample of 1919 parents. Small, significant associations between adventurous play and internalising problems, as well as positive affect during the first UK-wide Covid-19 lockdown, were found; children who spend more time playing adventurously had fewer internalising problems and more positive affect during the Covid-19 lockdown. Study 2 showed that these associations were stronger for children from lower income families than for children from higher income families. The results align with theoretical hypotheses about adventurous play. [ABSTRACT FROM AUTHOR]

Earthquakes have a negative impact on the mental health of children and adolescents. This article aimed to review common psychiatric reactions in children and adolescents after earthquakes, common psychiatric disorders such as acute stress disorder and post-traumatic stress disorder, grief, psychological first aid, child psychiatric consultation services during earthquakes, and preventive mental health approaches before earthquakes. In the first phase after an earthquake, children may experience normal acute stress reactions. Grief reactions due to loss of life may also be observed. Early psychological first aid is recommended for all child affected by an earthquake. The development of mental disorders such as post-traumatic stress disorder in children with severe and prolonged acute stress reactions and in high-risk populations warrants attention and early intervention. Post-traumatic stress disorder is a severe psychiatric disorder which can have long-term negative consequences. Appropriate use of child psychiatric inpatient services may be beneficial. Delirium is an urgent neuropsychiatric condition which requires careful management in this patient group. To reduce the impact of earthquakes on children's mental well-being, preventive mental health services should be strengthened. [ABSTRACT FROM AUTHOR]

This research focuses on developing Islamic mindfulness-based play activities to mitigate child mental health issues in the post-pandemic context. The study was conducted in Jakarta-Depok kindergartens using a modified Research and development (R&D) approach tailored for educational settings, as per Borg and Gall. The primary aim was to create and evaluate educational tools to foster Islamic mindfulness among young learners. The research involved identifying children's learning challenges post-pandemic and developing and refining educational games and teaching methods. Data collection encompassed observational studies, educator feedback, and direct interaction with children using the developed tools. The analysis evaluated these tools' usability, engagement level, and educational impact. The results highlighted the development of a physical model comprising a 14-chapter guidebook for tea. Still, it is a procedural model that condenses the original ten stages into seven. Essential components include yoga based on prayer movements, activities for enhancing food relationships, self-body awareness exercises, sensory training, gratitude journal writing, and positive affirmations based on Asmaul Husna. Evaluations by material and learning design experts and one-to-one teacher tests affirmed the model's quality. A field trial with 20 children showed enjoyment and preference for gratitude journal writing. Conclusively, the research effectively developed a model for Islamic mindfulness-based play activities, demonstrating the potential to enhance children's mental health post-pandemic. However, limitations such as geographic confinement and individual response variability suggest the need for broader application and further research to assess long-term impacts. This study contributes significantly to educational and psychological interventions, offering a culturally sensitive, holistic child development approach integrating mental health, spirituality, and education. [ABSTRACT FROM AUTHOR]

Purpose: Despite growing recognition that unfortunately common maternal stress exposures in childhood and pregnancy may have intergenerational impacts on children's psychiatric health, studies rarely take a life course approach. With child psychopathology on the rise, the identification of modifiable risk factors is needed to promote maternal and child well-being. In this study, we examined associations of maternal exposure to childhood traumatic events (CTE) and pregnancy stressful life events (PSLE) with child mental health problems in a large, sociodemographically diverse sample. Methods: Participants were mother–child dyads in the ECHO-PATHWAYS consortium's harmonized data across three U.S. pregnancy cohorts. Women completed questionnaires regarding their own exposure to CTE and PSLE, and their 4–6-year-old child's mental health problems using the Child Behavior Checklist (CBCL). Regression analyses estimated associations between stressors and child total behavior problems, adjusting for confounders. Results: Among 1948 dyads (child age M = 5.13 (SD = 1.02) years; 38% Black, 44% White; 8.5% Hispanic), maternal history of CTE and PSLE were independently associated with children's psychopathology: higher CTE and PSLE counts were related to higher total problems ([ßCTE = 0.11, 95% CI [.06,.16]; ßSLE = 0.21, 95% CI [.14, 0.27]) and greater odds of clinical levels of problems (ORCTE = 1.41; 95% CI [1.12, 1.78]; ORPSLE = 1.36; 95% CI [1.23, 1.51]). Tests of interaction showed PSLEs were more strongly associated with child problems for each additional CTE experienced. Conclusion: Findings confirm that maternal exposure to CTE and PSLE are independently associated with child mental health, and history of CTE exacerbates the risk associated with PSLE, highlighting intergenerational risk pathways for early psychopathology. Given the prevalence of these exposures, prevention and intervention programs that reduce childhood trauma and stress during pregnancy will likely positively impact women's and their children's health. [ABSTRACT FROM AUTHOR]

Schools are often seen as a key setting for the provision of mental health support for children. This study aimed to explore the professional perspectives of primary school educators in Victoria, Australia, regarding how schools can support the mental health of their students. Semi-structured interviews and focus groups were conducted with 17 primary school educators, from four schools. Thematic analysis was used to generate themes from the data. This study indicates that educators report significant concerns about the complexities of their role and their capacity to support children's mental health due to a lack of resources, overwhelming demands, and inadequate training. Educators highlighted the importance of partnership and communication with families and of a school culture that prioritises mental health. This study provides insights into external factors that can undermine effective support of children's mental health within primary schools and indicates a need for a more integrated approach to supporting children's mental health across education and healthcare. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to examine the intergenerational effects of maternal adverse childhood experiences (ACEs) and child mental health outcomes in rural Uganda, as well as the potentially mediating role of maternal depression in this pathway. Additionally, we sought to test the extent to which maternal social group membership attenuated the mediating effect of maternal depression on child mental health. Methods: Data come from a population‐based cohort of families living in the Nyakabare Parish, a rural district in southwestern Uganda. Between 2016 and 2018, mothers completed surveys about childhood adversity, depressive symptoms, social group membership, and their children's mental health. Survey data were analyzed using causal mediation and moderated‐mediation analysis. Results: Among 218 mother–child pairs, 61 mothers (28%) and 47 children (22%) showed symptoms meeting cutoffs for clinically significant psychological distress. In multivariable linear regression models, maternal ACEs had a statistically significant association with severity of child conduct problems, peer problems, and total child difficulty scores. Maternal depression mediated the relationship between maternal ACEs and conduct problems, peer problems, and total difficulty, but this mediating effect was not moderated by maternal group membership. Conclusions: Maternal depression may act as a potential mechanism linking maternal childhood adversity with poor child mental health in the next generation. Within a context of elevated rates of psychiatric morbidity, high prevalence of childhood adversity, and limited healthcare and economic infrastructures across Uganda, these results emphasize the prioritization of social services and mental health resources for rural Ugandan families. [ABSTRACT FROM AUTHOR]

The impact of socioeconomic status (SES) on early child development is well-established, but the mediating role of parental mental health is poorly understood. Data were obtained from The Avon Longitudinal Study of Parents and Children (ALSPAC; n = 13,855), including measures of early SES (age 8 months), key aspects of development during mid-late childhood (ages 7–8 years), and maternal mental health during early childhood (ages 0–3 years). In the first year of life, better maternal mental health was shown to weaken the negative association between SES and child mental health. Better maternal mental health was additionally shown to weaken the association between SES and child cognitive ability. These findings highlight the variability and complexity of the mediating role of parental mental health on child development. They further emphasise the importance of proximal factors in the first year of life, such as parental mental health, in mediating key developmental outcomes. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has had an acute impact on child mental and social health, but long-term effects are still unclear. We examined how child mental health has developed since the start of the COVID-19 pandemic up to 2 years into the pandemic (April 2022). Methods: We included children (age 8-18) from two general population samples (N = 222-1333 per measurement and N = 2401-13,362 for pre-covid data) and one clinical sample receiving psychiatric care (N = 334-748). Behavioral questionnaire data were assessed five times from April 2020 till April 2022 and pre-pandemic data were available for both general population samples. We collected parent-reported data on internalizing and externalizing problems with the Brief Problem Monitor and self-reported data on Anxiety, Depressive symptoms, Sleep-related impairments, Anger, Global health, and Peer relations with the Patient-Reported Outcomes Measurement Information System (PROMIS®). Results: In all samples, parents reported overall increased internalizing problems, but no increases in externalizing problems, in their children. Children from the general population self-reported increased mental health problems from before to during the pandemic on all six PROMIS domains, with generally worst scores in April 2021, and scores improving toward April 2022 but not to pre-pandemic norms. Children from the clinical sample reported increased mental health problems throughout the pandemic, with generally worst scores in April 2021 or April 2022 and no improvement. We found evidence of minor age effects and no sex effects. Conclusions: Child mental health in the general population has deteriorated during the first phase of the COVID-19 pandemic, has improved since April 2021, but has not yet returned to pre-pandemic levels. Children in psychiatric care show worsening of mental health problems during the pandemic, which has not improved since. Changes in child mental health should be monitored comprehensively to inform health care and policy. [ABSTRACT FROM AUTHOR]

This research aims to investigate the impact of the family on the social support for children with mental health disorders in a vulnerable environment such as the COVID-19 pandemic and the ability of parents to provide consistent care giving using their social support. The main question of this research paper is: what is the impact of the family in the situation of COVID-19 on the diversity of the processes actors provided in creating social adaptability for children with mental health? The previous question was treated via the following hypotheses: H1: the more the whole family is committed to the social support of the child with a mental health disorder, the less independent the achievement of resilience on an individual basis; H2: the more the child with a mental illness belongs to the family, the greater the family's involvement in social support, even for low-income families. This quantitative field study was conducted in southern Morocco by contacting a sample of respondents (86 respondents) from health institutions, civil society, and the children's parents and relatives. The study reflected two main findings: that the majority of children were with their families during the pandemic; and the lack of independence of parents and children in the adjustment process. [ABSTRACT FROM AUTHOR]

Background: Time-out (TO) is a widely used parental discipline strategy with strong research support in programmes that promote positive child development. Concerns have been raised, however, regarding adverse impact on child mental health (CMH) in part driven by evidence of widespread variability in appropriate implementation. There are no existing measures of TO. We present the first measure of procedural implementation of TO in a community sample of parents of children aged 6–8 years. Methods: A nationally representative sample (N = 474) of parents completed a survey on the implementation of TO, parent-child relationships, and emotional and behavioural difficulties. The scale of TO use was used to test the convergent validity between TO implementation and parenting practices/family adjustment and CMH. Results: Consistent with international research, >70% of parents have used TO with their children. There was high variability in the levels of appropriate implementation of TO. Scale reliability (Cronbach's alpha) was acceptable and tests of convergent validity indicated that as expected, less appropriate implementation of TO was associated with worse CMH and poorer parenting and family adjustment. Conclusions: The current findings suggest that the scale is a psychometrically sound instrument for measuring the appropriate procedural implementation of TO with young children. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and the public health measures adopted to contain it have highlighted the centrality of the work-family interface in the etiology of mental health among the employed population. However, while the impact on the mental health of workers has been well documented, the relationship with the mental health of children of those workers remains to be clarified. A systematic review was conducted through the identification of peer-reviewed studies on the association between parental work-family interface (e.g. work-family conflict and/or work-family enrichment) and children's mental health. This method is based on the consultation of 7 databases (MEDLINE, PubMed, Web of Science, PsycINFO, SocIndex, Embase, and Scopus), considering all studies published through June 2022 (PROSPERO: CRD42022336058). Methodology and findings are reported according to the PRISMA guidelines. 25 of the 4146 identified studies met our inclusion criteria. Quality appraisal was performed using a modified Newcastle–Ottawa scale. Most studies investigated only work-family conflict, ignoring work-family enrichment. Child mental health outcomes evaluated included internalizing behaviours (n = 11), externalizing behaviours (n = 10), overall mental health (n = 13), and problematic Internet usage (n = 1). Results of the review are summarized qualitatively. Our analysis shows equivocal evidence for the direct relationships between the work-family interface and children's mental health, as a large proportion of associations did not reach statistical significance. We can, however, posit that work-family conflict seems to be more associated with children's mental health problems while work-family enrichment was more related to children's positive mental health. A greater proportion of significant associations are observed for internalizing behaviors compared to externalizing behaviors. Almost all the studies that test for a mediating effect found that parental characteristics and parental mental health are significant mediators. Our research provides insight into the complex association between work-family interface and child mental health, showing both beneficial and detrimental consequences that may even occur simultaneously. This highlights the far-reaching effects of contexts affecting the work-family interface, including the COVID-19 pandemic. We conclude with the need for research adopting more standardized and nuanced measures of the work-family interface to further validate these conclusions. [ABSTRACT FROM AUTHOR]

Positive family relationships are important for child well-being. However, family relationships are unique for youth in out-of-home child welfare placements because they involve both biological and foster parents. The aim of this study was to test the interactive association between current caregiver involvement and contact with biological parents on youths' externalising symptoms using a sample representative of youth in out-of-home child welfare placements in the United States. Findings supported a significant interaction between current caregiver involvement and the amount of biological parent contact on youths' externalising symptoms, such that there was a more pronounced buffering effect of high caregiver involvement on youth externalising symptoms when there was more frequent youth contact with biological parents. Results can be used to support education initiatives about the importance of visitation for caseworkers and parents, and interventions aimed at promoting positive biological family and foster parent relationships focused on the best interests of the child. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic presents significant risks to population mental health. Despite evidence of detrimental effects for adults, there has been limited examination of the impact of COVID-19 on parents and children specifically. We aim to examine patterns of parent and child (0–18 years) mental health, parent substance use, couple conflict, parenting practices, and family functioning during COVID-19, compared to pre-pandemic data, and to identify families most at risk of poor outcomes according to pre-existing demographic and individual factors, and COVID-19 stressors. Participants were Australian mothers (81%) and fathers aged 18 years and over who were parents of a child 0–18 years (N = 2365). Parents completed an online self-report survey during 'stage three' COVID-19 restrictions in April 2020. Data were compared to pre-pandemic data from four Australian population-based cohorts. Compared to pre-pandemic estimates, during the pandemic period parents reported higher rates of parent depression, anxiety, and stress (Cohen's d = 0.26–0.81, all p < 0.001), higher parenting irritability (d = 0.17–0.46, all p < 0.001), lower family positive expressiveness (d = − 0.18, p < 0.001), and higher alcohol consumption (22% vs 12% drinking four or more days per week, p < 0.001). In multivariable analyses, we consistently found that younger parent age, increased financial deprivation, pre-existing parent and child physical and mental health conditions, COVID-19 psychological and environmental stressors, and housing dissatisfaction were associated with worse parent and child functioning and more strained family relationships. Our data suggest wide-ranging, detrimental family impacts associated with the COVID-19 pandemic; and support policy actions to assist families with financial supports, leave entitlements, and social housing. [ABSTRACT FROM AUTHOR]

• First population-based study to examine the gut microbiome and child mental health. • Analyses of gut microbiome diversity, taxonomic features and functional enrichment. • No associations identified with either overall or specific mental health problems. • Suggestive findings implicate genera previously linked to psychiatry disorders. • Longitudinal studies needed to clarify gut-brain-behaviour dynamics over time. The link between the gut microbiome and the brain has gained increasing scientific and public interest for its potential to explain psychiatric risk. While differences in gut microbiome composition have been associated with several mental health problems, evidence to date has been largely based on animal models and human studies with modest sample sizes. In this cross-sectional study in 1,784 ten-year-old children from the multi-ethnic, population-based Generation R Study, we aimed to characterize associations of the gut microbiome with child mental health problems. Gut microbiome was assessed from stool samples using 16S rRNA sequencing. We focused on overall psychiatric symptoms as well as with specific domains of emotional and behavioral problems, assessed via the maternally rated Child Behavior Checklist. While we observed lower gut microbiome diversity in relation to higher overall and specific mental health problems, associations were not significant. Likewise, we did not identify any taxonomic feature associated with mental health problems after multiple testing correction, although suggestive findings indicated depletion of genera previously associated with psychiatric disorders, including Hungatella , Anaerotruncus and Oscillospiraceae. The identified compositional abundance differences were found to be similar across all mental health problems. Finally, we did not find significant enrichment for specific microbial functions in relation to mental health problems. In conclusion, based on the largest sample examined to date, we do not find clear evidence of associations between gut microbiome diversity, taxonomies or functions and mental health problems in the general pediatric population. In future, the use of longitudinal designs with repeated measurements of microbiome and psychiatric outcomes will be critical to identify whether and when associations between the gut microbiome and mental health emerge across development and into adulthood. [ABSTRACT FROM AUTHOR]

The Parental Reflective Interview Procedure was developed as part of an initial assessment interview for an attachment-based intervention for child mental health conditions. This study was a pilot randomised controlled trial that utilised a parallel, single-blind trial design to evaluate the differences in the effects of the Parental Reflective Interview Procedure compared to a diagnostic interview on parental reflective functioning. The control group was administered a structured diagnostic interview (Mini International Neuropsychiatric Interview for Children and Adolescents—Parent Version) and matched for time with clinician. The study sample were 25 parents of clinic-referred children who scored above the clinical cut-off score on the Child Behaviour Checklist. Parental reflective functioning was measured with the Parental Reflective Functioning Questionnaire at baseline and repeated post-intervention, and then again at a two-week follow up. Results showed that the Parental Reflective Interview Procedure produced moderate improvements in parents' understanding of their children's mental states and maintenance in their reflections on intergenerational parent-child relationship patterns. The diagnostic interview showed decreases in both these dimensions. The findings suggest that the Parental Reflective Interview Procedure is a promising format for initial assessment when referral indicates difficulty in the parent-child relationship. The interview acts as a good orientation for parents to an intervention focused on parent-child relationship dynamics. Further work refining this interview, its coding and integration into a tailored feedback session is required. Highlights: There is growing evidence for the importance of interventions targeting parental reflective functioning in therapeutic work with children and families. A novel interview procedure aiming to orient parents towards reflection on their child was tested in an RCT design showed it was a promising preliminary interview for attachment-focused interventions. Tailoring assessment procedures to key features of a subsequent intervention appears to have beneficial effects in child and family therapy. [ABSTRACT FROM AUTHOR]

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This research explored parents' mental health literacy (MHL) skills (i.e., recognizing symptoms and identifying effective help‐seeking strategies) for child attention‐deficit/hyperactivity disorder (ADHD) and anxiety, factors associated with their MHL, and preferences for receiving information about each disorder. N = 128 parents were recruited from community organizations to participate in an online survey. Parents were randomly assigned to read one vignette depicting a child with symptoms of ADHD or anxiety. They were asked to identify the depicted problem and rate the helpfulness of potential help‐seeking strategies (i.e., different health professionals and medications). They also completed measures of parental self‐efficacy and parenting stress and indicated information preferences for learning about symptoms and treatment. Parents scored just above the mid‐range on a measure of their MHL skills, with no significant difference between parents responding to the ADHD and anxiety vignettes. Stronger MHL was associated with being a mother, having personal, family, or friend‐related mental health experience, and stronger parental self‐efficacy. Parents were interested in receiving more information about child ADHD and anxiety via health provider or written format. Results are valuable for informing future MHL intervention efforts to educate parents about symptoms and treatment for common child mental health problems such as ADHD and anxiety. [ABSTRACT FROM AUTHOR]

Maternal adversity and prenatal stress confer risk for child behavioral health problems. Few studies have examined this intergenerational process across multiple dimensions of stress; fewer have explored potential protective factors. Using a large, diverse sample of mother–child dyads, we examined associations between maternal childhood trauma, prenatal stressors, and offspring socioemotional-behavioral development, while also examining potential resilience-promoting factors. The Conditions Affecting Neurocognitive Development and Learning and Early Childhood (CANDLE) study prospectively followed 1503 mother–child dyads (65% Black, 32% White) from pregnancy. Exposures included maternal childhood trauma, socioeconomic risk, intimate partner violence, and geocode-linked neighborhood violent crime during pregnancy. Child socioemotional-behavioral functioning was measured via the Brief Infant Toddler Social Emotional Assessment (mean age = 1.1 years). Maternal social support and parenting knowledge during pregnancy were tested as potential moderators. Multiple linear regressions (N = 1127) revealed that maternal childhood trauma, socioeconomic risk, and intimate partner violence were independently, positively associated with child socioemotional-behavioral problems at age one in fully adjusted models. Maternal parenting knowledge moderated associations between both maternal childhood trauma and prenatal socioeconomic risk on child problems: greater knowledge was protective against the effects of socioeconomic risk and was promotive in the context of low maternal history of childhood trauma. Findings indicate that multiple dimensions of maternal stress and adversity are independently associated with child socioemotional-behavioral problems. Further, modifiable environmental factors, including knowledge regarding child development, can mitigate these risks. Both findings support the importance of parental screening and early intervention to promote child socioemotional-behavioral health. [ABSTRACT FROM AUTHOR]

This review assesses the effectiveness of integrated primary health and social care hubs on mental health outcomes for children experiencing adversity and describes common integration dimensions of effective hubs. PubMed, OVID Medline and PyschINFO databases were systematically searched for relevant articles between 2006--2020 that met the inclusion criteria: (i) interventional studies, (ii) an integrated approach to mental health within a primary health care setting, (iii) validated measures of child mental health outcomes, and (iv) in English language. Of 5961 retrieved references, four studies involving children aged 0--12 years experiencing one or more adversities were included. Most children were male (mean: 60.5%), and Hispanic or African American (82.5%). Three studies with low-moderate risk of bias reported improvements in mental health outcomes for children experiencing adversity receiving integrated care. The only RCT in this review did not show significant improvements. The most common dimensions of effective integrated hubs based on the Rainbow Model of Integrated Care were clinical integration (including case management, patient-centred care, patient education, and continuity of care), professional integration, and organisational integration including co-location. These results suggest hubs incorporating effective integration dimensions could improve mental health outcomes for children experiencing adversity; however, further robust studies are required. [ABSTRACT FROM AUTHOR]

Background: Emerging work examining the psychological impact of COVID-19 on children and families suggests that the relationship between pandemic-related stress, child psychosocial functioning, and caregiver mental health are interrelated. However, much of this research is unidirectional and thus little is known about the bidirectional cascading effects children and caregivers may experience. The current study examined the transactional relationships between caregiver and child mental health over time during the COVID-19 pandemic. Methods: Linguistically, racially, and ethnically diverse caregivers (N = 286) of young children completed measures of caregiver mental health, caregiver pandemic-related stress, and child mental health (i.e., externalizing, internalizing, prosocial behavior) across three time points in the spring of 2020. Results: Using autoregressive cross-lagged analyses, impaired caregiver mental health at Time 1 (April 2020) predicted increased caregiver pandemic-related stress at Time 2 (May 2020). Caregiver pandemic-related stress at Time 1 predicted increased child internalizing symptoms at Time 2 which, in turn, predicted increased caregiver pandemic-related stress at Time 3 (July 2020). Lastly, impaired caregiver mental health at Time 2 (May 2020) predicted increased child externalizing symptoms at Time 3 (July 2020). Conclusions: Assessing transactional relationships between child and caregiver mental health during the COVID-19 pandemic is important to inform models of risk and resilience. Interventions at the level of the caregiver, the child, and/or the family should be considered as a way to interrupt potential negative developmental cascades. [ABSTRACT FROM AUTHOR]

Oppositional defiant disorder (ODD) is a common mental health concern and is particularly prevalent among children living in poverty-impacted communities. A family strengthening/parent management training (PMT)-based multiple family group (MFG) program entitled, the 4 Rs and 2 Ss for Strengthening Families, focuses on the following family process variables: rules, responsibilities, relationships, respectful communication, social support, and stress. While evidence supports effectiveness of this treatment program, less is known about the specific relationship between the family process variables and mental health outcomes of children and caregivers. The current study examined these relationships among a sample of 287 caregiver/child dyads who participated in a NIMH-funded Type II hybrid effectiveness-implementation study in New York City. Data were analyzed using SPSS 27 and Mplus 8. Results indicated that two of the six family process variables related to one or more child and caregiver mental health outcome. Caregiver stress significantly related to child inattention (b = 0.034, SE = 0.01, p < 0.001), child ODD (b = 0.053, SE = 0.02, p < 0.01), and caregiver depression (b = 0.049, SE = 0.02, p < 0.01). Family rules significantly related to caregiver depression (b = 0.228, SE = 0.11, p < 0.05) over time. Findings point towards the substantial role of caregiver stress in child and caregiver mental health, in addition to the impact of inconsistent discipline with difficulty establishing rules on caregiver depression. Examinations of treatment components in relation to improvements in child and caregiver mental health can guide practitioners towards utilizing models that result in positive therapeutic outcomes and/or making adaptations with added content that has been shown to be effective. Highlights: Oppositional defiant disorder is a prevalent mental health concern among youth relating to negative outcomes in adulthood. The 4 Rs and 2 Ss for Strengthening Families is a family strengthening/parent management training program targeting family rules, responsibilities, relationships, respectful communication, social support, and stress. Two of the six family process variables (Rules & Stress) related to one or more child and caregiver mental health outcome. Findings point towards the substantial role of caregiver stress in child and caregiver mental health. Examinations of treatment components and targets are essential to inform practice and both utilization and adaptation of interventions. [ABSTRACT FROM AUTHOR]

Background: Despite the well-established link between childhood adversity and mental health problems, there is a dearth of evidence to inform decision making about the most acceptable and feasible interventions for preventing mental health problems for children experiencing adversity. Expert consensus is an important input into evidence-informed policy and practice but is often employed at the national level which misses important local contextual factors shaping decision making. This study aimed to: (1) reach consensus on local priority interventions for preventing mental health problems for children living with adversity in Wyndham, Victoria; and (2) understand the enabling factors and barriers to implementing these interventions. Methods: This study employed six online modified nominal group technique (NGT) workshops with 19 stakeholders; intersectoral service providers from health, social and education sectors and caregivers of children aged 0–8 years. Results: Three interventions reached consensus among the mixed stakeholder groups as being a high or very high priority for implementation in Wyndham: nurse home visiting, parenting programs and community-wide programs. Key rationales were the ability for these interventions to act as a gateway for families to increase their knowledge about topics immediately relevant to them (i.e. parenting), increase their knowledge about available supports and build relationships with service providers. Conclusions: Local priorities for preventing mental health problems for children living with adversity emphasized relational approaches to service provision and were shaped by the availability of existing interventions and supports in the locality. The NGT was found to be an effective method for prioritising evidence-based practice interventions in health settings, engaging local stakeholders, and identifying enablers and barriers to implementation. [ABSTRACT FROM AUTHOR]

The relevance of coping behavior for the individual's own mental health has been widely investigated. However, research on the association between coping of parents with a mental illness and their children's mental health is scarce. In the current study, we address the role of several parental coping strategies and their relation to child psychological symptoms. As part of the German randomized controlled multicenter study CHIMPS (children of mentally ill parents), parents with mental illness completed questionnaires on illness-related coping and child mental health symptoms. Children's diagnoses of a mental disorder were assessed with diagnostic interviews. The sample comprised n = 195 parents with mental illness and n = 290 children and adolescents aged 4–18 years. We conducted mixed models to investigate the associations of parental coping strategies with internalizing and externalizing symptoms as well as the diagnosis of a mental disorder in children controlling for sociodemographic factors and parental symptom severity. Parental coping characterized by religiosity and quest for meaning was significantly associated with fewer mental health symptoms and lower odds of a mental disorder in children, whereas a depressed processing style was related to increased internalizing problems in the children. Coping behavior in parents with mental illness is a relevant factor for the mental health of their children and should be considered in preventive interventions. [ABSTRACT FROM AUTHOR]

Given the high rates of co-occurrence of psychopathology within families, it is important to identify and characterize interventions that simultaneously reduce both parent and child symptoms, and improve parenting quality. This is needed as intervention development is increasingly moving toward integrated interventions that target some combination of parent and child mental health, and parenting behavior. Even so, much remains unknown regarding which treatment components provide maximum benefit for parent symptoms, child symptoms, and parenting behavior. This systematic review identified and characterized psychotherapeutic interventions that report improvements in each of three outcomes: parent symptoms, child symptoms and parenting behavior. Fifty-six unique interventions were eligible for review, of which 25 reported improvements in all three outcomes. All 25 of these interventions directly intervened on parenting behavior, often as the sole target of the intervention. Few interventions improved all three outcomes in samples in which parents, children or both met clinical-level thresholds of psychopathology. Additional research is needed to better understand the bi-directional and transactional influences of treatment on family members, and to better inform the development of interventions for dually disordered parent-child dyads across a range of diagnostic profiles. [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]

Homeless shelters throughout the U.S. are overcrowded and under-resourced. Families with children face substantial barriers to timely, successful shelter exit, and prolonged shelter stays threaten child mental health. This community-based system dynamics study explored barriers to timely, successful shelter exit and feedback mechanisms driving length of stay and child mental health risk. Group model building – a participatory systems science tool – and key informant interviews were conducted with clients (N = 37) and staff (N = 6) in three family homeless shelters in a Midwestern region. Qualitative content analysis with emergent coding identified key themes feedback loops. Findings indicated overcrowding delayed successful shelter exit; longer stays exacerbated crowding and stress in a vicious cycle. Furthermore, longer stays exacerbated child risk for mental disorder both directly and indirectly via crowding and caregiver stress. Capacity constraints limited families served, while contributing to ongoing unmet need. Future research should investigate the roles of these dynamic feedback relationships in the persistent vulnerability of homeless families. Service design should prioritize interventions that alleviate crowding and subsequent threats to mental health such as private or scattered-site shelter accommodations, affordable child care, and homelessness prevention to facilitate successful shelter exit and mitigate child mental health risk. [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]

Within interpretive qualitative research such as hermeneutics, there is a strong connection between past, present, and future in forging understandings of experience. We argue that foundational concepts related to temporality in hermeneutic philosophy can play a key role in participatory research approaches. Participatory research involves working with stakeholders over time, getting to know what is important to them, and attempting to understand how research objectives align with people's past histories and hopes for the future. We developed a model to exemplify the role of hermeneutics in participatory research, with a particular emphasis on hermeneutic temporality. This model follows the image of a ship that follows three phases: onset, sailing, and ripple effect. As illustrated with a research example in child mental health, we consider that following this model can promote the engagement process with stakeholders, emphasize the importance of people's situated experiences in shaping a specific research study, and facilitate addressing ethical challenges that may arise. [ABSTRACT FROM AUTHOR]

This study examines the association between parent-reported family economic hardship (FEH) and child mental health conditions. We hypothesized a positive association between parent perceptions of FEH and child mental health conditions that would persist after controlling for underlying demographic and socioeconomic characteristics. Cross-sectional data came from the 2016 and 2017 National Surveys of Children's Health (NSCH), nationally representative surveys of non-institutionalized children in the United States, aged 0–17 years. We conducted chi-square as well as multivariable logistic regression analyses to investigate the relationships between FEH and internalizing disorders and behavioral/conduct problems among children ages 3–17 years. Overall, one in four children experienced FEH during their lifetime. FEH was statistically significantly (p < 0.0001) and positively correlated with each mental health condition, and the association remained after adjusting for covariates. Specifically, FEH was associated with 84% increased odds of having an internalizing disorder (OR = 1.84, 95%, CI: 1.54–2.20) and 53% increased odds of having behavioral/conduct problems (OR = 1.53, 95% CI: 1.25–1.87). Findings suggest that income alone may be an insufficient predictor of the health risks of economic hardship. Further research should examine FEH as a broader measure of disadvantage and its relationship with child health. [ABSTRACT FROM AUTHOR]

The study examines the associations of specific self-reported internalizing and externalizing problems and performance in mathematics and reading in school-aged children across Europe. Data were drawn from 5,842 children between 6 and 13 years of age participating in the School Children Mental Health in Europe study and a large cross-sectional survey in France. Self-reported child mental health was assessed using the Dominic Interactive, academic performance was reported by teachers. Across Europe, controlling for key sociodemographic factors associated with achievement including maternal education, performance in mathematics was more often associated with the presence of externalizing and internalizing problems as compared to performance in reading. In addition, the findings point to significant sex differences in the associations of internalizing problems and academic achievement. Considering the impact of early academic difficulties in terms of later internalizing and externalizing problems and academic attainment, school-based interventions interrupting the cycle as early as possible are warranted. [ABSTRACT FROM AUTHOR]

Using a social determinants of health framework, we argue that the majority of evidence-based interventions focused on child and adolescent mental health are limited by their focus on individual youth (and sometimes families). While necessary, these interventions are insufficient for addressing the midstream- and upstream/macro-level determinants of mental health in society. We illustrate our perspective through four examples from youth mental health and related services, in which midstream and upstream interventions—i.e., at the community and public policy levels—need to be prioritized along with downstream treatments to improve population mental health and reduce social inequalities in mental health outcomes. [ABSTRACT FROM AUTHOR]

Background: Despite the ubiquitous use of Subjective Units of Distress scales (SUDs) in mental health settings to establish levels of distressing emotion, there has been little empirical research in this area. SUDs are commonly used in therapy and assessments, and are a particularly useful tool for establishing current and previous levels of distress in children and young people. Aims: To explore the use of the SUD analogue rating scale in initial child mental health assessments to better understand its application in this context. Method: The data corpus consisted of 28 naturally-occurring video recordings of children and young people attending their first assessment appointment at Child and Adolescent Mental Health Services (CAMHS). A thematic analysis was utilised to explore the specific interactional use of SUDs. Results: Four themes were identified; recency, longevity, context and miscommunication. The first three themes were found to supplement the child's emotional score on the scale and were important in establishing the necessity for further therapeutic support. Miscommunication as a theme highlighted the need for clarity when using SUDs with children and young people. Conclusions: Recommendations were suggested for practitioners working with children and young people relating to the extended use of rating scales in clinical assessments. [ABSTRACT FROM AUTHOR]

The aim of this observational study was to explore trial premature cessation, non-publication and trial registration time in child mental health. Data were extracted for "closed" trials in Clinicaltrials.gov registry and European Union Clinical Trial Register (EUCTR) and corresponding publications of completed trials indexed in three data bases (PubMed, Scopus and Google Scholar). We restricted the extraction to the 'Behaviours and Mental Disorders' category and participants' age of 0–17 years. Outcome measures were trial completion, results reporting within a year after the trial completion, publishing an article in a peer-reviewed journal within an average time to publish (729 days), and registration time. The number of EUCTR trials was relatively small (n = 35) and with many inconsistencies. Out of 827 "closed" trials extracted from ClinicalTrials.gov, 69% were completed, 24.2% of prematurely ceased trials did not report reasons for early termination, 12.2% of the completed trials had results reported within a year, and 29.3% had an article published within 24 months after completion. Middle-sized (100–499 participants) and behavioural trials had higher chances of being successfully completed. Middle-sized and industry-funded trials were associated with results reporting. Chances for publishing an article were lower for industry-funded trials. Industry funding and drug interventions were related to timely registration. Large sample and non-industry funding were related to retrospective registration, which was recorded more often in recent years than before (we observed trials registered from 2002 until 2017). This study found low dissemination rates in the field of child mental health, with worrying under-reporting of premature termination causes. These findings indicate that more children are being subjected to unnecessary risk that comes with trial participation. [ABSTRACT FROM AUTHOR]

Restraints and seclusion are routinely used in child mental health settings for conflict and crisis management, but raise significant ethical concerns. Using a participatory hermeneutic ethnographic framework, we studied conflict and crisis management in a child mental health setting offering care to children aged 6-12 years old in Quebec, Canada. The use of this framework allowed for an in-depth examination of the local imaginaries, of what is morally meaningful to the people in the setting, in addition to institutional norms, structures and practices. Data collection involved participant observation, interviews, and documentation review, with an interpretive framework for data analysis. We argue that the prevalent view of children shared by staff members as "incomplete human becomings" led to the adoption and legitimization of authoritative norms, structures and practices guided largely by a behavioral approach, which sometimes led to an increased use of control measures for reasons other than imminent harm. Children experienced these controlling practices as abusive and hindering the development of trusting relationships, which impeded the implementation of more collaborative approaches staff members sought to put in place to prevent the use of control measures. Study results are discussed in light of conceptions of children as moral agents. [ABSTRACT FROM AUTHOR]