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Context: Sport and physical activity (PA) programs are an important developmental resource for youth with Attention Deficit Hyperactivity Disorder (ADHD) and Disruptive Behavior Disorders. The purpose of this study is to assess sport participation rates, PA participation, and after-school supervision rates among African American children with ADHD and/or Disruptive Behavior Disorders. Design: In this cross-sectional study, parents of African American children with elevated symptoms of ADHD, oppositional defiant disorder, and/or conduct disorder (N = 175, 6- to 12-y-old, 31% female) reported after-school program participation over the past year. Methods: Logistic regression analyses tested relationships between ADHD symptoms, oppositional defiant disorder symptoms, and conduct disorder symptoms, likelihood of regular participation (≥2 d/wk) in sport, PA, and sedentary after-school programs, and likelihood of being supervised and unsupervised after school. All regressions controlled for age, sex, income, and medication status. Sample participation rates were descriptively compared with participation rates of same-aged peers regionally, and nationally, reported in 3 national surveys. Results: Parents in the local sample reported higher rates of sedentary after-school program participation (54%) but lower rates of PA program participation (31%), and sport participation (12%) compared with same-aged peers. The local sample was less likely to be unsupervised after-school compared with same-aged peers with only 27% of parents reporting that their child was unsupervised ≥ 2 days per week. Children endorsing oppositional defiant disorder (odds ratio = 2.05; P <.05) and conduct disorder (odds ratio = 5.74; P <.05) were more likely to be unsupervised more frequently after-school as compared with those not meeting endorsement. Conclusions: Given demonstrated benefits of youth sport programming and observed inequities in participation, there is a need to develop support models that connect parents, coaches, and social services agencies to facilitate inclusion. Sports medicine professionals are uniquely positioned to contribute to these efforts, as they are often key opinion leaders in both the youth sport and health care contexts. [ABSTRACT FROM AUTHOR]

Background: Naturalistic Developmental Behavioral Interventions (NDBIs) for young children with autism spectrum disorder commonly involve caregiver‐mediated approaches. However, to date, there is limited research on how caregivers' skills change, and, in turn, impact child outcomes. Methods: We evaluated the NDBI strategy use of 191 caregivers prior to participation in NDBIs (or control groups) across multiple randomized controlled trials, using the Measure of NDBI Strategy Implementation, Caregiver Change (MONSI‐CC). Clustering analyses were used to examine caregiver variability in NDBI strategy use at intervention entry. Generalized Linear Mixed Models were used to examine changes in caregiver strategy use over the course of intervention and its impact on changes in children's social communication. Results: Using clustering analysis, we found that caregivers' baseline skills fit four profiles: limited, emerging, variable, and consistent/high, with few demographic factors distinguishing these groups. Caregivers starting with limited or emerging skills improved in their strategy use with intervention. Caregivers starting with more skills (consistent/high or variable) maintained higher skills over intervention. Children of caregivers in these groups who received target NDBIs improved in their social communication skills. Conclusions: Results suggested that caregiver skills improve through participation in NDBIs and may directly contribute to their children's outcomes, although more research on mediating factors is needed. Individualized approaches for caregivers and their children starting with differing skill profiles at intervention entry may be warranted. [ABSTRACT FROM AUTHOR]

Objective: The current study aimed to validate an extended version of a frequently used parent-report measure of child functioning and parent self-efficacy, the Child Adjustment and Parent Efficacy Scale (CAPES). Method: A 5-item peer relationship problems subscale was developed to address the original measure's limitation in assessing the quality of children's peer relationships. Three additional items were added to the parent self-efficacy subscale that measures parents' confidence in supporting children to manage peer relationship problems. Utilising data from 2,272 Australian parents of primary-school-aged children, we evaluated the psychometric properties of the extended CAPES through conducting a confirmatory factor analysis, correlational analyses of relevant measures, and calculations of internal consistency. Results: A three-factor structure of the child adjustment subscale was supported, which included three subscales, namely the original emotional maladjustment subscale, the original behavioural problems subscale, and the newly developed peer relationship problems subscale. The one-factor structure of the updated parent self-efficacy subscale was also supported. All subscales displayed acceptable to excellent internal consistency, and significant correlations with relevant measures. Conclusions: The extended CAPES demonstrated good validity, reliability, and readability in this initial validation study. It has great potential to be used in both research and clinical practice. KEY POINTS: What is already known about this topic: Assessing child functioning and parent self-efficacy is crucial in family intervention research and practice. The Child Adjustment and Parent Efficacy Scale (CAPES) is a brief, valid, reliable, and change sensitive measure available in the public domain that assesses the emotional and behavioural adjustment of children and parents' confidence in managing potential issues. Despite its strengths, the original CAPES failed to measure the quality of children's peer relationships, which are integral to children's mental health. What this topic adds: We developed a five-item peer relationship problems subscale to be added to the CAPES. Our findings provided support for the proposed factor structure, internal consistency, and construct validity of the extended CAPES. The extended CAPES is a promising measure for use by both researchers and practitioners in the parenting and family intervention field. [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]

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]

Background: The manifestation of complex trauma results from exposure to severe and repetitive stressors occurring within the caregiver system. Frequently associated with child maltreatment, complex trauma can lead to impairments in multiple domains, including attachment, affect and behavioural regulation, and cognition. Treatments, including Trauma-Focused Cognitive Behavioural Therapy, have been shown to be efficacious, but high attrition rates point to the need for complementary methods that boost client retention and treatment efficacy. This systematic review examines whether dog-assisted therapy has beneficial impacts on the treatment of complex trauma and whether it can decrease treatment attrition among children presenting with complex trauma exposure. Methods: We followed PRISMA guidelines to locate relevant research reports. Seven published research reports matched the inclusion criteria. Results: Dog-assisted therapy may increase the efficacy of standard interventions for complex trauma, although only one study formally assessed treatment retention. Across most studies, there is an overall lack of detailed information on the nature of therapeutic activities involving the dog and how these activities may complement or enhance therapy as usual. Studies were of varying methodological quality, impacting the reliability of findings. Conclusions: Future studies should aim to better describe and justify dog-assisted therapy techniques and evaluate these in comparison with standard evidence-based approaches to the treatment of childhood complex trauma. [ABSTRACT FROM AUTHOR]

The changing landscape of family structures over the last decades has led to a growing need to investigate its impact on children's well-being. This study examined differences in mental health among children from different family compositions and how these differences may be affected by familial socioeconomic status (SES). Data were collected within the LIFE Child study. Participants included 2828 children aged 3–17 years raised in traditional families, stepfamilies, or single-parent families. Mental health was measured using the Strengths and Difficulties Questionnaire (SDQ (behavioral strengths and difficulties)) and the KIDSCREEN-27 questionnaire (quality of life). Linear regression analyses were applied to examine associations between family structure, SES, and mental health outcomes. Children from single-parent families exhibited worse mental health outcomes than those from traditional families across all domains of the SDQ and the KIDSCREEN-27. Children from stepfamilies showed significantly higher Total Difficulties scores (B = 1.29 and 1.42), with 3- to 10-year-olds displaying higher scores in the Hyperactivity & Inattention (B = 0.61) and Peer Relationship Problems (B = 0.36) subscales, and 11- to 17-year-olds showing higher Conduct Problems (B = 0.31), Emotional Symptoms (B = 0.58), and a worse Parent Relationship scores (B = − 1.82) than children from traditional families (all p < 0.05). After controlling for SES, several associations between family structure and mental health lost significance, while others persisted, particularly among older children. To promote mental health in non-traditional families, interventions should address socioeconomic disparities while also investigating factors contributing to the direct impact of family structure on mental well-being. Trial registration The LIFE Child study is registered on clinicaltrials.gov (No. NCT02550236). [ABSTRACT FROM AUTHOR]

Emphasis on continuous infant sleep overnight may be driven by parental concern of risk to child mental health outcomes. The Mercy Pregnancy and Emotional Wellbeing Study (MPEWS) examined whether infant sleep at 6 and 12 months postpartum predicts anxiety disorders at 2–4 years, and whether this is moderated by maternal depression, active physical comforting (APC) or maternal cognitions about infant sleep. Data included 349 women and infants. Infant sleep was measured using the Brief Infant Sleep Questionnaire and child anxiety disorders by the Preschool Age Psychiatric Assessment. The risk of developing generalised anxiety or social phobia disorders at 3–4 years was reduced by 42% (p = 0.001) and 31% (p = 0.001), respectively, for a one standard deviation increase in total sleep at 12 months. No other infant sleep outcomes were associated. Maternal depression, APC and cognitions about infant sleep did not significantly moderate these relationships. Focus may need to be on total infant sleep, rather than when sleep is achieved. Highlights: To assess whether infant sleep outcomes (i.e., frequency of nocturnal wakes; nocturnal wakefulness and total sleep per day) at 6 and 12 months predict early childhood anxiety disorders at 3–4 years of age.Maternally reported infant sleep outcomes were not associated with the risk of developing early childhood anxiety disorders at 3–4 years.It may be total infant sleep, irrespective of when sleep occurs or night waking and, independently, active physical comforting that requires further investigation. [ABSTRACT FROM AUTHOR]

This study examines the relationship between residence arrangements and depressive and anxiety symptoms from children's perspective and the moderating role of interparental conflict. The sample included 454 children from families recruited from family counselling offices across Norway. Mixed effects regression models assessed the association between four residence groups – symmetric shared, asymmetric shared, extended sole, and limited sole – and children's mental health symptoms. Findings indicate that children in different residence arrangements generally displayed similar levels of mental health symptoms, except those in asymmetric shared residence reported fewer depressive symptoms compared to those in limited sole residence. Higher interparental conflict was associated with increased anxiety symptoms, particularly in symmetric shared residence. These results suggest that shared residence may not always be in the child's best interest when there are high levels of interparental conflict. The study reveals variations within the traditional categorizations of "shared" and "sole" residence, highlighting the importance of nuanced differentiation. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic posed numerous obstacles to psychosocial wellbeing for children. We conducted a longitudinal study to evaluate child mental health and social risks during the pandemic. Methods: Participants were 172 caregivers of children aged 6–11 years old who attended well child visits within 6 months before pandemic onset at an urban safety net hospital in the US. Prepandemic data was extracted from the electronic medical record, and surveys were administered at three time points between August 2020 and July 2021. We measured mental health symptoms with the Pediatric Symptom Checklist-17, social risks (e.g., food and housing insecurity) with the THRIVE questionnaire, and school modality (in-person, hybrid, remote). Results: Compared to pre-pandemic, children had significantly higher PSC-17 total scores (overall mental health symptoms) and THRIVE total scores (total burden of social risks) at all three mid-pandemic waves. Using longitudinal mixed models accounting for time, social risks, and school modality, both social risks (B = 0.37, SE = 0.14, p < 0.01) and school modality were significantly associated with PSC-17 scores (B = − 1.95, SE = 0.63, p < 0.01). Children attending in-person school had fewer mental health symptoms than those attending remote or hybrid school. Conclusion: Mental health symptoms and social risks remained significantly higher fifteen months after the onset of the COVID-19 pandemic compared to prepandemic. In-person attendance at school appeared protective against persistently elevated mental health symptoms. [ABSTRACT FROM AUTHOR]

Background: Young people and families endure protracted waits for specialist mental health support in the United Kingdom. Staff shortages and limited resources have led many organizations to develop digital platforms to improve access to support. myHealthE is a digital platform used by families referred to Child and Adolescent Mental Health Services in South London. It was initially designed to improve the collection of routine outcome measures and subsequently the "virtual waiting room" module was added, which includes information about child and adolescent mental health as well as signposting to supportive services. However, little is known about the acceptability or use of digital resources, such as myHealthE, or about sociodemographic inequalities affecting access to these resources. Objective: This study aimed to assess the usability and acceptability of myHealthE as well as investigating whether any digital divides existed among its userbase in terms of sociodemographic characteristics. Methods: A survey was sent to all myHealthE users (N=7337) in May 2023. Caregivers were asked about their usage of myHealthE, their levels of comfort with technology and the internet. They completed the System Usability Scale and gave open-ended feedback on their experiences of using myHealthE. Results: A total of 680 caregivers responded, of whom 45% (n=306) were from a Black, Asian, or a minority ethnic background. Most (n=666, 98%) used a mobile phone to access myHealthE, and many had not accessed the platform's full functionality, including the new "virtual waiting room" module. Household income was a significant predictor of caregivers' levels of comfort using technology; caregivers were 13% more likely to be comfortable using technology with each increasing income bracket (adjusted odds ratio 1.13, 95% CI 1.00‐1.29). Themes generated from caregivers' feedback highlight strengths of digital innovation as well as ideas for improvement, such as making digital platforms more personalized and tailored toward an individual's needs. Conclusions: Technology can bring many benefits to health care; however, sole reliance on technology may result in many individuals being excluded. To enhance engagement, clinical services must ensure that digital platforms are mobile friendly, personalized, that users are alerted and directed to their full functionality, and that efforts are made to bridge digital divides. Enhancing dissemination practices and improving accessibility to informative resources on the internet is critical to provide fair access to all using Child and Adolescent Mental Health Services. [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]

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]

Social learning through friendships is important in child development. Autistic children often initiate and engage in social interactions differently than neurotypical peers. LEGO® based therapy is a group intervention which facilitates social interactions with peers using collaborative LEGO® play. A 1:1 cluster randomised controlled trial with autistic children aged 7–15 comparing 12 weeks' LEGO® based therapy and usual support to usual support alone in 98 mainstream schools (2017–2019) was carried out. The primary outcome was social skills (Social Skills Improvement System) completed by unblinded teachers (not intervention deliverers) at 20 weeks. Analysis used intention-to-treat. Fifty intervention schools (127 participants) and 48 control schools (123 participants) were allocated. Primary analysis included 45 intervention schools (116 participants) and 42 control schools (101 participants). The between-arms difference was 3.74 (p = 0.06, 95% confidence interval: −0.16, 7.63) and 1.68 (p = 0.43, 95% confidence interval: −2.51, 5.87) at 20 and 52 weeks (0.18 and 0.08 standardised effect sizes). Twenty-week outcomes for those receiving per protocol intervention were 4.23 (95% confidence interval 0.27, 8.19) with a standardised effect size of 0.21. Sensitivity estimates were between 3.10 and 4.37 (0.15–0.21 standardised effect sizes). Three unrelated serious adverse events were reported. LEGO® based therapy has a small positive non-significant benefit for social skills at 20 weeks but not 52 weeks. Autism is characterised by keen interests and differences in social interactions and communication. Activities that help autistic children and young people with social skills are commonly used in UK schools. LEGO® based therapy is a new activity that provides interesting and fun social opportunities for children and young people and involves building LEGO® models together. This study looked at LEGO® based therapy for the social skills of autistic children and young people in schools. It was a randomised controlled trial, meaning each school was randomly chosen (like flipping a coin) to either run LEGO® based therapy groups in school over 12 weeks and have usual support from school or other professionals, or only have usual support from school or other professionals. The effect of the LEGO® based therapy groups was measured by asking children and young people, their parents/guardians, and a teacher at school in both arms of the study to complete some questionnaires. The main objective was to see if the teacher's questionnaire answers about the children and young people's social skills changed between their first and second completions. The social skills of participants in the LEGO® based therapy groups were found to have improved in a small way when compared to usual support only. The study also found that LEGO® based therapy was not very costly for schools to run and parents/guardians and teachers said they thought it was good for their children and young people. We suggest further research into different potential benefits of LEGO® based therapy. [ABSTRACT FROM AUTHOR]

Objective: Children in asylum-seeking families are increasingly subject to deterrent host nation policies that undermine security in the post-migration context, however, little is known on the mental health consequences of such policy. This study examined the impact of prolonged visa insecurity on child mental health, by comparing two cohorts of refugee children entering Australia between 2010 and 2013, distinguished by visa security. Methods: The insecure visa sample comprised children from Tamil asylum-seeking families, while the secure visa sample was drawn from refugee families participating in the multi-ethnic 'Building a New Life in Australia' cohort study. Children in each sample were assessed for current mental health problems and trauma exposure. Mothers were assessed for trauma exposure, post-migration family stressors and post-traumatic stress disorder (PTSD). The effects of prolonged visa insecurity on child mental health via family-and child-level variables were modelled using multi-level path analysis. Results: Data comprised 361 children, aged 10–18, and 242 mothers across three levels of visa insecurity: permanent protection (n = 293), temporary protection (n = 40) and bridging visa (n = 28). Modelling showed that (1) visa insecurity was associated with poorer child mental health, (2) the association was mediated sequentially by post-migration family stressors and maternal PTSD and (3) the association was moderated by maternal PTSD. Conclusion: Our findings suggest that when government policy persistently undermines post-migration security, the capacity of families to protect children from accrued stressors is lowered, leaving a significantly higher proportion of children developing along trajectories of risk rather than resilience. [ABSTRACT FROM AUTHOR]

Emerging research suggests that the prevalence of child and adolescent mental health problems has increased considerably during the COVID-19 crisis. However, there have been few longitudinal studies on children's mental health issues according to their social determinants in this context, especially in Europe. Our aim was to investigate the association between family socioeconomic status (SES) and children' mental health during the period of school closure due to COVID-19. Longitudinal data came from 4575 children aged 8–9 years old in 2020 and participating in the ELFE population-based birth cohort that focuses on children's health, development and socialization. Parents completed the Strengths and Difficulties Questionnaire (SDQ) when children were (a) 5 years of age and (b) 9 years of age, which corresponded to the period of school closure due to the COVID-19 pandemic in France. We retrieved data from the ELFE cohort collected on children from birth to age 5 years (birth, 1 year, 2 years, 3,5 years and 5 years). Socioeconomic status (SES) was measured based on information obtained when the child was 5 years old. Data were analyzed using multinomial logistic regression models. Children's elevated levels of symptoms of Attention-deficit/Hyperactivity disorder (ADHD) during the period of school closure were significantly associated with prior low family SES (aOR 1.26, 95% CI 1.08–1.48). Children's elevated symptoms of hyperactivity/inattention and of emotional symptoms were associated with decline in income during the COVID crisis (respectively, aOR 1.38, 95% CI 1.16–1.63 and aOR 1.23, 95% CI 1.01–1.51). Moreover, when testing interactions, a low prior SES was significantly associated with a higher risk of emotional symptoms aOR 1.54 (1.07–2.21), only for children whose families experienced a decline in income, while gender, parental separation and prior mental health difficulties were not associated. This study underlines the impact of the financial crisis related to the COVID-19 epidemic on children's mental health. Both pre-existing family SES before lockdown and more proximal financial difficulties during the COVID crisis were negatively associated with children's psychological difficulties during the period of school closure. The pandemic appears to exacerbate mental health problems in deprived children whose families suffer from financial difficulties. [ABSTRACT FROM AUTHOR]

During the prolonged COVID-19 pandemic, anxiety and depression were common among caregivers and parents more prone to adopt harsh disciplinary techniques when angry or stressed. The purpose of this study was to investigate if there are any differences in parents' disciplinary strategies following social distancing efforts during the COVID-19 pandemic. An online questionnaire was completed by a convenience sample of parents (N = 605) and mothers (n = 533; 88.1%) aged 37.80 years old (SD = 5.66; range = 20–59) who lived with children aged 6–12 years in Iran during the COVID-19 pandemic. Iran's Multiple Indicator Demographic and Health Survey questionnaire was used to gauge child discipline. There was an increase in shaking (1.8%), shouting and yelling (15.5%). The findings of this study serve as a reminder to researchers and government officials that child abuse and violence are more likely to occur during stressful times and provide the scientific foundation for the development of tailored psychological treatment. [ABSTRACT FROM AUTHOR]

Objectives: Third wave cognitive behavioural therapies are increasingly used with children and adolescents. This meta‐analysis aimed to determine the effectiveness of four third‐wave interventions (acceptance and commitment therapy, compassion focused therapy, mindfulness‐based cognitive therapy, and metacognitive therapy) for youth. Methods: Four electronic databases were used to identify randomized controlled trials, which tested effects related to health, well‐being and functioning. Sensitivity analyses considering study quality were conducted and moderators were explored. Results: The results based on 50 RCTs meeting inclusion criteria indicated emotional symptoms/internalizing problems (g = −.68, 95% CI −.98 to −.37, k = 43, N = 3265), behavioural difficulties/externalizing problems (g = −.62, 95% CI −1.01 to −.22, k = 23, N = 1659), interference from difficulties (g = −.46, 95% CI −.87 to −.05, k = 21, N = 1786), third wave processes (g =.39, 95% CI.17 to.62, k = 22, N = 1900), wellbeing/flourishing (g =.76, 95% CI.35 to 1.17, k = 21, N = 1303) and physical health/pain (g =.72, 95% CI.01 to 1.44, k = 9, N = 1171) yielded significant effects. Effect for quality of life (g =.62, 95% CI −.08 to 1.31, k = 12, N = 1271) was non‐significant. When analysing only those studies rated moderate‐high quality, third wave interventions yielded significant superiority effects compared to controls for emotional symptoms/internalizing problems (g = −.55, 95% CI −.82 to −.27, k = 28, N = 2110), interference from difficulties (g = −.48, 95% CI −.90 to −.05, k = 21, N = 1605), third wave processes (g =.27, 95% CI.11 to.43, k = 18, N = 1692), well‐being/flourishing (g =.50, 95% CI.18 to.81, k = 16, N = 1063), and quality of life (g =.32, 95% CI.04 to.60, k = 10, N = 1212). Behavioural difficulties/externalizing problems (g = −.38, 95% CI −.86 to.10, k = 15, N = 1351) and physical health/pain (g =.52, 95% CI −.14 to 1.17, k = 8, N = 1139) ceased to be significant. Widespread heterogeneity raised concerns about generalizability and follow‐up data was relatively sparse. Conclusions: This meta‐analysis finds promising results for use of third wave CBT with youth, though the review has limitations. [ABSTRACT FROM AUTHOR]

Background: One in ten children have a parent diagnosed with a mental illness by specialised psychiatric services. Severe parental mental illness is a well-established risk factor for children's mental health problems, making the identification and support of these children a public health concern. This study investigated the mental health and family context of children of parents diagnosed with depression, anxiety, or bipolar disorder in this clinical setting. Methods: Parental reports on 87 children aged 8–17 years were analysed. The children's mental health was compared with that of a Swedish population-based sample. Multiple linear regression was used to investigate associations between child mental health and child gender, child age, parent symptoms and social status, family functioning, and perceived parental control. Furthermore, a cumulative risk index explored the effect of multiple risk factors on child mental health. Results: The children reportedly had significantly more mental health problems than did the population-based sample and about one-third had scores above the clinical cut-off. A significant multiple linear regression explained 49% of the variance in child mental health, with lower perceived parental control and younger child age being associated with more child mental health problems. With more reported risk factors, children reportedly had more mental health problems. Conclusions: The results underline the importance of identifying a patient's children and assessing multiple relevant risk factors in the child's life. Furthermore, the results indicate that the needs of younger children and of patients in their parenting role are important to address. [ABSTRACT FROM AUTHOR]

Maternal depression negatively impacts child mental health and is a well-known risk factor for child psychopathology. However, maternal depression treatment and child mental health treatment are rarely integrated. The purpose of this review was to assess the impact of maternal depression on child mental health treatment, including (1) how treatment of maternal depression affects child mental health outcomes, (2) the impact of maternal depression on children receiving mental health care, and (3) emerging models that address maternal depression in primary-care pediatrics and child mental health settings. A systematic literature review was conducted using PubMed and PsycInfo. Initial search yielded 224 records, and after exclusion, 29 papers were reviewed. Effective treatment of maternal depression is associated with a significant decrease in child psychiatric symptoms. Maternal depression negatively affects child mental health treatment in that there is a high rate of untreated mental illness among mothers of psychiatrically ill children, and maternal depression impedes effective child mental health treatment. Current models to address maternal depression in child settings include screening in pediatric primary care, psychotherapy for depressed mothers of psychiatrically ill children, and emerging models that integrate maternal and child mental health treatment. Effective treatment of maternal depression significantly improves child mental health and should be better integrated into child treatment. Opportunities to improve care include more robust screening for parental mental illness, supports to refer parents to psychiatric care, and on-site services for parents. Such interventions hold promise, but require significant support from a multidisciplinary team. [ABSTRACT FROM AUTHOR]

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]

Children whose mothers display more positivity during interactions tend to have better mental health. Some studies investigating associations between fathers' positivity and children's mental health have found small-to-moderate negative associations, while others show weak or no effects. The current study presents a series of meta-analyses (N = 59 studies) examining the association between paternal positivity and children's emotional and behavioral functioning, both concurrently and longitudinally. The pooled effect sizes for concurrent internalizing problems (N = 30; r = −0.10), longitudinal internalizing problems (N = 8; r = −0.07), concurrent externalizing problems (N = 40; r = −0.15), and longitudinal externalizing problems (N = 19; r = −0.11) were all significant and small in magnitude. Moderator analyses revealed that the associations between fathers' positivity and children's concurrent internalizing problems and longitudinal externalizing problems were stronger among low and diverse socioeconomic samples compared to middle/upper income samples. Furthermore, associations with children's externalizing problems were stronger in studies in which a single reporter assessed the outcome compared to multiple reporters, when questionnaires were used to measure parenting compared to interview or observation, and—for longitudinal associations only—in samples that had a larger proportion of females or older children. Results suggest that programs and policies that support fathers to have more positive interactions with their children could benefit children's mental health. Highlights: Series of meta-analyses examining the association between paternal positivity and children's emotional and behavioral functioning. Significant and small effects were found across all analyses. Effect sizes were moderated by sample and measurement characteristics. Implications for programs and policies are discussed. [ABSTRACT FROM AUTHOR]

Globally, over 13% of children and adolescents are affected by mental disorders, yet relatively little scholarship addresses how risk factors, symptoms, and nosology vary by culture and context, especially in young children living in post-conflict and low-resource settings. To address this gap, we conducted a qualitative study to identify and describe the most salient mental health problems facing children aged 6 to 10 years in Sierra Leone, as well as the thoughts, feelings, and behaviors related to these problems. Free list interviews (N = 200) and semi-structured interviews (N = 66) were conducted among caregivers, children, and other relevant key informants to explore risk factors and locally meaningful concepts of distress. Our findings indicate that children are faced with a variety of challenges in their social environments that contribute to distress, including hunger, unmet material needs, and excessive work. Our research identifies five contextually defined mental health problems faced by young children: gbos gbos (angry, destructive behavior), poil at (sad, disruptive behavior), diskoraj (sad, withdrawn), wondri (excessive worry), and fred fred (abnormal fear). The manifestations of these distress concepts are described in detail and contextualized according to Sierra Leone's history of war and current backdrop of poverty and insecurity. Implications are discussed for locally relevant diagnosis and treatment as well as for the wider literature on global child mental health. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic and the measures for controlling the pandemic adversely affected child and adolescent mental health; however, studies that examined the effects of the pandemic on child and adolescent mental health services are limited. This study aimed to determine the changes in admission to a child and adolescent psychiatry outpatient clinic (CAPOC) in the first year of the COVID-19 pandemic compared with the previous year. Methods: In this study, the information regarding admissions to Başkent University Faculty of Medicine's CAPOC between March 2019 and March 2021 was examined. Information including age, sex, admission date, the form of admission (first admission/follow-up), and the diagnosis was obtained from the electronic medical record system and the differences between the pre-pandemic period and the pandemic period were assessed. Results: It was found that during the pandemic, there was a decrease in CAPOC admissions; however, both female admissions and median age increased compared with the previous year. Also, admissions due to obsessive-compulsive disorder and somatic symptom-related disorders increased. Conclusions: Although there were fewer CAPOC admissions during the pandemic period compared with the pre-pandemic period, there were differences between the age, sex, and diagnosis distributions of the patients between the pandemic and the pre-pandemic period. Understanding the impact of the COVID-19 pandemic on CAPOC admissions will help plan child and adolescent mental health protective measures. [ABSTRACT FROM AUTHOR]

Toxic stress caused by child maltreatment can lead to adverse mental health outcomes in later life, yet unmeasured confounding has been a major issue in many previous studies. To examine the association between child maltreatment and resilience and behavior problems among early elementary school-age children, we used data from a population-based longitudinal survey targeting all first-grade children in 2015 in Adachi City, a ward in Tokyo, Japan. Children whose caregivers provided valid responses during the 2015 (first grade; ages 6–7 years), 2016 (second grade; ages 7–8 years), and 2018 (fourth grade; ages 9–10 years) waves of the study were included in the analysis (n  = 2,920). Fixed-effects regression models revealed that child maltreatment was inversely associated with resilience (β = −0.89, 95% confidence interval (CI): −1.05, −0.72) and prosocial behavior (β = −0.03, 95% CI: −0.05, −0.003) and positively associated with behavior problems (β = 0.32, 95% CI: 0.27, 0.37) over 4 years of follow-up (2015–2018), after controlling for all time-invariant confounders and measured time-varying confounders and survey year. These associations were consistent across sex. Child maltreatment may hamper the development of resilience and prosocial behavior and induce behavior problems in early elementary school children over time. Future researchers should identify modifiable protective factors for better mental health among maltreated children. [ABSTRACT FROM AUTHOR]

There is a significant gap between the need for child mental health services and use of these services by families. Parental attributions may play a role in this. This study examined whether mothers' attributions about their child's problems influence professional help-seeking intentions in a general sample of community mothers. Secondary analysis re-examined this hypothesis in a subgroup of mothers of children with clinically elevated mental health symptoms. Cross-sectional survey data were collected from mothers (N = 184) of children aged between 2 and 12 years recruited from the community. Mothers completed self-report questionnaires measuring parental attributions: child-responsible attributions and parental self-efficacy; professional help-seeking intentions; and psychosocial covariates: child mental health, mothers' anxiety and depression, child age, gender, marital status, education, and professional help-seeking experience. Hierarchical regression modelling indicated that parental attributions explained professional help-seeking intentions after controlling for covariates in both the general sample (ΔF = 6.07; p =.003) and subgroup analysis (ΔF = 10.22, p =.000). Professional help-seeking intentions were positively associated with child-responsible attributions (β =.19, p =.002) but not parental self-efficacy (β = –.01, p =.865) in the general sample, while positively associated with child-responsible attributions (β =.20, p =.009) and negatively associated with parental self-efficacy (β = –.16, p =.034) in the subgroup analysis. Findings were independent of the presence of clinically elevated symptoms, problem type, and severity. Overall, the findings support models suggesting that parental attributions have a role in professional help-seeking for child mental health problems. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has affected millions of people, and some researchers postulate that a mental health crisis will follow. The immediate effects of the COVID-19 pandemic on children's mental health are now starting to be published, and results appear to be mixed. There is no research, to the authors' knowledge, that empirically examines the functioning of young people following intervention from Child and Adolescent Mental Health Services (CAMHS) Crisis Teams in the UK during the COVID-19 pandemic. This service evaluation aims to do this using data from an NHS trust that supports 1.4 million people in the North East of England. We compared functioning, as measured by the Outcome Rating Scale (ORS), before and after treatment for young people discharged from the CAMHS Crisis Team between December 2019 and December 2020. ORS scores were significantly higher at the end of treatment (t(420) = −57.36, p < 0.001) with a large effect size (d = −1.56). Fifty eight percent of patients exhibited significant and reliable change (i.e. functioning improved to a 'healthy' level). No patients significantly deteriorated in functioning after accessing the crisis service. [ABSTRACT FROM AUTHOR]

A large body of literature has demonstrated that there are developmental differences in mental health problems. However, less is known about the development of mental health problems in ethnic minority children, particularly at the population level. Using a detailed ethnic classification and nationally representative data from the UK Millennium Cohort Study (n = 18, 521, 49% female, 18% ethnic minority), this study examines ethnic differences in children's mental health problems and trajectories of mental health from ages 3 to 14 years. Growth curve modeling revealed that ethnic minority children followed different developmental trajectories of internalizing and externalizing problems than white children, either in terms of the mean-level and/or rate of change across age. These differences were not explained by child sex, socioeconomic status, maternal depressive symptoms, and maternal immigrant status, highlighting the need for further research exploring the factors that underpin ethnic inequalities in child mental health. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic posed unanticipated challenges that could impact how the family system operates across the world. Restrictions imposed to control the rapid spread of the virus substantially increased violence in families. The current study aims to review violence in the family and its impact on the mental health of children during the pandemic. Method: A systematic search was conducted using keywords in the electronic databases PubMed, PsycINFO, and Web of Science, and a manual search was conducted on Google Scholar for articles from January 2020 to January 2021. Of the 50 records identified, seven studies that met eligibility criteria were selected for final analysis. Results: Results revealed that family violence during the pandemic has escalated the mental health problems of children, including aggressive and self-harming behaviours. Lockdown restrictions, social detachment, financial instability, fear of infection, and unemployment led to increased parental stress. Parents with a higher level of stress were more likely to maltreat their children. Conclusions: Exposure to short and long-term family violence can adversely impact the mental health of children and can negatively affect a child's present and future life. Recommendations for researchers, mental health practitioners, public health authorities, and other service providers are also outlined. [ABSTRACT FROM AUTHOR]

Background: Researchers are increasingly interested in understanding potentially traumatic experiences in children's lives, such as witnessing community violence (WCV) and the recent death of a close family member or friend. These experiences can be distressing and have adverse effects on children's psychological and behavioural adjustment, including externalising behaviours and internalising symptoms. Methodology: This paper reports the results of an exploratory study aimed to address knowledge gaps, particularly among children aged 5-9 years (n = 1 283), by examining the associations between WCV, recent death, and child behavioural outcomes. Additionally, the study explores the potential moderating roles of peer support and family functioning. Findings: The results indicate significant associations between WCV, recent death, and child behaviours. Conclusion: The findings underscore the important need for future research to examine the impact of WCV and recent death on children ages 5-9 years. [ABSTRACT FROM AUTHOR]

This descriptive study examined parents' knowledge of and attitudes about child and adolescent mental health, referred to here as parental mental health literacy (MHL). A sample of parents responded to vignettes about children and adolescents experiencing symptoms of ADHD, depression, and psychosis. Parents' MHL varied widely in response to the different vignettes, with respondents showing greater knowledge and less stigmatizing attitudes about ADHD than about the other mental health disorders presented in the vignettes. Social workers are encouraged to be more active in increasing parental MHL and educating the public to reduce stigma around child and adolescent mental health problems. [ABSTRACT FROM AUTHOR]

In the United States, approximately 20% of children and adolescents meet diagnostic criteria for a mental health diagnosis, but few receive treatment. The purpose of the current study was to explore the factors that contribute to help-seeking among mothers from diverse ethnic groups (52.5% European American/White, 23% African American/Black, and 24.6% Latinx). Participants were 122 mothers recruited from 2014 to 2017 through a convenience sample in Central Texas. Using MANOVA, results indicated that mother with no history of therapy use reported more fears about seeking therapy for children. Additionally, there was a trend towards African American mothers reporting more fears about therapists' responsiveness and image concerns. Finally, therapy fears significantly predicted mother's intentions to delay seeking therapy in the future. Implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

Integrating healthcare into education settings represents a promising model to address complex health problems in disadvantaged communities through improving access to health and social services. One such example of an effective school-based health hub is the Our Mia Mia (OMM) Wellbeing Hub, located in a primary school in Nowra and servicing a community experiencing significant socioeconomic disadvantage. The efficacy of OMM rests on its success in facilitating access to services by removing the barriers of cost and transport and establishing connection to community. The OMM fosters collaborations between health professionals and educators to coordinate holistic treatment and implement appropriate student supports in a timely manner. The support of key individuals and groups, in addition to the flexibility of the model, has allowed the hub to pivot and adapt to meet the changing needs of its community, particularly as challenges pertaining to bureaucracy, financial sustainability and community mistrust have presented themselves. Future directions for the OMM hub, and the possibility of adapting and translating school-based healthcare delivery models in other disadvantaged communities, is discussed. Integrating health care into education settings represents a promising model to address complex health problems in disadvantaged communities by improving access to services. Our Mia Mia is an example of a school-based health hub that has achieved success by removing barriers to health care access and facilitating collaboration between health and education. This case study exemplifies both the successes and challenges associated with school-based healthcare delivery, as well as critical learnings for the replication of this model in other disadvantaged communities. [ABSTRACT FROM AUTHOR]

A large number of children of depressed mothers have one or more mental disorders. This study aimed to evaluate the impact of maternal depression on the mental health of 4–5-year-old children of adolescent mothers, according to the hypotheses generated from the model of accumulation. Between October 2009 and March 2011, all pregnant adolescents who received prenatal care from the public health system in Pelotas (southern Brazil) were invited to participate in the study and have been prospectively followed. Of these individuals, 413 participants were evaluated in the postpartum period and when the child was 2–3 years old and 4–5 years old (current stage). The Strengths and Difficulties Questionnaire was used to assess mental health problems in children, and the Mini International Neuropsychiatric Interview (MINI)-Plus version was used to assess maternal depression. We applied a structured modeling approach to examine the relations between three different hypothesized life course models (accumulation, critical period, and mobility) and maternal depression. After selecting the most appropriate model, we used a logistic regression analysis to assess the effect of depression on mental health problems in 4–5-year-old children of adolescent mothers. We used the Chi square test to estimate the prevalence of mental health problems in 4–5-year-old children. The longer the time of exposure to maternal depression, the greater the probability that the child would present behavioral problems. Investments in strategies to prevent mental disorders beginning in the gestational period are important. [ABSTRACT FROM AUTHOR]

Socioeconomic disadvantage has been linked to mental health difficulties in children and adolescents, although many children appear to do well despite exposure to financial adversity in childhood. Our study looked at the effects of family financial difficulty on children's mental health outcomes (n = 636) at 4–5 years in a multi-ethnic UK cohort, the Born in Bradford cohort. We considered potential parent and child variables promoting resilience in this population. Univariate linear regression was used to identify associations between family financial difficulty measured antenatally and child mental health difficulties measured by teacher-rated Strengths and Difficulties (SDQ) scores at 4–5 years. Hierarchical multivariate regression was used to test for potential moderating effects of parent and child factors. Mothers completed the General Health Questionnaire-28, Kessler-6 Questionnaire and questions related to parenting warmth, hostility and confidence. Parent-rated Infant Characteristic Questionnaires and teacher-rated Early Years Foundation Stage scores provided information on child temperament, literacy and physical development as potential moderators. Financial difficulty was associated with worse mental health outcomes in children. High parent warmth, high child literacy scores and physical development scores were all associated with positive child mental health outcomes at 4–5 years. In terms of protective effects, only maternal warmth was found to significantly moderate the relationship between financial difficulty and child mental health difficulties. The current study demonstrates that family financial difficulty is associated with poorer child mental health outcomes in a UK cohort of mothers and their school-aged children. It provides evidence of the positive relationships between warm parenting, child literacy and child physical development with mental health in young children. The study supports the finding that warm parenting moderates the relationship between family financial difficulty and interventions supporting this aspect of parenting may therefore provide particular benefit to children growing up in this context. [ABSTRACT FROM AUTHOR]

Objectives: The adoption of research-supported treatments is contingent upon multiple interactional levels, including provider level factors. Provider-level factors have been shown to be critical to uptake. The purpose of this study is to examine the relationship between sociodemographic factors, attitudes, and perceived barriers/facilitators to implementation through a comparative approach involving practitioners trained to facilitate a multiple family group intervention for children with disruptive behavior. Methods: Participants included 91 practitioners who participated in an intervention study regarding barriers to adopting an evidence-based practice. Demographic characteristics were collected via a socio-demographic questionnaire. Barriers and facilitators were assessed via open-ended questions as well as a scale, developed by the authors and guided by the Consolidated Framework for Implementation Research that explored provider views regarding the intervention, the systemic and organizational context, experience facilitating groups and involving families in treatment, and feelings toward involving families in treatment. Between group analyses were conducted to examine demographic and characteristic differences of providers by implementation status. Independent samples t-tests for continuous characteristics and chi-square tests for categorical characteristics were used. Responses to open-ended questions were compiled, reviewed, and coded, and frequencies and percentages were calculated. Results: Results demonstrated that providers who implemented the intervention were significantly more likely to have favorable attitudes toward the intervention compared to those who did not implement it. Prior experience facilitating groups was significantly associated with implementation. Common barriers to implementation included ineligible caseloads and feeling unqualified to deliver the intervention. Conclusions: Further attention on improving recruitment rates and promoting adequate training and supervision is needed. [ABSTRACT FROM AUTHOR]

Although child corporal punishment can lead to adverse health outcomes in children, this practice remains prevalent in Japan. This study investigates whether, under Asian family norms, fathers' job stress is a risk factor for mothers' frequent use of child corporal punishment. A study sample of 522 children ages 0 to 6 years was obtained from a population-based survey in Tokyo. Data from mothers' self-reports of maternal caretaker child corporal punishment were regressed on paternal job stress using logistic regression analysis. Covariates include child age (months), child gender, number of children in the household, maternal education, maternal adverse childhood experiences, and annual household income. Maternal psychological distress was hierarchically included in the model. Paternal job stress was significantly associated with maternal frequent use of child corporal punishment independent of maternal psychological distress and other known risk factors such as child's age, maternal education, and maternal adverse childhood experiences. The results indicate that job stress may be a risk factor for parental child corporal punishment. Employers can contribute to improving children's health and safety in the household by designing workforce policies to reduce employee's stress and by offering psychoeducational programs for parents., Author(s): Rie Masuda [sup.1] , Paul Lanier [sup.2] , Hideki Hashimoto [sup.3] Author Affiliations: (Aff1) 0000 0001 2151 536X, grid.26999.3d, Division of Health Science and Nursing, Graduate School of Medicine, [...]