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This study examined the family emotional climate as assessed by Five Minute Speech Samples and the relation with parenting stress and parenting behaviors among parents of children (6-17 years, 64.7% boys) with autism spectrum disorder, cerebral palsy, Down syndrome, and without any known disability (n = 447). The large majority of parents (79%) showed low levels of Expressed Emotion, an indicator of a positive family climate. In all groups, more Emotional Over-involvement, more Criticism and fewer expressions of Warmth were associated with higher levels of parenting stress. Across groups, Emotional Over-involvement was related to more autonomy-supportive parenting, Criticism to more psychologically controlling and overreactive parenting, and Warmth was associated with more responsive and less psychologically controlling and overreactive parenting.

This preregistered study examined whether child temperament and executive functions moderated the longitudinal association between early life stress (ELS) and behavior problems. In a Dutch population-based cohort (n = 2803), parents reported on multiple stressors (age 0-6 years), child temperament (age 5), and executive functions (age 4), and teachers rated child internalizing and externalizing problems (age 7). Results showed that greater ELS was related to higher levels of internalizing and externalizing problems, with betas reflecting small effects. Lower surgency buffered the positive association of ELS with externalizing problems, while better shifting capacities weakened the positive association between ELS and internalizing problems. Other child characteristics did not act as moderators. Findings underscore the importance of examining multiple protective factors simultaneously.

Because parents of children with cerebral palsy encounter many challenges, the quality of their parenting varies substantially across time. To understand how and why their parenting behaviors change across time, we examined the contributions of child behavior and parents' psychological needs to explanations of yearly variation in responsive, autonomy-supportive, and psychologically controlling parenting. We also explored whether parents' motivation to take care of their child explained why some parents engage in better-quality parenting than others. Parents (N = 117) of children with cerebral palsy (M[subscript age] = 10.98 years) participated in a three-wave longitudinal study. Multilevel analyses indicated that yearly variations in parents' need satisfaction and frustration related to yearly fluctuations in, respectively, autonomy-supportive and psychologically controlling parenting. Child behaviors had few unique effects on parenting. Parents' autonomous motivation was associated with better overall quality of parenting. We discuss implications for practice and directions for future research.

This study aimed to gain more insight in the sources of daily parenting among mothers of children with autism spectrum disorder (ASD). Specifically, we examined associations between daily variations in child behavior, mothers' psychological needs, and mothers' controlling and autonomy-supportive parenting. Moreover, the study examined the potential mediating role of daily vitality and stress within these associations. In total 41 mothers (M[subscript age] = 41.84 years) of children with ASD (M[subscript age] = 10.92 years, range 7-15) participated in a 7-day diary study. Multilevel structural equation modeling revealed that both daily child behavior (i.e., externalizing problems and prosocial behavior) and mothers' psychological needs relate to day-to-day variation in parenting behavior. Daily stress and vitality played an intervening role in most of these associations.

This study aimed to describe problem behaviors and psychosocial strengths, examine the problem-strength interrelations, and evaluate profiles of problems and strengths in youth with Down syndrome (DS). The community-based sample consisted of 67 parents of children with DS aged between 4 and 19 years. Parents reported about the developmental age (Vineland screener), behavioral problems (Child Behavior Checklist), and psychosocial strengths (Behavioral and Emotional Rating Scale) of their child. Results indicate that attention, social, and thought problems were most prevalent, whereas family involvement and receiving/expressing affection were identified as strengths. A confirmatory factor analysis identified problems and strengths as distinct, yet related, variables. Moreover, a cluster analysis of problems and strengths identified four different profiles. Implications for interventions are discussed.

To investigate the effectiveness of interventions aiming to improve hot and cold executive functions (EFs) in children and adolescents with acquired brain injury (ABI) and to examine whether characteristics of the intervention, participants, etiology of ABI (Traumatic-brain-injury [TBI] or non-TBI), time of assessment, or study quality moderate intervention effects. Whereas cold EFs refer to purely cognitive EFs, hot EFs refer to the affective aspects of these cognitive skills. A total of 970 participants from 23 randomized-controlled-trial studies (112 effect sizes [ES]) were included. A three-level random effects approach (studies, ES, individual participants) was used. Moderation analyses were conducted through meta-regressions. The three-level random effects model showed a better fit than the two-level model. Almost all individual studies showed non-significant ES across outcomes but in combination interventions were effective (Cohen's d = 0.38, CI 0.16 ~ 0.61). Lower methodological quality, inclusion of participants with non-TBI, and parental participation predicted larger ES. Participants' age, time of assessment, number of sessions, and focus on hot or cold EFs were not related to ES. We found no evidence of publication bias. Interventions are effective with small to medium ES according to conventional criteria. Intervention effects do not seem to fade away with time. Parent participation in the intervention is important to improve EFs. The efficacy of interventions seems larger when non-TBI is part of the etiology of ABI. Variation between studies is relevant for tracing the effective intervention characteristics. Most studies are conducted in adolescence, and studies in early childhood are needed. [ABSTRACT FROM AUTHOR]

This study aimed to gain more insight in the sources of daily parenting among mothers of children with autism spectrum disorder (ASD). Specifically, we examined associations between daily variations in child behavior, mothers' psychological needs, and mothers' controlling and autonomy-supportive parenting. Moreover, the study examined the potential mediating role of daily vitality and stress within these associations. In total 41 mothers (Mage = 41.84 years) of children with ASD (Mage = 10.92 years, range 7-15) participated in a 7-day diary study. Multilevel structural equation modeling revealed that both daily child behavior (i.e., externalizing problems and prosocial behavior) and mothers' psychological needs relate to day-to-day variation in parenting behavior. Daily stress and vitality played an intervening role in most of these associations. [ABSTRACT FROM AUTHOR]

Recently, a phenotype of severe dysregulation, the Dysregulation Profile (DP), has been identified. DP consists of elevated scores on the Anxious/Depressed (AD), Aggressive Behavior (AGG) and Attention Problems (AP) scales of the Child Behavior Checklist (CBCL), Teacher Report Form (TRF), or Youth Self Report (YSR). A drawback in current research is that DP has been conceptualized and operationalized in different manners and research on the factor structure of DP is lacking. Therefore, we examined the factor structure of DP across multiple reporters, measurement invariance across gender, parents, and time, as well as links between DP and self-harm and suicidal ideation. Data from a large community sample were used ( N = 697), covering middle childhood ( M = 7.90, (SD = 1.16) and adolescence ( M = 13.93, SD = 1.14). Mothers, fathers, teachers, and youth themselves reported on children's emotional and behavioral problems using the CBCL, TRF, and YSR. Results indicated that in middle childhood and in adolescence, a bifactor model with a general factor of Dysregulation alongside three specific factors of AD, AGG, and AP fitted best, compared to a second-order or one-factor model. The model showed good fit for mother, father, teacher, and youth reports and showed invariance across gender, parents and time. Youth, mother, and father reported Dysregulation was uniquely and positively related to adolescent-reported self-harm and suicidal ideation. The DP is best conceptualized as a broad dysregulation syndrome, which exists over and above anxiety/depression, aggression, and attention problems as specific problems. The bifactor model of DP explains the uniqueness and interrelatedness of these behavioral problems and can help explaining shared and non-shared etiology factors. The exclusive link between the general dysregulation factor and adolescents' self-harm and suicidal ideation further established the clinical relevance of the bifactor model. [ABSTRACT FROM AUTHOR]

Background There is growing recognition of a syndrome of disturbed grief referred to as prolonged grief disorder (PGD). PGD is mostly studied in adults, but clinically significant PGD symptoms have also been observed in children and adolescents. Yet, to date no effective treatment for childhood PGD exists. The aims of this study are: (1) to investigate the effectiveness of Grief-Help, a nine-session cognitive-behavioural treatment for childhood PGD, combined with five sessions of parental counselling, immediately after the treatment and at three, six and twelve months follow-up; (2) to examine tentative mediators of the effects of Grief-Help, (i.e., maladaptive cognitions and behaviours and positive parenting), and (3) to determine whether demographic variables, child personality, as well as symptoms of PGD, anxiety, and depression in parents moderate the treatment effectiveness. Methods We will conduct a Randomised Controlled Trial (RCT) in which 160 children and adolescents aged 8-18 years are randomly allocated to cognitive behavioural Grief-Help or to a supportive counselling intervention; both treatments are combined with five sessions of parental counselling. We will recruit participants from clinics for mental health in the Netherlands. The primary outcome measure will be the severity of Prolonged Grief Disorder symptoms according to the Inventory of Prolonged Grief for Children (IPG-C). Secondary outcomes will include PTSS, depression and parent-rated internalizing and externalizing problems. Mediators like positive parenting and maladaptive cognitions and behaviours will be identified. We will also examine possible moderators including demographic variables (e.g. time since loss, cause of death), psychopathology symptoms in parents (PGD, anxiety and depression) and child personality. Assessments will take place in both groups at baseline, after the treatment-phase and three, six and twelve months after the post-treatment assessment. Discussion We aim to contribute to the improvement of mental health care for children and adolescents suffering from loss. By comparing Grief-Help with supportive counselling, and by investigating mediators and moderators of its effectiveness we hope to provide new insights in the effects of interventions for bereaved children, and their mechanisms of change. Trial registration Netherlands Trial Register NTR3854 [ABSTRACT FROM AUTHOR]

A significant minority of bereaved adults develops prolonged grief disorder (PGD), a syndrome encompassing debilitating symptoms of grief distinct from depression and anxiety. Few studies have examined the phenomenology and correlates of PGD among children and adolescents. In part, this is due to the lack of a psychometrically sound questionnaire to assess PGD symptoms in these groups. Based on an adult measure of PGD, we developed two questionnaires of PGD symptoms for children and adolescents named the Inventory of Prolonged Grief for Children (IPG-C) and Inventory of Prolonged Grief for Adolescents (IPG-A), respectively. Psychometric properties of these measures were examined in three samples, including mostly parentally bereaved children (aged 8-12 years, total sample n = 169) and adolescents (aged 13-18 years, total sample n = 153). First, findings showed that items of the IPG-C and IPG-A represented one underlying dimension. Second, the internal consistency and temporal stability of both questionnaires were adequate. Third, findings supported the concurrent validity (e.g., significant correlations with measures of depression and post-traumatic stress-disorder [PTSD]), convergent and divergent validity (stronger correlations with similar questionnaires of 'traumatic grief' than with two dissimilar questionnaires of 'ongoing presence' and 'positive memories') and incremental validity (significant correlations with an index of functional impairment, even when controlling for concomitant depression and PTSD) of the IPG-C and IPG-A. This report provides further evidence of the clinical significance of PGD symptoms among children and adolescents and promising psychometric properties of questionnaires that can be used to assess these symptoms. Copyright © 2011 John Wiley & Sons, Ltd. Key Practitioner Message The Inventory of Prolonged Grief for Children (IPG-C) and Inventory of Prolonged Grief for Adolescents (IPG-A) were developed to be able to assess symptoms of Prolonged Grief Disorder (PGD) among children and adolescents., In different samples, the internal consistency, temporal stability, and concurrent and construct validity of these questionnaires were found to be adequate., The IPG-C and the IPG-A can be used in research examining causes and consequences of PGD, and the effectiveness of bereavement interventions for children and adolescents., This study provides further evidence of the existence and clinical significance of PGD symptoms among children and adolescents and supports the inclusion of a new category for bereavement-related disorders in DSM-5. [ABSTRACT FROM AUTHOR]

Introduction: One of the most detrimental factors influencing development is growing up in poverty. According to the World Health Organization, extreme poverty is the leading cause of mortality and morbidity. Unfortunately, some children encounter more unhealthy and potentially detrimental circumstances than others, increasing their risk for later health problems. Poor perinatal outcomes are more often observed in deprived neighborhoods, with both more perinatal mortality and morbidity (prematurity and small for gestational age) in these neighborhoods. Additionally, growing up in families with a lower socio-economic status exposes children to more unsafe environments, making them more at risk for insecure attachment to their parents, behavioral problems, addiction, mental illnesses, deficits in cognitive development and domestic violence. In sum, children growing up in deprivation are more unhealthy, as a consequence of an increased risk of unfavorable perinatal outcomes in combination with growing up in a multidimensional unforgiving environment. We assume that the poor health status of these children is reflected in higher healthcare expenses, since they require more medical care than their healthy peers. Here, we aim to investigate the effects of deprivation on healthcare costs of young children in the Netherlands. Methods: This is a cross-sectional study, using data from several national registries. All children in the Netherlands, aged zero to three years old in 2014, were included. Healthcare costs included all expenses covered by obligatory basic health insurance. Deprivation was studied using monthly household income per 1000 euro's and neighborhood deprivation scores. The final linear regression model was built for healthcare costs as function of both deprivation variables, perinatal morbidity, ethnicity, a 3-way interaction of household income, perinatal morbidity and ethnicity (including subsequent 2-way interactions) and the 2-way interaction of deprivation index and perinatal morbidity. Results: A total of 583,625 children were included in the analyses. Both household income (β = - 4.72, 95% CI [-7.22, -2.23]) and deprivation score (β = 19.31, 95% CI [11.11, 27.51]) were significantly related to healthcare costs. Discussion and conclusion: This research shows that growing up with a lower household income and a higher neighborhood deprivation is significantly associated with higher healthcare costs in early life. These findings support the assumption that children growing up in deprivation have a poorer health status, resulting in (health) inequities already in early childhood. This inequity is particularly detrimental since the gap between poor and rich is widening, not only regarding income disparity, but also in the case of health inequality. Limitations: This research excluded children who died during, or soon after pregnancy, since these children have limited healthcare costs. Nevertheless, this outcome may be of even greater societal relevance when targeting the inequality gap. Suggestions for future research: Future research should focus attention on interventions targeting vulnerable population, before, during and after pregnancy, in order to gain highly necessary knowledge on how to provide an optimal start in life for all children. Lessons learned: More attention should be focused on marginalized populations in order to break through the intergenerational cycle of poor health. [ABSTRACT FROM AUTHOR]

Objective: High co-occurrence of externalizing and internalizing problems could underlie inconsistent findings regarding the relation between heart rate (HR) and psychopathology. In this study, HR measures were examined in relation to a general dysregulation profile studied from variable- and person-centered approaches.Method: The sample (N = 182) consisted of 8- to 12-year-old children referred for externalizing behaviors and typically developing children (mean age 9.70, SD 1.26; 75.8% boys). Resting HR (HRrest) was assessed during a 3-minute resting period. HR reactivity (HRreactivity) was assessed during an emotionally evoking go/no-go task.Results: From a variable-centered approach, a bifactor model was fitted with a general factor of dysregulation underlying symptoms of anxiety/depression, aggression, and attention problems. HRrest was positively associated with dysregulation and specific aggression. From a person-centered approach, a latent profile analysis was used to identify different psychopathology classes: normative (n = 92), predominantly aggressive (n = 69), and dysregulated (n = 14). The latter was characterized by co-occurring increased levels of anxiety/depression, aggression, and attention problems. HRrest was increased in the predominantly aggressive class and HRreactivity was increased in the dysregulated class.Conclusion: High HRrest, or (trait-like) over-arousal, seems to be associated with dysregulation rather than uniquely associated with low externalizing or high internalizing symptomatology. In addition, HRrest predicted greater aggression and HRrest was increased in the predominantly aggressive class. High HRreactivity, or enhanced emotional reactivity, might be characteristic for a clinically relevant dysregulated subgroup. Assessment of HR could provide additional knowledge on individual differences that can help refine diagnostics and intervention efforts. [ABSTRACT FROM AUTHOR]