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Peripartum depression (PPD) is considered a major public health concern due to its profound impact on families, including infants. In this paper, we report on a pilot initiative designed to reduce barriers and stigma related to the use of traditional infant mental health services for immigrant parents deemed at high risk of PPD. The Crying Clinic (CC) is an innovative walk‐in service offered in a culturally diverse Canadian community to support maternal well‐being and healthy parent–infant relationships. The CC was designed to be a gateway to existing infant mental health services, through its emphasis on accessibility and cultural sensitivity. Support for concrete concerns, such as anxiety about normative infant behaviors like crying, is underscored in this approach to attract vulnerable families who would otherwise not access mental health support. A review of 44 users, utilization, plans for the use of additional services, and client evaluations suggests that the CC accomplished most of its goals. We conclude that gateway service models such as the CC have the potential to enhance traditional infant mental health programs by creatively addressing the challenge of engaging highly vulnerable parents from culturally diverse backgrounds. [ABSTRACT FROM AUTHOR]

Inuit youth in Nunavut (NU) are resilient but face a protracted suicide crisis. The SPARX serious game and e-intervention, developed originally in New Zealand, teaches youth cognitive behavioural therapy (CBT) skills to ameliorate stress and depression. Inuit youth in NU reviewed and culturally adapted SPARX and an existing wellness outcome measure for Inuit. One hundred and twenty-one youth, aged 13 to 24, across NU then tested, played, and evaluated I(nuit)-SPARX, showing improvement in several areas of wellbeing post-play. Youth completed a CBT skills survey, engaged in sharing circles to assess CBT skill retention, and shared their thoughts about the usefulness and cultural fit of I-SPARX with Inuit Qaujimajatuqangit (IQ) . Communication Skills , Listening Skills , and Problem Solving emerged as the most helpful learned CBT skills, and NU youth provided real-world examples of using I-SPARX skills to support their mental wellness. Several principles of IQ were exemplified and upheld in the content of the adapted SPARX tool and the process of the project as a whole. Empirically grounded, asynchronous e-tools, developed in collaboration with Inuit communities to ensure cultural specificity, may support psychological wellness in communities where mental health resources are scarce.

Purpose: Active engagement in one's therapy is a key contributor to successful outcomes. Research on child engagement in cognitive behaviour therapy (CBT) has largely focused on youth without autism. This longitudinal study examined multiple indicators of child engagement in relation to outcomes for autistic children who took part in CBT for emotion regulation., Method: Data were collected from 60 autistic children who were between 8 and 13 years of age (86.7% male; M age = 9.58 years, SD = 1.44 years; 75% White). Indicators of child engagement included independent observer ratings of in-session involvement, as measured by the Child Involvement Rating Scale, and therapist ratings of the therapeutic relationship and homework completion using single-item measures. Indicators of engagement were measured at early (i.e., first third), middle (i.e., mid third), and late (i.e., final third) stages of treatment. Parent-reported emotion regulation was the primary treatment outcome, as measured by the Emotion Regulation Checklist., Results: After controlling for pre-treatment scores, in-session involvement significantly predicted some aspects of post-treatment emotion regulation, whereas therapeutic relationship and homework completion did not., Conclusions: Child in-session involvement throughout therapy may be particularly relevant for treatment change. Addressing issues related to in-session involvement early in treatment may help to promote therapeutic success for autistic children., (© 2023. The Author(s).)

There are tens of millions of children and youth in street situations (CYSS) worldwide, the majority of whom are males living in low- and middle-income countries. Many of these children demonstrate impressive adaptability and resilience. The focus of the current research was on the resilience of male CYSS in León, Nicaragua. Qualitative data were collected through individual interviews and focus groups with CYSS, their family members, community members, and staff of a local nonprofit, with the objective of exploring and consolidating local understandings of resilience. Grounded theory analysis of qualitative data yielded a context-specific conceptual model of resilience as it pertains to CYSS in León. Six qualities were identified to represent the experience of resilience in this group: agency, belonging, flexibility, protection, self-regulation, and self-worth. The knowledge generated from this research can serve as a foundation to develop and implement resilience-promoting interventions for CYSS., (© 2023 The Authors. Journal of Community Psychology published by Wiley Periodicals LLC.)

The objective of the current research was to investigate the relationship between parenting style, culture, and infant development in a sample of Latin American mother-infant dyads in Toronto, Canada. We examined associations between mothers' self-reported parenting style and infant cognitive and socioemotional development, which we compared to results from mothers belonging to two other Canadian immigrant populations. We further examined whether specific cultural correlates, including affiliation with traditional Latinx cultural beliefs familism and fatalism and acculturation, were associated with positive parenting behaviors in the Latin American sample. Across all three cultural groups, authoritative parenting predicted adaptive socio-emotional development, an effect which differed in magnitude across groups, providing support for the hypothesis that the effect of parenting behaviors on infant development are moderated by culture. Within the Latin American sample, affiliation with the value of familism was associated with higher scores of authoritative parenting, but familism decreased as acculturation to the host culture increased. This research adds to our understanding of factors that contribute to the well-being of Latin American families in Canada. Findings carry implications for provision of infant mental health services to Latin American immigrant families by identifying cultural variables which should be considered when providing parenting interventions to make such interventions more culturally relevant., (© 2023 The Authors. Infant Mental Health Journal published by Wiley Periodicals LLC on behalf of Michigan Association for Infant Mental Health.)

Background: Inuit youth in Northern Canada show considerable resilience in the face of extreme adversities. However, they also experience significant mental health needs and some of the highest adolescent suicide rates in the world. Disproportionate rates of truancy, depression, and suicide among Inuit adolescents have captured the attention of all levels of government and the country. Inuit communities have expressed an urgent imperative to create, or adapt, and then evaluate prevention and intervention tools for mental health. These tools should build upon existing strengths, be culturally appropriate for Inuit communities, and be accessible and sustainable in Northern contexts, where mental health resources are often scarce., Objective: This pilot study assesses the utility, for Inuit youth in Canada, of a psychoeducational e-intervention designed to teach cognitive behavioral therapy strategies and techniques. This serious game, SPARX, had previously demonstrated effectiveness in addressing depression with Māori youth in New Zealand., Methods: The Nunavut Territorial Department of Health sponsored this study, and a team of Nunavut-based community mental health staff facilitated youth's participation in an entirely remotely administered pilot trial using a modified randomized control approach with 24 youths aged 13-18 across 11 communities in Nunavut. These youth had been identified by the community facilitators as exhibiting low mood, negative affect, depressive presentations, or significant levels of stress. Entire communities, instead of individual youth, were randomly assigned to an intervention group or a waitlist control group., Results: Mixed models (multilevel regression) revealed that participating youth felt less hopeless (P=.02) and engaged in less self-blame (P=.03), rumination (P=.04), and catastrophizing (P=.03) following the SPARX intervention. However, participants did not show a decrease in depressive symptoms or an increase in formal resilience indicators., Conclusions: Preliminary results suggest that SPARX may be a good first step for supporting Inuit youth with skill development to regulate their emotions, challenge maladaptive thoughts, and provide behavioral management techniques such as deep breathing. However, it will be imperative to work with youth and communities to design, develop, and test an Inuit version of the SPARX program, tailored to fit the interests of Inuit youth and Elders in Canada and to increase engagement and effectiveness of the program., Trial Registration: ClinicalTrials.gov NCT05702086; https://www.clinicaltrials.gov/ct2/show/NCT05702086., (©Yvonne Bohr, Leah Litwin, Jeffrey Ryan Hankey, Hugh McCague, Chelsea Singoorie, Mathijs F G Lucassen, Matthew Shepherd, Jenna Barnhardt. Originally published in JMIR Serious Games (https://games.jmir.org), 09.03.2023.)

Understanding the role of therapeutic process factors in treatment change may prove useful for discerning why some autistic youth benefit from psychosocial interventions that target emotional and psychological aspects of mental health, while others do not. The aim of the current study was to synthesize what is currently known about therapeutic process factors in mental health treatment of emotional and psychological challenges for autistic youth, regarding how process factors have been measured in past research, and the relation between process factors and treatment outcome. A systematic review of the literature was conducted to narratively synthesize all articles published up until June 2021. Methodological quality of included studies was appraised. Twenty-five studies met inclusion criteria. Process factors assessed across studies included relational factors; treatment expectations, readiness, and satisfaction; and treatment engagement from youth and their parents. Process-outcome associations were reported for a limited number of constructs. There is a limited, albeit growing, body of high-quality research evaluating the role of process factors in the treatment of mental health issues for autistic youth. Future research should continue to examine process factors in relation to treatment outcome, and validate measures to accurately capture process-related constructs in mental health treatment for this population. Greater understanding of therapy processes can lead to developing evidence-informed strategies that clinicians can implement to promote positive expectations, relationships, and engagement., (© 2022. The Author(s).)

Lay Abstract: Autistic children and youth often experience mental health problems, such as anxiety, depression and behavioural challenges. Although there are therapy programmes that have been found helpful in reducing these issues, such as cognitive behaviour therapy, autistic children often struggle to receive adequate mental health care. Clinicians' knowledge, attitudes, confidence and beliefs about treating mental health problems in autistic people may be related to their choices in providing psychotherapy. Across Ontario, Canada, 611 mental health clinicians, working in publicly funded agencies, completed an online survey about their experiences and opinions on delivering therapy for autistic clients compared to those with attention-deficit hyperactivity disorder. Clinician knowledge was associated with their intention to treat autistic clients or clients with attention-deficit hyperactivity disorder, partly because of their attitudes and the social pressures or values they felt. Clinicians reported feeling less intent on providing therapy to autistic youth compared to youth with attention-deficit hyperactivity disorder because of differences in their attitudes, social pressures and knowledge. This research can inform the training and educational initiatives for mental health practitioners.

This study investigated how COVID-19 has affected the wellness of a group of Inuit youth leaders in Nunavut in the context of their involvement with an ongoing mental health research initiative, the Making I-SPARX Fly in Nunavut [ I-SPARX ] project. The study had three goals: (1) to understand how the pandemic has affected I-SPARX leaders' perceived involvement in the I-SPARX Project ; (2) to build knowledge around how the pandemic has impacted the daily life and wellbeing of youth in Nunavummiut communities; and (3) to acquire a culturally specific understanding of their coping mechanisms and resilience strategies through the lens of Inuit Qaujimajatuqangit (IQ). Nine Inuit youth were interviewed virtually about their participation in I-SPARX , their life during the pandemic, and their coping strategies. Their comments were analysed using inductive thematic analysis. Pandemic challenges, the utility of I-SPARX teachings and participation, and culturally and community-embedded pathways to resilience were discussed.The implications of COVID-19 on Inuit youth in remote communities are not fully understood. The current study illuminates their experiences of the pandemic to inform future research on ways in which Inuit youth might be supported in situations, such as a global pandemic, that restrict their traditional resilience-enhancing activities and create social isolation.

The Atypical Maternal Behavior Instrument for Assessment and Classification-Brief (AMBIANCE-Brief) was developed to provide a clinically useful and psychometrically sound assessment of disrupted parenting behavior for community practitioners. With prior evidence of this tool's reliability and validity in laboratory settings, this study aimed to determine whether providers from family service agencies could become reliable in the use of the level of disrupted communication following a brief training. Providers (N = 46) from three agency sites participated in a 2-day AMBIANCE-Brief training and, at the end of the training, coded eight videotaped mother-child interactions. Novice participant coding was compared to expert consensus ratings using intraclass correlations. On average, participants' interrater agreement was good (ICC mean  = .84, SD = 0.10), with 89% meeting the reliability standards of ICC ≥ .70. In response to queries, 100% of participants indicated that they would recommend the AMBIANCE-Brief training to their colleagues, 85% reported that the AMBIANCE-Brief measure would be useful or very useful for their clinical practice, and 56% of participant clinicians believed that parents would find the measure acceptable or very acceptable for integration into intervention or support planning. Altogether, these findings speak to the feasibility of using the AMBIANCE-Brief in community settings. Future studies are needed in diverse clinical and community contexts to evaluate whether use of this assessment tool can inform more targeted interventions tailored to the specific needs of families., (© 2020 Michigan Association for Infant Mental Health.)

Caregiver-child interaction is known to play a central role in children's socioemotional development, yet the diversity of measures commonly used to evaluate it call into question the nature of the construct being assessed. Contingency within caregiver-child interactions has been identified as a key dyadic process that requires taking a temporal perspective to evaluating interactions. The Early Mother-Child Interaction Coding System is a psychometrically sound measure that sequentially code the flow of interactive and non-interactive behaviours within a caregiver-infant system. Its use of the framework of nonlinear dynamical systems (NDS) expands our understanding of contingent caregiver-infant dyadic behaviour., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Supporting language skills in the early years is important because children who begin school with stronger language skills continue to perform well later in their language as well as academic and socioemotional growth. This three-wave longitudinal study of 50 mother-infant dyads reveals that maternal sensitivity and maternal language at 5 months each uniquely predicts child language at 49 months, controlling for age, education, and maternal verbal IQ as well as maternal supportive presence at 49 months. These findings reinforce the importance of maternal sensitivity and maternal language in infancy for child language development and specify that early maternal sensitivity and language, apart from maternal age, education, and IQ as well as later sensitivity, contribute to child language development.

The significance of caregiver sensitivity for child development has been debated among scholars, not least due to sensitivity's inconsistent predictive value over time and across contexts. A lack of uniformity in the definition of sensitivity contributes to this debate, but shortfalls of inter-tool concordance and construct validity in the instruments used to assess sensitivity may also be at issue. This study examines correspondences among four established standardized measures of caregiver sensitivity in independent classifications of the same sample of mothers of infants. 50 European American mother- infant dyads of diverse SES were independently assessed with three observational caregiver sensitivity measures: the Emotional Availability Scales (EAS; Biringen, 2008), the Parent Child Interaction - Nursing Child Assessment Feeding Scale (PCI-NCAFS; Oxford & Findlay, 2015), and the Maternal Behaviour Q-Sort (MBQS; Moran, Pederson & Bento, 2009). Ratings were juxtaposed with classifications of the same sample based on the original Ainsworth Maternal Sensitivity Scales (AMSS; Ainsworth, 1969). The EAS, NCAFS, and MBQS related to the AMSS, but large proportions of variance were unshared. Researchers and clinicians should be cautious when assuming that popular observational assessment instruments, commonly believed to measure a generic construct of caregiver sensitivity, are interchangeable, as these measures may evaluate different features of sensitivity to infants.

Background: A negative birth experience has been shown to have a significant impact on the well-being and future choices of mothers. The objective of this study was to assess the prevalence of, and identify the risk factors associated with a negative birth experience for women in Canada., Methods: The study was based on secondary data analysis of the Maternity Experiences Survey (MES), a Canadian population database administered to 6,421 Canadian women in 2006. The examined outcome - negative birth experience - was derived from mothers' self-report of overall labour and birth experience. Independent variables were maternal demographics, health characteristics, pregnancy-related characteristics, and birth characteristics. Multivariable logistic regression analysis was performed to determine the significant predictors of negative birth experience. Adjusted Odds Ratios (AOR) and 95 % Confidence Intervals (CI) are reported., Results: Negative birth experience was reported among 9.3 % of women. The main significant predictors of a negative birth experience included older age (AOR 2.29, 95 % CI, 1.03-5.07), violence experienced in the past two years (AOR, 1.62, 95 % CI, 1.21-2.18), poor self-perceived health (adjusted OR, 1.95, 95 % CI, 1.36-2.80), prenatal classes attended (adjusted OR, 1.36, 95 % CI, 1.06-1.76), unintended pregnancy (adjusted OR, 1.30, 95 % CI, 1.03-1.63), caesarean birth (AOR, 1.65, 95 % CI, 1.32-2.06), and neonate admission to intensive care (AOR, 1.40, 95 % CI, 1.08-1.82)., Conclusion: Significant predictors of a negative labour and birth experience were identified through this study, a first in the Canadian context. These findings suggest future research directions and provide a basis for the design and evaluation of maternal health policy and prevention programs.

Italy has experienced a recent surge in immigration, which has led to an increase in the country's birth rate. Many immigrant mothers are adolescent parents. 30 adolescent mothers (17 recent immigrants and 13 adolescents of Italian descent) completed measures of adolescent self-development and motherhood, perceived availability and satisfaction with social support, and emotional and behavioral characteristic of their children. Findings suggest that immigrant teen mothers show more difficulties related to parenting than do Italian born teen mothers. In particular, immigrant teen mothers report lower levels of social support satisfaction and availability, higher levels of parent-child dysfunction, and experience motherhood and child behavior as more problematic. The findings highlight and confirm the need for well-designed, specific supportive services for adolescent immigrant mothers.

This study examined the links between parental divorce, quality of maternal parenting, spousal relationships and middle adolescent romantic competence in 80 mother-adolescent daughter pairs (40 divorced). Mothers were asked to describe their attitudes and behaviors with regard to their daughters' romantic behavior. In addition, mothers were interviewed about their own romantic experiences when they were at the age of their daughters. Adolescent girls (mean age = 16.98 years; range 16-18) were administered a comprehensive interview about romantic competence. Findings indicated that adolescent girls from divorced families showed lower levels of romantic competence, which were expressed in their behavior, attitudes toward relationships and skill in handling those relationships. Divorce was found to have had an adverse effect on girls' romantic competence, whereas continued adaptive parenting and spousal relationships alleviated the effect of divorce. Mothers' coherent representation of their own adolescent romantic experiences also alleviated the effect of divorce on daughters' romantic behavior. Results show the important role of family relationships in fostering romantic competence among adolescent girls.

The study aims to examine the prevalence and characteristics of adolescent mothers throughout the provinces of Canada. The analysis was based on the Maternity Experience Survey targeting women aged ≥15 years who had singleton live births during 2005/2006 in the Canadian provinces and territories. The main dependent variable in this study was the mother's age at the time of delivery divided into teen mothers (<20 years) and average-aged mothers (≥20 and <35 years). Socio-economic factors, demographic factors and pregnancy related factors were considered for a logistic regression analysis comparing teen mothers to average-aged mothers. Bootstrapping was performed to account for the complex sampling design. The sample size was 6,188 weighted to represent 76,110 Canadian women. The proportion of teen mothers in the MES study was 2.9%, and their average age was 18.1 years (SD = 1.1). As compared to average-aged mothers, teen mothers were more likely to have low socio-economic status, be non-immigrants, have no partner, reside in the Western Prairies, have previously experienced physical or sexual abuse and have preferred to have had their pregnancies later into their adulthood. Despite the above, teen mothers were more likely to attend prenatal classes than average-aged mothers (Odds ratio = 2.54, 95% confidence interval: 1.74-3.71). Intervention studies should aim to raise awareness among teens to prevent teen pregnancies. Since teen mothers are very likely to attend prenatal courses, the focus of these classes should be tailored to the needs of teen mothers. More in depth qualitative studies should aim to understand their individual needs.

We describe the assessment and treatment of a mother who was a victim of domestic violence and of her 10-year-old son, both of whom were living in a domestic violence shelter. The Parent-Child Interaction Assessment-II Modifying Attributions of Parents intervention (PCIA-II/MAP; Bohr, 2005; Bohr et al., 2008; Bohr & Holigrocki, 2005) is a structured brief treatment using video recordings from a parent's play with his or her child. The play involves using toy people and animals to complete story stems related to a trip to the zoo (see Holigrocki, Kaminski, & Frieswyk, 1999, 2002). The therapist shows the parent video excerpts of the interaction, invites reflection and commentary, and collaborates with the parent to change how she makes sense of her child's behaviors. The pretreatment assessment revealed a depressed, fearful, highly stressed mother with a harsh parenting style. Her son experienced significant distress; had behavior problems; and viewed adults as harsh, fragile, irresponsible, and unavailable. Posttreatment gains were evident in the parent's reduced depression and greater parenting sensitivity; however, parenting stress and child behavior problems remained elevated. We emphasize the utility and application of a multimodal assessment that integrates rating scales, free response, and video-recorded interactions.

This study examines a practice which is characteristic of an era of intensifying globalization: As part of a transnational lifestyle, an increasing number of immigrants to North America send infants thousands of miles back to their country of origin to be raised by members of their extended families-a culturally sanctioned tradition. After several years of separation, the children return to the biological parents to attend school in the adopted country, a custom which, according to Western mental health models, could have significant sequelae for attachment relationships and other facets of development. This practice is particularly prevalent among immigrants from the People's Republic of China, but a modified version of it can be found in other groups as well. The work described here is the first phase of a longitudinal project that explores the advantages and potential repercussions, for both infants and parents, of a transnational lifestyle. The current study reviews the decision-making process of a group of Chinese Canadian immigrant parents who are considering a separation from their infants. Preliminary findings show that the expected concerns about disrupting attachment relationships are embedded in more salient considerations of economic need and cultural perspective. These exploratory data exemplify an emergent field of culture-focused research and practice in infant mental health, and support the call for innovative models to situate infant developmental pathways in global and transcultural contexts., (Copyright © 2009 Michigan Association for Infant Mental Health.)

This article describes one child and family treatment center's process of creating a long-awaited, new infant/child early intervention program. An experimental service model is discussed in the context of the need for empirically validated assessment and intervention for very young clients in high-risk families. Case examples and illustrations of service flow are provided. Some features of this program, such as the fact that it was set up for a seamless transition to a treatment research project, are highlighted., (Copyright © 2005 Michigan Association for Infant Mental Health.)

Psychometric and clinical correlates of the Eating Attitudes Test (EAT) are described for a large sample of female anorexia nervosa (N = 160) and female comparison (N = 140) subjects. An abbreviated 26-item version of the EAT (EAT-26) is proposed, based on a factor analysis of the original scale (EAT-40). The EAT-26 is highly correlated with the EAT-40 (r = 0.98) and the three factors form subscales which are meaningfully related to bulimia, weight, body-image variables and psychological symptoms. Whereas there are no differences between bulimic and restricter anorexia nervosa patients on the total EAT-26 and EAT-40 scores, these groups do indicate significant differences on EAT-26 factors. Norms for the anorexia nervosa and female comparison subjects are presented for the EAT-26, EAT-40 and the EAT-26 factors. It is concluded that the EAT-26 is a reliable, valid and economical instrument which may be useful as an objective measure of the symptoms of anorexia nervosa.