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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: Green space exposures may promote child mental health and well-being across multiple domains and stages of development. The aim of this study was to investigate associations between residential green space exposures and child mental and behavioral health at age 4-6 years. METHODS: Childrens internalizing and externalizing behaviors in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) cohort in Shelby County, Tennessee, were parent-reported on the Child Behavior Checklist (CBCL). We examined three exposures-residential surrounding greenness calculated as the Normalized Difference Vegetation Index (NDVI), tree cover, and park proximity-averaged across the residential history for the year prior to outcome assessment. Linear regression models were adjusted for individual, household, and neighborhood-level confounders across multiple domains. Effect modification by neighborhood socioeconomic conditions was explored using multiplicative interaction terms. RESULTS: Children were on average 4.2 years (range 3.8-6.0) at outcome assessment. Among CANDLE mothers, 65% self-identified as Black, 29% as White, and 6% as another or multiple races; 41% had at least a college degree. Higher residential surrounding greenness was associated with lower internalizing behavior scores (-0.66 per 0.1 unit higher NDVI; 95% CI: -1.26, -0.07) in fully-adjusted models. The association between tree cover and internalizing behavior was in the hypothesized direction but confidence intervals included the null (-0.29 per 10% higher tree cover; 95% CI: -0.62, 0.04). No associations were observed between park proximity and internalizing behavior. We did not find any associations with externalizing behaviors or the attention problems subscale. Estimates were larger in neighborhoods with lower socioeconomic opportunity, but interaction terms were not statistically significant. CONCLUSIONS: Our findings add to the accumulating evidence of the importance of residential green space for the prevention of internalizing problems among young children. This research suggests the prioritization of urban green spaces as a resource for child mental health.

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

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]

This study delves into whether children and adolescents and their parents share similar perceptions of mental health changes experienced during the COVID-19 pandemic. Analyzing data from 510 child-parent pairs, the research explores the alignment between self-reported mental health changes and support needs among children and adolescents aged 8–18 and their parent's perspectives. The findings reveal low agreement among child-parent pairs on pandemic-induced mental health changes and support needs, with Kappa values of 0.4 and 0.2, respectively. While most children and adolescents reported a decline in mental health, only 62% of parents acknowledged this change. Additionally, only one in four children and adolescents reported needing support, compared to one in eight parents. The child-parent agreement on pandemic-induced mental health changes was positively correlated with several factors: poorer pre-pandemic mental health status, online schooling experience during the pandemic, and changes in physical activity levels (whether an increase or decrease). Household income influenced agreement differently by ethnicity: minority children and adolescents showed reduced odds of agreement at lower income levels but increased odds at higher income levels, whereas White children's likelihood of agreement remained consistent across income levels. Lower agreement on support needs were observed among children and adolescents with emotional dysregulation and inadequate sleep, while higher agreement was found among those with immigrant parents. Addressing ongoing and emerging mental health challenges in the post-pandemic era necessitates innovative, adaptable, and equitable interventions, and improved communication between children and their parents. [ABSTRACT FROM AUTHOR]

Aim: There is limited research on the impact of preschool attendance on socio‐emotional problems. This study aimed to investigate the association between not attending preschool and emotional and behavioural problems among children aged 3–5 years in Sweden. Methods: We analysed cross‐sectional data from 9395 children, rated by both parents or by one parent. The dependent variable, emotional and behavioural problems, was measured using the Strengths and Difficulties Questionnaire (SDQ). Preschool attendance served as the independent variable. Single and multiple logistic regression analyses were conducted. Results: Only 1.2% of children did not attend preschool. Single logistic regression models, using SDQ subscales with scores at or above the cut‐off point as outcomes, showed that not attending preschool was associated with peer relationship problems, rated by mothers, and with peer relationship problems and overall difficulties, rated by fathers. These associations remained significant when controlling for covariates. Children with parents born outside Sweden or with lower educational levels had higher odds of experiencing peer relationship problems and overall difficulties. Conclusion: Children who do not attend preschool are at heightened risk of experiencing peer relationship problems. It is important to ensure that children who may benefit most from preschool education receive adequate support. [ABSTRACT FROM AUTHOR]

The role of education staff in supporting social, emotional, and mental health (SEMH) difficulties is critical, however access to specialist mental health input can be difficult. Digitally‐mediated service delivery was implemented during the COVID‐19 pandemic and may be integrated in a post‐COVID‐19 world to support education staff. Using a systems change evaluation framework, this study explored staff perceptions of a digitally‐mediated, multidisciplinary model for SEMH needs in primary school settings. Participants were education staff (n = 6) from five participating schools in a rural county in the UK and the multidisciplinary team (n = 7). Focus groups were conducted at baseline, 12 months, and 24 months during a 2‐year pilot project. Thematic analysis was used to analyse the data. Education staff and the multidisciplinary team perceived progress over time in relation to increased capacity (for early intervention) and improved coordination (between relevant children's services). Digitally‐mediated service delivery facilitated changes in practice that were empowering for education staff and supportive in meeting communication needs. This study provides preliminary support for acceptability of digitally‐mediated team communication as an enhanced model of SEMH service provision in primary school settings in the UK. Practitioner points: A systems change initiative (the SOMEHOW project) was perceived by education staff and a multi‐agency team as putting specialist, multi‐disciplinary expertise at the front door by offering a clear pathway to timely support and addressing system issues identified by education, health and social care professionals.Use of videoconferencing technology was clear and engaging for education staff and encouraged a multi‐disciplinary team to use innovative ways of communicating rich information.Accessing multi‐disciplinary expertise remotely via videoconferencing technology was transformative with respect to empowering education staff and parent/carer involvement. [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]

The study examined whether caregiver worry of COVID-19 infection and co-existence difficulty differentially predicted child mental health and wellbeing during the lockdown in two culturally different countries that were severely affected by the pandemic: the UK and Turkey. Co-existence difficulty is the hardship experienced by family members living all together in the same house at the same time during the lockdown period. Participants were 1849 caregivers of children between 5- and 12-years old living in the UK (n = 995) and Turkey (n = 854), who completed an electronic survey distributed via social networks during the initial phase of the COVID-19 lockdown (July and August 2020). Caregivers completed a set of questionnaires on child and family wellbeing and on whether the child's internalizing and externalizing symptoms changed during the lockdown as compared to before. Worry of COVID-19 infection was higher amongst caregivers in the Turkish sample and was associated with higher levels of child internalizing symptoms during the lockdown in the Turkish sample, however there were no statistically significant differences in the size of the impact of worry of infection on the children's internalizing symptoms between the two countries. Co-existence difficulty independently predicted increase in children's internalizing and externalizing symptoms during the lockdown in both samples. Families in the UK experienced a higher level of difficulty with co-existence compared to the families living in Turkey but the magnitude of the impact of co-existence difficulty on children's outcomes between the two samples was not significantly different.The findings suggest that public health strategies should aim to reduce social anxiety and invest in the development of programs aimed at supporting families to overcome the challenges of co-existence during times of public health crisis. [ABSTRACT FROM AUTHOR]

Early identification of social, emotional, and behavioral difficulties (SEBDs) in children is essential to provide support and reduce the risk of negative outcomes. Schools are considered ideal settings to identify SEBDs, and in many countries special educational needs coordinators (SENCOs) play a pivotal role in this respect. Although SENCOs may contribute to improving school-based identification of SEBDs by adopting a more systematic approach, they have a multitude of tasks and considerable professional discretion. As a result, there are differences between SENCOs in the quality of their identification practices in terms of the frequency of observations, the maintenance of a four-eyes principle, and the utilization of specialist knowledge, affecting whether and when SEBDs are identified. The aim of this study was to examine what factors can explain differences in these practices for early identification of SEBDs. Using a narrative qualitative approach, we interviewed 34 primary school professionals, studied school policy documents and observed team meetings. Thematic analysis revealed that an interplay of the factors: (1) (conformity to) school regulations, (2) team continuity, and (3) personal characteristics, explains why SENCOs decide differently on who conducts observations, and when. Generally, SENCOs are more likely to conform to frequent observations by at least two observers utilizing specialist knowledge, when schools have regulations that clearly define by whom and when observations should take place, with competent, committed, proactive school staff conforming to those regulations, within a stable team. Although each factor is important but not essential to ensure these practices, personal characteristics of the SENCO can compensate for a lack of clear school regulations or team discontinuity. Implications for school policy and practice are discussed. [ABSTRACT FROM AUTHOR]

In child and adolescent inpatient, residential and day-treatment facilities, the use of physical restraints and the occurrence of critical incidents are a significant problem. Restraints may sometimes be necessary if a child exhibits dangerous aggressive behavior, but may also be misused or overused, and have been shown to be preventable in many cases. This study aims to investigate if the implementation of the Neurosequential Model of Therapeutics (NMT) has an effect on the annual number of physical restraint incidents in a residential treatment facility for children with complex mental health disorders. Data before and after NMT implementation were collected from the agency's restraint records. The results showed that post-NMT implementation, there was a substantial and sustained reduction in restraint incidents, with a Cohen's d value of 2.03, indicating a very large effect. Limiting restraint use in treating children with complex mental health disorders can foster a safer and more therapeutic environment, with potential improvements in treatment outcomes. This study demonstrated a substantial drop in restraint incidents following the implementation of the Neurosequential Model in a residential facility for children aged 7–13. This reduction is presumably pivotal for children with complex mental health disorders, making treatment less coercive and offering promise for settings in which restraint incidents are a concern. [ABSTRACT FROM AUTHOR]

Background: This study examined the relationship between parents' perceived social support and their children's psychological adjustment. Methods: This cross-sectional survey study was conducted in 52 kindergartens and 78 preschools in Nagoya, Aichi, a major metropolitan area in Japan. Parents of eighth-grade children aged 13–14 years (N = 1,195) completed a questionnaire. A total of 602 valid responses were received. To accurately assess the relationship between parents' perceived social support and behavioral characteristics, respondents diagnosed with a developmental disability or who failed to answer the required questionnaire items were excluded from the analysis. Consequently, 536 (89.0%) of the 602 participants met the eligibility criteria. Results: The results indicated that the stronger the social support for parents, the lower the scores for externalizing and internalizing problems, and the higher the scores for prosociality. Conversely, insufficient social support may pose a risk to parental mental health and lead to suboptimal parenting practices. Issues in parental mental health adversely affect parenting, leading to fewer positive interactions with young children, increased rates of negative interactions and hostility, diminished communication, and delayed responses to children's behaviors. Conclusions: These results underscore the significant influence of parents' perceptions of social support on their parenting beliefs and behaviors, which may, in turn, affect the development of their children's mental health. Therefore, parents' perceptions of social support are likely positively associated with children's mental health. [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]

Abstract Background Children’s social-emotional development and mental well-being are critical to adult mental health. However, little is known about the mechanisms or factors that contribute to poor child mental health in low- and middle-income countries. Given the lack of child mental health research to guide interventions or social-emotional learning programs and policy planning, the present study aimed to address these knowledge gaps by examining the psychopathology mechanism involved in the development of childhood mental health problems. Methods This cross-sectional study recruited parents (N = 393) whose children attended preschool to primary classes in the Arghakhanchi district of Nepal. Data were gathered through parent interviews. Structural Equation Modeling was used to examine the pathways of the mediational mechanism that examined the influence of parental well-being on parenting and children’s mental health outcomes. Results Approximately 22% of the parents were at risk for moderate to severe mental health problems (anxiety: 24%, depression:19%). Parental mental health problems were higher in families who reported food insecurity, among female parents, less educated parents, and those who perceived themselves on a lower social ladder. Parental mental health, social support, and perceived class were associated with parent-child conflict. Greater parent-child conflict was associated with decreased social competence and increased anger, anxiety, and depression in children. Conclusion The results partially support the mediational model that Nepali parents’ well-being (especially in mental health symptoms, social support, and perception of family’s social class domains) is associated with less optimal parenting and, in turn, greater child mental health problems and lower social competence. This study provides new evidence of cross-cultural consistency in child psychopathology and guides the development of evidence-based programs to prevent and promote mental health among Nepali children and families.

In child and adolescent inpatient, residential and day-treatment facilities, the use of physical restraints and the occurrence of critical incidents are a significant problem. Restraints may sometimes be necessary if a child exhibits dangerous aggressive behavior, but may also be misused or overused, and have been shown to be preventable in many cases. This study aims to investigate if the implementation of the Neurosequential Model of Therapeutics (NMT) has an effect on the annual number of physical restraint incidents in a residential treatment facility for children with complex mental health disorders. Data before and after NMT implementation were collected from the agency’s restraint records. The results showed that post-NMT implementation, there was a substantial and sustained reduction in restraint incidents, with a Cohen’s d value of 2.03, indicating a very large effect. Limiting restraint use in treating children with complex mental health disorders can foster a safer and more therapeutic environment, with potential improvements in treatment outcomes. This study demonstrated a substantial drop in restraint incidents following the implementation of the Neurosequential Model in a residential facility for children aged 7–13. This reduction is presumably pivotal for children with complex mental health disorders, making treatment less coercive and offering promise for settings in which restraint incidents are a concern.

Abstract Background This study examined the relationship between parents’ perceived social support and their children’s psychological adjustment. Methods This cross-sectional survey study was conducted in 52 kindergartens and 78 preschools in Nagoya, Aichi, a major metropolitan area in Japan. Parents of eighth-grade children aged 13–14 years (N = 1,195) completed a questionnaire. A total of 602 valid responses were received. To accurately assess the relationship between parents’ perceived social support and behavioral characteristics, respondents diagnosed with a developmental disability or who failed to answer the required questionnaire items were excluded from the analysis. Consequently, 536 (89.0%) of the 602 participants met the eligibility criteria. Results The results indicated that the stronger the social support for parents, the lower the scores for externalizing and internalizing problems, and the higher the scores for prosociality. Conversely, insufficient social support may pose a risk to parental mental health and lead to suboptimal parenting practices. Issues in parental mental health adversely affect parenting, leading to fewer positive interactions with young children, increased rates of negative interactions and hostility, diminished communication, and delayed responses to children’s behaviors. Conclusions These results underscore the significant influence of parents’ perceptions of social support on their parenting beliefs and behaviors, which may, in turn, affect the development of their children’s mental health. Therefore, parents’ perceptions of social support are likely positively associated with children’s mental health.

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

Multilevel service delivery frameworks are approaches to structuring and organizing a spectrum of evidence-based services and supports, focused on assessment, prevention, and intervention designed for the local context. Exemplar frameworks in child mental health include positive behavioral interventions and supports in education, collaborative care in primary care, and systems of care in community mental health settings. Yet, their high-quality implementation has lagged. This work proposes a conceptual foundation for multilevel service delivery frameworks spanning diverse mental health service settings that can inform development of strategic implementation supports. We draw upon the existing literature for three exemplar multilevel service delivery frameworks in different child mental health service settings to (1) identify core components common to each framework, and (2) to highlight prominent implementation determinants that interface with each core component. Six interrelated components of multilevel service delivery frameworks were identified, including, (1) a systems-level approach, (2) data-driven problem solving and decision-making, (3) multiple levels of service intensity using evidence-based practices, (4) cross-linking service sectors, (5) multiple providers working together, including in teams, and (6) built-in implementation strategies that facilitate delivery of the overall model. Implementation determinants that interface with core components were identified at each contextual level. The conceptual foundation provided in this paper has the potential to facilitate cross-sector knowledge sharing, promote generalization across service settings, and provide direction for researchers, system leaders, and implementation intermediaries/practitioners working to strategically support the high-quality implementation of these frameworks.

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

Abstract Background Parental psychological distress is a well-known risk factor for developmental psychopathology, with longer term parental distress associated with worse youth mental health. Neurotoxicant exposure during pregnancy is a risk factor for both poor maternal and youth mental health. The impact of one class of pollutant, polycyclic aromatic hydrocarbons (PAH), on long-term trajectories of maternal distress and youth self-reported mental health symptoms in adolescence has been understudied. Methods PAH exposure was measured by DNA adducts in maternal blood sampled during the third trimester of pregnancy. Maternal distress, operationalized as maternal demoralization, was measured at 11 timepoints (prenatal to child age 16). Adolescent mental health symptoms were measured at age 13–15. Follow up analyses examined a subset of measures available at age 15–20 years. Structural equation modeling examined associations between PAH exposure during pregnancy and latent growth metrics of maternal distress, and between maternal distress (intercept and slope) and youth mental health symptoms in a prospective longitudinal birth cohort (N = 564 dyads). Results Higher prenatal PAH exposure was associated with higher concurrent maternal distress. Prenatal maternal distress was associated with adolescent’s self-reported anxiety, depression, and externalizing problems. On average, maternal distress declined over time; a slower decline in mother’s distress across the course of the child’s life was associated with greater self-reported anxiety and externalizing problems in youth. Conclusions Our findings are consistent with an intergenerational framework of environmental effects on mental health: PAH exposure during pregnancy affects maternal mental health, which in turn influences mental health outcomes for youth well into adolescence. Future research is necessary to elucidate the possible social and biological mechanisms (e.g., parenting, epigenetics) underlying the intergenerational transmission of the negative effects of pollution on mental health in caregiver-child dyads.

Abstract Background When creating resources, such as psychoeducational materials, for children and families, it is essential to consult all stakeholders. By asking service users what they would find helpful, we can ensure that psychoeducational materials developed are directly addressing a need. This report summarises the process of co-developing a psychoeducational video with young people for the adults in their lives. Methods and results The idea for a psychoeducational video originated from discussions within a Youth Advisory Group in a South London Child and Adolescent Mental Health Service. The group shared that they wanted a way of letting the adults in their lives know what is and is not helpful to hear when they are experiencing mental health distress. A workshop was held with young people to gather ideas for the content and style of a psychoeducational video resource. Through co-design methods, themes were identified including prioritising the young person’s lived experience, the importance of listening, respecting and validating, adults not making assumptions about a diagnosis, and actively involving young people in care planning. A script and accompanying video were produced over several co-design sessions and shared via multiple online mass communication channels. Conclusions This project was co-produced at all stages by young people with lived experience of mental health difficulties to develop a digital resource that they considered necessary and meaningful. Centring the voices of young people when producing materials concerning their mental health results in valuable resources and can bring autonomy to those involved.

Abstract Background Parental domestic violence and abuse (DVA), mental ill-health (MH), and substance misuse (SU) can have a negative impact on both parents and children. However, it remains unclear if and how parental DVA, MH, and SU cluster and the impacts this clustering might have. We examined how parental DVA, MH, and SU cluster during early childhood, the demographic/contextual profiles of these clusters, and how these clusters relate to child MH trajectories. Methods We examined data from 15,377 families in the UK Millennium Cohort Study. We used: (1) latent class analysis to create groups differentially exposed to parental DVA, MH, and SU at age three; (2) latent growth curve modelling to create latent trajectories of child MH from ages 3–17; and (3) a case-weight approach to relate latent classes to child MH trajectories. Results We identified three latent classes: high-frequency alcohol use (11.9%), elevated adversity (3.5%), and low-level adversity (84.6%). Children in the elevated adversity class had higher probabilities of being from low-socioeconomic backgrounds and having White, younger parents. Children exposed to elevated adversity displayed worse MH at age three (intercept = 2.274; p

AbstractIn Ethiopia, as in many other low-and middle-income countries, health professionals, particularly mental health workers, are scarce. The purpose of this case study is to describe the process of establishing training child psychiatry and capacity building to implement clinical care for child and adolescent mental health. We present a case study on training of child and adolescent psychiatry embedded within the master’s degree program in integrated clinical and community mental health at the department of psychiatry in Jimma University, Ethiopia. This program is jointly developed in collaboration between Jimma University and Ludwig-Maximilian-University, Germany. The core elements of the training were to train mental state description, making decisions on possible disorders, perform occupational activities, and design psychosocial interventions. The WHOmhGAP guide is considered as appropriate knowledgebase for our teaching program. Each course was evaluated bidirectional with multiple methods. From 2010 to 2024, twelve trainings were organized. We structured the program in three phases. The initial phase (2010–2014) was to establish collaboration with guest lecturers and to develop, implement, and evaluate the training. The second phase (2015–2019) changed to mentorship and transition from guest lecturers to local trainers and included a refresher course. Phase three (2020–2024) was independent work. An outpatient clinical service for children was implemented by the lead author and now is running at Jimma University. The implementation of the training took place in small steps. A long-term commitment of local and guest lecturers enabled to develop culturally appropriate solutions for the local context. A similar approach can be applied to effectively start and expand child and adolescent mental health care in other resource limited settings. [ABSTRACT FROM AUTHOR]

Background: Social inequalities in child mental health are an important public health concern. Whilst previous studies have examined inequalities at a single time point, very few have used repeated measures outcome data to describe how these inequalities emerge. Our aims were to describe social inequalities in child internalising and externalising problems across multiple countries and to explore how these inequalities change as children age. Methods: We used longitudinal data from eight birth cohorts containing participants from twelve countries (Australia, Belgium, Denmark, France, Germany, Greece, Italy, Netherlands, Poland, Norway, Spain and the United Kingdom). The number of included children in each cohort ranged from N = 584 (Greece) to N = 73,042 (Norway), with a total sample of N = 149,604. Child socio‐economic circumstances (SEC) were measured using self‐reported maternal education at birth. Child mental health outcomes were internalising and externalising problems measured using either the Strengths and Difficulties Questionnaire or the Child Behavior Checklist. The number of data collection waves in each cohort ranged from two to seven, with the mean child age ranging from two to eighteen years old. We modelled the slope index of inequality (SII) using sex‐stratified multi‐level models. Results: For almost all cohorts, at the earliest age of measurement children born into more deprived SECs had higher internalising and externalising scores than children born to less deprived SECs. For example, in Norway at age 2 years, boys born to mothers of lower education had an estimated 0.3 (95% CI 0.3, 0.4) standard deviation higher levels of internalising problems (SII) compared to children born to mothers with high education. The exceptions were for boys in Australia (age 2) and both sexes in Greece (age 6), where we observed minimal social inequalities. In UK, Denmark and Netherlands inequalities decreased as children aged, however for other countries (France, Norway, Australia and Crete) inequalities were heterogeneous depending on child sex and outcome. For all countries except France inequalities remained at the oldest point of measurement. Conclusions: Social inequalities in internalising and externalising problems were evident across a range of EU countries, with inequalities emerging early and generally persisting throughout childhood. [ABSTRACT FROM AUTHOR]

Children whose parents have a mental illness are much more likely to experience mental health problems and other adverse long‐term impacts. Child‐centred psychosocial interventions can be effective, but not much is known about how to design and implement them in different settings. A pre‐post, mixed methods, single‐arm evaluation of a co‐designed social support intervention with parents and children (4–18 years) measured parents' mental health (PHQ‐9), perceived social support (ENRICHD), parental self‐efficacy (PSAM) and children's mental health (SDQ), quality of life (Kidscreen‐27), and child service use (CAMHSRI‐EU) at baseline and 6 months. Qualitative data were gathered at 6 months to explore parents' and children's experience with the intervention. Twenty‐nine parents and 21 children completed baseline and follow‐up questionnaires; 22 parents and 17 children participated in interviews. Parents' depression (MD −1.36, SD 8.08), perceived social support (MD 1, SD 5.91), and children's mental health potentially improved, and children's service use and costs potentially reduced (€224.6 vs. €122.2, MD 112.4). Parental self‐efficacy was potentially reduced (MD −0.11, SD 3.33). The sample was too small to perform statistical analysis. Favourable themes emerged describing the high satisfaction with the intervention, parents' improved understanding of the impact of their mental health problems on children, and improvements in parent–child relationships. This study contributes to an emerging evidence base for co‐designed child‐centred interventions to prevent the transgenerational transmission of poor mental health. [ABSTRACT FROM AUTHOR]

Time-out (TO) is a widely utilised parental discipline technique with a strong evidence-base that nonetheless has attracted controversy regarding potential adverse effects on mental health in developing children. Associations between TO implementation and mental health outcomes have rarely been investigated, especially through the eyes of children who grew up experiencing TO. This study recruited 407 university students (Study 1) and a community sample of 535 young adults (Study 2); both samples aged 18–30 years. Young adults were surveyed on their retrospective reports of childhood TO experience, childhood experiences of adversity, perceived parenting style and parental attachment, and their current mental health outcomes (attachment style, emotion regulation and mental health). In Study 1, 334 (82.1%) young adults reported experiencing TO in childhood, but with widely varied implementation that differed considerably from its evidence-based ideal. Reports of more TO appropriate implementation were associated with less avoidant attachment, better mental health, and emotion regulation, over and above the effects associated with authoritative parenting and secure attachment in childhood. While exposure to childhood adversity was associated with poorer adulthood outcomes, TO implementation did not moderate the association. Study 2 replicated most findings from Study 1, except that appropriate TO implementation displayed a positive association with mental health and no associations with anxious and avoidant attachment and emotion regulation. These findings suggest the safety of TO use with young children, including those who experienced childhood adversity, and highlight the importance of disseminating sufficient parenting information on TO in the community. [ABSTRACT FROM AUTHOR]

The Child and Adolescent Mental Health Initiative (CAMHI) aims to enhance mental health care capacity for children and adolescents across Greece. Considering the need for evidence-based policy, the program developed an open-resource dataset for researching the field within the country. A comprehensive, mixed-method, community-based research was conducted in 2022/2023 assessing the current state, needs, barriers, and opportunities according to multiple viewpoints. We surveyed geographically distributed samples of 1,756 caregivers, 1,201 children/adolescents, 404 schoolteachers, and 475 health professionals using validated instruments to assess mental health symptoms, mental health needs, literacy and stigma, service use and access, professional practices, training background, and training needs and preferences. Fourteen focus groups were conducted with informants from diverse populations (including underrepresented minorities) to reach an in-depth understanding of those topics. A dataset with quantitative and qualitative findings is now available for researchers, policymakers, and society [https://osf.io/crz6h/ and https://rpubs.com/camhi/sdashboard]. This resource offers valuable data for assessing the needs and priorities for child and adolescent mental health care in Greece. It is now freely available to consult, and is expected to inform upcoming research and evidence-based professional training. This initiative may inspire similar ones in other countries, informing methodological strategies for researching mental health needs. [ABSTRACT FROM AUTHOR]

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

Background: The COVID-19 pandemic has had a substantial impact on children and families worldwide. Children's mental health has been at the forefront of pandemic research, with several observational studies documenting its decline. Limited person-centred research exists, however, investigating the diverse mental health responses of vulnerable children during COVID-19. Objective: The purpose of this study is to examine the profiles of 289 low-income children's mental health transitions from pre-COVID-19 to during COVID-19. Methods: Mothers' reports of children's mental health using the Strengths and Difficulties Questionnaire from before ( X ¯ = 2.73 years, SD = 0.23) and during ( X ¯ = 5.31 years, SD = 0.59) COVID-19 were used. Results: Three comparable profile solutions were identified pre- and early during the pandemic. Latent transition analysis revealed diverse patterns of children's mental health trajectory from prior to during COVID-19. Based on transition probabilities, the majority of children in the Average Levels of Internalizing/Externalizing Problems and Externalizing Problems profiles pre-pandemic showed stability in profile membership. Interestingly, most children in the high levels of Internalizing/Externalizing Problems profile pre-pandemic experienced some improvement in their mental health. Pre-pandemic maternal mental health and parenting had significant associations with children's profile membership at both time points. Conclusions: Our findings reveal the heterogeneity in children's mental health responses in times of large-scale crises. They also identify how pre-existing maternal risk factors may underlie the diverse experiences of children who underwent declining, stable, or improving mental health profiles during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

\nPRACTICE IMPLICATIONSDuring the past few decades, there has been an increasing recognition that many youth in out-of-home treatment settings have experienced complex trauma due to childhood experiences of intimate partner violence (CEIPV). These experiences may contribute to the internalizing and externalizing problematic behaviors that precipitate their placement in such programs. Using retrospective file review, this exploratory study aimed to explore the mechanisms within children’s mental health settings for determining CEIPV, including screening, assessment and other avenues of disclosure and to consider possible avenues for addressing CEIPV. Fifty files were selected for review, and after screening for CEIPV, 26 files remained in the sample and underwent a detailed review and data extraction process. The review identified significant gaps in documentation related to CEIPV, specific to identification and assessment, which may interfere with important intervention and prevention efforts within such settings. Practice implications and recommendations for improving assessment and intervention efforts to address these issues within out-of-home care settings are discussed. Efficacious CEIPV assessment leads to better recognition and intervention approaches, which may promote child and youth safety.Specific CEIPV assessment and intervention approaches are needed to direct our work with young people.Revisit what it means to be “stable, safe or ready,” before withholding interventions that may benefit young people in care.Consider incorporating ongoing risk assessment and safety planning approaches regarding CEIPV into our work with young people in care.Coordination and collaboration across systems (police, child welfare, violence against women services) could lead to optimal interventions and community-based linkages upon discharge from care.Efficacious CEIPV assessment leads to better recognition and intervention approaches, which may promote child and youth safety.Specific CEIPV assessment and intervention approaches are needed to direct our work with young people.Revisit what it means to be “stable, safe or ready,” before withholding interventions that may benefit young people in care.Consider incorporating ongoing risk assessment and safety planning approaches regarding CEIPV into our work with young people in care.Coordination and collaboration across systems (police, child welfare, violence against women services) could lead to optimal interventions and community-based linkages upon discharge from care. [ABSTRACT FROM AUTHOR]

ObjectiveMethodsResultsDiscussionParents with borderline personality disorder (BPD) can present with negative parenting and parent–child dysfunctional interactions. This can adversely impact their children, leading to internalising and externalising problems. No reviews of psychological interventions for these children have been found. The present systematic review aims to identify and describe the characteristics, outcomes and evidence of psychological interventions for children of parent(s) with BPD.Five databases were searched in addition to unpublished clinical trials. Of the 2243 records screened, 24 records were identified, of which 19 were studies, reporting on 17 different psychological interventions.Most studies had low-moderate quality and were case studies/case series. More than half of the psychological interventions were multi-strategic, long-term, with mothers and their infants, and based on a psychodynamic model. Results revealed some improvements in parent, parent–child relationship and child outcomes. However, only one psychological intervention presented evidence of effectiveness.Psychological interventions for children of parent(s) with BPD are scarce and no conclusions can be made about them. To establish evidence-based psychological interventions for these children, future research should consider conducting effectiveness studies, namely large-scale randomised controlled trial studies, with strong quality, and including the fathers and older children. This systematic review could aid clinicians and researchers in treating and studying psychological interventions for this at-risk group. [ABSTRACT FROM AUTHOR]

Background: Parental psychological distress is a well-known risk factor for developmental psychopathology, with longer term parental distress associated with worse youth mental health. Neurotoxicant exposure during pregnancy is a risk factor for both poor maternal and youth mental health. The impact of one class of pollutant, polycyclic aromatic hydrocarbons (PAH), on long-term trajectories of maternal distress and youth self-reported mental health symptoms in adolescence has been understudied. Methods: PAH exposure was measured by DNA adducts in maternal blood sampled during the third trimester of pregnancy. Maternal distress, operationalized as maternal demoralization, was measured at 11 timepoints (prenatal to child age 16). Adolescent mental health symptoms were measured at age 13–15. Follow up analyses examined a subset of measures available at age 15–20 years. Structural equation modeling examined associations between PAH exposure during pregnancy and latent growth metrics of maternal distress, and between maternal distress (intercept and slope) and youth mental health symptoms in a prospective longitudinal birth cohort (N = 564 dyads). Results: Higher prenatal PAH exposure was associated with higher concurrent maternal distress. Prenatal maternal distress was associated with adolescent's self-reported anxiety, depression, and externalizing problems. On average, maternal distress declined over time; a slower decline in mother's distress across the course of the child's life was associated with greater self-reported anxiety and externalizing problems in youth. Conclusions: Our findings are consistent with an intergenerational framework of environmental effects on mental health: PAH exposure during pregnancy affects maternal mental health, which in turn influences mental health outcomes for youth well into adolescence. Future research is necessary to elucidate the possible social and biological mechanisms (e.g., parenting, epigenetics) underlying the intergenerational transmission of the negative effects of pollution on mental health in caregiver-child dyads. [ABSTRACT FROM AUTHOR]

The recent rise in maternal workforce participation has led to more research regarding the role of maternal employment for (early) childhood mental health. This systematic review with meta-analysis covers new evidence on the association of both variables. A systematic literature search was conducted. Studies had to compare children 0–7 years of age on the basis of their mothers' employment status, working amount, employment duration, i.e., how long the mother had been back at work after birth, or timing of return to work. Child mental health was operationalized as behavior problems and prosocial behavior. Narrative and meta-analytic syntheses of evidence were conducted. Maternal employment was associated with more conduct problems but less internalizing behavior problems and anxious/depressed behavior in children; full-time employment was linked to more externalizing behavior problems and more hyperactivity/inattention. Longer employment duration was related to less (internalizing) behavior problems and more prosocial behavior but also more externalizing behavior problems. Narrative syntheses indicated early maternal return to work to be associated with more child externalizing behavior problems and less prosocial behavior. Whether maternal employment is associated with child mental health strongly depends on both variables' operationalization. Especially part-time employment, longer employment duration, and return to work only after the first year postpartum may be beneficial for child mental health. Practical implications pertain to an expanded offer of family leave and the endorsement of maternal employment after the first year postpartum. Here, factors that may buffer the negative associations with full-time employment warrant consideration. [ABSTRACT FROM AUTHOR]

Background: The significance of socioeconomic status (SES) in child mental health is well‐established in Western populations; however, there is little evidence on this topic in Chinese populations. The possibility that Chinese families with different SES elicit different parenting practices that cause positive or negative child mental health outcomes warrants further investigation. Methods: This study examined the associations of SES, parenting practices, and child mental health among 1401 Chinese school children and their parents residing in Shanghai. SES was measured by a composed index of parental education levels, occupations, and household incomes. The Alabama parenting questionnaire (APQ; child version) and the strengths and difficulties questionnaire (SDQ; parent version) were used to assess parenting practices and child mental health. We also explored the underlying mechanisms between parental SES and the mental health of children by testing different parenting practices as mediators of the relationships. Results: The results showed that a higher SES is positively associated with better mental health in children. Positive involvement and deficient monitoring can mediate the relationship between SES and child mental health outcomes. Negative discipline did not significantly mediate the above relationship. Conclusions: The results highlight the significance of positive involvement and sufficient monitoring in promoting children's mental health and provide evidence for designing effective programs to improve parenting skills. [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: Parental domestic violence and abuse (DVA), mental ill-health (MH), and substance misuse (SU) can have a negative impact on both parents and children. However, it remains unclear if and how parental DVA, MH, and SU cluster and the impacts this clustering might have. We examined how parental DVA, MH, and SU cluster during early childhood, the demographic/contextual profiles of these clusters, and how these clusters relate to child MH trajectories. Methods: We examined data from 15,377 families in the UK Millennium Cohort Study. We used: (1) latent class analysis to create groups differentially exposed to parental DVA, MH, and SU at age three; (2) latent growth curve modelling to create latent trajectories of child MH from ages 3–17; and (3) a case-weight approach to relate latent classes to child MH trajectories. Results: We identified three latent classes: high-frequency alcohol use (11.9%), elevated adversity (3.5%), and low-level adversity (84.6%). Children in the elevated adversity class had higher probabilities of being from low-socioeconomic backgrounds and having White, younger parents. Children exposed to elevated adversity displayed worse MH at age three (intercept = 2.274; p < 0.001) compared the low-level adversity (intercept = 2.228; p < 0.001) and high-frequency alcohol use class (intercept = 2.068; p < 0.001). However, latent growth factors (linear and quadratic terms) of child MH did not differ by latent class. Conclusions: Parental DVA, MH, and SU cluster during early childhood and this has a negative impact on children's MH at age three, leading to similar levels of poor MH across time. Intervening early to prevent the initial deterioration, using a syndemic-approach is essential. [ABSTRACT FROM AUTHOR]

Background: When creating resources, such as psychoeducational materials, for children and families, it is essential to consult all stakeholders. By asking service users what they would find helpful, we can ensure that psychoeducational materials developed are directly addressing a need. This report summarises the process of co-developing a psychoeducational video with young people for the adults in their lives. Methods and results: The idea for a psychoeducational video originated from discussions within a Youth Advisory Group in a South London Child and Adolescent Mental Health Service. The group shared that they wanted a way of letting the adults in their lives know what is and is not helpful to hear when they are experiencing mental health distress. A workshop was held with young people to gather ideas for the content and style of a psychoeducational video resource. Through co-design methods, themes were identified including prioritising the young person's lived experience, the importance of listening, respecting and validating, adults not making assumptions about a diagnosis, and actively involving young people in care planning. A script and accompanying video were produced over several co-design sessions and shared via multiple online mass communication channels. Conclusions: This project was co-produced at all stages by young people with lived experience of mental health difficulties to develop a digital resource that they considered necessary and meaningful. Centring the voices of young people when producing materials concerning their mental health results in valuable resources and can bring autonomy to those involved. [ABSTRACT FROM AUTHOR]

This study investigated how individualism, collectivism and conformity are associated with parenting and child adjustment in 1297 families with 10‐year‐old children from 13 cultural groups in nine countries. With multilevel models disaggregating between‐ and within‐culture effects, we examined between‐ and within‐culture associations between maternal and paternal cultural values, parenting dimensions and children's adjustment. Mothers from cultures endorsing higher collectivism and fathers from cultures endorsing lower individualism engage more frequently in warm parenting behaviours. Mothers and fathers with higher‐than‐average collectivism in their culture reported higher parent warmth and expectations for children's family obligations. Mothers with higher‐than‐average collectivism in their cultures more frequently reported warm parenting and fewer externalising problems in children, whereas mothers with higher‐than‐average individualism in their culture reported more child adjustment problems. Mothers with higher‐than‐average conformity values in their culture reported more father‐displays of warmth and greater mother‐reported expectations for children's family obligations. Fathers with higher‐than‐average individualism in their culture reported setting more rules and soliciting more knowledge about their children's whereabouts. Fathers who endorsed higher‐than‐average conformity in their culture displayed more warmth and expectations for children's family obligations and granted them more autonomy. Being connected to an interdependent, cohesive group appears to relate to parenting and children's adjustment. [ABSTRACT FROM AUTHOR]

This study examined associations between maternal and paternal cultural values (individualism, collectivism and conformity) and parenting dimensions (warmth, psychological control, autonomy granting, rule setting, knowledge solicitation and family obligations) and children's adjustment (internalising and externalising behaviours) in 113 families with children (Mage = 10.8 years) recruited from Zarqa, Jordan. Bivariate correlations and multiple regression analyses were used to examine study question. Results revealed that mothers' individualism was positively correlated with more maternal warmth, more rules/limit‐setting and fathers' and children's perceptions regarding children's greater family obligations. Fathers' individualism was not significantly correlated with any parenting or child adjustment variables. Mothers' and fathers' higher collectivism was correlated with more maternal and paternal warmth, respectively; however, mothers' and fathers' higher conformity values were not significantly correlated with any parenting or child adjustment variables. Mothers' collectivism was not associated with any parenting or child adjustment variables after taking into account the other cultural values, child gender and mothers' education; however, fathers' higher collectivism was associated with more paternal warmth, fathers' higher expectations for children's family obligations and less child internalising behaviour. The findings have implications for understanding how cultural values are related to parenting and children's adjustment in Jordan. [ABSTRACT FROM AUTHOR]

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

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

It has been called into question whether widely used screening instruments for child mental health can provide comparable results across countries and cultures. Socialization goals can influence whether and to what extent a parent considers a behavior to be problematic and thus might influence parental reports on their child's behavior. We tested comparability of parental reports between native German (N = 116) and Turkish origin (N = 77) parents in Germany in an online study using a vignette approach. Parents were asked to rate the perceived problem severity of the same behavior depicted in the vignettes. We expected and found that parents of Turkish origin in Germany rate the externalizing problem behaviour depicted in the vignettes as more problematic compared to native German parents. The effect was fully mediated by parental approval of the socialization goals obedience and collectivism. We also controlled for social desirability responding and an extreme response style. [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]

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

Objectives: Integrated primary care provides health and social care services to intervene early and support children and families. Funding of integrated care is a barrier to care provision, but evidence is limited for which funding models are most appropriate. Our study aimed to provide expert judgement on what funding model, or mix of models, are most likely effective for integrating primary care for families with children aged 0-12 years in Australia. Methods: We conducted a resource allocation survey to value funding models for integrated care. Participants were purposively sampled experts in primary health, social care and mental health care. Six funding types were included in the study. Outcome measures included ranking of funding model preferences and qualitative analysis from open-ended questions. Results: Block-funding, alternative-payment-methods and incentive-payments were preferred models for integrated care individually and within a blended model. Fee-for-service, capitation and pay-for-performance were the least preferred models. There was agreement Fee-for-service may hinder integrating care. Conclusions: A blended model, including alternative-payment-methods, incentive-payments and block-funding, were preferred models to best integrate care for child outcomes. Implications for Public Health: Determining how best to fund integrated primary care for children is a priority for decision-making in Australia, as fee-for-service is no longer considered appropriate.