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OBJECTIVE: To explore whether a mentalization-based communication training for pharmacy staff impacts their ability to elicit and recognize patients' implicit and explicit medication related needs and concerns.METHODS: A single-arm intervention pilot study was conducted, in which pre-post video-recordings of pharmacy counter-conversations on dispensed-medication (N = 50 and N = 34, respectively; pharmacy staff: N = 22) were coded. Outcome measures included: detecting needs and concerns, and implicitly and explicitly eliciting and recognizing them. Descriptive statistics and a multi-level logistic regression were conducted. Excerpts of videos with needs or concerns were analyzed thematically on mentalizing attitude aspects.RESULTS: Indications show that patients more often express their concerns in an explicit way post-measurement, just as pharmacy staffs' explicit recognition and elicitation of needs and concerns. This was not seen for patients' needs. No statistically significant differences were found for determinants for detecting needs or concerns (i.e., measurement-, professional-type, or interaction). Differences in mentalizing attitude were observed between pre-post-measurements, e.g., more attention for patients.CONCLUSION: This mentalizing training shows the potential of mentalizing to improve pharmacy staff members' explicit elicitation and recognition of patients' medication-related needs and concerns.PRACTICE IMPLICATIONS: The training seems promising for improving patient-oriented communication skills in pharmacy staff. Future studies should confirm this result.

Part of the appeal of attachment language is that it feels near to our everyday experience, as terms like 'attachment', 'security' or 'disorganisation' feel readily recognisable. Yet, not one of these terms is used by academic attachment researchers in line with ordinary language. This has hindered the evidence-based use of attachment in practice, the feedback loop from practice to research and the dialogue between attachment researchers in developmental psychology and in social psychology. This paper pinpoints the difficulties arising from the existence of multiple versions of 'attachment theory' that use exactly the same terms, held by communities that assume that they are referring to the same thing and with little infrastructure to help them discover otherwise. When we talk past one another, the different communities with a stake in knowledge of attachment are obstructed from genuinely learning from one another, drawing on their respective strengths and pursuing collaborations. One factor contributing to this situation has been the use of attachment terminology with technical meanings, but often without setting out clear definitions. We here introduce a guide to attachment terminology used by the academic community, which has recently been published on the website of the Society for Emotion and Attachment Studies. The guide is meant for researchers, clinicians and everyone concerned with attachment to increase understanding of the technical meaning of important terminology used by researchers, and support the quality of discussions between researchers, and between researchers and clinicians and other publics. ispartof: JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY vol:64 issue:5 pages:839-843 ispartof: location:England status: published

Heightened sensation-seeking is related to the development of delinquency. Moreover, sensation-seeking, or biological correlates of sensation-seeking, are suggested as factors linking victimization to delinquency. Here, we focused on epigenetic correlates of sensation-seeking. First, we identified DNA methylation (DNAm) patterns related to sensation-seeking. Second, we investigated the association between sensation-seeking related DNAm and the development of delinquency. Third, we examined whether victimization was related to sensation-seeking related DNAm and the development of delinquency. Participants (N = 905; 49% boys) came from the Avon Longitudinal Study of Parents and Children. DNAm was assessed at birth, age 7 and age 15–17. Sensation-seeking (self-reports) was assessed at age 11 and 14. Delinquency (self-reports) was assessed at age 17–19. Sensation-seeking epigenome-wide association study revealed that no probes reached the critical significance level. However, 20 differential methylated probes reached marginal significance. With these 20 suggestive sites, a sensation-seeking cumulative DNAm risk score was created. Results showed that this DNAm risk score at age 15–17 was related to delinquency at age 17–19. Moreover, an indirect effect of victimization to delinquency via DNAm was found. Sensation-seeking related DNAm is a potential biological correlate that can help to understand the development of delinquency, including how victimization might be associated with adolescent delinquency.

Background: To study clinicians' and parents' awareness of suicidal behaviour in adolescents reaching the upper age limit of their Child and Adolescent Mental Health Service (CAMHS) and its association with mental health indicators, transition recommendations and mental health service (MHS) use. Methods: 763 CAMHS users from eight European countries were assessed using multi-informant and standardised assessment tools at baseline and nine months follow-up. Separate ANCOVA's and pairwise comparisons were conducted to assess whether clinicians' and parents' awareness of young people's suicidal behaviour were associated with mental health indicators, clinician's recommendations to continue treatment and MHS use at nine months follow-up. Results: 53.5 % of clinicians and 56.9 % of parents were unaware of young people's self-reported suicidal behaviour at baseline. Compared to those whose clinicians/parents were aware, unawareness was associated with a 72–80 % lower proportion of being recommended to continue treatment. Self-reported mental health problems at baseline were comparable for young people whose clinicians and parents were aware and unaware of suicidal behaviour. Clinicians' and parents' unawareness were not associated with MHS use at follow-up. Limitations: Aspects of suicidal behaviour, such as suicide ideation, -plans and -attempts, could not be distinguished. Few young people transitioned to Adult Mental Health Services (AMHS), therefore power to study factors associated with AMHS use was limited. Conclusion: Clinicians and parents are often unaware of suicidal behaviour, which decreases the likelihood of a recommendation to continue treatment, but does not seem to affect young people's MHS use or their mental health problems.

Improving parenting, child attachment, and externalizing behaviors: Meta-analysis of the first 25 randomized controlled trials on the effects of Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD). VIPP-SD combines support of parental sensitive responsiveness with coaching parents in sensitive limit setting. Here, we present meta-analyses of 25 RCTs conducted with more than 2,000 parents and caregivers. Parents or children had various risks. We examined its effectiveness in promoting parental cognitions and behavior regarding sensitive parenting and limit setting, in promoting secure child–parent attachment, and reducing externalizing child behavior. Web of Science, MEDLINE, PubMed, and recent reviews were searched for relevant trials (until May 10, 2021). Multilevel meta-analysis with META, METAFOR, and DMETAR in R took account of the 3-level structure of the datasets (studies, participants, measures). The meta-analyses showed substantial combined effect sizes for parenting behavior (r = .18) and attitudes (r = .16), and for child attachment security (r = .23), but not for child externalizing behavior (r = .07). In the subset of studies examining effects on both parenting and attachment, the association between effect sizes for parenting and for attachment amounted to r = .48. We consider the way in which VIPP-SD uses video-feedback an active intervention component. Whether VIPP-SD indeed stimulates secure attachment through enhanced positive parenting remains an outstanding question for further experimental study and individual participant data meta-analysis.

Support from grandparents plays a role in mothers’ perinatal mental health. However, previous research on maternal mental health has mainly focused on influences of partner support or general social support and neglected the roles of grandparents. In this narrative review and meta-analysis, the scientific evidence on the association between grandparental support and maternal perinatal mental health is reviewed. Searches in PubMed, EMBASE, MEDLINE, Scopus, and PsycINFO yielded 11 empirical studies on N = 3381 participants, reporting on 35 effect sizes. A multilevel approach to meta-analysis was applied to test the association between grandparental support and maternal mental health. The results showed a small, statistically significant association (r = .16; 95% CI: 0.09–0.25). A moderator test indicated that the association was stronger for studies reporting on support from the maternal grandmother in particular (r = .23; 95% CI: 0.06–0.29). Our findings suggest that involved grandparents, in particular mother’s own mother, constitute a protective factor for the development of maternal postpartum mental health problems. These findings have clear implications for interventions. Future studies should examine whether stimulating high-quality support from grandparents is a fruitful avenue for enhancing maternal postpartum mental health.

Background: The configuration of having separate mental health services by age, namely child and adolescent mental health services (CAMHS) and adult mental health services (AMHS), might be a barrier to continuity of care that adversely affects young people's mental health. However, no studies have investigated whether discontinuity of care in the transition period affects mental health. We aimed to discern the type of care young people receive after reaching the upper age limit of their CAMHS and examine differences in outcomes at 24-month follow-up between young people receiving different types of care. Methods: To assess mental health in young people from 39 CAMHS in eight European countries (Belgium, Croatia, France, Germany, Italy, Ireland, the Netherlands, and the UK), we did a longitudinal cohort study. Eligible young people were CAMHS users up to 1 year younger than the upper age limit of their CAMHS or up to 3 months older, if they were still in CAMHS. Information on mental health service use, mental health problems (ie, using the Health of the Nation Outcome Scale for Children and Adolescents, Youth Self-Report and Adult Self-Report, DSM-5, and ICD-10), and sociodemographic characteristics were collected using self-reported, parent-reported, and clinician-reported interviews and questionnaires. Mixed models were applied to assess relationships between baseline characteristics, mental health service use, and outcomes. Findings: The MILESTONE cohort included 763 young people. The participants were 60·0% female (n=458) and 40·0% male (n=305), 90·3% White (n=578), and had a mean age of 17·5 years (range 15·2–19·6 years). Over the 24-month follow-up period, 48 young people (6·3%) actively withdrew from the study. For young people, the higher their scores on the Health of the Nation Outcome Scale for Children and Adolescents (p=0·0009) and Youth Self-Report and Adult Self-Report (p=0·046), and who had a clinical classification of severe mental illness (p=0·0033), had suicidal thoughts or behaviours or self-harm (p=0·034), used psychotropic medication (p=0·0014), and had a self-reported or parent-reported need for continued treatment (p

Interventions to support mentalizing abilities are relevant for all people to enhance social skills and well-being. For people with mild to borderline intellectual disabilities, learning mentalizing skills may be challenging, however, because of the abstract and complex nature of the construct. The application of serious games has the potential to teach and train in these skills and engage this target group in treatment. This study investigates the key elements of a design model for a serious game aimed at learning abstract skills, taking into account the needs and wishes of adults with mild to borderline intellectual disabilities. We first searched the literature for guidelines covering effective interventions and for game design elements with the potential to train in abstract skills and motivate this specific group. We then included co-researchers with mild to borderline intellectual disabilities in guiding the development of the serious game ‘You & I’. Here we describe application of the recommendations from the literature to the development of the game and the co-creation process. This process resulted in key elements described in a design model that provides more structured knowledge for future studies of teaching abstract skills using a serious game in this population.

Objective: The present study investigated the direction of the relation between oral communicative competence and social preference in early childhood classrooms. Additionally, we explored the role of dialogic classroom talk in this relation. Methods: N = 311 children (aged four to seven) participated. Oral communicative competence was measured with the Nijmegen Test for Pragmatics and social preference was assessed with a peer nomination method (both constructs measured at two timepoints). Results: Outcomes of cross-lagged analyses demonstrated a directional link from social preference to oral communicative competence, but not the other way around. There were no differences in the relation between the two constructs between classrooms in which dialogic classroom talk was implemented and classrooms in which it was not. Conclusion: This study seems to indicate the importance of children's social preference for developing adequate communicative abilities.

Nowadays, parents, caretakers, teachers and researchers have an increasing interest in the development and consequences of problematic social media use, especially among adolescents. A growing body of research investigates factors that may influence the development of problematic social media use. This study examined the role of the broader context of parental (time spent with parents and family support), peer (peer support and peer pressure), and individual factors (perceived self-control) in the development of adolescents' risky and problematic social media use (ref = normative), as well as the moderating role of self-control by using a longitudinal design. Adolescents (N = 1384) aged 11–19 years (Mage = 14.1, SD = 1.03) were included and completed a self-report questionnaire twice (6-month interval). A Multinomial Logistic Regression showed that parent and peer factors predicted risky social media use, but not problematic use of social media. Adolescents’ level of self-control did not modify these relationships. However, low self-control did increase the odds of developing risky or problematic social media use directly. In conclusion, this study provides preliminary evidence that general parent and peer factors can help to prevent risky social media use, but to a lesser extent problematic use of social media. For the latter, the individual factor self-control, however, seems to play a role.

How do hormonal levels in men change from pregnancy to after the birth of their firstborn child, and what is the role of oxytocin, alone or in interplay with other hormones, in explaining variance in their parenting quality? We explored in 73 first-time fathers the development of five hormones that have been suggested to play a role in parenting: oxytocin (OT), vasopressin (AVP), testosterone (T), oestradiol (E2) and cortisol (Cort). In an extended group of fathers (N = 152) we examined associations with fathers' behaviour with their 2-month-old infants. OT and E2 showed stability from the prenatal to the postnatal assessments, whereas AVP and T decreased significantly, and Cort decreased marginally. OT on its own or in interplay with other hormones was not related to paternal sensitivity. Using an exploratory approach, the interaction between T and E2 emerged as relevant for fathers' sensitive parenting. Among fathers with high E2, high T was associated with lower sensitivity. Although we did not find evidence for the importance of OT as stand-alone hormone or in interplay with other hormones in this important phase in men's lives, the interaction between T and E2 in explaining variation in paternal behaviour is a promising hypothesis for further research. This article is part of the theme issue 'Interplays between oxytocin and other neuromodulators in shaping complex social behaviours'. ispartof: Philosophical Transactions Of The Royal Society B-Biological Sciences vol:377 issue:1858 pages:1-11 ispartof: location:England status: published

Objective: Understanding the relationship between attachment and mental health has an important role in informing management of perinatal mental disorders and for infant mental health. It has been suggested that experiences of attachment are transmitted from one generation to the next. Maternal sensitivity has been proposed as a mediator, although findings have not been as strong as hypothesised. A meta-analysis suggested that this intergenerational transmission of attachment may vary across populations with lower concordance between parent and infant attachment classifications in clinical compared to community samples. However, no previous study has examined major depression and adult attachment in pregnancy as predictors of infant–parent attachment classification at 12 months postpartum. Methods: Data were obtained on 52 first-time mothers recruited in early pregnancy, which included 22 women who met diagnostic criteria for current major depression using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders. The Adult Attachment Interview was also administered before 20 weeks of pregnancy. A history of early trauma was measured using the Childhood Trauma Questionnaire and maternal sensitivity was measured at 6 months postpartum using the observational measure of the Emotional Availability Scales. Infant–parent attachment was measured using the Strange Situation Procedure at 12 months. Results: Overall, we found no significant association between the Adult Attachment Interview and the Strange Situation Procedure classifications. However, a combination of maternal non-autonomous attachment on the Adult Attachment Interview and major depression was a significant predictor of insecure attachment on the Strange Situation Procedure. We did not find that maternal sensitivity mediated parental and infant attachment security in this sample. Conclusion: While previous meta-analyses identified lower concordance in clinical samples, our findings suggest women with major depression and non-autonomous attachment have a greater concordance with insecure attachment on the Strange Situation Procedure. These findings can guide future research and suggest a focus on depression in pregnancy may be important for subsequent infant attachment.

The present study investigated associations between parents' secure base script knowledge and parental sensitivity and sensitive discipline in 461 families with 922 same-sex twin children ( M age = 7.00, SD = 2.18). In addition, we explored whether the strength of the associations between parents' secure base script knowledge and parental sensitivity and sensitive discipline were similar for mono- and dizygotic twin siblings. Parental sensitivity was observed during a computerized version of a structured cooperative drawing task (Etch-A-Sketch). Sensitive discipline was observed during a "Don't touch task" or during a "Do-Don't task". Parental sensitivity and discipline strategies were observed twice, once with each twin sibling. Parents' knowledge of the secure base script was measured with the Attachment Script Assessment. Linear mixed model analyses showed that parents with more secure base script knowledge interacted with their twin children in a more sensitive manner and showed more sensitive discipline. These findings show for the first time that parents' secure base script knowledge predicts not only parental sensitivity but also sensitive discipline. Associations between parents' secure base script knowledge and parental sensitivity and sensitive discipline were not impacted by children's similarity in genetic makeup. Future longitudinal studies utilizing multiple measures of sensitivity and discipline across the infancy, childhood, and early adolescence periods could provide more insight into the continuity of relations between secure base script knowledge and parental sensitivity and sensitive discipline. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Background Siblings of children with disabilities also need support. However, there are only a few evidence-based interventions for these siblings. The current study aims to assess the effectiveness of a newly developed serious game for young siblings of children with intellectual disability (ID) and/or visual impairment (VI). This serious game is hypothesized to improve sibling’s quality of life, adjustment to their brother’s or sister’s disability, and multiple aspects of psychosocial well-being. Methods The intervention consists of a serious game called “Broodles” (in Dutch: “Broedels”) that helps children to recognize and deal with thoughts, feelings, and difficult situations. The game consists of eight 20-minute levels that all have the same structure with eight game elements. Each level addresses a domain of sibling quality of life and combines animations, mini-documentaries, fun mini-games, and multiple-choice questions. In addition to the game, siblings make a worksheet after playing each level. In order to support the child, the parents or caregivers receive a short brochure with information and tips. The effectiveness of the intervention will be investigated among a sample of 154 children aged 6–9 years and their parents or caregivers, using a two-arm parallel RCT design. The experimental group will play the serious game “Broodles” over a period of 4 weeks, whereas the control group will be placed on a waiting list. Assessments will take place at three time points: pre-test (week 1), post-test (week 5), and follow-up (weeks 12–14). At each timepoint, children and parents will complete several questionnaires on quality of life and different aspects of psychosocial well-being. In addition, children will make drawings to assess the sibling relationship. Next to that, parents and children will answer closed and open-ended questions about the sibling adjustment to their brother or sister’s disability. Finally, parents and children will evaluate the serious game through closed and open-ended questions. Discussion This study contributes to the knowledge about sibling interventions and serious games. Additionally, if the serious game is proven to be effective, it will be a readily available, easily accessible, and free of charge intervention for siblings. Trial registration ClinicalTrials.gov, NCT05376007, registered prospectively on April 21, 2022.

Samen spelen met je kind is leuk. Je hebt plezier, je geniet samen; er is contact. Al vanaf het eerste begin heb je contact met je kind. Door aanraken, kijken, ‘praten’ en geluiden maken, ontstaat ongemerkt een ‘vraag-en-antwoordspel’, een subtiele wisselwerking: je kind maakt een geluidje, jij reageert erop door het geluid na te doen. Je kind voelt zich daardoor bevestigd: het is leuk wat ik doe, ze zien mij, ze begrijpen mij. Je kind reageert ook op jou; het kijkt naar je, luistert, lacht, maakt bewegingen waardoor ook jij je bevestigd voelt. Zo groeit de hechting, de emotionele band tussen je kind en jou; de basis voor de verdere ontwikkeling. Als je kind een visuele beperking heeft, kan de wisselwerking tussen jou en je kind, het speelse contact, zeker in het begin wat minder vanzelfsprekend verlopen. Dit boek geeft allerlei handreikingen waarmee je kunt aansluiten bij het spel van je kind en het nog leuker kunt maken.

Displaying selective attachment behaviours is an important developmental milestone for children with severe or profound intellectual disabilities (SPID). In the current study, between-child differences in their selective emotional responses to comfort provided by parents versus strangers were observed. We explored links between these differences and parental sensitivity and motor competence. A home-based experimental observation was conducted in 38 parent-child dyads, exposing children to four naturalistic stressors and to comfort provided by either their parents or a stranger. Emotional behaviour (arousal and valence) was micro-coded and differentiation variables were constructed, reflecting the children’s level of differentiation between the parent and the stranger. Parental sensitivity was coded using the Emotional Availability Scales. Results showed that these children’s differentiated responses to comfort were related to children’s motor competencies (particularly their fine motor skills), but not to parental sensitivity. This study shows the need to go beyond sensitivity to understand individual differences in the most basal aspects of attachment for children with SPID.

Het gebruik van technologie in de zorg kan bijdragen aan participatie, levensgemak, autonomie, positief zelfconcept en welzijn van mensen met een verstandelijke beperking. In dit artikel wordt vanuit verschillende wetenschappelijke studies een overzicht gegeven over de inzet van technologie in de zorg en aandachtspunten hierbij. Technologie kan worden gebruikt in het dagelijks leven voor het bevorderen van fysiek welzijn en voor het ondersteunen van adaptieve, cognitieve en sociale vaardigheden. Ook bij meer complexe orthopedagogische vraagstukken zoals interventies voor moeilijk verstaanbaar gedrag kan technologie ondersteunend zijn. Daarnaast kunnen computer-leerspellen (serious games) en apps worden ingezet voor het overdragen van kennis aan ouders en begeleiders. Uit toegepast onderzoek blijken er belangrijke aandachtspunten te zijn voor het gebruik van technologie in de zorg, zoals het omgaan met privacygevoelige data, het ontwikkelen van applicaties samen met de doelgroep en bieden van ondersteuning in het gebruik van technologie.

Purpose The service configuration with distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) may be a barrier to continuity of care. Because of a lack of transition policy, CAMHS clinicians have to decide whether and when a young person should transition to AMHS. This study describes which characteristics are associated with the clinicians’ advice to continue treatment at AMHS. Methods Demographic, family, clinical, treatment, and service-use characteristics of the MILESTONE cohort of 763 young people from 39 CAMHS in Europe were assessed using multi-informant and standardized assessment tools. Logistic mixed models were fitted to assess the relationship between these characteristics and clinicians’ transition recommendations. Results Young people with higher clinician-rated severity of psychopathology scores, with self- and parent-reported need for ongoing treatment, with lower everyday functional skills and without self-reported psychotic experiences were more likely to be recommended to continue treatment. Among those who had been recommended to continue treatment, young people who used psychotropic medication, who had been in CAMHS for more than a year, and for whom appropriate AMHS were available were more likely to be recommended to continue treatment at AMHS. Young people whose parents indicated a need for ongoing treatment were more likely to be recommended to stay in CAMHS. Conclusion Although the decision regarding continuity of treatment was mostly determined by a small set of clinical characteristics, the recommendation to continue treatment at AMHS was mostly affected by service-use related characteristics, such as the availability of appropriate services.

Infant crying is a strong emotional stimulus that elicits caregiving responses in adults. Here we examine the role of empathy (measured with the Polish version of Interpersonal Reactivity Index) and salivary oxytocin in modulating sensitive responsiveness to a crying infant simulator in two groups of heterosexual couples: 111 expecting or 110 not expecting a baby. Sensitive responsiveness was observed during a standardized procedure using the Ainsworth Sensitivity Scale while participants took care of the infant simulator, both individually and as a couple. Other-oriented empathy predicted elevated levels of individual but not couple sensitive responsiveness. More OT reactivity to crying predicted less responsiveness in non-expecting couples, which might be explained by their stronger focus on task performance. This study uniquely combined hormonal, observational and self-report measures in couples, and showed that personality and hormonal correlates of sensitive responsiveness might be studied before the child’s birth with the use of infant simulators.

Background:The multi-disciplinarity of long-term care for people with intellectual disabilities makes organisations seek stability and predictability, complicating implementing innovations. Interventions to implement a method for reducing restrictive measures were analysed through the lens of Normalisation Process Theory to understand the social mechanisms at play.Methods:Process notes, collected during a trial in which a method to reduce restrictive measures was implemented, were analysed guided by implementation interventions defined by Cochrane Effective Practice and Organisation of Care Review Group. These interventions were mapped to social mechanisms of Normalisation Process Theory.Results:Implementation interventions were widely used in which clients’ perspectives were expressed (client-related-interventions), and consensus processes were held with care professionals. These interventions initiated NPT’s social mechanisms’ Coherence, Cognitive Participation and Collective Action.Conclusions:The emphasis on consensus and clients’ perspectives when methodically reducing restrictive measures reflects some unique implementation challenges in long-term intellectual disability care.

Contains fulltext : 238957.pdf (Publisher’s version ) (Open Access) Becoming a parent requires new skills and frequent task switching during daily childcare. Little is known about the paternal brain during the transition to fatherhood. The present study examined intrinsic neuronal network connectivity in a group of first-time expectant and new fathers (total N = 131) using amygdala seed-based resting-state functional connectivity analysis. Furthermore, we examined the association between paternal involvement (i.e. hours spent in childcare and real-time push notifications on smartphone) and connectivity within the parental brain network in new fathers. There were no significant differences in functional connectivity between expectant and new fathers. However, results show that in new fathers, time spent in childcare was positively related to amygdala connectivity with the supramarginal gyrus, postcentral gyrus and the superior parietal lobule - all regions within the cognition/mentalizing network that have been associated with empathy and social cognition. Our results suggest that fathers' time investment in childcare is related to connectivity networks in the parental brain. 8 p.

Understanding if maternal depression is a predictor of infant-parent attachment classification is important to furthering knowledge about the early pathways and predictors of socio-emotional development. Yet few studies that have utilised the Strange Situation Procedure, the gold standard for measurement of infant-parent attachment, have examined antenatal depression as a predictor of attachment, and none has also included a measure of maternal trauma. This study uses data on 224 women recruited in early pregnancy and followed up until 12 months postpartum. Maternal depression was measured in pregnancy using the Structured Clinical Interview for the DSM and repeat Edinburgh Postnatal Depression Scale as well as Stressful Life Events scale across pregnancy and postpartum including items on domestic violence. A past history of trauma was measured using the Childhood Trauma Questionnaire. Attachment was measured using the Strange Situation Procedure (SSP) at 12 months postpartum. We found that maternal depression was not associated with insecure or disorganized attachment. However, a maternal history of childhood trauma and current domestic violence both predicted insecure-avoidant attachment at 12 months, whereas increased number of stressful life events prior to conception and in pregnancy was associated with insecure-resistant attachment. Neither trauma, past or current, nor depression predicted disorganized attachment. In the first study to have included measures of antenatal depression, maternal childhood trauma, and current stressful events as predictors of infant attachment measured using the SSP, we found maternal experiences of past and current trauma but not depression were significant predictors of infant-parent attachment security.

Background Child mental health problems are a major public health concern associated with poor mental and physical health later in development. The study evaluates a new community-based intervention to promote sensitive parenting and reduce enduring mental health problems and unhealthy weight among vulnerable infants aged 9-24 months. Methods We use a step-wedge cluster randomized controlled trial design conducted within a home visiting program offered by community health nurses to infant families in Denmark. Sixteen municipalities are randomly allocated to implement the intervention starting at three successive time points from May 1, 2022 to January 1, 2023. A total of 900-1000 families will be included. A standardized program, Psykisk Udvikling og Funktion (PUF), is used to identify infants with major problems of eating, sleep, emotional or behavioral regulation or developmental problems. The intervention builds on the Video-Feedback Intervention to Promote Positive Parenting (VIPP) program, adapted to the PUF-context and named the VIPP-PUF. Children will be followed up at ages 18 and 24 months. Primary outcome measure is the Strengths and Difficulties Questionnaire (SDQ) at child age 24 months. The other outcome measures include body mass index z-scores, the Ages and Stages Questionnaire Social-Emotional (ASQ:SE2); the Child Behavior Checklist (CBCL 1½ -5); Eating behavior Questionnaires; the Being a Mother-questionnaire (BaM13); the Parental Stress Scale (PSS); and the WHO-5 well-being index (WHO-5). Data on child and family factors are obtained from National registries and the Child Health Database. Quantitative measures are applied to examine the effectiveness of the VIPP-PUF intervention and the implementation process. Qualitative measures include interviews with CHNs, parents and municipality stakeholders to explore factors that may influence the adherence and effectiveness of the intervention. Discussion The study examines a service-setting based intervention building on the promotion of sensitive parenting to vulnerable infants. We use a mixed methods approach to evaluate the intervention, taking into account the influences of COVID-19 pandemic running since March 2020. Overall, the study has potential to add to the knowledge on the possibilities of prevention within the municipality child health care to reduce the risk of mental health problems and unhealthy weight in early childhood. Trial registration www.ClinicalTrials.gov; IDNCT04601779; Protocol ID 95-110-21307. Registered 25 June 2021.

Home-based parental involvement in early education is linked to beneficial outcomes in children’s development and may redress unequal educational outcomes associated with family background. The type of educational activities at home and the way parents provide their support may differ across parents with and without a migration background. It is unclear whether home-based parental involvement is measured as the same construct across different origin groups. In this study, the psychometric properties of two parent-report questionnaires on home-based parental involvement were evaluated in 131 Dutch mothers of kindergarten-aged children, of whom 47% had a migration background. The dimensional structure of both questionnaires was tested with Principal Component Analysis. Multi-group confirmatory factor analyses were conducted to test for measurement invariance of the ‘Parenting Questionnaire’ across migration background. Results supported the multidimensional nature of home-based parental involvement, as formal and informal activities formed distinct components in the involvement of this diverse parent sample. In addition, measurement invariance was largely confirmed, indicating that parent’s involvement style can be validly measured across parents with and without a migration background in the Dutch context. Incorporating both formal and informal activities with involvement styles is recommended when measuring home-based parental involvement in different origin groups.

In the care for people with intellectual disabilities in the Netherlands there is a growing emphasis on the relationship with relatives. The aim of this study is to explore the views of relatives regarding the quality of care and support for people with visual and intellectual disabilities. In this qualitative study twelve semi-structured interviews were conducted with relatives of people with visual and intellectual disabilities having experience with multiple group-homes of specialized care organizations. Analysis revealed seven overarching themes: 1) Be partners in care; 2) ‘Know’ the person with the disability; 3) Provide care from the heart; 4) Provide safety; 5) Provide opportunities for development; 6) Provide continuity in care; 7) Provide a ‘home’. We conclude that the attitudes of care professionals are very important to provide good care and support, as seen from the perspective of relatives. For relatives, it is important to be acknowledged by the care professionals.

Item does not contain fulltext Moving towards person-centered care, with equal partnership between healthcare professionals and patients, requires a solid role for the patient in the education of students and professionals. Patients can be involved as teachers, assessors, curriculum developers, and policy-makers. Yet, many of the initiatives with patients are isolated, small events for targeted groups and there is a lack of patient involvement at the institutional level. To support educators in involving patients, both at the institutional level and at single educational encounters, we offer twelve practical tips. This paper came about through an innovative collaboration between healthcare professionals, educators, teachers, and patients. These tips can be used as a tool to start or reinforce patient involvement in health professions education and provide guidance on how to make it a sustainable part of the curriculum. The article involves organizational conditions for success, tips for sustainable partnerships, ideas for curriculum design and proposes concrete teaching strategies. Finally, besides practical tips, we stress that involving patients in education is not business as usual, and paradoxically this needs to be acknowledged before it can become business as usual. 01 januari 2023

PurposeThe presence of distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) impacts continuity of mental health treatment for young people. However, we do not know the extent of discontinuity of care in Europe nor the effects of discontinuity on the mental health of young people. Current research is limited, as the majority of existing studies are retrospective, based on small samples or used non-standardised information from medical records. The MILESTONE prospective cohort study aims to examine associations between service use, mental health and other outcomes over 24 months, using information from self, parent and clinician reports.ParticipantsSeven hundred sixty-three young people from 39 CAMHS in 8 European countries, their parents and CAMHS clinicians who completed interviews and online questionnaires and were followed up for 2 years after reaching the upper age limit of the CAMHS they receive treatment at.Findings to dateThis cohort profile describes the baseline characteristics of the MILESTONE cohort. The mental health of young people reaching the upper age limit of their CAMHS varied greatly in type and severity: 32.8% of young people reported clinical levels of self-reported problems and 18.6% were rated to be ‘markedly ill’, ‘severely ill’ or ‘among the most extremely ill’ by their clinician. Fifty-seven per cent of young people reported psychotropic medication use in the previous half year.Future plansAnalysis of longitudinal data from the MILESTONE cohort will be used to assess relationships between the demographic and clinical characteristics of young people reaching the upper age limit of their CAMHS and the type of care the young person uses over the next 2 years, such as whether the young person transitions to AMHS. At 2 years follow-up, the mental health outcomes of young people following different care pathways will be compared.Trial registration numberNCT03013595., publishedVersion

Contains fulltext : 239201.pdf (Publisher’s version ) (Open Access) Social support is associated with mental well-being and favorable therapy outcomes. As autonomy-connectedness, the capacity for self-governance in interpersonal context, may affect reliance on others, we investigated whether stress-modulating effects of social support are moderated by autonomy-connectedness. Ninety-seven undergraduates completed measures on autonomy-connectedness and trait social anxiety, and attended a laboratory session with a friend (support) or alone (control). All underwent a virtual Trier Social Stress Test and completed anxiety, cortisol and heart rate (variability) measures. Preregistered analyses revealed that social support reduced anxiety reactivity and delayed heart rate variability decreases, but not heart rate. Contrary to hypotheses, autonomy-connectedness did not predict stress-reactivity or interact with condition. Exploratory analyses suggested effects of social support on cortisol reactivity and indicated that reported support quality varied by trait anxiety and self-awareness. Our findings underline the stress-modulating effects of social support and suggest that social support can benefit individuals with varying levels of autonomy-connectedness. 12 p.

Support from best friends is an important interpersonal factor in adolescent depression development but is often studied from an individual perspective in which dyadic effects are overlooked. This study aims to a) test whether differences in support vary at the individual level and are related to individual differences in the development of depressive symptoms, whether these differences vary at the dyadic level and are related to dyadic depression symptom development, or both, b) explore whether these associations are moderated by initial levels of depressive symptoms on the individual and/or dyadic level. Data from 452 adolescents (Mage = 13.03), nested in 226 same-gender friendship dyads (60.6% boy-dyads) who participated in the RADAR-Y project were included. Best friends self-reported annually (2006–2008; 3 waves) on their own depressive symptoms and perceived support from their friend. Multilevel models showed no direct association between support and depression development on the individual or dyadic level. However, the initial level of dyads’ depressive symptoms moderated the association between dyadic support and dyads’ subsequent depression symptom development. When dyads experienced relatively more initial depressive symptoms, higher levels of dyadic support were associated with relative increasing dyadic depressive symptoms. When dyads experienced relatively few initial depressive symptoms, higher levels of dyadic support were associated with relative decreasing dyadic depressive symptoms. Findings suggest that support from best friends can either protect against or exacerbate the development of depressive symptoms for friends, depending on the initial level of depressive symptoms of the dyad.

IntroductionParenthood can be experienced as a pleasant but challenging period for parents, possibly accompanied by parenting stress. Early parenthood in particular is a vulnerable period as many parents experience biological and psychosocial changes related to new parenthood. Previous studies have shown that parenting stress is related to child behavior problems, but few studies have investigated the transactional relations across time between parenting stress and child internalizing and externalizing outcomes separately, examining within-person changes. The first aim of this study was to examine the transactional within-person associations of parenting stress and child internalizing and externalizing behavior problems across childhood from age 9 months to 9 years. As a second aim, we examined parenting as a possible underlying mechanism of the transactional associations by testing whether parental warmth and hostility mediate within-person associations of parenting stress and child behavior across time.MethodData were analyzed from the Growing Up in Ireland longitudinal child cohort study including 7,208 caregiver-child dyads at wave 1 (child’s age 9 months), who were followed at child’s age three (wave 2), five (wave 3), and 9 years (wave 5). Primary caregiver’s and child’s age and gender, household income, occupational status, educational status, partner status, and cultural background were covariates assessed at all waves. Data were analyzed using a random intercept cross-lagged panel model (CLPM) in R-lavaan.ResultsBidirectional relations between parenting stress and child behavior were found for both internalizing and externalizing behavior from age 5 to 9, but not for earlier time points.DiscussionOur results did not indicate mediating effects of parental warmth or parental hostility in the associations between parenting stress and child behavior problems. Therefore, we conclude that parenting stress and child internalizing as well as parenting stress and child externalizing behaviors have transactional associations from child’s age 5 to 9 years. Future research examining transactional associations of parenting stress and child behaviors should investigate possible other mediations taking a within-person approach by utilizing the RI-CLPM.

Background Interparental violence has persistent adverse effects on victimized parents and children. Young children, including infants and toddlers, are at particular risk to develop long-lasting negative outcomes, and yet specific evidence on effective intervention approaches for this vulnerable group is still lacking. This study will test the effectiveness of an attachment- and trauma-informed intervention approach in a sample of parent-child dyads who have experienced severe interparental violence. We test the individual and combined effects of two interventions: (1) “Nederlandse Interventie Kortdurend op Atypisch oudergedrag” (NIKA; Dutch, short-term intervention focused on atypical parenting behavior) aimed at improving the attachment relationship and (2) eye movement desensitization and reprocessing (EMDR) therapy aimed at reducing parental post-traumatic stress disorder (PTSD) symptoms. Methods This study uses a multicenter randomized controlled design across multiple domestic violence shelters in the Netherlands. We aim to recruit 150 parent-child dyads with children aged between 0.5 and 6 years old. The study design consists of two phases. During the first phase for testing the effect of NIKA only, eligible dyads are randomly allocated to either NIKA or a waitlist usual care group. A pre-test is conducted prior to the treatment period and a post-test takes place directly afterwards (6 weeks after the pre-test). Phase 2 follows directly for testing the effects of EMDR and the combination of NIKA and EMDR. Parents who report clinical PTSD symptoms are randomly allocated to either EMDR therapy or a waitlist usual care group. Parents who do not report clinical PTSD symptoms only receive care as usual. Six weeks later, a post-test of phase 2 is conducted for all participating dyads. Primary study outcomes are disrupted parenting behavior, sensitive parenting behavior, and parental PTSD symptoms. Secondary study outcomes include PTSD symptoms and behavioral and emotional problems of the child. Discussion This study will inform and enhance the clinical field by providing new insights regarding effective treatment combinations for traumatized parents and their young children after interparental violence. Trial registration Netherlands Trial Register (NTR) NL9179. Registered 7 January 2021

Background: Moving around and being physically active can often be challenging for people with a visual impairment. The combination of a visual and intellectual disability can make being physically active even more difficult. The aim of the current study was to examine whether a technological device for physical activity promotion would be associated with more movement and whether using it would be experienced as enjoyable for people with visual and intellectual disabilities. Methods: A randomised multiple baseline design was used for this study. The participants were nine adults with a visual impairment and an IQ between 20 and 50. As participants interacted with the Light Curtain, movement was measured with triaxial accelerometers embedded in the Empatica E4 wristband. Independent observers scored activity, alertness and well-being from video-recordings using the following observation lists: the Happiness Feature Score (HFS) and the Arousal and Valence Scale (AVS). Results: Physical activity measured with the accelerometer and positive excitement measured with the AVS significantly increased among participants when they were engaged with the Light Curtain compared with care-as-usual activities. Well-being measured with the HFS did not show a significant difference between the baseline and intervention phases. Conclusions: Engagement with the Light Curtain increased physical activity and positive excitement in persons with visual and intellectual disabilities, but more research is necessary to understand how the Light Curtain might affect happiness and well-being.

Cycles of miscommunication often occur within the caregiver–child dyad when a child has a visual or visual-and-intellectual disability, influencing sensitive and responsive caregiver behaviour and child happiness. This study aims to examine the efficacy of using interactive technology, the Barti-mat, to promote sensitive and responsive caregiver behaviour, specifically mirroring behaviour, and increase the happiness of children with a visual or visual-and-intellectual disability. The secondary aim is to examine the social validity of the Barti-mat. A mixed-method approach was used, combining quantitative data from a multiple within-series single-case design and qualitative data comparing play-as-usual with play on the Barti-mat. Eleven caregiver–child dyads participated in a home-based study. No significant effects were found for Attunement nor for Valence. Significant improvements were found for Total Mirroring, Happiness, and Arousal. Overall, the caregivers enjoyed using the Bart-mat and were enthusiastic about the development of specialized play material for children with visual impairments. Results of the current study suggest that the Barti-mat can act as catalyst for caregiver mirroring behaviour and improve the happiness of a child with a visual or visual-and-intellectual disability. Caregivers were generally motivated to use and recommend the Barti-mat again. Minor product improvement recommendations were made. The Barti-mat is appropriate for a diverse group of caregivers and children with a visual or visual-and-intellectual disability and would be a good adjunct to preventive attachment-based interventions.

Key points1 Maternity services across Europe during the pandemic has undergone changes to limit virus transmission; however, many changes are not evidence-based.2 Although these changes were introduced to keep women, babies and healthcare staff safe, the exclusion of companions and the separation of mothers and babies is particularly antithetical to a human rights-based approach to quality care.3 A poll of COST Action 18211 network members showed that inconsistency in the application of restrictions was high, and there were significant deviations from the recommendations of authoritative bodies.4 Concerns have emerged that restrictions in practice may have longer term negative impacts on mothers and their families and, in particular, may impact on the long-term health of babies.5 When practice changes deviate from evidence-based frameworks that underpin quality care, they must be monitored, appraised and evaluated to minimise unintended iatrogenic effects.

The new Dutch Care and Coercion Act aims to better regulate the use of psychotropic drugs for challenging behaviour in people with an intellectual disability. This study explores experiences of intellectual disability physicians (IDPs) in prescribing psychotropic drugs and investigates how the Act and the new multidisciplinary guideline on challenging behaviour affects their practice. A qualitative study was conducted, consisting of nine semi-structured in-depth interviews with IDPs, followed by a thematic analysis. It was found that IDPs experienced the new Act and guideline as supportive of their work as guardians of the appropriate use of psychotropic drugs. The multidisciplinary character of the guideline was experienced positively. However, IDPs are faced with organisational barriers and time constraints, as such, they question the feasibility of implementing the Act. Based on these findings, it can be concluded that the Care and Coercion Act may support the existing shift towards the appropriate use of psychotropic drugs if required conditions can be met.

Research suggests that inter-individual differences in the degree of state attachment variability are related to differences in trait attachment and psychological problems between children. In this study, we tested whether such associations are also relevant at a within-person level, and if so, whether intra-individual fluctuations in the degree of variability were predictive of or predicted by intra-individual fluctuations in trait attachment and psychological problems. Children (N = 152, Mage = 10.41 years, SDage = 0.60 at time 1) were tested three times over a period of one year. At each timepoint, children reported on their expectations of maternal support in different distressing situations. Additionally, we administered measures of trait attachment to children and psychological problems to children and their mothers. We used Random-Intercept Cross-Lagged Panel Models to distinguish between-person from within-person associations between these constructs over time. The results revealed that the degree of state attachment variability was mainly relevant to understand differences between children in trait attachment and psychological problems: children who overall showed more state attachment variability were overall less securely attached at a trait-level and reported more psychological problems. Although evidence for within-person associations was less robust, there was some indication that the degree of state attachment variability might be related to the development of trust and psychological problems at a within-person level.

In the current study, the associations between multiple types of child maltreatment (CM), parent-offspring interactions, and family cohesion were examined in an extended family study. A total of 366 parent-offspring pairs from 137 nuclear families participated. Parents (Mage = 52.8 years, age range: 26.6-88.4 years, 57% female) reported about perpetrated CM and offspring (Mage = 25.7 years, range: 7.5-65.5 years, 58% female) about experienced CM during their childhood. Parent-offspring interactions were observed during a conflict interaction task. Cohesion within the nuclear family was observed during a playful tower building task. Results showed that parents and offspring displayed more aversive behavior in parent-offspring dyads characterized by higher levels of child abuse, but not in dyads characterized by higher levels of child neglect. In addition, less dyadic affective similarity was observed in parent-offspring dyads characterized by higher levels of child neglect, whereas dyadic affective similarity was higher in dyads characterized by higher levels of child abuse. Findings imply that interventions focused on parent-offspring interactions with a somewhat different content for neglectful and abusive families may be efficacious for families in the child welfare system. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

BackgroundOn 1 January 2020, the Care and Coercion Act came into effect in the Netherlands, subjecting involuntary care to more strict regulations and monitoring. This study tested changes in recordings of involuntary care during the transitional year of 2020 and after full implementation in 2021, which coincided with the first severe test of the new regulations, when COVID-19 lockdown measures were taken on 16 March 2020.MethodsData consisted of weekly counts of involuntary care from 1 January 2017 to 31 December 2021, taken from the care data of more than 3000 clients with intellectual disabilities and challenging behaviour of 's Heeren Loo, a large long-term care organisation in the Netherlands. An interrupted time series design was used to compare the period under the former law with the period under the new law and to the period during and after implementation, taking into account the impact of the COVID-19 lockdown measures on recordings of involuntary care.ResultsUnder the new act in Week 1 of 2020, a statistically significant drop occurred in involuntary care counts, after which these counts gradually decreased. The start of 2021, the year in which the act was fully implemented, showed an initial increase in counts of involuntary care, followed by a decrease (all Ps < .001). The introduction of the COVID-19 lockdown measures did not statistically affect the weekly counts of involuntary care.ConclusionsThe decrease in registered involuntary care after the Care and Coercion Act came into effect is a first indication of the efficacy of this new law that requires careful multidisciplinary consultations around the right of clients to respect their self-determination. Follow-up research should examine whether the impact of the new law aligns with clients' experiences of self-determination.

The Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) is effective in increasing parental sensitivity and sensitive discipline, and aims to decrease child behavior problems. Changes in quality of parenting may be accompanied by effects on child stress levels. However, studies of VIPP-SD effects on child behavior problems have shown mixed results and there are no studies to date of the effect of the intervention on children’s stress levels, as measured by hair cortisol concentration (HCC). Furthermore, differences in intervention effectiveness may be explained by differential susceptibility factors. We hypothesized that the effects of the VIPP-SD on child behavior problems might be moderated by currently available child polygenic scores of differential susceptibility (PGS-DS). In the current pre-registered trial, we randomly assigned 40% of n = 445 families with school-aged twin children to the intervention group. The VIPP-SD was successful in decreasing both children’s conduct problems and HCC. Effects were not moderated by available child PGS-DS. We conclude that a brief, home-based video-feedback parenting intervention can decrease child behavior problems and affect the child’s stress-related neuroendocrine system as assessed with hair cortisol. In future studies, more specific PGS-DS for externalizing behaviors should be used as well as parental PGS-DS.

When families live in shelters, family life can be strained. Living spaces are small, rooms can be noisy and crowded, and there are only few places for children to play. In previous research, parents have expressed that this frustrated their family functioning. That is a problem, because a shelter should function as a safe base from which the family can rebuild its independent life. If the shelter adds stress, it cannot function as intended. To contribute towards the reduction of this problem, nature is introduced at shelter locations, for example by creating gardens. Various studies have already shown that nature can reduce stress and offers an interesting play environment. However, it is important to establish what nature can do for family functioning of families in shelters. We firstly explored professionals’ perspective on the benefits of nature for family life in women’s shelters. Thematic analysis of transcripts of Community of Practice meetings showed five themes. According to professionals, nature (1)offers a place for family leisure time, (2)supports social connectedness, (3)supports psychological well-being, (4)offers metaphoric experiences, and (5)supports parenting. The first four themes are in line with extant literature. Professionals’ explanation of the fifth theme suggests that nature supports parenting by providing relatedness between parent and child, parental feelings of competence, and autonomy in parenting. Relatedness, competence, and autonomy are described as basic psychological needs of parents. We know that all parents experience ups-and-downs in their basic psychological needs, but we do not yet know of circumstances that support need crafting. We designed a quasi-experiment and a single case experiment to test if experiencing nature was associated with parents’ basic psychological needs. A quasi-experiment (N=160) with one measurement in the standard indoor context of the shelter and one measurement while experiencing nature showed that experiencing nature was associated with enhanced need satisfaction (d=0.28) and reduced need frustration (d=−0.24). The effect was especially pronounced for parents with young children. The single case experiment (N=3) involved repeated and randomized exposure to the indoor shelter context and to a natural environment. Parents’ basic psychological needs, parents’ affective state, and satisfaction with life were assessed. Exposure to nature significantly increased parents’ basic psychological need fulfillment but did not significantly improve affective state, nor satisfaction with life. We know from extant literature that parents are more likely to experience well-being and interact positively with their children when their basic psychological needs are fulfilled. For parents and professionals it is helpful to know that something as simple as an activity in nature can support parents. Professionals can use that insight in their supportive work by inviting families to do nature activities. For shelter professionals who want to use nature activities, it may be helpful to learn how other professionals choose nature activities for the support of the families in their care. A case narrative study was aimed to uncover professional choices by analysing case narratives that professionals wrote about the parenting supportive nature activities they employed. The analysis shows that professionals promoted a back-and-forth between children’s exploration away from the parent and return. In facilitating these interactions, professionals used specific qualities of the natural environment. A dimensional framework was extracted that described how professionals may choose activities. The studies in this dissertation show that physical places are related to parents’ basic psychological needs. The physical environment where parenting takes place apparently matters. This makes it interesting to more often ask where family life takes place. Could the physical environment be a possible explanatory factor for family functioning? Could the physical environment have a more prominent role in family supportive work? These now seem interesting angles for future research.

Introduction: In the worldwide COVID-19 pandemic, healthcare workers (HCWs) caring for people with intellectual disabilities (ID) face a unique risk above the already heightened occupational risk all HCWs are exposed to, but literature on this specific group is lacking. Understanding why individuals are hesitant to be vaccinated for COVID-19 is essential in order to provide the right measures in improving vaccination numbers. This article reviews the influencing factors of COVID-19 vaccine willingness and hesitancy in HCWs who work with people with ID. Methods: CINAHL, APA PsycArticles, APA PsycInfo, Web of Science, Semantic Scolar, Prospero, Outbreak Science, Cochrane and Scopus were searched for papers including the attitudes on COVID-vaccination of HCWs in the field of ID-care. Only two papers were found on HCWs working with people with ID, therefore the search was broadened to HCWs in general. Twenty-six papers were identified containing quantitative and qualitative data on 43,199 HCWs spread over 16 countries worldwide. Socio-demographical predictors of vaccine willingness were extracted and analysed, as well as attitudes of vaccine willingness and hesitancy. Results: Medical doctors, people of older age, men, and those previously vaccinated with the influenza vaccine were most willing to take the COVID-vaccine. Health factors and ethics were drivers of vaccine willingness; characterised by perceived COVID-threat and wanting to protect family members and others. Distrust and lack of information were the most common drivers of vaccine hesitancy; characterised by concerns on side effects, vaccine safety, vaccine efficacy, and speed of vaccine development. Limiting to the two papers investigating HCWs in the care of people with ID, some similarities were found: (1) only older age was a predictor for vaccine willingness and (2) concerns about possible side effects and the fast development of the vaccine were the main drivers for vaccine hesitancy. Additionally, vaccine willingness and hesitancy in HCWs are not stable over time and are affected by information sources and contextual factors. Conclusions: To achieve the highest COVID-vaccination degree worldwide amongst HCWs, recommendations are made for interventions on distrust-topics to nursing staff, people of younger age, women, and those not previously vaccinated within the HCW-population. Implications: Additional research is needed to specify more precisely the attitudes of HCWs caring for people with ID in general and in more countries worldwide.

Children with chronic illness (CI) are at risk for internalizing problems, which reduce their quality of life, hamper treatment, and increase family stress. Accordingly, behavioral interventions are provided at the family level. However, the effects of parental involvement on child outcomes are not consistently beneficial. Therefore, it is relevant to study the working mechanisms. In the present study, we tested child coping and parenting stress as underlying mechanisms of the effect of an intervention for children and an additional group intervention for parents. Data were analyzed from a randomized controlled trial. Families of children with chronic illness (N = 120, child M age = 12.11 years, range 7.98–18.07) participated in a cognitive-behavioral-based group intervention and were randomized in the child-only intervention or parent–child intervention. Primary outcomes were parent- and child-reported internalizing problems, whereas the mediators were the use of child active coping skills and parenting stress. The causal model was tested with multilevel mediation analysis. Active coping skills and parenting stress stood out as significant mediators of the effect of the intervention on parent- and child-reported internalizing behavior (Cohen’s d effect size range 0.29–1.57). When parents were involved in the intervention, children increased their use of active coping skills and parents decreased in parenting stress, which in turn improved child internalizing problems. Knowing that coping skills and parenting stress underlie the benefit of involving parents can be used for optimizing interventions for children with CI and addressing the risk of internalizing problems.

We investigated the impact of maternal status on hormonal reactivity and behavioral responses to an infant simulator in 117 women (54 primiparous, 63 nulliparous). The amount of affectionate touch and motherese were analyzed as behavioral measures of caregiving. Saliva was collected before and 10 min after interaction with the infant simulator to analyze oxytocin, testosterone, cortisol, and estradiol levels. Nulliparous women also provided information about their fertility motivation. Linear mixed models indicated that greater use of affectionate touch was associated with lower overall testosterone levels. Cortisol decreased in response to the interaction in both groups. In the primiparous group, the amount of affectionate touch associated inversely with cortisol levels, whereas in the nulliparous group such association was not found. Oxytocin or estradiol reactivity to the simulator did not differ between the groups, nor were these hormones associated with behavior. Higher fertility motivation in nulliparous women was related to more motherese, and lower testosterone levels. Our results indicate that the simulator elicits hormonal reactivity both in mothers and nonmothers, but the patterns of associations between caregiving behavior and hormonal levels may be partially different. These results encourage using the infant simulator to explore hormonal processes related to the transition to parenthood. publishedVersion

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic had brought negative consequences and new stressors to mothers. The current study aims to compare factors predicting maternal mental health during the COVID-19 lockdown in China, Italy, and the Netherlands.MethodsThe sample consisted of 900 Dutch, 641 Italian, and 922 Chinese mothers (age M = 36.74, s.d. = 5.58) who completed an online questionnaire during the lockdown. Ten-fold cross-validation models were applied to explore the predictive performance of related factors for maternal mental health, and also to test similarities and differences between the countries.ResultsCOVID-19-related stress and family conflict are risk factors and resilience is a protective factor in association with maternal mental health in each country. Despite these shared factors, unique best models were identified for each of the three countries. In Italy, maternal age and poor physical health were related to more mental health symptoms, while in the Netherlands maternal high education and unemployment were associated with mental health symptoms. In China, having more than one child, being married, and grandparental support for mothers were important protective factors lowering the risk for mental health symptoms. Moreover, high SES (mother's high education, high family income) and poor physical health were found to relate to high levels of mental health symptoms among Chinese mothers.ConclusionsThese findings are important for the identification of at-risk mothers and the development of mental health promotion programs during COVID-19 and future pandemics.

Background Children of lower-educated parents and children in schools with a relatively high percentage of peers with lower-educated parents (lower parental education schools) are more likely to develop emotional and behavioural problems compared to children in higher-educated households and schools. Universal school-based preventive interventions, such as the Good Behaviour Game (GBG), are generally effective in preventing the development of emotional and behavioural problems, but information about potential moderators is limited. This study examined whether the effectiveness of the GBG in preventing emotional and behavioural problems differs between children in lower- and higher-educated households and schools. Methods Using a longitudinal multi-level randomized controlled trial design, 731 children (Mage=6.02 towards the end of kindergarten) from 31 mainstream schools (intervention arm: 21 schools, 484 children; control arm: 10 schools, 247 children) were followed annually from kindergarten to second grade (2004–2006). The GBG was implemented in first and second grades. Results Overall, the GBG prevented the development of emotional and behavioural problems. However, for emotional problems, the GBG-effect was slightly more pronounced in higher parental education schools than in lower parental education schools (Bhigher parental education schools =−0.281, P Conclusions Studies into universal school-based preventive interventions, and in particular the GBG, should consider and incorporate school-level factors when studying the effectiveness of such interventions. More attention should be directed towards factors that may influence universal prevention effectiveness, particularly in lower parental education schools.

Intellectual disability is a neurodevelopmental disorder with a related co-occurrence of mental health issues and challenging behaviors. In addition to purely cognitive functions, socio-emotional competencies may also be affected. In this paper, the lens of developmental social neuroscience is used to better understand the origins of mental disorders and challenging behaviors in people with an intellectual disability. The current concept of intelligence is broadened by socio-emotional brain functions. The emergence of these socio-emotional brain functions is linked to the formation of the respective neuronal networks located within the different parts of the limbic system. Thus, high order networks build on circuits that process more basic information. The socio-emotional skills can be assessed and complement the results of a standardized IQ-test. Disturbances of the brain cytoarchitecture and function that occur at a certain developmental period may increase the susceptibility to certain mental disorders. Insights into the current mental and socio-emotional functioning of a person may support clinicians in the calibration of treatment and support. Acknowledging the trajectories of the socio-emotional brain development may result in a more comprehensive understanding of behaviors and mental health in people with developmental delays and thus underpin supports for promotion of good mental health in this highly vulnerable population. funds of the v. Bodelschwinghsche Stiftungen Bethel Bartiméus Fund

Background: Where self-report is unfeasible or observations are difficult, physiological estimates of pain are needed. Methods: Pain-data from 30 healthy adults were gathered to create a database of physiological pain responses. A model was then developed, to analyze pain-data and visualize the AI-estimated level of pain on a mobile app. Results: The initial low precision and F1-score of the pain classification algorithm were resolved by interpolating a percentage of similar data. Discussion: This system presents a novel approach to assess pain in noncommunicative people with the use of a sensor sock, AI predictor and mobile app. Performance analysis and the limitations of the AI algorithm are discussed.