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Objective This study examined the prevalence of elevated maternal anxiety and/or depression symptoms up to eight years after childbirth and the association between role and relationship strains during parenting and mental health challenges from three to eight years after childbirth. Methods This study used data from the All Our Families longitudinal pregnancy cohort. Role and relationship strain factors and anxiety and depression symptoms were measured at repeated time points from four months to eight years after childbirth. The proportion of women with elevated anxiety and/or depression was calculated at each available time point. Generalized estimating equation models were used to examine the association between role and relationship strain factors and anxiety and/or depression from three to eight years after childbirth. Predicted probability of having anxiety and/or depression was estimated across those with and without challenges with roles and relationships. The models were adjusted for known risk factors such as maternal income and perinatal anxiety and/or depression. Results The prevalence of elevated anxiety and/or depression ranged from 18.8% (at four months) to 26.2% (at eight years). The adjusted odds ratio of anxiety and/or depression was 3.5 (95% CI = 2.9, 4.3) for those juggling family responsibilities and 2.4 (95% CI = 2.0, 3.0) for those with stressful partner relationship compared to their counterparts. Similarly, experiencing financial crunch and poor partner relationship were associated with increased mental health difficulties. Women without challenges in roles or relationships had a 23% lower predicted probability of anxiety and/or depression than those with the challenges. Conclusions Monitoring mothers for anxiety and depression beyond the postpartum period and strategies that address role and relationship challenges may be valuable to women at risk of anxiety and depression.

There is now a growing understanding that translational research must be co-created in collaboration with community partners and that solutions to real-world social problems require stepping outside the academic silo. Fewer than half of psychology programs in Canada, however, offer courses in community-based research or evaluation, leaving a gap in skill development amongst the next generation of scholars. In an effort to partially fill this learning gap, the current paper provides insights into lessons learned from the perspectives of researchers and community partners alike, who have been mutually engaging in community-based research over the last 25 years. Ultimately this paper seeks to provide a roadmap for conducting community-based research and illustrates why it should be a central component to research seeking to answer critical questions in psychological science. First, we provide a conceptual foundation of community-based research. Next, using three specific community-based research projects as examples, we share the challenges and benefits of conducting research in the community context. Finally, we highlight future directions for increasing the uptake of community-based research in Canada.

ImportanceThere is a growing body of high-quality cohort-based research that has examined changes in child and adolescent mental health during the COVID-19 pandemic vs before the pandemic. Some studies have found that child and adolescent depression and anxiety symptoms have increased, while others have found these symptoms to have remained stable or decreased.ObjectiveTo synthesize the available longitudinal cohort-based research evidence to estimate the direction and magnitude of changes in depression and anxiety symptoms in children and adolescents assessed before and during the pandemic.Data SourcesMedline, Embase, and PsycInfo were searched for studies published between January 1, 2020, and May 17, 2022.Study SelectionIncluded studies reported on depression and/or anxiety symptoms, had cohort data comparing prepandemic to pandemic estimates, included a sample of children and/or adolescents younger than 19 years, and were published in English in a peer-reviewed journal.Data Extraction and SynthesisIn total, 53 longitudinal cohort studies from 12 countries with 87 study estimates representing 40 807 children and adolescents were included.Main Outcomes and MeasuresStandardized mean changes (SMC) in depression and anxiety symptoms from before to during the pandemic.ResultsThe analysis included 40 807 children and adolescents represented in pre–COVID-19 studies and 33 682 represented in during–COVID-19 studies. There was good evidence of an increase in depression symptoms (SMC, 0.26; 95% CI, 0.19 to 0.33). Changes in depression symptoms were most conclusive for study estimates among female individuals (SMC, 0.32; 95% CI, 0.21 to 0.42), study estimates with mid to high income (SMC, 0.35; 95% CI, 0.07 to 0.63), and study estimates sourced from North America (SMC, 0.25; 95% CI, 0.15 to 0.36) and Europe (SMC, 0.35; 95% CI, 0.17 to 0.53). There was strong evidence that anxiety symptoms increased slightly during the pandemic (SMC, 0.10; 95% CI, 0.04 to 0.16), and there was some evidence of an increase in study estimates with mid to high income.ConclusionsThis systematic review and meta-analysis of longitudinal studies including children and adolescents found an increase in depression symptoms during the COVID-19 pandemic, particularly among female individuals and those from relatively higher-income backgrounds.

This cohort study compared children’s recreational screen time with screen time before the COVID-19 pandemic and during 3 pandemic waves to examine whether changes in screen time were greater than those associated with age.

Screening for social determinants of health, including maternal depression, has become a common and recommended pediatric practice. However, the magnitude of association between maternal and child screening tools remains to be determined. The current study evaluated the association between maternal postnatal depressive symptoms and child developmental milestones, as well as moderators of these associations. A comprehensive search strategy was carried out in four databases (MEDLINE, EMBASE, APA PsycINFO, and Cochrane Central Register of Controlled Trials) from database inception to September 2022. Studies that examine postnatal depressive symptoms and associations with infant and early child (

Adverse childhood experiences (ACEs) are associated with poor physical and mental health outcomes in pregnancy, prompting many care agencies to ask about ACEs as part of routine care. However, limited research has been conducted in the clinical setting to demonstrate associations between ACEs and maternal health (i.e., pregnancy complications and birth outcomes) and mental health in pregnancy (i.e., depression, anxiety, and substance use). The aims of the current study were to: (1) examine the prevalence of ACEs reported by patients attending a maternity clinic for medically low-risk patients, and (2) evaluate whether these reports were associated with prenatal health and mental health. Participants included pregnant women (n = 338) receiving prenatal care at a low-risk outpatient medical clinical from June 2017 to December 2018. Total ACE scores, pregnancy complications (e.g., gestational hypertension, preeclampsia), birth outcomes (e.g., Apgar scores, preterm birth), and mental health outcomes (i.e., anxiety, depression, and substance use) were extracted from electronic medical records. The majority of women (67.8%) reported experiencing no ACEs, 16.0% reported one ACE, 10.1% reported two ACEs, and 6.2% reported three or more ACEs. ACEs were associated with increased odds of prenatal depression, anxiety, and substance use in a dose–response fashion, but not pregnancy health or birth outcomes. Prevalence rates of maternal ACEs obtained in the prenatal care setting were low compared to the general population. While ACEs were positively associated with maternal mental health and substance use in pregnancy, they were not associated with pregnancy complications.

Understanding the implications of the COVID-19 pandemic on the current generation of youth is critical for post-pandemic recovery planning. This study aimed to identify the most salient child (i.e., connectedness to caregivers, screen time, sleep, physical activity, peer relationships, and recreational activities) and family (i.e., COVID-19 financial impact, maternal depression and anxiety) factors associated with children's mental health and well-being during the COVID-19 pandemic, after controlling for pre-pandemic mental health. This study included 846 mother-child dyads (child age 9-11) from the All Our Families cohort. Mothers reported on the child's pre-pandemic mental health at age 8 (2017-2019) and during COVID-19 (May-July 2020), the family's financial impact due to COVID-19, and maternal depression and anxiety. During COVID-19 (July-August 2020), children reported on their screen time, sleep, physical activity, peer and family relationships, and recreational activities, as well as their happiness, anxiety and depression. After controlling for pre-pandemic anxiety, connectedness to caregivers (B - 0.16; 95% CI - 0.22 to - 0.09), child sleep (B - 0.11; 95% CI - 0.19 to - 0.04), and child screen time (B 0.11; 95% CI 0.04-0.17) predicted child COVID-19 anxiety symptoms. After controlling for pre-pandemic depression, connectedness to caregivers (B - 0.26; 95% CI - 0.32 to - 0.21) and screen time (B 0.09; 95% CI 0.02-0.16) predicted child COVID-19 depressive symptoms. After controlling for covariates, connectedness to caregivers (B 0.36; 95% CI 0.28-0.39) predicted child COVID-19 happiness. Fostering parent-child connections and promoting healthy device and sleep habits are critical modifiable factors that warrant attention in post-pandemic mental health recovery planning.

Background Parents have faced substantial social and economic challenges during the COVID-19 pandemic. Preliminary cross-sectional research has demonstrated increases in mental health problems in mothers during the COVID-19 pandemic compared with pre-pandemic estimates. We aimed to study an existing longitudinal cohort of mothers to assess changes in the prevalence of maternal depression and anxiety symptoms as a result of the COVID-19 pandemic over time and at the individual level. Methods In this longitudinal observational study, women who took part in the All Our Families pregnancy cohort in Canada were invited to complete a COVID-19 impact survey between May 20 and July 15, 2020. Women who had not agreed to additional research, had discontinued, were lost to follow-up, or who were not contactable via email were excluded. Maternal depression and anxiety symptoms during the COVID-19 pandemic were compared with three previous estimates collected at 3, 5, and 8-year timepoints (between April, 2012, and October, 2019). Depression symptoms were assessed using the 10-item Center for Epidemiological Studies Depression scale and anxiety symptoms were assessed using the short form of the Spielberger State-Trait Anxiety Inventory. Repeated cross-sectional analyses were done to assess temporal trends and fixed-effects regression models were fitted to assess within-person change over time. Findings Of the 3387 women included in the All Our Families study, 2445 women were eligible and were invited to participate in the COVID-19 impact study, of whom 1333 consented to participate, and 1301 were included in the longitudinal analysis. At the COVID-19 impact survey timepoint, a higher proportion of mothers had clinically significant depression (35·21%, 95% CI 32·48-38·04) and anxiety symptoms (31·39%, 28·76-34·15) than at all previous data collection timepoints. The mean depression score (8·31, 95% CI 7·97-8·65) and anxiety score (11·90, 11·66-12·13) at the COVID-19 pandemic timepoint were higher than previous data collection waves at the 3-year timepoint (mean depression score 5·05, 4·85-5·25; mean anxiety score 9·51, 9·35-9·66), 5-year timepoint (mean depression score 5·43, 5·20-5·66; mean anxiety score 9·49, 9·33-9·65), and 8-year timepoint (mean depression score 5·79, 5·55-6·02; mean anxiety score 10·26, 10·10-10·42). For the within-person comparisons, depression scores were a mean of 2·30 points (95% CI 1·95-2·65) higher and anxiety scores were a mean of 1·04 points (0·65-1·43) higher at the COVID-19 pandemic timepoint, after controlling for time trends. Larger increases in depression and anxiety symptoms were observed for women who had income disruptions, difficulty balancing home schooling with work responsibilities, and those with difficulty obtaining childcare. White mothers had greater increases in anxiety scores than non-white mothers and health-care workers had smaller increases in depressive symptoms than non-health-care workers. Interpretation Compared with previous estimates, the prevalence of maternal depression and anxiety among mothers in a Canadian cohort increased during the COVID-19 pandemic. Financial support, childcare provision, and avoiding the closure of schools, might be key priorities for preventing future increases in maternal psychological distress. Funding Alberta Innovates Health Solutions Interdisciplinary Team, Canadian Institutes of Health Research, Alberta Innovates, and Alberta Children's Hospital Foundation.

Although the medical impacts of COVID-19 are notable, the interpersonal, financial, and social consequences of the pandemic are likely to have the largest and most sustained effect on the psychological health of Canadians Since the onset of the pandemic, mental illness has increased and demand for resources and services are on the rise COVID-19 has served as a catalyst for the rapid implementation and acceptance of telemental health as a psychological service delivery option Telemental health has several benefits, including increased reach and accessibility for those living in rural areas, reduced treatment attrition, and cost savings due to reduced travel Although telemental health may be an innovative solution for broadly delivering psychological services, it can also pose threats to confidentiality and is limited to individuals with accessibility to the Internet and capability to navigate online platforms Telemental health may also not be appropriate for individuals with severe mental illness (e g , active psychosis, suicidality), who require in-person services to mitigate acute risk, or in situations in which a high degree of confidentiality is critical for accurate disclosure (e g , child maltreatment, domestic violence) In this commentary, we describe the benefits and challenges of telemental health, and also highlight important considerations for clinicians, children and youth, systems that coordinate and facilitate mental health services, and future research We conclude that telemental health is not a panacea and requires careful consideration for appropriateness depending on client needs and confidentiality, and standards for ensuring optimal outcomes for clients (PsycInfo Database Record (c) 2020 APA, all rights reserved) Abstract (French) Bien que les repercussions medicales de la COVID-19 soient notables, les consequences interpersonnelles, financieres et sociales de la pandemie auront probablement l'effet le plus important et le plus soutenu sur la sante psychologique des Canadiens Depuis l'apparition de la pandemie, la maladie mentale a augmente et la demande de ressources et de services est en hausse La COVID-19 a servi de catalyseur a la mise en oeuvre et a l'acceptation rapides de la telesante mentale comme option de prestation de services psychologiques La telesante mentale a plusieurs avantages, notamment une portee et une accessibilite accrues pour les personnes vivant dans les zones rurales, une reduction de l'attrition dans le traitement et des economies en raison de deplacements reduits Bien que la telesante mentale puisse etre une solution novatrice pour offrir des services psychologiques a grande echelle, elle peut egalement poser des menaces a la confidentialite et est limitee aux personnes ayant acces a Internet et ayant la capacite de naviguer sur les plateformes en ligne La telesante mentale peut egalement ne pas etre appropriee pour les personnes atteintes d'une maladie mentale grave (p ex , psychose active, tendances suicidaires), qui ont besoin de services en personne pour attenuer le risque aigu ou dans les situations ou un degre eleve de confidentialite est essentiel a une divulgation exacte (p ex , maltraitance des enfants, violence familiale) Dans ce commentaire, nous decrivons les avantages et les defis de la telesante mentale, et nous mettons egalement en evidence des considerations importantes pour les cliniciens, les enfants et les adolescents, les systemes qui coordonnent et facilitent les services de sante mentale et les recherches futures Nous concluons que la telesante mentale n'est pas une panacee et qu'elle necessite un examen minutieux de sa pertinence en fonction des besoins des clients et de la confidentialite, ainsi que des normes visant a garantir des resultats optimaux pour les clients (PsycInfo Database Record (c) 2020 APA, all rights reserved) Impact Statement Public Significance Statement -COVID-19 and its associated physical-distancing requirements served as a catalyst for the rapid uptake and implementation of telemental health This commentary explores both the benefits, as well as the cautions and challenges of using telemental health as a psychological service delivery option during COVID-19 and in a postpandemic future It is argued that each client's clinical needs, safety, and confidentiality, as well as comfort with online platforms, should be considered when determining their appropriateness for telemental health (PsycInfo Database Record (c) 2020 APA, all rights reserved)

The Atypical Maternal Behavior Instrument for Assessment and Classification-Brief (AMBIANCE-Brief) was developed to provide a clinically useful and psychometrically sound assessment of disrupted parenting behavior for community practitioners. With prior evidence of this tool's reliability and validity in laboratory settings, this study aimed to determine whether providers from family service agencies could become reliable in the use of the level of disrupted communication following a brief training. Providers (N = 46) from three agency sites participated in a 2-day AMBIANCE-Brief training and, at the end of the training, coded eight videotaped mother-child interactions. Novice participant coding was compared to expert consensus ratings using intraclass correlations. On average, participants' interrater agreement was good (ICCEl Instrumento Abreviado para Evaluación y Clasificación de la Conducta Materna Atípica (AMBIANCE-Abreviado; Madigan, Bronfman, Haltigan y Lyons-Ruth, 2018) se desarrolló para ofrecer a quienes practican en la comunidad una evaluación clínicamente útil y sicométricamente acertada de la conducta de crianza trastornada. Con la anterior evidencia de la confiabilidad y validez de esta herramienta en el marco de los laboratorios (Cooke, Eirich, Racine, Lyons-Ruth y Madigan, 2020), este estudio se propuso determinar si se podría confiar en quienes proveen el servicio como parte de las agencias de servicio a las familias después de un breve entrenamiento. Los proveedores (N = 46) de tres lugares de agencias participaron en un entrenamiento de dos días sobre AMBAIANCE-Abreviado y, al final del entrenamiento, codificaron ocho interacciones madre-niño grabadas en video. Se comparó la forma de codificar de los novatos con el puntaje consenso de los expertos usando correlaciones dentro de clases. El acuerdo entre los evaluadores fue bueno (ICC media = .84, SD = 0.10), con un 89% de los participantes que lograron el estándar de confiabilidad de ICC.70. En respuesta a preguntas, el 100% de los participantes indicó que ellos recomendarían el entrenamiento de AMBIANCE-Abreviado a sus colegas, 85% reportó que la medida AMBIANCE-Abreviado sería útil o muy útil en su práctica clínica, y 56% creían que los progenitores encontrarían la medida aceptable o muy aceptable para ser integrada en la intervención o el planeamiento de apoyo. En conjunto, estos resultados hablan de la factibilidad de usar AMBIANCE-Abreviado en el marco comunitario.L'Instrument d'Evaluation et de Classification-Brève du Comportement Maternel Atypique (AMBIANCE-Bref; Madigan, Bronfman, Haltigan,Lyons-Ruth, 2018) a été développé afin d'offrir une évaluation du comportement de parentage perturbé, cliniquement utile et saine du point de vue psychométrique, pour les acteurs communautaires. Avec des preuves préalables de la fiabilité et de la validité de cet outil en laboratoire (Cooke, Eirich, Racine, Lyons-Ruth,Madigan, 2020), cette étude s'est donné pour but de déterminer si les prestataires des agences de service à la famille pouvaient devenir fiables pour son utilisation après une formation courte. Des prestataires (N = 46) de trois sites d'agence ont participé à une formation AMBIANCE-Bref de deux jours et à la fin de la formation ont codé huit interactions mère-enfant filmées. Le codage du participant débutant a été comparé aux évaluations par consensus d'expertes en utilisant des corrélations intraclasses. Le coefficient d'objectivité était bon (moyenne des coefficient de corrélation intraclasse [ICC] = 84, SD = 0,10), avec 89% des participants remplissant les standards de fiabilité d'ICC ICC ³,70. En répondant aux questions, 100% des participants ont indiqué qu'ils ou elles recommanderaient la formation AMBIANCE-bref à leurs collègues, 85% ont indiqué que la mesure AMBIANCE-bref serait utile ou très utile pour leur pratique clinique, et 56% ont déclaré qu'ils ou elles croyaient que les parents trouveraient cette mesure acceptable ou très acceptable pour une intégration à une intervention ou le plan de soutien. Au total, ces résultats parlent de la viabilité de l'utilisation de l'AMBIANCE-bref dans des contextes communautaires.Das AMBIANCE-Brief: Schulungen zur Verwendung des Instruments für Praktizierende in Community-Settings Die Kurzform des Instruments zur Bewertung und Klassifikation von atypischem mütterlichem Verhalten (Atypical Maternal Behavior Instrument for Assessment and Classification-Brief; AMBIANCE-Brief; Madigan, Bronfman, HaltiganLyons-Ruth, 2018) wurde entwickelt, damit Praktizierende in Community-Settings auf ein klinisch brauchbares und psychometrisch fundiertes Beurteilungsmaß für gestörtes Elternverhalten zurückgreifen können. Gestützt durch im Laborsetting bereits erbrachte Reliabilitäts- und Validitätsnachweise (Cooke, Eirich, Racine, Lyons-RuthMadigan, 2020), sollte in dieser Studie untersucht werden, ob Praktizierende durch eine kurze Schulung zu einer reliablen Verwendung des Instruments befähigt werden. Mitarbeitende (N = 46) von drei Leistungsträgern nahmen an einer zweitägigen AMBIANCE-Brief-Schulung teil und kodierten am Ende der Schulung 8 auf Video aufgezeichnete Mutter-Kind-Interaktionen. Die Kodierungen der Teilnehmenden wurden mithilfe von Intraklassen-Korrelationen mit Konsens-Ratings von Expert_innen verglichen. Die Interrater-Übereinstimmung war gut (ICCmean = .84, SD = 0.10), wobei 89% der Teilnehmenden den Reliabilitätsstandard von ICC.70 erfüllten. 100% der Teilnehmenden gaben an, dass sie ihren Kolleg_innen die AMBIANCE-Brief Schulung empfehlen würden, 85% schätzten das AMBIANCE-Brief Instrument als nützlich oder sehr nützlich für ihre klinische Praxis ein und 56% glaubten, dass das Instrument bei Eltern bzgl. einer Integration in die Interventions- oder Unterstützungsplanung auf Akzeptanz stoßen würde. Insgesamt sprechen diese Ergebnisse für die Durchführbarkeit des AMBIANCE-Briefs in Community-Settings.地域社会でのトレーニングされたサービス・プロバイダーの簡易-AMBIANCE評価使用についての実現可能性 非定型母性行動の評価と分類のためのツールの簡易版(AMBIANCE-Brief; Madigan, Bronfman, Haltigan,Lyons-Ruth, 2018) は、地域の臨床家にとって、混乱した子育て行動に対して臨床的に役立ち心理測定的に健全な評価を提供できるように開発された。実験室でのこのツールの信頼性と有効性の事前証拠(Cooke, Eirich, Racine, Lyons-Ruth,Madigan, 2020)と共に、本研究では、家族サービス機関のプロバイダーが短期の訓練後にその使い方について信頼性のあるものになっているかどうかについて究明することを目的とした。3つの機関からのプロバイダー(N = 46人)が、2日間の簡易-AMBIANCE訓練に参加し、訓練の終了時に8つの録画された母子相互作用をコード化した。初心者でもある参加者のコーディングは、級内相関を使って専門家コンセンサス評価と比較した。評価者間合意は良く(ICCmean = .84, SD = 0.10)、参加者の89％がICC .70の信頼性基準を満たしていた。質問に対しての答えでは、参加者の100％が簡易-AMBIANCE訓練を同僚に勧めると述べ、85％が簡易-AMBIANCE評価が自分たちの臨床において役に立つあるいは大いに役に立つと報告した。また56％が、親が介入やサポート計画に対し、その評価を統合することに関して受け止めるあるいは大いに受け止めるであろうと信じていた。つまりこれらの結果は、地域社会における簡易-AMBIANCE評価使用についての実現可能性を明らかにした。.开发“简便类型的非典型母亲行为评定分类系统” (AMBIANCE-Brief; Madigan, Bronfman, Haltigan,Lyons-Ruth, 2018) 的目的是为社区从业者提供对养育行为中断在临床上有用的、心理测量上合理的评估。借助该工具在实验室环境中的可靠性和有效性的先前证据 (Cooke, Eirich, Racine, Lyons-Ruth,Madigan, 2020), 本研究旨在确定来自家庭服务机构的从业者在经过短暂培训后是否能够可靠地使用该工具。来自三个机构地点的从业者 (N = 46) 参加了为期两天的AMBIANCE-Brief培训, 并在培训结束时, 编码了八段录制的母子互动视频。利用组内相关性将新手参与者编码与专家共识评级进行比较。组间一致性很好 (ICCmean = .84, SD = 0.10), 其中89％的参与者符合ICC .70的可靠性标准。在回答询问时, 100%的参与者表示他们会向同事推荐AMBIANCE-brief培训, 85%的参与者报告AMBIANCE-brief测量对他们的临床实践是有用或非常有用的, 56%的参与者认为父母可以接受或非常接受该测量纳入干预或援助计划中。总之, 这些发现说明了在社区医疗机构中使用AMBIANCE-Brief的可行性。.جدوى تدريب مقدمي الخدمات على إجراء مقياس (Brief-AMBIANCE) للاستخدام في السياق المجتمعي مقياس السلوك الأمومي الغير نمطي المختصر (brief-Ambiance) تم تطويره من خلال دراسات ماديجان، برونفمان، هالتيغان، وليونس روث، 2018 لتوفير تقييم مفيد وسليم إكلينيكياً لسلوك الأبوة والأمومة المضطرب وذلك ليستخدمه الممارسون في السياق المجتمعي. ومع الأدلة المسبقة على موثوقية وصلاحية هذه الأداة في السياقات المعملية(كوك، آيريش، راسين، ليونز روث، وماديجان، 2020)، تهدف هذه الدراسة إلى تحديد ما إذا كان مقدمو الخدمات من هيئات الخدمات الأسرية يمكن أن يصبحوا موثوقين في استخدامها بعد تدريب قصير. شارك مقدمو الخدمات(N = 46) من ثلاثة مواقع تابعة لهيئات خدمات الأسرة في تدريب على استخدام (Brief-AMBIANCE) لمدة يومين، وفي نهاية التدريب، قاموا بتحليل ثمانية تفاعلات مسجلة بالفيديو بين الأم والطفل. وتم بعد ذلك مقارنة تقييم المشاركين المبتدئين مع تقييمات إجماع الخبراء باستخدام الارتباطات داخل المجموعات. وكان نتيجة الاتفاق جيدة (ICC = .84 و SD = 0.10) حيث حقق 89 % من المشاركين معايير الموثوقية (ICC = 0.70 أو:أكبر). ورداً على الاستفسارات، أشار 100 في المائة من المشاركين إلى أنهم سيوصون بـ “التدريب المختصر لـ”AMBIANCE" لزملائهم، وأفاد 85% منهم بأن المقياس الموجز لـAMBIANCE سيكون مفيداً أو مفيداً جداً لممارستهم الإكلينيكية، ويعتقد 56% أن الآباء سيجدون أن المقياس مقبول أو مقبول جداً للاستخدام في التدخل التجريبي أو دعم التخطيط. وتتحدث هذه النتائج بشكل إجمالي عن جدوى استخدام المقياس المختصر AMBIANCE في السياقات المجتمعية.

Strategies used to restrict the spread of COVID-19, such as school closures and limited extracurricular activities, have resulted in shifts in children's sedentary behaviors1 and increases in screen time have largely been assumed. One limitation of the existing research is that it is either cross-sectional1 or uses national norms as a comparison2 . Longitudinal cohorts with pre-COVID-19 estimates are needed to examine within-person changes in recreational screen time, to inform policy and practice efforts.

Survivors of childhood cancer may be at risk of experiencing pain, and a systematic review would advance our understanding of pain in this population. The objective of this study was to describe: 1) the prevalence of pain in survivors of childhood cancer, 2) methods of pain measurement, 3) associations between pain and biopsychosocial factors, and 4) recommendations for future research. Data sources for the study were articles published from January 1990 to August 2019 identified in the PubMed, PsycINFO, EMBASE, and Web of Science data bases. Eligible studies included: 1) original research, 2) quantitative assessments of pain, 3) articles published in English, 4) cancers diagnosed between birth and age 21 years, 5) survivors at 5 years from diagnosis and/or at 2 years after therapy completion, and 6) a sample size >20. Seventy-three articles were included in the final review. Risk of bias was considered using the Cochrane risk of bias tool. The quality of evidence was evaluated according to Grading of Recommendations Assessment Development and Evaluation (GRADE) criteria. Common measures of pain were items created by the authors for the purpose of the study (45.2%) or health-related quality-of-life/health status questionnaires (42.5%). Pain was present in from 4.3% to 75% of survivors across studies. Three studies investigated chronic pain according the definition in the International Classification of Diseases. The findings indicated that survivors of childhood cancer are at higher risk of experiencing pain compared with controls. Fatigue was consistently associated with pain, females reported more pain than males, and other factors related to pain will require stronger evidence. Theoretically grounded, multidimensional measurements of pain are absent from the literature.

Many children start but do not complete trauma treatment, and there is little knowledge of factors that predict treatment dropout in children who have endured maltreatment. The current study examines the risk and protective factors associated with premature treatment dropout within a sample of 118 children (aged 3–18) referred to a Child Advocacy Centre due to maltreatment, specifically abuse and neglect. In this retrospective chart review, data on risk (i.e., adverse childhood experiences [ACEs] and number of presenting clinical symptoms at intake) and protective factors (e.g., peer support, caregiver support) were extracted from clinical files by two trained coders using a standardized data extraction protocol. Results revealed that, after adjusting for child age, ACEs score, and presenting clinical concerns, children with more protective factors were less likely to drop out of treatment (OR=0.40, 95% CI [0.24, 0.69]). Child age also emerged as a significant predictor of treatment dropout, such that older children were more likely to drop out of treatment prematurely (OR=1.16, 95% CI [1.01, 1.32]). Results suggest that older children and children with fewer protective factors present may benefit from increased retention efforts to reduce treatment dropout.

Background A strong association between the number of adverse childhood experiences (ACEs) and the risk of maternal depression has been demonstrated; however, this association has not been examined with regards to changes in depression across the perinatal period. The objectives of this longitudinal study were to: (1) determine whether ACEs predict depressive symptomology in pregnancy and the postpartum period; (2) test the relative contribution of ACEs, with other established risks of depression, including social support, and (3) examine whether the association between ACEs and depression across the perinatal period vary as a function of social support. Methods Data from 1994 women were collected from a prospective pregnancy cohort. Women completed questionnaires related to ACEs prior to the age of 18. In pregnancy and at 4 months postpartum, social support was measured using the Medical Outcomes Study Social Support Survey and clinical cut-off scores for depression were assessed using the Edinburgh Postnatal Depression Scale. Results Logistic regression demonstrated that after accounting for sociodemographic factors and social support, ACEs predicted depressive symptoms in pregnancy (AOR = =1.26, CI = =1.12–1.43), the postpartum period (AOR = =1.34, CI = =1.17–1.52), and across the perinatal period (AOR = =1.31, CI = =1.12-1.54). Social support did not moderate the association between maternal ACEs and depression for any time point. Limitations retrospective and self-report nature of the data. Conclusion ACEs and low social support are both risk factors for depression, however low social support predicted the highest odds of depression, indicating the importance of asking about social support in pregnant and postpartum women.

Socio-demographic risks are associated with higher child screen time and higher screen time is associated with poor socioemotional and developmental health. Existing studies have not examined children's screen time as a mechanism through which distal risks may be associated with child outcomes. In the current study, we examined whether two proximal factors, screen time and parenting quality, mediate the relation between distal cumulative risk and child outcomes. Participants (N = 1992) were drawn from a birth cohort of mothers and their children (81% white; 46% female). Mothers reported on cumulative risk factors (maternal income, education, depression, stress, marital status, housing instability, unemployment, and maternal history of childhood adversity) during the prenatal period. Parenting quality (ineffective/hostile, positive interactions) and children's screen time (hours/week) were assessed when children were three years of age. Child socioemotional (internalizing and externalizing problems) and developmental (achievement of developmental milestones) outcomes were measured at five years of age. Path analysis revealed indirect effects from cumulative risk to internalizing symptoms and achievement of developmental milestones via screen time. Indirect effects were observed from cumulative risk to internalizing and externalizing behavior via hostile parenting behavior. Over and above the effects of parenting, screen time may be a factor that links structural forms of social disadvantage during the prenatal period to child socioemotional and developmental outcomes. Due to modest effect sizes of screen time, it remains the case that child socioemotional and developmental health should be conceptualized within the context of distal cumulative risk factors such as caregiver psychological and material resources.

Survivors of childhood cancer experience late effects as a result of their cancer treatment. Evidence for the prevalence of pain as a late effect has been equivocal. This study aimed to describe the prevalence and patterns of pain and biospsychosocial variables that may be related to pain in this population.Survivors of childhood cancer (n = 299; 52.5% male; median age = 16.1[4.6-32.6] years; years off therapy = 9.1[2.0-23.7]) were included. Survivors completed a health assessment questionnaire as part of their long-term survivor clinic appointment (median = 3.0 appointments, range = 1.0-7.0) annually or biannually between 2014 and 2017 (Time 1-Time 4). Prevalence of pain was examined and latent class analysis (LCA) was used to identify patterns of pain based on longitudinal reports of pain. Binary logistic regression examined biopsychosocial variables at Time 1 (T1) associated with class membership.Forty-seven percent of survivors reported pain during at least one clinic visit. Headaches were the most prevalent type of pain (26.4%). Survivors of Wilms' Tumor and Ewing's Sarcoma reported the highest prevalence of pain (51.5% and 50.0%, respectively). LCA revealed two clinically relevant profiles: "infrequent or no pain" (74.3%) and "persistent pain" (25.7%). Logistic regression showed that female sex (odds ratio, OR = 2.69, 95% confidence interval, CI [.99, 7.31]), depressive symptomatology at T1 (OR = 2.27, 95% CI [1.31, 3.94]), and drinking to intoxication at T1 (OR = 3.07, 95% CI [1.03, 9.15]), were related to persistent pain.Pain is prevalent among survivors of childhood cancer. Future research should characterize the experience of pain in this population so interventions may be developed. Assessment of pain during regular long-term follow-up appointments is warranted. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Adverse childhood experiences (ACEs) are associated with poor physical and mental health outcomes in pregnancy, prompting many care agencies to ask about ACEs as part of routine care. However, limited research has been conducted in the clinical setting to demonstrate associations between ACEs and maternal health (i.e., pregnancy complications and birth outcomes) and mental health in pregnancy (i.e., depression, anxiety, and substance use). The aims of the current study were to: (1) examine the prevalence of ACEs reported by patients attending a maternity clinic for medically low-risk patients, and (2) evaluate whether these reports were associated with prenatal health and mental health.Participants included pregnant women (n = 338) receiving prenatal care at a low-risk outpatient medical clinical from June 2017 to December 2018. Total ACE scores, pregnancy complications (e.g., gestational hypertension, preeclampsia), birth outcomes (e.g., Apgar scores, preterm birth), and mental health outcomes (i.e., anxiety, depression, and substance use) were extracted from electronic medical records.The majority of women (67.8%) reported experiencing no ACEs, 16.0% reported one ACE, 10.1% reported two ACEs, and 6.2% reported three or more ACEs. ACEs were associated with increased odds of prenatal depression, anxiety, and substance use in a dose-response fashion, but not pregnancy health or birth outcomes.Prevalence rates of maternal ACEs obtained in the prenatal care setting were low compared to the general population. While ACEs were positively associated with maternal mental health and substance use in pregnancy, they were not associated with pregnancy complications.

The COVID-19 pandemic has prompted unprecedented disruptions to the daily lives of children and adolescents worldwide, which has been associated with an increase of anxiety and depressive symptoms in youth. However, due to public health measures, in-person psychosocial care has been affected causing barriers to mental health care access. This study investigated the feasibility, acceptability and preliminary effectiveness of iCOPE with COVID-19, a brief telemental health intervention for children and adolescents to address anxiety symptoms. Sessions were provided exclusively using videoconferencing technology. Feasibility and acceptability were measured with client satisfaction data. The main outcome measure for effectiveness was anxiety symptom severity measured using the Screen for Child Anxiety and Related Disorders (SCARED). Results indicated that the treatment was well accepted by participants. Significant reductions in anxiety were noted for social anxiety, and were observed to be trending towards a mean decrease for total anxiety. The findings suggest that this brief telemental health intervention focused on reducing anxiety related to COVID-19 is acceptable and feasible to children and adolescents. Future research using a large sample and with a longer follow-up period could inform whether symptom decreases are sustained over time.

Background: Mothers have experienced a near doubling of depression and anxiety symptoms pre- to during the COVID-19 pandemic. The identification of mechanisms that account for this increase can help inform specific targets for mental health recovery efforts. The current study examined whether women with higher levels of depression and anxiety symptoms pre-pandemic, reported higher levels of depression and anxiety symptoms during the pandemic, and whether these increases were mediated by perceived stress, strained relationships, coping attitudes, participation in activities, alcohol use, and financial impact. Methods: Mothers (n = 1,333) from an ongoing longitudinal cohort (All Our Families; AOF) from Calgary, Alberta, Canada, completed online questionnaires prior to (2017–2019) and during the COVID-19 pandemic (May-July 2020). Mothers reported on depressive and anxiety symptoms pre- and during the pandemic, as well as perceived stress, engagement in physical and leisure activities, coping, alcohol use, and financial impact of the pandemic. Results: In unadjusted analyses, maternal depression and anxiety symptoms pre-pandemic were strongly associated with COVID-19 depressive (r = 0.57, p

CONTEXT A growing body of research has examined the role of maternal adverse childhood experiences (ACEs) on child behavior problems. OBJECTIVE To summarize the literature examining the association between maternal ACEs and child behavior problems via a systematic review. DATA SOURCES Electronic searches were conducted in Medline, PsycINFO, and Embase (1998–June 2020). Reference lists were reviewed. In total, 3048 records were screened. STUDY SELECTION Studies were included if an association between maternal ACEs and child externalizing (eg, aggression) and/or internalizing (eg, anxiety) problems was reported. In total, 139 full-text articles were reviewed for inclusion. DATA EXTRACTION Data from 16 studies met full inclusion criteria. Studies were synthesized by child externalizing and internalizing outcomes. RESULTS Maternal ACEs were significantly associated with child externalizing problems across all studies (number of studies synthesized per outcome [k] = 11). Significant associations were also found for inattention, hyperactivity, and impulsivity (k = 4), and aggression (k = 2). For internalizing problems (k = 11), significant associations were identified across 8 studies and nonsignificant associations were reported for 3 studies. Maternal ACEs were consistently associated with child anxiety and depression (k = 5). However, inconsistent findings were reported for somatization (k = 2). LIMITATIONS Results are limited to mother-child dyads and questionnaire measures of behavior problems in primarily North American countries. CONCLUSIONS Mothers’ ACEs demonstrated largely consistent associations with children’s behavior problems. Future research is needed to determine if specific types of maternal ACEs (eg, household dysfunction) are more strongly associated with child behavior problems.

IMPORTANCE: Emerging research suggests that the global prevalence of child and adolescent mental illness has increased considerably during COVID-19. However, substantial variability in prevalence rates have been reported across the literature. OBJECTIVE: To ascertain more precise estimates of the global prevalence of child and adolescent clinically elevated depression and anxiety symptoms during COVID-19; to compare these rates with prepandemic estimates; and to examine whether demographic (eg, age, sex), geographical (ie, global region), or methodological (eg, pandemic data collection time point, informant of mental illness, study quality) factors explained variation in prevalence rates across studies. DATA SOURCES: Four databases were searched (PsycInfo, Embase, MEDLINE, and Cochrane Central Register of Controlled Trials) from January 1, 2020, to February 16, 2021, and unpublished studies were searched in PsycArXiv on March 8, 2021, for studies reporting on child/adolescent depression and anxiety symptoms. The search strategy combined search terms from 3 themes: (1) mental illness (including depression and anxiety), (2) COVID-19, and (3) children and adolescents (age ≤18 years). For PsycArXiv, the key terms COVID-19, mental health, and child/adolescent were used. STUDY SELECTION: Studies were included if they were published in English, had quantitative data, and reported prevalence of clinically elevated depression or anxiety in youth (age ≤18 years). DATA EXTRACTION AND SYNTHESIS: A total of 3094 nonduplicate titles/abstracts were retrieved, and 136 full-text articles were reviewed. Data were analyzed from March 8 to 22, 2021. MAIN OUTCOMES AND MEASURES: Prevalence rates of clinically elevated depression and anxiety symptoms in youth. RESULTS: Random-effect meta-analyses were conducted. Twenty-nine studies including 80 879 participants met full inclusion criteria. Pooled prevalence estimates of clinically elevated depression and anxiety symptoms were 25.2% (95% CI, 21.2%-29.7%) and 20.5% (95% CI, 17.2%-24.4%), respectively. Moderator analyses revealed that the prevalence of clinically elevated depression and anxiety symptoms were higher in studies collected later in the pandemic and in girls. Depression symptoms were higher in older children. CONCLUSIONS AND RELEVANCE: Pooled estimates obtained in the first year of the COVID-19 pandemic suggest that 1 in 4 youth globally are experiencing clinically elevated depression symptoms, while 1 in 5 youth are experiencing clinically elevated anxiety symptoms. These pooled estimates, which increased over time, are double of prepandemic estimates. An influx of mental health care utilization is expected, and allocation of resources to address child and adolescent mental health concerns are essential.