Journal of Child and Family Studies最新文献

Positive family qualities, including low parent pressure to control weight, high physical activity support, frequent family meals, family connectedness, healthy family functioning, and parental monitoring, may promote youth psychological and behavioral health. We aimed to identify naturally occurring patterns of family qualities during adolescence and examine links with body satisfaction, self-esteem, depressive symptoms, disordered eating, and substance use during adolescence and young adulthood. Our goal was to inform family-centered interventions to prevent adverse health outcomes impacting youth. Data were from a longitudinal study of 1,568 youth (53% female; 20% Asian, 29% Black, 17% Latinx, 19% White), that spanned adolescence (M age = 14.4 years) to young adulthood (M age = 22.2 years). Results from latent class analysis indicated that 8% of families were thriving, with low probability of parent pressure to control weight and high probabilities of physical activity support, frequent family meals, family connectedness, healthy family functioning, and parental monitoring. Other classes were distinguished by weight-specific risk (23% of families), broad risk (34% of families), disengagement (18% of families), and high risk (16% of families). Youth in thriving families reported better psychological and behavioral health than their peers concurrently in adolescence and longitudinally in young adulthood; yet this pattern of family qualities was rare. Family-centered interventions that target parent pressure to control weight, physical activity support, family meals, family connectedness, family functioning, and parental monitoring may help prevent multiple psychological and behavioral health problems. Heterogeneity in family qualities suggests that family-centered interventions could be tailored based on family strengths.

Financial inclusion is critical to poverty reduction, but significant challenges remain. The impact of family economic empowerment interventions has not been tested among adolescent girls at risk of dropping out of school. Additionally, studies exploring adolescent girls' (and their caregivers') experiences with saving and depositing are limited. Hence, we qualitatively explored the saving and banking experiences of Ghanaian adolescent girls and their caregivers (n = 20 dyads) who participated in a combination intervention that included an economic empowerment component. Thematic analysis was used for data analysis. Results showed that most families did not have bank accounts due to lack of knowledge, limited literacy, and the belief that banks were for "rich" people. Forgetting necessary documents was a barrier and program support was a facilitator to account opening during the intervention. Stable income, matched savings, future planning, and small savings were facilitators whereas income fluctuation was a barrier to saving. Fund availability, filling deposit forms, and long lines were identified as challenges and support from bank personnel, relatives, and the program facilitated the depositing process. Our results identify the facilitators and barriers to saving and using bank services; and have programmatic and policy implications in Ghana.

The current study investigates the conjoint effect of prenatal Superstorm Sandy stress (SS) and postnatal parenting, as measured by affectionless control (AC), in determining the risk of early childhood psychopathology. The study included 154 children (45.5% males) longitudinally tracked from ages 2-5 years. Maternal AC was assessed using the Parental Bonding Instrument. The prevalence of child diagnostic outcomes (DSM-IV anxiety disorders, phobias, and disruptive behavior disorders) was ascertained by trained clinical interviewers using maternal responses to the Preschool Age Psychiatric Assessment. Children were stratified into four groups by SS and AC status to identify synergistic effects on psychopathology exceeding the risks expected in an additive model. Children exposed to both SS and AC had over 5-fold increased risk of any anxiety disorder, a 12-fold increased risk for disruptive behavior disorders, and a nearly 5-fold increased risk of any disorder relative to the reference group of children with neither exposure. The risks of anxiety, disruptive behavior, and any disorders were synergistically greater than the sum of independent effects of the two stressors, as evident in the synergy index. Evaluation of synergistically increased risks for childhood disorders will help to identify high-risk children, which in turn could inform design of multi-level interventions to mitigate child psychopathology.

Theory of mind (ToM) describes a child's ability to accurately attribute mental states to themselves and others. ToM has been conceptualized as a protective factor against psychopathology across childhood. Little is known about potential moderators of this association. For example, it is unclear whether there are subgroups of children for whom well-developed ToM plays a stronger protective role for adaptive functioning compared to other children. In a community sample of 467 children, this study examined whether child temperament assessed at age 3 years moderates the association between ToM at age 3 years and internalizing and externalizing symptoms at age 5 years. We used a community detection approach to identify three distinct temperament groups: emotionally and behaviorally well-regulated (EBR), emotionally and behaviorally dysregulated (EBD), and introverted and overcontrolled (IOC). Results from moderated regression analyses suggest that social competence had a stronger protective role for the two temperament groups at elevated risk for emotional and behavioral problems, i.e., EBD and IOC. For the IOC group, greater ToM was associated with reduced externalizing symptoms. Results support the view that ToM, one aspect of social competence, may serve as a protective factor against the development of psychopathology, particularly among introverted and overcontrolled children.

Despite high prevalence of emotional and behavioral difficulties (EBDs) among adolescents living with HIV (ALHIV), there are limited randomized trials assessing the impact of interventions on these outcomes. We assessed the impact of two evidence-based interventions in a three-arm cluster randomized controlled trial (RCT) where nine clinics were randomized to one of three study arms: (1) Usual Care; (2) Group-Cognitive Behavioral Therapy (G-CBT) + Usual Care; and (3) Multiple Family groups (MFG) + Usual Care. We utilized mixed effects models to assess the effect of the intervention on EBDs. While the main effect of the intervention was not significant, χ2(2) = 0.43, p = 0.806, the main effects for time χ2(2) = 32.47, p < 0.001, and intervention-time interaction, χ2 (2) = 59.59, p < 0.001, were statistically significant, suggesting reduction in the EBDs across the groups overtime. Pairwise comparisons showed that in the G-CBT group, EBDs reduced at three months [contrast = -7.59 (CI: -8.20 - -6.99), <0.001] and 6-months [contrast = -8.11 (CI: -12.64 - -3.57), <0.001] compared to baseline. No statistically significant pairwise comparisons across time were observed in the control group, which confirmed that the significant group-by-time interactions were driven by our intervention effects. Findings that G-CBT improved EBDs in this pilot trial highlight the potential efficacy of this intervention in addressing EBDs among ALHIV. However, further studies are warranted to investigate prolonged exposure to MFG as well as combination of MFG and G-CBT to understand the nuances that will ultimately inform the development of tailored effective interventions for addressing EBDs in this vulnerable population.

Offspring of parents who have experienced interpersonal trauma are at increased risk of mental health problems. Because children learn to identify, express, and regulate their emotions through their parents' emotion socialization practices, these parenting behaviors may be an important, modifiable target in the prevention of the intergenerational transmission of mental health risks within trauma-affected families. However, little is known about influences on parents' socialization. The current study examines maternal and youth mental health as correlates and predictors of mothers' supportive and unsupportive responses to their children's negative emotional displays within a heterogenous community sample of 44 victims of interpersonal trauma and their 9-12-year-old children (M = 10.7 SD =1.1). Mothers and youth reported on their mental health symptoms, emotion regulation, coping, and mothers' responses to youth displays of negative affect. At baseline, all but one of the maternal and youth mental health characteristics examined were identified as significant correlates of mothers' unsupportive responses. None of the characteristics were related to mothers' supportive responses. Predictors of changes in maternal responses were examined in a longitudinal subsample (n = 30). Youth's depressive, posttraumatic stress, and externalizing symptoms were associated with increases in mothers' unsupportive responses. Youth adaptive emotion coping skills were associated with decreases in maternal unsupportive responses. Maternal self-efficacy was associated with increases in maternal supportive responses. The current study suggests that both increases in parent and youth adaptive functioning as well as reductions in maternal and youth symptoms are associated with more optimal maternal responses to youth affective displays.

This qualitative study aimed to establish aspects of humanistic therapy that young people (13-16 years old) perceived as helpful and hindering, and to test a novel method for identifying perceived processes of change. A "medium q" thematic analysis was conducted followed by a coding-based "process of change analysis." Participants were 50 young people in London schools who experienced moderate or severe emotional symptoms and had participated in up to 10 sessions of a school-based humanistic intervention. Participants were predominantly female and ethnically heterogeneous. Therapist qualities most often perceived as helpful were affiliative in nature. Unhelpful therapist activities were silences and a lack of input. Young people described feeling free to talk and open up. Helpful outcomes included feeling unburdened, gaining insight, and improving relationships. "Getting things off their chest," "Advice and guidance," "Modeling relationships," and "insights to behavior change" were identified as specific processes of change in over 50% of young people. Approximately one-third felt hindered by a lack of therapist input, silences, or not feeling able to open up or trust. These findings indicate the potential value of an active, "process guiding" stance in humanistic therapy. Our process of change analysis has potential for identifying perceived change mechanisms in therapy. This work was supported by the Economic and Social Research Council [grant reference ES/M011933/1]. Anonymized qualitative interview transcripts are available on request to the First Author/Chief Investigator. Quantitative, participant-level data for the ETHOS study (with data dictionary), and related documents (e.g., parental consent form), are available via the ReShare UK Data Service (reshare.ukdataservice.ac.uk/853764/). Access requires ReShare registration.

Parental communication about body weight and shape is associated with offspring's eating behaviors and body image. However, predictors of parental weight/shape communication are less known. The present study explored whether direct (i.e., comments to the child about their weight and encouragement to diet) and indirect (i.e., modeling of the importance of body weight/shape via parent's own dieting and comments about their own weight) communication about weight, shape, and eating from parents in childhood predicted women's direct and indirect communication about weight/shape to their own child in adulthood. Participants were 634 adult mothers who provided retrospective reports of their parents' direct and indirect weight/shape-related communication during childhood. Participants then self-reported their own current direct and indirect weight/shape communication towards their own child. Multiple linear regression explored whether childhood direct and indirect communication predicts maternal weight/shape communication towards participants' own child in adulthood. Childhood direct weight/shape communication was a salient predictor of both current direct and indirect weight/shape communication. Childhood indirect weight/shape communication did not predict current direct communication when modeled with childhood direct communication, however, it was predictive of current indirect communication. Findings may highlight a need for parental psychoeducation on the lasting influence of familial weight/shape communication.

Parenting can be challenging, and military parents face additional family stressors related to relocations and deployments. ADAPT4U is an evidence-based preventive parenting program specifically designed for military parents of school-aged children. This study examines the feasibility and acceptability of in-person group and telehealth versions of the program. We used quantitative and qualitative data in a concurrent embedded design. Quantitative data were analyzed using SPSS with regressions and ANOVAs. Qualitative data were thematically coded by multiple authors and then a consensus process was undertaken. Both conditions were highly satisfactory for participants, with in-person group rated slightly higher. Families were more likely to attend telehealth than group, both at all and for at least 50% of sessions. Telehealth participants rated more highly: helpfulness, the facilitator was understanding and responsive, and they would participate in a future parenting program based on their experience. Qualitative results reflected positive experiences both with the content and facilitators, and concerns or recommendations that often were directly addressed by the other format (e.g., suggestions by in-person group participants for a telehealth format). Consistent themes across formats included wanting children to be involved in the program and more follow-up after the end of the program. The ADAPT4U program is highly acceptable to participants, and providing multiple format options (in-person group and individual telehealth) will likely make it more feasible for parents to participate in a way that works best for them.