Clinical Child and Family Psychology Review最新文献

As attachment-based interventions can improve caregiver-infant relationships and their subsequent psychological outcomes, the identification of relevant and effective interventions can facilitate their implementation into clinical practice. This systematic review aimed to a) provide an overview of manualised attachment-based interventions, without video-feedback as the main component, for caregivers and infants from conception to two years, and b) determine which of these interventions were effective in demonstrating improvements in caregiver-infant relational outcomes. To identify eligible interventions and their empirical evidence base, two search stages were conducted for 1) relevant interventions and 2) studies of interventions identified in the first stage that focussed on caregiver-infant relational outcomes. All studies included in Stage 2 were quality assessed and findings analysed. Twenty-six interventions were eligible for inclusion at Stage 1 but studies reporting on relational outcomes were identified for 16 interventions only. Forty studies reporting on those 16 interventions met inclusion criteria and were synthesised at Stage 2. Most studies were of good quality. Observer-rated measures were used in 90% of studies. There was evidence for these interventions in relation to improving caregiver-infant relational outcomes: 80% of studies reported a statistically significant positive change in a relational outcome for the intervention compared to pre-intervention or control group. The most promising evidence was identified for Attachment and Biobehavioral Catch-Up (ABC), Minding the Baby (MTB) and Circle of Security (COS). This systematic review offers guidance to healthcare professionals, commissioners and policymakers within perinatal sectors in relation to the training, delivery and implementation of evidenced manualised attachment-based interventions.

Parental bipolar disorder (BD) is associated with an increased risk of mental health problems in children. Despite the urgent need for clear guidance on how best to support parents with BD, current research lacks a unified analysis of the challenges and needs faced by these parents and their children. This review aims to explore the impact of BD on experiences of parent-child interactions or relationships to inform effective policies and interventions. Following a preregistered PROSPERO protocol, we searched Medline, Embase, PsycINFO, SCOPUS, and CINAHL for qualitative studies on parents with BD and their children (under 19 years) published since 1994. Each study was independently screened and jointly assessed for quality using the Critical Appraisal Skills Program. Our thematic synthesis entailed coding in NVivo, followed by collaborative theme generation on the Miro platform. We reviewed 19 studies, of which 9 studies reported on parents, 8 on children, and 2 on both parents and children. Our analysis generated four themes: (1) "The multifaceted landscape of parenting with BD," which outlines how mood swings affect parenting in diverse ways; (2) "The evolving dynamic of child-parent relationship amidst parental BD," including how children adapt and grow in understanding and responsibility in response to their parent's BD; (3) "The dual nature of childcare for parents with BD," which explores how childcare impacts parents' emotions and motivations, bringing both uplifting and challenging effects; (4) "Navigating parental challenges in the context of BD," highlighting the importance of open communication, self-reflection, and timely, unbiased support to mitigate challenges associated with parental BD. This qualitative synthesis focuses specifically on the parenting experiences of families affected by parental BD. It highlights the complex, dynamic impact of BD on parenting behaviors and children's coping mechanisms, calling for tailored therapeutic interventions that benefit both parents and children. The scope of our study is limited by factors such as a predominance of Western perspectives and an underrepresentation of fathers' experiences, highlighting the need for more diverse research in this area.

Video-aided feedback (VF) is a well-evidenced intervention technique to enhance the relationship between a parent and their young child. While parental acceptability is foundational to engagement and intervention efficacy, the parent’s perspective is only now emerging as a valued consideration when evaluating VF-based interventions. This systematic review metasynthesised qualitative research on the experiences of primary caregivers with a young child (primarily 0–30 months) of participating in a VF parenting intervention. A search of nine databases yielded 17 studies (10 published since 2020) involving parents who had participated in range of VF-focussed programmes. Thematic synthesis identified six themes: (1) Getting past the fear and discomfort: Being ‘good enough’ and ‘doing the right thing’; (2) The power of video: “I had never really noticed that before‟ (with two subthemes: video as validation and for seeing child behavioural intentionality; video as an agent for change); (3) The practitioner’s skill and role in creating a safe space; (4) The approach was too intangible, inflexible, positive, unclear; (5) When the intervention is over: Positive change and generalisation; (6) Parental engagement and involvement: Barriers and enhancements. While most parents reported experiencing a range of interpersonal and intrapersonal benefits from taking part in a VF parenting intervention, having to overcome initial strong negative and uncomfortable feelings were an important part of the journey. Some parents could not see the value of the approach or did not perceive the intervention to meet their needs. Insights into parental experience are complementary to outcome-based evaluations. However, biased design (e.g., only one study included intervention non-completers) and variable study quality need addressing in future studies. Implications for practice are discussed.

Self-harm in young people is associated with increased risk of suicide and other negative long-term outcomes. Understanding the motivations driving self-harm behaviours among young people can help to inform the development of preventative and treatment interventions. Self-harm rates have been rising, but reviews of the recent quantitative literature have not been undertaken. PsycInfo, Embase and Medline were systematically searched in September 2024 for studies published in the past ten years. Quantitative studies that examined motivations for self-harm (including prevalence and/or correlates) among young people (aged 10 to 24 years) with a history of self-harm were included in the review. The review was conducted in accordance with PRISMA guidelines and registered with PROSPERO (CRD42023429568). One hundred and seventeen studies met inclusion criteria. Intrapersonal motivations for self-harm (particularly emotion regulation, anti-dissociation and self-punishment) were more common than interpersonal motivations (e.g. peer bonding, communication). Intrapersonal motivations correlated with female gender, higher self-harm severity, current, repetitive and persistent self-harm, suicidality, poorer mental health and poorer emotion regulation. There was evidence to suggest that interpersonal motives are associated with younger age and some mental health difficulties (e.g. anxiety). Young people predominantly self-harm for intrapersonal reasons. Given that self-harm for intrapersonal reasons is associated with greater self-harm severity, suicidality and poor mental health, steps should be taken to prevent and reduce self-harm. Interventions for self-harm require a multifaceted approach that not only provides young people with alternate ways of regulating their emotions, but also targets risk factors that contribute to self-harm.

This meta-analytic review examined irritability across childhood and adolescence as it relates to symptoms of common mental health disorders in these periods. Of key interest was whether the relationship between irritability and symptom severity varies according to symptom domain. This was tested at the level of broad symptom dimensions (internalizing versus externalizing problems) as well as discrete diagnostic domains (e.g., anxiety, depression, oppositional defiant disorder, conduct disorder, attention deficit hyperactivity disorder; autism spectrum disorder). Following PRISMA guidelines, a systematic search of five databases was conducted to identify studies reporting on associations between irritability and mental health symptoms in samples of children aged 2–18 years. Meta-analytic tests based on random effects models examined concurrent and longitudinal associations between irritability and symptom severity. Meta-regression tested potential moderators including symptom domain, child age, sex, informant type, and study quality. 119 studies met inclusion criteria with a total of 122,456 participants. A significant and positive association was found between irritability and severity of concurrent overall psychopathology in the order of a moderate effect size, while small to moderate effect sizes characterized the association between irritability and later mental health outcomes in prospective data. Further variation in this association was seen across specific diagnostic domains and methodological moderators. Findings support the conceptualization of irritability as a transdiagnostic construct reflecting emotion dysregulation across diverse forms of psychopathology in childhood and adolescence. Further research into the risk mechanisms underlying irritability is needed, in addition to translational approaches to early intervention.

This scoping review examined grief related to the incarceration of a family member in order to establish a theoretical framework. A comprehensive search of PubMed, Social Sciences Citation Index, Embase, PsycInfo, Psychology & Behavioral Sciences, CINAHL, Cochrane Central Register of Controlled Trials & Cochrane Database of Systematic Reviews, PILOTS, and Psychiatry Online was conducted. We extracted data on sample characteristics, study design, purpose of the study, grief measure used, grief term and definition used, and key qualitative and quantitative findings. Twenty-five studies met inclusion criteria. Most studies used the terms 'ambiguous loss' (n = 15) and 'disenfranchised grief' (n = 12); however, grief terms and their definitions varied. The review identified 14 unique terms and more than 20 definitions. In several cases, the same term was defined and conceptualized differently between studies. This review also revealed shortcomings in existing theoretical frameworks for grief related to incarceration. Grief related to losing a family member to incarceration involves two distinct constructs: non-traditional losses and cascading losses. Non-traditional losses (measured on a continuum) capture elements of a loss to incarceration that are unique (compared to a loss via death) or may not be socially accepted, whereas cascading losses refers to the ongoing losses that one may experience related to the incarceration (e.g., loss of financial stability). This framework provides the field with consistent constructs and definitions that can be used to further advance research in incarceration-related grief and facilitates an improved ability to replicate findings between laboratories.

There is a long-standing interest in gender differences in satisfaction in intimate relationships. Whereas prior research has focused on gender differences in central tendency (i.e., means), we conducted two studies - a secondary analysis of data from a probability sample of Australian married couples and a meta-analysis - to examine gender differences in variability (i.e., variances). We hypothesized that compared to males, females would demonstrate greater variability in intimate relationship satisfaction (i.e., greater female variability hypothesis), particularly at lower levels of relationship satisfaction. Results from a secondary analysis of data from 2,711 married couples in the Household, Income and Labour Dynamics in Australia (HILDA) survey and from a meta-analysis of 20 years of research (k = 171, N = 84,976), including independent samples from 33 countries, indicated that relative to males, females reported greater variability in relationship satisfaction. Obtained effect sizes (female-to-male variance ratios [VRs] of 1.42 for the HILDA sample and 1.19 for the meta-analysis) were larger than proposed cutoffs for meaningful group differences in variability. Analysis of tail ratios (ratios of the relative proportion of females divided by the relative proportion of males in the distributional tail regions) in the HILDA sample indicated that gender differences in variability were greater at lower (versus higher) levels of satisfaction. Findings support the greater female variability hypothesis and suggest that by focusing only on gender differences in means, the existing literature has underestimated gender differences in intimate relationship satisfaction.

Measurement-Based Care (MBC) is the systematic use of patient-reported data to inform care decisions and monitor treatment progress. MBC has been shown to improve patient outcomes across medical and mental health treatment settings for adults and youth. While many studies have examined the use of MBC in specific care settings, few have focused on the implementation of MBC among youth populations or across care settings. While a review has shown that use of MBC benefits youth, no published reviews exist that summarize the successful strategies and barriers to implementation models across studies in youth service settings. To address these gaps, the present systematic review (N = 25 studies) focuses on the implementation of MBC across four youth service settings, including outpatient mental health centers, medical centers/pediatric clinics, schools, and clinical psychology training clinics. Results suggest that few studies employ consistent implementation models or strategies to guide efforts. Further, there is significant overlap in the successful strategies employed as well as the barriers to implementation of MBC across youth service settings, at the client, clinician, and organizational levels. Broadly, the authors recommend on the basis of findings that future implementation work in youth service settings: incorporate comprehensive training in the use of MBC for clinicians; incorporate stakeholder feedback into the implementation process for initial and sustained use; employ digital measurement feedback systems to deliver MBC that allow for real-time feedback and continuous technical support; and employ a health equity lens in implementation efforts to help address disparities in access to and use of MBC so that all youth and families may benefit from this evidence-based practice.

"Functional speech" by 5 years of age is widely established as increasing the probability of long-term positive outcomes across a range of domains for autistic individuals. While terms such as "functional" or "useful" speech are often used, what defines these terms is not well established. Furthermore, most research focusing on language development has emphasized the transition from little or no language to use of single words, but much less is known about the transition from single words to phrase speech, which could be equally important. The verb lexicon is foundational to the development of simple, generative phrases and has been linked to prosocial behaviors and general developmental outcomes including better social communication skills, socioemotional reciprocity, and nonverbal communication in autistic children. The current systematic review synthesized information from 20 independent samples to characterize autistic children who transitioned from single words to phrase speech. On average, 48% of the pooled sample transitioned to phrase speech during the study periods. Results were highly variable across studies. Participants under the age of 5 years were more likely to transition to phrases than participants over the age of 5. Though average standard scores were above 50, children who transitioned to phrases generally demonstrated below average adaptive and cognitive skills and moderate-high ASD symptomatology. Variable measures of cognition made it difficult to ascertain patterns in cognitive skills; nonetheless, nonverbal IQ emerged as a salient predictor of the transition to phrases across studies. More research is needed to better understand who transitions beyond single words, clinical benchmarks on the way to generative phrase speech and the factors that predict this transition. Such information can be used to inform clinical decision making and develop or improve targeted interventions based on individual communication profiles. This could make the use of phrases more likely for a greater number of autistic individuals, increasing the likelihood that these individuals communicate independently and effectively with others.