CLINICAL CHILD AND FAMILY PSYCHOLOGY REVIEW

Family Members Grieving the Loss of a Person to Incarceration: A Scoping Review
McLean E, Livingston TN, Morgan RD, Rhyne R, Edwards PJ, Prigerson HG and Singer J
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.
Understanding Mechanisms that Maintain Social Anxiety Disorder in Autistic Individuals Through the Clark and Wells (1995) Model and Beyond: A Systematic Review
Lei J, Mason C, Russell A, Hollocks MJ and Leigh E
Given the high co-occurrence of social anxiety in autism, no reviews to date have explored how cognitive and behavioural mechanisms identified to maintain social anxiety in non-autistic individuals may operate in autistic individuals. This systematic review evaluated: (1) empirical evidence underlying the Clark and Wells (1995) Cognitive Model of Social Anxiety in autistic individuals; (2) how vulnerability factors identified from autism literature (beyond core autistic traits) may be associated with social anxiety beyond the cognitive model. Published peer-reviewed English articles until 27th November 2023 were retrieved from PubMed, EMBASE, Ovid MEDLINE and PsycINFO. Quality appraisal and risk of bias were assessed using The Standard Quality Assessment Criteria for Evaluating Primary Research papers from a Variety of Fields tool. 47 articles met full inclusion criteria and included autistic individuals (with clinical diagnosis), a measure of social anxiety, and a mechanism outlined by either (or both) research questions. The majority of the 3340 participants across studies were male without intellectual disability, White/Caucasian, with 7 studies reporting an average age above 30 years old. Most studies used only self-report measures that may have inflated associations observed between social anxiety and mechanisms. All studies employed cross-sectional design, and no causality inferences could be drawn. Methodological issues around potential construct overlaps between social anxiety and autistic traits are highlighted. Overall, there is evidence in support of the as reported by Clark and Well (in: Heimberg (eds), A cognitive model of social phobia, The Guilford Press, 1995) model, as greater fear of negative evaluation from others, use of safety behaviours and somatic symptoms, and peer victimisation were associated with greater social anxiety. The review contributes evidence in support of autism specific contextual, predisposing/antecedent and maintenance factors of social anxiety beyond the original Clark and Well (in: Heimberg (eds), A cognitive model of social phobia, The Guilford Press, 1995) model. Given the potential for considerable heterogeneity for each highlighted process at an individual level across autistic individuals, clinicians can broaden formulation conversations with autistic clients to understand how autism related factors may influence the development and maintenance of social anxiety symptoms when applying and adapting the Clark and Well (in: Heimberg (eds), A cognitive model of social phobia, The Guilford Press, 1995) model.
An Interpersonal and Meta-analytic Approach to Parenting Behaviors and Adolescent Sleep
Ewing EL, Mackaronis JE, Poole EM, Critchfield KL and Gunn HE
Two dimensions of parenting behaviors-affiliative/non-affiliative and autonomy/control- are each consistently linked to adolescent sleep health. Parenting behaviors that facilitate good sleep likely involve affiliation (i.e., warmth) and some degree of parental guidance and appropriate autonomy-granting to the adolescent; however, these domains are often confounded in parenting assessments, which limits understanding and specificity of recommendations for providers and families on how to optimize adolescents' sleep. Thus, we categorized existing literature according to an interpersonal developmental framework to identify parenting behaviors most strongly linked to adolescent sleep health. Studies (k = 42) included 43,293 participants (M age = 14.84, SD age = 2.04). Structural analysis of social behavior (SASB) interpersonal coding was applied to define and operationalize parenting behaviors (independent variables). Dependent variables included measures of sleep health (i.e., sleep regularity, duration, efficiency, latency, timing, quality, alertness/sleepiness) and sleep disturbance. The final effect size of interest for analysis was a correlation coefficient r. Optimal parenting behaviors (e.g., warm, autonomy-granting, moderately controlling) were associated with longer sleep duration, earlier bedtime, less daytime sleepiness, shorter sleep latency, and fewer sleep disturbances. Suboptimal parenting behaviors (e.g., hostile, controlling) were associated with more daytime sleepiness and more sleep disturbances. This is one of the first studies to specify that, when paired with affiliation, both moderate control and moderate autonomy-granting were associated with better adolescent sleep health. Findings indicate that the importance of parental interpersonal warmth extends into adolescence and further suggest that the interpersonal security necessary for good sleep includes appropriate use of control and autonomy-granting behaviors.
Implementation of Measurement-Based Care in Mental Health Service Settings for Youth: A Systematic Review
Whitmyre ED, Esposito-Smythers C, López R, Goldberg DG, Liu F and Defayette AB
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.
Digital Location Tracking of Children and Adolescents: A Theoretical Framework and Review
Davis IS, Thornburg MA, Patel H and Pelham WE
Many parents in the U.S. have begun using GPS-based digital location tracking (DLT) technologies (smartphones, tags, wearables) to track the whereabouts of children and adolescents. This paper lays the foundation for an emerging science of DLT by performing the first theoretical analysis and review of empirical literature on DLT. First, we develop a framework to clarify how DLT should be conceptualized and measured, how it compares to historical strategies for monitoring youths' location, and the mechanisms by which it might affect youth adjustment. Second, we review what is known about DLT today, finding that (1) DLT use is now common from childhood to emerging adulthood, with 33-69% of U.S. families using it; (2) there are sociodemographic differences in DLT use; (3) DLT use has significant cross-sectional associations with other parenting behaviors, with family functioning, and with youth adjustment; and (4) there is much speculation, but minimal data, about the new ethical and developmental issues that might arise from DLT use (e.g., privacy invasions). Third, we critique the existing evidence base to outline priorities for future research, emphasizing the need for longitudinal data, better measurement, and moving beyond convenience samples. We conclude that DLT is a new, common, and vastly understudied parenting behavior of clinical and developmental relevance.
A Systematic Review of Parent Socialization of Negative Affect in Clinical Child Samples: Relations to Youth Emotion Regulation Abilities
Garcia KM, Shroff DM, Patrick A, Ollendick TH and Breaux R
Emotion-focused parenting practices, known as parent emotion socialization, play a crucial role in shaping youth's emotion regulation (ER) abilities. The impact of parent emotion socialization behaviors (ESB) on youth ER has been studied extensively in community samples. However, research on these relations in clinical samples is more limited, albeit growing. The current systematic review sought to evaluate the existing literature examining parent ESB of negative affect in various clinical child and adolescent samples. A literature search was conducted in April 2023, resulting in 1153 abstracts being reviewed. Two reviewers independently screened the titles and abstracts to identify relevant papers, with 152 articles being independently reviewed in full, of which 26 articles met inclusion criteria and are included in the current review. Studies (16 cross-sectional, 6 longitudinal, 4 intervention) utilized multi-methods of assessing youth ER, including questionnaires, physiological, and observational measures in a range of clinical samples, including youth diagnosed with internalizing, externalizing, and neurodevelopmental disorders, as well as youth at-risk for clinical diagnoses such as physically abused children. Overall, results support significant, negative associations between parent ESB practices and youth emotion dysregulation (rs = .22-.35) and negativity/lability (rs = .19-.60), and positive associations with youth ER abilities (rs = .18-.76). Some studies highlighted varying impacts of parental ESB on children with versus without clinical disorders/symptomology, with effects being more pronounced within clinical populations. Implications for these findings and future research directions are discussed, including the significance of focusing on parent ESB in intervention work with clinical child populations.
Examining the Transition from Single Words to Phrase Speech in Children with ASD: A Systematic Review
Byrne K, Sterrett K and Lord C
"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.
Gender Differences in Variability in Intimate Relationship Satisfaction: A Secondary Analysis and Meta-Analysis
Whisman MA and Balzert A
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.
The Effectiveness of Trauma-Informed Parenting Programs for Traumatized Parents and Their Components: A Meta-Analytic Study
Liu AY, Gubbels J and Orobio de Castro B
Parents who have been exposed to trauma face distinct challenges in parenting that can lead to negative child developmental outcomes and intergenerational transmission of trauma. Parenting programs for traumatized parents seem promising, but the existing evidence on their effectiveness has not yet been synthesized. This study aimed to examine the overall effect of trauma-informed parenting programs on (a) parenting and (b) parental mental health outcomes by conducting two three-level meta-analyses. Moderator analyses were performed to identify whether program components, delivery techniques, and other study and program characteristics were associated with effectiveness. A literature search conducted up to August 2024 yielded 15 studies reporting on 110 effect sizes. Significant overall effects were found of trauma-informed parenting programs on both parenting outcomes (d = 0.75, 95% CIs = [0.09, 1.15], p = .027) and parental mental health outcomes (d = 0.21, 95% CIs = [0.09, 0.32], p < .001). The first meta-analysis on parenting found no significant moderators, while the second meta-analysis on parental mental health indicated that programs emphasizing child disciplining skills yielded smaller effects (d = 0.04) compared to programs without this component (d = 0.31). Programs using modeling techniques yielded larger effects (d = 0.32) compared to programs without (d = 0.14). Larger program effects on parental mental health were also found for programs with longer durations and when individual sessions were used. Thus, evidence supports the effectiveness of trauma-informed parenting programs in improving parenting and reducing parental mental health problems.
A Systematic Review of Parental Involvement in Digital Cognitive Behavioural Therapy Interventions for Child Anxiety
Grajdan MMV, Etel E, Farrell LJ and Donovan CL
Cognitive behavioural therapy (CBT) is an efficacious intervention for child anxiety that has been translated into accessible digital formats, many of which involve parents in treatment. However, the value of parental involvement in treatment is not clearly understood. This systematic review examined characteristics of parental involvement (i.e., format and content of sessions, level of therapist guidance, and parent session compliance) in digital CBT for child anxiety (mean child age ≤ 12 years) and their relation to child outcomes (primary disorder remission, clinician-, parent-, and child-rated anxiety, and global functioning). Systematic searches in CINAHL, Embase, ERIC, PsychINFO, PubMed, and Scopus up to 14th August 2023, and citation searching, identified 27 articles (as 23 studies) assessing 14 interventions. Two were parent-only programmes for 3-6-year-old children, with the remaining being parent-child programmes targeting older children. Parents were actively involved as coaches/collaborators, assisting their children with anxiety management and exposure, and less often as co-clients working on their own difficulties. Benefits of treatment were observed across interventions, except for one, psychoeducation-based programme. Higher remission rates were more frequently observed in interventions delivered in controlled settings, those with fewer parent-only sessions, or those incorporating more parent- or therapist-led exposure sessions. Most studies were conducted with affluent samples, limiting generalisability, and several received a high risk of bias rating. Future research should examine parent and family related mechanisms of change and modify interventions for improved adherence, such as restricting the number of modules parents are required to complete and teaching key therapeutic strategies such as exposure early in the programme.
Multi-Informant Universal Mental Health Screening for Preschool-Aged Children by Parents and Educators: A PRISMA Systematic Review
McLean RK, Tully LA, Brinley SK, Carl T, Turnell A, Northam JC and Dadds MR
Children develop rapidly in the preschool period, making accurate appraisals of mental health (MH) difficult. The preschool years are a key period for early identification of MH concerns and could benefit from multi-informant, universal MH screening (UMHS). This systematic review aimed to identify multi-informant UMHS measures for preschool-aged children, and to examine their clinical utility, effectiveness, and acceptability. Studies reporting the predictive and incremental validity, effectiveness or acceptability of parent and educator-report UMHS measures for children aged 3-5 years were identified through CINAHL, Embase, ERIC, Medline, PsycINFO, Scopus and Web of Science. Studies were excluded if screening was not the primary focus, not universal, single informant, or primarily focussed on Autism Spectrum Disorder. A total of 11 studies using 10 measures was identified. Ten studies screened for broad MH difficulties. Three educator-report and one parent- and educator-report measures had acceptable predictive validity. One study reporting incremental validity found that adding educator-report to parent ratings significantly improved the identification of MH concerns. No studies reported on effectiveness. Three studies that explored acceptability reported strong support for either UMHS in general or specific measures. There are promising results that UMHS can accurately identify child MH concerns in the preschool period using parent and educator reports. However, with few of the examined measures reaching the benchmark standards for predictive validity and only one study examining incremental validity, further research is needed to establish clinical utility. UMHS with preschool populations appears to be acceptable; future studies should further examine multi-informant screening in preschool populations. This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO; https://www.crd.york.ac.uk/prospero ; registration number: CRD 42022383426).
Manualised Attachment-Based Interventions for Improving Caregiver-Infant Relationships: A Two-Stage Systematic Review
Wittkowski A, Crompton C and Wan MW
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.
Correction: Siblings of Persons with Disabilities: A Systematic Integrative Review of the Empirical Literature
Levante A, Martis C, Del Prete CM, Martino P, Primiceri P and Lecciso F
Siblings of Persons with Disabilities: A Systematic Integrative Review of the Empirical Literature
Levante A, Martis C, Del Prete CM, Martino P, Primiceri P and Lecciso F
The systematic review aimed to systematize the empirical literature on the psychological impact of disability on the siblings of persons with disabilities, to inform research and provide clinical recommendations. Two research questions addressed the review: (1) What are the main psychological constructs investigated in siblings of persons with disability? (2) What is the main role of each psychological construct in siblings of persons with disability experience? The electronic search was conducted in 7 databases and the PRISMA diagram was used. The inclusion criteria were: Papers published in English and in peer-reviewed journals; papers published between January 2014 and June 2024; qualitative, quantitative, and mixed studies; and papers on the psychological impact of disabilities and/or chronic illnesses on the experience of siblings of persons with disabilities. The standardized Mixed Method Appraisal Tool protocol was used to appraise the methodological quality of the studies. To summarize the findings, a narrative approach was adopted. A total of 60 studies have been reviewed. According to the methodological quality appraisal of studies, most of them reported a high (n = 45) and medium (n = 15) quality. They involved 10,146 participants. Findings revealed that sibling relationships, sibling-focused parentification, and emotional/behavioral adjustment are the main psychological constructs investigated by existing literature. Few studies focused on siblings' well-being. Studies exploring more than a psychological construct were included as a hybrid. Only one study examined the siblings' psychological experience during the COVID-19 pandemic. The quality of the sibling relationship ranged from good to poor; the caregiver is the main role played by siblings of persons with disabilities; anxiety, depression, and aggressive behaviors are the main emotional/behavioral symptoms revealed. Most studies (n = 39) recruited participants with brothers or sisters with mental disorders. The findings of this systematic review may play a role in the clinical field, as they might help to design gender- and age-specific intervention programs.
A Systematic Literature Review of Strategies Implemented in Extended Education Settings to Address Children's Mental Health and Wellbeing
Murray S, March S, Pillay Y and Senyard EL
Mental health and wellbeing problems in middle childhood are increasing worldwide which needs more support than just clinical services. Early intervention has been explored in other settings, but not in extended education care settings such as outside school hours care (OSHC). A systematic literature review was undertaken to determine what interventions have been tested in extended education settings to address or promote emotional, behavioural, or social wellbeing in children, and to assess how effective they have been. A PRISMA guided search found seven peer reviewed articles from an initial pool of 458. Data from the articles were extracted and the mixed method appraisal tool (MMAT) was applied to assess methodological quality of the studies design, data collection, and analyses. The final selections were methodologically heterogeneous with an average MMAT quality rating of 71%. All but one of the interventions were delivered to children in small group settings and were a mix of activities. Studies that trained educators to deliver the interventions were limited and no data were collected for them. The two interventions that trained educators to deliver content to children were seen as promising. This review showed an overall paucity of research examining interventions delivered in extended education settings to improve children's wellbeing. Given variations in extended education services and the absence of formal qualifications required for educators, further research is needed to understand what interventions may be effective and what role educators could play in such interventions or in supporting children's wellbeing in extended education.This review protocol was prospectively registered with PROSPERO . Registration ID: CRD42023485541 on 03/12/2023.
Emotion Regulation Flexibility in Adolescents: A Systematic Review from Conceptualization to Methodology
Haag AC, Bagrodia R and Bonanno GA
Considerable attention has been devoted to the concept of flexible emotion regulation, which de-emphasizes the importance of any specific regulatory strategy in favor of the flexible deployment of strategies in response to specific situational challenges. The bulk of research in this area has been conducted on adult samples. Research on emotion regulation flexibility (ERF) in youth has been documented in only a limited number of studies and using various definitions. This systematic review aims to gather and summarize different conceptualizations and methodological approaches of adolescent ERF. We incorporate these findings into a general framework to understand ERF and its role in adolescents' emotional, behavioral and social functioning. Adhering to the PRISMA guidelines, 11 studies were included in the review. While ERF has been defined in various and inconsistent ways, the included studies utilized conceptualizations from two overarching domains: the regulation of expressed emotion and the repertoire of emotion regulation strategies. Promising approaches and future directions will be highlighted.
When Being Bad Feels Good: A Systematic Review of the Relationship Between Positive Emotion and Antisocial Behavior in Children and Adolescents
Moore J, Tam LYC and Allen JL
Antisocial behavior in childhood and adolescence is associated with poor family and peer relationships, and a higher risk of mental and physical health problems in adulthood, as well as criminality. Emotions play a central role in children's moral development, but most research has focused on negative emotions (e.g., shame and guilt), in relation to childhood antisocial behavior. Research in adult populations indicates that positive emotions experienced in anticipation of, during, and after antisocial acts may play an important role in the development and maintenance of antisocial behavior. Consequently, this systematic review aimed to investigate the relationship between positive emotion and antisocial behavior in children and adolescents. A systematic search in five databases was conducted, yielding 52 studies that used different methodological approaches, samples, designs and methods to examine this association. Results provide support for a positive relationship between positive emotion and antisocial behavior across community, forensic and clinical samples. This link appeared to be stronger for younger children, boys, and for children high in social dominance, callous-unemotional or sensation-seeking traits. Results suggested that positive affect may act in concert with negative emotion, cognitive, personality and motivational processes, as well as peer influences to determine the initiation and maintenance of antisocial behavior. This review presents directions for future research and discusses the implications of findings for prevention and intervention programs for youth with antisocial behavior.
Correction: Determinants of Exposure Therapy Implementation in Clinical Practice for the Treatment of Anxiety, OCD, and PTSD: A Systematic Review
Racz JI, Bialocerkowski A, Calteaux I and Farrell LJ
A Systematic Review of Parental Self-Efficacy in Parents of Autistic Children
Brennan J, Ward OF, Tomeny TS and Davis TE
Parental self-efficacy (PSE) assesses a parent's expectations and beliefs about their ability to effectively parent their child. PSE has implications for a parent's well-being, parenting practices, mental health, the parent-child relationship, and child adjustment. While PSE has been extensively examined within the broader parenting literature, the examination of PSE specifically for parents of autistic children has gained increasing attention in recent years. The following systematic review aimed to investigate the role of PSE for parents of autistic children by examining variables that predict PSE or are predicted by PSE in relation to how they align with the broader parenting literature and are unique to autism. Utilizing PRISMA guidelines, peer-reviewed articles were included if (a) participants included caregivers of autistic children, (b) at least one quantitative outcome measure of PSE was utilized, and (c) the role of PSE was examined as an outcome, predictor, or variable in an explanatory model. A total of 53 studies were included in the review and the role of PSE was examined regarding family (e.g., parental characteristics, parent stress, well-being, and support) and child factors (e.g., autism symptomology, problem behaviors, interventions). Several themes emerged including a positive relationship between PSE and support, and a negative relationship between PSE and parenting stress, parent mental health outcomes (e.g., anxiety, depression), and autism symptomology. Findings were compared to the broader parenting and PSE literature to examine how increased considerations and challenges (e.g., child problem behaviors, social impairment, and caregiver strain) associated with raising an autistic child might impact PSE.
The Role of Parental Verbal Threat Information in Children's Fear Acquisition: A Systematic Review and Meta-analysis
Nimphy CA, Mitrou V, Elzinga BM, Van der Does W and Aktar E
Children can acquire fears of novel stimuli as a result of listening to parental verbal threat information about these stimuli (i.e., instructional learning). While empirical studies have shown that learning via parental information occurs, the effect size of parental verbal threat information on child fear of a novel stimulus has not yet been measured in a meta-analysis. We conducted a systematic review and meta analysis to assess the effect of parents' verbal statements on their children's fear acquisition. Additionally, we explored potential moderators of this effect, namely, parent and child anxiety levels, as well as child age. WebOfScience, Pubmed, Medline, and PsycINFO were used to identify eligible studies that assessed children's (30 months to 18 years old) fear of novel stimuli after being exposed to parental verbal threat information. We selected 17 studies for the meta-analysis and 18 for the systematic review. The meta-analysis revealed a significant causal effect of parental verbal threat information on children's fear reaction towards novel stimuli [g = 1.26]. No evidence was found for a moderation of verbal learning effects, neither by child or parent anxiety levels nor by child age. The effect of parents' verbal threat information on children's fear of novel stimuli is large and not dependent on anxiety levels or child age.
Parenting as a Moderator of the Relation Between Child Inhibited Temperament and Anxiety in Western Contexts: A Systematic Review
Aaron EM, Caley E and Kiel EJ
The literature on the role of parenting in the relation between child inhibited temperament and child anxiety is inconsistent, with some literature supporting a moderating role and some literature supporting alternative (e.g., mediating) roles. A systematic review of the evidence that parenting moderates the longitudinal relation between child inhibited temperament and child anxiety is needed. A systematic review of the literature was conducted in February and March of 2022 and repeated in January of 2024. Ten articles met criteria for inclusion, with 39 moderation analyses of interest among them. All included studies were conducted in Western contexts with predominately White, middle-class families. Thus, the current review can only be generalized to this population. Despite inconsistent findings, some evidence indicated that avoidance-promoting parenting behaviors such as overprotection and overinvolvement moderate the relation between child inhibited temperament and social anxiety symptoms, in particular. There was a lack of evidence that parenting behaviors moderate the relation between child inhibited temperament and anxiety disorders, and that affect-related parenting behaviors (e.g., negativity) moderate the relation between child inhibited temperament and non-social anxiety symptoms. There was mixed evidence regarding the moderating role of control-related parenting behaviors in the relation between child inhibited temperament and non-social anxiety symptoms, with some evidence that encouraging behaviors moderate this relation. Future research is needed to clarify these inconsistent and nuanced findings and investigate this moderation in non-Western, non-White, and low-income populations.
Brief School-Based Interventions Targeting Student Mental Health or Well-Being: A Systematic Review and Meta-Analysis
Cohen KA, Ito S, Ahuvia IL, Yang Y, Zhang Y, Renshaw TL, Larson M, Cook C, Hill S, Liao J, Rapoport A, Smock A, Yang M and Schleider JL
Brief, school-based mental health interventions hold promise for reducing barriers to mental health support access, a critical endeavor in light of increasing rates of mental health concerns among youth. However, there is no consensus on whether or not brief school-based interventions are effective at reducing mental health concerns or improving well-being. This systematic review and meta-analysis aims to provide consensus and determine directions for future work. Articles were included if they examined a brief (≤ four sessions or 240 min of intervention time) psychosocial intervention, were conducted within a Pre-K through 12th-grade school setting, included at least one treatment outcome evaluating mental health or well-being, and were published since 2000. A total of 6,702 papers were identified through database searching, of which 81 papers (k studies = 75) were ultimately selected for inclusion. A total of 40,498 students were included across studies and a total of 75 unique interventions were examined. A total of 324 effect sizes were extracted. On average, interventions led to statistically significant improvements in mental health/well-being outcomes versus control conditions up to one-month (g = .18, p = .004), six-month (g = .15, p = .006), and one-year (g = .10, p = .03) post-intervention. There may be benefits to brief school-based interventions from a preventative public health standpoint; future research may focus on how to optimize their real-world utility. Prospero pre-registration: CRD42021255079.
An Equity-Focused Assessment of Evidence-Based Parenting Intervention Research
Kerns SEU, Maddox SJ, Berhanu RE, Allan H, Wilson RA, Chiesa A, Orsi-Hunt R, McCarthy LP, Henry LJ and Smith CO
Evidence-based parenting interventions (EBPI) support children and families to promote resilience, address emotional and behavioral concerns, and prevent or address issues related to child maltreatment. Critiques of EBPIs include concerns about their relevance and effectiveness for diverse populations when they are implemented at population scale. Research methods that center racial equity and include community-based participatory approaches have the potential to address some of these concerns. The purpose of the present review was to document the extent to which methods associated with promoting racial equity in research have been used in studies that contribute to the evidence base for programs that meet evidentiary standards for a clearinghouse that was developed to support the Family First Prevention Services Act in the United States. We developed a coding system largely based on the Culturally Responsive Evaluation model. A sample of 47 papers that are part of the evidence base for ten in-home parent skill-based programs were reviewed and coded. Only three of 28 possible codes were observed to occur in over half of the studies (including race/ethnicity demographic characteristics, conducting measure reliability for the study sample, and including information on socioeconomic status). Although the overall presence of equity-informed methods was low, a positive trend was observed over time. This review highlights ways in which rigorous research can incorporate racial equity into the planning, design, execution, and interpretation and dissemination of programs of study. We posit that doing so improves the external validity of studies while maintaining high-quality research that can contribute to an evidence base.
Mandated Parent Education: Applications, Impacts, and Future Directions
Shapiro CJ, Hill-Chapman C and Williams S
Mandated participation in parent education programs is a common practice across the United States for families who are undergoing divorce or who are involved in the child welfare or juvenile justice systems. Mandates to participate in parenting programs create substantial challenges for families, service providers, and service systems. Furthermore, the type and quality of the parenting services accessed vary widely, and their impacts need to be better understood. To address this need, an overview of the current state of the empirical literature on the impacts and outcomes of mandated parenting interventions for divorce and in child welfare and juvenile justice settings is provided, and suggestions to the field are offered to refine research related to mandated parenting programs. Given the challenges that mandated parenting programs pose, an alternative approach that views parenting through a public health lens is highlighted to build on the growing body of research on the impacts of population-wide applications of parenting support programs, and as a possible way to decrease the number of parents who are required to attend parenting programs. Opportunities to advance universal parenting support within a range of community settings, including primary care, early childhood education, and community mental health systems are offered. Gaps in knowledge regarding mechanisms of action of universal supports and impacts on the number of parents mandated to treatment are highlighted, and future directions for research in this area are suggested.
A Systematic Review and Meta-Analysis of Impairment and Quality of Life in Children and Adolescents with Anxiety Disorders
Dickson SJ, Oar EL, Kangas M, Johnco CJ, Lavell CH, Seaton AH, McLellan LF, Wuthrich VM and Rapee RM
Anxiety disorders are common, emerge during childhood, and pose a significant burden to society and individuals. Research evaluating the impact of anxiety on functional impairment and quality of life (QoL) is increasing; however, there is yet to be a systematic review and meta-analysis of these relationships in pediatric samples. This systematic review and meta-analysis were conducted to determine the extent of impairments in functioning and QoL that young people with anxiety disorders experience relative to their healthy peers, as well as sociodemographic and clinical moderators of these relationships. Studies were included when they compared young people (mean age range within studies 7-17 years) with a primary clinical anxiety disorder to a healthy comparison group and measured impairment and/or QoL via a validated instrument. A total of 12 studies met criteria for this review (N = 3,129 participants). A majority of studies (K = 9) assessed impairment as an outcome measure, and three assessed QoL outcomes. Meta-analysis of nine studies (N = 1,457 children) showed large relationships between clinical anxiety and life impairment (g = 3.23) with the strongest effects seen for clinician report (g = 5.00), followed by caregiver (g = 2.15) and child (g = 1.58) report. The small number of studies and diversity in methodology prevented quantitative investigation of moderating factors. In the systematic review of QoL outcomes, all three studies reported significantly poorer QoL for youth with anxiety disorders relative to unaffected peers. Findings support the importance of measuring functioning and QoL as outcomes in clinical research and practice among anxious young people.This study is registered with PROSPERO under the identification number CRD42023439040.
Cognitive Functioning in Youth with Anxiety Disorders: A Systematic Review
Rabner JC, Ney JS and Kendall PC
Anxiety disorders are disorders involving cognition. Research on cognition in youth with anxiety can focus on cognitive content (e.g., self-talk) as well cognitive functioning. The present review examines domains of cognitive functioning (i.e., episodic memory, language, attention, executive functioning, motor skills, and visual functioning) in youth diagnosed with an anxiety disorder. A database search of Embase, PsycINFO, and PubMed yielded 28 studies that met inclusion criteria of youth aged 17 years or younger, a sample diagnosed with a principal anxiety disorder and a comparison sample of controls, a comparison between those samples, and use of a behavioral measure of neuropsychological performance. Findings did not identify any cognitive functioning strengths for anxious youth. Deficits were found in two domains (i.e., receptive language and motor skills) whereas no deficits were found in attention, visuospatial skills and one domain of executive functioning (i.e., inhibition). Most domains had mixed findings. Additional analysis indicated that anxiety disorders in youth are not associated with diminished IQ. Directions for future research are identified including (a) the prioritization of studies with larger, representative samples (b) the role of cognitive functioning as a predictor of anxiety treatment outcome (c) the examination of the effect of treatment on cognitive performance, and (d) the course of anxiety and potential impairment in cognitive functioning.
Involving Parents in Cognitive Behavioral Therapy for Children and Adolescents with Conduct Problems: Goals, Outcome Expectations, and Normative Beliefs About Aggression are Targeted in Sessions with Parents and Their Child
Matthys W and Schutter DJLG
Children and adolescents with conduct problems participate in Cognitive Behavioral Therapy (CBT), either in individual or group format, in view of learning social problem-solving skills that enable them to behave in more independent and situation-appropriate ways. Parents must support their child's learning processes in everyday life and therefore these processes need attention in CBT sessions in which parents and their child participate. The social problem-solving model of CBT previously described (Matthys & Schutter, Clin Child Fam Psychol Rev 25:552-572, 2022; Matthys & Schutter, Clin Child Fam Psychol Rev 26:401-415, 2023) consists of nine psychological skills. In this narrative review we propose that instead of addressing each skill separately in sessions with both parents and their child, therapists work on three schemas (latent mental structures): (1) goals, (2) outcome expectations, and (3) normative beliefs about aggression. Based on social-cognitive and cognitive neuroscience studies we argue that these three schemas affect five core social problem-solving skills: (1) interpretation, (2) clarification of goals, (3) generations of solutions, (4) evaluation of solutions, and (5) decision-making. In view of tailoring CBT to the individual child's characteristic schemas and associated social problem-solving skills, we suggest that children and adolescents participate in individual sessions with their parents. The therapist uses Socratic questioning in order to find out characteristic schemas of the child, encourage reflection on these schemas, and explore alternative schemas that had previously been outside the child's attention. The therapist functions as a model for parents to ask their child questions about the relevant schemas with a view of achieving changes in the schemas.
An Expanded Conceptual Framework for Understanding Irritability in Childhood: The Role of Cognitive Control Processes
Elvin OM, Modecki KL and Waters AM
Children prone to irritability experience significant functional impairments and internalising and externalising problems. Contemporary models have sought to elucidate the underlying mechanisms in irritability, such as aberrant threat and reward biases to improve interventions. However, the cognitive control processes that underlie threat (e.g., attention towards threats) and reward (e.g., attention towards reward-related cues) biases and the factors which influence the differential activation of positive and negative valence systems and thus leading to maladaptive activation of cognitive control processes (i.e., proactive and reactive control) are unclear. Thus, we aim to integrate extant theoretical and empirical research to elucidate the cognitive control processes underlying threat and reward processing that contribute to irritability in middle childhood and provide a guiding framework for future research and treatment. We propose an expanded conceptual framework of irritability that includes broad intraindividual and environmental vulnerability factors and propose proximal 'setting' factors that activate the negative valence and positive valence systems and proactive and reactive cognitive control processes which underpin the expression and progression of irritability. We consider the implications of this expanded conceptualisation of irritability and provide suggestions for future research.
What is Parental Monitoring?
Pelham WE, Racz SJ, Davis IS, Aks IR, Patel H, McMahon RJ, Thornburg MA, Huang YW, Schulze EM, Gonzalez O, Tapert SF and Brown SA
Parental monitoring is a construct of longstanding interest in multiple fields-but what is it? This paper makes two contributions to the ongoing debate. First, we review how the published literature has defined and operationalized parental monitoring. We show that the monitoring construct has often been defined in an indirect and nonspecific fashion and measured using instruments that vary widely in conceptual content. The result has been a disjointed empirical literature that cannot accurately be described as the unified study of a single construct nor is achieving a cumulative scientific character. Second, we offer a new formulation of the monitoring construct intended to remedy this situation. We define parental monitoring as the set of all behaviors performed by caregivers with the goal of acquiring information about the youth's activities and life. We introduce a taxonomy identifying 5 distinct types of monitoring behaviors (Types 1-5), with each behavior varying along five dimensions (performer, target, frequency, context, style). We distinguish parental monitoring from 16 other parenting constructs it is often conflated with and position monitoring as one element within the broader parent-youth monitoring process: the continuous, dyadic interplay between caregivers and youth as they navigate caregivers attempts' to monitor youth. By offering an explicit and detailed conceptualization of monitoring, we aim to foster more rigorous and impactful research in this area.
Advances, Challenges and Opportunities: The Treatment and Prevention of Anxiety and Behavioural Problems in Children and Young People : A Special Issue Dedicated to Professor Ron Prinz and Professor Thomas Ollendick
Farrell LJ