Success of University Student Volunteers in Obtaining Consent for Reviewing Private Health Information for Emergency Research

This study aimed to determine the success of university student volunteers in obtaining consent from parents to allow review of their child’s personal health information (PHI) for emergency research screening. This study also aimed to examine the variables associated with successful consent. This was a prospective cross-sectional study conducted at a pediatric emergency department (ED). University students, who functioned as delegates of the health information custodian, approached parents for consent. Of 2,506 parents, 1,852 (73.9%) provided consent to allow review of their child’s PHI for research screening. Variables associated with successful consent were high (≥12 months) versus low (<12 months) volunteer experience (OR = 2.0), research related (vs. unrelated) to the child’s chief complaint (OR = 2.0), child treated regularly by specialists at the study institution (OR = 1.7), and ED presentation mid-week vs. weekend (OR = 1.7) and morning vs. evening presentation (OR = 1.4). When approached by a university student volunteer, about 25% of parents declined to have their child’s PHI reviewed for research screening. This model of obtaining consent may put some emergency research at risk for selection bias. Variables that increase the odds of successful consent can be considered in program design to improve the effectiveness of this model.     

Generational Structure and Social Resources in Mid-Life: Influences on Health and Well-Being

The influence of generational structure on well-being in mid-life is examined in a regional representative sample of 807 adults aged 30–64. Results indicate that those who lack the personal and social resources of education and marriage, and have parents but no children, report higher levels of well-being than those with only child(ren) or both parent(s) and child(ren). Findings suggest that elders may serve as a key resource to adult children who lack personal and social resources in mid-life. Adults increasingly follow less traditional paths in life (e.g., those without children and/or never married), and hence, these findings have implications for current and future policies directed toward aging and family well-being.     

Maternal depression and children’s false belief understanding

Children of depressed mothers show substantial social impairment, which increases their risk for developing depression. Theory of mind understanding forms the basis of social functioning, and is impaired in children of currently depressed mothers. Models of risk emphasize that a history of any maternal depression confers risk to later psychopathology. Therefore, we tested a novel model of the impact of lifetime maternal depression on children’s false belief understanding that accounts for three primary factors that scaffold this understanding: maternal mental state talk, and children’s executive functioning and language abilities. Children aged 41–48 months with a maternal lifetime history of major depressive disorder (MDD; n = 19) performed significantly more poorly on the false belief battery compared to those without (n = 44). Further, lower levels of mental state talk, child executive functioning, and child language ability were significantly associated with poorer false belief scores. However, the relation between maternal MDD and children’s false belief performance was not mediated by any of these factors. These results indicate that maternal depression predicts poorer false belief understanding independently of other crucial scaffolding variables, and may be a social cognitive mechanism underlying the intergenerational transmission of depression.     

Parental status and psychological distress among older Thais

This study examines whether childless older Thais are more vulnerable to psychological distress relative to older adults with children. Drawing from the 2011 Survey of Older Persons in Thailand (n = 37,936), zero‐inflated negative binomial regression methods examine psychological distress of childless older adults relative to coresident and noncoresident parents. Analyses further explore how gender and marital status moderate this relationship. Results show that 40% of older Thais did not experience any symptoms of psychological distress in the past month. Compared to coresident parents, noncoresident parents showed a higher likelihood of experiencing psychological distress but being childless was associated with increased symptoms of psychological distress. While the relationship between parental status and psychological distress did not significantly differ by gender, marital status presents a significant moderating effect. Specifically, widowed childless older adults and widowed noncoresident parents experienced more symptoms of psychological distress relative to their married counterparts. In collectivistic societies, where the family unit is highly valued, and institutional support is weak, being childless and unmarried may negatively affect one's psychological well‐being in later life. Children and marriage are protective for older Thais’ psychological well‐being. The implications for social welfare policies are discussed.     

Unexpected Caregiving in Later Life: Illuminating the Narratives of Resilience of Grandmothers and Relative Caregivers through Photovoice Methodology

ABSTRACT

This research study implements photovoice methodology with unexpected caregivers to illuminate the lived experiences of female grandparents and relative caregivers who are raising young children in the later stages of their life. As they enter older adulthood, grandmothers are increasingly finding themselves taking care of their children’s children for various reasons, including, but not limited to, their adult child’s incarceration, mental health issues, drug and alcohol addiction, or child abuse or neglect. Informed by various feminist theoretical lenses, we use photovoice methodology to highlight the narratives of resilience and explore the ways in which grandmothers re-conceptualize their roles and identity as an unexpected caregiver and the sources of strength and resilience that inform the ways in which they navigate the various circumstances in their lives.     

Relation between young children's anger and fathers' mental health during the COVID-19 epidemic: Moderating role of gender and child number

The father–child interaction deserves attention during the COVID-19 epidemic. This study administrated the Child Anger Questionnaire and the SCL-90 Symptom Checklist to collect primary data from 1862 fathers of Chinese young children during the COVID-19 outbreak, examined the relation between young children's anger and their fathers' mental health, and verified whether the relation was moderated by the gender or the child number. The results demonstrated that the detection rate of anger among Chinese young children was 60.08%, the scores of SCL-90 factors of their fathers were significantly lower than the Chinese normal adult male norms and those of infant parents, and the anger of young children had a significant effect on their fathers' mental health. Gender and child number moderated this relation. It is of great significance to strengthen the attention to the anger of young children and the mental health of fathers during the period of public health emergencies, and to promote the harmonious interpersonal relationship between young children and their fathers.     

Intergenerational pathways leading to foster care placement of foster care alumni's children

This study examined a path model that postulated intergenerational relationships between biological parent psychosocial functioning and foster care alumni mental health, economic status and social support; and from these to the likelihood of children of foster care alumni being placed in foster care. The sample included 742 adults who spent time in foster care as children with a private foster care agency and who reported having at least one biological child. A full pathway was found between poorer father's functioning to greater alumni depression, which was in turn associated with negative social support, and then a greater likelihood of child out‐of‐home placement. Other parent to alumni paths were that poorer father functioning was associated with alumni anxiety and post‐traumatic stress disorder (PTSD), and poorer mother's mental health was associated with PTSD; however, anxiety and PTSD were not implicated as precursors of foster care placement of the child. Findings support the need for increased practice and policy support to address the mental health needs of parents of children in or at risk of foster care, as well as the children themselves, as family history may have a lasting influence on quality of life, even when children are raised apart from biological parents.     

Interrelatedness of children’s psychological and physiological responses to interparental conflict: A moderating role of harsh parenting

Children’s psychological and physiological responses to interparental conflict have received considerable attention due to their implications for later adjustment, yet limited research has investigated the interplay between these two response systems. This study investigates patterns of association between children’s psychological responses (e.g., emotional distress) and cortisol reactivity to interparental conflict, including possible moderations by negative caregiving environment. Participants included 193 families (mother, father, and child). Parents completed questionnaires relating to their caregiving behaviors toward the child (107 girls and 86 boys, M age = 7.99 years, SD = 0.53 years) and children’s psychological responses to interparental conflict. Children provided three saliva samples over the course of watching videos depicting conflicts between two adults, whom children were asked to pretend were their parents. Based on a series of Latent Growth Curve Models, only children’s emotional responses to interparental conflict (indicated by increased distress) were associated with greater cortisol reactivity. Additionally, fathers’ harsh parenting behavior moderated the relation between children’s emotional reactivity and cortisol reactivity, yet the moderation effect was not found for mothers’ parenting. Findings are discussed in terms of the importance of exploring both psychological and physiological reactivity to conflict and the possible moderating role of harsh parenting.     

Physical and mental health changes in aging foster parents: Do child behavioural problems hasten declines?

This study examined foster parent physical and mental health over time. It was hypothesized that increased severity and frequency of child behavioural problems, whether externalizing or internalizing, would be associated with poorer health over time, especially for foster parents ≥60 years of age. Data from the baseline and Wave 2 interview of the 2010 National Survey of Child and Adolescent Well‐Being were used. The final analytic sample included kin and nonkin foster parents who had custody of a foster child for both waves of data collection (n = 962). Ordinary Least Squares regression models with lagged dependent variables showed that foster parents ≥60 had deteriorating physical health over time, but caregiver age alone had no association with worsening mental health. However, parents ≥60 caring for children with externalizing behavioural problems had significantly improved physical health. Mental health of parents ≥60 significantly diminished if child externalizing or internalizing problems worsened. Findings indicate that for aging foster parents, externalizing child behaviours may stimulate physical activity and improved physical health, yet any type of child behavioural problem can deteriorate mental health functioning.     

Between‐ and within‐person predictors of children’s information management following rule violations

The purpose of this study was to better understand both why some children disclose more about their misbehavior to their parents than do other children, as well as why a child discloses to parents about misbehavior in some situations but not in others. Analyses test parental warmth, children's beliefs regarding the legitimacy of parental authority and their own obligation to disclose misbehavior, and parent's responses to children's disclosure of disagreement with parents’ rules and children's misbehavior as predictors of both between‐person and within‐person variations in disclosing and revealing forms of information management. Parent‐child dyads (n = 218) were interviewed during the summers following the child's 5th (M age = 11.9 years) and 6th grade school years. Feeling obligated to disclose rule violations and believing that parents have legitimate authority to impose rules across more topics explained why some children reveal more and conceal less from parents than do other children. Children were more likely to conceal information about the specific topics for which they felt less obligated to disclose rule violations and following rule violations in areas in which their parents previously punished rule violations.     

Emotion understanding and maternal sensitivity as protective factors against hostile attribution bias in anger‐prone children

The present research examined children’s anger proneness, emotion understanding, and maternal sensitivity during toddlerhood as predictors of children’s hostile attribution bias (HAB) during the later preschool years. At 2.8 years (N = 128), maternal sensitivity (e.g., child‐centered behavior) was observed during mother–child play and snack, and parents reported on children’s anger proneness. At 3.3 years, emotion understanding (i.e., ability to identify emotional expressions accurately) was measured via an interactive puppet interview. At 4.8 and 5.4 years, children's HAB was assessed via child responses to hypothetical vignettes of ambiguous peer provocations. Path models revealed that maternal sensitivity predicted fewer hostile attributions. In addition, emotion understanding and maternal sensitivity emerged as buffers against the negative effect of anger proneness on HAB. Specifically, greater anger proneness was associated with more frequent hostile attributions, but only when children had lower emotion understanding or had mothers who were less sensitive. The findings highlight the interplay between intrapersonal and interpersonal factors in early childhood that contribute to a hostile attribution bias during the preschool period.     

Hope and subjective well‐being among parents of children with special needs

The current study examined subjective well‐being (SWB) in parents who raise children with special needs. Previous studies that focused on parenting children with special needs stressed increased risk of depression. This study examined parental level of hope, the significance of being involved in a partner relationship and parental perception of the seriousness of their child's disability, each a factor that may influence parental SWB. A random sample of 92 parents raising children with special needs in Israel participated in the study. They completed three questionnaires, examining parent's perception of the severity of their child's disability, parental SWB and parents' level of hope. Results revealed that a high level of hope, being in a partnered relationship, and perception of the child's disability as having some positive influence on central aspects of the parents' life, are all significant contributors to raising parental SWB. Study findings show that ‘agency’, a component of the concept of ‘hope’, is a significant factor in predicting SWB in parents of a child with special needs. Perhaps awareness of how they can improve their SWB by using certain aspects of their lifestyle to their advantage can help improve quality of life for parents of children with special needs.     

Within‐ and between‐individual variation in fathers’ emotional expressivity in Chinese families: Contributions of children’s emotional expressivity and fathers’ emotion‐related beliefs and perceptions

Parental emotion socialization is a dynamic process encompassing moment‐to‐moment fluctuations in parents’ emotional displays and responsiveness. This study attempted to examine the within‐ and between‐individual variation in fathers’ emotional expressivity during a real‐time father–child interaction in Chinese families. Eighty‐five children (M_age = 7.58 years, SD = 0.50 years, 47.1% boys) from east China and their biological fathers participated in the study. Fathers’ and children’s emotional expressivity were observed during a problem‐solving interaction task. Fathers’ beliefs about children’s negative emotions and fathers’ perceptions of their children’s emotion regulation ability were assessed via self‐report questionnaires. Results showed that (1) At the within‐individual level, fathers’ and children’s emotional expressivity covariated with each other in concurrent intervals when controlling for their emotional expressivity in previous intervals; fathers’ emotional expressivity gradually became less positive over time whereas children’s emotional expressivity did not change significantly over time; (2) At the between‐individual level, fathers’ perceptions of children’s emotion regulation accounted for the between‐individual variance in the dynamics of fathers’ emotional expressivity. These findings chart the dynamics of paternal emotion expressivity during father–child interactions and shed light on the relevant roles of children’s emotional expressivity and fathers’ emotion‐related beliefs and perceptions.     

‘Not a good person’: family stigma of mental illness from the perspectives of young siblings

The purpose of this paper is to critically examine family stigma as one form of the stigma of mental illness in child and youth mental health. Presented are the outcomes of a thematic content analysis of in‐depth, semi‐structured interviews conducted with seven (n = 7) young siblings, ages 13 to 21 years old, with a brother or sister identified as having a mental‐health issue. The focus of the interviews was on the ways the siblings experienced their other sibling's mental health and how those experiences shaped their sense of self and family. From the analysis, young siblings had predominately negative experiences, struggled with making sense of their brother or sister and the family as ‘flawed’ against the mental illness as ‘bad’ and experienced considerable family stress and overt family stigma. Current practice theories fail to consider the complexity of these factors and, in doing so, fail to adequately explain the nature and extent to which stigmatization occurs for immediate family members. The importance of peer support and understanding stigma in social work practice with children and their families is discussed.     

Associations between ongoing COVID-19 lockdown and the financial and mental health experiences of Australian families

In 2020, Australia's successful COVID-19 public health restrictions comprised a national “initial lockdown” (March–May) and “ongoing lockdown” (July–November) for metropolitan Victorian residents only. We evaluated associations between ongoing lockdown and family finances and mental health. In the June and September 2020 Royal Children's Hospital National Child Health Polls, caregivers of children in Victoria and New South Wales (NSW) reported the following: job/income loss; material deprivation (inability to pay for essential items); income poverty; mental health (Kessler-6); perceived impact on caregiver/child mental health; and caregiver/child coping. Data from caregivers (N = 1207/902) in June/September were analysed using difference-in-difference modelling (NSW provided the comparator). During Victoria's ongoing lockdown, job/income loss increased by 11% (95%CI: 3%–18%); Kessler-6 poor mental health by 6% (95%CI: −0.3%–12%) and perceived negative mental health impacts by 14% for caregivers (95%CI: 6%–23%) and 12% for children (95%CI: 4%–20%). Female (vs. male) caregivers, metropolitan (vs. regional/rural) families, and families with elementary school-aged children (vs. pre-/high-school) were the most affected. The ongoing lockdown was associated with negative experiences of mental health, employment and income, but not deprivation or poverty, likely because of government income supplements introduced early in the pandemic. Future lockdowns require planned responses to outbreaks and evidence-informed financial and mental health supports.     

Parental mental health: disruptions to parenting and outcomes for children

The association between parental mental health problems and negative outcomes for children has been long known. This paper addresses three issues in relation to this. First, the scale of the problem is outlined, in terms of both the prevalence of mental health problems in parents and the likelihood of children exhibiting negative outcomes in these circumstances. Secondly, the specificity, or lack of it, of particular outcomes in the child in relation to different parental mental health problems is explored. Thirdly, the paper focuses on the importance of disruptions to parenting as a mechanism in the transmission of mental health problems to negative impacts on the child. Examples are given of how parenting is disrupted in non‐clinical community populations, and the subsequent impacts on the child. The case is made for the preventative importance of parenting and family support in mediating between parental mental health problems and negative impacts on the child.     

Physiological contagion in parent–child dyads during an emotional challenge

Parents and children mutually influence each other’s behavior, but little work has examined how parent–child dyads influence one another’s physiological responding under conditions of emotional challenge. This is important to examine because physiological substrates underlie the development of self‐regulation. We examined this in 97 parent–child dyads who participated in a frustrating laboratory challenge that first perturbed the affective state of the dyad and then allowed recalibration. Children were between 3 and 7 years of age (M = 5.80 years, SD = 1.25 years; 41 boys). Respiratory sinus arrhythmia (RSA) and pre‐ejection period (PEP) were assessed continuously as measures of parasympathetic and sympathetic nervous system activity, respectively. Actor–partner interdependence models were used to quantify the extent of physiological contagion between partners. The expected actor effects were found for RSA and PEP, and a partner effect was found for RSA only. Specifically, parents’ RSA reactivity to perturbation influenced children’s RSA reactivity during recalibration. This provides additional evidence for parent–child coregulation, during which parents support their children’s regulatory efforts. We found no partner effects for PEP. Taken together, our results suggest that the two ANS branches may serve different regulatory functions, with parasympathetic functioning relating more strongly to social interactions and dyadic challenges like those in the current study. This study provides the first evidence of physiological contagion in an emotionally challenging context between parents and children.     

Single Mothers,Nonresident Fathers,and Preschoolers’ Socioemotional Development: Social Support,Psychological Well-Being,and Parenting Quality

ABSTRACT

Using data from two waves of a short-term longitudinal study, the influences of mothers’ social support with respect to parenting from nonresident fathers and significant others on behavioral outcomes among poor and near-poor preschool-aged Black children were examined. The sample consisted of 99 single Black mothers—each with a preschool-aged child (ages 3 and 5 years old, respectively, at Time 1 and Time 2)—who were current and former welfare recipients. Results revealed protective effects of nonresident fathers’ presence in the context of mothers’ parenting stress and depressive symptoms at Time 1 that appeared to operate through decreases in the negative influences of these variables on the children's development of behavior problems 1.5 to 2 years later. Greater availability of instrumental support from significant others, including nonresident fathers, was associated with more adequate parenting at Time 1, and through the latter, with fewer child behavior problems at Time 2. Implications of these findings for program and policy interventions are discussed. Nonresident fathers are described in the Appendix.     

A new preventive intervention for children of substance‐abusing parents: Results of a randomized controlled trial

Children of substance‐abusing parents (COS) are at risk for developing psychosocial problems. We evaluated the effectiveness of the manualized, 9‐session psycho‐educational preventive intervention “TRAMPOLINE” (PE) for 8–12‐year‐old COS compared with a non‐educational “fun and play” group (NE) of equal length delivered by social workers in 27 German counselling centres. A randomized controlled trial was conducted to compare PE (n = 130) and NE (n = 88) outcomes at baseline, post intervention, and 6‐month follow‐up. Primary outcomes were related to stress and coping; secondary were also examined. Analyses were conducted using baseline‐adjusted repeated measures linear mixed models. Five outcomes revealed improvements both in PE and NE, four of which were more pronounced in PE, and one more pronounced in NE. Small but significant group differences in favour of PE were found in “social isolation” and “addiction‐related knowledge.” Children from both groups reported reduced mental distress, reduced avoidance in coping with family stress, improved self‐perceived autonomy, and a better parent–child relationship. No changes were observed in self‐efficacy, physical stress symptoms, and in other health‐related quality of life aspects. TRAMPOLINE can instill positive changes in COS by reducing mental distress and social isolation.