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Guided parent-delivered cognitive behavioural therapy (GPD-CBT) is an effective low-intensity treatment for childhood anxiety disorder in Western countries and can increase access to evidence-based psychological therapies.
Aim:
This study aimed to examine its feasibility in a Japanese sample.
Method:
Twelve children with anxiety disorders and their parents participated in the study, and ten children and parents completed the program. Participants were assessed at pre-, post- and one-month follow-up using a diagnostic interview for anxiety disorders, self- and parent-report measures for anxiety, depression, parental behaviour, and parental anxiety.
Results:
Four children (40% of completers) were free from their primary diagnoses immediately following the brief treatment, and seven children (70%) at the one-month follow-up. Changes in disorder severity, child and parent reported anxiety symptoms, and child reported depression symptoms were consistent with those found in Western trials of GPD-CBT and of Japanese trials of more intensive CBT for child anxiety disorders that involves both the child and the parent. Moderate increases were also found in child reported parental autonomy behaviours; however, there were only small changes in parent self-reported anxiety.
Conclusion:
These results support the potential of GPD-CBT to increase access to evidence-based treatments for anxiety disorders in Japanese children.
This qualitative study examined how families share information and feelings about advanced pediatric cancer from the perspective of both parents and children, as well as how these perspectives vary by child developmental stage.
Methods
Participants (24 mothers, 20 fathers, 23 youth [children and adolescents]) were from a larger longitudinal study at an academic pediatric hospital. Eligible youth had advanced cancer (physician-estimated prognosis of <60%, relapse, or refractory disease), were aged 5–19 years (>8 years old to participate independently), had an English-speaking parent, and lived within 140 miles of the hospital. Interviews were completed at enrollment and asked how families share information and emotions about the child’s cancer as a family.
Results
Saturation was reached at 20 interviews for mothers, fathers, and youth. Analyses revealed 4 major themes: (A) parents managing cancer-related information based on child age/developmental stage and processing styles of family members; (B) parents withholding poor prognosis information and emotions to maintain positivity; (C) lack of personal and familial emotion sharing; and (D) emotion sharing among their family and externally. Both parents and youth endorsed themes A, C, and D, but only parents endorsed theme B. Adolescents endorsed more themes than children. Parents of children (as opposed to adolescents) endorsed theme A more.
Significance of results
Although both parents and youth with advanced cancer were generally willing to talk about treatment, emotions were not consistently shared. Perspectives varied depending on the child’s developmental stage. Clinicians should assess parent and child information and emotion-sharing needs and provide individualized support to families regarding communication about advanced cancer.
Anxiety problems have a particularly early age of onset and are common among children. As we celebrate the anniversary of the BABCP, it is important to recognise the huge contribution that cognitive behavioural therapy (CBT) has made to the treatment of anxiety problems in children. CBT remains the only psychological intervention for child anxiety problems with a robust evidence base, but despite this, very few children with anxiety problems access CBT. Creative solutions are urgently needed to ensure that effective treatments can be delivered at scale. Here we focus on parent-led CBT as this offers a potential solution that is brief and can be delivered by clinicians without highly specialised training. Over the last decade there has been a substantial increase in randomised controlled trials evaluating this approach with consistent evidence of effectiveness. Nonetheless clinicians, and parents, often have concerns about trying the approach and can face challenges in its delivery.
Method:
We draw on empirical evidence and our clinical experience to address some of these common concerns and challenges, with particular emphasis on the key principles of empowering parents and working with them to provide opportunities for new learning for their children.
Conclusions:
We conclude by highlighting some important directions for future research and practice, including further evaluation of who does and does not currently benefit from the approach, determining how it should be adapted to optimise outcomes among groups that may not currently get maximum benefits and across cultures, and capitalising on recent technological developments to increase engagement and widen access.
To review research on the influence of parent-related factors on children’s dairy products consumption.
Design:
A search of electronic databases and a narrative synthesis of the literature were conducted. English-language articles were included if they reported data relating to parental influences on children’s consumption of dairy products and if statistical significance was reported.
Setting:
Studies were carried out in the USA (n 8) and in a range of countries across Europe (n 12) and Asia (n 5).
Participants:
The subjects of this research were children aged between 2 and 12 years of age, from a range of geographical locations.
Results:
Twenty-five studies met the inclusion criteria. The studies examined children’s dairy products consumption in relation to parental socio-economic status (education level and income) (n 12), home availability (n 2), home food environment (n 3), parental dairy products consumption (n 4), parent feeding practices (n 3), parents’ beliefs and attitudes (n 3) and parental nutrition knowledge (n 3). Results on the association between socio-economic status and children’s dairy products consumption varied; however, studies reporting a significant association generally observed a positive relationship. Fifteen studies reported children’s total dairy products intake as an outcome measure, with the remaining studies reporting intake of milk or other dairy products as individual foods.
Conclusions:
This review identified literature exploring a range of parental factors in relation to children’s dairy products intake. However, there were limited numbers of studies published within each category of modifiable factors. Further research on the parent-related determinants of dairy products consumption in children is required in order to identify potential intervention targets in this age group.
This review aims are to (1) identify relevant quantitative research on parental childhood vaccine hesitancy with vaccine uptake and vaccination intention being relevant outcomes and (2) map the gaps in knowledge on vaccine hesitancy to develop suggestions for further research and to guide interventions in this field.
Background:
Vaccine hesitancy recognises a continuum between vaccine acceptance and vaccine refusal, de-polarising past anti-vaccine, and pro-vaccine categorisations of individuals and groups. Vaccine hesitancy poses a serious challenge to international efforts to lessen the burden of vaccine-preventable diseases. Potential vaccination barriers must be identified to inform initiatives aimed at increasing vaccine awareness, acceptance, and uptake.
Methods:
Five databases were searched for peer-reviewed articles published between 1998 and 2020 in the fields of medicine, nursing, public health, biological sciences, and social sciences. Across these datasets, a comprehensive search technique was used to identify multiple variables of public trust, confidence, and hesitancy about vaccines. Using PRISMA guidelines, 34 papers were included so long as they focused on childhood immunisations, employed multivariate analysis, and were published during the time frame. Significant challenges to vaccine uptake or intention were identified in these studies. Barriers to vaccination for the target populations were grouped using conceptual frameworks based on the Protection Motivation Theory and the World Health Organization’s Strategic Advisory Group of Experts on Immunization Working Group model and explored using the 5C psychological antecedents of vaccination.
Findings:
Although several characteristics were shown to relate to vaccine hesitancy, they do not allow for a thorough classification or proof of their individual and comparative level of influence. Understudied themes were also discovered during the review. Lack of confidence, complacency, constraints, calculation, and collective responsibility have all been highlighted as barriers to vaccination uptake among parents to different degrees.
Providing the healthiest and safest environment in the first 1,000 days of life is the greatest gift which parents can give to their children. We return to the theme of control over our lives to ask who is in control of this gift, and whether today’s medicine and public health hold the answers. We explore the dilemmas facing today’s governments and the decisions that individuals make in terms of personal responsibility when maternal and child health are not prioritised by health policy-makers. We discuss sexual and reproductive rights, why women’s health has not been prioritised – especially during the pandemic – and reasons for high maternal mortality in some countries. We offer an optimistic close to the book; a call to action. We explain that, while planning for parenthood is important, the actions needed do not have to be sustained over a long period. We emphasise the many opportunities which adolescents and young people can seize as the parents of the future. This hope can generate the resolve to make the first 1,000 days of life as good as possible for the next generation. Knowing the secrets of our first 1,000 days is a vital part of this.
None of us can really remember anything about our lives before the age of two years. How much of what makes us what we are has been set by that time? We challenge the widely-accepted idea that what we are is ‘determined’ by inherited genes and we start to explore how interaction with parents/carers establishes our behaviour. We use examples drawn from fiction and the real world to explore how the brain learns from the conditions in early life. We explain why this adaptability underpins development of our senses, our behaviour and our self-control. This introduces control as one of the themes of the book – how much we are in control of our bodies and how control develops based on environmental cues. We question what effect today’s exposure to digital media may have on the developing brain, and explore new ideas about the development of defence mechanisms, from immunity to the gut microbiome. Through the quote from JM Barrie, author of ‘Peter Pan’: ‘You always know after you are two. Two is the beginning of the end’, we ask whether age two is the beginning of the end or the end of the beginning of development.
Supporting the mental health and well-being of children and young people is a top priority for parents, caregivers and teachers, but it can be tricky to find reliable and evidence-based information. Written by an experienced child and adolescent psychiatrist, in a user-friendly question and answer format, this book outlines the mental health challenges facing our children and young people and offers practical advice on how to best support them. The book covers a wide range of topics, including how biological factors and lifestyle factors affect mental health, parenting strategies, managing school, building networks of support, and connecting with children and young people. It gives a broad overview of the most common mental health difficulties and disorders, and considers how they can be managed. A must read for anyone looking to understand what a child or young person may be experiencing and why, and the practical ways in which to effectively support them.
To examine the parental food consumption and diet quality and its associations with children’s consumption in families at high risk for developing type 2 diabetes mellitus across Europe. Also, to compare food frequency consumption among parents and children from high-risk families to the European Dietary guidelines/recommendations.
Design:
Cross-sectional study using Feel4diabetes FFQ.
Setting:
Families completed FFQ and anthropometric measures were obtained. Linear regression analyses were applied to investigate the relations between parental food consumption and diet quality and their children’s food consumption after consideration of potential confounders.
Participants:
2095 European families (74·6 % mothers, 50·9 % girls). The participants included parent and one child, aged 6–8 years.
Results:
Parental food consumption was significantly associated with children’s intake from the same food groups among boys and girls. Most parents and children showed under-consumption of healthy foods according to the European Dietary Guidelines. Parental diet quality was positively associated with children’s intake of ‘fruit’ (boys: β = 0·233, P < 0·001; girls: β = 0·134, P < 0·05) and ‘vegetables’ (boys: β = 0·177, P < 0·01; girls: β = 0·234, P < 0·001) and inversely associated with their ‘snacks’ consumption (boys: β = –0·143, P < 0·05; girls: β = –0·186, P < 0·01).
Conclusion:
The present study suggests an association between parental food consumption and diet quality and children’s food intake. More in-depth studies and lifestyle interventions that include both parents and children are therefore recommended for future research.
Family caregiving role of children with epilepsy involves managing the daily lives of these children with disabilities. This can lead to impaired physical and psychological health of the caregiver.
Objectives
To assess the level of burden among caregivers of children with epilepsy and to determine the factors associated with it.
Methods
It was a descriptive and analytical survey. It involved the caregivers of children with epilepsy who were admitted to the pediatric neurology department at the Hedi Chaker University Hospital in Sfax during the period from July to October 2020. We used the 12-item Zarit (ZBI-12), the State-Trait-Anxiety Inventory (STAI), and the “BECK” Depression Inventory (BDI-13) to assess caregiver burden, anxiety and depression respectively.
Results
Forty-four caregivers participated in the survey. Their average age was 36 years and their relationship with patient was mother in 93.2% of cases. Among 44 children with epilepsy, 56.8% were boys and 34.1% were schooled. They had psychiatric comorbidity in 15.9% of cases. According to the ZBI scale, the level of burden was high in 45.5% of cases. The total ZBI score was significantly higher among caregivers with primary school level (p=0.05) and those with somatic disease (p=0.004). It was not correlated with the presence of child’s dependence on the others (p=0.20). High levels of depression, anxiety-state, and anxiety-trait among caregivers were correlated with the level of burden (p 0.000; 0.000 and 0.001, respectively).
Conclusions
Being a caregiver of a child with epilepsy is a burdensome circumstance. Hence the importance of offering psychological assistance for these caregivers.
Adrenal insufficiency is a rare medical condition which can occur in children. Parents, being the primary support and support for the child, are generally involved in the care of their sick child.
Objectives
To estimate the prevalence of anxiety symptoms and associated factors in parents of children with adrenal insufficiency.
Methods
This is an analytical cross-sectional case-control study over a period of 4 months in 2019, carried out with parents of children with Adrenal Insufficiency followed at the pediatric outpatient clinic in Taher Sfar Mahdia University Hospital. We used an anonymous questionnaire that included a socio-demographic fact sheet and the Hamilton anxiety scale for exploring anxiety symptoms.
Results
A total of 38 parents of children with Adrenal insufficiency and 38 control parents participated in the study. The current age of the child was between 1 and 16 years old with an average of 9.1 and standard deviation of 4.22 For the assessment of anxiety, 55.3% of the parents had a score greater than 20 attesting to the presence of an anxiety symptomatology. In addition, only 26.3% of control parents presented anxious symptoms. There is a significant difference between the two populations (p = 0.010 OR = 3.459). Anxiety was associated with having a child with SI (OR=3.4), female gender (OR=4.2), unemployment (OR=6.33), and low socioeconomic status.
Conclusions
Parents have a considerable burden in the care and management of their child with a chronic illness, which takes time and a lot of patience. Detecting anxiety symptoms in this population will help them manage it.
Family caregiving role of children with epilepsy involves managing the daily lives of these children with disabilities. This can lead to impaired physical and psychological health of the caregiver.
Objectives
To assess the level of burden among caregivers of children with epilepsy and to determine the factors associated with it.
Methods
It was a descriptive and analytical survey. It involved the caregivers of children with epilepsy who were admitted to the pediatric neurology department at the Hedi Chaker University Hospital in Sfax during the period from July to October 2020. We used the 12-item Zarit (ZBI-12), the State-Trait-Anxiety Inventory (STAI), and the “BECK” Depression Inventory (BDI-13) to assess caregiver burden, anxiety and depression respectively.
Results
Forty-four caregivers participated in the survey. Their average age was 36 years and their relationship with patient was mother in 93.2% of cases. Among 44 children with epilepsy, 56.8% were boys and 34.1% were schooled. They had psychiatric comorbidity in 15.9% of cases. According to the ZBI scale, the level of burden was high in 45.5% of cases. The total ZBI score was significantly higher among caregivers with primary school level (p=0.05) and those with somatic disease (p=0.004). It was not correlated with the presence of child’s dependence on the others (p=0.20). High levels of depression, anxiety-state, and anxiety-trait among caregivers were correlated with the level of burden (p 0.000; 0.000 and 0.001, respectively).
Conclusions
Being a caregiver of a child with epilepsy is a burdensome circumstance. Hence the importance of offering psychological assistance for these caregivers.
Being the parent of a child followed for a chronic pathology can require different resources and coping skills.
Objectives
to determine the adaptation strategies of the parents of children monitored for adrenal insufficiency in the face of their children’s pathology
Methods
We conducted a descriptive cross-sectional study carried out with parents of children with Adrenal Insufficiency followed at the pediatric outpatient clinic in Taher Sfar Mahdia University Hospital between February 2019 and April 2020. We used a pre-established questionnaire collecting sociodemographic data and the strategies of coping using the Brief-COPE Board.
Results
A total of 38 parents of children with adrenal insufficiency and 38 control parents participated in the study. The Brief-Cope board’s study of Coping strategies revealed that the strategies most used by parents of children with Adrenal insufficiency were, in descending order: religion (92.1%), support emotional (73.7%), distraction (63.9%), behavioral disengagement and acceptance (57.9%), instrumental support (52.6%), expression of feelings (50%), positive reinterpretation (39.5%), blame (38.9%), denial and humor (36.8%), active coping and planning (36.1%). On the other hand, those used by the control population were in descending order: religion (94.4%), distraction (84.2%), blame (78.9%), acceptance (72.2%) %), emotional support (69.4%), humor (63.9%), behavioral disengagement (61.1%), active coping (47.2%), expression of feelings (44 , 7%), planning (41.7%), instrumental support (30.6%), positive reinterpretation (22%), denial (19.4%).
Conclusions
Psychological support for the parents of children with chronic illnesses would be necessary to prevent parental burnout and improve their ability to adapt to their experiences
Edited by
James Law, University of Newcastle upon Tyne,Sheena Reilly, Griffith University, Queensland,Cristina McKean, University of Newcastle upon Tyne
Socio-economic differences in language have been noted as an important potential driver of ‘social reproduction’ – the transmission of socio-economic status from parents to children. Levels of language and vocabulary knowledge have also been implicated in wider social outcomes. This chapter provides a sociological perspective on language and vocabulary differences, and summarises some key empirical findings on a programme of work using UK birth cohort data. We address social inequalities in vocabulary, mechanisms of intergenerational transmission, and the role of reading for pleasure
To validate the two-factor structure (i.e., cognitive and somatic) of the Health and Behaviour Inventory (HBI), a widely used post-concussive symptom (PCS) rating scale, through factor analyses using bifactor and correlated factor models and by examining measurement invariance (MI).
Methods:
PCS ratings were obtained from children aged 8–16.99 years, who presented to the emergency department with concussion (n = 565) or orthopedic injury (OI) (n = 289), and their parents, at 10-days, 3-months, and 6-months post-injury. Item-level HBI ratings were analyzed separately for parents and children using exploratory and confirmatory factor analyses (CFAs). Bifactor and correlated models were compared using various fit indices and tested for MI across time post-injury, raters (parent vs. child), and groups (concussion vs. OI).
Results:
CFAs showed good fit for both a three-factor bifactor model, consisting of a general factor with two subfactors (i.e., cognitive and somatic), and a correlated two-factor model with cognitive and somatic factors, at all time points for both raters. Some results suggested the possibility of a third factor involving fatigue. All models demonstrated strict invariance across raters and time. Group comparisons showed at least strong or strict invariance.
Conclusions:
The findings support the two symptom dimensions measured by the HBI. The three-factor bifactor model showed the best fit, suggesting that ratings on the HBI also can be captured by a general factor. Both correlated and bifactor models showed substantial MI. The results provide further validation of the HBI, supporting its use in childhood concussion research and clinical practice.
Techniques of neutralization have largely been used to explain the triadic relationship between cybercrimes, offenders and victims, while the possible involvement of the offenders’ social networks as accomplices has been ignored. Interviewing parents, a qualitative study of their children’s romance scam involvement was conducted in Nigeria, exploring the parents’ disposition towards their children’s delinquent behaviour. In all, 52 interviews were conducted, and a thematic analysis of the narratives was carried out. Findings indicated that parents’ initial opposition to cybercrimes and support for enforcing laws against perpetrators changed towards accepting their children’s involvement in romance fraud. Parents adopted their children’s neutralization techniques in accepting their deviance. These findings have important implications in understanding the depth of Internet scams and parents’ social expectations in controlling their children’s behaviours.
Parents of infants with complex CHDs often describe their infants as especially fussy, irritable, and difficult to sooth, which together with the illness caretaking demands add to their stress. Little is known about how the behavioural style or temperament in the early months after discharge relates to parental quality of life. This study aimed to explore the associations between early infant temperament characteristics and parental quality of life in parents of infants with complex CHD.
Methods:
This descriptive, cross-sectional study, utilised data collected in a previously described multisite randomised clinical trial in the United States. Multivariable linear regression models were used to examine the associations of interest.
Findings:
Results demonstrated negative significant associations between most infant temperament subscales and parental quality of life. Higher scores on the Activity (β = −3.03, p = 0.021), Approach (β = −1.05, p = 0.021), Adaptability (β = −3.47, p = 0.004), Intensity (β = −2.78, p = 0.008), Mood (β = −4.65, p < 0.001), and Distractibility (β = −3.36, p = 0.007 were all significantly associated with lower parental quality of life scores, adjusting for parental dyadic adjustment, insurance type, number of medications, and number of unscheduled cardiologist visits.
Conclusions:
Parental perceptions of infant’s difficult behavioural style or temperament characteristics appear to be associated with poorer quality of life in parents of infants with complex CHD post-cardiac surgery. Findings can be used in the screening process of families at potential risk of increased stress and poor illness adaptation and in the design of interventions to target parental mental health in this vulnerable patient population.
TBT-S helps parents and other Supports to be aware of unique YA developmental needs and conflicts to offer appropriate assistance toward AN recovery. An experiential activity on guided reflections can enhance empathy for YA development along with skill development and the Young Adult Behavioral Agreement.
This chapter introduces a rationale for a YA Temperament Based Therapy with Support version of treatment. In YATBT-S, parents are primary “Supports,” or the “S” in TBT-S. This chapter addresses concepts unique to young adult development, including a model for parental involvement specifically tailored for the YA life stage. It addresses why parents need to be included in treatment for YA with AN. Components of YA developmental stages and forms of parental assistance are outlined to establish a collaborative, interdependent treatment model.
Multi-family therapy is a significant backdrop for YA TBT-S, and the format that has been studied to date. The data collected in trials suggests that TBT-S delivered in a multi-family context may play an important role in positive outcomes. Conducting TBT-S in multi-family groups is an effective way to facilitate peer-to-peer consultation, to enrich the learning process and potentially improve outcomes.The multi-family milieu improves participants’ understanding of the illness when they hear from multiple perspectives. It broaden viewpoints on effective ways to manage recovery and to generate new ideas. This method of treatment can assist in identifying and practicing productive actions in a safe environment.