Background Although prior research indicates that environmental instability adversely affects children's well-being, it remains unclear whether abusive or neglectful parenting behaviors constitute a central and proximal outcome of such instability. Objective To address these gaps, the present study sought to examine multiple forms of environmental instability as predictors of child maltreatment, controlling for persistent environmental harshness in corresponding domains. Participants and setting The present study utilized longitudinal, repeated-measures data from a cohort of births across 20 large American cities, oversampled for nonmarital births (N = 3544). Methods Conditions of environmental instability and environmental harshness from birth to age five were examined as predictors of caregivers' engagement in abusive and neglectful behaviors using longitudinal multilevel modeling. Results Average levels of emotional abuse increased between ages three and five, whereas physical abuse decreased over the same period. Results indicated that instability in both the domains of employment and informal support from age one to five were associated with greater abusive behaviors (i.e., emotional and physical abuse), independent of sustained exposure to environmental harshness over the same period. Conclusions This study underscores the importance for researchers and practitioners to attend to the specific role of instability in the early childhood environment in shaping child maltreatment risk and children's long-term well-being. Efforts to promote equitable family well-being are therefore likely to be most effective when they address not only families experiencing persistent adversity but also those vulnerable to sudden and unpredictable changes in their circumstances and needs.
Despite abundant evidence that the admission of an infant to a neonatal intensive care unit (NICU) is a highly stressful and potentially traumatic experience for both infants and parents, few psychosocial interventions target the needs of parents of NICU infants. In particular, interventions supporting parents beyond the initial medical crisis are notably lacking. Relational savoring (RS) is a brief, positive psychology intervention that attunes one's focus to moments of positive connectedness within their relationships, including parent-child relationships. While the benefits of RS for parent-child dyads are well documented, its efficacy has not been evaluated in parent-child dyads facing significant relational stressors, such as those experienced in post-NICU contexts. Using a randomized controlled design, this study tests the effects of RS compared to a neutral control in 240 post-NICU parents in the United States. Parents reported on their closeness to their child, parental emotional well-being, and parental satisfaction before and after the intervention, as well as their history of perinatal loss and stress. Results of multilevel models suggest that, relative to a neutral control task, parents assigned to the RS intervention group exhibited significantly greater increases in feelings of closeness to their child, parenting satisfaction, and parental emotional well-being. Interestingly, the reduction in negative affect pre- to post-intervention was more pronounced for parents with a history of miscarriage, stillbirth, child loss, and/or fertility difficulties. These findings suggest that RS may represent a scalable intervention to support parent-child relationships and parental well-being in the post-NICU period, particularly for parents with prior perinatal loss and stress.
Abstract Background: Working mothers in healthcare settings face complex role demands arising from the simultaneous responsibilities of professional duties, motherhood, and marital roles. These overlapping expectations may result in both challenges and benefits that influence family functioning and occupational well-being. This study aimed to explore the lived experiences and perceived consequences of employment among mothers working in healthcare settings. Materials: This qualitative study employed a conventional content analysis approach and was conducted in hospitals affiliated with Qazvin University of Medical Sciences, Iran, in 2025. Thirty employed mothers with at least one child were selected through purposive sampling. Data were collected through semi-structured, face-to-face interviews and analyzed using Graneheim and Lundman’s method until data saturation was achieved. Results: Analysis yielded 820 initial codes, which were organized into 23 subcategories and 7 categories under two main themes: negative and positive consequences of employment. Negative consequences included social deprivation, deterioration of family stability, family members’ dissatisfaction, and threats to well-being. Positive consequences included health improvement, economic strengthening, and social support. Conclusion: Employment among mothers working in healthcare settings generates a complex set of both constraining and enabling consequences for family functioning and individual well-being. While occupational demands contribute to role conflict and family strain, employment also enhances health literacy, financial independence, and social support. These findings highlight the importance of developing family-centered and gender-sensitive workplace policies to promote work–family balance among female healthcare workers.
ABSTRACT Objectives Mental wellbeing is lower in people with vision impairment (VI) but the mechanisms for this are not completely understood. Here we examined factors that limit and benefit wellbeing in children and young people with VI. Design Qualitative semi-structured interviews with children and young people with vision impairment and parents/carers of young people with VI. Interviews were recorded, transcribed and analysed by two researchers, working independently, using reflexive thematic analysis. Setting Low vision and genetic eye disease clinics in a tertiary eye hospital in London, England. Participants Young people aged 13-18 years with vision impairment (VI) caused by inherited macular disease and parents of young people with VI caused by inherited macular disease. Results Four overarching themes were developed: (1) Living in the aftermath of diagnosis , capturing participants’ internal experience of living with vision impairment from the time of diagnosis onward, including the psychological impact of negotiating the loss of vision and the challenge of accepting VI; (2) Fighting the system , reflecting how parents and CYP navigate both formal and informal support systems, highlighting the barriers they face; (3) Being seen and being misunderstood , encapsulating how VI influences the way that participants experience relationships, develop a sense of self and navigate their place within society; and (4) Building a life with vision impairment , centring on how participants function in everyday contexts whilst living with VI, alongside their aspirations for building their lives and living well in adulthood. Conclusions Vision impairment has emotional, social, and systemic consequences. Factors linking VI to reduced mental well-being included low acceptance of vision loss, low functional adaptation, reduced self-efficacy, effects of social stigma and discrimination. Strengths and limitations The study uses detailed interviews of wellbeing from two perspectives (young people and their parents/carers); Participants identified a broad range of positive and negative experiences which can be used to inform future interventions; All participants were under the care of a specialist eye clinic so they may not be fully representative of the broader population of people with vision impairment.
Objectives Close intergenerational relationships are associated with better mental health in later life, yet limited longitudinal research has examined how trajectories of relationship quality, especially differentiation across multiple children within the same family, relate to older parents' depressive symptoms. This study identifies distinct trajectories of parent-child relationship quality and examines their associations with depressive symptoms among older adults in China, while assessing whether these associations vary across socioeconomic groups. Methods Using nationally representative panel data from the China Longitudinal Aging Social Survey (2014-2020; N = 3,519), we applied group-based trajectory modeling to characterize six-year patterns of relationship quality, separately capturing the worst, best, and average ties within families. Linear regression models estimated associations between these trajectories and depressive symptoms at the final wave, adjusting for baseline characteristics and testing whether these associations differed by education, occupation, and hukou status. Results Parents in steadily or rapidly strengthening relationship trajectories reported significantly fewer depressive symptoms than those in persistently strained trajectories. When trajectories of the worst, best, and average ties were modeled simultaneously, only trajectories of the worst relationship remained significantly associated with depressive symptoms. These associations were concentrated among parents with lower socioeconomic status. Discussion Intergenerational relationship dynamics, particularly changes in the most strained tie, are linked to older adults' mental health in multi-child families. Findings highlight the psychological importance of relational repair and suggest that parents with fewer socioeconomic resources may be especially sensitive to relationship change.
As the largest long-term study of brain development and child and adolescent health in the United States, the Adolescent Brain Cognitive DevelopmentSM (ABCD) Study can offer empirical insights relevant for governments, influential think tanks, and other key stakeholders worldwide in establishing guidelines and informing decisions with potential long-term relevance for adolescent health. This review delves into some of the ABCD Study research cited to date by these organizations on important public health topics such as depression and suicidality; attention deficit hyperactivity disorder; digital technology, sleep patterns, and physical activity; and prenatal cannabis exposure. Furthermore, it underscores the untapped potential for ABCD Study findings to inform real-world efforts to improve the health and well-being of children and adolescents.
Background/Objectives: Stroke during pregnancy, childbirth, or the postpartum period is uncommon but may substantially affect women's everyday functioning and maternal roles. This study aimed to characterize functional independence, occupational performance and satisfaction, and quality of life in women who had a stroke during these periods and to explore their lived experiences of motherhood. Methods: An exploratory mixed-methods study used sequential complementary quantitative and qualitative components. Eleven women completed quantitative assessments of functional independence, occupational performance and satisfaction, and quality of life. Six women participated in semi-structured interviews. Qualitative data were analyzed thematically by three researchers, and findings were integrated during interpretation. Results: Participants showed relatively high functional independence, with a median Functional Independence Measure total score of 111 (interquartile range = 8). Qualitative findings revealed disruption and gradual redefinition of the maternal role, difficulties in mother-child bonding and childcare, physical, cognitive, and emotional sequelae, reliance on family support, and perceived gaps between stroke-related care and motherhood-related needs. Integration of the findings showed that relatively preserved basic independence could coexist with substantial difficulties in maternal activities, while occupational priorities frequently related to childcare and family life. Conclusions: Motherhood after stroke involves challenges that may not be adequately captured by general measures of independence. The findings identify meaningful maternal occupations and the integration of stroke-related and motherhood-related needs as areas warranting further investigation within person-centered rehabilitation.
Gómez-Calero C, Martín-Peralvo R, Brea-Rivero M et al.
More than one in three US parents use corporal punishment to discipline their children. The objective of this study is to add to a greater understanding of factors associated with self-reported corporal punishment, based on two survey items: one that asked about use of spanking and one that asked about hitting out of anger. The second objective was to examine the longitudinal relationship between parents' self-reported use of spanking at age 35 and their self-reports of hitting out of anger 5 years later. To accomplish these objectives, national US Monitoring the Future Panel Study data were used as follows. Objective 1: data collected in 1993-2020 from parents age 35 with child(ren) ages 2-12 at home. Objective 2: data collected in 1998-2020 from parents age 40 with child(ren) ages 7-17 at home. We conducted multinomial logistic regression to accomplish the objectives. Most factors significantly associated with increased odds of reporting spanking at age 35 differed from the factors associated with increased odds of reporting hitting out of anger at age 35. Reporting spanking at age 35 was associated with greater odds of reporting hitting out of anger at age 40 (aOR = 2.10, 95% CI: 1.71, 2.58). Depressive symptoms (aOR = 1.24, 95% CI: 1.09, 1.40) and disordered alcohol use (aOR = 1.55, 95% CI: 1.14, 2.11) were associated with greater odds of reporting hitting out of anger. Future research should continue to examine whether different types of corporal punishment have different determinants, whether and in what ways corporal punishment may escalate over time, and whether measurement error may impact this research.
Disparities in early childhood development due to poverty are linked to lifelong gaps in health and well-being. To address such disparities, interventions must not only include the prevention of toxic stress, but also the promotion of early relational health-that is the presence of safe, stable, nurturing relationships between young children and their caregivers. Moreover, a public health approach that integrates multiple programs in order to meet the unique needs and build on the varied resources of individual families is needed to effect population-level change. This randomized controlled trial seeks to examine the implementation and effectiveness of combining two evidence-based interventions, HealthySteps and PlayReadVIP. A total of 355 parent-child dyads, 35 in the implementation phase and 320 in the effectiveness phase, will be randomly assigned to receive HealthySteps+PlayReadVIP or traditional HealthySteps, as an active Control. Families will receive the intervention at each pediatric well-child visit from birth to age 2 and will complete assessments at enrollment and child age 12 and 24 months. In addition, up to ten HealthySteps Specialists and other care providers will be enrolled and will complete surveys at each assessment point. The primary outcomes include positive parent-child relationship, parent cognitive stimulation, and child socioemotional development.
Background Whether screening for Adverse Childhood Experiences (ACEs) can improve health outcomes may depend in part on screening being acceptable and accurate. Screening modality and context may be important determinants of these characteristics. Objective We compared telephone ACE screenings by 211LA (a health and human services information and referral center) to self-completed screenings during well-child visits and identified family factors associated with differences in ACEs reporting. Participants and setting This is a secondary analysis of data from the intervention arm (n = 51) of a pilot randomized trial of telephone ACE care coordination via 211LA versus usual care at three Federally Qualified Health Centers. Children who had ≥ 1 ACE on the Pediatric ACEs and Related Life-events Screener (PEARLS) administered during a well-child visit and were randomized to the intervention were connected to 211LA 1-2 weeks after their clinic visit. 211LA then administered a subsequent telephone PEARLS screening. Methods A within-subjects design examined whether scores differed between clinic and 211LA screening. Linear regressions tested whether trust in healthcare providers, parent stress, financial security, education, income, child age/sex, Latine ethnicity, and English proficiency predicted higher 211LA than clinic scores. Results In paired t-tests, mean ACE scores were higher (2.08 vs. 1.35, p = 0.002) through 211LA than through clinics. In linear regressions, greater trust in healthcare providers (β = 0.64, p = 0.049), more parental stress (β = 0.06, p = 0.028), and speaking English "Well" versus "Very well" (β = 1.85, p = 0.043) were associated with a greater difference in 211LA versus clinic scores. Conclusions Telephone-based screening may be effective for sensitive questions. Specific family factors may affect which screening approaches are preferable.
