Abstract Anxiety disorders are the most prevalent mental health problems in childhood. Engaging, adequate, and appropriate prevention programs are needed. Applied games form a potential alternative delivery model and recent evidence suggests that they could be effective. The present randomized controlled non-inferiority trial investigated the beneficial effects of the applied game MindLight compared to cognitive behavioral therapy (CBT) on mental health outcomes associated with anxiety symptoms: internalizing problems, externalizing problems, and self-efficacy. In addition, we examined who benefitted most from both programs and analyzed baseline levels of anxiety, maternal mental health problems, and self-efficacy as predictors of changes in anxiety symptoms. After being screened for elevated anxiety, 174 selected children (8–12-year-old) were randomized to play MindLight or to receive a prevention program based on CBT. Study variables were assessed before and after the intervention, and at 3- and 6-months follow-up. Intention-to-treat analyses showed a significant reduction in mother-reported internalizing and externalizing problems and an increase in self-efficacy. Importantly, the magnitude of change did not differ between intervention groups. Non-inferiority analyses showed that MindLight was as effective as CBT in affecting internalizing problems and self-efficacy. However, CBT was more effective in decreasing externalizing symptoms than MindLight. Furthermore, baseline anxiety levels, maternal mental health problems, and self-efficacy did not influence the change of anxiety symptoms over time. Applied games, specifically theory-based games such as MindLight, hold potential as effective interventions for not only targeting anxiety symptoms, but also more general mental health outcomes.
Elke A. Schoneveld, Aniek Wols, Anna Lichtwarck‐Aschoff et al.
Abstract This study examined the structure, reliability, and convergent validity of the adolescent version of the Mental Health Continuum-Short Form (Dutch MHC-SF-A), a self-report questionnaire for positive mental health assessment. This questionnaire was completed by 459 Dutch adolescents (178 boys and 281 girls) between the ages of 11 and 18 years at baseline and at a 4-week follow-up. Results revealed the 3-factor structure in emotional, psychological, and social well-being, a high internal reliability and a moderate test–retest reliability. Findings suggest that mental illness and well-being represent two related but distinct continua of mental health. Fostering adolescents’ well-being is important. Promoting positive emotions, creating a supportive and loving parent–adolescent relationship, and a supportive school environment will contribute to this.
Anne Kennes, Sanne C. T. Peeters, Mayke Janssens et al.
Abstract Parental behaviors may shape levels of psychopathic traits and antisocial outcomes among youth. To better evaluate the potential causality of these associations, we used eight follow-ups from the Pathways to Desistance study of 1354 offending adolescents (14.3% female; 40.1% black) and examined whether within-individual variation in parenting over time was associated with within-individual variation in psychopathic traits and offending. Multilevel regression models were adjusted for age, gender, ethnicity, contact with parental figure, and self-reported offending. Adolescent self-reported parental warmth was associated with lower psychopathic traits, and parental hostility with higher psychopathic traits. The results indicated that the more supportive and nurturing the parent, the lower the levels of psychopathic traits, whereas the more hostile the parent, the higher the levels, respectively. In addition, self-reported offending was predicted by higher parental hostility and lower maternal warmth. In time-lagged analysis, psychopathic traits did not predict parental behaviors. In young offenders parental warmth may protect against development of psychopathic traits in adolescence, whereas parental hostility may strengthen these traits. We conclude, that parenting quality matters in adolescence. Warm parenting style at this developmental period associates with lower psychopathic features among young offenders possibly lowering the risk of further criminal activity.
Heidi Backman, Taina Laajasalo, Markus M. Jokela et al.
Abstract Parenting a child with cancer creates numerous additional care demands that may lead to increased difficulties in balancing work and family responsibilities. Still, there is limited knowledge of how parents cope with both parenthood and paid work after a child’s cancer diagnosis. The aim of the study was to explore mothers’ and fathers’ experiences of balancing the dual roles of work and parenthood following a child’s cancer diagnosis. Nine focus groups with in total 32 parents of children with cancer in Sweden were conducted. The data was analysed using qualitative content analysis. Three categories were identified: Shifts in the importance of the parent role and the work role, Influence of context and conditions on the balance of roles, and Long-term unbalance of roles. Parents expressed an increased appreciation of time spent with family, but also emphasized the importance of work to counterbalance the sometimes overwhelming parenting demands. The pre-existing financial situation, work situation, and employer behaviour were important factors influencing the parents’ ability to balance work and family. Traditional gender roles influenced how couples divided responsibilities and reflected on their experiences. Mothers and fathers were also met with different expectations, which highlights the need for the healthcare to consider their communication with caregivers. Importantly, the parents expressed how the child’s illness affected their ability to balance work and family for a long time, while the understanding and support from others had steadily declined. Enabling parents to care for their ill child without sacrificing their own career is of utmost importance, and future research should focus on identifying which factors facilitate for parents to achieve a sustainable work-life balance.
Sofia Hjelmstedt, Ulla Forinder, Annika Lindahl Norberg et al.
Abstract Objectives Parental psychosis poses a risk factor for a child’s well-being. Few studies have focused on the parents’ views of how their psychosis affects their parenting, and results for parenting ability in this group are contradictory. The present study aimed to explore how parents with psychosis experience the effect(s) of their illness on parenting. Methods In-depth and semi-structured interviews were conducted with 15 parents who attended outpatient clinics specializing in psychosis. The transcripts were analyzed using thematic analysis. Data related to the research aim were analyzed deductively according to the protection, reciprocity, control, guided learning, and group participation model of parenting. Data in each domain were subsequently coded inductively to form subthemes. Results Results show that all domains of parenting appear to be affected by psychosis. The parents specifically mentioned that depression, fatigue, and difficulty focusing because of hearing voices had negative impacts on their abilities to provide protection, reciprocity, and control. The parents also expressed difficulties in maintaining routines in the child’s everyday life. Furthermore, the theme “Unpredictable absences” crosses all domains and highlights the parents’ recurrent mental and physical absences from their children during psychotic episodes. Conclusions The present study provides some insight into how different aspects of parenting may be affected by psychosis. We suggest that these effects on parenting need to be further explored and confirmed by research focusing on the child’s perspective and on observations of parent-child interaction.
Abstract Marital and parenting systems are likely to interact during the first year of an infant’s life. This study examines the longitudinal interrelations of relationship satisfaction and parental reflective functioning (PRF) and their predictive relations with later emotional availability (EA) and infant social-emotional behaviors (SEB) including skills as well as behavioral problems among first-time Finnish mothers and fathers (n = 556). The follow-up period was between three and 12 months. In addition to having direct effects, we examined a mediational model in which self-reports on PRF factors of interest and curiosity and appropriateness of reasoning would mediate the effects of previous relationship satisfaction to the parent and dyadic side of EA and infant SEB at 12 months. The results show significant stability for relationship satisfaction and PRF for both mothers and fathers as well as direct effects on EA and SEB. However, we found differences between mothers and fathers. For mothers, path analysis indicated support for a mediational model where earlier relationship satisfaction predicted later EA and infant problem behaviors also through the current level of PRF. For fathers, both relationship satisfaction and PRF had direct, but not mediated, effects, and on both infant problem behaviors as well as infant social competence. Together, despite these differences, focusing clinically on both relationship satisfaction and PRF may prove significant in preventing later relational and/or infant difficulties in SEB for both mothers and fathers.
Many parents of children with developmental disabilities, including autism spectrum disorders and attention deficit disorders, experience poor well-being and increased anxiety and depression. Very few interventions directly target parents’ needs. The peer-delivered HOPE Programme was designed to address this with six weekly group sessions focusing on self-management skills, including goal setting and expressing gratitude. This pre-post study aimed to examine changes in anxiety, depression, well-being, hope and gratitude, and to explore associations between changes in anxiety and depression and changes in gratitude and hope. Validated measures of depression, anxiety, positive well-being, gratitude and hope were used. Parents of children with a range of developmental disabilities, most commonly autism spectrum disorders, were recruited. Of 137 (86.9% female) recruited, 108 parents completed the course and post-course data. Parents’ depression, anxiety, well-being, gratitude and hope all significantly improved between baseline and post-course. Hope and gratitude correlated significantly with depression, anxiety and well-being. Baseline depression, baseline gratitude, post-course hope and gratitude explained 50% of the variance in post-course depression. Reduced work hours, and baseline and post-course hope and gratitude explained 40% of the variance in post-course well-being. Anxiety was not associated to hope nor gratitude at either time point. This study provides initial support for feasibility and potential effect of the peer delivered self-management intervention on parental anxiety and depression. Changes in gratitude and hope account for some change in depression, but not anxiety. A randomised controlled trial is needed to establish efficacy and explore mechanisms of change in-depth.
Abstract Objectives Adolescence represents a significant period of vulnerability for the development of depression. Whilst research has begun to explore factors associated with the development, maintenance and outcomes of adolescent depression, there is little research investigating this experience from a parental viewpoint. The aim of this study was to explore mothers’ experiences of having an adolescent child with depression. Methods Eight mothers of depressed adolescents were recruited following their child’s clinical assessment at a Child and Adolescent Mental Health Service and participated in semi-structured interviews. The transcripts of the interviews were analysed using interpretative phenomenological analysis. Results The analysis revealed five interlinked superordinate themes: Finding a reason, something to blame; Living with uncertainty; Feelings of helplessness and frustration; Depression causes change; Hiding own emotions and needs. A key finding across the themes was the emotional distress and sense of uncertainty experienced by the mothers. Conclusions The findings highlight avenues for clinical practice and further research including exploring the type and format of information and support that parents would value most, the views of fathers, and more in-depth exploration of the identified themes with parents using both qualitative and quantitative methods.
Sarah Armitage, Monika Parkinson, Sarah L. Halligan et al.
This systematic review thematically synthesised qualitative research exploring men’s experiences of their partner’s postnatal mental health problems and their impact on men’s emotional wellbeing, relationships and support needs. Maternal postnatal mental health problems impact women and their infants. Recognition of the role that men play in supporting women’s’ recovery and infants’ development is growing. However, less is known about how maternal postnatal mental health problems affect men and how they wish to be supported. A systematic review of the literature was conducted in January 2018 by searching five electronic databases (PsycINFO, EMBASE, MEDLINE, PubMed and Web of Science). Qualitative research studies published in English exploring men’s experiences of having a partner with postnatal mental health problems were included. Twenty papers met the inclusion criteria and were appraised for methodological quality. Data were thematically synthesised. In addition to nineteen subthemes, 5 main themes were identified: (1) Being a father, (2) Being a partner, (3) Experiencing negative emotions, (4) The ways in which men cope and (5) Where support is needed. Maternal postnatal mental health problems impacted men’s roles of being a father and a partner and gave rise to negative emotions. Men coped with these experiences in a number of ways, which were both helped and hindered by personal, social and professional factors. Participants’ coping methods were understood in relation to Coping Theory. Recommendations for perinatal mental health professionals included the need for increased public awareness of postnatal mental health.
To examine the relationship between self-compassion and positive and negative cognitive reactions to daily life problems in a sample of 117 adolescents aged 14–19 years. Participants completed a survey containing the Self-Compassion Scale (SCS), the Adolescents’ Reactions to Adversity Questionnaire – a self-developed scale for measuring cognitive responses to hypothetical scenarios describing daily life problems of young people (e.g., failing an important test, breaking up with a friend), and measures of neuroticism and self-esteem (control variables). Self-compassion as indexed by the SCS total score was found to be associated with higher levels of positive cognitive reactions and lower levels of negative cognitive reactions. These relations remained present when controlling for neuroticism and self-esteem. Further analyses revealed a quite differential pattern of results for the compassionate (self-kindness, common humanity, and mindfulness) and uncompassionate (self-judgment, isolation, and over-identification) components of the SCS. This study indicates that self-compassion is a relevant construct for understanding adolescents’ cognitive responses to daily problems and yields new evidence for our critical point that it is inappropriate to use the total self-compassion score in a context of protection and resilience against life stress.
Peter Muris, Henry Otgaar, Cor M. G. Meesters et al.
