OBJECTIVE: Parents of children with mental health problems often experience judgment about their parenting. Such stigma is associated with lower parental well-being and greater child symptom severity. Theory-driven descriptions of and interventions for parental stigma are limited. The authors aimed to investigate how parents experience and cope with stigma via the What Matters Most framework. METHODS: Interviews were conducted with 24 parents (50% women, mean±SD age=39.8±8.6 years) of children ages 6-17 with depression (N=9), attention-deficit hyperactivity disorder (N=7), or substance use problems (N=8). Interviews explored what parents view as central to being respected as a "good parent," how a child's mental health problems threaten these qualities and shape stigma toward parents, and how parents cope with stigma and restore a positive moral identity. RESULTS: Parents reported being respected for support, open communication, boundaries, role modeling, and their child's well-being. When children have mental health problems, stigma reflects perceived parental failure to meet ideals, leading to emotional distress and self-doubt. With support from peers and clinicians, parents found new ways to fulfill or redefine these ideals, reducing self-stigma. CONCLUSIONS: Parental stigma centers on threats to identity as good parents. Mental health services can mitigate stigma by helping parents reinterpret and reasonably fulfill parenting ideals.
An estimated one billion children live at extremely high risk of adverse effects from climate change. Even when children are not exposed to direct physical impacts, the existential threat of climate change can have a psychological impact by creating a stressor that exacerbates underlying mental health disorders or contributes to the development of new disorders. Children and adolescents worldwide are experiencing high rates of fear and worry related to climate change, particularly in low- and middle-income countries. Despite this disparate impact, most studies on this topic have been conducted in the Global North. The Galápagos Islands are part of a medium-income nation and will face stark impacts of climate change in the coming decades. Currently, it is unknown how the threat of climate change is affecting the mental health of the children living in the islands. To address this gap, we conducted semi-structured, qualitative interviews with children and adolescents on the island of San Cristóbal to determine their thoughts, perspectives, and understanding of climate change ( N = 30). These interviews also required participants to draw what they expect the island to look like in 100 years. We identified major themes from the interview transcripts and drawings, including the children’s personal identification with nature, feelings of anger and frustration, and feelings of sadness and loss regarding climate change. The findings from this study will inform interventions to promote emotional resilience among the children in San Cristóbal, as well as educational initiatives to address knowledge gaps.
Victoria Moffitt, Kelly Penelope Kennedy, Ayla Malefakis et al.
ABSTRACT Early and prolonged parent–child separation (EPPCS) may affect the health and well‐being of affected families. This phenomenon is common but understudied among Chinese immigrant families, especially those living in low‐income communities. Whereas some research has been conducted to understand the mental health and development of separated–reunited children, no research has examined the mental health condition of affected parents. The present study collected interviews ( N = 24) and daily diary survey data (50% of the interview sample) to explore parental mental health and emotions and related factors among Chinese immigrant parents who have reunited with their children after EPPCS. Results integrating qualitative and quantitative analysis showed relatively low challenging mental health conditions in general, yet moderate positive to minor negative emotions (i.e., without extreme emotional reactions) among parents. Factors related to parental mental health included financial stress, children's educational attainment, family relationships, acculturation and homesickness. Parenting stress and a lack of communication with children could affect their negative emotions. Engagement in leisure activities, healthy parent–child bonding, quality family time and the child's advancement in academics were found to be beneficial to parental mental health conditions and positive emotions. The study provides insights for policies and community‐based services to support parents' parenting skills and relationships with their separated children during separation and after reunification.
Abstract Internalizing problems are prevalent in childhood and are associated with exposure to adverse childhood experiences (ACEs); however, their co-development across childhood remains understudied. Prior research documents sociodemographic disparities (i.e., race/ethnicity, sex, income) in ACE exposure and internalizing problems. The current study examined individual and co-developing trajectories of ACEs and internalizing problems and sociodemographic disparities among 4,655 diverse at-risk youth at ages 3, 5, and 9. Participants were 52.2% boys and racially and ethnically diverse, with 44.7% Black, 22.5% Hispanic, 16.7% Other, and 16.2% White youth. Results showed various trajectories with stable levels of cumulative ACE exposure over time and internalizing problems trajectories that decreased or increased over time. Findings provide some evidence for a dose–response relationship between ACEs and internalizing problems. Youth of Color (φ = 0.26, 0.11, 0.19) and from low-income backgrounds ( ϵ 2 = 0.07–0.09, 0.02, 0.06–0.08) were more likely to be in worse trajectories of ACEs, internalizing problems, and joint trajectories across ages 3, 5, and 9, respectively. Findings underscore the need for culturally responsive trauma-informed interventions and policy-level efforts that target the root cause of inequities.
Cynthia M. Navarro Flores, Melanie M. Domenech Rodríguez, Brenna Gomer et al.
Abstract Purpose of Review This review aims to provide a brief historical overview of genetic counseling and its evolution, addressing the qualified professionals and clinical requirements necessary to obtain a diagnosis and post-test guidance across different stages of patients' lives. Recent Findings Recent advances in the understanding of genetic diseases and contemporary diagnostic tools offer a novel approach to evaluating conditions both prenatally and in pediatric patients, facilitating precise diagnoses and tailored clinical interventions, including modern treatment regimens. Summary Genetic counseling is a dynamic, multidisciplinary medical process that translates the complexities of hereditary and genomic conditions into actionable clinical care. Historically rooted in pediatric dysmorphology and conventional cytogenetics, the field has evolved into an essential specialty spanning multiple organ systems and life stages. A definitive diagnostic pathway requires detailed family history, gestational assessment, and meticulous physical examination—with dysmorphology analysis serving a pivotal role from the neonatal period onward. While conventional tools such as karyotype, chromosomal microarray analysis, and Sanger sequencing remain clinically relevant, next-generation sequencing technologies—including whole-exome sequencing, whole-genome sequencing, and optical genome mapping—have dramatically improved diagnostic yield, particularly in complex or atypical phenotypes. Following molecular confirmation, genetic counseling guides the interpretation of findings, recurrence risk assessment, family screening, and reproductive planning. Importantly, therapeutic paradigms have advanced beyond supportive and symptomatic care to encompass precision medicine, such as gene editing, cell therapies, and targeted pharmacological agents. Comprehensive care demands close integration among geneticists, pediatricians, subspecialists, and allied health professionals to provide long-term clinical management, surveillance, and psychosocial support.
Importance Family-centered care is an approach to pediatric health care that recognizes the essential role of the family in ensuring child health and well-being, seeks to establish collaborative partnerships among the child, family, and health care team, and provides a framework for implementing trauma-informed care. However, the association between receiving family-centered care and key measures of child and family well-being, including among families with a history of trauma and adversity, is unknown. Objectives To examine associations between family-centered care and child flourishing and family resilience and connection among US children and to assess whether associations differ by the child’s history of adverse childhood experiences (ACEs). Design, Setting, and Participants This cross-sectional study used 2021 to 2024 National Survey of Children’s Health data from children aged 6 to 17 years. Analyses were conducted in September to December 2025. Exposure Caregiver report of receipt of family-centered care by the child’s physician or other health care practitioners in the past 12 months. Main Outcomes and Measures Child flourishing and family resilience and connection based on caregiver response to established measures. Results This study assessed 110 984 children (mean [SD] age, 11.5 [0.02], years; 57 302 [51.0%] male and 53 682 [49.0%] female) who had a health care visit in the past 12 months. Adjusted for potential confounders, the prevalence of child flourishing was 8.6 percentage points higher (prevalence difference [PD], 0.086; 95% CI, 0.072-0.101), and the prevalence of family resilience and connection was 8.2 percentage points higher (PD, 0.082; 95% CI, 0.069-0.096) for those who received family-centered care compared with those who did not. Among children with and without ACEs, the prevalence of child flourishing (with ACES: PD, 0.112; 95% CI, 0.089-0.132; without ACEs: PD, 0.068; 95% CI, 0.049-0.087) and family resilience and connection (with ACEs: PD, 0.105; 95% CI, 0.085-0.125; without ACEs: PD, 0.0563; 95% CI, 0.043-0.081) was higher for those who received family-centered care compared with those who did not, with larger estimates among children with ACEs than children without ACEs. Conclusions and Relevance Results from this cross-sectional study found that family-centered care was associated with a higher prevalence of child flourishing and family resilience and connection, particularly among those with a history of adversity. These results suggest that family-centered care offers a practical and measurable way for health care professionals to promote well-being for all children and families but particularly for children with a history of ACEs.
Anna E. Austin, Christine Katie Thang, Sasha S. Svendsen
Adolescents are increasingly screened for suicide risk in primary care (PC), leading to increased suicide risk identification. Research highlights the importance of parents in promoting adolescent safety and well-being. However, parents and adolescents are not always aligned in how to engage parents in adolescent care. Furthermore, little is known about what support parents need when caring for a child with suicidal thoughts and behaviors (STB) in PC. In this study, 16 pediatric PC professionals, 20 adolescents with histories of STB, and 18 parents of adolescents with histories of STB completed interviews regarding their perspectives on adolescent suicide care in PC. Interviews asked about barriers, facilitators, needs, and if and how parents should be involved in PC-based adolescent suicide care. Interviews were audio recorded, transcribed, and analyzed using inductive and deductive thematic analysis. Results demonstrated that adolescents, parents, and PC professionals believe parents play an important role in adolescent suicide care in PC. However, all groups reported key challenges that impede effective parent involvement, including the following: (a) concerns about mental health and suicide stigma, (b) poor parent-child relationships, (c) parent-child difficulty communicating about mental health and safety, and (d) concerns about patient confidentiality and privacy. Additionally, parents reported needs, including (a) help navigating youth mental health services, (b) emotional support, and (c) education/resources about adolescent STB. Results highlight a tension between adolescent hesitancy toward parent involvement, parents' desire to be more included and informed in their child's care, and PC staff concerns regarding how to navigate this discrepancy. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Justification: Character strength-based interventions represent a potential strategy for promoting well-being during adolescence and strengthening psychological resources applicable in educational and preventive contexts. Objective: To synthesize the evidence published between 2020 and 2026 on the effects of these interventions on well-being and associated psychosocial outcomes in adolescents aged 10 to 19 years. Methodology: A systematic review guided by PRISMA 2020 was conducted, with searches in Scopus, PubMed, Taylor & Francis Online, and Dialnet. Of the 1,425 records identified, 12 articles corresponding to 11 independent studies or projects were included. Methodological quality was assessed using the MMAT 2018, and the findings were synthesized through a narrative review. Results: The interventions showed favorable outcomes in happiness, life satisfaction, positive affect, resilience, self-efficacy, and socioemotional functioning. Some studies also reported reductions in anxiety, depression, and hopelessness, although the effects were not uniform and did not always persist during follow-up. Methodological heterogeneity prevented the conduct of a meta-analysis. Conclusion: Character strengths are trainable resources with potential utility for promoting adolescent well-being, especially when their practice is guided, sustained, and culturally relevant.
Ángel Patricio Herrera-Carrión, Ana Cecilia Chimbo-Pérez, Darwin Sebastián Ruiz-Mena et al.
Current approaches for modeling discrete-valued outcomes associated with spatially-dependent areal units incur computational and theoretical challenges, especially in the Bayesian setting when full posterior inference is desired. As an alternative, we propose a novel statistical modeling framework for this data setting, namely a mixture of directed graphical models (MDGMs). The components of the mixture, directed graphical models, can be represented by directed acyclic graphs (DAGs) and are computationally quick to evaluate. The DAGs representing the mixture components are selected to correspond to an undirected graphical representation of an assumed spatial contiguity/dependence structure of the areal units, which underlies the specification of traditional modeling approaches for discrete spatial processes such as Markov random fields (MRFs). Notably, the MDGM is not proposed as an approximation to an MRF, but rather as an alternative that provides valid posterior inference while being computationally faster than exact MRF inference and more principled than the pseudo-likelihood approximation (aMRF) commonly used in practice. We introduce the concept of compatibility to show how an undirected graph can be used as a template for the dependencies between areal units to create sets of DAGs which, as a collection, preserve the dependencies represented in the template undirected graph. Lastly, we compare highlighted classes of MDGMs to MRFs and a popular Bayesian MRF model approximation used in high-dimensional settings in a series of simulations and an analysis of ecometrics data collected as part of the Adolescent Health and Development in Context Study.
Abstract Psychiatric residential treatment (RT) is one of the most restrictive levels of care for youth with severe emotional and behavioral challenges. Despite the complex needs of youth involved in RT, their perspectives remain underrepresented in research, limiting knowledge regarding approaches for engaging this population in research. This paper describes findings from the Families in Transition (FIT) Study, a randomized controlled trial that evaluated a group-based behavioral parent training program for parents of youth in RT. The current study was conceptually framed as a feasibility study of engaging youth in RT research. Data were collected from parents and youth at baseline, 6 weeks, and 6 months using measures of emotional and behavioral functioning, placement restrictiveness, and mental health symptoms. Feasibility was assessed through recruitment, enrollment, and retention, as well as barriers encountered during youth engagement. Although 64 parents enrolled in the parent study, only five youth enrolled in the youth component. Review of recruitment records and study notes identified multiple barriers to youth participation, including challenges associated with recruiting youth while residing in RT, parent apprehension regarding participation burden and emotional distress, and difficulties related to remote data collection. Procedural adaptations included prioritizing post-discharge recruitment, flexible scheduling, enhanced communication with parents, and implementation of extensive safety protocols. As a secondary exploratory objective, parent and youth responses on shared measures were compared descriptively. Although based on a small sample, parent and youth reports differed in their perceptions of emotional and behavioral concerns and placement restrictiveness. Findings highlight the challenges of engaging youth in RT in research and underscore the importance of collaboration, flexible procedures, and innovative approaches to incorporating youth voice in mental health research.
Sophie Berger, Susan M. Breitenstein, Nathan P. Helsabeck et al.
