The role of sleep in prospective associations between parent reported youth screen media activity and behavioral health.

BACKGROUND: Screen media activity (SMA) can negatively affect youth behavioral health. Sleep may mediate this association but has not been previously explored. We examined whether sleep mediated the association between SMA and youth behavioral health among a community sample. METHOD: Parents completed questions about their child (N = 564) ages 3-17 at Wave 1, Wave 2 (4-8 months later), and Wave 3 (12 months later). Path analyses were conducted to examine links between Wave 1 SMA and Wave 3 behavioral health problems (i.e., internalizing, externalizing, attention, peer problems) through Wave 2 sleep disturbance and duration. RESULTS: SMA was significantly associated with greater sleep disturbance, ß = .11, 95% CI [.01, .21] and shorter sleep duration, ß = -.16 [-.25, -.06], and greater sleep disturbance was associated with worse youth behavioral health across internalizing, ß = .14 [.04, .24], externalizing, B = .23 [.12, .33], attention, ß = .24 [.15, .34], and peer problems, ß = .25 [.15, .35]. Longer sleep duration was associated with more externalizing, ß = .13 [.04, .21], and attention problems, ß = .12 [.02, .22], and fewer peer problems, ß = -.09 [-.17, -.01], but not with internalizing problems. Lastly, there was a direct effect of SMA on peer problems, ß = -.15 [-.23, -.06] such that higher SMA that does not impact sleep may have a positive impact on reducing peer problems. CONCLUSIONS: Sleep (i.e., disturbances and shorter duration) may partially account for the small associations observed between SMA and worse behavioral health in youth. To continue expanding our understanding, future research should utilize more diverse representative samples, use objective measures of SMA and sleep, and examine other relevant aspects of SMA, including content, device type, and timing of use.

Remote Intensive Group Behavioral Treatment for Families of Children with Selective Mutism.

Selective mutism (SM) is a relatively rare, but highly interfering, child anxiety disorder characterized by a consistent failure to speak in certain situations, despite demonstrating fluent speech in other contexts. Exposure-based cognitive behavioral therapy and Parent-Child Interaction Therapy adapted for SM can be effective, but the broad availability and accessibility of such specialty care options remains limited. Stay-at-home guidelines to mitigate the spread of COVID-19 further limited the accessibility of office-based specialty care for SM. Building on separate lines of research supporting intensive treatments and telehealth service delivery models, this paper is the first to describe the development, preliminary feasibility, acceptability, and efficacy of a Remote Intensive Group Behavioral Treatment (IGBT) for families of young children with SM (N=9). Treatment leveraged videoconferencing technology to deliver caregiver training sessions, lead-in sessions, 5 consecutive daily IGBT sessions, and an individualized caregiver coaching session. Remote IGBT was found to be both feasible and acceptable. All families (100%) completed diagnostic assessments and caregiver-report questionnaires at four major study timepoints (i.e., intake, pre-treatment, post-treatment, 4-month follow-up) and participated in all treatment components. Caregivers reported high treatment satisfaction at post-treatment and 4-month follow-up and low levels of burden associated with treatment participation at post-treatment. Approximately half of participating children were classified as treatment responders by independent evaluators at post-treatment and 4-month follow-up. Although these pilot results should be interpreted with caution, the present work underscores the potential utility of using videoconferencing to remotely deliver IGBT to families in their natural environments.

An 18-week model of Parent-Child Interaction Therapy: clinical approaches, treatment formats, and predictors of success for predominantly minoritized families.

Introduction: Disruptive behavior disorders are among the most prevalent pediatric mental health referrals for young children. However, families from historically minoritized social identities have experienced disparities in treatment access, retention, and outcomes. Evidence-based interventions such as Parent-Child Interaction Therapy (PCIT) have been found to be effective in reducing children's disruptive behaviors in minoritized families. However, variable treatment length as a result of skill-based graduation criteria (e.g., observed caregiver verbalizations) may slow and/or hinder treatment progress, particularly for families where expected treatment verbalizations are less linguistically relative (e.g., no exact English to Spanish translations) and/or culturally familiar. Time-limited PCIT has been proposed as a strategy for promoting equity in treatment completion and outcomes amongst minoritized families, because treatment progression and/ or completion is not contingent upon caregiver linguistic skill demonstration. Methods: The current study evaluated the overall effectiveness of an 18-week model of PCIT and examined predictors of retention and treatment outcomes. Participants (N = 488 dyads) included predominantly racially, ethnically, linguistically, and socioeconomically diverse children aged two to eight years, and their caregivers. Results: Overall findings indicate that the 18-week PCIT model is an effective intervention for reducing children's externalizing and internalizing behaviors and improving caregiver parenting skills for most treatment completers. Despite advances in treatment completion, some caregiver social identities and PCIT treatment characteristics were predictive of lower completion rates and/or less optimal treatment outcomes. Discussion: Overall, this study provides strong support for widely disseminating use of the 18-week model of PCIT for most families served. Clinical implications and considerations for continued treatment inequity are discussed.

Measurement invariance in the assessment of parenting practices: A cross-cultural comparison of China and the United States.

Assessing parenting practices in a culturally informed manner is critical to clinical practice when working with families. Although many parenting measures have been translated into Chinese, limited evidence for measurement invariance is available. The present study aims to assess the measurement invariance of positive and negative parenting practices across Mandarin-speaking families living in Mainland China and English-speaking families living in the United States. Three thousand seven parents of children ages 6-12 years (770 English-speaking: parent Mage = 35.15 years, SD = 7.96; child Mage = 9.50 years, SD = 4.27; 2,237 Chinese-speaking: parent Mage = 38.46 years, SD = 4.42; child Mage = 9.40 years, SD = 1.78) completed the Multidimensional Assessment of Parenting Scale as a part of two separate research protocols. Multiple-group confirmatory factor analyses (CFAs) were used, and the source of invariance at the factor and item levels was examined. CFA revealed that a seven-factor solution was feasible across both samples, as evidenced by configural and metric invariance. We found a lack of scalar invariance; thus, we constructed a partial scalar invariance model and presented latent means, correlations, and variances of the seven subscales. Item-level parameter estimates and content analyses revealed potentially different item interpretations of the measure. The lack of scalar invariance suggests that researchers should not use mean differences (e.g., from simple t tests) for cross-cultural comparisons using common parenting questionnaires. Instead, we recommend analyzing data utilizing latent variable modeling (e.g., structural equation modeling) and future directions for improving measures as part of larger efforts for promoting inclusive parenting science. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Behavioral Parent Training for Preschool ADHD: Family-Centered Profiles Predict Changes in Parenting and Child Outcomes.

OBJECTIVE: Behavioral parent training (BPT) is the first line of treatment for preschool-aged children with attention-deficit hyperactivity disorder (ADHD); however, clinically significant improvements are not universal. In the current study, we employ a person-centered approach to create subgroups of families based on the intersection of multiple parent, child, and family pre-treatment factors. Further, we explore the utility of pre-treatment family profiles in predicting post-treatment differences in observed parenting behavior (i.e., behavioral control, parental warmth) and clinically significant change in child ADHD and oppositional symptoms. METHOD: Longitudinal data were collected using observational and parent-, teacher- and clinician-reported assessments from 130 parent-child dyads (Mage= 3.57, range = 3.0- 4.11, 73.8% male, 69.2% White, 25.6% Hispanic) participating in BPT. RESULTS: Findings from the current study suggest three distinct family profiles, which consisted of one profile with high family stress (HFS) as evidenced by elevated symptomatology across parent, child, and family-level domains, a second profile with elevated parental anxiety (PA), and a final profile with elevated parental depression (PD). These family-centered profiles were differentially associated with changes in observed parenting practices. Specifically, the PD profile (39%) demonstrated minimal improvements in behavioral control and warmth following treatment. In contrast, the HFS profile (30%) only improved in behavioral control and the PA profile (31%) improved in both parenting domains following treatment. In addition, marginally significant differences in child oppositional and ADHD symptoms were observed across profiles. CONCLUSIONS: Family-centered approaches may be useful for selecting and implementing interventions.

Parent-Child Role Confusion: Exploring the Role of Family Processes in the Context of Parental Depression.

OBJECTIVE: Parent-child role confusion has been shown to influence developmental outcomes for children whose parents have a history of depression; however, more research is needed to understand the pathways by which parental depression increases risk of role confusion. The current study aimed to extend previous literature by evaluating how different family processes (e.g., interparental conflict, guilt induction, family cohesion, and positive parenting practices) contribute to the development of emotional role confusion in families with a history of parental depression. METHOD: The sample was comprised of 90 parent-child dyads (parent Mage = 42, 90% female, 83.3% White; child Mage = 11.51, 51.1% female, 75.6% White) participating in the control group of a randomized controlled trial. All parents had a history of depression. A longitudinal path analysis was conducted to evaluate prospective associations in the multiple mediator model. RESULTS: Findings from the current study suggest that parental depressive symptoms are not directly related to the development of parent-child emotional role confusion, but are instead indirectly related through increased interparental conflict observed by youth. Although not identified as significant mediators, guilt induction and positive parenting practices emerged as predictors of emotional role confusion. Lastly, family cohesion did not appear to influence the development of role confusion. CONCLUSION: Findings suggest that parenting behaviors and coparenting relationship quality play important roles in the development of parent-child emotional role confusion, with interparental conflict emerging as the strongest predictor in families with a history of parental depression.

Profiles of Emotion Socialization Across Development and Longitudinal Associations with Youth Psychopathology.

Although there is relative consensus in the literature regarding associations between certain emotion socialization (ES) strategies and youth behavioral health, there is very limited research from a person-centered perspective. To address this gap, the current study examined patterns of ES strategies in families and explored predictors and youth outcomes associated with those patterns. An economically-diverse sample of 229 predominately White mothers and fathers of youth aged 3-12 years was recruited online for a longitudinal study. Latent profile analysis was used to determine the optimal number of family clusters with similar ES profiles. Model fit supported a four-class model, which consisted of an Emotion Coaching profile, characterized by the lowest levels of putatively labeled unsupportive ES practices and the highest levels of putatively labeled supportive ES practices, a Moderate profile characterized by moderate levels of both unsupportive and supportive ES practices, a Limited Engagement profile characterized by low levels of both unsupportive and supportive ES practices, and an Emotion Dismissing profile characterized by the highest levels of unsupportive ES practices and the lowest levels of supportive ES practices. Cross-sectional and longitudinal differences were observed across the ES profiles with regard to demographic and parent emotional competence predictors and youth outcomes. The current study extends the literature on ES by providing evidence on how distinct ES profiles differentially predict youth behavioral health outcomes. Findings also underscore the importance of examining parent emotional competence as a catalyst for adaptive change in the family system.

Keeping your coparent in mind: A longitudinal investigation of mindfulness in the family system.

Recent studies have increasingly focused on mindfulness as it relates to interpersonal processes. In particular, cross-sectional research has shown that parents' dispositional mindfulness is associated with increased mindful parenting and coparenting, as well as improved coparenting relationship quality. The current study replicates and extends such work, representing the first longitudinal investigation of mindful coparenting. A sample of 449 parents (60% mothers) of children between the ages of 3 and 17 years were recruited online through Amazon's Mechanical Turk (MTurk) as part of a larger study on the assessment of parenting. Parents reported on their dispositional mindfulness, mindful coparenting, and coparenting relationship quality at three time points across an 8-month period. Results from a cross-lagged panel model using maximum likelihood estimation suggested that higher levels of parental mindfulness at baseline were related with higher levels of mindful coparenting at 4 months, which, in turn, were related to higher quality coparenting relationship at 8 months. Support for this model was found for both mothers and fathers and across all examined child age groups (i.e., early childhood, middle childhood, and adolescence), highlighting the robust nature of these effects. Overall, findings suggest that increasing mindfulness at an individual level can promote meaningful change within a family system, specifically through improvements in coparenting and parent-child interactions.

Los estudios recientes se han centrado cada vez más en la conciencia plena en relación con los procesos interpersonales. En particular, las investigaciones transversales han demostrado que la conciencia plena disposicional de los padres está asociada con una crianza y una cocrianza más conscientes, así como con una mejor calidad de la relación de cocrianza. El presente estudio reproduce y amplía dicho trabajo, y representa la primera investigación longitudinal de cocrianza consciente. Se reunió virtualmente una muestra de 449 padres (el 60 % madres) de niños de entre 3 y 17 años mediante Amazon's Mechanical Turk (MTurk) como parte de un estudio más extenso sobre la evaluación de la crianza. Los padres informaron sobre su conciencia plena disposicional, la cocrianza consciente y la calidad de la relación de cocrianza en tres intervalos de tiempo durante un periodo de ocho meses. Los resultados de un modelo de panel de retardo cruzado utilizando la estimación por máxima verosimilitud indicaron que los niveles más altos de conciencia plena de los padres en el momento basal estuvieron relacionados con niveles más altos de cocrianza consciente a los cuatro meses, los cuales, a su vez, estuvieron relacionados con una relación de cocrianza de mayor calidad a los ocho meses. Se encontró respaldo para este modelo tanto en el caso de las madres como en el de los padres y entre todos los grupos etarios de los niños analizados (p. ej.: primera infancia, segunda infancia, adolescencia). Asimismo, se destacó la índole sólida de estos efectos. En general, los resultados indican que aumentar la conciencia plena a nivel individual puede promover un cambio significativo dentro de un sistema familiar, específicamente mediante mejoras en la cocrianza y en las interacciones entre padres e hijos.

Longitudinal Associations Between Parenting Practices and Youth Sleep Problems.

OBJECTIVE: Sleep problems among youth are highly prevalent and associated with adjustment difficulties. When considering influences on youth's sleep, bidirectional links between youth's sleep health and family functioning have been suggested. Parenting practices are among the many familial factors that could be transactionally related to poor sleep in youth; however, research is lacking on potential longitudinal associations between parenting practices and sleep problems in youth. In addition, sensitive periods for this link are mostly unknown. The current study examined longitudinal relations between constellations of parenting practices and youth sleep health to identify profiles of parenting practices that are predictive of sleep problems in youth across different developmental stages. METHOD: Participants were 292 parents (M = 36.51, SD = 7.3) of children between the ages of 3 and 14 years (M = 8.4, SD = 3.6). A person-centered approach was used to create profiles across traditionally labeled positive and negative parenting practices, as well as supportive and unsupportive parental emotion socialization strategies. Parenting profiles were then examined as longitudinal predictors of youth sleep problems. RESULTS: Findings revealed 3 distinct parenting profiles, which were differentially associated with sleep problems in youth, with the first profile predicting the lowest levels of sleep problems and the third profile predicting the highest levels of sleep problems, particularly among peripubertal youth. CONCLUSION: This study extends previous findings by elucidating distinct constellations of parenting practices that are differentially predictive of youth sleep problems and highlighting parenting among the various family processes that can longitudinally contribute to youth's sleep health.

The Longitudinal Influence of Caregiver Dispositional Mindful Attention on Mindful Parenting, Parenting Practices, and Youth Psychopathology.

OBJECTIVES: Although much research examining youth psychopathology from an ecological family systems theoretical framework has highlighted negative or pathological parental characteristics, it is important to identify and explore beneficial parent characteristics, such as mindful attention and awareness, that may be related to youth mental health. Dispositional mindfulness has been related, in cross-sectional research, to higher levels of mindful parenting, which impacts positive and negative parenting and, in turn, offspring internalizing and externalizing symptoms. The current study expands this work by examining associations among caregiver dispositional mindful attention, mindful parenting, parenting behaviors, and youth psychopathology in a short-term longitudinal model and by testing potential moderators. METHODS: A sample of 564 parents (60% mothers) of children between the ages of 3 and 17 reported on their dispositional mindful attention, mindful parenting, positive and negative parenting practices, and their youth's internalizing and externalizing symptoms at 4 time points over a 12-month period. RESULTS: The structural equation model indicated that higher levels of baseline caregiver dispositional mindful attention were related to higher levels of mindful parenting at 4 months. Higher levels of mindful parenting were associated with higher levels of positive parenting and lower levels of negative parenting practices at 8 months. Finally, lower levels of negative parenting practices were related to lower levels of internalizing and externalizing symptoms at 12 months. Moderator analyses suggested that all prospective associations in the model were equivalent for mothers and fathers, boys and girls, and children and adolescents. CONCLUSIONS: Findings shed light on the importance of considering caregiver dispositional mindful attention as it relates to parenting behaviors and youth mental health.

Psychometric properties of the Chinese version of the Multidimensional Assessment of Parenting Scale.

Parenting practices have been linked to a wide range of issues related to children's psychological adjustment; however, more research is warranted to further understand not only cultural variations of parenting norms, but also how such variations might differentially influence child outcomes. The current study examined the psychometric properties of a Chinese translation of the Multidimensional Assessment of Parenting Scale (MAPS) in order to: (a) assess both positive and negative dimensions of parenting in Chinese-speaking societies and (b) to explore the association between these practices and children's psychopathological symptoms. A total of 2,237 parents with children between 6 and 12 years old completed the MAPS, Interpersonal Mindfulness in Parenting Scale (IM-P), adapted Parental Bonding Instrument (PBI), and other measures related to children's psychosocial functioning. Exploratory and confirmatory factor analyses (CFA) revealed a clear six-factor structure. Strong to strict measurement invariance for child gender, parent gender, and child age were found. The results demonstrated adequate psychometric properties in terms of internal consistency and test-retest reliability. MAPS subscales also showed concurrent and convergent validity with mindful parenting, parent-child bonding, and children's psychopathology outcomes. The Chinese version of the MAPS will help facilitate multidimensional parenting research in Chinese-speaking societies and promote future cross-cultural studies examining the effect of positive and negative parenting on children's psychopathological adjustment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Parent Socialization of Coping and Child Emotion Regulation Abilities: A Longitudinal Examination.

This study examined the hypothesis that parent socialization of coping (SOC) would have a longitudinal relation with child emotion regulation abilities. Participants included a sample of 256 parents of 5- to 12-year-old children (child M age = 8.36, SD = 2.03, 54.7% male; parent M age = 34.49, SD = 6.20, 59% female). Data on demographic information, parenting behaviors, and child emotion regulation abilities were collected via online questionnaires at baseline and 12 months. Results from longitudinal structural equation modeling (SEM) analyses suggested that parent SOC, measured at baseline, predicted child adaptive and maladaptive emotion regulation, measured 12 months later. More specifically, parental engagement coping suggestions predicted child's adaptive emotion regulation, whereas parental disengagement coping suggestions predicted child's maladaptive emotion regulation. Further, child gender emerged as a moderator in the longitudinal association between socialization of engagement coping and child adaptive emotion regulation: Whereas this association was small and marginally significant for girls, it was large and statistically significant for boys. Results highlight the importance of parent SOC as potentially contributing to emotion regulation abilities of 5- to 12-year-olds.

Este estudio examinó la hipótesis de que la socialización del afrontamiento por parte de los padres tendría una relación longitudinal con las habilidades de regulación emocional de los niños. Los participantes fueron una muestra de 256 padres de niños de entre 5 y 12 años (edad promedio de los niños = 8.36, desviación típica= 2.03, el 54.7 % de sexo masculino; edad promedio de los padres = 34.49, desviación típica = 6.20, el 59 % de sexo femenino). Se recopilaron datos sobre información demográfica, conductas de crianza y habilidades de regulación emocional de los niños mediante cuestionarios en línea al inicio del estudio y a los 12 meses posteriores. Los resultados de los análisis de ecuaciones estructurales longitudinales sugirieron que el afrontamiento por parte de los padres, medido al inicio del estudio, predijo la regulación emocional adaptativa y desadaptativa medida 12 meses después. Más específicamente, las sugerencias de afrontamiento del interés de los padres predijeron la regulación emocional adaptativa del niño, mientras que las sugerencias de afrontamiento del desinterés de los padres predijeron la regulación emocional desadaptativa del niño. Además, el género del niño surgió como moderador en la asociación longitudinal entre la socialización del afrontamiento del interés y la regulación emocional adaptativa del niño: si bien esta asociación fue pequeña y marginalmente significativa para las niñas, fue grande y estadísticamente significativa para los niños. Los resultados destacan la importancia de la socialización del afrontamiento por parte de los padres como posible favorecedora de las habilidades de regulación emocional de los niños de entre 5 y 12 años.

Metabolic Syndrome in Dutch Patients With Bipolar Disorder: A Cross-Sectional Study.

OBJECTIVE: To characterize the prevalence of metabolic syndrome (MetS) among Dutch patients with bipolar disorder (BD), identify factors associated with MetS, and estimate the rate of pharmacologic treatment of MetS in this population. METHODS: A cross-sectional analysis of medical records of adult patients (≥ 18 years) with BD receiving psychotropic drug treatment was performed in a Dutch psychiatric outpatient setting. MetS was determined according to National Cholesterol Education Program Adult Treatment Panel III-Adapted (NCEP ATP III-A) criteria. Data collection via review of medical records from 2015 was conducted in 2016. RESULTS: The prevalence of MetS in the sample (N = 71) was 42.3%. Multivariate analysis showed sex and body mass index were independently associated with MetS. Males had an almost 8-fold higher risk of MetS than females (OR = 7.7, 95% CI, 1.5-39.6), and with every point of increase on BMI, the risk of MetS increased by 40% (OR = 1.4, 95% CI, 1.2-1.8). Of the patients with hyperglycemia, hypercholesterolemia, and hypertension, 81%, 72.4%, and 65.0%, respectively, did not receive drug treatment for these conditions. CONCLUSIONS: The study found a high prevalence rate of MetS and substantial undertreatment of the components of MetS in patients with BD in a Dutch outpatient clinic. Follow-up investigation in larger samples is warranted.