The Longitudinal Interplay between Adverse Peer Experiences and Self-Regulation Facets: A Prospective Analysis during Middle Childhood.

Positive peer experiences and self-regulation (SR) skills are crucial for children's healthy development, but little is known about how they interact during middle childhood. Therefore, we examined the prospective links between adverse peer experiences (APEs) and SR, drawing from the dataset of the PIER study. Across three measurement points, 1654 children aged 6-11 (T1), 7-11 (T2), and 9-13 years (T3) were included. We assessed the SR facets updating, flexibility, inhibition, emotional reactivity, inhibitory control, and planning using computerized tasks, parent- and teacher-reports. The latent variable of APEs consisted of measures of peer victimization and peer rejection assessed via self-, parent-, and teacher-report. Separate cross-lagged panel models were calculated, investigating the interplay of each SR facet and APEs. Results indicated that experiencing more APEs at T1 predicted higher emotional reactivity, and lower inhibition, inhibitory control, updating, and flexibility at T2. More APEs at T2 predicted higher emotional reactivity and lower planning at T3. Lower inhibition, updating, and flexibility at T2 predicted more APEs at T3. Accordingly, we found a negative bidirectional relationship between inhibition, updating, and flexibility with APEs. Our findings highlight that during middle childhood more APEs predict lower SR, which in turn predicts more experiences of peer victimization and rejection.

From Maltreatment to Psychiatric Disorders in Childhood and Adolescence: The Relevance of Emotional Maltreatment.

Different forms of maltreatment are thought to incur a cumulative and non-specific toll on mental health. However, few large-scale studies draw on psychiatric diagnoses manifesting in early childhood and adolescence to identify sequelae of differential maltreatment exposures, and emotional maltreatment, in particular. Fine-grained multi-source dimensional maltreatment assessments and validated age-appropriate clinical interviews were conducted in a sample of N = 778 3 to 16-year-olds. We aimed to (a) substantiate known patterns of clinical outcomes following maltreatment and (b) analyse relative effects of emotional maltreatment, abuse (physical and sexual), and neglect (physical, supervisory, and moral-legal/educational) using structural equation modeling. Besides confirming known relationships between maltreatment exposures and psychiatric disorders, emotional maltreatment exerted particularly strong effects on internalizing disorders in older youth and externalizing disorders in younger children, accounting for variance over and above abuse and neglect exposures. Our data highlight the toxicity of pathogenic relational experiences from early childhood onwards, urging researchers and practitioners alike to prioritize future work on emotional maltreatment.

Self-regulation facets differentially predict internalizing symptom trajectories from middle childhood to early adolescence: a longitudinal multimethod study.

BACKGROUND: Internalizing symptoms are among the most common psychological symptoms in childhood and adolescence, are highly stable and can cause severe impairment. Current research discusses lower capacities of self-regulation (SR) as risk factors for the development of internalizing symptoms. The present study identifies trajectories of internalizing symptoms in the transition phase from middle childhood to adolescence and examines multiple SR facets as predictors of potentially unfavorable trajectories, also in the presence of other established risk factors. METHODS: The study utilized a community sample of N = 1453 (52.2% female) German children, who provided data at up to three measurement points (t1: 6-11 years, t2: 7-11 years, t3: 9-13 years). Trajectories of internalizing symptoms were based on parents' ratings of the emotional problems scale of the Strengths and Difficulties Questionnaire. SR facets were assessed using multiple methods and informants. Two multinomial regression analyses were conducted to predict class membership by (1) SR facets and gender and (2) SR facets, gender, and other established risk factors (education status, family adversity, peer problems). RESULTS: Using growth mixture modelling, we identified three trajectory classes with stable low (n = 1200), increasing (n = 124), and early high decreasing internalizing symptoms (n = 129). In the regression analysis controlling for risk factors, membership in the increasing trajectory was significantly predicted by higher emotional reactivity (OR = 2.65, p < .001), higher cognitive flexibility/set-shifting (OR = 1.48, p = .032), and higher family adversity (OR = 1.38, p = .046). Membership in the early high decreasing trajectory was significantly predicted by higher emotional reactivity (OR = 4.15, p < .001), higher inhibitory control (OR = 1.47, p = .045), lower working-memory updating (OR = 0.69, p = .016), lower delay of gratification (OR = 0.75, p = .028), and higher family adversity (OR = 1.63, p = .001). CONCLUSIONS: SR facets incrementally and differentially predict potentially unfavorable trajectories of internalizing symptoms from age 6 to 13, surpassing the predictive value of gender or education status. Higher emotional reactivity emerged as the most influential factor, which could therefore be addressed in future prevention and intervention efforts.

[Smartphone Use in the Presence of Infants and Young Children: A Systematic Review]. / Smartphone-Nutzung in Gegenwart von Babys und Kleinkindern: Ein systematisches Review.

In previous years, concerns have been repeatedly raised regarding the impact of parental use of smartphones and other portable digital devices (PDD) in the presence of infants and young children on children's development. Recently, this topic gainedmore attention by researchers. Therefore, this review aimed at answering the following questions based on the current state of research: How does parental use of PDD in the presence of their 0-3-year-old child affect the quality of the parent-child interaction and relationship, their child's affective and physiological regulation as well as social-emotional and cognitive development? The literature search of six databases based on previously established criteria resulted in 22 articles. The results suggest that parents are less sensitive and responsive towards their children while using PDD. Furthermore, negative effects on children's affect and physiological regulation during parental device use were reported, which appear not to persist beyond the period of use. Moreover, parental technoference in everyday life might affect the parent-child relationship, although respective findings are inconsistent. Furthermore, parental technoference appears to be associated with impaired child learning. Further research is needed to determine the extent of parental use and specific patterns of use leading to lasting negative consequences for child development.

Maternal sensitivity and intrusiveness in early childhood as predictors of children's weight at school age.

BACKGROUND: While previous research indicates that low maternal sensitivity in mother-child interactions puts children at risk of overweight and obesity, maternal intrusiveness has rarely been investigated in association with children's weight. We investigated whether maternal sensitivity and intrusiveness in early childhood predict children's increased body mass index standard deviation scores (BMI-SDS) at school age. BMI-SDS are standardized for age and gender with respect to a reference standard. METHODS: At baseline (t1), we assessed maternal sensitivity and (non-)intrusiveness of 116 mothers with their children (48.3% female) aged 5-47 months (M = 24.00, SD = 11.36) using the emotional availability scales. We obtained anthropometric data for mothers at t1 by measuring height and weight in the laboratory and for children at birth assessed by medical staff. Six years later (t2) we obtained anthropometric data for children in the laboratory or based on parental report. Linear regression analyses were run with child BMI-SDS at t2 as outcome and sensitivity and (non-)intrusiveness as predictors, adjusting for confounders and exploring child age and gender as moderators. RESULTS: Maternal sensitivity only negatively predicted children's BMI-SDS in girls, while maternal intrusiveness predicted higher child BMI-SDS at school age regardless of child gender. The effect of maternal non-intrusiveness remained significant when controlling for confounders. CONCLUSION: Maternal intrusiveness in early childhood seems to represent a risk factor for increased BMI-SDS in children, while lower maternal sensitivity tends to be a risk factor for increased BMI-SDS in girls. This may have implications for prevention or intervention programmes.

[Evaluation of Short-term Psychoanalytic Child Therapy (PaCT) for Young Children with Depressive Disorders: Results from a Pilot Study]. / Evaluation der Psychoanalytischen Kurzzeittherapie (PaKT) für junge Kinder mit depressiven Störungen: Ergebnisse der Pilotstudie.

Depressive disorders in early childhood are associated with high psychosocial impairment and tend to remain stable over time without adequate treatment. Short-term psychoanalytic therapy is a common form of child psychotherapy, yet there is a lack of empirical evaluation of this approach for young children with depressive disorders. Therefore, this secondary evaluation of a study on the treatment of anxiety disorders used an uncontrolled pre-post design in a clinical setting to investigate whether children with depressive comorbidity would evidence significant diagnostic and symptomatic remission after treatment with manualized short-term Psychoanalytic Child Therapy (PaCT). Nineteen children who had an anxiety disorder and a (subclinical) depressive disorder (assessed with the Preschool Age Psychiatric Assessment using DSM-IV criteria) were treated with PaCT. After treatment, 15 of 19 children (78.94 %) were remitted and 15 of 17 children (88.24 %; 2 were lost to follow-up) were free of depressive disorders at the 6-month follow-up. Further analyses revealed significant effects for pre- to post and pre- to follow-up comparisons regarding internalizing symptoms and overall problems using parent- and (nursery-)teacher-ratings. These results suggest that short-term PaCT shows promise as a treatment for childhood depressive disorders.

Exclusion Expected? Cardiac Slowing Upon Peer Exclusion Links Preschool Parent Representations to School-Age Peer Relationships.

Attachment theory proposes that children's representations of interactions with caregivers guide information-processing about others, bridging interpersonal domains. In a longitudinal study (N = 165), preschoolers (Mage  = 5.19 years) completed the MacArthur Story Stem Battery to assess parent representations. At school-age (Mage  = 8.42 years), children played a virtual ballgame with peers who eventually excluded them to track event-related cardiac slowing, a physiological correlate of rejection, especially when unexpected. At both ages, parents and teachers reported on peer and emotional problems. During exclusion versus inclusion-related events, cardiac slowing was associated with greater positive parent representations and fewer emerging peer problems. Cardiac slowing served as a mediator between positive parent representations and peer problems, supporting a potential psychophysiological mechanism underlying the generalization of attachment-related representations to peer relationships.

Quality of life and psychological co-morbidities in children and adolescents with cardiac pacemakers and implanted defibrillators: a cohort study in Eastern Germany.

INTRODUCTION: The implantation of a pacemaker or an implantable cardioverter-defibrillator during childhood may reduce quality of life and lead to mental health problems. This study aimed to evaluate potential mental health problems (i.e., depressive and anxiety symptoms) and quality of life in children with cardiac active devices in comparison to healthy peers. METHODS: We analysed data of children with pacemakers or implantable cardioverter-defibrillators aged 6-18 years. Quality of life, depressive and anxiety symptoms were assessed by standardised questionnaires. The results were compared to age-matched reference groups. RESULTS: Children with implantable cardioverter-defibrillator showed significant lower quality of life in comparison to reference group (p = 0.03), but there was no difference in quality of life between children with pacemaker and reference group. There was no significant difference in depressive symptoms between children with a cardiac rhythm device compared to reference group (self-report: p = 0.67; proxy report: p = 0.49). There was no significant difference in anxiety (p = 0.53) and depressive symptoms (p = 0.86) between children with pacemaker and children with implantable cardioverter-defibrillator. CONCLUSIONS: Living with an implantable cardioverter-defibrillator in childhood seems to decrease the patients' quality of life. Although children with pacemaker and implantable cardioverter-defibrillator don't seem to show more depressive and anxiety symptoms in comparison to their healthy peers, there still can be an increased risk for those children to develop mental health problems. Therefore, treating physicians should be aware of potential mental health problems and provide the patients and their families with appropriate therapeutic offers.

Childhood Emotional and Conduct Problems in Childhood and Adolescence Differentially Associated with Intergenerational Maltreatment Continuity and Parental Internalizing Symptoms.

Caregivers' own childhood maltreatment experiences potentiate the risk for psychopathology and perpetration of maltreatment against one's children. In turn, both of these factors may negatively impact children's mental health. The nature of these intergenerational patterns of maltreatment may vary as a function of type of child outcome and may also be influenced by child age and sample characteristics (i.e., involvement of Child Protection Services, CPS). The present study uses a Structural Equational Model to examine cross-sectional relationships between caregiver maltreatment experiences in childhood and child-rated emotional and conduct problems and tests the mediational effect of caregiver internalizing symptoms and child maltreatment exposure. This sample is comprised of 791 children aged 3-16 years (Mage = 10.6 years; n = 302 3 to 8-year-olds, n = 489 9 to 16-year-olds; 51.5% male) and their caregivers (88.4% biological mothers). Children were recruited from CPS (n = 124), youth psychiatric services (n = 144), and the general population (n = 523). Results indicated indirect links between caregivers' childhood maltreatment experiences and their children's emotional and conduct problems. Specifically, caregiver-perpetrated child maltreatment predicted was related to child conduct problems, whereas both caregiver-perpetrated child maltreatment and caregiver internalizing symptoms were related to child emotional problems. Multi-group analyses revealed no moderation effect of CPS involvement. Our results highlight the importance of independent outcome-specific intergenerational patterns in prevention approaches for families with maltreatment experiences.

Latent trajectories of internalizing symptoms from preschool to school age: A multi-informant study in a high-risk sample.

Recent proposals suggest early adversity sets in motion particularly chronic and neurobiologically distinct trajectories of internalizing symptoms. However, few prospective studies in high-risk samples delineate distinct trajectories of internalizing symptoms from preschool age onward. We examined trajectories in a high-risk cohort, oversampled for internalizing symptoms, several preschool risk/maintenance factors, and school-age outcomes. Parents of 325 children completed the Strengths and Difficulties Questionnaire on up to four waves of data collection from preschool (3-5 years) to school age (8-9 years) and Preschool Age Psychiatric Assessment interviews at both ages. Multi-informant data were collected on risk factors and symptoms. Growth mixture modelling identified four trajectory classes of internalizing symptoms with stable low, rising low-to-moderate, stable moderate, and stable high symptoms. Children in the stable high symptom trajectory manifested clinically relevant internalizing symptoms, mainly diagnosed with anxiety disorders/depression at preschool and school age. Trajectories differed regarding loss/separation experience, maltreatment, maternal psychopathology, temperament, and stress-hormone regulation with loss/separation, temperament, maternal psychopathology, and stress-hormone regulation (trend) significantly contributing to explained variance. At school age, trajectories continued to differ on symptoms, disorders, and impairment. Our study is among the first to show that severe early adversity may trigger a chronic and neurobiologically distinct internalizing trajectory from preschool age onward.

Getting less than their fair share: Maltreated youth are hyper-cooperative yet vulnerable to exploitation in a public goods game.

Human cooperative behavior has long been thought to decline under adversity. However, studies have primarily examined perceived patterns of cooperation, with little eye to actual cooperative behavior embedded within social interaction. Game-theoretical paradigms can help close this gap by unpacking subtle differences in how cooperation unfolds during initial encounters. This study is the first to use a child-appropriate, virtual, public goods game to study actual cooperative behavior in 329 participants aged 9-16 years with histories of maltreatment (n = 99) and no maltreatment (n = 230) while controlling for psychiatric symptoms. Unlike work on perceived patterns of cooperation, we found that maltreated participants actually contribute more resources to a public good during peer interaction than their nonmaltreated counterparts. This effect was robust when controlling for psychiatric symptoms and peer problems as well as demographic variables. We conclude that maltreatment may engender a hyper-cooperative strategy to minimize the odds of hostility and preserve positive interaction during initial encounters. This, however, comes at the cost of potential exploitation by others.

[Factors Influencing Theory of Mind Development in Preschoolers within the Context of Early Interventions]. / Einflussfaktoren auf die Theory of Mind-Entwicklung im Vorschulalter im Rahmen Früher Hilfen.

Factors Influencing Theory of Mind Development in Preschoolers within the Context of Early Interventions The Theory of Mind (ToM) competency is closely related to the child's cognitive, language, and socio-emotional development. In early interventions, skills and developmental processes associated with ToM development are often primary intervention targets, but empirical support for direct or indirect influences of early interventions on ToM development is missing so far. Within the home visiting program "Pro Kind" N = 755 families were accompanied by professionals from the last trimester of pregnancy until the child's second birthday. In the present follow-up study we investigated influences of treatment, pre- and postnatal family environment, parental competencies and child competencies on the ToM ability in a sample of n = 39 five-year-old children using Ctree analyses. Prenatal and current parental stress as well as an enriched family learning environment, and children's language competencies in interaction with temperament significantly predicted ToM competency. The treatment had no direct influence on ToM development. Thus, the results argue for the urgent need to address maternal stress regulation and mentalizing competencies in early interventions during pregnancy, as well as to focus on promoting positive stimulating learning environments and language development after the child's birth.

Follow-up study regarding the medium-term effectiveness of the home-visiting program "Pro Kind" at age 7 years: study protocol for a randomized controlled trial.

BACKGROUND: Pro Kind is a German adaptation of the US Nurse Family Partnership program. It is an intervention based on home visits targeting first-time mothers from disadvantaged populations. Pro Kind was implemented as a randomized control trial from 2006 to 2012 with N = 755 first-time mothers (TG n = 394, CG n = 391). The 7-8-year follow-up aims to assess the mid-term effects of the program. METHODS/DESIGN: Mid-term outcomes are being assessed by trained assessors. In a multimethod approach telephone interviews, on-site interviews, observations and developmental tests will be held in order to assess children's and mothers' life satisfaction, mental health, cognitive and social development, parenting behavior, signs of child abuse or neglect as well as the family's socio-economic status. Furthermore, administrative data will be accessed to obtain information regarding the mother's usage of pediatric health care, welfare usage and employment history. DISCUSSION: Results regarding the mid-term effects of the intervention from the Pro Kind Follow-up will provide a scientific basis for future primary prevention programs as well as help stakeholders legitimizing early childhood investments. TRIAL REGISTRATION: German Clinical Trial Registration DRKS-ID, ID: DRKS00007554 . Registered on 11 June 2015, updated on 6 October 2017.

Like mother like daughter, like father like son? Intergenerational transmission of internalizing symptoms at early school age: a longitudinal study.

Despite the well-established link between parental depressive symptoms and children's internalizing symptoms, studies that divide transmission into gender-specific components remain scarce. Therefore, the present study focused on gender-specific associations between internalizing symptoms of parents and children over the course of early school age, a key stage where gender-specific roles are increasingly adopted. Participants were 272 children (49.6% girls) oversampled for internalizing symptoms. Parents completed questionnaires twice during early school age (mean age time 1 = 7.4 years; SD = 0.24; mean age time 2 = 8.5 years; SD = 0.28). Mothers and fathers separately reported on their own depressive symptoms and their child's internalizing symptoms. Latent multiple group analyses indicated gender-independent stability as well as gender-specific relations between parental and child outcomes. Maternal depressive symptoms were concurrently associated with symptoms of girls and boys, while paternal symptoms were concurrently associated only with symptoms of boys, but not of girls. Moreover, the associations between children and the parent of the same gender became more relevant over time, suggesting a growing identification with the same-gender model, particularly for fathers and boys. In regard to prospective effects, girls' internalizing symptoms at age 7 predicted paternal depressive symptoms 1 year later. In a rigorous longitudinal design, this study underscores the importance of gender specificity in the associations of internalizing symptoms between children and their mothers and fathers after controlling for symptom stability over time. The study also raises the interesting possibility that girls' internalizing symptoms elicit similar symptoms in their fathers.

Commentary: The dynamic panel model: a promising approach to clarify sources of influence in developmental psychopathology - a commentary on Wichstrøm et al. (2017).

In their study, Wichstrøm et al. (2017) have proposed a novel groundbreaking approach for developmental psychopathology that undoubtedly will inspire other research. Applying the dynamic panel model (DPM), the authors were able to show that within-disorder (homotypic) and between-disorder (heterotypic) continuities of psychiatric symptoms are mostly due to unmeasured time-invariant factors while only few effects of earlier symptoms on later symptoms remained significant after accounting for these factors. The DPM calls for future applications of this approach to samples across different countries, diverse developmental phases, and in various settings - community samples and clinical samples alike.

Commentary: The importance of exploring dose-dependent, subtype-specific, and age-related effects of maltreatment on the HPA axis and the mediating link to psychopathology. A response to Fisher (2017).

We greatly appreciate Dr. Fisher's commentary that provides an excellent backdrop and well-considered perspective on our findings. We agree that our results mesh well with previous work documenting hypocortisolism among youth who experienced early adversity, especially neglect. Moreover, as also perceptively noted by Dr. Fisher, our cross-sectional data provide support for the notion that hypocortisolism is not simply a transient phenomenon, but, rather, a persistent pattern characterizing maltreated youth. Specifically, the consistency of the between group effect (from age 9.69 onwards) on a multimonth index of cumulative cortisol and the dose-dependent gradient of cortisol secretion within the maltreated group, which was related to the number of subtypes and the length of exposure to maltreatment, lend weight to this view.