Prolonged Grief Disorder, but Not Death From COVID-19, Elicits Public Stigma: A Vignette-Based Experiment.

We investigated the effects of cause of death (COVID-19 with an underlying medical condition vs. without) and prolonged grief disorder status (PGD present or absent) on participants' reported public stigma towards the bereaved. Participants (N = 304, 66% women; Mage = 39.39 years) were randomly assigned to read one of four vignettes describing a bereaved man. Participants completed stigma measures assessing negative attributions, desired social distance, and emotional reactions. Participants reported significantly stronger stigmatizing responses towards an individual with PGD (vs. without PGD) across all stigma measures. There was no significant difference in stigma based on cause of death; however, stigma was reported regardless of cause of death. There was no significant interaction between cause of death and PGD on stigma. This study supports the robust finding of public stigma being reported toward an individual with PGD, suggesting these individuals are at risk of public stigma and not receiving adequate bereavement support.

Public stigma toward prolonged grief and COVID-19 bereavement: A vignette-based experiment.

We investigated the effects of cause of death and the presence of prolonged grief disorder (PGD) on eliciting public stigma toward the bereaved. Participants (N = 328, 76% female; Mage = 27.55 years) were randomly assigned to read one of four vignettes describing a bereaved man. Each vignette differed by his PGD status (PGD diagnosis or no PGD diagnosis) and his wife's cause of death (COVID-19 or brain hemorrhage). Participants completed public stigma measures assessing negative attributions, desired social distance, and emotional reactions. Bereavement with PGD (versus without PGD) elicited large and significantly stronger responses across all stigma measures. Both causes of death elicited public stigma. There was no interaction between cause of death and PGD on stigma. With increased PGD rates expected during the pandemic, the potential for public stigma and reduced social support for people bereaved via traumatic deaths and people with PGD requires mitigation.

Systematic Review and Meta-Analysis: Early Irritability as a Transdiagnostic Neurodevelopmental Vulnerability to Later Mental Health Problems.

OBJECTIVE: Irritability is a transdiagnostic indicator of child and adolescent internalizing and externalizing problems that is measurable from early life. The objective of this systematic review was to determine the strength of the association between irritability measured from 0 to 5 years and later internalizing and externalizing problems, to identify mediators and moderators of these relationships, and to explore whether the strength of the association varied according to irritability operationalization. METHOD: Relevant studies published in peer-reviewed, English-language journals between the years 2000 and 2021 were sought from EMBASE, PsycINFO, MEDLINE, CINAHL, and ERIC. We synthesized studies that included a measure of irritability within the first 5 years of life and reported associations with later internalizing and/or externalizing problems. Methodological quality was assessed using the JBI-SUMARI Critical Appraisal Checklist. RESULTS: Of 29,818 identified studies, 98 met inclusion criteria, with a total number of 932,229 participants. Meta-analysis was conducted on 70 studies (n = 831,913). Small, pooled associations were observed between infant irritability (0-12 months) and later internalizing (r = 0.14, 95% CI = 0.09, 0.20) and externalizing symptoms (r = 0.16, 95% CI = 0.11, 0.21) symptoms. For toddler/preschool irritability (13-60 months), small-to-moderate pooled associations were observed for internalizing (r = 0.21, 95% CI = 0.14, 0.28) and externalizing (r = 0.24, 95% CI = 0.18, 0.29) symptoms. These associations were not moderated by the lag between irritability and outcome assessment, although the strength of the associations varied according to irritability operationalization. CONCLUSION: Early irritability is a consistent transdiagnostic predictor of internalizing and externalizing symptoms in childhood and adolescence. More work is required to understand how to accurately characterize irritability across this developmental period, and to understand mechanisms underlying the relationship between early irritability and later mental health problems. DIVERSITY & INCLUSION STATEMENT: One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as living with a disability. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. STUDY PREREGISTRATION INFORMATION: Early irritability as a transdiagnostic neurodevelopmental vulnerability to early onset mental health problems: A systematic review; https://www.crd.york.ac.uk/prospero/; CRD42020214658.

Psychosocial wellbeing, parental concerns, and familial impact of children with developmental coordination disorder.

BACKGROUND: Developmental Coordination Disorder (DCD) is a neurodevelopmental condition impacting motor skill acquisition and competence. While previous studies have identified adverse psychosocial outcomes in DCD, they are limited by small or population-screened, community-based samples. AIMS: To understand the psychosocial difficulties, parental concerns, and familial impacts of childhood DCD in a large population-based sample. METHODS AND PROCEDURES: Parents of 310 children aged 4 - 18 years with a diagnosis of DCD (or synonymous term) completed the Impact for DCD survey. Parent-rated measures of emotional problems, peer problems, and prosocial behaviour were compared to normative data. Parental concerns for the impact of DCD on participation, interaction, emotional well-being, and the family system were examined. OUTCOMES AND RESULTS: Compared to typically developing children, children with DCD were rated significantly higher for emotional and peer problems, and significantly lower for prosocial behaviours. Parents most commonly reported concerns for their child's future and withdrawal from physical activity. The presence of one or more co-occurring disorders did not significantly influence outcomes. CONCLUSION AND IMPLICATIONS: Findings highlight the poor psychosocial outcomes for children with DCD. Crucially, poor psychosocial outcomes were just as likely in those with a single diagnosis of DCD as those with DCD and multiple co-occurring diagnoses. Parents reported concerns for their child (i.e., non-participation and social withdrawal) that are not targeted in existing DCD intervention modalities and emphasised the impact of DCD on the whole family unit. WHAT THIS PAPER ADDS: This paper presents data from the largest parent-reported survey of children with a known diagnosis of DCD (or synonymous labels). It highlights the significant impact of DCD on psychosocial outcomes in children across age groups. The children in this study were rated by their parents to have significantly higher levels of emotional and peer problems, and lower prosocial behaviours, than similarly aged Australian children without DCD. It also challenges the misconception that poor psychosocial outcomes in DCD are the result of co-occurring disorders, with outcomes observed to be as poor in children with a sole diagnosis of DCD in this sample. Furthermore, findings highlighted the significant worry and concern that parents with DCD face, particularly around their child's participation and their emotional health. Finally, parents reported on the considerable impact that DCD had on their family unit, regularly causing worry and concern, influencing their choice of activities, and causing financial strain. These concerns and impacts are not addressed in current intervention models for DCD and highlight the need for support mechanisms moving forward.

"Connection, community and convenience": A case study of a Facebook group for fathers navigating parenthood.

ISSUES ADDRESSED: Fathers remain less likely to participate in parenting interventions which can limit their ability to receive support and build their parenting capacity. The advent of social media has engendered novel opportunities for fathers to connect with, and support, one another in the form of online peer support. Growth of these online communities exemplifies the demand from fathers to relate to other fathers who are navigating parenthood. However, the benefits of membership to these communities remain unclear. This study evaluated the perceived benefits of members of an online father-to-father, community-created and moderated Facebook group designed for Australian fathers in both rural and metropolitan regions. METHODS: One-hundred and forty-five Australian fathers (aged 23-72 years) who were members of the same online fathering community completed an online survey where they qualitatively described their experiences as members of this community. RESULTS: Content analysis of open-ended survey questions revealed that fathers identified a series of unique and important personal and familial benefits, which were largely attributed to their ability to connect with fellow fathers. Specifically, the opportunity to have convenient access to a safe space for fathers to connect was highly valued, providing fathers with opportunities to support, discuss and normalise parenting experiences. CONCLUSIONS: Online father-to-father connection is a highly valued resource for fathers who are navigating parenthood. SO WHAT?: Online, community-led groups for fathers contribute to perceptions of genuineness and ownership by its members and provide a unique opportunity to connect and seek support for parenting.

Associations between the human immune system and gut microbiome with neurodevelopment in the first 5 years of life: A systematic scoping review.

The aim of this review was to map the literature assessing associations between maternal or infant immune or gut microbiome biomarkers and child neurodevelopmental outcomes within the first 5 years of life. We conducted a PRISMA-ScR compliant review of peer-reviewed, English-language journal articles. Studies reporting gut microbiome or immune system biomarkers and child neurodevelopmental outcomes prior to 5 years were eligible. Sixty-nine of 23,495 retrieved studies were included. Of these, 18 reported on the maternal immune system, 40 on the infant immune system, and 13 on the infant gut microbiome. No studies examined the maternal microbiome, and only one study examined biomarkers from both the immune system and the gut microbiome. Additionally, only one study included both maternal and infant biomarkers. Neurodevelopmental outcomes were assessed from 6 days to 5 years. Associations between biomarkers and neurodevelopmental outcomes were largely nonsignificant and small in effect size. While the immune system and gut microbiome are thought to have interactive impacts on the developing brain, there remains a paucity of published studies that report biomarkers from both systems and associations with child development outcomes. Heterogeneity of research designs and methodologies may also contribute to inconsistent findings. Future studies should integrate data across biological systems to generate novel insights into the biological underpinnings of early development.

How Caregivers Support Children's Emotion Regulation: Construct Validation of the Parental Assistance With Child Emotion Regulation (PACER) Questionnaire.

Caregivers play a crucial role in supporting the development of their children's emotion regulation. This study validated the Parental Assistance with Child Emotion Regulation (PACER) Questionnaire in a sample of 491 caregivers (M = 32.89 years) of young children ≤ 5 years. Exploratory structural equation modeling provided evidence of the instrument's ability to assess parental support for 10 distinct emotion regulation strategies that match the intended design of the instrument. Latent profile analysis revealed three distinct caregiver profiles characterized by above-average support for strategies that previously have been shown to be predictive of adaptive outcomes, maladaptive outcomes, or mixed-outcomes, respectively. Results add to existing literature that suggests the PACER is a valid and reliable assessment of caregiver-implemented support of emotion regulation strategies for children ≤ 5 years old. Evidence of distinct caregiver profiles highlights opportunities for prevention and intervention efforts to bolster extrinsic support for adaptive emotion regulation strategies. This instrument may be well-suited to capturing changes throughout the early developmental period, in addition to monitoring caregiver-facing interventions promoting optimal emotion regulation in children.

Australian Psychologists Experiences with Digital Mental Health: a Qualitative Investigation.

Digital mental health is changing the landscape of service delivery by addressing challenges associated with traditional therapy. However, practitioners' use of these resources remains underexamined. This study explored psychologists' attitudes and experiences with digital mental health intervention. Taking a qualitative exploratory approach via thematic analysis, the study sought to answer the following research questions: (i) How do psychologists perceive digital mental health? and (ii) What is their experience using digital mental health as part of routine practice? Ten practising psychologists participated in online semi-structured interviews (approximately 50 min), with interviews then transcribed verbatim. Interview data were analysed according to the six-phase approach to thematic analysis proposed by Braun and Clarke. Three themes were identified: (1) attitudes towards digital mental health; (2) use within routine practice; and (3) perspectives on an effective model for implementation. Practitioners play a major role in the design and delivery of digital mental health services. Barriers and facilitators at the practitioner-level (e.g. knowledge and competence with tools, perceptions on the utility of digital interventions) and the service-level (e.g. government support for digital health) should be considered in the future design of digital mental health resources and service delivery. Supplementary Information: The online version contains supplementary material available at 10.1007/s41347-022-00271-5.

Unfinished business and self-blaming emotions among those bereaved by a COVID-19 death.

In view of the mounting death toll of COVID-19 worldwide and the complicating circumstances that commonly accompany such losses, we studied the grief experiences of 209 adult mourners who lost a loved one to coronavirus with a focus on self-blaming emotions and unresolved issues with the deceased. We found universal endorsement of one or more forms of self-blame (guilt, regret, shame) or unfinished business (UB), with over one-third of mourners endorsing all four experiences. Those having a closer relationship to the deceased reported both greater distress over UB and more intense and dysfunctional grief symptomatology. Strikingly, unresolved conflict, a major dimension of UB, accounted for nearly 40% of the unique variance in problematic grief, which bore no relation to time since the loss.

Maternal Emotion Regulation and Early Childhood Irritability: The Role of Child Directed Emotion Regulation Strategies.

Parental assistance with children's emotion regulation (ER) is a form of emotion socialization behavior that has recently been operationalized with the development of the Parent Assistance with Child Emotion Regulation (PACER) questionnaire. In line with Eisenberg et al.'s heuristic model of the socialization of emotion, this study sought to test the links between mothers' ER difficulties, their use of ER strategies with their child, and child irritability - a salient dimension of child regulatory difficulties. Cross-sectional data was collected online with mothers (N = 371) of children aged one month to 5 years (M = 2.07 years, SD = 1.25) and data were analysed using hierarchical multiple regression analysis. After controlling for child age and gender, maternal distress, and household income, we found small but significant associations between maternal ER difficulties and child irritability. However, maternal use of ER strategies did not account for further variance in child irritability. These findings suggest that there are meaningful associations between maternal ER and child irritability, although maternal strategies to support child ER appear independent of their own ER capacity. Whilst not associated with child irritability, maternal support for children's ER may be associated with other indicators of mental health risk and resilience.

Risk factors for dysfunctional grief and functional impairment for all causes of death during the COVID-19 pandemic: The mediating role of meaning.

The COVID-19 pandemic, coupled with significant social changes due to legislative and public health requirements, has changed the way in which people experience grief. We examined whether dysfunctional grief symptoms, disrupted meaning, risk factors, and functional impairment differed between people bereaved from COVID-19 and from other natural or violent causes in this same period. A sample of 409 participants (67.73% male; M = 37.54 years) completed an online survey in June 2021. There were no statistically significant differences between the three groups on any of the outcome variables; all three groups manifested clinical levels of functional impairment equal to or greater than bereaved groups diagnosed with complicated or prolonged grief disorder prior to the pandemic. Disrupted meaning partially mediated the relationship between risk factors on the one hand and functional impairment and dysfunctional grief symptoms on the other. Findings indicate that deaths during COVID-19, rather than deaths from COVID-19, may precipitate symptoms of significant clinical concern.

Sensitivity of the child behaviour checklist sleep items and convergent validity with the Sleep Disorders Scale for Children in a paediatric ADHD sample.

OBJECTIVE: The Child Behavior Checklist (CBCL) is a commonly used measure of child and adolescent functioning, which includes seven items that can be aggregated to provide a purportedly valid measure of sleep functioning. The objective of this study was to examine the convergent validity of the CBCL in a paediatric ADHD population and to evaluate the sensitivity of the instrument when benchmarked against the Sleep Disorders Scale for Children (SDSC). METHODS: The parents of 215 individuals (ages 6-17 years, 86% male) completed the CBCL and SDSC as part of a battery of measured administered as part of a specialised ADHD service located in Perth, Western Australia. All participants had a diagnosis of ADHD confirmed by a paediatrician or psychiatrist prior to attending the service. RESULTS: The CBCL Sleep Composite Scale was strongly correlated with the SDSC, but reported below adequate internal reliability. Receiver Operating Characteristic (ROC) suggests that a cut-off score of 4 may have good diagnostic accuracy compared to SDSC. CONCLUSIONS: The CBCL Sleep Composite Scale may be reasonable to use if no purpose-developed sleep screening tool is available. The CBCL sleep items demonstrated good convergent validity, however, did not otherwise demonstrate acceptable psychometric properties that would endorse its use in an ADHD sample. The development of a specific measure of sleep in children with ADHD children is recommended.

Do motor coordination and sleep difficulties predict peer functioning in children and adolescents with attention-deficit and hyperactivity disorder after accounting for existing ADHD symptomology?

Children with attention-deficit and hyperactivity disorder (ADHD) are more likely to experience peer problems compared to their non-ADHD peers, though ADHD-specific symptoms only partially explain this association. This study examined whether sleep difficulties and motor coordination problems are additional predictors of peer problems in an ADHD population. An ADHD sample of 72 participants aged 6-14 years (M = 9.86 years, SD = 1.79 years) was evaluated for an association of peer problems with measures of motor coordination, sleep difficulties as well as ADHD and comorbidity symptoms. Hierarchical multiple regression analysis (HMRA) was used to test the current study aims. Motor coordination, but not sleep difficulties, predicted additional variance in peer problems after controlling for inattention, hyperactivity/impulsivity, internalizing problems, oppositionality, and conduct problems. Poor motor coordination predicts peer problems beyond ADHD symptoms. Clinicians seeking to improve peer functioning in children with ADHD should also consider motor coordination difficulties in addition to existing treatment strategies. Statement of contribution What is already known Children with attention-deficit and hyperactivity disorder (ADHD) experience greater peer problems (i.e., making friends, being victimized, participating in play) than their typically developing peers. Previous studies have attributed this association between ADHD and peer problems to the symptoms of ADHD (i.e., inattention and/or hyperactivity) disrupting the typical trajectory of social development. However, quantitative studies have identified that symptoms of ADHD predict only portion of the variance in a child's peer problems - highlighting that there may be other unique factors that contribute to the higher incidence of peer problems typically observed in this population. What this study adds This study tested whether additional theoretically relevant factors could predict levels of peer problems in children with ADHD beyond the primary symptoms of the disorder. Internalizing symptomatology, conduct problems, oppositionality, motor coordination, and sleep difficulties were added to a regression model already including inattention and hyperactivity symptoms. These factors explained 51% of the variability in peer problems. In this sample of 72 ADHD children, the results of the final model highlighted that only motor coordination and conduct problems remained significant predictors of peer problems - highlighting two potentially important target areas for screening and intervention.

Factor structure of the Sleep Disturbance Scale for Children (SDSC) in those with Attention Deficit and Hyperactivity Disorder (ADHD).

OBJECTIVE: To examine the factor structure of the Sleep Disorder Scale for Children (SDSC) in children and adolescents with attention deficit and hyperactivity disorder (ADHD). METHOD: The caregivers of 307 children with ADHD completed the SDSC. Standard and bifactor confirmatory factor analysis (CFA) evaluated the goodness-of-fit of competing factor structures. RESULTS: The original and unidimensional factor structure produced sub-optimal fit. Bifactor exploratory factor analysis (EFA) was performed to examine the underlying structure of the SDSC. A revised bifactor solution comprising six-specific factors and a general factor was identified. A nested version of this model was deemed to be the preferred model, which also demonstrated good psychometric properties. CONCLUSION: There is evidence of a 'general sleep difficulties' factor in children with ADHD. Four of the six original factors were replicated in this study. However, the revised factor structure suggests that clinicians should be cautious of the utility of subscale scores pending further validation in ADHD samples.

The relationship between motor skills and psychosocial factors in young children: A test of the elaborated environmental stress hypothesis.

BACKGROUND: The elaborated environmental stress hypothesis (EESH) provides a framework that describes how motor skills may indirectly cause internalizing problems through various mediating psychosocial factors. While there is evidence to support this framework, little is known about how the proposed relationships may vary across different stages of development. AIMS: This study aimed to investigate whether peer problems and perceived self-competence mediated the relationship between motor skills and internalizing problems in pre-primary children, and at 18-month follow up. SAMPLE: A community sample of 197 pre-primary school children (M = 5.40 years, SD = 0.30 years; 102 males, 95 females) participated at Time 1, with 107 completing the Time 2 follow-up. METHODS: Standardized instruments were used to measure motor skills and verbal IQ. Perceived self-competence was measured using a self-report measure. Participant peer problems and internalizing problems were measured using teacher report. Age, gender, and verbal IQ were included as covariates. RESULTS: Mediation analysis using PROCESS showed that the relationship between motor skills and internalizing problems was mediated by peer problems at Time 1. At Time 2, the relationship was mediated by peer problems and perceived physical competence. CONCLUSIONS: The current results indicate the EESH may function differently across different periods of development. The transition from pre-primary to Grade 1 represents a time of important cognitive and psychosocial development, which has implications for how the relationship between motor skills and internalizing problems can be understood. These findings highlight potential age-appropriate targets for psychomotor interventions aiming to improve the emotional well-being of young children.

The Relationship between Motor Skills, Perceived Social Support, and Internalizing Problems in a Community Adolescent Sample.

OBJECTIVES: Poor motor skills are associated with a range of psychosocial consequences, including internalizing (anxious and depressive) symptoms. The Elaborated Environmental Stress Hypothesis provides a causal framework to explain this association. The framework posits that motor skills impact internalizing problems through an indirect effect via perceived social support. However, empirical evaluation is required. We examined whether motor skills had an indirect effect on anxious and depressive symptoms via perceived family support domains. METHODS: This study used a community sample of 93 adolescents (12-16 years). Participants completed measures of motor skills, perceived social support across three dimensions (family, friend, and significant other), depressive symptoms, and anxious symptoms. Age, gender, verbal IQ, and ADHD symptoms were included as control variables. RESULTS: Regression analysis using PROCESS revealed that motor skills had an indirect effect on depressive symptoms via perceived family support, but not by perceived friend support or significant other support. The negative association between motor skills and anxious symptoms was not mediated by any perceived social support domain. CONCLUSIONS: Findings are consistent with previous literature indicating an association between motor skills and internalizing problems. However, we identified a different pattern of relationships across anxious and depressive symptoms. While anxiety and depressive symptoms were highly correlated, motor skills had an indirect effect on depressive symptoms via perceived family support only. Our findings highlight the importance of family support as a potential protective factor in the onset of depressive symptoms. This study provides partial support for the Elaborated Environmental Stress Hypothesis, however further research is required.

The Elaborated Environmental Stress Hypothesis as a Framework for Understanding the Association Between Motor Skills and Internalizing Problems: A Mini-Review.

Poor motor skills have been shown to be associated with a range of psychosocial issues, including internalizing problems (anxiety and depression). While well-documented empirically, our understanding of why this relationship occurs remains theoretically underdeveloped. The Elaborated Environmental Stress Hypothesis by Cairney et al. (2013) provides a promising framework that seeks to explain the association between motor skills and internalizing problems, specifically in children with developmental coordination disorder (DCD). The framework posits that poor motor skills predispose the development of internalizing problems via interactions with intermediary environmental stressors. At the time the model was proposed, limited direct evidence was available to support or refute the framework. Several studies and developments related to the framework have since been published. This mini-review seeks to provide an up-to-date overview of recent developments related to the Elaborated Environmental Stress Hypothesis. We briefly discuss the past research that led to its development, before moving to studies that have investigated the framework since it was proposed. While originally developed within the context of DCD in childhood, recent developments have found support for the model in community samples. Through the reviewed literature, this article provides support for the Elaborated Environmental Stress Hypothesis as a promising theoretical framework that explains the psychosocial correlates across the broader spectrum of motor ability. However, given its recent conceptualization, ongoing evaluation of the Elaborated Environmental Stress Hypothesis is recommended.