Prevalence of Adverse Childhood Experiences in Adolescents with Special Educational and Care Needs in the Netherlands: A Case-File Study of Three Special Educational and Care Settings.

To date, Adverse Childhood Experiences (ACEs) in adolescents with special educational and care needs have received little attention as an important risk factor for their behavioral, emotional, and learning problems. This study provides insight into ACE prevalence and family risk factors in three Dutch special educational and care settings for vulnerable school-aged youth. 268 adolescents (10-18 years old) with severe and persistent problems at individual and family level, from a special educational setting (setting 1; n = 59), a residential care setting (setting 2; n = 86) and an alternative educational setting (setting 3; n = 123) were included. A retrospective cross-sectional study design was used. Data were collected between 2016 and 2019 through structured case-file analysis. A substantial proportion of the adolescents in all settings experienced at least one ACE, with 69.5% in setting 1, 84.9% in setting 2 and 95.1% in setting 3. Family risk factors were relatively common, among which a limited social network in all settings (20-50%) and debts in setting 2 and 3 (25-40%). The substantial ACE prevalence underlines the need for early ACE awareness. Trauma-informed care and education are needed to adequately understand trauma-related behaviors, prevent retraumatization, and enhance learning and healthy development. Given that ACEs regarding household dysfunction and family risk factors seem to be common in adolescents with special educational and care needs, family centered approaches should be implemented as well in the interest of lifelong health and well-being for both adolescents and their families.

Socioeconomic position, family context, and child cognitive development.

Socioeconomic position (SEP) may have different effects on cognitive development and family context could play a role in this association. This work aimed to analyse the role of socioeconomic positions, measured via various indicators collected longitudinally, in cognitive development at 7-11 years of age, evaluating the role of family context as a potential mediator. The study sample included 394 and 382 children from the INMA Gipuzkoa and Valencia cohorts, respectively. SEP indicators were assessed during pregnancy (family social class, parental education, employment, and disposable income) and at 7 (Gipuzkoa) and 11 (Valencia) years of age (At Risk of Poverty or Social Exclusion (AROPE)). Family context and cognitive development were measured with the Haezi-Etxadi Family Assessment Scale 7-11 (HEFAS 7-11) and Raven's Coloured Progressive Matrices (Raven's CPM), respectively. Linear regression models were developed to assess the relationships between (a) SEP-family context, (b) SEP-cognitive development, and (c) family context-cognitive development, adjusting for a priori-selected confounders. Simple and multiple mediation analyses were performed to explore the role of family context in the SEP-cognitive development relationship. Lower SEP was related with a lower cognitive score, this association being particularly robust for family social class. SEP indicators were related to subscales of family context, in particular those regarding cognitive stimulation, parental stress, and parenting. A relationship was also found between these three subscales and child cognitive development, mediating the effect of family social class on child cognition by 5.2, 5.5, and 10.8%, respectively, and 12.0% jointly.    Conclusion: Both family SEP and context contribute to a child's cognitive development. Equalising policies and positive parenting programmes could contribute to improving cognitive development in children. What is Known: • Parental social class, education, and employment status have been widely employed to measure socioeconomic position. What is New: • This work focuses on standard measurements of socioeconomic position but also other economic indicators such as the EHII and AROPE, and their effect on child cognitive development and family context. • Promotion of cognitive and linguistic development, parental stress and conflict, and parental profile fostering child development mediated the effect of family social class on cognitive development.

Examining the whole plate: The role of the family context in the understanding of children's food refusal behaviors.

INTRODUCTION: In the context of understanding children's food refusal behaviors, such as food fussiness and food neophobia, research has predominantly focused on the role of parental feeding strategies. However, little is known about which general family context variables add to the understanding of children's food refusal behaviors. The purpose of this study was to examine the relation between 1) parents' own use of maladaptive emotion regulation strategies when they are anxious, 2) parents' reactions towards their children's emotions in stressful situations, and 3) parenting styles on the one hand, and children's food refusal behaviors on the other. METHODS: Mothers and fathers (N = 157) of young children (M = 4.64, SD = 1.7) completed a series of self- and parent-report questionnaires. RESULTS: The model examining the role of parenting styles was found to be significantly related to food refusal behaviors in children. More specifically, the current findings demonstrate that higher levels of a coercive parenting style were associated with higher levels of both food fussiness and food neophobia in children. Furthermore, higher levels of a chaotic parenting styles were associated with higher levels of food neophobia in children. The models examining parents' maladjusted emotion regulation strategies when anxious and parents' reactions towards their children's emotions during stressful situations were not found to be significant. CONCLUSIONS: Factors related to the parenting style appear to be important for understanding food refusal behaviors in children. Replication of the findings using longitudinal and observational designs is needed.

Association Between Family Context and Sleep Trajectory in Middle-Aged and Elderly Chinese Adults.

Objective: The study aims to reveal the association between family context and sleep trajectories in middle-aged and elderly Chinese adults. Methods: Subjects (n=7777) aged between 40 and 65 years were selected from the China Family Panel Studies (CFPS). Latent class analysis and the multi-trajectory method were used to identify the family context and sleep trajectories from 2010 to 2018. Multinomial (polytomous) logistic regression was performed to explore the relationship between family context and sleep trajectories. Results: Five family context classes were identified according to family demographic characteristics. Simultaneously, four sleep trajectories were determined based on three sleep-related indexes. Subjects from family that had only sons or multiple-child are liable to shorten or prolong sleep duration and increase midday nap ratios compare with subjects who from family that had one or more daughters, and in future public health prevention and control, more attention could be paid to such families. Conclusion: The study found that family context is associated with sleep trajectories among middle and old Chinese adults. Subjects from families with only girls seemed to have more stable sleep trajectories, while those with one or more boys' families had unstable sleep trajectories. Further interventions would be carried out for sleep disorders, it is necessary to pay more attention to the family context, especially the number and gender of children.

Indicators of Eating Disorders in Sexually Abused Brazilian Adolescents: Family and School Contexts.

Eating disorders, characterized by abnormal eating behaviors, are among a wide variety of psychiatric conditions that mainly affect children and adolescents. These disorders have a multifactorial origin and can be associated with restrictive diets, negative feelings, harmful family relationships, and post-traumatic stress. Thus, this study's objective was to evaluate the association between indicators of eating disorders and family and school contexts in Brazilian adolescents who previously experienced sexual abuse and examine the findings based on sex. National School Health Survey data were utilized. Among 102,301 students between 11 and 19 years of age, 4124 reported having experienced sexual abuse and were included in this study. Self-report questionnaires were used to assess participants' health status and the presence of risk behaviors, which were examined through multivariate analysis using a Poisson regression model. The results indicated positive relationships between self-induced vomiting, laxative misuse, and other purgative methods and infrequent meals with family, hunger, and the presence of violence in students' daily lives, regardless of sex (p < 0.05). In addition, body dissatisfaction and negative feelings about one's body were associated with having been bullied or teased by schoolmates for both sexes (p < 0.05). Distant relationships with parents were associated with purgative methods and body dissatisfaction among female students (p < 0.05). In conclusion, body dissatisfaction, negative feelings about one's body, laxative misuse, self-induced vomiting, and purgative methods were found to be associated with factors in family and school contexts such as hunger, infrequent meals with family, family violence, distant relationships with parents, and bullying at school in adolescents who have previously experienced sexual abuse.

"Help Me Control My Impulses!": Adolescent Impulsivity and Its Negative Individual, Family, Peer, and Community Explanatory Factors.

The literature shows that impulsivity, prevalent in adolescence, is negatively linked with a variety of psychosocial factors (e.g., positive interpersonal relationships, emotion regulation); however, there is limited research examining the relative contribution of multiple factors for this trait nor exploring how these factors influence the associations between impulsivity and risk-related outcomes. Drawing on multiple components of the unified theory of development (i.e., psychological variables, peers subsystem, community subsystem, family processes subsystem), this cross-sectional study aims to identify explanatory psychosocial variables (i.e., early memories of warmth and safeness, rational decision-making style, resilience, emotion regulation, coping, parental attachment, social group attachment, satisfaction with school and family-related variables) that are negatively related with impulsivity, in younger (13-15) and older (16-19 years) adolescents, and explore their moderating role in the associations between this trait and some risk-related outcomes (i.e., verbal aggression, anger, self-harm, other high-risk behaviors). A representative sample of 6894 adolescents (52.9% female) living in the Azores (Portugal), with ages ranging from 13 to 19 (M = 15.4), was used. Two stepwise multiple regressions, one for each age group, revealed that only emotion regulation, parental attachment, and social group attachment had a negative effect on impulsivity in both age groups; additionally, satisfaction with teachers also had this effect in younger adolescents. The first three variables weakened the positive associations between impulsivity and the risk-related outcomes. These results suggest that the psychological system and all subsystems of the social context measured play a relevant role in explaining adolescent impulsivity and that it may be reduced by promoting emotion regulation, positive parenting practices, healthier relationships with peers, and healthier relationships with teachers.

Understanding the Family Context: A Qualitative Descriptive Study of Parent and NICU Clinician Experiences and Perspectives.

Enabling individualized decision-making for patients requires an understanding of the family context (FC) by healthcare providers. The FC is everything that makes the family unique, from their names, preferred pronouns, family structure, cultural or religious beliefs, and family values. While there is an array of approaches for individual clinicians to incorporate the FC into practice, there is a paucity of literature guiding the process of collecting and integrating the FC into clinical care by multidisciplinary interprofessional teams. The purpose of this qualitative study is to explore the experience of families and Neonatal Intensive Care Unit (NICU) clinicians with information sharing around the FC. Our findings illustrate that there are parallel and overlapping experiences of sharing the FC for families and clinicians. Both groups describe the positive impact of sharing the FC on building and sustaining relationships and on personalization of care and personhood. The experience by families of revolving clinicians and the risks of miscommunication about the FC were noted as challenges to sharing the FC. Parents described the desire to control the narrative about their FC, while clinicians described seeking equal access to the FC to support the family in the best way possible related to their clinical role. Our study highlights how the quality of care is positively impacted by clinicians' appreciation of the FC and the complex relationship between a large multidisciplinary interprofessional team and the family in an intensive care unit, while also highlighting the difficulties in its practical application. Knowledge learned can be utilized to inform the development of processes to improve communication between families and clinicians.

Factores de riesgo/resiliencia en familias con hijos con autismo. Asociación con la evolución en la adolescencia / Risk/resilience factors in families with children with autism. Association with evolution in adolescence

Resumen La influencia del estrés de los padres y el efecto moderador de las estrategias de afrontamiento y apoyo social en niños con autismo están bien documentados. El número de trabajos con un di seño transversal contrasta con la escasez de estudios con diseño longitudinal que permitirían profundizar en las relaciones entre las características del contexto familiar y la evolución del trastorno. El presente trabajo de seguimiento está dedicado al análisis de esas relaciones en el tiempo transcurrido desde la infancia (T1) a la adolescencia (T2), valorando además los resultados en diferentes dominios del desarrollo. Participaron 45 adolescentes con TEA divididos en dos grupos en función del ambiente familiar, de alto riesgo (AR; N= 18) y de bajo riesgo (BR; N=27). Los resultados confirman y extienden los que han aportado trabajos transversales, evidenciando la influencia negativa de un ambiente familiar de riesgo en la severidad del TEA y en el desarrollo de habilidades socio-adaptativas. La psicoeducación, la terapia cognitivo-conductual y el mindfulness han de mostrado que pueden disminuir el estrés de los padres y aumentar el sentimiento de auto-eficacia.

Abstract The influence of parental stress and the moderating effect of coping strategies and social support in children with autism is well documented. The number of works with a cross-sectional design contrasts with the scarcity of studies with a longitudinal design that would allow to deepen in the relationships between characteristics of the family context and the evolution of the disorder. The present follow-up study is devoted to the analysis of these relationships over time from childhood (T1) to adolescence (T2), also assessing the results in different developmental domains. Forty-five adolescents with ASD participated, divided into two groups according to family environment, high risk (HR; N=18) and low risk (LR; N=27). The results confirm and extend those obtained in cross-sectional work, showing the negative influence of a risky family environment on the severity of ASD and the development of socio-adaptive skills. Psychoeducation, cognitive-behavioural therapy and mindfulness have been shown to decrease parental stress and increase feelings of self-efficacy.

In or out of sync? Concordance between parent and adolescent sleep varies by family context.

Evidence suggests significant interrelations among parent and adolescent sleep (i.e., concordance). However, less is known regarding how parent-adolescent sleep concordance varies as a function of the family context. This study examined daily and average concordance between parent and adolescent sleep and explored adverse parenting and family functioning (e.g., cohesion, flexibility) as potential moderators. One hundred and twenty-four adolescents (Mage  = 12.90) and their parents (93% mothers) wore actigraphy watches assessing sleep duration, efficiency, and midpoint across 1 week. Multilevel models indicated daily (within-family) concordance between parent and adolescent sleep duration and midpoint. Average (between-family) concordance was found for sleep midpoint only. Family flexibility was linked with greater daily concordance in sleep duration and midpoint, whereas adverse parenting predicted discordance in average sleep duration and efficiency.

Relational Competence, School Adjustment and Emotional Skills: A Cross-Sectional Study in a Group of Junior and High School Students of the Sicilian Hinterland.

Research has demonstrated the influence of emotional adjustment on the manifestation of problematic behaviors in adolescence, especially during the COVID-19 pandemic. The aim of the present research is to investigate the role of self-esteem and relational skills on school performance in a group of middle and high school students during the COVID-19 period. The research involved 392 students, aged between 11 and 20 (M = 13.78; S.D. = 2.56). Participants completed the following instruments: an anamnestic constructed ad hoc questionnaire; the Interpersonal Relationships Test, in order to evaluate the perception of adolescents concerning the quality of their relationships in social, family and school contexts; and the Multidimensional Test of Self-Esteem, structured in six scales, which coincide with the dimensions considered constitutive of self-esteem. The preliminary data have shown how the older girls, attending the high school, tend to manifest a higher level of social competence with peer group and teachers. Furthermore, the perception of a reduced emotional self-efficacy but an elevated environmental control and good interpersonal skills seem to predict the school adjustment. Understanding adolescents' perceptions of difficulties and their social support networks can offer some insight into how major social changes can be associated with individual well-being, especially during the COVID-19 pandemic.

[Risk/resilience factors in families with children with autism. Association with evolution in adolescence]. / Factores de riesgo/resiliencia en familias con hijos con autismo. Asociación con la evolución en la adolescencia.

The influence of parental stress and the moderating effect of coping strategies and social support in children with autism is well documented. The number of works with a cross-sectional design contrasts with the scarcity of studies with a longitudinal design that would allow to deepen in the relationships between characteristics of the family context and the evolution of the disorder. The present follow-up study is devoted to the analysis of these relationships over time from childhood (T1) to adolescence (T2), also assessing the results in different developmental domains. Forty-five adolescents with ASD participated, divided into two groups according to family environment, high risk (HR; N=18) and low risk (LR; N=27). The results confirm and extend those obtained in cross-sectional work, showing the negative influence of a risky family environment on the severity of ASD and the development of socio-adaptive skills. Psychoeducation, cognitive-behavioural therapy and mindfulness have been shown to decrease parental stress and increase feelings of self-efficacy.

La influencia del estrés de los padres y el efecto moderador de las estrategias de afrontamiento y apoyo social en niños con autismo están bien documentados. El número de trabajos con un diseño transversal contrasta con la escasez de estudios con diseño longitudinal que permitirían profundizar en las relaciones entre las características del contexto familiar y la evolución del trastorno. El presente trabajo de seguimiento está dedicado al análisis de esas relaciones en el tiempo transcurrido desde la infancia (T1) a la adolescencia (T2), valorando además los resultados en diferentes dominios del desarrollo. Participaron 45 adolescentes con TEA divididos en dos grupos en función del ambiente familiar, de alto riesgo (AR; N= 18) y de bajo riesgo (BR; N=27). Los resultados confirman y extienden los que han aportado trabajos transversales, evidenciando la influencia negativa de un ambiente familiar de riesgo en la severidad del TEA y en el desarrollo de habilidades socio-adaptativas. La psicoeducación, la terapia cognitivo-conductual y el mindfulness han demostrado que pueden disminuir el estrés de los padres y aumentar el sentimiento de auto-eficacia.

Poverty, social exclusion, and mental health: the role of the family context in children aged 7-11 years INMA mother-and-child cohort study.

Mental health problems are common in childhood and tend to be more frequent in populations at risk of poverty or social exclusion (AROPE). The family environment can play a role in reducing the impact of economic hardship on these problems. The aim of this study was to assess the effect of multidimensional poverty on the mental health of children aged 7-11 years and the role of the family environment in two areas of Spain. Participants were 395 and 382 children aged 7 and 11 from Gipuzkoa and Valencia, respectively. Internalizing and externalizing problem scales of the child behaviour checklist (CBCL) were used. AROPE indicators were obtained by questionnaire, and three dimensions of the family context (Organization of the Physical Environment and Social Context, Parental Stress and Conflict, and Parental Profile Fostering Development) were measured through subscales 3, 4 and 5 of the Haezi-Etxadi family assessment scale (7-11) (HEFAS 7-11), respectively. Data were analysed using negative binomial regression and Structural Equation Modelling. AROPE prevalence was 7.1 and 34.5% in Gipuzkoa and Valencia, respectively. In both cohorts, there was a significant increase in internalizing and externalizing problems among participants with a higher AROPE score. However, AROPE did not affect internalizing problems in children from families living in a better physical environment and with social support (Subscale 3). The AROPE effect was jointly mediated by subscales 4 and 5 in 42 and 62% of internalizing and externalizing problems, respectively. Preventing economic inequities by economic compensation policies, improving the neighbourhood and immediate environment around the school, and promoting positive parenting programmes can improve mental health in childhood.

The COVID-19 pandemic, mask-wearing, and emotion recognition during late-childhood.

Face masks are an effective and important tool to prevent the spread of COVID-19, including among children. However, occluding parts of the face can impact emotion recognition, which is fundamental to effective social interactions. Social distancing, stress, and changes to routines because of the pandemic have also altered the social landscape of children, with implications for social development. To better understand how social input and context impact emotion recognition, the current study investigated emotion recognition in children (7-12 years old, N = 131) using images of both masked and unmasked emotional faces. We also assessed a subsample of participants ("pre-pandemic subsample," n = 35) who had completed the same emotion recognition task with unmasked faces before and during the pandemic. Masking of faces was related to worse emotion recognition, with more pronounced effects for happy, sad, and fearful faces than angry and neutral faces. Masking was more strongly related to emotion recognition among children whose families reported greater social disruption in response to the pandemic. Finally, in the pre-pandemic subsample, emotion recognition of sad faces was lower during versus before the pandemic relative to other emotions. Together, findings show that occluding face parts and the broader social context (i.e., global pandemic) both impact emotion-relevant judgments in school-aged children.

Associations of attention problems and family context in childhood and adolescence with young adult daily smoking: General and smoking-specific family contexts.

BACKGROUND: The potential heterogeneity in daily smoking across young adulthood has been relatively understudied. Relatedly, the unique and joint associations of earlier risk factors with young adults' daily smoking largely remain unknown. To address these gaps, this work identified subgroups of daily smoking trajectories during young adulthood and linked them to earlier attention problems and smoking-specific and general family context. METHODS: Data came from the Seattle Social Development Project, a longitudinal study following a community sample (N = 808). Participants' daily smoking was measured from ages 21-33. Earlier attention problems were assessed at ages 14-16 and 18. Earlier smoking-specific and general family factors were assessed at ages 10-16 and 18. RESULTS: Growth mixture models produced four profiles: chronic daily smokers, increasers, decreasers, and no-daily smokers. Results from multinomial logistic regressions revealed that earlier attention problems and smoking-specific family factors may contribute to daily smoking in the early 20 s, whereas earlier general family context provided protection for trajectories of daily smoking characterized by changes in the late 20 s and early 30 s DISCUSSION: Selective prevention strategies that expand people's repertoire of healthy options to address attention problems might be helpful, considering the possibility of using tobacco as means to mitigate attention problems. Our findings also highlight the importance of nurturing earlier general family context, a relatively overlooked dimension in smoking prevention efforts, to facilitate young adult smokers' desistence from daily smoking, particularly those who have attention problems in adolescence.

Rules, role models or overall climate at home? Relative associations of different family aspects with adolescents' problematic social media use.

AIM: This study aimed to enhance knowledge on which aspects of the family context are most relevant in identifying at-risk/problematic social media users among adolescents. Therefore, we examined the relative contribution to adolescents' at-risk/problematic social media use (SMU) of general and Internet-specific family factors related to three different family (sub)systems: parent-child (Internet-specific rule-setting, reactive restrictions towards Internet use, co-use, adolescents' involvement in rule-setting and positive parenting), parent (parental screen time, phubbing, stress, anxiety and depression) and family (family functioning, family intactness and SES) (sub)system. METHODS: Questionnaire data came from 403 adolescents (M = 13.51, SD = 2.15) and 396 parents (M = 46.59, SD = 5.29) who participated in wave 1 of the Dutch 'Digital Family project'. RESULTS: Logistic regression analyses showed that only factors related to the parent-child subsystem remained significant in predicting being an at-risk/problematic social media user when examining predictors related to the parent-child, parent and family (sub)system simultaneously. Specifically, general and Internet-specific parenting practices contributed to the prediction above and beyond each other. Positive parenting and Internet-specific rule-setting seem protective, while parental reactive restrictions towards Internet use could be a risk factor. Positive parenting showed the largest effect size. CONCLUSION: The results suggest that parental behaviors directed towards the child should be a focus of attention in prevention of adolescents' problematic SMU. In addition, our findings highlight the importance of untangling restrictive mediation (impulsive, in the moment, attempts to limit SMU versus communicating clear rules in advance) when examining its effects.

What are the Origins of Chronic Back Pain of "Obscure Origins"? Turning Toward Family and Workplace Social Contexts.

Chronic back pain (CBP) is a common symptom throughout the world, and those undergoing it often experience a profound degradation of life. Despite extensive research, it remains an elusive symptom. In most cases, CBP is "non-specific," since bio-mechanisms examined in the clinic do not account for it; another way of saying this is that it is "of obscure origins." This paper re-directs attention towards origins that are distal and usually out of sight from the vantage point of the clinic. CBP as considered here is non-specific, persists ≥ 3 months, and, additionally, interferes with activities of daily life, such as family interaction or work. A theory proposed in the paper draws upon Durkheim's Suicide to explain why exposures in the distal social contexts of family and workplace are fundamentally implicated in CBP. The theory is formed out of previously published studies on family and workplace social contexts of CBP and, in effect, provides a theoretical framework with which to review them. After treatment of CBP in the clinic, patients return to family and workplace contexts. Unless exposures in these contexts are addressed, they serve as continually renewing sources of CBP that remain unabated regardless of mechanism-based treatment in the clinic.

How Healthy Aging and Contact With Children Are Associated With Satisfaction in Middle-Aged and Older Parents in China: A Mediation Analysis.

Objectives: This study aims to examine the mediation role of satisfaction with children on the association between contact with children (CCT) and healthy aging among middle-aged and older parents in China. Methods: Data from 9,575 parents over 45 years old were obtained from the 2018 China Health and Retirement Longitudinal Survey. A multinomial logistic regression model was applied to measure the association between contact, satisfaction, and healthy aging with potential confounders controlled. We used the Sobel-Goodman Mediation test to analyze the mediation role of satisfaction on the association between types of CCT and healthy aging. Results: Parents with contact with adult children had higher satisfaction with children [for contact weekly (satisfied/unsatisfied): relative risk ratio (RRR) = 2.44, CI = 1.92-3.10] and higher healthy aging [for contact weekly (Q5/Q1): RRR = 1.41, CI = 1.13-1.77]. Satisfaction was strongly related to healthy aging [for satisfied (Q5/Q1): RRR = 3.44, CI = 2.14-5.51], and mediated 19.05% of healthy aging for weekly contact (Sobel test z = 4.338; indirect role = 0.014, CI = 0.011-0.018; direct role = 0.061, CI = 0.029-0.094). Subgroup analysis further revealed that satisfaction with contact played a partial mediating role between monthly contact and healthy aging in female and rural groups. Conclusions: Monthly CCT is more appropriate for older parents. Satisfaction with children in older parents seems to act as a significant and partial mediator of the relationship between contact and healthy aging. The contribution of satisfaction to healthy aging could be important to be considered and promoted in women and rural older parents, independent of CCT.

Listening in: An Alternative Method for Measuring the Family Emotional Environment.

The family emotional environment influences children's development of emotion regulation in various ways. Children's difficulties with effectively regulating emotions, in turn, can contribute to the development of psychopathology. However, the pathways that explain how environmental emotion-including overheard emotion among family members-influences children's development of healthy or problematic emotion regulation are unclear. In this article, we briefly discuss the most common methods (e.g., questionnaires, laboratory observations) used to assess emotion in the family. We consider the benefits and limitations of these methods and discuss the need for objective measurement of the family emotional environment. We include a description of the Electronically Activated Recorder (EAR), which provides unobtrusive, extended sampling of the emotional tone of family interaction in the home. We present preliminary evidence of its use with 7- and 8-year-old and their families during one day at home. The method reveals that objectively assessed parent-to-parent interactions that are negatively toned, but not parental self-report of conflict or expressivity, are associated with children's self-reported emotional reactions to hearing independently recorded clips of their mothers' voices during simulated angry interactions. The finding suggests unique contributions of objective, unobtrusive, extended measurement of the family emotional environment to understanding aspects of children's emotional development that may not be captured with other commonly used methods. We discuss future directions that explore how EAR may be used to further our knowledge of the pathways between environmental emotion as a risk factor that influences children's emotional functioning and their psychological well-being.

Mental health in children of parents being treated by specialised psychiatric services.

BACKGROUND: One in ten children have a parent diagnosed with a mental illness by specialised psychiatric services. Severe parental mental illness is a well-established risk factor for children's mental health problems, making the identification and support of these children a public health concern. This study investigated the mental health and family context of children of parents diagnosed with depression, anxiety, or bipolar disorder in this clinical setting. METHODS: Parental reports on 87 children aged 8-17 years were analysed. The children's mental health was compared with that of a Swedish population-based sample. Multiple linear regression was used to investigate associations between child mental health and child gender, child age, parent symptoms and social status, family functioning, and perceived parental control. Furthermore, a cumulative risk index explored the effect of multiple risk factors on child mental health. RESULTS: The children reportedly had significantly more mental health problems than did the population-based sample and about one-third had scores above the clinical cut-off. A significant multiple linear regression explained 49% of the variance in child mental health, with lower perceived parental control and younger child age being associated with more child mental health problems. With more reported risk factors, children reportedly had more mental health problems. CONCLUSIONS: The results underline the importance of identifying a patient's children and assessing multiple relevant risk factors in the child's life. Furthermore, the results indicate that the needs of younger children and of patients in their parenting role are important to address.

Family environmental antecedents of pubertal timing in girls and boys: A review and open questions.

Across nonhuman species, pubertal timing is affected by the social environment, with consequences for reproductive success and behavior. In human beings, variations in pubertal timing have not been systematically examined in relation to social environmental antecedents, although their psychological consequences are well documented. This paper focuses on links in human beings between pubertal timing and the childhood social environment, with several sections: A review of studies relating pubertal timing to the family context, a key aspect of the social environment; challenges in studying the issue; and opportunities for future work that takes advantage of and creates links with evidence in other species. The review shows that pubertal timing in girls is accelerated by adversity in aspects of the early family social context, with effects small in size; data in boys are not sufficient to enable conclusions. Inferences from existing studies are limited by variations in conceptualizations and measurement of relevant aspects of puberty and of the family social environment, and by methodological issues (e.g., reliance on existing data, use of retrospective reports, nonrandom missing data). Open questions remain about the nature, mechanisms, and specificity of the links between early family social environment and pubertal timing (e.g., form of associations, consideration of absence of positive experiences, role of timing of exposure). Animal studies provide a useful guide for addressing these questions, by delineating potential hormonal mechanisms that underlie links among social context, pubertal timing, and behavior, and encouraging attention to aspects of the social environment outside the family, especially peers.