Promoting sexual health in transgender and gender diverse adolescents through an online sexuality psychoeducation program for parents: A case study.

We describe the implementation and evaluation of an online sexuality psychoeducation group program for parents of young people attending the transgender and gender diverse outpatient service of a pediatric hospital. The 10 participants completed semi-structured pre- and post-intervention questionnaires assessing: whether they had ever discussed with their children about aspects of sexuality, or had the intention of doing it in the future; the level of knowledge and comfort in speaking about these topics; the perceived level of helpfulness of the intervention; and, by using open-ended items, the topics they considered to be most relevant. After attending the program, parents reported they had started talking with their children about issues which previously had been little or not discussed, such as sexting, sexually transmitted diseases, pregnancy, fertility, abuse, and healthy relationships. Participants reported increased levels of knowledge and comfort in addressing these topics and highlighted the importance of being emotionally available to their children. We discuss implications for future intervention development.

Children with Prader-Willi Syndrome and COVID-19: a longitudinal study of the effect of social re-opening after the lockdown.

BACKGROUND: This study longitudinally investigated mental health indicators, body mass index (BMI), and access to school and health-care services in children with Prader-Willi syndrome (PWS) and community controls (CC) during the first wave of the COVID-19 pandemic. METHODS: The parents of 71 children (34 PWS and 37 CC) aged 6-17 years completed an online questionnaire during the initial COVID-19 lockdown (T0) and the subsequent partial (T1) and full re-opening (T2). We examined access to school and health-care services, BMI, and mental health (DSM-5 Parent/Guardian Rated Cross-Cutting Syndrome Measure) across the three time-points. For BMI and DSM-5 measure, we tested within- (Friedman's ANOVA repeated measures) and between- (robustified linear mixed-models, rLMM) group differences over time. RESULTS: Around 30% of PWS children maintained contact with medical personnel through telemedicine. PWS children kept contact with both teachers and classmates at a lower rate than CC. At all time-points, BMI was higher in PWS than CC. During partial reopening, while children with PWS had a decrease in BMI, CC showed an increase, with a significant interaction time*group interaction. Mental symptoms significantly declined in both groups, although in CC the decrease was greater than in PWS. CONCLUSIONS: PWS children were at a disadvantage during the COVID-19 outbreak for lower access to school than CC. The improvement of mental health in both groups with the reopening confirms the importance of social activities outside the family. The decrease in BMI in the PWS group indicates the positive role of caregivers' monitoring on eating habits of children.

The association of attachment, mentalization and reflective functioning with mental health in gender diverse children and adolescents: A systematic review.

Gender diverse children (here defined as minors under 18) face greater risk for depression, anxiety and suicidality than their cisgender peers. This situation calls for research on protective factors of mental health in this population, and on appropriate therapeutic and supportive interventions. This systematic review aimed at (1) examining literature on the role of attachment, mentalization and reflective functioning in protecting mental health of gender diverse children and identifying the mental health outcomes that have been assessed; and (2) outlining interventions based on attachment, mentalization and reflective functioning that have been proposed. The work was conducted according to the PRISMA guidelines. Fifty-one studies were identified and 9 met the inclusion criteria. Results indicate that, besides a general protective role for mental health, attachment, mentalization and reflective functioning moderate and mediate, through different pathways, (1) the association between gender diversity and emotional/behavioural problems; and (2) the negative effects of minority stress. Mentalization seems to be an individual resilience factor; the capacity of the caregiver to serve as a secure base and validate the internal experience of incongruence of the child promote a healthy psychological development. Three levels of action for interventions were identified: individual, family and community.

Psychopathological profile in children with Prader-Willi syndrome as compared with autism spectrum disorder.

BACKGROUND: Children with Prader-Willi syndrome (PWS) can present with social deficits and repetitive behaviours that are also encountered in autism spectrum disorder (ASD). This study aimed at ascertaining possible differences in psychopathology between PWS and ASD, with particular attention to obsessional thinking, repetitive behaviours, and impulsivity. METHODS: 71 children, aged 4-15 years: 24 with PWS, 23 with ASD, and 24 community controls, were assessed on two standardized parent-reported questionnaires: the Child Behaviour Check List (CBCL) and the Autism Spectrum Quotient (AQ). Group differences were tested with one-way ANOVA. RESULTS: ASD had higher CBCL internalizing symptom scores (67.50 + 9.09) than PWS (56.62 + 9.02, Cohen's d=1.20). On specific CBCL items, PWS had more obsessionality than ASD, which, in turn, showed more impulsivity than PWS. ASD had higher AQ scores than PWS, with small to medium effect sizes (d's ranging from 0.22 to 0.53). CONCLUSIONS: The PWS phenotype was characterized by intense obsessionality, more marked than in ASD. ASD had greater psychopathology than PWS, especially of the internalizing type. Although limited by the small sample size, this study identifies obsessionality as common feature in PSW. Such symptom, considering the negative impact on daily functioning, requires clinical attention for specific treatment approaches.

A psychological support group for parents in the care of families with gender diverse children and adolescents.

Parenting gender diverse children and adolescents can be a challenging experience, entailing doubts about how to protect and support them during their development. Parental reactions impact on the child's sense of security and well-being. Therefore, when caring for families with gender diverse children, it is important to offer support to parents. In this article we present an experience with a 12-month support group for parents of young people who attended the service for gender identity development at a paediatric hospital. We describe the group structure and methodology, together with the process for evaluating the intervention. At 6-month intervals, parents were asked to indicate the most important topics that had emerged during the monthly sessions. At 12 months, they completed a semi-structured feedback questionnaire about their experience in the group, including possible difficulties encountered. Thematic analysis showed an evolution in time, with participants taking a more complex perspective on gender diversity and the needs of their children, while feeling more able to deal with the uncertainties related to gender identity development. After attending the group, parents reported feeling less lonely, more confident, and better able to communicate with their children. They related these positive changes to the opportunity of sharing experiences and mutual learning. This feed-back provides preliminary evidence that the psychological support group was perceived to be a useful resource by parents of gender diverse young people.

Father Involvement and Cognitive Development in Early and Middle Childhood: A Systematic Review.

This systematic review aims to examine the existing literature concerning the association between father involvement and the development children's cognitive skills during early and middle childhood. Specifically, it analyzes: (1) how the number of researches developed across years; (2) which are the main socio-demographic characteristics of the samples; (3) which are the main focuses examined; and (4) which operational definitions were used to assess father involvement and children cognitive skills. Following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, the articles were searched through PubMed and EBSCO (PsycInfo, PsycArticles, Education Source, Social Sciences Abstract, Family Studies Abstracts, Gender Studies Database and CINAHL complete). The findings suggest that, although each research used a different operational definition of the father involvement construct, in recent years there was a wide and constant interest increase about this issue. Most of the empirical studies utilized quantitative methods, whereas relatively few used qualitative and only one mixed methods. As regards the analysis of socio-demographic characteristics of the samples there is a great evidence that most of them included biological and residential fathers: it may reflect that this type of sample is easier to recruit than non-residential and non-biological fathers. Regarding the socio-economic status and the ethnicity of families, the data highlighted how in recent years the literature on father involvement is starting to look at differences in ethnic and cultural backgrounds, in contrast to past researches. The findings revealed that the main focus is the impact of father involvement on children's cognitive skills and the most of the studies highlighted that it is positive and statistically significant. Regarding to the assessment of father involvement and children's cognitive skills, the literature is quite heterogeneous.

Twins' and Singletons' Linguistic Environment: A Systematic Review.

Background: Among twins, lower linguistic skills emerged when compared with singletons. Considering the association found between parental linguistic input and children's language development, exploring the differences between twins and singletons' linguistic environments could find variables that are potentially associated with the lower linguistic skills of twins. Aim: The current systematic review aims to analyze and systematize the existing literature focused on the comparison of twins' and singletons' linguistic environments within their first 3 years of life. Methodological issues (i.e., the procedure used to assess the linguistic environment, the coding of the linguistic environment's features, the computational method employed to assess the parental linguistic input, and participant characteristics) and differences found among twins and singletons regarding their linguistic environment (i.e., linguistic input quantity, linguistic input complexity, linguistic features of child-directed speech, parental responsiveness, and directiveness, joint attention, and book reading) were highlighted. Method: The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement was followed. Eligible studies were searched through EBSCO, PubMed, and Web of Science. From this search, 1,347 study results emerged, and 8 studies were included. Results: To our knowledge, this is the first systematic review focused on the comparison of twins' and singletons' linguistic environments. Differences between the groups were found in all of the included studies. Data against twins were generally identified regarding all the considered linguistic environment's features. However, conflicting results within and between the included studies emerged, mainly according to the computational method employed (i.e., twin moms value, twin direct dyadic value, twin direct dyadic + both value, and input directed toward both children simultaneously). Conclusion: The disadvantaged linguistic environment of twins is likely due to limited parental resources and demands associated with the management of two children of the same age. However, the limited and conflicting data found did not allow for a firm conclusion to be drawn on the differences in the twins' and singletons' linguistic environments. Further studies on the topic are needed.

Corrigendum: When Intimate Partner Violence Meets Same Sex Couples: A Review of Same Sex Intimate Partner Violence.

[This corrects the article DOI: 10.3389/fpsyg.2018.01506.].

A Parent-Report Gender Identity Questionnaire for Children: Psychometric Properties of an Italian Version.

This article presents an Italian version of the Gender Identity Questionnaire for Children (GIQC) (Cohen-Kettenis et al., 2006; Johnson et al., 2004), a parent-report questionnaire covering a range of gender characteristics of children. We developed the GIQC-Italian version with the translation/back translation method and administered it, with a sociodemographic data sheet, to the parents of 1148 children aged 3-12 years (non-clinical sample). After obtaining descriptive data for each item, in line with Johnson et al. (2004), we examined dimensionality through exploratory factor analysis (EFA). Considering the results and that our sample was entirely non-clinical, we developed a new scoring procedure. The EFA on the new scores generated three scales: (1) a Female-Typical Behavior Scale, (2) a Male-Typical Behavior Scale, and (3) a Cross-Gender Scale. Additional EFA and confirmatory factor analyses (WLSMV estimator by using a 80/20 random-split-sample analytical approach) confirmed the three-factor solution as the best fitting dimensional structure for the revised GIQC. The Cronbach's α of the scales showed a satisfactory internal consistency. The frequency distribution of the scales scores showed it is possible to find atypical gender behavior and preferences in non-clinical samples. Independent samples t test confirmed a significant difference between boys' and girls' scores. Older children reported scores indicating less gender non-conforming characteristics than younger, except for the Female-Typical Behavior Scale in the girls' subsample. Results are discussed in the light of the existing literature about gender development. Our findings suggest that the GIQC-Italian version could be a useful tool for studying gender development in the Italian context.

Intimate Partner Violence in the Golden Age: Systematic Review of Risk and Protective Factors.

Intimate partner violence (IPV) is identifiable as a major public health concern worldwide. The international literature highlights how this phenomenon is complex and transversal to all age groups. While the global population is becoming older, the scientific research about risk and protective factors related to IPV in the golden age is diverse, and the different findings of the various studies have not been systematized so far. Thus, in this systematic review, we aim to analyze the scientific studies that investigate the risk and the protective factors of violent dynamics between elderly couples. From the perspective of the theoretical frameworks and the methodological approaches used, we present the main conceptual themes that emerge. Following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, we review the articles that report the analyses of protective and risk factors of IPV perpetration. Our results indicate social support, help-seeking behavior, and the availability of community-based services addressing the issues of abuse as the main protective factors. The risk factors are related to economic conditions, belonging to an ethnic minority, cognitive or physical impairment, other conditions associated with cultural background and relational dynamics, such as intrapartner dependence and intergenerational transmission of violence and trauma, and caregiving stress. We discuss possible future directions of research to improve the understanding of IPV in the elderly population and the implications for the development of intervention policies at preventive and supportive levels.

When Intimate Partner Violence Meets Same Sex Couples: A Review of Same Sex Intimate Partner Violence.

Over the past few decades, the causes of and intervention for intimate partner violence (IPV) have been approached and studied. This paper presents a narrative review on IPV occurring in same sex couples, that is, same sex IPV (SSIPV). Despite the myth that IPV is exclusively an issue in heterosexual relationships, many studies have revealed the existence of IPV among lesbian and gay couples, and its incidence is comparable to (Turell, 2000) or higher than that among heterosexual couples (Messinger, 2011; Kelley et al., 2012). While similarities between heterosexual and lesbian, gay, and bisexual (LGB) IPV were found, unique features and dynamics were present in LGB IPV. Such features are mainly related to identification and treatment of SSIPV in the community and to the need of taking into consideration the role of sexual minority stressors. Our findings show there is a lack of studies that address LGB individuals involved in IPV; this is mostly due to the silence that has historically existed around violence in the LGB community, a silence built on fears and myths that have obstructed a public discussion on the phenomenon. We identified the main themes discussed in the published studies that we have reviewed here. The reviews lead us to the conclusion that it is essential to create a place where this subject can be freely discussed and approached, both by LGB and heterosexual people.

Parental Relationship with Twins from Pregnancy to 3 Months: The Relation Among Parenting Stress, Infant Temperament, and Well-Being.

Objective: The transition to parenthood, from pregnancy to postpartum period, is a critical process, particularly for couples expecting twins. There is very little literature regarding the links between anxiety, depression, dyadic adjustment, parental stress, and infant temperament spanning from pregnancy to postpartum. This study has two aims: first, to examine whether mothers' and fathers' anxiety, depression, and dyadic adjustment, assessed at the sixth month of pregnancy and 3 months postpartum, are associated with infants' negative affectivity (NA) and parenting stress; second, to examine whether there is any difference between fathers' and mothers' levels of parenting stress and perception of the twins' temperament, as well as to evaluate, separately for mothers and fathers, whether the levels of parenting stress and perception of child temperament differ for each twin. Method: The study participants were 58 parents (29 couples) and their healthy 58 twin babies (51.7% boys, 48.3% girls). Mothers' ages ranged from 30 to 44 years, (MAge = 36.3 years, SD = 3.2 years), and fathers' ages ranged from 32 to 52 years, (MAge = 38.2 years, SD = 4.4 years). The parents, during the pregnancy period and 3 months after delivery, filled out the Edinburgh Postnatal Depression Scale, the State-Trait Anxiety Inventory, and the Dyadic Adjustment Scale. Three months after delivery they also filled out the Parenting Stress Index-Short Form and the Infant Behavior Questionnaire Revised. Results: The analyses showed a significant correlation between parental anxiety/depression symptoms and infants' NA and parenting stress (in both mothers and fathers). Moreover, compared to fathers, mothers reported higher scores on specific dimensions of the infants' NA, [t(28) = -2.62 and p < 0.05; t(28) = 2.09 and p < 0.05], and parenting stress, [t(28) = 2.19 and p < 0.05; t(28) = 2.23 and p < 0.05], but only for Twin 2. Finally, the results showed that mothers' perceptions of child temperament vary between two twins, [e.g., distress to limitations: t(28) = 2.08 and p < 0.05]. Discussion: This study highlights the peculiarity of twin parenthood during the fourth trimester. In particular, the differences between twins' mothers' and fathers' perceptions are relevant from a clinical perspective and for perinatal professionals. It would be interesting to study the long-term impact of mothers' and fathers' differing perceptions of their twins.