Parent-child therapy helps young children with depression

New research demonstrates that an interactive therapy involving parents and their depressed preschoolers can reduce rates of depression and lower the severity of children’s symptoms | The American Journal of Psychiatry | via ScienceDaily

Children as young as three can be clinically depressed, and often that depression recurs as they get older and go to school. It also can reappear during adolescence and throughout life.

New research from Washington University School of Medicine demonstrates that an interactive therapy involving parents and their depressed children can reduce rates of depression and lower the severity of children’s symptoms:

Abstract
Objective:
Clinical depression in children as young as age 3 has been validated, and prevalence rates are similar to the school-age disorder. Homotypic continuity between early and later childhood depression has been observed, with alterations in brain function and structure similar to those reported in depressed adults.

These findings highlight the importance of identifying and treating depression as early as developmentally possible, given the relative treatment resistance and small effect sizes for treatments later in life. The authors conducted a randomized controlled trial of a dyadic parent-child psychotherapy for early childhood depression that focuses on enhancing the child’s emotional competence and emotion regulation.

Method:
A modified version of the empirically tested parent-child interaction therapy with a novel “emotion development” module (PCIT-ED) was compared with a waiting list condition in a randomized controlled trial in 229 parent-child dyads with children 3–6.11 years of age. Both study arms lasted 18 weeks.

Results:
Children in the PCIT-ED group had lower rates of depression (primary outcome), lower depression severity, and lower impairment compared with those in the waiting list condition. Measures of child emotional functioning and parenting stress and depression were significantly improved in the PCIT-ED group.

Conclusions:
The findings from this randomized controlled trial of a parent-child psychotherapy for early childhood depression suggest that earlier identification and intervention in this chronic and relapsing disorder represents a key new pathway for more effective treatment. Manualized PCIT-ED, administered by master’s-level clinicians, is feasible for delivery in community health settings.

Luby, J. L. et al. |  A Randomized Controlled Trial of Parent-Child Psychotherapy Targeting Emotion Development for Early Childhood Depression | American Journal of Psychiatry | Published Online 20 June 2018

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Does a lack of sleep or poor quality of sleep affect parenting?

May 2018 | Sleep better, parent better: Study shows link between maternal sleep and permissive parenting | Science Daily

A US study that looked at maternal sleep and parenting has found that for mothers who fell asleep easily or who slept for long periods their adolescent children reported lower levels of permissive parenting. By contrast, mothers  were not receiving enough sleep, or receiving poor quality sleep, it had an effect on their levels of permissiveness with their adolescents. The researchers studied over 200 mothers and their adolescent children (average age 15). The mothers wore wearable technology that monitored their sleep quality, the young people completed questionnaires about their perception of their mothers’ parenting via Science Daily .

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The full news article from Science Daily can be accessed here 

Abstract

Utilizing a multi‐method design, the present study examined the association between maternal sleep, assessed via actigraphy and self‐reports, and permissive parenting (e.g. lax, inconsistent discipline) during adolescence, as well as the extent to which this association differed by mothers’ race/ethnicity and socioeconomic status. The sample was comprised of 234 mothers (M age = 41.76 years, SD = 6.25; 67% European‐American, 31% African‐American, 2% other race/ethnicities) and 237 adolescents (113 boys, 124 girls; M age = 15.80 years, SD = 0.80; 66% European‐American, 34% African‐American). Mothers’ sleep duration (actual sleep minutes) and quality (sleep efficiency, latency, long wake episodes) were assessed using actigraphy. Mothers also reported on their sleep problems and adolescents reported on mothers’ permissive parenting behaviours. Results revealed that actigraphy‐based longer sleep duration and shorter sleep latency were associated with lower levels of permissive parenting. Further, mothers’ race/ethnicity and socioeconomic status moderated the association between actigraphy‐based sleep quality (i.e. sleep efficiency, long wake episodes) and permissive parenting. Specifically, a negative association between sleep efficiency and permissive parenting was evident only for African‐American mothers. In addition, a positive association between more frequent night wakings and permissive parenting was evident only for mothers from lower socioeconomic status households. The findings highlight the benefits of longer and higher‐quality sleep for reducing the risk of permissive parenting, especially among ethnic minority mothers and mothers from lower socioeconomic status households.

Full reference:

Tu, K.M. Elmore‐Staton,  L, Buckhalt, J.A., El‐Sheikh, M. | The link between maternal sleep and permissive parenting during late adolescence |  J Sleep Res2018;e12676. https://doi.org/10.1111/jsr.12676

The article has been published in the Journal of Sleep Research
It can be requested by Rotherham NHS staff here

 

The role of family and school-level factors in bullying and cyberbullying

This UK study aims to investigate student-level and school-level characteristics of those who become involved in bullying and cyberbullying behaviours as victims or perpetrators | BMC Pediatrics

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Background: Bullying and cyberbullying are common phenomena in schools. These negative behaviours can have a significant impact on the health and particularly mental health of those involved in such behaviours, both as victims and as bullies.

Conclusions: Bullying victimization and cyberbullying prevalence vary across school type and school quality, supporting the hypothesis that organisational/management factors within the school may have an impact on students’ behaviour. These findings will inform future longitudinal research investigating which school factors and processes promote or prevent bullying and cyberbullying behaviours.

Full reference: Leonardo B. et al. (2017) The role of family and school-level factors in bullying and cyberbullying: a cross-sectional study. BMC Pediatrics. Published: 11 July 2017

Mindfulness-Based Intervention for Parents of Children with Autism

Parents of children with autism spectrum disorder (ASD) frequently report poor psychological well-being.

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The purpose of this study was to examine the effectiveness of brief mindfulness-based intervention (MBI) on perceived stress, anxiety, and depression among parents of children with ASD in Jordan.

After the intervention program, the one-way analyses of covariance (ANCOVA) indicated that parents in the intervention group had better outcomes on the measures of psychological well-being and mindfulness than those in the comparison group (P < 0.01). Furthermore, results of paired samples t test indicated that parents in the intervention group demonstrated significant improvements in measures of stress, anxiety, depression, and mindfulness scores with medium to large effect size (Cohen d between 0.42 and 0.85, P < 0.01).

Although the comparison group demonstrated small improvement in measures of the dependent variables, these improvements were much less than improvements in the intervention group. The MBIs are culturally adaptable, feasible, and effective interventions to improve psychological well-being in parents of children with ASD.

Full reference: Rayan, A. & Ahmad, M. (2017) Effectiveness of Mindfulness-Based Intervention on Perceived Stress, Anxiety, and Depression Among Parents of Children with Autism Spectrum Disorder. Mindfulness. 8(677)

 

Mindfulness training for parents of children with special needs

Petcharat, M. & Liehr, P. Journal of Child and Adolescent Psychiatric Nursing | Published online: 27 April 2017

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Problem: Parents of children with special needs encounter specific challenges in carrying out their caregiving roles. They experience difficulty accepting their children due to unrealistically high expectations. Mindfulness training (MT) may increase parental psychological well-being and acceptance.

Objective: The purpose of this article is to examine the evidence-base for the effectiveness of MT in enhancing psychological well-being for parents of children with special needs as a foundation for guidance for nurses in mental health practice.

Findings: The studies indicated that cultivating a more mindful way of parenting is associated with reduced stress, anxiety, and depression. Parents experienced increased mindful awareness and improved psychological well-being, and they were more accepting of their children. Their children also had fewer behavior problems and enhanced positive interaction with their parents. Because mindfulness interventions fall within the scope of independent nursing practice, nurses can play a significant role in applying mindfulness to promote psychological well-being in parents who have children with special needs.

Read the full abstract here

Mindfulness and Support and Information Group Interventions for Parents of Adults with Autism Spectrum Disorder

Lunsky, Y. et al. Journal of Autism and Developmental Disorders | Published online: 3 April 2017

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This study evaluated two community based interventions for parents of adults with autism spectrum disorder and other developmental disabilities.

Parents in the mindfulness group reported significant reductions in psychological distress, while parents in the support and information group did not. Reduced levels of distress in the mindfulness group were maintained at 20 weeks follow-up. Mindfulness scores and mindful parenting scores and related constructs (e.g., self-compassion) did not differ between the two groups.

Results suggest the psychological components of the mindfulness based group intervention were effective over and above the non-specific effects of group processes and informal support.

Read the abstract here

Trait Mindfulness Attenuates the Adverse Psychological Impact of Stigma on Parents of Children with Autism Spectrum Disorder

Chan, K.K.S. & Lam, C.B. Mindfulness (2017). doi:10.1007/s12671-016-0675-9

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Stigma attached to autism spectrum disorder (ASD) is prevalent, but few studies have examined its psychological impact on parents of children with ASD and the potential protective factors in this family context. The present study aimed to test the associations of public stigma and courtesy stigma with depression, anxiety, and caregiving burden among parents of children with ASD and to explore whether trait mindfulness would moderate these associations.

Cross-sectional questionnaire data were collected from 424 parents of children with ASD residing in Hong Kong, China. Hierarchical regressions revealed significant interactions between public stigma and trait mindfulness and between courtesy stigma and trait mindfulness in predicting depression, anxiety, and caregiving burden.

Our findings contributed to the theoretical literature by highlighting the adverse impact of both public stigma and courtesy stigma on the mental health and caregiving experience of parents of children with ASD, as well as the potential protective effects of trait mindfulness in such processes. Our findings also had important practical implications for the design of effective interventions for this stigmatized group of families.

Read the abstract here