Enhancing Adoptive Parenting: Devising Promising Interventions

After describing the common problems of children placed for adoption from local authority care and the views and concerns of adopters as recipients of services, the article describes two contrasting interventions designed to enhance new adopters' parenting skills and understanding. Aspects covered are the empirical and theoretical justifications for the interventions, the process of manualisation and the plan to evaluate the effectiveness of the interventions in a randomised controlled trial.     

Taking a Public Health Approach to School-Based Parenting Interventions: The Triple P-Positive Parenting Program

Considerable advances have been made through parenting and school-based interventions in preventing or reducing misbehavior. However, the majority of parents who might benefit from these services are unable to access them. In this paper we propose that a promising solution is to adopt a public health approach that provides a well-coordinated continuum of care with multiple levels of service sufficient to meet parent and student needs. We argue that this public health approach, which parallels the Response to Intervention (RTI) approach frequently seen in United States schools, can best be achieved by melding multi-level parenting programs with multi-level school-wide interventions. To illuminate some of the potential benefits and challenges of this public health approach which bridges gaps between school, clinical, and community psychology, we describe the Triple P-Positive Parenting Program and propose some adaptations needed to develop an effective interface between Triple P and schools.     

Balancing Work and Family: A Controlled Evaluation of the Triple P- Positive Parenting Program as a Work-Site Intervention

Background: Despite a wealth of evidence showing that behavioural family intervention is an effective intervention for parents of children with behavioural and emotional problems, little attention has been given to the relationship between parents functioning at work and their capacity to manage parenting and other home responsibilities. This study evaluated the effects of a group version of the Triple-P Positive Parenting Program (WPTP) designed specifically for delivery in the workplace.
Method: Participants were 42 general and academic staff from a major metropolitan university who were reporting difficulties managing home and work responsibilities and behavioural difficulties with their children. Participants were randomly assigned to WPTP, or to a waitlist control (WL) condition.
Results: Following intervention, parents in WPTP reported significantly lower levels of disruptive child behaviour, dysfunctional parenting practices, and higher levels of parental self-efficacy in managing both home and work responsibilities, than parents in the WL condition. These short-term improvements were maintained at 4-months follow-up. There were also additional improvements in reported levels of work stress and parental distress at follow-up in the WPTP group compared to post-intervention.
Conclusions: Implications for the development of 'family-friendly' work environments and the prevention of child behaviour problems are discussed.     

Parenting stress in mothers of children with an intellectual disability: the effects of parental cognitions in relation to child characteristics and family support

Background Recent theories of stress and coping in parents of children with intellectual disabilities (ID) emphasize the importance of cognitive appraisals in influencing parents’ levels of stress and their adaptations to difficulties presented by the children. This study investigated the relationships between parental cognitions, child characteristics, family support and parenting stress. The aspects of cognitions studied were: parenting self-esteem (including efficacy and satisfaction) and parental locus of control. Methods The group studied consisted of 46 mothers of children with ID. The Vineland Adaptive Behavior Scales and Maladaptive Behavior Domain were administered by interview. Mothers also completed four questionnaires: the Family Support Scale, the Parenting Sense of Competence Scale, a shortened form of the Parental Locus of Control Scale and the Parenting Stress Index (Short Form). Results Data were analysed using Pearson's correlation coefficients, partial correlations and a regression analysis. The results indicated that most of the variance in parenting stress was explained by parental locus of control, parenting satisfaction and child behaviour difficulties. Whilst there was also a strong correlation between family support and parenting stress, this was mediated by parental locus of control. Conclusions The results demonstrate the potential importance of parental cognitions in influencing parental stress levels. It is argued that these results have implications for clinical interventions for promoting parents’ coping strategies in managing children with ID and behavioural difficulties.     

Technology Matters: Digital micro interventions to support parenting: Evaluating time out apps

Digital interventions to support parenting skills are popular but engagement can be low. Digital micro interventions such as apps targeting specific aspects of parenting are a novel development with the potential to overcome this challenge. Time out is an evidence-based component of many parenting skills training programmes and is an appropriate target for digital micro intervention. We describe the eight requirements of high-quality time out according to the literature and how these can be supported by an app. Searches of the App Store, Google Play, and Alexa Skills in the UK identified six apps designed to support time out. Current time out apps all promoted consistency, but they all risked low-quality time out through inappropriate initiation, duration, and termination. Professionals in child and adolescent mental health should explore the details of any digital micro interventions being used by parents for time out and provide appropriate counselling. We recommend that all future digital micro interventions in this area should incorporate evidence-based guidance.     

Psychological services utilization: relationship to severity of behaviour problems in intellectual disability services

Using the Developmental Disabilities Profile, a population service registry, the present study gives an analysis of the relationship between the rated frequency of contact with psychology specialists and a composite rating of 13 behaviour problems in intellectual disability services. An analysis of information on 45 810 adults with intellectual disability indicated that, when the population was divided into quintile groups based on behaviour severity, distinctively different distributions of rated contacts with psychologists were discernible. The people rated in the highest quintile for severity of maladaptive behaviour constituted especially high utilizers of psychology services. About 37% of participants had had no contact with psychologists during the past year, whereas 26% had such contact weekly or more frequently. The findings are introduced and discussed in the context of psychological practice in intellectual disability services and trends toward managed health and behavioural health care in the USA.     

Interpersonal differentiation within depression diagnosis: Relating interpersonal subgroups to symptom load and the quality of the early therapeutic alliance

Abstract

We examined interpersonal problems in psychotherapy outpatients with a principal diagnosis of a depressive disorder in routine care (n=361). These patients were compared to a normative non-clinical sample and to outpatients with other principal diagnoses (n=959). Furthermore, these patients were statistically assigned to interpersonally defined subgroups that were compared regarding symptoms and the quality of the early alliance. The sample of depressive patients reported higher levels of interpersonal problems than the normative sample and the sample of outpatients without a principal diagnosis of depression. Latent Class Analysis identified eight distinct interpersonal subgroups, which differed regarding self-reported symptom load and the quality of the early alliance. However, therapists' alliance ratings did not differentiate between the groups. This interpersonal differentiation within the group of patients with a principal diagnosis of depression may add to a personalized psychotherapy based on interpersonal profiles.     

Social and Interpersonal Factors Relating to Adolescent Suicidality: A Review of the Literature

This article reviews the empirical literature concerning social and interpersonal variables as risk factors for adolescent suicidality (suicidal ideation, suicidal behavior, death by suicide). It also describes major social constructs in theories of suicide and the extent to which studies support their importance to adolescent suicidality. PsychINFO and PubMed searches were conducted for empirical studies focused on family and friend support, social isolation, peer victimization, physical/sexual abuse, or emotional neglect as these relate to adolescent suicidality. Empirical findings converge in documenting the importance of multiple social and interpersonal factors to adolescent suicidality. Research support for the social constructs in several major theories of suicide is summarized and research challenges are discussed.     

Pathways from maternal depression to young adult offspring depression: an exploratory longitudinal mediation analysis

Maternal depression in the peri‐natal period is associated with increased risk for young adult depression in offspring. This study explored mediation of these links via trajectories of child conduct and emotional problems (Strengths and Difficulties Questionnaire) from ages 4–16 years old in data from the Avon Longitudinal Study of Parents and Children cohort (n = 13373). Through gender‐specific structural equation models, a composite measure of exposure to early maternal depression (Edinburgh Postnatal Depression Scale), predicted young adult depression at age 18 (Revised Clinical Interview Schedule – distal outcome). Mediational effects were then estimated by testing which parts of joint piecewise latent trajectory models for child/adolescent conduct and emotional problems were associated with both exposure and distal outcome. For girls, only conduct problems in early childhood were consistently indicated to mediate effects of early maternal depression on risk of young adulthood depression. Some evidence for a pathway via changing levels of childhood and adolescent emotional difficulties was also suggested. For boys, by contrast, the differing models gave less consistent findings providing some evidence for a small time‐specific indirect effect via early childhood conduct problems. In addition to its practice implications the current methodological application offers considerable potential in exploratory longitudinal developmental mediation studies. © 2016 The Authors International Journal of Methods in Psychiatric Research Published by John Wiley & Sons Ltd     

Brain Uptake and Utilization of Fatty Acids,Lipids and Lipoproteins: Application to Neurological Disorders

Transport, synthesis, and utilization of brain fatty acids and other lipids have been topics of investigation for more than a century, yet many fundamental aspects are unresolved and, indeed, subject to controversy. Understanding the mechanisms by which lipids cross the blood brain barrier and how they are utilized by neurons and glia is critical to understanding normal brain development and function, for the diagnosis and therapy of human diseases, and for the planning and delivery of optimal human nutrition throughout the world. Two particularly important fatty acids, both of which are abundant in neuronal membranes are: (a) the ω3 polyunsaturated fatty acid docosahexaenoic acid, deficiencies of which can impede brain development and compromise optimal brain function, and (b) the ω6 polyunsaturated fatty acid arachidonic acid, which yields essential, but potentially toxic, metabolic products. There is an exciting emerging evidence that modulating dietary intake of these fatty acids could have a beneficial effect on human neurological health. A workshop was held in October, 2004, in which investigators from diverse disciplines interacted to present new findings and to discuss issues relevant to lipid uptake, utilization, and metabolism in the brain. The objectives of this workshop were: (1) to assess the state-of-the-art of research in brain fatty acid/lipid uptake and utilization; (2) to discuss progress in understanding molecular mechanisms and the treatment of neurological diseases related to lipids and lipoproteins; (3) to identify areas in which current knowledge is insufficient; (4) to provide recommendations for future research; and (5) to stimulate the interest and involvement of additional neuroscientists, particularly young scientists, in these areas. The meeting was divided into four sessions: (1) mechanisms of lipid uptake and transport in the brain, (2) lipoproteins and polyunsaturated fatty acids, (3) eicosanoids in brain function, and (4) fatty acids and lipids in brain disorders. In this article, we will provide an overview of the topics discussed in these sessions.     

Synopses of Posters Presented at the International Workshop on Brain Uptake and Utilization of Fatty Acids,Lipids, and Lipoproteins: Application to Neurological Disorders

Thirty-five posters were presented at the Workshop on Brain Uptake And Utilization Of Fatty Acids, Lipids, and Lipoproteins. They were grouped into four categories: (1) mechanisms of lipid uptake and transport to the brain, (2) lipoproteins and polyunsaturated fatty acids, (3) eicosanoids in brain function, and (4) fatty acids and lipids in brain disorders. This article summarizes the highlights of the research presented in these posters. The individual abstracts follow these synopses.     

What factors influence individuals and couples to seek help for sexual and/or relationship difficulties from primary care professionals: an exploratory qualitative study

This study aims to gain information about what factors influence individuals and couples to discuss sexual and/or relationship difficulties with a primary healthcare professional. Although there is evidence that sexual and relationship difficulties are quite prevalent, there is little empirical evidence as to the factors that influence help seeking behaviour. In particular why some people choose to seek help from a primary care professional. Five participants (three women and two men) took part in qualitative in-depth semi-structured interviews, which were recorded and transcribed. Data analysis involved a Thematic Analysis approach that identified six themes influencing help seeking behaviour, which were named: Relationship characteristics; Context; Perception of problem; Professional approachability; Awareness of services; and Client openness. The Information Processing Model offers the best theory with which to interpret and understand the findings of this study and enables health professionals to understand that help seeking behaviour relies on a number of steps that could be amenable to intervention. The study concludes that education and training programmes should be improved for primary healthcare staff and initiatives to raise awareness of sexual and relationship difficulties with both professionals and the public be developed and maintained.     

Factors influencing intentions to seek a cognitive status examination: a study based on the Health Belief Model

AIMS: The aim of the present study was to examine the factors influencing intention to seek a cognitive status evaluation in the presence of memory problems. METHODS: A convenience sample of 186 community-dwelling adults (mean age=64) were interviewed face-to-face using measures derived from the Health Belief Model. RESULTS: Participants' intentions to be examined were higher when presented with scenarios describing family history of Alzheimer's disease (AD). Perceived barriers and cues to action were significant predictors of intention, accounting for 24% of the variance. CONCLUSIONS: These findings suggest the need to develop effective educational strategies to improve knowledge about AD and decision-making concerning cognitive status examinations.     

Factors Associated with the Referral of Anxious Children to Mental Health Care: the Influence of Family Functioning,Parenting, Parental Anxiety and Child Impairment

This study aims to identify factors that predict the mental health care referral of anxious children. In total, 249 children and families, aged 8–13 years, participated: 73 children were referred with anxiety disorders to mental health care [mean (M) age =10.28, standard deviation (SD) =1.35], 176 non‐referred anxious children recruited in primary schools (M age =9.94, SD =1.22). Child anxiety and other disorders were assessed with semi‐structured interviews. Child anxiety symptoms, behavioural problems, parental anxiety, the parenting styles overprotection, autonomy encouragement, rejection, and the family functioning dimensions control and relational functioning, were assessed with child, father and mother report on questionnaires. The summed interference rating of children's anxiety disorders was a predictor of referral, consistent over child and parent reports, but not comorbidity. Most family and parenting variables did not predict referral, nor differed between the referred and non‐referred sample. Contrary to our hypothesis, maternal self‐reported anxiety decreased the odds of referral and child reported parental autonomy granting increased, while child reported overprotection decreased the odds of referral. The impairment for the child due to the number and severity of their anxiety disorder(s) is, based on child, mother and father report associated with referral. This indicates that those who need it most, receive clinical treatment. Copyright © 2014 John Wiley & Sons, Ltd.