The effectiveness of Grief-Help, a cognitive behavioural treatment for prolonged grief in children: study protocol for a randomised controlled trial

BACKGROUND: There is growing recognition of a syndrome of disturbed grief referred to as prolonged grief disorder (PGD). PGD is mostly studied in adults, but clinically significant PGD symptoms have also been observed in children and adolescents. Yet, to date no effective treatment for childhood PGD exists. The aims of this study are: (1) to investigate the effectiveness of Grief-Help, a nine-session cognitive-behavioural treatment for childhood PGD, combined with five sessions of parental counselling, immediately after the treatment and at three, six and twelve months follow-up; (2) to examine tentative mediators of the effects of Grief-Help, (i.e., maladaptive cognitions and behaviours and positive parenting), and (3) to determine whether demographic variables, child personality, as well as symptoms of PGD, anxiety, and depression in parents moderate the treatment effectiveness. METHODS/DESIGN: We will conduct a Randomised Controlled Trial (RCT) in which 160 children and adolescents aged 8–18 years are randomly allocated to cognitive behavioural Grief-Help or to a supportive counselling intervention; both treatments are combined with five sessions of parental counselling. We will recruit participants from clinics for mental health in the Netherlands. The primary outcome measure will be the severity of Prolonged Grief Disorder symptoms according to the Inventory of Prolonged Grief for Children (IPG-C). Secondary outcomes will include PTSD, depression and parent-rated internalizing and externalizing problems. Mediators like positive parenting and maladaptive cognitions and behaviours will be identified. We will also examine possible moderators including demographic variables (e.g. time since loss, cause of death), psychopathology symptoms in parents (PGD, anxiety and depression) and child personality. Assessments will take place in both groups at baseline, after the treatment-phase and three, six and twelve months after the post-treatment assessment. DISCUSSION: We aim to contribute to the improvement of mental health care for children and adolescents suffering from loss. By comparing Grief-Help with supportive counselling, and by investigating mediators and moderators of its effectiveness we hope to provide new insights in the effects of interventions for bereaved children, and their mechanisms of change. TRIAL REGISTRATION: Netherlands Trial Register NTR385

Parental Self-Control and the Development of Male Aggression in Early Childhood: A Longitudinal Test of Self-Control Theory

A number of studies have evaluated associations between parenting practices, adolescent self-control, and adolescent antisocial behavior. Yet, few studies have examined associations between these constructs in early childhood or examined the extent to which both maternal and paternal self-control shapes them. To address these gaps, the current study utilizes longitudinal data collected on a sample of 117 Dutch boys and their parents to investigate the across time interrelationships between parental self-control, ineffective parenting, child self-control, and child aggression. The results provide evidence of an indirect association between maternal self-control and early childhood self-control through maternal ineffective parenting, an indirect association between maternal ineffective parenting and early childhood aggression through early childhood self-control, and an indirect association between maternal self-control and early childhood aggression through both maternal ineffective parenting and early childhood self-control. In contrast, paternal self-control and paternal ineffective parenting were unrelated to child self-control and child aggression. The implications and limitations of the study are discussed

Self-regulation and frontal EEG alpha activity during infancy and early childhood: A multilevel meta-analysis

Integrating behavioral and neurophysiological measures has created new and advanced ways to understand the development of self-regulation. Electroencephalography (EEG) has been used to examine how self-regulatory processes are related to frontal alpha power during infancy and early childhood. However, findings across previous studies have been inconsistent. To address this issue, the current meta-analysis synthesized all prior literature examining associations between individual differences in self-regulation and frontal EEG alpha power (baseline and/or task). In total, 23 studies consisting of 1275 participants between 1 month and 6 years of age were included, which yielded 149 effect sizes. Findings of the three-level meta-analytic model demonstrated a non-significant overall association between self-regulation and frontal alpha power. Yet, significant moderating effects were found for self-regulation construct (emotion regulation, effortful control, executive function), self-regulation measurement (behavioral task, computer assessment, lab observation, questionnaire), and children's mean age. Self-regulation was only significantly correlated with frontal alpha power when studies focused on the executive functioning construct. Moreover, the use of behavioral tasks or questionnaires and a higher mean age of the children resulted in small but significant effect size estimates. Higher frontal alpha power values were related to higher order top-down mechanisms of self-regulation, indicating that these mechanisms might become stronger when the frontal cortex is sufficiently developed. The findings of the current meta-analysis highlight the importance of longitudinal analyses and multimethod approaches in future work to reach a more comprehensive understanding of the role of frontal EEG alpha activity in the etiology of individual differences in early self-regulation. Research Highlights: The first meta-analysis of individual differences in self-regulation and frontal EEG alpha power during infancy and early childhood demonstrated a non-significant overall association. Moderation analyses revealed that variations in frontal alpha power were significantly associated with executive function, but not with effortful control and emotion regulation. Frontal alpha power was related to variations in self-regulation when measured by behavioral tasks and questionnaires, but not via computer assessments and lab observations. The association between individual differences in self-regulation and frontal alpha power becomes significantly stronger with age

The effectiveness of blended versus regular Forensic Outpatient Systemic Therapy in the treatment of juvenile antisocial behavior: a study protocol of a randomized controlled trial

Background: Antisocial behavior during adolescence can have long-lasting negative effects and leads to high societal costs. Forensic Outpatient Systemic Therapy (Forensische Ambulante Systeem Therapie; FAST) is a promising treatment for juveniles aged 12–21 showing severe antisocial behavior. The intensity, content and duration of FAST can be adjusted to the needs of the juvenile and their caregiver(s), which is considered crucial for effective treatment. Next to the regular version of FAST (FASTr), a blended version (FASTb) in which face-to-face contacts are replaced by minimally 50% online contacts over the duration of intervention was developed during the Covid-19 pandemic. The current study will investigate whether FASTb is equally effective as FASTr, and through which mechanisms of change, for whom, and under which conditions FASTr and FASTb work. Methods: A randomized controlled trial (RCT) will be carried out. Participants (N = 200) will be randomly assigned to FASTb (n = 100) or FASTr (n = 100). Data collection will consist of self-report questionnaires and case file analysis, and include a pre-test at the start of the intervention, a post-test immediately after the intervention, and a six month follow-up. Mechanisms of change will be investigated using monthly questionnaires of key variables during treatment. Official recidivism data will be collected at two-year follow-up. Discussion: This study aims to improve the effectiveness and quality of forensic mental health care for juveniles with antisocial behavior by studying the effectiveness of blended care, which has not been studied before in treatment of externalizing behavior. If found to be at least as effective as face-to-face treatment, blended treatment can help meet the urgent need for more flexible and efficient interventions in this field. In addition, the proposed study aims to unravel what works for whom, knowledge urgently needed in mental health care for juveniles with severe antisocial behavior. Trial registration: This trial was registered at ClinicalTrials.gov on 07/11/2022, registration number NCT05606978

The Role of Psychopathic Traits and Supportive Parental Practices in Long-Term Juvenile Recidivism: a 10-Year Follow-Up.

Recidivism rates of juvenile delinquents remain high despite numerous intervention efforts. Identifying factors that can predict (long-term) recidivism is therefore an important research issue. Knowledge on why juveniles re-offend is a key to effective interventions as it helps to identify factors most likely to be successful targets in intervention programs. A 10-year follow-up study prospectively examined whether psychopathic traits and supportive parental practices predicted the timing and frequency of recidivism in juvenile delinquents. Participants were 256 adolescents who were referred to treatment for serious antisocial behavior (72.4% male). Participants were between 12 and 18 years old at baseline (M = 15.9 years). Parents reported on juveniles’ psychopathic traits and supportive parental practices at baseline. At 10-year follow-up, the official recidivism data were collected. A substantial number of juveniles (86.3%) had recidivated at 10-year follow-up. Juvenile psychopathic traits and supportive parental practices did not incrementally predict the timing or frequency of recidivism over time over and beyond the static control variables gender and prior offenses. The present study confirms previous work suggesting that static risk factors gender and prior offenses are strongest predictors of recidivism

Stevig als een Rots, Flexibel als Water? Effectiviteit van een Schoolinterventie Gericht op het Intrapersoonlijk en Interpersoonlijk Domein

Samenvatting De huidige studie had als doel om te onderzoeken of 1) de schoolinterventie Rots en Water (r&w) effectief was in het verbeteren van competenties en voorkomen van problemen in het intra- en interpersoonlijk domein van leerlingen op het voorbereidend middelbaar beroepsonderwijs (vmbo), en of 2) interventie-effecten veranderden naarmate er meer mensen betrokken waren bij de interventie (kernteam van leerkrachten, het hele schoolteam, het hele schoolteam en ouders). We hebben een gerandomiseerde gecontroleerde studie uitgevoerd onder brugklassers (N = 1299; Mleeftijd = 12,38; 54 % jongens) die vier keer digitale vragenlijsten hebben ingevuld. De resultaten lieten zien dat r&w een aantal interventie-specifieke uitkomsten (zelfcontrole en emotionele zelfregulatie), uitkomsten in het intrapersoonlijk domein (psychologisch welzijn, seksuele autonomie en internaliserend gedrag) en in het interpersoonlijk domein (agressie) verbeterde, maar uitsluitend wanneer een kernteam van leerkrachten betrokken was bij de implementatie van de interventie. De (gematigde) interventie-effecten waren het grootste in het eerste jaar van de tweejarige interventie. Deze resultaten laten zien dat r&w positieve effecten kan bewerkstelligen bij vmbo-leerlingen wanneer deze geïmplementeerd wordt door een kernteam. Het lijkt dus waardevol voor scholen om te investeren in interventies met een leerstijl die aansluit bij die van de doelgroep, met een hoge kwaliteit van implementatie en een beperkt aantal betrokken personen

Stability and change in maternal parenting profiles across infancy and toddlerhood

During infancy and toddlerhood, parents show large individual differences in the extent to which they are able to tailor their parenting behaviors to their children's swiftly changing developmental needs. The first aim of our study was, therefore, to distinguish parenting profiles at three time points during infancy and toddlerhood (i.e., 5, 10, and 36 months) based on mothers' supportive presence, structure and limit-setting, and quality of instruction, as well as to examine the stability of profile structure and profile membership across time. The second aim was to examine how profile membership and profile transitions at each time point are associated with relevant parental, contextual, and child-specific factors. Data from 244 Dutch mother-child dyads were collected at three waves: when children were approximately 5 months ( n = 203), 10 months ( n = 181), and 3 years of age ( n = 178). We found three types of parenting profiles at each wave: a competent profile, a sufficient profile, and a maladaptive profile. Only the competent parenting profile was found to have a stable structure across all three waves. In general, profile membership was least stable for the maladaptive profile. Results also showed that maternal agreeableness and a higher educational level increased the likelihood to exhibit a more competent parenting profile. Our findings advance our understanding of how parenting profiles might change due to children's swiftly changing needs and inform efforts to tailor parenting interventions to individual parents. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Adding Structured Components to Home Visitation to Reduce Mothers’ Risk for Child Maltreatment: a Randomized Controlled Trial.

Purpose: Home visitation program effects are generally small, which may be caused by flexible intervention content leading to inconsistent outcomes. In this study we therefore examined whether the effectiveness of a Dutch home visitation program (i.e., Supportive Parenting) can be improved by adding structured intervention components targeting key risk factors for child maltreatment: parental sense of competence, perceived stress, parental anger, and PTSD symptoms. Method: Participants were randomly assigned to an experimental group (n = 74) that received four additional intervention components in two home visits, or a control group (n = 60) that received regular Supportive Parenting. Outcomes were assessed before (T1) and after (T2) the first, and before (T3) and after (T4) the second home visit. Effects were examined using ANCOVA for primary outcomes: parental sense of competence, perceived stress, parental anger, and PTSD symptoms, and secondary outcomes: risk of child maltreatment, parental warmth, and negative parenting. Moderation effects were examined for T1 scores, child temperament and life events. Results: Mothers who received the intervention components showed less stress compared to the control group at T3 and T4. There were no differences between groups on other outcomes and no moderation effects, although parental sense of competence reduced and anger increased within the experimental group specifically. Conclusion: The structured components may enhance the effectiveness of Supportive Parenting to reduce parenting stress. Future research into how other outcomes can be improved is needed

The direct and indirect effects of parenting behaviors and functional brain network efficiency on self-regulation from infancy to early childhood: A longitudinal mediation model

There is growing interest in the hypothesis that early parenting behaviors impact children’s self-regulation by affecting children’s developing brain networks. Yet, most prior research on the development of self-regulation has focused on either environmental or neurobiological factors. The aim of the current study was to expand the literature by examining direct and indirect effects of variations in parenting behaviors (support and stimulation) and efficiency of functional brain networks (small-worldness) on individual differences in child self-regulation, using a three-wave longitudinal model in a sample of 109 infants and their mothers. Results revealed that parental support predicted child self-regulation at 5 months, 10 months, and 3 years of age. This effect was not mediated by infants’ small-worldness within the alpha and theta rhythm. Parental stimulation predicted higher levels of infants’ alpha small-worldness, whereas parental support predicted lower levels of infants’ theta small-worldness. Thus, parents may need to stimulate their infants to explore the environment autonomously in order to come to more efficient functional brain networks. The findings of the current study highlight potential influences of both extrinsic environmental factors and intrinsic neurobiological factors in relation to child self-regulation, emphasizing the role of parental support as a form of external regulation during infancy, when the brain is not yet sufficiently developed to perform self-regulation itself