Parenting Programs to Reduce Recurrence of Child Maltreatment in the Family Environment: A Systematic Review

Physical maltreatment is a public health issue affecting millions of children in their lifetime, with a high risk of recurrency. Although there are several parenting programs (PPs) available, existing reviews on their effectiveness in preventing physical abuse recurrences have many limitations. The current systematic review aims at (1) providing a summary of evidence on the effectiveness of behavioral/cognitive-behavioral PPs in preventing physical re-abuse; (2) extending previous reviews by including reduction of child maltreatment recurrence as the main outcome but also focusing on the effect of PPs on maltreatment risk, parent and child psychopathology, and parent-child relationship; and (3) including only RCT with at least one follow-up. A PRISMA-compliant systematic review was performed in the EBSCOhost and PUBMED databases. In total, 93 articles were identified, of which 8 were included in the review. Among them, three reported a significant reduction in recidivism rates and maltreatment risk, and five improvements in parent-child relationships. Although limitations arise from methodological heterogeneity across studies, there is some evidence that some brief and manualized cognitive behavioral PPs can reduce the recurrence of child physical maltreatment and improve parent-child relationships. More studies are needed to give further support to PP effectiveness in protecting children from recurrent maltreatment

The development of perceived maternal hostile, aggressive conflict from adolescence to early adulthood: Antecedents and outcomes

Abstract The goal of this study was to investigate the development of mothereadolescent hostile aggressive conflict (MHAC) from late adolescence to young adulthood. The role of child' depressive and delinquency problems and family characteristics, as well as the relation of level and change in MHAC to adolescents' delinquency and depression in early adulthood will be investigated. From the Genzano Longitudinal study 385 adolescents (51% males) participated in this study and completed self report measures. Latent growth curve modeling, separately by gender, indicated that the overall level MHAC exhibited a modest decline over time. For both males and females, depressive problems were associated to higher initial levels of MHAC and early maternal age predicted less decline of MHAC. Starting levels of MHAC were associated with Delinquency in males and with Depression in females, while the growth of MHAC was associated to delinquency in males and females and to depression in males

The descriptive epidemiology of DSM-IV Adult ADHD in the World Health Organization World Mental Health Surveys

We previously reported on the cross-national epidemiology of ADHD from the first 10 countries in the WHO World Mental Health (WMH) Surveys. The current report expands those previous findings to the 20 nationally or regionally representative WMH surveys that have now collected data on adult ADHD. The Composite International Diagnostic Interview (CIDI) was administered to 26,744 respondents in these surveys in high-, upper-middle-, and low-/lower-middle-income countries (68.5% mean response rate). Current DSM-IV/CIDI adult ADHD prevalence averaged 2.8% across surveys and was higher in high (3.6%)- and upper-middle (3.0%)- than low-/lower-middle (1.4%)-income countries. Conditional prevalence of current ADHD averaged 57.0% among childhood cases and 41.1% among childhood subthreshold cases. Adult ADHD was significantly related to being male, previously married, and low education. Adult ADHD was highly comorbid with DSM-IV/CIDI anxiety, mood, behavior, and substance disorders and significantly associated with role impairments (days out of role, impaired cognition, and social interactions) when controlling for comorbidities. Treatment seeking was low in all countries and targeted largely to comorbid conditions rather than to ADHD. These results show that adult ADHD is prevalent, seriously impairing, and highly comorbid but vastly under-recognized and undertreated across countries and cultures

The Mediation of Care and Overprotection between Parent-Adolescent Conflicts and Adolescents’ Psychological Difficulties during the COVID-19 Pandemic: Which Role for Fathers?

Background: There is evidence of a significant raise in youths’ emotional and behavioral difficulties during the pandemic. Only a few studies have addressed parent-adolescent conflict, and none investigated the possible mediating effect of parenting in the association between conflicts with parents and adolescents’ symptoms. This study aimed at investigating youths’ psychological symptoms during the pandemic, focusing on the predicting effect of parent-adolescent conflict. The mediating role of care and overprotection was also explored, considering whether adolescent gender moderated this mediation. Methods: 195 adolescents aged 14–18 years participated in an online longitudinal study. Perceived conflict with parents and parenting dimensions (Parental Bonding Instrument; PBI) were assessed at baseline (2021). Self-reported psychological difficulties (Strengths and Difficulties Questionnaire; SDQ) were collected at baseline and after one year (2022). Results: A significantly severer symptomatology was found in adolescents having a conflictual relationship with one or both parents. Major conflicts with parents correlated with lower care and greater overprotection in mothers and fathers. However, parental overprotection and maternal care were not mediators of the relationship between conflict and youths\u27 difficulties. The only exception was represented by paternal care that fully mediated this relationship in both adolescent males and females. Conclusions: Although further investigations are needed to overcome limitations due to the small sample, findings extend our insight into the impact of parent-adolescent conflict, highlighting the role of fathers’ care and the need to maximize their involvement in clinical interventions

Minori stranieri vittime di abuso: quale ruolo per il pediatra?

Il panorama degli abusi che coinvolgono i minori stranieri presenti in Italia è sempre più diversificato e significativo. Nuovi sono i bisogni che si presentano al mondo dell'assistenza e della cura. In particolare i pediatri sono chiamati ad attrezzarsi con nuove conoscenze e nuovi strumenti per relazionarsi ed operare nelle situazioni di difficoltà, disagio e abuso che vedono vittima bambini e adolescenti stranieri. Il capitolo si sofferma sugli specifici fattori di rischio all'abuso nei casi di infanzia straniera

IL TERREMOTO DELL’EMILIA ROMAGNA DEL 2012: PREVALENZA E PERSISTENZA DEL DISTURBO POST-TRAUMATICO DA STRESS NEI BAMBINI E NEGLI ADOLESCENTI

Il Disturbo Post Traumatico da Stress (PTSD) è uno dei disturbi che più frequentemente si manifesta nei bambini e negli adolescenti a seguito di disastri naturali come i terremoti, con percentuali che, secondo gli studi, oscillano tra il 5 e il 60% dei soggetti esposti. La maggior parte dei casi va incontro a una remissione spontanea entro 12 mesi, tuttavia in circa 1/3 dei soggetti questo disturbo progredisce verso un decorso cronico, con potenziali serie conseguenze a medio e lungo termine associate, tra l’altro, a gravi disturbi del sonno e ad abuso di sostanze. Una indagine epidemiologica di tipo cross-sectional, approvata dal comitato etico provinciale, è stata condotta nella provincia di Modena nel periodo Maggio 2013-Maggio 2014 con l’obiettivo di riconoscere i potenziali casi di PTSD di tipo cronico (con sintomi manifesti a più di un anno dall’episodio stressante) in bambini e adolescenti residenti nella zona del cratere sismico e di identificare i potenziali fattori di protezione e di rischio di natura sociale, familiare e demografica associati con l’insorgenza e la cronicizzazione di tale disturbo

How to Train Professionals to Effectively Manage Child Abuse Cases? The Case-Example of a University-Based and Multidisciplinary Training Program in Italy

Despite the increasing number of child psychological, physical and sexual abuse cases, and the subsequentneed for interagency interventions, professional knowledge about the dynamics, nature, strengths and difficultiesof the integrated response to child abuse is not universal. In addition to this, training programsfor the delivery of a multidisciplinary approach to child abuse cases has always received little attention.The purpose of this chapter is to describe the postgraduate training course \u201cAssessment and treatmentapproach when handling child abuse cases and paedophilia\u201d, developed by the University of Modena andReggio Emilia (Italy), as an example of a university based and multidisciplinary training to child abuseprofessionals. This program is aimed at assisting graduated communities\u2019 professionals - such as childpsychiatrists, psychologists, social workers, educators, law enforcement officers, judges and lawyers - todevelop evidence based strategies to respond to child abuse. First the training program will be presented,describing contents and methods used to facilitate critical reflection and analysis of practice/policy: lectures,case studies, work-groups and team-building, web-based and experiential learning. Furthermore, theimpact on trainee knowledge, attitudes, and behaviors will be described and discussed on the basis of theexisting literature. Barriers to multidisciplinary work such as work style and communication differencesamong professions, attitudes and behaviors toward children, will be also critically discussed

Impact, psychological sequelae and management of trauma affecting children and adolescents

Purpose of reviewIn this review we examine the most recent literature on theimpact, psychological sequelae and management of traumaaffecting children and adolescents. We focus onconsequences of early traumatic events in childhood,adolescence and adulthood; mediating variables (risk andprotective factors); and intervention strategies and availabletreatments.Recent findingsIncreasingly often, mental health professionals are beingasked to address the needs of children and adolescentswho have been exposed to traumatic events, either asindividuals (e.g. sexual and physical abuse, road trafficaccidents) or in groups (e.g. war, terrorism, naturaldisasters). Studies on a wide range of age groups,populations and types of trauma revealed that traumatizedchildren and adolescents are at high risk for developing arange of differing behavioural, psychological andneurobiological problems. Social support may have aprotective effect on the relationship between exposure totraumatic events and psychosocial symptoms.SummarySeveral recent studies analyze a wide range of earlytraumatic events that may be directly or indirectlyexperienced (including exposure through the mass media).These studies raise many fundamental questions about theimpact such events may have on youths, for example aboutvalidity of current diagnostic criteria for post-traumaticstress disorder, comorbidity with anxiety, depressivedisorders and childhood traumatic grief symptoms.Vulnerability and protective factors, mainly gender, age andsocial support are considered. A common problem inresearch into the impact of trauma on children is thepresence of many limitations; studies are oftenretrospective and use self-report questionnaires, and theresults may not be generalizable (i.e. they are trauma orpopulation specific). There is a lack of well designedstudies, addressing in particular treatments for posttraumaticsymptoms in children and adolescents.Keywordsadolescents, children, post-traumatic stress disorder,psychological traum

Cooperation with Teachers as a Mediator of the Relationship between Family Conflict and Children’s Psychological Difficulties

Parent–child conflict can have a series of negative consequences concerning youth emotional and behavioral development. The link between family conflict and children’s externalizing symptoms is well established, whereas the association with internalizing symptoms is less explored. Within the school context, children are engaged in other meaningful relationships (i.e., with teachers and peers) which contribute to their growth. This cross-sectional study aimed at understanding whether a cooperative behavior with the teachers is able to mediate the association between parent–child conflict and children’s psychopathological symptoms. We recruited 319 (150 boys) school-aged children (M = 11.3 years; SD = 1.8 years) and their parents and teachers. Children self-reported on their internalizing symptoms, whereas parents completed a questionnaire concerning their relationship with the child, and teachers rated children’s behavior and internalizing/externalizing symptoms. Analyses conducted through Hayes’ PROCESS tool showed that cooperation with the teacher partially mediated the association between parent–child conflict and child-reported depressive symptoms. Notably, cooperative behavior fully mediated the link between parent–child conflict and children’s internalizing and externalizing symptoms reported by teachers. Difficulties exhibited at school partly derive from a conflictual home environment. Our findings showed that such problems can be reduced thanks to a cooperative relationship with the teacher

Prevalence and risk factors of chronic Post-Traumatic Stress Disorder in children and adolescents after the 2012 earthquake affecting the province of Modena (Northern Italy).

Introduction: Post-traumatic stress disorder (PTSD) is the most frequent psychological disorder occurring after natural disasters. Some cases have a chronic, unremitting course causing long term health impacts and relevant social costs. On May 2012, two earthquakes of high Richter magnitude hit Modena (Italy), causing 27 deaths, several hundred of injured citizen and more than 15000 homeless. The aim of this study was to investigate the prevalence of chronic PTSD in children and adolescents, two extremely sensitive subpopulations, and to identify individual and social predictive risk and protective factors Methods: A cross-sectional study approved by Ethical Committee was conducted. Subjects aged 9-14, providing a written informed consent, were recruited from local schools, randomly selected from the earthquake area (EA) and an extra-earthquake area (EEA), with similar demographic and geographic characteristics. The UCLA-PTSD Index for DSM-IV was used to assess PTSD in students; risk/protective factors were investigated using a traumatic exposure checklist and the Strengths and Difficulties Questionnaire. Parental psychopathology was assessed by Symptom Checklist-90-R. Results: 683 students (2% of residents) and 1161 parents were enrolled. Overall, 9 subjects (1.3%) showed chronic PTSD symptoms. Most (8) were living in EA. The risk of suffering from PTSD symptoms was higher in girls, older students and subjects most directly affected by earthquake. Distressing factors no earthquake-related appeared predictive of distress as well. Further, psychopathological symptoms in parents were significantly associated with high PTSD scores in children. Conclusions: PTSD prevalence appeared lower than observed in similar studies. However, anxiety and depressive symptoms were widespread and correlate with several predictive factors. We hope that our findings will help planning future preventive and supportive effective public health interventions in similar distressing situations