Somatisation and functional impairment in adolescents: longitudinal link with mothers' reactions

Adolescents' somatisation (i.e., the psychological tendency to experience and report multiple physical complaints for which no definite medical cause can be found; SOM) and functional impairment (i.e., all bothersome aftermath of somatisation; FI) were studied in relation to mothers' protection, encouraging/monitoring, and minimisation of physical functional complaints. Besides main effects, interaction effects with other child and parenting characteristics were examined. A total of 990 adolescents and their mothers filled out questionnaires when the adolescents were respectively 12-13 (T1) and 13-14 (T2) years old. At T1, there was a significant relation between mothers' higher amounts of minimisation and adolescents' higher levels of SOM. Further, the link between mothers' higher levels of T1 minimisation and adolescents' higher amounts of T1 FI was significant, but not for adolescents with high levels of depressive mood. Longitudinal analyses revealed that mothers' reactions did not significantly predict adolescents' SOM/FI, nor did adolescents' SOM/FI significantly predict mothers' reactions. Practical implications are discussed

The association between parenting behavior and somatization in adolescents explained by physiological responses in adolescents

Introduction: This study adds to the knowledge on somatization in adolescents by exploring its relation with parenting behavior and the mediating/moderating role of physiological responses in adolescents to parenting behavior. Method: Eighteen adolescents with high and 18 adolescents with low somatization scores and their mothers completed a discussion task, from which observed parenting behavior scores were derived. Skin conductance in adolescents was measured before and during the discussion. Results: For adolescents with high levels of physiological responses, unadaptive parenting was related to a higher chance of high somatization scores. For low physiologically responsive adolescents, the relation between parenting behavior and somatization was not significant. Conclusion: Parenting behavior is not univocally related to somatization in adolescents, but the association depends on physiological responses in adolescents. (C) 2014 Elsevier B.V. All rights reserved

The relation between parenting stress and adolescents' somatisation trajectories: a growth mixture analysis

Objective: The impact of somatisation in adolescence is substantial. Knowledge on (predictors of) individual-level development of somatisation is necessary to develop tailored treatment. The current study assessed individual-level development of somatisation by means of latent mixed modelling. Parenting stress was included as a predictor of somatisation trajectory membership and within-trajectory variation. Methods: A total of 1499 adolescents and one of their parents (mostly the mother) agreed to participate. Questionnaires were administered when the adolescents were respectively 12-13 (T1), 13-14 (T2), and 14-15 (T3) years old. Adolescents reported on their somatisation, parents on their parenting stress. Results: Four individual somatisation trajectories were found: increased, long-term low, long-term high, and decreased. Higher early parenting stress (T1) significantly predicted less favourable trajectory membership (increased and long-term high). The relation between later parenting stress (T2 and T3) and somatisation depended on trajectory membership. For adolescents in the long-term high and decreased somatisation trajectories, lower T2 and T3 parenting stress was related to higher somatisation, while for adolescents in the long-term low and increased trajectories, higher T2 and T3 parenting stress was related to higher somatisation. Conclusions: The results support a general recommendation to prevent the onset of high levels of parenting stress. In addition, for families in which high levels of parenting stress already exist, clinicians should be aware of natural fluctuations in parenting stress, its associated features (e.g., aspects of overall care, like looking for professional help) and of the consequences this might have for the adolescent

Home-visiting interventions for families with complex and multiple problems:A systematic review and meta-analysis of out-of-home placement and child outcomes

Children growing up in families experiencing complex and multiple problems (FECMP) are at an increased risk of developing problems in multiple areas of life. A wide array of home-visiting interventions has been developed to address the complex care needs of these families. The aim of this study is to investigate out-of-home placement rates and child outcomes of these home-visiting interventions. A systematic review and meta-analysis was conducted using five scientific databases (PsycInfo, ERIC, SocIndex, MedLine, & Picarta). The systematic search of these databases yielded 8,377 hits. Forty-two publications reporting on 50 studies were included in the review. A random-effects survival curve meta-analysis model was estimated for out-of-home placement and random-effects meta-analysis models were estimated for children's behavioral problems and stressful experiences. Out-of-home placement increased from 7.5% at case closure to 24.3% one year after case closure. On average there was a moderate decrease in emotional and behavioral problems (d = 0.50) and stressful experiences (d = 0.50) during intervention, but considerable problems remained after case closure. More research is needed to investigate family and service characteristics that may explain heterogeneity in outcomes. Furthermore, there is a need to adopt a broader perspective in evaluations of home-visiting services by including outcomes related to the skills, development, and wellbeing of children

Direct and indirect relationships between parental personality and externalising behaviour:The role of negative parenting

Although the impact of parent characteristics and parenting practices on the development of behavioural problems in childhood is often recognised, only a few research programmes have assessed the unique contributions of negative parenting as well as the parent personality characteristics in the same study. Using the Five Factor Model, we examined the extent to which mothers' and father's personality characteristics were related to parenting and children's externalising behaviour in a proportional stratified sample of 599 nonclinical elementary school-aged children. Path analysis indicated that negative parenting practices and parents personality characteristics operate together to predict children's externalising problem behaviour. Consistent with past research (Patterson & Dishion, 1988; Patterson, Reid, & Dishion, 1992), parent personality traits were indirectly related to children's externalising problem behaviour. Their effect was mediated by negative parenting practices. But in addition and in contrast to Patterson's theoretical model, parent personality traits also contributed directly to children's externalising problem behaviour. For the mother data, as well as for the father data, the personality dimensions Emotional Stability and Conscientiousness were negatively and Autonomy was positively related to children's externalising problem behaviours

Determinants and Outcomes of Social Climate in Therapeutic Residential Youth Care: A Systematic Review

Background: Previous studies on effectiveness of therapeutic residential youth care (TRC) have indicated that, compared to short-term effects, long-term effects are less convincing. Moreover, there is limited evidence on how TRC achieves treatment goals: TRC remains too much of a “black box”. To gain durable treatment results we need to know more about how results are achieved, rather than investigating the achieved results itself. One of the factors associated with this process of change is the social climate within TRC institutions. Up until now, no literature reviews about how social climate is affect by institution and youth characteristics, and how social climate affects outcomes has been performed. Objective: To provide an overview of the literature on associations between determinants and social climate and between social climate and outcomes in TRC. Method: We searched multiple databases with a predetermined set of search criteria in the years 1990 and March 2017. We identified 8408 studies and reduced the final sample to 36 studies. Most studies were empirical assessments with a correlational design and were conducted in Western countries. Results: Effect sizes for the studies ranged from small to large and varied between and within studies. Most associations were found between social climate and positive outcomes. The most mentioned social climate constructs were: an open climate, support, and autonomy. Conclusions: The results are challenging to summarize due to variations in the concepts and operationalizations of social climate. The organizational culture must support a social climate which is supportive, structured and caring, and provide youth with an environment to grow. A positive social climate must constantly be evaluated and recreated based on combining the perspectives of residents, staff and external perspectives

Shopping centre siting and modal choice in Belgium: a destination based analysis

Although modal split is only one of the elements considered in decision-making on new shopping malls, it remarkably often arises in arguments of both proponents and opponents. Today, this is also the case in the debate on the planned development of three major shopping malls in Belgium. Inspired by such debates, the present study focuses on the impact of the location of shopping centres on the travel mode choice of the customers. Our hypothesis is that destination-based variables such as embeddedness in the urban fabric, accessibility and mall size influence the travel mode choice of the visitors. Based on modal split data and location characteristics of seventeen existing shopping centres in Belgium, we develop a model for a more sustainable siting policy. The results show a major influence of the location of the shopping centre in relation to the urban form, and of the size of the mall. Shopping centres that are part of a dense urban fabric, measured through population density, are less car dependent. Smaller sites will attract more cyclists and pedestrians. Interestingly, our results deviate significantly from the figures that have been put forward in public debates on the shopping mall issue in Belgium

‘Some anti-malarials are too strong for your body, they will harm you.’ Socio-cultural factors influencing pregnant women’s adherence to anti-malarial treatment in rural Gambia

Background Despite declining prevalence of malaria in The Gambia, non-adherence to anti-malarial treatment still remains a challenge to control efforts. There is limited evidence on the socio-cultural factors that influence adherence to anti-malarial treatment in pregnancy. This study explored perceptions of malaria in pregnancy and their influence on adherence to anti-malarial treatment in a rural area of The Gambia. Methods An exploratory ethnographic study was conducted ancillary to a cluster-randomized trial on scheduled screening and treatment of malaria in pregnancy at village level in the Upper River Region of The Gambia from June to August 2014. Qualitative data were collected through interviewing and participant observation. Analysis was concurrent to data collection and carried out using NVivo 10. Results Although women had good bio-medical knowledge of malaria in pregnancy, adherence to anti-malarial treatment was generally perceived to be low. Pregnant women were perceived to discontinue the provided anti-malarial treatment after one or 2 days mainly due to non-recognition of symptoms, perceived ineffectiveness of the anti-malarial treatment, the perceived risks of medication and advice received from mothers-in-law. Conclusion Improving women’s knowledge of malaria in pregnancy is not sufficient to assure adherence to anti-malarial treatment. Addressing structural barriers such as unclear health workers’ messages about medication dosage, illness recognition, side effects of the medication and the integration of relatives, especially the mothers-in-law, in community-based programmes are additionally required