Avoidant/Restrictive Food Intake Disorder. A longitudinal study of malnutrition and psychopathological risk factors from 2 to 11 years of age

Aim: To evaluate different types and degrees of malnutrition over time in a sample of children diagnosed with Infantile Anorexia (IA), based on the DC:0-3R criteria, and recently defined by DSM-5 as the first subtype of Avoidant/Restrictive Food Intake Disorder (ARFID), and to investigate the relationship between children’s severity of malnutrition and emotional/behavioral development, and mothers’ long-term psychopathological symptoms. Methods: A total of 113 children (58 boys, 55 girls), originally diagnosed with IA, and their mothers, were evaluated at four assessment points at the children’s mean age of 2, 5, 7, and 11 years. Several measures were used to assess the children’s growth and level of malnutrition, mothers’ psychopathological symptoms and eating attitudes, as well as their children’s emotional/behavioral functioning. Results: A steady improvement in the severity of malnutrition over time emerged, but 73% of children still had ongoing mild to moderate to severe malnutrition at 11 years of age. Moreover, the children showed increasing internalizing and externalizing emotional/behavioral problems, and their mothers’ psychopathological symptoms and eating problems worsened as well over time. At 11 years of age, the girls’ emotional/behavioral problems and their mothers’ psychopathology and disturbed eating attitudes were more severe than that of the boys and their mothers. Finally, during the last assessment, significant associations between the mothers’ psychopathology and disturbed eating attitudes, the severity of the children’s malnutrition, and their emotional/behavioral problems emerged. Discussion: Our longitudinal study points out that the developmental course of children, originally diagnosed with IA and who received limited psychosocial treatment, is characterized by an enduring risk of malnutrition and increasing psychopathological symptoms in both, the children and their mothers, up to the sensitive period of pre-pubert

Mother–Infant and Extra-dyadic Interactions with a New Social Partner: Developmental Trajectories of Early Social Abilities during Play

Mother–infant interactions during feeding and play are pivotal experiences in the development of infants’ early social abilities (Stern, 1985, 1995; Biringen, 2000). Stern indicated distinctive characteristics of mother–infant interactions, respectively, during feeding and play, suggesting to evaluate both to better describe the complexity of such early affective and social experiences (Stern, 1996). Moreover, during the first years of life, infants acquire cognitive and social skills that allow them to interact with new social partners in extra-dyadic interactions. However, the relations between mother–child interactions and infants’ social skills in extra-dyadic interactions are still unknown. We investigated longitudinally the relations between mother–child interactions during feeding and play and child’s pre-verbal communicative abilities in extra-dyadic interactions during play. 20 dyads were evaluated at T1 (infants aged between 9–22 months) and 6 months later, at T2. The interdyadic differences in mother–infant interactions during feeding and play were evaluated, respectively, with the “Feeding Scale” (Chatoor et al., 1997) and with the “Play Scale” (Chatoor, 2006) and the socio-communicative abilities of children with a new social partner during play were evaluated with the “Early Social Communication Scales” (Mundy et al., 2003). We distinguished the dyads into two categories: dyads with functional interactions (high dyadic reciprocity, low dyadic conflict) and dyads with dysfunctional interactions (lower dyadic reciprocity, higher dyadic conflict). At T1, infants belonging to dyads with dysfunctional interactions were significantly lower in “Initiating Joint Attention” and in “Responding to Joint Attention” in interaction with a new social partner compared to the infants belonging to dyads with functional interactions. At T2, infants belonging to dyads with dysfunctional interactions were significantly lower in “Initiating Social Interactions” with a new social partner compared to the infants belonging to dyads with functional interactions. There were significant correlations between the quality of mother–infant interactions during feeding and infants’ social abilities in interaction with a stranger both at T1 and at T2. This study showed a stable relation over time between mother–child interactions and child’s social communicative skills in extra-dyadic interactions

Risk and Protective Factors Associated with Student Distress and School Dropout: A Comparison between the Perspectives of Preadolescents, Parents, and Teachers

This study investigates the principal risk and protective factors associated with student distress and school dropout in a group of preadolescents, through a qualitative and quantitative comparison between the perspectives of students, parents, and teachers. We administered a questionnaire to evaluate student distress and school dropout in a middle school (student's age range 13-15 years). We afterwards analyzed the responses of students at risk of school dropout. We also administered a semi-structured interview with their parents and their teachers. The results indicated significant levels of school distress in students (Collective Distress > 8.75) and a problematic relationship between parents and students (22.42%). We also found a problematic relationship between teachers and students (24.39%). The main protective factor of student distress and school drop-out indicated by the students was a more sensitive and supportive relationship with both parents and teachers. On the contrary, parents and teachers indicated as possible causes of school distress and drop-out the intrinsic students' motivation or other external factors associated with the community. The results of our study highlight the importance to apply a multidimensional and transactional psycho-educational model, in which the relationship between the students and their caretaker plays a major role

Infantile anorexia and co-parenting: A pilot study on mother-father-child triadic interactions during feeding and play

Infantile Anorexia (IA), defined by the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood Revised (DC: 0-3R, Zero To Three, 2005), occurs when the child (a) refuses to eat adequate amounts of food for at least 1 month, and shows growth deficiency, (b) does not communicate hunger and lacks interest in food, and (c) the child\u2019s food refusal does not follow a traumatic event and is not due to an underlying medical illness. IA usually emerges during the transition to self-feeding, when the child issues of autonomy are played out daily in the feeding situation. Studies evidence that the feeding interactions between children with IA and their mothers are characterized by low reciprocity, greater interactional conflict and negative affects (Chatoor et al., 2000; Ammaniti et al., 2010, 2012). Moreover, these studies pointed out that maternal depression and eating disorders are frequently associated with IA (Cooper et al., 2004; Ammaniti et al., 2010; Lucarelli et al., 2013). To date, research has focused almost exclusively on the mother\u2013child dyad, while fathers\u2019 involvement, co-parental and family interactions are poorly studied. The current study is a pilot research that investigated mother\u2013father\u2013child triadic interactions, during feeding and play, in families with children diagnosed with IA, in comparison to families with normally developing children. Until now, at the study participated N D 10 families (five with a child with IA diagnosis and five with lack of child\u2019s IA diagnosis, matched for child\u2019s age and gender). The parents\u2013child triadic interactions were assessed in feeding and play contexts using the Lausanne Trilogue Play (Fivaz-Depeursinge and Corboz-Warnery, 1999), adapted to observe father-mother-infant primary triangle in the feeding context, compared to the play context (Lucarelli et al., 2012). Families of the IA-group showed difficulties in expressing and sharing pleasure and positive affects, and in structuring a predictable and flexible context. Children showed little autonomy and difficulty in being actively engaged and tune with parents. Dysfunctional family interactions are a critical issue for IA that affects co-parental and family subsystems, stressing the importance of an articulated diagnostic assessment in order to target effective treatment approaches

Children with autism spectrum disorders and severe visual impairments: Some general principles for intervention according to the perspective of clinical psychology of disability

In the last decades, an increasing number of researchers addressed the relationship between autism spectrum disorders (ASD) and severe visual impairment (SVI) (like blindness or very low visual acuity) and nowadays autism could be considered one of the most reported coexisting developmental disorders in children with blindness or other severe visual impairment. As ASD and SVI' signs and symptoms affect functioning and quality of life and different domains of functioning of children with this comorbidity, it is very important to support individuals and their families as soon as possible in the cycle of life and to promote specific interventions aimed to promote developmental potential of everyone with both ASD and VI, based on the unique balance between strengths, needs and abilities of everyone. Children and individuals with SVI and ASD and SVI are a very heterogeneous group, both about the areas of social interaction, communication, and behaviour, as well as about visual abilities and about all the other aspects of their neuropsychological and functional profiles that are influenced by their visual impairments itself, their ASD itself and the combination of them. In this paper, we aim to discuss some general principles useful to design and to develop specific interventions and to promote inclusion of children with ASD and SVI

Perinatal Parenting Stress, Anxiety, and Depression Outcomes in First-Time Mothers and Fathers: A 3- to 6-Months Postpartum Follow-Up Study

Objective: Although there is an established link between parenting stress, postnatal depression, and anxiety, no study has yet investigated this link in first-time parental couples. The specific aims of this study were 1) to investigate whether there were any differences between first-time fathers’ and mothers’ postnatal parenting stress, anxiety, and depression symptoms and to see their evolution between three and 6 months after their child’s birth; and 2) to explore how each parent’s parenting stress and anxiety levels and the anxiety levels and depressive symptoms of their partners contributed to parental postnatal depression. Method: The sample included 362 parents (181 couples; mothers’ MAge = 35.03, SD = 4.7; fathers’ MAge = 37.9, SD = 5.6) of healthy babies. At three (T1) and 6 months (T2) postpartum, both parents filled out, in a counterbalanced order, the Parenting Stress Index-Short Form, the Edinburgh Postnatal Depression Scale, and the State- Trait Anxiety Inventory. Results: The analyses showed that compared to fathers, mothers reported higher scores on postpartum anxiety, depression, and parenting stress. The scores for all measures for both mothers and fathers decreased from T1 to T2. However, a path analysis suggested that the persistence of both maternal and paternal postnatal depression was directly influenced by the parent’s own levels of anxiety and parenting stress and by the presence of depression in his/her partner. Discussion: This study highlights the relevant impact and effects of both maternal and paternal stress, anxiety, and depression symptoms during the transition to parenthood. Therefore, to provide efficacious, targeted, early interventions, perinatal screening should be directed at both parents