Transdiagnostic Associations Among Parental Causal Locus Attributions, Child Behavior and Psychosocial Treatment Outcomes: A Systematic Review

[Parental Distress of Patients Who Refuse to Eat: Toward a Deeper Understanding and Greater Support for Parents of Children Suffering from an Eating Disorder]

Parental Distress of Patients Who Refuse to Eat: Toward a Deeper Understanding and Greater Support for Parents of Children Suffering from an Eating Disorder Abstract: Many parents experience their role as parents of a daughter/son with anorexia nervosa as very troublesome and demanding. In several departments of child and adolescen psychiatry in Germany, the contact between parents and adolescent patients with anorexia nervosa is still restricted because parents are often judged responsible for the eating disorder of their child - or at least seen as troublemakers during their child's inpatient treatment. Parents blame themselves for the development of anorexia nervosa, and in comparison to other mental disorders of adolescence, they experience even more guilt and shame. Many of them suffer from psychiatric disorders themselves (not a few from eating disorders), which reinforce feelings of helplessness and shame. Several parents have partnership problems and must take off work to support their child, which often leads to financial losses for the whole family. They complain that they have insufficient support and feel misunderstood by health professionals whom they wish to have a profound knowledge of the disorder and who would trust and understand the carers. This article provides several recommendations to improve the relationship between parents and therapists: termination of contact restrictions, detailed information for the parents about possible biological and psychological causes of eating disorders, including psychoeducational groups and involvement in treatment, not only through therapeutic conversations but also through practical exercises such as meal support. An innovative approach is home treatment, which offers the chance to integrate parents into treatment and thus improve their skills in handling their daughter´s/son´s illness. We should be aware that parents are the most important resource to help young patients with debilitating eating disorders.

Parents' Information Needs in Relation to Adolescent Self-Harm: Perspectives of Parents and Professionals

OBJECTIVE

Discovering that an adolescent is self-harming is extremely distressing for parents and this distress can be compounded by lack of easily accessible and well targeted information on what they can do to help. Some research has even suggested that parental distress can be an obstacle to seeking professional help. This paper describes two studies that sought to identify the information needs of parents in the immediacy of discovering self-harm and in ongoing efforts to support their child.

METHOD

Study 1: on-line survey of 128 parents who had experienced their child's self-harm; study 2: two-round Delphi method with 29 professionals who provide therapeutic interventions to adolescents who self-harm. The primary aim of both studies was to elicit views on parents' information needs in relation to supporting adolescents who self-harm.

RESULTS

There was a high level of agreement between parents and professionals on the needs for information on topics such as: communication, psychoeducation, managing emotional responses, parenting strategies and interventions. The professionals also emphasized the need for parents to practice self-care and the value of teaching alternative coping strategies to adolescents. Parents placed greater emphasis than professionals on the need for information on future therapeutic needs.

CONCLUSION

Despite the agreement between parents and professionals on most of the information needed, there were sufficient differences in emphasis to confirm the importance of consulting with both groups. The findings can be used to develop information sources that are specifically tailored to the needs of parents at all stages of adolescent self-harm.

Child Ability and Parental Attributions: Development and Validation of the Reasons for Children's Behavior Scale

Parent attributions for children's behavior affect parenting practices and emotional reactions. The current study aimed to create a new measure of parental attributions, called the Reasons for Children's Behavior (RCB), to capture how parents take developmental ability into account when making attributions for specific behaviors. A 224-item survey was completed by 836 participants, including original items and established parent attribution and parenting construct scales. Exploratory factor analyses and item-response theory analyses were utilized to develop the RCB, which includes 30 items comprising seven subscales. The RCB demonstrated an extremely stable factor structure, high levels of internal consistency across 25 demographic groups, reasonable test-retest correlations across 2 weeks, appropriate convergent and discriminant validity, and unique predictive validity (i.e., incremental validity). The RCB offers researchers and clinicians a novel tool to better understand how parent attributions for child behavior impact parenting and larger family dynamics.

Associations between parental dispositional attributions, dismissing and coaching reactions to children's emotions, and children's problem behaviour moderated by child gender

This study examined whether parents' attribution of their child's emotions (internalizing, externalizing) to dispositional causes is associated with children's problem behaviour (internalizing, externalizing). The mediating roles of parents' emotion-dismissing and -coaching reactions and the moderating role of child's gender was also examined. Participants were 241 US parents with a child (43% girls) between the ages of 5 and 7. Parents were presented with vignettes in which a gender-neutral child displayed internalizing and externalizing emotions and were asked to imagine their own child in the vignettes. Subsequently, parents indicated whether they attributed the child's emotion to dispositional causes and the likelihood of reacting in an emotion-dismissing and -coaching way in each situation. Child problem behaviour was measured using the CBCL. Results show that parental dispositional attributions were associated with child internalizing and externalizing problems, and this association was consistently mediated by emotion-dismissing reactions. The association between parental dispositional attributions and emotion-dismissing, as well as its indirect effect on child internalizing problems, was stronger for boys than for girls, whereas the indirect effect via emotion-coaching was stronger for girls than for boys. Thus, the parental attribution process seems to be different for boys and girls.

Mindfulness, Parental Attributions, and Parenting: the Moderating Role of Child Mental Health

Objectives

Research interest in mindfulness, the capacity for present-oriented, nonjudgmental attention and awareness, and its relation to parenting has been growing in recent years. However, factors facilitating the association between mindfulness and parenting are not yet well understood. In the present study, we examined whether parents’ biased causal thinking about children’s misbehaviors, i.e., parental attributions, may mediate the link between parents’ dispositional mindfulness and parenting. Given that parents of children with clinically elevated mental health difficulties tend to report more biased parental attributions, we further examined whether the proposed mediation may differ across parents of children with and without clinical diagnoses or referrals for mental health difficulties.

Methods

Parents (59.8% mothers) of 8- to 12-year-old children with (n = 157) and without (n = 99) clinical diagnoses or referrals for mental health difficulties participated in online surveys assessing their mindfulness, parental attributions, and negative parenting behaviors.

Results

More mindful parents reported less negative parenting, with the link significantly mediated by less biased parent-directed attributions, but not child-directed attributions. The mediating effect via parent-directed attributions was significantly moderated by the child’s clinical status: the effect was retained only for parents of children with clinical diagnoses or referrals for mental health difficulties. No significant moderation effect emerged for child-directed attributions.

Conclusions

The results provide initial support for the links among parents’ mindfulness, parental attributions, and parenting. The present findings suggest that parental mindfulness may be important for less biased parental attributions, with implications for parenting behaviors at least in the context of children’s mental health disorders.

Parental Attributions in Ethnocultural Minority, Immigrant, and Country of Origin Parents: A Scoping Review and Call for Research

OBJECTIVE

Maladaptive parental attributions for their children's behavior have been linked to poorer parenting skills, heightened child internalizing and externalizing difficulties, and parents' less willingness to engage in treatment. Although most parental attributions research has been focused on White or European-origin parents, attention has recently turned to ethnic and cultural groups that are underrepresented literature. The present scoping review synthesized existing work on parental attributions among ethnocultural minority and immigrant parents in an adopted country and parents residing in their native non-Western country of origin.

METHOD

A systematic search of five databases was conducted for literature published up to and including the last week of December 2020. Title and abstract screening, then full-text screening, identified 18 records for inclusion in the review.

RESULTS

Although descriptive, single-culture studies showed that maladaptive parental attributions were associated with poorer parenting and child outcomes across cultures, studies comparing ethnocultural groups demonstrated differences in parental attributions across groups.

CONCLUSIONS

Despite the rise in and importance of literature on parental attributions, these results point to a limited scope in understanding parental attributions of ethnocultural minority, immigrant, and country of origin parents. Gaps identified in the literature point to promising future research directions, and a call is made for culturally sensitive parental attribution measures.

Impacts of Dual-Income Household Rate on Suicide Mortalities in Japan

To explore impact of enhancing social advancement of females in Japan, this study determined the effects of the dual-income household rate on suicide mortalities disaggregated by attributes of gender, age, and motives between 2009 and 2017 in Japan. This study analysed impact of dual-income household rate, other household-related factors (savings, liabilities and yearly incomes per household, minors and elderly rate per household), and social/employment factors (complete unemployment rate, employment rate, temporary male and female employment rates and certification rate of long-term care insurance) on suicide mortalities disaggregated by attributes of gender, age, and motives using hierarchical linear-regression model. Dual-income household rate was significantly/negatively related to suicide mortality of the working-age female population, but significantly/positively related to that of the elderly female population. Suicide mortalities of the working-age male population and the elderly male population were significantly/positively related to dual-income household rate. Male suicide mortalities caused by family-, health-, economy- and employment-related motives were significantly/positively related to dual-income household rate; however, the dual-income household rate was significantly/positively related to female suicide mortalities caused by family-, health-, economy- and school-related motives, but significantly/negatively related to suicide mortalities caused by romance-related motives. Dual-income households suppress social-isolation and develop economical/psychological independence of females, leading to reduced suicide mortality in working-age females. However, elderly and school-age populations, who are supported by the working-age female, suffer from isolation. Working-age males also suffer from inability to adapt from the traditional concept of work–life and work–family balances to the novel work–family balance concept adapted to dual-income households. These results suggest occurrence of new social/family problems in the 21st century due to vulnerability of traditional Japanese culture and life–working–family balance concepts as well as novel sociofamilial disturbances induced by declining birth rate and ageing population in Japan.