Parent and child psychopathological symptoms: the mediating role of parental emotion dysregulation

Maternal alcohol dependence symptoms, maternal insensitivity to children's distress, and young children's blunted emotional reactivity

Maternal insensitivity to children's emotional distress (e.g., expressions of sadness or fearfulness) is one mechanism through which maternal alcohol dependence may increase children's risk for psychopathology. Although emotion dysregulation is consistently associated with psychopathology, it remains unclear how or why alcohol dependence's effects on caregiving responses to children's distress may impact children's emotion regulation over time, particularly in ways that may engender risks for psychopathology. This study examined longitudinal associations between lifetime maternal alcohol dependence symptoms, mothers' insensitivity to children's emotional distress cues, and children's emotional reactivity among 201 mother-child dyads (Mchild age = 2.14 years; 56% Black; 11% Latino). Structural equation modeling analyses revealed a significant mediational pathway such that maternal alcohol dependence predicted increases in mothers' insensitivity to children's emotional distress across a one-year period (β = .16, p = .013), which subsequently predicted decreases in children's emotional reactivity one year later (β = -.29, p = .009). Results suggest that mothers with alcohol dependence symptoms may struggle to sensitively respond to children's emotional distress, which may prompt children to suppress or hide their emotions as an adaptive, protective strategy. The potential developmental benefits and consequences of early, protective expressive suppression strategies are discussed via developmental psychopathology frameworks.

The Role of Parental and Adolescent Psychosocial Factors in Different Aggression Profiles: A Comparative Approach

Background: This study explores parental dysregulation when associated with adolescents' involvement in street fights with peers. Parental dysregulation, characterized by emotional volatility, impulsivity, and inconsistent discipline, significantly affects adolescent development, influencing their social, emotional, and behavioral functioning. Street fights, which involve physical violence among adolescents in public settings, pose risks to both individuals and the community. This research aims to identify risk factors and underlying mechanisms associated with adolescent street fights, providing insights for targeted interventions and prevention strategies. Aim: The study employs social learning theory to explain how adolescents may model aggressive behaviors observed in dysregulated parents and family systems theory to highlight the role of dysfunctional family dynamics in being associated with aggression. A sample of 292 male adolescents and their parents was assessed using self-report measures. Results: Statistical analyses revealed higher levels of emotional dysregulation, depression, and hostility among parents of adolescents frequently involved in street fights. Conclusions: These findings underscore the need for interventions focusing on improving parental emotional regulation, reducing hostile behaviors, and enhancing family communication to mitigate adolescent aggression. Further research should explore diverse populations and longitudinal data to strengthen these conclusions.

Cognitive-behavioral stress management relieves anxiety, depression, and post-traumatic stress disorder in parents of pediatric acute myeloid leukemia patients: a randomized, controlled study

OBJECTIVES

Cognitive-behavioral stress management (CBSM) is an effective psychological intervention to relieve psychological and symptomatic distress. This study aimed to investigate the effect of CBSM in anxiety, depression, and post-traumatic stress disorder (PTSD) in parents of pediatric acute myeloid leukemia (AML) patients.

METHODS

Totally, 56 pediatric AML patients and 100 parents were randomized into the CBSM group (28 patients and 49 parents) and the normal control (NC) group (28 patients and 51 parents) to receive corresponding interventions for 10 weeks. The questionnaire scores were assessed at month M0, M1, M3, and M6.

RESULTS

In parents of pediatric AML patients, self-rating anxiety scale score at M1 (p = 0.034), M3 (p = 0.010), and M6 (p = 0.003), as well as anxiety at M3 (p = 0.036) and M6 (p = 0.012) were decreased in the CBSM group versus the NC group. Self-rating depression scale score at M3 (p = 0.022) and M6 (p = 0.002), as well as depression at M6 (p = 0.019) were declined in the CBSM group versus the NC group. Symptom checklist-90 (a psychotic status questionnaire) score at M3 (p = 0.031) and M6 (p = 0.019) were declined in the CBSM group versus the NC group. Regarding PTSD, the impact of the events scale-revised score at M3 (p = 0.044) and M6 (p = 0.010) were decreased in the CBSM group versus the NC group. By subgroup analyses CBSM (versus NC) improved all outcomes in parents with anxiety at M0 and depression at M0 (all p < 0.050), but could not affect the outcomes in parents without anxiety or depression at M0 (all p > 0.050).

CONCLUSION

CBSM reduces anxiety, depression, and PTSD in parents of pediatric AML patients.

Associations between parental psychopathology and youth functional emotion regulation brain networks

Parental mental health is associated with children's emotion regulation (ER) and risk for psychopathology. The relationship between parental psychopathology and children's functional ER networks and whether connectivity patterns mediate the relationship between parent and youth psychopathology remains unexplored. Using resting-state functional magnetic resonance imaging data from the Adolescent Brain Cognitive Development Study (N = 4202, mean age = 10.0) and a multilevel approach, we analyzed the relationship between self-reported parental psychopathology and their offsprings' connectivity of four ER networks, as well as associations with self-reported youth psychopathology at a 3-year follow-up. Parental internalizing and total problems were associated with 1) higher connectivity between a subcortical-cortical integrative and ventrolateral prefrontal cortical (PFC) network, 2) lower connectivity between dorsolateral and ventrolateral PFC networks involved in cognitive aspects of ER, and 3) lower connectivity within a subcortical ER network (β = -0.05-0.04). Parental externalizing and total problems were associated with lower connectivity within the integrative network (βext = -0.05; βtot = -0.04). Mediation analyses yielded direct effects of parental to youth psychopathology, but no mediation effect of ER network connectivity. Overall, our results show that ER network connectivity in youth is related to parental psychopathology, yet do not explain intergenerational transmission of psychopathology.

Transgenerational transmission of psychopathology: when are adaptive emotion regulation strategies protective in children?

BACKGROUND

Children of parents with a mental illness (COPMI) have multiple psychological and developmental risks, including an increased lifetime risk of developing a mental illness themselves. Emotion regulation (ER) has been identified as a potential underlying mechanism of the transgenerational transmission of mental disorders. This study compares ER strategies in parents with and without a mental illness and their children. Further, it aims to examine the relationship between parents and children's psychopathology with a focus on the role of parental and child ER.

METHODS

Participants were 96 COPMI (77% female) and 99 children of parents without mental illness (COPWMI, 83% female) aged 4-16 years and their parents. Psychopathology and ER strategies of parents and children were assessed with a series of questionnaires.

RESULTS

Both COPMI and their parents showed significantly more psychopathology and more maladaptive and adaptive ER strategies in comparison with COPWMI and their parents. Parent and child adaptive ER strategies mediated the relationship between the psychopathology of parents and children only when child maladaptive ER strategies were low.

CONCLUSIONS

The findings further our understanding of the processes by which parental psychopathology affects child outcomes. Our findings highlight the importance of implementing preventive programs that specifically target the reduction of maladaptive ER in children to interrupt the transgenerational transmission of psychopathological symptoms.

RSA instability in mothers of preschoolers and adolescents is related to observations of supportive parenting behaviors

Respiratory sinus arrhythmia (RSA; a measure of respiratory modulation of vagal control of heart rate) is a dynamic process. For mothers, RSA functioning has been associated with depressive symptoms and coincides with supportive parenting. However, research has largely focused on RSA suppression (i.e., difference score from rest to stress task). The present study examined depressive symptoms and supportive parenting with RSA instability-a dynamic measure of the magnitude of RSA change across a task. In two samples of mothers (N = 210), one with preschoolers (Study 1: n = 108, Mage = 30.68 years, SD = 6.06, 47.0% Black, 43.0% White) and one with adolescents (Study 2: n = 102, Mage = 35.51, SD = 6.51, 75.2% Black), RSA instability was calculated during an interaction task. In both studies, instrumental supportive parenting behaviors were negatively related to RSA instability. Findings provide preliminary support for RSA instability as an indicator of physiological dysregulation for mothers.

Estimating the Heterogeneous Causal Effects of Parent-Child Relationships among Chinese Children with Oppositional Defiant Symptoms: A Machine Learning Approach

Oppositional defiant symptoms are some of the most common developmental symptoms in children and adolescents with and without oppositional defiant disorder. Research has addressed the close association of the parent-child relationship (PCR) with oppositional defiant symptoms. However, it is necessary to further investigate the underlying mechanism for forming targeted intervention strategies. By using a machine learning-based causal forest (CF) model, we investigated the heterogeneous causal effects of the PCR on oppositional defiant symptoms in children in Chinese elementary schools. Based on the PCR improvement in two consecutive years, 423 children were divided into improved and control groups. The assessment of oppositional defiant symptoms (AODS) in the second year was set as the dependent variable. Additionally, several factors based on the multilevel family model and the baseline AODS in the first year were included as covariates. Consistent with expectations, the CF model showed a significant causal effect between the PCR and oppositional defiant symptoms in the samples. Moreover, the causality exhibited heterogeneity. The causal effect was greater in those children with higher baseline AODS, a worse family atmosphere, and lower emotion regulation abilities in themselves or their parents. Conversely, the parenting style played a positive role in causality. These findings enhance our understanding of how the PCR contributes to the development of oppositional defiant symptoms conditioned by factors from a multilevel family system. The heterogeneous causality in the observation data, established using the machine learning approach, could be helpful in forming personalized family-oriented intervention strategies for children with oppositional defiant symptoms.

Self-regulation facets differentially predict internalizing symptom trajectories from middle childhood to early adolescence: a longitudinal multimethod study

BACKGROUND

Internalizing symptoms are among the most common psychological symptoms in childhood and adolescence, are highly stable and can cause severe impairment. Current research discusses lower capacities of self-regulation (SR) as risk factors for the development of internalizing symptoms. The present study identifies trajectories of internalizing symptoms in the transition phase from middle childhood to adolescence and examines multiple SR facets as predictors of potentially unfavorable trajectories, also in the presence of other established risk factors.

METHODS

The study utilized a community sample of N = 1453 (52.2% female) German children, who provided data at up to three measurement points (t1: 6-11 years, t2: 7-11 years, t3: 9-13 years). Trajectories of internalizing symptoms were based on parents' ratings of the emotional problems scale of the Strengths and Difficulties Questionnaire. SR facets were assessed using multiple methods and informants. Two multinomial regression analyses were conducted to predict class membership by (1) SR facets and gender and (2) SR facets, gender, and other established risk factors (education status, family adversity, peer problems).

RESULTS

Using growth mixture modelling, we identified three trajectory classes with stable low (n = 1200), increasing (n = 124), and early high decreasing internalizing symptoms (n = 129). In the regression analysis controlling for risk factors, membership in the increasing trajectory was significantly predicted by higher emotional reactivity (OR = 2.65, p < .001), higher cognitive flexibility/set-shifting (OR = 1.48, p = .032), and higher family adversity (OR = 1.38, p = .046). Membership in the early high decreasing trajectory was significantly predicted by higher emotional reactivity (OR = 4.15, p < .001), higher inhibitory control (OR = 1.47, p = .045), lower working-memory updating (OR = 0.69, p = .016), lower delay of gratification (OR = 0.75, p = .028), and higher family adversity (OR = 1.63, p = .001).

CONCLUSIONS

SR facets incrementally and differentially predict potentially unfavorable trajectories of internalizing symptoms from age 6 to 13, surpassing the predictive value of gender or education status. Higher emotional reactivity emerged as the most influential factor, which could therefore be addressed in future prevention and intervention efforts.

The effect of internalized stigmatization on care burden in adolescent psychiatric patients and their parents

Introduction

The purpose of this study was to determine the effect of internalized stigma perceived by adolescents with mental disorders and their families, on the burden of care on their families.

Methods

The study was conducted in a descriptive and correlational desing with adolescents and their parents who applied to the child and adolescent psychiatry outpatient clinic between March 1 and June 1, 2022. A total 101 adolescents and 101 parents who met the sampling criteria and agreed to participate in the study. Only 1 parent per adolescent was included in the study.

Results

It was found that the mean age of the adolescents was 15.05  ±  (1.80), 57.4% were female and 56.4% were secondary school graduates, and 26.7% of the adolescents, all of whom were unemployed, were diagnosed with a mood disorder, 50.5% had received outpatient treatment previously, and 22.8% had chronic diseases. It was found that the mean age of the parents who participated in the study was 45.53  ±  (6.48), 77.1% were female and 28.7% were secondary school graduates. Also, 22.8% of the parents had a chronic disease, 28.7% had a chronic disease in their family and 32.7% had another family member in need of care, and 17.0% of the parents had received training on mental disorders previously. It was found that the parents' total means ZBI score was 42.74  ±  (11.92). When the ZBI total scores were examined in terms of sociodemographic variables, no significant differences were found between the groups according to the variables. There was only a weak, positive and significant relationship between the age of the parents and in the present study, it was found that adolescents with mental disorders and their families experienced internalized stigmatization and this stigmatization increased the care burden on parents.

Discussion

Mental health and psychiatric nurses can facilitate this population's access to treatment by planning and implementing psychosocial interventions to reduce the internalized stigma of children and adolescents and their families.

Bowlby's five therapeutic tasks: bringing them up to date for children

Bowlby remained attached to his psychoanalytic roots and conceptualised treatment in terms of one-to-one relationships, albeit acknowledging the need for a family formulation. Bowlby's five therapeutic tasks were never adapted to the current understanding of working with the relationships fostering the development and maintenance of children's attachment strategies. This paper goes through each of Bowlby's five tasks and adapts them to our current understanding of development, with consequences for prioritising family approaches, rather than a secure base alone with a therapist. In doing so I will review the process of achieving security, seeing it as more similar to an allostatic process than a state of homeostasis.

Therapeutic work to enhance parental mentalizing for parents with ACEs to support their children's mental health: A theoretical and clinical review

This review outlines the literature concerning the impact of adverse childhood experiences (ACEs) on parenting, focusing on how childhood trauma in parents might impede the development of adaptive parental mentalizing skills. Non-adaptive parental mentalizing may lead to non-mentalizing cycles between parents and children, which can put the child's mental health at risk. When parents who have endured ACEs have to cope with their children's mental health problems, they may have to deal with a double dose of parental stress related to their own traumatic history and their children's emotional difficulties. This heightened parental stress may further shake the parents' mentalizing skills. In line with this special issue's topic, we propose the promoting and restoring of parental mentalizing as a treatment goal for parents who have endured ACEs and whose children face mental health difficulties. We review the empirical and clinical evidence regarding the benefits of effective parental mentalizing and the availability of techniques to enhance it. We argue that working therapeutically and focusing on supporting and advancing parental mentalizing is an effective and feasible treatment goal with parents who endured ACEs. We demonstrate how we use these interventions through fictional vignettes from our therapeutic work and offer recommendations for clinical work with parents with traumatic histories.

Parent emotional regulation: A meta-analytic review of its association with parenting and child adjustment

We conducted a meta-analytic review of 53 studies published between 2000 and 2020 to quantify associations of parents’ emotion regulation with parenting behavior and children’s emotion regulation and internalizing and externalizing symptoms. Twelve meta-analyses, which included between 4 to 22 effect sizes ( N from 345 to 3609), were conducted to summarize associations of parent emotion regulation with positive or negative parenting behaviors and child outcomes of emotion regulation, difficulties in emotion regulation, internalizing symptoms, or externalizing behavior. Given the range of behavioral parent emotion regulation measures used across studies, effect sizes for parent emotion regulation strategy use ( skill) were analyzed separately from effect sizes for parents’ difficulties with emotion regulation. Summary effect sizes ranged from |.08| to |.28| for relations of parent emotion regulation skill with parenting behaviors and children’s adjustment. Summary effect sizes ranged from |.03| to |.42| for relations of parent emotion regulation difficulties with parenting behaviors and children’s adjustment. In general, parents with better emotion regulation skill or fewer difficulties are higher in positive parenting behaviors and have children with better emotion regulation and fewer internalizing symptoms. Evidence was less clear-cut for child externalizing behaviors. Significant effect size heterogeneity was observed in most analyses, and study characteristics (measures, child age, parent gender, sampling, and region where the study was conducted) were examined as moderators. Measures used, child age, and participant risk status moderated effect size in some analyses.

Schulbasiertes Training für Jugendliche zur Emotionsregulation

Zusammenfassung. Theoretischer Hintergrund: Trainingsprogramme zur Emotionsregulation für Jugendliche sind notwendig, da eine Dysregulation der Emotionen die Entwicklung von psychischen Störungen begünstigen kann. Fragestellung: Ziel dieser systematischen Literaturübersicht ist es, einen Überblick über aktuelle Publikationen zu Trainingsprogrammen von 2015 – 2020 zu geben. Methode: Im Rahmen der Literaturrecherche konnten sechs Publikationen eingeschlossen werden. Ergebnisse: Es zeigten sich positive Effekte bei der Programmdurchführung durch externe Personen, vor allem durch Fachpersonen und keine bis negative Effekte bei der Durchführung durch das Schulpersonal. Ein positiver Einfluss durch die Einbeziehung der Eltern konnte in einem Trainingsprogramm vermutet werden, wobei die Ergebnisse statistisch nicht signifikant waren. Schlussfolgerung: Es zeigt sich die Notwendigkeit weiterer Evaluation von Trainingsprogrammen, welche sich vor allem auch mit dem Einbezug der Bezugspersonen beschäftigen und untersuchen, inwiefern Trainer_inneneffekte auch bei Studien mit einer besseren Vergleichbarkeit vorliegen.

Application of the actor-partner interdependence model in parent-adolescent emotion regulation and depression

BACKGROUND

The family environment is an important context for the development and maintenance of depressive symptoms within families. In this study, we evaluated whether parent and adolescent self-reports of emotion regulation constructs are linked with their own (actor effects) and each other's (partner effects) depressive symptoms.

METHODS

Participants were 123 adolescent-parent dyads, recruited from adolescent inpatient and partial hospitalization programs, who completed self-report assessments of emotion dysregulation and depression.

RESULTS

Using the Actor-Partner Interdependence Model (APIM), results revealed expected actor effects for emotion regulation strategies, but not impulsiveness. A significant partner effect for parents' impulsiveness and adolescents' depressive symptoms was observed, demonstrating the interdependent nature of these characteristics in the sample. Interpretation of APIM model coefficients indicated that greater parent impulsiveness was associated with less adolescent depression symptom severity.

LIMITATIONS

Limitations include a small sample of primarily Caucasian adolescents who were receiving intensive psychiatric services making generalizability more challenging. The sample also consisted of largely mothers which is important to consider given there are known gender differences in rates of depression and sensitivity to interpersonal processes.

CONCLUSIONS

Overall, findings shed light on the nature of these characteristics within the families of depressed adolescents and the role of emotion regulation in the parent-child relationship. Implications of this work and future studies are discussed.

Person-centered profiles of parasympathetic physiology, anxiety symptoms, and depressive symptoms in mothers and fathers of young children

Respiratory sinus arrhythmia (RSA) is a biomarker of mental health, but RSA-symptom relations in parents of young children are understudied. We examined how anxiety symptoms, depressive symptoms, resting RSA, and RSA reactivity during challenging parent-child interactions clustered in a community sample of mothers (N = 126) and fathers (N = 87) of 3-year-olds and whether profiles predicted child emotional and behavioral dysregulation at age 4. Mothers fit four profiles (Typical, Mild Risk, Moderate Risk/Withdrawal, and Moderate Risk/Augmentation), suggesting that RSA reactivity was distinct by predominant symptom type at higher levels of risk: specifically, heightened RSA withdrawal was associated with a higher probability of anxiety symptoms and RSA augmentation was associated with a higher probability of depressive symptoms. Fathers fit three profiles (Typical, Mild Risk, and Moderate Risk) where Moderate Risk was characterized by RSA augmentation and a higher probability of both anxiety and depressive symptoms. Mild risk profiles showed heightened resting RSA for mothers and fathers but no differences in RSA reactivity. Both mild and moderate risk profiles predicted higher child dysregulation 1 year later compared to typical profiles. Findings offer preliminary evidence that parasympathetic physiology covaries with symptoms differently for mothers and fathers and that parental profiles of physiology and symptoms inform children's developmental psychopathology.

[The Emotional Competence of Mothers and the Clinical Quality of Mother-Child Relationship in a Preschool Psychiatric Population]

The Emotional Competence of Mothers and the Clinical Quality of Mother-Child Relationship in a Preschool Psychiatric Population The quality of mother-child interaction and relationship is an essential risk factor for the development of mental disorders at preschool age. We examine maternal emotional competence and maternal level of psychopathology as predictors for the quality of mother-child relationship. At the beginning of their treatment a clinical sample of mother-child-dyads at the Child Psychiatric Family Day Hospital in Münster was assessed concerning the emotional competence of mothers (EKF), the maternal psychopathology (SCL) and the mother-child relationship quality, the latter with three different instruments reflecting the mother's, the child's and the therapist's perspective (PIR-GAS, SKEI, M-PCR). The mothers showed decreased results in the EKF scales emotional regulation, recognition of emotions and in the EKF-overall-score and presented a higher level of maternal psychopathology compared to the normal population. There is a direct relation between emotional regulation and the M-PCR scales affective bond and functional-conflict. Besides the direct influence of the maternal psychopathology, the expected moderator effect of emotional expressiveness and the M-PCR scale functional-conflict, reported by mothers, was apparent. Certain aspects of the emotional competence of mothers and their psychopathology show an influence on mother-child relationship quality. The method and the perspective of assessment are crucial to the results.

Multiple Levels of Family Factors and Oppositional Defiant Disorder Symptoms Among Chinese Children

Family factors are closely associated with child developmental outcomes. This study examined the relationship of oppositional defiant disorder (ODD) symptoms and factors at whole family, dyadic, and individual levels in Chinese children. Participants, who were recruited from 14 primary schools in north, east, and south-west China, included 80 father-child dyads and 169 mother-child dyads. Children in the participating dyads were previously diagnosed with ODD. Results revealed that family cohesion/adaptability was indirectly associated with ODD symptoms via parent-child relationship and child emotion regulation. Parent-child relationship affected ODD symptoms directly and indirectly through child emotion regulation. In addition, the effects of family cohesion/adaptability on parent emotion regulation and child emotion regulation were mediated by the parent-child relationship. The tested model provides a comprehensive framework of how family factors at multiple levels are related to child ODD symptoms and highlights the importance of understanding child emotional and behavioral problems within the family context, more specifically within the multiple levels of family relationships.

Elterliche Emotionsdysregulation als Risikofaktor für die kindliche Entwicklung

Zusammenfassung. Emotionsregulation ist eines der zentralen Themen der Entwicklungspsychopathologie. Der überwiegende Anteil an Forschungsarbeiten widmet sich der Frage zur Entwicklung von Emotionsregulation, welche als zentrale Entwicklungsaufgabe im Kindesalter erachtet wird. Die Herausbildung einer altersangemessenen Emotionsregulation besitzt eine entscheidende Bedeutung für die psychische Gesundheit und dem späteren Schulerfolg eines Kindes. Obwohl die elterliche Emotionsregulation als ein zentraler Aspekt des Erziehungsverhaltens verstanden wird, ist noch immer nicht hinreichend geklärt, wie Eltern ihre eigenen Gefühle im Erziehungskontext regulieren. Dieser Beitrag bietet einen Überblick zum aktuellen Forschungsstand zu den Auswirkungen einer elterlichen Emotions(dys)regulation auf familiäre Prozesse der kindlichen Emotionsregulation und den Entwicklungsergebnissen des Kindes. Empfehlungen für die klinische Praxis werden diskutiert.