Stroking in early mother-infant exchanges: The role of maternal tactile biography and interoceptive sensibility

Caress-like is a crucial component of caregiving and a key factor in mother-infant interactions. Mother's experience of touch during her own childhood (i.e., tactile biography) has been found to be related to maternal actual use of caress-like touch (i.e., stroking) during mother-infant exchanges. Evidence also suggests that maternal interoceptive sensibility (i.e., self-perceived sensitivity to inner-body sensations) might be related to sensitive caregiving abilities. However, further empirical investigation is needed to understand to what extent tactile biography and interoceptive sensibility have an impact on mothers' stroking when interacting with their infants. Using an online survey, this cross-sectional study explored the potential association between maternal tactile biography, interoceptive sensibility and use of touch for interaction with their own infants in a group of 377 Italian mothers (mean age = 33.29; SD = 4.79). We tested and compared a series of multivariate linear mediation models using maternal tactile biography as predictor, maternal use of affective touch as outcome variable and Multidimensional Assessment of Interoceptive Awareness (MAIA) subscale scores as mediators. We found that, if a mother had positive touch experiences in her own childhood, she may be more likely to use touch in a positive and nurturing way with her own infant (i.e., stroking). Furthermore, mothers' interoceptive sensibility in the form of attention regulation, self-regulation and body listening mediates the association between their past experiences of positive touch and their use of caress-like touch in mother-infant exchanges. This study highlights that maternal tactile biography is directly associated with mothers' use of caress-like touch and indirectly linked to it through the mediating role of interoceptive sensibility.

Adolescents and young adults with oncohematological disease: use of social networks, impact of SARS-COV-2, and psychosocial well-being

Objective

Adolescents and young adults (AYA) with oncohematological diseases could have important psychosocial difficulties that could be worsened by the effects of the COVID19 pandemic. At this developmental stage, it is also important to assess the use of social networks (SNs). This study aims to investigate the type of social network use and the consequences of the COVID19 period. These patients are compared with matched healthy peers.

Methods

After the informant consent signature, the adolescents completed a series of self-report questionnaires on the use of SNs, on communication preferences, on social anxiety and on Covid19 impact through the online platform of LimeSurvey. Most of the adolescents belonged to the 18-20 age group (42.5%), were female (62%) and mainly off therapy (72%).

Results

Adolescents spent more than 2 h/day on Instagram and 1 h and half on Whatsapp, while Tik Tok use was on average 1 h/day, especially used by younger patients (r = -0.33, p = 0.023). Males used Twitch (t45 = -2.06, p = 0.05) and Youtube (t45 = -2.18, p = 0.03) for longer than females. AYA in therapy used more Tik Tok (U = 137.50; p = 0.03), Ask/Tellonym (U = 172.50; p = 0.05) and Twitch (U = 144; p = 0.017) than those off therapy. Healthy AYA showed lower levels of exposure (Z = -4.17; p = 0.00001) and impact (Z = -5.12; p = 0.00001) to Covid19, while the level of social anxiety is comparable and is in the normal range in both groups.

Discussion

Some clinical considerations and suggestions could be given based on these empirical results to health professionals in the care of AYA cancer patients.

Infants' sex affects neural responses to affective touch in early infancy

Social touch is closely related to the establishment and maintenance of social bonds in humans, and the sensory brain circuit for gentle brushing is already active soon after birth. Brain development is known to be sexually dimorphic, but the potential effect of sex on brain activation to gentle touch remains unknown. Here, we examined brain activation to gentle skin stroking, a tactile stimulation that resembles affective or social touch, in term-born neonates. Eighteen infants aged 11-36 days, recruited from the FinnBrain Birth Cohort Study, were included in the study. During natural sleep, soft brush strokes were applied to the skin of the right leg during functional magnetic resonance imaging (fMRI) at 3 cm/s velocity. We examined potential differences in brain activation between males (n = 10) and females (n = 8) and found that females had larger blood oxygenation level dependent (BOLD) responses (brushing vs. rest) in bilateral orbitofrontal cortex (OFC), right ventral striatum and bilateral inferior striatum, pons, and cerebellum compared to males. Moreover, the psychophysiological interactions (PPI) analysis, setting the left and right OFC as seed regions, revealed significant differences between males and females. Females exhibited stronger PPI connectivity between the left OFC and posterior cingulate or cuneus. Our work suggests that social touch neural responses are different in male and female neonates, which may have major ramifications for later brain, cognitive, and social development. Finally, many of the sexually dimorphic brain responses were subcortical, not captured by surface-based neuroimaging, indicating that fMRI will be a relevant technique for future studies.

Exploring maternal touch in the infant’s first 18 months of Life: A study on an Italian sample

Affective touch is a crucial component of caregiving in early life and constitutes a key factor with a significant impact on infant later-life outcomes. The Parent-Infant Caregiving Touch Scale (PICTS) allows to quantify and qualify the caregiver's self-perception of touch in the first months of an infant's life. In the current study, we contributed to validation of the PICTS in the Italian language in order to explore whether early maternal touch would be associated with maternal emotional state, maternal history of affective touch experiences throughout the lifespan, and infants' sex and age. Data analyses were run on a sample of 377 Italian mothers (mean age = 33.29; SD = 4.79) participating in an online survey. Confirmatory factor analysis was applied. A three-dimensional structure of PICTS (i.e., stroking, affective communication, and holding) after removing one item out resulted in the best model in our sample. Maternal emotional state did not affect PICTS factor scores while maternal comfort and amount of affective touch experienced during adulthood was significantly associated with the stroking, affective communication, and holding factors. Regarding infants' dimensions, infants' sex and age were not associated with PICTS factor scores. Findings suggest that the PICTS Italian version is a good measurement of caregiver's self-perception of touch in early infancy and that maternal history of touch is associated with a mother's current use of touch.

Tactile Biography Questionnaire: A contribution to its validation in an Italian sample

As the interest in the beneficial effects of positive touch experiences is rapidly growing, having reliable and valid tools to its assessment is essential. The Tactile Biography Questionnaire (TBQ) allows to quantify individual differences in affective touch experiences throughout life. The aim of this article is to present a contribution to its validation in the Italian population. Data analysis were run on a sample of 2040 Italian individuals (Females = 1342, 64%) participating in an on-line survey. Confirmatory Factor Analysis and invariance analyses for gender were applied. Concurrent validity was checked using two specific subscales of the Touch Avoidance Questionnaire (TAQ—i.e., Family and Stranger). The four-dimensional structure of the TBQ was confirmed in the overall sample and by gender. Also, the TBQ showed an excellent internal consistency and a good concurrent validity with TAQ. The present study suggests that the TBQ can be used to support healthcare professionals and researchers to assess experiences of affective touch in different settings.

Psychological Well-Being, Cognitive Functioning, and Quality of Life in 205 Adolescent and Young Adult Childhood Cancer Survivors Compared to Healthy Peers

The majority of the studies underlined how adolescent and young adult (AYA) Cancer Survivors had no significant differences in their well-being and quality of life compared with a control group of healthy counterparts, although French et al. (2013) found less years of education among cancer survivors. The present study aimed at comparing AYA cancer survivors and a control group of peers who had no history of serious illness, in terms of well-being, cognitive functioning, and perceptions of life. Participants in this study were 205 AYA cancer survivors, 126 males, off therapy from a mean of 10.87 years (SD = 4.91), with a mean age of 18.96 (SD = 3.08), recruited during follow-up visits and healthy counterparts (n = 205), matched for age and gender. They all completed self-report questionnaires: Ladder of Life, BSI-18 and Cognitive problems. Paired t test evidenced significant differences between survivors (Mean = 6.19; SD = 2.07) and controls (Mean = 6.88; SD = 2.02) in perceptions of quality of life regarding 5 years before the current time [t₍₂₀₄₎ = −3.39; p = 0.001], with a lower level for childhood cancer survivors. Specifically, Hierarchical regression (R² = 0.05, p = 0.04) identified a shorter time since the completion of treatment (β = 0.18, p = 0.03) and a trend of stem cell transplantation experience (β = −0.11, p = 0.06) as factors associated with negative perception of precedent quality of life. The AYA cancer survivors reported lower cognitive difficulties (Mean = 1.46) than controls (Mean = 1.56) [t₍₂₀₄₎ = −3.41; p = 0.001]: in memory (Mean_clinical = 1.32 vs Mean_control = 1.50) [t₍₂₀₄₎ = −4.52; p = 0.001], in concentration (Mean_clinical = 1.36 vs Mean_control = 1.54) [t₍₂₀₄₎ = −4.66; p = 0.001] and in mental organization skills (Mean_clinical = 1.47 vs Mean_control = 1.56) [t₍₂₀₄₎ = −2.56; p = 0.01], even if they had a lower educational attainment [X(9)2 = 131.28; p = 0.001]. They showed similar satisfaction with their psychological well-being and their lives as healthy counterparts, except for past life perceptions associated with the cancer period. Important recommendations for future research and clinical suggestions could be given.

Pain coping strategies in paediatric patients newly diagnosed with leukaemia compared with healthy peers

Objective

Children with leukaemia experience special difficulties adapting to stressful medical procedures and to the adverse effects of chemotherapy, though they can implement their coping strategies.

The aims of the study were to assess whether the coping‐with‐pain strategies could be influenced by a child's personal and illness factors and to render possible comparisons between children with leukaemia and healthy peers. Another aim was to compare parents' and children's reports on coping strategies.

Methods

A total of 125 patients (average age = 6.79 years; SD = 3.40) with acute leukaemia (lymphocytic leukaemia 90.4% and myeloid leukaemia 9.6%) and age‐matched healthy children with their parents were enrolled in the study. A socio‐demographic questionnaire and the Waldon–Varni Pediatric Pain Coping Inventory, parent and self‐report versions, were administered 1 month after diagnosis. Data regarding the therapy's side effects were recorded.

Results

The comparison between proxy‐reports of the two groups of parents found significant differences in terms of social support, self‐cognitive instructions and catastrophising strategies. Children aged 6–10 years relied more heavily on distraction than children of other ages, using more problem‐solving and self‐cognitive instructions. The results indicated moderate parent–child agreement.

Conclusion

Health professionals could help paediatric leukaemic patients in adopting more efficiently pain coping strategies applicable for different ages.

The role of maternal touch in the association between SLC6A4 methylation and stress response in very preterm infants

Very preterm (VPT) infants requiring hospitalization in the Neonatal Intensive Care Unit (NICU) are exposed to several stressful procedural experiences. One consequence of NICU-related stress is a birth-to-discharge increased serotonin transporter gene (SLC6A4) methylation that has been associated with poorer stress regulation at 3 months of age. Maternal touch is thought to support infants' stress response, but its role in moderating the effects of SLC6A4 methylation changes is unknown. The aim of this study was to assess the role of maternal touch in moderating the association between increased SLC6A4 methylation and stress response in 3-month-old VPT infants. Twenty-nine dyads were enrolled and at 3 months (age corrected for prematurity), participated in the Face-to-Face Still-Face paradigm to measure infants' stress response (i.e., negative emotionality) and the amount of maternal touch (i.e., dynamic and static). Results showed that low level of maternal touch is associated with high level of negative emotionality during social stress. Furthermore, during NICU stay SLC6A4 methylation in VPT exposed to low level of maternal touch at 3 months was associated with increased negative emotionality. Thus, low levels of maternal static touch can intensify the negative effects of SLC6A4 epigenetic changes on stress response in 3-month-old VPT infants.

COPEWithME: The Role of Parental Ability to Support and Promote Child Resilient Behaviors During the COVID-19 Emergency

The COVID-19 pandemic has led to lockdown in many countries and Italy was the first one interested in Europe. The lockdown strategy is an essential step to curb the exponential rise of COVID-19 cases, but it is very demanding for the population involved and especially for children and their families. The aims of the present study are: (a) to explore the psychometric properties of the COPEWithME questionnaire, a new tool to evaluate parents' ability to support and promote child resilient behaviors, (b) to investigate the relation between parents' resilience and their ability to support and promote child resilient behaviors with child resilience and child stress-related behaviors assessed during the COVID-19 outbreak. Participants (N = 158 mothers, with 6- to 11-years-old children, 53% female), who were volunteers and anonymous, filled out an online questionnaire composed by CD-RISC 25, PMK-CYRM-R, and COPEWithME. With regard to the COPEWithME, validation exploratory factor analyses revealed a one-factor solution of 18 items. The COPEWithME positively correlates both with mothers' resilience and with children's resilience. Mediation analysis showed that the association between mothers' resilience and children's stress-related behaviors was mediated by the mothers' ability to support and promote child resilient behaviors. The COPEWithME, to our knowledge, is the first measure of parents' ability to support and promote resilient behaviors in school-age children, a key parenting skill that may help children in dealing with stressful situations such as the COVID-19 outbreak. These findings represent useful insights to advance mental health interventions in the post-pandemic phases suggesting focusing on a family's resources and resilience processes.

Health-Related Quality of Life, Family Conflicts and Fear of Injecting: Perception Differences between Preadolescents and Adolescents with Type 1 Diabetes and Their Mothers

Good management of diabetes requires at the same time self-regulation behaviour and a balanced involvement of family components. This cross-sectional study’s aims were: understanding fear of injections and perceptions of family conflicts in preadolescents and adolescents with type 1 diabetes mellitus and their mothers, comparing their perceptions, and identifying the risk factors impacting patients’ quality of life. Eligibility criteria were: treatment for diabetes mellitus type I, currently aged 10–18 years, attending the hospital for annual hospital follow-ups. Exclusion criteria were: intellectual disabilities, inability to complete questionnaires alone and neuropsychiatric illness with active pharmacotherapy. The study design was cross-sectional. Participants were one hundred and two patients (Mean age = 14.6, SD = 2.4; age range = 10–19 years; Females = 52 and Males = 50) and their mothers (Mean age = 46.9, SD = 6.2, age range = 27–63 years), who filled in self and proxy-report questionnaires (N total= 204). The results showed that 20% of patients and 14.7% of their mothers reported clinical scores for fear of self-injection and blood testing. The mothers reported lower fear of injecting and higher family conflicts compared with the patients. Age, fear of injecting and family conflicts were significantly associated with patients’ quality of life perceptions. Clinical considerations and recommendations are given based on the empirical results.

Neuroimaging and DNA Methylation: An Innovative Approach to Study the Effects of Early Life Stress on Developmental Plasticity

DNA methylation plays a key role in neural cell fate and provides a molecular link between early life stress and later-life behavioral phenotypes. Here, studies that combine neuroimaging methods and DNA methylation analysis in pediatric population with a history of adverse experiences were systematically reviewed focusing on: targeted genes and neural correlates; statistical models used to examine the link between DNA methylation and neuroimaging data also considering early life stress and behavioral outcomes. We identified 8 studies that report associations between DNA methylation and brain structure/functions in infants, school age children and adolescents faced with early life stress condition (e.g., preterm birth, childhood maltreatment, low socioeconomic status, and less-than optimal caregiving). Results showed that several genes were investigated (e.g., OXTR, SLC6A4, FKBP5, and BDNF) and different neuroimaging techniques were performed (MRI and f-NIRS). Statistical model used ranged from correlational to more complex moderated mediation models. Most of the studies (n = 5) considered DNA methylation and neural correlates as mediators in the relationship between early life stress and behavioral phenotypes. Understanding what role DNA methylation and neural correlates play in interaction with early life stress and behavioral outcomes is crucial to promote theory-driven studies as the future direction of this research fields.

Quality of Life and Symptoms of PTSD during the COVID-19 Lockdown in Italy

The COVID-19 pandemic has led to a complete lockdown in many countries and Italy was the first country interested in Europe, as the cases spread very quickly with a high rate of mortality. While the lockdown strategy is an essential step to curb the exponential rise of COVID-19 cases, it can have a significative impact on mental health on the population involved, that is still not well known and must be explored. The objective of the present research is to investigate the Quality of Life (QoL) and Symptoms of PTSD (PTSS) encountered during the quarantine period (April 2020) due to the spread of COVID-19 in Italy. Participants (N = 1839; 1430 females and 409 males), who were volunteers and anonymous, adults (18-73 years), were drawn from a convenience sample of the general population and asked to fill out an online questionnaire, after giving an informed written consent. The General Health Questionnaire (GH12), used to assess health related QoL, identified 24.5% of respondents as problematic, and the Impact of Event Scale-Revised (IES-R), used to assess PTSS, identified the 23.5% with clinical scores. Results showed that married people/cohabitants, non-workers, and those with a lower level of education perceived a better QoL and less PTSS. The most frequent emotions felt during the first month of quarantine and referred to by participants were sadness (72%), boredom (54.5%), impotence (52%), and anxiety (50%). The COVID-19 pandemic represents one of the most stressful events in recent times worldwide and poses a major challenge for social, economic, and, above all, psychological resources of the population that must be assessed and supported if insufficient.

Pediatric Patients Treated for Leukemia Back to School: A Mixed-Method Analysis of Narratives about Daily Life and Illness Experience

In the last few years, more children and adolescents healed from leukemia go back to their daily life, even if they can show some psycho-social difficulties. The study adopted semi-structured interviews and a mixed-method approach to examine the narratives of 75 children and adolescents about their return to school post 2-years treatment for leukemia. The aims are to collect their illness experiences, to understand how they feel about school and daily routines and to identify the best socio-demographic and illness predictors of a good re-adaptation to school and daily life. The results show that by increasing age and when the pediatric patient have received a hematopoietic stem cell transplantation, at the stop-therapy time, her/his perception about relationships at school and academic performance decrease, especially if his/her feelings about the disease and follow-up visits are negative.

Parents, Preschools, and the Developmental Niches of Young Children: A Study in Four Western Cultures

Recent years have witnessed increasing attention to early childhood education and care as a foundation for children's successful development in school and beyond. The great majority of children in postindustrial societies now attend preschools or daycare, making this setting a major part of their culturally constructed developmental niches. Although an extensive literature demonstrates the importance of parental involvement or engagement in their children's schools, relationships between parents and their children's preschools have received scant attention in the research literature. This paper aims to address that gap through a mixed-methods cross-cultural study of parents and preschools in four Western countries: Italy, Spain, the Netherlands, and the United States. Following an introduction to national systems of preschool in each country, parents' involvement and ideas about the family-school relationship are presented, drawing from parental diaries and from semistructured interviews (n = 110). Results indicate areas of cross-cultural similarity but also some differences, especially between the U.S. sample and the three European samples. Discussion addresses the question of how preschools and parents can work together to create optimal developmental niches for their young children. The authors also suggest that parent-preschool relationships deserve greater attention by both researchers and program developers.

Parents' Concepts of the Successful School Child in Seven Western Cultures

Although children's school success is a parental goal in most cultures, there is wide cultural variation in the qualities that parents most wish their children to develop for that purpose. A questionnaire contained forty-one child qualities was administered to 757 parents in seven cultural communities in Australia, Italy, the Netherlands, Poland, Spain, Sweden, and the United States. Exploratory factor analysis was conducted separately within each sample and results revealed both similarities and differences across the seven samples. The factor structures showed considerable similarity: four domains of characteristics (Cognitive Qualities, Social Qualities, Negative temperament, and Good Characters) were identified in each sample as strongly influencing children's success in school. However, parents differed across the seven cultural communities in the importance they attributed to these factors. The results also reveal some culturally unique patterns in parents' concepts of the successful schoolchild; the seven samples were differentiated by distinctive associations of individual qualities around the four common domains. These results offer new insights for incorporating perspectives from other cultures into our own concepts of what qualities are most important for children's success in school, and how educators can be cognizant of differing cultural perspectives represented by the families whose children are their students.

Health Locus of Control in Parents of Children with Leukemia and Associations with Their Life Perceptions and Depression Symptomatology

In childhood cancer, parents have an important role in the promotion of their children's wellbeing and in their adoption of a locus of control style towards their children's health. The current study aimed at identifying types of locus of control in parents of children with leukemia and the possible association with depressive symptomatology and current life perception. One hundred and four parents were recruited at the Hematology-Oncology Clinic of the Department of Woman's and Child's Health, University of Padua, one month after a leukemia diagnosis. Participants were Caucasian with a mean age of 37.28 years (SD = 5.89), mostly mothers (87.5%) and with a mean of 12.16 years of education (SD = 3.82). After signing the informed consent, they filled in the Ladder of Life, the Brief Symptom Inventory-18 and the Parental Health Locus of Control (PHLOC) questionnaires. Paired-samples t-test (t = -14.42; df = 103; p = 0.0001) showed that parents of children with leukemia were more inclined to have an external locus of control than an internal one. The hierarchical regression analysis model (R² = 0.34; F = 4.32; p = 0.0001) identified health professional influence (ß = -0.28; p = 0.004), current life perception (ß = -0.3; p = 0.013) and future life perception (ß = -0.26; p = 0.012) as significant predictors of parental depression. Current life perception was best predicted (R² = 0.25; F = 3.96; p = 0.01) by the parental influence locus of control style (ß = 0.25; p = 0.03). Improving trust in the medical staff care and strengthening the internal locus of control in parents could be a preventive program to cope with parental depression symptomatology.

Developmental Continuity and Change in the Cultural Construction of the "Difficult Child": A Study in Six Western Cultures

This study explores the cultural construction of "difficult" temperament in the first 2 years of life, as well as the logistical and thematic continuity across infancy and childhood in what mothers perceive as difficult. It extends earlier work regarding older children in six cultural sites: Italy, the Netherlands, Poland, Spain, Sweden, and the United States. In order to compare temperament profiles across sites, a "derived etic" version of standard temperament scales is constructed, and then examined in relation to mothers' global ratings of how "difficult" the child is to manage. Results are compared to the earlier report. Negative Mood and low Adaptability tend to be problematic in most sites in both age groups. High Activity and Intensity increase in their relevance to difficulty from the first 2 years to early childhood. In some sites, dispositions such as low Approach become less difficult to manage. Of particular note are culturally unique patterns of continuity that appear to be related to larger cultural themes. These results have implications for our theoretical understanding of parenting, as well as for educational and clinical practice.

Psychological Wellbeing in Adolescents with Leukaemia: A Comparative Study with Typical Development Peers

There is still little research on psychological wellbeing, life satisfaction and reported problems in preadolescents and adolescents under therapy for leukaemia, and also little research comparing them with their healthy peers. The present study aimed to analyse the life satisfaction, hope, psychological wellbeing and reported problems’ intensity in 60 patients aged 8–18 during the first year of therapy, to identify those more at risk and to compare their reports with matched healthy peers. A battery of self-reported questionnaires was administered during hospitalisation or day hospital admissions post 6 months and post 12 months from the diagnosis. Younger patients (aged 8–13 years) were more at risk than older ones in their problems’ intensity and psychological symptoms; females and Acute Myeloid Leukaemia patients reported lower current life satisfaction perceptions; hope was associated with lower depression symptoms and mood problems. Healthy peers have a better perception of current life, but reported a lower hope score, more anxiety symptoms and more cognitive problems than patients. The first 6 months were more critical for patients’ psychological health. Basing on these empirical data, the inclusion of mental health care professionals or supportive psychotherapy into the treatment is recognized as extremely useful.

EMDR and Nonpharmacological Techniques for Anxiety Prevention in Children Prior to Invasive Medical Procedures: A Randomized Controlled Trial

Nonpharmacological Techniques (NPT) have been suggested as an efficient and safe means to reduce pain and anxiety in invasive medical procedures. Due to the anxious and potentially traumatic nature of these procedures, we decided to integrate an eye movement desensitization and reprocessing (EMDR) session in the preprocedure NPT. The main purpose of this study was to evaluate the efficacy of one session of EMDR in addition to the routine NPT. Forty-nine pediatric patients (Male = 25; Female = 24) aged 8–18 years (M = 13.17; SD = 2.98) undergoing painful and invasive medical procedures were randomized to receive standard preprocedural care (N = 25) or a session of EMDR in addition to the standard nonpharmacological interventions (N = 24). Participants completed the anxiety and depression scales from the Italian Psychiatric Self-evaluation Scale for Children and Adolescents (SAFA) and rated anxiety on a 0–10 numeric rating scale. Participants in the NPT+EMDR condition expressed significantly less anxiety before the medical procedure than those in the NPT group (p = .038). The integration of EMDR with NPT was demonstrated to be an effective anxiety prevention technique for pediatric sedo-analgesia. These results are the first data on the efficacy of EMDR as a technique to prevent anxiety in pediatric sedo-analgesia. There are important long-term clinical implications because this therapy allows an intervention on situations at risk of future morbidity and the prevention of severe disorders.

Developing behavioural indicators for intellectual functioning and adaptive behaviour for ICD-11 disorders of intellectual development

BACKGROUND

We present the work conducted to arrive at deriving behavioural indicators that could be used to guide clinical judgement in determining the presence and severity of deficits in intellectual functioning and adaptive behaviour for the purpose of making a diagnosis of disorders of intellectual development.

METHODS

An interdisciplinary expert panel provided guidance in developing behavioural indicators for intellectual functioning. A national dataset of adaptive behaviour on a sample of individuals with a diagnosis of intellectual disability was used to develop the behavioural indicators for the adaptive behaviour. The adaptive behaviour data were analysed using a cluster analysis procedure to define the different severity groupings by chronological age groups.

RESULTS

We present a series of tables containing behavioural indicators across the lifespan for intellectual functioning and adaptive behaviour, including conceptual, social and practical skills. These tables of behavioural indicators have been proposed for use in the clinical version of the 11th revision of the International Classification of Diseases and Related Health Problems (ICD-11) to be published by the World Health Organization.

CONCLUSIONS

The proposed behavioural indicators for disorders of ID described in the present article and to be included in the ICD-11 Clinical Descriptions and Diagnostic Guidelines are put forth to assist professionals in making an informed clinical decision regarding an individual's level of intellectual functioning and adaptive behaviour for the purpose of making a determination about the presence and severity of disorders of ID.

Adolescent and young adult cancer survivors narrate their stories: Predictive model of their personal growth and their follow-up acceptance

PURPOSE

Few studies have captured the unique ways in which cancer affects the growth and development of adolescent and young adult cancer survivors. This paper illustrates the daily life of childhood cancer survivors who are now adolescents and young adults, their post-traumatic growth and follow-up perceptions, adopting a narrative approach.

METHODS

One thousand adolescent and young adult cancer survivors, mean age at diagnosis being 9.26 years old (SD = 4.29) and current mean age of 19.28 (SD = 2.96), were interviewed in depth using a new version of Ecocultural Family Interview-Cancer (EFI-C), which has proved to be a psychometrically reliable instrument.

RESULTS

Post-traumatic growth was predicted directly by age at diagnosis and, indirectly, by the mediation of the health medical staff-patient relationship during the illness, hospitalization memories, and patient's narrating skills. Positive feelings towards follow-up visits were predicted by the health staff-patient relationship during the illness (Chi-Square = 2.87; df = 3, p-value = 0.41; RMSEA = 0.0001).

CONCLUSION

Adolescent and young adult cancer survivors who were older and had established strong relationships with health professionals at the clinic were more able to narrate their experiences, display a positive comprehension of the events with a pragmatic acceptance of the follow-up procedures. Relationships with health professionals should therefore be monitored and improved, both during the cancer treatment and in the off-therapy period. The narrative technique allows adolescent and young adult cancer survivors to reorganize and give shape to their traumatic experience.

Self-Esteem and Academic Difficulties in Preadolescents and Adolescents Healed from Paediatric Leukaemia

Adolescents with cancer may demonstrate problems in their self-esteem and schooling. This study aims to screen the preadolescents and adolescents more at risk in their self-esteem perception and schooling difficulties post-five years from the end of therapy. Twenty-five paediatric ex-patients healed from leukaemia were recruited at the Haematology-Oncologic Clinic (University of Padua). The mean age of the children was 13.64 years (Standard Deviation (SD)) = 3.08, range = 10-19 years), most were treated for acute lymphoblastic leukaemia (ALL) (84%) and relatively equally distributed by gender. They filled in the Multidimensional Self-Esteem Test, while parents completed a questionnaire on their child's schooling. Global self-esteem was mostly below the 50 percentile (58.5%), especially regarding interpersonal relationships (75%). An independent sample t-test showed significant mean differences on the emotionality scale (t = 2.23; degree of freedom (df) = 24; p = 0.03) and in the bodily experience scale (t = 3.02; df = 24; p = 0.006) with survivors of Acute Myeloid Leukaemia (AML) having lower scores. An Analysis of Variance (ANOVA) showed significant mean differences in the bodily experience scale (F = 12.31; df = 2, p = 0.0001) depending on the survivors' assigned risk band. The parent reports showed that 43.5% of children had difficulties at school. Childhood AML survivors with a high-risk treatment were more at risk in their self-esteem perceptions. Preventive interventions focusing on self-esteem and scholastic wellbeing are suggested in order to help their return to their normal schedules.

Vineland-II adaptive behavior profile of children with attention-deficit/hyperactivity disorder or specific learning disorders

BACKGROUND

The evaluation of adaptive behavior is informative in children with attention-deficit/hyperactivity disorder (ADHD) or specific learning disorders (SLD). However, the few investigations available have focused only on the gross level of domains of adaptive behavior.

AIMS

To investigate which item subsets of the Vineland-II can discriminate children with ADHD or SLD from peers with typical development.

METHODS AND PROCEDURES

Student's t-tests, ROC analysis, logistic regression, and linear discriminant function analysis were used to compare 24 children with ADHD, 61 elementary students with SLD, and controls matched on age, sex, school level attended, and both parents' education level.

RESULTS

Several item subsets that address not only ADHD core symptoms, but also understanding in social context and development of interpersonal relationships, allowed discrimination of children with ADHD from controls. The combination of four item subsets (Listening and attending, Expressing complex ideas, Social communication, and Following instructions) classified children with ADHD with both sensitivity and specificity of 87.5%. Only Reading skills, Writing skills, and Time and dates discriminated children with SLD from controls.

CONCLUSIONS

Evaluation of Vineland-II scores at the level of item content categories is a useful procedure for an efficient clinical description.

Post-traumatic Stress Symptoms and Post-traumatic Growth in 223 Childhood Cancer Survivors: Predictive Risk Factors

With modern therapies and supportive care, survival rates of childhood cancer have increased considerably. However, there are long-term psychological sequelae of these treatments that may not manifest until pediatric survivors are into adulthood. The prevalence of post-traumatic stress disorder in young adult survivors of childhood cancer ranges from 6.2 to 22%; associated risk factors are young age at the assessment, female gender, low education level, and some disease-related factors. The aim of this study was to investigate, in adolescent and young adult (AYA) survivors of childhood cancer, the incidence and severity of post-traumatic stress symptoms (PTSSs), and to identify the risk factors and the associated post-traumatic growth (PTG) index. Participants were 223 AYA cancer survivors recruited during follow-up visits in the Oncohematology Clinic of the Department of Child and Woman’s Health, University of Padua. Data were collected from self-report questionnaires on PTSS incidence, PTG mean score, perceived social support, and medical and socio-demographic factors. Ex-patients’ mean age at the assessment was 19.33 years (SD = 3.01, 15–25), 123 males and 100 females, with a mean of years off-therapy of 9.64 (SD = 4.17). Most (52.5%) had survived an hematological disorder and 47.5% a solid tumor when they were aged, on average, 8.02 years (SD = 4.40). The main results indicated a moderate presence of clinical (≥9 symptoms: 9.4%) and sub-clinical PTSS (6–8 symptoms: 11.2%), with the avoidance criterion most often encountered. Re-experience symptoms and PTG mean score were significantly associated (r = 0.24; p = 0.0001). A hierarchical regression model (R² = 0.08; F = 1.46; p = 0.05) identified female gender (β = 0.16; p = 0.05) and less perceived social support (β = -0.43; p = 0.05) as risk factors to developing PTSS. Another hierarchical regression model assessed the possible predictors of the PTG total score (R² = 0.36; F = 9.1; p = 0.0001), with female gender (β = 0.13; p = 0.04), actual age (β = 0.52; p = 0.0001), younger age at the diagnosis (β = -0.3; p = 0.02), and less years off-therapy (β = -0.58; p = 0.0001) impacting on PTG.

Post-traumatic stress symptoms among mothers of children with leukemia undergoing treatment: a longitudinal study

OBJECTIVE

To assess post-traumatic stress symptoms (PTSS) in mothers of children over 2 years of leukemia treatment, to identify possible early family and child predictors of this symptomatology and to indicate the temporal trajectory of PTSS.

METHODS

Participants were 76 Italian mothers (mean age = 37.30 years; SD = 6.07) of children receiving treatment for acute lymphoblastic (n = 69) or myeloid (n = 7) leukemia. Mothers had 12.05 years of education (SD = 3.87), and their incomes were average (52.1%), high (26%) and low (21.9%) for Italian norms, never in poverty. The pediatric patients with leukemia were equally distributed by gender with their mean age of 7.10 years (SD = 4.18). Post-traumatic stress symptoms were measured by a 17-item checklist. Scales assessing anxiety, depression, physical (Brief Symptom Inventory 18) and cognitive functioning (Problem Scale), and life evaluation were also used. There were five assessment points: 1 week (T1), 1 month (T2), 6 months (T3), 12 months (T4) and 24 months post-diagnosis (T5).

RESULTS

The main results indicated moderate presence of clinical PTSS (≥9 symptoms: 24% at T2, 18% at T3, 16% at T4 and 19% at T5) that remained stable across time points, whereas Brief Symptom Inventory 18 Global score decreased and life evaluation improved. A series of hierarchical regression models identified cognitive functioning early after the diagnosis as the best predictive factor of PTSS across time points.

CONCLUSION

Specific psychological interventions could be devised for mothers at risk for short and long-term PTSS just after the diagnosis.

Children's activities and their meanings for parents: a mixed-methods study in six Western cultures

Theoretical perspectives and research in sociology, anthropology, sociolinguistics, and cultural psychology converge in recognizing the significance of children's time spent in various activities, especially in the family context. Knowing how children's time is deployed, however, only gives us a partial answer to how children acquire competence; the other part must take into account the culturally constructed meanings of activities, from the perspective of those who organize and direct children's daily lives. In this article, we report on a study of children's routine daily activities and on the meanings that parents attribute to them in six Western middle-class cultural communities located in Italy, The Netherlands, Poland, Spain, Sweden, and the United States (N = 183). Using week-long time diaries kept by parents, we first demonstrate similarities as well as significant differences in children's daily routines across the cultural samples. We then present brief vignettes--"a day in the life" --of children from each sample. Parent interviews were coded for themes in the meanings attributed to various activities. Excerpts from parent interviews, focusing on four major activities (meals, family time, play, school- or developmentally related activities), are presented to illustrate how cultural meanings and themes are woven into parents' organization and understanding of their children's daily lives. The results of this mixed-method approach provide a more reliable and nuanced picture of children's and families' daily lives than could be derived from either method alone.

Eliciting adaptive emotion in conversations with parents of children receiving therapy for leukemia

Clinician-parent communication may often be difficult, especially soon after the diagnosis. The aims of this article are to identify the communication strategies associated with expressions of adaptive emotions in parents and to explore the effect of the type of leukemia and of parent's gender on parents' expressions of emotions. The data are obtained from 4.622 conversational turns of 20 videotaped interviews with 10 mothers and 10 fathers of children at their first hospitalization for leukemia. A coding scheme for parent emotional expressions was reliably applied by two independent judges. An original self-report questionnaire on parents' emotional states was used before and after the interview. Positive politeness of interviewer elicits adaptive emotional expressions in parents. Mothers of children with acute myeloid leukemia and fathers of children with acute lymphoblastic leukaemia appear more distressed during the interview. This interview can be identified as an innovative technique of communication with parents of children with cancer.

Quality of life and psychosocial sequelae in children undergoing hematopoietic stem-cell transplantation: a review

This paper reviews the research published in the last 18 yr on QoL and psycho-social sequelae in pediatric patients who have undergone HSCT. A corpus of 47 empirical studies was selected and is presented here. From this selection five main topics linked to psychological adjustment to HSCT emerged: QoL; psychological symptoms; cognitive sequelae; social adaptation; psycho-social interventions for children. The information which emerged from the review of the literature is discussed with special attention to methodological issues. Directions for future research are proposed.

Validation of the Parent Health Locus of Control Scales in an Italian sample

Aim

This study examined the psychometric properties and the replicability of De Vellis's (1993) Parent Health Locus of Control (PHLOC) scales in an Italian sample.

Method

The Italian version of PHLOC was administered to 470 mothers of birth to 3-year-old children.

Results

Varimax rotated confirmatory factor analysis identified the six original subscales, namely Child, Divine, Fate, Media, Parental, and Professional influences over child health. Internal consistency of the subscales was good (α > .70), and test-retest correlations were adequate (r > .80). More highly educated mothers rated media influence as most important. No differences were found considering children's age, gender, and birth order.

Conclusion

The results offer good evidence of the cross-cultural validity of the PHLOC scales, an instrument that can be useful in interventions with families by the health care practitioners to prevent neglectful childrearing practices.

Attention and reaction to distress in infancy: a longitudinal study

The primary aim of this study was to verify whether early individual differences in look duration are related to general mechanisms of the infant nervous system that draw together attention and emotion. Thirty-one infants were observed at 3, 5, and 11 months of age. Facial expressions of pain and distress were observed by means of C. Izard's (1979) Maximally Discriminative Facial Movement Coding System 90 s after routine pediatric vaccinations. Several measures of visual attention were taken experimentally in a separate testing session. Significant correlations between measures of attention and duration of facial expressions of pain and distress were found at each age level. Infants who showed pain or distress for a shorter time period also paid attention for a shorter time period and vice versa. The main conclusion is that individual differences combining control of both pain and attention can be identified from early infancy.

Pain in infancy: individual differences

Two patterns of reactions to painful medical procedures were found in infancy, i.e., continuous and interval patterns. Also, infants often in a good mood in everyday life (as reported by their mothers) showed pain more briefly after blood sampling, while infants often in a bad mood in everyday life showed pain longer.