Parent-child interaction therapy (PCIT) is effective at reducing children's externalizing behavior. However, modifications are often made to PCIT, and it is not known whether these impact ...effectiveness.
To systematically review and meta-analyze the effects of PCIT on child externalizing behaviors, considering modifications, study design, and bias.
We searched PubMed, PsycINFO, Education Resources Information Center, Sociological Abstracts, and A+ Education.
We selected randomized controlled or quasi-experimental trials.
We analyzed child externalizing and internalizing behaviors, parent stress, parent-child interactions, PCIT format, and study design and/or characteristics.
We included 23 studies (1144 participants). PCIT was superior to control for reducing child externalizing (standardized mean difference SMD: -0.87, 95% confidence interval CI:-1.17 to -0.58). PCIT studies that required skill mastery had significantly greater reductions in externalizing behavior than those that did not (Mastery: SMD: -1.09, 95% CI: -1.44 to -0.73; Nonmastery: SMD: -0.51,95% CI: -0.85 to -0.17,
= .02). Compared with controls, PCIT significantly reduced parent-related stress (mean difference MD: -6.98, 95% CI: -11.69 to -2.27) and child-related stress (MD: -9.87, 95% CI: -13.64 to -6.09). Children in PCIT were observed to be more compliant to parent requests (SMD: 0.89, 95% CI: 0.50 to 1.28) compared with controls. PCIT effectiveness did not differ depending on session length, location (academic versus community settings), or child problems (disruptive behaviors only compared with disruptive behavior and other problems).
Results for parent-child observations were inconsistently reported, reducing the ability to pool important data.
PCIT has robust positive outcomes across multiple parent-reported and observed parent-child interaction measures, and modifications may not be required even when implemented in diverse populations.
Background
Drawing from the extended UNICEF model of children's eating and weight problems and growing empirical evidence, exposure to adversity may place mothers at increased risk for child feeding ...difficulties.
Aim
The aim of the present study of a community sample of mothers was to examine whether maternal psychological distress, exposure to stressful events, and poor self‐rated health in their child's first year of life were associated with breastfeeding duration, as well as concurrent and prospective feeding problems.
Materials & Methods
Participants were 5107 Australian mother‐child dyads from the infant cohort of the Longitudinal Study of Australian Children (LSAC). Data for the present study was drawn from questionnaires completed by the mother at Wave 1 and Wave 2 (conducted 2 years apart). On average, at Wave 1, mothers and children (51% male) were aged 31 years and 9 months, respectively; while at Wave 2 their ages were 33 years and 34 months, respectively.
Results
Maternal psychological distress and poorer self‐rated health were uniquely predictive of concurrent and prospective child feeding difficulties, while poorer self‐rated health was also concurrently associated with a shorter duration of breastfeeding.
Discussion
These findings suggest that poorer maternal functioning poses a significant risk for early child feeding difficulties, and highlights the potential benefit of screening and early intervention for mothers experiencing emotional and physical health problems.
Conclusion
Further research is needed that takes a broad view of maternal functioning, and examines reciprocal interactions between maternal and child characteristics in understanding the development of child feeding problems.
The aim of this study was to identify the interrelations between, and the core components of, adaptive and maladaptive measures of eating behaviours. Participants were 2018 females (Mage = 23.14 ...years) who completed measures of intuitive eating, mindful eating, overeating regulation, dietary restraint, emotional eating, external eating, and overeating dysregulation in contexts of leisure and discomfort. Most associations between eating measures were significant, with the largest association between eating for physical rather than emotional reasons (intuitive eating) and emotional eating, and the smallest and nonsignificant associations usually involving the mindful eating subscales. Principle component analysis of the composite scores for all measured eating subscales revealed a 4-component structure. Component 1, labelled attuned eating, reflected positive loadings for eating for physical rather than emotional reasons (intuitive eating); act with awareness, present eating, and non-reactivity (mindful eating); and overeating regulation. Attuned eating also had negative loadings for emotional eating, external eating, and leisure and discomfort overeating dysregulation. Component 2, labelled unrestrained eating, reflected positive loadings for unconditional permission to eat (intuitive eating) and acceptance (mindful eating), but also a negative loading for dietary restraint. Component 3, labelled eating and hunger awareness, had positive loadings for reliance on hunger/satiety cues (intuitive eating) and awareness (mindful eating). Component 4, labelled casual eating attitudes, was represented by positive loadings for non-reactivity and flexibility (mindful eating). These findings highlight the complexity of eating behaviour by revealing that although many adaptive and maladaptive eating concepts appear to tap opposite ends of a continuum of attuned versus disinhibited eating, several other adaptive and maladaptive eating concepts are better described as tapping somewhat unique attitudes, beliefs, motivations, and behaviours regarding food and eating.
The aim of the present study was to examine whether parents' reported use of controlling feeding practices (restrictive feeding and pressure to eat) change over 6 months, and whether parents' ...concerns about their own weight and shape are prospectively associated with increasing use of controlling feeding practices. Participants were 48 Australian parents (92% female; Mage = 37.8 years) who completed questionnaires twice, with a 6-month time lag, regarding a target child aged 7.6 years on average (52% female). Results revealed that, in general, parental feeding practices and body dissatisfaction showed little change over 6 months. As expected, parental body dissatisfaction predicted increased use over time of restrictive feeding practices for the purpose of managing child weight, but (unexpectedly) not restrictive feeding for child health or pressure to eat. The findings provide key evidence that parents who use higher levels of controlling feeding practices are likely to continue to do so over time, and that parental body dissatisfaction poses a small but significant risk for parents' increasing use of restrictive feeding for management of child weight. The present findings support suggestions that the connection between parent body dissatisfaction and maladaptive feeding practices play a role in the intergenerational transmission of body image and eating pathology.
•Pressure to eat and restrictive feeding showed rank order consistency over 6 months.•No mean-level differences over time for pressure to eat and restriction for health•Mean-level differences (i.e., decline) over time found for restriction for weight•Parent body dissatisfaction predicted greater restrictive feeding for child weight.•Parent body dissatisfaction was not related to pressure or restriction for health.
We review the research conducted in the past 15 years concerned with the role of friends and peers in adolescent body dissatisfaction. A number of friend and peer group characteristics have been ...associated with heightened body dissatisfaction both concurrently and longitudinally. Most widely studied and more consistently linked to body dissatisfaction are appearance teasing and perceived pressure from friends to be thin. Other interactions between friends and peers that communicate and strengthen appearance ideals and direct attention to appearance also have been associated with body dissatisfaction, including appearance‐related conversations, friends' modeling of dieting behavior, and perceptions of friends' appearance‐related attitudes. Finally, the research is critiqued, new directions considered, and strategies are proposed that could be implemented to reduce body dissatisfaction.
Adolescents' appearance-related concerns can provoke increasing emotional, social, and eating-related problems. The aims of this five-wave (2.5-year), multiple-informant longitudinal study were to ...(a) examine growth trajectories of appearance anxiety symptoms and appearance esteem, (b) identify whether trajectories differed by gender, and (c) examine several launching factors including parent-reported physical maturation, peer-rated physical appearance, body mass index, and appearance teasing by parents and peers. Participants were 387 adolescents (44% boys) aged 10 to 13 years at the first assessment. Steep growth in appearance anxiety symptoms was found for both girls and boys, but there was no average change in appearance esteem. Girls had more elevated appearance anxiety symptoms and lower appearance esteem than boys, girls' body mass index was associated with symptoms, and earlier physical maturation and teasing about appearance, alone and in combination, were associated with growth in appearance anxiety symptoms for girls and boys. Earlier maturing boys who were highly teased by parents, but even more so when teased by peers, were at utmost risk for elevated appearance anxiety symptoms and increasing symptoms over time. In contrast, all girls exhibited elevated or increasing appearance anxiety symptoms across time, with the exception of girls with the latest maturation who also reported little teasing about their appearance.
Emotional eating, defined as eating in response to affect, may increase during early adolescence, a time of heightened emotionality and increased prevalence of emotional disorders. We investigated ...change in emotional eating, while also testing the influence of social–emotional risk factors. Study participants (N = 379, mean age Mage = 12.0 years; 56% girls) completed measures of emotional eating twice over 1 year and reported on social adversity within peer and parent contexts (i.e., appearance teasing by peers and parents, and peer rejection) and depression and social anxiety symptoms. Relational victimization and peer rejection, measured via classmate-reports, were also examined as correlates of emotional eating. Emotional eating increased, on average, for Grade 6 and 7 students, marginally increased in Grade 5 students, and increased in boys and girls. In a multivariate prospective model, appearance teasing by parents and social anxiety symptoms were prospectively associated with a higher level of emotional eating 1 year later.
Most adolescents and young adults navigate seamlessly between offline and online social environments, and interactions in each environment brings with it opportunities for appearance concerns and ...preoccupation, as well as victimization and teasing about appearance. Yet, research has concentrated primarily on face-to-face victimization and its role in offline appearance anxiety symptoms in adolescents and young adults. To extend this to include cyber-victimization and online behaviors indicative of appearance anxiety, the present longitudinal study investigated the risk of face-to-face and cyber-victimization for offline appearance anxiety and online appearance preoccupation. Participants were 650 adolescents age 15 to 19 years (
M
age
= 17.3 years, 59% female) who completed two surveys over one-year. Correlations identified both forms of victimization as associated with offline appearance anxiety and online appearance preoccupation. Yet, in a structural equation model, face-to-face peer victimization, but not cyber-victimization, was uniquely associated with increased offline appearance anxiety and online appearance preoccupation from T1 to T2. Offline appearance anxiety and online appearance preoccupation strongly covaried and were bidirectionally associated over time. Female gender and age were associated with more anxiety and preoccupation. When gender moderation was tested, only the stability in appearance anxiety was moderated, with greater stability in females than males. Overall, offline and online appearance anxieties are highly interrelated and share a common risk factor in face-to-face appearance-related victimization by peers.
Review Zimmer-Gembeck, Melanie J.; Webb, Haley J.; Pepping, Christopher A. ...
International journal of behavioral development,
01/2017, Letnik:
41, Številka:
1
Journal Article
Recenzirano
Attachment theorists have described the parent–child attachment relationship as a foundation for the emergence and development of children’s capacity for emotion regulation and coping with stress. ...The purpose of this review was to summarize the existing research addressing this issue. We identified 23 studies that employed validated assessments of attachment, which were not based on self-report questionnaires, and separated the summary into findings for toddlers/preschool, children, and adolescents. Although most associations were weak and only a minority of the multiple possible associations tested was supported in each study, all studies (but one) reported at least one significant association between attachment and emotion regulation or coping. The evidence pointed to the regulatory and coping problems of toddlers showing signs of ambivalent attachment or the benefits of secure (relative to insecure) attachment for toddlers, children, and adolescents. Toddlers who showed signs of avoidant attachment relied more on self-related regulation (or less social-oriented regulation and coping), but it was not clear whether these responses were maladaptive. There was little information available regarding associations of ambivalent attachment with school-age children’s or adolescents’ emotion regulation. There were also few studies that assessed disorganized attachment.
The purpose of this study was to test whether Parent-Child Interaction Therapy (PCIT), a widely used effective therapy for children’s externalizing behaviors and parenting problems, was associated ...with improvements in parents’ emotion regulation and reflective functioning. We also investigated whether these improvements had unique associations with children’s improvements in externalizing and internalizing symptoms. Participants were 139 Australian children aged 29 to 83 months and their caregivers; all were referred for child externalizing behavior problems coupled with parenting skill deficits or high parent stress. All data were gathered via a questionnaire completed prior to and after completion of PCIT. Significant improvements were found in parents’ self-reported emotion dysregulation and capacity to use cognitive reappraisal for emotion regulation. There was also improvement in parents’ self-report of children’s symptoms, parenting practices, and reflective functioning in the form of prementalizing, which measured a low capacity to understand the emotional world of the child. Multiple regression showed that improvements in cognitive reappraisal, prementalizing, and negative parenting practices were associated with improvement in children’s symptoms. The findings extend the existing evidence for PCIT as an effective parenting intervention, adding parents’ perceived emotion regulation and reflective functioning to the list of positive outcomes from PCIT. Improved emotion regulation and reflective functioning, unique from changes in parenting practices, could be mechanisms that help explain why PCIT has been associated with improvements in children’s externalizing behaviors.
•Parent-child Interaction Therapy is an effective therapy for child externalizing.•Pre- to post-PCIT, parents’ emotion regulation improved.•Pre- to post-PCIT, parents’ prementalizing functioning improved.•Pre- to post-PCIT, positive and negative parenting practices improved.•Parental changes during PCIT were associated with more improved child symptoms.
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