Studies have shown that a mother's history of childhood maltreatment is associated with her child's experience of internalising and externalising difficulties.
To characterise the mediating pathways ...that underpin this association.
Data on a mother's history of childhood maltreatment, depression during pregnancy, postnatal depression, maladaptive parenting practices and her child's experience of maltreatment and internalising and externalising difficulties were analysed in an Avon Longitudinal Study of Parents and Children (ALSPAC) sample of 9397 mother-child dyads followed prospectively from pregnancy to age 13.
Maternal history of childhood maltreatment was significantly associated with offspring internalising and externalising difficulties. Maternal antenatal depression, postnatal depression and offspring child maltreatment were observed to significantly mediate this association independently.
Psychological and psychosocial interventions focused around treating maternal depression, particularly during pregnancy, and safeguarding against adverse childhood experiences could be offered to mothers with traumatic childhood histories to help protect against psychopathology in the next generation.
Therapists and other health professionals might benefit from interventions that increase their self-compassion and other-focused concern since these may strengthen their relationships with clients, ...reduce the chances of empathetic distress fatigue and burnout and increase their well-being. This article aimed to review the effectiveness of mindfulness-based interventions (MBIs) and loving-kindness mediation (LKM) in cultivating clinicians’ self-compassion and other-focused concern. Despite methodological limitations, the studies reviewed offer some support to the hypothesis that MBIs can increase self-compassion in health professionals, but provide a more mixed picture with regard to MBIs’ affect on other-focused concern. The latter finding may in part be due to ceiling effects; therefore future research, employing more sensitive measures, would be beneficial. Turning to LKM, there is encouraging preliminary evidence from non-clinician samples that LKM, or courses including LKM and related practices, can increase self-compassion and other-focused concern. As well as extending the LKM evidence base to health professionals and using more robust, large-scale designs, future research could usefully seek to identify the characteristics of people who find LKM challenging and the supports necessary to teach them LKM safely.
Patient empowerment may be particularly important in children and young people (CYP) with CF, due to high treatment burden and limited peer support opportunities. This review aimed to meta-synthesize ...the qualitative literature pertaining to empowerment in CYP with CF.
This work was guided by the ENTREQ framework, with a search strategy based on the SPIDER framework. A systematic search of PsycInfo, Medline, CINAHL and ASSIA databases was conducted. Identified studies were quality assessed and data analysed using thematic synthesis. PROSPERO registration: CRD42019154014.
Seventeen studies met inclusion criteria, though none explicitly explored empowerment. Thematic synthesis identified six analytic themes: relational support, information and understanding and feeling heard and respected appeared to facilitate empowerment, while prejudices and assumptions were identified as potential barriers. Mastery and competence and Navigating being different appeared to be components of empowerment.
The findings provide an initial understanding of patient empowerment in CYP with CF. Potential clinical implications include the need for more CYP-friendly information, more shared decision making and more opportunities to experience mastery. The need for further research is highlighted, particularly relating to developmental influences and factors unique to CF, which are not adequately addressed in existing patient empowerment models.
Implications for rehabilitation
Empowerment in children and young people with cystic fibrosis can be facilitated by supportive and respectful relationships with family, friends and clinical teams, that enable them to feel heard and understood.
It can be further supported by providing developmentally appropriate information and opportunities for children and young people to experience mastery and competency in typical childhood activities.
Prejudices and assumptions about the capabilities of children and young people with CF, even when based in good intentions, can act as a barrier to empowerment.
Empowerment can shape (and be shaped by) the way the children and young people navigate differences associated with living with CF.
Background
Studies have identified that food allergy (FA) in children is related to poorer caregiver quality of life (QoL). However, it is unclear which interventions are most effective at improving ...outcomes for caregivers of children with FA. This review aimed to identify and determine the efficacy, acceptability and quality of interventions for caregivers of children with FA.
Methods
A systematic search of four databases was conducted to identify studies evaluating any intervention that targeted well‐being and support of caregivers of children with FA. Studies were not excluded based on design and were rated for quality using the Mixed Methods Appraisal Tool (MMAT) and the Cochrane risk of bias tool for randomized controlled trials (RCTs).
Results
Fifteen studies met the inclusion criteria: eight studies used a pre‐test/post‐test design, four studies used a post‐test design, two studies used an RCT design, and one study used a case‐control design. Seven studies were educational interventions, five were psychological interventions, and three involved peer/professional support. All interventions had high participant acceptability; some evidence for cognitive behavioural interventions in supporting mothers was observed. Educational interventions tended to be associated with improvements in FA knowledge. With the exception of three studies, most studies were assessed as poor or moderate in terms of quality.
Conclusion
There is a paucity of high‐quality research evaluating interventions to improve outcomes in parents of children with FA. Limited evidence suggests that cognitive behavioural interventions could benefit some mothers, but this has not been tested in other populations. Future research should use methodologically sound designs with validated outcome measures.
There is growing interest in mindfulness-based interventions (MBIs) in the management of multiple physical and mental health issues. Although MBIs utilize a group format, research on how this format ...impacts teaching and learning mindfulness is lacking. This study aimed to develop a detailed theory of MBI group processes utilizing a grounded theory methodology. This article presents our subsequent model, developed from semistructured interviews conducted with MBI students, teachers, and trainers (N = 12). A core category, the group as a vessel on a shared journey, and three higher-order categories emerged from the data. They illustrate how MBI group processes navigate a characteristic path. Teachers build and steer the group “vessel” in a way that fosters a specific culture and sense of safety. The group is facilitated to share communal experiences that augment learning and enrich mindfulness practice. Limitations and implications for clinicians and researchers are discussed.
Objectives
Mindfulness-based programs (MBPs) vary in length of mindfulness practices included. It might be expected that longer practice leads to greater benefits in terms of increased mindfulness ...and decreased psychological distress. However, the evidence for such dose–response effects is mixed and generally does not support such strong causal conclusions given its correlational nature. Therefore, the current study sought to clarify which length of mindfulness practice led to greater benefits using an experimental design.
Methods
Participants (
N
= 71; 71.8% female), who were healthy adults with limited prior mindfulness practice experience, were randomized to either (i) four longer (20-min) mindfulness practices, (ii) four shorter (5-min) mindfulness practices, or (iii) an audiobook control group. All sessions were held in-person over a 2-week period, each group listened to the same total length of material each session, and participants refrained from formal mindfulness practice outside of sessions.
Results
Both longer and shorter practice significantly improved trait mindfulness, depression, anxiety, and stress compared with controls. Unexpectedly, shorter practice had a significantly greater effect on trait mindfulness (
d
= 2.17;
p
< .001) and stress (
d
= − 1.18;
p
< .01) than longer practice, with a trend in the same direction for depression and anxiety. Mediation analysis findings were mixed.
Conclusions
Even a relatively small amount of mindfulness practice can be beneficial and shorter practices may initially be more helpful for novice practitioners in MBPs with minimal teacher contact. Further research is needed to examine such dose–response effects when teacher involvement is greater and over the longer term.
Trial Registration
ClinicalTrials.gov
pre-registration identifier: NCT03797599
Background:
Child maltreatment can have a long-term impact on mental health. Less is known about the consequences of child maltreatment on the next generation’s psychological wellbeing.
Aim:
This ...systematic review aimed to synthesise the existing empirical literature on the association between a mother’s history of maltreatment in her own childhood and her children’s experiences of psychopathology, and to characterise potential mediating pathways.
Method:
Electronic database and hand searches yielded 12 studies, with a combined sample size of 45,723 mother–child dyads, which met criteria for inclusion in the review.
Results:
There was evidence of an overall positive association between a mother’s history of child maltreatment and her child’s experience of emotional and behavioural difficulties across childhood and adolescence. Maternal psychological distress and poorer parenting practices were found to be key mediating pathways of this association.
Conclusion:
Children of mothers who were exposed to maltreatment in childhood appear to be at an increased risk for psychopathology. Mothers with traumatic childhood experiences should be offered improved access to psychological therapies and parenting programmes to help mitigate the potential impact of child maltreatment on future generations.
We report a meta- and primary data-analysis investigating the efficacy of cognitive therapy (CT) for pathological worry in adults with GAD that includes an analysis of primary data not reported in ...previous meta-analyses. Eligible studies included those whose participants met the criteria for a diagnosis of GAD and those that used the PSWQ as an outcome measure. All eligible studies used a randomized controlled design. Analyses included a random-effects meta-analysis of between-study effect sizes and hierarchical linear models of both within study change over time and primary recovery data. The results show that CT was effective in reducing pathological worry when compared with non-therapy controls (d=1.81), and gains were largely maintained at follow-up. The magnitude of effects reported was larger than previously found, suggesting an increased efficacy of newer forms of CT. However, we found weaker evidence to suggest that CT for pathological worry was superior to non-CT treatment controls (d=0.63). Analysis of primary recovery data revealed that 57% of participants were classed as recovered at 12months following CT, and CT had significantly better recovery rates than all other comparison treatments at post-treatment and 12-month follow-up. These findings support the increasing efficacy of CT as a treatment for GAD. However, CT interventions still need further refinement to help a greater proportion of sufferers achieve recovery.
► Cognitive therapy was found to be effective in reducing worry when compared with non-therapy controls. ► The magnitude of effects was greater than previously found. ► There was weaker evidence that cognitive therapy was superior to alternative non-CT therapies. ► 57% of participants were classed as recovered following cognitive therapy.
There is a need to better understand how individuals in different religious groups construct and maintain their worldviews. This study explores how religious practices, beliefs, and relationships ...create and sustain the worldviews of five British Muslims. Semi-structured interviews were inductively analyzed using interpretative phenomenological analysis (IPA) to idiographically explore the participants’ lived experiences. This analysis developed multiple subordinate themes that formed two superordinate themes: “Submitting to Allah” and “Being a British Muslim.” The participants’ experiences of being raised in Muslim families strongly shaped their beliefs and they each strongly identify themselves as both Muslim and British. These important relationships taught them to follow the teachings of the Qur’an and to live their lives in submission to God. The analysis suggests the belief that the Qur’an is the authoritative and enduring revelation of God to mankind provided the core of their worldview and that this belief had far-reaching implications for every aspect of their lives. Their social relationships and religious practices both continually affirmed this fundamental belief in their sacred text and created a social reality in which the participants experienced God and submitted to the will of Allah. The combination of many different religious practices, social relationships, and personal experiences imbued the Qur’an with the power and authority to shape the participants’ lives and sustained their religious community. The participants’ intratextually fundamentalist approach to the Qur’an helped them create coherent worldviews that were filled with meaning and purpose.
Background
Parents of children with food allergies (CwFA) experience reduced quality of life (QoL) and may have reduced access to in‐person interventions in the COVID‐19 pandemic. This trial ...developed and evaluated an online, self‐help, information provision website, aimed at improving QoL in parents of CwFA.
Methods
In a single‐blinded, randomised controlled trial (RCT), participants were randomised to either receive access to the website or a waiting‐list control. At baseline, post‐intervention (week 4) and follow‐up (week 8), measures of parental food allergy‐related QoL, depression, anxiety, stress, intolerance of uncertainty (IU) and self‐efficacy were obtained.
Results
A total of 205 participants were randomised; 97% were females, 91% white and 78% educated ≥ degree level, with a mean age of 38.95 years (SD = 6.89). 44.9% (n = 92) were retained at follow‐up. The arms did not significantly differ on any outcome at any time point. For a sub‐group of participants above the clinical cut‐off for depression at baseline, the intervention may have improved QoL. Participants reported the website content as useful and accessible, but accessed it infrequently. In baseline data, IU and self‐efficacy were significantly associated with QoL.
Conclusion
While the COVID‐19 pandemic has encouraged greater provision of online interventions, our RCT suggests this particular website is not suitable for this population in general, although future research could examine its efficacy for depressed parents of CwFA, to increase confidence that the sub‐group finding was not a Type 1 error. The baseline data suggest IU and self‐efficacy remain potential proximal targets for intervention.
PDF
