Search Results (799)

Background/Objectives: Parental mental health challenges are associated with parenting difficulties and child mental health issues. Parenting interventions can support families; however, parents with mental health challenges face barriers to accessing parenting support, which is not consistently offered within adult mental health settings. Embedding technology-assisted parenting programs into these settings could provide accessible, holistic support. Partners in Parenting Kids (PiP Kids) is a digital parenting program designed to prevent child anxiety and depression, yet its suitability for parents with mental health challenges and fit within mental health services remains unclear. This study aimed to co-design and adapt PiP Kids for future implementation in an Australian adult mental health service. Methods: Parents who recently sought mental health support (n = 8) and service providers (n = 7) participated in co-design workshops to explore needs and preferences for a technology-assisted parenting program and iteratively develop a prototype. Parents (n = 3) trialled the online component of the prototype and participated in qualitative interviews to assess acceptability. Results: The adapted clinician-supported program was designed to facilitate (1) parent and clinician readiness for parenting support; (2) emotional and social support for parents and clinicians; (3) practical, personalised parenting knowledge; (4) parent-led empowerment; and (5) accessible, integrated support. Prototype clinician training was developed to strengthen the clinician-support component. Parents indicated initial acceptability of the online prototype while reiterating the value of including face-to-face support. Conclusions: This study co-designed an online, clinician-supported parenting program for future embedding within adult mental health settings. The findings highlight key considerations for developing and implementing technology-assisted interventions that promote family-focused care for parents seeking mental health support. Full article

Background/Objectives: Socioeconomic stressors, such as financial strain, rising living costs, and perceived price burden, have gained relevance in the post-pandemic period and may adversely affect adolescent mental health. This study examined the association between subjective financial stress and symptoms of depression, anxiety, and emotional/behavioral difficulties among adolescents in Northern Italy. Methods: Data were obtained from the 2025 Corona and Psyche South Tyrol (COP-S) population survey. A total of 2554 adolescents aged 11–19 years and their parents participated; 1598 adolescents provided complete data for analyses of socioeconomic stressors (parent-reported Family Affluence Scale III, adolescent self-reported and parent proxy and self-reported burden due to price increases). Mental health outcomes included depressive symptoms (PHQ-2), generalized anxiety (SCARED-GAD), and emotional/behavioral difficulties (SDQ). Associations were assessed using chi-square tests, Kendall’s tau correlations, and two-factor ANOVA models. Results: Elevated depressive symptoms were present in 10.7% of adolescents, emotional/behavioral difficulties in 13.9%, and anxiety symptoms in 27.9% of adolescents. Female adolescents consistently showed higher symptom levels in all domains. Self-reported financial burden was the strongest and most consistent correlate of mental health problems, demonstrating small-to-moderate positive correlations with depressive symptoms (τ = 0.20, p < 0.001), emotional/behavioral difficulties (τ = 0.14, p < 0.001), and anxiety (τ = 0.25, p < 0.001). Parent-reported burden showed weaker and less consistent associations, and the Family Affluence Scale III was not significantly related to any of the mental health outcomes. ANOVA models indicated that adolescents’ own perception of financial burden significantly predicted anxiety levels in both age groups (11–14 and 15–19 years), whereas discrepancies between adolescent and parent burden perceptions were particularly relevant among younger adolescents. Conclusions: In this affluent European region, subjective financial strain, especially adolescents’ perception of burden due to rising prices, is a stronger determinant of depressive symptoms, anxiety, and psychosocial difficulties than parental burden reports or structural affluence indicators. Adolescents, especially females, appear to be particularly vulnerable. These findings underscore the importance of addressing subjective financial stress in adolescent mental health and public health strategies. Full article

The adult child–parent relationship is a key source of emotional support across adulthood and older age. This study takes a dyadic, attachment-based perspective to examine how (dis)similarities in attachment orientations between older parents and adult children relate to the emotional support they provide each other. A total of 104 adult child–parent dyads (M parents’ age = 67.85; M adult children’s age = 36.18) participated. Structural Equation Modeling (SEM) and Response Surface Analysis (RSA) were used to assess how dyadic (dis)similarities in attachment anxiety and avoidance are associated with own support provision. Both parents and adult children provided greater emotional support when their attachment insecurity was at low levels. Support also increased when the partner showed higher insecurity but differed across generations: parents offered more support when the child’s anxiety or avoidance exceeded their own, even at own high levels of insecurity, whereas children supported insecure parents only when their own insecurity was relatively low. Attachment-based processes in the adult child–parent bond serve as a source of emotional connection, operating differently across generations: parents can adapt caregiving to meet children’s needs, while children’s support is more constrained by their own attachment insecurity. Full article

Background/Objectives: Providing children with information about their treatment can help reduce uncertainty and anxiety associated with hospital procedures. The aim of this study was to develop and evaluate an app designed to prepare young children and their parents for a hearing examination in a playful and engaging way. Methods: This exploratory study adopted a participatory design approach. Children, parents, and clinicians co-created the app, and evaluations were conducted through focus group meetings, dialogue meetings, and surveys. Results: Children, parents, and clinicians evaluated the app positively. Findings indicated that children who used the app before their hearing examination met audiologists’ expectations to a greater extent than those who did not. However, no significant differences were found between the two groups regarding satisfaction with the examination, the children’s sense of safety, or parents’ prior knowledge of the procedure. The study also revealed implementation challenges: only 20% of children visiting the department had used the app beforehand, and funding for ongoing maintenance was not adequately addressed. Conclusions: Preparing children for hearing examinations with an app appears promising. However, to ensure the quality, accessibility, and sustainability of digital healthcare solutions, challenges related to implementation and maintenance must be considered in future studies. Full article

This study illustrates the application of Acceptance and Commitment Therapy (ACT) for a 12-year-old boy with separation anxiety and his mother. Over 23 sessions, ACT strategies promoted psychological flexibility, values-based parenting, and adaptive behaviors. The intervention reduced the child’s experiential avoidance, anxiety, and depressive symptoms, while increasing value-oriented actions, while the mother showed improved psychological flexibility and life satisfaction. The results were sustained at a three-month follow-up. This case study highlights the potential of ACT in treating childhood separation anxiety by simultaneously involving parents, demonstrating its feasibility and efficacy. The findings provide guidance for adapting ACT for families and child populations. Full article

Parental educational anxiety poses a significant risk to children’s academic development. This two-stage study first establishes Parental Mathematics Education Anxiety (PMEA) as a unique construct and then examines the complex effects of a positive suggestion intervention. Study 1, a questionnaire-based investigation, revealed that PMEA is a significant and independent negative predictor of children’s mathematics achievement, distinct from parents’ general state anxiety or their own mathematics anxiety. It also identified socioeconomic factors, such as family income and parental education, as key drivers of PMEA. Study 2 employed an experimental design to test an intervention, revealing that the effectiveness of positive suggestions is not universal but is significantly moderated by the three-way interaction of PMEA level, child type (with/without math learning difficulties), and suggestion frequency. Notably, for non-math-difficult children, frequent positive suggestions from high-anxiety parents were found to be potentially detrimental (a “backfire effect”), whereas for math-difficult children in high-anxiety homes, a higher frequency of suggestion was necessary to yield benefits. These findings deepen the understanding of PMEA’s mechanisms and underscore the necessity of moving beyond one-size-fits-all approaches toward differentiated, context-aware intervention strategies in family education. Full article

Background/Objectives: Parental presence or absence (PPA) in the dental operatory remains a central issue in paediatric behaviour guidance, commonly employed as a non-pharmacological approach, yet frequently perceived as a professional dilemma among paediatric dentists. Its behavioural impact on children during dental treatment remains debated. This systematic review evaluates the influence of PPA on children’s behaviour in dental settings and explores moderating factors. Methods: A PRISMA-guided systematic review was conducted in PubMed, Web of Science, and Scopus for primary studies published between 2005 and 2025. Eligibility criteria included clinical studies involving paediatric patients primarily aged 2–14 years, comparing parental presence vs. absence during dental visits. Results: The 16 included studies consisted of randomized controlled trials (n = 9), cohort studies (n = 3), and analytical cross-sectional designs (n = 4). Findings were heterogeneous; nine of sixteen studies reported that PPA improved cooperative behaviour, particularly in younger children (ages 4–6), those with higher IQ, or those with initially negative behaviour. Five studies found no significant effect, while two noted increased anxiety or disruptive behaviour with parental presence. Parenting style and cultural context influenced outcomes, with authoritative styles associated with better cooperation. Conclusions: PPA can enhance behaviour in specific subgroups but lacks universal benefits. Paediatric dentists should individualize its use according to each child’s developmental stage, emotional profile, and family dynamics, particularly parenting style, to optimize outcomes. Full article

Background: Parents of youth with chronic health conditions face several challenges in supporting their children across contexts. Involvement of parents in a child’s pain management approach is accepted as best practice, yet there is little guidance on how to best parent the child with chronic pain. Prior studies have shown that parents require support and education to effectively care for their children and themselves. This quality improvement program evaluation aimed to evaluate group-level: (1) feasibility of the Creating Bonds program, (2) acceptability and perceived effectiveness of the program, and (3) suggestions for program improvements. Methods: In this quality improvement program evaluation, parents (N = 40) of youth with chronic pain from the United States and Europe were recruited online to participate in a virtual peer-support and educational program, Creating Bonds, offered through the nonprofit organization, Creative Healing for Youth in Pain. Creating Bonds is an 8-week, virtual, supportive, and educational program for parents and caregivers of youth with chronic pain led by a licensed clinical psychologist. A mixed methods approach evaluated the impact of and suggestions for improving the program. Independent samples t-tests were used to examine quantitative items related to understanding of pain, isolation, confusion, distress, relationships, and self-care. Qualitative responses were evaluated for common themes through an inductive thematic analysis. Results: Results indicated that Creating Bonds significantly improved parents’ level of understanding of chronic pain, relationships with others, and self-care, and significantly reduced confusion about parenting a child with chronic pain, stress, and anxiety levels (ps < 0.05). Levels of isolation moderately decreased. Parents qualitatively described the experience as validating, connecting, and educational, with both emotional relief and practical strategies emerging as benefits. Conclusions: Quantitative results and qualitative themes capture the dual role of the Creating Bonds program in providing tangible parenting tools alongside education and critical psychosocial support. Parents entered with uncertainty, a desire for strategies, and hope for connection, and they came away with validation, practical parenting tools, and a community facing similar experiences. Full article

Background/Objectives: Caring for a child with Autism Spectrum Disorder (ASD) is often associated with elevated psychological distress and reduced life satisfaction. Mindfulness-based interventions may offer substantial benefits by enhancing emotion regulation, reducing maladaptive cognitive patterns, and strengthening mindful parenting. This randomized controlled trial (RCT) examined the effectiveness of an eight-week Mindfulness-Based Cognitive Therapy (MBCT) program, enriched with mindful parenting practices, delivered to parents of children with ASD. The primary aim was to improve parental mental health, while secondary analyses explored potential indirect, parent-perceived changes in child behavior outcomes. Methods: Fifty-six parents of children with ASD were randomly assigned to an MBCT intervention group (n = 30) or a waitlist control group (n = 26). Parents completed assessments at baseline (T0), post-intervention (T1), and at one-month follow-up (T2), including the Depression Anxiety Stress Scales–21 (DASS-21), the Positive and Negative Affect Schedule (PANAS), and the Satisfaction With Life Scale (SWLS). They also rated the overall severity of their child’s behavior problems to explore indirect treatment effects. Results: All parents receiving MBCT (100%) completed the program successfully and reported high acceptability. At baseline, no significant differences were observed between groups. At T1, the MBCT group demonstrated significant reductions in depression, anxiety, and stress, alongside increases in positive affect and life satisfaction. These improvements were maintained or strengthened at T2. However, the control group showed no significant changes over time. Additionally, parents in the MBCT group reported indirect improvements in their children’s behavioral adjustment at T1 and T2. Conclusions: Findings demonstrate that MBCT constitutes an effective intervention for reducing parental psychopathology and indirectly supporting parent-perceived improvements in child behavior, emphasizing the importance of incorporating mindfulness and mindful parenting components into family-centered interventions for parents of children with ASD. Full article

According to the Australasian Society for Developmental Paediatrics, experiential learning and outdoor play contain elements of risk, bravery, uncertainty, exploration, personal challenge, and adventure. These attributes are fundamental to a child’s growth, development, and wellbeing, and yet, in contemporary society, outdoor experiences have significantly declined. This scoping review explores the benefits and affordances of nature-based risky play and adventure education across early childhood and adolescence, asking what developmental opportunities emerge when children and adolescents engage in meaningful outdoor challenges. Adopting a benefit–risk approach where safety is “as safe as necessary” rather than “as safe as possible,” the review identifies common elements across developmental stages. A scoping review following PRISMA-ScR guidelines synthesised empirical studies (2015–2025). Our review included 40 empirical studies from a total of 5218 references, using diverse methodologies conducted predominantly in Western nations. All 40 studies reported positive associations across multiple developmental domains. Eight key themes developed: resilience and confidence, wellbeing, physical skills, autonomy and agency, nature connectedness, quality play provision, and educator influence. Authentic child agency and autonomy functioned as critical mechanisms through which benefits are realised across early childhood and school-aged populations. Key benefits included enhanced mental health, social competence, and anxiety prevention. Implementation barriers persist, including parental anxiety, institutional liability concerns, and cultural risk aversion. Evidence overwhelmingly supports nature-based risky play and outdoor adventure education as beneficial for child and adolescent development. Translation into practice remains limited by stakeholder attitudes and systemic barriers. Future research should prioritise longitudinal studies, cross-cultural investigation, and equity-focused approaches addressing disparities in access to positive risk-taking. Full article

Background/Objectives: In youth competitive sports, excessive parental expectations are frequently identified as critical external stressors that can impair athlete well-being. Grounded in Self-Determination Theory (SDT), this study aimed to investigate specific psychological needs that mediate the relationship between parental expectations and competitive state anxiety, particularly within the context of adolescent tennis players. Methods: A sample of 420 adolescent tennis players participated in this study. Participants completed self-report questionnaires, including the Parental Expectations Questionnaire for parental expectations, the Chinese version of the Basic Psychological Needs Scale for basic psychological needs (autonomy, competence, and relatedness), and the Chinese version of the Competitive State Anxiety Inventory-2 for competitive state anxiety. Data were analyzed using regression models and mediation analysis to test the hypothesized relationships. Results: Parental expectations significantly and positively predicted competitive state anxiety (B = 0.111, p < 0.01). Furthermore, high parental expectations were negatively associated with the satisfaction of basic psychological needs, specifically demonstrating a significant negative prediction of competence satisfaction (β = −0.18, p = 0.005). Mediation analysis revealed that the need for competence significantly and partially mediated the relationship between parental expectations and anxiety (B = 0.019, p < 0.001), whereas the indirect effects of autonomy and relatedness were non-significant. Conclusions: Findings indicate that parental expectations function both as a direct stressor and a psychological burden that specifically undermines the athlete’s sense of competence. These results highlight that in individual competitive sports, the erosion of self-efficacy is the primary psychological conduit linking parental pressure to pre-competitive distress. Full article

Background: Open access endoscopy (OAE) allows outpatient endoscopic procedures without prior consultation with the endoscopist, a practice common in adult gastroenterology but not part of pediatric gastroenterology practice. Here we evaluate the feasibility and safety of a newly implemented pediatric OAE program. Methods: We identified patients aged 18 and under who underwent OAE in the first year of our program using a prospectively maintained endoscopy database. The program involved three experienced endoscopists and included demographics, indications, interventions, and adverse events. Patients/parents received follow-up calls on day 1 and day 7 to detect adverse events and assess perceptions of the OAE process. Results: A total of 54 outpatient OAE procedures were performed, with a median patient age of 10 years (range 18 months–18 years). This included 33 esophagogastroduodenoscopies (EGDs) and 16 colonoscopies, all with biopsies. ERCPs were performed for stone management (4) and stricture evaluation/stent exchange (1). All procedures were successful with no adverse events reported, and patient/parent feedback indicated that the OAE approach was beneficial in terms of lifestyle, socioeconomic, and psychological aspects. Some challenges were identified through follow-up discussions. Conclusions: Our early experience suggests that pediatric OAE is feasible and appeared safe within this small pilot cohort, with no adverse events observed. Advantages of pediatric OAE include minimizing missed school days and reducing medical anxiety. Feedback has led to refinements in practice at our institution, and further study on OAE is warranted at the endoscopy society level. Larger studies are needed to determine safety, effectiveness, and generalizability. Full article

3-Methylcrotonyl-CoA carboxylase deficiency (3-MCCD) is a metabolic disorder with a wide clinical spectrum ranging from asymptomatic individuals to severe metabolic decompensation. Following the introduction of expanded newborn screening, a high number of asymptomatic individuals with 3-MCCD were identified, prompting debates about its inclusion in screening panels. In order to inform policy and healthcare decisions regarding the inclusion of 3-MCCD in newborn screening programs, we evaluated the long-term outcomes for newborns with positive results over a decade of screening experience in North-East Italy, as well as the psychological impact on their parents. Of the 336,668 newborns screened between 2014 and 2025, 9 were confirmed to be affected. These infants underwent annual clinical and biochemical assessments, including dried blood spot acylcarnitine profile, plasma free carnitine, and urinary organic acids assays. An emergency protocol was provided to all affected children to manage intercurrent illnesses. An ad hoc survey was developed to assess the psychological impact of the disease on parents. During follow-up (mean age at last visit: 4.2 years), one patient experienced metabolic decompensation during an intercurrent illness, which was promptly treated. One patient presented with growth retardation and another with transient psychomotor delay. Five patients developed carnitine deficiency, requiring supplementation. Psychological assessments revealed an initial high level of parental psychological impact, which decreased over time. All parents strongly supported the screening program. Newborn screening for 3-MCCD enabled the early identification and management of affected individuals, thereby avoiding severe metabolic decompensation. Although there is an initial psychological burden on parents, it significantly decreases over time. Therefore, the long-term benefits of newborn screening for 3-MCCD seem to outweigh the psychological drawbacks. Full article

The authors examine the emotions contained in 2 Cor 7:5–16. They refer to the nativist approach, in particular to Jaak Panksepp’s theory of primary emotions and Jonathan Haidt’s five foundations of morality. The emotions of Paul, Titus, and the Corinthians described in 2 Cor 7:5–16 can be classified into Panksepp’s categories of FEAR/anxiety, GRIEF/separation distress, CARE/nurturing, and RAGE/anger. They serve as a response to the pain and threat posed by the community’s separation from Paul and aim to repair and strengthen the family/parental relationship with the apostle. Following Haidt’s typology, most of the emotions in 2 Cor 7:5–16 can be located in the care/harm module, related to Paul’s care about his spiritual children in Corinth. In addition, other modules can be engaged to link various emotions in 2 Cor 7:5–15: fairness/reciprocity, focused on reciprocal altruism, in-group/loyalty, reinforcing mutual loyalty, authority/respect, working for Paul’s authority in Corinth, and purity/sanctity serving the holiness of the community and their belonging to Christ. The nativist approach to Pauline emotions smoothly transitions into a socio-cultural approach, pointing to their complementarity. This combination allows for the appreciation for the role of emotions in making moral judgments and helps understand the similarities and differences between ancient and modern views of emotionality. It also aids in grasping the interconnectedness and adaptive functions of emotions, serving the individual and the community. Full article

Background: Depression and anxiety are prevalent mental health disorders among children and adolescents, with diet quality emerging as a modifiable risk factor. However, evidence regarding the association between comprehensive diet quality and mental health in school-aged children remains limited. Methods: This cross-sectional study included 400 Chinese children aged 8–12 years. Diet quality was assessed using the low-burden Diet Quality Questionnaire (DQQ), from which three Global Diet Recommendations (GDRs) scores were derived: GDR-Healthy, GDR-Limit, and total GDR. Depression and anxiety symptoms were evaluated using the Children’s Depression Inventory (CDI) and the Social Anxiety Scale for Children (SASC), respectively. Log-binomial regression models were used to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for the associations between GDR scores and mental health symptoms (depression, anxiety, comorbidity). Subgroup analyses stratified by age and sex were conducted to explore heterogeneity. Results: Higher total GDR scores were associated with lower risks of depressive symptoms (RR = 0.90, 95% CI: 0.84–0.96), anxiety symptoms (RR = 0.93, 95% CI: 0.88–0.99), and their comorbidity (RR = 0.88, 95% CI: 0.79–0.97) after adjustment for age, sex, zBMI, physical activity, region of residence, only-child status and parental education. The GDR-Healthy score was independently associated with lower risks of depression symptoms (RR = 0.89, 95% CI: 0.83–0.96) and comorbidity (RR = 0.87, 95% CI: 0.79–0.95), while no significant associations between GDR-Limit score and mental health disorders were observed. Subgroup analyses indicated that the association was consistent across sex and age subgroups. Conclusions: Better diet quality and particularly higher intake of health-protective foods is associated with lower risks of depression, anxiety, and their comorbidity symptoms in Chinese school-aged children in this cross-sectional study. These findings support the integration of diet quality monitoring and nutritional interventions into public health strategies to promote mental health in children. Full article