Search Results (988)

Family empowerment is a key component of effective family-centered practices in healthcare, mental health, and educational services. The Family Empowerment Scale (FES) is the most commonly used instrument to evaluate empowerment in families raising children with emotional, behavioral, or developmental disorders. Despite its importance, the FES for diverse populations, especially Latinx parents, has rarely been evaluated using innovative psychometric approaches. In this study, we evaluated key dimensions and psychometric evidence of the Family Empowerment Scale (FES) for 96 Latinx parents of children with intellectual and developmental disabilities (IDD) in the United States using an exploratory graph analysis (EGA). The EGA identified a five-dimensional structure, and EGA models outperformed the original CFA 3-factor models for both parents of children with autism and other disabilities. This study identified distinct, meaningful dimensions of empowerment that reflect both shared and unique empowerment experiences across two Latinx parent groups. These insights can inform the design of culturally responsive interventions, instruments, and policies that more precisely capture and boost empowerment in Latinx families. This study contributes to closing a gap in the literature by elevating the voices and experiences of Latinx families by laying the groundwork for more equitable support systems in special education and disability services. Full article

Background: Emotional abuse is both prevalent and underrecognized particularly in culturally complex settings like India. Adolescents, being in a critical developmental phase, are especially vulnerable to the long-lasting psychological effects of emotional abuse. This qualitative literature review aims to synthesize findings from primary studies that explore the lived experiences of emotional abuse among Indian adolescents and identify emerging patterns across sociocultural contexts. Method: Electronic databases, including DOAJ, Google Scholar, ProQuest, JSTOR, Pubmed, PsycNet, and SCOPUS, were searched for peer-reviewed articles published in English up to March 2025. Inclusion criteria comprised qualitative or mixed-methods research focusing on emotional abuse among adolescents aged 12–20 in Indian contexts. The Critical Appraisal Skills Programme (CASP) was used for quality assessment. Results: Five major thematic domains were identified across the included studies: (1) Family as a primary site of emotional abuse; (2) Gendered experiences of abuse; (3) Cultural normalization and silence; (4) Psychological and emotional consequences; and (5) Coping and resilience among adolescents. These themes reflect shared experiences of emotional abuse shaped by cultural, familial, and gender-based expectations. Conclusions: This review highlights the urgent need for increased awareness and culturally sensitive interventions addressing emotional abuse in Indian adolescents. The findings suggest that parents, educators, and policymakers must recognize emotionally harmful behaviors and implement prevention-oriented strategies, particularly through non-violent communication and adolescent mental health support frameworks. Full article

Background/Objectives: Despite the importance of parent mental health for child health, there are no global prevalence data on parental mental health symptoms when children are hospitalized. We aimed to describe depression and anxiety symptom prevalence and associated factors among parents of hospitalized children. Methods: We conducted this 14-country prospective cohort survey with parents/primary caregivers staying at a nearby Ronald McDonald House^® during their child’s hospital treatment. We used the Hospital Anxiety and Depression Scale to measure depression and anxiety symptoms and validated scales and theory-based questions to measure parent, family, and child covariates. We calculated the prevalence of clinically significant or concerning symptoms of depression and anxiety, and used multivariable regression analyses to examine associations between covariates and outcomes. Results: Among 3350 participants, 1789 (49.7%) reported depression symptoms and 2286 (69.0%) reported anxiety symptoms. Worry about housing and poorer ratings of their child’s health were associated with increased risk of depression symptoms. Poorer rating of the child’s health, living with a partner, and discrimination in daily life were associated with increased risk of anxiety symptoms. Higher levels of self-care, hospital family-centered care, and social support were associated with reduced risk of depression symptoms. Higher levels of self-care and social support were associated with reduced risk of anxiety symptoms. Conclusions: Clinically significant or concerning depression and anxiety symptoms are common among parents of hospitalized children globally. Hospitals should consider offering routine mental health symptom screening and preventative mental health and support services to all parents. Full article

Background/Objective: A growing body of international research continues to show evidence of worsening youth mental health since the beginning of the COVID-19 global pandemic, yet very little research in this area has included young children under 6 years. Given the potential impact of early life stress during this critical period of development, it is crucial to better understand the effects on this age group. The objective of this study was to better understand the impact of the COVID-19 pandemic on the emotional health of very young children. Methods: This study utilized retrospective chart review of primary care records to compare the prevalence of markers of stress in two cohorts of children under the age of 6 years, comparing children presenting for care prior to the pandemic (1 April 2019–31 March 2020; control period) with those presenting for care during the first year of the pandemic (1 April 2020–31 March 2021; study period) in a large pediatric primary care clinic in Washington, DC, USA. Based on power calculations, charts of 200 patients from each cohort were reviewed and prevalence of stress markers were summarized using counts and percentages and compared between groups using chi-squared tests. Multivariable logistic regression models were also conducted for each domain adjusting for age, gender, and insurance type. Results: Overall, sleep difficulties were significantly more prevalent during the pandemic period compared to the control period (14% vs. 6.5%, p = 0.013). In addition, signs of stress presented differently across age groups. For example, during the pandemic period toddlers (13–35 months) were 13 times more likely (OR = 13, 95% CI [2.82, 60.4], p < 0.001) and preschool-aged children (36–71 months) were 18.5 times more likely (OR = 18.5, 95% CI [4.0, 86], p < 0.001) than infants to present with behavior problems, indicating substantially higher risk of externalizing symptoms in older children compared to infants. Toddlers were less likely than infants to present with mood changes (e.g., fussiness or crying) (OR = 0.15, 95% CI [0.03, 0.65], p = 0.011). In addition, toddlers (OR = 0.55, 95% CI [0.31, 0.97], p = 0.038) and preschool-aged children (OR = 0.15, 95% CI [0.06, 0.4], p < 0.001) were also less likely to present with feeding difficulties compared to infants. Conclusions: One of the very few studies of young children under 6 years (including infants) during the COVID-19 pandemic, this study found that even very young children experienced stress during the pandemic. Signs of emotional stress were identified in a primary care office during routine care, highlighting an important opportunity for early intervention and/or prevention, such as counseling and resources for caregivers, in settings where young children are already presenting for routine care. Full article

The literature has been scarce in addressing parental interference/family abduction and its relationship with depressive symptoms. Due to this, the objective of this study was to examine the association between family abduction/parental interference and depressive symptoms in a national sample of 11,568 children and adolescents aged 12 to 18 from Chile. Robust linear regression models were conducted to assess how these experiences are related to depressive symptoms while controlling for age. Our results show that children and adolescents who reported these experiences in their lives presented higher levels of depressive symptoms. Additionally, although all forms of caregiver victimization were associated with depressive symptoms, parental interference/family abduction also showed a significant association, even when controlling for sociodemographic variables. These findings highlight the need for attention to the phenomenon of family abduction/parental interference, especially concerning its potential associations with mental health outcomes such as depression. Theoretically, the study contributes to the limited body of research on this form of caregiver victimization, and practically, it provides evidence that may inform future prevention strategies and mental health policies targeting children and adolescents exposed to high-conflict family dynamics in the Chilean context. Full article

Maternal mental illness significantly impacts caregiving, influencing both mothers and their children. This narrative review examines the challenges faced by mothers with conditions such as depression, anxiety, bipolar disorder, and schizophrenia, which often disrupt caregiving routines, emotional stability, and social integration. These difficulties can hinder secure attachments and contribute to adverse developmental outcomes in children, including heightened risks of anxiety, depression, behavioral issues, and cognitive impairments. Children of mothers with mental illnesses are 1.8 times more likely to develop emotional or behavioral problems and face a 2.7 times higher risk of suicidal ideation during adolescence. Intergenerational transmission of mental illness is also prevalent, with affected children showing a 2.5 times greater likelihood of developing mental illnesses in adulthood. Effective interventions include cognitive behavioral therapy (CBT), family-based approaches, and community programs integrating parenting education and mental health resources. These strategies have demonstrated improvements in maternal well-being and child resilience. The review highlights the need for comprehensive policies addressing maternal mental health, early intervention for children, and culturally sensitive support systems to break cycles of intergenerational mental illness. Future research should prioritize evaluating long-term intervention effectiveness and exploring innovative tools like digital mental illnesses solutions to support affected families. Full article

Background/Objectives: The COVID-19 pandemic introduced various stressors for families, including changes to daily routines, work, and schooling. Studies have linked these stressors to increased mental health challenges for parents and children. Sleep difficulties were also common during the pandemic, with some children and parents experiencing poorer sleep quality and shorter sleep duration. However, it remains unclear whether the effects of COVID-19 stress on mental health challenges are explained, at least in part, by effects of COVID-19 stress on child and/or parent sleep challenges. This study examined the impacts of COVID-19 stress on sleep and, in turn, mental health difficulties in school-aged children and their parents in Canada and the United States. Methods: Parents (N = 961) completed validated measures of COVID-19 stress, and of their own and their child’s sleep and mental health. Path analyses tested direct and indirect effects of COVID-19 stress on mental health outcomes with sleep problems as the potential mediator. Results: Child sleep problems partially mediated COVID-19 stress effects on both parent (β = 0.33) and child (β = 0.20) mental health difficulties, while parent sleep problems contributed significantly but to a lesser degree (parent mental health: β = 0.07; child mental health: β = 0.03). There also remained significant direct effects of COVID-19 stress on both child and parent mental health difficulties that were not mediated through sleep difficulties. Conclusions: Our findings underscore the interconnected nature of sleep and mental health, demonstrating that stress-related disruptions in sleep (particularly children’s sleep) can exacerbate mental health difficulties for both parents and children during crises like the COVID-19 pandemic. Full article

Background: Medical education is considered one of the most academically and emotionally demanding training programs. Throughout their education, medical students are exposed to various factors that can lead to psychological distress, depression, and anxiety. The aim of this longitudinal study was to examine the changes in psychological distress, depression, anxiety levels and internet addiction among medical students throughout their six-year education and to identify the contributing factors. Methods: The study cohort consisted of 282 students who enrolled in the medical faculty in the 2017–2018 academic year. A questionnaire including sociodemographic characteristics, the General Health Questionnaire-12 (GHQ-12), Beck Depression Inventory (BDI), State–Trait Anxiety Inventory (STAI), and Young Internet Addiction Test (IAT) was administered to the students during the first week of their education. The same questionnaire was readministered at the end of the third and sixth years. Friedman’s variance analysis was used to compare measurement data across the three time points, while Cochran’s Q Test was employed for categorical variables. Results: The median scores of the GHQ-12, BDI, S-Anxiety, and IAT significantly increased from the first to the sixth year (p < 0.05). The prevalence of depressive symptoms, S-Anxiety, and risky internet use significantly increased from the first to the final year, particularly between the third and sixth years. According to logistic regression analysis based on sixth-year data, students whose fathers were university graduates, who had been diagnosed with COVID-19, and who were dissatisfied with their social lives were found to be at increased risk for psychological distress and depression. Students with high parental expectations were found to be at risk of depression and S-anxiety. Those dissatisfied with their occupational choice were at risk for both psychological distress and S-anxiety. Conclusions: It was found that the mental health of medical students deteriorated during their education, especially during the clinical years. Given that these students will be responsible for protecting and improving public health in the future, it is essential to prioritize their own mental well-being. Interventions aimed at preserving the mental health of medical students should be planned. Full article

Background/Objectives: Parenting stress, the emotional strain resulting from the demands of child-rearing, can profoundly affect both parental well-being and children’s emotional and behavioral development. This study examined the impact of maternal parenting stress during early childhood on the longitudinal progression of children’s internalizing, externalizing, and attention deficit hyperactivity disorder (ADHD) symptoms, from early childhood through adolescence. Methods: The study included 406 mother–child pairs from the Rhea mother–child cohort in Crete, Greece. Maternal parenting stress was assessed at age 4 using the Parental Stress Scale (PSS). Children’s symptoms were evaluated at ages 4 (Strengths and Difficulties Questionnaire, ADHD Test), 6, 11, and 15 years (Child Behavior Checklist, Conners’ Parent Rating Scale) through maternal reports. Multivariate mixed regression models, incorporating a random intercept for each child and a random slope for age at follow-up, were used to analyze the trajectories of symptoms from ages 4 to 15. Group-based trajectory modeling was applied to identify trajectory groups from 4 to 15 years, and multinomial logistic regression models were implemented to examine the associations between parental stress and group trajectories. Results: The results revealed that higher parental stress at age 4 was significantly associated with increased internalizing (b = 0.94, 95% CI: 0.68, 1.21), externalizing (b = 1.03, 95% CI: 0.75, 1.30), and ADHD symptoms (b = 0.86, 95% CI: 0.58, 1.14) over the study period. Notably, the impact of parenting stress on behavioral problems decreased with age (interaction with age, p = 0.032). Additionally, higher parenting stress at age 4 was linked to a greater likelihood of belonging to adverse symptom trajectories, including high decreasing, low increasing, and stable high trajectories for both internalizing and externalizing problems. Conclusions: These findings underscore the importance of early maternal parenting stress as a predictor of long-term emotional and behavioral difficulties in children, emphasizing the need for early intervention programs that support maternal mental health and children’s emotional development. Full article

Background: Pediatric Crohn’s Disease (CD) affects more than physical health, influencing emotional well-being, social integration, and developmental milestones, with an impact on disease management. This study aimed to explore adolescents’ lived experiences with CD and identify factors influencing their motivation for self-management. Methods: A descriptive, cross-sectional qualitative study was conducted using a semi-structured, self-administered online questionnaire. Participants (n = 10) were adolescents with CD who had been diagnosed for over three years and were recruited from a tertiary pediatric gastroenterology center. Data included demographics, clinical characteristics, IMPACT-III (HRQOL), and PROMIS short forms. Open-ended responses underwent thematic analysis using the framework developed by Braun and Clarke. Results: Participants (80% female, median age 16.2 years, median disease duration 4.6 years) were all in clinical remission (median PCDAI = 2) and with good quality of life (median IMPACT-III = 80.7). Six themes emerged: (1) disease knowledge, (2) emotional responses, (3) coping and adaptation, (4) social support, (5) daily life and school impact, and (6) transition to adult care. Most participants demonstrated strong disease literacy and reported effective coping strategies. Emotional responses to diagnosis ranged from relief (60%) to distress (40%); relapses commonly triggered anxiety and fear. Therapeutic changes and disease monitoring were perceived as beneficial (100%) but with concern. Diagnostic procedures were viewed as burdensome by 70% of respondents. School performance and extracurricular participation were negatively affected in 40% during flares. Concerns regarding the future were reported by 40% of participants, with 30% believing that CD might limit life aspirations. While 60% managed their disease independently, 30% relied on parental support. All acknowledged the need for transition to adult care, though readiness varied. Conclusions: This study illustrates the overall impact of disease on pediatric CD patients. It reports significant emotional challenges and difficulties, as well as an impact on daily life, despite good disease knowledge. The findings underscore the importance of psychosocial well-being, ongoing mental health assessment, non-invasive monitoring, and holistic care, emphasizing the patient perspective, in managing pediatric CD. Full article

This study aimed to explore how social media usage influenced both parent and adolescent mental health and social identity during and after the COVID-19 pandemic through the theoretical foundational lens of social comparison theory. In-depth interviews with 24 mothers of adolescent children (ages 10–19) were conducted to address the research questions. Qualitative thematic analysis of the interview transcripts revealed eight emerging themes: (1) learning and entertainment, (2) maternal fears related to content binging and cyberbullying, (3) finding connection and comfort through social media during the pandemic, (4) ongoing digital care work as lasting maternal labor, (5) iterative dialogue: platform restrictions and content curation boundaries, (6) upward and downward social comparison, (7) fear of missing out (FoMO), and (8) third-person perception (TPP). The findings show that mothers perceive social media usage as either beneficial or harmful among adolescents (their children); upward and downward social comparison via social media exhibits more dynamic mechanisms. Moreover, this study enhances our theoretical understanding by linking social media usage to social identity, social comparison, and mental health during a global health crisis. Full article

The growing influence of technology in the healthcare industry has led to the creation of innovative applications that improve convenience, accessibility, and diagnostic accuracy. However, health applications face significant challenges concerning user privacy and data security, as they handle extremely sensitive personal and medical information. Privacy-Enhancing Technologies (PETs), such as Privacy-Attribute-based Credentials, Differential Privacy, and Federated Learning, have emerged as crucial tools to tackle these challenges. Despite their potential, PETs are not widely utilized due to technical and implementation obstacles. This research introduces a comprehensive framework for protecting health applications from privacy and security threats, with a specific emphasis on gamified mental health apps designed to manage Attention Deficit Hyperactivity Disorder (ADHD) in children. Acknowledging the heightened sensitivity of mental health data, especially in applications for children, our framework prioritizes user-centered design and strong privacy measures. We suggest an identity management system based on blockchain technology to ensure secure and transparent credential management and incorporate Federated Learning to enable privacy-preserving AI-driven predictions. These advancements ensure compliance with data protection regulations, like GDPR, while meeting the needs of various stakeholders, including children, parents, educators, and healthcare professionals. Full article

Background Objectives: Parental anxiety and depression demonstrate bidirectional connections with child developmental outcomes (e.g., disruptive behavior). Directly targeting child development through behavioral parent training (BPT) has potential for reversing this cycle. Parent–Child Interaction Therapy (PCIT), a BPT with robust research evidence for decreasing child disruptive behaviors, has demonstrated promise in also decreasing caregiver anxiety and depression. However, the mechanisms that explain this relationship are less understood. Methods: The current study examined whether caregivers (N = 840) completing time-limited PCIT experienced significant reductions in depression and anxiety symptoms and improvements in child disruptive behaviors at each time point. Generalized estimate equation analyses assessed whether caregiver anxiety and depression moderated changes in child disruptive behavior. Mediation analyses explored the extent that changes in caregiver–child interactions over time explained changes in family outcomes. Results: Child disruptive behavior and caregiver depression and anxiety symptoms improved significantly at each time point of PCIT. Change in child behavioral outcomes was significantly moderated by caregiver race. Caregivers with higher anxiety reported fewer improvements in child disruptive behavior compared to other caregivers. Changes in caregiver anxiety and depression over the course of treatment were partially mediated by improvement in caregiver–child interaction skills. Changes in child disruptive behavior were not mediated by improvement in caregiver–child interaction skills. Conclusions: Results demonstrate that time-limited PCIT could significantly improve caregiver anxiety and depression, and some PCIT-taught parenting skills are direct drivers of this process. Further research is needed to understand other mechanisms underlying the relationship between PCIT and improved family outcomes. Full article

As mental health has gained prominence in recent years, elite ice hockey players have shared their experience of psychological problems, including adverse alcohol use, anxiety, depression, distress, eating disorders, and sleep disturbances. Mental health remains a sensitive issue for ice hockey players, as stigma, a strong hockey culture, lack of mental health literacy, and negative past experiences with seeking help constitute barriers to seeking support. This scoping review aims to identify the psychological factors contributing to elite ice hockey players’ well-being. After screening the titles and abstracts of three databases within a 2002–2025 timeframe, a total of 517 articles were retrieved. Seventeen articles targeting ice hockey athletes over 14 years of age competing at an elite level were selected. Three main categories emerged from the included studies: anxiety and depressive symptoms, motivational variables, and coping strategies at different career stages. Factors such as retirement, concussions, social support, parenting style, task-approach goals, and task-oriented behavior were influential components to the well-being and mental health of elite ice hockey players. Using the Lazarus and Folkman model, the identified psychological factors may help athletes and various actors surrounding them to better understand athletes’ well-being. Full article

Background: Youth tobacco use remains a significant public health concern, particularly in urban communities disproportionately burdened by health disparities. In Baltimore City, where tobacco-related harms are elevated, understanding the relationship between tobacco use—including e-cigarettes—and mental health among high school students is essential for guiding equitable prevention and cessation strategies. The CEASE (Communities Engaged and Advocating for a Smoke-free Environment) program, in collaboration with the American Lung Association’s Not On Tobacco (N-O-T) initiative, developed an online school-based survey to inform community-responsive interventions. Aims: This study aimed to examine the associations between cigarette use, including conventional cigarette use, and self-rated mental health among high school students in Baltimore City. Methods: High school students in Baltimore City completed an anonymous online survey that assessed demographic characteristics, tobacco knowledge and use, mental health, and related behaviors. Self-rated mental health was dichotomized as poor versus fair/good. Tobacco use categories included current use of e-cigarettes and conventional cigarettes. Logistic regression models were used to examine associations between tobacco use and self-rated mental health, adjusting for age, gender, race, and parental education. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported. Results: No statistically significant associations were found between self-rated mental health and e-cigarette use and conventional tobacco use after adjusting for covariates. Conclusions: The absence of a significant association may reflect unique aspects of the social context in Baltimore City, where youth may not use tobacco products as a coping mechanism for mental health challenges. Alternatively, it may be due to limitations in measurement, particularly the use of a single-item mental health assessment. These findings should be considered preliminary. Future research using more comprehensive mental health measures and larger samples is warranted to further explore these complex relationships. Full article