Theoretical and Empirical Foundations for Early Relationship Assessment in Evaluating Infant and Toddler Mental Health

Author(s):  
Roseanne Clark ◽  
Audrey Tluczek ◽  
Elizabeth C. Moore ◽  
Amber L. Evenson

This chapter reviews the theoretical foundations and empirical support for employing a relational perspective when assessing the mental health of an infant or toddler. A review of specific measures widely used in assessing the quality of affect and behavior in parent–child interactions, relationship quality, and parenting capacities (see Clark, Tluczek, Moore, & Evenson, 2019, Chapter 3) illustrates the importance of utilizing a parent–child relationship paradigm in the assessment of the mental health and social and emotional functioning of infants and young children. Although the term parent is used throughout the chapter, another significant caregiver who holds a parenting or primary caregiving role may be substituted as needed, such as a grandparent or foster parent.

Author(s):  
H. Sampasa-Kanyinga ◽  
K. Lalande ◽  
I. Colman

Abstract Aims Previous research has found links between cyberbullying victimisation and internalising and externalising problems among adolescents. However, little is known about the factors that might moderate these relationships. Thus, the present study examined the relationships between cyberbullying victimisation and psychological distress, suicidality, self-rated poor mental health and substance use among adolescents, and tested whether parent–child relationship and child's sex would moderate these relationships. Methods Self-report data on experiences of cyberbullying victimisation, self-rated poor mental health, psychological distress, suicidality and substance use were derived from the 2013 Ontario Student Drug Use and Health Survey, a province-wide school-based survey of students in grades 7 through 12 aged 11–20 years (N = 5478). Logistic regression models adjusted for age, sex, ethnicity, subjective socioeconomic status and involvement in physical fighting, bullying victimisation and perpetration at school. Results Cyberbullying victimisation was associated with self-rated poor mental health (adjusted odds ratio (OR) 2.15; 95% confidence interval (CI) 1.64–2.81), psychological distress (OR 2.41; 95% CI 1.90–3.06), suicidal ideation (OR 2.38; 95% CI 1.83–3.08) and attempts (OR 2.07; 95% CI 1.27–3.38), smoking tobacco cigarette (OR 1.96; 95% CI 1.45–2.65), cannabis use (OR 1.82; 95% CI 1.32–2.51), and binge drinking (OR 1.44; 95% CI 1.03–2.02). The association between cyberbullying victimisation and psychological distress was modified by parent–child relationship and child's sex (three-way interaction term p < 0.05). The association between cyberbullying victimisation and psychological distress was much stronger among boys who have a negative relationship with their parents. Conclusions Findings suggest that cyberbullying victimisation is strongly associated with psychological distress in most adolescents with the exception of males who get along well with their parents. Further research using a longitudinal design is necessary to disentangle the interrelationship among child's sex, parent–child relationship, cyberbullying victimisation and mental health outcomes among adolescents in order to improve ongoing mental health prevention efforts.


2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
P. Shah ◽  
M.C. Almeida

Aims:This workshop will present a theoretical framework to conceptualize early childhood behavior problems in the context of the early parent-child relationship, and will demonstrate how this relational framework can be used to diagnose, classify, and treat child behavior concerns in children under the age of five.Background:There is increasing evidence to suggest that a significant number of very young children manifest signs of early psychopathology, and that behavioral problems that emerge early are likely to persist, and warrant further assessment and intervention. One of the challenges to identifying early psychopathology in young children is how to diagnose and classify early behavioral disturbances using a developmental and relational framework.Methods:This presentation will describe an “infant mental health approach” to diagnose and intervene with young children with behavioral concerns. This comprehensive model of behavioral assessment incorporates an assessment of the parent's perceptions of the child, observations of dyadic interactions, and utilizes a developmental context to diagnose, classify and treat early behavioral concerns in children under the age of five. Using the DC 0-3R, this model will highlight how an understanding of child behavior in the context of the parent-child relationship can be a helpful framework to diagnose and treat early behavioral disturbances in children under the age of 5. Participants will learn how to identify vulnerabilities in the parent-child relationship, how to diagnose and conceptualize early psychopathology in young children, and how to formulate interventions to support dyads at risk.


2021 ◽  
Author(s):  
◽  
Wendy Joan Kelly

<p>Socio-emotional outcomes for children placed in care are more positive when foster parents have a secure state of mind regarding attachment and are able to think about the child’s unique psychological perspective (Dozier, Stovall, Albus & Bates, 2001; Schofield & Beek, 2005a). One aspect of parents’ thinking about the child has been conceptualised as mind-mindedness (Meins, 1998) and is measured by the proportion of mind-related comments made when a parent is asked to describe their child. The first study examines whether foster parent’s mind-mindedness and attachment perceptions, amongst other child and foster parent characteristics, are positively associated with the foster parent-child relationship and the child’s emotional and behavioural outcomes.  The study found that foster parents with higher mind-mindedness had foster children with fewer behaviour problems and this relationship was enhanced by foster parents having positive attachment perceptions. Moreover, foster parent mind-mindedness was not related to the quality of the parent-child relationship, except when parents had positive attachment perceptions. Regarding the child’s placement characteristics, the number of previous placements the child had experienced predicted the child’s emotional and behaviour problems and the age at which the child was placed predicted the quality of the foster parent-child relationship. The best placement predictors of both outcome variables considered together were the age at which the child was placed and short term placements.  Drawing on attachment theory, and guided by the findings of study one, the author developed a a training programme and a Relational Learning Framework (RLF) to assist foster parents and foster care practitioners to understand the child’s psychological perspective. The second study employed a multiple- baseline design to evaluate the effectiveness of the RLF guided training programme. Statistically significant improvements were found regarding parents’ reports of children’s behaviour problems, parents’ daily stress, the attachment relationship and children’s overall functioning at post-test. However, at follow-up, only the children’s overall functioning remained significantly improved, although increases in positive mind-mindedness became statistically significant, relative to post-test. Some foster parents showed decreases in wellbeing scores, relative to their scores at pre- and post-test.  The third study used a pre- post-test design to evaluate the effectiveness of the training programme to assist foster care practitioners to apply the RLF in their clinical practice and to deliver the training programme to foster parents. At post-test, practitioners’ empathy and reflectiveness showed a statistically significant increase but no statistically significant increases were found in practitioners’ mind-mindedness. The training was rated highly by participants and a thematic analysis of diary entries showed that they used the RLF in their practice, were able to help foster parents understand the child’s perspective, and reported positive therapeutic gains from utilising these techniques.  The research provides preliminary evidence that foster parent mind-mindedness, in conjunction with attachment perceptions, is associated with the child’s emotional and behaviour problems and the foster parent-child relationship. The results from the intervention study with foster parents showed initially promising gains, which were not maintained at follow-up, and the results from the foster care practitioners study indicated improvements in practitioners’ empathy and reflectiveness, as well as positive outcomes of using the training material.</p>


2021 ◽  
Author(s):  
◽  
Wendy Joan Kelly

<p>Socio-emotional outcomes for children placed in care are more positive when foster parents have a secure state of mind regarding attachment and are able to think about the child’s unique psychological perspective (Dozier, Stovall, Albus & Bates, 2001; Schofield & Beek, 2005a). One aspect of parents’ thinking about the child has been conceptualised as mind-mindedness (Meins, 1998) and is measured by the proportion of mind-related comments made when a parent is asked to describe their child. The first study examines whether foster parent’s mind-mindedness and attachment perceptions, amongst other child and foster parent characteristics, are positively associated with the foster parent-child relationship and the child’s emotional and behavioural outcomes.  The study found that foster parents with higher mind-mindedness had foster children with fewer behaviour problems and this relationship was enhanced by foster parents having positive attachment perceptions. Moreover, foster parent mind-mindedness was not related to the quality of the parent-child relationship, except when parents had positive attachment perceptions. Regarding the child’s placement characteristics, the number of previous placements the child had experienced predicted the child’s emotional and behaviour problems and the age at which the child was placed predicted the quality of the foster parent-child relationship. The best placement predictors of both outcome variables considered together were the age at which the child was placed and short term placements.  Drawing on attachment theory, and guided by the findings of study one, the author developed a a training programme and a Relational Learning Framework (RLF) to assist foster parents and foster care practitioners to understand the child’s psychological perspective. The second study employed a multiple- baseline design to evaluate the effectiveness of the RLF guided training programme. Statistically significant improvements were found regarding parents’ reports of children’s behaviour problems, parents’ daily stress, the attachment relationship and children’s overall functioning at post-test. However, at follow-up, only the children’s overall functioning remained significantly improved, although increases in positive mind-mindedness became statistically significant, relative to post-test. Some foster parents showed decreases in wellbeing scores, relative to their scores at pre- and post-test.  The third study used a pre- post-test design to evaluate the effectiveness of the training programme to assist foster care practitioners to apply the RLF in their clinical practice and to deliver the training programme to foster parents. At post-test, practitioners’ empathy and reflectiveness showed a statistically significant increase but no statistically significant increases were found in practitioners’ mind-mindedness. The training was rated highly by participants and a thematic analysis of diary entries showed that they used the RLF in their practice, were able to help foster parents understand the child’s perspective, and reported positive therapeutic gains from utilising these techniques.  The research provides preliminary evidence that foster parent mind-mindedness, in conjunction with attachment perceptions, is associated with the child’s emotional and behaviour problems and the foster parent-child relationship. The results from the intervention study with foster parents showed initially promising gains, which were not maintained at follow-up, and the results from the foster care practitioners study indicated improvements in practitioners’ empathy and reflectiveness, as well as positive outcomes of using the training material.</p>


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