Integrated Treatment Programmes for Mothers with Substance Use Problems: A Systematic Review and Meta-analysis of Interventions to Prevent Out-of-home Child Placements

Approximately half of mothers receiving substance use treatment are involved with childcare proceedings. This review aims to determine whether integrated treatment programmes for mothers with substance use problems are effective in preventing out-of-home placement (temporally/permanent) and influencing other maternal factors such as patterns of substance use, treatment completion and parenting behaviours. Six trials were identified—two randomised controlled trials and four non-randomised controlled studies. The pooled sample of participants was 1717. The results showed that mothers who participated in integrated treatment programmes were significantly less likely to have the children removed from their care (Odds Ratio (OR) = 0.40, 95% CI = 0.27, 0.61), more likely to complete substance use treatment (OR = 3.01, 95% CI = 1.79, 5.06), and more likely to reduce their alcohol consumption (Standardised Mean Difference (SMD) = −0.40, 95% Cl = −0.78, −0.01) and drug use (SMD = −0.30, 95% CI = −0.53, −0.07). However, non-significant reductions were observed for parent–child conflict (SMD = −0.35, 95% CI = −0.72, 0.03) and child abuse risk (SMD = −0.03, 95% CI = −0.36, 0.31). While the findings from this review suggest that mothers involved in integrated treatment programmes could potentially be less likely to experience out-of-home child placements and more likely to improve substance use treatment outcomes, little evidence exists for the effectiveness of these interventions. Further research, particularly high-quality RCTs, is required to demonstrate and persuade health and public policy on the far-reaching value of the integrated approaches.

Applying Socio-Emotional Information Processing Theory to Explain Child Abuse Risk: Emerging Patterns from the COVID-19 Pandemic

The COVID-19 pandemic has exerted profound effects on parents, which may translate into elevated child abuse risk. Prior literature demonstrates that Social Information Processing theory is a useful framework for understanding the cognitive processes that can contribute to parental abuse risk, but the model has not adequately integrated affective processes that may coincide with such cognitions. Given that parents are experiencing intense emotions during the pandemic, the current study sought to examine how socio-emotional processes might account for abuse risk during the pandemic (perceived pandemic-related increases in harsh parenting, reported physical and psychological aggression, and child abuse potential). A sample of 304 mothers participated in an online study, reporting on their abuse risk as well as a number of socio-emotional processes. Greater approval of physical discipline and weaker anger regulation abilities were directly or indirectly related to measures of abuse risk during the pandemic, with maternal justification to use parent-child aggression to ensure obedience consistently relating to all indicators of abuse risk during the pandemic. Socio-emotional processes that include anger appear particularly relevant during the heightened period of strain induced by the pandemic. By studying multiple factors simultaneously, the current findings can inform child abuse prevention efforts.

Assessing Mothers’ Automatic Affective and Discipline Reactions to Child Behavior in Relation to Child Abuse Risk: A Dual-Processing Investigation

Given the scope and adverse clinical consequences of child abuse, assessment of salient etiological factors can lend critical insights needed for abuse prevention. Increasingly, dual-processing models have been applied to aggression, which postulate that parallel automatic and conscious processes can evoke aggressive behavior, implicating both affective and cognitive elements in both routes. Using two samples of mothers ( n = 110 and n = 195), the current investigation considered evidence of the reliability and convergent, concurrent, and construct validity of the new Automatic Parent Emotion Analog Response task relevant to parent–child aggression, contrasted with a self-reported conscious processing measure. Findings provide evidence that affective reactions of both anger and worry relate to child abuse risk and inclination to respond aggressively, and demonstrate how mothers’ automatic reactions relate to both perceived child misbehavior and child dangerous behavior. Current results lend psychometric support for automatic processing in parent–child aggression consistent with other dual-processing theories of aggression.

Risk of Child Abuse and Its Predictors in Mothers with Children Under 5 Years Old

Introduction: Child abuse as a public health problem has adverse consequences for children’s physical and mental health. Even mothers may be responsible for child abuse, so it is essential to identify high-risk cases and take preventive measures. Objective: This study aimed to determine the potential risk of child abuse and its predictors of risk among mothers with children under 5 years old referred to comprehensive health service centers in Rasht City, Iran, in 2019. Materials and Methods: This is a cross-sectional study conducted on 450 mothers of children under 5 years old referred to the comprehensive health service centers in Rasht. The study data were collected by Adult-Adolescent Parenting Inventory form (AAPI-2 form A). The obtained data were analyzed using descriptive statistics, stepwise multiple linear regression, and the Friedman test to investigate the relationship between subscales. Results: The samples were mothers with a mean±SD age of 30.6±5.2 years. Mostly had diploma (41.78%), were housewife (79.33%) and all of them were married. The total mean±SD of score obtained for the child abuse risk was 3.18±0.56. Most mothers (87.31%) had moderate to severe level of child abuse risk. Based on multiple linear regression test, education (β=0.161, 95%CI; 0.076-0.247, P =0.001), being an employee (β=0.223, 95%CI; 0.059-0.387, P=0.008), family income (β=0.092, 95% CI; 0.006-0.179, P=0.037), spouse’s education (β=0.128, 95% CI; 0.046-0.209, P=0.002), and addiction status of spouse (β=0.236, 95% CI; 0.006-0.466, P=0.044) were predictors of child abuse risk among the studied variables, respectively. Conclusion: The results showed that most samples had a moderate risk of child abuse. It reveals the necessity to assess the attitudes of mothers about parenting, which predicts the potential of child abuse to some extent and can provide a basis of educational interventions for mothers to prevent child abuse.

The Perfect Storm: Hidden Risk of Child Maltreatment During the Covid-19 Pandemic

The Covid-19 pandemic upended the country, with enormous economic and social shifts. Given the increased contact from families living in virtual confinement coupled with massive economic disarray, the Covid-19 pandemic may have created the ideal conditions to witness a rise in children’s experience of abuse and neglect. Yet such a rise will be difficult to calculate given the drop in official mechanisms to track its incidence. The current investigation utilized two studies conducted early in the pandemic to evaluate maltreatment risk. In the first cross-sectional study, parents ( n = 405) reported increased physical and verbal conflict and neglect which were associated with their perceived stress and loneliness. In the second study, parents ( n = 106) enrolled in a longitudinal study reported increased parent-child conflict, which was associated with concurrent child abuse risk, with several links to employment loss, food insecurity, and loneliness; findings also demonstrated increases in abuse risk and psychological aggression relative to pre-pandemic levels. Findings are discussed in the context of a reactive welfare system rather than a pro-active public-health oriented approach to child maltreatment, connecting with families through multiple avenues. Innovative approaches will be needed to reach children faced with maltreatment to gauge its scope and impact in the pandemic’s aftermath.

Assessing Mothers' Automatic Affective and Discipline Reactions to Child Behavior in Relation to Child Abuse Risk: A Dual-Processing investigation

Given the scope and adverse clinical consequences of child abuse, assessment of salient etiological factors can lend critical insights needed for abuse prevention. Increasingly, dual-processing models have been applied to aggression which postulate that parallel automatic and conscious processes can evoke aggressive behavior, implicating both affective and cognitive elements in both routes. Using two samples of mothers (n=110 and n=195), the current investigation considered evidence of the reliability and convergent, concurrent, and construct validity of the new Automatic Parent Emotion Analog Response (APEAR) task relevant to parent-child aggression, contrasted with a self-reported conscious processing measure. Findings provide evidence that affective reactions of both anger and worry relate to child abuse risk and inclination to respond aggressively, and demonstrate how mothers’ automatic reactions relate to both perceived child misbehavior and child dangerous behavior. Current results lend psychometric support for automatic processing in parent-child aggression consistent with other dual-processing theories of aggression.

Testosterone Associations With Parents’ Child Abuse Risk and At-Risk Parenting: A Multimethod Longitudinal Examination

The current investigation considered salivary testosterone as a potential biomarker of physical child abuse risk. Parents enrolled in a prospective, longitudinal, multimethod study beginning prenatally provided saliva when their toddlers were 18 months old. Mothers and fathers self-reported on their empathy, frustration tolerance, and child abuse risk, as well as completing analog tasks of frustration intolerance and child abuse risk and participating in structured parent-child interactions. In contrast to mothers, fathers’ higher testosterone levels were associated with increased child abuse risk, less observed positive parenting, more observed negative parenting, and an analog task of frustration intolerance; such findings were reflected across time. Further, fathers’ socioeconomic status moderated the association between testosterone levels and abuse risk. No evidence of partner effects was observed in dyadic analyses. The current findings suggest that higher testosterone levels reflect an increased likelihood that paternal physically abusive behavior may be expressed.

Exploring Positive Classical Conditioning Procedure Effects on Evaluations of Children, Thoughts About Children, and Behaviors Toward Children: Two Experiments

Exposing parents to a positive classical conditioning (+CC) procedure can (a) prompt positive evaluations of children, (b) alter judgments made about children from their behavior, and (c) reduce harsh behaviors enacted toward children. Two studies explored possible limits of these effects. Results from Study 1 showed that only some +CC effects evinced in prior research emerged when the positive trait words used as the unconditioned stimuli in prior research were replaced with positive emojis. Results from Study 2 showed with positive trait word stimuli that a backward +CC procedure produced many of the same effects produced by the forward +CC procedure. These results collectively support the idea that +CC procedures may simultaneously prompt several different kinds of learning. From a practical perspective, consideration of these various kinds of learning is important to an understanding of when the use of the +CC procedure might reduce child abuse risk.