Dynamic associations between high childhood adversity and poor physical and mental health throughout childhood in 12,446 children from the DANLIFE cohort
Tjeerd Rudmer de Vries, Leonie K. Elsenburg, Signe Kær Bennetsen, Adrian Zucco, Naja Hulvej Rod
Copenhagen Health Complexity Center, Department of Public Health, University of Copenhagen, Denmark
Background
Childhood adversity accumulates with poor physical and mental health in some families and children, leading to patterns of increasing levels of vulnerability across childhood. While evidence of these patterns has steadily increased over the years, we remain knowing relatively little about the underlying dynamics – i.e. the dynamic associations over time – that give rise to these patterns.
Methods
We investigated bidirectional associations between childhood adversities and hospitalizations for mental and physical health problems across four developmental periods using cross-lagged networks models in a sample of 12,446 children included in the Danish Life Course (DANLIFE) register-based cohort study. Childhood adversities include measures of material deprivation, experiences of loss or threat of loss and family dynamics. Hospitalizations for mental and physical health problems were identified through inpatient, outpatient and emergency hospital contacts.
Results
Childhood adversities and mental and physical health problems were densely intertwined across childhood. However, mental and physical health problems were suggested to arise in infancy and then become largely self-perpetuating through reinforcing feedback loops between health states and autocorrelation effects. We found no evidence that childhood adversity was associated with subsequent health problems across childhood, suggesting that adversity does not affect health directly continuously. Strikingly, poor mental and physical health problems were more strongly associated with subsequent adversity than vice versa.
Conclusions
Complex dynamic associations give rise to patterns of childhood adversity and poor health. Our findings contribute to a better understanding of the emergence of vulnerability related to childhood adversity and poor health across entire childhoods, highlighting the importance of embracing the complex nature of these emergent phenomena, both in research and intervention.
Disruptive Child Behaviors, Parent-Training, and Income Inequality: A Quasi-Experimental Design Combining Survey and Registry Data for Long-Term Insights
Lea Greve, Hanne Nørr Fentz, Tea Trillingsgaard
Aarhus University, Denmark
Background: Disruptive child behaviors, characteristic of prevalent disorders such as ADHD, ODD, and CD, are linked to significant strain on families. Examinations of how evidence-based parent-training programs may mitigate or buffer against such long-term strain are sparse.
Aims: We aimed to examine economic inequality and long-term spill-over effects of the Incredible Years parent-training program on family income among Danish families with disruptive child behavior problems.
Methods: We used a quasi-experimental design, comparing a a large Danish effectiveness sample of families (n = 707) who had received the IY parent-training to a matched control group of families (n = 690) with children in the same age-span (2-12 years, M = 3.6 years) drawn from the national registers. Propensity score matching is a means of enhancing baseline family comparability across several (socioeconomic, demographic, and health) factors between matched intervention and control families to mimic an experimental design. Multiple linear regression models were conducted to compare the average annual family income in intervention, control and background population (n = 292,966) families across a 7-year time-span from 2 years prior to the intervention to 4 years after.
Results: Intervention families experienced widening income disparities compared to control (from -0.1% to 4.8%, p = .000) and background population families (from 17% to 20%, p = .000), from two years before to four years after the intervention. Long-term income inequalities were not mitigated by participation in parent-training.
Implications: While the IY parent-training program effectively targets disruptive child behaviors, economically disadvantaged families in Denmark may require additional systemic and contextual supports to mitigate long-term economic vulnerabilities. This underscores the importance of addressing the broader family context, including family economy, as well as parent-child interactions in families with high levels of disruptive child behaviors.
Can we predict which components of behavioral parent training for children with ADHD work for whom? A two-stage individual participant data meta-analysis.
Francesca Bentivegna1,2,3, Marjolein Luman4,5, Tycho J. Dekkers1,2,5,6,7, Saskia van der Oord8, Patty Leijten9, PAINT-IPDMA collaborator group10, Barbara J. van den Hoofdakker1,2,11, Annabeth P. Groenman1,2,9
1University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry Groningen, the Netherlands; 2Accare Child Study Center, Groningen, the Netherlands; 3The Research School of Behavioral and Cognitive Neuroscience, University of Groningen, the Netherlands; 4Vrije Universiteit Amsterdam, Department of Clinical, Neuro- and Developmental Psychology, Amsterdam, the Netherlands; 5Levvel, Academic Center for Child- and Adolescent Psychiatry and Specialized Youthcare, Amsterdam, the Netherlands; 6Amsterdam University Medical Centers (AUMC), Department of Child and Adolescent Psychiatry, Amsterdam, the Netherlands; 7University of Amsterdam, Department of Psychology, Amsterdam, the Netherlands; 8KU Leuven, Clinical Psychology, Leuven, Belgium; 9University of Amsterdam, Research Institute of Child Development and Education, Amsterdam, the Netherlands; 10Other organizations; 11University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, Groningen, the Netherlands
Three components of behavioral parent training have been found to be particularly effective in reducing behavioral difficulties in children with ADHD: the manipulation of antecedents of behavior, and using positive and negative consequences. What remains to be clarified is for which families these components are associated with stronger changes in child behavior. Specifically, this study aims to explore which child, parent, and family characteristics are predictive of stronger associations between a higher dosage of each component and improvements in child behavior (i.e., ADHD symptoms, behavioral problems, and impairment).
We employed individual participant data (N = 1,647) from 29 randomized controlled trials of parent interventions included in an individual participant data meta-analysis (IPDMA). The IPDMA data were combined with a database containing information on specific techniques of each parent training program, which were scored using a previously developed taxonomy. Trials were included if participants were preschool- or primary school-aged children diagnosed with ADHD using diagnostic interviews or validated questionnaires. A number of child, parent and family predictors will be included in the analyses. With the data harmonization currently nearing completion, we will employ a two-stage IPDMA approach whereby the data from interventions groups will be analyzed separately for each trial and then combined with the dosage of the techniques through meta-regression analysis.
During ECDP, we will present the results of these analyses. Given the novelty of our question, we do not have any prespecified expectations regarding our findings. By shedding light on which components of behavioral parent training work for whom, our work can promote the development of more effective, individually tailored interventions with a focus on specific child, parent, and family aspects that are likely to influence intervention outcomes.
The psychological effects of Covid-19 pandemic on children: An investigation from bioecological perspective
Ezgi YILDIZ1, Berfin DEGER2
1Hacettepe University, Turkiye; 2Bolu Abant İzzet Baysal University
The current study examined the emotional and behavioral effects of the COVID-19 pandemic on children through the lens of Bronfenbrenner's bioecological theory. Specifically, the study focused on how individual differences in emotion regulation, family protective factors within the microsystem, and school-family relations in the mesosystem impacted children's emotional and behavioral problems during the pandemic. Two models were used: the first model assessed pre-pandemic problems, while the second model focused on pandemic-related issues. It was hypothesized that the influence of these factors would increase as they moved further from the child’s immediate environment, and that all variables would negatively predict children's emotional and behavioral problems.
A total of 238 mothers of children aged 4 to 11 years participated. Informants completed several online questionnaires, including the Emotion Regulation Scale, Family Protective Factors Questionnaire, School Interaction Questionnaire, Strengths and Difficulties Questionnaire, and Parental Perception of the Emotional and Behavioral Effects of Quarantine. Hierarchical regression analysis was employed to examine the data.
Results showed that in model 1, only emotion regulation predicted pre-pandemic problems. In model 2, emotion regulation and family protective factors negatively predicted pandemic-related problems. However, school-family interaction did not significantly affect children’s emotional and behavioral issues. These findings provide valuable insights into the roles of individual and environmental factors in shaping children’s emotional and behavioral outcomes, particularly during times of crisis and disaster.
The Traces of Grief: Psychoanalytic Reflections on Early Childhood Loss
Melike Çakır, Selin Uçar Özsoy
Middle East Technical University, Turkiye
Losing a parent is a core-shaker situation especially for children. When facing with the death of a beloved one, children show different type of apprehension and reaction to it based on their developmental stage. It is well-known that children are able to understand the nature of death as adults do around ten or twelve years old. Related to this, children can experience grief once they make sense of physical aspects of death. The grief experience is also affected by the attitudes of the alive parent or other adults who are closer to the children. In other words, the reactions of the parents are highly observed by children. This involves children learning how to grief from their parents. There is a tendency to protect children from intense events, this eventually leads to misinformation or not telling anything to children. It is highlighted in literature that unsolved grief process in children may cause some visible symptoms almost two years after the loss. In light of these dynamics, this study explores the mourning process of a child who lost his father, a correctional officer martyred in an attack, at the age of five. Through non-directive play therapy sessions, the now eight-year-old boy’s verbal expressions and play are analyzed to understand his psychological and emotional responses to loss. His play and narratives revolve around the video game character Sonic the Hedgehog and his rivalry with Eggman, repeatedly enacting their battles to kill one another. Notably, when asked about the nature of conflict and death within the game, he consistently responds, 'I don't know.' These observations suggest that he may be using play and storytelling as a means of processing and making sense of death. The study highlights the role of symbolic representation in children's mourning and the therapeutic potential of play in grief processing.
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