Search Results (1,170)

Background/Objectives: Children’s mental health and positive development are shaped by family, environmental, and individual factors. Although neurodevelopmental disabilities (NDDs) are well-established correlates of poorer mental health outcomes, few national-scale studies have simultaneously modeled positive (flourishing) and negative (anxiety, depression) outcomes within a unified ecological framework. This study examined how parent mental health, peer victimization, neighborhood and school context, and four NDD diagnoses (autism spectrum disorder [ASD], attention-deficit/hyperactivity disorder [ADHD], developmental delay, and learning disability) are associated with flourishing, current anxiety, and current depression in a national sample of U.S. children aged 6–17 years. Methods: Cross-sectional data from the 2023–2024 National Survey of Children’s Health (NSCH; N = 71,172) restricted to ages 6–17 with complete data (unweighted n = 64,263; weighted population estimate ≈ 44.6 million children) were analyzed using Complex Sample logistic regression (SPSS 30), accounting for stratified design (state × stratum), household clustering, and sampling weights. Three hierarchical models were estimated for each outcome. NDD-stratified subgroup analyses (n = 13,971; weighted ≈ 8.6 million) triangulated moderation findings. Multiple imputation (m = 5) sensitivity analyses confirmed robustness. Results: Weighted prevalence was 60.7% for flourishing, 13.2% for current anxiety, and 5.1% for current depression. In Block 2 models, poorer parent mental health and more frequent bullying victimization were robustly associated with all outcomes (flourishing OR = 0.62 and 0.65; anxiety OR = 1.64 and 1.63; depression OR = 1.95 and 1.75; all p < 0.001). Supportive neighborhood (flourishing OR = 1.40, depression OR = 0.80) and safe school (flourishing OR = 1.20, anxiety OR = 0.87) were protective. ADHD was the strongest disability-specific correlate (flourishing OR = 0.29; anxiety OR = 4.69; depression OR = 4.27). Three of the twelve interaction terms were significant, all involving ADHD. Relative to children without any NDD, subgroup analyses suggested attenuated associations of parent mental health and bullying with anxiety and depression among children with any NDD (e.g., bullying on anxiety: no-NDD aOR = 1.73 vs. Any-NDD 1.52); however, formal interaction tests identified ADHD as the only significant moderator of these associations. On the absolute-risk scale, however, the increase in internalizing problems with more frequent bullying was larger in children with ADHD. Conclusions: Family mental health support and bullying prevention are universally relevant levers for improving children’s mental health and flourishing. Although attenuation of the odds-ratio associations was observed primarily in ADHD-related analyses, specifically for the internalizing outcomes (anxiety and depression), universal anti-bullying and parent mental health interventions remain relevant for children with NDDs, supporting integration into pediatric clinical and public-health programs alongside disability-specific support pathways. Full article

Background: Congenital heart defects (CHD) are prevalent, affecting 1% of live births globally. Despite improved survival rates, adults with CHD face increased risks of psychological distress and neurocognitive deficits. The P-BAHn study (P-BAHn = “Psyche Bei Angeborenen Herzfehlern”, Psyche for congenital heart defects) evaluates the mental health status and psychosocial challenges of German children and adolescents with CHD, focusing on retrospectively assessed COVID-19-related burden and patient-/parent-rated experiences with psychological, psychotherapeutic, or psychiatric treatment (PST). Methods: A cross-sectional, online-based survey was conducted using the National Register for Congenital Heart Defects (NRCHD). The final dataset comprised 1567 respondent-level records from 1310 families, including 992 parent reports and 575 self-reports from children/adolescents aged 6 to <18 years. The survey assessed mental health, emotional well-being, psychosocial status, demographics, medical history, and psychological treatment. Data were analyzed descriptively using chi-square tests and t-tests for exploratory unadjusted group comparisons. In addition, exploratory multivariable logistic regression analyses were performed for selected key outcomes. Results: School-related stress was common in young CHD patients (45.3%) and was associated with older age and female sex (51.5% female vs. 35.6% male) in adjusted analyses. Overall, 17.0% of patients reported having a mental illness, most commonly anxiety (6.8%), eating disorders (5.6%), and depression (4.7%); neither sex nor CHD severity was significantly associated with self-reported mental illness in adjusted analyses. Less good/poor self-rated health was associated with older age and complex CHD in both patient and parent reports. Retrospectively assessed pandemic-related changes were perceived as quite or extremely stressful by 23.9% of patients. High COVID-19-related burden was associated with female sex, whereas CHD severity was not significant after adjustment. Among patients with previous or current PST, patient- and parent-rated treatment benefit varied by patient sex and CHD complexity. Previous/current PST was reported by 25.9% of patients and 23.8% of parents and was associated with older age in both respondent groups and with complex CHD in parent reports. Among patients with previous/current PST, 56.4% reported high perceived support. Conclusions: The P-BAHn study highlights the need for targeted psychosocial support for children and adolescents with CHD, including female patients, those with complex conditions, and patients reporting school- or crisis-related burden. Retrospectively reported pandemic-related burden underscores the importance of integrating crisis-sensitive strategies into psychosocial care frameworks. Longitudinal studies are essential to understand mental health trajectories and to evaluate the sustained patient- and parent-perceived benefit as well as clinical effectiveness of PST use. Enhancing support services and refining intervention models will improve the well-being and quality of life for young CHD patients. Full article

Temporal psychological well-being (subjective well-being, future confidence and life satisfaction) is an important indicator of the level of mental health and well-being. During adolescence, the dynamic development of their psychological well-being is more susceptible to multiple factors. However, the trends and multidimensional influences on adolescents’ temporal psychological well-being, as well as their co-development with the relationship between interpersonal relationships and temporal psychological well-being, are not known. Therefore, 568 adolescents (M_age ± SD = 17.41 ± 1.14) aged 16 to 19 years were selected for this study using longitudinal data from the 2018, 2020, and 2022 China Family Panel Studies (CFPS). Analyses were conducted using the latent growth curve model (LGCM). It was found that adolescents’ subjective well-being, future confidence, and life satisfaction showed a significant linear decline. Health status, academic pressure, and parent–child relationships were significantly associated with the initial level and developmental trajectory of temporal psychological well-being. In addition, we observed co-development patterns between interpersonal relationships and adolescents’ temporal psychological well-being, such that parallel changes in interpersonal relationships coincided with changes in well-being over time, and vice versa. This study reveals the dynamic patterns of changes in adolescents’ temporal psychological well-being and their co-development with relationships, providing empirical evidence for targeted interventions. Full article

Background: Loneliness and depression are interrelated constructs that significantly impact adolescents’ mental health. Understanding their interplay, particularly at the symptom level, is critical for developing effective interventions. Objective: To examine longitudinal relationships between loneliness and depressive symptoms during late childhood, aiming to identify symptom-level interactions and directional effects. Participants and Setting: A total of 4333 children (M_age = 11.06, SD = 0.73; 50.8% girls) from the NLSY79 Children and Young Adults survey participated, with data collected over two years. Methods: A cross-lagged panel network (CLPN) model was employed to analyze symptom-level associations between loneliness and depressive symptoms. This approach combines network analysis and cross-lagged panel modeling, allowing for the estimation of both autoregressive effects (stability of symptoms over time) and cross-lagged effects (directional relationships between symptoms across time points). Results: The longitudinal network suggests the following: (1) a reciprocal link between loneliness and both sadness and parental pressure; (2) a forward effect of loneliness on anxiety and being busy; (3) the loneliness-reducing effect of prior happiness and loneliness-increasing effect of boredom. Conclusions: The findings highlight the complex interplay between loneliness and depressive symptoms, emphasizing reciprocal and unidirectional effects at the symptom level. These insights underscore the need for targeted, symptom-focused interventions to address loneliness and its impact on adolescent mental health. Full article

Background: Health-promoting lifestyle behaviors established during young adulthood play a crucial role in shaping long-term physical and mental health outcomes, including the risk of chronic disease, psychological well-being, and quality of life. Parenting styles represent an important psychosocial factor that may be associated with health-related behaviors; however, evidence regarding their association with multidimensional health-promoting lifestyles among university students remains limited. Methods: A cross-sectional study was conducted among 700 university students. Parenting styles (authoritative, authoritarian, and permissive) were assessed using validated self-report measures. Health-promoting lifestyle behaviors were measured with the Health-Promoting Lifestyle Profile II (HPLP II), including six subscales: Health Responsibility, Physical Activity, Nutrition, Spiritual Growth, Interpersonal Relations, and Stress Management, as well as the overall HPLP II score. Multiple linear regression analyses were performed to examine associations between parenting styles and each HPLP II subscale and the total score. Results: All regression models were statistically significant (p < 0.001), explaining between 5.2% and 13.5% of variance across HPLP II subscales and 11.8% of variance in the total score. Authoritative parenting was significantly positively associated all health-promoting lifestyle domains (β = 0.22–0.33, p < 0.001), including physical activity, interpersonal relations, stress management, and overall health-promoting lifestyle. Permissive parenting was negatively associated with several domains, particularly physical activity, interpersonal relations, stress management, and the total HPLP II score (β = −0.07 to −0.12, p < 0.05). Authoritarian parenting showed weaker and more selective negative associations, most notably with nutrition and stress management. Conclusions: Parenting styles are significantly associated with health-promoting lifestyle behaviors among university students. Authoritative parenting was consistently associated with more favorable health-promoting lifestyle patterns across multiple domains, whereas permissive and authoritarian parenting may be linked to less favorable health behaviors. These findings suggest that perceived parenting styles are associated with health-related behaviors among university students. Full article

Child and adolescent mental health (CAMH) is a global concern that is increasingly recognized and prioritized. Worldwide, mental health conditions affect a significant number of children and adolescents; however, access to CAMH services remains limited. This study sought to explore the implementation of child and adolescent mental health services in the rural Chris Hani District of the Eastern Cape province, South Africa, from the perspectives of health professionals and teachers, focusing on strengths, weaknesses, opportunities, and threats. Using a qualitative approach, a sample of 36 participants (12 health professionals and 24 teachers) was purposively recruited. Data were collected through face-to-face, semi-structured individual interviews and focus group discussions. Thematic analysis identified several strengths, including effective screening and identification of CAMH problems, training in psychiatry and psychology, teacher support, collaboration with stakeholders, and the availability of policy and guidelines. Key weaknesses included inadequate CAMH training, a limited CAMH workforce, personal barriers, guidelines primarily oriented toward physical health, and insufficient basic infrastructure. Opportunities for improvement include enhancing the skills of the existing workforce, increasing engagement in extramural activities, and empowering parents with knowledge of available CAMH services. Identified threats included the normalization of CAMH symptoms, challenges involving parents and feeder schools, stigma, poor stakeholder collaboration, and inadequate guidelines. Overall, the analysis of strengths, weaknesses, opportunities, and threats reflects the broader challenges present in low-resource settings that hinder the implementation of CAMH services. It also highlights the need for integrative approaches to implementing CAMH services in rural contexts, while identifying opportunities to improve service delivery. Full article

Previous research demonstrates that housing security and quality influence physical and mental health. Despite a rich literature on housing and health, less is known about the processes through which housing mobility programs directly affect family health. We use a single-case design to examine how the health of families with children is impacted by Families Flourish, a mobility program that combines three years of rental assistance with life coaching and placement in safe, well-resourced neighborhoods. Drawing on developmental and formative evaluation data, including longitudinally collected surveys, interviews, and administrative records, we trace families’ experiences over time. Our analysis identifies distinct pathways through which mobility improves mental and physical health—via improved indoor air quality, reduced environmental and parental stress, and enhanced access to resources. Initial health gains are subsequently leveraged to improve educational and economic outcomes. We observe a temporal sequence in outcomes, with early physical health gains and later mental health improvements as stability and safety increase. We conclude by situating these identified pathways within existing scholarship and discussing implications for planning and fair housing practice. Full article

Driven by the Confucian cultural ideal of “wang zi cheng long”—the fervent hope that one’s child will rise like a dragon (i.e., achieve extraordinary success)—Chinese parents commonly engage in intensive academic involvement, such as frequent homework checking. However, the mechanisms through which this high-intensity monitoring affects adolescent mental health, and whether its effects are culturally specific, remain underexplored. Drawing upon the stimulus–organism–response (SOR) theory and the stress process model, this study used data from the 2022 China Family Panel Studies (CFPS) on 1831 adolescents aged 9–15 to examine the impact of parental homework checking frequency on adolescent loneliness, the mediating role of academic pressure, and the moderating role of parental educational expectations. The results show that parental homework checking frequency was positively associated with academic pressure, which in turn was positively associated with loneliness. The mediating role of academic pressure was significant. Parental educational expectations significantly and negatively moderated the relationship between homework checking and academic pressure, and the moderated mediation was significant. Simple slope analysis indicated that the positive association between homework checking and academic pressure was stronger. In the Confucian cultural context that emphasizes academic achievement and filial responsibility, frequent parental homework checking is associated with adolescent loneliness through increased academic pressure. Unexpectedly, high parental expectations served as a buffer—a pattern that differs from typical findings in Western individualistic cultures, where high expectations often directly increase psychological distress. These findings suggest that interventions in Chinese family education should distinguish controlling from supportive monitoring and transform high expectations into emotional support and resource investment, thereby reducing adolescents’ academic pressure and loneliness. Full article

Background: With the rising demand for psychiatric mental health services and the development of online technology, telemental health services are gaining popularity. Psychiatrists and psychologists differ significantly in service patterns and ethical models. This study investigated their ethical patterns and used the technology acceptance model (TAM) to explore how professionals’ attitudes influence their ethical and regulatory use of telemental health services. Methods: The online survey included their basic information, telemental health service patterns, attitudes toward telemental health services, and ethical norms. This cross-sectional online survey was conducted among psychiatrists and psychologists in China between April and October 2022. Of the 1071 respondents in the parent survey, 690 professionals who reported using telemental health services were included in the present subgroup analysis. Results: In some instances, practitioners offering telemental health services may not adhere to ethical standards, particularly in the case of psychologists. A significant proportion of respondents expressed concerns including potential emergencies, technical issues, and security, suggesting the need for a re-evaluation of the ethical framework. The TAM showed higher behavioral intention was associated with lower ethical compliance scores. Conversely, elevated subjective norms and perceived behavioral control have the potential to encourage ethical compliance. Conclusions: Telemental health services are widely used in China, but important gaps remain in ethical compliance and regulatory implementation. Future efforts should focus on strengthening professional training, improving platform security and emergency response procedures, and developing clearer institutional and professional guidelines for ethical telemental health practice. Full article

Background: Adults closest to children, including parents and caregivers, teachers, and therapists, are major determinants of child mental health outcomes. However, access to high-quality psychological training for these groups remains severely limited and inequitable. Artificial intelligence (AI) tools may offer a scalable, accessible, and low-cost route to training delivery. This review aimed to provide the first systematic synthesis of evidence on AI tools used to train caregivers, educators, and therapists/practitioners in psychological approaches relevant to child and adolescent mental health. Methods: A systematic review was conducted in accordance with PRISMA guidelines (PROSPERO: CRD420261336167). Five databases, MEDLINE, PsycINFO, Embase, Web of Science, and ERIC, were searched from inception to March 2026, supplemented by reference hand-searching and forward citation tracking. Studies were eligible if they evaluated an AI-based training tool used with adults in caregiving, educational, or therapeutic roles involving children or adolescents aged 0–18 years, delivered a defined psychological approach, and reported at least one training outcome. Owing to substantial methodological and outcome heterogeneity, findings were synthesised narratively, and meta-analysis was not undertaken. Results: Twenty-four studies from nine countries, published between 2019 and 2026, met inclusion criteria. Studies were grouped into caregiver training (Group A, 5 papers), educator training (Group B, 3 papers), and therapist/practitioner training (Group C, 16 papers). Identified AI modalities included natural language processing (NLP)-based chatbots, generative AI/large language model (LLM) systems, AI-integrated virtual reality (VR), and AI-based feedback and analysis tools. Feasibility and acceptability findings were generally positive across groups. However, the evidence base was limited by pervasive methodological weaknesses, including small samples, with most studies enrolling fewer than 30 participants, reliance on unvalidated self-report outcomes, and the absence of follow-up data beyond one month. Conclusions: AI tools show early promise as scalable approaches to psychological training, particularly for procedural skill acquisition and enhancement of practitioner self-efficacy. However, the current evidence base is insufficient to support claims of effectiveness. A structural credibility–accessibility paradox characterises the field: tools with the strongest controlled evidence are the least scalable, while the most accessible tools have the weakest empirical support. Adequately powered, independent randomised controlled trials (RCTs) using validated outcomes, active comparators, and follow-up extending over multiple months are needed across all three population groups. Full article

Somali refugee mothers navigating parenting in the United States face compounding challenges that extend well beyond the initial resettlement period. This study employed a multi-method qualitative design, including utilizing a focus group and follow-up key informant interviews with Somali refugee mothers. Thematic framework analysis identified three overarching domains of challenges and resilience. First, a pervasive deficit of functional literacy, defined as the practical capacity to navigate American institutional systems, emerged as the primary stressor, superseding material poverty as a barrier to daily functioning. Second, significant intergenerational tensions were documented, including role reversal between mothers and children, erosion of parental authority, and breakdown of the traditional expectations that adult children provide financial and social support to aging parents. Third, single motherhood amplified all other stressors, producing progressive role strain and mental health decline in the absence of extended family support. Despite these challenges, participants demonstrated substantial resilience through informal mutual aid networks, religious practice, and deliberate cultural and linguistic preservation. Findings have direct implications for the design of culturally responsive resettlement programming, family counseling services, and mental health interventions for Somali refugee populations. Full article

Background/Objectives: Parenting interventions are an effective way to support child development, and brief screening tools can support equitable implementation of parenting interventions by reducing program costs, increasing accessibility, and engaging populations who have traditionally been underserved. However, brief assessments are frequently overlooked and underutilized. The Family Check-Up (FCU) Online is a digital parenting intervention that integrates a brief FCU Online Assessment, feedback, and parenting skills via an app along with optional provider support. To date, no prior work has validated the FCU Online Assessment. Method: The current study combined two samples of parents participating in FCU Online studies and assessed: (1) reliability, (2) construct validity, (3) convergent validity by comparing FCU Online Assessment subscales to similar parenting and child behavior measures, and (4) predictive validity by using FCU Online Assessment at pretest to predict posttest scores as well as parenting and child behaviors at time 2 and time 3. Results: Strong reliability was found among all five subscales, including Low Conflict (7 items, α = .81), Positive Parenting Practices (11 items, α = .80), Positive School Behaviors (5 items, α = .83), Consistent Rules and Routines (11 items, α = .81), and Child Mental Health (5 items, α = .80). The FCU Online Assessment demonstrated construct and convergent validity, as well as predictive validity in that the FCU Online Assessment at pretest predicted posttest scores. Conclusions: The FCU Online Assessment is a brief, reliable, and valid measure of parenting and child wellbeing. It can be used by parents and providers alike to evaluate parenting skills and child mental health, develop targeted goals and intervention approaches, and assess family wellbeing over time. Full article

Background/Objectives: Parenting stress and life satisfaction are important indicators of family well-being and parent mental health in families of children with disabilities. However, limited empirical attention has been given to how these outcomes differ among parents whose children receive adapted physical activity (APA) services within South Korea’s Developmental Rehabilitation Service system. This cross-sectional study examined subgroup differences in parenting stress and life satisfaction according to sociodemographic, disability-related, and service-utilization characteristics among parents of children receiving APA services. Methods: Data were collected from 295 parents of school-aged children with disabilities enrolled in APA services at child development centers. Welch-type tests, Welch’s ANOVA or one-way ANOVA, Pearson correlation analyses, Benjamini–Hochberg FDR adjustment, and supplementary analyses of covariance (ANCOVA) were used to examine group differences and the stability of selected associations after adjustment for prespecified covariates. Confirmatory factor analysis and gender-based measurement invariance testing were also conducted for the adapted parenting stress scale. Results: Parenting stress subdomains were positively correlated with one another (r = 0.19–0.53) and negatively correlated with life satisfaction (r = −0.28 to −0.40). Female parents reported higher social and psychological stress than male parents. Household income showed the largest association with economic stress, and significant differences were also observed according to parental age, education level, disability severity, and selected service-utilization characteristics. Some associations remained after ANCOVA adjustment, whereas others were attenuated or emerged only after adjustment. Conclusions: The findings indicate subgroup differences in parenting stress and life satisfaction among parents of children receiving APA services. Because the study used a cross-sectional, self-reported design with convenience sampling and an adapted instrument, the results should be interpreted as preliminary associative evidence rather than evidence of causal or service-specific effects. Future longitudinal, comparative, and service-level research is needed to clarify how APA service contexts relate to caregiver well-being over time. Full article

Depression and clinical anxiety (also known as ‘internalising disorders’) are commonly experienced by autistic children. Parents play an important role in reducing their child’s risk of developing internalising disorders, and existing technology-assisted parenting programs have shown promise in empowering parents in this role. Yet, existing interventions do not currently meet the unique needs of parents of autistic children. This study aimed to co-design adaptations to an existing technology-assisted parenting program (Partners in Parenting Kids) to enhance its relevance and acceptability for parents of school-aged autistic children. An iterative two-phase co-design study was conducted with parents of autistic children (n = 5) and service providers (n = 5). In Phase 1, semi-structured interviews explored participant experiences and needs in the context of parenting support, as well as perspectives on parenting programs. In Phase 2, eight co-design workshops were conducted with parents and service providers to build on the findings from Phase 1 and to collaboratively adapt the program content, delivery, and design features. Workshops involved participatory design activities to foster collaborative sharing of ideas and decision-making. Transcripts from both phases were analysed using reflexive thematic analysis. Themes identified in Phase 1 included: (1) Day-to-day challenges of parenting an autistic child; (2) Unique parent knowledge base and skill set; and (3) Desired qualities of parenting programs. Themes from Phase 2 of the study included: (1) Meaningful connections with others in the community; (2) Acceptance of autism; and (3) Diversity within the community. These themes are described in terms of their design implications for the resultant parenting program (Partners in Parenting Kids-Autism). The findings provide critical insights into desired qualities of parenting programs for parents of autistic children. Importantly, they also shed light on key design recommendations for future work focused on empowering parents to support their child’s mental health through interventions. Full article

Background/Objectives: Given that post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG) are separate constructs that can co-occur following adversity, we examined how prior adversity and current functioning difficulties may relate to the likelihood of meeting criteria for PTSD and scoring above the cutoff for PTG among individuals who reported being impacted by their prior adversity. Methods: Participants (n = 2112) in this international sample completed online measures assessing their adversity history, current functioning difficulties (i.e., negative world assumptions and autonomic reactivity), PTSD symptomatology, and PTG. Results: Chi square analyses suggested a trend toward an association between meeting criteria for PTSD and scoring above the cutoff for PTG, although not statistically significant (p = 0.061). Multivariable logistic regression analysis found that individuals most impacted by caregiver abuse and certain specific adversities (i.e., parent with a mental health problem, caregiver and non-caregiver sexual abuse, and being held captive) were more likely to meet the criteria for PTSD. Whereas those most impacted by life-threatening situations and the specific adversities of being impacted by a life-threatening illnesses or injury, were more likely to meet the criteria for PTG. However, the strongest predictor of the likelihood of PTSD was increased autonomic reactivity, and the strongest predictor of the likelihood of PTG was fewer negative world assumptions. Conclusions: Our research suggests the need to assess the perceived impact of adversity history, as well as the potential negative consequences of autonomic reactivity and negative world assumptions, as these may be associated with PTSD symptomatology and PTG. Full article