ABSTRACT

Responding effectively to verbal stimuli requires auditory-visual conditional discriminations (AVCDs), which some learners with severe language delays struggle to acquire. The purpose of this study was to evaluate the effects of transferring control over object selection from a modeled action to a spoken word. The participants were two six-year-old twins who already had generalized object imitation skills but had not successfully acquired any listener discriminations. During the object imitation to AVCD transfer procedure, the instructor initially modeled a play-based functional action with each object and reinforced object imitation. Correct object imitation was then followed by an AVCD trial. Effects on acquisition were evaluated in a two-tier multiple baseline design across participants with replication across stimulus sets. Both the participants not only acquired the AVCD targets across 4 sets, but showed generalization and maintenance across other AVCD targets during and following the study.

Background

Children with developmental language disorder (DLD) are reported to have word spelling difficulties. These findings concern monolingual children with DLD; little is known about bilingual children with DLD. We examined word spelling abilities of bilingual children with DLD to determine if bilingualism is an additional risk factor for spelling problems.

Methods

We compared word spelling outcomes of monolingual (n = 87) and bilingual children with DLD (n = 51), who attended upper elementary years (Grade 5 or 6) of special education for children with DLD. Spelling measures obtained were a standardised curriculum-based word spelling task, an experimental dictation task and word spelling in short written texts.

Results

Outcomes on the curriculum-based spelling test established that both the monolingual and bilingual groups of children with DLD on average showed a spelling delay. Results on this test, as well as those of the experimental dictation task and the writing task, did not indicate differences between the monolingual and bilingual groups with DLD, even when lower oral language outcomes of bilingual children in the school language were controlled for.

Conclusions

The results indicate that DLD is a risk factor for word spelling difficulties while bilingualism is not.

Background

Children with developmental language disorder (DLD) are reported to have word spelling difficulties. These findings concern monolingual children with DLD; little is known about bilingual children with DLD. We examined word spelling abilities of bilingual children with DLD to determine if bilingualism is an additional risk factor for spelling problems.

Methods

We compared word spelling outcomes of monolingual (n = 87) and bilingual children with DLD (n = 51), who attended upper elementary years (Grade 5 or 6) of special education for children with DLD. Spelling measures obtained were a standardised curriculum-based word spelling task, an experimental dictation task and word spelling in short written texts.

Results

Outcomes on the curriculum-based spelling test established that both the monolingual and bilingual groups of children with DLD on average showed a spelling delay. Results on this test, as well as those of the experimental dictation task and the writing task, did not indicate differences between the monolingual and bilingual groups with DLD, even when lower oral language outcomes of bilingual children in the school language were controlled for.

Conclusions

The results indicate that DLD is a risk factor for word spelling difficulties while bilingualism is not.

ABSTRACT

Objective

This study investigated the perspectives of clients in early psychosis intervention programmes regarding the types, quality and relevance of information they desire and receive, particularly related to intimacy, romance and sexuality.

Methods

Participants (N = 35) rated the degree to which they desired and received information on topics related to treatment and recovery, as well as the quality and importance of that information.

Results

Between 25% and 50% of participants desired information on friendships, sexual functioning, sexual desire, sexual risk factors and romantic relationships. Less than half of participants who wanted information on romantic relationships, friendships, sexual desire and sexual functioning received this information. When this information was provided, however, participants reported it to be of high quality.

Conclusions

Findings demonstrate that intimacy, romance and sexuality remain areas of need that are relevant to recovery for people with psychosis, yet they continue to be insufficiently addressed in healthcare settings.

ABSTRACT

Background

Advancements in medicine have increased the life expectancy of the people with profound intellectual and multiple disabilities. The hypothesis is that as parents get older, they worry about no longer being there for their child. This paper explores the extent to which the experiences of older parents may differ from that of younger parents.

Method

The participants were parents of people included in the French EVAL-PLH cohort. Psychological status, quality of life and coping were compared between (i) parents of the youngest persons (< 20 years) versus parents of the oldest persons (≥ 35 years); (ii) youngest (< 45 years) versus oldest parents (≥ 55 years).

Results

Compared with the youngest parents, the oldest parents did not differ in anxiety–mood disorders, quality of life or coping strategies used.

Conclusion

We did not confirm that ageing generates psychological changes for parents. Future qualitative studies should deeply examine this underexplored issue.

Trial Registration: Clinical trial number: NCT02400528

ABSTRACT

Background

Resting metabolic rate (RMR), the energy required by the body at rest, is the largest part of total daily energy expenditure. Commonly used prediction equations may overestimate RMR in adults with Down syndrome (DS). The purpose of this study was to assess the equivalency of prediction equations for estimating RMR in adults with DS.

Methods

Twenty-five adults with DS (24 ± 5 years of age, 64% female) completed RMR assessments at an academic medical centre in the United States between November 2021 and July 2023. Measured RMR (kilocalories per day) was compared to estimated RMR from eight prediction equations using a null hypothesis significance (i.e., a paired t-test) and equivalence (i.e., a two one-sided test) tests. Bland–Altman plots, Pearson correlations and linear regressions were used to evaluate the bias between the measured and predicted RMR values.

Results

Measured RMR in adults with DS was 1090 ± 136 kcal/day. Prediction equations overestimated RMR by 8 ± 16% (76 ± 165 kcal/day) to 45 ± 16% (488 ± 165 kcal/day) except for the Bernstein fat-free mass equation which underestimated RMR by 0.2 ± 11.5% (8 ± 123 kcal/day) and was statistically equivalent to measured RMR in our sample (p = 0.027).

Conclusions

The Bernstein fat-free mass equation offers better accuracy in adults with DS than other RMR prediction equations, but the equation needs to be evaluated in larger, more diverse samples of adults with DS.

ABSTRACT

Aim

Identifying young people in the early stages of psychosis identification is critical, since a longer duration of untreated psychosis is associated with poorer recovery outcomes. However, many mental health students and trainees do not receive training in this area. The aim of this study was to pilot test the effectiveness of an early-stage psychosis training program for mental health students and trainees.

Method

A pre/post matched sample of interdisciplinary mental health students and trainees (N = 21) attended a 75-min early-stage psychosis training program, and completed measures related to stigma, clinical training outcomes, and knowledge.

Results

There were significant improvements in psychosis-related stigma, intended clinical behaviour and knowledge. There was also high satisfaction with the training program.

Conclusion

This study suggests that a brief early-stage psychosis training program is acceptable to students and trainees and feasible to implement and may yield significant benefits regarding students and trainees' personal psychosis stigma, as well as improvements in clinical behaviour and psychosis knowledge.

ABSTRACT

Objective

Early intervention in psychosis is associated with favourable outcomes. We investigated whether loved ones' illness duration moderated caregiver outcomes following a Cognitive Behavioural Therapy-informed Family Intervention for psychosis (FIp).

Methods

We conducted a secondary analysis of measures of FIp participants' depression and anxiety symptoms, caregiver appraisals, expressed emotion and foundational psychotherapeutic competencies at pre-, post- and 4-month follow-up. Our primary aim was to evaluate whether duration of illness moderated participant outcomes.

Results

Relative to pre-intervention, all caregivers reported lower depression, anxiety and expressed emotion, as well as higher positive attitudes and mastery of cognitive behavioural skills, at post-intervention and 4-month follow-up. Outcomes were not moderated by their loved one's illness duration.

Conclusion

Families may benefit equally from FIp regardless of illness duration. Although we recommend that FIp are offered as early as possible, modifications for families with lengthier illness courses are not implicated by our findings.

ABSTRACT

Background

This study describes the proportion of Ontario adults with and without intellectual and developmental disabilities (IDD) who used community- and hospital-based healthcare in the first 2 years of the pandemic compared with the year pre–COVID-19.

Methods

Linked health administrative databases identified 87 341 adults with IDD and also adults without IDD living in Ontario, Canada. For each cohort, counts and proportions of adults who used different types of healthcare services were reported for the pre–COVID-19 year (16 March 2019 to 14 March 2020) and the first two COVID-19 years (15 March 2020 to 14 March 2021 and 15 March 2021 to 14 March 2022).

Results

Compared with the year prior to COVID-19, the proportion of adults with and without IDD who used health services was lower during the first COVID-19 year, but the likelihood of all types of visits increased during the second year. The likelihood of using homecare and of being hospitalized nearly returned to pre-pandemic levels. Virtual physician visits increased in each COVID-19 year from 5.2% prior to the pandemic to 13.0% in year 1 and 58.7% in year 2. For all years, the proportion of adults who used each service type was higher for those with IDD than without IDD.

Conclusions

For adults with and without IDD in Ontario, Canada, during the first two COVID-19 years healthcare use decreased for all service types, except for virtual physician visits. In the second year, healthcare use increased but did not reach pre–COVID-19 levels. In all years, adults with IDD were more likely to use services than other adults.

Abstract

Prior research suggests that feeling needed and useful plays a central role in adolescent psychosocial development and well-being. However, little is known about whether feeling needed and useful benefits adolescents' well-being in daily life, especially for those with suicidal ideation. The current study examined the daily association between feeling needed and useful and emotional and social well-being in a daily diary sample of adolescents (N = 122; M _age = 12.64) with and without suicidal ideation. Results from multilevel modeling showed that on days when youth experienced higher levels of feeling needed and useful, they reported lower negative emotions, higher positive emotions, and increased family connectedness. Furthermore, significant moderation effects indicated that daily feelings of being needed and useful were associated with higher positive emotions and peer connectedness only for youth with suicidal ideation. The findings support the importance of feeling needed and useful in adolescent development and highlight its beneficial effects among adolescents at risk for suicide.

Abstract

This study is the first to explore the relation between children's attachment classifications, assessed by Mary Ainsworth's Strange Situation Procedure (SSP), and mothers’ acceptance-rejection behaviors from the lens of Interpersonal Acceptance-Rejection Theory (IPARTheory). As a pilot study, the sample consisted of 23 Egyptian mother-child dyads. The mean age of children in the SSP was 18.6 months (SD = 3.10). Mothers’ acceptance-rejection behaviors were explored through the Parental Acceptance-Rejection/Control Questionnaire (PARQ/Control). The pilot study's findings revealed that maternal acceptance-rejection behaviors significantly differed across children's attachment classifications. The findings also shed light on gender differences in parenting, as mothers tended to show a higher level of hostility/aggression, undifferentiated rejection, and control with their daughters more than sons. This study is an important stepping-stone for attachment research in the Arab world. It highlights several cultural aspects to be taken into account for future research using the SSP in Egypt or any other Arab country.

ملخص

ھﺬه اﻟﺪراﺳﺔ ھﻲ اﻷوﻟﻰ اﻟﺘﻲ ﺗﺴﺘﻜﺸﻒ اﻟﻌﻼﻗﺔ ﺑﯿﻦ ﺗﺼﻨﯿﻔﺎت اﻟﺘﻌﻠﻖ/اﻟﺘﺮاﺑﻂ اﻟﻌﺎطﻔﻲ ﻟﺪى اﻷطﻔﺎل، واﻟﺘﻲ ﺗﻢ ﺗﻘﯿﯿﻤﮭﺎ ﻣﻦ ﺧﻼل إﺟﺮاء اﻟﻤﻮﻗﻒ اﻟﻐﺮﯾﺐ (SSP) ﻟﻤﺎري أﯾﻨﺴﻮرث، وﺳﻠﻮﻛﯿﺎت اﻟﻘﺒﻮل واﻟﺮﻓﺾ ﻟﺪى اﻷﻣﮭﺎت ﻣﻦ ﻣﻨﻈﻮر ﻧﻈﺮﯾﺔ اﻟﻘﺒﻮل واﻟﺮﻓﺾ ﺑﯿﻦ اﻷﺷﺨﺎص.(IPARTheory) ﻛﺪراﺳﺔ ﺗﺠﺮﯾﺒﯿﺔ، ﺗﻜﻮﻧﺖ اﻟﻌﯿﻨﺔ ﻣﻦ 23 ﺛﻨﺎﺋﯿًﺎ ﻣﺼﺮﯾًﺎ ﻟﻸم واﻟﻄﻔﻞ. ﻛﺎن ﻣﺘﻮﺳﻂ ﻋﻤﺮ اﻷطﻔﺎل 18.6 ﺷﮭﺮا. ﺗﻢ اﻛﺘﺸﺎف ﺳﻠﻮﻛﯿﺎت اﻟﻘﺒﻮل واﻟﺮﻓﺾ ﻟﺪى اﻷﻣﮭﺎت ﻣﻦ ﺧﻼل اﺳﺘﺒﯿﺎن اﻟﻘﺒﻮل واﻟﺮﻓﺾ/اﻟﺘﺤﻜﻢ اﻷﺑﻮي.(PARQ/Control) ﻛﺸﻔﺖ ﻧﺘﺎﺋﺞ اﻟﺪراﺳﺔ اﻟﺘﺠﺮﯾﺒﯿﺔ أن ﺳﻠﻮﻛﯿﺎت اﻟﻘﺒﻮل واﻟﺮﻓﺾ ﻟﺪى اﻷﻣﮭﺎت ﺗﺨﺘﻠﻒ ﺑﺸﻜﻞ ﻛﺒﯿﺮ ﻋﺒﺮ ﺗﺼﻨﯿﻔﺎت اﻟﺘﻌﻠﻖ ﻟﺪى اﻷطﻔﺎل. ﻛﻤﺎ أﻟﻘﺖ اﻟﻨﺘﺎﺋﺞ اﻟﻀﻮء ﻋﻠﻰ اﻻﺧﺘﻼﻓﺎت ﺑﯿﻦ اﻟﺠﻨﺴﯿﻦ ﻓﻲ ﺳﻠﻮﻛﯿﺎت اﻷم ﻓﻲ اﻟﺘﺮﺑﯿﺔ، ﺣﯿﺚ ﺗﻤﯿﻞ اﻷﻣﮭﺎت إﻟﻰ إظﮭﺎر ﻣﺴﺘﻮى أﻋﻠﻰ ﻣﻦ اﻟﺘﺤﻜﻢ واﻟﻌﺪوان واﻟﺮﻓﺾ ﻏﯿﺮ اﻟﻤﺘﻤﺎﯾﺰ ﻣﻊ ﺑﻨﺎﺗﮭﻦ أﻛﺜﺮ ﻣﻦ اﻷﺑﻨﺎء. ﺗﺸﻜﻞ ھﺬه اﻟﺪراﺳﺔ ﺧﻄﻮة ﻣﮭﻤﺔ ﻓﻲ ﻣﺠﺎل أﺑﺤﺎث اﻟﺘﻌﻠﻖ ﻓﻲ اﻟﻌﺎﻟﻢ اﻟﻌﺮﺑﻲ، ﻓﮭﻲ ﺗﺴﻠﻂ اﻟﻀﻮء ﻋﻠﻰ اﻟﻌﺪﯾﺪ ﻣﻦ اﻟﺠﻮاﻧﺐ اﻟﺜﻘﺎﻓﯿﺔ اﻟﺘﻲ ﯾﻨﺒﻐﻲ أﺧﺬھﺎ ﻓﻲ اﻻﻋﺘﺒﺎر ﻓﻲ اﻷﺑﺤﺎث اﻟﻤﺴﺘﻘﺒﻠﯿﺔ اﻟﺘﻲ ﺗﺴﺘﺨﺪم SSP ﻓﻲ ﻣﺼﺮ أو أي دوﻟﺔ ﻋﺮﺑﯿﺔ أﺧﺮى.

Abstract

Social understanding competence develops in sensitive and co-regulating caregiver interactions. Parental reflective functioning (PRF) and parenting stress can affect children's social understanding. This study investigated if children's social understanding was associated with PRF and parenting stress. Parents of 305 Italian children aged from 24 to 72 months (M  = 48.2, SD = 13.9; 47.9% girls) completed an online survey. Parents completed the following questionnaire: The Parenting Stress Index—Short Form, the Parental Reflective Functioning Questionnaire, and the Children's Social Understanding Scale. Results showed that children's social understanding was predicted by lower parenting stress, b = .002, p = .017, and parent's interest and curiosity about the child's mental states, b = .07, p = .013. Findings confirm that high levels of parenting stress and low PRF constitute unfavorable conditions for preschoolers’ socio-cognitive development. Thus, the present study can have implication for interventions aimed at improving children's social understanding that should focus on reducing parenting stress and enhancing parental mentalizing.

Resumen

La competencia de comprensión social se desarrolla en interacciones sensibles y co-reguladoras de quien presta el cuidado. El funcionamiento con reflexión del progenitor (PRF) y el estrés de crianza pueden afectar la comprensión social de los niños. Este estudio investigó si la comprensión social de los niños estaba asociada con PRF y el estrés de crianza. Los progenitores de 305 niños italianos de edad entre 24 y 72 meses (M = 48.2, SD = 13.9; 47.9% niñas) completaron una encuesta en línea. Los progenitores completaron los siguientes cuestionarios: El Índice de Estrés de la Crianza—Versión Corta, el Cuestionario sobre el Funcionamiento con Reflexión del Progenitor, así como la Escala sobre la Comprensión Social de los Niños. Los resultados mostraron que tanto el más bajo estrés de crianza, b = .002, p = .017, como el interés y curiosidad del progenitor acerca de los estados mentales del niño, b = .07, p = .013, predecían la comprensión social de los niños. Las conclusiones confirman que los altos niveles de estrés de crianza y un bajo PRF constituyen condiciones no favorables para el desarrollo sociocognitivo de niños prescolares. Por tanto, el presente estudio puede tener implicaciones en las intervenciones cuya meta es mejorar la comprensión social de los niños que debe enfocarse en reducir el estrés de crianza e incrementar la mentalización del progenitor.

Résumé

La compétence de compréhension sociale se développe dans les interactions sensibles et co-régulatrices avec les personnes prenant soin de l'enfant. Le fonctionnement de réflexion des parents (FRP en français) et le stress parental peuvent affecter la compréhension sociale de l'enfant. Cette étude a examiné si la compréhension sociale des enfants était associée à la FRP et au stress parental. Les parents de 305 enfants italiens âgés de 24 à 72 mois (M = 48,2, SD = 13,9; 47,9 % filles) ont répondu à un sondage en ligne. Les parents ont rempli le questionnaire suivant: l'indice de stress parental—formulaire abrégé, le questionnaire sur le fonctionnement des parents et l’échelle de compréhension sociale des enfants. Les résultats ont montré que la compréhension sociale des enfants était prédite par un stress parental plus faible, b = .002, p = .017, et par l'intérêt et la curiosité des parents à propos de l’état mental de l'enfant, b = .07, p = . 013. Les résultats confirment que des niveaux élevés de stress parental et un faible FRP constituent des conditions défavorables pour le développement socio-cognitif des enfants d’âge préscolaire. Ainsi, cette étude peut avoir une implication pour les interventions visant à améliorer la compréhension sociale des enfants, études qui devraient se concentrer sur la réduction du stress parental et l'amélioration de la mentalisation parentale.

Zusammenfassung

Die Kompetenz sozialen Verstehens entwickelt sich in sensiblen und ko-regulierenden Interaktionen mit der Bezugsperson. Die elterliche reflektive Mentalisierungsfähigkeit (Parental Reflective Functioning; PRF) und elterlicher Stress können das soziale Verstehen von Kindern beeinflussen. In dieser Studie wurde untersucht, ob das soziale Verstehen der Kinder mit PRF und elterlichem Stress zusammenhängt. Eltern von 305 italienischen Kindern im Alter von 24 bis 72 Monaten (M = 48,2, SD = 13,9; 47,9 % Mädchen) füllten eine Online-Umfrage aus. Die Eltern füllten die folgenden Fragebogen aus: die Kurzform des Parenting Stress Index, den Parental Reflective Functioning Questionnaire und die Children's Social Understanding Scale. Die Ergebnisse zeigten, dass das soziale Verstehen der Kinder durch geringeren elterlichen Stress (b = .002, p = .017) und das Interesse und die Neugier der Eltern an den mentalen Zuständen des Kindes (b = .07, p = .013) vorhergesagt wurde. Die Ergebnisse bestätigen, dass ein hohes Maß an elterlichem Stress und eine niedrige PRF ungünstige Bedingungen für die sozio-kognitive Entwicklung von Vorschulkindern darstellen. Daher kann die vorliegende Studie Auswirkungen auf Interventionen zur Verbesserung des sozialen Verstehens von Kindern haben, die sich auf die Verringerung des elterlichen Stresses und die Verbesserung der elterlichen Mentalisierung konzentrieren sollten.

要旨

社会理解力は、敏感で協調的な養育者との相互交流の中で発達する。 親の省察機能(PRF)と育児ストレスは、子どもの社会理解に影響を与える可能性がある。本研究では、子どもの社会的理解がPRFや育児ストレスと関連しているかどうかを検証した。 生後24ヵ月から72ヵ月の305人のイタリアの子ども(M = 48.2、SD = 13.9、女児47.9％)の親がオンライン調査に回答した。親は、子育てストレス指数-ショート形式、親の省察機能質問票、子どもの社会理解尺度の各質問票に回答した。その結果、子どもの社会的理解は、育児ストレスの低さ、b = .002、p = .017、子どもの精神状態に対する親の関心と好奇心、b = .07、p = .013によって予測されることが示された。この結果から、育児ストレスが高く、PRFが低いことは、就学前の子どもの社会認知的発達にとって好ましくない条件であることが確認された。したがって、本研究は、育児ストレスの軽減と親のメンタライジングの強化に焦点を当てた、子どもの社会的理解の向上を目指した介入に示唆を与えるものである。

摘 要

社交理解能力的发展依赖于敏感且共同调节的看护者互动。父母反思功能(PRF)和育儿压力会影响儿童的社交理解能力。本研究旨在探讨儿童的社交理解能力是否与父母的PRF及育儿压力相关。305名意大利儿童(年龄范围为24至72个月, 平均年龄为48.2个月, 标准差为13.9;47.9%为女孩)的父母完成了一项在线问卷调查。父母完成了以下问卷:育儿压力指数简表、父母反思功能问卷以及儿童社交理解量表。结果表明, 较低的育儿压力(b = .002, p = .017)以及父母对儿童心理状态的兴趣和好奇心(b = .07, p = .013)能够预测儿童更高的社交理解能力。研究结果证实, 高育儿压力和低PRF不利于学龄前儿童的社会认知发展。因此, 本研究对干预措施具有启示意义, 干预应着重于降低育儿压力并提升父母的心智化能力, 以改善儿童的社交理解能力。

ملخص

تتطور كفاءة الفهم الاجتماعي في تفاعلات مقدمي الرعاية الحساسة والمنظمة بشكل مشترك. يمكن أن يؤثر الأداء التأملي للوالدين(PRF) وضغوطات الوالدين على الفهم الاجتماعي للأطفال. بحثت هذه الدراسة في ما إذا كان الفهم الاجتماعي للأطفال مرتبطًا بتقييم الأداء التأملي للوالدين وضغوطات التربية. أكمل آباء 305 من الأطفال الإيطاليين تتراوح أعمارهم بين 24 و72 شهرًا (منهم 47.9% بنات) استبيانًا عبر الإنترنت. أكمل الوالدان الاستبيان التالي: مؤشر إجهاد التربية—النموذج القصير، واستبيان الأداء الأبوي التأملي، ومقياس الفهم الاجتماعي للأطفال. أظهرت النتائج أنه تم التنبؤ بالفهم الاجتماعي للأطفال من خلال انخفاض الضغط العصبي عند الوالدين ، واهتمام الوالدين وفضولهم حول الحالات النفسية للطفل. تؤكد النتائج أن المستويات العالية من إجهاد الوالدين وانخفاض معدل اهتمام الوالدين بالحالة النفسية للطفل في مرحلة ما قبل المدرسة تشكل ظروفًا غير مواتية للنمو الاجتماعي والمعرفي لدى الأطفال في مرحلة ما قبل المدرسة. وبالتالي، يمكن أن يكون للدراسة الحالية تأثير على التدخلات التي تهدف إلى تحسين الفهم الاجتماعي للأطفال والتي يجب أن تركز على الحد من ضغوط الوالدين وتعزيز الاستبصار الذهني للوالدين.

Abstract

This brief report examined the co-development of ethnic/racial identity (ERI) and future orientation among ethnically/racially minoritized adolescents. The current study used three waves of longitudinal data (N = 619) spanning 8th to 10th grades from a diverse sample (55.9% Latino/a/x, 21.2% biracial/multiethnic/other, 13.2% Asian, 9.7% Black; 54.1% female; 57.4% economically disadvantaged). We investigated the developmental trajectories of future orientation and ethnic identity and determined if these trajectories were interrelated. The results of the single and parallel process latent growth curve models showed that mean levels of ERI increased while future orientation decreased over time. Initial levels of ERI were significantly related to accelerated declines in future orientation. Exploratory analyses, which tested distinct forms of ethnic/racial discrimination as moderators, revealed that the negative association between ERI in 8th grade and the rate of change in future orientation was significant only at average and high levels of educator-perpetrated discrimination. These results point to complex interrelations between ERI formation and experiences of ethnic/racial discrimination and their influence on trajectories of future orientation during early to middle adolescence.

Abstract

We compared referrals and connection to care between perinatal patients: 90 receiving OB/GYN care in clinics with integrated behavioral health consultants with infant mental health specialization (IMH-BHC), and 68 receiving traditional care, in the United States. Participants identified as: Native American/Alaskan native, 1.90%; Asian, .63%; African American, 58.23%; Middle Eastern, 6.96%; African National/Caribbean Islander, .63%; Latin-American, 8.86%; and White, 28.48%.

Approximately 80% of families in each group were offered referrals. By design, intervention women received mental health services during pregnancy; 16% of women in either group received postpartum mental health services. Intervention group participants were over three times as likely to engage in IMH home visiting. Treatment families were less likely to follow up with infant referrals, but also had fewer infant emergency room visits.

All intervention participants met with an IMH-BHC prior to recruitment; however, only 20% self-reported encounters with a mental health professional, indicating these interactions may not be identified by the participants as mental health care; therefore, openness to treatment may be increased for women who feel stigma around mental health care.

Given the importance of perinatal mental health, OB/GYN clinics and others serving perinatal patients may consider integrating IMH providers as part of the care team.

ملخص

تُعد التدخلات الثنائية التي تستهدف الصحة النفسية للوالدين والعلاقة بين الوالدين والرضيع أمراً بالغ الأهمية نظراً للعواقب المحتملة للمرض النفسي واضطراب العلاقة بين الوالدين والرضيع والأسرة في فترة ما حول الولادة. تصف هذه الورقة البحثية نموذج الرعاية من الحمل إلى الأبوة(P2P) ، وهو برنامج مجتمعي ثنائي قائم على العلاقة بين الوالدين والرضيع مصمم لدعم الأسر الضعيفة في غرب أستراليا في سياق الحاجة المحددة لبناء قدرات القوى العاملة. تم إجراء دراسة تقييمية عملية للخدمة، وتحليل البيانات السريرية الروتينية التي تم جمعها من 105 من الأزواج الذين أكملوا مقاييس ما قبل التدخل وبعده، بما في ذلك مقياس إدنبرة للاكتئاب بعد الولادة، ومقياس فحص القلق في فترة ما حول الولادة، ومقياس العلاقات بين الأمهات والأشياء—نموذج قصير. أشارت تحليلات مؤشر التغيير الموثوق به إلى انخفاض قبلي وبعدي في أعراض الاكتئاب والقلق في الفترة المحيطة بالولادة لـ 71% و68% من العينة على التوالي. كما أظهرت النتائج تحسينات كبيرة قبلية وبعدية بأحجام تأثير متوسطة (r = −.46, r = − .32) لتصورات تقديم الرعاية للرضيع. توفر هذه النتائج دليلًا مؤقتاً على أن نموذج الرعايةP2P قد يكون فعالاً في تحسين الصحة النفسية للوالدين وتصورات تقديم الرعاية. ويلزم إجراء المزيد من البحوث لتقييم فعالية نموذج الرعاية من شخص إلى شخص فيما يتعلق بتعزيز رفاهية الأسرة، وإبلاغ السياسات وتطوير خدمات الصحة النفسية.

摘 要

我们比较了在美国接受围产期护理的患者中, 90名在设有专注于婴儿心理健康的综合行为健康顾问(IMH-BHC)的妇产科诊所接受护理的患者(干预组), 与68名接受传统护理的患者(对照组)在转诊和接受护理方面的差异。参与者的族裔分布如下:美洲原住民/阿拉斯加原住民1.90%;亚洲裔0.63%;非裔美国人58.23%;中东裔6.96%;非洲裔/加勒比岛民0.63%;拉丁美洲裔8.86%;白人28.48%。

约80%的家庭获得了转诊服务, 且干预组与对照组之间无显著差异。按照研究设计, 干预组女性在怀孕期间接受心理健康服务;两组中16%的女性接受产后心理健康服务。干预组的参与者接受IMH家访的可能性是对照组的三倍以上。尽管如此, 干预组家庭较少跟进婴儿的转诊服务, 其婴儿急诊室就诊次数也较少。

所有干预组参与者在招募前均与IMH-BHC会面;然而, 只有20%的参与者自述与心理健康专业人士有过接触, 这表明她们可能没有将这些互动视为心理健康护理;因此, 对于那些因心理健康污名化而犹豫接受帮助的女性来说, 这种模式可能提高她们对治疗的接受度。

鉴于围产期心理健康的重要性, 妇产科诊所及其他服务围产期患者的医疗机构可以考虑将IMH提供者整合到护理团队中。

Résumé

Nous avons comparé les références et les liens aux soins entre des patientes périnatales: 90 de ces patientes ont reçu des soins d'obstétrique et de gynécologie dans des cliniques avec des consultations en santé comportementale intégrées spécialisées en santé mentale infantile (IMH-BHC), et 68 de ces patientes ont reçu des soins traditionnels, cela aux États-Unis. Les participants se sont identifiées en tant que: autochtones américaines/alaskiennes, 1, 90 %; asiatiques, 0, 63 %; afro-américaines, 58, 23 %; du Moyen-Orient, 6, 96 %; d'Afrique ou des Caraïbes, 0, 63 %; latines-américaines, 8, 86 %; et blanches, 28, 48 %. Environ 80 % des familles ont été envoyées consulter, sans différences de groupe. Selon la structure de l’étude, les femmes du groupe d'intervention ont reçu des services de santé mentale pendant la grossesse; 16 % des femmes des deux groupes ont reçu des services de santé mentale après l'accouchement. Les participantes du groupe d'intervention se sont avérés être plus de trois fois plus à même de participer à la visite à domicile de santé mentale du nourrisson. Les familles du groupe de traitement se sont avérées moins à même de s'engager dans le suivi avec les nourrissons envoyés consulter mais ont aussi fait preuve de moins de visites aux Urgences pour les nourrissons. Toutes les participantes à l'intervention ont rencontré un IMH-BHC avant le recrutement. Cependant seules 20 % d'entre elles ont rapporté avoir rencontré un professionnel de la santé mentale, ce qui montre que ces interactions ne peuvent pas être identifiées par les participantes comme étant des soins en santé mentale; Par conséquent, l'ouverture au traitement peut être plus grande pour les femmes qui ressentent une stigmatisation des soins de santé mentale. Compte tenu de l'importance de la santé mentale périnatale, les cliniques d'obstétrique et de gynécologie et les autres services qui servent les patients périnataux peuvent envisager d'intégrer des prestataires de santé mentale du nourrisson dans leur équipe de soins.

Zusammenfassung

Wir verglichen die Überweisungen und die Anbindung an die Versorgung zwischen perinatalen Patient:innen in den USA: 90, die in Kliniken mit integrierten verhaltensmedizinischen Beratern mit Spezialisierung auf die psychische Gesundheit von Säuglingen (IMH-BHC) gynäkologische Betreuung erhielten, und 68, die auf herkömmliche Weise betreut wurden. Die Teilnehmenden identifizierten sich als: Ureinwohnende Amerikas/Alaskas, 1,90 %; Asiat:innen, 0,63 %; Afroamerikaner:innen, 58,23 %; aus dem Nahen Osten, 6,96 %; aus Afrika/von karibischen Inseln, 0,63 %; Lateinamerikaner:innen, 8,86 %; und Weiße, 28,48 %. Etwa 80 % der Familien wurde eine Überweisung angeboten, wobei es keine Gruppenunterschiede gab. Die Frauen der Interventionsgruppe erhielten während der Schwangerschaft psychische Gesundheitsbetreuung; 16 % der Frauen in beiden Gruppen nahmen nach der Geburt psychische Gesundheitsbetreuung in Anspruch. In der Interventionsgruppe war eine Teilnahme an IMH-Hausbesuchen mehr als drei Mal so wahrscheinlich. In den Familien der Interventionsgruppe war die Wahrscheinlichkeit geringer, dass weitere Überweisungen für das Kind erfolgten, aber Säuglinge wurden auch seltener in die Notaufnahme gebracht. Alle Teilnehmerinnen der Interventionsgruppe hatten vor der Rekrutierung einen IMH-BHC aufgesucht; allerdings berichteten nur 20 % von Begegnungen mit einer psychosozialen Fachkraft, was darauf hindeutet, dass diese Interaktionen von den Teilnehmerinnen möglicherweise nicht als psychische Gesundheitsversorgung wahrgenommen wurden. Daher könnte die Offenheit für eine Behandlung bei Frauen, die Stigma um Themen psychischer Gesundheit empfinden, erhöht sein. Angesichts der Bedeutung perinataler psychischer Gesundheit sollten gynäkologische Kliniken und andere Stellen, die perinatale Patientinnen betreuen, in Erwägung ziehen, IMH-Fachkräfte in ihr Behandlungsteam zu integrieren.

抄録

私達は、周産期患者における紹介とケアとの継続性について、次の2グループ間で比較した。すなわち、米国の乳幼児精神保健専門統合行動健康コンサルタント(IMH-BHC)がいるクリニックで産婦人科医療を受けている90人と、従来の医療を受けている68人である。参加者は以下のように識別された。アメリカ先住民/アラスカ先住民1.90％、アジア人0.63％、アフリカ系アメリカ人58.23％、中東系6.96％、アフリカ系アメリカ人/カリビアンアイランダー0.63％、ラテン系アメリカ人8.86％、白人28.48％。

約80％の家族が紹介され、グループ差はなかった。デザインとして、介入群の女性は妊娠中にメンタルヘルスサービスを受け、いずれの群でも16％の女性が産後にメンタルヘルスサービスを受けた。介入群の参加者は、IMH家庭訪問に参加する傾向が3倍以上であった。治療の家族は乳幼児紹介によるフォローアップを受ける傾向が低かったが、乳幼児の救急外来受診も少なかった。介入参加者全員が、募集前にIMH-BHCと面談した。しかしながらメンタルヘルス専門家との面談を自己報告したのはわずか20％であった。これは、これらの面談が参加者にメンタルヘルスケアとして認識されていない可能性を示している。したがって、メンタルヘルスケアに後ろめたさをを感じている女性にとっては、治療への風通しが高まる可能性がある。

周産期メンタルヘルスの重要性を考慮すると、産婦人科クリニックや周産期患者にサービスを提供する他の機関は、ケアチームの一部としてIMHプロバイダーを統合することを検討してもよいであろう。

Resumen

Comparamos referencias profesionales y conexiones con el servicio de cuidado a pacientes perinatales: 90 que recibían cuidado obstétrico/ginecológico (OB/GYN) en clínicas con integrados consultores sobre la actitud en cuanto a salud, especializados en salud mental infantil (IMH-BHC), y 68 que recibían el servicio de cuidado tradicional, en Estados Unidos. Las participantes se identificaban así: indígena norteamericana/nativa de Alaska, 1.90%; asiática, 0.63%; afroamericana, 58.23%; del medio oriente, 6.96%; nativa de África/islas del Caribe, 0.63%; latinoamericana, 8.86%; blanca, 28.48%.

A aproximadamente 80% de las familias se les ofreció referencia profesional, sin distinción de grupo. Según diseño, las mujeres de la intervención recibieron servicios de salud mental durante el embarazo; 16% de las mujeres en un grupo o el otro recibió servicios de salud mental después del parto. Quienes participaban en la intervención estaban más de tres veces dispuestas a recibir visitas de salud mental infantil (IMH) a casa. Las familias en el tratamiento estuvieron menos propensas a dar seguimiento a referencias profesionales, pero también tuvieron menos visitas con el infante a la sala de urgencia.

Todas las participantes en la intervención se reunieron con un IMH-BHC antes del reclutamiento; sin embargo, sólo 20% auto reportaron encuentros con un profesional de salud mental, lo que indica que las participantes pudieran no identificar estas interacciones como cuidado de salud mental; por tanto, la disposición al tratamiento pudiera incrementarse para mujeres que ven como estigma el cuidado de salud mental.

Dada la importancia de la salud mental perinatal, las clínicas OB/GYN y otras oficinas que les sirven a pacientes perinatales pudieran considerar integrar profesionales IMH como parte del equipo de cuidado.