We applied network analysis combined with community detection algorithms to examine how adverse experiences (AEs) (e.g., abuse, bullying victimization, financial difficulties) are, individually and conjunctively, associated with emotional and behavioral problems at age fourteen in the Dutch TRacking Adolescents’ Individual Lives Survey (TRAILS, N = 1880, 52.2% female). We found that bullying victimization, peer rejection, parental mental health problems, emotional abuse, and sexual abuse were the only AEs directly contributing to risk of emotional problems. Parental divorce and emotional abuse were the only AEs directly contributing to risk of behavioral problems. Most AEs (e.g., parental employment, parental physical illness) were not conditionally associated with emotional and behavioral problems but may nevertheless contribute to emotional and behavioral problems via associations with other AEs (e.g., parental unemployment and emotional abuse). Community detection algorithms suggested that many of the AEs cluster together (e.g., physical abuse, emotional abuse, and sexual abuse; financial difficulties and parental unemployment), sometimes with emotional and behavioral problems (e.g., bullying victimization, peer rejection and emotional problems). Our findings shed light on how individual AEs contribute to risks of emotional and behavioral problems directly, and indirectly through associations with other AEs.

Parental reflective functioning (PRF) is the ability of parents to understand their child’s behavior in light of underlying mental processes; it is a core element in the parent–child relationship. RF is also considered crucial for self-regulation for both parents and their children. We investigated the relationship between improvement in PRF after DUET group intervention (a RF-based intervention) and improvement in the parent–child interaction, child RF, and child adjustment, and we examined whether these improvements were distinct for children with different temperamental traits (e.g., effortful control). Eighty-four parents completed the DUET program and were assessed before and after the intervention. PRF was measured using observation (mind-mindedness) and a questionnaire. Statistical analysis included hierarchical regression and moderation of regression analysis. Results showed that improvement in the parent–child interaction, child RF, and child behavioral problems were related to improvement in PRF. Furthermore, we found that child temperament acted as a moderator in the link between PRF and child RF, supporting a vantage sensitivity model, meaning that it was the more sensitive children who benefitted the most as a result of the positive change in their parents’ RF. Clinical and future directions of this study are discussed.

Early adolescents (ages 10–14) living in low- and middle-income countries have heightened vulnerability to psychosocial risks, but available evidence from these settings is limited. This study used data from the Global Early Adolescent Study to characterize prototypical patterns of emotional and behavioral problems among 10,437 early adolescents (51% female) living in the Democratic Republic of Congo (DRC), Malawi, Indonesia, and China, and explore the extent to which these patterns varied by country and sex. LCA was used to identify and classify patterns of emotional and behavioral problems separately by country. Within each country, measurement invariance by sex was evaluated. LCA supported a four-class solution in DRC, Malawi, and Indonesia, and a three-class solution in China. Across countries, early adolescents fell into the following subgroups: Well-Adjusted (40–62%), Emotional Problems (14–29%), Behavioral Problems (15–22%; not present in China), and Maladjusted (4–15%). Despite the consistency of these patterns, there were notable contextual differences. Further, tests of measurement invariance indicated that the prevalence and nature of these classes differed by sex. Findings can be used to support the tailoring of interventions targeting psychosocial adjustment, and suggest that such programs may have utility across diverse cross-national settings.

Impaired facial emotion recognition is a transdiagnostic risk factor for a range of psychiatric disorders. Childhood behavioral difficulties and parental emotional environment have been independently associated with impaired emotion recognition; however, no study has examined the contribution of these factors in conjunction. We measured recognition of negative (sad, fear, anger), neutral, and happy facial expressions in 135 children aged 5–7 years referred by their teachers for behavioral problems. Parental emotional environment was assessed for parental expressed emotion (EE) – characterized by negative comments, reduced positive comments, low warmth, and negativity towards their child – using the 5-minute speech sample. Child behavioral problems were measured using the teacher-informant Strengths and Difficulties Questionnaire (SDQ). Child behavioral problems and parental EE were independently associated with impaired recognition of negative facial expressions specifically. An interactive effect revealed that the combination of both factors was associated with the greatest risk for impaired recognition of negative faces, and in particular sad facial expressions. No relationships emerged for the identification of happy facial expressions. This study furthers our understanding of multidimensional processes associated with the development of facial emotion recognition and supports the importance of early interventions that target this domain.

Maternal smoking during pregnancy is associated with both reduced birth weight and adverse neurobehavioral outcomes. The aim of this study was to investigate longitudinal associations between maternal smoking during pregnancy and childhood behavioral outcomes, and to determine the role of birth weight in mediating such associations. The study included 489 mother–child pairs. Prenatal exposures were assessed via maternal interviews conducted on average 1 year after delivery and child behavior assessments were completed at 5–12 years of age using the Child Behavior Checklist (CBCL) and Teacher Report Form (TRF). Maternal smoking during pregnancy was associated with externalizing and total behavior problems according to both mother and teacher report. Maternal smoking was also associated with the following percentage increases in scores: 41% (CBCL) and 44% (TRF) for aggressive behavior and 65% (CBCL) and 47% (TRF) for attention problems. Associations with behavior problems were attenuated or no longer observed for mothers that quit smoking in early pregnancy. The proportion of the total effect of maternal smoking on behavioral outcomes explained by differences in birth weight was small and ranged from 6.6% for externalizing behavior on the CBCL to 20.1% for rule-breaking behavior on the CBCL. Our results suggest that birth weight differences explain only a small proportion of the magnitude of association between maternal smoking during pregnancy and selected behavioral outcomes.

This research analyzes, for the first time using a Spanish sample, the behavioral problems of adolescents in the custody of their grandparents. The sample consisted of 68 adolescents (31 boys and 37 girls, with a mean age of 13.7 years) in the custody of 54 grandparents with an average age of 65.9 years for the grandfathers, and 63.6 years for the grandmothers. The instrument employed was the Child Behavior Checklist (CBCL;; Achenbach, 2001). The results indicate that the majority of both boys and girls can be classified within the normal range on scales of internal behavior, external behavior and total behavioral problems. When gender and age differences were analyzed, it was found that boys had more behavioral problems than girls on scales of incompliance with rules and external behavior. Meanwhile, it was shown that older adolescents had more somatic problems, as well as more behavioral problems, as measured by both the internal scale and total scale of the CBCL, than the younger participants.

The purpose of this study was to compare differences in temperament and emotional and behavioral problems in a community sample of young children who experience headaches to those without such complaints. The whole sample was comprised 75 non-referred, preschool-aged children (3–5 years old), including 22 with headache complaints and 53 without headaches (control group). The children’s headache symptoms were assessed with a questionnaire that was given to the mothers. Rothbart’s Children’s Behavior Questionnaire was used to assess temperament, and the Child Behavior Checklist 1 ½–5 was used to assess emotional and behavioral problems. Compared with the control group, children with headache complaints showed more discomfort, which is the amount of negative affect induced by the sensory qualities of stimulation, including intensity, rate, or complexity of light, movement, sound, texture, or a combination of these modes of stimuli. These children also had higher scores for externalizing and internalizing emotional and behavioral problems compared to children without headaches. These findings show that the preschool-aged children with headaches presented more emotional and behavioral problems than the control group.

Background: Although research has highlighted the importance of including cultural factors in the analysis of caregiver stress, little is known about the effects of motives for caregiving on the stress and coping process. This study is aimed at analyzing the dimensional structure of the Cultural Justifications for Caregiving Scale – Revised (CJCS-R), and the effects of motives for caregiving on stressors, caregiver resources and outcome variables.

Methods: Dementia caregivers (N = 166) were interviewed and the following variables were assessed: motives for caregiving (CJCS-R), stressors (frequency of behavioral problems), resources (rumination, cognitive reappraisal), and outcomes (depression, anxiety and anger).

Results: A bidimensional structure was obtained for the CJCS-R, and the two factors were labeled Intrinsic and Extrinsic motives for caregiving. Participants were divided into four groups corresponding to four motivation profiles: HIHE = High Intrinsic Motives + High Extrinsic motives; LILE = Low Intrinsic Motives + Low Extrinsic Motives; HILE = High Intrinsic Motives + Low Extrinsic Motives; and LIHE = Low Intrinsic Motives + High Extrinsic Motives. No differences between groups were found in frequency of behavioral problems. Caregivers in the LIHE group had significantly worse consequences on caregiver resources and outcome variables compared to the other groups.

Conclusions: The results support the usefulness of considering motives for caregiving as a multidimensional construct. Analyzing caregivers' motivation profiles may constitute a useful strategy for identifying caregivers at risk. Caregivers scoring simultaneously low on intrinsic motives and high on extrinsic motives may be at particular risk for negative caregiving outcomes.

Background: The IPA Taskforce on Mental Health Issues in Long-Term Care Homes seeks to improve mental health care in long-term care (LTC) homes. The aim of this paper is to provide recommendations on comprehensive assessment of depression and behavioral problems in order to further stimulate countries and professionals to enhance their quality of care.

Methods: Existing guidelines on comprehensive assessment of depression or behavioral problems in nursing home (NH) patients or patients residing in LTC homes were collected and a literature review was carried out to search for recent evidence.

Results: Five guidelines from several countries all over the world and two additional papers were included in this paper as a starting point for the recommendations. Comprehensive assessment of depression in LTC homes consists of a two-step screening procedure: an investigation to identify factors that influence the symptoms, followed by a formal diagnosis of depression according to DSM-IV-TR or the Provisional Diagnostic Criteria for Depression in Alzheimer Disease in cases of dementia. Comprehensive assessment of behavioral problems encompasses three steps: description and clarification of the behavior, additional investigation, and assessment of probable causes of the behavior. The procedure starts in the case of moderate behavioral problems.

Conclusion: The recommendations given in this paper provide a useful guide to professional workers in the LTC sector, but clinical judgment and the consideration of the unique aspects of individual residents and their situations is necessary for an optimal assessment of depression and behavioral problems. The recommendations should not be rigidly applied and implementation will differ from country to country.

Background: Psychosocial interventions in long-term care have the potential to improve the quality of care and quality of life of persons with dementia. Our aim is to explore the evidence and consensus on psychosocial interventions for persons with dementia in long-term care.

Methods: This study comprises an appraisal of research reviews and of European, U.S. and Canadian dementia guidelines.

Results: Twenty-eight reviews related to long-term care psychosocial interventions were selected. Behavioral management techniques (such as behavior therapy), cognitive stimulation, and physical activities (such as walking) were shown positively to affect behavior or physical condition, or to reduce depression. There are many other promising interventions, but methodological weaknesses did not allow conclusions to be drawn. The consensus presented in the guidelines emphasized the importance of care tailored to the needs and capabilities of persons with dementia and consideration of the individual's life context.

Conclusions: Long-term care offers the possibility for planned care through individualized care plans, and consideration of the needs of persons with dementia and the individual life context. While using recommendations based on evidence and consensus is important to shape future long-term care, further well-designed research is needed on psychosocial interventions in long-term care to strengthen the evidence base for such care.