Chronic health problems are hypothesised to be a risk factor to child and adolescent mental health, due the consistent and continuing stress these health problems pose to normative patterns of development. However, this theory remains to be substantiated by empirical research. Moreover, a systematic review conducted as part of this research indicated that the empirical body is not one on which the validity of this theory can be adequately tested. The major question posed is whether the lack of high quality epidemiological data in the field is obscuring a true psychiatric risk associated with chronic illness in childhood and adolescence, or whether, in contrast, the theory of chronic health problems as a particular risk factor to child and adolescent mental health, is based on false premises. In order to provide a stronger insight into the association of chronic health problems to mental ill-health across the late childhood and adolescent period, this study used data from a large, representative British sample (the Avon Longitudinal Study of Parents and Children (ALSPAC)) and sensitive measures of mental health outcomes. Mediating factors in these associations were also identified, and a model of the association of chronic health problems to poor mental health outcomes in early adolescence was developed. In order to ensure that all findings were applicable across chronic health conditions, outcomes over this period for children with chronic illness more generally were compared to outcomes for children with asthma diagnoses. Children with chronic health problems presented with a disproportionate rate of psychiatric illness at 10 years, and these chronic health problems continued to be associated with poor mental health outcomes across the early to mid-adolescent period. The outcomes at 10 and 13 years were suggested to be mediated by factors non-specific to any diagnosis, specifically peer victimisation and health-related school absenteeism. Limitations to external validity in the research, and implications for public health and future research are discussed.

Childhood sexual assault (CSA) refers to a sexual act that is imposed on a child or adolescent who lacks the emotional capacity, maturity, and cognitive development to understand what they are engaging in, and is incapable or unwilling to give consent. Many individuals who experience CSA also experience adult sexual assault, such as rape. To date, there is limited research that has examined early maladaptive schemas (EMS) and CSA, and no research that examines the relationship between CSA, EMS, and revictimization. The present study examined EMS as mediators of revictimization and mental health outcomes (i.e., depression and PTSD) among 263 college women who experienced CSA. Participants completed the Sexual Experiences Survey (SES-LFV; Koss et al., 2007) which assesses victimization and perpetration of unwanted sexual experiences, the Young Schema Questionnaire (YSQ-SF: Young, 1998) to measure early maladaptive schemas, Posttraumatic Stress Disorder Checklist 5, a brief self-report instrument consisting of 20 items that reflect the symptoms of PTSD outlined in DSM-5, and the Center for Epidemiological Studies Depression Scale (CESD-R; Radloff, 1977) is a brief self-report instrument used to measure symptoms of depression. As hypothesized, CSA was positively correlated with revictimization. CSA was correlated with EMS, specifically, emotional deprivation, mistrust/abuse, social isolation, defectiveness/shame, and self-sacrifice, but not abandonment. Surprisingly, EMS did not mediate the relationship between CSA and revictimization. EMS mediated the relationship between CSA and mental health outcomes, such as, depression and PTSD. EMS social isolation mediated the relationship between CSA and depression symptoms and EMS mistrust/abuse, social isolation, and self-sacrifice mediates the relationship between CSA and PTSD. In conclusion, our findings could be used to further investigate what appropriate early childhood interventions could possibly be used to address and treat early maladaptive schemas.

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The current study sought to examine client outcome data for clients seen for outpatient psychotherapy services by graduate-level student therapists in doctoral psychology training clinics in order to better understand the change process occurring in such settings and to examine whether services being offered are meaningful for clients. One hundred ninety-nine clients seen by graduate-level therapists at a training clinic setting were assessed on a session-by-session basis using the Outcome Questionnaire-45 in order to identify the percentage of clients who met criteria for clinically significant change, reliable improvement, no change, or deterioration in outcomes across the course of treatment. Approximately 28% of clients seen for treatment met criteria for clinically significant change at the termination of treatment and 23% reliably improved. Survival analysis indicated that the median time required to attain clinically significant change was six sessions. Current findings are compared to earlier investigations in both training and nontraining settings. The implications of these findings for education and training, client care and clinical services, and policy are discussed.

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Background: Children who enter foster care usually do so because of maltreatment by their birth families. Early adversity such as this is associated with many negative outcomes, including disturbances of attachment and mental health in childhood and throughout the lifespan. Young children (under 5) are particularly at risk due to maltreatment rates being highest in this age range, and because of the vital brain development that occurs during this time. Improving the quality of existing relationships for young children is the most cost effective way to improve mental health outcomes. It is important that research investigates which relational and psychological variables that exist within the foster carer-child relationship may be protective against developing negative mental health outcomes, so as to inform carer training and future interventions for this vulnerable group. Aims: The aims of this research project were twofold. The first aim was to systematically review the existing literature on links between foster carer psychological variables (such as commitment to their foster child), and/or child psychological variables (such as their attachment style), and the mental health outcomes of children in foster care. The second aim was to investigate whether foster carer acceptance, commitment, awareness of influence and reflective functioning (RF) predict the mental health outcomes of Scottish preschool aged children who are looked after in foster care. Method: A systematic review of the existing literature was undertaken to address the first aim. The search strategy resulted in 12 quantitative studies that investigated links between child or carer psychological variables and child mental health outcomes. An empirical study of 179 pre-school aged children in foster care in Scotland was carried out to address the second aim. Participants were taking part in a wider RCT of a novel intervention to improve outcomes and permanency decisions for children in foster care. Foster carer acceptance, commitment, and awareness of influence was assessed using the This Is My Baby Interview, and scores of RF were coded from the transcripts of this interview using a computer-based algorithm. Child mental health information was gathered using the Infant Toddler Social Emotional Assessment. Data was gathered at 2 time points; baseline assessments occurred around 4 weeks after entry to care, and follow-up assessments were carried out a year later. Results: The systematic review found good evidence that foster child attachment security is linked to more positive mental health outcomes. It also found some evidence suggesting that foster carer psychological variables such as commitment and quality of caregiving also relate to child mental health outcomes, but this research is in its infancy and it is therefore difficult to draw firm conclusions around this. The results of the empirical study showed that carer commitment and awareness of influence predict child competence at baseline, and RF predicts internalising and externalising problems at follow up. No predictive relationships were found between carer variables and child mental health over time. Conclusion: The results from both studies suggest that carer psychological variables such as commitment to their foster child may relate to child mental health development. These results have implications in terms of foster carer training, and for intervention development for this vulnerable population. This research is however in its infancy, and the results suggest a complex picture with regard to carer psychological variables and child mental health. Large-scale high quality longitudinal research is needed to provide a clear understanding of these relationships.

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