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Objectives: This study sought to determine whether a computerised cognitive bias modification programme could be effective within a waiting-room setting for parents accompanying their children to CAMHS appointments. The primary objectives were to determine whether detectable changes to participants' emotion recognition could be observed in this setting, and whether this approach would be acceptable to the population. Secondary measures investigated whether the programme would lead to changes in participants' affect or changes in parents' appraisals of difficulties with children. Methods: A computerised emotion recognition training task was delivered to all participants during four weekly sessions. Participants in the experimental condition (n=17) received feedback aiming to shift their detection of positive facial emotions, while those in the control condition (n=14) received feedback which was not designed to elicit any shift in emotion detection. Results: Positive shifts in emotion recognition were observed in the experimental group, although no changes were observed in secondary measures in either control or experimental groups. Qualitative data indicated that the programme was acceptable and appropriately constructed. Conclusion: This study demonstrates that cognitive bias modification is possible within a waiting-room setting, although the extent to which this can lead to clinically significant improvements in mood or relationships remains uncertain. This work has implications for emotion recognition interventions for clinical populations known to present with negative emotional biases (e.g. anxiety and depression) and represents an important first research step towards developing interventions to improve parent-child relationships.

The goal of the current study was to examine the impact of mothers’ attachment classification on their ability to change their parenting beliefs and behaviors over the course of a parenting intervention program. Results indicated that in large part, this study did not support the idea that secure mothers would benefit more from a parenting intervention program than insecure mothers. However, treatment group placement was found to moderate the extent to which attachment security and time interact on level of permissiveness. Specifically, insecure mothers in the seminar plus hands-on condition significantly decreased in their permissiveness over time. Thus, insecure individuals benefit from parenting intervention programs when they have the opportunity to practice as well as learn the material presented to them. / text

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Research suggests that the relationship between caregivers and their infants has a significant effect on development and well-being across the lifespan. There is a significant body of research into psychological interventions which focus on this relationship. However, there is only limited research into the impact of antenatal interventions which aim to promote the caregiver-foetus relationship, thus preventing later difficulties in the caregiver-infant relationship. Findings so far suggest that such interventions could be effective, and recommendations have been made for further studies exploring the effect antenatal interventions on the caregiver-foetus relationship. This pilot study explored the impact of a newly developed psychoeducational intervention entitled “Baby World” on the caregiver-foetal relationship. Seventy-nine females and 26 males who were expecting their first child were recruited from an NHS midwife service in London. They were randomly allocated to experimental or control groups. All participants completed questionnaires measuring antenatal attachment, mental health and childhood experiences of caregiving at baseline. Those in the experimental group then attended the Baby World class. All participants then completed the questionnaires for a second time, and then attended the standard antenatal classes. Following attendance at these classes, participants completed the questionnaires for a third time and gave anonymous responses to qualitative questions. Statistical analyses of the quantitative data indicated that the intervention did not have an impact on antenatal attachment. Results did show that antenatal attachment increased over time, whilst anxiety decreased. A significant correlation was found between recollections of maternal caring and antenatal attachment. Qualitative analysis suggested that the intervention did have an impact on aspects of the relationship. In the qualitative responses, the majority of participants wrote that the class had been a positive experience for them, and that it had increased their confidence about being a caregiver. Many of the responses indicated that the class had positively affected their skills in reflective functioning, caregiver sensitivity and attunement, and changed their perspective on how to interact with their infant. The results add to the literature regarding the impact of antenatal interventions on the caregiver-foetus relationship. Further research is needed to explore the impact of the intervention on the relationship more closely, in particular to understand which aspects of the relationship may be affected. There are several limitations of the study, in particular the small sample size and the limited number of expectant fathers who participated. Reasons for these limitations are discussed.

This study examined sense of community (SOC) and participant engagement in the first 12 months of a longitudinal, group-based intervention program for parents, Legacy for ChildrenTM. Previous research in self-help/mutual support groups and alternative living environments for recovering addicts suggested SOC may positively influence engagement in programs and may be an active ingredient to the success of such programs. Literature on SOC has been limited by cross-sectional investigations and lacked a developmental perspective of changes in SOC over time. This study examined the following questions: 1) Does SOC with the parenting program differ between intervention and control participants at 6 months and 12 months following entry into Legacy? 2) How do baseline levels of social support, stress, and self-efficacy relate to sense of community with the parenting program? 3) Do intervention participants’ baseline demographic and psychological characteristics relate to attendance and engagement in the first 20 weeks of parent groups? 4) Does participant engagement predict SOC with the parenting program over time? Does early SOC predict later engagement? Study hypotheses were examined using repeated measures ANOVA, hierarchical linear regression, and structural equation modeling. The sample included 289 mothers recruited at the Miami Legacy for Children intervention site; eligible mothers were adults, received Medicaid, were English speaking, and had a newborn child. Mothers were randomly assigned to the intervention or control group. Results of the structural model using only intervention participants suggest that attendance and engagement in parent groups contributed significantly and positively to sense of community with the program over time. The intervention group had a slightly higher SOC with the program than the control group. However, levels of SOC with the program declined from 6 to 12 months among intervention participants while stability or slight increases in SOC characterized the control participants’ SOC during this time. Regardless of experimental condition, changes in SOC within the first year of the program were small in magnitude and suggest that changes in SOC between groups may take more time to evaluate fully. Implications of these findings to the development of SOC in intervention settings are discussed.

Tic disorders can have a significant emotional and social impact on children and their families. There is increasing support for the use of parenting programmes in childhood conditions; however research into the applicability of such programmes in tic disorders is limited. This thesis therefore aimed to investigate the topic of parenting interventions in tic disorders. The thesis presents five chapters, written as a series of self-contained papers and prepared in accordance with selected journal submission guidance. Paper 1 is a systematic literature review of the implementation and effectiveness of behavioural parent training programmes across neurodevelopmental disorders. Twenty-two randomised controlled studies were included in the review. Neurodevelopmental disorders included attention deficit hyperactivity disorder, autistic spectrum conditions, intellectual difficulties and developmental disorders and tic disorders. Training programmes included Triple P, Barkley’s Defiant Children, Parent Child Interaction Therapy, New Forest Parenting, Parenting your Hyperactive Preschooler, Parents Plus Children, Preschoolers with Autism, Incredible Years and an idiosyncratic programme. Effects of interventions on child outcomes were examined alongside intervention characteristics and content. Results indicated robust evidence for effects of parent training on attention-deficit/hyperactivity difficulties and externalising difficulties, across neurodevelopmental disorders and training programmes. Evidence to support the effect of parent training on internalising, social and global difficulties across disorders was less robust, with fewer and inconsistent outcomes reported. Clinical and research implications resulting from the findings are discussed. Papers 2 and 3 present empirical studies. Both studies are Q-methodological investigations into opinions on parenting interventions in tic disorders. Q-methodology is a technique which enables participants’ subjective viewpoints to be grouped using by-person factor analysis. Views on the acceptability, effectiveness, feasibility and utility of parenting interventions were explored across parents of children with tic disorders (Paper 2) and professionals (Paper 3). Across both studies, seven main factors were identified (parents four, professionals three). Findings highlighted that interventions were generally considered acceptable, justified and perceived as needed. However, important differences in opinions were found within and between parent and professional groups, highlighting key clinical considerations for possible intervention format, delivery and content. Paper 4 provides a commentary of the clinical implications of these findings when the two studies are considered together, and provides guidance to further develop and implement interventions. Paper 5 presents a critical review, including discussion of the strengths, limitations and implications of the findings, alongside personal reflections on the research process.

We conducted a study to evaluate the effectiveness of Mom Power, a multifamily parenting intervention to improve mental health and parenting among high-risk mothers with young children in a community-based randomized controlled trial (CB-RCT) design. Participants (N = 122) were high-risk mothers (e.g., interpersonal trauma histories, mental health problems, poverty) and their young children (age <6 years), randomized either to Mom Power, a parenting intervention (treatment condition), or weekly mailings of parenting information (control condition). In this study, the 13-session intervention was delivered by community clinicians trained to fidelity. Pre- and post-trial assessments included mothers’ mental health symptoms, parenting stress and helplessness, and connection to care. Mom Power was delivered in the community with fidelity and had good uptake (>65%) despite the risk nature of the sample. Overall, we found improvements in mental health and parenting stress for Mom Power participants but not for controls; in contrast, control mothers increased in parent-child role reversal across the trial period. The benefits of Mom Power treatment (vs. control) were accentuated for mothers with interpersonal trauma histories. Results of this CB-RCT confirm the effectiveness of Mom Power for improving mental health and parenting outcomes for high-risk, trauma-exposed women with young children.

No description available.

Stress resilience in parenting depends on the parent's capacity to understand subjective experiences in self and child, namely intersubjectivity, which is intimately related to mimicking other's affective expressions (i. e., mirroring). Stress can worsen parenting by potentiating problems that can impair intersubjectivity, e.g., problems of “over-mentalizing” (misattribution of the child's behaviors) and “under-coupling” (inadequate child-oriented mirroring). Previously we have developed Mom Power (MP) parenting intervention to promote maternal intersubjectivity and reduce parenting stress. This study aimed to elucidate neural mechanisms underlying the effects of MP with a novel Child Face Mirroring Task (CFMT) in functional magnetic-resonance-imaging settings. In CFMT, the participants responded to own and other's child's facial pictures in three task conditions: (1) empathic mirroring (Join), (2) non-mirroring observing (Observe), and (3) voluntary responding (React). In each condition, each child's neutral, ambiguous, distressed, and joyful expressions were repeatedly displayed. We examined the CFMT-related neural responses in a sample of healthy mothers (n = 45) in Study 1, and MP effects on CFMT with a pre-intervention (T1) and post-intervention (T2) design in two groups, MP (n = 19) and Control (n = 17), in Study 2. We found that, from T1 to T2, MP (vs. Control) decreased parenting stress, decreased dorsomedial prefrontal cortex (dmPFC) during own-child-specific voluntary responding (React to Own vs. Other's Child), and increased activity in the frontoparietal cortices, midbrain, nucleus accumbens, and amygdala during own-child-specific empathic mirroring (Join vs. Observe of Own vs. Other's Child). We identified that MP effects on parenting stress were potentially mediated by T1-to-T2 changes in: (1) the left superior-temporal-gyrus differential responses in the contrast of Join vs. Observe of own (vs. other's) child, (2) the dmPFC-PAG (periaqueductal gray) differential functional connectivity in the same contrast, and (3) the left amygdala differential responses in the contrast of Join vs. Observe of own (vs. other's) child's joyful vs. distressed expressions. We discussed these results in support of the notion that MP reduces parenting stress via changing neural activities related to the problems of “over-mentalizing” and “under-coupling.” Additionally, we discussed theoretical relationships between parenting stress and intersubjectivity in a novel dyadic active inference framework in a two-agent system to guide future research.