Journal of Child Psychology and Psychiatry and Allied Disciplines

The effects of postnatal depression on cognitive test scores at 20 months and 4;8 years of age as well as the timing (onset in the early postnatal period versus later), severity, number of episodes, duration of longest phase, recency, and chronicity of material depression on children's cognitive scores at 6;3 years was investigated. In South Bavaria, Germany, 1329 mothers of singletons were screened when the children were 6;3 years of age for the presence of depressive symptoms since the birth of their infant. A standard interview (SADS‐L) was used to ascertain DSM‐IV diagnosis and details of depressive episodes. Ninety‐two mothers were diagnosed as having suffered DSM‐IV defined depression (7%). Seven hundred and twenty‐one mothers had no depressive episodes or symptoms from their children's birth until 6;3 years and were used as control group. The children had been assessed with the Griffiths Scales of Babies’ Abilities (20 months), the Columbia Mental Maturity Scales (CMM) at 4;8 years, and the Kaufman Assessment Battery for Children (K‐ABC) at 6;3 years. No significant main effects of severity, timing of onset, duration, or chronicity of depression of the child's cognitive development were found. Significant interactions of gender with chronicity of maternal depression (i.e. early‐onset major and repeated episodes) were detected. Low SES boys or boys born at neonatal risk of mothers with chronic depression had lower Achievement Scores in the K‐ABC at 6;3 years than children of mothers with less severe depression or controls. It is concluded that maternal depression per se has negligible effects on children's cognitive development. Long‐term effects may be found when maternal depression is chronic, the child is a boy and neonatal risk‐born, or the family suffers other social risks.

The aim of the study was to examine long‐term sequelae in the children of mothers who were depressed at 3 months postpartum. In a community sample from two general practices in South London, 149 women were given psychiatric interviews at 3 months postpartum and 132 of their children (89%) were tested at 11 years of age. The children of women who were depressed at 3 months postpartum had significantly lower IQ scores. They also had attentional problems and difficulties in mathematical reasoning, and were more likely than other children to have special educational needs. Boys were more severely affected than girls, with the sex difference most pronounced on Performance IQ. The links between postnatal depression and the children's intellectual problems were not mediated by parental IQ and were not accounted for by measures of social disadvantage nor by the mother's later mental health problems. Breastfeeding did not remove the effect of the mother's illness on Full Scale IQ, but exerted its own influence on Verbal IQ and appeared to mediate the link with mathematical ability. The findings show that adverse experiences in infancy predict cognitive ability and academic performance a decade later.

As part of a longitudinal study of the influence of postnatal depression on child development, the cognitive functioning of index and control children was assessed at age 5 years. There was no evidence of an adverse effect of postnatal depression, even amongst sub‐groups of children suggested to be vulnerable (boys and children from low SES families). However, early experience of insensitive maternal interactions predicted the persistence of poorer cognitive functioning. A number of factors in the child's current environment, including stimulation at home, social class and, for boys, the experience of schooling, contributed to cognitive performance. The findings are considered in relation to the ongoing debate on sensitive periods.

Background:  The differential effectiveness of parent training has led researchers to examine a variety of child, parent, and familial variables that may predict treatment response. Studies have identified a diverse set of child, parent psychological/behavioral and demographic variables that are associated with treatment outcome and dropout.

Method:  The parent training literature was examined to isolate child, parent, and family variables that predict response to parent training for child externalizing behavior problems. A literature review was conducted spanning articles published from 1980 to 2004 of indicated prevention (children with symptoms) and treatment (children with diagnosis) studies. Meta‐analyses were conducted to determine standardized effect sizes associated with the identified predictors.

Results:  Many of the predictors of treatment response examined in this meta‐analysis resulted in moderate standardized effect sizes when study results were subjected to meta‐analytic procedures (i.e., low education/occupation, more severe child behavior problems pretreatment, maternal psychopathology). Only low family income resulted in a large standardized effect size. Predictors of drop‐out resulted in standardized effect sizes in the small or insubstantial range.

Conclusions:  Response to parent training is often influenced by variables not directly involving the child, with socioeconomic status and maternal mental health being particularly salient factors.

This paper examines the impact of a 12‐episode television series, “Families”, on disruptive child behavior and family adjustment. This media intervention comprises the first of a five‐level early intervention parenting and family support strategy, known as Triple P (Positive Parenting Program). Fifty‐six parents of children aged between 2 and 8 years were randomly assigned to either watching the television series or to a waitlist control group. Compared to the control group, parents in the television viewing (TV) condition reported significantly lower levels of disruptive child behavior and higher levels of perceived parenting competence, immediately following intervention. Prior to intervention approximately 42.9% of the children in the TV condition were in the clinically elevated range for disruptive child behavioral problems. This had reduced to 14.3% following intervention. In addition, a high level of consumer acceptability was reported by parents in the TV condition. All post‐intervention effects were maintained at 6‐month follow‐up. Implications for public health approaches to family mental health are discussed.

Background:  Child and adolescent mental health problems are prevalent and require adequate interventions. Despite several evidence‐based interventions for these problems described in the literature, few studies addressed strategies to diffuse efficacious interventions for child mental disorders especially in developing countries.

Methods:  An extensive but not systematic review of the literature was performed aiming to identify evidence‐based interventions for children and adolescents with mental disorders, professionals to target in disseminating these interventions, and the available strategies to diffuse information.

Results:  Substantial evidence‐based information is available to guide preventive, psychosocial and psychopharmacological interventions. The effectiveness of treatments in real‐world settings and the cost‐effectiveness of interventions are rarely tested. Professionals at different levels (teachers, school counselors, social workers, general practitioners, pediatricians, child psychologists and psychiatrists) should be targeted in diffusing efficacious interventions for child mental health problems worldwide. Telepsychiatry and the internet seem to be the most promising strategies to diffuse knowledge with lower costs.

Conclusions:  Medical and allied professionals must incorporate child and adolescent mental health issues in their under‐ and postgraduate curricula, and be better prepared to critically evaluate available information. Professionals need to disseminate evidence‐based programs to guide parents and teachers in developing countries to deal with child and adolescent difficulties. Countries need to explore internet solutions for dissemination of medical information.

AbstractA significant percentage of children with disruptive behaviour disorders do not receive mental health assistance. Utilization is lowest among groups whose children are at greatest risk. To increase the availability, accessibility, and cost efficacy of parent training programs, this prospective randomized trial compared a large group community‐based parent training program to a clinic‐based individual parent training (FT) program. All families of junior kindergartners in the Hamilton public and separate school boards were sent a checklist regarding problems at home. Those returning questionnaires above the 90th percentile were block randomly assigned to: (1) a 12–week clinic‐based individual parent training (Clinic/Individual), (2) a 12–week community‐based large group parent training (Community/Group), or (3) a waiting list control condition. Immigrant families, those using English as a second language, and parents of children with severe behaviour problems were significantly more liklely to enrol in Community/Groups than Clinic/Individual FT. Parents in Community/Groups reported greater improvements in behaviour problems at home and better maintenance of these gains at 6‐month follow‐up. A cost analysis showed that, with groups of 18 families, Community/Groups are more than six times as cost effective as Clinic/Individual programs.

This article charts a strategic research course toward an empirical foundation for the diagnosis of conduct disorder in the forthcoming DSM‐V. Since the DSM‐IV appeared in 1994, an impressive amount of new information about conduct disorder has emerged. As a result of this new knowledge, reasonable rationales have been put forward for adding to the conduct disorder diagnostic protocol: a childhood‐limited subtype, family psychiatric history, callous‐unemotional traits, female‐specific criteria, preschool‐specific criteria, early substance use, and biomarkers from genetics, neuroimaging, and physiology research. This article reviews the evidence for these and other potential changes to the conduct disorder diagnosis. We report that although there is a great deal of exciting research into each of the topics, very little of it provides the precise sort of evidence base required to justify any alteration to the DSM‐V. We outline specific research questions and study designs needed to build the lacking evidence base for or against proposed changes to DSM‐V conduct disorder.

Background:  This study investigated whether providing self‐directed and web‐based support for parents enhanced the effects of viewing a reality television series based on the Triple P – Positive Parenting Programme.

Method:  Parents with a child aged 2 to 9 (N = 454) were randomly assigned to either a standard or enhanced intervention condition. In the standard television alone viewing condition, parents watched the six‐episode weekly television series, ‘Driving Mum and Dad Mad’. Parents in the enhanced television viewing condition received a self‐help workbook, extra web support involving downloadable parenting tip sheets, audio and video streaming of positive parenting messages and email support, in addition to viewing the television series.

Results:  Parents in both conditions reported significant improvements in their child’s disruptive behaviour and improvements in dysfunctional parenting practices. Effects were greater for the enhanced condition as seen on the ECBI, two of the three parenting indicators and overall programme satisfaction. However, no significant differences were seen on other measures, including parent affect indicators. The level of improvement was related to number of episodes watched, with greatest changes occurring in families who watched each episode. Improvements achieved at post‐intervention by parents in both groups were maintained at six‐month follow‐up. Online tip sheets were frequently accessed; uptake of web‐based resources was highest early in the series.

Conclusions:  The value of combining self‐help approaches, technology and media as part of a comprehensive public health approach to providing parenting support is discussed.