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Internalising disorders are one of the most common mental health problems in children under 12 years, yet mixed findings exist for current treatment options. This pilot involves a novel 10-session intervention, BEST-Foundations, to treat internalising symptoms in children using a family-inclusive model. Initial findings and feasibility using a mixed-methods approach are reported. Twenty-two participants from eight families (n = 8 children; n = 8 mothers; n = 6 fathers) participated in an uncontrolled single treatment design. Included children (aged 3–11 years) reported clinical-level internalising symptoms on the Child Behaviour Checklist. Data were collected across four timepoints: baseline, pre-intervention, post-intervention, and 4-weeks follow-up. As predicted, mothers reported large improvements in child internalising symptoms pre-post (SMD = −.83; 95% CI = 50.58–70.42) and maintained pre to follow-up (SMD = −.92; 95% CI = 50.14–69.11). Sustained improvements were also found in externalising problems and total problems. Qualitative analysis indicated families reported positive improvements in targeted areas including parent confidence and parent–child relationships. Findings demonstrate initial feasibility data and effect size estimates comparable to previous trials using the "BEST" framework, and larger than CBT-based interventions. Results are considered preliminary due to the small sample. Further evaluation is warranted, showing the value of family-inclusive interventions to treat child internalising problems. What is already known about this topic: Modifiable family-based risk and protective factors influence internalising symptoms in children. Currently, inconclusive support exists for targeted treatment options for child internalising symptoms, highlighting the need to explore novel, feasible, evidence-based approaches for children under 12 years. Parental involvement in treatment is considerably heterogeneous, and the inclusion of fathers is lacking. What this topic adds: The BEST-Foundations intervention translates from theory to practice, demonstrating initial feasibility with families in improving internalising symptoms in children under 12 years. Fathers may express initial hesitation, yet engaging them in treatment is important. Parents reported improved confidence and perspective taking after taking part in the BEST-Foundations intervention. [ABSTRACT FROM AUTHOR]

Understanding how a mother's traumatic experiences influence her interactions with her infant may have importance for understanding infant development and mental health. Data for this study were drawn from an Australian pregnancy cohort, the Mercy Pregnancy and Emotional Wellbeing Study. Maternal trauma from Childhood, Childbirth Experiences, and Stressful Life Events were examined. At six-months postpartum, 211 predominantly first-time mothers (mean age 31.5 years), and their infants, were video-recorded interacting for 40 minutes. Interactions were assessed with the Emotional Availability (EA) Scales. Using structural equation modelling to test multiple mediation pathways, moderate-to-severe childhood trauma had only a direct effect on reducing maternal EA with the infant (β=−.17, p=.031), as did current stressful life events (β=−.19, p=.019), after controlling for maternal depression, age, and tertiary education. This highlights that proximate trauma specific to the perinatal period may not account for the effect of distal childhood trauma on maternal EA at six-months postpartum. [ABSTRACT FROM AUTHOR]

Background: Disorganised attachment in childhood has been considered an important early marker for the development of socio‐emotional and mental health problems. This review critically examines the current evidence and methodology employed to assess the influence of perinatal maternal mental health on disorganised attachment in infancy. Methods: A search revealed 1 149 articles reporting studies examining predictors of disorganised attachment. An additional 564 grey literature articles were identified via bibliographic searches. After screening for inclusion of maternal mental health measures and use of the Strange Situation Procedure, 28 articles met inclusion criteria. Results: Few studies robustly examined clinical levels of maternal mental health over time and the potential effects on infant disorganised attachment. Still, the bulk of current evidence does not support a strong positive association between disorganised attachment and low to moderate levels of maternal depression. The relationship between disorganised attachment and chronic and/or severe maternal depression is unclear given the dearth of research into the area. Limited research has examined other mental health disorders, with one study suggesting borderline personality disorder is associated with disorganised attachment. A level of bias in the literature was evident, with many studies recruiting non‐clinical samples and excluding those with significant mental health concerns. Conclusions: Most non‐significant findings were reported in non‐clinical samples, while most positive findings were reported in clinical samples, suggesting that severity of mental disorder may be a critical factor. Further research on the relationship between disorganised attachment and chronic and severe maternal depression, psychotic, trauma, bipolar, and personality disorders is required. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to examine associations between family-based stressors and depressive symptoms in adolescents. Method Participants were 10-14 year olds who participated in a large Australian population study (n = 6,552). Depressive symptoms and pubertal development were assessed using the self-report Short Mood and Feelings Questionnaire and the Pubertal Development Scale. Three indicators of stress exposure were examined-low emotional closeness to parents, residential and school transitions, and family conflict. The effect of gender, stress exposure and the interaction of gender and stress exposure on depressive symptoms was tested using multivariate logistic regression. Results High family conflict, residential instability and low emotional closeness with parents were independently associated with adolescent depressive symptoms. There was a significant gender by emotional closeness interaction; females reporting low emotional closeness to their parents were 2.3 times more likely to report high depressive symptoms than females reporting high emotional connections with parents. Conclusions Female adolescents may be more susceptible to particular types of stresses and particularly the quality of the parent-child relationship. [ABSTRACT FROM AUTHOR]

Background: This study investigated the relationship between parental personality patterns and internalising and externalising behaviour problems in a clinically referred sample of children (aged 4-8) and adolescents (aged 12-18). Methods: Data from families involved in two clinical trials in Victoria, Australia were analysed ( n = 59). Families were administered the Millons Clinical Multiaxial Inventory-III (MCMI-III) which reports personality patterns consistent with Axis II disorder and an Achenbach measure of mental health as appropriate to child's age (Child Behavior Checklist (CBCL), Youth Self-Report (YSR), or Adult Self-Report (ASR)). Relationships between internalising and externalising behaviour problems, and parental personality patterns were examined via correlation and regression analyses. Results: The study found a positive correlation between parental borderline, paranoid, and avoidant personality patterns, and child and adolescent externalising behaviour problems. The relationships were generally stronger for adolescents than for children. However, no relationship was observed between parental personality patterns and internalising behaviour problems. Conclusions: These findings underline the importance of clinical assessment of the family ecology as a whole-including the interaction between parental personality patterns and child and adolescent behaviour and emotional problems. These findings contribute to the understanding of developmental risk factors for child and adolescent mental health and the transmission of psychopathology across generations. [ABSTRACT FROM AUTHOR]

This paper reviews the history of the recognition of borderline personality disorder as a clinical disorder, followed by a review of the contemporary practice of diagnosing borderline personality disorder in psychiatric settings. Many researchers have cautioned against the conflation of difficult patients with the diagnostic category of borderline personality disorder. The current study examines how clinical indicators used to screen for this complex disorder differ across service settings, professions, specialised training and years of clinical experience. A purpose-designed survey was administered to 108 mental and emergency medicine health practitioners across an Australian health service and a New Zealand health service to record the level of significance placed on different clinical indicators in the application of the diagnosis of borderline personality disorder. A heavy reliance was placed on observable behavioural symptoms, such as self-mutilation and impulsive behaviours that are self-damaging, in the screening of borderline personality disorder as a psychiatric diagnosis. Statistically significant differences were found between emergency medical staff and mental health clinicians in their use of diagnostic indicators of borderline personality disorder, χ2(4) = 17.248, p = .002. Implications of these findings for the screening, assessment and diagnosis of patients with borderline personality disorder are discussed. [ABSTRACT FROM AUTHOR]