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Different forms of maltreatment are thought to incur a cumulative and non-specific toll on mental health. However, few large-scale studies draw on psychiatric diagnoses manifesting in early childhood and adolescence to identify sequelae of differential maltreatment exposures, and emotional maltreatment, in particular. Fine-grained multi-source dimensional maltreatment assessments and validated age-appropriate clinical interviews were conducted in a sample of N = 778 3 to 16-year-olds. We aimed to (a) substantiate known patterns of clinical outcomes following maltreatment and (b) analyse relative effects of emotional maltreatment, abuse (physical and sexual), and neglect (physical, supervisory, and moral-legal/educational) using structural equation modeling. Besides confirming known relationships between maltreatment exposures and psychiatric disorders, emotional maltreatment exerted particularly strong effects on internalizing disorders in older youth and externalizing disorders in younger children, accounting for variance over and above abuse and neglect exposures. Our data highlight the toxicity of pathogenic relational experiences from early childhood onwards, urging researchers and practitioners alike to prioritize future work on emotional maltreatment. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and the ongoing lockdowns might have had a strong impact on mental health of mothers and their infants/toddlers. For example, families had to deal with health issues and social isolation, which might have affected mental health and parent-child interactions. The aim of this study is to evaluate differences in (1) infantile regulatory disorders, (2) maternal mental health, (3) the impact of maternal mental health on infantile regulatory disorders, and (4) alterations in the mother-child interaction for participants recruited before versus after the onset of the first German lockdown. For this reason, mother-child dyads have been divided into two groups and were compared by analyzing clinical interviews on psychopathology of mother and child (M.I.N.I. & DC:05) and mother-child-interactions (Emotional Availability Scales). Results showed that (1) differences in infantile sleeping disorders emerged (phi = 0.243; p = 0.016) compared to the pre-lockdown group, while (2) the occurrence of maternal panic and anxiety increased in the post-lockdown group (phi = 0.229; p = 0.022). Moreover, there was (3) an association for maternal panic and child's sleep disorder, and (4) specific associations with maternal non-hostility in the mother-child-interaction. In conclusion, the present study highlights the differences of maternal mental health occurrences and infants' regulatory problems, as well as the possible effects of the COVID-19 pandemic for infants. In the pre-lockdown group, maternal non-hostility might have acted as a promotive factor against regulatory disorders, while this mechanism was mitigated in the post-lockdown group. [ABSTRACT FROM AUTHOR]

Objective: This study presents a psychometric evaluation of the avoidant/restrictive food intake disorder (ARFID) module 2.0 for the Eating Disorder Examination (EDE), its child (ChEDE), and parent version. Within a pediatric sample seeking treatment for restrictive feeding or eating disorders and non‐treatment‐seeking controls, the module's interrater reliability, parent–child agreement, and its convergent, divergent, and discriminant validity were examined. Method: The child, adult, and/or parent version of the German ARFID module was administered to N = 176 children and adolescents (0–17 years) and their parents, as were the (Ch)EDE, well‐established measures on food‐avoidance behaviors, food variety, and body esteem, and objective anthropometric measures. Results: Across all versions of the ARFID module, substantial to almost perfect interrater reliability was shown. Parent–child agreement for ARFID diagnosis was substantial. Based on medium‐to‐large associations between interview‐assessed avoidant/restrictive food intake and questionnaire‐assessed food‐avoidance behaviors, food variety, and objective weight status, the module showed high convergent validity, especially for the child and parent version. Low associations of avoidant/restrictive food intake with weight and shape concern demonstrated divergent validity. Individuals with ARFID differed significantly from those with anorexia nervosa and individually matched controls in a range of clinical characteristics, indicating discriminant validity. Discussion: This comprehensive validation supports the EDE ARFID module to be a valuable measure for the assessment and diagnosis of ARFID in 0–17‐year‐olds based on self‐ and parent‐report. Validation of the ARFID module against other interview‐based measures on ARFID and its evaluation in an adult sample are pending. Public Significance: Based on good reliability and validity of the avoidant/restrictive food intake disorder (ARFID) module for the Eating Disorder Examination (EDE) in its child, adult, and parent version, the present study paves the way for the clinical and research use of the interview‐based EDE ARFID module for assessing ARFID across childhood and adolescence. [ABSTRACT FROM AUTHOR]

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Our longitudinal study contributes to the body of literature on depression in childhood by examining potential protective factors. We investigated the influence of maternal depressive symptoms on child depressive symptoms at early school age and its gender-specific moderation by children's narrative representations of the maternal figure, over and above children's own depressive symptoms at preschool age. Children's narrative representations were assessed using the MacArthur Story Stem Battery in 170 preschool children (92 girls; 54.1 %) oversampled for internalizing symptoms. Children's depressive symptoms were assessed at preschool age (Time 1; 4-6 years) and at early school age (Time 2; 6-8 years) by maternal report; mothers' depressive symptoms were assessed at Time 1. The results showed that for boys, only their own depressive symptoms at Time 1 predicted their depressive symptoms at Time 2. For girls, maternal depressive symptoms were a significant risk factor for their own depressive symptoms at Time 2. Regarding this association, we also found a moderation effect: girls with more positive narrative representations of the maternal figure showed a reduced negative impact of maternal depressive symptoms on their own depressive symptoms at Time 2. This implies that clinical practice should screen a child for early depressive symptoms, especially if the mother displays depressive symptoms. Clinicians might also assess children's inner working models, which can serve as a protective factor. [ABSTRACT FROM AUTHOR]

Objective: Recent research has identified mother-child relationships of low quality as possible risk factors for childhood obesity. However, it remains open how mothers' own obesity influences the quality of mother-child interaction, and particularly emotional availability (EA). Also unclear is the influence of maternal emotional competencies, i.e. understanding emotions and recognizing facial emotions. This study aimed to (1) investigate differences between obese and normal-weight mothers regarding mother-child EA, maternal understanding emotions and recognition of facial emotions, and (2) explore how maternal emotional competencies and maternal weight interact with each other in predicting EA. A better understanding of these associations could inform strategies of obesity prevention especially in children at risk.Methods: We assessed EA, understanding emotions and recognition of facial emotions in 73 obese versus 73 normal-weight mothers, and their children aged 6 to 47 months (Mchild age=24.49, 80 females).Results: Obese mothers showed lower EA and understanding emotions. Mothers' normal weight and their ability to understand emotions were positively associated with EA. The ability to recognize facial emotions was positively associated with EA in obese but not in normal-weight mothers. Maternal weight status indirectly influenced EA through its effect on understanding emotions.Conclusion: Maternal emotional competencies may play an important role for establishing high EA in interaction with the child. Children of obese mothers experience lower EA, which may contribute to overweight development. We suggest including elements that aim to improve maternal emotional competencies and mother-child EA in prevention or intervention programmes targeting childhood obesity. [ABSTRACT FROM AUTHOR]

This study aimed to determine longitudinal associations of early triadic family processes and 3-year-old children's strengths and difficulties and to control those associations for family risk factors. In 80 families expecting their first child, we assessed parents' anticipations of future family relationships (Triadic Capacity) and parents' psychological distress, marital quality, and education level. When the children were 4 months of age, we observed triadic family interaction in a standardized laboratory play scenario. The children's strengths and difficulties at age three were assessed using multiple methods. As expected, parents' Triadic Capacity assessed before the child was born predicted triadic family interaction 4 months after birth. Early triadic family processes explained variance in children's emotional functioning at age three over and above the effects of family stress factors assessed before the child was born. However, early triadic family processes did not explain children's co-operative behaviour or children's symptoms at age three. Results also highlighted the roles of fathers' education level in children's externalizing behaviour, mothers' psychological distress at children's low co-operative behaviour, and low marital quality in children's internalizing behaviour. [ABSTRACT FROM AUTHOR]

Although case studies in avoidant/restrictive food intake disorder (ARFID) indicate severe nutritional deficiencies in those with a highly limited amount or variety of food intake, systematic analyses on food intake in treatment-seeking children and adolescents with ARFID are lacking. Within this study, n = 20 patients with an interview-based diagnosis of ARFID (0–17 years) were included and compared to n = 20 healthy controls individually matched for age and sex. Children or parents completed three-day food diaries and a food list. Macronutrient, vitamin, and mineral supply was determined based on the percentage of their recommended intake. The results showed a significantly lower total energy and protein intake in ARFID versus controls, with trends for lower fat and carbohydrate intake. ARFID subtypes of limited amount versus variety of food intake significantly differed in macro-, but not micronutrient intake. Those with ARFID met only 20–30% of the recommended intake for most vitamins and minerals, with significantly lower intake relative to controls for vitamin B1, B2, C, K, zinc, iron, and potassium. Variety of food intake was significantly reduced in ARFID versus controls in all food groups except carbohydrates. This study demonstrated that ARFID goes along with reduced everyday life macro- and micronutrient intake, which may increase the risk for developmental and health problems. Future studies additionally assessing serum nutrient levels in a larger sample may further explore differences in food intake across diverse ARFID presentations. [ABSTRACT FROM AUTHOR]

Objective: A higher density of sleep electroencephalogram (EEG) spindles has been cross-sectionally associated with more efficient cortical-subcortical connectivity, superior intellectual and learning abilities, and healthier emotional and behavioral traits. In the present study, we explored to what extent sleep spindle density (SSD) at age five years could predict emotional and behavioral traits at six and nine years.Methods: A total of 19 healthy preschoolers at age five years underwent in-home sleep EEG recordings for visual scoring of non-rapid eye movement stage 2 (NREM-S2) sleep spindles, and SSD in NREM-S2 was calculated. Parents and teachers rated children's emotional and behavioral characteristics at ages five, six, and nine years.Results: Higher SSD at five years predicted higher prosocial behavior scores at nine years, as rated by parents and teachers, and lower hyperactivity scores as rated by teachers. Multiple regression analyses showed that SSD predicted prosocial behavior and hyperactivity independently of earlier prosocial behavior or hyperactivity.Conclusion: The pattern of results suggests that a higher SSD at five years is predictive of higher scores for positive emotional and behavioral characteristics four years later. Therefore, spindle density indices might be acknowledged as an indicator not only of cognitive but also of emotional-behavioral development in children. [ABSTRACT FROM AUTHOR]

Abstract: The current cross-sectional study investigated basal and stress-challenged hypothalamic–pituitary–adrenocortical (HPA) system function in 102 five-year old kindergarten children (59 boys, 43 girls) who had been assessed by a comprehensive psychological and behavioral test battery. Baseline HPA system activity was significantly increased in girls when compared to boys (p <0.001). Furthermore, basal HPA system activity predicted a high hormonal release during stress with – again – girls showing higher hormonal responses than boys (p <0.01). Importantly, increased HPA system activity (baseline and stress-challenged) was significantly associated with hyperactivity/impulsivity and emotional problems in boys and with positive emotions in girls (p <0.05). These results suggest an occurrence of neurobiological alterations early in development. The observed neurobiological changes are gender specific already at the age of 5 years. Prospective long-term follow up of the identified subjects with HPA axis alterations will clarify if these markers are predictive for the onset of psychiatric disorders. [Copyright &y& Elsevier]