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Time-out (TO) is a widely utilised parental discipline technique with a strong evidence-base that nonetheless has attracted controversy regarding potential adverse effects on mental health in developing children. Associations between TO implementation and mental health outcomes have rarely been investigated, especially through the eyes of children who grew up experiencing TO. This study recruited 407 university students (Study 1) and a community sample of 535 young adults (Study 2); both samples aged 18-30 years. Young adults were surveyed on their retrospective reports of childhood TO experience, childhood experiences of adversity, perceived parenting style and parental attachment, and their current mental health outcomes (attachment style, emotion regulation and mental health). In Study 1, 334 (82.1%) young adults reported experiencing TO in childhood, but with widely varied implementation that differed considerably from its evidence-based ideal. Reports of more TO appropriate implementation were associated with less avoidant attachment, better mental health, and emotion regulation, over and above the effects associated with authoritative parenting and secure attachment in childhood. While exposure to childhood adversity was associated with poorer adulthood outcomes, TO implementation did not moderate the association. Study 2 replicated most findings from Study 1, except that appropriate TO implementation displayed a positive association with mental health and no associations with anxious and avoidant attachment and emotion regulation. These findings suggest the safety of TO use with young children, including those who experienced childhood adversity, and highlight the importance of disseminating sufficient parenting information on TO in the community., Competing Interests: Declarations Ethical approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the University of Sydney Human Research Ethics Committee. Consent for publication Each of the authors contributed to the work, and have seen and agreed with the contents of the manuscript. All authors have agreed to submit the manuscript. Informed consent Informed consent was obtained from all individual participants included in the study. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Parental discipline strategies are a necessary and critical aspect of positive child development. Their qualities confer risk versus protection for the development of mental health problems. Time-out from positive reinforcement is now one of the most common and well-researched discipline procedures across the world, with overwhelming evidence to support its efficacy and acceptability. It has also recently attracted considerable criticism from writers evoking child well-being considerations based on attachment theory. The main concern is that the removal of a child to time-out exposes the child to a break in attachment security and, for children with trauma histories, potentially causes harm. Here, we consider what a discipline strategy should be from a mental health perspective and, utilizing the best available models of developmental mental health and psychopathology, derive five axioms for judging and guiding the worth and acceptability of any particular discipline strategy. We then use these axioms to evaluate and specify how time-out can be used in a way that maximizes positive child outcomes, and then review its use with children who have experienced complex trauma. We show that time-out, when conceptualized and enacted consistently with contemporary models of learning, attachment, self-regulation, and family systems theory, is actually a positive perturbation to these systems that can rapidly remediate problems the child is experiencing, and thereby generally enhances child well-being. Clinical, research, and policy implications are briefly discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Half of all lifetime mental health disorders emerge in childhood, so intervening in the childhood years is critical to prevent chronic trajectories of mental health disorders. The prevalence of child mental health disorders is not decreasing despite the increased availability of evidence-based interventions. One key reason for the high prevalence and low treatment uptake may be low levels of child mental health literacy in the general community. Mental health literacy refers to knowledge and beliefs about mental health disorders that aid in their recognition, prevention and management. There is emerging evidence of poor recognition of child mental health problems in the community and low levels of parental knowledge about how to seek help, along with high levels of stigmatising attitudes. Although Australia has been a world leader in research and practice in improving mental health literacy for adolescent and adult mental health disorders, particularly depression and anxiety, mental health literacy for childhood disorders has been largely overlooked. In order to improve knowledge of child mental health disorders, reduce stigma, improve appropriate help-seeking and impact on the prevalence of child mental health disorders, we argue that a national initiative focussing on increasing mental health literacy for childhood disorders is urgently needed.

There is limited prospective research on the relation between school connectedness (i.e., the extent to which students feel accepted, valued, respected, and included in the school) and mental health symptoms in adolescents. A sample of 2,022 students (999 boys and 1,023 girls) ages 12 to 14 years were measured at 2 time points (12 months apart) on school connectedness and mental health symptoms (general functioning, depression, and anxiety symptoms). School connectedness correlated extensively with concurrent mental health symptoms at both time points (between 38% and 55% covariation with depression, 26% to 46% with general functioning, and 9% and 16% for anxiety symptoms). Using hierarchical linear modeling, school connectedness also predicted depressive symptoms 1 year later for both boys and girls, anxiety symptoms for girls, and general functioning for boys, even after controlling for prior symptoms. The reverse, however, was not true: Prior mental health symptoms did not predict school connectedness 1 year later when controlling for prior school connectedness. Results suggest a stronger than previously reported association with school connectedness and adolescent depressive symptoms in particular and a predictive link from school connectedness to future mental health problems.

The construct of "empathy" embodies a number of characteristics necessary for psychological health in children. Surprisingly, most research has been based solely on children and adolescent report and observational measures despite evidence that multi-informant assessment is fundamental to the accurate measurement of such constructs. We present research documenting the development and validation of a brief parent-report measure of child empathy targeted at the formative years for the development of empathic skills, through to adolescence. The Griffith Empathy Measure, adapted from the Bryant Index of Empathy, showed convergence with child ratings, and good reliability and validity across gender and age. Consistent with theoretical accounts of empathy, it was found to include affective and cognitive components that showed divergent associations with other aspects of child functioning.

Background: Time-out (TO) is a widely used parental discipline strategy with strong research support in programmes that promote positive child development. Concerns have been raised, however, regarding adverse impact on child mental health (CMH) in part driven by evidence of widespread variability in appropriate implementation. There are no existing measures of TO. We present the first measure of procedural implementation of TO in a community sample of parents of children aged 6–8 years. Methods: A nationally representative sample (N = 474) of parents completed a survey on the implementation of TO, parent-child relationships, and emotional and behavioural difficulties. The scale of TO use was used to test the convergent validity between TO implementation and parenting practices/family adjustment and CMH. Results: Consistent with international research, >70% of parents have used TO with their children. There was high variability in the levels of appropriate implementation of TO. Scale reliability (Cronbach's alpha) was acceptable and tests of convergent validity indicated that as expected, less appropriate implementation of TO was associated with worse CMH and poorer parenting and family adjustment. Conclusions: The current findings suggest that the scale is a psychometrically sound instrument for measuring the appropriate procedural implementation of TO with young children. [ABSTRACT FROM AUTHOR]

There is a significant gap between the need for child mental health services and use of these services by families. Parental attributions may play a role in this. This study examined whether mothers' attributions about their child's problems influence professional help-seeking intentions in a general sample of community mothers. Secondary analysis re-examined this hypothesis in a subgroup of mothers of children with clinically elevated mental health symptoms. Cross-sectional survey data were collected from mothers (N = 184) of children aged between 2 and 12 years recruited from the community. Mothers completed self-report questionnaires measuring parental attributions: child-responsible attributions and parental self-efficacy; professional help-seeking intentions; and psychosocial covariates: child mental health, mothers' anxiety and depression, child age, gender, marital status, education, and professional help-seeking experience. Hierarchical regression modelling indicated that parental attributions explained professional help-seeking intentions after controlling for covariates in both the general sample (ΔF = 6.07; p =.003) and subgroup analysis (ΔF = 10.22, p =.000). Professional help-seeking intentions were positively associated with child-responsible attributions (β =.19, p =.002) but not parental self-efficacy (β = –.01, p =.865) in the general sample, while positively associated with child-responsible attributions (β =.20, p =.009) and negatively associated with parental self-efficacy (β = –.16, p =.034) in the subgroup analysis. Findings were independent of the presence of clinically elevated symptoms, problem type, and severity. Overall, the findings support models suggesting that parental attributions have a role in professional help-seeking for child mental health problems. [ABSTRACT FROM AUTHOR]

Background: From birth, the human propensity to selectively attend and respond to critical super-stimuli forms the basis of future socio-emotional development and health. In particular, the first super-stimuli to preferentially engage and elicit responses in the healthy newborn are the physical touch, voice and face/eyes of caregivers. From this grows selective attention and responsiveness to emotional expression, scaffolding the development of empathy, social cognition, and other higher human capacities. In this paper, the protocol for a longitudinal, prospective birth-cohort study is presented. The major aim of this study is to map the emergence of individual differences and disturbances in the system of social-Responsiveness, Emotional Attention, and Learning (REAL) through the first 3 years of life to predict the specific emergence of the major childhood mental health problems, as well as social adjustment and impairment more generally. A further aim of this study is to examine how the REAL variables interact with the quality of environment/caregiver interactions. Methods/Design: A prospective, longitudinal birth-cohort study will be conducted. Data will be collected from four assessments and mothers' electronic medical records. Discussion: This study will be the first to test a clear developmental map of both the unique and specific causes of childhood psychopathology and will identify more precise early intervention targets for children with complex comorbid conditions. [ABSTRACT FROM AUTHOR]

Parents' attributions about their child's personality and behaviour are known to predict the quality of parent-child interactions and outcomes for the child, including those from parenting interventions. Nothing is known, however, about the quantity and quality of attributions parents use during free speech about their children referred for treatment of behavioural and emotional problems. We tested hypotheses about the types of attributions and associations among parental attributions, parental psychopathology and child conduct problems, using 504 five-minute speech samples (FMSS) coded using the Parent Attribution Speech Sample (PASS) coding system. Both mothers and fathers talked about their thoughts and feelings regarding their children with disruptive behaviour problems (N = 295; 74% male; 3-8 years old). The assessment of spontaneous parental attributions via the PASS coding system was shown to be valid and reliable. Mothers made more negative, dispositional attributions than fathers, however, parents of either gender made, on average, more positive than negative attributions about their children. Parents' natural attributions about these children with emotional and behavioural problems were rather independent from parents' own mental health, but were consistently related to child factors. Specifically, across parent gender and across all attribution dimensions, levels of callous-unemotional traits were associated with spontaneous parental attributions above and beyond other child and parent factors. Overall, the results show that parents' spontaneous speech about referred children contains important information about their causal attributions, and that these are associated with child temperament rather than specific referral symptoms. [ABSTRACT FROM AUTHOR]

Child conduct problems (CPs) are a robust predictor of adult mental health; the concurrence of callous-unemotional (CU) traits confers specific risk for psychopathy. Psychopathy may be related to disturbances in the oxytocin (OXT) system. Evidence suggests that epigenetic changes in the OXT receptor gene (OXTR) are associated with lower circulating OXT and social-cognitive difficulties. We tested methylation levels of OXTR in 4- to 16-year-old males who met DSM criteria for a diagnosis of oppositional-defiant or conduct disorder and were stratified by CU traits and age. Measures were DNA methylation levels of six CpG sites in the promoter region of the OXTR gene (where a CpG site is a cytosine nucleotide occurs next to a guanine nucleotide in the linear sequence of bases along its lenth, linked together by phosphate binding), and OXT blood levels. High CU traits were associated with greater methylation of the OXTR gene for two cytosine nucleotide and guanine nucleotide phosphate linked sites and lower circulating OXT in older males. Higher methylation correlated with lower OXT levels. We conclude that greater methylation of OXTR characterizes adolescent males with high levels of CU and CPs, and this methylation is associated with lower circulating OXT and functional impairment in interpersonal empathy. The results add genetic evidence that high CU traits specify a distinct subgroup within CP children, and they suggest models of psychopathy may be informed by further identification of these epigenetic processes and their functional significance. [ABSTRACT FROM AUTHOR]

Background: The effectiveness of a training programme targeting structural and therapy process strategies to enhance treatment attendance among families of conduct problem children was evaluated across three community mental health clinics. Method: Utilising a staggered multiple-baseline design, referrals prior to clinician training were compared to posttraining referrals ( N = 221). Results: In comparison to service as usual, children and their families referred after the training initiative had significantly higher treatment attendance (66% vs. 83%) and 79% less likelihood of attrition, though findings were mixed for child's mental health. Conclusions: The findings provide initial support for the effectiveness of the clinician training programme in increasing treatment involvement. [ABSTRACT FROM AUTHOR]

Emotional processing styles appear to characterize various forms of psychopathology and environmental adversity in children. For example, autistic, anxious, high- and low-emotion conduct problem children, and children who have been maltreated, all appear to show specific deficits and strengths in recognizing the facial expressions of emotions. Until now, the relationships between emotion recognition, antisocial behaviour, emotional problems, callous-unemotional (CU) traits and early maltreatment have never been assessed simultaneously in one study, and the specific associations of emotion recognition to maltreatment and child characteristics are therefore unknown. We examined facial-emotion processing in a sample of 23 adolescents selected for high-risk status on the variables of interest. As expected, maltreatment and child characteristics showed unique associations. CU traits were uniquely related to impairments in fear recognition. Antisocial behaviour was uniquely associated with better fear recognition, but impaired anger recognition. Emotional problems were associated with better recognition of anger and sadness, but lower recognition of neutral faces. Maltreatment was predictive of superior recognition of fear and sadness. The findings are considered in terms of social information-processing theories of psychopathology. Implications for clinical interventions are discussed. [ABSTRACT FROM AUTHOR]

Objective: Damage to the amygdala produces deficits in the ability to recognize fear due to attentional neglect of other people's eyes. Interestingly, children with high psychopathic traits also show problems recognizing fear; however, the reasons for this are not known. This study tested whether psychopathic traits are associated with reduced attention to the eye region of other people's faces.Method: Adolescent males (N = 100; age mean 12.4 years, SD 2.2) were stratified by psychopathic traits and assessed using a Tobii eye tracker to measure primacy, number, and duration of fixations to the eye and mouth regions of emotional faces presented via the UNSW Facial Emotion Task.Results: High psychopathic traits predicted poor fear recognition (1.21 versus 1.35; p < .05) and lower number (1.85 versus 2.51; p < .001) and duration (375 versus 620 ms; p < .001) of eye fixations, and fewer first foci to the eye region (1.01 versus 2.01; p < .001). There were no differences in gaze indices to the mouth region. All indices of gaze to the eye region correlated positively with accurate recognition of fear for the high psychopathy group, especially the number of times that subjects looked at the eyes first (r = .50; p < .01).Conclusions: Attention to other people's eyes is reduced in young people with high psychopathic traits, thus accounting for their problems with fear recognition, and is consistent with amygdala dysfunction failing to promote attention to emotional salience in the environment. [ABSTRACT FROM AUTHOR]

Failure of parents to attend and engage in treatment is a significant barrier to implementing effective interventions in child and adolescent mental health. Approaches to enhance treatment attendance and participation have targeted both structural operations of the clinic and aspects of the therapeutic process. Little research, however, has looked at clinicians' use of strategies to enhance treatment participation. Fifty-one mental health practitioners completed measures of strategies to increase treatment participation among families of conduct problem children. Client attendance was collected for each clinician over a 1-month period. As hypothesized, therapists were more aware of, and reported greater use of, therapy process compared to structural approaches to increase treatment participation. Clinician ratings of usefulness, competence and willingness to use therapy process strategies predicted client appointment attendance. The results are discussed in relation to the importance of training and supervision of professionals working with families in mental health services targeting a range of strategies to enhance treatment participation. [ABSTRACT FROM AUTHOR]

An ecological model of adolescent mental health is proposed, based on data obtained from the Portuguese survey conducted by the first author (Matos, 2005; Matos et al., 2000, 2003, 2004), who is the national representative for the World Health Organisation collaborative European study: Health Behaviour in School-Aged Children (Currie, Hurelmann, Settertobulte, Smith, & Todd, 2000; Currrie, Roberts, Morgan, et al., 2004). In particular, we were interested in whether parent encouragement for school added a specific effect to adolescent health over and above that afforded by the quality of the home and school environments. A nationally representative sample of 6903, 10- to 17-year-old adolescents participated in the survey. Measures were constructed of physical health, conduct problems, anxiety/depression, family communication, school environment, and parental encouragement for school. A series of regression analyses supported an ecological model of psychological health in which the family and school, as well as the relationship between the two, show relationships to adolescent health, conduct, and anxiety/depression problems. Despite the design and sampling limitations, results suggest that parental encouragement for school can be considered as having a specific positive effect on adolescent health, beyond the effect of school environment and family communication addressed individually. [ABSTRACT FROM AUTHOR]

We examine the Australian psychometric properties of the Strengths and Difficulties Questionnaire (SQD), a brief screening measure of behavioural and emotional problems in children and adolescents. Using a large community sample (n = 1359) of young Australian children (4−9 years), we assessed the internal consistency, stability, and external validity of the parent-report SDQ. Normative data and cut-offs were also produced. Moderate to strong internal reliability was exhibited across all SDQ subscales, and support was found for the original five-factor structure of the measure. Adequate validity was evidenced in the relationship of these scales to one another, while correlations between the SDQ subscales, teacher ratings, and diagnostic interviews demonstrated sound external validity. SDQ total difficulties scores were associated with concurrent treatment status and scores over a 12-month period were stable. The current study of the SDQ with Australian children presents evidence of sound psychometric properties. Being the first study to empirically support the use of the SDQ in Australia, it is recommended that the youth and teacher-report forms of the measure receive similar attention in the future. [ABSTRACT FROM AUTHOR]

Reviews evidence for the significance of childhood cruelty to animals as a predictor of later violence toward humans. Moves are underway in the United States (US) and Britain to encourage communication and cross-fertilisation between animal welfare and child protection and crime prevention services. Literature on healthy versus deviant child-pet interactions is reviewed, with particular regard to the prediction of later violence. Assessment and definitional issues are addressed. The discussion culminates with a summary of substantive findings and the identification of several research designs that are needed to clarify the potential of early identification and remediation of child cruelty to animals as a mental health promotion and violence prevention strategy. [ABSTRACT FROM AUTHOR]

We examined two systems of assessing family interactions that are in common usage: a home based observation of free parent-child interaction and a clinic based observation of a structured mother-child problem solving discussion. Participants were 18 depressed, 27 conduct disordered and 16 comparison children and their mothers. Results indicated that: 1) these observations may yield very different data about child, and to a lesser extent, parent behavior, 2) parental affect in the clinic was related to their level of aversive behaviour in the home, 3) levels of both aversive and positive behavior for children and their mothers were correlated within each setting, 4) accuracy of diagnostic classifications made on the basis of the observational data were highest for comparison and conduct disordered children, but lowest for depressed children observed in the clinic, and 5) the inclusion of data on mothers' behavior increased classification accuracy for conduct disordered children only. [ABSTRACT FROM AUTHOR]

There is a growing recognition of the importance of identifying both trans-diagnostic risk factors across the major disorders that onset early in childhood, as well as precise vulnerabilities that differentiate among specific disorders. In this paper, we propose a model to explain individual differences in the development of the major forms of mental health problems that can be identified early in life through excesses and deficits in emotional attention, responsiveness and learning (i.e., the REAL model). The model leads to a number of specific hypotheses relating to trans-diagnostic (common to all disorders) and specific risk to the major mental disorders of childhood. Like earlier models of temperament, the REAL constructs are defined in terms of how the child responds to environmental conditions. Our proposal is that the development of psychopathology is in part based on how adverse environmental conditions trigger, inhibit, and interact with these specific biological vulnerabilities at sensitive periods in the developing human. To illustrate this interplay of biology and experience, we summarize key findings from the growing field of epigenetics and child mental health, arguing that epigenetic processes might mediate the relationship between environmental adversity and the major neurodevelopmental systems of REAL. Finally, we argued that the REAL model highlights important avenues for early intervention based on common and unique factors across childhood disorders. • We propose a model of trans-diagnostic factors underlying the development of mental health disorders. • These factors are individual differences in emotional attention, responsiveness and learning (the REAL model). • The model makes specific hypotheses about trans-diagnostic (common to all disorders) and specific risk for thedisorders of childhood. • Environments trigger, inhibit, and interact with these specific biological vulnerabilities at sensitive periods. • The REAL model highlights important avenues for early intervention based on common and unique factors across childhood disorders. [ABSTRACT FROM AUTHOR]