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Despite Australia's high standard of health care provision, Australian Aboriginal women continue to experience poor pregnancy outcomes in terms of maternal and foetal morbidity and mortality. In an attempt to improve these outcomes, health care providers have developed targeted antenatal programmes that aim to address identified health behaviours that are known to contribute to poor health during pregnancy. While some areas of improvement have been noted in rates of engagement with health services, the rates of premature births and low birth weight babies continue to be significantly higher than in the non-Aboriginal population. It appears that Australian researchers have been focused on the behaviour of the individual and have failed to fully consider the impact that social and emotional well-being has on both health behaviours and pregnancy outcomes. This review has highlighted the need for an approach to both research and clinical practice that acknowledges the Aboriginal view of health which encompasses mental, physical, cultural and spiritual health. Until clinicians and Aboriginal women have a shared understanding of how social and emotional well-being is experienced by Aboriginal women, in other words their explanatory model, it is unlikely that any meaningful improvements will be seen.

The family context plays a critical role in the health of the child. This was the first study to examine the usefulness of the General Functioning subscale of the Family Assessment Device (FAD-GF) in assessing family functioning and its relationship to internalizing symptoms in school-aged children aged between 9 and 11 years of age. Eight hundred and forty-seven year 4 and 5 students from 13 schools (607 intervention students, and 240 control students) participated in the Aussie Optimism Positive Thinking Skills Program (AO-PTS) - a universal school-based program targeting internalizing symptoms. Students rated how 'healthy' they perceived their family to be at pre-test and at 6-months follow-up. Although some aspects of validity and reliability could be improved, results indicated that perceptions of family functioning at pre-test were predictive of internalizing symptoms at the 6-months follow-up. The FAD-GF therefore showed promise as a potential measure of family functioning for children as young as 9 years old. Regardless of children's pre-test levels of perceived family functioning, no intervention effects were found on the anxiety and depression scales; this finding suggests that child perceptions of family functioning may act as a general protective factor against internalizing symptomology.

Introduction: Social disconnectedness and isolation are risk factors for poor mental health. Community-based friendship group interventions have been designed to increase an individual’s social capital and consequently their mental wellbeing. Structured and unstructured friendship groups reflect two distinct approaches to friendship group interventions. Methods: This meta-analysis investigated whether structured or unstructured community friendship groups are more effective for mental health and social capital outcomes. A systematic search of quantitative studies was conducted across seven databases and study quality was assessed using the Effective Public Health Practice Project (EPHPP) tool. Eight studies (2 unstructured and 6 structured friendship groups) were included in the review, published between 2005 and 2020. Results: Structured friendship groups had a small significant effect on reducing participant depression symptoms. There was not enough available data to compare the effectiveness of structured and unstructured groups for mental health outcomes. There was substantial heterogeneity between studies to calculate pooled effect sizes for any social capital outcomes. Data synthesis indicated mixed reviews for social capital outcomes, likely due to the large heterogeneity and limited studies. Discussion: This meta-analysis provides limited support for positive mental health outcomes following structured community-based friendship group interventions. There is a need for additional research as a large research gap remains, particularly for unstructured friendship groups. [ABSTRACT FROM AUTHOR]

Introduction: Mental health difficulties in early childhood can have a debilitating and ongoing impact throughout an individual's life; emotion regulation can serve as a protective factor. Therefore, evidence-based prevention programs that teach children effective skills and strategies for emotion regulation are needed. Methods: As part of the Aussie Optimism pilot study evaluating the "I Spy Feelings" program, this study aims to assess the short-term effects of the program on emotion regulation in pre-primary aged children after 2 months via a longitudinal cluster randomized controlled trial. Participants included parents (N =73) of 5- to 6-year-old children attending four different Catholic primary schools. Children from two of the schools were allocated to the intervention group where they participated in the program (N =33), while children from the other two schools were allocated to the control group where they did not (N =40). At each time point, all parents completed abridged Children's Emotional Management Scales measuring how well parents believe their child is able to cope with anger, sadness and worry. Results: A significant intervention effect 2 months after intervention was found for the outcome of anger coping such that parents whose children were in the intervention group reported significantly greater improvement in their children's ability to cope with anger compared to parents whose children were in the control group. No significant effect was found for the outcome of sadness, and results for the worry subscale were inconclusive due to unacceptable internal consistency. Discussion: The present study provides insight into the benefit of programs designed to enhance the emotion regulation skills of very young children. Further follow-up is needed to assess whether the "I Spy Feelings" program has lasting effects. [ABSTRACT FROM AUTHOR]

Introduction: The transition to parenthood is a high-risk period for many parents and is an important period for child development. Research has identified that parental mental health, reflective functioning (capacity to consider mental states of oneself and others) and coparenting (capacity to work together well as a parenting team) may be particularly significant predictors of later child outcomes, however these factors have seldom been considered together. The present study therefore aimed to investigate the relationship between these factors and the extent to which they predict child social emotional development. Methods: Three hundred and fifty parents of infants aged 0 to 3 years 11 months were recruited to complete an online Qualtrics questionnaire. Results: Results indicate that both positive coparenting and parental reflective functioning (Pre-mentalizing and Certainty subscales) were found to significantly predict child development. General reflective functioning (Uncertainty subscale) predicted parental depression and anxiety, however unexpectedly, parental mental health was not a significant predictor of child development, but did predict coparenting. General reflective functioning (Certainty subscale) was also found to predict coparenting, which in turn was found to predict parental reflective functioning. We found an indirect effect of general reflective functioning (Certainty) on child SE development via parental reflective functioning (Prementalizing). We also found an indirect effect of negative coparenting on child development via parental reflective functioning (Pre-mentalizing). Discussion: The current results support a growing body of research highlighting the important role reflective functioning plays in child development and wellbeing as well as parental mental health and the interparental relationship. [ABSTRACT FROM AUTHOR]

The selection of valid and reliable instruments for research and clinical purposes is needed to increase our understanding of the role that expectations of motherhood have in early identification and treatment of perinatal mental health difficulties. We aimed to identify and assess the psychometric properties of self-report measures of expectations of motherhood. A systematic review was conducted and articles describing the development or validation of quantitative self-report measures of expectations of motherhood were included. The developmental quality (risk of bias) and psychometric properties of each measure were assessed according to the 2018 COSMIN guidelines. Twenty-five articles describing 16 measures were identified and included. Eleven measures were designed to assess a broad range of expectations, while the remaining measures mainly assessed expectations of childbirth. The quality of measure development was mostly poor and rated as adequate or better for only three measures. The most suitable measures with the strongest evidence of good psychometric properties are the Slade-Pais Expectations About Childbirth Scale and the Rigidity of Maternal Beliefs Scale. This systematic review of measures of expectations has identified relatively few measures with adequate psychometric properties. Further development of existing measures is needed for use in both research and clinical settings. KEY POINTS What is already known about this topic: Maternal mental health difficulties can have significant and long-term adverse consequences on mothers, their children, and families. Previous evidence suggests that holding unrealistic maternal expectations may contribute to postpartum mental health difficulties. Early identification of the potentially modifiable risk factor of maternal expectations may contribute to improving postpartum mental health outcomes. What this topic adds: This is the first systematic review to assess the developmental quality and psychometric properties of 16 measures of expectations of motherhood. The Slade-Pais Expectations About Childbirth Scale had the strongest evidence for good psychometric properties. For the majority of the measures, adequate methods for ensuring good content validity during measure development and validation were not used. [ABSTRACT FROM AUTHOR]

Changing technology, and the pervasive demand created by a greater need in the population for access to mental health interventions, has led to the development of technologies that are shifting the traditional way in which therapy is provided. This study investigated the efficacy of a behavioral couples therapy program conducted via videoconferencing, as compared to face-to-face. There were 60 participants, in couples, ranging in age from 21 to 69 years old. Couples had been in a relationship for between 1 to 49 years. The 30 couples were randomly allocated to the face-to-face or videoconferencing group. They all took part in Couple CARE—a couples behavioral education program which promotes self-change in order to increase relationship satisfaction. The six session manualized intervention was offered in an identical manner to all clients, in each condition. Data analysis was based on several questionnaires completed by each couple at pre, post and 3-months follow-up. Results showed that therapeutic alliance ratings did not differ between groups, but increased significantly over time for both groups. Additionally, the results indicated improvements in relationship satisfaction, mental health, and all other outcome scores over time, which did not differ based on condition. This study uniquely contributes to the literature exploring the use of technology to provide therapy. Specifically, the study provides evidence for couples therapy via videoconferencing as a viable alternative to face-to-face interventions, especially for those couples who may not have access to the treatment they require. It is anticipated that the results of this study will contribute to the field of online therapy, and add to fostering confidence in agencies to allow expansion of services conducted via videoconferencing. [ABSTRACT FROM AUTHOR]

The period of infancy and early childhood is a critical time for interventions to prevent future mental health problems. The first signs of mental health difficulties can be manifest in infancy, emphasizing the importance of understanding and identifying both protective and risk factors in pregnancy and the early postnatal period. Parents are at a higher risk of developing mental health problems during the perinatal period. An understanding of the evidence around prevention and intervention for parental anxiety and depression is vital to the process of prevention of early mental health disorders in infants and young children. Here we review the existing prevention and treatment interventions in the early years focusing on the period from conception to 3 years – the majority targeting parents in order to improve their mental health, and that of their infants. Elements of successful programs for parents include psychoeducation and practical skills training, as well as work on the co-parenting relationship, developing secure attachment, and enhancing parental reflective functioning. While both targeted and universal programs have produced strong effect sizes, universal programs have the added benefit of reaching people who may otherwise not have sought treatment. In synthesizing this information, our goal is to inform the development of integrated models for prevention and novel early intervention programs as early in life as possible. [ABSTRACT FROM AUTHOR]

Research indicates that mental health disorders can occur in children as young as 4 years of age, prompting the need for prevention programs for young children. The ability to use healthy strategies to cope with emotions is a protective factor against mental health disorders that can be effectively taught to children from an early age. The current study used a pre-test post-test cluster randomized controlled trial to test the efficacy of the new Aussie Optimism: I Spy Feelings Program. The aim of the study was to investigate the effects of the program on children's emotional coping. The program included content on emotion regulation strategies, focusing on the emotions of happiness, sadness, anger, fear, and worry. The participants were 73 children (intervention = 33; control = 40) from pre-primary classes. Four schools were cluster randomized to the intervention or control group, resulting in two schools in each condition. Parents completed measures of their children's emotional coping with sadness, anger and worry. Children in the intervention group participated in ten sessions of the I Spy Feelings Program, spread over 5 weeks. The results indicated a significant, small to moderate intervention effect for coping with anger. Children in the control group decreased in their ability to cope with anger, while children in the intervention group remained stable. No intervention effects were found for coping with sadness or worry, with results for these emotions staying stable across time for both groups. This pilot study will inform the further development of the program. The effects of the program on coping with anger provide support for the use of emotion regulation strategies in intervention programs to maintain healthy emotional coping, which is a protective factor against internalizing and externalizing disorders in childhood. [ABSTRACT FROM AUTHOR]

Anxiety and depression are common mental health problems experienced by children in Australia. The impact of these internalizing disorders is pervasive, affecting many areas of life. By the time problems have been detected in children they can be severe in nature and harder to treat. Hence, early intervention is of utmost importance. Despite the existence of numerous prevention programs for children, there is limited empirical evidence for a program that has an impact on symptoms of both anxiety and depression. Physical activity and improved motor coordination have been indicated as having positive effects on children's mental health, although the impact of including these in a program targeting internalizing disorders has not been established. This study aimed to evaluate the efficacy of the Feelings and Friends (Year 3) program (FFY3), revised to include activities to build motor-coordination and encourage physical activity. Participants were 24 children from the Perth metropolitan area alongside one of each of their parents. Results indicated significant short-term intervention effects on one of the primary outcome variables; intervention group parents reported significant pre-post improvement in child depressive symptoms, which were maintained at 3-month follow-up (ηp2 = 0.10). There were also intervention effects observed for parent-reported separation anxiety (ηp2 = 0.10), externalizing symptoms (ηp2 = 0.19), and conduct problems (ηp2 = 0.16). An additional finding indicated the intervention students reported significant improvement from session one to session two in global distress (ηp2 = 0.22). No other significant intervention effects were evident. Findings from this study indicate that FFY3 is a promising intervention to address internalizing and externalizing symptoms in 8-9 year-old children. [ABSTRACT FROM AUTHOR]

The Aussie Optimism Program: Feelings and Friends (AOP-FF) is a 10 week, universal mental health promotion program based on social/emotional and cognitive and behavioral strategies. The aim of the current study was to evaluate the efficacy of a universal Cognitive Behavioral Therapy based program in preventing and reducing internalizing problems in 6-8 year olds (Years 1-3 in Australia). Year 1-3 students from a low SES primary school (N = 206) were randomly assigned in classes to either an intervention or a control group and assessed at baseline and post-test. Results showed a significant (p = 0.009) and small to moderate (partial eta-squared = 0.034) pre-post decrease in parent-reported anxiety symptoms for the intervention group, in conjunction with a non-significant (p = 0.708) and negligible (partial eta-squared = 0.001) pre-post increase for the control group. A larger randomized controlled trial assessing longer term effects is needed. In addition the program needs to be simplified for year 1-2 students with a separate more developmentally appropriate program for year 3 students. [ABSTRACT FROM AUTHOR]

Background: Preventative and treatment programs for people at risk of developing psychological problems after exposure to war trauma have mushroomed in the last decade. However, there is still much contention about evidence-based and culturally sensitive interventions for children. The aim of this study was to examine the efficacy of the Teaching Recovery Techniques in improving the emotional and behavioral outcomes of war-affected children resettled in Australia. Methods and Findings: A cluster randomized controlled trial with pre-test, post-test, and 3-month follow-up design was employed. A total of 82 participants (aged 10-17 years) were randomized by school into the 8-week intervention (n = 45) or the waiting list (WL) control condition (n = 37). Study outcomes included symptoms of post-traumatic stress disorder, depression, internalizing and externalizing problems, as well as psychosocial functioning. A medium intervention effect was found for depression symptoms. Participants in the intervention condition experienced a greater symptom reduction than participants in the WL control condition, F(1, 155) = 5.20, p = 0.024, partial η² = 0.07. This improvement was maintained at the 3-month follow-up, F(2, 122) = 7.24, p = 0.001, partial η² = 0.20. Conclusions: These findings suggest the potential benefit of the school and group-based intervention on depression symptoms but not on other outcomes, when compared to a waiting list control group. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12611000 948998. [ABSTRACT FROM AUTHOR]

Abstract: The Aussie Optimism: Positive Thinking Skills Program (AOP-PTS) is an innovative curriculum-based mental health promotion program based on cognitive and behavioural strategies. The program is aimed at preventing depressive and anxiety symptoms and disorders in middle primary school children aged 9–10 years. Students from 22 low SES primary schools (N = 910) were randomly assigned to an intervention or a control group and assessed at baseline, post-test, 6 months and 18 months. The intervention group received the program implemented by teachers and the control group received their regular Health Education curriculum. Students completed questionnaires on depression, anxiety, and attribution style. At risk students were further assessed with the computerised Diagnostic Interview for Children and Adolescents. Parents reported on their children's externalising and internalising problems at home. Children in the intervention condition reported a significant pre-post reduction in depressive symptoms, and there was a significant pre-post reduction in parent-reported emotional difficulties which was maintained at 6 month follow-up; no changes were evident in the control group. Both groups showed significant improvements in child-reported anxiety and attribution style, and significant improvements in parent-reported pro-social behaviours. For both groups, there were no significant post-baseline changes in incidence and recovery rates for depression, anxiety, or internalising symptoms. These findings suggest that AOP-PTS has the potential to treat depressive symptomatology in the immediate term but the effects were not sustained. There is also evidence of improved emotional resilience up to 6 months following the program. Further follow-up to investigate longer term effects is needed. [Copyright &y& Elsevier]

Animal Fun was designed to enhance motor and social development in young children. Its efficacy in improving motor skills was presented previously using a randomised controlled trial and a multivariate nested cohort design. Based on the Environmental Stress Hypothesis, it was argued that the program would also result in positive mental health outcomes, investigated in the current study. Pre-intervention scores were recorded for 511 children aged 4.83-6.17 years (M=5.42, SD=.30). Intervention and control groups were compared 6 months following intervention, and again in their first school year. Changes in teacher-rated prosocial behaviour and total difficulties were assessed using the Strengths and Difficulties Questionnaire, and data analysed using Generalised Linear Mixed Models. There was a significant improvement in prosocial behaviour of children in the intervention group six months after initial testing, which remained at 18-month follow-up. Total difficulties decreased at 6 months for the intervention group, with no change at 18 months. This effect was present only for the hyperactivity/inattention subscale. The only significant change for the control group was an increase in hyperactivity/inattention scores from pre-intervention to 18-month follow-up. The Animal Fun program appears to be effective in improving social and behavioural outcomes. [ABSTRACT FROM AUTHOR]