A growing body of evidence suggests family accommodation (FA) contributes to pediatric anxiety onset, maintenance, and blunted treatment response and has inspired novel treatment approaches. Many measures of FA have been developed in the past two decades, yet their psychometric properties have not been thoroughly examined, compared, and aggregated to inform measurement selection in research and clinical settings. Accurately measuring FA is critical for refining etiological theories of youth anxiety disorders and informing clinical interventions. The current review aims to summarize and critically analyze existing FA measurement tools to inform measure selection and highlight critical weaknesses and areas for future FA measurement research. FA measurements were identified via a search of PsycINFO and PubMed and were evaluated using the criteria for evidence-based assessment (Hunsley & Mash, 2007). Most FA measures demonstrated adequate psychometric properties, suggesting FA measure selection will largely depend upon context, available resources, intended use, and FA subdomains of interest. FA measurement will benefit from additional research using longitudinal methods and more diverse samples.
Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental condition in childhood and adolescence. Supporting parents through mobile health (m-health) interventions is a promising non-pharmacological approach to ADHD management; however, evidence regarding their characteristics and effectiveness remains limited. This systematic review aimed to identify and synthesize m-health interventions designed to support parents of children with ADHD. A systematic search was conducted in Scopus, Web of Science, Embase, and PubMed. Data were synthesized according to intervention delivery formats, intervention aims, and reported outcomes. Of the 13,001 identified records, 21 studies met the inclusion criteria and were assessed as being of fair methodological quality with a low risk of bias. Because some interventions used multiple delivery formats and addressed multiple aims, percentages were calculated based on the total number of identified delivery-format and intervention-aim instances rather than the number of included studies. Mobile application–based interventions were the most frequently used delivery format (n = 17; 58.6
The transdiagnostic approach has emerged as a promising framework in psychological interventions, with the Super Skills for Life (SSL) program standing out for its role in reducing anxious-depressive symptoms in children and adolescents. This work aimed to conduct a systematic review and meta-analysis to synthesize the effects of SSL on the decrease of symptoms of depression; social, generalized and overall anxiety; and/or emotional problems in youth. Additionally, the stability of these effects over time and the influence of participant- and intervention-related variables were explored. A comprehensive search was conducted in PubMed, Scopus, Web of Science, PsycInfo and grey literature, and implementers of the program were contacted. A total of 20 documents corresponding to 18 studies were identified, and meta-analytic and meta-regression models were fitted. Within-group symptom reductions were significant from pre- to post-intervention (g = 0.343 − 0.591), and also for most outcomes in comparison with inactive control groups (g = 0.360 − 0.566). No significant changes were observed between post-intervention and follow-up, except for a small but significant improvement in emotional problems (g = 0.165). For this outcome, significantly greater symptom reductions were found in children, compared to adolescents, and in indicated prevention or treatment compared to non-indicated or universal implementation. Individual formats were associated to higher effect sizes than group formats. Despite observed heterogeneity, findings support the effectiveness of SSL compared to inactive controls in reducing anxious-depressive symptoms. Pre-post comparisons also suggest these reductions, which are more pronounced under specific conditions.
Failure to launch (FTL) is a phrase used to describe abled young adults who live with their parents, are not in school, and are not employed, reflecting difficulties in adult functioning and delayed achievement of expected developmental milestones. Although frequently encountered in clinical settings from parents seeking treatment for their children and themselves, FTL has received little systematic empirical attention in the clinical psychology literature. The present review disentangles FTL from related constructs and highlights the need for a dedicated body of research. First, we define FTL and review findings from one empirical study of FTL adults. Next, we compare FTL to neighboring constructs such as peter-pan syndrome, pathological demand avoidance, "not in education, employment, or training" (NEET), boomerang children, modern-type depression, and hikikomori, emphasizing both points of overlap and distinction. We then review relevant findings from these literatures, including discussion of prevalence rates, correlates, risk factors, and outcomes of related syndromes, with a particular focus on the hikikomori literature. Next, we review existing assessment tools and summarize emerging psychotherapeutic interventions. We conclude by considering how researchers can draw on existing literature to inform future research on FTL youth. Although FTL appears to be a pressing clinical problem, research is necessary to understand its etiology and developmental course and to identify avenues for prevention and intervention.
Autistic individuals often experience differences in social-cognitive processing, including mentalization, the capacity to understand one's own and others' mental states, which may influence social and emotional functioning. This systematic review synthesizes the current evidence base on interventions targeting mentalization and Theory of Mind (ToM), conceptualized here as related but distinct constructs, with ToM reflecting more specific cognitive perspective-taking skills within the broader mentalization framework. A comprehensive search across multiple databases, without restrictions on language or year of publication, identified 19 eligible studies involving autistic individuals and their caregivers. Study quality was appraised using the Mixed Methods Appraisal Tool (MMAT), providing an indication of methodological rigor across diverse designs, though not a formal assessment of risk of bias. Across studies, interventions were generally associated with improvements in reflective functioning and performance on structured ToM tasks (e.g., false-belief understanding). However, these gains were predominantly observed in proximal, task-based measures, with limited and inconsistent evidence for generalization to real-world social functioning. This pattern raises important questions regarding the ecological validity of commonly used ToM assessments and whether observed improvements reflect meaningful changes in everyday social interaction or task-specific learning. Substantial heterogeneity in study design, intervention characteristics, outcome measures, and participant profiles further limits comparability and precludes firm conclusions regarding effectiveness. Overall, while mentalization- and ToM-based interventions show promise, the current evidence base remains methodologically and conceptually constrained. Future research should prioritize ecologically valid outcome measures, clearer specification of intervention mechanisms, and more rigorous study designs, including long-term follow-up, to better determine whether these interventions support meaningful, real-world social and relational outcomes for autistic individuals and their families.
Homework adherence represents a salient, modifiable target for improving cognitive behavioral therapy (CBT) outcomes for pediatric internalizing disorders. While the adult literature has found a clear connection between CBT homework adherence and treatment outcomes, the evidence among youth have been mixed regarding the extent to which between-session homework adherence predicts CBT outcomes. The present study conducted a systematic review and meta-analysis that examines the association between homework adherence and CBT outcomes in clinical trials of internalizing disorders for youth. Fourteen studies met prespecified inclusion criteria, comprising a total sample of 1179 participants (M age = 11.33 years, 53.79
Digital media is an increasingly central part of children's and adolescents' lives, prompting growing concern among parents, educators, clinicians, and policymakers about its impact on cognitive, emotional, social, and physical well-being. This narrative review synthesizes evidence from 52 systematic reviews and meta-analyses, along with key individual studies, to assess the state of knowledge on youth digital media use. Findings show a clear pattern: problematic media use is consistently linked to adverse outcomes across domains, whereas general digital media use shows mixed effects shaped by content, motives, context, individual traits, and theoretical perspectives. The review highlights the need to move beyond simplistic screen time metrics toward dynamic, person-centered models that clarify mechanisms, identify at-risk children and adolescents, and guide targeted interventions and policy responses in families, schools, clinical practice, and digital platform governance.
Encopresis is a common disorder of childhood that accounts for about one in four referrals to pediatric gastroenterology clinics (Culbert Banez, 2007). Encopresis involves the repeated passage of feces into inappropriate places. Encopresis with constipation and overflow incontinence (retentive encopresis) accounts for more than 80
There is a general conception that mental health problems are increasing in younger generations, though little objective comparisons exist. The current meta-analysis examined changes in subclinical mean-level emotional and behavioral problems among population-based samples of youth (1-18 years) globally over the last four decades. We searched systematically in PubMed, Web of Science, Scopus, EBSCO and Google Scholar with pre-registered criteria [removed for masked review]. Included studies ( k = 175, N = 418,528) used the standardized and cross-culturally validated Child Behavior Checklist with parents, teachers and self-reports. A cross-temporal meta-analysis was conducted with data points between 1981 to 2019. Age, sex, response rate, continent were used as moderators. Meta-regression analyses, with year of data collection as predictor, showed that total emotional and behavioral problems did not change in the past 40 years. However, there was evidence of change in specific problems. We find strong evidence for decreased aggression in children over time (parent report: k = 47, b year = -0.18, p = .009, 95%CI[-0.31,-0.05]; self-report: k = 9, b year = -0.41, p = .006, 95%CI[-0.66,-0.16]). There was evidence of a decrease in parent reported externalizing problems in middle childhood ( k = 60, b year = -0.21, p < .001, 95%CI[-0.30,-0.11]) and specifically in teenage boys ( k = 12, b year = -0.27, p = .049, 95%CI[-0.54,0]). In contrast, there were increases in parent-reported attention ( k = 63, b year= 0.24, p = .004, 95%CI[0.08,0.40]) and thought problems ( k = 40, b year= 0.09, p = .006, 95%CI[0.03,0.15]) for youth overall, and anxiety-depression symptoms specifically in teens ( k = 12, b year = 0.26, p = .011, 95%CI[0.07,0.45]), although with high heterogeneity. In sum, our results do not support concerns that children and young people today experience more emotional and behavioural problems than previous generations, rather, they experience subtly different patterns of difficulties. However, an important limitation of the study is that post COVID-19 changes were not studied.
Adjustment disorders are amongst the most prevalent diagnoses in youth but there is currently limited empirically-supported guidance in treating this disorder. There are a couple approaches for determining effective treatments for youth with adjustment disorders based on theoretical models and empirical research. From the approach of clinical psychology and research on the treatment of psychological disorders, evidence-based interventions (EBIs) for related disorders can be matched to the particular symptoms of adjustment disorder that the youth experiences. From the approach of developmental psychopathology and prevention science, research on resilience as well as the mechanisms through which psychopathology develops following stress exposure provide insight into appropriate strategies for coping with stress. This paper reviews and synthesizes findings on the prevention and treatment of psychopathology in order to outline a recommended, empirically-supported approach for treating adjustment disorders in youth. Overall, components of cognitive and behavioral therapies have the most research support and can equip youth with multiple strategies for coping with stress. Additional evidence-based practices and treatment approaches to serve this population are discussed.
This narrative review examines the complex relationship between autism and two fundamental social needs: the need to belong and the need to be alone, which underpin the conceptually distinct experiences of loneliness and solitude. After outlining core features of autism spectrum disorder−focusing on characteristic patterns of social functioning across the spectrum−we synthesize evidence showing that individuals with autism frequently report elevated loneliness alongside a comparatively stronger preference for solitude than typically developing peers. We conceptualize this seemingly counterintuitive pattern as the solitude-loneliness (SOLO) paradox. We propose that, within the autistic population, loneliness emerges from the dynamic interplay among social-communication differences, sensory hypersensitivity and related neurocognitive characteristics, coping strategies, and the chronic frustration of unmet social needs. Extending this framework, we explore how the SOLO paradox may, in some cases, contribute to more severe or maladaptive outcomes, including extreme social withdrawal (hikikomori) and problematic internet use. We conclude by discussing directions for future research, emphasizing the importance of translating conceptual advances into supportive strategies that meaningfully enhance the well-being of individuals on the autism spectrum.
A lack of positive and the presence of negative parenting are frequently mentioned as risk factors for the development and maintenance of childhood and adolescent depression. However, meta-analytic research is mostly based on parenting as perceived by the child or parent, with the potential risk of a reporter bias. Also, specific patterns of observed child behavior among children with childhood depression are often overlooked and there currently is no meta-analysis on this topic. The current meta-analyses integrate the cross-sectional and longitudinal relation between observed parenting and childhood depression, and the cross-sectional relation between observed child behavior and childhood depression. This preregistered study (k = 90) includes 350 effect sizes on five observed parenting behaviors and 131 effect sizes on six observed child behaviors in parent–child interactions that were found via PsychINFO, Web of Science, and Proquest Dissertations and Theses (until the end of September 2024). Multilevel meta-analyses show that parental warmth/support and harsh control/criticism co-occur with and precede childhood depression, with small effect sizes, while childhood depression generally did not precede negative parenting. This aligns with previous research based on subjective reports, indicating that low parental warmth and higher criticism may form risk factors for childhood depression. Observed parental autonomy granting, guidance/structure, and parental depressed affect did not relate to childhood depression. Further, children with depression showed more negative affect, reduced autonomy and engagement, illustrating the interactional challenges these families face. Family interventions could validate and address the challenges posed to children as well as parents in families with a child with depression.
The arrival of a baby and the early years of a child's life represent a critical period for parents, often marked by increased parental stress that can impact both their well-being and the child's development. Although parental stress has been widely studied, no systematic review has yet focused specifically on early childhood. To address this gap, we conducted a systematic review synthesizing evidence on factors examined as antecedents of parental stress during the first three years postpartum. Following PRISMA guidelines, we included 108 quantitative studies published in the past 12 years that investigated variables statistically modeled as predictors of parental stress. Key determinants of parental stress were identified at three levels: (1) at the personal level, internalizing symptoms, adverse childhood experiences, and perinatal negative experiences were related to higher stress; (2) at the relational level, marital satisfaction and coparenting quality were associated with lower stress; and (3) at the contextual level, social support from friends and family served as a protective factor of parental stress, while children's developmental problems served as risk factors. Despite the increasing number of longitudinal studies and the growing inclusion of fathers in research, few studies have focused on participants from social minority groups or from non-Western contexts. These findings may contribute to the development of effective strategies to support families during the early years of parenthood.
Mental health problems occur frequently in the perinatal period and timely identification is key for appropriate support to be offered. Women are routinely asked about their mental health and may undergo formal screening as part of healthcare services in the perinatal period. The aim of this review was to explore women’s views and experiences of being screened for mental health problems and to identify which aspects of this screening process they considered to be important. A systematic search was conducted across five electronic databases for potentially eligible studies published up to July 2025. A meta-ethnographic approach was used to synthesise the findings extracted from the thirty-eight papers included in the final analysis. Reciprocal translation resulted in a line of argument synthesis incorporating three over-arching themes. These were ‘Opportunities presented by screening’ ‘Difficulties with screening’ and ‘Context and constraints’. Identification of salient aspects of the screening process revealed that preferences for how screening is conducted were varied, but more important than the specific method/mode used was the value that women placed on the concept of screening. Nevertheless, several process related factors, such as women’s knowledge and expectations of screening, the screening method and environment, were found to be influential. An important implication for clinical care is that perinatal mental health screening can offer impactful and positive opportunities for women when they see value in the process and when this is facilitated by well validated, person-centred, and flexible screening approaches. Questions regarding suicide/self-harm specifically, presented difficulties, and there is an urgent need to examine how this can be made more acceptable to women.
Australian Aboriginal people have evolved advanced relational knowledge systems for raising children and young people over thousands of years. Documentation of this knowledge within peer-reviewed literature is dispersed across a broad set of disciplines and sources that are mostly contextualised within Eurocentric frameworks. In this scoping review, we describe the literature on Australian Aboriginal Early Relational Knowledge Systems. Our aim is to describe how Australian Aboriginal approaches to relational wellbeing uniquely promote health and human development from pre-conception, to childhood, to adolescence and into parenting next generation offspring. We privilege Australian Indigenous authors as the holders of knowledge and limit our review to data sources led by Australian Indigenous people. A systematic search for relevant studies was conducted across four databases: MEDLINE, PsycINFO, Embase and CINAHL. This yielded 5,141 articles, of which 26 met criteria. A further 5 articles were identified through citation searching resulting in 31 included articles. We describe how Aboriginal children and young people develop relational security through engagement with multiple complex social systems within family and community, through interaction with Country, and across human and non-human elements, many features of which are missed in Western theories and Western interpretation of Aboriginal relational knowledge. Culturally valid and reliable assessment measures are urgently needed to accurately represent and monitor population relational health in Aboriginal children and young people.
Record-high temperatures and more frequent heatwaves are well-documented consequences of climate change, but the developmental consequences of heat during sensitive periods such as pregnancy and early childhood are unclear. We conducted a pre-registered systematic review (PROSPERO CRD42024596655) of empirical studies examining associations of ambient heat exposure during the prenatal period or ages 0–5 with developmental outcomes measured later in childhood, adolescence, or adulthood. Eleven databases were searched in August 2024 and supplemented with backward and forward citation tracking. Two reviewers independently screened, extracted, and appraised studies using the Mixed Methods Appraisal Tool. Findings were synthesized narratively due to heterogeneity in design, exposure, and outcomes. Of 11,955 records, five studies met inclusion criteria. Four reported that higher early-life heat exposure was associated with adverse cognitive, mental health, or behavioural outcomes across the life course, while one found null effects. Effect modification was observed by developmental timing, region, season, and contextual factors. Retrieved studies were geographically narrow and methodologically heterogeneous. Although data are limited, emerging findings suggest that heat exposure in early life may have lasting adverse effects on development. More rigorous and more globally representative studies are needed to clarify mechanisms, sensitive windows, and moderators, and to inform prevention and adaptation.
The development of secure bonds between children and adult carers, particularly parents, is determined by a complex ecosystem of relationships that includes parents, care providers in other settings, and the values and institutions that care for those who care for children. Here we conduct a scoping review to map scientific progress in the development of evidence based interventions across all levels of relational ecology of early child development, form families to communities, the connections between them, and the structures that support them. A systematic search for relevant studies was conducted across three databases: Ovid MEDLINE, PsychInfo, and Embase. A total of 4970 articles were retrieved, with a final retained set of 123 papers (30207 families across 110 unique interventions). Most intervention development has focused on the relationship between children and their mothers. Few interventions directly targeted father involvement in parenting, or broader systems of care within the family (e.g., grandparents) and beyond (e.g., early childcare workers, family friendly workplaces, and the healthcare system). Many population-based programs were situated within existing universal healthcare services for parents of newborns, highlighting scalability and potential for delivering programs proportionate to need. However, further work is needed to convert this potential scalability into a reality. Further investment in intervention development in relational systems beyond the family is urgently needed if we are to create the broader conditions needed to ensure that emotional bonds between children and their adult carers can flourish.
Evidence-based parenting interventions (EBPIs) are among the most powerful interventions in child mental health, but they are often impacted by non-response and drop-out. Extensive research has demonstrated that measurement-based care (MBC), which involves routine collection of client-reported measures to track intervention progress and inform shared decision-making, is associated with improved outcomes in adult mental health populations, including reduced rates of deterioration and drop-out. Comparatively, there has been little research on MBC in child mental health. MBC is inherently more complex and nuanced in EBPIs for child mental health due to the need to collect and integrate data from multiple caregivers, therefore the application of MBC requires careful consideration. This paper presents key considerations and recommendations for the effective implementation of MBC in EBPIs, with a focus on the application of the Collect, Share, Act Model (Barber & Resnick, 2022). Key considerations and recommendations are provided for: (1) collecting multi-informant data, (2) selecting measures, (3) administering measures, (4) sharing and integrating multiple and discrepant perspectives, (5) examining trajectories of change in EBPIs, (6) using MBC data to optimise clinical decision making and intervention planning, (7) considering organisational factors that may affect implementation, and (8) using MBC with culturally and linguistically diverse populations. A new framework is provided, the Parenting CIRCLE of MBC, to guide how MBC data can inform clinical decision making to personalise EBPIs to the needs and preferences of families.
Schema therapy (ST) is an integrative psychotherapy targeting early maladaptive schemas formed in childhood. Recently, ST has been increasingly used to treat emotional, behavioral, and interpersonal difficulties in youth. This review synthesized evidence on ST interventions for individuals aged 5–18 across individual, group, and parent-focused formats. Following PRISMA 2020, a systematic search of PubMed, Cochrane Library, Scopus, Web of Science, and Ovid MEDLINE (2000–2025) identified studies using schema therapy or schema-informed interventions with quantitative outcomes from quasi-experimental or pre–post designs. Twenty-one studies met inclusion criteria: five individual, nine group, and eight parent- or family-based interventions (one overlapping). This review is registered with PROSPERO (CRD420251064229, May 30, 2025). Across modalities, schema therapy was associated with improvements in emotional regulation, depressive and anxiety symptoms, behavioral difficulties, and interpersonal functioning across studies. Group and individual formats reduced emotional and behavioral problems, enhanced coping, and improved social functioning. Even brief programs with few sessions were associated with meaningful improvements, with several studies showing maintained gains at short-term follow-up. Parent-focused interventions were associated with improvements in children’s emotional and behavioral outcomes while enhancing parental insight, self-efficacy, and family functioning. However, notable variability in treatment duration, outcome measures, and intervention structures remained across studies. Schema therapy shows promising efficacy for emotional, behavioral, and relational outcomes in youth, with parent involvement enhancing effects. Yet, heterogeneity in protocols and implementation underscores the need for standardization. Future studies should use standardized, randomized, and longitudinal designs to strengthen evidence for developmentally tailored schema therapy.
This paper provides the conceptual framework for a new review series that bring together the global literature on population approaches to nurturing relational health across the first three years of life. Early relational health is defined as ‘the everyday interactions that happen between children and their carers across the many settings in which they live and grow … that meet universal needs for food and shelter, for safety, and for a sense of belonging, worth, identity and place that collectively establish secure foundations for lifespan health and development'. The first four reviews describe (1) the relational ecology of early childhood, (2) associations with early brain development, (3) associations with relational outcomes beyond early childhood, and (4) evidence-based interventions for nurturing relational health within universal, population-based, settings (e.g., maternal-child health). The next four reviews tackle the deeper intergenerational question of what it means to raise children and young people in ways that also set developmental conditions for future roles as parents by describing (5) Australian Aboriginal ways of nurturing relationally healthy children and young people, (6) findings from intergenerational cohort studies, (7) population based interventions for nurturing relational health from childhood to parenthood (e.g., schools and communities), and (8) approaches to implementing evidence-based interventions in ways that ensure sustainability. An additional technical paper describes the development and testing of a new AI platform (LitQuest) that was purpose built to expedite title and abstract screening for the review series. Findings from the complete series are synthesised in a final paper that identifies critical gaps in the evidence base and provides recommendations for future research to advance population-level approaches to nurturing relational health from the earliest years of life.
