It is well established that mothers’ parenting impacts children's adjustment. However, much less is known about how children's psychopathology impacts their mothers’ parenting and how parenting and child symptoms relate either bidirectionally (i.e., a relationship in both directions over two time points) or transactionally (i.e., a process that unfolds over time) to one another over a span of several years. In addition, relatively little research addresses the role of fathers’ parenting in the development of children's symptoms and, conversely, how children may elicit certain types of parenting from fathers. In this study, data were collected from 491 families on mothers’ and fathers’ parenting styles (authoritarianism, authoritativeness, permissiveness, and overprotectiveness) and children's symptoms of psychopathology (attention deficit, oppositional defiant, depression, and anxiety) when children were age 3, 6, and 9 years old. Cross-lagged panel analyses revealed that parents and children affected one another in a bidirectional and transactional fashion over the course of the six years studied. Results suggest that children's symptoms may compound over time partially because they reduce exposure to adaptive and increase exposure to maladaptive parenting styles. Likewise, maladaptive parenting may persist over time due to the persistence of children's symptoms.

This chapter details novel approaches to blending exposure practice with other behavioral techniques to potentiate its effects. We hope that it will expand the arsenal of strategies for practicing clinicians who wish to use exposure techniques in treatment. We discuss the growing body of literature supporting the use of these techniques, and specifics of how to integrate aspects of acceptance and commitment therapy into exposure treatment. For example, we highlight incorporating values, thought defusion, and acceptance into a traditional exposure framework. Specific examples are provided to guide practitioners who are new to the technique.

Objective: COVID-19 is an international public health crisis, putting substantial burden on medical centers and increasing the psychological toll on health care workers (HCW). Methods: This paper describes CopeColumbia, a peer support program developed by faculty in a large urban medical center's Department of Psychiatry to support emotional well-being and enhance the professional resilience of HCW. Results: Grounded in evidence-based clinical practice and research, peer support was offered in three formats: groups, individual sessions, and town halls. Also, psychoeducational resources were centralized on a website. A Facilitator's Guide informed group and individual work by including: (1) emotional themes likely to arise (e.g., stress, anxiety, trauma, grief, and anger) and (2) suggested facilitator responses and interventions, drawing upon evidence-based principles from peer support, stress and coping models, and problem-solving, cognitive behavioral, and acceptance and commitment therapies. Feedback from group sessions was overwhelmingly positive. Approximately 1/3 of individual sessions led to treatment referrals. Conclusions: Lessons learned include: (1) there is likely an ongoing need for both well-being programs and linkages to mental health services for HCW, (2) the workforce with proper support, will emerge emotionally resilient, and (3) organizational support for programs like CopeColumbia is critical for sustainability.

The link between parental depressive history and parenting styles is well established, as is the association of parenting with child psychopathology. However, little research has examined whether a depressive history in one parent predicts the parenting style of the other parent. As well, relatively little research has tested transactional models of the parenting-child psychopathology relationship in the context of parents' depressive histories. In this study, mothers and fathers of 392 children were assessed for a lifetime history of major depression when their children were 3 years old. They then completed measures of permissiveness and authoritarianism and their child's internalizing and externalizing symptoms when children were 3, 6, and 9 years old. The results showed that a depressive history in one parent predicted the other parent's permissiveness. Analyses then showed that child externalizing symptoms at age 3 predicted maternal permissiveness and authoritarianism and paternal permissiveness at age 6. Maternal permissiveness at age 6 predicted child externalizing symptoms at age 9. No relationships in either direction were found between parenting styles and child internalizing symptoms. The results highlight the importance of considering both parents' depressive histories when understanding parenting styles, and support transactional models of parenting styles and child externalizing symptoms.

Considerable research exists documenting the relationship between maternal mood disorders, primarily major depressive disorder (MDD), and a variety of negative child outcomes. By contrast, research exploring the reverse pathway whereby child traits are associated with later maternal mood disorders is much more limited. We examined whether young children's temperament and psychopathology predicted maternal mood disorders approximately 6 years later. Child temperament and symptoms were assessed at age three using semi-structured diagnostic interviews and parent-report inventories. Maternal psychopathology was assessed with semi-structured interviews when children were 3 and 9 years old. Mothers also reported on their marital satisfaction when children were 3 and 6 years old. Child temperamental negative affectivity (NA), depressive symptoms, and externalizing behavior problems significantly predicted maternal mood disorders over and above prior maternal mood, anxiety, and substance disorders. The link between children's early externalizing symptoms and maternal mood disorders 6 years later was mediated by maternal marital satisfaction 3 years after the initial assessment. These findings suggest that early child temperament and psychopathology contribute to risk for later maternal mood disorders both directly and through their impact on the marital system. Research indicates that effective treatment of maternal depression is associated with positive outcomes for children; however, this study suggests that treating early child problems may mitigate the risk of later maternal psychopathology.

OBJECTIVE:Although enuresis is relatively common in early childhood, research exploring its antecedents and implications is surprisingly limited, perhaps because the condition typically remits in middle childhood. METHOD:We examined the prevalence, predictors, prognostic factors, and outcomes of primary enuresis in a large (N = 559) multi-method, multi-informant prospective study with a community-based sample of children followed from age 3 years to age 9 years. RESULTS:We found that 12.7% of our sample met criteria for lifetime enuresis, suggesting that it is a commonly occurring childhood disorder. Males were more than twice as likely as females to have a lifetime diagnosis. Significant age 3 predictors of developing primary enuresis by age 9 included child anxiety and low positive affectivity, maternal history of anxiety, and low authoritative parenting. In addition, poorer global functioning and more depressive and anxiety symptoms at age 3 years predicted a greater likelihood of persistence through age 9. By age 9 years, 77% of children who had received a diagnosis of primary enuresis were in remission and continent. However, children who had remitted exhibited a higher rate of attention-deficit/hyperactivity disorder (ADHD) and greater ADHD and depressive symptoms at age 9 compared to children with no lifetime history of enuresis. CONCLUSION:Results of the present study underscore the clinical significance of primary enuresis and demonstrate that it shows both strong antecedent and prospective associations with psychopathology. The findings also highlight the possible role of parenting in the development of enuresis.