G20 Initiative for Early Childhood Development: Building human capital to break the cycle of poverty and inequality - G20 (2018)
Keywords: early childhood development; G20

Global Education Monitoring Report 2019: Migration, displacement and education: Building bridges, not walls - UNESCO (Global Education Monitoring Report, 2018)
Keywords: Education; Global Education Monitoring Report; migration and displacement

Cities Welcoming Refugees & Migrants: Enhancing effective urban governance in an age of migration - UNESCO (UNESCO, 2016)
Keywords: refugees and migrants; urban governance

Framework for reopening schools - UNESCO; UNICEF; WorldBank; WorldFoodProgram; UNHCR (UNICEF, 2020)
Keywords: COVID-19; Education; school safety; Schools

Global Peace Index 2019: Measuring peace in a complex world - InstituteEconomics&Peace (Institute for Economics & Peace, 2019)
Keywords: climate change; economic impact of violence; global peace; negative peace; peace; positive peace

Social Protection and Welfare Systems: Implications for Early Childhood Development - L. Aber; L. Biersteker; A. Dawes; L. Rawlings (Handbook of Early Childhood Development Research and Its Impact on Global Policy, 2013)

Very Early Childhood Development - Aboud, F. E.; Yousafzai, A. K. (Reproductive, Maternal, Newborn, and Child Health: Disease Control Priorities, Third Edition (Volume 2), 2016)
Discusses mental development from birth to age 24 months in low- and middle-income countries (LMICs), focusing on cognitive and language domains, while touching on socioemotional, fine motor, and gross motor development, by (1) describing the measurement of these domains in order to provide an operational definition of the term mental development: (2) examining conditions that derail early child development, which arise during the prenatal period and continue throughout the next 24 months; and (3) presenting the results of several systematic reviews and meta-analyses to show the effects of stimulation and nutrition, along with disease-related interventions to promote mental development. The risk factors of greatest importance concern low-quality psychosocial stimulation at home; inadequate child nutrition; infections from environmental vectors, such as trachoma and malaria; and maternal nutrition and mental health during the first 1,000 days. Interventions include psychosocial stimulation, prenatal and postnatal nutrition, improvements in the physical environment, and maternal mental health care.
Black, Robert E Laxminarayan, Ramanan Temmerman, Marleen Walker, Neff Aboud, Frances E Yousafzai, Aisha K Review Book Chapter
Keywords: access to health services; Child Development; child health; childhood diseases; cognitive development; health outcomes; infancy; malnutrition; Mental Health; nutrition; Postnatal Care; Quality of Health Care

Evaluation of an early childhood parenting programme in rural Bangladesh. - Aboud, F. E. (J Health Popul Nutr, 2007)
To promote physical and mental development of children, parenting education programmes in developing countries focus on specific practices such as age-appropriate responsive stimulation and feeding. A programme delivered to groups of poor mothers of children, aged less than three years, in rural Bangladesh was evaluated using an intervention-control post-test design. Mothers (n=170) who had attended a year of educational sessions and their children were compared with those (n=159) from neighbouring villages who did not have access to such a programme. After covariates were controlled, the parenting mothers obtained higher scores on a test of child-rearing knowledge and on the Home Observation for Measurement of the Environment (HOME) inventory of stimulation. The parenting mothers did not communicate differently with their children while doing a picture-talking task, and children did not show benefits in nutritional status or language comprehension. Parenting sessions offered by peer educators were informative and participatory, yet they need to include more practice, problem-solving, and peer-support if information is to be translated into behaviour.
Keywords: Adult; Bangladesh; Child Development; Child, Preschool; Female; Health Behavior; Health Knowledge, Attitudes, Practice; Health Promotion; Humans; Intervention Studies; Male; Mothers; Parenting; Parents; Program Evaluation; Social Support

Medical Humanitarianism: Ethnographies of Practice - S. Abramowitz; C. Panter-Brick (Penn University Press, 2015)

Medical humanitarianism: anthropologists speak out on policy and practice. - Abramowitz, S.; Marten, M.; Panter-Brick, C. (Med Anthropol Q, 2015)
In recent years, anthropologists have become increasingly present in medical humanitarian situations as scholars, consultants, and humanitarian practitioners and have acquired insight into medical humanitarian policy and practice. In 2012, we implemented a poll on anthropology, health, and humanitarian practice in which 75 anthropologists discussed their experiences in medical humanitarianism. Our goal was to move beyond the existing anarchy of individual voices in anthropological writing and gain an aggregate view of the perspective of anthropologists working in medical humanitarian contexts. Responses lead to six inductively derived thematic priorities. The findings illustrate how anthropologists perceive medical humanitarian practice; which aspects of medical humanitarianism should be seen as priorities for anthropological research; and how anthropologists use ethnography in humanitarian contexts.

Empathy an invaluable natural resource for peace - Abu-Akel, A.; Armour, E.; Baron-Cohen, S.; Charnalia, N.; Leckman, J.; Rounthwaite. D.; Staiti, H. (Foundation Child, 2019)
Keywords: conflict resolution; Empathy; peace-building; reconciliation

Linking peacebuilding and child development: A basic framework - Abu-Nimer, Mohammed; Nasser, Ilham (Pathways to peace: The transformative power of children and families, 2014)
This chapter addresses debates in the field of peacebuilding, with a focus on conflict resolution and peace education. Strategies in conflict resolution and peace education which can be applied as mechanisms to promote peace-oriented behaviors in young children are shared. Peace education studies conducted in the early years of life are reviewed and a call for investment in education programs that promote healthy children in peaceful communities is advocated. This chapter encourages dialog on best methods and strategies to utilize the knowledge in peacebuilding and conflict resolution in early childhood development.
Keywords: conflict resolution; early childhood interventions; peace education; peacebuilding

Dialogue, Conflict Resolution, and Change: Arab-Jewish Encounters in Israel - Abu-Nimer, M. (State University of New York Press, 1999)

Evaluating Interreligious Peacebuilding and Dialogue (De Gruyter, 2021)
Keywords: Interreligious and Intercultural peacebuilding; peacebuilding

Forgiveness in The Arab and Islamic Contexts - Abu-Nimer, M.; Nasser, I. (Journal of Religious Ethics, 2013)

Hippocampal dysfunction effects on context memory: possible etiology for posttraumatic stress disorder. - Acheson, D. T.; Gresack, J. E.; Risbrough, V. B. (Neuropharmacology, 2012)
Hippocampal volume reductions and functional impairments are reliable findings in posttraumatic stress disorder (PTSD) imaging studies. However, it is not clear if and how hippocampal dysfunction contributes to the etiology and maintenance of PTSD. Individuals with PTSD are often described as showing fear responses to trauma reminders outside of contexts in which these cues would reasonably predict danger. Animal studies suggest that the hippocampus is required to form and recall associations between contextual stimuli and aversive events. For example, the hippocampus is critical for encoding memories in which a complex configuration of multiple cues is associated with the aversive event. Conversely, the hippocampus is not required for associations with discrete cues. In animal studies, if configural memory is disrupted, learning strategies using discrete cue associations predominate. These data suggest poor hippocampal function could bias the organism toward forming multiple simple cue associations during trauma, thus increasing the chances of fear responses in multiple environments (or contexts) in which these cues may be present. Here we will examine clinical and preclinical literature to support a theory of hippocampal dysfunction as a primary contributory factor to the etiology of PTSD, and discuss future research required to test these hypotheses. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.
Keywords: Hippocampus; Humans; Memory; Nerve Net; Neuropsychological Tests; Stress Disorders, Post-Traumatic

The effect of intranasal oxytocin treatment on conditioned fear extinction and recall in a healthy human sample. - Acheson, D.; Feifel, D.; de Wilde, S.; McKinney, R.; Lohr, J.; Risbrough, V. (Psychopharmacology (Berl), 2013)
RATIONALE: To improve outcomes for patients undergoing extinction-based therapies (e.g., exposure therapy) for anxiety disorders such as post-traumatic stress disorder (PTSD), there has been interest in identifying pharmaceutical compounds that might facilitate fear extinction learning and recall. Oxytocin (OT) is a mammalian neuropeptide that modulates activation of fear extinction-based neural circuits and fear responses. Little is known, however, about the effects of OT treatment on conditioned fear responding and extinction in humans. OBJECTIVES: The purpose of the present study was to assess the effects of OT in a fear-potentiated startle task of fear conditioning and extinction. METHODS: A double-blind, placebo-controlled study of 44 healthy human participants was conducted. Participants underwent a conditioned fear acquisition procedure, after which they were randomized to treatment group and delivered OT (24 IU) or placebo via intranasal (IN) spray. Forty-five minutes after treatment, participants underwent extinction training. Twenty-four hours later, subjects were tested for extinction recall. RESULTS: Relative to placebo, the OT group showed increased fear-potentiated startle responding during the earliest stage of extinction training relative to placebo; however, all treatment groups showed the same level of reduced responding by the end of extinction training. Twenty-four hours later, the OT group showed significantly higher recall of extinction relative to placebo. CONCLUSIONS: The current study provides preliminary evidence that OT may facilitate fear extinction recall in humans. These results support further study of OT as a potential adjunctive treatment for extinction-based therapies in fear-related disorders.
Keywords: Adult; Conditioning (Psychology); Extinction, Psychological; Fear; Female; Humans; Male; Mental Recall; Oxytocin; Reflex, Startle; Treatment Outcome; Young Adult

Role of the amygdala in processing visual social stimuli. - Adolphs, Ralph; Spezio, Michael (Prog Brain Res, 2006)
We review the evidence implicating the amygdala as a critical component of a neural network of social cognition, drawing especially on research involving the processing of faces and other visual social stimuli. We argue that, although it is clear that social behavioral representations are not stored in the amygdala, the most parsimonious interpretation of the data is that the amygdala plays a role in guiding social behaviors on the basis of socioenvironmental context. Thus, it appears to be required for normal social cognition. We propose that the amygdala plays this role by attentionally modulating several areas of visual and somatosensory cortex that have been implicated in social cognition, and in helping to direct overt visuospatial attention in face gaze. We also hypothesize that the amygdala exerts attentional modulation of simulation in somatosensory cortices such as supramarginal gyrus and insula. Finally, we argue that the term emotion be broadened to include increased attention to bodily responses and their representation in cortex.
Keywords: Amygdala; Animals; Attention; Expressed Emotion; Facial Expression; Humans; Pattern Recognition, Visual; Photic Stimulation; Social Behavior

The social brain: neural basis of social knowledge. - Adolphs, Ralph (Annu Rev Psychol, 2009)
Social cognition in humans is distinguished by psychological processes that allow us to make inferences about what is going on inside other people-their intentions, feelings, and thoughts. Some of these processes likely account for aspects of human social behavior that are unique, such as our culture and civilization. Most schemes divide social information processing into those processes that are relatively automatic and driven by the stimuli, versus those that are more deliberative and controlled, and sensitive to context and strategy. These distinctions are reflected in the neural structures that underlie social cognition, where there is a recent wealth of data primarily from functional neuroimaging. Here I provide a broad survey of the key abilities, processes, and ways in which to relate these to data from cognitive neuroscience.
Keywords: Amygdala; Animals; Biological Evolution; Brain; Brain Mapping; Empathy; Facial Expression; Humans; Nerve Net; Pattern Recognition, Visual; Personal Construct Theory; Prefrontal Cortex; Self Concept; Social Behavior

On the absence of a ‘Socio-emotional Enablement’ discourse component in international socio-economic development thought - Affolter, Friedrich W. (Scandinavian Journal of Caring Sciences, 2004)

Learning for Peace: Lessons learned from UNICEF’s Peacebuilding, Education, and Advocacy in Conflict-Affected Context Programme - Affolter, Friedrich W.; Azaryeva Valente, Anna (Springer International Publishing, 2019)

Life skills and financial education for peace - Aflatoun (Aflatoun International, 2019)
Keywords: harmony; peace; peacebuilder; serenity; Violence; War

The Role of the Health Sector in Advancing Nurturing Care: AKDN Syria’s Implementation of Care for Child Development - AgaKhanFoundation (Aga Khan Foundation, 2021)
Keywords: early childhood; Health; nutrition

Resilience – From Conceptualization to effective intervention. Policy Brief for Humanitarian and Development Agencies. - A. Ager; J. Annan; C. Panter-Brick (2013)

Aiming higher for maternal and child nutrition in South Asia - Torlesse, Harriet; Aguayo, Víctor M. (Maternal & Child Nutrition, 2018)

Essay: Healing through art therapy in disaster settings - S.H. Ahmed; M.N. Siddiqi (The Lancet, 2006)

An ethological approach to personality development. - Ainsworth, Mary S.; Bowlby, John (American Psychologist, 1991)

Infant Development and Mother-Infant Interaction among Ganda and American Families - M. D. S. Ainsworth (Culture and Infancy: Variations in the Human Experience, 1977)

Patterns of Attachment - M. D. S. Ainsworth; M. C. Blehar; E. Waters; S. Wall (Erlbaum, 1978)

Infancy in Uganda: Infant Care and the Growth of Love - M. D. S. Ainsworth (Johns Hopkins Univ. Press, 1967)

Evaluation of the Better Parenting Programme in Jordan. - Al-Hassan, Suha M; Lansford, Jennifer E (Early Child Dev Care, 2011)
This study evaluates the Better Parenting Programme (BPP), which has been implemented nationally in Jordan to enhance parents' knowledge, attitudes, and behaviours related to caring for young children. Participants (N = 337, 94% female) were randomly assigned to an experimental group or a control group. The experimental group participated in the BPP; the control group did not. Before and after the BPP, all participants completed questionnaires to assess their knowledge regarding key areas of child development, activities with their children, discipline practices, and perceptions regarding behaviours that constitute child abuse and neglect. Over time, participants in the experimental group (but not the control group) improved on parenting knowledge, spending time playing and reading books with their children, using more explanations during the course of disciplining their child, and accurately perceiving behaviours that constitute child neglect. Results suggest modest beneficial effects of participation in the Better Parenting Programme.

Tomorrow's players under occupation: an analysis of the association of political violent with psychological functioning and domestic violence, among Palestinian youth. - Al-Krenawi, Alean; Graham, John R; Sehwail, Mahmud A (Am J Orthopsychiatry, 2007)
A 2005 survey of 2,328 youth (ages 12 to 18) in the West Bank, Palestine, revealed an association between exposure to politically violent events, domestic violence, and school violence and with psychological symptomatology. Results also found associations between family violence, family economic status, and psychological symptomatology. Respondents reported low levels of family functioning. Data revealed some geographic variability in experiences of politically violent events, domestic violence, school violence, and psychological symptomatology. Implications for practice are discussed.
Keywords: Adolescent; Arabs; Domestic Violence; Female; Humans; Israel; Male; Middle East; Politics; Questionnaires; Social Behavior Disorders

Promoting mother‐infant relationships and underlying neural correlates: Results from a randomized controlled trial of a home‐visiting program for adolescent mothers in Brazil - Alarcão, Fernanda Speggiorin Pereira; Shephard, Elizabeth; Fatori, Daniel; Amável, Renata; Chiesa, Anna; Fracolli, Lislaine; Matijasevich, Alicia; Brentani, Helena; Nelson, Charles A.; Leckman, James; Miguel, Eurípedes Constantino; Polanczyk, Guilherme V. (Developmental Science, 2021)
Keywords: EG; home-visiting intervention; infant social development; maternal care competencies; mother-infant attachment

Long term consequences of early childhood malnutrition - Alderman, H. (Oxford Economic Papers, 2006)

Association between economic growth and early childhood nutrition - Alderman, H.; Haddad, L.; Headey, D. D.; Smith, L. (Lancet Glob Health, 2014)
Alderman, Harold Haddad, Lawrence Headey, Derek D Smith, Lisa eng Comment Letter England 2014/10/12 06:00 Lancet Glob Health. 2014 Sep;2(9):e500. doi: 10.1016/S2214-109X(14)70266-9. Epub 2014 Aug 27.
Keywords: *Body Height; *Body Weight; *Developing Countries; *Economic Development; *Gross Domestic Product; *Income; Child Nutrition Disorders/*economics; Female; Humans; Male

The Refugee Crisis and the Rights of Children: Perspectives on Community-Based Resettlement Programs - Alipui, N.; Gerke, N. (New Dir Child Adolesc Dev, 2018)
We are currently facing one of the largest and most complex refugee crises in modern times. Conflict and natural disasters have resulted in 22.5 million refugees worldwide, more than half are children. As the world struggles to respond to this massive displacement of people, how is this affecting child refugees' development and what is being done about it? In this commentary, we explore answers to these central questions. First, we review the situation of child refugees in numbers, exploring their geographic concentration. Second, we review child refugees' access to basic services, including early childhood development, with a special emphasis on community-based programs and initiatives that have proven to be particularly effective in addressing the needs of resettled child refugees. We find in particular that early childhood development activities in emergency contexts have seen remarkable improvements with critical benefits for the development of the youngest child refugees. Our aim is to bring attention to the particular difficulties child refugees must endure and to highlight those practices and approaches that are helping child refugees reach their full potential.
Alipui, Nicholas Gerke, Nicole eng Review 2018/03/15 06:00 New Dir Child Adolesc Dev. 2018 Mar;2018(159):91-98. doi: 10.1002/cad.20228.

Mental health and psychosocial support in crisis and conflict: report of the Mental Health Working Group - Allden, K.; Jones, L.; Weissbecker, I.; Wessells, M.; Bolton, P.; Betancourt, T. S.; Hijazi, Z.; Galappatti, A.; Yamout, R.; Patel, P.; Sumathipala, A. (Prehosp Disaster Med, 2009)
INTRODUCTION: The Working Group on Mental Health and Psychosocial Support was convened as part of the 2009 Harvard Humanitarian Action Summit. The Working Group chose to focus on ethical issues in mental health and psychosocial research and programming in humanitarian settings. The Working Group built on previous work and recommendations, such as the Inter-Agency Standing Committee's Guidelines on Mental Health and Psychosocial Support in Emergency Settings. OBJECTIVES: The objective of this working group was to address one of the factors contributing to the deficiency of research and the need to develop the evidence base on mental health and psychosocial support interventions during complex emergencies by proposing ethical research guidelines. Outcomes research is vital for effective program development in emergency settings, but to date, no comprehensive ethical guidelines exist for guiding such research efforts. METHODS: Working Group members conducted literature reviews which included peer-reviewed publications, agency reports, and relevant guidelines on the following topics: general ethical principles in research, cross-cultural issues, research in resource-poor countries, and specific populations such as trauma and torture survivors, refugees, minorities, children and youth, and the mentally ill. Working Group members also shared key points regarding ethical issues encountered in their own research and fieldwork. RESULTS: The group adapted a broad definition of the term "research", which encompasses needs assessments and data gathering, as well as monitoring and evaluation. The guidelines are conceptualized as applying to formal and informal processes of assessment and evaluation in which researchers as well as most service providers engage. The group reached consensus that it would be unethical not to conduct research and evaluate outcomes of mental health and psychosocial interventions in emergency settings, given that there currently is very little good evidence base for such interventions. Overarching themes and issues generated by the group for further study and articulation included: purpose and benefits of research, issues of validity, neutrality, risk, subject selection and participation, confidentiality, consent, and dissemination of results. CONCLUSIONS: The group outlined several key topics and recommendations that address ethical issues in conducting mental health and psychosocial research in humanitarian settings. The group views this set of recommendations as a living document to be further developed and refined based on input from colleagues representing different regions of the globe with an emphasis on input from colleagues from low-resource countries.
Allden, K Jones, L Weissbecker, I Wessells, M Bolton, P Betancourt, T S Hijazi, Z Galappatti, A Yamout, R Patel, P Sumathipala, A eng 2009/10/07 06:00 Prehosp Disaster Med. 2009 Jul-Aug;24 Suppl 2:s217-27.
Keywords: *Conflict (Psychology); *Mental Health; *Social Support; Altruism; Confidentiality; Ethics, Research; Humans; Informed Consent

A Study of a Violence Prevention Program in Prekindergarten Classrooms - Allen, S. F. (Children & Schools, 2009)

Enabling the implementation of the 2030 agenda through SDG 16+: Anchoring peace, justice and inclusion - Global Alliance (United Nations, 2019)
Keywords: 2030 Agenda; inclusion; justice; peace; SDG 16+; Sustainable Development Goals (SDGs)

The Nature of Prejudice - G. W. Allport (Addison-Wesley, 1958)

Effects of early intervention and the moderating effects of brain activity on institutionalized children's social skills at age 8. - Almas, Alisa N; Degnan, Kathryn A; Radulescu, Anca; Nelson, Charles A; Zeanah, Charles H; Fox, Nathan A (Proc Natl Acad Sci U S A, 2012)
The present study examined the social skills of previously institutionalized, 8-y-old Romanian children from the Bucharest Early Intervention Project and the influence of attachment security and brain electrical activity (alpha power) on these skills. Participants included children randomized to an intervention involving foster care [Foster Care Group (FCG)], children randomized to remain in institutions [Care As Usual Group (CAUG)], and never-institutionalized children living with their families in the Bucharest community [Never-Institutionalized Group (NIG)]. A continuous rating of children's attachment security to their primary caregiver was assessed at 42 mo of age. When children were 8 y old, teachers rated their social skills, and the children's resting electroencephalogram alpha power was recorded. Teachers rated social skills of FCG children who were placed into foster care before 20 mo of age as no different from NIG children, and both of these groups were higher than CAUG children and FCG children placed after 20 mo. Electroencephalogram alpha power at age 8 significantly moderated the relations between attachment security and social skills. These findings characterize institutionalized children's social skills in middle childhood within the context of a randomized intervention while highlighting the roles of both relational and biological factors in these developmental trajectories.
Keywords: Brain; Caregivers; Child; Child Development; Child, Institutionalized; Early Intervention (Education); Electroencephalography; Female; Foster Home Care; Humans; Male; Object Attachment; Romania; Social Change

We are here: An integrated approach to youth-inclusive peace processes - Altiok, A.; Grizelj, I. (Ministry for Foreign Affairs of Finland, 2019)
Keywords: gender equality; inclusion; justice; mediation; peace; peacebuilding; policy; youth

Global policy paper “We Are Here: An integrated approach to youth-inclusive peace processes” - Altiok, A; Grezelj, I (Youth, Peace and Security, 2019)
Keywords: peacebuilding; youth-inclusive peace

Parent education by maternity nurses and prevention of abusive head trauma. - Altman, Robin L; Canter, Jennifer; Patrick, Patricia A; Daley, Nancy; Butt, Neelofar K; Brand, Donald A (Pediatrics, 2011)
OBJECTIVE: A consortium of the 19 community hospitals and 1 tertiary care children's hospital that provide maternity care in the New York State Hudson Valley region implemented a program to teach parents about the dangers of shaking infants and how to cope safely with an infant's crying. This study evaluated the effectiveness of the program in reducing the frequency of shaking injuries. METHODS: The educational program, which was delivered by maternity nurses, included a leaflet explaining abusive head trauma ("shaken baby syndrome") and how to prevent it, an 8-minute video on the subject, and a statement signed by parents acknowledging receipt of the information and agreeing to share it with others who will care for the infant. Poisson regression analysis was used to compare the frequency of shaking injuries during the 3 years after program implementation with the frequency during a 5-year historical control period. RESULTS: Sixteen infants who were born in the region during the 8-year study period were treated at the children's hospital for shaking injuries sustained during their first year of life. Of those infants, 14 were born during the 5-year control period and 2 during the 3-year postimplementation period. The decrease from 2.8 injuries per year (14 cases in 5 years) to 0.7 injuries per year (2 cases in 3 years) represents a 75.0% reduction (P = .03). CONCLUSIONS: Parent education delivered in the hospital by maternity nurses reduces newborns' risks of sustaining an abusive head injury resulting from shaking during the first year of life.
Keywords: Adult; Child Abuse; Child, Preschool; Craniocerebral Trauma; Cross-Sectional Studies; Female; Health Education; Health Knowledge, Attitudes, Practice; Humans; Infant; Infant, Newborn; Male; Maternal-Child Nursing; New York; Nurse's Role; Parent-Child Relations; Parents; Prevalence; Program Development; Program Evaluation; Risk Assessment; Shaken Baby Syndrome

Acute effects of intranasal oxytocin on subjective and behavioral responses to social rejection. - Alvares, Gail A; Hickie, Ian B; Guastella, Adam J (Exp Clin Psychopharmacol, 2010)
The hormone and neuropeptide oxytocin is believed to buffer against social stress and reduce social-threat perception. We employed a widely used ostracism paradigm, Cyberball, to investigate whether oxytocin ameliorated the acute behavioral and affective consequences of social rejection. In a double-blind, randomized, between-subjects design, 74 healthy male and female participants were administered intranasal oxytocin or placebo and subsequently ostracized or included during this virtual ball-tossing game. Ostracized participants reported negative affective and attachment-related reactions, as well as a significant motivational change in increased desire to be involved in the game; these effects were not influenced by oxytocin. Intranasal oxytocin did, however, increase included participants' desire to play again with the same participants, suggesting oxytocin enhanced desire for future social engagement following inclusion. These findings are argued to provide evidence that the effects of oxytocin in promoting social approach behavior may be context specific and sensitive to positive social cues. The results suggest that in an explicitly aversive context, oxytocin does not buffer against the immediate impact of blunt social rejection.
Keywords: Administration, Intranasal; Adolescent; Adult; Double-Blind Method; Female; Humans; Internet; Interpersonal Relations; Male; Middle Aged; Oxytocics; Oxytocin; Rejection (Psychology); Sex Characteristics; Social Behavior; Social Perception; Stress, Psychological; Young Adult

Children and Media Tips from the American Academy of Pediatrics - AmericanAcademyPediatrics (2018)
Keywords: children and media; screen time

The Little Book of Restorative Discipline for Schools: Teaching Responsibility, Creating Caring Climates - Amstutz, L.S.; Mullet, J.H. (Good Books, 2005)

Life in groups: the roles of oxytocin in mammalian sociality. - Anacker, Allison M J; Beery, Annaliese K (Front Behav Neurosci, 2013)
In recent decades, scientific understanding of the many roles of oxytocin (OT) in social behavior has advanced tremendously. The focus of this research has been on maternal attachments and reproductive pair-bonds, and much less is known about the substrates of sociality outside of reproductive contexts. It is now apparent that OT influences many aspects of social behavior including recognition, trust, empathy, and other components of the behavioral repertoire of social species. This review provides a comparative perspective on the contributions of OT to life in mammalian social groups. We provide background on the functions of OT in maternal attachments and the early social environment, and give an overview of the role of OT circuitry in support of different mating systems. We then introduce peer relationships in group-living rodents as a means for studying the importance of OT in non-reproductive affiliative behaviors. We review species differences in oxytocin receptor (OTR) distributions in solitary and group-living species of South American tuco-tucos and in African mole-rats, as well as singing mice. We discuss variation in OTR levels with seasonal changes in social behavior in female meadow voles, and the effects of OT manipulations on peer huddling behavior. Finally, we discuss avenues of promise for future investigation, and relate current findings to research in humans and non-human primates. There is growing evidence that OT is involved in social selectivity, including increases in aggression toward social outgroups and decreased huddling with unfamiliar individuals, which may support existing social structures or relationships at the expense of others. OT's effects reach beyond maternal attachment and pair bonds to play a role in affiliative behavior underlying "friendships", organization of broad social structures, and maintenance of established social relationships with individuals or groups.

Heredity, environment, and the question how? - Anastasi, A. (Psychol Rev, 1958)
Keywords: Environment; Heredity

The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. - Anda, Robert F; Felitti, Vincent J; Bremner, J Douglas; Walker, John D; Whitfield, Charles; Perry, Bruce D; Dube, Shanta R; Giles, Wayne H (Eur Arch Psychiatry Clin Neurosci, 2006)
BACKGROUND: Childhood maltreatment has been linked to a variety of changes in brain structure and function and stress-responsive neurobiological systems. Epidemiological studies have documented the impact of childhood maltreatment on health and emotional well-being. METHODS: After a brief review of the neurobiology of childhood trauma, we use the Adverse Childhood Experiences (ACE) Study as an epidemiological "case example" of the convergence between epidemiologic and neurobiological evidence of the effects of childhood trauma. The ACE Study included 17,337 adult HMO members and assessed 8 adverse childhood experiences (ACEs) including abuse, witnessing domestic violence, and serious household dysfunction. We used the number of ACEs (ACE score) as a measure of cumulative childhood stress and hypothesized a "dose-response" relationship of the ACE score to 18 selected outcomes and to the total number of these outcomes (comorbidity). RESULTS: Based upon logistic regression analysis, the risk of every outcome in the affective, somatic, substance abuse, memory, sexual,and aggression-related domains increased in a graded fashion as the ACE score increased (P <0.001). The mean number of comorbid outcomes tripled across the range of the ACE score. CONCLUSIONS: The graded relationship of the ACE score to 18 different outcomes in multiple domains theoretically parallels the cumulative exposure of the developing brain to the stress response with resulting impairment in multiple brain structures and functions.
Keywords: Adult; Brain; Child; Child Abuse; Domestic Violence; Family Health; Humans; Life Change Events; Mental Disorders; Survivors

American Psychologist / Special Issue: Peace Psychology - Anderson, N (2013)

A systematic policy analysis of Early Childhood Development and peacebuilding in fourteen conflict-affected and post-conflict countries - Ang, L.; Oliver. S.; UNICEF (UCL Insitute of Education, 2016)

Improving Mental Health Outcomes of Burmese Migrant and Displaced Children in Thailand: a Community-Based Randomized Controlled Trial of a Parenting and Family Skills Intervention - Annan, J.; Sim, A.; Puffer, E. S.; Salhi, C.; Betancourt, T. S. (Prev Sci, 2017)
The negative effects of displacement and poverty on child mental health are well-known, yet research on prevention interventions in low- and middle-income countries, especially fragile states, remains limited. We examined the effectiveness of a parenting skills intervention on mental health outcomes among Burmese migrant and displaced children living in 20 communities in Thailand. Participants were primary caregivers and children aged 7 to 15 years (n = 479 families). Families were randomly assigned to receive an adapted version of the Strengthening Families Program (n = 240) or a wait-list control condition (n = 239). Assessments were conducted at baseline and 1-month post-intervention for both conditions and at 6 months for treatment group only. One month after the program, children in the treatment condition showed significant reductions in externalizing problems (caregiver effect size (ES) -0.22, p = 0.02; child report ES -0.11, p = 0.02) and child attention problems compared with controls (caregiver report ES -0.23, p = 0.03). There was no significant treatment effect on children's internalizing problems (ES -0.06; p = 0.31). Children reported a significant increase in prosocial protective factors relative to controls (ES 0.20, p < 0.01). Results suggest that an evidence-based parenting skills intervention adapted for a displaced and migrant Burmese population facing high levels of adversity can have positive effects on children's externalizing symptoms and protective psychosocial factors. TRIAL REGISTRATION: Clinicaltrials.gov: https://clinicaltrials.gov/show/NCT01829815.
Annan, Jeannie Sim, Amanda Puffer, Eve S Salhi, Carmel Betancourt, Theresa S eng Randomized Controlled Trial 2016/11/20 06:00 Prev Sci. 2017 Oct;18(7):793-803. doi: 10.1007/s11121-016-0728-2.
Keywords: *Family; *Parenting; Adolescent; Child; Cultural Characteristics; Displacement; Female; Humans; Low and middle income countries; Male; Mental Health; Migrants; Myanmar; Parenting; Thailand; Transients and Migrants/*psychology

Peace and Conflict: Journal of Peace Psychology (American Psychological Association, Division 48, 2021)
Keywords: conflict resolution; peace; Psychology

Journal of Peace Psychology (2021)
Keywords: conflict resolution; peace; Psychology

Social networks and cooperation in hunter-gatherers. - Apicella, Coren L; Marlowe, Frank W; Fowler, James H; Christakis, Nicholas A (Nature, 2012)
Social networks show striking structural regularities, and both theory and evidence suggest that networks may have facilitated the development of large-scale cooperation in humans. Here, we characterize the social networks of the Hadza, a population of hunter-gatherers in Tanzania. We show that Hadza networks have important properties also seen in modernized social networks, including a skewed degree distribution, degree assortativity, transitivity, reciprocity, geographic decay and homophily. We demonstrate that Hadza camps exhibit high between-group and low within-group variation in public goods game donations. Network ties are also more likely between people who give the same amount, and the similarity in cooperative behaviour extends up to two degrees of separation. Social distance appears to be as important as genetic relatedness and physical proximity in explaining assortativity in cooperation. Our results suggest that certain elements of social network structure may have been present at an early point in human history. Also, early humans may have formed ties with both kin and non-kin, based in part on their tendency to cooperate. Social networks may thus have contributed to the emergence of cooperation.
Keywords: Anthropology; Biological Evolution; Cooperative Behavior; Game Theory; Humans; Probability; Rural Population; Social Support; Tanzania; Wilderness

The Honor Code: How Moral Revolutions Happen - Appiah, A. (W. W. Norton, 2011)

Delineating the maladaptive pathways of child maltreatment: a mediated moderation analysis of the roles of self-perception and social support. - Appleyard, Karen; Yang, Chongming; Runyan, Desmond K (Dev Psychopathol, 2010)
The current study investigated concurrent and longitudinal mediated and mediated moderation pathways among maltreatment, self-perception (i.e., loneliness and self-esteem), social support, and internalizing and externalizing behavior problems. For both genders, early childhood maltreatment (i.e., ages 0-6) was related directly to internalizing and externalizing behavior problems at age 6, and later maltreatment (i.e., ages 6-8) was directly related to internalizing and externalizing behavior problems at age 8. Results of concurrent mediation and mediated moderation indicated that early maltreatment was significantly related to internalizing and externalizing behavior problems at age 6 indirectly both through age 6 loneliness and self-esteem for boys and through age 6 loneliness for girls. Significant moderation of the pathway from early maltreatment to self-esteem, and for boys, significant mediated moderation to emotional and behavioral problems were found, such that the mediated effect through self-esteem varied across levels of social support, though in an unexpected direction. No significant longitudinal mediation or mediated moderation was found, however, between the age 6 mediators and moderator and internalizing or externalizing problems at age 8. The roles of the hypothesized mediating and moderating mechanisms are discussed, with implications for designing intervention and prevention programs.
Keywords: Adaptation, Psychological; Affective Symptoms; Age Factors; Child; Child Behavior Disorders; Child, Preschool; Female; Follow-Up Studies; Humans; Infant; Internal-External Control; Loneliness; Male; Personality Development; Psychology, Child; Risk Factors; Self Concept; Sex Factors; Social Perception; Social Support

A cost-effectiveness evaluation of a home visit program for adolescent mothers. - Aracena, Marcela; Krause, Mariane; Pérez, Carola; Méndez, María Jesús; Salvatierra, Loreto; Soto, Mauricio; Pantoja, Tomás; Navarro, Sandra; Salinas, Alejandra; Farah, Claudio; Altimir, Carolina (J Health Psychol, 2009)
A home visit intervention program for adolescents throughout their pregnancy and during the early stages of motherhood was evaluated. The participants (N = 90) were part of a larger group of adolescents treated in two health centers in a poor neighborhood in Santiago, Chile. The program was carried out by volunteer community health monitors and evaluated through an experimental, randomized, controlled clinical trial. Cost-effectiveness was examined in comparison with standard health care. Results show higher scores for the intervention group on the mothers' mental health and nutritional state, as well as on the children's levels of linguistic development.
Keywords: Adolescent; Chile; Cost-Benefit Analysis; Female; House Calls; Humans; Male; Mothers; Outcome Assessment (Health Care); Poverty; Pregnancy; Pregnancy in Adolescence; Young Adult

The Safe Kindergarten: Promotion of Communication and Social Skills Among Kindergartners - Aram, Dorit; Shlak, Maya (Early Education & Development, 2008)

Emotional, physical, and social needs among 0-5-year-old children displaced by the 2010 Chilean earthquake: associated characteristics and exposures - Arbour, M.; Murray, K. A.; Yoshikawa, H.; Arriet, F.; Moraga, C.; Vega, M. A. (Disasters, 2017)
An 8.8-magnitude earthquake occurred off the coast of Chile on 27 February 2010, displacing nearly 2,000 children aged less than five years to emergency housing camps. Nine months later, this study assessed the needs of 140 displaced 0-5-year-old children in six domains: caregiver stability and protection; health; housing; nutrition; psychosocial situation; and stimulation. Multivariate regression was applied to examine the degree to which emotional, physical, and social needs were associated with baseline characteristics and exposure to the earthquake, to stressful events, and to ongoing risks in the proximal post-earthquake context. In each domain, 20 per cent or fewer children had unmet needs. Of all children in the sample, 20 per cent had unmet needs in multiple domains. Children's emotional, physical, and social needs were associated with ongoing exposures amenable to intervention, more than with baseline characteristics or epicentre proximity. Relief efforts should address multiple interrelated domains of child well-being and ongoing risks in post-disaster settings.
Arbour, MaryCatherine Murray, Kara A Yoshikawa, Hirokazu Arriet, Felipe Moraga, Cecilia Vega, Miguel Angel Cordero eng England 2016/05/14 06:00 Disasters. 2017 Apr;41(2):365-387. doi: 10.1111/disa.12197. Epub 2016 May 12.
Keywords: *Disasters; *Earthquakes; *Homeless Youth/psychology/statistics & numerical data; *Needs Assessment; Child Development; child status index; Child Welfare; Child, Preschool; children; Chile; earthquake; Emotions; Female; Health; Humans; Infant; Infant, Newborn; Male; Mental Health; nutrition; post-disaster; Relief Work; socio-emotional well-being

Neurobiology of executive functions: catecholamine influences on prefrontal cortical functions. - Arnsten, Amy F T; Li, Bao-Ming (Biol Psychiatry, 2005)
The prefrontal cortex guides behaviors, thoughts, and feelings using representational knowledge, i.e., working memory. These fundamental cognitive abilities subserve the so-called executive functions: the ability to inhibit inappropriate behaviors and thoughts, regulate our attention, monitor our actions, and plan and organize for the future. Neuropsychological and imaging studies indicate that these prefrontal cortex functions are weaker in patients with attention-deficit/hyperactivity disorder and contribute substantially to attention-deficit/hyperactivity disorder symptomology. Research in animals indicates that the prefrontal cortex is very sensitive to its neurochemical environment and that small changes in catecholamine modulation of prefrontal cortex cells can have profound effects on the ability of the prefrontal cortex to guide behavior. Optimal levels of norepinephrine acting at postsynaptic alpha-2A-adrenoceptors and dopamine acting at D1 receptors are essential to prefrontal cortex function. Blockade of norepinephrine alpha-2-adrenoceptors in prefrontal cortex markedly impairs prefrontal cortex function and mimics most of the symptoms of attention-deficit/hyperactivity disorder, including impulsivity and locomotor hyperactivity. Conversely, stimulation of alpha-2-adrenoceptors in prefrontal cortex strengthens prefrontal cortex regulation of behavior and reduces distractibility. Most effective treatments for attention-deficit/hyperactivity disorder facilitate catecholamine transmission and likely have their therapeutic actions by optimizing catecholamine actions in prefrontal cortex.
Keywords: Adamantane; Animals; Attention; Benzopyrans; Catecholamines; Dose-Response Relationship, Drug; Electroencephalography; Guanfacine; Humans; Memory, Short-Term; Microscopy, Immunoelectron; Motor Activity; Neurobiology; Prefrontal Cortex; Problem Solving; Reaction Time

The Jigsaw Classroom: Building Cooperation in the Classroom - Aronson, E.; Patnoe, S. (Longman, 1997)

Evaluation of the Responsible, Engaged, and Loving (REAL) Fathers Initiative on Physical Child Punishment and Intimate Partner Violence in Northern Uganda - Ashburn, Kim; Kerner, Brad; Ojamuge, Dickens; Lundgren, Rebecka (Prevention Science, 2017)
Keywords: Child maltreatment; Gender; Intimate Partner Violence; men; Uganda

Approaches to conflict and conflict resolution in toddler relationships - Ashby, N.; Neilsen-Hewett, C. (Journal of Early Childhood Research, 2012)

The emotional costs of parents' conditional regard: a self-determination theory analysis. - Assor, Avi; Roth, Guy; Deci, Edward L (J Pers, 2004)
Parents' use of conditional regard as a socializing practice was hypothesized to predict their children's introjected internalization (indexed by a sense of internal compulsion), resentment toward parents, and ill-being. In Study 1, involving three generations, mothers' reports of their parents' having used conditional regard to promote academic achievement predicted (a) the mothers' poor well-being and controlling parenting attitudes, and (b) their college-aged daughters' viewing them as having used conditional regard, thus showing both negative affective consequences from and intergenerational transmission of conditional regard. Study 2 expanded on the first by using four domains, including both genders, and examining mediating processes. College students' perceptions of their mothers' and fathers' having used conditional regard in four domains (emotion control, prosocial, academic, sport) were found to relate to introjected internalization, behavioral enactment, fluctuations in self-esteem, perceived parental disapproval, and resentment of parents. Introjection mediated the link from conditional regard to behavioral enactment. The results suggest that use of conditional regard as a socializing practice can promote enactment of the desired behaviors but does so with significant affective costs.
Keywords: Adaptation, Psychological; Adolescent; Child; Cross-Sectional Studies; Factor Analysis, Statistical; Female; Humans; Intergenerational Relations; Male; Models, Psychological; Mothers; Parent-Child Relations; Personal Autonomy; Psychological Theory; Self Concept; Socialization

Early Childhood as a Foundation for Civic Engagement - J. Astuto; M. D. Ruck (Handbook of Research of Civic Engagement in Youth, 2010)

Prevalence of mental disorders among children exposed to war: a systematic review of 7,920 children. - Attanayake, Vindya; McKay, Rachel; Joffres, Michel; Singh, Sonal; Burkle, Frederick; Mills, Edward (Med Confl Surviv, 2009)
Worldwide, millions of children are affected by armed conflict. However, data on the prevalence of mental disorders among these children is sparse. We aimed to determine the prevalence of mental disorders among children affected by war using a systematic review and meta-regression analysis. We systematically reviewed existing literature to identify studies on prevalence of post-traumatic stress disorder (PTSD), anxiety, depression and psychosis among children exposed to armed conflict. We searched electronic databases and references listed in studies to obtain eligible studies. We pooled studies using the random-effects method and explored heterogeneity using meta-regression analysis. Seventeen studies met our inclusion criteria. Studies included 7,920 children. Sample sizes ranged from 22 to 2,976. Four studies were conducted during a conflict and others during post-conflict. All the studies reported PTSD as the primary outcome ranging from 4.5 to 89.3%, with an overall pooled estimate of 47% (9% CI: 35-60%, I2 = 98%). Meta-analysis heterogeneity was attributable to study location (OR 1.33, 95% CI: 1.27-1.41), method of measurement (OR 1.36, 95% CI: 1.29-1.44) and duration since exposure to war (coefficient 0.17, 95% CI: 0.94-0.25). In addition, four studies reported elevated depression that allowed pooling (43%, 95% CI: 31-55%) and three studies reported elevated anxiety disorders allowing pooling (27%, 95% CI: 21-33%). Our systematic review suggests a higher prevalence rate of mental disorders among children exposed to conflict than among the general population. Given the number of current conflicts, there is a paucity of information regarding mental disorders among children affected by war.
Keywords: Child; Child Welfare; Humans; Mental Disorders; War

Ready to engage. Perspectives of teachers and parents on social and emotional learning and service-learning in America’s public schools - Atwell, MN; Bridgeland, JM; Manspile, EP (Allstate Foundation, 2021)
Keywords: Education; social emotional learning; United States

THE CULTURE QUESTION AND CONFLICT RESOLUTION - Avruch, Kevin; Black, Peter W. (Peace & Change, 1991)

Culture and Conflict Resolution - Avruch, K. (United States Institute of Peace Press, 1998)

A Generic Theory of Conflict Resolutions A Critique - Avruch, Kevin; Black, Peter W. (Negotiation Journal, 1987)

Threshold Externalities in Economic Development - Azariadis, Costas; Drazen, Allan (The Quarterly Journal of Economics, 1990)

Cortical sources of EEG rhythms are abnormal in down syndrome. - Babiloni, Claudio; Albertini, Giorgio; Onorati, Paolo; Muratori, Chiara; Buffo, Paola; Condoluci, Claudia; Sarà, Marco; Pistoia, Francesca; Vecchio, Fabrizio; Rossini, Paolo M (Clin Neurophysiol, 2010)
OBJECTIVE: Previous studies have been inconclusive whether dominant resting state alpha rhythms are greater or lower in amplitude in subjects with Down syndrome (DS) when compared to control subjects, ample resting alpha rhythms being considered as a reflection of good mechanisms of cortical neural synchronization. Here we tested the hypothesis that when the effects of head volume conduction are taken into account by the normalization of the cortical sources of resting alpha rhythms, these sources are lower in amplitude in DS subjects than in controls in line with typical findings in Alzheimer's disease patients. METHODS: Eyes-closed resting electroencephalographic (EEG) data were recorded in 45 DS subjects (25 males; mean age of 22.8years+/-0.7 standard error of mean (SEM)) and in 45 age-matched cognitively normal subjects (25 males; mean age of 22.4years+/-0.5 SEM). EEG rhythms of interest were delta (2-4Hz), theta (4-8Hz), alpha 1 (8-10.5Hz), alpha 2 (10.5-13Hz), beta 1 (13-20Hz), beta 2 (20-30Hz), and gamma (30-40Hz). Cortical EEG sources were estimated by low resolution electromagnetic tomography (LORETA) and normalized across all voxels and frequencies. RESULTS: Central, parietal, occipital, and temporal cortical sources of resting alpha and beta rhythms were lower in amplitude in the DS than control subjects, whereas the opposite was true for occipital delta cortical sources. A control analysis on absolute source values showed that they were globally larger in amplitude across several frequency bands in DS than control subjects. CONCLUSIONS: These results suggest that normalized cortical sources of alpha rhythms are lower in amplitude in DS than control subjects, as it is typically found in Alzheimer's disease. SIGNIFICANCE: DS is accompanied by a functional impairment of cortical neuronal synchronization mechanisms in the resting state condition.
Keywords: Adult; Analysis of Variance; Brain Mapping; Cerebral Cortex; Down Syndrome; Electroencephalography; Female; Humans; Image Processing, Computer-Assisted; Male; Nerve Net; Neuropsychological Tests; Patient Selection; Signal Processing, Computer-Assisted

Parenting practices and problem behavior across three generations: Monitoring, harsh discipline, and drug use in the intergenerational transmission of externalizing behavior. - Bailey, J.A.; Hill, K.G.; Oesterle, S. (Dev Psychol, 2009)

Parenting practices and problem behavior across three generations: monitoring, harsh discipline, and drug use in the intergenerational transmission of externalizing behavior - Bailey, J. A.; Hill, K. G.; Oesterle, S.; Hawkins, J. D. (Dev PsycholDev Psychol, 2009)
Using data from grandparents (G1), parents (G2), and children (G3), this study examined continuity in parental monitoring, harsh discipline, and child externalizing behavior across generations, and the contribution of parenting practices and parental drug use to intergenerational continuity in child externalizing behavior. Structural equation and path modeling of prospective, longitudinal data from 808 G2 participants, their G1 parents, and their school-age G3 children (n = 136) showed that parental monitoring and harsh discipline demonstrated continuity from G1 to G2. Externalizing behavior demonstrated continuity from G2 to G3. Continuity in parenting practices did not explain the intergenerational continuity in externalizing behavior. Rather, G2 adolescent externalizing behavior predicted their adult substance use, which was associated with G3 externalizing behavior. A small indirect effect of G1 harsh parenting on G3 was observed. Interparental abuse and socidemographic risk were included as controls but did not explain the intergenerational transmission of externalizing behavior. Results highlight the need for preventive interventions aimed at breaking intergenerational cycles in poor parenting practices. More research is required to identify parental mechanisms influencing the continuity of externalizing behavior across generations.
1939-0599 Bailey, Jennifer A Hill, Karl G Oesterle, Sabrina Hawkins, J David R01 DA009679/DA/NIDA NIH HHS/United States R01 DA012138-05/DA/NIDA NIH HHS/United States R01 DA012138/DA/NIDA NIH HHS/United States R01 DA009679-11/DA/NIDA NIH HHS/United States R01DA12138-05/DA/NIDA NIH HHS/United States R01DA09679-11/DA/NIDA NIH HHS/United States R01DA023089-01/DA/NIDA NIH HHS/United States Journal Article Research Support, N.I.H., Extramural United States Dev Psychol. 2009 Sep;45(5):1214-26. doi: 10.1037/a0016129.
Keywords: *Intergenerational Relations; *Parent-Child Relations; *Parenting; Adolescent; Adolescent Behavior; Adult; Child; Child Behavior; Female; Humans; Internal-External Control; Juvenile Delinquency/*psychology; Life Change Events; Longitudinal Studies; Male; Negotiating; Personality Assessment; Risk Factors; Socioeconomic Factors; Substance-Related Disorders/*psychology; Surveys and Questionnaires; Young Adult

Reducing maternal intimate partner violence after the birth of a child: a randomized controlled trial of the Hawaii Healthy Start Home Visitation Program. - Bair-Merritt, Megan H; Jennings, Jacky M; Chen, Rusan; Burrell, Lori; McFarlane, Elizabeth; Fuddy, Loretta; Duggan, Anne K (Arch Pediatr Adolesc Med, 2010)
OBJECTIVES: To estimate whether home visitation beginning after childbirth was associated with changes in average rates of mothers' intimate partner violence (IPV) victimization and perpetration as well as rates of specific IPV types (physical assault, verbal abuse, sexual assault, and injury) during the 3 years of program implementation and during 3 years of long-term follow-up. DESIGN: Randomized controlled trial. SETTING: Oahu, Hawaii. PARTICIPANTS: Six hundred forty-three families with an infant at high risk for child maltreatment born between November 1994 and December 1995. Intervention Home visitors provided direct services and linked families to community resources. Home visits were to initially occur weekly and to continue for at least 3 years. MAIN OUTCOME MEASURES: Women's self-reports of past-year IPV victimization and perpetration using the Conflict Tactics Scale. Blinded research staff conducted maternal interviews following the child's birth and annually when children were aged 1 to 3 years and then 7 to 9 years. RESULTS: During program implementation, intervention mothers as compared with control mothers reported lower rates of IPV victimization (incidence rate ratio [IRR], 0.86; 95% confidence interval [CI], 0.73-1.01) and significantly lower rates of perpetration (IRR, 0.83; 95% CI, 0.72-0.96). Considering specific IPV types, intervention women reported significantly lower rates of physical assault victimization (IRR, 0.85; 95% CI, 0.71-1.00) and perpetration (IRR, 0.82; 95% CI, 0.70-0.96). During long-term follow-up, rates of overall IPV victimization and perpetration decreased, with nonsignificant between-group differences. Verbal abuse victimization rates (IRR, 1.14, 95% CI, 0.97-1.34) may have increased among intervention mothers. CONCLUSION: Early-childhood home visitation may be a promising strategy for reducing IPV.
Keywords: Adolescent; Adult; Child; Child Abuse; Child Welfare; Domestic Violence; Factor Analysis, Statistical; Female; Hawaii; Health Promotion; Home Care Services; House Calls; Humans; Maternal Welfare; Mothers; Regression Analysis; Young Adult

Effects of political and military traumas on children: the Palestinian case. - Baker, A; Shalhoub-Kevorkian, N (Clin Psychol Rev, 1999)
Social scientists have long recognized that individuals subjected to traumatic events associated with military and political conflict experience dire psychological consequences. The systematic study of this phenomenon, however, could be considered a nascent event. Research on the psychological sequel of traumatic events (traumatology) is well-rooted in the recognition and development of posttraumatic stress disorder as a separate psychological disorder category. The early studies in this field focused mainly on adult populations. With the recent advent of involvement of children in military conflicts such as in Africa (e.g., Mozambique), the Middle East (e.g., Palestine, Lebanon), and Southeast Asia (e.g., Cambodia), psychologists have taken a keen interest in examining the psychological effects such conflicts reap on children. Hence, a growing but modest body of literature has been amassed within the past 20 years on the subject. This article is an attempt to synthesize this literature in order to examine the universal and culture-specific correlates of political and military trauma. Specifically, the article will focus on the psychological symptoms children display following their exposure to such traumatic events. Special emphasis will be placed on anxiety, phobic, psychosomatic, and depressive symptoms. More importantly, however, an examination will be made to ascertain which factors (e.g., psychosocial, cultural, and political) serve to shield (protect) or predispose (vulnerability) children to psychological dysfunction. Furthermore, the analyses presented will be gender specific. The article will attempt to delineate a paradigm that explains the relationship between trauma, culture, and personality. Although the article will examine studies from various regions, specific emphasis will be placed on the Palestinian experience.
Keywords: Adult; Arabs; Cross-Cultural Comparison; Female; Humans; Israel; Male; Politics; Stress Disorders, Post-Traumatic; War

Less is more: meta-analyses of sensitivity and attachment interventions in early childhood. - Bakermans-Kranenburg, Marian J; Van IJzendoorn, Marinus H; Juffer, Femmie (Psychol Bull, 2003)
Is early preventive intervention effective in enhancing parental sensitivity and infant attachment security, and if so, what type of intervention is most successful? Seventy studies were traced, producing 88 intervention effects on sensitivity (n = 7,636) and/or attachment (n = 1,503). Randomized interventions appeared rather effective in changing insensitive parenting (d = 0.33) and infant attachment insecurity (d = 0.20). The most effective interventions used a moderate number of sessions and a clear-cut behavioral focus in families with, as well as without, multiple problems. Interventions that were more effective in enhancing parental sensitivity were also more effective in enhancing attachment security, which supports the notion of a causal role of sensitivity in shaping attachment.
Keywords: Behavior Therapy; Cross-Sectional Studies; Family Therapy; Follow-Up Studies; Humans; Infant; Object Attachment; Outcome and Process Assessment (Health Care); Parenting; Personality Assessment; Randomized Controlled Trials as Topic

Gene-environment interaction of the dopamine D4 receptor (DRD4) and observed maternal insensitivity predicting externalizing behavior in preschoolers. - Bakermans-Kranenburg, Marian J; Van IJzendoorn, Marinus H (Dev Psychobiol, 2006)
Previous studies have related aggression and other externalizing problems in children to either dopamine D4 receptor polymorphisms or harsh and insensitive parenting. In this study it was determined whether the combination of the DRD4 7-repeat polymorphism and maternal insensitivity predicted significantly more externalizing behavior in preschoolers. The results pointed to a gene-environment interaction effect: maternal insensitivity was associated with externalizing (oppositional, aggressive) behaviors, but only in the presence of the DRD4 7-repeat polymorphism. The increase in externalizing behaviors in children with the 7-repeat allele exposed to insensitive care compared to children without these combined risks was sixfold. The data indicate that children are differentially susceptible to insensitive parenting dependent on the presence of the 7-repeat DRD4 allele.
Keywords: Alleles; Child Behavior; Child, Preschool; DNA Primers; Environment; Female; Humans; Infant; Male; Maternal Behavior; Mother-Child Relations; Observation; Parenting; Polymorphism, Genetic; Receptors, Dopamine D4

Sniffing around oxytocin: review and meta-analyses of trials in healthy and clinical groups with implications for pharmacotherapy. - Bakermans-Kranenburg, M J; van I Jzendoorn, M H (Transl Psychiatry, 2013)
The popularity of oxytocin (OT) has grown exponentially during the past decade, and so has the number of OT trials in healthy and clinical groups. We take stock of the evidence from these studies to explore potentials and limitations of pharmacotherapeutic applications. In healthy participants, intranasally administered OT leads to better emotion recognition and more trust in conspecifics, but the effects appear to be moderated by context (perceived threat of the 'out-group'), personality and childhood experiences. In individuals with untoward childhood experiences, positive behavioral or neurobiological effects seem lowered or absent. In 19 clinical trials, covering autism, social anxiety, postnatal depression, obsessive-compulsive problems, schizophrenia, borderline personality disorder and post-traumatic stress, the effects of OT administration were tested, with doses ranging from 15 IU to more than 7000 IU. The combined effect size was d=0.32 (N=304; 95% confidence interval (CI): 0.18-0.47; P<0.01). However, of all disorders, only studies on autism spectrum disorder showed a significant combined effect size (d=0.57; N=68; 95% CI: 0.15-0.99; P<0.01). We hypothesize that for some of the other disorders, etiological factors rooted in negative childhood experiences may also have a role in the diminished effectiveness of treatment with OT.
Keywords: Administration, Intranasal; Anti-Anxiety Agents; Anxiety; Child; Child Development Disorders, Pervasive; Depression; Humans; Mental Disorders; Oxytocin; Personality Disorders; Phobic Disorders; Schizophrenia; Stress Disorders, Post-Traumatic; Trust

The hidden efficacy of interventions: gene×environment experiments from a differential susceptibility perspective. - Bakermans-Kranenburg, Marian J; Van IJzendoorn, Marinus H (Annu Rev Psychol, 2015)
The efficacy of interventions might be underestimated or even go undetected as a main effect when it is hidden in gene-by-environment (G×E) interactions. This review moves beyond the problems thwarting correlational G×E research to propose genetic differential susceptibility experiments. G×E experiments can test the bright side as well as the dark side of the moderating role of genotypes traditionally considered to represent vulnerability to negative conditions. The differential susceptibility model predicts that carriers of these risk genotypes profit most from interventions changing the environment for the better. The evolutionary background of G×E and differential susceptibility is discussed, and statistical methods for the analysis of differential susceptibility (versus diathesis stress) are reviewed. Then, based on results from 22 randomized G×E experiments, meta-analytic evidence for the differential susceptibility model is presented. Intervention effects are much stronger in the susceptible genotypes than in the nonsusceptible genotypes. The final sections suggest possibilities to broaden the G component in the G×E equation by including genetic pathways, and to broaden the E component by including methylation level and gene expression as promising ways to probe the concept of the environment more deeply and address the perennial issue of what works for whom.
Keywords: Gene-Environment Interaction; Genetic Predisposition to Disease; Humans; Neurosciences; Research Design

Differential susceptibility to rearing environment depending on dopamine-related genes: new evidence and a meta-analysis. - Bakermans-Kranenburg, Marian J; Van IJzendoorn, Marinus H (Dev Psychopathol, 2011)
In the current paper we present new empirical data and meta-analytic evidence for the role of dopamine-related genes as a susceptibility factor interacting with the rearing environment for better and for worse, that is, increasing children's susceptibility to both the adverse effects of unsupportive environments and the beneficial effects of supportive rearing. In Study 1 we examined the readiness of 91 7-year-old children to donate their money to a charity (UNICEF). We tested whether the association between attachment and donating behavior was moderated by the presence of the dopamine receptor D4 (DRD4) 7-repeat allele. The attachment story completion task was used to assess attachment as an index of the quality of the rearing environment. Children with secure attachment representations donated more but only if they had the DRD4 7-repeat allele. In Study 2 we present the results of a meta-analysis of gene-environment studies on children up to 10 years of age involving dopamine-related genes (dopamine receptor D2, DRD4, dopamine transporter). The cumulative negative effects of these "risk genes" and adverse rearing environments have been stressed, but potentially cumulative positive effects of these same genes interacting with positive rearing environments remained largely unnoticed. We examined the associations between negative and positive rearing environments and developmental outcomes as moderated by dopamine-related gene polymorphisms. Children with the less efficient dopamine-related genes did worse in negative environments than the comparisons without the "genetic risk," but they also profited most from positive environments. Findings are discussed in light of evolutionary theory, and illustrated with some practical implications of differential susceptibility.
Keywords: Adult; Altruism; Child; Child Development; Child Rearing; Dopamine; Female; Genetics, Behavioral; Genotype; Humans; Male; Models, Neurological; Object Attachment; Parenting; Polymorphism, Genetic; Receptors, Dopamine D4; Social Behavior; Social Environment

Oxytocin decreases handgrip force in reaction to infant crying in females without harsh parenting experiences. - Bakermans-Kranenburg, Marian J; Van IJzendoorn, Marinus H; Riem, Madelon M E; Tops, Mattie; Alink, Lenneke R A (Soc Cogn Affect Neurosci, 2012)
Infant crying can elicit sensitive caregiving as well as hostility and harsh parenting responses. In the current study (N = 42 females) with a double-blind experimental design, we tested the effect of intranasal oxytocin administration on the use of excessive force using a hand-grip dynamometer during listening to infant cry sounds. Participants' experiences with harsh parental discipline during childhood were found to moderate the effect of oxytocin administration on the use of excessive force. Participants' whose parents did not discipline them harshly used less excessive force in the oxytocin condition, but for participants who were disciplined harshly there was no difference between the oxytocin and placebo condition. Such effects were not found during listening to infant laughter. We conclude that early caregiving experiences constitute an important moderator of the prosocial and/or stress-reducing effects of oxytocin. Oxytocin administration may increase trust and cooperation in individuals with supportive backgrounds, but not generate this effect in individuals who as a consequence of unfavorable early caregiving experiences may have a bias toward negative interpretation of social cues.
Keywords: Administration, Intranasal; Adult; Crying; Female; Hand Strength; Humans; Infant; Infant Behavior; Linear Models; Middle Aged; Oxytocin; Parents; Twins, Dizygotic; Twins, Monozygotic; Young Adult

Oxytocin receptor (OXTR) and serotonin transporter (5-HTT) genes associated with observed parenting. - Bakermans-Kranenburg, Marian J; Van IJzendoorn, Marinus H (Soc Cogn Affect Neurosci, 2008)
Both oxytocin and serotonin modulate affiliative responses to partners and offspring. Animal studies suggest a crucial role of oxytocin in mammalian parturition and lactation but also in parenting and social interactions with offspring. The serotonergic system may also be important through its influence on mood and the release of oxytocin. We examined the role of serotonin transporter (5-HTT) and oxytocin receptor (OXTR) genes in explaining differences in sensitive parenting in a community sample of 159 Caucasian, middle-class mothers with their 2-year-old toddlers at risk for externalizing behavior problems, taking into account maternal educational level, maternal depression and the quality of the marital relationship. Independent genetic effects of 5-HTTLPR SCL6A4 and OXTR rs53576 on observed maternal sensitivity were found. Controlling for differences in maternal education, depression and marital discord, parents with the possibly less efficient variants of the serotonergic (5-HTT ss) and oxytonergic (AA/AG) system genes showed lower levels of sensitive responsiveness to their toddlers. Two-way and three-way interactions with marital discord or depression were not significant. This first study on the role of both OXTR and 5-HTT genes in human parenting points to molecular genetic differences that may be implicated in the production of oxytocin explaining differences in sensitive parenting.
Keywords: Adult; Brain; Brain Chemistry; Child; Child, Preschool; Cooperative Behavior; Empathy; Female; Humans; Infant; Male; Maternal Behavior; Mother-Child Relations; Parenting; Polymorphism, Genetic; Receptors, Oxytocin; Serotonin Plasma Membrane Transport Proteins; Social Behavior

Effects of an attachment-based intervention on daily cortisol moderated by dopamine receptor D4: a randomized control trial on 1- to 3-year-olds screened for externalizing behavior. - Bakermans-Kranenburg, Marian J; Van IJzendoorn, Marinus H; Mesman, Judi; Alink, Lenneke R A; Juffer, Femmie (Dev Psychopathol, 2008)
The effect of the Video-Feedback Intervention to Promote Positive Parenting and Sensitive Discipline (VIPP-SD) on daily cortisol production was tested in a randomized controlled trial with 130 families with 1- to 3-year-old children screened for their relatively high levels of externalizing behavior. Six 1.5-hr intervention sessions focusing on maternal sensitivity and discipline were conducted with individual families at their homes. Children in the intervention group showed lower cortisol levels, with a moderating role of the dopamine receptor D4 (DRD4) VNTR exon III polymorphism. The VIPP-SD program proved to be effective in decreasing daily cortisol production in children with the DRD4 7-repeat allele, but not in children without the DRD4 7-repeat allele. Our findings indicate that children are differentially susceptible to intervention effects dependent on the presence of the 7-repeat DRD4 allele.
Keywords: Alleles; Arousal; Behavior Therapy; Child Behavior Disorders; Child, Preschool; Education; Exons; Genetic Predisposition to Disease; Humans; Hydrocortisone; Infant; Internal-External Control; Minisatellite Repeats; Mother-Child Relations; Object Attachment; Polymorphism, Genetic; Receptors, Dopamine D4; Temperament; Video Recording

Research Review: genetic vulnerability or differential susceptibility in child development: the case of attachment. - Bakermans-Kranenburg, Marian J; Van IJzendoorn, Marinus H (J Child Psychol Psychiatry, 2007)
Gene-environment interactions interpreted in terms of differential susceptibility may play a large part in the explanation of individual differences in human development. Reviewing studies on the behavioral and molecular genetics of attachment, we present evidence for interactions between genetic and environmental factors explaining individual differences in attachment security and disorganization. In particular, the DRD4 7-repeat polymorphism seems associated with an increased risk for disorganized attachment, but only when combined with environmental risk. Gene-environment (G x E) interactions may be interpreted as genetic vulnerability or differential susceptibility. We found support for the differential susceptibility hypothesis predicting not only more negative outcomes for susceptible children in unfavorable environments, but also positive outcomes for susceptible children in favorable environments.
Keywords: Adult; Child; Child Behavior Disorders; Child Development; Disease Susceptibility; Female; Genetic Predisposition to Disease; Genetics, Behavioral; Humans; Male; Molecular Biology; Object Attachment; Parent-Child Relations; Polymorphism, Genetic; Reactive Attachment Disorder; Receptors, Dopamine D4; Social Environment

Mental health and wellbeing during the transition to fatherhood - Baldwin, Sharin; Malone, Mary; Sandall, Jane; Bick, Debra (JBI Database of Systematic Reviews and Implementation Reports, 2018)

Evaluating the 3Cs Program for Caregivers of Young Children Affected by the Armed Conflict in Colombia - González Ballesteros, Lina María; Flores, José M.; Ortiz Hoyos, Ana María; Londoño Tobón, Amalia; Hein, Sascha; Bolívar Rincon, Felipe; Gómez, Oscar; Ponguta, Liliana Angelica (Journal on Education in Emergencies, 2021)
Keywords: armed conflict; caregiving; Colombia

Peace Psychology Book SeriesChildren and Peace (Springer International Publishing, 2020)

Exercise of human agency through collective efficacy - Bandura, A. (Current Directions in Psychological ScienceCurrent Directions in Psychological ScienceCurrent Directions in Psychological Science, 2000)
Social cognitive theory adopts an agentic perspective in which individuals are producers of experiences and shapers of events. Among the mechanisms of human agency, none is more focal or pervading than the belief of personal efficacy. This core belief is the foundation of human agency. Unless people believe that they can produce desired effects and forestall undesired ones by their actions, they have little incentive to act. The growing interdependence of human functioning is placing a premium on the exercise of collective agency through shared beliefs in the power to produce effects by collective action. The present article analyzes the nature of perceived collective efficacy and its centrality in how people live their lives. Perceived collective efficacy fosters groups' motivational commitment to their missions, resilience to adversity, and performance accomplishment.
471lh Times Cited:354 Cited References Count:20
Keywords: collective agency; collectivism-individualism; emergent properties; interdependence; multilevel; perceived self-efficacy; performance; self-efficacy; social cognitive theory; team

Multicultural Education: Issues and Perspectives - Banks, J.A.; Banks, C.A.M.G. (Wiley, 2009)

Multicultural Education: Characteristics and Goals - J. A. Banks (Multicultural Education: Issues and Perspectives (7th edition), 2010)

Nature and nurture in own-race face processing. - Bar-Haim, Yair; Ziv, Talee; Lamy, Dominique; Hodes, Richard M (Psychol Sci, 2006)
A standard visual preference task was used to examine 3-month-olds' looking times at own-race versus other-race faces as a function of environmental exposure to faces from the two categories. Participants were Caucasian infants living in a Caucasian environment, African infants living in an African environment, and African infants living in a predominantly Caucasian environment. The results indicate that preference for own-race faces is present as early as 3 months of age, but that this preference results from exposure to the prototypical facial environment.
Keywords: Cognition; Ethnic Groups; Face; Humans; Infant; Social Environment; Visual Perception

The Indescribable and the Undiscussable: Reconstructing Human Discourse After Trauma - Bar-On, D. (Central European University Press, 1999)

Sociopsychological Foundations of Intractable Conflicts - Bar-Tal, D. (American Behavioral Scientist, 2007)

Development of social categories and stereotypes in early childhood: The case of “The Arab” concept formation, stereotype and attitudes by Jewish children in Israel - Bar-Tal, Daniel (International Journal of Intercultural Relations, 1996)

Husbands involvement in birth preparedness and complication readiness in Axum town, Tigray region, Ethiopia, 2017 - Baraki, Zeray; Wendem, Fthi; Gerensea, Hadgu; Teklay, Hafte (BMC Pregnancy and Childbirth, 2019)
Keywords: Birth preparedness; Complication readiness; Husband involvement

Treating War Trauma in Children and Youth from the Former Yugoslavia - A. Barath (Managing Multiethnic Local Communities in the Countries of the Former Yugoslavia, 2000)

Political violence, social integration, and youth functioning: Palestinian youth from the Intifada - Barber, B. K. (Journal of Community PsychologyJournal of Community PsychologyJournal of Community Psychology, 2001)
Informed by social ecological, social capital, and social disorganisation theories, this study tested an ecological model of youth experience In the Palestinian Intifada. The sample included 6,000 Palestinian 14 year olds, assessed in 1994 and 1995 after the end of the conflict. Data from retrospective self-reports of youth exposure to and involvement in political violence, and self-reports of current individual functioning (depression and antisocial behavior) and integration In several social contexts (family, peer relations, religion, education, and community), revealed: direct associations between Intifada experience and antisocial behavior and depression (females only; Intifada experience was positively associated with religiosity and unrelated to social integration in family, school, and peer relations; in some cases, social integration in family education, religion, and peer relations significantly moderated the associations between Intifada experience and youth problems; Integration in the several social contexts was directly related in predictable ways to youth problem behaviors, with neighborhood disorganisation the most consistent and Powerful predictor. The discussion centers around youth resilience to the effects of political violence, the role of psychological meaning children and adolescents can attach to political violence, and the overall salience of social integration in youth development. (C) 2001 John Wiley & Sons, Inc.
426bc Times Cited:67 Cited References Count:49
Keywords: children

Connectedness in the lives of children and adolescents: a call for greater conceptual clarity. - Barber, Brian K; Schluterman, Julie Mikles (J Adolesc Health, 2008)
Studies of the role of connectedness in the health and development of children and adolescents are accumulating rapidly. Although findings are uniformly consistent in documenting its correlation with a host of health indicators, the construct is in need of substantial conceptual clarification to maximize its research and applied utility. Current conceptualizations and operationalizations inconsistently span a wide spectrum of varied elements of social experience--including the quality of a relationship, the degree of liking an environment or relationship, the quality of performance in an environment or relationship, the possession of feelings or attitude states, and a combination of states and the behaviors that antecede them--resulting in an ability to adequately understand what the construct is and how, why, and when it is most protective. This paper documents this variability in an effort to sensitize researchers, practitioners, and policy makers to the complexity of the construct. It further describes one ongoing, multicultural research project that is currently informing international health initiatives as an illustration of one approach to addressing the complexity with goals of precision, parsimony, cultural sensitivity, and applied utility.
Keywords: Adolescent; Adolescent Development; Child; Child Development; Female; Humans; Interpersonal Relations; Male

Annual Research Review: The experience of youth with political conflict--challenging notions of resilience and encouraging research refinement. - Barber, Brian K (J Child Psychol Psychiatry, 2013)
AIMS AND METHOD: Drawing on empirical studies and literature reviews, this paper aims to clarify and qualify the relevance of resilience to youth experiencing political conflict. It focuses on the discordance between expectations of widespread dysfunction among conflict-affected youth and a body of empirical evidence that does not confirm these expectations. FINDINGS: The expectation for widespread dysfunction appears exaggerated, relying as it does on low correlations and on presumptions of universal response to adversity. Such a position ignores cultural differences in understanding and responding to adversity, and in the specific case of political conflict, it does not account for the critical role of ideologies and meaning systems that underlie the political conflict and shape a young people's interpretation of the conflict, and their exposure, participation, and processing of experiences. With respect to empirical evidence, the findings must be viewed as tentative given the primitive nature of research designs: namely, concentration on violence exposure as the primary risk factor, at the expense of recognizing war's impact on the broader ecology of youth's lives, including disruptions to key economic, social, and political resources; priority given to psychopathology in the assessment of youth functioning, rather than holistic assessments that would include social and institutional functioning and fit with cultural and normative expectations and transitions; and heavy reliance on cross-sectional, rather than longitudinal, studies. CONCLUSIONS: Researchers and practitioners interested in employing resilience as a guiding construct will face such questions: Is resilience predicated on evidence of competent functioning across the breadth of risks associated with political conflict, across most or all domains of functioning, and/or across time? In reality, youth resilience amidst political conflict is likely a complex package of better and poorer functioning that varies over time and in direct relationship to social, economic, and political opportunities. Addressing this complexity will complicate the definition of resilience, but it confronts the ambiguities and limitations of work in cross-cultural contexts.
Keywords: Adaptation, Psychological; Adolescent; Child; Civil Disorders; Cross-Cultural Comparison; Cross-Sectional Studies; Humans; Longitudinal Studies; Mental Disorders; Politics; Research; Resilience, Psychological; Risk Factors; Social Adjustment; Social Environment; Socioeconomic Factors; Violence

Political violence, social integration, and youth functioning: Palestinian youth from the Intifada - Barber, Brian K. (Journal of Community Psychology, 2001)

Adolescents and War: How Youth Deal with Political Violence - Barber, B.K. (Oxford University Press, 2009)
Hundreds of thousands of children are forced or legally recruited combatants in no fewer than 70 warring parties across the world. In addition to these child soldiers, thousands of youth voluntarily participate in politically related conflict. Why, how, and in what capacities are such large numbers of teenagers involved in war, and how are they affected? This book brings together world experts in an evidence-based volume to thoroughly understand and document the intricacies of youth who have had substantial involvement in political violence. Contributors argue that the assumption that youth are automatically debilitated by the violence they experience is much too simplistic: effective care for youth must include an awareness of their motives and beliefs, the roles they played in the conflict, their relationships with others, and the opportunities available to them after their experiences with war. The book suggests that the meaning youth make of a conflict may protect them from mental harm.
Keywords: adolescents; child soldiers; children; political violence; War; youth

Demographic, physical and mental health assessments in the adolescent brain and cognitive development study: Rationale and description - Barch, D. M.; Albaugh, M. D.; Avenevoli, S.; Chang, L.; Clark, D. B.; Glantz, M. D.; Hudziak, J. J.; Jernigan, T. L.; Tapert, S. F.; Yurgelun-Todd, D.; Alia-Klein, N.; Potter, A. S.; et al. (Dev Cogn NeurosciDev Cogn Neurosci, 2018)
The Adolescent Brain and Cognitive Development (ABCD) Study incorporates a comprehensive range of measures assessing predictors and outcomes related to both mental and physical health across childhood and adolescence. The workgroup developed a battery that would assess a comprehensive range of domains that address study aims while minimizing participant and family burden. We review the major considerations that went into deciding what constructs to cover in the demographics, physical health and mental health domains, as well as the process of selecting measures, piloting and refining the originally proposed battery. We present a description of the baseline battery, as well as the six-month interim assessments and the one-year follow-up assessments. This battery includes assessments from the perspectives of both the parent and the target youth, as well as teacher reports. This battery will provide a foundational baseline assessment of the youth's current function so as to permit characterization of stability and change in key domains over time. The findings from this battery will also be utilized to identify both resilience markers that predict healthy development and risk factors for later adverse outcomes in physical health, mental health, and substance use and abuse.
1878-9307 Barch, Deanna M Albaugh, Matthew D Avenevoli, Shelli Chang, Linda Clark, Duncan B Glantz, Meyer D Hudziak, James J Jernigan, Terry L Tapert, Susan F Yurgelun-Todd, Debbie Alia-Klein, Nelly Potter, Alexandra S Paulus, Martin P Prouty, Devin Zucker, Robert A Sher, Kenneth J U24 DA041147/DA/NIDA NIH HHS/United States R01 DA041528/DA/NIDA NIH HHS/United States U01 DA041120/DA/NIDA NIH HHS/United States K05 AA017242/AA/NIAAA NIH HHS/United States U01 DA041134/DA/NIDA NIH HHS/United States U01 DA041022/DA/NIDA NIH HHS/United States U01 DA041089/DA/NIDA NIH HHS/United States U01 DA041106/DA/NIDA NIH HHS/United States U01 DA041117/DA/NIDA NIH HHS/United States U01 DA041028/DA/NIDA NIH HHS/United States U01 DA041148/DA/NIDA NIH HHS/United States U01 DA041174/DA/NIDA NIH HHS/United States Journal Article Research Support, N.I.H., Extramural Review Netherlands Dev Cogn Neurosci. 2018 Aug;32:55-66. doi: 10.1016/j.dcn.2017.10.010. Epub 2017 Nov 3.
Keywords: *Assessment; *Mental Health; *Physical health; *Psychopathology; Adolescent; Brain/*growth & development; Child; Cognition/*physiology; Demography/*methods; Female; Humans; Male; Mental Health/*standards

Children's physiological and emotional reactions to witnessing bullying predict bystander intervention. - Barhight, Lydia R; Hubbard, Julie A; Hyde, Christopher T (Child Dev, 2013)
Study goals were to explore whether children clustered into groups based on reactions to witnessing bullying and to examine whether these reactions predicted bullying intervention. Seventy-nine children (M = 10.80 years) watched bullying videos in the laboratory while their heart rate (HR) was measured, and they self-reported on negative emotion after each video. Bullying intervention was assessed by school peers. Two groups emerged based on reactions to the bullying videos: The Emotional group (43% of children) displayed HR acceleration and reported high negative emotion, whereas the Unemotional group (57% of children) showed HR deceleration and reported low negative emotion. Group membership predicted bullying intervention, with peers reporting that Emotional children were more likely to stop a bully than Unemotional children.
Keywords: Bullying; Child; Child Behavior; Crime Victims; Emotions; Empathy; Female; Heart Rate; Humans; Interpersonal Relations; Male; Peer Group; Schools; Self Report

Contemporary Hunter-Gatherers: Current Theoretical Issues in Ecology and Social Organization - Barnard, A (Annual Review of Anthropology, 1983)

Maternal responsiveness and cognitive development in children - M. H. Barnstein; C. S. Tamis-LeMonda (Maternal Responsiveness: Characteristics and consequences, 1989)

Developmental origins of non-communicable disease: implications for research and public health. - Barouki, Robert; Gluckman, Peter D; Grandjean, Philippe; Hanson, Mark; Heindel, Jerrold J (Environ Health, 2012)
This White Paper highlights the developmental period as a plastic phase, which allows the organism to adapt to changes in the environment to maintain or improve reproductive capability in part through sustained health. Plasticity is more prominent prenatally and during early postnatal life, i.e., during the time of cell differentiation and specific tissue formation. These developmental periods are highly sensitive to environmental factors, such as nutrients, environmental chemicals, drugs, infections and other stressors. Nutrient and toxicant effects share many of the same characteristics and reflect two sides of the same coin. In both cases, alterations in physiological functions can be induced and may lead to the development of non-communicable conditions. Many of the major diseases - and dysfunctions - that have increased substantially in prevalence over the last 40 years seem to be related in part to developmental factors associated with either nutritional imbalance or exposures to environmental chemicals. The Developmental Origins of Health and Disease (DOHaD) concept provides significant insight into new strategies for research and disease prevention and is sufficiently robust and repeatable across species, including humans, to require a policy and public health response. This White Paper therefore concludes that, as early development (in utero and during the first years of postnatal life) is particularly sensitive to developmental disruption by nutritional factors or environmental chemical exposures, with potentially adverse consequences for health later in life, both research and disease prevention strategies should focus more on these vulnerable life stages.
Keywords: Environmental Exposure; Epigenomics; Female; Gene-Environment Interaction; Human Development; Humans; Male; Metabolic Syndrome X; Pregnancy; Prenatal Exposure Delayed Effects; Prevalence; Public Health

Contributions of nonmaternal caregivers to infant feeding in a low-income African-American sample - Barrett, K. J.; Wasser, H. M.; Thompson, A. L.; Bentley, M. E. (Maternal & Child Nutrition, 2018)

Early childhood development: a new challenge for the SDG era - Barros, A. J.; Ewerling, F. (Lancet Glob Health, 2016)
Barros, Aluisio J D Ewerling, Fernanda eng Comment England 2016/11/20 06:00 Lancet Glob Health. 2016 Dec;4(12):e873-e874. doi: 10.1016/S2214-109X(16)30298-4.
Keywords: *Child Development; *Public Health; Child, Preschool; Humans

A review of electrophysiology in attention-deficit/hyperactivity disorder: I. Qualitative and quantitative electroencephalography. - Barry, Robert J; Clarke, Adam R; Johnstone, Stuart J (Clin Neurophysiol, 2003)
OBJECTIVE: This article reviews the electroencephalography (EEG) literature in relation to attention-deficit/hyperactivity disorder (AD/HD). METHODS: The review briefly outlines the history of the disorder, focusing on the changing diagnostic systems which both reflect and constrain research into AD/HD. Both qualitative and quantitative EEG studies are examined, and their results are discussed in relation to various models of AD/HD. Implications of these data for future research and development in AD/HD are considered. RESULTS: In terms of resting EEG, elevated relative theta power, and reduced relative alpha and beta, together with elevated theta/alpha and theta/beta ratios, are most reliably associated with AD/HD. Theta/alpha and theta/beta ratios also discriminate diagnostic subgroups of AD/HD. Recent studies of EEG heterogeneity in this disorder indicate the existence of different profiles of cortical anomalies which may cut across diagnostic types. CONCLUSIONS: The research to date has identified a substantial number of EEG correlates of AD/HD which hold promise for improving our understanding of the brain dysfunction(s) underlying the disorder. Further work in this field may benefit from a broader conceptual approach, integrating EEG and other measures of brain function.
Keywords: Attention Deficit Disorder with Hyperactivity; Brain; Electroencephalography; Humans

Access and Quality of Education for International Migrant Children - Bartlett, L. (UNESCO, 2015)
Background paper prepared for the Education for All Global Monitoring Report 2015 "Education for All 2000-2015: Achievements and Challenges".

Social effects of oxytocin in humans: context and person matter. - Bartz, Jennifer A; Zaki, Jamil; Bolger, Niall; Ochsner, Kevin N (Trends Cogn Sci, 2011)
Building on animal research, the past decade has witnessed a surge of interest in the effects of oxytocin on social cognition and prosocial behavior in humans. This work has generated considerable excitement about identifying the neurochemical underpinnings of sociality in humans, and discovering compounds to treat social functioning deficits. Inspection of the literature, however, reveals that the effects of oxytocin in the social domain are often weak and/or inconsistent. We propose that this literature can be informed by an interactionist approach in which the effects of oxytocin are constrained by features of situations and/or individuals. We show how this approach can improve understanding of extant research, suggest novel mechanisms through which oxytocin might operate, and refine predictions about oxytocin pharmacotherapy.
Keywords: Animals; Brain; Cognition Disorders; Humans; Oxytocin; Social Behavior

Oxytocin selectively improves empathic accuracy. - Bartz, Jennifer A; Zaki, Jamil; Bolger, Niall; Hollander, Eric; Ludwig, Natasha N; Kolevzon, Alexander; Ochsner, Kevin N (Psychol Sci, 2010)
Keywords: Administration, Intranasal; Adult; Cross-Over Studies; Double-Blind Method; Emotions; Empathy; Humans; Individuality; Male; Oxytocin; Theory of Mind; Young Adult

Effects of oxytocin on recollections of maternal care and closeness. - Bartz, Jennifer A; Zaki, Jamil; Ochsner, Kevin N; Bolger, Niall; Kolevzon, Alexander; Ludwig, Natasha; Lydon, John E (Proc Natl Acad Sci U S A, 2010)
Although the infant-caregiver attachment bond is critical to survival, little is known about the biological mechanisms supporting attachment representations in humans. Oxytocin plays a key role in attachment bond formation and maintenance in animals and thus could be expected to affect attachment representations in humans. To investigate this possibility, we administered 24 IU intranasal oxytocin to healthy male adults in a double-blind, placebo-controlled, crossover designed study and then assessed memories of childhood maternal care and closeness--two features of the attachment bond. We found that the effects of oxytocin were moderated by the attachment representations people possess, with less anxiously attached individuals remembering their mother as more caring and close after oxytocin (vs. placebo) but more anxiously attached individuals remembering their mother as less caring and close after oxytocin (vs. placebo). These data contrast with the popular notion that oxytocin has broad positive effects on social perception and are more consistent with the animal literature, which emphasizes oxytocin's role in encoding social memories and linking those memories to the reward value of the social stimulus.
Keywords: Administration, Intranasal; Adult; Animals; Cross-Over Studies; Double-Blind Method; Humans; Male; Maternal Behavior; Memory; Object Attachment; Oxytocin; Placebos; Social Perception

Prosocial Behavior and Altruism - C. D. Batson (The Handbook of Social Psychology, 1998)

Oxytocin shapes the neural circuitry of trust and trust adaptation in humans. - Baumgartner, Thomas; Heinrichs, Markus; Vonlanthen, Aline; Fischbacher, Urs; Fehr, Ernst (Neuron, 2008)
Trust and betrayal of trust are ubiquitous in human societies. Recent behavioral evidence shows that the neuropeptide oxytocin increases trust among humans, thus offering a unique chance of gaining a deeper understanding of the neural mechanisms underlying trust and the adaptation to breach of trust. We examined the neural circuitry of trusting behavior by combining the intranasal, double-blind, administration of oxytocin with fMRI. We find that subjects in the oxytocin group show no change in their trusting behavior after they learned that their trust had been breached several times while subjects receiving placebo decrease their trust. This difference in trust adaptation is associated with a specific reduction in activation in the amygdala, the midbrain regions, and the dorsal striatum in subjects receiving oxytocin, suggesting that neural systems mediating fear processing (amygdala and midbrain regions) and behavioral adaptations to feedback information (dorsal striatum) modulate oxytocin's effect on trust. These findings may help to develop deeper insights into mental disorders such as social phobia and autism, which are characterized by persistent fear or avoidance of social interactions.
Keywords: Adaptation, Psychological; Adult; Analysis of Variance; Brain; Brain Mapping; Double-Blind Method; Games, Experimental; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Male; Nerve Net; Oxygen; Oxytocin; Psychometrics; Questionnaires; Reaction Time; Risk-Taking; Trust

The Discipline Controversy Revisited - Baumrind, Diana (Family Relations, 1996)
Neither extreme position in the reincarnated discipline controversy offers parents an efficacious model of childrearing today, any more than it did 30 years ago when the authoritative model was developed as a viable alternative to both the conservative (authoritarian) model and the liberal (permissive) model. Each polarized model contains its germ of truth, but each demonizes the other. It is argued here that within a responsive and supportive parent-child relationship, prudent use of punishment is a necessary tool in the disciplinary encounter.

Children, Wired: For Better and for Worse - Bavelier, Daphne; Green, C. Shawn; Dye, Matthew W.G. (Neuron, 2010)

Three-year-old outcomes of a brief universal parenting intervention to prevent behaviour problems: randomised controlled trial. - Bayer, Jordana K; Hiscock, Harriet; Ukoumunne, Obioha C; Scalzo, Katherine; Wake, Melissa (Arch Dis Child, 2010)
OBJECTIVE: To determine whether a structured programme of parent anticipatory guidance 'Toddlers Without Tears,' delivered in universal primary care, can prevent preschool child behaviour problems. DESIGN: Cluster randomised controlled trial. SETTING/PARTICIPANTS: 40 primary care nursing centres (clusters) in metropolitan Melbourne, Australia. 733 English-speaking mothers of 6- to 7-month-old infants consecutively recruited from well-child appointments; 589 (80%) retained at age 3 years. INTERVENTION: Parenting programme from age 8 to 15 months, with two group sessions co-led by well-child providers and a parenting expert. The programme addressed normal behaviour development and offered strategies to increase desired and reduce unwanted behaviour. While 93% of intervention parents received at least some of the programme, only 49% completed all components. Control Usual primary care. MAIN OUTCOME MEASURES: Maternal report of child externalising behaviour (Child Behaviour Checklist), parenting (Parent Behaviour Checklist) and maternal mental health (Depression Anxiety Stress Scales) when children were aged 3 years. RESULTS: Behaviour scores in the intervention and control groups were similar (mean (SD)) 11.4 (7.1) versus 12.4 (7.6); adjusted mean difference -0.8, 95% CI -2.2 to 0.6, p=0.26). On the parenting subscale scores, intervention parents reported fewer unreasonable expectations of child development (37.3 (10.9) vs 39.9 (10.2), adjusted mean difference -3.1, 95% CI -4.9 to -1.4, p=0.001). The mean scores for harsh/abusive and nurturing parenting, and maternal mental health, were similar between the two groups. CONCLUSIONS: A brief universal parenting programme in primary care is insufficient to prevent development of preschool externalising problems. A new population trial targeting more intensive prevention to distressed parents with toddler behaviour problems is now under way, aiming to prevent externalising and internalising problems before school entry. TRIAL REGISTRATION NUMBER: ISRCTN77531789.
Keywords: Adult; Child Behavior; Child Behavior Disorders; Child, Preschool; Female; Follow-Up Studies; Humans; Infant; Male; Mental Health; Mothers; Parent-Child Relations; Parenting; Program Evaluation; Socioeconomic Factors; Treatment Outcome

Parenting in a pandemic - BBC (BBC Parentland, 2020)
How do you keep your family healthy and happy in the coronavirus lockdown? Mercy and Linda put your questions – from giving birth in a pandemic to how to explain Covid-19 to kids - to two experts: Dr Pia Rebello Britto, UNICEF’s Chief of Early Childhood Development, and Dr Steve Wall, Senior Director of Newborn Health at Save the Children.
Keywords: COVID-19; pandemic; Parenting

Toxic Stress in Children - Beal, Judy A. (MCN, The American Journal of Maternal/Child Nursing, 2019)

Appetitive motivation predicts the neural response to facial signals of aggression. - Beaver, John D; Lawrence, Andrew D; Passamonti, Luca; Calder, Andrew J (J Neurosci, 2008)
The "behavioral approach system" (BAS) (Gray, 1990) has been primarily associated with reward processing and positive affect. However, additional research has demonstrated that the BAS plays a role in aggressive behavior, heightened experience of anger, and increased attention to facial signals of aggression. Using functional magnetic resonance imaging, we show that variation in the BAS trait in healthy participants predicts activation in neural regions implicated in aggression when participants view facial signals of aggression in others. Increased BAS drive (appetitive motivation) was associated with increased amygdala activation and decreased ventral anterior cingulate and ventral striatal activation to facial signals of aggression, relative to sad and neutral expressions. In contrast, increased behavioral inhibition was associated with increased activation in the dorsal anterior cingulate, a region involved in the perception of fear and threat. Our results provide the first demonstration that appetitive motivation constitutes a significant factor governing the function of neural regions implicated in aggression, and have implications for understanding clinical disorders of aggression.
Keywords: Adolescent; Adult; Aggression; Facial Expression; Female; Humans; Male; Motivation; Nerve Net; Photic Stimulation; Reward

Impact of an educational intervention on caregivers' beliefs about infant crying and knowledge of shaken baby syndrome. - Bechtel, Kirsten; Le, Kim; Martin, Kimberly D; Shah, Niyati; Leventhal, John M; Colson, Eve (Acad Pediatr, 2011)
OBJECTIVE: Shaken baby syndrome (SBS) is the leading cause of traumatic infant death. We examined whether the message about not shaking an infant should be included in the newborn anticipatory guidance provided by pediatric residents. The aim of this study was to determine the impact of an educational intervention (Take 5 Safety Plan for Crying) delivered by pediatric residents at newborn hospital discharge on beliefs about infant crying and knowledge of SBS among caregivers of young infants being treated in an urban primary care center. METHODS: Structured interviews were done in one convenience sample of caregivers before (historical control group) and in a second set of different caregivers after (intervention group) an educational intervention was implemented at hospital discharge. Logistic regression was used to calculate adjusted associations between the intervention and caregivers' beliefs/knowledge. RESULTS: One hundred ten caregivers were in the historical control group and 112 in the intervention group. The intervention group had more mothers and the infants were younger. Controlling for these differences, intervention group caregivers were more likely to state they would take a break if frustrated with infant crying (OR 3.10, 95% CI, 1.62-5.93), were more likely to state frustration caused infant shaking (OR 2.21, 95% CI, 1.20-4.20), and to state their knowledge of SBS was from hospital staff (OR 3.39, 95% CI, 1.61-4.20). CONCLUSION: This targeted postpartum intervention incorporated into newborn anticipatory guidance can influence caregivers' beliefs about infant crying and knowledge of SBS.
Keywords: Academic Medical Centers; Adult; Caregivers; Child Abuse; Connecticut; Crying; Guideline Adherence; Health Knowledge, Attitudes, Practice; Humans; Infant Behavior; Infant, Newborn; Interviews as Topic; Logistic Models; Male; Parents; Patient Education as Topic; Pediatrics; Shaken Baby Syndrome; Young Adult

Familiarity promotes the blurring of self and other in the neural representation of threat. - Beckes, Lane; Coan, James A; Hasselmo, Karen (Soc Cogn Affect Neurosci, 2013)
Neurobiological investigations of empathy often support an embodied simulation account. Using functional magnetic resonance imaging (fMRI), we monitored statistical associations between brain activations indicating self-focused threat to those indicating threats to a familiar friend or an unfamiliar stranger. Results in regions such as the anterior insula, putamen and supramarginal gyrus indicate that self-focused threat activations are robustly correlated with friend-focused threat activations but not stranger-focused threat activations. These results suggest that one of the defining features of human social bonding may be increasing levels of overlap between neural representations of self and other. This article presents a novel and important methodological approach to fMRI empathy studies, which informs how differences in brain activation can be detected in such studies and how covariate approaches can provide novel and important information regarding the brain and empathy.
Keywords: Adult; Brain; Brain Mapping; Empathy; Female; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Male; Oxygen; Photic Stimulation; Questionnaires; Recognition (Psychology); Young Adult

Nutritional supplementation in girls influences the growth of their children: prospective study in Guatemala. - Behrman, Jere R; Calderon, Maria C; Preston, Samuel H; Hoddinott, John; Martorell, Reynaldo; Stein, Aryeh D (Am J Clin Nutr, 2009)
BACKGROUND: Better early childhood nutrition improves schooling, adult health, skills, and wages, but there is little evidence regarding its effect on the next generation. OBJECTIVE: We assessed whether nutritional supplementation in children aged <7 to 15 y affected their children's nutritional status 29-38 y later. DESIGN: We studied 791 children 0-12 y who were offspring of 401 Guatemalan women who had participated as children in a nutritional supplementation trial in which 2 villages were randomly assigned to receive a nutritious supplement (atole) and 2 were assigned to receive a less-nutritious supplement (fresco). We compared anthropometric indicators between the offspring of mothers exposed to atole and the offspring of mothers exposed to fresco. RESULTS: Compared with the offspring of women exposed to fresco, the offspring of women exposed to atole had a 116-g (95% CI: 17, 215 g) higher birth weight, were 1.3-cm (0.4, 2.2 cm) taller, had a 0.6-cm (0.4, 0.9 cm) greater head circumference, had a 0.26 (0.09, 0.43) greater height-for-age z score, and had a 0.20 (0.02, 0.39) greater weight-for-age z score. The association for height differed by offspring sex. Sons of women exposed to atole were 2.0-cm (95% CI: 1.0, 3.1 cm) taller than the sons of women exposed to fresco. Supplementation was not associated with 6 other offspring anthropometric indicators that reflect measures of adiposity. Supplementation in boys did not affect their children's anthropometric measures. CONCLUSION: Nutritional supplementation in girls is associated with substantial increases in their offsprings' (more for sons) birth weight, height, head circumference, height-for-age z score, and weight-for-age z score.
Keywords: Adolescent; Adult; Body Height; Body Size; Body Weight; Child; Dietary Supplements; Female; Growth; Guatemala; Humans; Intelligence; Male; Middle Aged; Nutritional Status; Placebos; Pregnancy; Skinfold Thickness

Population Quantity, Quality and Mobility - Behrman, J.R.; Kohler, H. P. (Towards a Better Global Economy: Policy Implications for Citizens Worldwide in the 21st Century, 2014)

The International Food Policy Research Institute (IFPRI) and the Mexican PROGRESA Anti-Poverty and Human Resource Investment Conditional Cash - Behrman, J. R. (World DevelopmentWorld DevelopmentWorld Development, 2010)
The Mexican PROGRESA/Oportunidades anti-poverty and human resource conditional cash transfer (CCT) program has influenced considerably policies in many countries. The Mexican government engaged the International Food Policy Research Institute (IFPRI) to undertake the initial evaluation of PROGRESA/Oportunidades. This paper considers: (1) Was the PROGRESA program design influenced by prior IFPRI research? (2) Why was IFPRI chosen to undertake the initial impact evaluation of PROGRESA? (3) How did the IFPRI evaluation of PROGRESA contribute to the program? (4) Were there spillovers of the IFPRI evaluation of PROGRESA? It concludes that estimated benefit cost ratios of IFPRI's evaluation of PROGESA considerably exceed one. (C) 2010 Elsevier Ltd. All rights reserved.
Sp. Iss. SI 670ec Times Cited:2 Cited References Count:20
Keywords: conditional cash transfers; ifpri; latin america; mexico; progresa/oportunidades; project evaluation

Methodologies to Evaluate Early Childhood Development Programs - Behrman, J.R.; Glewwe, P.; Miguel, E. (The World Bank, 2007)
Keywords: Child Development; early childhood development; methodologies

Teaching Contested Narratives - Bekerman, Z.; Zembylas, M. (Cambridge University Press, 2014)

Converging on child mental health - toward shared global action for child development - Belkin, G.; Wissow, L.; Lund, C.; Aber, L.; Bhutta, Z.; Black, M.; Kieling, C.; McGregor, S.; Rahman, A.; Servili, C.; Walker, S.; Yoshikawa, H. (Glob Ment Health (Camb), 2017)
We are a group of researchers and clinicians with collective experience in child survival, nutrition, cognitive and social development, and treatment of common mental conditions. We join together to welcome an expanded definition of child development to guide global approaches to child health and overall social development. We call for resolve to integrate maternal and child mental health with child health, nutrition, and development services and policies, and see this as fundamental to the health and sustainable development of societies. We suggest specific steps toward achieving this objective, with associated global organizational and resource commitments. In particular, we call for a Global Planning Summit to establish a much needed Global Alliance for Child Development and Mental Health in all Policies.
Belkin, G Wissow, L Lund, C Aber, L Bhutta, Z Black, M Kieling, C McGregor, S Rahman, A Servili, C Walker, S Yoshikawa, H eng 001/World Health Organization/International England 2017/12/13 06:00 Glob Ment Health (Camb). 2017 Oct 19;4:e20. doi: 10.1017/gmh.2017.13. eCollection 2017.
Keywords: Child Development; child mental health; Global Action; governance; Mental Health; prevention; Promotion; Public Health approach; Quality Improvement; Social Determinants of health; Social Emotional Development; systems-thinking; Task-shifting

Building, Imagining, and Experiencing Europe: Institutions and Identities in the European Union - I. Bellier; T. Wilson (An Anthropology of the European Union, 2000)

The intergenerational transmission of parenting: introduction to the special section - Belsky, J.; Conger, R.; Capaldi, D. M. (Dev PsycholDev Psychol, 2009)
Long-standing interest in the intergenerational transmission of parenting has stimulated work focused on child maltreatment, harsh parenting, and warm-supportive rearing. In addition to documenting significant, even if modest, continuity in parenting across generations, research in this area has addressed questions of mediation and moderation. This special section extends work in this general area, with 2 studies further chronicling intergenerational transmission and 3 further illuminating mechanisms through which parenting in 1 generation is repeated in a subsequent generation. Lacking, however, is high-quality work highlighting the conditions under which parenting is not transmitted across generations. (PsycINFO Database Record (c) 2009 APA, all rights reserved).
1939-0599 Belsky, Jay Conger, Rand Capaldi, Deborah M R01 HD051746/HD/NICHD NIH HHS/United States R01 HD051746-03/HD/NICHD NIH HHS/United States R01 HD051746-02/HD/NICHD NIH HHS/United States R01 HD051746-04/HD/NICHD NIH HHS/United States R01 HD051746-01/HD/NICHD NIH HHS/United States Introductory Journal Article United States Dev Psychol. 2009 Sep;45(5):1201-4. doi: 10.1037/a0016245.
Keywords: *Intergenerational Relations; *Parent-Child Relations; *Parenting; Adolescent; Adult; Child; Child Behavior; Child, Preschool; Female; Humans; Male; Negotiating; Young Adult

War, trauma and children's development: Observations from a modern evolutionary perspective - Belsky, J. (International Journal of Behavioral DevelopmentInternational Journal of Behavioral DevelopmentInternational Journal of Behavioral Development, 2008)
Lethal intergroup conflict has been part of the human experience ever since our species emerged on the African savannah. Modern evolutionary thinking suggests that children's development could have evolved a variety of responses to it, some of which are highlighted upon considering, from the field of behavioural ecology, life-history theory and, derived from it, Belsky, Steinberg and Draper's ( 1991) evolutionary theory of socialization. This speculative essay examines the implications of such thinking, specifically with regard to insecure attachment, anxiety, depression, aggression, pubertal and sexual development, as well as mating and parenting. Considered, too, are issues of intergenerational transmission and variation in developmental reactivity to exposure to deadly political violence of the ethnic-cleansing variety in childhood.
332wr Times Cited:23 Cited References Count:115
Keywords: Aggression; aggressive-behavior; Anxiety; behavior problems; Depression; disorganized attachment; evolution; families; holocaust survivors; infant attachment; marital conflict; Parenting; political violence; psychological adjustment; reproductive strategy; stress

Variation in Susceptibility to Environmental Influence: An Evolutionary Argument - Belsky, Jay (Psychological Inquiry, 1997)

Genetics and the geography of health, behaviour and attainment - Belsky, Daniel W.; Caspi, Avshalom; Arseneault, Louise; Corcoran, David L.; Domingue, Benjamin W.; Harris, Kathleen Mullan; Houts, Renate M.; Mill, Jonathan S.; Moffitt, Terrie E.; Prinz, Joseph; Sugden, Karen; Wertz, Jasmin; et al. (Nature Human Behaviour, 2019)
Keywords: genetics; geography

Childhood experience, interpersonal development, and reproductive strategy: and evolutionary theory of socialization. - Belsky, J; Steinberg, L; Draper, P (Child Dev, 1991)
The concept of "reproductive strategy" drawn from the field of behavioral ecology is applied to the study of childhood experience and interpersonal development in order to develop an evolutionary theory of socialization. The theory is presented in terms of 2 divergent development pathways considered to promote reproductive success in the contexts in which they have arisen. One is characterized, in childhood, by a stressful rearing environment and the development of insecure attachments to parents and subsequent behavior problems; in adolescence by early pubertal development and precocious sexuality; and, in adulthood, by unstable pair bonds and limited investment in child rearing, whereas the other is characterized by the opposite. The relation between this theory and prevailing theories of socialization, specifically, attachment, social-learning, and discrete-emotions theory, is considered and research consistent with our evolutionary theory is reviewed. Finally, directions for future research are discussed.
Keywords: Adult; Child; Child Development; Child Rearing; Child, Preschool; Humans; Infant; Models, Psychological; Parenting; Reproduction; Sociology

Effects of Sure Start local programmes on children and families: early findings from a quasi-experimental, cross sectional study. - Belsky, Jay; Melhuish, Edward; Barnes, Jacqueline; Leyland, Alastair H; Romaniuk, Helena (BMJ, 2006)
OBJECTIVE: To evaluate the effects of Sure Start local programmes (SSLPs) on children and their families. To assess whether variations in the effectiveness of SSLPs are due to differences in implementation. DESIGN: Quasi-experimental cross sectional study using interviews with mothers and cognitive assessment of children aged 36 months who speak English. SETTING: Socially deprived communities in England: 150 communities with ongoing SSLPs and 50 comparison communities. PARTICIPANTS: Mothers of 12,575 children aged 9 months and 3927 children aged 36 months in SSLP areas; mothers of 1509 children aged 9 months and 1101 children aged 36 months in comparison communities. OUTCOME MEASURES: Mothers' reports of community services and local area, family functioning and parenting skills, child health and development, and verbal ability at 36 months. RESULTS: Differences between SSLP areas and comparison areas were limited, small, and varied by degree of social deprivation. SSLPs had beneficial effects on non-teenage mothers (better parenting, better social functioning in children) and adverse effects on children of teenage mothers (poorer social functioning) and children of single parents or parents who did not work (lower verbal ability). SSLPs led by health services were slightly more effective than other SSLPs. CONCLUSION: SSLPs seem to benefit relatively less socially deprived parents (who have greater personal resources) and their children but seem to have an adverse effect on the most disadvantaged children. Programmes led by health services seem to be more effective than programmes led by other agencies.
Keywords: Child Development; Child Health Services; Child Welfare; Child, Preschool; Community Health Services; Cross-Sectional Studies; Early Intervention (Education); England; Family Health; Humans; Infant; Language Development; Mothers; Phonetics; Poverty Areas; Program Evaluation

Beyond risk, resilience, and dysregulation: phenotypic plasticity and human development. - Belsky, Jay; Pluess, Michael (Dev Psychopathol, 2013)
We provide a theoretical and empirical basis for the claim that individual differences exist in developmental plasticity and that phenotypic plasticity should be a subject of study in its own right. To advance this argument, we begin by highlighting challenges that evolutionary thinking poses for a science of development and psychopathology, including for the diathesis-stress framework that has (fruitfully) guided so much empirical inquiry on developmental risk, resilience, and dysregulation. With this foundation laid, we raise a series of issues that the differential-susceptibility hypothesis calls attention to, while highlighting findings that have emerged over just the past several years and are pertinent to some of the questions posed. Even though it is clear that this new perspective on Person × Environment interaction is stimulating research and influencing how hypotheses are framed and data interpreted, a great many topics remain that need empirical attention. Our intention is to encourage students of development and psychopathology to treat phenotypic plasticity as an individual-difference construct while exploring unknowns in the differential-susceptibility equation.
Keywords: Biological Evolution; Humans; Individuality; Mental Disorders; Phenotype; Resilience, Psychological; Risk Factors; Social Environment

For better and for worse: Differential susceptibility to environmental influences - Belsky, J.; Bakermans-Kranenburg, M. J.; van IJzendoorn, M. H. (Current Directions in Psychological ScienceCurrent Directions in Psychological ScienceCurrent Directions in Psychological Science, 2007)
Evidence that adverse rearing environments exert negative effects particularly on children presumed "vulnerable" for temperamental or genetic reasons may actually reflect something else: heightened susceptibility to the negative effects of risky environments and to the beneficial effects of supportive environments. Building on Belsky's (1997, 2005) evolutionary-inspired proposition that some children are more affected-both for better and for worse-by their rearing experiences than are others, we consider recent work on child vulnerability, including that involving measured genes, along with evidence showing that putatively vulnerable children are especially susceptible to both positive and negative rearing effects. We also consider methodological issues and unanswered questions in the differential-susceptibility equation.
234te Times Cited:344 Cited References Count:25
Keywords: attachment; Behavior; childhood; differential susceptibility; Gene-Environment Interaction; infants; Parenting; sensitivity; Socialization; Temperament

An assessment of antenatal care among Syrian refugees in Lebanon - Benage, M.; Greenough, P. G.; Vinck, P.; Omeira, N.; Pham, P. (Confl Health, 2015)
BACKGROUND: After more than three years of violence in Syria, Lebanon hosts over one million Syrian refugees creating significant public health concerns. Antenatal care delivery to tens of thousands of pregnant Syrian refugee women is critical to preventing maternal and fetal mortality but is not well characterized given the multiple factors obtaining health data in a displaced population. This study describes antenatal care access, the scope of existing antenatal care, and antenatal and family planning behaviors and practice among pregnant Syrian refugees in various living conditions and multiple geographic areas of Lebanon. METHODS: A field-based survey was conducted between July and October 2013 in 14 main geographic sites of refugee concentration. The assessment evaluated antenatal services among a non-randomized sample of 420 self-identified pregnant Syrian refugee women that included demographics, gestational age, living accommodation, antenatal care coverage, antenatal care content, antenatal health behaviors, antenatal health literacy, and family planning perception and practices. RESULTS: In total, 420 pregnant Syrian refugees living in Lebanon completed the survey. Of these, 82.9% (348) received some antenatal care. Of those with at least one antenatal visit, 222 (63.8%) received care attended by a skilled professional three or more times, 111 (31.9%) 1-2 times, and 15 (4.3%) had never received skilled antenatal care. We assessed antenatal care content defined by blood pressure measurement, and urine and blood sample analyses. Of those who had received any antenatal care, only 31.2% received all three interventions, 18.2% received two out of three, 32.1% received one out of three, and 18.5% received no interventions. Only (41.2%) had an adequate diet of vitamins, minerals, and folic acid. Access, content and health behaviors varied by gestational age, type of accommodation and location in Lebanon. CONCLUSIONS: Standards of antenatal care are not being met for pregnant Syrian refugee women in Lebanon. This descriptive analysis of relative frequencies suggests reproductive health providers should focus attention on increasing antenatal care visits, particularly to third trimester and late gestational age patients and to those in less secure sheltering arrangements. With this approach they can improve care content by providing early testing and interventions per accepted guidelines designed to improve pregnancy outcomes.
Benage, Matthew Greenough, P Gregg Vinck, Patrick Omeira, Nada Pham, Phuong eng England 2015/03/06 06:00 Confl Health. 2015 Feb 26;9:8. doi: 10.1186/s13031-015-0035-8. eCollection 2015.
Keywords: Antenatal; Contraception; Family planning; Lebanon; Refugee; Reproductive health; Syria

Gene variants associated with antisocial behaviour: a latent variable approach - Bentley, M. J.; Lin, H.; Fernandez, T. V.; Lee, M.; Yrigollen, C. M.; Pakstis, A. J.; Katsovich, L.; Olds, D. L.; Grigorenko, E. L.; Leckman, J. F. (J Child Psychol Psychiatry, 2013)
OBJECTIVE: The aim of this study was to determine if a latent variable approach might be useful in identifying shared variance across genetic risk alleles that is associated with antisocial behaviour at age 15 years. METHODS: Using a conventional latent variable approach, we derived an antisocial phenotype in 328 adolescents utilizing data from a 15-year follow-up of a randomized trial of a prenatal and infancy nurse-home visitation programme in Elmira, New York. We then investigated, via a novel latent variable approach, 450 informative genetic polymorphisms in 71 genes previously associated with antisocial behaviour, drug use, affiliative behaviours and stress response in 241 consenting individuals for whom DNA was available. Haplotype and Pathway analyses were also performed. RESULTS: Eight single-nucleotide polymorphisms (SNPs) from eight genes contributed to the latent genetic variable that in turn accounted for 16.0% of the variance within the latent antisocial phenotype. The number of risk alleles was linearly related to the latent antisocial variable scores. Haplotypes that included the putative risk alleles for all eight genes were also associated with higher latent antisocial variable scores. In addition, 33 SNPs from 63 of the remaining genes were also significant when added to the final model. Many of these genes interact on a molecular level, forming molecular networks. The results support a role for genes related to dopamine, norepinephrine, serotonin, glutamate, opioid and cholinergic signalling as well as stress response pathways in mediating susceptibility to antisocial behaviour. CONCLUSIONS: This preliminary study supports use of relevant behavioural indicators and latent variable approaches to study the potential 'co-action' of gene variants associated with antisocial behaviour. It also underscores the cumulative relevance of common genetic variants for understanding the aetiology of complex behaviour. If replicated in future studies, this approach may allow the identification of a 'shared' variance across genetic risk alleles associated with complex neuropsychiatric dimensional phenotypes using relatively small numbers of well-characterized research participants.
Bentley, Mary Jane Lin, Haiqun Fernandez, Thomas V Lee, Maria Yrigollen, Carolyn M Pakstis, Andrew J Katsovich, Liliya Olds, David L Grigorenko, Elena L Leckman, James F eng R25 MH077823/MH/NIMH NIH HHS/ R01DA021624/DA/NIDA NIH HHS/ T32MH018268/MH/NIMH NIH HHS/ T32 MH018268/MH/NIMH NIH HHS/ R01DA216240/DA/NIDA NIH HHS/ R01 DA021624/DA/NIDA NIH HHS/ Research Support, N.I.H., Extramural England 2013/07/05 06:00 J Child Psychol Psychiatry. 2013 Oct;54(10):1074-85. doi: 10.1111/jcpp.12109. Epub 2013 Jul 3.
Keywords: Adolescent; Adolescent Behavior/*physiology; Antisocial behaviour; Antisocial Personality Disorder/*genetics; co-action of gene variants; Female; Follow-Up Studies; Genetic Predisposition to Disease/*genetics; Genotype; Genotyping Techniques; Humans; latent variable analysis; Male; Models, Genetic; Phenotype; Pilot Projects; Polymorphism, Single Nucleotide/*genetics; Randomized Controlled Trials as Topic; Reaction Time/genetics; shared variance

Resolving International Conflicts: The Theory and Practice of Mediation - Bercovitch, J. (Lynne Rienner Publishers, 1996)

Genetic syndromes caused by mutations in epigenetic genes. - Berdasco, María; Esteller, Manel (Hum Genet, 2013)
The orchestrated organization of epigenetic factors that control chromatin dynamism, including DNA methylation, histone marks, non-coding RNAs (ncRNAs) and chromatin-remodeling proteins, is essential for the proper function of tissue homeostasis, cell identity and development. Indeed, deregulation of epigenetic profiles has been described in several human pathologies, including complex diseases (such as cancer, cardiovascular and neurological diseases), metabolic pathologies (type 2 diabetes and obesity) and imprinting disorders. Over the last decade it has become increasingly clear that mutations of genes involved in epigenetic mechanism, such as DNA methyltransferases, methyl-binding domain proteins, histone deacetylases, histone methylases and members of the SWI/SNF family of chromatin remodelers are linked to human disorders, including Immunodeficiency Centromeric instability Facial syndrome 1, Rett syndrome, Rubinstein-Taybi syndrome, Sotos syndrome or alpha-thalassemia/mental retardation X-linked syndrome, among others. As new members of the epigenetic machinery are described, the number of human syndromes associated with epigenetic alterations increases. As recent examples, mutations of histone demethylases and members of the non-coding RNA machinery have recently been associated with Kabuki syndrome, Claes-Jensen X-linked mental retardation syndrome and Goiter syndrome. In this review, we describe the variety of germline mutations of epigenetic modifiers that are known to be associated with human disorders, and discuss the therapeutic potential of epigenetic drugs as palliative care strategies in the treatment of such disorders.
Keywords: Animals; Chromatin Assembly and Disassembly; DNA Methylation; Epigenesis, Genetic; Genetic Diseases, Inborn; Germ-Line Mutation; Humans; Syndrome

The science of early adversity: is there a role for large institutions in the care of vulnerable children? - Berens, A. E.; Nelson, C. A. (Lancet, 2015)
It has been more than 80 years since researchers in child psychiatry first documented developmental delays among children separated from family environments and placed in orphanages or other institutions. Informed by such findings, global conventions, including the 1989 UN Convention on the Rights of the Child, assert a child's right to care within a family-like environment that offers individualised support. Nevertheless, an estimated 8 million children are presently growing up in congregate care institutions. Common reasons for institutionalisation include orphaning, abandonment due to poverty, abuse in families of origin, disability, and mental illness. Although the practice remains widespread, a robust body of scientific work suggests that institutionalisation in early childhood can incur developmental damage across diverse domains. Specific deficits have been documented in areas including physical growth, cognitive function, neurodevelopment, and social-psychological health. Effects seem most pronounced when children have least access to individualised caregiving, and when deprivation coincides with early developmental sensitive periods. Offering hope, early interventions that place institutionalised children into families have afforded substantial recovery. The strength of scientific evidence imparts urgency to efforts to achieve deinstitutionalisation in global child protection sectors, and to intervene early for individual children experiencing deprivation.
Berens, Anne E Nelson, Charles A eng MH091363/MH/NIMH NIH HHS/ Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Review England 2015/02/02 06:00 Lancet. 2015 Jul 25;386(9991):388-98. doi: 10.1016/S0140-6736(14)61131-4. Epub 2015 Jan 29.
Keywords: *Child Welfare; Brain/growth & development; Child; Child Development; Child, Institutionalized/*psychology; Deinstitutionalization; Developmental Disabilities/etiology/*prevention & control; Humans; Institutionalization; Orphanages; Social Support

Maternal stress during pregnancy predicts cognitive ability and fearfulness in infancy. - Bergman, Kristin; Sarkar, Pampa; O'Connor, Thomas G; Modi, Neena; Glover, Vivette (J Am Acad Child Adolesc Psychiatry, 2007)
OBJECTIVE: To examine the effects of prenatal stress on cognition and behavioral fearfulness in infants. METHOD: Mothers were recruited at amniocentesis at Queen Charlotte's and Chelsea Hospital, London, between 2001 and 2005, and recalled when their children were 14 to 19 months to assess cognitive development using the Bayley Scales and fearfulness using the Lab-TAB. Measures of prenatal and postnatal life events and current psychological state were collected at the postnatal visit. RESULTS: Prenatal stress predicted both mental development (rs = -0.39, n = 123 p < .0001) and observed fearfulness (rs = 0.33, n = 106, p < .001); the magnitude of effect was essentially unchanged after covarying postnatal stressors, maternal education and psychological state, exposures to medications and substances during pregnancy, and birth outcomes. Prenatal stress accounted for 17% of the variance in cognitive ability and 10% of the variance in observed fearfulness. The correlation between mental development and fearfulness was minimal (r = -0.06, not significant). Prenatal partner relationship strain accounted for 73.5% and 75.0% of the prenatal stress related variance on infant cognitive and fearfulness scores, respectively. CONCLUSIONS: These findings strengthen previous research that suggests that fetal programming can be important for neurodevelopmental and psychiatric outcomes. They imply that the mechanisms by which mental development and fearfulness are affected are different and that prenatal stress due to relationship strain may warrant particular attention.
Keywords: Adult; Child, Preschool; Cognition Disorders; Fear; Female; Humans; Infant; Life Change Events; Mothers; Phobic Disorders; Predictive Value of Tests; Pregnancy; Pregnancy Complications; Questionnaires; Stress, Psychological

Enhancing attachment organization among maltreated children: results of a randomized clinical trial. - Bernard, Kristin; Dozier, Mary; Bick, Johanna; Lewis-Morrarty, Erin; Lindhiem, Oliver; Carlson, Elizabeth (Child Dev, 2012)
Young children who have experienced early adversity are at risk for developing disorganized attachments. The efficacy of Attachment and Biobehavioral Catch-up (ABC), an intervention targeting nurturing care among parents identified as being at risk for neglecting their young children, was evaluated through a randomized clinical trial. Attachment quality was assessed in the Strange Situation for 120 children between 11.7 and 31.9 months of age (M = 19.1, SD = 5.5). Children in the ABC intervention showed significantly lower rates of disorganized attachment (32%) and higher rates of secure attachment (52%) relative to the control intervention (57% and 33%, respectively). These results support the efficacy of the ABC intervention in enhancing attachment quality among parents at high risk for maltreatment.
Keywords: Adolescent; Adult; Child Abuse; Child Welfare; Child, Preschool; Education; Female; Follow-Up Studies; Humans; Infant; Life Change Events; Male; Parent-Child Relations; Reactive Attachment Disorder; Young Adult

Early Childhood Matters Magazine - BernardvanLeerFoundation (Bernard van Leer Foundation, 2018)

Early Childhood Matters | Special Issue "A good start: Advances in early childhood development" - BernardvanLeerFoundation (Bernard van Leer Foundation, 2015)
Keywords: early childhood care and education

Young children and families in crisis and displacement: Selected articles from our Early Childhood Matters publication - BernardvanLeerFoundation (Bernard van Leer Foundation, 2019)
Keywords: forced displacement; refugee and migrant children; refugee families

Parochial altruism in humans. - Bernhard, Helen; Fischbacher, Urs; Fehr, Ernst (Nature, 2006)
Social norms and the associated altruistic behaviours are decisive for the evolution of human cooperation and the maintenance of social order, and they affect family life, politics and economic interactions. However, as altruistic norm compliance and norm enforcement often emerge in the context of inter-group conflicts, they are likely to be shaped by parochialism--a preference for favouring the members of one's ethnic, racial or language group. We have conducted punishment experiments, which allow 'impartial' observers to punish norm violators, with indigenous groups in Papua New Guinea. Here we show that these experiments confirm the prediction of parochialism. We found that punishers protect ingroup victims--who suffer from a norm violation--much more than they do outgroup victims, regardless of the norm violator's group affiliation. Norm violators also expect that punishers will be lenient if the latter belong to their social group. As a consequence, norm violations occur more often if the punisher and the norm violator belong to the same group. Our results are puzzling for evolutionary multi-level selection theories based on selective group extinction as well as for theories of individual selection; they also indicate the need to explicitly examine the interactions between individuals stemming from different groups in evolutionary models.
Keywords: Adolescent; Adult; Aged; Altruism; Biological Evolution; Game Theory; Humans; Middle Aged; Models, Biological; Papua New Guinea; Punishment

South African Child Gauge 2013 - Berry, L.; University of Cape Town. Children's Institute (Children's Institute, University of Cape Town, 2013)

Association between economic growth and early childhood nutrition - Bershteyn, A.; Lyons, H. M.; Sivam, D.; Myhrvold, N. P. (Lancet Glob Health, 2015)
Bershteyn, Anna Lyons, Hil M Sivam, Dhileep Myhrvold, Nathan P eng Comment Letter England 2015/01/27 06:00 Lancet Glob Health. 2015 Feb;3(2):e79-80. doi: 10.1016/S2214-109X(14)70382-1.
Keywords: *Body Height; *Body Weight; *Developing Countries; *Economic Development; *Gross Domestic Product; *Income; Child Nutrition Disorders/*economics; Female; Humans; Male

Early Childhood Education and Care Physical Environment and Child Development: State of the art and Reflections on Future Orientations and Methodologies - Berti, Sara; Cigala, Ada; Sharmahd, Nima (Educational Psychology Review, 2019)
Keywords: Adults’ perceptions; Child Development; Children’s perceptions; Early childhood education and care services; Physical environment

Psychosocial adjustment and mental health in former child soldiers--systematic review of the literature and recommendations for future research - Betancourt, T. S.; Borisova, I.; Williams, T. P.; Meyers-Ohki, S. E.; Rubin-Smith, J. E.; Annan, J.; Kohrt, B. A. (J Child Psychol Psychiatry, 2013)
AIMS AND SCOPE: This article reviews the available quantitative research on psychosocial adjustment and mental health among children (age <18 years) associated with armed forces and armed groups (CAAFAG)--commonly referred to as child soldiers. METHODS: PRISMA standards for systematic reviews were used to search PubMed, PsycInfo, JSTOR, and Sociological Abstracts in February 2012 for all articles on former child soldiers and CAAFAG. Twenty-one quantitative studies from 10 countries were analyzed for author, year of publication, journal, objectives, design, selection population, setting, instruments, prevalence estimates, and associations with war experiences. Opinion pieces, editorials, and qualitative studies were deemed beyond the scope of this study. Quality of evidence was rated according to the systematic assessment of quality in observational research (SAQOR). FINDINGS: According to SAQOR criteria, among the available published studies, eight studies were of high quality, four were of moderate quality, and the remaining nine were of low quality. Common limitations were lack of validated mental health measures, unclear methodology including undefined sampling approaches, and failure to report missing data. Only five studies included a comparison group of youth not involved with armed forces/armed groups, and only five studies assessed mental health at more than one point in time. Across studies, a number of risk and protective factors were associated with postconflict psychosocial adjustment and social reintegration in CAAFAG. Abduction, age of conscription, exposure to violence, gender, and community stigma were associated with increased internalizing and externalizing mental health problems. Family acceptance, social support, and educational/economic opportunities were associated with improved psychosocial adjustment. CONCLUSIONS: Research on the social reintegration and psychosocial adjustment of former child soldiers is nascent. A number of gaps in the available literature warrant future study. Recommendations to bolster the evidence base on psychosocial adjustment in former child soldiers and other war-affected youth include more studies comprising longitudinal study designs, and validated cross-cultural instruments for assessing mental health, as well as more integrated community-based approaches to study design and research monitoring.
Betancourt, Theresa S Borisova, Ivelina Williams, Timothy P Meyers-Ohki, Sarah E Rubin-Smith, Julia E Annan, Jeannie Kohrt, Brandon A eng K01 MH077246/MH/NIMH NIH HHS/ P60 MD002261/MD/NIMHD NIH HHS/ 1K01MH077246-01A2/MH/NIMH NIH HHS/ Research Support, N.I.H., Extramural Review England 2012/10/16 06:00 J Child Psychol Psychiatry. 2013 Jan;54(1):17-36. doi: 10.1111/j.1469-7610.2012.02620.x. Epub 2012 Oct 12.
Keywords: *Mental Health; *Resilience, Psychological; *Social Adjustment; *Warfare; Adolescent; Child; Female; Humans; Male; Military Personnel/*psychology; Prevalence; Risk Factors; Social Support; Stress Disorders, Post-Traumatic/epidemiology/etiology/rehabilitation; Violence/*psychology

Optimizing an Era of Global Mental Health Implementation Science - Betancourt, T. S.; Chambers, D. A. (JAMA Psychiatry, 2016)
Betancourt, Theresa S Chambers, David A eng Review 2016/01/01 06:00 JAMA Psychiatry. 2016 Feb;73(2):99-100. doi: 10.1001/jamapsychiatry.2015.2705.
Keywords: *Global Health; *Health Services Research; *Mental Health Services; Humans

Identifying Priorities for Mental Health Interventions in War-Affected Youth: A Longitudinal Study - Betancourt, T. S.; Gilman, S. E.; Brennan, R. T.; Zahn, I.; VanderWeele, T. J. (Pediatrics, 2015)
BACKGROUND: War-affected youth often suffer from multiple co-occurring mental health problems. These youth often live in low-resource settings where it may be infeasible to provide mental health services that simultaneously address all of these co-occurring mental health issues. It is therefore important to identify the areas where targeted interventions would do the most good. METHODS: This analysis uses observational data from 3 waves of a longitudinal study on mental health in a sample of 529 war-affected youth (24.2% female; ages 10-17 at T1, 2002) in Sierra Leone. We regressed 4 mental health outcomes at T3 (2008) on internalizing (depression/anxiety) and externalizing (hostility/aggression) problems and prosocial attitudes/behaviors and community variables at T2 (2004) controlling for demographics, war exposures, and previous mental health scores at T1, allowing us to assess the relative impact of potential mental health intervention targets in shaping mental health outcomes over time. RESULTS: Controlling for baseline covariates at T1 and all other exposures/potential intervention targets at T2, we observed a significant association between internalizing problems at T2 and 3 of the 4 outcomes at T3: internalizing (beta = 0.27, 95% confidence interval [CI]: 0.11-0.42), prosocial attitudes (beta = -0.20, 95% CI: -0.33 to -0.07) and posttraumatic stress symptoms (beta = 0.22, 95% CI: 0.02-0.43). No other potential intervention target had similar substantial effects. CONCLUSIONS: Reductions in internalizing may have multiple benefits for other mental health outcomes at a later point in time, even after controlling for confounding variables.
Betancourt, Theresa S Gilman, Stephen E Brennan, Robert T Zahn, Ista VanderWeele, Tyler J eng 1K01MH077246-01A2/MH/NIMH NIH HHS/ R01ES017876/ES/NIEHS NIH HHS/ R01HD073349-01/HD/NICHD NIH HHS/ Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't 2015/07/08 06:00 Pediatrics. 2015 Aug;136(2):e344-50. doi: 10.1542/peds.2014-1521. Epub 2015 Jul 6.
Keywords: *Health Priorities; *Mental Health Services; *Needs Assessment; *Warfare; Adolescent; Female; Humans; Longitudinal Studies; Male; Mental Disorders/*therapy; Sierra Leone

Attending to the mental health of war-affected children: the need for longitudinal and developmental research perspectives - Betancourt, T. S. (J Am Acad Child Adolesc Psychiatry, 2011)
Betancourt, Theresa S eng Comment Editorial 2011/03/23 06:00 J Am Acad Child Adolesc Psychiatry. 2011 Apr;50(4):323-5. doi: 10.1016/j.jaac.2011.01.008.
Keywords: *Afghan Campaign 2001-; *Developing Countries; *Life Change Events; *Resilience, Psychological; *Social Environment; Female; Humans; Male; Stress Disorders, Post-Traumatic/*diagnosis

Interventions for children affected by war: an ecological perspective on psychosocial support and mental health care. - Betancourt, T. S.; Meyers-Ohki, Sarah E; Charrow, Alexandra P; Tol, Wietse A (Harv Rev Psychiatry, 2013)
BACKGROUND: Children and adolescents exposed to armed conflict are at high risk of developing mental health problems. To date, a range of psychosocial approaches and clinical/psychiatric interventions has been used to address mental health needs in these groups. AIMS: To provide an overview of peer-reviewed psychosocial and mental health interventions designed to address mental health needs of conflict-affected children, and to highlight areas in which policy and research need strengthening. METHODS: We used standard review methodology to identify interventions aimed at improving or treating mental health problems in conflict-affected youth. An ecological lens was used to organize studies according to the individual, family, peer/school, and community factors targeted by each intervention. Interventions were also evaluated for their orientation toward prevention, treatment, or maintenance, and for the strength of the scientific evidence of reported effects. RESULTS: Of 2305 studies returned from online searches of the literature and 21 sources identified through bibliography mining, 58 qualified for full review, with 40 peer-reviewed studies included in the final narrative synthesis. Overall, the peer-reviewed literature focused largely on school-based interventions. Very few family and community-based interventions have been empirically evaluated. Only two studies assessed multilevel or stepped-care packages. CONCLUSIONS: The evidence base on effective and efficacious interventions for conflict-affected youth requires strengthening. Postconflict development agendas must be retooled to target the vulnerabilities characterizing conflict-affected youth, and these approaches must be collaborative across bodies responsible for the care of youth and families.
Keywords: Adolescent; Child; Humans; Mental Disorders; Mental Health Services; Psychotherapy; War

We left one war and came to another: resource loss, acculturative stress, and caregiver-child relationships in Somali refugee families - Betancourt, T. S.; Abdi, S.; Ito, B. S.; Lilienthal, G. M.; Agalab, N.; Ellis, H. (Cultur Divers Ethnic Minor Psychol, 2015)
Refugee families often encounter a number of acculturative and resettlement stressors as they make lives for themselves in host countries. These difficulties may be compounded by past trauma and violence exposure, posing increased risk for mental health problems. Greater knowledge is needed about protective processes contributing to positive development and adjustment in refugee families despite risk (e.g., resilience). The aims of this research were to identify and examine strengths and resources utilized by Somali refugee children and families in the Boston area to overcome resettlement and acculturative stressors. We used maximum variation sampling to conduct a total of 9 focus groups: 5 focus groups (total participants N = 30) among Somali refugee adolescents and youth, capturing gender and a range of ages (15 to 25 years), as well as 4 focus groups of Somali refugee mothers and fathers in groups (total participants N = 32) stratified by gender. Drawing from conservation of resources theory (COR), we identified 5 forms of resources comprising individual, family, and collective/community strengths: religious faith, healthy family communication, support networks, and peer support. "Community talk" was identified as a community dynamic having both negative and positive implications for family functioning. Protective resources among Somali refugee children and families can help to offset acculturative and resettlement stressors. Many of these locally occurring protective resources have the potential to be leveraged by family and community-based interventions. These findings are being used to design preventative interventions that build on local strengths among Somali refugees in the Boston area.
Betancourt, Theresa S Abdi, Saida Ito, Brandon S Lilienthal, Grace M Agalab, Naima Ellis, Heidi eng K01 MH077246/MH/NIMH NIH HHS/ 1K01MH077246-01A2/MH/NIMH NIH HHS/ 2U79SM060444/SM/CMHS SAMHSA HHS/ 5U79SM058141/SM/CMHS SAMHSA HHS/ Research Support, N.I.H., Extramural Research Support, U.S. Gov't, P.H.S. 2014/08/05 06:00 Cultur Divers Ethnic Minor Psychol. 2015 Jan;21(1):114-25. doi: 10.1037/a0037538. Epub 2014 Aug 4.
Keywords: *Acculturation; Adolescent; Adult; Boston; Caregivers/*psychology; Family/ethnology/*psychology; Female; Focus Groups; Humans; Male; Refugees/*psychology; Somalia/ethnology; Stress, Psychological/ethnology/*etiology; Warfare; Young Adult

The mental health of children affected by armed conflict: protective processes and pathways to resilience - Betancourt, T. S.; Khan, K. T. (Int Rev Psychiatry, 2008)
This paper examines the concept of resilience in the context of children affected by armed conflict. Resilience has been frequently viewed as a unique quality of certain 'invulnerable' children. In contrast, this paper argues that a number of protective processes contribute to resilient mental health outcomes in children when considered through the lens of the child's social ecology. While available research has made important contributions to understanding risk factors for negative mental health consequences of war-related violence and loss, the focus on trauma alone has resulted in inadequate attention to factors associated with resilient mental health outcomes. This paper presents key studies in the literature that address the interplay between risk and protective processes in the mental health of war-affected children from an ecological, developmental perspective. It suggests that further research on war-affected children should pay particular attention to coping and meaning making at the individual level; the role of attachment relationships, caregiver health, resources and connection in the family, and social support available in peer and extended social networks. Cultural and community influences such as attitudes towards mental health and healing as well as the meaning given to the experience of war itself are also important aspects of the larger social ecology.
Betancourt, Theresa Stichick Khan, Kashif Tanveer eng K01 MH077246/MH/NIMH NIH HHS/ K01 MH077246-01A2/MH/NIMH NIH HHS/ Review England 2008/06/24 09:00 Int Rev Psychiatry. 2008 Jun;20(3):317-28. doi: 10.1080/09540260802090363.
Keywords: *Adaptation, Psychological; *Warfare; Adolescent; Child; Child, Orphaned/psychology; Community Mental Health Services; Cultural Characteristics; culture; Family/psychology; Female; Humans; Male; Models, Psychological; Object Attachment; Refugees/psychology; Risk Factors; Social Environment; Social Support; Stress Disorders, Post-Traumatic/diagnosis/*psychology/therapy

The intergenerational impact of war: longitudinal relationships between caregiver and child mental health in postconflict Sierra Leone - Betancourt, T. S.; McBain, R. K.; Newnham, E. A.; Brennan, R. T. (J Child Psychol Psychiatry, 2015)
BACKGROUND: Trauma from witnessing events such as bombings and killings as well as direct victimization or participation in violence has been associated with psychosocial distress and poor mental health among war-exposed children and adolescents. This study examines the relationship between caregiver mental health and child internalizing (anxiety and depression) symptoms over a 4-year period in postconflict Sierra Leone. METHODS: The sample included 118 adolescent Sierra Leonean youth (73% male; mean age = 16.5 years at Time 1) and their caregivers (40% male; mean age = 39.0 at Time 1). To measure depression and anxiety symptoms, the Hopkins Symptom Checklist-25 was used with adults and the Oxford Measure of Psychosocial Adjustment - previously validated for use with children and adolescents in the region - was used to assess youth. A multivariate hierarchical linear model (HLM) for studying change within dyads was implemented to study covariation in internalizing symptoms among caregivers and youth over time; these models also included covariates at the individual, family and community levels. The relationship of caregiver mental health to child's internalizing was tested in a latent variable extension of the HLM. RESULTS: The latent variable extension estimated that a one standard deviation (SD) change in caregiver anxiety/depression was associated with a .43 SD change in youth internalizing (p < .01) over the 4-year period. Family acceptance was negatively related to youth internalizing (p < .001), while community stigma was positively associated (p < .001). CONCLUSIONS: The findings highlight an important interplay between caregiver and child mental health within the postconflict setting and the need for psychosocial interventions to extend beyond the individual to account for family dynamics.
Betancourt, Theresa S McBain, Ryan K Newnham, Elizabeth A Brennan, Robert T eng 1K01MH077246-01A2/MH/NIMH NIH HHS/ Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't England 2015/02/11 06:00 J Child Psychol Psychiatry. 2015 Oct;56(10):1101-7. doi: 10.1111/jcpp.12389. Epub 2015 Feb 9.
Keywords: Adolescent; Adult; Anxiety; Anxiety/*psychology; Caregivers/psychology; Child; Depression; Depression/*psychology; dyadic analysis; Family Relations/psychology; Family/*psychology; Female; Humans; intergenerational; Longitudinal Studies; Male; Military Personnel/*psychology; Psychological Trauma/*psychology; Sierra Leone; Social Stigma; War; Warfare and Armed Conflicts/*psychology

Context matters: community characteristics and mental health among war-affected youth in Sierra Leone - Betancourt, T. S.; McBain, R.; Newnham, E. A.; Brennan, R. T. (J Child Psychol Psychiatry, 2014)
BACKGROUND: Worldwide, over one billion children and adolescents live in war-affected settings. At present, only limited research has investigated linkages between disrupted social ecology and adverse mental health outcomes among war-affected youth. In this study, we examine three community-level characteristics - social disorder and collective efficacy within the community, as reported by caregivers, and perceived stigma as reported by youth - in relation to externalizing behaviors and internalizing symptoms among male and female former child soldiers in postconflict Sierra Leone. METHODS: A total of 243 former child soldiers (30% female, mean age at baseline: 16.6 years) and their primary caregivers participated in interviews in 2004 and 2008, as part of a larger prospective cohort study of war-affected youth in Sierra Leone. Two-point growth models were estimated to examine the relationship between community-level characteristics and externalizing and internalizing outcomes across the time points. RESULTS: Both social disorder within the community, reported by caregivers, and perceived stigma, reported by youth, positively covaried with youths' externalizing and internalizing scores - indicating that higher levels of each at baseline and follow-up were associated with higher levels of mental health problems at both time points (p < .05). The relationship between collective efficacy and mental health outcomes was nonsignificant (p > .05). CONCLUSIONS: This study offers a rare glimpse into the role that the postconflict social context plays in shaping the mental health among former child soldiers. Results indicate that both social disorder and perceived stigma within the community demonstrate an important relationship to externalizing and internalizing problems among adolescent ex-combatants. Moreover, these relationships persisted over a 4-year period of follow-up. These results underscore the importance of the postconflict social environment and the need to develop postconflict interventions that address community-level processes in addition to the needs of families and individuals.
Betancourt, Theresa S McBain, Ryan Newnham, Elizabeth A Brennan, Robert T eng K01 MH077246/MH/NIMH NIH HHS/ R01 HD073349/HD/NICHD NIH HHS/ 1K01MH077246-01A2/MH/NIMH NIH HHS/ R01HD073349-01/HD/NICHD NIH HHS/ Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S. England 2013/10/10 06:00 J Child Psychol Psychiatry. 2014 Mar;55(3):217-26. doi: 10.1111/jcpp.12131. Epub 2013 Sep 14.
Keywords: *Social Environment; *Social Stigma; *Warfare; Adolescent; Adult; child soldiers; Combat Disorders/complications; externalizing; Female; Follow-Up Studies; Humans; internalizing; Male; Mental Disorders/etiology/*psychology; Mental Health; Military Personnel/psychology; Post-conflict; Residence Characteristics; Sierra Leone; Social ecology; War; Young Adult

Comparing Trauma Exposure, Mental Health Needs, and Service Utilization Across Clinical Samples of Refugee, Immigrant, and U.S.-Origin Children - Betancourt, T. S.; Newnham, E. A.; Birman, D.; Lee, R.; Ellis, B. H.; Layne, C. M. (J Trauma Stress, 2017)
Most mental health services for trauma-exposed children and adolescents were not originally developed for refugees. Information is needed to help clinicians design services to address the consequences of trauma in refugee populations. We compared trauma exposure, psychological distress, and mental health service utilization among children and adolescents of refugee-origin, immigrant-origin, and U.S.-origin referred for assessment and treatment by U.S. providers in the National Child Traumatic Stress Network (NCTSN). We used propensity score matching to compare trauma profiles, mental health needs, and service use across three groups. Our sample comprised refugee-origin youth (n = 60, 48.3% female, mean age = 13.07 years) and propensity-matched samples of immigrant-origin youth (n = 143, 60.8% female, mean age = 13.26 years), and U.S.-origin youth (n = 140, 56.1% female, mean age = 12.11 years). On average, there were significantly more types of trauma exposure among refugee youth than either U.S.-origin youth (p < .001) or immigrant youth (p </= .001). Compared with U.S.-origin youth, refugee youth had higher rates of community violence exposure, dissociative symptoms, traumatic grief, somatization, and phobic disorder. In contrast, the refugee group had comparably lower rates of substance abuse and oppositional defiant disorder (ps ranging from .030 to < .001).This clinic-referred sample of refugee-origin youth presented with distinct patterns of trauma exposure, distress symptoms, and service needs that merit consideration in services planning.
Betancourt, Theresa S Newnham, Elizabeth A Birman, Dina Lee, Robert Ellis, B Heidi Layne, Christopher M eng K01 MH077246/MH/NIMH NIH HHS/ Comparative Study 2017/06/07 06:00 J Trauma Stress. 2017 Jun;30(3):209-218. doi: 10.1002/jts.22186. Epub 2017 Jun 6.
Keywords: Adolescent; Child; Emigrants and Immigrants/psychology/*statistics & numerical data; Exposure to Violence/psychology/*statistics & numerical data; Female; Health Services Needs and Demand/*statistics & numerical data; Humans; Male; Mental Disorders/epidemiology; Patient Acceptance of Health Care/*statistics & numerical data; Refugees/psychology/*statistics & numerical data; Stress Disorders, Post-Traumatic/epidemiology/psychology

Ethics in Community-Based Research with Vulnerable Children: Perspectives from Rwanda - Betancourt, T. S.; Smith Fawzi, M. C.; Stevenson, A.; Kanyanganzi, F.; Kirk, C.; Ng, L.; Mushashi, C.; Bizimana, J. I.; Beardslee, W.; Raviola, G.; Smith, S.; Kayiteshonga, Y.; et al. (PLoS One, 2016)
A "risk of harm" protocol to identify youth in need of immediate emergency assistance in a study on mental health and HIV in Rwanda among 680 youth ages 10-17 is described. Cases are presented that describe the experience in using this protocol to ensure safety of participants, with ethical and logistical challenges considered. Among the population of the study, 3.2% were deemed "risk of harm." The most prevalent presenting problem was non-fatal suicidal behavior (91% of risk of harm cases), with 36% having a history of a reported previous attempt. Challenges included: acute food insecurity/significant poverty; lack of support/adequate supervision from family members; family violence; alcohol abuse; and HIV-related stigma. Development of a "risk of harm" protocol and collaboration between study staff, community leadership, health authorities, and health workers are critical to ensuring participants' safety in research among vulnerable populations.
Betancourt, Theresa Smith Fawzi, Mary C Stevenson, Anne Kanyanganzi, Fredrick Kirk, Catherine Ng, Lauren Mushashi, Christina Bizimana, Justin I Beardslee, William Raviola, Giuseppe Smith, Stephanie Kayiteshonga, Yvonne Binagwaho, Agnes eng R34 MH084679/MH/NIMH NIH HHS/ T32 MH093310/MH/NIMH NIH HHS/ 2016/06/29 06:00 PLoS One. 2016 Jun 28;11(6):e0157042. doi: 10.1371/journal.pone.0157042. eCollection 2016.
Keywords: *Vulnerable Populations; Acquired Immunodeficiency Syndrome/diagnosis/*epidemiology; Adolescent; Child; Community-Based Participatory Research/*ethics/methods; Female; Humans; Male; Mental Health/statistics & numerical data; Rwanda; Socioeconomic Factors; Suicide/statistics & numerical data

Using Mixed-Methods Research to Adapt and Evaluate a Family Strengthening Intervention in Rwanda - Betancourt, T. S.; Meyers-Ohki, S. E.; Stevenson, A.; Ingabire, C.; Kanyanganzi, F.; Munyana, M.; Mushashi, C.; Teta, S.; Fayida, I.; Cyamatare, F. R.; Stulac, S.; Beardslee, W. R. (Afr J Trauma Stress, 2011)
INTRODUCTION: Research in several international settings indicates that children and adolescents affected by HIV and other compounded adversities are at increased risk for a range of mental health problems including depression, anxiety, and social withdrawal. More intervention research is needed to develop valid measurement and intervention tools to address child mental health in such settings. OBJECTIVE: This article presents a collaborative mixed-methods approach to designing and evaluating a mental health intervention to assist families facing multiple adversities in Rwanda. METHODS: Qualitative methods were used to gain knowledge of culturally-relevant mental health problems in children and adolescents, individual, family and community resources, and contextual dynamics among HIV-affected families. This data was used to guide the selection and adaptation of mental health measures to assess intervention outcomes. Measures were subjected to a quantitative validation exercise. Qualitative data and community advisory board input also informed the selection and adaptation of a family-based preventive intervention to reduce the risk for mental health problems among children in families affected by HIV.. Community-based participatory methods were used to ensure that the intervention targeted relevant problems manifest in Rwandan children and families and built on local strengths. RESULTS: Qualitative data on culturally-appropriate practices for building resilience in vulnerable families has enriched the development of a Family-Strengthening Intervention (FSI). Input from community partners has also contributed to creating a feasible and culturally-relevant intervention. Mental health measures demonstrate strong performance in this population. CONCLUSION: The mixed-methods model discussed represents a refined, multi-phase protocol for incorporating qualitative data and community input in the development and evaluation of feasible, culturally-sound quantitative assessments and intervention models. The mixed-methods approach may be applied to research in other parts of sub-Saharan Africa and beyond.
Betancourt, Theresa S Meyers-Ohki, Sarah E Stevenson, Anne Ingabire, Charles Kanyanganzi, Fredrick Munyana, Morris Mushashi, Christina Teta, Sharon Fayida, Ildephonse Cyamatare, Felix Rwabukwisi Stulac, Sara Beardslee, William R eng R34 MH084679/MH/NIMH NIH HHS/ Uganda 2011/06/01 00:00 Afr J Trauma Stress. 2011 Jun;2(1):32-45.

Trajectories of internalizing problems in war-affected Sierra Leonean youth: examining conflict and postconflict factors. - Betancourt, T. S.; McBain, R.; Newnham, E. A.; Brennan, R. T. (Child Dev, 2013)
Three waves of data from a prospective longitudinal study in Sierra Leone were used to examine internalizing trajectories in 529 war-affected youth (ages 10-17 at baseline; 25% female). Latent class growth analyses identified 4 trajectories: A large majority of youth maintained lower levels of internalizing problems (41.4%) or significantly improved over time (47.6%) despite very limited access to care, but smaller proportions continued to report severe difficulties 6 years postwar (4.5%) or their symptoms worsened (6.4%). Continued internalizing problems were associated with loss of a caregiver, family abuse and neglect, and community stigma. Despite the comparative resilience of most war-affected youth in the face of extreme adversity, there remains a compelling need for interventions that address family- and community-level stressors.
Keywords: Adaptation, Psychological; Adolescent; Child; Female; Humans; Internal-External Control; Male; Mental Disorders; Prospective Studies; Risk Factors; Sierra Leone; War

A behavioral intervention for war-affected youth in Sierra Leone: a randomized controlled trial - Betancourt, T. S.; McBain, R.; Newnham, E. A.; Akinsulure-Smith, A. M.; Brennan, R. T.; Weisz, J. R.; Hansen, N. B. (J Am Acad Child Adolesc PsychiatryJ Am Acad Child Adolesc Psychiatry, 2014)
OBJECTIVE: Youth in war-affected regions are at risk for poor psychological, social, and educational outcomes. Effective interventions are needed to improve mental health, social behavior, and school functioning. This randomized controlled trial tested the effectiveness of a 10-session cognitive-behavioral therapy (CBT)-based group mental health intervention for multisymptomatic war-affected youth (aged 15-24 years) in Sierra Leone. METHOD: War-affected youth identified by elevated distress and impairment via community screening were randomized (stratified by sex and age) to the Youth Readiness Intervention (YRI) (n = 222) or to a control condition (n = 214). After treatment, youth were again randomized and offered an education subsidy immediately (n = 220) or waitlisted (n = 216). Emotion regulation, psychological distress, prosocial attitudes/behaviors, social support, functional impairment, and posttraumatic stress disorder (PTSD) symptoms were assessed at pre- and postintervention and at 6-month follow-up. For youth in school, enrollment, attendance, and classroom performance were assessed after 8 months. Linear mixed-effects regressions evaluated outcomes. RESULTS: The YRI showed significant postintervention effects on emotion regulation, prosocial attitudes/behaviors, social support, and reduced functional impairment, and significant follow-up effects on school enrollment, school attendance, and classroom behavior. In contrast, education subsidy was associated with better attendance but had no effect on mental health or functioning, school retention, or classroom behavior. Interactions between education subsidy and YRI were not significant. CONCLUSION: YRI produced acute improvements in mental health and functioning as well as longer-term effects on school engagement and behavior, suggesting potential to prepare war-affected youth for educational and other opportunities. Clinical trial registration information-Trial of the Youth Readiness Intervention (YRI); http://clinicaltrials.gov; NCT01684488.
Betancourt, Theresa S McBain, Ryan Newnham, Elizabeth A Akinsulure-Smith, Adeyinka M Brennan, Robert T Weisz, John R Hansen, Nathan B eng K01 MH077246/MH/NIMH NIH HHS/ 5K01MH077246-05/MH/NIMH NIH HHS/ P30 AG024409/AG/NIA NIH HHS/ 5P30AG024409-08/AG/NIA NIH HHS/ 1F31MH097333-01A1/MH/NIMH NIH HHS/ F31 MH097333/MH/NIMH NIH HHS/ Randomized Controlled Trial Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't 2014/12/03 06:00 J Am Acad Child Adolesc Psychiatry. 2014 Dec;53(12):1288-97. doi: 10.1016/j.jaac.2014.09.011. Epub 2014 Oct 2.
Keywords: *Warfare; Adolescent; Adult; Cognitive Therapy/*methods; Female; Humans; intervention; Male; Mental Disorders/etiology/*therapy; Mental Health; randomized controlled trial; report no biomedical interests or potential conflicts of interest.; Sierra Leone; Treatment Outcome; War-affected; Young Adult; youth

High Hopes, Grim Reality: Reintegration and the Education of Former Child Soldiers in Sierra Leone - Betancourt, T. S.; Simmons, S.; Borisova, I.; Brewer, S. E.; Iweala, U.; Soudiere, M. D. (Comp Educ Rev, 2008)
Betancourt, Theresa S Simmons, Stephanie Borisova, Ivelina Brewer, Stephanie E Iweala, Uzo Soudiere, Marie de la eng K01 MH077246/MH/NIMH NIH HHS/ K01 MH077246-01A2/MH/NIMH NIH HHS/ 2009/04/02 09:00 Comp Educ Rev. 2008 Nov 1;52(4):565-587. doi: 10.1086/591298.

Commentary: Advancing an implementation science agenda on mental health and psychosocial responses in war-affected settings: comment on trials of a psychosocial intervention for youth affected by the Syrian crisis - by Panter-Brick et al. (2018) - Betancourt, T. S.; Fazel, M. (J Child Psychol Psychiatry, 2018)
Syria's civil conflict has created the largest humanitarian disaster of our time, causing massive population displacement, tremendous exposure to trauma, and loss. Advancing the mental health and psychosocial responses of war-affected populations both during acute humanitarian emergencies and in post-conflict transition is imperative in forging a constructive implementation agenda. This study makes an important contribution in building evidence toward effective interventions to advance the mental health and well-being of those affected by the Syrian crisis. Using an innovative approach, this work demonstrates that a thoughtful, ethical, and scientifically valid trial can be carried out in the midst of mass displacement. Further research is urgently needed on the effectiveness of interventions for vulnerable populations, with a growing need to embed studies of evidence-based mental health interventions within humanitarian responses.
Betancourt, Theresa S Fazel, Mina eng England 2018/04/19 06:00 J Child Psychol Psychiatry. 2018 May;59(5):542-544. doi: 10.1111/jcpp.12870.

Addressing health disparities in the mental health of refugee children and adolescents through community-based participatory research: a study in 2 communities - Betancourt, T. S.; Frounfelker, R.; Mishra, T.; Hussein, A.; Falzarano, R. (Am J Public Health, 2015)
OBJECTIVES: We sought to understand the problems, strengths, and help-seeking behaviors of Somali Bantu and Bhutanese refugees and determine local expressions of mental health problems among youths in both communities. METHODS: We used qualitative research methods to develop community needs assessments and identify local terms for child mental health problems among Somali Bantu and Bhutanese refugees in Greater Boston and Springfield, Massachusetts, between 2011 and 2014. A total of 56 Somali Bantu and 93 Bhutanese refugees participated in free list and key informant interviews. RESULTS: Financial and language barriers impeded the abilities of families to assist youths who were struggling academically and socially. Participants identified resources both within and outside the refugee community to help with these problems. Both communities identified areas of distress corresponding to Western concepts of conduct disorders, depression, and anxiety. CONCLUSIONS: There are numerous challenges faced by Somali Bantu and Bhutanese youths, as well as strengths and resources that promote resilience. Future steps include using culturally informed methods for identifying those in need of services and developing community-based prevention programs.
Betancourt, Theresa S Frounfelker, Rochelle Mishra, Tej Hussein, Aweis Falzarano, Rita eng R24 MD008057/MD/NIMHD NIH HHS/ 5R24MD008057-02/MD/NIMHD NIH HHS/ Multicenter Study Research Support, N.I.H., Extramural 2015/04/24 06:00 Am J Public Health. 2015 Jul;105 Suppl 3:S475-82. doi: 10.2105/AJPH.2014.302504. Epub 2015 Apr 23.
Keywords: *Community-Based Participatory Research; *Health Services Needs and Demand; *Health Status Disparities; *Healthcare Disparities; Adolescent; Bhutan/ethnology; Child; Female; Humans; Male; Massachusetts/epidemiology; Mental Disorders/*epidemiology/*ethnology; Refugees/*psychology; Somalia/ethnology

Sierra Leone's former child soldiers: a longitudinal study of risk, protective factors, and mental health - Betancourt, T. S.; Brennan, R. T.; Rubin-Smith, J.; Fitzmaurice, G. M.; Gilman, S. E. (J Am Acad Child Adolesc Psychiatry, 2010)
OBJECTIVE: To investigate the longitudinal course of internalizing and externalizing problems and adaptive/prosocial behaviors among Sierra Leonean former child soldiers and whether postconflict factors contribute to adverse or resilient mental health outcomes. METHOD: Male and female former child soldiers (N = 260, aged 10 to 17 years at baseline) were recruited from the roster of an non-governmental organization (NGO)-run Interim Care Center in Kono District and interviewed in 2002, 2004, and 2008. The retention rate was 69%. Linear growth models were used to investigate trends related to war and postconflict experiences. RESULTS: The long-term mental health of former child soldiers was associated with war experiences and postconflict risk factors, which were partly mitigated by postconflict protective factors. Increases in externalizing behavior were associated with killing/injuring others during the war and postconflict stigma, whereas increased community acceptance was associated with decreases in externalizing problems (b = -1.09). High baseline levels of internalizing problems were associated with being raped, whereas increases were associated with younger involvement in armed groups and social and economic hardships. Improvements in internalizing problems were associated with higher levels of community acceptance and increases in community acceptance (b = -0.86). Decreases in adaptive/prosocial behaviors were associated with killing/injuring others during the war and postconflict stigma, but partially mitigated by social support, being in school and increased community acceptance (b = 1.93). CONCLUSIONS: Psychosocial interventions for former child soldiers may be more effective if they account for postconflict factors in addition to war exposures. Youth with accumulated risk factors, lack of protective factors, and persistent distress should be identified. Sustainable services to promote community acceptance, reduce stigma, and expand social supports and educational access are recommended.
Betancourt, Theresa S Brennan, Robert T Rubin-Smith, Julia Fitzmaurice, Garrett M Gilman, Stephen E eng K01 MH077246/MH/NIMH NIH HHS/ K01 MH077246-01A2/MH/NIMH NIH HHS/ 1K01MH077246-01A2/MH/NIMH NIH HHS/ Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S. 2010/05/25 06:00 J Am Acad Child Adolesc Psychiatry. 2010 Jun;49(6):606-15. doi: 10.1016/j.jaac.2010.03.008. Epub 2010 May 1.
Keywords: *Adaptation, Psychological; *Civil Disorders; *Developing Countries; *Internal-External Control; *Resilience, Psychological; *Social Adjustment; *Social Behavior; Adolescent; Aggression/psychology; Anxiety Disorders/diagnosis/epidemiology/psychology; Child; Cross-Sectional Studies; Depressive Disorder/diagnosis/epidemiology/psychology; Female; Homicide/psychology; Humans; Longitudinal Studies; Male; Mental Disorders/diagnosis/epidemiology/*psychology; Military Personnel/*psychology; Prejudice; Rape/psychology; Sierra Leone; Social Identification; Social Support; Stress Disorders, Post-Traumatic/diagnosis/epidemiology/psychology; Violence/psychology/statistics & numerical data; Wounds and Injuries/psychology; Young Adult

Developing an African youth psychosocial assessment: an application of item response theory - Betancourt, T. S.; Yang, F.; Bolton, P.; Normand, S. L. (Int J Methods Psychiatr Res, 2014)
This study aimed to refine a dimensional scale for measuring psychosocial adjustment in African youth using item response theory (IRT). A 60-item scale derived from qualitative data was administered to 667 war-affected adolescents (55% female). Exploratory factor analysis (EFA) determined the dimensionality of items based on goodness-of-fit indices. Items with loadings less than 0.4 were dropped. Confirmatory factor analysis (CFA) was used to confirm the scale's dimensionality found under the EFA. Item discrimination and difficulty were estimated using a graded response model for each subscale using weighted least squares means and variances. Predictive validity was examined through correlations between IRT scores (theta) for each subscale and ratings of functional impairment. All models were assessed using goodness-of-fit and comparative fit indices. Fisher's Information curves examined item precision at different underlying ranges of each trait. Original scale items were optimized and reconfigured into an empirically-robust 41-item scale, the African Youth Psychosocial Assessment (AYPA). Refined subscales assess internalizing and externalizing problems, prosocial attitudes/behaviors and somatic complaints without medical cause. The AYPA is a refined dimensional assessment of emotional and behavioral problems in African youth with good psychometric properties. Validation studies in other cultures are recommended.
Betancourt, Theresa S Yang, Frances Bolton, Paul Normand, Sharon-Lise eng K01 MH077246/MH/NIMH NIH HHS/ P60 MD002261/MD/NIMHD NIH HHS/ 1K01MH077246-01A2/MH/NIMH NIH HHS/ Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't 2014/01/31 06:00 Int J Methods Psychiatr Res. 2014 Jun;23(2):142-60. doi: 10.1002/mpr.1420. Epub 2014 Jan 30.
Keywords: *Models, Theoretical; Adolescent; Adolescent Behavior/*psychology; Adolescent Development/*physiology; Africa; children and adolescents; Factor Analysis, Statistical; Female; Humans; item response theory (IRT); Male; mental health assessment; psychometric measurement; Psychometrics/*methods; Surveys and Questionnaires; Uganda

Building an evidence base on mental health interventions for children affected by armed conflict - Betancourt, T. S.; Williams, T. (Intervention (Amstelveen), 2008)
This paper reviews what is currently known from research about the effectiveness of interventions to address mental health problems in children and adolescents affected by armed conflict. The focus will be on interventions delivered in conflict affected countries either during active humanitarian emergencies or during the post conflict period. The paper will discuss two main paradigms of intervention dominating the field: psychosocial approaches and clinical/psychiatric approaches. The paper reviews some of the basic literature, theories and issues involved in assessment, programme planning, monitoring and evaluation of both approaches. In order to explore these issues in depth, the paper will draw from the author's field experiences with research in the Russian Federation and in northern Uganda. The paper also presents a brief review of a handful of other published evaluations of mental health interventions for war affected children. We will close with a discussion of what future research is needed to build an evidence base regarding mental health interventions for children affected by armed conflict as well as the ethical and feasibility issues associated with carrying out this work.
Betancourt, Theresa S Williams, Timothy eng K01 MH077246/MH/NIMH NIH HHS/ K01 MH077246-01A2/MH/NIMH NIH HHS/ Netherlands 2008/01/01 00:00 Intervention (Amstelveen). 2008;6(1):39-56. doi: 10.1097/WTF.0b013e3282f761ff.

Moderators of treatment effectiveness for war-affected youth with depression in northern Uganda - Betancourt, T. S.; Newnham, E. A.; Brennan, R. T.; Verdeli, H.; Borisova, I.; Neugebauer, R.; Bass, J.; Bolton, P. (J Adolesc Health, 2012)
PURPOSE: As we build the evidence base of interventions for depression among war-affected youth, it is critical to understand factors moderating treatment outcomes. The current study investigated how gender and history of abduction by Lord's Resistance Army rebels moderated treatment outcomes for war-affected youth. METHODS: The study-a three-armed, randomized, controlled trial-was conducted with internally displaced war-affected adolescents in northern Uganda. Participants with significant depression symptoms (N = 304; 57% female; 14-17 years of age) were randomly assigned to an interpersonal psychotherapy group (IPT-G), a creative play/recreation group, or a wait-list control condition. Secondary analyses were conducted on data from this randomized controlled trial. RESULTS: A history of abduction by Lord's Resistance Army rebels was reported by 42% of the sample. Gender and abduction history interacted to moderate the effectiveness of IPT-G for the treatment of depression. In the IPT-G intervention arm, treatment effectiveness was greatest among female subjects without an abduction history, with effect size = 1.06. IPT-G was effective for the treatment of depression for both male and female subjects with a history of abduction (effect size = .92 and .50, respectively). Male subjects with no abduction history in IPT-G showed no significant improvement compared with those in the control conditions. CONCLUSIONS: Abduction history and gender are potentially important moderators of treatment effects, suggesting that these factors need to be considered when providing interventions for war-affected youth. IPT-G may be an effective intervention for female subjects without an abduction history, as well as for both male and female former child soldiers, but less so for male subjects without an abduction history.
Betancourt, Theresa S Newnham, Elizabeth A Brennan, Robert T Verdeli, Helen Borisova, Ivelina Neugebauer, Richard Bass, Judith Bolton, Paul eng 1K01MH077246-01A2/MH/NIMH NIH HHS/ P60 MD002261/MD/NIMHD NIH HHS/ Randomized Controlled Trial Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't 2012/11/24 06:00 J Adolesc Health. 2012 Dec;51(6):544-50. doi: 10.1016/j.jadohealth.2012.02.010. Epub 2012 Apr 5.
Keywords: *Psychology, Adolescent; *Warfare; Adolescent; Depressive Disorder/diagnosis/etiology/*therapy; Female; Humans; Male; Military Personnel/*psychology; Psychotherapy/*methods; Refugees/*psychology; Sex Distribution; Stress Disorders, Post-Traumatic/diagnosis/etiology/*therapy; Treatment Outcome; Uganda

Sierra Leone's child soldiers: war exposures and mental health problems by gender - Betancourt, T. S.; Borisova,, II; de la Soudiere, M.; Williamson, J. (J Adolesc HealthJ Adolesc Health, 2011)
PURPOSE: To examine associations between war experiences, mental health, and gender in a sample of male and female Sierra Leonean former child soldiers. METHODS: A total of 273 former child soldiers (29% females) were assessed for depression and anxiety by using the Hopkins Symptoms Checklist, and for hostility, confidence, and prosocial attitudes by using an instrument developed for use with Sierra Leonean child soldiers. RESULTS: The former child soldiers had witnessed and perpetrated violence at largely comparable rates, although females experienced higher rates of rape (p < .0001). More females scored within clinical ranges for depression (p = .008) and anxiety (p < .0001). In multiple regression analyses, female gender was a significant predictor of lower levels of confidence but not of mental health problems. Children who perpetrated injury or killing reported greater levels of depression (p < .0001), anxiety (p < .0001), and hostility (p < .0001). Surviving rape was associated with increased anxiety (p < .05) and hostility (p < .05), in males. Surviving rape was also related to higher confidence levels (p < .05) and prosocial attitudes (p < .05). Male former child soldiers who lost caregivers were also more vulnerable to depression (p < .05) and anxiety (p < .05), strong and significant effects noted among male child soldiers. CONCLUSIONS: In our sample, female and male child soldiers experienced comparable levels of most war exposures. Female soldiers reported higher rates of rape and lower levels of adaptive outcomes. Toxic forms of violence (killing or injuring; rape) were associated with particularly poor outcomes. Although all boys and girls who experience rape and loss of caregivers are generally at risk for mental health problems, boys in our sample demonstrated increased vulnerability; these findings indicate a need for more inclusive mental health services.
Betancourt, Theresa S Borisova, Ivelina I de la Soudiere, Marie Williamson, John eng K01 MH077246/MH/NIMH NIH HHS/ K01 MH077246-01A2/MH/NIMH NIH HHS/ 1K01MH077246-01A2/MH/NIMH NIH HHS/ Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S. 2011/06/28 06:00 J Adolesc Health. 2011 Jul;49(1):21-8. doi: 10.1016/j.jadohealth.2010.09.021. Epub 2010 Dec 24.
Keywords: *Warfare; Adolescent; Cohort Studies; Cross-Sectional Studies; Female; Humans; Male; Mental Disorders/*epidemiology; Military Personnel/*psychology; Sex Factors; Sierra Leone/epidemiology; Young Adult

Psychosocial adjustment and mental health in former child soldiers--systematic review of the literature and recommendations for future research. - Betancourt, T. S.; Borisova, Ivelina; Williams, Timothy P; Meyers-Ohki, Sarah E; Rubin-Smith, Julia E; Annan, Jeannie; Kohrt, Brandon A (J Child Psychol Psychiatry, 2013)
AIMS AND SCOPE: This article reviews the available quantitative research on psychosocial adjustment and mental health among children (age <18 years) associated with armed forces and armed groups (CAAFAG)--commonly referred to as child soldiers. METHODS: PRISMA standards for systematic reviews were used to search PubMed, PsycInfo, JSTOR, and Sociological Abstracts in February 2012 for all articles on former child soldiers and CAAFAG. Twenty-one quantitative studies from 10 countries were analyzed for author, year of publication, journal, objectives, design, selection population, setting, instruments, prevalence estimates, and associations with war experiences. Opinion pieces, editorials, and qualitative studies were deemed beyond the scope of this study. Quality of evidence was rated according to the systematic assessment of quality in observational research (SAQOR). FINDINGS: According to SAQOR criteria, among the available published studies, eight studies were of high quality, four were of moderate quality, and the remaining nine were of low quality. Common limitations were lack of validated mental health measures, unclear methodology including undefined sampling approaches, and failure to report missing data. Only five studies included a comparison group of youth not involved with armed forces/armed groups, and only five studies assessed mental health at more than one point in time. Across studies, a number of risk and protective factors were associated with postconflict psychosocial adjustment and social reintegration in CAAFAG. Abduction, age of conscription, exposure to violence, gender, and community stigma were associated with increased internalizing and externalizing mental health problems. Family acceptance, social support, and educational/economic opportunities were associated with improved psychosocial adjustment. CONCLUSIONS: Research on the social reintegration and psychosocial adjustment of former child soldiers is nascent. A number of gaps in the available literature warrant future study. Recommendations to bolster the evidence base on psychosocial adjustment in former child soldiers and other war-affected youth include more studies comprising longitudinal study designs, and validated cross-cultural instruments for assessing mental health, as well as more integrated community-based approaches to study design and research monitoring.
Keywords: Adolescent; Child; Female; Humans; Male; Mental Health; Military Personnel; Prevalence; Resilience, Psychological; Risk Factors; Social Adjustment; Social Support; Stress Disorders, Post-Traumatic; Violence; War

Promoting parent-child relationships and preventing violence via home-visiting: a pre-post cluster randomised trial among Rwandan families linked to social protection programmesAbstractBackgroundMethodsResultsConclusionsTrial registration - Betancourt, Theresa S.; Jensen, Sarah K. G.; Barnhart, Dale A.; Brennan, Robert T.; Murray, Shauna M.; Yousafzai, Aisha K.; Farrar, Jordan; Godfroid, Kalisa; Bazubagira, Stephanie M.; Rawlings, Laura B.; Wilson, Briana; Sezibera, Vincent; et al. (BMC Public Health, 2020)
Keywords: early childhood development; father engagement; home visiting; Poverty; social protection; Violence

A qualitative study of mental health problems among children displaced by war in northern Uganda - Betancourt, T. S.; Speelman, L.; Onyango, G.; Bolton, P. (Transcult PsychiatryTranscult Psychiatry, 2009)
While multiple studies have found that children affected by war are at increased risk for a range of mental health problems, little research has investigated how mental health problems are perceived locally. In this study we used a previously developed rapid ethnographic assessment method to explore local perceptions of mental health problems among children and adults from the Acholi ethnic group displaced by the war in northern Uganda. We conducted 45 free list interviews and 57 key informant interviews. The rapid assessment approach appears to have worked well for interviewing caretakers and children aged 10-17 years. We describe several locally defined syndromes: two tam/par/kumu (depression and dysthymia-like syndromes), ma lwor (a mixed anxiety and depression-like syndrome), and a category of conduct problems referred to as kwo maraco/gin lugero. The descriptions of these local syndromes were similar to western mood, anxiety and conduct disorders, but included culture-specific elements.
Betancourt, Theresa Stichick Speelman, Liesbeth Onyango, Grace Bolton, Paul eng K01 MH077246/MH/NIMH NIH HHS/ K01 MH077246-01A2/MH/NIMH NIH HHS/ Research Support, Non-U.S. Gov't England 2009/06/23 09:00 Transcult Psychiatry. 2009 Jun;46(2):238-56. doi: 10.1177/1363461509105815.
Keywords: *Cross-Cultural Comparison; *Developing Countries; Adolescent; Adult; Anxiety Disorders/diagnosis/*ethnology/psychology; Child; Cross-Sectional Studies; Depressive Disorder/diagnosis/*ethnology/psychology; Dysthymic Disorder/diagnosis/*ethnology/psychology; Female; Humans; Interview, Psychological; Male; Refugees/*psychology; Social Problems/psychology; Uganda

Interventions for children affected by war: an ecological perspective on psychosocial support and mental health care - Betancourt, T. S.; Meyers-Ohki, S. E.; Charrow, A. P.; Tol, W. A. (Harv Rev PsychiatryHarv Rev Psychiatry, 2013)
BACKGROUND: Children and adolescents exposed to armed conflict are at high risk of developing mental health problems. To date, a range of psychosocial approaches and clinical/psychiatric interventions has been used to address mental health needs in these groups. AIMS: To provide an overview of peer-reviewed psychosocial and mental health interventions designed to address mental health needs of conflict-affected children, and to highlight areas in which policy and research need strengthening. METHODS: We used standard review methodology to identify interventions aimed at improving or treating mental health problems in conflict-affected youth. An ecological lens was used to organize studies according to the individual, family, peer/school, and community factors targeted by each intervention. Interventions were also evaluated for their orientation toward prevention, treatment, or maintenance, and for the strength of the scientific evidence of reported effects. RESULTS: Of 2305 studies returned from online searches of the literature and 21 sources identified through bibliography mining, 58 qualified for full review, with 40 peer-reviewed studies included in the final narrative synthesis. Overall, the peer-reviewed literature focused largely on school-based interventions. Very few family and community-based interventions have been empirically evaluated. Only two studies assessed multilevel or stepped-care packages. CONCLUSIONS: The evidence base on effective and efficacious interventions for conflict-affected youth requires strengthening. Postconflict development agendas must be retooled to target the vulnerabilities characterizing conflict-affected youth, and these approaches must be collaborative across bodies responsible for the care of youth and families.
Betancourt, Theresa S Meyers-Ohki, Sarah E Charrow, Alexandra P Tol, Wietse A eng K01 MH077246/MH/NIMH NIH HHS/ R01 HD073349/HD/NICHD NIH HHS/ Review 2013/05/10 06:00 Harv Rev Psychiatry. 2013 Mar-Apr;21(2):70-91. doi: 10.1097/HRP.0b013e318283bf8f.
Keywords: *Warfare; Adolescent; Child; Humans; Mental Disorders/etiology/prevention & control/*therapy; Mental Health Services/*standards; Psychotherapy/methods/*standards

Development of the SAFE Checklist Tool for Assessing Site-Level Threats to Child Protection: Use of Delphi Methods and Application to Two Sites in India - Betancourt, T. S.; Zuilkowski, S. S.; Ravichandran, A.; Einhorn, H.; Arora, N.; Bhattacharya Chakravarty, A.; Brennan, R. T. (PLoS One, 2015)
BACKGROUND: The child protection community is increasingly focused on developing tools to assess threats to child protection and the basic security needs and rights of children and families living in adverse circumstances. Although tremendous advances have been made to improve measurement of individual child health status or household functioning for use in low-resource settings, little attention has been paid to a more diverse array of settings in which many children in adversity spend time and how context contributes to threats to child protection. The SAFE model posits that insecurity in any of the following fundamental domains threatens security in the others: Safety/freedom from harm; Access to basic physiological needs and healthcare; Family and connection to others; Education and economic security. Site-level tools are needed in order to monitor the conditions that can dramatically undermine or support healthy child growth, development and emotional and behavioral health. From refugee camps and orphanages to schools and housing complexes, site-level threats exist that are not well captured by commonly used measures of child health and well-being or assessments of single households (e.g., SDQ, HOME). METHODS: The present study presents a methodology and the development of a scale for assessing site-level child protection threats in various settings of adversity. A modified Delphi panel process was enhanced with two stages of expert review in core content areas as well as review by experts in instrument development, and field pilot testing. RESULTS: Field testing in two diverse sites in India-a construction site and a railway station-revealed that the resulting SAFE instrument was sensitive to the differences between the sites from the standpoint of core child protection issues.
Betancourt, Theresa S Zuilkowski, Stephanie S Ravichandran, Arathi Einhorn, Honora Arora, Nikita Bhattacharya Chakravarty, Aruna Brennan, Robert T eng Research Support, Non-U.S. Gov't 2015/11/06 06:00 PLoS One. 2015 Nov 5;10(11):e0141222. doi: 10.1371/journal.pone.0141222. eCollection 2015.
Keywords: *Child Protective Services/methods/statistics & numerical data; Checklist; Child; Construction Industry; Delphi Technique; Humans; India; Railroads; Safety/standards

A Longitudinal Study of Psychosocial Adjustment and Community Reintegration among Former Child Soldiers in Sierra Leone - Betancourt, T. S. (Int Psychiatry, 2010)
Betancourt, Theresa S eng K01 MH077246/MH/NIMH NIH HHS/ England 2010/07/01 00:00 Int Psychiatry. 2010 Jul;7(3):60-62.

Child soldiers: reintegration, pathways to recovery, and reflections from the field - Betancourt, T. S. (J Dev Behav Pediatr, 2008)
Betancourt, Theresa Stichick eng 2008/04/15 09:00 J Dev Behav Pediatr. 2008 Apr;29(2):138-41. doi: 10.1097/DBP.0b013e31816be946.
Keywords: *Relief Work; *Warfare; Child; Child Abuse/*rehabilitation; Crime/*psychology; Female; Humans; Male; Military Personnel/*psychology; Sierra Leone; Uganda

Validating the Center for Epidemiological Studies Depression Scale for Children in Rwanda - Betancourt, T. S.; Scorza, P.; Meyers-Ohki, S.; Mushashi, C.; Kayiteshonga, Y.; Binagwaho, A.; Stulac, S.; Beardslee, W. R. (J Am Acad Child Adolesc Psychiatry, 2012)
OBJECTIVE: We assessed the validity of the Center for Epidemiological Studies Depression Scale for Children (CES-DC) as a screen for depression in Rwandan children and adolescents. Although the CES-DC is widely used for depression screening in high-income countries, its validity in low-income and culturally diverse settings, including sub-Saharan Africa, is unknown. METHOD: The CES-DC was selected based on alignment with local expressions of depression-like problems in Rwandan children and adolescents. To examine criterion validity, we compared CES-DC scores to depression diagnoses on a structured diagnostic interview, the Mini International Neuropsychiatric Interview for Children (MINI KID), in a sample of 367 Rwandan children and adolescents aged 10 through 17 years. Caregiver and child or adolescent self-reports endorsing the presence of local depression-like problems agahinda kenshi (persistent sorrow) and kwiheba (severe hopelessness) were also examined for agreement with MINI KID diagnosis. RESULTS: The CES-DC exhibited good internal reliability (alpha = .86) and test-retest reliability (r = .85). The area under the receiver operating characteristic curve for the CES-DC was 0.825 when compared to MINI KID diagnoses, indicating a strong ability to distinguish between depressed and nondepressed children and adolescents in Rwanda. A cut point of>/=30 corresponded with a sensitivity of 81.9% and a specificity of 71.9% in this referred sample. MINI KID diagnosis was well aligned with local expressions of depression-like problems. CONCLUSION: The CES-DC demonstrates good psychometric properties for clinical screening and evaluation in Rwanda, and should be considered for use in this and other low-resource settings. Population samples are needed to determine a generalizable cut point in nonreferred samples.
Betancourt, Theresa Scorza, Pamela Meyers-Ohki, Sarah Mushashi, Christina Kayiteshonga, Yvonne Binagwaho, Agnes Stulac, Sara Beardslee, William R eng K01 MH077246/MH/NIMH NIH HHS/ R34MH084679-02/MH/NIMH NIH HHS/ K01MH077246-05/MH/NIMH NIH HHS/ T32 MH096724/MH/NIMH NIH HHS/ R34 MH084679/MH/NIMH NIH HHS/ Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't 2012/12/04 06:00 J Am Acad Child Adolesc Psychiatry. 2012 Dec;51(12):1284-92. doi: 10.1016/j.jaac.2012.09.003. Epub 2012 Nov 8.
Keywords: *Depression/diagnosis/epidemiology/psychology; *Mass Screening/methods/standards; Adolescent; Behavioral Symptoms/*diagnosis; Child; Female; Humans; Male; Predictive Value of Tests; Psychiatric Status Rating Scales/*standards; Reproducibility of Results; ROC Curve; Rwanda/epidemiology; Translations

War-Related Traumas and Mental Health Across Generations - Betancourt, T. S.; Thomson, D.; VanderWeele, T. J. (JAMA Psychiatry, 2018)
Betancourt, Theresa S Thomson, Dana VanderWeele, Tyler J eng 2017/12/01 06:00 JAMA Psychiatry. 2018 Jan 1;75(1):5-6. doi: 10.1001/jamapsychiatry.2017.3530.

Correction: Ethics in Community-Based Research with Vulnerable Children: Perspectives from Rwanda - Betancourt, T. S.; Smith Fawzi, M. C.; Stevenson, A.; Kanyanganzi, F.; Kirk, C.; Ng, L.; Mushashi, C.; Bizimana, J.; Beardslee, W.; Raviola, G.; Smith, S.; Kayiteshonga, Y.; et al. (PLoS One, 2016)
[This corrects the article DOI: 10.1371/journal.pone.0157042.].
Betancourt, Theresa S Smith Fawzi, Mary C Stevenson, Anne Kanyanganzi, Fredrick Kirk, Catherine Ng, Lauren Mushashi, Christina Bizimana, Justin Beardslee, William Raviola, Giuseppe Smith, Stephanie Kayiteshonga, Yvonne Binagwaho, Agnes eng Published Erratum 2016/09/16 06:00 PLoS One. 2016 Sep 15;11(9):e0163384. doi: 10.1371/journal.pone.0163384. eCollection 2016.

The intergenerational effect of war - Betancourt, T. S. (JAMA Psychiatry, 2015)
Betancourt, Theresa S eng 2015/01/08 06:00 JAMA Psychiatry. 2015 Mar;72(3):199-200. doi: 10.1001/jamapsychiatry.2014.2669.
Keywords: *Intergenerational Relations; *Warfare; Child; Child Development/*physiology; Humans; Violence/*psychology

Post-traumatic stress symptoms among former child soldiers in Sierra Leone: follow-up study - Betancourt, T. S.; Newnham, E. A.; McBain, R.; Brennan, R. T. (Br J Psychiatry, 2013)
BACKGROUND: Former child soldiers are at risk of developing post-traumatic stress disorder (PTSD); however, the trajectory of symptoms has yet to be examined. AIMS: The risk and protective factors associated with PTSD symptom change among former child soldiers in Sierra Leone were investigated. METHOD: Data from 243 former child soldiers (mean age 16.6 years, 30% female) were analysed. RESULTS: Self-reported rates of possible PTSD using standard cut-off points declined from 32% to 16% 4 years later (P<0.05). Symptoms of PTSD at baseline were significantly associated with war experiences (P<0.01) and post-conflict family abuse (P<0.001). Reliable improvement in symptoms was reported by 30%. In growth models examining symptom change, worsening of symptoms was associated with death of a parent (P<0.05) and post-conflict stigma (P<0.001). Protective effects were observed for increases in family acceptance (P<0.001). CONCLUSIONS: The findings indicated improvement in PTSD symptoms among former child soldiers despite limited access to care. Family and community support played a vital part in promoting psychological adjustment.
Betancourt, Theresa S Newnham, Elizabeth A McBain, Ryan Brennan, Robert T eng P60 MD002261/MD/NIMHD NIH HHS/ 1K01MH07724601A2/MH/NIMH NIH HHS/ Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S. England 2013/07/28 06:00 Br J Psychiatry. 2013 Sep;203(3):196-202. doi: 10.1192/bjp.bp.112.113514. Epub 2013 Jul 25.
Keywords: *Warfare; Adolescent; Combat Disorders/*epidemiology/rehabilitation; Family Relations; Female; Follow-Up Studies; Humans; Male; Military Personnel/*psychology/statistics & numerical data; Prospective Studies; Sierra Leone/epidemiology; Stereotyping; Violence/statistics & numerical data

Trajectories of internalizing problems in war-affected Sierra Leonean youth: examining conflict and postconflict factors - Betancourt, T. S.; McBain, R.; Newnham, E. A.; Brennan, R. T. (Child Dev, 2013)
Three waves of data from a prospective longitudinal study in Sierra Leone were used to examine internalizing trajectories in 529 war-affected youth (ages 10-17 at baseline; 25% female). Latent class growth analyses identified 4 trajectories: A large majority of youth maintained lower levels of internalizing problems (41.4%) or significantly improved over time (47.6%) despite very limited access to care, but smaller proportions continued to report severe difficulties 6 years postwar (4.5%) or their symptoms worsened (6.4%). Continued internalizing problems were associated with loss of a caregiver, family abuse and neglect, and community stigma. Despite the comparative resilience of most war-affected youth in the face of extreme adversity, there remains a compelling need for interventions that address family- and community-level stressors.
Betancourt, Theresa S McBain, Ryan Newnham, Elizabeth A Brennan, Robert T eng K01 MH077246/MH/NIMH NIH HHS/ R01 HD073349/HD/NICHD NIH HHS/ 1K01MH077246-01A2/MH/NIMH NIH HHS/ Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't 2012/09/26 06:00 Child Dev. 2013 Mar-Apr;84(2):455-70. doi: 10.1111/j.1467-8624.2012.01861.x. Epub 2012 Sep 24.
Keywords: *Adaptation, Psychological; *Internal-External Control; *Warfare; Adolescent; Child; Female; Humans; Male; Mental Disorders/*psychology; Prospective Studies; Risk Factors; Sierra Leone

Sierra Leone's former child soldiers: a follow-up study of psychosocial adjustment and community reintegration - Betancourt, T. S.; Borisova,, II; Williams, T. P.; Brennan, R. T.; Whitfield, T. H.; de la Soudiere, M.; Williamson, J.; Gilman, S. E. (Child Dev, 2010)
This is the first prospective study to investigate psychosocial adjustment in male and female former child soldiers (ages 10-18; n = 156, 12% female). The study began in Sierra Leone in 2002 and was designed to examine both risk and protective factors in psychosocial adjustment. Over the 2-year period of follow-up, youth who had wounded or killed others during the war demonstrated increases in hostility. Youth who survived rape not only had higher levels of anxiety and hostility but also demonstrated greater confidence and prosocial attitudes at follow-up. Of the potential protective resources examined, improved community acceptance was associated with reduced depression at follow-up and improved confidence and prosocial attitudes regardless of levels of violence exposure. Retention in school was also associated with greater prosocial attitudes.
Betancourt, Theresa Stichick Borisova, Ivelina Ivanova Williams, Timothy Philip Brennan, Robert T Whitfield, Theodore H de la Soudiere, Marie Williamson, John Gilman, Stephen E eng K01 MH077246/MH/NIMH NIH HHS/ K01 MH077246-01A2/MH/NIMH NIH HHS/ 1K01MH077246-01A2/MH/NIMH NIH HHS/ P60 MD002261/MD/NIMHD NIH HHS/ Research Support, N.I.H., Extramural Research Support, U.S. Gov't, Non-P.H.S. 2010/07/20 06:00 Child Dev. 2010 Jul-Aug;81(4):1077-95. doi: 10.1111/j.1467-8624.2010.01455.x.
Keywords: *Adaptation, Psychological; *Social Adjustment; *Warfare; Adolescent; Child; Family; Female; Follow-Up Studies; Hostility; Humans; Interpersonal Relations; Male; Military Personnel/*psychology; Prospective Studies; Psychology, Adolescent; Psychology, Child; Residence Characteristics; Sierra Leone; Socioeconomic Factors; Violence

Trauma history and psychopathology in war-affected refugee children referred for trauma-related mental health services in the United States - Betancourt, T. S.; Newnham, E. A.; Layne, C. M.; Kim, S.; Steinberg, A. M.; Ellis, H.; Birman, D. (J Trauma Stress, 2012)
There is an increasing need to deliver effective mental health services to refugee children and adolescents across the United States; however, the evidence base needed to guide the design and delivery of services is nascent. We investigated the trauma history profiles, psychopathology, and associated behavioral and functional indicators among war-affected refugee children presenting for psychological treatment. From the National Child Traumatic Stress Network's Core Data Set, 60 war-affected refugee children were identified (51.7% males, mean age = 13.1 years, SD = 4.13). Clinical assessments indicated high rates of probable posttraumatic stress disorder (30.4%), generalized anxiety (26.8%), somatization (26.8%), traumatic grief (21.4%), and general behavioral problems (21.4%). Exposure to war or political violence frequently co-occurred with forced displacement; traumatic loss; bereavement or separation; exposure to community violence; and exposure to domestic violence. Academic problems and behavioral difficulties were prevalent (53.6% and 44.6%, respectively); however, criminal activity, alcohol/drug use, and self-harm were rare (all < 5.45%). These findings highlight the complex trauma profiles, comorbid conditions, and functional problems that are important to consider in providing mental health interventions for refugee children and adolescents. Given the difficulties associated with access to mental health services for refugees, both preventive and community-based interventions within family, school, and peer systems hold particular promise.
Betancourt, Theresa S Newnham, Elizabeth A Layne, Christopher M Kim, Soeun Steinberg, Alan M Ellis, Heidi Birman, Dina eng 1K01MH077246-01A2/MH/NIMH NIH HHS/ 3U79SM054284-10S/SM/CMHS SAMHSA HHS/ Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S. 2012/12/12 06:00 J Trauma Stress. 2012 Dec;25(6):682-90. doi: 10.1002/jts.21749.
Keywords: *Warfare; Adolescent; Child; Child, Preschool; Humans; Male; Mental Disorders/*epidemiology/etiology/psychology; Mental Health Services; Refugees/*psychology; Stress Disorders, Post-Traumatic/*epidemiology; United States

Interrelatedness of child health, protection and well-being: an application of the SAFE model in Rwanda - Betancourt, T. S.; Williams, T. P.; Kellner, S. E.; Gebre-Medhin, J.; Hann, K.; Kayiteshonga, Y. (Soc Sci Med, 2012)
This study examines the core components of children's basic security and well-being in order to examine issues central to improving child protection in Rwanda. Sources of data included 15 focus groups with adults, 7 focus groups with children ages 10-17, and 11 key informant interviews with child protection stakeholders, including representatives from international NGOs, community-based groups, and the Rwandan Government, all of which took place in April and May of 2010. Participants painted a complex picture of threats to children's basic security in Rwanda. Three key themes were pervasive across all interviews: (1) deterioration of social and community cohesion in post-genocide Rwanda; (2) the cascading effects of poverty; and (3) the impact of caregiver illness and death on the caregiving environment. Consistent with the SAFE (Safety/freedom from harm; Access to basic physiological needs and healthcare; Family and connection to others; Education and economic security) model of child protection, participants rarely elaborated on a child protection threat independent of other basic security needs and rights. Findings suggest a need for integrated approaches to child protection that recognize this interrelatedness and extend beyond issue-specific child protection responses. This study contributes to a growing body of work highlighting the interrelated nature of child protection threats and the implications of adaptive and dangerous survival strategies that children and families engage in to meet their basic security needs. Analysis of this interrelatedness provides a roadmap for improving policies and implementing integrated and robust child protection strategies in Rwanda and other settings.
Betancourt, Theresa S Williams, Timothy P Kellner, Sarah E Gebre-Medhin, Joy Hann, Katrina Kayiteshonga, Yvonne eng England 2012/03/31 06:00 Soc Sci Med. 2012 May;74(10):1504-11. doi: 10.1016/j.socscimed.2012.01.030. Epub 2012 Mar 9.
Keywords: *Caregivers; *Child Welfare; *Poverty; *Social Environment; *Social Problems; Adolescent; Adult; Child; Child, Orphaned; Critical Illness; Focus Groups; HIV Infections/complications/psychology; Homicide/psychology; Humans; Interviews as Topic; Rwanda; Safety

Past horrors, present struggles: the role of stigma in the association between war experiences and psychosocial adjustment among former child soldiers in Sierra Leone - Betancourt, T. S.; Agnew-Blais, J.; Gilman, S. E.; Williams, D. R.; Ellis, B. H. (Soc Sci Med, 2010)
Upon returning to their communities, children formerly associated with armed forces and armed groups--commonly referred to as child soldiers--often confront significant community stigma. Much research on the reintegration and rehabilitation of child soldiers has focused on exposure to past war-related violence and mental health outcomes, yet no empirical work has yet examined the role that post-conflict stigma plays in shaping long-term psychosocial adjustment. Two waves of data are used in this paper from the first prospective study of male and female former child soldiers in Sierra Leone. We examined the role of stigma (manifest in discrimination as well as lower levels of community and family acceptance) in the relationship between war-related experiences and psychosocial adjustment (depression, anxiety, hostility and adaptive behaviors). Former child soldiers differ from one another with regard to their post-war experiences, and these differences profoundly shape their psychosocial adjustment over time. Consistent with social stress theory, we observed that post-conflict factors such as stigma can play an important role in shaping psychosocial adjustment in former child soldiers. We found that discrimination was inversely associated with family and community acceptance. Additionally, higher levels of family acceptance were associated with decreased hostility, while improvements in community acceptance were associated with adaptive attitudes and behaviors. We found that post-conflict experiences of discrimination largely explained the relationship between past involvement in wounding/killing others and subsequent increases in hostility. Stigma similarly mediated the relationship between surviving rape and depression. However, surviving rape continued to demonstrate independent effects on increases in anxiety, hostility and adaptive/prosocial behaviors after adjusting for other variables. These findings point to the complexity of psychosocial adjustment and community reintegration in these youth and have a number of programmatic and policy implications.
Betancourt, Theresa S Agnew-Blais, Jessica Gilman, Stephen E Williams, David R Ellis, B Heidi eng K01 MH077246/MH/NIMH NIH HHS/ P60 MD002261/MD/NIMHD NIH HHS/ 1K01MH077246-01A2/MH/NIMH NIH HHS/ Research Support, N.I.H., Extramural Research Support, U.S. Gov't, Non-P.H.S. England 2009/10/31 06:00 Soc Sci Med. 2010 Jan;70(1):17-26. doi: 10.1016/j.socscimed.2009.09.038. Epub 2009 Oct 28.
Keywords: *Adaptation, Psychological; *Psychology, Adolescent; *Psychology, Child; *Stereotyping; Adolescent; Child; Family/psychology; Female; Humans; Interpersonal Relations; Interviews as Topic; Life Change Events; Male; Mental Disorders/epidemiology; Military Personnel/*psychology; Prospective Studies; Regression Analysis; Residence Characteristics; Sierra Leone/epidemiology; Stress, Psychological/epidemiology; Warfare

A qualitative case study of child protection issues in the Indian construction industry: investigating the security, health, and interrelated rights of migrant families - Betancourt, T. S.; Shaahinfar, A.; Kellner, S. E.; Dhavan, N.; Williams, T. P. (BMC Public Health, 2013)
BACKGROUND: Many of India's estimated 40 million migrant workers in the construction industry migrate with their children. Though India is undergoing rapid economic growth, numerous child protection issues remain. Migrant workers and their children face serious threats to their health, safety, and well-being. We examined risk and protective factors influencing the basic rights and protections of children and families living and working at a construction site outside Delhi. METHODS: Using case study methods and a rights-based model of child protection, the SAFE model, we triangulated data from in-depth interviews with stakeholders on and near the site (including employees, middlemen, and managers); 14 participants, interviews with child protection and corporate policy experts in greater Delhi (8 participants), and focus group discussions (FGD) with workers (4 FGDs, 25 members) and their children (2 FGDs, 9 members). RESULTS: Analyses illuminated complex and interrelated stressors characterizing the health and well-being of migrant workers and their children in urban settings. These included limited access to healthcare, few educational opportunities, piecemeal wages, and unsafe or unsanitary living and working conditions. Analyses also identified both protective and potentially dangerous survival strategies, such as child labor, undertaken by migrant families in the face of these challenges. CONCLUSIONS: By exploring the risks faced by migrant workers and their children in the urban construction industry in India, we illustrate the alarming implications for their health, safety, livelihoods, and development. Our findings, illuminated through the SAFE model, call attention to the need for enhanced systems of corporate and government accountability as well as the implementation of holistic child-focused and child-friendly policies and programs in order to ensure the rights and protection of this hyper-mobile, and often invisible, population.
Betancourt, Theresa S Shaahinfar, Ashkon Kellner, Sarah E Dhavan, Nayana Williams, Timothy P eng Research Support, Non-U.S. Gov't England 2013/09/21 06:00 BMC Public Health. 2013 Sep 17;13:858. doi: 10.1186/1471-2458-13-858.
Keywords: *Child Welfare; *Construction Industry; Adult; Child; Child, Preschool; Female; Focus Groups; Health Services Needs and Demand; Humans; India; Infant; Infant, Newborn; Male; Transients and Migrants/*statistics & numerical data

Methods to Assess Adverse Childhood Experiences of Children and Families: Toward Approaches to Promote Child Well-being in Policy and Practice - Bethell, C. D.; Carle, A.; Hudziak, J.; Gombojav, N.; Powers, K.; Wade, R.; Braveman, P. (Acad PediatrAcad Pediatr, 2017)
BACKGROUND: Advances in human development sciences point to tremendous possibilities to promote healthy child development and well-being across life by proactively supporting safe, stable and nurturing family relationships (SSNRs), teaching resilience, and intervening early to promote healing the trauma and stress associated with disruptions in SSNRs. Assessing potential disruptions in SSNRs, such as adverse childhood experiences (ACEs), can contribute to assessing risk for trauma and chronic and toxic stress. Asking about ACEs can help with efforts to prevent and attenuate negative impacts on child development and both child and family well-being. Many methods to assess ACEs exist but have not been compared. The National Survey of Children's Health (NSCH) now measures ACEs for children, but requires further assessment and validation. METHODS: We identified and compared methods to assess ACEs among children and families, evaluated the acceptability and validity of the new NSCH-ACEs measure, and identified implications for assessing ACEs in research and practice. RESULTS: Of 14 ACEs assessment methods identified, 5 have been used in clinical settings (vs public health assessment or research) and all but 1 require self or parent report (3 allow child report). Across methods, 6 to 20 constructs are assessed, 4 of which are common to all: parental incarceration, domestic violence, household mental illness/suicide, household alcohol or substance abuse. Common additional content includes assessing exposure to neighborhood violence, bullying, discrimination, or parental death. All methods use a numeric, cumulative risk scoring methodology. The NSCH-ACEs measure was acceptable to respondents as evidenced by few missing values and no reduction in response rate attributable to asking about children's ACEs. The 9 ACEs assessed in the NSCH co-occur, with most children with 1 ACE having additional ACEs. This measure showed efficiency and confirmatory factor analysis as well as latent class analysis supported a cumulative risk scoring method. Formative as well as reflective measurement models further support cumulative risk scoring and provide evidence of predictive validity of the NSCH-ACEs. Common effects of ACEs across household income groups confirm information distinct from economic status is provided and suggest use of population-wide versus high-risk approaches to assessing ACEs. CONCLUSIONS: Although important variations exist, available ACEs measurement methods are similar and show consistent associations with poorer health outcomes in absence of protective factors and resilience. All methods reviewed appear to coincide with broader goals to facilitate health education, promote health and, where needed, to mitigate the trauma, chronic stress, and behavioral and emotional sequelae that can arise with exposure to ACEs. Assessing ACEs appears acceptable to individuals and families when conducted in population-based and clinical research contexts. Although research to date and neurobiological findings compel early identification and health education about ACEs in clinical settings, further research to guide use in pediatric practice is required, especially as it relates to distinguishing ACEs assessment from identifying current family psychosocial risks and child abuse. The reflective as well as formative psychometric analyses conducted in this study confirm use of cumulative risk scoring for the NSCH-ACEs measure. Even if children have not been exposed to ACEs, assessing ACEs has value as an educational tool for engaging and educating families and children about the importance of SSNRs and how to recognize and manage stress and learn resilience.
1876-2867 Bethell, Christina D Carle, Adam Hudziak, James Gombojav, Narangerel Powers, Kathleen Wade, Roy Braveman, Paula K12 HD085848/HD/NICHD NIH HHS/United States Journal Article United States Acad Pediatr. 2017 Sep - Oct;17(7S):S51-S69. doi: 10.1016/j.acap.2017.04.161.
Keywords: *adverse childhood experiences; *child health; *Child Welfare; *Life Change Events; *measurement; *Psychological Trauma; *resilience; *Stress, Psychological; Bullying; Child; Child of Impaired Parents; Domestic Violence; exposure to violence; Health Policy; Humans; Income; Mental Disorders; Parental Death; Prejudice; Reproducibility of Results; Residence Characteristics; Risk Assessment; Socioeconomic Factors; Substance-Related Disorders

The oxytocin paradox. - Bethlehem, Richard A I; Baron-Cohen, Simon; van Honk, Jack; Auyeung, Bonnie; Bos, Peter A (Front Behav Neurosci, 2014)

Regional Capacity Building Workshop on Men,Caring and Fatherhood. - N. Bhandari; R. Karkara (Save the Children Sweden, 2005)

Mothers explanatory models of infant stress & adversity in rural Haryana, India: qualitative findings from the Early Life Stress sub-study of the SPRING cluster-randomised controlled trial (SPRING-ELS) - Bhopal, Sunil; Verma, Deepali; Roy, Reetabrata; Divan, Gauri; Hill, Zelee; Kirkwood, Betty (Wellcome Open Research, 2018)

Synthesis Report: Language Education and Social Cohesion (LESC) Initiative in Malaysia, Myanmar and Thailand - Bianco, J.L. (UNICEF East Asia and Pacific Regional Office 2016, 2016)