Parenting and children's behavioural problems: Micro- and macro-processes at play in the context of intervention

养育和儿童的行为问题：干预背景下发挥作用的微观和宏观过程

• 批准号: ES/X001865/1
• 负责人: Emily Midouhas
• 金额: $ 41.8万
• 依托单位: University College London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2023
• 资助国家: 英国
• 起止时间: 2023 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FX001865%2F1
• 关键词: Parenting; children; behavioural; problems; Micro

Child mental health problems are a public concern: 5-10% of children are currently living with a diagnosed mental health disorder. Around half of these relate to behaviour problems (e.g., tantrums, aggression). Left untreated, children are at higher risk of school exclusion, social difficulties and later mental health disorder. Behaviour problems are one of the most common reasons parents ask for or are referred for professional support ("intervention"). Intervention can be effective, but a third of children don't improve. Understanding the origins and development of these problems as well as how, when and why intervention works is crucial.A common belief is that parents "cause" children's behaviour problems because of how they parent or behave themselves. However, while parents influence children, children also affect parents. For example, parents' stress can have a negative impact on parenting and child behaviour. But equally, when children show difficult behaviour, parent stress can increase. Another example is that smacking children can increase the chances of aggression, but children being aggressive can also increase the likelihood of parents using harsh discipline like smacking. Breaking these "negative cycles" between parents and children is one of the best ways to improve behaviour problems and is a common intervention focus.Although we know that negative cycles are important for child mental health and good targets for support, there are key questions about which we know little. What child, family, school and neighbourhood factors predict negative cycles? Are there positive long-term effects of accessing mental-health services on parenting, child behaviour and negative cycles? These are what we call macro-level questions.There are also micro-level questions. When we test intervention effects we look for improved parenting and child behaviour. But we tend not to look at the two together, the negative cycle itself. This is crucial if we are to make lasting differences to families because, even if we reduce harsh parenting or improve child behaviour, there is a risk that the negative cycle starts again because of previous history. What happens at home between support sessions? Do negative cycles change during intervention? When? Why?Both macro- and micro-level questions are important for basic understanding and ultimately knowing how to improve intervention approaches so that more families benefit. To answer them, our project has two parts.First, in the general population, we will look at negative parent-child cycles and consider what child, family, school and neighbourhood factors help healthier interactions over time. We will also look at the role of intervention in how parenting, child behaviour and negative cycles develop and change across childhood. To do this, we will use information collected over many years from ALSPAC, a large UK research sample of families and link it with mental health service use data.Second, we will look at changes to negative cycles while intervention is going on, working in partnership with UK child and adolescent mental health services. Here, we will collect new information from families currently receiving support. To collect data that is detailed enough to answer our research questions, we have designed-with parents and intervention providers-an App called CALMS (Contextualising and Augmenting Learning in Mental Health Support). CALMS allows parents to tell us about their own and their child's behaviours twice a day. For the first time, CALMS lets us track information about negative parent-child cycles at home between sessions while intervention is on-going.We will share our findings with a range of stakeholders including parents, clinicians and academics at an event. We will seek their views on how our study's findings can be used to inform our understanding of and future research on parent-child dynamics in the context of professional support.

儿童心理健康问题是公众关注的：5-10％的儿童目前患有诊断为精神健康障碍。其中约有一半涉及行为问题（例如发脾气，侵略）。剩下的未经治疗，儿童面临学校排除，社会困难和后来的精神健康障碍的较高风险。行为问题是父母要求或转介专业支持的最常见原因之一（“干预”）。干预可能是有效的，但三分之一的孩子没有改善。了解这些问题的起源和发展以及干预措施的起作用是至关重要的。一种普遍的信念是，父母“造成”儿童的行为问题，因为他们是如何父母或行为自己的。但是，尽管父母影响孩子，但孩子也会影响父母。例如，父母的压力会对育儿和孩子的行为产生负面影响。但同样，当孩子表现出困难的行为时，父母的压力会增加。另一个例子是，打击孩子可以增加侵略性的机会，但是侵略性的孩子也可以增加父母使用诸如Smacking（Smacking）的严厉纪律的可能性。破坏父母和子女之间的“负面周期”是改善行为问题的最佳方法之一，并且是普遍的干预重点。尽管我们知道负面周期对儿童心理健康和支持的良好目标至关重要，但我们对此知之甚少。哪些孩子，家庭，学校和社区因素可以预测负面周期？获得心理健康服务对育儿，儿童行为和负面周期的长期影响吗？这些就是我们所说的宏观问题。也有微观的问题。当我们测试干预效果时，我们会寻找改善的育儿和儿童行为。但是我们倾向于不将两者共同看待负面周期本身。如果我们要对家庭持续差异，这至关重要，因为即使我们减少了苛刻的育儿或改善儿童行为，也有可能由于以前的历史而再次开始负面周期。在支持会议之间在家中会发生什么？干预期间负周期会发生变化吗？什么时候？为什么？宏观和微观层面的问题对于基本的理解至关重要，最终知道如何改善干预方法，从而使更多的家庭受益。为了回答他们，我们的项目有两个部分。首先，在一般人群中，我们将研究负面的亲子周期，并考虑孩子，家庭，学校和邻里因素有助于随着时间的推移更健康的互动。我们还将研究干预在整个童年时期如何发展和改变育儿，儿童行为和负面周期的作用。为此，我们将使用来自ALSPAC的多年来收集的信息，ALSPAC是一个大量的英国家庭研究样本，并将其与精神卫生服务的使用数据联系起来。第二，我们将在干预过程中进行负面周期的变化，并与英国儿童和青少年心理健康服务合作。在这里，我们将从目前获得支持的家庭那里收集新信息。为了收集足够详细的数据以回答我们的研究问题，我们设计了与父母和干预提供商一起设计的名为Calms的应用程序（心理健康支持中的情境化和增强学习）。 Calms允许父母每天两次告诉我们自己和孩子的行为。 Calms首次让我们跟踪有关在进行干预期间在家之间在家中的负面亲子周期的信息。我们将在活动中与包括父母，临床医生和学者在内的一系列利益相关者分享我们的发现。我们将寻求他们对如何使用研究的发现，以了解我们对在专业支持背景下对亲子动态的研究的理解和未来研究的看法。