Background: Flow is a peak experiential state, during which athletes report focused concentration, effortless performance and enhanced enjoyment. Flow, or ‘the zone’, has received particular interest within sporting circles because flow experiences appear to be associated with peak athletic performances. Yet, the nature of the flow-performance relationship is not straightforward and is yet to be critically reviewed. Objectives: This systematic review and meta-analysis sought to examine the empirical evidence for a flow-performance relationship, examine potential mechanisms, and assess the quality of current evidence. Methods: a PRISMA guided systematic review was conducted in May 2020. Peer-reviewed articles, published in English language journals, which examined the relationship between flow and performance were searched for, using five online databases. The results of the studies were collated into a narrative synthesis as well as a meta-analysis. Results: Twenty articles met the inclusion criteria, featuring 22 studies that were appropriate for meta-analysis. The pooled effect size (r = 0.31, 95% CI [0.24; 0.38]) indicated that across a range of sporting and gaming tasks there was a consistent medium-sized relationship between flow experience and task performance. A number of mechanisms were proposed to explain this relationship, but none were supported by convincing empirical evidence. Conclusions: Performance enhancing effects appear highly likely given the functional mental state that arises during flow. Yet, current evidence is unable to determine the exact nature of the flow-performance relationship, or the mechanisms which mediate this effect. A number of conceptual and methodological challenges

Parental domestic violence and abuse (DVA), mental ill-health (MH), and substance misuse (SU) are three adverse childhood experiences (ACEs) that are prevalent, (potentially) interrelated, and detrimental to parents and children. This thesis explores how we can better prevent and address co-occurring parental DVA, MH, and SU.

This thesis comprises: 1) a secondary data analysis utilising the Millennium Cohort Study to explore how parental DVA, MH, and SU co-occur during early childhood and how this impacts child MH trajectories; 2) a systematic review of family focused interventions that aim to address parental DVA, MH, and SU in combination; and 3) a qualitative study involving interviews with service users and focus groups with service providers and senior leadership/commissioners to develop an understanding of stakeholders’ experiences of current service provision for parental DVA, MH, and SU.

The secondary data analysis found parental DVA, MH, and SU co-occur during early childhood and that this can negatively impact children at age three. Families experiencing these co-occurring adversities were more likely to be experiencing socio-economic disadvantage. The systematic review identified no family focused interventions that had combined positive impacts on parental DVA, MH, and SU. Interventions mostly targeted mothers, those from low-socioeconomic backgrounds, and used an identification and referral approach to addressing multiple needs. The qualitative study highlighted the importance of early, relational support that addressed wider determinants. However, joined-up provision was challenged by an overwhelmed workforce and siloed services.

Overall findings highlight a lack of evidence on what works to prevent and address parental DVA, MH, and SU in combination. Working at the intersection of these ACEs is likely to require early, ‘think family’ support that addresses wider determinants, as well as more fundamental systems change. Future work should re-frame parental DVA, MH, and SU as a syndemic and co-develop approaches to better support families.

Parental domestic violence and abuse (DVA), mental ill-health (MH), and substance misuse (SU) are three public health issues that tend to cluster within families, risking negative impacts for both parents and children. Despite this, service provision for these issues has been historically siloed, increasing the barriers families face to accessing support. Our review aimed to identify family focused interventions that have combined impacts on parental DVA, MH, and/or SU. We searched 10 databases (MEDLINE, PsycINFO, Embase, CINAHL, Education Research Information Centre, Sociological Abstracts, Applied Social Sciences Index & Abstracts, ProQuest Dissertations and Theses Global, Web of Science Core Collection, and Cochrane Central Register of Controlled Trials) from inception to July 2021 for randomised controlled trials examining the effectiveness of family focused, psychosocial, preventive interventions targeting parents/carers at risk of, or experiencing, DVA, MH, and/or SU. Studies were included if they measured impacts on two or more of these issues. The Cochrane Risk of Bias Tool 2 was used to quality appraise studies, which were synthesised narratively, grouped in relation to the combination of DVA, MH, and/or SU outcomes measured. Harvest plots were used to illustrate the findings. Thirty-seven unique studies were identified for inclusion. of these, none had a combined positive impact on all three outcomes and only one study demonstrated a combined positive impact on two outcomes. We also found studies that had combined adverse, mixed, or singular impacts. Most studies were based in the U.S. targeted mothers, and were rated as 'some concerns' or 'high risk' of bias. The results highlight the distinct lack of evidence for, and no 'best bet', family focused interventions targeting these often-clustered risks. This may, in part, be due to the ways interventions are currently conceptualised or designed to influence the relationships between DVA, MH, and/or SU. Trial registration: PROSPERO registration: CRD42020210350.

BACKGROUND: the Incredible Years® (IY) Teacher Classroom Management (TCM) programme may reduce disruptive behaviour in the classroom and improve child and teacher mental health; however, few studies have considered how acceptable TCM is to teachers or what facilitators and barriers there are to its implementation. AIMS: in this paper we examine the acceptability of the full 6-day TCM programme and teachers' perceived barriers and facilitators to implementation in the English (UK) primary school context. SAMPLE: Forty-four English (UK) primary school teachers who attended the TCM programme as part of the STARS trial. METHODS: We completed focus groups and telephone interviews with participating teachers 2 months after they completed the TCM programme. Thematic analysis was used to examine the data, and a framework approach was applied to organize and summarize themes. RESULTS: Teachers liked the structure of the course, the peer group learning environment, delivery methods, and the opportunity to reflect outside the classroom on their practice. They reported that the video clips used lacked cultural relevance and highlighted the importance of group leadership style. Perceived facilitators to implementation included an understanding of the theory underpinning TCM and adaptability of the TCM strategies. Barriers included perceived gaps in the course content in relation to challenging behaviour, applying strategies with older children and the school context within which teachers were working. CONCLUSION: Our findings suggest high levels of acceptability to TCM overall, but also highlight the need for a whole school approach to combat potential barriers to implementation.

Flow is an optimal experience that has received particular interest within sport because of a possible relationship with enhanced athletic performances. Yet, the strength and direction of the putative flow–performance relationship remain unclear. Consequently, a PRISMA guided systematic review was conducted in May 2020 to examine the empirical evidence for a flow–performance relationship, to examine potential mechanisms, and to assess the quality of current evidence. Peer-reviewed articles that examined the relationship between flow and performance in sport or computer gaming tasks were searched for using five online databases. The results were collated into a narrative synthesis and a meta-analysis. Twenty articles met the inclusion criteria, featuring 22 studies that were appropriate for meta-analysis. The overall quality of the studies was fairly good, with a mean quality assessment score of 76.5% (SD = 9.7). The pooled effect size (r = 0.31, 95% CI [0.24; 0.38]) indicated that across a range of sport and gaming tasks there was a medium-sized flow–performance relationship. However, current evidence is unable to determine the causal direction of this relationship or the mechanisms that mediate it. A number of conceptual and methodological challenges facing the study of flow are discussed and recommendations for future work are outlined.

Developmental coordination disorder (DCD) describes a condition of poor motor performance in the absence of intellectual impairment. Despite being one of the most prevalent developmental disorders, little is known about how fundamental visuomotor processes might function in this group. One prevalent idea is children with DCD interact with their environment in a less predictive fashion than typically developing children. A metric of prediction which has not been examined in this group is the degree to which the hands and eyes are coordinated when performing manual tasks. To this end, we examined hand and eye movements during an object lifting task in a group of children with DCD (n=19) and an age-matched group of children without DCD (n=39). We observed no differences between the groups in terms of how well they coordinated their hands and eyes when lifting objects, nor in terms of the degree by which the eye led the hand. We thus find no evidence to support the proposition that children with DCD coordinate their hands and eyes in a non-predictive fashion. In a follow-up exploratory analysis we did, however, note differences in fundamental patterns of eye movements between the groups, with children in the DCD group showing some evidence of atypical visual sampling strategies and gaze anchoring behaviours during the task.

Background: the Incredible Years® (IY) Teacher Classroom Management (TCM) programme may be an effective way to reduce teacher stress levels, improve child behaviour, and promote positive socio-emotional development. However, few studies have considered what teachers think of the course and how it might work. Aims: in this paper, we examine teachers’ perceptions of the impact of the TCM programme and how it might work in the classroom. Sample(s): Forty-four UK primary school teachers who attended the TCM programme as part of the STARS trial (Ford et al. 2018, Psychol. Med. 49, 828). Methods: Focus groups and interviews were held with teachers two months after completing the TCM programme. Thematic analysis (Braun & Clarke, 2006, Qual. Res. Psychol. 3, 77) was employed to explore the subsequent data. Results: Three main themes were identified: impact on the teacher; on children; and on parent-teacher relationships. Impact on the teacher included a positive change in their ethos. Teachers reported being more able to see things from the child's perspective; placing a greater focus on building positive relationships; thinking before responding; feeling calmer, more confident, and in control; and employing strategies to create positive interactions with children. Teachers felt this had had a positive impact on their pupils’ development and relationships with parents. Feedback on whether or not TCM was effective in tackling particularly challenging behaviour was more mixed. Conclusions: Our findings suggest that teachers experience the TCM programme as beneficial. This is discussed alongside other qualitative and quantitative studies in this field.

Background
Teaching is a stressful occupation with poor retention. The Incredible Years® Teacher Classroom Management (TCM) programme is a training program that past research has demonstrated may be an effective intervention for children’s mental health, but little research has explored any impacts there may be on the teachers’ own professional confidence and mental health.
Aims
In this paper we evaluate whether TCM may lead to changes in teachers’ wellbeing, namely a reduction in burnout and an improvement in self-efficacy and mental health.
Sample
Eighty schools across the South West of England were recruited between September 2012 and September 2014. Headteachers were asked to nominate one class teacher to take part.
Methods
Eighty teachers were randomised to either attend a TCM course (intervention) or not (control). TCM was delivered to groups of up to twelve teachers in six whole-day workshops that were evenly spread between October and April. At baseline and nine months follow-up we measured teachers’ mental health using the Everyday Feelings Questionnaire (EFQ), burnout using the Maslach Burnout Inventory-General Survey (MBI-GS) and self-efficacy using the Teachers’ Sense of Efficacy Scale-Short (TSES-Short).
Results
Using linear regression models there was little evidence of differences at follow-up between the intervention and control teachers on the outcomes (the smallest p-value was 0.09).
Conclusions
Our findings did not replicate previous research that TCM improved teachers’ sense of efficacy. However, there were limitations with this study including low sample size.

Abstract
Background. We evaluated the effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management (TCM) programme as a universal intervention, given schools’ important influence on child mental health.
Methods. A two-arm, pragmatic, parallel group, superiority, cluster randomised controlled trial recruited three cohorts of schools (clusters) between 2012 and 2014, randomising them to TCM (intervention) or Teaching As Usual (TAU-control). TCM was delivered to teachers
in six whole-day sessions, spread over 6 months. Schools and teachers were not masked to allocation. The primary outcome was teacher-reported Strengths and Difficulties Questionnaire (SDQ) Total Difficulties score. Random effects linear regression and marginal logistic regression models using Generalised Estimating Equations were used to analyse the
outcomes. Trial registration: ISRCTN84130388.
Results. Eighty schools (2075 children) were enrolled; 40 (1037 children) to TCM and 40 (1038 children) to TAU. Outcome data were collected at 9, 18, and 30-months for 96, 89, and 85% of children, respectively. The intervention reduced the SDQ-Total Difficulties score at 9 months (mean (S.D.):5.5 (5.4) in TCM v. 6.2 (6.2) in TAU; adjusted mean difference
= −1.0; 95% CI−1.9 to −0.1; p = 0.03) but this did not persist at 18 or 30 months. Cost-effectiveness analysis suggested that TCM may be cost-effective compared with TAU at 30-months, but this result was associated with uncertainty so no firm conclusions can be drawn. A priori
subgroup analyses suggested TCM is more effective for children with poor mental health.
Conclusions. TCM provided a small, short-term improvement to children’s mental health particularly for children who are already struggling.

This paper assesses the reliability and validity of the teacher-completed Pupil Behaviour Questionnaire (PBQ), by comparing it to the already extensively validated teacher-completed Strengths and Difficulties Questionnaire (SDQ). Participants included 2074 primary school children participating in a universal school-based trial and 41 vulnerable children who were taking part in a study exploring the impact of exclusion from school. Exploratory factor analysis results (first factor accounts for 80.8% of the variation in the items) and the high Cronbach’s alpha value of 0.85 indicate that the PBQ consists of one substantive factor/dimension. Strong correlations between the total PBQ score and the conduct sub-scale (Spearman’s correlation coefficient (rs) = 0.67) and total difficulties score (rs = 0.59) of the SDQ indicate convergent validity. This study suggests that the PBQ is a reliable measure, and provides some evidence of validity. Further work is needed to test the PBQ in an older, more diverse populations and to measure sensitivity to change.

BACKGROUND: a number of studies demonstrate that children who are younger within their school year have poorer academic attainment and are more likely to have special educational needs. Few, however, have considered the impact relative age may have on child mental health, behaviour and happiness in school. METHODS: This paper utilized data from the Supporting Teachers and Children in Schools study (2075 pupils aged 5 to 9 years from 80 primary schools) to explore the relationship among relative age, behaviour and happiness in school. Behavioural and emotional development was assessed by using the teacher-reported and parent-reported Strengths and Difficulties Questionnaire and the Pupil Behaviour Questionnaire. Children's happiness within school was assessed by using the How I Feel About My School Questionnaire. RESULTS: Relatively younger children had higher Total Difficulties scores on the Strengths and Difficulties Questionnaire than their peers. There was a mean increase per 30-day decrease in relative age of 0.09 (95% CI: 0.03 to 0.16; p = 0.007) in teacher-reported and 0.08 (0.001 to 0.16; p = 0.05) in parent-reported scores. There was little evidence of a relationship between relative age and children's behaviour and happiness in school. CONCLUSIONS: for children with complex difficulties, being relatively young for their school year may be an additional stressor that may undermine mental health.