Relationships between psychosocial factors and abusive parenting attitudes in low-income single mothers

BACKGROUND: Linkages among family violence, maternal mental health, and parenting attitudes are not clearly understood. OBJECTIVE: To investigate the relationships of abuse (childhood and/or partner), everyday stressors, self-esteem, depressive symptoms, and anger with abusive parenting attitudes. METHOD: Cross-sectional analysis of data collected in interviews with 53 low-income, single mothers from wave two of a 3-wave study. A conceptual framework and bivariate correlations guided a series of multiple regressions to identify the best predictors for each variable. RESULTS: A high prevalence of abuse, depressive symptoms, and abusive parenting attitudes was found. Few women had ever received mental health treatment. Abuse (partner and childhood physical) predicted higher everyday stressors which in turn predicted lower self-esteem. Childhood abuse and lower self-esteem predicted more depressive symptoms. More depressive symptoms were related to higher levels of state anger. More everyday stressors and more depressive symptoms predicted higher levels of trait anger. Higher levels of anger expression were associated with higher everyday stressors and lower self-esteem. The presence of partner abuse best predicted higher levels of overall abusive parenting attitudes and more parent-child role reversal. Less parental empathy was associated with higher levels of state anger. CONCLUSIONS: This study partially explains the relationships of maternal abuse history and mental health status with parenting attitudes. Other predictors of parenting attitudes remain to be identified. The findings underscore the need for healthcare providers to consider the mental health status and abuse histories of low-income, single mothers. The potential disturbance in the parenting process of single mothers in abusive relationships warrants further investigation.     

Maternal stresses and depressive symptoms: correlates of behavior problems in young children

In a sample of 115 mothers of 5- and 6-year-old children maternal everyday stressors, stressful life events, and maternal depressive symptoms were compared with mothers' reports of children's behavior problems. Maternal depressive symptoms did not mediate the relationship between either form of stress and child behavior problems. Maternal everyday stressors were more strongly associated with child behavior problems than were life events. Children of mothers indicating a high level of everyday stressors were 13 times more likely to be rated as having behavior problems than children of mothers reporting a low level of everyday stressors. The best prediction of mothers' reports of children's behavioral problems was provided by maternal everyday stressors and stressful life events considered simultaneously.     

Maladaptive Mother-Child Relationships: A Pilot Study

The primary purposes of this pilot study were to identify maternal psychosocial correlates of unrealistic expectations of children and of child abuse potential, and to investigate the relationships of these factors with child behavior. A cross-sectional, two-group design was used. One group consisted of 20 low-income mothers whose preschool children were referred to a family care center for suspected abuse or neglect. A comparison group was made up to 20 low-income mothers whose children attended a university-based pediatric clinic and who were not referred for abuse or neglect. Data were collected during structured in-home interviews with the mothers. Measures of parental bonding, maternal depressive symptoms, unrealistic expectations of children, child abuse potential, and child behavior were obtained. Preschool teachers of the children also rated the children's behavior. Mothers with high depressive symptoms reported more unrealistic expectations of children and had greater child abuse potential scores than those with fewer symptoms. The more child behavior problems mothers reported, the greater their unrealistic expectations of the children and the higher their score for child abuse potential. Maternal depressive symptoms were not directly related to child behavior. Teacher reports of child behavior were moderately correlated with maternal reports, but no study variable was associated with teacher reports.     

Maternal factors associated with child behavior.

BACKGROUND: Knowledge of the relative contributions of risk factors in predicting young children's behavior problems may provide insights for the development of preventive interventions. OBJECTIVE: The purpose of this cross-sectional study was to identify maternal predictors of children's internalizing and externalizing behaviors in a volunteer sample of 205 low-income, single mothers with children between 2 and 6 years of age. METHOD: Data were collected on chronic stressors, self-esteem, negative thinking, depressive symptoms, and child behavior during in-home interviews with the mothers. RESULTS: Mothers' reports of internalizing and externalizing behaviors did not differ by sex or race of the child. Chronic stressors and depressive symptoms, in addition to control variables, explained 27% of the variability in internalizing behavior while these two variables accounted for 21% of the variability in externalizing behavior. For both internalizing and externalizing behavior, chronic stressors exerted the largest total effects. The effects of self-esteem and negative thinking were indirect, with the latter playing a stronger role. The indirect effect of negative thinking on child behavior was exerted through depressive symptoms, while self-esteem was linked with child behavior through both negative thinking and depressive symptoms. CONCLUSIONS: Decreasing mothers' negative thinking, a variable amenable to intervention, may not only decrease a mother's depressive symptoms but also improve her perception of the child's behavior. CLINICAL RELEVANCE: Decreasing mothers' negative thinking may provide a way to reduce their depressive symptoms and result in fewer behavior problems among their young children. Nurses working in primary care and community-based settings are in key positions to address this problem and improve the mental health of low-income mothers and positively affect the behavior of their children.     

Dysfunctional Attitudes, Coping, and Depression Among HIV-Seropositive Men Who Have Sex with Men

Several studies have documented elevated levels of psychological distress among HIV-seropositive (HIV+) symptomatic men who have sex with men (MSM). However, very little is known about the role of dysfunctional attitudes and coping strategies in maintaining and ameliorating distress levels in ways that can inform those developing psychosocial interventions for HIV+ persons. This study evaluated relations between dysfunctional attitudes and depression and examined the role of coping as a mediator of this relationship among 115 HIV+ symptomatic MSM. Higher Dysfunctional Attitude Scale scores were associated with more reported depressive symptoms. The use of adaptive coping strategies such as active coping was associated with lower depression, whereas use of maladaptive strategies such as denial was related to higher levels of depression. Both adaptive and maladaptive coping strategies mediated the relationship between dysfunctional attitudes and depression. Findings suggest that interventions aiming at reducing psychological distress in this population using cognitive restructuring and related techniques may achieve their effects by enhancing adaptive coping strategies on the one hand and reducing maladaptive strategies on the other.     

The relationships among self-esteem, stress, coping, eating behavior, and depressive mood in adolescents

The prevalence of adolescent overweight is significant, almost 25% in some minorities, and often is associated with depressive symptoms. Psychological and psychosocial factors as well as poor coping skills have been correlated with unhealthy eating and obesity. The purpose of this study was to examine relationships among self-esteem, stress, social support, and coping; and to test a model of their effects on eating behavior and depressive mood in a sample of 102 high school students (87% minority). Results indicate that (a) stress and low self-esteem were related to avoidant coping and depressive mood, and that (b) low self-esteem and avoidant coping were related to unhealthy eating behavior. Results suggest that teaching adolescents skills to reduce stress, build self-esteem, and use more positive approaches to coping may prevent unhealthy eating and subsequent obesity, and lower risk of depressive symptoms.     

Prevalence and Correlates of Depressive Symptoms in Mothers of Young Children

Mothers of young children are at risk for depressive symptoms due to their gender and status as parents. The primary purposes of this study were (1) to assess the prevalence of depressive symptoms in a sample of mothers with young children, (2) to identify sociodemographic correlates of depressive symptoms among the women, and (3) to determine if chronic stress is associated with depressive symptoms independent of other risk factors. In-home interviews were conducted with 196 mothers of 5- and 6-year-old children using the Center for Epidemiologic Studies--Depression (CES-D) Scale and the Everyday Stressors Index (ESI). High depressive symptoms (CES-D greater than or equal to 16) were reported by 49% of the mothers. They were highest among those who had never married, had less than a high school education, were under 25 years of age, were black, and had a low income. The ESI was a strong predictor of high depressive symptoms, controlling for sociodemographic characteristics. In comparison to mothers reporting a low level of everyday stressors (score = 5), those scoring 15 were 3 times more likely to have high depressive symptoms; those scoring 35 were more than 30 times as likely to have high CES-D scores. The results suggest the importance of chronic daily stressors as correlates of depressive symptoms in mothers of young children and also point to the need for multivariate models when examining predictors of those symptoms.     

Relationship among employment status, stressful life events, and depression in single mothers.

This purpose of this study was to extend our understanding of employment status as a social determinant of psychological distress among single mothers. A cross-sectional survey assessing stressful life events and depression was completed with 96 single mothers (48 employed and 48 social assistance [SA] recipients) between November 2003 and March 2004. The prevalence of depressive symptoms was significantly higher for the SA recipients. Mild, moderate, and severe depressive symptoms were reported by 2%, 23%, and 67%, respectively, of SA recipients. Total stressful events were markedly greater for SA recipients. In addition, SA recipients reported larger numbers of housing, health, social, and financial stressors. Regression analysis indicated that 40.6% of the variation in depressive symptoms among single mothers was explained by their employment status and stressful events. The findings suggest that women's employment status significantly impacts on their psychological well-being. Implications for nursing practice, policy development, and future research are identified and discussed.     

Employment status, depressive symptoms, and the mediating/moderating effects of single mothers' coping repertoire

OBJECTIVE: Single mothers, especially those on social assistance, report significantly more depressive symptoms than the general public. This article examines the relationships among employment status, stressful life events, and depressive symptoms among single mothers, with a special focus on the potential mediating and moderating roles of coping repertoire. DESIGN: Cross-sectional survey design. SAMPLE: Ninety-six single mothers (48 employed and 48 single mothers on social assistance) who were the primary caregiver for at least 1 child 4-18 years old. MEASUREMENTS: Mailed questionnaires that included an adapted version of the Social Readjustment Rating Scale, the Coping Strategy Inventory, and the Beck Depression Inventory, 2nd ed. were completed by study participants. RESULTS: Coping repertoire did not mediate the relationship between either employment status or stress exposure and depressive symptoms. Coping had an antagonistic and differential moderating effect on the association between employment status and depressive symptoms for employed single mothers and mothers receiving social assistance. CONCLUSION: Effective strategies aimed at promoting single mothers' mental health need to address both the severity of depressive symptoms found among single mothers, and the social-system factors that threaten single mothers' psychological well-being. The implications for practice and policy are discussed.     

The relationship between maternal chronic pain and child adjustment: the role of parenting as a mediator.

The role of parenting in the relationship between maternal chronic pain and negative child outcomes, including internalizing, externalizing, and social and health problems, was investigated. Parenting strategies used by mothers with chronic pain were compared to parenting strategies used by a control group of mothers without pain. Thirty-nine mothers experiencing chronic pain, their 55 children, 35 pain-free mothers, and their 48 children participated in the study. The results showed that for mothers with chronic pain, dysfunctional parenting strategies and the quality of the mother-child relationship were related to negative child outcomes. Mothers with chronic pain were more likely to engage in lax parenting and report reduced relationship quality with children than were control mothers. For the chronic pain group, over-reactive parenting was found to mediate the relationship between maternal physical functioning and child adjustment. Dysfunctional parenting strategies may constitute part of the risk that maternal chronic pain poses for children. The similarities between the impact of maternal chronic pain on child adjustment and that of other maternal stressors, such as depression, are discussed. PERSPECTIVE: In mothers with chronic pain, poor maternal physical functioning was associated with increased maternal over-reactive behavior that was in turn related to poor child adjustment. Maternal over-reactive behavior did not, however, differ in chronic pain and control mothers.     

慢性病患儿父母应激源、应对方式、心理状态及其影响因素的研究

目的了解慢性病患儿父母的应激源、应对方式、心理状态及其影响因素,为临床工作者提供信息,为临床干预提供依据。方法对280名慢性病儿童父母进行调查,采用半结构访谈方式了解其应激源,采用CHIP应对方式量表、Zung焦虑自评量表（SAS）和Zung抑郁自评量表（SDS）了解其应对方式、焦虑、抑郁状态。结果患儿父母应激源主要包括6个方面：患儿病情及身体状况、疾病治疗、经济方面、照顾患儿方面、角色功能及沟通交流。父母采用的积极应对方法比较局限,更多集中在为患儿寻求和维持更好的疾病治疗方面,而忽视了其自身的心理调节和寻求社会支持。58．6％的父母存在焦虑,56．8％存在抑郁,49．6％的父母同时存在焦虑和抑郁。父母应激源越多压力程度越大,采用积极应对方式的频率越少,焦虑和抑郁程度越重;良好的心理状态与其积极的应对方式呈正相关。结论慢性病患儿父母应激源较多,压力较大,对积极的应对方式的选择还比较局限,心理问题也较严重,应引起重视。     

Moving beyond survival: coping behaviours of low-income single mothers

Moving beyond survival: coping behaviours of low-income single mothers.
The purposes of this study were to describe the psychosocial and environmental contexts affecting the lives of low-income, single mothers and to explore their everyday coping strategies. Nine mothers of preschool children participated in multiple, unstructured and semi-structured in-home interviews. Traumatic childhood experiences including death of a parent and abuse contributed to the mothers' depression and to their coping strategies for survival. The women used creative economic survival strategies such as bartering to meet their families' basic needs. Social isolation, downward social comparison, conflict avoidance, and self-reliance were the emotional self-protective survival strategies used. Strategies to move up economically and emotionally related to the women's desire for a better life for themselves and their families.     

Stress and coping in high-risk mothers: difficult life circumstances,psychiatric-mental health symptoms,education, and experiences in their families of origin

A pilot study was conducted to test methods and measures used to assess factors related to stress and coping in high-risk mothers and their effect on parenting. Twenty mothers with 12-month-old toddlers were recruited from a WIC population; they came into an observational laboratory where they were interviewed about stressors in their lives and their symptoms of stress and were videotaped interacting with their children. Maternal difficult life circumstances, psychiatric-mental health symptoms, education, maternal experiences in their families of origin, and parenting stress explained 74% of the variance in maternal sensitive-responsiveness with their toddlers in the laboratory setting. The findings support the methods of the study. Clinical implications and implications for future research to assist in the development of interventions for this population are discussed. Increased attention to screening for maternal psychiatric-mental health symptoms and for negative experiences in mothers' families of origin may provide important opportunities for intervention with these mothers.     

Stress and coping responses to proficiency testing in school-age children

Nurses encounter school-age children experiencing multiple stressors and stress symptoms. Performance on proficiency tests is viewed as stressor. The purpose of this repeated measures study was to assess 53 fourth grade children's appraisal of proficiency tests, concurrent stressors, stress symptoms, and coping strategies. During October, February, March, and April, children completed a ranking of their stress associated with proficiency testing and also reported their stressors, stress symptoms, and coping strategies. Results indicated that children appraised proficiency tests as most stressful at the beginning of the school year but less stressful at the time of the test. Stressors and stress symptoms increased from baseline to 1 month before testing then declined. The number of coping strategies used by the children decreased throughout the year. Nurses can work with parents and teachers to identify children with test anxiety and target these children for interventions to improve their coping strategies.     

Changes in Mood and Depressive Symptoms and Related Change Processes During Cognitive–Behavioral Stress Management in HIV-Infected Men

This study examined the effects of a cognitive–behavioral stress management (CBSM) intervention vs. a no-treatment control group in 100 HIV-infected gay men. CBSM participants showed significant decreases in mood disturbance and depressive symptoms as well as changes in coping, perceptions of social support, self-efficacy, and dysfunctional attitudes. Stepwise regression analyses were conducted to determine which of these changes were most important for reductions in mood disturbance and depressive symptoms. Although increases in self-efficacy emerged as a significant predictor of reduction in both mood disturbance and depressive symptoms, improvements in behavioral coping strategies were most closely tied to lowered overall mood disturbance whereas improvements in cognitive coping strategies and reduction in dysfunctional attitudes were more closely associated with decreases in depressive symptoms. These results support the use of multimodal CBSM interventions for HIV-infected men as a way to modify many different types of processes independently associated with different indicators of psychological adjustment.     

Stressors, coping and depression in haemodialysis patients

BACKGROUND: Depression is common in persons receiving outpatient haemodialysis, but little work has been done to explore the variables associated with depression. AIMS: The primary purposes of this study were to (i) examine relationships among stressors, coping and depression and (ii) test the mediating role of coping. DESIGN/METHODS: Data were collected at two points in time, three months apart in 1995/1996. The final convenience sample at Time 2 was 86 participants from two United States midwestern, inner-city dialysis units. Structured interviews were conducted using the Centre for Epidemiologic Studies Depression Scale, the haemodialysis stressor scale (HSS) and the coping strategy indicator. RESULTS: At Time 1 more psychosocial stressors were associated with greater use of problem-solving, social-support and avoidance coping. Both avoidance coping and more psychosocial stressors at Time 1 were related to depression at Time 2. Finally, avoidance coping was found to explain much of the relationship between psychosocial stressors and depression. CONCLUSIONS: Research is now needed that explicates the causal relationships among stress, coping and depression in haemodialysis patients.     

Examining the Adjustment Patterns of Adults With Multiple Chronic Pain Conditions and Multiple Pain Sites: More Pain,No Gain

The present study examined how multiple chronic pain conditions and pain sites are associated with sociodemographics, chronic pain adjustment profiles, and emotional distress. A total of 2,407 individuals who reported at least 6 months of having consistent pain severity, pain interference, and/or emotional burden due to pain were recruited through random digit dialing across the United States. Participants’ chronic pain adjustment profiles (ie, pain intensity, pain interference, emotional burden, pain catastrophizing, pain coping, pain attitudes, and social resources) were assessed. Anxiety and depressive symptoms were also measured using a subsample of 181 participants who provided 3-month follow-up data. More than 60% of individuals with chronic pain reported having multiple pain conditions. Middle-aged single women with fibromyalgia, disability and of low socioeconomic status reported a greater number of pain conditions and pain sites. Structural equation modeling revealed that a higher number of pain conditions and sites were associated with more dysfunctional chronic pain adjustment profiles. The subsample analyses showed that reporting a greater number of pain conditions predicted a higher level of depression and anxiety 3 months later, controlling for pain-related anxiety and depressive symptoms, pain severity and interference at baseline. Having multiple pain conditions and sites may represent a psychosocial barrier to successful adjustment to chronic pain.PerspectiveThis article argues for the importance of assessing the number of co-occurring chronic pain conditions and bodily areas that are affected by pain in both pain research and clinical settings. Measuring and incorporating such information could potentially enhance our nascent understanding of the adjustment processes of chronic pain.