The Efficacy of Parent Training for Promoting Positive Parent—Toddler Relationships

The effectiveness of a parent training program for promoting positive parent-child relationships was examined among families of 2-year-olds. Forty-six mothers and fathers and their toddlers were assigned to either an intervention or comparison group. Intervention group parents participated in a 10-week program that focused on principles for effectively interacting with their toddlers. Parents completed measures of parenting self-efficacy, depression, stress, and perceptions of their toddler's behaviors and were videotaped playing with their toddlers preintervention, postintervention, and 3 months following the intervention. Repeated measures ANOVAs showed that the parent training program led to significant increases in maternal self-efficacy, decreases in maternal stress, and improvements in the quality of mother-toddler interactions. No significant effects were found among fathers. Explanations for obtaining different outcomes for mothers and fathers are discussed and directions for future research are recommended. ©1995 John Wiley & Sons, Inc.     

Positive Experiences of Mothers and Fathers of Children with Autism

Background The present study examined the positive experiences of parents raising school‐aged children with autism within the context of parenting stress. Materials and Methods Participants included 23 mother/father pairs raising children with autism (ages 5 to 11 years, M = 7.39). Parents completed measures of parenting stress and positive experiences of raising their children. Results Consistent with previous research in a pre‐school aged population of children with autism, mothers reported significantly more positive experiences than did fathers. Mothers’ and fathers’ reports of their positive experiences were negatively related to their reports of parenting stress. Fathers’, but not mothers’, positive experiences were negatively related to their partners’ reports of parenting stress. Conclusion Findings are discussed within a positive psychology framework suggesting that a focus on positive experiences may buffer against negative well‐being.     

A population-based study of exclusive breastfeeding in Icelandic women: is there a relationship with depressive symptoms and parenting stress?

This study investigated whether postpartum depressive symptoms and parenting stress are related to exclusive breastfeeding in mothers at 2-3 months postpartum. Data were collected from 734 Icelandic mothers postpartum. Parenting stress, depressive symptoms, feeding methods and demographical data were assessed by self-administered questionnaires. A high level of maternal education increased the likelihood of exclusive breastfeeding whereas lower maternal education, high levels of depressive symptoms, twins and single motherhood reduced the likelihood of exclusive breastfeeding. It is concluded that depressive symptoms are related to lower levels of exclusive breastfeeding and that exclusive breastfeeding becomes more likely with higher level of maternal education.     

Immigrant youth at risk for disorders of mood: recognizing complex dynamics

The number of youth immigrating to the United States from Latin America and the Caribbean has consistently and dramatically been increasing. However, little research or epidemiological data that capture the mental health status of these youth from their countries of origin or once they enter the United States exist. As a result of migration and the acculturation process, these youth are at risk for exacerbation of preexisting mood disorders or development of mood or other psychiatric symptoms. Pre-migration social and environmental stressors affecting this population include poverty, exposure to violence, sexual or physical victimization, and substance abuse. Post-migration stressors include loss (of friends, family, country, and lifestyle), changes in social support, negative experiences in the United States, language difficulties, and academic challenges. This review of the existing literature will describe the contextual experiences of immigrant Latin American and Caribbean youth from their country of origin and as new immigrants in the United States, discuss their risk for mood disorders, highlight relevant assessment data that should be obtained, and identify treatment implications for advanced practice psychiatric-mental health nurses working with this population.     

Sense of Coherence,Parenting Attitudes and Stress among Mothers of Children with Autism in Hong Kong

Background The moderating and mediating relationships among sense of coherence, parental attitudes and parenting stress for caregiving parents of children with autism were tested. Materials and Methods One hundred and fifty‐seven mothers of children with autism recruited from representative community service centres in Hong Kong completed the Chinese versions of Sense of Coherence Scale (SOC), Confidence and Acceptance subscales of Parent‐Attitude Survey Scales and Parenting Stress Index Short Form. Results Accounting for mothers’ demographic background, SOC showed a moderating effect with child's symptoms and parenting stress. Mothers with a strong SOC perceived lower stress than their counterparts even when their children presented with more severe autistic symptoms. Two proximal factors in parenting, parental confidence and acceptance of the child, were found to partially mediate SOC and stress. Conclusions The stress experience of mothers of children with autism is related strongly to a global sense of coherence as well as more specific parenting attitudes.     

Postpartum return to work: mothering stress, anxiety, and gratification.

Over half of mothers with infants less than 1 year old are employed, yet there is limited research examining the early parenting experiences of these women. The purpose of this study was to examine maternal gratification, stress, and separation anxiety, in relation to employment patterns and selected health-status indicators, of women returning to work during the first postpartum year. Data were gathered from 142 employed, well-educated, partnered, predominantly Caucasian women at 1, 4, and 8 months postpartum, using a mailed questionnaire. Their parenting experiences improved throughout the first postpartum year. While depression and fatigue were associated with greater parenting stress and anxiety, as well as a decreased sense of gratification from parenting, few women experienced these symptoms at clinically significant levels. Employment patterns were unrelated to parenting stress or gratification. These findings can be used by clinicians when counselling women regarding the decision to return to work after childbirth.     

Effects of stress and social support on postpartum health of Chinese mothers in the United States

Postpartum maternal well being across cultures has received limited research attention. We examined relationships among stress, social support, and health in 152 Chinese mothers <1 year postpartum in the United States. These mothers did not perceive high levels of stress, although they did not receive as much support as they indicated they needed; 23.7% of mothers scored high for depressive symptoms. About half of the mothers experienced interrupted sleep, decrease in memory, and lack of sexual desire. All health measures were inter‐correlated. Social support moderated the effects of stress on depressive symptoms. Culturally relevant care that is perceived as supportive may promote postpartum maternal health. © 2009 Wiley Periodicals, Inc. Res Nurs Health 32:582–591, 2009     

Stress among Mothers of Children with Intellectual Disabilities in Urban India: Role of Gender and Maternal Coping

Background The study assessed stress among mothers of young children with intellectual disabilities in urban India and examined the extent to which child functioning and maternal coping predict maternal stress. Through qualitative analyses, the study identified negative and positive dimensions of Indian mothers’ caregiving experiences. Materials and Methods Mothers completed Parenting Stress Index‐Short Form, and children’s teachers completed Vineland‐II teacher rating form. Maternal responses to a semi‐structured interview were rated to assess maternal coping and content analysed to derive qualitative themes. Results Three‐fourths of the sample obtained a clinically significant stress score, and maternal coping emerged as a robust predictor of stress for mothers of boys with intellectual disabilities. Qualitative analyses indicated positive and negative maternal experiences related to self, child, family and community. Conclusions The high level of stress has important clinical implications. Similarly, the significant role of maternal coping, moderating role of child gender and the multidimensional caregiving experiences have implications for future research and family interventions in India.     

Types, availability, and perception of social support among parents of young children with cognitive delays in Vietnam

Parents of young children with disabilities experience increased parenting stress owing to the caregiving demands the children place on them and concern over how they will raise and care for their children in the future. Support or understanding from others can be helpful in relieving the psychological and physical strain that caregivers experience. The project examined the types and availability of social support for Vietnamese parents of young children with cognitive delays, and their perceived social support and parenting stress. Fourteen types of informal support (spouse, wife's father, wife's mother, husband's father, husband's mother, wife's siblings, husband's siblings, sons, daughters, other relatives, friends, neighbors, and parents of other children with disabilities and social helpers) and eight types of professional support (teachers, therapists, doctors, private therapists, home helpers, social agencies, babysitters, and doctors in community health clinics) were available. When the level of intellectual functioning among children was lower, both mothers and fathers reported less availability of support from most types of informal support and teachers. For both mothers and fathers, a larger network of informal and professional support reduced the amount of stress they experienced. Specifically, however, when immediate family members were not available, mothers were more likely to experience parenting stress whereas the unavailability of friends and neighbors increased fathers' parenting stress. While addressing the stigma in society that affects the lives of the families of the children with disabilities in gaining informal support, the need for developing professional services in developing countries is discussed.     

The relationship of maternal attributes, resources, and perceptions of postpartum experiences to depression

The relationships of maternal attributes, resources, and perceptions of the postpartum experience to postpartum depression (PPD) were examined. One hundred and forty-three mothers completed measures of maternal attributes, resources, and perceptions of the postpartum experience, as well as depressed mood and clinical depression symptoms. Results from canonical correlation analysis revealed two patterns. Pattern 1: Women without history of depression, more emotional support from partners, higher parenting evaluation, lower centrality of the infant in the mother's thoughts and actions, and fewer life changes had lower depressed mood and fewer clinical depression symptoms than their counterparts. Pattern 2: Mothers without history of depression who were married, with higher financial stress, and lower parenting evaluation had higher depressed mood, but not more clinical depression symptoms. Maternal age, parity, time since delivery, income, and help from partner were unrelated to either depression indicator. These patterns suggest multiple paths to PPD, and the need for routine mental health assessment and exploration of women's perceptions of their postpartum experience.     

Parenting stress, marital quality, and child behavior problems at age 7 years

The study examined the relationship of early family environment and infant characteristics with childhood behavior problems at age 7 years. Sixty-two mothers and 56 fathers of preterm (30-36 weeks gestation and greater than 1500 g) and full-term boys and girls completed the Parenting Stress Index, Dyadic Adjustment Scale, and a measure of socioeconomic status during the child's first year. When their child was age 7 years, parents completed the Eyberg Child Behavior Inventory Intensity (frequency of behavior) and Problem (impact of behavior) scales. Hierarchical regression analyses showed that parenting stress because of their child's distractibility during infancy predicted the frequency of childhood behavior problems at age 7 years for mothers and of the impact of behaviors on the mother and the father. The quality of the marital relationship during infancy predicted the frequency of behavior problems reported by fathers. Public health nurses are well positioned to assess parenting stress and marital quality and to provide support to families during the early stages of parenthood.     

Maternal depression and anxiety and infant development: a comparison of foreign-born and native-born mothers

Studies that investigate infant and/or child development in families of depressed or anxious mothers do not include samples of foreign-born non-English-speaking mothers. This article describes a pilot study investigating infant development, maternal depression, and anxiety in comparison samples of native-born and foreign-born mothers and children from Vietnam, Laos (Hmong), and the Democratic Republic of Congo. Maternal depression and anxiety were measured with the Hopkins Symptom Checklist-25, and the developmental status of children 0-25 months of age was measured with the Denver II. Foreign-born mothers were more anxious than native-born mothers. Non-English-speaking foreign-born mothers were clinically depressed (1.83) and moderately anxious (1.62). Infants of native-born mothers and English-speaking foreign-born mothers performed better on the Denver II than children of foreign-born non-English-speaking mothers. Infants and toddlers of non-English-speaking mothers appear to be at high risk for delays during their first 25 months of life. Public health nurses need to advocate for appropriate interpreter services and mental health resources for non-English-speaking mothers of young children. Developmental screening should reflect cultural variations in parental expectations of how and when children meet developmental milestones. Replication studies and investigation about the long-term development of this high-risk group of children are needed.     

Psychosocial predictors of maternal depressive symptoms, parenting attitudes, and child behavior in single-parent families.

The purposes of the study were to identify psychosocial predictors of depressive symptoms among low-income, single mothers and to investigate the effects of maternal psychosocial factors, depressive symptoms, and parenting attitudes on children's behavior. In-home interviews were conducted with 225 mothers to obtain data on their everyday stressors, coping strategies, social resources, depressive symptoms, and parenting attitudes, as well as reports of their children's behavior. High depressive symptoms occurred among 59.6% of the women. Higher depressive symptoms were associated with greater everyday stressors, fewer social resources, and greater use of avoidance coping. Neither social resources nor coping strategies buffered the relationship between everyday stressors and depressive symptoms. Maternal depressive symptoms predicted parenting attitudes. Parenting attitudes, in turn, predicted child behavior. These findings suggest that depressive symptoms are indirectly associated with mothers' reports of child behavior through their influence on parenting attitudes.     

Short‐term in‐home intervention reduces depressive symptoms in Early Head Start Latina mothers of infants and toddlers

Depressive symptoms may compromise the ability of low‐income Latina mothers with limited English language proficiency to parent their infants or toddlers. Eighty Early Head Start Latina mothers with limited English language proficiency were randomized to an advanced practice nurse‐delivered, culturally tailored, in‐home psychotherapy intervention, or to usual care. Repeated measures regression analysis showed a significantly greater decrease in depressive symptoms for intervention mothers compared to the usual care group at 22 and 26 weeks (4 weeks post intervention). Intervention mothers' reports of their child's aggression diminished significantly from T1 to T4 compared to usual care mothers (p = .03). Self‐efficacy appeared to only partially mediate the intervention effect, and maternal health moderated the intervention impact. Results indicate that the intervention reduced depressive symptoms and, compared to previous studies in this population, retention of mothers in both intervention and control conditions was improved. © 2009 Wiley Periodicals, Inc. Res Nurs Health 33:60–76, 2010     

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.     

The Buffering Effect of Resilience upon Stress, Anxiety and Depression in Parents of a Child with an Autism Spectrum Disorder

The possible buffering effects of psychological resilience on stress, anxiety and depression associated with parenting a child with an Autism Spectrum Disorder (ASD) were investigated in 73 mothers and 35 fathers who had at least one child with an ASD and who completed a questionnaire about their experiences as parents. Mothers were significantly more anxious and depressed than fathers, and reported being “stretched beyond their resources” more frequently than fathers. Both mothers and fathers reported clinically significant anxiety and depression between three and five times the rate reported in the normal adult population. Moderation analysis showed that psychological resilience acted as a buffer against the development of elevated anxiety and depression associated with high levels of daily stress from parenting. Further, although the daily stress of parenting a child with an ASD was associated with quite severe anxiety and depression, even relatively low levels of resilience buffered against this anxiety and depression. Suggestions are made for assisting parents to develop psychological resilience in dealing with the stress associated with parenting their child with an ASD.