The Role of Maternal Psychological Adjustment in the Measurement of Children's Functional Status

Studied the ways that mothers interpret illness behavior intheir children to assess whether maternal psychological adjustmentpredicts maternal perceptions of children's behavioral limitationsand attribution of these behaviors to chronic illness. Functionalstatus ratings and attributions to illness by 365 mothers of5-to 8-year-old children with chronic illnesses were associatedwith children's overall adjustment but not with mothers' ownpsychological distress. Illness attributions also were relatedto the child's medical visits and hospitalizations. Thus, mother'sillness attributions are related to her perceptions of the child'shealth and more general behavioral adjustment, but not to herown mental health. Results support the validity of the FS II(R)as a measure of functioning related to children's health statusthat is not influenced by maternal psychological adjustment.     

Child and Maternal Adaptation To Cystic Fibrosis and Insulin-Dependent Diabetes Mellitus: Differential Patterns Across Disease States

Investigated the relationship between maternal and child emotionaladaptation both across and within samples of children with cysticfibrosis (CF) and insulin-dependent diabetes mellitus (IDDM).Higher levels of maternal depression were associated with increaseddepression in children with IDDM. In addition, increased illnessseverity and greater length of time since diagnosis were relatedto increased depression in children with IDDM. Whereas maternaldepression was related to decreased trait anxiety for childrenin the CF group, neither maternal anxiety or depression wereassociated with child depression or state anxiety. Empiricaland clinical implications of a disease-specific approach tostudying chronic disease in children are discussed.     

Examining the Effects of Chronic Disease and Disability on Children's Sibling Relationships

Research on siblings of children with a variety of developmentaldisabilities and major chronic illnesses was reviewed withinthe context of literatures on typical sibling relationshipsand family adaptation. Assumptions, questions, and methods guidingcurrent research were analyzed and critiqued. To date, studieshave addressed a narrow range of variables and issues-the detectionof maladjustment being the primary concern. Further, predominantreliance on more subjective and anecdotal research methods andfailure to control for confounding factors limit the value ofinvestigations. Certain popular beliefs and perceptions havegained support but others have not, in particular the assumptionthat siblings of handicapped and ill children experience morefrequent psychological disturbance. A variable matrix is proposedthat may help investigators identify relevant factors, avoidpotential confounds, and generate productive hypotheses andresearch designs.     

A Content Analysis of Safety Behaviors of Television Characters: Implications for Children's Safety and Injury

Examined frequency and characteristics of safety behaviors intelevision programs popular with child audiences. A sample of52 programs was coded for safety event location, demographiccharacteristics of safety models, social and physical contextsof safety events, and successful or unsuccessful outcomes ofsafety behaviors. Results indicate an overall rate of 13 safetybehaviors per hour, with over half of all safety behaviors locatedin commercial advertisements. Most safety behaviors were performedby male adult characters, had limited relevance for children,and were not associated with either positive or negative outcomes.Findings are discussed in terms of their relevance for observationallearning of safety behaviors by child viewers.     

Maternal and littermate deprivation disrupts maternal behavior and social-learning of food preference in adulthood: tactile stimulation, nest odor, and social rearing prevent these effects

Maternal and littermate (social) separation, through artificial rearing (AR), disrupts the development of subsequent maternal behavior and social learning in rats. The addition of maternal-licking-like stimulation during AR, partially reverses some of these effects. However, little is know about the role of social stimuli from littermates and nest odors during the preweaning period, in the development of the adult maternal behavior and social learning. The purpose of this study was to examine the effects of peer- and peer-and-odor rearing on the development of maternal behavior and social learning in rats. Female pups were reared with mothers (mother reared-MR) or without mothers (AR) from postnatal day (PND) 3. AR rats received three different treatments: (1) AR-CONTROL group received minimal tactile stimulation, (2) AR-ODOR females received exposure to maternal nest material inside the AR-isolation-cup environment, (3) AR-SOCIAL group was reared in the cup with maternal nest material and a conspecific of the same-age and same-sex and received additional tactile stimulation. MR females were reared by their mothers in the nest and with conspecifics. In adulthood, rats were tested for maternal behavior towards their own pups and in a social learning task. Results confirm our previous report that AR impairs performance of maternal behavior and the development of a social food preference. Furthermore, social cues from a littermate, in combination with tactile stimulation and the nest odor, reversed the negative effects of complete isolation (AR-CONTROL) on some of the above behaviors. Exposure to the odor alone also had effects on some of these olfactory-mediated behaviors. These studies indicate that social stimulation from littermates during the preweaning period, in combination with odor from the nest and tactile stimulation, contributes to the development of affiliative behaviors.     

Interparental Agreement on Internalizing, Externalizing, and Total Behavior Problems: A Meta-analysis

Previous studies have addressed the degree of correspondence between interparental reports of children's behavior problems, but have not examined the discrepancies in these reports. A meta-analysis containing 60 studies and 126 independent effect sizes was conducted. Results suggest that maternal and paternal ratings exhibit moderate correspondence in ratings of internalizing behavior problems in children and large correspondence in ratings of externalizing and total behavior problems in children. In terms of discrepancy of reports, parents reported similar levels of all types of problems. Age, gender, and socioeconomic status were found to moderate correspondence between mothers' and fathers' ratings but did not moderate discrepancies in mothers' and fathers' ratings.     

Relationship of Parental Psychological Distress to Consequences of Chronic Health Conditions in Children

Objective: To assess whether parents' self-reported psychologicaldistress was related to consequences of chronic health conditionsin their children as reflected by three domains: functionallimitations, reliance on compensatory mechanisms, and serviceuse above routine care. Methods: We used telephone survey data on children's healthand parents' psychiatric symptoms from an inner-city communitysample (n = 380) and a population-based national sample (n =398). Results: In the national sample, parents of children with functionallimitations were more distressed than parents whose childrenexperienced other types of condition consequences or none. Inthe inner-city sample, presence of a health condition was associatedwith greater parental distress, but there were no significanteffects by consequence type. Conclusions: Research needs to determine if parents of childrenwith functional limitations represent a high-risk group andto identify the factors associated with their elevated distress.     

Childhood chronic illness as a family stressor.

Investigated the impact of childhood chronic illness within a family context. We interviewed 30 mothers of 6- to 14-year-old children with asthma or diabetes and 30 mothers of healthy children of the same age and sex. Family functioning, extrafamilial social support available to mothers, and child life stress events were examined in relation to the children's psychological adjustment and illness events. The mothers of asthmatic children reported a greater number of internalizing behavior problems in their children, perceived their own social support as less adequate, and reported a greater number of stressful events. Regression analyses demonstrated that family functioning, maternal social support, and chronic illness were significantly related to the psychological adjustment of the child. The importance of family functioning and resources available to the family, such as social support, are discussed as protective influences in coping with childhood chronic illness.     

Maternal inheritance of BDNF deletion,with phenotype of obesity and developmental delay in mother and child

Childhood obesity is a significant world health problem. Understanding the genetic and environmental factors contributing to the development of obesity in childhood is important for the rational design of strategies for obesity prevention and treatment. Brain‐derived neurotrophic factor (BDNF) plays an important role in the growth and development of the central nervous system, there is also an evidence that BDNF plays a role in regulation of appetite. Disruption of the expression of this gene in a child has been previously reported to result in a phenotype of severe obesity, hyperphagia, impaired cognitive function, and hyperactivity. We report a mother and child, both with micro‐deletions encompassing the BDNF gene locus, who both have obesity and developmental delay, although without hyperactivity. This report highlights the maternal inheritance of a rare genetic cause of childhood obesity.     

Maternal parenting style and adjustment in adolescents with type I diabetes

OBJECTIVE: To investigate the cross-sectional relationship between maternal parenting style and indicators of well-being among adolescents with diabetes. METHODS: Seventy-eight adolescents (ages 11.58-17.42 years, M = 14.21) with type 1 diabetes and their mothers separately reported perceptions of maternal parenting style. Adolescents reported their own depressed mood, self-efficacy for managing diabetes, and diabetes regimen adherence. RESULTS: Adolescents' perceptions of maternal psychological control were associated with greater depressed mood regardless of age and gender. Firm control was strongly associated with greater depressed mood and poorer self-efficacy among older adolescents, less strongly among younger adolescents. Adolescents' perceptions of maternal acceptance were associated with less depressed mood, particularly for girls and with better self-efficacy for diabetes management, particularly for older adolescents and girls. Maternal reports of acceptance were associated only with adherence. CONCLUSIONS: Maternal parenting style is associated with well-being in adolescents with diabetes, but this association is complex and moderated by age and gender.     

Influences of Transportation on Health Decision-Making and Self-Management Behaviors among Older Adults with Chronic Conditions

Although transportation has been established as a facilitator/barrier to health self-management, little is known about how the context of transportation shapes health self-management behaviors and decision-making among older adults with chronic conditions. This study interviewed 37 older adults with chronic conditions in Florida to examine their perspectives about how transportation influences their chronic care self-management. The data were systematically analyzed for themes. The thematic findings revealed how transportation intersected with participants' everyday experiences with chronic health self-management, how they evaluated transportation as part of the process of making decisions about health, and how creative problem-solving about transportation became an additional health self-management activity for addressing their complex needs. These findings suggest that the context of transportation goes beyond a basic facilitator/barrier for health and enhance our understanding about how transportation services and policies may be changed to better address the needs of older adults with chronic conditions.     

Maternal Child-Rearing Behavior in Three Groups: Cystic Fibrosis, Insulin-Dependent Diabetes Mellitus, and Healthy Children

Compared child-rearing behaviors among mothers of children (ages4–14) with cystic fibrosis (CF) (N = 26), insulin-dependentdiabetes mellitus (IDDM) (N = 26), and mothers of physicallyhealthy children (N = 26), on six domains, including involvement,limit setting, responsiveness, reasoning and guidance, freeexpression, and intimacy using the Iowa Parent Behavior Inventory.Maternal Reports of their child-rearing behavior were comparableacross the three groups with one exception: Mothers of childrenwith chronic illnesses (CF and IDDM) were significantly lesslikely to set limits than mothers of healthy children. The presentfindings are consistent with those of other studies that haveidentified few differences in child-rearing practices betweenmothers of children with chronic illnesses and mothers of healthychildren. Future research should identify situation-specificparenting tasks unique to childhood chronic illness.     

Using Shared and Unique Parental Views to Study the Etiology of 7-Year-Old Twins' Internalizing and Externalizing Problems

In a sample of 1,940 Dutch 7-year-old twin pairs we studied the etiology of individual differences in Internalizing and Externalizing behavioral problems. For the majority of twins in the sample, both maternal and paternal ratings of behavioral problems were obtained from the Child Behavior Checklist. This made it possible to take into account processes underlying agreement and disagreement between maternal and paternal ratings. For both problem behaviors, a Psychometric model fitted the data better than a Rater Bias model, implying that parents, in addition to the behaviors they similarly observed, also assessed unique aspects of their children's behaviors. Relatively large genetic influences were found for Externalizing problems, explaining over 50% of the variance in both boys and girls. For internalizing problems, the heritability was over 30% in both sexes. Shared environmental factors were nearly as important as genetic influences in explaining the variation in behavioral problems. For both Externalizing and Internalizing problems, around 30% of the variance was accounted for by the shared environmental factors.     

Contributions of Genes and Environments to Stability and Change in Externalizing and Internalizing Problems During Elementary and Middle School

We examined longitudinally collected behavioral reports by teachers on a unique twin sample at the ages of 7, 8, 9, 10, 11, and 12 years. As twin and adoption studies implicate the role of genetic influence on behavioral problems found to be stable in epidemiological samples, the current study employs a developmental behavior genetic model to examine the extent to which genetic and environmental contributions to problem behaviors are stable and/or change during development. In this sample of 410 monozygotic (MZ) and 354 dizygotic (DZ) twins, MZ twins were rated as more similar than DZ twins on average. In general, boys were more frequently rated as displaying externalizing behaviors than were girls across each of the six observations, while girls’ internalizing problems were found not to be significantly different from boys’. For both sexes, stability in externalizing problem behaviors was due to a single common genetic factor whose effects acted pleiotropically at each age in the presence of unique environmental influences that were transmitted from age-to-age. Change was largely due to uncorrelated age-specific non-shared environmental and additive genetic effects. Contributions to stability for internalizing problems were due to age-to-age transmission of earlier expressed genetic effects. Change for girls and boys internalizing problems were largely due to environmental experiences unique to siblings along with uncorrelated age-specific genetic effects. These results further inform the notion that individual environments are important factors in the etiology of problem behaviors, but suggest that heritable contributions to phenotypic stability are largely the same across middle childhood and early adolescence. Clinical implications of these findings are discussed.     

Hair cortisol in the perinatal period mediates associations between maternal adversity and disrupted maternal interaction in early infancy

Existing literature points to the possibility that cortisol could be one link between maternal adversity and poorer parenting quality, but most studies have examined salivary cortisol concentrations rather than hair cortisol concentrations. The current study examined hair cortisol concentration (HCC) during the third trimester of pregnancy as a mediator between maternal adversity indicators (childhood abuse, severe mental illness, symptomatic functioning) and maternal caregiving behavior at 4 months postpartum. Forty-four women participated in the study: 30 with severe mental disorders, and 14 nonclinical controls. HCC was assessed during the third trimester of pregnancy (HCC-P) and at 4 months postpartum (HCC-4M). Sexual, physical, and emotional abuse were assessed by the Adverse Childhood Experiences Study Questionnaire. Maternal disrupted interaction was reliably coded from mother–infant video interactions during a Still-Face Procedure. Mediation models indicated that maternal HCC-P and HCC-4M mediated associations between maternal psychopathology (severe mental illness, symptomatic functioning) and maternal disrupted interaction at 4 months. Maternal HCC at 4 months also mediated associations between experienced childhood abuse and overall disrupted interaction. Our findings indicate that HCC may be a potential early biomarker for future caregiving challenges among mothers with severe mental illness and histories of childhood abuse.     

Moderating Effects of Family Structure on the Relationship Between Physical and Mental Health in Urban Children with Chronic Illness

Examined whether certain family structures modify the relationshipbetween psychological adjustment and severity of physical illness,as measured by an index of functional status, among childrenwith chronic illness. 352 families were divided into four types:two biological parents (n = 149), mother plus another adultrelative (n = 47), mother plus unrelated spouse or partner (n= 23), and mother alone (n = 133). Correlations between children'sfunctional status and adjustment were higher in the mother plusunrelated partner and mother alone families, and lower whenmother lived with either the biological father or another adultrelative. Children in the mother plus unrelated partner groupalso tended to have poorer overall adjustment than other children.Results are discussed in terms of family structure, childhoodillness and adjustment, and the possible mechanisms that interrelatethese variables.