Personality, coping style and well-being of parents rearing children with developmental disabilities

Background Parents with children with developmental disabilities (DD) encounter a variety of stressors associated with rearing their children and must develop effective coping mechanisms in order to adapt successfully to these challenges. Previous research has failed to establish the role of parental individual differences in the reported use of different coping strategies. The current study explores parental personality and whether children with DD were adopted or born into the families and their influence on the coping strategies used by mothers and fathers. Methods A total of 97 mother–father dyads rearing at least one child with DD were participants. They narrated stressful situations related to their child and completed the Ways of Coping Questionnaire twice. Data were also collected with regard to personality, depression and subjective well‐being (SWB). Results Both adoptive and birth mothers and fathers used more problem‐focused than emotion‐focused strategies. Personality factors, Neuroticism especially, were predictive of coping strategy use. Higher levels of Positive Reappraisal were associated with higher levels of SWB, whereas higher levels of Escape‐Avoidance were associated with lower levels of SWB, but only for mothers. Results were consistent with a dispositional model of strategy use in that frequency of use was associated with personality characteristics, was consistent over time, and for different children in the same families. Future research should focus on the persistence of the associations between strategy use and well‐being and whether they hold true at different stages of the lifespan when coping contexts may change quite dramatically.     

Quality of life and mental health of parents of children with mental health problems

Mental health of parents and their quality of life is likely to be affected when a child in the family has a psychiatric disorder. The purpose of this study is to assess quality of life and mental health of parents of referred children waiting for service at the only child psychiatric service in Iceland, with reassessment at least 3 months after first attendance to the service. In order to do so, 208 parents of 123 children waiting for psychiatric care were sent the Icelandic Quality of Life (IQL), the General Health Questionnaire (GHQ-30) and the CAGE screen for alcoholism. For reassessment, responders in the first phase were assessed again with the IQL and GHQ-30, at least 3 months after initiation of child psychiatric interventions. A total of 120 of the 208 parents (58%) responded in the first phase of the study, 49 fathers and 71 mothers. The mean (+/- s, standard deviation) standardized IQL T-score was for the fathers 51+/- 7.5 but significantly lower for the mothers or 45 +/-11.5 (P = 0.001) compared to normal sample of same-age women (T-scores of 50 are normal). Nearly 55% of women compared with 26% of men were psychiatric cases, scoring 5 or higher on the GHQ. According to a CAGE score of 2 and above 16% of fathers and 14% of mother abused alcohol. No significant change occurred in parents GHQ-30 or IQL before and after initiation of treatment. We conclude that mothers of children with mental disorders have poor quality of life, and high prevalence of mental disorders; hence child psychiatry clinics need to ensure that mothers receive appropriate care along with the child.     

Economic implications of caregiving at midlife: comparing parents with and without children who have developmental disabilities

We compared the economic well-being and maternal employment of parents whose children did or did not have developmental disabilities. This prospective study is a secondary analysis of data from the Wisconsin Longitudinal Study, collected when respondents were aged 18, 36, and 53, on average. Although the two groups were similar at age 18, income and savings differed markedly by age 53, but statistically significant differences were not found on other measures. Mothers of children with disabilities were less likely to have job spells lasting more than 5 years and had lower earnings when they were 36 years old. Further, there was a trend for them to be less likely to have full-time jobs as their children grew older.     

The contribution of marital quality to the well-being of parents of children with developmental disabilities

Background This study examines the contribution of the marital relationship to the well‐being of both mothers and fathers of children with developmental disabilities. Parent well‐being is conceptualized in terms of mental health, parenting stress and parenting efficacy. Methods These analyses are based on data from 67 families participating in the Early Intervention Collaborative Study, an ongoing longitudinal investigation of the development of children with disabilities and the adaptation of their families. Multidimensional assessment techniques were used to collect data from married mothers and fathers and their child with a disability. Mother and father data were analysed separately using parallel hierarchical regression models. Results For both mothers and fathers, greater marital quality predicted lower parenting stress and fewer depressive symptoms above and beyond socio‐economic status, child characteristics and social support. In relation to parenting efficacy, marital quality added significant unique variance for mothers but not for fathers. For fathers, greater social support predicted increased parenting efficacy. Child behaviour was also a powerful predictor of parental well‐being for both mothers and fathers. Conclusion The findings support the importance of the marital relationship to parental well‐being and illustrate the value of including fathers in studies of children with developmental disabilities.     

A comparison of coping strategies used by parents of children with disabilities and parents of children without disabilities

The purpose of this study was to determine whether coping strategies differ in parents of children with disabilities and parents of children without disabilities. Participants consisted of 112 parents, including 50 parents of children with disabilities and 62 parents of children without disabilities. It was hypothesized that coping strategies would be different between the two parent groups. It was also hypothesized that parents of children with disabilities would Seek Social Support and utilize Planful Problem Solving more often than parents of children without disabilities. Coping strategies employed were significantly different between the groups. Seeking Social Support was a more commonly used method of coping among parents of children with disabilities, as was Escape Avoidance and Positive Reappraisal.     

The developmental health of children of parents with intellectual disabilities: Cross sectional study

In a representative population-based sample of 46,025 families caring for a young child, parental intellectual disability (identified in 588 families) was associated with increased risk of child developmental delay, child speech and language problems, child behaviour problems and frequent child accidents and injuries. Parental intellectual disability was also associated with increased risk of exposure to a wide range of environmental adversities such as poverty, poor housing and social isolation. Adjusting for between-group differences in exposure to low socio-economic position reduced the risk of adverse child outcomes by over 50% on each of the four measures of child developmental health. In the final fully adjusted model parental intellectual disability was associated with increased risk of child developmental delay and child speech and language problems. However, there were no significant associations between parental intellectual disability and child behaviour problems or frequent accidents and injuries.     

Family developmental risk factors among adolescents with disabilities and children of parents with disabilities

This paper investigates how the learning environments and family dynamics differ if households have a child with a disability or a parent with a disability. Using data from the National Longitudinal Survey of Youth 1997, results indicate that children with disabilities experience similar learning environments as other children, but have somewhat weaker relationships with their parents. In two-parent families, maternal disability lowers parents' school involvement and is associated with a less enriching home environment. Paternal disability reduces maternal monitoring and positive family activities possibly because mothers divert care-giving resources from their children to their male partners. Children in mother-headed households experience learning environments and family dynamics that are similar regardless of their own disability status or that of their mothers, but these outcomes are markedly inferior to those of children growing up in two-parent households. Future research on adolescent development should consider the disability status of children and parents, with particular attention to patterns of gendered care-giving in American families.     

Trajectories of mental health problems in children of parents with mental health problems: results of the BELLA study

Children of parents with mental health problems (CPM) have an increased risk for behavioral and psychological problems. This study investigated the age- and gender-specific course as well as predictors of mental health problems in CPM using the longitudinal data (baseline 1- and 2-year follow-ups) of a German general population sample from the BELLA study. Children and adolescents aged 11–17 years (at baseline) who had a parent with mental health problems (n = 325) were analyzed. The mental health problems of the children were assessed by the self-reported version of the strengths and difficulties questionnaire (SDQ). We used individual growth modeling to investigate the age- and gender-specific course, and the effects of risk as well as personal, familial and social protective factors on self-reported mental health problems in CPM. Additionally, data were examined differentiating internalizing and externalizing mental health problems in CPM. Results indicated that female compared to male CPM showed increasing mental health problems with increasing age. Mental health problems in CPM were associated with lower self-efficacy, worse family climate and less social competence over time. Internalizing problems were associated with lower self-efficacy, less social competence and more severe parental mental health problems. Externalizing problems were associated with lower self-efficacy, worse family climate and lower social competence. The main limitations of the study are the short time period (2 years) covered and the report of mental health problems by only one parent. Our findings should be considered in the development of treatment and prevention programs for mental health problems in CPM.     

Empowerment in parents of school-aged children with and without developmental disabilities

Background Despite the widespread use of the term ‘empowerment’ in clinical literature to describe both a desirable process and the outcome of service delivery, the term remains more of a theoretical than practical construct. This study examined the factors that contribute to empowerment in parents of school-aged children with and without developmental disabilities (DD) using the Double ABCX model of family adaptation contrasted with the linear ACBX model. Methods Parents of children with (n = 100, 97% mothers) and without (n = 100, 98% mothers) DD completed questionnaires relating to child behaviour problems, parent stress and well-being, and formal and informal support. Structural equation modelling was used Results Parents of children with DD reported more child behaviour problems, more stress, less well-being and more social support than parents of children without DD. Structural equation modelling supported the ACBX model for both groups. A linear relationship was found in which parent well-being and resources mediated the relationship between the stressor (child behaviour problems) and the outcome (empowerment). Conclusions The results of the current study support Hastings and Taunt's assertion in 2002, in that empowerment was adequately explained using a traditional model of family functioning. The significant prediction offered by the parent's resources points to the need to deliver services in a manner that is more family-centred. In the education system, this means providing parents with clear messages regarding the schools goals, clarifying the parent's rights and responsibilities, including the parent in planning and decision making, respecting their knowledge as caregivers and supporting their hopes for their child.     

The mental health of young children with intellectual disabilities or borderline intellectual functioning

Objective  

To determine within a nationally representative sample of young Australian children: (1) the association amongst intellectual disability, borderline intellectual functioning and the prevalence of possible mental health problems; (2) the association amongst intellectual disability, borderline intellectual functioning and exposure to social disadvantage; (3) the extent to which any between-group differences in the relative risk of possible mental health problems may be attributable to differences in exposure to disadvantageous social circumstances.     

Health outcomes of midlife and older Latina and black American mothers of children with developmental disabilities

The impact of caring for a child with a developmental disability on the physical and mental health of Latina and Black American women was examined. We used the National Health Interview Survey to compare the health of older mothers who were co-residing with a child who had a developmental disability to the health of same age mothers without caregiving responsibilities. Findings show that for both groups, older adult caregivers were more likely to report having limitations from arthritis than their noncaregiving counterparts. Caregiving was associated with more depressive symptoms for Latinas, but this relationship was not found for Black American women. Findings suggest that physical and mental health of caregivers need more attention in research and practice.     

Assessment of mental health problems in people with intellectual disabilities

Although it is widely accepted that individuals with intellectul disabilities face an increased vulnerability to developing mental health problems, there is currently a lack of agreement about the most appropriate form of assessment. When applied to people with intellectual disabilities, there is no consensus about which problems should be included in the term "mental health problem," and identifying mental illness is far from straightforward. The adoption of standardized classification systems assumes that individuals with intellectual disabilities have adequate linguistic skills and they present mental health problems in the same way as members of the general population. Yet, individuals with intellectual disabilities are less likely to fulfill verbal expectations that are the basis of current classification systems and many exhibit problem behaviors incompatible with existing criteria. Nevertheless, accurate diagnosis provides a clear direction for interventions. Although there is currently a lack of consensus about which instruments are most effective, the routine use of valid and reliable assessment and monitoring tools may significantly improve the quality of research and care. The complexity of factors influencing the mental health of individuals with intellectual disabilities has implications for how these needs can be effectively met. Clearly, diagnostic classification provides only partial guidance to morbidity and the quality of life experienced and mental health services increasingly adopt a problem-based, "biopsychosocial" approach to assessment and treatment delivered by multidisciplinary teams. The most basic and vital role of carers within this context is the awareness that a person with intellectual disabilities may suffer from a mental illness. Carers play a central role in recognising possible mental illness, making referrals for further psychiatric assessment and providing diagnostic information and treatment feedback. In the absence of information about the manifestation of mental health problems in individuals with intellectual disabilities, it is likely that the signs of mental illness will be overlooked. Training initiatives, aimed at increasing the ability of care staff to recognise the signs of mental illness and to make informed referral decisions, are vital in ensuring adequate access to mental health services by individuals with intellectual disabilities.     

Improving care for families where children and parents have concurrent mental health problems

Background: When mental illness affects children and parents within the same family there is a need for close professional collaboration between the respective psychiatric teams. However, there is no nationally established precedence for this, and the area has not been investigated within the published literature. Method: Retrospective case note study of 322 child psychiatric patients to estimate the prevalence of parental mental illness and analyse the degree of professional liaison taking place. Results: Twenty‐eight children had parents with concurrent mental health problems. Only four of these cases (14.2%) contained evidence of ongoing professional liaison between child and adult mental health teams. Conclusion: Inadequate liaison between child and adult services is a problem within the UK mental health system and detrimental to patient care. Recent national interest in establishing a more integrated family‐focused service is encouraging, but will take time to implement and will not replace the need for separate specialist services. Efficient clinical collaboration must be developed at local levels to create a more comprehensive management strategy for children and parents with concurrent mental health problems.