Surviving childhood cancer, social support, and parents' psychological adjustment.

Assessed whether the continuing emotional strain of parenting a child cancer survivor is associated with elevated levels of psychological distress (depression and anxiety) in parents. The role of social support in moderating this relationship was also evaluated. When parents of cancer survivors (63 mothers and 49 fathers) were compared to a matched sample of parents (64 mothers and 62 fathers) with healthy children there were no differences in levels of depression or anxiety overall but among parents experiencing low levels of social support, parents of cancer survivors were more depressed and anxious than parents of healthy children. Perceived social support has a significant inverse relationship with psychological distress for both parents but seems to be more important for mothers. The elevated risk for psychological distress noted for those experiencing low levels of support appears to be more generalized for fathers than mothers.     

Mealtime Behavior and Parent-Child Interaction: A Comparison of Children with Feeding Problems, and Nonclinic Controls

Examined the role of family interaction factors in dietary complianceproblems reported by parents of children with cystic fibrosis(CF). The family mealtime interactions of children with CF,children with feeding problems and nonclinic controls were observed,and parents monitored children's eating behavior at home. Parentsof children with CF reported more concern about feeding problemsand recorded more disruptive mealtime behavior than parentsof nonclinic children. Observational data showed children withCF to display overall rates of disruptive mealtime behaviornot significantly different from either comparison group. Mothersof children with CF were observed to engage in higher ratesof aversive interaction with their child than did mothers ofnonclinic controls. Fathers of children with CF reported lowermarital satisfaction than fathers of controls. Both mothersand fathers of children with CF reported lower parenting self-efficacythan non-CF families. Clinical implications are discussed.     

Fathers’ and mothers’ attachment styles,couple conflict,parenting quality,and children’s behavior problems: an intervention test of mediation

ABSTRACT

A diverse sample of 239 primarily low-income couples participated in a random controlled trial of the Supporting Father Involvement couples group intervention. In this report, we examined the value of adding measures of fathers’ attachment style and parenting to mothers’ measures in order to explain variations in children’s behavior problems. We also tested the hypothesis that the link between intervention-induced reductions in couple conflict and reductions in anxious/harsh parenting can be explained by intervention effects on parents’ attachment insecurity or on anxiety and depression. Fathers’ attachment security and parenting behavior added significantly to mothers’ in accounting for children’s internalizing and externalizing problem behaviors. Fathers’ anxious attachment style and anxiety/depression mediated the link between post-intervention reductions in parental conflict and anxious/harsh parenting. For mothers, only improvements in attachment security accounted for those links. The findings support the need for attachment researchers to consider the contributions of both parents to their children’s development.     

Parent Stress and Coping in Relation to Child ADHD Severity and Associated Child Disruptive Behavior Problems

Examined parent role distress and coping in relation to childhood attention deficit hyperactivity disorder (ADHD) in mothers and fathers of 66 children age 7 to 11 (42 boys, 24 girls; mean age = 10.2). Parents of children with ADHD combined and inattentive subtypes expressed more role dissatisfaction than parents of control children. Parents of ADHD combined and inattentive type children did not differ significantly in levels of distress. For mothers, child inattention and oppositional-conduct problems but not hyperactivity contributed uniquely to role distress (dissatisfaction related to parenting or parenting performance). For fathers, parenting role distress was associated uniquely with child oppositional or aggressive behaviors but not with ADHD symptom severity. Parent coping by more use of positive reframing (thinking about problems as challenges that might be overcome) was associated with higher role satisfaction for both mothers and fathers. Community supports were associated with higher distress for mothers only.     

Functioning among mothers and fathers of children with juvenile rheumatic disease: a longitudinal study.

Examined the adaptation of mothers and fathers of children with juvenile rheumatic disease on two occasions, 1 year apart, using 159 married couples at Time 1, and 111 of these couples at Time 2. A stress and coping model was tested in which parental functioning is determined by ongoing life stressors (patient and spouse dysfunction), family resources, and parents' illness-related coping. Mothers reported more depression than fathers did. However, poorer concurrent functioning among both mothers and fathers was explained partly by patients having more functional disability, pain, and psychosocial problems. In addition, spouse's dysfunction and the parent's use of avoidance coping were related to poorer parental adaptation, both concurrently and 1 year later. The implications of the findings for developing stress and coping models of parental adaptation to having a chronically ill child, and for intervention strategies with parents, patients, and families, are discussed.     

Child illness, the parenting alliance, and parenting stress

Assessed relationship between children's minor illnesses during the first 3 years of life and parenting stress in the 4th year. Also examined whether a good parenting alliance would compensate for or moderate this relationship. Parents of 56 3- to 4-year-olds completed parenting alliance and stress questionnaires. Child morbidity, assessed from medical records, was directly related to mothers' but not fathers' feelings of stress. The parenting alliance was more strongly related to parenting stress for fathers than for mothers. However, child morbidity and parenting alliance interacted in predicting child-related paternal stresses. While fathers in a poor alliance reported more stress, stress was unrelated to their children's illnesses; for fathers in a moderate to strong alliance, illness and stress were positively correlated. Even minor child illnesses appear to be a source of stress for parents.     

Personal Adjustment and Perceptions of Grandchild Behavior in Custodial Grandmothers

Examined parenting stress, depression, parenting satisfaction, and perceptions of child behavior in 35 custodial grandmothers seeking outpatient psychological services for their grandchildren ages 3 to 12. These clinic grandmothers reported significantly greater stress and depression, less parenting satisfaction, and more negative perceptions of their grandchildren's behavior than did 35 nonclinic custodial grandmothers. Also, similar to a comparison group of 35 clinic mothers and to the empirical literature on clinic parents, the clinic grandmothers' personal adjustment (i.e., stress and depression) was related significantly to their perceptions of their grandchildren's behavior. Thus, assessment of custodial grandmothers' adjustment, as well as grandchild behavior, in clinical settings appears warranted.     

A National Directory of Four Year Colleges,Two Year Colleges,and Post High School Training Programs for Young People With Learning Disabilities (Book)

Studied child- and parent-focused parenting stress in 71 clinically depressed and 53 nondepressed mothers of infants 3 to 13 months old. Depressed mothers reported more parenting stress and daily hassles, less marital harmony, and less social support than nondepressed mothers, and they were rated as less competent with their infant. Mothers of temperamentally difficult infants reported greater stress, and depressed women with difficult infants were highest in child-focused stress. In hierarchical multiple-regression analyses predicting child-focused stress, infant difficulty was the only significant predictor for depressed women, but nondepressed women's child-focused stress was predicted by both the demographic composite and infant difficulty. The depressed group's parent-related stress was predicted by depression level, infant temperament, and marital discord, but for nondepressed mothers, only the demographic factors and infant temperament were significant predictors. Depressed women reporting greater child- and parent-focused stress were independently rated as less competent parents than those under less stress.     

Parenting Stress and Child Adjustment: Some Old Hypotheses and New Questions

Individual differences in parenting stress, experienced by most parents as those aversive feelings that are associated with the demands of the parenting role, have been shown to be an important aspect of parent, child, and family functioning. A definition of parenting stress is provided, along with its application to more general stress models. Three implicit hypotheses in much of the past research on parenting stress and behavior are evaluated: (a) parenting stress is causally related to poor parenting, (b) poor parenting is causally related to problems in child adjustment, and (c) parenting behavior mediates the associations between parenting stress and child adjustment. In addition, three questions for future research regarding within-family and within-Individual variation in parenting stress are raised: (a) Is parenting stress genetically influenced? (b) Do mothers and fathers show similar or different levels of parenting stress? (c) Is parenting stress “child specific” within families?     

Childhood illness-related parenting stress: the pediatric inventory for parents

OBJECTIVE: To develop a measure of parenting stress related to caring for a child with an illness and to evaluate its psychometric properties with a group of parents of children with cancer. METHODS: One hundred twenty-six parents (105 mothers, 21 fathers) of children (65 boys and 61 girls, M: age: 12.75 years) being followed by an oncology service were assessed using the 42-item self-report Pediatric Inventory for Parents (PIP). Internal consistency was assessed and construct validity was investigated with standardized, general self-report measures of anxiety and parenting stress. RESULTS: Internal consistency reliability for the PIP was high (Cronbach alpha range:80-.96). PIP scores were significantly correlated with a measure of state anxiety and also with parenting stress, demonstrating construct validity. After we controlled for demographic variables and general parenting stress, PIP scores showed strong independent associations with state anxiety. CONCLUSIONS: Preliminary data indicate that the PIP is a reliable and valid tool to assess parenting stress in pediatric oncology populations. As a measure of illness-related parenting stress, the PIP may be used to provide information about parent well-being that extends beyond that obtained from general measures.     

Spillover of Marital Interactions and Parenting Stress in Families of Children With Autism Spectrum Disorder

Few disorders appear to be more challenging for parents than autism spectrum disorder (ASD). Little is known about the extent to which parenting stress experienced by parents of children with ASD affects or is affected by marital quality. We examined daily spillover between level of parenting stress and marital interactions in a sample of 176 married couples (89.4% Caucasian, non-Hispanic) who have a child with ASD (5–12 years of age, 85% male) via a 14-day daily diary approach. On each day of the daily diary, parents individually reported on 8 positive and 8 negative marital interactions and their level of parenting stress. Dyadic multilevel modeling analyses using hierarchical linear modeling were conducted to examine same-day and lagged-effect associations between number of positive and negative marital interactions and level of parenting stress. Having a day with a higher number of negative marital interactions was associated with a higher level of parenting stress for both mothers and fathers of children with ASD. Having a day with fewer positive marital interactions was associated with having a more stressful parenting day for mothers of children with ASD. Same-day spillover was moderated by parent gender and the functioning of the child with ASD. Spillover flowed bidirectionally for mothers of children with ASD. Helping parents of children with ASD find ways to engage in positive marital interactions on stressful parenting days and avoid having negative affect, tension, and behaviors stemming from negative marital interactions spill into parenting experiences are important intervention targets.     

The CPI subscales as predictors of parental coping with childhood leukemta

Determined the role of the standard CPI subscales, the Summed Coping Scale, and the Current Adjustment Rating Scale in prediction of parental coping with leukemia, with 30 mothers and 25 fathers of children with Leukemia. None of the standard CPI subscales was found to be a significant predictor of coping, as measured by a situation-specific instrument, the Family Coping Scale. The Summed Coping Scale and the CARS were significant as predictors for fathers, but not for mothers. It is suggested that coping with the specific situation may be a better predictor of later coping in a similar situation than more global assessments.     

Brief report: fathering a child living with HIV/AIDS: psychosocial adjustment and parenting stress

OBJECTIVE: To examine the psychosocial stressors experienced by fathers of children diagnosed with HIV/AIDS. METHODS: Thirty-one fathers whose children (ages 6 to 19) were participating in pediatric HIV clinical trials completed self-report measures of parenting stress, psychological distress, and need for psychosocial services. RESULTS: Over half of this sample experienced significantly elevated levels of both parenting stress and psychological distress compared to standardized norms. Ninety-seven percent of these men reported the need for services including gender-specific support groups, assistance with discipline, disease management, and assistance with planning for the future. CONCLUSIONS: Elevated levels of parenting stress and psychological distress in fathers of children living with HIV suggest the need for additional psychological intervention in this population.     

Parenting and psychosocial development of IVF children: a follow-up study

BACKGROUND: This report details a follow-up study of the parent-child relationship and the child's psychosocial development after IVF. The pilot study compared 31 IVF families and 31 families with a naturally conceived child when the children were aged 2 years. Twenty-seven IVF and 23 control families participated again when the children were aged 8-9 years. METHODS: Fathers and mothers completed questionnaires assessing parenting variables and the child's behaviour. For most children, behavioural ratings were also obtained from the child's teacher. RESULTS: No significant differences were found between IVF and control parents' reports of child behaviour, parenting behaviour, parenting stress and most of the parenting goals. The parenting goal adjustment was significantly more important for IVF than for control fathers; religion was more important for IVF than for naturally conceiving mothers. Teacher ratings of the child's behaviour did not differ significantly between the IVF and control groups. All couples but one had talked to other persons about the IVF conception; 75% of the IVF parents had not yet informed their children. IVF parents who had informed their child observed more (internalizing and for fathers also overall) problem behaviours in their child, compared with IVF parents who had not yet disclosed the IVF conception. CONCLUSIONS: Parenting and the children's psychosocial development do not differ significantly between IVF families and control families.     

Affect recognition and the quality of mother-infant interaction: understanding parenting difficulties in mothers with schizophrenia

This study investigated the quality of mother-infant interaction and maternal ability to recognise adult affect in three study groups consisting of mothers with a diagnosis of schizophrenia, mothers with depression and healthy controls. Sixty-four mothers were recruited from a Mother and Baby Unit and local children’s centres. A 5-min mother-infant interaction was coded on a number of caregiving variables. Affect recognition and discrimination abilities were tested via a series of computerised tasks. Group differences were found both in measures of affect recognition and in the mother-infant interaction. Mothers with schizophrenia showed consistent impairments across most of the parenting measures and all measures of affect recognition and discrimination. Mothers with depression fell between the mothers with schizophrenia and healthy controls on most measures. However, depressed women’s parenting was not significantly poorer than controls on any of the measures, and only showed trends for differences with mothers with schizophrenia on a few measures. Regression analyses found impairments in affect recognition and a diagnosis of schizophrenia to predict the occurrence of odd or unusual speech in the mother-infant interaction. Results add to the growing body of knowledge on the mother-infant interaction in mothers with schizophrenia and mothers with depression compared to healthy controls, suggesting a need for parenting interventions aimed at mothers with these conditions. While affect recognition impairments were not found to fully explain differences in parenting among women with schizophrenia, further research is needed to understand the psychopathology of parenting disturbances within this clinical group.     

Effects of paternal depression on fathers' parenting behaviors: A meta-analytic review

One possible mechanism for the familial transmission of depression is through its negative effects on parenting and the parent–child relationship. Although previous research indicates that depression is associated with parenting impairment for mothers, no quantitative synthesis of the empirical literature on the effects of paternal depression on fathers' parenting has been conducted. The present meta-analysis examined the effects of paternal depression on fathers' positive and negative parenting behaviors. The mean effect sizes, computed using 40 independent effect sizes derived from 28 published and unpublished studies, indicated that paternal depression has significant, though small, effects on parenting, with depressed fathers demonstrating decreased positive and increased negative parenting behaviors. Several moderating effects were found, including child and father age, and sample race/ethnicity, and effects were comparable for studies that used self-report measures and observational methods to assess fathers' parenting behaviors. Moreover, effect sizes for the relationship between paternal depression and fathers' parenting behaviors were comparable to those found for mothers. The present findings indicate that paternal depression has a significant and deleterious effect on parenting behaviors by fathers, and speak to the importance of continuing to include fathers in research on child development and the family environment.     

Parenting and the psychological development of a representative sample of triplets conceived by assisted reproduction

BACKGROUND: The aim of the study was to examine the quality of parenting and the psychological development of three-year-old children in IVF/ICSI families with triplets. METHODS: Comparisons were carried out between a representative sample of 10 families with triplets and matched groups of 15 families with twins and 30 families with singletons. The families were recruited from Follow-Up, a national organization in France that was established to study children conceived by assisted reproduction. Standardized measures of the mother's psychological well-being (parenting stress, depression and quality of marriage) and standardized measures of the child's psychological development (emotional/behavioural problems and general development) were completed by the mother. RESULTS: Mothers with a multiple birth were found to experience greater difficulties in parenting than mothers of singletons, with no differences between mothers of triplets and mothers of twins. Regarding the children, there were no differences in emotional or behavioural problems between triplets, twins and singletons. However, there were indications of mild delay among triplets and twins in some aspects of language development in comparison with the singleton children. CONCLUSIONS: The birth of triplets or twins does appear to cause difficulties for parents in the early years, however, the children themselves do not seem to experience markedly raised levels of psychological or developmental problems.     

Effect of Maternal Anxiety on Parenting Stress of Fathers of Children With ADHD

BackgroundHyperactivity, inattention, and impulsivity of children with attention deficit hyperactivity disorder (ADHD) increase parenting stress and familial conflict. Among parent-related factors, maternal mental health has been studied in-depth, but studies on paternal factors in this context are scarce. This cross-sectional study was conducted of children with ADHD and their parents in South Korea. We investigated the relationships between ADHD symptom severity of children and the mental health of their mothers and fathers.MethodsThe study included 70 children with ADHD and their 140 married heterosexual parents (70 fathers and 70 mothers). Children completed the Child Depression Inventory and State-Anxiety Inventory for children, and their parents completed the Korean ADHD rating scale-IV, Adult ADHD self-report scale, State-Anxiety Inventory, Patient Health Questionnaire-9, and Parental Stress Scale.ResultsThere was a significant positive correlation between children’s ADHD symptoms and maternal anxiety symptom severity, whereby more severe ADHD symptoms were associated with more severe maternal anxiety symptoms. There was also a significant positive correlation between maternal anxiety symptom severity and paternal parenting stress severity, whereby more severe maternal anxiety was associated with more severe paternal parenting stress. A mediation model showed that paternal parenting stress severity was not directly related to children’s ADHD symptoms, but the severity of maternal anxiety mediated this relationship.ConclusionThe present study found the importance of mental health in mothers of children with ADHD and the interrelatedness of mental health within families. Future assessments and treatment of children with ADHD should include both the children and their parents.     

Parental Serotonin Transporter Polymorphism (5-HTTLPR) Moderates Associations of Stress and Child Behavior With Parenting Behavior

The serotonin transporter-linked polymorphic region (5-HTTLPR) is associated with caregiving in nonhuman animals and with affective and cognitive correlates of human parenting, yet its association with human parenting is largely unknown. Using a well-characterized sample of parents and offspring, we evaluated the association of parental 5-HTTLPR with observed positive and negative parenting behavior, as well as its biologically plausible moderation of child-related stress and disruptive child behavior as predictors of parenting. One hundred and sixty-two parents (86% mothers) and their 6- to 9-year-old children with and without attention-deficit/hyperactivity disorder were ascertained using multiple methods including structured interviews, rating scales, and observed parent-child interaction, yielding strong measures of key constructs. Controlling for multiple youth-level (e.g., sex, 5-HTTLPR genotype, disruptive behavior) and parent-level (e.g., demographics, depression, attention-deficit/hyperactivity disorder) factors, parents with an S allele exhibited significantly less observed positive parenting than those with the LL genotype. Significant Gene × Environment interactions were also observed: Child-related stress was negatively associated with observed parental negativity among SS/SL genotype parents but not LL genotype parents; next, observed disruptive child behavior was positively associated with parental negativity for both genotypes, but the effect was strongest in SS/SL parents. These preliminary findings suggest that parental 5-HTTLPR is uniquely associated with positive and negative parenting behavior, with more specific patterns according to child-related stress and disruptive child behavior. We consider implications for future research evaluating genetic influences on parenting as well as considerations for designing and delivering parenting-based interventions.