The European study of assisted reproduction families: the transition to adolescence

BACKGROUND: Findings are presented of the second phase of a European longitudinal study of families created by assisted reproduction. The present investigation reports on data obtained during the child's transition to adolescence. METHODS: A total of 102 IVF families, 94 donor insemination (DI) families, 102 adoptive families, and 102 families with a naturally conceived child were compared on standardized interview and questionnaire measures of parenting and children's psychological well-being. RESULTS: The assisted reproduction families were similar to the adoptive and natural conception families for many of the measures of the quality of parent-child relationships. To the extent that differences were found between the assisted reproduction families and the other family types, these reflected mainly more positive functioning among the assisted reproduction families, with the possible exception of the overinvolvement with their children of a small proportion of assisted reproduction mothers and fathers. The assisted reproduction children were functioning well and did not differ from the adoptive or naturally conceived children on any of the measures of psychological adjustment. However, only 8.6% had been told about their genetic origins. CONCLUSIONS: IVF and DI families with an early adolescent child appear to be functioning well.     

Single parents of children with chronic illness: an understudied phenomenon

OBJECTIVE: To examine the chronic illness literature and evaluate the impact on single parenting and children and adolescents with chronic illness. METHODS: We conducted literature reviews of relevant research pertaining to single-parent families on PubMed, Medline, and PsychINFO and also surveyed pertinent book chapters and all of the articles from the Journal of Pediatric Psychology since 1987 for articles, specifically examining the potential associations of single (lone) parenting versus two-parent households on children's psychosocial functioning and the impact of the child's illness on caregiver functioning. RESULTS: While the literature has examined and discussed the stressors associated with parenting a child with an illness, including the impact of illness on finances, family roles, and caregiver burden, few studies have examined single parents of children and adolescents with chronic illnesses and related stressors stemming from being a lone caregiver. CONCLUSIONS: There is a dearth of studies examining the association between lone parenting and psychosocial functioning among children and adolescents with chronic illnesses. Specific questions necessitating future investigation are summarized and recommendations are made for future research in this important area of inquiry.     

Children: The European study of assisted reproduction families: family functioning and child development

Findings are presented of a European study (conducted in theUK, Italy, Spain and The Netherlands) of family relationshipsand the social and emotional development of children in familiescreated as a result of the two most widely used reproductivetechnologies, in-vitro fertilization (IVF) and donor insemination(DI), in comparison with control groups of families with a naturallyconceived child and adoptive families. Mothers of children conceivedby assisted reproduction expressed greater warmth towards theirchild, were more emotionally involved with their child, interactedmore with their child and reported less stress associated withparenting than mothers who conceived their child naturally.Similarly, assisted reproduction fathers were found to interactmore with their child and to contribute more to parenting thanfathers with a naturally conceived child. With respect to thechildren themselves, no group differences were found for eitherthe presence of psychological disorder or for children's perceptionsof the quality of family relationships. The findings relatingto the quality of parenting and the socio-emotional developmentof the children were similar in each of the four countries studied.     

The influence of assisted reproduction on family functioning and children's socio-emotional development: results from a European study

BACKGROUND: ICSI is used with increasing frequency, but there is less information about the children born following this method of assisted reproduction than other forms of IVF. Some authors have suggested that it may contribute to more family stress than IVF. METHODS: ICSI conceived children were compared with IVF conceived children and naturally conceived (NC) controls. They were selected in five European countries: Belgium, Denmark, Greece, Sweden and the UK, and seen for psychological testing and a paediatric examination when they were 5 years old. In all countries, except Greece, mothers and fathers were asked to complete questionnaires about parental well-being, family relationships, parenting and child behaviour. RESULTS: Very few differences were found between the ICSI and NC group or the ICSI and IVF group. The only significant differences were that mothers in the ICSI conceived group reported fewer hostile or aggressive feelings towards the child and higher levels of commitment to parenting than the mothers of NC children. CONCLUSIONS: The study confirms the results of previous work with IVF families. This should be encouraging for families using these techniques in the future.     

Psychological consequences of pediatric burns from a child and family perspective: A review of the empirical literature

In order to inform clinical practice, we reviewed the empirical literature on emotional, behavioral and social outcomes in children with burns and their families published between 1989 and 2011. A systematic search of the literature yielded 75 articles. Qualitative synthesis of the results showed that child anxiety, traumatic stress reactions, and behavioral problems were considerably prevalent in the first months after the burn event. Among parents, high rates of posttraumatic stress, depressive symptoms, and guilt feelings were found. Cross-sectional studies, often performed many years after the injury, suggest that some children experience long-term psychological problems, such as anxiety, depression, and difficulties with social functioning. However, there was little evidence that behavior in general, self-esteem, or body image were impaired in the total population of children with a history of burns. Long-term family outcome studies suggest that psychological problems persist in a substantial subgroup of parents. Child peritraumatic factors anxiety and pain, parental posttrauma psychological reactions, and family functioning were the most consistently reported factors associated with child outcome. More recent studies have demonstrated that burn severity may have an indirect effect on child postburn psychosocial outcome. Clinical implications, methodological strengths and limitations of the reviewed studies, and directions for future research are discussed.     

Non-genetic and non-gestational parenthood: consequences for parent-child relationships and the psychological well-being of mothers, fathers and children at age 3

BACKGROUND: Findings are presented of the third phase of a longitudinal study of children conceived by assisted reproduction procedures involving surrogacy and/or donor conception. METHODS: At the time of the child's third birthday, 34 surrogacy families, 41 donor insemination families and 41 oocyte donation families were compared with 67 natural conception families on standardized interview and questionnaire measures of the psychological well-being of the parents, mother-child relationships and the psychological well-being of the child. RESULTS: The differences found between family types reflected higher levels of warmth and interaction between mothers and their 3-year-old children in assisted reproduction families than in families with a naturally conceived child. A higher proportion of surrogacy parents than donor conception parents had told their children about the nature of their birth. CONCLUSIONS: It appears that the absence of a genetic and/or gestational link between parents and their child does not have a negative impact on parent-child relationships or the psychological well-being of mothers, fathers or children at age 3.     

EXPLAINING THE ASSOCIATION BETWEEN ADOLESCENT PARENTING AND PRESCHOOLERS’ SCHOOL READINESS: A RISK PERSPECTIVE

This study examined whether mother and father risk, child risk, family risk, and mother and father cognitive stimulation mediated the association between adolescent age status of co‐residential mothers and fathers and 48‐month child school readiness. Using the Early Childhood Longitudinal Study‐Birth cohort, it was found that the children of adolescent mothers and fathers scored lower on emerging literacy and math than those born to adult parents. The findings showed that individual mother and father cumulative risk and cumulative family risk at various times during early childhood partially mediated the associations between adolescent parent status and child outcomes as well as between young adult parent status and child outcomes. These findings indicated that multiple domains of risk, including father, mother, and family risk should be taken into account in order to gain a fuller understanding of the effects of adolescent parenting (and young adult parenting) on child outcomes.     

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.     

Mediators of depressive symptoms in children with type 1 diabetes and their mothers

OBJECTIVE: To examine the relationships among maternal and child depressive symptoms and child and family psychosocial factors. METHOD: Secondary analysis of baseline data for a coping skills intervention for school-age children (ages 8-12) with type 1 diabetes (T1D) and their mothers. Children and mothers completed measures of depressive symptoms, coping, quality of life, and family functioning. RESULTS: There was a strong relationship between maternal and child depressive symptoms (r = .44, p < .001). Maternal depressive symptoms were negatively related to child quality of life, perceptions of coping, and family functioning. Impact of diabetes on quality of life, finding coping with diabetes upsetting, and family warmth mediated the relationship between maternal and child depressive symptoms. CONCLUSIONS: Maternal depression may negatively affect child adjustment through its influence on quality of life, coping, and family functioning. Implications for interventions to improve psychosocial adjustment in children with T1D are discussed.     

Lesbian families and family functioning: an overview

OBJECTIVES: In the last 30 years a growing body of studies on lesbian parents and the development of children has been published. METHODS: Four computerized databases were identified studies for inclusion in this review of research on lesbian families, namely PsychInfo, Educational Resources Information Centre (ERIC), Medline, and the Social Sciences Citation Index. RESULTS: Forty-four empirical studies on lesbian families published between 1978 and 2003 were reviewed. In the research on lesbian families two phases were identified. To begin with, systematic studies on lesbian families focused on lesbian families with children who were born in a previous heterosexual relationship. More recently, studies included lesbian families whose children were born to the lesbian couple (planned lesbian families). In both phases, articles reporting results on children's development (such as sexual identity, emotional/behavioral development, social relationships and cognitive functioning), and parental functioning (such as mental psychological health and parenting skills). This paper presents and discusses major finding of the reviewed articles. CONCLUSION: Studies in both phases have emphasized that lesbian and heterosexual families are very much alike. However, it is the stigma of lesbianism that makes the family situation of lesbian families different. PRACTICE IMPLICATIONS: Healthcare workers should be informed about the similarities and differences between lesbian families and heterosexual families, and about the non-traditional family situation of planned lesbian families.     

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.     

Culture and the socialization of child cardiovascular regulation at school entry in the US

The measurement of cardiovascular functioning targets an important bridge between social conditions and differential well‐being. Nevertheless, the biocultural, psychosocial processes that link human ecology to cardiovascular function in children remain inadequately characterized. Childrearing practices shaped by parents' cultural beliefs should moderate children's affective responses to daily experience, and hence their psychophysiology. The present study concerns interactions among family ecology, the normative social challenge of entry into kindergarten, and parasympathetic (vagal) cardiac regulation in US middle‐class children (N = 30). Although parents believed children must be protected from overscheduling to reduce stress and improve socio‐emotional adaptation, maternal rather than child schedules predicted parasympathetic regulation during a nonthreatening social engagement task following school entry. Children of busier married mothers, but less busy single mothers, showed the context‐appropriate pattern of parasympathetic regulation, low respiratory sinus arrhythmia (RSA). These findings are expected if: maternal and family functioning, rather than the scheduling of the child's daily life, principally drive young children's cardiovascular responsiveness to a normative challenge; and busy schedules represent high family functioning with married mothers, but not under single‐parent conditions wherein adult staffing is uniquely constrained. Family ecology is shaped by culture, and in turn shapes the development of children's cardiovascular responses. Appropriately fine‐grained analysis of daily experience can illustrate how culturally driven parenting practices may have unintended consequences for child biological outcomes that vary by family structure. Am. J. Hum. Biol., 2008. © 2008 Wiley‐Liss, Inc.     

Family adjustment to childhood developmental disability: a measure of parent appraisal of family impacts

OBJECTIVE: To develop the Family Impact of Childhood Disability Scale (FICD) to assess subjective interpretation or "primary appraisal" of parents regarding the impact of a child with developmental disabilities on the family. METHOD: A random sample of 87 families was assessed while children with developmental disabilities were in the preschool years. After 7 years had elapsed, 64 of these families were interviewed again when the children were in the preteen years. A set of standardized self-report measures provided mother and father views of child, parent, and family functioning. RESULTS: The FICD demonstrated adequate internal consistency, with some evidence of discriminant and predictive validity. The FICD total score, based on the discrepancy between positive and negative subscale scores, was found to be a significant predictor of future parenting stress of mothers and of fathers, even when controlling for other important explanatory variables such as marital adjustment and level of disability in a child. CONCLUSIONS: The 15-item FICD offers a brief assessment of both positive and negative parent appraisals, with a total discrepancy score that predicts long-term parenting stress.     

Child development and quality of parenting in lesbian families: no psychosocial indications for a-priori withholding of infertility treatment. A systematic review

Among fertility centres, much discussion focuses on whether to withhold infertility treatment from special patient groups (lesbians, prospective single parent(s), prospective parent(s) of relatively advanced age, or with severe diseases) because it is assumed that this is in the best interest of the child. The present study aimed to establish whether there is any empirical evidence for this assumption. A literature search was made in PubMed/Medline and PsycINFO to identify studies that had assessed psychological outcomes of children and quality of parenting after infertility treatment. Eight studies met the following inclusion criteria: published in an English-language peer-reviewed journal between 1978 and 2002, and focused on psychosocial child development and quality of parenting after infertility treatment in the above-mentioned special patient groups. All reviewed studies focused on lesbian or single-parent families. Overall, the methodological quality of studies as assessed by a standardized set of criteria was high. The evidence of the studies (assessed by the best evidence synthesis method) was strong for the conclusion that in lesbian families the psychosocial development of children (median age 6.1 years) and the quality of parenting are not different from those in healthy heterosexual two-parent families after infertility treatment or natural conception. Therefore, withholding infertility treatment from lesbian families on the assumption that such intervention may not be in the interest of the prospective child seems unjustified. For the other special patient groups, no conclusions could be drawn, because of a lack of relevant studies.     

Neurocognitive development of young children with sickle cell disease through three years of age

OBJECTIVE: To determine (1) the neurocognitive development of children with sickle cell disease (SCD) from 6 months through 36 months of age, (2) the independent and combined contributions of biomedical risk and parenting risk to child neurocognitive functioning, and (3) the independent and combined contributions of biomedical risk, parent cognitive processes, and family functioning to parent adjustment. METHOD: The study sample included 89 African American children and their parents served through the Duke University-University of North Carolina Comprehensive Sickle Cell Center. Measures of cognitive and psychomotor development were obtained at 6, 12, 24, and 36 months of age, and parents completed self-report measures of the cognitive processes of daily stress and attributional style, psychological adjustment, and family functioning. RESULTS: There was no significant decrease in psychomotor functioning (PDI) over time but cognitive functioning (MDI) declined, with a significant decrease occurring between the 12- and 24-month assessment points. At 24 months, poorer cognitive functioning was associated with parenting risk, in terms of a learned-helplessness attributional style, and biomedical risk, in terms of HbSS phenotype. Levels of psychological distress within the clinical range were reported by 24% of the parents, and poorer parent adjustment was associated with high levels of daily stress, less knowledge about child development, lower expectations of efficacy, and HbSC phenotype. CONCLUSIONS: The findings indicate that young children with SCD are at risk for neurocognitive impairment and provide support for the initiation of early intervention studies to promote neurocognitive development.     

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.     

幼儿母亲育儿压力的特点及其与婚姻质量的关系

目的：考察幼儿母亲育儿压力的特点及其与婚姻质量间的关系，为改善婚姻质量，提高养育成效提供依据。方法：采用育儿压力问卷和婚姻质量问卷，对在北京市4所普通幼儿园中随机抽取的535名幼儿的母亲进行调查并做出统计分析。结果：2岁儿童的母亲由于儿童适应问题所引起的压力感明显高于5岁儿童的母亲：不同教育水平的母亲育儿压力存在显著差异：婚姻质量对母亲育儿压力的不同侧面影响不同，对母亲侧面影响更明显。结论：孩子年龄不同、受教育水平不同的母亲育儿压力存在显著差异：不同婚姻质量组母亲育儿压力存在显著差异。     

Parenting concerns,family support systems,and life problems in Mexican-origin women: A comparison by nativity

Low-income Mexican-origin families have been neglected in studies of normative family functioning and transition to parenting roles. This study examined the child and family concerns and perception of parenting role among 122 Mexican-origin women in Los Angeles and assessed differences by parity and nativity. The results showed significant sociodemographic differences among respondents by nativity. Mexican-American women had significantly higher levels of education and were less likely to be married than recent Mexican immigrant women. There were no significant differences between groups on reported levels of life problems by nativity. Family social support data revealed that Mexican Americans were more likely to have large family networks, to live with parents and siblings, and to report that their family provided “a lot of help.” Data on perception of parenting for first-time mothers revealed that Mexican immigrant women were twice as likely as Mexican-American women to report that they “anticipated doing a better job of parenting than most mothers.” Baby concerns in first-time pregnant women revealed that married respondents reported more concerns than nonmarried respondents. Among mothers, Mexican-American mothers reported fewer child concerns than Mexican immigrant mothers. The major implication of these results is related to the provision of psychoeducational parenting programs compatible with the concerns and needs of Latino parents.     

Brief report: Predictors of parenting stress among parents of children with biochemical genetic disorders

OBJECTIVE: To examine predictors of parenting stress in parents whose children were diagnosed with a biochemical genetic disorder clinically or through newborn screening. METHODS: Parents of 263 children with biochemical genetic disorders (139 identified by newborn screening, 124 identified clinically) completed interviews focused on child health, medical service use, satisfaction with services, parenting stress, and family functioning. RESULTS: Multiple regression analyses suggested that child adaptive functioning, parental satisfaction with support, and difficulties parents experienced meeting their child's health care needs were associated with scores on the Parenting Stress Index (R2 =.51). CONCLUSIONS: Initiatives to improve child adaptive functioning and parental support as well as practical assistance to help parents meet their child's health needs may reduce parental stress and family disruption in this population.     

Mothering from the Inside Out: results of a pilot study testing a mentalization-based therapy for mothers enrolled in mental health services

Mothers who are involved with mental health services (for themselves or their children) rarely receive adequate support for their role as parents. Mental illness in a parent or child often exacerbates the challenges of managing psychological distress that is germane to the parenting roll. Mentalization-based approaches to psychotherapy for parents have the potential to address challenges of emotional regulation in parents by supporting their capacity to recognize and modulate negative affect during stressful parenting situations. In this study, we piloted Mothering from the Inside Out (MIO) with 17 mothers receiving services at a community-based mental health clinic. MIO is a 12-week, mentalization-based parenting intervention that demonstrated efficacy in two previous randomized controlled trials with substance using mothers. In this study, we were interested in determining whether community-based clinicians could deliver MIO with sustained fidelity. We were also interested in examining the preliminary feasibility, acceptability and efficacy of MIO when delivered by clinicians in a community mental health center. Finally, we were interested in replicating prior tests of the proposed treatment mechanisms. Treatment outcomes included maternal reflective functioning, psychiatric and parenting stress, and mother–child interaction quality. Our findings indicated that MIO was feasible and acceptable when delivered in the community-based setting and that all maternal indices improved. However, no improvement in mother–child interaction quality was found, possibly because of insufficient time for these changes to consolidate.