Expressed emotion, parenting stress, and adjustment in mothers of young children with behavior problems

Expressed Emotion (EE), a measure of the emotional climate of the family, predicts subsequent adjustment of adults with mental disorder (Leff & Vaughn, 1985). Despite the acknowledged importance of the family in childhood disorders, there have been relatively few studies of expressed emotion with adolescents and school-aged children and virtually none focused on preschoolers. The present study utilized the Five Minute Speech Sample (FMSS) to examine how Expressed Emotion relates concurrently and longitudinally to child problem status in a community sample of 112 preschool-aged children. At preschool, the proportion of high EE increased significantly across three child groups: Comparison (8.1%), Borderline Problem (15.8%), and High Problem (41.2%); however, preschool EE was not predictive of subsequent child status at 1st grade. Expanded FMSS codes. tapping positive affect and worry about the child, were also related to child problem group at preschool and were predictive of subsequent child status at 1st grade. Because parents' stress and adjustment were also highly related to child problem group status, we examined whether the FMSS codes were essentially a proxy for these or whether they explained unique variance. In two stepwise regressions on preschool child group status (divided by total problems and by externalizing problems), maternal stress was the only variable to enter. Also, in predicting to 1st grade externalizing child group status, only maternal stress entered. Discussion focused on the extension of the EE construct and other FMSS coding to young children, and the need to recognize that to some extent these variables may reflect maternal stress and adjustment.     

Toileting concerns, parenting stress, and behavior problems in children with special health care needs

This study examined the relationship between toileting concerns, behavior problems, and parenting stress in parents of children with special health care needs (CSHCN). Participants included parents of 99 males and 71 females aged 4 to 12 years with neural tube defects (NTD), developmental-behavioral disabilities (DBD), or history of perinatal intraventricular hemorrhage (IVH). Parents completed the Achenbach Child Behavior Checklist (CBCL) and the Parenting Stress Index-Short Form (PSI-SF). Parents expressing toileting concerns on the CBCL reported significantly more personal distress and more externalizing problems versus those with continent children. Variation within subsamples suggested that expectations based on nature of disability may be a factor in parent adjustment. Direct assessment and intervention of toileting issues should be a high priority in secondary stress prevention with CSHCN and their families.     

焦虑性障碍儿童情绪问题及教育心理控制源的研究

目的：对单纯焦虑性障碍儿童的情绪问题及父母的子女教育心理控制源进行初步研究,为焦虑性障碍的早期发现及早期干预提供理论依据。方法：选取2005年9~12月期间确诊的单纯焦虑性障碍儿童110人（焦虑组）及正常儿童113人（对照组）。由儿童本人填写儿童焦虑性情绪障碍筛查表、儿童抑郁障碍自评量表以及子女教育心理控制源量表,最后回收量表197份。结果：焦虑组儿童躯体化、广泛性焦虑、分离性焦虑、社交恐怖、学校恐怖得分、焦虑总分及抑郁总分均明显高于对照组儿童,差异有统计学意义（P<0.01）。焦虑组儿童父母的“教育成效”得分高于对照组,差异有统计学意义（P<0.01）。结论：焦虑性障碍儿童情绪问题突出,焦虑性障碍患儿父母的教育成效较差。     

The relations among cumulative risk, parenting, and behavior problems during early childhood

Background: This study examined relations among cumulative risk, nurturant and involved parenting, and behavior problems across early childhood. Methods: Cumulative risk, parenting, and behavior problems were measured in a sample of low‐income toddlers participating in a family‐centered program to prevent conduct problems. Results: Path analysis was utilized to examine longitudinal relations among these constructs, with results supporting an indirect effect of cumulative risk on externalizing and internalizing problems through nurturant and involved parenting. Conclusion: Results highlight the importance of cumulative risk during early childhood, and particularly the effect that the level of contextual risk can have on the parenting context during this developmental period.     

The mass media and the prevention of child behavior problems: the evaluation of a television series to promote positive outcomes for parents and their children

This paper examines the impact of a 12-episode television series, "Families", on disruptive child behavior and family adjustment. This media intervention comprises the first of a five-level early intervention parenting and family support strategy, known as Triple P (Positive Parenting Program). Fifty-six parents of children aged between 2 and 8 years were randomly assigned to either watching the television series or to a waitlist control group. Compared to the control group, parents in the television viewing (TV) condition reported significantly lower levels of disruptive child behavior and higher levels of perceived parenting competence, immediately following intervention. Prior to intervention approximately 42.9% of the children in the TV condition were in the clinically elevated range for disruptive child behavioral problems. This had reduced to 14.3 % following intervention. In addition, a high level of consumer acceptability was reported by parents in the TV condition. All post-intervention effects were maintained at 6-month follow-up. Implications for public health approaches to family mental health are discussed.     

Psychosocial effect and economic burden on parents of children with locomotor disability

Objective  

To assess the social and financial burden of parents of children with locomotor disability.     

Situational analysis of parenting problems for caregivers of children with sickle cell syndromes.

A situational analysis of problematic situations was conducted for 37 caregivers of children with sickle cell disease (SCD) who ranged in age from 5 to 13 years. Participants responded to a semistructured interview related to caring for a child with SCD. The interview included the domains of medication adherence, nutrition, minimizing and coping with pain episodes, social problems, academic difficulties, and children's expression of negative feelings related to having SCD. Caregivers described a total of 356 problems. Almost all caregivers reported experiencing problems with their children's nutrition (n = 35), minimizing pain episodes (n = 34), and their children expressing feelings about having SCD (n = 33). Moderately challenging and emotionally upsetting problems were reported for coping with pain episodes. The total number of problems was significantly higher for boys than for girls. Nutrition issues were more frequently reported for younger children. Findings have salient clinical implications for the care of children with SCD.     

The burden of oral ill health for children

This paper aims to draw attention to the common oral and dental diseases and conditions in childhood in the context of aetiological factors and to highlight how many of the risk factors for oral and dental ill health are common to other areas of chronic diseases among this age group: diet, hygiene, trauma, stress, and in older children and adolescents, smoking, alcohol use, and use of illegal substances. Suggestions as to how to address these common risk factors are proposed.     

The importance of parenting in the development of disorganized attachment: evidence from a preventive intervention study in adoptive families

Background:  As infant disorganized attachment is a serious risk factor for later child psychopathology, it is important to examine whether attachment disorganization can be prevented or reduced.
Method:  In a randomized intervention study involving 130 families with 6-month-old adopted infants, two attachment-based intervention programs were tested. In the first program, mothers were provided a personal book, and in the second program mothers received the same personal book and three home-based sessions of video feedback. The third group did not receive intervention (control group).
Results:  The intervention with video feedback and the personal book resulted in enhanced maternal sensitive responsiveness ( d  = .65). Children of mothers who received this intervention were less likely to be classified as disorganized attached at the age of 12 months ( d  = .46), and received lower scores on the rating scale for disorganization than children in the control group ( d  = .62). In the book-only intervention group children showed lower disorganization ratings compared to the control group, but no effect on the number of infants with disorganized attachment classifications was found.
Conclusion:  Our short-term preventive intervention program with video feedback and a book lowered the rate of disorganized attachment. The effectiveness of our intervention documents the importance of parenting in the development of infant attachment disorganization.     

Maternal smoking and behavior problems of children.

Numerous health consequences of children's exposure to maternal smoking have been demonstrated, including increased rates of low birth weight, infant mortality, respiratory infections, asthma, and modest impairments of cognitive development. There is little evidence, however, linking maternal smoking and increased rates of children's behavior problems. Data from the population-based National Longitudinal Survey of Youth were used to investigate the possible association of maternal smoking and behavior problems among 2256 children aged 4 through 11 years. In multiple regression analyses the authors controlled for child's race, age, sex, birth weight, and chronic asthma; family structure, income, and divorce or separation in the prior 2 years; mother's education, intelligence, self-esteem, employment status, chronic disabling health conditions, and use of alcohol during pregnancy; and the quality of the home environment as assessed by the Home Observation for Measurement of the Environment-Short Form to investigate the relationship between maternal smoking and children's behavior problems. The measure of maternal smoking status reflected two levels of smoking intensity (less than a pack per day and a pack or more per day) for each of three different categories of children's exposure: prenatal only (mother smoked only during pregnancy), passive only (mother smoked only after pregnancy), and prenatal plus passive exposure (mother smoked both during and after pregnancy). Measures of children's behavior problems included the overall score on a 32-item parent-reported child Behavior Problem Index (PBI), scores on the BPI's subscales, and rates of extreme scores on the BPI.(ABSTRACT TRUNCATED AT 250 WORDS)     

Behavioural problems in children and parenting stress associated with primary nocturnal enuresis in Hong Kong

The aim of this study was to investigate the behavioural problems and parenting stress of enuretic children in the local Chinese community. The study recruited 89 children with primary nocturnal enuresis (PNE) from the paediatric clinics of 9 regional hospitals in Hong Kong, and 131 age- and gender-matched control children without PNE from the Student Health Centres. After adequate instruction, the parents completed the Child Behaviour Checklist (CBCL) and Parenting Stress Index (PSI). A trained interviewer interviewed the parents and children and rated the children on the Global Assessment of Functioning (GAF). The PNE group had worse overall scores in both the Problem and Competence scales of CBCL; in particular, they had more attention problems and aggressive behaviours, and lower social competence and school performance than the control group. Their parents demonstrated more parenting stress as shown by higher PSI scores. Conclusion: In the local Chinese population, PNE was associated with more childhood behavioural problems and greater parenting stress. Attention to the psychosocial functioning of the child and parents may be important in the management of enuresis.     

The role of mother-child relationship in the association between maternal parenting stress and emotional and behavioral problems in preschool children北大核心CSCD

Objective To study the moderating effect of mother-child relationship in the association between maternal parenting stress and emotional and behavioral problems in preschool children, and to provide reference for the prevention and control of emotional and behavioral problems in preschool children. Methods Using a stratified cluster sampling method, 2 049 preschool children were surveyed from November to December 2021, who sampled from 12 kindergartens in Wuhu City, Anhui Province. The emotional and behavioral problems of preschool children were assessed with the Strength and Difficulties Questionnaire. Pearson correlation analysis was used to evaluate the relationship of maternal parenting stress and mother-child relationship with children's emotional and behavioral problems. The PROCESS Macro was used to analyze the moderating effect of conflicted and dependent mother-child relationships in the association between maternal parenting stress and emotional and behavioral problems in these preschool children. Results Among these preschool children, maternal parenting stress was positively correlated with the scores of emotional symptoms, conduct problems, hyperactivity, and peer problems subscales and total difficulty scores (P<0.001); intimate mother-child relationships were negatively correlated with the scores of conduct problems, hyperactivity, and peer problems subscales and total difficulty scores (P<0.001); conflicted and dependent mother-child relationships were positively correlated with the scores of emotional symptoms, conduct problems, hyperactivity, and peer problems subscales and total difficulty scores (P<0.001). After controlling for relevant confounding factors, conflicted mother-child relationship (β=0.05, P=0.001) and dependent mother-child relationship (β=0.04, P=0.012) were found to have a moderating effect on the association between maternal parenting stress and total difficulty scores in these preschool children. Conclusions Negative mother-child relationships play a moderating role in the association between maternal parenting stress and emotional and behavioral problems in preschool children. Prevention of emotional and behavioral problems in preschool children should focus on reducing maternal parenting stress and improving negative mother-child relationships. © 2023 Xiangya Hospital of CSU. All rights reserved.     

The burden of asthma in children: an Australian perspective

The burden of asthma among children is high in Australia compared with many other countries. Recent data show that 14-16% of children report a diagnosis of asthma that remains a problem. Boys, children under the age of 5 years and urban indigenous children experience a greater burden of asthma than other children. More than one-third of children with asthma have sleep disturbance due to the illness and 60% have missed school and/or experienced other restrictions in their activities due to the disease. Despite this, there is continuing evidence of under-utilisation of effective treatment for the disease. Asthma is a major cause of healthcare utilisation among children. Since the early 1990s, there has been a decline in both hospitalisation rates and general practitioner consultation rates for asthma among children. It remains to be seen whether this favourable trend will continue and extend into the adult age range.     

The burden of pneumonia in children: an Australian perspective

The burden of pneumonia in Australian children is significant with an incidence of 5-8 per 1000 person-years. Pneumonia is a major cause of hospital admission in children less than 5 years of age. Indigenous children are at particular risk with a 10-20-fold higher risk of hospitalisation compared to non-Indigenous children. They also have longer admissions and are more likely to have multiple admissions with pneumonia. There are limited data on pathogen-specific causes of pneumonia, however Streptococcus pneumonia is the most common bacterial cause in children under 5 years of age and respiratory syncytial virus (RSV) and influenza are the predominant viral causes in young children. Pneumonia due to Haemophilus influenza type b (Hib) has been virtually eliminated by the introduction of universal Hib immunisation. Further studies are needed to accurately define the epidemiology of pneumonia due to specific pathogens to help target treatment and immunisation strategies.     

The burden of asthma in children: a European perspective

Asthma is the most common chronic disease in childhood, imposing a huge burden on the patient, their family and society. It is a worldwide disease with variable expression between countries and between different populations in a country. There is evidence that its prevalence has increased considerably over the last two decades and is still increasing, despite there being some indications that the increase in prevalence may have plateaued in some countries in the last few years. Better understanding of the natural course of asthma and improved asthma control can lead to a decreased burden on the patient, their family and society. The burden of asthma consists mainly of a decreased quality of life for the patient and their family, as well as high costs for society; the healthcare expenditures for asthma in developed countries are 1-2% of the total healthcare costs.