Parental Stress in Families with Children with Early Intervention Needs linked to Socio-Environmental Vulnerability

Background Parenting stress was investigated in mothers with a child with Angelman syndrome (AS) or Prader–Willi syndrome (PWS), which are genetically related.Method Mothers of 24 children with AS and 23 children with PWS (2–12 years) completed the Nijmegen Parenting Stress Index-Short, Developmental Behaviour Checklist, and Vineland Screener 0–12.Results Parenting stress was high for 58% of AS and 26% of PWS cases. For both syndromes, no relationship existed with the child's gender, age, or behavioural problems. In PWS there was no effect on level of functioning. Overall, more mothers with a child with AS perceived high parenting stress. When children showed low levels of behavioural problems this difference was contained. However, when children exhibited severe behavioural problems, parenting stress was the same for both syndromes.Conclusion In AS professional family support is essential, since parenting is stressful for many mothers. In PWS, this is especially the case when behavioural problems are present.

The COVID-19 pandemic posed significant challenges for parents, due to the closure of childcare facilities and schools, the shift to working from home, and the loss of support services. To examine the extent to which COVID-related stress (CRS) and caring for psychiatrically vulnerable children (PVC) influenced parental stress and the experience of psychological basic needs during the first COVID-19 lockdown. Parents of PVC (n = 203) and parents of non-PVC (n = 919) completed questionnaires assessing parental stress and psychological needs. Associations were examined using multiple regression analyses. Parents of PVC experienced higher parental stress, greater need frustration and lower need satisfaction. CRS increased these experiences for all parents; while caring for PVC specifically contributed to higher parental stress. Notably, an interaction effect between PVC and CRS was found in total parental stress: CRS had less impact on parental stress in families with PVC. The findings underscore the need for (secondary) preventive support for all parents, and specific, accessible, and high-quality support for parents of PVC during pandemics. Moreover, targeted attention for parents both with or without PVC remains essential at policy and research levels.

The Parenting Stress Index-Short Form (PSI-SF) is one of the most widely used instruments for measuring parenting stress in families of children with autism spectrum disorders (ASD). However, no research to date has examined the psychometric properties of the PSI-SF in a sample of parents of young children with ASD. In this regard, item response theory (IRT) can be used to estimate how much information or discrimination each item of a scale offers across the entire range of the latent variable being measured, by creating individual item information curves or profiles. The purpose of this study was to use IRT to examine the discriminability of PSI-SF items in a sample of parents of young children with ASD who experience varying levels of parental stress. The study involved the parents of 141 children with autism spectrum disorders (91.4% mothers; mean age 36.2 years) who completed the PSI-SF following diagnosis. Item characteristic curves were constructed for each of the PSI-SF items and examined with regard to item functioning. Results indicated that, for the most part, changes in parental distress severity were reflected in changes on item scores. However, several items on the subscales measuring parent-child dysfunctional interactions and child behavior difficulty functioned poorly to discriminate parents across a range of total stress severity. The parent-child dysfunctional interaction and difficult child subscales of the PSI-SF scale should be used with caution with parents of young children with ASD. More research is required to examine PSI-SF content validity, at least among parents of children with ASD and perhaps parents of children with other disabilities as well.

Families of children with autism spectrum disorders: Communication and mental health

The purpose of this study was to explore factors related to parental depressive symptoms (PDS) and family quality of life (FQOL) in parents of adolescents and young adults (AYA) with and without a specific chronic health condition (CHC), spina bifida. Two hundred and nine parents of AYA (112 with SB; and 97 without) and their AYA (46% males and 54% females) took part in a multi-site cross-sectional descriptive correlational study. In telephone interviews parents reported on measures of family satisfaction, resources, cohesion, stress, demographic and clinical data. In the multivariate analyses, 38% of the variance of PDS was explained by family income, family resources and parent stress. Having a child with SB was not predictive of PDS. However, having a child with SB, along with family satisfaction, parent stress and PDS explained 49% of the variance of FQOL. PDS partially mediate the relationship of family resources and FQOL. PDS, family stress, and resources should be evaluated routinely, especially for those with low income. Parents of AYA with SB who have elevated PDS are at increased risk of having lower reported FQOL.

Contributors to Parenting Stress in Tuberous Sclerosis Complex at Preschool Age.

Using a cross-sectional research design, 152 Chinese immigrant mothers and 45 fathers living in the United States completed a previously validated online survey examining how fathers’ involvement in childcare, mothers’ perceptions of social support and reported self-efficacy were related to mothers’ parenting stress. The study purpose was to investigate the association between mothers’ reports of parenting stress and two sources of parenting support: mothers’ reports of fathers’ involvement and social support. A regression analysis examining the extent to which mothers’ reports of father involvement and perceived social support influenced Chinese immigrant mothers’ reported parenting stress showed that fathers’ emotional involvement was a significant predictor of mothers’ parenting stress. Mothers’ perceived social support was a stronger predictor, accounting for more variance in parenting stress than reports of fathers’ involvement across all the five dimensions. The mediating role of mothers’ self-efficacy on the relation between fathers’ involvement and mothers’ parenting stress was tested. Mothers’ self-efficacy did not account for the association between Chinese immigrant mothers’ reports of fathers’ involvement across five dimensions and mothers’ parenting stress. In conclusion, these findings herein suggest both father involvement and social support from significant others may influence Chinese immigrant mothers’ experiences of parenting stress.

Chronic illness and mental retardation are both associated with an increased rate of behavioural problems in children and with considerable emotional strain in families. The aim of the study was to analyse and compare the specific effects of two exemplary conditions on familial stress and coping. Forty-nine boys with Fragile X syndrome (FXS) were compared with 46 boys with Spinal Muscular Atrophy (SMA) and 32 male controls. Intelligence was measured with the RAVEN or K-ABC tests. Psychopathology was assessed with the CBCL questionnaire and a structured psychiatric interview (Kinder-DIPS), parental stress with the QRS, coping with the F-COPES and social support with the F-SOZU questionnaires. The mean age of the FXS boys was 8.6, of the SMA boys 12.7 and of the controls 11.2 years. The mean IQ was 47 for the FXS, 112 for the SMA and 103 for the control groups. According to the CBCL, 89.8% of the FXS boys, 21.7% of the SMA and 15.7% of the controls had a total score in the borderline or clinical range. The rates were 63.3%, 34.8% and 21.9% for internalising and 67.3%, 10.9% and 18.8% for externalising behaviour, respectively. 81.6% of the FXS and 10.9% of the SMA patients had a DSM-IV or ICD-10 psychiatric diagnosis. The most common were ADHD (FXS: 36) and Separation Anxiety Disorder (SMA: 4). In total, parental stress was significantly higher in the FXS than in the SMA families (and in both compared to controls). There were no major inter-group differences regarding social support and familial coping. Children with FXS are severely mentally retarded and have a high rate of mainly externalising disorders. Despite good coping abilities and social support, this is associated with high familial stress. The SMA boys, with an intelligence in the upper normal range, are no more deviant than their healthy controls. Parental stress is lower in the SMA families with good coping abilities. In conclusion, families with mentally retarded children are in even greater need of help than those of children with severe chronic illness/physical handicap.

Studies have shown that parents of children with autism spectrum disorders experience stress in parenting their children (e.g. Anyanwu et al. in Glob J Health Sci 11(8):51–60, 2019; Ayers in Self-care: why parents of children with disabilities must nurture themselves, 2012. http://www.disaboom.com/childrewithdisabilities ; Bonis in Issues Mental Health Nurs 37:153–163, 2016). The current study examined the effect of rational emotive family health therapy (REFHT) on parenting stress in families of children with autism spectrum disorders. A total of 128 participants allocated randomly to the intervention group and no-contact control group served as participants in this study. A 12-week REFHT programme that focused on reducing parenting stress was delivered to the intervention group by the therapists. Data analyses were completed using repeated-measures ANOVA. Results revealed no significant difference between the participants in the treatment group and no-contact control group at the initial evaluation. We found significant improvement in the management of parenting stress among parents of children with autism spectrum disorders after exposure to REFHT and at follow-up. Therefore, we concluded that rational emotive family health therapy has beneficial and sustained effects in improving the management of parenting stress among parents of children with autism spectrum disorders.

The purpose of this study was to compare the parenting stress experienced by parents of 121 children from 5 to 9 years old with autism spectrum disorder (ASD), attention deficit/hyperactivity disorder (ADHD), comorbid ASD+ADHD, and typical development in different domains related to child and parent characteristics using the Parenting Stress Index. The three clinical groups presented greater perceived parenting stress than did the comparison group (CG). The ADHD group obtained higher levels of parenting stress related to attachment and depression than did the other groups. The ASD+ADHD group presented a unique profile of differences from the CG on Health and Spouse subscales. Results highlight the importance in clinical practice of considering parenting stress as a relevant variable for intervention in these clinical families.

For prevention of anxiety in children and adolescents, it is important to know whether family stress is a predictor of anxiety. We studied this in 1,875 adolescents from the Tracking Adolescents’ Individual Lives Survey (TRAILS) who were followed up for 2 years, from age 10–12 to 12–14 years. Adolescents reported anxiety and depression symptoms at both assessments, and parents reported family stress (family dysfunction and parenting stress) at the first assessment. Family dysfunction was not associated with future anxiety, whereas high parenting stress was. Furthermore, family dysfunction was more strongly associated with anxiety than with depression, whereas parenting stress was more strongly associated with depression. Level of parental psychopathology explained part of the association of family stress with anxiety. The associations were modest and the understanding of the origins of adolescents’ anxiety will require identifying other factors than family stress that account for more of the variance.

Parental imprisonment, and more recently other close family imprisonment, has been associated with long-term harms to children. A number of researchers have proposed that parenting stress caused by family imprisonment could impact on caregivers’ ability to offer a secure parent–child relationship after a close family member is imprisoned. Such relationship problems might then mediate further harms to children. The Family Stress-Proximal Process (FSPP) model conceptualises family imprisonment as an ongoing stressor that influences relational processes in families. Using HILDA, a nationally-representative Australian survey, we test key aspects of this theoretical model for women affected by close family imprisonment. We demonstrate that recent close family imprisonment does indeed significantly increase risks of high maternal parenting stress. Women affected by this high parenting stress are also significantly more likely to report feeling less satisfied with their relationship with their child one year later. Nonetheless, only a third of women experiences high parenting stress after close family imprisonment. And, women who experience close family imprisonment without high parenting stress do not have a greater risk of subsequent relationship dissatisfaction. We conclude that the prevention or reduction of parenting stress in families affected by close family imprisonment could have a protective effect on subsequent mother-child relationships.

Background There are well documented associations between unmet social needs and undesirable health outcomes, but little data exist on the association between unmet social needs and stress in families of children with asthma. Objectives To document the relationship between unmet social needs and parental stress in a Canadian paediatric asthma clinic. Design/Methods Ongoing prospective observational study to determine the association between unmet social needs and parental stress was conducted in a tertiary care paediatric asthma clinic, between September 2022 and September 2023. Participants were parents of children with a diagnosis of asthma, treated with at least one controller medication. Unmet social needs were collected by parental self-report using a questionnaire assessing 8 domains: employment, housing, ability to pay for utilities, financial resources, food security, transportation, childcare, and education. The four-item Perceived Stress Scale was used to assess how parents perceived stress and how they felt they were able to manage situations in their lives. Chi-square tests compared our independent variable, the presence vs. absence of unmet social needs, to our dependent variables; each measure of stress (control over important aspects of ones’ life, confidence in ability to overcome problems, feeling that everything was going well, ability to overcome too many accumulated difficulties). Results Of 162 participants, seventy-seven (48%) reported at least one unmet social need. Compared to participants without unmet social needs, those with unmet needs were more likely to report having no control over important aspect of their work or main activity (p< 0.001); less likely to report having confidence in their ability to overcome problems (p< 0.001); less likely to report having the feeling that everything was going well (p< 0.001); and less likely to report having the ability to overcome too many accumulated difficulties (p< 0.001). Conclusion Findings suggest significant association between unmet social needs and parental stress of asthmatic children. Parental stress and unmet needs may concomitantly increase the burden of adhering to asthma controller medication, making adherence more challenging through pathways related to the interactions between cognitive burden and precarious living situations. This ongoing Canadian study seeks to elucidate the mechanisms by which these factors make adherence to asthma medication more challenging for families, so these challenges can be addressed.

BackgroundIt is yet to be clarified if and how parenting stress was linked to adolescent depressive symptoms during the pandemic.ObjectivesThis study adopted an interdependent approach to examine the relationship between parenting stress and adolescent depressive symptoms in Chinese families. It then examined the mediating effects of overt and covert coparenting conflict behaviors.MethodsAs a national survey, data were obtained from different regions in China. Fathers, mothers, and adolescents from 1031 families participated in this study. The fathers and mothers reported parenting stress; the adolescents rated their fathers and mothers’ overt and covert coparenting conflict behaviors and their own depressive symptoms.ResultsMaternal parenting stress was related to adolescent depressive symptoms through the mediating effects of paternal overt and maternal covert coparenting conflict behaviors. Both paternal and maternal parenting stress were directly related to adolescent depressive symptoms. However, maternal parenting stress had a more substantial effect on adolescent depressive symptoms than paternal parenting stress.ConclusionsThe findings support the effects of parenting stress on adolescent depressive symptoms. The study also highlights the mediating roles of paternal overt and maternal covert coparenting conflict behaviors in relationships.

The present study examined effects of sociodemographic, risk, and resilience factors on marital, parental, and financial stress early in the COVID-19 pandemic. A cross-sectional online survey was conducted among 480 married Palestinians living in Israel, using self-report questionnaires. Descriptive statistics and bivariate correlations were computed. Then, hierarchical multiple regression analyses were conducted to predict each of the three stress measures. Finally, dominance analyses were conducted to compare the contributions of sociodemographic, risk, and resilience factors. The results showed considerable differences between predictors of marital and parental stress and predictors of financial stress. For marital and parental stress, resilience factors mainly family resilience were the strongest predictors, followed by risk factors and then sociodemographic characteristics. For financial stress, risk factors (mainly financial damage and prior stressful life events) were the strongest predictors, followed by sociodemographic characteristics and resilience factors (mainly individual resilience). These results suggest that family and individual resilience reduce marital and parental stress under difficult conditions, including the COVID-19 pandemic. Though resilience has been found to ameliorate financial stress to some extent, it appears that other measures are required to manage stress related to financial difficulties.