When chronic disability meets acute stress: psychological and functional changes.

Parental Coping Strategies and Strengths in Families of Young Children with Disabilities* Sharon Lesar Judge** This study investigated the relationship between parental perceptions of coping strategies and family strengths in families of young children with disabilities. The 69 participants completed the Ways of Coping Questionnaire and the Family Hardiness Index. Results indicated that the use of social supports was highly associated with family strengths. In contrast, wishful thinking, self-blame, distancing, and self-control were negatively related to family strengths. Implications for practice are discussed Key Words: family strengths, children with disabilities, parental coping, parents of disabled children. Proponents of family-centered services for young children with disabilities have advocated a strength-based approach in promoting positive family functioning (Dunst, Trivette, & Deal, 1988, 1994; Powell, Batsche, Ferro, Fox, & Dunlap, 1997; Weissbourd & Kagan, 1989). This approach assumes that all families have strengths they can build on and that the family's strengths, including the social networks and informal supports already available to and within the family, should be the foundation upon which new supports are designed or provided (Dunst et al., 1994). One goal of family-centered early intervention is to identify existing family strengths and capabilities so that interventions are built on things a particular family already does well. By using family strengths as building blocks and tools, the family becomes even stronger and more capable of supporting the well-being of individual family members and the family unit (Trivette, Dunst, Deal, Hamby, & Sexton, 1994). Since current early intervention practices call for strength-based models of family support, there is a pressing need for empirical evidence about the relationship between parental coping and the family system to guide professionals in their development of programs and provision of services for families. Families use a variety of coping strategies that may influence family functioning. The work of Pearlin and Schooler (1978) and Folkman and Lazarus (Folkman & Lazarus, 1980; Folkman & Lazarus, 1985; Folkman & Lazarus, 1986; Lazarus & Folkman, 1984) indicate that coping is a major factor in the relation between stressful events and adaptational outcomes. This body of research is characterized by an interest in the different coping behaviors people employ in response to different life events. Family coping strategies can potentially strengthen or maintain family resources that serve to protect the family from the demands of stressful encounters (McCubbin et al., 1980). The various types of strengths that families possess reflect the way in which families cope and grow (Dunst et al., 1988). Lazarus and Folkman (1984) have defined coping as constantly changing cognitive and behavioral efforts to manage specific external and/or internal demands that are appraised as taxing or exceeding the resources of the person (p. 141). According to this definition, coping includes any attempt or effort to manage stress, regardless of how well it works. Coping strategies involve efforts to alter the cause of the stress (problem-focused coping) and efforts to regulate emotional responses to the stressors (emotion-focused coping). For example, problem-focused forms of coping include active problem-solving and seeking social support as well as aggressive interpersonal efforts to alter the situation. In contrast, emotion-focused forms of coping include detaching from the situation, controlling one's feelings, wishing the problem would go away, and blaming oneself for the situation. According to Frey, Greenberg, and Fewell (1989), problem-solving is the preferred style of coping with disability-related problems. Research indicates that emotion-focused coping that involves wishful thinking, denial, or avoidance is positively related to reports of depressed moods (e. …

Caring for children with congenital heart disease places significant stress on caregivers. Minimal data exist evaluating stress levels in caregivers of children with hypoplastic left heart syndrome (HLHS). The goal of this study was to obtain baseline stress scores for caregivers of children with HLHS and determine if associations exist between scores and specific caregiver factors. A cross-sectional study using a web-based survey targeted towards caregivers of children with HLHS was performed. Baseline demographics of the caregiver and child with HLHS were obtained. Caregivers completed three validated questionnaires including the Pediatric Quality of Life Inventory (PedsQL), Parenting Stress Index- Short Form (PSI-SF) and the Pediatric Inventory for Parents (PIP). Four hundred fifty-nine caregivers completed at least one questionnaire. PSI-SF total score was 80.5 ± 23.1 (> 86 = significant stress), PIP frequency total score was 119.0 ± 37.2, and PIP difficulty total score was 118.1 ± 35.7. Lower quality of life was significantly correlated with higher scores on the PSI-SF (r = -0.6), the presence of a developmental issue in the child (r = 0.3) as well as higher scores on the PIP frequency (r = -0.5) and difficulty scales (r = 0.4). Other demographic values for the caregiver and child did not significantly correlate with PSI or PIP total scores. Anxiety/stress scores of caregivers with children with HLHS are correlated with how well the child is perceived to be doing physically and developmentally by the caregivers. Caregivers with physical and/or developmental concerns may need added psychosocial support.

When a child develops a psychological disorder, even a mild one, early diagnosis is essential to provide a timely and appropriate intervention that can improve the child’s symptoms and development. Early identification can prevent consequences of differing levels, in the short and long term, in the individual, in their family and in society as a whole. Hence the importance of the paediatrician’s point of view and clinical knowhow in identifying potential disorders early, but also of the parents’ views. It is therefore important to actively involve parents in initial diagnosis. In this regard, within the NASCITA Project, a study branch aimed to build a shared, active approach between parents, paediatricians and neuropsychiatrists/psychologists was activated for the 2-year health assessments (well-child visits) phase. Three tests were used: the M-CHAT-R (Modified Checklist for Autism in Toddlers, Revised) to evaluate language, social skills, behaviour, sensory areas; the PSI-SF (Parenting Stress Index - Short Form) to verify the degree of discrepancy perceived by the parent between the child’s requests and their ability to deal with them properly; the DERS (Difficulties in Emotion Regulation Scale) to highlight the difficulties of each parent in recognising, interpreting, and managing their emotions. The tests were given to 380 parents (142 couples, 215 mothers and 23 fathers) by 45 family paediatricians during the well-child visit held at two years of age. In all, 33 children (9%) resulted at risk, with a score of ≥ 3, 1 of whom was found to be at high risk. For 64 children (16.8%) at least one of the parents tested positive for PSI-SF and for 19 (5%) children at least one parent tested positive with the DERS. After combining the results obtained from the three tests and the clinical evaluation and by assessing the child’s condition with respect to those results, the paediatrician can provide the parents with a concise description of what emerged and the specialist with a summarised report. Such an effort leads to timely, shared communication within the parent-paediatrician-neuropsychiatrist triad that includes specificity of intervention and that can contribute to the effectiveness of the response.

The aim of this study was to describe stress in the parents of children with cerebral palsy and investigate associations with very high stress. A cross-sectional survey was conducted of parents of 818 children aged 8 to 12 years from nine regions in Europe. Families were eligible to participate if they were living in one of the specified geographic areas. Parental stress was captured using the Parenting Stress Index Short Form, which has 36 items and takes 10 minutes to complete. Parents rate items on a 5-point Likert scale, with higher scores indicating higher stress. The Short Form yields scores on three subscales and a Total Stress score. A trained research associate administered the questionnaire in the child's home and visits lasted 90 to 120 minutes. All data collected were reported by parents unless otherwise stated. The Total Stress score on the Parenting Stress Index was dichotomized into scores of less than 99 or 99 or more, the latter indicating 'very high' stress. Most respondents were mothers (94%), and 26% reported very high stress levels. The parents of children with communication impairment had higher odds for very high stress (odds ratio [OR] 1.9; 95% confidence interval [CI] 1.2-3.0) than those whose child had no such impairment; the parents of children with moderate or severe pain had higher odds for very high stress (OR 1.7 [95% CI 1.1-2.4] and 2.5 [95% CI 1.5-4.3] respectively) than those whose child had no pain; and the parents of children with an intellectual impairment had higher odds for very high stress (OR 1.8; 95% CI 1.2-2.9) than those whose child had none. There was no association between very high stress and motor impairment. The subscales 'parent-child dysfunctional interaction' and 'difficult child' contributed most to the Total Stress score. Parents of children with communication difficulties, intellectual impairment, or pain are at very high risk of stress. The final model explained 12% of the observed variation in very high stress.

The use of modified ride-on cars to maximize mobility and improve socialization-a group design

Purpose: The purpose of this study was to identify the relationship of children’s behavior problems and child-rearing stress to rejective parenting attitude in mothers. Methods: Study participants were 595 mothers who had children aged 3 to 5 who attended one of 10 kindergartens or infant schools in M or B Cities. The instruments used for this study were a self-report questionnaire, CBCL (Child Behavior Check List), PARQ (Parenting Acceptance-Rejection Questionnaire), and PSI (Parenting Stress Index Short Form by Abidin). Regression analysis was the statistical method used for data analysis. Results: The factors associated with rejective parenting attitude were child-rearing stress, birth order, mother’s education, the major caregiver in the family, and the type of family. These factors explained 33.7% of rejective parenting attitude. Conclusion: The findings indicate a need to develop and provide parenting programs to reduce child-rearing stress in mothers.

Background. In a previous study, we demonstrated that the accumulation of parenting stress during prolonged school closures and restrictions on daily activities due to the COVID-19 pandemic in Japan indicates the need for mental health intervention for parents at higher risk of parenting stress. However, few studies have focused on parenting stress in other Asian countries, although they have experienced higher numbers of infections. The aim of the present study was to investigate whether parenting stress among caregivers increased across Asia due to school closures and restrictions on activities during the COVID-19 pandemic and to examine whether there were any country-specific, cross-country, or cross-regional risk factors for increased parenting stress. Methods. We conducted an online survey immediately after the number of new cases in India significantly increased (September to November 2020). We measured parenting stress, anxiety, and fear associated with the COVID-19 crisis, as evaluated by the Parenting Stress Index, Short-Form (PSI-SF) and the Coronavirus Anxiety Scale (CAS), across three Asian countries—India (n = 142), Malaysia (n = 69), and Japan (n = 182)—in addition to the US (n = 203). We also investigated whether respondents had adverse childhood experiences (ACE) as a risk factor for parenting stress. Results. For all countries, we found significant increases in participants’ current parenting stress levels, compared to what they recalled regarding their lives before COVID-19-related restrictions and school closures were enacted. Textual analysis qualitatively identified common terms related to parenting stress across all countries. We also found a statistical model that indicated ACE in parents was a critical risk factor for higher parenting stress via increasing anxiety and fear related to the pandemic. Conclusions. These results indicate the need to improve the mental health of caregivers who are at risk for higher levels of parenting stress during the COVID-19 pandemic in Asian countries as well as Western countries. These results indicate that there is a need to improve the mental health of caregivers who are at risk for higher levels of parenting stress during the COVID-19 pandemic globally.

Sudden unexpected death in epilepsy

We analyzed data from 87 mothers of children ages 15 to 44 months with cerebral palsy (CP) or no diagnosis, who completed the Dyadic Adjustment Scale, Parenting Stress Index, Support Functions Scale, and Inventory of Social Support. Principal components analysis of the 15 subscales from the 5 measures revealed few cross-measure loadings. Mothers of children with CP (severe or mild) reported higher levels of parenting stress than did mothers of controls. However, cluster analysis of self-report measures yielded a 5-cluster solution, with no diagnostic group differences across clusters. That is, there were no overall differences in self-reported family functioning according to presence or severity of the child's disability. The results are discussed in terms of the organization of family systems and their relationship to child diagnosis. Clinical implications for assessing and working with families are noted.

Article history: Received October 28, 2012 Received in revised format 18 February 2013 Accepted 19 February 2013 Available online February 25 2013 This paper performs a study to find the effect of training maternal behavior on a group of mothers who live in city of Esfahan, Iran. The study divides them into two experimental group and control group and examines the effects of training programs. The sample includes 40 women who have, at least, one child aged 4-8 years. The survey uses Abidin parenting stress questionnaire [Abidin, R. R. (1995). Parenting Stress Index. Odessa, FL: Psychological Assessment Resources.] and one group goes under 8 sessions of 2 hours long training programs. The results of ANOVA test indicate that two groups of mothers behave differently after attending training programs when the level of significance is one percent. © 2013 Growing Science Ltd. All rights reserved.

Background: This paper aimed to explore the associations between maternal representations of attachment evaluated during pregnancy, pre and postnatal maternal depression, parenting stress and child’s attachment at 15 months after childbirth. Methods: Mothers (n = 71), and their infants participated in a longitudinal study of maternal attachment, pre and postnatal depression, parenting stress and child attachment. Adult Attachment Interview (AAI) was conducted between 24 and 26 weeks of pregnancy (Time 1), depression was assessed using the Edinburgh Perinatal Depression Scale (EPDS) (at Time 1 and 6 months after childbirth, i.e., Time 2), parenting stress was assessed using the Parenting Stress Index—Short Form (PS-SF) (at Time 2) and the Strange Situation Procedure (SSP) at child’s 15 months of age (Time 3). Results: Free-autonomous maternal classification of attachment increases the likelihood of secure child classification in her offspring, while decreases that of avoidance and ambivalence. Insecure maternal representation of attachment evaluated during pregnancy and higher levels of parenting stress at six months after childbirth was associated with higher rates of infant insecure attachment at 15 months. Conclusions: Our study validates the importance of considering maternal representations of attachment crucial in determining the quality of the caregiving environment, thereby the healthy development of children, despite the presence of other contextual risk.

Objective To evaluate benefits for postnatal women of two psychologically informed interventions by health visitors.Design Prospective cluster trial randomised by general practice, with 18 month follow-up.Setting 101 general practices in...

The aim of this research was to study the relationship between parenting stress and coping strategies of mothers of children with Attention Deficit Hyperactivity Disorder (ADHD). The sample consisted of 143 mothers with a child who had been diagnosed with ADHD. The mothers completed a sociodemographic questionnaire, the Coping Strategies Questionnaire (CAE) and the Parenting Stress Index Short Form (PSI-SF). The results showed that mothers experienced high levels of stress and they tended to use coping strategies focused on problem solving. Meaningful differences were found between parenting stress and coping strategies according to sociodemographic characteristics. Negative correlations between parenting stress and coping strategies showed that coping strategies focused on problem solving were associated with lower levels of stress. Besides, positive correlations between parenting stress and coping strategies showed that higher levels of emotional coping strategies were associated with higher levels of parenting stress.

Mothers of children with autism spectrum disorder (ASD) report high levels of stress and lower levels of well-being than parents of typically developing children. Current interventions for ASD typically focus on working with the child rather than delivering strategies to help support parents. To evaluate the effectiveness of a psychoeducation intervention developed to support mothers of children with ASD in Saudi Arabia. Sixty-two mothers (23-52years) of children (26-78months) were recruited to a multisite randomized controlled trials of the intervention. The intervention consisted of one face-to-face session (60min) and four virtual sessions (30min each) delivered using WhatsApp. Parenting stress was the primary outcome, with secondary outcomes focusing on maternal depression, anxiety, and happiness, and child behaviour problems and ASD symptoms. Data were collected at baseline T1, immediately postintervention T2 and 8-week follow-up T3. One-way analysis of covariance was used at T2 and T3 with T1 scores entered as a covariate. Improvements were found at T2 for stress (F=234.34, p=.00, and d=-1.52) and depression (F=195.70, p=.00, and d=-2.14) but not anxiety, and these results were maintained at T3. Changes in child behaviour problems were limited to improvements in hyperactivity at T2 (F=133.66, p=.00, and d=-1.54). Although changes in stress and depression were statistically significant, change to clinically normal levels was limited to depression. None of the participants had recovered after the intervention (Parent Stress Index Short Form stress scores), whereas 23 mothers (71.87%) in the intervention group had recovered at T2 and 22 (68.75%) at T3 (Hospital Anxiety and Depression Scale depression scores). This intervention with WhatsApp support is beneficial but may need to be augmented with other forms of support for mothers of children with ASD including more condensed sessions on stress and interventions targeting anxiety.

The present study examines the influence of child adaptive behavior deficits on parenting stress and family quality of life (FQOL) among a sample of families with children newly diagnosed with autism spectrum disorder (ASD). The study used measures completed by families who were participants in a Parent Education Program designed to teach families about ASD. Parents completed the Vineland Adaptive Behavior Scales, Second Edition (Vineland-II; Sparrow, Cicchetti, & Balla, 2005), the Parenting Stress Index Short Form (PSI-4-SF; Abidin, 1995), and The Family Quality of Life Survey (FQOLS; Hoffman, Marquis, Poston, Summers, & Turnbull, 2006). Differences among mothers and fathers in reported stress and family quality of life were examined, and the relative predictability of the Vineland-II subdomains for stress and family quality of life was analyzed using linear multiple regression. Results indicated that child socialization deficits were most predictive of parenting stress levels, and communication deficits accounted for the most variance in family quality of life. Due to the high stress levels reported among families of children with ASD and the potential negative effects of chronic stress, these findings are suggestive of beneficial targets for intervention. Other implications of these findings and future directions are discussed.