Abstract
Parental chronic illness may adversely impact youth and family functioning. This study examined a moderated mediation model of the effects of parental illness on youth and family functioning derived from the Family Ecology Framework. Consistent with this model, we predicted that youth caregiving and stress would serially mediate the adverse impacts of parental illness on youth adjustment and family functioning and that psychological flexibility would moderate these mediational mechanisms. A total of 387 youth, with parents affected by chronic illness, completed a questionnaire assessing parental illness severity, youth caregiving and stress, psychological flexibility, youth adjustment (i.e., internalizing and externalizing problems and psychological wellbeing), and family functioning. Path analyses indicated that the adverse effects of parental illness on youth adjustment and family functioning were serially mediated by youth caregiving and stress. Psychological flexibility buffered the adverse effects of these serial mediators on youth internalizing problems and psychological wellbeing. These findings identified three potential intervention targets: youth caregiving, related stress appraisals, and psychological flexibility. Given the large body of evidence showing that acceptance and commitment therapy fosters psychological flexibility, this intervention approach has the potential to address the psychosocial and mental health vulnerabilities of youth in the context of parental illness, which constitutes a serious public health issue.
Highlights
Parental illness may adversely affect youth and family functioning
The aim of the present study was to test a moderated mediation model derived from the Family Ecology Framework (FEF), which proposed that youth caregiving and stress were serial mediators of the impacts of parental illness on youth adjustment and family functioning and that psychological flexibility moderated the effects of these mediational mechanisms
Results of the present study suggest that parental illness severity is associated with the redistribution of family roles, whereby youth engage in more youth caregiving, which is related to higher stress in youth and, in turn, poorer youth and family outcomes
Summary
Parental illness may adversely affect youth and family functioning. It is estimated that approximately 12% to 15% of youth have a parent with a chronic illness [1,2]. Parental illness is associated with a significantly higher risk for youth mental and physical health problems, poorer health-related quality of life (HRQoL), and social, educational and employment difficulties that persist well into adulthood [5,6,7,8,9,10,11,12,13,14,15]. Having a parent with a chronic illness is related to a significantly higher risk for internalizing problems (e.g., depressive, anxiety, and somatic symptoms), externalizing problems (e.g., aggressive and delinquent behaviors), lower life satisfaction, and loneliness [9,10,11,12,13,14,15,16,17]. The youth of chronically ill parents are at higher risk of affective dysregulation, Int. J.
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