Parents' perceptions of diabetes in adolescent daughters and its impact on the family.

Recent findings revealed that the causes of adolescent involvement in risk behaviors are lack of love, support, warmth and acceptance from their parents (Newby S Deepshikha & Bhanot, 2011).Aggressive behaviors were most common among adolescents in the early ages; their aggression is mostly against family, school property, classmates, and teachers. Hitting, pushing, spreading rumors, engaging in school fights, excluding a peer from a group, poor control of emotions, social withdrawal, and hitting a peer to get money were some of the common aggressive behaviors (Rew, Horner, & Brown, 2011;Yeh, 2011). Rule breaking behaviors were considered as the next level of risk behavior. Adolescents were breaking the normal expectations of the family, school, and society and were violating clearly defined regulations. Selfinjurious behavior such as burning the skin, limb hitting and bruising, head banging, picking at wounds, peeling the skin, deep biting, severe skin scratching, were found to be increasing tremendously among adolescents (Ohlemeyer & Wildeisen, 2005).Adolescents who experience lack of normal parental love, care, and warmth develop negative perception about themselves, their family, and their parents (Okorodudu & Nwamaka, 2010). Having unstable and unaccepting familial contexts would be like pouring oil on this burning flame (Saxena, Srivastava & Naithani, 2011).As a result of it the adolescents would develop the tendency to engage in aggressive, rule-breaking, and self-destructive behaviors(Bolognini, Plancherel, Laget, & Haifon, 2003).These were fostered by their belief that others were interfering with their independence and autonomy (Zhang & Arvey, 2009).In Asian culture parents use more punishments and exercise higher control and authority to coax the best performance from their children, which make the children rebellious and delinquent (Okorodudu & Nwamaka, 2010). There is also much evidence to prove that parental unpreparedness to deal with transitional changes that adolescents were going through lead to an affectionless style of parenting (McKinney, Donnelly & Renk, 2008). This would lessen the emotional bonding between parents and adolescents, causing the adolescents to internalize and externalize different problems (McKinney, & Renk, (2011).Adolescence is a challenging period for parents and teenagers (Coley, Votruba-Drzal, & Schindler, 2009). It is a warning to the elders to prepare their children for adaptation and to help them develop the capacities and skills they need to cope with the changes they are going through(Bolognini, Plancherel, Laget, & Halfen, 2003) . During this time parental reaction to adolescent transitions would depend on how prepared the parents were (Spring, Rosen & Matheson (2002). Lack of parental awareness about the external and internal changes experienced by the adolescents during their transition could cause breakdown in their relationship (Shearer, Crouter, & McHale, 2005).In such a situation, parental education would help the parents to develop the skills needed to relate with their adolescents (Bunting, 2004) .A family-based and attachment-focused intervention program would help to improve family unity, communication, and coping skills (Accordino, Keat II & Guemey, 2003). It will also support the development of a healthy adjustment between adolescents and their parents (Moretti, Holland,& Moore, 2002). According to Moss et al. (2012) an attachment-based intervention program is more effective in reducing internal and external behavioral problems among adolescents because it is based on improving parental sensitivity and child security. …

Despite continued advancements in medical care and improved survival or life expectancy, childhood deaths due to complex chronic conditions (CCC) or prematurity are inevitable. Deaths during the first year of life constitute approximately 50% of disease-related deaths, the causes of which include perinatal complications, prematurity, or congenital anomalies. Beyond the age of one year, the three most common life-limiting CCCs are neurological/neuromuscular and cardiovascular conditions (including genetic disorders), and malignancies. The majority of disease- and prematurity-related deaths occur in hospitals and for children dying at home, hospital use in their terminal stage is high. Symptom burden and reliance on medical technology has been reported to be considerable. Circumstances and characteristics of deaths, however, are known to vary by age and medical conditions.
\nWhen facing the death of their child, parents experience an unimaginably painful life event and severe crisis that affects the whole family for life. In this highly stressful time parents are confronted with uncertainty and are required to make difficult decisions, e.g. withdrawal of life-sustaining interventions. Their need for compassionate professional support is high. Paediatric palliative (PPC) and end-of-life (EOL) care emerged as a medical subspecialty aimed at meeting the specific needs of seriously ill children and their families. Meeting these needs requires a comprehensive and integrative approach from a compassionate and skilled multidisciplinary team. Parental needs have been studied in the past and an overview of themes/domains most important to parents can be summarised as: sincere relationships and emotional, spiritual and cultural support; genuine communication; alleviation of suffering; continuity, coordination and accessibility of care; and bereavement support. Deficiencies in meeting parental needs were identified across all themes, e.g. insufficient communication, lack of respect, and lack of emotional support. 
\nMost of the evidence related to the parental perspective of their child’s EOL care originates from qualitative research. To assess and explore the parental perspective effectively, an approach combining quantitative and qualitative information is likely to provide the most comprehensive view of experiences and unmet needs. A few self-administered questionnaires designed to assess the experiences and needs of parents of a dying child exist. None of the instruments available were applicable to the heterogeneous field of paediatric EOL care, including children of different age groups, with different underlying illnesses and in different clinical settings.
\nThe development of PPC in Switzerland lags behind when compared with other developed countries, such as the United Kingdom or the USA. Need for action has been recognised by the Federal Office of Public Health and the call for a thorough assessment of current practices, needs, available resources and existing services as requirement to formulate and plan further measures to promote PPC in Switzerland has been issued. 
\nThis dissertation is embedded in the PELICAN study (Paediatric End-of-LIfe CAre Needs in Switzerland, 2012 – 2015). The overarching aims of the nationwide PELICAN study were to provide comprehensive information and to understand the current practice of EOL care (i.e. in this study, the last 4 weeks of life prior to death) in paediatric settings in Switzerland (hospital and community care) and to explore and describe parental perspectives and the perspectives of the healthcare professionals involved. Based on the results, recommendations for best-practice during this highly vulnerable and critical phase of life not only for the affected child but also for the family will be formulated.
\nThe dissertation is organized in 9 chapters:
\nChapter 1 introduces in the field of paediatric EOL care and reviews relevant topics. The epidemiology of childhood illness- and prematurity-related death is described together with characteristics and circumstances of death. PPC and EOL are being defined and the he provision of paediatric palliative and EOL care are introduced. Existing evidence about the parental perspective of their child’s EOL care is summarised, and a potential framework for the quantitative assessment of parental experiences and needs is described. The emerging research gaps, and the rational and aims of this dissertation are described in chapter 2 together with the context in which the PELICAN study took place. 
\nChapter 3 comprises the PELICAN study protocol. It provides an introduction, rational and specific aims of the entire research project including three main studies and two subs-studies combining quantitative and qualitative methodology. Methods for each study arm are detailed. This dissertation comprises PELICAN I and the quantitative part of PELICAN II, including the development and testing of the Parental PELICAN Questionnaire (PaPEQu).
\nChapter 4 reports on patterns of care at EOL in neonates and children with complex chronic conditions. Data from 149 paediatric patients who died in the years 2011 or 2012 due to a cardiac, neurological or oncological condition, or during the neonatal period were collected in 13 hospitals, two long-term institutions and 10 community-based healthcare service providers throughout Switzerland. Sixty-two percent of the patients died in intensive care units, 84% of them following the withdrawal of life-sustaining treatment. Reliance on invasive medical interventions was prevalent, and the use of medication was high, with a median count of 12 different drugs during the last week of life. Patients experienced an average number of 6.42 symptoms. The prevalence of various types of symptoms differed significantly among the four diagnostic groups. Only half of the patients who spent days at home received community-based healthcare. The study provides a comprehensive overview of current EOL care practices in a real-life setting of different healthcare providers and the findings provide a knowledge base for paediatric palliative care teams.
\nChapter 5 describes the development and initial validation of the Parental PELICAN Questionnaire (PaPEQu) – an instrument to assess parental experiences and needs during their child’s EOL care. The PaPEQu was developed in four phases between August 2012–March 2014: phase 1: item generation; phase 2: validity testing; phase 3: translation; phase 4: pilot testing. Psychometric properties were assessed after applying the PaPEQu in a sample of 224 bereaved parents in April 2014. Validity testing covered the evidence based on tests of content, internal structure and relations to other variables. The PaPEQu consists of approximately 90 items in four slightly different versions accounting for particularities of the four diagnostic groups. The questionnaire’s items were structured according to six quality domains described in the literature. Evidence of initial validity and reliability could be demonstrated with the involvement of healthcare professionals and bereaved parents. The PaPEQu holds promise as a measure to assess parental experiences and needs and is applicable to a broad range of paediatric specialties and settings.
\nChapter 6 reports on the results of the survey with the newly developed PaPEQu. Responses regarding parental experiences and perceived satisfaction are described. Differences between the four diagnostic groups are analysed using a generalized estimation equation to account for the dyadic data structure. Of 307 eligible families, 267 could be contacted and 135 (51 %) consented to participate in this questionnaire survey. Our findings show positive parental experiences of their child’s EOL care and high perceived satisfaction with the care their child received. Parents of a child with cancer rated their experiences highest in most of the six quality domains and reported the highest satisfaction with care. The lowest scores were mainly reported by parents from the neurology group, with the exception of the shared decision making domain, where parents of neonates reported significantly less positive experiences. Although positive in general, our study results suggest some areas for improvement. The integration of specialised paediatric palliative care has the potential to minimise lost opportunities to support and assist parents.
\nIn chapter 7 finally, the results of all studies are being synthesized and discussed within the state of science. Strengths and weaknesses of methods are examined and implications on the level of policy, practice and research are derived. This dissertation concludes with the recognition that urgently needed data to advance the development of PPC in Switzerland is now available. It also recognises however, that we are challenged to demonstrate the effectiveness of PPC services in order to grow out of the infancy of this medical subspecialty.

In the present scenario, the adolescents face enormous challenges in the Indian society. Adolescents are the most vulnerable group in any population and needs the greatest social care. Adolescence as a developmental period is filled with many changes and crisis. Some of these challenges might be relatively minor, while others are disastrous on a much larger scale. Challenges faced by adolescents may deteriorate their well-being. Although family is the best place for an adolescent to grow and develop, at times, families become incapable to cater the needs of the adolescents due to family conflicts and other unavoidable circumstances. Large numbers of adolescents end up in institutional care. Though there are no official estimates of this number, Aangan India, an NGO, in its annual report of 2009-2010 puts the number at 4.5 million (2010).Institutional care is considered as an appropriate measure for providing care to orphan and destitute adolescents in India. Child welfare has become a major concern in our society with the increased number of children and adolescents ending up in institutional care. According to Childline India (2008), adolescents become destitute, for the interim or permanently of neglected parental care for many reasons including the illness, death or imprisonment of parents, parental conflict, separation due to migration or armed conflict, the removal by child welfare authorities and/or the courts based on the best interests, detention of the adolescent, or following the adolescent's own initiative to leave home. Henceforth, large populations of adolescents grow up without one or both of their parents as destitute.Adolescents undergo traumatic experiences because of parental loss and the stigmatization associated with this loss (Jain & Negi, 2001). In the case of destitute adolescents, early separation from parents, deprivation of parental care, love, affection, warmth, security, acceptance and discipline during childhood and adolescence disrupts their normal socio-emotional development (Hiremani, Khadi, Gaonkar, & Katarki 1994). They tend to feel unwanted and develop a high risk of abuse, exploitation and neglect. Institutional care in early life predisposes children to intellectual, behavioral and social problems later in life. According to Steinberg (2001) inadequate individual care in institutions, socially and emotionally weaken adolescents. Most of the destitute adolescents do not experience the warmth of love and support of parents feels that he/she is unwanted and tend to have negative attitude towards life and get depressed (Hamburg, 2006). In a crisis situation, destitute adolescents develop tunnel vision, which makes them unable to sec the positive aspects of their life. They tend to develop aggressive, non-compliant behavior, anxiety and problems with social relationships (Singh & Akbar, 1970). Caroll (1999) called the institutional life of adolescents as a state of 'chronic emotional deprivation'.Violence at home is one of the major predictors of adolescents experiencing homelessness. This makes them feel that they have no home to return due to irreconcilable familial conflicts. They run away from their houses without the parent's/guardian's permission or are moved from their families by the child welfare authorities and finally end up in institutions. Destitute adolescents often have prior experiences of violence, either eye witnessing violence or being abused physically or sexually (Dutta, Baratha, & Goswamy, 1998). Higher risks of exposure to violence or trauma in adolescence lead to behavioral and mental health problems.Mental health for adolescents is just as impoitant as their physical health. Mental health includes the ability to enjoy life, and create a balance between life activities and the efforts to achieve psychological well-being. The World Health Organization defines well-being as 'a state of mind in which an individual is able to realize his or her own abilities, cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community. …

Childhood adversities and psychopathological outcomes

The aim of the research is the study of interaction between the adolescent communication and parents with the perception of family cohesion and flexibility. The subject of research: the study of peculiarities of family factors, especially the interaction of adolescents with parents who are in different contexts of social situation of development (different relationships and family functions, in terms of training in public schools specialized type). Methods: 1. Questionnaire for studying the interaction of parents with children I. Markovskaya. (We used the option for adolescents and parents). [6] 2. Diagnosis of cohesion and flexibility of the family system – D. Olson technique [16,17] In this case, the questionnaire D. Olson filled with teenagers and their parents. 3. Questionnaire marriage satisfaction V.V. Stolin. The sample: A total of 116 adolescents attended secondary school in the city of Tashkent, 53 teenagers from specialized schools open type, 48 parents of adolescents enrolled in secondary schools in Tashkent and 10 parents of adolescents enrolled in special schools for the open type of deviant adolescents (total 227 people). Relatively Moscow sample in the study involved 99 adolescents from high school of Moscow, 39 teenagers from specialized schools for open type of deviant adolescents 20 parents of adolescents enrolled in secondary school in Moscow and 8 parents of adolescents enrolled in special schools open type for deviant adolescents (total 164). The total number of subjects teens and parents – 391 people. Hypotheses of the study : 1. peculiarities of the family situation in families of the usual and deviant adolescents from Moscow and Tashkent are different and have different profiles of educational competence of parents. 2. There is a relationship between the occurrence of parental dysfunction as emotional distance, rejection, inconsistency, lack of cooperation, marriage dissatisfaction with perception of cohesion and flexibility of family system at deviant adolescents.

The silent truth of teenage pregnancies--Birth to Twenty cohort's next generation.

With the rising numbers of prisoners in Australia and the recognition of prisoners as parents across policy and academic domains, an increased interest in children affected by parental incarceration has emerged. Such interest focuses on three areas of inquiry: psychological impacts of parental incarceration on children and young people; links to intergenerational crime; and current responses to children and young people with a parent in prison. Much of this research about children has been undertaken with adults; it is often unclear whether researchers spoke with children and young people about the issues they reported on. Where children and young people have participated in research, it generally focused on data collection from surveys and other measurement tools. Research that explored children and young people’s experiences of parental incarceration, as perceived by them, is limited. A small number of international studies, predominantly from the United Kingdom (UK) and United States of America (US), have spoken with children directly about this issue; however, there is a considerable gap in research that considers the Australian context, particularly the Australian Capital Territory (ACT). This study aimed to fill this gap. It explores the self-reported experiences of children and young people living in the ACT who have or have had a parent in prison. All participants experienced paternal incarceration; three experienced maternal incarceration. This thesis analyses the results of qualitative interviews with children aged 8–18. Employing a childhood studies framework, this research highlights the voices of children and young people, emphasising their own perspectives and meaning-making. A reference group comprising five young people provided guidance at the commencement of the study. Sixteen children and young people participated in semi-structured interviews. Participants were recruited from a range of services across Canberra, including prison, statutory child protection services, youth work services and other non-government services. Data were analysed using an interpretative phenomenological analysis approach. This approach illuminated the complexity of the meanings children and young people placed upon their experience of parental incarceration. This analytical method also ensured that children and young people stayed at the forefront of the findings. The findings highlight that, when a parent commits a crime, the adult criminal justice system institutes a process in which the children of prisoners may, or may not, actively participate. From the point of arrest to the release of their parent, children and young people describe how their everyday lives were influenced by the criminal justice system and how they in turn managed and responded to the challenges that arose. Children and young people spoke about a diverse range of experiences at different points across the criminal justice process, which lasted for different periods of time. Children and young people described how the adult criminal justice system frequently created or exacerbated experiences of instability and uncertainty across specific life domains. They reported challenges with family relationships, housing, caring responsibilities, finances and education. They also described distinct differences in the types of relationships they had with their parent before, during and after incarceration. Consistent with childhood studies, children and young people described how they would meet these challenges and work to change them. Children and young people also experienced a range of emotions. Feelings of loss, stress, disconnection, shame and stigma were present for many participants. The feelings they described were not necessarily associated with the level of involvement they had with their incarcerated parent. In exploring children and young people’s understanding of parental incarceration, this research adds to the emerging body of work about children of prisoners in the Australian context. Children and young people’s participation has allowed their experiences of parental incarceration to be considered beyond the criminological and developmental psychology perspectives that have traditionally dominated much of the research in this field. This thesis provides a theoretical contribution by considering the tensions that exist in how children enact agency and the way they influence and are influenced by the social process and structures around them. In better understanding the experiences of children and young people, this thesis makes an important contribution to the development of sensitive and appropriate policy and practice within social work and more broadly so that children with a parent in prison may be better responded to.

The study investigated lived experiences of single parent families of a high density suburb in Masvingo province, Zimbabwe. The qualitative approach utilising a descriptive survey was employed to study the phenomena. The population of the study comprised of female headed households. Households and respondents were sampled using convenience and purposive sampling. Data was collected through questionnaires, semi structured interviews and non participant observation. The data was presented and analysed in narrative form basing on the research questions and the themes which emerged. The findings from the study revealed that the extended family was an important factor in single parent families. The findings also revealed that fulfilment of family functions; physical, emotional, and psychological is sometimes a challenge in single parent families. The study established that to a greater extent the absence of one parent may contribute towards poor emotional and social development of the children. The study also established that the population studied experienced work overload, economic hardships and loneliness, especially the parents. The study recommends that single parents should form support groups where they share ideas on addressing challenges they face. The study also recommends community and extended family involvement in child rearing to provide role models in the place of the absent parent. Replica studies be conducted on single parents in other contexts to provide a holistic picture of single parenting and measures to minimise negative effects on children and parents.

Emotional Competence is the ability to recognize and appropriately respond to the experience of emotions. Appropriately responding to emotions means that the person is able to make distinction between useful and notusefiil emotions. When a person is emotionally competent, he has the ability to act only from a calm inner clarity and adapt at regaining that calm clarity whenever it may become temporarily masked by the presence of not-useful emotions. Emotional competence is the skill that can be learned. It is the ability to understand, manage, express and use emotions effectively. It is one's ability to express or release one's inner feelings (emotions). It implies an ease around others and determines one's ability to effectively and successfully lead and express (Anne, 2000). It is described as the essential social skills to recognize, interpret and respond constructively to emotions in yourself and others (John, 1992). Recording to Goleman (2003), Emotional competence is a learned ability grounded in Emotional intelligence. Emotional intelligence influences our potential for learning the practical emotional competencies, and developing the emotional literacy necessary for quality of life, life satisfaction and overall happiness.To achieve and maintain a feeling of adequacy, the individual has to acquire a few workable assumptions about the world, where need for competence emeige as most of the fundamental motives of life, because a person survive through competence, grow through competence and actualize oneself through competence (Allport, 1961). These competencies develop in a child's personality through a close and secure interpersonal relationship with his parents. So the present study attempts to explore emotional competence in relation to parental involvement.Parental involvement implies how the parents involve themselves in developing overall personality of the child. All the parents have expectations, like and dislikes and preferences regarding how children should be handled, brought up and educated. When parents are rational and their attitude towards their children in logical and considerate, it is sure to pick up a behavior pattern, which is analytical and co-operative. Om case parents are too emotional, and their attitude is non-rational and they act more in terms of expediency in an authoritative manners, the child will fail to attain proper emotional training, thus lacking in emotional competence. So, the interaction of emotional competence and parental involvement is very crucial.Objectives of the study* To identify gender differences on all the dimensions of Emotional Competence of Adolescents.* To identify the effect of Parental involvement on all the dimensions of Emotional Competence.* To identify the interaction effect of parental involvement and gender on all the dimensions of Emotional Competence.Hypotheses of the study* There will be significant gender differences on all the dimensions of Emotional Competence.* Adolescents with different levels of Parental Involvement (high, Average and low) will differ significantly on all the dimensions of Emotional Competence.* There will be a significant interaction of Parental Involvement and Gender on all the dimensions of Emotional Competences.MethodParticipantsThe sample for the present study consists of 150 adolescents (75 boys and 75 girls) equally divided into three groups on the basis of their perceived parental involvement (high, average and low). The mean age of the boys was 18.1 years and for the girls it was 16.5 years.InstrumentsParental Involvement Scale: Chopra and Sahoo's (2007) PIS was used to assess parental involvement of the respondents. The scale consists of 34 statements. All these statements are positive. Each statement has three options for choice like frequently, occasionally and never. The range of the score is 34-102.Emotional Competence Scale: Sharma and Bhardawan's (2007). …

Background and Aims : Research has highlighted some of the parental stressors experienced in hospitals by parents of children that required repeated admissions. Little had been written about parents of essentially healthy children with a first admission for an acute condition/needing surgery. A small qualitative study investigating the hospitalisation experiences of this group of parents was completed by the author earlier. The aim of the present study was to find out if the factors identified previously as being the most stressful, do in fact contribute to the distress experienced by parents in hospital. Design and Participants : This cross-sectional study used comparative and correlational analyses. The sample included 75 parents of children in hospital. Measures : Variables were measured using a range of constructed questionnaires. Results : The results showed that parents experienced a higher level of psychological distress while at the hospital, compared to a couple of weeks prior to their child’s admission. Parents’ perceived seriousness of their child’s condition, was correlated with higher level of anxiety while at the hospital. Other results indicated that parents were satisfied with hospital procedures, staff communication and parental role. However, parents of children with first admissions were less satisfied with some aspects of communication and more confused about parental role compared to parents of children with repeated admissions. Findings highlighted the levels/sources of support parents received. It was noted that there was a significant relationship between depression and support from family and a significant trend was also found for depression and support from other parents on the ward. Implication : The discussion considers explanations for the findings, which are discussed in relation to previous literature. Clinical implications for undertaking work with health care professionals and working with parents on paediatric wards are examined. The limitations of this study are explored and further research is suggested.

There is abundant evidence supporting the importance of accepting and autonomy-supportive parenting rather than rejecting and autonomy-restrictive or controlling parenting for development. This is especially relevant for adolescent and young adult (youth) adaptive development, including the development of relational schemas, coping skills and emotional health. Moreover, the impact of the quality of parent-child (and other) relationships on youth’s emotional health has been described as mediated via relational schemas, with schemas defined as beliefs, biases, and expectations that arise out of social experiences. For example, rejection sensitivity (RS) theory (Downey & Feldman, 1996) is one influential perspective that explicitly identifies how social experiences of rejection, victimisation, or isolation gives rise to a cognitive-affective bias of anxious expectation, biased perceptions, and defensive overreactions to ambiguous or overt cues of rejection. These cognitive affective biases in turn, are implicated in the development and maintenance of negative outcomes, such as internalising symptoms. However, components of this model, when applied to older adolescents and young adults, have rarely examined the mechanisms that help account for the associations of parental experiences, RS, and internalising symptoms. To this end, the aim of the four empirical studies conducted for this thesis was to apply the RS framework to test a model that specifically accounts for how interpersonal experiences (in the form of parenting behaviours), biased perceptions and beliefs regarding interpersonal exchanges (i.e., RS), and intrapersonal vulnerabilities (i.e., maladaptive socio-emotional responses) all play roles in elevated internalising symptoms for older adolescents and young adults. A parallel aim was to identify protective factors (i.e., cognitive reappraisal and coping flexibility) that may modify the risk of these interpersonal and intrapersonal factors for older adolescents and young adults. To achieve these aims, the four studies utilized either cross-sectional or two waves of longitudinal data collected from older adolescents and young adults over a 1-year period. Study 1 tested a comprehensive RS-model among a sample of 628 older adolescents and young adults. Structural equation models (SEMs) were used to identify serial-mediation pathways of risk stemming from parenting practices and RS onto higher depressive and anxious symptoms. Study 2 examined the temporal risk that RS plays for increased internalising symptoms over a one-year time span via heightened emotional dysregulation, expressive suppression, and social avoidance among 402 longitudinal participants from Study 1. Further, in Study 2, bi-directional relations between socio-emotional responses and internalising symptoms were tested, with results supporting bi-directional associations over time. Study 3 drew upon the cross-sectional sample from Study 1 (N = 643) to examine the moderating effects of three related, but distinct, components of the self-perceived capacity for flexibly coping with stress (i.e., multiple coping strategy use, situational coping, and coping rigidity). More specifically, these three capacities were examined as potential moderators of the relations between several regulatory strategies (emotion dysregulation, suppression, social avoidance, and cognitive reappraisal) and internalising symptoms. Finally, making use of the longitudinal sample, Study 4 (N = 394) examined the moderating effects of cognitive reappraisal and coping flexibility (i.e., multiple coping strategy use) on the concurrent and temporal associations of parenting, RS, and internalising symptoms over a 1-year period. Altogether, three general conclusions from these studies are described. First, though parenting practices are correlates of youths’ internalising symptoms, it is RS that is the most salient risk of symptoms over time. Second, emotional dysregulation, suppression, and social avoidance are key mechanisms that independently confer risk for more elevated symptoms and partially account for the increased risk of elevated perceptions of RS and greater symptoms over time. Additionally, cognitive reppraisal played a unique and buffering role in cross-sectional associations. Third, coping flexibility appears to be an important resource for youth, but further research is needed to examine the interplay of flexible coping capacities with parenting, ER, ways of coping, and internalising symptoms among youth. Theoretical and practical implications are discussed, along with recommendations for future research. Taken together, the current research identifies multiple interpersonal and intrapersonal risk and protective factors that are relevant for understanding increases in internalising symptomology during late adolescence and young adulthood. Furthermore, these factors, in particular, could be targeted as avenues for intervention to help youth cope with interpersonal stressors of rejecting and autonomy-restrictive parenting and RS.

Children of parents with mental illness (COPMI) are a substantial, yet until quite recently, marginalised group within society. Whilst extensive empirical research has been conducted into their risk for adverse psychosocial outcomes as well as potential for resilience, there has been relatively little focus on their personal experiences and understandings of such experiences. In recent years, national and international mental health service policies and guidelines for service provision have been developed to address the specific needs of families and children where parents have mental illness, including serious mental illnesses such as schizophrenia and bipolar disorder. These policies and related service provision guidelines have appropriately focused health professionals' attention on the needs and importance of prevention and early intervention for COPMI. There has not, however, been an associated focus on the needs and experiences of adult children of parents with mental illness (ACOPMI), who have remained significantly marginalised in respect to policy and mental health service provision whilst also demonstrating an increased risk for psychosocial adversity yet potential for resilience. Thus, there has been a gap in knowledge of the experiences of adult children with parents who have mental illness, and their needs have not been served adequately. This narrative inquiry set out to extend the limited understandings of the needs and experiences of adult children of parents with serious mental illnesses (ACOPSMI) such as schizophrenia and major depression. These illnesses have been recognised through research as having potential for long-term and often adverse impacts on children. A lengthy unstructured narrative interview and member check process was conducted with nine ACOPSMI in Australia over a nine month period. The inclusion of the researcher's experience through the use of auto-ethnography resulted in a total of ten participants in the study. Postmodern assumptions have provided a framework for this inquiry and so in this thesis multiplicity, diversity and attending to the voices of those on the margins have been privileged. In order to identify the concerns of ACOPSMI using methods that allowed their voices and stories to be heard from multiple perspectives, a dual analytic process was developed. As per Lather's (1997) recommendation of doing a 'double science', a conventional or realist interpretation of participants' experiences was initially performed. Field texts were analysed according to van Manen's (1990) interpretive phenomenological thematic approach. This initial analytic phase sought to develop and build upon the existing literature which had used similar approaches. In order to thicken interpretations and add a fresh dimension to conventional understandings, the postmodern or alternate story of their experiences was then illuminated through a postmodern narrative analysis. This approach employed an analytic framework developed from the work of several other postmodern and/or narrative writers. From the initial analysis, four phenomenological themes of participants' experiences were uncovered. Consistent with previous literature, these adult children experienced a number of difficulties in growing up with parents with serious mental illness, including assuming responsibility for their parent and family, experiencing negative emotional impacts and developing their own mental health problems, and finding it challenging to connect emotionally with their parents and others. They also, however, demonstrated considerable resilience and effective ways of coping with their experience which assisted many of them to forge productive lives and overcome negative impacts of their past. This thesis discusses these participants' experiences from both conventional and alternate perspectives, as well as addressing the inter-textuality of meanings that may be found between the spaces of such findings. In the light of participants' experiences, recommendations have been developed for health professionals' practice which seek to inform and guide them in working with adult children and families where parents have serious mental illness.

In this study I have explored first-person stories of young people, parents and healthcare professionals about their experiences of living and working with medically unexplained physical symptoms (MUPS). MUPS claims large amounts of healthcare professionals’ time and technological resources in primary and secondary healthcare. As a consequence there has been an increasing amount of research interest in MUPS sufferers in recent years. However, few studies have explored the experience of MUPS sufferers from a social constructionist, dialogical and narrative epistemological standpoint. A cross-disciplinary review of the literature on MUPS revealed the experiences of young people and their families to be similar to those with a diagnosis of chronic illness and their families. A dearth of qualitative studies have explored the first-person accounts of young people, their parents, and healthcare professionals who live and work with the condition. Research aims were generated following the review of the literature: To explore the meanings that young people, their parents and healthcare professionals attach to their experience of MUPS in the absence of a medical diagnosis To explore stories constructed from these experiences by young people, their parents, and healthcare professionals about the impact of MUPS upon identity and significant relationships To discover the discourses and narrative templates that inform healthcare professionals’ practice with young people and their families who live with MUPS To identify cultural and institutional discourses and narrative templates from focus group members’ stories of experience; that position or marginalise MUPS sufferers and their families. The focus group method was chosen for data collection. Seven focus groups were held in a Paediatric Liaison Department (PLS) in a Regional Hospital in the East Midlands, U.K. Young people and parents were recruited to the focus groups from historical casework of the PLS Department. Healthcare professionals were recruited from the hospital paediatric and PLS teams. The focus groups involved two groups for adolescents with MUPS and two groups of parents of adolescents with MUPS. Three other focus groups involved healthcare professionals who work with adolescents and their families with MUPS. The focus group discussions were videotaped and transcribed by the researcher and two forms of analysis were employed: Thematic Analysis (TA) and Dialogical Narrative Analysis (DNA). The two forms of analysis produced multiple literal themes and implicit stories abstracted from focus group members’ accounts. A major theme for young people and parents was their feelings of anger and frustration following the initial medical interview with their doctors. Young people and parents reported they were not only disbelieved by the doctor about the existence and severity of the symptoms, but the doctor attributed negative attributions about their presentation such as ‘You’re lazy’, ‘It’s psychosomatic’, ‘All in your head’, ‘Fussy parent’. Without a diagnosis concerns of the young people and their parents were not legitimised. Young people and parents lost confidence in medical institutions. Young people responded by withdrawal and increasing social isolation. Many parents took on the role of advocacy in an attempt to restore their child’s credibility and the family’s integrity. Some of the doctors interviewed spoke about the dearth of training in MUPS in both paediatrics and psychiatry. They suggest that managing MUPS patients can be very time-consuming for hard-pressed clinicians. Within the medical encounter they sometimes feel pressured or ambivalent about whether to continue to investigate despite previous negative results. Doctors also stated that MUPS patients can generate anxiety and uncertainty in clinicians. More main themes emerged including recognising MUPS as primarily ‘an idiom of distress’ and the shortcomings of the biomedical paradigm in addressing the problems and dilemmas of MUPS sufferers, their parents and healthcare professionals. In the Discussion Chapter I propose a model of training and CPD for healthcare professionals. The model proposes introducing a hermeneutic approach and open emotional postures to compliment the deductive role of the diagnosing physician. It is proposed that by accessing concepts from both the scientific and phenomenological paradigms healthcare professionals will reduce the possibility of incongruence and potential for impasse within the physicianpatient relationship. In the conclusion of the report a number of recommendations are given based upon the outcomes of the study to introduce the benefits for professionals in adding theoretical concepts from systemic family psychotherapy, dialogical and narrative theory to inform and promote a hermeneutic discursive centred practice with MUPS sufferers and their families.

Health is a multidimensional concept that in addition to not being sick, the disabled, happiness and well-being takes (Larsan, 1991) defines mental health, although a lot has changed most psychiatrists, psychologists and mental health researchers to overlook the positive aspects of health. The new patterns of health care mainly focuses on negative features and gauges are often problems with physical health (mobility, pain, fatigue and sleep disorders), psychological problems (depression, anxiety) and social problems (inability to play a social role, marital problems) deals (Reef, 1998), Almost 60 years ago, the World Health Organization as a state of well-being and mental health of complete physical, mental and social and not merely the absence of defined patient (world Health organization, 2001,2004), One of the concepts related to mental health, psychological well-being that has attracted much attention in the last two decades (Shahaiyan & Joseph, 2007) is a cognitive psychological well-being has several emotional component. People with a high sense of psychological well-being experience positive emotions and positive evaluation of the events of their lives. While those with a sense of well-being down the events of their lives unfavorably and more negative emotions like anxiety, depression and anger experience (Abdi Zarrin, 2010 ), The big question that occupied the minds of the researchers is that the most important factors affecting the psychological well-being is? In the meantime, without a doubt, the family and the way it interacts with the children is one of the most important cases. Family, first and most enduring character of the kids and the underlying physical, intellectual, social, emotional and moral in it. Including the most basic social institution of the family is usually the most important in all societies, and is the fulcrum and center of social life. In fact, a person is born and lives in the family and to grow it. Family educational environment is one of the most pivotal in maintaining mental health, social and physical person has an important role. Psychological conditions such as emotional relations of parents to children, children of parents towards each other and towards the creation of mental health, social skills development, career development and educational success of children and the role of facilitators or inhibitors (Keramati and colleagues, 2005). Family in its ability to handle the changes, solve conflict, solidarity among members and successfully applied in disciplinary patterns, observing the boundaries between people, of the provisions and principles of the organization with the aim of protection of the family system is. Quantitative and qualitative changes in the process of family communication patterns in the family will be resistant to the formation of personality and mental health of children is effective (Alderman et al., 2004). Family studies, is more to the issue of how people deal with stressors, coping ability and strength and how families have the basic abilities of the impact (Fitzpatrick Koeyrner, and, in 2004). Character and behavior of parents and children to educational practices and how they relate to children. Parental behavior may be associated with love or hostility, formal or flexible, and be gentle or the parents of authoritarian and illiberal that each of these methods and a combination of different effects on growth, development and adaptation of the child's personality (Makaremi et al., 1986). The psychologists believe that children's behavior is highly correlated with educational practices of parents and between parents and children have a good relationship and a good emotional nature. The course of human development has many ups and downs, but the in-between stage of adolescence is unique and different developments in this sensitive stage of its patron. Parents and their educational practices including this stage and growth factors that play a decisive role are normal teenagers. …

Large numbers of studies, mostly from the U.S., have addressed the effects of parental separation and divorce, pointing to disadvantages of children and adolescents growing up in separated families. However, evidence on this topic varies across countries and is limited for Germany. Using longitudinal data from waves 1 and 3 of the German Family Panel pairfam, we investigated differences in adolescents’ well-being by comparing stable nuclear families (n = 1968), single mother families (n = 360), and stepfather families (n = 214), as well as an additional smaller group of adolescents whose parents separated between waves 1 and 3 (“prospective separators”; n = 76). Adolescents’ satisfaction with different domains of life (family, education/work, and their general life satisfaction) as well as their self-esteem were used as indicators of well-being. A series of multiple regression analyses tested the effects of family structure on well-being at T1 and changes in well-being over time, controlling for various background factors. Furthermore, likely mediation effects of infrequent contact to the non-resident father and economic strain were tested. The findings show (relatively minor) effects of parental separation, namely lower well-being among youth1 in single mother families compared to nuclear families. Disadvantages of youth in single mother families could only be partly explained by the higher financial strain generally experienced in these families. Youth in stepfather families reported a similar overall well-being as adolescents in nuclear families, but indicated a greater decrease in family satisfaction over time. Pre-separation disadvantages among prospective separators were limited to greater dissatisfaction with school. Infrequent contact with the non-resident father did not affect adolescents’ well-being. Effects of family structure did not differ between boys and girls, but maternal education moderated the effects of family structure on adolescents’ life satisfaction. Overall, the findings are in line with other evidence from Germany, which points towards only limited disadvantages of youth in separated or divorced families.