Protective Factors on the Impact of Parental Stress on Distress in Parents of Autistic Children

Background: There is evidence that parents of children with neurodevelopmental disorders report higher levels of parenting stress compared to parents of typically developing (TD) children, with more than half of those parents experiencing levels of parenting stress within the clinical range. However, there is very little research on whether parents of children with Developmental Coordination Disorder (DCD) also experience high levels of parenting stress, and, if so, the factors that contribute to this stress. Aim: The current study explored whether parents of children with DCD experience higher levels of parenting stress compared to parents of TD children, and the factors that predict parenting stress in parents of children with DCD. Method: 174 parents of children (ages 5-12) with a diagnosis of DCD and 24 parents of TD children participated in an online survey. Participants completed five questionnaires measuring parenting stress, social support, parenting self-efficacy, the child’s emotional and behavioural problems, and severity of the child’s motor coordination problems. Results: Parents of children with DCD reported experiencing significantly higher levels of parenting stress than parents of TD children. Two-thirds of parents of children with DCD reported experiencing levels of parenting stress within the clinical range. The severity of the child’s emotional and behavioural problems, the level of social support and parenting self-efficacy were found to be significant predictors of parenting stress, but not the severity of the child’s motor difficulties. Discussion: These findings are mostly consistent with research on other neurodevelopmental disorders. They highlight that these parents may be a vulnerable group which requires support from professionals to cope with the demands of caring for their children. The management of behavioural problems, the parent’s self-efficacy, and increasing the level of social support should be considered in the development of tailored interventions for these parents.

Objective This study aimed to evaluate attachment, emotion regulation, and mindfulness in patients with substance use disorder (SUD) in comparison to a control group (CG). Methods The study comprised 50 individuals with SUD and 50 healthy people. Addiction Profile Index (API) was applied to the patient group whereas a sociodemographic data form, Mindful Attention Awareness Scale (MAAS), Experiences in Close Relationships Scale (ECRS), Difficulty in Emotion Regulation Scale (DERS) and SCID-5 were applied to both groups. Results Age, education level, MAAS, ECRS, DERS scores showed statistically significant differences between the groups. Substance use and age, education level, ECRS (avoidant attachment) and DERS were shown to be significant in logistic regression analyses. Age, education level and MAAS demonstrated protective effects, while ECRS (avoidant attachment) and DERS showed weak predictors. MAAS was found to be negatively significant with a weak protective effect and determined that ECRS (anxious attachment) and DERS were positively significant and moderately predictive in the SUD severity. Conclusion It can be concluded that disordered attachment and emotion dysregulation may have a more pronounced effect on SUD and severity, while mindfulness may have a weaker efficacy with the evaluation of these variables, which may be important in terms of prevention and treatment.

The levels of parental stress among parents of children with Asperger's syndrome in comparison with parents of children with autism are unknown in the Japanese population. The stress levels in Japanese parents caring for children with Asperger's syndrome were compared with the stress levels found in Japanese parents caring for children with autism using the Parenting Stress Index/Short Form. In a sample of 193 families, both groups had a significant increase in parental stress levels. In addition, strong evidence was obtained for the presence of higher levels of parental stress in the Asperger's group compared with the parents of the autism group after controlling for the impact of confounders, F(5,187) = 9.11, P = 0.003. The elevated levels of parental stress found in the Asperger's group appeared to be attributable to characteristics associated with the child's basic behavior. The potential mechanism, implications and strategies for further research are discussed. There are significantly elevated parental stress levels in Japanese parents of children with Asperger's syndrome or autism. In addition, the total parental stress levels were significantly higher in parents of children with Asperger's syndrome than in parents of children with autism.

Background Few previous studies have examined Antonovsky's (1979, 1987) sense of coherence (SOC) in parents of young children with developmental disability (DD). This study explored relationships between parental stress, SOC, social support, and health in parents of preschool children with and without DD. A secondary aim was to explore the relevance of the SOC construct to parental adjustment.Method Data were analysed from 59 families with preschool children with DD and 45 families of typically developing preschoolers (children without DD) who completed the study questionnaire.Results Mothers and fathers of children with DD reported high levels of parenting stress, with 84% of mothers' and 67% of fathers' scores falling within the clinical range. Parents of children with DD consistently reported higher levels of parenting stress, weaker SOC, and, for mothers and parents in 2‐parent families, poorer health than parents of children without DD. Within families, mothers of children with DD reported poorer health, higher levels of parenting stress, and weaker SOC than their partners. There were no significant differences in reported health, parenting stress, or SOC between parents of children without DD.Conclusions The results supported previous findings on high levels of parental stress in parents of preschool children with DD. The weaker SOC of parents of children with DD is likely to be an indication of the pervasive impact on parents of their child's DD. These findings also indicated possible gender differences in parental adjustment to their child's DD. Overall, the findings of this study support the usefulness of SOC theory in understanding adaptation in parents of children with DD.

Psychological distress among parents of children with mental retardation in the United Arab Emirates

Corrigendum

Parents of children affected by developmental delays (DD) have been shown to experience elevated levels of parenting stress compared to parents of typically developing children. Recent studies suggest that higher levels of parenting stress can adversely impact child behavior, such that higher levels of parenting stress are often associated with higher levels of both internalizing and externalizing behavior problems. However, the specific mechanisms through which parenting stress influences child behavioral outcomes remain unclear. The parent-child relationship may be one potential medium through which parenting stress impacts child behavioral outcomes. The current study involved data from the Mindful Awareness for Parenting Stress Project, a randomized controlled trial examining the efficacy of mindfulness-based stress reduction in reducing parental stress and subsequent child behavior problems. Participants included 102 parents of children, ages 2.5 to 5 years old, with DD. Results of a multiple mediation analysis indicted that one component of the parent-child relationship, parent-child relational frustration, significantly mediated the relationship between parenting stress and child outcomes, such that higher levels of parental stress at baseline were associated with increased relational frustration, which in turn was associated with more total child behavior problems. Recognizing that dyadic parent-child factors such as relational frustration impact the association between heightened parenting stress and adverse behavioral outcomes among children with DD may allow interventions to be developed that not only reduce parenting stress, but also specifically target improving the parent-child relationship, with the ultimate goal of decreasing child behavior problems among children with DD.

This research aims to explore the associations of maternal anxiously attached feelings towards the child, parenting stress, and negative parenting among Chinese mothers with school-aged children. 105 Chinese mothers participated in it. The study utilized the modified anxious attachment subscale in Experiences in Close Relationships Scale, the Parenting Stress Index, and the subscale of authoritarian parenting in The Short Version of Parenting Style and Dimension Questionnaire. It found that parenting stress played a mediator role in the relationship between parents’ anxiously attached feelings towards a child and negative parenting. These results highlight the importance of intervention programs aiming for parenting stress management.

Mothers and fathers of children and adolescents with Down syndrome experience parenting stress differently: Analysis on associated factors.

To explore the associations between early adverse stress, attachment insecurity in adulthood (anxious and avoidant), pathological personality styles (self-criticism and dependency), difficulties in emotion regulation, and depression severity. Cross-sectional study of 178 outpatients diagnosed with major depression in Santiago, Chile. Participants filled the Childhood Trauma Questionnaire Short Form, the Experience in Close Relationships Scale, the Depressive Experience Questionnaire, the Difficulties in Emotion Regulation Scale, and the Patient Health Questionnaire-9 item. Full-information maximum likelihood path analyses with bias-corrected bootstrapped confidence intervals were conducted. Anxious attachment in adulthood and self-criticism mediated the association between early adverse stress and depression severity through their effects on difficulties in emotion regulation. Early adverse stress was not associated with avoidant attachment in adulthood and dependency; these variables were indirectly associated with depression severity. Difficulties in emotion regulation were exclusively directly related to depression severity, mediating the effects of the preceding variables. Our findings propose an integrative model for psychological mechanisms mediating between early adverse stress and depression. Difficulties in emotion regulation should be considered when treating adults with depression exposed to early adverse stress. The contribution of specific types of early adverse stressors and difficulties in emotion regulation should be further explored.

Objective This study aims to investigate the quality of life (QOL), parental stress, and perception of social support in parents of children with neurodevelopmental disorders (NDD) in Saudi Arabia. Background Studies have shown that parenting a child with NDD impacts the QOL, parental stress, and life satisfaction of parents. Those studies, however, assessed those factors separately as well as focusing on autism spectrum disorder (ASD). This study will use a mixed methods approach to gain a deeper understanding of those three factors as they related to parenting a child with NDD. Method Data about parental stress, QOL, and other related sociodemographic variables were collected from parents of children with NDD (N= 63). Next, semi-structured interviews were conducted with four of those parents to gain a deeper understanding of the parents' QOL, parental stress, and perception of social support. Results An analysis of variance (ANOVA) test demonstrated that parents who had children with severe symptoms had poorer QOL and higher levels of parental stress compared to parents who had children who had moderate and mild symptoms. In addition, parents who had children with ASD had poorer QOL compared to all of the other disorders. There was no statistically significant difference in QOL and parental stress between mothers and fathers. The thematic analysis highlighted that the most significant challenges they face are financial, familial, and well-being worries. Conclusion In conclusion, this study shows that parents of children with NDD exhibited higher levels of parental stress and lower levels of QOL depending on the diagnosis and intensity of the child's symptoms. In addition, the interviews highlighted some key challenges that the parents felt affected their QOL and stress levels, as well as their views on family, friends, and community social support. Implications This study can help in developing or improving supportive programs and interventions for parents with children with NDD to enhance their QOL, reduce parental stress, and create a better social support system.

This study examined the relationship between sensory processing difficulties, parental stress, and behavioral problems in a clinical sample of young children with developmental and behavioral difficulties. We hypothesized that a high rate of sensory processing difficulties would be found, that there would be a high rate of comorbidity between sensory processing difficulties and behavioral problems, and that children's sensory processing difficulties and parental stress would be highly correlated. Parents of 59 children ages two to five who attended an out-patient clinic in a low income, urban community completed the Child Behavior Checklist, Parental Stress Inventory-Short Form and the Short Sensory Profile. Children in this clinical population showed a high prevalence (55.9%) of sensory processing difficulties, a significantly higher rate than previously reported. Sensory processing deficits were correlated with behavioral difficulties and parental stress levels-suggesting that as sensory processing difficulties increase, so do behavioral difficulties and parental stress. Parents of children with sensory processing deficits had significantly higher levels of parental stress than parents of children without sensory deficits. Parenting stress levels were also clinically elevated for the cohort of children in which sensory processing difficulties and behavioral concerns co-existed. These findings suggest that treatment outcomes might improve and parental stress could be reduced if mental health clinicians were trained to identify and address sensory problems. This could result in more children being screened and treated for sensory processing difficulties and an eventual reduction in the rates of parental stress.

High parenting stress is associated with diminished quality of life in parents and more problem behaviors in autistic children. Mindfulness-based interventions have demonstrated efficacy in mitigating parenting stress. Psychological flexibility and resilience have been recognized as protective factors against psychological distress. However, the extent to which psychological flexibility and resilience mediate the effect of mindfulness on parenting stress among parents of autistic children remains unclear. This cross-sectional study examined the mediating roles of psychological flexibility and resilience in the relationship between mindfulness and parenting stress. We recruited a convenience sample of 181 Chinese parents of autistic children from Shenzhen Longhua Maternity and Child Healthcare Hospital in Shenzhen, China. This study assessed characteristics, parents' mindfulness, psychological flexibility, resilience, and parenting stress. Results indicated that parents experienced considerable parenting stress. Correlation analysis found that higher mindfulness, psychological flexibility, and resilience were associated with lower parenting stress. After controlling for children's age, gender, core symptom severity, parents' age, gender, marital status, and education levels, psychological flexibility and resilience completely mediated the relationship between mindfulness and parenting stress. These findings suggest that multicomponent psychological interventions may enhance the mental health of parents of children with autism, warranting further investigation.Lay AbstractRaising a child with autism spectrum disorder can be very stressful for parents, and this stress can lead to serious problems, like diminished quality of life in parents and more challenging behaviors in autistic children. But there's something called mindfulness that can help parents feel less stressed. Mindfulness is like training your mind to stay calm and focused. It's like learning to take a deep breath and find calm in a busy day. Our study in China investigated 181 parents of children with autism from Shenzhen Longhua Maternity and Child Healthcare Hospital in Shenzhen, China. We wanted to see if two things-being able to bounce back from hard times (resilience) and being flexible in how you think and act (psychological flexibility)-help mindfulness work its magic in easing stress. We found that more mindful parents also felt less stressed. Moreover, having psychological flexibility and resilience seemed to be the reason why mindfulness was so helpful. After controlling for covariates including children's age, gender, core symptom severity, parents' age, gender, marital status, occupational status, and education levels, the effects of mindfulness on stress still existed. This tells us that programs that teach mindfulness, along with how to build resilience and be more flexible in thinking, could make a difference for parents of children with autism. It could help them feel less stressed and more at peace.

Parents of children with developmental delays (DD) typically report elevated levels of parental stress compared with parents of typically developing children. Children with DD are also at high risk for exhibiting significant behaviour problems. Parental stress has been shown to impact the development of these behaviour problems; however, it is rarely addressed in interventions aimed at reducing child behaviour problems. The current study examined the efficacy of mindfulness-based stress reduction (MBSR) for parents of children with DD by investigating whether this intervention is effective in reducing parenting stress and whether decreases in parenting stress lead to reductions in behaviour problems among children with DD. Forty six parents of children with DD were randomly assigned to an immediate treatment or wait list-control group. Participants completed questionnaires assessing parental stress and child behaviour problems at intake and at a second assessment, which took place after only the immediate treatment group had received the MBSR. Parents who participated in MBSR reported significantly less stress and depression as well as greater life satisfaction compared with wait list-control parents. Regarding child outcomes, children whose parents participated in MBSR were reported to have fewer behaviour problems following the intervention, specifically in the areas of attention problems and ADHD symptomatology. Results indicated that MBSR may be an effective intervention for ameliorating parental stress and mental health problems among parents of children with DD. Additionally, these benefits may 'spill over' and improve behaviour challenges among these children.

Parents of children with neurodevelopmental conditions (NDC) are at risk of experiencing elevated levels of parental stress. Access to robust instruments to assess parental stress is important in both clinical and research contexts. Objective: We aimed to evaluate the psychometric properties of a Swedish version of the Parental Stress Scale (PSS), completed by parents of 3- to 17-year-old children, with and without NDCs. Main analyses were conducted on data from three independent samples: a community sample (n=1018), a treatment-seeking sample of parents of children with various disabilities (n=653), and a sample of parents of children with Attention-Deficit/Hyperactivity Disorder (ADHD) who themselves reported varying ADHD symptom severities (n=562). Additional analyses were enabled by the use of data from a complementary test-retest sample (n=337). The internal consistency of the PSS was good (Cronbach's alpha, α=.87) and its test-retest reliability moderate (ICC=.66). The scale correlated in the expected direction with related constructs (r=.50-.56 in the community sample). An exploratory factor analysis found its internal structure to reflect two aspects of parental stress: Lack of Parental Rewards and Role Satisfaction (factor 1, α=.90) and Parental Stressors and Distress (factor 2, α=.85). The treatment-seeking parents of children with disabilities reported higher parental stress than community reference parents (p<.001; Cohen's d=1.17). Moreover, we found that parents with high ADHD symptom severity reported higher parental stress than parents with low ADHD symptom severity (p<.001; d=0.39). In summary, we found evidence in support of the reliability and validity of the PSS, which overall was judged to be useful as a measure of parental stress in a Swedish context. In addition, our results underline the importance of considering parental stress and related needs in assessments and intervention planning involving families of children with NDCs.