Self-control and coping responses are mediating factors between child behavior difficulties and parental stress and family impact in caregivers of children with severe epilepsy

Anne Vagner Jakobsen,Ask Elklit

doi:10.1016/j.yebeh.2021.108224

Anne Vagner Jakobsen, Ask Elklit

Open Access

https://doi.org/10.1016/j.yebeh.2021.108224

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Abstract

ObjectivesTo gain a better understanding of parental support needs by assessing parental individual psychological factors as mediating factors between child behavior difficulties and parental perceived stress and family impact of severe childhood epilepsy. MethodsOne-hundred and sixty two parents of children with severe epilepsy were enrolled in the survey during the hospitalization of their child at the Danish Epilepsy Center. Questionnaires targeted the impact on the family, coping style responses, sense of control, and the level of parental perceived stress. ResultsSerial mediation models demonstrated a mediating effect of self-control and emotional coping (EMCOP) response between child behavioral difficulties and both parental stress (F(4, 127) = 56.371, p < 0.001, R2 = 0.64) and family impact (F(3, 134) = 32.202, p < 0.001, R2 = 0.42). Low level of control was associated with a higher level of EMCOP response, and a high EMCOP response was associated with greater perceived stress and family impact. Social support ceased to be a protective factor for parental stress in the presence of decreased self-control and higher levels of EMCOP response. ConclusionIndividual caregiver psychological factors influence the degree to which sequelae of epilepsy impact family life and perceived stress in parents. Coping interventions should direct awareness toward the life-control aspect, coping response styles, and illness-specific factors to ensure that appropriate support is provided. Maintaining parental resources is essential, and the parents’ capacities to handle the child’s behavioral difficulties should be considered.

Highlights

Caring for a child with a chronic and sometimes life-threatening disease such as severe childhood epilepsy engenders high levels of psychopathology and stress in caregivers [1,2,3,4,5]
We demonstrated in a previous publication that social support, the child’s difficulties, and self-control were significant predictors of the level of the caregiver’s stress when controlling for demographic factors and child epilepsy variables [2]
Our results indicate that rational and detached coping responses may act as protective factors toward parental stress, while both avoidant and emotional coping (EMCOP) responses can cause higher levels of stress

Summary

Introduction

Caring for a child with a chronic and sometimes life-threatening disease such as severe childhood epilepsy engenders high levels of psychopathology and stress in caregivers [1,2,3,4,5] The causes of this high impact might seem evident; the relationship between illness-related factors and the level of impact on caregivers is not always a direct association. External locus of control at one end of the continuum is the generalized belief that outside forces determine important life events more than the person herself does. This could be factors such as fate, luck, or the influence of powerful others. According to the transactional theory by Lazarus et al [20,21,22], the relationship between impaired locus of control and stress should be understood in the context of adaptive coping mechanisms

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