Abstract
Parental rearing behavior is one factor that influences the strength of resilience. In turn, resilience influences depression. However, it is unclear whether resilience has a mediating effect on the relationship between parental rearing and depression in adolescents with congenital heart disease (CHD). Therefore, the associations between parental rearing behavior and resilience and between rearing behavior and symptoms of depression were investigated with respect to age, gender and disease severity. Patients completed a parental rearing behavior questionnaire, a resilience scale and the Children's Depression Inventory during a routine clinic visit. Structural equation modeling with maximum likelihood estimation was used to analyze the data. The median age of the 180 patients included in the study was 17.8 years, and 64% were male. Lower resilience was found to be associated with overprotection, punishment, rejection, and control. There was a strong relationship between resilience and symptoms of depression. Resilience varied according to gender, age group, and disease severity. Parental rearing behaviors such as emotional warmth, rejection, punishment, control, and overprotection have a significant influence on adolescent's resilience. When developing intervention programs to increase resilience and reduce depression in adolescents with CHD, parenting attitudes, gender, age, and CHD severity should be considered.
Highlights
Outcomes have continued to improve following advances in cardiac surgical and catheter intervention, the negative impact of congenital heart disease (CHD) remains
27–40% adolescents and adults with CHD are affected by depression (4)
Depression, in adolescents with CHD, was reported to be significantly associated with “resilience, parental attitude, age, cyanosis, and school performance” (2)
Summary
Outcomes have continued to improve following advances in cardiac surgical and catheter intervention, the negative impact of congenital heart disease (CHD) remains. Altered body image (from operation scars), interruptions to schooling, frequent hospital admissions, physical limitations, and parental overprotection of adolescents with CHD might contribute to psychosocial problems (1–3). Depression is a serious health problem, especially in adolescence. 27–40% adolescents and adults with CHD are affected by depression (4). Previous studies reported that adolescents with CHD have more severe problems with depression and behavioral issues than healthy adolescents (2, 5). Depression, in adolescents with CHD, was reported to be significantly associated with “resilience, parental attitude, age, cyanosis, and school performance” (2)
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