Child Adjustment Difficulties Research Articles

Linking child adjustment difficulties with mother's maladaptive parental behavior: The mediating roles of parental cognitions and parenting stress.

Child abuse is prevalent worldwide, with most of the burden in developing countries. To reduce and prevent child abuse occurrence, many efforts are directed toward reducing maladaptive parental behaviors (MPBs), a predictor of parents' risk of engaging in child abusive behaviors. MPBs have been associated with child (e.g., behavioral difficulties) and parent characteristics (e.g., parenting stress and parental cognitions), although little research tested for mediational pathways. This study aimed to test the pathways through which child and parent characteristics are linked to MPB. Consistent with the social information processing model of parenting, we hypothesized that child behavioral difficulties would exert an indirect influence on MPB through parenting stress and that parenting stress will exert a direct and indirect effect on MPB through parental cognitions (i.e., expectations, attitudes, and attributions). This study used data from 243 mothers of children aged between 2 and 9 years in Romania. Two-stage structural equation modeling was employed to test the hypothesized model. Results support the role of child behavior, parenting stress, and parental cognitions in predicting MPB (R2 = 0.69). Significant indirect effects were found from child behavior to MPB via parenting stress and parental cognitions. Direct effects from parenting stress and parental cognitions to MPB were significant. Findings show that parenting stress and parental cognitions are important mechanisms through which child behavioral difficulties influence maladaptive parental behavior, underscoring the need to focus on these mechanisms when assessing or intervening with families at risk for child abuse.

Disentangling the trajectories of maternal depressive symptoms and partnership problems in the transition to parenthood and their impact on child adjustment difficulties.

Maternal perinatal depression (PND) and partnership problems have been identified to influence the development of later child adjustment difficulties. However, PND and partnership problems are closely linked which makes it difficult to draw conclusions about the exact transmission pathways. The aim of the present study was to investigate to what extent PND symptoms and partnership problems influence each other longitudinally and to examine the influence of their trajectories on child adjustment difficulties at the age of three. Analyses were based on publicly available data from the German family panel "pairfam". N = 354 mothers were surveyed on depressive symptoms and partnership problems annually from pregnancy (T0) until child age three (T4). Child adjustment difficulties were assessed at age three. Results of latent change score modeling showed that partnership problems predicted change in PND symptoms at T0 and T3 while PND symptoms did not predict change in partnership problems. Child adjustment difficulties at age three were predicted by PND symptoms, but not by partnership problems. Partnership problems predicted externalizing, but not internalizing symptoms. Results underline the effects of family factors for the development of child adjustment difficulties and emphasize the importance of early interventions from pregnancy onwards.

Chinese child unsociability, maternal maladaptive parenting, and peer exclusion among preschoolers: A cross‐lagged model

AbstractPrevious research has consistently found that unsociability is linked to adjustment difficulties in Chinese children. However, far less attention has been paid to how parents and peers react when confronted with unsociable children. In this study, we explored the longitudinal linkages among Chinese preschoolers' unsociability, maladaptive parenting, and peer exclusion. Participants were mothers and teachers of N = 391 (Mage = 4.4 years, SD = 0.91 years; 54.5% boys) preschoolers attending eight kindergartens in Shanghai, People's Republic of China, followed over 8 months. Multi‐source assessments were employed. Mothers rated children's unsociability and their maladaptive (physical hostility, verbal hostility, punishment) parenting practices, and teachers rated children's peer exclusion at each time point. Our results indicated that child unsociability contributed to later increases in both maladaptive parenting and peer exclusion. However, maladaptive parenting and peer exclusion could not predict later increases in unsociability. Results are discussed in terms of the implications of unsociability among Chinese children.

Maternal Emotional Reminiscing, Child Autobiographical Memory, and Their Associations with Pre-Schoolers’ Socioemotional Functioning

ABSTRACT This study aimed to explore the possible indirect pathway between maternal reminiscing style and child socioemotional functioning (prosocial behaviors and emotional adjustment difficulties) through children’s autobiographical memory (elaboration and specificity). A secondary exploratory aim was to examine whether cultural context moderated these indirect effects. Participants included 94 mother-child dyads drawn from middle- and high-income families in China and Australia. The dyads completed measures of child memory specificity, maternal report of child socioemotional functioning, and a shared emotional reminiscing task that assessed child memory elaboration and maternal sensitive guidance. Path analysis results indicated an indirect effect of maternal supportive reminiscing via child memory elaboration (but not memory specificity) on children’s prosocial behaviors, regardless of the cultural group. However, there was no evidence to suggest an indirect pathway between maternal supportive reminiscing and child adjustment difficulties (or prosocial behaviors) through child memory specificity in either cultural context. These findings provide preliminary support to the recent conceptualization of an indirect pathway between maternal sensitive guidance during emotional reminiscing and children’s prosocial behaviors through child memory elaboration. However, it is important to note that the cross-sectional design limits the causal inferences that can be drawn from the findings. The implications for memory specificity in child socioemotional functioning were less clear and indicated a need for further research in this area.

Family Function and Child Adjustment Difficulties in the COVID-19 Pandemic: An International Study.

To estimate specific proximal and distal effects of COVID-19-related restrictions on families on children’s adjustment problems, we conducted a six-site international study. In total, 2516 parents from Australia, China, Italy, Sweden, the United Kingdom, and the United States of America living with a young child (Mage = 5.77, SD = 1.10, range = 3 to 8 years, 47.9% female) completed an online survey between April and July 2020. The survey included the Strengths and Difficulties Questionnaire and family risk factors (parent distress, parent–child conflict, couple conflict, and household chaos) as well as a scale to index COVID-19-related family disruption. Our analyses also included public data on the stringency of national restrictions. Across the six sites, parental responses indicated elevated levels of hyperactivity, conduct, and emotion problems in children from families characterized by heightened levels of parent distress, parent–child conflict, and household chaos. In contrast, increased peer problems were more strongly related to COVID-19-related social disruption and stringency measures. Mediation models demonstrated that associations between COVID-19 social disruption and child difficulties could be explained by parental distress. Taken together, these results suggest that although the experience of the pandemic differed across countries, associations between COVID-19-related family experiences and child adjustment difficulties were similar in their nature and magnitude across six different contexts. Programs to support family resilience could help buffer the impact of the pandemic for two generations.

Single mothers by choice: Parenting and child adjustment in middle childhood.

Findings are presented of the second phase of a longitudinal study of families created by single mothers by choice. Forty-four single heterosexual mothers were compared with 37 partnered heterosexual mothers, all with a donor-conceived child aged around 8–10 years. Standardized interview, observational, and questionnaire measures of maternal wellbeing, mother-child relationships and child adjustment were administered to mothers, children, and teachers. There were no differences in maternal mental health, the quality of mother-child relationships or children’s emotional and behavioral problems between family types. However, higher levels of parenting stress and higher levels of children’s prior adjustment difficulties were each associated with children’s adjustment difficulties in middle childhood irrespective of family type. The findings suggest that the presence of two parents—or of a male parent—is not essential for children to flourish, and add to the growing body of evidence that family structure is less influential in children’s adjustment than the quality of family relationships.

Discrepancies in Parent Perceptions of Child Vulnerability in Youth With Spina Bifida.

This study aimed to describe informant discrepancies between mother and father reports of child vulnerability in youth with spina bifida (SB) and examine variables that were associated with these discrepancies. Ninety-two parent dyads, with a child with SB (ages 8-15 years), were recruited as a part of a longitudinal study. Mothers and fathers completed questionnaires assessing parental perception of child vulnerability (PPCV), as well as medical and demographic information, behavioral aspects of the couple relationship, parenting stress, mental health of the parent, and child behavioral adjustment. The degree to which there was a parenting alliance was assessed with observational data. Mother-father discrepancies were calculated at the item level. Findings revealed that greater father mental health symptoms, parenting stress, and child behavior problems were associated with "father high and mother low" discrepancies in PPCV. There were also lower scores on observed parenting alliance when there were higher rates of "father high and mother low" discrepancies in PPCV. For families of youth with SB, discrepancies in PPCV where fathers perceive high vulnerability and mothers perceive low vulnerability may be a "red flag" for the presence of other parental and child adjustment difficulties. Findings are discussed in terms of the Attribution Bias Context Model and underscore the importance of including fathers in research on families who have children with chronic health conditions.

Psychiatric comorbidity and social adjustment difficulties in children with disruptive mood dysregulation disorder: A national epidemiological study

BackgroundWe examined correlates, psychiatric comorbidities, and social adjustment difficulties in children with disruptive mood dysregulation disorder (DMDD) from a national epidemiological study in Taiwan. MethodsThe sample consisted of 4816 children, who were 3rd, 5th, and 7th graders from schools randomly chosen based on the urbanization level in a recent national survey of childhood mental disorders. Among the 4816 children (2520 boys, 52.3%) interviewed using the Kiddie epidemiologic version of the Schedule for Affective Disorders and Schizophrenia (K-SADS-E) for the DSM-5, 30 children were diagnosed as DMDD (23 boys, 76.7%). They and their parents also reported on the Social Adjustment Inventory for Children and Adolescents (SAICA). We conducted regressions for survey data that controlled for stratification and clustering. ResultsThe weighted prevalence of DMDD was 0.3~0.76% in Taiwanese children. Lower parental educational levels, male predominance, higher psychiatric comorbidities, and worse self-report school functions (e.g., more behavioral problems with peers) were observed in children with DMDD than those without. Additional analyses revealed that oppositional defiant disorder (ODD) but not DMDD was related to conduct disorder. Children with ODD with or without DMDD had more problems regarding attitudes toward school, academic performance, and parent-child interaction at home than those with DMDD-only. LimitationsSmall sample size of DMDD. ConclusionsDMDD is a rare disorder in the community. Children with DMDD had more psychiatric comorbidities, and subjectively experienced more difficulties than those without. DMDD and ODD both resulted in severe impairment yet in different domains.

Critical review of theoretical frameworks elucidating the mechanisms accounting for the adverse developmental outcomes observed in children following exposure to intimate partner violence

The adoption of a useful theoretical framework is a fundamental component of any research study, whether the investigator is using a deductive theory-verifying approach or an inductive theory-generating approach. In an attempt to encourage the use of valid and reliable theoretical frameworks in both research and clinical practice with children exposed to intimate partner violence (IPV), the main purpose of the present paper was to present a critical review of four of the most widely used theoretical frameworks used to explain the mechanisms accounting for the adverse developmental outcomes observed in children exposed to IPV. First, we described the main propositions of these frameworks, which include developmental psychopathology, social learning theory, attachment theory, and trauma theory. Next we provided a critical review of the main empirical findings related to the study of children's adjustment following exposure to IPV within each of these frameworks, as well as a critical comparison of the four frameworks that takes into account their explanatory power concerning the development of adjustment difficulties observed in this population. We concluded our review by recommending the most suitable and useful frameworks with regard to elucidating the mechanisms involved in the development of adjustment difficulties in children following exposure to IPV. • The present paper presented a critical review of four of the most studied theoretical frameworks used to explain the mechanisms accounting for the adverse developmental outcomes observed in children exposed to intimate partner violence (IPV). • The paper described the main propositions of the following four theoretical frameworks: developmental psychopathology, social learning theory, attachment theory, and trauma theory. • The review paper also provided a critical review of the main empirical findings related to the study of children's adjustment following exposure to IPV within each of these frameworks. • The present review included also a critical comparison of the four frameworks that takes into account their explanatory power concering the development of adjustment difficulties observed in children following exposure to IPV.

Childhood Sleep Functioning as a Developmental Precursor of Adolescent Adjustment Problems.

Sleep has been linked to adjustment difficulties in both children and adolescents; yet little is known about the long-term impact of childhood sleep on subsequent development. This study tested whether childhood sleep problems, sleep quantity, and chronotype predicted internalizing and externalizing problems during adolescence. Latent Growth Modeling using the Czech portion of the European Longitudinal Study of Pregnancy and Childhood (N = 4393) was utilized to test the developmental trajectories of sleep characteristics (from 1.5 to 7years) as predictors of adjustment problems trajectories (from 11 to 18years). Findings provided evidence that children with higher levels of sleep problems at 1.5years (and throughout childhood) reported higher levels of internalizing and externalizing problems at age 11. Additionally, greater eveningness at age 1.5 predicted a greater increase in externalizing problems from ages 11 to 18years. The results emphasize the importance of childhood sleep problems in evaluating the risk of future adjustment difficulties.

Prospective Associations between Maternal Self-Sacrifice/Overprotection and Child Adjustment: Mediation by Insensitive Parenting

Prior research on Expressed Emotion (EE) in parents’ Five Minute Speech Samples (FMSS) suggests that parental attitudes that are overprotective or blur boundaries between the parent and child (i.e., the criteria for self-sacrifice/overprotection; SSOP) are related to increases in children’s behavior problems. Some theorists contend that parents who demonstrate high levels of SSOP treat their children more insensitively, but others argue that SSOP does not result in insensitive parenting during the early childhood years. To date, there is no evidence that can be brought to bear upon this tension within the field regarding the developmental implications of SSOP in childhood. This longitudinal investigation of 223 child-mother dyads (47.9% female; Mage_W1 = 49.08 months; 56.5% Hispanic/Latina) evaluated whether maternal insensitivity at age 6 mediated the link between mothers’ SSOP with respect to their 4-year-old children and children’s behavior problems (i.e., internalizing, attention/hyperactivity) at age 8. A path analysis revealed significant indirect pathways from mothers’ SSOP during the preschool period to children’s increased internalizing and attention/hyperactivity problems at age 8 via elevated maternal insensitivity at age 6. These associations did not differ significantly across groups as a function of child gender, maternal race/ethnicity, single-mother status, or family poverty. FMSS evaluations of SSOP may offer a culturally valid and clinically valuable screening tool to detect parental attitudes that confer elevated risks for insensitive parenting practices and later child adjustment difficulties.

The impact of fathers' military deployment on child adjustment. The support needs of primary school children and their families separated during active military service: A pilot study.

Although direct exposure to war-related trauma negatively impacts children's psychological well-being, little is known about this impact within the context of parental military deployment to a combat zone and 'indirect' experience of the effects of armed conflict. This study investigates the impact of father's military deployment to Afghanistan on child well-being in primary schoolchildren and compares measures of adjustment with a matched group of children with fathers deployed on military training (non-combat) deployment. Data were collected within primary schools in 2011-2012 from 52 children aged 8-11 years with fathers deploying to Afghanistan ( n = 26) and fathers deploying on military training ( n = 26) via self-completion of questionnaires assessing symptoms of anxiety, depression, stress and levels of self-esteem. Data were collected in both groups, at pre-, mid- and post-parental deployment. Class teachers and parents (non-deployed) completed a measure of child behaviour and parents completed a measure of parenting stress and general health. Unexpectedly child adjustment difficulties were not significantly raised in children whose parents deployed to Afghanistan. Ratings of behavioural difficulties and depression were low in both groups. However, clinically elevated levels of anxiety and stress symptoms were reported by both groups of children at each stage of deployment. No associations between parental stress, parental mental health and child adjustment were found. High levels of children's anxiety and stress reported during fathers' active military service warrant further investigation. Implications for school and health monitoring and CAMHS community liaison work are discussed.

Predictors of Engagement in Family Mediation and Outcomes for Families that Fail to Engage.

An important limitation to the effectiveness of family mediation in assisting separated parents is parents failing to engage in the mediation process. In 524 parents who presented to a telephone-based mediation service, 113 (22%) initiating parents withdrew from mediation before the other parent was invited to participate, 241 (46%) initiating parents had respondent parents who declined to participate in mediation, and 170 cases (33%) completed mediation. We tested whether socio-demographic variables, psychological distress, coparental acrimony, parenting problems, or children's behavioral difficulties predicted mediation engagement. High interparental acrimony predicted failure to engage in mediation, but none of the other variables predicted mediation engagement. We followed a sample of 131 families that did not mediate and found they showed elevated psychological distress, acrimony, parenting problems and child adjustment difficulties, which remained unchanged 6months later. Further research is needed to explore strategies to enhance respondent parent engagement with mediation, and to address the negative outcomes for those separated families not proceeding with mediation.

Measuring cancer-specific child adjustment difficulties: Development and validation of the Children's Oncology Child Adjustment Scale (ChOCs).

Childhood cancer is associated with child adjustment difficulties including, eating and sleep disturbance, and emotional and other behavioral difficulties. However, there is a lack of validated instruments to measure the specific child adjustment issues associated with pediatric cancer treatments. The aim of this study was to develop and evaluate the reliability and validity of a parent-reported, child adjustment scale. One hundred thirty-two parents from two pediatric oncology centers who had children (aged 2-10 years) diagnosed with cancer completed the newly developed measure and additional measures of child behavior, sleep, diet, and quality of life. Children were more than 4 weeks postdiagnosis and less than 12 months postactive treatment. Factor structure, internal consistency, and construct (convergent) validity analyses were conducted. Principal component analysis revealed five distinct and theoretically coherent factors: Sleep Difficulties, Impact of Child's Illness, Eating Difficulties, Hospital-Related Behavior Difficulties, and General Behavior Difficulties. The final 25-item measure, the Children's Oncology Child Adjustment Scale (ChOCs), demonstrated good internal consistency (α = 0.79-0.91). Validity of the ChOCs was demonstrated by significant correlations between the subscales and measures of corresponding constructs. The ChOCs provides a new measure of child adjustment difficulties designed specifically for pediatric oncology. Preliminary analyses indicate strong theoretical and psychometric properties. Future studies are required to further examine reliability and validity of the scale, including test-retest reliability, discriminant validity, as well as change sensitivity and generalizability across different oncology samples and ages of children. The ChOCs shows promise as a measure of child adjustment relevant for oncology clinical settings and research purposes.

Relationship of cognitive function and adjustment difficulties among children and adolescents with dissociative disorder.

Background and Aims:Although it has been suggested that children and adolescents with dissociative disorder have some cognitive deficits, the association of these cognitive impairments with adjustment difficulties has not been evaluated. The present study aimed to assess the relationship between cognitive functioning and adjustment difficulties in children and adolescents with dissociative disorder.Methods:This cross-sectional, descriptive assessment was carried out in the outpatient setting of child and adolescent psychiatric service in a tertiary care hospital. Fifty newly diagnosed children and adolescents with dissociative disorder were included. The cognitive functions were assessed by varied neuropsychological tests, and Bell's adjustment inventory was used for assessing various domains of adjustment.Results:The mean age of the sample which comprised 40% males was 13.0 (±2.4) years. The mean intelligence quotient (IQ) of the sample was 90.6. Impairment in cognitive test was maximum for verbal working memory followed by sustained attention, visual learning and memory, and verbal retention and recall. Adjustment difficulties were greatest in the domains of self, followed by domains of health, school, and family. Significant association was found between the IQ and adjustment in school; visual learning and memory and adjustments in school and overall adjustment; and sustained attention and adjustment of health.Conclusions:Dissociative children have poor cognitive ability which may be related to poor adjustment scores.

Maternal Affective Illness in the Perinatal Period and Child Development: Findings on Developmental Timing, Mechanisms, and Intervention.

Maternal mental illness is one of the most reliable risks for clinically significant child adjustment difficulties. The research literature in this area is very large and broad and dates back decades. In this review, we consider recent research findings on maternal mental illness and child development by focusing particularly on affective illness the perinatal period. We do this because maternal affective illness in the perinatal period is common; recent evidence suggests that pre- and postpartum maternal depression may have lasting effects on child behavioral and somatic health; research in the perinatal period raises acute and compelling questions about mechanisms of transmission and effect; and perinatal-focused interventions may offer distinct advantages for benefitting mother and child and gaining insights into developmental mechanisms. Throughout the review, we attend to the increasing integration of psychological and biological models and the trans-disciplinary approach now required for clinical investigation.

Providing Psychosocial Support to Children and Families in the Aftermath of Disasters and Crises.

Disasters have the potential to cause short- and long-term effects on the psychological functioning, emotional adjustment, health, and developmental trajectory of children. This clinical report provides practical suggestions on how to identify common adjustment difficulties in children in the aftermath of a disaster and to promote effective coping strategies to mitigate the impact of the disaster as well as any associated bereavement and secondary stressors. This information can serve as a guide to pediatricians as they offer anticipatory guidance to families or consultation to schools, child care centers, and other child congregate care sites. Knowledge of risk factors for adjustment difficulties can serve as the basis for mental health triage. The importance of basic supportive services, psychological first aid, and professional self-care are discussed. Stress is intrinsic to many major life events that children and families face, including the experience of significant illness and its treatment. The information provided in this clinical report may, therefore, be relevant for a broad range of patient encounters, even outside the context of a disaster. Most pediatricians enter the profession because of a heartfelt desire to help children and families most in need. If adequately prepared and supported, pediatricians who are able to draw on their skills to assist children, families, and communities to recover after a disaster will find the work to be particularly rewarding.

Transition to Early Childhood Education: Parents' Use of Coping Strategies in Dealing with Children's Adjustment Difficulties in Hong Kong

THE TRANSITION FROM HOME to early childhood education can be stressful for both children and parents. How parents cope with this potentially stressful event affects both the children's adaptation and the parents' lives during the preschooler stage of the family lifecycle. This paper examines how parents respond to their children's adjustment difficulties, particularly a reluctance to attend school, by examining the coping strategies of 29 Hong Kong parents. The parents expressed different kinds of negative emotions regarding their children's reluctance to go to school due to various adjustment difficulties. Parents' coping strategies can be classified as planful coping, seeking social support, accepting responsibilities, distancing, self-controlling and positive reappraisal according to Folkman and Lazarus's Ways of Coping (WOC) framework. The implications of these strategies for how early childhood professionals can support parents are discussed.

Conceptualization and Assessment of Multiple Forms of Social Withdrawal in Turkey

AbstractWe examined the meaning, assessment, and implications of different forms of social withdrawal in Turkey across two studies. In study 1, semi‐structured interviews were conducted with children, mothers, and teachers to identify descriptors of social withdrawal. Shyness and unsociability were confirmed through content analyses, and regulated withdrawal, a new subtype characterized by overregulation of behaviors and suppression of own desires during social interactions, was revealed. Based on these findings, the child social preference scale, an established North American measure of social withdrawal, was revised. In study 2, a confirmatory factor analysis on a sample of 599 9–11‐year‐old children revealed three distinct forms of social withdrawal. Shyness was related to a wider range of child adjustment difficulties than unsociability and regulated withdrawal, although all forms of withdrawal were associated with child adjustment difficulties, providing support for the importance of children's active involvement in social relationships for their positive development and well‐being.

Understanding the mediating role of corporal punishment in the association between maternal stress, efficacy, co-parenting and children's adjustment difficulties among Arab mothers

This study, guided by the Family Systems Theory, examines the direct effect of maternal use of corporal punishment on children's adjustment difficulties. Also, it explores whether corporal punishment serves as a mediating factor in the relationship between several maternal characteristics, marital relationships, and children's adjustment difficulties. A total of 2,447 Arab mothers completed anonymous, structured, self-report questionnaires. The use of corporal punishment was generally strongly supported by the Arab mothers in our sample. A greater likelihood of using corporal punishment was found among mothers of boys rather than girls, among mothers with lower perceived self-efficacy to discipline children, and among mothers with a lower perception of their husbands’ participation in child-related labor. In addition, the higher a mother's reports on disagreement with her husband about discipline methods and the stronger her level of maternal stress, the more likely she was to use corporal punishment. Corporal punishment also mediated the association between the above mentioned factors and child adjustment difficulties. Furthermore, a husband's emotional support and family socioeconomic status were directly associated to children's adjustment difficulties. The results of the current study emphasize the need to observe children's development within the context of their family systems and to consider the mutual influences of different subsystems such as marital relationships and mother–child interactions. Prevention and intervention programs should raise parents’ awareness concerning the harmful effects of corporal punishment and take into account the impact of dynamic transactions of parental conflicts and disagreements regarding discipline methods on child outcomes.