Children's Psychological Adjustment Research Articles

Interparental violence and childhood adjustment: how and why maternal sensitivity is a protective factor.

This study examined sensitive parenting as a protective factor in relations between interparental violence (IPV) and children's coping and psychological adjustment. Using a multimethod approach, a high-risk sample of 201 two-year-olds and their mothers participated in three annual waves of data collection. Moderator analyses revealed that sensitive parenting buffered the risk posed by IPV on children's changes in externalizing and prosocial development over a 2-year period. Tests of mediated moderation further indicated that sensitive parenting protected children from the vulnerability of growing up in a violent home through its association with lower levels of children's angry reactivity to interparental conflict. Results highlight the significance of identifying the mechanisms that mediate protective factors in models of family adversity.

The role of perceived social support in loneliness and self-esteem among children affected by HIV/AIDS: a longitudinal multilevel analysis in rural China.

To delineate the trajectories of loneliness and self-esteem over time among children affected by parental HIV and AIDS, and to examine how their perceived social support (PSS) influenced initial scores and change rates of these two psychological outcomes. We collected longitudinal data from children affected by parental HIV/AIDS in rural central China. Children 6-18 years of age at baseline were eligible to participate in the study and were assessed annually for 3 years. Multilevel regression models for change were used to assess the effect of baseline PSS on the trajectories of loneliness and self-esteem over time. We employed maximum likelihood estimates to fit multilevel models and specified the between-individual covariance matrix as 'unstructured' to allow correlation among the different sources of variance. Statistics including -2 Log Likelihood, Akaike Information Criterion and Bayesian Information Criterion were used in evaluating the model fit. The results of multilevel analyses indicated that loneliness scores significantly declined over time. Controlling for demographic characteristics, children with higher PSS reported significantly lower baseline loneliness score and experienced a slower rate of decline in loneliness over time. Children with higher PSS were more likely to report higher self-esteem scores at baseline. However, the self-esteem scores remained stable over time controlling for baseline PSS and all the other variables. The positive effect of PSS on psychological adjustment may imply a promising approach for future intervention among children affected by HIV/AIDS, in which efforts to promote psychosocial well being could focus on children and families with lower social support. We also call for a greater understanding of children's psychological adjustment process in various contexts of social support and appropriate adaptations of evidence-based interventions to meet their diverse needs.

A typology of interpartner conflict and maternal parenting practices in high-risk families: examining spillover and compensatory models and implications for child adjustment.

The present study incorporates a person-based approach to identify spillover and compartmentalization patterns of interpartner conflict and maternal parenting practices in an ethnically diverse sample of 192 2-year-old children and their mothers who had experienced higher levels of socioeconomic risk. In addition, we tested whether sociocontextual variables were differentially predictive of theses profiles and examined how interpartner-parenting profiles were associated with children's physiological and psychological adjustment over time. As expected, latent class analyses extracted three primary profiles of functioning: adequate functioning, spillover, and compartmentalizing families. Furthermore, interpartner-parenting profiles were differentially associated with both sociocontextual predictors and children's adjustment trajectories. The findings highlight the developmental utility of incorporating person-based approaches to models of interpartner conflict and maternal parenting practices.

Interpersonal engagement mediates the relation between maternal affect and externalising behaviour in young children with type 1 diabetes.

Mother-child interactions around a shared activity have been shown to play a key role in the development of young children’s capacity to interact cooperatively with others. This evidence is particularly germane to type 1 diabetes (T1D) management in younger children where cooperation with parental treatment efforts is crucial for treatment success and where maternal distress and child behavioural problems are risk factors for treatment management, biomedical and psychological outcomes. In 49 4-to-8 year old children with T1D, we investigated whether the association between maternal affect and child problematic behaviour is mediated by mother-child interactions in the context of a T1D-relevant collaborative problem-solving activity. Mothers completed standardised measures of maternal and child psychological adjustment and interacted with their children in the problem-solving activity, analysed for quality of interpersonal engagement based on evaluations of maternal (sensitivity and cognitive stimulation) and dyadic (joint attention and warmth) behaviours. Mediation analyses confirmed the hypothesis that interpersonal engagement mediates the relation between maternal affective state and child behavioural problems. Specifically, more negative maternal affect is associated with lower levels of interpersonal engagement; these less engaged interactions in turn are associated with more behavioural problems in children. These findings are consistent with research involving typically developing children. The implications of our findings are twofold. First, in the context of psychological adjustment to T1D, maternal affect and mother-child interactions are 2 potential targets for interventions which promote cooperative interactions. Second, understanding and caring for children at biological risk requires attention to developmental psychology theory and method; in particular, research addressing parent-child cooperation carries both conceptual and clinical relevance.

Children and Adolescents With Same-Gender Parents: A Meta-Analytic Approach in Assessing Outcomes

Given the societal, political, and cultural divide on the topic of same-gender parenting, there is a need for a stronger body of evidence that accurately identifies outcomes for children and adolescents of gay and lesbian parents. In addition, attention should be paid to the validity of the argument that parenting capabilities are gender-exclusive and children need both a mother and a father. The present study was a quantitative synthesis of the available literature to investigate the effects of parental gender and sexual identity on child and adolescent outcomes. An electronic search of relevant databases resulted in 33 unpublished and published studies (N of children = 5,272) that included a comparison of same-gender or different-gender parents and their children. Results indicated several significant findings for the parent-child relationship and child gender role behavior outcomes. Other outcomes, including child sexual orientation, cognitive abilities, psychological adjustment, and gender identity, were not moderated by parent gender or sexual orientation. Implications for future research are discussed.

Psychosocial profiles of children with achondroplasia in terms of their short stature-related stress: a nationwide survey in Japan.

To assess psychosocial profiles of children with achondroplasia using a nationwide survey. Achondroplasia, showing short stature and disproportionately short limbs, causes physical inconvenience such as difficulty in reaching high objects. It is, however, still controversial whether the condition is associated with psychological problems, especially in childhood. A cross-sectional descriptive design was employed. To evaluate psychosocial profiles and adaptation processes in children with achondroplasia, we developed an inventory of scales based on the psychological stress model of which conceptual framework was comprised of stressor, coping process, coping resource and adaptation outcome domains. Participants were recruited nationwide through the largest advocacy support group for achondroplasia in Japan. Of the 130 group members, 73 X-ray-diagnosed patients, aged 8-18 years, completed the inventory of questionnaires to be analysed. As for the stressor domain, patients experienced short stature-related unpleasant experiences more frequently (z-score: +1·3 in average, +3·9 in physical inconvenience). Nevertheless, these experiences had little effect on the coping process (threat appraisal: -0·2, control appraisal: +0·1) and the adaptation outcome (stress response: +0·3, self-concept: 0·0). Interestingly, self-efficacy in the coping resource domain was noticeably increased (+3·1) and was strongly correlated with most variables in the coping process and in adaptation outcome domains. Although the children with achondroplasia experienced more short stature-related stressors, there was no evidence of any psychosocial maladaptation. This finding suggests that coping process as well as coping resources such as self-efficacy could be important targets for promoting psychological adjustment in children with achondroplasia. To help children with achondroplasia adapt socially, nurses and other healthcare providers should routinely assess their psychological adaptation process, especially cognitive appraisal and self-efficacy.

Psychological adjustment in children with episodic migraine: A population-based study.

psychological adjustment in a preadolescent pediatric population as a function of headache diagnosis. Children from a city public education system were enrolled in this study. Parents were interviewed using validated headache questionnaires and the Strengths and Difficulties Questionnaire (SDQ), which measures psychological adjustment. Crude and adjusted prevalence ratios were obtained using a binary regression model. The relative risk (RR) of SDQ items and scores were modeled as a function of headache diagnosis in adjusted analyses. Multivariate models estimated determinants of psychological adjustment characteristics in children with migraine. The sample consisted of 846 children (65.9% of the target sample) from 5 to 12 years old (50.5% girls). Relative to children without headache, children with episodic migraine (EM) were more likely to have abnormal scores on the following SDQ scales: emotional symptoms (RR = 3.43, 95% confidence interval (CI) = 2.51-4.69), conduct problems (RR = 1.96, 95% CI = 1.37-2.79), total difficulties (RR = 2.23, 95% CI = 1.59-3.13), and total impact (RR = 2.85, 95% CI = 1.15-7.11). The multivariate analysis showed that total difficulties in psychological adjustment in children with EM were significantly influenced by headache frequency (p < .05), analgesic intake (p < .001), and the occurrence of nausea (p < .01) and vomiting (p < .05) in headache attacks. To the best of our knowledge, this is the first study reported in the literature to identify determinants of the association between migraine and difficulties in psychological adjustment in preadolescent children. Providers and educators should be aware of this association, and studies that address causality should be conducted. Keywords: headache, migraine, psychological adjustment, SDQ, children, epidemiology.

Parent–child cultural orientations and child adjustment in Chinese American immigrant families.

Direct and indirect/mediated relations of (a) children's and parents' cultural orientations and (b) parent-child gaps in cultural orientations to children's psychological adjustment were examined in a socioeconomically diverse sample of 258 Chinese American children (age = 6-9 years) from immigrant families. Parents reported on children's and their own Chinese and American orientations in language proficiency, media use, and social relationships. Parents and teachers rated children's externalizing and internalizing problems and social competence. Using structural equation modeling, we found evidence for both the effects of children's and parents' cultural orientations and the effects of parent-child gaps. Specifically, children's American orientations across domains were associated with their better adjustment (especially social competence). These associations were partly mediated by authoritative parenting. Parents' English and Chinese media use were both associated with higher authoritative parenting, which in turn was associated with children's better adjustment. Furthermore, greater gaps in parent-child Chinese proficiency were associated with children's poorer adjustment, and these relations were partly mediated by authoritative parenting. Together, the findings underscore the complex relations between immigrant families' dual orientations to the host and heritage cultures and children's psychological adjustment.

Extracurricular interest as a resilience building block for children affected by parental HIV/AIDS

Parental illness and death due to human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) impose challenges to children's psychological adjustment. Positive psychology emphasizes individual's resilience in the face of adversity, trauma, and tragedy. Limited data are available regarding the factors that can cultivate resilience of children affected by HIV/AIDS. This study aims to examine the role of extracurricular interest in strengthening resilience among children affected by HIV/AIDS. Participants included 755 children orphaned by parental HIV/AIDS, 466 vulnerable children living with HIV-positive parent(s), and 404 comparison children from HIV-free families in the same community in rural China. The measures include extracurricular interest (i.e., reading, sports, music, painting, science, and playing chess) and indicators of psychological adjustment (i.e., depression, loneliness, and self-esteem). Having extracurricular interest was positively associated with self-esteem and negatively associated with depression and loneliness. Having extracurricular interest attenuated the negative effect of parental HIV/AIDS on children's self-esteem and loneliness, after controlling for children's age, gender, and family socioeconomic status. The findings underscore the importance of nurturing extracurricular interest and make available of such activities to promote resilience for children affected by HIV/AIDS in resource-limited settings.

Adoptive gay father families: parent-child relationships and children's psychological adjustment.

Findings are presented on a U.K. study of 41 gay father families, 40 lesbian mother families, and 49 heterosexual parent families with an adopted child aged 3–9 years. Standardized interview and observational and questionnaire measures of parental well-being, quality of parent–child relationships, child adjustment, and child sex-typed behavior were administered to parents, children, and teachers. The findings indicated more positive parental well-being and parenting in gay father families compared to heterosexual parent families. Child externalizing problems were greater among children in heterosexual families. Family process variables, particularly parenting stress, rather than family type were found to be predictive of child externalizing problems. The findings contribute to theoretical understanding of the role of parental gender and parental sexual orientation in child development.

Psychological and Quality of Life Outcomes in Pediatric Populations: A Parent-Child Perspective

To compare the levels of quality of life (QoL) and psychological adjustment of children with different chronic health conditions with healthy children; to compare the QoL of parents of children with a chronic condition with parents of healthy children; and to examine the role of parents' QoL and children's psychological adjustment (ie, internalizing/externalizing problems) on children's QoL. The sample comprised 964 family dyads composed of 1 parent and 1 child/adolescent aged 8-18 years with diabetes (n = 85), asthma (n = 308), epilepsy (n = 68), cerebral palsy (n = 94), obesity (n = 110), or no medical conditions (n = 299). The children completed self-report measures of QoL and psychological adjustment, and the parents completed a questionnaire on QoL. Children with epilepsy and obesity reported the lowest levels of QoL and elevated levels of psychological problems, and parents of children with obesity reported the lowest levels of QoL. Adolescents reported worse adjustment than children. Regression models revealed that children's internalizing and externalizing problems were important, although distinct, explanatory factors of QoL across all groups. Children with chronic conditions, particularly epilepsy and obesity, are at increased risk for maladjustment. A routine assessment of QoL and psychological functioning should be performed in these children to better understand how specific conditions affect the lives of children with chronic conditions and their families. Family-oriented pediatrics should be considered, particularly in the treatment of obesity.

Childhood Psychological Problems in School Settings in Rural Southern Africa

BackgroundMany children can be exposed to multiple adversities in low and middle-income countries (LMICs) placing them at potential risk of psychological problems. However, there is a paucity of research using large representative cohorts examining the psychological adjustment of children in school settings in these countries. Children’s psychological adjustment has been shown to affect educational progress which is critical for their future. This study, based in a rural, socio-economically disadvantaged area of South Africa, aimed to examine the prevalence of children’s psychological problems as well as possible risk and protective factors.MethodsRates of psychological problems in 10–12 year olds were examined using teacher- and child-report questionnaires. Data on children from 10 rural primary schools, selected by stratified random sampling, were linked to individual and household data from the Agincourt health and socio-demographic surveillance system collected from households over 15 years.ResultsA total of 1,025 children were assessed. Teachers identified high levels of behavioural and emotional problems (41%). Children reported lower, but substantial rates of anxiety/depression (14%), and significant post-traumatic stress symptoms (24%); almost a quarter felt unsafe in school. Risk factors included being a second-generation former refugee and being from a large household. Protective factors highlight the importance of maternal factors, such as being more educated and in a stable partnership.ConclusionThe high levels of psychological problems identified by teachers are a serious public health concern, as they are likely to impact negatively on children’s education, particularly given the large class sizes and limited resources in rural LMIC settings. Despite the high levels of risk, a proportion of children were managing well and research to understand resilience could inform interventions.

Patterns of children's adrenocortical reactivity to interparental conflict and associations with child adjustment: A growth mixture modeling approach.

Examining children's physiological functioning is an important direction for understanding the links between interparental conflict and child adjustment. Utilizing growth mixture modeling, the present study examined children's cortisol reactivity patterns in response to a marital dispute. Analyses revealed three different patterns of cortisol responses, consistent with both a sensitization and an attenuation hypothesis. Child-rearing disagreements and perceived threat were associated with children exhibiting a rising cortisol pattern, whereas destructive conflict was related to children displaying a flat pattern. Physiologically rising patterns were also linked with emotional insecurity and internalizing and externalizing behaviors. Results supported a sensitization pattern of responses as maladaptive for children in response to marital conflict, with evidence also linking an attenuation pattern with increased family risk. The findings of the present study support children's adrenocortical functioning as one mechanism through which interparental conflict is related to children's coping responses and psychological adjustment.

Medida da aliança parental: validação portuguesa e construção de uma versão reduzida

OBJETIVO: A Medida de Aliança Parental (PAM) avalia a qualidade da relação interparental na prestação de cuidados da criança. O presente artigo apresenta a validação de uma versão portuguesa da medida, bem como examina as qualidades psicométricas de uma versão reduzida com 6 itens do instrumento (PAM-R). MÉTODO: A amostra foi constituída por 182 pais (63% mães), dos quais 72 preencheram um instrumento de avaliação dos problemas de ajustamento psicológico das crianças. RESULTADOS: As análises fatoriais confirmatórias não corroboraram a estrutura dos dois modelos testados. No entanto, excelentes valores foram encontrados nos índices de adequação do modelo da PAM-R. Não foram encontrados erros de especificação no modelo unidimensional testado, o que suporta a validade fatorial da versão reduzida da PAM. A PAM-R apresentou excelentes valores de consistência interna e uma correlação negativa e significativa com a medida de problemas de ajustamento das crianças. CONCLUSÕES: PAM-R emerge como uma medida que possibilita a avaliação do impacto das dimensões familiares no funcionamento e desenvolvimento psicológico das crianças, em contextos de prestação de cuidados de saúde primários.

Psychological adjustment of children with cancer as compared with healthy children: a meta-analysis

Childhood cancer is a life-threatening disease and the cause of great stress for children who suffer from its diagnosis and treatment. The aim of this study was to verify, through meta-analytical tools, whether children in active treatment for cancer differ in their psychological adjustment from healthy children. Ten studies fulfilled the inclusion criteria for the meta-analytic approach. A fixed effects model did not yield significant results, suggesting that there is no evidence for a difference in psychological adjustment between ill and healthy children, inasmuch as the former seem to adjust as well as the latter. Some methodological aspects are also considered, including issues related to the definition of psychological adjustment and its operationalisation and to the relative scarcity of published articles in this particular realm. Moreover, suggestions for future studies are discussed.

An exploratory study of positive and incongruent communication in young children with type 1 diabetes and their mothers

The incidence of type 1 diabetes is increasing in young children. However, they are overlooked in treatment adherence and intervention research despite evidence that parents often experience difficulty securing their treatment cooperation, especially with the diet. We investigated positive and incongruent (i.e. the co-occurrence of contradictory verbal and non-verbal messages) communication in the mother-child dyad and their association with child adjustment and dietary adherence outcomes. Participants were 23 6- to 8-year-old children with type 1 diabetes and their mothers. We conducted dietary adherence interviews with mothers and performed nutritional analyses to assess children's consumption of extrinsic sugars (e.g. confectionary). Mothers completed a standardized assessment of child psychological adjustment. Mothers and children engaged in a videotaped problem-solving task related to the dietary regimen, with maternal and child utterances and non-verbal behaviours analysed for positive dyadic and incongruent communication. Positive dyadic communication correlated with lower levels of child incongruent communication, fewer behavioural problems and better overall adjustment. Higher levels of maternal and child incongruent communication correlated with more behavioural and emotional problems and poorer overall adjustment. Higher levels of maternal incongruent communication correlated with poorer dietary adherence. Results converged to form a conceptually and empirically coherent pattern in that behavioural indices of poorer communication in both mother and child consistently correlated with poorer child adjustment outcomes. This study shows that specific features of dyadic, child and maternal communication could be targeted in developmentally sensitive interventions to promote positive communication in the home management of type 1 diabetes care for young children.

Kinder krebskranker Eltern – elterliches Coping, familiäres Funktionsniveau und psychosoziale Anpassung der Kinder

Children exposed to parental cancer have an increased risk of mental health problems. However, the parental illness itself and its features do not predict children's psychological adjustment. Parent- and family-related factors are more predictive for children's well-being and the incidence of psychopathological symptoms, respectively. This study focuses on parental ways of coping with illness from both, the ill and healthy parent's perspective, and the relationship with family functioning and children's adjustment. Results show a significant impact of parental coping styles on children's health-related quality of life and psychopathological symptoms and, furthermore, that this relationship is mediated by aspects of family functioning. This study support the importance of family systems approaches. Implications for further studies and practical issues are discussed.

Psychological Adjustment of Children in Foster Care: Review and Implications for Best Practice

Approximately 800,000 children are served by the foster care and adoption system each year based on 2008 data from the United States Department of Health and Human Services. While receiving services, children in the system often undergo multiple placements, in addition to having endured traumatic experiences such as child maltreatment and neglect. These experiences make foster care children more likely to experience adjustment and behavior problems. With such a large number of children in the foster care and adoption system, it is important to understand protective and risk factors playing a part in their ability to be resilient as well as barriers to treatment that may affect optimal adjustment. The current review examines adjustment difficulties as well as risk and protective factors, barriers to mental health care, and discusses clinical implications.

Child Routines Moderate Daily Hassles and Children's Psychological Adjustment

This study examined child routines as a moderator of the relation between children's daily hassles and internalizing and externalizing behavior problems. School and community children (n = 131) ages 8 through 12 reported on daily hassles, and their primary caregivers reported on child routines and behavior problems. Moderated multiple regression indicated significant main effects for child routines. A significant interaction was found between children's daily hassles and child routines for the internalizing model, but not for the externalizing model. Children reporting more daily hassles had fewer internalizing behaviors when they also had more frequent child routines.

Parent–child communication and psychological adjustment in children with a brain tumor

Internalizing problems, anxiety, depression, withdrawal, and consequent social problems are frequently observed in children with brain tumors. The objective of this work is to describe the relationship between these psychological problems and the type of parent-child communication established about the disease. A group of 64 children surviving a brain tumor (aged 4-18 years) underwent psychological assessment by means of parent reports on the Child Behavior Checklist (CBCL) and the Vineland Adaptive Behavior Scales (VABS). A semi-structured interview with each child and their parents enabled us to classify the method of communication regarding the disease as "avoidance," "ineffective," and "effective." Demographic, clinical, and functional data relating to the disease were also collected. A significant relationship between the onset of Internalizing problems, withdrawal, anxiety-depression, and social problems and the presence of avoidance or ineffective communication about the disease was observed (P = 0.001, P = 0.001, P = 0.001, and P = 0.01, respectively). These psychological problems did not prove to be associated to demographic or clinical variables; however, they were found to be related to the children's residual functional problems. By contrast, the method of communication proved to be unrelated to clinical or functional variables, but it was associated to demographic variables such as sex and age at assessment. Effective (complete, truthful, consistent, comprehensible, gradual and continuous, and tailored) communication to the child about his/her condition proved to be associated with a better psychological outcome.