Double ABCX Model Research Articles

A Double ABC-X Model of Family Stress and Adaptation of Asian Parents

This study examined a moderated mediation model examining parent stress from the pile-up of pandemic-related stressors informed by the Double ABCX theoretical model of family stress and adaptation. Participants included a subset (n = 25346) of nine Asian countries’ (China, N = 5387; India, N = 4892; Indonesia, N = 3651; Malaysia, N = 3768; Philippines, N = 4401; Mongolia, N = 2658; Pakistan, N = 4836; Singapore, N = 3209; Bangladesh, N = 4625) of the Covid Family Life Study. The results revealed that family and relationship satisfaction were positively associated with stress at low, moderate, and high levels of family resilience beliefs, with the strongest association for individuals with low family resilience beliefs. However, both family and relationship satisfaction did not mediate the association between stressor pile-up and stress across all levels of family resilience beliefs. Implications of these results for interventions aiming to foster parental well-being in disaster contexts were discussed.

Exploring the factors contributing to parent stress symptoms during the COVID-19 pandemic in Europe: An ABC-X model approach.

The COVID-19 pandemic has had a significant impact on the mental health and well-being of families worldwide, with parents particularly at risk for stress and other psychological symptoms. In this study, we sought to understand the factors contributing to parent stress symptoms during the early stages of the pandemic in 23 European countries (N = 40,138) using the double ABC-X model. We examined whether the relationship between stressor pile-up and perceived stress was mediated by family satisfaction and relationship satisfaction and whether family resiliency beliefs impacted these mediated relationships. Our results showed a direct association between stressor pile-up and parent stress symptoms, but we did not find evidence for the mediating role of family satisfaction or relationship satisfaction in this relationship. We also found that family resiliency beliefs did not moderate the indirect effects of family satisfaction and relationship satisfaction on parent stress symptoms. These findings suggest that the ABC-X model may not fully capture the processes affecting parents' experience of stress during the pandemic and that alternative models such as the vulnerability-stress-adaptation model may be more relevant. Future research should also consider the potential negative impact of resiliency beliefs on mental health and other risk and protective factors such as self-compassion.

Effectiveness of Integrative Structural Family Therapy and Double ABCX Model on Marital Adjustment and Parenting Stress Among Parents of Children with Autism: Randomized Controlled Trial

Marital adjustment is an important predictor of coping with stress among parents of children with autism spectrum disorder (ASD). A randomized controlled trial conducted on 60 parents of children with ASD showed that integrative SFT and double ABCX therapy, conducted over ten sessions of multiple family therapy in group counseling for five weeks and a one-month follow-up at special needs children’s centers in Jordan, resulted in a 48% increase in marital adjustment and a 34% reduction in parenting stress. These therapies significantly improved the well-being of parents of children with autism, while the control group did not.

Perceived Mental and Physical Health During the Pandemic: The Role of Financial Stress

This study uses the double ABC-X model to explore the link between COVID-19-induced stressors and health outcomes. Analyzing a unique online survey of 2,290 respondents in 2021, our results suggest that the process behind the relationship between financial strain and health is nuanced where financial stress plays an important role. Specifically, the results reveal that changes in income, employment status, and expectations regarding future income significantly affect perceived mental and physical health, with financial stress acting as a significant mediator. Our findings imply that financial counseling could be more effective if the client’s idiosyncratic coping mechanisms such as their financial stress are incorporated in the practice beyond quantitative analyses. Our findings provide directions for future research, as well as implications for financial counselors, healthcare providers, and policymakers.

중년기 은퇴불안이 심리적 안녕감에 이르는 적응과정

Background/Objectives: The purpose of this study was to determine the influence of each variable by applying the Double ABC-X model to the adaptation process from middle-aged retirement anxiety to psychological well-being. Methods: Collected data from 361 working middle-aged were analyzed using SPSS 26.0 and AMOS 23.0. Results: T he accumulated stressors(aA), resources(bB), cognitions(cC), coping, and adaptation(xX) variables of the model were substituted with middle-aged retirement anxiety(aA), self-efficacy(bB), emotional awareness clarity(cC), adaptive cognitive emotion regulation strategy(coping), and psychological well-being(xX). The study results were as follows: first, aA was found to have a negative direct effect on bB, cC, and coping. Second, bB and cC in the middle-aged had a direct positive(+) effect on coping. Third, bB, cC, and coping in the middle-aged had a direct positive(+) effect on xX. Final, the aA indirectly affects psychological well-being through bB, cC, and coping, and bB and cC have an indirect effect on xX through coping. As a result of confirming the goodness of fit of the Double ABC-X model, the goodness of fit for the structural model of this study was CMIN/DF=1.940, GFI=.955, AGFI=.926, RMR=.034, RMSEA=.054, NFI=.945, CFI=.972, TLI=.961, which met the acceptance criteria, and as a result of pathway analysis, all 8 pathways were found to be significant at the p<.05 or higher level. Conclusion/Implications: As the influence of the variables applied from the Double ABC-X model is all significant, it is meaningful that the adaptation process of middle-aged retirement anxiety to psychological well-being was explained using the Double ABC-X model. In addition, the importance and application of cognitive emotion regulation strategy intervention were discussed and suggested.

Family Support Services and Reported Parent Coping Among Caregivers of Children with Emotional, Behavioral, or Developmental Disorders.

Caregivers of children with special health care needs (CSHCN) experience substantial strain caring for their child's special needs because of high needs for health and other support services. Caregivers of CSHCN with emotional, behavioral, or developmental problems (EBDPs) report stress and poor mental health at higher rates than caregivers of other CSHCN. Although family support services are associated with caregiver mental health and well-being among families of CSHCN, the association of these factors with caregiver coping has been underexamined. Using the Double ABCX Model of Family Adaptation to guide variable selection, this study uses 2016 to 2019 data from the National Survey of Children's Health. Univariate, bivariate, and multivariate logistic analyses examined the association between caregivers' receipt of adequate care coordination and emotional support services and their reported coping with the day-to-day strains of parenting. These relationships are compared between caregivers of CSHCN with and without EBDPs. Receipt of adequate care coordination was associated with higher rates of caregiver-reported positive coping for all caregivers of CSHCN who have no source of emotional support. Receipt of emotional support services was associated with increased reports of positive coping for caregivers for all CSHCN as well. Caregivers reporting only informal sources of emotional support, however, also reported higher rates of positive coping when compared with caregivers with no source of emotional support. Mobilization of resources that can aid caregivers in coordinating care and provide emotional support may play a key role in positive caregiver coping for families of CSHCN.

Ethnic Related Challenges and Coping Strategies of Couples in Intercultural Marriages in Elmina

The purpose of this phenomenological study was to identify potential ethnic-related challenges in intercultural marriages and uncover some of the coping strategies applied by couples to cope with these challenges and it was based on the double ABCX model of stress and coping. Twenty (20) intercultural couples were interviewed individually and data was analyzed using the QSRNVIVO 9 computer software. Results revealed that the intercultural couples studied had common ethnic-related challenges such as: family disapproval, language and communication barriers, cultural norms, raising children and cultural traditions. Coping strategies included humor, seeking professional help, social support networks, supportive communication, binding daily chores and care and loving actions. It was revealed that these couples were committed to their marriage and each other and they believed that they could overcome whatever challenge that may come their way. This study recommends among other things that counselors should use culture as a lens to explore the differences and opportunities in intercultural marriages needed to create stability and balance in their homes.

When Family Life Contributes to Cancer Caregiver Burden in Palliative Care.

The difficulties of caring for a family member with advanced cancer are well documented. Support from a caregiver's social network-especially other family-is vital to reducing caregiver burden and psychological distress. However, the family environment is not always supportive as reports of family conflict and dissatisfaction with support are common. Despite knowing that family relationships are complex, little is known about the types of family stress that caregivers of advanced cancer patients face in their daily lives. To address this gap, researchers applied concepts from the double ABCX model to conduct a reflexive thematic analysis of interviews with 63 caregivers of cancer patients receiving outpatient palliative care. Four themes of family stress were identified: failed support, relational tensions, denial, and additional care work. Findings inform clinical assessment and caregiver intervention development by revealing the importance of measuring the mundane machinations of family life for caregivers of adult cancer patients.

A biopsychosocial model of NICU family adjustment and child development.

Although infants in Neonatal Intensive Care Units (NICU) are at risk for developmental impairments and parents are at risk for emotional distress, factors that explain outcomes remain unknown. Here, we developed the first biopsychosocial model to explain family adjustment after NICU discharge. Participants included 101 families at The Children's Hospital of Philadelphia Neonatal Follow-Up Program who had been discharged 1.5-2.5 years prior. We gathered data using validated assessments, standardized assessments, and electronic medical records. Our structural equation model, informed by the Double ABC-X Model, captured the dynamic relationships among infant, parent, couple, and family factors. Infant medical severity, posttraumatic stress, couple functioning, and family resources (e.g., time, money) were key for family adjustment and child development. Interventions that target parental posttraumatic stress, couple dynamics, parental perception of time for themselves, and access to financial support could be key for improving NICU family outcomes.

Resilience of infertile families undergoing in vitro fertilization: An application of the double ABC-X model

BackgroundFamily resilience plays a crucial role in protecting the mental health and family stability of infertile patients. However, information associated with infertile families resilience is scarce. The double ABC-X model provides a roadmap for this, helps organize knowledge, and lays the foundation for knowledge development. AimsTo describe the current situation of family resilience of infertile women, and to test the predictive theoretical model of family resilience based on infertility stigma, individual resilience, coping style, and posttraumatic growth. DesignA cross-sectional study. MethodsA convenience sample of 372 infertile women undergoing in vitro fertilization were recruited between April and August 2020. The Chinese-Family Resilience Assessment Scale, Infertility Stigma Scale, Simplified Coping Style Questionnaire, Chinese version of Connor-Davidson Resilience Scale, and Chinese version of Post Traumatic Growth Inventory were used to measure family resilience, infertility stigma, individual resilience, coping style, and posttraumatic growth. Structural equation models were used to analyze the relationship among these variables. ResultsThe results showed that family resilience was related to infertility stigma, positive coping, and individual resilience. Moreover, the path analysis indicated that positive coping and individual resilience mediated the effects of infertility stigma on family resilience. ConclusionsA high level of stigma among infertile women should be identified. Interventions for targeting positive coping and individual resilience might ultimately increase their family resilience.

Family Cohesion and Positive Sibling Relationships in Families Raising a Child with or without a Disability

ABSTRACT Scant research exists regarding how family cohesion is related to relationships among siblings with and without disabilities. The purpose of this study, based upon the Double ABCX Model of Adaptation, was to investigate cohesion and sibling relationships in families raising typically developing siblings (TDC) and families raising children with some type of disability. Mothers and fathers of 221 sibling pairs completed demographic, family cohesion, and sibling relationships questionnaires. Paired t-tests, correlations, and structural equation modeling were used to analyze the data. Mothers reported higher levels of family cohesion than fathers. Comparing families raising TDC with families raising a child with some type of disability, parents of TDC reported higher cohesion than parents of children with autism spectrum disorder (ASD); fathers of TDC reported higher cohesion than fathers of children with Down syndrome (DS). However, parents of TDC reported less positive sibling relationships than parents of DS. Higher levels of cohesion correlated with more positive sibling relationships. It was concluded that relationships exist between family cohesion and sibling relationships, and these perceptions differ between families raising children with or without disabilities. Implications for research and practice are discussed.

Trajectories of Marital Satisfaction among Parents of Youth with Spina Bifida.

This study examined marital satisfaction among parents of youth with spina bifida (SB) over an 8-year period and investigated the usefulness of the double ABCX model for understanding factors that predict change in marital satisfaction across child age. Data from five time points of a longitudinal investigation of psychosocial outcomes in youth with SB were included. Mothers and fathers of children with SB (aged 8-17) reported on marital satisfaction and components of the double ABCX model. Change in marital satisfaction was examined across child age with components of the double ABCX model, as well as interactions between components, as predictors. Marital satisfaction was significantly higher in the present sample than in a normative sample of married couples. Although there were no significant changes in marital satisfaction for either parent as a function of child age, there was significant variability for the intercept and slope of maternal and paternal marital satisfaction within the sample. Family support predicted a higher intercept, and mental health symptoms predicted a lower intercept, for maternal and paternal marital satisfaction. More stressors and SB-related family stress predicted a lower intercept for paternal marital satisfaction. Family support and family stress attributed to SB moderated the relationship between child vulnerability and maternal marital satisfaction. Observed family cohesion and child psychosocial quality of life moderated the relationship between family stressors and paternal marital satisfaction. Findings demonstrate the usefulness of the double ABCX model for this population.

Effects of family disintegration on children later depression

Studies examining the effects of marital dissolution on children's welfare have repeatedly found that children of separated parents perform worse on several well-being parameters than those from intact households. Depression is highly represented in the health care system among children and older offspring of divorced parents. This study utilizes the double ABCX model to examine the relationship between divorce and depression. The goal of the study was to see if divorce is a sound predictor of depression. Divorce was shown to only explain a modest portion of the variation in depression (r^2= .04). This level of variation suggests that other than divorce, various additional variables have a role in depression. The study closes with the indication that if additional moderating variables such as the child's maturity and availability of household resources before and after dissolution were encompassed in the analysis, divorce would become a stronger risk factor for depression. Family disharmony may be linked to a higher incidence of severe depressive illness in children of divorced parents.

Hardships & Resilience: Families in a Pandemic.

The COVID-19 pandemic created unique hardships for families with school-aged children. To better understand these hardships, we asked the question: How did family units of various racial and socioeconomic backgrounds experience the pandemic? Qualitative phenomenology was the methodological basis for this study, and the Double ABC-X Model of Family Behavior was applied to analyze how the pandemic and racial tensions that occurred in the past 18 months affected families. We specifically focused on including the voices of minoritized populations as they are less often represented in phenomenological research. Semi-structured virtual interviews were conducted with families from Minnesota and Illinois. NViVo was used to code and analyze the interviews. Five themes were identified which demonstrated family strength and experience of hardship: resilience, boundaries, community support, fear, and communication.

Perceived mental health in parents of children with rare congenital surgical diseases: a double ABCX model considering gender

BackgroundPrevious research has supported the utility of the Double ABCX model of family adaptation for parents in various diseases. Nonetheless, it remains unclear how raising a child with rare congenital surgical diseases impacts the mental health of both mothers and fathers.MethodsThe potential predictors of maternal and paternal mental health in a German sample of 210 parents of children with rare congenital surgical diseases were investigated. Parents were investigated cross-sectionally utilizing standardized psychometric questionnaires that assessed factors attributed to parental adaptation within the Double ABCX model.ResultsStressor pile-up, family functioning, perceived stress, and mental health were positively associated with mothers and fathers. However, further analyses revealed that family functioning, social support, and perceived stress fully mediated the positive association between stressor pile-up and mental health in mothers, but not fathers.ConclusionOur findings suggest that parental adaptation to a rare congenital surgical disease in their children may be improved by increased intra- and extrafamilial resources and decreased perceived family-related stress in mothers, but not fathers. Our results may help to identify gender-specific factors that may guide clinicians and future interventions.

Perceived stress, resources and adaptation in relation to the COVID-19 lockdown in Spanish foster and non-foster families.

The lockdown imposed as a result of the COVID‐19 pandemic has placed unprecedented stress on families. The family is a key system in relation to child development, and when birth families are unable to meet their child's needs, foster carers become an important source of support in their development. The Double ABC‐X Model of family stress and adaptation considers that a family's capacity to cope with stressful situations is influenced by pile‐up of stressors, family resources and perception of the situation. Following this model, the study aimed to determine the impact of the COVID‐19 lockdown on family stress and functioning. The sample comprised 347 Spanish adults (100 with foster families and 247 with non‐foster families) who completed a survey during lockdown. The results showed that certain sociodemographic variables (gender, income, working from home, characteristics of the home and children with special educational needs) were associated with stressors during lockdown, perception of the lockdown, and family adaptation to stress during lockdown. Associations were also found between stressors, family resources, perception of lockdown, and family adaptation in foster and non‐foster families, with the former having a more positive perception of the lockdown experience. The relevance of the results and their implications are discussed.

A Structure Model of Family Empowerment in Preventing Smoking Initiation among Adolescent: An Empirical Study Conducted in Urban Area of Indonesia

BACKGROUND: Family empowerment is a critical component for smoking prevention efforts among adolescents. Few information regarding the family empowerment model developed in preventing smoking initiation among adolescents in Indonesia. AIM: The aim of this study was to identify determinants of the family empowerment model in preventing smoking initiation among adolescents in Indonesia. METHODS: A cross-sectional research design was used for families with adolescent girls and boys (aged 10–14 years) in West Java, Indonesia. The convenience sampling procedure was employed. The study analyzed family demands and parenting stress as stressors. Family resources were divided into family functioning and communication process. The perception or judgment factor was assumed as parenting efficacy. Family empowerment has been identified as an indicator of adaptation. Structural equation modeling was used for data analysis. RESULTS: The survey respondents consisted of 175 respondents. The mean age was 40.56 (SD = 11.73) and 57.2% had graduated from above high school. These findings suggest that family demands and parenting stress have an indirect effect on family empowerment through parenting efficacy, family functioning, and communication processes. The contribution of the effect of family demands, parenting stress, parenting efficacy, family function, and communication process on family empowerment was 68%. CONCLUSION: The family empowerment could be defined in the Double ABCX model in the prevention of smoking in adolescents and that the numerous adverse effects of stress can be modulated through parental efficacy as well as the ability to function of the family and communication. It recommends making family interventions an integral part of public health initiatives for the prevention of smoking initiation, as well as health policy formation.

Understanding perceptions underlying the self-reported stress among parents of adolescents with autism spectrum disorder: Considerations for supporting families

BackgroundParents raising adolescents with autism spectrum disorder (ASD) often report higher stress than other parents. The influence of parents’ internal, or cognitive, experiences (i.e., their own perceptions) on this elevated stress has yet to be explored. Addressing this gap may reveal opportunities for enhancing support for families by elucidating malleable targets for reducing parents’ self-reported stress and/or informing family-focused intervention. The Double ABCX Model of Family Adaptation is a framework for understanding how perceptions, social support, and personal resources (i.e., coping) may affect stress. MethodsWe examined parents’ perceptions about ASD, perceived support, and coping among 214 parents of adolescents with ASD. Regression analyses were used to explore whether these factors were associated with parenting stress among those raising adolescents with ASD. Moderation effects of positive coping on the relationship between parent perceptions and parenting stress were also explored. ResultsParent perceptions about within family support, the extent of ASD symptom predictability, and treatment being able to ‘control’ ASD were related to parenting stress. However, positive coping did not moderate the relationship between these perceptions and parenting stress. ConclusionsStudy findings emphasize significant associations between specific parental perceptions and the self-reported stress among families of adolescents with ASD. Particularly important to parenting stress were how much parents’ perceived adequate support within the family, that treatment was useful for controlling their adolescent’s ASD, and that their adolescent’s symptoms were predictable. These findings suggest that the way parents think about their adolescents’ ASD and the adequacy of the support within their own families are associated with parenting stress, and therefore may serve as treatment targets for positively affecting whole family outcomes, as well as foundations for additional research.

Quality of Life Among Malaysian Parents with Autism Spectrum Disorder Child: The Double ABCX Model Approach.

This paper reported the quality of life (QoL) of 260 Malaysian parents with autism spectrum disorder (ASD) and factors which influencing it. About half of these parents reported to having good QoL. The factors identified in the double ABCX model showed that perceived social support and sense of coherence (SOC) were mediated by coping strategies and had a positive direct and indirect effect on parents' QoL. These finding reiterate the importance of social support, coping skills, and strong SOC reflection skills in influencing the QoL of parents with ASD child. We therefore suggest parents to utilize the widely available social and organization supports to gain good QoL, which is also important for the wellbeing of their child.

Activism, Growth, and Empowerment of Israeli Parents of Children With Disabilities.

Traditionally, studies on parenting children with disabilities have focused mostly on experiences of stress. More recently, studies have turned to examining parental coping from the perspective of strength, focusing on the ability to achieve growth and empowerment. Most studies, however, have not examined parental activism as a coping mechanism. Based on the Double ABCX Model of Family Adjustment and Adaptation, this study, conducted in Israel, assessed the adequacy of a theoretical model linking stress, coping, activism, growth, and empowerment of parents of children with disabilities. Activist and nonactivist parents (N = 123) completed a structured questionnaire that included measures of stress, coping, empowerment, and growth. Stress was negatively associated with empowerment and growth, whereas problem-focused coping and parental activism were positively associated with empowerment and growth. Activism was found to mediate the relationships between stress and growth and empowerment, with lower levels of stress being related to higher levels of activism, which was in turn correlated to higher levels of empowerment and growth. Parental activism, consisting of deconstructing problems faced by the family and demanding change in social discourse with a view toward inclusion, choice, rights, and equality, is a useful mechanism for parents in alleviating levels of stress and enhancing sense of empowerment and growth.