Elevated Parenting Stress Research Articles

A prospective study of postnatal depressive symptoms and associated risk factors in first-time fathers

BackgroundRecent studies show that paternal depression negatively impacts children's behavioral and emotional development. This study determined the prevalence of depressed mood in first-time fathers at 2 and 6 months postpartum and identified associated risk factors. MethodsA prospective cohort study with 622 men who completed sociodemographic and psychosocial questionnaires during their partner's third trimester of pregnancy. Fathers completed measures again at 2 and 6 months postpartum and partners completed the depressed mood measure at all three timepoints. A cutoff of ≥10 for the Edinburgh Postnatal Depression Scale identified depressed mood status. ResultsThe prevalence of depressive symptoms in fathers was 13.76% at 2 months and 13.60% at 6 months postpartum. Men who were depressed during their partner's pregnancy were 7 times more likely to be depressed at 2 months postpartum. Depressed mood status at both the antenatal and 2 month postpartum assessment was associated with increased risk of depressed mood at 6 months postpartum. Older age, poor sleep quality at study entry, worse couple adjustment, having a partner experiencing antenatal depressive symptoms and elevated parental stress were associated with depressive symptoms at 2 months postpartum. Poor sleep quality, financial stress and a decline in couple adjustment were independently associated to depressive symptoms at 6 months postpartum. LimitationsThis sample was fairly well-educated and predominately middle-class. Depressive symptoms were assessed using a self-report questionnaire. ConclusionsThe psychosocial risk factors identified provide opportunities for early screening and targeted prevention strategies for fathers at risk for depression during the transition to parenthood.

Mindfulness-Based Stress Reduction for Parents of Children With Developmental Delays: A Follow-Up Study

ABSTRACTParents of children with developmental delays (DD) consistently report higher levels of stress compared to parents of typically developing children. Elevated parenting stress is concerning, not only because of the associated poorer physical and mental health outcomes for the parents but also because of its role in the development of behavior problems and subsequent psychopathology in their children. A growing body of research suggests that Mindfulness-Based Stress Reduction (MBSR) is effective in reducing parenting stress and child behavior problems among families of children with DD; however, there is a shortage of studies examining whether the effects of MBSR in this population are maintained in the longer term. In the current study, we used a waitlist-control design to examine whether MBSR directly improved parental mental health (i.e., parenting stress, depression, and satisfaction with life) and indirectly reduced child externalizing and internalizing behaviors. Eighty parents of children with DD between the ages of 2.5 and 5 (M = 4.18, SD = 1.01) were randomly assigned to an immediate treatment group or a waitlist-control group. Results indicated that parents who received MBSR reported significantly greater improvements in mental health outcomes as well as reduced child behaviors related to attention and withdrawn behaviors compared to parents in the control group. Further, changes seen through MBSR were maintained at a 6-month follow-up assessment. These findings suggest that improvements in parent and child outcomes through MBSR may have longer term benefits for families of children with DD.

Level of parenting stress in mothers of singletons and mothers of twins until one year postpartum: A cross-sectional study.

To date, it is unclear which factors are associated with parenting stress. There are no studies investigating the association between parenting stress and coping strategies such as coparenting and social support, while simultaneously considering demographic and obstetric factors, in mothers of singletons and twins. To investigate if parenting stress is associated with personal, and obstetric characteristics, the level of coparenting, and the availability of and satisfaction with social support in mothers of singletons and twins until one year postpartum. A cross-sectional study was conducted. A total of 151 singleton mothers and 101 twin mothers were included. Both singleton and twin mothers experiencing lower parenting stress levels indicated a better coparenting relationship quality (β=-0.253, p<0.01; β=-0.341, p=0.001). Elevated parenting stress levels positively influenced the level of satisfaction with social support in only mothers of twins (β=0.273, p<0.01). The availability of social support, personal, and obstetric characteristics were not associated with the level of parenting stress in neither singleton nor twin mothers. Coparenting seems to be a significant coping strategy reducing the level of parenting stress in singleton and twin mothers, irrespective of their personal and obstetric characteristics. Large-scale longitudinal research is needed to identify predictors of parenting stress, which may help to develop parenting stress reducing interventions. The acknowledgement and support of an adequate coparenting relationship quality by health care professionals might be an important factor to include in such interventions.

Web-Based Prevention of Parenting Difficulties in Young, Urban Mothers Enrolled in Post-Secondary Education.

Research consistently indicates that young mothers are at elevated risk for adverse social and economic risks. Recent attention has been paid to the value of maternal educational attainment for their children's economic and social outcomes. Pursuit of post-secondary education requires mothers to balance multiple roles, potentially stressing the parent-child relationship. Yet, almost no studies have addressed parenting and associated stress in young mothers enrolled in post-secondary education, and no preventive intervention trials have been conducted. We screened young mothers (<25years at child's birth) pursuing post-secondary education in an urban, inner city college for study inclusion based on elevated parenting stress, and participated in a randomized controlled trial to assess the efficacy of a web-based parenting intervention (Triple P Online) in reducing parenting stress and dysfunctional discipline (N=52). Mothers were randomly assigned to the web-based parenting program condition or to a waitlist control condition. Mothers who completed at least the first four core modules of the online program had lower scores on the Parenting Scale's subscales (Overreactivity, Verbosity, and Laxness), compared to those who did not complete four or more modules. No intervention effects were obtained for parenting stress. The current study provides preliminary evidence of the efficacy of this online parenting program for reducing risk for dysfunctional discipline in student mothers. Future research is warranted to replicate these findings, and to test whether provision of supplemental support for implementation, or briefer program formats may promote both program compliance and outcomes related to reducing parenting stress.

The Role of Parental Depressive Symptoms in Predicting Dysfunctional Discipline Among Parents at High-Risk for Child Maltreatment

Parental depressive symptoms are an important public health concern because they have been linked, in numerous previous studies, to negative parenting behaviors including dysfunctional discipline and child abuse and neglect. Taking this into consideration, parental depressive symptoms warrant particular attention among families with child maltreatment allegations--a group at high risk of dysfunctional discipline and future physical abuse. The current study sought to examine relations between parental depressive symptoms and dysfunctional discipline in an ethnically diverse sample of 234 families who were referred for psychological services due to concerns of child maltreatment. Referrals were made by school, medical, or child welfare personnel. 59.8 % of children were male and the average age was 7.05 years. RESULTS indicated that parental depressive symptoms were significantly correlated with dysfunctional discipline including laxness, over-reactivity, and hostility. However, all three relations lost statistical significance after controlling for parental stress. The findings of this study suggest that well-documented relations between parental depression and negative parenting behavior may be driven by elevated parental stress rather than reflecting risks uniquely associated with depressive pathology. Language: en

Changes in parenting and child behavior after the home-start family support program: A 10 year follow-up

BackgroundHome-Start is a parenting support program in which mothers experiencing difficulties in family life and parenting, receive weekly support at home from a volunteer. The present study extends the work of Hermanns et al. (2013), by examining self-reported and observed parenting and child behavior outcomes at 10.6year follow-up. MethodsThe mothers of the Home-Start group (n=59), who received Home-Start for on average 6.6months, a comparison group, who reported elevated parenting stress and need for support (n=56), and a randomly selected community sample (n=36), reported on their feelings of competence about parenting, their parenting behavior and their child's problem behavior. Observational data were collected on five of the seven measurement occasions, until 8.8year follow-up. ResultsImprovements on feelings of competence, consistent and non-rejecting parenting behavior and internalizing and externalizing problem behaviors during intervention period are sustained. That means that on the long term, the parent and child's improvements did not further improve, nor did they deteriorate. Observational measures showed a decrease in positive and negative parenting and positive and negative child behaviors in general for all groups. ConclusionsHome-Start, a volunteer-based community wide family support program, contributes to positive short term changes, which are sustained in the long-term.

Maternal predictors of anxiety risk in young males with fragile X.

Children with fragile X syndrome (FXS) demonstrate high rates of anxiety disorders, with 65-83% meeting diagnostic criteria. The severity of anxiety symptoms in FXS has been shown to be partially predicted by elevated negative affect across early childhood [Tonnsen et al. (2013a); J Abnorm Child Psychol 41:267-280]. This association suggests that biologically driven vulnerability emerges early in development, as is reported in non-clinical populations. However, anxiety emergence is likely moderated by multifaceted genetic, biological and environmental risk and protective factors. Mothers with the FMR1 premutation have been shown to exhibit elevated parenting stress and internalizing symptoms, which have each been associated with child behavior problems [Bailey et al. (2008a); Am J Med Genet Part A 146A:2060-2069 and Bailey et al. (2008b) Am J Med Genet Part A 146A:720-729]. Despite these findings, it is unclear whether maternal factors directly relate to anxiety vulnerability in high-risk children with FXS, a question essential to informing targeted, family-sensitive treatment. The present study examines how maternal protective and risk factors relate to child inhibition reflected in (1) child anxiety symptoms, (2) child trajectories of negative affect, and (3) the association between child anxiety and negative affect. Primary predictors include maternal parenting stress, indicators of mental health risk (anxiety and depressive symptoms), and maternal optimism. We also examine genetic correlates in mothers (CGG repeats, activation ratio, mRNA). Our findings suggest that behavioral inhibition in young children with FXS is associated with higher parenting stress and lower optimism, and higher parenting stress is associated with lower maternal X-activation ratio. These findings underscore the need for family-sensitive treatment strategies for anxiety disorders in children with FXS.

Long-term developmental outcome of children with a fetal diagnosis of isolated inferior vermian hypoplasia

ObjectivesIsolated inferior vermian hypoplasia (iiVH) is one of the most common fetal cerebellar anomalies presenting for fetal neurological counselling with controversial postnatal neurodevelopmental outcome. In the present study, we characterised...

An Initial Investigation of Parenting Stress, Social-Emotional Protective Factors, and Behavior Concerns within a Head Start Population

This study examines associations between parenting stress, protective factors, and behavior concerns in an at-risk preschool population. Participants included 77 parents of children enrolled in Head Start programs in the Midwest, which served predominantly low-income, diverse parent and child populations. Parents completed a parenting stress questionnaire and a questionnaire that assessed for children’s protective factors and behavior concerns. Associations were found between elevated protective factors and low parenting stress, as well as between elevated behavior concerns and elevated parenting stress. Parents of children exhibiting more protective factors had significantly less parenting stress, compared to parents of children exhibiting more behavior concerns. Additionally, parents with non-clinical levels of parenting stress had children that exhibited significantly more protective factors and less behavior concerns compared to children of parents with clinically significant levels of parenting stress. This is the first study to demonstrate that low levels of parenting stress are associated with more protective factors in an at-risk preschool population. Future research needs to explore the predictive nature parenting stress and protective factors have on one another, given the bi-directionality of parent-child interactions.

Long-term changes in parenting and child behavior after the Home-Start family support program

Abstract Background The intervention Home-Start is a wide spread program in a number of countries, among which the Netherlands. In Home-Start, trained volunteers visit families with young children in need of support once or twice a week to help them to deal with problems in family life and parenting. Little is known, however, about the effects of Home-Start. This study describes short-term and long term changes in families that participated in Home-Start. Methods Three groups of families with young children (at the start mean age 1 1/2 years) were followed over a period of four years. One of the groups of families participated in the Home-Start family support program in the first 6.6 months of this period. The two other groups were (1) a randomly selected community sample and (2) a group of families with elevated parenting stress and a need for support. Data were collected at the beginning of the study, (after median 1.4 months), directly after the intervention (median 6.6 months) and at two follow-up occasions (respectively, median 12.5 and 49.2 months after the first measurement). At the last measurement, data were available for 33, 45 and 34 families respectively. Results Multilevel analysis showed more positive changes in parental wellbeing, competence and behavior (more consistent behavior and less rejection) during the intervention period in the Home-Start group than in the two other groups. At the three year follow up, the Home-Start group showed, compared to the other groups, more improvements in parenting (more responsiveness), but also diminished child externalizing and internalizing behavior problems (less oppositional defiant behavior, affective problems and anxiety problems). Conclusions Home-Start seems a promising family support intervention that deserves to be studied more extensively.

Parenting stress in Chinese mothers of children with autism spectrum disorders

Elevated parenting stress has been observed among mothers of children with autism spectrum disorders (ASDs) in western countries, but little is known about mothers of Han Chinese children. The aim of the current study was to further the knowledge about stress experienced by Chinese mothers of children with ASD by examining maternal parenting stress in Heilongjiang province of China. In this cross-sectional study, data about participants' demographic characteristics, parenting stress, anxiety, depression, child's behavioral problems, coping strategies, and social support were collected though a questionnaire survey. The participants included 150 families with ASD children, who were consecutively admitted to the clinics of the Children Development and Behavior Research Center in Harbin Medical University, Heilongjiang Disabled Persons Federation, and Mudanjiang Child Welfare Home. The participants reported elevated parenting stress. Mothers' parenting stress was associated with levels of depression and anxiety, and child's behavioral symptoms. Child's behavioral symptoms, maternal anxiety, maternal depressive symptoms, and lack of governmental financial support were associated with overall parenting stress. Government support may play an important role in reducing parenting stress in this population.

The relationship between the broader autism phenotype, child severity, and stress and depression in parents of children with autism spectrum disorders

This study examined the relationship between child symptom severity, parent broader autism phenotype (BAP), and stress and depression in parents of children with ASD. One hundred and forty-nine parents of children with ASD completed a survey of parenting stress, depression, broader autism phenotype, coping styles, perceived social support, and child symptom severity. Parents reported elevated parenting stress and depression relative to normative samples. A path analysis indicated that both child symptom severity and parent BAP were positively correlated with these outcomes. The relationship between BAP and the outcome measures was partially mediated by maladaptive coping and social support and the relationship between child symptom severity and outcomes was partially mediated by social support.

Parental stress associated with caring for children with Asperger’s syndrome or autism

The levels of parental stress among parents of children with Asperger's syndrome in comparison with parents of children with autism are unknown in the Japanese population. The stress levels in Japanese parents caring for children with Asperger's syndrome were compared with the stress levels found in Japanese parents caring for children with autism using the Parenting Stress Index/Short Form. In a sample of 193 families, both groups had a significant increase in parental stress levels. In addition, strong evidence was obtained for the presence of higher levels of parental stress in the Asperger's group compared with the parents of the autism group after controlling for the impact of confounders, F(5,187) = 9.11, P = 0.003. The elevated levels of parental stress found in the Asperger's group appeared to be attributable to characteristics associated with the child's basic behavior. The potential mechanism, implications and strategies for further research are discussed. There are significantly elevated parental stress levels in Japanese parents of children with Asperger's syndrome or autism. In addition, the total parental stress levels were significantly higher in parents of children with Asperger's syndrome than in parents of children with autism.

Parenting Stress in Mothers and Fathers of Toddlers with Autism Spectrum Disorders: Associations with Child Characteristics

Elevated parenting stress is observed among mothers of older children with autism spectrum disorders (ASD), but little is known about parents of young newly-diagnosed children. Associations between child behavior and parenting stress were examined in mothers and fathers of 54 toddlers with ASD (mean age = 26.9 months). Parents reported elevated parenting stress. Deficits/delays in children's social relatedness were associated with overall parenting stress, parent-child relationship problems, and distress for mothers and fathers. Regulatory problems were associated with maternal stress, whereas externalizing behaviors were associated with paternal stress. Cognitive functioning, communication deficits, and atypical behaviors were not uniquely associated with parenting stress. Clinical assessment of parental stress, acknowledging differences in parenting experiences for mothers and fathers of young children with ASD, is needed.

Stressful impact of depression on early mother–infant relations

The long-lasting effects of post-natal depression (PND) on parenting stress were assessed. It was also asked whether change in parenting stress followed conventional cognitive-behavioural therapy (CBT) treatment for PND and the benefits of targeted parent–infant intervention was assessed. Data were from three sources (1) a longitudinal cohort of post-partum depressed and non-depressed women; (2) a treatment study of 162 depressed women involving CBT, routine care and a comparison group of 162 non-depressed women; (3) a pilot study of a specialized parent–infant intervention with 22 depressed women. The longitudinal cohort showed elevated parenting stress persisting until 3.5 years post-partum. In the treatment study, 73 per cent of depressed women had parenting stress scores indicating clinically dysfunctional mother–infant relations before treatment (compared to less than 3 per cent in the non-depressed group). This rate was still 56 per cent after 12 weeks of CBT, with average parenting stress similar to women in routine care. During 3 weeks of a specialized parent–infant intervention, there was a more rapid decline in parenting stress. Thus, parent–infant difficulties due to PND were persistent and CBT targeted only at maternal mood had limited impact on these. Parenting stress appeared to improve to more normal levels after the specialized mother–infant module and this needs to be confirmed in a fully controlled study. Broadened criteria for identifying ‘best-practice’ treatments for PND would take account of impact on mother–infant interactions. Copyright © 2006 John Wiley & Sons, Ltd.

Assessing associations between medication adherence and potentially modifiable psychosocial variables in pediatric kidney transplant recipients and their families

Post-transplant immunosuppressant (IS) medication adherence is essential for long-term graft survival and relatively little is known about psychosocial barriers that interfere with optimum medication adherence in pediatric kidney transplant patients. The objective of this prospective observational cohort study was to assess the impact of modifiable psychosocial variables on medication adherence. Our hypothesis was that parental stress, dysfunctional parent-child interactions and child behavior problems would be associated with poorer medication adherence. Thirteen pediatric kidney transplant patients and their caregivers were enrolled. Transplant recipients who were able to read and caregivers of all the transplant recipients completed behavioral and attitudinal surveys. A subgroup of seven families dispensed their primary IS medication from an electronic monitoring vial (MEMS Smart Cap). For these patients, medication adherence was calculated by computing a ratio of the medication taken divided by the prescribed dose. In addition, for the entire group, serial IS levels were reviewed by two board certified pediatric nephrologists who categorized all 13 transplant recipient families as either 'probably adherent (PA)' or 'possibly non-adherent (PNA)'. Pearson correlation coefficients and independent samples Student t-tests were used to assess the association between medication adherence and psychosocial variables measured by standardized questionnaires. In this study, elevated parental stress, dysfunctional parent-child interactions, and child behavior problems were associated with poorer medication adherence. In addition, we found evidence to support the relationship between subjective dissatisfaction with appearance and poorer medication adherence. These findings suggest that pre-transplant recipient evaluations of risk factors for poor adherence are warranted.

Early predictors of school-age behavior problems and social skills in children with intraventricular hemorrhage (IVH) and/or extremely low birthweight (ELBW).

Child and family characteristics from early infancy (birth-3 months adjusted age, AA) and toddler period (24-30 months) were examined as potential predictors of behavior problems and social skills at 7.5 years of age in 90 LBW infants with IVH and/or ELBW who were part of a longitudinal study of early intervention effectiveness. Severity of medical problems at birth and child temperament at 3 months AA were associated with future social skill levels, but not with behavior problems. Family variables in the first months of the child's life including low income, single parent household, and high parenting stress were significantly correlated with behavior problems at 7.5 years of age. Difficult temperament and elevated parenting stress in the toddler period were strongly associated with later behavior problems. Toddler developmental quotient (DQ) was a strong predictor of future social skills. PRACTICE OR POLICY: These data highlight the importance of early intervention that targets child behavior and emotional adjustment along with cognitive development, especially in low income and single parent households. Interventions that target parent-child interaction and parent stress are also crucial in these populations, even beyond the birth-three period.