Parental Health Research Articles

A two-institution pilot study on the psychological burden and distress of parents caring for children with shunted hydrocephalus.

Little is known about the emotional health of parents caring for children with shunted hydrocephalus. The aim of this pilot study was to find out whether parents caring for shunt-treated hydrocephalic children experience serious psychological problems and psychosocial distress and whether these problems are related to the sociodemographic background of the caregivers, the clinical characteristics of their children, and parents' illness-related concerns and perceived burden of their children's illness. This pilot study was performed in an outpatient setting at two German hospitals. The following questionnaires were handed out to parents of children with shunted hydrocephalus (< 21 years of age): the Patient Health Questionnaire (PHQ-9) for depression, the Generalized Anxiety Disorder Scale (GAD-7) for anxiety, the Distress Thermometer (DT) for psychosocial distress, the Hydrocephalus Concerns Questionnaire (HCQ) for assessment of parents' illness-related concerns, and the Hydrocephalus Outcome Questionnaire (HOQ) for assessment of perceived children's disease burden. Clinical data of the respective children were collected from electronic charts. Parents' demographic data were evaluated via questionnaires. Parents' psychological variables were correlated with demographic and clinical data and HCQ and HOQ scores. Regression analyses of HCQ and HOQ scores with psychological items were performed. Sixty-three parents were included in this study. Of these, 60% reported clinically relevant levels of either depression (11%), anxiety (10%), and/or psychosocial distress (57%). There were no associations between parental sociodemographic or children's clinical characteristics with parents' psychosocial well-being or psychosocial distress. Depression, anxiety, and DT scores were highly intercorrelated and significantly correlated with HCQ scores (r = 0.508, r = 0.516, r = 0.442; p < 0.01). Thereby, worries about shunt-related complications were the most reported concern in the HCQ. Depression and anxiety correlated with the scores of some HOQ subcategories. In preliminary regression analyses, higher illness-related concerns predicted occurrence of parents' anxiety. The authors' results support the notion that there is a need for psychosocial support for a proportion of parents who care for shunted hydrocephalic children. Perceived child symptom burden and parental illness concerns were identified as relevant correlates of parental psychological well-being. Thus, concerns specific to shunt-related problems could be a first starting point for the development of individual support measures.

Examining the Development of Peer Attachment Based on Parental Attachment, and Collaborative Impacts on Mental Health among Japanese Youth

This study aimed at confirming the factor structure of the Japanese version of Inventory of Parent and Peer Attachment (IPPA) for peers. Furthermore, it examined whether or not peer attachment is significantly influenced by father and/or mother attachment, and to see whether father and mother attachment affects mental health directly and/or indirectly via peer attachment for each gender among Japanese youth. The targets of this study were 433 (men: 149, women: 284) Japanese college students who completed every item of the Japanese version of father, mother, and peer IPPAs, as well as Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM) to evaluate their mental health. Confirmatory Factor Analysis (CFA) was conducted to confirm the factor structure of the Japanese version of peer IPPA. Structural Equation Modelling (SEM) was utilized to see whether or not peer attachment is significantly influenced by father and/or mother attachment, and whether or not peer attachment mediates between parental IPPA and mental health. A bi-factor model, constituted by one general factor and three specific factors forming the original IPPA developed by Armsden &amp; Greenberg (1989), was supported by excluding one item from the specific factor Alienation. SEM revealed that the mental health of both male and female respondents was significantly influenced by peer attachment. Among males, its platform was built by attachment only to the father, whereas among females, it was built by both father and mother attachment.

Exploring relationships between parental stress, coping, and psychological outcomes for parents of infants with CHD.

This study aimed to explore relationships between parental stress, coping, and outcomes for parents of infants with CHD, via observational approach reflecting domains of the Parental Stress and Resilience in CHD (PSRCHD) model. Fifty-five parents of 45 infants with CHD completed questionnaires with measures of parental stress, Problem-Focused Coping (PFC), Emotion-Focused Coping (EFC), Avoidant Coping (AC), mental health (symptoms of anxiety and symptoms of depression), post-traumatic growth (PTG) and quality of life (QoL). Demographic and infant clinical data were obtained. Parental stress showed significant small to medium positive correlations with MH and PTG, but no significant correlations with QoL. EFC and AC showed significant small to medium positive correlations with MH, and medium negative correlations with parental QoL. EFC and PFC had significant small to medium correlations with PTG. PFC and AC had significant small to medium correlations with infant QoL. Hierarchical multiple regression analyses indicated that parental symptoms of anxiety, PTG, parental QoL, infant QoL were significantly predicted by models comprising of parental stress, coping styles, and clinical controls (adjusted R2 = 13.0-47.9%, p range < 0.001-.048), with results for parental symptoms of depression falling marginally above significance (adjusted R2 = 12.3%, p = .056). Parental stress, coping styles, and length of hospital stay are related to psychological outcomes in parents of infants with CHD. Future research may use the PSRCHD framework to assess mechanisms underlying CHD parents' stress and coping experiences and investigate longitudinal relationships between parental factors and parent and child outcomes.

Exploring Parents' Experiences and Needs During Disclosure of a Cerebral Palsy Diagnosis of Their Young Child: A Scoping Review.

Parents often perceive the news that their child has cerebral palsy (CP) as overwhelming and shocking. They are at increased risk of parental stress and mental health problems, which in turn can affect the interaction between the parent and the child. Parental mental health outcomes are known to be affected by the process of disclosure of a diagnosis. In this study, we aimed to synthesize the current knowledge about parents' experiences and needs regarding communication during the disclosure of the diagnosis of their child with (or at risk of) CP. A scoping review following the methodological steps outlined by the Joanna Briggs Institute was performed using PubMed, Embase, CINAHL and PsycINFO. We qualitatively explored parent-reported experiences and needs across included studies, using thematic analysis. A total of 19 studies were included. Six themes were identified, three in relation to experiences (i.e., preceding experiences and feelings, perceptions of the disclosure and emotional impact) and three in relation to needs (i.e., transparency in information, supportive attitude and having a say). Despite high variability across studies regarding parental needs, most studies reported the need for (i) honest and clear information, (ii) good communication skills amongst professionals and (iii) emotional and practical support after diagnosis. Our findings suggest that parents' experiences and needs in the period when their child's diagnosis of (high risk of) CP is communicated are highly variable, due to an interplay of personal and contextual factors. To facilitate good communication during disclosure, it is crucial that health care professionals assess and understand this complex process and consider parents' needs for open communication and autonomy in the process. Therefore, professionals need to attune to parents' needs and their individual preferences regarding conversations about their child with (or at risk of) CP.

Psychometric properties of the Parenting Stress Index-Short Form in a Peruvian sample

BackgroundThe stress experienced by parents in fulfilling their parental role has consequences for couple dynamics, parent–child interactions, and the mental health of parents. However, studies on the psychometric properties of the PSI-SF, particularly among Latin American parents, are scarce. Therefore, this study aims to evaluate the psychometric properties of the Spanish version of the Parenting Stress Index-Short Form (PSI-SF).MethodsThe participants were Peruvian mothers and fathers with children in early childhood and primary education, with a mean age of 34.4 years (SD = 6.8). The sample was obtained in two phases: 130 participants for the Exploratory Factor Analysis (EFA) and 791 participants for the Confirmatory Factor Analysis (CFA).ResultsThe study results show a modified three-factor structure of the PSI-SF scale, with adequate fit indices (GFI = .99, AGFI = .99, SRMR = .024, CFI = .98, TLI = .98, RMSEA = .074) and loadings above 0.40. Additionally, the three factors of the scale demonstrated high reliability, with Cronbach's alpha and McDonald's omega values for Parental Distress (α = .94; ω = .95), Parent–Child Dysfunctional Interaction (α = .97; ω = .97), and Difficult Child (α = .94; ω = .94). The scale was also found to be invariant with respect to gender.ConclusionIn conclusion, the study results suggest that the modified PSI-SF has adequate psychometric properties and is invariant for assessing parental stress in Peruvian fathers and mothers with children in early childhood and primary education.

Validation of the Dutch Infant Crying and Parent Well-Being Screening Tool in Parents of Infants Less than 12 Months of Age

To evaluate reliability and validity of the Dutch version of the Infant Crying and Parent Well-Being (ICPW) tool in identifying parents struggling with infant crying in the first year of life. The original ICPW tool was translated into Dutch following established guidelines. The internal consistency and criterion validity of the Dutch ICPW tool were evaluated using a cross-sectional design. The translated ICPW tool and validated questionnaires on parental depression, stress, anxiety, and parenting balance were presented to parents of infants under 12months during child health care visits and online. The survey was completed by 488 parents, 400 mothers and 88 fathers. Of these, 172 participated after a child health care visit and 316 via online platforms. The Dutch ICPW showed satisfactory internal consistency (α=0.69) and excellent criterion validity with parental mental health measures (r=0.53-0.85). ICPW scores demonstrated positive correlations with parental depression, stress, and anxiety levels, and a negative correlation with parenting balance. Both mothers and fathers with a positive ICPW screen (≥3) reported significantly higher levels of parental mental health issues compared with those with a negative screen (P<.001). The ICPW was positive in 32% of the parents (n=155), with consistent total scores regardless of the infant's increasing age (r=-0.024, P=.59). The ICPW tool exhibited a strong negative predictive value (93%) for diagnosing postpartum depression. The Dutch ICPW tool is a reliable and valid screening instrument for identifying parents struggling with infant crying.

Research Note: The Association Between Parity and Odds of Alzheimer's Disease and Dementias Status.

While parity is a significant factor influencing parental health, its relationship with dementia remains underexplored. This research note advances the literature by conducting a well-powered analysis of associations between parity (i.e., number of children) and Alzheimer's disease and dementias (AD/D) status in large-scale population data. The data contain a large number of AD/D cases (37,228 women and 19,846 men), allowing a range (1-10) of parity associations to be estimated precisely. Using proxy (adult child's) reports of parental AD/D status, we find that both fathers and mothers with grand multiparity have decreased odds of AD/D status, and the effect sizes become larger as parity increases, with 30-40% reduction in AD/D status at parities above 7. The association is stronger for mothers than for fathers. This finding differs from much of the prior literature and likely suggests the impact of parity, as one of the important life course contexts, on people's cognitive function and risk of having AD/D. Finally, we include population projections that consider how large changes in parity distributions over time may contribute to small elevations in AD/D rates.

Psychological distress in the neonatal intensive care unit: a meta-review.

Parental psychological distress (PD) (anxiety, depression, stress and post-traumatic stress syndrome) can adversely affect parents' own physical and mental health as well as their children's long-term health and development. Numerous studies have addressed PD in mothers of infants admitted to NICU, with interventions proposed, but few have addressed the impact on fathers or other family members. The present review examined systematic reviews that addressed PD in NICU and potential interventions. A meta-review was performed by searching various databases between 2000 and May 2024. Fifty-four studies were included. The incidence of maternal PD varied depending on the screening tool used (13-93%), as did paternal PD (0.08-46%). The incidence of PD in sexual, racial and gender minorities, siblings, grandparents and those in lower-middle income countries is not known. Numerous screening tools were used with a wide variety of cut-off values. Various intervention programmes were evaluated and showed contradictory evidence regarding their effect on PD. Routine screening should be implemented together with acombination of interventional programmes, specifically family-centred interventions. More research is required for PD in siblings, sexual and genderminority parents as well as parents living in low middle income countries. Psychological distress is high in NICU, affecting parents and siblings. Maternal psychological distress may have long lasting effects on infant health and differs from that of fathers, who require as much attention as mothers Little is known about emotional stress in siblings and sex and gender minority group peoples Few interventions showed conclusive effectiveness in reducing psychological distress with combination interventions showing more effectiveness than single interventions.

Non-communicable diseases: Opportunities to promote future health during the first 1000 day of life

The Developmental Origins of Health and Disease (DOHaD) framework now underlies the evolution and epigenetics of many non-communicable diseases that develop in adult life. Type 2 diabetes, obesity, hypertension, heart disease and stroke in particular have links back to events during the first 1000 days of life, and as the world is witnessing an epidemic of these conditions, identifying measures able to contribute to reducing the potential for these NCDs to develop in our aging populations becomes all the more important. Parental health at conception and good maternal health and nutrition throughout pregnancy are known to be integral to normal infant development and health in later life, but more recently the central importance of infant nutrition that achieves healthy weight gain has become recognized. In this context, achieving growth patterns for infants that avoid either the onset of obesity or development of stunting during the first 1000 days of life appears to be an achievable goal with significant potential for the avoidance of many NCDs in later life. Hence the relevance of health promotion initiatives to share this knowledge among health care providers and educate parents on the benefits of optimal infant nutrition.

Parenting strategies to support adolescent mental health during a pandemic: A Delphi consensus study

BackgroundThe COVID-19 pandemic has had ongoing detrimental effects on mental health, especially for young people. Parents can play a crucial role in the prevention of youth depression and anxiety disorders. While parenting guidelines for reducing the risk of adolescent depression and anxiety have been developed, they needed to be adapted for the unique challenges brought by a pandemic. MethodThis study employed the Delphi methodology to establish expert consensus on parenting strategies that are important for preventing adolescent depression or anxiety disorders during a pandemic. Through a literature search and panel recommendations, we identified 304 parenting recommendations. These were presented to an international panel of 35 experts in parenting and youth mental health, who rated the importance of these recommendations in preventing adolescent depression and anxiety over three survey rounds. ResultsThere were 167 parenting strategies endorsed as important or essential in reducing adolescents' risk of developing depression or anxiety disorders during a pandemic by ≥90% of the panel. These strategies were written into a set of specific and actionable guidelines for parenting through the pandemic, and made freely available online for parents. ConclusionsThis study adapted an original set of parenting guidelines for the COVID-19 pandemic, supported by research evidence and/or international experts, which can be promoted in Western English-speaking communities to help parents protect their adolescents from depression and anxiety disorders during pandemic and post-pandemic times.

MHealth Service Effects for Negative Emotions Among Parents of Preterm Infants: A Systematic Review and Meta-Analysis.

This review aims to ascertain the effects of mHealth on negative emotions among parents of preterm infants and analyze the current state of mHealth services in this context. Caring for preterm infants often engenders negative emotions in parents, such as anxiety, depression, and stress. Mobile Health (mHealth) services offer potential benefits for preterm infant care. However, there are several uncertainties regarding the impact of mHealth services on parental emotions. Randomized controlled trial (RCT) and quasi-RCT were published in English and Chinese until 2023 and are available in the electronic databases of MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINHAHL), Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang Database, and China Science and Technology Journal Database were reviewed. Review Manager 5.4 was employed for random-effects meta-analysis. Seven RCTs and 6 quasi-RCTs with high risks were included, most of them were based on small sample size and single-centered. Meta-analysis demonstrated that mHealth interventions mitigated negative emotions, including anxiety (standard mean difference [SMD]=-1.07; 95% confidence interval [CI], -1.47 to -0.66; P<0.0001), depression (SMD=-1.94; 95% CI, -3.01 to -0.86; P<0.0001), and stress (SMD=-1.24; 95% CI, -2.07 to -0.40; P<0.0001), among parents of preterm infants. It is recommended to develop independent specialized software for mHealth, enhance theoretical underpinnings, and standardize practical protocols. Incorporating early recognition and screening of negative emotions within mHealth could offer comprehensive support for the mental health of parents with preterm infants. The mHealth-based interventions are needed to focus on the parents' emotional needs and minimize the impacts associated with mental stress.

Longitudinal pathways between parent depression and child mental health in families of autistic children

Abstract Autistic children and their parents are at risk for mental health problems, but the processes driving these connections are unknown. Leveraging three data cycles (spaced M = 11.76 months, SD = 2.77) on 162 families with autistic children (aged 6–13 years), the associations between parent–child relationship quality (warmth and criticism), child mental health problems, and parent depression symptoms were examined. A complete longitudinal mediation model was conducted using structural equation modeling. Father depression mediated the link between child mental health problems and father critical comments (β = −0.017, p = 0.018; CI [−.023 – −.015]). Father report of child mental health problems mediated the association between father depression and father critical comments (β = 0.016, p = 0.040; CI [0.003–0.023]) as well as the association between father positive remarks and father depression (β = −0.009, p = 0.032; CI [−0.010 – −0.009]). Additionally, father positive remarks mediated the connection between father depression and child mental health problems (β = 0.022, p = 0.006; CI [0.019–0.034]). No mediation effects were present for mothers. Findings highlight that the mental health of parents and autistic children are intertwined. Interventions that improve the parent–child relationship may reduce the reciprocal toll of parent and child mental health problems.

Parental Health Literacy and Acute Care Utilization in Children With Medical Complexity.

Health literacy is the ability to find, understand, and use information and services to inform health-related decisions and actions. Inadequate health literacy is associated with health disparities, poor health outcomes, and increased emergency department (ED) visits and hospitalizations. Children with medical complexity (CMC) have high rates of acute health care utilization. We examined the association of parental health literacy with acute care utilization and costs in CMC. This cross-sectional study included parents of CMC receiving primary care at a free-standing children's hospital. We measured parental health literacy using the Single Item Literacy Screener, which measures the assistance needed to read health care materials. Our main predictor was parental health literacy, categorized as adequate versus inadequate. In a sensitivity analysis, we categorized health literacy as never needing assistance versus needing any assistance. Main outcomes were annual ED visits, hospitalizations, and associated costs. Of the 236 parents of CMC, 5.5% had inadequate health literacy. Health literacy was not associated with acute care utilization or associated costs. In our sensitivity analysis, CMC whose parents need any assistance to read health care materials had 188% higher ED costs (adjusted rate ratio 2.88 [95% confidence interval: 1.63-5.07]) and 126% higher hospitalization costs (adjusted rate ratio 2.26 [95% confidence interval: 1.49-3.44]), compared with CMC whose parents never need assistance. Inadequate parental health literacy was not associated with acute care utilization. However, CMC of parents needing any assistance to read health materials had higher ED and hospitalization costs. Further multicenter studies are needed.

The Association Between Parenting Stress and Parenting Behaviors in Chinese Parents of Children with Autism Spectrum Disorders: The Mediating Role of Parental Anxiety and Depression

ABSTRACT Background Parents of children with autism spectrum disorders (ASD) experience heightened levels of parenting stress and more affective symptoms. Although the relationship between parenting stress and mental health has been extensively studied, limited understanding exists regarding parenting behaviors and related factors. This study aimed to explore the role of parents’ affective symptoms in the relationship between parenting stress and parenting behaviors among Chinese parents of children with ASD. Methods A total of 185 parents participated in one online survey, reporting parenting behaviors, parenting stress, depression and anxiety symptoms. Results (1) A higher level of parenting stress was associated with reduced positive parenting behaviors and increased negative parenting behaviors. (2). Parents’ anxiety and depression symptoms mediated the relationship between parenting stress and positive parenting behaviors. Conclusion Parenting stress has potential detrimental effects on parenting behaviors in Chinese parents of children with ASD through the mediation of parental depression and anxiety.

Unveiling the silent struggle: navigating the labyrinth of mental health for parents of children with life-threatening illnesses in Pakistan.

Dear Editor, We write this letter to highlight the scarcely recognised complexity associated with the unrecognised mental health needs of parents of children diagnosed with life-threatening or life-limiting illnesses. It has been widely established that parents of children with disabilities are at an increased risk of developing variants of mental diseases when compared to parents of children without such disabilities. Parents tend to alter their lives socially to acclimatize themselves as caregivers for their children, therefore adopting a role that becomes far more labyrinthine as both parent and caregiver. (1) Mental health in general, is a subject that is insufficiently addressed in societal and scholarly contexts, specifically in Pakistan, particularly among parents. Within the scope of parents acting as sole caregivers, stress is a prominent determinant contributing to their mental health. Stress can attenuate parents’ and children’s abilities to navigate these circumstances and diminish their capacity for problem-solving and coping. (2) There are a myriad of factors that contribute to the reported prevalence of mental health-related disorders among parents of children with disabilities. Mental health remains a stigmatised entity. Such disregard impedes the delivery of healthcare towards patients suffering from mental health illnesses. There is a noteworthy hindrance in individuals facing such factors when amalgamatinge into society. When considering parental figures of diseased children, this facet serves to isolate further and reinforce such mental health illnesses. The lack of quantifiable data on anti-stigma interventions in Low and Middle-Income Countries, including Pakistan, underscores the urgent need for research. (3) Parents of children admitted to the ICU have a near-pervasive struggle with mental health and an innate inability to disclose their requirements for support. Factors barricading such disclosure should be identified and broken down through interventions, facilitating access to vital mental health support. (4) Caregivers must establish coping strategies, and remain a steady pillar of support and comfort to their child. The Keeping Hope Alive Toolkit intervention was established, which worked on fostering emotional experiences, living in the moment, remembering self and supporting social preferences, this intervention provided a template for emotional support. (5) We hope this letter can underscore how important supporting parental disclosure of unmet mental health needs is – a rampant and insufficiently reported plight in Pakistan. The ability to recognise these emotions and rectify them is not highlighted in this region but is imperative to implement, to improve the provision of healthcare to diseased children and their parents alike.

Parental psychopathology and offspring anxiety disorders in childhood and adolescence: A Finnish nationwide register study

BackgroundResearch suggests an association between parental psychiatric disorders and offspring anxiety disorders, yet comprehensive studies are limited. This study aims to investigate the associations between various parental psychiatric disorders and anxiety disorders in their offspring. MethodUsing Finnish register data, this nested case-control study analyzed 867,175 singleton live births from 1992 to 2006, identifying 21,671 cases of anxiety disorders diagnosed between 1998 and 2016. Matched with four controls each (n = 72,414) based on age and biological sex, the study adjusted for demographic and prenatal factors using conditional logistic regression models to calculate odds ratios (aORs). ResultsThere was a significant association between parental psychiatric disorders and increased risk of anxiety disorders in offspring. The risk was notably higher when both parents had psychiatric disorders (aOR = 5.04; 95 % CI, 4.70‐5.39; p < .001). Maternal psychiatric disorders were strongly associated with offspring anxiety than paternal disorders (aOR 1.52; 95 % CI 1.43–1.61; p < .001). This association was consistent regardless of timing of parental diagnosis. Significant associations were observed between any parental psychiatric disorder and increased risks in offspring for specific phobia, social phobia, generalized anxiety disorder, separation anxiety, and panic disorder. Maternal psychiatric disorders showed elevated risk for panic disorder and social phobia among girls and separation anxiety and generalized anxiety among boys. ConclusionThe findings emphasize the significant impact of parental psychiatric health on offspring anxiety disorders, highlighting the influence of genetic and environmental factors. Addressing parental mental health is crucial in preventing childhood anxiety disorders.

Psychological burden of hearing-impaired children and their parents through the COVID-19 pandemic.

Childhood hearing impairment has potential repercussions on the mental well-being of both children and their parents. As a vulnerable population in accessing health care services, they may face specific challenges, especially during the COVID-19 pandemic. This cross-sectional study aims to investigate the association between childhood hearing impairment and the mental health of children and their parents, and to assess health care utilization of hearing-impaired children and its impact on mental outcomes for both during the COVID-19 pandemic. Using the National Health Interview Survey (NHIS) database, we analyzed data for 15,989 children aged 5-17 and their corresponding parents. The correlations between childhood hearing impairment and mental outcomes were examined using logistic regression models. The 2020 (quarter 3 and quarter 4)-2021 NHIS data was singled out and re-analyzed, focusing on the utilization of medical care during the COVID-19 pandemic. After accounting for covariates, hearing-impaired children exhibited a higher frequency of anxiety (OR 2.33, 95% CI 1.79-3.02) or depression (OR 2.14, 95% CI 1.59-2.88). Parents of hearing-impaired children had significantly higher odds of a higher frequency of anxiety (OR 1.55, 95% CI 1.20-2.01) or depression (OR 1.73, 95% CI 1.30-2.29). Interaction effect of hearing impairment with survey year on parents' mental health outcomes was observed (p for interaction <0.1). Children with hearing loss had higher odds of reporting delayed medical care (OR 2.00, 95% CI 1.11-3.59) or canceled medical care (OR 1.96, 95% CI 0.98-3.96, p = 0.059) due to the pandemic. Delayed medical care (OR 12.41, 95% CI 2.78-55.46) or canceled medical care (OR 6.26, 95% CI 1.28-30.75) due to the COVID-19 pandemic significantly contributed to the increase of anxiety frequency in hearing-impaired children. Childhood hearing impairment exhibits a substantial impact on children's and parental mental health, which is further exacerbated by the COVID-19 pandemic. Families of hearing-impaired children appear to be in a vulnerable position during public health emergencies such as the COVID-19 pandemic, which can further exacerbate their mental outcomes.

The Impact of Children's Health Shocks on Parents' Labor Earnings and Mental Health

Abstract We provide novel evidence on the causal impact of a child's health shock on parents' labor market outcomes. Using high-quality Finnish and Norwegian administrative data, we construct counterfactuals for treated households with families who experience the same shock in later years. We find a sharp break in mothers' earnings trajectories after the event, while we do not find significant effects for fathers. Our findings do not align with the hypothesis of household specialization explaining these adjustments. Instead, the evidence suggests that these changes are driven by increased caregiving demands, with mothers bearing the primary burden. We also document a substantial impact on parents' mental well-being.

Posttraumatic stress symptoms in parents of children with newly diagnosed cancer: 1-year trajectories and relationship variables as predictors.

The way in which parental posttraumatic stress symptoms (PTSS) unfold in the first year after a cancer diagnosis in their child is poorly understood. The aims of this study were to identify parental PTSS trajectories and to examine couple-related predictors (dyadic coping and we-disease appraisals), sociodemographic predictors (education and sex), and medical predictors (child's physical impairment) of trajectory membership. A 1-year prospective study was conducted, and 157 parents of children newly diagnosed with cancer were assessed. PTSS was measured with the Posttraumatic Diagnostic Scale for DSM-5 (PDS-5) at 3-6 weeks (T1), 6 months (T2), and 12 months (T3) after the diagnosis. The trajectories were identified with Latent Class Growth Analysis, the predictors were explored with binomial logistic regression. Two distinct trajectories were found. The majority of parents (86.0%) followed a low PTSS trajectory, characterized by initially low scores that slightly decreased over 12 months. In contrast, 14.0% of parents displayed a stable, high PTSS trajectory. A high trajectory of child's physical impairment and low scores in parental dyadic coping were significantly associated with the likelihood of a high parental PTSS trajectory. The findings provide new insights into the critical period of the first year after a child's cancer diagnosis. While most parents display a resilient, low PTSS trajectory, a minority consistently experience high PTSS levels. Child's physical impairment and dyadic coping should be considered as predictors for early identification of vulnerable parents. Incorporating dyadic coping in parental support following a childhood cancer diagnosis could be beneficial for parental mental health.

The effect of parental health shocks on living arrangements and employment.

This study investigates the impacts of health shocks among older individuals on the dynamics of their living arrangements in Europe and the United States. Exploiting unpredicted health shocks, we use an event-study difference-in-differences approach to demonstrate that health shocks increase difficulties with activities of daily living and instrumental activities of daily living, thereby increasing the need for care. Our findings indicate that health shocks raise the probability of nursing home residency and co-residence with adult children by 0.7 and 1.4 percentage points in Europe, and by 2.1 and 1.8 percentage points in the U.S., respectively. Further analyses reveal that more generous long-term care public policies correlate with a higher probability of nursing home residency and a lower probability of co-residing with adult children, highlighting the significant role of public policies in household responses to health shocks. Additionally, we find that health shocks negatively impact adult children's labor supply, particularly in the U.S.