Levels Of Family Stress Research Articles

Just the Two of Us? How Parents Influence Adult Children's Marital Quality

We work from a life-course perspective to explore how relationships with parents affect adult children's marital quality. We further ask whether the effects of parents on adult children's marital quality depend on the adult child's gender, age, marital duration, and childhood family experiences. Growth-curve analysis of national, longitudinal data (Americans' Changing Lives) indicated that relationships with fathers (n = 336) and mothers (n = 520) differentially affected the marital quality of adult children over time. Findings suggest that the effects of the parent - adult child relationship on adult children's marriages depend on age, marital duration, and levels of family stress experienced in childhood.

Perceived family stress, parenting efficacy, and child externalizing behaviors in second-generation immigrant mothers

Examining family stress and parenting efficacy in relation to child externalizing problems in immigrant families. In this study, we compared the levels of family stress, parenting efficacy, and toddler externalizing behaviors in Dutch (n = 175) and second-generation Turkish immigrant families (n = 175) living in the Netherlands. In addition, the influence of Turkish mothers' acculturation on toddler externalizing behaviors and its association with perceived stress and efficacy were examined. Turkish mothers reported higher levels of daily stress and marital discord than Dutch mothers, but did not differ in perceptions of parenting efficacy and children's externalizing behaviors. The associations between child and family variables were similar in the Dutch and the Turkish groups, as more family stress was related to more externalizing behaviors in toddlers. Low parenting efficacy was the most important predictor of child externalizing behaviors in both groups. Acculturation of Turkish mothers was not associated with family and child variables, and did not moderate the association between family variables and child externalizing behaviors. However, emotional connectedness to the Turkish culture was related to less daily stress and fewer marital problems. The results support the no-group differences hypothesis and also imply that cultural maintenance may be adaptive for parental well-being.

Family intervention for co-occurring substance use and severe psychiatric disorders: Participant characteristics and correlates of initial engagement and more extended exposure in a randomized controlled trial

Clients with severe mental illness and substance use disorder (i.e., dual disorders) frequently have contact with family members, who may provide valuable emotional and material support, but have limited skills and knowledge to promote recovery. Furthermore, high levels of family conflict and stress are related to higher rates of relapse. The present study was a two-site randomized controlled trial comparing a comprehensive, behaviorally-based family intervention for dual disorders program (FIDD) to a shorter-term family psychoeducational program (FPE). The modal family was a single male son in his early 30s diagnosed with both alcohol and drug problems and a schizophrenia-spectrum disorder participating with his middle-aged mother, with whom he lived. Initial engagement rates following consent to participate in the study and the family intervention programs were moderately high for both programs (88% and 84%, respectively), but rates of longer term retention and exposure to the core elements of each treatment model were lower (61% and 55%, respectively). Characteristics of the relatives were the strongest predictors of successful initial engagement in the family programs with the most important predictor being relatives who reported higher levels of benefit related to the relationship with the client. Subsequent successful exposure to the family treatment models was more strongly associated with client factors, including less severity of drug abuse and male client gender. The results suggest that attention to issues of motivating relatives to participate in family intervention, and more focused efforts to address the disruptive effects of drug abuse on the family could improve rates of engagement and retention in family programs for dual disorders.

Double-Exposure to Acute Stress and Chronic Family Stress is Associated With Immune Changes in Children With Asthma

To understand how psychological stress heightens risk for asthma flare-ups, we examined the relationship between acute stress, chronic family stress, and the production of asthma-related cytokines. Seventy-one children with asthma and 76 medically healthy children completed interviews regarding life stress, and peripheral blood samples were collected. After mononuclear cells had been mitogenically stimulated, production of the cytokines interleukin (IL)-4, IL-5, IL-13, and IFN-gamma was measured. All measurements were repeated every 6 months for 2 years. Children reported on their asthma symptoms for 14 days after each study visit. Children with asthma who had higher levels of chronic family stress showed increased production of IL-4, IL-5, and IFN-gamma at times when they had experienced an acute event compared with times when they had not. These stress-related changes did not occur in asthmatic children with lower levels of chronic family stress, or in healthy controls. The combination of acute and chronic stress was also associated with increased asthma symptoms. These findings suggest that acute negative life events have a particularly strong impact among a subgroup of children with asthma who are under high chronic family stress. The heightened inflammatory profile in this group suggests an explanation for why children experiencing life stressors are at greater risk for asthma exacerbations.

Language Brokering Contexts and Behavioral and Emotional Adjustment Among Latino Parents and Adolescents

This study examined behavioral and emotional adjustment in family contexts in which there was high versus low demand for adolescents to serve as language brokers in a sample of 73 recently immigrated Latino families with middle-school-aged adolescents. Language brokering was conceptualized as a family process rather than merely an individual phenomenon. Multiple agents were used to assess language brokering and parent and youth adjustment. Results indicated that high language brokering contexts had negative associations with family stress, parenting effectiveness, and adolescent adjustment in terms of academic functioning, socioemotional health, and substance use. The findings are particularly important given the limited and mixed findings from formative research on language brokering, particularly in areas within the United States with emerging immigrant populations. Findings suggest the need for advancing practices that increase language and cultural supports for immigrant families and support parents' efforts to foster positive youth and family adjustment.

The Nature and Predictors of Undercontrolled and Internalizing Problem Trajectories Across Early Childhood

Using growth curve modeling, trajectories of undercontrolled (oppositional, irritable, inattentive and overactive behaviors) and internalizing (worried, sad and fearful) problems from 18 months to 4.5 years were studied in a population based sample of 921 Norwegian children. At the population level, undercontrolled problems decreased and internalizing problems increased with increasing age. Child temperament and family factors present at 18 months predicted 43% of the stability and 20% of the linear changes in undercontrolled problems and 30% of the stability and 7% of the linear changes in internalizing problems. Persisting effects of child and family factors from 18 month were found on the two problem dimensions over and above the impact of changes in the same risk factors. Lower initial level of partner support and higher initial level of child emotionality predicted higher slope of undercontrolled problems and higher initial level of family stress predicted higher slope for internalizing problems. As expected, time to time change (t1 to t2 and t2 to t3) in risk factors predicted time to time change in problem scores as well. The study shows the significance of early emerging internalizing and undercontrolled problems, the need to consider their pathways separately from very young ages, lasting effects of early experiences, and the importance of a dynamic approach to the analysis of risk.

Family-level Coparenting Processes and Child Gender as Moderators of Family Stress and Toddler Adjustment.

The goal of this multi-method study was to examine how child gender and coparenting processes influence associations between family stress and toddlers' social adjustment. The participants, 104 dual-earner couples and their 2-year-old children, were videotaped in their home during a freeplay activity. Mothers and fathers completed questionnaires about stress in their roles as partners, workers, and parents and their child's social-emotional adjustment. Consistent with previous research, higher levels of family stress were associated with poorer adjustment for children. Family harmony, represented by warmth and cooperation, was significantly associated with fewer internalizing problems for children even when family stress was considered. Conversely, coparental banter or 'playful humour' between parents moderated the nature of the association between family stress and children's adjustment. Banter between parents was especially protective for girls suggesting that, even in families with toddler-aged children, gender plays an important role in family-level coparenting processes. Future research needs to consider more fully the impact that child characteristics, such as gender, have on the interplay between the family context and children's development.

Adolescent development and family functioning in youth with spina bifida

The purpose of this article is to review research concerning adolescent development and family functioning among youth with spina bifida myelomeningocele (SBM). Adolescence is a developmental period characterized by substantial changes in biological, psychological, and social functioning, as well as transformation and reorganization within the family system. A biopsychosocial-contextual model of development was utilized to describe the interface between normative adolescent development and the experience of a chronic health condition among youth with SBM. Major empirical findings relevant to family functioning in adolescents with SBM are presented, including the family environment, parenting behaviors, and marital and parental functioning. There is variability with regards to the influence of SBM on the family system and research identifies both disruption and resilience in families. Current research suggests that families of youth with SBM may have higher levels of family stress, difficulties with family roles, lower levels of cohesion, less adaptive parental control and overprotection, and a greater risk for child and parental psychosocial adjustment difficulties. The review concludes with a discussion of the clinical implications of these findings for the care of youth with SBM and directions for future research.

Stress, Mental Health, and Job Performance among Active Duty Military Personnel: Findings from the 2002 Department of Defense Health-Related Behaviors Survey

This study examined the extent to which high levels of occupational and family stress were associated with mental health problems and productivity loss among active duty military personnel. We analyzed data from the 2002 Department of Defense Survey of Health-Related Behaviors among Military Personnel, which provided extensive population-based information on 12,756 active duty personnel in all branches of the military worldwide. Military personnel reported higher levels of stress at work than in their family life. The personnel reporting the highest levels of occupational stress were those 25 or younger, those who were married with spouses not present, and women. Personnel with high levels of stress had significantly higher rates of mental health problems and productivity loss than those with less stress. We recommend that prevention and intervention efforts geared toward personnel reporting the highest levels of stress be given priority for resources in this population.

Blood pressure levels and psychosocial stress in students of health sciences. University of Valle, Cali, Colombia, 2003-2004.

Objective: To evaluate the levels of family stress, social stress and the blood pressure levels in young people and the possible correlation. Materials and methods: A descriptive study was performed recruiting healthy students of health sciences in the University of Valle in Cali, Colombia during 2002-2003. The psychosocial stress inventory included evaluation of the family stress and the evaluation of social stress. The blood pressure was evaluated by physicians using standardized technique with calibrated manual sphygmomanometers. Results: 185 students were recruited with an average age of 21.2±2.6 years old, 178 (96%) were singles, 100 (54%) were women, 173 (93.5%) were of mixed ethnic background, 154 (83.2%) were from middle socioeconomic level (level 3-4). The family dysfunction was observed in 131 (70.8%) students, 66 (35.6%) had high cumulative social changes. The average blood pressure level in all students was normal (106.4/69.7) with high blood pressure levels in males than in females (p< 0.001) associated with the body mass index (p< 0.001) and the black race ( p< 0.02). Family dysfunction was not associated with changes in blood pressure (p=0.80). Social stress was not associated with blood pressure levels (p=0.98). Conclusion: In young people psychosocial stress was high but did not affect blood pressure levels probably due to compensatory physiologic action of vascular endothelium.

Evaluation of Visiting Nursing Care Using Geographical Information System(GIS) Technology

Previous evaluation studies of the visiting nursing program explained an average change of the participants' health status, without considering socio-ecological characteristics and their impacts. However, these factors must affect individual health problems and lifestyles. For effective and appropriate community based programs, the Geographical Information System (GIS) can be utilized. GIS is a computer-based tool for mapping and analyzing things that happen on earth, and integrates statistical analysis with unique visualization. The purpose of this study was to evaluate visiting nursing care and to advocate the usefulness of planning and evaluating visiting nursing programs using Exploratory Spatial Data Analysis (ESDA) with GIS technology. One hundred eighty-four elderly participants with cerebrovascular risk factors who lived in 13 areas of one community received visiting nursing care. The data analyzed characteristics of pre-post change and autocorrelation by ESDA using GIS technology. Visiting nursing care showed an improvement in the participants' lifestyle habits, and family management ability and stress level, while the improvements were different depending on the regions. The change of family management ability and stress level correlated with neighborhoods (Morgan's I= 0.1841, 0.1675). Community health providers need to consider the individual participant's health status as well as socio-ecological factors. Analysis using GIS technology will contribute to the effective monitoring, evaluation and design of a visiting nursing program.

Freshmen adaptation to university life: Depressive symptoms, stress, and coping

Attending a university for the first time can be a stressful experience for many new college students. This study examines the relationships among femininity and masculinity, depressive symptomatology, levels of stress, and the types of coping strategies used by college freshmen. Results of this study suggest that these variables were related uniquely for first-year college students. Masculinity and femininity significantly predicted problem-focused coping, and femininity significantly predicted emotion-focused coping. Further, the levels of family and college stress reported by college students, as well as their endorsement of avoidant coping, significantly predicted their levels of depressive symptoms. Overall, the results of this study suggest that understanding the relationships among the gender role, the levels of depressive symptomatology, and the levels of stress exhibited by college freshmen may be important in facilitating their transition and adjustment to university life.

Predictors of stress in mothers and fathers of children with fragile X syndrome

This study examined parental and family stress and functioning where there is a child with fragile X syndrome. Mothers and fathers in 40 families were asked about their child with fragile X syndrome, family supports, their psychological stress, the marital relationship, and their family stress. Results indicate parents were well adjusted in terms of their levels of psychological stress and in their marital relationships, however, parents reported high levels of family stress. Mothers and fathers were found to experience similar levels of stress and to report similar levels of satisfaction with supports. Stress was predicted by different variables in mothers and fathers, suggesting that different processes underlie their experiences. The strongest predictor of maternal stress was the level of marital satisfaction while the strongest predictor of paternal stress was the level of the child's adaptive skills.

Multiple behavioral risk factors among adolescent survivors of childhood cancer in the Survivor Health and Resilience Education (SHARE) Program

Health-compromising behaviors among survivors of childhood cancer may increase their risks of cancer recurrence and the onset of chronic disease in adulthood. Regardless of whether such behaviors occur singly or in combination with one another, multiple behavioral risk factors must be identified and addressed early to promote better health outcomes within this special population. Adolescent survivors may be especially vulnerable, as reported rates of smoking and other risky behaviors are at or near levels of their healthy peers. The psychological literature suggests stress may play a role in risk behavior initiation and maintenance, including multiple behavioral risks, and that adolescent survivors are stress-prone. This report focuses on the prevalence and co-occurrence of three behavioral risk factors (cigarette use, insufficient physical activity, and non-adherence to sun protection recommendations) and describes stress-health behavior relationships in this special population. All patients in this study (n = 75) were adolescent survivors of childhood cancer and completed a baseline assessment of their health behaviors and stress as part of a randomized controlled trial of health promotion. Twenty-eight percent of the patients reported one of three risk factors, 12% reported two of three risk factors, and 7% reported all three risk factors. Non-adherence to sun protection was the single most common risk factor; physical inactivity and non-adherent sun protection were the most common co-occurring risk factors. Greater age and stress were significantly associated with the presence of more behavioral risk factors. The evidence suggests interventions to reduce multiple health-compromising behaviors in these patients are warranted, and that efforts to address these patients' personal and family stress levels are important as well.

Mental health and lifestyle correlates of sexual problems and sexual satisfaction in heterosexual Hong Kong Chinese population

ObjectivesTo examine the lifestyle, mental health, and stress-related factors associated with various types of sexual problems among sexually active, heterosexual Hong Kong residents aged 18 to 59 years. MethodsAn anonymous, cross-sectional, random telephone survey was conducted using a special, validated, computerized telephone interview method. A total of 1281 men and 2130 women completed the interview (response rate 50.6%). Sexual problems were determined according to the Diagnostic and Statistical Manual (of Mental Disorders) IV definitions. ResultsAmong the men, multivariate analyses indicated that older age, poor spousal relationship, less exercise, high level of family stress, high level of financial-related stress, and past year substance use were significantly associated with sexual problems (odds ratio [OR] 1.41 to 3.83). Among the women, being married or cohabiting with a partner was positively associated with lubrication problems, lack of orgasm, lack of pleasure, lack of interest (OR 1.43 to 1.73) and negatively associated with pain during intercourse (OR 0.66) and anxiety (OR 0.62). A high level of financial stress and neuroses diagnoses were also associated with various female sexual problems (OR 1.40 to 2.66). Sexual satisfaction was associated with being married/cohabitating (OR 1.94) and negatively associated with a poor spousal relationship, low level of exercise, and a high level of work-related stress among men (OR 0.37 to 0.71). Among women, a poor spousal relationship and high levels of family stress and financial stress were associated with not being satisfied sexually (OR 0.24 to 0.71). ConclusionsMental health, stress-related factors, and lifestyle factors contribute to sexual problems among Hong Kong Chinese adults. The factors differed between the two sexes.

Incidence of and Risk Factors for Acute Stress Disorder in Children with Injuries

To assess the incidence of and risk factors for Acute Stress Disorder (ASD) in children with injuries. Numerous studies have documented the increased incidence of PTSD in those initially diagnosed with ASD. PTSD symptoms cause tremendous morbidity and may persist for many years in some children. Children hospitalized with one or more injuries were interviewed and assessed with the following: Child Stress Disorders Checklist (CSDC), Family Strains Scale, Brief Symptom Inventory (BSI) and Facial Pain Scale. Participants included sixty-five children (ages 7-18 years). The mechanisms of injury varied (e.g. MVC, penetrating). The mean injury severity score was 8.9 +/- 7. The mean length of hospital stay was 4.6 +/- 4.6 days. Altogether, 18 (27.7%) of participants met DSM IV criteria for ASD during their acute hospital stay. Risk factors such as level of family stress, caregiver stress, child's experience of pain, and child's age were predictive of acute stress symptoms. We have identified four risk factors of ASD that have implications for the treatment, and possibly, preventative intervention for PTSD. Further investigation and greater understanding of risk factors for ASD in children with injuries may facilitate the design of acute interventions to prevent the long-term negative outcomes of traumatic events.

Nursing/Psychosocial/Health Services

Nursing/Psychosocial/Health Services

Factors that contribute to child maltreatment severity: a multi-method and multidimensional investigation

Objectives: This study used data gathered during evaluations conducted by the Comprehensive Assessment and Training Services (CATS) Project to determine the relative contribution of four primary domains (demographic, adult characteristics, child characteristics, relational characteristics) to variation in the severity of child maltreatment, and to facilitate the development of empirically-based risk assessment tools. Methods: A multidimensional, multi-method approach to data collection was used to assess 208 maltreating parents. Hierarchical multiple regression analyses were performed by entering each domain of variables into the regression equation in four consecutive blocks. Results: The results of this study suggest that maltreatment severity varies as a function of the level of trauma recovery, substance misuse, a child's externalizing behavior, and qualitative features of the parent-child relationship, as well as the level of family stress. Relationship variables added to the amount of variance accounted for in the overall model, beyond demographic, adult, and child variables. Conclusions: The findings of this study call attention to the importance of developing a multidimensional assessment model of the factors leading to child maltreatment severity and to broadening the parameters of assessment models used in child maltreatment research. The role that each of the contributing factors plays in the interference of effective parenting is also discussed.

Materialism and the Family Structure–Stress Relation

In this study, we examined the role that materialism plays in the family structure–stress relation in a sample of adolescents. Materialism is a complex construct that appears to both mediate and moderate the family structure–stress relation as well as have both positive and negative effects. The happiness dimension of materialism in particular appears to both mediate and moderate the family structure–stress relation. Adolescents who associate happiness with material possessions report higher levels of family stress due to family disruption (parental divorce) compared with those who are less likely to associate happiness with material possessions. This finding runs contrary to recent marketing research. Additionally, we found the success dimension of materialism to have a direct and salubrious impact on family stress levels.

The Continuing Consequences of Segregation: Family Stress and College Academic Performance*

Objectives. We seek to determine whether the high levels of African‐American residential segregation experienced have continuing academic consequences. Because segregation works to concentrate poverty and the social problems associated with it, the friends and relatives of African‐American students face an elevated risk of stressful life events, which undermine grade performance.Methods. We use data from the National Longitudinal Survey of Freshmen to measure the frequency with which members of students' social networks experienced stressful events during their freshman and sophomore years of college, comparing whites, Asians, Latinos, and African Americans from integrated neighborhoods with those coming from segregated neighborhoods.Results. African‐American students from segregated neighborhoods experience higher levels of family stress than others. This stress is largely a function of violence and disorder in segregated neighborhoods. Students respond by devoting more time to family issues and their health and grades suffer as a result.Conclusions. Racial segregation is a structural feature of U.S. society that has continuing power to undermine the academic achievement of students long after they have seemingly left segregated living behind.