Parent-child Dysfunctional Interaction Research Articles

PARENTING STRESS: COMPARISON BETWEEN PARENTS OF ATYPICAL CHILDREN AND TYPICAL CHILDREN

Parenting stress is experienced when demand exceeds the capabilities and resources that parents have. This study aims to compare the level of parental stress between parents of atypical children and typical children. A survey has been conducted with 46 parents of atypical children and 54 parents of typical children who were selected around Selangor. The Parenting Stress Index-Short Form (PSI-SF), which is formed from three domains: (1) parental distress, (2) parent-child dysfunctional interaction, and (3) difficult child, has been used to measure the level of parenting stress. The samples were asked to fill out the PSI-SF questionnaire, and the data collected was then analyzed with the Statistical Package for Social Sciences, version 27.0. The result showed that there was a significant difference in parenting stress levels between parents of atypical children and typical children. The mental health of atypical parents is greatly affected not only by the stress of daily life, work, marital problems, interpersonal relationships, and so on. Many of them also feel lonely and isolated since their worries and anxiety are not being understood. The implication of this study is to create awareness among parents of atypical children about their state of mental health before it reaches levels of depression. Therefore, appropriate support and assistance are needed by this group of parents in order to improve their quality of life and family relationships.

Early Intervention, Regular Education, and Family: Reciprocal Influences on Communication and Language Disorders.

Families are the primary caregivers and the main source of support for their children. Family resilience involves coping and adapting to stressful situations. This study explored the impact of previous treatment experience on parental resilience, in families, as well as the relationship between family history of communication and language disorders and parental stress. These variables were assessed through the Resilience Scale and the Parental Stress Index in parents of 220 children aged 3 to 6 years attending mainstream schools and early intervention (EI) centers in Caceres (Spain). The results revealed significant differences in resilience between parents who had received previous treatments and those who had not (p = 0.11). Furthermore, a significant association was found between having no family history of communication and language disorders and the Dysfunctional Parent-Child Interaction subscale from the Parental Stress Index (U = -2.079, p = 0.038). These findings highlight the relevance of previous experience in EI to build family resilience as resilient parents are more likely to be actively involved in their children's education and create a supportive environment. Thus, promoting resilience in educational settings may have positive effects on children's and families' quality of life during the EI process.

The Relationship between Coping Strategies and Parenting Stress in Childhood Epilepsy

Background: Epilepsy is a common childhood disease that can lead to high stress levels in parents, subsequently affecting family dynamics. The coping strategies practised by parents often play a major role in determining the level of parenting stress. Objective: This study aimed to identify the proportion of parents with parenting stress among those who have children with epilepsy, to compare the level of stress in different domains (parent, child, and parent-child interaction) as well as to examine the relationship between parenting stress and parental coping strategies. Methods: In this cross-sectional study, a total of 61 parents of children with epilepsy aged between 2 to 12 years old were recruited from the Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) paediatric clinic over eight months. Validated questionnaires were used to determine the parenting stress level and coping strategies. Results: The proportion of parents with high stress scores (13.1%) was lower in this study compared to previous studies, except for non-Malay parents. Among the three domains, 29.5% of parents reported a high stress level under Parent-Child Dysfunctional Interaction (P-CDI). A negative correlation was observed between active coping and total parenting stress scores (TPSS) (r = -0.323, p = 0.011). In contrast, there was a positive correlation between self-blame coping and TPSS (r = 0.315, p = 0.014). Conclusion: Parents of children with epilepsy mostly reported low TPSS, except for non-Malays. Parents are encouraged to practise more active coping and less self-blame in managing children with newly diagnosed epilepsy.

Mediating effects of parent–child dysfunctional interactions in the relationship between parenting distress and social–emotional problems and competencies

This study investigated the association between parenting distress and four variables of young children’s social–emotional problems and competencies: externalizing, internalizing, and dysregulation problems, and social–emotional competencies, and whether parent–child dysfunctional interactions mediated these associations. Participants were Chinese toddlers (N = 711) aged 24–36 months in family (44.3%) and center-based (55.7%) care. The results from structural equation modeling showed that parent–child dysfunctional interactions fully mediated the relationship between parenting distress and externalizing, and dysregulation problems, and social–emotional competencies, while partially mediated in the internalizing problems for both groups. Furthermore, multi-group SEM models showed the direct and indirect pathways differed between two groups. The research concludes that parent-child interaction plays a crucial role in mediating the relationship between parenting distress and young children’s social–emotional problems and competencies. For families’ choice of childcare, this study suggests early center-based services provided for toddlers exposed to family risk characteristics such as parents’ poor mental health, and more importantly, low levels of parent–child interactions.

Parental Stress in a Pediatric Ophthalmology Population.

To determine the rate of parental stress within a pediatric ophthalmology population, parents in an urban or suburban community pediatric ophthalmology clinic were administered the Parental Stress Index Short Form survey. Demographic information and parental depression or anxiety data were collected and analyzed using an independent sample t-test and chi-squared analysis. Stress measures were recorded as percentiles. One hundred and twenty-one surveys revealed the following mean percentiles: Total Stress, 45.9 ± 22.4; Parental Distress (PD), 49.7 ± 19.8; and Parent Child Dysfunctional Interaction (P-CDI), 45.1 ± 23.6. The PD percentiles of the non-married parents, those with positive parental depression or anxiety scores, and those with a high school diploma or less were 55.9 ± 18.5 versus 45.2 ± 19.6, p < 0.01; 55.2 ± 18.6 versus 46.7 ± 19.9, p < 0.05; and 56.8 ± 18.2 versus 47.0 ± 19.8, p < 0.01, respectively. The parents with a high school diploma or less in a suburban environment demonstrated higher PD/P-CDI scores versus those of an urban population. Those with median household incomes (MHI) below USD 60,000 in both the total and suburban populations showed higher PD scores. There is no significant difference in parental stress between the pediatric ophthalmology patients and the general population. The parents who are unmarried, depressed, have a high school degree or less, or an MHI below USD 60,000 experience significantly higher stress levels.

Early developmental support for preterm infants based on exploratory behaviors: A parallel randomized controlled study.

Preterm infants are at high risk for developmental disabilities, and their parents are at increased risk for high stress. Early intervention programs are applied to reduce these adverse outcomes. The primary aim is to compare the efficacy of the novel Explorer Baby early intervention program for the holistic development of preterm infants. The second objective was to compare the stress levels of their mothers. Randomized clinical trial with 38 weeks-6 months corrected age preterm infants at low risk for cerebral palsy, randomly assigned to experimental (Explorer Baby) or active control neurodevelopmental therapy (NDT) groups. Fifty-seven infants were enrolled in the study, and 51 (26 Explorer Baby, 25 NDT) completed it. Bayley III was used as a primary outcome before, during, and after the intervention. When we compared the changes between the groups before and after therapy, no significant differences were found in any of the primary or secondary outcomes (between-group comparisons). When comparing the changes in both groups before and after therapy (in-group comparison), the Explorer Baby group demonstrated significant improvements in cognitive (Hedges' g=.83) and explorative language skills (Hedges' g=.65), whereas the NDT group showed improved parent-child dysfunctional interaction (Hedges' g=2.66) between T0-T1 and T0-T2. The Explorer Baby early intervention program may be a preferred option to support premature infants without brain injury, as it shows greater skill acquisition than NDT, although not statistically significant. Both methods are safe as they support premature babies without negatively affecting mothers' overall stress levels.

Effectiveness of the Triple P Program on Parental Stress and Self-efficacy in the Context of a Community Roll-out

This study evaluated the effectiveness of the Triple P (Primary Care and/or Group) parenting support program on various aspects of the parenting experience through a quasi-experimental pretest – post-test protocol with an active comparison group (Care as usual). A sample of 384 parents assigned to two groups (n Triple P = 291; n Care as usual = 93) completed three subscales of the Parenting Stress Index – 4 – Short Form (Parental Distress, Parent-Child Dysfunctional Interaction, and Difficult Child) and the Parental Self-Agency Measure. The amount of intervention received by each parent was considered in the analyses. Path analysis showed that the type (Triple P vs Care as usual) and the amount of intervention (number of sessions attended) contributed independently to predicting changes in parenting experience between pretest and post-test. Receiving Triple P was systematically associated with more positive outcomes than receiving care as usual, whereas more intervention was positively associated with improved self-efficacy and parent-child relationship quality. Overall, the model explained between 4.0% and 12.6% of the variance in individual change, depending on the outcome, suggesting that unmeasured drivers of change came into play. A follow-up of parents in the Triple P group two to four years after the end of the program (n follow-up = 164) showed that the observed changes were maintained over time, with moderate to large effect sizes. These results help to broaden the evidence base on the effectiveness of this program in a sociocultural and linguistic context different from that in which it was developed.

Intergenerational Continuity of Childhood Adversity and Its Underlying Mechanisms Among Teen Mothers and Their Offspring.

The present study investigates how parenting stress mediates the intergenerational continuity of childhood adversity in teenage mothers. Childhood adversity experiences of caregivers significantly affect their offspring's exposure to childhood adversity. However, little is known about the mechanisms linking childhood adversity across generations. The study measures how parental distress and parent-child dysfunctional interaction mediate the association between teen mothers' childhood adversity and their offspring's adversity, measuring when the offspring reached 11.5years of age. The results revealed that parental distress, but not parent-child dysfunctional interaction, mediated the association between teen mothers' child abuse and their offspring's household dysfunction. This suggests that parental distress may be a crucial intervention target to prevent the intergenerational continuity of childhood adversity. The findings imply that efforts to prevent the intergenerational continuity of childhood adversity may be more successful if the public and professionals have a broader understanding of the associations between early adversity and parenting contexts. In conclusion, the study shed light on the potential mechanisms underlying the intergenerational continuity of childhood adversity and highlights the importance of targeting parenting stress, specifically parental distress, as an intervention strategy to prevent the perpetuation of childhood adversity across generations.

Identifying major predictors for parenting stress in a caregiver of autism spectrum disorder using machine learning models.

Previous studies have investigated predictive factors for parenting stress in caregivers of autism spectrum disorder (ASD) patients using traditional statistical approaches, but their study settings and results were inconsistent. Herein, this study aimed to identify major predictors for parenting stress in this population by developing explainable machine learning models. Study participants were collected from the Department of Child and Adolescent Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, the Republic of Korea between March 2016 and October 2020. A total of 36 model features were used, which include subscales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) for caregivers' psychopathology, Social Responsiveness Scale-2 for core symptoms, and Child Behavior Checklist (CBCL) for behavioral problems. Machine learning classifiers [eXtreme Gradient Boosting (XGBoost), random forest (RF), logistic regression, and support vector machine (SVM) classifier] were generated to predict severe total parenting stress and its subscales (parental distress, parent-child dysfunctional interaction, and difficult child). Model performance was assessed by area under the receiver operating curve (AUC), sensitivity, specificity, accuracy, positive predictive value, and negative predictive value. We utilized the SHapley Additive exPlanations tree explainer to investigate major predictors. A total of 496 participants were included [mean age of ASD patients 6.39 (SD 2.24); 413 men (83.3%)]. The best-performing models achieved an AUC of 0.831 (RF model; 95% CI 0.740-0.910) for parental distress, 0.814 (SVM model; 95% CI 0.720-0.896) for parent-child dysfunctional interaction, 0.813 (RF model; 95% CI 0.724-0.891) for difficult child, and 0.862 (RF model; 95% CI 0.783-0.930) for total parenting stress on the test set. For the total parenting stress, ASD patients' aggressive behavior and anxious/depressed, and caregivers' depression, social introversion, and psychasthenia were the top 5 leading predictors. By using explainable machine learning models (XGBoost and RF), we investigated major predictors for each subscale of the parenting stress index in caregivers of ASD patients. Identified predictors for parenting stress in this population might help alert clinicians whether a caregiver is at a high risk of experiencing severe parenting stress and if so, providing timely interventions, which could eventually improve the treatment outcome for ASD patients.

The Impact of Single Motherhood on a Child’s Emotional Disposition in Asia: A Scoping Review

Corresponding to the current pandemic issue, Covid-19 has driven unprecedented economic loss and instability to many, particularly among low-income families, especially in Asia. In context, families involved single mothers who are markedly affected by job loss; thus, low-income households had markedly affected the well-being and development of children. In addition to family environment, sociodemographic variables, such as socioeconomic status, educational level of parents, and parental conflict, had also been associated with problematic or competent behaviors during childhood. This scoping review aimed to determine current knowledge regarding the impact of single motherhood on the emotional well-being of a child. This review was reported in accordance with the guidelines of the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Three databases, namely Scopus, Web of Science, and Education Resources Information Center (ERIC), were used for data scoping. A total of 341 studies were identified, but only 15 studies conducted in the Asian continent were eligible for selection. Results showed five significant findings concerning parent–child dysfunctional interaction, time spent, family socioeconomic status, parenting skills, and parental styles that impacted the emotional well-being of children, causing child development delay and delinquency.

Relationship between child sleep problems in autism spectrum disorder and parent mental health and well-being

Sleep problems are a common comorbidity in children and adolescents with autism spectrum disorder (ASD). The aim of this study is to determine how sleep problems affect not only the child with ASD, but parents also. Parents of 409 children and adolescents with ASD completed the Children's Sleep Habits Questionnaire, Pittsburgh Sleep Quality Index, Parenting Stress Index-Short Form, World Health Organization Quality of Life Abbreviated Version (WHOQOL-BREF), Hospital Anxiety and Depression Scale, and the Multidimensional Scale of Perceived Social Support. The majority (86.6%) of parents presented with poor sleep. The majority (95.3%; n = 387) of children presented with sleep problems, while 4.7% (n = 22) did not have sleep problems. A cross-sectional within-subjects research design was utilised, with the following analyses conducted: Pearson correlations, chi-square tests, t-tests, and MANOVAs. Relationships were found between child sleep problems and parent sleep problems, specifically child parasomnias, sleep duration, night wakings, and sleep onset delay. Parents of children with sleep problems experienced more parenting stress, specifically on the Difficult Child and Parent-Child Dysfunctional Interaction subscales of the Parenting Stress Index-Short Form. Parents of children and adolescents with sleep problems had significantly higher levels of anxiety and depression than parents of children and adolescents who did not have sleep problems. A relationship between sleep problems and lower quality of life was found. Parents of children with sleep problems received significantly lower scores on the WHOQOL-BREF domains of Physical Health, Psychological and Environment than parents of children without sleep problems. There was no significant difference found between parents of children with or without sleep problems on perceived social support. The current study demonstrated how child sleep affects parental well-being. While sleep problems are one comorbid condition in ASD, future research is needed to determine the impact of other comorbidities in parents of children and adolescents with ASD.

0758 Initial Efficacy of a Brief, Trauma-Informed Sleep Intervention for Children in Foster Care

Abstract Introduction Children in foster care experience impairing sleep problems that contribute to greater attachment, emotional and behavioral problems concurrently and over time. Sleep nonetheless remains a critically neglected aspect of health among this vulnerable group. To address the unique sleep needed of this population, we developed a brief, telehealth-delivered behavioral sleep intervention for caregivers of young children currently or formerly in foster care, called Sleep and Adjustment in Foster Environments for Toddlers and Preschoolers (SAFE-T). The current study examined the initial efficacy of SAFE-T. Methods N = 25 foster or adoptive foster parents with a 2- to 5-year-old child (M = 3.9; SD = 1.7) were recruited from the state of Texas. After a baseline assessment including the Children’s Sleep Habits Questionnaire (CSHQ) and Parenting Stress Index (PSI), families were randomized to SAFE-T or an active control group. SAFE-T families (n = 14) received 3 telehealth-delivered sessions with a therapist who provided information about healthy sleep and trauma-informed suggestions for reducing child sleep problems. Control families (n = 11) were sent an informational booklet about sleep to keep. A post-treatment assessment was completed approximately one month after he initial assessment. Results Compared to the control group, the SAFE-T group evidenced greater reductions in total CSHQ sleep problem scores (η2 = .14), including Sleep Anxiety (partial eta squatted = .16), Sleep Onset Delay (η2 = .08), Bedtime Resistance (η2 = .09) and Daytime Sleepiness (η2 = .07) scores at post treatment. Based on the PSI, caregivers in the SAFE-T group reported greater reductions in Difficult Child scores (η2 = .35), Parent-Child Dysfunctional Interactions (η2 = .31) and Parenting Stress (η2 = .16) compared to the control group. Conclusion Medium to very large effects were found for reductions in caregiver-reported child sleep problems as well as parenting stress following intervention with SAFE-T. These promising results suggest that a brief, trauma-informed sleep intervention may be effective in improving child sleep health and caregiver well-being in foster families. Support (if any) This study was funded by the Grant to Enhance and Advance Research (GEAR) from the University of Houston.

Evaluation of a person‐centred psychotherapy programme for children with developmental disabilities and parents in disadvantaged families

AbstractBackgroundThe needs of parents of children with developmental disabilities (DD) in disadvantaged families are frequently unmet by service providers. This service gap likely diminishes the therapeutic gains of children's treatment. Catering to the psychological needs of both children and parents is important. The present study evaluates the effectiveness of a person‐centred psychotherapy programme for children with DD and parents in disadvantaged families in reducing parenting stress and promoting positive children's behaviours.MethodFifteen parent–child dyads participated in a person‐centred psychotherapy programme consisting of eight 1‐hr child‐centred play therapy (CCPT) sessions and four 1‐hr person‐centred therapy (PCT) sessions. The parents completed a quantitative questionnaire before and after the programme.ResultsThe results indicated a significant reduction in children's conduct problems, with a large effect size, and in the levels of parental distress, parent–child dysfunctional interaction and difficulty in controlling their child's behaviours, with large effect sizes after the interventions.ConclusionsThis study provides positive evidence for the effectiveness of the person‐centred intervention programme. The results imply that individual humanistic therapy sessions are essential and effective to cater to parents' needs. Service providers can provide PCT to parents when delivering child services.

Father trait anger: Associations with father-infant bonding and subsequent parenting stress.

Parent anger presents a risk to family safety and child development. Father trait anger may also compromise the early relational context of fathers and offspring, yet evidence is lacking. The aim of this study is to examine effects of father trait anger on parenting stress in the toddler years, and the mediational role of father-infant bonding. Data were from 177 Australian fathers of 205 children. Trait anger (total, angry temperament, and angry reaction), father-infant bonding subscales (patience and tolerance, affection and pride, and pleasure in interaction), and subsequent parenting stress (parental distress, difficult child, and parent-child dysfunctional interaction) were assessed. At each of the subscale levels, mediational path models examined whether father-infant bonding explained the relationship between trait anger and parenting stress. Models were presented where there was at least a small association between the mediator and both the predictor and outcome. Patience and tolerance was the only domain of father-infant bonding correlated with both trait anger and all parenting stress outcomes. Patience and tolerance partially mediated the effect of total trait anger on parental distress and fully mediated effects on difficult child and parent-child dysfunctional interaction. Patience and tolerance fully mediated relationships between angry temperament and all domains of parenting stress. Angry reactions only had a direct effect on parental distress. Father trait anger both directly and indirectly (through patience and tolerance in the father-infant bond) impacts their experiences of parenting stress in the toddler years. Early interventions to manage father trait anger and improve father-infant bonding may benefit fathers and children.

Mental Health Is a Family Affair-Systematic Review and Meta-Analysis on the Associations between Mental Health Problems in Parents and Children during the COVID-19 Pandemic.

As a multidimensional and universal stressor, the COVID-19 pandemic negatively affected the mental health of children, adolescents, and adults worldwide. In particular, families faced numerous restrictions and challenges. From the literature, it is well known that parental mental health problems and child mental health outcomes are associated. Hence, this review aims to summarize the current research on the associations of parental mental health symptoms and child mental health outcomes during the COVID-19 pandemic. We conducted a systematic literature search in Web of Science (all databases) and identified 431 records, of which 83 articles with data of over 80,000 families were included in 38 meta-analyses. A total of 25 meta-analyses resulted in significant small to medium associations between parental mental health symptoms and child mental health outcomes (r = 0.19 to 0.46, p < 0.05). The largest effects were observed for the associations of parenting stress and child mental health outcomes. A dysfunctional parent-child interaction has been identified as a key mechanism for the transmission of mental disorders. Thus, specific parenting interventions are needed to foster healthy parent-child interactions, to promote the mental health of families, and to reduce the negative impacts of the COVID-19 pandemic.

Parental Stress in Raising a Child with Developmental Disabilities in a Rural Community in South Africa.

Although acceptable levels of parental stress are experienced by all parents who raise children, this stress is substantially higher among parents who raise children with developmental disabilities. Sociodemographic determinants further exacerbate parental stress among parents in rural communities, which are disadvantaged in many ways. This study aimed to quantify parental stress among mothers and female caregivers of children with developmental disorders and investigate factors associated with such stress in rural Kwa-Zulu Natal, South Africa. A cross-sectional quantitative survey was used, in which the Parenting Stress Index-Short Form (PSI-SF) and a sociodemographic questionnaire was administered to mothers and caregivers who were raising children aged 1 to 12 years old who were living with developmental disabilities. The PSI-SF scores were used, where a total score of ≤84 percentile was categorised as normal/no parenting stress, 85-89 percentile was categorised as high parental stress, and scores of ≥90 were classified as clinically significant. The sample of 335 participants consisted of 270 (80.6%) mothers and 65 (19.4%) caregivers. Their ages ranged from 19 to 65 years, with a mean of 33.9 (±7.8) years. The children were mostly diagnosed with delayed developmental milestones, communication difficulties, epilepsy, cerebral palsy, autism, ADHD, cognitive impairment, sensory impairments, and learning difficulties. The majority (52.2%) of the participants reported very high-clinically significant stress levels (≥85%ile). The four factors that independently and significantly predicted high parental stress were the advanced age of mothers and caregivers (p = 0.002, OR 2.3, 95% CI 1.34-3.95), caring for a child with multiple diagnoses (p = 0.013, OR 2.0, 95% CI 1.16-3.50), non-school enrolment of the child (p = 0.017, OR 1.9, 95% CI 1.13-3.46), and frequent hospital visits (p = 0.025, OR 1.9, 95% CI 1.09-3.44). At the subscale level, child non-enrolment in a school was found to independently predict parent distress (PD) and parent-child dysfunctional interaction (P-CDI). Frequent hospital visits were statistically and significantly associated with the difficult child (DC) and P-CDI subscales. The study established high parental stress in mothers and caregivers raising children with developmental disabilities. Lack of access to school was an independent factor that consistently increased parental stress. There is a need for support and directed intervention programs aimed at supporting mothers and caregivers of children with developmental disabilities, which will enhance their parenting abilities.

Effect of Psychological Counseling Based on Problem Management Plus on Social Anxiety in Parents of Children with Autism Spectrum Disorder.

Autism spectrum disorder (ASD) is a widespread mental growth disorder. Children with ASD are unlikely to restore the ability of living independent, which definitely brings their parents greater psychological pressure and psychological problems such as social anxiety. Therefore, it is pressing to conduct intervention research on social anxiety and other problems in parents of children with ASD. In 2022, Seventy-three parents of children with ASD were enrolled from Beijing Tongkangyuan Children's Rehabilitation Institute. They were randomly divided into the experiment group (N=36) and the control group (N=37). The experiment group was intervened with psychological counseling based on problem management plus in combination with Tai Chi. The control group did not receive any psychological intervention. Social Anxiety Scale for Children, Parenting Stress Index-Short Form and Social Support Rate Scale were used for measurement before and after the intervention. The experiment group had significantly higher decreases than the control group in the total score in social anxiety and the scores in its two dimensions after intervention (P=0.001). The experiment group had significant decreases in the total score in parenting stress and the scores in parenting distress and dysfunctional parent-child interaction (P=0.001), while there was no change in the control group. The experiment group had significant improvement in social support, which was also significantly higher than that of the control group (P=0.001). Psychological counseling based on problem management plus could effectively alleviate social anxiety and parental pressure in parents of children with ASD, improve their social support and play a significant role in enhancing their mental health.

Type of Family Support for Infant and Toddler Care That Relieves Parenting Stress: Does the Number of Children Matter?

The present study aimed to investigate the status and relationships between family support for infant and toddler care and parenting stress, and to explore differences related to the number of children in the families. We conducted a survey among 13,390 Chinese parents who were randomly sampled from six provinces of China. Descriptive analysis, multivariate analysis of variance, and regression analysis indicated that (1) current family support for infant and toddler care in China is insufficient; (2) most Chinese parents reported moderate parenting stress, with the highest scores given for parental distress, followed by difficult child, and parent-child dysfunctional interaction; (3) the larger the number of children in the family, the less the family support for infant and toddler care, the greater the parenting stress; (4) there was a difference between the effects of family support for infant and toddler care on relieving parenting stress among families with different numbers of children. These findings indicate that different types of family support for infant and toddler care should be provided for families with different numbers of children, to ease parenting stress and promote the implementation of the government's current fertility policy.

Mindful Parenting Group Intervention for Parents of Children with Anxiety Disorders.

Parenting behaviour and rearing style contribute to the intergenerational relationship between parental and child anxiety. Current psychological interventions for child anxiety typically do not adequately address parental mental health, parenting behaviours or the parent-child relationship. The current pilot study examines the effectiveness of a mindful parenting intervention (MPI) for parents of young children with clinical anxiety. It was hypothesised that the intervention would be associated with improvements in parental stress, mental health, and mindfulness, and a reduction in child clinical anxiety symptoms. Twenty-one parents of children aged 3-7years diagnosed with anxiety disorders participated in an 8-week group MPI program that aimed to increase their intentional moment to moment awareness of the parent-child relationship. Parental (anxiety, depression, hostility, stress, burden, mindfulness, mindful parenting) and child (anxiety diagnoses, anxiety severity, comorbidities) outcomes were assessed at pre- and post-intervention, and at 3-month follow-up. Parents reported a significant increase in mindful parenting and a significant reduction in parent-child dysfunctional interaction, but no change in mental health symptoms. There was a significant reduction in parent-rated child anxiety symptoms, severity of child anxiety diagnosis and number of comorbid diagnoses at post and 3-month follow-up. Limitations include a lack of waitlist control, small sample size, and participants were largely mothers, from intact families and highly educated. There was attrition of 43% and outcomes were predominantly self-report. MPIs offer a novel and potentially effective method of increasing mindful parenting, decreasing dysfunctional parent-child interactions, reducing parenting stress and might also be an effective early intervention for indirectly decreasing young children's clinical anxiety symptoms. Larger-scale controlled trials of MPIs are needed.

The role of parenting stress in anxiety and sleep outcomes in toddlers with congenital heart disease.

This retrospective cohort study investigates how parenting stress, measured at 4 months of age by use of a classic three-dimensional parent-reported scale (Parenting Stress Index, 4th Ed. or PSI-4), can predict anxiety symptoms and quality of sleep at 24 months in toddlers with congenital heart disease (CHD). Sixty-six toddlers with CHD followed at our cardiac neurodevelopmental follow-up clinic were included in this study. As part of their systematic developmental assessment program, parents completed questionnaires on their stress level (PSI-4) when their child was 4 months old, and on their child's anxiety symptoms and quality of sleep at 24 months. Eight multiple linear regression models were built on the two measures collected at 24 months using the PSI-4 scores collected at 4 months. For each measure, four models were built from the PSI-4 total score and its three subscales (Parental Distress, Parent-Child Dysfunctional Interaction, Difficult Child), controlling for sex and socioeconomic status. The PSI-4 Difficult Child subscale, which focuses on parenting anxiety related to the child's behavioral problems and poor psychosocial adjustment, accounted for 17% of the child's anxiety symptoms at 24 months. The two other PSI-4 subscales (Parental Distress and Parent-Child Dysfunctional Interaction) and the PSI-4 total score did not contribute significantly to the models. None of the four regression models on perceived quality of sleep were significant. It is important to note that 33% of parents responded defensively to the PSI-4. Parenting stress related to the child's behavioral problems and poor psychosocial adjustment, measured when the child is 4 months old, is associated with the child's ulterior anxiety symptoms. As very few standardized tools are available to assess the behavioral and psychoaffective development of infants, this study highlights the importance of early psychosocial screening in parents of infants with CHD. The high rate of significant Defensive Responding Indices reminds us to not take parent reports at face value, as their actual stress levels might be higher.