Parent-child Relationship Problems Research Articles

Mental Health of School-Aged Children Treated with Propranolol or Atenolol for Infantile Hemangioma and Their Parents

Background: Infants with infantile hemangioma (IH) have been effectively treated with propranolol or atenolol. Concerns were raised about the mental health of these children at school age, due to central nervous system effects of propranolol and visible nature of IH. Objective: This study aimed to compare the mental health at school age of children treated with propranolol to children treated with atenolol for IHs and their parents. Methods: This two-centered cross-sectional study included children aged ≥6 years and treated with either propranolol or atenolol for IH during infancy. Children’s outcomes were performance-based affect recognition (Dutch version of the Developmental Neuropsychological Assessment-II [NEPSY-II-NL]), parent-reported emotional and behavioral functioning (Child Behavioral Checklist [CBCL]), and health-related quality of life (KIDSCREEN-27). Parents’ outcome was parenting stress (Parenting Stress Questionnaire [OBVL]). Results: Data of 105 children (36 propranolol, 69 atenolol; 6.0–11.8 years) were analyzed. Mental health outcomes did not differ between both β-blocker groups. Although overall functioning was in line with norms, children presented specific problems concerning affect recognition, parent-reported attention, and social quality of life. Parents showed increased physical symptoms, depressive symptoms, and parent-child relationship problems. Conclusion: No difference in mental health at school age was found between children treated with propranolol or atenolol for IH. Although few overall mental health problems were found, specific problems require follow-up. Follow-up of children should be directed toward affect recognition, attention, and social functioning in daily life. Problems reported by parents could be ameliorated by mental health support during and after their infant’s β-blocker treatment.

Pre-post Mixed Methods Study of a Parent and Teen Support Intervention to Prevent Violence Against Adolescents in the Philippines

PurposeThis study examines the feasibility of a culturally adapted parenting intervention (MaPa Teens) within the national cash transfer system to reduce violence against adolescents, the first such program in the Philippines. MethodsThirty caregiver-adolescent dyads who were beneficiaries of a government conditional cash transfer program participated in a pilot of a locally adapted version of the Parenting for Lifelong Health for Parents and Teens program. Primary outcomes of reducing child maltreatment and associated risk factors were evaluated using a single-group, pre-post design. Focus group discussions explored the perceptions of participants and facilitators regarding program acceptability and feasibility. ResultsSignificant and moderate reductions were reported in overall child maltreatment and physical abuse (caregiver and adolescent reports) and in emotional abuse (adolescent report). There were significant reductions in neglect, attitudes supporting punishment, parenting stress, parental and adolescent depressive symptoms, parent-child relationship problems, and significant improvement in parental efficacy in managing child behavior. Adolescents reported reduced behavior problems, risk behavior, and witnessing of family violence. Participants valued learning skills using a collaborative approach, sustained their engagement between sessions through text messages and phone calls, and appreciated the close interaction with caring and skilled facilitators. Program areas of improvement included addressing barriers to attendance, increasing adolescent engagement, and revising the sexual health module. DiscussionThe study provides preliminary support for the effectiveness and feasibility of the program in reducing violence against Filipino adolescents. Findings suggest potential adaptations of the program, and that investment in more rigorous testing using a randomized controlled trial would be worthwhile.

Correlates of maternal Emotional Stability: Findings from the Millennium Cohort Study

This study explored correlates of maternal Emotional Stability drawing on a longitudinal data, from the Millennium Cohort Study (MCS): a sample of 10,925 mothers. Data were collected when children were at ages 9 months, and then 3 and 7 years. Structural equation modelling showed that family poverty indicator, maternal psychological distress, parent-child relationship, and children's behavioural problems all had significant and direct effects on maternal trait Emotional Stability (Neuroticism), accounting for 26% of the total variance. The strongest predictor was maternal psychological distress, followed by children's behavioural problems. Further, maternal psychological distress had direct effects on both parent-child relationship and children's behavioural adjustment. The implications and limitations are discussed.

Mindfulness During Pregnancy and Parental Stress in Mothers Raising Toddlers

ObjectivesParental stress has been associated with adverse child outcomes and maternal functioning. Yet, maternal factors during pregnancy that can potentially protect against later parental stress, such as mindfulness, have not been studied. Therefore, we aimed to address the possible associations between prenatal mindfulness and levels of parental stress in mothers raising toddlers.MethodsWomen in the current study (n = 165) were prospectively followed from pregnancy until 3 years after childbirth, as part of a longitudinal population based cohort (HAPPY study). At 22 weeks of pregnancy, women completed the Three Facet Mindfulness Questionnaire–Short Form (TFMQ-SF) to assess facets of mindfulness (acting with awareness, non-judging, and non-reacting). Women completed the Parenting Stress Questionnaire (PSQ) 3 years after childbirth, reporting on three components of parental stress: (1) parent-child relationship problems, (2) parenting problems, and (3) role restriction.ResultsResults of multiple linear regression analyses showed that the acting with awareness facet of mindfulness during pregnancy was a significant predictor of fewer parent-child relationship problems and parenting problems, even when adjusted for prenatal and maternal distress and child behavior problems. Higher levels of non-reacting during pregnancy were also significantly associated with fewer parenting problems in mothers raising toddlers.ConclusionsThe current study emphasizes that mindfulness during pregnancy may be a protective factor for later parental stress. More research is needed to confirm these findings and to evaluate the possible benefit of a mindfulness intervention training during pregnancy on parenting and child outcomes.

Problems of feeding, sleeping and excessive crying in infancy: a general population study

ObjectiveTo study regulatory problems (RPs) of feeding, sleeping and excessive crying in infancy, and explore the influence of maternal mental health problems and parent–child relationship problems.Design and settingData were collected...

A Research Program Testing the Effectiveness of a Preventive Intervention for Couples with a Newborn.

Noxious family environments are associated with a wide range of adverse child outcomes. In order to prevent couple and parent-child relationship problems, a number of programs have been developed for couples with newborns. The current paper describes a program of research evaluating the American version of couple CARE for parents of newborns. This version of CCP was administered to low-income, unmarried couples with a new baby in an uncontrolled demonstration project (Study 1), compared with a waitlist control condition in a randomized controlled trial (Study 2), and evaluated with low-income parents recruited from urban hospitals in two major metropolitan areas of the United States (Study 3 and Study 4). Despite participant satisfaction with CCP, preventive effects of the program were limited and there was one potential iatrogenic effect. Results were likely impacted by major challenges with recruiting participants and maintaining their engagement in CCP for the duration of the program. We discuss methodological differences between this series of studies and previous trials of prevention programs and make recommendations for improving service delivery to at-risk new parents. These results have implications for public policies that aim to benefit children and families.

Close relationships and depression: A developmental cascade approach.

Previous research has shown that problematic parent-child, peer, and romantic partner relationships are associated with an increased likelihood for major depressive disorder (MDD). Less research has evaluated the developmental unfolding of how these interpersonal relationship features are both an antecedent versus a consequence of MDD symptoms from adolescence through young adulthood. These gaps were evaluated using a large community sample (N = 1,127; 54% female, 96% white) via a developmental cascade model. Results showed support for significant antecedent effects, as greater parent-child relationship problems at ages 11 and 17 predicted rank-order increases in MDD symptoms at ages 14 and 20. Supporting a developmental cascade of problematic social relationships, greater parent-child relationship problems at ages 11 and 14 also predicted greater subsequent rank-order increases in antisocial peer affiliation at ages 14 and 17. Greater affiliation to antisocial peers at age 20 predicted greater rank-order increases in romantic relationship problems at age 24, which in turn predicted greater MDD symptoms at age 29. Cross-effects were generally small (βs ≤ .16), illustrating other factors may be relevant to the development or consequences of MDD. Nonetheless, findings support the importance of efforts to strengthen social support networks to offset risk as well as potentially treat depression.

Mother's marital satisfaction associated with the quality of mother-father-child triadic interaction.

Low marital satisfaction has been shown to be a risk factor for early parenthood and parent-child relationship problems (Erel & Burman, ; McHale, ). The aim of this study was to assess how parental reports of marital satisfaction related to family alliance and coordination in the observed triadic interaction. The study group included 120 families. Marital satisfaction was evaluated during pregnancy, at 4months, and at 18months using the Revised Dyadic Adjustment Scale (RDAS; Busby, Christensen, Crane & Larsson, ) for both parents. Mother-father-child interaction was analyzed in the Lausanne Triadic Play setting and coded using the Family Alliance Assessment Scale (Favez, Lavanchy Scaiola, Tissot, Darwiche & Frascarolo, ) when the child reached 18months of age. The mother's higher marital satisfaction at every measuring point was associated with a cooperative family alliance and/or higher family coordination at 18months. The father's experience of marital satisfaction was not related to family interaction at any assessment point. Our study suggests that a mother's experience of lower marital satisfaction during pregnancy may be an early sign of later problems in family relationships.

Parent-child relationship and behavior problems in children with ADHD

Objectives: Previous studies have examined the effect of parent–child relationships on conduct problems, but rarely are the mother–child and father–child relationships studied independently. The current study examined parent–child relationships and their connection to comorbid behaviors in children with Attention-Deficit/Hyperactivity Disorder (ADHD). More specifically, this study explored the mother–child and father–child relationship in children with ADHD, with an explicit focus on the aspects of the parent–child relationship that are related to more positive behavioral outcomes.Methods: A sample of 74 children with ADHD (aged 8–11 years) and their mothers (n = 74) and fathers (n = 37) participated in the current study and completed a variety of parenting and behavioral measures. A number of relationship factors, including parent- and child-reported levels of attachment were examined in connection to parental ratings of behavioral outcomes such as defiance, aggression, and conduct problems.Results: Results indicated that different aspects of the parent–child relationship for mothers and fathers were related to ratings of behavioral problems. Relational frustration was found to be a consistent predictor of negative ratings of behavior for both parents, while involvement was a predictor of more positive ratings of behavior for fathers only.Conclusions: A better understanding of the specific aspects of the mother–child and father–child relationship may play a role in helping to understand the link between parent–child relationships and behavioral concerns in children with ADHD. Implications for practice are highlighted with a particular emphasis on strengthening the parent–child bond in families with children with ADHD.

Pain Regulation in Nonsuicidal Self-injury

Non-suicidal self-injury (NSSI), a new disorder included in the for further study section of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders [1], refers to a deliberate behavior that directly damages one's own body tissue without suicidal intention [2]. This behavior has become a major public health concern among adolescents, affecting about 18% of community adolescents all over the world [3]. This high prevalence of NSSI may make people wonder why so many adolescents engage in this behavior. We may think that NSSI must cause physical pain. It is against the innate and evolutionary drive of self-preservation. However, although getting involved hurting oneself, as many as 80% of adolescent self-injurers reported little or no pain while engaging in the act [4]. Laboratorial studies using various NSSI proxies (e.g., cold, heat, electric shock) also provided supports for the diminished pain perception in individuals with NSSI [5,6]. Regarding the mechanism underlying the relationship between diminished pain perception and NSSI, studies suggested that emotion dysregulation and self-invalidation may act as potential mediators [7,8]. Apart from the abnormal physical pain perception, the engagement in NSSI also involves social pain dysregulation. Social pain is associated with actual or potential damage to one's sense of social connection or social value and is often described by the language of physical pain (such as broken hearts, or hurt feeling) across a variety of cultures [9,10]. Interpersonal disturbances, particularly in the family context, may influence the development of NSSI in adolescence [11]. It is suggested that the overall quality of attachment with parents in childhood, injury in parent-child bonds, and experiences of separation and loss may contribute to later NSSI [11-13]. Additionally, maternal emotional neglect (e.g., lack of maternal care), paternal insecure attachment, lack of intimacy within the parent-child relationship, and family invalidation were reported to be associated with NSSI [12,14-16]. In short, when there are problems in parent-child relationships, which are the most important social connections, individuals may suffer social pain, which may then lead to the engagement in NSSI. Non-suicidal self-injury is not the privilege of humans. Other animals may also engage in NSSI. It is thus meaningful to explore this phenomenon in non-human primates, even in other mammals [17]. Approximately 10% of animals under individual caging (i.e. social isolation) engage in NSSI [18]. Isolated animals, both with and without abnormal rearing, may exhibit NSSI. Besides, the duration of isolation, and the beginning age of isolation may play a key role in determining the extent of risk for later developing NSSI [19]. Previous research suggests that both physical pain and social pain dysregulations may be involved in NSSI. In fact, considerable evidence has been showing that social pain shares parts of the same phenomenological, neurological, and psychological systems with physical pain [10,20]. We thus speculate that one important function of NSSI may be social pain regulation, by means of inflicting physical pain on the body. Several studies have provided preliminary evidence for this speculation, such that acute physical pain (NSSI-proxy) was found to lead to emotional benefits [2,21,22]. Additionally, only under conditions of interpersonal distress did heightened physical pain tolerance among self-injurers occur [23]. Therefore, although most past studies focused on the emotion regulation function of NSSI [24,25], we suggest future research to consider pain regulation as an important mechanism underlying the engagement in NSSI. Language: en

부모자녀관계문제 유아와 일반 유아의 어머니 상호작용 특성 분석

부모자녀관계문제 유아와 일반 유아의 어머니 상호작용 특성 분석

Gene-environment interplay between parent-child relationship problems and externalizing disorders in adolescence and young adulthood.

Previous studies have shown that genetic risk for externalizing (EXT) disorders is greater in the context of adverse family environments during adolescence, but it is unclear whether these effects are long lasting. The current study evaluated developmental changes in gene-environment interplay in the concurrent and prospective associations between parent-child relationship problems and EXT at ages 18 and 25 years. The sample included 1382 twin pairs (48% male) from the Minnesota Twin Family Study, participating in assessments at ages 18 years (mean = 17.8, s.d. = 0.69 years) and 25 years (mean = 25.0, s.d. = 0.90 years). Perceptions of parent-child relationship problems were assessed using questionnaires. Structured interviews were used to assess symptoms of adult antisocial behavior and nicotine, alcohol and illicit drug dependence. We detected a gene-environment interaction at age 18 years, such that the genetic influence on EXT was greater in the context of more parent-child relationship problems. This moderation effect was not present at age 25 years, nor did parent-relationship problems at age 18 years moderate genetic influence on EXT at age 25 years. Rather, common genetic influences accounted for this longitudinal association. Gene-environment interaction evident in the relationship between adolescent parent-child relationship problems and EXT is both proximal and developmentally limited. Common genetic influence, rather than a gene-environment interaction, accounts for the long-term association between parent-child relationship problems at age 18 years and EXT at age 25 years. These results are consistent with a relatively pervasive importance of gene-environmental correlation in the transition from late adolescence to young adulthood.

Family resources as mediators in the relation between divorce and children's school engagement

Children are increasingly growing up in non-intact families. Because the family is a vital developmental part of growing-up, parental divorce can have far-reaching effects on children. This article investigates whether divorce interferes with children's engagement in school. According to the deprivation perspective, the effect of a parental divorce on children is mediated through the availability of family resources. Structural equation models are performed on the Leuven's Adolescent and Family Study. We conclude that the parental divorce effect on school engagement is mediated by the parent-child relationship, parental conflict, and financial problems at home.

Mindful Parenting in Mental Health Care: Effects on Parental and Child Psychopathology, Parental Stress, Parenting, Coparenting, and Marital Functioning

This study evaluated the acceptability and effects of a Mindful Parenting course in mental health care. Parents (n = 86) referred to secondary mental health care because of their children’s and/or their own psychopathology, or parent–child relationship problems, followed a Mindful Parenting course in a group format (10 groups). Assessments took place just before the course (pre-test), immediately after the nine-week course (post-test), and at 8-week follow-up. A waitlist assessment took place only for those parents who had to wait for a course (n = 23). Measures concerned parent report of psychopathology symptoms of their target child, as well as their own psychopathology symptoms, parental stress, parenting behaviors, coparenting, and marital functioning. Only one parent dropped out and parents evaluated the program as valuable and effective in many areas of family functioning. No improvement was reported during waitlist, except for an improvement in parental externalizing symptoms. Improvements after the course occurred in the target child’s internalizing and externalizing psychopathology symptoms, parents’ own internalizing symptoms and further improvement on their externalizing symptoms. Also, improvements occurred on parental stress, parenting, and coparenting, but not on marital functioning. Improvements were generally maintained at follow-up. In conclusion, the very low dropout rate as well as the positive evaluations, suggest that Mindful Parenting is an acceptable and feasible intervention in mental health care. Mindful Parenting appears a promising new intervention for parents in mental health care, as it seems effective on a broad range of child, parent, and family variables. Studies comparing Mindful Parenting to other effective interventions, such as Parent Management training, are needed to gain more knowledge about its relative and differential effectiveness.

Developmental Trajectories of Cigarette Use and Associations With Multilayered Risk Factors Among Chinese Adolescents

We aimed to identify developmental trajectories of cigarette use and risk factors associated with the distinct developmental courses of smoking in Chinese early adolescents from age 12 to 16 years. Analysis was conducted with secondary data from a longitudinal, prospective cohort of 3,521 Chinese adolescents randomly selected from 4 rural and 7 urban middle schools in Wuhan, China. A group-based growth mixture modeling approach was adopted to identify developmental trajectories of cigarette use. Multilayered intrapersonal (e.g., attitudes toward smoking) and interpersonal (e.g., parental smoking and perceived parental disapproval of smoking) risk factors selected from an ecological perspective were prospectively linked to the identified patterns of smoking trajectory. Three trajectory patterns were identified from the whole cohort: nonsmokers (48.7%), stable light/occasional smokers (48.6%), and accelerating smokers (2.7%). After adjustments for gender, urban residence, and family socioeconomic status, adolescents with higher levels of problems in parent-child relationships and family disharmony, higher perceived norms of peer smoking, higher proportion of good friend smoking, having more troubles with teachers, poorer academic performance, and reporting more frequent depressive symptoms were significantly more likely to be in the trajectory group of either stable light/occasional smokers or accelerating smokers than in the group of nonsmokers. The probability of being in the accelerating smoking trajectory group was positively and significantly related to parental smoking and lack of school bonding. Study findings help to advance knowledge of the distinct developmental courses of smoking behavior and their associations with multilayered risk factors among Chinese early adolescents.

Phenomenology of Clinic-Referred Children and Adolescents with Oppositional Defiant Disorder and Comorbid Anxiety

This study examined profiles of clinic-referred youth with co-morbid oppositional defiant disorder (ODD) and anxiety disorders (ADs) compared to youth with ODD without ADs. One hundred and twenty seven clinic-referred youth with ODD (ages 7–14, 85.6 % Caucasian) were assessed through a multi-method, multi-informant approach. Global functioning, ODD symptom impairment, child internalizing symptoms, caregiver distress, and parent-child relationship quality were explored to test group differences based on AD diagnosis. Youth with ODD and comorbid ADs generally had higher levels of global impairment, internalizing symptoms, caregiver distress, and parent-child relationship problems as compared to youth with ODD only. These findings, which generally suggest greater impairment in the group of youth with ODD/AD, offer support for the presence of distinct clinical features in youth with ODD/AD compared to youth with ODD alone. Such findings may have important implications for assessment and treatment of ODD in youth. For example, interventions to target broader child internalizing symptoms, caregiver distress, and parent-child relationships may be particularly important in youth with ODD/AD profiles.

Problematic parent-infant relationships in two-parent families: prevalence and risk factors in a Brazilian neighborhood.

Although the quality of parent-child relationships is known to be associated with the offspring's mental health, little is known about the prevalence of problematic relationships in this scenario. This cross-sectional study aims to investigate the prevalence and risk factors of different types of early parent-infant relationships in a Brazilian population group. During 1 year, all families (n = 230) from an urban community of Porto Alegre, southern Brazil, with 4-month-old infants born in public hospitals were identified, and 148 were fully investigated by two family therapists. This study describes data on the 116 infants with two-parent families. Demographic, obstetric, and relational variables were collected through questionnaires and scales (Parent-Infant Relationship Global Assessment Scale, Global Assessment of Relational Functioning, and Self-Report Questionnaire). Prevalence ratios were calculated, and Poisson regression with robust variance was performed to adjust for covariates. Almost 10% of mothers and 12% of fathers showed at least a significantly perturbed relationship with their 4-month-old infants. Inadequate mother-infant bonding coincided with evidence of paternal mental disorder, poor maternal social network, and discontinuation of breastfeeding at 4 months. A problematic father-infant relationship was associated with a dysfunctional couple relationship and with low infant birth weight. There is a high prevalence of early parent-child relationship problems, suggesting a need for health system interventions. Parent-infant relational problems are prevalent very early in life and more associated with other relational problems than with socioeconomic burden.

Cognitive and Psychiatric Status in Pediatric Multiple Sclerosis (MS) (P04.106)

Objective: To assess the cognitive and psychiatric features of a sample of children with pediatric Multiple Sclerosis (MS). Background Children and adolescents with MS often have special needs as cognitive dysfunction and behavioral and emotional issues develop. The relation between cognitive, psychosocial, and psychiatric difficulties is poorly understood. Here, the goal was to examine the psychiatric, cognitive and neurologic features in pediatric MS. Design/Methods: Forty-five (45) pediatric onset MS patients (age range: 8.5 to 18.3, median: 15.7, female: 64.4%) underwent neurological evaluation, cognitive testing, and fatigue and quality of life (PedsQL) questionnaires. A child psychiatrist administered a semi-structured psychiatric interview (Schedule for Affective Disorders and Schizophrenia for School-Age Children) and assessed global social and psychiatric functioning (CGAS). Cognitive impairment was defined as failing (i.e. 1 SD below published norms) 20% or more of 12 administered tests. Results: 27/45 (60%) of patients had at least one psychiatric disorder; 18/27 (66%) had more than one disorder. The most common diagnoses were anxiety disorder (n=12, 44.4%), depression (n=9, 33%), ADHD (n=9, 33%), adjustment disorder (n=4, 14.8%), PTSD (n=3, 11%), parent-child relationship problems (n=3, 11%) and ODD (n=2, 7%). There was one child each with bipolar disorder and reactive attachment disorder. Those with psychiatric diagnoses versus those without had slightly greater frequencies of cognitive impairment (74% vs. 55%, p =ns, particularly on tasks requiring complex attention, executive functioning and information processing speed), worse overall psychosocial functioning (lower CGAS scores, p Conclusions: Psychiatric disorders in children with pediatric MS are varied and are associated with increased fatigue, poor psychosocial functioning, and poor quality of life: Cognitive impairment is also frequent in this group. Disclosure: Dr. Weisbrot has nothing to disclose. Dr. Charvet has received personal compensation for activities with Johnson & Johnson as an employee. Dr. Serafin has nothing to disclose. Dr. Belman has nothing to disclose. Dr. Seibert has nothing to disclose. Dr. Moadel has nothing to disclose. Dr. Krupp has received personal compensation for activities with Teva Neuroscience, BiogenIdec, Serono, Inc., Bayer Pharmaceuticals Corporation, Guidepoint Global, Pfizer Inc, Axon Advisors, Sanofi-Aventis Pharmaceuticals, Inc., as a speaker, consultant and/or participant on an advisory board. Dr. Krupp has received (royalty or license fee or contractual rights) payments from Genzyme Corporation, Bristol-Myers Squibb Company, MedImmune, and Novartis. Dr. Krupp has received research support from Serono Inc. and Biogen Idec.

Impact of Divorce on Children: Developmental Considerations

Although divorce can have significant negative impact on children, a variety of protective factors can increase the likelihood of long-term positive psychological adjustment. • Exposure to high levels of parental conflict is predictive of poor emotional adjustment by the child regardless of the parents' marital status. • Epidemiologic data reveal that custody and parenting arrangements are evolving, with more emphasis on joint custody and access to both parents by the child. • Pediatricians' knowledge of childhood development is essential in providing anticipatory guidance to parents throughout the divorce process and beyond.

Prospectively assessed early life experiences in relation to cortisol reactivity in adolescents at risk for asthma.

Altered cortisol reactivity in individuals with asthma likely increases the risk of inflammation in the face of stress. Understanding antecedents of cortisol reactivity enhances knowledge of factors affecting asthma. Forty-eight subjects genetically predisposed for asthma, recruited from a study that assessed them from birth, completed a laboratory stress procedure and self-report measures at ages 17-19 years. Observation and parent reports from age 0 to 2 years were used to create a parent child relationship risk variable and to define criteria for a cumulative risk variable. In repeated measures analysis of 46 adolescents, those who had experienced early parent child relationship problems, specifically insecure attachment, had an attenuated cortisol stress response, even after controlling for concurrent psychological function and recent stressors (F = 4.6, p < .005). Cortisol stress response was not related to asthma status. This study supports a relationship between the parent child relationship during the first 2 years of life and later cortisol response to stress in youth at genetic risk for asthma.