Parent Dyads Research Articles

Intergenerational Transmission of Posttraumatic Orientation to Bodily Signals Following Child Maltreatment.

Recent studies have indicated that CM (child maltreatment) may influence individuals' perception of their bodies, often resulting in a posttraumatic orientation to bodily signals (OBS). Given the intricate relationship between bodily and interpersonal experiences, it is hypothesized that posttraumatic OBS may be intergenerationally transmitted. However, knowledge regarding this phenomenon, and its underlying mechanisms, remains limited. Two studies tested (a) the link between CM and posttraumatic OBS, mediated by posttraumatic stress (PTS) symptoms and attachment security, and (b) the intergenerational transmission of a posttraumatic OBS following CM among dyads of parents and their young adult offspring. The first study included 445 young adults (mean age = 352, SD = 10.2), and the second study included 393 dyads (parents' mean age = 58, SD = 5.91; offspring's mean age = 27, SD = 3.91). The participants completed self-reported questionnaires. Study 1 found that posttraumatic OBS was associated with CM, through the mediation of PTS symptoms (indirect effect = 0.15, p = .005), and insecure attachment (indirect effects between 0.132 and 1.44, p < .006). The second study found two pathways of intergenerational transmission. The first pathway showed indirect paths between parents' CM exposure and offspring's posttraumatic OBS, through parents' reaction to CM (PTS symptoms, anxious attachment, and avoidant attachment) and posttraumatic OBS (indirect effects between 0.006 and 0.013, p < .039). The second pathway revealed indirect links between parents' CM exposure and offspring's posttraumatic OBS, through parents' and offspring's reaction to CM (indirect effects between 0.006 and 0.56, p < .015). The study's findings add empirical evidence that posttraumatic OBS is a significant implication of CM. The second study illuminates the intergenerational transmission of a posttraumatic OBS following parental CM exposure, uncovering PTS symptoms, and insecure attachment styles as potential underlying mechanisms.

Challenging the dichotomy: Examining parent socialization goals and behaviors regarding positive affect in Bengaluru, India.

Parents' responses to youth positive affect (PA) have been dichotomized as enhancing and dampening. This dichotomy may not fit with cultural scripts about emotion in communities where a balance between positive and negative emotions is preferred. To assess parents' PA socialization in a culturally relevant manner for urban, middle-class families in India, we developed a new measure of parental goals about happiness and adapted the Responses to Adolescent Happy Affect Scale (RAHAS). We tested the psychometric properties of these measures and assessed relations among parental socialization goals and behaviors across 5 months. Our sample included 377 adolescent (84.4% girls; Mage = 14.47) and parent (63.9% mothers) dyads, primarily Hindu, in Bengaluru, India. Two parental goals factors emerged: "Balancing and Controlling" and "Maximizing and Sharing" happiness. Three factors emerged for the adapted RAHAS. Two factors were the same as the original RAHAS: (a) "Enhancing" strategies to upregulate PA and (b) "Dampening" strategies to downregulate PA. A third factor emerged: (c) "Balancing" strategies, which were culturally salient for families in India and aimed for moderation. Among socialization behaviors, "Enhancing" and "Dampening" were inversely related, while "Balancing" related positively to each. Balancing and Controlling goals were only correlated to "Balancing" behaviors. Maximizing and Sharing goals were correlated positively with "Enhancing" and inversely with "Dampening." Longitudinally, Maximizing and Sharing and Balancing and Controlling goals were related to a significant increase and marginal decrease in "Dampening," respectively. Challenging the dichotomy, our findings highlight the relevance of balancing to theories of PA socialization.

The effects of neighborhood perceptions on response to a technology-assisted parenting intervention for adolescent substance use: protocol of a diversity supplement to parent SMART (Substance Misuse in Adolescents in Residential Treatment)

BackgroundIt is well established that an adolescent’s neighborhood is associated with their likelihood of developing a substance use disorder. The availability of drugs, lack of access to resources, and exposure to violence are all associated with greater substance use among young people, leading to more pronounced health inequities. Technology assisted interventions (TAIs) have been touted to enhance the reach of substance use treatment and improve outcomes for high-need families living in underserved neighborhoods. A key question is whether neighborhood characteristics impact the effectiveness of TAIs, given these interventions are embedded within an adolescent’s natural environment. This National Institute on Drug Abuse-funded Diversity Supplement will examine the role of perceived neighborhood characteristics on response to Parent SMART, a TAI for parents of adolescents in residential substance use treatment (R37DA052918; PI: Becker). Aim 1 will use both adolescent and parent self-report of multiple neighborhood dimensions (e.g., physical environment, social disorder, satisfaction with community resources) to identify indicators predictive of treatment response. Aim 2 will then explore the indirect relationship between neighborhood context and response to Parent SMART, via engagement.MethodsParticipants include adolescent and parent dyads enrolled in an effectiveness trial evaluating Parent SMART, a TAI for parents of adolescents in residential substance youth treatment. Participants will complete self-report measures of neighborhood physical environment, social disorder, and satisfaction with community resources at baseline to predict parenting and youth substance outcomes at 6-, 12-, and 24-weeks post discharge.DiscussionTo date, few studies have explicitly tested how neighborhood affects response to TAIs for adolescent substance use. Assessing adolescent and parent perceptions of neighborhood characteristics holds potential to pinpoint key contextual factors that affect TAI response and to promote consideration of multi-level health equity determinants in substance use research. Understanding neighborhood influences can advance public health by helping tailor TAIs to address the unique needs of adolescents living in underserved communities.Trial registrationThis study extends the measurement and analysis plan of a pragmatic effectiveness trial. The pragmatic effectiveness trial is registered at ClinicalTrials.gov NCT05169385; https://clinicaltrials.gov/ct2/show/NCT05169385

Postpartum Mental Health Care Use Among Parents During Simultaneous Parental Leave

Flexible parental leave schemes can help families balance work, childcare, and postpartum treatment, including treatment for mental health. In Sweden, both parents are eligible to use parental leave simultaneously in the first year after birth; however, the consequences for postpartum mental health care uptake remain underinvestigated. To examine the association between parents' use of simultaneous parental leave and their use of postpartum mental health care in Sweden. This cohort study obtained baseline data from national registries in Sweden, including live births of singleton offspring between January 1, 2014, to December 31, 2015, and simultaneous parental leave use (any vs none) in the 12 months after birth. The population-based sample was composed of parental dyads (mothers and fathers) who were eligible for simultaneous parental leave and were followed up from January 1, 2015, to December 31, 2016. Statistical analyses were conducted between December 15, 2023, and August 14, 2024. Simultaneous parental leave use up to 12 months post partum. Total population register data were used to identify maternal and paternal outpatient care visits for mental health (substance use disorder [SUD], mood or affective disorders, and stress-related disorders) and psychotropic prescription dispensations (antidepressants and anxiolytics) during the first postpartum year. Logistic regression was applied to estimate the odds of these outcomes by simultaneous parental leave use, controlling for parents' age, sociodemographic characteristics, and prebirth mental health care use. Robustness analyses using propensity score matching were performed. The sample comprised 207 283 parental dyads, of whom 153 342 (74.0%) did not use simultaneous parental leave in the first postpartum year and 53 941 (26.0%) did. Among those who used simultaneous parental leave, the mean (SE) age at childbirth was 29.63 (0.02) years for mothers and 32.80 (0.03) years for fathers. Compared with mothers who did not use parental leave simultaneously with their partners, mothers who did were more likely to receive antidepressant prescriptions in the first postpartum year (odds ratio [OR], 1.07; 95% CI, 1.02-1.11). Fathers who used simultaneous parental leave vs those who did not had increased odds of SUD-related outpatient care visits (OR, 1.10; 95% CI, 1.02-1.20). Longer simultaneous parental leave was associated with greater odds of mental health care use for both parents, and earlier leave was associated with greater odds of health care use by mothers. Findings for mothers, but not fathers, remained significant in robustness analyses using propensity score matching. This cohort study found that simultaneous parental leave use was associated with greater health care uptake for postpartum mental health conditions in both mothers and fathers. This finding supports the need to consider the benefits of generous family policies as well as the risks of structural obstacles to postpartum mental health care access across the world.

Initial development of a digitally based comprehensive child mental health questionnaire.

The present report describes the item development and initial validation of a comprehensive child mental health questionnaire through a series of four studies. To maximize clinical utility, the questionnaire was developed to directly reflect Diagnostic and Statistical Manual of Mental Disorders, fifth edition psychiatric criteria and diagnoses, cover all mental health conditions that present in youth, and capitalize on the benefits of digital administration, particularly tiered branching logic. Study 1 describes the item generation and development of a tiered item structure. Study 2 established internal consistency and discriminant validity in a representative community sample of 1,000 youth aged 7-17 and a parent. Study 3 examined the acceptability of the questionnaire's content and structure to families and made indicated text revisions. Finally, Study 4 cross validated the internal consistency and tiered structure of a revised version of the questionnaire in a second representative normative sample of 1,000 parent and child dyads. The four studies resulted in a questionnaire consisting of one general mental health question (parent-report only), 16 items (for both parent and child) on a diagnostic category checklist, and 40 scales with screener and follow-up items reflecting DSM-5 criteria for specific disorders (371 parent items and 326 child items). The data support the potential of the questionnaire to efficiently assess the breadth of youth psychiatric symptoms efficiently. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Practical Resources for Effective Postpartum Parenting (PREPP): a randomized controlled trial of a novel parent-infant dyadic intervention to reduce symptoms of postpartum depression: RCT of the PREPP intervention for postpartum depression

BackgroundThere is little known about the effectiveness of psychological interventions to prevent postpartum depression that focus on the birthing parent and infant dyad. Risk factors for PPD include depression during pregnancy, low parenting self-efficacy, and disrupted parental nocturnal sleep. The brief Practical Resources for Effective Postpartum Parenting (PREPP) intervention is designed for pregnant individuals at-risk for postpartum depression, providing them with 1) caregiving strategies aimed at reducing infant fuss and cry behavior and increasing infant sleep, 2) self-reflection and mindfulness skills and 3) psychoeducation about the postpartum period and infant behavior. The aims are to set more realistic postpartum expectations, enhance parenting confidence and sleep via supporting infant regulatory behavior, improve parental affect regulation and ultimately reduce the risk of postpartum depression. ObjectivesAssess the effectiveness of PREPP compared to enhanced treatment as usual in reducing symptoms of depression and anxiety and episodes of infant fuss and cry behavior and improving parental and infant sleep in the early postpartum. Study designA randomized controlled trial was conducted of 175 pregnant individuals. Inclusion criteria were standard prenatal care for a singleton pregnancy, aged 18 to 45 and at increased risk of PPD as determined by a score of ≥19 on the Predictive Index of Postnatal Depression or ≥7 on the Edinburgh Postnatal Depression Scale. Participants assigned to the PREPP group (n=88) received three coaching sessions and two phone check-ins. Participants assigned to the enhanced treatment as usual group (n=87) received three sessions which included psychoeducation, mood assessments, and clinical referral and follow-up as indicated. Assessments were conducted at 28 to 32 weeks and 34 to 39 weeks gestation, and at six, 12 and 16 weeks postpartum and included measures of parental depression, anxiety and sleep (Edinburgh Postnatal Depression Scale, Patient Health Questionnaire (PHQ-9), Hamilton Rating Scales of Depression and Anxiety and Pittsburgh Sleep Quality Index) and infant sleep and fuss and cry behavior (Baby Day Diary). ResultsCompared to enhanced treatment as usual, PREPP significantly reduced depressive symptoms at six, 12 and 16 weeks postpartum with medium to large effect sizes (d=0.7-0.98). Compared to enhanced treatment as usual, participants receiving PREPP reported less of a decline in sleep quality at six weeks postpartum (p=0.035) and the effect size was large (d=0.83). Moreover, parents receiving the PREPP intervention reported less infant fussing and crying, with the largest effect for morning crying (p<0.001; d=-1.48). ConclusionsThe results provide evidence that PREPP, initiated during pregnancy, reduced symptoms of parental depression and infant fuss and cry behavior in the early postpartum, compared to enhanced treatment as usual, in a sample at-risk for postpartum depression.

Development and testing of a videogame intervention for symptom management among 8–18 years old children with cancer: a study protocol

IntroductionEvidence shows that cancer treatment-related symptoms could be managed effectively in 8–18 years old children through Digital Health Interventions (DHIs), consequently improving their health-related quality of life (HRQOL). However, limited...

Individual, dyadic, collaborative planning, physical activity, and nutrition: A randomized controlled trial in parent-child dyads.

This study was designed to investigate the effects of individual, dyadic, and collaborative planning on moderate-to-vigorous physical activity (MVPA; primary outcome) and energy-dense food intake (secondary outcome) in dyads of parents and their 9-15-year-old children. Individual planning reflects an "I-for-me" planning of one person's behavior. Collaborative ("we-for-us") planning refers to joint planning of both dyad members' behavior, whereas dyadic ("we-for-me") planning involves joint planning of only the target person's behavior. N = 247 dyads participated in a randomized controlled trial with individual, dyadic, or collaborative physical activity (PA) planning and control conditions (education about PA, sedentary behavior, nutrition, energy intake-expenditure balance). MVPA was measured with ActiGraph wGT3X-BT accelerometers at baseline, 1-week, and 36-week follow-ups. Energy-dense food intake was self-reported at baseline, 9-week, and 36-week follow-ups. Linear mixed models were fit for parents and children separately. At the 36-week follow-up, children in the dyadic "we-for-me" planning condition decreased their MVPA compared to the control condition. At the same time, children in the dyadic planning condition also decreased energy-dense food intake at the 36-week follow-up. No effects were found among children in individual and collaborative PA planning conditions. Parents in any experimental conditions decreased energy-dense food intake. Children's decrease in MVPA in dyadic PA planning condition was offset by a reduction of energy intake, which may represent a compensatory mechanism. The limited effectiveness of the dyadic "we-for-me" interventions in parent-child dyads may result from young people's needs for individuation and their reactance to parental support. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Trajectories of Change in Parent–Child Interaction Therapy Outcomes in Latinx Families: Implications for Cultural Adaptation

ABSTRACT Objective Parent–Child Interaction Therapy (PCIT) is a parenting program in which caregivers must achieve “skill criteria” in using Do Skills and avoiding Don’t Skills to complete treatment. Despite PCIT’s emphasis on these skills, little is known about how Latinx caregivers acquire these Western-based parenting practices and whether cultural mismatches lead to inequities in outcomes. This study compared the trajectories of change in PCIT skills and treatment outcomes of Latinx and non-Latinx White families. Method We analyzed weekly treatment data from 64 families (20.3% Spanish-speaking Latinx, 51.6% English-speaking Latinx, 28.1% non-Latinx White) served in community clinics. Caregivers were mostly females (95.3%), on average 35.13 years old, and lived in poverty (77.6%). PCIT skills were coded using the Dyadic Parent–Child Interaction Coding System, and child behavior problems were reported using the Eyberg Child Behavior Inventory. Results Latinx and non-Latinx White caregivers acquired Do Skills similarly during treatment. In contrast, some Latinx caregivers began treatment using significantly more Don’t Skills and needed more sessions to achieve some aspects of PCIT skill criteria compared with non-Latinx White caregivers. Latinx families also experienced similar or even more pronounced reductions in child behavior problems than non-Latinx White families. There were no significant differences in the percentage of caregivers who achieved PCIT skill criteria or left treatment prematurely. Conclusions This study provides evidence that strictly defined PCIT skill criteria may lead to inequities in treatment length for some Latinx families. Informed by these findings, we propose data-driven adaptations to improve the cultural fit of PCIT for Latinx groups.

Hope and relationship dynamics among couples faced with their child's cancer: A dyadic phenomenological interpretative analysis

PurposeThe onset of paediatric cancer leads to changes in the functioning of the parental couple. The interactions and interdependence between partners affect their individual and dyadic adjustments. Hope can enable parents to cope with difficulties and alleviate their distress. The aim of this study is to explore how both partners experience their relationship dynamics and hope within the couple. MethodThis qualitative study focused on 7 couples whose child was in remission from cancer; each parent was interviewed separately. The semi-structured interviews were subjected to interpretative phenomenological analysis. ResultsThree themes were found to characterise the experiences of couples faced with their child's cancer. “Captain and first mate" emphasises the gendered and hierarchical distribution of roles based on the analogy of a crew struggling against the threat of cancer. “The emotional compass" focuses on how emotions guide each partner's attempts to meet their own need for emotional expression and that of their partner. "In the same boat, with divergent hope sails" reflects the complex and diverse ways in which hope and forms of hope are expressed, perceived as a resource which is often precious, sometimes viewed as unthinkable because it reflects the violence associated with the despair of the situation and transferred from one parent to the other. DiscussionThese findings highlight the need to focus on the organisation of role, the interaction of emotional needs and the dynamics of hope within parental dyads to optimise the management of couples faced with their child's cancer.

Attachment Styles in Romantic Relationships and Perceived Support in Postpartum Couples

The transition to parenthood is a significant life event that presents various challenges. Adequate support for both parents is crucial, as insufficient support can lead to negative outcomes. While insecure attachment has been identified as a risk factor during this period, there is limited research on how dyadic attachment styles influence perceptions of received support. This study investigates the relationship between momentary perceptions of support matching and attachment styles among parental dyads using the experience sampling method (ESM) to reduce retrospective bias. For seven days, 40 mothers of infants aged 3-12 months completed daily self-report measures relating to desired and received support from their romantic partner. Multilevel analyses revealed that securely attached mothers perceived greater support matching compared to those with insecure attachment styles. The attachment style of the support provider (father) did not significantly affect the mother’s perceptions of support adequacy. These findings highlight the importance of attachment security in shaping support perceptions and suggest that attachment-based interventions could improve support experiences for new parents. Future research should explore the nuances of attachment pairings and their impact on support dynamics within couples. Interventions following childbirth should focus on improving maternal attachment security to enhance support matching and well-being for new parents. Keywords: attachment style, romantic attachment, postpartum, support

Quality of parent–child interaction in underserved migrant areas in Kyrgyz Republic: a pilot study

BackgroundAfter societal change in Kyrgyz Republic, the pattern of parent–child interaction in the changing parenting culture is an important factor influencing the positive development of Kyrgyz children. This study is aim to assess the quality of parent–child interactions in Kyrgyzstan by analyzing the interaction patterns and playfulness of children during free play at home.MethodsThis was a descriptive pilot study using video-recorded observations to explore parent–child interactions. The Dyadic Parent–Child Interaction Coding System and a playfulness instrument were used to assess the patterns and quality of the interaction. A total of 20 dyads of children aged 24 to 58 months and their parents, living in migrant communities of Kyrgyzstan, participated in this study.ResultsMajor parent–child interaction patterns included 731 turns of parent–child dyads during 1040 episodes. Verbal as well as nonverbal behaviors of parents were observed while interacting with their children. Parents used direct and indirect commands most frequently, while praise was used the least in interactions. Children frequently used compliance as well as noncompliance when they interacted with their parents. Children had low playfulness scores while interacting with their parents. Cognitive spontaneity was the component with the lowest score among all subdomains of playfulness.ConclusionFuture studies are recommended to develop strategies to facilitate parents’ active interaction with their children, promote children’s playfulness, and improve the quality of their mutual interaction.

Latinx parent-child acculturative stress profiles and their relation to expressed emotion and academic achievement.

This study derived parent-child acculturative stress (AS) profiles to evaluate how dyadic AS relates to parental expressed emotion (EE) and academic achievement. A sample of 284 Latinx youth (Mage = 11.5 years; 55.6% female) and their parents completed The Acculturative Stress Measure, and AS profiles were obtained using latent profile analyses (LPA). Profiles were compared across two outcomes: child and parent reports of parental EE using the Brief Dyadic Scale of Expressed Emotion, which measures parental warmth, criticism, and emotional overinvolvement (EOI), and child standardized test scores. Four AS profiles emerged using LPA fit indices: high child-low parent (HCLP; 7.7%), low child-high parent (LCHP; 13.4%), moderate child-low parent (MCLP; 14.4%), and low child-low parent (LCLP; 64.4%). Youth and parents in profiles reporting higher AS reported higher EE, particularly EOI. Youth in profiles characterized by greater AS obtained lower test scores. Parent and child dyads can experience different levels of AS. Higher dyadic AS was associated with worse perceived parental attitudes, as measured by EE, and lower academic achievement. Parental EE subscale differences varied based on the informant and their AS level. Findings underscore the importance of considering cultural factors and incorporating multiple family member experiences to meet the needs of Latinx families. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Latinx youth's and parents' covid-19 beliefs, vaccine hesitancy and vaccination rates: Longitudinal associations in a community sample.

The Latinx population has the second highest COVID-19 death rate among racial/ethnic groups in the United States and less than half of Latinx youth aged 5-17 years old completed their COVID-19 primary vaccination series as of September 2022. COVID-19 vaccine misinformation detrimentally impacts vaccination rates. In this study, we examined factors that predicted Latinx youth COVID-19 vaccine hesitancy and vaccination status. A community-based sample of 290 Latinx parent and adolescent dyads from a Southwestern metropolitan area of the United States who were recruited to complete an online survey at baseline at T1 (August 2020 -March 2021) and one year later. We tested a longitudinal mediation model in which we examined individual and family factors that would predict youth COVID-19 vaccine hesitancy and vaccination status over time. Youth's pandemic disbelief (i.e., the belief that the COVID-19 pandemic is a conspiracy or not real) predicted greater youth's COVID-19 vaccine hesitancy, and in turn, a lower likelihood of youth's COVID-19 vaccination. Youth's pandemic disbelief also predicted greater parent's vaccination hesitancy which, in turn, predicted greater youth's vaccination hesitancy and a lower likelihood of COVID-19 vaccination. Parents' pandemic disbelief predicted their own COVID-19 hesitancy, but not youth hesitancy. Our study findings provide initial evidence that general pandemic disbelief was a significant driver of vaccine hesitancy and vaccination among Latinx families. The study contributes to the limited research investigating COVID-19 vaccination in the Latinx community and among Latinx youth, further aiding how COVID-19 vaccine disparities can be mitigated among racial/ethnic populations.

Linked lives: intergenerational transmission of labour-market pathways between parent dyads and children.

While a vast number of studies confirm the transmission of labour-market disadvantages from one generation to the next, less is known about how parents' interconnected labour-market pathways co-evolve and shape the opportunities and obstacles for their children's future careers. This study uses a multidimensional view of intergenerational transmission by describing the most typical pathways of parents' occupational careers and assesses how these patterns are associated with their children's labour-market outcomes. Drawing on Swedish longitudinal register data, we used multichannel sequence analysis to follow a cohort of people born in 1985 (n = 72,409) and their parents across 26 years. We identified four parental earning models, differentiating between (1) dual earners with high wages, (2) dual earners with low-wage, (3) one-and-a-half-earners and (4) mother as the main breadwinner. Regression analysis shows strong intergenerational transmission among the most advantageous trajectories, with education as a key determinant for young people to become less dependent on family resources. This study stresses the importance of intra-couple perspectives in life course research to understand how inequalities are shaped and preserved across generations.

Understanding the dyadic mental health of refugee parents and children after fleeing the 2022 Ukraine war.

In February 2022, Ukraine suffered a devastating assault by Russia, leading to destruction, casualties, and displacement. Among those displaced were over 1.5 million families with children. War and displacement expose families to a heightened risk of mental health issues. These risks increase when both the parents and the children are exposed to trauma and develop mental health difficulties. This study investigated the prevalence of posttraumatic stress disorder (PTSD) and other mental health issues among parents and children and the associations between them. The study included 50 dyads of children and parents who had arrived in Israel after fleeing the war in Ukraine. Parents completed self-report questionnaires to assess their mental health and their children's mental health. About 56% of the parents and 2% of the children met the criteria for PTSD, and 50% of the children and 56% of the parents met the cutoff for clinical general psychological distress. Significant correlations were found between the parent's PTSD levels and the children's PTSD symptoms. Significant correlations were found between the parent's general distress and the children's PTSD symptoms, general distress, and externalizing problems. Children whose parents showed high rates of PTSD showed significantly higher PTSD and distress rates. Parents and children of refugees show high levels of mental health difficulties. The children's mental health is associated with the parent's mental health. A deeper understanding of the challenges faced by refugee families can inform the development of targeted assistance programs and the recruitment and training of personnel in host countries. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Discrepancies in perceived family resilience between adolescents with chronic illness and parents: using response surface analysis to examine the relationship with adolescents’ psychological adjustment

BackgroundThis study aimed to explore discrepancies in adolescents with chronic illness and their parents’ perceptions of family resilience, as well as the relationship between these differences and the psychological adjustment of adolescents with chronic illness.MethodsA cross-sectional study was conducted. A total of 264 dyads of parents (77.7% mothers, mean age 41.60 years, SD = 6.17) and adolescents (48.5% girls, mean age 12.68 years, SD = 2.11) with chronic illness were recruited through convenience sampling from three children’s hospitals in Wenzhou, Hangzhou, and Shanghai, China between June 2022 and May 2023. The Chinese version of the Family Resilience Scale and the Psychological Adjustment Scale, which are commonly used measures with good reliability and validity, were employed to assess family resilience and psychological adaption, respectively. The data were analyzed using polynomial regression and response surface analysis.ResultsAdolescents with chronic illness reported higher family resilience than their parents (t=-2.80, p < 0.05). The correlations between family resilience and adolescents’ psychological adjustment reported by the adolescents (r = 0.45–0.48) were higher than parents (r = 0.18–0.23). In the line of congruence, there were positive linear (a1 = 1.09–1.60, p < 0.001) and curvilinear (a2=-1.38∼-0.72, p < 0.05) associations between convergent family resilience and adolescents’ psychological adjustment. In the line of incongruence, when adolescents reported lower family resilience than parents, adolescents had a lower level of psychological adjustment (a3=-1.02∼-0.45, p < 0.05). Adolescents’ sociability decreased when the perceived family resilience of parent-adolescent dyads converged (a4 = 1.36, p < 0.01).ConclusionThe findings highlighted the importance of considering the discrepancies and congruence of family resilience in the parent-child dyads when developing interventions to improve the psychological adjustment of adolescents with chronic illness. Interventions aimed at strengthening family communication to foster the convergence of perceptions of family resilience in parent-adolescent dyads were warranted.

QOL-40. FAMILY MENTAL HEALTH SCREENING EARLY AFTER A DIAGNOSIS OF PEDIATRIC BRAIN TUMOR

Abstract INTRODUCTION A new diagnosis of a brain tumor in a child has significant emotional consequences for every member of the family. Despite this, early phases of oncologic care rarely provide formal mental health screening. METHODS In 2021, we implemented a mental health screening protocol for patients with a newly diagnosed brain tumor admitted to our pediatric intensive care unit (PICU) at the time of diagnosis, and their parents. Screening instruments were selected based on previous validation and relevance to both a brain tumor diagnosis and PICU admission. Parents were contacted by our team shortly after their child’s diagnosis and completed the screening within a month via an online interface. Parent proxy reports for children were used when necessary. Scores were shared with the family and neuro-oncology team. When indicated, supportive counseling and care coordination were offered. RESULTS Since 2021, 97 new brain tumor patients have met criteria for mental health screening. Of these, 72 patient and parent dyads were provided the screening protocol, and 31 fully completed the screening (mean patient age 7.3 yrs; 81% white; 58% male). Of the families that completed the evaluation, most parents (83%) reported their child’s diagnosis negatively impacted their health-related quality of life (HRQL), while 75% of children themselves reported a lower HRQL than population norms. Nearly half of children (44%) self-reported having symptoms outside of normal range for anger, anxiety or depression and 33% had abnormal scores for pain interference with their daily lives. More than half (65%) of families reported lower family functioning than population norms. CONCLUSION Families of children with a new diagnosis of brain tumor are at risk for impaired mental health and quality of life early after diagnosis. A systematic approach to assess and address these concerns early after diagnosis is needed.

Patient and Parent Knowledge, Understanding, and Concerns After a New Diagnosis of Ehlers Danlos Syndrome.

After diagnosis of Ehlers Danlos Syndrome (EDS), it is unclear what information patients and parents need and understand about EDS. The objective of this study is to characterize patient and parent knowledge and concerns about EDS after a diagnosis of EDS is made to determine patient and parent concerns and identify barriers that cause discomfort with the diagnosis. A convenience sample of patient and parent dyads were recruited after new diagnosis of EDS. Patients and parents completed questionnaires that assessed knowledge, comfort, and barriers of EDS before and after diagnosis, EDS education materials accessed, and additional clinical needs and concerns. Seventy-two dyads completed the survey. Many respondents actively seek information on the diagnosis and management of EDS. Parents and patients look for information about EDS differently. Parents have more concerns after diagnosis and both want well-constructed, empirically supported educational materials delivered via multiple modalities, which makes clinical guidelines more essential.

Trajectories of illness uncertainty among parents of children with atypical genital appearance due to differences of sex development.

The present study aimed to identify distinct trajectories of parental illness uncertainty among parents of children born with atypical genital appearance due to a difference of sex development over the first year following diagnosis. It was hypothesized that four trajectory classes would emerge, including "low stable," "high stable," "decreasing," and "increasing" classes, and that select demographic, familial, and medical factors would predict these classes. Participants included 56 mothers and 43 fathers of 57 children born with moderate to severe genital atypia. Participants were recruited from eleven specialty clinics across the U.S. Growth mixture modeling (GMM) approaches, controlling for parent dyad clustering, were conducted to examine classes of parental illness uncertainty ratings over time. A three-class GMM was identified as the best-fitting model. The three classes were interpreted as "moderate stable" (56.8%), "low stable" (33.0%), and "declining" (10.3%). Findings suggest possible diagnostic differences across trajectories. Findings highlight the nature of parents' perceptions of ambiguity and uncertainty about their child's diagnosis and treatment the year following their child's birth/diagnosis. Future research is needed to better understand how these trajectories might shift over the course of the child's development. Results support the development of tailored, evidence-based interventions to address coping with uncertainty among families raising a child with chronic health needs.