Parental Psychiatric Symptoms Research Articles

Do environmental effects indexed by parental genetic variation influence common psychiatric symptoms in childhood?

Parental genes may indirectly influence offspring psychiatric outcomes through the environment that parents create for their children. These indirect genetic effects, also known as genetic nurture, could explain individual differences in common internalising and externalising psychiatric symptoms during childhood. Advanced statistical genetic methods leverage data from families to estimate the overall contribution of parental genetic nurture effects. This study included up to 10,499 children, 5990 mother–child pairs, and 6,222 father–child pairs from the Norwegian Mother Father and Child Study. Genome-based restricted maximum likelihood (GREML) models were applied using software packages GCTA and M-GCTA to estimate variance in maternally reported depressive, disruptive, and attention-deficit hyperactivity disorder (ADHD) symptoms in 8-year-olds that was explained by direct offspring genetic effects and maternal or paternal genetic nurture. There was no strong evidence of genetic nurture in this sample, although a suggestive paternal genetic nurture effect on offspring depressive symptoms (variance explained (V) = 0.098, standard error (SE) = 0.057) and a suggestive maternal genetic nurture effect on ADHD symptoms (V = 0.084, SE = 0.058) was observed. The results indicate that parental genetic nurture effects could be of some relevance in explaining individual differences in childhood psychiatric symptoms. However, robustly estimating their contribution is a challenge for researchers given the current paucity of large-scale samples of genotyped families with information on childhood psychiatric outcomes.

The possible relation between stigma, parent psychiatric symptoms, quality of life and the disease burden in families of children with autism spectrum disorder in Egypt: a multicentre study

BackgroundMost autism spectrum disorder (ASD) interventions evaluated child outcomes and ignoring the role of parent and family factors on both the immediate- and long-term effects of therapy. The purpose of this study was to determine the relationship between stigma, parent mental health problems, and quality of life and burden in families of children with ASD in Egypt and its risk factors. Seventy parents of ASD children were recruited from two child intervention centers. Participants were divided into two groups based on burden scale: caregivers of moderate burden (n = 27) and caregivers of severe burden (n = 43). All parents were evaluated for demographic data, zarit Burden Interview, socioeconomic scale, symptom checklist–90 (SCL90), Explanatory Model Interview Catalogue Community Stigma Scale (EMIC-CSS), and the World Health Organization Quality of Life–BREF (WHOQOL-BREF).ResultsHalf of the parents reported significant stigma, particularly caregivers with a severe burden. Caregivers with severe burden had more depression and about twice the frequency of sensitivity and somatization problems, lower QoL (20%) as compared with caregivers with moderate burden. Parents with ASD had many associate factors such as work, male autistic children and their caregiver, age of children and parents, the severity of the condition, and disease duration with burden, stigma, QoL, and mental health problems.ConclusionsThis study linked the interrelationships between increased burden and stigma, impaired quality of life, and parental mental health problems; the presence of one of these variables was found to increase the risk of other variables.

Structural Equation Modeling (SEM): Childhood Aggression and Irritable ADHD Associated with Parental Psychiatric Symptoms.

Background: Children with attention deficit hyperactivity disorder (ADHD) co-occurring with Oppositional Defiant Disorder (ODD) further present aggressive behavior and may have a depressive parent. A child with co-occurring ADHD and ODD has differentially higher levels of behavioral and emotional difficulties. Little is known about how the irritable subtype of ADHD in children mediates the development of parental symptomatology. This study aims to elucidate the direct or indirect influence of childhood disruptive ADHD with aggressive behavior on their parental symptom using Structural Equation Modeling (SEM). Methods: A total of 231 ADHD children and their parents completed the Swanson, Nolan, and Pelham Version IV questionnaire for symptoms of ADHD, Oppositional Defiant Disorder (ODD) scale for irritable symptoms, Child Behavior Check List (CBCL) for aggression, and Symptom Checklist (SCL) for parental symptom. Results: The three-factor confirmatory factor analysis (CFA) model found symptoms of inattention, hyperactivity/impulsivity, irritable ODD, and aggression were inter-related. Mediational analyses demonstrated ODD mediates symptoms directly predicting the risk of increasing ADHD severity. Disruptive child symptoms (ADHD + ODD + aggression) may increase the risk of depression-related symptoms in the parent. When the child’s aggression increases by one standard deviation (SD), parental psychiatric symptoms increase by 0.235 SD (p < 0.001). Conclusions: By this SEM pathway analysis, there is the correlation between the disruptive, more aggressive subtype of ADHD in children/adolescents and the existence of psychopathological symptomatology of their parents. ADHD + ODD + aggression in children should be classified as an irritable subtype of ADHD, warranting early diagnosis and intensive treatment.

Psychiatric disorders, family functions, and parent psychiatric symptoms in children and adolescents with chronic dermatological diseases treated with phototherapy

Objective: The aim of this study was to examine comorbid psychiatric disorders, family functioning, and parental psychiatric symptoms in children and adolescents with chronic dermatological diseases and compare them with those of healthy controls. Materials and Methods: The research sample consisted of patients between the age of 9 and 18 years (n = 45) with alopecia areata, vitiligo, or psoriasis and a control group (CG) of healthy children and adolescents of the same age (n = 42). The psychiatric diagnoses of cases were established using Schedule for Affective Disorders and Schizophrenia for School Aged Children Present-Lifetime Version. Family assessment device (FAD) was used to evaluate family functioning levels. Parental psychiatric symptom levels were obtained by the Symptom Checklist-90-R. Results: Children and adolescents with chronic dermatological diseases had significantly higher rates of any anxiety disorders and any axis I comorbid psychiatric disorders than healthy controls after adjusting for socioeconomic status (P < 0.05). There were no significant differences in parental psychiatric symptom levels and family functioning levels between two groups; however, families of patients with comorbid psychiatric disorders had significantly higher scores in problem-solving and communication subscales of the FAD when compared to those of patients without psychiatric disorders and CG. Conclusions: Our findings suggest that children and adolescents with chronic dermatological diseases have higher risk for anxiety disorders. When psychiatric disorders co-occur with the dermatological disease in children and adolescents, they may adversely affect the family functioning, in the domains of problem-solving and communication skills.

Resemblance and clustering of mother's and father's psychopathology levels among Chinese parents of schoolchildren with psychiatric disorders.

Few studies have assessed the characteristics of spousal psychopathologies among parents of schoolchildren with and without psychological disorders (PD) in China. Parental symptoms were measured using the General Health Questionnaire (GHQ) in 275 mothers and 278 fathers of 298 schoolchildren with PDs diagnosed in a population survey and in 825 mothers and 834 fathers of 894 schoolchildren without PDs as a 1:3 matched comparison group. Spousal GHQ scores were compared. Childhood PD type, presence of childhood comorbidities, and multiple parental and family characteristics were examined as predictors for parental GHQ scores by multiple linear regression analyses. The GHQ scores were significantly higher among mothers and fathers of children with any PD. Maternal GHQ scores were higher than paternal scores and significantly correlated with paternal GHQ scores in both groups. Spousal GHQ, personal PD history, and childhood PD comorbidity were significant independent predictors of both parents' GHQ scores. There were also significant associations among parental chronic disease, low family income, and paternal and maternal GHQ score, as well as among low maternal education, less common disorder (LCD) prevalence in children and maternal GHQ score. The rate of GHQ score ≥3 for both parents was significantly higher in the study group than the control group (15.1 vs.7.0%). Parents of children with any PD type demonstrate significantly elevated psychopathologies, and psychopathology tends to occur concomitantly and resemble that of the other spouse. Screening and treatment of parental psychiatric symptoms will benefit all family members.

Personality and subjective psychiatric symptoms of parents of obese youth: a controlled study

ABSTRACTOBJECTIVE: In this study, it was aimed to evaluate the relationship between parental personality characteristics and psychiatric symptoms with childhood obesity.METHODS: This cross-sectiona...

Do Parental Psychiatric Symptoms Predict Outcome in Children With Psychiatric Disorders? A Naturalistic Clinical Study

Parental psychiatric symptoms can negatively affect the outcome of children's psychopathology. Studies thus far have mainly shown a negative effect of maternal depression. This study examined the associations between a broad range of psychiatric symptoms in mothers and fathers and the child's outcome. Internalizing and externalizing psychiatric symptoms were assessed in 742 mothers, 440 fathers, and their 811 children at the first evaluation in 3 child and adolescent psychiatric outpatient clinics and at follow-up (on average 1.7 years later). Predictions of child's symptoms scores were tested at follow-up by parental symptom scores at baseline, parental scores at follow-up, and offspring scores at baseline. Children whose mother or father scored above the (sub)clinical threshold for psychiatric symptoms at baseline had higher symptom scores at baseline and at follow-up. Offspring follow-up scores were most strongly predicted by offspring baseline scores, in addition to parental psychiatric symptoms at follow-up. Offspring symptom scores at follow-up generally were not predicted by parental scores at baseline. Maternal and paternal associations were of similar magnitude. Higher symptom scores at follow-up in children of parents with psychopathology were mainly explained by higher symptom scores at baseline. Continuing parent-offspring associations could be a result of reciprocal effects, ie, parental symptoms influencing offspring symptoms and offspring symptoms influencing parental symptoms. Nevertheless, the results show that these children are at risk for persisting symptoms, possibly indicating the need to treat maternal and paternal psychopathology.

Risk factors for parental psychopathology: a study in families with children or adolescents with psychopathology

The parents of children with psychopathology are at increased risk for psychiatric symptoms. To investigate which parents are mostly at risk, we assessed in a clinical sample of families with children with psychopathology, whether parental symptom scores can be predicted by offspring psychiatric diagnoses and other child, parent and family characteristics. Parental depressive, anxiety, avoidant personality, attention-deficit/hyperactivity (ADHD), and antisocial personality symptoms were measured with the Adult Self Report in 1805 mothers and 1361 fathers of 1866 children with a psychiatric diagnosis as assessed in a child and adolescent psychiatric outpatient clinic. In a multivariate model, including all parental symptom scores as outcome variables, all offspring psychiatric diagnoses, offspring comorbidity and age, parental age, parental educational attainment, employment, and relationship status were simultaneously tested as predictors. Both 35.7% of mothers and 32.8% of fathers scored (sub)clinical for at least one symptom domain, mainly depressive symptoms, ADHD symptoms or, only in fathers, avoidant personality symptoms. Parental psychiatric symptoms were predicted by unemployment. Parental depressive and ADHD symptoms were further predicted by offspring depression and offspring ADHD, respectively, as well as by not living together with the other parent. Finally, parental avoidant personality symptoms were also predicted by offspring autism spectrum disorders. In families with children referred to child and adolescent psychiatric outpatient clinics, parental symptom scores are associated with adverse circumstances and with similar psychopathology in their offspring. This signifies, without implying causality, that some families are particularly vulnerable, with multiple family members affected and living in adverse circumstances.

Interactive Effect of Parent and Adolescent Psychiatric Symptoms on Substance Use among Adolescents in Community Treatment.

Both adolescent and parent psychiatric symptoms are well-established risk factors for adolescent substance use (SU), but the ways that these symptoms interact are not well understood. This study examined the interactive effects of parent and adolescent psychiatric symptoms on adolescent frequency of alcohol and marijuana use, over and above the effects of parental SU. Seventy adolescents presenting to a community mental health center (CMHC) participated. Parent and adolescent psychiatric symptoms were measured with the brief symptom inventory (BSI) and child behavior checklist (CBCL), respectively. Hierarchical regressions revealed different patterns for adolescent alcohol and marijuana use. For alcohol, the BSI parent phobic anxiety subscale predicted increased adolescent use while the parent interpersonal sensitivity subscale predicted decreased use: the effects of these parental symptoms were strongest among adolescents with higher levels of externalizing problems on the CBCL. For marijuana, the BSI parent psychoticism subscale predicted increased adolescent use, whereas paranoid ideation predicted decreased use. Results suggest that adolescent SU treatment and assessment should attend to both adolescent and parent psychiatric symptoms.

The Impact of Parental Psychiatric Symptoms and Parent-Child Relationships on Behavioural and Emotional Problems in Newly-Diagnosed Toddlers and Preschool Children with Autism Spectrum Disorders

Background: Emotional and behavioural problems occur at a high rate in children with autism spectrum disorders (ASD). These problems are associated with a broad range of risk factors such as parental psychopathology and family environment in school-age children and adolescents. However, limited information is available about these phenomena in toddlers and preschool children. This cross-sectional study examined the association of maternal and paternal psychiatric symptoms and mother-child relationships with emotional and behavioural problems and socioemotional competence of newly-diagnosed young children with ASD. Method: Autistic symptoms, developmental level, and mother-child relationship of children were evaluated. Parents completed a checklist on child behavioural and emotional problems, and individual questionnaires on their own mental health. Results: Participants were 35 children with ASD aged 18 – 53 months, referred to an infant mental health clinic. Maternal hostility and poor mother-child relationships have been found to be independently associated with emotional and behaviour problems in these children. Conclusions: This study suggests that maternal hostility and mother-child relationship problems may play a role for the development of emotional and behaviour problems in toddlers and preschool children with ASD.

Risks of Abnormal Internet Use Among Adolescents with Attention-deficit/Hyperactivity Disorder

Purpose This aim of the study is to investigate the risks among adolescents with attention-deficit/hyperactivity disorder (ADHD) who develop compulsive Internet use (CIU) and adolescents who do not develop CIU. Methods Seventy-eight adolescents with ADHD completed general demographic questionnaires that included information on body mass index, subtype, comorbidity, and behavioral problems. The family characteristics included information on parental ADHD diagnosis, psychiatric symptoms, and media exposure problems. The respondents were categorized as ADHD with CIU or ADHD with non-CIU, based on the Internet addiction cutoff point by the standardized measurements of the Chen Internet Addiction Scale. Results The results revealed 12.8% of the adolescents with ADHD had CIU. They were characterized by average height, tendency to withdraw, having a young father, and playing computer games for more than 1 hour daily. Conclusion More attention to ADHD adolescents with CIU is warranted. An early intervention program is suggested for their social withdrawal tendency.

Nonverbal intelligence in young children with dysregulation: the Generation R Study.

Children meeting the Child Behavior Checklist Dysregulation Profile (CBCL-DP) suffer from high levels of co-occurring internalizing and externalizing problems. Little is known about the cognitive abilities of these children with CBCL-DP. We examined the relationship between CBCL-DP and nonverbal intelligence. Parents of 6,131 children from a population-based birth cohort, aged 5 through 7 years, reported problem behavior on the CBCL/1.5-5. The CBCL-DP was derived using latent profile analysis on the CBCL/1.5-5 syndrome scales. Nonverbal intelligence was assessed using the Snijders Oomen Nonverbal Intelligence Test 2.5-7-Revised. We examined the relationship between CBCL-DP and nonverbal intelligence using linear regression. Analyses were adjusted for parental intelligence, parental psychiatric symptoms, socio-economic status, and perinatal factors. In a subsample with diagnostic interview data, we tested if the results were independent of the presence of attention deficit hyperactivity disorder (ADHD) or autism spectrum disorders (ASD). The results showed that children meeting the CBCL-DP (n = 110, 1.8%) had a 11.0 point lower nonverbal intelligence level than children without problems and 7.2-7.3 points lower nonverbal intelligence level than children meeting other profiles of problem behavior (all p values <0.001). After adjustment for covariates, children with CBCL-DP scored 8.3 points lower than children without problems (p < 0.001). The presence of ADHD or ASD did not account for the lower nonverbal intelligence in children with CBCL-DP. In conclusion, we found that children with CBCL-DP have a considerable lower nonverbal intelligence score. The CBCL-DP and nonverbal intelligence may share a common neurodevelopmental etiology.

Relation Between Parent Psychiatric Symptoms and Youth Problems: Moderation through Family Structure and Youth Gender

Links between parents' psychiatric symptoms and their children's behavioral and emotional problems have been widely documented in previous research, and the search for moderators of this association has begun. However, family structure (single versus dual-parent households) has received little attention as a potential moderator, despite indirect evidence that risk may be elevated in single-parent homes. Two other candidate moderators-youth gender and age-have been tested directly, but with inconsistent findings across studies, perhaps in part because studies have differed in whether they used youth clinical samples and in which informants (parents vs. youths) reported on youth problems. In the present study, we examined these three candidate moderators using a sample of exclusively clinic-referred youths (N = 333, 34 % girls, aged 7-14,) and assessing youth problems through both parent- and youth-reports. Both family structure and youth gender emerged as robust moderators across parent and youth informants. Parent symptoms were associated with youth internalizing and externalizing problems in single-parent but not dual-parent homes; and parent symptoms were associated with youth internalizing problems among boys, but not girls. The moderator findings suggest that the risks associated with parent psychopathology may not be uniform but may depend, in part, on family structure and youth gender.

Adolescents’ Internalizing Problems Following Traumatic Brain Injury Are Related to Parents’ Psychiatric Symptoms

A small body of previous research has demonstrated that pediatric traumatic brain injury (TBI) increases risk for internalizing problems, but findings have varied regarding their predictors and correlates. We examined the level and correlates of internalizing symptoms in 130 teens who had sustained a complicated mild to severe TBI within the past 1 to 6 months. Internalizing problems were measured via both maternal- and paternal-report Child Behavior Checklist. We also measured family functioning, parent psychiatric symptoms, and postinjury teen neurocognitive function. Mean parental ratings of internalizing problems were within the normal range. Depending on informant, 22% to 26% of the sample demonstrated clinically elevated internalizing problems. In multiple and binary logistic regression models, only parent psychiatric symptoms consistently provided unique prediction of teen internalizing symptoms. For maternal but not paternal report, female gender was associated with greater internalizing problems. Parent and teen emotional problems are associated following adolescent TBI. Possible reasons for this relationship, including the effects of TBI on the family unit, are discussed.

Associations among depression, perceived self-efficacy, and immune function and health in preadolescent children

Experimental animal studies and adult research consistently show that stress exposure and/or psychological symptoms are associated with poorer health and immune functioning. The application to children is not yet clear, however, and we lack developmental models for studies in this area. The objective of this paper was to test the hypothesis that self-reported self-efficacy and depression, two markers of psychological well-being in children, would predict immunity and rate of illnesses. The data are based on a prospective study of 141 healthy, normally developing children aged 7-13 years who were recruited from an ambulatory pediatric setting. Children completed self-efficacy and depression measures and had blood obtained for IL-6 plasma levels and natural killer cell functional assays on three occasions, 6 months apart. Parents maintained weekly child illness diaries over 1 year using a thermometer to record fever. Parent psychiatric symptoms and income were used as covariates. Results indicated that, across the three occasions of measurement collected over the 1-year period, higher perceived self-efficacy was significantly associated with lower plasma interleukin 6 concentrations. There was no overall main effect of depressive symptoms on immune measures; however, for older girls, higher depression was associated with elevated natural killer cell cytotoxicity and an increased rate of total illnesses and febrile illnesses. The findings provide some of the first evidence that psychological processes are associated with immunity and health in a normally developing sample of preadolescents. Furthermore, the pattern of results suggests a modified model of a link between psychological well-being and immunological processes in children. These results build on and expand research on the notion of allostatic load and develop a groundwork for developmental studies in this area.

Monitoring challenges: a closer look at parental monitoring, maternal psychopathology, and adolescent sexual risk.

The present study sought to examine associations between maternal psychopathology, parental monitoring, and adolescent sexual activity among adolescents in mental health treatment. Seven hundred ninety mother-adolescent dyads recruited from adolescent mental health treatment settings completed audio computer-assisted structured interview assessments examining parent psychiatric symptoms, parental monitoring, and adolescent sexual risk behavior. Path analysis was used to examine the associations between variables of interest. Maternal caregivers who reported more mental health symptoms were more likely to have adolescents who reported recent sex and this relationship was mediated by less parental monitoring. These findings suggest that maternal caregivers with mental health symptoms may need specific interventions that provide assistance and support in monitoring their teens in order to reduce sexual risk taking among adolescents in mental health treatment.

Recovery in parents of children and adolescents who survived septic shock caused by Neisseria meningitidis: A cross-sectional study

To assess psychological distress, styles of coping and disease-related psychosocial limitations in parents of children and adolescents who survived meningococcal septic shock (MSS) 4-16 years ago. An exploratory design using standardised questionnaires and interviews. The psychological investigation took place in the department of Child and Adolescent Psychiatry of the ErasmusMC-Sophia Children's Hospital. 87 mothers and 77 fathers participated in this study. The General Health Questionnaire was used to assess parents' psychological distress; the Utrecht Coping List to assess styles of coping. A semi-structured disease-specific interview served to explore long-term disease-related psychosocial limitations for parents. MSS parents reported similar psychiatric symptoms and styles of coping in comparison to reference groups. Severity of illness and the child's age at time of illness were not significant predictors of parental psychological distress and styles of coping. The presence of somatic sequelae, cognitive or behavioural and emotional problems was not associated with the levels of parental psychiatric symptoms or styles of coping. The vast majority of parents reported no current disease-related psychosocial limitations due to the MSS. Parents of children who survived MSS show recovery. Nevertheless a minority still experiences emotional burden and disease-related limitations.

Maternal smoking during pregnancy and child behaviour problems: the Generation R Study

Several studies showed that maternal smoking in pregnancy is related to behavioural and emotional disorders in the offspring. It is unclear whether this is a causal association, or can be explained by other smoking-related vulnerability factors for child behavioural problems. Within a population-based birth cohort, both mothers and fathers reported on their smoking habits at several time-points during pregnancy. Behavioural problems were measured with the Child Behavior Checklist in 4680 children at the age of 18 months. With adjustment for age and gender only, children of mothers who continued smoking during pregnancy had higher risk of Total Problems [odds ratio (OR) 1.59, 95% confidence interval (CI): 1.21-2.08] and Externalizing problems (OR 1.45, 95% CI: 1.15-1.84), compared with children of mothers who never smoked. Smoking by father when mother did not smoke, was also related to a higher risk of behavioural problems. The statistical association of parental smoking with behavioural problems was strongly confounded by parental characteristics, chiefly socioeconomic status and parental psychopathology; adjustment for these factors accounted entirely for the effect of both maternal and paternal smoking on child behavioural problems. Maternal smoking during pregnancy, as well as paternal smoking, occurs in the context of other factors that place the child at increased developmental risk, but may not be causally related to the child's behaviour. It is essential to include sufficient information on parental psychiatric symptoms in studies exploring the association between pre-natal cigarette smoke exposure and behavioural disorders.

The associations between psychosocial stress and the frequency of illness, and innate and adaptive immune function in children

Objective Family processes have a substantial impact on children’s social and emotional well-being, but little is known about the effects of family stress on children’s physical health. To begin to identify potential links between family stress and health in children, we examined associations between specific aspects of family psychosocial stress and the frequency of illnesses in children, measures of innate and adaptive immune function, and human herpesvirus 6 (HHV-6) reactivation. Study design Prospective study of 169 ambulatory school-age children and parents. Parents completed multiple assessments of stress at 7 sequential six-month visits and maintained weekly illness diaries for their children over three years using a thermometer to record fever. Children had blood obtained for HHV-6 and immune function studies at each visit including natural killer (NK) cell function and the percentage of CD4 and CD8 cells associated with immune control of cytomegalovirus (CMV). Results Parental psychiatric symptoms were associated with a higher frequency of illnesses: for each 1 U increase in symptom score children had an increased 1-year rate of total illnesses of 40% (rate ratio, 1.40; 95% CI, 1.06–1.85) and febrile illnesses of 77% (rate ratio, 1.77, 95% CI, 1.00–3.13). Parental psychiatric symptom scores were also associated with enhanced NK cell function (estimate, 0.15; 95% CI, 0.05–0.26) and increased percentages of CD8+CD28-CD57+ cells in the blood of CMV seropositive children (estimate, 2.57; 95% CI, 0.36–4.79). HHV-6 reactivation was not detected. Conclusions There is an association between specific psychosocial stress exposure and rates of illness and immune function in normally developing children.

Association of Family Stress With Natural Killer Cell Activity and the Frequency of Illnesses in Children

To examine prospective associations between chronic stress in the parent-child and family systems and subsequent rates of illnesses and the activity of natural killer (NK) cells in children. Prospective cohort study. The Golisano Children's Hospital at Strong, Rochester, NY, from July 1, 2001, to June 30, 2003. One hundred sixty-nine socioeconomically and racially diverse children (aged 5-10 years) and their parents. Parents completed measures of their psychiatric symptoms and stress in the family every 6 months. Children's blood samples were obtained for NK cytotoxicity assays every 6 months. Parent-reported total child illnesses and febrile illnesses and results of NK cell cytotoxicity assays. We estimated adjusted illness rate ratios and adjusted mean differences in NK activity. Elevated parental psychiatric symptoms occurring with family stressors were associated with more total illnesses (rate ratio, 1.11; 95% confidence interval [CI], 1.00-1.22) and febrile illnesses (rate ratio, 1.36; 95% CI, 1.13-1.64) in children. Natural killer cell function was enhanced in children whose parents reported more chronic stress (estimate, 0.15; 95% CI, 0.05-0.26). Natural killer cell function was not associated with short-term changes in stress. Stress-illness relationships were not associated with stress-related alterations in NK cell function. Chronic family stress was associated with increased illnesses in children. Unlike older adults, children living with elevated chronic stress had enhanced rather than decreased NK cytotoxicity, suggesting chronic stress may have different effects on the developing immune system. Impaired parental functioning may be a mechanism linking family stress with adverse effects on children's health.