Parental Caregiving Research Articles

Developmental antecedents of adherence to masculinity norms: A 9-year longitudinal study of urban Chinese families.

A growing body of literature shows that adherence to some aspects of Western masculinity norms, including the suppression of emotional vulnerability, avoidance of seeking support from others, and exaggerated physical toughness, is associated with poorer psychological and social outcomes. While existing research suggests that parental gender beliefs and caregiving behaviors might influence the development of children's gendered behaviors, little is known about the developmental origins of individual differences in adherence to masculinity norms. The current study aims to address this gap and presents a longitudinal investigation of how parental gender beliefs and maternal sensitivity during infancy contribute to children's adherence to masculinity norms during middle childhood. Data were drawn from a mixed-method 9-year longitudinal study of 374 urban Chinese families (48.40% with daughters). Parental gender beliefs were assessed at 24 months, maternal sensitivity was assessed with mother-child interaction observations at 14 and 24 months, and children's self-reported adherence to masculinity norms were assessed at age 10 years. Results indicate that while parental gender beliefs had no associations with children's adherence to masculinity norms, maternal sensitivity predicted children's adherence to masculinity norms (β = -.18, p = .008) above and beyond parental gender beliefs and parental education level; moreover, there was a significant interaction of sex on the effect of maternal sensitivity on children's adherence to masculinity (β = -.23, p = .025), and the association was significant only for boys. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Sibling Availability, Sibling Sorting, and Subjective Health Among Chinese Adults

Despite rising numbers of only children in China, little is known about their family dynamics and well-being in adulthood—for example, how often they marry other only children and whether those in siblingless families have worse or better health than others. Theoretical expectations produce opposing predictions: siblings might provide social and emotional support and reduce parental caregiving pressures, but only children might receive more support from parents and grandparents. Using the 2010 China Family Panel Study, we examine marital sorting on Chinese adults’ number of siblings and test whether sibling availability and sibling sorting are associated with subjective physical and mental health. Despite general perceptions that China has an exceedingly high prevalence of adults with no siblings that might produce very small families, results demonstrate a low prevalence of siblingless couples (i.e., both spouses are only children). Married adults with no siblings or siblings-in-law have better subjective physical health but similar levels of subjective mental health relative to their counterparts with siblings. The health advantages of siblingless marital unions are greater for rural and female adults. Declining sibling prevalence in China will shape future family demographic dynamics but appears less detrimental to population health than sometimes assumed.

Selection on the joint actions of pairs leads to divergent adaptation and coadaptation of care-giving parents during pre-hatching care.

The joint actions of animals in partnerships or social groups evolve under both natural selection from the wider environment and social selection imposed by other members of the pair or group. We used experimental evolution to investigate how jointly expressed actions evolve upon exposure to a new environmental challenge. Our work focused on the evolution of carrion nest preparation by pairs of burying beetles Nicrophorus vespilloides, a joint activity undertaken by the pair but typically led by the male. In previous work, we found that carrion nest preparation evolved to be faster in experimental populations without post-hatching care (No Care: NC lines) than with post-hatching care (Full Care: FC lines). Here, we investigate how this joint activity evolved. After 15 generations of experimental evolution, we created heterotypic pairs (NC females with FC males and NC males with FC females) and compared their carrion nest making with homotypic NC and FC pairs. We found that pairs with NC males prepared the nest more rapidly than pairs with FC males, regardless of the female's line of origin. We discuss how social coadaptations within pairs or groups could act as a post-mating barrier to gene flow.

Continuity vs. Discontinuity: A Case of Home Language and Literacy Socialization in Indonesia

The present study explores the language and literacy socialization (LLS) of Indonesian children from low- to middle-income families. The Indonesian government has never truly involved home and family as the base for literacy socialization in its programs, affecting the nation-state's low rank in literacy proficiency. This paper aims to describe the LLS of low- to middle-income Indonesian families and examine how the language used by caregivers and parents stimulates the issue of continuity or discontinuity between home and school literacy practices. The study used an ethnographic approach in which the researchers observed the LLS events of 6 families in Surabaya, Indonesia. Conversations between caregivers/parents and children during literacy events were recorded. The findings suggest that every family has different patterns of literacy practices depending on their beliefs and culture at home and that parents' or caregivers' language and style of communication may facilitate or hinder children's access to literacy. Two socialization patterns were identified, including reference to past experience and collaborative negotiation of meaning. It is argued that not only the background of education but also caregivers' literacy culture and educational beliefs play a role in their strategy of language and literacy socialization at home.

Exploring the Link Between Parenting Styles and Childhood Trauma

Parenting styles and childhood trauma are intricately linked, with the quality of parental caregiving playing a crucial role in shaping children's vulnerability to trauma and subsequent psychological outcomes. The manner in which parents engage with and their children can significantly impact their emotional well-being and resilience in the face of adversity. Parenting styles encompass the array of behaviors, attitudes, and strategies that parents employ in raising their children, shaping the nature of the parent-child relationship and influencing children's development across various domains. Childhood trauma refers to experiences of abuse, neglect, or other adverse events that occur during the formative years of childhood, exerting profound and lasting effects on individuals' psychological well-being and functioning. The purpose of the present study was to investigate the link between parenting styles and childhood trauma. Parental control scale and Adverse childhood experience scale were administered on a sample of 190 (male=95, female=95) people between the ages of 18-22. The correlation between parenting styles and childhood trauma was studied using Pearson’s correlation. The results showed that there was a moderately strong positive correlation between parenting styles and childhood trauma.

Experiences of Parental Caregivers of Adults with Autism in Navigating the World of Employment.

Caregiving often presents challenges for parents, particularly for parents of loved ones with disabilities or health challenges, who need and/or want to be employed. This study describes the employment experiences of aging parents as they continue to balance engagement in the paid workforce with the ongoing provision of care for their adult children with autism spectrum disorder (ASD). The purpose of this study was to examine the lived experiences of parents of adult children with ASD in the context of balancing career and caregiving responsibilities. The current study uses a qualitative phenomenological research approach to describe the lived experiences of 51 parents who were caring for an adult child with ASD. The parents participated in telephone interviews to obtain information about their career experiences while providing care and support to their adult children with ASD. Three caregiving themes emerged including: (a) difficulty balancing caregiving with work responsibilities, (b) reasons for working, not working, or working intermittently, and (c) work as an escape or wanting to work more. As more individuals with ASD reach adulthood, often relying to varying extents on their families for daily support, parental employment will continue to be impacted as they juggle their career with caregiving responsibilities. Economically, one or more family members typically need to work to sustain the family's needs and employment support should be considered. As a society, families often need to make choices even with an adult child with ASD of who will work, how, and when.

Childhood Adversities and Caregiving for Older Parents: Building Capacity for a Caring Society.

This study investigates the relationships between childhood adversities and the provision of informal care for older parents in later life in China. The data came from 4 waves of the China Health and Retirement Longitudinal Study (N = 20,047). Using multilevel logistic regression models, we examined the relationships between adverse experiences in childhood and both the propensity and intensity of caregiving for older parents. Drawing on the regression results, we then estimated the total number of caregivers for older parents in China. Experiencing 1 additional childhood adversity was associated with a decrease of 8% in the odds of providing informal care (p < .001). The association between childhood adversity and caregiving remained significant after sociodemographic factors and later-life outcomes were controlled for. We estimated that 58.3 million middle-aged adults in China were providing care for parents in 2020. Had people experienced 1 fewer adversity in their childhood, there would have been 2.2 million more caregivers in 2020. Had they experienced 2 fewer adversities, there would have been 3.4 million more caregivers. The factors associated with informal caregiving can be traced back to early-life experiences. To address the shortage of informal care supply, it is crucial to foster a caring culture from the very beginning of human development.

Electronic Communication between Children’s Caregivers and Healthcare Team: a scoping review on parental caregiver’s perceptions &amp; experience (Preprint)

Electronic Communication between Children’s Caregivers and Healthcare Team: a scoping review on parental caregiver’s perceptions &amp; experience (Preprint)

How do new crises impact HIV risk behaviour – exploring HIV risk behaviour according to COVID-19-related orphanhood status in South Africa?

ABSTRACT The COVID-19 pandemic resulted in high death rates globally, and over 10.5 million children lost a parent or primary caregiver. Because HIV-related orphanhood has been associated with elevated HIV risk, we sought to examine HIV risk in children affected by COVID-19 orphanhood. Four hundred and twenty-one children and adolescents were interviewed, measuring seven HIV risk behaviours: condom use, age-disparate sex, transactional sex, multiple partners, sex associated with drugs/alcohol, mental health and social risks. Approximately 50% (211/421) experienced orphanhood due to COVID-19, 4.8% (20/421) reported living in an HIV-affected household, and 48.2% (203/421) did not know the HIV status of their household. The mean age of the sample was 12.7 years (SD:2.30), of whom 1.2% (5/421) were living with HIV. Eighty percent (337/421) reported at least one HIV risk behaviour. HIV sexual risk behaviours were more common among children living in HIV-affected households compared to those not living in HIV-affected households and those with unknown household status (35.0% vs. 13.6% vs.10.8%, X2 = 9.25, p = 0.01). Children living in HIV-affected households had poorer mental health and elevated substance use (70.0% vs. 48.5%, X2 = 6.21, p = 0.05; 35.0% vs. 19.9%, X2 = 4.02, p = 0.1306, respectively). HIV-affected households may require specific interventions to support the health and well-being of children and adolescents.

A Hybrid Digital Parenting Program Delivered Within the Malaysian Preschool System: Protocol for a Feasibility Study of a Small-Scale Factorial Cluster Randomized Trial.

The United Nations' Sustainable Development Goal 4, and particularly target 4.2, which seeks to ensure that, by 2030, all children have access to quality early childhood development, care, and preprimary education so that they are ready for primary education, is far from being achieved. The COVID-19 pandemic compromised progress by disrupting education, reducing access to well-being resources, and increasing family violence. Evidence from low- and middle-income countries suggests that in-person parenting interventions are effective at improving child learning and preventing family violence. However, scaling up these programs is challenging because of resource constraints. Integrating digital and human-delivered intervention components is a potential solution to these challenges. There is a need to understand the feasibility and effectiveness of such interventions in low-resource settings. This study aims to determine the feasibility and effectiveness of a digital parenting program (called Naungan Kasih in Bahasa Melayu [Protection through Love]) delivered in Malaysia, with varying combinations of 2 components included to encourage engagement. The study is framed around the following objectives: (1) to determine the recruitment, retention, and engagement rates in each intervention condition; (2) to document implementation fidelity; (3) to explore program acceptability among key stakeholders; (4) to estimate intervention costs; and (5) to provide indications of the effectiveness of the 2 components. This 10-week factorial cluster randomized trial compares ParentText, a chatbot that delivers parenting and family violence prevention content to caregivers of preschool-aged children in combination with 2 engagement components: (1) a WhatsApp support group and (2) either 1 or 2 in-person sessions. The trial aims to recruit 160 primary and 160 secondary caregivers of children aged 4-6 years from 8 schools split equally across 2 locations: Kuala Lumpur and Negeri Sembilan. The primary outcomes concern the feasibility and acceptability of the intervention and its components, including recruitment, retention, and engagement. The effectiveness outcomes include caregiver parenting practices, mental health and relationship quality, and child development. The evaluation involves mixed methods: quantitative caregiver surveys, digitally tracked engagement data of caregivers' use of the digital intervention components, direct assessments of children, and focus group discussions with caregivers and key stakeholders. Overall, 208 parents were recruited at baseline December 2023: 151 (72.6%) primary caregivers and 57 (27.4%) secondary caregivers. In January 2024, of these 208 parents, 168 (80.8%) enrolled in the program, which was completed in February. Postintervention data collection was completed in March 2024. Findings will be reported in the second half of 2024. This is the first factorial cluster randomized trial to assess the feasibility of a hybrid human-digital playful parenting program in Southeast Asia. The results will inform a large-scale optimization trial to establish the most effective, cost-effective, and scalable version of the intervention. OSF Registries; https://osf.io/f32ky. DERR1-10.2196/55491.

Impact of atopic dermatitis on quality of life in children and their families: A tertiary care hospital-based study from Northern India

Objectives: Atopic dermatitis (AD) is a chronic inflammatory skin disease that is more frequent among children. Childhood is a critical time for physical and psychosocial development and AD develops more commonly in children in the first five years of life. The objective of the study was to determine the impact of AD on the quality of life (QoL) of Indian children and their families and correlate it with AD severity and the perception of severity as estimated by the family. Material and Methods: In the present study, 30 children clinically diagnosed with AD and 30 age- and sex-matched healthy controls presenting to our hospital were evaluated. Data on QOL were obtained through a questionnaire; Infants Dermatitis Quality of Life Index (IDQOL), Children’s Dermatology Life Quality Index (CDLQI), and Dermatology Life Quality Index (DQLI) were used for patients,and the Dermatitis Family Impact (DFI) questionnaire for the family of the patients. The severity of the disease was determined using the Scoring for AD (SCORAD) index. Results: In our study, there were 16 male patients and 14 female patients. History of atopy was significantly higher in children with AD (p &lt;0.001); 13 patients had mild, 17 had moderate, and none of the patients had severe disease. The severity of the disease was found to correlate negatively with the age of the child. IDQOL positively correlated with the age of children with AD (r = 0.865, P &lt; 0.001). CDLQI negatively correlated with the age of children with AD (r = −0.616, P = 0.033). Impairment in IDQOL and CDLQI showed a significant positive correlation with DFI (r = 0.846, P &lt; 0.001; r = 0.910, P &lt; 0.001). Conclusion: AD is associated with lowered QOL of the patient,which increases with the severity of the disease. Itch and sleep disturbance were the most severely affected symptoms of AD. The disease significantly impacted the QOL of the family. The main issue with parents caring for AD children is continuous expenditure on treatment, emotional distress, and physical exhaustion. Therefore, efforts are needed to help parents by medical care personnel so that the outcomes in both the child and the significantly burdened parent caregiver can be improved.

Aging Well Together: Promoting Brain Health for Aging Individuals with IDD and Their Families

Adults with intellectual and developmental disabilities (IDD) have been historically excluded from participating in aging-focused research, continue to experience barriers accessing appropriate health care, and encounter distinct challenges as they age compared to people without IDD. These challenges and their effects often extend to their immediate support system, including family caregivers, including parents, siblings, and other kin. Family caregivers, often in the role of 'perpetual caregivers,' can struggle to support aging adults with IDD as they also concurrently experience the effects of their own aging, potentially hindering their ability to provide lifelong care. As parents age, the burden of care may shift to others within this support network such as siblings who, due to various constraints (e.g., geographic location, personal obligations, and financial restrictions) can also experience challenging caregiving responsibilities. Research on the mental health of family caregivers has predominantly focused either on the impact of caregiving among parents of people with IDD (and to a lesser extent on siblings) or on late-life caregivers of aging adults without IDD. This leaves a significant gap in understanding how to support caregivers during mid-late adulthood as their family member with IDD ages or as they themselves undergo age-related changes. &#x0D; In this paper, we provide a brief overview of research on family caregiving of older adults with IDD, followed by a description of a national effort, The Brain Health-IDD initiative. This initiative aims to develop strategies that will support the promotion of brain health in aging adults with IDD and their family caregivers. As part of this effort, family caregivers, both siblings and parents of adults with IDD are working together with researchers and clinicians to co-design, co-deliver and evaluate a virtual education program for families. &#x0D; The paper concludes by reflecting on the program's importance from the perspective of sibling and parent caregivers. This inclusive approach emphasizes the broader responsibility of supporting families navigating the challenges of disability and aging in mid-late adulthood, highlighting the need for support and awareness across all levels of care. &#x0D;

Playing with the child within: Early parenthood experiences of parents who were out-of-home placed during childhood

Experience of out-of-home care (OHC) is associated with life-long vulnerability, and research indicates that parents with experiences of OHC are at higher risk of having their own children placed in out-of-home care. However, research on these parents is limited and lacks a resilience perspective. Here, we focused on parents with OHC experience as children but with custody of their own children (N = 12) and asked where these parents can draw strength in parenting, using a standardized interview with focus on thoughts, feelings, and parenting experiences. Importantly, all content related to OHC experience was disclosed in the context of discussing parental caregiving, without any specific questions asked. We investigated whether caregiving representations associated with the ability to promote security in the child were linked to parents’ attachment scripts, comprising implicit expectations of sensitivity and helpfulness in attachment-related interactions, or reflective functioning, denoting the capacity to take the mental perspective of the child. We coded interviews following standardized coding instructions, for reflective thinking and other important variables that capture strategies for processing relational and emotional themes. Narratives in which the parents had spontaneously made references to their childhood experiences were coded through qualitative content analysis. Results showed that autonomous caregiving representations were associated with the content in parents’ attachment scripts but not their reflective functioning. Themes reveal distinct tendencies in these parents’ caregiving representations: Own adverse childhood experiences were often expressed as separation anxiety or feelings of guilt in relation to parenting. An unmet need for support was common , as were concerns about stigma and vulnerability associated with disseminating information about their background. Nevertheless, parental caregiving involves for those parents motivation to break patterns of adversity, provide sensitive parenting, but also understand, accept oneself and develop.

Identifying elevated child weight from 3 to 24 months: Early transitions into nonparental care and to solid foods.

Early entry into nonparental care (NPC) and introduction to solid foods (ITS) have been linked to elevated weight, however, little research exists on the combined influence of these transitions on child weight over time. Identify groups of children based on early NPC and ITS timing and examine whether NPC-ITS groups differentially affect child weight over time. Data were drawn from STRONG Kids2 (n = 468). Primary predictors include NPC (by 3M)-ITS (< or ≥6M) groups; outcome variables include child weight-for-length/height z-scores (WFL/WFHz) (3, 12, 18, and 24 months). Multilevel regression was used to examine the NPC-ITS groups as predictors of child WFL/WFHz. Six groups were identified: 27% Parental Care-ITS before 6M, 31% Parental Care-ITS after 6M, 12% Daycare-ITS before 6M, 14% Daycare-ITS after 6M, 10% Kincare-ITS before 6M, and 7% Kincare-ITS after 6M. Children who were in daycare (regardless of ITS) or kincare-ITS before 6M demonstrated the highest WFL/WFHz over time, compared to their parental care counterparts. NPC-ITS combinations on child WFL/WFHz across the first 2 years of life highlight the need for a partnership approach among parental and nonparental caregivers to support the feeding of infants throughout the transition to solid foods.

An Intersectional Approach to Understanding the Psychological Health Effects of Combining Work and Parental Caregiving.

Role theory suggests occupying simultaneous family caregiving and employment roles in midlife may exert positive and negative effects on psychological health. However, there is a lack of causal evidence examining the degree to which combinations of these roles influence psychological health at the intersection of gender and racial identity. Longitudinal data from the Health and Retirement Study (2004-2018) are used to estimate a series of individual fixed effects models examining combinations of employment status and parental caregiving situation on Center for Epidemiological Studies-Depression Scale (CES-D) depression scores among Black and White men and women aged 50-65. Subsequent models were stratified by intensity of caregiving situation and work schedule. Individual fixed effects models demonstrate combining work, and parental caregiving is associated with greater depressive symptoms than only working, and with lower depressive symptoms than only caregiving, suggesting that paid employment exerts a protective effect on psychological health whereas parental caregiving may be a risk factor for depressive symptoms in later life. Analyses using an intersectional lens found that combining paid work with parental caregiving exerted a protective effect on CES-D scores among White women and men regardless of participants' intensity of care situation or work schedule. This effect was not present for Black men and women. Accounting for intersectionality is imperative to research on family caregiving, work, and psychological health.

The Impact of Parental Electronic Health Literacy on Disease Management and Outcomes in Pediatric Type 1 Diabetes Mellitus: Cross-Sectional Clinical Study.

Despite the growing uptake of smart technologies in pediatric type 1 diabetes mellitus (T1DM) care, little is known about caregiving parents' skills to deal with electronic health information sources. We aimed to assess the electronic health literacy of parents caring for children with T1DM and investigate its associations with disease management and children's outcomes. A cross-sectional survey was performed involving 150 parent-child (8-14 years old with T1DM) dyads in a university pediatric diabetology center. Parents' electronic health literacy (eHealth Literacy Scale [eHEALS]), general health literacy (Chew questionnaire and Newest Vital Sign [NVS]), and attitudes toward T1DM care (Parental Self-Efficacy Scale for Diabetes Management [PSESDM] and Hypoglycemia Fear Survey [HFS]) were investigated. Children's treatment, HbA1c level, and quality of life (Pediatric Quality of Life Inventory Diabetes Module [PedsQL Diab] and EQ-5D-Y-3L) were assessed. Multiple linear regression analysis was performed to investigate the determining factors of 6-month average HbA1c. Of the 150 children, 38 (25.3%) used a pen, 55 (36.7%) used a pen plus a sensor, 6 (4.0%) used an insulin pump, and 51 (34.0%) used an insulin pump plus a sensor. Parents' average eHEALS score (mean 31.2, SD 4.9) differed significantly by educational level (P=.04) and the children's treatment (P=.005), being the highest in the pump + sensor subgroup. The eHEALS score showed significant Pearson correlations with the Chew score (r=-0.45; P<.001), NVS score (r=0.25; P=.002), and PSESDM score (r=0.35; P<.001) but not with the children's HbA1c (r=-0.143; P=.08), PedsQL Diab (r=-0.0002; P>.99), and EQ-5D-Y-3L outcomes (r=-0.13; P=.12). Regression analysis revealed significant associations of the child's HbA1c level with sex (β=0.58; P=.008), treatment modality (pen + sensor: β=-0.66; P=.03; pump + sensor: β=-0.93; P=.007), and parents' self-efficacy (PSESDM; β=-0.08; P=.001). Significantly higher parental electronic health literacy was found in T1DM children using a glucose sensor. The electronic health literacy level was associated with parents' diabetes management attitude but not with the child's glycemic control. Studies further investigating the role of parental electronic health literacy in T1DM children managed at different levels of care and the local context are encouraged.

Is Trauma-Informed Care Possible without Information? - Experience of Trauma Awareness among Estonian Foster Parents and Residential Caregivers.

Trauma-informed care (TIC) is a relatively new topic in the Estonian child protection system, but it has become the particular focus of substitute care. The Estonian child protection system focuses on protecting children from maltreatment, and neglects the adult carers' right to adequate information about the child's trauma experience. This makes trauma-informed care vague. This article is based on focus groups conducted for a wider study that aims to develop the basis for a TIC training course for foster parents and staff members working as direct caregivers in residential substitute care. The foster parents and staff members participated in four focus groups, with special attention on their experiences with TIC. The participants eagerly shared their experiences, and thematic narrative analysis was used during the data analysis. The central theme of the participants' stories was the need for information about the child's traumatic past. The findings indicate that a complex interplay exists between the needs of children entering substitute care and the capacity of the foster parents and residential care staff to meet those needs. It is complicated for a child to heal from trauma if the child's past is hidden from their carers. This could result in re-traumatisation and hinder the child from making sense of past trauma. Estonia's child protection system needs greater awareness of the impact of trauma on the child's behaviour and how to help the child heal. This is directly connected to the need for clear and precise information, which is one of the basic rights of the child.

Parents’ Evaluation of Changes in Parents’ and Children’ Physical and Psychological Health Status in COVID-19 Pandemic

Introduction: People’s social activities were restricted by COVID-19 pandemic measures such as blocking access to cities, suspending schools. For normal psychological development and well-being of children, social interaction is an essential component. COVID-19 crisis has affected the psychological well-being of both parents and children through parental job loss, income loss, caregiving burden and terror of infection. &#x0D; Materials &amp; Methods: This research was done in the 2020-2021 academic year. Snowball sampling method is used, and 100 participants were reached during a 4-week time interval after ethical approval. Survey was created as an online form and its link was distributed via social media platforms. Survey composed of demographic questions and topic related questions about COVID-19 to both parents and children. Questionnaire was designed for parents to fill out. For data analysis, Chi-Square test was used.&#x0D; Results: The mean age of participants was 40.36 ± 6.463 and mean age of participants’ children was 11.69 ± 3.390. 93% of participants indicated that internet usage of their child increased during the pandemic. 91.9% of the parents stated that they have fears/concerns about the coronavirus becoming pandemic in the world. 52% of the parents stated that their child gained weight during the pandemic process. Significant association was found between the child's weight gain and the increase in the child's fears/worries (p= .006). A significant relationship was found between the presence of COVID-19 cases in or around the family and the increase in the fears/worries of the children (p= .024). &#x0D; Conclusion: According to parents’ perspective, 93% of participants’ child internet usage increased during pandemic. 73% of the parents reported that there has been an increase in the fears/ worries of children. On the other hand, 96% of the participants have stated that they have concerns of being negatively affected economically due to coronavirus pandemic. Significant relationship between fears/worries of parents’ and children was not found. In our study, there has been a significant relationship between fears/worries of children and their weight status. Parents of children who stated an increase in the worries of their child also stated that their children gained weight. Also, significant relationship was found between the presence of COVID-19 cases in or around the family and the increase in the fears/worries of the children.

Child behavior problems and parental psychological distress in Chinese families of children with autism: The putative moderating role of parental social support and cultural values.

The wellbeing of parents of children with autism residing in mainland China remains understudied. We aimed to examine whether and how parental perceived social support, individualism, and collectivism acted together to moderate the relationships between child behavior problems and parental psychological distress in Chinese parents of children with autism. With convenience and snowball sampling, data on 268 primary caregiver parents of children with autism were collected from an online cross-sectional survey. Linear regression analysis indicated that child behavior problems were significantly associated with increased psychological distress in Chinese parents of children with autism. There was no evidence to support the stress-buffering model of social support in moderation analysis of the association between child behavior problems and parental psychological distress. Nonetheless, increased social support was associated with lower levels of parental psychological distress. Moderated moderation analyses did not support a role for individualism or collectivism as a moderator of the putative buffering role of social support. However, there was evidence that parental individualism was associated with increased parental psychological distress. Our findings highlight that child behavior problems are a robust correlate of parental psychological distress, and parental social support may act as a compensatory factor promoting less psychological distress rather than having a protective role. The role of social support and cultural values in the wellbeing of parents of children with autism in China requires additional exploration, including longitudinal research designs.

Care of People Living with Dementia in Bulgaria: Between Over-Responsibility to the Family and Distrust in Public Health Services and Policies

Abstract Thirty years after the transition to democracy in Bulgaria, there is a lack of social and community support for people living with dementia and for their families and caregivers. Both residential and assisted living facilities in the country have remained both unpopular and underdeveloped, and based on in-depth biographical and expert interviews and focus groups, we shall discuss the subjective experience of informal caregivers of people living with dementia, accumulated in the confined space of home and family. We shall try to show how inconsistent application of the European Union’s social policies as well as the existence of enduring socio-cultural stereotypes relating to parental care places caregivers in passive, but over-responsible and implicitly critical positions towards the management both of public and private services for older people in Bulgaria.