Parental Depressive Symptoms Research Articles

Are parental depressive symptoms related to the sleep quality and physical activity of their children with developmental disabilities?

BackgroundParenting young children with developmental disabilities presents unique opportunities and challenges. Parents can experience meaningful priority shifts in and appreciation for their lives, but they can also be at greater risk for diminished emotional health. Physiological child factors warrant further investigation as correlates for parent risk of or protection from depression. AimThis study examined the relations between parental depressive symptoms and the (1) sleep quality and (2) physical activity in their children with developmental disabilities adjusting for parent- and child-level factors. Methods and ProceduresChildren and parents were recruited for participation in this study from a university-based neurodevelopmental clinic. Parents completed questionnaires about themselves including measures of depressive symptoms and about their children including measures of sleep quality and physical activity. Researchers administered developmental measures to the children and physicians completed children’s diagnostic evaluations. Participants were 147 children (32 ± 4 months old) mostly with autism spectrum disorder (ASD) and their parents (mostly mothers). Factors associated with parent-reported depressive symptoms were analyzed with a generalized linear model. Outcomes and ResultsAn R2deviance value of 43 % confirmed that there was a substantial, moderate-to-large sized, improvement in the proportion of variance explained by the final model when compared with a null, or intercept-only, model. Depressive symptoms were approximately two times higher for parents of children with above average sleep disturbances and one and half times higher for parents whose children engaged in above average physical activity. Conclusion and ImplicationsOur study demonstrates the importance of considering children’s sleep and physical activity in supporting children’s developmental disabilities because they may offer pathways to enhanced family resilience and well-being.

20.5 Preliminary Evidence for Associations of the Infant Gut Colonization With Parent-Infant Relationship, Maternal Depression, Stress, and Parenting Styles

The objectives of this presentation are to: 1) examine associations among infant gut colonization based on microbiome measurements in the infant population and maternal depressive symptoms and distress; 2) examine associations among infant microbiome and parent-infant interactions during a vaccination procedure; and 3) examine how infant cries correlate with their microbiome at 4 months of age. For this pilot study, we recruited a prospective cohort of infants (n = 31) and parents (n = 31). We examined the association between the infant gut microbiome at 4 months during well-child visits (WCVs), maternal depression (by Patient Health Questionnaire-9 [PHQ-9]), parent and child characteristics and life stress (by Parenting Stress Index [PSI-IV]), and parent-infant interactions (by Measure of Adult and Infant Soothing and Distress [MAISD]). For each of the variables, we looked at 3 types of associations to identify the component of the microbiome revealed by whole-genome shotgun sequencing: β-diversity (via Bray-Curtis [BC] and Jaccard distances), α-diversity (via Shannon and Inverse-Simpson indexes), and differential abundance (via linear models for differential abundance [LinDA]). Infant cries in response to vaccination were assessed for spectral characteristics, with higher frequencies being associated with greater stress response (mid frequency: 1000-5000 Hz, high frequency: 5000 Hz+). Taxonomic classification identified 19 phyla, 417 genera, and 1246 species. The PHQ-9 scores obtained at 2 months were associated with 4 bacterial species (Ruminococcus flavefaciens, Actinomyces johnsonii, [Clostridium] dakarense, and Bilophila wadsworthia; false discovery rate [FDR] < 0.1) and β-diversity (p = 0.006-BC; p = 0.005-Jaccard). Infant cries with greater high-frequency band power (p < 0.03) and a greater high-to-mid frequency ratio metrics (p < 0.05) associated with higher infant stress were related to lower α-diversity. There were no correlations between PHQ-9 at 4 months, PSI-IV, and microbiome diversity. Data from our study point to a connection between higher perception of stress in infants reflected in their cries and lower microbiome diversity (higher diversity more desirable). We found that parental depressive symptoms influenced their infants’ microbiome. More studies are needed to explore ways in which the quality of the infant-caregiver relationship influences intestinal microbiota.

Parental Psychological Control, Parent-Related Loneliness, Depressive Symptoms, and Regulatory Emotional Self-Efficacy: A Moderated Serial Mediation Model of Nonsuicidal Self-Injury

Objective Adolescent nonsuicidal self-injury (NSSI) has become an alarming public health concern. Parental psychological control has been identified as a risk factor for NSSI in some western samples. However, the relationship between parental psychological control and NSSI remains unclear among Chinese adolescents. Furthermore, little is known about how parental psychological control affects NSSI. This study aims to examine a moderated serial mediation model of NSSI, revealing the mediating and moderating mechanisms underlying the relationship between parental psychological control and NSSI. Method A total of 953 Chinese secondary school students (47.7% females, mean age = 12.53 years, SD = 0.63) completed questionnaires of NSSI, parental psychological control, parent-related loneliness, depressive symptoms, and regulatory emotional self-efficacy. Results Parental psychological control was positively associated with NSSI. This association was mediated by parent-related loneliness and depressive symptoms independently. Also, it was serially mediated by parent-related loneliness and depressive symptoms. In addition, regulatory emotional self-efficacy moderated the indirect relationships between parental psychological control and NSSI. Conclusions Findings of this study shed light on how NSSI is affected by parental psychological control, parent-related loneliness, depressive symptoms, and regulatory emotional self-efficacy, and provide insights into the prevention and intervention measures targeting adolescent NSSI. HIGHLIGHTS Parental psychological control was positively associated with NSSI. Parent-related loneliness and depressive symptoms independently and serially mediated the association between parental psychological control and NSSI. Regulatory emotional self-efficacy moderated the indirect relationships between parental psychological control and NSSI.

Parental Depressive Symptoms, Parent Attributional Style, and Child Coping as Predictors of Depressive Symptoms in Children of Parents with Anxiety or Mood Disorders

Few studies have examined the effects of parental depressive symptoms on children in China. The present study examined the relationships between parental depression, parental attributional style, children’s coping strategies and 5–12-year-old children’s depressive symptoms in a sample of Chinese children whose parents had been diagnosed with an anxiety or a mood disorder. The present study confirmed that children of parents with anxiety or mood disorders would show high levels of depressive symptoms. Parents with an optimistic or neutral attributional style rated their children as showing fewer depressive symptoms than parents with a pessimistic style. This study showed a significant positive relationship between children’s disengagement coping and children’s reports of depressive symptoms. The findings highlight the need for early identification of, and support and intervention programs for, parents suffering from depression and children of depressed parents as a means of protecting the psychological well-being of both parents and children.

Parents’ Depressive Symptoms and Child Adjustment: the Mediating Role of Mindful Parenting and Children’s Self-Regulation

Parental depression is linked to a myriad of child adjustment outcomes. To identify the potential processes between parents’ depressive symptoms and child adjustment in early childhood, this cross-sectional study investigated mindful parenting and children’s self-regulation as mediators. Participants were 320 Chinese families involving maritally intact mothers, fathers, and children (49.01% girls) from 34.73 to 55.66 months old (M = 46.32, SD = 3.77). Mothers and fathers completed self-report questionnaires assessing parental depressive symptoms, mindful parenting, children’s self-regulation, and adjustment outcomes. Children completed a task assessing their self-regulation. A structural equation model was conducted to examine the mediation model cross-sectionally. The structural equation model indicated that mindful parenting and children’s self-regulation mediated the association between parents’ depressive symptoms and children’s adjustment. Specifically, mothers’ and fathers’ depressive symptoms were associated with their own, but not their spouses’, mindful parenting. Mindful parenting was then associated with children’s self-regulation, which was related to internalizing problems, externalizing problems, and prosocial behavior. Differential findings as a function of parents’ gender were also indicated. The present study revealed mindful parenting and children’s self-regulation as mediators between parental depressive symptoms and adjustment in early childhood. Both mothers’ and fathers’ depressive symptoms were associated with mindful parenting, which was crucial for children’s self-regulation, psychosocial adjustment, and behavioral adjustment. These findings inform practitioners about the relevance of parents’ depressive symptoms and mindful parenting to children’s adjustment in early childhood.

Child Sleep Linked to Child and Family Functioning in Children with Down Syndrome.

Sleep problems have a bi-directional impact on the daytime performance of children, parental well-being, and overall family functioning in the general population. Children with Down syndrome (DS) are at a high risk of sleep problems, yet the relationship between sleep problems, adaptive functioning, and family stress in children with DS is not well documented. We examined the relationship between sleep (i.e., duration and quality) and child and parent/family functioning. Sixty-six children with DS wore an actigraph for a week to assess their sleep duration and sleep efficiency. Their parents completed ratings on child sleep duration and parasomnias, child adaptive functioning, parental depression and sleep, and family stress. The parents’ reports of their children’s sleep duration were associated with parental depressive symptoms. The parents’ reports of their children’s restless sleep behaviors were associated with poorer performances in child-compliant/calm behaviors, worse parental sleep, and negative parental feelings and sibling relationships. The findings from actigraph measures of the children’s sleep demonstrated that greater sleep efficiency was associated with greater child adaptive functioning and fewer parental depressive symptoms. The study findings provide preliminary evidence that sleep problems are related to child adaptive functioning, parental functioning, and family stress in children with DS.

Different associations of parental control, attachment, and child depressive symptoms between paternal and maternal Grandparenting families

Different associations of parental control, attachment, and child depressive symptoms between paternal and maternal Grandparenting families

Covariance Between Parent and Child Symptoms Before and During the COVID-19 Pandemic.

ObjectiveCOVID-19 has had unprecedented effects on American families, including increases in depression, anxiety, and irritability for both parents and children. While parents and children influence each other’s psychological functioning during non-disaster times, this effect may be amplified during times of disaster. The current study investigated how COVID-19 influenced covariance of depressive symptoms and irritability in children and their parents.MethodsThree hundred and ninety-one parents and their 8- to 17-year-old children (Mage = 10.68 years old, 70% male, 86% White) from a large sample of children and parents, primarily from Southeastern Louisiana, completed self-report measures of depression and irritability approximately 6 weeks into the COVID-19 pandemic, as well as providing retrospective reports of their symptoms prior to the pandemic. Actor–partner interdependence models were used to measure the reciprocal effects of parent symptoms on children and vice versa, both before and during the pandemic.ResultsActor effects in both the depressive symptoms and irritability models suggested that pre-COVID-19 depressive symptoms and irritability were robust predictors of early-COVID-19 depressive symptoms and irritability for both parents and children. Partner effects were also detected in the irritability model, in that parental irritability prior to COVID-19 was associated with decreased child irritability during the pandemic. Both before and during the pandemic, associations between parent and child depressive symptoms and irritability scores were weaker in families evidencing greater dysfunction.ConclusionsResults suggest that COVID-19-related stress is associated with increases in both parent and child symptomatology, and that family relationships likely influence associations between these symptoms.

Suicidality and Its Associated Factors Among Students in Rural China During COVID-19 Pandemic: A Comparative Study of Left-Behind and Non-Left-Behind Children.

Introduction: The coronavirus disease 2019 (COVID-19) has rapidly spread worldwide. The harmful impact of COVID-19 is beyond just physical health concern. The unprecedented public health crisis has also taken its toll on the mental health of adolescents. The present study aims to estimate the prevalence of suicidal ideation and attempts and investigate the similarities and differences in the influential factors for suicidal ideation and attempts among left-behind children (LBC) and non-left-behind children (NLBC) in rural China during the COVID-19 pandemic.Method: A total of 761 rural Chinese students, of whom 468 were left behind, completed the cross-sectional questionnaires including demographic data, Cognitive Emotion Regulation Questionnaire, nine-item Patient Health Questionnaire, seven-item Generalized Anxiety Disorder Scale, suicidal ideation, and suicidal attempts. Chi-square test, independent-sample t-test, and logistic regression were performed in the statistical analysis.Results: Overall, 36.4 and 10.4% of rural Chinese students reported suicidal ideation (37.8% for LBC vs. 34.1% for NLBC) and attempts (11.3% for LBC vs. 8.9% for NLBC) during the COVID-19 pandemic. Among LBC, parental educational level (adjusted odds ratio, Adj. OR = 1.60), maladaptive strategies (Adj. OR = 1.04), anxious symptoms (Adj. OR = 2.61), and depressive symptoms (Adj. OR = 3.85) were significantly associated with suicidal ideation, while age (Adj. OR = 0.56), maladaptive strategies (Adj. OR = 1.08), symptoms of anxiety (Adj. OR = 3.85), and symptoms of depression (Adj. OR = 2.68) were significantly related to suicidal attempts during the COVID-19 outbreak. Among NLBC, gender (Adj. OR = 2.20), parental educational level (Adj. OR = 1.77), perceived family economic status (Adj. OR = 0.39), anxious symptoms (Adj. OR = 2.38), and depressive symptoms (Adj. OR = 2.77) were significantly associated with suicidal ideation, whereas only anxious symptom (Adj. OR = 5.85) was significantly related to suicidal attempts.Conclusion: Suicidal ideation and attempts are prevalent among students in rural China during the COVID-19 outbreak. Our findings also revealed the shared and unique factors for suicidal ideation and attempts among LBC and NLBC during the COVID-19 epidemic. With regard to the differences between LBC and NLBC, the use of maladaptive strategies and age might be vital factors for suicide prevention measures directed specifically toward LBC, whereas interventions sensitive to gender and perceived social economic status should be specifically designed for NLBC amid the COVID-19 pandemic.

Impact of parental perinatal depressive and anxiety symptoms trajectories on early parent-infant impaired bonding: a cohort study in east and west coasts of Malaysia.

The association between maternal depressive and anxiety symptoms and impaired bonding with infants were widely studied, but not in fathers and none in Malaysia. We investigated the impact of different trajectories of perinatal depressive and anxiety symptoms on parent-infant impaired bonding during 2-3months postpartum in both mothers and fathers in two areas of Malaysia. This study originated from a psychiatric morbidity cohort study carried out in health clinics in east and west Malaysia. Edinburgh Postnatal Depression Scale and anxiety subscale of Depression, Anxiety, and Stress Scale at late pregnancy and 2-3months postpartum and Postpartum Bonding Questionnaire were completed by 566 mothers and 457 fathers. About 11.7% mothers and 16.1% fathers reported depressive symptoms during pregnancy, 6.5% mothers and 10.5% fathers during 2-3months postpartum, and 3-4% mothers and fathers both depressive and anxiety symptoms 2-3months postpartum. The mean impaired bonding score was highest in mothers and fathers who had both depressive and anxiety symptoms 2-3months postpartum. Impaired bonding is associated with higher EPDS and DASS (anxiety subscale) scores 2-3months postpartum in both parents. Physical partner violence and deteriorated marital relationship were associated with increased risk of impaired bonding in mothers. The association between depressive, anxiety, and comorbidity of depressive and anxiety symptoms in both mothers and fathers and parent-infant impaired bonding during 2-3months postpartum urges for screening and treatment of depressive and anxiety symptoms in both parents during early parenthood.

Forms and frequency of vicarious racial discrimination and African American parents’ health

BackgroundAfrican Americans often witness or learn about others’ racial discrimination experiences (i.e., vicarious racial discrimination). Vicarious racial discrimination may contribute to adverse physical and psychological health outcomes for African Americans. We examined relations between four types of vicarious racial discrimination and depressive symptoms and self-rated health among African American parents. MethodsPath analyses were conducted to examine the linkage between each type of vicarious racial discrimination and both depressive symptoms and self-rated health. Chi-square difference tests were conducted to determine if the four forms of vicarious racial discrimination significantly differed in their relations to both depressive symptoms and self-rated health. ResultsWitnessing or learning about their children's racial discrimination experiences was significantly related to higher parental depressive symptoms. Witnessing or learning about a racial discrimination experience of a stranger through the news or social media was significantly related to lower self-rated health. ConclusionsThe findings highlight the importance of examining the health implications of vicarious racial discrimination. Different types of vicarious racial discrimination experiences matter concerning depressive symptoms and self-rated health.

Psychiatric problems during the COVID-19 pandemic in children with autism spectrum disorder.

Children with autism spectrum disorder (ASD) are at elevated risk for psychiatric problems in response to the COVID‐19 pandemic. This risk is due to their high rates of pre‐pandemic psychiatric comorbidities and the pandemic's disruption to routines and access to necessary supports. Prior research has indicated that children with ASD may experience a worsening of specific psychiatric symptoms in response to COVID‐19, though this body of work is limited in scope. The present study expands this literature by examining specific types of psychiatric problems that emerged about 2 months after the onset of the pandemic, and risk factors predicting changes in these psychiatric symptoms. Parents of children with a confirmed ASD diagnosis (N = 257), who enrolled in a clinic registry at an outpatient specialty autism center, were included in this study. All data were gathered online via customized and standardized questionnaires. Results showed that 59% of children experienced either a worsening of their pre‐pandemic psychiatric diagnoses and/or the development of new psychiatric symptoms during the pandemic. Multivariable regression models indicated that risk factors for increased psychiatric problems included child understanding of COVID‐19, COVID‐19 illness in the family, low family income, and elevated parental depression and anxiety symptoms (all p < 0.05). Findings from this study emphasize the urgent need to provide effective and accessible psychiatric services for children with ASD and their families during and after the pandemic.Lay summaryChildren with ASD are at high risk for psychiatric problems during the COVID‐19 pandemic. We found that 59% of children in our clinical sample are experiencing increased psychiatric problems. The child's understanding of COVID‐19, COVID‐19 illness in the family, low family income, and depression and anxiety symptoms in the parent increase the risk for poor mental health during the pandemic. These findings indicate the importance of helping children with ASD access mental health treatment during COVID‐19.

National Norms and Correlates of the PHQ-8 and GAD-7 in Parents of School-age Children.

Anxiety and depressive disorders are global public health concerns, and research suggests that these disorders are common in parents and can adversely influence family functioning. However, little is known about normative levels of anxiety and depressive symptoms in parents of school-age children. The present study reports on generalized anxiety and depressive symptoms in 1570 parents and guardians of a nationally representative sample of children ages five to twelve years using two widely used and validated questionnaires: the eight-item variant of the Patient Health Questionnaire depression scale (PHQ-8) and the seven-item Generalized Anxiety Disorder scale (GAD-7). Moderate to severe levels of generalized anxiety symptoms were reported in 12.7% of the total sample and moderate to severe levels of depressive symptoms were reported in 14.1% of the sample; 17.7% of the sample reported moderate to severe levels of either generalized anxiety or depressive symptoms. This percentage was higher for females, younger parents and guardians, and parents and guardians reporting lower household incomes. These data, collected online in early 2018, may be useful for researchers and clinicians studying and treating anxiety and depression in parents. Further, these data provide a baseline for researchers currently studying the impact of changes related to the novel coronavirus (COVID-19) pandemic (e.g., school closures) on the mental health of parents of school-age children.

Examining reciprocal associations between parent depressive symptoms and child internalizing symptoms on subsequent psychiatric disorders: An adoption study.

The dynamic interplay between parent depressive symptoms and child internalizing behavior over time is not well understood. We used data from a prospective parent-offspring adoption design (N = 561) to examine associations between adoptive parent depressive symptoms and child internalizing behavior when children were ages 18 months, 27 months, 4.5 years, and 6 years, and subsequent child psychiatric disorder symptoms when children were between the ages of 6-8 years. Models also accounted for the contributions of birth parent psychopathology, birth mother depressive symptoms during pregnancy, and infant negative emotionality. Bidirectional associations between adoptive parent depressive symptoms and child internalizing behavior were examined using a random-intercept cross-lagged panel model. There was evidence for associations between child internalizing behavior and adoptive parent depressive symptoms over time, with mothers' depressive symptoms being a more salient risk factor for child internalizing behavior than fathers'. We found one significant cross-lagged association from adoptive mother depressive symptoms at child age 18 months to child internalizing behavior at age 27 months. Infant negative emotionality (i.e., emotional liability) at age 9 months predicted both child internalizing behavior and adoptive parent depressive symptoms. Results suggest that postnatal maternal depressive symptoms confer specific risks for child internalizing behaviors in toddlerhood and childhood and depressive symptoms in childhood.

Differential Associations Between Parents' Versus Children's Perceptions of Parental Socialization Goals and Chinese Adolescent Depressive Symptoms.

Although prior studies have demonstrated the associations between parental socialization goals and parenting practices, as well as parenting practices and adolescent depressive symptoms, respectively, research examining the comprehensive developmental pathways among these constructs (i. e., the path from parental socialization goals to parenting practices to adolescent depressive symptoms) is scarce, especially in the Chinese context. Grounded in the integrative model of parenting, this study investigated the associations between parental socialization goals and adolescent depressive symptoms by examining the indirect pathways through parents' autonomy support and psychological control as well as the moderating effect of educational stage. In Study 1, 345 Chinese adolescents and their primary caregivers completed a measure on parental socialization goals. Adolescents also reported on their depressive symptoms. Results showed that children who reported more self-development parental goals showed fewer depressive symptoms. However, parents' reports of goals or child-parent perceptual discrepancies were not related to children's depressive symptoms. Drawing on this finding, 424 middle school and 301 high school Chinese adolescents completed measures regarding parental socialization goals, autonomy support, psychological control, and their own depressive symptoms in Study 2. Results showed that parental autonomy support linked the associations of self-development and achievement-oriented parental goals and children's depressive symptoms among middle school students, whereas parental psychological control linked such associations among high school students. Our findings provide a more holistic view on how parents' socialization goals are related to children's depressive symptoms via their parenting practices. We also discussed the practical implications for the clinical work regarding adolescent depressive symptoms.

Mechanisms of parental distress during and after the first COVID-19 lockdown phase: A two-wave longitudinal study.

BackgroundIn these unpredictable times of the global coronavirus disease 2019 (COVID-19) pandemic, parents worldwide are affected by the stress and strain caused by the physical distancing protocols that have been put in place.ObjectiveIn a two‐wave longitudinal survey, we investigated the levels of parental stress and symptoms of anxiety and depression in a sample of parents at two time points; during the implementation of the strictest physical distancing protocols following the onset of the COVID-19 pandemic (T1, N = 2,868) and three months after the discontinuation of the protocols (T2, N = 1,489). Further, we investigated the relationships between parental stress and anxiety and depression relative to relationship quality and anger toward their children at the two aforementioned time points, including subgroups based on age, parental role, cultural background, relationship status, education level, number of children, employment status and pre-existing psychiatric diagnosis.Methods and findingsParents were asked to fill out a set of validated questionnaires on the two measurement points. Parental stress significantly decreased from T1 to T2, indicating that the cumulative stress that parents experienced during the implementation of the distancing protocols declined when the protocols were phased out. The decrease of perceived parental stress was accompanied by a significant decrease in the symptoms of both depression and anxiety among the participating parents. Symptoms meeting the clinical cut-offs for depression (23.0%) and generalized anxiety disorder (23.3%) were reported among participating parents at T1, compared to 16.8% and 13.8% at T2, respectively. The reduction in depression and anger toward their child(ren) from T1 to T2 was associated with a reduction of parental stress. Relationship quality and anger toward their child(ren) at T1 further predicted a change in the level of parental stress from T1 to T2.ConclusionsThe study underlines the negative psychological impacts of the implementation of the distancing protocols on parents’ health and well-being. Uncovering the nature of how these constructs are associated with parents and families facing a social crisis such as the ongoing pandemic may contribute to the design of relevant interventions to reduce parental distress and strengthen parental coping and resilience.

Parental perception of FIRES outcomes, emotional states, and social media usage.

SummaryObjectiveTo investigate parental perception of FIRES outcomes, assess emotional states and related social media usage.MethodsA survey‐based study of parents of children with FIRES participating in a FIRES‐specific Facebook group was performed. The survey collected information on medical aspects of their child's course in the acute, subacute, and chronic periods, emotional states, and social media usage. Child outcome was assessed utilizing the pediatric extended Glasgow outcome scale (GOS‐E). Parental emotional states were assessed utilizing the Depression, Anxiety and Stress Scale (DASS). Descriptive statistics were performed. Associations were described using the Spearman rank correlation. Open‐ended questions were included. Thematic analysis was performed.ResultsTwenty‐nine surveys were analyzed. All children were in the chronic phase at time of survey response, except for two who died. Mothers answered 22 surveys, and fathers answered seven. Median age at FIRES presentation was 5.6 years [IQR 4.2‐8.95], with a median number of 3 seizures per week [IQR 0‐10, range 0‐50], 4 daily anti‐seizure medicines [IQR 3‐5], and chronic GOS‐E of 6 [IQR 2‐8 range 2‐8]. Most parents reported none to mild levels of depression, anxiety, and stress. Higher seizure burden positively correlated with parental depression symptoms (r = .41 (95% CI 0.01, 0.70), P = .045). Most parents found social media helpful with coping and 96% desired FIRES research advertised. Twenty‐five parents shared their recommendations to fellow parents and the medical team in an open‐ended format. Themes included support, expertise, and medical advice.SignificanceDespite their children's significantly impaired functional outcome after FIRES and high rates of medically refractory epilepsy, the cohort demonstrated remarkable emotional resilience. They perceive social media as beneficial, are interested in social media‐advertised research, and share valuable advice. Social media may serve as an introductory platform to enhance the physician‐scientist‐parent/patient relationship.

Joint effects of children's emotional problems and parental depressive symptoms on the occurrence of internet gaming disorder among children and adolescents: A longitudinal study.

Background and aimsParental depressive symptoms may aggravate the effects of children’s emotional problems on risks for Internet gaming disorder (IGD). Here we examined the joint effects of children’s emotional problems and parents’ depressive symptoms on the incidence of IGD.MethodsA large prospective, population-based cohort tested potential interactions between children’s emotional problems, parents’ depressive symptoms, and incidence of high risk of IGD (HRIGD). Family dyads (n=2,031) that included children who were non-HRIGD at baseline completed assessments of childhood and parental affective symptomatology. HRIGD was assessed at baseline and 12 months. Relative excess risk due to interaction (RERI) estimated the magnitudes of interactions.ResultsIn terms of risk for the development of IGD, parental depression was 1.8 times greater, children’s emotional problems were 2.9 times greater, and both risk factors together were 6.1 times greater than the background risk, with the last two findings reaching statistical significance. The expected risk for the development of HRIGD was RR=3.7.Discussion and conclusionsChildren’s emotional problems demonstrated a particularly strong relationship with HRIGD. Joint effects of children’s emotional problems and depressive symptoms in parents on the incidence of HRIGD were stronger than the sum of the independent effects of each factor. The findings suggest that combining interventions for the treatment of children’s emotional problems and parents’ depressive symptoms may have extra risk reduction effects on preventing IGD in children and adolescents.

Development and psychometric evaluation of the CO-PARTNER tool for collaboration and parent participation in neonatal care.

Active parent participation in neonatal care and collaboration between parents and professionals during infant hospitalization in the neonatal intensive care unit (NICU) is beneficial for infants and their parents. A tool is needed to support parents and to study the effects and implementation of parent-partnered models of neonatal care. We developed and psychometrically evaluated a tool measuring active parent participation and collaboration in neonatal care within six domains: Daily Care, Medical Care, Acquiring Information, Parent Advocacy, Time Spent with Infant and Closeness and Comforting the Infant. Items were generated in focus group discussions and in-depth interviews with professionals and parents. The tool was completed at NICU-discharge by 306 parents (174 mothers and 132 fathers) of preterm infants. Subsequently, we studied structural validity with confirmatory factor analysis (CFA), construct validity, using the Average Variance Extracted and Heterotrait-Monotrait ratio of correlations, and hypothesis testing with correlations and univariate linear regression. For internal consistency we calculated composite reliability (CR). We performed multiple imputations by chained equations for missing data. A 31 item tool for parent participation and collaboration in neonatal care was developed. CFA revealed high factor loadings of items within each domain. Internal consistency was 0.558 to 0.938. Convergent validity and discriminant validity were strong. Higher scores correlated with less parent depressive symptoms (r = -0.141, 95%CI -0.240; -0.029, p = 0.0141), less impaired parent-infant bonding (r = -0.196, 95%CI -0.302; -0.056, p<0.0001), higher parent self-efficacy (r = 0.228, 95%CI 0.117; 0.332, p<0.0001), and higher parent satisfaction (r = 0.197, 95%CI 0.090; 0.308, p = 0.001). Parents in a family integrated care model had higher scores than in standard care (beta 6.020, 95%CI 4.144; 7.895, p<0.0001) and mothers scored higher than fathers (beta 2.103,95%CI 0.084; 4.121, p = 0.041). The CO-PARTNER tool explicitly measures parents' participation and collaboration with professionals in neonatal care incorporating their unique roles in care provision, leadership, and connection to their infant. The tool consists of 31 items within six domains with good face, content, construct and structural validity.

585-P: Buffering Effects of Subjective SES on Parental Depressive Symptoms following Child T1D Diagnosis

Introduction: Parent depression is linked to negative child T1D outcomes. Some studies find that subjective (SSES) and objective socioeconomic status (OSES) are uniquely related to depressive symptoms, but few studies have examined them together in a T1D population. The current study explores the associations among SSES, OSES, and parent mood following child T1D diagnosis. Method: Participants included 157 parents (62% non-Hispanic white, 77% married, 92% female, 28% public insurance) of young children (Mage=4.46±1.64 years) newly diagnosed (M=29 days post-diagnosis) with T1D. At baseline of a behavioral RCT, parents self-reported on their depressive symptoms (Center for Epidemiological Studies-Depression Scale; CES-D; ≥16=elevated scores), SSES (The MacArthur Scale of Subjective Social Status), and OSES (lower OSES=public insurance; higher OSES=private insurance). χ2 test of independence was used to compare rates of elevated CES-D scores across four OSES/SSES categories (n, % elevated): both lower (n=14; 79%), lower OSES/higher SSES(n=29; 31%), higher OSES/lower SSES(n=49; 48%), and both higher (n=63; 44%). Results: There was a significant association between OSES/SSES category and parent depressive symptoms, χ2(3, N=153)=8.81, p=.03. Post hoc analyses using Bonferroni corrections indicated one significant group difference: the lower OSES/higher SSES group had significantly lower rates of elevated CES-D scores than the both lower group. Discussion: During the stressful period following a young child’s T1D diagnosis, higher perceived SES, relative to one’s peers, may be a protective factor against depressive symptoms, specifically for parents with public insurance. Despite having fewer financial resources, these parents reported depressive symptoms similar to parents with private insurance. Future studies using a positive psychology framework may examine methods to improve subjective well-being in parents of children with T1D. Disclosure C. H. Wang: None. C. Tully: None. M. Monaghan: None. M. E. Hilliard: None. R. Streisand: None. Funding National Institute of Diabetes and Digestive and Kidney Disease (R01DK102561)