Parental Psychological Flexibility Research Articles

Child and Parent Risk and Resilience Factors as Predictors of Long-term Recovery in Youth Undergoing Spinal Fusion Surgery.

Undertreated pediatric postsurgical pain negatively affects health-related quality of life (HRQOL) and functioning and may lead to chronic postsurgical pain (CPSP). Predictors of recovery have been identified but more research is needed, particularly regarding resilience, social factors, and long-term effects. The aim of the present study was to investigate child and parent risk and resilience factors as predictors of long-term postsurgical recovery for adolescents. Participants were patients with Adolescent Idiopathic Scoliosis (AIS), 12 to 18 years old, undergoing spinal fusion, and their parents. Recruitment occurred at the orthopedic units at 4 hospitals in Belgium. Data were collected before surgery (T0), at 3 (T1) and 6 weeks (T2), 6 months (T3), and 1 year (T4) post surgery. Multiple regression models were used to evaluate the predictive effect of pain intensity, pain catastrophizing, psychological flexibility, and pain acceptance on long-term functioning, HRQOL, and pain. The sample comprised 100 adolescents and 61 parents. Pain at T0, T1, and T3 and adolescent pain catastrophizing (T0) predicted health-related quality of life, functioning, and pain at T4 (while pain at T2 predicted HRQOL and pain). Parent pain catastrophizing predicted pain at T4. Adolescent and parental psychological flexibility predicted HRQOL, and parent psychological flexibility also predicted pain at T4. Adolescent acceptance at T1 predicted pain, and acceptance at T2 predicted HRQOL, at T4. The study identified pain and adolescent pain catastrophizing as risk factors, and adolescent and parental psychological flexibility and adolescent pain acceptance as resilience factors, for long-term recovery in youths undergoing spinal fusion. Postsurgical pain management targeting these factors may therefore promote recovery for these adolescents.

Co-parenting, Parental Burnout, Child Internalizing and Externalizing Problems: Moderation by Parental Psychological Flexibility

Co-parenting, Parental Burnout, Child Internalizing and Externalizing Problems: Moderation by Parental Psychological Flexibility

Roles of Parental Psychological Flexibility, Self-Compassion, and Self-Efficacy in Affecting Mental Health and Quality of Life in Parents of Children with Eczema.

Parents of young children with eczema often experience adverse mental health consequences, including depression, anxiety, stress, and a reduced health-related quality of life (HRQoL), due to the unpredictable nature of flare-ups and exacerbations. This study investigated the roles of psychological flexibility, self-compassion, and self-efficacy in fostering parental mental health outcomes and HRQoL while caring for children diagnosed with eczema. Baseline data from an ongoing clinical trial examining the effects of a family acceptance-and-commitment-therapy-based eczema management program (FACT-EMP) on parent-child dyads affected by eczema (N = 110 dyads, 75.5% mothers; 66.4% boys) were analyzed using adjusted hierarchical regression analyses. The findings indicate that psychological inflexibility was significantly associated with symptoms of anxiety, depression, stress, and HRQoL. Self-compassion was significantly linked to all assessed mental health outcomes, whereas self-efficacy showed a significant association only with symptoms of depression. These results underscore the significance of promoting parental psychological flexibility and self-compassion through acceptance and commitment therapy and compassion-based approaches to enhance mental health and quality of life while managing children's eczema.

Internet-based versus face-to-face Acceptance and Commitment Therapy for parental psychological flexibility

Internet-based versus face-to-face Acceptance and Commitment Therapy for parental psychological flexibility

The relationship between parental stress and psychological adjustment of the children: The role of parental psychological flexibility as a mediator

There is growing interest in parental psychological flexibility, understood as parents' ability to enjoy an optimal relationship with their children by accepting their negative emotions and thoughts in the present moment, while remaining child-conscious, in value-based parenting. Parenting can sometimes be stressful, especially when faced with the varied and changing challenges of parenthood. Parental stress, in turn, has been related to high levels of psychological inflexibility. So, this study aimed to analyze the relationship of parental psychological flexibility with parental stress and its impact on children's psychological adjustment. The sample consisted of 909 families with children aged 3–18 years who answered the following questionnaires: The Parental Acceptance Questionnaire (6-PAQ), which measures psychological flexibility, the Parental Stress Scale (PSS), and the Strenght and Difficulties Questionnaire (SDQ), which studies the general psychological state of children and adolescents by screening for emotional and behavioral difficulties. These variables were analyzed by difference analysis according to the level of psychological flexibility, regression analysis, and mediation analysis. The group of parents who scored highest on psychological inflexibility scored high on parental stress and the child psychological adjustment scales, except for the prosocial behavior subscale. The results show that parental psychological inflexibility is related to higher levels of parental stress, and in turn, has an impact on greater psychological maladjustment in children. These relationships are analyzed from their clinical and educational implications as factors and objectives to be incorporated into family intervention.

Mother’s Parental Psychological Flexibility and Children’s Self-reliance Behaviors in Chinese Primary School: The Mediating Role of Resilience

Mother’s Parental Psychological Flexibility and Children’s Self-reliance Behaviors in Chinese Primary School: The Mediating Role of Resilience

A Parent-Targeted Group Intervention for Pediatric Pain Delivered In-Person or Virtually: Feasibility, Acceptability, and Effectiveness.

Parents play integral roles in their youth's chronic pain and can experience elevated distress related to caregiving. This study examined a cognitive-behavior therapy-based parent-targeted group intervention, including understudied/novel resilience/risk (eg, distress, parenting self-regulation), and compared the effect of in-person versus virtual delivery format. (1) Adequate feasibility and acceptability (enrolment>33%, attendance >60%, attrition <25%, satisfaction ratings >90%), with higher indicators of feasibility in the virtual groups; (2) Significant improvements in parent psychological flexibility, protectiveness, distress, and parenting self-regulation at posttreatment that were maintained at follow-up, with no difference between delivery type. Parents were enroled from an outpatient pediatric chronic pain clinic and participated in the group intervention in-person or virtually; questionnaires were completed at baseline, posttreatment, and 3-month follow-up. Enrolment (55% in-person, 65% virtual) and attendance (86% in-person, 93% virtual) were higher, and attrition was lower than expected (4% in-person, 7% virtual). Satisfaction was high (4.95/5 in-person, 4.85/5 virtual); on written feedback, parents enjoyed connecting with other parents (27/56, 48%) the most. The least preferred were the virtual format (5/36, 14%) and timing of the group (6/52, 12%). There were no differences between delivery formats in feasibility/acceptability. The intervention significantly improved parents' psychological flexibility, protectiveness, distress, and parenting self-regulation over time. A small group difference favored the in-person format for psychological flexibility, and an interaction effect for parenting self-regulation was found. This standalone parent-targeted group intervention had positive effects on parent outcomes delivered either in-person or virtually.

Psychological flexibility as a predictor of mental health outcomes in parents of pre-school children during the COVID-19 pandemic: A two-year longitudinal study

In light of the adverse mental health impacts of the COVID-19 pandemic for parents of preschool-aged children, it is important to identify modifiable protective factors that can inform interventions for parents who continue to struggle. The present study examined prospective and concurrent associations of parental psychological flexibility (acceptance, defusion, and committed action) with measures of parental stress and depression symptoms in an international sample of parents of preschoolers assessed at three time points over the first two years of the COVID-19 pandemic: The start of the pandemic (T1) as well as the end of the first (T2) and second (T3) year of the pandemic. Consistent with hypotheses, the three measures of parent psychological flexibility (assessed at T2) prospectively predicted parenting stress levels one year later (T3) (p < .05). Defusion and Committed Action also prospectively predicted lower levels of depression symptoms one year later [p < .05]. Comparable concurrent analyses of data of parents who provided data at T1 and T2 (N = 79) are also presented with acceptance and defusion negatively associated with parental stress (p < .001) and defusion negatively associated with depression (p < .05). This study contributes longitudinal evidence for the value of psychological flexibility for parents and suggests that Acceptance and Commitment Therapy interventions may help to support parental mental health during sustained periods of stress such as the COVID-19 pandemic.

Psychometric Properties of the Turkish Version of the Parental Psychological Flexibility Questionnaire

This study aimed to examine the psychometric properties of the Parental Psychological Flexibility Questionnaire (PPFQ) developed by Burke and Moore (2015) in a Turkish sample. For this purpose, the three-factor structure of the scale was tested by conducting Exploratory Factor Analysis (EFA) with a sample of 274 parents with kids aged between 9-17. The criterion-related validity of the PPFQ was tested by checking Pearson correlation coefficients. The structure of the PPFQ was confirmed by testing Confirmatory Factor Analysis (CFA) with a sample of 353 parents with kids 9-17. Following the confirmation of the three-factor structure of the scale, reliability coefficients were tested for the whole scale and its subscales via test-retest reliability and Cronbach’s alpha coefficients. The results of the EFA and CFA revealed that the Turkish form of the PPFQ was also a three-factor scale as it was in the original version. Additionally, concerning the criterion validity, PPFQ was found to be significantly linked to related measures. Finally, the reliability scores were also satisfactory. These findings were discussed in line with the relevant literature.

Personality Traits and Parental Burnout Among Fathers: A Moderated Mediation Model

Focusing on a sample of fathers, this study examined the effects of two personality traits, agreeableness and neuroticism, on parental burnout, as well as the mediating role of parenting sense of competence and moderating effects of parental psychological flexibility. Data were collected from 263 fathers of middle-school children in central China, with questionnaires including the agreeableness and neuroticism subscales from the Big Five personality trait scale, Parenting Sense of Competence Scale, Parenting Psychological Flexibility scale, and Parental Burnout Assessment. To analyze the hypothesized moderated mediation model, bootstrapping analysis and structural equation modeling were performed. Results showed that agreeableness was negatively correlated with parental burnout, while neuroticism was positively correlated with parental burnout; both these relationships were partially mediated by parenting sense of competency. Further, psychological flexibility moderated the relationship between parenting sense of competence and parental burnout. When parenting psychological flexibility was low, parenting sense of competence was significantly related to parental burnout, while parenting psychological flexibility was high, parenting sense of competence was not related to parental burnout significantly. These preliminary findings provide theoretical guidance and an empirical basis for intervention strategies to prevent burnout among fathers.

Parental Psychological Flexibility and Children’s Behavior Problems in Rural Areas in Northeast China: The Mediation of Children’s Emotion Regulation

Children's behavior problems are not conducive to their sustainable development. Therefore, it is of great value to explore the mechanism of relevant influencing factors on the behavior problems of rural preschoolers. This study aimed to reveal the direct effect of parental psychological flexibility on children's behavior problems and the mediating effect of children's emotion regulation. Based on simple random sampling, 355 caregivers (male = 31.25 years, SD = 9.78; 74.08% females; 9.01% bachelor degree) were recruited from eight rural kindergartens in three provinces in northeast China. With questionnaires, caregivers reported their parental psychological flexibility and assessed their children's emotion regulation and behavior problems. SPSS 25.0 software was used for statistical data analysis. The results support our hypotheses, suggesting that parental psychological flexibility, emotional stability, and emotional regulation negatively predicted children's externalizing and internalizing behavior problems. Meanwhile, emotional stability and regulation partially mediated the relationship between parental psychological flexibility and children's externalizing and internalizing behavior problems. These findings provide a new perspective for preventing and intervening in preschoolers' behavior problems.

Acceptance and Commitment Training Focused on Psychological Flexibility for Family Members of Children with Intellectual Disabilities.

The objective of the study was to analyse the effect of a psychological flexibility intervention programme based on Acceptance and Commitment Therapy (ACT) on 36 family members of children with intellectual disabilities. The 6-PAQ (parental psychological flexibility), PSS-14 (perceived stress), GHQ-12 (psychological health), and WBSI (suppression of unwanted thoughts) were used as measurement instruments before the programme (pre), after (post), and at follow-up (after two months). Possible change in family interactions due to the family intervention was also assessed through self-monitoring. A decrease in psychological inflexibility, a reduction in stress, an improvement in psychological well-being, and a reduction in the tendency to suppress thoughts and emotions were observed after the programme. Furthermore, the effects seem to extend to family interactions, with an increase in positive interactions and a decrease in negative ones. The study leads us to think about the importance of psychological flexibility in children with chronic conditions as a process that mediates the impact of stress and family well-being.

The impact of psychological flexibility on family dynamics amidst the COVID-19 pandemic: A longitudinal perspective

BackgroundHealth risks associated with contracting COVID-19, stay-at-home orders, and pandemic-related economic and social hardships created unique challenges for individuals throughout the pandemic, and in particular for families whose daily routines were disrupted at the start of the pandemic. This study applied a contextual behavioral science lens to Family Systems Theory to examine the impact of COVID-19 stressors on family and individual functioning. MethodsA sample of 742 coparents (86% married/engaged; 84% Caucasian; 71% female; M = 40.7 years old, SD = 8.1; Mincome = $82,435, SDincome = $27,604) of school-aged children (5–18 years old) completed a baseline survey from late March to late April 2020. Of the initial sample, 556 coparents completed weekly diaries for 8 weeks. ResultsMediation models were tested within a multilevel path modeling framework to evaluate both the stable, between-family differences (i.e., at level 2) and the within-family changes from week to week (i.e., at level 1). Across both levels of the model, parent psychological inflexibility was robustly linked to poorer functioning across all levels of the family system, showing direct links to a majority of the processes assessed. The results further supported a top-down spillover cascade in which parent inflexibility was proximally linked to greater COVID-19 related stress and parent depressive symptoms, which were proximally linked to poorer romantic functioning (greater negative conflict, lower satisfaction), which were proximally linked to poorer family functioning (greater coparent discord and family chaos), which were proximally linked to poorer parenting (greater angry/reactive parenting), which was proximally linked to greater child distress. Multi-group models suggested that the results were largely stable across (1) parent race (white vs non-white), (2) family size (1 child vs 2 or more), (3) child age (less than 10 years old vs 10 or older), (4) parent age (under 40 vs. 40 or older), (5) perceived COVID-19 risk, (6) parent gender (mothers vs fathers), (7) household income groups (less than $100k vs $100k or more), and (8) perceived economic stress/uncertainty (low vs high). However, a handful of moderated effects emerged from those multi-group models suggesting that fathers might be slightly more prone to negative spillover effects across the family systems and that wealthier families might have experienced the stress of new demands (e.g., homeschooling, remote working) as more disruptive. ConclusionsResults highlight the crucial role parental psychological flexibility and inflexibility play in families managing the stress of COVID-19, as well as key mechanisms for how those stressors may either reverberate or become dampened throughout the family system.

Psychological Flexibility Is Associated with Parental Stress in Relatives of People with Intellectual Disabilities.

The objective of the study was to examine the relationship between psychological flexibility, perceived stress, and psychological heath in relatives of people with a disability diagnosis. 151 relatives completed an online questionnaire that included 6-PAQ (parental psychological flexibility), PSS (perceived stress), GHQ-12 (psychological health) and WBSI (suppression of unwanted thoughts). The results showed significant relationships between the four measured variables. A bimodal distribution was observed in the variables related to psychological flexibility. The multiple regression showed that difficulties in self as context, committed actions and defusion explain a high percentage of the variance of parental stress and general psychological health. The study provides new evidence to consider psychological flexibility as a mediating variable in psychological well-being. The presented data served as the basis for the development of an ACT-based intervention protocol and the implementation of a clinical trial for relatives of children with disabilities.

Piloting the Circle of Security Parenting group with parents of children with a learning disability: An exploratory case study

AbstractBackgroundThe Circle of Security Parenting programme is a manualised parenting intervention that aims to enhance secure attachment and improve relationships between children and their caregivers. It is gaining global popularity and acquiring emerging support. Researchers are increasingly interested in its effectiveness in enhancing parent–child attachment, improving parent psychological flexibility and reducing parental stress. However, research to date has predominantly focused on parents of typically developing children, despite the Circle of Security Parenting intervention being used as a parenting programme in specialist services for children with learning disabilities. There is, however, no clear evidence that this programme meets the diverse needs of parents who encounter additional challenges that may impact on the development of secure parent–child attachment relationships. This case study aims to pilot a seven‐session Circle of Security Parenting programme for parents of children with learning disabilities.MethodsFour participants completed pre‐ and post‐intervention outcome measures specified by Circle of Security Parenting, including: the Parental Stress Scale, Parental Acceptance Questionnaire, Acceptance and Action Questionnaire II and the Caregiver Helplessness Questionnaire.FindingsQuantitative results are mixed, and did not demonstrate the improvements in parental stress or psychological flexibility that might be expected. Qualitative accounts of participants' experiences offer potential explanations for the findings that may be unique to parents of children with learning disabilities.ConclusionThis paper recognises that further research is needed to identify evidence‐based programmes that meet the needs of this population.

Relationship between paternal adult attachment and adolescent anxiety: The chain-mediating effect of paternal psychological flexibility and father-adolescent attachment.

Grounded in family systems theory and the internal working model of attachment, the present study tested the effects of paternal adult attachment, paternal psychological flexibility and father-adolescent attachment on adolescent anxiety. In total, 906 pairs of fathers and their adolescents completed a set of questionnaires, including the Experiences in Close Relationships Scale, Parental Psychological Flexibility Questionnaire, Inventory of Parent and Peer Attachment, and Trait Anxiety Inventory. The results revealed that paternal adult attachment avoidance had a positive impact on adolescent anxiety. The relationship between paternal adult attachment and adolescent anxiety was chain mediated by paternal psychological flexibility and father-adolescent attachment. The mediation effects contained two paths: the separate mediation effect of paternal psychological flexibility, and the chain mediation effect of paternal psychological flexibility and father-adolescent attachment. The results of the study show that the father's adult attachment can not only directly affect adolescent anxiety, but also indirectly affect adolescent anxiety through the paternal psychological flexibility and the quality of father-adolescent attachment. Fathers have an important effect on adolescent anxiety.

Effects of an Online Acceptance and Commitment Therapy Intervention on Children\u2019s Quality of Life

The present study examined if an Acceptance and Commitment Therapy (ACT)–based online intervention for parents had indirect effects on their children’s quality of life mediated by changes in parental well-being, psychological flexibility and mindfulness skills. Participants were 74 adults, who either received an ACT-based guided online intervention or were allocated to the wait list control group, and their children (n = 66) who had type 1 diabetes or functional disabilities. Structural equation modeling (SEM) and a bias-corrected bootstrap approach were applied to examine the indirect effects of the treatment on children’s quality of life through changes in parents’ well-being and psychological processes involving psychological flexibility, cognitive defusion, and mindfulness skills. Children’s quality of life was assessed both by self-reports and parents’ evaluations. Significant indirect effects on children’s quality of life were found through improvements in parental well-being and mindfulness skills. The intervention had significant indirect effects on parents’ evaluations of their children’s quality of life concerning family and other social relationships, as well as on physical well-being. In regard to children’s self-reported quality of life, the intervention had significant indirect effects on self-esteem, family relations, emotional well-being, and functioning at school/kindergarten. The results indicate that it is beneficial for children’s quality of life to improve parents’ ability to describe their experiences, being non-reactive to one’s inner experiences and acting with awareness as well as cognitive defusion.

A Review of the Effects of Parents’ Psychological Flexibility and Parental Psychological Flexibility on Children and Adolescents

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Factors Influencing Adolescent Anxiety: The Roles of Mothers, Teachers and Peers.

Grounded in social–ecological system theory, the present study tested the mediating effects of maternal psychological flexibility and mother–adolescent attachment on the relationship between maternal adult attachment and adolescent anxiety as well as the moderating effects of teacher support and peer support on the relationship between mother–adolescent attachment and adolescent anxiety. In total, 1139 Chinese mothers and adolescents completed a set of questionnaires, including the Experiences in Close Relationships Scale, Parental Psychological Flexibility Questionnaire, Inventory of Parent and Peer Attachment, Trait Anxiety Inventory, and Multidimensional Scale of Perceived Social Support. The results revealed that maternal adult attachment had a positive impact on adolescent anxiety. The relationship between maternal adult attachment and adolescent anxiety was chain mediated by maternal psychological flexibility and mother–adolescent attachment. In addition, teacher support and peer support had moderating effects on the relationship between mother–adolescent attachment and adolescent anxiety. These findings support the systematic social ecosystem perspective and highlight the differences in the effects of different maternal adult attachment styles, teacher support, and peer support on adolescent anxiety.

Influence of Parental Psychological Flexibility on Pediatric COVID-19 Vaccine Hesitancy: Mediating Role of Self-Efficacy and Coping Style.

Background: Pediatric COVID-19 vaccine hesitancy hinders the establishment of immune barrier in children. Psychological flexibility may be a key contributing factor to pediatric COVID-19 vaccine hesitancy, and self-efficacy and coping style play an important role in the relationship, but the underlying mechanisms remain unknown.Methods: A cross-sectional study was conducted on parents from June 2021 to July 2021. A total of 382 parents were recruited for an online-investigation. Serial mediation models were used to examine whether self-efficacy and coping style mediated in the psychological flexibility-pediatric COVID-19 vaccine hesitancy linkage.Result: Psychological flexibility was negatively related to pediatric COVID-19 vaccine hesitancy (r = −0.198, P < 0.001). Coping styles rather than self-efficacy played a mediating role independently (95% CI: −0.263 to −0.058). Serial mediation analyses indicated that self-efficacy and coping style co-play a serial mediating role in the association of psychological flexibility and pediatric COVID-19 vaccine hesitancy (95% CI: −0.037 to −0.001).Conclusion: The present study showed that high psychological flexibility, high self-efficacy, and positive coping style were conducive to the lower pediatric COVID-19 vaccine hesitancy.