Parental Adjustment Research Articles

Parental decisional regret after surgical treatment in young boys born with hypospadias

Parental decisional conflict and decisional regret are aspects in parental adjustment to childhood elective surgery. This study assessed correlates of parental decisional regret in parents of young boys treated for hypospadias. Parents of 261 boys treated for hypospadias at the Radboudumc between 2006 and 2014 were approached to complete questionnaires on socio-demographics, clinical details, postoperative outcomes, decisional conflict and decisional regret. Of the 97 participating parents, 50.5% reported some form of decisional regret, in 11.3% this was moderate to strong. Decisional conflict (β=.68, p<.001) and psychosocial behavior problems of the child (β=.20, p<.05) significantly predicted decisional regret. Demographic and medical variables did not correlate with parental decisional regret. A substantial number of parents report some form of decisional regret regarding the elective surgery for hypospadias in their child. Although most parents only show mild forms of regret, in the perspective of discussions on this surgery in early childhood, future research could shed more light on the interrelationship between medical and psychosocial factors in the process of decision-making around surgery, in boys with hypospadias and their parents.

Short-term Longitudinal Studies on the Relation among Children’s Perception of Parenting, Rumination and School Adjustment in Late Childhood

Short-term Longitudinal Studies on the Relation among Children’s Perception of Parenting, Rumination and School Adjustment in Late Childhood

Relations Between Bicultural Attitudes, Paternal Versus Maternal Acceptance, and Psychological Adjustment of Ethnic Minority Youth in Bangladesh

The purpose of this study was to explore the effects of perceived paternal and maternal acceptance on the bicultural orientations and psychological adjustment of ethnic-minority young adults in Bangladesh. The study was based on a sample of 412 young adults (mean age 22 years), consisting of 40% women and 60% men from 18 tribal subgroups in Bangladesh. Measures used were Parental Acceptance–Rejection Questionnaire (PARQ), Bicultural Attitude Scale (BAS) and Personality Assessment Questionnaire (PAQ). Results showed that there are significant positive correlations between perceived parental (paternal and maternal) acceptance, heritage culture, and psychological adjustment of the respondents. Results further showed that perceived paternal acceptance has independent and stronger effect than perceived maternal acceptance on the bicultural orientations and psychological adjustment of the minority young adults in Bangladesh.

Symptom Severity, Internalized and Externalized Behavioral and Emotional Problems: Links with Parenting Stress in Mothers of Children Recently Diagnosed with Autism.

The present study examined which aspects of the child's behavior and clinical profile accounted for three dimensions of parenting stress: related to parenting roles, to interactions with the child, and to the child. Measures of adaptive behavior, intellectual functioning, autism symptom severity, and challenging behavior and emotional difficulties were examined as predictors of parenting stress in 157 mothers of children recently diagnosed with autism. Children's emotional problems and aggressive behavior were most predictive of parenting distress, whereas autism symptoms along with emotional problems and aggressive behavior, respectively, were linked to stress pertaining to interactions and to the child. These findings underscore the need for comprehensive and complementary interventions that focus on children's behavior and symptoms but also on parent adjustment.

Longitudinal Associations between Intake of Fruit and Vegetables and Height Attainment from Preschool to School Entry.

To examine associations between fruit and vegetable intake in young childhood and height attainment during preschool and at school entry. Data for this study was based on “The Healthy Start” primary intervention study, which included 635 obesity-prone children, (58% boys), from the greater Copenhagen area, with a mean (SD) age of 4.0 (1.1) years (age range 2–6 years) at baseline. In the current study, 553 children (57% boys) were included with information on dietary intake at baseline and height measured at baseline (preschool age), and 511 children (56.8% boys) with the height measured at school entry (~6 years old). Height was measured by trained health professionals during the intervention and by school nurses at school entry. Information on intakes of fruit and vegetables, separately and combined, was gathered with four-day dietary records reported by parents. Participants were grouped into tertiles for their intakes at baseline. Compared to boys with low consumption, those with a moderate and high intakes of fruit and vegetables (F&V) had a greater attained height at preschool of 1.3 cm (95% confidence interval (CI): 0.3; 2.3) and at school entry of 2.4 cm (95% CI: 0.8; 3.9) and 1.8 cm (95% CI: 0.2; 3.4), respectively, also after adjustment for differences in age, body mass index (BMI), and total energy intake. Additional adjustment for mid-parental height and parents’ education did not alter the significant associations between moderate consumption of F&V and attained height at preschool and school entry. There was no association among girls. Our results showed that a moderate consumption of F&V was directly associated with higher attainment in height at preschool and school entry in boys. From a public health perspective, it should be prioritized to continue developing intervention programs to improve fruit and vegetable intake.

The COVID-19 Family Stressor Scale: Validation and Measurement Invariance in Female and Male Caregivers.

The COVID-19 pandemic has raised significant concerns regarding the effect of social disruptions on parental mental health, family well-being, and children's adjustment. Due to the pace of the pandemic, measures of pandemic-related disruption have not been subject to rigorous empirical validation. To address this gap, a multi-national sample (United Kingdom, 76%; United States, 19%; Canada, 4%, and Australia, 1%) of 372 female caregivers and 158 male caregivers of 5–18-year-old children was recruited online. Participants completed a survey including a 25-item scale indexing disruption in finances, basic needs, personal and family welfare, career/education, household responsibilities, and family relationships related to the pandemic. An exploratory factor analysis yielded an optimal three-factor solution: factors included Income Stress (five items related to income, debt, and job loss; loadings ranged from 0.57 to 0.91), Family Stress (seven items related to family altercations and child management; loadings from 0.57 to 0.87), and Chaos Stress (four items related to access to supplies, crowded shopping areas, news coverage; loadings from 0.53 to 0.70). Multiple-group confirmatory factor analysis demonstrated measurement invariance of each factor across female and male caregivers, indicating that factor structure, loadings, and thresholds were equivalent across groups. Composites reflective of each factor were computed, and Mann-Whitney U tests indicated that female caregivers consistently scored higher than male caregivers on COVID-19 stressors related to income, family, and chaos. Finally, concurrent validity was demonstrated by significant bivariate correlations between each scale and caregiver, family, and child outcomes, respectively. This demonstrates the validity of the COVID-19 Family Stressor Scale for use with female and male caregivers in family-based research. The current sample was predominantly White-European, married/common-law, and had at least some post-secondary education. Additional sampling and validation efforts are required across diverse ethnic/racial and socioeconomic groups.

Relations between Perceptions of Parental Acceptance-Rejection, Forgiveness, Vengeance, and Psychological Adjustment in Kuwaiti Youth and Adults

The current research is aimed at investigating the relations between forgiveness, vengeance, perceptions of parental acceptance-rejection, and psychological adjustment in 528 Kuwaiti males and females (mean age =30.92, and SD= 7.72 years) by using Arabic versions of the following four measures and questionnaires 1) The Heartland Scale, 2) The Vengeance Scale, 3)The Acceptance-Rejection Questionnaire (PARQ), and 4) The Personality Assessment Questionnaire (PAQ). The data was analyzed using descriptive and inferential statistical analysis. Results revealed that forgiveness correlated significantly negative with vengeance, and significantly positive with both the perceptions of parental acceptance and healthier psychological adjustment. Vengeance correlated significantly positive with perception of parental rejection and unhealthier psychological adjustment. No significant differences were found between males and females in perception of mother warmth. Males, compared with females, were significantly higher in perceiving maternal and paternal rejection. Females, compared with males, perceived their fathers as having more warmth, Older and married participants reported significantly higher levels of healthier adjustment and forgiveness, compared with younger and unmarried participants. Males and younger participants reported significantly higher levels of vengeance, compared with females and older participants. Significant influence of education or work on the perception of parental acceptance-rejection, psychological adjustment, forgiveness No and vengeance, was found. A Multiple Mediator Model "MMM" showed that forgiveness and vengeance fully mediated and moderated the relation between perceptions of parental acceptance-rejection and psychological adjustment. Moreover, the M. M. M. analysis showed that perceptions of parental acceptance-rejection and psychological adjustment were effective predictors of the relationship between forgiveness and vengeance. Limitations of the study were considered and the significance of the results is discussed. In consideration of results, some suggestions were made for the implementation and for further research.

Family Resilience, Parenting Styles and Psychosocial Adjustment of Children With Chronic Illness: A Cross-Sectional Study.

Objectives: To evaluate the level of parent-reported family resilience, parenting styles and psychosocial adjustment of children with chronic illness and to identify the relationships between family resilience, parenting styles and psychosocial adjustment in families with children with chronic illness.Methods: A cross-sectional study was conducted between June 2019 and August 2019. A total of 236 parents of children with chronic illness and 98 parents with healthy children were recruited from general hospitals by convenience sampling. A parent completed the Chinese Family Resilience Assessment Scale, the Parenting Rearing Patterns Questionnaire and the Strengths and Difficulties Questionnaire. Family resilience, parenting styles, and psychosocial adjustment of children with chronic illness were compared with those of healthy children. Structural Equation Modeling (SEM) was performed to explore the mediation effect of parenting styles between family resilience and psychosocial adjustment among children with chronic illness.Results: Parents of children with chronic illness reported lower level of family resilience and authoritative parenting, but more peer relationship problems compared to parents of healthy children. SEM showed that authoritative parenting fully mediated the relationship between family resilience and psychosocial adjustment of children with chronic illness.Conclusion: Childhood chronic illness reduces family resilience, authoritative parenting and children's psychosocial adjustment, but authoritative parenting mediated these effects, so authoritative parenting may be important for family resilience in families of children with chronic illness. Pediatric clinicians and nurses should provide family-centered interventions, as well as parenting training, to improve children's psychosocial outcomes.

Parenting Style and Adolescent Adjustment: Findings of a Cross-Sectional Study in Urban Dhaka

Background: Adolescent adjustment is associated by parenting style as well as influenced by other factors of life. The objective of this study was to assess the association between parenting style and adolescent adjustment.&#x0D; Methods: This cross-sectional study was conducted among 360 adolescents (180 boys and 180 girls) between 15-19 years selected by systematic random sampling from two institutions. Data were collected by semi-structured selfadministered questionnaire after taking informed written consent. The research was conducted in full accord with ethical principles and by keeping in view of the objectives of the study.&#x0D; Results: Among the students, majority (74.2%) were between 15-17 years. The mean (±SD) of age was 16.66 (±1.108). Regarding parenting style, majority, 40.0% parents followed permissive style, 25.8% and 25.3% followed authoritative parenting. Only 8.9%followed negligent parenting. Majority, 59.7% of the adolescent were well adjusted. Parenting style was associated with adolescent adjustment (p&lt;.01). There was significant mean difference in adjustment between boys and girls showing better adjustment of boys than girls (p&lt;.01). Logistic regression between parenting style and adolescent adjustment showed, adjustment was high (OR=6.3) in permissive parenting.&#x0D; Conclusion: This study showed there is significant influence of parenting style in adjustment of adolescent boys and girls which is related to the adjustment in almost all areas of life.&#x0D; JOPSOM 2020; 39(2): 8-13

Parental stress and adjustment in the context of rare genetic syndromes: A scoping review.

Chromosomal abnormalities are now considered a common cause of intellectual disability. With increased genetic testing, phenotyping and technological advancements, many new syndromes have been identified. This review sought to explore parental stress and adjustment in the context of rare genetic syndromes to evaluate their clinical impact. A systematic review of English peer-reviewed literature across three databases (PsycINFO, Medline, CINAHL) was completed and 69 articles were included. Parents of children with rare genetic syndromes experienced greater distress relative to other disabilities. Differences in parental wellbeing were syndrome-specific relative to ASD thus demonstrating the need to consider the contribution of syndrome-specific phenotypes. Child emotional and behavioural difficulties were the most consistent predictor of parental distress. Research reflecting other factors such as physical health, syndrome-specific behaviours, benefit finding and, parental appraisal in the context of a rare genetic aetiology is required in order to support parental adjustment in these conditions.

The role of child negative emotionality in parenting and child adjustment: Gene-environment interplay.

Evocative gene-environment correlation (rGE) describes a process through which children's heritable characteristics influence their rearing environments. The current study examined whether heritable influences on parenting and children's behavioural outcomes operate through child negative emotionality. Using data from the Early Growth and Development Study, we examined associations among adoptive parent reports of child anger and sadness at 4.5 years, adoptive parents' hostile and warm parenting at 6 years and child behavioural problems and social competence at age 7. Birth parent temperament was included to test whether child effects on parents reflect evocative gene-environment correlation (rGE). Child anger at 4.5 years evoked hostile parenting from adoptive parents at 6 years, which was subsequently related to child problem behaviours at 7 years. Evocative rGE effects were identified for adoptive parents' hostile parenting. By employing a genetically informed design, we found that birth parent temperament was related to child negative emotionality. Adoptive parents were sensitive to child negative emotionality, and this sensitivity was linked to the child's later adjustment.

Infant massage programs for newborn babies: systematic review

Introduction Parenthood is a period of stress and great demand for parents. Taking care of a baby requires parental adjustment and behavioural development in order to satisfy child’s needs. Infant massage is an important parental support strategy which enhances parent-child relationship and promotes baby’s development [1]. This is a widely and effective technique used in preterm and term infants. In recent years, many studies showed several benefits, such as improved weight gain; pain reduction; relaxation; increased alertness and learning; decreased stress, depression and anxiety levels; promoted deep sleep and improved immune system [2–4]. However, when evaluating term massage programs, it is noticed that there are no similar methodologies between studies. The purpose of this study is to review massage programs for newborn babies. Materials and methods This is a systematic review study. A literature search was conducted via three databases: PubMed, PEDro and Scielo using the search terms “Massage therapy”; “Infant massage”; “Baby massage”; “Full term”; “term babies”; “neonates”, “newborn” and “Maternal support” or “Mother support”. The inclusion criteria were: Studies published in English, Spanish or Portuguese; RCT studies; Quasi-experimental studies; Studies with massage program; Studies with term babies’ samples; Studies published between 2009 and 2019. The exclusion criteria were studies with term “babies with congenital disease”. A total of 62 papers were found and analysed by both authors. Fourteen met the criteria, 5 RCT’s and 9 quasi experimental studies. Results Studies described 6 programs of infant massage to newborn babies. Ten studies described mothers applying term massage program, 3 applied by health professionals and 1 divided between health professionals when in hospital and by their mothers when babies were discharged. The most representative direction of massage was from head to feet. Majority of the studies used group strategy for teaching infant massage to mothers. Programs varied from 1–3 days twice a day for 15 mn to once a week between 30–60 mn during 4–8 weeks. Studies were scored by PEDro’s scale and ranged from 2 to 7. Half of the studies obtained score 5. Discussion and conclusion We can conclude that 6 massage programs are described in literature; the majority is performed by babies’ mothers and there is a wide variety concerning program duration and frequency. Studies outcomes showed effects both on newborn babies and mother–baby relationship. Infant massage programs seem to be an important group teaching strategy for new parents. However, more studies should be done in order to understand if newborn massage works, regardless of the program type.

Parenting and adolescent adjustment: The mediational role of family self-esteem

The present study analyzes the relationship between parental socialization practices, acceptance/involvement, and strictness/imposition, and different indicators of adolescent adjustment, taking into account the role of family self-esteem. A sample of 848 Spanish adolescents (54.70% females) ranging in age from 14 to 18 years old (M = 16.11, SD = 1.10) participated in the study. A series of structural equations models (SEMs) were tested to examine the mediational role of family self-esteem in the relationship between parenting practices and the outcome variables that capture adolescent adjustment: emotional instability, antisocial behavior, and academic achievement. The influence of parental practices on adolescent adjustment is expected to take place through family self-esteem. The results showed that the effect of acceptance/involvement and strictness/imposition practices on emotional instability, antisocial behavior, and academic achievement was mediated by family self-esteem. Family self-esteem eliminates the previous direct relationships between parental practices and all the adolescent adjustment variables, except the one between acceptance/involvement and emotional instability, which was reduced but not eliminated. Acceptance/involvement practices positively influence adolescents’ adjustment via family self-esteem, whereas strictness/imposition practices negatively influence adolescents’ adjustment via family self-esteem. This study contributes to clarifying the relationship between parental practices and adolescent adjustment, considering family self-esteem as a mediational variable rather than as an adolescent adjustment indicator. The present findings and their implications for parenting science are discussed.

Intergenerational Transmission of Perceived Parental Acceptance–Rejection and Psychological Adjustment: Grandmothers, Mothers, and Adult-Granddaughters

Parent–child relationship quality has a lifelong impact on individuals’ psychological adjustment, and the family system includes recurring relational patterns across generations. The aim of the current study was to examine the intergenerational transmission of perceived parental acceptance-rejection and psychological adjustment across three generations of the same family lineage. Data were collected from three generations of female members of 246 families. The repeated measures ANOVA and latent growth curve modeling were used for both group-based and family lineage-based comparisons. In addition, autoregressive cross-lagged modeling was used to examine the theoretical model of intergenerational transmission. Results provided sufficient evidence for a modest linear decrease in overall score of perceived parental rejection across generations. However, the positive changes in perceived paternal attitudes emerged with a one-generation time lag compared to perceived maternal attitudes. The model provided an indirect transmission across generations, and second-generation mothering mediated the transmissions between grandmothers and granddaughters. Consecutive generations provided appropriate conditions for readjusting the perceived quality of parent–child relationship established in the previous generations, and the current study mainly highlighted the change in relational patterns across generations.

Shared decision making in youth with brachial plexus birth injuries and their families: A qualitative study

ObjectiveThe objective of this study is to elucidate the decision-making experiences of youth with brachial plexus birth injuries who face preference-sensitive decisions regarding treatment options for a persistent elbow contracture. MethodsTranscripts, research-created drawings, and field notes from in-depth interviews with 5 young adults and 14 youth-parent dyads, and 15 participant observation sessions of families and clinicians in the clinic setting were deductively and inductively coded and thematically analyzed. ResultsYouth’s shared decision making was influenced by relational processes with their clinicians and parents. Youth’s trust in their clinicians’ recommendations for pursuing treatment and pressure from their parents to pursue or continue rehabilitation treatment affected how their voices were expressed and heard. Parental emotional adjustment to the birth injury played a role in parental perceptions of what was deemed their youth’s best interest in the shared decision. ConclusionsThe decision-making experiences of youth with brachial plexus birth injury illustrate the complexity of paediatric preference-sensitive decisions and the significance of social and emotional factors on these shared decisions. Practice implicationsOpportunity for youth to express their voice without external pressure during shared decision making is needed to make well-informed decisions based on their own values. Interventions such as decision coaching and decision support tools may help youth and parents to formally identify and discuss these relational processes.

The influence of paternal and maternal parenting styles on adolescents’ regulatory focus: A longitudinal study

To strengthen the evidence for the developmental assumption of regulatory focus theory, that individuals’ chronic self-regulatory orientations root in parenting behaviors, the present study investigated the influences of maternal and paternal parenting styles on Chinese adolescents’ regulatory focus and the effects of regulatory focus on mental health using an 8-month longitudinal design. 466 Chinese middle and high school students completed the regulatory focus, perceived maternal and paternal parenting style, life satisfaction, and positive and negative social adjustment measures. The results showed that: (1) Adolescents’ promotion focus positively predicted life satisfaction and positive social adjustment and negatively predicted negative social adjustment. Prevention focus positively predicted negative social adjustment. (2) Maternal emotional warmth positively predicted promotion focus, whereas paternal harsh discipline positively predicted prevention focus. (3) Promotion focus mediated the relationship between maternal emotional warmth and life satisfaction and positive and negative social adjustment. Prevention focus mediated the relationship between paternal harsh discipline and negative social adjustment.

Parent Perceptions of Infant Symptoms and Suffering and Associations With Distress Among Bereaved Parents in the NICU

ContextHealthcare providers and parents face many challenges caring for infants at the end of life (EOL). Symptom assessment and management in critically ill infants can be especially difficult. However, the impact of the infant's EOL experience on bereaved parents is largely unknown. ObjectiveExplore associations between parental perceptions of infant symptoms and suffering at EOL in the neonatal intensive care unit (NICU) and parent adjustment following the death. MethodsRetrospective, cross-sectional pilot study involving parents of infants who died within the previous five years in a large, Midwestern, level IV NICU. Parents were recruited through mailed invitations, and 40 mothers and 27 fathers participated from 40 families. Parents retrospectively reported on infant symptom burden and suffering during the last week of life and the Impact of Events Scale-Revised (IES-R), and Prolonged Grief-13 (PG-13). Hierarchical regressions examined demographic/medical factors and parent perceptions at EOL in relation to post-traumatic stress symptoms (PTSS) and prolonged grief (PG). ResultsClinical levels of PTSS (Mothers = 18%; Fathers = 11%) and PG (Mothers and Fathers = 3%) were low. Maternal perception of higher symptom burden was associated with greater PTSS, R2 = 0.46, P= 0.001, and PG, R2 = 0.47, P < 0.01. Paternal perception of greater infant suffering was associated with greater PTSS, R2 = 0.48, P= 0.001, and PG, R2 = .38, P < 0.01. ConclusionPerceptions of symptoms and suffering were associated differently with mother and father adjustment after bereavement. While not necessarily causal, better symptom management at EOL could minimize distress for both infants and their parents.

Psycho-emotional adjustment in parents of adolescents: A cross-sectional and longitudinal analysis of the impact of the COVID pandemic

Purpose: adolescence is a time of change and it generally entails a greater family vulnerability thus; the aim of this study was to identify the risk factors for poor emotional adjustment to COVID among parents of adolescents. Design and methods: 94 parents of adolescents (11–18 years old, M = 13.90, SD = 1.85) participated at different times during the state of alert in Spain. 91.5% were mothers. Their ages ranged from 35 to 63 years (M = 46.54; SD = 5.09). The variables assessed were anxiety, depression and stress (DASS), moods (MOOD), somatization (SCL) and resilience (CD-RISC). Descriptive analyses, t-tests, ANOVAs, correlations, and hierarchical regressions were performed. All this by means of a cross-sectional and longitudinal study design. Results: at the beginning of the confinement parents showed low levels of emotional distress and moderate levels of positive emotionality and resilience. However, those with a prior psychological problem, who had lost their job, or had lost someone to the pandemic, showed worse emotional adjustment. Resilience was relevant in predicting anxiety-depressive symptoms, and a low level of happiness was relevant in predicting stress. Emotional symptoms improved over time, and resilience remained stable. Conclusions: the emotional impact of COVID over time is influenced by mood, mental health, and resilience. In addition, parents who had a previous health problem, had lost their job or a loved one, had a worse adjustment. Practical implications: it is important to carry out intervention programs that increase resilience, treating parents who require it, since their emotional adjustment has repercussions on the emotional adjustment of family system.

‘More than a box of puzzles’: Understanding the parental experience of having a child with a rare genetic condition"

BackgroundChromosomal microarray (CMA) testing has been adopted as the first-tier diagnostic test for developmental disabilities. However, determining the clinical significance of the results is often complex. This qualitative study seeks to explore parental interpretation, adaption and coping in the context of ambiguous rare genetic findings in order to support parental adjustment and wellbeing. MethodsIn-depth interviews were conducted with parents (n = 30) of children identified with a rare genetic chromosomal abnormality. ResultsThree major themes were identified following a thematic analysis: ‘Learning of the Genetic Diagnosis', “The Reality of the Rarity’ and ‘Beyond Genetics: The Child Takes Centre Stage’. Findings demonstrated that parental adjustment to their child's genetic results are mediated by several factors including child difficulties and stage of development, clinician communication, perception of genetics, intrinsic coping strategies, access to practical and emotional support as well as broader contextual experiences. ConclusionThis study highlights the importance of considering the parental perspective in the context of genetic testing in clinical practice.

Parental Supervision: Predictive Variables of Positive Involvement in Cyberbullying Prevention.

From an increasingly early age, parents face the challenge of educating their sons and daughters to act in the world of offline and online relationships. If for professional educators it is not proving easy, the involvement and guidance of parents in their children′s use of the internet seems to be a complex and unexplored challenge. This work aims to analyse the variables that influence digital education and determine a predictive model of positive parental involvement. This study was done with a representative sample consisting of five hundred and ninety-six families (596), representing the parents of children from schools with similar socio-cultural indexes. To do this, and using self-report instruments convertible into independent scales, four predictor variables were analysed: (1) parental knowledge of cyberbullying; (2) perception of parental competence in this regard; (3) parental perception of online risks; and (4) the attribution of parental responsibility in digital education. A structural equations model (SEM) examined the predictive value of these variables with respect to positive parental involvement. The structural equations model confirmed direct and mediated relationships between the independent and mediating variables on the dependent variable: parental supervision. The results indicate that positive parental involvement can be predicted from higher scores in parental knowledge of cyberbullying, perception of parental competence, risk adjustment, and attribution of parental responsibility.