Parenting Stress Index-Short Form Research Articles

Occupational Therapy Outcome Measures in Preschool Children With Autism Spectrum Disorders: A Scoping Review.

With the rising prevalence of autism spectrum disorder (ASD), early assessment of preschool children is vital for occupational therapists. This scoping review aimed to provide detailed information about outcome measures used in occupational therapy interventions in preschool children with ASD and map the focus of the outcome measures based on the International Classification of Functioning, Disability, and Health (ICF) components. A thorough search from 2000 to 2022 was conducted that employed ICF linking rules to categorize the outcome measures. Seventy-four outcome measures were identified. They predominantly targeted body function and activity/participation, with less emphasis on environmental factors, and none assessed body structure. The most common measures were Vineland Adaptive Behavior Scale (VABS-2), Canadian Occupational Performance Measure (COPM), and Parenting Stress Index-Short Form (PSI-SF). This study offers a diverse array of outcome measures and underscores the potential of the ICF framework in enhancing evaluations, particularly concerning broader environmental components as one of the primary facilitating/hindering factors in the participation of children with ASD.

Parental stress in the relationship with children affected by chronic hematologic disease.

Sickle cell disease (SCD) and autoimmune thrombocytopenic purpura (AITP) are pediatric diseases which frequently are associated with cognitive, social and emotional complications and can lead caregivers to important consequences. The aim of this study was to examine the potential psychologic parental distress and the plausible interference with suffering of their children. We recruited 39 parents of 44 pediatric patients and divided them into two groups: patients affected by SCD and patients affected by AITP. Parenting Stress Index Short-form (PSI-SF) was proposed to the parents. We investigated the statistical correlations between the PSI-SF variables of the test, the patients scores at the cognitive test, the patients age, and the scores obtained at the mood test. The analysis of the parents scores obtained by the test reported that the stress levels of the parents of children affected by SCD are higher than those the other group. The analysis of the data showed that 72% of the patients score was average in the cognitive test, whereas 28% of them obtained a score below average; in the mood assessment tests: 35% of the patients reported elevated scores in the depression subscale; 21% showed an elevated score in the anxiety subscale. The data obtained provide us useful indications about pattern of behavior between the parents and the children affected by chronic hematological diseases. The differences in the perception of the parental distress were associated with children's disease, social problems increased parental distress, which was correlated with depression symptoms of the children.

PARENTING STRESS: COMPARISON BETWEEN PARENTS OF ATYPICAL CHILDREN AND TYPICAL CHILDREN

Parenting stress is experienced when demand exceeds the capabilities and resources that parents have. This study aims to compare the level of parental stress between parents of atypical children and typical children. A survey has been conducted with 46 parents of atypical children and 54 parents of typical children who were selected around Selangor. The Parenting Stress Index-Short Form (PSI-SF), which is formed from three domains: (1) parental distress, (2) parent-child dysfunctional interaction, and (3) difficult child, has been used to measure the level of parenting stress. The samples were asked to fill out the PSI-SF questionnaire, and the data collected was then analyzed with the Statistical Package for Social Sciences, version 27.0. The result showed that there was a significant difference in parenting stress levels between parents of atypical children and typical children. The mental health of atypical parents is greatly affected not only by the stress of daily life, work, marital problems, interpersonal relationships, and so on. Many of them also feel lonely and isolated since their worries and anxiety are not being understood. The implication of this study is to create awareness among parents of atypical children about their state of mental health before it reaches levels of depression. Therefore, appropriate support and assistance are needed by this group of parents in order to improve their quality of life and family relationships.

Resilient Moderating Effect between Stress and Life Satisfaction of Mothers and Fathers with Children with Developmental Disorders Who Present Temporary or Permanent Needs.

(1) Background: The stress experienced by parents with children with developmental disorders who present temporary or permanent needs, makes them experience a series of daily situations that may be linked to coping strategies. Resilient attributes are considered one of the factors that have a decisive influence on the behavior of parents related to raising their children and that affect greater well-being and life satisfaction. The objective of this research is to study the mediating effect of resilient attributes between parental stress and life satisfaction; (2) Methods: In this study, mothers and fathers of boys and girls from 0 to 6 years old with developmental disorders from different Early Childhood Care Centers (CAIT) in the Province of Jaén (Andalusia) [Spain]. Of them, 96 are mothers (78.0%) and 27 are fathers (22.0%), with a mean age of 37.85 years (±5.043). The Parenting Stress Index-Short Form (PSI-SF), Resilience Scale (RS-14), and Satisfaction with Life Scale (SWLS) were used. The structural equations model (PLS-SEM) was applied to estimate the proposed theoretical model, from an explanatory-predictive perspective; (3) Results: The results showed the coefficients of determination Parental distress [(Q2 = 0.144); (R2 = 0.329)]; Personal competence [(Q2 = 0.106); (R2 = 0.246)]; Acceptance of self and life [(Q2 = 0.094); (R2 = 0.172)] and Life satisfaction [(Q2 = 0.182); (R2 = 0.563)], in the estimation of the reflective model, indicating a moderate fit; (4) Conclusions: The present investigation is not conclusive; however, the implications of these findings are discussed and suggestions for future research are considered.

Pediatrician and parental evaluation of child neurodevelopment at 2 years of age

BackgroundThe early identification of infants with a risk for neurodevelopmental disorders in the first few years of life is essential for better developmental outcomes. Screenings should be carried out by combining the family pediatricians’ and parents’ perspectives, the two fundamental sources of information on children’s health. The present study has three aims: (a) to test the feasibility of parent-report instruments to detect warning signs in their children’s development; (b) to ascertain whether there is an agreement between the family pediatricians’ (FP) clinical judgments of warning signs and the parental perceptions; (c) to determine whether there is a link between parents’ distress and child development.MethodsWithin the NASCITA birth cohort, in addition to the family pediatrician’s clinical evaluation with routine tools, the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) was completed by parents to assess the child’s language, social skills, behavior, and sensory areas. Parents were also asked to complete the Parenting Stress Index, Short Form (PSI-SF) to verify the magnitude of stress in the parent-child system. Univariate and multivariate analyses were performed to evaluate the association between child and parental characteristics and the presence of warning signs.ResultsThe follow-up assessment was completed for 435 infants: 69 (15.8%) presented warning signs: 43 in the pediatrician’s assessment and 36 in the M-CHAT-R (10 in both). A total of 16 children (14 with warning signs) received a diagnosis after a specialist evaluation. Being male (OR 2.46, 95%CI: 1.23–4.91) and having sleep disorders (OR 2.43, 95% CI 1.17–5.04) was associated with a greater likelihood of warning signs in the multivariate analysis, while reading aloud was a protective factor (not exposed versus exposed (OR = 3.14; 95% CI 1.60–6.17). For 73 children (18.4%), at least one parent tested positive for PSI-SF. An increased prevalence of parental distress was observed in children with warning signs (OR 2.36, 95% CI 1.27–4.37).ConclusionsIntegrating physician and parental perspectives during well-child visits and in clinical practice appears feasible and can improve the identification of children at risk of developmental disorders.

Infant-Directed Speech to Preterm Infants during the First Year Postpartum: The Influence of Preterm Birth Weight and Maternal Parenting Stress

Premature birth can increase the level of parenting stress (PS), especially in the case of parents of high-risk infants (extremely low birth weight (ELBW) and very low birth weight (VLBW)). Though published research has explored how maternal PS influences early dyadic interactions, limited research has focused on infant-directed speech (IDS), and no studies have investigated the link between prematurity severity based on birth weight and maternal IDS. This study, involving 100 mother–infant dyads, categorized into 30 ELBW premature infants, 30 VLBW premature infants, and 40 full-term (FT) ones, examined the impact of preterm birth weight and maternal parenting stress on IDS features during early interactions at 3 and 9 months postpartum. Maternal input was assessed using the CHILDES system, while parenting stress was evaluated using the Parenting Stress Index-Short Form. The results revealed that high-risk conditions (ELBW preterm birth and high parenting stress) at 3 months were associated with reduced affect-salient speech and increased questioning. IDS functional patterns, specifically the proportion of affect-salient speech and questions, were influenced by both birth weight groups and parenting stress levels at 3 months but not at 9 months. These findings highlight the need to assess, within the context of prematurity, both birth weight and parenting stress in clinical practice, offering insights for developing interventions supporting positive parent–infant interactions and facilitating infant development.

Efficacy of parent-child interaction therapy for children born premature.

Premature children are known to be at a high risk of developing behavioral problems. This study examined the effectiveness of parent-child interaction therapy (PCIT) in reducing behavioral problems in young children born premature. The study included 18 child-parent pairs with children born at less than 35 weeks of gestation (range: 23-34 weeks, median: 31.0 weeks) and aged 27-52 months (median: 38.0 months). They were assigned to either the PCIT group (n = 7) or the non-PCIT group (n = 11) based on maternal desire for treatment. The study was designed to examine the effects of PCIT. Specifically, the Eyberg Child Behavior Inventory (ECBI) intensity score, ECBI problem score, and Parenting Stress Index Short Form (PSI-SF) scores were compared before treatment and after 6 months. In the PCIT group, the mean ECBI intensity score was 135.7 (SD = 13.5; T-score = 64) at baseline and 90.1 (SD = 15.5; T-score = 46) at post-assessment, the mean ECBI problem score was 9.8 (SD = 1.9; T-score = 54) at baseline and 4.4 (SD = 3.1; T-score = 44) at post-assessment, the mean PSI-SF total score was 60.1 (SD = 4.8; 95%tile) at baseline and 49.6 (SD = 5.6; 85%tile) at post-assessment, showing a significant improvement (ECBI intensity scores: p < 0.001, d = 2.03; ECBI problem scores: p < 0.001, d = 1.94; PSI-SF total scores: p = 0.004, d = 0.86). On the other hand, none of the scores showed significant change in the non-PCIT group. The PCIT can be considered as a potential treatment option for behavioral problems in young children born premature.

Beyond Diagnosis: Preliminary Study of Impact on Children and Parents in Neurodevelopmental Disorders and Juvenile Idiopathic Arthritis-Associated Uveitis

Chronic diseases are a growing problem for global health due to the large number of people they involve, the repercussions they have on the mental and physical well-being of those affected, and the costs to society. Particularly, chronic illnesses of childhood have important psychological implications, not only for affected children but also for their parents. Among these pathologies, neurodevelopmental disorders (NDDs) and uveitis associated with juvenile idiopathic arthritis (JIA-U) may affect mental and physical health, emotions, memory, learning, and socializing. This study evaluates the psychological and behavioral/emotional impact of NDDs and JIA-U on children and parents. Specifically, 30 children with active JIA-U and 30 children with NDDs and their parents completed the Child Behavior Checklist (CBCL) and Parent Stress Index—Short Form (PSI) questionnaires. Children with NDDs have statistically significant differences in all the emotional and behavioral variables compared to JIA-U children, and parents of children with NDDs experience an increased stress load compared to parents of children with JIA-U. This study emphasizes the wide range of emotional and behavioral challenges that parents face with NDDs. This study emphasizes that parents of children with NDDs not only experience higher levels of stress compared to parents of normally developing children but also experience higher levels of stress compared to parents of children with potentially debilitating chronic diseases such as JIA-U.

Parental stress and food allergy phenotypes in young children: A National Birth Cohort (JECS).

Food allergy children and their families tend to have emotional distress and anxiety. There have been few reports of differences in parenting stress and a child's food allergy phenotypes. We examined the associations between food allergy phenotypes in children and parenting stress assessed by the Parenting Stress Index-Short Form (PSI-SF) from a national birth cohort (Japan Environment and Children's Study). We included 65,805 children for statistical analysis. Of them, 7.2% of children had a food allergy diagnosis at 2 years old. The means of the total PSI-SF (39.9 ± 10.3, 39.1 ± 9.9), CD-SF (19.5 ± 5.4, 19.1 ± 5.2), and PD-SF (20.5 ± 6.3, 20.0 ± 6.1) scores are similar for caregivers in the with and without food allergy groups. Food allergy diagnosis resulted in significantly higher total PSI scores (coefficient .47, 95% CI 0.19-0.75, p = .001), CD-SF (coefficient .22, 95% CI 0.07-0.38, p = .004), and PD-SF (coefficient .24, 95% CI 0.08-0.41, p = .004). A similar trend was observed for allergy reactions to hen's egg. However, there was no clear relationship between allergic reactions to milk, wheat, nuts, and PSI-SF. Parental stress was significantly related to a child's food allergy. Furthermore, hen's egg allergy increased parental stress. Multiple food avoidance might also increase parental stress. Healthcare providers need to be aware of parental stress in our daily clinic.

Parenting young children during COVID-19: Parenting stress trajectories, parental mental health, and child problem behaviors.

Parenting stress reflects a discrepancy between a parent's perception of their resources, the demands of their child's needs, and the caregiving relationship and contexts (Abidin, 1992). Parenting stress can increase the risk of issues in the parent-child relationship, as well as child behavioral and emotional outcomes (Neece et al., 2012; Spinelli et al., 2021). Chronic stressors, such as living through the COVID-19 pandemic, have the potential to increase the demands of parenting and thus parenting stress. Using latent growth curve modeling, we examined parenting stress trajectories of 298 American parents with young children (Mage = 15.02 months, range = 1-34 months) over the first year of the COVID-19 pandemic. We also examined the effects of parental mental health on parenting stress, and the effects of parental mental health and parenting stress on child problem behaviors using data gathered through the Prolific survey platform. Parental mental health, measured by depressive symptoms Centre for Epidemiological Studies Depression Scale-10, anxiety symptoms Generalized Anxiety Disorder Scale (GAD-7), and overall stress levels 10-item Perceived Stress Scale, was related to higher initial parenting stress index-short form. Changes in parenting stress over time were linked with higher levels of children's problem behaviors (CBCL). Child temperament was also related to initial parenting stress. Lower levels of household income were linked with higher levels of parental mental health symptoms and higher rates of parenting stress increases over time. These results highlight the importance of considering the well-being of all family members in child outcomes, and the ways in which different experiences and resources during the COVID-19 pandemic affect parental and child well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Factors in Parenting Stress in Young Patients With Breast Cancer and Implications for Children’s Emotional Development

The number of patients with breast cancer who have children is substantial. However, the emotional burden of this disease and its implication for childhood development remain largely unknown. To investigate the clinical factors in parenting stress in mothers with breast cancer and the association of maternal depression and parenting stress with their children's emotional development. This cross-sectional study involved a survey of females with stage 0 to 3 breast cancer and was conducted from June 2020 to April 2021 in Seoul, South Korea. Participants were aged 20 to 45 years and completed the Center for Epidemiologic Studies Depression-Revised scale and basic questionnaires on demographic and clinical characteristics. Participants with children completed the Korean Parenting Stress Index Short Form (K-PSI-SF), Child Behavior Checklist, Junior Temperament and Character Inventory, and Children's Sleep Habits Questionnaire. Having children in patients with breast cancer. Multivariable logistic and linear regression analyses were performed to investigate the association between maternal depression and parenting stress. A total of 699 females (mean [SD] age, 39.6 [4.6] years) were included, of whom 499 had children (mean [SD] age of children, 8.0 [2.7] years). Depression was more common in patients with children (odds ratio [OR], 2.25; 95% CI, 1.01-5.05) and patients who had gonadotropin-releasing hormone treatment (OR, 1.68; 95% CI, 1.15-2.44). Disease duration was inversely associated with depression (OR, 0.85; 95% CI, 0.76-0.96). Cancer-related factors were not associated with the K-PSI-SF score. Having children aged 6 years or older (β = 3.09; 95% CI, 0.19-5.99); being the sole primary caregiver (β = -3.43; 95% CI, -5.87 to -0.99); and reporting certain temperament (eg, novelty seeking: β = 0.58; 95% CI, 0.46-0.71), emotional problems (eg, anxious/depressed: β = 8.09; 95% CI, 3.34-12.83), and sleeping pattern (eg, bedtime resistance: β = 0.57; 95% CI, 0.15-0.99) subscale scores in their children were associated with parenting stress. Depression and parenting stress were correlated (β = 0.56; 95% CI, 0.45-0.66; P < .001). The emotional challenges encountered by children of mothers with breast cancer were not significantly different from reference values. This study found that in patients with breast cancer, child-related factors and depression were significantly associated with parenting stress, but breast cancer-related factors were not correlated. The findings suggest that mothers with breast cancer are susceptible to both depression and parenting stress and that tailored counseling and support are needed.

The mediation effect of mental resilience between stress and coping style among parents of children with cochlear implants: Cross-sectional study

PurposeThis study aimed to examine the relationship of stress, mental resilience, and coping style, and the mediation effect of mental resilience between stress and coping style among parents of children with cochlear implants. Design and methodsA cross-sectional design was used. A total of 231 parents of children with cochlear implants were recruited from May 1, 2022, to February 28, 2023 at a comprehensive tertiary hospital and a cochlear implant rehabilitation center in China. Parenting Stress Index-Short Form (PSI-SF), the Connor-Davidson Resilience Scale (CD-RISC) and the Simplified Coping Style Questionnaire(SCSQ) were used to measure stress, mental resilience, and coping style respectively. ResultsThe mean score observed for PSI-SF, CD-RISC, active coping, and passive coping was 87.85 ± 24.59, 55.63 ± 16.11, 21.36 ± 6.73, and 9.05 ± 4.52, respectively.Mental resilience was a significant mediator explaining the effect of stress on active coping (β = −0.294; 95% bias-corrected bootstrap CI: −0.358 to −0.164). ConclusionsAttention should be paid to the status of stress, mental resilience and coping style in parents of children with cochlear implants. Mental resilience mediated stress and coping style. Practice implicationsThis study provides a theoretical basis for establishing an active coping care program for parents of children with cochlear implants. There is a need to identify strategies that can help increase the level of mental resilience of parents of children with cochlear implants and more subjective and objective social support should be provided to reduce their stress and to encourage active coping style.

Early Literacy Promotion Using Automated Hovering Among Young Minority Children

ObjectiveTo determine feasibility, acceptability, and explore outcomes of behavioral economic (BE) strategies to increase parent-child shared reading within a Reach Out and Read program. MethodsWe conducted rapid-cycle interviews with 10 parents to assess text messages followed by an 8-week randomized controlled trial of 3 BE strategies at 2 urban primary care practices: daily text messages (texting); daily text messages and regret messaging (regret); or daily text messages, regret messaging, and lottery participation (lottery). Parent-child dyads were eligible if children were <24 months old, Medicaid-eligible, and had access to phones capable of receiving and sending text messages. Parents completed the Read Subscale of the StimQ and Parenting Stress Index-short form (PSI-SF) pre- and postintervention, MacArthur Communicative Development Inventory (CDI), Devereux Early Childhood Assessment (DECA), and a satisfaction measure postintervention. Differences between groups were assessed using intention-to-treat analysis. ResultsOf 45 dyads randomized, 41 (91%) completed the study. Most participants were Black with incomes <$55,000. Parents reported reading on average 4 d/wk with no change in the reading frequency over time. StimQ scores increased over time, but there were no significant differences in StimQ, PSI-SF, CDI, and DECA scores between groups. Parents in all 3 groups reported satisfaction (3.8/5.0) with the intervention. ConclusionsImplementation of BE strategies in 2 Reach Out and Read programs was feasible, near acceptable, and improved home reading environment scores. Future study should investigate BE strategies vis-à-vis usual care and be of sufficient duration and intensity to engage participants to assess its impact on patient and parent outcomes.

Siblings of children with type 1 diabetes mellitus: Psychosocial health, coping

PurposeThe literature widely reported the psychosocial toll of Type 1 diabetes mellitus (T1DM) on patients, though the family functioning of T1DM patients, particularly siblings, has traditionally obtained far less consideration. This study was framed to investigate the psychosocial adjustments of siblings of children with T1DM and to evaluate the frequencies and the perceived efficacy of coping strategies adopted by siblings. Design and methodsThis cross-sectional study included parents (n = 100) and siblings (n = 100) of children with T1DM. Parents completed the following questionnaires: Parenting Stress Index-Short Form, Pediatric Quality of Life Inventory™ Family Impact Module, and Strengths and Difficulties Questionnaire (SDQ), while siblings completed SDQ self-report and kidcope questionnaires. ResultsThirty-eight percent of siblings of children with T1DM reported significant emotional and behavioral problems related to HbA1c level, higher parenting stress, and worse family functioning (p < 0.05). Younger siblings considered social support and distraction the most effective coping strategies, while older siblings perceived adaptive coping as the most effective. Social support and problem-solving were found to be protective factors for better sibling adjustments; meanwhile, better family adjustments were related to social support and cognitive restructuring (p < 0.05). ConclusionsResults demonstrate that siblings of children with T1DM experienced psychosocial maladjustment. Sibling adjustments are family interrelated. Adaptive coping strategies may play a buffer role for siblings and family adjustment. Practice implicationsThe study highlights the need for comprehensive evaluations of family dynamics and sibling psychosocial functioning to provide appropriate family-centered care.

Parental Stress in a Pediatric Ophthalmology Population.

To determine the rate of parental stress within a pediatric ophthalmology population, parents in an urban or suburban community pediatric ophthalmology clinic were administered the Parental Stress Index Short Form survey. Demographic information and parental depression or anxiety data were collected and analyzed using an independent sample t-test and chi-squared analysis. Stress measures were recorded as percentiles. One hundred and twenty-one surveys revealed the following mean percentiles: Total Stress, 45.9 ± 22.4; Parental Distress (PD), 49.7 ± 19.8; and Parent Child Dysfunctional Interaction (P-CDI), 45.1 ± 23.6. The PD percentiles of the non-married parents, those with positive parental depression or anxiety scores, and those with a high school diploma or less were 55.9 ± 18.5 versus 45.2 ± 19.6, p < 0.01; 55.2 ± 18.6 versus 46.7 ± 19.9, p < 0.05; and 56.8 ± 18.2 versus 47.0 ± 19.8, p < 0.01, respectively. The parents with a high school diploma or less in a suburban environment demonstrated higher PD/P-CDI scores versus those of an urban population. Those with median household incomes (MHI) below USD 60,000 in both the total and suburban populations showed higher PD scores. There is no significant difference in parental stress between the pediatric ophthalmology patients and the general population. The parents who are unmarried, depressed, have a high school degree or less, or an MHI below USD 60,000 experience significantly higher stress levels.

Parenting stress and health-related quality of life among parents of extremely preterm born early adolescents in England: a cross-sectional study

ObjectiveTo determine whether extremely preterm (EP) birth exerts persisting effects on parents in early adolescence.DesignCross-sectional survey conducted between March 2017 and October 2018.SettingEvaluation of a longitudinal population-based birth cohort in...

Maternal Stress: The First 14 Months Postpartum

SYNOPSIS Objective. Maternal stress is a psychological response to the demands of motherhood. A high level of maternal stress is a risk factor for maternal mental health problems, including depression and anxiety, as well as adverse infant socioemotional and cognitive outcomes. Yet, levels of maternal stress (i.e., levels of stress related to parenting) among low-risk samples are rarely studied longitudinally, particularly in the first year after birth. Design. We measured maternal stress in an ethnically diverse sample of low-risk, healthy U.S. mothers of healthy infants (N = 143) living in South Florida across six time points between 2 weeks and 14 months postpartum using the Parenting Stress Index-Short Form, capturing stress related to the mother, mother-infant interactions, and the infant. Results. Maternal distress increased as infants aged for mothers with more than one child, but not for first-time mothers whose distress levels remained low and stable across this period. Stress related to mother-infant dysfunctional interactions lessened over the first 8 months. Mothers’ stress about their infants’ difficulties decreased from 2 weeks to 6 months, and subsequently increased from 6 to 14 months. Conclusions. Our findings suggest that maternal stress is dynamic across the first year after birth. The current study adds to our understanding of typical developmental patterns in early motherhood and identifies potential domains and time points as targets for future interventions.

Child Attachment Representations and Parenting Stress in Mothers and Fathers of School-Age Children with a Diagnosis of Autism Spectrum Disorder: A Pilot Cross-Sectional Study.

Mothers and fathers of autistic children (ASD) tend to report elevated levels of parenting stress. Thus, it is critically important to understand which factors contribute to an imbalance between the perceived demands of parenting and the available psychological resources. To date, little is known about the association between child attachment representations and parenting stress. In this study, we first examined group differences in parenting stress levels based on child diagnosis and parents' gender. Second, we explored the predictive role of child diagnosis, autism severity, and child attachment representations on parenting stress. The study involved 23 school-age children with ASD (IQ > 70), 27 without ASD (7-13 years), and their mothers (n = 50) and fathers (n = 50). Data were collected from 2017 to 2020. Parents completed the Social Responsiveness Scale 2 and the Parenting Stress Index-Short Form, while the children's attachment representations were assessed using the School-age Assessment of Attachment. Parents of children with ASD reported higher stress compared with controls. No differences were found between mothers and fathers. Implicit attachment representations have been found to be associated with parenting stress only in mothers, while the severity of social impairment showed a significant effect on parenting stress in both parents. These findings revealed the potential benefit of adaptive attachment representations not only for children themselves but also for mothers and the family system, suggesting the bidirectional nature of parent-child relationships in the context of ASD. The uniqueness of maternal and paternal parenting experiences should be considered when parenting stress is addressed.

Relationship Between Gastrointestinal Symptoms in Autism Spectrum Disorder and Parent Stress, Anxiety, Depression, Quality of Life and Social Support.

Gastrointestinal (GI) symptoms are a common comorbidity in children and adolescents with autism spectrum disorder (ASD). Little is known about the impact that GI symptoms have on parental well-being. Parents of 409 children and adolescents with ASD completed the GI Symptoms Inventory, Parenting Stress Index-Short Form, World Health Organization Quality of Life Abbreviated Version, Hospital Anxiety and Depression Scale, and the Multidimensional Scale of Perceived Social Support. High levels of stress were demonstrated by parents with 40.1% receiving clinically significant scores. A relationship was found between parental stress and GI symptoms. Parental anxiety and depression were found at high levels but were not more common in parents of individuals with GI symptoms than those without. Lower levels of quality of life were found in parents of individuals with GI symptoms compared to parents of individuals without GI symptoms. Parents of children with GI symptoms were less satisfied with their personal and social relationships with others. Parents of children with GI symptoms had lower scores on a measure of perceived social support than parents of children and adolescents without GI symptoms. GI symptoms are stressful for parents and future research is needed to determine how to alleviate this stress and to improve the quality of life of parents of individuals with ASD.

Typology and correlates of parental stress among caregivers of children with DBDs in low-resourced communities in Uganda.

Disruptive Behavior Disorders (DBDs) is one of the most common mental health problems among children in Uganda and SSA. Yet, to our knowledge no research has studied parenting stress (PS) among caregivers of children with DBDs, or investigated which risk factors originate from the child, parent, and contextual environment. Using a rigorous analytical approach, we aimed to: 1) identify different types and; 2) examine factors associated with PS and how correlates differ according to the type of stress experienced among caregivers of children with DBDs in low-resourced Ugandan communities. We used data from 633 caregivers of children with DBDs from SMART-Africa Uganda study. PS, was measured using the 36-item Parenting Stress Index-Short Form (PSI-SF). To identify focal correlates related to child/parent/contextual environment, we performed variable importance screening using the Stata command -gvselect- and specified mixed/melogit multilevel modeling with random effects. Secondly, focal correlates were included in the cross-fit partialing out lasso linear/logistic regression (double machine-learning) model. Caregivers mostly experienced stress from parental distress and caring for a child with difficult behavior. As scores increased by one unit on: caregiver mental health distress, PSI-SF increased by 0.23 (95% CI = 0.15, 0.32) (reflecting higher stress levels); Child difficulties, PSI-SF increased by 0.77 (95% CI = 0.52, 1.02). Contrastingly, for every one unit increase in family cohesion scores, PSI-SF decreased by 0.54 (95% CI = -0.84, -0.23). Caregivers with college/diploma/undergraduate/graduate education had less stress than those completing primary only or never attended school [Coefficient = -8.06 (95% CI = -12.56, -3.56)]. Family financial supporters had significantly higher Parental distress than caregivers who were not [Coefficient = 2.68 (95% CI = 1.20, 4.16)]. In low-resource settings like Uganda where mental health support is limited, community-based family-focused and economic empowerment interventions that improve community support systems and address financial barriers can reduce stress levels of caregivers of children with DBDs.