Perceived Child Vulnerability Research Articles

Parental Perceptions of Child Vulnerability and Parent Stress as Predictors of Pain and Adjustment in Children With Chronic Arthritis

Parental predictors of child psychological adjustment and pain were investigated in 51 children with arthritis. Children rated depressive symptoms, anxiety, and pain. Disease severity was determined by a physician provided active joint count, as well as a physician's global assessment. Parents rated their own depressive symptoms, stress, and perceptions of child vulnerability. Regression analyses indicated that higher parental perceptions of child vulnerability predicted increased child depressive symptoms and anxiety. Parent stress predicted both child anxiety and pain. Thus, the important role parent variables play in child health outcomes was reinforced, thereby strengthening the indication to assess parent functioning when performing clinical evaluations of adjustment to juvenile arthritis.

Parental Overprotection, Perceived Child Vulnerability, and Parenting Stress: A Cross-Illness Comparison

The current study sought to investigate differences in parenting capacity variables across four disease groups. Parents (N = 425), the majority of whom were mothers, of children with either cancer, asthma, Type 1 diabetes, or cystic fibrosis, completed measures of parental overprotection, perceived child vulnerability, and parenting stress. After controlling for significant demographic variables, parents of children with cystic fibrosis and asthma reported higher perceived child vulnerability than parents of children with either diabetes or cancer, while parents of children with asthma and diabetes reported higher parenting stress than parents of children with cancer or cystic fibrosis. No differences between disease groups were found for parental overprotection. The current study provides support for an illness-specific approach to understanding parenting capacity variables in the context of childhood chronic illnesses.

Are former late-preterm children at risk for child vulnerability and overprotection?

BackgroundParent perception of child vulnerability (PPCV) and parent overprotection (POP) are believed to have serious implications for age appropriate cognitive and psychosocial development in very low birth weight preterm children. AimWith recent concerns about suboptimal developmental outcomes in late-preterm children, this study was aimed at examining the relationship between history of late-preterm birth (34-36 6/7weeks gestation), and PPCV, POP, and healthcare utilization (HCU). Study designThis was a cross-sectional observational design. ParticipantsStudy participants were mothers of 54 healthy singleton children recruited from community centers including Women and Children Clinics (WIC), primary care clinics and daycare centers in the upper Midwest region. Outcome measuresOutcome measures included Forsyth Child Vulnerability Scale (CVS), Thomasgard Parent Protection Scale (PPS) scores, and healthcare utilization (HCU). Potential covariates included history of life-threatening illness, child and maternal demographics, and maternal stress and depression using the Center for Epidemiologic Studies Depression Scale (CESD). ResultsHCU (p=0.02) and the PPS subscales of supervision (p=0.003) and separation (p=0.03) were significant predictors of PPCV in mothers of 3–8years old children with late-preterm history. Age of the child (p=0.008) and CVS scores (p=0.005) were significant predictors of POP. Maternal age (p=0.04), stress (p=0.04), and CVS scores (p=0.003) were significant predictors of HCU. Dependence, a subscale of the PPS, correlated with the child's age and gender even after controlling for age. ConclusionHistory of late-preterm did not predict MPCV, MOP, or HCU in healthy children. Future research is needed in larger more diverse samples to better understand causal relationships and develop strategies to lessen risks of MPCV and MOP.

The relationship between parental overprotection and health-related quality of life in pediatric cancer: the mediating role of perceived child vulnerability

The current study sought to examine the relation of parental overprotection and perceived child vulnerability to parent-reported health-related quality of life in parents of children with cancer. Parents (N = 89) of children who had been diagnosed with cancer completed measures of parental overprotection, perceived child vulnerability, and parent-proxy report of health-related quality of life. After controlling for theoretically relevant covariates, parental overprotection and perceived child vulnerability were both found to be significantly related to child health-related quality of life. Additional analyses revealed that perceived child vulnerability mediated the relationship between overprotective parenting behaviors and the child's health-related quality of life. The findings highlight the need to assess for these discrete parenting variables in parents of children with cancer and to develop interventions to target parental perceptions of vulnerability.

Parental stress and perceived vulnerability at 5 and 10 years after pediatric SCT

With the aim of assessing parental stress after SCT, 73 parents of children and adolescents who underwent SCT 5 or 10 years ago responded to questionnaires on general distress (General Health Questionnaire (GHQ)), disease-related stress (Pediatric Inventory for Parents-short form (PIP-SF)) and perceptions of child vulnerability (Child Vulnerability Scale (CVS)). General distress scores were comparable with the reference groups, but 40% of the mothers at 5 years after SCT reported increased stress levels as compared with 26% in the community-based reference group. Disease-related stress was comparable with the reference group of parents of children who were just off cancer treatment, 5 years after SCT. At 10 years after SCT, scores were lower than the reference group. Perceived child vulnerability did diminish over time, but remained high in parents of SCT survivors, compared with parents of healthy children: 96% of the parents at 5 years after SCT and 76% of the parents at 10 years after SCT scored above the cutoff point. Perceived vulnerability was found to be a predictor for parental disease-related stress. To conclude, although most parents of SCT survivors are resilient, the majority of parents perceive their child to be much more vulnerable as compared with parents of healthy children. This perception is associated with disease-related stress and may induce overprotective parenting.

The Relation Between Parental Psychological Distress and Adolescent Anxiety in Youths With Chronic Illnesses: The Mediating Effect of Perceived Child Vulnerability

The purpose of this study was to examine the relation of perceived child vulnerability (PCV) and parental psychological distress (PPD) to adolescent anxiety (AANX) in youths with chronic illnesses. Ninety-one (n = 91) adolescents diagnosed with either type 1 diabetes mellitus (DM1) or asthma and their parents were recruited as part of a larger study examining parent and child adjustment to chronic illness. Adolescents completed a measure of anxiety, and parents completed measures of PCV and PPD. After controlling for multiple demographic and illness parameters, both PPD and PCV significantly predicted AANX. Further analysis indicated that the relation between PPD and AANX was mediated by PCV. These findings suggest that parent-reported psychological distress is associated with adolescent-reported anxiety. Notably, PCV appears to be a possible mechanism by which PPD influences anxiety in adolescents with chronic illnesses. Clinical relevance, study limitations, directions for future research, and implications for practice are discussed.

The relationship of parent self-focused negative attributions to ratings of parental overprotection, perceived child vulnerability, and parenting stress.

The present study describes an examination of the relationship of parent self-focused negative attributions to specific parenting variables, namely parental overprotection, perceived child vulnerability, and parenting stress. Parents of children diagnosed with one of three chronic illnesses, Type 1 diabetes (DM1), asthma (AS), or cystic fibrosis (CF), completed self-report measures of attributions for illness-unrelated events, parental overprotection, perceived child vulnerability, and parenting stress. Results indicated that parent self-focused negative attributions were significantly associated with parenting stress among the combined and DM1-only samples. In addition, parent self-focused negative attributions were associated with perceived child vulnerability among the CF-only group, whereas selffocused negative attributions were not associated with any of the parenting variables within the AS-only group. The current results suggest that parent self-focused negative attributions may exert illness-specific influences on other cognitive processes (e.g., perceptions of child vulnerability, perceptions of stress), which have the potential to influence child adjustment outcomes.

The relationship of parental overprotection, perceived vulnerability, and parenting stress to behavioral, emotional, and social adjustment in children with cancer

To examine the relationship of self-reported parental overprotection, perceived child vulnerability, and parenting stress to parent-reported behavioral, emotional, and social adjustment of children currently on treatment for cancer. Parents of 62 children (34 boys, 28 girls) currently on treatment for cancer were recruited from an outpatient pediatric cancer clinic. Children ranged in age from 2 to 12 years; age at diagnosis ranged from 1.33 to 11.83 years. Higher levels of parenting stress, but not parental overprotection or perceived child vulnerability, were associated with poorer behavioral and social adjustment. Higher levels of perceived child vulnerability and parenting stress, but not parental overprotection, were independently associated with poorer emotional adjustment. Specific parenting variables appear to be related to specific adjustment outcomes in children with cancer. Longitudinal follow-up of these children is necessary to determine the developmental trajectory of parent variables and long-term child outcomes.

The Relationship of Parental Overprotection, Perceived Child Vulnerability, and Parenting Stress to Uncertainty in Youth with Chronic Illness

To examine the relationship of parent-reported overprotection (OP), perceived child vulnerability (PCV), and parenting stress (PS) to youth-reported illness uncertainty, and to explore potential developmental differences. Eighty-two children and 82 adolescents (n = 164) diagnosed with Type 1 diabetes mellitus (DM1) or asthma, completed a measure of illness uncertainty, while their parents completed measures of OP, PCV, and PS. After controlling for demographic and illness parameters, both PCV and PS significantly predicted youth illness uncertainty in the combined sample. Within the child group, only PS significantly predicted illness uncertainty, whereas only PCV significantly predicted uncertainty for adolescents. Specific parenting variables are associated with youth-reported illness uncertainty; however, their relationship varies according to developmental level. Although OP has been identified as a predictor of child psychological outcomes in other studies, it does not appear to be associated with illness uncertainty in youth with DM1 or asthma.

An Examination of Parenting Variables and Child Self-Care Behavior Across Disease Groups

The present study examined the relationship of three parent-related variables, namely, perceived child vulnerability, parental overprotection, and parenting stress to child self-care behaviors among 200 children with Type 1 diabetes, asthma, or cystic fibrosis. A related goal of the study was to examine for illness- and age-related differences among the same variables of interest. Results indicated that higher levels of parenting stress were associated with lower parent ratings of their child’s self-care behaviors. Additional analyses of individual illness groups demonstrated that age was significantly related to both child and parent ratings of self-care only for the diabetes group, with older children engaging in lower levels of self-care. Such results support continued investigation of parent behaviors and beliefs as they relate to child self-care outcomes at different ages in pediatric chronic illness populations.

The Effect of Caregiver Perceptions of Child Vulnerability on Functioning and Health Care Utilization in Children With Chronic Pain Syndromes

The Effect of Caregiver Perceptions of Child Vulnerability on Functioning and Health Care Utilization in Children With Chronic Pain Syndromes

The Relationship of Parental Overprotection and Perceived Child Vulnerability to Depressive Symptomotology in Children With Type 1 Diabetes Mellitus: The Moderating Influence of Parenting Stress

Our study examined the relationship between parental overprotection and perceived child vulnerability to self-reported depressive symptoms in 8- to 12-year-old children diagnosed with type 1 Diabetes Mellitus. The moderating influence of parenting stress was also examined. Mothers (N = 43) completed measures of parental overprotection, perceived child vulnerability, and parenting stress, and the children completed a measure of child depression. Findings revealed that both child vulnerability and parenting stress were associated with higher levels of depressive symptoms; no relationship was found between overprotection and child depressive symptoms. Regression results further indicated that parenting stress moderated the relationship between perceived child vulnerability and depressive symptomotology. Thus, parenting stress appears to magnify the relationship between perceived child vulnerability and child-reported depressive symptoms. Our findings lend additional empirical support for the transactional relationship between discrete parenting variables and child distress. These results also support the view that overprotection and child vulnerability are distinct but overlapping constructs. Interventions that target specific parenting approaches and general parenting stress may be effective in ameliorating child distress.

An Evaluation of an Integrated Health Care Program for Children With Special Needs

This study was designed to evaluate a program integrating physical and mental health services for children with special health care needs. Clinical outcomes were assessed by comparing families in integrated clinics (N = 80) with families in traditional clinics (N = 36). Parents and children ages 8 to 16 completed a series of questionnaires to assess differences in child behavior and coping, parents' perceptions of child vulnerability, and parent well-being and coping. Demographic variables and child's health status were also assessed with questionnaires and controlled for in subsequent analyses. There were no differences between groups on demographic variables or health status, though children in the integrated clinics had been diagnosed at an earlier age. Parents in the integrated program reported significantly fewer behavioral symptoms than parents in the nonintegrated clinics. Significantly fewer children from integrated clinics were in the clinical range for poor school functioning compared to children in nonintegrated clinics. No differences emerged in coping or parent well-being. Results provide preliminary support for integrating health and mental health care services for children with special needs. Suggestions for improving future evaluation efforts and clinical practice are discussed.

Caretaker perception of child vulnerability predicts behavior problems in NICU graduates.

This study explores parental perception of child vulnerability (PPCV) and parent overprotection (POP) and their relationship to neonatal medical problems, child development and behavior. Participants included 90 lower income parents of NICU graduates ages 22-81 months consecutively enrolled at a high-risk neonatal developmental follow-up clinic. Parents completed the Child Vulnerability Scale (CVS), the Parent Protection Scale (PPS) and the Child Behavior Checklist (CBCL) regarding their children. Step-wise regression analysis revealed the CVS as the sole predictor of child behavior, accounting for 13% of the variance in the CBCL Total T-score (R(2) =.13, $be =.86, p <.006). Neonatal medical problems, Child DQ, and most parental demographic variables did not correlate with CVS or PPS scores. A significant correlation between CVS and the separation subscale of the PPS was noted (r =.31, p <.01). We conclude that NICU graduates perceived vulnerable by their caretakers have significant behavioral difficulties compared to those perceived as not vulnerable. Future research should address early parental antecedents of PPCV, the persistence of PPCV, and its effects on behavioral outcomes.

Parent-child relationship disorders: what do the Child Vulnerability Scale and the Parent Protection Scale measure?

While scales exist to aid clinicians in the assessment of parent-child relationship disorders, there are minimal data regarding their clinical usefulness. This study examined the ability of parent responses to questions regarding the child's health, behavior, and development to predict total scores on the Child Vulnerability Scale and the Parent Protection Scale. Of 120 potential participants, 103 parents (92% mothers, 69% white, 54% married, 44% lower socioeconomic status) with children aged 2-5 years completed the Child Health and Family Functioning Questionnaire. Logistic regression yielded a correct prediction rate of 77% for perceived child vulnerability and 76% for parental overprotection. Our data provide support for the independence of parental perceptions of increased child vulnerability and parental overprotection as well as for the content validity of the Child Vulnerability Scale and the Parent Protection Scale.

Parental perceptions of child vulnerability, overprotection, and parental psychological characteristics.

While a parental perception of child vulnerability to illness/injury is often used interchangeably with parental overprotection, research suggests that these constructs are independent. Distinct parental psychological characteristics were hypothesized for each construct. The parents of 871 children, ages 22-72 months, completed a four-part protocol (clinical background data, Child Vulnerability Scale, Parent Protection Scale, and Brief Symptom Inventory). A distinct parent symptom profile was found for perceived child vulnerability (somatization, obsessive-compulsiveness, and anxiety). Overprotection was associated with phobic anxiety, psychoticism, and paranoid ideation. These findings provide further support for the differentiation of these constructs.

Parental overprotection and its relation to perceived child vulnerability.

A study of 280 parents with a child age 5-10 years examined the relation between and correlates of parental overprotection (less education, younger child age, being an only child) and parental perception of increased child vulnerability (history of life-threatening illness, child medical condition, first child). One-third of parents who considered their child vulnerable were also considered overprotective.

Parent-Child Relationship Disorders. Part II. The Vulnerable Child Syndrome and its Relation to Parental Overprotection

Parents who are excessively concerned about their child's health are often characterized as being overprotective. We hypothesized that parental overprotection is independent of parental perception of child vulnerability to illness or injury despite their presumed interchangeability. A community-based sample of 892 parents (92% white, 84% married, 88% middle-upper socioeconomic status, 90% mothers) completed a three-part protocol (clinical background data, the Child Vulnerability Scale, and the Parent Protection Scale). Correlates of high parental perception of child vulnerability included a medical condition in the child, a history of life-threatening illness or injury, and the child being seen for a sick visit. Correlates of high parental overprotection included younger age of child and parent. Only 20% of those parents who considered their child vulnerable were also considered overprotective.

The Vulnerable Child Syndrome Revisited

Dimensions of the vulnerable child syndrome are clarified in a critical review of the research and clinical literature. The central construct of the vulnerable child syndrome, an increased parental perception of child vulnerability to illness or injury, is examined in the context of separation and loss. Measures of perceived child vulnerability are reviewed. A new conceptual model of parental perception of child vulnerability is presented that takes into account child, parent, parent-child, parent-clinician, and family factors. Directions for future research are suggested.