Parental Problems Research Articles

Smoking as an early risk factor for problematic parenting practices

Abstract Parenting among those who use non-illicit and more common drugs such as cigarettes remains an understudied area for investigation. Secondary data analyses were performed in 2015 on a prospective study with parent and twin data available on n=3,009 individual members of female twin pairs born between July 1975 and June 1985 identified from Missouri-state birth records. Maternal smoking when the twins were 3+ years of age remained a significant predictor of offspring report of childhood sexual abuse (OR, 1.40; 95% CI, 1.02-1.92) after controlling for key covariates. Given limited public health resources, mothers who smoke during child’s preschool years may be targeted for tailored parenting intervention.

Do Mothers and Fathers Moderate the Influence of Each Other’s Self-efficacy Beliefs and Parenting Behaviors on Children’s Externalizing Behavior?

The aim of the current study was to test first the validity of the social learning model, in which children’s externalizing behavior (EB) is considered to be related to problematic parenting, and second, whether and to what extent mothers and fathers moderate the influence of each other’s parenting on children’s EB. Two models were tested with a set of longitudinal prospective data collected from 419 mothers and 419 fathers. The first model tested the relations between parental self-efficacy beliefs at 4 years of age, parenting behaviors at age 5 and child’s EB at age 6. The second model tested the moderating effect of parenting behavior displayed by one parent on the way in which the other parent’s concurrent beliefs and subsequent behaviors impact on their child’s EB. The results mainly supported the first model, in particular the bidirectional relations between parents’ controlling behavior and children’s EB. The second model did not fit the data well. The existence of a moderating role of the other parent’s behavior was only demonstrated for the relation between mothers’ or fathers’ controlling behaviors and children’s EB. Very similar results were found for mothers and fathers. The results are discussed for their research and clinical implications.

Adverse childhood experiences, poverty, and parenting stress.

Adverse childhood experiences (ACEs) are associated with physical and mental health problems in adulthood, as well as unresolved or discordant states of mind regarding attachments that have implications for problematic parenting. Currently, there are no studies on the association between ACEs and adults' subjective experiences of stress in the parenting role, where socioeconomic status (SES)−related poverty effects have been controlled for--the central question behind the current study. We examined exposure to ACEs among 118 mothers (n = 33 low SES/impoverished and n = 85 middle/high SES) and parenting distress. Participants completed an ACE questionnaire that assessed exposure to 10 adverse experiences from childhood (e.g., abuse, neglect, household dysfunction), and the Parenting Stress Index−Short Form. Parenting distress and ACEs were significantly higher in the low SES group; yet, even after controlling for SES, higher ACE scores added significant explained variance in parental distress in a linear regression model. DISCUSSION focuses on the need to administer ACE screening in prenatal and pediatric settings to identify and to offer trauma- and attachment-informed treatment, so to reduce the intergenerational transmission of risk associated with problematic parenting. (PsycINFO Database Record (c) 2016 APA, all rights reserved) Language: en

Parenting and family support within a broad child abuse prevention strategy: Child maltreatment prevention can benefit from public health strategies

By definition, child maltreatment (CM) by a family caregiver is parenting gone awry. That prevention of CM would not directly involve the strengthening of parenting is not an easily defended position. However, it is also widely accepted that broader contextual conditions and factors, including those associated with pronounced poverty, adversely affect families and parenting, and exacerbate risk for CM. Parenting-focused intervention is not the only piece needed in a prevention strategy, but it is a critical piece nonetheless. Another contextual consideration, often overlooked, is the collective modeling and contagion effect of parenting across the entire community, for better or worse. Coercive and problematic parenting practices do not arise in a vacuum, nor do pro-social ones. Interventions to improve parenting are important to CM prevention but need to be embedded in a broader public health strategy.

Parenting in the Wake of Abuse: Exploring the Mediating Role of PTSD Symptoms on the Relationship Between Parenting and Child Functioning

BackgroundChildren whose mothers report partner violence and symptoms of posttraumatic stress disorder (PTSD) are at risk for behavior dysfunctions. AimTo examine the mediating effects of maternal PTSD symptoms on the relationship of parenting behaviors to child internalizing and externalizing behavior dysfunctions. FindingsMaternal PTSD symptoms have a partial mediating effect on the relationship between inconsistent discipline and child internalizing and externalizing behaviors. Maternal PTSD symptoms have a fully mediating effect on the relationship between poor supervision and child internalizing behaviors. ConclusionsThere is a need to identify women who report partner violence and are at high risk for PTSD and intervene early to prevent problematic parenting and resulting child behavior problems.

Changing problematic parent–child interaction in child anxiety disorders: The promise of Acceptance and Commitment Therapy (ACT)

Anxiety disorders present a significant concern for children, affecting up to 20% of those under 12 years old. The importance of parenting behavior in the development and maintenance of childhood anxiety disorders has been established both theoretically and empirically. We review the literature on cognitive-behavioral parenting interventions aimed at reducing child anxiety and discuss the limitations of this approach and of the research to date. We then present Acceptance and Commitment Therapy (ACT) as a treatment model that holds promise for shifting problematic parent–child interactions, and we review the relevant theoretical and empirical literature supporting this promise.

Mealtime behavior and diabetes-specific parent functioning in young children with type 1 diabetes.

Management of meals and mealtime behavior is often challenging for parents of young children with Type 1 diabetes. Parent functioning related to diabetes care may directly affect mealtime behaviors and glycemic control. This study evaluated associations among diabetes-specific parent functioning, parent and child mealtime behaviors, and glycemic control. Parents of young children with Type 1 diabetes (n = 134) completed self-report measures assessing diabetes-specific functioning (hypoglycemia fear, diabetes self-efficacy, diabetes-related quality of life) and child and parent mealtime behaviors. Hemoglobin A1c and percentage of blood glucose values out of range (<70 mg/dL or >200 mg/dL) over a 30-day period were abstracted from medical charts as indicators of glycemic control. Structural equation modeling was utilized to evaluate predictors and related outcomes of child and parent mealtime behavior. The proposed model fit the data very well. More frequent problematic child mealtime behaviors were associated with poorer glycemic control; however, more frequent problematic parent mealtime behaviors were marginally associated with better glycemic control. Poorer diabetes-specific parent functioning was associated with more frequent problematic child and parent mealtime behaviors. Problematic child mealtime behaviors, such as disruptive behavior, present a significant risk for poorer glycemic control. Parents may engage in ineffective mealtime management strategies in an effort to meet glycemic recommendations and avoid hyperglycemia and hypoglycemia. Future research will help to determine whether parents may benefit from specific, developmentally appropriate behavioral strategies to manage meals and snacks and promote optimal diabetes management.

Children's elicitation of changes in parenting during the early childhood years

Using a subsample of the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B; n=1550), this study identified parents who engaged in more developmentally problematic parenting—in the form of low investment, above average television watching, and use of spanking—when their children were very young (M=24.41 months, SD=1.23) but changed their parenting in more positive directions over time. Latent profile analysis and other techniques revealed that parents who demonstrated less optimal parenting behaviors when their children were 2 years old were more likely to be African American, from lower socioeconomic backgrounds, and experiencing greater depressive symptoms. Approximately half of such parents, however, made positive changes in their parenting practices, with 5% in the profile characterized by high investment and low use of spanking by the time that their children were in elementary school. These positive changes in parenting behavior were more likely to occur among parents whose children were already demonstrating early reading skills and less problem behavior. These potential “child effects”, suggesting that children elicited improvements in parenting, were more pronounced among higher income families but did not vary according to parents’ educational attainment. Findings from this study have implications for intervention programs, suggesting that children's academic and behavioral skills can be leveraged as one means of facilitating positive parenting.

Parental experiential avoidance as a potential mechanism of change in a parenting intervention for parents of children with pediatric acquired brain injury.

To consider the relationship of parental experiential avoidance (EA) to psychological symptoms and problematic parenting strategies after pediatric acquired brain injury (ABI). Using available data from a randomized controlled trial of a group-based Acceptance and Commitment Therapy (ACT) workshop plus a behavioral family intervention (BFI) for parents of children with ABI (n = 59), correlational and mediational analyses were conducted to consider the role of parental EA as a process of change for parent outcomes. Parent EA positively correlated with ineffective parenting behaviors and levels of psychological distress, both cross-sectionally and longitudinally. Reductions in EA mediated the treatment effect on reducing ineffective parenting behaviors and parent distress, but issues of temporality were present. EA is related to parent outcomes following pediatric ABI. A larger and methodologically rigorous study is called for to further elucidate this finding and specifically determine the benefits of targeting EA with interventions such as ACT, in conjunction with evidence-based BFIs.

Bias in child maltreatment self-reports using interactive voice response (IVR)

Few methods estimate the prevalence of child maltreatment in the general population due to concerns about socially desirable responding and mandated reporting laws. Innovative methods, such as interactive voice response (IVR), may obtain better estimates that address these concerns. This study examined the utility of interactive voice response (IVR) for child maltreatment behaviors by assessing differences between respondents who completed and did not complete a survey using IVR technology. A mixed-mode telephone survey was conducted in English and Spanish in 50 cities in California during 2009. Caregivers (n=3,023) self-reported abusive and neglectful parenting behaviors for a focal child under the age of 13 using computer-assisted telephone interviewing and IVR. We used hierarchical generalized linear models to compare survey completion by caregivers nested within cities for the full sample and age-specific ranges. For demographic characteristics, caregivers born in the United States were more likely to complete the survey when controlling for covariates. Parenting stress, provision of physical needs, and provision of supervisory needs were not associated with survey completion in the full multivariate model. For caregivers of children 0–4 years (n=838), those reporting they could often or always hear their child from another room had a higher likelihood of survey completion. The findings suggest IVR could prove to be useful for future surveys that aim to estimate abusive and/or neglectful parenting behaviors given the limited bias observed for demographic characteristics and problematic parenting behaviors. Further research should expand upon its utility to advance estimation rates.

Perspectives on Joint Custody Presumptions as Applied to Domestic Violence Cases

Despite the trend toward statutory presumptions in favor of joint legal and physical custody, practitioners increasingly recognize that domestic violence has serious implications for the efficacy and safety of parenting and shared care. This article explores the implications of domestic violence for shared parenting and for the statutory legal and physical custody presumptions and exceptions which are triggered by or are applicable to domestic violence. This article proposes that a better framework for addressing intimate partner violence–related custody cases is one that guides practitioners toward fact‐based determinations of the implications of the violence for parenting and co‐parenting in individual cases.Key Points for the Family Court Community:Parents who are coercive controlling abusers frequently exhibit the types of problematic parenting behaviors which make shared parenting unrealistic.Instead of applying blanket joint custody presumptions, all family court practitioners, including judges, should: (1) be alert to signs that domestic violence may be an issue; (2) understand the nature and context of any abuse; (3) determine the implications, if any, of the abuse for parenting and co‐parenting; and (4) account for the violence and its implications in their handling of cases.Exceptions for domestic violence cases fail to prevent the inappropriate application of joint custody presumptions to many families for whom domestic violence is a significant issue because: (1) abuse is often not detected by the system, (2) victims have problems proving that the abuse occurred, and (3) many practitioners are disinclined to believe that the abuse occurred.

Retention in a Parenting Intervention Among Parents Involved with the Child Welfare System

Although parenting interventions are among the most commonly required case plan activities for parents involved with child welfare system, a large percentage of families who begin parenting interventions drop out prematurely. The purpose of this concurrent mixed-methods study was to better understand risk factors associated with retention in a 10 week evidence-based parenting intervention. Qualitative interviews and standardized measures were completed with 31 parents who were court ordered to participate in a parenting intervention due to child welfare system involvement. We compared and contrasted patterns across completion and non-completion groups. Results indicated specific similarities and differences in anticipated gains, motivation, and social support among parents who completed the intervention compared to those who did not. Additionally, parents who did not complete the intervention tended to have higher problematic parenting scores and levels of parenting stress, and the least amounts of social support compared to those who successfully completed the intervention. Patterns among three typologies highlighted important differences across groups. Results indicated that in order to promote successful engagement and retention in parenting interventions among parents involved with the child welfare system it may be important to screen for cumulative risks during the early stages of the intervention and to augment services to better meet the needs of this at-risk population.

Pilot Study Results for a Novel Behavior Plus Nutrition Intervention for Caregivers of Young Children With Type 1 Diabetes

To present results for a parent-based educational intervention targeting mealtime behaviors plus nutrition among families of young children (mean age, 5.0 ± 1.2 years) with type 1 diabetes mellitus (T1DM). The researchers recruited 9 caregivers who participated in the 6-session intervention and completed baseline and posttreatment assessments, which included dietary intake, acceptability of diet changes, mealtime behavior, and mean blood glucose values. Children's mean daily blood glucose levels decreased from 185 ± 46 mg/dL to 159 ± 40 mg/dL (P < .001). There were also decreases in problematic parent and child mealtime behaviors. There was no change in children's dietary intake indicators that could be detected. It appears promising that this targeted behavior plus nutrition intervention can improve glycemic control and behavior for young children with type 1 diabetes mellitus. Larger, randomized controlled trials will clarify significant results, limitations, and sustainability. Techniques within the program may have application to current practice.

Parents' depressive symptoms and children's adjustment over time are mediated by parenting, but differentially for fathers and mothers

Parenting has been found to act as a mediator of the relation between parents' depressive symptoms and children's adjustment. The present study replicated this result, and also found specific effects of gender for both parents and children. A total of 319 parents provided reports of their depressive symptoms (BDI) and two parenting styles (APQ; inconsistent discipline and positive parenting) as well as of their elementary schoolchildren's adjustment (VBV-EL; oppositional-defiant behaviour, hyperactivity, internalizing, social-emotional competence). The first and second measurement occasions were six months apart. Bivariate correlations showed the expected pattern of positive associations between parental depression, child maladjustment and problematic parenting. However, the results differed for mothers and fathers, and the mediation was moderated by the children's gender. Inconsistent discipline was a mediator for both fathers and mothers. The path from fathers' depression was additionally negatively mediated by positive parenting. Boys were more vulnerable than girls.

Adverse Childhood Experiences (ACEs) Questionnaire and Adult Attachment Interview (AAI): Implications for parent child relationships

Although Adverse Childhood Experiences (ACEs) are linked to increased health problems and risk behaviors in adulthood, there are no studies on the association between ACEs and adults’ states of mind regarding their early childhood attachments, loss, and trauma experiences. To validate the ACEs questions, we analyzed the association between ACEs and emotional support indicators and Adult Attachment Interview (AAI) classifications in terms of unresolved mourning regarding past loss or trauma and discordant states of mind in cannot classify (U/CC) interviews. Seventy-five urban women (41 clinical and 34 community) completed a questionnaire on ACEs, which included 10 categories of abuse, neglect, and household dysfunction, in addition to emotional support. Internal psychological processes or states of mind concerning attachment were assessed using the AAI. ACE responses were internally consistent (Cronbach's α=.88). In the clinical sample, 84% reported≥4 ACEs compared to 27% among the community sample. AAIs judged U/CC occurred in 76% of the clinical sample compared to 9% in the community sample. When ACEs were≥4, 65% of AAIs were classified U/CC. Absence of emotional support in the ACEs questionnaire was associated with 72% of AAIs being classified U/CC. As the number of ACEs and the lack of emotional support increases so too does the probability of AAIs being classified as U/CC. Findings provide rationale for including ACEs questions in pediatric screening protocols to identify and offer treatment reducing the intergenerational transmission of risk associated with problematic parenting.

The Triple Aim: A Golden Opportunity for Geriatrics

The Triple Aim: A Golden Opportunity for Geriatrics

The influence of parental monitoring and parent–adolescent communication on Bahamian adolescent risk involvement: A three-year longitudinal examination

The literature suggests that parental monitoring can best be conceptualized and measured through the domains of parental knowledge, youth disclosure, parental solicitation, and parental control. Using longitudinal data on 913 grade-six Bahamian students followed over a period of three years, we examined the unique and independent roles of these domains of parental monitoring and parent–adolescent communication in relation to adolescent involvement in delinquency, substance use, and sexual risk behaviors. The results obtained with mixed-effects models indicate that parental knowledge, youth disclosure, and parental control are negatively associated with both delinquency and substance use. Open parent–adolescent communication was associated with decreased sexual risk behavior, whereas problematic parent–adolescent communication was associated with increased sexual risk behavior. The results obtained with path models indicate that youth disclosure is a significant longitudinal predictor of reduced adolescent delinquency and that parental control during early adolescence predicted reduced substance use in middle adolescence. The findings suggest that parental knowledge, youth disclosure and parental control differ in their impacts on substance use, delinquency and sexual risk behaviors. Problematic parent–adolescent communication is consistently associated with increases in all three types of adolescent risk behaviors. Future parental monitoring interventions should focus on enhancing parents' interpersonal communication skills and emphasize the differences in and importance of the unique components of parental monitoring.

The link between personality disorder and parenting behaviors: A systematic review

Abstract Objective To systematically review the literature on the link between personality disorder and parenting capacity from an attachment theory perspective. Method Four electronic databases were searched systematically. Those studies that met the pre-defined inclusion criteria were quality assessed. Data was then extracted and synthesized from the included studies using a qualitative approach. Results Fifteen thousand and sixty one hits were found. A further 22 studies were identified through expert contact, and two from references lists. Two thousand eight hundred and eighty five duplicates were removed and a further 11,926 irrelevant studies were excluded. Of the remaining 250 articles, 229 did not meet the inclusion criteria and were therefore removed and two articles were unobtainable. A further 19 studies were removed following quality assessment, leaving a total of 11 studies to be reviewed. The majority of the findings supported the association between a diagnosis of personality disorder, poor parent–child interactions and problematic parenting practices. Conclusions Parental personality disorder was identified as a risk factor for impaired parenting behaviors and disturbed parent–infant. More rigorous research is required in relation to how co-morbidity and personality disorder alone influence the broad dimensions of parenting capacity for both mothers and fathers.

Poverty-related Stress and Developmental Behaviour among Low Socio-economic Groups: A Review

As we are aware low socio-economic status (SES) and consequence poverty is a major social problem of any developing society. Sometimes the state's major revenue only goes to different welfare programmes to uplift the poor section of the society. Poverty-related stress causes certain mental issues like depression, aggression, and delinquency and frustration irrespective of age and gender, which may lead people to commit crimes and sometimes even suicide. Experts feel that anxiety, depression, adjustment problem, trauma, aggression, attention difficulties are some types of poverty-related psycho-pathological problems among the poor people. Poverty-related stress not only affects children and young adults, but it also creates stress on aged people in the family including marital conflict, problematic parenting, social crimes, weak child rating, etc in families. Consequently it affects the developmental behaviour of low SES people and poses the question on why the poor people have been socially excluded always. This article provides a social platform to conduct debates on the causes of poverty-related psychological issues on community and this article is based on the author's field work experiences in the low profile areas of Bangalore city- India

Children of Mentally Ill Parents Participating in Preventive Support Groups: Parental Diagnoses and Child Risk

In the Netherlands, preventive support groups are offered to children of mentally ill parents. Given the variety of parental diagnoses it might be questionable if offering a standardized program for all these children is the most effective response. While no overall knowledge exists about the type of parental disorder and varying risk levels and support needs among the participating children, we examined whether there are differences between these children that are related to their parents’ diagnoses. With questionnaires we assessed risk factors in 122 mentally ill parents and their children: high parental illness severity, low perceived parental competence, parent–child interaction problems, poor family functioning, difficult child temperament, and low child competence. We also assessed the children’s psychosocial problems and negative cognitions about their parent’s illness. Results showed that most parents had co-morbidity (multiple diagnoses) and/or personality disorders. Children of parents with either of these conditions were more likely to be exposed to the risk factors: high parental illness severity, low perceived parental competence, problematic parent–child interaction, and low perceived child competence, compared to children of parents without these conditions. They were also faced with more risk factors and had more psychosocial problems and negative cognitions. From these results we may conclude that children of parents with co-morbidity and/or personality disorders require more extensive support than children of parents without these conditions. We suggest strengthening the children’s competence and involving parents as important focuses of preventive interventions for children at high risk. Longitudinal studies should test these assumptions.