Parental Stress Research Articles

Enhancing foster care relationships through attachment-based intervention: the safe families study protocol, a randomized controlled trial of the circle of security parenting program®

BackgroundChildren in out-of-home care constitute a vulnerable population often experiencing mental health challenges related to early adversity and placement disruptions. The Circle of Security Parenting program® (COS-P) is an attachment-based intervention designed to enhance carer sensitivity and reflective competence, ultimately improving the quality of carer-child relationships.MethodsThis study protocol follows a mixed-methods randomized controlled trial evaluating the effectiveness of the COS-P program for foster carers in France. A total of 70 foster carers will be randomly assigned to either the intervention group (receiving COS-P in addition to Treatment as Usual) or the waitlist control group (receiving Treatment as Usual only). Quantitative measures, including the Caregiving Composite Questionnaire, Parenting Stress Index, and the Marschak Interaction Method, will be administered at baseline and at follow-up). Qualitative data will be collected through focus groups with foster carers and COS-P facilitators, and through self-confrontation interviews with a subset of foster carers.DiscussionThis study is the first to evaluate the COS-P program for foster carers in France. Findings will provide valuable insights into the program’s effectiveness in improving carer-child relationships and foster carer well-being, ultimately contributing to better outcomes for children in out-of-home care. The study will also explore potential moderators of treatment outcome, and shed light on the subjective experiences of participants.Trial registrationThis trial is registered on ClinicalTrials.gov : NCT06701877.

Using the effort-reward imbalance (ERI) model to predict parental burnout.

Parental burnout is a multifaceted syndrome resulting from excessive stress in the parenting role. Despite experiencing similar parenting stressors, not all parents experience burnout. Could the difference in rewards contribute to explaining this seeming paradox? This longitudinal study (N = 1,301) explored the relevance of the effort-reward imbalance (ERI) model as an alternative etiological theory of parental burnout. The findings substantiate most of the hypotheses derived from the ERI model: higher levels of effort, overcommitment, and ERI were positively associated with parental burnout, and higher rewards were linked to lower levels of burnout. Overcommitment moderated the relation between ERI and parental burnout, but surprisingly, this association was stronger under conditions of low overcommitment compared to high overcommitment. These findings suggest that interventions aimed at reducing effort and/or enhancing rewards could potentially mitigate parental burnout. Further research is required to elucidate the role of overcommitment in parenting. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Family matters: social support, parental stress, and psychological symptoms

Purpose Social support has been suggested to reduce psychological symptomatology, especially when facing stressful events. However, less is known about the underlying mechanisms through each social support from different sources may interact with parental stress in protecting parents’ symptomatology. Design/methodology/approach A cross-sectional study was conducted online using the Depression, Anxiety, and Stress Scale, the Parental Stress Scale and the Multidimensional Scale of Perceived Social Support with 108 Portuguese parents of children attending Grades 1–9. Using a path analysis approach, we explored a mediating model with perceived social support as a factor that could reduce stress, anxiety, and depression directly, and indirectly by lessening perceived parental stress. Findings Social support, particularly from family, was the only significant predictor of lower levels of stress and depression. Alternatively, social support from family had only an indirect effect on anxiety connected with parental stress, particularly in the areas of fear and anguish. Originality/value These findings provide a comprehensive understanding of the relationship between perceived social support, parental stress, and psychological symptomatology. They can also be used to develop relevant psychological intervention actions and to reinforce ways of strengthening social support—particularly from family—to make it continuously available to parents managing stressful situations.

Does perceived social cohesion moderate the effect of parental stressors on depressive symptoms? A longitudinal, multi-level analysis before and during the COVID-19 pandemic

Background Perceived social cohesion (PSC) is a protective factor for mental health. Yet, evidence on social mechanisms influencing mental health is scarce. Aims We examined the moderating role of PSC between parental stressors and depressive symptoms before and during the COVID-19 pandemic. Methods We performed a multilevel moderated linear regression analysis using German Socio-Economic Panel (G-SOEP) data to investigate the interaction of PSC in 2018 and in 2020 with parental stressors (having pre-school-aged child(-ren), concerns about COVID-19 infection, financial insecurity, working from home, changes at work) and depressive symptoms (PHQ-4) in 2020 and 2021. Results 3,112 observations from 1,621 participants were included in the regression analyses. The parental stressors had mostly negative, although not always significant effects on PHQ-4. Both PSC measures positively moderated the association between experienced financial insecurity and PHQ-4. PCS 2020 positively moderated the association between the stressors “not working from home” and “being unemployed in 2020 or 2021” compared to “having no changes at work” for those employed. It negatively moderated the association between “having some concerns about infection” and PHQ-4. Conclusions PSC can act as a buffer for parental mental health. Social cohesion should be promoted in public health interventions, especially during pandemics or disasters.

Emotional Reactivity and Behavioral Problems in Preschoolers: The Interplay of Parental Stress, Media-Related Coping, and Child Screen Time

Background/Objectives: Excessive screen time has been linked to poorer developmental outcomes in preschool years, with the impact depending on context. Parents of emotionally reactive children, in particular, may use screens to manage their child’s emotions, especially when experiencing distress themselves. This reliance on screens can hinder the development of self-regulation, leading to behavioral difficulties. Our study aimed to explore how emotional reactivity, parental distress, screen time, and media-related coping interact while contributing to externalizing (behavioral) problems in preschool-aged children. Methods: The study included 754 children (49.1% girls), aged 2–5 years (M = 44.6 months, SD = 13.7). Parents reported children’s emotional reactivity and externalizing problems using the Child Behavior Checklist and provided data on daily screen time and media-related coping behaviors. Bivariate correlations, group comparisons, and structural equation modeling were employed to analyze the data. Results: Children averaged 111.86 min of daily screen time (SD = 83.94), with 35.2% of parents using screens as a coping strategy. Emotional reactivity was the strongest predictor of externalizing problems, while the role of screen time was weak, yet significant. Parental distress was positively associated with child emotional reactivity and screen time. Structural equation modeling showed that child emotional reactivity related to behavioral problems both directly and indirectly via parental distress, media-related coping, and increased screen time. Conclusions: The findings highlight emotional reactivity as a key factor in child behavioral problems, emphasizing the cumulative risks posed by parental distress and screen use. The results suggest interventions promoting healthier screen habits and supporting parental well-being.

Associations Between Child and Parent Characteristics and Parenting Stress in Japanese Mothers of Children With Attention Deficit Hyperactivity Disorder (ADHD).

Parents of children with attention deficit hyperactivity disorder (ADHD) experience elevated levels of stress in their parenting role. Understanding what contributes to such stress is important for its management. We assessed associations between child and parent characteristics and parenting stress in Japanese mothers of 6-12-year-old children with ADHD recruited through the community (n = 51) and hospital child psychiatry/pediatric clinics (n = 124). Hierarchical multiple regression analyses assessed the extent to which child symptom severity (ADHD and ODD), parenting efficacy, depression, and maternal ADHD symptoms explained variance in both child-domain and parent-domain parenting stress. Child symptom severity and maternal depression accounted for significant variance in child-domain parenting stress. Child ODD, parenting efficacy, depression, and maternal ADHD (clinic sample) explained significant variance in parent-domain parenting stress. Exploratory cross-sectional mediational analyses highlight the inter-relatedness of the associations between parenting-efficacy, maternal depression and parent-domain parenting stress. The association between maternal ADHD and parent-domain parenting stress is statistically fully mediated by maternal depression. The pattern of associations between child and parent characteristics and parenting stress in Japanese mothers of children with ADHD are consistent with Abidin's model of parenting stress with implications for clinical management.

What you should know about the Surgeon General's advisory on parental stress.

What you should know about the Surgeon General's advisory on parental stress.

Association between behavioral problems and parental stress in children and adolescents with epilepsy.

The current study evaluated the association between behavioral problems in children and adolescents with epilepsy and parental stress. A prospective observational study of 314 consecutive parents of children and adolescents with epilepsy who attended the out-patient epilepsy clinic of a tertiary care hospital was done between June 2022 and September 2023. Self-reported Child Behaviour Check List (CBCL) was reported by parents; who also reported the parental stress scale (PSS). The data as per CBCL guidelines was evaluated in three groups of children and adolescents with epilepsy aged 1.5 to 5years; 6 to 10years and 11 to 18years. The associations between score on CBCL with reported score on PSS was evaluated. Among the 314 children and adolescents with epilepsy, 37(11.8%) were aged between 1.5 to 5years; while 108(34.4%) aged between six to 10years, the remaining 169(53.8%) aged between 11 to 18years. In children below 5years of age, internalizing factors like anxiety/depression, somatic symptoms were significantly higher. Importantly, the reported scores on PSS were lower in parents of adolescents than children with epilepsy. When evaluated for correlation of CBCL with PSS, internalizing characteristics like withdrawal were strongly associated with parental stress in children below the age of 5years. On the contrary, in children aged above five years, and in adolescents externalizing characteristics showed strong correlations with parental stress. Child's higher school performance had a negative correlation with PSS(R-Square: -0.499; p<0.001) and requirement for special school or child not attending school had positive correlation with PSS(R-square: 0.433;p<0.001). Behavioral problems in children and adolescents with epilepsy differ with age. Parental stress is associated with internalizing behavior in pre-school children whereas externalizing behavior dominated in children and adolescents. Poor performance of children at school and requirement for special school is associated with high parental stress.

Early Childhood Income Instability and Mental Health in Adolescence: Parenting Stress and Child Maltreatment as Mediators.

Ample research has examined how point-in-time or static measures of economic deprivation are associated with children's mental health outcomes. Less is known about the relationship between early childhood unstable income and mental health outcomes. Using the Future of Families and Child Wellbeing Study, this study examined (1) the latent patterns of early childhood economic well-being, predicted by income level and instability (i.e., direction and frequency of income change); (2) the association of income deprivation patterns with subsequent anxiety and depression symptoms, paying particular attention to the mediating roles of parenting stress and child maltreatment risk. The latent class analysis results suggested four distinct groups representing different combinations of income level and instability. Structural equation modeling results indicated indirect links between income deprivation patterns and mental health outcomes, through parenting stress and physical and psychological abuse. Findings indicated the importance of policies and programs promoting economic stability over the long run.

Prolonged grief and posttraumatic stress in parents who lost a child in a road traffic accident: A latent class analysis

Prolonged grief and posttraumatic stress in parents who lost a child in a road traffic accident: A latent class analysis

The role of interpersonal emotion regulation tendencies in the association between maternal childhood maltreatment and social support in parenting.

Alleviating psychological stress in parenting is crucial for breaking the intergenerational cycle of childhood maltreatment (CM). However, issues with social support-recognized as effective in addressing parenting challenges, including psychological stress-have been noted among parents with CM experiences. Specifically, these issues include a lack of resources and diminished effectiveness of social support. Previous findings suggest that decreased interpersonal emotion regulation (IER) contributes to both issues; however, no empirical study has examined this mechanism. This study explored the role of IER in the association between CM, social support, and psychological stress. Data from 1889 Japanese mothers were used for analysis. An online cross-sectional survey was conducted. Structural equation modeling validated the model, indicating that CM is associated with increased psychological stress through decreased IER and reduced social support resources (χ2=8.67, p<.05, CFI=0.99, GFI=1.00, AGFI=0.99, RMSEA=0.042). Multiple regression analysis revealed a significant IER×social support utilization interaction effect on psychological stress (β=-0.06, p<.01). Social support utilization significantly associated with reduced psychological stress for both high and low IER mothers; however, the association was stronger for those with high IER (β=-0.23, p<.01) than those with low IER (β=-0.12, p<.01). Decreased IER tendencies are linked to social support challenges among parents with CM experiences. However, high IER tendencies may exacerbate psychological symptoms in parenting contexts, necessitating careful consideration in interventions.

PILOT IMPLEMENTATION OF A MULTICOMPONENT INTERVENTION PROGRAM FOR CHILDREN IN THE RISK GROUP IN TERMS OF SOCIAL-EMOTIONAL DEVELOPMENT IN PRESCHOOL PERIOD

The purpose of this study is to examine the effects of a multicomponent intervention program for children who are in the risk group in terms of social-emotional development in preschool period on children's social-emotional development, behavioral problems and well-being, and parents' competence, parenting relationships and parental stress levels. In line with this purpose, the research has a mixed design feature as it includes quantitative and qualitative dimensions. The qualitative part was conducted with a phenomenological design to evaluate the participants' perceptions of the program, while the quantitative part was designed with a pretest-posttest and control group experimental design. Necessary ethical permissions were obtained for the research. The following scales were administered to the participants according to the criteria for assignment to the groups, primarily voluntariness: Social Skills Assessment Scale, Preschool Behavior Questionnaire (PBQ), Social Emotional Well-Being and Psychological Resilience Scale for Preschool Children (PERIK), Perceived Parental Self-Efficacy Scale (PPSE), Parent Stress Scale (PSS), Parenting Relationship Questionnaire (BASC-3) and personal information form. In the statistical analysis of the data, qualitative data were analyzed using MaxQDA-2018 qualitative data analysis program and quantitative data were analyzed using IBM SPSS Statistics 22 package program. Wilcoxon Signed Ranks test and Mann Whitney U test were used in qualitative data. In the experimental group, a significant (p0.05). It can be concluded that the multicomponent intervention program for children in the risk group in terms of social-emotional development in preschool period is effective in the social-emotional development of children. Comprehensive experimental studies on this subject are needed.

Parental Stress Is a Public Health Crisis, the U.S. Surgeon General Warns

Parental Stress Is a Public Health Crisis, the U.S. Surgeon General Warns

Parental stress modifies effects of early life exposure to interior environmental factors and extraventricular air pollution on childhood otitis media

Parental stress modifies effects of early life exposure to interior environmental factors and extraventricular air pollution on childhood otitis media

Effect of floral therapy in mothers of premature newborns: A randomized controlled trial.

To analyze the effect of using Bach's emergency compound, Five-Flower essence, on the stress level of mothers with premature newborns. The randomized, triple-blind, placebo-controlled clinical trial was conducted with 117 postpartum women. They were divided into intervention (with five-flower) and control groups. Their children were admitted to a Maternity Hospital in São Paulo, Brazil, from June 2019 to May 2021. The use of the Five-Flower essence was proposed during hospitalization (4 drops every 15min four times a day) and at home (16 drops a day at pre-determined times) in the ten days after the first intervention. The pre-and post-intervention parameters were evaluated using the Instrument Parental Stress Scale: Neonatal Intensive Care Unit and cortisol analysis. Student's T, Mann-Whitney, Chi-square, Fisher's exact tests, and Generalized Estimating Equation models were used to analyze the data. The 5% significance level was considered in statistical tests. The groups were homogeneous regarding sociodemographic, obstetric, and neonatal characteristics (p>0.05). Mean stress scores were calculated for the control (3.75) and intervention (3.82) groups before intervention and a range was observed for the control (2.75-3.44) and intervention (2.55-3.54) groups after the intervention; the difference between groups was statistically significant (p<0.05). Mean cortisol levels were calculated for the control (3.53) and intervention (3.45) groups before intervention and a range was observed for the control (3.38-2.75) and intervention (2.32-2.86) groups after intervention, showing distinct declines in the groups but without statistical difference (p>0.05). The use of the Five-Flower essence as a non-pharmacological therapy is effective in reducing the stress and cortisol levels in mothers of premature newborns admitted to neonatal and semi-intensive care units.

Examining the association between child development and parental mental health after preterm birth-related stress: a systematic review of the literature and meta-analysis protocol

IntroductionPreterm infants born before 32 weeks of gestation are generally admitted to a neonatal intensive care unit (NICU) to receive life-saving treatment, resulting in early exposure to stressful events. Yet,...

부모 양육스트레스 잠재집단에 따른 아동학대의 차이와 예측요인 분석

This study aims to classify latent profiles based on parental parenting stress, identify differences in child abuse across latent profiles, and analyze the predictive influence of various factors on the classification of latent profiles. The study participants comprised 1,140 children and their parents who responded to the 14th wave of the Korean Children’s Panel Survey. The study methods included latent profile analysis(LPA), chi-square tests, and multinomial logistic regression analysis. The results of the study are as follows: First, five latent profiles of parenting stress were identified: 'Low-level Parenting Stress Profile,' 'Moderate-level Parenting Stress Profile,' 'High-level Parenting Stress Profile,' 'Father-dominant Parenting Stress Profile,' and 'Mother-dominant Parenting Stress Profile.' Second, regarding differences in child abuse across latent profiles, the 'Low-level Parenting Stress Profile' showed the lowest levels of child abuse, making it a low-risk profile for child abuse. In contrast, the 'High-level Parenting Stress Profile' and the 'Father-dominant Parenting Stress Profile' exhibited the highest levels of child abuse, categorizing them as high-risk profiles. Third, parental depression, subjective happiness, and marital satisfaction significantly predicted the classification of parenting stress latent profiles, with the influence of each factor varying by latent profile. This study classified parenting stress latent profiles and examined differences in child abuse across these profiles, confirming the relationship between parenting stress and child abuse. Furthermore, the findings highlight implications for tailored intervention strategies to prevent child abuse based on latent profile characteristics.

잠재전이분석을 활용한 유치원·초등학교 전환기 어머니의 양육스트레스 잠재집단 전이 양상과 영향 요인 검증

Objectives This study examined how mothers' parenting stress latent groups appear during kindergarten and ele mentary school years of their children, and also explored whether parenting efficacy and social support affect the classification and transfer of mothers' parenting stress latent groups. Methods A total of 1,361 students data from the 7th and 8th years of the Korean Children and Youth Panel Survey was analyzed. The data for the 7th year corresponds to the time when newborns born in 2008 are in kindergarten, and the data for the 8th year corresponds to the first grade of elementary school. The Latent Transition Analysis with the three-stage estimation method was used to identify the latent groups of mothers' parenting stress and the transition pattern. Results First, The latent group of mothers’ parenting stress during both kindergarten and elementary school years of their children was identified as three latent groups: low, middle, and high level. Second, transition into the dif ferent latent group of mother's parenting stress were varied to children’s growth period. Third, emotional support, social support, and parenting efficacy were influencing the classification of the latent groups of mothers’ parenting stress when their children were in the kindergarten, however, they do not appear any influences when they moved into the elementary school. Fourth, parenting efficacy and instructional support had influences on transition in mothers’ parenting stress from kindergarten to elementary school period. Conclusions Results of this study implies that encouraging improvement of parenting efficacy and strengthen so cial support in order to lower mothers’ parenting stress during the transition period when their children move from kindergarten to the elementary school.

Osteopathic treatment of infants with infantile colic/excessive crying: a prospective, multicentric, randomized controlled trial and nested observational trial.

Colic in infants is defined as excessive crying in an otherwise healthy and thriving baby. Colic is a common but poorly understood and often frustrating problem for caregivers. To study whether osteopathic treatments of infants with infantile colic / excessive crying (IC/EC) have an impact on the subjectively perceived psychological stress of caregivers compared to usual care. The study was designed as a prospective, multicenter, randomized controlled trial. Infants aged 1 week to 3 months and who met Rome IV criteria for IC/EC were included. By means of external randomization, infants were allocated to an intervention group or a control group. Infants in the intervention group received three osteopathic treatments at intervals of one weeks. The treatments were custom-tailored and based on osteopathic principles. Controls received their osteopathic treatment after a 3 week untreated period. The primary outcome parameter was the assessment of parental psychological stress (three questions), measured using a numeric rating scale (NRS; 0-10). Furthermore, the average daily crying time (measured using the Likert scale), the crying intensity (measured using the NRS) and the parents' self-confidence (measured using the Karitane Parenting Confidence Scale) were assessed. A total of 103 infants (average age 39.4 ±19.2 days) were included, 52 in the intervention group and 51 in the control group. An inter-group comparison of changes revealed clinically relevant improvements in favor of the intervention group for the main outcome - parameter psychological stress - for all 3 questions (e.g., for question 2 respectively 3, NRS: between group difference of means 3.5; 95% CI: 2.6 to 4.4; p < 0.001). For the secondary outcome parameters of crying intensity and crying time/day, the changes were of similar magnitude. Three osteopathic treatments given over a period of two weeks led to statistically significant and clinically relevant positive changes of parental psychological stress. German Clinical Trials Register: DRKS00025867, registration date 10.08.21.

Parental Stress and Mental Health Outcomes Following the October 7th Events: Insights from Israeli Families of Children with Special Needs

The October 7th events precipitated an unprecedented psychological crisis for Israeli families, particularly affecting parents of children with special needs. This empirical study aimed to investigate the psychological factors contributing to parental stress and mental health outcomes in a community sample of 2097 parents, comparing those with children with special needs (n = 540) to those with typically developing children (n = 1557). Findings revealed that parents of children with special needs exhibited significantly higher levels of attachment anxiety and avoidance, parental stress, and intolerance of uncertainty, while reporting lower levels of parental competence, perceived social support, and mental health. Notably, meaning in life did not significantly differ between the groups. Correlational analyses indicated that attachment anxiety and avoidance were negatively correlated with parental competence, social support, meaning in life, and mental health while positively correlating with parental stress and intolerance of uncertainty. Mediation analyses showed that attachment anxiety and avoidance significantly predicted increased parental stress and reduced mental health, with these effects mediated by lower parental competence and diminished meaning in life. Moreover, intolerance of uncertainty mediated the effect of attachment anxiety on mental health. However, the mediating role of perceived social support on parental stress was absent among parents of children with special needs. These findings underscore the need for targeted interventions that bolster parental resilience, particularly for families of children with special needs during times of crisis.