Parental Stress Research Articles

Effects of postpartum fatigue, parenting stress, and family support on postpartum depression in Chinese first-time mothers: a cross-sectional study.

This study aimed to explore the levels of postpartum fatigue, parenting stress, family support, and postpartum depression (PPD) experienced by first-time Chinese mothers and to investigate their impact on PPD. This cross-sectional survey involved 150 primigravida women attending postnatal checkups in Hebi City, Henan Province, China. Demographic data and information on environmental variables (living conditions, family relationships), postpartum fatigue, parenting stress, family support (expected vs. actual level), and PPD were collected. The average age of the women was 26.25 years (SD, ±3.90), with 78.7% at risk for PPD (score ≥10). Significant correlations were found between PPD and postpartum fatigue (r=.63, p<.001), parenting stress (r=.59, p<.001), and family support (r=.40, p<.001). In model 1, which examined the influence of women's demographic variables on PPD, significant factors included a poor relationship with parents (β=.24, p=.001), a poor relationship with parents-in-law (β=.18, p=.029), and a poor relationship with the husband (β=.20, p=.013). When the three research variables were incorporated into model 2, the factors contributing to a higher level of PPD included a poor relationship with parents-in-law (β=.14, p=.033), increased postpartum fatigue (β=.37, p<.001), increased parenting stress (β=.33, p<.001), and less family support than expected (β=.12, p=.048). The most critical factors influencing PPD include postpartum fatigue, parenting stress, poor relationships with parents-in-law, and low family support among Chinese primiparas. To mitigate PPD levels, healthcare professionals should screen mothers for depression in outpatient clinics and offer education and counseling to both mothers and their families or companions regarding PPD.

Exploring relationships between parental stress, coping, and psychological outcomes for parents of infants with CHD.

This study aimed to explore relationships between parental stress, coping, and outcomes for parents of infants with CHD, via observational approach reflecting domains of the Parental Stress and Resilience in CHD (PSRCHD) model. Fifty-five parents of 45 infants with CHD completed questionnaires with measures of parental stress, Problem-Focused Coping (PFC), Emotion-Focused Coping (EFC), Avoidant Coping (AC), mental health (symptoms of anxiety and symptoms of depression), post-traumatic growth (PTG) and quality of life (QoL). Demographic and infant clinical data were obtained. Parental stress showed significant small to medium positive correlations with MH and PTG, but no significant correlations with QoL. EFC and AC showed significant small to medium positive correlations with MH, and medium negative correlations with parental QoL. EFC and PFC had significant small to medium correlations with PTG. PFC and AC had significant small to medium correlations with infant QoL. Hierarchical multiple regression analyses indicated that parental symptoms of anxiety, PTG, parental QoL, infant QoL were significantly predicted by models comprising of parental stress, coping styles, and clinical controls (adjusted R2 = 13.0-47.9%, p range < 0.001-.048), with results for parental symptoms of depression falling marginally above significance (adjusted R2 = 12.3%, p = .056). Parental stress, coping styles, and length of hospital stay are related to psychological outcomes in parents of infants with CHD. Future research may use the PSRCHD framework to assess mechanisms underlying CHD parents' stress and coping experiences and investigate longitudinal relationships between parental factors and parent and child outcomes.

지역사회 공공 여가시설 접근 편리성과 사회적 지원이 어머니의 양육스트레스에 미치는 영향

This study aimed to examine the impact of accessibility to public leisure facilities and social support on mothers' parenting stress. An analysis was conducted on 1,296 mothers of 6th-grade children in the 13th wave (2020) of the Panel Study on Korean Children (PSKC). The results are as follows: First, the higher the accessibility to public leisure facilities in the community, the lower the stress related to the mother's parental role and overall parenting stress. Second, it was found that the higher the level of social support for the mother, the less stress related to their parental role and overall parenting stress. In particular, emotional support was proved to be the most influential, and it was verified that providing intimacy and trust first for raising children is an important factor that can reduce parenting stress. The findings of this study validate that enhancing accessibility to community leisure facilities and strengthening various social supports can reduce parenting stress for mothers with upper-grade elementary school children. This confirms the social importance of leisure support and suggests the significance of interventions through social relationship support to reduce parenting stress.

Predicting Parental Post-Traumatic Stress Symptoms Following their Child's Stay in a Pediatric Intensive Care Unit, Prior to Discharge.

Objective: Develop an inpatient predictive model of parental post-traumatic stress (PTS) following their child's care in the Pediatric Intensive Care Unit (PICU). Design: Prospective observational cohort. Setting: Two tertiary care children's hospitals with mixed medical/surgical/cardiac PICUs. Subjects: Parents of patients admitted to the PICU. Interventions: None. Measurements and Main Results: Preadmission and admission data from 169 parents of 129 children who completed follow up screening for parental post-traumatic stress symptoms at 3-9 months post PICU discharge were utilized to develop a predictive model estimating the risk of parental PTS 3-9 months after hospital discharge. The parent cohort was predominantly female (63%), partnered (75%), and working (70%). Child median age was 3 years (IQR 0.36-9.04), and more than half had chronic illnesses (56%) or previous ICU admissions (64%). Thirty-five percent (60/169) of parents met criteria for PTS (>9 on the Post-traumatic Stress Disorder Symptom Scale-Interview). The machine learning model (XGBoost) predicted subjects with parental PTS with 76.7% accuracy, had a sensitivity of 0.83 (95% CI 0.586, 0.964), a specificity of 0.72 (95% CI 0.506, 0.879), a precision of 0.682 (95% CI 0.451, 0.861) and number needed to evaluate of 1.47 (95% CI 1.16, 1.98). The area under the receiver operating curve was 0.78 (95% CI 0.64, 0.92). The most important predictive pre-admission and admission variables were determined using the Local Interpretable Model-Agnostic Explanation, which identified seven variables used 100% of the time. Composite variables of parental history of mental illness and traumatic experiences were most important. Conclusion: A machine learning model using parent risk factors predicted subsequent PTS at 3-9 months following their child's PICU discharge with an accuracy of 76.7% and number needed to evaluate of 1.47. This performance is sufficient to identify parents who are at risk during hospitalization, making inpatient and acute post admission mitigation initiatives possible.

Parental Stress and Attitudes of Children’s Mothers Aged 0 to 10 Years

Parental Stress and Attitudes of Children’s Mothers Aged 0 to 10 Years

Stress Assessment in Parents of Children With Autism Spectrum Disorder: A Prospective Case-Control Study.

Autism spectrum disorder (ASD) is a disorder that is manageable but has no cure. Therefore, it is associated with parental stress, which is often not given importance. Early identification and holistic management of children with ASD are needed. This prospective case-control study, conducted over 18 months, included 111 newly diagnosed autism cases (ages 2-9) from the Child Development Clinic at Shri Mahant Indiresh Hospital, Dehradun, India, diagnosed as per the International Clinical Epidemiology Network (INCLEN) criteria (DSM-V). Controls were 99 typically developing children from a well-baby clinic. Data collection involved administering the Autism Parenting Stress Scale and a predesigned questionnaire to both cases and controls. Parents with psychiatric or mental health issues were excluded. Parents of children with autism exhibited significantly higher stress scores compared to parents of typically developing children. In our study, out of a total of 210 subjects, 52.9% were diagnosed with autism, while 47.1% were controls.Cases were analyzed based on household and socioeconomic background. It was found that 94.6% of the cases showed significant stress levels. ASDsignificantly impacts parental stress, particularly among families from higher socioeconomic backgrounds and metropolitan areas. This study emphasizes the need for targeted support and interventions to address elevated stress levels and improve family dynamics, especially for parents of higher-functioning children.

Exploring Parents' Experiences and Needs During Disclosure of a Cerebral Palsy Diagnosis of Their Young Child: A Scoping Review.

Parents often perceive the news that their child has cerebral palsy (CP) as overwhelming and shocking. They are at increased risk of parental stress and mental health problems, which in turn can affect the interaction between the parent and the child. Parental mental health outcomes are known to be affected by the process of disclosure of a diagnosis. In this study, we aimed to synthesize the current knowledge about parents' experiences and needs regarding communication during the disclosure of the diagnosis of their child with (or at risk of) CP. A scoping review following the methodological steps outlined by the Joanna Briggs Institute was performed using PubMed, Embase, CINAHL and PsycINFO. We qualitatively explored parent-reported experiences and needs across included studies, using thematic analysis. A total of 19 studies were included. Six themes were identified, three in relation to experiences (i.e., preceding experiences and feelings, perceptions of the disclosure and emotional impact) and three in relation to needs (i.e., transparency in information, supportive attitude and having a say). Despite high variability across studies regarding parental needs, most studies reported the need for (i) honest and clear information, (ii) good communication skills amongst professionals and (iii) emotional and practical support after diagnosis. Our findings suggest that parents' experiences and needs in the period when their child's diagnosis of (high risk of) CP is communicated are highly variable, due to an interplay of personal and contextual factors. To facilitate good communication during disclosure, it is crucial that health care professionals assess and understand this complex process and consider parents' needs for open communication and autonomy in the process. Therefore, professionals need to attune to parents' needs and their individual preferences regarding conversations about their child with (or at risk of) CP.

The effects of infant abdominal massage on the parental stress level among Chinese parents in Hong Kong – A mixed clustered RCT

ObjectiveTo investigate the effectiveness and the experience of infant abdominal massage on reducing the parental stress level.MethodsA clustered RCT was conducted, 160 parents were recruited from 10 mother groups. An infant abdominal massage class was given to those in the intervention group by a certified International Association of Infant Massage instructor. The Chinese Parenting Stress Index (PSI-SF) was used to measure parental stress levels at baseline and 4 weeks after the intervention. 8 parents from the intervention group were invited for an online interview to understand the experience of parents in participating the infant abdominal massage class. Thematic analysis was applied.ResultsThe parental stress level was significantly decreased among intervention group with a mean difference of -5.46 (95% CI = 0.72 to 10.2, p = .049). ITT analysis was adopted for compliance analysis. The overall compliance for the intervention was 66% and found to have a significant effect on parental stress level (p < .01). The total PSI-SF among fathers was slightly higher than that among mothers. Furthermore, no moderating factors were found to have a significant interaction effect on PSI-SF (p < .05).For qualitative data, an overarching theme was generated that infant abdominal massage brought a positive experience despite the uncertainties affecting the compliance. Four themes and nine sub-themes were identified. Which were: (1) receiving clear and informative infant abdominal massage classes; (2) The influence of uncertain conditions on compliance; (3) Improving parental satisfaction; and (4) feeling it was a worthwhile experience.ConclusionThis study provides a cost-effective method for parents to tackle their parental stress, the findings aid in the planning or adjustment of current postpartum depression screening while also helping to lower the risk of postpartum mood disorders.Trial registrationClinical Trial Number (NCT05650424 || http://clinicaltrials.gov/study/NCT05650424), registered on December 1, 2022. and HKU Clinical Trails Registry (HKUCTR3008), registered on November 3, 2022.

A systematic review and meta-analysis of the parental stress scale's psychometric properties.

Parental stress can affect the ability of parents to cope with the challenges of raising children. The result can be a negative cycle within the family dynamic, which in turn can interfere with children's development and emotional regulation. Among the many instruments available to assess parental stress, the Parental Stress Scale (PSS) deserves particular mention. To our knowledge, there are currently no systematic reviews evaluating the psychometric properties of the PSS. The aim of this systematic review was to assess the psychometric properties of the PSS using the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) methodology and to conduct a meta-analysis. A thorough literature search was conducted from different databases. A meta-analysis to test the generalisability of PSS internal consistency across its component factors was performed. A total of 20 validation studies of the PSS were identified. Based on the COSMIN methodology, this instrument receives an 'A' rating, meaning that it is considered to be a cross-sectional instrument with the necessary scientific evidence for the assessment of the construct of parental stress. The meta-analysis testing the generalisability of its internal consistency yielded satisfactory results across the different factors. Future research should focus on those psychometric properties of the PSS that have not been studied as extensively, such as reproducibility, responsiveness, measurement error, and measurement invariance.

Investigation of the Effectiveness of a Relation Based Early Intervention Program on Parent Outputs

ABSTRACT This investigation aims to adapt to Turkish and examine the Keyhole Early Intervention Program’s effectiveness with parents who have children with autism spectrum disorder (ASD) in early childhood. In the study, using parallel pattern approaching mixed research methods, Maternal Behavior Rating Scale- Turkish Version (MBRS-TV) Parenting Stress Index Short Form (PSI-SF), semi-structured interview questions and personal information form were used. The study in which the criterion sample is used in the selection of the study group is pre-experimental. In quantitative data analysis, Friedman’s Two-Way Analysis of Variance and Wilcoxon Signed Ranks test showed that the Keyhole Early Intervention Program increased emotional expressiveness and decreased parental stress.

Psychometric properties of the Parenting Stress Index-Short Form in a Peruvian sample

BackgroundThe stress experienced by parents in fulfilling their parental role has consequences for couple dynamics, parent–child interactions, and the mental health of parents. However, studies on the psychometric properties of the PSI-SF, particularly among Latin American parents, are scarce. Therefore, this study aims to evaluate the psychometric properties of the Spanish version of the Parenting Stress Index-Short Form (PSI-SF).MethodsThe participants were Peruvian mothers and fathers with children in early childhood and primary education, with a mean age of 34.4 years (SD = 6.8). The sample was obtained in two phases: 130 participants for the Exploratory Factor Analysis (EFA) and 791 participants for the Confirmatory Factor Analysis (CFA).ResultsThe study results show a modified three-factor structure of the PSI-SF scale, with adequate fit indices (GFI = .99, AGFI = .99, SRMR = .024, CFI = .98, TLI = .98, RMSEA = .074) and loadings above 0.40. Additionally, the three factors of the scale demonstrated high reliability, with Cronbach's alpha and McDonald's omega values for Parental Distress (α = .94; ω = .95), Parent–Child Dysfunctional Interaction (α = .97; ω = .97), and Difficult Child (α = .94; ω = .94). The scale was also found to be invariant with respect to gender.ConclusionIn conclusion, the study results suggest that the modified PSI-SF has adequate psychometric properties and is invariant for assessing parental stress in Peruvian fathers and mothers with children in early childhood and primary education.

Validation of the Dutch Infant Crying and Parent Well-Being Screening Tool in Parents of Infants Less than 12 Months of Age

To evaluate reliability and validity of the Dutch version of the Infant Crying and Parent Well-Being (ICPW) tool in identifying parents struggling with infant crying in the first year of life. The original ICPW tool was translated into Dutch following established guidelines. The internal consistency and criterion validity of the Dutch ICPW tool were evaluated using a cross-sectional design. The translated ICPW tool and validated questionnaires on parental depression, stress, anxiety, and parenting balance were presented to parents of infants under 12months during child health care visits and online. The survey was completed by 488 parents, 400 mothers and 88 fathers. Of these, 172 participated after a child health care visit and 316 via online platforms. The Dutch ICPW showed satisfactory internal consistency (α=0.69) and excellent criterion validity with parental mental health measures (r=0.53-0.85). ICPW scores demonstrated positive correlations with parental depression, stress, and anxiety levels, and a negative correlation with parenting balance. Both mothers and fathers with a positive ICPW screen (≥3) reported significantly higher levels of parental mental health issues compared with those with a negative screen (P<.001). The ICPW was positive in 32% of the parents (n=155), with consistent total scores regardless of the infant's increasing age (r=-0.024, P=.59). The ICPW tool exhibited a strong negative predictive value (93%) for diagnosing postpartum depression. The Dutch ICPW tool is a reliable and valid screening instrument for identifying parents struggling with infant crying.

Exploring the factors contributing to parent stress symptoms during the COVID-19 pandemic in Europe: An ABC-X model approach.

The COVID-19 pandemic has had a significant impact on the mental health and well-being of families worldwide, with parents particularly at risk for stress and other psychological symptoms. In this study, we sought to understand the factors contributing to parent stress symptoms during the early stages of the pandemic in 23 European countries (N = 40,138) using the double ABC-X model. We examined whether the relationship between stressor pile-up and perceived stress was mediated by family satisfaction and relationship satisfaction and whether family resiliency beliefs impacted these mediated relationships. Our results showed a direct association between stressor pile-up and parent stress symptoms, but we did not find evidence for the mediating role of family satisfaction or relationship satisfaction in this relationship. We also found that family resiliency beliefs did not moderate the indirect effects of family satisfaction and relationship satisfaction on parent stress symptoms. These findings suggest that the ABC-X model may not fully capture the processes affecting parents' experience of stress during the pandemic and that alternative models such as the vulnerability-stress-adaptation model may be more relevant. Future research should also consider the potential negative impact of resiliency beliefs on mental health and other risk and protective factors such as self-compassion.

Illness cognitions and parental stress symptoms following a child's cancer diagnosis.

This research aims to explore parents' cognitive beliefs, specifically illness cognitions, in response to their children being diagnosed with cancer. This study is an initial step toward providing regular psychosocial assessment as a standard for psychosocial care for children with cancer and their families in Latvia. Data were collected from 120 parents (mostly mothers, n = 109) as an initial evaluation of the psychosocial risks faced by families participating in the support program "Holistic and Multidisciplinary Support for Children with Functional Disabilities and Their Family Members," which was managed by the Children's Hospital Foundation at the Children's Clinical University Hospital in Riga (Latvia) from 2020 to 2023. The patients comprised 66 boys and 54 girls (M age = 7.1, SD = 4.7, range: 0-17 years) with diverse cancer diagnoses. The parents completed the Latvian version of the Psychosocial Assessment Tool [adapted from PAT 3.1], with five subscales included in the data analysis (Social Support, Child Problems, Family Problems, Stress Reactions, and Family Beliefs). The Family Belief subscale was adjusted specifically to address the unique objectives and research questions of the current study. Significant correlations were found between children's psychological problems (e.g., getting upset about medical procedures, hyperactivity, excessive use of electronic devices, etc.) and parental stress reactions after diagnosis and with self-reported symptoms of anxiety and depression. The associations were statistically significant, even after controlling for sociodemographic and medical factors such as diagnosis. The relationship between children's problems and parental stress reactions was partly mediated by Family Beliefs about illness. The most informative beliefs associated with parental stress symptoms and the family's psychosocial risk level were identified, and significant results were found according to the main component of beliefs (catastrophic vs. optimistic) that explained 42% of the variance in the Family Beliefs subscale. Understanding the habitual responses to stress and identifying the thinking patterns of parents that lead to distorted views and maladaptive coping are essential for customizing personalized interventions to enhance treatment compliance. The Latvian version of PAT is a useful psychosocial screening measure in pediatric oncology settings.

Better together: involving parents to improve the impact of a video game program to promote primary school students’ emotional competencies

AbstractThe objective of the present study was to evaluate whether parents’ participation could enhance the impact of a video game designed to promote children’s emotional competencies. To achieve this, the video game Happy 8–12 was implemented at school. A separate group of children also played the video game Happy for Families at home with their parents. Differences between children who participated together with their parents, children who played only at school and a control group were explored. Additionally, the study examined improvements in children’s anxiety and academic performance, as well as parents’ emotional awareness, emotional regulation, and parental stress. The sample comprised 137 students along with 42 parents. Results indicated improvements in both groups of children compared to the control group, particularly in emotional awareness, life and well-being competencies, and the global emotional competence. Increases in emotional regulation, emotional autonomy, and social competence, were observed solely among children who participated with their parents. However, no differences emerged in terms of anxiety and academic achievement when compared to the control group. In addition to these findings, parents demonstrated improvements in emotional awareness and regulation, though there was no significant reduction in parental stress. These preliminary results support the efficacy of Happy 8–12 and Happy for Families in promoting children’s emotional competencies and emphasize the importance of involving parents to enhance the intervention outcomes.

The Association Between Parenting Stress and Parenting Behaviors in Chinese Parents of Children with Autism Spectrum Disorders: The Mediating Role of Parental Anxiety and Depression

ABSTRACT Background Parents of children with autism spectrum disorders (ASD) experience heightened levels of parenting stress and more affective symptoms. Although the relationship between parenting stress and mental health has been extensively studied, limited understanding exists regarding parenting behaviors and related factors. This study aimed to explore the role of parents’ affective symptoms in the relationship between parenting stress and parenting behaviors among Chinese parents of children with ASD. Methods A total of 185 parents participated in one online survey, reporting parenting behaviors, parenting stress, depression and anxiety symptoms. Results (1) A higher level of parenting stress was associated with reduced positive parenting behaviors and increased negative parenting behaviors. (2). Parents’ anxiety and depression symptoms mediated the relationship between parenting stress and positive parenting behaviors. Conclusion Parenting stress has potential detrimental effects on parenting behaviors in Chinese parents of children with ASD through the mediation of parental depression and anxiety.

Parenting Stress and Child Behavior Problems among Latino and non-Latino Families of Autistic Children: Exploring Day-to-Day Temporal Relations

Behavior problems are common among young autistic children and are related to elevated parenting stress levels among their caregivers. However, previous studies of this population have rarely examined relations between child behavior problems and parenting stress at a daily level and, to date, have not examined how these relations may differ for Latino families. Using a day-to-day, within-person design, this study bidirectionally examined these temporal relations among 70 families of autistic children (ages 3–5 years, 74.3% male, 49% Latino parents) who participated in a 14-day daily-diary study. Parent-reported child behavior problem severity and parenting stress were measured daily. Constructs were partitioned into their between- and within-person components and analyzed using time-lagged MLM models. At the between-person level, greater reported child behavior problem severity, relative to the group average, was positively associated with next-day parenting stress and vice versa. This relationship was moderated by Latino ethnicity, such that the positive relationship between reported child behavior problem severity and next-day parenting stress was weaker for Latino (versus non-Latino) families. These bidirectional relationships differed at the within-person level, such that, unexpectedly, greater-than-usual parenting stress, compared to parents’ own average, was negatively associated with next-day child behavior severity. Findings underscore the value of using daily diary methodology to decompose between- and within-person effects, and reveal potential intervention targets to improve parent and child functioning, particularly among minoritized families of autistic children.

Effectiveness of Coping Strategies for Stress and Anxiety for Parents (Caregiver) of Cerebral Palsy children using Thumb Abduction Splint

Effectiveness of Coping Strategies for Stress and Anxiety for Parents (Caregiver) of Cerebral Palsy children using Thumb Abduction Splint

Influence of parental stress on online learning engagement among parents in Arab nations

ABSTRACT This study examines the impact of parental stress on engagement with online learning during and after the COVID-19 pandemic in Arab nations. A total of 729 parents from various Arab countries participated in the study by completing a 42-item questionnaire that measured four types of stress—personal, academic, technical, and financial—as well as behavioural, emotional, and cognitive engagement. Demographic factors, including gender, income, number of children, and country of residence, were found to correlate with different levels of stress and engagement. Structural Equation Modelling (SEM) and Confirmatory Factor Analysis (CFA) were employed to validate the relationships between stress and engagement, while MANOVA explored the effects of demographic variables. The results show that personal and academic stress positively influence all forms of engagement, while technical stress has a significant negative effect. Financial stress did not demonstrate a measurable impact on parental engagement. The findings highlight the need for targeted strategies to manage parental stress, particularly personal and academic, to improve parental involvement in online education. These insights are crucial for policymakers and educators in developing support systems for parents during transitions to online learning environments.

Predicting longitudinal trajectories of adaptive couple processes in families of autistic children: Applying the Vulnerability Stress Adaptation model

BackgroundMany couples raising an autistic child report long-standing and thriving couple relationships, even within the context of elevated parenting stress. Little is known however, about the factors that promote or hinder adaptive couple processes or how these processes may shift over time. Drawing on the Vulnerability Stress Adaptation (VSA) model, the present study examined adaptive couple problem-solving processes across three years and the extent to which these processes were predicted by parent broader autism phenotype (BAP) and level of parenting stress in couples raising an autistic child. MethodIn total, 189 couples (378 parents) raising an autistic child (aged 5–12 years) completed questionnaires assessing parent BAP and level of parenting stress. Couples also engaged in observed problem-solving interactions at four time points spanning three years. ResultsThe use of adaptive couple problem-solving behaviors (Solution Focused Reciprocity and Positive Teamwork) declined linearly across time. Father BAP predicted greater decline in these adaptive processes (Solution Focused Reciprocity and Positive Teamwork), particularly when mother-reported parenting stress was low. No main effects of parenting stress on change in adaptive couple problem-solving behaviors emerged. ConclusionsFindings highlight the utility of the VSA Model for understanding the short-term longitudinal course of problem-solving behaviors in couples raising an autistic school-aged child. This study can inform efforts to promote healthy and long-lasting couple relationships in this population.