Swedish Parenthood Stress Questionnaire Research Articles

Depressive symptoms, parental stress, and attachment style in mothers and fathers two and a half years after childbirth: Are fathers as affected as mothers?

The study aimed to determine the prevalence of depressive symptoms and whether parental stress and attachment style affected depression in mothers and fathers two and a half years after the birth of a child. The parents completed several questionnaires including the Edinburgh Postnatal Depression Scale, the Swedish Parenthood Stress Questionnaire and the Relationship Questionnaire. The prevalence rate of depressive symptoms in mothers was 14.9%, while for fathers it was 11.5%. Differences between the parents identified as depressed and those without depressive symptoms were also analysed. There were no significant differences between depressed and non-depressed parents on the secure, avoidant and fearful attachment styles. However, there was a significant difference between groups on the preoccupied subscale. The final aim was to calculate if attachment style contributed to the level of depression while accounting for the impact of parental stress. Parental stress (incompetence, social isolation and spouse relationship problems) was the best predictor for mothers’ depressive symptoms, while parental stress (social isolation and health) and the preoccupied attachment style were the best predictors for such symptoms in fathers. The findings indicated that parental stress and depressive symptoms are closely related and can explain the difficulties parents face.

Impact of Low Anorectal Malformation on Parenting Stress: A Mixed-Method Study

The purpose of this study was to investigate parenting stress among parents of children with low ARM. Study aims: 1) Compare parenting stress among parents of children with low ARM, with parents of healthy children using questionnaires. 2) Identify subscales within the questionnaire which needed to be further explored. 3) Use semi-structured interviews with parents of children with low ARM, to explore parenting stress and to explain, expand and or support the quantitative findings. Design and MethodsAn explanatory sequential mixed methods design was used in this follow up study. The parents completed the Swedish Parenthood Stress Questionnaire (SPSQ), semi-structured interviews were conducted. ResultsFifteen mothers and 13 fathers of children with low ARM age 8–18, returned completed questionnaires. A control group of 17 mothers and 6 fathers of healthy children age 8–18 that had visited the hospital for a minor procedure was recruited for comparison purposes. There were no significant differences found between index group and controls except in the subscale Incompetence, where parents of children with low ARM reported lower levels of stress compared to controls. Nine semi-structured interviews were conducted with parents of children with low ARM. Qualitative content analysis was used and revealed three themes – Communication between parents, Expectations of parenthood, and Challenges concerning parenthood. ConclusionsParents of children with low ARM did not report high levels of stress. When interviewed, they told about earlier experiences of emotional stress, feelings of guilt, and chaos at the time the child was born and during infancy.

Division of parental leave and perceived parenting stress among mothers and fathers

Objective: To explore associations between division of parental leave and perceived parenting stress in mothers and fathers of infants.Background: In Sweden, both parents have the same right to parental leave, and fathers use about a quarter of the total 480 benefit days. Little is known about the parents’ psychological well-being in terms of stress arising from the parenting role and its association with equal or unequal division of parental leave.Methods: 280 parents completed the Swedish Parenthood Stress Questionnaire (SPSQ) at 6 months and 18 months after childbirth.Results: Fathers who shared parental leave equally were less affected by perceived parenting stress than those who shared unequally (adjusted B –0.20; 95% CI –0.33 to –0.06). No such association was found among mothers.Conclusion: Parents’ choices regarding parental leave division were associated with perceived parenting stress among fathers, but not among mothers. Unequal division of leave contributed to parenting stress in fathers.

Parenting stress among parents of children with congenital diaphragmatic hernia

PurposeThe aim of this study was to examine parental stress among parents of children with congenital diaphragmatic hernia (CDH).MethodsBetween 2005 and 2009, a total of 51 children with CDH were treated at Astrid Lindgren Children’s Hospital. The survival rate at discharge was 86% and long-term survival rate 80%. One parent each of the long-term survivors (41 children) was included in the present study, and 34 parents (83%) agreed to participate. Participants received the Swedish Parenthood Stress Questionnaire (SPSQ). The questionnaire was supplemented by data from case records.ResultsParents of children with CDH, who had been supported by ECMO or had a long hospital stay, showed significantly higher overall parental stress. Mothers scored an overall higher parental stress compared with fathers. A prenatal diagnosis of CDH or lower parental educational level resulted in significantly higher parental stress in some of the factors.ConclusionsParental stress in parents of children with CDH seems to increase with the severity of the child’s malformation. Mothers tend to score higher parental stress than fathers.

Effects of Parent Training Programs on Parental Stress in a General Swedish Population Sample

This is a confirmatory study that assessed the effects of parent training programs on parental stress in a general population. There is a need to repeat and confirm earlier findings to acquire solid knowledge for policy stakeholders. In a quasi-experimental design, self-reported data were gathered at three occasions from 83 parents of children between the ages from one to ten years. These parents had responded to advertisements of parent training programs, and were matched to a comparison group of 83 parents chosen from a governmental database. Parent training program based upon behavioral, cognitive-behavioral, Adlerian and family system-theories. Parental stress due to incompetence, role restriction, social isolation, spousal relationship problems, and health problems were measured by the Swedish Parenthood Stress Questionnaire that is based on the Parent Stress Index Scale. The data indicated a reduction of stress in the sub-scale of health problems among parents in the intervention group with an effect size of 0.33, however, no other subscale showed the intervention as a significant variable when controlling for confounding variables. This study adds on the accumulated knowledge of supporting interventions for parents. We conclude that parent training programs have a significant effect on the stress components of parental health when implemented in real-life settings.

Association between depressive symptoms and parental stress among mothers and fathers in early parenthood: A Swedish cohort study

Aim To determine whether there is an association between depressive symptoms and parental stress among mothers and fathers during early parenthood in Sweden.Methods In this study, 401 mothers and 396 fathers (393 couples) were included; the Edinburgh Postnatal Depression Scale and the Sense of Coherence Scale were measured 3 months after childbirth, and the Swedish Parenthood Stress Questionnaire and the Sense of Coherence Scale after 18 months. Complete data for multivariable analysis were available for 264 mothers and 252 fathers.Results The mothers estimated greater total depressive symptoms and parental stress than the fathers did. Both the mothers and the fathers had the greatest level of stress in the sub-area ‘Role restriction’. The mothers had the lowest level of stress in the sub-area ‘Social isolation’ and the fathers in the sub-area ‘Incompetence’. The mothers perceived greater levels of stress than the fathers did in all sub-areas except for ‘Social isolation’, where the fathers perceived higher stress. There was an association between the parents’ depressive symptoms and parental stress. The parents’ own depressive symptoms at 3 months and sense of coherence and the partners’ parental stress at 18 months were positively associated with the parental stress at 18 months in univariable and multivariable analyses.Conclusions Understanding the relationship between depressive symptoms and parental stress is important for health professionals so they can offer parents adequate support in early parenthood to optimize the conditions for raising a child. This knowledge should also be communicated to the parents.

A randomised trial of continuous skin-to-skin contact after preterm birth and the effects on salivary cortisol, parental stress, depression, and breastfeeding

AimTo evaluate the effects of almost continuous skin-to-skin contact (SSC) on salivary cortisol, parental stress, parental depression, and breastfeeding. Study designThis is a randomised study engaging families of late preterm infants (32–35weeks gestation). Salivary cortisol reactivity was measured in infants during a nappy change at one month corrected age, and in infants and mothers during still-face at four month corrected age. Both parents completed the Swedish Parenthood Stress Questionnaire (SPSQ) at one month and the Edinburgh Postnatal Depression Scale (EPDS) at one and four months. Ainsworth's sensitivity scale was used to control for parental sensitivity. SubjectsThirty-seven families from two different neonatal care units in Sweden, randomised to either almost continuous SSC or standard care (SC). ResultsInfants randomised to SSC had a lower salivary cortisol reactivity at one month (p=0.01). There was a correlation between the mothers' and the preterm infants' salivary cortisol levels at four months in the SSC group (ρ=0.65, p=0.005), but not in the SC group (ρ=0.14, p=0.63). Fathers in SSC scored lower on the SPSQ sub-scale spouse relationship problems compared to fathers in SC (p<0.05). ConclusionsAlmost continuous SSC decreases infants' cortisol reactivity in response to handling, improves the concordance between mothers' and infants' salivary cortisol levels, and decreases fathers' experiences of spouse relationship problems.

Parental stress and dyadic consensus in early parenthood among mothers and fathers in Sweden

Parental stress can negatively affect the parent-child relationship and reduce the well-being of the whole family. Family disagreement is associated with parental divorce and with psychological problems in children. The aim was to examine perceived parental stress and draw comparisons among mothers and among fathers, in relation to educational level, parental experience, existence of a parental role model and sense of coherence. The aim was also to examine perceived dyadic consensus and its association with perceived parental stress within couples. Questionnaires were completed by 320 mothers and 315 fathers at 1 week and 18 months post-partum. The Swedish Parenthood Stress Questionnaire, the Sense of Coherence Scale and the Dyadic Consensus Subscale were used. Low education, lack of a role model and poor sense of coherence promoted stress in mothers in the subareas social isolation and spouse relationship problems, while lack of a role model and poor sense of coherence promoted stress in fathers in the subarea social isolation. Furthermore, parental experiences promoted stress among mothers in the subarea incompetence while this was not seen among fathers. Mothers perceived a higher level of dyadic consensus than fathers in the items recreational activities, friends, aims and life goals, time spent together, and decisions regarding career and personal development. Household tasks was the only item where fathers perceived a higher level of dyadic consensus than mothers. Additionally, there were associations between perceived parental stress and dyadic consensus in several items and in the total score. To promote parents' health and family stability, health professionals should consider factors affecting stress and stress reactions, and take gender roles into account.

Parental stress in early parenthood among mothers and fathers in Sweden

Parental stress affects parenting behaviour and the quality of dyadic parent-child interactions. Mothers generally show higher parental stress than fathers. Our aims were to assess the perceived level of parental stress in early parenthood and examine the differences between mothers and fathers within couples in relation to their levels of education, parental experience, existence of a parental role model and sense of coherence. In total, 307 mothers and 301 fathers of 18-month-old children answered the Swedish Parenthood Stress Questionnaire (SPSQ); and 318 mothers and 311 fathers answered the Sense of Coherence (SOC-3) scale; 283 couples answered both the SPSQ and SOC-3. Mothers perceived higher levels of stress than fathers in the sub-areas incompetence (p < 0.001), role restriction (p < 0.001), spouse relationship problems (p = 0.004) and health problems (p = 0.027), and in total (p = 0.001). In contrast, fathers perceived higher stress than mothers in the sub-area social isolation (p < 0.001). When the data were stratified with respect to education, parental experience, existence of a parental role model and sense of coherence, significant results were observed in some of these sub-areas. Mothers and fathers experience stress in different areas during their early parenthood. Healthcare professionals should be aware of the differences in stress that exist between mothers and fathers, so that parents can be adequately prepared for parenthood and avoid parental stress.

Parenting stress and emotional wellbeing in mothers and fathers of preschool children

The aims of the study were to compare parenting stress and emotional wellbeing in mothers and fathers of preschool children, to look for predictors of different aspects of parenting stress in mothers and fathers, and to discriminate parenting stress from psychological distress and anxiety. We studied 256 mothers and 204 fathers of children aged 1-7 years. The Swedish Parenthood Stress Questionnaire (SPSQ) assesses stress related to parenting. Emotional wellbeing was defined by the General Health Questionnaire-28 (GHQ-28) and the State Anxiety Inventory (STAI-X1) that measures psychological distress and anxiety, respectively. Fathers reported significantly more social isolation than mothers (P < 0.001). On all other parameters mothers, had higher scores, representing more stress and less wellbeing than fathers. Anxiety and psychological stress were strong predictors of parental stress in both mothers and fathers. Furthermore, maternal parental stress was predicted by birth of subsequent children and younger child age. Higher educational attainment predicted increased role restriction in fathers and more health problems in mothers. A principal component analysis (PCA) of the SPSQ, GHQ-28, and STAI-X1 showed that all endpoints of the analysis are positively correlated. Fathers reported significantly more social isolation, but less role restriction, incompetence and state anxiety than mothers. The SPSQ together with GHQ-28 and STAI-X1 allow a targeted screening aimed at contrasting parents who experience reduced emotional wellbeing with those who struggle with stress directly related to their parenting role.

Adult attachment and parenting stress among parents of toddlers

Objective: The aim was to revise the dimensionality of the Relationship Scales Questionnaire (RSQ) assessing adult attachment and relate it to parenting stress within a large sample of parents of toddlers. Methods: As part of a longitudinal population-based study, 8122 parents (97% mothers) completed the 18-item version of RSQ and the Swedish Parenthood Stress Questionnaire (SPSQ) when their child was 2–3 years of age. Results: Exploratory factor analyses gave three uncorrelated RSQ factors named (1) Importance of Independence, (2) Relationship-related Anxiety, and (3) Discomfort with Closeness, with Cronbach’s α ⩾ 0.65. In a linear regression Parenting Stress was most closely related to Relationship-related Anxiety (b = 0.20, t = 39.0), weaker associations were found with the attachment dimensions capturing avoidance: Importance of Independence (b = 0.07, t = 13.40) and Discomfort with Closeness (b = 0.07, t = 12.04). The SPSQ subscales Incompetence (R 2 = 17%) and Social Isolation (R 2 = 22%) showed stronger association with adult attachment than the remaining three. Conclusion: The agreement with previous findings in other study populations indicates that substantial and meaningful dimensions of attachment have been captured. Attachment anxiety and discomfort with closeness seem to have an important relationship with the perception of parenting stress, especially concerning feelings of incompetence and social isolation.

Underlying correlation structures of parental stress, general health and anxiety

A partial least square regression (PLSR) was performed on the Swedish Parenthood Stress Questionnaire (SPSQ) sum score and subscales on incompetence, role restriction, social isolation, spouse relationship and health problems, using 42 items from the General Health Questionnaire (GHQ) and 20 items from the State Anxiety Inventory (STAI-X1). The dataset contained 227 fathers and 301 mothers of children aged 1.0-6.6 years from a population-based study on parental psychological distress in the general Norwegian population, and all items correlated positively with SPSQ. Subscales on spouse relationship, incompetence, social isolation and role restriction related to items on state anxiety and depression. The SPSQ subscale on health problems related to GHQ items on somatic symptoms and social dysfunction. The STAI-X1 item "not feeling rested" had a particularly important effect on parental stress. Underlying correlation structures between parental stress and items from STAI-X1 and GHQ were explored, but only the SPSQ sum score could be acceptably predicted. PLSR as a statistical methodology was found useful for health and psychometric data.

Family stress and BMI in young children

The aim of this study was to investigate if family stress and parental attachment style are associated with body mass index (BMI) in young children, and identify possible explanations. A cross-sectional survey with a two-stage design was used. Parents of 873 children participated. They completed a demographic questionnaire, the Swedish Parenthood Stress Questionnaire (SPSQ), the Relationship Questionnaire (RQ) and reported their children's television-viewing habits (as a marker of physical activity). Children's height, weight and BMI were obtained from a general population-based register, BASTA. Associations with over- and underweight in children were assessed using multiple logistic regression analysis. Family stress indicated by SPSQ-score was associated with suboptimal BMI. Maternal, but not paternal, SPSQ-stress score was statistically significantly associated with overweight and underweight, with adjusted odds ratios (and 95% confidence interval) of 4.61 (3.11-6.84; p < 0.001) and 3.08 (1.64-5.81; p < 0.001) respectively. Associations between childhood BMI and parental attachment style were identified, but were not independent of maternal SPSQ-score. Our findings support a role for family stress in development of both overweight and underweight among young children. This is likely to be attributed to behavioural mechanisms but a more direct metabolic influence of stress could also be involved.

Effects of natural childbirth preparation versus standard antenatal education on epidural rates, experience of childbirth and parental stress in mothers and fathers: a randomised controlled multicentre trial

ObjectiveTo examine the effects of antenatal education focussing on natural childbirth preparation with psychoprophylactic training versus standard antenatal education on the use of epidural analgesia, experience of childbirth and parental stress in first-time mothers and fathers.DesignRandomised controlled multicentre trial.SettingFifteen antenatal clinics in Sweden between January 2006 and May 2007.SampleA total of 1087 nulliparous women and 1064 of their partners.MethodsNatural group: Antenatal education focussing on natural childbirth preparation with training in breathing and relaxation techniques (psychoprophylaxis). Standard care group: Standard antenatal education focussing on both childbirth and parenthood, without psychoprophylactic training. Both groups: Four 2-hour sessions in groups of 12 participants during third trimester of pregnancy and one follow-up after delivery.Main outcome measuresEpidural analgesia during labour, experience of childbirth as measured by the Wijma Delivery Experience Questionnaire (B), and parental stress measured by the Swedish Parenthood Stress Questionnaire.ResultsThe epidural rate was 52% in both groups. There were no statistically significant differences in the experience of childbirth or parental stress between the randomised groups, either in women or men. Seventy percent of the women in the Natural group reported having used psychoprophylaxis during labour. A minority in the Standard care group (37%) had also used this method, but subgroup analysis where these women were excluded did not change the principal findings.ConclusionNatural childbirth preparation including training in breathing and relaxation did not decrease the use of epidural analgesia during labour, nor did it improve the birth experience or affect parental stress in early parenthood in nulliparous women and men, compared with a standard form of antenatal education.

Stability and prediction of parenting stress

AbstractThe study focused on stability and prediction of parenting stress experiences over a 6‐year period. Mothers (N=93) who had received a clinical intervention for feeding or sleeping problems during infancy (Time 1; T 1) were followed‐up when the children were 5–10 years old (Time 2; T 2). An age‐ and sex‐of‐child matched normal group was used for comparison of stress levels at T 2. Parenting stress was measured by the Swedish Parenthood Stress Questionnaire, which consists of a general parenting stress scale and sub‐scales tapping different aspects of parenting stress experiences. T 1 predictors were clinical assessments of child problem load, maternal unresponsiveness, and family psychosocial problems. T 2 predictors were mother‐reported concurrent child problem load and psychosocial problems. The individual stability in stress experiences was moderate. Effect sizes indicated that mothers with early clinical contacts had reduced their stress to levels close to those in the normal sample. Parenting stress at T 2 could be predicted from early and from concurrent child and family problems. The results point to the relevance of early clinical assessments and to the importance of a sub‐area approach in parenting stress research, as there were differences between stress sub‐areas regarding both prediction and stability. Copyright © 2007 John Wiley &amp; Sons, Ltd.

Parental stress and toddler behaviour at age 18 months after pre‐term birth

To describe the parent's judgement of their own stress and the child's behaviour at 18 months after pre-term birth and if there are any correlations between these assessments, the morbidity in the neonatal period, the gestational age at birth and the occurrence of twin/triplet births. Twenty-one mothers and 19 fathers of pre-term infants answered two questionnaires, The Swedish Parenthood Stress Questionnaire (SPSQ) and The Toddler Behaviour Questionnaire (TBQ). Mothers scored somewhat higher than fathers concerning parental stress. Parents with twins/triplets and of children born in gestational week 25-30 felt more stress, though the differences were not statistically significant. High-risk diagnoses did not correlate to any of the dimensions. The parents judged the behaviour of the children similar except that parents of children born in gestational week 25-30 scored significantly higher for intensity/activity (p = 0.002). The correlation between parental stress and judgement of their children's behaviour did not show any significant association except for the dimension regularity in TBQ (p = 0.016). The mothers' and fathers' assessments of their own stress and of the children's behaviour were similar. Parents of very pre-term children felt more stress and judged the children somewhat delayed in their social behaviours, probably due to their low gestational age.

Treatment of sleep problems in families with young children: effects of treatment on family well‐being

Aim: To evaluate a standardized sleep programme that is a two‐step variation of graduated extinction, where the child is first taught to fall asleep by him/herself at bedtime (first intervention) and two weeks later also after night awakenings (second intervention). As it has been claimed that extinction procedures may be harmful to the child, this study documents both night‐ and daytime behaviour before and after interventions. Method: The study included a total of 95 families, with children from 4 to 45 mo of age exhibiting frequent signalled awakening episodes during the night. Sleep diaries, visual analogue scales (VAS) on daytime behaviour and the Flint Infant Security scale, completed by parents, were used as instruments. Parents also completed VAS scales and the Swedish Parenthood Stress Questionnaire scales on their own well‐being. Results: All families carried out the interventions. Parents reported significant improvements in sleep quality, daytime behaviour and family well‐being as early as two weeks after the first intervention. Before intervention, the sleep‐disturbed children were rated as more insecure than a matched comparison group with unknown sleep behaviour. This difference was eliminated after the interventions. The more anxious the children were rated before intervention, the more they tended to benefit from it. Conclusion: If parents experience young children's night awakenings as a problem, teaching the children to fall asleep by themselves usually solves this problem quickly. According to parental ratings, family well‐being and negative daytime behaviour are also improved

Treatment of sleep problems in families with young children: effects of treatment on family well-being

To evaluate a standardized sleep programme that is a two-step variation of graduated extinction, where the child is first taught to fall asleep by him/herself at bedtime (first intervention) and two weeks later also after night awakenings (second intervention). As it has been claimed that extinction procedures may be harmful to the child, this study documents both night- and daytime behaviour before and after interventions. The study included a total of 95 families, with children from 4 to 45 mo of age exhibiting frequent signalled awakening episodes during the night. Sleep diaries, visual analogue scales (VAS) on daytime behaviour and the Flint Infant Security scale, completed by parents, were used as instruments. Parents also completed VAS scales and the Swedish Parenthood Stress Questionnaire scales on their own well-being. All families carried out the interventions. Parents reported significant improvements in sleep quality, daytime behaviour and family well-being as early as two weeks after the first intervention. Before intervention, the sleep-disturbed children were rated as more insecure than a matched comparison group with unknown sleep behaviour. This difference was eliminated after the interventions. The more anxious the children were rated before intervention, the more they tended to benefit from it. If parents experience young children's night awakenings as a problem, teaching the children to fall asleep by themselves usually solves this problem quickly. According to parental ratings, family well-being and negative daytime behaviour are also improved.

Parental stress in families of 2 year old extremely low birthweight infants

Objective: To compare the parental stress in the families of 2 year old extremely low birthweight (ELBW) infants with that in control families, and to compare the stress of mothers...