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Journal of Clinical Child and... 2022Parent-child role confusion has been shown to influence developmental outcomes for children whose parents have a history of depression; however, more research is needed... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
Parent-child role confusion has been shown to influence developmental outcomes for children whose parents have a history of depression; however, more research is needed to understand the pathways by which parental depression increases risk of role confusion. The current study aimed to extend previous literature by evaluating how different family processes (e.g., interparental conflict, guilt induction, family cohesion, and positive parenting practices) contribute to the development of emotional role confusion in families with a history of parental depression.
METHOD
The sample was comprised of 90 parent-child dyads (parent 42, 90% female, 83.3% White; child = 11.51, 51.1% female, 75.6% White) participating in the control group of a randomized controlled trial. All parents had a history of depression. A longitudinal path analysis was conducted to evaluate prospective associations in the multiple mediator model.
RESULTS
Findings from the current study suggest that parental depressive symptoms are not directly related to the development of parent-child emotional role confusion, but are instead indirectly related through increased interparental conflict observed by youth. Although not identified as significant mediators, guilt induction and positive parenting practices emerged as predictors of emotional role confusion. Lastly, family cohesion did not appear to influence the development of role confusion.
CONCLUSION
Findings suggest that parenting behaviors and coparenting relationship quality play important roles in the development of parent-child emotional role confusion, with interparental conflict emerging as the strongest predictor in families with a history of parental depression.
Topics: Adolescent; Female; Humans; Male; Depression; Parent-Child Relations; Parents; Parenting; Family Conflict
PubMed: 33769163
DOI: 10.1080/15374416.2021.1894943 -
European Journal of Pain (London,... Aug 2022Intensive interdisciplinary pain treatment (IIPT) for youth with high impact chronic pain has been found to be effective in improving child symptoms and functioning.... (Review)
Review
BACKGROUND AND OBJECTIVE
Intensive interdisciplinary pain treatment (IIPT) for youth with high impact chronic pain has been found to be effective in improving child symptoms and functioning. However, it remains unclear how these interventions impact the parents' own well-being, as well as cognitions and behaviours which are known to influence child pain and functioning. Thus, the current study sought to determine the effect of IIPT on parent mental health, cognitions and behaviours in parents of youth attending IIPT with their child.
DATABASES AND DATA TREATMENT
A search of the electronic databases CINAHL, Ovid EBM Reviews, Embase, Medline, APA PsychINFO, Scopus and web of Science was conducted. Studies were included if they comprised at least 10 parents of patients aged 9-22 with nonmalignant chronic pain attending an IIPT and were written in English.
RESULTS
A random-effects model was used to pool the standardized mean change (SMC) across seven prepost studies. At discharge, IIPT participation was associated with small to moderate improvements in direct parental outcomes (general mental health, anxiety, depression and parenting stress), a moderate improvement in pain catastrophizing and large improvements in psychological flexibility and parenting behaviours. Most improvements were maintained at follow-up. The risk of bias of all studies was rated as serious and the certainty of the evidence as low, suggesting limited confidence in the estimates.
CONCLUSIONS
Although parents appear to benefit from attending an IIPT with their child, RCTs are needed to substantiate the effect of these interventions on important aspects of parent well-being and functioning.
Topics: Adolescent; Anxiety; Child; Chronic Pain; Humans; Mental Health; Parenting; Parents
PubMed: 35638305
DOI: 10.1002/ejp.1986 -
European Journal of Psychotraumatology 2023Stepped care cognitive behavioural therapy for children after trauma (SC-CBT-CT; aged 7-12 years) can help to increase access to evidence-based trauma treatments for...
Stepped care cognitive behavioural therapy for children after trauma (SC-CBT-CT; aged 7-12 years) can help to increase access to evidence-based trauma treatments for children. SC-CBT-CT consists of a parent-led therapist-assisted component (Step One) with an option to step up to standard therapist-led treatment (Step Two). Studies have shown that SC-CBT-CT is effective; however, less is known about what parent variables are associated with outcome of Step One. To examine parent factors and their relationship with completion and response among children receiving Step One. Children ( = 82) aged 7-12 ( = 9.91) received Step One delivered by their parents ( = 82) under the guidance of SC-CBT-CT therapists. Logistic regression analyses were used to investigate whether the following factors were associated with non-completion or non-response: the parents' sociodemographic variables, anxiety and depression, stressful life experiences and post-traumatic symptoms, negative emotional reactions to their children's trauma, parenting stress, lower perceived social support, and practical barriers to treatment at baseline. Lower level of educational achievement among parents was related to non-completion. Higher levels of emotional reactions to their child's trauma and greater perceived social support were related to non-response. The children seemed to profit from the parent-led Step One despite their parents` mental health challenges, stress, and practical barriers. The association between greater perceived social support and non-response was unexpected and warrants further investigation. To further increase treatment completion and response rates among children, parents with lower education may need more assistance on how to perform the interventions, while parents who are very upset about their child's trauma may need more emotional support and assurance from the therapist. ClinicalTrials.gov NCT04073862; https://clinicaltrials.gov/ct2/show/NCT04073862. Retrospectively registered 03 June 2019 (first patient recruited May 2019).
Topics: Humans; Child; Parents; Parenting; Anxiety Disorders; Cognitive Behavioral Therapy; Emotions
PubMed: 37366166
DOI: 10.1080/20008066.2023.2225151 -
Frontiers in Public Health 2022To explore the impact of poverty on parent-child relationships, parental stress and parenting practices.
OBJECTIVES
To explore the impact of poverty on parent-child relationships, parental stress and parenting practices.
DESIGN
A mixed methods study.
SAMPLE
Four hundred and eighty five Hong Kong Chinese parents who had children aged 3-6 years, and who were from low-income families. Eleven of these parents were randomly selected for individual semi-structured interviews.
MEASUREMENTS
A sociodemographic questionnaire, the parent-child relationship score, the Parental Stress Scale and the Perceived Parental Aggression Scale.
RESULTS
The parents were found to have an impaired relationship with their children. The findings indicated that employment status, parental stress and harsh parenting were significantly associated with parent-child relationships. The qualitative findings revealed that parents from low-income families encountered a wide range of difficulties, which made these parents more likely to experience parental stress, thereby increasing their tendency to adopt harsh parenting practices that undermined parent-child relationships.
CONCLUSION
This study sheds light on the associations between parent-child relationships, parental stress and parenting practices in low-income families. These findings will enhance nurses' understanding of the impact of poverty on parent-child relationships, and highlight the need for nurses to ensure that underprivileged parents and their children receive adequate primary care to prevent the development of psychological problems in this vulnerable group.
Topics: Humans; Parent-Child Relations; Parenting; Parents; Poverty; Surveys and Questionnaires
PubMed: 35548071
DOI: 10.3389/fpubh.2022.849408 -
Journal of Clinical Child and... 2022Behavioral parent training (BPT) is the first line of treatment for preschool-aged children with attention-deficit hyperactivity disorder (ADHD); however, clinically...
OBJECTIVE
Behavioral parent training (BPT) is the first line of treatment for preschool-aged children with attention-deficit hyperactivity disorder (ADHD); however, clinically significant improvements are not universal. In the current study, we employ a person-centered approach to create subgroups of families based on the intersection of multiple parent, child, and family pre-treatment factors. Further, we explore the utility of pre-treatment family profiles in predicting post-treatment differences in observed parenting behavior (i.e., behavioral control, parental warmth) and clinically significant change in child ADHD and oppositional symptoms.
METHOD
Longitudinal data were collected using observational and parent-, teacher- and clinician-reported assessments from 130 parent-child dyads ( 3.57, range = 3.0- 4.11, 73.8% male, 69.2% White, 25.6% Hispanic) participating in BPT.
RESULTS
Findings from the current study suggest three distinct family profiles, which consisted of one profile with high family stress (HFS) as evidenced by elevated symptomatology across parent, child, and family-level domains, a second profile with elevated parental anxiety (PA), and a final profile with elevated parental depression (PD). These family-centered profiles were differentially associated with changes in observed parenting practices. Specifically, the PD profile (39%) demonstrated minimal improvements in behavioral control and warmth following treatment. In contrast, the HFS profile (30%) only improved in behavioral control and the PA profile (31%) improved in both parenting domains following treatment. In addition, marginally significant differences in child oppositional and ADHD symptoms were observed across profiles.
CONCLUSIONS
Family-centered approaches may be useful for selecting and implementing interventions.
Topics: Attention Deficit Disorder with Hyperactivity; Behavior Therapy; Child, Preschool; Female; Humans; Male; Parenting; Parents; Schools
PubMed: 33492172
DOI: 10.1080/15374416.2020.1867987 -
Journal of Child Psychology and... Feb 2022Family mindfulness-based intervention (MBI) for child attention-deficit/hyperactivity disorder (ADHD) targets child self-control, parenting and parental mental health,... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Family mindfulness-based intervention (MBI) for child attention-deficit/hyperactivity disorder (ADHD) targets child self-control, parenting and parental mental health, but its effectiveness is still unclear.
METHODS
MindChamp is a pre-registered randomised controlled trial comparing an 8-week family MBI (called 'MYmind') in addition to care-as-usual (CAU) (n = 55) with CAU-only (n = 48). Children aged 8-16 years with remaining ADHD symptoms after CAU were enrolled together with a parent. Primary outcome was post-treatment parent-rated child self-control deficits (BRIEF); post hoc, Reliable Change Indexes were explored. Secondary child outcomes included ADHD symptoms (parent/teacher-rated Conners' and SWAN; teacher-rated BRIEF), other psychological symptoms (parent/teacher-rated), well-being (parent-rated) and mindfulness (self-rated). Secondary parent outcomes included self-ratings of ADHD symptoms, other psychological symptoms, well-being, self-compassion and mindful parenting. Assessments were conducted at post-treatment, 2- and 6-month follow-up.
RESULTS
Relative to CAU-only, MBI+CAU resulted in a small, statistically non-significant post-treatment improvement on the BRIEF (intention-to-treat: d = 0.27, p = .18; per protocol: d = 0.33, p = .11). Significantly more children showed reliable post-treatment improvement following MBI+CAU versus CAU-only (32% versus 11%, p < .05, Number-Needed-to-Treat = 4.7). ADHD symptoms significantly reduced post-treatment according to parent (Conners' and SWAN) and teacher ratings (BRIEF) per protocol. Only parent-rated hyperactivity impulsivity (SWAN) remained significantly reduced at 6-month follow-up. Post-treatment group differences on other secondary child outcomes were consistently favour of MBI+CAU, but mostly non-significant; no significant differences were found at follow-ups. Regarding parent outcomes, significant post-treatment improvements were found for their own ADHD symptoms, well-being and mindful parenting. At follow-ups, some significant effects remained (ADHD symptoms, mindful parenting), some additional significant effects appeared (other psychological symptoms, self-compassion) and others disappeared/remained non-significant.
CONCLUSIONS
Family MBI+CAU did not outperform CAU-only in reducing child self-control deficits on a group level but more children reliably improved. Effects on parents were larger and more durable. When CAU for ADHD is insufficient, family MBI could be a valuable addition.
Topics: Adolescent; Attention Deficit Disorder with Hyperactivity; Child; Humans; Mindfulness; Parenting; Parents; Self-Control
PubMed: 34030214
DOI: 10.1111/jcpp.13430 -
Child Psychiatry and Human Development Dec 2022Parent training is a central focus of behavioral intervention, with emphasis on teaching parents to become change agents for their children by using behavioral...
Parent training is a central focus of behavioral intervention, with emphasis on teaching parents to become change agents for their children by using behavioral management skills. However, its effectiveness is limited by a parent's ability to engage in the learning process. Parents managing external stressors, psychopathology, or poverty often do not gain the skills and thus, the treatment may minimally impacts parent and child behavior. In order to increase a parent's ability to acquire and implement new skills accurately, referred to as parent treatment integrity, the current study added a parent-support component to the RUBI Autism Network's Parent Training for Disruptive Behaviors protocol. The parent-support component was intended to remove barriers to skill acquisition during the parent training session by alleviating some of the interfering parental stress. In an alternating treatments design, a community-based sample of five parent-child dyads (average age of child = 32 months) participated in the parent-training protocol; half of the intervention sessions included a 15-min parent-support component. The addition of the parent-support component increased parent engagement, treatment integrity, and learned parenting skills, like parent praise. Results support a model of change for parenting behavior. Inclusion of a parent-support component is supported as an effective practice for parent training.
Topics: Autism Spectrum Disorder; Child; Child Behavior Disorders; Child, Preschool; Humans; Parenting; Parents; Problem Behavior
PubMed: 34164759
DOI: 10.1007/s10578-021-01210-w -
Journal of Family Psychology : JFP :... Apr 2022Coronavirus disease (COVID-19) pandemic is an unprecedented challenging time for parents and adolescents. The present study examines the role of parent work-life...
Coronavirus disease (COVID-19) pandemic is an unprecedented challenging time for parents and adolescents. The present study examines the role of parent work-life conflict on adolescent adjustment (i.e., academic engagement and mental health) and family processes (i.e., parental mental health and parenting) as potential mediators for this association. A total of 692 middle school students (53.2% boys; = 13.54 years, = 0.58) and their parents (29.6% fathers and 70.4% mothers; = 44.75 years, = 4.14 years) completed an online survey in May 2020 in Beijing, China. Results indicated that many parents (24.6%) experienced work-life conflicts amid the COVID-19 pandemic. Findings also showed that parent work-life conflict was negatively associated with youth academic engagement and mental health indirectly through parental mental health difficulties and parenting behavior (parental control, autonomy granting, and parental involvement). In addition, parental mental health difficulties had direct and indirect effects on youth adjustment via parenting behaviors, such that parental involvement and autonomy granting predicted greater academic engagement and covitality (co-occurrence of positive traits and positive mental health), whereas the parental control predicted youth mental health difficulties. Our findings extend prior research by examining the pathways linking parental work-life conflict to youth adjustment during COVID-19. Findings are discussed in terms of how to better support families and promote better youth academic engagement and well-being during COVID-19. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Topics: Adolescent; Adult; COVID-19; Child, Preschool; Female; Humans; Infant; Male; Mental Health; Pandemics; Parent-Child Relations; Parenting; Parents
PubMed: 35099233
DOI: 10.1037/fam0000948 -
Journal of Youth and Adolescence Mar 2023Emerging evidence suggests that family members' stress and family interactions vary across days. This study examined the daily associations among parental and adolescent...
Emerging evidence suggests that family members' stress and family interactions vary across days. This study examined the daily associations among parental and adolescent daily stress, parental warmth, and adolescent adjustment with a 30-day daily diary study among 99 ethnically diverse Canadian parent-adolescent dyads (54% White, 23% Asian, 9% multiracial, M= 14.5, 55% female). Multilevel structural equation modeling revealed a negative within-day link between parental daily stress and parental warmth, and positive within-day links between adolescent daily stress and their emotional problems and negative affect. Parental warmth was positively associated with the next day's adolescent positive affect and prosocial behaviors, and explained the cross-day link between parental daily stress and adolescent adaptive outcomes. The findings indicate parent-driven effects in daily family stress processes.
Topics: Humans; Female; Adolescent; Male; Parent-Child Relations; Canada; Parents; Adolescent Behavior; Parenting
PubMed: 36273075
DOI: 10.1007/s10964-022-01691-5 -
Attachment & Human Development Apr 2022Parental reflective functioning (PRF) is a core element in the parent-child relationship. This study set out to investigate changes in PRF following the DUET program,...
Parental reflective functioning (PRF) is a core element in the parent-child relationship. This study set out to investigate changes in PRF following the DUET program, a 12-week group intervention program. We proposed that the DUET intervention would enhance maternal reflective capacities, resulting in better mother-child emotional availability, better child self-regulation, and decreased child behavioral problems. Seventy mothers completed the DUET group intervention. Of these mothers, nine mothers were first allocated to the waiting-list group and thereafter were included in an intervention group. PRF was measured using observation (mind-mindedness) and an interview (PDI). Following the intervention, a significant improvement was evident in PRF, in parental beliefs about feeling, and in parental sense of efficacy. In addition, the mother-child interaction was more positive, child behavioral problems decreased, and child self-regulation increased. This improvement remained stable over a period of 6 months. Clinical and future directions of this study are discussed.
Topics: Female; Humans; Mother-Child Relations; Mothers; Object Attachment; Parent-Child Relations; Parenting; Parents
PubMed: 33939572
DOI: 10.1080/14616734.2021.1919159