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Comparing stress levels of parents of children with cancer and parents of children with physical disabilities.

AIM: To evaluate whether parental stress differs between parents of children with physical disabilities and parents of children with cancer. METHODS: Parents (92 with disabled children and 89 with children with cancer) were recruited to complete the measures of the Parenting Stress Index/Short Form. RESULTS: Diagnostic group differences were found across the parenting stress measures used in this study. The parents of children with cancer experienced significantly higher levels of stress compared with the parents of disabled children. The mean scores of each subscale (PD, PCDI, and DC) and total score scales in both groups approached were above the 90th percentile of Abidin's normative sample (PD = 36, PCDI = 27, DC = 36, Total = 91), except for the PD and DC subscales in the disabled children group, which approached the 90th percentile. CONCLUSION: The results of the study suggest that most of the parents in our sample should be referred for more in-depth diagnostic study and professional counseling in stress management. Therefore, a normative score on the PSI/SF for Taiwanese parents with healthy children should be established to identify whether differences exist between parents whose children are healthy and those whose children have been diagnosed with a chronic illness.

Adolescent↗

The relationship between parental factors at infancy and parent-reported control over children's eating at age 7.

The objective of this study was to determine predictors of parental control over children's eating. Data were obtained from 135 children and their parents from the Stanford Infant Growth Study. Assessments were obtained from parents at their child's birth and age 7. Parental body dissatisfaction at their child's birth predicted pressure to eat for both sons and daughters. In addition, minority status, parent being born outside of the United States, and a mother's early return to work predicted parental pressure to eat for sons. For daughters, an early maternal pushy feeding style also predicted parental pressure to eat. Parental hunger, a parental history of eating disorders and parent being born outside of the United States predicted food restriction for daughters. There were no predictors of food restriction for sons. We concluded that parental control appears not always to be simply a reaction to a child's lack of self-control or overweight, but may be present before such issues arise, particularly with the presence of certain cultural factors.

Attitude↗

Investigating parental preferences regarding the development and implementation of a parent-directed drug-related educational intervention: an exploratory study.

Strengthening parents' capacity to reduce children's risk of alcohol, tobacco and other drug-related harm is recognised as an important public health strategy in Australia, but engaging parents' involvement in these training programs is known to be challenging. This study utilised a self-complete questionnaire and structured small group discussions with parents in order to identify their needs in terms of communicating with their children about drinking alcohol and smoking cigarettes. It also investigated their preferences regarding the nature of a parent drug education intervention as well as strategies to recruit and actively engage them in parent-directed interventions. Parents identified numerous barriers to their participation in such programs and reported any intervention targeting them should be able to be completed in their home, be non-judgemental, easy to read, time-efficient, easy to use, fun, colourful and interactive. Parents recommended practical communication skills (such as how to talk with children, how to raise the topic and what topics to talk about) be addressed in the intervention. They also recommended a range and combination of strategies to promote and maintain parent involvement, such as providing small rewards for the children of parents who participate. Despite some limitations, the findings of this study contribute important practical knowledge regarding how to recruit, engage and retain higher percentages of parents in parent training programs.

Adolescent↗

Children's responses to low parental mood. II: Associations with family perceptions of parenting styles and child distress.

OBJECTIVE: In an earlier article (part 1) the authors identified four patterns of children's responses to parental low mood: Active Empathy, Emotional Overinvolvement, Indifference, and Avoidance. They then hypothesized that these response patterns were related to parenting styles and to discrepancies in family members' perceptions of parenting and child mental distress. METHOD: A normal population sample of 990 twelve-year-old Finnish children and their mothers (843) and fathers (573) was used. Within-family multivariate analyses conducted in mother-father-child triads (470) were used to examine whether quality of parenting varied according to children's responses and whether parents' and children's perceptions of parenting and child distress were different. RESULTS: Children in the Active Empathy and Indifference groups experienced more positive parenting than those in the other two groups. Discrepancies in family members' perceptions of child distress and mothering and fathering were especially characteristic of the Emotional Overinvolvement group. Typical for the Avoidance group was a within-family agreement on poor parenting and severe child distress. CONCLUSIONS: Children's response patterns as regards parental low mood are related to family dynamics. The study suggests that discrepancies in parents' and children's perceptions of parenting and child distress can be meaningful in understanding family interactions and child development and well-being.

Adult↗

Sending parents outpatient letters about their children: parents' and general practitioners' views.

Parents' cooperation is essential to ensuring implementation of effective healthcare management of children, and complete openness should exist between paediatricians and parents. One method of achieving this is to send parents a copy of the outpatient letter to the general practitioner (GP) after the child's outpatient consultation. To determine the views of parents and GPs a pilot survey was conducted in two general children's outpatient clinics in hospitals in Newcastle upon Tyne. In March and April 1991 a postal questionnaire was sent to 57 parents of children attending the clinics, and a similar questionnaire to their GPs to elicit, respectively, parents' understanding of the letter and perception of its helpfulness, and GPs' views on the value of sending the letters to parents. Completed questionnaires were received from 34(60%) parents and 47(82%) GPs; 26(45%) respondents were matched pairs. 27(79%) parents said they understood all of the letter, 19(56%) that it helped their understanding, 32(94%) felt it was a good idea, and 31(91%) made positive comments. In all, 29(61%) GPs favoured the idea and six (13%) did not. Eleven (23%) said they would be concerned if this became routine practice, and 20(74%) of the 27 providing comments were doubtful or negative; several considered that they should communicate information to parents. The views in the matched pairs were dissimilar: parents were universally in favour whereas many GPs had reservations. The authors concluded that sending the letters improved parents' satisfaction with communication, and they recommend that paediatricians consider adopting this practice.

Adult↗

A comparison of mothers' and fathers' experience of parenting stress and attributions for parent child interaction outcomes.

Parents of children with disabilities are vulnerable to parenting stress, which may place them at physical and psychological risk. However, it is not clear whether fathers experience stress differently to mothers, or whether their experiences are reported less frequently. Additionally, there is little reported on the relationships and gender differences between mothers' and fathers' attributions for parent child interaction outcomes. Parenting stress was assessed in this study using Abidin's (1990) Parenting Stress Index (PSI), and parenting attributions were assessed using the original (Bugental et al., 1989; Bugental and Shennum, 1984), and modified versions of the Parenting Attribution Test, also known as the Child Interaction Survey (CIS) (M-CIS: Esdaile and Greenwood, 1995b). Participants were 53 mothers and 25 fathers of children with disabilities. Having a child with a disability was associated with elevated scores on the PSI; some gender differences were found. Only one significant outcome was found on the assessment of parenting attributions. Thus, the findings suggest that further research is indicated to explore differences in mothers' and fathers' experiences of parenting stress, and the assessment of parenting attributions. The fact that having a child with a disability was associated with elevated scores on the PSI for both mothers and fathers indicates the importance of considering stress management as an integral part of occupational therapy programmes that involve parents of children with special needs. Therapists also need to consider possible gender differences when planning stress management programmes including both mothers and fathers of children with disabilities.

Adult↗

Parent-youth discrepancy in the assessment and treatment of youth in usual clinical care setting: consequences to parent involvement.

BACKGROUND: Involving parents in the treatment of youth referred for mental health problems is an important agenda. Parent involvement is associated with treatment retention, greater family participation, and positive outcomes. The main goal of the present study was to examine the role of youth and parent report of the youth's psychopathology and interpersonal problems on parent involvement in outpatient treatment of the youth. METHODS: Data were gathered from 63 referred youth in treatment in an outpatient clinic. Subjects reported the youth's interpersonal problems and problem syndromes. The direct account of the youth and parents was examined for association with two indices of parent involvement, namely, the mothers' behavioral involvement (BI) and personal emotional involvement (PEI) in the treatment process. RESULTS: Results showed that while direct reports of the youth and parents were not significant predictors of parent involvement, discrepancy scores predicted parent involvement. Further, there were twice as many scales of interpersonal problems that were related to parent involvement as the syndrome scales. CONCLUSION: The ability of discrepancy scores in predicting parent involvement underscores that it is not only a risk factor for later development of adverse outcomes, but also related with essential treatment processes. Clinicians may be able to address these issues and aid in treatment processes leading to desired outcomes.

Adolescent↗

Parent-child closeness affects the similarity of drinking levels between parents and their college-age children.

College males reported drinking more frequently and in higher amounts than females. Correlations between quantity-frequency (QF) indices of drinking by parents and by their college-age children showed the greatest similarity between fathers and sons. Log linear analyses compared each parent's drinking level against each of three other factors that might affect the QF levels of college-age children: the relationship between parent and child, the effect of the parent's drinking on the parent, and how the parent's drinking affected their treatment of the child. The results supported models in which the relationship of each parent's drinking to the QF levels of both sons and daughters was affected by the closeness of the parent-child relationship. However, there was no support for models involving how each parent's drinking affected that parent or how each parent's drinking affected their treatment of the child.

Adolescent↗

Adolescent-parent relations in Hong Kong: parenting styles, emotional autonomy, and school achievement.

This 4-phase study of Hong Kong Chinese adolescent-parent relationships (906 adolescents and 1,091 parents) revealed the following: (a) Adolescents and their parents differ in their perceptions of parenting style. (b) Autonomy is negatively associated with parents' perceived authoritative parenting style and school achievement. (c) Neither parenting style nor measures of parents' beliefs in training their children (R. Chao, 1994) are associated with self-reports of school achievement. However, (d) parents of students from the highest (Band 1) academically oriented schools in Hong Kong rated themselves as higher in authoritativeness and lower in authoritarianism than parents of adolescents from the lowest academically oriented (Band 5) schools. Findings are discussed in relation to posited differences in adolescent-parent relationships in Western and Chinese cultures.

Achievement↗

Family socialization of adolescent's self-reported cigarette use: the role of parents' history of regular smoking and parenting style.

OBJECTIVE: To examine the main and interactive effects of parental history of regular cigarette smoking and parenting style on adolescent self-reported cigarette use. METHODS: Predictors of adolescent self-reported cigarette use, including parents' history of regular cigarette smoking and two dimensions of parenting behavior, were analyzed in a sample of 934 predominately Caucasian (96.3%) parent-adolescent dyads. Families were drawn from the control group of a randomized control trial aimed at preventing adolescent substance use. RESULTS: In addition to the main effects of parents' history of regular smoking and parental warmth, logistic regression analysis revealed that the interaction of these two variables was associated with adolescent self-reported cigarette use. Parental warmth was associated with a decreased likelihood of the adolescent ever having smoked a cigarette; however, this was true only if neither parent had a history of regular cigarette smoking. CONCLUSIONS: Findings suggest that adolescent smoking prevention programs may be more efficacious if they address both parental history of regular smoking and parenting behavior.

Adolescent↗

The relation between the absolute level of parenting and differential parental treatment with adolescent siblings' adjustment.

BACKGROUND: The present study extends existing studies on the role of differential parental treatment in explaining individual differences in adolescent problem behaviors above the absolute level of parenting and clarifies the function of gender of the child, birth rank and gender constellation of the sibling dyads. METHOD: The absolute level of parenting practices and differential treatment were examined in a sample of 288 Dutch families consisting of two parents and two adolescents. Parents reported on adolescent internalizing and externalizing problem behavior and adolescents reported on parental warmth and coercive control. RESULTS: Parenting dimensions were related to problem behavior for same- and mixed-gender sibling pairs, with coercive control as the strongest predictor. No direct association was found between differential parental treatment and child outcomes above the absolute levels of parenting in same-gender sibling pairs. However, differential maternal and paternal control was related to internalizing behavior of girls and differential paternal warmth was linked to externalizing behavior of the older siblings in mixed-gender sibling pairs. CONCLUSION: Differential parental treatment is uniquely associated with child problem behavior above the absolute level of parenting for girls and early-born children in mixed-gender sibling pairs. Any examination of the effects of differential treatment should not be undertaken without considering the gender and birth rank of the sibling pairs.

Adolescent↗

Parent education: an evaluation of STEP on abusive parents' perceptions and abuse potential.

PROBLEM: To examine the effects of a structured, time-limited parent training group on abusive or potentially abusive parents. METHODS: A pretest-posttest control group design was used with consenting parents (N = 18) to examine the effects of Systematic Training for Effective Parenting (STEP) on abusive parents' perceptions of their children's behaviors and on the parents' potential to physically abuse. The Adlerian Parental Assessment of Child Behavior Scale and the Child Abuse Potential Inventory were used to measure treatment effects. FINDINGS: After participating in STEP, abusive parents had significantly more positive perceptions of their children and were significantly less potentially abusive. Using volunteers, the project cost an average of $100 for each parent. CONCLUSIONS: The research lends empirical support to individual psychology and family systems theory. Future research is indicated using larger samples to examine lay vs. professional leadership of the groups, as well as comparisons of different parenting programs with abusive parents.

Adult↗

Training programme for parents of teenagers: active parental participation in development and implementation.

In Sweden, all new parents should be offered parental training, but up until now, the programmes have been provided only within maternity and child healthcare, and they have been initiated and planned by central public authorities. We describe the process whereby a training programme for parents of teenagers was developed, in co-operation with the parents themselves, and we report the results of a brief questionnaire survey to the participating parents. A 'parents' school' was planned by 36 parents and a project leader, and between 14 and 26 parents participated in four planning meetings. Four lecture evenings, including group discussions, were arranged, a total of 105 parents registered their interest in participating, and between 50 and 70 attended each lecture. The majority of the parents reported being basically satisfied, feeling that they had acquired knowledge and insights about the teenage phase, and they wanted the 'parents' school' to continue.

Adolescent↗

Authoritative parenting and drug-prevention practices: implications for antidrug ads for parents.

This research employed the theory of reasoned action to investigate the role of authoritative parenting in 3 drug-prevention behaviors: (a) parental monitoring, (b) parent-child discussions, and (c) awareness of the child's environment. A phone survey of 158 parents of adolescents in 7th, 9th, and 11th grades revealed that authoritative parenting was correlated with parenting practices that reduce the likelihood of adolescent drug use, including discussing family rules about drugs, discussing strategies to avoid drugs, discussing those in trouble with drugs, parental monitoring, knowing the child's plans for the coming day, and personally knowing the child's friends well. Additionally, authoritative parenting moderated the attitude-behavioral intention relation for parental monitoring and awareness of the child's environment, with the weakest relation detected for low-authoritative parents. The utility of these findings in helping design and target antidrug messages for parents more effectively is discussed.

Adolescent↗

The impact of parental borderline personality disorder on vulnerability to depression in children of affectively ill parents.

Children of parents with major depressive disorder (MDD) are four to six times more likely than other children to develop MDD. Little research has examined whether comorbid parental diagnoses further increase children's risk. This study examines whether children of parents with comorbid MDD and Borderline Personality Disorder (BPD) (1) are at greater risk for experiencing depressive symptoms and/or episodes and (2) whether such increased risk may be due, in part, to their exhibiting higher levels of cognitive/interpersonal vulnerability factors. Children (n = 140; ages 6-14) of parents with MDD completed measures assessing cognitive/interpersonal vulnerability factors. Parents completed semi-structured clinical interviews assessing severity of current depressive symptoms and BPD. Both children and parents completed a semi-structured clinical interview assessing the child's current and past history of MDD. Children of parents with comorbid MDD and BPD exhibited higher levels of current depressive symptoms and higher levels of cognitive/interpersonal vulnerability factors than children of parents with MDD but no BPD, even after controlling for parents' current levels of depressive symptoms. The relationship between parental BPD and chil-dren's current levels of depressive symptoms was partially mediated by children's cognitive/interpersonal vulnerability factors. Last, children of parents with comorbid BPD and MDD were 6.84 times more likely to exhibit a current or past diagnosis of MDD.

Adolescent↗

To whom do inner-city minors talk about their pregnancies? Adolescents' communication with parents and parent surrogates.

A study of 334 black, urban teenagers who sought pregnancy tests in two Baltimore clinics in 1985-1986 explored communication between the teenagers and their parents or parent surrogates before the pregnancy test visit and, among those whose test results were positive, before the final pregnancy outcome decision. Of these young women, 66% had discussed the possibility that they were pregnant with a parent (usually the mother) or parent surrogate before the test; an additional 6% had turned to another adult. At a follow-up interview a year later, 91% of those whose test results had been positive reported that they had consulted a parent or parent surrogate before deciding what to do about the pregnancy, and 4% had confided in another adult. The probability that an adolescent would consult a parent before deciding what to do about her pregnancy was higher if she was younger, if she lived with the parent and if she found the parent easy to talk to. A year after the pregnancy test, 88% of the adolescents who had given birth or had had an abortion were satisfied with their pregnancy outcome. Satisfaction was not related to whether the young woman had discussed her decision with a parent. Dissatisfaction was most likely if the parent did not support the final outcome, if someone other than the young woman had made the final decision, or if the final outcome was different from the adolescent's preference at the time of the pregnancy test.

Abortion, Legal↗

Parent expectations for antibiotics, physician-parent communication, and satisfaction.

OBJECTIVES: To explore how parents communicate their preferences for antibiotics to their child's physician and to examine whether physicians can communicate why antibiotics are not being prescribed in a way that maintains satisfaction with the visit. DESIGN: Previsit survey of parents, audiotaping of the study encounters, and a postvisit survey of parents and physicians. SETTING: Two private pediatric practices. PARTICIPANTS: Ten physicians (response rate = 77%) and a consecutive sample of 295 eligible parents (response rate = 86%) who attended acute care visits for their children between October 1996 and March 1997. MAIN OUTCOME MEASURES: Physician-perceived pressure to prescribe antibiotics and parental visit-specific satisfaction. RESULTS: Fifty percent of parents expressed a previsit expectation for antibiotics. Among these parents, only 1% made a direct verbal request for them. Even when no direct requests for antibiotics were made, physicians still perceived an expectation for antibiotics 34% of the time. Among parents who did not receive expected antibiotics, those offered a contingency plan from the physician (i.e., the possibility of receiving antibiotics in the future if their child did not get better) had a higher mean satisfaction score than parents not receiving a contingency plan (76 vs. 58.9; P<.05). CONCLUSION: Physicians should consider providing a contingency plan to parents who expect antibiotics for their children when there is no clinical indication. Further study is needed to determine how parents indirectly communicate their desire for antibiotics and what additional communication techniques physicians can use to resist the overprescribing of antibiotics.

Adolescent↗

Parent identification of early emerging child behavior problems: predictors of sharing parental concern with health providers.

OBJECTIVES: To better understand the predictors of parental discussions with pediatric care providers (pediatricians, psychologists/psychiatrists, social workers, early intervention providers, or other medical specialists) regarding early child behavior problems and to suggest strategies for eliciting early identification from parents in health care settings. DESIGN: A cross-sectional survey of parents of children from a representative healthy birth cohort. The survey included the Infant-Toddler Social Emotional Assessment, measurement of parental worry regarding problematic behavior, and demographic factors. SETTING: Fifteen urban and suburban towns in the northeastern United States. PARTICIPANTS: The study sample consisted of all parents of 11- to 39-month-olds (n = 269) who exceeded the 90th percentile on 1 or more Infant-Toddler Social Emotional Assessment problem domain scores (representing elevated problematic behavior symptoms) from an original sample of 1278. RESULTS: Few parents (17.7%) who reported elevated problematic behavior spoke to a provider about such problems. In adjusted models, speaking to a provider was associated with reported worry about behavior (odds ratio [OR], 3.47 [95% confidence interval (CI), 1.74-6.92]) and with low reported child social-emotional competence (OR, 2.68 [95% CI, 1.23-5.84]). In adjusted models, worry was most likely among parents who reported low child competence (OR, 2.18 [95% CI, 1.07-4.22]) and disruption in family routines attributed to the child's behavior (OR, 2.38 [95% CI, 1.31-4.33]). CONCLUSIONS: Parental worry is a robust predictor of help seeking among parents of children with behavioral problems. Further, lags in social competence contribute to both parental worry and help seeking. These findings, in conjunction with previous evidence that child behavior problems amenable to early intervention are often unidentified, suggest that systematic inquiry by health care providers about parental concerns is important in the identification of early emerging behavioral health problems.

Adult↗