Perceptions of Hospitalization by Children with Chronic Illnesses and Siblings

Understanding children’s perceptions of their illnesses and functioning when they are undergoing medical procedures remains an important area for research. Further research about siblings’ perceptions will also provide knowledge about how they are coping with a brother or sister’s chronic illness. The current study examined the perceptions of children with illnesses and their siblings using a play interview. Themes in the data indicated resilience in child functioning for both patients and siblings. Children with chronic illnesses could experience pain, which often related to fears and other negative feelings about hospitalization and potentially doctors or nurses, if they were administering painful procedures. Distraction and prayer were coping tools for patients. However, most patients believed their illness and recovery would be a “long journey.” Brothers and sisters of children with chronic illnesses could experience loneliness. A more common report was a strong desire to help and be a support for a brother or sister with an illness. Support from parents was critical for both patients and siblings and both typically enjoyed child life activities. A member-checking process, with a different group of children with illnesses and siblings, was used to audit themes discovered after reviewing play interviews. The audit process supported the positive and negative themes in the data. In the future, examining the impact of magical thinking on outcomes and conducting studies after the children have gained distance from medical trauma will be important. Moreover, increasing a focus on resilience as a hallmark of children’s functioning remains another area for further research.     

The Role of Maternal Illness Perceptions in Family Functioning in Adolescent Girls with Anorexia Nervosa

Family based treatment of anorexia nervosa (AN) requires heavy parental involvement. To be effective, parents must possess a coherent understanding of the illness and believe that it is treatable. Yet we know little of how parents view the illness, nor whether these views are unique to AN. We examined illness perceptions in AN, how they compare to those of individuals with a serious medical illness, and how they relate to adjustment and coping. Twenty-five girls with AN, 24 girls with Type I diabetes, and their mothers completed measures of family functioning and psychological symptoms. Mothers also completed a measure of illness perceptions. Mothers viewed AN as less chronic, understandable, and controllable than mothers of girls with diabetes viewed their daughter’s respective illness. Such negative cognitions were associated with poor family functioning and maternal and adolescent adjustment. These findings have implications for enhancing family based treatments, as well as for modifying public health messages to reduce the pervasive stigma that influences such unhelpful perceptions about the illness.     

Obsessive-Compulsive Disorder: The Process of Parental Adaptation and Implications for Genetic Counseling

Obsessive-compulsive disorder (OCD) has primarily pediatric onset and well-documented unique impacts on family functioning. Limited research has assessed the understanding that parents of children with OCD have of the etiology of the condition, and there are no data regarding potential applications of genetic counseling for this population. We recruited 13 parents of 13 children diagnosed with OCD from the OCD Registry at British Columbia Children’s Hospital, and conducted qualitative semi-structured telephone interviews to explore participants’ experiences with their child’s OCD, causal attributions of OCD, and perceptions of two genetic counseling vignettes. Interviews were audio-recorded, transcribed, and analyzed using elements of grounded theory qualitative methodology. Analysis revealed key components and contextual elements of the process through which parents adapt to their child’s OCD. This adaptation process involved conceptualizing the meaning of OCD, navigating its impact on family dynamics, and developing effective illness management strategies. Adaptation took place against a backdrop of stigmatization and was shaped by participants’ family history of mental illness and their child’s specific manifestations of OCD. Parents perceived genetic counseling, as described in the vignettes, as being empowering, alleviating guilt and blame, and positively impacting treatment orientation. These data provide insight into the process of parental adaptation to pediatric OCD, and suggest that genetic counseling services for families affected by OCD may help facilitate adaptation to this illness.     

Parents’ reactions to children’s stuttering and style of coping with stress

PurposeThe aim of the research was to determine: (a) how parents react to their child’s stuttering, (b) what stress coping strategies they utilise, as well as (c) whether stress coping style depends on parents’ reaction to their child’s stuttering.MethodsThe research involved 23 mothers and 23 fathers of children who stutter (CWS) at the age of three to six years old. The Reaction to Speech Disfluency Scale (RSDS), developed by the authors, was used in the research. To determine the parents’ coping the Coping Inventory in Stressful Situations (CISS) by N.S. Endler and D.A Parker was applied.ResultsThe strongest reactions are observed on the cognitive level. Stronger cognitive, emotional and behavioural reactions are observed in the mothers towards their disfluently speaking sons and in the fathers towards their daughters. Having analysed the profiles of coping styles, it can be noticed that the task-oriented coping is most frequently adapted by the fathers. The mothers most often use the avoidance-oriented coping. No relevant correlation was observed between the fathers’ coping style and their reactions to the child’s disfluent speech. As far as the mothers are concerned, it has been proved that an increase in behavioural reactions correlates with the avoidance-oriented coping.ConclusionThe cognitive reactions of the parents’ towards their child’s stuttering were most frequent, while the emotional ones were the least frequent. Confronted with a stressful situation, the fathers most often adapt the task-oriented coping, whereas the mothers use the avoidance-oriented coping. Educational objectives: the reader will be able to (1) learn what the key reactions of parents to their children’s stuttering are, (2) describe stuttering as a stress factor for the parents, (3) describe the factors which influence parents’ reactions to their child’s stuttering and their coping style.     

The role of family in adolescents' peer acceptance

The study examined the relative importance of the quality of relationships with parents and grandparents, maternal acceptance and control, the structure of the family, the number of siblings, and adolescents' own attachment style to their perceived peer acceptance. The sample consisted of 300 adolescents (mean age = 15.5) and 300 mothers (mean age = 41.5). Regarding the role of family relationships, the results indicated that only the quality of the mother–child relationship was related to adolescents' peer acceptance. Maternal acceptance and control, however, were unrelated to youth's perceptions of acceptance by peers. Adolescents who had more siblings, lived in a single‐mother family, and were high in anxious attachment reported lower peer acceptance.     

Siblings of Children with disabilities: Psychological and behavioural characteristics

The purpose of the current study was to assess the behavioural and psychological characteristics of siblings of children with disabilities and the perceptions of parents and children regarding sibling relationships. Participants included 32 children between 6 and 13 years of age, one-half with a younger sibling with a disability and one-half with a younger sibling without a disability. Analyses revealed a difference in children's perceptions of maternal partiality, with siblings of children with disabilities perceiving their mothers to be more partial to their siblings than did siblings of children without disabilities. Further, parents of children with disabilities indicated a greater difference in status/power between their child and his/her younger sibling than did parents of children without disabilities. No significant differences were found between groups on measures of behaviour problems, social competence, or self-esteem, supporting other research that has failed to find negative outcomes for siblings of children with disabilities. The implications of these results for parents and professionals are discussed.     

Gender Stereotypes in the Family Context: Mothers, Fathers, and Siblings

Gender stereotypes of children and their parents were examined. Participants included 355 three-year-old children, their one-year-old siblings, and their mothers and fathers. Families were selected from the Western region of the Netherlands. Implicit gender stereotypes were assessed with computerized versions of the Action Inference Paradigm (AIP; both child and parents) and the Implicit Association Test (parent only). Parental explicit gender stereotypes were measured with the Child Rearing Sex-Role Attitude Scale. Findings revealed that mothers had stronger implicit gender stereotypes than fathers, whereas fathers had stronger explicit stereotypes than mothers. Fathers with same-gender children had stronger implicit gender stereotypes about adults than parents with mixed-gender children. For the children, girls’ implicit gender stereotypes were significantly predicted by their mother’s implicit gender stereotypes about children. This association could only be observed when the AIP was used to assess the stereotypes of both parent and child. A family systems model is applicable to the study of gender stereotypes.     

Exploring the Recovery of Non-offending Parents after a Child’s Sexual Abuse Event

A variety of factors influence a child’s recovery from a child sexual abuse (CSA) event including the non-offending parent’s role in the healing process of their child. The purpose of this study was to gain a better understanding of how non-offending parents recuperate from a CSA occurrence. By better understanding non-offending parents’ perspectives related to the healing process, health professionals can provide effective supports, programs, and services. We recruited and conducted in-depth qualitative interviews with 16 non-offending parents to explore their risk factors, protective factors, stressors, coping strategies, and perceptions of healing following their child’s sexual abuse event. We also invited parents to contribute specific ideas to improve programs and services offered to families of sexual abuse served by a child advocacy center located in an urban pediatric hospital. Our findings included five themes: (1) a variety of emotions are present; (2) family context influences recovery; (3) coping is different for everyone; (4) navigating the justice system is frustrating; and (5) healing is a process. The results of our study revealed that the non-offending parents that were managing their child’s sexual abuse event more productively were further along in the healing process (as compared with their counterparts) and had successfully processed their emotions, described less chaos in their family unit, employed positive coping strategies, and had found a way to move forward and accept a “new normal”. The findings of our study can be used to promote recovery and provide better services to non-offending parents following a CSA event.

     

Family Functioning and Coping Behaviors in Parents of Children with Autism

We analyzed family dynamics and coping behaviors of parents with a child with an autistic spectrum disorder. Previous research suggests that moderate levels of cohesion and adaptability are associated with higher levels of positive coping, and that the more coping strategies a family implements, the greater their satisfaction with family functioning. Using a family systems approach, the relationships among the familial variables of cohesion, adaptability, and social support were evaluated for their contributions to coping in the family unit. We also compared the responses of mothers and fathers. Surprisingly, for these parents of children with autism, those who rated their family as enmeshed implemented more positive coping strategies than did those from other cohesion styles. This finding suggests that the enmeshed style may be more adaptive for a family that encounters extreme challenges. Notably, mothers and fathers agreed on all variables except for perception of social support from family and friends. Mothers perceived more social support from family and friends. The results lead to several interesting suggestions for future research.     

Coping Strategies and Resolution in Mothers of Children With Cerebral Palsy

“Parental resolution” represents parents coming to terms with their child’s health condition. Differences in the use of coping strategies between mothers who were resolved versus unresolved to their child’s diagnosis was investigated, and a possible moderating effect of these strategies was explored. A strategy aimed at mobilizing the family to acquire and accept help (institutional, formal support) was shown to be a significant moderating variable, in a way that its more frequent use allowed mothers of children with better functional status (but not mothers of children with poorer functional status) to reach resolution.     

Resources for resilient caregiving by parents of children with schizophrenia in Swaziland: A multiple case study

This study reports on the care-provisioning experiences of parents (n = 6; females = 5) raising children with schizophrenia in a rural Swazi setting. The parents were individually interviewed at their homes on caregiving aspects such as burden, coping, quality of life, expressed emotions and social support of their child with schizophrenia. Data were thematically analysed. Parent carers of children with schizophrenia reported to have personal resources for resilient caregiving such as motivation for caring, and caregiving satisfaction. They perceived compassion gains from improved quality of life for their children through the caregiving experiences. Findings suggest a need for public mental health education and provision of welfare support of parents’ personal resources for resilient caregiving.     

Children of Mentally Ill Parents Participating in Preventive Support Groups: Parental Diagnoses and Child Risk

In the Netherlands, preventive support groups are offered to children of mentally ill parents. Given the variety of parental diagnoses it might be questionable if offering a standardized program for all these children is the most effective response. While no overall knowledge exists about the type of parental disorder and varying risk levels and support needs among the participating children, we examined whether there are differences between these children that are related to their parents’ diagnoses. With questionnaires we assessed risk factors in 122 mentally ill parents and their children: high parental illness severity, low perceived parental competence, parent–child interaction problems, poor family functioning, difficult child temperament, and low child competence. We also assessed the children’s psychosocial problems and negative cognitions about their parent’s illness. Results showed that most parents had co-morbidity (multiple diagnoses) and/or personality disorders. Children of parents with either of these conditions were more likely to be exposed to the risk factors: high parental illness severity, low perceived parental competence, problematic parent–child interaction, and low perceived child competence, compared to children of parents without these conditions. They were also faced with more risk factors and had more psychosocial problems and negative cognitions. From these results we may conclude that children of parents with co-morbidity and/or personality disorders require more extensive support than children of parents without these conditions. We suggest strengthening the children’s competence and involving parents as important focuses of preventive interventions for children at high risk. Longitudinal studies should test these assumptions.     

Change in the Psychological Adjustment of Children with Cystic Fibrosis or Sickle Cell Disease and Their Mothers

Objectives: This study has three interrelated objectives: (1) to track the adjustment of children and adolescents with sickle cell disease (SCD) or cystic fibrosis (CF) and their mothers through a third assessment point 2 years after the initial assessment; (2) to determine whether the adaptational processes of the transactional stress and coping model associated with adjustment at the initial assessment continue to be associated with adjustment 2 years later; and (3) to determine whether the pattern of association of adaptational processes with adjustments differs by illness subgroup. Methods: The study samples included 59 children with CF and 50 children with SCD and their mothers. Measures were obtained on maternal adjustment and appraisals of daily and illness stress, coping methods, and family functioning. Child measures included child-reported and mother-reported child adjustment and child perceptions of self-worth and health locus of control and pain coping methods. Results: Consistency in adjustment classification was only 31–32% for child self-report, 66% for mother-reported child behavior problems, and 56–77% for mother self-reported adjustment for the CF and SCD groups, respectively. Support was provided for the association of adaptational processes with maternal adjustment and with the adjustment of children with SCD but not for children with CF. Conclusion: The stability of adjustment has implications for prevention and treatment intervention and subsequent research steps. Intervention efforts should be focused on the relatively small subgroups of children with chronic illnesses and their mothers with consistently poor adjustment.     

Motivational Antecedents and Consequences of the Mother–Adolescent Communication

Communication between parents and their children represents an important factor of family socialization. Nevertheless, little is known about why parents communicate in different ways and how these qualitative differences in parent–child communication may affect the child. Building on self-determination theory, the present study focuses on motivational antecedents of need-supportive communication as a function of parental child-related beliefs (i.e., long-term goals that parents have set for their children’s future, and parental child-related behavior expectations in terms of parental dissatisfaction or satisfaction with child behavior). Moreover, the effect of perceived need-supportive communication on children’s prosocial behavior and (externalizing and internalizing) behavioral difficulties will be addressed. Three waves of data from 1125 mothers and adolescents aged between 10 and 17 years were analyzed using growth-curve modeling. We found linearly increasing trajectories in extrinsic parental goals for children and dissatisfaction with child behavior, and decreasing trajectories of need-supportive communication. Individual differences do not vary significantly over time. In addition, holding extrinsic parental goals for children positively predicts parents’ dissatisfaction with their child’s behavior and negatively predicts need-supportive communication. Parents’ dissatisfaction with their child’s behavior also contributes to decreasing need-supportive communication. As expected, need-supportive communication predicts prosocial behavior and externalizing behavioral difficulties. When need-supportive communication decreases over time, both externalizing and internalizing behavioral difficulties increase. Furthermore, the effect of mothers beliefs on adolescents socioemotional development was mediated through perceived mother’s communication quality. These results suggest that parental child-related beliefs are important motivational antecedents of parent–child communication that may prevent behavioral difficulties.     

Adaptation of Child's Report of Parent Behavior Inventory for a Spanish population

This study presented an adaptation in Spanish of the Child's Reports of Parental Behavior Inventory (CRPBI) . The CRPBI is an instrument that allows us to assess family discipline perceived by children in the relation with their mothers and with their fathers. It's considered a good instrument to assess the perceptions that children have of parent behavior. The Spanish adaptation has been carried out with a sample of 1,274 Spanish adolescents (males and females) from different educational centers of the Valencian Community (13-18 years). The results show that affect, support and control are the main dimensions in the perceived child rearing styles of parents in our population.     

Father and mother contributions to family functioning when the child has a mental delay

Less is known about the father's than the mother's role in family adaptation to children with disabilities. The purpose of this study was to examine relationships of both father and mother use of coping strategies and perceptions of the child with measures of family functioning style. Subjects were 26 families of 30-month-old children with a mental delay and a comparison group of 26 families of same-aged children with no delay. Functioning style for study families showed a balance of cohesion and adaptability; comparison families were more chaotically flexible on the adaptability scale. Mothers and fathers agreed on family functioning style. Study parents made the greatest use of external coping strategies, while in both groups mothers used more external and fathers more internal coping strategies. Relationships between coping and family functioning varied by parent and by group. Results suggest the need for further exploration of the separate needs of fathers and mothers in maintaining balanced family functioning.     

Parental Perceived Control and Social Support: Linkages to Change in Parenting Behaviors During Early Adolescence

Prior studies have found that parents’ perceptions of control over their lives and their social support may both be important for parenting behaviors. Yet, few studies have examined their unique and interacting influence on parenting behaviors during early adolescence. This longitudinal study of rural parents in two‐parent families (N = 636) investigated (a) whether perceived control and social support when their youth were in sixth grade were independently or interactively associated with changes in parenting behaviors (discipline, standard setting) and parent–child warmth and hostility 6 months later and (b) if these linkages differed by parent gender. We also investigated the interactive links between perceived control, social support, and parenting. Specifically, we tested if parents’ perceived control moderated the linkages between social support and parenting and if these linkages differed by parent gender. Greater perceived control predicted more increases in parents’ consistent discipline and standard setting, whereas greater social support predicted increases in parent–child warmth and decreases in parent–child hostility. Parental perceived control moderated the effect of social support on parental warmth: For mothers only, social support was significantly linked to parent–child warmth only when mothers had low (but not high) perceived self‐control. The discussion focuses on reasons why perceived control and social support may have associations with different aspects of parenting and why these might differ for mothers and fathers.     

The Influence of Race and Income on Community Mothers’ Acceptance of Child Management Methods

The consideration of diverse family factors on parents’ acceptance of behavioral parent training (BPT) components aids in the development and delivery of culturally sensitive parenting programs. Perceptions of acceptability are particularly important to investigate among low-income and racial-minority families, as they are less likely to engage in nonadapted BPT programs. Therefore, the current study examines the synergistic effects of race and income on mothers’ acceptance of five common child management methods relevant to BPT. The relationship between mothers’ acceptability ratings and self-reported parenting practices was also explored. Participants were 106 White and Black mothers from different income levels who completed measures related to the acceptability of response cost, positive reinforcement, time-out, spanking, and medication. The results indicated that mothers from varying backgrounds differed in their acceptance of child management methods, particularly with regard to corporal punishment. Additionally, a relationship was found between parents’ acceptability ratings and their self-reported parenting behavior. The findings support the consideration of parents’ perceptions of child discipline methods when recommending and delivering BPT programs to diverse parents.     

Discrepancies Between Parent and Adolescent Beliefs About Daily Life Topics and Performance on an Emotion Recognition Task

Parents and children and adolescents commonly disagree in their perceptions of a variety of behaviors, including the family relationship and environment, and child and adolescent psychopathology. To this end, numerous studies have examined to what extent increased discrepant perceptions—particularly with regard to perceptions of the family relationship and environment—predict increased child and adolescent psychopathology. Parents’ and children and adolescents’ abilities to decode and identify others’ emotions (i.e., emotion recognition) may play a role in the link between discrepant perceptions and child and adolescent psychopathology. We examined parents’ and adolescents’ emotion recognition abilities in relation to discrepancies between parent and adolescent perceptions of daily life topics. In a sample of 50 parents and adolescents ages 14-to-17 years (M?=?15.4 years, 20 males, 54 % African-American), parents and adolescents were each administered a widely used performance-based measure of emotion recognition. Parents and adolescents were also administered a structured interview designed to directly assess each of their perceptions of the extent to which discrepancies existed in their beliefs about daily life topics (e.g., whether adolescents should complete their homework and carry out household chores). Interestingly, lower parent and adolescent emotion recognition performance significantly related to greater parent and adolescent perceived discrepant beliefs about daily life topics. We observed this relation whilst accounting for adolescent age and gender and levels of parent-adolescent conflict. These findings have important implications for understanding and using informant discrepancies in both basic developmental psychopathology research and applied research in clinic settings (e.g., discrepant views on therapeutic goals).     

The Effects of Parental Depressive Symptoms,Appraisals, and Physical Punishment on Later Child Externalizing Behavior

Examined a cognitive-behavioral pathway by which depressive symptoms in mothers and fathers increase risk for later child externalizing problem behavior via parents’ appraisals of child behavior and physical discipline. Participants were 245 children (118 girls) at risk for school-age conduct problems, and their parents and teachers. Children were approximately 3 years old at Time 1 (T1) and 5 ½ years old at Time 2 (T2). At T1, mothers and fathers reported their depressive symptoms, perceptions of their child’s reciprocal affection and responsiveness, frequency of physical punishment, and child externalizing problems. Mothers, fathers, and teachers provided ratings of externalizing behavior at T2. Structural equation modeling revealed that parents’ negative attributions mediated positive relations between their depressive symptoms and frequency of physical punishment for both fathers and mothers. More frequent physical punishment, in turn, predicted increased child externalizing behavior at T2. In future research, transactional mechanisms underlying effects of clinical depression on child conduct problems should be explored at multiple stages of development. For parents showing depressive symptoms, restructuring distorted perceptions about their children’s behavior may be an important component of intervention programs.