Parentification,Stress, and Problem Behavior of Adolescents who have a Parent with Mental Health Problems

When adolescents live with a parent with mental illness, they often partly take over the parental role. Little is known about the consequences of this so‐called parentification on the adolescents' internalizing and externalizing problems. This survey study examined this effect cross‐sectionally and longitudinally in a sample of 118 adolescents living with a parent suffering from mental health problems. In addition, the study examined a possible indirect effect via perceived stress. Path analyses were used to examine the direct associations between parentification and problem behavior as well as the indirect relations via perceived stress. The results showed that parentification was associated with both internalizing and externalizing problems cross‐sectionally, but it predicted only internalizing problems 1 year later. An indirect effect of parentification on adolescent internalizing and externalizing problems via perceived stress was found, albeit only cross‐sectionally. These findings imply that parentification can be stressful for adolescents who live with a parent with mental health problems, and that a greater awareness of parentification is needed to prevent adolescents from developing internalizing problems.     

The Role of Parental and Adolescent Attributions in Adjustment of Adolescents with Chronic Illness

Previous literature has demonstrated the separate contributions of parental attributions and adolescent attributions to psychosocial adjustment of adolescents with chronic illness. However, it is unknown whether parental attributions affect adolescents' mental health directly or indirectly by influencing the youths' attributional style. This study evaluated the direct and indirect (through adolescent attributions) effects of parental attributions on internalizing and externalizing problems of adolescents with chronic illness. Adolescents (N?=?128; M?=?14.7?years) diagnosed with cystic fibrosis or diabetes and their caregivers completed measures of attributional style and adolescent adjustment. Parents' optimistic attributions were associated with fewer adolescent internalizing and externalizing problems. These effects were partly mediated by adolescent attributions. These results suggest that targeting both adolescent and parent attributions may be important for improving adolescents' adjustment to a chronic illness.     

Socioeconomic Status and Child Mental Health: The Role of Parental Emotional Well-Being and Parenting Practices

This study examined the role of parental emotional well-being and parenting practices as mediators of the association between familial socioeconomic status (SES) and child mental health problems. The sample included 2,043 5th-7th graders (50.7 % female) participating in the second wave of the Bergen Child Study. Children completed the Strengths and Difficulties Questionnaire, parents reported family economy and education level, emotional well-being (measured with the Everyday Feelings Questionnaire), and the use of negative disciplinary and affirmative parenting practices (measured using the Family Life Questionnaire). Path analyses were conducted to examine the associations between SES and externalizing and internalizing problems. Results supported a model where family economy was associated with externalizing problems through parental emotional well-being and parenting practices, whereas maternal education level was associated with externalizing problems through negative discipline. The direct association between paternal education level and externalizing problems was not mediated by parenting. For internalizing problems, we found both direct associations with family economy and indirect associations with family economy through parental emotional well-being and parenting. The results suggest that parental emotional well-being and parenting practices are two potential mechanisms through which low socioeconomic status is associated with child mental health problems.     

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.     

Differential Outcomes of Adolescents with Chronically Ill and Healthy Parents

Approximately 10% of children grow up with a parent who has been diagnosed with a chronic medical condition (CMC) and seem to be at risk for adjustment difficulties. We examined differences in behavioral, psychosocial and academic outcomes between 161 adolescents from 101 families with a chronically ill parent and 112 adolescents from 68 families with healthy parents, accounting for statistical dependence within siblings. Children between 10 and 20 years and their parents were visited at home and filled in questionnaires. Multilevel analyses showed that 20–60% of the variance in most adolescent outcomes was due to the family cluster effect, especially in internalizing problem behavior, caregiving variables and quality of parent attachment. Conversely, the variance in stress and coping variables and grade point average (GPA) was mainly due to individual characteristics. Adolescents with parents affected by CMC displayed more internalizing problems than the comparison group and scored higher on frequency of household chores, caregiving responsibilities, activity restrictions, isolation, daily hassles and stress. In addition, their grade point average was comparatively worse. No group differences in externalizing problems, coping skills and quality of parent attachment were found. In conclusion, the family cluster effect largely explains adolescent outcomes and should be accounted for. Adolescents with parents affected by CMC are subject to an increased risk for internalizing problems, adverse caregiving characteristics, daily hassles, stress and a low GPA. According to a family-centered approach, school counselors and health care practitioners should be alert to adjustment difficulties of children with a chronically ill parent.     

Unfolding Relations among Mindful Parenting,Recurrent Conflict,and Adolescents’ Externalizing and Internalizing Problems

The current study examined unfolding relations among mothers’ mindful parenting, parent–adolescent recurrent conflict, and adolescents’ externalizing and internalizing problems. In a community sample of 117 families (31% black, Asian, American Indian, or Latino), parents and adolescents (52% female; average age = 12.13 years) were followed over 15 months. Parents answered questions about mindful parenting and recurrent conflict, and adolescents reported on their own externalizing and internalizing problems. Path analyses indicated that higher levels of mindful parenting were significantly related to lower levels of recurrent conflict 2–3 months later, controlling for previous levels of recurrent conflict. Moreover, lower levels of recurrent conflict were significantly related to lower levels of externalizing problems and internalizing problems 1 year later, controlling for previous levels of those problems. Subgroup analyses indicated that relations were comparable across subgroups defined by adolescent gender, race, parent marital status, and family financial strain. The effects of mindful parenting were robust even after accounting for other indicators of positive and supportive parenting, namely inductive reasoning and warmth in the parent–adolescent relationship. These findings highlight the potential of mindful parenting to improve family interactions and adolescent adjustment.     

Adolescent Family Adversity and Mental Health Problems: The Role of Adaptive Self-regulation Capacities. The TRAILS Study

Adolescent family adversity is a considerable adaptive challenge in an increasingly turbulent developmental period. Using data from a prospective population cohort of 2230 Dutch adolescents, we tested risk-buffering interactions between adolescent family adversity and self-regulation capacities on mental health. We used two adaptive self-regulation capacities that could allow adolescents to manage relatively well with family adversity: (1) parent-reported effortful control, and (2) an attentional flexibility (in this case, set-shifting) task. Adolescent family adversity was associated with internalizing problems and externalizing problems. The risk-buffering effects of effortful control were found for externalizing problems but not for internalizing problems. There were no risk-buffering effects of attentional flexibility on both types of mental health problems. Effortful control is likely to benefit adolescents’ ability to channel their frustrations in adaptive ways in the presence of family adversity. Additionally, (attentional) set-shifting tasks might have a limited predictive value for risk-buffering research.     

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.     

Interparental conflict and adolescent emotional security across family structures

This study investigated whether interparental conflict was differentially related to forms of emotional security (i.e., family, interparental, parent–child) and whether forms of emotional security were differentially associated with mental health problems for adolescents in married versus divorced/separated families. Participants were 1032 adolescents (ages 10–15; 51% male, 49% female; 82% non-Hispanic White, 9% Black/African American, 5% Hispanic, 2% Asian or Pacific Islander, 2% Native American) recruited from a public school in a middle-class suburb of a United States metropolitan area. We used multiple group multivariate path analysis to assess (1) associations between interparental conflict and multiple measures of emotional insecurity (i.e., family, interparental, and parent–child), (2) associations between measures of emotional insecurity and internalizing and externalizing problems, and (3) moderation effects of parent–child relationships. The patterns of association were similar across family structures. A high-quality parent–child relationship did not mitigate the harmful effects of interparental conflict on emotional insecurity or mental health problems. Findings suggest that regardless of family structure, emotional security across multiple family systems may be a critical target for intervention to prevent youth mental health problems, in addition to interventions that reduce conflict and improve parent–child relationships.     

Association Between Socio-Ecological Risk Factor Clustering and Mental,Emotional, and Behavioral Problems in Hispanic Adolescents

Compared to non-Hispanic whites, Hispanic adolescents in the U.S. report higher rates of several mental, emotional, and behavioral problems such as substance use, sexual risk behaviors, and internalizing and externalizing problems. There is evidence of common pathways in the development of mental, emotional, and behavioral problems with certain subgroups of Hispanic adolescents being at greater risk. In the present article, we report analysis of baseline data for 959 Hispanic adolescents who participated in one of two randomized controlled trials evaluating a family-based preventive intervention. Utilizing latent class analysis, we identified subgroups of Hispanic adolescents based on socio-ecological risk and protective factors (e.g., parent–adolescent communication, parental involvement in school). Three distinct socio-ecological risk subgroups (high, medium, and low risk) were identified and exhibited significant differences from each other across a majority of socio-ecological risk and protective factors. Adolescents in higher socio-ecological risk subgroups reported greater mental, emotional, and behavioral problems across all outcomes. Individual comparisons revealed significant differences between the low socio-ecological risk group and both the medium and high socio-ecological risk group in lifetime alcohol use, smoking, and sex, as well as internalizing and externalizing problems. Implications for intervention include focusing on specific risk subgroups and targeting shared risk and protective factors rather than specific mental, emotional, and behavioral outcomes.     

Family Contexts: Parental Experiences of Discrimination and Child Mental Health

Research on the mental health correlates of discrimination traditionally has been intra-individual, focusing exclusively on the individual directly experiencing discrimination. A small number of studies have begun to consider the links between parental experiences of discrimination and child mental health, but little is known about potential underlying mechanisms. The present study tested the independent mediating effects of parent mental health and household socioeconomic status on the associations between parental experiences of discrimination (past-year perceived discrimination and perceptions of being unaccepted culturally) and child mental health (internalizing and externalizing symptoms) using a bootstrapping analytic approach. Data were drawn from racial/ethnic minority (n = 383) and White (n = 574) samples surveyed in an urban Midwestern county. For all measures of discrimination and child mental health, findings supported an association between parental experiences of discrimination and child mental health. Whereas parent mental health served as a significant mediator in all analyses, socioeconomic status did not. Mediation findings held for both the White and racial/ethnic minority samples. Results suggest that parental experiences of discrimination and mental health may contribute to child mental health concerns, thus highlighting the role of family contexts in shaping child development.     

Health-Related Quality of Life and Perceived Need for Mental Health Services in Adolescent Solid Organ Transplant Recipients

The purpose of the current investigation was to assess interest in mental health services among parents of adolescent solid organ transplant recipients and the relationship between parent perceived need for mental health services and patient health-related quality of life (HRQOL). Sixty-three parents rated interest in receiving 10 mental health services, and patient HRQOL ratings were gathered from adolescent transplant recipients and their parents. Ninety-four percent of parents expressed some level of interest in at least one of the proposed services, with over 40 % indicating maximum interest. Parents’ perceived need for mental health services was inversely related to adolescent and parent reports of HRQOL on the behavior, mental health, family cohesion, and parental impact-emotional domains. Results suggest that parents of adolescent solid organ transplant recipients are interested in receiving mental health services for their families. Assessment of need for mental health services and HRQOL may inform the medical team of families requiring intervention.     

The Contributions of Child Behavioral Functioning and Parent Distress to Family Functioning in Pediatric Inflammatory Bowel Disease

The objective of this study was to examine the relative contributions of both parental and adolescent functioning to family functioning in adolescent patients with inflammatory bowel disease (IBD) and their families. Participants were 45 adolescents (27 male, 18 female) 13-17?years old (M?=?15.41?years, SD?=?1.32) with IBD and their parents. Families completed measures of patient behavioral functioning and depression, parent distress and family functioning. Disease severity assessments were completed via data provided by patients' gastroenterologists. Results indicated that parent-reported patient behavioral problems accounted for a significant 26% of variance in family functioning. Post-hoc analysis revealed that externalizing behavior problems accounted for the majority of this variance compared to internalizing behavior problems. These results suggest that externalizing problems may have a more significant impact on these families than previous research indicates. Moreover, externalizing behaviors may significantly impact family adaptation and should be taken into consideration during routine clinical care. Further research is needed to replicate and expand upon these findings.     

Intergenerational Transmission of Emotion Dysregulation Through Parental Invalidation of Emotions: Implications for Adolescent Internalizing and Externalizing Behaviors

We examined parent emotion dysregulation as part of a model of family emotion-related processes and adolescent psychopathology. Participants were 80 parent–adolescent dyads (mean age = 13.6; 79 % African-American and 17 % Caucasian) with diverse family composition and socioeconomic status. Parent and adolescent dyads self-reported on their emotion regulation difficulties and adolescents reported on their perceptions of parent invalidation (i.e., punishment and neglect) of emotions and their own internalizing and externalizing behaviors. Results showed that parents who reported higher levels of emotion dysregulation tended to invalidate their adolescent’s emotional expressions more often, which in turn related to higher levels of adolescent emotion dysregulation. Additionally, adolescent-reported emotion dysregulation mediated the relation between parent invalidation of emotions and adolescent internalizing and externalizing behaviors. Potential applied implications are discussed.     

Protective effect of supportive family relationships and the influence of stressful life events on adolescent adjustment

Abstract

The purpose of this study was to determine the association between the occurrence of stressful life events and internalizing and externalizing problems, and to analyze longitudinally buffering effects of supportive family relationships. To this end, 100 Spanish adolescents were studied twice, when they were in mid-adolescence (15–16 years) and two years later. They completed questionnaires regarding stressful life events, family relationships, and adolescent adjustment. Results showed that high quality parent-adolescent relationships protected boys and girls against the negative consequences of stressful life events on externalizing, but not internalizing, symptoms. The adolescents who enjoyed good relationships with their parents in mid-adolescence did not increase their externalizing problems in late adolescence as consequence of the occurrence of stressful events. However, these stressors did lead to an increase in the number of externalizing problems when the family relationships were of a middle or low quality. These results highlight the important role that supportive family relationships play in the behavioral adjustment of adolescents, protecting them against some negative consequences of stressful life events, and suggest the relevance of supporting parents through resources such as parent education in order to help them to improve their relationships with their adolescents.     

Linking Foster Family Characteristics and Mental Health Symptoms of Youth in Care

Youth in foster care are disproportionately at risk for developing internalizing and externalizing problems (Lawrence et al., 2006); however, a history of maltreatment prior to foster care placement does not automatically result in poor mental health outcomes. Among non-foster care youth, the quality of family interactions has been related to adjustment outcomes, such that low family cohesion and high family conflict is associated with poor mental health symptoms (Caples & Barrera, 2006). While little is known about these constructs in foster care placements, they may help explain the variance in internalizing and externalizing problems for youth in foster care. The present study aimed to examine whether characteristics of the foster care environment (i.e., conflict, cohesion) across various placement types (i.e., traditional foster homes, group-care settings) could help explain the link between previous maltreatment exposure and mental health problems. The sample included 178 youth in foster care (M_age?=?15.18, SD?=?1.76) and their foster caregivers living in the Midwest. Youth participants completed self-report measures about prior maltreatment history, current family environment characteristics, and youth internalizing symptoms. Foster caregivers completed measures on current family environment and youth externalizing symptoms. Results indicated that caregiver report, but not youth report, of family cohesion was negatively associated with youth report of internalizing problems. When examining the indirect effects, youth report of family conflict partially accounted for the link between youth self-report of maltreatment and internalizing symptoms (B?=?0.106, 95% CI?=?0.026–0.186). Caregiver report of family conflict fully accounted for the association between youth self-report of maltreatment and caregiver report of youths’ externalizing symptoms (B?=?0.108, 95% CI?=?0.005–0.211). Findings highlight the importance of utilizing multiple informants when measuring foster family environment and suggest that family conflict is particularly salient for the mental health of youth in foster care.

     

Parent-child conflict and psychological maladjustment: a mediational analysis with reciprocal filial belief and perceived threat

Empirical research has shown that parent–child conflict is positively related to poor adjustment in adolescents; however, the underlying processes have not been adequately examined. To explore the possible mediating pathways, reciprocal filial belief and perceived threat were chosen to represent two likely mechanisms accounting for how parent–child conflict harms adolescents' perceptions of their relationship with their parents and their self‐perceptions within their cognitive‐appraisal framework. The former operates by attenuating children's affection towards their parents and the latter by lowering their self‐perceptions. This study also distinguishes internalizing from externalizing problems in order to examine whether lower reciprocal filial belief more strongly mediates the relation between conflict with parents and adolescents' externalizing problems and whether perceived threat more strongly mediates the relation between conflict with parents and adolescents' internalizing problems. Hypotheses are as follows: (1) the more parent–child conflict adolescents report, the less reciprocal filial belief they recognize, which, in turn, leads to more maladjustments, especially externalizing ones; (2) the more parent–child conflicts adolescents report, the more threat they perceive, which, in turn, leads to more maladjustments, especially internalizing ones. Participants consisted of 603 Taiwanese adolescents (226 males and 377 females) aged 15 to 19 (average age=16.95; SD=0.78). Structural equation modelling analyses confirmed the hypotheses. However, the three direct effects of conflict on internalizing problems, aggression, and deviant behaviour were still significant. In addition, a greater effect of the paternal than the maternal role on the link between conflict and attenuated reciprocal filial belief, and between perceived threat and internalizing problems, was identified. Implications for understanding the mediation processes responsible for all indirect effects, even the subsidiary ones, and the greater impact of conflict with the father than with the mother are discussed. Limitations of the study and considerations for future research are also addressed.     

Children's mental health in times of economic recession: replication and extension of the family economic stress model in Finland

This study evaluated the applicability of the family economic stress model (FESM) in understanding the influences of economic hardship on child mental health during a nationwide economic recession in Finland. The information was gathered from 527 triads of 12-year-olds and their mothers and fathers from a population sample. The structural equation models showed that the FESM fit the data well, indicating its generalizability in Finnish society. The results confirmed that a reduction in disposable family income constitutes a risk for child mental health through increased economic pressure and negative changes in parental mental health, marital interaction, and parenting quality. Controlling the children's prerecession mental health substantiated that economic hardship can lead to deterioration in children's mental health. Alternative models based on fully recursive analyses revealed reciprocal influences between parents and their children over time: Children's prerecession mental health problems predicted compromised parenting, which in turn contributed to children's internalizing and externalizing symptoms during the recession.     

The Social Ecology of Parental Monitoring: Parent–Child Dynamics in a High‐Risk Peruvian Neighborhood

While parental monitoring is understood to protect adolescents from engaging in risk behaviors, little is known about how the family dynamics involved in parental monitoring differ across sociocultural contexts. We sought to gain an in‐depth understanding of parent–child relationship dynamics and parental knowledge of adolescents’ activities in an urban Peruvian neighborhood with high levels of crime and adolescent substance use. We conducted 15 in‐depth interviews and two focus groups with adolescents and 12 in‐depth interviews with mothers sampled from a secondary school in Callao, Peru. Our findings emphasize the importance of parent–child confianza (trust) as a foundation for parental awareness of adolescents’ lives and activities. Participants in our sample characterized confianza as encouraging adolescent disclosure and shaping how parental solicitation and rules were interpreted by adolescents. Participants described how confianza was rooted in features of the parent–child relationship, including shared parent–child time, parental affection, adolescent perceptions of parents’ ability to give good advice, and awareness of how parents would react to delicate topics. Participants linked these family dynamics, in turn, to economic hardship, parental feelings of sacrifice and stress, perceptions of neighborhood risk, and gender norms limiting fathers’ involvement in caregiving. Results have implications for the planning and adaptation of family‐based prevention programs for use in high‐risk contexts in Latin America.     

Are ethnic minority adolescents at risk for problem behaviour? Acculturation and intergenerational acculturation discrepancies in early adolescence

The present study investigated the adjustment of Indian adolescents living in Britain as well as the links between parents' and adolescents' acculturation styles and the adolescents' problem behaviours. The sample consisted of 68 young adolescents (31 Indian and 37 English) between the ages of 10 and 13, and their mothers and fathers. Mothers, fathers and adolescents reported about their own acculturation style, and parents also reported on their adolescents' problem behaviour. Overall Indian adolescents exhibited more internalizing problems than did their English peers. Furthermore, within the Indian group, the more Westernized mothers were in their acculturation style, the higher the level of externalizing problem behaviour their adolescents exhibited. In addition, the more traditional adolescents were the more internalizing problems they displayed. Finally, Indian adolescents experienced more internalizing problems when their parents were more Western or less traditional than the adolescents themselves. These findings highlight the importance of examining not only parental acculturation style, but also the parent–child acculturation discrepancy as a risk factor for problem behaviour.