Family Cohesion and Health-Related Quality of Life of Children with Type 1 Diabetes: The Mediating Role of Parental Adjustment

Despite the increasing number of studies on the health-related quality of life (HRQOL) of children with type 1 diabetes (T1D), little is known about the influence of family and parental factors on this outcome. This study aimed to explore whether family cohesion and children’s HRQOL were connected through three indicators of parental psychological adjustment (parenting stress, depressive symptoms, and anxious symptoms) as well as whether these links varied according to the child’s age. Levels of family cohesion, parenting stress, and depression/anxiety symptoms of parents of children with T1D and parents of healthy children were compared. The sample included 88 child–parent dyads composed of children/adolescents (8–18 years old) with T1D and one of their parents and 121 dyads composed of healthy children/adolescents and one of their parents. The parents completed self-report measures of family cohesion, parenting stress, and emotional adjustment, and the children completed measures of HRQOL. Testing of the hypothesized moderated mediational model showed that higher HRQOL ratings in children were associated with higher levels of cohesion through lower levels of parental stress, regardless of the child’s age. Parents of children with T1D perceived less cohesion and felt more anxiety and stress about parenting tasks compared to parents of healthy children. Our findings suggest that parents of children with T1D are at an increased risk of psychological maladjustment. Moreover, this study highlights the interrelation between family/parental functioning and child adjustment and makes an innovative contribution by identifying a mechanism that may account for the link between family and child variables.     

Family Impact and Parenting Styles in Families of Children with ADHD

Attention deficit hyperactivity disorder (ADHD) begins in childhood and is characterized by attention deficits, hyperactivity, or impulsiveness that is inconsistent with a child’s developmental level. The effects of ADHD are not limited to the child alone but can affect their familial context, particularly parenting styles. Using data from 68 parents of 6–11-year-old ADHD-diagnosed children, we attempted to identify the predictive variables of two parenting styles: criticism-rejection and permissiveness-indulgence. We analyzed two complex predictive models using structural equation modeling. We hypothesized that family impact variables would mediate the relation between the child’s behavior and parenting. The data showed that the child’s ADHD was only indirectly related to parenting styles, whereas child’s behavior problems had a direct relationship. The results stressed the central role of the child’s behavior on family social life, parents’ marital relationship, and parents’ feelings about their children. These variables mediated the relationship between the children’s disorders and parenting styles. On the other hand, perceived social support had an inverse relationship with this negative family impact, and it even had relevant indirect effects on criticism and permissiveness.     

Bidirectional Effects between Parenting and Aggressive Child Behavior in the Context of a Preventive Intervention

Over time, developmental theories and empirical studies have gradually started to adopt a bidirectional viewpoint. The area of intervention research is, however, lagging behind in this respect. This longitudinal study examined whether bidirectional associations between (changes in) parenting and (changes in) aggressive child behavior over time differed in three conditions: a child intervention condition, a child + parent intervention condition and a control condition. Participants were 267 children (74 % boys, 26 % girls) with elevated levels of aggression, their mothers and their teachers. Reactive aggression, proactive aggression and perceived parenting were measured at four measurement times from pretest to one-year after intervention termination. Results showed that associations between aggressive child behavior and perceived parenting are different in an intervention context, compared to a general developmental context. Aggressive behavior and perceived parenting were unrelated over time for children who did not receive an intervention. In an intervention context, however, decreases in aggressive child behavior were related to increases in perceived positive parenting and decreases in perceived overreactivity. These findings underscore the importance of addressing child-driven processes in interventions aimed at children, but also in interventions aimed at both children and their parents.     

How Many Parents Should There Be in a Family?

In this article, I challenge the widespread presumption that a child should have exactly two parents. I consider the pros and cons of various numbers of parents for the people most directly affected – the children themselves and their parents. The number of parents, as well as the ratio of parents to children, may have an impact on what resources are available, what relationships can develop between parents and children, what level of conflict can be expected in the family, as well as the costs involved in parenting and the experience of parenting a child. Indirectly, there is also an effect on who will have the opportunity to be a parent, as well as on wider social issues that I mention but do not discuss. Having considered all these factors, I conclude that there is some reason to believe that three or more parents is usually better than one or two, especially if children are to have siblings, which is typically beneficial. However, these reasons are not strong enough to support a general presumption in favor of any particular number. We should therefore jettison the two-parent presumption and make different numbers of parents more socially accepted as well as legally possible.     

Parental Overprotection,Perceived Child Vulnerability,and Parenting Stress: A Cross-Illness Comparison

The current study sought to investigate differences in parenting capacity variables across four disease groups. Parents (N = 425), the majority of whom were mothers, of children with either cancer, asthma, Type 1 diabetes, or cystic fibrosis, completed measures of parental overprotection, perceived child vulnerability, and parenting stress. After controlling for significant demographic variables, parents of children with cystic fibrosis and asthma reported higher perceived child vulnerability than parents of children with either diabetes or cancer, while parents of children with asthma and diabetes reported higher parenting stress than parents of children with cancer or cystic fibrosis. No differences between disease groups were found for parental overprotection. The current study provides support for an illness-specific approach to understanding parenting capacity variables in the context of childhood chronic illnesses.     

Bidirectional Relations between Parenting Practices and Child Externalizing Behavior: A Cross-Lagged Panel Analysis in the Context of a Psychosocial Treatment and 3-Year Follow-up

In the current study, we examined longitudinal changes in, and bidirectional effects between, parenting practices and child behavior problems in the context of a psychosocial treatment and 3-year follow-up period. The sample comprised 139 parent–child dyads (child ages 6–11) who participated in a modular treatment protocol for early-onset ODD or CD. Parenting practices and child behavior problems were assessed at six time-points using multiple measures and multiple reporters. The data were analyzed using cross-lagged panel analyses. Results indicated robust temporal stabilities of parenting practices and child behavior problems, in the context of treatment-related improvements, but bidirectional effects between parenting practices and child behavior were less frequently detected. Our findings suggest that bidirectional effects are relatively smaller than the temporal stability of each construct for school-age children with ODD/CD and their parents, following a multi-modal clinical intervention that is directed at both parents and children. Implications for treatment and intervention are discussed.     

Mindful Parenting: A Call for Research

Interest in mindfulness-based interventions for children and adolescents is growing, but despite substantial evidence that parental distress and psychopathology adversely affects children, there is little research on how mindfulness-based parenting interventions might benefit the child as well as the parent. As an established intervention for prevention of depressive relapse, mindfulness-based cognitive therapy (MBCT) conducted with parents is an intervention that potentially could improve parent–child relationships, reduce child symptoms, and promote healthy child development. Mindful parenting interventions bring mindful attention directly to parent–child interactions and are similar but not identical to existing clinical mindfulness interventions such as MBCT. Mindfulness-based parenting interventions have an interpersonal, rather than intrapsychic focus, with particular attention given to the parent–child relationship. Preliminary research suggests that this intervention approach may reduce stress, enhance parenting satisfaction, decrease child aggression, and increase children’s prosocial behaviors. Initial evidence supporting the effectiveness of mindful parenting programs is promising and supports our call for ongoing research.     

Why Do Parents Seek Help When Their Children’s Behavior Is Within Normative Levels?

The purpose of this study was to address the following question: Why do parents first seek help with parenting when they report their child’s disruptive behaviors are within normative levels? Two groups were selected for study from a sample of 91 parents of 3- to 6-year-olds who sought help with parenting: Parents reporting disruptive behavior problems in the normative range (n?=?22) or above a clinical cutoff (n?=?19). Logistic regression was used to examine two competing hypotheses about family variables which may account for why parents seek help when reporting normative levels of disruptive behaviors: Alternative family stress (i.e., high levels of family stress other than child disruptive behavior) and parent enhancement and validation (i.e., enhance and validate parenting although child behavior is in normal range). No support emerged for the alternative family stress hypothesis whereas multiple indicators (better use of disciplinary strategies, seeking services for a first born child, and being more highly educated) provided support for the parent enhancement and validation hypothesis.     

Parenting and child body mass index: Longitudinal investigation of maternal and paternal influence

The aim of this study was to investigate the cross‐sectional and longitudinal relationships between general parenting and body mass index (BMI) status of children between the ages of 4 and 7 in Australia. A nationally representative sample of 4,423 children (49% female) and their parents was used for the present study. Measures of parental demandingness and responsiveness were completed by parents at child age 4–5 years. Height and weight measurements of children were taken at child age 4–5, and again at 6–7, from which BMI status was calculated. No influence of mothers' parenting on child BMI status was shown, and fathers' responsiveness was found to be predictive of increased risk for overweight/obesity at 6–7 years. While the present study is complicated by measurement issues, findings suggest that increased risk for overweight in young children may be associated with responsiveness in fathers. Obesity prevention programs involving parents should take into account the influence of fathers' parenting on child BMI status.     

Parental Anxiety Disorders, Child Anxiety Disorders, and the Perceived Parent–Child Relationship in an Australian High-Risk Sample

This study was designed to explore the role of perceived parenting behavior in the relationship between parent and offspring anxiety disorders in a high-risk sample of adolescents. We examined the relationship between parental and child anxiety disorders and tested whether perceived parenting behavior acted as a mediator between these variables. Analyses were performed on a high-risk sample of 816 fifteen-year-olds drawn from a birth cohort in Queensland, Australia. Parental depression and income were covaried. Maternal anxiety disorder significantly predicted the presence of anxiety disorders in children; the association between paternal anxiety disorder and child anxiety disorder was not significant. There was no evidence that perceived parenting played a mediating role in the association between mother and child anxiety disorders. These results replicate earlier studies' findings of elevated rates of anxiety disorders among the offspring of anxious parents, but only when the child's mother is the anxious parent.     

The Associations between Mothers’ and Grandmothers’ Depressive Symptoms,Parenting Stress,and Relationship with Children: An Actor–Partner Interdependence Mediation Model

Three-generation households that include parents and grandparents raising children together have become increasingly common in China. This study examined the relations among depressive symptoms, parenting stress, and caregiver–child relationships in the mother–grandmother dyadic context. Participants were mothers and grandmothers from 136 three-generation households. Results from Actor–Partner Interdependence Mediation Modeling indicated that mothers’ depressive symptoms were indirectly related to mother–child conflict/closeness through own parenting stress; grandmothers’ depressive symptoms were indirectly related to grandmother–child conflict through own parenting stress. Mothers’ depressive symptoms were indirectly related to grandmothers’ conflict with children through grandmothers’ parenting stress, and grandmothers’ depressive symptoms were indirectly related to mothers’ conflict/closeness with children through mothers’ parenting stress. The relation between mothers’ parenting stress and mother–child closeness was stronger than the relation between grandmothers’ parenting stress and grandmother–child closeness. Findings highlight the implications of using a family system perspective and the dyadic approach in understanding and improving family functioning in Chinese three-generation households.     

Higher cortisol is associated with poorer executive functioning in preschool children: The role of parenting stress,parent coping and quality of daycare

Child executive functions (cognitive flexibility, inhibitory control, working memory) are key to success in school. Cortisol, the primary stress hormone, is known to affect cognition; however, there is limited information about how child cortisol levels, parenting factors and child care context relate to executive functions in young children. The aim of this study was to examine relationships between child cortisol, parenting stress, parent coping, and daycare quality in relation to executive functions in children aged 3–5 years. We hypothesized that (1) poorer executive functioning would be related to higher child cortisol and higher parenting stress, and (2) positive daycare quality and positive parent coping style would buffer the effects of child cortisol and parenting stress on executive functions. A total of 101 children (53 girls, 48 boys, mean age 4.24 years ±0.74) with complete data on all measures were included. Three saliva samples to measure cortisol were collected at the child’s daycare/preschool in one morning. Parents completed the Behavior Rating Inventory of Executive Function – Preschool Version (BRIEF-P), Parenting Stress Index (PSI), and Ways of Coping Questionnaire (WCQ). The Early Childhood Environment Rating Scale – Revised (ECERS-R) was used to measure the quality of daycare. It was found that children with poorer executive functioning had higher levels of salivary cortisol, and their parents reported higher parenting stress. However, parent coping style and quality of daycare did not modulate these relationships. Identifying ways to promote child executive functioning is an important direction for improving school readiness.     

Parenting Styles in a Cultural Context: Observations of "Protective Parenting" in First-Generation Latinos

Current literature presents four primary parenting styles: authoritative, authoritarian, permissive, and neglectful. These styles provide an important shortcut for a constellation of parenting behaviors that have been characterized as consisting of warmth, demandingness, and autonomy granting. Empirically, only warmth and demandingness are typically measured. Research reporting on parenting styles in Latino samples has been equivocal leading to questions about conceptualization and measurement of parenting styles in this ethnic/cultural group. This lack of consensus may result from the chasm between concepts (e.g., authoritarian parenting) and observable parenting behaviors (e.g., warmth) in this ethnic group. The present research aimed to examine parenting styles and dimensions in a sample of Latino parents using the two usual dimensions (warmth, demandingness) and adding autonomy granting. Traditional parenting styles categories were examined, as well as additional categorizations that resulted from adding autonomy granting. Fifty first-generation Latino parents and their child (aged 4–9) participated. Parent–child interactions were coded with the Parenting Style Observation Rating Scale (P-SOS). In this sample, the four traditional parenting categories did not capture Latino families well. The combination of characteristics resulted in eight possible parenting styles. Our data showed the majority (61%) of Latino parents as "protective parents." Further, while mothers and fathers were similar in their parenting styles, expectations were different for male and female children. The additional dimensions and implications are discussed. The importance of considering the cultural context in understanding parenting in Latino families is emphasized, along with directions for future research.     

Asian-Indian Parents’ Attributions About the Causes of Child Behavior: A Replication and Extension With Parents From Chennai,India

Using hypothetical vignettes, 152 parents of children 10–17 years old living in Chennai, India, made attributions about whether the origins of 2 positive and 2 negative behaviors performed by their own child or another child were due to the child's personality or the situation, or to parenting or nonparenting influences based on the frequency, intensity, and cross-situational consistency of the behavior. Parents attributed the positive behaviors of all children to the personality of the child and to parenting. Parents attributed negative behavior of their own children to situational influences and nonparenting effects, but attributed the negative behavior of other children to their personality and to parenting, a pattern that enhances and reinforces parent self-esteem. Results were discussed in terms of the self-serving bias and the actor–observer bias, cognitive distortions that protect and enhance parents’ views of themselves and their children.     

Effects of a Military Parenting Program on Parental Distress and Suicidal Ideation: After Deployment Adaptive Parenting Tools

Few studies have examined whether parenting prevention programs might mitigate risk for suicidality in parents, yet parent suicidality is a strong risk factor for offspring suicidality. We report results from a randomized controlled trial of a parenting program for deployed National Guard and Reserve families with a school‐aged child. Intent‐to‐treat analyses showed that random assignment to the parenting program (ADAPT) was associated with improved parenting locus of control (LOC). Improved parenting LOC was concurrently associated with strengthened emotion regulation which predicted reductions in psychological distress and suicidal ideation at 12 months postbaseline. Results are discussed in the context of ongoing efforts to reduce suicide rates in military populations.     

The Impact of Parent Empowerment in Children’s Mental Health Services on Parenting Stress

Emotional and behavioral (EB) problems in children are associated with increased perceptions of strain in parenting. Among children receiving services, parenting stress has been linked to initiating services for their children, and may strain the relationship between parent and child. In contrast, parental engagement and empowerment in services is an important quality indicator for positive treatment outcomes. However, no known studies have examined the association between parent empowerment in their child’s services and their perceptions of stress related to parenting a child with significant mental health needs. Further, no studies have explored whether empowerment moderates the relationship between the child’s symptoms and parental perceptions of stress. The current study examined the impact of child EB problems and parent empowerment on parenting stress. Among a sample of 525 parents of children receiving school-based services for disruptive behavior disorders, child EB problems significantly predicted parenting stress. Parent empowerment also correlated with lower parenting stress, as hypothesized. Although parent empowerment was not found to moderate the relationship between child symptomatology and parenting stress, the relationship between parent empowerment and parenting stress differed based on child gender and age. Parent empowerment was associated with lower parenting stress more for parents of females and younger children than for parents of males and older children.     

Adolescents’ Behaviors as Moderators for the Link between Parental Self-Efficacy and Parenting Practices

Based on theory that parents with higher levels of self-efficacy (PSE) should find it easier to parent effectively in the face of challenging child behaviors than should parents with lower levels of PSE, this study examines the link between PSE and parenting using children’s behaviors as potential moderators. Participants were 130 parents who had an older adolescent (M _age?=?17.58) in addition to the target adolescent (M _age?=?11.79), and both adolescents’ externalizing behaviors were used as moderators for the link between PSE and parenting of the target adolescent. Path analysis in Mplus showed that higher PSE was linked to more promotive parenting but only among parents who had an older adolescent with lower levels of externalizing behaviors. Among parents of adolescents with higher levels of externalizing behaviors, whose promotive parenting was significantly lower than other parents overall, PSE did not predict promotive parenting. The link between PSE and parenting did not differ depending on the target adolescents’ behavior. Findings suggest that the link between parents’ beliefs and parenting depends on the broader family context. More specifically, how PSE is linked to parenting practices depends at least partly on the experiences that parents bring from parenting an older adolescent to their interactions with a later-born adolescent. From a clinical perspective, parents might need guidance in how to think about their earlier parenting experiences when parenting a younger adolescent.     

Coping and care-related stress in parents of a child with autism spectrum disorder

Background and Objectives: Parenting a child with Autism Spectrum Disorder (ASD) is challenging and can result in elevated levels of parenting stress. This study investigated the relationship between parent-ratings of their child’s ASD symptoms and two conceptually different measures of parenting stress: One specific to the ASD context and the other a general stress measure applicable to the broader caregiving context. Additionally, the influence of coping style on the relationship between child’s ASD symptoms and parenting stress was investigated.

Design and Methods: Using an internet survey, parents (N?=?178) caring for a child with ASD reported on coping strategies, completed two measures of parenting stress, and assessed their child’s ASD symptoms.

Results: Parenting stress increased with severity of the child’s ASD symptoms, but the strength of this relationship depended on whether a general or disorder-specific measure of parenting stress was used. Regression analyses indicated that some coping strategies moderated the impact of ASD symptom severity on the parent’s care-related stress, but moderation depended on how stress was conceptualized.

Conclusion: This study reinforces the importance of identifying the coping strategies of parents of children with developmental disorders, and highlights the consequences of using different conceptual approaches to measure parenting stress.     

Reflective Parenting Programs: Theory and Development

Recent research has indicated that parental reflective functioning or mentalization plays a crucial role in the development of a range of healthy adaptations in both parent and child. While many parenting interventions developed over the course of the last 20 years have implicitly attempted to enhance mentalization in parents, this article describes an effort to directly intervene with parents to enhance or encourage the development of reflective capacities. In this article, the broad outlines of a reflective parenting approach are described. Two reflective parenting programs are then considered, one a group intervention designed for low-risk parents, the other a home visiting intervention designed for high-risk parents and children.     

Social reasoning about ‘second‐shift’ parenting

The present study investigated children's and adolescents’ social reasoning about parenting roles in the home, specifically ‘second‐shift parenting’ by a mother or father. Surveys were administered to children (age 10) and adolescents (age 13), nearly evenly divided by gender (N= 200) in which two hypothetical scenarios were evaluated. Participants were asked to evaluate and justify second‐shift parenting arrangements for the family overall, for the parent in the role, and for the child in the family. Results showed that participants expected mothers rather than fathers to take on the second‐shift role, and second‐shift parenting was evaluated as more unfair for fathers than for mothers. Personal choice reasoning was used for justifying arrangements for the second‐shift parent and moral reasoning was used for justifying arrangements for the child. Social reasoning about the context of parental caretaking roles was multifaceted and varied by age and gender of participant more so than by self‐reported personal family arrangements.