Association of alexithymic characteristics and posttraumatic stress responses following medical treatment for children with refractory hematological diseases

Recent research has examined posttraumatic stress disorder (PTSD) following medical treatment for children with refractory hematological diseases such as leukemia. However, much remains unknown. This study examined the association of alexithymic characteristics on the manifestation of posttraumatic stress responses in 33 children with refractory hematological diseases. Of 33 children, 27 (81.8%) exhibited posttraumatic stress responses following medical treatment for refractory hematological diseases. The frequency of posttraumatic stress responses was significantly higher than with children who experienced severe flood disaster. Also, the severity of posttraumatic stress responses was significantly stronger than for children who experienced severe flood disaster. Moreover, children with refractory hematological diseases were more likely to exhibit alexithymic characteristics. The alexithymic characteristics were significantly and positively correlated with avoidance and emotional numbing among posttraumatic stress responses. The results suggest the possibility that alexithymic characteristics may be predictive of the manifestation of avoidance and emotional numbing among posttraumatic stress responses following medical treatment for refractory hematological diseases.     

Parenting stress in parents of children with attention-deficit hyperactivity disorder and parents of children with learning disabilities

Parenting a child with ADHD can challenge parenting resources and coping. Increasingly, researchers are examining the relationship between the behavior of the child with ADHD and family functioning. While studies have shown inceased parenting stress in parents of children with ADHD, these studies have compared children with ADHD to non-disabled children. This study compares reports of parenting stress among mothers of children with ADHD, mothers of children with learning disabilities and mothers of non-referred children. Results showed that parenting stress was highest for mothers of children with ADHD. Increased parenting stress was associated with child characteristics and, in particular, with externalizing behavior problems.     

Exploring Correlates and Predictors of Stress in Parents of Children Who are Deaf: Implications of Perceived Social Support and Mode of Communication

Parenting stress has been linked to negative outcomes for both parents and children, including poor attachment, behavior problems, less positive parent–child interactions, and marital dissatisfaction. Given that parents of special needs children often experience excess stress, they may be susceptible to negative outcomes, thus investigations of protective factors are needed. We explored relationships among parenting stress, social support, mode of communication, and child cochlear implant status in parents rearing a deaf child or child with hearing loss. Findings of our exploratory study indicated that parents of children who use sign language only reported more support, while parents of children who use total communication exhibited less self-reported stress. Also, parents with children who use implants did not differ on any of the measures compared to parents of children without implants. Additional findings suggested that higher levels of perceived social support corresponded with lower stress among parents, however, receipt of supportive behaviors did not correlate significantly with parenting stress. In an overall model, perceived social support and mode of communication were significant predictors of parenting stress. Finally, enacted support predicted significantly life satisfaction in parents. Implications and limitations, as well as suggestions for future research, will also be offered.     

Perceptions of Stress,Coping, and Intervention Preferences among Caregivers of Disadvantaged Children with Asthma

Asthma remains the most prevalent chronic illness among children. Despite the substantial body of literature examining children with asthma, few studies have examined parents’ perspectives of the condition and experiences of caregiver stress. Parents of children with chronic illnesses experience elevated stress and may have limited opportunities to cope with complex emotions while caring for children with asthma. Drawing from focus groups and interviews with African American and Hispanic parents of children with asthma, this qualitative study was conducted as part of a patient-centered engagement process to inform the refinement of an intervention aimed at reducing stress among parents of children with asthma. All data were transcribed and underwent three waves of inductive analysis. The content analysis indicated that the unpredictable nature of asthma and the caregiving burden associated with managing children’s asthma contributed to parents’ stress, and external contexts compounded the impact of these stressors. Parents also reported having difficulty identifying how they coped with stress and employed approaches to coping with stress that they applied intermittently but encountered several barriers to enacting known or available coping strategies. Analyses also revealed that parents desired a multimodal stress reduction intervention that emphasized building relationships, allowed for flexibility, and encouraged staff-parent communication. Whereas African American and Hispanic parents’ experiences of stress and coping strategies were similar, their preferences differed in regards to incorporating technology into the intervention, the credentials of facilitators, and the salience of language preferences. Understanding the complexities of stressors facing caregivers is important for developing interventions to support parents and children coping with asthma, and in particular when working with families from diverse backgrounds.     

Relations between Parenting Stress,Parenting Style,and Child Executive Functioning for Children with ADHD or Autism

Relations among parenting stress, parenting style, and child executive functioning for children with disabilities are not easily teased apart. The current study explored these relations among 82 children and adolescents age 7–18: 21 with attention deficit/hyperactivity disorder, 33 with autism spectrum disorder, and 28 typically developing. Results indicated that children with attention deficit/hyperactivity disorder or autism spectrum disorder had more executive functioning deficits, and their parents reported more parenting stress and a greater use of permissive parenting, compared to typically developing children. In general, increased parenting stress was associated with greater use of authoritarian and permissive parenting styles, as well as more problems with behavior regulation for children. Authoritarian and permissive parenting styles were associated with poorer child executive functioning. Child diagnostic group (attention deficit/hyperactivity disorder, autism spectrum disorder, typically developing) moderated relations between parent stress and child functioning, and between parenting style and child functioning. Implications for intervention with families of children with disabilities are discussed.     

Young Children’s Physiological Reactivity during Memory Recall: Associations with Posttraumatic Stress and Parent Physiological Synchrony

Autonomic reactivity is implicated in stress response and social engagement – both key components of posttraumatic stress disorder (PTSD) – but few studies have examined autonomic reactivity in pediatric samples, and no known studies have examined physiological synchrony among children with PTSD and caregivers. In a sample of 247 young children (94 girls, 153 boys), most (85%) of whom had exposure to trauma and 40% who met criteria for PTSD, we examined children’s patterns of respiratory sinus arrhythmia (RSA) at baseline and in response to a memory recall task, as well as correspondence between parents’ and children’s RSA. Children with PTSD demonstrated significantly higher reactivity than other groups during their recollection of a traumatic memory, but not during other memory tasks. Regarding synchrony, caregivers’ and children’s RSA were more significantly and positively correlated during the trauma recall task among children who had had exposure to a potentially traumatic event but did not meet PTSD criteria, suggesting physiological synchrony may be protective in contexts of trauma. Overall, findings demonstrate physiological reactivity differences among young children with PTSD. While more work is needed to understand the meaning of parent-child physiological synchrony, these data suggest that children’s psychopathology is associated with physiological synchrony processes among young children with exposure to trauma.     

A Review of Reviews Examining Neurological Processes Relevant to Impact of Parental PTSD on Military Children: Implications for Supporting Resilience

In this study, 10 recent meta-analytic and systematic review studies were synthesized on the neurological underpinnings of stress and trauma with implications for the impact of parental post-traumatic stress disorder (PTSD) and resilience among military children. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) group guidelines and utilizing a validated quality assessment tool, this systematic review of reviews incorporated results from more than 35,971 individuals with stress exposures, effects, or disorders and healthy controls. This synthesis found support for important gene, physiology, and environment correlations and interactions that predict increased risk for stressful life events and PTSD, but not direct transmission, among military children. Future research is needed to determine if these constitute indirect pathways of intergenerational transmission in military children.     

Posttraumatic stress and worry as mediators and moderators between political stressors and emotional and behavioral disorders in Palestinian children

This study was designed to assess whether the symptoms of posttraumatic stress mediate or moderate the relationship between political stressors and emotional and behavioral disorders in Palestinian children. It was hypothesized that (a) posttraumatic stress and worry mediate the effect of political stressors on behavioral and emotional disorders and (b) the relationship between political stressors and behavioral and emotional disorders should be attenuated for children with low levels of worry and posttraumatic stress and strengthened for children with high levels of worry and posttraumatic stress. The total sample was 1267 school age children of both sexes with a mean age of 11.97 years. Interviews were conducted with children at school. As hypothesized, the results indicated that posttraumatic stress and worry mediated and moderated the relationship between political stressors and emotional and behavioral disorders in children. Cognitive-behavioral therapy may be used to reduce the incidence of posttraumatic stress and decrease self-reported worry, somatic symptoms, general anxiety, and depression among children exposed to political trauma. Cognitive-behavioral treatment that exclusively targets excessive worry can lead to clinical change in the other interacting subsystems at the cognitive, physiological, affective and behavioral levels.     

Academic Stressors and Anxiety in Children: The Role of Paternal Support

We examined the role of paternal support in the relation between academic stress and the mental health of primary school children in Hong Kong. The participants of this cross-sectional study were 1,171 fifth and sixth graders. The results indicated that academic stress was a risk factor that heightened student anxiety levels and that parental emotional support was a protective factor that contributed to better mental health among children. However, paternal informational support delivered to children during times of high academic stress appeared to heighten student anxiety levels. The practical implications of the findings on parent education are discussed.     

Trauma-Focused CBT in the Context of Parental Chronic Medical Conditions: A Case Report

Parental chronic medical conditions (CMCs) are relatively common and have been shown to impact children’s psychosocial functioning. Previous research suggests that, for some youth, parental CMCs may be conceptualized as a form of traumatic stress. Trauma-focused cognitive behavioral therapy (TF-CBT) is a multicomponent, evidence-based intervention that is designed to reduce symptoms of posttraumatic stress, depression, and anxiety, as well as behavioral problems, among children and adolescents. Despite its robust empirical support, however, no known studies have utilized this treatment approach to address the mental health needs of youth affected by parental CMCs. The purpose of this article is to describe the application of TF-CBT to treat an adolescent male whose mother was diagnosed with a CMC, which had resulted in continuous family stressors since his birth. Results suggest that TF-CBT offers a promising approach for treating symptoms of posttraumatic stress, anxiety, and depression among children of parents with CMCs, and clinical trials to investigate its effectiveness among this population may be warranted.     

Parenting Stress through the Lens of Different Clinical Groups: a Systematic Review & Meta-Analysis

Research has demonstrated an association between parenting stress and child behavior problems, and suggested levels of parenting stress are higher among parents of children at risk for behavior problems, such as those with autism and developmental delay (ASD/DD). The goal of the present study was to conduct a systematic review of parenting stress and child behavior problems among different clinical groups (i.e., ASD/DD, chronic illness, with or at-risk for behavioral and/or mood disorders). We also examined demographic and methodological variables as moderators and differences in overall levels of parenting stress between the clinical groups. This systematic review documents a link between parenting stress and child behavior problems with an emphasis on externalizing behavior. One-hundred thirty-three studies were included for quantitative analysis. Parenting stress was more strongly related to child externalizing (weighted ES r = 0.57, d = 1.39) than internalizing (weighted ES r = 0.37, d = 0.79) problems. Moderation analyses indicated that the association between parenting stress and behavior problems was stronger among studies which had mostly male and clinic-recruited samples. Overall, parenting stress levels were higher for parents of children with ASD/DD compared to parents of children from other clinical groups. Findings document the association between parenting stress and child behavior problems and highlight the importance of assessing parenting stress as part of routine care and throughout behavioral intervention programs, especially for groups of children at high risk for behavior problems, such as children with ASD/DD, in order to identify support for both the parent(s) and child.     

Longitudinal changes in marital satisfaction during middle age in Taiwan

The current 8‐year panel study explored changes in marital satisfaction among 614 married middle‐aged persons with seventh‐grade children. It also examined how individual health (physical health and depressive moods) and role changes (parenting transitions and life stress) were related to trajectories of marital satisfaction and investigated the buffering effect of family cohesion on these associations. Growth curve analyses show an inverted‐U shape in marital satisfaction during middle age. This indicates that regardless of the gender or age of the respondents, marital satisfaction among middle‐aged adults increased when their children were in the 9^th and 12^th grade, and then declined when their children were in their sophomore year of college. Declining physical health and an increase in depressive moods were related to a drop in marital satisfaction. Stressful events in midlife had negative effects on marital satisfaction, and family cohesion served as a buffer to mitigate the adverse impact of life stress on marital satisfaction. Overall, these results highlight the role of adolescent children in understanding why marital satisfaction changes among middle‐aged parents and emphasize the importance of health and life stress in relation to midlife marital satisfaction. These findings are discussed with life course perspectives and Taiwanese cultural values in relation to familism and academic achievement among children.     

Children's vulnerability to stressful life events in mothers' eyes: Effects of gender and parental experiences

Although the professional literature indicates greater vulnerability to stress among boys than girls, research on stereotypes and gender typing in socialization offers indirect evidence of a contrary belief among parents. In order to assess sex differences in vulnerability directly, 80 Israeli middle-class mothers of elementary school children were asked to predict the difficulty that low- and high-stress life events would pose for child protagonists in eight vignettes. Sex of child was manipulated by gender label denotation. Results indicated that mothers of boys predicted greater child difficulties with stress than mothers of girls. They also predicted that boys would have more difficulty than girls, a sex difference that did not appear among mothers of girls. The results suggest that maternal perceptions of sex differences in vulnerability are influenced by observation of their own children under stress. Further, professional opinion and lay wisdom as to actual male vulnerability are not necessarily at loggerheads.     

Developmental and medical factors associated with parenting stress in mothers of toddlers born very preterm in a neonatal follow-up clinic

The purpose of this exploratory, cross-sectional study was to identify child-related factors associated with maternal parenting stress in toddlers born very preterm and followed in a neonatal follow-up (NFU) clinic. The study aimed to describe the associations of current medical complications and presence of developmental delays with total parenting stress. Participants were 53 mother–child dyads presenting in a NFU clinic. Mothers completed the Parenting Stress Index-Short Form (PSI-SF), and children were administered the Brigance Early Head Start Screen II. Medical variables were also collected from the child's medical record. Approximately 24% of mothers had at least one elevated subscale score on the PSI-SF. Regression analyses indicated that receipt of early intervention services was associated with increased parenting stress among mothers of toddlers born very preterm, though number of current medical complications was not. Parents of children born very preterm are at increased risk for parenting stress that extends beyond discharge from the neonatal intensive care unit . Clinicians working in NFU clinics are positioned to monitor for increased parenting stress, particularly among families of children with emerging signs of developmental delay.     

Caregiving stress and adjustment problems of Kenyan orphans raised by grandmothers

The present study compared levels of caregiving stress among 115 biological mothers and 134 grandmothers raising their orphaned grandchildren. The associations between parenting stress and adjustment difficulties exhibited by children raised by these two groups of caregivers were also assessed. Full‐time caregiving grandmothers reported elevated levels of stress more than did the biological mothers. A significant negative association was found between child maladjustment and caregiving stress. Caregivers' experienced stress was linked to advanced age and extensive, new adoptive roles now occupied by grandmothers. There was no evidence suggesting that these orphaned children were less well adjusted when compared to children still living with their own birth parents. Copyright © 2005 John Wiley & Sons, Ltd.     

留守对农村儿童青少年社会适应的影响:倾向值匹配的比较分析

以河南和陕西两省3812名4~9年级农村学生为研究样本, 考察其在抑郁、自尊、问题行为、幸福感、未来压力感知及人际关系方面的社会适应状况, 并运用倾向值匹配方法探讨了父母外出务工对其产生的影响。结果发现, 在倾向值匹配之前, 双亲外出务工的留守儿童在未来压力感知、抑郁和幸福感3方面的适应状况均比非留守儿童差, 在师生关系上得分高于非留守儿童;单亲外出务工的留守儿童感知到的未来压力及抑郁水平也显著高于非留守儿童。经过倾向值匹配处理后, 双亲外出留守儿童的幸福感仍显著低于非留守儿童, 单亲外出留守儿童的未来压力感知也高于非留守儿童, 但其他方面的差异不再显著。研究结果提示对于留守与非留守儿童存在的社会适应差异不能完全归咎于父母的外出务工状态。     

Preventing the detrimental effect of posttraumatic stress in young children: The role of theory of mind in the aftermath of a natural disaster

We conducted a field study to test whether parents' negative reactions to a natural disaster affected children's reactions, together with the factors buffering this negative influence. Specifically, we examined whether parents' posttraumatic stress symptoms following an earthquake were associated with children's posttraumatic symptoms and their use of negative coping strategies. Theory of mind (ToM) was tested as the factor allowing children to reduce the detrimental effects of posttraumatic stress symptoms on negative coping. Hypotheses were tested in a sample of elementary school children and their parents in the aftermath of the earthquakes that struck Northern Italy in 2012. Results revealed that mothers' (but not fathers') posttraumatic stress symptoms were positively associated with children's posttraumatic stress symptoms, which acted as mediator on the use of negative coping strategies by children, but only among children with low ToM abilities. We discuss the theoretical and practical implications of findings.     

Teachers' dispositional mindfulness and the quality of their relationships with children in Head Start classrooms

The quality of teachers' relationships with children is a key predictor of children's later social emotional competence and academic achievement. Interventions to increase mindfulness among teachers have focused primarily on the impacts on teachers' subjective well-being, but not on the quality of their relationships with children. Furthermore, none of these interventions have involved preschool teachers. To consider the potential of mindfulness-based interventions to improve the quality of teachers' relationships with preschool-aged children, we examined data from an online survey of 1001 classroom teachers in 37 Pennsylvania Head Start Programs. Using path analysis we investigated the association between teachers' dispositional mindfulness and the quality of their relationships with children (conflict and closeness). We further examined whether this association was mediated by teacher depressive symptoms and moderated by perceived workplace stress. Higher levels of dispositional mindfulness among teachers were associated with higher quality relationships with children (less conflict and greater closeness). The association between greater dispositional mindfulness and less conflict was partially mediated by lower depressive symptoms, and the conditional direct effect of mindfulness on conflict was stronger when perceived workplace stress was lower. These findings suggest that preschool teachers who have higher levels of dispositional mindfulness may experience higher quality relationships with children in their classrooms. Interventions to increase levels of dispositional mindfulness among early childhood educators may improve their well-being along with the quality of their relationships with children, potentially impacting children's educational outcomes. The potential impacts of such interventions may be even stronger if structural and systemic changes are also made to reduce workplace stress.     

流动儿童压力应对方式与抑郁感、社交焦虑的关系:一项追踪研究

为了探讨流动儿童压力应对方式与抑郁感、社交焦虑的变化特点及其动态关系,本研究通过整群抽样法从5所北京市公立学校和1所打工子弟学校选取1164名流动儿童,采用问卷调查的形式对其进行为期一年的追踪测查,追踪时回收有效数据680份.对前、后测均参加调查的680名被试的数据进行分析,结果发现:(1)经过一年的城市适应,流动儿童整体的积极应对增多,消极应对减少,抑郁感下降,但社交焦虑水平无明显变化;(2)流动儿童个体在压力应对、抑郁感、社交焦虑的发展上均表现出两极分化的现象,年龄越小、来京时间越短、低年级及女生流动儿童群体的发展趋势更为良好;(3)流动儿童压力应对方式与抑郁感、社交焦虑间存在相互作用的动态关系,前测压力应对方式、抑郁感、社交焦虑均能显著预测后测相应变量的水平,前后测压力应对方式对抑郁感、社交焦虑均有即时预测作用,而前测抑郁感和社交焦虑对后测压力应对方式有不同的延时性影响.     

Differential Effects of Family Stress Exposure and Harsh Parental Discipline on Child Social Competence

Low family socioeconomic status (SES) is a robust risk factor for adverse child outcomes, yet the specific processes that account for this risk are not fully understood. This study examines whether and how variation in two adverse factors, stressful life events and harsh parental discipline, affect children’s social competence within a high-risk environment, and whether some children are more vulnerable to these effects than others. Data were collected from 207 families of kindergarten children at risk for behavioral maladjustment. Children’s physiological regulation (respiratory sinus arrhythmia; RSA) measured during rest was examined as a moderator of risk exposure. Results indicate that both greater exposure to life stress and harsh discipline were correlated with lower social competence. Although children’s resting RSA was not a direct predictor of their social competence, it moderated the association between life stress and social competence. Greater exposure to life stress was more strongly associated with lower social competence among children with lower resting RSA. Higher RSA may help to buffer the effects of stress and facilitate appropriate social development. RSA did not moderate the effects of harsh discipline. This differential pattern of findings suggests that children’s physiological regulation can facilitate an effective response to situational stressors, but may be less efficacious in buffering against stress in the context of the parent-child relationship.