Prioritizing Parental Worry Associated with Duchenne Muscular Dystrophy Using Best-Worst Scaling

Duchenne muscular dystrophy (DMD) is a progressive, fatal pediatric disorder with significant burden on parents. Assessing disease impact can inform clinical interventions. Best-worst scaling (BWS) was used to elicit parental priorities among 16 short-term, DMD-related worries identified through community engagement. Respondents viewed 16 subsets of worries, identified using a balanced, incomplete block design, and identified the most and least worrying items. Priorities were assessed using best-worst scores (spanning +1 to ?1) representing the relative number of times items were endorsed as most and least worrying. Independent-sample t-tests compared prioritization of parents with ambulatory and non-ambulatory children. Participants (n?=?119) most prioritized worries about weakness progression (BW score?=?0.64) and getting the right care over time (BW?=?0.25). Compared to parents of non-ambulatory children, parents of ambulatory children more highly prioritized missing treatments (BW?=?0.31 vs. 0.13, p?<?0.001) and being a good enough parent (BW?=?0.06 vs. ?0.08, p?=?0.010), and less prioritized child feeling like a burden (BW?=??0.24 vs. ?0.07, p?<?0.001). Regardless of child’s disease stage, caregiver interventions should address the emotional impact of caring for a child with a progressive, fatal disease. We demonstrate an accessible, clinically-relevant approach to prioritize disease impact using BWS, which offers an alternative to the use of traditional rating/ranking scales.     

Differential Effects of Mother’s and Father’s Parenting on Prosocial and Antisocial Behavior: Child Sex Moderating

The current study examined the differential effects of maternal and paternal parenting on prosocial and antisocial behavior during middle childhood, and the moderating role of child sex. Parents of 96 boys and 107 girls (mean age?=?92.42?months, SD?=?3.52) completed different questionnaires to assess parenting and child behavior. All participants were Caucasian from south of Spain. Multiple hierarchical regressions (enter method) were performed to determine significant predictors of prosocial and antisocial behavior. The results showed that maternal and paternal hostility predicted an increase of externalizing problems in boys and girls (p?<?.001 in both sex groups). As well, Warmth/Induction of both parents predicted an increase in adaptive skills in boys and girls (p?<?.001 in both sex groups). On the other hand, differential effects of fathers’ and mothers’ parenting were found: both for boys and girls, maternal inconsistency positively predicted externalizing problems and negatively adaptive skills (p?<?.001 in both sex groups) and paternal overprotection positively predicted externalizing problems and negatively adaptive skills (p?<?.05 in both sex groups). Finally, maternal coercion negatively predicted adaptive skills in boys and girls (p?<?.05 in both sex groups); however, it increased externalizing problems only in girls (p?<?.05), whereas maternal permissiveness only increased these problems in boys (p?<?.01 in both cases). The discussion highlighted the importance of considering both parents’ and children’s sex to further knowledge of parenting styles affecting children’s behaviors.     

Antenatal determinants of early childhood talking delay and behavioural difficulties

The determinants of talking delay alone or its comorbidity with behavioural difficulties was examined in 5768 two-year-old members of the Growing Up in New Zealand longitudinal study. Using the MacArthur-Bates Communicative Development inventories and the total difficulties score from the preschool Strengths and Difficulties Questionnaire, a composite measure was created so that children were categorised as showing no language or behavioural concerns (72.5%), behavioural only difficulties (6.1%), language only difficulties (18.1%), and comorbid language and behavioural difficulties (3.3%). Analyses revealed that antenatal factors such as maternal perceived stress, inadequate folate intake, vitamin intake, alcohol consumption during the first trimester and maternal smoking all had a significant effect on child outcomes. In particular, low multivitamin intake and perceived stress during pregnancy were associated with coexisting language and behavioural difficulties. These findings support international research in showing that maternal factors during pregnancy are associated with developmental outcomes in the early childhood period, and demonstrate these associations within a NZ context. Interventions which address maternal stress management and health behaviours during pregnancy could be beneficial to offspring development.     

Exploring the Relationships Between Maternal Mental Health Symptoms and Young Children’s Functioning in a Low-Income,Minority Sample

Poor maternal mental health, including depression and high stress levels, can negatively impact many domains of child development, particularly among low-income, ethnic minority families experiencing multiple stressors. Low-income minority mothers, particularly Hispanic mothers, are also at increased risk of experiencing exposure to community violence and other types of trauma. However, studies exploring the additional impact of maternal trauma symptoms on children’s functioning are rare. This study aims to address this gap by examining the impact of maternal trauma symptoms on young children’s functioning in a low-income, predominantly Hispanic sample through the mechanisms of maternal depressive symptoms, and mother’s experiences of parenting stress and strain. The sample consisted of 158 biological mothers (58% Hispanic, 13% African American, 5.7% White American) who were participating in community-based mental health treatment for their children (M_AGE?=?3.7, SD?=?1.2). Mothers completed questionnaires providing information on their children’s behaviors and their own mental health and stress levels at intake. Path analysis indicated that there was a significant indirect effect of maternal trauma symptoms on children’s behavior problems through maternal depressive symptoms and maternal stress in the parent-child relationship (β?=?0.09, p?<?0.01). In addition, there was a direct effect of maternal trauma symptoms on children’s behavior problems (β?=?0.32, p?<?0.001). The results suggest that maternal trauma symptoms, in addition to maternal depressive symptoms, contribute to poor maternal and child functioning.     

The Influence of Body Mass Index on the Perceived Quality of Life during Pregnancy

Obesity contributes to various pregnancy complications and therefore, may compromise maternal quality of life. The study aim was to investigate the relationship between body mass index (BMI) and health-related quality of life (HRQoL) during pregnancy. Study involved every 6th woman who gave birth in the Clinic for Obstetrics and Gynecology Clinical Center of Serbia during the year 2010. Initial and end pregnancy BMIs were calculated for every woman. The parturients (604) completed the SF36 questionnaire (physical-PHC; mental-MHC; total quality of life-TQL), Beck’s Depression Inventory, Fatigue Severity Scale, Pregnancy Symptom Scale, Multidimensional Personal Support Scale, and Acceptance of Illness Scale. Before pregnancy most women had normal or decreased weight, while at the end of pregnancy the majority were overweight or obese (p?=?0.000). Initial and end pregnancy weights (p?<?0.05) and BMIs (p?<?0.05) were positively correlated with depression. Depression was significantly lower in overweight compared to mildly or morbidly obese women during pregnancy (p?<?0.05). Pregnancy weight change correlated negatively with PHC (p?=?0.029), and positively with fatigue (p?=?0.030), and symptoms (p?=?0.011). Of all BMI categories, morbidly obese women had the worst feeling of social support (p?<?0.05). Pregnancy symptoms were significantly less problematic in women with normal weight compared to overweight and obese women during pregnancy (p?<?0.05). Assessing the impact of all investigated parameters together, we established significant models for PHC (p?=?0.036), depression (p?=?0.030), and fatigue (p?=?0.038). Pregnant women should be advised to keep their gestational weight gain within the normal recommended range to have a good pregnancy outcome and HRQoL.     

Effects of Individual,Peer, and Family Factors on Child Alcohol Abuse in Ukraine

The present study aims to estimate the relationship between child alcohol problems, sociodemographic characteristics, externalizing behavior, parental and peer alcohol use, and family violence by using a cross-sectional community sample of 320 Ukrainian children (9–16 years of age, 50% boys) and their parents. Participants answered questions from the Drinking and Drug History and Current Use Patterns Questionnaire, the Revised Conflict Tactics Scales, the Alabama Parenting Questionnaire, and the Child Behavior Checklist. Fifty-two percent of children reported alcohol use within the past year and 32% experienced alcohol-related problems. The average number of reported alcohol problems was 11.19 (SD?=?63.65). Five robust regression models examined correlates of early problem drinking in Ukraine. The final model indicated older child age (β?=?0.21, p?<?0.001), more symptoms of externalizing behavior (β?=?0.17, p?<?0.01), and higher peer alcohol use (β?=?0.23, p?<?0.001) were significantly and positively associated with child alcohol problems. Results of the final model explained 32% of the variance in child alcohol problems, F(8, 311)?=?10.76, p?<?0.001. In conclusion, the findings suggest that older age, exposure to high-risk alcohol permeated peer environments, impulsivity, and rule-breaking behaviors are linked with the trajectory of early alcohol abuse among Ukrainian children. Mechanisms that reduce the harmful influence of these risk factors on alcohol consumption need to be in place.     

Childhood Adversity and Children’s Academic Functioning: Roles of Parenting Stress and Neighborhood Support

Existing research has shown that adverse childhood experiences from family instability and lack of safety increase children’s risk for poor academic functioning. A recent conceptual framework, however, has emphasized the need to investigate how parenting might mediate while community context might moderate the association between childhood adversity and children’s cognitive development. In the current study, we tested the roles of parenting stress and neighborhood support in the association between cumulative childhood adversity and children’s current academic functioning. We conducted a secondary data analysis on the subsample of school-aged children (i.e., 6–17 years old; N?=?65,680) from the 2011–2012 United States National Survey of Children’s Health (NSCH). The parent provided telephone survey data on six types of adversity (e.g., parent’s divorce) that the target child experienced, parenting stress, neighborhood support, as well as the child’s academic functioning. Controlling for the child’s age, gender, ethnicity, and the parent’s education level, structural equation modeling (SEM) revealed a significant moderated mediating effect: parenting stress partially mediated the association between history of childhood adversity and children’s current academic functioning (β?=??1.760, p?<?0.001), while neighborhood support moderated the association between parenting stress (β?=?0.492, p?<?0.001) and academic functioning.     

Living Well in Later Life: The Influence of Sense of Coherence,and Socio-Demographic,Lifestyle and Health-Related Factors on Older Adults’ Satisfaction with Life

This study aims at exploring a structural model of satisfaction with life’s (SWL) predictors in a cross-national sample of older adults. A quantitative approach was followed with a cross-sectional study design. A community-dwelling sample of 1,234 older adults from four different nationalities residing in Portugal, was assessed regarding SWL, sense of coherence (SOC) and socio-demographic, lifestyle and health-related characteristics. Sampling was performed in lifelong learning centres’ message boards and local community centres’ list-serves in the Lisbon metropolitan area and in the Algarve region. Structural equation modeling was used to investigate a structural model of the self-reported SWL, comprising SOC, socio-demographic characteristics (age, sex, education, marital and professional status, household, adult children, income, living setting and religion), as well as lifestyle and health-related characteristics (physical activity, recent disease and medication). Significant predictors are SOC (β?=?0.733; p?<?0.001), religion (β?=?0.725; p?<?0.001), income (β?=?0.551; p?<?0.001), adult children (β?=?0.546; p?<?0.001), education (β?=??0.403; p?<?0.001), living setting (β?=??0.292; p?<?0.001) and medication (β?=??. 197; p?<?0.001). The variables accounted for 24.8 % of the variability of SWL. Moreover, differences between the four nationality groups (F _{(3, 671)}?=?3.671, p?=?0.066) were not found concerning SWL. Sense of coherence is the strongest predictor of self-reported SWL. Other predictors are religion, income, adult children, education, living setting and medication. The four nationalities did not present significant differences, concerning SWL. This study points out the potential factors that influence older adults’ SWL, in particular SOC, religion and income, as promoters of aging well, within a salutogenic model of health for older populations.     

Emotion Regulation in Families of Children with Behavior Problems and Nonclinical Comparisons

The current study compared parents’ emotion regulation (ER) in clinical (those with a child with externalizing behavioral problems) and low-risk comparison families. Additionally, mediation models were explored with parent ER predicting child behavior problems through child ER. Participants were 60 families with children (71.7% boys; 73% Caucasian) ages 2 through 8 years (M?=?4.62; SD?=?1.69) from a rural population in the United States: 34 clinical families referred for parent training and 26 nonclinical families. A blocking design was used to balance the two groups on key demographic characteristics. Parents’ and children’s ER was assessed using parent-report surveys and structured behavioral observations. Analyses indicated higher rates of parental emotion dysregulation (specifically, more difficulty when upset with achieving goal-directed behaviors, p?=?.01, d?=?0.67; controlling impulses, p?=?.01, d?=?0.64; limited use of ER strategies, p?=?.02, d?=?0.62; and more negative verbalizations to their child during the observed task, p?<?.01, d?=?0.73) and child emotion dysregulation (specifically, more difficulty as reported by parents, p?<?.01, d?=??2.42) in the clinical group. Mediational analyses indicated there were indirect paths from parental ER to children’s behavioral problems through child ER. Findings from this research suggest a need to measure and target ER in both parents and their children when working with families who are referred for treatment of child behavior problems.     

Examining the Validity of Cyclothymic Disorder in a Youth Sample: Replication and Extension

DSM-IV-TR defines four subtypes of bipolar disorder (BP): bipolar I, bipolar II, cyclothymic disorder and bipolar not otherwise specified (NOS). However, cyclothymic disorder in children is rarely researched, or often subsumed in an “NOS” category. The present study tests the replicability of findings from an earlier study, and expands on the criterion validity of cyclothymic disorder in youth. Using the Robins and Guze (1970) framework we examined the validity of cyclothymic disorder as a subtype of BP. Using a youth (ages 5–17) outpatient clinical sample (N?=?894), participants with cyclothymic disorder (n?=?53) were compared to participants with other BP spectrum disorders (n?=?399) and to participants with non-bipolar disorders (n?=?442). Analyses tested differences in youth with cyclothymic disorder and bipolar disorder not otherwise specified who do, and those who do not, have a parent with BP. Compared to youth with non-bipolar disorders, youth with cyclothymic disorder had higher irritability (p?<?0.001), more comorbidity (p?<?0.001), greater sleep disturbance (p?<?0.005), and were more likely to have a family history of BP (p?<?0.001). Cyclothymic disorder was associated with a younger age of onset compared to depression (p?<?0.001) and bipolar II (p?=?0.05). Parental BP status was not significantly associated with any variables. Results support that cyclothymic disorder belongs on the bipolar spectrum. Epidemiological studies indicate that cyclothymic disorder is not uncommon and involves significant impairment. Failing to differentiate between cyclothymic disorder and bipolar NOS limits our knowledge about a significant proportion of cases of bipolarity.     

Development,Social-Emotional Behavior and Resilience of Orphaned Children in a Family-Oriented Setting

SOS children’s villages take care of orphaned or abandoned children who are likely to suffer from multiple psychosocial problems. Nevertheless, much is not known about the developmental, social-emotional, nutritional and resilience status of young SOS children (SOSc) living in poor settings of developing countries such as Ethiopia. The present study examined the developmental, social-emotional, nutritional and resilience status of SOSc in Jimma town of Ethiopia. In total, we selected 62 children (3.5–71.8 months of age; 32 boys and 30 girls) and tested for their personal-social, language, fine and gross motor development with the culturally adapted and standardized developmental screening tool, Denver II-Jimma; and their social-emotional behavior with the ages and stages questionnaire: social-emotional (ASQ:SE). We compared their outcomes to 62 age- and sex- matched family-reared children. To estimate the nutritional status of all children, we followed the WHO child growth standards. We used an interview guide to investigate resilience of the children. SOSc performed significantly poorer on language (p?<?0.001, effect size (es)?=?0.957), gross motor (p?<?0.001, es?=?0.879) and social-emotional (p?<?0.001, es?=?1.220) outcomes. Twenty-two (35.5%) of SOSc were undernourished and 17 (77.30%) of them were stunted. SOSc demonstrated resilient behavior, and child, SOS family and community characteristics were the major protective factors which enabled them to thrive in spite of the loss of their parents. Early intervention focusing on language, gross motor and social-emotional skills may be particularly beneficial to support children in SOS villages.     

The Influences of Parent and Peer Attachment on Bullying

Individuals with secure attachments to parents and peers are less likely to be bullies and victims of bullying. The current study examined the interplay between gender, parent attachment, and peer attachment as factors related to roles (bullying involvement, defending a victim, and outsider) during bullying. One-hundred forty-eight adolescents (M age?=?15.68) completed surveys about parent and peer attachment and roles during bullying. Findings indicated that females were less likely than males to be involved in bullying and were more likely than males to defend a victim or be an outsider (ps?<?.05). Greater attachment security to parents and peers was associated with less involvement in bullying and greater defending of victims (ps?<?.05). Additionally, a significant three-way interaction demonstrated that greater peer attachment security predicted less bullying involvement for those with lower parent attachment security (p?<?.05), but not for those with higher parent attachment security (p?>?.05). However, this was only true for males (p?<?.01). These results indicate that having a secure attachment to peers may be a potential protective factor against bullying involvement for males with insecure attachments to parents. Future research should examine the possible mechanisms involved in the association between attachment and bullying, such as empathy, aggression, or social information processing.     

Assessment of Work–Family Conflict Among Women of the Sandwich Generation

The term sandwich generation refers to the middle-aged generation who are responsible for caring elderly parents and dependent children. This situation is worse in case of working women who have job obligations along with family responsibilities. Therefore, this study is aimed to investigate level of the four-dimensional work–family conflict among working women of the sandwich generation. This cross-sectional study was conducted among 90 Malaysian working women using self-reported data. Multiple-stage simple random sampling was used to recruit women from public service departments of Malaysia. Self-administrated questionnaires were used for data collection. Data were analyzed using SPSS version 21. One-third of our respondents (33.3%) are members of sandwich generation who simultaneously provide care to elderly parents and children. However, 66.7% of women in this study are caregivers for either elderly parent or their children. The results of t-test showed that level of time-based FIW was significantly (t?=?? 2.02, p?<?0.05) higher in sandwich generation members (Mean?=?12.33, SD?=?1.95) compared to women caring for either parent or children (Mean?=?11.25, SD?=?2.58). The results of Multiple linear regression indicated that membership in sandwich generation significantly predict (b?=?0.26, p?<?0.05) FIWt after controlling for the effect of socio-demographic variables. Our findings showed that women who simultaneously take care of both elderly parent and children significantly experience higher level of time-based Family Interference into Work (FIWt). In contrast, membership in sandwich generation was not related to higher level of time-based Work Interference into Family (WIFt).     

Anomalies in Measuring Health-Related Quality of Life: Using the PedsQL 4.0™ with Children Who Have Peanut Allergy and Their Parents

The purpose of this study was to examine the relationship between health-related quality of life, using the PedsQL? 4.0, and peanut allergy in children. As part of a larger study, 51 parents completed a demographics questionnaire, a Pediatric Quality of Life Inventory? (PedsQL 4.0), and a series of questions regarding their child’s peanut allergy. 48 child participants, ages 6 to 12, completed a PedsQL? 4.0, and some specific questions regarding their peanut allergy. Parents of children with peanut allergy reported higher scores for their children for physical functioning (t (50)?=?3.6, p?<?.001) and lower scores for emotional functioning (t (50)?=??4.88, p?<?.001) compared to published norms for healthy controls. Further analysis, as explored in this paper, showed differences in functioning based on school placement. Children who were homeschooled reported lower physical functioning scores. These reports appear anomalous given that peanut allergy should not affect physical strength or stamina and may be tapping into another reason that these children are homeschooled. The anomalous results of the current study, in the area of physical functioning for children with peanut allergy, support the current trend of more disease-specific health-related quality of life measures for children.     

Maternal Depression in Families of Children with ADHD: A Meta-Analysis

Although research has demonstrated a relationship between maternal depression and child attention deficit/hyperactivity disorder (ADHD); the strength of the relationship is currently unclear. The results of some studies have found a strong association between maternal depression and child ADHD, while other studies have found little or no association. A meta-analysis was conducted to clarify the strength of the association between maternal depression and child ADHD. The current study included 51 published and unpublished studies that included a quantitative comparison between maternal depression and child ADHD. Mothers of children with ADHD had significantly higher levels of depressive symptoms than mothers of children without ADHD (d?=?0.58; 95% CI [0.43, 0.74]; p?<?.001; k?=?18). The relationship between maternal depressive symptoms and child ADHD symptoms was moderate (r?=?.22; 95% CI [.17, .28]; p?<?.001; k?=?21). 17.11% of mothers of children with ADHD currently met criteria for a depressive disorder (95% CI [11.95, 23.89], p?<?.001, k?=?19). The DSM version used to evaluate child ADHD status was the only moderator that was statistically significant (p?=?.021, k?=?15). Specifically, studies that used the DSM-III or DSM-III-R were associated with larger effect sizes than studies that used the DSM-IV or DSM-IV-TR. The results suggest that clinicians should screen for the possible co-occurrence of maternal depression when working with families of children with ADHD.     

Maternal and Paternal Perception of Child Vulnerability and Behaviour Problems in Very Preterm Born Children

Preterm born children have more behaviour problems than term born children. Perinatal risks, current child functioning, sociodemographic characteristics, parental psychological distress and parental perceptions of child vulnerability (PCV) have been shown to be risk factors for behaviour problems. However, the role of maternal and paternal PCV is unclear, as these have not been investigated as a risk factor for behaviour problems, with all other risk factors taken into account. Aim of this study is to investigate whether maternal and paternal PCV are independent risk factors for behaviour problems in very preterm (VP) and term born children. The present study is a single centre prospective cohort study. Preterm children (n = 104), born at <30 weeks' gestation and/or birth weight <1000 g, and term children (n = 95) were assessed at age 5. Results showed that risk factors for parent‐rated behaviour problems were low/middle parental education, VP birth, parental stress and, in VP children, maternal PCV. Risk factors for teacher‐rated behaviour problems were low/middle parental education, foreign parental country of birth, intrauterine growth restriction and objective child vulnerabilities. It can be concluded that maternal PCV is a risk factor for parent‐rated behaviour problems in VP children. When VP children are presented with behavioural problems, clinicians ought to be aware of the possibility that parents might still perceive their child as vulnerable. The neonatal history of the child, the way parents experienced that period, their perceptions of the child and possible consequences of these perceptions could be subjects for conversation during visits at follow‐up clinics. Copyright © 2015 John Wiley & Sons, Ltd.     

Factors Influencing Adolescents’ Self-control According to Family Structure

We compared factors influencing adolescents’ self-control according to their family structure. Participants were 944 adolescents in five cities in South Korea (115 from single-parent families, 65 from grandparent-led families, and 764 from two-parent families). Data were collected using self-report questionnaires containing items on self-control, stress, parenting attitude, parent–adolescent communication, and family cohesion. Data were analyzed using stepwise multiple regressions with SPSS program. The factors influencing adolescents’ self-control differed across the three family structure groups. For single-parent families, stress and parental attitudes were significantly related to adolescents’ self-control (adjusted R²?=?0.37, p?<?0.001). In contrast, for grandparent-led families, family cohesion and parental attitude were significantly related to adolescents’ self-control (adjusted R²?=?0.31, p?<?0.01), while for two-parent families, stress, parental attitude, and parent–adolescent communication were related to the outcome (adjusted R²?=?0.24, p?<?0.001). Parental attitude was thus a common factor relating to self-control, regardless of family structure. On the other hand, the main factors influencing adolescents with low self-control were gender and stress. Our results confirm that adolescents’ self-control is not only affected by personal factors but also by parental and family factors. It is important to improve individual program to improve adolescents’ self-control according to family structure. The results of study may act as a base for improving individual intervention programs aimed at promoting adolescents’ self-control by factoring in family structure.     

Associations of Quality of Life,Physical Activity and Mood States in Women with Breast Cancer Treated with Curative Intent

This study aims to investigate the associations between quality of life, physical activity and mood states in women with breast cancer. A total of 354 women (mean age, 51.74?±?8.63 years; body mass index (BMI), 28?±?5.67 kg/m²) completed the Baecke Physical Activity Questionnaire, Profile of Mood States (POMS), European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) and European Organisation for Research and Treatment of Cancer Breast Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-BR23). Pearson’s correlation and multiple linear regressions were used to verify the relations between outcomes and independent variables. Correlations between scores on POMS, Baecke Physical Activity Questionnaire and global health status/quality of life subscale of EORTC QLQ-C30 found associations (p?<?0.01) between physical activity (r?=?0.191), vigour (r?=?0.333) and fatigue (r?=??0.433). Multiple linear regression analysis of the global health status/quality of life subscale of the EORTC QLQ-C30 showed significant differences for vigour (p?<?0.001), social function (p?=?0.003), side effects of systemic therapy (p?=?0.019), arm and breast symptoms (p?<?0.001) and Baecke physical activity score (p?=?0.006). Physical activity is an independent factor related to the quality of life in women with breast cancer. Understanding these variables may influence clinical decisions during treatment and allow positive interventions regarding symptoms, functions and lifestyle.