Validity of the Short Form of the Parenting Stress Index for Fathers of Toddlers

We examined the psychometric properties of two scales of the parenting stress index-short form (PSI-SF) in a low-income sample of fathers of toddlers. The factor structure, reliability, and validity of the parental distress and parent–child dysfunctional interaction subscales were assessed for 696 fathers in a multi-site study of Early Head Start. Confirmatory factor analyses (CFA) compared the fit of the developer recommended two-factor scales with five-factor scales theoretically derived and supported with mothers. Our results suggested that two subscales from the PSI-SF were reliable and valid for this sample of racially diverse, low-income fathers of toddlers. However, these subscales capture multiple dimensions of parenting stress and results also supported the use of more narrowly defined aspects of parenting stress that included general distress, distress specifically related to parenting demands, problematic interactions of the father–toddler dyad, perceptions of the child, and parental perceptions of self as a parent. These unidimensional scales may prove useful in research and clinical activities by allowing researchers to elucidate the mechanisms through which stress impacts parenting and permitting clinicians information to develop more targeted interventions for young children and their families.     

Associations among mothers’ representations of their relationship with their toddlers,maternal parenting stress,and toddlers’ internalizing and externalizing behaviors

This study examined the array of associations among the emotional valence and the coherence of mothers’ representations of their relationship with their toddlers, mothers’ reported parenting stress, and toddlers’ internalizing and externalizing behaviors. To evaluate maternal representations, 55 mothers were interviewed using the Five Minute Speech Sample procedure (FMSS; Magaña et al., 1986), which was coded for criticism and positive comments (Magaňa-Amato, 1993), as well as coherence (Sher-Censor & Yates, 2015). Mothers also completed the Parenting Stress Index − Short Form (PSI; Abidin, 1997) to evaluate their parenting stress and the Child Behavior Checklist (CBCL/1.5–5; Achenbach & Rescorla, 2000) to assess their toddlers’ internalizing and externalizing behaviors. Results indicated that parenting stress was associated with maternal criticism and fewer positive comments in the FMSS, but not with the coherence of mothers’ FMSS. Parenting stress, criticism, and lower coherence in the FMSS were associated with maternal reports of externalizing behaviors. Only parenting stress and lower coherence in the FMSS were related to mothers’ reports of internalizing behaviors of the child. Thus, the emotional valence and the coherence of mothers’ representations of their relationship with their child and parenting stress may each constitute a distinct aspect of parenting and contribute to the understanding of individual differences in toddlers’ internalizing and externalizing behaviors. Implications for research and practice with families of toddlers are discussed.     

Parenting and Prematurity: Understanding Parent Experience and Preferences for Support

Infants born very preterm are at risk of developmental and behavioural problems and their parents are at risk of psychological distress and compromised parenting. This study has two key aims: (1) to identify, from the parents’ own perspective, the unique aspects of parenting an infant born very preterm and (2) to assess parent preferences for support including opinions of a new, tailored parenting intervention, Prem Baby Positive Parenting Program (Triple P). A qualitative approach was taken with focus groups of 18 parents of infants born preterm and a thematic analysis conducted. Parents identified several unique aspects of parenting an infant born preterm including: difficulty coping with the stress of hospitalisation; institutionalisation to the hospital environment; a lack of preparation for the transition to parenthood; grief; isolation; getting into “bad parenting habits” of overnurturance and a lack of certainty about developmental expectations. Parents preferred parenting support that is tailored to parents of infants born preterm, has flexible delivery, enhances coping skills and the spousal relationship and is sensitive to the emotional context of parenting an infant born preterm. Understanding the experiences and the preferences of parents of infants born preterm is an important step in tailoring parenting interventions to fit their needs.     

Extremely Preterm Birth Outcome: A Review of Four Decades of Cognitive Research

Premature birth incidence and survival rates are increasing steadily due to advances in obstetric and neonatal intensive care. Those born at the limits of viability are highly at-risk of adverse neurocognitive function over their lifespan, leading to current controversy regarding aggressive resuscitation efforts for these extremely preterm children. However, data from earlier generation cohorts who were born in substantially different eras of neonatal intensive care cannot be relied on to predict outcome of today’s newborn. Our review by the crucial variable of birth cohort year shows a changing developmental trajectory in which today’s extremely preterm survivor is likely to have fewer severe medical complications, better neurological outcomes, and fewer adverse cognitive late effects. Such data further underscore the importance of concurrently considering medical, familial, socioenvironmental, and neurobiological factors in combination with individual neonatal intensive care center protocols when studying outcomes of the preterm child. This complex, interrelated range of factors directly affects the immature, rapidly developing premature brain. However, ongoing surveillance to detect subsequent delay or impairment and to apply interventional strategies early in the developmental course holds promise for further enhancement of functional outcome.     

From prematurity to parenting stress: The mediating role of perinatal post-traumatic stress disorder

Preterm delivery may lead to the emergence of symptoms of Post-Traumatic Stress disorder (PTSD), which may, in turn, affect the quality of the mother-child relationship. The aim of this study is to shed light on the development of parenting stress in mothers of preterm and full-term children. It is hypothesized that PTSD symptoms mediate the relationship between preterm/full-term birth and the levels of parenting stress. Perinatal PTSD, parenting stress and social support were assessed in 156 mothers of full-term children and 87 mothers of preterm children. Mothers of preterm children experienced more post-traumatic stress and parenting stress than mothers of full-term children. However, the relationship between preterm delivery and subsequent levels of parenting stress was mediated by PTSD symptoms. These findings suggest that the maternal perception of childbirth as a traumatic experience and the subsequent development of PTSD symptoms are pivotal in the emergence of parenting stress.     

Compliance,opposition, and behavior problems in toddlers born preterm or low birthweight

Although children born preterm or low birth weight (PT LBW) are more likely to exhibit behavior problems compared to children born at term, developmental and family processes associated with these problems are unclear. We examined trajectories of maternal depressive symptoms in relation to toddler compliance and behavior problems in families with PT LBW infants. A total of 177 infants (93 boys, 84 girls) and their mothers enrolled in the study during the infant's NICU stay. Data were collected at five time points across 2 years. Assessments of maternal depressive symptoms were conducted at all time points, and toddler compliance and opposition to maternal requests and behavior problems were assessed at 2 years. Toddlers born earlier with more health problems to mothers whose depressive symptoms increased over time exhibited the most opposition to maternal requests during a cleanup task at 24 months, consistent with multiple risk models. Mothers with elevated depression symptoms reported more behavior problems in their toddlers. The study has implications for family‐based early intervention programs seeking to identify PT LBW infants at highest risk for problem behaviors.     

母亲抑郁情绪对幼儿内化问题的影响：有调节的中介模型

采用问卷法对298名6个月婴儿的母亲进行为期8个月的追踪,通过交叉滞后回归以及多层回归分析探究母亲抑郁情绪与母亲教养压力的准因果关系,母亲抑郁情绪与幼儿内化问题间的有调节的中介效应。结果表明：（1）母亲抑郁情绪与母亲教养压力存在准因果关系,母亲抑郁情绪可显著正向预测母亲的教养压力。（2）母亲感受到的教养压力对母亲抑郁情绪与幼儿内化问题的关系具有部分中介效应。母亲抑郁情绪不仅对幼儿内化问题产生直接影响,也可通过母亲的教养压力对幼儿内化问题产生间接影响。不过这一中介模型受母亲受教育程度的调节。只有在母亲受教育程度低时,教养压力对母亲抑郁情绪与幼儿内化问题的中介作用才成立,母亲较高的受教育程度可以明显减弱由于母亲抑郁情绪对幼儿内化问题的影响。这在一定程度上揭示了母亲抑郁情绪对幼儿内化问题的影响机制,对缓解母亲抑郁水平高的幼儿的内化问题提供理论和参考价值。     

Why do parents use screen media with toddlers? The role of child temperament and parenting stress in early screen use

Considering child characteristics may be an important piece to understanding parental decision-making for children’s screen use. The current cross-sectional study examined the mediating role of maternal parenting stress in the relation of child temperament to young children’s screen use. Recognizing the multidimensional aspects of temperament, three mediated pathways for three temperament domains (i.e., negative affectivity, surgency, and effortful control) were tested. Mothers of toddlers, 18–36 months (N = 296), completed an online survey, reporting on child temperament, total parenting stress, and child screen use. The results showed that mother-child dynamics were related to toddlers’ screen use. Toddlers’ negative affectivity and effortful control were each associated with toddlers’ screen use through maternal parenting stress. Higher negative affectivity was associated with higher maternal parenting stress, which in turn, was related to greater screen use in toddlers. Toddlers’ lower effortful control was related to higher maternal parenting stress, which in turn, was associated with greater screen use. Toddlers’ surgency was not related to either maternal parenting stress or toddlers’ screen use. The findings from this study contribute to an understanding of media-related parenting in toddlerhood and may help with the development of strategies for supporting healthy media habits in families with young children.     

Maternal sociodemographic factors differentially affect the risk of behavioral problems in Brazilian and Italian preterm toddlers

The main aim of the present study was to examine differences in behavioral problems in toddlers born very preterm in Brazil and Italy. The sample comprised 154 toddlers (18–24 months of age) born very preterm, including 76 toddlers from Brazil and 78 toddlers from Italy. The Child Behavior Checklist was used to assess behavioral problems. Specific sociodemographic factors (i.e., maternal age at childbirth and maternal education) and neonatal factors (i.e., gestational age, sex, and length of hospitalization) were tested as potential mediators of country-related differences in behavioral problems. Brazilian toddlers presented more internalizing, externalizing, and total behavioral problems compared with their Italian counterparts. The effect of country on the toddlers’ internalizing and total behavioral problems was mediated by maternal age at childbirth and education. Independent effects of country, maternal age at childbirth, and maternal education emerged for externalizing behavioral problems. No significant effect emerged for neonatal variables. These findings suggest that sociodemographic factors, in addition to country-related differences, should be considered when assessing the risk of behavioral problems in preterm toddlers.     

Predictors of early vocabulary growth in children born preterm and full term: A study of processing speed and medical complications

Delays in expressive vocabulary may be harbingers of long-term language difficulties. In toddlers born full term (FT), individual differences in language processing speed are associated with variation in expressive vocabulary growth. Children born preterm (PT) are at increased risk for persistent language deficits. Here, we evaluate predictors of early vocabulary growth in PT toddlers in relation to two sources of variability: language processing speed and medical complications of prematurity. Vocabulary growth from 16 to 30 months (adjusted for degree of prematurity) was modeled longitudinally using parent reports in English-speaking FT (n = 63; ≥37 weeks, ≥2495 g) and PT (n = 69; ≤32 weeks, <1800 g) children, matched on sex and socioeconomic status. Children were tested in the “looking-while-listening task” at 18 months to derive a measure of language processing speed. Each PT child was assessed for number of medical complications (13 maximum), based on medical chart reviews. PT and FT children displayed similar vocabulary trajectories; however, birth group disparities began to emerge by 30 months. PT children were slower in language processing speed than FT children. Critically, language processing speed predicted expressive vocabulary size at 30 months; interactions with birth group were not significant (all p > .20). In PT children, faster language processing speed predicted stronger outcomes regardless of number of medical complications; slower processing speed and more medical complications predicted poorer outcomes. Faster processing speed reflected favorable neuropsychological processes associated with faster expressive vocabulary growth that overrode the impact of medical complications on language outcomes in PT children.     

Cumulative psychosocial and medical risk as predictors of early infant development and parenting stress in an African-American preterm sample

The present study examined predictive linkages between cumulative psychosocial and medical risk, assessed neonatally, and infant development and parenting stress at 4 months of infant corrected age. Predominantly low-income, African-American mothers and their preterm infants served as participants. Cumulative psychosocial risk predicted early mental, but not motor development, while cumulative medical risk predicted both mental and motor development. Cumulative psychosocial risk, but not medical risk, predicted parenting stress. Few studies of preterm infants have reported links between cumulative psychosocial risk and infant development at such an early age, nor has earlier work found associations between cumulative psychosocial risk and mothers' perceptions of parenting. Results support the premise that early intervention should target both the medical and psychosocial needs of low-income families with preterm infants, and that addressing psychosocial stressors shortly after birth may improve developmental outcomes in infancy.     

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.     

Maternal Empathy and Changes in Mothers’ Permissiveness as Predictors of Toddlers’ Early Social Competence with Peers: A Parenting Intervention Study

The goal of the current study was to examine how changes in parenting due to a parenting intervention designed to decrease permissive parenting affected the quality of children’s peer interactions. Forty-nine mothers of toddlers aged 2–3 years participated in a 12-week intervention in which half got hands-on training and practice using positive guidance in a toddler classroom setting, while the other half learned positive guidance solely via a seminar format. To observe children’s peer interactions, toddlers were divided into 8 groups of 5–7 children mixed across condition. Observers coded mothers’ empathy, permissiveness, and positive guidance parenting strategies. Children’s peer interactions were coded for antisocial behaviors, verbal aggression, physical aggression, prosocial behaviors, positive social bids, and empathy. Prior analysis of this intervention indicated that mothers in both conditions showed reductions in permissiveness over the course of the intervention. Results from the present study indicated that reductions in permissiveness predicted decreases in toddlers’ verbal aggression. Maternal empathy was a moderator such that mothers low in empathy who got hands-on training in positive guidance had children who demonstrated the greatest reductions in antisocial behaviors.     

FATHER–CHILD PLAY DURING THE PRESCHOOL YEARS AND CHILD INTERNALIZING BEHAVIORS: BETWEEN ROBUSTNESS AND VULNERABILITY

Play observations with a total of 400 toddlers and preschoolers were videotaped and rated for Intensity and Quality of play with their parents. Parents were asked about perceived stress and personality characteristics (Big 5). Child's motor, cognitive skills, temperament, and internalizing behaviors were assessed. Study 1 investigated the robustness of play across child age and gender, and examined differences between fathers and mothers. Study 2 explored the vulnerability of play with fathers of children born preterm (PT‐fathers) and fathers who had experienced adverse childhoods (AC‐fathers). Study 3 investigated child internalizing behaviors. Intensity of play was maintained almost independently of child age and gender. It was similar for AC‐ and PT‐fathers, and similar to maternal Intensity. In contrast, paternal Quality of play was higher with boys and independent of fathers’ personality and perceived parenting stress whereas maternal Quality of play was higher with girls and linked to mothers’ perceived parenting competence, acceptability of the child, and neuroticism. AC‐fathers scored significantly low on Quality, as did PT‐fathers, but the Quality of their play became better with growing child age, birth weight, and cognitive (but not motor and temperament) scores. Finally, child internalizing behaviors were negatively related to paternal Quality of play.     

Parenting stress and competence among mothers of young children with substance use disorders: The roles of trauma and reflective functioning

Posttraumatic stress symptoms are prominent in the lives of parents of young children with substance use disorders (SUD). Parenting experiences, particularly stress and competence, impact parenting behaviors and concomitant child growth and development. Factors that promote positive experiences of parenting, such as parental reflective functioning (PRF), and protect the mother and child from negative outcomes are crucial to understand to develop effective therapeutic interventions. The current US study analyzed baseline data from a parenting intervention evaluation to examine how length of substance misuse, PRF, and trauma symptoms were associated with parenting stress and parenting sense of competence among mothers in treatment for SUDs. Measures included the Addiction Severity Index, PTSD Symptom Scale-Self Report, Parental Reflective Functioning Questionnaire, Parenting Stress Index/Short Form, and Parenting Sense of Competence Scale. The sample included 54 predominantly White mothers with SUDs who had young children. Two multivariate regression analyses found that (1) lower parental reflective functioning and higher posttraumatic stress symptoms were associated with higher parenting stress, and (2) only higher posttraumatic stress symptoms were associated with lower levels of parenting sense of competence. Findings underscore the importance of addressing trauma symptoms and PRF when aiming to improve parenting experiences for women with an SUD.     

Maternal factors and experiences associated with observed parenting behavior in mothers attending a residential parenting program

Parents experiencing early parenting difficulties often seek support through parenting programs. Characteristics of mothers seeking parenting support and information at an early parenting center in Victoria, Australia and the relationships between these factors and parenting behavior were explored using an observational measure of parent–child interaction. Participants were 43 mothers and children attending a 5‐day residential parenting program at the Queen Elizabeth Centre. Maternal and sociodemographic data as well as an observational mother–child interaction task from the Nursing Child Assessment Satellite Training Parent Child Interaction Teaching scale were completed and scored on the first day of the program. Certain maternal factors and experiences were associated with observed parenting behavior. Poorer maternal sleeping quality, unplanned pregnancy and preterm birth were all associated with less optimal parenting behavior in certain domains. Findings are discussed with reference to the impact of past experiences around pregnancy and birth as well as the current context and well‐being of mothers attending early parenting centers.     

Public health issues related to infection in pregnancy and cerebral palsy

Cerebral palsy is the most common neuromotor developmental disability of childhood, affecting as many as 8,000 to 12,000 children born in the U.S. each year (corresponding to a prevalence rate of between 2 and 3 per 1000 children). Recent improvements in neonatal care have not resulted in a decline in the overall prevalence of cerebral palsy and, in fact, greater numbers of very preterm/very low birth weight infants are surviving with cerebral palsy and other developmental problems. Infection in pregnancy may be an important cause of the disorder. In preterm infants, there appears to be about a 2-fold increased risk for cerebral palsy from chorioamnionitis, and in term infants the estimated increased risk is about 4-fold. Provisionally, chorioamnionitis might account for 12% of spastic cerebral palsy in term infants and 28% of cerebral palsy in preterm infants. Studies of biochemical markers of fetal inflammation typically associated with infection also suggest that an inflammatory response may be an important independent etiologic factor. If a substantial proportion of cerebral palsy is attributable to acute amnionitis infection and/or neonatal sepsis, cerebral palsy should have decreased in the United States after administration of intrapartum antibiotics became widespread in response to publication of public health consensus guidelines for Group B streptococcus in 1996. However, failure to detect declines could have a number of explanations and these explanations illustrate the many public health challenges related to intrauterine infection and cerebral palsy. Given the gaps in our current knowledge about intrauterine infection and cerebral palsy, public health recommendations for timely and specific prevention activities are limited at this time.     

Stress in Mothers with Intellectual Disabilities

Both low parental IQ and stress have been shown to be associated with parenting difficulties and adverse child outcomes. We examined stress in parents with low IQ as a potential contributor to their documented parenting problems. Eighty-two mothers with intellectual disabilities (IQ < 80; labelled as having mental retardation) were given the Parenting Stress Index and they were found to be enduring very high levels of overall stress (95th percentile), stress related to child characteristics (95th percentile), and stress related to other life experiences (90th percentile) as compared to the normative test group. We divided the 82 mothers with intellectual disabilities into three groups depending on the age of their children. The mothers with school-age children reported significantly higher stress than parents of infant/toddler and preschool children. A hierarchical regression analysis revealed that child age and living in a crowded environment were significant predictors of parenting stress. The results confirm that mothers with intellectual disabilities experience extreme stress that, together with other factors, may hinder adequate parenting.     

Maternal correlates of 2‐year‐old American Indian children's social‐emotional development in a Northern Plains tribe

The developmental experiences of very young American Indian children today are not well documented in the current literature. The present study sought to explore the social‐emotional development of American Indian toddlers living on a Northern Plains reservation, as a function of maternal variables. Mothers completed self‐report questionnaires about their experiences and their children's development. Observer ratings of children's development also were conducted. Maternal stress, substance use/abuse, perceptions of stress in the mother–child relationship, social support, and American Indian cultural identity were significantly related to children's social‐emotional development. This study is the first to explore these relationships in a Northern Plains American Indian sample of young children and their mothers. Results suggest possible points of intervention for improving the developmental outcomes of very young American Indian children.     

Parenting Stress, Social Support, and Depression for Ethnic Minority Adolescent Mothers: Impact on Child Development

Rates of teenage pregnancies are higher for African American and Latina adolescents compared to their White peers. African American and Latina adolescent mothers also experience more adversities than their White peers, such as higher rates of depression, school dropout, and economic disadvantage. Furthermore, children of adolescent mothers are at higher risk for adverse development. Parenting stress and social support can impact outcomes experienced by adolescent parents and their children. The present study examined the influence of adolescent mothers’ parenting stress and perceived social support on maternal depression at baseline (6 months after birth), and its impact on infant development 1 year later (18 months after birth). Participants were 180 adolescent mothers of African American or Latino/Hispanic descent. Results suggest that higher levels of parenting stress and less perceived social support were associated with higher levels of depression in the adolescent mothers at baseline. Higher levels of maternal depression were also associated with more developmental delays in infants 1 year post-baseline. Additionally, depression mediated the relationship between parenting stress and later child outcomes. These findings highlight the importance of examining parenting factors such as parenting stress, social support, and maternal depression in ethnic minority adolescent parents, and provide valuable information regarding unique risk and protective factors associated with positive maternal outcomes for ethnic minority adolescent parents and healthy development for their children.