Psychological adjustment of pediatric lung transplantation candidates and their parents

Investigated psychological functioning of 45 children and adolescents (ages 5 to 17 years) and their parents presenting at a major medical center for evaluation for lung transplantation. Patients completed self-reports, and parents completed measures on their children's behavior problems and emotional distress as well as on their own symptoms of distress. In general, children and their parents reported normal functioning on standard psychological measures. Few children fell in the clinically significant range, whereas 21% of mothers and 14% of fathers reported clinically significant levels of distress. Older children reported lower levels of depressive symptoms than younger children, and patients with cystic fibrosis manifested lower levels of internalizing symptoms than those with other pulmonary diseases. Findings demonstrate the resiliency of children and their parents facing a stressful point in the child's medical status and document the usefulness of psychological screening of patients and parents to identify those in need of clinical intervention.     

Examining Relationships Between Ethnic Identity, Family Environment, and Psychological Outcomes for African American Adolescents

Ethnic identity has been linked to a number of healthy psychological outcomes for African American adolescents. The levels of conflict and cohesion in the family environment have also been found to be predictive of adolescent mental health. This study examined whether the ethnic identity and levels of conflict and cohesion in the family environments were related to adolescents’ psychological adjustment. Participants included 61 African American adolescents, ages 10–14 years old, and their parents. Hierarchical regression models were used to determine the cumulative effects of ethnic identity and family functioning on adolescent mental health, specifically adolescent levels of depression, self-esteem, and interpersonal functioning. Results indicated that having a positive ethnic identity and a cohesive family environment were most strongly associated with psychological adjustment. Implications of these results are discussed in terms of family interventions.     

Relationships with Parents, Spousal Reciprocity, and Psychological Distress in Middle-Age Adults

Data from 301 middle-age couples were employed to investigate links between their recalled parents’ parenting styles and perceptions of reciprocity with their parents, as well as their current perceptions of spousal reciprocity, on their psychological distress. The research extends Baumrind’s theory of childhood parenting styles and Youniss’ theory of late adolescents’ perceived reciprocity to a developmental model for middle-age psychological distress. Differential effects were found according to the gender of both the offspring and the parent. There were significant positive findings only if the opposite-sex parent was perceived as authoritative, and significant negative findings if the same-sex parent was perceived as authoritarian. Regression models indicated mediated, integrated relationships (through maternal and spousal reciprocity) for females, but no mediations were found for males. Significantly more variance in emotional distress was explained by spousal reciprocity than by the parent related variables, and for the men than for the women.     

Adolescents-Family Connectedness: A First Cross-Cultural Research on Parenting and Psychological Adjustment of Children

Connectedness between children and their family is a major factor that distinguishes between collective and individualistic cultures. The Multigenerational Interconnectedness Scale, measuring adolescents-family connectedness was administered to adolescents in nine western and eastern countries. The findings show that connectedness in eastern countries was higher than that in western ones. Female adolescents were more connected to their families than males. Connectedness was higher among families with a higher economic level and where the parents had more education. Financial and functional connectedness was associated with adolescents’ better mental health, whereas emotional connectedness (or dependency) was associated with psychological disorders. The association between connectedness and psychological disorders was not the same across countries.     

The Effect of Parental Responsiveness on Differences in Psychological Distress and Delinquency between Singleton and Non-Singleton Chinese Adolescents

We assessed the differences in psychological distress and delinquent participation between singleton and non-singleton Chinese adolescents and the extent to which parental responsiveness (mother’s vs. father’s) might account for such differences. Using survey reports of 1,924 7th and 8th graders from three middle schools in the outskirts of Fuzhou, China, we observed small but significant differences between singleton and non-singleton adolescents. Singletons reported lower levels of psychological distress and delinquent participation than non-singleton adolescents. Furthermore, singletons received higher levels of parental responsiveness, which was inversely related to psychological distress and delinquent participation, respectively. The difference in psychological distress between singletons and non-singletons was completely mediated by both maternal and paternal responsiveness. Paternal responsiveness alone fully mediated the difference in delinquent participation between singleton and non-singleton adolescents. We discussed these results in light of both theoretical literature and empirical implications.     

Parenting After a Natural Disaster: A Qualitative Study of Norwegian Families Surviving the 2004 Tsunami in Southeast Asia

How do parents support their children after a high-impact disaster? To answer this question, face-to-face interviews were conducted with 51 Norwegian parents. These parents and children were all severely exposed to the trauma of the tsunami disaster. The analyses show how parents interpret their children’s signs of distress, as well as their own strategies of support in the aftermath. The main strategies described by the parents were watchful waiting, careful monitoring of the children’s reactions and a sensitive timing when providing support. Such monitoring, and interpretation of signs of distress, served as an aid for the parents in determining what needs their children had and what support they therefore needed to provide. A range of support strategies were employed, including re-establishing a sense of safety, resuming normal roles and routines, and talking to their children. Parents who were themselves severely impacted by the disaster reported a reduced ability to assess their children’s reactions and thereby were unable to provide optimal care in the aftermath. Interestingly, the parents’ support strategies mirror the early intervention recommendations put forward in the NICE guidelines and in the Psychological First Aid guidelines which is a well accepted and promising practice for helping children after disasters.     

Substance Use and Health and Safety among Homeless Youth

This study examines how substance use is associated with the health and safety of homeless youth using cross-sectional, self-report data from 285 homeless adolescents. Path models were used to examine concurrent relationships between youth’s substance use and multiple aspects of their health and safety, including measures of psychological distress, housing risk and instability, and medical problems. Substance use was examined with both global (i.e., a composite of days of use across various drugs and alcohol) and specific (i.e., rates of use of specific drugs, injection drug use) measures. After controlling for demographic and historical variables, number of days of use was significantly related to psychological distress, whereas injection drug use was significantly related to housing risk. Examination of specific drugs revealed relationships between psychological distress and the use of alcohol, cocaine, and amphetamines, and a specific relationship between housing risk and the use of heroin. None of the measures of substance use was significantly related to youth’s medical problems. Implications for interventions with homeless adolescents are discussed.     

青少年和父母对心理咨询认识的质性研究

用访谈法探讨8个已求助和5个未求助家庭的青少年和父母对心理咨询的认识;比较已求助者和未求助者、青少年和父母对心理咨询认识的差异。结果显示,青少年和父母从6个方面描述心理咨询:功能、形式、适用问题、服务提供者、求助者和效果,各方面提及次数最多的分别是问题解决、谈话法、心理困扰、心理医生、心理有病的人和有帮助;误解包括心理咨询是针对心理有病的人,只有严重问题才需要求助。已求助者比未求助者更了解心理咨询,提及问题解决、心理困扰和有帮助的次数更多。青少年更多认为心理咨询是心理老师处理正常群体的心理困扰;父母更多认为心理咨询是心理医生处理心理疾病。青少年和父母对心理咨询的认识趋于理性和准确,但仍有误解需要澄清。     

Special People? An Exploratory Study into Re-entering Missionaries’ Identity and Resilience

Home country re-entry from cross-cultural missionary work abroad may be associated with psychological distress. Re-entrants experience multiple losses including loss of identity which may be associated with personal/relational identity gaps and depersonalization/dehumanization. However, research suggests that some re-entrants are resilient with good mental health, while others are fragile with poor mental health. The aims of this paper are to explore the nature and frequency of re-entering missionaries’ identity gaps and their depersonalization/dehumanization in resilient and fragile re-entrants. Fifteen re-entering adult Australian cross-cultural missionary workers from four interdenominational Australian mission organizations completed semi-structured interviews. Results were analysed using modified Consensual Qualitative Research methods. Links were established between personal/relational identity gaps, depersonalization/dehumanization and resilience on re-entry. Implications for re-entrants’ care are discussed with suggestions for further research.     

What Does the Alliance Predict in Group Interventions for Early Psychosis?

The therapeutic alliance is considered an essential component of any clinical or psychological intervention. The therapeutic alliance can however change over time, and therefore it is relevant to determine if the alliance and its variations are related to clinical outcomes. The present study had three objectives: (1) determine the impact of the alliance measured by the client and the therapist, on clinical and psychosocial outcomes of individuals with early psychosis receiving group interventions; (2) measure the concordance between the client and the therapists’ ratings of the alliance; and (3) determine the best predictor of the client’s alliance in our sample. A total of 36 individuals with early psychosis who participated in group interventions for symptom management answered the WAI three times, and so did the group therapists. Outcomes included measures of insight, symptoms (total, positive and negative), and self-esteem. Attendance and group participation were also measured. Results suggest that the overall client’s alliance predicted total symptoms and self-esteem at post-therapy, whereas both clients’ and therapists’ ratings predicted group attendance and participation. Greater variations in the alliance overtime for the clients were somewhat linked to worse negative symptoms at post-therapy. Alliance ratings were generally high and fairly concordant between therapists and clients. Only the baseline measure of capacity for attachment, predicted the client’s overall alliance scores. Clinical implications are discussed.     

Negative and Positive Disability-related Events and Adjustment of Parents with Acquired Physical Disabilities and of their Adolescent Children

This study merged stress-and-coping research with the social model of disability to describe the most frequently experienced disability-related events experienced by 19 parents with acquired physical disabilities and their adolescent children, and examined the relations between these events, severity of disability, and psychological adjustment. Parents and adolescents reported many more positive than negative disability-related events, although parents reported significantly more negative events than did their children. Frequency of parents’ experienced negative disability-related events correlated significantly with self-reported anxiety, depression, and weaker feelings of parental self-efficacy, with their reports of adolescents’ internalizing and externalizing problems, and with adolescents’ self-reports of depression, anxiety, and lower self-esteem. Frequency of adolescents’ negative disability-related events correlated significantly with self-reported depression and lower self-esteem, and approached significance with self-reported anxiety. There were no significant associations between parents’ positive events and self-reported or adolescent adjustment. Total frequency of adolescents’ positive events correlated significantly with less parent-reported anxiety. There were several significant associations between parental rating of severity of disability and number of physical limitations with their and their children’s adjustment. Implications for understanding the daily effects of parental physical disability on parents and their adolescent children are discussed, and recommendations are suggested for prevention interventions.     

The Interface between Mental Health Providers, Families, and Schools: Parent and Child Attitudes about Information-Sharing

Youth with emotional and behavioral disorders (EBD) are at an increased risk for school problems and negative consequences into adulthood, increasing the need for collaboration between families, school personnel and mental health providers. Current treatment guidelines emphasize the importance of information-sharing between providers and schools, yet few studies have addressed parents’ or students’ attitudes and preferences about this process or about the disclosure of mental health-related information to school professionals. Using a sample of 73 pairs of parents and their adolescents seeking outpatient treatment, this study assessed parental and adolescent attitudes about disclosure of mental health treatment information to school personnel. The majority of parents reported that the school should be informed that their adolescent was receiving counseling or medication for EBD, and that they should be the primary informant, rather than providers. By comparison, adolescents preferred more discretion about their involvement in treatment. Taken together, the study results highlight a number of implications relevant to the therapeutic relation and the process of obtaining and sharing mental health-related treatment information with various school personnel. Future research directions regarding the consultative and collaborative process with school personnel are also discussed.     

Adolescent Perceptions of Parental Behaviors,Adolescent Self-Esteem,and Adolescent Depressed Mood

Using symbolic interaction, we developed a research model that proposed adolescent perceptions of parental support and psychological control would be related to adolescent depressed mood directly and indirectly through self-esteem. We tested the model using self-report questionnaire data from 161 adolescents living with both of their biological parents. To examine possible gender of adolescent differences, we tested two multigroup models separately for adolescents’ perceptions of mothers’ and fathers’ parental behaviors. Both the fathers’ and mothers’ models yielded (a) direct paths from self-esteem to depressed mood (for boys and girls), psychological control to depressed mood (for boys) and (b) an indirect path from support to self-esteem to depressed mood (for girls and boys) and an indirect path from psychological control to self-esteem to depressed mood (for girls). In addition, in the fathers’ model a significant direct path was found between fathers’ support and depressed mood (for girls).     

Factors associated with the mental health of adolescents when a parent has cancer

This study explored factors associated with the mental health in adolescents (ages 11-17; n = 54) within 12 months after a parent had been diagnosed with cancer. A control group was included (ages 11-17; n = 49). A demographic questionnaire, the SF-8 Health Survey, the Youth Self Report and the McMaster Family Assessment Device were used. Similar levels of psychological distress and healthy family functioning were reported in the clinical and the control group. No effect of gender of the ill parent and that of the adolescent was found. A negative correlation was found between the physical health of the ill parent and the mental health of the adolescent. Healthy family functioning correlated with less psychological distress in adolescents with a parent with cancer. Open communication, flexible problem solving and appropriate affective involvement were significant predictors for less psychological distress in the adolescents. The study concludes that a healthy family functioning facilitated the adolescent's adjustment to parental cancer.     

Psychological Distress among Immigrant Adolescents: Culture-specific Factors in the Case of Immigrants from the Former Soviet Union

Studies investigating the effects of immigration on the psychological wellbeing of adolescents have produced variable and inconclusive results: some identify immigrant adolescents as a group of risk whereas others fail to demonstrate higher psychological distress in this group of adolescents. It is suggested in the present paper that cultural factors active in specific ethnic groups of immigrants may in part account for this inconsistency. The present study explores the psychological distress of immigrant adolescents from the Former Soviet Union (FSU) in Israel. The respondents were 560 university students (250 females and 310 males) who had immigrated to Israel from the FSU since 1989. The present report relates to one of the instruments applied in the study: the Brief Symptom Inventory (BSI). Mean BSI scores of the respondents were significantly higher than those of Israeli adolescents and in some categories higher than the American norms. A high percent of the immigrant respondents have reported severely troubling symptoms; however no significant differences were found between the BSI scores of FSU immigrants in Israel and their peers in the FSU. The findings are discussed in light of some sociocultural characteristics of society in the FSU.     

Stress and coping: The Loma Prieta Earthquake

This study examined the stress response, coping strategies, and behavioral intentions of 185 subjects following the Loma Prieta Earthquake. Subjects completed a series of open ended questions about previous experience with earthquakes and their preparedness for previous and future earthquakes. The Impact of Event Scale (IES) and the Symptom Checklist, Version 90R (SCL-90R), were used to measure participants’ subjective stress response and symptoms of psychological distress at two days and either one week or three weeks following the earthquake. At one or three weeks, some subjects also completed the Coping Strategies Inventory. This study describes the stress response in this earthquake population and explores the relationship of the passage of time and past experiences with earthquakes to psychological distress following the earthquake. Coping strategies and behavioral intentions were also assessed. Results indicated that, although stress levels were elevated at the time of the initial testing, there were declines in reported stress as early as the one week follow-up session. Additionally, a number of gender differences were found in terms of the stress response to the earthquake.     

Parental Experiences of Having a Child with Obsessive-Compulsive Disorder: Associations with Clinical Characteristics and Caregiver Adjustment

We examined parental experience of having a child with obsessive-compulsive disorder (OCD) in 62 parent–child dyads. Youth with a primary diagnosis of OCD and their parent(s) were administered the CY-BOCS jointly by a trained clinician. Parents completed several measures about their child’s OCD-related impairment and accommodation, emotional and behavioral functioning, parental distress, caregiver stress, and parental experiences of having a child with OCD. Results indicated that parents of children with OCD are considerably distressed about their child’s condition. As expected, negative parental experiences (e.g., anxiety about child’s condition, uncertainty about their future) were directly related to OCD symptom severity and impairment, as well as child internalizing and externalizing problems, family accommodation of symptoms, and caregiver strain. The presence of emotional resources was negatively related to most outcomes, although some of these relationships did not achieve statistical significance. The presence of internalizing symptoms mediated the relationship between parental experiences and parental distress. Given these findings, addressing parental experiences as part of a family based cognitive-behavioral treatment program for pediatric OCD may help reduce parental distress and improve patient prognosis.     

Family Management of Pediatric Cancer: Links with Parenting Satisfaction and Psychological Distress

Research has long acknowledged the disruptions posed by pediatric cancer diagnosis and treatment to family life. Nonetheless, the mechanisms through which the family response influences parents’ mental health in this adverse context are not fully understood. The main goal of the present study was to examine the direct and indirect links, via parenting satisfaction, between family condition management and psychological distress of parents of children with cancer. Participants were 201 parents (86.6% mothers) of children/adolescents diagnosed with cancer who completed self‐report questionnaires assessing family condition management (family life difficulty and parental mutuality), parenting satisfaction, and psychological distress (anxiety and depression). Structural equation modeling was used to test the proposed mediation model. The results showed that parenting satisfaction mediated the association between both the family condition management dimensions (family life difficulty and parental mutuality) and depression. Specifically, greater family life difficulties and lower parental mutuality were associated with lower parenting satisfaction, which, in turn, was associated with higher levels of depression. Additionally, greater family life difficulties and lower parental mutuality were directly linked to higher levels of anxiety. Multigroup analyses suggested that the model was valid across patient age groups (children vs. adolescents) and treatment status (on vs. off‐treatment). These findings reinforce the need for family‐ and parent‐based interventions in the pediatric oncology field. Interventions that target families’ difficulties and promote their resources are likely to foster parenting satisfaction and psychological adjustment.     

Adolescent adjustment and well-being: effects of parental divorce and distress

This study investigates the long-term effects of parental divorce on adolescent psychological adjustment and well-being, and to what extent the effects are accounted for by parental psychological distress. Data were collected among 8,984 Norwegian adolescents (13-19 years) and their parents. Outcome variables were symptoms of anxiety and depression, subjective well-being, and three areas of school problems. Parental divorce was found to be associated with both higher mean levels and larger variances in adolescent problems. Divorce and parental distress contributed independently to adolescent distress, supporting the notion of "double exposure" effects. The prevalence of adolescents with substantial distress symptoms was 14% among those with non-distressed non-divorced parents and 30% among those with divorced and distressed parents. In general effects remained when controlling for demographic factors. Long-term effects of divorce on symptoms of anxiety and depression were stronger among girls than among boys.