The Relation Between Parental Mental Illness and Adolescent Mental Health: The Role of Family Factors

Children of parents with a mental illness are often found to be at high risk of developing psychological problems themselves. Little is known about the role of family factors in the relation between parental and adolescent mental health. The current study focused on parent–child interaction and family environment. This cross-sectional questionnaire study included 124 families with a mentally ill parent and 127 families without a mentally ill parent who at the time of the study had children aged 11–16 years old. Parents completed questionnaires about their mental health, parent–child interaction (i.e., parental monitoring and parental support), and family environment (i.e., cohesion, expressiveness, and conflict). Adolescents reported their internalizing and externalizing problems. Path analyses were used to examine the direct associations between parental mental illness and adolescent problems as well as the indirect relations via parent–child interaction and family environment. The results showed that interaction between parents with a mental illness and their child was significantly worse compared to parents without a mental illness. The family environment of parents with mental illness was also more negative. Mentally ill parents monitored their adolescents less, which in turn related to more externalizing problems of the adolescents. No factors mediated the relation between parental mental health and adolescent internalizing problems. Moreover, no direct effects of parental support, family cohesion, and family expressiveness with externalizing problems were found. These findings imply that parental monitoring should get a specific focus of attention in existing interventions designed to prevent adolescents with a mentally ill parent from developing problems.     

Optimism,appraisals, and coping in the adjustment of mothers and their children with spina bifida

Families of children with physical disabilities show substantial differences in the levels of adjustment of both the children and their parents. These differences result, in part, from the complex interplay of family and child adaptation resources, such as coping and social support. In order to identify factors which may differentiate levels of adjustment among families with children with physical disabilities, this study examined relationships among optimism, primary and secondary appraisals of and coping with child-related stressors, maternal psychological adjustment, and child adjustment in 29 families with a child with spina bifida without mental retardation and 28 comparison families with a nondisabled child. For the spina bifida group, primary appraisals were related to the use of avoidant coping strategies, and these coping strategies were related to maternal psychological adjustment and child internalizing behavior problems. No significant differences between the groups in terms of the nature of the relationships or in the levels of the variables were found with the exception that mothers of children with spina bifida were less optimistic than comparison mothers. These data support the importance of coping in understanding the psychological adjustment of mothers faced with a chronic stressor in the family.     

Family income,parental education and internalizing and externalizing psychopathology among 2–3‐year‐old Chinese children: The mediator effect of parent–child conflict

Using a sample of 156 Chinese children aged 2–3 years and their parents, this study examined the effects of socio‐economic status, specifically family income and parental education, on the children's internalizing and externalizing psychopathology and whether these effects were mediated by mother–child and father–child conflict. Results indicated that family income, maternal education and paternal education all negatively predicted externalizing symptoms. Income also negatively predicted internalizing symptoms among boys but not girls. Maternal education negatively predicted internalizing symptoms among girls but not boys. The effects of income on psychopathology were fully mediated by mother–child and father–child conflict. In contrast, the effects of education were not mediated or only partially mediated by conflict. Findings are discussed in the framework of the family stress model.     

The Impact of Child Symptom Severity on Stress Among Parents of Children with ASD: The Moderating Role of Coping Styles

We examined the impact of autism severity and parental coping strategies on stress in parents of children with ASD. Children’s autism symptoms and parental coping strategies (task-oriented, emotion-oriented, social diversion, and distraction) were evaluated as predictors of four types of parental stress (parent and family problems, pessimism, child characteristics, and physical incapacity). In order to examine potential buffering effects of coping strategies on stress associated with the child’s symptom severity, the interactive effects of autism symptoms with coping strategies were also examined. Participants included 77 primary caregivers of a child with ASD. Using multiple regression analyses, emotion-oriented coping scores were associated with more parent and family problems, and task-oriented coping was associated with lower physical incapacity scores. The child’s autism severity was the strongest and most consistent predictor of stress. Further, emotion-oriented coping moderated the relationship between pessimism stress and autism symptomatology, and distraction coping was a moderator between parent and family stress and autism symptoms. Results indicate that increasing our knowledge of the coping strategies that are more or less effective and under what conditions some coping strategies may be either beneficial or harmful for this population of parents has direct implications for treatment and parent education efforts.     

Child Characteristics as Moderators of the Association Between Family Stress and Children's Internalizing, Externalizing, and Peer Rejection

We examined child characteristics of coping strategies, age, and gender as moderators of the association between family stressors and internalizing, externalizing, and peer rejection in a sample of 228 3rd–5th grade children. Consistent with previous research, children in the current study who experienced a higher number of family stressors were significantly less well-accepted by classmates. This association was not moderated by children's coping strategies or child age. Child gender did moderate the association between family stressors and internalizing behavior. Specifically, as the number of stressors increased, internalizing behavior decreased among girls, but not boys. The results are discussed in terms of the role of child variables in explaining the variability in children's responses to family stress.     

Associations Between Fathers’ and Mothers’ Psychopathology Symptoms,Parental Emotion Socialization,and Preschoolers’ Social-Emotional Development

In this study we tested whether the relation between fathers’ and mothers’ psychopathology symptoms and child social-emotional development was mediated by parents’ use of emotion talk about negative emotions in a sample of 241 two-parent families. Parents’ internalizing and externalizing problems were measured with the Adult Self Report and parental emotion talk was observed while they discussed a picture book with their children (child age: 3 years). Children’s parent-reported internalizing and externalizing problems and observed prosocial behaviors were assessed at the age of 3 years and again 12 months later. We found that mothers’ use of emotion talk partially mediated the positive association between fathers’ internalizing problems and child internalizing problems. Fathers’ internalizing problems predicted more elaborative mother–child discussions about negative emotions, which in turn predicted more internalizing problems in children a year later. Mothers’ externalizing problems directly predicted more internalizing and externalizing problems in children. These findings emphasize the importance of examining the consequences of parental psychological difficulties for child development from a family-wide perspective.     

Family Coping During Hospitalization of Children with Chronic Illnesses

Information about family coping when a child with a chronic illness is hospitalized for procedures related to his or her illness is needed. The current research presents the results of two pilot studies designed to assess family resilience and coping, during a hospitalization for medical procedures for a child with a chronic condition. Sixty-one parents participated in the first study and reported on their child’s hospital experiences and completed a survey designed to assess family coping. Twelve mothers and one grandmother completed interviews examining their perceptions of their coping, siblings’ coping, and coping of the child with an illness for study two. Results of Study 1 indicated parents’ perceived the family as resilient. Cognitive strategies were used to see the hospital stay as positive for the child or to accept what had to occur as having the possibility of improving the child’s life. Some of the mothers mentioned financial stress as being difficult for the family. Results of Study 2 also supported resilient functioning for mothers, siblings, and children with illnesses. Mothers reported they stayed strong for their child. Siblings could serve as protectors, helpers, and companions and were described as adapting well. Children with illnesses used distraction (e.g., play, art, music) to facilitate their coping. Findings of this study indicated parents perceived the family as coping well and supporting the child with an illness. Future research will need to assess perceptions of siblings and fathers and assess family members’ perspectives at different times over the course of children’s illnesses.     

Relationship between family religious behaviors and child well-being among third-grade children

While there is growing empirical evidence that religion can have a positive impact on the health and well-being of adults and adolescents, less is known about its influence on the welfare of children. The current paper examined the relative importance of family religiosity and religious behaviors on multiple measures of children's well-being (general health, academic achievement, social skills, and behavior problems) and sought to identify whether religious variables contribute above and beyond non-religious measures of family caregiving. Parent use of religious coping and family religious behaviors, the latter defined as attendance at religious or spiritual programs, predicted several aspects of child well-being above and beyond parenting styles. Parental religious coping significantly predicted child social skills and externalizing behaviors above and beyond parenting styles. Family religious service attendance significantly predicted child health and social skills, and inversely predicted internalizing behaviors, above and beyond both parenting styles and parent use of religious coping.     

Child Involvement in Interparental Conflict and Child Adjustment Problems: A Longitudinal Study of Violent Families

This study examined whether child involvement in interparental conflict predicts child externalizing and internalizing problems in violent families. Participants were 119 families (mothers and children) recruited from domestic violence shelters. One child between the ages of 7 and 10 years in each family (50 female, 69 male) completed measures of involvement in their parents’ conflicts, externalizing problems, and internalizing problems. Mothers completed measures of child externalizing and internalizing problems, and physical intimate partner violence. Measures were completed at three assessments, spaced 6 months apart. Results indicated that children’s involvement in their parents’ conflicts was positively associated with child adjustment problems. These associations emerged in between-subjects and within-subjects analyses, and for child externalizing as well as internalizing problems, even after controlling for the influence of physical intimate partner violence. In addition, child involvement in parental conflicts predicted later child reports of externalizing problems, but child reports of externalizing problems did not predict later involvement in parental conflicts. These findings highlight the importance of considering children’s involvement in their parents’ conflicts in theory and clinical work pertaining to high-conflict families.     

Parents’ Reports of Children’s Internalizing Symptoms: Associations with Parents’ Mental Health Symptoms and Substance Use Disorder

This brief report examined the unique associations between parents’ ratings of child internalizing symptoms and their own depression and anxiety in families with parental substance use disorder (SUD). Further, we examined whether parental SUD (father only, mother only, both parents) was related to discrepancy in mothers’ and fathers’ reports of children’s internalizing symptoms. Participants were 97 triads (fathers, mothers) in which one or both parents met criteria for SUD. Polynomial regression analyses were conducted to examine whether father-mother reports of child internalizing symptoms had unique associations with parents’ own symptoms of depression and anxiety while controlling for child gender, child age, and SUD diagnoses. Controlling for fathers’ symptoms and other covariates, mothers experiencing more depression and anxiety symptoms reported more symptoms of child internalizing symptoms than did fathers. Mothers’ and fathers’ SUD was associated with higher anxiety symptoms among mothers after controlling for other variables. A second set of polynomial regressions examined whether father-mother reports of child internalizing symptoms had unique associations with parents’ SUD diagnoses while controlling for child gender and child age. After controlling for mothers’ symptoms and other covariates, parents’ reports of children’s internalizing symptoms were not significantly associated with either parent’s SUD or parental SUD interactions (i.e., both parents have SUD diagnoses). Taken together, mothers’ ratings of children’s internalizing symptoms may be accounted for, in part, by her reports of depression and anxiety symptoms.     

Perceived parental depression,intrusive rumination,and internalizing problems: A three-wave longitudinal study in adolescents

Background/objectiveResearch suggests that perceiving parental depression elicits internalizing problems in adolescents, but certain studies have indicated that adolescents’ internalizing problems also increase their perception of parental emotion. To further investigate the inconsistent findings about the nature of this relationship, the current study used longitudinal data to examine the causal association between adolescents’ internalizing problems and the parental depression they perceived, as well as the role of intrusive rumination in the relationship. Method: In this longitudinal study, 392 adolescents who experienced the catastrophic Jiuzhaigou earthquake in 2017 were surveyed at three time points after the earthquake: 12 months (T1), 21 months (T2) and 27 months (T3). A cross-lagged panel model was used to carry out the data analysis. Results: Mutual cause-and-effect relationships were found between intrusive rumination and both perceived parental depression and internalizing problems, respectively; a unilateral causal relationship in which internalizing problems positively predicted perceived parental depression was also found. In addition, internalizing problems predicted perceived parental depression via the mediating role of intrusive rumination; similarly, intrusive rumination predicted perceived parental depression via internalizing problems. Conclusions: Internalizing problems were a risk factor for perceived parental depression, and intrusive rumination played an important role in the relationship between internalizing problems and perceived parental depression.     

Interparental conflict, negative parenting, and children's adjustment: bridging links between parents' depression and children's psychological distress

Pathways linking parental depressive symptoms, adult relationship insecurity, interparental conflict, negative parenting, and children's psychological adjustment (internalizing symptoms and externalizing problems) were assessed using a 3-wave longitudinal research design. Two-parent families (N = 352) with 11- to 13-year-old children (179 boys, 173 girls) participated in the study. Maternal and paternal depressive symptoms were associated with insecurity in adult close relationships assessed 12 months later, which was concurrently related to heightened levels of interparental conflict. Controlling for children's initial symptom levels, interparental conflict was related to child appraisals of father and mother rejection assessed an additional 12 months later, which were related to children's internalizing symptoms and externalizing problems, respectively. Results are discussed with regard to the implications for understanding the complex interplay between adult depressive symptoms, attributions in close adult relationships, interparental conflict, negative parenting, and children's psychological adjustment.     

The Relationship Between Male-Perpetrated Interparental Aggression,Paternal Characteristics,and Child Psychosocial Functioning

It is well established that children in homes where interparental violence is present are at increased risk for psychosocial (i.e., internalizing, externalizing, and attention) difficulties. However, previous studies have provided a limited view on the variety of factors that commonly co-occur in these environments (e.g., other characteristics of the parents and family) and how they may collectively impact children. Knowing this information could have implications for parental interventions aimed at preventing the continuation or initiation of psychosocial problems in children. Thus, the present study simultaneously examined the association between father-perpetrated interparental aggression, father characteristics, and child psychosocial functioning in a sample of 145 men arrested for domestic violence. Results showed that of all the variables examined, paternal antisocial personality traits and interpersonal hostility were uniquely associated with overall child psychosocial impairment, externalizing problems, and attention problems. Implications for intervention programs are discussed.     

Family Influences on the Long Term Post-Disaster Recovery of Puerto Rican Youth

This study focused on characteristics of the family environment that may mediate the relationship between disaster exposure and the presence of symptoms that met DSM-IV diagnostic criteria for symptom count and duration for an internalizing disorder in children and youth. We also explored how parental history of mental health problems may moderate this mediational model. Approximately 18 months after Hurricane Georges hit Puerto Rico in 1998, participants were randomly selected based on a probability household sample using 1990 US Census block groups. Caregivers and children (N?=?1,886 dyads) were interviewed with the Diagnostic Interview Schedule for Children and other questionnaires in Spanish. Areas of the family environment assessed include parent-child relationship quality, parent-child involvement, parental monitoring, discipline, parents’ relationship quality and parental mental health. SEM models were estimated for parents and children, and by age group. For children (4–10 years old), parenting variables were related to internalizing psychopathology, but did not mediate the exposure-psychopathology relationship. Exposure had a direct relationship to internalizing psychopathology. For youth (11–17 years old), some parenting variables attenuated the relation between exposure and internalizing psychopathology. Family environment factors may play a mediational role in psychopathology post-disaster among youth, compared to an additive role for children. Hurricane exposure had a significant relation to family environment for families without parental history of mental health problems, but no influence for families with a parental history of mental health problems.     

The Role of Parental Distress in Moderating the Influence of Child Neglect on Maladjustment

Despite pervasive evidence of the harmful impact of neglect on children’s adjustment, individual differences in adaptation persist. This study examines parental distress as a contextual factor that may moderate the relation between neglect and child adjustment, while considering the specificity of the relation between neglect and internalizing versus externalizing problems. In a sample of 66 children (33 with a documented child protective services history of neglect prior to age six), neglect predicted internalizing, and to a lesser extent externalizing, problems as rated by teachers at age seven. Parental distress moderated the relation between neglect and internalizing, but not externalizing, problems. Specifically, higher levels of neglect predicted more internalizing problems only among children of distressed parents. These findings indicate that parent-level variables are important to consider in evaluating the consequences of neglect, and point to the importance of considering contextual factors when identifying those children most at risk following neglect.     

Psychological adjustment of children in the pretransplant phase of bone marrow transplantation: Relationships with parent distress,parent stress,and child coping

Families of 22 children preparing to undergo bone marrow transplantation (BMT) provided information concerning parent-reported major negative life stress, child coping strategies, parental psychological symptomatology, and child adjustment. Immediately prior to BMT, children and families are confronted with multiple stresses which challenge the child's coping and strain the parents' ability to assist the child with coping. Hence, stress, parental adjustment (distress), and child coping may be important factors affecting the child's overall psychological adjustment. Results showed that 15–25% of children and parents experienced clinically significant levels of psychological distress. Parent and child psychological distress were closely related. Major negative life stresses experienced by the parent and use of avoidant coping by the child significantly predicted child adjustment problems in the pretransplant period. Coping skills interventions targeting avoidant coping and management of parental stress/distress may reduce child psychosocial risk prior to BMT.     

Socioeconomic Status and Child Mental Health: The Role of Parental Emotional Well-Being and Parenting Practices

This study examined the role of parental emotional well-being and parenting practices as mediators of the association between familial socioeconomic status (SES) and child mental health problems. The sample included 2,043 5th-7th graders (50.7 % female) participating in the second wave of the Bergen Child Study. Children completed the Strengths and Difficulties Questionnaire, parents reported family economy and education level, emotional well-being (measured with the Everyday Feelings Questionnaire), and the use of negative disciplinary and affirmative parenting practices (measured using the Family Life Questionnaire). Path analyses were conducted to examine the associations between SES and externalizing and internalizing problems. Results supported a model where family economy was associated with externalizing problems through parental emotional well-being and parenting practices, whereas maternal education level was associated with externalizing problems through negative discipline. The direct association between paternal education level and externalizing problems was not mediated by parenting. For internalizing problems, we found both direct associations with family economy and indirect associations with family economy through parental emotional well-being and parenting. The results suggest that parental emotional well-being and parenting practices are two potential mechanisms through which low socioeconomic status is associated with child mental health problems.     

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.     

Father Involvement and Behavior Problems among Preadolescents at Risk of Maltreatment

Although there is a well-established connection between father involvement and children’s positive behavioral development in general, this relation has been understudied in more vulnerable and high-risk populations. The aims of this study were to examine how the quantity (i.e., the amount of shared activities) and quality (i.e., perceived quality of the father-child relationship) of father involvement are differently related to internalizing and externalizing behavior problems among preadolescents at risk of maltreatment and test if these associations are moderated by father type and child maltreatment. A secondary data analysis was conducted using data from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Generalized estimating equations analysis was performed on a sample of 499 preadolescents aged 12 years. The results indicated that higher quality of father involvement was associated with lower levels of internalizing and externalizing behavior problems whereas greater quantity of father involvement was associated with higher levels of internalizing and externalizing behavior problems. The positive association between the quantity of father involvement and behavior problems was stronger in adolescents who were physically abused by their father. The association between father involvement and behavior problems did not differ by the type of father co-residing in the home. The findings suggest that policies and interventions aimed at improving the quality of fathers’ relationships and involvement with their children may be helpful in reducing behavior problems in adolescents at risk of maltreatment.     

Sex differences in the reciprocal relationships between mild and severe corporal punishment and children's internalizing problem behavior in a Chinese sample

The study aimed to investigate the sex differences in the reciprocal relations between parental corporal punishment and child internalizing problem behavior in China. Four hundred fifty-four Chinese elementary school-age children completed measures of their parental corporal punishment toward them and their own internalizing problem behavior at two time points, 6 months apart. Structural equation modeling revealed that both parental mild and severe corporal punishment significantly predicted child internalizing problem behavior for girls, but only parental severe corporal punishment marginally predicted child internalizing problem behavior for boys; child internalizing problem behavior predicted both mild and severe corporal punishment for boys but not for girls. The findings highlight the important role of severity of corporal punishment and child sex in understanding the relations between parental corporal punishment and child internalizing problem behavior and have implications for the intervention efforts aimed at reducing child internalizing symptoms or parental corporal punishment in China.