Treatment effectiveness of PMTO for children's behavior problems in Iceland: Assessing parenting practices in a randomized controlled trial

Findings are presented from an Icelandic randomized control trial (RCT) evaluating parent management training – Oregon model (PMTO?), a parent training intervention designed to improve parenting practices and reduce child behavior problems. In a prior report from this effectiveness study that focused on child outcomes, children in the PMTO condition showed greater reductions in reported child adjustment problems relative to the comparison group. The present report focuses on observed parenting practices as the targeted outcome, with risk by treatment moderators also tested. It was hypothesized that mothers assigned to the PMTO condition would show greater gains in pre‐post parenting practices relative to controls. The sample was recruited from five municipalities throughout Iceland and included 102 participating families of children with behavior problems. Cases were referred by community professionals and randomly assigned to either PMTO (n = 51) or community services usually offered (n = 51). Child age ranged from 5 to 12 years; 73% were boys. Contrary to expectations, findings showed no main effects for changes in maternal parenting. However, evaluation of risk by treatment moderators showed greater gains in parenting practices for mothers who increased in depressed mood within the PMTO group relative to their counterparts in the comparison group. This finding suggests that PMTO prevented the expected damaging effects of depression on maternal parenting. Failure to find hypothesized main effects may indicate that there were some unobserved factors regarding the measurement and a need to further adapt the global observational procedures to Icelandic culture.     

Protective Factors for Depression Among African American Children of Predominantly Low-Income Mothers with Depression

Maternal depression has a deleterious impact on child psychological outcomes, including depression symptoms. However, there is limited research on the protective factors for these children and even less for African Americans. The purpose of the study is to examine the effects of positive parenting skills on child depression and the potential protective effects of social skills and kinship support among African American children whose mothers are depressed and low-income. African American mothers (n = 77) with a past year diagnosis of a depressive disorder and one of their children (ages 8–14) completed self-report measures of positive parenting skills, social skills, kinship support, and depression in a cross-sectional design. Regression analyses demonstrated that there was a significant interaction effect of positive parenting skills and child social skills on child depression symptoms. Specifically, parent report of child social skills was negatively associated with child depression symptoms for children exposed to poorer parenting skills; however, this association was not significant for children exposed to more positive and involved parenting. Kinship support did not show a moderating effect, although greater maternal depression severity was correlated with more child-reported kinship support. The study findings have implications for developing interventions for families with maternal depression. In particular, parenting and child social skills are potential areas for intervention to prevent depression among African American youth.     

Impact of Depression and Childhood Trauma in Mothers Receiving Home Visitation

Research has documented the deleterious effects of maternal depression and childhood trauma on parenting and child development. There are high rates of both depression and childhood trauma in new mothers participating in home visitation programs, a prevention approach designed to optimize mother and child outcomes. Little is known about the impacts of maternal depression and childhood trauma on parenting in the context of home visitation. This study contrasted depressed and non-depressed mothers enrolled in the first year of a home visitation program on parenting stress, quality of home environment, social network, and psychiatric symptoms. Mothers were young, low income, and predominantly unmarried. Results indicated that depressed mothers displayed impairments in parenting, smaller and less robust social networks, and increased psychiatric symptoms relative to their non-depressed counterparts. Path analyses for the full sample revealed a path linking childhood trauma, depression, and parenting stress. Path analyses by group revealed several differential relationships between dimensions of social network and parenting. Number of embedded networks, namely the number of different domains in which the mother is actively interacting with others, was associated with lowered parenting stress among non-depressed mothers and increased parenting stress in their depressed counterparts with childhood trauma histories. In depressed mothers, social network size was associated with lower levels of parenting stress but decreased quality of the home environment, whereas number of embedded networks was positively related to quality of the home environment. Implications of findings for home visitation programs are discussed.     

在美国样本中母亲抑郁症状与儿童退缩的关系:教养行为的中介作用

本研究通过使用美国国家儿童健康与人类发育研究所的纵向研究数据建立分层线性模型,探究在儿童的早期发展中,母亲抑郁症状对儿童的社会性退缩的影响,以及母亲的教养行为在这一关系中的中介作用,结果发现：（1）在儿童24~54个月期间,随着母亲抑郁症状的升高,儿童的社会性退缩也随之升高;（2）母亲抑郁症对儿童社会性退缩的影响存在着性别差异,与女孩相比,男孩的社会性退缩更容易受到母亲抑郁症状的影响;（3）在男孩中,消极的教养行为在母亲抑郁症状与男孩的社会性退缩之间起到了中介作用,而在女孩中,这一中介作用并不显著。     

Impact of Perceived Social Support and Depression on the Parental Attitudes of Mothers of Children Who are Deaf

Literature shows that mothers of children with disabilities report high levels of depression. Social support facilitates the well-being of mothers and it helps to cope with a range of disability related stressors. This study was designed to assess the impact of having a child who is deaf on maternal depression and to test how social support may facilitate coping with the depression caused by deafness as well as the parenting behaviors of those mothers. 103 mothers of children who are deaf, ranging from the 36 months to 72 months of age participated in the study. Parental attitude research instrument, beck depression inventory and multidimensional scale of perceived social support were used for data collection. Results showed that 24.4 % of the mothers showed depression and perceived social support from family and friends were found to be predicting depression. Further analysis showed that depression was found to be affecting authoritarian and hostile parenting styles. Perceived social support from friends and significant other did not have significant effect on parental attitudes. The findings showed that having a child who is deaf causes high levels of depression in mothers which leads to insufficient and/or inappropriate parenting attitudes. On the other hand, social support is a protective source lowering depression levels of mothers as well as indirectly facilitating the maintenance of positive parenting.     

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.     

Maternal Employment and Family Socioeconomic Status: Unique Relations to Maternal Stress,Parenting Beliefs,and Preschoolers’ Adjustment in Taiwanese Families

With the rapid increase in women’s labor force participation in Asia, a greater understanding of the impact of maternal employment on parenting and child development in Asia is much needed. The present study examined the concurrent relations between maternal employment status and family characteristics (e.g., socioeconomic status/SES, family structure) in Taiwanese families, and the unique relations of maternal employment and family SES to maternal stress, parenting beliefs, and preschoolers’ socioemotional adjustment. In a school-based sample of 511 preschoolers (age range?=?4–6 years, 52.9% girls), their mothers, and teachers in Taipei and Taitung, mothers reported their employment status, family characteristics, perceived stress and parenting beliefs. Mothers and teachers rated preschoolers’ adjustment. Results showed that compared to unemployed mothers in Taiwan, employed mothers were more likely to come from families with higher SES and fewer children, and nuclear (vs. extended) families. Structural equation modeling was used to test the hypothesized model. Mothers from lower-SES families reported higher stress and higher endorsement of coercive parenting, and lower endorsement of authoritative parenting than mothers from higher-SES families. Controlling for SES, employed mothers endorsed higher coercive parenting than unemployed mothers. Mothers’ endorsement of authoritative parenting was associated with better child adjustment by mothers’ (but not teachers’) reports, whereas maternal stress and coercive parenting were associated with poorer child adjustment (by mothers’ reports only). In sum, maternal employment was intricately associated with family SES in Taiwanese families, and the two contextual factors shape parenting and child adjustment in different processes.     

儿童早期的母亲生活压力对其5岁行为问题的预测效应：链式中介分析

通过对107名幼儿及其母亲历时5年的5次追踪测量, 考察了儿童早期(9~38个月)母亲生活压力对5岁时儿童行为问题的预测效应及其作用机制。结果发现, 在儿童早期, 母亲生活压力具有相对的稳定性, 但引起母亲生活压力的主要生活事件排序有所变化; 儿童早期母亲生活压力对儿童行为问题的作用机制有两种方式：一方面表现为母亲生活压力对儿童5岁时的情绪症状和品行问题的直接效应; 另一方面表现为通过减少母亲积极养育行为进一步影响儿童情绪症状和同伴问题的间接效应; 此外, 儿童早期母亲生活压力还通过积极养育和儿童努力控制的链式中介作用对儿童过度活跃和亲社会行为产生影响。结论:母亲生活压力对儿童行为问题具有预测效应, 这种效应的机制包括母亲生活压力的直接效应以及通过积极养育、努力控制的间接效应。     

Supportive Coparenting,Parenting Stress,Harsh Parenting,and Child Behavior Problems in Nonmarital Families

Supportive coparenting is an identified protective factor for child development and behavioral outcomes. What is less known is how supportive coparenting dynamically links with other aspects of parenting and parent well‐being, particularly in multi‐stressed nonmarital families. This study used data from the Fragile Families and Child Wellbeing study, analyzed within a structural equation model, to explore how mothers’ experience of maternal depression, maternal age, father education, and SES interacted with their parenting stress and supportive coparenting to impact child behavioral problems and harsh parenting practices. Among the findings, more supportive coparenting was found to be significantly associated with fewer child behavioral problems and less harsh parenting. Transmitted through supportive coparenting and parenting stress acting as mediator, maternal depressive symptoms were indirectly and positively related to harsh parenting practices and child behavior problems. These findings are discussed within the context of the broader literature and next steps for research are discussed.     

Toddlers' self-regulation development from 14 to 26 months: The unique role of paternal discipline

Toddlerhood is a critical period for children's self-regulation development during which parenting is undoubtedly a key influencing factor. The role that parents especially fathers play in shaping the emergence of self-regulation is still under investigation. This longitudinal study was carried out in 38 families in China, in which toddlers and both parents participated in two waves of observations during home visits, one performed when the toddlers were around 14 months old and another one 12 months later. Children's self-regulation was measured by behaviour control and Stroop tasks. Parental positive and negative discipline was coded by videotaped parent–child interactions. Results indicated that the mothers showed more positive discipline than the fathers at child 14 months, and there were no significant differences in positive and negative discipline between the fathers and mothers at child 26 months, neither in their negative discipline at child 14 months. Only the fathers' positive and negative discipline at child 14 months both significantly predicted toddlers' behaviour control at 26 months—over and above maternal discipline. This study reveals fathers' unique and irreplaceable contributions to children's early self-regulation development.     

Maternal depression and parenting in relation to child internalizing symptoms and asthma disease activity.

This study tested a hypothesized model of the relationship between maternal depression and child psychological and physical dysfunction mediated by parenting and medication adherence. A sample of 242 children with asthma, aged 7 to 17, participated with their mothers. Maternal depression was assessed by self-report, and parenting was observed during family interaction tasks. Internalizing symptoms were assessed by self- and clinician reports. Asthma disease activity was assessed according to National Heart Lung and Blood Institute guidelines, and medication adherence was evaluated with a 24-hr recall method. Structural equation modeling indicated that negative parenting partially mediated the relationship between maternal depression and child internalizing symptoms. Child internalizing symptoms, in turn, mediated the associations between both maternal depression and negative parenting and asthma disease activity. Medication adherence did not mediate the link from maternal depression to disease activity. Thus, maternal depression was linked to child psychological dysfunction both directly and indirectly via negative parenting but linked to physical dysfunction only indirectly through psychological dysfunction. These findings suggest that diagnosing and treating depression in mothers of children with asthma would enhance child well-being both psychologically and physically.     

Longitudinal prediction of child outcomes from differing measures of parenting in a low-income sample

This study examined predictions from preschool parenting measures to middle childhood cognitive and socioemotional child outcomes to explore whether parenting assessment methodologies that require more time, training, and expense yield better predictions of child outcomes than less intensive methodologies. Mother-child dyads (N = 278) in low-income African American families were assessed when the child was in preschool, using maternal report, the Home Observation for Measurement of the Environment-Short Form (P. Baker & F. Mott, 1989; R. Bradley & B. Caldwell, 1984), and structured observational measures of parenting. Child outcomes reported by children, mothers, teachers, and direct assessment were collected 4 years later. All parenting methodologies showed some predictive value; however, observational parenting measures showed the strongest and most consistent predictions of child outcomes.     

Maternal depression and its relationship to life stress,perceptions of child behavior problems,parenting behaviors,and child conduct problems

This study examined the relationship of reported maternal depression to prior and current life stressors, and to mother perceptions of child adjustment, parenting behaviors, and child conduct problems. Forty-six depressed mothers and 49 nondepressed mothers and their clinic-referred children (aged 3-8 years) participated. Depressed mothers were more critical than nondepressed mothers, but the behavior of children of depressed and nondepressed mothers showed no significant differences. Depressed mothers were more likely to have experience child abuse, spouse abuse, or more negative life events than nondepressed mothers. Maternal reports of stress related to mother characteristics and to negative life events were the most potent variables discriminating depressed from nondepressed mother families.     

MATERNAL DEPRESSION AND THE DEVELOPMENT OF EXECUTIVE FUNCTION AND BEHAVIOR PROBLEMS IN HEAD START: INDIRECT EFFECTS THROUGH PARENTING

The present study used a large, nationally representative sample of Head Start children (N=3,349) from the Family and Child Experiences Survey of 2009 (FACES) to examine associations among maternal depression (measured when children were ?36 months old) and children's executive function (EF) and behavior problems (measured when children were ?48 months old). Preliminary analyses revealed that 36% of mothers in the sample had clinically significant levels of depressive symptoms. Furthermore, a path analysis with demographic controls showed a mediation effect that was significant and quite specific; mother‐reported warmth (and not mother–child reading) mediated the path between maternal depression, children's EF, and behavior problems. Findings provide empirical support for a family process model in which warm, sensitive parenting supports children's emerging self‐regulation and reduces the likelihood of early onset behavior problems in families in which children are exposed to maternal depression.     

Increasing parenting self-efficacy: The Fussy Baby Network® intervention

High levels of infant crying place families at risk for disrupted relationships, parenting stress, and even for child maltreatment. We conducted an evaluation of the Fussy Baby Network^® (FBN), a program supporting families struggling with infant crying and related concerns. The study contrasted 29 families who sought help from FBN with 27 families with excessively crying infants who did not seek services. Researchers measured parenting self-efficacy, depression, and stress in each group before and after the intervention. Results from hierarchical multiple regression analysis indicated greater improvements over time in parenting self-efficacy for parents receiving FBN services. Furthermore, the greater improvements in parenting self-efficacy in the intervention group were not directly attributable to reductions in infant crying. These findings provide preliminary evidence that the FBN approach may be effective at boosting the confidence of parents struggling with caring for their infants. Future research with larger samples with baseline equivalence and stronger research designs should explore this intervention further. This study also suggests that interventions for families with excessively crying infants should move beyond the focus of reducing infant crying to a broader strategy of supporting parents and strengthening relationships between parents and their infants to build parenting capacity.     

Parent–Child Interaction Therapy with Toddlers in a community-based setting: Improvements in parenting behavior,emotional availability,child behavior,and attachment

Parent–Child Interaction Therapy with Toddlers (PCIT-T) is a new attachment-based parenting intervention designed to meet the needs of children aged 12–24 months presenting with challenging behaviors. This study examined outcomes of the first phase of PCIT-T, Child Directed Interaction–Toddler (CDI-T), 4-months post treatment. Participants were 56 toddlers (Child Mage = 19.13 months) referred to receive CDI-T over an 8-week period at an Australian community-based child behavior treatment clinic for treatment of difficult toddler behaviors. Participants completed questionnaires and observational measures at baseline (Time 1), post-treatment (Time 2), and 4-month follow-up (Time 3). At both Time 2 and Time 3, there were statistically significant increases in observed positive parenting skills and emotional availability and decreases in negative parenting behaviors and child noncompliance. There were also significant improvements in parent-reported child externalizing and internalizing behaviors, parental stress, and maternal depression. There was a pattern of a shift away from attachment insecurity and attachment disorganization. Results suggest that the CDI-T phase of PCIT-T is a promising intervention for toddlers presenting with behavioral issues. Future studies should be conducted to assess efficacy in other settings, using larger samples and utilizing randomized controlled designs.     

Maternal Depression,Locus of Control,and Emotion Regulatory Strategy as Predictors of Preschoolers’ Internalizing Problems

Childhood internalizing problems may occur as early as preschool, tend to be stable over time, and undermine social and academic functioning. Parent emotion regulatory behaviors may contribute to child internalizing problems and may be especially important during the preschool years when parents model emotion coping and regulation for their children. Parents who feel out of control of their preschoolers’ behavior and emotional states may adopt avoidant emotion regulatory strategies. We proposed that parent depression, perceived locus of control, and experiential avoidance would be linked with internalizing symptoms in a high-risk sample of preschool-aged children. We also expected that locus of control would mediate the relationship between maternal depression, experiential avoidance, and child internalizing problems. Seventy-four urban, low-income, diverse mothers of Head Start preschool children completed rating scales measuring their own depression, locus of control, experiential avoidance, and their children’s internalizing behaviors. Correlational analyses revealed that mothers reporting higher levels of depression were more likely to report experiential avoidance, feeling out of control in their parenting role, and internalizing symptoms in their children. Hierarchical multiple regressions showed that locus of control explained additional unique variance in child internalizing problems over and above that explained by maternal depression. Locus of control mediated the relationship between maternal depression and child internalizing symptoms. The importance of considering parent locus of control and its relation to children’s internalizing symptoms is discussed as a potential target for early childhood prevention programs.     

African American Single Mothers and Children in Context: A Review of Studies on Risk and Resilience

This paper presents a comprehensive review of research linking single-parent family structure to parenting processes, maternal well-being, and child developmental outcomes among African Americans. The approaches used to study these families, related methodological and conceptual concerns, and the factors linked to maternal well-being, effective parenting processes, family functioning, and child outcomes are addressed. Much work remains to be done on conceptualizing and assessing parenting processes among African Americans in general and single African American mothers in particular. Researchers must examine more carefully the circumstances that foster or impede successful parenting among these mothers. Studies also are needed to disentangle the interactions between economic stress and parenting behavior and to determine the extent to which the findings can be applied to middle-income single African American parents.     

The influence of maternal optimality and infant temperament on parenting stress at 12 months among mothers with substance abuse and psychiatric problems

The present prospective longitudinal study aimed to investigate the long‐term impact of maternal optimality assessed during pregnancy on parenting stress at infant age 12 months. In this study the concept of optimality was utilized to investigate maternal variations regarding resources during pregnancy in relation to later parenting stress, among three different groups of mothers that were recruited from substance abuse treatment, psychiatric outpatient treatment and well‐baby clinics respectively. The influence of infant temperament on parenting stress was also examined. All mothers were interviewed during pregnancy. At 12 months, infant temperament (Colorado Childhood Temperament Inventory; Rowe & Plomin, 1977) and stress in the parent and child domain (Parenting Stress Index; Abidin, 1955) were assessed. Results demonstrated higher levels of parenting stress among mothers in the clinical groups, compared to the non‐clinical group. Furthermore, it was the maternal psychiatric optimality index in combination with child temperament characteristics (child emotionality) that contributed uniquely to stress in the parent domain, while stress in the child domain was significantly associated only with child temperament characteristics (both child emotionality and soothability). The association between maternal psychiatric optimality assessed in pregnancy, infant temperament and parenting stress when the infants were 12 months old, points to the importance of simultaneously addressing the mothers' own psychological distress, and to support positive mother–infant interactions. Each woman's individual optimality profile may be used to display needs of follow‐up in order to prevent enduring effects of non‐optimality on parenting stress.     

With a little help from my friends: maternal social support,via parenting,promotes willingness to share in preschoolers born to young mothers

Little is known about prosocial behaviours in children of young mothers. This longitudinal study involved 44 young mother (age <20 years at birth of first child) families and 44 older mother families, who were carefully matched for child age and gender, as well as for family structure (number of children, lone‐parent status) and socio‐economic background (maternal education, head‐of‐household unemployment, low family income). At the first time‐point (M child age = 2.45 years), mothers listed family members or friends who provided practical and/or emotional support; videos of mother–child interaction in play and tidy‐up were coded for positive and negative parenting. Two years later (M child age = 4.32 years), children's prosocial behaviours were assessed via (i) an experimental task of willingness to share and (ii) video‐based ratings of sharing and helping during dyadic play with friends. T‐tests showed few group differences in prosocial behaviours. Regression analyses showed that, for young mother families only, reduced negative parenting mediated associations between support from friends and preschoolers' willingness to share. Support from friends, via parenting, may promote willingness to share in children born to young mother families. Copyright © 2009 John Wiley & Sons, Ltd.