Experience of physical abuse in childhood and perpetration of physical punishment and violence in adulthood amongst fathers: findings from the Pacific Islands Families Study

BACKGROUND

Family violence is a serious and increasingly significant public health issue, both in New Zealand and internationally. While Pacific families in New Zealand experience disproportionately higher rates of violence compared to their Palagi counterparts, little epidemiological information exists about the effect of childhood abuse on Pacific fathers and whether it increases their proclivity on perpetrating violence.

AIMS

To determine the prevalence of physical discipline administered to young Pacific children by their fathers and physical intimate partner violence (IPV) perpetrated against their partners; and to relate this to fathers' recalled levels of paternal and maternal childhood physical abuse.

METHODS

A cohort of Pacific infants born during 2000 in Auckland, New Zealand, was followed. At 6-weeks and 2-years postpartum, home interviews conducted for mothers and experience of IPV within the last 12 months was measured using the Conflict Tactics Scale. At 1-year and 2-years postpartum, home interviews conducted for fathers and acts of physical discipline were elicited. At the 1-year phase, childhood history of physical abuse was also elicited using the Exposure to Abusive and Supportive Environments Parenting Inventory. Crude and adjusted generalised estimating equation models were employed for statistical analyses.

RESULTS

The sample included 786 partnered fathers who were living with their child at the 1-year measurement wave and 579 fathers at the 2-years measurement wave. Smacking children was common (25.0% at 1-year, 81.7% at 2-years) and hitting children with an object was not infrequent (1.4% at 1-year, 14.2% at 2-years). Physical IPV perpetrated by the father ranged from 23.1% to 27.5% while severe IPV was reported by 10.1% to 14.3% of partners. Fathers subjected to higher levels of paternal physical abuse in childhood were significantly more likely to physically discipline their child with smacking than those with lower levels of paternal physical abuse, after adjusting for confounding factors; as were fathers subjected to higher levels of maternal physical abuse. While not statistically significant, fathers subjected to higher levels of paternal or maternal physical abuse in childhood had estimated odds ratios greater than unity for all other physical violence measures captured compared to fathers with lower levels of paternal or maternal physical abuse.

DISCUSSION

Violence perpetrated by fathers on children and their partners appears common for many Pacific families in New Zealand. These findings highlight the deleterious effect of paternal and maternal physical abuse in childhood on subsequent physical violence and IPV in adulthood. To break this intergenerational cycle of violence, culturally targeted and specific approaches are needed to negate this complex and damaging phenomena.

Agreement and discordance of parents' and teachers' reports of behavioural problems among Pacific children living in New Zealand

Research suggests that ratings of child psychopathology by parents and teachers are generally not highly correlated. We examined the agreement and discordance between the child behaviour ratings of parents and teachers of a cohort of 6-year-old Pacific children living in New Zealand, based on scores from the Child Behaviour Checklist and the Teacher Report Form. Mother's reports were obtained for 1019 children, of whom, 602 also had father's reports and 559 had teacher's reports. Rater agreement was low between all pairs of informants. Fathers and teachers had higher agreement than mothers and fathers, the latter in turn had higher agreement than mothers and teachers, and agreement was generally higher for Externalizing problems than Internalizing problems. In terms of discordance, mothers reported more aggressive behaviour than fathers, while fathers reported more Internalizing and Total problems than mothers. Mothers and fathers generally reported more behaviour problems than teachers. The higher agreement found between informants from different settings (fathers and teachers) than between informants from similar settings (mothers and fathers) is in contrast with some of the literature. Further research is needed to investigate how child, informant, and setting characteristics affect ratings of children's behaviour.

What defines 'low birth weight' in Pacific infants born in New Zealand?

AIM

To report the combined and ethnic specific proportions of preterm and low birth weight (LBW) births, and average birth weights, for New Zealand's four major Pacific ethnic groups (Samoan, Tongan, Cook Island Māori, Niuean).

METHODS

Data were gathered from the Pacific Island Families Study (PIFS). Mothers of a cohort of 1398 Pacific infants born in South Auckland New Zealand (NZ) during 2000 were interviewed when their infants were 6 weeks old. Birth outcome data were obtained from hospital records on receipt of full informed consent.

RESULTS

Of the Pacific ethnic groups preterm rates ranged from 5.3% to 8.3% (7.3% overall), LBW rates ranged from 3.4% to 5.7% (4.0% overall), and average birth weight of full-term deliveries ranged from 3467 gm to 3751 gm (3664 gm overall). Cook Island and Niuean infants were significantly lighter than Samoan infants. Infants of Pacific born mothers were significantly heavier than infants born to NZ born Pacific mothers. There were no differences observed between infants of 'ethnically homogenous' parents compared 'ethnically heterogeneous' parents. The 10th percentile for all Pacific ethnic groups ranged from 2894 to 3065 grams.

CONCLUSION

These data reaffirm that infants of various Pacific ethnic groups are larger than other New Zealand infants. Furthermore, analyses of the PIFS cohort suggest that a LBW threshold for NZ born Pacific infants of 3000 grams may be more appropriate.

Prevalence and concordance of smoking among mothers and fathers within the Pacific Islands Families Study

Cigarette smoking continues to contribute to the adverse mortality and morbidity rates for Pacific people in New Zealand. Using a large cohort study of Pacific families, this paper investigates the prevalence of smoking amongst Pacific mothers and fathers over three time-points, up to six years after the arrival of their child, to determine the concordance of both partners' reports of that smoking. Moreover, the patterns of smoking between partners were investigated over the three major Pacific ethnicities that reside in New Zealand (Samoan, Tongan and Cook Island Māori). Maternal self-report prevalence of smoking estimates ranged from 29.8% (1-year) to 33.6% (6-years). Paternal self-reported prevalence of smoking estimates were higher, and ranged from 37.9% (2-years) to 45.2% (6-years). The prevalence estimates for smoking in both mothers and fathers over all three measurement waves were higher than the 26.9% reported for Pacific people in the 2006/07 New Zealand Health Survey. No significant change in fathers' smoking prevalence over time was observed (p = 0.37); however a significant increase in mothers' smoking prevalence over time was noted (p = 0.002). Significantly, for about 25% of Pacific children both their parents were current smokers. Reducing infant exposure to tobacco smoke, by encouraging parents to quit smoking or banning smoking in the home and local environment (such as vehicles), is likely to bring about improved health outcomes for many Pacific children. Findings suggest that the interaction between parents should be considered rather than focusing on mothers' or fathers' smoking behaviour in isolation.

The evolution of family complexity from the perspective of nonmarital children

We document the incidence and evolution of family complexity from the perspective of children. Following a cohort of firstborn children whose mothers were not married at the time of their birth, we consider family structure changes over the first 10 years of the child's life-considering both full and half-siblings who are coresidential or who live in another household. We rely on detailed longitudinal administrative data from Wisconsin that include information on the timing of subsequent births to the mother and father, and detailed information on earnings, child support, and welfare. We find that 60% of firstborn children of unmarried mothers have at least one half-sibling by age 10. Our results highlight the importance of having fertility information for both fathers and mothers: estimates of the proportion of children with half-siblings would be qualitatively lower if we had fertility information on only one parent. Complex family structures are more likely for children of parents who are younger or who have low earnings and for those in larger urban areas. Children who have half-siblings on their mother's side are also more likely to have half-siblings on their father's side, and vice versa, contributing to very complex family structures-and potential child support arrangements-for some children.

Effect of pregnancy planning and fertility treatment on cognitive outcomes in children at ages 3 and 5: longitudinal cohort study

OBJECTIVE

To investigate how pregnancy planning, time to conception, and infertility treatment influence cognitive development at ages 3 and 5.

DESIGN

Prospective population based cohort study.

SETTING

Millennium Cohort Study in the United Kingdom.

PARTICIPANTS

18,818 children recruited at 9 months and followed up at 3 and 5 years. 11,790 singletons with available data on pregnancy, cognitive outcomes, and confounders were included in analyses at age 3 and 12,136 at age 5. Exposure measures Mothers reported whether the pregnancy was planned, and their feelings when first pregnant; those in whom the pregnancy was planned provided time to conception, and details of any assisted reproductive technologies. The population was divided into "unplanned" (unplanned and unhappy), "mistimed" (unplanned but happy), "planned" (planned, time to conception <12 months), "subfertile" (planned, time to conception ≥ 12 months), "induced ovulation" (received clomiphene citrate), and "assisted reproduction" (in vitro fertilisation or intracytoplasmic sperm injection). The "planned" group was the comparison group in all analyses.

OUTCOME MEASURES

Three components of the British Ability Scales (BAS II). Naming vocabulary assessed verbal ability at age 3; this test was repeated at age 5 with the picture similarities and pattern construction subscales, which measure non-verbal and spatial abilities.

RESULTS

In unadjusted analyses, the scores on all scales in children from unplanned pregnancies were significantly lower than in those from planned pregnancies-for example, the difference in mean verbal ability score at age 3 was -4.8 (95% confidence interval -6.0 to -3.7; P<0.05), equivalent to an average delay of four months. After adjustment for sociodemographic factors these differences were attenuated: -0.3 (-1.3 to 0.7), equivalent to no delay. Children born after assisted reproduction performed consistently better in verbal ability tests (3.8 (-0.2 to 7.9) at age 3 and 3.5 (0.2 to 6.8) at age 5), which suggests that on average these children are three to four months ahead; this difference did not completely disappear with adjustment for confounders. Children born after infertility treatment had lower mean scores in non-verbal tests (-1.2 (-4.1 to 1.6) after assisted reproduction and -1.5 (-3.5 to 0.4) after induced ovulation) and in spatial ability tests (-2.7 (-6.9 to 1.6) after assisted reproduction), though the differences were not significant.

CONCLUSIONS

Pregnancy planning, subfertility, or assisted reproduction do not adversely affect children's cognitive development at age 3 or 5. The differences observed in the unadjusted analyses are almost entirely explained by marked inequalities in socioeconomic circumstances between the groups.

[Contributions to the implementation of screening tests for assessing the neuropsychic development in children]

Currently, in Romania the general practitioner does not use screening tests to detect the developmental problems in children. That might be the reason why many cases are diagnosed too late.

AIM

To evaluate the impact and the usefulness of a screening tool for neurodevelopmental disorders in primary care.

MATERIAL AND METHODS

This trans-sequential study was carried out a on a series of 324 children under the age of 5 in the interval January 2007-December 2010. The neurodevelopmental status of the children was assessed by two methods: routine clinical assessment, and ASQ screening tools.

RESULTS

Compared to routine assessment, by which 33 children (10,2%) with development delays have been detected, the use of parent-addressed questionnaires raised the detection percentage to 12% (6 more children). The use of parent-addressed questionnaires also improved the doctor-patient communication, increased the degree of parental involvement in their child's development stimulation, especially with regard to the malfunctions in verbal and cognitive behavior.

CONCLUSIONS

The use of validated screening tests is a goal for improving the primary care practice.

Maternal smoking during pregnancy and offspring growth in childhood: 1993 and 2004 Pelotas cohort studies

OBJECTIVE

To explore the effects of maternal smoking during pregnancy on offspring growth using three approaches: (1) multiple adjustments for socioeconomic and parental factors, (2) maternal-paternal comparisons as a test of putative intrauterine effects and (3) comparisons between two birth cohort studies.

METHODS

Population-based birth cohort studies were carried out in Pelotas, Brazil, in 1993 and 2004. Cohort members were followed up at 3, 12, 24 and 48 months. Multiple linear regression analysis was used to examine the relationships between maternal and paternal prenatal smoking and offspring anthropometric indices. In the 2004 cohort, the association of smoking with trunk length, leg length and leg-to-sitting-height ratio at 48 months was also explored.

RESULTS

Maternal smoking during pregnancy was associated with reduced z scores of length/height-for-age at each follow-up in both cohorts and reduced leg length at 48 months in the 2004 cohort. Children older than 3 months born to smoking women showed a higher body mass index-for-age z score than children of non-smoking women.

CONCLUSIONS

The results of this study strongly support the hypothesis that maternal smoking during pregnancy impairs linear growth and promotes overweight in childhood.

Paternal contribution to small for gestational age babies: a multicenter prospective study

Our aims were to investigate whether men who fathered small for gestational age (SGA) infants themselves had lower birthweight, were more likely to be obese, have central adiposity and elevated blood pressure in adult life compared with men who fathered non-SGA infants. A total of 2,002 couples participating in the Screening for Pregnancy Endpoints (SCOPE) study were enrolled in early pregnancy and pregnancy outcome data collected prospectively. SGA was defined as birthweight <10th customized centile, obesity as BMI ≥30 kg/m(2), central adiposity as waist circumference >102 cm. Logistic regression was used to compare rates of obesity, and central adiposity between men who fathered SGA infants compared with those with non-SGA infants and the final model was adjusted for maternal and paternal confounders. The men who fathered an SGA infant (209 (10.4%)) themselves had lower mean birthweight (3,291 (530) g vs. 3,472 (584) g, P < 0.0001), were more likely to be obese (50 (24.8%) vs. 321 (18.3%), adjusted odds ratio (OR) 1.50, 95% confidence interval 1.05-2.16, adjusted for maternal and paternal factors) and to have central adiposity (52 (25.1%) vs. 341 (19.2%), adjusted OR 1.53, 95% confidence interval 1.06-2.20) compared with men who fathered a non-SGA infant. Elevated paternal blood pressure was not associated with SGA. In conclusion, we report a novel relationship between paternal obesity/central adiposity and birth of an SGA infant, which appears to be independent of maternal factors associated with fetal growth restriction.

Gender differences in filicide offense characteristics--a comprehensive register-based study of child murder in two European countries

OBJECTIVE

This study searched for gender differences in filicidal offense characteristics and associated variables.

METHODS

In this bi-national register-based study all filicide perpetrators (75 mothers and 45 fathers) and their crimes in Austria and Finland 1995-2005 were examined for putative gender differences. The assessed variables were associated with the offense characteristics, the offenders' socioeconomic and criminal history, and related stressful events.

RESULTS

Mothers had previously committed violent offenses less often than fathers (5% vs. 28%, p<0.001) and they were less often employed (27% vs. 49%, p<0.05). Mothers' victims were on average younger than those of fathers; median ages of the victims were 3.4 and 6.1 years, respectively (p<0.001). Fathers were more often intoxicated during the offense (11% vs. 42%, p<0.001) and also used shooting as the method of operation more often than mothers (5% vs. 27%, p<0.001). Mothers used drowning, criminal negligence, and poisoning more often than fathers. Fathers' motives were more impulsive in nature (13% vs. 41%, p<0.001). After the killing, mothers tried to get rid of the body more often than fathers (25% vs. 7%, p<0.05).

CONCLUSIONS

Fathers who commit filicide may represent at least two subgroups, the one not unlike the common homicide offender; the other, the overloaded, working and suicidal father. Mothers may include several types of offenders, one of which is the neonaticide offender. More detailed descriptions and, therefore, more research are needed.

PRACTICE IMPLICATIONS

Distressed parents and families need support and health care personnel, social work and other officials need to be alert to notice fatigued parents' signs of despair, especially when several stressful experiences amass. Straightforward enquiry to the situation and even practical and psychological help may be needed for enhanced protection of children. The role of employers should also be discussed in relation to the welfare of working parents.

Drug abuse and intimate partner violence: a comparative study of opioid-dependent fathers

Because very little is known about the coparenting relationships of drug-abusing men, this comparative study was designed to examine the lifetime prevalence and recent frequency of intimate partner violence in the coparenting relationships of 106 fathers enrolled in methadone maintenance treatment. When compared with 118 community controls, the opioid-dependent fathers reported greater prevalence of physical, sexual, and psychological aggression directed at the mother of their youngest biological child over the course of the relationship. They also reported more frequent physical, sexual, and psychological aggression directed at the mother during the previous year. Similarly, the opioid-dependent fathers reported both greater prevalence of physical and sexual aggression directed at them by the mother of their youngest child over the course of the relationship and more frequent sexual aggression directed at them over the previous year. The results highlight the need for clinicians to consider risk for intimate partner violence in coparenting relationships when planning family-oriented intervention designed to meet the needs of fathers, mothers, and children affected by chronic drug abuse.

Association between paternal smoking and nutritional status of under-five children attending Diarrhoeal Hospital, Dhaka, Bangladesh

AIM

The study aimed at determining whether there is an association between paternal smoking and nutritional status of children aged 0-59 months. Furthermore, the study looked at the presence of any nutritional differentials within different socio-economic groups.

METHODS

Secondary analysis of data on children aged 0-59 months enrolled in the Hospital Surveillance System of International Centre for Diarrhoeal Disease Research, Dhaka Hospital, Bangladesh, during 1996-2006.

RESULTS

Among 13,555 under-five children, fathers of 49% were smokers. In multivariate logistic regression models adjusting for potential confounders, fathers' smoking was significantly associated with increased risk of moderate underweight (OR 1.16, 95% CI 1.08-1.25), severe underweight (OR 1.15, 95% CI 1.06-1.26), moderate stunting (OR 1.15, 95% CI 1.06-1.23) and severe stunting (OR 1.13, 95% CI 1.03-1.25). In middle and lower socio-economic strata, risk of moderate and severe child malnutrition was found to be significantly increased in the group where the father was a smoker.

CONCLUSION

Results indicate that there is an association between fathers' smoking and malnutrition of under-five children particularly in lower socio-economic group. A possible mechanism - if this association is causal - may be through a negative effect on family economy.

Paternal psychosocial characteristics and corporal punishment of their 3-year-old children

This study uses data from 2,309 biological fathers who participated in the Fragile Families and Child Well-Being Study (FFCWS) to examine associations between psychosocial characteristics and levels of corporal punishment (CP) toward their 3-year-old children over the past month. Results indicate that 61% of the fathers reported no CP over the past month, 23% reported using CP once or twice, and 16% reported using CP a few times in the past month or more. In multivariate models controlling for important sociodemographic factors as well as characteristics of the child, fathers' parenting stress, major depression, heavy alcohol use, and drug use were significantly associated with greater use of CP, whereas involvement with the child and generalized anxiety disorder were not. Girls were less likely to be the recipient of CP than were boys, and child externalizing behavior problems but not internalizing behavior problems were associated with more CP.

Adolescent fathers involved with child protection: social workers speak

This study examined adolescent paternity through structured interviews with their social workers. It adds to the literature by exploring if there were young men involved with the child protection services (CPS) system who are fathers, identifying their unique needs, and beginning discussions on working with these young men. CPS social workers from six area offices and one juvenile detention facility completed surveys for each father on their caseload. A 3.5% rate of adolescent paternity was observed across these offices. Information about the nature of the young men's involvement with CPS, their involvement with their children, and their unique needs as fathers are provided. This paper also identifies some practice and policy implications for adolescent fathers and CPS charged with their care.

A care coordination program for substance-exposed newborns

The Vulnerable Infants Program of Rhode Island (VIP-RI) was established as a care coordination program to promote permanency for substance-exposed newborns in the child welfare system. Goals of VIP-RI were to optimize parents' opportunities for reunification and increase the efficacy of social service systems involved with families affected by perinatal substance use. Findings from VIP-RI's final four years show that by 12 months, 86% of substance-exposed newborns had identified permanent placements and 77% were placed with biological parents or relatives.

The presence of a stepfather and child physical abuse, as reported by a sample of Brazilian mothers in Rio de Janeiro

OBJECTIVE

Substitute fathers are often reported to commit child abuse at higher rates than birth (i.e., putative genetic) fathers. Due to the paucity of studies, especially in developing countries, and to some conflicting results from developed countries regarding the identity of perpetrators of less extreme forms of physical abuse of children in stepfamilies, the aim of this study was to assess whether the presence of a stepfather would constitute a risk factor for violence against Brazilian children, as reported by their mothers.

METHODS

Three hundred eighty five women with a current male partner and a child aged 1-12 years were interviewed. Child physical abuse was assessed using the Conflict Tactic Scales Parent Child. Data were analyzed through multiple logistic regressions.

RESULTS

Physical abuse (including severe physical abuse) was reported for 34.0% of the children with stepfathers (N=54) versus 17.6% of those living with putative genetic fathers (N=331). When adjusted for income, education, ages, whether the child was the first born, number of siblings, number of people in the household, how much time the man spent with the child, how many years he resided with the mother, and alcohol abuse and drug use by the mother and her partner, the adjusted odds ratio was 2.7 (95% CI: 1.2-5.9) for stepfather households over 2 genetic parent households. Surprisingly, the elevated risk to stepchildren was due to alleged abuse by the interviewee herself rather than her partner.

CONCLUSION

Brazilian mothers professed to abuse their own children at substantially higher rates when their male partners were stepfathers to the focal child as compared to genetic fathers.

Mothers' maximum drinks ever consumed in 24 hours predicts mental health problems in adolescent offspring

BACKGROUND

The maximum number of alcoholic drinks consumed in a single 24-hr period is an alcoholism-related phenotype with both face and empirical validity. It has been associated with severity of withdrawal symptoms and sensitivity to alcohol, genes implicated in alcohol metabolism, and amplitude of a measure of brain activity associated with externalizing disorders in general. In a previous study we found that the maximum number of drinks fathers had ever consumed in 24 hrs was associated with externalizing behaviors and disorders in preadolescent and adolescent children. The purpose of the present study was to determine whether maternal maximum consumption has similar correlates.

METHOD

We examined associations between maternal maximum consumption and alcohol dependence, respectively, and disruptive disorders and substance-related problems in two large independent population-based cohorts of 17-year-old adolescents.

RESULTS

Maximum consumption was associated with conduct disorder, disruptive disorders in general, early substance use and misuse, and substance disorders in adolescent children regardless of sex. Associations were consistent across cohorts, providing internal replication. They also paralleled our previous findings regarding paternal status. They could not be explained by maternal alcohol dependence, effects of drinking during pregnancy, or paternal maximum consumption. They were not simple artifacts of the fact that maximum consumption is a continuous measure while alcohol dependence is dichotomous.

CONCLUSIONS

Despite deriving from a single question about lifetime behavior, parental maximum consumption appears to reflect vulnerability for mental health problems, especially substance-related ones, more directly than a diagnosis of alcohol dependence.

Prevalence of childhood physical abuse in a representative sample of college students in Samsun, Turkey

The main objective of this article is to obtain the prevalence of childhood physical abuse experiences in college students.This cross-sectional study was performed on a gender-stratified random sample of 988 participants studying at Ondokuz Mayis University, with self-reported anonymous questionnaires. It included questions on physical abuse in childhood, on whom and why the violence was inflicted, and on the reactions exhibited. Of the 988 participants, 527 (53.3%) had a history of childhood physical abuse (64.0% in men and 41.6% in women). The prevalence of being subject to physical violence was 1.5 times higher in men. Mothers more frequently inflicted violence on daughters and fathers on sons. According to participants, most frequent reasons for physical violence were "loss of perpetrator's self-control" and "establishment of discipline at home." The most frequent statement observed among the participants was humiliation after subjection to physical violence. It is concluded that the first (and the most) important preventive measure is to protect and strengthen the social, economic, and judicial status of the Turkish family. Second, it should by all means be prevented that violence remains legal in some social conditions like child abuse.

Like father, like son: the intergenerational cycle of adolescent fatherhood

OBJECTIVES

Strong evidence exists to support an intergenerational cycle of adolescent fatherhood, yet such a cycle has not been studied. We examined whether paternal adolescent fatherhood (i.e., father of study participant was age 19 years or younger when his first child was born) and other factors derived from the ecological systems theory predicted participant adolescent fatherhood.

METHODS

Data included 1496 young males who were interviewed annually from the National Longitudinal Survey of Youth 1997. Cox regression survival analysis was used to determine the effect of paternal adolescent fatherhood on participant adolescent fatherhood.

RESULTS

Sons of adolescent fathers were 1.8 times more likely to become adolescent fathers than were sons of older fathers, after other risk factors were accounted for. Additionally, factors from each ecological domain-individual (delinquency), family (maternal education), peer (early adolescent dating), and environment (race/ethnicity, physical risk environment)-were independent predictors of adolescent fatherhood.

CONCLUSIONS

These findings support the need for pregnancy prevention interventions specifically designed for young males who may be at high risk for continuing this cycle. Interventions that address multiple levels of risk will likely be most successful at reducing pregnancies among partners of young men.

Parenting stress and coping styles in mothers and fathers of pre-school children with autism and Down syndrome

BACKGROUND

The study examined the profile of stress in mothers and fathers of preschool children with autism, Down syndrome and typically developing children. A further aim was to assess the association between parenting stress and coping style.

METHODS

A total of 162 parents were examined using Holroyd's 66-item short form of Questionnaire of Resources and Stress for Families with Chronically Ill or Handicapped Members and the Coping Inventory for Stressful Situations by Endler and Parker.

RESULTS AND CONCLUSIONS

The results indicated a higher level of stress in parents of children with autism. Additionally, an interaction effect was revealed between child diagnostic group and parent's gender for two scales of parenting stress: dependency and management and limits of family opportunities. Mothers of children with autism scored higher than fathers in parental stress; no such differences were found in the group of parents of children with Down syndrome and typically developing children. It was also found that parents of children with autism differed from parents of typically developing children in social diversion coping. Emotion-oriented coping was the predictor for parental stress in the samples of parents of children with autism and Down syndrome, and task-oriented coping was the predictor of parental stress in the sample of parents of typically developing children. The results strongly supported earlier findings on parenting stress in parents of children with autism. They also shed interesting light on the relationship between coping styles and parental stress.

Psychiatric family history and schizophrenia risk in Denmark: which mental disorders are relevant?

BACKGROUND

A family history of schizophrenia is the strongest single indicator of individual schizophrenia risk. Bipolar affective disorder and schizo-affective disorders have been documented to occur more frequently in parents and siblings of schizophrenia patients, but the familial occurrence of the broader range of mental illnesses and their role as confounders have not been studied in large population-based samples.

METHOD

All people born in Denmark between 1955 and 1991 (1.74 million) were followed for the development of schizophrenia (9324 cases) during 28 million person-years at risk. Information of schizophrenia in cohort members and psychiatric history in parents and siblings was established through linkage with the Danish Psychiatric Central Register. Data were analysed using log-linear Poisson regression.

RESULTS

Schizophrenia was, as expected, strongly associated with schizophrenia and related disorders among first-degree relatives. However, almost any other psychiatric disorder among first-degree relatives increased the individual's risk of schizophrenia. The population attributable risk associated with psychiatric family history in general was 27.1% whereas family histories including schizophrenia only accounted for 6.0%. The general psychiatric family history was a confounder of the association between schizophrenia and urbanization of place of birth.

CONCLUSIONS

Clinically diagnosed schizophrenia is associated with a much broader range of mental disorders in first-degree relatives than previously reported. This may suggest risk haplotypes shared across many disorders and/or shared environmental factors clustering in families. Failure to take the broad range of psychiatric family history into account may bias results of all risk-factor studies of schizophrenia.

Predictors of coping in parents of children with an intellectual disability: comparison between Lebanese mothers and fathers

This cross-sectional study was designed to assess the predictors of coping behaviors of 147 Lebanese parents (101 mothers and 46 fathers) with a child with intellectual disability. It assessed the contribution of child's and parent's characteristics, informal social support, and stress on the coping behaviors of fathers and mothers. Multiple regression analysis confirmed that the father's education, informal social support, and stress were the best predictors of coping. The child's age, severity of illness, and parental health did not significantly contribute to predicting coping behaviors. Contrary to expectations in a Middle Eastern culture, both fathers and mothers reported similar levels of stress, perceived informal social support, and coping. Although informal social support cannot be forced on parents, health professionals can mobilize resources that are culturally sensitive, such as home visitation by nurses or support from other parents. This may especially be beneficial in developing countries with limited resources.

Parental socioeconomic status and unintentional injury deaths in early childhood: consideration of injury mechanisms, age at death, and gender

The aim of this study was to determine whether the socioeconomic status (SES) of parents influences early childhood unintentional injury deaths for different injury mechanisms and the gender and age at death of the child. Study design is a population-based retrospective study. Death certificate data from 1995 to 2004 were linked to birth certificate data from 1995 to 1996 for each child who died when aged < or = 8 years. Parental age, birth order, marital status, residence area, educational level, and occupation were used as indices for SES. Cox proportional-hazards analysis was employed. Our results indicate that nonmetropolitan residence, low parental education level, and a father working in a nonadministrative job or as a farmer were associated with a higher risk of death from injury for both boys and girls. A mother aged younger than 20 years and parents working in manual jobs were associated with a higher risk in boys only. The risks of some socioeconomic factors (low parental education and a father working in a manual job or as a farmer) were evident for children aged 1-4 years. The risks of rural residency tended to increase in older children, and the risk of injury from having a mother aged younger than 20 years increased for younger children. The risks of childhood injury deaths from traffic accidents, falls, and fire/burns were associated with the SES of the parents. Younger parents were associated with higher risks of injury deaths from traffic accidents (hazard ratio [HR]: father, 7.9; mother, 1.9) and falls (HR: father, 2.0; mother, 2.5). A father working as a farmer was associated with a higher risk of childhood injury death from fire/burns (HR = 4.0). In conclusion, the parental SES risk profiles of childhood injury deaths varied with the age and gender of the child, and with the injury mechanism. Therefore, reducing excess injury deaths during early childhood requires preventive efforts targeted at high-risk parents, and based on injury mechanism and on the gender and age of the child.