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McBride H, Jhawar N, Boucicaut L, Bearden CE, Kates WR, Woolf-King SE, Antshel KM. Mental health, coping, and protective factors in mothers of children with 22q11.2 deletion syndrome. Am J Med Genet B Neuropsychiatr Genet 2024:e32973. [PMID: 38409998 DOI: 10.1002/ajmg.b.32973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 12/29/2023] [Accepted: 02/07/2024] [Indexed: 02/28/2024]
Abstract
Compared to the large body of maternal mental health research for other pediatric disorders, we know far less about the experience of mothers of children with 22q11DS. This study investigates the coping methods, protective factors, and mental health of this population. These findings might lead to better support for 22q11DS maternal mental health. An international sample of 71 mothers (M = 40.5 years) of children with 22q11DS (M = 9.2 years) was recruited and completed an online survey assessing maternal mental health (symptoms of depression, anxiety, traumatic stress, general stress, and alcohol consumption), coping methods, and mental health protective factors (social support, dyadic adjustment, parenting competence). Maternal ratings of child mental health symptoms were also obtained. Mothers' self-report revealed a high percentage who screened positive for elevated levels of general stress (69%), hazardous alcohol consumption (30.9%), traumatic stress (33.8%), anxiety (26.8%), and depression (26.8%). After controlling for demographic variables and child mental health symptoms, maternal self-reported maladaptive coping methods were positively associated with maternal symptoms of depression, anxiety, stress, and traumatic stress. Reducing maladaptive coping methods may be a promising intervention for improving mental health in mothers of children with 22q11DS.
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Affiliation(s)
- Haley McBride
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Nandini Jhawar
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Laurie Boucicaut
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences and Psychology, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA
- Department of Psychology, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA
| | - Wendy R Kates
- Department of Psychiatry and Behavioral Sciences, SUNY-Upstate Medical University, Syracuse, New York, USA
| | | | - Kevin M Antshel
- Department of Psychology, Syracuse University, Syracuse, New York, USA
- Department of Psychiatry and Behavioral Sciences, SUNY-Upstate Medical University, Syracuse, New York, USA
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Walkowiak D, Domaradzki J. Parental experiences and needs of caring for a child with 22q11.2 deletion syndrome. Orphanet J Rare Dis 2023; 18:379. [PMID: 38049864 PMCID: PMC10696670 DOI: 10.1186/s13023-023-02980-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 11/18/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND For a variety of reasons, raising a child with 22q11.2DS has significant psychosocial and financial repercussions for the family caregivers. Our aim was to identify and explain the expectations and concerns of Polish parents of 22q11.2DS children. An online survey was developed consisting of four sections: demographics, emotions experienced by caregivers while performing their duties, attitudes of the respondents about providing care, and finally different aspects of the caregivers' life satisfaction. The study was conducted with the support of the Polish 22q11 Association. RESULTS Forty-four caregivers of Polish origin completed the survey, all but one of whom were mothers. Thirty-four per cent (n = 15/44) declared full-time employment. According to 73% (n = 32/44) of those surveyed, the child's disease has not harmed their relationship with the partner. In spite of the fact that the median diagnosis time was 1.9 years (ranging from 0 to 12 years), the caregivers indicated that they had contacted on average 3.9 doctors before obtaining the right diagnosis (range 1-17). The Internet was the main source of information and knowledge about their child's disease for 93% of respondents (n = 41/44), while for 54% (n = 24/44) it was the association for people with 22q11DS. Only 26% rated as very good or good the support for caregivers offered by the central and local government or its agendas. The physicians' knowledge about 22q11DS was positively rated by 14% of respondents (n = 6/44). The most frequently chosen source of support for 66% of respondents (n = 29/44) turned out to be their families, and for 34% - a Facebook support group (n = 15/44). Asked how often they rated their quality of life (QoL) highly, none of our respondents chose the option "always", although 64% (28/44) gave the answer "often". CONCLUSION Our study is the first one in Poland to develop an online survey specifically for use with caregivers of paediatric patients with 22q11.2DS. Our respondents revealed that caring for 22q11.2 children entails a burden that extends far beyond clinical facets and has a significant impact on every dimension of the caregivers' lives, including their mental health, everyday activities, families, professional career and social lives. At the same time, caregivers are de facto left alone with the bureaucracy of the healthcare system.
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Affiliation(s)
- Dariusz Walkowiak
- Department of Organization and Management in Health Care, Poznan University of Medical Sciences, Przybyszewskiego 39, Poznań, 60-356, Poland.
| | - Jan Domaradzki
- Department of Social Sciences and Humanities, Poznan University of Medical Sciences, Poznań, Poland
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Nakajima N, Tanaka M, Kanehara A, Morishima R, Kumakura Y, Ohkouchi N, Hamada J, Ogawa T, Tamune H, Nakahara M, Mori S, Ichihashi K, Jinde S, Kano Y, Sakamoto I, Tanaka K, Hirata Y, Ohashi H, Shinohara T, Kasai K. Relationship between high trait anxiety in 22q11.2 deletion syndrome and the difficulties in medical, welfare, and educational services. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e80. [PMID: 38868412 PMCID: PMC11114383 DOI: 10.1002/pcn5.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 01/08/2023] [Accepted: 01/23/2023] [Indexed: 06/14/2024]
Abstract
Aim The 22q11.2 deletion syndrome (22q11DS) is associated with a high prevalence of mental health comorbidities. However, not enough attention has been paid to the elevated prevalence of high trait anxiety that begins early in life and may be enduring. We sought to identify specific medical, welfare, or educational difficulties associated with high trait anxiety in 22q11DS. Methods A questionnaire-based survey was conducted for the parents of 22q11DS individuals (N = 125). First, a multiple regression analysis was conducted to confirm the hypothesis that high trait anxiety in individuals with 22q11DS would be associated with parents' psychological distress. This was based on 19 questionnaire options regarding what difficulties the parents currently face about their child's disease, characteristics, and traits. Next, we explored what challenges faced in medical, welfare, and educational services would be associated with the trait anxiety in their child. Results The multiple regression analysis confirmed that the high trait anxiety was significantly associated with parental psychological distress (β = 0.265, p = 0.018) among the 19 clinical/personal characteristics of 22q11DS. Furthermore, this characteristic was associated with various difficulties faced in the medical care, welfare, and education services, and the parent-child relationship. Conclusion To our knowledge, this is the first study to clarify quantitatively how the characteristic of high anxiety level in 22q11DS individuals is related to the caregivers' perceived difficulties in medical, welfare, and educational services. These results suggest the necessity of designing service structures informed of the fact that high trait anxiety is an important clinical feature of the syndrome.
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Affiliation(s)
- Naomi Nakajima
- Department of NeuropsychiatryThe University of Tokyo HospitalTokyoJapan
| | - Miho Tanaka
- Department of NeuropsychiatryThe University of Tokyo HospitalTokyoJapan
| | - Akiko Kanehara
- Department of NeuropsychiatryThe University of Tokyo HospitalTokyoJapan
| | - Ryo Morishima
- The Health Care Science InstituteTokyoJapan
- Department of Neuropsychiatry, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Yousuke Kumakura
- Department of NeuropsychiatryThe University of Tokyo HospitalTokyoJapan
- Department of Mental Health, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Noriko Ohkouchi
- Department of NeuropsychiatryThe University of Tokyo HospitalTokyoJapan
| | - Junko Hamada
- Department of NeuropsychiatryThe University of Tokyo HospitalTokyoJapan
| | - Tomoko Ogawa
- Department of Child PsychiatryThe University of Tokyo HospitalTokyoJapan
| | - Hidetaka Tamune
- Department of Cellular Neurobiology, Graduate School of MedicineThe University of TokyoTokyoJapan
- World‐Leading Innovative Graduate Study Program for Life Science and Technology (WINGS‐LST)The University of TokyoTokyoJapan
| | - Mutsumi Nakahara
- Graduate School of Clinical PsychologyKagoshima UniversityKagoshimaJapan
| | - Shunsuke Mori
- Department of Neuropsychiatry, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Kayo Ichihashi
- Department of NeuropsychiatryThe University of Tokyo HospitalTokyoJapan
| | - Seiichiro Jinde
- Department of NeuropsychiatryThe University of Tokyo HospitalTokyoJapan
- Department of Neuropsychiatry, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Yukiko Kano
- Department of Child PsychiatryThe University of Tokyo HospitalTokyoJapan
- Department of Child Neuropsychiatry, Graduate, School of MedicineThe University of TokyoTokyoJapan
| | - Ichiro Sakamoto
- Department of Cardiovascular MedicineKyushu University Graduate School of Medical SciencesFukuokaJapan
| | - Kyoko Tanaka
- Department of Psychosocial MedicineNational Center for Child Health and DevelopmentTokyoJapan
| | - Yoichiro Hirata
- Department of PediatricsKitasato University School of MedicineKanagawaJapan
| | - Hirofumi Ohashi
- Division of Medical GeneticsSaitama Children's Medical CenterSaitamaJapan
| | - Tokuko Shinohara
- Department of Pediatric Cardiology and Adult Congenital CardiologyTokyo Women's Medical UniversityTokyoJapan
| | - Kiyoto Kasai
- Department of NeuropsychiatryThe University of Tokyo HospitalTokyoJapan
- Department of Neuropsychiatry, Graduate School of MedicineThe University of TokyoTokyoJapan
- The International Research Center for Neurointelligence (IRCN), The University of Tokyo Institutes for Advanced Study (UTIAS)The University of TokyoTokyoJapan
- UTokyo Institute for Diversity and Adaptation of Human Mind (UTIDAHM)The University of TokyoTokyoJapan
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Tanaka M, Kanehara A, Morishima R, Kumakura Y, Okouchi N, Nakajima N, Hamada J, Ogawa T, Tamune H, Nakahara M, Jinde S, Kano Y, Kasai K. Educational challenges for 22q11.2 deletion syndrome in Japan: Findings from a mixed methods survey. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:558-570. [PMID: 36782372 DOI: 10.1111/jar.13079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/13/2023] [Accepted: 01/21/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND The 22q11.2 deletion syndrome (22q11DS) is characterised by a changing pattern of overlapping intellectual, physical, and mental disabilities along the course of one's life. However, the impact of overlapping disorders (multimorbidity) on educational challenges remains unclear. METHOD A survey was conducted with 88 caregivers of individuals with 22q11DS. A quantitative analysis of educational challenges and support needs divided into age groups (7-12, 13-15, 16-18, and 19 years and over) and a qualitative analysis of the free-text items in the questionnaire was conducted. RESULTS Caregivers were more interested in comprehensive developmental support when their children were younger, and the emphasis shifted to concerns regarding environments that matched individual characteristics at older ages. Furthermore, when there are multiple disabilities or disorders, support is concentrated on the more obvious disabilities, and the lack of support for the less superficially obvious disabilities associated with multiple difficulties, including mental health problems, can be a challenge for people with 22q11DS and their families. CONCLUSIONS This study suggests a need for increased focus on multimorbidity and associated disabilities in school education that are difficult to observe because of their mildness or borderline levels if present alone.
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Affiliation(s)
- Miho Tanaka
- Department of Neuropsychiatry, The University of Tokyo Hospital, Tokyo, Japan
| | - Akiko Kanehara
- Department of Neuropsychiatry, The University of Tokyo Hospital, Tokyo, Japan
| | - Ryo Morishima
- The Health Care Science Institute, Tokyo, Japan.,Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yousuke Kumakura
- Department of Neuropsychiatry, The University of Tokyo Hospital, Tokyo, Japan.,Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Noriko Okouchi
- Department of Neuropsychiatry, The University of Tokyo Hospital, Tokyo, Japan
| | - Naomi Nakajima
- Department of Neuropsychiatry, The University of Tokyo Hospital, Tokyo, Japan
| | - Junko Hamada
- Department of Neuropsychiatry, The University of Tokyo Hospital, Tokyo, Japan.,Department of Child Psychiatry, The University of Tokyo Hospital, Tokyo, Japan
| | - Tomoko Ogawa
- Department of Child Psychiatry, The University of Tokyo Hospital, Tokyo, Japan
| | - Hidetaka Tamune
- Department of Cellular Neurobiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,World-Leading Innovative Graduate Study Program for Life Science and Technology (WINGS-LST), The University of Tokyo, Tokyo, Japan
| | - Mutsumi Nakahara
- Graduate School of Clinical Psychology, Kagoshima University, Kagoshima, Japan
| | - Seiichiro Jinde
- Department of Neuropsychiatry, The University of Tokyo Hospital, Tokyo, Japan.,Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yukiko Kano
- Department of Child Psychiatry, The University of Tokyo Hospital, Tokyo, Japan.,Department of Child Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, The University of Tokyo Hospital, Tokyo, Japan.,Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,The International Research Center for Neurointelligence (WPI-IRCN) at The University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan
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