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Rigney G, Jo J, Williams K, Terry DP, Zuckerman SL. Parental Factors Associated With Recovery After Mild Traumatic Brain Injury: A Systematic Review. J Neurotrauma 2023; 40:2015-2036. [PMID: 37212287 DOI: 10.1089/neu.2023.0015] [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] [Indexed: 05/23/2023] Open
Abstract
While parental factors have been shown to potentially influence recovery after mild traumatic brain injury (mTBI) in children, both the strength and direction of the relationships remain unclear. We performed a systematic review regarding the association between parental factors and recovery after mTBI. PubMed, CINHL, Embase, PsychINFO, Web of Science, ProQuest, Cochrane Central, and Cochrane databases were queried for articles published between September 1, 1970, and September 10, 2022, reporting any parental factor and its association with recovery after mTBI in children younger than 18 years old. The review included both quantitative and qualitative studies published in English. Regarding the directionality of the association, only studies that assessed the effects of parental factors on recovery after mTBI were included. Study quality was assessed using a five-domain scale created by the Cochrane Handbook and the Agency for Healthcare Research and Quality. The study was prospectively registered with PROSPERO (CRD42022361609). Of 2050 studies queried, 40 met inclusion criteria, and 38 of 40 studies used quantitative outcome measures. Across 38 studies, 24 unique parental factors and 20 different measures of recovery were identified. The most common parental factors studied were socioeconomic status/income (SES; n = 16 studies), parental stress/distress (n = 11), parental level of education (n = 9), pre-injury family functioning (n = 8), and parental anxiety (n = 6). Among all associations between parental factors and recovery reported, having a family history of a neurologic disease (i.e., migraine, epilepsy, neurodegenerative disease; 5/6 significant associations reported, 83%), parental stress/distress (9/11, 82%), parental anxiety (4/6, 67%), parental level of education (5/9, 56%), and SES/income (11/19, 57.9%) were shown to have the strongest evidence reporting significant associations with recovery, while a family history of psychiatric disease (3/6, 50%) and pre-injury family functioning (4/9, 44%) showed mixed results. Evidence regarding other parental factors including parental sex, race/ethnicity, insurance status, parental history of concussion, family litigation status, family adjustment levels, and family psychosocial adversity were limited, as studies investigating such factors were few. The current review highlights literature describing several parental factors that significantly influence recovery from mTBI. It will likely be useful for future studies to incorporate parental SES, education, stress/distress, anxiety, quality of parent-child relationships, and parenting style when examining modifying factors in recovery after mTBI. Future studies should also consider how parental factors may serve as potential interventions or policy levers to optimize sport concussion-related policy and return-to-play guidelines.
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Affiliation(s)
- Grant Rigney
- Department of Neurosurgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Jacob Jo
- Vanderbilt Sport Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kristen Williams
- Vanderbilt Sport Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Douglas P Terry
- Vanderbilt Sport Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Scott L Zuckerman
- Vanderbilt Sport Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Meijer L, Finkenauer C, Blankers M, de Gee A, Kramer J, Shields-Zeeman L, Thomaes K. Study protocol: development and randomized controlled trial of a preventive blended care parenting intervention for parents with PTSD. BMC Psychiatry 2023; 23:102. [PMID: 36765312 PMCID: PMC9921412 DOI: 10.1186/s12888-023-04548-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 01/13/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Children of parents with post-traumatic stress disorder (PTSD) are at increased risk of adverse psychological outcomes. An important risk mechanism is impaired parental functioning, including negative parenting behavior, perceived incompetence, and lack of social support. Several parenting interventions for trauma-exposed parents and parents with psychiatric disorders exist, but none have specifically targeted parents with PTSD. Our objective is to evaluate the effectiveness of a blended care preventive parenting intervention for parents with PTSD. METHODS The intervention was adapted from an existing online intervention, KopOpOuders Self-Help. In co-creation with parents with PTSD and partners, the intervention was adapted into KopOpOuders-PTSD, by adding PTSD-specific content and three in-person-sessions with a mental health prevention professional. Effectiveness will be tested in a randomized controlled trial among N = 142 parents being treated for PTSD at Arkin Mental Health Care (control condition: treatment as usual, n = 71; intervention condition: treatment as usual + intervention, n = 71). Online questionnaires at pretest, posttest, and three-month follow-up and ecological momentary assessment at pretest and posttest will be used. Intervention effects on primary (parenting behavior) and secondary outcomes (perceived parenting competence, parental social support, parenting stress, child overall psychological problems and PTSD symptoms) will be analyzed using generalized linear mixed modeling. We will also analyze possible moderation effects of parental PTSD symptoms at pretest on primary and secondary outcomes. DISCUSSION This study protocol describes the randomized controlled trial of KopOpOuders-PTSD, a blended care preventive parenting intervention for parents with PTSD. Findings can contribute to understanding of the effectiveness of parenting support in clinical practice for PTSD. TRIAL REGISTRATION This protocol (Version 1) was registered on 11-02-2022 at ClinicalTrials.gov under identification number NCT05237999.
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Affiliation(s)
- Laurien Meijer
- Sinai Centrum / Arkin Mental Health Care, Laan van de Helende Meesters 2, 1186 AM, Amstelveen, The Netherlands. .,Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands.
| | - Catrin Finkenauer
- grid.5477.10000000120346234Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Matthijs Blankers
- grid.491093.60000 0004 0378 2028Arkin Mental Health Care, Amsterdam, the Netherlands ,grid.416017.50000 0001 0835 8259Trimbos Institute/Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Anouk de Gee
- grid.416017.50000 0001 0835 8259Trimbos Institute/Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Jeannet Kramer
- grid.416017.50000 0001 0835 8259Trimbos Institute/Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Laura Shields-Zeeman
- grid.416017.50000 0001 0835 8259Trimbos Institute/Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Kathleen Thomaes
- grid.491093.60000 0004 0378 2028Sinai Centrum / Arkin Mental Health Care, Laan van de Helende Meesters 2, 1186 AM Amstelveen, The Netherlands ,grid.509540.d0000 0004 6880 3010Department of Psychiatry, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands
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Gómez‐Ortiz O, Rubio A, Roldán‐Barrios A, Ridao P, López‐Verdugo EI. Parental stress and life satisfaction: A comparative study of social services users and nonusers from a gender perspective. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:345-360. [PMID: 35708652 PMCID: PMC10084402 DOI: 10.1002/jcop.22907] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/09/2022] [Accepted: 05/20/2022] [Indexed: 05/08/2023]
Abstract
The psychometric properties of the Spanish version of the Parental Stress Scale (PSS) scale have not been verified on the Spanish population. Similarly, the literature on gender differences and parental stress is inconclusive, and there is little evidence of their relationship with life satisfaction. To analyze the psychometric properties of the Spanish version of the PSS scale, (2) to examine possible gender differences, and (3) to study the relationship between parental stress (PS) and parental rewards (PR) and satisfaction with life (SWL) attending to the possible moderating effect of gender. These objectives were examined in samples comprising Social Services Users (SSU) (N = 525; 78.3% female; Mage = 38.3) and non-SSU users (N = 421; 41.1% male; Mage = 37.08). A CFA corroborated a two-factor structure: PS and PR. In the SSU sample, mothers showed higher PS and lower PR. However, PR was also higher in mothers from the non-SSU sample compared to fathers. PR and PS were directly related to SWL in the SSU sample. However, gender moderated the relationship between PR and SWL in the non-SSU sample in the case of mothers. The results are discussed considering gender roles and the characteristics of both samples.
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Affiliation(s)
| | - Ana Rubio
- Department of PsychologyUniversity of CórdobaCórdobaSpain
| | | | - Pilar Ridao
- Department of Developmental and Educational PsychologyUniversity of SevillaSevillaSpain
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Huffhines L, Coe JL, Busuito A, Seifer R, Parade SH. Understanding links between maternal perinatal posttraumatic stress symptoms and infant socioemotional and physical health. Infant Ment Health J 2022; 43:474-492. [PMID: 35513001 PMCID: PMC9177799 DOI: 10.1002/imhj.21985] [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: 05/06/2021] [Accepted: 02/02/2022] [Indexed: 11/10/2022]
Abstract
Maternal posttraumatic stress symptoms (PTSS) are associated with adverse consequences for older children, but very few studies have examined links between perinatal maternal PTSS and infant outcomes. Trauma exposure and psychopathology, including PTSS, is often heightened for women during pregnancy through 1 year postpartum. Therefore, the perinatal period may be a critical time for understanding the risk maternal PTSS and other mental health factors pose to the socioemotional and physical health of infants. The present study explored the relation between maternal PTSS and infant socioemotional and physical health problems in a sample of racially and ethnically diverse mother-infant dyads (N = 295) assessed prenatally and at 12 months postpartum. This study also examined whether there are: (1) moderating effects of maternal depressive symptoms and parenting stress on these associations and (2) indirect effects of PTSS on infant outcomes through observed maternal sensitivity. Results indicated that postpartum depressive symptoms and parenting stress, rather than PTSS, were associated with greater infant socioemotional health problems. However, prenatal PTSS were associated with greater infant physical health problems when mothers also reported clinically significant levels of postpartum depressive symptoms. Maternal sensitivity was not associated with maternal PTSS, depressive symptoms, or parenting stress, nor was it related to infant socioemotional and physical health; thus, maternal sensitivity was not tested as an intermediary mechanism linking maternal mental health with infant outcomes. Implications for promoting maternal mental health in the perinatal period to bolster socioemotional and physical health of infants are discussed.
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Affiliation(s)
- Lindsay Huffhines
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, Rhode Island, USA
| | - Jesse L Coe
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, Rhode Island, USA
| | - Alex Busuito
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Ronald Seifer
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, Rhode Island, USA.,Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Stephanie H Parade
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, Rhode Island, USA
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Raising Children in Risk Neighborhoods from Chile: Examining the Relationship between Parenting Stress and Parental Adjustment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010045. [PMID: 35010304 PMCID: PMC8751053 DOI: 10.3390/ijerph19010045] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 02/06/2023]
Abstract
Introduction: Parenting stress and parental adjustment could implicate key differences in the relational dynamics that parents establish with their children, particularly when families come from vulnerable social contexts. Method: Participants were 142 fathers and mothers from a risk neighborhood of Chile. The variables examined were parenting stress (parental distress, parent–child dysfunctional interaction and difficult child) and parental adjustment (depression, anxiety, and stress). Parents also completed a sociodemographic characterization survey. The statistical analyses were a correlation analysis and multiple linear regression analyses. Results: Overall, not all components of parenting stress were related to parental adjustment. Only parental distress was found as a significant predictor of poor parental adjustment (greater depression, anxiety, and stress), but not parent–child dysfunctional interaction and having a difficult child. Conclusions: The present study findings highlight the influence of stress on parenting as a relevant dimension of research for the improvement of the intervention deployed by the state regarding the protection of vulnerable Chilean children, providing multiple clinical and psychosocial applications for research and intervention purposes.
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Marzilli E, Cerniglia L, Tambelli R, Trombini E, De Pascalis L, Babore A, Trumello C, Cimino S. The COVID-19 Pandemic and Its Impact on Families' Mental Health: The Role Played by Parenting Stress, Parents' Past Trauma, and Resilience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11450. [PMID: 34769967 PMCID: PMC8583183 DOI: 10.3390/ijerph182111450] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/18/2021] [Accepted: 10/27/2021] [Indexed: 11/25/2022]
Abstract
International research has evidenced the psychological impact of the COVID-19 pandemic on families, and the key role played by parenting stress levels. Although significant associations with parents' past trauma and resilience have been shown, this study aimed to explore their complex interplay on the relationship between parents' peritraumatic distress due to COVID-19, parenting stress, and children's psychopathological difficulties. We recruited 353 parents with children aged two to 16 years via an online survey during the Italian second wave of COVID-19. Parents' peritraumatic distress due to COVID-19, parenting stress, past trauma and resilience, and children's psychological difficulties were assessed through self-report and report-form questionnaires. Parents' past traumas significantly predicted peritraumatic distress due to COVID-19 and children's psychological difficulties. The relationship between past traumas and children's psychological difficulties was serial mediated by parents' peritraumatic distress and parenting stress. Direct and total effects of parent's resilience on parent's peritraumatic distress were not significant, but there were significant indirect effects via parenting stress and via parents' peritraumatic distress and parenting stress, indicating inconsistent mediation. This study evidenced the key risk and protective role played by, respectively, parents' past traumas exposure and resilience on the relationship between parents' psychological difficulties due to COVID-19, parenting stress, and children's psychological difficulties, with important clinical implications.
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Affiliation(s)
- Eleonora Marzilli
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, 00186 Rome, Italy; (E.M.); (R.T.)
| | - Luca Cerniglia
- Faculty of Psychology, International Telematic University Uninettuno, 00186 Rome, Italy;
| | - Renata Tambelli
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, 00186 Rome, Italy; (E.M.); (R.T.)
| | - Elena Trombini
- Department of Psychology, University of Bologna, 40127 Bologna, Italy; (E.T.); (L.D.P.)
| | - Leonardo De Pascalis
- Department of Psychology, University of Bologna, 40127 Bologna, Italy; (E.T.); (L.D.P.)
| | - Alessandra Babore
- Laboratory of Dynamic Psychology, Department of Psychological Sciences, Health and Territory, Università degli Studi “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (A.B.); (C.T.)
| | - Carmen Trumello
- Laboratory of Dynamic Psychology, Department of Psychological Sciences, Health and Territory, Università degli Studi “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (A.B.); (C.T.)
| | - Silvia Cimino
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, 00186 Rome, Italy; (E.M.); (R.T.)
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