1
|
Xu Y, Harrison TM. Socioemotional and Behavioral Problems of Grandchildren Raised by Grandparents: The Role of Grandparent-Grandchild Relational Closeness and Conflict. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1623. [PMID: 37892286 PMCID: PMC10605244 DOI: 10.3390/children10101623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023]
Abstract
This study examined the associations of grandparent-grandchild relational closeness and conflict with grandchildren's socioemotional and behavioral problems, including emotional symptoms, conduct problems, hyperactivity, peer problems, and abnormal prosocial behaviors. We analyzed primary cross-sectional survey data collected from custodial grandparents in the United States using logistic regression models. The results indicated that grandparent-grandchild relational closeness was significantly associated with lower odds of custodial grandchildren having emotional symptoms, conduct problems, peer problems, and abnormal prosocial behaviors, whereas grandparent-grandchild relational conflict was significantly associated with higher odds of emotional symptoms, conduct problems, hyperactivity, peer problems, and abnormal prosocial behaviors. Implications for increasing grandparent-grandchild relational closeness and decreasing relational conflicts among grandparent-headed families are discussed, which might improve grandchildren's socioemotional and behavioral well-being.
Collapse
Affiliation(s)
- Yanfeng Xu
- College of Social Work, University of South Carolina, Columbia, SC 29208, USA
| | - Theresa M Harrison
- Carolina Family Engagement Center, College of Education, University of South Carolina, Columbia, SC 29208, USA
| |
Collapse
|
2
|
Smith GC, Hayslip B. Grandmother and Grandchild Reports of Psychological Difficulties Among Custodial Grandchildren: Whose View Matters and Why is It Important? CHILDREN AND YOUTH SERVICES REVIEW 2023; 148:106793. [PMID: 37220553 PMCID: PMC10201918 DOI: 10.1016/j.childyouth.2022.106793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We conducted this first ever study comparing reports of custodial grandchildren's (CG) psychological difficulties obtained jointly from 163 custodial grandmothers (CGM) and their CG between ages 6-12. Internalizing and externalizing difficulties were indicated by whether any of the corresponding scales on the Strengths and Difficulties Questionnaire (SDQ, reported by CGM) or Dominic Interactive (DI, reported by CG) reached the 90th percentile. Internalizing and externalizing difficulties were reported by informant types at rates higher than those typically observed in the general population, with externalizing difficulties being more prevalent among male CG. At the dichotomous level of (dis)agreement, nearly two-thirds of informant pairs showed concordance regarding whether or not they reported the CG at the 90th percentile on either externalizing and internalizing difficulties. When (dis)agreement was further broken into four specific categories (i.e., "neither report", "both report", "CGM only", and "CG only", CGM's use of mental health services, race, depressive and anxiety symptoms, harsh/punitive discipline, and warmth impacted such concordance as did CG's gender, age, and use of mental health services. The overall findings were remarkably similar regardless of which specific SDQ and DI scales were used in the analyses. The present study unearths new ground regarding the extent to which grandchildren's distress is similarly perceived by CG themselves versus their CGMs. Such findings are important to the extent that accurate estimates exist regarding the emotional difficulties CG face and lay the groundwork for timely and efficacious interventions designed to alleviate their distress.
Collapse
|
3
|
Xu Y, Wang Y, McCarthy LP, Harrison T, Doherty H. Mental/behavioural health and educational outcomes of grandchildren raised by custodial grandparents: A mixed methods systematic review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:2096-2127. [PMID: 35712998 PMCID: PMC10084073 DOI: 10.1111/hsc.13876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 05/07/2022] [Accepted: 05/28/2022] [Indexed: 05/27/2023]
Abstract
Grandparents caring for grandchildren has increased globally in the past two decades, but we have a limited understanding of its effects on custodial grandchildren's mental/behavioural health and educational outcomes. This mixed methods systematic review aims to synthesise mental/behavioural health and educational outcomes of custodial grandchildren within custodial grandparent-headed families and with comparison to other types of household structure and further examine factors associated with these outcomes. A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. We searched ERIC, Family Studies Abstracts, PsycINFO, PubMed, Scopus, Social Work Abstract and SocINDEX in March 2021 and screened 14,515 articles, which resulted in the inclusion of 42 studies, including 33 quantitative, seven qualitative and two mixed methods studies. The quality of included studies was assessed. This review covered 10 countries, yet most studies revealed that grandchildren raised by grandparents had adverse mental/behavioural health and educational outcomes compared to their peers raised by biological parents. This review further identified multi-level factors contributing to custodial grandchildren's adverse outcomes. Methodological limitations and implications for future practice and research were discussed.
Collapse
Affiliation(s)
- Yanfeng Xu
- University of South Carolina College of Social WorkColumbiaSouth CarolinaUSA
| | - Yao Wang
- University of Maryland School of Social WorkBaltimoreMarylandUSA
| | | | - Theresa Harrison
- University of South Carolina College of EducationColumbiaSouth CarolinaUSA
| | - Hanna Doherty
- University of South Carolina College of Social WorkColumbiaSouth CarolinaUSA
| |
Collapse
|
4
|
Smith GC, Hancock GR, Hayslip B. Predictors and moderators of treatment efficacy in reducing custodial grandmothers' psychological distress. Aging Ment Health 2022; 26:250-262. [PMID: 33393377 PMCID: PMC8846565 DOI: 10.1080/13607863.2020.1857688] [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] [Indexed: 02/03/2023]
Abstract
It is increasingly recommended that hypothesis-generating studies be conducted after initial RCTs in order to identify moderators of differential treatment efficacy on individual outcomes. Such analyses are important because they help clarify the best inclusion and exclusion criteria or choice of stratification for maximizing power in subsequent RCTs, reduce the chances of discarding interventions that may appear to lack efficacy when only average treatment effects are taken into consideration, and facilitate the matching of individual clients to treatment alternatives. We identified predictors and moderators of treatment-related change in psychological distress among custodial grandmothers (n = 343) assigned within a prior RCT to behavior parent training (BPT), cognitive behavior therapy (CBT), or information only control (IOC) conditions. Latent change scores in psychological distress were estimated for each grandmother across pre-test to post-test and pre-test to six months, as indicated by self-reported and clinical ratings of depression and anxiety symptoms. These estimates served as outcomes in classification and regression tree analyses conducted separately within the CBT and BPT conditions to identify predictors of treatment efficacy. Matched groups based upon identified predictors were then formed across all RCT conditions, and Predictor × RCT Condition interactions were computed to test for moderation of differential treatment efficacy. Grandmother age was the only predictor and moderator of BPT efficacy at both measurement points, whereas multifaceted predictors and moderators emerged for CBT which varied by time since treatment.
Collapse
Affiliation(s)
- Gregory C. Smith
- School of Lifespan Development and Educational Sciences, Kent State University, Kent, OH, USA
| | - Gregory R. Hancock
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
| | - Bert Hayslip
- Department of Psychology, University of North Texas, Denton, Denton, TX, USA
| |
Collapse
|
5
|
Grandparental care and sleep disturbances in preschool children: a population-based prospective cohort study. Sleep Med 2021; 82:165-171. [PMID: 33933721 DOI: 10.1016/j.sleep.2021.03.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 03/27/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Sleep disturbances are common in preschoolers, and profoundly affected by parenting. Grandparents are increasingly involved in childcare and have attracted worldwide attention for their potential impacts on child well-being. However, no studies have explored child sleep health within the context of grandparental care. We aimed to explore the association between grandparents as primary caregivers and children's sleep disturbances. METHODS Participants included 20,324 preschoolers from the Shanghai Children's Health, Education and Lifestyle Evaluation-Preschool (SCHEDULE-P) in Shanghai, China. They were initially assessed in November 2016 and were reassessed in April 2018 and April 2019. Children's primary caregivers were collected at each survey. Sleep disturbances were assessed by the Children's Sleep Habits Questionnaire (CSHQ). RESULTS At baseline, 84.4% of children had global sleep disturbances (CSHQ total score >41). Compared with parents, random-effects model indicated that grandparents as primary caregivers increased the adjusted odds ratio (OR) for children's global sleep disturbances by 30% (OR [95%CI]: 1.30 [1.21, 1.40]). To the specific domains of CSHQ, two-way repeated-measures ANOVA showed significant "caregiver transition" group × wave interaction in the behavioral sleep disturbances, such as "Bedtime Resistance" (p < 0.001). At each survey, children with grandparents as primary caregivers demonstrated significant higher behavioral sleep disturbances than their counterparts with parental care. CONCLUSIONS Grandparental care is associated with increased sleep disturbances, particularly behavioral sleep disturbances, in preschoolers. Future studies should explore the underlying mechanisms and whether sleep programs targeting grandparents can decrease children's sleep disturbances.
Collapse
|
6
|
Montoro-Rodriguez J, Hayslip B, Ramsey J, Jooste JL. The Utility of Solution-Oriented Strategies to Support Grandparents Raising Grandchildren. J Aging Health 2021; 33:647-660. [PMID: 33780271 DOI: 10.1177/08982643211004817] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: The purpose of this article is to evaluate the effectiveness of a psychosocial intervention program to improve the health and social psychological outcomes for grandparents raising grandchildren using the theory of Selection, Optimization, and Compensation (Baltes, P. B., & Baltes, M. M. (1990). Psychological perspectives on successful aging: The model of selective optimization with compensation. In P. B. Baltes & M. M. Baltes (Eds.), Successful aging: Perspectives from the behavioral sciences (pp. 1-34). Cambridge University Press. doi:10.1017/CBO9780511665684.003). Methods: Fifty-two grandparents were randomly assigned either to a 6-session solution-oriented goal-setting program or to a waiting list control condition who subsequently received the intervention. Results: Grandparents in the intervention group, in comparison to the waiting list control group, reduced their level of depression, improved their parental efficacy, overall psychosocial adjustment, and increased their ability to choose effective goals. For the most part, findings were replicated in the waiting list control analyses. Discussion: While these findings are consistent with previous studies using psychosocial interventions with parents and grandparent caregivers, they also provide support for strength-based proactive behavioral approaches to improve the quality of life of grandparent caregivers.
Collapse
Affiliation(s)
| | - Bert Hayslip
- Department of Psychology, 3404University of North Texas, Denton, TX, USA
| | - Jennifer Ramsey
- Department of Gerontology, 14727University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Jane L Jooste
- 41618Lewisville Independent School District, Lewisville, TX, USA
| |
Collapse
|
7
|
Sadruddin AFA, Ponguta LA, Zonderman AL, Wiley KS, Grimshaw A, Panter-Brick C. How do grandparents influence child health and development? A systematic review. Soc Sci Med 2019; 239:112476. [PMID: 31539783 DOI: 10.1016/j.socscimed.2019.112476] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 07/31/2019] [Accepted: 08/01/2019] [Indexed: 01/09/2023]
Abstract
Grandparents are often a key source of care provision for their grandchildren, yet they are sidelined in caregiving research and policy decisions. We conducted a global, systematic review of the literature to examine the scope and quality of studies to date (PROSPERO database CRD42019133894). We screened 12,699 abstracts across 7 databases, and identified 206 studies that examined how grandparents influence child health and development. Indicators of grandparent involvement were contact, caregiving behaviors, and financial support. Our review focused on two research questions: how do grandparents influence child health and development outcomes, and what range of child outcomes is reported globally? We examined study design, sample characteristics, key findings, and outcomes pertaining to grandchildren's physical health, socio-emotional and behavioral health, and cognitive and educational development. Our search captured studies featuring grandparent custodial care (n = 35), multigenerational care (n = 154), and both types of care (n = 17). We found substantial heterogeneity in the data provided on co-residence, caregiving roles, resources invested, outcomes, and mechanisms through which "grandparent effects" are manifested. We identified two important issues, related to operationalizing indicators of grandparent involvement and conceptualizing potential mechanisms, leading to gaps in the evidence base. Currently, our understanding of the pathways through which grandparents exert their influence is constrained by limited data on what grandparents actually do and insufficient attention given to interpersonal and structural contexts. We present a conceptual framework to explicitly measure and theorize pathways of care, with a view to inform research design and policy implementation. We underscore the need for more robust data on three indicators of caregiver involvement-contact, behavior, and support-and for careful description of structural and interpersonal contexts in caregiving research.
Collapse
|
8
|
Kelley SJ, Whitley DM, Campos PE. Differential Impact of an Intervention for Grandmothers Raising Grandchildren. JOURNAL OF INTERGENERATIONAL RELATIONSHIPS 2019. [DOI: 10.1080/15350770.2018.1535351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Susan J. Kelley
- College of Nursing and Health Professions, Georgia State University, Atlanta, GA, USA
| | - Deborah M. Whitley
- School of Social Work, Andrew Young School of Policy Studies, Georgia State University, Atlanta, GA, USA
| | | |
Collapse
|
9
|
Smith GC, Hayslip B, Hancock GR, Strieder FH, Montoro-Rodriguez J. A randomized clinical trial of interventions for improving well-being in custodial grandfamilies. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2018; 32:816-827. [PMID: 30188171 PMCID: PMC6130919 DOI: 10.1037/fam0000457] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Despite the rising cultural phenomenon of grandparents parenting grandchildren on a full-time basis due to problems within the birth parent generation, intervention studies with these families have been scarce, methodologically flawed, and without conceptual underpinnings. We conducted a randomized clinical trial (RCT) with 343 custodial grandmothers recruited from across 4 states to compare the effectiveness of behavioral parent training (BPT), cognitive-behavioral therapy (CBT), and information-only control (IOC) conditions at lowering grandmothers' psychological distress, improving their parenting practices, and reducing the internalizing and externalizing difficulties of target grandchildren between ages 4 and 12. These outcomes were derived conceptually from the family stress model and modeled as latent constructs with multiple indicators. Each RCT condition was fully manualized and delivered across 10 sessions within groups led jointly by trained professionals and peer facilitators in community settings. Multidomain second-order latent difference score models were performed on a full intent-to-treat basis to compare the 3 RCT conditions on changes in the above outcomes from baseline to postintervention and from baseline to 6 months postintervention. In general, while CBT and BPT interventions were both superior to IOC at both times of measurement on most outcomes, they differed little from each other. Effect sizes were generally in the moderate to large range and similar to those found in prior studies of BPT and CBT with traditional birth parents. We conclude from this research that evidence-based interventions focusing on appropriate skill development and behavioral change can yield positive outcomes within custodial grandfamilies. (PsycINFO Database Record
Collapse
Affiliation(s)
- Gregory C Smith
- School of Lifespan Development and Educational Sciences, Kent State University
| | - Bert Hayslip
- Department of Psychology, University of North Texas
| | - Gregory R Hancock
- Department of Human Development and Quantitative Methodology, University of Maryland
| | | | | |
Collapse
|