Parenting Scale: Which Version Should We Use?

Depression, parenting and the COVID-19 pandemic in Canada: results from three nationally representative cross-sectional surveys

OBJECTIVES

Depression is associated with problems in functioning in many aspects of life, including parenting. COVID-19 has increased risk factors for depression. We investigated the prevalence of depression among parents during the pandemic and the association with dysfunctional parenting.

DESIGN

Canadian nationwide cross-sectional study.

SETTING AND PARTICIPANTS

The 2020 and 2021 Surveys on COVID-19 and Mental Health (SCMH) and the Canadian Community Health Survey (CCHS) (2015‒2019). Responding sample sizes for parents were 3121 for the 2020-SCMH; 1574 for the 2021-SCMH and 6076 for the CCHS.

PRIMARY OUTCOME MEASURES

All three surveys collected information on symptoms of major depressive disorder (MDD). The SCMH measured harsh parenting.

RESULTS

Based on data from the 2021-SCMH collected during wave 3 of COVID-19, 14.4% of fathers and 21.2% of mothers screened positive for MDD. These prevalence estimates were similar to those from the 2020-SCMH during wave 2, but at least two times higher than pre-COVID-19 estimates from the CCHS. Multivariate analyses revealed a linear association between MDD and harsh parenting. COVID-19-related stressors were associated with harsh parenting. Among mothers, feeling lonely or isolated because of COVID-19 was a risk factor for harsh parenting; among fathers, being a front-line worker was a risk factor. Meditation was a protective factor for mothers.

CONCLUSIONS

After years of stability, the prevalence of MDD increased substantially among Canadian parents during the pandemic. Ongoing monitoring is vital to determine if elevated levels of depression persist because chronic depression increases the likelihood of negative child outcomes. Programmes aimed at addressing depression and bolstering parenting skills are needed as families continue to face stressors associated with COVID-19.

Mindfulness and Imagery Enhanced Behavioral Parenting: Effectiveness Pilot of the Confident Carers Cooperative Kids Program

Mindfulness is increasingly offered to parents of children presenting with behavioral problems, either as a stand-alone intervention, or integrated within existing behavioral parenting interventions. There is relatively modest support for mindful parenting, with small to medium effect size improvements demonstrated across child and parent outcome measures. Here we introduce a mindfulness and imagery enhanced behavioral parenting program. We argue blending mindfulness, imagery and behavioral skills could produce improved parenting engagement and perseverance, leading to stronger outcomes. Pilot data is presented from two contrasting real world clinical settings. Parents attending the 8-week Confident Carers Cooperative Kids (CCCK) group program in a university clinic setting were invited to be included in the study (n = 20). Permission was also gained to use archival data from a community organisation offering CCCK groups to parents who were at risk of child welfare involvement (n = 14). Pre- and post-intervention measures were completed across both groups on parent-reported child behavior, parent wellbeing, adaptive parenting, and mindful parenting. Parents from both groups achieved significant pre- to post-intervention improvements in child behavior problems, parent wellbeing, adaptive parenting, and mindful parenting, with large effect sizes. Larger improvements in child behavior problems were reported by parents from the community group compared with the university group. The CCCK intervention appears beneficial across child and parent outcomes, including for families most in need. A larger sample is required to replicate and extend these promising findings.

Mindfulness, Parental Attributions, and Parenting: the Moderating Role of Child Mental Health

Objectives

Research interest in mindfulness, the capacity for present-oriented, nonjudgmental attention and awareness, and its relation to parenting has been growing in recent years. However, factors facilitating the association between mindfulness and parenting are not yet well understood. In the present study, we examined whether parents’ biased causal thinking about children’s misbehaviors, i.e., parental attributions, may mediate the link between parents’ dispositional mindfulness and parenting. Given that parents of children with clinically elevated mental health difficulties tend to report more biased parental attributions, we further examined whether the proposed mediation may differ across parents of children with and without clinical diagnoses or referrals for mental health difficulties.

Methods

Parents (59.8% mothers) of 8- to 12-year-old children with (n = 157) and without (n = 99) clinical diagnoses or referrals for mental health difficulties participated in online surveys assessing their mindfulness, parental attributions, and negative parenting behaviors.

Results

More mindful parents reported less negative parenting, with the link significantly mediated by less biased parent-directed attributions, but not child-directed attributions. The mediating effect via parent-directed attributions was significantly moderated by the child’s clinical status: the effect was retained only for parents of children with clinical diagnoses or referrals for mental health difficulties. No significant moderation effect emerged for child-directed attributions.

Conclusions

The results provide initial support for the links among parents’ mindfulness, parental attributions, and parenting. The present findings suggest that parental mindfulness may be important for less biased parental attributions, with implications for parenting behaviors at least in the context of children’s mental health disorders.

Successful implementation of parenting support at preschool: An evaluation of Triple P in Sweden

Although emotional and behavioural problems among young children are common and, if unaddressed, can lead to multi-facetted problems later in life, there is little research investigating the implementation of parenting programs that target these problems. In this study, the RE-AIM framework was used to evaluate the implementation of the Triple P parenting program in a preschool setting at a medium-sized municipality in Sweden. Reach increased over time, showing an overall increase in participating fathers and parents with lower education. Effectiveness outcomes showed an improvement in emotional and behavioural problems in children and less mental health-related symptoms and higher self-efficacy in parents. Adoption rate was 93.3%. To ensure staff “buy-in”, designated coordinators made changes in recruitment procedures, and provided supervision and training to all Triple P practitioners. Implementation adaptations were made, such as minor revisions of parenting strategies and other program content, as well as providing child care during seminars and groups, and setting up weekend-groups. Maintenance assessed through 12 month follow-up data suggested that several child and parent outcomes were maintained over time. Uppsala municipality continues to offer Triple P to parents. The reach, effectiveness, adoption, implementation and maintenance of the program were all satisfactory and demonstrated the suitability of delivering evidence-based parenting support using preschools as an arena.

The Role of Intimate Partner Violence, Couple Dissatisfaction and Parenting Behaviors in Understanding Parental Burnout

Parental burnout (PB), a relatively new and under-studied construct, is defined as a condition resulting from chronic parenting stress. While recent research confirmed its negative associations with familial variables, such as relationship satisfaction and positive parenting practices, little is known about the role of intimate partner violence (IPV) and how it relates to parental burnout. The present study, therefore, aimed to extend existing knowledge on chronic parenting stress by 1) testing for the mediational role of couple dissatisfaction in explaining the link from IPV victimization to PB as well as the link from IPV victimization to dysfunctional parenting, and 2) investigating how specialist gender roles and parental responsibilities for child care relate to IPV victimization and PB. Data collection was part of an international collaboration on factors related to parental satisfaction and exhaustion across different countries. Self-report data from Austrian mothers (N = 121) were collected online and analyzed using structural equation modeling. Results indicated that couple dissatisfaction mediates the link from IPV victimization to PB, as well as IPV victimization to dysfunctional parenting. Furthermore, only specialist gender roles were significantly related to IPV, while parental responsibilities for child care did not significantly relate to experiences of violence. Additionally, neither specialist gender roles nor parental responsibilities were significantly associated with PB in the final model. Overall, our findings connect to family models, such as the Family System Theory and Spillover Theory, underscoring the importance of couples' relationship quality for understanding parental burnout and parenting behaviors in mothers.

The psychometric properties of the parenting scale for Spanish mothers with children aged between 2 and 7 years

PURPOSE

This study aimed to evaluate the psychometric properties of the Spanish version of the Parenting Scale in a large sample of Spanish mothers.

DESIGN AND METHODS

A two-stage cross-sectional study of the adaptation and cultural validation of the Parenting Scale in a Spanish-speaking environment. In Stage I, the Parenting Scale was translated and back-translated and its semantic, linguistic and contextual equivalence was assessed. In Stage II, the Spanish-language version was validated after its application to 662 Spanish mothers with healthy children aged between 2 and 7 years. Several factor structure models of the Parenting Scale were compared by confirmatory factor analysis. Convergent validity, internal consistency and test-retest reliability were also examined.

RESULTS

The model of Irvine et al. (1999) presented the best fit to our data. This model demonstrated adequate reliability (internal consistency and stability). The total score and each factor of the Parenting Scale correlated positively with perceived stress in mothers, difficulties in mother-child bonding and child hyperactivity, and negatively with child prosocial behavior.

CONCLUSIONS

The Spanish version of the Parenting Scale is a valid and reliable measure that can be used by healthcare professionals and scientists to assess dysfunctional parenting in Spanish mothers of children aged 2 to 7 years.

PRACTICE IMPLICATIONS

This study will allow the use of the Parenting Scale in epidemiological and cross-cultural studies in a variety of applied contexts. Additionally, health professionals who work with families in Spain will have access to a valid and reliable instrument for the assessment of mothers' parenting styles.

Validating the Neurodevelopmental Domain of Neurodevelopmental Ecological Screening Tool: An Ecological Screener for Use With 3-5 Year-Old Children Impacted by Poverty and Homelessness

The Neurodevelopmental Ecological Screening Tool (NEST) is a new instrument to screen children for developmental challenges. This article describes the validation of the NEST neurodevelopmental domain. Data were collected from a nationwide purposely restricted sample of caregivers of children aged 3–5 years ( n = 231) living in poverty and experiencing homelessness. We used Rasch-based Rating Scale Models to select items with good fit. Cronbach’s alpha was used to measure the internal consistency validity of the entire neurodevelopmental domain. Construct validity and dimensional structure were obtained using confirmatory factor analysis. Interclass correlations were used to measure the test–retest reliability of the subdomains. Neurodevelopmental Ecological Screening Tool scores were compared to results on clinician-administered gold standard measures for a subsample ( n = 48). The neurodevelopmental domain score represents a single overarching risk construct with some variance attributable to distinct developmental constructs and validly and reliably identifies a child’s level of developmental risk.

Parental ADHD Symptoms and Inhibitory Control in Relation to Parenting Among Mothers of Children With and Without ADHD

Objective: The study examined how the interplay between maternal ADHD symptoms and maternal inhibitory control and child ADHD is related to parenting behaviors. Method: The sample included 141 mothers and their 8- to 12-year-old children, 61 children with ADHD and 80 without. Parenting was measured using self-reports (i.e., overreactive and lax parenting) and observation (i.e., negative and supportive parenting). Maternal inhibitory control was measured using a neurocognitive task. Hierarchical multiple regressions were conducted to predict parenting, controlling for child sex, conduct behaviors, and parenting distress. Results: Interactions between maternal ADHD symptoms and maternal inhibitory control suggested that hyperactive-impulsive symptoms were linked to parenting negativity only when inhibitory control was low, and maternal inattention symptoms were related to lax parenting only when maternal inhibitory control was high or when children did not have ADHD. Conclusion: Results indicate the importance of maternal regulation processes in the mechanisms linking maternal ADHD with parenting.

Facilitating implementation of an evidence-based method to assess the mental health of 3-5-year-old children at Child Health Clinics: A mixed-methods process evaluation

BACKGROUND

A number of instruments for identifying mental health problems in children are available, but there is limited knowledge about how to successfully implement their use in routine practice. The Strengths and Difficulties Questionnaire (SDQ) is an instrument with sound psychometric properties. Because using multi-informant SDQs when assessing young children has been emphasized, parent- and preschool teacher reports on the SDQ were introduced at Child Health Clinics in a Swedish municipality. This paper aimed to describe a facilitation programme developed to support the introduction of SDQ in clinical practice and evaluate how nurses perceived the facilitation strategies used. Moreover, the dose (delivery) and reach (response rate and population coverage) of the questionnaires were assessed.

METHODS

The mixed-methods process evaluation was guided by Moore et al.'s framework. Process data were excerpted from monitoring data, the trial database, research group documents, study materials, group interviews with nurses, and a survey on nurses' opinions and experiences of the screening method and the implementation process. Data were analysed using descriptive statistics and qualitative content analysis.

RESULTS

Facilitation strategies used included: educational meetings, educational outreach visits, newsletters, facilitative administrative support, and adaptations made in procedures and materials when required. Although nurses described a variety of barriers at the organisational and individual level, they were in favour of using the SDQ in clinical practice and emphasised the importance of the facilitation strategies used for its implementation. While dose levels (77-91%) indicated that nurses essentially delivered the intervention as intended, parental response rates remained between 54 and 63% and population coverage at around 50%, throughout the intervention period.

CONCLUSION

The facilitation program was perceived to support the implementation of the SDQ at the yearly check-ups in the child healthcare setting, but further efforts are required to reach all families.

Development and evaluation of the psychometric properties of a brief parenting scale (PS-7) for the parents of adolescents

This study aimed to develop a seven-item brief parenting scale (PS-7) based on the original parenting scale (PS) and various other shortened versions and with a better factor structure for the parents of adolescents. The scale was tested with a sample of 3,777 parents (2,205 mothers and 1,572 fathers). Confirmatory factor analysis was used to evaluate the dimensionality of the different versions of the PS. Only the PS-7 with a two-factor structure, i.e., laxness (three items) and overreactivity (four items), showed a good model fit based on a representative sample of parents of junior secondary school students. Overall, the results suggest that PS-7 is comparable to the original PS and possesses good psychometric properties in terms of internal consistency, factorial validity, construct validity, criterion validity and discriminant validity. The abbreviated parenting scale also provides a reliable and cost-effective method for assessing parental practices for treatment and assessing treatment outcomes.

Do parents of children with metabolic diseases benefit from the Triple P - Positive Parenting Program? A pilot study

Background Parents of children with metabolic diseases report more parenting stress, anxiety, depression and dysfunctional parenting styles than parents of children without metabolic diseases. In addition, their children have more behavioral problems. Beside the fact that metabolic diseases are rare, they form a relatively large proportion in the morbidity and mortality of chronically ill children. Methods In this pilot study 14 parents of children with metabolic diseases, aged between 2.5 and 13 years, participated in a quasi-experimental pre-post-follow-up study. Results After participating in the Level 4 Group Triple P-program there were small effects in decreasing child behavioral problems and large effects in decreasing dysfunctional parenting styles. There was a moderate to large reduction of parental stress and a large reduction of parental anxiety. Only the effects on the behavioral problems and the parenting style 'laxness' were no longer significant at 6 months follow-up. Conclusions In summary it can be said that the existing Triple P-program has good effects, with a great degree of satisfaction, for parents of children with metabolic diseases in reducing dysfunctional parenting styles, parenting stress and behavioral problems of their children. One should not wait for a specialized program to reach these parents, but further research is necessary as a greater effect can be expected when this program is adapted to these parents.

Personal and couple level risk factors: Maternal and paternal parent-child aggression risk

Previous literature examining parent-child aggression (PCA) risk has relied heavily upon mothers, limiting our understanding of paternal risk factors. Moreover, the extent to which factors in the couple relationship work in tandem with personal vulnerabilities to impact PCA risk is unclear. The current study examined whether personal stress and distress predicted PCA risk (child abuse potential, over-reactive discipline style, harsh discipline practices) for fathers as well as mothers and whether couple functioning mediated versus moderated the relation between personal stress and PCA risk in a sample of 81 couples. Additionally, the potential for risk factors in one partner to cross over and affect their partner's PCA risk was considered. Findings indicated higher personal stress predicted elevated maternal and paternal PCA risk. Better couple functioning did not moderate this relationship but partially mediated stress and PCA risk for both mothers and fathers. In addition, maternal stress evidenced a cross-over effect, wherein mothers' personal stress linked to fathers' couple functioning. Findings support the role of stress and couple functioning in maternal and paternal PCA risk, including potential cross-over effects that warrant further inquiry.

Specific Learning Disorders: A Look Inside Children's and Parents' Psychological Well-Being and Relationships

Despite their ascertained neurobiological origin, specific learning disorders (SLD) often have been found to be associated with some emotional disturbances in children, and there is growing interest in the environmental and contextual variables that may modulate children's developmental trajectories. The present study was aimed at evaluating the psychological profile of parents and children and the relationships between their measures. Parents of children with SLD (17 couples, 34 participants) and parents of children with typical development (17 couples, 34 participants) were administered questionnaires assessing parenting styles, reading history, parenting stress, psychopathological indexes, and evaluations of children's anxiety and depression. Children (N = 34, 10.7 ± 1.2 years) were assessed with self-evaluation questionnaires on anxiety, depression, and self-esteem and with a scale assessing their perception of parents' qualities. Results showed that parents of children with SLD have higher parental distress, poorer reading history, and different parenting styles compared to parents of children with TD; there were no differences in psychopathological indexes. The SLD group also rated their children as more anxious and depressed. Children with SLD had lower scholastic and interpersonal self-esteem, but they report ratings of parents' qualities similar to those of TD children. Relationships between parents' and children's measures were further explored. Implications for research and practice are discussed.

Mothers' and fathers' attendance in a community-based universally offered parenting program in Sweden

AIM

Using a public health perspective, this study examined the characteristics of mothers and fathers who attended, compared to those who did not attend, a community-based practitioner-led universally offered parenting program.

METHOD

Mothers (141) and fathers (96) of 4- to 5-year-olds completed a set of questionnaires, including their demographic characteristics, their child's behavioral and emotional problems, and their own parenting behavior. They were all then given the opportunity to attend level 2 of the Triple P--Positive Parenting Program. During the first six months of the study, 33 mothers and 11 fathers opted to attend the program.

RESULTS

The relation between program attendance and parental characteristics was similar for mothers and fathers. In general, fathers, non-native and lower educated parents were less likely to attend the program. Mothers, but not fathers, were more likely to attend if they reported more child behavior problems, while fathers, but not mothers, were observed at a trend level to attend if they perceived their child as having more emotional problems. In addition, parents in general were more likely to attend if they used more harsh parenting strategies.

CONCLUSIONS

Although the universal offer did not reach parents universally, generally those parents who needed it were more likely to attend. Furthermore, this study shows that different factors may impact mothers' and fathers' attendance; therefore, parental data should be analyzed separately and different recruitment strategies should be used for mothers and fathers.

Child behaviour problems, parenting behaviours and parental adjustment in mothers and fathers in Sweden

AIMS

We aim to examine the relationship between child behavioural problems and several parental factors, particularly parental behaviours as reported by both mothers and fathers in a sample of preschool children in Sweden.

METHODS

Participants were mothers and fathers of 504 3- to 5-year-olds that were recruited through preschools. They completed a set of questionnaires including the Eyberg Child Behavior Inventory, Parenting Sense of Competence Scale, Parenting Scale, Parent Problem Checklist, Dyadic Adjustment Scale and Depression Anxiety Stress Scale.

RESULTS

Correlational analyses showed that parent-reported child behaviour problems were positively associated with ineffective parenting practices and interparental conflicts and negatively related to parental competence. Regression analyses showed that, for both mothers and fathers, higher levels of parental over-reactivity and interparental conflict over child-rearing issues and lower levels of parental satisfaction were the most salient factors in predicting their reports of disruptive child behaviour.

CONCLUSIONS

This study revealed that swedish parents' perceptions of their parenting is related to their ratings of child behaviour problems which therefore implies that parent training programs can be useful in addressing behavioural problems in Swedish children.

Evaluation of a Brief Format of the Triple P-Positive Parenting Program: A Pilot Study With Indonesian Parents Residing in Australia

Dissemination of evidence-based parenting programs in developing countries is warranted, but prior to dissemination, the cultural appropriateness of programs needs to be assessed. This study provides an evaluation of the level of acceptability among Indonesian parents and the efficacy of a brief parenting program, the Triple P-Positive Parenting seminar. Thirty Indonesian parents of children aged 2–12 years old residing in Australia participated in the study. A 90-minute Triple P seminar with minimal changes in the format was delivered to parents in Indonesian. Parents reported a high level of acceptability and satisfaction with the program content. The efficacy of the program was also explored. Parents reported less frequent use of dysfunctional parenting practices, particularly permissive parenting style, and reduction in the intensity of child emotional and behavioural problems 3 weeks after the seminar. The effect was maintained at 3-month follow up. The results suggest that the Triple P seminar is acceptable and useful for Indonesian parents. Substantial changes in the content of the parenting program may not be necessary. Translated materials, culturally relevant examples and opportunity for questions appeared sufficient for parents. Future studies are required, including randomised controlled trials and larger sample sizes.

The Children and Parents in Focus project: a population-based cluster-randomised controlled trial to prevent behavioural and emotional problems in children

Background

There is large body of knowledge to support the importance of early interventions to improve child health and development. Nonetheless, it is important to identify cost-effective blends of preventive interventions with adequate coverage and feasible delivery modes. The aim of the Children and Parents in Focus trial is to compare two levels of parenting programme intensity and rate of exposure, with a control condition to address impact and cost-effectiveness of a universally offered evidence-based parenting programme in the Swedish context.

Methods/Design

The trial has a cluster randomised controlled design comprising three arms: Universal arm (with access to participation in Triple P - Positive Parenting Program, level 2); Universal Plus arm (with access to participation in Triple P - Positive Parenting Program, level 2 as well as level 3, and level 4 group); and Services as Usual arm. The sampling frame is Uppsala municipality in Sweden. Child health centres consecutively recruit parents of children aged 3 to 5 years before their yearly check-ups (during the years 2013–2017). Outcomes will be measured annually. The primary outcome will be children’s behavioural and emotional problems as rated by three informants: fathers, mothers and preschool teachers. The other outcomes will be parents’ behaviour and parents’ general health. Health economic evaluations will analyse cost-effectiveness of the interventions versus care as usual by comparing the costs and consequences in terms of impact on children’s mental health, parent’s mental health and health-related quality of life.

Discussion

This study addresses the need for comprehensive evaluation of the long-term effects, costs and benefits of early parenting interventions embedded within existing systems. In addition, the study will generate population-based data on the mental health and well-being of preschool aged children in Sweden.

Trial registration

ISRCTN: ISRCTN16513449.