Posttraumatic Growth Among Parents of Children with Autism Spectrum Disorder in China and Its Relationship to Family Function and Mental Resilience: A Cross-Sectional Study

Predictors of Moderate-High Posttraumatic Growth in Parents of Children With Cancer: A Cross-sectional Study

BACKGROUND

Parents of children with cancer may experience posttraumatic growth (PTG). In clinical practice, this parental enhancement is more likely to be seen with a moderate-high PTG.

OBJECTIVE

The aim of this study was to determine the moderate-high PTG prevalence of parents of children diagnosed with cancer at least 6 months and to investigate its relationship with hope, social support, and patient-parent characteristics.

METHODS

This cross-sectional study was conducted with the parents of children with cancer admitted to the pediatric hematology-oncology unit using the Parent-Child Characteristic Questionnaire, Posttraumatic Growth Inventory, Multidimensional Scale of Perceived Social Support and Dispositional Hope Scale. Univariate and multivariate logistic regression analyses were performed to investigate the variables associated with moderate-high PTG.

RESULTS

One hundred one parents were enrolled in this study, and the prevalence of the moderate-high PTG was 79.2%. There was a statistically significant difference between moderate-high PTG and children's age (P = .037). Multivariate logistic regression analysis showed that social support from significant others (odds ratio = 1.138, 95% confidence interval = 1.030-1.257, P = .011) was a predictor of moderate-high PTG.

CONCLUSIONS

Moderate-high PTG is common among parents of children diagnosed with cancer. Perceived social support from healthcare professionals and other patient parents is a predictive factor.

IMPLICATIONS FOR PRACTICE

Interventions that encourage the support of health professionals and interaction with the parents of other patients, such as peer counseling, group-based interventions, and expanding the social support network, seem to be clinically promising in helping parents to improve from the cancer experience.

Post-traumatic growth correlates among parents of children with chronic illnesses: A systematic review and meta-analysis

Parenting a child with a chronic illness presents a complex journey marked by various challenges, along with possible personal growth following these challenges. In this systematic review we present three meta-analyses, in order to examine the associations of post-traumatic growth (PTG) among parents of children with diverse chronic illnesses, and psychological distress, social support, and resilience. Analyzing 34 studies encompassing a total of 5328 parents, the results reveal several key findings. First, PTG was found to be prevalent among the parents. Second, there was no significant correlation between PTG and psychological distress, suggesting that these two processes may exist independently. Third, a positive correlation was observed between PTG and both social support and resilience-related factors, underscoring the role of these factors in fostering growth among parents of children with chronic illnesses. Additionally, illness type emerged as a moderator, affecting the strength of the above-mentioned correlations with PTG. Specifically, in the case of psychiatric illnesses, correlations of PTG with social support and resilience were stronger than in the context of other illnesses. Overall, this review emphasizes the significance of recognizing and addressing PTG correlates among parents of children with chronic illnesses, offering insights for clinical practice.

Posttraumatic Growth and its Correlates Among Parents of Children With Cleft Lip and/or Palate

This study examined the posttraumatic growth (PTG) about parents of children with cleft lip and/or palate (CL/P) and the correlates of PTG.

A cross-sectional study.

Parents (N = 388) of children with isolated CL/P (ages 3 months-18 years) who had at least one cleft surgery within an oral and maxillofacial surgery department of a university-affiliated tertiary hospital in a provincial capital in southwest China.

Demographic information questionnaire, The Posttraumatic Growth Inventory, Simplified Coping Style Questionnaire, and Social Support Rating Scale were used for data collection.

Parents' mean PTG score was in the moderate range (M = 65.7, SD = 13.73). PTG differed regarding the participants' sex, ethnicity, and educational background. Pearson's correlation analysis revealed that positive coping (r = 0.43, P < .01), negative coping (r = 0.13, P < .01), and social support (r = 0.26, P < .01) were positively correlated with PTG. Multiple regression model showed that 20.6% (P < .001) of the variance in PTG was explained by higher positive coping (β = 0.35, P < .001), greater social support (β = 0.13, P = .01), and for cleft lip compared to cleft palate (β = -0.14, P ≤ .01), with no variance difference for cleft lip and palate.

Parents of children with CL/P had moderate PTG. Potentially modifiable correlates of PTG suggest interventions to enhance parental positive coping and social support may increase PTG. Further studies are needed to confirm the PTG level and its affecting factors of parents of children with CL/P.

Predictors of posttraumatic growth in 475 Chinese parents of children newly diagnosed with autism spectrum disorder

PURPOSE

To examine the predictive effects of children's symptom severity, rumination, parental self-efficacy, and social support on posttraumatic growth (PTG) in parents of autistic children.

DESIGN AND METHODS

Parents (n = 475) completed the demographic questionnaire, Posttraumatic Growth Inventory, Autism Behavior Checklist, Event Related Rumination Inventory, Parenting Sense of Competence, and Social Support Rating Scale in a cross-sectional survey conducted in a tertiary hospital in Guangzhou, China, between September 2019 and January 2021. Multiple linear regression analyses were conducted using SPSS version 25.0.

RESULTS

The PTG score was positively associated with rumination (r = 0.325, P < 0.05), parental self-efficacy (r = 0.219, P < 0.05), and social support (r = 0.374, P < 0.05). Multiple linear regression analysis revealed that household income (β = 0.095, P < 0.05), intrusive rumination (β = -0.100, P < 0.05), deliberate rumination (β = 0.391, P < 0.001), subjective support (β = 0.239, P < 0.001), and children's daily living skills deficiencies as perceived by parents (β = 0.107, P < 0.05) significantly predicted PTG, accounting for 33.3% of the variance [F(P) = 13.444, P < 0.001].

CONCLUSIONS

Psychosocial factors (rumination and subjective support) are essential to facilitate PTG in parents whose children are newly diagnosed with autism.

PRACTICE AND IMPLICATIONS

With the consideration of different sociodemographic features, clinicians and researchers are encouraged to explore cognitive-based psychosocial interventions targeting parents' psychological growth and parenting training programs targeting autistic children's self-care ability.

Narrative analysis of parents' experiences with participating in the intervention of children on the autism spectrum in mainland China

PURPOSE

Although the challenges encountered by parents of children on the autism spectrum during the intervention process have garnered scholarly attention, how parents subjectively review those challenges and construct meanings of their experiences remained underexamined. By applying the narrative analysis framework, we investigated the lived experiences of parents of children on the autism spectrum regarding challenges they faced in the intervention process, along with the meanings of those experiences that they constructed in the sociocultural context of mainland China.

METHODS

We purposively sampled 16 parents to narrate their experiences following semistructured interviews. Each participant had one child who had participated in autism intervention for more than two years.

RESULT

The narrative analysis revealed that parents experienced a series of challenges imposed by structural barriers in the intervention process, which resulted in psychological distress and negative perceptions of their parental identities. Albeit susceptible to those adversities, the parents actively constructed new meanings of parenthood and their children's situations through reflexive dialogues.

CONCLUSION

Our results indicate the essential role of meaning-oriented coping in helping parents with children on the autism spectrum to mitigate the negative influence of challenges on their parental identity, strengthen their parent-child relationships, and readjust their priorities for intervention.IMPLICATIONS FOR REHABILITATIONThe role of encouraging new meanings through reflexive dialogues was found to be particularly important among parents with children on the autism spectrum to cope with the challenges they faced in the intervention process.New meanings assigned can mitigate the negative impact of challenges on parents' parental identity, strengthening their parent-child relationships, and readjusting their priorities for intervention within the Chinese socio-cultural context.It is crucial for social workers and other practitioners to support parents in mainland China by facilitating them to assign new meanings to the challenging situations.It is important for social workers and other practitioners to encourage parents to cultivate inner strengths and self-value to support their children on the autism spectrum.

Social support mediates the relationship between dispositional gratitude and psychological distress in caregivers of autistic children

Grateful caregivers report lower levels of psychological distress. Social support, engendered by gratitude and buffering against stress, might mediate this effect. Here we explored whether the protective psychological effect of dispositional gratitude might be mediated by increased social support. A sample of 126 caregivers of autistic children completed questionnaires assessing dispositional gratitude, social support and psychological distress. Gratitude inversely predicted psychological distress, as did social support after adjusting for gratitude. Gratitude positively predicted social support. Gratitude no longer predicted psychological distress after adjusting for social support. Indirect effects analysis revealed the gratitude-distress relationship occurred indirectly via social support. Grateful caregivers reported higher levels of social support, and this predicted lower psychological distress. Gratitude, relatively stable as a disposition, has a state component that is sensitive to change, and healthcare professionals might do well to recommend gratitude enhancing interventions for caregivers of autistic children.

The association between family function and sleep disturbances of preschool children in rural areas of China: a cross-sectional study

This study aimed to explore the association between family function and sleep disturbances in preschool children in rural areas of China. Caregivers of preschool children completed sociodemographic questionnaires, the Children's Sleep Habits Questionnaire (CSHQ), the Self-rating Anxiety Scale (SAS) and the Family APGAR scale. Using sleep disturbances in children as the dependent variable, family function and other related factors as independent variables, binary logistic regression analyses were performed to examine associations between family function and sleep disturbances in children. A total of 3,636 caregivers of preschool children were enrolled in our study, and the prevalence of sleep disturbances among their preschool children was 89.4%. In our study, lower family function was associated with higher risk of sleep disturbances among preschool children. After adjusting for age (years), education level of mother, discipline attitudes of father and mother, only child status and caregivers' anxiety, the associations were statistically significant both in families of which caregivers of children are their parents or other relatives. (AOR for parents = 1.487, 95% CI:1.152-1.919, P = 0.002; AOR for other relatives = 1.963, 95% CI:1.302-2.958, P = 0.001). Our study results indicated that family function was associated with sleep disturbances in preschool children, and future high-quality cohort studies are needed to explore this topic in more detail.

What factors are associated with posttraumatic growth among mothers of children with developmental disabilities in South Korea?

BACKGROUND

The identification of PTG and its correlates in the aftermath of a traumatic event would assist professionals in recognizing and amplifying individual's potential strengths. However, there are few studies on PTG and its correlates in mothers who have birthed or raised children with developmental disabilities in South Korea.

AIM

This study examined the predictive role of caregiving strain and social support on the subdimensions of PTG among South Korean mothers of children with developmental disabilities.

METHODS AND PROCEDURES

The participants were 344 mothers of children with intellectual disabilities or autism. PTG was divided into four sub-dimensions (change in self-perception, increase in interpersonal depth, finding new possibilities, and increase in spiritual interest), and the predictive roles of caregiving strain and social support on each sub-dimension were identified using hierarchical multiple regression.

OUTCOMES AND RESULTS

Subjective caregiving strain; family support services; and support from family, friends, or significant others were significantly related to the subdimensions of PTG. Interestingly, support from significant others was positively associated with PTG.

CONCLUSIONS AND IMPLICATIONS

Social support was more likely to influence all subdimensions of PTG, except for changes in self-perception while only subject caregiving strain was associated with PTG. Thus, policymakers and practitioners should prioritize expanding family support services and strengthening various informal supportive resources for mothers with higher PTG.

Posttraumatic growth: the role of perceptions, coping and depressive symptoms among mothers of children with Autism Spectrum Disorder in Greece

Background: Parenting a child with Autism Spectrum Disorder (ASD) may lead to emotional distress. However, it has been recognized that it can also be accompanied with positive experiences that may conduce parents to posttraumatic growth (PTG). Few studies have investigated the factors that may be associated with growth. The present study aimed to assess the role of maternal perceptions, coping strategies and depressive symptoms to PTG. Method: In this cross-sectional study, 123 mothers of ASD offspring completed self-reported questionnaires to assess posttraumatic growth (PTGI); coping strategies (Βrief-COPE); perceptions about ASD (B-IPQ) and depressive symptoms (PHQ-9). Hierarchical regression analysis was used to assess their independent associations. Results: A significant proportion of mothers (56.1%) reported moderate to high growth levels (PTGI ≥ 63). Nearly half of the mothers (46.3%) reported clinically significant depressive symptoms. Engagement (b = 0.361), cognitive reframing (b = 0.214), personal control (b = 0.200) and depressive symptoms (b = -0.232) were independently and significantly associated with PTG. Conclusions: Mothers of children with ASD may experience moderate to high PTG. Engagement, cognitive reframing, personal control and depressive symptoms were significant predictors of growth level. Interventions aiming to support mothers to potentiate their personal control over ASD, to use adaptive coping strategies and to reduce distress may facilitate their growth.

The predictive role of coping styles and sense of coherence in the post-traumatic growth of mothers with disabled children: a cross-sectional study

BACKGROUND

Coping and accepting stressful events can lead to positive psychological changes, growth, and excellence. In this regard, the present study was conducted to determine the relationship between coping styles and sense of coherence with post-traumatic growth in mothers with disabled children in Bushehr (a southern city in Iran).

METHODS

The present cross-sectional study was performed on 260 mothers with children with disabilities who were filed in the rehabilitation centers covered by the Welfare Department of Bushehr in 2018. Demographic information form, Tedeschi and Calhoun post-traumatic growth questionnaire, Antonovsky sense of coherence, and Billings and Moos coping styles were employed to collect data. Data were analyzed by SPSS software using Pearson correlation coefficient and linear regression analysis at a significance level of less than 0.05.

RESULTS

The mean age and standard deviation were 35.83 ± 7.41 for the mothers, and 7.20 ± 4.05 for the children. The mean and standard deviation of post-traumatic growth was 64.88 ± 14.90, sense of coherence was 116.36 ± 22.65 and coping styles was 30.59 ± 6.39. The results of linear regression show that only the two dimensions of meaningfulness (p = 0.013 and β = 0.170) and manageability from the sense of coherence (p = 0.001 and β = 0.432) can predict post-traumatic growth in mothers with disabled children in Bushehr. Also, from the coping style dimensions, only the emotion-focused variable (p = 0.001 and β = 0.353) is a predictor of post-traumatic growth.

CONCLUSION

Considering the role of sense of coherence and coping style in predicting post-traumatic growth, to implement rehabilitation programs and support the families of these children, it is essential to plan for the development of social and psychological support for mothers with disabled children.

Posttraumatic growth and rumination among parents of children with autism spectrum disorder: The mediating role of social support

Although rumination and social support are regarded as essential predictors of posttraumatic growth (PTG), few studies have explored the associations among PTG, rumination, and social support in parents of children with autism spectrum disorder (ASD). This study examined whether social support mediates the relationship between rumination and PTG. Cross-sectional questionnaire data were collected from 385 parents of children with ASD from September 2019 to November 2020 by convenience sampling. Participants completed the Posttraumatic Growth Inventory, Event Related Rumination Inventory, and Social Support Rating Scale. Path analyses showed that subjective support partially mediates the relationship between deliberate rumination and PTG (β = 0.073, P &lt; 0.001), and indirect effects account for 15.30% of the total effects. In addition, a negative direct path was found between intrusive and PTG because of the suppression effect of subjective support (β = -0.110, P &lt; 0.01), and indirect effects accounted for 80% of the direct effects. For future studies, it underscores the essential role of subjective support and rumination in promoting PTG in parents of children with ASD.

Risk and protective factors for posttraumatic stress and posttraumatic growth in parents of children with intellectual and developmental disorders

Background

Parents of children with intellectual and developmental disorders often experience potentially traumatic events while caring for their children. Heightened posttraumatic stress (PTS) and posttraumatic growth (PTG) have been found in this population.

Objective

We aimed to explore risk and protective factors for their PTS and PTG.

Method

A cross-sectional study was conducted with 385 parents (average age M = 43.14 years, SD = 7.40; 95.3% mothers).

Results

Parenting trauma showed an adverse effect on developing PTS (beta = 0.25, p < .01) and a positive role in promoting PTG (beta = 0.16, p < .01). Social support was protective in its correlation with lower levels of PTS (beta = -0.12, p < .01) and higher levels of PTG (beta = 0.22, p < .01). Barriers to care were associated with increased PTS (beta = 0.23, p < .01), but unrelated to PTG (beta = .01, p = .855). Negative parenting showed a significant, but small, correlation with more severe PTS (beta = 0.11, p < .05), and was unrelated to PTG (beta = -0.09, p = .065).

Conclusions

Our study increases the understanding of posttraumatic reactions in parents, predominantly mothers, of children with IDD and identified parenting-related trauma, social support, and barriers to mental health care as predictive factors of the reactions. More research is needed to confirm and validate the effects of the discussed factors. Although causation can not be inferred, prompt and adequate screening and therapeutic resources should be provided to those mothers who were exposed to multiple stressful caregiving events and had limited healthcare access and less support from their spouses, peers, and caregiving partners.

HIGHLIGHTS

Parents of a child with Intellectual and Developmental Disorders with parenting trauma had higher posttraumatic stress (PTS) and posttraumatic growth (PTG).Social support was related to lower PTS and higher PTG.Barriers to care were related to higher PTS but unrelated to PTG.

The mediating role of coping in the relationship between family function and resilience in adolescents and young adults who have a parent with lung cancer

PURPOSE

Resilience plays an important role in helping individuals to adapt to adversity and improve their psychosocial outcomes. This study aims to examine the mediating role of coping in the relationship between family function and resilience in adolescents and young adults (AYAs) who have a parent with lung cancer.

METHOD

A total of 135 AYAs with a lung cancer parent were recruited from a tertiary grade A cancer center in southern China, and investigated using a self-designed general information questionnaire, the Resilience Scale for Chinese Adolescents, the Simplified Coping Style Questionnaire, and the Family Adaptation, Partnership, Growth, Affection, Resolve index.

RESULTS

The mean score of AYAs' resilience was (3.61 ± 0.49), and its influencing factors included AYAs' years in work, family function, and positive coping. The total effect of family function on resilience was significant (total effect = 0.38, 95% CI [0.048-0.115]), and a positive indirect effect was identified for family function on resilience via positive coping (indirect effect = 0.10, 95% CI [0.005-0.043]).

CONCLUSION

Family functioning can facilitate resilience either directly or by promoting positive coping. This study suggests that individualized interventions can be made to improve resilience by promoting family function, or by enhancing positive coping in AYAs with a lung cancer parent.

The Relationship Between Resilience and Posttraumatic Growth Among the Primary Caregivers of Children With Developmental Disabilities: The Mediating Role of Positive Coping Style and Self-Efficacy

This study was conducted to investigate the relationship between posttraumatic growth (PTG), resilience, positive coping style, and self-efficacy among the primary caregivers of children with developmental disorders in Chongqing, China. A total of 198 primary caregivers (parents and grandparents) aged from 22 to 66 years old (M = 35.55, SD = 9.16), including 155 females (78.3%) and 43 males (21.7%), were enrolled. The Posttraumatic Growth Inventory, Connor-Davidson Resilience Scale-10, Simplified Coping Style Questionnaire, and General Self-Efficacy Scale were used for data collection. The results found that PTG could be positively predicted by resilience. Positive coping style and self-efficacy mediated the relationship between resilience and PTG. The different levels of PTG were determined by the resident location, monthly income and education of the primary caregivers. The results suggest that it is critical to improve the mental health of the primary caregivers (parents and grandparents) of children with developmental disabilities. Our results also provide a scientific basis for future research.