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Griffith GM, Saville CWN, Halstead EJ, Hastings RP. Mindfulness as a Potential Moderator Between Child Behavior Problems and Maternal Well-Being. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 128:411-424. [PMID: 37875273 DOI: 10.1352/1944-7558-128.6.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 01/22/2023] [Indexed: 10/26/2023]
Abstract
Mindfulness-based programs can help lower psychological distress among parents of children with developmental disabilities. However, less is known about the functions of mindfulness in relation to parental outcomes. In a cross-sectional survey, mothers of children with developmental disabilities (N = 313) reported on their child's behavior problems, trait mindfulness, mindful parenting, and a range of outcomes (anxiety and depression symptoms, parenting stress, family satisfaction, and positive gain). Neither trait mindfulness or mindful parenting acted as moderators between child behavior problems and outcome variables, although both had main effect (compensatory) associations with parent outcomes. Benefits of mindfulness-based programs may be general rather than specifically in the context of high child behavior problems, given the lack of evidence for the moderating function of mindfulness.
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Affiliation(s)
- Gemma M Griffith
- Gemma M. Griffith, Centre for Mindfulness Research and Practice, Bangor University, UK
| | | | | | - Richard P Hastings
- Richard P. Hastings, Centre for Educational Development, Appraisal and Research, Warwick University, UK
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Van Riper M, Cosgrove B, Fleming L. Adaptation at the Family Level in Families of Individuals With Down Syndrome: A Scoping Review. JOURNAL OF FAMILY NURSING 2023; 29:324-347. [PMID: 37066798 PMCID: PMC10629249 DOI: 10.1177/10748407231163236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Down syndrome (DS) is a chromosomal disorder associated with intellectual and physical disabilities and has historically been viewed by health care providers through a negative lens when considering the effect the condition has on the individual, family, and community. The purpose of this scoping review was to provide an overview of recent research concerning adaptation in families of individuals with DS with a focus on family adaptation rather than individual or dyadic adaptation. Three literature indexes were searched from 2017 to 2022, with 41 articles included. Foci of the studies included strength/resilience, stress/coping, and negative/challenge. Thirteen studies reported using a family framework. Multiple methodological approaches and family measures were used in the studies and are outlined. Findings from this review show there has been a shift in focus when researching families of individuals with DS from a negative and challenging experience to one of strength and resilience.
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Coulman E, Gore N, Moody G, Wright M, Segrott J, Gillespie D, Petrou S, Lugg-Widger F, Kim S, Bradshaw J, McNamara R, Jahoda A, Lindsay G, Shurlock J, Totsika V, Stanford C, Flynn S, Carter A, Barlow C, Hastings RP. Early Positive Approaches to Support (E-PAtS) for Families of Young Children With Intellectual Disability: A Feasibility Randomised Controlled Trial. Front Psychiatry 2021; 12:729129. [PMID: 34992552 PMCID: PMC8725992 DOI: 10.3389/fpsyt.2021.729129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/30/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Parents of children with intellectual disabilities are likely to experience poorer mental well-being and face challenges accessing support. Early Positive Approaches to Support (E-PAtS) is a group-based programme, co-produced with parents and professionals, based on existing research evidence and a developmental systems approach to support parental mental well-being. The aim of this study was to assess the feasibility of community service provider organisations delivering E-PAtS to parents/family caregivers of young children with intellectual disability, to inform a potential definitive randomised controlled trial of the effectiveness and cost-effectiveness of E-PAtS. Methods: This study was a feasibility cluster randomised controlled trial, with embedded process evaluation. Up to two parents/family caregivers of a child (18 months to <6 years old) with intellectual disability were recruited at research sites and allocated to intervention (E-PAtS and usual practise) or control (usual practise) on a 1:1 basis at cluster (family) level. Data were collected at baseline and 3 and 12 months' post-randomisation. The following feasibility outcomes were assessed: participant recruitment rates and effectiveness of recruitment pathways; retention rates; intervention adherence and fidelity; service provider recruitment rates and willingness to participate in a future trial; barriers and facilitating factors for recruitment, engagement, and intervention delivery; and feasibility of collecting outcome measures. Results: Seventy-four families were randomised to intervention or control (n = 37). Retention rates were 72% at 12 months post-randomisation, and completion of the proposed primary outcome measure (WEMWBS) was 51%. Recruitment of service provider organisations and facilitators was feasible and intervention implementation acceptable. Adherence to the intervention was 76% and the intervention was well-received by participants; exploratory analyses suggest that adherence and attendance may be associated with improved well-being. Health economic outcome measures were collected successfully and evidence indicates that linkage with routine data would be feasible in a future trial. Conclusions: The E-PAtS Feasibility RCT has demonstrated that the research design and methods of intervention implementation are generally feasible. Consideration of the limitations of this feasibility trial and any barriers to conducting a future definitive trial, do however, need to be considered by researchers. Clinical Trial Registration: https://www.isrctn.com, identifier: ISRCTN70419473.
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Affiliation(s)
- Elinor Coulman
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Nick Gore
- Tizard Centre, University of Kent, Cornwallis North East, Canterbury, United Kingdom
| | - Gwenllian Moody
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Melissa Wright
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Jeremy Segrott
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - David Gillespie
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Fiona Lugg-Widger
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Sungwook Kim
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Jill Bradshaw
- Tizard Centre, University of Kent, Cornwallis North East, Canterbury, United Kingdom
| | - Rachel McNamara
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Andrew Jahoda
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Geoff Lindsay
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, United Kingdom
| | | | - Vaso Totsika
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, United Kingdom
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom
- Centre for Developmental Psychiatry and Psychology, Monash University, Melbourne, VIC, Australia
| | - Catherine Stanford
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, United Kingdom
| | - Samantha Flynn
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, United Kingdom
| | - Annabel Carter
- Tizard Centre, University of Kent, Cornwallis North East, Canterbury, United Kingdom
| | - Christian Barlow
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Richard P. Hastings
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, United Kingdom
- Centre for Developmental Psychiatry and Psychology, Monash University, Melbourne, VIC, Australia
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Bailey T, Hastings RP, Totsika V. COVID-19 impact on psychological outcomes of parents, siblings and children with intellectual disability: longitudinal before and during lockdown design. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:397-404. [PMID: 33634520 PMCID: PMC8013753 DOI: 10.1111/jir.12818] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/06/2021] [Accepted: 01/12/2021] [Indexed: 05/08/2023]
Abstract
BACKGROUND Parents of children with intellectual disability (ID) report comparatively lower levels of well-being than parents of children without ID. Similarly, children with ID, and to a lesser extent their siblings, are reported to show comparatively higher levels of behaviour and emotional problems. Psychological problems may be accentuated by restrictions associated with the COVID-19 pandemic, due to increased social, caring and economic stressors and reduced social support. However, existing studies have not been able to examine the impact of COVID-19 restrictions accounting for pre-COVID levels of well-being in these families. In a naturalistic design, we examined outcomes for parents, siblings and children with ID in a two-wave longitudinal study where Wave 2 data were gathered for some families before and some during COVID-19 restrictions. METHODS Parents of children with ID who took part in a Wave 2 survey pre-lockdown (n = 294) and during/post-lockdown (n = 103) completed a number of measures about their well-being and the behaviour and emotional problems of both their child with ID and their nearest-in-age sibling. These same measures had also been completed for all families 2-3 years previously in Wave 1 of the study. RESULTS After accounting for covariates including family socio-economic circumstances, pre-lockdown and post-lockdown groups did not differ on Waves 1 to 2 change for measures of parental psychological distress, life satisfaction, the impact of caregiving on their lives or perceived positive gains; nor child or sibling internalising or externalising behaviour problems. CONCLUSIONS Findings of the current study indicate that during and shortly after the COVID-19 lockdown in the United Kingdom, well-being in families of children with an ID (as reported by parents) was at similar levels compared with prior to the lockdown period.
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Affiliation(s)
- T. Bailey
- CEDARUniversity of WarwickCoventryUK
| | - R. P. Hastings
- CEDARUniversity of WarwickCoventryUK
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash HealthMonash UniversityMelbourneVicAustralia
| | - V. Totsika
- CEDARUniversity of WarwickCoventryUK
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash HealthMonash UniversityMelbourneVicAustralia
- Department of PsychiatryUniversity College LondonLondonUK
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Jess M, Flynn S, Bailey T, Hastings RP, Totsika V. Failure to replicate a robust Down syndrome advantage for maternal well-being. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:262-271. [PMID: 33404135 PMCID: PMC8049030 DOI: 10.1111/jir.12808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/26/2020] [Accepted: 12/08/2020] [Indexed: 05/13/2023]
Abstract
BACKGROUND Family members caring for children with intellectual disability (ID) routinely report heightened levels of psychological distress. However, families of children with Down syndrome typically report better outcomes (known as the Down syndrome advantage). We examined whether the Down syndrome advantage would be present for maternal psychological distress, impact of caregiving, life satisfaction and perceived positive impact of the child with ID when controlling for external variables. METHODS Mothers of children with Down syndrome (n = 111) and mothers of children with ID of mixed aetiologies (n = 196) completed measures about their own mental health, perceived impact of caregiving, life satisfaction and perceived positive impact of their child on themselves and the family unit. RESULTS A series of group comparisons revealed small to moderate differences supporting the presence of a putative Down syndrome advantage in relation to personal maternal well-being outcomes. However, when child-related characteristics and external variables were controlled, the Down syndrome advantage was no longer present, with reduced, small effect sizes observed for all maternal outcomes. CONCLUSIONS Initial group differences in psychological distress and life satisfaction were largely associated with family poverty, indicating that the Down syndrome advantage may be less robust than previously thought. Future research should seek to move beyond examining the existence of the putative Down syndrome advantage and focus on how families of children with Down syndrome experience family life, including longitudinal research exploring responses to life cycle and transition challenges.
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Affiliation(s)
- M. Jess
- CEDARUniversity of WarwickCoventryUK
| | - S. Flynn
- CEDARUniversity of WarwickCoventryUK
| | - T. Bailey
- CEDARUniversity of WarwickCoventryUK
| | - R. P. Hastings
- CEDARUniversity of WarwickCoventryUK
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash HealthMonash UniversityMelbourneVictoriaAustralia
| | - V. Totsika
- CEDARUniversity of WarwickCoventryUK
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash HealthMonash UniversityMelbourneVictoriaAustralia
- Division of Psychiatry, Faculty of Brain SciencesUniversity College LondonLondonUK
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Lunsky Y, Albaum C, Baskin A, Hastings RP, Hutton S, Steel L, Wang W, Weiss J. Group Virtual Mindfulness-Based Intervention for Parents of Autistic Adolescents and Adults. J Autism Dev Disord 2021; 51:3959-3969. [PMID: 33420938 PMCID: PMC7796683 DOI: 10.1007/s10803-020-04835-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2020] [Indexed: 12/05/2022]
Abstract
Mindfulness-based approaches have been shown to be effective in improving the mental health of parents of youth and adults with autism and other developmental disabilities, but prior work suggests that geography and caregiving demands can make in-person attendance challenging. The purpose of this study was to evaluate the feasibility, acceptability and preliminary outcomes of a mindfulness-based group intervention delivered to parents virtually. It was feasible to deliver this manualized intervention. Twenty-one of 39 parents completed the intervention and completers reported high satisfaction ratings. Parents reported reduced levels of distress, maintained at 3-month follow-up, and increased mindfulness. Changes reported following intervention were similar to changes reported in a prior study of parents competing an in person mindfulness group.
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Affiliation(s)
- Y Lunsky
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Medical Sciences Building, 1 King's College Cir, Toronto, ON, Canada.
| | - C Albaum
- Department of Psychology, York University, Department of Psychology Room 291. Behavioural Sciences Building 4700 Keele Street, Toronto, ON, Canada
| | - A Baskin
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, ON, Canada
| | - R P Hastings
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, CV4 7AL, UK
- Department of Psychiatry, Centre for Developmental Psychiatry and Psychology, Monash University, Clayton, VIC, 3168, Australia
| | - S Hutton
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, ON, Canada
| | - L Steel
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, ON, Canada
| | - W Wang
- Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON, Canada
| | - J Weiss
- Department of Psychology, York University, Department of Psychology Room 291. Behavioural Sciences Building 4700 Keele Street, Toronto, ON, Canada
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