Longitudinal associations among maternal depressive symptoms, child emotional caretaking, and anxious/depressed symptoms in pediatric cancer

Parentification Vulnerability, Reactivity, Resilience, and Thriving: A Mixed Methods Systematic Literature Review

Parentification occurs when youth are forced to assume developmentally inappropriate parent- or adult-like roles and responsibilities. This review thoroughly examines current empirical research on parentification, its outcomes, and related mechanisms to outline patterns of findings and significant literature gaps. This review is timely in the large context of the COVID-19 pandemic, when pandemic-induced responsibilities and demands on youth, and the shifting family role may exacerbate parentification and its consequences. We used the 2020 updated Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) framework to identify 95 studies (13 qualitative, 81 quantitative, 1 mixed methods) meeting eligibility criteria. Representation from six continents highlights parentification as a global phenomenon. Using thematic analysis, we identified five themes from qualitative studies and five from quantitative studies. These were further integrated into four common themes: (1) some parentified youth experienced positive outcomes (e.g., positive coping), albeit constructs varied; (2) to mitigate additional trauma, youth employed various protective strategies; (3) common negative outcomes experienced by youth included internalizing behaviors, externalizing problems, and compromised physical health; and (4) youths' characteristics (e.g., rejection sensitivity, attachment style), perceived benefits, and supports influenced parentification outcomes. Future methodological and substantive directions are discussed.

Importance of Social Support of Parents of Children with Cancer: A Multicomponent Model Using Partial Least Squares-Path Modelling

The purpose of the present study is to build a model combining some variables that have been previously studied separately to improve our understanding on how they relate in parents of children with cancer. A total of 112 parents with an average age of 41 completed the self-assessment questionnaires containing the factors studied: social support received, social support provided, stress, adjustment of parents and life satisfaction. Two models were developed: one for social support received and one for social support provided. Structural equation models based on the variance estimated through partial least squares were used to analyze factors involved in quality of life based on an exploratory model of second order. The estimated model was robust in terms of quality of measurement (reliability and validity). According to results from the structural model, in the model of social support received, the impact of social support received on stress was considerable (β = -0.26; p = 0.02) and it explained 16% of the variance. The impact of social support received by parents on their adjustment (β = -0.56; p < 0.001) was also considerable, explaining 32% of the variance. Finally, adjustment of parents also showed an effect on life satisfaction (β = -0.33; p < 0.001) and it explained 26% of the variance. However, the relation between social support received (β = 0.15; p = 0.11) and life satisfaction, the relation between stress (β = -0.15; p = 0.08) and life satisfaction, and the relation between adjustment of parents (β = 0.20; p = 0.07) and stress were not significant. In the model of social support provided by parents, social support provided (β = 0.35; p < 0.001), and adjustment of parents (β = -0.31; p < 0.01) impacted life satisfaction, explaining 36% of the variance. Social support provided (β = -0.34; p < 0.01) impacted adjustment of parents and it explained 12% of the variance. Adjustment of parents (β = 0.28; p < 0.05) also impacted parents' perception of stress, explaining 14% of the variance. However, the relation between social support provided (β = -0.17; p = 0.06) and stress, and the relation between stress (β = -0.13; p = 0.08) and life satisfaction, were not significant. Social support received showed a strong connection with stress and parents' adjustment. Additionally, social support received showed a decrease in stress and parents' adjustment. Social support provided by parents and the adjustments they experience are linked to their life satisfaction. Additionally, social support provided showed a decrease in adjustment and an increase in parents' life satisfaction. The models can be used to improve parents' situations and it has strong practical implications.

Identification of behavioral disorders using the Achenbach questionnaire in children with tumors of the posterior cranial fossa after completion of special treatment (pilot research)

Background. The increase in life expectancy of children who survived cancer leads to new tasks for doctors, psychologists and rehabilitation specialists to assessing the consequences of the experienced disease and its treatment. The most common disorders in children who have survived oncological diseases are behavioral disorders, a decrease in mood background, as well as chronic fatigue.Aim. To identify predictors of behavioral disorders in children who have survived central nervous system oncological diseases.Materials and methods. The study involved 52 children with central nervous system tumors aged 6 to 17 years. The median time after completion of therapy in this group of patients was 18 (3–117) months.Results. As a result of the study, it was shown that such treatment parameters as the degree of tumor malignancy and the radiation therapy volume are associated with behavioral disorders in children who have survived cancer. In such children, a reduced mood background was revealed, and the older the child, the higher the probability of a reduced mood background. A reduced mood background is also associated with the use of vincristine preparation. Children who have a residual tumor are more likely to complain of unpleasant sensations in the body. All children, despite the specifics of their treatment, complain of constant fatigue, which affects their daily activity.Conclusion. Thus, factors that are associated with behavioral disorders in children who have survived oncological diseases in the central nervous system were identified.

Parent-Child Role Confusion: Exploring the Role of Family Processes in the Context of Parental Depression

OBJECTIVE

Parent-child role confusion has been shown to influence developmental outcomes for children whose parents have a history of depression; however, more research is needed to understand the pathways by which parental depression increases risk of role confusion. The current study aimed to extend previous literature by evaluating how different family processes (e.g., interparental conflict, guilt induction, family cohesion, and positive parenting practices) contribute to the development of emotional role confusion in families with a history of parental depression.

METHOD

The sample was comprised of 90 parent-child dyads (parent Mage = 42, 90% female, 83.3% White; child Mage = 11.51, 51.1% female, 75.6% White) participating in the control group of a randomized controlled trial. All parents had a history of depression. A longitudinal path analysis was conducted to evaluate prospective associations in the multiple mediator model.

RESULTS

Findings from the current study suggest that parental depressive symptoms are not directly related to the development of parent-child emotional role confusion, but are instead indirectly related through increased interparental conflict observed by youth. Although not identified as significant mediators, guilt induction and positive parenting practices emerged as predictors of emotional role confusion. Lastly, family cohesion did not appear to influence the development of role confusion.

CONCLUSION

Findings suggest that parenting behaviors and coparenting relationship quality play important roles in the development of parent-child emotional role confusion, with interparental conflict emerging as the strongest predictor in families with a history of parental depression.

Psychological Distress in Parents of Children with Cancer: A Descriptive Correlational Study

Objective:

This study aimed to ascertain levels of distress and contributing factors among parent caregivers of pediatric cancer patients in Singapore.

Methods:

In this descriptive correlational study, parental caregivers were recruited via convenience sampling during their child's inpatient admission or outpatient appointment. They were asked to complete a self-administered demographic survey and the Distress Thermometer for Parents (DT-P) tool. Descriptive statistics, Chi-square tests, and correlation analyses were performed.

Results:

The mean DT-P score was 5.07 (standard deviation = 2.78), out of a maximum of 10. Distress was reported among 67.9% (n = 55) of caregivers. The cognitive domain of caregiving problems on the DT-P was found to correlate with distress. Parents most frequently reported cognitive problems (n = 21, 25.9%) and, least often, social problems (n = 6, 7.4%). Practical (P = 0.040), emotional (P = 0.001), physical (P = 0.026), and cognitive problems (P = 0.001) of caregiving were statistically significantly associated with distress.

Conclusions:

Notable levels of distress and proportions of distressed parents highlighted the heavy burden of caregiving. This may also be attributed to the differences in caregiving challenges. The psychological effects of parental caregiving highlight the need for supportive measures for pediatric cancer caregivers.

Patient and sibling adjustment to pediatric cancer: the roles of parental relationship adjustment and depressive symptoms

PURPOSE

Pediatric cancer may impact parents' partner relationship and increase patient, parent, and sibling distress. This study examined parents' reports of their relationship adjustment and depressive symptoms and their association with their ratings of patients' and siblings' emotional/behavioral problems in families of recently diagnosed pediatric cancer patients.

DESIGN

Cross-sectional questionnaire study.

SAMPLE

A total of 31 parents (87% female; 71% Latino) of pediatric cancer patients.

METHODS

Parents reported on their relationship adjustment, depressive symptoms, and the patients' and siblings' emotional/behavioral problems.

FINDINGS

Poorer relationship adjustment was correlated with more parent depressive symptoms and patient emotional/behavioral problems. Parent depressive symptoms were positively correlated with emotional/behavioral problems in patients and siblings. After accounting for child age and parent depressive symptoms, relationship adjustment remained significantly associated with patient, but not sibling, problems.

CONCLUSIONS

When parents have poorer relationship adjustment following diagnosis, children with cancer may be at increased risk for emotional/behavioral problems.

IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS OR POLICY

Interventions targeting the partner relationship may be relevant to supporting family adjustment following diagnosis.