Fathers' and mothers' perceptions of their child and maternal depressive symptoms

Mental Health Screening in Pediatric Primary Care: Factors Associated With Screening Completion and Elevated Scores

This study aimed to examine predictors of complete and elevated youth mental health screens. Parents of 4- to 11-year-old children completed the Strengths and Difficulties Questionnaire (SDQ) during a routine, universal mental health screening initiative in primary care. Bivariate logistic regressions were run to examine associations between independent (visit age, sex, race/ethnicity, language, insurance, and guardian) and dependent variables (screening completion and elevated SDQ score). Parents of younger and Spanish-speaking (vs English-speaking) children were less likely to have a complete SDQ screen. Among those with complete SDQ screens, older children, male children, those with public or no insurance, and those who had a mother (vs father) complete the screener were more likely to have an elevated score. Understanding patterns of screening completion rates and predictors of elevated screens provides valuable information to improve resource mapping and planning. Findings can inform mental health screening implementation and optimization within primary care.

Positive Engagement with Pets Buffers the Impact of Intimate Partner Violence on Callous-Unemotional Traits in Children

Childhood exposure to intimate partner violence (IPV) is associated with serious psychological outcomes including increased odds of developing callous-unemotional (CU) traits and behaviors. Recent studies suggest that concomitant exposure to animal cruelty (AC) may increase this risk. However, even under these circumstances, bonds with companion animals may still be a protective factor that buffers the deleterious impact of IPV on child adjustment. This cross-sectional study evaluates whether, and to what extent, the association between exposure to IPV and children's CU and empathic-prosocial (EP) traits vary as a function of children's positive engagement with pets and exposure to AC. Participants included 204 children (aged 7-12 years; 57% Latinx) and their maternal caregiver who were recruited from domestic violence agencies in a western US state. We conducted multiple moderation analyses to evaluate each outcome individually (i.e., CU traits, EP traits), adjusting for the effects of child age, gender, and Hispanic ethnicity. Positive engagement with pets significantly moderated the relationship between IPV and CU traits, ∇R = 0.03, F (1, 195) = 7.43, β = -0.17, t(195) = -2.73, p = .007. Specifically, when high levels of positive engagement with pets is present, IPV is negatively associated with CU traits, whereas the reverse was true at low levels of positive engagement with pets. Evidence of moderation by AC was not supported. Our findings suggest that children who form close relationships with their pets in the context of IPV appear to derive important support from these animals; safeguarding the well-being of these animals may be critical to their long-term emotional health.

Patterns of Associations Between Maternal Symptoms and Child Problem Behaviors: The Mediating Role of Mentalization, Negative Intentionality, and Unsupportive Emotion Socialization

We examined how maternal depression, anxiety, hostility, mentalization, negative intentionality (NI), and unsupportive emotion socialization (UES) predict child internalizing and externalizing problem behaviors (CIEPB). Mothers (N = 537) of toddlers (M_age = 23.26 months, Range 10-44 months) completed the Brief Symptom Inventory, the Parental Reflective Functioning Questionnaire, the Infant Intentionality Questionnaire, the Coping with Children's Negative Emotions Scale, and the Child Behavior Checklist. All maternal symptoms negatively predicted mentalization and positively predicted NI, UES, and CIEPB. NI and UES mediated the relationship between maternal symptoms and CIEPB. Negative intentionality mediated the link between maternal hostility and internalizing behaviors, indicating a possible intervention area. Mentalization had an effect on externalizing behaviors only for high-SES, anxious mothers, underscoring the role of SES. Thus, the relationship between maternal symptoms, cognitive and behavioral parenting characteristics and CIEPB supports the multifinality principle for early childhood psychopathology development and shows the importance of screening for maternal symptoms and CIEPB.

Reactive and Regulatory Temperament: Longitudinal Associations with Internalizing and Externalizing Symptoms through Childhood

Previous studies of the relationship between temperament and psychopathology have been limited by focusing on main effects of temperament on psychopathology, reliance solely on maternal reports of child temperament, and predominately using cross-sectional designs. This study extended this work by focusing on interactions between reactive (positive emotionality/PE; negative emotionality/NE) and regulatory (effortful control) dimensions of temperament, using laboratory observations of temperament, and focusing on longitudinal prediction of internalizing and externalizing behavior problems. 536 children (46.1% Female, 92.4% White) were followed in a prospective, longitudinal study of the relationship between temperament and psychopathology. Temperament was assessed using laboratory observations when children were at age 3. Mothers and fathers reported on internalizing and externalizing symptoms in their children at ages 3, 6, and 9. Multilevel modeling analyses examined associations between the interaction of temperament traits and patterns of change in internalizing and externalizing psychopathology. Interactions between reactive PE traits (Sociability, Exuberance), but not NE traits (Dysphoria, Fear), and regulatory temperament (Disinhibition) were associated with the slope of maternal-reported internalizing and paternal-reported externalizing symptoms such that youth low in PE traits and high in effortful control experienced a greater decline in symptoms over time. In conclusion, among children with lower levels of PE traits, strong regulatory abilities are associated with greater reductions in internalizing and externalizing symptoms over time. These models highlight the complex interaction between reactive and regulatory temperament and expand current understanding of temperamental risk for psychopathology.

Psychopathology in 7-year-old children: Differences in maternal and paternal ratings and the genetic epidemiology

The assessment of children's psychopathology is often based on parental report. Earlier studies have suggested that rater bias can affect the estimates of genetic, shared environmental and unique environmental influences on differences between children. The availability of a large dataset of maternal as well as paternal ratings of psychopathology in 7-year old children enabled (i) the analysis of informant effects on these assessments, and (ii) to obtain more reliable estimates of the genetic and non-genetic effects. DSM-oriented measures of affective, anxiety, somatic, attention-deficit/hyperactivity, oppositional-defiant, conduct, and obsessive-compulsive problems were rated for 12,310 twin pairs from the Netherlands Twin Register by mothers (N = 12,085) and fathers (N = 8,516). The effects of genetic and non-genetic effects were estimated on the common and rater-specific variance. For all scales, mean scores on maternal ratings exceeded paternal ratings. Parents largely agreed on the ranking of their child's problems (r 0.60-0.75). The heritability was estimated over 55% for maternal and paternal ratings for all scales, except for conduct problems (44-46%). Unbiased shared environmental influences, i.e., on the common variance, were significant for affective (13%), oppositional (13%), and conduct problems (37%). In clinical settings, different cutoffs for (sub)clinical scores could be applied to paternal and maternal ratings of their child's psychopathology. Only for conduct problems, shared environmental and genetic influences explain an equal amount in differences between children. For the other scales, genetic factors explain the majority of the variance, especially for the common part that is free of rater bias. © 2016 The Authors. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics Published by Wiley Periodicals, Inc.

"She Was a Little Social Butterfly": A Qualitative Analysis of Parent Perception of Social Functioning in Adolescent and Young Adult Brain Tumor Survivors

Psychosocial sequelae of diagnosis and treatment for childhood brain tumor survivors are significant, yet little is known about their impact on adolescent and young adult (AYA) brain tumor survivors. Interviews were conducted with parents of AYA brain tumor survivors with a focus on social functioning. Semistructured interviews were conducted with English- and Spanish-speaking parents of AYA brain tumor survivors ≥10 years of age who were >2 years postdiagnosis, and analyzed using emergent themes theoretically integrated with a social neuroscience model of social competence. Twenty parents representing 19 survivors with a survivor mean age 15.7 ± 3.3 years and 10.1 ± 4.8 years postdiagnosis were interviewed. Several themes relevant to the social neuroscience social competence model emerged. First, parents' perceptions of their children's impaired social functioning corroborated the model, particularly with regard to poor social adjustment, social withdrawal, impaired social information processing, and developmentally inappropriate peer communication. Second, ongoing physical and emotional sequelae of central nervous system insults were seen by parents as adversely affecting social functioning among survivors. Third, a disrupted family environment and ongoing parent psychosocial distress were experienced as salient features of daily life. We document that the aforementioned framework is useful for understanding the social impact of diagnosis and treatment on AYA brain tumor survivorship. Moreover, the framework highlights areas of intervention that may enhance social functioning for AYA brain tumor survivors.

Effects of enuresis nocturna on parents of affected children: case-control study

BACKGROUND

Enuresis nocturna (EN) is a chronic medical disorder that may cause a parent to question their parenting ability and contribute to an inability to perform the parental role. The aim of the study was to investigate the effects of EN on the relationship between parents, and the effect of mood changes in the couples on the children.

METHODS

Forty children with EN (group 1) were enrolled in the study, and 44 consecutive healthy children (group 2) were randomly selected from the same school. The clinical diagnosis for the patient group was based on a careful history. Spielberg's State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), and Dyadic Adjustment Scale (DAS) were applied to all parents, and the answers were recorded.

RESULTS

STAI scores differed between the mothers in the two groups in terms of trait anxiety, while significant differences between the fathers in terms of both state and trait anxiety were observed. The BDI scores were similar between the two groups. The scores of dyadic consensus were lower in the mothers, while the affectional expression scores were lower in the EN study group fathers compared with controls. The total DAS scores were significantly lower in the parents of the children with EN.

CONCLUSION

The parents of children with EN seem to experience increased levels of anxiety. Their desire to continue the marital relationship, the overall quality of their marital relationship and their comfort as a family may also be negatively affected by having a child with EN.

The impact of depressive symptoms in adults with ADHD symptoms on family function and ADHD symptoms of their children

OBJECTIVE

People with attention-deficit/hyperactivity disorder (ADHD) exhibit considerable impairment in social, academic, or occupational functioning. The present study aimed to examine the patterns of associations between ADHD symptoms, depression, and family functioning.

METHODS

The sample consisted of 1,022 adults randomly selected from a district in Seoul, South Korea. Several self-assessment scales were utilized to rate ADHD symptoms (both past and current), current symptoms of depression, and level of family functioning. ADHD symptoms in the children of these participants were also assessed. Pearson's correlation and multiple linear regression analyses were performed; structural equation modeling (SEM) was conducted to determine the best fitting model.

RESULTS

Adult ADHD symptoms were positively associated with depressive symptoms. Depressive symptoms, in turn, mediated the relationship between adult ADHD symptoms and cohesion among family members. In addition, depressive symptoms mediated the relationship between adult ADHD symptoms and their children's ADHD symptoms.

CONCLUSION

The relationship between adult ADHD symptoms and family dysfunction may be influenced by depressive symptoms. When treating ADHD in adults, clinicians should pay attention to the presence or absence of depression.

Depressed mothers as informants on child behavior: methodological issues

Mothers with depressive symptoms more frequently report behavioral problems among their children than non-depressed mothers leading to a debate regarding the accuracy of depressed mothers as informants of children's behavior. The purpose of this integrative review was to identify methodological challenges in research related to the debate. Data were extracted from 43 articles (6 theoretical, 36 research reports, and 1 instrument scoring manual). The analysis focused on the methodologies considered when using depressed mothers as informants. Nine key themes were identified and I concluded that researchers should incorporate multiple informants, identify the characteristics of maternal depression, and incorporate advanced statistical methodology. The use of a conceptual framework to understand informant discrepancies within child behavior evaluations is suggested for future research.

Maternal parenting stress and mothers' reports of their infants' mastery motivation

Mastery motivation is a psychological force that stimulates an individual to attempt to master a task that is challenging to him or her. This prospective longitudinal study examined the relationship between maternal stress, using the Parenting Stress Index-Short Form, and infant mastery motivation, using the Dimensions of Mastery Questionnaire, for 150 mother-infant pairs assessed at both 6- and 18-months of age. Infants of mothers with elevated stress levels at 6 months tended to show lower mastery motivation at 18 months (standardized beta=-.46, p=.001). Conversely, infants with lower general competence (standardized beta=-.24, p=.021) and lower persistence during social interactions with other children (standardized beta=-.18, p=.037) at 6 months of age had mothers with elevated total stress at 18 months of age. Implications for programs which simultaneously intervene with child and mother are discussed.

Understanding discrepancies in parent-child reporting of emotional and behavioural problems: Effects of relational and socio-demographic factors

BACKGROUND

Discrepancies between parents and children in their assessment of children's mental health affect the evaluation of need for services and must be taken seriously. This article presents the differences between parents' and children's reports of the children's symptoms and social impairment, based on the results of the Strengths and Difficulties Questionnaire (SDQ). The interrelationship between relational aspects and socio-demographic factors with patterns of disagreement are explored.

METHODS

Differences in the prevalence and means of SDQ symptom and impact scores were obtained from 8,154 primary school children, aged between 10 and 13 years, and their parents. Agreement between matched pairs was measured using Pearson's and Spearman's rho correlations. Socio-demographic variables, communication patterns and parental engagement were analysed as possible correlates of informant discrepancies using bivariate and multivariate logistic regression models.

RESULTS

In general, although children reported more symptoms, they reported less impact of perceived difficulties than parents. The parents were more consistent in their evaluation of symptoms and impact than were the children. Exploration of highly discrepant subgroups showed that, when children reported the most symptoms and impact, qualitative aspects of the parent-child relationship and family structure seemed to be more powerful predictors of disagreement than were gender of the child and socio-demographic variables. When parents reported the most symptoms and impact, low parental educational level, low income and male gender of the child played an additional role.

CONCLUSIONS

Our findings underline the importance of paying attention to child reports of emotional-behavioural difficulties, particularly when parents do not identify these problems. Considerations on what meaning parent-child discrepancy might have in the context of the parent-child relationship or the family's psychosocial status should be integrated in the overall understanding of the child's situation and subsequent recommendations.

Problem behavior, parental stress and enuresis

PURPOSE

We determined maternal and paternal ratings of problem behavior in 5 to 13-year-old children with (non)monosymptomatic enuresis and investigated parental stress and the association between parental ratings of child behavior and parental stress.

MATERIALS AND METHODS

We compared problem behavior in 78 children with (non)monosymptomatic enuresis vs that in 110 without enuresis using the Child Behavior Checklist and the Disruptive Behavior Disorders Rating Scale. Parental stress was measured using the Parenting Stress Index.

RESULTS

Maternal results replicated previous findings of significantly higher Child Behavior Checklist scores for externalizing and total problems compared with those in the control group, whereas no significant differences were found for paternal ratings. Mothers and fathers of enuretic children reported significantly higher scores on the Disruptive Behavior Disorders Rating Scale inattention, hyperactivity/impulsivity and oppositional defiant disorder subscales than parents of children without enuresis. The Parenting Stress Index revealed significantly higher overall stress in mothers and fathers of children with (non)monosymptomatic enuresis compared with that in parents of controls. Especially parental stress related to child characteristics was associated with a greater report of child behavior problems.

CONCLUSIONS

Each parent but especially mothers reported more problem behavior in children with (non)monosymptomatic enuresis than in controls. They also reported more stress, which correlates highly with parental ratings of problem behavior in children with (non)monosymptomatic enuresis.

The generation gap in numbers: parent-child disagreement on youth's emotional and behavioral problems: a Greek community based-survey

OBJECTIVE

To evaluate discrepancies between parent and child reports on youth's emotional and behavioral problems in a representative, community based sample of Greek 18-year-olds, and to identify associated factors.

METHODS

A total of 2,927 completed pairs of parent-child questionnaires were studied, including the child behavior checklist (CBCL) and the youth self-report (YSR). Linear regression analysis was used to identify both child and parental characteristics significantly associated with parent/child disagreement on scores for youth's Internalising, Externalising and Total problems scales for both genders separately.

RESULTS

Although there was a strong correlation between scores on the YSR and CBCL corresponding scales, parent/child discrepancies were more likely to occur when the later: had good academic performance, were dissatisfied from their self-image or their life. Parental factors that influence discrepancies in parent/child scale scores were: low paternal education for both genders, father being the informant for boys, and maternal stress and lack of awareness of leisure activities for girls.

CONCLUSION

The associations found highlight the contributions of both parents and children to the discrepancies on emotional and behavioral problems in adolescence. This study may facilitate constructive parenting practices through generations.