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Huang YF, Chang SC, Purborini N, Lin YK, Chang HJ. The Efficacy of Health Promotion Program Among Parents Who Had Children With Attention-Deficit/Hyperactivity-Disorder. J Atten Disord 2023; 27:1488-1503. [PMID: 37515356 DOI: 10.1177/10870547231187165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
OBJECTIVES To explore the effect of health promotion program (HPP) on stress, quality of life, health-promoting lifestyles, and children's attention-deficit/hyperactivity disorder (ADHD) symptoms in parents of children with ADHD. METHODS Sixty parents of children with ADHD were equally randomized into the intervention (health promotion program) and control (usual care) groups. Outcomes included parents' stress, quality of life, health-promoting lifestyles, and children's ADHD symptoms before, immediately after, and 1, 3, and 6 months after the intervention. The GEE was used to evaluate the effectiveness. RESULTS The intervention group reported significant improvement in the children's hyperactivity/impulse and opposition at the 6- and 3-month, respectively. Parental overall stress significantly improved at 3 and 6 months. Parents' quality of life had significant effects at the immediate, 3-month, and 6-month. Self-actualization behavior for health-promoting lifestyles had significant effects at the immediate follow-up. CONCLUSION HPP can promote the mental well-being of parents of children with ADHD.
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Li S, Yong Y, Li Y, Li J, Xie J. Cognitive-Based Interventions for Improving Psychological Health and Well-Being for Parents of Children with Developmental Disabilities: A Systematic Review and Meta-analysis. J Autism Dev Disord 2023:10.1007/s10803-023-06063-x. [PMID: 37668850 DOI: 10.1007/s10803-023-06063-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2023] [Indexed: 09/06/2023]
Abstract
This review aims to systematically summarize existing evidence to determine the effectiveness of cognitive-based interventions (CBIs) on psychological health and well-being among parents of children with developmental disabilities (DD). Six databases were searched to identify eligible randomized controlled trials (RCTs) from their inception to April 2023. The revised Cochrane Risk of Bias tool for RCTs was applied to assess the risk of bias and the certainty of evidence was evaluated using the Grading of Recommendation, Assessment, Development and Evaluation. Meta-analyses were conducted using a random-effects model. Twenty-five RCTs involving 1915 participants were identified. The results indicated that CBIs reduced parental stress levels (Hedges' g = - 0.69), depressive symptoms (g = - 0.95), anxiety levels (g = - 0.78), and parental distress (g = - 0.29), and improved parental well-being (g = 0.62) and parent‒child relationships (g = 0.43) postintervention compared with the active/inactive control groups. Subgroup analysis of the effectiveness of interventions using mindfulness-based interventions and cognitive behavioural therapy showed positive effects. The favourable intervention duration and participant targets were also identified in this review. Furthermore, the effects of CBIs were impacted by the different types of DD among the children. This review highlighted the positive effects of CBIs on parental stress levels, depressive symptoms, anxiety levels, parental distress levels, parental well-being levels, and parent‒child relationships. Future well-designed RCTs are needed to further investigate the effects of MBIs and CBT interventions on children with DD and their parents, as well as the factors and mechanisms of action affecting the efficacy of these interventions.
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Affiliation(s)
- Sini Li
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, China
| | - Yijing Yong
- Cognition and Human Behaviour Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, China
| | - Jianhe Li
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, China.
| | - Jiao Xie
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, China.
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China.
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Glass A, Attrill C, Magee C, Blunden S. Factors associated with melatonin use in child sleep disturbance: A survey of Australian parents. Sleep Med 2023; 107:330-337. [PMID: 37295036 DOI: 10.1016/j.sleep.2023.04.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/22/2023] [Accepted: 04/26/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Sleep disturbances are prevalent in Australian children and cause a significant amount of stress to both children and their parents. If sleep disturbances are left untreated, they can result in detrimental consequences to both child and parental wellbeing. While behavioural interventions are recognised as the gold standard treatment for paediatric insomnia, there is a growing use of melatonin from both prescription and non-prescription sources in paediatrics. However, empirical research on the efficacy and safety of melatonin for children is sparse, conflicting, and inconsistent. This first Australian study aimed to investigate correlates of melatonin use in a sample of children with sleep disturbance in Australia and assess whether melatonin is being administered to children contrary to Therapeutic Goods Administration Guidelines. METHODS An exploratory online study was undertaken with 318 parents of Australian children with sleep disturbance (95.30% females). Logistic regression, mediation and descriptive analysis were conducted. RESULTS As hypothesised, higher parental stress, older child age, and a diagnosis of ADHD were significantly associated with melatonin use in this sleep disturbed sample. Other potential correlates such as financial stress, number of household dependents, child sleep disturbance, and autism were not significantly associated with melatonin use in adjusted analyses. CONCLUSION Findings show off-label melatonin use in children with sleep disturbance is prevalent. For the first time, this study showed an indirect path linking child sleep disturbances with melatonin use via parental stress. Overall, while the safety of melatonin use remains unknown, there is a clear need to mitigate parental stress to minimise potentially unmonitored and improper use of melatonin in children.
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Affiliation(s)
- Alison Glass
- School of Health, Medical, and Applied Sciences, Central Queensland University, Queensland, Australia
| | - Ceinwyn Attrill
- Centre for Emotional Health, School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Chris Magee
- NSW government, Cambelltown local government council, Australia
| | - Sarah Blunden
- School of Health, Medical, and Applied Sciences, Central Queensland University, Queensland, Australia.
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Jendreizik LT, von Wirth E, Döpfner M. Familial Factors Associated With Symptom Severity in Children and Adolescents With ADHD: A Meta-Analysis and Supplemental Review. J Atten Disord 2023; 27:124-144. [PMID: 36326291 DOI: 10.1177/10870547221132793] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Both genetic and environmental factors contribute to the development of ADHD, but associations between risk factors and ADHD symptom severity in affected children remain unclear. This systematic review and meta-analysis synthesizes evidence on the association between familial factors and symptom severity in children with ADHD (PROSPERO CRD42020076440). METHOD PubMed and PsycINFO were searched for eligible studies. RESULTS Forty-three studies (N = 11,123 participants) were meta-analyzed. Five additional studies (N = 2,643 participants) were considered in the supplemental review. Parenting stress (r = .25), negative parenting practices (r = .19), broken parental partnership (r = .19), critical life events (r = .17), parental psychopathologies (r = .14-.16), socioeconomic status (r = -.10), and single-parent family (r = .10) were significantly associated with ADHD symptom severity. CONCLUSION These results suggest that psychosocial familial factors show small but significant associations with symptom severity in children with ADHD. Implications are discussed.
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Lee CS, Ng KH, Chan PC, Peng X. Effectiveness of mindfulness parent training on parenting stress and children’s ADHD-related behaviors: A systematic review and meta-analysis. Hong Kong J Occup Ther 2022; 35:3-24. [PMID: 35847187 PMCID: PMC9279872 DOI: 10.1177/15691861211073826] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 12/29/2021] [Indexed: 11/18/2022] Open
Abstract
Background/Objective Literature shows that there is a circular relationship between children’s ADHD-related
behaviors and parenting stress. This systematic review and meta-analysis aimed to
understand if mindfulness parent trainings have benefits for both parenting stress and
the problem behaviors in children with ADHD. Methods Five databases, CINAHL, Embase, PsycINFO, PubMED, and Web of Science, were searched.
Within-group effects at post-treatment and follow-up assessment, and between-group
effects at post-treatment were analyzed. Effect sizes (Hedges’ g) were also
calculated. Results Ten studies (5 RCTs and 5 non-RCTs) met the selection criteria and were selected for
systematic review, and nine of them were included for meta-analysis. Among these 10
studies, five studies involved mindfulness training for both parents and children, while
the other five studies involved mindfulness training for parents only. Within-group
effects at post-treatment were small-to-large for all outcomes. Hedges’ g ranged between
−0.17 [95% CI (−0.98, 0.64)] and 4.70 [95% CI (3.59, 5.81)] for parenting stress; 0.17
[95% CI (−0.03, 0.37)] and 4.03 [95% CI (2.97, 5.09)] for children’s problem behaviors;
and 0.20 [95% CI (−0.10, 0.50)] and 2.98 [95% CI (2.16, 3.80)] for children’s ADHD
symptoms. Between-group comparisons showed mindfulness parent training was superior to
other active controls on all outcomes. Conclusion Findings suggest that mindfulness parent training may be beneficial for parenting
stress and children’s ADHD-related behaviors, and due to the small number of studies
reviewed, cautions should be taken when interpreting the results.
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Affiliation(s)
- Clara S.C. Lee
- Departemnt of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Ka-hin Ng
- Departemnt of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Phyllis C.K. Chan
- Departemnt of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Xianwei Peng
- Departemnt of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Yousef AM, Sehlo MG, Mohamed AE. The negative psychological impact of COVID-19 pandemic on mothers of children with attention deficit hyperactivity disorder (ADHD): a cross-section study. MIDDLE EAST CURRENT PSYCHIATRY 2021. [PMCID: PMC8413698 DOI: 10.1186/s43045-021-00139-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background ADHD is an important cause for psychiatric care as one of the most prominent neurodevelopmental conditions. Being an ADHD child’s parent is a daunting and sometimes stressful job that becomes more challenging during the COVID-19 pandemic and its negative consequences. This cross-sectional study was applied to 54 mothers of ADHD children and adolescents; the data of the ADHD children and adolescents have been registered before the lockdown on their regular follow-up visits on the child and adolescent’s clinic of the psychiatry department. Data of the study were collected through an electronic Google form included a COVID-19 questionnaire, The Depression, Anxiety, and Stress Scale—21 Items (DASS-21) (Arabic version), and Conners’ Parent Rating Scale Revised-short version (CPRS-48). We aimed to assess symptoms of anxiety, depression, and stress symptoms among the mothers of ADHD children and adolescents during COVID-19 outbreaks and determine the relationship between these symptoms and the changed circumstances that occurred by the COVID-19 pandemic, also with the behavioral problem of their children that may deteriorate by their mothers’ psychological state. Results Most of our participants were from the low socioeconomic class and were married. In total, 29.6% of the mother of ADHD children had confirmed COVID-19 cases among their family members, while 11.1% of our subjects lost a family member due to this epidemic, 22% of our sample lost their work because of COVID-19. We found that the COVID-19 pandemic has a big financial drawback on the family of our participants by a percentage of 31.5%. We noticed that 48.1% of our sample documented domestic violence toward them compared to before COVID-19. A total of 92.6% of the mothers who participated in our study assessed the period of change and restrictions as being very demanding. We found that 74.1% of ADHD patients were not compliant with their medications than before the epidemic. Also, we found that the mothers of ADHD children have bigger challenges in managing the child’s meals, structured activities, and sleep compared to before COVID-19. We showed that 53.7% of the mothers had depressive symptoms, 61% had anxiety symptoms, and 53.7% had stress symptoms. These symptoms were statistically associated with the lost family member due to COVID-19, the financial drawbacks of the COVID-19 outbreak, and the domestic violence toward mothers, compared to before COVID-19, the non-compliance of their children on the medications compared to before COVID-19, the presence of confirmed COVID-19 cases among family members, mother’s assessment of the period of change and restrictions as being very demanding compared to before COVID-19, and the non-compliance of their children on the medications compared to before COVID-19 as well as the increased behavioral symptoms of their children. Conclusion COVID-19 pandemic has psychological influences on mothers of children with ADHD. A significant number of them may have depression, anxiety, and stress symptoms that could affect their children’s compliance with the medication and, consequently, their symptomatology.
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Ebara T, Yamada Y, Shoji N, Ito Y, Nakagawa A, Miyachi T, Ozaki Y, Omori T, Suzuki S, Kojima M, Ueyama J, Tomizawa M, Kato S, Oguri T, Matsuki T, Sato H, Oya N, Sugiura-Ogasawara M, Saitoh S, Kamijima M. Cohort profile: Aichi regional sub-cohort of the Japan Environment and Children's Study (JECS-A). BMJ Open 2019; 9:e028105. [PMID: 31722936 PMCID: PMC6858231 DOI: 10.1136/bmjopen-2018-028105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Effects of fetal, perinatal and childhood environment on the health of children at birth and during later life have become a topic of concern. The Aichi regional sub-cohort of the Japan Environment and Children's Study (JECS-A) is an ongoing birth cohort of pregnant women and their children which has been used to provide unique data, as adjunct studies of JECS, on multifaceted potential factors affecting children's health. PARTICIPANTS The JECS-A is part of the JECS which follows a total of 100 000 pairs of children and their mothers (fathers' participation is optional) across 15 regions in Japan. In JECS-A, of the 8134 pregnant women living in Ichinomiya City and Nagoya City, Japan, a total of 5721 pregnant women and their 5554 children were included. Sociodemographic and psychological data as well as biological specimens were collected from the pregnant women and their spouses (if available) in the cohort during their pregnancy. Information on children included in the JECS-A was collected from their mothers and includes demographic, behavioural, childcare, psychological and psychiatric data. Urine extracted from disposable diapers and anthropometric data were also obtained from the children. FINDINGS TO DATE A similar distribution trend for age at delivery was confirmed between the pregnant women enrolled in the JECS-A and the national statistics of the relevant areas. However, differences in education level and household income were observed. A total of 5502 children remained in the cohort at 18 months after delivery. Compared with the national statistics, the basic demographics of the children in the cohort represented the population in the study areas. FUTURE PLANS The enrolled children in the JECS-A will be followed until the age of 13 years. The studies that come from JECS-A will complement JECS and bring novel results with a high level of generalisability.
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Affiliation(s)
- Takeshi Ebara
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Yasuyuki Yamada
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
- Department of Sports Management, Juntendo University School of Health and Sports Science, Graduate School of Health and Sports Science, Inzai, Chiba, Japan
| | - Naoto Shoji
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
- Department of Health and Sport Sciences, School of Health Sciences, Asahi University, Mizuho, Gifu, Japan
| | - Yuki Ito
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Atsuko Nakagawa
- Faculty of Psychological Development, Nagoya City University Graduate School of Humanities and Social Sciences, Nagoya, Aichi, Japan
| | - Taishi Miyachi
- Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
- Nagoya West District Care Center for Disabled Children, Nagoya, Japan
| | - Yasuhiko Ozaki
- Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Toyonori Omori
- Health Care Policy and Management, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Masayo Kojima
- Medical Education, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Jun Ueyama
- Department of Pathophysiological Laboratory Sciences, Field of Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine Faculty of Medicine, Nagoya, Aichi, Japan
| | - Motohiro Tomizawa
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Sayaka Kato
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
- Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Tomoko Oguri
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Taro Matsuki
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Hirotaka Sato
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Naoko Oya
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
- Research Fellow of Japan Society for the Promotion of Science, Chiyoda, Tokyo, Japan
| | - Mayumi Sugiura-Ogasawara
- Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Shinji Saitoh
- Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
| | - Michihiro Kamijima
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Aichi, Japan
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Muñoz-Silva A, Lago-Urbano R, Sanchez-Garcia M, Carmona-Márquez J. Child/Adolescent's ADHD and Parenting Stress: The Mediating Role of Family Impact and Conduct Problems. Front Psychol 2017; 8:2252. [PMID: 29312090 PMCID: PMC5744077 DOI: 10.3389/fpsyg.2017.02252] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 12/11/2017] [Indexed: 11/30/2022] Open
Abstract
Objective: The demands of parenting are usually associated with some stress, and elevated levels of stress may affect the parent-child relationships and parenting practices. This is especially the case of families where children have special needs conditions or disorders, like Attention Deficit Hyperactivity Disorder (ADHD). Method: This study examined parenting stress among mothers of children and adolescents with ADHD. The sample comprised 126 mothers of girls (36; 29%) and boys (90; 71%) aged 6-17 years old. Results: Mothers reported their own stress levels as well as the children and adolescents' variables (severity of their ADHD symptoms, conduct, and emotional problems) and family-contextual variables (negative impact on family's social life, impact on couple relationship, and perceived social support). Hierarchical multiple regression showed that (a) negative impact on social life and conduct problems were the strongest predictors of mother's stress. Bootstrap mediation analyses revealed that (b) the association between child and adolescent's ADHD and parenting stress was mediated by children's conduct problems and by negative impact on family's social life, and not by children's emotional problems nor by mother's perceived social support. The mediation analysis also suggested (c) a pathway from child/adolescent's ADHD through children's conduct problems and then through their negative impact on family's social life to mother's parenting stress. Conclusion: These results suggest that both child/adolescent's and family factors should be considered in the designing of interventions for reducing parenting stress in families of children and adolescents with ADHD.
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Affiliation(s)
- Alicia Muñoz-Silva
- Department of Social, Developmental and Educational Psychology, University of Huelva, Huelva, Spain
| | | | - Manuel Sanchez-Garcia
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
| | - José Carmona-Márquez
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
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