Promoting Strengths and Resilience in Single-Mother Families

Parental stress and working situation during the COVID-19 shutdown - Effects on children's skill development

OBJECTIVE

This study examines whether parental emotional distress during the first pandemic-related school shutdown in 2020 in Germany affected the development of primary school students' mathematical skills and investigates changes in parents' working conditions as triggers of cascading stress processes.

BACKGROUND

The Family Stress Model (FSM) explains the mechanisms that mediate between families' structural conditions and children's developmental outcomes. Foundational works for this approach focus on historic events that instigate rapid structural changes which, in turn, undermine families' economic situation. The economic losses trigger stress processes. Research on the COVID-19 pandemic reports heightened levels of parental stress and negative impacts on children's cognitive and socioemotional development. This study examines the role of parental emotional distress during the COVID-19 shutdown on children's cognitive development. Expanding on the classical FSM, we hypothesize that changes in parents' working situation, rather than economic changes, may have triggered family stress processes during the shutdown, as federal support largely cushioned economic cutbacks in Germany.

METHOD

For the German National Educational Panel Study (NEPS), interviews were conducted with parents, and primary school students in Starting Cohort 1 were tested after the first shutdown in 2020. The database provides rich information from survey waves prior to the COVID-19 pandemic, allowing a longitudinal analysis of a sample of 1512 primary school students with ordinary least squares regression.

RESULTS

Parents' emotional distress during the pandemic had a robust negative effect on students' mathematical skills, even when controlling for prior parenting stress. Changes in parents' working conditions also had an effect on children's test scores, and the negative effect of working from home on the test scores was mediated by parents' emotional distress.

CONCLUSION

The COVID-19 pandemic was a historic event which, at least in Germany, challenged the mental health of many parents and, in turn, impaired the skill development of primary school students. We introduce the role of changes in working conditions as triggers of such processes.

The psychosocial impact on single mothers' well-being - A literature review

In India, single-parent families are proliferating. In particular, women are taking the lead in assuming the role. They are the most vulnerable of all the disadvantaged groups. Due to an absence of financial and social support, single mothers endure a great deal of emotional strain. So, the aim of the study is to investigate the various psychosocial factors that influence the well-being of single mothers. Additionally, this research seeks to assess the coping strategies employed by single mothers. This article reviews 80 studies on psychosocial concerns faced by single mothers, focusing on mental health, challenges, and social support. It cites 71 publications from 80 sources from Google Scholar, Scopus, Web of Science, and PubMed, between 1980 and 2023. The study used keywords as a search strategy such as "single mother," "mental health," "challenges," and "social support." The results showed that the absence of financial resources, education, and social support had a negative impact on the emotional and social well-being of single mothers. Children of single mothers are more likely to struggle with addictions like alcoholism, tobacco use, delinquency, hazardous sexual behavior, and even suicidal thoughts due to dysfunctional parenting. As a result, single mothers use their religious convictions, support networks, and social networks as coping mechanisms. The study implies that premarital counseling and health education are essential for young couples to prevent family disintegration in the event of divorce and separation. To provide assistance and improve the overall quality of life for this vulnerable population, collaboration between government and nongovernment organizations is necessary.

Preparing solo mothers for childbirth and parenthood - The importance of being with like-minded women

OBJECTIVES

Denmark and many high-income countries have seen an increase in the number of single women getting pregnant through medical assisted reproduction (MAR). These women are also named solo mothers. According to the Danish Health Authorities, they should, as all other pregnant women, be offered antenatal education. The aim of this study was to explore solo mothers' needs in order to prepare them for childbirth and parenthood.

METHODS

This qualitative study was set to investigate solo mothers' experiences and requirements during pregnancy toprepare them for childbirth and parenting. Semi-structured interviews were conducted by telephone or face-to-face. A systematic text condensation and interpretation was used to analyse data.

RESULTS

38 interviews were conducted before and after pregnancy. Twenty solo mothers participated in the study. Three themes emerged from the analysis: 'Confrontation with the normative pregnancy', 'Mirroring and network' and 'Using formal and informal sources to gain information'.

CONCLUSION

The conventional antenatal packages offered by the healthcare system did not meet the solo mothers' needs. The women called for content and information tailored to single parents. Solo mothers may benefit from structured antenatal classes in small groups. Being with like-minded women was essential for preparing for childbirth and parenting.

Profiles of perceived resources among low-income, rural mothers: Prospective associations with maternal and child outcomes

Low-income, rural families face significant mental health risks. However, the understanding of resources associated with mental health risks is limited. The present study investigated the associations between perceived resources of low-income, rural mothers, and longitudinal maternal and child outcomes. This study utilized longitudinal data from the Family Life Project (N = 1203), from US rural areas with high poverty rates. Mothers reported their resources at 6-month postpartum, and their levels of depression, anxiety, and role overload were assessed at 2-year postpartum. Mothers reported their children's behavioral problems at 3 years old. Using a person-centered approach, we identified four maternal profiles: lower resources (7.1%); higher intra-family support (11.1%); higher inter-family support (20.8%); and higher resources (60.9%). In general, the higher resource profile was associated with lower mental health concerns of mothers and lower levels of behavior problems of children. Mothers in the higher intra-family support profile had disproportionately higher role overload. Children of mothers in the higher inter-family support profile showed disproportionately higher behavioral problems. Maternal partner status and education were significant predictors of resource profiles. Findings support the heterogeneity in perceived resources among low-income, rural families and different risk levels. Identifying these subgroups has significant implications for policy and interventions aimed toward this vulnerable population.

Grandparental support and maternal depression: Do grandparents' characteristics matter more for separating mothers?

Grandparental support may protect mothers from depression, particularly mothers who separate and enter single parenthood. Using longitudinal Finnish register data on 116,917 separating and 371,703 non-separating mothers with young children, we examined differences in mothers' antidepressant purchases by grandparental characteristics related to provision of support. Grandparents' younger age (<70 years), employment, and lack of severe health problems predicted a lower probability of maternal depression. Depression was also less common if grandparents lived close to the mother and if the maternal grandparents' union was intact. Differences in maternal depression by grandparental characteristics were larger among separating than among non-separating mothers, particularly during the years before separation. Overall, maternal grandmothers' characteristics appeared to matter most, while the role of paternal grandparents was smaller. The findings suggest that grandparental characteristics associated with increased potential for providing support and decreased need of receiving support predict a lower likelihood of maternal depression, particularly among separating mothers.

Longitudinal Analysis of the Relationship Between Internalized HIV Stigma, Perceived Social Support, Resilience, and Depressive Symptoms Among People Living with HIV in China: A Four-Wave Model

Depression is one of the most common mental health problems among people living with HIV (PLWH). However, the longitudinal psychological mechanism underlying the link of internalized HIV stigma and depressive symptoms remains a research gap. This study attempted to articulate how and to what extent perceived social support and resilience mediate the longitudinal associations between internalized HIV stigma and depressive symptoms. A sample consisting of 1,098 Chinese PLWH (Mage = 38.63, SD = 9.20; 63.9% male) with a six-month interval and four waves of follow-up was used in the current study. Participants were asked to complete self-report questionnaires. The associations among main study variables were examined via a complete longitudinal mediation approach. Results indicated that the linkage between internalized HIV stigma at T1 and depressive symptoms at T4 was serially mediated by perceived social support at T2 and resilience at T3, and perceived social support at T2 and depressive symptoms at T3 serially mediated the relationship between resilience at T1 and internalized HIV stigma at T4. Depressive symptoms at a previous time point consistently predicted the levels of internalized HIV stigma at subsequent time points. The study highlights the complex interplay between internalized HIV stigma, mental health problems, and protective factors in a longitudinal context. The findings suggest the need to incorporate interventions aimed at enhancing social support and resilience in mental health programs for PLWH, as these factors may interrupt the pathway from internalized HIV stigma to depressive symptoms and potentially improve the overall psychological well-being of this population.

Understanding the pathway between work and health outcomes for women during the preconception, pregnancy, and postpartum periods through the framing of maternal obesity

The link between work and health outcomes for preconception, pregnant, and postpartum (PPP) working women is complex. Further, innovation and enhanced understanding are required to address the work-related determinants of maternal obesity. However, workplace health promotion is not typically systems-based nor attuned to the specific needs and context of individual PPP women. We propose that to improve health outcomes for PPP women, we must understand the pathways between paid work and health for the individual woman by taking a systems-thinking approach. In this paper, we (a) outline the rationale for why the oversimplification or "dilution" of individual context may occur; (b) present a systems-informed pathway model (the "Context-Exposure-Response" Model) and overview of potential work-related impacts on health and wellbeing outcomes for PPP women using maternal obesity to provide context examples; (c) further investigate the role of motivational factors from a systems perspective; and (d) briefly examine the implications for policy, practice, and intervention design. It is anticipated that this research may act as a starting point to assist program developers, researchers, and policymakers to adopt a systems-focused perspective while contributing to the health improvement and obesity prevention of PPP women.

A qualitative study of healthy eating, physical activity, and mental health among single mothers in Canada

Single motherhood is associated with higher demands in home and family responsibilities that may exist in similar sized households with grandparents. These demands can compete with opportunities and resources for maintenance of healthy behaviours. This may have been exacerbated during the COVID-19 pandemic since supports outside the home may have been restricted by public health measures. A qualitative narrative study was conducted to explore these issues with 12 single mothers in Canada. Semi-structured interviews provided an in-depth understanding of the challenges and facilitators to maintaining healthy eating habits, physical activity levels, and mental health. Theory-driven content and structural analysis were applied through a descriptive thematic approach. Challenges to maintaining healthy eating behaviours included stay-at-home orders, limited budget, unhealthy food/cravings, and lack of motivation. In contrast, living with grandparents who provide help or having an understanding of healthy food were factors that facilitated engagement in healthy eating. Challenges to maintaining physical activity levels included lack of willpower, lack of time, and low energy. Whereas time on one's own, weighing scales or outdoor gear, and weather conditions promoted physical activity. Spirituality and gratitude were the main coping mechanisms used to deal with loneliness, unemployment, and depressive symptoms. Further research into the utility of gratitude as a coping mechanism could inform public health interventions that aim to increase levels of well-being among single mothers.

Self-Stigma and Mental Health in Divorced Single-Parent Women: Mediating Effect of Self-Esteem

Numerous studies have addressed the issue of "self-stigma" among divorced single-parent women. However, there is a scarcity of quantitative data available on this subject. Moreover, while self-esteem is a crucial factor throughout life, it has been extensively studied in the context of "children" from single-parent families, but not from the perspective of parents themselves. To address this gap, the present study aimed to explore the relationship between self-stigma, self-esteem, and mental health in 347 divorced, single-parent women. The online survey recruited participants randomly, with a specific focus on single mothers who were divorced and had more than one child under the age of 18. The analysis involved utilizing SPSS 25.0 (IBM Co., Armonk, NY, USA) and PROCESS Macro Version 4.1 (Model 4) to conduct descriptive statistics, frequency analysis, reliability assessment, correlation analysis, and mediating analysis. The findings revealed that self-esteem played a partial mediating role in the relationship between self-stigma and mental health. In other words, higher levels of self-stigma among divorced, single-parent women were associated with poorer mental health outcomes. Additionally, the study discovered that engaging in more self-stigma was linked to lower self-esteem and increased mental health distress. These results underscore the significance of internal factors, such as self-stigma and self-esteem, and highlight their relevance in formulating policies aimed at supporting divorced single-parent women. Policymakers should take these factors into account to develop effective strategies to aid this specific group.

Influence of Parenting Guilt on the Mental Health among Single-Parent Women: Multiple Additive Moderating Effect of Economic Well-Being and Level of Education

This study explored how the core problems (e.g., parenting, economy, and education level) of single-parent women affect their mental health. Although parenting guilt, economic well-being, and level of education are important variables that affect the mental health of single parents, there is no study that examines the interaction effect between them together. Therefore, this study examined the moderating effects of economic well-being and level of education on the relationship between parenting guilt and mental health in 419 single-parent women. In addition, it was verified whether there was a multiple additive modulation effect when they were put in at the same time. As a result, the higher the parenting guilt and the lower the economic well-being, the higher the level of mental health pain, but the level of education had no statistical significance. However, the interaction term between parenting guilt and education level had statistical significance, while the interaction term between parenting guilt and economic well-being did not produce significant results. These findings suggest the importance of education for single-parent women's mental health as well as the need to establish policies that allow them to have sufficient time and room for child rearing.

Demographic and Disease-Related Predictors of Socioemotional Development in Children with Neurofibromatosis Type 1 and Plexiform Neurofibromas: An Exploratory Study

Individuals with neurofibromatosis type 1 (NF1) and plexiform neurofibromas (PNs) have a higher risk for socioemotional problems. The current study aims to identify the socioemotional developmental pattern and its predictors across childhood and adolescence in individuals with NF1 and PNs. Participants included 88 children with NF1 and PNs (aged 6-18 years old, M = 12.05, SD = 3.62, 57% male) in a natural history study. Neuropsychological assessments were administered three times over six years. There are large variabilities in socioemotional development in the study participants. Developmental patterns varied across socioemotional domains, respondent type (parent-report [PR] vs. child-report [CR]), demographic factors, and NF1 disease-related factors. For instance, lower parental education was associated with a greater decline in internalizing problems (PR) but a greater increase in school disconnectedness (CR) over time. Non-White (vs. White) children were more likely to experience increased adaptive skills (PR) but decreased personal adjustment (CR). Children with more visible tumors experienced a greater decrease in school disconnectedness (CR). Children with more NF1 complications experienced a greater decrease in externalizing problems (PR). These findings indicate the necessity of using multi-informants and investigating subdomains of socioemotional functions. They also highlight the importance of developing individualized approaches to patient care and interventions.

Akhir N, Amin AS, Mohd Shukry ANA, Abdul Rashid MR, Wan Yusof WN. Perceptions of Quality of Life during the Pandemic: A Case Study on B40 Single Mothers

During the pandemic, the lives of B40 single mothers were severely affected, especially in terms of social, economic, and psychological factors. The reduction of income caused by the crisis has forced single mothers and their children to live frugally and without luxury. They also had to perform more than one job at a time during the pandemic to meet their children's needs. A qualitative study has been conducted to explore the perceptions of quality of life during the pandemic among B40 single mothers. Respondents were selected based on demographic characteristics established before the study. A focus group discussion has been conducted on ten (10) B40 single mothers in Balik Pulau, Penang. Single mothers were selected based on purposive sampling. They had to meet the inclusive criteria required to participate in the study, specifically: aged between 20 and 60 years old, belonged to the B40 income category, had children under 18 years old living together, and became single mothers due to divorce or death of husbands. The focused group discussion explored issues related to qualities of life during the pandemic. B40 single mothers expressed their concern about access to health facilities, security in residence, children's education, and economic stability. These areas of life quality have been significantly affected especially during Movement Control Order (MCO). In short, the quality of life of these single mothers has been significantly affected by the pandemic. Their vulnerability towards stress, anxiety, and depression have worsened due to financial issues. Besides the need for emotional and social support, this study found that these single mothers entail financial support.

Examining family processes linked to adolescent problem behaviors in single-mother families: The moderating role of school connectedness

Objective

Previous research has shown that adolescents in single-mother households are at heightened risk for adjustment problems. However, limited studies have investigated the mechanisms leading to adolescent problem behaviors in single-mother households. To address this research gap, this study applied the Family Stress Model to examine how single mothers’ material hardship is linked to adolescent problem behaviors, focusing on the mediating roles of mothers’ depression and mother-adolescent closeness. The moderating role of adolescent school connectedness in the relationships between mother-adolescent closeness and school connectedness and between mothers’ depression and school connectedness was also investigated.

Materials and methods

The study analyzed data from 1,384 adolescents and their single mothers who participated in the Fragile Families and Child Wellbeing Study at Wave 6. The associations between study variables were analyzed using structural equation modeling by decomposing the direct, indirect, and total effects of material hardship on adolescent problem behaviors. School connectedness’s interactions with mother-adolescent closeness and mothers’ depression were also examined.

Results

Results showed a significant indirect relationship between material hardship and adolescent problem behaviors through sequential mediation of mothers’ depression and mother-adolescent closeness. Mothers’ depression also significantly mediated the relationship between material hardship and problem behaviors. Lastly, school connectedness moderated the relationship between mother-adolescent closeness and adolescents’ internalizing behaviors. The association between mother-adolescent closeness and adolescents’ internalizing behavior was weaker for adolescents with higher levels of school connectedness.

Conclusion

The results indicate the important indirect effect of economic strain on adolescents’ problems behaviors in single-mother households, which has been less emphasized compared to the effects in earlier childhood. High rates of material hardship and adolescent problem behaviors in single-mother families call for multifaceted interventions focusing on family processes and protective factors, including school environment.

Assessing positive adaptation during a global crisis: The development and validation of the family positive adaptation during COVID-19 scale

The COVID-19 pandemic has negatively impacted the psychosocial functioning of children and families. It is important to consider adversity in relation to processes of positive adaptation. To date, there are no empirically validated multi-item scales measuring COVID-related positive adaptation within families. The aim of the current study was to develop and validate a new measure: the Family Positive Adaptation during COVID-19 Scale (Family PACS). The sample included 372 female and 158 male caregivers (73% White-European/North American; median 2019 income = $50,000 to $74,999 USD) of children ages 5–18 years old from the United Kingdom (76%), the United States (19%), Canada (4%), and Australia (1%), who completed measures in May 2020. Participants responded to a 14-item survey indexing a range of perceived coping and adaptation behaviors at the beginning of the pandemic. An exploratory factor analysis yielded an optimal one-factor solution comprised of seven items related to family cohesion, flexibility, routines, and meaning-making (loadings from 0.44 to 0.67). Multigroup confirmatory factor analysis demonstrated measurement invariance across female and male caregivers, demonstrating that the factor structure, loadings, and thresholds did not vary by caregiver sex. There was evidence for concurrent validity with significant bivariate correlations between the Family PACS scores and measures of caregiver positive coping, parenting practices, couple satisfaction, and family functioning (correlations from 0.10 to 0.23), but not negatively-valenced constructs. Findings inform our conceptualization of how families have adapted to adverse pandemic-related conditions. Further, we provide preliminary support for the Family PACS as a practical tool for evaluating positive family adaptation during this global crisis, with implications for future widespread crises.

Harm or protection? Two-sided consequences of females' susceptible responses to multiple threats

The target article presented a plausible argument that females' susceptibility to threats might be self-protection for staying alive, but some evidence requires scrutiny. We need to consider (1) the biases of narrative reviews, (2) subjective life quality, and (3) the shadow side of extreme reactions to threats before concluding that females' threat-based response is a self-protection mechanism that promotes survival.

Older adults recall memories of life challenges: the role of sense of purpose in the life story

Late life is still often characterized as a time of loss and decline. The current study moved beyond this view, using both the resilience framework and the life story approach to highlight the rich life experiences of older adults. Doing so created an opportunity to explore perspectives on sense of purpose in life, from the vantage point of old age. The study had two central questions. That is, how have older adults drawn on their sense of purpose across their lives, and what factors led to the development of a sense of purpose? Following guidelines for the consensual qualitative research method (CQR; Hill et al., The Counseling Psychologist, 25(4), 517-572, 1997; Hill & Knox, 2021), in-depth, semi-structured interviews were conducted with 18 older women and men (aged 60 - 100 years) and transcribed for analysis. The CQR method revealed seven domains in the interviews. Three domains were relevant to the first research question, including: overcoming life challenges to pursue purpose, perspective-taking to maintain purpose, and purpose as part of one's religion. Four domains provided insights on the second research question: life background influencing purpose, shifts in purpose across life, fulfilling purpose across life, and obstacles to pursuing purpose in life. Findings highlighted how older people use sense of purpose as a guide in the face of life's inevitable challenges. They also revealed the unique life story paths that lead to the development of purpose across individuals' lifetimes. The implications of maintaining a sense of purpose in life, across the later years, are discussed.

Informal support and obligation contribute to fewer child behavior problems over time

OBJECTIVE

This study used longitudinal data from a sample of low-income mothers and their children to examine how informal support and obligation, or informal networks, contribute to children's behavior. We also tested the potential mediating role of maternal parenting stress.

BACKGROUND

Many studies document the importance of informal support for maternal stress and child behavior to offset the negative impact of poverty for low-income families. Evidence suggests the importance of also considering the obligations that such informal support access may impart.

METHOD

Using data from the Welfare, Children, Families Study, a longitudinal study of diverse, low-income, urban mothers in three cities (n = 2,142), we used a parallel process latent growth curve model approach to examine how informal support and obligation contributed to maternal stress and child behavior.

RESULTS

Models indicated that mothers with healthy safety nets, including informal support and manageable obligations, had children with fewer behavior problems, and parenting stress partially accounted for the positive effects.

CONCLUSIONS

Results highlight the importance of considering reciprocity norms among low-income mothers; one-sided support or obligation can be problematic for both maternal stress and child behavior problems.

IMPLICATION

Results suggest the merit of empirically supported interventions to teach relationship skills and facilitate healthy relationships among low-income mothers.

Effectiveness of yoga training programs to reduce depression and improve resilience of single mothers

Single mothers are vulnerable to mental health such as depression, but emotional support is insufficient. Yoga is known to be effective in reducing negative emotions and promoting resilience. This study was conducted in order to verify the effectiveness of yoga training programs in reducing depression and improving the resilience of single mothers. Participants in the study included 20 single mothers who belonged to the Single Mothers Association, who were randomly assigned to training (n=10) and nontraining (n=10) groups. The yoga training program for single mothers consisted of Asana yoga, meditation, and mind expression through expert meetings; a total of eight sessions were conducted once a week for 120 min. Testing for depression and resilience was performed before and after the program in order to verify the effectiveness of the program. According to the results of the study, depression in single mothers who participated in the yoga training program was significantly decreased, and resilience was significantly increased. Therefore, the effectiveness of the yoga training program in lowering the depression of single mothers and improving resilience was confirmed. In the future conduct of many studies will be required in order to help the mental health of single mothers.

The Impact of Different Parental Figures of Adolescents Living With HIV: An Evaluation of Family Structures, Perceived HIV Related Stigma, and Opportunities for Social Support

Although antiretroviral therapy (ART) has changed the expected health outcomes for HIV, there are still issues related to stigma, how people living with HIV are perceived, and the availability of social support. The purpose of this study was to explore the associations between family structure and psychosocial wellbeing reflected by perceived HIV stigma and social support among adolescents living with HIV in Kumasi, Ghana. This article used baseline data from two mixed methods studies that evaluated the safety and preliminary efficacy of group-based support programs for ART adherence improvement among adolescents living in Kumasi, Ghana (N = 70, aged 12–18 years). A multivariate linear regression analysis was employed to examine the associations between family structure and the outcomes of stigma and social support. The main variables for family structure were single mothers and female caregivers. We found that single motherhood was a significant determinant of stigma. When compared to other categories of caregiver types, adolescents being raised by their single mothers was associated with a 0.259 decrease in the mean internal HIV stigma score (p = 0.029). Also, for female adolescents, being raised by a female guardian (e.g., mother, aunt, grandmother, and sister) was associated with a 20.92 point increase in the overall support index (p = 0.005). This study shows that the type of parent or guardian, and their gender, influences the perceived stigma and available social support among adolescents living with HIV in Ghana. Vulnerable subgroups of adolescents living with HIV, particularly those raised up by male caregivers, should be provided with additional support.

Maternal advanced age, single parenthood, and ART increase the risk of child morbidity up to five years of age

Background

Advanced maternal age, single status and use of assisted reproductive technology (ART) are increasing in mothers in high-income countries, and all are known risk factors for negative obstetric outcomes. Less is known about their long-term consequences for childhood morbidity. Thus, the aim of this study was to investigate morbidity up to five years of age, in the children of older, single, and/or ART-treated mothers.

Methods

A cross-sectional using Swedish registers was performed comprising 23 772 children. The prevalence of diagnosis and the number of hospital visits for specialist care, were compared and analyzed in relation to maternal age at childbirth, maternal civil status, and mode of conception. The odds ratio for specialized care within each ICD-chapter were estimated using single and multiple logistic regression.

Results

Children born to single mothers and children conceived using ART had significantly more outpatient visits for specialist care and significantly more diagnoses compared to children with married/cohabiting mothers, and spontaneously conceived children. Children born to mothers of advanced maternal age (≥40) had fewer in- and outpatient visits. However, they were significantly more often diagnosed within ICD-chapters XVI, XVII i.e., they experienced more morbidity in the neonatal period.

Conclusion

The results indicate that children born to single mothers and children of ART-treated mothers have a higher morbidity and consume more specialist care than children of married/cohabiting and spontaneously pregnant mothers. We conclude that the use of ART, maternal single status and advanced maternal age are risk factors of importance to consider in pediatric care and when counseling women who are considering ART treatment.

Validation of the Korean version of the Perinatal Infant Care Social Support scale

Purpose

The purpose of this study was to develop and test the validity and reliability of the Korean version of the Perinatal Infant Care Social Support (K-PICSS) for postpartum mothers.

Methods

This study used a cross-sectional design. The K-PICSS was developed through forward-backward translation. Online survey data were collected from 284 Korean mothers with infants 1-2 months of age. The 19-item K-PICSS consists of functional and structural domains. The functional domain of social support measures infant care practices of postpartum mothers. Exploratory factor analysis (EFA) and known-group comparison were used to verify the construct validity of the K-PICSS. Social support and postpartum depression were also measured to test criterion validity. Psychometric testing was not applicable to the structural social support domain.

Results

The average age of mothers was 32.76±3.34 years, and they had been married for 38.45±29.48 months. Construct validity was supported by the results of EFA, which confirmed a three-factor structure of the scale (informational support, supporting presence, and practical support). Significant correlations of the K-PICSS with social support (r=.71, p<.001) and depression (r=–.40, p<.001) were found. The K-PICSS showed reliable internal consistency, with Cronbach’s α values of .90 overall and .82–.83 in the three subscales. The vast majority of respondents reported that their husband or their parents were their main sources of support for infant care.

Conclusion

This study demonstrates that the K-PICSS has satisfactory construct validity and reliability to measure infant care social support in Korea.

Life challenges and resilience: the role of perceived personality continuity

OBJECTIVES

Self-functioning, one aspect of mental health, is positive in later life. Although experiencing challenges may disrupt mental health, internal resources can foster resilience. This study examines how the frequency of recent challenges relates to current self-functioning. Perceived personality continuity, one's sense of maintaining their trait personality, is investigated as an internal resource.

METHOD

Participants (N = 99 young adults, 88 older adults) reported all challenging events experienced in the last six years. Perceived personality continuity over the same time was assessed. Multi-measurement of current self-functioning included self-concept clarity, self-esteem, and self-acceptance.

RESULTS

Older adults reported higher self-concept clarity and self-esteem; young adults reported higher self-acceptance. Experiencing more challenges related to lower self-concept clarity and self-esteem across age groups, with a stronger negative link to self-esteem for young adults. Perceived personality continuity partially mediated relations between: (i) challenges and self-concept clarity, and (ii) challenges and self-esteem. Perceived personality continuity mediated positive self-functioning for older adults only.

CONCLUSION

A late life strength, older adults report higher self-functioning overall. Challenges negatively relate to self-functioning across age groups, but younger adults' self-esteem is more vulnerable. When having faced challenges, older adults' perceived personality continuity is critical to positive current self-functioning.

Maintenance of smoking cessation in Korean single mothers

BACKGROUND

Single mothers in South Korea are vulnerable to developing smoking habits, due to many difficulties and limitations; however, they have often been overlooked by smoking cessation support services. Therefore, this study aimed to investigate the general and smoking-related characteristics of single mothers registered with the Visiting a Smoking Cessation Service in Seoul, South Korea, to identify factors associated with smoking cessation maintenance at 4 weeks and 24 weeks after they initially quit smoking.

METHODS

The participants were 77 single mothers registered in the Smoking Cessation Service Program. Data were included from a three-year span (January 2017-December 2019). Smoking cessation counseling, motivational enhancement, and self-exploration counseling were provided for six months. The participants were evaluated on their smoking cessation status at 4 weeks and 24 weeks.

RESULTS

Most participants were aged 22 years or younger. The rates of smoking cessation maintenance were 58.4 and 18% at 4 weeks and 24 weeks, respectively. The higher the number of counseling sessions, the higher the participants' chances of maintaining smoking in all non-smoking periods, and whether pregnancy, CO level, and drinking were significant only in a short-term non-smoking period (4 weeks).

CONCLUSIONS

Our results suggest that the number of smoking cessation counseling sessions is important for long-term smoking cessation beyond short-term cessation in single mothers. To increase the smoking cessation rate of single mothers, it is important to conduct customized smoking cessation counseling at the time of smoking cessation and continue such counseling in the long term.

Technology-Assisted Parenting Interventions for Families Experiencing Social Disadvantage: a Meta-Analysis

Technology-assisted interventions have been identified as a means to increase accessibility and enhance engagement of parenting programs. The current meta-analytic review examines the effectiveness of these interventions in families experiencing social disadvantage. A literature search was conducted spanning March 2007-June 2019. Nine studies met inclusion criteria (total of 864 participants) which included an evaluation of a parenting intervention for families with at least one of the following demographic challenges, low socioeconomic status, single parenthood, and/or young parenthood. Interventions (or a component of the intervention) were delivered by computer, cell phone, smartphone, and/or tablet. Data were organized into three categories: parental psychological well-being (e.g., self-esteem, social support), parenting (e.g., observed or self-reported parenting behavior), and child behavior (e.g., disruptive behavior). Effect sizes (Hedges' g) were calculated and moderators (i.e., contact with an interventionist, intervention length, publication year, % female parents, mean parent age, parental education, % minority, and child age) were examined through Q-statistics and meta-regression, as appropriate. Intervention showed a near-significant impact on parental psychological well-being (g = .35, p = .051). Furthermore, interventions that did not include direct contact with an interventionist showed no evidence of effectiveness (g = - .02); interventions that incorporated contact were significantly more effective (g = .68). In addition, intervention length moderated intervention effectiveness; shorter interventions yielded greater improvements in well-being, compared with longer interventions. Interventions were also associated with significant improvements in parenting (g = .38) and child behavior (g = .39). These findings provide support for the use of technology-assisted parenting interventions in populations experiencing social disadvantage.

Adherence to laboratory testing in pediatric liver transplant recipients

BACKGROUND

The objectives of this retrospective cohort study are to describe rates of adherence to laboratory testing 6 months to 3 years post-liver transplantation and to examine demographic and clinical factors related to lab non-adherence and the association with medication adherence and clinical outcomes.

METHODS

Medical chart review was conducted for 54 youth (mean age = 5.0 years) transplanted between 2003 and 2014. Lab adherence (≥80%) was measured as the proportion of completed labs out of the number expected. Immunosuppressant drug-level variability was used as a proxy for medication adherence. Clinical outcomes included LAR, viral infection, hospitalization, and non-routine clinic visit ≥12 months after transplant.

RESULTS

Lab adherence decreased substantially over time. Single-parent household (aOR 5.86; 95% CI: 1.38-24.93) and no history of early rejection (aOR 3.96; 95% CI: 1.04-15.24) were independently associated with non-adherence. Lab non-adherence was significantly associated with medication non-adherence (P < .05), LAR (P = .02), and non-routine clinic visits (P = .03).

CONCLUSIONS

Systematic monitoring of lab adherence may help in identifying pediatric LT recipients at increased risk for excessive healthcare use and adverse outcomes possibly due to poor disease management.

Maternal Mental Health Mediates the Relationship Between Household Food Insecurity and Early Child Development in Brazil

BACKGROUND

Optimal early child development (ECD) is fundamental for every child to achieve their developmental potential and thrive. Household food insecurity (HFI) is a risk factor for suboptimal development, but there is still a need to better understand the pathways that explain this relationship.

OBJECTIVE

To evaluate whether maternal mental health and infant's diet mediate the association between HFI and ECD using structural equation modeling.

METHODS

Cross-sectional study with 474 mother-infant dyads. Mothers answered a questionnaire that evaluated variables through validated instruments. Structural equation modeling analyses were conducted to obtain standardized effects (β) and bias-corrected 95% CI, enabling comparisons between the magnitude of the effects. The following observed variables were included: HFI, ECD, consumption of a healthy and diverse diet, the presence of a partner in the household, wanted pregnancy, and current breastfeeding. Latent variables were included to evaluate mental health, poverty, and neonatal health.

RESULTS

Poor maternal mental health mediated the relationship between HFI and ECD (β = -.05), but a healthy and diverse diet was not a mediator in this relationship. Poverty was related to lower development scores directly (β = .21) and indirectly (β = .02). Not having a partner (β = .05) and having an unwanted pregnancy (β = .02) predicted indirectly lower development scores.

CONCLUSIONS

Poor maternal mental health mediates the relationship between HFI and ECD, and ECD is influenced by poverty, single motherhood, and unwanted pregnancy through different pathways. Therefore, public policies and interventions that aim to promote an optimal ECD should also approach these aspects.

Nonresident Fathers' and Grandparents' Early Years Support and Middle Childhood Socio-Emotional Adjustment

OBJECTIVE

This study investigates how different patterns of nonresident father support for children and mothers in the early years predict middle childhood adjustment, and whether grandparent support has compensating effects.

BACKGROUND

Nonresident fathers' involvement in children's lives benefits socio-emotional adjustment, but it is unclear whether support directed at children is compromised by interparental tensions, or whether other factors may compensate for weaker patterns of father support.

METHOD

Latent class analyses identified patterns of nonresident father support for single mothers and their 34-month-old child (None 35%, Low 16%, Moderate 21%, High 28%) and grandparent support (Low 15%, Moderate Maternal 33%, High Maternal 43%, High Maternal and Paternal 9%), using a sample of 648 families from the Growing Up in Scotland cohort. Effects of father support on children's internalizing and externalizing problems from age 46 to 122 months were explored (n = 352), together with moderating effects of grandparent support.

RESULTS

Low, Moderate and No father support had similar estimated effects on higher externalizing and internalizing problem levels, and steeper increases in internalizing problems. Compared to Low grandparent support, High Maternal and Paternal grandparent support reduced effects of weaker father support on both types of problem; and was more protective than High Maternal grandparent support against internalizing problems.

CONCLUSION

Weaker patterns of nonresident father support in early childhood, characterized by low involvement and interparental tensions or by no contact, were associated with poorer middle childhood adjustment. Support from both sets of grandparents offered children most protection against the effects of weaker father support.

Single mothers by choice: Parenting and child adjustment in middle childhood

Findings are presented of the second phase of a longitudinal study of families created by single mothers by choice. Forty-four single heterosexual mothers were compared with 37 partnered heterosexual mothers, all with a donor-conceived child aged around 8-10 years. Standardized interview, observational, and questionnaire measures of maternal wellbeing, mother-child relationships and child adjustment were administered to mothers, children, and teachers. There were no differences in maternal mental health, the quality of mother-child relationships or children's emotional and behavioral problems between family types. However, higher levels of parenting stress and higher levels of children's prior adjustment difficulties were each associated with children's adjustment difficulties in middle childhood irrespective of family type. The findings suggest that the presence of two parents-or of a male parent-is not essential for children to flourish, and add to the growing body of evidence that family structure is less influential in children's adjustment than the quality of family relationships. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Low-Income Parents' Perceptions of and Engagement With a Digital Behavioral Parent Training Program: A Mixed-Methods Study

BACKGROUND: Parent training is a method for strengthening parenting skills, reducing child behavior problems, and promoting positive parent-child relationships. However, few parents have access to these evidence-based programs. The ezParent program, a tablet-based delivery adaptation of the group-based Chicago Parent Program, is a parent training program designed to address the needs of families raising young children in urban poverty. AIMS: This study aimed to explore (a) parents' perceptions of the benefits and barriers associated with their use of the ezParent program and (b) the ways in which the ezParent components and perceived usability varied by program use (module completion). METHOD: An explanatory mixed-methods design was used with the overall intent to use the qualitative data to help explain in greater detail the quantitative results. RESULTS: Fifty-nine parents of 2- to 5-year-old children from two pediatric primary care clinics serving predominantly low-income and racial/ethnic minority families in Chicago (Cohort 1) and Baltimore (Cohort 2) participated in follow-up interviews. Among those interviewed, 23 (38.9.5%) parents completed all six modules and 12 parents (20.3%) completed none of the modules. However, of those 12, 8 (67%) logged in to the program and completed portions of Module 1. Parents who completed more modules reported more program benefits, and those who completed fewer modules reported more barriers. CONCLUSIONS: Exploring users' experience with current digital applications, researchers and application developers can better design future tablet-based interventions to be both effective and acceptable by consumers.

Pupillary and Attentional Responses to Infant Facial Expressions in Mothers Across Socioeconomic Variations

Maternal responses to infant facial expressions were examined in two socioeconomically diverse samples of South African mothers (Study I, N = 111; and Study II, N = 214; age: 17-44 years) using pupil and gaze tracking. Study I showed increased pupil response to infant distress expressions in groups recruited from private as compared to public maternity clinics, possibly reflecting underlying differences in socioeconomic status (SES) across the groups. Study II, sampling uniformly low-SES neighborhoods, found increased pupil dilation and faster orientation to expressions of infant distress, but only in the highest income group. These results are consistent with maternal physiological and attentional sensitivity to infant distress cues but challenge the universality of this sensitivity across socioeconomic diversity.

Stress, Resilience, and Well-Being in Italian Children and Their Parents during the COVID-19 Pandemic

The novel coronavirus (COVID-19) outbreak has forced parents and children to adopt significant changes in their daily routine, which has been a big challenge for families, with important implications for family stress. In this study, we aimed to analyze the potential risk and protective factors for parents' and children's well-being during a potentially traumatic event such as the COVID-19 quarantine. Specifically, we investigated parents' and children's well-being, parental stress, and children's resilience. The study involved 463 Italian parents of children aged 5-17. All participants completed an online survey consisting of the Psychological General Well Being Index (PGWB) to assess parental well-being, the Strengths and Difficulties Questionnaire (SDQ) to measure children's well-being, the Parent Stress Scale (PSS) to investigate parental stress, and the Child and Youth Resilience Measure (CYRM-R) to measure children's resilience. The results show that confinement measures and changes in daily routine negatively affect parents' psychological dimensions, thus exposing children to a significant risk for their well-being. Our results also detect some risk factors for psychological maladjustments, such as parental stress, lower levels of resilience in children, changes in working conditions, and parental psychological, physical, or genetic problems. In this study, we attempted to identify the personal and contextual variables involved in the psychological adjustment to the COVID-19 quarantine to identify families at risk for maladjustment and pave the way for ad hoc intervention programs intended to support them. Our data show promising results for the early detection of the determinants of families' psychological health. It is important to focus attention on the needs of families and children-including their mental health-to mitigate the health and economic implications of the COVID-19 pandemic.

Psychological distress among low-income mothers: the role of public and private safety nets

Poverty is linked with a host of negative outcomes. Approximately one-third of unmarried mothers and their children live in poverty in the United States. Public and private supports have the potential to mitigate the adverse effects of poverty; however, these supports may be unstable over time. The purpose of this study was to determine public and private safety net configurations of low-income mothers longitudinally and test linkages between safety net configurations and maternal psychological distress. Using longitudinal data from the Welfare, Children, Families project conducted in 1999, 2001, and 2005 (n = 1,987), results of multilevel models of change indicated that less than one-half of low-income mothers used public assistance and had private support at any one point. Safety net configurations and psychological distress levels changed over time with deterioration occurring more than improvement, and private safety net availability offered protection from psychological distress. These findings can be used to inform family support services and highlight the need to augment public assistance programs with services aimed to also address maternal psychological well-being and social support. Doing so can be a means of improving the public and private safety nets and outcomes of vulnerable families.

Mothers who have given birth at an advanced age - health status before and after childbirth

Women postpone childbirth to an age when morbidity is higher and fertility has decreased and yet the knowledge of mothers' morbidity related to age remains scarce. Swedish national register data from the Medical Birth Register and National Patient Register was used to investigate the incidence of diseases listed in the International Classification of Diseases, version 10 (ICD-10) in women who gave birth 2007-8. The index group consisted of women 40 years of age or older (n = 8 203) were compared to a control group of women, younger than 40 years (n = 15 569) at childbirth. The period studied was five years before childbirth to five years after. The main outcome measures were incidence of disease diagnosed in specialized hospital care. Demographical data and use of assisted reproduction (ART) were adjusted for. The results showed that older women were more likely to be single; less frequently used tobacco; were educated on a higher level; had a higher BMI and more often had used ART to become pregnant. The older women showed a higher morbidity rate. In the diagnostic groups: Neoplasms, Blood and immune system, Eye and adnexa, Ear and mastoid, Circulatory, Digestive, Skin and subcutaneous tissue, Musculoskeletal and connective tissue, and Genitourinary. The results add to the body of knowledge of a number of specific risks faced by older mothers and may be used to identify preventive actions concerning fertility and morbidity both before and after childbirth.

Single mothers' subjective well-being: empirical evidence from Malaysia

The authors' purpose of this study is to investigate the antecedents of single mothers' subjective well-being. A questionnaire-based survey was conducted using a multi-stage random sampling technique. Data were analyzed using Partial Least Square Structural Equation Modeling. The main findings are: (1) religiosity and locus of control positively influenced subjective well-being, (2) locus of control negatively influenced financial strain, (3) financial strain negatively influenced subjective well-being, and (4) age moderated the relationship between financial strain and subjective well-being. Implications and future research suggestions are discussed.

Toward fostering resilience on a large scale: Connecting communities of caregivers

In interventions for at-risk children, Tom Dishion strongly exhorted programs that are short term, cost-effective, and delivered in families' own communities, just as resilience researchers underscore the need for programs that provide ongoing support for children's primary caregivers, and are implementable on a large scale. Presented here are preliminary results on a short-term intervention for mothers, the Authentic Connections Virtual Groups. A previous randomized trial of the in-person version of this program, conducted with mothers at high risk for stress and burnout, showed significant benefits. There had been zero dropouts across the 3-month program, and participants showed significant improvements on psychological indices as well as cortisol, even 3 months after the program ended. In the present study, virtual groups were conducted with five sets of women, all white-collar professionals with highly stressful, exacting careers, and most also primary caregivers of their children. Again, there were zero dropouts. Mean satisfaction ratings were 9.6 of 10, and the Net Promoter Score (promoters vs. detractors) fell in the "world class" range. To illuminate mechanisms of change, participants' responses to open-ended questions on the groups' value are presented verbatim. Recurrently mentioned were the development of new, authentic connections and invaluable ongoing support. These results, with the low costs and ease of women's attendance, attest to the value of expanding offerings such as these, toward benefiting even more highly stressed mothers themselves as well as the children for whose care they are responsible.

Family Member Incarceration, Psychological Stress, and Subclinical Cardiovascular Disease in Mexican Women (2012-2016)

Objectives. To examine the association between family member incarceration, psychological stress, and subclinical cardiovascular disease (CVD).Methods. Between 2012 and 2016, 1849 CVD-free women from the Mexican Teachers' Cohort responded to questions on family incarceration from the Life Stressor Checklist. Perceived stress and hair cortisol levels were measured in a subset of participants. Carotid intima-media thickness was measured, and carotid atherosclerosis was determined in all participants. We used multivariable quantile, linear, and logistic regression models to evaluate the association between family member incarceration, stress, and subclinical CVD.Results. Among women with a mean age of 49.7 years (SD ±5.2), 15.3% reported family member incarceration. We found that both perceived stress and hair cortisol levels were significantly higher in women with an incarcerated family member relative to women without one. After multivariable adjustment, women who reported family member incarceration had 41% (95% confidence interval = 1.04, 2.00) higher odds of carotid atherosclerosis compared with those who did not.Conclusions. Family member incarceration was associated with robust markers of stress and cardiovascular risk. Mass incarceration may have a long-lasting impact on physical health of affected families.

Does hair cortisol really reflect perceived stress? Findings from low-income mother-preschooler dyads

Hair cortisol concentration (HCC) has emerged as an objective biological measure of stress in humans, but findings on the relationships between perceived stress and HCC and between mothers' HCC and children's HCC are inconsistent. To advance the understanding of HCC and its relationship with perceived stress, this study aimed to examine the relationships among mothers' HCC, perceived stress, distress, coping, and preschoolers' HCC in a low-income population. A correlational study was conducted with 35 Head Start mother-preschooler dyads. Mothers' mean HCC was 6.97 pg/mg, and preschoolers' mean HCC was 32.02 pg/mg. The receiver operating characteristic analysis identified an optimal HCC cutoff of 4.1 pg/mg based on the 10-item Perceived Stress Scale to divide mothers into low and high HCC groups. Mothers' perceived stress was negatively related to their HCC (ρ = -0.49, p = 0.005). While there were no statistically significant relationships between mothers' HCC and their perceived distress or coping in the low HCC group, mothers' HCC in the high HCC group was positively related to their perceived coping (ρ = 0.53, p = 0.036). Mothers' HCC was positively correlated with preschoolers' HCC (ρ = 0.39, p = 0.030). In the high HCC group, mothers' perceived stress and distress had very small correlations with preschoolers' HCC. In contrast, in the low HCC group, mothers' perceived stress and distress had very large correlations with preschoolers' HCC (ρ = 0.83, p < 0.001; ρ = 0.74, p = 0.001, respectively). The findings suggest mothers' coping ability plays a significant buffering role in modifying the influence of mothers' perceived stress on preschoolers' stress; however, considering the limited sample size, this conclusion warrants further investigation. This study provides an important foundation for studying HCC in low-income mothers and their preschoolers.

Informal Networks of Low-Income Mothers: Support, Burden, and Change

OBJECTIVE

The authors examined the support and burden of low-income, urban mothers' informal networks.

BACKGROUND

Living or growing up in poverty strongly predicts barriers and instability across several life domains for mothers and their children. Informal networks can play a critical role in promoting maternal and child well-being particularly in the midst of poverty. Understanding informal support and the reciprocal burden it may create is especially relevant for low-income families living with a reduced public safety net in the post-welfare reform era. Therefore, study aims were to measure support and burden among low-income mothers and determine if support and burden change over time.

METHOD

Data were from the Welfare, Children, Families (WCF) project, a longitudinal study of 2,400 low-income, caregivers of children and adolescents living in Boston, Chicago, or San Antonio (http://web.jhu.edu/threecitystudy/index.html)). We applied latent class analyses to support and burden indicators in four domains-emotional, favor, child care, and financial.

RESULTS

Results supported four profiles of informal networks - healthy, unhealthy, burden only, and support only. Although most mothers had healthy informal networks, approximately one-third experienced no support or support imbalance which related to network changes at later time points. Demographic characteristics largely were not predictive of support profile or profile change.

CONCLUSION

Although many mothers had healthy support and burden, the most vulnerable did not have consistently healthy informal networks. The identification of a sizable minority of low-income mothers who cannot consistently rely on informal support is significant in light of diminished formal supports available to children and families.

Intergenerational continuity in alcohol misuse: Maternal alcohol use disorder and the sequelae of maternal and family functioning

Early onset of alcohol use is associated with a host of detrimental outcomes. As such, understanding the complex etiology of early onset alcohol use for prevention purposes is an important goal. Specific environmental stressors within the family (i.e., financial stress, negative parental well-being and negative family climate) heighten the risk of early onset alcohol use; however, the extent to which these factors are set in motion by prior maternal history of alcohol misuse has yet to be investigated. We used prospective, longitudinal data from 385 mother-child dyads to examine the link between a maternal alcohol use disorder and her child's early onset of alcohol use through the sequelae of maternal financial strain, maternal depressive symptoms, maternal excessive alcohol use, and negative family climate. Results indicate that a maternal alcohol use disorder itself, and the confluence of a maternal alcohol use disorder, subsequent financial strain, and depressive symptoms produce a negative family climate. In turn, a negative family climate increases the likelihood of alcohol use by the age of 15 among offspring. Moreover, we demonstrate that the cascade of consequences on maternal and family functioning linking a maternal alcohol use disorder to her child's early onset of alcohol use is proximal in nature, unfolding concurrently rather than in yearly spans of time. We discuss the implications of these findings with respect to the etiology of early onset alcohol use (and extant theoretical models) and prevention programming. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Mental health among single mothers in Cyprus: a cross-sectional descriptive correlational study

Background

International literature reveals that single mothers experience increased levels of chronic stress, which is mainly due to economic hardship and reduced levels of social support. Eventually this leads to psychological distress. While most of the studies commonly identify that mental health disorders are common among single mothers compared to their married counterparts, the magnitude of the problem might be even larger since diagnosis-specific tools may mask important levels of distress of milder intensity. This study aims to assess the level of mental distress experienced by single mothers as measured by the GHQ-28, and how it is influenced by socioeconomic factors, as well as the level of perceived social support.

Methods

Between January and March 2012, Greek speaking single mothers who reside in Cyprus were recruited by either personal conduct through Single Mothers’ Association (SMA), or by using snowball sampling technic. Mental distress was assessed with the General Health Questionnaire (GHQ-28) and perceived social support with the Social Provision Scale (SPS). All scales were completed anonymously and voluntarily by 316 single mothers. Univariable and multivariable associations with socio-demographic characteristics were investigated using chi-square tests and in multivariable backward stepwise logistic regression models respectively. Odds ratio of psychological distress across decreasing levels of social support were estimated in logistic regression models. .

Results

As many as 44.6% of the sample appeared to experience psychological distress (GHQ-28 total score ≥ 5). Strong associations with all health assessment tools were observed with variables relating to the lowest monthly family income, the presence of economic difficulties, the higher educational level, the age group 35–44 years and pre-existing illness. Social support as perceived by the mothers displayed a strong negative independent association with psychological distress, even after adjusting confounders.

Conclusion

This study highlights that single mothers are very likely to experience poor psychological well-being. With a steady rise in the proportion of single-parent families headed by a mother, these findings highlight a significant issue that would adversely affect many women and consequently their children and the community. It also emphasizes the necessity for interventions and strategies at community level in order to support this vulnerable population group.

Informal Support among Low-income Mothers Post Welfare Reform: A Systematic Review

The vulnerability and instability of low-income mothers situated in a context with a weak public safety net make informal social support one of few options many low-income mothers have to meet basic needs. This systematic review examines (a) social support as an empirical construct, (b) the restricted availability of one important aspect of social support-informal perceived support, hereafter informal support-among low-income mothers, (c) the role of informal support in maternal, economic, parenting, and child outcomes, (d) the aspects of informal support that influence its effects, and (e) directions for future research. Traditional systematic review methods resulted in an appraisal of 65 articles published between January 1996 and May 2017. Findings indicated that informal support is least available among mothers most in need. Informal support provides some protection from psychological distress, economic hardship, poor parenting practices, and poor child outcomes. To promote informal support and its benefits among low-income families, future research can advance knowledge by defining the quintessential characteristics of informal support, identifying instruments to capture these characteristics, and providing the circumstances in which support can be most beneficial to maternal and child well-being. Consistent measurement and increased understanding of informal support and its nuances can inform intervention design and delivery to strengthen vulnerable mothers' informal support perceptions thereby improving individual and family outcomes.

Relations Among Maternal Life Satisfaction, Shared Activities, and Child Well-Being

Maternal well-being is assumed to be associated with well-being of individual family members, optimal parenting practices, and positive developmental outcomes for children. The objective of this study was to examine the interplay between maternal well-being, parent-child activities, and the well-being of 5- to 7-year-old children. In a sample of N = 291 mother-child dyads, maternal life satisfaction, the frequency of shared parent-child activities, as well as children's self-regulation, prosocial behavior, and receptive vocabulary were assessed using several methods. Data were collected in a special study of the Socio-Economic Panel Study (SOEP), a representative longitudinal survey of private households in Germany. Using structural equation modeling, significant positive direct and indirect relations between maternal life satisfaction, frequency of shared parent-child activities, children's self-regulation, prosocial behavior, and receptive vocabulary were found. The more satisfied the mother was, the more she shared activities with her child and the more the child acted prosocially. Furthermore, the higher the frequency of shared parent-child activities, the higher the child scored in all three analyzed indicators of children's well-being: self-regulation, prosocial behavior, and receptive vocabulary. The current study supports the assumption of maternal well-being as the basis of positive parenting practices and child well-being.

Does Parent Training Format Affect Treatment Engagement? A Randomized Study of Families at Social Risk?

We examined whether parent engagement in parent training (PT) differed based on PT format (parent group-based with video versus mastery-based individual coaching with child) in an economically disadvantaged sample of families seeking behavioral treatment for their preschool children in an urban mental health clinic. Parents (N=159; 76.1% mothers, 69.8% African American, 73% low-income) were randomized to one of two interventions, Chicago Parent Program (parent group + video; CPP) or Parent Child Interaction Therapy (individualized mastery-based coaching; PCIT). Parent engagement indicators compared were PT attendance and completion rates, participation quality, and parent satisfaction. Risk factors predictive of PT attrition (parent depression, psychosocial adversity, child behavior problem severity, length of wait time to start PT) were also compared to determine whether they were more likely to affect engagement in one PT format versus the other. No significant differences were found in PT attendance or completion rates by format. Clinicians rated parents' engagement higher in PCIT than in CPP while satisfaction with PT was rated higher by parents in CPP compared to PCIT. Never attending PT was associated with more psychosocial adversity and externalizing behavior problems for CPP and with higher baseline depression for PCIT. Parents with more psychosocial adversities and higher baseline depression were less likely to complete PCIT. None of the risk factors differentiated CPP completers from non-completers. Delay to treatment start was longer for PCIT than CPP. Strengths and limitations of each PT format are discussed as they relate to the needs and realities of families living in urban poverty.