The relations between socio-demographic information and negative symptoms, mental health, and quality of life: a latent profile analysis with psychotic patients in Kosovo

The current study aims to identify meaningful psychotic patients' profiles by examining certain combinations of patient's demographic and socio-economic variables (sex, age, marital status, number of children, cohabitant and level of education). Moreover, we aim to assess whether there is any significant effect of class membership (profile) on negative symptoms, health state, and quality of life among psychotic patients. A convenience sample of 103 patients (age: M = 22, SD = 1.75), was drawn from the clinical populations of Kosovo. Demographic and socio-economic data was obtained through individual interviews, meanwhile a battery of questionnaires was used to assess negative symptoms, mental health, and quality of life of patients. The 4-class solution was selected as the best fitting model and used in subsequent analyses. Results indicated a significant effect of class membership on health state, quality of life and negative symptoms. Practical implications are discussed.

Quality of Life in Patients with Chronic Psychotic Disorders: A Practical Model for Interventions in Romanian Mental Health Centers

Background and Objectives: Current psychiatric care is increasingly focusing on patients' quality of life (QoL). Research is still trying to determine the main factors which influence QoL. The present study aims to assess the QoL of patients with chronic psychotic-spectrum disorders, as well as its relation to symptomatology, functionality, adaptive behavior, and perceived level of recovery. Materials and Methods: The study included a sample of 78 patients with chronic psychosis. Symptomatology and illness severity were assessed with the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression Scale-Severity (CGI-S) scales, respectively. The Global Assessment of Functioning Scale (GAFS) and the Adaptive Behavior Assessment System II (ABAS-II)-Adult Form were used for the assessment of patients' functionality, and the Quality-of-Life Inventory (QOLI) scale was applied for the evaluation of QoL. Results: According to the CGI-Severity scale, 20.5% of the patients were borderline mentally ill, and 24.4% were mildly ill. The highest number of patients (34.6%) were moderately ill, while 14.1% and 2.6% were markedly ill and severely ill, respectively. Among the moderately ill patients, more than half (63%) were patients with schizophrenia, 18.5% were patients with delusional disorder, and 18.5% were patients with schizoaffective disorder. Most of the patients (43.6%) presented moderate functioning deficiency, while 38.5% of the patients presented severe deficiency, according to the GAFS score. When assessed with the ABAS, we observed that almost half of the patients (44.9%) showed an average functioning across skill areas in the conceptual, social, and practical domains. A percent of 67.9% of the patients presented an average QoL, while 15.4% and 12.8% showed a very low and low QoL. QoL was not influenced by the patients' symptomatology, gender, and education level. Having children, family support, better social and conceptual skills, and a higher perceived level of recovery was correlated with an increased QoL, hierarchical multiple regression R2 = 0.379, F(9, 68) = 2.616, and p = 0.012. Conclusions: Psychiatric interventions in psychosis should focus not only on symptoms' control, but also on improving social and family support, as well as adaptive skills to increase the patients' QoL.

Parenting Styles and Child's Well-Being: The Mediating Role of the Perceived Parental Stress

In the last decades, consensus from laymen, scholars, and policy-makers has emphasized the role of child-parent relationships to promote child’s development and positive well-being. Parenting style was claimed as one of the crucial factors for the child’s positive adjustment. The main aim of the present study was to investigate the relationships between authoritative and authoritarian parenting styles and child’s difficulties. The mediational role of parent’s perception of a difficult child on the above mentioned relation was taken into account. The study was carried out on a sample of 459 couples including mothers (n = 459) and fathers (n = 459) of children aged 2 to 10 years old who filled in the Parenting Styles & Dimensions Questionnaire short version, the Strengths and Difficulties Questionnaire, and the Parenting Stress Index-short form. Main findings indicated that authoritative style was associated with less child’s maladjustment, while the authoritarian one showed the opposite association. These relationships were partially mediated by the perception of a difficult child, which partially explained the link between parenting style and child’s problems. Above and beyond the role of parent’s perception as a difficult child, parenting styles had an important effect on child’s difficulties. Future studies should replicate these results with other samples, use the spouse version of the parenting styles, control the effect of socio-economic status and other variables related to family functioning, as well as to consider the child’s perception regarding parents’ parenting style.

Risk and Protective Factors Associated With Health-Related Quality of Life of Parents With Mental Illness

Purpose: Health-related quality of life (HRQoL) can be reduced in parents with mental illness (mental illness) who face the dual demands of disabling symptoms and their impact on family, social, and occupational life. This study aimed at analyzing the influence of various factors on HRQoL in parents with mental illness. Method: Baseline data of the German randomized controlled multicenter project CHIMPS (children of parents with mental illness) was used for analyses. The final sample consisted of n = 208 parents with mental illness and n = 197 children and adolescents aged 8-18 years. HRQoL was assessed with the EQ-5D. Results: Parents with mental illness reported significantly lower global and specific HRQoL than the German reference population. They were least satisfied with aspects that relate to anxiety and depression followed by usual activities, pain and discomfort. Better global HRQoL was primarily associated with self-reported physical and mental health, as well as adaptive coping behavior. Associations with mobility, self-care, usual activity, pain and discomfort, anxiety and depression were analyzed and discussed. Conclusions: HRQoL in parents with mental illness is reduced. Clinical interventions should focus on the alleviation of mental health symptoms and probably somatic symptoms and promote adaptive coping skills.

Parenting with mental illness among patients presenting to a teaching hospital in Sri Lanka: Challenges and perceived care needs

Parenting with mental illness is associated with family conflicts, parenting difficulties, low parental confidence and increased mental health and behavioural problems in children. Family focused interventions improve child outcomes by about 40 %. However, such services are not available in Sri Lanka.A cross sectional descriptive study was carried out in the general adult psychiatry follow-up clinics in a Teaching Hospital in Colombo, Sri Lanka to assess the needs of parents with mental illness. A specifically designed interviewer administered questionnaire was used to collect sociodemographic details, difficulties with parenting and perceived care needs. A specifically designed data extraction form was used to gather information from the clinic records, about the parents' illness.Our study revealed that 45.1 % of children knew that their parent had a psychiatric disorder. A total of 67.3 % of parents believed that their mental illness had an impact on their parenting of which, 26.8 % thought that this impact was marked. 67.8 % of parents believed that their illness was having an impact on their children. A total of 36.4 % of parents reported having concerns about their children's behaviour, emotions or relationships but only 16.4 % of them said that they would discuss these with their treating doctor. Our study showed that mental illness in parents had a substantial impact on parenting and their children. However, those who sought professionals help in this regard were few and far between. Services aimed at the specific needs of these parents should be developed.

HIV Status Disclosure through Family-Based Intervention Supports Parenting and Child Mental Health in Rwanda

INTRODUCTION

Few evidence-based interventions exist to support parenting and child mental health during the process of caregiver HIV status disclosure in sub-Saharan Africa. A secondary analysis of a randomized-controlled trial was conducted to examine the role of family-based intervention versus usual social work care (care as usual) in supporting HIV status disclosure within families in Rwanda.

METHOD

Approximately 40 households were randomized to family-based intervention and 40 households to care as usual. Parenting, family unity, and child mental health during the process of disclosure were studied using quantitative and qualitative research methods.

RESULTS

Many of the families had at least one caregiver who had not disclosed their HIV status at baseline. Immediately post-intervention, children reported lower parenting and family unity scores compared with those in the usual-care group. These changes resolved at 3-month follow-up. Qualitative reports from clinical counselor intervention sessions described supported parenting during disclosure. Overall findings suggest adjustments in parenting, family unity, and trust surrounding the disclosure process.

CONCLUSION

Family-based intervention may support parenting and promote child mental health during adjustment to caregiver HIV status disclosure. Further investigation is required to examine the role of family-based intervention in supporting parenting and promoting child mental health in HIV status disclosure.

Parenting Mediates the Impact of Caregivers' Distress on Children's Well-Being in Families Affected by HIV/AIDS

Parental illness imposes great challenges to children's life and mental health. Having a parent infected by HIV may further challenge children's psychological well-being. Existing studies have demonstrated a negative impact of caregiver's distress on children's well-being. Limited studies examined the potential pathways of the link. This study aims to examine whether parenting stress, parenting competence and parental responsiveness can explain the relationship between caregivers' distress and children's well-being. A community sample of children of parents living with HIV and their current caregivers (n = 754 dyads) was recruited in rural central China. Children completed the measures on their psychological well-being and perceived parental responsiveness of their caregivers. Caregivers reported on their psychological well-being, parenting stress, and parenting competence. Structural equation modeling analysis showed that caregivers' distress indirectly affect children's well-being through parenting stress, parenting competence and parental responsiveness. Parenting stress explained the impact of caregiver's distress on parental responsiveness and showed pervasive effects on parenting competence. Our findings lend credence to family-based intervention for children affected by HIV and affirm the importance of incorporating the cognitive, emotional and behavioral components of parenting practices in such intervention.

Through the depths and heights of darkness; mothers as patients in psychiatric care

INTRODUCTION

This study attempts to contribute to the knowledge of caring science and mental health care by means of a profound understanding of the patients' existential world when being a mother in receipt of psychiatric care, with focus on inner processes such as health and suffering. Mothers struggle to cope with the demands of the illness and the responsibility for their children. They see themselves through their children and regard the child as an important part of themselves. Mothers experience guilt and shame related to motherhood, and when they have to relinquish their responsibility as a mother, they consider themselves a failure. Despite a range of practical and emotional difficulties, motherhood involved extremely positive experiences, which provide a purpose as well as fulfilment and meaning in life.

METHODOLOGY

This study is rooted in philosophical hermeneutics inspired by Gadamer with an inductive-deductive-abductive approach. Interpretation of the data was made on different levels of abstraction described as rational, contextual, existential and ontological. The point of departure was the caring science theory about health and suffering and the hermeneutic philosophy of understanding.

RESULT OF THE INTERPRETATION

The interpretation revealed the mothers' experiences of health and suffering as a struggle between the darkness of suffering and their inner source of strength. In the light of the theory of caring, the conscience became visible as the bearer of the human being's inner ethos of love and compassion. Experiences of health and suffering were interpreted as a struggle between guilt and responsibility, where conscience emerged as the road from ontological guilt to responsibility that leads the human being to what is true, beautiful and good in life.

Stepparents and parenting stress: the roles of gender, marital quality, and views about gender roles

Previous research suggests that stepparenting can be stressful, although the mechanisms that contribute to the experience of parenting stress in stepfamilies are less clear. This study examines gender, marital quality, and views about gendered family roles as correlates of parenting stress among 310 stepmothers, stepfathers, and biological mothers and fathers. Findings suggest that stepparents, and especially stepmothers, experience higher levels of parenting stress than biological parents. Findings also suggest that less traditional views about gendered family roles and higher dyadic adjustment are associated with lower parenting stress for stepparents, particularly in combination. Stepparents reporting both of these protective factors were indistinguishable in terms of parenting stress from biological parents. These findings indicate potential pathways to mitigate the stress associated with stepparenting.

Relationship between positive self-recognition of maternal role and psychosocial factors in Japanese mothers with severe mental illness

Mothers with mental illness have positive self-recognition of maternal role (PM), and it is important for parenting. The purpose of this study was to determine the psychosocial factors related to the PM. We recruited a total of 74 women diagnosed as having schizophrenia or mood disorders according to the DSM-IV-TR and who had minor children. Participant completed devaluation-discrimination measure, The social support questionnaire, self-efficacy for community life scale (SECL), parenting stress-short form scale (PS-SF), and Acceptance of maternal role scale. To identify factors predicting the PM, we utilized hierarchical regression analysis. The variables in all blocks explained 53% of the variance in the PM. In the final model, 'hard' living conditions (β = -0.31, P < 0.05), SECL (β = 0.34, P < 0.01) and PS-SF (β = -0.45, P < 0.01) were significant predictors of the PM. Our result indicates that psychosocial approach could enhance the PM.

Narratives by Japanese mothers with chronic mental illness in the Tokyo metropolitan area: their feelings toward their children and perceptions of their children's feelings

Women with mental illness generally have normal fertility rates. Mothers with mental illness think that their children are important for their lives but also experience difficulties in relating to their children. Therefore, it is important to understand the mothers' perception of what experiences influence them or their parenting practices in relationships with their children. We conducted narrative interviews with 20 Japanese mothers who were being treated for either schizophrenia or mood disorders. The data were analyzed using the Modified Grounded Theory Approach. For the mothers, their feelings toward their children and their perception of their children's feelings toward them or their illness influenced the mothers and their parenting practices. Implications for support are discussed and directions for future research are presented.

Relationship between parental psychopathology, parenting strategies and child mental health--findings from the GB national study

BACKGROUND

Parental and child psychiatric disorders have been found to be associated, and this association can be mediated by other psychosocial variables, including parenting attitudes and strategies. As most previous studies included clinical samples, the purpose of this study was to establish the relationship between parental psychopathology and parenting strategies with child psychiatric disorders in a national survey population.

METHODS

The sample included 10,438 children of 5-15 years and their parents, from representative UK households. Families were assessed on child psychiatric diagnosis, parental psychopathology, family functioning, and socioeconomic status. Parenting strategies included using rewards, physical and non-physical punishments towards their child.

FINDINGS

Parental psychopathology scores (OR 3.99, 95% CI 3.13-5.09) and non-physical punishment (OR 1.50, 95% CI 1.27-1.76) were associated with child psychiatric disorders. This association was particularly prominent among children with conduct disorders: parental psychopathology scores (OR 3.13, 95% CI 2.28-4.30) and non-physical punishment (OR 3.19, 95% CI 2.55-3.97). Absence of child psychopathology was associated with a combination of rewarding and non-punitive parenting strategies.

CONCLUSIONS

Although parents in the general population may be using less physical strategies than in the past, non-physical punishment is strongly related to mental health problems in children. Enhancement of positive parenting through universal and targeted interventions is an important preventive strategy.

Care: giving, receiving and meaning in the context of mental illness

Understanding the dynamics of caregiving is essential to providing effective support to individuals and families living with serious mental illnesses. Yet, research in this area has typically explored caregiving without consulting mentally ill people. This paper adds this overlooked viewpoint by exploring the experience of care relationships by people diagnosed with schizophrenia. A secondary analysis of interview data from 21 individuals reveals that relevant dimensions of care relationships include: providers of care; types of care received; self-care; contested practices in care; negotiating practices; recipients of care; and types of care provided to other people. Addressing care within this broader conceptualization can contribute to developing interventions for individuals and families that more fully recognize the potential for people with mental illnesses to be active participants in care relationships.

Timing of mental illness onset and motherhood

The timing of mental illness onset in relationship to birth of children was explored as a possible indicator of the extent to which mothers experienced difficulties in parenting and functioning. Analyses employed data from a longitudinal study of urban-based, primarily minority mothers with mental illness (N = 379) who had parenting responsibility for their minor children. We found that women who were parents first and experienced mental illness onset after the birth of all their children showed the most positive trajectories over the study course. Mothers whose mental illness onset occurred before the birth of any of their children also showed improvements in functioning and symptomatology over time. In contrast, mothers whose mental illness onset had occurred in temporal proximity to the birth of a child showed little improvement. They also were younger, on average, at first birth, and had the largest number of children. Thus, timing of mental illness onset and childbirth may be predictive of longer-term maternal functioning and therefore may be useful in clinical assessment and treatment.