Children's Provision of Family Caregiving: Benefit or Burden?

Filial responsibilities and psychological wellbeing among Chinese adolescents in poor single-mother families: does parental warmth matter?

Introduction

Adolescent children raised in single-mother households, particularly those living in poverty, often need to assume more instrumental and emotional familial responsibilities to cope with family challenges.

Method

This study examined the relationships between these filial responsibilities and adolescent psychological wellbeing, as well as the moderating effect of maternal warmth on these relationships via survey. The sample comprised 325 Chinese adolescent children (43.3% girls; Mage = 13.5) from economically disadvantaged single-mother families in Hong Kong.

Results

The results indicated that adolescents' instrumental filial responsibilities were positively associated with their life satisfaction. Emotional filial responsibilities, on the other hand, were positively linked to life satisfaction and negatively associated with depression. Furthermore, maternal warmth was found to moderate the relationship between emotional filial responsibilities and life satisfaction. Adolescents who perceived higher levels of maternal warmth and performed more emotional filial responsibilities reported greater life satisfaction than those who performed fewer such responsibilities. Furthermore, the moderating effect of maternal warmth on the relationship between instrumental filial responsibilities and life satisfaction varied between boys and girls. Additionally, the age of the adolescent moderated the effect of maternal warmth on the relationship between emotional filial responsibilities and adolescent anxiety.

Discussion

These findings suggest that filial responsibilities do not necessarily impede adolescent wellbeing. Instead, maternal warmth appears to be a crucial family factor that influences the nature of the relationship between filial responsibilities and adolescent wellbeing. These insights are valuable for family scholars and practitioners, informing the design of supportive services to enhance the psychological wellbeing of Chinese adolescents from economically disadvantaged single-mother families.

It isn't just Mom: Gendered provision of family and home responsibilities among emerging adults during COVID-19

Media and research reports have highlighted the disproportionate burden of home and family responsibilities shouldered by women and mothers due to COVID-19-related school/childcare shutdowns. This cross-sectional study extends this line of inquiry to emerging adults. Our study of 329 diverse emerging adults suggests that young women took on more home/family responsibilities than young men amidst the pandemic, and that these duties were associated with symptoms of depression. However, results also indicate that emerging adults who reported greater home/family responsibilities amidst the pandemic also experienced more quality family time, suggesting that pandemic-related challenges may have also been accompanied by opportunities for family connection. Contrary to previous research that has shown home/family responsibilities to be concentrated by SES and race/ethnicity, we found that participants uniformly endorsed COVID-19-related impacts on home/family responsibilities across these demographic distinctions. This could reflect the ubiquity of COVID-19's impact; across race/ethnicity and class-but differentially by gender-young adults faced significant challenges in taking on new home/family roles.

Maternal Distress and Adolescent Mental Health in Poor Chinese Single-Mother Families: Filial Responsibilities-Risks or Buffers?

Single motherhood and poverty have a significant, negative impact on mothers and their children. When their mothers experience maternal distress, adolescent children have to take up more instrumental and emotional filial responsibilities to comfort their mother and adapt to related changes. Based on 325 mother-child dyads of Chinese single-mother families experiencing economic disadvantage, this study examined the relationship between maternal distress and adolescent mental health problems (indexed by anxiety and depression) and the moderating roles of instrumental and emotional filial responsibilities. Results indicated that maternal distress was positively associated with anxiety and depression in adolescent children. In addition, instrumental filial responsibility intensified the associations of maternal distress with adolescent anxiety and depression. Moreover, the moderating role of emotional filial responsibility in the predictive relationship between maternal distress and adolescent anxiety was different in boys and girls. Adolescent girls with more emotional filial responsibility reported higher adolescent anxiety than did those who shouldered less emotional filial responsibility when their mother exhibited more distress, whereas the relationship between maternal distress and adolescent anxiety was stable in boys, regardless of emotional filial responsibility. In short, the present study showed that parentification was likely to occur in poor Chinese single-mother families, and adolescent children who took up a more caregiving role in the family exhibited poorer mental health. Family counselling and tangible support for single-mother families experiencing economic disadvantage are urged.

Parent-Reported Caregiving Roles of Siblings of Children with Inborn Errors of Metabolism

OBJECTIVES

Research examining sibling caregiving contributions to medically complex pediatric patients, including those with inborn errors of metabolism (IEMs), is limited. We assess caregiving roles and attributes of siblings and hypothesize that there will be differences in parent-reported contributions among siblings of children with IEMs and siblings of typically developing (TD) children.

STUDY DESIGN

A convergent parallel mixed-methods study design guided analysis of data from parental surveys and semistructured interviews. Interviews were conducted with parents (n = 49) of children with IEMs and parents (n = 28) of exclusively TD children. We used inductive thematic analysis to identify themes related to sibling caregiving. The caregiving and support roles for siblings (n = 55) of children with IEMs and siblings (n = 42) of TD children were coded to assess each sibling's caregiving contributions and personal attributes.

RESULTS

Logistic regressions, using generalized estimating equations, were fitted. Results showed that siblings of children with IEMs were significantly more likely to provide monitoring (odds ratio [OR]: 3.62, confidence interval [CI]: 1.30-10.07) and emotional/social support (OR: 4.02, CI: 1.67-9.67) than siblings of TD children. Themes arising from interviews with parents of children with IEMs focused on sibling attributes, parental expectations regarding sibling caregiving, and challenges to the sibling-sibling and parent-sibling relationships. Themes revealed nuances in the sibling caregiving experience.

CONCLUSION

Siblings of children with IEMs make meaningful caregiving contributions and may provide care differently than siblings of TD children. Understanding childhood caregiving roles may inform how health care providers and parents encourage sibling caregiving contributions into adulthood.

Racial/Ethnic and Sex/Gender Differences in Sleep Duration Trajectories From Adolescence to Adulthood in a US National Sample

Racial/ethnic and sex/gender disparities in sleep duration have been documented in adolescence and adulthood. Identifying racial/ethnic and sex/gender differences in sleep duration trajectories from adolescence to adulthood can inform interventions on the developmental periods individuals are most at risk for short sleep duration. We examined racial/ethnic and sex/gender differences in self-reported sleep duration trajectories from adolescence to adulthood using data from waves I, III, IV, and V of the National Longitudinal Study of Adolescent to Adult Health (1994-2018; n = 12,593). Multigroup growth mixture modeling was used to enumerate sleep duration trajectories from adolescence to adulthood. There were 3 common trajectory types across race/ethnicity and sex/gender groups: 1) consistent increasing short sleepers (i.e., increasing probability of short sleep into adulthood) (67.3%); 2) late-onset short sleepers (i.e., no probability of short sleep duration in adolescence until adulthood) (20.2%); and 3) early-onset short sleepers (i.e., declining probability of short sleep duration from adolescence into adulthood) (12.5%). The prevalence of the consistent-increasing trajectory was highest among Black male respondents, while late onset was highest among White female respondents and early onset greatest among Latinx male respondents. Findings underscore the need to intervene in early adolescence to prevent short sleep duration in adulthood.

Parentification in Polish Adolescents: a Prevalence Study

This study investigated the prevalence of parentification in a nationwide cross-sectional study. There were N = 47,984 Polish adolescents aged 12-21 (M = 15.60; SD = 1.98; female 52.7%, male 47.3%). The results indicated that more adolescents experienced emotional parentification (toward parents 35.9%; toward siblings 25.2%) as compared to instrumental parentification (toward parents 7.2%; toward siblings 15.5%), which is noteworthy, since emotional parentification is the most detrimental form of parentification in USA samples. Overall, 15.5% of the participants reported a sense of injustice related to their family caregiving roles and 61.2% reported satisfaction related to their family caregiving roles. The results are important given the dearth of prevalence studies.

Quality of Life of Schoolchildren Living with a Long-Term Sick Parent: The Role of Tasks at Home, Life Circumstances and Social Support

This study investigates whether there are differences in quality of life-i.e., psychosomatic complaints and life satisfaction-between schoolchildren with and without a chronically ill or disabled parent at home. It also examines the role played by the intensity of tasks, life circumstances, and social support at home and school. In 2017, a Dutch representative sample of adolescents aged between 12 and 16 (from the Health Behaviour in School-aged Children study) completed a questionnaire about illness of family members, tasks at home, life circumstances and characteristics, social support, psychosomatic complaints and life satisfaction. In total, 5470 schoolchildren who did not have a parent with a chronic illness and 652 who did have a parent with a chronic illness were selected (average age 13.9). Stepwise multilevel logistic regression analyses in STATA were used. Schoolchildren with an ill parent had more psychosomatic complaints and lower life satisfaction than their counterparts without an ill parent, even when controlling for extra task hours, specific life circumstances and characteristics (e.g., more likely to be growing up in a single-parent family or stepfamily and more likely to be female), and lower perceived support. These aspects are also predictors of a lower quality of life. Professionals should address these aspects of the life of schoolchildren with a sick parent in such a way that they are facilitated to make a successful transition to adulthood.

Caring for Elderly People with Severe Conditions: Do Religious Education and Values Make a Difference?

Western societies are experiencing a demographic shift towards an increased elderly population that is often affected by limiting conditions. This growth is not always balanced by a greater concern and assistance from younger cohorts, which could perceive that demand as a heavy burden, especially under conditions where children often move to work far away from their families. The present research tries to understand this challenging situation by studying the attitudes of preadolescents and adolescents towards the elderly. This study has explored the reactions of students between 12 and 17 years old towards images and experiences around the oldest and most frail. The collected data indicate the positive role of religion and spirituality in their concern, and the moderating factor of empathy, with gender and age being less significant in their attitudes towards the elderly in their social environment.

Experiences and needs of children with siblings diagnosed with Type 1 diabetes: A mixed studies systematic review

PROBLEM

The lives of family members for children with Type 1 diabetes mellitus (T1DM) after often shaped around the diagnosis as long-term/life-long care is needed. The combination of illness symptoms, treatment cost, and caregiving demands for T1DM negatively affects family functioning. While the experiences and needs of both parents and children suffering from T1DM are well documented, literature on healthy siblings of children with T1DM remains scarce.

PURPOSE

This systematic review aims to consolidate and examine the experiences and needs of siblings of children with T1DM.

ELIGIBILITY CRITERIA

Qualitative and quantitative studies exploring the experiences and needs of children under 18 years old whose siblings are diagnosed with T1DM.

SAMPLE

Six electronic databases (PubMed, CINAHL, PsycINFO, EMBASE, Scopus and ProQuest) were searched from inception till July 2021. Thirteen studies met the inclusion criteria and were subjected to narrative synthesis.

RESULTS

Four themes were generated from the synthesis: (1) emotional responses to sibling's condition, (2) stepping out of comfort zone, (3) changes in family dynamics, and (4) takeaways and a way forward.

CONCLUSIONS

The impact of T1DM diagnosis on siblings of children with T1DM suggest a need for healthcare providers to provide them better emotional and informational support, and allow them more involvement in the care for their sibling with T1DM.

IMPLICATIONS

Findings from this review will be able to inform policymakers on the development of future support programmes for children with T1DM and their families and encourage clinicians to revise T1DM care plans to be more family-centered. PROSPERO number: CRD42020204985.

Psychosocial functioning in adolescents growing up with chronic disease: The Dutch HBSC study

Many adolescents worldwide (indirectly) grow up with a chronic disease, which may impact their functioning and wellbeing. The objective of this study is to assess whether adolescents with a (family member with a) chronic disease differ from their healthy counterparts in terms of psychosocial functioning. Data from the Dutch 2013 HBSC-survey were used, including 7168 adolescents (Mean_age = 13.7, SD = 1.57, 50.5% female). Participants indicated whether they or one of their family members had a long-term (> 3 months) disease or disability (mental/physical) and were categorized into four groups based on disease presence (none, other, self, both). Psychosocial functioning was assessed in terms of life satisfaction, self-rated health, psychosomatic health, mental health problems, support, substance use, physical exercise, screen time, and school liking. Chronically diseased adolescents (n = 162) reported lower life satisfaction, self-rated and psychosomatic health, more mental health problems, lower peer support, more substance use, and less physical exercise compared to healthy peers. Chronically diseased adolescents who also had a family member with a chronic disease (n = 74) showed comparable outcomes on these life domains, although they did not differ from their healthy peers regarding peer support, substance use, and physical activity. Healthy adolescents with a chronically diseased family member (n = 737) reported significantly lower life satisfaction, self-rated and psychosomatic health, more mental health problems, and less family support compared to healthy peers who grew up in healthy families; however, they reported more positive outcomes than adolescents who had a chronic disease themselves.Conclusion: Having a (family member with a) chronic disease is associated with impaired psychosocial functioning on various life domains. Our findings aid in understanding the psychosocial associates of chronic disease and imply that caregivers should be observant of psychosocial problems among vulnerable adolescents to provide appropriate guidance. What is Known: • Adolescents who grow up with a (family member with a) chronic disease encounter numerous challenges that may be related to poorer developmental outcomes on the long term. What is New: • This study adds a comprehensive overview of the psychosocial functioning of adolescents with a (family member with a) chronic disease, as compared to healthy counterparts that grow up in a healthy family.

Exploring Resiliency and Parentification in Polish Adolescents

Parentification is a form of distorted division of roles and responsibilities in the family where the roles of parent and child are reversed. A situation that goes beyond the child’s capabilities and exhausts resources usually yields numerous negative consequences. Nevertheless, in some circumstances, parentification may be beneficial by shaping resiliency. The main aim of the study was to examine the relations between parentification characteristics and resiliency. There were 208 adolescents (M_age = 14.55; SD_age = 1.00) who participated in the study. Resiliency was evaluated using the Polish Scale for Children and Adolescents SPP-18. Parentification level was measured with the polish Parentification Questionnaire for Youth. The analyses revealed significant relations between parentification and resiliency dimensions. The relations were different based on the participant’s gender. The obtained results underline the role of resiliency in shaping the perception of family role dysfunctions such as parentification.

The intersectionality of gender and poverty on symptom suffering among adolescents with cancer

BACKGROUND

To determine if the intersectionality of gender and poverty is associated with health disparities among adolescents with cancer. We hypothesized unobserved latent classes of patients exist with respect to cancer-related symptoms; and class classification varies by gender-poverty combinations.

PROCEDURE

Cross-sectional data were collected among adolescents with cancer and families (N = 126 dyads) at four tertiary pediatric hospitals. Adolescents were aged 14-21 years, English speaking, cancer diagnosis, not developmentally delayed, psychotic, homicidal, suicidal, or severely depressed. Latent class analysis and multinomial logit models were used for analysis. Patient-Reported Outcomes Measurement Information System (PROMIS) pediatric symptom measures, Short forms, evaluated anxiety, depressive symptoms, pain interference, and fatigue. Family-reported household income used 2016 Federal Poverty Level (FPL) guidelines.

RESULTS

Three distinct groups of patients were identified using PROMIS symptom patterns: High Distress-25%; High Physical/Low Psychological Distress-14%; and Low Distress-62%. Female adolescents living in households with incomes at or below the 2016 FPL had 30 times the odds of being classified in the High Distress class (higher probabilities of experiencing anxiety, depressive symptoms, pain interference, and fatigue) compared to those in the High Physical/Low Psychological Distress class (female and poverty: AOR = 30.27, 95% CI 1.23, 735.10), and this was statistically significant (β = 3.41, 95% CI 0.21, 6.60; p = .04) but not compared to those in Low Distress.

CONCLUSION

Adolescent females with cancer with households in poverty had significantly greater odds of experiencing high symptom distress, compared to those with high physical but low psychological distress. More comprehensive screening and intervention, as needed, may decrease disparities.

Factors associated with quality of life for children affected by parental illness or substance abuse

BACKGROUND

There have been inconsistent findings from studies examining factors associated with quality of life (QoL) for children affected by parental illness.

AIM

The aim of this study was to explore factors associated with self-reported QoL in children affected by parental illness or parental substance abuse.

DESIGN

A cross-sectional multicentre study.

METHODS

The sample included 246 families with children 8-18 years recruited via ill parents who received treatment for severe physical illness, mental illness or substance abuse in specialised health services. We performed multiple linear regression analyses to examine factors associated with the children's self-reported QoL.

MAIN OUTCOME MEASURE

KIDSCREEN-27.

RESULTS

The children's self-reported QoL was positively associated with the ill parent's self-reported physical health, the children's self-reported social skills, the degree to which other adults took over the ill parent's responsibilities, provision of sibling care, provision of health care for the ill parent and positive outcome of caregiving. The children's QoL was negatively associated with the children's self-reported responsibilities due to parental illness, provision of emotional care for the ill parent, negative outcomes of caregiving and external locus of control. The model explained 63% of the variance (adjusted R2 ) in children's total QoL.

STUDY LIMITATIONS

Sampling bias may have occurred during recruitment.

CONCLUSIONS

The findings suggest factors of importance for the children's QoL. Clinicians should assess whether an ill parent's physical health may influence negatively on their ability to perform daily responsibilities at home and care for their children, and clinicians can use children's self-reported QoL to identify children who are most negatively affected.

Demographic, health, and economic transitions and the future care burden

The COVID-19 pandemic has caused millions of infections and deaths worldwide, forced schools to suspend classes, workers to work from home, many to lose their livelihoods, and countless businesses to close. Throughout this crisis, families have had to protect, comfort and care for their children, their elderly and other members. While the pandemic has greatly intensified family care responsibilities for families, unpaid care work has been a primary activity of families even in normal times. This paper estimates the future global need for caregiving, and the burden of that need that typically falls on families, especially women. It takes into account projected demographic shifts, health transitions, and economic changes in order to obtain an aggregate picture of the care need relative to the potential supply of caregiving in low-, middle- and high-income countries. This extensive margin of the future care burden, however, does not capture the weight of that burden unless the quantity and quality of care time per caregiver are taken into account. Adjusting for care time given per caregiver, the paper incorporates data from time-use surveys, illustrating this intensive margin of the care burden in three countries that have very different family and economic contexts-Ghana, Mongolia, and South Korea. Time-use surveys typically do not provide time data for paid care services, so the estimates depend only on the time intensity of family care. With this caveat, the paper estimates that the care need in 2030 would require the equivalent of one-fifth to two-fifths of the paid labor force, assuming 40 weekly workhours. Using the projected 2030 mean wage for care and social service workers to estimate the hypothetical wage bill for these unpaid caregivers if they were paid, we obtain a value equivalent to 16 to 32 percent of GDP in the three countries.

The Relations Among Types of Parentification, School Achievement, and Quality of Life in Early Adolescence: An Exploratory Study

Children who experience parentification may have trouble performing developmental tasks due to being overwhelmed by their family caregiving roles and responsibilities. Past studies have found that parentification is negatively associated with academic achievement. However, most of these studies are limited in that they are retrospective and examine the association but not the mechanisms shaping them. The aim of the study was to explore to what extent diverse types of parentification relate to academic achievement and to what extent these relations are mediated by self-reported quality of life among adolescents. The study sample was composed of Polish early adolescents (N = 191; age: M = 14.61; SD = 1.26). Types of parentification were measured with the Parentification Questionnaire for Youth, and quality of life was assessed with KidScreen27. School achievement was measured based on mean semester grade. We explored the associations among study variables and performed six mediation models in the planned analyses. Overall, bivariate relations were significant in a theoretically expected way, although the effect sizes for these associations were rather small. In the mediation analyses, the results showed that four of the six models were not significant. Different from previous studies, instrumental parentification was positively related to school achievement. Additionally, this positive association was mediated by adolescents' general quality of life. Taken together, the findings were similar and different from the empirical literature base on types of parentification and select outcomes.

Intergenerational caring: a systematic literature review on young and young adult caregivers of older people

BACKGROUND

The theme of young family caregivers of older relatives is still partially uncovered, although the phenomenon is increasing worldwide. This Systematic Literature Review discusses methodological and content issues of ten articles covering this topic, in order to contribute to increase the knowledge and provide suggestions for designing effective support services for adolescent young caregivers. To this purpose, the findings of this review are framed within the caregiving stress appraisal model (renamed CSA model) elaborated by Yates' and collegues, in order to highlight differences between young caregivers and the older ones.

METHODS

Multiple databases including PubMed, Web of Science, Scopus, ProQuest - Psychology Database, CINAHL Complete - EBSCOHost were used to carry out a systematic review of the literature. Additional references were retrieved from experts contacted and research knowledge. The selected articles underwent both methodological appraisal and contents analysis: for every article an appraisal score was calculated and themes and sub-themes were identified.

RESULTS

Out of the ten included studies three were mixed methods, six qualitative and one quantitative. Nine reached a high quality methodological score and one medium. Four main themes emerged from the content analysis: aspects of the caregiving relationship; effects of caregiving; coping strategies; recommendations for services, policy and research.

CONCLUSIONS

Selected studies explored practical features of the relationship between young caregivers and older family members (tasks performed, motivations, coping strategies) and highlighted both positive and negative outcomes on young people's everyday life condition and future development. Nevertheless, these evidences were often limited to small samples that did not allow to make generalizations. More studies are needed including large samples in order to deepen the different aspects of caregiving and design tailored support services.

Non-Parental Family Members as Brokers of Family Social Capital: Compensatory Time Use in India

Non-parental family members are understudied but important brokers of family social capital, especially in contexts without a nuclear-family norm. We used rich time diary data from a sample of 1568 South Indian adolescents to examine the relationships between any time spent with parents, parents' residency status, and the time spent with non-parental family members. We found that adolescents with at least one non-resident parent spent significantly more time with siblings, on average, when compared to adolescents with resident parents. We further found that adolescents spent more time with siblings in educational activities, such as studying, when they had at least one non-resident parent. These findings point to the importance of considering non-parental family members in studies of family social capital, especially in low- and middle-income contexts. Our findings challenge resource dilution theories by demonstrating that siblings themselves act as resources, rather than simply competitors for parental resources.

Role Fulfillment Mediates the Association Between Daily Family Assistance and Cortisol Awakening Response in Adolescents

Family assistance (helping the family) is associated with both positive and negative psychological and biological outcomes during adolescence. However, the association between family assistance and the hypothalamic-pituitary-adrenal (HPA) axis remains unstudied. Thus, we assess how helping the family relates to adolescents' diurnal cortisol, an index of HPA activity, and psychological outcomes. Three hundred and seventy ethnically diverse adolescents (ages 11-18) reported daily helping behaviors and psychological experiences for 14 days and provided four saliva samples per day for 4 days. Multilevel modeling revealed that cortisol awakening response was lower the day after adolescents helped their families more. This association was explained, in part, by perceived role fulfillment (feeling like a good son, daughter, and sibling). Results highlight a possible psychological and biological benefit of assisting the family during adolescence.

Effects of Family Obligation Values and Autonomy Support on Internalizing Symptoms of Vietnamese-American and European-American Adolescents

OBJECTIVES

Although negotiation of family relatedness and personal autonomy is a key developmental task of adolescence, what is most adaptive for adolescents may vary across cultures. The purpose of the present study was to examine whether relations between family obligation values and adolescent internalizing symptoms may vary as a function of the level of parental autonomy support perceived by the adolescent, and to assess the extent to which such associations vary by ethnic group.

METHODS

The study included 614 adolescents (Mean age = 15.57 years, 50% male) from Vietnamese-American (55%) and European-American (45%) backgrounds. Adolescents reported their: (a) family obligation values to (a1) respect, (a2) provide current assistance, and (a3) provide future support to the family, (b) perceived maternal and paternal autonomy support, and (c) internalizing symptoms.

RESULTS

Effects of family obligation values differed across the three subdomains as a function of maternal autonomy support and ethnic group. Family obligation values to respect the family (a1, above) were related to lower levels of internalizing symptoms for both Vietnamese- and European-American adolescents who received high levels of maternal autonomy support. Ethnic differences emerged such that only among Vietnamese-American adolescents, there was a negative relation between current assistance values (a2, above) and internalizing symptoms among adolescents with high maternal autonomy support.

CONCLUSIONS

Overall, findings highlight the importance for parents to nurture adolescents' family obligation values while also promoting their autonomy development.

Crossing boundaries: A pilot study of maternal attitudes about child maltreatment in nine countries

BACKGROUND

Definitions of child maltreatment vary widely between studies, and even more so between different cultural contexts.

OBJECTIVE

In this pilot study, we examine between-country variations in maternal notions about what constitutes child maltreatment.

PARTICIPANTS AND SETTING

The sample consisted of 466 mothers recruited in Chile, China, Greece, Iran, the Netherlands, Portugal, South Africa, Turkey, and Uruguay.

METHODS

All mothers completed a new Q-sort measure, ranking 90 parenting behaviors linked to subtypes of maltreatment (emotional neglect, emotional abuse, physical neglect, and physical abuse) from least to most detrimental to child development.

RESULTS

Between-country agreement regarding the harmfulness of the parenting behaviors was high (r = .45), but there were different patterns of reported harmfulness of subtypes of maltreatment (although driven mostly by deviating patterns in the South African sample). Further, there were significant country effects on the number and type of behaviors labeled as maltreatment (pƞ² = .15), and the number of items labeled as requiring intervention (pƞ² = .19).

CONCLUSIONS

Variations in conceptions of maltreatment need to be studied in larger more representative samples and taken into account in the assessment and treatment of child maltreatment across cultures.

Understanding on the association between informal caregiver characteristics and cognitive function of adults with cancer: a scoping review protocol

INTRODUCTION

Adults with cancer frequently report symptoms such as decline in cognitive function throughout the trajectory of illness. Patients with cognitive deficits need support and assistance from their informal caregivers and often rely on them to manage their symptoms based on their degree of deficits. Patients spend a significant amount of time with their informal caregivers and become interdependent with each other. In spite of their interdependence, it is unclear whether patients' cognitive outcomes (ie, cognitive function) are associated with their informal caregivers. Therefore, the body of literature related to the association between caregiver characteristics and cognitive function of adults with cancer needs to be fully mapped with assessment for knowledge gaps.

METHODS AND ANALYSIS

Methods for this scoping review was informed by the framework proposed by Arksey and O'Malley. Seven electronic databases will be searched: (1) PubMed (MEDLINE), (2) CINAHL, (3) Embase, (4) PsycINFO, (5) Scopus, (6) Sociological Abstracts and (7) ProQuest dissertation abstracts. In addition, the search for grey literature will include the conference abstracts available through Embase, Scopus and Sociological abstracts as well as dissertations available in ProQuest dissertations. All retrieved citations will be independently screened by two authors and eligibility will be determined based on inclusion and exclusion criteria at title and abstract level. Studies meeting inclusion criteria, will be screened at full text level by two reviewers followed by abstraction of included studies. Eligible studies will be collated, summarised and reported using the data charting form that research team developed.

ETHICS AND DISSEMINATION

This scoping review does not require ethics approval. Results of this scoping review will be disseminated via conference presentation and/or publication in a scientific journal.

Familism and inflammatory processes in African American, Latino, and White youth

OBJECTIVE

African Americans and Latinos make up the two largest minority groups in the United States, and compared with Whites, these ethnic minority groups face disproportionate risk for certain physical health problems. However, factors that may protect these groups against early risk for poor health are not entirely understood. Familism, which emphasizes family interdependence and commitment, and is more prevalent among Latino and African American families, may be one such factor. The current study examined whether values and behaviors related to familism were differentially associated with inflammatory processes among White, African American, and Latino youth.

METHOD

Participants were 257 youth who completed measures of familism values and behaviors and whose parents reported on their ethnicity. Participants also provided blood samples for the assessment of proinflammatory cytokine responses to bacterial challenge and of sensitivity to anti-inflammatory features of cortisol and interleukin (IL)-10.

RESULTS

Significant familism values and behaviors by ethnicity interactions were observed. For Latino and African American youth but not for White youth, more familism values were associated with greater sensitivity to IL-10. Additionally, for African American youth, more familism behaviors were associated with decreased cytokine responses to bacterial challenge and greater sensitivity to cortisol and IL-10. By contrast, familism behaviors were associated with lower sensitivity to cortisol in White youth and were not associated with any inflammatory outcomes in Latino youth.

CONCLUSION

This pattern of findings suggests that for African American youth and to some extent for Latino youth, familism values and behaviors may be protective against the elevated risk for poor health they face. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Autonomy-related Parenting Processes and Adolescent Adjustment in Latinx Immigrant Families

It is unclear how autonomy-related parenting processes are associated with Latinx adolescent adjustment. This study uses Latent Profile Analysis to identify typologies of parental monitoring and parent-adolescent conflict and examines their association with Latinx youth's school performance and depressive symptoms. The sample included 248 Latinx 9th and 10th graders (50% female) who completed surveys during fall (Time 1) and spring (Time 2) semesters of the school year. When compared to a high monitoring/low conflict parenting profile, a moderate monitoring/moderate conflict profile was associated with stronger declines in school performance; for boys, a high monitoring/moderately high conflict profile also was associated with greater increases in depressive symptoms. For Latinx immigrant families, researchers should consider monitoring and conflict as co-occurring processes.

Family obligations and asthma in youth: The moderating role of socioeconomic status

OBJECTIVE

Fulfilling family obligations-providing instrumental help to and spending time with family-is a common aspect of family relationships. However, whether fulfilling these obligations links with physical health remains unclear. In this study, we investigated whether fulfilling family obligations was associated with asthma outcomes among youth, and whether these associations differed depending on family socioeconomic status (SES).

METHOD

Participants were 172 youth, 8 to 17 years of age (Mage = 12.1; 54% boys) who had been physician-diagnosed with asthma and reported on family-obligation frequency; completed the Asthma Control Test (ACT; Nathan et al., 2004), a clinical measure of asthma control; and completed a measure of airway inflammation (i.e., fractional exhaled nitric oxide). Parents also completed the ACT in reference to their asthmatic children and reported on family income.

RESULTS

Fulfilling family obligations was not associated with asthma outcomes (βs < .14, ps > .075). However, SES (family income) interacted with family obligations, such that fulfilling family obligations was associated with greater airway inflammation (interaction term β = -.17, p = .023) and poorer parent-reported asthma control (interaction term β = .15, p = .039), only among youth from lower SES backgrounds. Exploratory analyses suggest that these interactions were robust against covariates and were largely consistent across age and the two dimensions of family-obligation behaviors.

CONCLUSION

Findings from this study suggest that among youth from lower SES backgrounds, engaging in more frequent family-obligation behaviors may have negative repercussions in terms of their asthma. (PsycINFO Database Record

Factors deterring dentistry, medical, pharmacy, and social science undergraduates from pursuing nursing as a healthcare career: a cross-sectional study in an Asian university

BACKGROUND

Globally more registered nurses need to be recruited to meet the needs of aging populations and increased co-morbidity. Nursing recruitment remains challenging when compared to other healthcare programs. Despite healthcare students having similar motivation in joining the healthcare industry, many did not consider nursing as a career choice. This study aims to identify the deterrents to choosing nursing among healthcare undergraduates by examining the differences in the factors influencing healthcare career choices and nursing as a career choice.

METHODS

A cross sectional study was conducted using a 35-parallel items instrument known as Healthcare Career Choice and Nursing Career Choice scale. Six hundred and four (n = 604) first year medical, pharmacy, dentistry and social science students from a university in Singapore completed the survey.

RESULTS

Nursing as a career was perceived by healthcare students to be more likely influenced by prior healthcare exposure, the nature of the work, job prospects, and social influences. Lack of autonomous decision making, perceived lower ability to make diagnosis, having to attend to patients' hygiene needs, engendered stigma, and lack of parental support were identified as deterring factors to choosing nursing as a career.

CONCLUSION

An understanding of the deterrents to choosing nursing as career allows policy makers and educational leaders to focus on recruitment strategies. These include providing more exposure to nurses' roles in early school years, helping young people to overcome the fear of providing personal hygiene care, promoting nurses' autonomous nursing practice, addressing gender stigma, and overcoming parental objection.

Sibling relationships as sources of risk and resilience in the development and maintenance of internalizing and externalizing problems during childhood and adolescence

Sibling relationships are a unique and powerful context for children's development, characterized by strong positive features, such as warmth and intimacy, as well as negative qualities like intense, potentially destructive conflict. For these reasons, sibling interactions may be both a risk and a protective factor for the development and maintenance of emotional and behavioral dysfunction. We review evidence indicating that sibling interactions are linked to internalizing and externalizing symptoms and identify possible mechanisms for these associations. Sibling conflict contributes uniquely to symptomatology and may be particularly problematic when accompanied by lack of warmth, which is generally associated with decreased internalizing and externalizing problems. On the other hand, greater warmth can be associated with heightened externalizing symptoms for later-born children who may model the behavior of older siblings. Although it will be important to monitor for increased sibling collusion, several intervention studies demonstrate that it is possible to reduce conflict and increase warmth between brothers and sisters, and that improving sibling interactions can teach children social-cognitive skills that are beneficial in other relationships (e.g., friendships). Developing brief assessment tools differentiating normative from pathogenic sibling conflict would assist clinical decision making. Future intervention work could provide a more stringent test of the hypothesis that strengthening sibling relationships improves children's socio-emotional adjustment.

Ethnic differences in the developmental significance of parentification

Using an ecological framework, this 2-wave longitudinal study examined the effects of parentification on youth adjustment across the transition to adolescence in a high-risk, low-income sample of African American (58%) and European American (42%) mother-child dyads (T1 Mage = 10.17 years, T2 Mage = 14.89 years; 52.4% female). Children's provision of family caregiving was moderately stable from early to late adolescence. Emotional and instrumental parentification evidenced distinct long-term effects on adolescents' psychopathology and the quality of the parent-child relationship. Ethnicity moderated these relations. Emotional and instrumental parentification behaviors were associated with predominantly negative outcomes among European American youth in the form of increased externalizing behavior problems and decreased parent-child relationship quality, whereas emotional parentification was associated with positive outcomes among African American youth in the form of increased parent-child relationship quality, and instrumental parentification was neutral. These findings support a multidimensional view of parentification as a set of culturally embedded phenomena whose effects can only be understood in consideration of the context in which they occur.

Gender differences in the effects of community violence on mental health outcomes in a sample of low-income youth receiving psychiatric care

Previous research suggests that community violence impacts mental health outcomes, but much of this research has not (a) distinguished between different types of community violence, (b) examined gender differences, and (c) focused on youth living in urban poverty. The current study addresses these questions. Participants were 306 youth (23 % girls) and one parent/guardian receiving outpatient psychiatric services for disruptive behavior disorders in a large urban city. Youth and parents reported on youth's experience of different types of community violence (being a direct victim, hearing reports, and witnessing violence), and whether violence was directed toward a stranger or familiar. Outcomes included youth externalizing, internalizing, and posttraumatic stress symptoms assessed via parent and youth reports. Being a direct victim of violence accords risk for all mental health outcomes similarly for both boys and girls. However, gender differences emerged with respect to indirect violence, such that girls who hear reports of violence against people they know are at increased risk for all assessed mental health outcomes, and girls who witness violence against familiars are at increased risk for externalizing mental health symptoms in particular. There are gender differences in violence-related mental health etiology, with implications for intervention assessment and design.

Parentification, substance use, and sex among adolescent daughters from ethnic minority families: the moderating role of monitoring

Guided by structural family systems theory, this study explored the relationship between parentification and adolescent daughters' sexual risk engagement and substance use. We also explored how adolescent reports of parental monitoring moderated the relationship between parentification and adolescent risk. Data were from a cross-sectional, cross-generational study of 176 mother-daughter dyads from low-income, inner-city, ethnic minority families. In this sample, which included a subset of mothers with HIV, parental physical symptoms were associated with slightly higher levels of parentification. Parentification was associated with adolescent daughters' intention to have sex (but not substance use) in a direction opposite to prediction. Higher parentification was associated with lower intention to have sex. Parental monitoring did not moderate relationships between parentification and adolescent risk. These findings highlight that despite the negative influence hypothesized in structural family systems theory, parentification was not associated with risk engagement of high-risk adolescent daughters in ethnic minority families with low income.

Sibling Caretaking Among Mexican American Youth: Conditions That Promote and Hinder Personal and School Success

This study examined how Mexican American youths' extent of sibling caretaking is related to their personal and school adjustment, and whether mothers' gender-role attitudes and youths' familistic beliefs moderate these associations. One hundred and ninety-five Mexican American youth (M age 14.8 years; 64% girls) and their mothers participated in the study. Youth completed questionnaires about their extent of sibling caretaking, their educational aspirations, school involvement, school absences, grades, and their prosocial tendencies. Results indicated that, when examined singly, frequent sibling caretaking was related to youths' higher educational aspirations, greater prosocial tendencies, and more school engagement for older youth, but also to more school absences. When extensive sibling care was coupled with mothers' sex-stereotyped attitudes, youth experienced poorer outcomes. Youth who held strong familistic beliefs and were highly involved in sibling care reported lower educational aspirations, particularly girls. Findings underscore the importance of considering socialization influences when evaluating associations between sibling caretaking and youths' development.

Trying to comfort the parent: a qualitative study of children dealing with parental depression

In this article, we look at children's experiences of parentification in families in which one of the parents is hospitalized for depression. Children (7-14 years old) and their parents were invited for a family interview. Using thematic analysis, we constructed a general framework of 14 children's experiences, guided by the explorative research question: How do children experience parental depression and how do they experience their own caregiving in the family? The thematic analysis revealed eight themes. One of these themes (trying to comfort the parent) was selected for a microanalysis in one family interview. Our study illustrates the process of overt negotiating of caretaking between parent and child with an underlying moral dilemma and related emotions. The dynamic of children hiding their worry can be seen as an answer to the parent's expressed wish to not burden her children. These dynamics are situated in ongoing debates in family therapy literature, and some suggestions for therapeutic practice are formulated.

The nature of caregiving in children of a parent with multiple sclerosis from multiple sources and the associations between caregiving activities and youth adjustment overtime

This study explored youth caregiving for a parent with multiple sclerosis (MS) from multiple perspectives, and examined associations between caregiving and child negative (behavioural emotional difficulties, somatisation) and positive (life satisfaction, positive affect, prosocial behaviour) adjustment outcomes overtime. A total of 88 families participated; 85 parents with MS, 55 partners and 130 children completed questionnaires at Time 1. Child caregiving was assessed by the Youth Activities of Caregiving Scale (YACS). Child and parent questionnaire data were collected at Time 1 and child data were collected 12 months later (Time 2). Factor analysis of the child and parent YACS data replicated the four factors (instrumental, social-emotional, personal-intimate, domestic-household care), all of which were psychometrically sound. The YACS factors were related to parental illness and caregiving context variables that reflected increased caregiving demands. The Time 1 instrumental and social-emotional care domains were associated with poorer Time 2 adjustment, whereas personal-intimate was related to better adjustment and domestic-household care was unrelated to adjustment. Children and their parents exhibited highest agreement on personal-intimate, instrumental and total caregiving, and least on domestic-household and social-emotional care. Findings delineate the key dimensions of young caregiving in MS and the differential links between caregiving activities and youth adjustment.

Um dia na vida de irmãos que cuidam de irmãos

O objetivo deste artigo é descrever a rotina de adolescentes de baixa renda que cuidam de seus irmãos. Participaram do estudo 20 adolescentes de 12 a 16 anos. Foi utilizada uma ficha de dados sociodemográficos, genograma familiar e entrevista semiestruturada sobre um dia de suas vidas. Organizaram-se as atividades relatadas em cinco categorias: cuidado pessoal, cuidado dos irmãos, domésticas, escolares e de lazer. A partir dessas atividades dividiram-se os participantes em três grupos: responsáveis pelo cuidado dos irmãos, ajudam suas mães e sem essas atividades. Os resultados indicaram que adolescentes de ambos os sexos cuidam dos irmãos, mas são as meninas que mais assumem tarefas domésticas. Quando responsabilizados pelo cuidado, suas atividades escolares e de lazer são prejudicadas.

Mexican American Adolescents' Family Caregiving: Selection Effects and Longitudinal Associations With Adjustment

One hundred ten Mexican American adolescents (12 - 17 years) who provide infant care for their older sisters were studied to determine the effects of family caregiving responsibilities on adolescents' adjustment. Controlling for prior adjustment and family context factors, providing many hours of caregiving predicted an increase in youths' school absences and disciplinary problems. Frequent conflict surrounding caregiving was associated with increased stress and depression and lower school grades. Older girls appear to select into caregiving and experience the most problematic outcomes. Strong family obligations were not protective against caregiving stress but, rather, further compromised youths' well-being for those who were highly involved in their family's care.