Psychosocial and biological markers of daily lives of midlife parents of children with disabilities

Disability Is Not a Burden: The Relationship between Early Childhood Disability and Maternal Health Depends on Family Socioeconomic Status

Narratives rooted in ableism portray disabled children as burdens on their families. Prior research highlights health disparities between mothers of disabled children and mothers of nondisabled children, but little is known about how socio-structural contexts shape these inequities. Using longitudinal data from the Future of Families and Child Wellbeing Study (n = 2,338), this study assesses whether the relationship between early childhood disability and maternal health varies by household socioeconomic status (SES). Findings reveal that, on average, mothers of children disabled by age five report worse health than mothers of nondisabled children; however, this pattern is only evident among lower SES mothers and disappears for higher SES mothers. Contextualizing the findings within the systemic ableism literature highlights how-instead of portraying disabled children as burdens on their families-scholars and policymakers should focus on how ableism and poverty burden disabled people and their families in ways that pattern health risks.

Adaptation to changes in COVID-19 pandemic severity: Across older adulthood and time scales

The COVID-19 pandemic has been observed to negatively affect older adults' psychological health compared with prepandemic levels. However, older adults' coping efficacy may differ depending on their age, and little is known about effects of fluctuations in pandemic severity. Two longitudinal studies tested the hypothesis that pandemic severity would affect psychological health and be moderated by age. In Study 1 (N = 111), older adults (aged 62-96) were assessed semiannually before and after the first United States COVID-19 case over up to 10 years. Depressive symptoms and stress, but not cognitive difficulties, were higher during COVID-19; pandemic severity had little effect. Estimated increases were smaller for a 65-year-old than for an 85-year-old. In Study 2 (N = 221), older adults (aged 51-95) were assessed weekly over up to 8 weeks during the COVID-19 pandemic. Higher national pandemic severity was associated with more cognitive difficulties, more depressive symptoms, and more stress. In an opposite pattern from Study 1, estimated increases were larger for a 65-year-old than for an 85-year-old. Old-old adults might be most susceptible to long-term psychological effects of the pandemic era, as in Study 1, but more resilient to short-term effects, as in Study 2. Coping strategies associated with increasing age may be less efficacious for more chronic and severe problems. Conversely, the same coping strategies may be more efficacious for shorter, less severe problems. Differentiating between reactivity to longer term and shorter term pandemic stressors can identify the most resilient or vulnerable ages within older adulthood. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Are all parental experiences equal?: Cluster analysis of salivary cortisol and perception of parental stress in mothers of children with autism spectrum disorder

Many parents of children with autism spectrum disorder (ASD) report high stress levels related to their parenting role. The experience of stress is reflected in physical symptoms and well-being, as observed by abnormal patterns of cortisol regulation. However, it may be a mistake to conceive parenthood as unilaterally stressful as diverse experiences are possible. Mothers of children with ASD provided salivary cortisol samples and self-rated parental stress. The area under the curve with respect to ground was calculated in regard to three daily collection time points. As a group, mothers reported average levels of parenting stress and flat daily cortisol output. The current age of the child and age at the time of diagnosis moderately predicted overall daily cortisol. Hierarchical clusters analysis identified four distinct profiles of stress regulation based on daily cortisol regulation and perception of parental stress. Groups did not differ based on the severity of symptoms related to autism or demographic information. We suggest that other variables, such as stress mediators and secondary stressors, may explain variability in stress regulation. Future research and intervention should perceive the parental experience as heterogeneous and focus on individualizing the support offered in light of diverse experiences.

Biomarkers of stress in caregivers of children with special health care needs: A protocol for systematic review

BACKGROUND

Children with Special Health Care Needs (CSHCN) require greater attention from family caregivers as they present temporary or permanent physical, developmental, behavioral, or emotional issues. This demand for care generates overload and stress among family caregivers. So far, there is no study that gathers the available literature regarding the use of biomarkers to assess stress among caregivers of CSHCN. Hence, we aimed to synthetize and to assess the scientific evidence on biomarkers associated with stress in caregivers of CSHCN.

METHODS

This systematic review and meta-analysis protocol was elaborated following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). The search strategy will be undertaken through 7 electronic bibliographic databases: Embase, MEDLINE/PubMed, Cochrane Library, Web of Science, CINAHL, Scopus, and PsycINFO. In addition, secondary searches in other sources, such as Clinical trials.gov-NIH, The British Library, Pro Quest Dissertations Database, Google Scholar, and medRXiv will be also carried out. The reference section of the included studies will be hand searched for additional relevant studies. There will be no restriction regarding the publication dates or languages for this systematic review. Moreover, in an independently manner, 2 investigators will select studies, perform data extraction, as well as perform a critical appraisal of the risk of bias and overall quality of the selected studies, based on their designs. The heterogeneity among the studies will be assessed using the I2 statistic test. According to the results of this test, we will verify whether a meta-analysis is feasible. If feasibility is confirmed, a random-effect model analysis will be carried out. For data analysis, the calculation of the pooled effect estimates will consider a 95% CI and alpha will be set in 0.05 using the SPSS version 23.0.

RESULTS

This systematic review and meta-analysis will provide better insights regarding the biomarkers associated with stress in caregivers of CSHCN. Hence, consistent data and robust evidence will be provided to help practitioners and decision-makers in this area.

CONCLUSIONS

To the best of our knowledge this study, will be the first to synthetize and critically evaluate the scientific evidence on biomarkers associated with stress in caregivers of CSHCN.

Exploring Parents’ Concerns Regarding Long-Term Support and Living Arrangements for Their Children with Fragile X Syndrome

Given limited data regarding future planning specific to Fragile X Syndrome (FXS) individuals and the growing population of individuals within this community, this study sought to explore the concerns and challenges caregivers of individuals affected by FXS encounter when considering long-term support plans. This involved identifying the reasons individuals with FXS continue to reside with family and the reservations caregivers have regarding future supports and living arrangements. We administered an anonymous online survey consisting of 34 questions assessing eligibility, living arrangements/supports, and future concerns. We found that most individuals with FXS were affected with moderate Intellectual and Developmental Disabilities (IDD) and co-occurring behavioral conditions but had overall good health. The majority of individuals with FXS currently resided with family due to parental desire, their own desire, and the inability to live independently. For one-third of caregivers, the plan for future living arrangements is to continue residing with family members long-term. A large proportion of caregivers had not considered alternative arrangements or were unsure. More than 70% of caregivers of individuals with FXS are concerned about multiple aspects of the individual’s future. Caregivers of younger individuals are the most concerned, but also believe they have time before they need to plan or are unable to currently assess the future need for support.

MYTime: A Mindfulness and Yoga Program to Promote Health Outcomes in Parents of Children With Autism Spectrum Disorder

Background

Parenting a child with Autism Spectrum Disorder can be stressful and result in health consequences for the caregivers, a population that is often overlooked and underserved. While mind-body interventions such as mindfulness yoga can help promote positive health outcomes, limited research has explored the impact of such a program on caregivers of children on the autism spectrum.

Objective

The primary objective of this pilot study was to evaluate the effects of a 12-week mindfulness yoga program (MYtime) on perceived stress, anxiety, and depression among urban caregivers of children on the autism spectrum.

Methods

Twenty-seven parents were randomized into either MYTime (n = 13) or the control group (n = 14). Perceived Stress Scale (PSS) and Depression, Anxiety, and Stress Scale (DASS) were administered.

Results

The MYTime group reported lower stress, depression and anxiety while the control group maintained similar scores across pre- and post-assessment. Following 12 weeks of participation the PSS and DASS scores improved by 25% and 49% respectively for parents in the MYTime group. In comparison, PSS scores worsened by 5% and DASS scores improved by 17% for the Control group. Differences in pre-and post-assessment scores were not significant for either group (P > .05).

Conclusion

The results from this pilot study indicate that a mindfulness yoga program could be considered among feasible interventions aimed at improving the health of parents of children on the autism spectrum.

Examining negative affect, sleep duration, and using food to cope as predictors of weight in midlife women

Midlife women are vulnerable to developing obesity. Behavioral and psychosocial factors including sleep duration, stress eating, and negative emotionality are risk factors. However, little is known about the complex daily interplay between sleep, eating, emotion, and weight among midlife women. The current study examined how daily sleep, using food to cope, and negative emotionality are associated with weight using a daily process research design. An archival analysis was performed using the Midlife in the United States-II study (MIDUS II). The sample consisted of 489 midlife women (40-64 years of age). Variables included ecological momentary assessments of daily sleep duration, using food to cope, and negative affect (means and intraindividual variability) and a standardized measurement of BMI. Sleep duration variability was a significant predictor of BMI, albeit the model only accounted for .8% of the variance in BMI (b = .019, p < .05). In the final adjusted model, sleep duration variability, using food to cope, age, and physical activity were all significant predictors of BMI F(5, 559) = 21.503, p < .001, R² = .161, ⨂R² = .024, p = .001. Variability in negative affect, mean sleep duration or negative affect and the interactions between sleep duration (mean, variability) and negative affect (mean, variability) were not significant. Greater variability in sleep duration and greater use of food to cope predicted higher BMI in this sample across age and physical activity levels. Results highlight that daily health and psychosocial factors play an important role in weight.

Adolescent effects on mothers’ bedtime cortisol: Cognitive interference as a mediating mechanism

Prior studies have shown that parent and adolescent cortisol are associated across days and that this covariation may be adolescent-driven. This study extends this literature by (a) testing whether parents' cognitive interference (i.e., distracting and ruminative thoughts potentially due to worry) mediates the linkages between adolescent and next-day parent cortisol and (b) whether these linkages were moderated by parent gender or warmth. Daily diary data, including bedtime cortisol, were collected on two samples of employees and their adolescent-aged children (N = 318 dyads, M_{youth age}  = 13.18 years, 74% mothers). We tested mediation with autoregressive cross-lagged models. Moderated mediation by parent gender was found in our bedtime cortisol models. Higher adolescent bedtime cortisol levels were associated with higher next-day levels of mothers' cognitive interference. In turn, higher levels of mothers' cognitive interference were linked to higher mothers' same-day bedtime cortisol levels. These linkages were not significant for fathers. Cognitive interference did not mediate the associations between child and parent area under the curve or cortisol awakening response. No moderation was evident for parental warmth. Results suggest that mothers' cognitions play a key role in the transmission of elevated bedtime cortisol levels from adolescents to their mothers.

In Their Own Words: Mothers Narrate the Lived Experience of Raising Children with Developmental Disorders Who Engage in Socially Disruptive Conduct

The occupational role of a mother parenting a child with developmental and socially disruptive conduct is unique. How mothers express their experiences is poorly explored in the literature. This study aims to better understand mothers’ description of their unique experiences in order to better inform interventions. Using a narrative inquiry approach, mothers convey unique stressors related to two central themes (role fulfillment and role support) during a journal writing intervention. Studying mothers’ own words as they attempted to make sense of their experiences aligns with the foundational principles of narrative medicine: People make sense of their experiences through storytelling. Knowledge gained from this research underscores the importance of centering a mother’s voice in order to create effective interventions.

Burden of treatment, emotion work and parental burnout of mothers to children with or without special needs: A pilot study

The psychological phenomenon of Parental Burnout (PB) results from an imbalance between continuous exposure to chronic parenting stress and available coping resources. The study’s aim was to examine relationships between mothers’ perceived burden of treatment and PB, and their ability to utilize emotion work (EW) as a psychological coping resource. Ninety-eight Israeli mothers (46 had children with special needs with disabilities—W-SND, and 52 had children without special needs—WO-SN) completed questionnaires assessing their perception of burden of treatment, EW and PB. According to the findings, mothers of children W-SND reported significantly higher PB, a higher perceived burden of treatment and deeper EW than mothers of children WO-SN. Additionally, among all the mothers, a positive significant correlation was found between perceived burden of treatment and PB, while among mothers of children W-SND, positive correlations were found between their perceived burden of treatment and deep EW, and between deep EW and PB. These findings suggest that among mothers of children W-SND, PB is related to their perception of the burden of treatment and to performing deep EW. Additional psychological, cultural and environmental factors should be investigated, in order to gain new perspectives regarding PB as a psychological phenomenon that affects parenting and the ability to utilize coping mechanisms for mothers generally and for mothers of children W-SND especially.

Parenting a Child with a Neurodevelopmental Disorder

Purpose of Review

Traditional thinking and focus in ‘childhood disability’ have been on the child with the impairment — with the imperative to make the right diagnosis and find the right treatments. The implicit if not direct expectation was that interventions should aim to ‘fix’ the problems. Professionals have led the processes of investigation and management planning, with parents expected to ‘comply’ with professionals’ recommendations. Much less attention has been paid to parents’ perspectives or their wellbeing.

Recent Findings

In the past two decades, we have seen a sea change in our conceptualizations of childhood disability. The WHO’s framework for health (the International Classification of Functioning, Disability and Health (aka ICF)) and CanChild’s ‘F-words for Child Development’ inform modern thinking and action. We now recognize the family as the unit of interest, with parents’ voices an essential element of all aspects of management. The goals of intervention are built around the F-words ideas of function, family, fun, friendships, fitness and future.

Summary

There has been world-wide uptake of the F-words concepts, with increasing evidence of the impact of these ideas on parents and professionals alike. There are important implications of these developments on the structure, processes and content of services for children with neurodevelopmental disorders, their families and the services designed to support them.

Psychological Resources and Biomarkers of Health in the Context of Chronic Parenting Stress

Background

Epidemiological studies link psychological resources to better physical health. One reason may be that psychological resources are protective in stressful contexts. This study tested whether indeed psychological resources are protective against biological degradation for healthy mid-life women under the chronic stress of caring for a child with an autism spectrum disorder diagnosis (“caregivers”).

Methods

We tested whether five types of psychosocial resources (i.e., eudaimonic well-being, autonomy, purpose in life, self-acceptance, and mastery) were associated with biological indices of aging in a sample of mid-life women stratified by chronic stress; half were caregivers (n = 92) and half were mothers of neurotypical children (n = 91; controls). Selected stress and age related biological outcomes were insulin resistance (HOMA-IR), systemic inflammation (IL-6, CRP), and cellular aging (leukocyte telomere length). We tested whether each resource was associated with these biomarkers, and whether caregiving status and high parenting stress moderated that relationship.

Results

All the psychological resources except mastery were significantly negatively associated with insulin resistance, while none were related to systemic inflammation or telomere length. The relationships between eudaimonic well-being and HOMA-IR, and self-acceptance and HOMA-IR, were moderated by parental stress; lower resources were associated with higher insulin resistance, but only for women reporting high parental stress. The well-known predictors of age and BMI accounted for 46% of variance in insulin resistance, and psychological resources accounted for an additional 13% of variance. 

Conclusion

These findings suggest that higher eudaimonic well-being and greater self-acceptance may be protective for the metabolic health of mid-life women, and particularly in the context of high parenting stress. This has important implications given the rising rates of both parental stress and metabolic disease, and because psychological interventions can increase eudaimonic well-being and self-acceptance.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12529-021-10007-z.

Savouring as an Intervention to Decrease Negative Affect in Anxious Mothers of Children with Autism and Neurotypical Children

Savouring is an emotion regulation strategy and intervention that focuses on the process of attending, intensifying and prolonging positive experiences and positive affect associated with these memories. Personal savouring involves a reflection on positive memories that are specific to the individual and do not involve others. In contrast, relational savouring entails reflecting on instances when people were responsive to the needs of their significant others. Such interventions hold potential benefits in enhancing positive affect (PA) and reducing negative affect (NA) for both parents of children with autism spectrum disorder (ASD) and parents of neurotypical children. Adults with greater symptoms of generalised anxiety have been found to have less PA and more NA. However, no study has investigated the effects of a mother’s anxiety symptoms on the efficacy of savouring in enhancing PA and reducing NA. Thus, this paper combined personal and relational savouring to investigate whether savouring may enhance PA and reduce NA of a pooled sample of mothers of neurotypical children and mothers of children with ASD. 52 mothers of neurotypical children and 26 mothers of children with ASD aged 3–7 years old were given a series of questionnaires and randomly assigned to either relational savouring or personal savouring conditions. In relational savouring, mothers were asked to reflect upon a shared positive experience with their child while in the personal savouring condition, a personal positive experience was recalled. Across mothers of children with ASD and neurotypical children, findings suggest that savouring leads to a decrease in NA (p < 0.01) but not increases in PA. Similarly, mothers with higher levels of anxiety experience a greater decrease in NA (p < 0.001) compared to mothers with lower levels of anxiety post-savouring. This study proposes that a brief savouring intervention may be effective among mothers of preschoolers. As lower levels of negative affect is linked to healthier psychological well-being, mothers might be able to engage in more effective and warm parenting after savouring exercises, which would cultivate positive mother-child relationships that benefit their children in the long-term.

Apolipoprotein ɛ4 Allele and Subjective Cognitive Functioning in Parents of Adults With Disabilities

OBJECTIVES

Parents of individuals with disabilities face ongoing responsibilities of providing care and support for their children, even during the child's adulthood. Past research has shown that this caregiving role is linked to chronic stress and subsequent adverse health outcomes for parents, including impaired cognition. This study examines the impacts of genetic risk for cognitive impairment (apolipoprotein [APOE] ɛ4 allele) among parents of adults with disabilities and comparison parents whose adult children do not have disabilities.

METHOD

We performed rank order regression analysis of data from the Wisconsin Longitudinal Study (2004-2006 and 2010-2012 surveys and DNA samples). Participants included parents of adults with disabilities (247 mothers and 159 fathers) and comparison parents whose adult children were not disabled (1,482 mothers and 954 fathers).

RESULTS

Mothers who had adult children with disabilities and who were APOE ɛ4 carriers reported significantly declining levels of subjective cognitive functioning over time, but mothers of adults with disabilities who did not have the APOE ɛ4 allele did not manifest this change. Among comparison group mothers, cognitive change over time was not a function of their APOE ɛ4 carrier status. Fathers' cognitive function did not differ significantly by either parental status or APOE ɛ4 carrier status.

DISCUSSION

The results show that older mothers of adults with disabilities are more susceptible to cognitive impairment than their age peers if they have the genetic risk factor of APOE ɛ4 allele.

Mental health risks of parents of children with developmental disabilities: A nationally representative study in the United States

BACKGROUND

Caring for a child with a developmental disability may affect parents' mental health. There are few longitudinal or nationally representative studies, none on new mental health problems. Studies have few young children, and few adult children.

OBJECTIVE/HYPOTHESES

We hypothesized that parents of children with developmental disability would be more likely to develop mental health problems than other parents.

METHODS

We used the Panel Study of Income Dynamics (PSID, 1997-2017) and its Child Development Supplements, defining developmental disability by diagnoses such as autism spectrum disorder or intellectual disability, and requiring additional evidence of lasting impairment. We linked children's and parents' data spanning 20 years, including 44,264 mental health measurements for 4024 parents of 7030 children. Discrete-time hazard analysis controlled for child and parent characteristics.

RESULTS

About 9.4% of children had developmental disability. Parents of children with developmental disability were more likely to develop mental health problems than other parents. The odds of developing anxiety or depression were higher when an adult child with developmental disability lived independently, nearly 3 times higher for mothers (OR 2.89, CI 2.33-3.59) and more than twice as large for fathers (OR 2.35, CI 1.70-3.26). Compared to fathers whose children did not have developmental disability and challenging behaviors, the odds of psychological distress were over 7 times larger (odds ratio, OR 7.18, 95% confidence interval, CI, 5.37-9.61) for those whose children had developmental disability and challenging behaviors.

CONCLUSIONS

Parents of children with developmental disability may benefit from increased emotional support, respite, and interventions addressing challenging behaviors.

Longitudinal changes in well-being of parents of individuals with developmental or mental health problems

A large body of work demonstrates the impact of caregiving burden on the well-being of parents of individuals with developmental conditions or mental health problems. However, a relative dearth of research examines this impact longitudinally into parents' older age. Objective. The current study examines (1) longitudinal changes in the effect of having a child with a developmental or mental health problem on parental negative affect, psychological well-being, and somatic symptoms, (2) age and gender moderations on these effects, and (3) the unique impact of factors related to the child's condition. Method. This study employs hierarchical linear regression models to examine longitudinal survey data from midlife adults (N = 1,101) from two waves of the National Study of Midlife in the United States (MIDUS). Results. Models revealed some evidence for age attenuation of the impact of caregiving stress. Parents of children with developmental problems still had higher negative affect, poorer psychological well-being, and more somatic symptoms on average than parents in a comparison sample, whereas parents of children with mental health problems only showed evidence of higher negative affect compared to this sample. Within-group analyses also revealed differences between each parenting group into later adulthood. Conclusions. Parents of individuals with developmental or mental health problems may be at risk for poorer well-being late in life. Yet, age and gender differences as well as diagnostic group differences nuance these findings.

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Non-normative parenting poses a risk for parental well-being.

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Parents' elevated negative affect persisted over time, into later adulthood.

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For some parents, health consequences attenuated with age.

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Older parental age was protective for well-being.

Does Empathy Have a Cost? Older Adults and Social Partners Experiencing Problems

BACKGROUND AND OBJECTIVES

Empathy underlies older adults' awareness and responses to their social partners' needs, but it is unclear whether such awareness is beneficial or harmful to older adults' well-being. We examined whether older adults' empathy was associated with having encounters with social partners incurring problems and their own well-being throughout the day.

RESEARCH DESIGN AND METHODS

Participants were adults aged more than 65 years from the Daily Experiences and Well-being Study. These older adults (n = 313) rated empathy and indicated social partners' problems (e.g., health, emotional, and financial problems) in a baseline interview. They also reported encounters with social partners and their mood every 3 hr over 5-6 days.

RESULTS

Multiple regressions showed that more empathic older adults reported a greater proportion of social partners with major life problems than less empathic older adults. Older adults' empathy was not associated with their contact or negative encounters with social partners experiencing problems. Multilevel models revealed that encounters with these social partners had negative consequences for older adults' mood throughout the day; however, these consequences were reduced in more empathic older adults.

DISCUSSION AND IMPLICATIONS

This study emphasizes the importance of empathy in late life and refines our understanding of older adults' social lives and well-being. Findings carry implications for interventions that aim to protect older adults' well-being when their close others incur crises.

Parent Psychological and Physical Health Outcomes in Pediatric Hematopoietic Stem Cell Transplantation

BACKGROUND

Parents of children undergoing hematopoietic stem cell transplantation (HSCT) are at risk of adverse health outcomes due to their intense caregiver demands.

OBJECTIVE

The aim of this study was to describe adverse health outcomes in parents of children who survived an allogeneic HSCT done within the past 1 to 10 years.

METHODS

This cross-sectional study, conducted at a children's hospital in the western United States, enrolled English- and Spanish-speaking parents of children who survived allogeneic HSCT between 2005 and 2015. Outcome measures included Beck Anxiety and Depression Inventories, Perceived Stress and Parent Stress Scales, Physical Symptom Inventory, and Short-Form 36 version 2. Parent scores were compared with normative means. Subsequently, the parent sample was stratified by the amount of time since their child's HSCT for comparison between groups.

RESULTS

Fifty-four mothers and 7 fathers (n = 61) were enrolled. Global mental health scores were lower for parents in the sample compared with norms (P = .003). Parents in the sample reported moderate anxiety and depression (20% and 23%, respectively), yet reported less parenting stress and superior health outcomes compared with norms (P < .001). Social functioning and general health scores were lower for parents whose children survived an allogeneic HSCT done within the past 1 to 4.99 years (P = .012).

CONCLUSION

Parents of survivors of allogeneic HSCT may concurrently experience posttraumatic growth and stress following their child's HSCT.

IMPLICATIONS FOR PRACTICE

Health screening and psychological support for parents of children post-HSCT may help to identify parents at risk of adverse outcomes and allow for early, targeted interventions.

Health of parents of individuals with developmental disorders or mental health problems: Impacts of stigma

OBJECTIVE

Parents of individuals with developmental disorders or mental health problems often provide life-long care and support to their children, which negatively affects their health in part due to chronic stress. This study aimed to examine the experience of stigma as a source of chronic stress among parents of individuals with developmental disorders or mental health problems and the effect of stigma on parental health outcomes.

METHOD

Using data from the Survey of Midlife in the United States (MIDUS 2 and 3), we constructed a sample for a longitudinal analysis including 128 parents of individuals with developmental disorders (e.g., autism, cerebral palsy, epilepsy, Down syndrome, intellectual disabilities, brain injury, ADD/ADHD) or mental health problems (e.g., bipolar disorder, schizophrenia, major depression) and 2256 parents whose children were nondisabled.

RESULTS

Parents who had children with developmental disorders or mental health problems prior to the beginning of the study (i.e., at MIDUS 1) reported higher levels of stigma related to embarrassment/shame and daily discrimination than parents of nondisabled individuals ten years later at MIDUS 2, which in turn were associated with poorer parental health outcomes (poorer self-rated health and a greater number of chronic conditions) nearly a decade after that at MIDUS 3.

CONCLUSIONS

The findings suggest that the stigma associated with parenting a child with disabilities may be one mechanism that places such parents at risk for poor health. Efforts to alleviate the stigma associated with developmental disorders or mental health problems may have beneficial effects on health of parents of individuals with such conditions.

Later Life Impacts of Social Participation on Parents of Adult Offspring With and Without Intellectual and Developmental Disabilities

Social participation is an important resource for parents in old age, and may be particularly important for parents living with adult offspring with intellectual and developmental disabilities. To evaluate whether socializing with friends and family and participating in social organizations protects against depression in old age, this study examined parents of adult offspring with disabilities ( n = 164) and without disabilities ( n = 820). As expected, more socializing with friends and more participating in organizations were associated with fewer depressive symptoms for all parents. However, socializing with family members predicted fewer depressive symptoms only for parents co-residing with their adult offspring with disabilities, suggesting that socializing with family is particularly important for parents providing direct care to adults with disabilities.

Types of Family Caregiving and Daily Experiences in Midlife and Late Adulthood: The Moderating Influences of Marital Status and Age

Guided by the life-course perspective, this study contributes to the family caregiving, aging, and disability literature by examining the daily experiences of three types of family caregivers in midlife and late adulthood. A sample of 162 caregivers from the National Survey of Midlife in the United States study completed interviews, questionnaires, and a Daily Diary Study. Multilevel models showed the patterns of daily time use did not differ by caregiver types. Caregivers of sons/daughters with developmental disabilities (DD) experienced more daily stressors than caregivers of parents with health conditions (HC) and caregivers of spouses with HC. Unmarried caregivers of sons/daughters with DD reported spending more time on daily leisure activities and exhibited greater daily stressor exposure than other family caregivers. Age did not moderate the associations between caregiver types and daily experiences. Findings highlight the important consideration of the caregivers' characteristics to better determine the quality of their daily experiences in midlife and late adulthood.

'Shutting the World Out': An Interpretative Phenomenological Analysis Exploring the Paternal Experience of Parenting a Young Adult with a Developmental Disability

BACKGROUND

An in-depth exploration of the experience of midlife fathers of developmentally disabled young adults (aged 19-32 years) was motivated by a dearth of research in this area (McKnight, PsyPAG Quarterly, 94, 2015, 10).

METHOD

Five fathers participated in semi-structured interviews which were subjected to interpretative phenomenological analysis (Smith, Flowers and Larkin, 2009, Interpretative Phenomenological Analysis: Theory, Method, and Research. London: Sage).

RESULTS

The final thematic structure comprises four inter-related themes. They demonstrate a high degree of concern for children's well-being; the joy adult children confers on their father's lives as well as the difficulties men experience in response to the limited opportunities available to their offspring. Importantly findings also illustrate the way in which men struggle to contend with painful emotions.

CONCLUSIONS

Societal conceptions of masculinity, fatherhood and disability necessarily influence the way fathers experience the world (Yarwood, Fathering, 9, 2011, 150). It is imperative that service providers recognize the particular challenges faced by fathers, seeking ways to better engage and support them.

Psychobiological influences on maternal sensitivity in the context of adversity

This study evaluated prospective longitudinal relations among an index of poverty-related cumulative risk, maternal salivary cortisol, child negative affect, and maternal sensitivity across the first 2 postpartum years. Participants included 1,180 biological mothers residing in rural and predominantly low-income communities in the United States. Multilevel growth curve analyses indicated that an index of cumulative risk was positively associated with maternal cortisol across the postpartum (study visits occurring at approximately 7, 15, and 24 months postpartum) over and above effects for African American ethnicity, time of day of saliva collection, age, parity status, having given birth to another child, contraceptive use, tobacco smoking, body mass index, and breastfeeding. Consistent with a psychobiological theory of mothering, maternal salivary cortisol was negatively associated with maternal sensitivity observed during parent-child interactions across the first 2 postpartum years over and above effects for poverty-related cumulative risk, child negative affect, as well as a large number of covariates associated with cortisol and maternal sensitivity. Child negative affect expressed during parent-child interactions was negatively associated with observed maternal sensitivity at late (24 months) but not early time points of observation (7 months) and cumulative risk was negatively associated with maternal sensitivity across the postpartum and this effect strengthened over time. Results advance our understanding of the dynamic, transactional, and psychobiological influences on parental caregiving behaviors across the first 2 postpartum years. (PsycINFO Database Record

Daily parental knowledge of youth activities is linked to youth physical symptoms and HPA functioning

Considerable evidence documents linkages between parental knowledge of youth activities and youth risky behavior. We extended this research to determine whether parental knowledge was associated with youth physical health, including reports of physical symptoms (e.g., headaches, stomachaches) and a biomarker of hypothalamic pituitary adrenocortical (HPA) axis functioning (i.e., salivary cortisol levels). Participants were children of employees in the Information Technology division of a Fortune 500 company (N = 132, mean age youth = 13.39 years, 55% female) who participated in a daily diary study. Data were collected via telephone calls on 8 consecutive evenings. On 4 study days, cortisol samples were collected at 4 time points (waking, 30 min after waking, before dinner, bedtime). Multilevel models revealed that, at the between-person level, youth whose parents had higher average knowledge about their activities, exhibited lower bedtime cortisol levels. Furthermore, at the within-person level, on days when parents displayed more knowledge than usual (relative to their own 8-day average), youth had lower before-dinner cortisol than usual. Linkages between average parental knowledge and physical health symptoms were moderated by youth age: Younger but not older adolescents whose parents were more knowledgeable had fewer physical health symptoms, on average. A next step is to identify the processes that underlie these associations.

The psychophysiological impact of childhood autism spectrum disorder on siblings

OBJECTIVE

The negative impact of caring for a child with autism spectrum disorder (ASD) on parents' psychophysiological functioning has been widely evidenced. However, siblings, who also face emotional, social and physical challenges associated with having a brother/sister with ASD, have been less widely studied. This study examined the psychophysiological impact of childhood ASD on siblings.

METHODS

A sample of 25 siblings of children with ASD (and their mothers) and a control group of 20 siblings of neuro-typical children (and their mothers) completed questionnaires assessing: (a) demographic and lifestyle information, (b) family characteristics, (c) child behaviour problems, (d) social support and (e) depressive symptomology. Saliva samples were collected at several time points on two consecutive days, and estimates of the cortisol awakening response (CAR), diurnal cortisol slope and mean diurnal cortisol output were derived.

RESULTS

Total depressive symptoms were higher in siblings of children with ASD compared with controls. Group differences with respect to depressive symptomology were driven more by emotional than functional problems. With respect to physiological functioning, groups were comparable on all cortisol indices. In siblings of children with ASD, social support, especially from parents and close friends, predicted total depressive symptoms, as did the behaviour problems of their brother/sister with ASD.

CONCLUSION

Siblings of children with ASD experience greater emotional problems and overall depressive symptoms compared with a control group. Interventions that enhance social support, as well as helping siblings better understand the behaviour problems of their brother/sister with ASD, might be effective for alleviating depressive symptoms.

Daily interactions in the parent-adult child tie: Links between children's problems and parents' diurnal cortisol rhythms

Studies have established that grown children's problems affect parental well-being, but a dearth of research has addressed daily interactions and biological systems that may underlie these associations. This study examined whether parents have different types of daily interactions with adult children who have problems and whether those interactions are associated with variations in parents' diurnal cortisol rhythms. Middle-aged parents (n=197) reported their interactions with adult children for seven consecutive days and provided saliva, analyzed for cortisol, three times a day (wake, 30 min after wake, bedtime) for four of those days. Parents were more likely to report negative encounters but not less likely to report positive interactions or contact with adult children who suffered from problems. Interactions with adult children who had physical-emotional problems had more immediate same day associations with cortisol whereas interactions with adult children who had lifestyle-behavioral problems had more delayed, or next day associations with cortisol. Daily interactions and their associations with the hypothalamic-pituitary-adrenal-axis may be important mechanisms by which adult children with problems negatively affect parental well-being.

Do Fathers' Sexual Behaviors Vary with the Sex of Firstborns? Evidence from 37 Countries

This article investigates whether men's sexual behavior is influenced by the sex of their firstborn children and, if so, at what stage of firstborns' development this occurs. Using standardized data from 37 Demographic and Health Surveys (N = 61,801), I compare the sexual activities, sexually transmitted infection symptoms, and sexual ideologies of fathers with firstborn sons and fathers with firstborn daughters. I also explore whether fathers' attitudes mediate the effects of firstborn sex. The findings indicate that fathers with firstborn sons are less likely to report using condoms and more likely to report paying for sex and having genital ulcers than fathers with firstborn daughters. These differences are limited to the firstborn's adolescent years and are slightly mediated by attitudinal differences. Together, these results raise new questions about the underlying mechanisms linking men's sexual behavior to their children's gendered development.

Parent stress across molecular subtypes of children with Angelman syndrome

BACKGROUND

Parenting stress has been consistently reported among parents of children with developmental disabilities. However, to date, no studies have investigated the impact of a molecular subtype of Angelman syndrome (AS) on parent stress, despite distinct phenotypic differences among subtypes.

METHOD

Data for 124 families of children with three subtypes of AS: class I and II deletions (n = 99), imprinting centre defects (IC defects; n = 11) and paternal uniparental disomy (UPD; n = 14) were drawn from the AS Rare Diseases Clinical Research Network (RDCRN) database and collected from five research sites across the Unites States. The AS study at the RDCRN gathered health information to understand how the syndrome develops and how to treat it. Parents completed questionnaires on their perceived psychological stress, the severity of children's aberrant behaviour and children's sleep patterns. Children's adaptive functioning and developmental levels were clinically evaluated.

RESULTS

Child-related stress reached clinical levels for 40% of parents of children with deletions, 100% for IC defects and 64.3% for UPD. Sleep difficulties were similar and elevated across subtypes. There were no differences between molecular subtypes for overall child and parent-related stress. However, results showed greater isolation and lack of perceived parenting skills for parents of children with UPD compared with deletions. Better overall cognition for children with deletions was significantly related to more child-related stress while their poorer adaptive functioning was associated with more child-related stress. For all three groups, the severity of children's inappropriate behaviour was positively related to different aspects of stress.

CONCLUSIONS

How parents react to stress depends, in part, on children's AS molecular subtype. Despite falling under the larger umbrella term of AS, it is important to acknowledge the unique aspects associated with children's molecular subtype. Identifying these factors can lead to tailored interventions that fit the particular needs of families of children with different AS subtypes.

Intergenerational Support in a Daily Context

PURPOSE OF THE STUDY

Using retrospective global reports, studies have found that middle-aged adults in the United States provide intermittent support to their aging parents and more frequent support to grown children. To date, studies have not examined support middle-aged adults provide to different generations on a daily basis. Daily support may include mundane everyday exchanges that may (or may not) affect well-being.

DESIGN AND METHODS

Middle-aged adults (N = 191, mean age 55.93) completed a general interview regarding family ties, followed by interviews each day for 7 days (N = 1,261 days). Daily interviews assessed support (e.g., advice, emotional, practical help) participants provided each grown child (n = 454) and aging parent (n = 253). Participants also reported daily mood.

RESULTS

Most participants provided emotional support (80%), advice (87%), and practical help (69%) to a grown child and also provided emotional support (61%) and advice (61%) or practical help (43%) to a parent that week. Multilevel models confirmed generational differences; grown children were more likely to receive everyday support than parents. Providing support to grown children was associated with positive mood, whereas providing support to parents was associated with more negative mood.

IMPLICATIONS

Daily intergenerational support was more common than studies using global reports of support have found. Some daily support may be fleeting and not stand out in memory. The findings were consistent with the intergenerational stake hypothesis, which suggests middle-aged adults are more invested in their grown children than in their parents. Nonetheless, middle-aged adults were highly involved with aging parents.

Cognitive Aging in Parents of Children with Disabilities

OBJECTIVE

This study examines the cognitive functioning of parents of children with disabilities, specifically, whether there is an evidence of accelerated cognitive aging among these parents. In addition, the study investigates the moderating influences of two variables: parents' gender and stress from negative parenting experience.

METHOD

The analyses utilize data from the National Survey of Midlife in the United States (2005). The analytic sample consisted of two groups of parents, who completed the cognitive battery, the interview, and the mail-back survey: 128 parents who had children with childhood-onset disabilities and 512 matched comparison parents who had only nondisabled children.

RESULTS

Age differences in episodic memory were more pronounced among mothers of children with disabilities than among mothers with nondisabled children, especially among mothers with higher levels of negative parenting experience. In contrast, there were no interaction effects of parenting status, age, and negative parenting experience among fathers.

DISCUSSION

The results show that parenting children with disabilities over a prolonged period of time jeopardizes cognitive function (especially memory) among older mothers, possibly via the mechanism of heightened parenting stress due to higher levels of negative parenting experience.

Adverse health in parents of children with disabilities and chronic health conditions: a meta-analysis using the parenting stress index's health sub-domain

BACKGROUND

Compared with parents of same-aged children without disabilities, parents of children with disabilities and with chronic health conditions (CHC) show higher levels of stress and depression. Fewer studies, however, examine the physical health of these parents, and studies report mixed findings. Many studies, however, report mother's self-reported health using the Health Sub-domain of Abidin's Parenting Stress Index (PSI). We therefore conducted a meta-analysis comparing the physical health of parents of children with developmental disabilities (DD) and CHC vs. parents of children without DD/CHC in studies utilising this measure.

METHODS

Eligible studies used the long form of the PSI and reported results from the 5-item Health sub-domain. Group comparison effect sizes were synthesised in a meta-analysis, and we also examined the potential relations of child, parent, and study characteristics. Our search yielded 19 eligible studies.

RESULTS

Compared with parents of children without DD/CHC, parents of children with DD/CHC reported higher PSI health problem scores, with a weighted mean effect size of 0.39 (95% CI = 0.23-0.55). Effect sizes ranged from -0.13 to 1.46 and there was evidence of heterogeneity in the effect sizes (τ2  = 0.07; Q18  = 48.64, P < 0.01; I2  = 63.0%). Studies with higher numbers of reporting quality indicators generally reported larger effects and more recent studies showed smaller effects. Although several child and parent characteristics were moderately associated with effect sizes, none reached statistical significance.

CONCLUSIONS

Practitioners should be alerted to the need for health prevention and treatment in this at-risk parent group.

The psychophysiological and health corollaries of child problem behaviours in caregivers of children with autism and ADHD

BACKGROUND

The positive relationship between problem behaviours of children with additional complex needs and psychological distress in their caregivers has been widely evidenced. Fewer studies, however, have assessed the relationship between care recipients' problem behaviours and key physiological processes, relevant for the physical health status of their care providers. This study examined the psychological, endocrine and health corollaries of child problem behaviours in caregivers of children with autism and attention deficit hyperactivity disorder.

METHODS

Caregivers (n = 18) completed self-report measures of psychological distress, child problem behaviours and incidences of commonly occurring ailments. To capture important parameters of the basal diurnal cortisol pattern, caregivers collected saliva samples at waking, 30 min post waking, 1200 h and 2200 h on two consecutive weekdays.

RESULTS

Data revealed a positive relationship between caregivers' perceived levels of stress and problems with child conduct behaviours. In addition, caregivers who reported more problems with child emotional and hyperactivity behaviours displayed atypical cortisol patterns characterised by flatter diurnal cortisol slopes and reduced cortisol awakening response magnitude. Subjective reports of commonly occurring ailments were also greater in caregivers experiencing more problems with child emotional behaviours.

CONCLUSIONS

These findings have implications for interventions that aim to improve the psychophysiological well-being of the caregiver by targeting problem behaviours of the care recipient.

Daily positive events and inflammation: findings from the National Study of Daily Experiences

BACKGROUND

Inflammation is implicated in the development of chronic diseases and increases the risk of mortality. People who experience more daily stressors than others have higher levels of inflammation, but it is unknown whether daily positive events are linked to inflammation.

OBJECTIVE

To examine the association of daily positive events with 3 inflammatory markers, interleukin-6 (IL-6), C-reactive protein (CRP), and fibrinogen.

METHOD

A cross-sectional sample of 969 adults aged 35-86 from the Midlife in the United States Study completed telephone interviews for 8 consecutive evenings. Participants reported positive experiences that occurred over the past 24h. Blood samples were obtained at a separate clinic visit and later assayed for inflammatory markers. Regression analyses evaluated the frequency of daily positive events (defined as the percent of study days with at least 1 positive event) as a predictor of each inflammatory marker. Covariates included information on demographics, physical health, depressive symptoms, dispositional and behavioral factors, and daily positive and negative affect.

RESULTS

On average, participants experienced positive events on 73% of days (SD=27%). The frequency of daily positive events was associated with lower IL-6 (p<0.001) and CRP (p=0.02) in the overall sample, and lower fibrinogen among women (p=0.01). The association remained for IL-6 in the fully adjusted model, but was no longer significant for CRP and fibrinogen after controlling for household income and race. Effects were more pronounced for participants in the lowest quartile of positive event frequency than for those in the top 3 quartiles, suggesting that lack of positivity in daily life may be particularly consequential for inflammation. Furthermore, interpersonal positive events were more predictive of lower IL-6 overall and lower fibrinogen in women than non-interpersonal positive events.

CONCLUSION

Daily positive events may serve a protective role against inflammation.

Midlife as a Pivotal Period in the Life Course: Balancing Growth and Decline at the Crossroads of Youth and Old Age

We provide evidence for multidirectionality, variability, and plasticity in the nature and direction of change in physical health, cognitive functioning, and well-being during the middle years of the life course. The picture of well-being in midlife based on longitudinal data from the Midlife in the United States (MIDUS) study is a more positive one than portrayed in previous cross-sectional studies. We present middle age as a pivotal period in the life course in terms of balancing growth and decline, linking earlier and later periods of life, and bridging younger and older generations. We highlight the role of protective factors and multisystem resilience in mitigating declines. Those in middle age play a central role in the lives of those who are younger and older at home, in the workplace, and in society at large. Thus, a focus on promoting health and well-being in middle age can have a far-reaching impact.

Perceived appearance judgments moderate the biological stress effects of social exchanges

Social relationships are generally thought of as beneficial. However, the present study set out to test the hypothesis that for individuals who perceive others to judge their appearance negatively, daily social interactions can also be a source of stress. Indeed when assessing 38 young adults, we found that both more incidences of negative exchanges reported during the past month as well as perceived negative appearance judgments by others were associated with more self-reported stress. Interestingly, however, for individuals with low attribution body esteem, higher numbers of positive social exchanges during the past month were related to health-relevant changes in biological markers of chronic stress as well. The same was true for individuals with high attribution body esteem who reported to experience only very few positive exchanges. As such, these findings go beyond the initial focus on low body esteem and negative social exchanges and introduce high body esteem as well as daily positive exchanges as potential health risk factors.

Trajectories of diurnal cortisol in mothers of children with autism and other developmental disabilities: relations to health and mental health

This study used a stress biomarker, diurnal cortisol, to identify how elevated stress in mothers of children and adults with autism and other disabilities relates to their health and mental health. Based on semi-parametric, group-based trajectory analysis of 91 mothers, two distinctive cortisol trajectories emerged: blunted (63 %) or steep (37 %). Mothers in the blunted (vs. steep) trajectory had higher stress levels, lower health ratings, and 89 % of mothers of children with autism, and 53 % with other disabilities, belonged to this trajectory. Atypical cortisol awakening responses and evening rises were differentially associated with anxiety, depression, health problems and employment status. Stress-reducing interventions are needed for parents of children with autism and other disabilities that include biomarkers as indices of risk or treatment outcome.

A review of rhythm and responsiveness of cortisol in individuals with autism spectrum disorders

Examination of the hypothalamic-pituitary-adrenal (HPA) axis via cortisol among individuals with autism spectrum disorder (ASD) has been a growing area of research interest. The following review includes investigations of cortisol conducted with cohorts of individuals with ASD across the lifespan over the past four decades. In general, studies find dysregulation when examining the diurnal rhythm as a whole in lower functioning children with ASD; however, limited evidence exists for alterations in higher functioning individuals and in specific aspects of the diurnal cycle (cortisol awakening response, daily decline, variability) relative to typically developing individuals. Studies examining the responsiveness of cortisol in ASD suggest an overall sluggishness of the HPA axis in responding to physiological or physical manipulation. Hypo-responsiveness was observed in stressors that involve social evaluative threat, however, hyper-responsiveness of the HPA axis was observed in situations involving unpleasant stimuli or relatively benign social situations. A number of important considerations when conducting studies of cortisol in ASD cohorts are discussed.

Maternal well-being and child behavior in families with fragile X syndrome

The purpose of this study was to examine the bidirectional relationships relationship between maternal mental health status, maternal stress, family environment and behavioral functioning of children with fragile X syndrome (FXS), the leading cause of inherited intellectual disability. Children with FXS commonly demonstrate challenging behavior related to anxiety, attention, and aggression, whereas mothers of children with FXS have been identified as susceptible to mental health challenges due to their status as genetic carriers of the FXS premutation, as well as the environmental stressors of raising children with special needs. The longitudinal design of this study builds upon prior work that established a concurrent relationship among these factors in families of children with other intellectual disorders. Findings indicated that maternal mental health status was not significantly related to changes in levels of child challenging behavior, heightened child challenging behavior was related to improvements in maternal depression over time, and heightened levels of child challenging behavior was related to increased feelings of maternal closeness toward the child over time. The unexpected nature of the results regarding maternal depression and closeness provides new and more complex hypotheses about how mothers of special needs children demonstrate adaptation and resilience. The findings have implications for maternal and familial mental health treatment as well as future research.

Associated features in females with an FMR1 premutation

Changes in the fragile X mental retardation 1 gene (FMR1) have been associated with specific phenotypes, most specifically those of fragile X syndrome (FXS), fragile X tremor/ataxia syndrome (FXTAS), and fragile X primary ovarian insufficiency (FXPOI). Evidence of increased risk for additional medical, psychiatric, and cognitive features and conditions is now known to exist for individuals with a premutation, although some features have been more thoroughly studied than others. This review highlights the literature on medical, reproductive, cognitive, and psychiatric features, primarily in females, that have been suggested to be associated with changes in the FMR1 gene. Based on this review, each feature is evaluated with regard to the strength of evidence of association with the premutation. Areas of need for additional focused research and possible intervention strategies are suggested.

Depressive Mood, Anger, and Daily Cortisol of Caregivers on High- and Low-Stress Days

OBJECTIVES

This study examines the association of daily cortisol with depressive mood and anger.

METHOD

Depressive mood, anger and 2 markers of cortisol, area under the curve (AUC), and cortisol awakening response (CAR) were examined for caregivers (N = 164) of individuals with dementia (IWDs) across 8 days, some of which IWDs attended an adult day service (ADS) program. Caregivers were primarily female (86.7%) with a mean age of 61.99. First, multilevel models were run with CAR and AUC each as separate covariates of anger and depressive mood. A second set of models examined contextual factors of caregivers (i.e., care-related stressors and amount of ADS use) were added to the models for anger and depressive mood (Model 2).

RESULTS

On days where caregivers had AUCs below their average they expressed higher anger scores. However in Model 2, anger was associated with more care-related stressors, but not ADS use or daily cortisol. Caregivers who on average had smaller CARs were more likely to be depressed. In Model 2, depressed mood was associated with more care-related stressors and a low average CAR.

DISCUSSION

We found that hypocortisol patterns, reflective of chronic stress experienced by caregivers, are associated with negative mood.

Daily Work Stress and Awakening Cortisol in Mothers of Individuals with Autism Spectrum Disorders or Fragile X Syndrome

The effect of daily work stress on the next morning's awakening cortisol level was determined in a sample of 124 mothers (M age = 49.89, SD= 6.33) of adolescents and adults with developmental disabilities and compared to 115 mothers (M age = 46.19, SD = 7.08) of individuals without disabilities. Mothers participated in 8 days of diary telephone interviews and provided saliva samples. Multilevel models revealed that mothers of individuals with developmental disabilities had lower awakening cortisol levels than comparison mothers. Work stress interacted with parental status to predict the awakening cortisol level on the following morning. When mothers of individuals with developmental disabilities experienced a work stressor, their awakening cortisol level was significantly higher on the subsequent morning, but for comparison mothers, work stressors were not significantly associated with cortisol level. Findings extend understanding of the differential impacts of specific types of stressors on physiological functioning of mothers of individuals with and without developmental disabilities.

Cortisol response to stress in caregivers of offspring with autism spectrum disorder is associated with care recipient characteristics

Providing care for people with autism spectrum disorder (ASD) is particularly stressful and frequently associated with disturbances in the hypothalamic-pituitary-adrenal (HPA) axis of the caregiver. This study examined whether the stress response is modulated by factors such as age of the care recipient and number of years spent by the caregiver in providing care for the ASD individual. Caregivers of children (n = 15), adolescents (n = 12), and adults (n = 11) with ASD were exposed to two episodes of acute psychosocial stressor in a 1 day session. Salivary cortisol samples were obtained before, during, and after the stressor episodes. Psychological characteristics (states of anxiety, anger, and mood) were measured before and after the stressor episodes. The characteristics of the ASD individuals (age, degree of autism, global activity, and level of autonomy) were also registered. A difference in stress response was found when caregivers of ASD children were compared with those of ASD adolescents and adults, ε = 0.25, F(2.24,53.65) = 5.82, p < 0.004; ε = 0.23 and F(2.11,48.43) = 4.88, p < 0.01, respectively. Thus, upon acute-stressor exposure, caregivers of ASD individuals presented a stress response that correlated with the age of the patient (the older the patient, the lower the cortisol response). Additional factors, such as number of years spent providing care and level of autonomy of the recipient, also significantly contributed to the stress response. Together, the results demonstrate that recipient characteristics contribute to the detection of high-risk individuals within a caregiver population.

Toddler inhibited temperament, maternal cortisol reactivity and embarrassment, and intrusive parenting

The relevance of parenting behavior to toddlers' development necessitates a better understanding of the influences on parents during parent-child interactions. Toddlers' inhibited temperament may relate to parenting behaviors, such as intrusiveness, that predict outcomes later in childhood. The conditions under which inhibited temperament relates to intrusiveness, however, remain understudied. A multimethod approach would acknowledge that several levels of processes determine mothers' experiences during situations in which they witness their toddlers interacting with novelty. As such, the current study examined maternal cortisol reactivity and embarrassment about shyness as moderators of the relation between toddlers' inhibited temperament and maternal intrusive behavior. Participants included 92 24-month-old toddlers and their mothers. Toddlers' inhibited temperament and maternal intrusiveness were measured observationally in the laboratory. Mothers supplied saliva samples at the beginning of the laboratory visit and 20 minutes after observation. Maternal cortisol reactivity interacted with inhibited temperament in relation to intrusive behavior, such that mothers with higher levels of cortisol reactivity were observed to be more intrusive with more highly inhibited toddlers. Embarrassment related to intrusive behavior as a main effect. These results highlight the importance of considering child characteristics and psychobiological processes in relation to parenting behavior.

The effects of adult day services on family caregivers' daily stress, affect, and health: outcomes from the Daily Stress and Health (DaSH) study

PURPOSE

We examine the effects of use of adult day service (ADS) by caregivers of individuals with dementia (IWD) on daily stressors, affect, and health symptoms. Participants were interviewed for 8 consecutive days. On some days, the IWD attended an ADS program and on the other days caregivers provide most or all of the care at home.

METHODS

Participants were 173 family caregivers of IWDs using an ADS program. Daily telephone interviews assessed care-related stressors, noncare stressors, positive events, affect, and health symptoms. Multilevel models with data nested within persons were used to examine effects of ADS use on daily stressor exposure, affect, and health symptoms.

RESULTS

Caregivers had lower exposure to care-related stressors on ADS days, more positive experiences, and more noncare stressors. ADS use lowered anger and reduced the impact of noncare stressors on depressive symptoms.

IMPLICATIONS

The findings demonstrate that stressors on caregivers are partly lowered, and affect is improved on ADS days, which may provide protection against the effects of chronic stress associated with caregiving.

Daily health symptoms of mothers of adolescents and adults with fragile x syndrome and mothers of adolescents and adults with autism spectrum disorder

Health symptoms of mothers of adolescents and adults with fragile X syndrome (FXS; n = 112) were compared to a nationally-representative sample of mothers of similarly-aged children without disabilities (n = 230) as well as to a sample of mothers of adolescents and adults with autism spectrum disorders (ASD; n = 96). Health symptoms experienced in the previous 24 h were recorded during 8 consecutive days of a daily diary study. Both mothers of a son or daughter with FXS and mothers of a son or daughter with ASD had a higher proportion of days with headaches, backaches, muscle soreness, fatigue, and hot flashes than mothers of children without disabilities. Mothers of children with disabilities appear to be at particular risk for health problems, highlighting a need for comprehensive services for families across the lifespan.