Serious psychological distress among parenting and nonparenting adults

A Systematic Review and Meta-analysis of Parental Depression, Antidepressant Usage, Antisocial Personality Disorder, and Stress and Anxiety as Risk Factors for Attention-Deficit/Hyperactivity Disorder (ADHD) in Children

Poor parental mental health and stress have been associated with children's mental disorders, including attention-deficit/hyperactivity disorder (ADHD), through social, genetic, and neurobiological pathways. To determine the strength of the associations between parental mental health and child ADHD, we conducted a set of meta-analyses to examine the association of parent mental health indicators (e.g., parental depression, antidepressant usage, antisocial personality disorder, and stress and anxiety) with subsequent ADHD outcomes in children. Eligible ADHD outcomes included diagnosis or symptoms. Fifty-eight articles published from 1980 to 2019 were included. We calculated pooled effect sizes, accounting for each study's conditional variance, separately for test statistics based on ADHD as a dichotomous (e.g., diagnosis or clinical cutoffs) or continuous measurement (e.g., symptoms of ADHD subtypes of inattentiveness and hyperactivity/impulsivity). Parental stress and parental depression were significantly associated with increased risk for ADHD overall and both symptoms and diagnosis. Specifically, maternal stress and anxiety, maternal prenatal stress, maternal depression, maternal post-partum depression, and paternal depression were positively associated with ADHD. In addition, parental depression was associated with symptoms of ADHD inattentive and hyperactive/impulsive subtypes. Parental antisocial personality disorder was also positively associated with ADHD overall and specifically ADHD diagnosis. Prenatal antidepressant usage was associated with ADHD when measured dichotomously only. These findings raise the possibility that prevention strategies promoting parental mental health and addressing parental stress could have the potential for positive long-term impacts on child health, well-being, and behavioral outcomes.

Regional Differences in Serious Psychological Distress and Overall Physical and Mental Health

To determine regional differences in the prevalence of overall physical health, overall mental health, and serious psychological distress (SPD). Data from the 2004 to 2016 Medical Expenditure Panel Survey were used for weighted analysis across region. Relationship modifiers considered were sociodemographic factors, health factors, and measures of health expenditures. A higher burden ratio of health care expenditures is negatively associated with health outcomes, across all US regions and insurance. Compared to 2004 values, SPD, overall physical health, and mental health are significantly improved after 2014. This research supports the whole health paradigm, indicating that overall mental and physical health are closely related. The burden of health care costs is an important consideration and related to overall health outcomes, regardless of insurance status or region. These considerations are likely increasingly important to consider with recent global events.

Subjective appraisal of threat (criterion A2) as a predictor of distress in childbearing women

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, has removed criterion A2 from the diagnosis of posttraumatic stress disorder. The current study aimed to assess the claim that criterion A2 has low use in predicting distress, while addressing the shortcomings of previous research looking at criteria A1 and A2. Data from a longitudinal, prospective study was used, with 933 women having been assessed at four time points both prebirth and postbirth. In our sample of women, model comparisons suggest that criterion A2 should be reintroduced into the diagnostic criteria as it provides a better indicator of who goes on to have problems after giving birth than criterion A1 on its own. There is also evidence that this subjective reaction to event confrontation (A2) should include anger, shame, and guilt.

Association of serious psychological distress with health services expenditures and utilization in a national sample of US adults

OBJECTIVE

The Kessler six-item scale has been shown to be a valid and reliable measure of serious psychological distress (SPD) in community samples. We examined the effect of SPD on health service expenditures and utilization for seven categories in a national probability sample of community dwelling adults in the United States.

METHODS

We used the two-step sample selection model to examine the association between SPD and total, office-based, outpatient, emergency department (ED), inpatient, dental, home health and prescription expenditures and utilization in 18,330 US adults who participated in the 2007 Medical Expenditure Panel Survey (MEPS).

RESULTS

SPD was significantly associated with $1735 ( 95% CI: $702-2769) higher total expenditures, $285 higher office expenditures ( 95% CI: $30-539), $183 higher ED expenditures (95% CI: $64-303), $282 (95% CI: $62-503) higher home health expenditures, $614 (95% CI: $403-825) higher prescription expenditures and $41 (95% CI: -$103 to $22) lower dental expenditures. SPD was associated with 3.09 (95% CI: 2.09-4.08) more office visits, 0.27 (95% CI: 0.17-0.36) more ED visits, 0.84 (95% CI: 0.36-1.32) more inpatient visits, 2.93 (95% CI: 0.13-5.70) more home health visits, 8.13 (95% CI: 6.08-10.18) more prescriptions and 0.18 (95% CI: -0.30 to -0.07) less dental visits.

CONCLUSIONS

Among US adults, SPD is associated with significant increases in total expenditures and most other categories of expenditure and utilization. Targeted interventions to mitigate the adverse effects of SPD are needed.

Development and Implementation of a Women’s Health Promotion Program

The Moms for Moms (M4M) program provides mothers the arena necessary to explore new ideas and definitions about mothering as well as skills and strategies concerning parenting, family management, and healthy habits. A participatory approach has been used to understand the development and implementation of the program from the perspective of the participants and community agency staff in an urban city. This approach provides detailed descriptions and interpretations of the shared beliefs, behaviors, and values of the participants as well as how these attributes are shaped by involvement in M4M. The findings from a needs assessment and program feasibility study conducted from August 2006 to June 2008 are used to inform a recently launched Healthy Lifestyles Initiative at a community-based agency for women, to determine if M4M fits within the culture of the organization and to determine the relevance of participatory methods to engage mothers and community agencies in creating health promotion programming.

Influence of number of children on cancer screening among adults in the United States

OBJECTIVE

To investigate the influence of children in the household on the likelihood of reporting cancer screening among adult men and women living in the United States.

METHODS

2004-2006 Medical Expenditure Panel Surveys (MEPS) were used to calculate the probability of self-reported cancer screening by number of children for adult men and women with adjustment for age, sex, marital status, race, education, current smoking status, obesity status, health insurance and having a usual health-care provider.

RESULTS

The largest percentage of persons who had cancer screening was among respondents with no children in the household. In multivariate results, the probability of endoscopy was lower for persons with one child (24%) and two or more children (21%) in comparison with persons with no children living in the household (30%). Prostate-specific antigen (PSA) testing was lower among men with one child (17%) and two or more children (14%) in comparison with no children (22%). Pap smears were lower for women with two or more children (50%) but not different for women with one child (55%) in comparison with no children (56%). Mammograms were lower for women with one child (48%) and two or more children (42%) in comparison with no children in the household (55%).

CONCLUSION

Across several different cancer screening modalities, the probability of screening is lower as the number of children in the household increases. Children may be an additional barrier to screening beyond factors such as socioeconomic status and access to care.

Moderation and mediation in the relationship between mothers' or fathers' serious psychological distress and adolescent substance use: findings from a national sample

PURPOSE

This study estimated percentages of adolescents living with a mother or father with serious psychological distress (SPD), and examined moderation and mediation of the relationships between mother or father SPD and adolescent substance use.

METHODS

We analyzed data from nationally representative samples of adolescents interviewed with their mothers (n = 4734) and fathers (n = 3176) in the combined 2002 and 2003 National Surveys on Drug Use and Health (NSDUHs).

RESULTS

An estimated 4.1% of adolescents living with their father had a father with SPD during the past year, and 11.5% of adolescents living with their mother had a mother with SPD during this time period. A positive association was found between mothers' SPD and adolescent binge drinking (OR = 1.49, 95% CI = 1.01-2.21), but no association was found between fathers' SPD and adolescent binge drinking. Mothers' SPD was associated with increased risk of binge drinking among adolescents aged 14-15 years (OR = 2.52, 95% CI = 1.38-4.60), and fathers' SPD was associated with lowered risk of binge drinking among black adolescents (OR = .08, 95% CI = .01-.79). A positive association was found between mothers' SPD and adolescent illicit drug use (OR = 1.55, 95% CI = 1.08-2.23), but no association was found between fathers' SPD and adolescent illicit drug use. Mothers' SPD was associated with increased risk of illicit drug use among female adolescents (OR = 2.14, 95% CI = 1.24-3.70) and among adolescents of white ethnicity (OR = 1.78, 95% CI = 1.19, 2.68). Parental involvement partially mediated the relationship between mothers' SPD and daughters' illicit drug use; mothers' SPD was associated with lower levels of parental involvement, which in turn were associated with an increased probability of daughters' illicit drug use.

CONCLUSIONS

Overall, parents' SPD is associated differentially with adolescent substance use depending on the gender of parent and adolescent, adolescent age, race/ethnicity, and substance used. Parental involvement appears to be one mechanism through which mothers' SPD influences daughters' illicit drug use. Future research should further consider the interindividual effects of parents' SPD and associated parenting behaviors on adolescent risk behaviors.