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Löchner J, Ulrich SM, Lux U. The impact of parents' stress on parents' and young childrens' mental health-Short- and long-term effects of risk and resilience factors in families with children aged 0-3 in a representative sample. Stress Health 2024; 40:e3400. [PMID: 38625815 DOI: 10.1002/smi.3400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 02/23/2024] [Accepted: 03/26/2024] [Indexed: 04/18/2024]
Abstract
Stress in parents has a significant impact on parenting and infant's development. However, few studies have examined cross-sectional and longitudinal links on risk and resilience of burdened families. Thus, this study aimed to investigate subjective risk and resilience factors on family well-being. Data stem from the 2015 nationwide study "Children in Germany" ("Kinder in Deutschland" - KiD 0-3). Parents of children aged zero to 3 years (N = 8.063) were recruited from random probability-sampled paediatric clinics (n = 271) across Germany. Risk and resilience variables such as parents' perceived stress (PSS-4), competence, isolation and attachment (PSI), as well as parental inner anger (items from CAP), relationship quality (DAS-4) and the child's negative emotionality (items from SGKS) were assessed at baseline in addition to demographic variables to predict parents' mental health (PHQ-4) and negative emotionality of the child at baseline (T1) and in the 2-year follow-up (T2) using linear regression models. At baseline, parents' mental health was predicted by inner anger, the child's negative emotionality and being a single parent (R2 = 45.1%) at baseline, but only by parenting competence at the two-year-follow-up (R2 = 25.1%). The child's negative emotionality was predicted (R2 = 27.5%) by the child's age, and parental inner anger and competence, attachment, perceived stress, mental health as well as education background. At two-year-follow-up, the child's age, single parenthood, social welfare benefit, child's negative emotionality at baseline, relationship quality and competence were significant predictor variables (R2 = 22.8%). This study highlights the impact of specific risk and resilience factors not only on parents' mental health but also the child's negative emotionality in the short and long-term in early childhood. Universal, but also selective prevention programs should increase parents' resilience (e.g., focusing on self-efficacy, competence, coping strategies).
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Affiliation(s)
- Johanna Löchner
- Department of Child and Adolescent Psychiatry, University Hospital Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Tübingen, Germany
- Department of Families and Family Policies, National Centre for Early Prevention, German Youth Institute, Munich, Germany
| | - Susanne M Ulrich
- Department of Families and Family Policies, National Centre for Early Prevention, German Youth Institute, Munich, Germany
| | - Ulrike Lux
- Department of Families and Family Policies, National Centre for Early Prevention, German Youth Institute, Munich, Germany
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Fricke J, Bolster M, Icke K, Lisewski N, Kuchinke L, Ludwig-Körner C, Schlensog-Schuster F, Reinhold T, Berghöfer A, Roll S, Keil T. Assessment of Psychosocial Stress and Mental Health Disorders in Parents and Their Children in Early Childhood: Cross-Sectional Results from the SKKIPPI Cohort Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:920. [PMID: 39201854 PMCID: PMC11352251 DOI: 10.3390/children11080920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/22/2024] [Accepted: 07/26/2024] [Indexed: 09/03/2024]
Abstract
BACKGROUND/OBJECTIVES Early childhood can be a stressful period for families with a significant impact on parents' mental health, the child's healthy development, and the development of a secure mother-child attachment. The goal of the cross-sectional study part of SKKIPPI was to assess the occurrence of psychosocial stress and mental health disorders in parents as well as in their offspring in early childhood in three German regions. METHODS Based on random samples from three residents' registration offices, parents with infants aged up to 12 months were invited to participate. An online screening questionnaire was developed in four languages to assess common psychosocial stressors and mental health problems of parents with small children. RESULTS The study enrolled 4984 mothers and 962 fathers. The most common potential psychosocial stressors were professional problems (mothers 22%, fathers 33%), lack of social support (20%, 14%), and severe, negative experiences in childhood (22%, 16%). Obsessive-compulsive thoughts (21%, 16%) and depressive (9%, 9%) and anxiety symptoms (11%, 7%) were the most frequently reported mental health problems by both parents. Regulatory problems of the child were reported by between 1.5% and 5.1% of parents. CONCLUSIONS The study showed that a substantial proportion of parents are burdened by psychosocial problems and suffer from mental health problems in the first years after the birth of their children. Early preventive and low-threshold support measures should be available in the health and social care system. Low-threshold questionnaires, which cover a wide range of possible stress factors, should be further developed for the practical healthcare of this group of people.
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Affiliation(s)
- Julia Fricke
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (J.F.); (M.B.); (K.I.); (T.R.); (S.R.); (T.K.)
- Unit for Municipal Health Strategies for the City of Freiburg and the District of Breisgau-Hochschwarzwald, 79104 Freiburg, Germany
| | - Marie Bolster
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (J.F.); (M.B.); (K.I.); (T.R.); (S.R.); (T.K.)
| | - Katja Icke
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (J.F.); (M.B.); (K.I.); (T.R.); (S.R.); (T.K.)
| | - Natalja Lisewski
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (J.F.); (M.B.); (K.I.); (T.R.); (S.R.); (T.K.)
| | - Lars Kuchinke
- International Psychoanalytic University, 10555 Berlin, Germany; (L.K.); (C.L.-K.)
| | | | - Franziska Schlensog-Schuster
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland;
| | - Thomas Reinhold
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (J.F.); (M.B.); (K.I.); (T.R.); (S.R.); (T.K.)
- Institute for Complementary and Integrative Medicine, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
| | - Anne Berghöfer
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (J.F.); (M.B.); (K.I.); (T.R.); (S.R.); (T.K.)
| | - Stephanie Roll
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (J.F.); (M.B.); (K.I.); (T.R.); (S.R.); (T.K.)
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (J.F.); (M.B.); (K.I.); (T.R.); (S.R.); (T.K.)
- Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, 97070 Wuerzburg, Germany
- State Institute of Health, Bavarian Health and Food Safety Authority, 97688 Bad Kissingen, Germany
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Fu Y, Lin X, Li Y, Zhang M, Chen WT, Huang F. Trajectories of cognitive reactivity and its predictive value on postpartum depression in Chinese women: a latent class growth modeling analysis. J Psychosom Obstet Gynaecol 2023; 44:2256470. [PMID: 37747284 DOI: 10.1080/0167482x.2023.2256470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/03/2023] [Indexed: 09/26/2023] Open
Abstract
Many women are experiencing postpartum depression (PPD) after giving birth. How to recognize and intervene in high-risk PPD women early and effectively remains unknown. Our objective is to describe the latent trajectory groups of cognitive reactivity (CR) in perinatal women, and their relationship to demographic and disease-related factors, as well as investigate the associations with PPD. Data from 321 perinatal women who were evaluated in urban tertiary hospitals in China at three-time points: 32-35 weeks of pregnancy, 1 week postpartum, and 6 weeks postpartum. Latent class growth modeling was used to identify the trajectory patterns of CR and logistic regression was used to explore the association between demographic and disease-related factors, CR trajectories, and depression. Three trajectory groups were identified: the continuing deterioration group (17.2%), the postpartum deterioration group (22.1%), and the consistent resilient group (60.7%). Participants with a bachelor's degree or higher and with gestational diabetes diagnosis were more likely to be in the continuing deterioration group. Those who were from only-child families were more likely to be in the postpartum deterioration group. Women in the continuing deterioration group and postpartum deterioration group were more likely to experience PPD. Targeted interventions should be developed based on trajectory group of CR.
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Affiliation(s)
- Yanqing Fu
- Fujian Medical University Union Hospital Department of Gynaecology and Obstetrics Nursing, Fuzhou, Fujian, China
| | - Xiujing Lin
- School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
| | - Yonglin Li
- School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
| | - Minfang Zhang
- Fujian Medical University Union Hospital Department of Gynaecology and Obstetrics Nursing, Fuzhou, Fujian, China
| | - Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, CA, USA
| | - Feifei Huang
- School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
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Lux U, Entleitner-Phleps C, Langmeyer AN, Löchner J, Walper S, Ulrich SM. [Stressful Living Conditions in Nuclear, Single Parent and Stepfamilies and Use of Prevention Services. Findings of Two Representative German Studies]. DAS GESUNDHEITSWESEN 2023; 85:975-981. [PMID: 37972581 PMCID: PMC11248162 DOI: 10.1055/a-2106-9582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
AIM OF THE STUDY Comparison of (stressful) living conditions and use of universal, selective and indicated prevention services in nuclear, single parent and stepfamilies with young children. METHODS Using two representative German surveys of mothers with children aged 0-3 years (KiD 0-3 2015, n=6,671, and AID:A 2019, n=1,501), mothers' reported burden and the use of various prevention services in different family types were examined descriptively and with Chi²-tests. RESULTS Overall, single parent families and, to some extent, stepfamilies showed increased socioeconomic stress compared to nuclear families (e. g., young motherhood, higher poverty risk). In particular, universal prevention services (e. g., prenatal classes, parent-child courses) were used less frequently by single parent families, while selective and indicated services such as family or child guidance counselling services and offers of youth welfare agencies were used more frequently. CONCLUSION Increased socioeconomic stress suggests a higher need for support among single parents compared to nuclear families. Universal group offers are possibly not sufficient to meet these needs, whereas selective individual counselling offers such as pregnancy and child guidance counseling are used more frequently by single parent families and stepfamilies compared to nuclear families. There seems to be a lack of (group) offers tailored to single parent families - particularly in the first developmental phase of a child's life.
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Affiliation(s)
- Ulrike Lux
- Department Pädagogik und Rehabilitation, Ludwig-Maximilians-Universität, München, Germany
- Nationales Zentrum Frühe Hilfen (NZFH), Deutsches Jugendinstitut eV München, Germany
| | | | | | - Johanna Löchner
- Kinder- und Jugendpsychiatrie, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Sabine Walper
- Department Pädagogik und Rehabilitation, Ludwig-Maximilians-Universität, München, Germany
- Institutsleitung, Deutsches Jugendinstitut eV München, Germany
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Friedmann A, Buechel C, Seifert C, Eber S, Mall V, Nehring I. Easing pandemic-related restrictions, easing psychosocial stress factors in families with infants and toddlers? Cross-sectional results of the three wave CoronabaBY study from Germany. Child Adolesc Psychiatry Ment Health 2023; 17:76. [PMID: 37353851 DOI: 10.1186/s13034-023-00618-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/19/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Families with young children are particularly vulnerable for the stressors induced by the COVID-19 pandemic. However, studies on their psychosocial situation during the course of the crisis are still sparse. METHODS In a comparison of three survey waves (wave I and III = high COVID-19 incidences), we cross-sectionally investigated the proportion of families (Ntotal = 2940) with children aged 0-3 years experiencing pandemic burden, parenting stress, and parental and child mental health problems in relation to COVID-19 incidences and restrictions in Southern Germany via validated questionnaires. Potential influencing factors were also explored. RESULTS The number of parents with a high pandemic burden decreased over the course of the pandemic with a peak of 65.3% in wave I (significant changes except wave II versus III). Participants with high parenting stress significantly increased from 38.2% in wave I to 51.2% in wave III. The number of parents with symptoms of depression and anxiety remained constantly high with a maximum of 28.4% being affected. Infants with crying/sleeping problems increased significantly from 26.4% in wave I to 35.5% in wave III. Toddlers' emotional and behavioral problems showed a peak of 23.9% in wave III (no significant changes). Increased family conflicts were the strongest predictor for parenting stress (ß = 0.355), maternal (ß = 0.305), infants' (ß = 0.149) and toddlers' (ß = 0.216) mental health problems during the pandemic. CONCLUSIONS Psychosocial stress factors in families with infants and toddlers remained highly pronounced and even partly increased irrespective of pandemic events. The findings suggest a staggered negative impact of pandemic-related factors on young children's mental health. Promoting infants' mental health as well as strengthening parental resources by reducing parenting stress should be a top healthcare priority in the aftermath of COVID-19. Trial registration The study was pre-registered in OSF ( https://osf.io/search/?q=tksh5&page=1 ).
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Affiliation(s)
- Anna Friedmann
- Chair of Social Pediatrics, TUM School of Medicine, Technical University of Munich, Heiglhofstraße 65, 81377, Munich, Germany.
| | - Catherine Buechel
- Chair of Social Pediatrics, TUM School of Medicine, Technical University of Munich, Heiglhofstraße 65, 81377, Munich, Germany
| | - Clara Seifert
- Chair of Social Pediatrics, TUM School of Medicine, Technical University of Munich, Heiglhofstraße 65, 81377, Munich, Germany
- Chair of Human Movement Science, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Stefan Eber
- Professional Association of Pediatricians in Bavaria (BVKJ) and PaedNetz Bayern, Munich, Germany
| | - Volker Mall
- Chair of Social Pediatrics, TUM School of Medicine, Technical University of Munich, Heiglhofstraße 65, 81377, Munich, Germany
| | - Ina Nehring
- Chair of Social Pediatrics, TUM School of Medicine, Technical University of Munich, Heiglhofstraße 65, 81377, Munich, Germany
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Lux U, Müller M, Reck C, Liel C, Walper S. Linking maternal psychopathology to children's excessive crying and sleeping problems in a large representative German sample-The mediating role of social isolation and bonding difficulties. INFANCY 2023; 28:435-453. [PMID: 36397657 DOI: 10.1111/infa.12514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 10/07/2022] [Accepted: 10/25/2022] [Indexed: 11/21/2022]
Abstract
Attaining self-regulation is a major developmental task in infancy, in which many children show transient difficulties. Persistent, clinically relevant difficulties in self-regulation include excessive crying or sleeping disorders. Many families with affected children are burdened with multiple psychosocial risk. This suggests that regulatory problems are best conceptualized as the maladaptive interplay of overly burdened parents and a dysfunctional parent-child interaction. The current study examines whether social isolation and bonding difficulties function as mediating mechanisms linking maternal psychopathology to (1) children's excessive crying and (2) sleeping problems. The sample comprised N = 6598 mothers (M = 31.51 years) of children between zero to three years of age (M = 14.08 months, 50.1% girls). In addition to socio demographic data, the written questionnaire included information on maternal depression/anxiety, isolation, bonding, and children's regulatory problems. Hypotheses were tested with a mediation model controlling for psychosocial risk and child characteristics. As expected, maternal symptoms of depression/anxiety were linked to infants' excessive crying and sleeping problems. Social isolation and bonding difficulties mediated this association for excessive crying as well as for sleeping problems, but social isolation was a single mediator for sleeping problems only. The findings provide important insights in the mediating pathways linking maternal psychopathology to children's regulatory problems.
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Affiliation(s)
- Ulrike Lux
- National Centre for Early Prevention, German Youth Institute, Munich, Germany.,Ludwig-Maximilians-University Munich, Munich, Germany
| | - Mitho Müller
- Ludwig-Maximilians-University Munich, Munich, Germany
| | - Corinna Reck
- Ludwig-Maximilians-University Munich, Munich, Germany
| | - Christoph Liel
- National Centre for Early Prevention, German Youth Institute, Munich, Germany
| | - Sabine Walper
- National Centre for Early Prevention, German Youth Institute, Munich, Germany.,Ludwig-Maximilians-University Munich, Munich, Germany
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Kolodziej D, Wolkwitz P, Schön G, Siefert S, Pawils S. Evaluation of a Child-centred Psychosocial Healthcare Intervention (KIDPROTEKT) - Results of a Cluster Randomized Controlled Trial in Paediatric and Gynaecologic Practices. INTERVENCION PSICOSOCIAL 2023; 32:33-42. [PMID: 37361631 PMCID: PMC10268543 DOI: 10.5093/pi2023a2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 10/11/2022] [Indexed: 06/28/2023]
Abstract
KID-PROTEKT is a child-centred psychosocial healthcare intervention which aims at improving the identification of psychosocial needs and navigation in the outpatient gynaecologic and paediatric setting. In this cluster randomized-controlled trail we examined the effect of KID-PROTEKT on the referrals (to support services) in comparison to the regular gynaecologic and paediatric outpatient healthcare . A variant based on the qualification of the healthcare providers (qualified treatment, QT) and a variant with social worker (supported treatment, ST) were compared to the regular healthcare (treatment as usual, TAU). Twenty-four gynaecologic and paediatric practices were randomized to one of three study arms. Therefore 8,458 pregnant women and families recruited in one of these practices were enrolled in the study. Participating patients reported on average 1.73 (SD = 1.34) psychosocial risks. In total 522 patients were linked to a support service. Compared to TAU, the probability of a referral was significantly higher in QT (OR = 10.70) and ST (OR = 11.28). Also, a higher number of psychosocial risks were linked to a referral (OR = 2.72). These findings support the importance of a psychosocial assessment in the gynaecologic and paediatric setting.
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Affiliation(s)
- Désirée Kolodziej
- University Medical Center Hamburg-EppendorfHamburgGermanyUniversity Medical Center Hamburg-Eppendorf, Hamburg, Germany;
| | - Philipp Wolkwitz
- University Medical Center Hamburg-EppendorfHamburgGermanyUniversity Medical Center Hamburg-Eppendorf, Hamburg, Germany;
| | - Gerhard Schön
- University Medical Center Hamburg-EppendorfHamburgGermanyUniversity Medical Center Hamburg-Eppendorf, Hamburg, Germany;
| | - Sönke Siefert
- Catholic Children’s Hospital WilhelmstiftHamburgGermanyCatholic Children’s Hospital Wilhelmstift, Hamburg, Germany
| | - Silke Pawils
- University Medical Center Hamburg-EppendorfHamburgGermanyUniversity Medical Center Hamburg-Eppendorf, Hamburg, Germany;
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Ulrich SM, Lux U, Liel C, Walper S. Long-term effects of targeted prevention programmes for families with young children: A population-based study on parenting stress and children's negative emotionality. Child Care Health Dev 2022; 48:763-771. [PMID: 35170070 DOI: 10.1111/cch.12985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/28/2022] [Accepted: 02/10/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Many prevention programmes for families focus parental adversities and adverse childhood experiences. Effects of such programmes are often examined in clinical trials; there is less research on effects under naturalistic conditions. The aim of this study was to examine the longitudinal association between parenting stress and child's negative emotionality, its modification through targeted prevention programmes, and to investigate the effects in the general population. METHODS Data were taken from a sample of n = 903 families with infants (mean age: 13.3 months) who participated in a baseline study (T1) and a follow-up study (T2) 2 years later. The survey included parental self-report measurements on parenting stress and child's negative emotionality (T1 and T2 each) and targeted prevention programmes (T1 only). An autoregressive cross-lagged panel design was used to analyse the association of parenting stress and the child's negative emotionality, including use of targeted prevention programmes as moderator. We also tested if targeted prevention programmes can reduce parenting stress or child's negative emotionality using Propensity Score Matching (PSM). RESULTS Parenting stress at T1 affected children's negative emotionality at T2, but children's negative emotionality at T1 did not affect parenting stress at T2. When targeted prevention was included as moderator, the correlation disappeared among programme users. With PSM, there was no direct effect on parenting stress or child's negative emotionality. But a subsample of parents with high parenting stress at T1 who used targeted prevention at T1 reported less child's negative emotionality problems at T2 than parents who scored high in parenting stress but did not receive targeted prevention at T1. CONCLUSION Results suggest that the spillover from parenting stress to child's negative emotionality may be modified by prevention. Prevention programmes may help to build resources and have a direct positive effect on the child, especially for parents with high parenting stress.
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Affiliation(s)
- Susanne M Ulrich
- National Centre for Early Prevention, German Youth Institute, Department of Families and Family Policies, Munich, Germany
| | - Ulrike Lux
- National Centre for Early Prevention, German Youth Institute, Department of Families and Family Policies, Munich, Germany
| | - Christoph Liel
- National Centre for Early Prevention, German Youth Institute, Department of Families and Family Policies, Munich, Germany
| | - Sabine Walper
- National Centre for Early Prevention, German Youth Institute, Department of Families and Family Policies, Munich, Germany
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Buechel C, Nehring I, Seifert C, Eber S, Behrends U, Mall V, Friedmann A. A cross-sectional investigation of psychosocial stress factors in German families with children aged 0-3 years during the COVID-19 pandemic: initial results of the CoronabaBY study. Child Adolesc Psychiatry Ment Health 2022; 16:37. [PMID: 35581664 PMCID: PMC9113073 DOI: 10.1186/s13034-022-00464-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 04/02/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Psychosocial stress during the COVID-19 pandemic is increasing particularly in parents. Although being specifically vulnerable to negative environmental exposures, research on psychosocial stress factors in infants' and toddlers' families during the pandemic is so far sparse. The CoronabaBY study investigates the perceived pandemic burden, parenting stress and parent and child mental health problems in families with children aged 0-3 years in Bavaria, Southern Germany. Further, the relationships between these psychosocial stressors are examined and sociodemographic characteristics that may be predictive of these factors will be explored. METHODS Participants were cross-sectionally surveyed via smartphone app. Standardized questionnaires on perceived pandemic burden, parenting stress, parental symptoms of depression and anxiety, infants' crying, sleeping and feeding problems or toddlers' emotional and behavioral problems were applied. RESULTS N = 991 parents (Mage = 33.7 years, SD = 4.5; 93.7% mothers, 91.5% born in Germany) with infants (n = 554; Mage = 5.9 months, SD = 3.0) or toddlers (n = 435; Mage = 25.9 months, SD = 6.5) participated in the first half-year of 2021. Sixty-five percent of the parents perceived a high pandemic burden, 37.7% experienced parenting stress and 24.1% showed affective symptoms (anxiety: 30.1%, depression: 18.5%). Feeding problems, crying/ sleeping problems and multiple regulatory problems were found in 34.8%, 26.2% and 13.5% of the infants, respectively. Amongst toddlers, 8.5% showed noticeable behavior and emotional problems. Children`s mental health problems correlated moderately with parenting stress and parental affective symptoms and weakly with perceived pandemic burden. A lower financial status, higher parental education and increasing child age were significant but weak predictors for higher parenting stress, affective symptoms and higher psychological problems in children. CONCLUSIONS A majority of the surveyed families with infants and toddlers experience the pandemic as stressful. The main challenges are parental affective symptoms and limited resources for childcare due to parenting stress. Overall, infants and toddlers show similar levels of mental health problems when being compared to pre-pandemic studies, but staggered detrimental effects on children`s mental health might occur if the stressful conditions persist. This is already indicated by correlations between parental and child psychosocial stress factors.
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Affiliation(s)
- Catherine Buechel
- Technical University of Munich, TUM School of Medicine, Chair of Social Pediatrics, Munich, Germany.
- , Heiglhofstraße 65, 81377, München, Germany.
| | - Ina Nehring
- Technical University of Munich, TUM School of Medicine, Chair of Social Pediatrics, Munich, Germany
| | - Clara Seifert
- Technical University of Munich, TUM School of Medicine, Chair of Social Pediatrics, Munich, Germany
| | - Stefan Eber
- Professional Association of Pediatricians in Bavaria and PaedNetz Bayern, Munich, Germany
| | - Uta Behrends
- Department of Pediatrics, Kinderklinik München Schwabing, StKM GmbH and Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Volker Mall
- Technical University of Munich, TUM School of Medicine, Chair of Social Pediatrics, Munich, Germany
| | - Anna Friedmann
- Technical University of Munich, TUM School of Medicine, Chair of Social Pediatrics, Munich, Germany
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Metzner G, Horstmann S, Barth M, Giesler JM, Jünemann S, Kaier K, Schlett C, Schroeder N, Siebolds M, Sinss F, van Staa J, Glattacker M, Renner I. Evaluation of a cross-sectoral care intervention for families with psychosocial burden: a study protocol of a controlled trial. BMC Health Serv Res 2022; 22:475. [PMID: 35410201 PMCID: PMC8996544 DOI: 10.1186/s12913-022-07787-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/16/2022] [Indexed: 11/18/2022] Open
Abstract
Background Family risk factors, e.g. low socioeconomic status or parental mental health disorders, can affect children’s health and development. Thus, targeted preventive services for families with psychosocial burden are crucial. The German Early Childhood Intervention (ECI) program is a preventive approach that aims to strengthen parent’s resources by supportive services. However, research has revealed that only a proportion of the families considered to have substantial risk factors access the ECI program. To increase pediatricians’ skills in identifying risk factors, and to improve the cross-sectoral collaboration between relevant professionals and the referral of families to supportive services, the PATH-intervention (Pediatric Attention To Help) was developed. The PATH-intervention includes interprofessional quality circles and a one-day training program for the pediatricians. This study aims to evaluate this complex cross-sectoral care intervention for families with psychosocial burden. Methods Using a prospective quasi-experimental, controlled (matched-pair), longitudinal mixed-method design, we will compare families under treatment of pediatricians trained in the PATH-intervention with families under treatment of a control group of pediatricians. Participating families are asked to complete online-surveys. As a primary outcome, we will examine the use of supportive services of the ECI by burdened families. Secondary outcomes are the proportion of correctly identified families with psychosocial burden by the pediatricians, as well as information provision and motivation of the families to use the supportive services. Additionally, the cost-effectiveness ratio will be investigated. In the process evaluation, we will qualitatively explore the acceptance of the PATH-intervention of all involved stakeholders and the treatment fidelity of the trained pediatricians. Discussion This study will determine whether the PATH-intervention enables the pediatricians to identify and recommend supportive services to burdened families, as well as the families’ use of the supportive services of the ECI. Qualitative data will give insight into the acceptance of the intervention from the perspective of all stakeholders and the treatment fidelity. Results of this study could be the starting point for the broader implementation of the PATH-intervention as standard care. Trial registration German Clinical Trials Register (DRKS): DRKS00023461 (3rd December 2020); WHO UTN: U1111- 260-6575. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07787-9.
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Affiliation(s)
- Gloria Metzner
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Hugstetter Str. 49, 79106, Freiburg, Germany.
| | - Sabine Horstmann
- National Centre for Early Prevention, Federal Centre for Health Education, Maarweg 149-161, 50825, Köln, Germany
| | - Michael Barth
- Center for Pediatrics, Medical Center, University of Freiburg, Mathildenstraße 1, 79106, Freiburg, Germany
| | - Jürgen M Giesler
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Hugstetter Str. 49, 79106, Freiburg, Germany
| | - Susanne Jünemann
- National Centre for Early Prevention, Federal Centre for Health Education, Maarweg 149-161, 50825, Köln, Germany
| | - Klaus Kaier
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Zinkmattenstr. 6a, 79108, Freiburg, Germany
| | - Christian Schlett
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Hugstetter Str. 49, 79106, Freiburg, Germany
| | - Nora Schroeder
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Hugstetter Str. 49, 79106, Freiburg, Germany
| | - Marcus Siebolds
- Department of Health Care, Catholic University of Applied Sciences, Wörthstraße 10, 50668, Köln, Germany
| | - Frank Sinss
- National Centre for Early Prevention, Federal Centre for Health Education, Maarweg 149-161, 50825, Köln, Germany
| | - Juliane van Staa
- National Centre for Early Prevention, Federal Centre for Health Education, Maarweg 149-161, 50825, Köln, Germany
| | - Manuela Glattacker
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Hugstetter Str. 49, 79106, Freiburg, Germany
| | - Ilona Renner
- National Centre for Early Prevention, Federal Centre for Health Education, Maarweg 149-161, 50825, Köln, Germany
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Sclar GD, Mosler HJ. Caregiver social support and child toilet training in rural Odisha, India: What types of support facilitate training and how? Appl Psychol Health Well Being 2021; 14:413-433. [PMID: 34668329 PMCID: PMC9297906 DOI: 10.1111/aphw.12311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 09/19/2021] [Accepted: 09/20/2021] [Indexed: 11/30/2022]
Abstract
Studies show positive impacts of social support on childcare practices, but there is limited research on child toilet training. Social support with toilet training may be especially important for rural Indian caregivers as this is a new childcare practice for many and mothers face an already demanding workload. The aim of this study was to examine the role of social support in toilet training using mediation and conditional process analyses. We surveyed 570 caregivers of children <5 years old living in rural Odisha, India. We found certain types of support aid toilet training through three mechanisms: directly, by improving self‐efficacy, and by buffering against stress. Informational and instrumental support had a positive direct effect on toilet training while emotional support had no effect. Instrumental support also aided toilet training indirectly through bolstering a caregiver's perceived self‐efficacy. These effects of instrumental support were not moderated by the caregiver's support network size. Additionally, we found perceived stress had a negative indirect effect on caregivers' toilet training efforts through diminishing self‐efficacy, but this effect was buffered (i.e. moderated) by social support. These findings offer useful programmatic insights and expand the evidence‐base on how social support functions to another childcare practice and cultural context.
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Affiliation(s)
- Gloria D Sclar
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Department of Psychology, University of Zürich, Zürich, Switzerland
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Ulrich SM, Löchner J, Paul M, Lux U. Stability and Change in Self-Reported Psychosocial Stress Among Parents of Small Children–Results of the Longitudinal Study “Kinder in Deutschland – KiD 0–3”. DEUTSCHES ARZTEBLATT INTERNATIONAL 2021; 118I processed the file.I'm waiting for feedback tomorrow:595-596. [PMID: 34789371 DOI: 10.3238/arztebl.m2021.0262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 12/21/2020] [Accepted: 06/07/2021] [Indexed: 11/27/2022]
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