Observed macro- and micro-level parenting behaviors during preadolescent family interactions as predictors of adjustment in emerging adults with and without spina bifida

Medical responsibility growth in youth with spina bifida: Neuropsychological and parenting predictors

OBJECTIVE

For youth with spina bifida (SB) there is a growing need to understand how responsibilities for health care are transferred from family- to self-management over time. The current study examined trajectories of responsibility for medical tasks in youth with SB across adolescence, as well as executive functioning/attention and parenting behaviors as predictors of growth.

METHOD

As part of a larger, longitudinal study, 140 youth with SB (ages 8-15 at time 1; Mage = 11.43) reported on their responsibility for relevant medical tasks across five time points. Attention and executive functioning were assessed via performance-based and parent/teacher-report methods. Parenting behaviors consisted of acceptance, behavioral control, and psychological control and were assessed via observational and parent-report.

RESULTS

Growth curve analyses revealed significant increases in youth medical responsibility across all SB tasks over time. Attention, executive functioning, maternal behavioral control, and paternal psychological control emerged as predictors of growth parameters in responsibility for communicating about SB and managing health care appointments.

CONCLUSION

Results indicated that youth with SB obtain increasing responsibility for their health care over time. The transfer of responsibility for SB management may differ based on individual (i.e., the child's neuropsychological abilities) and family level (i.e., parenting behaviors) factors. Further research is needed to understand how growth in medical responsibility relates to changes in other aspects of SB self-management across development, such as medical adherence. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Evaluation of Daily Lives of Children and Adolescents with Celiac Disease and Nursing Approaches

The incidence of celiac disease has been increasing in recent years. Celiac disease is an autoimmune enteropathy that emerges mostly in the childhood period. This disorder is a chronic condition of the small intestine due to gluten intake in individuals with genetic predisposition. In the treatment of celiac disease, gluten-free diet therapy is applied. However, the adaptation process to the diet may create difficulties for patients. Compliance with diet is much more difficult among patients with celiac disease in childhood and adolescence than in adult patients. Children and adolescents face distinct difficulties in their homes, at school, and in their social lives. Besides following dietary treatment, children and adolescents living with celiac disease need peer support to manage their daily routines. In this article, we aimed to discuss the problems experienced by children and adolescents living with celiac disease and nursing approaches to these problems.

Pathways by which Maternal Factors are Associated With Youth Spina Bifida-Related Responsibility

OBJECTIVE

Achieving condition-related autonomy is an important developmental milestone for youth with spina bifida (SB). However, the transfer of condition-related responsibility to these youth can be delayed due to parent factors. This study aimed to investigate two potential pathways by which maternal factors may be associated with condition-related responsibility among youth with SB: (a) Maternal adjustment → perception of child vulnerability (PPCV) → youth condition-related responsibility; and (b) Maternal PPCV → overprotection → youth condition-related responsibility.

METHODS

Participating youth with SB (N = 140; Mage=11.4 years, range = 8-15 years) were recruited as part of a longitudinal study; data from three time points (each spaced 2 years apart) from the larger study were used. Mothers reported on personal adjustment factors, PPCV, and overprotection. An observational measure of overprotection was also included. Mothers, fathers, and youth with SB reported on youths' degree of responsibility for condition-related tasks. Analyses included age, lesion level, IQ, and the dependent variables at the prior wave as covariates.

RESULTS

Bootstrapped mediation analyses revealed that PPCV significantly mediated the relationship between maternal distress and youth responsibility for medical tasks such that higher levels of distress at Time 1 predicted higher levels of PPCV at Time 2 and lower youth medical responsibility at Time 3. Furthermore, self-reported maternal overprotection significantly mediated the relationship between maternal PPCV and youth responsibility for medical tasks.

CONCLUSIONS

Maternal personal distress, PPCV, and self-reported overprotection are interrelated and affect youth's condition-related responsibility. Interventions for mothers of youth with SB that target these factors may improve both maternal and youth outcomes.

Cultural Considerations for Autonomy and Medical Adherence in a Young Palestinian American Muslim Female With Spina Bifida: A Longitudinal Case Study in a Research Context

This case study examines the unique presentation of a young Palestinian-American Muslim female, who is a part of an ongoing longitudinal study examining family and peer relationships, psychological adjustment, and neuropsychological functioning in youth with spina bifida. Throughout ten years of data collection, Palestinian-Arab culture and Islamic faith have consistently emerged as important factors that can be considered when interpreting this participant's general level of autonomy, medical autonomy, medical adherence, and psychological adjustment. This case study examines important aspects of adaptive and independent functioning for youth with spina bifida and how this family's culture interacts with these different domains of functioning. Moreover, it explores potential conflicts between an Arab collectivist family structure and Western biomedical ethics and suggests how clinicians might navigate these conflicts and bolster culturally-rooted strengths of families and patients from non-Western backgrounds.

Exploratory Factor Analysis of Observational Parent-Child Interaction Data

The majority of studies using observational coding systems for family interaction data derive scales describing family members' behaviors based on rational/theoretical approaches. This study explored an empirical approach to identifying the component structure of parent-child observational data that incorporated the affective context of the interaction. Dyads of 155 typically developing 8-year-olds and their mothers completed questionnaires and two interaction tasks, one each designed to illicit positive and negative interactions. Behaviors were coded based on a modified version of the Family Interaction Macro-coding System. Multiple factor analysis identified four-component solutions for the maternal and child data. For both, two of the components included negative behaviors, one positive behavior, and one communicative behavior. Evidence for the validity of the maternal and child components was demonstrated by associations with child depression and anxiety symptoms and behavioral problems. Preliminary evidence supports an empirical approach to identify context-specific components in parent-child observational data.

Characterizing the Pain Narratives of Parents of Youth With Chronic Pain

OBJECTIVES

Questionnaire-based research has shown that parents exert a powerful influence on and are profoundly influenced by living with a child with chronic pain. Examination of parents' pain narratives through an observational lens offers an alternative approach to understanding the complexity of pediatric chronic pain; however, the narratives of parents of youth with chronic pain have been largely overlooked. The present study aimed to characterize the vulnerability-based and resilience-based aspects of the pain narratives of parents of youth with chronic pain.

METHODS

Pain narratives of 46 parents were recorded during the baseline session as part of 2 clinical trials evaluating a behavioral intervention for parents of youth with chronic pain. The narratives were coded for aspects of pain-related vulnerability and resilience.

RESULTS

Using exploratory cluster analysis, 2 styles of parents' pain narratives were identified. Distress narratives were characterized by more negative affect and an exclusively unresolved orientation toward the child's diagnosis of chronic pain, whereas resilience narratives were characterized by positive affect and a predominantly resolved orientation toward the child's diagnosis. Preliminary support for the validity of these clusters was provided through our finding of differences between clusters in parental pain catastrophizing about child pain (helplessness).

DISCUSSION

Findings highlight the multidimensional nature of parents' experience of their child's pain problem. Clinical implications in terms of assessment and treatment are discussed.

Peer Attachment, Perceived Parenting Style, Self-concept, and School Adjustments in Adolescents with Chronic Illness

PURPOSE

The purpose of this study was to identify how peer attachment and parenting style differentially affect self-concept and school adjustment in adolescents with and without chronic illness.

METHODS

A cross-sectional study using multiple group analysis on the Korean panel data was used. A nationwide stratified multistage cluster sampling method was used and the survey was conducted in 2013 on 2,092 first-year middle school students in Korea. We used standardized instruments by the National Youth Policy Institute to measure peer attachment, parenting style, self-concept, and school adjustment. Multiple-group structural equation modeling was used to evaluate the difference of relations for peer attachment, parenting style, self-concept, and school adjustment variable between adolescents with chronic illness and those without chronic illness.

RESULTS

The model fit of a multiple-group structural equation modeling was good. The difference of the path from negative parenting style to self-concept between the two groups was significant, and a significant between-group difference in the overall path was found. This indicated that self-concept in adolescents with chronic illness was more negatively affected by negative parenting style than in adolescents without chronic illness.

CONCLUSIONS

Healthcare providers can promote the process of school adjustment in several ways, such as discussing this issue directly with adolescent patients, along with their parents and peers, examining how the organization and content of the treatment can be modified according to the adolescents' school life.

Screening for Postpartum Depression and Associated Factors Among Women in China: A Cross-Sectional Study

Objectives: This study examined what percentage of Chinese mothers during a three-year postpartum period were screened for postpartum depression and explored the correlation between postpartum depression and various socio-demographic, psychological, and cultural factors. Study design: Cross-sectional survey. Methods: A total of 506 mothers 23 years of age and older who were within three years postpartum completed the online survey. The survey collected information such as family economic status, a history of depression, preparation for pregnancy, relationships with husbands, and family members, adult attachment types (Adult Attachment Scale, AAS), and depression (The Center for Epidemiologic Studies Depression Scale, CESD). Results: Approximately 30% of mothers 1-3 years postpartum reported symptoms above the CESD cut-off score (≥16 scores) associated with the risk for depression (28.0% in the first year, 30.8% in the second year, and 31.8% in the third year). Factors significantly associated with depression in participants in the correlation analysis were education level; family income; preparation for pregnancy; a history of depression; amount of time spent with their husbands; relationships with husbands, parents, and parents-in-law; and a close, dependent, and/or anxious attachment style. Multiple regression analyses revealed that a history of depression; less preparation for pregnancy; poorer relationships with husbands, parents, and parents-in-law; and a more anxious attachment style were strongly related to a higher risk of postpartum depression. Conclusion: The overall percentage of mothers after delivery who were vulnerable to depression in China remains high. Various factors were significant predictors of postpartum depression. The research findings have several valuable implications for intervention practices. For example, attachment styles and depression history in the assessments of perinatal depression could improve screenings and the design of interventions. Additionally, improving the family relationships and family environments of women post-delivery may be promising approach for postpartum depression prevention or intervention.

Family systems therapy for substance-using mothers and their 8- to 16-year-old children

Family systems therapy has shown to be a powerful adjunct to substance use treatment for couples and for adolescent substance users (Rowe, 2012). However, studies including children (8-16 years of age) in the treatment of their substance using mothers have been overlooked and are essentially nonexistent. Addressing the quality of the mother-child relationship and communication through family systems therapy may prove to be a potent intervention focus for improving mothers' substance use outcomes and parent-child interaction. As such, the current study recruited 183 mothers who sought outpatient treatment through a local substance use treatment facility and randomly assigned them to also receive family systems therapy or Women's Health Education. Self-report and observational data were collected, and assessment interviews were completed at baseline and 3, 6, 12, and 18 months postbaseline. Findings showed that women assigned to family systems therapy showed a quicker decline in alcohol, marijuana, and cocaine use, supporting the efficacy of family therapy as an important addition to mother's substance use treatment plans. Data also revealed an association between change in observed autonomy-relatedness and substance use, though mediation was not found. To our knowledge this is the first effort to successfully document a family systems therapy for substance using mothers with minor children in their care. (PsycINFO Database Record

Longitudinal associations among maternal communication and adolescent posttraumatic stress symptoms after cancer diagnosis

OBJECTIVE

The purpose of this study was to prospectively examine adolescent and maternal posttraumatic stress symptoms (PTSS) and maternal communication from time near cancer diagnosis to 12-month follow-up to identify potential risk factors for adolescent PTSS.

METHODS

Forty-one adolescents with cancer (10-17 years, 54% female) and their mothers self-reported PTSS at T1 (two months after cancer diagnosis) and T3 (1-year follow-up). At T2 (3 months after T1), mother-adolescent dyads were videotaped discussing cancer, and maternal communication was coded with macro (harsh and withdrawn) and micro (solicits and validations) systems.

RESULTS

Adolescent PTSS at T1 was associated with adolescent PTSS at T3. Greater maternal PTSS at T1 predicted greater harsh maternal communication at T2. There was an indirect effect of maternal PTSS at T1 on adolescent PTSS at T3 through maternal validations at T2.

CONCLUSIONS

Findings underscore the importance of maternal PTSS, maternal communication, and subsequent adolescent PTSS over the course of treatment of childhood cancer. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.