Siblings of Children With a Complex Chronic Health Condition: Maternal Posttraumatic Growth as a Predictor of Changes in Child Behavior Problems

The role of family and individual factors in going through adolescence having a disabled sibling - analysis of a healthy child's functioning. A case-control study protocol

BACKGROUND

Having a disabled sibling can be a source of extremely important and enriching experiences that foster the development of social and emotional competences, as well as broadening the child's perspective and knowledge. On the other hand, it also poses many challenges for the siblings, especially in adolescence. Thus, the aim of the proposed project is to investigate the specificity of the growing up process in young people with disabled siblings.

PARTICIPANTS AND PROCEDURE

A total of 160 dyads (320 participants) - an adolescent and one of his/her parents - will take part in this cross-sectional case-control study. Participants will be assigned to four groups, having a sibling with: 1) intellectual disability, 2) motor disability, 3) chronic somatic disease, and 4) the control group - having a sibling without any disability. Both the healthy adolescent and one of the parents will fill out a set of questionnaires regarding the study variables: Questionnaire of Relationships with Siblings, Parental Attitude Scale-2, KidScreen-27, Parentification Questionnaire for Youth, Teenage Rebellion Questionnaire, Child Behavior Checklist 6-18.

RESULTS

The primary outcomes include investigating the healthy adolescent functioning in three environments: family, peers and school. The proposed research model focuses both on the difficulties associated with having a disabled sibling (e.g. possible occurrence of disorders) and resources (e.g. higher quality of relationships in the family, especially in the sibling subsystem).

CONCLUSIONS

The proposed comprehensive approach to the issue of disability in the family from the perspective of a healthy child will allow for a better understanding of the mechanisms underlying the process of growing up with disabled siblings.

How Maternal Trauma Exposure Contributed to Children's Depressive Symptoms following the Wenchuan Earthquake: A Multiple Mediation Model Study

Although well-established literature has indicated the burden of mental health among victims after the Wenchuan earthquake, no research has focused on the mental health of mothers and their children who experienced the earthquake and were pregnant during or shortly after it. This study investigates the relationship between maternal trauma exposure (TE) and children's depressive symptoms after the Wenchuan earthquake and explores the risk and protective factors underlying this relationship. A sample of 547 mother-child dyads, in which the mother experienced the Wenchuan earthquake, was used to assess maternal depressive symptoms, maternal TE, children's depressive symptoms, children's perceived impact of the earthquake and maternal posttraumatic growth (PTG). The results showed that maternal TE had two significant one-step indirect associations with children's depressive symptoms (through children's perceived impact of the earthquake and maternal PTG) and one two-step indirect association with children's depressive symptoms (through maternal depressive symptoms via children's perceived impact of the earthquake). The results indicated that maternal depressive symptoms, children's perceived impact of the earthquake and maternal PTG mediated the association between maternal TE and children's depressive symptoms. These findings highlight the importance of mothers in supporting the mental health of these children. Maternal depressive symptoms and PTG, two posttraumatic outcomes, played positive and negative roles in the intergenerational transmission of trauma. Thus, post-disaster interventions should reduce the maternal transmission of trauma-related information and improve maternal PTG to support children's mental health.

The Relationship Between Resilience and Posttraumatic Growth Among the Primary Caregivers of Children With Developmental Disabilities: The Mediating Role of Positive Coping Style and Self-Efficacy

This study was conducted to investigate the relationship between posttraumatic growth (PTG), resilience, positive coping style, and self-efficacy among the primary caregivers of children with developmental disorders in Chongqing, China. A total of 198 primary caregivers (parents and grandparents) aged from 22 to 66 years old (M = 35.55, SD = 9.16), including 155 females (78.3%) and 43 males (21.7%), were enrolled. The Posttraumatic Growth Inventory, Connor-Davidson Resilience Scale-10, Simplified Coping Style Questionnaire, and General Self-Efficacy Scale were used for data collection. The results found that PTG could be positively predicted by resilience. Positive coping style and self-efficacy mediated the relationship between resilience and PTG. The different levels of PTG were determined by the resident location, monthly income and education of the primary caregivers. The results suggest that it is critical to improve the mental health of the primary caregivers (parents and grandparents) of children with developmental disabilities. Our results also provide a scientific basis for future research.

The role of social connection on the experience of COVID-19 related post-traumatic growth and stress

BACKGROUND

Historically social connection has been an important way through which humans have coped with large-scale threatening events. In the context of the COVID-19 pandemic, lockdowns have deprived people of major sources of social support and coping, with others representing threats. Hence, a major stressor during the pandemic has been a sense of social disconnection and loneliness. This study explores how people's experience of compassion and feeling socially safe and connected, in contrast to feeling socially disconnected, lonely and fearful of compassion, effects the impact of perceived threat of COVID-19 on post-traumatic growth and post-traumatic stress.

METHODS

Adult participants from the general population (N = 4057) across 21 countries worldwide, completed self-report measures of social connection (compassion for self, from others, for others; social safeness), social disconnection (fears of compassion for self, from others, for others; loneliness), perceived threat of COVID-19, post-traumatic growth and traumatic stress.

RESULTS

Perceived threat of COVID-19 predicted increased post-traumatic growth and traumatic stress. Social connection (compassion and social safeness) predicted higher post-traumatic growth and traumatic stress, whereas social disconnection (fears of compassion and loneliness) predicted increased traumatic symptoms only. Social connection heightened the impact of perceived threat of COVID-19 on post-traumatic growth, while social disconnection weakened this impact. Social disconnection magnified the impact of the perceived threat of COVID-19 on traumatic stress. These effects were consistent across all countries.

CONCLUSIONS

Social connection is key to how people adapt and cope with the worldwide COVID-19 crisis and may facilitate post-traumatic growth in the context of the threat experienced during the pandemic. In contrast, social disconnection increases vulnerability to develop post-traumatic stress in this threatening context. Public health and Government organizations could implement interventions to foster compassion and feelings of social safeness and reduce experiences of social disconnection, thus promoting growth, resilience and mental wellbeing during and following the pandemic.

Post-Traumatic Growth and Stress-Related Responses During the COVID-19 Pandemic in a National Representative Sample: The Role of Positive Core Beliefs About the World and Others

Given the need to understand both the negative and positive psychological consequences of the current global COVID-19 pandemic (Brewin et al. in Perspectives in Public Health 10.1177/1757913920957365 2020), the aim of this study was to test a cognitive model of post-traumatic symptoms (PTS) and post-traumatic growth (PTG) during confinement caused by the SARS-COV-2 epidemic. In line with cognitive models of trauma elaboration (Park in Psychological Bulletin 10.1037/a0018301), we included in our model some beliefs associated to the world (e.g., primal beliefs about a good world), to the self (e.g., death anxiety or orientation toward the future) and to others (e.g., suspiciousness or identification with humanity). To evaluate the explanatory model, a national representative sample of adults between the ages of 18 and 75 (N = 1951) was surveyed between 7th and 13th April, 2020, in the middle of a strict 7-week national confinement. Structural equation modelling yielded a very similar model to the one initially specified. The results highlight the role of both negative and positive core beliefs, which are pertinent to the current pandemic threat, in the appearance of PTS and PTG, respectively. In short, primal beliefs about a good world, openness to the future and identification with humanity were associated with PTG; while suspiciousness, intolerance of uncertainty, anxiety about death and also identification with humanity were associated with PTS and consequent impairment. This is an innovative study of different pathways to traumatic responses and growth during a pandemic. Future research is needed to replicate its findings.

Well siblings' experiences of living with a child following a traumatic brain injury: a systematic review protocol

BACKGROUND

The aim of this systematic review is to synthesize the available evidence identified through a systematic search on well siblings' experiences of living with a child following a traumatic brain injury (TBI). Brain injuries in children have been referred to as the "silent epidemic" of current times. Brain injuries in children are also recognized as a global public health concern, with the impact on children, effects on family life, and caregiving markedly misunderstood and underestimated. It is widely recognized that a serious brain injury impacts on the whole family, both immediate and extended regardless of the age of the individual who experiences the brain injury. While some research refers to parental experiences of children with TBIs and caregivers experiences, there is a dearth of literature relating to the impact on well siblings and their perspectives. Well siblings' experiences regarding the impact of living with a child post-TBI are not well understood. In order to advance the delivery of family nursing care in the home, an understanding of the well siblings' experiences is fundamental.

METHODS

The search will be conducted using seven medical and healthcare databases for articles published up until February 2019. Two reviewers will independently screen the articles for inclusion and assess for study quality using the standardized critical appraisal instrument from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Two reviewers will extract data from each study and carry out data analysis to uncover themes within the literature. Data synthesis of findings will be carried out using JBI-QARI.

DISCUSSION

It is anticipated that the findings of the proposed review will be of interest to health and social care professionals, particularly those working in units where children have suffered TBIs, their well siblings, and families. The aim is to identify well siblings' experiences which can inform enhanced care delivery to the families of children following a TBI. The findings of this review will provide evidence to aid professionals with the assessment of siblings' needs to enhance their sense of self within the family unit. Future directions, in addition to potential limitations of the approach, will be discussed.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO 2018 CRD42018111036.

Supporting Parent Caregivers of Children with Life-Limiting Illness

The well-being of parents is essential to the well-being of children with life-limiting illness. Parents are vulnerable to a range of negative financial, physical, and psychosocial issues due to caregiving tasks and other stressors related to the illness of their child. Pediatric palliative care practitioners provide good care to children by supporting their parents in decision-making and difficult conversations, by managing pain and other symptoms in the ill child, and by addressing parent and family needs for care coordination, respite, bereavement, and social and emotional support. No matter the design or setting of a pediatric palliative care team, practitioners can seek to provide for parent needs by referral or intervention by the care team.