Parental stress and dyadic consensus in early parenthood among mothers and fathers in Sweden

Sociodemographic factors and their predictive role in parents' future anxiety

BACKGROUND

High levels of future anxiety in parents may not only affect their cognitive processes, and attitudes but also impact their parenting behaviour and relations with the children.

OBJECTIVE

In the present study, we aimed to identify the differences in the intensity of parents' future anxiety across demographic variables and to assess demographic predictors of FA.

METHODS

A group of 103 parents from Eastern Poland (71% mothers and 29% fathers) completed the Future Anxiety Scale. Their children were aged 3-16 years. The 10 aspects of Future Anxiety were compared across the five parent demographic variables of gender, age, level of education, place of living (rural vs. urban), and number of children.

RESULTS

The results show that parents' education level, gender, and the number of children in the family were predictors of FA. Parents' age and place of living did not significantly predict FA. Mothers reported significantly higher levels of anxiety than fathers, for both general future anxiety and helplessness. Parents who had only one child reported higher levels of helplessness. However, it was the parents' level of education that showed the greatest number of significant differences. Parents with only secondary education reported higher average scores on seven (70%) of the 10 aspects of future anxiety. The differences were significant for general future anxiety, health and wellbeing, restricted freedom, the meaning of life, pessimism, helplessness, and isolation.

CONCLUSION

These findings indicated the possible groups of parents who may need support and identified potential areas of intervention.

On cloud nine? Maternal emotional wellbeing six weeks up to one year postpartum - A cross-sectional study

BACKGROUND

Little is known about the full scope of emotional wellbeing of mothers up to one year postpartum, to adequately support women during transition to motherhood. Reduced emotional wellbeing (REW) affects women's adaption to the changes and challenges in becoming a mother. We aimed to increase the knowledge and understanding of mothers' emotional wellbeing and the influencing factors.

METHODS

This cross-sectional study includes 385 Flemish mothers up to one year postpartum. Online data were collected with the General Health Questionnaire-12, Postpartum Bonding Questionnaire, Personal Well-Being Index-Adult, The Basic Psychological Needs Scale, Sense of Coherence-13 and Coping Operations Preference Enquiry.

RESULTS

A total of 63.9% of the participants reported REW. Mothers with REW more often had (a history of) psychological problems compared to mothers with healthy emotional wellbeing (p = 0.007). Multiple linear regression analysis showed negative associations between emotional wellbeing and satisfaction (p = 0.002; p < 0.001), comprehensibility (p = 0.013) and positive associations between emotional wellbeing and bonding (p < 0.001), manageability (p = 0.033), problem solving (p = 0.030) and avoidance (p = 0,011) - with an explained variance of 55.5%.

LIMITATIONS

Some limitations of our study are the GHQ-12 cut-off value, the nature and implication of (a history of) psychological problems and the self-selected population.

CONCLUSION

It would be of worth for midwives to discuss with mothers (to be) what to expect. This - to support mothers in making sense of their life as a mother and how various factors might influence their emotional wellbeing. The high prevalence of REW is worrying, but needs to be interpreted with caution.

Factors influencing postpartum depression among Japanese parents: A prospective longitudinal study

AIM

Postpartum depression (PPD) may have negative effects on the parents and lead to impaired cognitive, socioemotional, and behavioral development in their children. The purpose of this study was to examine factors associated with PPD in parents during the first year after delivery.

METHODS

This study used a self-administered questionnaire. Questionnaires were mailed at 5 days, 3 months, 6 months, and 1 year after delivery, respectively. The particpants were 107 pairs of mothers and fathers. PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Data on sense of coherence (SOC), Quality Marriage Index, Social Support Scale, Mother-to-Infant Bonding Scale, and sociodemographic variables were collected. Multiple regression analysis was performed to examine the strength of the association between several variables and the EPDS at each survey period for fathers and mothers, respectively.

RESULTS

The prevalence of PPD in the first-year postpartum ranged from 12.1%-23.4% to 7.5%-8.4% for fathers and mothers, respectively. SOC had the strongest impact on EPDS scores for both fathers and mothers at all four survey periods.

CONCLUSIONS

Our findings suggest that stress coping skills are an important factor affecting PPD throughout the first-year postpartum for both fathers and mothers.

Risk for partners' depression and anxiety during pregnancy and up to one year postpartum: A longitudinal cohort study

INTRODUCTION

Families may benefit from increased focus on partner emotional well-being during pregnancy and the perinatal period. Our aim was to explore the risk for depression and anxiety during pregnancy and one year postpartum in relation to partners' self-reported health, sense of coherence, social support, and lifestyle factors.

METHODS

This is a longitudinal cohort study using three questionnaires that were answered twice during pregnancy and at one year postpartum. Participants (n=532) were recruited between April 2012 and September 2013, and follow-up was between April 2012 and March 2015, in Sweden.

RESULTS

In late pregnancy, 8.9% of the prospective partners were at high risk for depression and 8.3% one year postpartum. An increased risk for depression was found amongst those reporting 'fair or very poor' sexual satisfaction and those reporting 'fair or very poor' health during pregnancy and postpartum. High anxiety was reported by 10.8% during late pregnancy and 12.4% one year postpartum. Partners who were unemployed, had financial difficulties, and who scored low on a Sense of Coherence scale, showed significantly higher anxiety in late pregnancy and postpartum. Social support has a significant and positive impact concerning signs of depression and anxiety, both during pregnancy and postpartum.

CONCLUSIONS

More than 10% of partners in this study showed depressive symptoms and anxiety, indicating a problem in need of attention by stakeholders. Strengthening social support is of greatest importance. It is time for the introduction of family-focused care aimed at prevention of depression and anxiety, and maintenance of family well-being.

Concordance within parent couples' perception of parental stress symptoms among parents to 1-18-year-olds with physical or mental health problems

Parents of children with physical or mental health problems are at higher risk for experiencing parental stress. However, mothers and fathers may experience parental stress differently. The aim was to examine whether mothers and fathers of children with physical and/or mental health problems are equally inclined within the couples to experience different aspects of parental stress when considering child and parent couple characteristics. Single aspects of Parental stress were assessed with nine items from the Parental Stress Scale in 197 parent couples of children aged 1–18 years with physical and/or mental health problems. Agreement within parent couples for each item was tested using two tests of marginal homogeneity for dependent data: a nominal G²-test and an ordinal γ-test. Analyses were conditioned on child gender, child age, couple educational level, and overall parental stress. For seven aspects of parental stress, differences in agreement within the couples were found with at least one of the conditioning variables. For five aspects (item 3, 4, 9, 10, 13) addressing specific personal experience of daily stressors related to having children and feeling inadequate as a parent, the differences were systematic. Mothers were more inclined to experience these aspect of parental stress than fathers, specially mothers of boys, a younger child, in couples with an education above high school or with a higher stress level. Agreement was found for two aspects (item 14 and 16) of parental stress. This study suggests that mothers’ and fathers’ experience of most aspects of parental stress vary within the couples. Knowledge on systematic difference between parents’ experience of parental stress may inform future interventions. For aspects where mothers generally experience the highest degree of stress, fathers may be involved as support. Future studies may explore the role of diagnoses, coping strategies and examine concordance in parental stress symptoms in other subgroups.

The Parental Stress Scale revisited: Rasch-based construct validity for Danish parents of children 2-18 years old with and without behavioral problems

BACKGROUND

Experiencing parental stress is common among parents of children of all ages and is elevated in families characterized by stressors such as poverty, mental health problems, and developmental problems. The Parental Stress Scale (PSS) is a short measure for the assessment of perceived stress resulting from being a parent.

METHODS

This study examines the construct validity and psychometric properties of the Danish PSS using Rasch and graphical loglinear Rasch models in a sample of parents of 2-18-year-old children with and without known behavior problems. We emphasized analyses of differential item functioning, to ascertain whether the scale yields unbiased scores for subgroups of parents.

RESULTS

The 18-item PSS did not fit the Rasch model or a graphical loglinear Rasch model. After dichotomizing item responses and eliminating items 2 and 11, we found the PSS to consist of two distinct subscales measuring parental stress and lack of parental satisfaction. For the total sample, the Parental Stress subscale fit a very complex graphical loglinear Rasch model with differential item functioning relative to parental education and whether children had behavior problems or not. The Lack of Parental Satisfaction subscale fit a simple graphical loglinear Rasch model with differential item functioning only relative to subsample. When dividing into subsamples of parents of children with and without behavior problems, the Parental Stress subscale fit a simple graphical loglinear Rasch model, though still with differential item functioning, while the Lack of Parental Satisfaction subscale fit the Rasch model in each subsample of parents. Both subscales performed best for parents of children with behavior problems.

CONCLUSIONS

The PSS should be used in a 16-item version and scored as two subscales. The PSS appears better suited for use among parents of children with behavior problems than within a sample without any known difficulties.

Parenting stress and its correlates in an infant mental health unit: a cross-sectional study

Background: An infant's development is closely linked to the relationship they have with their parents. Parenting stress, affective disorder, and an upbringing with substance-abusing parents can affect parenting quality and increase the risk of children developing behavioral, mental and social problems. The overall aim of the study was to investigate how parents of children attending an outpatient Infant Mental Health (IMH) unit rate their own psychological health and parenting stress, and to explore predictors of parenting stress.Methods: The sample comprised 197 parents, 129 mothers and 68 fathers, referred with their infant/toddler to an outpatient IMH unit for interplay treatment. On admission, the parents completed self-report questionnaires concerning their own mental health problems and parenting stress.Results: The mothers reported significantly more psychiatric symptoms and parenting stress than the fathers. Fathers with substance-abusing parents had often experienced divorce in the family of origin, had a low level of education, and had often experienced trauma. Depression was a predictor for parenting stress for both mothers and fathers.Conclusion: The parents' situation was strained, presenting a variety of psychiatric symptoms and high levels of parenting stress, making assessment of parental health before starting treatment important. The mothers' situations were more serious compared with the fathers', and for both parents depression was a significant predictor for parenting stress. To increase the chances of a positive treatment outcome for the child, both parents should be included in the treatment.

Dyadic Adjustment and Prenatal Parental Depression: A Study with Expectant Mothers and Fathers

Introduction: This paper evaluated the relationships between the dyadic adjustment of expectant parents and prenatal maternal and paternal depression.

Method: Participants were 98 couples who were expectant parents in the third trimester of pregnancy. Most couples (97%) were primiparous. Participants' prenatal depression, psychiatric symptomatology, perinatal affectivity, and dyadic adjustment were evaluated.

Results: Hierarchical regression and relative weight analyses showed the importance of various marital adjustment dimensions in predicting prenatal maternal and paternal depression. In particular, the marital relationship variables of dyadic consensus and affective expression of both partners was related to prenatal depression in expectant mothers, with the relationship even stronger in expectant fathers. The results suggested that for both partners, perception of marital relationship quality contributes to the development of depressive symptoms in new mothers and fathers to a greater degree than the single perception of one partner.

Discussion: Clinically, the results suggest that clinicians should focus on partner relationships in the perinatal period. The provision of psychological interventions to improve a couple's functioning may help to protect new parents against depressive symptomatology.

The Predictive Role of Maternal Parenting and Stress on Pupils' Bullying involvement

The link between inappropriate parenting style and both bullying and victimization is well documented. However, it is not clear as to which kind of parenting style is associated with victimization. Furthermore, no studies have yet been conducted regarding the role of parental stress in bullying and victimization. This study aimed to examine the role of parenting styles and maternal stress in pupils' bullying and victimization. A total of 300 primary school pupils, enrolled in fourth and fifth grades, participated in the study. Initially, 100 noninvolved pupils were randomly selected using a multistage cluster sampling method. Then using a screening method, 100 bully pupils and 100 victimized peers were selected. Olweus Bullying Scale and teacher nomination were administered for screening these pupils. Baumrind Parenting Style Questionnaire and revised version of Abidin Parental Stress Index (short form) were also applied to all pupils in the study. Data were analyzed using discriminant function analysis. The findings showed that (a) with regard to parenting styles, significant differences were found among groups. Authoritarian parenting style could significantly predict pupils' bullying behavior, whereas victimization was predictable in families with permissive parenting style. In addition, noninvolved pupils were predicted to have authoritative parenting style. (b) Considering maternal stress, significant differences were observed across groups. Parents of bullies and victims were predicted to have higher maternal stress than noninvolved pupils. The implications of the study in relation to the role of mothers in bullying and victimization are discussed.

Lifestyle factors, self-reported health and sense of coherence among fathers/partners in relation to risk for depression and anxiety in early pregnancy

BACKGROUND

Father's health is important for mothers and unborn/newborn children and knowledge about expectant fathers' health in relation to lifestyle and psychosocial aspects is essential.

AIMS

To determine sociodemographic and lifestyle factors, self-reported health and sense of coherence among fathers and partners in relation to their risk for depression and anxiety in early pregnancy.

METHODS

A cross-sectional design, descriptive statistics, chi-squared analysis, T-test, binary logistic regression, multiple logistic regression with OR and 95% CI were used.

RESULTS

A total of 532 prospective fathers/partners constituted the cohort (mean age 31.55, SD 5.47 years). Nearly, one in ten (9.8%) had a statistically high risk for depression; mainly those who were unemployed (p = 0.043), had financial distress (0.001), reported 'very or fairly bad' health (p = 0.002), had a 'very or fairly bad' sexual satisfaction (p = 0.006) and scored low on the SOC scale (p < 0.001). They smoked more often (p = 0.003) were hazardous users of alcohol (p = 0.001) and slept with difficulties (p = 0.001). Those with sleeping difficulties were 5.7 times more likely to have several symptoms of depression (p = 0.001). Hazardous users of alcohol and smokers had 3.1 respectively 3.0 times higher risk for depression (p = 0.001 respectively 0.003). The single strongest risk factor was a low score on the SOC-scale which gave 10.6 (AOR 10.6; 95% CI 5.4-20.6) higher risk for depression. High-anxiety 'just now' was reported by 8.9% and 'in general' by 7.9%, and those who had sleeping difficulties reported 'very or fairly bad' health (p < 0.001).

CONCLUSIONS

Allocating more resources and introducing more family-focused care with depression and anxiety screening in early pregnancy for both expecting parents at antenatal care should be strongly considered by actors and policymakers, as this is a step in maintaining a family's well-being.

Psychometric properties of the Danish Parental Stress Scale: Rasch analysis in a sample of mothers with infants

The Parental Stress Scale (PSS) was developed as a short measure of perceived stress resulting from being a parent. The current study examined the psychometric properties of the Danish version in a sample of 1110 mothers of children aged 0 to 12 months using Rasch models. Emphasis was placed on the issues of uni-dimensionality and absence of differential item functioning relative to the age and educational level of the mothers. Results showed that no adequate fit could be established for the full PSS scale with 18 dichotomized items. Further analyses showed that items 2 and 11 had to be eliminated from the scale, and that the remaining items did not make up a unidimensional PSS scale, but two subscales measuring different aspect of parental stress: a 9-item scale measuring parental stress and a 7-item scale measuring lack of parental satisfaction. Fit to the Rasch model could not be established for any of the two subscales. For the parental stress subscale, we found evidence of local dependence for four item pairs (3 and 4, 9 and 10, 10 and 16, 12 and 16), as well as evidence of two items functioning differentially: item 16 relative to level of education, and item 3 relative to both age and educational level. For the lack of parental satisfaction subscale, we found evidence of local dependence between some two pairs (1 and 17, 17 and 18), but no evidence of differential item functioning. Both subscales fit graphical loglinear Rasch models adjusting for local dependence and differential item functioning. Plotting the adjusted subscale scores against one another showed that the two-scale solution provides additional information, as some mothers are stressed but not lacking in parental satisfaction.

Parental stress and depressive symptoms increase the risk of separation among parents with children less than 11 years of age in Sweden

AIMS

Parental separations have become more frequent in recent decades. In Western countries, about 25% of children experience parental separation. There is a need to explore the risk factors for separation to give children an optimal childhood. The objective of the present study was to examine parental stress and depressive symptoms during early parenthood and their association with parental separation.

METHODS

Four hundred and seven couples completed questionnaires on depressive symptoms for 3 months and parental stress for 18 months after childbirth. Total parental stress and five sub-areas were investigated. To study the separation rate, parents' addresses were recorded 9 to 11 years after childbirth.

RESULTS

Twenty-nine percent of the parents were separated 9 to 11 years after childbirth. Separation was associated with depressive symptoms at 3 months (mothers p = .002, fathers p = .025) and total parental stress at 18 months after childbirth (mothers p = .010, fathers p = .005). The sub-areas of parental stress, Spouse relationship problems (mothers p = <.001, fathers p = .001) and fathers' Social isolation ( p = .005), were associated with separation. In multivariable regression analyses of the parents' separation rate 9 to 11 years after childbirth, the only significant predictor was mothers' Spouse relationship problems ( p < .001).

CONCLUSIONS

The knowledge that parental stress and depressive symptoms are risk factors for separation may simplify professional support for parents in early parenting. Courses for new and expectant parents can use this knowledge to increase parents' awareness.

Parenting stress among parents of children with congenital diaphragmatic hernia

PURPOSE

The aim of this study was to examine parental stress among parents of children with congenital diaphragmatic hernia (CDH).

METHODS

Between 2005 and 2009, a total of 51 children with CDH were treated at Astrid Lindgren Children's Hospital. The survival rate at discharge was 86% and long-term survival rate 80%. One parent each of the long-term survivors (41 children) was included in the present study, and 34 parents (83%) agreed to participate. Participants received the Swedish Parenthood Stress Questionnaire (SPSQ). The questionnaire was supplemented by data from case records.

RESULTS

Parents of children with CDH, who had been supported by ECMO or had a long hospital stay, showed significantly higher overall parental stress. Mothers scored an overall higher parental stress compared with fathers. A prenatal diagnosis of CDH or lower parental educational level resulted in significantly higher parental stress in some of the factors.

CONCLUSIONS

Parental stress in parents of children with CDH seems to increase with the severity of the child's malformation. Mothers tend to score higher parental stress than fathers.

Association between depressive symptoms and parental stress among mothers and fathers in early parenthood: A Swedish cohort study

Aim To determine whether there is an association between depressive symptoms and parental stress among mothers and fathers during early parenthood in Sweden. Methods In this study, 401 mothers and 396 fathers (393 couples) were included; the Edinburgh Postnatal Depression Scale and the Sense of Coherence Scale were measured 3 months after childbirth, and the Swedish Parenthood Stress Questionnaire and the Sense of Coherence Scale after 18 months. Complete data for multivariable analysis were available for 264 mothers and 252 fathers. Results The mothers estimated greater total depressive symptoms and parental stress than the fathers did. Both the mothers and the fathers had the greatest level of stress in the sub-area 'Role restriction'. The mothers had the lowest level of stress in the sub-area 'Social isolation' and the fathers in the sub-area 'Incompetence'. The mothers perceived greater levels of stress than the fathers did in all sub-areas except for 'Social isolation', where the fathers perceived higher stress. There was an association between the parents' depressive symptoms and parental stress. The parents' own depressive symptoms at 3 months and sense of coherence and the partners' parental stress at 18 months were positively associated with the parental stress at 18 months in univariable and multivariable analyses. Conclusions Understanding the relationship between depressive symptoms and parental stress is important for health professionals so they can offer parents adequate support in early parenthood to optimize the conditions for raising a child. This knowledge should also be communicated to the parents.