Children's adjustment to a parent's stroke: determinants of health status and psychological problems, and the role of support from the rehabilitation team.
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OBJECTIVE: To investigate the support given to young children of patients with stroke by rehabilitation teams and to identify characteristics of the patients, spouses and children that relate to children's adjustment 2 months after the patient's discharge. SUBJECTS AND METHODS: Seventy-seven children (< or =18 years of age) of patients with stroke consecutively admitted to inpatient rehabilitation were included. Adjustment was measured with the Child Behaviour Check List, Child Depression Inventory and Functional Status II. Multilevel regression analyses were conducted to identify determinants of adjustment. RESULTS: Half of the children received some form of support from a rehabilitation team. Receiving more support was related to more severe disability of the parent with stroke, but not to the child's health or behavioural problems at the start of the stroke victim's inpatient stay. At the start of rehabilitation, 54% of the children had subclinical or clinical problems. Children's adjustment 2 months after their parent's discharge was related to the strain on spouses and not to the patients' characteristics or those of the support. CONCLUSION: The children's adjustment was related to the strain perceived by the healthy parent. There is a need for support that focuses on the experience of children of patients with stroke, regardless of stroke severity. (+info)
How early bonding, depression, illicit drug use, and perceived support work together to influence drug-dependent mothers' caregiving.
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In this study, the authors used an attachment framework to examine how drug-dependent mothers' early bonding experience, depression, illicit drug use, and perceived support work together to influence the family environment. The authors hypothesized that (a) depression and drug use function as proxies for a stronger risk factor, the perceived absence of support available in everyday life, and (b) associations between mothers' early bonding experience and family environment are mediated by perceptions of support and nurture available in everyday life. The authors used a "building block" analytic approach and data collected from 125 mothers enrolled in methadone maintenance to test hypotheses. Both hypotheses were confirmed for 1 outcome, family adaptability. For the 2nd outcome, family cohesion, only perceived support was a significant predictor. Although preliminary, the findings suggest that perceptions of relationships in everyday life play a critical role in the etiology of drug-dependent mothers' parenting. (+info)
Association of parental depression with psychiatric course from adolescence to young adulthood among formerly depressed individuals.
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The authors examined whether parental major depressive disorder (MDD) is associated with course of depression and other psychopathology among formerly depressed adolescents as they enter adulthood. The sample consisted of 244 individuals (age 24) in a longitudinal study who had experienced MDD by 19. Maternal MDD was associated with MDD recurrence, chronicity and severity, anxiety disorders, and (among sons only) lower psychosocial functioning in offspring between the ages of 19 and 24. Paternal MDD was associated with lower functioning. Sons of depressed fathers had elevated suicidal ideation and attempt rates in young adulthood. Recurrent paternal MDD was associated with depression recurrence in daughters but not sons. The impact of parental MDD on offspring could not be attributed to characteristics of the offspring's depression prior to age 19. (+info)
Early experiences and their relationship to maternal eating disorder symptoms, both lifetime and during pregnancy.
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BACKGROUND: There is some evidence that early sexual abuse is an aetiological factor for eating disorder. However, there is sparse information from large-scale, non-clinical studies. AIMS: This study was designed to explore which early experiences, recalled during pregnancy, were associated with both lifetime and antenatal eating disorder symptoms in a community sample. METHOD: Univariate and multivariate analyses were conducted of data from questionnaires administered during pregnancy to a community sample of pregnant women. RESULTS: Recall of parental mental health problems and of early unwanted sexual experiences were independently associated with both lifetime eating problems, laxative use and vomiting during pregnancy, and marked concern during pregnancy over shape and weight. CONCLUSIONS: There are public health implications for these results. Eating disorders in mothers represent a risk for child development. It may be important to enquire during pregnancy about a history of eating problems and to provide the opportunity for early experiences to be discussed. (+info)
The quality of communication between parents and adolescent children in the case of parental cancer.
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BACKGROUND: This study was designed to investigate: (i) parent-adolescent communication in families of cancer patients; (ii) relationships between parent-adolescent communication and posttraumatic stress symptoms (PTSS) in adolescent children; and (iii) associations between parents' illness characteristics and parent-adolescent communication. PATIENTS AND METHODS: A total of 212 adolescents completed the Impact of Event Scale and Parent-Adolescent Communication Scale. RESULTS: Adolescents communicated less openly with mothers with cancer than controls with mothers; this was the only significant difference with the reference group. Daughters communicated more openly with ill parents than with healthy parents. More open communication with healthy parents was related to fewer PTSS in daughters. More problem communication with both parents was related to more PTSS in both sons and daughters. Sons reported more problems in communication with ill parents in case of more intensive treatment or recurrent disease. Daughters experienced less open communication with both parents when ill parents received more intensive treatment. Time since diagnosis was not related to parent-adolescent communication. Multivariate analyses showed that communication patterns specifically affected PTSS of daughters. Problem communication with the healthy parent was the strongest predictor of intrusion while problem communication with the ill parents was the strongest predictor of avoidance. CONCLUSIONS: Parent-adolescent communication in families of cancer patients differs little from that in families not confronted with parental cancer. Problem communication outweighed lack of openness with respect to development of PTSS. Recurrent disease and intensive treatment regimens affected parent-adolescent communication negatively. (+info)
Psychosocial impairment in offspring of depressed parents.
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BACKGROUND: Offspring of depressed parents experience impairment in a number of domains of functioning. Few studies have examined the impact of both maternal and paternal depression and co-morbid psychopathology on offspring functioning. METHOD: Oregon Adolescent Depression Project participants were administered diagnostic interviews and completed measures of psychosocial functioning during adolescence (mean = 16.6, S.D. = 1.19) and again during young adulthood (mean = 24.5, S.D. = 0.51). Diagnostic interviews were also conducted with the mothers and fathers of the target individual. RESULTS: After controlling for relevant demographic characteristics, parental co-morbid psychopathology, and offspring psychopathology, maternal depression was associated with higher levels of physical symptoms (beta = 0.14, S.E. = 0.07) during adolescence, and higher levels of minor stressors (beta = 2.52, S.E. = 1.07) and a greater risk for using mental health services (OR 1.86, 95% CI 1.14-3.03) in young adulthood. Paternal depression was associated with offspring experiencing more major stressors (beta = 0.27, S.E. = 0.07), having lower perceived social competence (beta = -0.17, S.E. = 0.08), and being more likely to attempt suicide (OR 2.65, 95% CI 1.19-5.92) during adolescence, as well as lower perceived social competence (beta = -1.21, S.E. = 0.49) in young adulthood.Conclusions. Offspring of depressed parents demonstrate impairment in a variety of domains, even after controlling for the effects of their own psychopathology. Further research on the mechanisms that lead to these impairments, as well as the role of these impairments in the subsequent development of psychopathology, is warranted. (+info)
Social competence in children of alcoholic parents over time.
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In the current study, the authors tested the hypothesis that children of alcoholic parents (COAs) show deficits in social competence that begin in early childhood and escalate through middle adolescence. Teachers, parents, and children reported on the social competence of COAs and matched controls in a community sample assessed from ages 6 to 15. Hierarchical linear growth models revealed different patterns of change in social competence across development as a function of the reporter of various indicators of competence. Moreover, female COAs showed deficits in social competence in early childhood that receded in adolescence and that varied across subtypes of parent alcoholism. Implications of these findings for understanding the development of social competence in children, and at-risk children in particular, are discussed. (+info)
When a parent has a stroke: clinical course and prediction of mood, behavior problems, and health status of their young children.
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BACKGROUND AND PURPOSE: The purpose of this research was to describe the clinical course of children's functioning (depression, behavioral problems, and health status) during the first year after parental stroke and to determine which patient-, spouse-, or child-related factors at the start of inpatient rehabilitation can predict children's functioning after parental stroke at 1-year poststroke. METHODS: Interviews with 82 children (4 to 18 years of age) and their parents (n=55) shortly after admission to a rehabilitation center, 2 months after discharge from inpatient rehabilitation, and 1 year after stroke. Depression was assessed using the Children Depression Inventory, behavioral problems with the Child Behavior Check List, and health status with the Functional Status II. Potential predictors were gender and age (child), activities of daily living disability and communication ability (patient), and spouse's depression and perception of the marital relationship. RESULTS: At the start of the stroke patient's rehabilitation, 54% of the children had > or =1 subclinical or clinical problems, which improved to 29% 1 year after stroke. Children's functioning 1 year after stroke could best be predicted by their functioning at the start of rehabilitation. Spouse depression and perception of marital relationship were also significant predictors. A total of 28% to 58% of the variance in children's functioning could be explained. CONCLUSIONS: Children's functioning after parental stroke improved during the first year after stroke. Identifying children at risk for problems 1 year after stroke requires assessment of children's functioning and the healthy spouse's depressive symptoms and perception of the marital relationship at the start of rehabilitation. This demonstrates the need for a family-centered approach in stroke rehabilitation. (+info)