The impact of maternal HIV infection on parenting in inner-city African American families.

Parenting behavior and its association with child psychosocial adjustment were examined in inner-city African American families. Participants included 86 HIV-infected women and their noninfected children and 148 HlV-seronegativo women and their noninfected children. Interview data were collected concerning maternal physical health, parenting behaviors, and child psychosocial adjustment. The results indicated that mother-child relationship quality and monitoring were important parenting factors for adaptive child psychosocial functioning. HIV-infected mothers reported poorer mother-child relationship quality and less monitoring of their children's activities than did noninfected mothers, suggesting that maternal HIV infection may disrupt effective parenting. Directions for future research and clinical implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting adjustment in children and adolescents with sickle cell disease: A test of the risk-resistance–adaptation model.

Objective: A theoretical model was used to examine the impact of risk and resistance factors on the psychological adjustment of children and adolescents with sickle cell disease (SCD). Participants: One hundred eighteen children and adolescents with SCD receiving treatment at a comprehensive sickle cell center and their mothers. Measures: Included risk factors (condition parameters, functional independence, and disability stressors), resistance factors (stress processing, intrapersonal factors, and social ecological factors), and adjustment. Results: Adaptive behavior was associated with child maladjustment, severity of disability was associated with disability stress, and child competence was associated with child maladjustment. Coping did not moderate the association between stress and maladjustment, and adaptive behavior and stress did not mediate the association between severity of disability and maladjustment, as the model had predicted. Conclusions: Results support the continued use of theoretically driven models to investigate the adjustment of children and adolescents with chronic conditions and to promote comparisons of different chronic illnesses and disabling conditions… (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal mood, video-mediated cognitions, and daily stress during home-based, family interactions.

This article presents an in vivo investigation of maternal negative mood, maternal video-mediated cognitions, and daily stressors in families with young children. Specifically, it was hypothesized that greater levels of maternal depressed, anxious, and hostile mood states immediately prior to a daily, reportedly routine, stressful parent–child interaction would be significantly associated with higher percentages of dysfunctional and lower percentages of functional cognitions. Forty-five mothers of 2- to 5-year-old children participated in this study by rating their mood before being videotaped in a daily routine with their child they reported as recurrent and stressful (e.g., mealtime). Using video-mediated recall (VMR) methodology, mothers were instructed to recall their cognitions upon immediate video review. Results indicated that greater levels of negative mood were associated with a greater percentage of dysfunctional cognitions and a smaller percentage of functional cognitions. Levels of maternal depressed mood were significantly and independently associated with greater rates of dysfunctional and lower rates of functional cognitions. Negative mood states were not consistently associated with the amount of maternal self-reported general irrationality, pointing to the utility of the VMR to elicit maternal cognitions specific to the observed interaction, which may have more implications for clinical intervention than more general irrationality measures. Evaluating maternal mood and using video-mediated maternal cognitions regarding daily family stressors can precipitate clinical interventions meant to reduce family-related stress and potentially improve maternal and child mental health outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of coping strategies of aging mothers of adults with mental illness or mental retardation.

Differences in coping by 105 aging mothers of adults with mental illness and 389 similar mothers of adults with mental retardation were investigated. Although no differences in problem-focused coping were found, mothers of adults with mental illness used more emotion-focused coping, which predicted greater maternal depression. For mothers of adults with retardation, depressive symptoms were a function of their child's behavior problems, although this source of stress was buffered by coping. For mothers of adults with mental illness, depression was a function of caregiving demands, but coping did not buffer the effects of stress. Explanations for findings include maternal perceptions of the context of care, of her control over the disability, and her caregiving efficacy. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Longitudinal effects of adaptability on behavior problems and maternal depression in families of adolescents with autism.

Research on families of individuals with autism has tended to focus on child-driven effects utilizing models of stress and coping. The current study used a family systems perspective to examine whether family level adaptability promoted beneficial outcomes for mothers and their adolescents with autism over time. Participants were 149 families of children diagnosed with autism who were between the ages of 10 and 22 years during the 3-year period examined. Mothers reported on family adaptability, the mother–child relationship, their own depressive symptoms, and the behavior problems of their children at Wave 1, and these factors were used to predict maternal depression and child behavior problems 3 years later. Family level adaptability predicted change in both maternal depression and child behavior problems over the study period, above and beyond the contribution of the dyadic mother–child relationship. These associations did not appear to depend upon the intellectual disability status of the individual with autism. Implications for autism, parent mental health, family systems theory, and intervention with this population are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Maternal cocaine use and the caregiving environment during early childhood.

The purpose of this study was to examine the quality of the caregiving environment for young children of polydrug cocaine-using mothers. Three aspects of the caregiving environment were examined: physical and social settings for development, maternal psychosocial functioning, and child rearing customs and attitudes. It was hypothesized that maternal cocaine use would be associated with more negative caregiving environments. Results indicated that cocaine-using mothers were more likely to have symptoms of posttraumatic stress disorder, experience or witness community violence, and use negative discipline and that their children were more likely to remain in foster care for longer periods of time, experience more changes in primary caregivers, and be visited by male caregivers less often. The implications of these findings for child adjustment and directions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rapid detection and counting of viable bacteria in vegetables and environmental water using a photon-counting TV camera

A physical, cognitive, or mental disability presents significant challenges to an individual in gaining access to a coordinated program of preventive, primary, and secondary health care services. This article describes the health care needs of people with disabilities and discusses how the financial incentives in managed care may threaten access to the health care services they need to maintain their health and functional independence. We argue that despite the shortcomings of present models, managed care has the potential to improve the health care of people with disabilities. Moreover, as health plans become increasingly accountable to consumers (and begin to compete on the basis of quality), they will not be able to ignore the distinct health care needs of people with disabilities.     

Mothers and fathers of young developmentally disabled and nondisabled boys: Adaptation and spousal support.

Assessed the extent to which the presence of a young developmentally disabled or nondisabled male child affected adaptation and family roles for both parents. Developmental child assessments, in-home ratings of parenting, and maternal and paternal self-assessments and interviews were included. Marital adjustment, disruptions in family life, and observed parenting of the child (but not depression) varied with disability status of child. Mothers in both groups reported more depressive symptoms and family disruptions than fathers. Fathers of disabled children assumed less responsibility than comparison fathers for child care, even in mother-employed families. Decreased father involvement in child care was specific to the disabled child, not to siblings, and was related to severity of the child's atypical behaviors. Expressive support from one's spouse was the best predictor of quality of parenting for both mothers and fathers of disabled and nondisabled sons. Disharmony between current and "appropriate" spousal support was a significant negative predictor of perceived and observed parental adaptation. The concept of harmonic responsiveness was proposed to explain how proffered support must be tuned to the perceived needs and expectations of one's spouse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Autoimmune hyperthyroidism in prepubertal children and adolescents: comparison of clinical and biochemical features at diagnosis and responses to medical therapy

The purpose of this study was: (i) to examine the impact of the clinical severity, anatomical location and treatment of psoriasis on patients' quality of life, and (ii) to investigate the effects of perceptions of psoriasis-related stress on patients' physical and mental health and on areas of disability in everyday life. All patients (n = 204) attending a psoriasis specialty clinic were invited to complete a multidimensional quality of life assessment comprising the Psoriasis Disability Index (PDI), the SF-36 Health Survey and the Psoriasis Life Stress Inventory (PLSI). Results (n = 150) indicated that overall clinical severity of psoriasis as assessed by the Psoriasis Area and Severity Index, and duration of psoriasis, were unrelated to impairment in any areas of quality of life. Anatomical location (social visibility) of psoriasis was associated with self-report of poor physical health (P = 0.01), and there was a modest association with patients' mental health (P = 0.04); however, anatomical location of psoriasis was not significantly associated with self-reported disability in everyday life, or stress scores. Patients who were classified as more reactive to the stress associated with psoriasis (78% of the sample) were functioning less well in terms of their mental health (P = 0.001) and also experienced significantly more disability in all areas of everyday life (P = 0.001). Differences in method of treatment for psoriasis did not significantly affect scores on the psoriasis-specific (PDI; PLSI) or generic (SF-36) quality of life measures. A multiple regression analysis demonstrated that stress resulting from anticipating other people's reactions to their psoriasis contributed more to the variance in patients' disability in everyday life than any other medical or health status variable. The results support the importance of assessing the effects of stress in patients' adjustment to their condition and may indicate a role for adjunctive psychological stress management training for a significant number of patients with psoriasis.     

Functional performance in people with chronic obstructive pulmonary disease

The extent to which individuals with a chronic physical illness perform their day-to-day activities and maintain the independence and autonomy they desire is both an indicator of adaptation and an important clinical outcome criterion. Yet the concept of functional performance is not well understood. Studies of people with chronic obstructive pulmonary disease (COPD) have attempted to identify physiologic and psychosocial factors that contribute to functioning in this population. These studies have used a melange of terms, including functional status, functional ability, quality of life, and health status interchangeably. They have also employed a variety of instruments to operationalize functional performance and an assortment of predictors to understand the phenomena. Perhaps as a result of this disarray, no attempt has been made to synthesize the literature for nursing research and practice. The purpose of this paper is to summarize the research on functional performance in people with COPD, indicate areas of understanding and quandary, suggest possible flaws, and propose several new directions for practice and research.     

Relation entre l'attachement et les interactions mère-enfant en milieu naturel et expérimental à l'age scolaire.

The purpose of the present study is to examine the relation between quality of mother-child interaction in a lab and home setting, and quality of attachment of school-age children. A second objective of the study is to evaluate the associations between quality of mother-child interactions, attachment and maternal psychosocial measures (social support, depression, and parental stress). Security of attachment (Separation-Reunion procedure, Main & Cassidy, 1988) and the quality of mother-child interaction was evaluated for a sample of 38 children (mean age = 6 years). Mothers also completed self-report measures for depression, stress, and social support. Concurrent to the lab assessment, quality of mother-child interaction was also evaluated during a home visit. Results indicated a strong association between interactive patterns in both settings. Moreover, interactive patterns differed in terms of attachment classification with secure children showing the most harmonious patterns and disorganized/controlling children showing the most dysfunctional patterns. Maternal psychosocial measures were not related to child security of attachment, but mothers of insecure children reported marginally more stress related to the child. Maternal psychosocial adjustment was, in part, related to dyadic mother-child interaction in the home and lab setting. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Deposition of genetically engineered human antibodies into the egg yolk of hens

This is an exploratory study that investigated factors influencing the psychosocial adjustment of Central American immigrants with disabilities. The relationships between stress, and perception of disability severity and (a) depression and (b) anxiety were assessed. Furthermore, this study investigated whether social support moderated the impact of stress and severity of disability on depression and anxiety. Stress, severity of disability, and social support explained a high percentage (54%) of the variance in depression. High levels of stress, increased perceptions of severity of disability, and low social support were associated with increased depression. The interactions between support and stress and between support and disability severity did not significantly add to the original model which predicted depression. Main effects were found for stress, disability severity, and the interaction between support and disability severity. Stress and social support significantly accounted for 31% of the variance in anxiety. Increased stress and decreased social support were associated with greater levels of anxiety. The interaction between support and stress did not significantly predict anxiety. Implications of the study in terms of future research and intervention programs targeting mental health outcomes for Latino immigrants with disabilities are discussed.     

Conflict resolution among field-independent and field-dependent Anglo-American and Mexican-American children and their mothers.

32 Anglo-American and Mexican-American boys and girls selected for their extreme field independence or dependence (Man-in-the Frame box, adapted from the rod-and-frame test) interacted with their mothers in 3 role plays designed to provoke conflict over issues of maternal authority and children's independence. The mother–child interactions were recorded, transcribed, and content analyzed. Anglo-American children more often than Mexican-American children entered and persisted in direct conflict with their mothers as indicated by a number of variables such as disagreement and justification of their own will. There was some tendency for Mexican-American mothers to ask fewer questions and to assert their own will more than Anglo-American mothers. Field independence among boys, but field dependence among girls, was associated with more assertive behaviors. Mothers of field-independent children used a somewhat more elaborate verbal code. The study supports hypothesized cultural differences in mother–child interaction patterns, but fails to support the presumed socialization antecedents of field dependence and the cross-sex generality of its correlates. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Determinants of children's health care use: an investigation of psychosocial factors

Factors related to the amount of health care used by 5- to 11-year-old children in a health maintenance organization (HMO) were investigated using a comprehensive multivariate model that assessed the contribution of child health need, mental health, and social functioning; maternal mental health, social support and health care utilization; and family functioning and life events. Mothers reported on the 450 participating children. Health care visits for a two-year retrospective period were obtained from the computerized encounter system. Child health need and maternal patterns of health care use were powerful predictors of the overall amount of health care used, and these factors discriminated high users from low users of care. Family conflict was associated with a higher volume of care, while children's depressive symptoms and non-white race were related to lower use. Maternal social support, mental health, and life events were not predictive of use in either full multivariate model. Enabling factors were held relatively constant by participation of all families in a prepaid HMO. The multiple regression model explained 33% of the variance in use, slightly more than in previous studies of children's health care use. When included in a comprehensive analysis, child and family psychosocial characteristics help to explain children's health care use beyond what is possible using simple health and illness variables. The implications of these findings in the development of further research and to the practice of routine pediatric care are discussed.     

Reframing the meaning of disability to families: the embrace of paradox

In our society, families turn to medical science and health practitioners for assistance when a family member becomes disabled. In the cases of chronic illnesses and developmental disabilities, health professionals may focus interventions on the disease processes, feeling unprepared to deal with the broader issues families struggle with in managing disability. In addition, collaboration between professionals and parents may be strained when family's discourse is viewed as unrealistic, overly emotional, exceedingly optimistic and confusing by professionals. Using in-depth case studies, this qualitative research examined the daily occupations and subjective well-being of six Mexican-origin mothers parenting children with disabilities. Emergent findings demonstrated that these mothers do express apparently contradictory emotions of grief and joy, hope and fear that influenced their subjective well-being. The meaning of the mothers' contrary statements was illuminated in a life metaphor, the embrace of paradox. The embrace of paradox was the management of the internal tension of opposing forces between loving the child as he or she was and wanting to erase the disability, between dealing with the incurability while pursuing solutions and between maintaining hopefulness for the child's future while being given negative information and battling their own fears. The tensions created by the paradox promoted an internal striving to maintain a tenuous hopefulness despite "crashes" in their maternal work, and promoted an extension of maternal skills working toward a hopeful life trajectory for the mother and her child. In the embrace of paradox mothers created a positive bias and regained a sense of control that fueled their optimism in maternal work.     

Hope and social support as resilience factors against psychological distress of mothers who care for children with chronic physical conditions.

On the basis of the multivariate conceptual model proposed by J. L. Wallander et al (1989), perceptions of hope and social support were hypothesized to serve as resilience factors against distress in mothers of children with chronic physical conditions. Relationships among these variables were tested. Ss were 111 mothers of 5 to 18-yr-old children who had cerebral palsy, spina bifida, or insulin-dependent diabetes mellitus. Tests used included the Hope Scale, Social Support Questionnaire-6, Brief Symptom Inventory, and Parents of Children With Disabilities Inventory. There were no differences in distress among mothers raising children with different conditions. Both hope and social support were associated negatively and uniquely with distress in these mothers. Perceptions of hope moderated the relationship between disability-related stress and maladjustment, suggesting a buffering effect when stress is high. However, hope did not appear to be a mediator of the relationship between social support and distress. These findings enhance our conceptual understanding of distress in maternal caregivers of children with a chronic physical condition. They also support improving sense of hope as is done in some problem-solving training programs to enhance coping in distressed individuals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of parental and extrafamilial social support in the psychosocial adjustment of children with a chronically ill father

The relationships among illness stress, perceived support, and child psychosocial adjustment were examined for children living with a chronically ill father. Participants included fathers, mothers, and one child from 53 families in which the father had hemophilia and, in some cases, was HIV seropositive. Objective indicators of severity of illness and subjective measures of the physical and psychological impact of illness were used as sources of children's stress. Results indicated that the impact of illness, but not the severity of illness itself, related to child psychosocial adjustment. Main effects were observed for parental support on child- and parent-reported internalizing problems and stress-buffering effects were obtained for parental support and extrafamilial support on parent-reported internalizing problems. Parental support also demonstrated a stress-buffering effect for child-reported depression. Assessment and intervention implications for behavioral clinicians and researchers are discussed.     

Maternal assessment of infant development: associations with alcohol and drug use in pregnancy

Surveillance by parental concern has been advocated to assess whether formal child developmental testing is needed. To determine whether alcohol intake or illicit drug use in pregnancy is associated with differences in maternal perception of infant development, mothers with acknowledge alcohol and drug habits during pregnancy (N = 120) were interviewed at 11 months' postpartum, within 1 month before infant testing by use of the Bayley Scales of Infant Development. Women with heavy alcohol intake during pregnancy (> 3.5 oz absolute alcohol per week) were 15-fold more likely to overestimate their infant's mental development (P < 0.05), whereas mothers using illicit drugs were 4-fold more likely to overestimate their infant's physical development (P = 0.02). Given the frequent denial of substance abuse, we suggest that health care providers be cautious in accepting a lack of parental concern about a child's development and rely more heavily on formal testing, particularly in high-risk populations.     

Psychosocial outcomes of telephone-based counseling for adults with an acquired physical disability: A meta-analysis.

Background: The delivery of mental health services by telephone, referred to as telecounseling, has the potential to improve the health outcomes of adults with an acquired physical disability in a cost-effective way. However, the efficacy of this form of treatment requires further evaluation before it is used on a larger scale. Aim: This meta-analysis provides a critical and quantitative evaluation of the impact of telephone-administered psychological interventions on the psychosocial functioning of adults with an acquired physical disability caused by spinal cord injury, limb amputation, severe burn injury, stroke, or multiple sclerosis. Method: A comprehensive search of eight electronic databases identified eight studies (N = 658 participants) that compared treatment efficacy to that of matched control groups. Differences in the psychosocial outcomes of treatment and control participants were examined using Cohen's d effect sizes. Fail-safe Ns and 95% confidence intervals were used to evaluate the significance of these results. Results: Significant improvements in coping skills and strategies (overall d = 0.57), community integration (overall d = 0.45), and depression (overall d = 0.44) were observed immediately after telecounseling, with modest improvements in quality of life maintained at 12 months post-intervention (overall d = 0.37). Conclusions: The results suggest that telecounseling is an effective treatment modality for adults adjusting to a physical disability; however, further trials are needed to establish the long term psychosocial benefits. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Effects of family foundations on parents and children: 3.5 years after baseline.

This study investigated the ability of a psychosocial prevention program implemented through childbirth education programs to enhance the coparental and couple relationship, parental mental health, the parent-child relationship, and child outcomes. A sample of 169 heterosexual, adult couples expecting their first child was randomized to intervention and control conditions. The intervention families participated in Family Foundations, a series of eight classes delivered before and after birth, which was designed as a universal prevention program (i.e., applicable to all couples, not just those at high risk). Intent-to-treat analyses utilizing data collected from child age 6 months through 3 years indicated significant program effects on parental stress and self-efficacy, coparenting, harsh parenting, and children's emotional adjustment among all families, and maternal depression among cohabiting couples. Among families of boys, program effects were found for child behavior problems and couple relationship quality. These results indicate that a universal prevention approach at the transition to parenthood focused on enhancing family relationships can have a significant and substantial positive impact on parent and child well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved)