Journal of Pediatric Psychology最新文献

Background: Caregiver-child relationships are closely related to early childhood development outcomes. This study explores the association between child sleep patterns and the caregiver-child relationship in rural China and the mediating role of caregiver depression.

Method: Drawing on a survey of 776 children aged 5-25 months and their primary caregivers, we used ordinary least squares regression to analyze whether children's sleep patterns are associated with the caregiver-child relationship. We conducted mediation analyses to explore how caregiver depression mediated the association between children's sleep patterns and the caregiver-child relationship, and whether the association differed between mother- and grandmother-caregiving households. In analyzing the caregiver-child relationship, we used two of the most widely examined descriptive axes: care and control, where care is measured by the degree of warmth between the caregiver and the child, and control is measured by invasiveness (as opposed to autonomy), which reflects the degree to which the caregiver perceives the child as intrusive or overly demanding.

Results: Results show that caregivers of children with more sleep difficulties perceived less warmth and more invasion in their relationship with the child. Maternal depressive symptoms mediated the relationship between children's sleep and caregiver-child interactions by predicting caregivers' perceived invasion.

Conclusion: The findings provide new evidence on the relationship between children's sleep patterns and caregiver-child relationships in rural areas. Efforts to improve child development in low-resource settings should attend to both caregiver depression and child sleep quality.

Objective: Type 1 diabetes (T1D) and life-threatening food allergies (FAs) are two diet-dependent chronic illnesses (DDCIs) that require rigorous self-management centered on strict dietary monitoring. Grounded in self-determination theory, this study aimed to investigate differences in motivation for healthy eating and well-being among adolescents coping with DDCI, compared to individuals without DDCI. Additionally, it explored the mediating role of general health practices in the relationship between motivation for healthy eating and well-being.

Methods: A total of N = 116 adolescents, aged 10-18 years (T1D: N = 36, M±SD age = 15.28 ± 1.85; FA: N = 39, M±SD age = 13.31 ± 2.40; no-DDCI: N = 41, M±SD = 14.71 ± 1.76), completed questionnaires assessing motivation for healthy eating, general health practices, and well-being.

Results: Internal motivation for healthy eating was positively associated with general health practices in all 3 groups. A moderated-mediation model revealed that among adolescents with DDCI, internal motivation for healthy eating was positively associated with psychological well-being. Internal motivation was also positively associated with physical well-being, but only among adolescents with FA. Conversely, only among adolescents with T1D, external motivation for healthy eating was negatively associated with psychological and physical well-being. Lack of motivation for healthy eating was negatively associated with general health practices among adolescents with T1D and individuals without DDCI.

Conclusions: Adolescents with DDCI face challenges in adhering to healthy eating recommendations and translating knowledge into action. Targeted interventions are necessary to enhance internal and autonomously driven motivation for dietary changes. Personalized nutrition programs for adolescents living with DDCI may effectively promote self-management and overall well-being in this population.

Objective: Adolescents with chronic health conditions (CCs) face unique developmental challenges that affect their psychological well-being. Benefit-finding and growth (BFG) may serve as a psychological resource for this population. However, longitudinal evidence on the hypothesized predictors of BFG and its impact on subjective well-being (SWB) remains scarce. This study explores the reciprocal associations between emotion-focused coping, BFG, and SWB in adolescents with CCs.

Methods: The sample included 498 adolescents (aged 12-21 years) with type 1 diabetes, juvenile idiopathic arthritis, or cystic fibrosis receiving care in Germany. Using latent cross-lagged panel models, we analyzed the directionality of the relationships between coping strategies (acceptance, cognitive reappraisal, seeking social support), BFG, and SWB (satisfaction with life, positive well-being) over 1 year. Sociodemographic and disease-related variables were controlled.

Results: Seeking social support at T1 was significantly associated with higher levels of BFG at T2, whereas no significant prospective associations were observed for T1 acceptance and reappraisal. An inverse cross-lagged association was found between BFG at T1 and reappraisal at T2. Furthermore, BFG at T1 was significantly associated with higher satisfaction with life at T2.

Conclusions: This study provides the first longitudinal evidence of bidirectional relationships between emotion-focused coping and BFG, as well as BFG and SWB in adolescents with CCs. The findings highlight the crucial role of seeking social support in promoting BFG, which enhances adaptive emotion regulation and satisfaction with life. Future interventions should target social resources and cognitive coping strategies to improve psychological well-being in this population.

Clinical trial registration: German Clinical Trials Register (DRKS), no. DRKS00025125. Registered on May 17, 2021.

Objective: Much of the literature that examines well-being in parent caregivers of children with chronic conditions addresses psychosocial correlates. Yet, few studies address an integral cognitive aspect of daily life, prospective memory (PM), in association with parent well-being. The present work addressed this gap and examined parents' self-reported PM demands related to managing their child's chronic conditions and frequency of PM forgetting to well-being.

Methods: A sample of 149 parents of children with chronic conditions completed an online survey including measures of parent and family demographics, PM demands, PM forgetting, perceptions of parenting self-efficacy, and well-being: depressive symptoms, anxious symptoms, general stress, and parenting-related stress. Hierarchical regression analyses evaluated the unique contributions of PM demands and forgetting to each well-being outcome over-and-above other known demographic correlates and perceptions of parenting self-efficacy.

Results: Analyses suggested that PM experiences, particularly forgetting, explained a significantly greater proportion of variance in each well-being outcome beyond the demographic factors and perceptions of parenting self-efficacy. Additionally, exploratory analyses revealed that there was an indirect effect of PM forgetting on each wellbeing outcome via self-efficacy, suggesting that greater confidence in one's parenting may explain the link between perceived forgetfulness and detriments to well-being.

Conclusion: The present work adds to the literature by documenting the unique effects of everyday cognitive experiences (PM demands and forgetting) in relation to parent caregiver well-being. These findings have important implications for possible interventions to improve caregivers' everyday remembering and well-being.

Objective: Parents' ability to cooperate and work as a team in feeding their children relates to positive health and relational outcomes. However, our understanding of feeding coparenting largely relies on parents' perceptions. It is unclear how mothers' and fathers' perceptions of feeding coparenting relate to objective ratings of these behaviors at mealtime and whether features of the marital relationship relate to measurements of feeding coparenting and discrepancies in couple members' perceptions of these dynamics.

Methods: The current study analyzed daily self-reports and observer ratings of feeding coparenting among dyads for 1 week, along with parent perceptions of marital quality, in a sample of 63 mother-father dyads present at their preschool-age child's dinner meal (266 dinner observations).

Results: Using a series a multilevel models, results showed mothers' daily perceptions of feeding coparenting related to ratings of feeding coparenting balance; parents' perceptions of daily feeding coparenting related to their reports of marital quality; and lower maternal feeding coparenting perceptions relative to their partner's perceptions related to lower mother-reported marital quality and higher father-reported marital quality.

Conclusions: Findings are discussed in terms of measurement considerations and contextual factors impacting feeding coparenting.

Objective: Diabetes distress (DD), the negative emotional response related to the burdens of diabetes management, has been studied primarily in adults with type 2 diabetes and youth with type 1 diabetes (T1D), but less is known about DD among caregivers of youth with T1D.

Methods: Caregivers of adolescents with T1D (n = 198, Mage = 45.6 ± 7.3, 84% female, 66% non-Hispanic White) were enrolled in a two-site randomized clinical trial aimed at treating DD among adolescents. The current study is a secondary analysis of baseline data to examine factors associated with DD among caregivers. Caregivers completed measures of DD, diabetes-related family conflict, and adolescents' diabetes self-management behaviors. Caregivers also reported on demographic factors, and clinical data were extracted from adolescents' medical records.

Results: Female caregivers, caregivers of younger adolescents, caregivers reporting lower household income, caregivers of lower subjective social status, and single/nonpartnered caregivers reported significantly higher caregiver DD. Further, after adjusting for demographic factors, higher diabetes-related family conflict and lower adolescent diabetes self-management behaviors were associated with significantly higher caregiver DD.

Conclusions: Correlates of caregiver DD provide insight into potential risks and modifiable factors that may help clinicians develop interventions to target caregiver DD to improve outcomes in both caregivers and adolescents with T1D.

Objective: The present meta-analysis aimed to test whether young people with chronic physical health conditions (CPHC) show elevated anxiety levels.

Methods: Studies were included if they (a) compared levels of anxiety symptoms or the prevalence of anxiety disorders between young people with CPHC and their peers without such conditions or test norms, or they provided sufficient information for comparison with test norms or a control group from that country with a similar mean age, (b) assessed children or adolescents (≤18 years), and (c) were published or made available by September 2024. Risk for bias was evaluated using the Mixed Methods Appraisal Tool. A systematic search in the electronic databases, PsycInfo, MEDLINE, Google Scholar, and PSYNDEX, and cross-referencing identified 1,251 papers for inclusion in the multi-level meta-analysis.

Results: On average, children with CPHC had higher anxiety symptoms compared to controls (g = 0.31), with the highest effect sizes observed in young people with thalassemia (g = 0.80), chronic headache (g = 0.60), chronic fatigue syndrome (g = 0.54), and hearing impairment (g = 0.51). Higher between-group differences were observed in observer-ratings compared to self-ratings, in studies comparing participants with peers rather than test norms, in samples with higher proportions of female participants and ethnic minorities, and in studies from developing countries. Results also varied depending on which anxiety measure was used and certain indicators of study quality.

Conclusions: Efforts are needed to screen young people with CPHC for anxiety symptoms and implement measures to prevent or reduce elevated symptoms.

Objective: Caregivers of children with chronic conditions can experience psychological distress and an impact on quality of life (QoL). Cleft lip and/or palate (CL/P) is one of the most common congenital conditions worldwide. Utilizing data extracted from The Cleft Collective cohort studies in the United Kingdom, this study investigated longitudinal psychological well-being in caregivers of young children with CL/P, to inform screening practices and early intervention.

Methods: Baseline (post-diagnosis) and 5-year questionnaire data were extracted for 525 caregivers (342 biological mothers, 183 fathers/partners). Outcome measures included the PedsQL-Family Impact Module, the Perceived Stress Scale, and the Hospital Anxiety and Depression Scale.

Results: QoL significantly improved from T1 (post-birth) to T2 (5 years) as reported by mothers and fathers/partners. At T2, scores on all measures were aligned with, or more favorable than, norms. A minority continued to report clinically significant levels of distress at 5 years. Predictors of poorer outcomes on all measures included a less positive life orientation, more negative appraisals of CL/P, less favorable baseline scores, lower healthcare satisfaction, and prior mental health conditions. Outcomes were also less favorable for caregivers of children with combined cleft lip and palate compared to other cleft types. Reductions in negative appraisals of CL/P were significantly associated with improved QoL over time.

Conclusions: QoL and psychological well-being in caregivers is generally positive at 5 years. A minority experienced poorer outcomes and routine assessment by a multidisciplinary team is therefore recommended. Targeting early negative appraisals may help to facilitate long-term caregiver adjustment.