Journal of Pediatric Psychology最新文献

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.

Objective: Differences of sex development (DSD) affect somatic sex determination and differentiation and are associated with stigmatization risks. This scoping review evaluated reports of stigma experiences described by individuals with DSD, caregivers of individuals with DSD, and non-affected individuals (e.g., laypeople).

Methods: A multi-step, iterative process was used for the search strategy. Databases utilized included Cochrane Library, PubMed, Ovid MEDLINE (Ovid MEDLINE(R) and Epub Ahead of Print, In-process & Other Non-Indexed Citations, Daily and Versions(R)), Embase (Elsevier), CINAHL Complete (EBSCO), PsychInfo (EBSCO), LGBT Life (EBSCO), and Scopus (Elsevier). Peer-reviewed, English language, quantitative or qualitative studies that evaluated stigma or stigma-related attitudes toward individuals with DSD published from 1955 through August 2024 were included. Stigma was categorized as felt (feared rejection), enacted (bullying), or systemic/structural (e.g., institutionalized policies).

Results: Searches yielded 6,892 articles after eliminating duplicates. Following full-text screening, 206 articles were included in the review indicating that DSD-specific stigma was measured. However, measuring stigma was a specific study aim in a minority of publications (51 articles, 25%), with evidence for felt (164 articles, 80%), enacted (127 articles, 62%), and structural/systemic stigma (70 articles, 34%) reported across informants and DSD diagnosis. Few studies utilized validated DSD-specific stigma measures.

Conclusions: Stigma is commonly reported in the literature across the spectrum of DSD conditions but is rarely measured. Stigma was predominantly assessed using open-ended questions, with limited use of validated measures. Results have implications for clinical care, including stigma-related screening and intervention and the need for future research using standardized stigma assessments.

Objectives: To characterize intraindividual trajectories of behavioral and emotional problems in children with congenital heart disease (CHD) between 2 and 5 years of age, and to explore the predictors of these trajectories.

Methods: Sixty-six patients (42 boys) followed at the neurocardiac clinic of the Sainte-Justine University Hospital in Montréal, Québec, Canada were recruited. Their behavioral and emotional problems at 2, 3 ½, and 5 years of age were reported by parents.

Results: Correlations revealed moderate to high rank-order stability in child behavioral and emotional problems across time. Multilevel growth curves indicated significant fluctuations in intraindividual levels of these problems across time, which were not explained by child aging. Lower gestational age was associated with higher levels of anxious/depressed symptoms at age 2 years, which persisted through time. Severe forms of CHD were associated with a time-related decrease in three types of problems: attention, attention deficit and hyperactivity, and oppositional and defiant.

Conclusions: Levels of parent-reported behavioral and emotional problems in children with CHD tend to persist from ages 2 to 5 years, suggesting the importance of early screening. However, unexplained intraindividual changes were also identified, highlighting the necessity to investigate other parental risk factors, for instance. Infants with a lower gestational age should be given special consideration since they continued to display more anxious/depressed symptoms up to school entry compared to children with CHD born at term. The decrease observed in some symptoms for children with severe CHD could result from altered parental perceptions or adverse effects of prolonged hospitalizations.

Objective: Parents of youth with type 1 diabetes (T1D) experience substantial disease-specific demands and distress, yet their perceptions about the emotional support they receive related to the challenges of caring for a child with diabetes have not been well described. This research aimed to characterize the types of emotional support parents of youth with T1D receive and how they experience emotional support.

Methods: As part of a larger qualitative study on diabetes health-related quality of life, 23 parents (96% mothers) of youth with T1D (M age = 10.9 ± 3.8 years; 35% female) completed semi-structured interviews about various aspects of parenting a child with T1D, including emotional support they received. Interviews were transcribed verbatim, coded, analyzed using thematic analysis, and interpreted according to the social-ecological model to generate major and minor themes.

Results: Three themes were constructed. The "Individual" theme included parent-specific factors, including their openness to and satisfaction with diabetes-specific emotional support they receive. Reflecting sources of emotional support, the "Interpersonal" theme included parents' central supportive networks (e.g., family, professionals), and the "Community" theme included parents' extended supportive networks (e.g., community members, T1D organizations, other families). Parents valued emotional support that was nonjudgmental and demonstrated knowledge of T1D.

Conclusions: Both individual and environmental factors relate to how parents seek and receive emotional support from various sources. Clinicians should normalize the experience of needing emotional support to make parents feel comfortable sharing their experiences openly and, when appropriate, help link families to resources to meet their emotional support needs.