Healthcare Training Institute - Quality Education since 1979
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Current theory and research indicate the importance of incorporating multiple family risk factors into accounts of child growth and development (Cox & Paley, 2003; Cummings, Davies, & Campbell, 2000). For example, problematic child adjustment has been reliably linked to family factors such as disruptions in the parent – child relationship (Baumrind, 1993; Gaylord, Kitzmann, & Coleman, 2003; Prevatt, 2003) and elevated levels of parental psychological symptoms (Downey & Coyne, 1990). Notably, following long traditions of separate consideration, recent studies have included both family processes in the study of child adjustment, with initial findings indicating that qualities of the parent – child relationship and parental psychological adjustment work in synchrony to relate to child outcomes (e.g., Mowbray, Oyserman, Bybee, & MacFarlane, 2002). However, questions about the nature of these associations remain, especially with respect to pathways through which these family processes are linked.
Parental Psychological Distress and Child Adjustment
Although women evidence higher levels of depressive and other symptoms (Derogatis, 1994), it is important to continue to develop an understanding of fathers’ symptoms in relation to child adjustment. Mothers with higher symptom levels tend to have spouses with elevated symptoms and psychological diagnoses (e.g., C. R. Goodman & Shippy, 2002; Hammen, 2003), thus potentially placing their children at even heightened risk for problems themselves. Furthermore, Connell and Goodman’s (2002) review indicated that maternal and paternal symptom distress are more similar than different in their prediction of child adjustment problems.
Lewinsohn, Solomon, Seeley, and Zeiss (2000) sampled community-based adolescents, adults, and older adults and found that higher levels of depressive symptoms were related to higher levels of psychosocial problems as well as to diagnoses of major depressive disorder and substance abuse. Their findings imply that depression is a continuous process and that depressive symptoms, even at low levels, pose significant risks to family members (Lewinsohn et al., 2000). Adopting a symptom-based approach rather than a diagnostic approach also offers the advantage of providing greater variability in psychopathology scores (Bradbury, 2001).
Parental Psychological Distress and the Parent – Child Relationship
Psychological control is distinguished from firm control by the use of indirect means (e.g., inducing guilt, withdrawing love) versus the use of direct means (e.g., setting behavioral limits or curfews) in dealing with children (Rogers, Buchanan,& Winchell, 2003; Smetana & Daddis, 2002). Parental acceptance includes qualities of demonstrating love and involvement toward children (Lamborn, Mounts, Steinberg,&Dornbusch, 1991). These parenting dimensions have been recognized as reliable predictors of youth adjustment. For example, Steinberg, Elmen, and Mounts (1989) documented that higher levels of acceptance, psychological autonomy, and firm control make independent contributions to adolescent school achievement.
The successful implementation of any dimension of parenting is potentially challenged when parents are dealing with psychological distress, ranging from subclinical to impaired levels (Oyserman, Mowbray, Meares, & Firminger, 2000). Specifically, parental negativity toward children, and forms of ineffective discipline problems, are more likely expressed in the context of parental psychological distress (Berg-Nielsen, Vikan, & Dahl, 2002). Thus, children of parents with psychological distress tend to experience multiple family risk factors. Indeed, Berg-Nielsen et al.’s (2002) review indicated that children of parents with psychological dysfunction or psychiatric symptoms are more likely to exhibit internalizing and externalizing problems when they are also dealing with parenting maladjustment. That is, psychological symptoms and problems with parenting typically co-occur and potentially work through one another in the prediction of child adjustment problems.
Parenting Dimensions as Links between Parental Psychological Distress and Child Adjustment
In an empirical test of this process, McCarty, McMahon, and the Conduct Problems Prevention Research Group (2003) studied four hypothesized mediators of the association between maternal depressive symptoms and child internalizing and disruptive behavior disorders, including mother – child communication, the quality of the mother – child relationship, maternal social support, and stressful life events in the family. Results indicated that the mother – child relationship, indexed by maternal ratings of how well they got along with their child and interviewers’ ratings using a cold-warmth scale, mediated the depression – child disruptive behavior disorders link, whereas maternal ratings of social support mediated child internalizing diagnoses. Although the results of the model predicting disruptive behavior disorders appear to implicate maternal parenting behaviors as a mediator, questions remain concerning the effect of fathers’ psychological symptoms and parenting characteristics in this family-wide process.
Elucidating interrelations among these family processes has implications for the well-being of children. For example, using a large sample of Australian adolescents, Brennan, LeBrocque, and Hammen (2003) found positive mother – child relationships, characterized by low levels of psychological control, high levels of warmth, and low levels of overinvolvement, to serve as protective factors in adolescents’ resilient adjustment in the face of maternal depression. Clearly, these parenting dimensions play an important role in parental psychological distress and warrant further study as a means of advancing prevention and treatment approaches for children of depressed or otherwise affected parents.
Reflection Exercise #9