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Parents experience differentiated emotions after learning of their child’s abuse; however, little is known about the effect of trauma therapy on these differentiated reactions and the factors associated with these reactions. This study examined the impact of child trauma therapy on parents’ distress, guilt, and shame over the course of treatment and following treatment, the correlates of these emotional reactions before treatment, and the correlates of changes in these reactions. The sample at pre-therapy included 92 trauma-exposed children (68.90% female, Mage = 9.58 years, 38.10% Caucasian) and their parents receiving Trauma-Focused Cognitive Behavioural Therapy (TF-CBT). Parents rated their distress, guilt, and shame, their functioning (stress-levels, parent support), and their child’s functioning (emotion regulation and internalizing/externalizing symptoms) at pre-therapy, post-therapy, and 6-month follow-up. Significant modest-to-large improvements in parent distress, guilt, and shame were found immediately following TF-CBT and from pre-therapy to 6-month follow up. Parent and child functioning, as well as characteristics of the child’s abuse, accounted for a significant proportion of the variance in parents’ distress, guilt, and shame prior to treatment, with child internalizing symptoms being a consistent correlate. Changes in parent support and child internalizing symptoms were associated with changes in parent distress and shame over the course of TF-CBT, and changes in child externalizing symptoms were associated with changes in parents’ shame from pre-therapy to follow-up. Improvements in parents’ discrete emotional reactions were observed throughout TF-CBT and months after therapy has ended. The implications of results, as related to the key factors associated with these reactions, are discussed.

In August 2017, Hurricane Harvey disrupted the lives of millions in the Houston/Galveston gulf coast region, causing injury, loss, and major uncertainty of wellbeing. Natural disasters can influence parent mental health and parenting behaviors, though less is known about how these factors might be associated with parenting accommodations provided to children immediately following a disaster. OBJECTIVE: This study examined parental anxiety, depression, and post-traumatic stress symptoms (PTSS), as well as pre-existing parenting practices (i.e., positive parenting, supervision, discipline) as clinical predictors of parenting accommodations (PA) in the aftermath of Hurricane Harvey. Parents of children ages 2–17 (n = 130) completed self-report measures approximately one month after Hurricane Harvey. A three-step hierarchical multiple regression was conducted to predict PA from demographic variables (age, income, gender), parental levels of anxiety, depression, and PTSS, and parenting practices. Results indicated that families with lower income, higher rates of inconsistent discipline, and higher levels of parental anxiety reported engaging in greater PA following Hurricane Harvey. Accommodations may be explained in the context of reactive parenting practices aimed at reducing child and parent distress following a natural disaster. Consistent routines, limit-setting, and other positive parenting practices may be important treatment targets to reduce parenting accommodations following a natural disaster.

While extensive evidence links service use for mental health problems to demographic variables and positive attitudes, studies have not explored the role of transdiagnostic risk factors, like distress intolerance (DI) and repetitive negative thinking (RNT). This study examined the relationship between parental DI and RNT on mental health treatment seeking for parents themselves and their children. Results suggest higher DI and RNT predict service use among parents (p

Contains fulltext : 218268.pdf (Publisher’s version ) (Closed access) BACKGROUND: Untreated dental caries negatively impacts children and their families; the implication of which is best measured through assessing quality of life. Information related to Oral Health-Related Quality of Life (OHRQoL) in Peruvian pre-school children is scarce. AIM: To investigate the relationship between dental caries and the OHRQoL of 3-year-old children. DESIGN: Randomly selected government pre-schools (n = 17), situated in three low socio-economic status districts in Lima, participated. The OHRQoL data were obtained using the Peruvian (P) ECOHIS questionnaire. Clinical examinations using the Caries Assessment Spectrum and Treatment (CAST) instrument were performed on 308 children. From which, 213 parents returned the P-ECOHIS form. ANOVA, Tamhane, and Tukey methods were used to analyse the data. RESULTS: The mean age of the children was 3.04 years. The two highest mean P-ECOHIS scores in the child section were 'child symptoms' and 'child psychology' while 'parent distress' scored highest in the parent section. The prevalence of dental caries was 64.3% (CAST scores 4-7). Including CASTcode 3 (enamel carious lesion), the dental caries prevalence was 93.4%. The mean P-ECOHIS scores for 'child symptoms', 'child functions', 'child impact', 'parent distress', and 'the sample' were statistically significantly higher for children with MaxCASTcodes 5 and 6 (dentine and pulpally involved cavities, respectively) than for those with MaxCASTcode 3. CONCLUSION: The presence of cavitated teeth with and without pulpal involvement impacts negatively on the OHRQoL of 3-year-old children.

Objectives The aim of this study was to measure the effect of a group-based parent education program on parenting stress and attitude and comparing the same according to adult attachment styles. Methods Twenty-two mothers who enrolled in the parent education program participated in our study. The participants filled in the Korean version of the Experience in Close Relationship Revised (ECR-R), Korean-Parenting Stress Index-Short Form (K-PSI-SF), Maternal Behavior Research Instrument (MBRI), and Symptom Checklist-90-Revised (SCL-90-R) before and after the program. We compared the pre-and post-scores of the groups and compared the differences in effect according to adult attachment styles. Results For all study participants, the Parent Distress (p=0.023) and Total Parenting Stress (p=0.018) significantly declined after the parent education program. There were no differences in other variables. Within the secure attachment group, the Total Parenting Stress (p= 0.008), Parent Distress (p=0.015), and Difficult Child (p=0.011) scores in the K-PSI-SF significantly decreased after participating in the program. The Difficult Child scores (p=0.040) significantly dropped in the K-PSI-SF post program within the secure attachment group, compared to the insecure attachment group. Conclusion The group-based parent education program impacted parenting stress. Depending on the adult attachment styles, the effect of the program varied.

OBJECTIVES: Sensitive parenting requires modulation of emotions in order to effectively organize and orient behavioral responses. There is considerable evidence that psychological distress can impair sensitive parenting practices, and also that psychological distress is associated with deficits in emotion regulation capacities. The negative effect that psychological distress has on parents’ emotion regulation capacities may be a mechanistic pathway through which psychological distress impacts parenting, as dysregulated emotions may be more proximal to parenting behaviors than distress itself; however, this specific link between psychological distress, emotion regulation, and parenting is not often examined in parenting models. METHODS: The current study tested these relations in a high sociodemographic risk community-sample, oversampled for violence exposure, of caregivers of preschoolers. Caregivers self-reported on their psychological distress and emotion regulation difficulties. Parent sensitivity was assessed via observations of parent-child interactions. RESULTS: Results indicated that difficulties in emotion regulation were a mediator for the relation between parents’ psychological distress and sensitive parenting behaviors. Difficulties in emotion regulation predicted decreased sensitivity above and beyond the effect of psychological distress. CONCLUSIONS: These findings emphasize the importance of regulation of emotional reactions in order to orient and engage in sensitive parenting behaviors. Additionally, they suggest clinically that supporting parents’ emotion regulation capacities specifically may promote more sensitive parenting in contexts of parental psychological distress.

Background Parents of childhood cancer patients experience changes in relationships with their health-care team as the child transitions from treatment to long-term survivorship (LTS). These changes may affect parent receptivity of survivorship-health-related programs, yet little is known about the experience of changing clinical relationships for parents as treatment ends and children transition into LTS. Methods In-depth, semistructured interviews were conducted with 20 English-speaking parents of childhood cancer survivors less than 13 years old who were greater than 1-year posttreatment. Audiotaped, transcribed interview content was analyzed using emergent themes grouped and refined in a process of multistaged constant comparison. Results There was a consensus among parents regarding the emotional stressors of the period immediately after the end of treatment. Regardless of positive or negative recollection of treatment, parents commonly viewed their health-care team with affection and this period as one of stability and security. Transitioning off treatment was viewed as a severe disruption of the security of weekly, treatment-related contact with nurses, nurse practitioners, physician's assistants, and physicians. LTS was generally viewed as presenting lower levels, but new types of stress as new, psychosocial late effects were seen to emerge. Clinical needs shifted to prevention and late-effect management. Conclusion Parents of young childhood cancer survivors experience a similar emotional trajectory from treatment to transitioning off treatment and into LTS. This period is seen by parents as uniquely distressing because it represents a disruption of the hard-won safety represented by regular clinical relationships.

The onset of the Covid-19 pandemic has disrupted the lives of families in the United States and across the world, impacting parent mental health and stress, and in turn, the parent-child relationship. Music is a common parent-child activity and has been found to positively impact relationships, but little is known about music’s role in parent-child interactions during a pandemic. The current study utilized an online questionnaire to assess the use of music in the home of young children and their parents in the United States and Canada during Covid-19 and its relationship with parents’ affective attachment with their child. Musical activity was high for both parents and children. Parents reported using music for both emotion regulation and to socially connect with their children. Parent-child musical engagement was associated with parent-child attachment, controlling for relevant parent variables including parent distress, efficacy, education, and parent-child engagement in non-musical activities. These results indicate that music may be an effective tool for building and maintaining parent-child relationships during a period of uncertainty and change.

Resilience is a key characteristic to study in families, particularly those who have experienced significant systemic risk factors. While much resilience research focuses on ethnic and cultural minorities, little research focuses specifically on American Indian/Alaskan Native (AI/AN) families. The parent-child relationship has been demonstrated to be a key characteristic in families, and this relationship may also serve as a protective factor for AI/AN families. Positive parent-child relationships are consistently linked to positive child outcomes, and parental psychological symptoms are linked with child psychological symptoms in non-Native families. These associations warrant further examination among AI/AN families. We hypothesized that the parent-child relationship would moderate the link between parent distress (i.e., depressive and anxious symptoms) and child internalizing problems in a sample of 57 AI/AN parents of children 3-5 years of age. As expected, the parent-child relationship moderated the associations between parent anxiety symptoms and child internalizing symptoms, and between parent depressive symptoms and child internalizing symptoms. Furthermore, the strength of the parent-child relationship buffered the effects of parent distress on child internalizing symptoms. Results highlight the potentially protective role of strong parent-child relationships in AI/AN families.

The COVID-19 pandemic and associated government-mandated shutdowns disrupted schooling, socialization, and family life for school-aged children during spring 2020. These disruptions may have contributed to increased child behavior problems. Thus, we examined behavior problems in 247 children aged 7 to 9 years during Ohio's shutdown period. We investigated whether differences in parent-reported child behavior problems were associated with concurrent parent distress during spring 2020 and/or children's social-emotional skills measured via teacher-reports from the previous year (spring 2019). Parent distress significantly predicted behavior problems, such that more distressed parents also reported more child behavior problems. Child pre-pandemic peer social skills also significantly predicted behavior problems, such that more skilled children exhibited fewer behavior problems. There were no interaction effects between parent distress and children's social-emotional skills on child behavior problems. Further research is needed to understand how children's social-emotional skills impact their ability to cope during times of epidemiological crisis.

Objective How family environment and parental factors affect health status and symptoms in childhood cancer survivors is understudied. We examined the influence of family cohesion, parent distress, and overprotection on child symptom burden and health-related quality of life (HRQOL) and family strain in survivors of childhood acute lymphoblastic leukemia. Methods Parents of 213 children treated with chemotherapy only completed a survey when survivors were at least 5-year postdiagnosis. Family Environment Scale, Brief Symptom Inventory-18, Parent Protection Scale, Pediatric Quality of Life Inventory, and Impact on Family were used to assess family cohesion, parental distress, overprotection, child symptom burden and HRQOL, and family strain, respectively. Path analysis was conducted to quantify effects of family cohesion on family strain through parental distress, overprotection, child symptoms, and HRQOL. Results Lower family cohesion (β = 0.06, 95% CI, 0.01-0.13), higher parental distress (β = 0.35, 95% CI, 0.20-0.45), and overprotection (β = 0.17, 95% CI, 0.01-0.32) were associated with more child symptom burden. More symptom burden were associated with poorer child HRQOL (β = 0.66, 95% CI, 0.57-0.75), which in turn was associated with more family strain (β = 0.11, 95% CI, 0.01-0.22). Lower maternal education was associated with overprotection (β = -0.23, 95% CI, -0.33 to -0.12), more child symptoms (β = -0.30, 95% CI, -0.41 to -0.16), poorer child HRQOL (β = -0.36, 95% CI, -0.46 to -0.21), and more family strain (β = -0.15, 95% CI, -0.23 to -0.08). Conclusions Family and parental factors contributed to health outcomes of childhood acute lymphoblastic leukemia survivors. Interventions to enhance family cohesion, decrease parental distress and overprotection, and ameliorate child symptoms may improve family functioning.

Background/Purpose. During hospitalization in the pediatric intensive care unit (PICU), approximately 25-60% of parents experience clinical levels of distress (i.e., traumatic stress, anxiety, and depressed mood), which likely impacts their decision-making, ability to care for their child, and puts them at risk for long-term psychological sequelae (e.g., posttraumatic stress disorder). Despite this, PICU providers rarely refer parents to formal psychological services, and parents report that their emotional needs are not well addressed by hospital staff. Difficulty identify and/or responding to distressed parents may explain these deficiencies. Therefore, the present study …

Assessment of parenting frequently relies on parent self-report despite well-documented discrepancies between this methodology and observational measures. In the current study, we investigated patterns of disagreement between self-reported and observational measures of positive parenting and negative parenting with 102 dyads of parents and 4–6 year-old children. Specifically, we tested whether differences in parent distress and family socioeconomic status (SES) moderated the association between self-reported and observed parenting. Results showed significant interactions with less agreement between self-report and observational measures among parents reporting higher levels of distress and among families from lower SES backgrounds. Effects were more pronounced in models of negative parenting than those of positive parenting. Findings suggest that two factors relevant to parenting quality, emotional distress and SES, predict meaningful differences in manner of parent-report relative to observational measures. We discuss implications for the extant literature and for future efforts regarding effective and efficient parenting measurement.

OBJECTIVES: Bereaved siblings experience more externalizing problems compared to non-bereaved peers and norms; however, the mechanisms explaining this phenomenon have not been empirically examined. This study tested the serial indirect effects of sibling bereavement on adolescents’ externalizing problems through parent distress (i.e., internalizing symptoms) and parenting (i.e., parenting behaviors, parent-adolescent communication). METHODS: During home visits, 72 bereaved adolescents (ages 10–18) whose brother/sister died from cancer and 60 comparison peers reported about their externalizing problems and their mothers’ and fathers’ parenting behaviors (warmth, behavioral control, psychological control) and parent-adolescent communication (open communication, problematic communication). Mothers and fathers reported their own internalizing symptoms. RESULTS: Bereaved siblings reported more externalizing problems (p =.048) and bereaved mothers reported more internalizing symptoms relative to the comparison group (p =.015). Serial multiple mediation models indicated that elevated externalizing problems were partially explained by both bereaved mothers’ internalizing symptoms and parenting and communication (less warmth [CI: 0.04, 0.86], more psychological control [CI: 0.03, 0.66], and more problematic mother-adolescent communication [CI: 0.03, 0.79]), with a significant indirect effect also emerging for open mother-adolescent communication [CI: 0.05, 1.59]. Bereaved fathers did not significantly differ in internalizing symptoms from comparison fathers (p =.453), and no significant indirect effects emerged for fathers. CONCLUSIONS: Elevated externalizing problems in bereaved siblings may result from mothers’ distress and the impact on their parenting and communication. Targeting adjustment and parenting in bereaved mothers following a child’s death may reduce externalizing problems in bereaved siblings. Research to evaluate family-centered interventions is needed.

Pruritus is a common problem following burn injuries; however, the literature to date has focused on adult survivors and/or pediatric survivors of large burns. The current study examines acute postburn pruritus in children under the age of 4 years (N = 256) with smaller burns (mean TBSA = 3.99%), which represents the most common type of patient typically treated in pediatric burn centers. Parents rated their child for pruritus, irritability, and sleep disturbances; additionally, parents completed a self-report of distress. Nearly half (47.3%) were rated by parents as displayed some level of pruritus, with the greatest proportion rated as mild. Regression analysis indicated that child minority status, greater burn TBSA, and more days elapsed since burn predicted higher levels of pruritus. In turn, pruritus was positively correlated with child irritability, delayed sleep onset, sleep disturbance, and parent distress. Thus, our results indicate that parent-rated pruritus in young pediatric burn patients is important to evaluate, as itch is significantly associated with other important clinical outcomes as early as the first month of the burn for pediatric patients and their parents.

Objective Examine caregiver demand and general parent distress as mediators in the parent illness uncertainty-child depressive symptom association in youth with juvenile rheumatic diseases. Methods Children and adolescents completed the Child Depression Inventory; caregivers completed the Parent Perceptions of Uncertainty Scale, the Care for My Child with Rheumatic Disease Scale, and the Brief Symptom Inventory. The pediatric rheumatologist provided ratings of clinical disease status. Results Analyses revealed significant direct associations between illness uncertainty and caregiver demand, and between caregiver demand and both parent distress and child depressive symptoms. Results also revealed significant parent uncertainty → caregiver demand → parent distress and parent uncertainty → caregiver demand → child depressive symptom indirect paths. Conclusions Results highlight the role of illness appraisals in adjustment to juvenile rheumatic diseases, and provide preliminary evidence that parent appraisals of illness uncertainty impact parent distress and child depressive symptoms indirectly through increased perceptions of caregiver demand.

Parents commonly report elevated distress following a child's burn injury, yet limited research has identified child or injury characteristics that may explain parent distress. The main goal of the current study is to examine prevalence and predictors of parent distress following children's burn injuries by evaluating distress symptoms in a clinic sample of parents whose children present for evaluation and treatment at a regional burn center. Participants included parents of 407 children who experienced a burn injury. Of this sample, follow-up data at a second time point was obtained for 130 children and their caregivers. Parents completed a measure of distress. Clinical and demographic variables were extracted retrospectively from the medical chart. Clinical and at risk levels of distress were reported by nearly 19% of parents at Time 1. Parent distress at Time 1 was associated with child minority race, fewer days since burn injury, and greater burn size. A propensity score was used to account for potential differences between parents with data at Time 1 only versus those with data at Time 2. Parents with Time 2 data tended to have higher levels of distress at Time 1. Of parents with Time 2 data, 17% continued to report elevated distress, and Time 1 distress was the best predictor of later distress. A proportion of parents report elevated distress following their children's burn injuries. Our results suggest that best practices should include routine screening of parent distress following pediatric burn injuries to guide appropriate interventions.

Background: Pediatric survivors of childhood cancer are at increased risk of poor quality of life and social-emotional outcomes following treatment. The relationship between parent psychological distress and child adjustment in pediatric cancer survivors has been well established. However, limited research has examined the factors that may buffer this association. The current study examined the associations between psychosocial family risk factors, parental psychological distress, and health-related quality of life (HRQL) in pediatric cancer survivors. Methods: Fifty-two pediatric cancer survivors (34 males, 18 females, mean age = 11.92) and their parents were recruited from a long-term cancer survivor clinic. Children and their parents who consented to participate completed the Pediatric Quality of Life Inventory 4.0. Parents completed a demographic information form, the Psychosocial Assessment Tool (PAT 2.0) and the Brief Symptom Inventory (BSI). The Intensity of Treatment Rating (itr-3) was evaluated by the research team. Results: Multiple regression analyses revealed that parental psychological distress negatively predicted parent-reported hrql, while treatment intensity, gender, and psychosocial risk negatively predicted parent and child-reported hrql. Psychosocial risk moderated the association between parent psychological distress and parent-reported child hrql (p = 0.03), whereby parents with high psychological distress but low levels of psychosocial risk reported their children to have higher HRQL. Conclusion: Low levels of family psychosocial risk buffer the impact of parent psychological distress on child HRQL in pediatric cancer survivors. The findings highlight the importance of identifying parents and families with at-risk psychological distress and psychosocial risk in order to provide targeted support interventions to mitigate the impact on HRQL.

Pupils with autism spectrum disorder (ASD) received 6 months of intensive interaction or treatment as usual. They were assessed for behaviour problems at the start and end of the period, and changes were related to child and parent factors. Intensive interaction did not offer any greater advantages to child behaviour than treatment as usual. However, intensive interaction was more effective for pupils with less challenging behaviour. Levels of depression in mothers were related negatively to changes in child behaviours. These data suggest that intensive interaction may be of limited utility for reducing problem behaviours of pupils with ASD, but that the approach could be effective with less behaviourally challenging pupils and that levels of parent distress may reduce its impact.

Objective To examine associations among parent perceptions of infant symptoms/suffering, parent distress, and decision making about having additional children after an infant's death in the NICU. Design Mixed-methods pilot study incorporating mailed surveys and qualitative interviews. Setting Midwestern Level IV regional referral NICU. Participants Participants were 42 mothers and 27 fathers whose infants died in the NICU. Methods Parents reported on infant symptoms/suffering at end of life and their own grief and posttraumatic stress symptoms. Qualitative interviews explored decision making about having additional children. Results Approximately two thirds of bereaved parents had another child after their infant's death (62% of mothers, 67% of fathers). Mothers who had another child reported fewer infant symptoms at end of life compared with mothers who did not ( p = .002, d = 1.28). Although few mothers exceeded clinical levels of prolonged grief (3%) and posttraumatic stress symptoms (18%), mothers who had another child endorsed fewer symptoms of prolonged grief ( p = .001, d = 1.63) and posttraumatic stress ( p = .009, d = 1.16). Differences between fathers mirrored these effects but were not significant. Parent interviews generated themes related to decision making about having additional children, including Impact of Infant Death, Facilitators and Barriers, Timing and Trajectories of Decisions, and Not Wanting to Replace the Deceased Child. Conclusion Having another child after infant loss may promote resilience or serve as an indicator of positive adjustment among parents bereaved by infant death in the NICU. Prospective research is necessary to distinguish directional associations and guide evidence-based care.

Chronic musculoskeletal pain in adolescence is a significant public health concern with 3-5% of adolescents suffering from significant pain-related disability. Pain-related fear and avoidance of activities has been found to have a significant influence on pain outcomes in children and adolescents and is a risk factor for less favorable response to treatment. To address this need, we developed graded exposure treatment for youth with chronic pain (GET Living). We describe the rationale, design, and implementation of a two-group randomized controlled trial (RCT) enhanced with single-case experimental design (SCED) methodology with a sample of 74 adolescents with chronic musculosketal pain and their parent caregivers. GET Living includes education, behavioral exposures, and parent intervention jointly delivered by pain psychology and physical therapy providers. The multidisciplinary pain management control group includes pain psychology delivered education and pain self-management skills training (e.g., relaxation, cognitive skills) and separate physical therapy. Assessments include brief daily diaries (baseline to discharge, 7-days at 3-month and 6-month follow-up), comprehensive in-person evaluations at baseline and discharge, and questionnaire across all time points (baseline, discharge, 3-month and 6-month follow-up). Primary outcome is pain-related fear avoidance. Secondary outcome is functional disability. We also outline all additional outcomes, exploratory outcomes, covariates, and implementation measures. The objective is to offer a mechanism-based, targeted intervention to youth with musculoskeletal pain to enhance likelihood of return to function. ispartof: Contemporary Clinical Trials Communications vol:16 ispartof: location:Netherlands status: Published online

Functional abdominal pain disorders (FAPD) are common pediatric pain conditions that often present with co-occurring anxiety, which is associated with adverse outcomes including increased pain, disability, and somatization. Parents of children with abdominal pain report higher levels of anxiety than parents of children without abdominal pain disorders. In addition, measures of child anxiety (e.g., anxiety sensitivity) in youth with pain conditions are related to somatization and other adverse outcome. However, it is unknown how parent and child anxiety cumulatively influence outcomes in youth with FAPD. Thus, the present investigation sought to examine the role of parent distress (e.g., stress, anxiety, depression) and child anxiety in relation to pain-related functioning (pain, functional disability, and somatization) in youth (ages 9-14) with FAPD (N=78). Youth completed measures of anxiety, pain, functional disability, and somatization, and parents completed a measure of parental distress. Child anxiety was significantly correlated to child somatization (r =0.34, p

Parents of youth with juvenile rheumatic diseases (JRD) often take on illness management responsibilities that can become burdensome, potentially resulting in poor parent adjustment outcomes. However, not all caregivers will experience increased distress as a result of variability in stress appraisals. The current study examined the role of parent illness attitudes in the relation between perceived caregiver demand and parental distress. Youth (N = 70) ages 7-18 years diagnosed with a JRD and their parents were recruited from a pediatric rheumatology clinic. Parents completed measures of caregiver demand, parental distress, and illness attitudes. Hierarchical regression revealed a relationship between caregiver demand and parental distress. A significant relationship was also found between caregiver demand and parent illness attitudes, as well as parent illness attitudes and parental distress. Thus, parent illness attitudes mediated the relationship between caregiver demand and parental distress. Techniques aimed at altering negative illness attitudes may help parents cope with their caregiving responsibilities.

To test whether children’s pessimistic causal attributions mediate the parent distress–child depressive symptom relation in youth diagnosed with juvenile rheumatic diseases (JRDs) and their parents. Fifty-two youth completed the Children’s Attributional Style Questionnaire and the Children’s Depression Inventory; parents completed the Brief Symptom Inventory. Parent distress was significantly related to children’s depressive symptoms. More importantly, children’s pessimistic attributions were shown to fully mediate the observed association between parent distress and children’s depressive symptoms. Results support a parent distress→ child attribution→ child depressive symptom interpretation, suggesting that parent distress engenders children’s depressogenic attributions, which eventuate in an increased vulnerability for depressive symptoms. The implications of our findings for clinical intervention and future research are discussed.

This study sought to examine the differential effect of youth age on the association between parental uncertainty and both parent distress and youth depressive symptoms within the context of juvenile rheumatic disease.: The sample comprised 51 youth aged 9 to 17 years diagnosed with a juvenile rheumatic disease and their parents. Youth completed a measure of depressive symptoms (i.e., Children's Depression Inventory); parents completed measures of illness uncertainty (i.e., Parental Perceptions of Uncertainty Scale) and parental distress (i.e., Brief Symptom Inventory).: Parental uncertainty demonstrated a significant main effect on both parent distress and youth depressive symptoms. However, these main effects were qualified by significant parental uncertainty × youth age interactions. Parental uncertainty was significantly related to parent distress for both younger and older youth but was only significantly related to youth depressive symptoms in the sample of older youth.: Parental uncertainty due to illness seems to be more predictive of both parent and youth distress with increasing youth age. These findings indicate that the impact of parental illness uncertainty on adjustment outcomes is pronounced as children transition into developmental periods of increasing autonomy and independence.