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Parenting Skills with Conduct Disordered Pre-Adolescents
Parenting Skills with Conduct Disordered Pre-Adolescents

Section 23
Parental Psychological Distress & Child Adjustment

CEU Question 23 | CEU Answer Booklet | Table of Contents | Parenting
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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). Psychological Distress Parenting  mft CEUFor 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
Parental symptomatology and psychological disorders are reliable correlates of child adjustment problems (see Connell & Goodman, 2002). Although depression historically has received the most attention (Cummings & Davies, 1994), various symptoms and diagnoses of parental psychological dysfunction are predictive of child maladjustment (Mowbray et al., 2002). As an example, Beidel and Turner (1997) found that children whose parents had an anxiety disorder, depressive disorder, or mixed anxiety/ depressive disorder were more likely than children of nondisordered parents to have a disorder themselves. Recent reviews have documented the need to further study the mechanisms through which psychological symptoms of parents and their children are interrelated (Downey & Coyne, 1990; S. H. Goodman & Gotlib, 1999).

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
Regarding links between parental psychological symptoms and parenting behaviors, Cusinato (1998) noted that most studies have focused on parental depression and anxiety in relation to parenting styles of emotional warmth, control, and consistency. Results typically demonstrate lower functioning parenting by symptomatic parents than their nonaffected counterparts. Given the interpersonal deficits and relationship impairments associated with psychological maladjustment (Horowitz, 2004; Segrin, 2001), it follows that the parent – child relationship is at risk when either mothers, fathers, or both exhibit elevated levels of psychological symptoms.  In a recent study, Calam, Bolton, Barrowclough, and Roberts (2002) assessed 61 mothers and their children (aged 4 to 11 years) who were referred for behavior problems. Interviewers rated, among other variables, mothers’ hostility on the bases of comments indicating generalized criticism or rejection. This hostility (toward child) was significantly linked to higher levels of parenting stress (Calam et al., 2002), indicating that additional tests that consider multiple symptom dimensions as well as father data are warranted.

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
The parent – child relationship has received support as an important mechanism in models of family process and child development. Notably, parenting has been shown to partially account for the association between the interparental relationship and child functioning (Erel&Burman, 1995). Characteristics of the parent – child relationship have also been posited to link parental psychological functioning and child adjustment (Oyserman, Bybee, & Mowbray, 2002).

Specifically, parenting has been identified as a possible pathway of transmission between maternal depression and child psychopathology (Burke, 2003). Reviews have indicated that parents with psychological problems, particularly depression, tend to make more critical appraisals of their children and display more negative affect, and are more likely to exhibit maladaptive parenting styles and disrupted attachment bonds (see Cummings & Davies, 1994; S. H. Goodman & Gotlib, 1999). Parents suffering from psychological distress are also likely to experience problems with child management and discipline (Oyserman et al., 2000). In summary, all family members involved are at higher risk for psychosocial maladjustment when a parent experiences depressed mood or other psychological symptoms (Hammen, 2003).

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.
- Papp, Lauren, Cummings, Mark, & Marcie Goeke-Morey; Parental psychological distress, parent-child relationship qualities, and child adjustment: direct, mediating, and reciprocal pathways; Parenting: Science & Practice; Jul-Sept 2005; Vol. 5; Issue 3.

Personal Reflection Exercise #9
The preceding section contained information about parental psychological distress and childhood adjustment.  Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 23
According to Steinberg, Elmen, and Mounts, what three factors make independent contributions to adolescent school achievement? Record the letter of the correct answer the CEU Answer Booklet.

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