Perceptions of social support: comparisons between fathers of children with autism spectrum disorder and fathers of children without developmental disabilities.

BACKGROUND: Research highlights the need for ongoing social support of mothers of children with Autism spectrum disorders (ASD). Despite recognised differences between mothers and fathers, little is known about the particular social support needs of fathers of children with ASD. Broadly, this study aimed to explore the support needs of fathers of children with ASD compared with fathers of children without a disability (W/OD) and the relation between social support, psychological distress and sociodemographic factors. METHOD: Drawing from a large, nationally representative community sample of children, 159 fathers of children with ASD were identified, where 6578 fathers of children W/OD were used as a comparison sample. RESULTS: Over 70% of fathers of children with ASD reported that support was inaccessible and were significantly more likely to report so compared with fathers of children W/OD. Emotional/informational social support was the strongest social support domain associated with fathers' experiences of psychological distress. CONCLUSIONS: This study provided important insight into the social support needs of fathers of children with ASD.

Intergenerational Impacts of Family Violence - Mothers and Children in a Large Prospective Pregnancy Cohort Study.

BACKGROUND: Violence and other adversities commonly co-occur, yet are usually investigated individually. The primary objectives of this paper are to investigate: (i) the relationship between maternal exposure to violence (including childhood abuse and intimate partner violence) and postpartum mental and physical health; and (ii) the extent to which exposure to violence and poor maternal mental and physical health are associated with children's emotional-behavioral difficulties. METHODS: Prospective pregnancy cohort (n = 1507) followed up to 4 year postpartum. Validated measures used: Composite Abuse Scale; Edinburgh Postnatal Depression Scale, SF-36, Child Maltreatment History Self Report; Strengths and Difficulties Questionnaire. Logistic regression was used to investigate associations between maternal childhood abuse, intimate partner violence (IPV), maternal health and child emotional and behavioral difficulties at age 4. OUTCOMES: Two out of five women (41%) reported abuse in childhood, and almost one in three (29%) reported IPV during the first four years of motherhood. Women reporting both physical and sexual childhood abuse had markedly raised odds of IPV and poor physical and mental health at all time points (pregnancy, first year postpartum and four year postpartum). For the index child, violence exposures (maternal childhood abuse or IPV) and poor maternal physical or mental health were associated with higher odds of emotional/behavioral difficulties at age four. In multivariable models (adjusted for child gender and maternal age), cumulative exposures (multiple violence exposures or poor maternal mental or physical health at multiple time points) each independently added to increased odds of emotional-behavioral difficulties. Children of mothers who reported a history of childhood abuse but were not exposed to IPV had odds of difficulties similar to children of mothers not reporting any violence exposure, suggesting resilient outcomes where violence experiences are not repeated in the next generation. INTERPRETATION: The clustering of risk (child and adult violence experiences) and the accumulation of risk within families (IPV, poor maternal health, child difficulties) highlight the need for effective early intervention to limit or ameliorate the impact of violence across the lifespan, and to break the intergenerational cycle of disadvantage.

Vulnerability to intimate partner violence and poor mental health in the first 4-year postpartum among mothers reporting childhood abuse: an Australian pregnancy cohort study.

The purpose of this study was to investigate intergenerational patterns of abuse and trauma and the health consequences for women in the early childbearing years. A prospective pregnancy cohort of 1507 nulliparous women (≦24 weeks gestation) were recruited in Melbourne, Australia, 2003-2005. Follow-up was scheduled in late pregnancy, 3-, 6- and 12-month and 4-year postpartum. Childhood abuse was retrospectively reported at 4-year postpartum using the Child Maltreatment History Self Report. Intimate partner violence (IPV) was assessed at 1- and 4-year postpartum with the Composite Abuse Scale. Maternal depressive symptoms were assessed in all follow-ups using the Edinburgh Postnatal Depression Scale. Multivariable logistic regression was used to examine associations between childhood abuse, maternal mental health and IPV. Childhood abuse was reported by 41.1 % of women. In the 4 years after having their first child, 28.2 % of women reported IPV, 25.2 % depression and 31.6 % anxiety. Childhood abuse was associated with odds of depression or anxiety 1.5-2.6 times greater and 1.8-3.2 times greater for IPV. Childhood physical abuse remained significantly associated with depression and anxiety in pregnancy and postpartum after adjusting for IPV and stressful life events, while sexual abuse remained significantly associated only with anxiety. Women who begin childbearing with a history of childhood abuse are more vulnerable to IPV and poor mental health. All health care services and agencies in contact with children, young people and families should have adequate training to identify trauma associated with abuse and IPV and provide first line supportive care and referral.

Does non-pharmacological therapy for antenatal depression reduce risks for the infant?

Depression during pregnancy has been associated with an increased risk of adverse outcomes for the infant such as preterm birth. These risks are not reduced with pharmacological treatment, but the effect of non-pharmacological therapies is unknown. We performed a systematic review to assess the risk of adverse perinatal outcomes in non-pharmacologically treated depressed women compared to non-depressed women. We found no studies that met our inclusion criteria, highlighting a critical need for research on this topic.

Maternal anxiety, risk factors and parenting in the first post-natal year.

BACKGROUND: The antecedents and consequences of maternal post-natal anxiety have received comparatively less attention than depression despite being one of the most frequently reported mental health difficulties experienced by parents following childbirth. The aim of this study was to extend emerging literature on post-natal anxiety by investigating the prevalence of maternal anxiety symptoms, and its relationship with parenting behaviours (i.e. warmth, hostility) and experiences (i.e. parenting efficacy and satisfaction) within the first post-natal year. The psychosocial risk factors for post-natal anxiety symptoms were also explored. METHODS: A community sample of 224 Australian mothers of infants (aged 0-12 months) completed a self-report questionnaire. RESULTS: Mothers in the current sample reported significantly more symptoms of anxiety compared with a normative sample. Approximately 18% of mothers reported mild to extremely severe symptoms of anxiety, with a high proportion experiencing co-morbid depressive symptoms. Maternal anxiety was associated with low parenting warmth, involvement, efficacy and satisfaction, and high parenting hostility. Yet, co-morbid depression and anxiety was more strongly associated with these parenting behaviours and experiences than anxiety alone. CONCLUSION: A range of psychosocial risk factors (e.g. education, sleep, relationship quality) were associated with maternal post-natal anxiety symptoms, providing opportunities for early identification and targeted early intervention.

The relationship between parental fatigue, parenting self-efficacy and behaviour: implications for supporting parents in the early parenting period.

BACKGROUND: Emerging evidence indicates that parental fatigue is associated with low warmth and increased hostility in parent-child interactions. One possible pathway by which fatigue may impact on parenting behaviour is via parental self-efficacy (PSE), whereby high fatigue may undermine PSE, which is often associated with suboptimal parenting behaviour. The current study sought to explore a model of the relationships between parental fatigue, parenting warmth and hostility, where PSE mediates these relationships and whether the nature of these relationships differ by social or family context. METHODS: The current sample was drawn from a larger Australian community sample survey on parent well-being and parenting. It consisted of 1143 parents (mothers, n = 1003; fathers, n = 140) of children aged 0-4 years. RESULTS: Path analysis revealed that the relationship between fatigue and parenting warmth and hostility was fully mediated by PSE. CONCLUSIONS: These results indicate that fatigue has the potential to negatively influence parenting behaviours that are important for their children's well-being and development, and that fatigue plays a mediating role in this relationship. Implications of the study for psycho-education and interventions targeting the management of parental fatigue are discussed.

Mothers' work-family conflict and enrichment: associations with parenting quality and couple relationship.

BACKGROUND: Employment participation of mothers of young children has steadily increased in developed nations. Combining work and family roles can create conflicts with family life, but can also bring enrichment. Work-family conflict and enrichment experienced by mothers may also impact children's home environments via parenting behaviour and the couple relationship, particularly in the early years of parenting when the care demands for young children is high. METHODS: In order to examine these associations, while adjusting for a wide range of known covariates of parenting and relationship quality, regression models using survey data from 2151 working mothers of 4- to 5-year-old children are reported. RESULTS/CONCLUSION: Results provided partial support for the predicted independent relationships between work-family conflict, enrichment and indicators of the quality of parenting and the couple relationship.

Risk factors associated with the mental health of fathers of children with an intellectual disability in Australia.

BACKGROUND: Raising a child with a disability places considerable demands and stress on parents, which can contribute to mental health difficulties. Research has primarily focused on mothers' mental health, and our understanding of the effects on fathers remains limited. The factors that place fathers at increased risk of mental health difficulties are also poorly understood. This study aimed to redress these gaps by reporting on the mental health of a large sample of fathers of children with an intellectual disability (ID) (aged 3-15 years), comparing this to published Australian norms and mothers of children with ID. The second aim of the study was to explore risk factors associated with fathers' mental health. METHOD: The data for this study come from 315 Australian fathers of children (aged 3-15 years) with ID, who participated in the large-scale evaluation of the Signposts for building better behaviour programme. Fathers completed a range of self-report questionnaires at baseline including the Depression Anxiety Stress Scale (DASS). RESULTS: Fathers in the present sample reported significantly more symptoms of depression and stress than the Australian normative data, with approximately 6-8% reporting symptoms in the severe to extremely severe range. The strongest predictors of fathers' mental health difficulties were children's behaviour problems, daily stress arising from fathers' own needs and children's care needs, and low parenting satisfaction. Socio-economic factors did not predict mental health difficulties. CONCLUSION: This study is among one of the first to report the mental health of fathers of children with a disability in Australia. Findings highlight that some fathers of children with ID are at heightened risk of experiencing mental health difficulties, underscoring the importance of the provision of information and interventions to promote their mental health.

Maternal postnatal mental health and later emotional-behavioural development of children: the mediating role of parenting behaviour.

BACKGROUND: Maternal postnatal mental health difficulties have been associated with poor outcomes for children. One mechanism by which parent mental health can impact on children's outcomes is via its effects on parenting behaviour. METHOD: The longitudinal relationships between maternal postnatal distress, parenting warmth, hostility and child well-being at age seven were examined for 2200 families participating in a population-based longitudinal study of Australian children. RESULTS: The relationship between postnatal distress and children's later emotional-behavioural development was mediated by parenting hostility, but not parenting warmth, even after accounting for concurrent maternal mental health. Postnatal distress was more strongly associated with lower parenting warmth for mothers without a past history of depression compared with mothers with a past history of depression. CONCLUSIONS: These findings underscore the contribution of early maternal well-being to later parenting and child outcomes, highlighting the importance of mental health and parenting support in the early parenting years. Implications for policy and practice are discussed.

Parental fatigue and parenting practices during early childhood: an Australian community survey.

BACKGROUND: Parenting behaviours are influenced by a range of factors, including parental functioning. Although common, the influence of parental fatigue on parenting practices is not known. The first aim of this study was to investigate the relationship between fatigue and parenting practices. The second aim was to identify parental psychosocial factors significantly associated with fatigue. METHODS: A sample of 1276 Australian parents, of at least one child aged 0-5 years, completed a survey. Demographic, psychosocial (social support, coping responses) and parental sleep and self-care information was collected. Hierarchical regression was performed to assess the contribution of fatigue (modified Fatigue Assessment Scale) to parental practices (warmth, irritability and involvement), and parenting experiences (Parenting Stress Index, Parenting Sense of Competence Scale). Hierarchical multiple regression assessed the contribution of a range of parental sleep, psychosocial (social support, coping responses) and self-care variables to fatigue when demographic characteristics were held constant. RESULTS: Higher fatigue was significantly associated with lower parental competence (ß=-0.17, P < 0.005), greater parenting stress (ß= 0.21, P < 0.005) and more irritability in parent-child interactions (ß= 0.11, P < 0.005). Several psychosocial characteristics were associated with higher parental fatigue, including inadequate social support, poorer diet, poorer sleep quality and ineffective coping styles including self-blame and behaviour disengagement. CONCLUSIONS: Fatigue is common, and results suggest that fatigue contributes to adverse parental practices and experiences. However, possible risk factors for higher fatigue were identified in this study, indicating opportunities for intervention, management and support for parents.

Child, parent and family factors as predictors of adjustment for siblings of children with a disability.

BACKGROUND: Siblings adjust to having a brother or sister with a disability in diverse ways. This study investigated a range of child, parent and family factors as predictors of sibling adjustment outcomes. METHODS: Forty-nine siblings (aged 7-16 years) and parents provided information about (1) sibling daily hassles and uplifts; (2) sibling coping; (3) parent stress; (4) parenting; and (5) family resilience. Multiple regression techniques were used. RESULTS: It was found that parent and family factors were stronger predictors of sibling adjustment difficulties than siblings' own experiences of stress and coping. Specifically, socio-economic status, past attendance at a sibling support group, parent stress, family time and routines, family problem-solving and communication, and family hardiness-predicted sibling adjustment difficulties. Finally, siblings' perceived intensity of daily uplifts significantly predicted sibling prosocial behaviour. CONCLUSIONS: The results revealed that the family level of risk and resilience factors were better predictors of sibling adjustment than siblings' own experiences of stress and coping resources, highlighting the importance of familial and parental contributions to the sibling adjustment process. The implications of these results for the design of interventions and supports for siblings are discussed.