Modelo híbrido de treinamento parental para mães de crianças pré-escolares com transtorno do espectro autista baseado na análise do comportamento aplicada para redução do estresse parental

Este estudo buscou avaliar as contribuições de um treinamento parental híbrido realizado com oito mães de crianças pré-escolares com transtorno do espectro do autismo baseado na ciência da análise do comportamento aplicada para a redução do estresse parental. Foi realizado a construção e implementação do treinamento parental híbrido. A amostra foi dividida em grupo tratamento e controle. Em termos de análise de dados, foram feitas comparações do nível de estresse no período pré/pós-intervenção, assim como a análise de uma prática direta com a criança de forma presencial com o grupo tratamento. Os resultados obtidos demonstraram que as mães do grupo tratamento reagiram positivamente com as vídeos e materiais apresentados. No entanto, não foi observado diferenças estatísticas significativas para sugerir a redução do nível de estresse entre os dois grupos. As limitações do estudo foram o tamanho reduzido da amostra e o fato das crianças de ambos os grupos continuarem recebendo o tratamento em terapia intensiva durante a aplicação do treinamento parental.

Este estudio buscó evaluar los aportes de un entrenamiento parental híbrido realizado con ocho madres de niños preescolares con trastorno del espectro autista basado en la ciencia del análisis aplicado de la conducta para la reducción del estrés parental. Se llevó a cabo la construcción e implementación de un entrenamiento parental híbrido. Se dividió la muestra en grupo de tratamiento y control, y se realizaron comparaciones del nivel de estrés en el período pre/postintervención, así como el análisis de la práctica directa con el niño en un cara a cara con el grupo de tratamiento. Los resultados obtenidos demuestran que las madres del grupo de tratamiento reaccionaron positivamente a los videos y materiales presentados; sin embargo, no se observaron diferencias estadísticas significativas que sugieran una reducción en el nivel de estrés entre los dos grupos. Las limitaciones del estudio fueron el pequeño tamaño de la muestra y el hecho de que los niños de ambos grupos continuaron recibiendo tratamiento de terapia intensiva durante la implementación de la capacitación de los padres.

This study sought to evaluate the contributions of a hybrid parental training carried out with eight mothers of preschool children with autism spectrum disorder, based on the science of applied behavioral analysis for reducing parental stress. The hybrid parental training was constructed and implemented by the researchers. The sample was divided into two groups: a Treatment Group and a Control Group. In the data analysis, comparisons were made of the levels of stress pre- and post-intervention and for the treatment group, direct practice with the child in a face-to-face environment was also analyzed. The results showed that the mothers in the treatment group reacted positively to the video and materials presented; however, no significant statistical differences were found that would suggest a reduction in stress levels between the two groups as a result of the training given. The limitations of the study were its small sample size and the fact that the children in both groups continued to receive intensive therapy treatment during the application of the parental training.

Financial insecurity and mental well-being: experiences of parents amid the lebanese economic crisis.

BACKGROUND: This study investigates the impact of financial insecurity on the mental well-being and stress levels of parents in Lebanon amid the country's severe economic crisis. The context of Lebanon's economic collapse, coupled with the effects of the COVID-19 pandemic and the Beirut port explosion, has exacerbated financial and psychological distress among the population. This research aims to understand the correlation between financial instability and parental stress, identifying key factors contributing to mental health challenges in this demographic. METHODS: Employing a quantitative research approach, data was collected through an online survey from 785 parents from different backgrounds in Lebanon. The survey incorporated sociodemographic questions, the InCharge Financial Distress/Financial Well-Being Scale (IFDFW), and the Arabic version of the Parental Stress Scale (PSS). Data analysis was conducted using SPSS version 25. RESULTS: Findings showed significant correlations between high levels of parental stress and factors such as age (r = 0.071, p = 0.047) and lower education levels. Notably, refugees residing in Lebanon exhibited higher stress levels compared to Lebanese parents (mean stress score: 51.73 vs. 45.71, p < 0.001). Similarly, employed participants exhibited higher stress levels compared to the nonworking (mean stress score: 46.75 vs. 44.60, p = 0.003). A significant inverse association was found between financial well-being and parental stress (r=-0.216, p < 0.001), emphasizing the profound impact of economic instability on mental health. CONCLUSIONS: This study highlights the adverse effects of financial insecurity on parents' mental health, primarily during a period of economic instability, emphasizing the urgent need for targeted support interventions. These findings contribute to the literature on economic crises and mental health, providing a basis for future research and policy development in similar contexts.

Family resources, resilience beliefs, and parental adaptation: A moderated mediation analysis.

Despite the extensive body of evidence documenting how pandemic-related stressors (e.g., disruptions in daily routine) impact individuals' mental health, research examining family mechanisms through which stressors impact parental stress remains insufficient. The present study aims to address this gap by exploring a moderated mediation model that predicts parental stress resulting from the accumulation of pandemic-related stressors. Specifically, we hypothesized a second-stage moderated mediation model in which family resilience beliefs moderated the second-stage indirect paths through family relationships and marital satisfaction, resulting in conditional indirect effects. Study data were collected from American parents (n = 1386). There was no evidence that family relationships and marital satisfaction mediated the association between stressor pile-up and parent stress. In addition, family resilience beliefs did not significantly impact how marital satisfaction or family relationships affect parental stress. However, marital satisfaction mediated the relationship between stressor pile-up and parental stress across all levels of family resilience beliefs. The findings of this study carry significant implications for post-pandemic family interventions, suggesting the incorporation of resilience belief training and stress management strategies to improve intrafamilial communication.

Living the first years in a pandemic: children's linguistic development and related factors in and out of the COVID-19 lockdowns.

This retrospective study provides insights on linguistic development in exceptional circumstances assessing 378 children (between 2;6 and 3;6) who lived their first years during the COVID-19 pandemic and comparing it with normative data collected before this period (CDI-III-PT; Cadime et al., 2021). It investigates the extent to which linguistic development was modulated by a complex set of factors, including sex, maternal education, book reading, language-promoting practices, COVID-19 infection, parental stress and sleeping problems, considering three periods (during lockdowns, out of lockdowns and at present). The results show a substantial negative effect of the pandemic on both lexical and syntactic development. Considering individual variation, structural equation modelling unveiled a complex scenario in which age, sex, book reading, language-promoting practices, sleeping problems and COVID-19 infection showed a direct effect on linguistic development. Maternal education and parental stress had an indirect effect on children's language, mediated by book reading and sleeping problems, respectively.

Sociodemographic and Clinical Profile of 915 Autistic Preschoolers Engaged in Intensive Early Intervention in Australia.

There is a paucity of information on the sociodemographic and clinical characteristics of autistic children with high support needs. This study aims to address this gap by profiling a cohort of 915 children enrolled in full-time early intervention for autism spectrum disorder (ASD) in Australia between 2012 and 2024. Intake questionnaires assessed the sociodemographic characteristics of families entering the service. Clinical measures included the Autism Diagnostic Observation Schedule (2nd ed.), Mullen Scales of Early Learning, and Vineland Adaptive Behaviour Scale (2nd and 3rd eds.). Family measures included the Parenting Stress Index (4th ed., Short Form) and Autism Family Experience Questionnaire. Results indicated a male to female ratio of 3.8:1, clear delays from the age of first concern to diagnosis and intervention, and notable proportions of culturally diverse families. While clinical data indicated cognitive and adaptive deficits beyond findings in other ASD studies, measures of stress and family experiences were comparable to other autism literature. By reporting these findings, this study aims to facilitate a more informed, tailored and nuanced approach to addressing the unique challenges faced by autistic children with high support needs. The scope and limitations of this cohort are discussed.

Illness cognitions and parental stress symptoms following a child's cancer diagnosis.

Objective: This research aims to explore parents' cognitive beliefs, specifically illness cognitions, in response to their children being diagnosed with cancer. This study is an initial step toward providing regular psychosocial assessment as a standard for psychosocial care for children with cancer and their families in Latvia. Methods: Data were collected from 120 parents (mostly mothers, n = 109) as an initial evaluation of the psychosocial risks faced by families participating in the support program "Holistic and Multidisciplinary Support for Children with Functional Disabilities and Their Family Members," which was managed by the Children's Hospital Foundation at the Children's Clinical University Hospital in Riga (Latvia) from 2020 to 2023. The patients comprised 66 boys and 54 girls (M age = 7.1, SD = 4.7, range: 0-17 years) with diverse cancer diagnoses. The parents completed the Latvian version of the Psychosocial Assessment Tool [adapted from PAT 3.1], with five subscales included in the data analysis (Social Support, Child Problems, Family Problems, Stress Reactions, and Family Beliefs). The Family Belief subscale was adjusted specifically to address the unique objectives and research questions of the current study. Results: Significant correlations were found between children's psychological problems (e.g., getting upset about medical procedures, hyperactivity, excessive use of electronic devices, etc.) and parental stress reactions after diagnosis and with self-reported symptoms of anxiety and depression. The associations were statistically significant, even after controlling for sociodemographic and medical factors such as diagnosis. The relationship between children's problems and parental stress reactions was partly mediated by Family Beliefs about illness. The most informative beliefs associated with parental stress symptoms and the family's psychosocial risk level were identified, and significant results were found according to the main component of beliefs (catastrophic vs. optimistic) that explained 42% of the variance in the Family Beliefs subscale. Implication: Understanding the habitual responses to stress and identifying the thinking patterns of parents that lead to distorted views and maladaptive coping are essential for customizing personalized interventions to enhance treatment compliance. The Latvian version of PAT is a useful psychosocial screening measure in pediatric oncology settings.

ProVIA-Kids - outcomes of an uncontrolled study on smartphone-based behaviour analysis for challenging behaviour in children with intellectual and developmental disabilities or autism spectrum disorder.

Introduction: Challenging behaviour (CB) is a common issue among children with autism spectrum disorder or intellectual and developmental disability. Mental health applications are low-threshold cost-effective tools to address the lack of resources for caregivers. This pre-post study evaluated the feasibility and preliminary effectiveness of the smartphone app ProVIA-Kids using algorithm-based behaviour analysis to identify causes of CB and provide individualized practical guidance to manage and prevent CB. Methods: A total of 18 caregivers (M = 38.9 ± 5.0) of children with a diagnosis of autism spectrum disorder (44%), intellectual and developmental disabilities (33%) or both (22%) aged 4-11 years (M = 7.6 ± 1.8) were included. Assessments were performed before and after an 8-week intervention period. The primary outcome was the change in parental stress. Caregiver stress experience due to CB was also rated daily via ecological momentary assessments within the app. Secondary outcomes included the intensity of the child's CB, dysfunctional parenting, feelings of parental competency as well as caregivers' mood (rated daily in the app) and feedback on the app collected via the Mobile Application Rating Scale. Results: We observed increases in parental stress in terms of conscious feelings of incompetence. However, we also saw improvements in parental stress experience due to CB and overreactive parenting, and descriptive improvements in CB intensity and caregiver mood. Discussion: ProVIA-Kids pioneers behaviour analysis in a digital and automated format, with participants reporting high acceptance. Pilot results highlight the potential of the ProVIA-Kids app to positively influence child behaviour and caregiver mental health over a longer intervention period. Registration: The study was registered at https://www.drks.de (ID = DRKS00029039) on May 31, 2022.

Arabic validation of the parental stress scale (PSS) in a population-based sample of Lebanese parents.

BACKGROUND: Parental stress significantly impacts the well-being of families, and necessitates culturally sensitive tools for its assessment. The Parental Stress Scale, widely used in diverse cultural settings, lacks a validated Arabic version suitable for the Lebanese context, where unique sociopolitical and economic factors might influence parental stress differently. This study aimed to translate, culturally adapt, and validate the scale in Arabic among a Lebanese sample. METHODS: Following the Snowball sampling method, participants (n = 502) were adult Lebanese parents who answered demographic questions and completed the Arabic version of the Parental Stress Scale and the Depression, Anxiety, and Stress Scale-8. RESULTS: Confirmatory Factor Analysis showed a two-factor model of the Parental Stress Scale (CFI = 0.956). We found adequate composite reliability for both the 'Parental Stress' (ω = 0.91/α = 0.91) and 'Parental satisfaction' (ω = 0.94/α = 0.94) subscales. Convergent validity and concurrent validity were demonstrated through positive correlations with measures of depression, anxiety and stress. Our translation of the scale was shown to be invariant across sexes, with fathers scoring significantly higher than mothers. CONCLUSION: Our validated Arabic version of the Parental Stress Scale offers a culturally sensitive instrument for assessing parental stress in Lebanon. This tool enables healthcare providers and researchers to identify stressors affecting Lebanese families, facilitating the development of targeted interventions to support parental mental health.

Parental Stress and Psychological Distress and Their Association With Spousal Support Among Parents of School-Age Children During the COVID-19 Pandemic in South India: A Cross-Sectional Observational Study.

CONTEXT: The COVID-19 pandemic presented unprecedented challenges to families in the form of social isolation, economic difficulties and inaccessibility of educational and supportive services. AIMS: To assess the levels of parental stress and psychological distress among parents of school-age children during the COVID-19 pandemic and to analyse its correlation with spousal support. MATERIALS AND METHODS: A cross-sectional, web-based study was conducted among the parents of school-age children in south India. One hundred thirty-two completed responses were obtained. Study tools included Parental Stress Scale, Spouse Support Scale and Kessler's psychological distress scale-6 item version. RESULTS: The mean parental stress score was 42.39 ± 9.679. Sixty percent of the participants reported moderate to high levels of psychological distress. Parental stress and psychological distress scores were noted to have a significant negative correlation with spousal support scores (r=-.486, p=.000 and r=-.401, p=.000 respectively). CONCLUSION: Our study findings show that the COVID-19 pandemic has taken a toll on the psychological well-being of parents of school-age children. Supportive interventions to address parenting difficulties need to be undertaken to prevent long-term adverse mental health outcomes. Lessons learnt from the pandemic are important for clinicians and policymakers to take measures to alleviate parental stress as well as to promote the psychological well-being of parents and children.

The effect of live-performed music therapy with physical contact in preterm infants on parental perceived stress and salivary cortisol levels.

Introduction: Parents of preterm infants face a stressful life event which might have long term impact on the parent-child relation as well as on the infant's cognitive and socio-emotional development. Both music therapy (MT) and physical contact (PC) are stress-reducing interventions for parents and preterm infants on the neonatal intensive care unit (NICU). Meanwhile, especially close PC is considered as standard care (SC) in most NICUs. However, the effect of live performed MT with PC on parental perceived stress and cortisol levels has barely been investigated. We hypothesized that MT with PC leads to reduced stress levels and lower salivary cortisol concentrations compared to SC in parents of preterm infants during the first 4 weeks after birth. Methods: Randomized-controlled trial enrolling the parents of 99 preterm infants (MT n = 50, SC n = 49 infants). The infants received either MT with PC or SC only. Perceived stress was measured with the perceived stress questionnaire 20 (PSQ-20) after birth and 4 weeks later. Salivary cortisol levels were obtained and measured weekly after birth for 4 weeks. Results: Forty-two mothers and eight fathers of the intervention group (MT with PC) as well as n = 43 mothers and n = 6 fathers of the control group (SC) were enrolled. For the intervention group, salivary cortisol was reduced 4 weeks after birth [mothers 5.5 nmol/l (confidence interval (CI) 3.6-7.5); fathers 8.3 (CI 7.2-9.4)] compared to the control group [mothers 10.3 nmol/l (CI 5.4-15.3); fathers 14.8 (CI 8.9-20.7)]. Overall perceived stress scores decreased in the intervention group (mothers -17.6; fathers -12.6) and increased in the control group (mothers +6.1; fathers +21.4) over 4 weeks. Discussion: Live-performed MT with PC in preterm infants might be an effective, non-invasive intervention to reduce parental stress and cortisol levels. Future studies should investigate the long-term effects of this intervention on the parent-infant relation as well as on the infants' cognitive and socio-emotional development. Clinical trial registration: https://drks.de/search/en/trial/DRKS00025755 identifier [DRKS00025755].

Exploring the factors contributing to parent stress symptoms during the COVID-19 pandemic in Europe: An ABC-X model approach.

The COVID-19 pandemic has had a significant impact on the mental health and well-being of families worldwide, with parents particularly at risk for stress and other psychological symptoms. In this study, we sought to understand the factors contributing to parent stress symptoms during the early stages of the pandemic in 23 European countries (N = 40,138) using the double ABC-X model. We examined whether the relationship between stressor pile-up and perceived stress was mediated by family satisfaction and relationship satisfaction and whether family resiliency beliefs impacted these mediated relationships. Our results showed a direct association between stressor pile-up and parent stress symptoms, but we did not find evidence for the mediating role of family satisfaction or relationship satisfaction in this relationship. We also found that family resiliency beliefs did not moderate the indirect effects of family satisfaction and relationship satisfaction on parent stress symptoms. These findings suggest that the ABC-X model may not fully capture the processes affecting parents' experience of stress during the pandemic and that alternative models such as the vulnerability-stress-adaptation model may be more relevant. Future research should also consider the potential negative impact of resiliency beliefs on mental health and other risk and protective factors such as self-compassion.

Parental experiences of raising an autistic child in Ireland: A qualitative thematic analysis.

LAY ABSTRACT: Parenting an autistic child can be a challenging experience. Parents of autistic children often require social and professional support to cope with the various stresses they encounter and to ensure their children achieve their optimal potential. Recently, the way professional supports are organised in Ireland has changed. Very little previous recent research has investigated parents' experiences of raising an autistic child in Ireland. This study interviewed six parents asking them about their challenges, stress levels, coping strategies and their perceptions regarding professional support services. The data from these interviews were organised into themes. A major finding was that parents felt the healthcare system was failing to provide help for their children, and that support services in Ireland can cause more parental distress than dealing with their child's difficulties. Other causes of parental stress included the child's behaviours that they found challenging, stigma, a lack of awareness about autism and isolation. This study shows that both autistic children and their parents are at increased risk of developing mental health problems due to a flawed healthcare system that requires improvement urgently.

Assessment of Stress and Anxiety in Parents of Neonates Admitted in a Tertiary Care Neonatal Intensive Care Unit (NICU).

Background A newborn's admission into the Neonatal Intensive Care Unit (NICU) is one unexpected event capable of causing much stress and anxiety among parents. The current study aims to evaluate and compare parental stress and anxiety levels between mothers and fathers. Methodology This cross-sectional study was conducted in the NICU of a tertiary care center, in Uttarakhand where a total of 306 mothers and fathers were enrolled. Data was compiled using a questionnaire consisting of demographic details of parents and infants' clinical profiles, Parental Stressor Scale (PSS) NICU, and State-Trait Anxiety Inventory (STAI) scales were used to evaluate stress and anxiety, respectively. Results Mothers mean stress levels were greater and statistically significant. The most affected subscale in both parents was the change in parental role (M: 4.4/F: 3.3; p < 0.001). Parents with high trait anxiety also had high state anxiety (M: 51.3/F: 45.5; p < 0.001). Mothers were found to have higher trait and state anxiety than fathers. Conclusion Parents of newborns admitted in the NICU experience significant stress and anxiety. Mothers had higher levels of stress and anxiety; similar findings have been recorded previously in Indian and western literature.

A systematic review and meta-analysis of the parental stress scale's psychometric properties.

Parental stress can affect the ability of parents to cope with the challenges of raising children. The result can be a negative cycle within the family dynamic, which in turn can interfere with children's development and emotional regulation. Among the many instruments available to assess parental stress, the Parental Stress Scale (PSS) deserves particular mention. To our knowledge, there are currently no systematic reviews evaluating the psychometric properties of the PSS. The aim of this systematic review was to assess the psychometric properties of the PSS using the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) methodology and to conduct a meta-analysis. A thorough literature search was conducted from different databases. A meta-analysis to test the generalisability of PSS internal consistency across its component factors was performed. A total of 20 validation studies of the PSS were identified. Based on the COSMIN methodology, this instrument receives an 'A' rating, meaning that it is considered to be a cross-sectional instrument with the necessary scientific evidence for the assessment of the construct of parental stress. The meta-analysis testing the generalisability of its internal consistency yielded satisfactory results across the different factors. Future research should focus on those psychometric properties of the PSS that have not been studied as extensively, such as reproducibility, responsiveness, measurement error, and measurement invariance.

Psychometric properties of the Parenting Stress Index-Short Form in a Peruvian sample.

BACKGROUND: The stress experienced by parents in fulfilling their parental role has consequences for couple dynamics, parent-child interactions, and the mental health of parents. However, studies on the psychometric properties of the PSI-SF, particularly among Latin American parents, are scarce. Therefore, this study aims to evaluate the psychometric properties of the Spanish version of the Parenting Stress Index-Short Form (PSI-SF). METHODS: The participants were Peruvian mothers and fathers with children in early childhood and primary education, with a mean age of 34.4 years (SD = 6.8). The sample was obtained in two phases: 130 participants for the Exploratory Factor Analysis (EFA) and 791 participants for the Confirmatory Factor Analysis (CFA). RESULTS: The study results show a modified three-factor structure of the PSI-SF scale, with adequate fit indices (GFI = .99, AGFI = .99, SRMR = .024, CFI = .98, TLI = .98, RMSEA = .074) and loadings above 0.40. Additionally, the three factors of the scale demonstrated high reliability, with Cronbach's alpha and McDonald's omega values for Parental Distress (α = .94; ω = .95), Parent-Child Dysfunctional Interaction (α = .97; ω = .97), and Difficult Child (α = .94; ω = .94). The scale was also found to be invariant with respect to gender. CONCLUSION: In conclusion, the study results suggest that the modified PSI-SF has adequate psychometric properties and is invariant for assessing parental stress in Peruvian fathers and mothers with children in early childhood and primary education.

Effectiveness of a home-based, post-discharge early intervention program for very preterm infants in reducing parental stress: a randomized controlled trial.

BACKGROUND: This study aims to evaluate the impact of a home-based, post-discharge early intervention (EI) program on reducing parental stress levels in families with preterm infants born between 28+ 0 and 31+ 6 weeks gestational age. METHODS: A randomized controlled trial was conducted, with families randomly allocated to either the EI or standard care (SC) group. A term reference group was also recruited for comparison. The Parental Stress Index-Short Form was used to assess parental stress levels, yielding a total stress score and three subdomain scores. Assessment was performed at baseline, at the 60-day mark of the study, and when the infants reached six corrected months of age. Parents in the reference group were assessed only at six months of corrected age for infants. The intervention comprised three sections: intellectual, physical, and social training, which was administered to the infants in the EI group immediately after discharge and to those in the SC group after 60 days of enrollment. RESULTS: Seventy-three families were enrolled in this study, with 37 allocated to the EI group, and 36 to the SC group. Prior to intervention, higher stress levels were reported by mothers in both groups than fathers, with no difference observed between the EI and SC groups. Re-assessment performed at 60 days of the study showed that mothers and fathers in the EI group had significantly lower total stress score than those in the SC group (82.00 ± 5.64 vs. 94.26 ± 7.99, p < 0.001; 80.74 ± 7.14 vs. 89.94 ± 9.17, p < 0.001, respectively), which was predominantly due to the lower scores in parental distress and parental-child dysfunction interaction subdomains in the EI group (both had p < 0.001). Mothers in the EI group exhibited a more pronounced reduction in total stress score after intervention when compared to fathers (13.15 ± 4.68 vs. 8.26 ± 4.03, p < 0.001). At six months of infant age, the total stress score and subdomain scores of parents in the EI and SC groups were similar, but significantly higher than those of the reference group. CONCLUSION: The home-based, post-discharge EI program demonstrated significant effectiveness in reducing parental stress levels among the parents of very preterm infants. TRIAL REGISTRATION: This study was registered in the Chinese Clinical Trial Registry (registration number: CTR1900028330). Registration date: December 19, 2019.

Stress in parents of preschoolers with Autism Spectrum Disorders: an update review.

BACKGROUND: Parental stress experienced in the context of caring for children with autism spectrum disorder (ASD) in preschool is significant and has been poorly studied; studies tend to focus on more advanced ages of children where parental symptomatology has become chronic. The current study sought to provide new empirical evidence on factors associated with parental stress. METHODS: An exhaustive search was conducted in four academic databases: CINAHL Complete, Medline Complete, Web of Science (WoS), and Scopus, limiting the articles to those published between 2017 and 2023. RESULTS: The sample obtained consisted of 24 selected articles, which were produced in 11 countries, and all were in English. In terms of content, the topics addressed were the manifestation of parental stress, factors of the child with ASD and their relationship with parental stress, factors of parents of children with ASD, family factors of parents of children with ASD, social factors of parents of children with ASD, parental stress and access to formal care services, and parental stress and specialized interventions. CONCLUSIONS: It is possible to affirm that research reports indicate that the general level of stress among parents of children with ASD is compared to their reference groups, both in relation to child-related stress and other stressors. The variables that affect parental stress exhibit a reciprocal influence among them, so interventions aimed at early childhood should incorporate both the children and their parental figures. This is in consideration of the impact that stress has on the mental health of parents, establishing that parents with better health have early access to support services during the early years of parenting, as well as in later years.

INTRODUCCIÓN: El estrés parental vivenciado en el contexto de cuidado de los niños con trastorno del espectro autistas en etapa preescolar es significativo y ha sido muy poco estudiado, las investigaciones tienden a focalizarse en edades de los niños más avanzada donde la sintomatología de los padres se ha cronificado. El objetivo de la presente investigación fue actualizar el corpus de evidencia empírica referida a los factores relacionados con el Estrés parental. MÉTODOS: Se realizó una búsqueda exhaustiva en cuatro bases de datos académicas: CINAHL Complete, Medline Complete, Web of Science (WoS) y Scopus, limitando los artículos publicados entre los años 2017 y 2023. RESULTADOS: La muestra obtenida fue de 24 artículos seleccionados, los cuales fueron producidos por 11 países todos de habla inglesa. En cuanto al contenido, los temas abordados son: La manifestación del estrés parental, factores del niño con TEA y su relación con el estrés parental, factores de los padres de los niños con TEA, factores familiares de los padres de los niños con TEA, factores sociales de los padres de los niños con TEA, estrés parental y acceso a los servicios formales de atención, y estrés parental e intervenciones especializadas. CONCLUSIONES: Es posible afirmar que las investigaciones reportan que el nivel general de estrés de los padres de niños con TEA es superior al de sus grupos de referencia, tanto en relación al estrés relacionado con el niño, como el que no. Las variables que afectan el estrés parental presentan una influencia recíproca entre éstas, por lo que las intervenciones dirigidas a la primera infancia deberían incorporar a los niños y a sus figuras parentales. Esto, en atención al impacto que el estrés presenta en la salud mental de los padres, estableciendo que los padres con mejor salud mental presentan mayor acceso temprano a los servicios de apoyo durante los primeros años de crianza, y en los años posteriores.

Interpretability and clinical utility of the strength and stressors in parenting questionnaire.

This study aimed to enhance the interpretability and clinical utility of the strength and stressors in parenting (SSF) questionnaire, a parent-reported questionnaire designed to assess strength, stress and associated risks of mental ill-health in parents of children with developmental disabilities. Responses to the SSF and a demographic questionnaire were collected from 576 parents of children with (n = 203) and without (n = 373) developmental disabilities. To enhance the interpretability of the SSF, a subset of 129 parents were invited to complete an additional questionnaire consisting of three free-text questions regarding recent help-seeking behavior, experiences of mental ill-health and experiences of parenthood. Parents' responses to the free-text questions were then categorized as indicative of higher or lower degrees of stress and compared to their SSF score distribution to derive empirical cut-offs for strength, stress and risk of mental ill-health as measured by the SSF. The credibility of these cut-offs was evaluated by comparing the cut-offs with SSF scores collected from the other 447 parents. Finally, SSF scores from parents of children without developmental disabilities (n = 373) were used to generate percentile values for the SSF to enable a standardized interpretation of SSF scores. To increase the utility of the SSF, we examined a recurring pattern of missing answers to items 23 and 33-38, noted in previous studies of the SSF and repeated in the present study. These items were excluded from further analysis since our examination revealed that they were not missing at random but rather constituted real differences in parental experiences, such as receiving a healthcare allowance, or caring for more than one child. The proposed empirical cut-offs performed well in discriminating between the two groups and yielded a specificity of 77-89% and a sensitivity of 68-76% for the strength, stress and risk of mental ill-health subscales of the SSF. This study also presents a conversion chart associating each SSF score with a corresponding percentile value. We propose modifications to the SSF, whereby items 23 and 33-38 are excluded, which will enable a more reliable assessment of parental experiences. This will, together with the empirical cut-offs and percentile values, enhance the interpretability and clinical utility of the SSF.

The effects of infant abdominal massage on the parental stress level among Chinese parents in Hong Kong - A mixed clustered RCT.

OBJECTIVE: To investigate the effectiveness and the experience of infant abdominal massage on reducing the parental stress level. METHODS: A clustered RCT was conducted, 160 parents were recruited from 10 mother groups. An infant abdominal massage class was given to those in the intervention group by a certified International Association of Infant Massage instructor. The Chinese Parenting Stress Index (PSI-SF) was used to measure parental stress levels at baseline and 4 weeks after the intervention. 8 parents from the intervention group were invited for an online interview to understand the experience of parents in participating the infant abdominal massage class. Thematic analysis was applied. RESULTS: The parental stress level was significantly decreased among intervention group with a mean difference of -5.46 (95% CI = 0.72 to 10.2, p = .049). ITT analysis was adopted for compliance analysis. The overall compliance for the intervention was 66% and found to have a significant effect on parental stress level (p < .01). The total PSI-SF among fathers was slightly higher than that among mothers. Furthermore, no moderating factors were found to have a significant interaction effect on PSI-SF (p < .05).For qualitative data, an overarching theme was generated that infant abdominal massage brought a positive experience despite the uncertainties affecting the compliance. Four themes and nine sub-themes were identified. Which were: (1) receiving clear and informative infant abdominal massage classes; (2) The influence of uncertain conditions on compliance; (3) Improving parental satisfaction; and (4) feeling it was a worthwhile experience. CONCLUSION: This study provides a cost-effective method for parents to tackle their parental stress, the findings aid in the planning or adjustment of current postpartum depression screening while also helping to lower the risk of postpartum mood disorders. TRIAL REGISTRATION: Clinical Trial Number (NCT05650424 || http://clinicaltrials.gov/study/NCT05650424 ), registered on December 1, 2022. and HKU Clinical Trails Registry (HKUCTR3008), registered on November 3, 2022.

Relationships between Anxiety, Repetitive Behavior and Parenting Stress: A Comparative Study between Individuals with Autism from Spain and Colombia.

The present study analyzed the association between anxiety, repetitive behavior and parental stress in individuals with autism from Spain (n = 60, mean age = 8.52, SD = 4.41) and Colombia (n = 58, mean age = 10.29, SD = 4.98). Similarly, differences in anxiety, repetitive behavior and parental stress between both countries were analyzed. Outcomes revealed a strong relationship between anxiety and repetitive behavior in both populations. Furthermore, moderate positive associations were observed between anxiety, repetitive behavior and parental stress in the Spanish sample. However, parental stress was found to be moderately and negatively related with anxiety and repetitive behavior in the Colombian sample. Finally, no differences were found in anxiety and repetitive behavior between countries, but differences did emerge for parental stress which was found to be higher in the Colombian sample. In conclusion, differences in parental stress may be due to regional differences in socio-health resources, socio-economics, parenting styles, etc.