How do exhausted parents experience their interactions with their children? A qualitative and participative study.

Introduction: Parental burnout, known as a state of physical and psychological exhaustion, results in an imbalance between the parent's perceived stressors in relation to parenting, and the resources available to the parent to cope with such stressors. The causes and consequences of parental burnout for the parents themselves have been studied from the parents' point of view, but the perception of parents regarding the impact of parental burnout on the parent-child relationship has not yet been documented. Methods: We conducted a qualitative study through semi-structured interviews with exhausted parents (n=21). We aimed to better understand their general interactions with their children, as well as the way they communicate with them about their state of exhaustion, knowing that dealing with parental suffering can have a long-term impact on the child. Results: Our results reveal that exhausted parents experience a widespread loss of control in all areas of their lives, particularly in their interaction with their children, which generates feelings of guilt and shame. Communicating their experience to their children can create various difficulties for both parents and children. This may complicate the process of seeking help and reinforce the feeling of isolation. Discussion: An emerging result from our analysis leads us to identify a need for the parents to be heard and validated in their suffering who took part in this research.

Mental Health Nurses' Social Representations of People Who Experience Mental Illness: A Story of Paradoxes.

Public representations of people who experience mental illness (PEMI) have been well documented within the stigma literature. However, studies about mental health nurses' representations of PEMI are still scarce and characterized by contradictions. Using the theoretical concept of social representation instead of stigma, the current study aims to explore and understand mental health nurses' social representations of PEMI. Qualitative research was conducted based on 13 semi-structured interviews with nurses from two psychiatric units in general hospitals. Data were analyzed using interpretative phenomenological analysis. Results showed that nurses' social representations were characterized by paradoxes. They explicitly displayed positive social representations, while nuancing them from an implicit point of view. The nurses wanted to work toward a destigmatizing voice for PEMI while nuancing their assertions to sound honest and accurate, which led them to a state of cognitive dissonance.

Healing the Separation in High-Conflict Post-divorce Co-parenting.

Objective: Our research aim is to enrich the conceptualization of high conflict post-divorce co-parenting by understanding the dynamic process involved. Background: The studied phenomena were explored by linking previous scientific knowledge to practice. Method: We cross-referenced the previous study results with the experiences reported by eight professionals and tried to answer the following research question: how professionals' experience and previous scientific knowledge contribute to a better understanding of HC post-divorce co-parenting? Individual face to face interviews were conducted and analyzed regarding the qualitative theoretical reasoning of thematic analysis. Results: Analysis allowed us to highlight how four main axes are related to HC post-divorce co-parenting: (1) Parents for life, (2) Acting in the child's best interests, (3) Managing disagreements, and (4) Healing the separation. Conclusion: Our findings capture high conflict post-divorce co-parenting as a multidimensional dynamic process. As such, dealing with co-parenting disagreements must be understood as a moment in a process that is influenced by, and influences, other dimensions. Implications: Interventions must consider the four dimensions and their reciprocal interactions. The essential elements underlying parents' difficulties may reside at a multiplicity of levels: inter-relational, contextual, and intrapsychic. Each level contains key potential factors in understanding these families, and in formulating intervention guidelines.

Friend or foe? A qualitative study exploring the relationship of people with obesity and food consumption.

BACKGROUND: Obesity is a major health problem worldwide, and one of its causes is unhealthy eating. A healthy diet should ensure that energy intake (calories) is in balance with energy expenditure, but in this paper a subjective experience of healthy eating will be discussed. Research has revealed many determinants of food consumption, but a more holistic view of food consumption is often overlooked. AIM: The aim was to go beyond identifying determinants of eating by exploring the experience of (healthy) food for people with obesity. METHODS: Semi-structured interviews were conducted with eight patients with obesity. RESULTS: Interpretative phenomenological analysis identified four superordinate themes: ambivalence in the emotional relationship with food, an obesogenic environment where it is less acceptable to society to be obese, an experience of unfairness in the relationship to eating in comparison with other people, and the parental role as an existential motivation to eat healthier. CONCLUSION: The relationship of people with obesity and food is highly complex and personal, and is influenced by the uncontrollability of the social and physical environment. These personal experiences of people with obesity should be taken into account in the psychological treatment of obesity. The current research adds to the mostly motivational determinants discovered with social cognition models, by showing the subjective experience of (healthy) food consumption for people with obesity.

The family practice of support-giving after a pediatric cancer diagnosis: A multi-family member interview analysis.

PURPOSE: Pediatric cancer presents many challenges to the life of the child diagnosed with cancer and his/her family. Among the studies investigating risk and protective factors, social support has emerged as an important construct. However, little is known on how family members support each other in this particular context. METHOD: In order to further explore this process, interviews were performed separately with mothers, fathers and siblings. For the purpose of this study (as this is part of a larger project), data from four families in which both parents and at least one sibling participated, were used. Multi Family Member Interview Analysis was used as the methodological framework to analyze the individual interviews, allowing a detailed and systematic analysis of shared family experiences. RESULTS: The analysis of the data revealed three themes: Being together matters: the families identified the need of being physically together; Finding support in (not) talking: the complexity of sharing emotions was explained and Working together as a team: the families described working together as a team in order to get everything organized. CONCLUSIONS: This study broadens our understanding of the interpersonal process of family support-giving when facing pediatric cancer. When meeting with families, families should be invited as a unit in order to best capture family level experiences. Also, clinicians should be sensitive to the different cancer-related communication needs within the family (i.e., the need to talk or not to talk) and incorporate this knowledge into their care.

Identifying Positive Adaptive Pathways in Low-Income Families in Singapore: Protocol for Sequential, Longitudinal Mixed-Methods Design.

BACKGROUND: This study aims to examine the adaptive process of children and mothers from multistressed low-income families in Singapore. It aims to bridge the knowledge gap left by existing poverty studies, which are predominately risk focused. Through a sequential longitudinal mixed-methods design, we will differentiate children and mothers who demonstrate varied social, developmental, and mental health trajectories of outcomes. Through utilizing the Latent Growth Curve Model (LGCM), we aim to detect the development and changes of the positive Family Agency and adaptive capacities of these families over time. The construct of Family Agency is underpinned by the theoretical guidance from the Social Relational Theory, which examines child agency, parent agency, relational agency, and the interactions among these members. It is hypothesized that positive Family Agency within low-income families may lead to better outcomes. The key research questions include whether the extent of positive Family Agency mediates the relationship among financial stress, resource utilization, home environment, and parental stress. OBJECTIVE: The study elucidates the Family Agency construct through interviews with mother-child dyads. It also aims to understand how financial stress and resources are differentially related to home environment, parent stress, and parent and child outcomes. METHODS: In phase 1, 60 mother-child dyads from families receiving government financial assistance and with children aged between 7 and 12 years will be recruited. In-depth interviews will be conducted separately with mothers and children. On the basis of 120 interviews, a measurement for the construct of Family Agency will be developed and will be pilot tested. In phase 2a, a longitudinal survey will be conducted over 3 time points from 800 mother-child dyads. The 3 waves of survey results will be analyzed by LGCM to identify the trajectories of adaptation pathways of these low-income families. In addition, 10 focus groups with up to 15 participants in each will be conducted to validate the LGCM results. RESULTS: This project is funded by the Social Science Research Thematic Grant (Singapore). The recruitment of 60 mother-child dyads has been achieved. Data collection will commence once the amendment to the protocol has been approved by the Institutional Review Board. Analysis of phase 1 data will be completed by the end of the first quarter of 2019, and the first set of results is expected to be submitted for publication by the second quarter of 2019. Phase 2 implementation will commence in the second quarter of 2019, and the project end date is in May 2021. CONCLUSIONS: Findings from this study can potentially inform social policy and programs as it refines the understanding of low-income families by distinguishing trajectories of adaptive capacities so that policies and interventions can be targeted in enhancing the adaptive pathways of low-income families with children. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/11629.

A Critical Analysis of Intimate Partner Sexual Violence in Iran.

According to global data, intimate partner violence and its corresponding impact threaten the lives of almost 35% of women at some point in their life. The aim of this research was to explore the effects of intimate partner sexual violence on women's sense of self-efficacy when it comes to speaking out against violence and seeking help. In-depth interviews and a thematic analysis approach were employed to collect and analyze the data. The participants were 10 women with experiences of intimate partner sexual violence. They were selected through purposive and snowball sampling. Two main themes were drawn from the data, including Exposure and Empowerment. Exposure refers to the type of violence women have experienced and its physical and emotional effects; and Empowerment refers to factors women considered as giving them the courage to speak out against perpetrators, to seek help from others, or to refrain from doing either. It is concluded that Iranian women are not passive when exposed to intimate partner sexual violence, and social support, mainly from family and friends, was a pathway to feelings of empowerment; without this support, women's emotional health is put in jeopardy. Due to the importance of social networks in creating a sense of empowerment, it is recommended that professionals involved in cases of intimate partner sexual violence create an alliance with the women's families and friend and educate them on how to prevent violence or offer help before the violence takes its toll on woman's emotional and physical wellbeing.

Siblings' Experiences of Everyday Life in a Family Where One Child Is Diagnosed With Blood Cancer: A Qualitative Study.

BACKGROUND: Childhood cancer not only presents challenges to the life of the child with cancer but also to the siblings' daily family life. The aim of the current study was to gain a better understanding of siblings' experiences of living in a family where one child has been diagnosed with blood cancer. METHOD: Ten siblings of children with leukemia or non-Hodgkin lymphoma completed a semistructured interview about their everyday family life experiences postdiagnosis. The verbatim transcripts of the interviews served as the data for an interpretative phenomenological analysis. RESULTS: The results showed that overall the siblings experienced a continuity in many aspects of their family life: they still experienced their family as an important source of support and information/communication, as warm and loving and as a safe harbor where family members aim to protect each other. However, at the same time, the participating siblings also expressed that some things felt unmistakably different postdiagnosis: They felt that their family as a whole had been ripped apart, with a greater focus on the diagnosed child and changing responsibilities for each family member. CONCLUSION: This study informs parents and clinicians about the daily family life experiences from the siblings' perspective, a perspective that is often overlooked. A focus on challenges as well as continuities within family life, the wish for connection expressed by the siblings, and the uniqueness of every sibling's experiences is what can be taken away from this study by psychosocial workers in the field.

Expatriate Family Adjustment: An Overview of Empirical Evidence on Challenges and Resources.

The current theoretical paper presents a comprehensive overview of findings from research attempting to understand what happens with expatriates and their families while living abroad. Our paper draws on research on adjustment of individual family members (expatriates, their partners, and children) and families as a whole, across different literatures (e.g., cultural psychology, family psychology, stress literature). The key challenges of expatriation are discussed, as well as family members' resources. Our findings lead to the following conclusions: First, there is lack of systematic research as studies are either missing a theoretical background or largely neglect the multi-informant approach. A comprehensive theory of expatriate family adjustment integrating multiple theoretical perspectives, including the culture identity formation and the impact of home country and host country culture, is called upon. Second, the majority of studies paid little attention to define the concept of family or failed to take into account the cultural aspect of relocation. Third, there is a call for more longitudinal studies including all family members as adjustment is a process that unfolds over time and therefore cannot be sufficiently explained by cross-sectional studies. Suggestions for future research and practical implications are provided, with a special focus on how families could be assisted during their adjustment process.

Students with Autism Spectrum Disorder and Their Parents in the Transition into Higher Education: Impact on Dynamics in the Parent-Child Relationship.

This study examined how 34 senior students and first-year college students with autism spectrum disorder, their mothers (n = 34) and fathers (n = 26) navigate the higher education transition, and how this context impacts on dynamics in the parent-child relationships. Semi-structured interviews were analyzed based on grounded theory and dyadic analysis principles. Both parties were confronted with an abundance of challenges and experienced strong feelings of ambivalence, stress and anxiety. Differences in perspectives occurred regarding the construction of adulthood, the acquisition of autonomy, disclosure and subscribing to support services. These differences caused tensions in the parent-child relationship, hindering the transformation of the relationship into an adult-like mutual relationship. Clinical implications are extrapolated on the basis of these findings.

Sources of perceived responsiveness in family relationships.

Perceived responsiveness has become one of the most important constructs in the relationship sciences. It is central to the development of a secure attachment style, the experience of social support, an internal locus of control, and the sense of control in close relationships. Conversely, an unresponsive environment is associated with learned helplessness and depression. Viewed through the lens of the social relations model (SRM), perceived responsiveness in family relationships could have multiple sources: the perceiver; the target or partner; the perceiver-target relationship; and the family group. This study used the SRM to determine the relative importance of these sources of perceived responsiveness in the relationships of 207 two-parent two-child families. Characteristics of the perceiver and the target each accounted for about 25% of the systematic variance in perceived responsiveness, whereas the perceiver-target relationship accounted for approximately 48%. At the individual level of analysis, reciprocity of perceived responsiveness was pervasive in the family relationships of the two children. Regardless of age, young people who generally perceived others as responsive were generally perceived by others as responsive. At the dyadic level of analysis, reciprocity was present in two dyads: mother-father and older child-younger child. Reliable target variances support the view that perceived responsiveness is not just "inside the head" of the perceiver, and reciprocity correlations suggest potentially useful systemic interventions. (PsycINFO Database Record

Parents' Perspectives of Changes Within the Family Functioning After a Pediatric Cancer Diagnosis: A Multi Family Member Interview Analysis.

Pediatric cancer is a life-threatening disease that challenges the life of the diagnosed child, the parents, and possible siblings. Moreover, it also places considerable demands on family life. The aim of this study was to explore changes in the family functioning after a pediatric cancer diagnosis. Ten couples who had a child with leukemia or non-Hodgkin lymphoma were interviewed individually about their experiences. Interviews were semistructured, and the data were analyzed using Multi Family Member Interview Analysis. Three themes emerged from the data: (a) Family Cohesion: Strengthened Versus Fragmented; (b) Educational Norms and Values: Overindulgence Versus Being Stricter, and (c) Normality: Loss Versus Preservation. The conflicting dynamics present in these emerging themes exemplify the complexity of this process of family adaptation. This study illustrates the need to take into account the family level, as well as the conflicting feelings parents may experience after a pediatric cancer diagnosis.

Agency of depressed adolescents: embodiment and social representations.

PURPOSE: Major depression is becoming more common among adolescents. Most research into major depression disorder focuses on intrapersonal and interpersonal processes, but the importance of sociocultural factors is less investigated. This study explores the role of social representations in the construction of adolescents diagnosed with major depression. The researched was informed by the concept of human agency and Social Relational Theory. METHOD: Interviews were conducted with fifteen hospitalized adolescents diagnosed with a major depression disorder using a semi-structured interview schedule. The research question was: What are the social representations about being a normal person that influence depressed adolescents and their lived experiences of having major depression? Transcripts were subjected to Interpretative Phenomenological Analysis. RESULTS: Five superordinate themes emerged out of the data: (a) Depression means personal failure; (b) Feeling bad is not allowed and is not normal: in fact, depression doesn't really exist; (c) You are obliged to have an intimate relationship, otherwise you are not normal; (d) It is important to have future projects for personal and social well-being; (e) Being socially well integrated is normality. CONCLUSIONS: Clinical and therapeutic implications are discussed.

Associations between Relational Pronoun Usage and the Quality of Early Family Interactions.

Our study examined the relationships of relational pronouns used in parental conversation to the quality of early family interactions, as indexed by Family Alliance (FA). We hypothesized that more positive family interactions were associated with the use of more we-pronouns (e.g., we, us, our; we-ness) and fewer I- and you-pronouns (e.g., I, me, you, your; separateness) by both mothers and fathers. Our statistical model using a multilevel modeling framework and two levels of analysis (i.e., a couple level and an individual level) was tested on 47 non-referred families (n = 31 primiparous families; child's age, M = 15.75 months, SD = 2.73) with we-ness and separateness as outcomes and FA functions as between-dyads variables. Analyses revealed that we-ness within the parental couple was only positively associated with family affect sharing while separateness was negatively associated with different FA functions (e.g., communication mistakes). Our main finding suggested that the kinds of personal pronouns used by parental couples when discussing children's education would be associated to the emotional quality of the family interactions.

Toward Understanding the Child's Experience in the Process of Parentification: Young Adults' Reflections on Growing up With a Depressed Parent.

This article reports on a qualitative study with 21 young adults who grew up with a depressed parent. We examined how young adults make sense of their childhood experiences of parental depression and how their retrospective reflections help us to understand the experiences of children and the processes of parentification. Participants recounted that their childhood consisted mainly of actions in the service of family well-being. At that time, they reflected on their own experiences only rarely. In adolescence, there was an evolution toward a greater consideration for oneself and a repositioning within the family. In the discussion, we explore the therapeutic implications of this study--and in particular--the meaningfulness of silence in the family process of parentification.

Is Dysfunctional Use of the Mobile Phone a Behavioural Addiction? Confronting Symptom-Based Versus Process-Based Approaches.

UNLABELLED: Dysfunctional use of the mobile phone has often been conceptualized as a 'behavioural addiction' that shares most features with drug addictions. In the current article, we challenge the clinical utility of the addiction model as applied to mobile phone overuse. We describe the case of a woman who overuses her mobile phone from two distinct approaches: (1) a symptom-based categorical approach inspired from the addiction model of dysfunctional mobile phone use and (2) a process-based approach resulting from an idiosyncratic clinical case conceptualization. In the case depicted here, the addiction model was shown to lead to standardized and non-relevant treatment, whereas the clinical case conceptualization allowed identification of specific psychological processes that can be targeted with specific, empirically based psychological interventions. This finding highlights that conceptualizing excessive behaviours (e.g., gambling and sex) within the addiction model can be a simplification of an individual's psychological functioning, offering only limited clinical relevance. KEY PRACTITIONER MESSAGE: The addiction model, applied to excessive behaviours (e.g., gambling, sex and Internet-related activities) may lead to non-relevant standardized treatments. Clinical case conceptualization allowed identification of specific psychological processes that can be targeted with specific empirically based psychological interventions. The biomedical model might lead to the simplification of an individual's psychological functioning with limited clinical relevance.

The role of interpersonal influence in families in understanding children's eating behavior: a social relations model analysis.

This study investigates children's eating behavior in a context of bidirectional parent-child influences. Parents and children were asked about their sense of influence and of being influenced concerning food rules. For parents, these feelings seemed to be partly correlated with children's eating behavior. Additionally, Social Relations Model analysis revealed that parents' and children's feelings of influence and being influenced were not only dependent on characteristics of the rater or actor, but also characteristics of the partner and of the unique relationship were found to be important. Furthermore, evidence was found for bidirectional influences, but only for the mother-older sibling dyad.