Parenting Stress and Sense of Competence as Mediators in the Relationship Between Child Externalizing Behavior Problems and Caregiver Depression

Background and Purpose: Maternal depression has been found to impact children with regard to attachment pattern, internalizing and externalizing behaviors, adjustment, academic functioning, and language development. Researchers have also found a bi-directional, or reciprocal, relationship between parental depression and child externalizing behavior problems. However, the specific factors, or mechanisms, influencing that direction of the relationship between child behavior and parental depression have yet to be determined. This study examines whether parenting stress or parenting self-efficacy mediates the relationship between child externalizing behavior problems and caregiver depressive symptoms among low-income, urban caregivers of children aged 7 to 11 with disruptive behavior disorders.

Methods: This is a cross-sectional study and secondary analysis of baseline data from the Family Groups for Urban Youth with Disruptive Behaviors study, a longitudinal, quasi-experimental study currently underway at Mt. Sinai School of Medicine, Department of Community Psychiatry (supported by Grant Number 5R01 MH072649 from the National Institute of Mental Health; Principal Investigator, Mary M. McKay, Ph.D.). Study participants are caregivers of children, aged 7 to 11, who met diagnostic criteria for Oppositional Defiant Disorder or Conduct Disorder. All data being utilized are from parent-reported measures. Caregivers' depressive symptoms were measured by the Center for Epidemiologic Studies Depression Scale (CES-D), and child externalizing behavior problems by the IOWA Conners Rating Scale. Parents also completed the Parenting Stress Index-Short Form and the Parental Sense of Competence Scale (satisfaction and skills subscales).

Results: The data show that the caregivers are primarily low-income Hispanic and African American single mothers of male children. 83% of caregivers are mothers, and most caregivers (63%) are not married. Only one quarter of caregivers are employed full-time, while 32% are unemployed and 13% are disabled. Over two-thirds of caregivers have an income of less than $19,999, and 43% have an income of less than $9,999; 41% did not complete high school. More than half of caregivers (58%) described themselves as Hispanic/Latino, while 28% described themselves as Black/African American. The majority of the children are male (65%).There were significant bivariate correlations between almost all of the study variables, with caregiver depressive symptoms and parenting stress exhibiting the strongest association. Multiple regression and mediation analyses were undertaken, and the results show that parenting stress and parenting self-efficacy—satisfaction mediate the relationship between child externalizing behavior problems and caregiver depressive symptoms, while parenting self-efficacy—skills does not. In addition, caregiver participants are experiencing higher than average levels of both depressive symptoms and parenting stress.

Conclusions and Implications: Results indicate that practitioners who treat children with disruptive behavior disorders should assess the impact of the behavior on caregivers and provide interventions to address elevated parenting stress and dissatisfaction with the parenting role, in order to treat more comprehensively depressive symptomatology among these caregivers.