Parent Attitudes and Perceptions of Internalized Emotional Distress in Children With Developmental Conditions
While past studies have assessed the effect of parental depression on child adjustment problems (Langrock, Compas, Keller, Merchant & Copeland, 2002), the general import of positive parental attitudes about disability on family relationships (Kandel & Merrick, 2007), and the impact of child disability on parent mental health (Reichman, Corman, & Noonan, 2008), there has been little focus on the connection between how parents view their child’s disability and their reports of their child’s own degree of depressive distress. This study addresses the question: Are parental attitudes about their child’s developmental condition associated with parental reports of internalized emotional distress in their children with special health care needs?
Methods:
We used data from the Centers for Disease Control and Prevention’s 2011 Survey of Pathways to Diagnosis and Services for Children with Special Health Care Needs, a nationally representative sample of children with developmental conditions aged 6 to 17 years. The study sample included 2,988 children whose parents responded to a post-core-survey questionnaire. A series of weighted logistic regression analyses were used to model the relationships between parents’ attitudes (i.e., understanding of the condition, feelings about the condition, family burden, and social effects of the condition), and perceptions of the child’s degree of depressive distress.
Results:
We found that parental attitudes about their child’s developmental condition are indeed significantly related to their reports of depressive symptomology in their children, even when controlling for an array of other demographic, diagnosis-related, and condition-related attributes. For example, parents who indicated that their child’s illness is a mystery to them were 66.1% more likely to report depressive distress in their child (p<.01, CI: 1.188-2.323). Those who indicated that their child’s condition causes family burden were 67.9% more likely to report depressive distress in their child (p<.01, CI: 1.163-2.425). Because our analyses further indicated that parents of children diagnosed with Autism Spectrum Disorder were over two times as likely to report depressive distress in their children as were parents of children with other diagnoses and conditions, we also present and discuss results from a subsample of families affected by ASD.
Conclusions and Implications:
Clearly, our findings do not provide answers to the all-important question of what is driving the relationship between parental views of their child’s condition and their reports of their child’s distress. We believe that it is reasonable to assume that some of this relationship is being driven by the child’s distress: that the child’s depressive distress is negatively impacting parents’ understanding of the condition, their feelings about the condition, and their assessment of the degree of family burden. We believe that it is also probable that some of the relationship stems from unmeasured or unobserved factors that are driving both parental attitudes and the child’s distress. A less explored possibility that is rife with practice implications is the idea that parents, often in partnership with their children, are forming narratives about the child’s condition and its impact on parent and child well-being that may be important considerations in developing therapeutic and service-oriented relationships.