Query: parental stress child wellbeing systematic review

title: Parental stress and adjustment in the context of rare genetic syndromes: A scoping review.
abstract: Chromosomal abnormalities are now considered a common cause of intellectual disability. With increased genetic testing, phenotyping and technological advancements, many new syndromes have been identified. This review sought to explore parental stress and adjustment in the context of rare genetic syndromes to evaluate their clinical impact. A systematic review of English peer reviewed literature across three databases (PsycINFO, Medline, CINAHL) was completed and 69 articles were included. Parents of children with rare genetic syndromes experienced greater distress relative to other disabilities. Differences in parental wellbeing were syndrome specific relative to ASD thus demonstrating the need to consider the contribution of syndrome specific phenotypes. Child emotional and behavioural difficulties were the most consistent predictor of parental distress. Research reflecting other factors such as physical health, syndrome specific behaviours, benefit finding and, parental appraisal in the context of a rare genetic aetiology is required in order to support parental adjustment in these conditions.

title: Mindfulness, Stress and Well Being in Parents of Children with Autism Spectrum Disorder: A Systematic Review
abstract: Parenting a child with Autism Spectrum Disorder (ASD) is often associated with reduced quality of life, high stress, depression and anxiety due to the ongoing nature of care. This review systematically investigated the efficacy of mindfulness interventions in reducing stress and increasing psychological wellbeing in parents of children with ASD. A comprehensive electronic database search was conducted for relevant articles. Only studies investigating parental stress or a measure of psychological wellbeing in parents of children with ASD post a mindfulness based intervention were included. Ten studies met inclusion criteria; each was examined for treatment fidelity. All included studies contributed at least one self report finding supporting the efficacy of mindfulness interventions in reducing stress and increasing psychological wellbeing. Three studies included physiological measures of reduced stress and emotional responses. Two reported concomitant improvements in child behavior. Mindfulness based interventions potentially have long term positive effects on stress levels and psychological wellbeing of parents of children with ASD, in addition to enhancing their child's behavior. Future research is needed to develop a cost and time effective intervention aimed at maximising efficacy of current interventions in children with ASD and their parents.

title: Parents of Children with Autism Spectrum Disorder: a systematic review
abstract: Having a child with Autism Spectrum Disorder can affect family wellbeing and caregiver's parenting skills. The present review aims to explore the main difficulties reported by parents of children with autism and the most used interventions to provide them support to date.  26 research articles published from 2006 to 2019 were selected and compared, specifically 10 quantitative and 16 qualitative studies, in which the following topics were discussed: parental stress in the presence of autism, presence of guidelines for intervention and relative difficulties to the achievement of the diagnosis.  The results of the review analysis indicate that parental stress is one of the difficulties in assuming a primary role. Parents caring for a child with Autism Spectrum Disorder have been shown to experience significantly higher levels of stress than parents of typically developing children.  The presence of guidelines and the difficulties in achieving a diagnosis are closely related to the issue of parental stress, increasing or decreasing the perceived stress of parents.

title: The efficacy of mindful parenting interventions: A systematic review and meta analysis.
abstract: Mindful parenting is the process of bringing awareness and attention intentionally in a non reactive and non judgemental way to a child at any present moment. Parenting mindfulness is believed to influence parenting factors and parental psychological outcomes, child's emotional and behavioural outcomes, and family relationships. However, the efficacy of such interventions on interpersonal mindfulness in parenting and parenting behaviours has received minimal empirical attention.  This meta analysis aims to quantitatively evaluate the efficacy of mindful parenting interventions on parenting mindfulness and parenting behaviours. Parenting stress, parents' psychological wellbeing, interpersonal relationships, and child behavioural outcomes were examined secondarily. When meta analysis was not possible (due to insufficient data in the included studies) the narrative approach was taken to present the findings.  A systematic review, meta analysis, and narrative summary.  Six electronic databases (PubMed, Embase, PsycINFO, CINAHL, Scopus, and ProQuest Dissertations and Theses) were systematically searched for articles in the English language from their respective dates of inception to December 2020. Studies involving clinical and non clinical samples of parents with children or youths aged 24 years and below were included. Only randomised controlled trials were included. Studies were excluded if the mindfulness intervention did not focus on parenting skills training; that is, it focused on childbirth, stress reduction or incorporated other forms of therapy (e.g. cognitive behavioural therapy) Data was synthesised using a random effects model in RevMan 5.4. The outcomes of primary interest were parenting mindfulness and parenting behaviours. The secondary outcomes were parenting stress, parents' psychological wellbeing, interpersonal relationships, and child behavioural outcomes.  Eleven studies representing 1,340 parents from six countries were included in the review. No evidence of intervention effect was found for overall parenting mindfulness and overall parenting stress. However, mindful parenting interventions demonstrated a moderate effect size when examining parenting mindfulness scores (standardised mean differences (d)=0.62, 95% CI: 0.11, 1.13, p 0.02) of parents with non clinical samples of children. No intervention effect was found for overall parenting stress. Due to insufficient studies and data, findings on parenting behaviours, psychological wellbeing, relationships, and child behaviour were presented narratively.  Mindful parenting interventions are associated with higher parenting mindfulness scores for parents of typically developing children when compared with a control group. The limited studies and mixed results on positive parenting behaviours, parental psychological wellbeing, parental relationship with child and partner, and child behavioural outcomes serve as an impetus for further research.

title: The impact of parental accompaniment in paediatric trauma: a helicopter emergency medical service (HEMS) perspective
abstract: Major trauma remains a significant cause of mortality and morbidity in young people and adolescents throughout the western world. Both the physical and psychological consequences of trauma are well documented and it is shown that peri traumatic factors play a large part in the emotional recovery of children involved in trauma. Indeed, parental anxiety levels may play one of the biggest roles. There are no publically available guidelines on pre hospital accompaniment, and where research has been done on parental presence it often focuses primarily on the parents or staff, rather than the child themselves. Whilst acknowledging the impact on parents and staff, the importance of the emotional wellbeing of the child should be reinforced, to reduce the likelihood of developing symptoms in keeping with post traumatic stress disorder. This non systematic literature review, aims to examine the impact of parental accompaniment to hospital, following paediatric trauma, and to help pre hospital clinicians decide whether accompaniment would be of benefit to their patient population. The lack of published data does not enable a formal recommendation of parental accompaniment in the helicopter to be mandated, though it should be the preference in land based conveyance. Future research is needed into the emotional recovery of children after trauma, as well as the experiences of patient, parent and staff during conveyance.

title: 44 Session 12 30 1 00 Format Broadcast Room KG
abstract: 1 Session: 11:30 12:00 Format: Broadcast Room: KG23 Mindfulness, stress, and wellbeing in parents of children with autism spectrum disorder: a systematic review Renee Lee CACHIA, Angelika ANDERSON, Dennis MOORE Monash University, Clayton, Australia Abstract Parenting a child with Autism Spectrum Disorder (ASD) is often associated with reduced quality of life, high stress, depression and anxiety due to the ongoing nature of care. Parent stress can reduce the effectiveness of early teaching interventions and restrict the implementation of behavioural strategies, further limiting optimal developmental outcomes in children with ASD. This review systematically investigated the efficacy of mindfulness interventions in reducing stress and increasing psychological wellbeing in parents of children with ASD. A comprehensive electronic database search was conducted for relevant articles in which only studies investigating parental stress or a measure of psychological wellbeing in parents of children with ASD post a mindfulness based intervention were included. Ten studies met inclusion criteria; each was examined for treatment fidelity. The current presentation will explore all included studies, to which each study contributed at least one self report finding supporting the efficacy of mindfulness interventions in reducing stress and increasing psychological wellbeing. Among these, three studies included physiological measures of reduced stress and emotional responses while two reported concomitant improvements in child behaviour. This study suggests that mindfulness based interventions potentially have long term positive effects on stress levels and psychological wellbeing of parents of children with ASD, in addition to significantly enhancing their child's behaviour. Future research is needed to develop a cost and time effective intervention aimed at maximising efficacy of current interventions in children with ASD and their parents.

title: Different types of parental stress and childhood obesity: A systematic review of observational studies
abstract: Different types of parental stress may influence children's health behaviors and weight. The aim of this review was to systematically examine the relationships between parental stress and child obesity. We reviewed 27 studies published through December 2018 and classified parental stress as parents' general stress, parenting role stress, and life event stress. There were positive relationships of parents' general stress and parenting role stress with child obesity among families with younger children and in longitudinal studies. The relationship between life event stress and child obesity differed by measures. We found that parenting role stress may be associated with unhealthy parenting practices. Contextual factors such as children's and parents' sex, race or ethnicity, socioeconomic status, and family structure appeared to play a moderating role in the relationship between parents' stress and child obesity, which warrant cautious interpretation. Our recommendations for future research include clarifying further the types of parental stress that influence child obesity, evaluating long term relationship between parental stress and child obesity, and identifying possible mediating factors to support the relationship between parents' stress and child obesity. Researchers may also consider developing stress management programs for parents to address child obesity.

title: Child and Family Outcomes Following Pandemics: A Systematic Review and Recommendations on COVID 19 Policies
abstract: A systematic review of mental health outcomes and needs of children and families during past pandemics was conducted based on the PRISMA protocol. The objectives were to evaluate the quality of existing studies on this topic, determine what is known about mental health outcomes and needs of children and families, and provide recommendations for how COVID 19 policies can best support children and families.  Seventeen studies were identified through a search of PsycINFO, PubMed, Scopus, Web of Science, and Google Scholar.  Studies examining child outcomes indicate that social isolation and quarantining practices exert a substantial negative impact on child anxiety, post traumatic stress disorder, and fear symptoms. Potential risk factors such as living in rural areas, being female, and increasing grade level may exacerbate negative mental health outcomes for children. Studies examining parental and family outcomes indicate that parents experience high stress, anxiety, and financial burden during pandemics. The age of the parent and family socioeconomic status (SES) appeared to mitigate negative outcomes, where older parents and higher SES families had lower rates of mental health problems. Parents' fear over the physical and mental health of their children, concerns over potential job loss and arranging childcare contributes to elevated stress and poorer well being.  Findings from this review suggest current gaps in COVID 19 policies and provide recommendations such implementing "family friendly" policies that are inclusive and have flexible eligibility criteria. Examples include universal paid sick leave for parents and financial supports for parents who are also frontline workers and are at an elevated risk for contracting the disease.

title: Effects of parental mental illness on children's physical health: systematic review and meta analysis
abstract: Children of parents with mental disorder face multiple challenges.  To summarise evidence about parental mental disorder and child physical health.  We searched seven databases for cohort or case control studies quantifying associations between parental mental disorders (substance use, psychotic, mood, anxiety, obsessive compulsive, post traumatic stress and eating) and offspring physical health. Studies were excluded if: they reported perinatal outcomes only <28 days) or outcomes after age 18; they measured outcome prior to exposure; or the sample was drawn from diseased children. A meta analysis was conducted.  Searches revealed 15 945 non duplicated studies. Forty one studies met our inclusion criteria: ten investigated accidents/injuries; eight asthma; three other atopic diseases; ten overweight/obesity; ten studied other illnesses (eight from low and middle income countries (LMICs) Half of the studies investigated maternal perinatal mental health, 17% investigated paternal mental disorder and 87% examined maternal depression. Meta analysis revealed significantly higher rates of injuries (OR 1.15, 95% CI 1.04 1.26) asthma (OR 1.26, 95% CI 1.12 1.41) and outcomes recorded in LMICs (malnutrition: OR 2.55, 95% CI 1.74 3.73; diarrhoea: OR 2.16, 95% CI 1.65 2.84) Evidence was inconclusive for obesity and other atopic disorders.  Children of parents with mental disorder have health disadvantages; however, the evidence base is limited to risks for offspring following postnatal depression in mothers and there is little focus on fathers in the literature. Understanding the physical health risks of these vulnerable children is vital to improving lives. Future work should focus on discovering mechanisms linking physical and mental health across generations.

title: The impact of parental posttraumatic stress disorder on parenting: a systematic review
abstract: Posttraumatic stress disorder (PTSD) is a serious and debilitating disorder that can develop following exposure to a traumatic event. Where parents develop PTSD, it may have an impact on their parenting role.  The objective was to review the existing evidence base on parental PTSD, examining whether parental PTSD has an impact on key parenting domains.  A comprehensive web based search identified 27 quantitative studies that examined parental PTSD in relation to parenting domains.  Several parenting domains were investigated including: parenting satisfaction, parenting stress, the parent child relationship, and specific parenting practices. Sample sizes ranged from 19 to 3931 parents. A range of parental traumas were investigated, including traumatic birth experiences, military trauma, and intimate partner violence. Findings indicated associations between parental PTSD and several domains of parenting, but there were inconsistencies across studies.  Findings suggested that parental PTSD is associated with impaired functioning across a number of parenting domains, including increased levels of parenting stress, lower parenting satisfaction, less optimal parent child relationships, and more frequent use of negative parenting practices, such as overt hostility and controlling behaviours. However, methodological limitations across the literature as a whole limited the potential to infer causal impacts of PTSD on parenting. Further study is also needed to advance our current understanding around the impact of different trauma types on parenting domains.  The review brought together existing evidence in the parental PTSD literature, to further understand how parental PTSD impacts parenting domains. A total of 27 articles were reviewed, examining several parenting domains including: parenting satisfaction, parenting stress, the parent child relationship, and specific parenting practices. Parents with PTSD may experience more impaired functioning in these specific domains compared to parents without PTSD. Methodological limitations across the literature limit potential inference from the current findings; therefore further study is still needed.