Psychological consequences for parents of false negative results on prenatal screening for Down's syndrome: retrospective interview study

ObjectiveTo determine the psychological consequences for parents of children with Down''s syndrome of having received a false negative result on prenatal screening.DesignComparison of adjustment of parents who received a false negative result with that of parents not offered a test and those who declined a test.SettingParents were interviewed in their own homes.ParticipantsParents of 179 children with Down''s syndrome (mean age 4 (range 2-6) years).ResultsOverall, regardless of screening history, parents adjusted well to having a child with Down''s syndrome. Compared with mothers who declined a test, mothers in the false negative group had higher parenting stress (mean score 81.2 v 71.8, P=0.016, 95% confidence interval for the difference 1.8 to 17.0) and more negative attitudes towards their children (124.9 v 134.2, P=0.009, −16.2 to −2.4). Fathers in the false negative group had higher parenting stress test scores (77.8 v 70.0, P=0.046, 1.5 to 14.2) than fathers not offered a test. Mothers in the false negative group were more likely to blame others for the outcome than mothers who had not been offered the test (28% v 13%, P=0.032, 3% to 27%). Mothers and fathers in the false negative group were more likely to blame others for this outcome than parents who had declined a test (mothers 28% v 0%, P=0.001, 19% to 37%; fathers 27% v 0%, P=0.004, 17% to 38%). Blaming others was associated with poorer adjustment for mothers and fathers.ConclusionsA false negative result on prenatal screening seems to have a small adverse effect on parental adjustment evident two to six years after the birth of an affected child.     

Intelligence and family size: A paradox resolved

Abstract

IQ data was studied for over a thousand families for both parents and offspring, and also for the non‐reproducing siblings of parents. The inclusion of these siblings allowed the authors to resolve the paradox presented by the failure of the general intelligence level to decline in accord with the large negative correlation (‐0.30) between intelligence and number of children in the family. When the non‐reproducing siblings of the parents are included, the negative correlation disappears. The higher reproductive rate of individuals in the lower IQ groups who are parents is offset by the larger proportion of their siblings who never marry or who fail to reproduce when married. Thus, the IQ level of the whole population should remain relatively static from one generation to the next, or at least not drop rapidly.     

Email submissions from outside the United Kingdom

ObjectivesTo identify whether psychiatric disturbance in parentally bereaved children and surviving parents is related to service provision.DesignProspective case-control study.SettingTwo adjacent outer London health authorities. Participants45 bereaved families with children aged 2 to 16 years.ResultsParentally bereaved children and surviving parents showed higher than expected levels of psychiatric difficulties. Boys were more affected than girls, and bereaved mothers had more mental health difficulties than bereaved fathers. Levels of psychiatric disturbance in children were higher when parents showed probable psychiatric disorder. Service provision related to the age of the children and the manner of parental death. Children under 5 years of age were less likely to be offered services than older children even though their parents desired it. Children were significantly more likely to be offered services when the parent had committed suicide or when the death was expected. Children least likely to receive service support were those who were not in touch with services before parental death.ConclusionsService provision was not significantly related to parental wishes or to level of psychiatric disturbance in parents or children. There is a role for general practitioners and primary care workers in identifying psychologically distressed surviving parents whose children may be psychiatrically disturbed, and referring them to appropriate services.

Key messages

• Parentally bereaved children show high levels of psychological disturbance, with boys being more vulnerable than girls
• Surviving mothers show more psychiatric morbidity than surviving fathers
• Psychological distress in bereaved parents is associated with psychological difficulties in their children
• Service provision for bereaved children is not determined by mental health difficulties in either parents or children, or by parental wishes; it is influenced only by the manner of parental death and the age of the child
• The mismatch between need and service provision indicates a role for general practitioners and primary care workers in identifying distressed or disturbed families in need of public or voluntary service help

     

Death of an offspring and parental risk of ischemic heart diseases: A population-based cohort study

BackgroundThe death of a child is an extreme life event with potentially long-term health consequences. Knowledge about its association with ischemic heart diseases (IHDs) and acute myocardial infarction (AMI), however, is very limited. We investigated whether the death of an offspring is associated with the risk of IHD and AMI.Methods and findingsWe studied parents of live-born children recorded in the Danish (1973 to 2016) and the Swedish (1973 to 2014) Medical Birth Registers (n = 6,711,952; mean age at baseline 31 years, 53% women). We retrieved information on exposure, outcomes, and covariates by linking individual-level information from several nationwide registers. We analyzed the abovementioned associations using Poisson regression. A total of 126,522 (1.9%) parents lost at least 1 child during the study period. Bereaved parents had a higher risk of IHD and AMI than the nonbereaved [incidence rate ratios (IRRs) (95% confidence intervals (CIs)): 1.20 (1.18 to 1.23), P < 0.001 and 1.21 (1.17 to 1.25), P < 0.001, respectively]. The association was present not only in case of losses due to CVD or other natural causes, but also in case of unnatural deaths. The AMI risk was highest in the first week after the loss [IRR (95% CI): 3.67 (2.08 to 6.46), P < 0.001], but a 20% to 40% increased risk was observed throughout the whole follow-up period. Study limitations include the possibility of residual confounding by socioeconomic, lifestyle, or health-related factors and the potentially limited generalizability of our findings outside Scandinavia.ConclusionsThe death of an offspring was associated with an increased risk of IHD and AMI. The finding that the association was present also in case of losses due to unnatural causes, which are less likely to be confounded by cardiovascular risk factors clustering in families, suggests that stress-related mechanisms may also contribute to the observed associations.

Dang Wei and co-workers study associations between offspring death and parental risk of adverse cardiac outcomes.     

Association of dietary risks,behavioural and lifestyle factors,and the magnitude of disability burden among Australian cancer patients: An observational epidemiology study

BackgroundCancer patients are confronted with a variety of other health-related issues, including physical disability, poor quality of life, and psychological challenges. This study aims to quantify the association of dietary, behavioural and lifestyle risk factors and comorbidities on the magnitude and distribution of disability burden among cancer patients in Australia.MethodsThis study comprised a sample of 2283 cancer patients drawn from the latest nationwide Australian National Health Survey conducted in 2017–18. Negative binomial regression models were used to estimate the incidence rate ratio (IRR) of the number of disabilities and its associations.ResultsForty-five percent of cancer patients experienced at least one disability. The magnitude of disability was significantly associated with sugar-sweetened drink consumption ≥ 3 days per week (IRR= 1.12, 95% CI: 1.02–1.26), a lack of physical activity (IRR = 1.69, 1.38–2.07), frequent or regular alcohol consumption (IRR = 1.95, 1.84–2.08), poor health status (IRR = 1.99, 1.78–2.24) and the presence of five or more chronic comorbid conditions (IRR = 3.59, 2.90–4.46). Cancer patients who consumed vegetables at least two or more times per day had a 10% lower risk of disability burden (IRR = 0.90, 0.82–0.99).ConclusionsThis study shows the association of diet, behavioural, and lifestyle risk factors on the degree of disability burden among cancer patients, highlighting the need for bold and effective policies. The findings will inform the implementation of evidence-based lifestyle interventions and offer a foundation for evaluating their influence on cancer survivors’ health.     

Relating Specific Emotions to Intrinsic Motivation: On the Moderating Role of Positive and Negative Emotion Differentiation

Despite the fact that studies on self-determination theory have traditionally disregarded the explicit role of emotions in the motivation eliciting process, research attention for the affective antecedents of motivation is growing. We add to this emerging research field by testing the moderating role of emotion differentiation –individual differences in the extent to which people can differentiate between specific emotions– on the relationship between twelve specific emotions and intrinsic motivation. To this end, we conducted a daily diary study (N = 72) and an experience sampling study (N = 34). Results showed that the relationship between enthusiasm, cheerfulness, optimism, contentedness, gloominess, miserableness, uneasiness (in both studies 1 and 2), calmness, relaxation, tenseness, depression, worry (only in Study 1) on one hand and intrinsic motivation on the other hand was moderated by positive emotion differentiation for the positive emotions and by negative emotion differentiation for the negative emotions. Altogether, these findings suggest that for people who are unable to distinguish between different specific positive emotions the relationship between those specific positive emotions and intrinsic motivation is stronger, whereas the relationship between specific negative emotions and intrinsic motivation is weaker for people who are able to distinguish between the different specific negative emotions. Theoretical and practical implications are discussed.     

Genetic and Familial Environmental Effects on Suicide – An Adoption Study of Siblings

Background

While there is clear evidence of familial influences on suicide, the origin of these is less certain. We have investigated genetic and familial environmental factors by studying the occurrence of suicide in biological and adoptive siblings of adoptees who died by suicide compared to siblings of surviving adoptees.

Method

We used the Danish Adoption Register and Danish population registers to compare 221 siblings of adoptees who died by suicide with the siblings of 1,903 adoptees who did not die by suicide. All adoptions in the Danish Adoption Register are non-familial, i.e. the adoptive parents are biologically unrelated to the adoptee. Analyses were conducted on incidence rates of suicide in biological and adoptive siblings given occurrence of suicide in the adoptees while also taking into account psychiatric disorders.

Results

The risk of suicide in full siblings of adoptees who died by suicide before age 60 years was significantly higher than in full siblings of adoptees who had not died by suicide (incidence rate ratios (IRR) = 5.01; 95% confidence interval [CI] = 1.28 - 19.6). This increase persisted after adjustment for history of psychiatric admission of siblings (IRR = 4.19; 95% CI = 1.00 - 17.5).

Conclusions

Genetic factors influence risk of suicide, probably independently of psychiatric disorder. This is relevant in provision of advice to families, including possible prevention of suicide.     

My Child Redeems My Broken Dreams: On Parents Transferring Their Unfulfilled Ambitions onto Their Child

From the early days of psychology, theorists have observed that parents sometimes transfer their own unfulfilled ambitions onto their child. We propose that parents are especially inclined to do so when they see their child as part of themselves, more so than as a separate individual. When parents see their child as part of themselves, their child’s achievements may easily come to function as a surrogate for parents’ own unfulfilled ambitions. In the present experiment, 73 parents (89% women, M _age = 43 years) were randomly assigned to reflect on either their own or others’ unfulfilled ambitions. Results showed that, when faced with their own unfulfilled ambitions, parents who see their child as part of themselves want their child to fulfill their unfulfilled ambitions. This study provides the first experimental evidence to suggest that parents may desire their child to redeem their broken dreams.     

Factors influencing genetic counseling attendance rate: A geographically based study

Abstract

A study of factors influencing genetic counseling attendance rate has been conducted in the Bouches‐du‐Rhône area, in the south of France. In this area, a birth defects monitoring system (Eurocat n°22) annually covers 23,000 births. All the genetic services are delivered by only one genetic center located in Marseilles, and the data collected are computerized. The comparison of these two data bases gives an opportunity to estimate the rate of genetic counseling attendance after the occurrence of an affected stillbirth or live birth. Among the parents of 358 infants born in 1983–84 in this area with a pathology requiring genetic counseling, 226 (63 per cent) attended the Genetic Center within the first year after birth. The rate of attendance is statistically higher (p < 0.01) for the parents who had a stillbirth (78 per cent) than for those who had a live birth (57 per cent). It is also higher (p < 0.01) for the Marseilles maternities group (68 per cent) than for the group outside Marseilles (50 per cent). The referral delays are also analyzed according to malformation etiology and to viability of the child by the eighth day of lue. Besides evaluating a particular genetic center's effectiveness in diffusing information to the public concerned, this work shows that couples’ request is strongly dependent on a psychological need.     

DXA measurements confirm that parental perceptions of elevated adiposity in young children are poor

Objective: To compare parental assessments of child body weight status with BMI measurements and determine whether children who are incorrectly classified differ in body composition from those whose parents correctly rate child weight. Also to ascertain whether children of obese parents differ from those of non‐obese parents in actual or perceived body weight. Research Methods and Procedures: Weights, heights, BMI, and waist girths of New Zealand children ages 3 to 8 years were determined. Fat mass, fat percentage, and lean mass were measured by DXA (n = 96). Parents classified child weight status as underweight, normal‐weight, slightly overweight, or overweight. Centers for Disease Control and Prevention 2000 percentiles of BMI were used. Results: Parents underestimated child weight status. Despite having 83% more fat mass than children with BMI values below the 85th percentile, only 7 of 31 children with BMI values at or above the 85th percentile were rated as slightly overweight or overweight. In the whole sample, participants whose weight status was underestimated by parents (40 of the 96 children) had l9% less fat mass but similar lean mass as children whose weight status was correctly classified. However, children of obese and non‐obese parents did not differ in body composition or anthropometry, and obese parents did not underestimate child weight more than non‐obese parents. Discussion: Because parents underestimate child weight, but BMI values at or above the 85th percentile identify high body fat well, advising parents of the BMI status of their children should improve strategies to prevent excessive fat gain in young children.     

Differential parental investment in families with both adopted and genetic children

Stepchildren are abused, neglected and murdered at higher rates than those who live with two genetically related parents. Daly and Wilson used kin selection theory to explain this finding and labeled the phenomenon “discriminative parental solicitude.” I examined discriminative parental solicitude in American households composed of both genetic and unrelated adopted children. In these families, kin selection predicts parents should favor their genetic children over adoptees. Rather than looking at cases of abuse, neglect, homicide and other antisocial behavior, I focused on the positive investments parents made in their children as well as the outcomes of each child. The results show that parents invested more in adopted children than in genetically related ones, especially in educational and personal areas. At the same time, adoptees experienced more negative outcomes. They were more likely to have been arrested, to have been on public assistance and to require treatment for drug, alcohol or mental health issues. They also completed fewer years of schooling and were more likely to divorce. In adoptive families, it appears that “the squeaky wheel gets the grease.” Parents invest more in adoptees not because they favor them, but because they are more likely than genetic children to need the help. I conclude that discriminative parental solicitude differs in adoptive and step households because adoptive families generally result from prolonged parenting effort, not mating effort like stepfamilies.     

Measuring later health status of high risk infants: randomised comparison of two simple methods of data collection

ObjectiveTo test two methods of providing low cost information on the later health status of survivors of neonatal intensive care.DesignCluster randomised comparison.SettingNine hospitals distributed across two UK health regions. Each hospital was randomised to use one of two methods of follow up.ParticipantsAll infants born ⩽32 weeks'' gestation during 1997 in the study hospitals.MethodFamilies were recruited at the time of discharge. In one method of follow up families were asked to complete a questionnaire about their child''s health at the age of 2 years (corrected for gestation). In the other method the children''s progress was followed by clerks in the local community child health department by using sources of routine information.Results236 infants were recruited to each method of follow up. Questionnaires were returned by 214 parents (91%; 95% confidence interval 84% to 97%) and 223 clerks (95%; 86% to 100%). Completed questionnaires were returned by 201 parents (85%; 76% to 94%) and 158 clerks (67%; 43% to 91%). Most parents found the forms easy to complete, but some had trouble understanding the concept of “corrected age” and hence when to return the form. Community clerks often had to rely on information that was out of date and difficult to interpret.ConclusionNeither questionnaires from parents nor routinely collected health data are adequate methods of providing complete follow up data on children who were born preterm and required neonatal intensive care, though both methods show potential.

What is already known on this topic

Outcome of neonatal intensive care should include later health status not just early mortalityAlthough these data are commonly sought, for various reasons no existing routine system currently delivers the information for ⩾95% of the population (95% representing the minimum acceptable standard)Running one-off studies to gain later follow up data is difficult and costly

What this study adds

Potentially these data could come from parents but to reach 95% ascertainment perhaps 5-10% of parents would require help and support to provide informationExisting data flows may be able to provide the required information if the timing of routine reviews and methods of data recording were harmonised across the United KingdomThe costs attached to introducing such a system seem to be low     

Parental Feeding Style and the Inter‐generational Transmission of Obesity Risk

Objective: This study was designed to determine whether a community sample of obese mothers with young children used different feeding styles compared with a matched sample of normal‐weight mothers. Four aspects of feeding style were assessed: emotional feeding, instrumental feeding (using food as a reward), prompting/encouragement to eat, and control over eating. Research Methods and Procedures: Participants were from 214 families with same‐sex twins; 100 families in which both parents were overweight or obese and 114 in which both parents were normal weight or lean. Results: We found that obese mothers were no more likely than normal‐weight mothers to offer food to deal with emotional distress, use food as a form of reward, or encourage the child to eat more than was wanted. The obese and normal‐weight mothers did differ on “control”; obese mothers reported significantly less control over their children's intake, and this was seen for both first‐born and second‐born twins. Twin analyses showed that these differences were not in response to children's genetic propensities, because monozygotic correlations were no greater than dizygotic correlations for maternal feeding style. Discussion: These results suggest that the stereotype of the obese mother, who uses food in nonnutritive ways so that her child also becomes obese, is more likely to be myth than fact. However, the results raise the possibility that lack of control of food intake might contribute to the emergence of differences in weight.     

Puerperal morbidity: A neglected area of maternal health in Sri Lanka

Abstract

Data on women with at least two children are used to examine how the breastfeeding experience with the first child affects whether subsequent children are breastfed. Our results indicate that women most often repeat with later children the feeding decision they made with their first child. That is, those who breastfed their first child are very likely to breastfeed a later child and those who did not breastfeed their firstborn are unlikely to breastfeed a later‐bom. Among those who did not breastfeed their first child, education beyond high school increases the likelihood that they will switch to breastfeeding with a later‐born. Those who breastfed their first child are less likely to breastfeed a later‐born if the first breastfeeding experience was of short duration or was perceived to be unsuccessful or unsatisfactory or if the woman had not gone beyond high school or received anesthesia at the later birth. Hence, educational differences are greater at higher parities than at first parity.     

Acknowledging Animals: A Memorial Service for Teaching and Research Animals

Abstract

A campus-wide memorial service was held to acknowledge the contribution of animals to excellence in research and teaching at the University of Guelph. The conception, rationale behind, and execution of this project are described, including the actual text of the service, as a model for other animal-using institutions. Such rituals can play an important role in reflecting and encouraging an attitude of respect for the animals. There is a tendency for employees of animal-using facilities to develop mechanical or compartmentalized attitudes toward their work. Rituals of acknowledgment, such as the one described here, promote active awareness as well as discussion of the issues and emotions raised by animal use. We believe this can only result in improved animal care.     

A period analysis of parity distribution among white and nonwhite women in the United States, 1940–1974

Abstract

The historical trends of childlessness and of one‐child, two‐child, and three‐or‐more‐child families among white and nonwhite women in the United States are studied in terms of period fertility tables. Given the age and parity of a woman, we can read from the fertility tables how her parity is expected to change at successive ages during the rest of her childbearing period, if she is subjected to the age‐parity‐specific fertility rates for a particular year. The fertility tables for white and nonwhite women are constructed for the years 1940, 19S0, 1960, 1970, and 1974. These tables show that among white women who have completed their childbearing (with period rates), the percentage with more than two children has decreased from 66 in 1960 to 27 in 1974, whereas the corresponding reduction among nonwhite women is from 67 to 48 per cent (Table 1, Case 1).     

Away-from-home food intake and risk for obesity: examining the influence of context

Objective: This study examined sociodemographic and cultural determinants of away‐from‐home food consumption in two contexts and the influence of frequency of away‐from‐home food consumption on children's dietary intake and parent and child weight status. Methods and Procedures: Parents of children (N = 708) in grades K‐2 were recruited from 13 elementary schools in Southern California. Parents were asked through a questionnaire the frequency with which they eat meals away from home and the restaurant they frequented most often. The height and weight of the parents and their children were measured to calculate BMI. Results: Consuming foods at least once a week from relatives/neighbors/friends (RNF) homes was associated with children's dietary intake and children's risk for obesity. For example, children of parents with weekly or greater RNF food consumption drank more sugar‐sweetened beverages. Parents of families who ate at restaurants at least weekly reported that their children consumed more sugar‐sweetened beverages, more sweet/savory snacks, and less water compared with families who did not frequent restaurants this often. The type of restaurant visited did not affect diet intake or obesity. More acculturated families exhibited less healthy dietary behaviors than less acculturated families. Discussion: Restaurants remain an important setting for preventing child and adult obesity, but other settings outside the home need to be considered in future intervention research. This may especially involve eating in the homes of RNF.     

A Pet for the Children: Factors Related to Family Pet Ownership

ABSTRACT

The demographic variables related to pet ownership in New Zealand families of 8–12 -year-olds were investigated. Questionnaire surveys were used to establish data from 312 families of primary school children. Family composition, reasons for pet acquisition, and the advantages and disadvantages of pets were also examined. Almost 90% of families owned at least one pet, and over half of these families included a child who was the sole owner of a pet. Parental employment level, living locality, and sibling status (number and position) were related to pet ownership. Parents acquired pets for their children mainly to teach responsibility and care, or because their child had asked for the pet, and these reasons were related to sibling status. Perceived advantages of pet ownership included teaching responsibility and care, love, respect and affection, and companionship. Over half the sample claimed no disadvantages of pet ownership. The most common disadvantages were finding holiday care, the time and work involved in pet care, and the mess caused by animals. Implications for future research include the distinction between child-owned and family-owned pets, the reasons for acquiring pets and their effect on the relationship with the pet, and comparisons of parent and child beliefs about the role of the family pet.     

Association between Spouse/Child Separation and Migration-Related Stress among a Random Sample of Rural-to-Urban Migrants in Wuhan,China

BackgroundMillions of people move from rural areas to urban areas in China to pursue new opportunities while leaving their spouses and children at rural homes. Little is known about the impact of migration-related separation on mental health of these rural migrants in urban China.MethodsSurvey data from a random sample of rural-to-urban migrants (n = 1113, aged 18–45) from Wuhan were analyzed. The Domestic Migration Stress Questionnaire (DMSQ), an instrument with four subconstructs, was used to measure migration-related stress. The relationship between spouse/child separation and stress was assessed using survey estimation methods to account for the multi-level sampling design.Results16.46% of couples were separated from their spouses (spouse-separation only), 25.81% of parents were separated from their children (child separation only). Among the participants who married and had children, 5.97% were separated from both their spouses and children (double separation). Spouse-separation only and double separation did not scored significantly higher on DMSQ than those with no separation. Compared to parents without child separation, parents with child separation scored significantly higher on DMSQ (mean score = 2.88, 95% CI: [2.81, 2.95] vs. 2.60 [2.53, 2.67], p < .05). Stratified analysis by separation type and by gender indicated that the association was stronger for child-separation only and for female participants.ConclusionChild-separation is an important source of migration-related stress, and the effect is particularly strong for migrant women. Public policies and intervention programs should consider these factors to encourage and facilitate the co-migration of parents with their children to mitigate migration-related stress.     

Family planning among Japanese on public relief

Abstract

Two recurrent concepts in fertility literature permit prediction of an inverse relationship between social class and fertility. The commitment to familism refers to the degree that couples embrace a family‐centered style of life over a consumerist or careerist style of life. Commitment to individual children refers to the emotional and material involvement of parents in each child they have. Data show that commitment to individual children is negatively related to fertility, that social class is negatively related to commitment to familism, that social class is positively related to commitment to individual children, and that commitment to familism and commitment to individual children account for relationships between class and fertility.