Attachment style in parents of children with chronic gastrointestinal disease

Attachment is a point of interest in psychosomatic research since it influences a wide array of biopsychosocial phenomena. Data from literature highlights the role of this concept in the context of Inflammatory Bowel disease (IBD), still, there is a lack of data regarding attachment among parents of children with chronic gastrointestinal diseases. The main hypothesis for the current study is that parents of children with IBD will have a more insecure attachment than parents of children with celiac disease (CD) and parents of healthy children. The second hypothesis is that insecure attachment among parents of sick children will be associated with lower parental quality of life (QoL). 46 parents of children with IBD, 42 parents of children with CD and 43 parents of healthy children completed the validated modification of the Brennan's Experiences in Close Relationship Inventory. Results were categorized as secure and insecure attachment. In order to assess parental QoL, the WHOQOL-BREF questionnaire was used. The Total QoL was calculated as a sum of all domain items. Secure attachment was found in 45.7% parents of children with IBD, in 35.7% parents of children with CD and in 32.6% parents of healthy children. Surprisingly, the lowest rate of secure attachment was found in parents of healthy children. However, significant differences among groups do not exist. For all groups of parents the attachment style is associated with Total QoL, although only among parents of children with IBD, the secure attachment independently and significantly predicts higher parental Total QoL. According to results, we might say that parental attachment style does not have a role that exclusively belongs in the context of paediatric chronic gastrointestinal diseases. However, parents of children with IBD who have insecure attachment represent target group for psychosocial support in order to improve their QoL.     

Transnational families and the subjective well-being of migrant parents: Angolan and Nigerian parents in the Netherlands

Studies on transnational families argue that the subjective well-being of migrant parents is negatively affected by living separated from their children. Most studies employ qualitative methods without a control group and hence are not able to distinguish whether the effects found are associated with separation only or with other factors. This paper investigates the association between parental subjective well-being and parent–child separation by comparing migrant parents who have at least one child in their country of origin with those who live with all their children in the Netherlands. The paper further investigates whether the same associations are found between migrant groups from Angola and Nigeria. Results indicate that transnational parents indeed report lower subjective well-being, as measured by happiness, life satisfaction and mental health for both groups and additionally, self-assessed health for Angolans. However, legal status, socio-economic status and the quality of the parent–child relationship are found to be important mediators.     

Parental quality of life in the framework of paediatric chronic gastrointestinal disease

Chronic gastrointestinal diseases, such as inflammatory bowel disease (IBD) and celiac disease (CD), might have impact not only on the affected child but also on their parents since inside the family framework, a change in each member may have influence on the whole system. The aim of this study was to test the hypothesis that parents whose children have IBD or CD will have a lower quality of life (QoL) compared to parents of healthy children, as well as that lower QoL will be found among parents who perceive lower health related quality of life (HRQOL) of their child. 55 parents of children with IBD, 49 of CD and 53 parents of healthy children were included in the study. Children were aged 7-18 years. In order to measure parental QoL, a Croatian version of the WHOQOL-BREF questionnaire was administered, with four domains: physical health, psychological health, social relationship and environment. The Total QoL was calculated as a sum of all domain items. The parent-proxy report of children's HRQOL, PedsQL 4.0 Generic Core Scales was used. Main result shows that parents of children with IBD report a significantly lower psychological health, compared to parents of other children, and significantly lower physical health compared to parents of healthy children. Among parents of children with CD and parents of healthy children, better parental Total QoL was significantly correlated with better parental report of children's HRQOL, while for parents of children with IBD those associations were not found. Results of study show association between presence of the disease in offspring with poorer parental QoL, thus highlight the importance of supporting not only children with chronic disease but also involving their parents in psychosocial interventions, as well as supporting the patient's association groups which gather both children with chronic disease and their parents.     

Nonspecific inherited risk factors for acute respiratory diseases in children living in the western part of the Baikal-Amur railway

Variation of 9 polymorphic loci was compared in 2 groups of children from Russian native and migrant population of Western area of Baikal-Amur Railway--those who suffered from acute respiratory diseases during first year of life and their parents, and normal children and their parents. Frequencies of genotypes 1-1 (HP locus). 00 (ABO locus), and pp (F locus) were significantly higher in normal children than in the affected ones. Heterozygosity observed in native parents of the diseased children was lower as compared with other groups. It was possible to distinguish two groups, according to the degree of genic similarity: the first one included healthy children and their parents from migrant and native population, the second one included all affected children and their parents. Significance of association between phenotypes at 3 loci (HP, ABO, P) and predisposition of the children to acute respiratory diseases were evaluated. A conclusion was made that in children of both migrant and native Russian parents similar combinations of anthropological traits and gene markers are the factors of their nonspecific resistance to acute respiratory diseases.     

Correlates of Participation in a Pediatric Primary Care‐Based Obesity Prevention Intervention

The purpose of this study was to examine the correlates of participation in a childhood obesity prevention trial. We sampled parents of children recruited to participate in a randomized controlled trial. Eligible children were 2.0–6.9 years with BMI ≥95th percentile or 85th to <95th percentile if at least one parent was overweight. We attempted contact with parents of children who were potentially eligible. We recruited 475 parents via telephone following an introductory letter. We also interviewed 329 parents who refused participation. Parents who refused participation (n = 329) did not differ from those who participated (n = 475) by number of children at home (OR 0.94 per child; 95% CI: 0.77–1.15) or by child age (OR 1.07 per year; 95% CI: 0.95–1.20) or sex (OR 1.06 for females vs. males; 95% CI: 0.80–1.41). After multivariate adjustment, parents who were college graduates vs. <college graduates were less likely to participate (OR 0.62; 95% CI: 0.46–0.83). In addition, parents were less likely (OR 0.41; 95% CI: 0.31–0.56) to participate if their child was overweight vs. obese. Among the 115 refusers with obese children, 21% cited as a reason for refusal that their children did not have a weight problem, vs. 30% among the 214 refusers with overweight children. In conclusion, parents of preschool‐age children with a BMI 85–95th%ile are less likely to have their children participate in an obesity prevention trial than parents of children with BMI >95th%ile. One reason appears to be that they less frequently consider their children to have a weight problem.     

Loss in higher multiple pregnancy and multifetal pregnancy reduction.

From early pregnancy into childhood, higher multiples have much higher rates of mortality, whether from spontaneous abortion, the 'vanishing twin' syndrome, fetal or infant death. Many parents must cope with the death of one baby whilst the siblings remain critically ill or later become disabled and yet there grief is often underestimated. Little is known about the long term feelings of parents who choose to have a multifetal pregnancy reduction (MFPR). Most say they made the right decision but also that there was insufficient respect for their loss. They are often anxious about what, if anything, to tell the survivors and how they might react. Long term follow-up studies of the children as well as the parents are needed. Meanwhile parents who chose to have a MFPR must be given more information and ongoing support.     

Cognitive abilities and language comprehension in preschool children with perinatal brain lesion

Perinatal brain lesion is a risk factor for development, making parents of such children particularly worried about consequences it may have on the child's cognitive and language development. Although literature findings on the outcome of perinatal brain lesion are inconsistent, most of the studies have found a positive general outcome, but also subtle deficits that affect the child's academic success. Since language comprehension and cognitive abilities influence learning abilities at school, we wanted to know how six-year olds who were selected based on pathological ultrasonographical findings (ischemic or hemorrhagic brain lesion) would perform on subtests of Wechsler battery (WISC) and language comprehension measures (Reynell Developmental Language Scale and Peabody Picture Vocabulary Test), compared with controls. The second issue we investigated was whether in children who suffered a perinatal brain lesion cognitive abilities predicted the level of language comprehension in the same way as in children without perinatal brain lesion. The relation between cognitive and linguistic abilities is still a controversial one, and a different relation would mean that these two groups of children have different structure of abilities probably due to perinatal brain lesion. Forty children who suffered a perinatal brain lesion and forty age-matched children without perinatal risk factors were examined. Our results showed that the groups differed more in linguistic than in cognitive variables. Also, the two groups showed different relation patterns between cognitive abilities and language comprehension. Cognitive abilities were statistically significantly associated with language comprehension in children who suffered a perinatal brain lesion, while this association was not statistically significant within the control group. Since a number of participants with perinatal brain lesion had language difficulties, it is presumed that they rely on cognitive abilities in order to overcome and compensate for language shortcomings.     

Sociodemographic and motivational characteristics of parents who volunteer their children for clinical research: a controlled study.

OBJECTIVE--To determine the sociodemographic and motivational characteristics of parents who volunteer their children for clinical research. DESIGN--A questionnaire was administered to parents who volunteered their children for a randomised, double blind, placebo controlled trial of a drug to treat asthma and to a control group of parents whose children were eligible for the trial but had refused the invitation. SETTING--A children''s hospital in Australia. SUBJECTS--68 Parents who had volunteered their children and 42 who had not; a response rate of 94% and 70%, respectively. MAIN OUTCOME MEASURES--Responses of parents to questionnaire designed to assess their perceptions, attitudes, and health seeking behaviour as well as sociodemographic data. RESULTS--Volunteering parents were less well educated with only 15% (10/68) of mothers and 16% (11/68) and of fathers having had a tertiary or university education compared with 26% (11/42) of mothers and 45% (19/42) in the non-volunteering group. Fewer volunteering parents had professional or administrative jobs than did non-volunteering parents (mothers 6% (4/68); fathers 9% (6/68) v mothers 14% (6/42); fathers 31% (13/42)). Volunteering parents had less social support, and they displayed greater health seeking behaviour and consumed more habit forming substances. They were motivated by a desire to help others and to contribute to medical research, but they were also searching for more information and better ways to help their own children. CONCLUSION--Parents who volunteer their children for medical research are significantly more socially disadvantaged and emotionally vulnerable.     

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.     

Child fostering as a reproductive strategy among Southern African pastoralists

Information on child fosterage was obtained on 1902 individuals in the course of collecting 611 reproductive histories from Herero and Mbanderu pastoralists in northwestern Botswana in southern Africa. The hypothesis that women foster out their children as a strategy for increasing the number of children they produce is tested. Analysis of these data indicate that sex and birth year of children and parents' marital status significantly influence a child's risk of being fostered, but the relationship of fostering to fertility is unclear. More recently born individuals, females, and children born to parents who were not married to each other are more likely to be fostered than older individuals, males, and children born to parents who were married to each other. A child's risk of being fostered does not appear to be influenced by mother's age if the parents were married to each other, while children born to parents who were not married to each other are more likely to be fostered if the mother is very young, but this pattern is not clear. No association between fostering and mortality was found.     

The problem of the mentally defective child

Continued effort is necessary not only to prevent mental deficiency but to find methods of treating it. Meanwhile, physicians must have a keener appreciation of the feelings of the parents about their retarded children and must interpret the implications of the problems in a way the parents can understand. Further community effort is necessary to provide institutional and foster home care for those who need it. Educational and training programs should be extended and developed for all those who can benefit from such programs. The problem of mental deficiency is not that of the parents alone, nor of physicians, nor of the psychologists, nor of the social workers, nor of the educators. It is a problem which requires the cooperation of all these groups for solution.     

THE PROBLEM OF THE MENTALLY DEFECTIVE CHILD

Continued effort is necessary not only to prevent mental deficiency but to find methods of treating it. Meanwhile, physicians must have a keener appreciation of the feelings of the parents about their retarded children and must interpret the implications of the problems in a way the parents can understand. Further community effort is necessary to provide institutional and foster home care for those who need it. Educational and training programs should be extended and developed for all those who can benefit from such programs.The problem of mental deficiency is not that of the parents alone, nor of physicians, nor of the psychologists, nor of the social workers, nor of the educators. It is a problem which requires the cooperation of all these groups for solution.     

Hopelessness of mothers who have children with Down syndrome

This study was conducted to determine hopelessness status of mothers who have children with Down syndrome. Beck Hopelessness Scale was used in this restrictive type study. The average value of mothers enrolled in the study was detected as 8.29 +/- 2.49. Age, education level, socio-economical status, work and the problems between parents were also examined and it was found that there is a relationship between the education level, socio-economical status, the problems between parents and the hopelessness scale (p < 0.01). Consequently, it is apparent that the mothers who have children with Down syndrome need social and psychological support to overcome their feelings of hopelessness.     

Accepting Adoption’s Uncertainty: The Limited Ethics of Pre-Adoption Genetic Testing

An increasing number of children are adopted in the United States from countries where both medical care and environmental conditions are extremely poor. In response to worries about the accuracy of medical histories, prospective adoptive parents increasingly request genetic testing of children prior to adoption. Though a general consensus on the ethics of pre-adoption genetic testing (PAGT) argues against permitting genetic testing on children available for adoption that is not also permitted for children in general, a view gaining traction argues for expanding the tests permitted. The reasoning behind this view is that the State has a duty to provide a child with parents who are the best “match,” and thus all information that advances this end should be obtained. While the matching argument aims to promote the best interests of children, I show how it rests on the claim that what is in the best interests of children available for adoption is for prospective adoptive parents to have their genetic preferences satisfied such that the “genetics” of the children they end up adopting accurately reflects those preferences. Instead of protecting a vulnerable population, I conclude, PAGT contributes to the risks of harm such children face as it encourages people with strong genetic preferences to adopt children whose genetic backgrounds will always be uncertain.     

The intergenerational transmission of Australian Indigenous languages: why language maintenance programmes should be family-focused

By 2050, the majority of Australia’s surviving Indigenous languages are likely to become extinct. The intergenerational transmission of languages in which children acquire languages from their parents and grandparents is a key mechanism for reversing language shift, but many Australian children whose parents speak an Indigenous language do not speak that language. Using a unique, national survey of Australian Indigenous children, I identify factors associated with the successful intergenerational transmission of Indigenous languages within Aboriginal and Torres Strait Islander families. Results highlight the importance of parents’ language use. Although community-level characteristics account for some of the variance in successful language transmission, parents who use Indigenous languages at home, speak them as well as they speak English, and do not also speak a creole language are more likely to pass those languages onto their children.     

Do Children Lose and Maintain Weight Easier Than Adults: A Comparison of Child and Parent Weight Changes From Six Months to Ten Years

Recent research has shown weight maintenance for obese preadolescent children over 60 and 120 month intervals, while studies on adults consistently show they fail to maintain weight loss. This paper is designed to examine differences in percent overweight changes at 6, 60 and 120 months in obese parents and children from 113 families who participated in randomized controlled outcome studies evaluating family-based behavioral treatment. Analyses showed children had significantly greater changes in percent overweight than their parents at each time point. Chi-Square and Logistic Regression analyses showed children were more likely than their parents at each time point to have percent overweight decreases greater than 20%, with over 20% of the children and less than 1% of the parents showing changes this large. The implications of these results for weight control are discussed. These results suggest there may be differences in the efficacy of treating obesity in children versus adults.     

Dermatoglyphic studies in the parents of trisomy 21 children I. Distribution of dermatoglyphic discriminants

A sample of 312 parents of a child with complete trisomy 21 (168 mothers and 144 fathers) has been compared with 295 parents of non-mongol children (61 mothers and 134 fathers) with respect to distribution of individual dermatoglyphic discriminant scores. Selection of dermatoglyphic traits as well a weightings have been based on the discriminant function, constructed for normal controls against cytogenetically diagnosed trisomy 21 mosaics. The results indicate that the proportion of individuals with an increased chance of mosaicism is appreciably greater in a sample of both the mothers and the fathers of mongol children, as compared with the parents of non-mongol children. For D greater than + 3.00, including also the overlap range values, it is, on the average, twice as high as in the control parents, while for the D values greater than + 4.00, strongly indicative of mosaicism, it is about five times higher than in control parents. This is so in spite of the fact that all parents, who had previously been cytogenetically tested and diagnosed as mosaics, were not included in this sample. Although the meaning of these results cannot yet be completely understood, they justify the extension of the use of dermatoglyphic discriminants in studies on parental mosaicism in trisomy 21.     

Parents, ADHD and the internet

The objective of this study is to examine the potential impact of using the internet on medical consultations by analysing the attitudes, attributions, and emotional responses of parents who have been informed by specialists that their child does not have attention-deficit hyperactivity disorder (ADHD) and to examine the nature of the feedback they obtained from members of online internet support groups. Over 40,000 messages from the five most popular international internet forums discussing children with ADHD were analysed. Messages from parents who reported that they had seen at least one specialist (e.g. paediatrician, psychiatrist or psychologist) because of their concerns that their child had ADHD were identified. The children included boys and girls with an age range from 2 to 16?years. Of these, we analysed messages where the parents additionally reported that the specialist had excluded a diagnosis of ADHD. Using these criteria, 91 messages from parents who had consulted over 200 different specialists and 398 replies to these messages were identified for content analysis. The replies to concerned parents were analysed to determine whether they were offered impartial advice. A majority of the parents reported that they did not believe the specialist and were unhappy about their child not being diagnosed with ADHD. They expressed dissatisfaction with the professional's opinions and the implication that their child's conduct was caused by their poor parenting skills. Importantly, 87.6?% of the responses that these parents received, from other members of online forums, reinforced the parent's negative attitude towards the professional's judgement. It was generally suggested that the parents should not believe the expert and should seek a further opinion. The use of the internet may encourage "doctor shopping" and mistrust in health services. Medical professionals and others may need to be aware of this, and parents may need more support than is generally offered to be able to accept alternative explanations for their child's behaviour.     

Survey of parents' attitudes to the recommended Haemophilus influenzae type b vaccine program.

A survey was conducted in a general pediatric practice to determine parents'' attitudes to and compliance with the recommended Haemophilus influenzae type b vaccine program. Of 133 families surveyed 127 (95%) responded to the questionnaire. About one third of the parents did not have their children vaccinated. The decision against vaccination was made despite parent education, follow-up telephone contact and the pediatrician''s expressed support of the vaccine program. Most of the respondents (86%) had no previous knowledge of the vaccine. The factor of greatest concern was the possibility of an adverse reaction. This concern was significantly more common among the parents who decided not to have their children vaccinated than among those who had their children vaccinated (chi 2 = 6.52, p less than 0.025). One third of the parents who indicated that they intended to have their children vaccinated required a telephone reminder. The findings suggest a need for public education about the vaccine, with particular emphasis directed at allaying fears about side effects.     

Implications of caring for an aging parent.

The burden of care for the aged often falls on their adult children, who are themselves stressed by the developmental tasks of middle age. These people are frequently unprepared for the role of caregiver, in which they become parents to their own parents. The author describes the potentially turbulent effect of this role and discusses the origin of the stresses that the caregiver may experience. Doctors need to recognize and deal with the negative feelings, such as resentment, anger, frustration, ambivalence, guilt and demoralization, that may arise in adult children who care for their parents. These emotions must be put into proper context if the mental and physical health of the caregivers as well as the vital support they provide for their elderly parents are to be maintained.