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      Belastungen und Ressourcen von Eltern psychisch erkrankter Kinder : Eine clusteranalytische Untersuchung

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          Abstract

          Zusammenfassung. Theoretischer Hintergrund: Eltern von psychisch erkrankten Kindern sind vielfältigen Belastungen ausgesetzt. Fragestellung: Lassen sich Eltern psychisch erkrankter Kinder hinsichtlich Stressmerkmalen und Bewältigungsstrategien empirisch in Subgruppen mit ähnlichem Muster unterteilen ? Methode: N = 100 Elternteile wurden bei psychiatrischer Erstvorstellung ihrer Kinder mittels evaluierter Fragebögen nach aktuellen Stressoren und Copingstrategien sowie nach erzieherischen Rahmenbedingungen befragt. Die Subgruppen wurden mittels Clusteranalyse anhand der drei Stress-Skalen gebildet. Ergebnisse: Es bildeten sich zwei Cluster mit unterschiedlicher Stressbelastung. Höhere Stressbelastung war mit geringerem Alter der Eltern, höherem Alleinerziehenden-Anteil, ungünstigen Bewältigungsmechanismen und mehr psychischer Erkrankung auf Elternseite assoziiert. Diskussion und Schlussfolgerung: In der Elternarbeit sollten die unterschiedlichen Belastungen und Ressourcen beachtet werden.

          Mental Distress and Resources in Parents to Children With Mental Diagnosis: A Cluster Analysis Study

          Abstract. Theoretical Background: Parents of children with psychiatric diagnoses face a range of stresses and strains, and display varying psychological capabilities to meet these challenges. Currently, mental distress and coping in parents of children diagnosed with mental disorders are not being assessed systematically before treatment. Objective: In the present study, we investigated whether parents of children with mental disorders can be divided into subgroups of characteristic patterns of distress and coping strategies. Furthermore, we compared these subgroups regarding variables like characteristics of their children and their diagnoses and specific aspects of parenting. Exploratively, we investigated the association of specific mental disorders in children with stress and coping in their parents. Method: N = 100 parents of children who had been referred to a specialized child and adolescent psychiatric outpatient unit were recruited. The study took place at the initial psychiatric assessment of the children prior to treatment. We assessed mental distress, coping, parenting style, and parenting conditions using evaluated questionnaires. The subgroups were formed using a k-means cluster analysis based on the three subscales of stress, and the subgroups found were compared regarding further variables: age of children and parents, diagnoses of children and parents (self-report), socioeconomic status, coping strategies and intelligence. Results: Cluster analysis revealed two subgroups with highly significantly different levels of stress, which was true for all three subscales. Higher distress was associated with younger age of parents, a larger proportion of single parents, reduced cooperation in (co)‌parenting, less coping through social support, and higher abuse of alcohol and nicotine. Based on self-assessment, major depression and anxiety disorders, as well as the presence of any mental disorder, were more prevalent in the high stress group. Mental stress in parents was not associated with specific diagnoses. Discussion and Conclusion: In order to provide viable treatments in child and adolescent psychiatry, mental health care teams should pay particular attention to a vulnerable group of parents who are impaired by a range of stressors and who dispose over a limited range of coping strategies. While these parents might respond well to initial social support and mental treatment for themselves, a significant proportion of parents shows relatively low stress levels and can become involved in therapy without further preparation. Mental distress in parents or families does not seem to be driven by specific diagnoses or clusters of diagnoses but by other factors. We propose that this should be reflected in the initial diagnostic process by using screening questionnaires covering stress, coping, and mental disorders. Consequently, family treatment might be adapted to current stress and coping capacities in the frame of individualized medicine.

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          Parenting Stress and Child Adjustment: Some Old Hypotheses and New Questions

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            Parenting Stress

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              Remissions in maternal depression and child psychopathology: a STAR*D-child report.

              Children of depressed parents have high rates of anxiety, disruptive, and depressive disorders that begin early, often continue into adulthood, and are impairing. To determine whether effective treatment with medication of women with major depression is associated with reduction of symptoms and diagnoses in their children. Assessments of children whose depressed mothers were being treated with medication as part of the multicenter Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial conducted (between December 16, 2001 and April 24, 2004) in broadly representative primary and psychiatric outpatient practices. Children were assessed by a team of evaluators not involved in maternal treatment and unaware of maternal outcomes. Study is ongoing with cases followed at 3-month intervals. One hundred fifty-one mother-child pairs in 8 primary care and 11 psychiatric outpatient clinics across 7 regional centers in the United States. Children were aged 7 to 17 years. Child diagnoses based on the Kiddie Schedule for Affective Disorders and Schizophrenia; child symptoms based on the Child Behavior Checklist; child functioning based on the Child Global Assessment Scale in mothers whose depression with treatment remitted with a score of 7 or lower or whose depression did not remit with a score higher than 7 on the Hamilton Rating Scale for Depression. Remission of maternal depression after 3 months of medication treatment was significantly associated with reductions in the children's diagnoses and symptoms. There was an overall 11% decrease in rates of diagnoses in children of mothers whose depression remitted compared with an approximate 8% increase in rates of diagnoses in children of mothers whose depression did not. This rate difference remained statistically significant after controlling for the child's age and sex, and possible confounding factors (P = .01). Of the children with a diagnosis at baseline, remission was reported in 33% of those whose mothers' depression remitted compared with only a 12% remission rate among children of mothers whose depression did not remit. All children of mothers whose depression remitted after treatment and who themselves had no baseline diagnosis for depression remained free of psychiatric diagnoses at 3 months, whereas 17% of the children whose mothers remained depressed acquired a diagnosis. Findings were similar using child symptoms as an outcome. Greater level of maternal response was associated with fewer current diagnoses and symptoms in the children, and a maternal response of at least 50% was required to detect an improvement in the child. Remission of maternal depression has a positive effect on both mothers and their children, whereas mothers who remain depressed may increase the rates of their children's disorders. These findings support the importance of vigorous treatment for depressed mothers in primary care or psychiatric clinics and suggest the utility of evaluating the children, especially children whose mothers continue to be depressed.
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                Author and article information

                Contributors
                Journal
                kie
                Kindheit und Entwicklung
                Hogrefe Verlag, Göttingen
                0942-5403
                2190-6246
                April 2022
                04 March 2022
                : 31
                : 2 , Special Issue: Auswirkungen der COVID-19-Pandemie
                : 119-128
                Affiliations
                [ 1 ]Ambulanzzentrum des Zentrums für Integrative Psychiatrie, Universitätsklinikum Schleswig-Holstein (UKSH), Campus Kiel
                [ 2 ]Universität Groningen, Medizinische Fakultät, Groningen, Niederlande
                [ 3 ]Justus-Liebig-Universität Gießen, Fachbereich Psychologie und Sportwissenschaft, Gießen
                Author notes
                Dr. Manuel Munz, Ambulanzzentrum, Kinder- und Jugendpsychiatrische, Institutsambulanz, Zentrum für Integrative Psychiatrie, Universitätsklinikum Schleswig-Holstein (UKSH) Campus Kiel, Niemannsweg 147, 24105 Kiel, manuel.munz@ 123456uksh.de
                Article
                kie_31_2_119
                10.1026/0942-5403/a000361
                28377fa1-b191-43ec-b1ae-d7e008f2018a
                Distributed as a Hogrefe OpenMind article under the license CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0)

                Distributed as a Hogrefe OpenMind article under the license CC BY-NC-ND 4.0 ( https://creativecommons.org/licenses/by-nc-nd/4.0)

                History
                Funding
                Förderung: Open Access-Veröffentlichung ermöglicht durch das Universitätsklinikum Schleswig-Holstein (UKSH) Campus Kiel.
                Categories
                Freier Beitrag

                Psychology,Family & Child studies,Development studies,Clinical Psychology & Psychiatry
                Ressourcen,elterliche Belastung,psychische Erkrankung von Kindern,Behandlungsplanung,parental stress,coping,treatment strategy,child and adolescent psychiatry

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