Associations between parent-child relationship quality and obesogenic risk in adolescence: a systematic review of recent literature.

Adolescence is a period of significant cognitive, social and physiological change, presenting unique risk factors for weight gain. Childhood obesity research has traditionally focused on the influence of parent-level factors on children's eating and weight status. Increasingly, emphasis is turning towards the reciprocal nature of the parent-child relationship and its influence on health behaviour. A systematic literature review was conducted to investigate the relationship between parent-child relationship quality (defined as the felt emotional bond between parent and child) and obesogenic risk (weight status, eating attitudes and behaviours, level of physical activity and sedentary behaviour) in adolescence; 26 papers were included in the review. The results neither support nor challenge an association between parent-child relationship quality and weight, with study design flaws and limited measurement of the parent-child relationship precluding robust conclusions. The review does however suggests that several aspects of the parent-child relationship are important in understanding eating attitudes and behaviours, including the felt emotional bond between the parent and child, the child's perception of how much the parent cares for them and the mother's sensitivity towards the child. The need for further longitudinal research into the association between parent-child relationship quality and obesity risk across this developmental period is discussed.

Parent cognitions and parent-infant interaction: the relationship with development in the first 12 months

This study examined parent cognitions and parent-infant interaction in terms of their contribution to infant development in the first 12 months. With a sample of 95 mother-infant dyads, results using structural equation modelling confirmed the expected finding that parent-infant interaction mediates the association between parent cognitions and infant development. An unexpected finding was that the direct association between parent cognitions and infant development was stronger than the direct association between parent-infant interaction and infant development. These findings are discussed with regard to the implications for preventative and early intervention models.

Parent, child and state in Chinese children’s books

The representation of the relationship between parent and child, the moral cornerstone of Chinese society, is uniquely influential in Chinese children’s literature. After an extended period of almost two thousand years during which depictions of this relationship were static and unchanging, the beginning of the twentieth century ushered in a dynamic series of changes which responded to political needs. In this study we focus on these changes, examining four distinctive periods: the pre-modern dynastic period until 1911; the Republican and Nationalist phase from 1911 to 1949; the phase of Mao’s socialism from 1949 to 1976; and the post-Mao phase from 1976 to 2000.

Parent-child agreement using the Spence Children's Anxiety Scale and a thermometer in children with autism spectrum disorder

Children with Autism Spectrum Disorder (ASD) experience high anxiety which often prompts clinical referral and requires intervention. This study aimed to compare parent and child reports on the Spence Children's Anxiety Scale (SCAS) and a child-reported "worry thermometer" in 88 children aged 8-13 years, 44 with ASD and 44 age, gender, and perceptual IQ matched typically developing children. There were no gender differences in child report on the SCAS and worry thermometers. Results indicated generally good correlations between parent and child self-reported SCAS symptoms for typically developing children but poor agreement in parent-child ASD dyads. The worry thermometer child-report did not reflect child or parent reports on the SCAS. Findings suggest 8-13-year-old children with ASD may have difficulties accurately reporting their anxiety levels. The clinical implications were discussed.

Parent and family factors associated with service use by young people with mental health problems: a systematic review

AIM: To conduct a systematic review of parent and family factors associated with service use for young people with mental health problems, to inform early intervention efforts aimed at increasing service use by young people. METHODS: A systematic search of academic databases was performed. Articles were included in the review if they had: a sample of young people aged between 5 and 18 years; service use as the outcome measure; one or more parental or family variables as a predictor; and a comparison group of non-service using young people with mental health problems. In order to focus on factors additional to need, the mental health symptoms of the young person also had to be controlled for. Stouffer's method of combining P-values was used to draw conclusions as to whether or not associations between variables were reliable. RESULTS: Twenty-eight articles were identified investigating 15 parental or family factors, 7 of which were found to be associated with service use for a young person with mental health needs: parental burden, parent problem perception, parent perception of need, parent psychopathology, single-parent household, change in family structure and being from the dominant ethnic group for the United States specifically. Factors not found to be related to service use were: family history of service use, parent-child relationship quality, family functioning, number of children, parent education level, parent employment status, household income and non-urban location of residence. CONCLUSIONS: A number of family-related factors were identified that can inform effective interventions aimed at early intervention for mental health problems. Areas requiring further research were also identified.

Early childhood education and care educators supporting parent-child relationships: a systematic literature review

Building strong relationships between children and parents is vital for children’s social and emotional development. A majority of children attend early childhood education and care (ECEC) settings where they experience a range of relationships (educator–child, educator– parent, parent–child). Educators build relationships with children and parents, yet their influence on parent–child relationships is not well understood. Therefore, an evaluation of interventions/programs designed to promote parent–child relationships in ECEC settings (long day care, occasional care and preschool) and a range of settings (play groups, community groups and health centers) was conducted. The search revealed 21 peer-reviewed studies and seven interventions: two conducted in ECEC settings and five in a range of parent–child support settings. All studies reported intervention efficacy, yet none examined educators’ influence on parent–child relationships. Investigation into current educator practices is recommended to ensure educators are supported to promote and nurture parent– child relationships, consequently strengthening children’s social and emotional development.

Family risk factors for cannabis use: a population-based survey of Australian secondary school students

The objective of this study was to investigate relationships between adolescent cannabis use and indices of parent - child attachment, family functioning and parent attitudes to drugs and delinquency. A total of 2848 year 9 and 2363 year 11 students participated in the Victorian Adolescent Health and Well-Being Survey (1999). The study was a school-based random sample of 535 metropolitan and rural, government and non-government secondary schools throughout Victoria, Australia. Cannabis use was defined as 'any' and 'weekly' use in the last 30 days. Multivariate logistic regression was used to identify independent associations between cannabis use and parent - child attachment, family functioning and parent attitudes to drugs and delinquency. Cannabis use in year 9 was associated with permissive parent attitudes to drugs and delinquency (any use: adjusted odds ratio (OR) = 8.1; weekly use: adjusted OR = 7.6), and was particularly sensitive to small changes in the quality of the parent - child relationship with risk increasing threefold for those describing their attachment as 'good' compared with 'very good' (any use: adjusted OR = 2.8, weekly use adjusted OR = 2.9). A similar, but more moderate pattern association was evident in year 11. After adjusting for other family and background factors, poor family functioning showed minimal association with level of cannabis use at both year levels. Results suggest that intervention efforts might sensibly target strengthening parent - children relationships and promoting less permissive parent attitudes to drug use.

The role of evolution, bonding, and parenting style in understanding parental differences

This research demonstrates the influence of parental bonding and parental authority on the parent-child relationship and subsequent child development in both biological and step-families. Differential effects of parental behaviour on child attachment style development were found for biological children and stepchildren. The results provide guidance for intervention and future research.

Weight changes among preschool children project

A prospective methodological design was used to provide comprehensive evidence of the influence of parenting (mothers and fathers) on the patterns of preschool children’s weight gain. With the exception of the parent-child observational measure, measures of all predictor and outcome variables have been obtained for children aged 24 to 36 months at three time points: at recruitment and at 12 and 24 months post recruitment; parent-child interactions have been obtained during home visits at recruitment and 12 months post recruitment.

Gender differences in adolescent depression: Differential female susceptibility to stressors affecting family functioning

Objective: The aim of this study was to examine associations between family-based stressors and depressive symptoms in adolescents.

Method: Participants were 10-14 year olds who participated in a large Australian population study (n=6,552). Depressive symptoms and pubertal development were assessed using the self-report Short Mood and Feelings Questionnaire and the Pubertal Development Scale. Three indicators of stress exposure were examined-low emotional closeness to parents, residential and school transitions, and family conflict. The effect of gender, stress exposure and the interaction of gender and stress exposure on depressive symptoms was tested using multivariate logistic regression.

Results: High family conflict, residential instability and low emotional closeness with parents were independently associated with adolescent depressive symptoms. There was a significant gender by emotional closeness interaction; females reporting low emotional closeness to their parents were 2.3 times more likely to report high depressive symptoms than females reporting high emotional connections with parents.

Conclusions: Female adolescents may be more susceptible to particular types of stresses and particularly the quality of the parent-child relationship.

The effect of low parental warmth and low monitoring on disordered eating in mid-adolescence: findings from the Australian Temperament Project

OBJECTIVE: To investigate the interactions between low parental warmth and monitoring at age 13-14 years and disordered eating attitudes and behaviours at age 15-16 years. METHOD: Data on 1300 (667 females) adolescents and their parents were drawn from The Australian Temperament Project (ATP), a 30 year (15 wave) population based longitudinal study of social-emotional development. Parent participants completed surveys on parenting practices in late childhood, and adolescent participants reported disordered eating using the drive for thinness and bulimia subscales of the Eating Disorder Inventory (EDI) and an additional body dissatisfaction scale. Interaction was examined on the additive scale by estimating super-additive risk; i.e., risk in excess of the sum of individual risks. RESULTS: For boys, neither parental warmth or monitoring, nor their interaction, was related to disordered eating. For girls, low parental warmth (alone) was associated with bulimic behaviours. In contrast, exposure to both low monitoring and warmth was associated with ∼3½-fold, ∼4-fold and ∼5-fold increases in the odds of reporting body dissatisfaction, drive for thinness and bulimia, respectively. For body dissatisfaction and drive for thinness, risk associated with joint exposure exceeded the sum of individual risks, suggesting an additive interaction between parenting styles. CONCLUSION: Further investment in family-level interventions that focus on promoting parental monitoring behaviour and a warm parent-child relationship remain important strategies for preventing a range of disordered eating behaviours in adolescents.

Parent-proxy and child self-reported health-related quality of life: using qualitative methods to explain the discordance

Background: Although parent-proxy reports of health-related quality of life (HRQOL) are only moderately correlated with child reported HRQOL, it remains unknown why these scores differ. The aim of this study was to use a qualitative methodology to examine why parents and children report different levels of HRQOL.

Method: The sample consisted of 15 parent–child pairs. A think-aloud technique was used where parents and children were given a generic HRQOL instrument (KIDSCREEN) and instructed to share their thoughts with the interviewer. Qualitative analyses were conducted to assess whether parents and children base their answer on different experiences or reasoning, have different response styles, or interpret the items differently.

Results: There was discordance between parents and children, in terms of rating scale and in terms of the reasoning for their answer. Children tended to have different response styles to parents, where for example, children tended to provide extreme scores (highest or lowest score) and base their response on one single example, more than parents. Parents and children interpreted the meaning of the items very similarly.

Discussion: This study provides evidence to suggest that discordance among parent-child pairs on KIDSCREEN scores may be as a result of different reasoning and different response styles, rather than interpretation of items. These findings have important implications when parent-proxy reported HRQOL is used to guide clinical/treatment decisions.

Association between parent and child dietary sodium and potassium intakes as assessed by 24-h urinary excretion

The aim of this study was to assess the association between parent and child sodium (Na) and potassium (K) intake as assessed by 24-h urinary excretion (24hUE). Primary school children and their parent(s) provided one 24-h urine sample and information on cooking and children's discretionary salt use. Valid urine samples were provided by 108 mothers (mean age 41.8 (5.1) (SD) years, Na 120 (45) mmol/day) (7.0 g/day salt equivalent) and 40 fathers (44.4 (4.9) years, Na 152 (49) mmol/day (8.9 g/day salt), and 168 offspring (51.8% male, age 9.1 (2.0) years, Na 101 (47) mmol/day (5.9 g/day salt). When adjusted for parental age, child age and gender a 17 mmol/day Na (1 g/day salt) increase in mother's 24hUE was associated with a 3.4 mmol/day Na (0.2 g/day salt) increase in child's salt 24hUE (p = 0.04) with no association observed between father and child. Sixty-seven percent of parents added salt during cooking and 37% of children added salt at the table. Children who reported adding table salt had higher urinary excretion than those who did not (p = 0.01). The association between mother and child Na intake may relate to the consumption of similar foods and highlights the importance of the home environment in influencing total dietary sodium intake.