Cortney Wolfe-Christensen

The relationship of parental overprotection, perceived vulnerability, and parenting stress to behavioral, emotional, and social adjustment in children with cancer

To examine the relationship of self‐reported parental overprotection, perceived child vulnerability, and parenting stress to parent‐reported behavioral, emotional, and social adjustment of children currently on treatment for cancer.

The Relationship Between Single-Parent Status and Parenting Capacities in Mothers of Youth with Chronic Health Conditions: The Mediating Role of Income

OBJECTIVE To retrospectively examine the relationship of single-parent status to parenting capacity variables in mothers of youth with a chronic health condition. METHODS Parental overprotection, perceived vulnerability, and parenting stress were assessed in 383 mothers (308 married and 75 single parents) of youth with one of six chronic health conditions (i.e., type 1 diabetes, asthma, cancer, cystic fibrosis, hemophilia, or sickle cell disease). RESULTS Single mothers evidenced higher levels of both perceived vulnerability and parenting stress, but not overprotection, than married parents. These differences disappeared in the presence of income as a predictor. CONCLUSIONS Single parents appear to evidence differences in parenting capacity; however, low income appears to account in large part for the higher level of risk associated with single-parent status.

Persistent psychosocial problems in children who develop posterior fossa syndrome after medulloblastoma resection.

Posterior fossa syndrome (PFS) occurs in approximately 20% of patients after resection of a tumor from the posterior fossa. Few descriptions of persistent psychosocial consequences exist. We assessed whether the development of PFS is associated with increased risk for emotional, behavioral, and social problems after the cessation of cancer treatment.

Primary Caregivers of Children Affected by Disorders of Sex Development: Mental Health and Caregiver Characteristics in the Context of Genital Ambiguity and Genitoplasty

Purpose. To determine the relationship between having a child with a DSD including ambiguous external genitalia, as well as the decision of whether or not to have early genitoplasty for that child, on the mental health and parenting characteristics of caregivers. Materials and Methods. Caregivers were recruited from centers that specialize in DSD medicine and completed the Beck Depression Inventory 2nd Edition (BDI-2), Beck Anxiety Index (BAI), Parent Protection Scale (PPS), Child Vulnerability Scale (CVS) and Parenting Stress Index/Short Form (PSI/SF). Results and Conclusions. Sixty-eight caregivers provided informed consent and completed the study. Among female caregivers whose children never received genitoplasty, greater parenting stress was reported . For male caregivers, those whose children received genitoplasty within the first year of life reported more overprotective parenting and parenting stress than those whose children received genitoplasty later than 12 months of age ; , respectively).

From Hypercalciuria to Hypocitraturia—A Shifting Trend in Pediatric Urolithiasis?

PURPOSE We analyzed the metabolic abnormalities in children with urolithiasis, and the relationship between diet and hypocitraturia. MATERIALS AND METHODS A single center, retrospective analysis was conducted in all children with renal and/or ureteral calculi seen at our Multidisciplinary Stone Clinic between January 2010 and July 2011. Data at presentation were extracted from the clinical database. RESULTS We analyzed 63 children (37 girls) with urolithiasis with a mean age of 13.43 ± 4.61 years. Of the 45 patients with 24-hour urinalysis, a metabolic risk factor was present in 68.9%, with hypocitraturia (58.1%) and hypercalciuria (48.3%) being the most common. Children with isolated hypocitraturia had lower urinary magnesium and potassium levels (1.06 ± 0.62 mg/kg and 0.53 ± 0.24 mmol/kg per day) than those with no metabolic abnormalities (1.72 ± 0.61 mg/kg and 0.68 ± 0.20 mmol/kg per day) (p = 0.015 and p = 0.132, respectively). Urinary citrate was positively correlated with urinary potassium (r = 0.50, p = 0.002) and urinary magnesium (r = 0.49, p = 0.001). Dietary analysis revealed a lower intake of magnesium and potassium in children with hypocitraturia (28.97% ± 12.25% and 15.42% ± 7.25% recommended dietary index) than in normocitraturic cases (51.06% ± 17.51% and 45.23% ± 29.49% recommended dietary index) (p = 0.042 and p = 0.056, respectively). CONCLUSIONS The majority of children had an identifiable metabolic risk factor for urolithiasis, with hypocitraturia being the most common. This shift in metabolic trend may be a significant contributor to the increasing incidence in pediatric urolithiasis. Hypocitraturia appears to be dietary in origin, correlated with a low consumption of potassium and magnesium.

Parenting Characteristics of Female Caregivers of Children Affected by Chronic Endocrine Conditions: A Comparison Between Disorders of Sex Development and Type 1 Diabetes Mellitus

Rearing a child with a chronic illness is stressful and can potentially affect parenting style, which may result in poorer outcomes for children. The purpose of this study was to compare parenting characteristics of female caregivers rearing children with a disorder of sex development (DSD) to female caregivers rearing children with type 1 diabetes mellitus (T1DM). Caregivers of both groups were matched according to age and compared on measures of stress and parenting practices. Both groups demonstrated significant levels of stress and negative parenting practices. Children with T1DM and male children with non-life-threatening DSD were perceived as more vulnerable by their caregivers. Better understanding of parenting experiences of female caregivers rearing children with DSD, particularly male children, will facilitate the development of individualized interventions to ameliorate negative parenting practices and stress, with the long-term goal of improved health outcomes for their children.

Longitudinal Assessment of Maternal Parenting Capacity Variables and Child Adjustment Outcomes in Pediatric Cancer

This preliminary investigation aimed to longitudinally examine parenting capacity variables, namely parental overprotection, perceived child vulnerability, and parenting stress and their relation to child adjustment in mothers of children on treatment for cancer. As part of a larger study, biological mothers (N=22) completed measures of parental overprotection, perceived child vulnerability, parenting stress, and child adjustment at Time 1 and a follow-up time point. Analyses were conducted to determine whether (1) levels of parental overprotection, perceived child vulnerability, and parenting stress declined from Time 1 to follow-up and (2) if Time 1 parenting capacity variables were associated with child adjustment at follow-up. Results revealed that parental overprotection, perceived child vulnerability, and parenting stress declined from Time 1 to follow-up, and levels of parental overprotection, perceived child vulnerability, and parenting stress at Time 1 were significantly related to child adjustment at follow-up. Collectively, the preliminary findings of this study indicate that mothers of children with cancer evidence improved parenting capacity over time. Furthermore, it seems that Time 1 parenting capacity variables are significantly related to later child adjustment.

Use of the Behavioral Assessment System for Children 2nd Edition: Parent Report Scale in Pediatric Cancer Populations

This study examined the use of the Behavioral Assessment System for Children—2nd Edition: Parent Report Scale (BASC-2; Reynolds & Kamphaus, Behavior assessment system for children, 2004) in a pediatric cancer population. Comparisons of scale scores were made between pediatric cancer participants and controls. Within group comparisons were also made between subtypes of pediatric cancer. Parents of 111 children and adolescents who had experienced pediatric cancer completed the BASC-2 as part of larger studies of parent-child adjustment to cancer. Scores on the BASC-2 for cancer survivors were compared to a matched control group. Results from MANOVA analyses revealed that children with cancer were categorized as evidencing more emotional and cognitive complaints compared to the control children. Notably, no significant within group differences emerged on the subscales with regard to cancer subtype. Although preliminary, these results suggest that the BASC-2 can identify the cognitive and emotional differences between cancer survivors and controls.

The Relation of Caregiver Demand to Adjustment Outcomes in Children With Cancer: The Moderating Role of Parenting Stress

This study investigated the relation of caregiver demand (CD) and parenting stress (PS) to child adjustment in a pediatric cancer sample. Mothers of children with cancer completed measures of PS and CD and rated their childs emotional, behavioral, and social adjustment. PS emerged as an independent predictor of the childs emotional, behavioral, and social adjustment; and moderated the relation between CD and child internalizing problems (IP). Contrary to expectations, children evidenced fewer IP under conditions of high CD and low PS, and more IP under conditions of low CD and low PS.

The Relation Between Parental Psychological Distress and Adolescent Anxiety in Youths With Chronic Illnesses: The Mediating Effect of Perceived Child Vulnerability

The purpose of this study was to examine the relation of perceived child vulnerability (PCV) and parental psychological distress (PPD) to adolescent anxiety (AANX) in youths with chronic illnesses. Ninety-one (n = 91) adolescents diagnosed with either type 1 diabetes mellitus (DM1) or asthma and their parents were recruited as part of a larger study examining parent and child adjustment to chronic illness. Adolescents completed a measure of anxiety, and parents completed measures of PCV and PPD. After controlling for multiple demographic and illness parameters, both PPD and PCV significantly predicted AANX. Further analysis indicated that the relation between PPD and AANX was mediated by PCV. These findings suggest that parent-reported psychological distress is associated with adolescent-reported anxiety. Notably, PCV appears to be a possible mechanism by which PPD influences anxiety in adolescents with chronic illnesses. Clinical relevance, study limitations, directions for future research, and implications for practice are discussed.