AIDS and Behavior

, 11:409 | Cite as

Knowledge of Maternal HIV/AIDS and Child Adjustment: The Moderating Role of Children’s Relationships with their Mothers

  • Deborah J. Jones
  • Sarah E. Foster
  • Alecia A. Zalot
  • Charlene Chester
  • Antonette King
Original Paper


The current study examined whether child-reported maternal warmth and support moderated the association between knowledge of maternal illness and child psychosocial adjustment among 86 low-income, African American mothers with HIV/AIDS and their non-infected children. Mother–child relationship quality moderated the association between children’s knowledge of maternal HIV/AIDS and children’s externalizing, but not internalizing, difficulties. Consistent with the stress-buffering hypothesis, a warm and supportive mother–child relationship afforded a more robust buffer against externalizing difficulties for children who knew of their mother’s illness than for children who did not. Clinical implications and future directions are discussed.


African American HIV/AIDS Mother–child relationship quality Child adjustment 


  1. Achenbach, T. (1991a). Manual for the child behavior checklist 4–18 and 1991 profile. Burlington, VT: Department of Psychiatry, University of Vermont.Google Scholar
  2. Achenbach, T. (1991b). Manual for the youth self report and 1991 profile. Burlington, VT: Department of Psychiatry, University of Vermont.Google Scholar
  3. Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage.Google Scholar
  4. Anderson, R. N., & Smith, B. L. (2003). Deaths: Leading causes for 2001. National Vital Statistics Reports, 52, 27–33.Google Scholar
  5. Armistead, L. P., Forehand, R., Brody, G., & Maguen, S. (2002). Parenting and child psychosocial adjustment in single-parent African American families: Is community context important? Behavior Therapy, 33, 361–375.CrossRefGoogle Scholar
  6. Armistead, L. P., Klein, K., & Forehand, R. (1995). Parent physical illness and child functioning. Clinical Psychology Review, 15, 409–422.CrossRefGoogle Scholar
  7. Armistead, L. P., Morse, E., Forehand, R., Morse, P. S., & Clark, L. (1999). African American women and self-disclosure of HIV infection: Rates, predictors, and relationship to depressive symptomatology. AIDS and Behavior, 3, 195–204.CrossRefGoogle Scholar
  8. Armistead, L. P., Tannenbaum, L., Forehand, R., Morse, E., & Morse, P. S. (2001). Disclosing HIV status: Are mothers telling their children? Journal of Pediatric Psychology, 26, 11–20.PubMedCrossRefGoogle Scholar
  9. Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.PubMedCrossRefGoogle Scholar
  10. Bettoli-Vaughn, E., Brown, R., Brown, V., & Baldwin, K. (1998). Psychological adjustment and adaptation of siblings and mothers of children with HIV/AIDS. Family Systems and Health, 16, 249–265.CrossRefGoogle Scholar
  11. Brennan, P. A., Le Brocque, R., & Hammen, C. (2003). Maternal depression, parent-child relationships, and resilient outcomes in adolescence. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 1469–1477.PubMedCrossRefGoogle Scholar
  12. Centers for Disease Control and Prevention. (2004a). HIV/AIDS surveillance report, 2003. Atlanta: US Department of Health and Human Services.Google Scholar
  13. Centers for Disease Control and Prevention. (2004b). Diagnoses of HIV/AIDS—32 States, 2000–2003. Morbidity and Mortality Weekly Report, 53, 1106–1110.Google Scholar
  14. Cohen, S. (1988). Psychosocial models of the role of social support in the etiology of physical disease. Health Psychology, 7, 269–297.PubMedCrossRefGoogle Scholar
  15. Cohen, S., & Wills, T. A. (1985). Stress, social support, and the stress-buffering hypothesis. Psychological Bulletin, 98, 310–357.PubMedCrossRefGoogle Scholar
  16. Cohen, S., & Wills, T. A. (1985). Stress, social support, and the stress-buffering hypothesis. Psychological Bulletin, 98, 310–357.PubMedCrossRefGoogle Scholar
  17. Dallaire, D. H., Pineda, A. Q., & Cole, D. A. (2006). Relation of positive and negative parenting to children’s depressive symptoms. Journal of Clinical Child and Adolescent Psychology, 35, 313–322.PubMedCrossRefGoogle Scholar
  18. Dodge, K. A., Pettit, G. S., & Bates, J. E. (1994). Socialization mediators of the relation between socioeconomic status and child conduct problems. Child Development, 65, 649–665.PubMedCrossRefGoogle Scholar
  19. Drotar, D., Stein, R. E. K., & Perrin, E. C. (1995). Methodological issues in using the child behavior checklist and its related instruments in clinical child psychology research. Journal of Clinical Child Psychology, 24, 184–192.CrossRefGoogle Scholar
  20. Family Health Project Research Group. (1997). The family health project: A multidisciplinary longitudinal investigation of children whose mothers are HIV infected. Clinical Psychology Review, 18, 839–856.CrossRefGoogle Scholar
  21. Fitzpatrick, K. M. (1993). Exposure to violence and presence of depression among low income African American youth. Journal of Consulting and Clinical Psychology, 61, 528–531.PubMedCrossRefGoogle Scholar
  22. Forehand, R., & Jones, D. J. (2003). Neighborhood violence and coparenting conflict: Interactive influences on psychosocial adjustment of children living in inner-city environments. Journal of Abnormal Child Psychology, 31, 591–604.PubMedCrossRefGoogle Scholar
  23. Forehand, R., Jones, D. J., Kotchick, B. A., Armistead, L., Morse, E., Morse, P. S., et al. (2002). Noninfected children of HIV-infected mothers: A 4-year longitudinal study of childpsychosocial adjustment and parenting. Behavior Therapy, 33, 579–600.CrossRefGoogle Scholar
  24. Forehand, R., Steele, R., Armistead, L., Morse, E., Simon, P., & Clark, L. (1998). The family health project: Psychosocial adjustment of children whose mothers are HIV infected. Journal of Consulting and Clinical Psychology, 66, 513–520.PubMedCrossRefGoogle Scholar
  25. Forsyth, B. W. C., Damour, L., Nagler, S., & Adnopoz, J. (1996). The psychological effects of parental human immunodeficiency virus infection on uninfected children. Archives of Pediatrics and Adolescent Medicine, 150, 1015–1020.PubMedGoogle Scholar
  26. Hembree-Kigin, T. L., & McNeil, C. B. (1995). Parent-child interaction therapy. New York: Plenum Press.Google Scholar
  27. Herek, G. M. (1999). AIDS and stigma. American Behavioral Scientist, 42, 1106–1116.Google Scholar
  28. Jarrett, R. L., & Burton, L. M. (1999). Dynamic dimensions of family structure in low-income African American families: Emergent themes in qualitative research. Journal of Comparative Family Studies, 30, 177–187.Google Scholar
  29. Johnson, L., & Staples, R. (2005). Black families at the crossroads. San Francisco: Jossey-Bass.Google Scholar
  30. Jones, D. J., Beach, S. R. H., Forehand, R., & The Family Health Project Research Group. (2001a). HIV-infection and depressive symptoms: An investigation of African American single-mothers. AIDS Care, 13, 343–350.Google Scholar
  31. Jones, D. J., Beach, S. R. H., Forehand, R., & The Family Health Project Research Group. (2001b). Disease status in African American single-mothers with HIV/AIDS: The role of depressive symptoms. Health Psychology, 20, 417–423.Google Scholar
  32. Jones, D. J., Forehand, R., O’Connell, C., Brody, G., & Armistead, L. (2005). Neighborhood violence and maternal monitoring in African American single mother-headed families: An examination of the moderating role of social support. Behavior Therapy, 36, 25–34.CrossRefGoogle Scholar
  33. Jones, D. J., Foster, S., Forehand, G., & O’Connell, C. (2005). Neighborhood violence and psychosocial adjustment in low-income urban African American children: Physical symptoms as a marker of distress. Journal of Child and Family Studies, 14, 237–259.CrossRefGoogle Scholar
  34. Jones, D. J., Shaffer, A., Forehand, R., Brody, G., & Armistead, L. (2003). Coparenting conflict, in single-mother headed families: Do parenting skills serve as a mediator or moderator of children’s psychosocial adjustment? Behavior Therapy, 34, 259–272.CrossRefGoogle Scholar
  35. Kaczynski, K. J., Lindahl, K. M., & Malik, N. M. (2006). Marital conflict, maternal and paternal parenting, and child adjustment: A test of mediation and moderation. Journal of Family Psychology, 20, 199–208.PubMedCrossRefGoogle Scholar
  36. Kirshenbaum, S. B., & Nevid, J. S. (2002). The specificity of maternal disclosure of HIV/AIDS in relation to children’s adjustment. AIDS Education and Prevention, 14, 1–16.PubMedCrossRefGoogle Scholar
  37. Korneluk, Y. G. & Lee, C. M. (1998). Children’s adjustment to parental physical illness. Clinical Child and Family Psychology Review, 1, 179–193.PubMedCrossRefGoogle Scholar
  38. Kovacs, M. (1981). Rating scales to assess depression in school-aged children. Acta Paedopsychiatrica, 46, 305–315.PubMedGoogle Scholar
  39. Lamborn, S. D., Dornbusch, S. M., & Steinberg, L. (1996). Ethnicity and community context as moderators of the relations between family decision making and adolescent adjustment. Child Development, 67, 282–301.CrossRefGoogle Scholar
  40. Levy, A., Laska, F., Abelhauser, A., Delfraissy, J., Goujard, C., Boue, F., et al. (1999). Disclosure of HIV seropositivity. Journal of Clinical Psychology, 55, 1041–1049.PubMedCrossRefGoogle Scholar
  41. McMahon, R. J., & Forehand, R. J. (2003). Helping the noncompliant child: Family-based treatment for oppositional behavior (2nd ed.). New York: Guilford Press.Google Scholar
  42. Murphy, L. M. B., Koranyi, K., Crim, L., & Whited, S. (1999). Disclosure, stress, and psychological adjustment among mothers affected by HIV. AIDS Patient Care and STDs, 13, 111–118.PubMedCrossRefGoogle Scholar
  43. Murphy, D. A., Steers, W. N., & Stritto, M. E. D. (2001). Maternal disclosure of mothers’ HIVserostatus to their young children. Journal of Family Psychology, 15, 441–450.PubMedCrossRefGoogle Scholar
  44. Muthén, L. K., & Muthén, B. O. (1998). Mplus user‘s guide. Los Angeles: Author.Google Scholar
  45. Pittman, L. D., & Chase-Lansdale, P. L. (2001). African American adolescent girls in impoverished communities: Parenting style and adolescent outcomes. Journal of Research on Adolescence, 11, 199–224.CrossRefGoogle Scholar
  46. Preacher, K. J., Curran, P. J., & Bauer, D. J. (in press). Computational tools for probing interaction effects in multiple linear regression, multilevel modeling, and latent curve analysis. Journal of Educational and Behavioral Statistics.Google Scholar
  47. Prinz, R. J., Foster, S., Kent, R. N., & O’Leary, K. D. (1979). Multivariate assessment of conflict in distressed and nondistressed mother-adolescent dyads. Journal of Applied Behavior Analysis, 12, 691–700.PubMedCrossRefGoogle Scholar
  48. Robin, A. L., & Foster, S. L. (1989). Negotiating parent-adolescent conflict: A behavioral family systems approach. New York: Guilford Press.Google Scholar
  49. Robin, A. L., & Weiss, J. G. (1980). Criterion-related validity of behavioral and self-report measures of problem-solving communication skills in distressed and nondistressed parent-adolescent dyads. Behavioral Assessment, 2, 339–352.Google Scholar
  50. Rotheram-Borus, M. J., Draimin, B. H., Reid, H. M., & Murphy, D. A. (1997). The impact of illness disclosure and custody plans on adolescents whose parents live with AIDS. AIDS, 11, 1159–1164.PubMedCrossRefGoogle Scholar
  51. Semple, S. J., Patterson, T. L., Temoshok, L. R., McCutchan, J. A., Straits-Tröster, K. A., & Chandler, J. L., et al. (1993). Identification of psychobiological stressors among HIV positive women. Women and Health, 20, 15–36.CrossRefGoogle Scholar
  52. Shaffer, A., Jones, D. J., Kotchick, B. A., Forehand, R., & The Family Health Project Research Group. (2001). Telling the children: Disclosure of maternal HIV infection and its effect on child psychosocial adjustment. Journal of Child and Family Studies, 10, 301–313.Google Scholar
  53. Tompkins, T. L., Henker, B., Whalen, C. K., Axelrod, J., & Comer, L. K. (1999). Motherhood in the context of HIV infection: Reading between the numbers. Cultural Diversity and Ethnic Minority Psychology, 5, 197–208.CrossRefGoogle Scholar
  54. Vandewater, E. A., & Lansford, J. E. (2005). A family process model of problem behaviors in adolescents. Journal of Marriage and Family, 67, 100–109.CrossRefGoogle Scholar
  55. Wethington, E., & Kessler, R. C. (1986). Perceived support, received support, and adjustment to stressful life events. Journal of Health and Social Behavior, 27, 78–89.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  • Deborah J. Jones
    • 1
  • Sarah E. Foster
    • 1
  • Alecia A. Zalot
    • 1
  • Charlene Chester
    • 1
  • Antonette King
    • 2
  1. 1.Department of PsychologyUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Department of PsychologySan Francisco State UniversitySan FranciscoUSA

Personalised recommendations