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AIDS and Behavior

, Volume 19, Issue 11, pp 2130–2139 | Cite as

Parenting Mediates the Impact of Caregivers’ Distress on Children’s Well-Being in Families Affected by HIV/AIDS

  • Peilian ChiEmail author
  • Xiaoming Li
  • Cheuk Chi Tam
  • Hongfei Du
  • Guoxiang Zhao
  • Junfeng Zhao
Original Paper

Abstract

Parental illness imposes great challenges to children’s life and mental health. Having a parent infected by HIV may further challenge children’s psychological well-being. Existing studies have demonstrated a negative impact of caregiver’s distress on children’s well-being. Limited studies examined the potential pathways of the link. This study aims to examine whether parenting stress, parenting competence and parental responsiveness can explain the relationship between caregivers’ distress and children’s well-being. A community sample of children of parents living with HIV and their current caregivers (n = 754 dyads) was recruited in rural central China. Children completed the measures on their psychological well-being and perceived parental responsiveness of their caregivers. Caregivers reported on their psychological well-being, parenting stress, and parenting competence. Structural equation modeling analysis showed that caregivers’ distress indirectly affect children’s well-being through parenting stress, parenting competence and parental responsiveness. Parenting stress explained the impact of caregiver’s distress on parental responsiveness and showed pervasive effects on parenting competence. Our findings lend credence to family-based intervention for children affected by HIV and affirm the importance of incorporating the cognitive, emotional and behavioral components of parenting practices in such intervention.

Keywords

Children affected by HIV/AIDS Parenting stress Parenting competence Parental responsiveness Caregiver 

Notes

Acknowledgments

This study reported in this article was supported by NIH Research Grant from the National Institute of Nursing Research (R01NR13466). The authors wish to thank Bo Wang for his statistical advices in preparing the manuscript.

References

  1. 1.
    Pedersen S, Revenson TA. Parental illness, family functioning, and adolescent well-being: a family ecology framework to guide research. J Fam Psychol. 2005;19(3):404–19.CrossRefGoogle Scholar
  2. 2.
    Chi P, Li X. Impact of parental HIV/AIDS on children’s psychological well-being: a systematic review of global literature. AIDS Behav. 2013;17(7):2554–74.PubMedCentralCrossRefPubMedGoogle Scholar
  3. 3.
    Richter LM, Naicker S. A review of published literature on supporting and strengthening child-caregiver relationships (Parenting). 2013, USAID’s AIDS Support and Technical Assistance Resources, AIDSTAROne, Task Order 1, Arlington, VA.Google Scholar
  4. 4.
    Spies R, et al. Linkages between HIV/AIDS, HIV/AIDS-psychoses and parenting: a systematic literature review. Vulnerable Children and Youth Studies. 2014;9(2):174–92.CrossRefGoogle Scholar
  5. 5.
    Hong Y, et al. Care arrangements of AIDS orphans and their relationship with children’s psychosocial well-being in rural China. Health Policy Plan. 2011;26(2):115–23.PubMedCentralCrossRefPubMedGoogle Scholar
  6. 6.
    Lachman JM, et al. Positive parenting for positive parents: HIV/AIDS, poverty, caregiver depression child behavior, and parenting in South Africa. AIDS Care. 2014;26(3):304–13.PubMedCentralCrossRefPubMedGoogle Scholar
  7. 7.
    Murphy DA, et al. Anxiety/stress among mothers living with HIV: effects on parenting skills and child outcomes. AIDS care. 2010;22(12):1449–58.PubMedCentralCrossRefPubMedGoogle Scholar
  8. 8.
    Richter LM, et al. Strengthening families to support children affected by HIV and AIDS. AIDS Care. 2009;21:3–12.PubMedCentralCrossRefPubMedGoogle Scholar
  9. 9.
    Pelton J, Forehand R. Orphans of the AIDS epidemic: an examination of clinical level problems of children. J Am Acad Child Adolesc Psychiatry. 2005;44(6):585–91.CrossRefPubMedGoogle Scholar
  10. 10.
    Murphy DA, Marelich WD. Resiliency in young children whose mothers are living with HIV/AIDS. AIDS Care. 2008;20(3):284–91.PubMedCentralCrossRefPubMedGoogle Scholar
  11. 11.
    Cluver LD, et al. AIDS-orphanhood and caregiver HIV/AIDS sickness status: effects on psychological symptoms in South African youth. J Pediatr Psychol. 2012;37(8):857–67.CrossRefPubMedGoogle Scholar
  12. 12.
    Dix T, Meunier LN. Depressive symptoms and parenting competence: an analysis of 13 regulatory processes. Dev Rev. 2009;29(1):45–68.CrossRefGoogle Scholar
  13. 13.
    Murphy DA, et al. Family routines and parental monitoring as protective factors among early and middle adolescents affected by maternal HIV/AIDS. Child Dev. 2009;80(6):1676–91.PubMedCentralCrossRefPubMedGoogle Scholar
  14. 14.
    Anderson LS. Predictors of parenting stress in a diverse sample of parents of early adolescents in high-risk communities. Nurs Res. 2008;57(5):340.PubMedCentralCrossRefPubMedGoogle Scholar
  15. 15.
    Rogers H, Matthews J. The parenting sense of competence scale: investigation of the factor structure, reliability, and validity for an Australian sample. Australian Psychologist. 2004;39(1):88–96.CrossRefGoogle Scholar
  16. 16.
    Gelkopf M, Jabotaro SE. Parenting style, competence, social network and attachment in mothers with mental illness. Child & Family Social Work. 2013;18(4):496–503.CrossRefGoogle Scholar
  17. 17.
    Oyserman D, et al. Parenting self-construals of mothers with a serious mental illness: efficacy, burden, and personal growth1. J Appl Soc Psychol. 2004;34(12):2503–23.CrossRefGoogle Scholar
  18. 18.
    Van Loon RA. Redefining motherhood: adaptation to role change for women with AIDS. Families Soc. 2000;81(2):152–61.CrossRefGoogle Scholar
  19. 19.
    He Z, Ji C. Nutritional status, psychological well-being and the quality of life of AIDS orphans in rural Henan Province China. Trop Med Int Health. 2007;12(10):1180–90.CrossRefPubMedGoogle Scholar
  20. 20.
    West A, Wedgwood K. Children affected by AIDS, orphans and impact mitigation in China. In AIDS and social policy in China., Kaufman J, Kleinman A, Saich T, editors. Cambridge: Harvard University Asia Center; 2006. p. 243–64Google Scholar
  21. 21.
    Ministry of Health of People’s Republic of China, 2012 China AIDS Response Progress Report; 2012.Google Scholar
  22. 22.
    Ministry of Health People’s Republic of China. Joint United Nations Programmeon HIV/AIDS, and World Health Organization, 2011 Estimates for the HIV/AIDS Epidemic in China. China: Beijing; 2011.Google Scholar
  23. 23.
    Li X, et al. Lifetime incidence of traumatic events and mental health among children affected by HIV/AIDS in rural China. J Clin Child Adolesc Psychol. 2009;38(5):731–44.CrossRefPubMedGoogle Scholar
  24. 24.
    Fendrich M, Wessiman MM, Warner V. Screening for depressive disorder in children and adolescents: validating the Center for Epidemiologic Studies Depression Scale for Children. Am J Epidemiol. 1990;131(3):538–51.PubMedGoogle Scholar
  25. 25.
    Andresen EM, et al. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994;10(2):77–84.PubMedGoogle Scholar
  26. 26.
    Asher SR, Hymel S, Renshaw PD. Loneliness in children. Child Dev. 1984;55(4):1456–64.CrossRefGoogle Scholar
  27. 27.
    Rosenberg, M., Society and the adolescent self-image. Princeton. N.J.: Princeton University Press; 1965.Google Scholar
  28. 28.
    Fang X, et al. Parental HIV/AIDS and psychosocial adjustment among rural Chinese children. J Pediatr Psychol. 2009;34(10):1053–62.PubMedCentralCrossRefPubMedGoogle Scholar
  29. 29.
    Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385–401.CrossRefGoogle Scholar
  30. 30.
    Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behav Res Ther. 1995;33(3):335–43.CrossRefPubMedGoogle Scholar
  31. 31.
    Cohen S, Williamson G. Perceived stress in a probability sample of the United States. In the social psychology of health: Claremont symposium on applied social psychology, Spacapam S, Oskamp S, Editors. Newbury Park: Sage; 1988.Google Scholar
  32. 32.
    Yu X, et al. Risk and protective factors in association with mental health problems among people living with HIV who were former plasma/blood donors in rural China. AIDS Care. 2009;21(5):645–54.CrossRefPubMedGoogle Scholar
  33. 33.
    Wang Z, et al. Psychometric properties of the Chinese version of the perceived stress scale in policewomen. PLoS ONE. 2011;6(12):e28610.PubMedCentralCrossRefPubMedGoogle Scholar
  34. 34.
    Boey KW. Cross-validation of a short form of the CES-D in Chinese elderly. Int J Geriatr Psychiatry. 1999;14(8):608–17.CrossRefPubMedGoogle Scholar
  35. 35.
    Johnston C, Mash EJ. A measure of parenting satisfaction and efficacy. J Clin Child Psychol. 1989;18(2):167–75.CrossRefGoogle Scholar
  36. 36.
    Jackson C, Henriksen L, Foshee VA. The Authoritative Parenting Index: predicting health risk behaviors among children and adolescents. Health Educ Behav. 1998;25(3):319–37.CrossRefPubMedGoogle Scholar
  37. 37.
    Quintana SM, Maxwell SE. Implications of recent developments in structural equation modeling for counseling psychology. Counsel Psychol. 1999;27(4):485–527.CrossRefGoogle Scholar
  38. 38.
    Muthén LK, Muthén BO. Mplus 5.1 [computer program]. Los Angeles 2007.Google Scholar
  39. 39.
    Ritchie J, Spencer L. Qualitative data analysis for applied policy research. The qualitative researcher’s companion. Thousand Oaks: Sage Publications Inc; 2002. p. 305.Google Scholar
  40. 40.
    Deković M, et al. Tracing changes in families who participated in the home-start parenting program: parental sense of competence as mechanism of change. Prev Sci. 2010;11(3):263–74.PubMedCentralCrossRefPubMedGoogle Scholar
  41. 41.
    Petersen I, et al. Psychosocial challenges and protective influences for socio-emotional coping of HIV+ adolescents in South Africa: a qualitative investigation. AIDS care. 2010;22(8):970–8.PubMedCentralCrossRefPubMedGoogle Scholar
  42. 42.
    Pequegnat W, Szapocznik J. Working with families in the era of HIV, AIDS. Thousand Oaks: Sage Publications Inc; 2000.Google Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of Psychology, Faculty of Social SciencesUniversity of MacauMacau SARChina
  2. 2.Pediatric Prevention Research CenterWayne State University School of MedicineDetroitUSA
  3. 3.Institute of Behavior and PsychologyHenan UniversityKaifengChina

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