Research has demonstrated an association between parenting stress and child behavior problems, and suggested levels of parenting stress are higher among parents of children at risk for behavior problems, such as those with autism and developmental delay (ASD/DD). The goal of the present study was to conduct a systematic review of parenting stress and child behavior problems among different clinical groups (i.e., ASD/DD, chronic illness, with or at-risk for behavioral and/or mood disorders). We also examined demographic and methodological variables as moderators and differences in overall levels of parenting stress between the clinical groups. This systematic review documents a link between parenting stress and child behavior problems with an emphasis on externalizing behavior. One-hundred thirty-three studies were included for quantitative analysis. Parenting stress was more strongly related to child externalizing (weighted ES r = 0.57, d = 1.39) than internalizing (weighted ES r = 0.37, d = 0.79) problems. Moderation analyses indicated that the association between parenting stress and behavior problems was stronger among studies which had mostly male and clinic-recruited samples. Overall, parenting stress levels were higher for parents of children with ASD/DD compared to parents of children from other clinical groups. Findings document the association between parenting stress and child behavior problems and highlight the importance of assessing parenting stress as part of routine care and throughout behavioral intervention programs, especially for groups of children at high risk for behavior problems, such as children with ASD/DD, in order to identify support for both the parent(s) and child.

The goal of the present study was to evaluate the psychometric properties of the English and Spanish versions of the Parenting Stress Index-Short Form (PSI-SF) with mothers of 12- to 15-month-old infants with elevated levels of behavior problems and from predominately Hispanic, low-income backgrounds. Mothers of 58 infants were assessed as part of a larger study examining a brief home-based intervention for infants with elevated behavior problems. Internal consistency was good for all three subscales (i.e., Parental Distress, Parent-Child Dysfunctional Interaction, and Difficult Child) and the Total Stress scale. Convergent validity of subscales was supported by correlations with measures of theoretically related constructs, including maternal depressive symptoms, maternal parenting practices, and infant behavior. Furthermore, examination of the optimal clinical cutoff by examining sensitivity and specificity suggested that for this high-risk sample lower percentile scores (73rd – 77th), relative to the published 85th percentile cutoff, were sufficient for identifying mothers with clinically elevated depressive symptoms and infants with clinically elevated behavioral and emotional difficulties. The current results provide psychometric support for the PSI-SF as an effective and appropriate measure for use with high-risk families that have been underrepresented in previous research, including mothers of very young children with behavior problems, Hispanic and Spanish-speaking populations, and low-income families.

To meet the mental health needs of infants from high-risk families, we examined the effect of a brief home-based adaptation of Parent-Child Interaction Therapy (PCIT) on improvements in infant and parent behaviors and reductions in parenting stress. Participants included 60 infants (55% male; average age of 13.5 ± 1.31 months) who were recruited at a large urban primary care clinic and were included if their scores exceeded the 75th percentile on a brief screener of early behavior problems. Most infants were from an ethnic or racial minority background (98%) and lived below the poverty line (60%). Families were randomly assigned to receive the home-based parenting intervention or standard pediatric primary care. Observational and parent-report measures of infant and parenting behaviors were examined at pre- and post-intervention and at 3- and 6-month follow-ups. Infants receiving the intervention were more compliant with maternal commands at the 6-month follow-up and displayed lower levels of externalizing and internalizing behavior problems across post and follow-up assessments compared to infants in standard care. Mothers receiving the intervention displayed a significantly higher proportion of positive and lower proportion of negative behaviors with their infant during play compared to mothers in the standard care group. There were no significant group differences for parenting stress. Results provide initial evidence for the efficacy of this brief and home-based adaptation of PCIT for infants. These findings highlight the benefit of identification and intervention as early as possible to promote mental health for infants from high-risk families.

Background Although a number of studies have examined the factor structure of the Edinburgh Postnatal Depression Scale (EPDS) in predominately White or African American samples, no published research has reported on the factor structure among Hispanic women who reside in the United States. Objective The current study examined the factor structure of the EPDS among Hispanic mothers in the United States. Method Among 220 Hispanic women, drawn from a pediatric primary care setting, with an infant aged 0 to 10 months, 6 structural models guided by the empirical literature were evaluated using confirmatory factor analysis. Results Results supported a 2-factor model of depression and anxiety as the best fitting model. Multigroup models supported the factorial invariance across women who completed the EDPS in English and Spanish. Conclusion These findings provide initial support for the 2-factor structure of the EPDS among Hispanic women in the United States.

In the U.S., there is a growing Latino population, in which parents primarily speak Spanish to their children. Despite the evidence that language preference is associated with level of acculturation and influences parenting practices in these families, no study has compared how Spanish-and English-speaking Latino families acquire and utilize the skills taught during parent-training programs such as Parent-Child Interaction Therapy (PCIT). Twenty-seven mother-infant Latino dyads received a home-based adaptation of the Child-Directed Interaction (CDI) phase of PCIT as part of a larger randomized control trial. Most infants were male (63%), and their average age was 13.7 months (SD = 1.43). Most families (52%) lived below the poverty line. The Dyadic Parent-Child Interaction Coding System-Third Edition (DPICS-III) was employed to evaluate PCIT skills at baseline and post-treatment, as well as at 3- and 6-month follow-up, assessments. We conducted multiple linear regression analyses among Spanish-speaking (55%) and English-speaking (45%) families to examine differences in acquisition and utilization of do and don’t skills at each assessment while controlling for mother’s education. Results yielded no group differences in the acquisition rate of do or don’t skills at any time point. However, Spanish-speaking mothers used significantly more don’t skills than English-speaking mothers at each assessment. Specifically, Spanish-speaking families used significantly more commands at baseline, post-treatment, and the 6-month followup assessments, as well as more questions at post-treatment and at the 6-month follow-up assessments. These findings highlight the importance of addressing cultural values such as respeto to ensure culturally robust parent-training programs for Latino families.