Icd 384 PDF
Icd 384 PDF
Icd 384 PDF
Copyright # 2005 John Wiley & Sons, Ltd. Received 6 July 2003
Accepted 10 May 2004
118 K.A. Crnic, C. Gaze and C. Hoffman
INTRODUCTION
Relations between stress and parenting have long been of interest within the field
of child development. Recent reviews of the parenting stress literature (Crnic and
Low, 2002; Deater-Deckard, 1998) have provided compelling views of the
determinants and effects of stressed parenting, and identified a number of
directions for future research. Among the major issues to be addressed is the
effect of chronic parenting stress on parents and children across the develop-
mental period. Concurrent links between parenting stress and poor child
functioning have been reasonably well established (Crnic and Low, 2002),
although it has been often hypothesized that parenting behaviours likely mediate
the relation between stress and child functioning. Nonetheless, few studies have
employed longitudinal designs capable of testing mediational processes. Also of
interest is differentiation among types of stresses that might affect parenting and
family processes (Deater-Deckard, 1998), specifying the unique contribution of
within-family events from more general life events on parenting behaviour and
child outcomes.
Historically, parenting stress has been conceptualized in multiple ways.
Major life event approaches have proven useful in distinguishing families at
risk for problematic outcome (Crnic et al., 1983; Crnic and Greenberg, 1990),
however, major life events are by nature low frequency events and not specific to
within-family processes. More specific to parenting and family processes,
Abidin’s (1983, 1990) parenting stress model has focused on addressing parental
distress and child difficulties. A wealth of research that utilizes the parenting
stress index (PSI; Abidin, 1995) has recently emerged establishing the validity
of addressing problematic situations within the family as stressful circumstance,
although differentiating the stress and outcome indices can sometimes
be challenging. Finally, Crnic and Greenberg (1990) presented a model of
parenting daily hassles in which parenting stress was conceptualized within a
minor event perspective that addresses the potential everyday frustrations and
irritations that accompany childrearing and children’s typical, but often
challenging behaviour. In their initial study, parenting daily hassles proved to
be related to parent’s satisfaction with parenting as well as child behaviour
problems, although the study involved data from only a single time point and
was correlational in nature. Nonetheless, the findings offered initial support for
the notion that parental experiences of minor daily hassles of parenting might
affect children’s development, and were a more salient source of influence than
were indices of life event stress that mothers concurrently experienced.
Subsequent research in the area of parenting daily hassles has further supported
the validity of parenting daily hassles as a meaningful stress context for families
and child development (Belsky et al., 1996a; Creasey and Reese, 1996; Crnic and
Booth, 1991). Despite the encouraging results of these studies, there has been
surprisingly little research further investigating the relations between minor
parenting daily hassles, parenting behaviour and child outcomes (Crnic and Low,
2002).
Typically, studies of parenting stress have focused either on factors that predict
parenting stress or address the behavioural and psychological consequences of
parenting stress. Although much of the research presumes that parenting
behaviour is the indirect link between parenting stress and child adjustment, few
studies have directly tested this mediation process (Deater-Deckard, 1998).
Whether indirect or not, a multitude of adverse outcomes have been found to be
associated with parenting stress, including increased child behaviour problems
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Cumulative Parenting Stress Across the Preschool Period 119
and more negative or less involved parenting (Crnic and Low, 2002; Deater-
Deckard and Scarr, 1996; Patterson, 1983; Repetti and Wood, 1997).
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120 K.A. Crnic, C. Gaze and C. Hoffman
more negative, or that mothers with more difficult children experience more
stress. Certainly, there is reason to be cautious in interpreting concurrent relations
between parenting stress and reported child outcomes. Although more long-
itudinal studies are needed to investigate the relations between parenting stress
and child behaviour across time, at least one study suggests support for the idea
that parenting stress may play a causal role in the emergence of problematic child
behaviour. Across child ages 2–3 years, Belsky et al. (1996b) found that maternal
hassles were an important correlate distinguishing troubled families within their
samples. More direct evidence that includes independent observations of child
behaviour with longitudinal stress assessments would provide more a compel-
ling case for such causal speculations.
Although the evidence is strong for an association between parenting stress
and problematic child development, a major issue involves whether the effect is
direct or indirect. Indeed, as Deater-Deckard (1998) has indicated, an assumption
of research in this field is that parenting behaviour mediates the effect of
parenting stressors on children’s functioning. While intuitively sensible, few
studies have addressed this question. Deater-Deckard and Scarr (1996) found
relatively weak but suggestive evidence that parental authoritarian discipline
mediated the relations between parent stress and child behaviour problems. Still,
an understanding of the mechanism that underlies the association between
parenting stress and child functioning remains a key issue to be addressed
(Deater-Deckard, 1998).
Present Study
Overall, despite a consensus that stress is associated with adverse outcomes for
parents and children, many questions remain with respect to cumulative or
chronic stress conditions, the exact nature of the parent and child factors that are
at specific risk to be affected, and the processes through which stress exerts its
influence. To this end, the current study addresses cumulative stress across two
domains: life events and parenting daily hassles. These stress domains are
assessed across a 2 year period from child age 3 years to child age 5. Derived
cumulative stress factors explore prediction to various indices of observed
maternal behaviour, child behaviour, and mother–child relationship quality in
naturalistic home observations, as well as to mother and father reports of child
behaviour problems. Finally, this study explores whether the association between
parenting stress and child functioning is mediated by specific parenting or
dyadic interaction factors.
METHOD
Participants
The original sample consisted of 141 families of typically developing 3-year-old
children and their families (71 girls, 70 boys). Ninety-per cent of the children
lived in two-parent families. Sixty per cent of the children were Caucasian, 12%
were African–American, 9% were Hispanic, 5% were Asian and 15% were
biracial. Sixty-one per cent of the mothers were employed. Maternal education
ranged from 10th grade through graduate work, with a mean of 15.7 years of
school. Participants in this study were part of a larger longitudinal study of
children and their families, and data were collected from 1998 to 2002. One-third
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Cumulative Parenting Stress Across the Preschool Period 121
Procedures
Once identified as potential participants, families were contacted and a home
visit was set up. At this time, the mother and father were each given a booklet of
questionnaires to complete, which they returned by mail. Parents were asked to
complete the questionnaires independently and not to share their answers. After
this initial appointment, separate home observation and laboratory sessions were
scheduled. Home observations were conducted every 6 months between the
child’s third and fifth birthdays. Booklets and laboratory sessions were
completed at the child’s third, fourth and fifth birthdays. The present study
includes data collected at each of the five home observations and from the three
questionnaire sets.
The home observations were scheduled at a time when the entire family
would be present, most often in the evening around dinnertime. Families
received remuneration for each home observation. A trained observer went
into the home to observe the behaviour of the focal child, the behaviour of the
mother and father in relation to the child, and the dyadic interactions between
the three family members. At the beginning of the visit, each parent rated his or
her daily hassles (see Measures). Once these were completed the naturalistic
observation began. The family was asked to behave as if the observer was not
there and to act as they normally would. When the child moved around
the home, the observer followed, finding an unobtrusive place to stand in
each location. If a child tried to interact with the observer, the observer would
not respond and would non-verbally re-direct the child. Across the home
visit, observational ratings were made 4 times. The child and family were
observed for 10 min, then the observer would take 5 min to rate family
interactions. Observers were trained by watching videotaped home observations
and attending live home observations with an experienced coder until reliability
was established, defined as reaching a criterion over 70% exact agreement and
95% agreement within one scale point with the criterion coder. Once an observer
reached reliability, individual observers conducted home observations. To
maintain cross-site reliability (Los Angeles, Central Pennsylvania), a criterion
coder was designated at each site. Reliability was collected regularly within site
and across site to ensure that reliability was maintained. This inter-site reliability
was based on videotaped home observations, and within-site reliability was
assessed using the same videotapes, and on live home observations when
possible. Kappa for within-site reliability at the two sites was 0.61 and 0.59,
respectively, and 0.64 for across-site reliability, levels that are considered
acceptable (Fleiss et al., 1969).
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122 K.A. Crnic, C. Gaze and C. Hoffman
Measures
Stress
At the beginning of each home observation, each parent indepen-
dently completed the measure of parenting daily hassles (Crnic and Greenberg,
1990). The measure consists of 20 items related to child and family hassles,
for which the parent was asked to rate on five-point scales how often the
item happened and how much of a hassle each item was perceived to
be. Examples of items include: being nagged, whined at, complained to; the
kid’s schedules (e.g. preschool, school, naps, other activities) interfere
with meeting your own or household needs; having to change your plans
because of an unpredicted child need; the kids are hard to manage in public
(grocery store, shopping centre, restaurant). Two summary scores are created
from this measure: the frequency of parenting hassles, and the perceived
intensity of parenting hassles. The intensity score offers an index of appraised
stressfulness, whereas the frequency score more reflects the presence of stressors.
Individual cognitive appraisal of the significance of events for one’s well being is
the primary factor predicting the impact of a stressor (Lazarus et al., 1985), and
therefore the present study used only the perceived intensity scores of parenting
hassles for mothers. Alpha reliabilities for this index have been consistently high,
averaging approximately 0.90 across studies (Belsky et al., 1995; Crnic and
Greenberg, 1990).
A parenting hassles composite was created to reflect the cumulative nature or
chronicity of parenting stress for mothers across the preschool period. Scores on
the Intensity Scale of the PDH at each of the five data collection periods were split
at the 70th/30th percentile. Mothers scoring in the lower 70% of the sample at an
individual period received a score of ‘0’ and were identified as ‘low stress’ for
that period. Mothers in the highest 30% received a score of ‘1’ and were
designated as ‘high stress’ for that period. Scores were then summed across the
five periods, resulting in a score that ranged from 0 to 5, indicating the chronicity
of parenting daily hassles across this study period.
In addition to the measures administered at the home observation, each
parent completed a set of questionnaires to assess overall family functioning,
parental attitudes and beliefs, and the parent–child relationship. Parents
completed these questionnaires when their children were ages 3, 4 and 5 years.
Included in these questionnaire measures was the life experiences survey
(LES; Sarason et al., 1978), a 46-item measure on which mothers were asked
to rate whether or not each item on the list occurred within the past 6 months,
and if it did occur, to rate whether the event was positive or negative and how
much of an effect it had on a four-point scale. Examples of items found on
the measure include: death of a spouse; loss of job; getting married; birth of a
child, assuming a mortgage. Four scores were then created: the number of
positive events, the number of negative events, the sum of the effects of the
positive events and the sum of the effects of the negative events. For the present
study, only the sum of the effects of the negative events was used, as this score
reflects the mothers’ cognitive appraisal of stress and is consistent with previous
research (e.g. Crnic and Greenberg, 1990). A composite life stress score was
created in a fashion similar to that for the PDH measure. Data from each of the
three periods in which the LES was obtained were split at the 70th/30th
percentile, and mothers scored as 0 or 1 for each period, with scores of 1 reflecting
high stress for that period. These three scores were then summed to create an
index of the chronicity of high life stress.
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Cumulative Parenting Stress Across the Preschool Period 123
Parent–Child Interaction
Observational data of parent–child interactions were taken from the 60-month
home observation. Observers rated parent–child interaction using the home
observation coding system (Belsky et al., 1995). As described above, ratings of
individual and dyadic behaviour were made after each of four 10-min
observation periods. Ratings consisted of 26 items, which were rated on a five-
point scale from 1 (low) to 5 (high). The current study focused on maternal
negativity, maternal positivity, child negativity, child positivity, and dyadic
pleasure and conflict expressed between the mother and child. Positivity and
negativity were rated independently based on frequency and intensity, for both
mothers and children. Parental positivity was defined as spontaneous smiles or
laughter specifically addressed toward the target child, while parental negativity
was defined as expressions of negative affect, such as comments or yelling,
toward the target child. Child positivity was defined as behaviour ranging from
brief smiles to laughter, while child negativity was defined as behaviour ranging
from pouting to physical expressions of anger or yelling. Dyadic pleasure was
defined as mutual enjoyment evidenced by both the parent and child during
their interactions. Dyadic conflict was defined as observable conflict or negativity
expressed by both parent and child towards one another.
RESULTS
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124 K.A. Crnic, C. Gaze and C. Hoffman
Table 1. Mean and standard deviations for composite maternal stress scores, mother and
child behaviour ratings, and mothers report of child behaviour problems
Variable M (S.D.) N
Cumulative high PDH index 1.30 (1.55) 137
Cumulative high LES index 0.94 (0.96) 133
Maternal negativity at 60 months 1.40 (0.57) 125
Maternal positivity at 60 months 2.27 (0.75) 125
Child negativity at 60 months 1.31 (0.35) 125
Child positivity at 60 months 2.81 (0.71) 125
Dyadic pleasure 1.57 (0.50) 125
Dyadic conflict 1.12 (0.34) 125
CBCL total raw score (mother) 27.82 (19.46) 124
CBCL total raw score (father) 28.48 (22.71) 108
measured annually rather than at 6 month intervals, results were similar. About
28% of mothers reported high life stress at two of the three measurement periods
(stably high), and 72% reported high stress once or not at any period (stably low).
Although both stress factors are moderately to strongly stable across the two year
period of study, the correlation between the cumulative life stress and parenting
daily hassle factors was 0.13, indicating that the two factors were predominantly
independent.
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Table 2. Correlations among maternal stress measures across time and mother and child ratings at 60 months
Construct assessed 1 2 3 4 5 6 7 8 9 10 11 12 13 14 14
1. PDH 36 months }
2. PDH 42 months 0.74** }
3. PDH 48 months 0.58** 0.69** }
9. Mother negativity 0.12 0.05 0.05 0.06 0.07 0.31** 0.18* 0.18* }
10. Mother positivity 0.15 0.18* 0.19* 0.19* 0.24** 0.10 0.17 0.29** 0.16 }
11. Child negativity 0.15 0.17 0.24** 0.21* 0.19* 0.13 0.12 0.25** 0.31** 0.11 }
12. Child positivity 0.07 0.08 0.20* 0.06 0.01 0.01 0.06 0.20* 0.09 0.23* 0.11 }
13. Child Beh problems 0.35** 0.35** 0.30** 0.32** 0.37** 0.27** 0.24* 0.21* 0.11 0.13 0.31** 0.11 }
14. Mother–child pleasure 0.18* 0.19* 0.24** 0.30** 0.29** 0.02 0.11 0.12 0.09 0.68** 0.16 0.06 0.11 }
15. Mother–child conflict 0.00 0.05 0.00 0.05 0.02 0.26** 0.17 0.31** 0.46** 0.06 0.49** 0.33* 0.35** 0.07 }
*p 5 0.05.
**p 5 0.01.
125
Table 3. Chronicity of stress as indexed by the number of periods in which mothers were
in the highest 30th percentile of reported daily hassle and life stress
Number of high stress periods PDH (n ¼ 137) LES (n ¼ 133)
Frequency Percent Frequency Percent
None 62 45.3 55 41.4
1 period 27 19.7 41 30.8
2 periods 18 13.1 27 20.3
3 periods 12 8.8 10 7.5
4 periods 11 8.0 } }
5 periods 7 5.1 } }
for 2.6% of the variance in dyadic conflict (again in the expected direction), an
amount that approached significance, whereas parenting hassles added almost
nothing meaningful to this equation.
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Cumulative Parenting Stress Across the Preschool Period 127
Mediational Analyses
A major question was whether the observed effects of stress on children’
functioning would be indirect; that is, mediated by parenting interactions, as
mothers’ behaviour is more proximal to the child’s experience than is maternal
cognitive appraisal of stressful circumstance. To address this issue, the relations
among the key variables were assessed to determine whether the data met
criteria to test for mediation (Baron and Kenny, 1986; MacKinnon et al., 2002).
Table 6. Hierarchical regressions results for maternal stress predictions to child affect and
behaviour problems at 60 months
R R2 b FD p
Predictors of child positivity
Step 1
Life events stress 0.143 0.020 0.133 2.548 0.113
Step 2*
Parenting hassles 0.174 0.030 0.100 1.223 0.271
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128 K.A. Crnic, C. Gaze and C. Hoffman
DISCUSSION
Stress in the family context, especially when that stress is chronic and present
early in development, has detrimental effects on the well being of parents,
children, and parent–child relationships. Major life events and the specific minor
daily hassles of parenting, although basically independent sources of stress on
families, are both influential but also somewhat differentially affect parenting
and the quality of early parent–child interaction.
Parenting stress has been conceptualized in multiple ways over the past
decade or so (Abidin, 1990; Crnic and Greenberg, 1990; Deater-Deckard, 1998;
Crnic and Low, 2002). Such conceptualizations include notions in which stressful
events may reflect experience that does not include the immediate family, but
influences parental functioning, such as general life events (Conger et al., 1995).
More typically, parenting stress involves situations in which parents and or
children create difficult or challenging circumstances through their behaviour,
expectations, or needs. A full understanding of the nature of parenting stress
requires attention across all aspects of the construct. Findings from the current
study are exemplary, as mothers’ cumulative life stress and specific parenting
hassles contributed both independently to parent and child measures, and
somewhat differentially to parent–child dyadic interaction in the home
environment.
Both life stress and parenting daily hassles appear to be stable across the
preschool period, suggesting that stressed parents tend to remain stressed, and
cumulative stress may build across developmental periods to create increased
risk for parenting and child functioning. The shorter the time period between
assessments of parent stress, the greater the stability of parenting stress as a rule.
Certainly, this would be expected, but even across the full 2 years, stressed
parents at child age 3 were likely to report higher stress at child age 5. Findings
demonstrating the number of times that mothers’ reported high stress across the
five measurement periods also suggest fair stability, and most mothers reported
few occasions of high stress across the preschool period. A small, but important
subgroup of mothers reported consistently high parenting stress across this
period, whereas variability in stress reports was apparent in only about 20% of
the sample.
Stability was somewhat greater for parenting hassles than life stresses, which is
sensible given that daily hassles are meant to reflect the kinds of events that occur
on a daily basis whereas major life events are not. Yet it is surprising that
parenting daily hassles show the stability they do across the preschool ages, as
there is relatively rapid change and growth in child capabilities and demands
during these years. Likewise, parenting tasks change and become more complex
as children move from preschool to school age. Perhaps the greater stability of
parenting daily hassles partly reflects a contribution of relatively stable maternal
personality characteristics to the stress appraisal process, as has been shown by
Belsky et al. (1995). Yet, it is also likely the case that across ages, the types of
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Cumulative Parenting Stress Across the Preschool Period 129
challenges and parenting tasks involved may change, but are no less stressful to
experience. At this point, it is unclear whether particular aspects of parent stress
change across time or developmental period. Regardless, mother’s appraisal of
the degree of stressfulness remains similar over time, corresponding with
findings from related studies (Deater-Deckard et al., 1996; Dyson, 1993).
The results of this study provide ample support for the notion that cumulative
parenting stress affects parenting behaviour and the quality of dyadic
parent–child interactions in naturalistic settings. It had been previously
suggested that naturalistic settings would offer the most robust contexts in
which to assess such relations (Crnic and Greenberg, 1990), and that indeed
appears to be the case. Findings also support the growing body of work
indicating that parenting stress affects the ways in which parents actually parent
their children (Crnic and Low, 2002; Deater-Deckard, 1998). Critically, this study
does so by showing cumulative stress relations to independently observed
parenting behaviour and dyadic interactions and thereby avoids the often-
chronicled method confound in studies whose findings rely entirely on maternal
reports of stress and any dependent measure of interest. The indices of dyadic
interaction and those of mother (and child) behaviour were taken from the same
episodes however, and so they are not entirely independent as the correlations
among them generally suggest.
To some extent, differential predictability of life stress and parenting daily
hassles to aspects mother–child dyadic interaction was found. Parenting hassles
were associated with less dyadic pleasure, whereas major life event stress was
somewhat more associated with dyadic conflict. The failure to find associations
between parenting hassles and the more negative parent and dyadic indices runs
somewhat counter to previous research which has shown that parenting stress is
associated with indices of negative parenting (Abidin, 1990; Belsky et al., 1996a;
Deater-Deckard and Scarr, 1996; Rodgers, 1993). However, most previous
research relied on measurements of parenting stress that incorporated more
difficult and problematic circumstances as well as the presence of distress in the
parent (e.g. the PSI). The parenting daily hassles approach, however, focuses
more on those minor everyday occurrences that may irritate and annoy, and
cumulatively affect the quality of the parent–child relationship. This is a key
differentiation among the stress measurement approaches, as the daily hassles
approach reflects more normative, non-pathological events to which parents
respond. The fact that the events to which parents respond are more normative or
typical, and are less expressly pathological, may explain their effect to depress
positivity and enjoyment between the parent and child rather than to create
hostility and conflict. Although there is a substantial literature that addresses the
implications of increased negativity and hostility between parent and child
(Cummings et al., 2000), it is much less clear at this point what the long-term
ramifications of decreased positivity and pleasure in the mother–child relation-
ship might be.
Certainly, children are at risk under conditions in which families are stressed,
regardless of the source of that stress (Morgan et al., 2002). Results from the
current study again confirm the strength of this association, across both indices of
observed behaviour and reported behaviour problems. In contrast to the effects
on parenting, both parenting hassles and life stress made meaningful contribu-
tions to children’s observed negativity as well as reported behaviour problems.
This is sensible, as more negative child behaviour reflects one aspect of why
parents view child behaviour as a hassle, and rate it so. It is important to note,
however, that when child negativity is controlled, the relationship between
Copyright # 2005 John Wiley & Sons, Ltd. Inf. Child Dev. 14: 117–132 (2005)
130 K.A. Crnic, C. Gaze and C. Hoffman
Copyright # 2005 John Wiley & Sons, Ltd. Inf. Child Dev. 14: 117–132 (2005)
Cumulative Parenting Stress Across the Preschool Period 131
ACKNOWLEDGEMENTS
This research described in this article was supported in full with a grant from
National Institutes of Health, NICHD (# HD34879), Keith Crnic, Principal
Investigator; Bruce Baker, Jan Blacher, and Craig Edelbrock, co-investigators.
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Copyright # 2005 John Wiley & Sons, Ltd. Inf. Child Dev. 14: 117–132 (2005)