Stress and the Home Environment in Caregivers of Children with Sickle Cell

Abstract Objective Caregivers of young children with chronic illnesses are at high risk for elevated levels of stress and mental health symptoms. This study examined stress and mental health symptoms as well as the socioeconomic status (SES) and home environments of a cohort of caregivers of infants and toddlers with sickle cell disease (SCD). Methods Forty-two caregivers of infants and toddlers (aged 1–34 months) with SCD completed the Brief Symptom Inventory (BSI) and Parent Stress Index (PSI). The Home Observation for Measurement of the Environment (HOME) was used to assess family living environments. Results Compared to test norms, caregivers reported high levels of situational/demographic life stress [mean difference (MD) 5.7, p = .003] and child distractibility/hyperactivity (MD 3.62, p = .001) on the PSI. However, no significant differences in psychological symptoms of distress were noted on the BSI. Caregivers scored significantly lower than norms on PSI subdomains of acceptability (MD −1.88, p = .03), competence (MD −3.11, p = .002), depression (MD −3.94, p < .001), and the overall parent domain (MD −12.55, p = .005). Significant correlations were found between PSI scores and the HOME and between SES and the HOME. Conclusion Caregivers of infants and toddlers with SCD experience elevated levels of life stress but, in turn, endorse high acceptance of their child and self-competence in parenting. Although life stress may be high in this population, symptoms of psychological distress were not identified. Caregivers reporting elevated life and illness-specific stressors may benefit from environmental supports and interventions.

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Influence of early life stress on later hypothalamic–pituitary–adrenal axis functioning and its covariation with mental health symptoms: A study of the allostatic process from childhood into adolescence

Development and Psychopathology ◽

10.1017/s0954579411000484 ◽

2011 ◽

Vol 23 (4) ◽

pp. 1039-1058 ◽

Cited By ~ 122

Author(s):

Marilyn J. Essex ◽

Elizabeth A. Shirtcliff ◽

Linnea R. Burk ◽

Paula L. Ruttle ◽

Marjorie H. Klein ◽

...

Keyword(s):

Mental Health ◽

Hpa Axis ◽

Life Stress ◽

Early Life ◽

Specific Activity ◽

Early Life Stress ◽

Hierarchical Linear Model ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Hypothalamic Pituitary Adrenal

AbstractThe hypothalamic–pituitary–adrenal (HPA) axis is a primary mechanism in the allostatic process through which early life stress (ELS) contributes to disease. Studies of the influence of ELS on children's HPA axis functioning have yielded inconsistent findings. To address this issue, the present study considers multiple types of ELS (maternal depression, paternal depression, and family expressed anger), mental health symptoms, and two components of HPA functioning (traitlike and epoch-specific activity) in a long-term prospective community study of 357 children. ELS was assessed during the infancy and preschool periods; mental health symptoms and cortisol were assessed at child ages 9, 11, 13, and 15 years. A three-level hierarchical linear model addressed questions regarding the influences of ELS on HPA functioning and its covariation with mental health symptoms. ELS influenced traitlike cortisol level and slope, with both hyper- and hypoarousal evident depending on type of ELS. Further, type(s) of ELS influenced covariation of epoch-specific HPA functioning and mental health symptoms, with a tighter coupling of HPA alterations with symptom severity among children exposed previously to ELS. Results highlight the importance of examining multiple types of ELS and dynamic HPA functioning in order to capture the allostatic process unfolding across the transition into adolescence.

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The effect of mindfulness-based stress intervention on neurobiological and symptom measures in adolescents with early life stress: A feasibility randomized controlled trial

10.31219/osf.io/b5pyr ◽

2020 ◽

Author(s):

Zsofia Cohen ◽

Kelly T. Cosgrove ◽

Elisabeth Akeman ◽

Sara Coffey ◽

Kent Teague ◽

...

Keyword(s):

Mental Health ◽

Stress Reduction ◽

Life Stress ◽

Early Life ◽

Controlled Trial ◽

Early Life Stress ◽

Medium Effect ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Symptom Level

Background Early life stress (ELS) has been linked to poor mental and physical health outcomes in adolescence and adulthood. Mindfulness reduces symptoms of depression and anxiety and improves cognitive and social outcomes in both youth and adults. However, little is known whether mindfulness can mitigate against the adverse neurobiological and psychological effects of ELS. This study aimed to examine the feasibility of conducting a group mindfulness intervention in adolescents with ELS and provide preliminary indication of potential effects on stress-related biomarkers and mental health symptoms. Methods Forty adolescents were randomized to receive either eight sessions of Mindfulness-Based Stress Reduction for Teens in group format (MBSR-T; n = 21) or Control (CTRL; n = 17). Outcomes were assessed at baseline and follow-up and included measures associated with neurobiological functioning (immune and endocrine biomarkers) and self-reported mental health symptoms. Linear mixed effects models were used to assess the effects of group and time on these outcome measures. ResultsSixteen of the 21 adolescents completed the intervention, attending an average of 6.5 sessions. The model examining depressive symptoms revealed a medium effect for symptom reduction [Cohen’s d = .69] in the MBSR-T relateive to CTRL groups.ConclusionsThis study demonstrated feasibilility of conducting a group-based MBSR intervention for adolescents with ELS. There was some evidence for efficacy on a symptom level with potential subtle changes on a biological level. Future larger studies are needed to determine the efficacy of group-based mindfulness interventions in this population.

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Mental Health Assessment of Youth with Sickle Cell Disease and Their Primary Caregivers During the COVID-19 Pandemic

10.22541/au.164132321.14305773/v1 ◽

2022 ◽

Author(s):

Nancy Green ◽

Deepa Manwani ◽

Kim Smith-Whitley ◽

Banu Aygun ◽

Abena Appiah-Kubi ◽

...

Keyword(s):

Mental Health ◽

Sickle Cell Disease ◽

Food Insecurity ◽

Sickle Cell ◽

Health Assessment ◽

Cell Disease ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Mental Health Assessment ◽

On Line

Youth with sickle cell disease (SCD) and their caregivers are susceptible to stress and depression, perhaps exacerbated by pandemic-associated health and economic concerns. Most of the 50 youth-caregiver dyads enrolled in the multi-site HABIT trial took an on-line survey of self-reported mental health symptoms and food insecurity during the 2020 COVID-19 pandemic. Compared to largely pre-pandemic results, prevalence of mental health symptoms in dyad members appeared to have shifted: fewer youth and more caregivers were affected during the pandemic; many of both groups lacked optimism. Pandemic screening of youth with SCD for mental health symptoms and food insecurity appears warranted.

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A national survey of self-reported mental health of Veterans pursuing post-secondary education in Canada

Journal of Military Veteran and Family Health ◽

10.3138/jmvfh-2020-0047 ◽

2021 ◽

pp. e20200047

Author(s):

John S. Ogrodniczuka ◽

Tim Laidler ◽

John L. Oliffecc

Keyword(s):

Mental Health ◽

Secondary Education ◽

Psychological Symptoms ◽

Post Secondary Education ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Post Secondary ◽

The Past ◽

High Prevalence ◽

Self Harm

Lay Summary This article details self-reported mental health symptoms among Canadian Veterans pursing post-secondary education in Canada. Participants reported high prevalence of psychological symptoms, most notably feeling exhausted (80.5%) and overwhelmed (78.9%). More than 1 in 10 respondents reported seriously considering suicide (13.4%), and 5.9% had attempted suicide in the past 12 months. Furthermore, 8.7% of respondents had indicated intentional self-harm (cut, burned, bruised, or otherwise injured themselves) within the past 12 months. The findings reflect significant mental health symptoms for Veterans attending Canadian colleges and universities, underscoring the need to provide tailored services to safely integrate Veterans to campus life.

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