Age Differences in the Mediating Effects of Parenting Stress on the Relationship Between Cyanotic Congenital Heart Disease and Externalizing Problems in Children and Adolescents

Background: Children and adolescents with cyanotic congenital heart disease have been found to be at an increased risk of internalising problems. The underlying mechanisms, however, remain uncertain. Aims: To examine the association between cyanotic congenital heart disease and internalising problems and assess whether parenting stress mediates this association. Method: The study sample was 699 children and adolescents (aged 2–17 years) with congenital heart disease (253 with cyanotic congenital heart disease and 446 with acyanotic congenital heart disease) in Taiwan. The Child Behavior Checklist and the Parenting Stress Index were used to assess internalising problems and parenting stress, respectively. A series of multiple regression models was conducted using the SPSS PROCESS procedure to test the association between types of congenital heart disease and internalising problems and the mediating role of parenting stress. A bootstrapping approach was applied to determine the significance of mediation. Results: Compared with acyanotic congenital heart disease, cyanotic congenital heart disease was associated with increased levels of internalising problems (B=2.52, P<0.01), and this association was mediated by parenting stress (B=0.97, 95% bias-corrected bootstrap confidence interval 0.24, 1.75). In particular, parents of children with cyanotic congenital heart disease reported significantly more parenting stress compared with parents of children with acyanotic congenital heart disease (B=4.63, P<0.01), which contributed to elevated levels of internalising problems in the offspring (B=0.21, P<0.001). Conclusion: Cyanotic congenital heart disease conferred risks for internalising problems in children and adolescents, and this association was mediated by parenting stress. Interventions to decrease internalising problems in children and adolescents with cyanotic congenital heart disease may be more effective by targeting parenting stress.

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Illness-Related Parenting Stress and Maladjustment in Congenital Heart Disease: Mindfulness as a Moderator

Journal of Pediatric Psychology ◽

10.1093/jpepsy/jsaa081 ◽

2020 ◽

Vol 45 (10) ◽

pp. 1208-1215

Author(s):

Meredith Bishop ◽

Lindsey L Cohen ◽

Abigail S Robbertz

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Parenting Stress ◽

Congenital Heart ◽

Mindful Parenting ◽

Structural Defects ◽

Background Information ◽

Infants And Toddlers ◽

Coronary Blood Vessels ◽

The Relationship

Abstract Objective Congenital heart disease (CHD) is characterized by structural defects to the heart or the coronary blood vessels and often requires surgical repair. Raising an infant or toddler with CHD can be challenging and lead to high parenting stress and maladjustment. The parenting literature suggests that mindfulness may buffer parenting stress. The purpose of this study was to examine whether mindfulness might moderate the relationship between illness-related parenting stress and maladjustment in parents of infants and toddlers with CHD. Methods Parents of infants and toddlers with CHD attending an outpatient clinic provided background information and completed measures of illness-related parenting stress, mindfulness, and maladjustment. Results Results indicated that illness-related parenting stress was associated with maladjustment, and mindfulness moderated this relationship. Specifically, illness-related parenting stress was related to maladjustment at low and average levels of mindfulness; at high mindfulness, there was no association between illness-related parenting stress and maladjustment. Conclusions Consistent with the broader literatures, our sample of parents of infants and toddlers with CHD reported high illness-related parenting stress and maladjustment. Building on other studies demonstrating the benefits of mindful parenting, our results suggest that engaging in mindfulness might thwart the association between illness-related parenting stress and maladjustment in parents of infants and toddlers with CHD.

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Executive Function in Children and Adolescents with Critical Cyanotic Congenital Heart Disease

Journal of the International Neuropsychological Society ◽

10.1017/s1355617714001027 ◽

2014 ◽

Vol 21 (1) ◽

pp. 34-49 ◽

Cited By ~ 82

Author(s):

Adam R. Cassidy ◽

Matthew T. White ◽

David R. DeMaso ◽

Jane W. Newburger ◽

David C. Bellinger

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Executive Function ◽

Problem Solving ◽

Children And Adolescents ◽

Congenital Heart ◽

Single Ventricle ◽

Fontan Procedure ◽

Cyanotic Congenital Heart Disease ◽

Self Report

AbstractChildren and adolescents with critical cyanotic congenital heart disease (CHD) are at risk for deficits in aspects of executive function (EF). The primary aim of this investigation was to compare EF outcomes in three groups of children/adolescents with severe CHD and controls (ages 10–19 years). Participants included 463 children/adolescents with CHD [dextro-transposition of the great arteries (TGA), n=139; tetralogy of Fallot (TOF), n=68; and, single-ventricle anatomy requiring Fontan procedure (SVF), n=145] and 111 controls, who underwent laboratory and informant-based evaluation of EF skills. Rates of EF impairment on D-KEFS measures were nearly twice as high for CHD groups (75–81%) than controls (43%). Distinct EF profiles were documented between CHD groups on D-KEFS tasks. Deficits in flexibility/problem-solving and verbally mediated EF skills were documented in all three CHD groups; visuo-spatially mediated EF abilities were impaired in TOF and SVF groups, but preserved in TGA. Parent, teacher, and self-report ratings on the BRIEF highlighted unique patterns of metacognitive and self-regulatory concerns across informants. CHD poses a serious threat to EF development. Greater severity of CHD is associated with worse EF outcomes. With increased understanding of the cognitive and self-regulatory vulnerabilities experienced by children and adolescents with CHD, it may be possible to identify risks early and provide individualized supports to promote optimal neurodevelopment. (JINS, 2014, 20, 34–49)

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Increased atrial and brain natriuretic peptides in adults with cyanotic congenital heart disease; enhanced understanding of the relationship between hypoxia and natriuetic peptide secretion

ACC Current Journal Review ◽

10.1016/j.accreview.2004.08.057 ◽

2004 ◽

Vol 13 (9) ◽

pp. 47 ◽

Cited By ~ 1

Author(s):

W.E. Hopkins ◽

Z. Chen ◽

N.K. Fukagawa

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Natriuretic Peptides ◽

Congenital Heart ◽

Cyanotic Congenital Heart Disease ◽

Brain Natriuretic Peptides ◽

Peptide Secretion ◽

The Relationship

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Propofol vs Sevoflurane in Cyanotic Congenital Heart Disease

Case Medical Research ◽

10.31525/ct1-nct04125550 ◽

2019 ◽

Author(s):

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Cyanotic Congenital Heart Disease

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Pubertal status of children with congenital heart disease

Cardiology in the Young ◽

10.1017/s1047951121002651 ◽

2021 ◽

pp. 1-5

Author(s):

Zahra Ghaemmaghami ◽

Zahra Khajali ◽

Mohammad Dalili ◽

Zahra Fotovati ◽

Maryam Moradian ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Children And Adolescents ◽

Congenital Heart ◽

Normal Population ◽

Large Sample Size ◽

Pubertal Status ◽

Major Aspect ◽

Pubertal Onset ◽

Pubertal Stages

Abstract Background: CHD influences many aspects of life in affected individuals. Puberty, a major aspect of development, is a concern for patients and families. Objectives: We investigated pubertal status in children and adolescents with CHD. Methods: Patients with CHD aged 6–18 were enrolled. Cardiac diagnoses were confirmed using history, examination, and paraclinical tools including echocardiography. An endocrinologist determined pubertal stages, and the second Tanner stages for pubarche (P2), thelarche (B2), and gonadarche (G2) were considered as the pubertal onset. A study with a large sample size on pubertal onset in a normal population was used for comparison. Results: Totally, 451 patients (228 girls and 223 boys) at a median (10th–90th percentile) age of 10.79 (8.02–14.28) years for the girls and 10.72 (8.05–14.03) years for the boys were enrolled. The median (10th–90th percentile) ages at B2 and P2 in the girls with CHD were 10.77 (9.55–12.68) and 10.53 (9.39–12.28) years, respectively, which were higher than the median ages of 9.74 (8.23–11.94) and 10.49 (8.86–12.17) years in the normal girls. The median (10th–90th percentile) ages at G2 and P2 in the boys with CHD were 11.04 (8.85–13.23) and 11.88 (9.78–13.46) years, correspondingly, which were higher than the median ages of 9.01 (6.00–11.84) and 10.34 (6.84–13.10) years in the normal boys. Conclusions: Pubertal onset could be delayed in children with CHD when compared with the normal population.

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