Anxiety/stress among mothers living with HIV: effects on parenting skills and child outcomes

Abstract

Parental HIV infection has been associated with negative outcomes for children, and parenting skills appear to be one mechanism operating in that association. The present study focuses on the relations between maternal stress, parenting, and child functioning among families where the mother is living with HIV. Sixty-nine mothers with at least one child between six and 12 years old completed questionnaires at the baseline assessment of an intervention designed to facilitate maternal disclosure of HIV status. Respondents were assessed using multiple measures of stress/anxiety, parenting skills, and child outcomes, including the Parenting Stress Index, the RAND Mental Health Inventory, the Family Routines Questionnaire, and the Child Behavior Checklist. Covariance structural modeling was used to assess the variable relationships, with latent constructs created for maternal anxiety/stress, parenting skills, and child problem behaviors (both direct and indirect effects were evaluated, with a model-based bootstrap used to verify model stability). Results demonstrated that maternal stress was negatively associated with a broad range of parenting skills, and that parenting skills were negatively associated with child problem behaviors. Mothers living with HIV who are anxious about their own health and functioning, and who were more stressed in their parental role, were more likely to exhibit poorer parenting skills - specifically to engage children less frequently in family routines (e.g., eating meals together, having a bedtime routine), poorer parent-child communication, and poorer and less consistent parenting discipline. Not uncommonly, mothers living with HIV experience a range of stressors above and beyond those related to their illness (e.g., poverty, residence in high risk and low resource communities, discrimination). Results demonstrate the need for interventions designed to decrease maternal stress and enhance parenting skills for families affected by HIV.

Figure 1

Final Covariance Structural Model of Child Problem Behaviors, with Child/Mother Demographics, Parental Anxiety/Stress, and Parenting Skills as Predictors Note: Initial model did not include covariance between Health Anxiety and RAND MHI Anxiety, nor specific variance path from Parental Stress to Child Behavior Problems. Standardized path parameters are presented. Path parameters with () indicate path was set to 1.00. The disturbance term for Parenting Skills was set at .001. Solid lines indicate significant paths, while dashed lines indicate nonsignificant paths. *p < .05. **p < .01.