Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun 3;46(5):588-598.
doi: 10.1093/jpepsy/jsab004.

Distress Trajectories for Parents of Children With DSD: A Growth Mixture Model

Megan N Perez  1 , Ashley H Clawson  1 , Marissa N Baudino  1 , Paul F Austin  2 , Laurence S Baskin  3 , Yee-Ming Chan  4 , Earl Y Cheng  5 , Douglas Coplen  6 , David A Diamond  7 , Allyson J Fried  8 , Thomas Kolon  9 , Bradley Kropp  10 , Yegappan Lakshmanan  11 , Theresa Meyer  5 , Natalie J Nokoff  12 , Blake W Palmer  10 , Alethea Paradis  6 , Dix P Poppas  13 , Kristy J Scott Reyes  10 , Pierre Williot  8 , Cortney Wolfe-Christensen  10 , Elizabeth B Yerkes  5 , Amy B Wisniewski  1 , Larry L Mullins  1
Affiliations

Distress Trajectories for Parents of Children With DSD: A Growth Mixture Model

Megan N Perez et al. J Pediatr Psychol. .

Abstract

Objective: This study identifies trajectories of parent depressive symptoms after having a child born with genital atypia due to a disorder/difference of sex development (DSD) or congenital adrenal hyperplasia (CAH) and across the first year postgenitoplasty (for parents who opted for surgery) or postbaseline (for parents who elected against surgery for their child). Hypotheses for four trajectory classes were guided by parent distress patterns previously identified among other medical conditions.

Methods: Participants included 70 mothers and 50 fathers of 71 children diagnosed with a DSD or CAH with reported moderate to high genital atypia. Parents were recruited from 11 US DSD specialty clinics within 2 years of the child's birth and prior to genitoplasty. A growth mixture model (GMM) was conducted to identify classes of parent depressive symptoms over time.

Results: The best fitting model was a five-class linear GMM with freely estimated intercept variance. The classes identified were termed "Resilient," "Recovery," "Chronic," "Escalating," and "Elevated Partial Recovery." Four classes have previously been identified for other pediatric illnesses; however, a fifth class was also identified. The majority of parents were classified in the "Resilient" class (67.6%).

Conclusions: This study provides new knowledge about the trajectories of depressive symptoms for parents of children with DSD. Future studies are needed to identify developmental, medical, or familial predictors of these trajectories.

Keywords: DSD; differences of sex development; intersex; parents; psychological distress; psychosocial.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Plot of Participant Raw Scores.
Figure 2.
Figure 2.
Growth mixture models of parent depressive symptoms.
See this image and copyright information in PMC

References

    1. Asparouhov T., Muthén B. (2014). Auxiliary variables in mixture modeling: Using the BCH method in Mplus to estimate a distal outcome model and an arbitrary secondary model. Mplus Web Notes, 21(2), 1–22.
    1. Beck A. T., Steer R. A., Brown G. K. (1996). Manual for the Beck Depression Inventory-II. Psychological Corporation.
    1. Berlin K. S., Williams N. A., Parra G. R. (2014a). An introduction to latent variable mixture modeling (Part 1): Overview and cross-sectional latent class and latent profile analyses. Journal of Pediatric Psychology, 39(2), 174–187. 10.1093/jpepsy/jst084 - DOI - PubMed
    1. Berlin, K. S., Williams, N. A., & Parra, G. R. (2014b). An introduction to latent variable mixture modeling (Part 2): Overview and cross-sectional latent class and latent profile analyses. Journal of Pediatric Psychology, 39(2), 174–187. http://doi.org/10.1093/jpepsy/jst085 - DOI - PubMed
    1. Crissman H. P., Warner L., Gardner M., Carr M., Schast A., Quittner A. L., Kogan B., Sandberg D. E. (2011). Children with disorders of sex development: A qualitative study of early parental experience. International Journal of Pediatric Endocrinology, 2011(1), 10.10.1186/1687-9856-2011-10 - DOI - PMC - PubMed

Publication types