Parental post-traumatic stress, overprotective parenting, and emotional and behavioural problems for children with critical congenital heart disease

Abstract

Objective: To examine relationships amongst parental post-traumatic stress symptoms, parental post-traumatic growth, overprotective parenting, and child emotional/behavioural problems in families of children with critical CHD.

Method: Sixty parents (15 fathers) of children aged 1-6 completed online questionnaires assessing parental post-traumatic stress symptoms and post-traumatic growth, overprotective parenting, and child emotional/behavioural problems. Bivariate correlations and mediational analyses were conducted to evaluate overprotective parenting as a mediator of the association between parental post-traumatic stress symptoms and child emotional/behavioural problems.

Results: Parents reported significant post-traumatic stress symptoms, with over 18% meeting criteria for post-traumatic stress disorder and 70% meeting criteria in one or more clusters. Parental post-traumatic growth was positively correlated with intrusion (r = .32, p = .01) but it was not associated with other post-traumatic stress symptom clusters. Parental post-traumatic stress symptoms were positively associated with overprotective parenting (r = .37, p = .008) and total child emotional/behavioural problems (r = .29, p = .037). Overprotective parenting was positively associated with total child emotional/behavioural problems (r = .45, p = .001) and fully mediated the relationship between parental post-traumatic stress symptoms and child emotional/behavioural problems.

Conclusion: Overprotective parenting mediates the relationship between parental post-traumatic stress symptoms and child emotional and behavioural problems in families of children with CHD. Both parental post-traumatic stress symptoms and overprotective parenting may be modifiable risk factors for poor child outcomes. This study highlights the need for interventions to prevent or reduce parental post-traumatic stress symptoms and to promote effective parenting following a diagnosis of CHD.

Keywords: Congenital heart disease; neurodevelopmental outcomes; overprotective parenting; post-traumatic stress; post-traumatic stress disorder.

Figure 1.

Mediation of overprotective parenting on the relationship between parental PTSS and child emotional/behavioural problems. N = 52. *p < .05. **p < .01. PTSS = post-traumatic stress symptoms. Child age was included as a covariate in the model. a = total effect of parental PTSS on overprotective parenting. b = total effect of overprotective parenting on child emotional/behavioural problems, controlling for parental PTSS. ab = completely standardised indirect effect of parental PTSS on child emotional/behavioural problems. c = total effect of parental PTSS on child emotional/behavioural problems (sum of direct and indirect effects). c’ = direct effect of parental PTSS on child emotional/behavioural problems.