Associations Between Maternal Caregiving and Child Indicators of Toxic Stress Among Multiethnic, Urban Families.
Eileen M Condon, Margaret L Holland, Arietta Slade and 3 others
PMID 30683581WHAT IT FOUND
In 54 low-income families, mothers who reported less ability to think about their child’s mind had children with more behavior problems, hospitalizations, surgeries and learning difficulties.
Hostile parenting was also linked to more behavior problems. These are associations, not proof.
Key findings
01Hostile/coercive parenting was associated with higher total behavior problems and higher log-transformed externalizing behavior problems in children.
02Mothers who reported prementalizing modes, such as assuming a child is deliberately annoying, had children with more behavior problems and higher odds of hospitalization, surgery and learning problems.
03Mothers who reported neither too much nor too little certainty about their child’s mental states had children with fewer emergency department visits.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study included only 54 low-income families from the control group of an early home visiting trial, so it may not represent other families. It was cross-sectional, so it cannot show that parenting caused toxic stress, behavior problems or biomarker differences. The researchers did not adjust for multiple comparisons, so some significant associations could be false positives. Caregiving and child health and behavior were mostly parent self-report, and some scales had low reliability or limited variance. The Certainty about Mental States subscale had low reliability (α=.44), and supportive/engaged parenting scores had very limited variance. Biomarker analyses had missing data and possible confounders: 41 hair samples were analysed, salivary cytokines N=51 and CRP N=50, and hair cortisol varied by hair shape and washing frequency. There are no standardized pediatric reference ranges for hair and salivary biomarkers, so absolute levels are hard to interpret. A single investigator collected all biomarkers and anthropometric measures. This may have introduced measurement bias.
Declared interests
The article is tagged as supported by NIH extramural and non-U.S. government research support. The authors report no conflicts of interest.
The easy way to misread this
Do not conclude that parenting style causes toxic stress or changes inflammatory markers. This small cross-sectional study found associations, several correlations were not significant in regression models, and the caregiving measures were self-report with low reliability in some subscales.