Abstract
Childhood chronic illness is associated with deleterious effects on caregivers’ mental health and children’s socio-emotional development. This study investigated the mediation role of caregivers’ mental health on the association between children’s chronic illness and internalizing and externalizing behavioral problems in a sample of low-SES Brazilian families. Participants comprised 111 primary caregivers of 113 children aged between 7 and 11 years. A sample of 57 caregivers of children with chronic illness and a comparison group of 54 caregivers of healthy children were assessed regarding the following variables: family SES (Hollingshead criteria); caregivers’ sleep disturbances (PSQI), common mental disorders symptoms (SRQ-20); stress (LISS); and children’s internalizing and externalizing problems (CBCL/6-18). The chronic illness group scored higher than the healthy group in all the assessed variables, with the exception of the externalizing problems variable. Moreover, caregivers’ mental health problems presented positive correlations with children’s behavior problems and negative correlations with family SES. Using SEM, mediation analyses revealed a unidimensional latent variable, caregiver mental health problems, which mediated the relationship between children’s chronic illness and their behavior problems. Children’s chronic illness was associated with higher levels of mental health problems in caregivers, which in turn was linked to children’s higher externalizing and internalizing problems. Psychosocial intervention and policies addressing caregivers’ mental health and financial support to low-income families may benefit the socio-emotional development of chronically ill children.
Highlights
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Caregivers’ mental health problems mediated the association between children’s chronic illnesses and internalizing problems.
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Caregivers’ mental health problems mediated the association between children’s chronic illnesses and externalizing problems.
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Children’s chronic illnesses were associated with higher levels of caregivers’ mental health problems, which were linked to higher scores of internalizing and externalizing problems.
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The social vulnerability was associated with mental health problems in caregivers with and without chronically ill children.
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The authors would like to thank the participants of this study and the professionals of the Professor Edgar Santos University Hospital (HUPES) and of the Hercilia Moreira and Oswaldo Cruz elementary schools.
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This work was supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil [National Council for Scientific and Technological Development], (Master Scholarship, grant number 133588/2017-3, to the first author).
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The study conception and design, material preparation, and data collection and analyses were performed by A.C.S.S. and P.A. L.B. contributed to the data interpretation and critically revised the manuscript. E.J.M.F. performed data analyses and discussion. All authors read and approved the final manuscript.
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Silva, A.C.S., Alvarenga, P., Barros, L. et al. Chronic Illness and Child Behavior Problems in Low-SES Families: The Mediation of Caregivers’ Mental Health. J Child Fam Stud 31, 2594–2607 (2022). https://doi.org/10.1007/s10826-022-02317-x
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DOI: https://doi.org/10.1007/s10826-022-02317-x