父母的悲痛及教养方式对丧亲兄弟姐妹外化问题的影响。
The Influence of Parent Distress and Parenting on Bereaved Siblings' Externalizing Problems.
作者信息
Howard Sharp Katianne M, Meadows Emily A, Keim Madelaine C, Winning Adrien M, Barrera Maru, Gilmer Mary Jo, Akard Terrah Foster, Compas Bruce E, Fairclough Diane L, Davies Betty, Hogan Nancy, Vannatta Kathryn, Gerhardt Cynthia A
机构信息
The Research Institute at Nationwide Children's Hospital, The Ohio State University, Columbus, OH.
University of Toledo, Toledo, OH.
出版信息
J Child Fam Stud. 2020 Apr;29(4):1081-1093. doi: 10.1007/s10826-019-01640-0. Epub 2019 Dec 10.
OBJECTIVES
Bereaved siblings experience more externalizing problems compared to non-bereaved peers and norms; however, the mechanisms explaining this phenomenon have not been empirically examined. This study tested the serial indirect effects of sibling bereavement on adolescents' externalizing problems through parent distress (i.e., internalizing symptoms) and parenting (i.e., parenting behaviors, parent-adolescent communication).
METHODS
During home visits, 72 bereaved adolescents (ages 10-18) whose brother/sister died from cancer and 60 comparison peers reported about their externalizing problems and their mothers' and fathers' parenting behaviors (warmth, behavioral control, psychological control) and parent-adolescent communication (open communication, problematic communication). Mothers and fathers reported their own internalizing symptoms.
RESULTS
Bereaved siblings reported more externalizing problems ( =.048) and bereaved mothers reported more internalizing symptoms relative to the comparison group ( =.015). Serial multiple mediation models indicated that elevated externalizing problems were partially explained by both bereaved mothers' internalizing symptoms and parenting and communication (less warmth [CI: 0.04, 0.86], more psychological control [CI: 0.03, 0.66], and more problematic mother-adolescent communication [CI: 0.03, 0.79]), with a significant indirect effect also emerging for open mother-adolescent communication [CI: 0.05, 1.59]. Bereaved fathers did not significantly differ in internalizing symptoms from comparison fathers ( =.453), and no significant indirect effects emerged for fathers.
CONCLUSIONS
Elevated externalizing problems in bereaved siblings may result from mothers' distress and the impact on their parenting and communication. Targeting adjustment and parenting in bereaved mothers following a child's death may reduce externalizing problems in bereaved siblings. Research to evaluate family-centered interventions is needed.
目的
与未经历丧亲之痛的同龄人及正常水平相比，经历丧亲之痛的兄弟姐妹会出现更多外化问题；然而，解释这一现象的机制尚未得到实证检验。本研究通过父母痛苦（即内化症状）和养育方式（即养育行为、亲子沟通）来检验兄弟姐妹丧亲对青少年外化问题的系列间接影响。
方法
在家庭访视期间，72名兄弟姐妹死于癌症的丧亲青少年（年龄10 - 18岁）以及60名对照同龄人报告了他们的外化问题、父母（母亲和父亲）的养育行为（温暖、行为控制、心理控制）以及亲子沟通（开放沟通、问题沟通）情况。母亲和父亲报告了他们自己的内化症状。
结果
与对照组相比，丧亲的兄弟姐妹报告了更多的外化问题（ = 0.048），丧亲的母亲报告了更多的内化症状（ = 0.015）。系列多重中介模型表明，丧亲母亲的内化症状、养育方式和沟通方式（较少的温暖[置信区间：0.04，0.86]、更多的心理控制[置信区间：0.03，0.66]以及更多有问题的母子沟通[置信区间：0.03，0.79]）部分解释了外化问题的增加，开放的母子沟通也产生了显著的间接影响[置信区间：0.05，1.59]。丧亲父亲在内化症状方面与对照父亲没有显著差异（ = 0.453），父亲方面也没有出现显著的间接影响。
结论
丧亲兄弟姐妹外化问题的增加可能是由于母亲的痛苦及其对养育方式和沟通的影响。针对孩子死亡后丧亲母亲的调整和养育方式进行干预，可能会减少丧亲兄弟姐妹的外化问题。需要开展研究来评估以家庭为中心的干预措施。
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