Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy.
Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Viale Europa 115, 47023 Cesena, Italy.
Int J Environ Res Public Health. 2021 May 4;18(9):4902. doi: 10.3390/ijerph18094902.
Parental chronic illness may adversely impact youth and family functioning. This study examined a moderated mediation model of the effects of parental illness on youth and family functioning derived from the Family Ecology Framework. Consistent with this model, we predicted that youth caregiving and stress would serially mediate the adverse impacts of parental illness on youth adjustment and family functioning and that psychological flexibility would moderate these mediational mechanisms. A total of 387 youth, with parents affected by chronic illness, completed a questionnaire assessing parental illness severity, youth caregiving and stress, psychological flexibility, youth adjustment (i.e., internalizing and externalizing problems and psychological wellbeing), and family functioning. Path analyses indicated that the adverse effects of parental illness on youth adjustment and family functioning were serially mediated by youth caregiving and stress. Psychological flexibility buffered the adverse effects of these serial mediators on youth internalizing problems and psychological wellbeing. These findings identified three potential intervention targets: youth caregiving, related stress appraisals, and psychological flexibility. Given the large body of evidence showing that acceptance and commitment therapy fosters psychological flexibility, this intervention approach has the potential to address the psychosocial and mental health vulnerabilities of youth in the context of parental illness, which constitutes a serious public health issue.
父母的慢性疾病可能会对青少年和家庭功能产生不利影响。本研究从家庭生态框架出发，检验了父母疾病对青少年和家庭功能影响的一个被调节的中介模型。根据这一模型，我们预测父母疾病对青少年适应和家庭功能的负面影响将通过青少年的照顾和压力来串联中介，而心理灵活性将调节这些中介机制。共有 387 名患有慢性疾病的父母的青少年完成了一份问卷，评估了父母疾病的严重程度、青少年的照顾和压力、心理灵活性、青少年的适应（即内化和外化问题以及心理健康）以及家庭功能。路径分析表明，父母疾病对青少年适应和家庭功能的负面影响是通过青少年的照顾和压力来串联中介的。心理灵活性缓冲了这些串联中介对青少年内化问题和心理健康的负面影响。这些发现确定了三个潜在的干预目标：青少年照顾、相关压力评估和心理灵活性。鉴于大量证据表明接受和承诺疗法促进了心理灵活性，这种干预方法有可能解决父母患病背景下青少年的社会心理和心理健康脆弱性问题，这是一个严重的公共卫生问题。
