Blanchet Brynna H, Hayes Timothy, Gillenson Caroline, Neuman Keara, Heymann Perrine, Comer Jonathan S, Bagner Daniel M
Department of Psychology, Center for Children and Families, Florida International University.
J Clin Child Adolesc Psychol. 2024 Mar 21:1-12. doi: 10.1080/15374416.2024.2317409.
Child behavior problems have been shown to contribute to caregiver distress and vice versa among youth with developmental delay (DD). However, studies have not examined these associations among children and caregivers from underrepresented ethnic/racial backgrounds. Furthermore, research has not explored how associations function differently following internet-delivered treatment or based on the level of acculturation and enculturation.
We examined bidirectional associations between caregiver distress (i.e. symptoms of depression, anxiety, and stress) and externalizing and internalizing behavior problems in 3- to 5-year-old children with DD from underrepresented ethnic/racial backgrounds. We also examined the impact of internet-delivered Parent-Child Interaction Therapy (iPCIT) and the moderating role of acculturation and enculturation on these bidirectional associations.
Children aging out of early intervention services ( = 150) and their primary caregiver were randomized to receive iPCIT or referrals as usual (RAU) in the community.
Findings provide support for bidirectional associations between child internalizing behavior problems and caregiver depressive symptoms, although there were fewer significant associations among families randomized to iPCIT compared to RAU. Weaker associations were observed among families with higher levels of enculturation, whereas stronger associations were observed among families with higher levels of acculturation.
Results highlight a sensitive period from age 3.5 to 4 years old for bidirectional associations between caregiver distress and child behavior problems and highlight the importance of addressing family cultural values during treatment. Findings also suggest the utility of internet-delivered behavioral parenting interventions in weakening the effect of child behavior problems on caregiver distress and vice versa.
在发育迟缓（DD）的青少年中，儿童行为问题已被证明会导致照顾者困扰，反之亦然。然而，研究尚未考察来自代表性不足的种族/民族背景的儿童及其照顾者之间的这些关联。此外，研究尚未探讨在接受互联网治疗后或根据文化适应和文化传承水平，这些关联的作用方式有何不同。
我们研究了来自代表性不足的种族/民族背景的3至5岁发育迟缓儿童的照顾者困扰（即抑郁、焦虑和压力症状）与外化和内化行为问题之间的双向关联。我们还研究了互联网提供的亲子互动疗法（iPCIT）的影响以及文化适应和文化传承对这些双向关联的调节作用。
即将结束早期干预服务的儿童（n = 150）及其主要照顾者被随机分配接受iPCIT或社区常规转诊（RAU）。
研究结果支持儿童内化行为问题与照顾者抑郁症状之间的双向关联，尽管与RAU组相比，随机接受iPCIT的家庭中显著关联较少。在文化传承水平较高的家庭中观察到的关联较弱，而在文化适应水平较高的家庭中观察到的关联较强。
结果突出了3.5至4岁这一照顾者困扰与儿童行为问题之间双向关联的敏感期，并强调了在治疗过程中考虑家庭文化价值观的重要性。研究结果还表明，互联网提供的行为养育干预措施有助于减弱儿童行为问题对照顾者困扰的影响，反之亦然。
