2012 › Trails



Parenting and family factors: The influence of maternal vulnerability and parenting stress on chronic pain in adolescents in a general population sample: the TRAILS study

Authors: Darlington A.S.E., Verhulst F.C., De Winter A., Ormel J., Passchier J., Hunfeld J.A.M.

Chronic pain (i.e. suffering from pain in the last 3 months) in children and adolescents is widespread, with prevalences of up to 25% (Perquin et al., 2000; Huguet and Miro, 2008; Stanford et al., 2008). A majority of them report pain in the absence of an underlying physical condition. Investigating possible pychosocial predictors of unexplained chronic pain in adolescents is crucial in understanding its development and prevention. A general population sample of adolescents (n=2230) from the TRAILS cohort study was investigated longitudinally to assess the influence of maternal vulnerability, in terms of anxiety, depression, stress, and parenting stress at age 10-12 years, on the presence of chronic pain at age 12-15 years. Of these adolescents, 269 (12.9%) reported experiencing chronic pain, of which 77% reported severe chronic pain (> 50 mm on a Visual Analogue Scale). Logistic regression analyses showed that mothers with high levels of anxiety, stress or parenting stress were more likely to have a child with chronic pain than those with low levels. Mediation analyses indicated that parenting stress mediates the effect between maternal anxiety, stress, and chronic pain.
One of the limitations of the study is that even if the data represent a longitudinal investigation we cannot be completely sure of cause and effect relationships, since chronic pain was not measured at both time points in the same way. Further, the role of the father has not been examined in this study, as a potential source of influence on chronic pain.
The strength of the study lies in the large number of adolescents questioned, the longitudinal nature and the elaborate questions posed to them regarding pain. Future studies should thoroughly explore additional factors relating to maternal vulnerability, such as the specific parenting behavior.
Concerning its potential for clinical practice, the findings suggest that interventions to diminish anxiety complaints and parenting stress in the mother may prevent chronic pain in later phases of adulthood.

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Parenting and family factors: Childhood family instability and mental health problems during late adolescence: A test of two mediation models. The TRAILS study

Authors: Bakker MP, Ormel J, Verhulst FC, Oldehinkel AJ.

This study tested whether childhood family instability is associated with mental health problems during adolescence through continued family instability or rather through early onset of mental health problems, using data from a prospective population cohort of 2230 Dutch adolescents. Childhood family instability was associated with both internalizing problems and externalizing problems during late adolescence. The association between childhood family instability and adolescent mental health problems largely disappeared when controlling for early onset of mental health problems but only slightly when controlling for continued family instability during adolescence. These patterns were comparable for both types of mental health problems, but relatively stronger for internalizing problems. Growing up in an unpredictable family environment has longlasting negative mental health effects, most of which are due to early onset of mental health problems. Child health care professionals might achieve better longterm results with these at-risk children when they use individual-based interventions rather than family-based interventions.

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Parenting and family factors: Who Dates? The Effects of Temperament, Puberty, and Parenting on Early Adolescent Experience with Dating: The TRAILS Study

Authors: Ivanova K., Veenstra R., Mills M.

This article focuses on how temperament, pubertal maturation, and perception of parenting behaviors affect the propensity to date in early adolescence (mean age = 13.55). Hypotheses are tested with a representative sample of 2,230 Dutch adolescents, the TRacking Adolescents’ Individual Lives Survey (TRAILS). The results suggest that adolescents are more likely to have experience with dating when they score higher on the need for high-intensity pleasure, pubertal maturation, and perceived parental rejection. Shyness, on the other hand, has the opposite effect. In addition, a moderation effect is observed such that the more rejecting the parents are perceived to be, the less effect the temperament characteristic of high-intensity pleasure has on dating. Future research should investigate in further detail whether dating could be seen as a way for early adolescents to establish their grown-up status or as a way to compensate for heightened parental rejection.

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Parenting and family factors: Symptoms of anxiety in adolescents. Findings from the TRAILS-study

Authors: Oort F.V.A. van, Ormel J., Verhulst F.C.

Background. The Dutch TRAILS-study focuses on the development of youth from early adolescence into adulthood. An important aspect of this development is the development of anxiety. Little was known about typical development of symptoms of anxiety over adolescence. Aim. To describe normative development of anxiety over adolescence, as well as risk indicators for high levels of anxiety. Methods. Studies were imbedded in TRAILS, a large cohort study following children (10y) into adulthood (25y). Results. Our studies show that on average levels of anxiety decrease in early adolescence and subsequently increase in middle or late adolescence, depending on the subtype of anxiety. We found child, parent and peer factors at age 10-12 that were related with higher anxiety levels. Some, e.g., parenting style, were related with higher anxiety only in early adolescence, whereas others, e.g., victim of bullying by peers were related with higher anxiety levels throughout adolescence regardless of stability of victimization. Conclusion. Our studies contribute to a better understanding of normative development of anxiety over adolescence.

The article is in Dutch; here you find the earlier published article in English

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Parenting and family factors: Family environment is associated with HPA-axis activity in adolescents.The TRAILS study

Authors: Marsman R., Nederhof E., Rosmalen J.G.M., Oldehinkel A.J., Ormel J., Buitelaar J.K.

The purpose of the present study was to investigate the developmental programming part of the theory of biological sensitivity to context using family environmental factors and hypothalamus-pituitary-adrenal (HPA) axis functioning. Specifically, we investigated whether perceived parenting (Rejection and Emotional Warmth) and socio-economic status (SES) predicted basal cortisol levels and the cortisol awakening response (CAR). In a population-based cohort of 1594 adolescents (mean age = 11.08, SD = 0.54) we assessed salivary cortisol, SES and perceived parenting. Perceived parental Emotional Warmth showed an inverse, linear association with basal cortisol levels. In addition, there was a curvilinear relationship between SES and both basal cortisol levels and the CAR. Our findings with regard to basal cortisol levels confirmed our hypothesis: lower basal HPA-axis activity in both high and low SES families compared to intermediate SES families.

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Parenting and family factors: The Impact of Parenting Styles on Adolescent Alcohol Use: The TRAILS Study

Authors: Visser L, de Winter AF, Vollebergh WA, Verhulst FC, Reijneveld SA

Aims. To investigate the influence of parenting styles (Overprotection, Emotional Warmth, and Rejection) in early adolescence on regular alcohol use in late adolescence. Methods. We analyzed data from the first three waves (mean ages: 11.09, 13.56 and 16.27 years, respectively) of a population-based prospective cohort study of 2230 adolescents, conducted between 2001 and 2007. Adolescents reported on parental overprotection, emotional warmth, and rejection (T1). Regular alcohol use was defined as six and seven glasses or more a week for girls and boys, respectively. We further assessed family socioeconomic status (SES), parental divorce, parental alcohol use, educational level of the adolescent, and alcohol use at baseline. Results. Parental overprotection had the strongest relationship to regular alcohol use: adolescents who perceived more parental overprotection were at increased risk of developing regular alcohol use, even after adjustment for several confounders. Rejection was not related to adolescents’ alcohol use and, after adjustment for the other variables, neither was emotional warmth. Conclusion. Overprotective parenting is a determinant of future regular adolescent alcohol use and therefore health professionals should pay particular attention to those adolescents who have overprotective parents. The role of adolescent characteristics in the relationship between overprotection and alcohol use deserves further study.

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