Individual and contextual determinants of quality of life in adolescents with congenital heart disease

PURPOSE: An essential goal of health care interventions is to promote quality of life. In line with recent biopsychosocial frameworks emphasizing individual and contextual resources for improving quality of life, the present prospective study aimed at identifying potential determinants of quality of life in a large sample of adolescents with congenital heart disease (CHD). In doing so, the present study focused on parental support, peer support, and sense of coherence (SOC), all representing key psychosocial constructs in adolescence. METHODS: Adolescents with CHD (n at time 1 = 429; 46.6% girls) were assessed twice over a period of 9 months. Cross-lagged analysis from a structural equation modeling approach was used to examine the direction of effects among the study variables, simultaneously controlling for demographic and clinical parameters. RESULTS: Important temporal sequences and developmental pathways were uncovered over time. Perceived health status, SOC, and parental support positively predicted quality of life over time; parental support was also found to positively predict SOC over time. Hence, parental support predicted both directly and indirectly (i.e., through SOC) quality of life over time. Finally, both perceived health status and SOC predicted peer support over time. CONCLUSIONS: The present longitudinal study using a large sample of adolescents with a wide spectrum of congenital heart defects substantially extended our knowledge base on biopsychosocial functioning and quality of life in this population. Both individual and contextual resources need to be taken into account to shed a comprehensive picture of quality of life in adolescents with CHD.status: publishe

Adolescents’ Conflict Management Styles with Mothers : Longitudinal Associations with Parenting and Reactance

Adolescents’ conflict management styles with parents are assumed to have an important impact on the quality of the parent-adolescent relationship and on adolescents’ psychosocial development. Longitudinal research investigating possible determinants of these conflict management skills is scarce. The parenting context and adolescents’ tendency to reject maternal authority are expected to shape adolescents’ conflict management styles. Therefore, the present three-wave longitudinal study focuses on how parenting and adolescents’ reactance relates to adolescents’ conflict management styles and conflict frequency with mothers over time, and whether reactance may also explain the associations between parenting and certain conflict variables. We addressed these research questions by using a hybrid cross-lagged panel model with parenting as a latent variable (i.e., supportive parenting) and the other variables as manifest variables. Supportive parenting was measured by four well-known parenting dimensions: autonomy support, responsiveness, psychological control, and harsh control. Four conflict styles were investigated: positive problem solving, withdrawal, conflict engagement, and compliance. Questionnaires were completed by 812 adolescents at three annual waves (52% girls at Time 1). Supportive parenting was associated with fewer conflicts, more positive problem solving, and less compliance and reactance over time. Reactance was associated with more conflicts, conflict engagement and withdrawal, and less compliance. We did not find evidence for the mediating role of reactance in the over-time associations between parenting and adolescents’ conflict management and frequency. Both parenting and reactance appeared important and unique determinants for adolescents’ conflict management styles and frequency

Adolescents’ Conflict Management Styles with Mothers : Longitudinal Associations with Parenting and Reactance

Adolescents’ conflict management styles with parents are assumed to have an important impact on the quality of the parent-adolescent relationship and on adolescents’ psychosocial development. Longitudinal research investigating possible determinants of these conflict management skills is scarce. The parenting context and adolescents’ tendency to reject maternal authority are expected to shape adolescents’ conflict management styles. Therefore, the present three-wave longitudinal study focuses on how parenting and adolescents’ reactance relates to adolescents’ conflict management styles and conflict frequency with mothers over time, and whether reactance may also explain the associations between parenting and certain conflict variables. We addressed these research questions by using a hybrid cross-lagged panel model with parenting as a latent variable (i.e., supportive parenting) and the other variables as manifest variables. Supportive parenting was measured by four well-known parenting dimensions: autonomy support, responsiveness, psychological control, and harsh control. Four conflict styles were investigated: positive problem solving, withdrawal, conflict engagement, and compliance. Questionnaires were completed by 812 adolescents at three annual waves (52% girls at Time 1). Supportive parenting was associated with fewer conflicts, more positive problem solving, and less compliance and reactance over time. Reactance was associated with more conflicts, conflict engagement and withdrawal, and less compliance. We did not find evidence for the mediating role of reactance in the over-time associations between parenting and adolescents’ conflict management and frequency. Both parenting and reactance appeared important and unique determinants for adolescents’ conflict management styles and frequency

Adolescents' conflict management styles with mothers: Longitudinal associations with parenting and reactance

Adolescents' conflict management styles with parents are assumed to have an important impact on the quality of the parent-adolescent relationship and on adolescents' psychosocial development. Longitudinal research investigating possible determinants of these conflict management skills is scarce. The parenting context and adolescents' tendency to reject maternal authority are expected to shape adolescents' conflict management styles. Therefore, the present three-wave longitudinal study focuses on how parenting and adolescents' reactance relates to adolescents' conflict management styles and conflict frequency with mothers over time, and whether reactance may also explain the associations between parenting and certain conflict variables. We addressed these research questions by using a hybrid cross-lagged panel model with parenting as a latent variable (i.e., supportive parenting) and the other variables as manifest variables. Supportive parenting was measured by four well-known parenting dimensions: autonomy support, responsiveness, psychological control, and harsh control. Four conflict styles were investigated: positive problem solving, withdrawal, conflict engagement, and compliance. Questionnaires were completed by 812 adolescents at three annual waves (52% girls at Time 1). Supportive parenting was associated with fewer conflicts, more positive problem solving, and less compliance and reactance over time. Reactance was associated with more conflicts, conflict engagement and withdrawal, and less compliance. We did not find evidence for the mediating role of reactance in the over-time associations between parenting and adolescents' conflict management and frequency. Both parenting and reactance appeared important and unique determinants for adolescents' conflict management styles and frequency.status: publishe

Adolescents' conflict resolution styles toward mothers: The role of parenting and personality

© 2016, Springer Science+Business Media New York. In the present research, we examined associations between contextual and individual factors and adolescents’ conflict resolution with mothers. In Study 1, we explored links between maternal responsiveness and psychological control and adolescent conflict resolution styles (positive problem solving, conflict engagement, withdrawal, and compliance) with two informants. In Study 2, we examined the unique contribution of adolescents’ personality above and beyond perceived parenting in the prediction of conflict resolution styles. Results of both studies indicated that responsiveness was related positively to problem solving and negatively to withdrawal. Psychological control was positively associated with destructive resolution styles. Study 2 indicated that extraversion predicted more problem solving and conflict engagement, and less withdrawal. Agreeableness predicted more problem solving and less conflict engagement. Finally, certain personality traits moderated associations between parenting and conflict resolution, indicating that some adolescents are more sensitive to these parenting dimensions than others.status: publishe

Adolescents’ Conflict Resolution Styles Toward Mothers : The Role of Parenting and Personality

In the present research, we examined associations between contextual and individual factors and adolescents’ conflict resolution with mothers. In Study 1, we explored links between maternal responsiveness and psychological control and adolescent conflict resolution styles (positive problem solving, conflict engagement, withdrawal, and compliance) with two informants. In Study 2, we examined the unique contribution of adolescents’ personality above and beyond perceived parenting in the prediction of conflict resolution styles. Results of both studies indicated that responsiveness was related positively to problem solving and negatively to withdrawal. Psychological control was positively associated with destructive resolution styles. Study 2 indicated that extraversion predicted more problem solving and conflict engagement, and less withdrawal. Agreeableness predicted more problem solving and less conflict engagement. Finally, certain personality traits moderated associations between parenting and conflict resolution, indicating that some adolescents are more sensitive to these parenting dimensions than others

Adolescents with congenital heart disease: The importance of perceived parenting for psychosocial and health outcomes

OBJECTIVE: : Little is known about how parenting relates to psychosocial functioning and health behavior in adolescents with congenital heart disease (CHD). Different parenting styles were identified through relying on adolescent perceptions of multiple dimensions (regulation, responsiveness, and psychological control). The degree to which parents were perceived as consistent in their rearing style was assessed. METHOD: : Adolescents with CHD were selected from the database of pediatric and congenital cardiology of the University Hospitals Leuven; control individuals were recruited at secondary schools. A total of 429 adolescents (14-18 years) with CHD participated; 403 were matched on gender and age with control individuals. Adolescents completed questionnaires on maternal and paternal regulation, psychological control, and responsiveness. Main outcome measures were depressive symptoms, loneliness, quality of life, health status, alcohol, cigarette, and drug use. RESULTS: : No significant differences emerged between adolescents with CHD and controls in perceived parenting styles. Democratic parenting was accompanied by the most optimal pattern of outcomes in adolescents with CHD, whereas psychologically controlling parenting by the least optimal pattern. Overprotective parenting was related to high patient substance use. Perceiving both parents as democratic turned out most favorably for psychosocial functioning and quality of life, whereas parental consistency was unrelated to substance use in adolescents with CHD. DISCUSSION: : By building bridges between the fields of adolescent medicine and family studies, the present study generated important information on the role of parents in psychosocial and behavioral functioning of adolescents with CHD. Future longitudinal studies could inform family-based interventions for this population.status: publishe

Examining the longitudinal relations among adolescents' conflict management with parents and conflict frequency

© 2017 Elsevier Ltd Parent-adolescent conflicts are not necessarily detrimental for adolescent development. The way adolescents handle conflicts with parents is of crucial importance. The present five-wave longitudinal study (N = 1313) focuses on how adolescents' conflict management behaviors and conflict frequency with parents are interrelated over time. Four conflict management behaviors were investigated: positive problem solving, withdrawal, engagement, and compliance. Using cross-lagged panel analysis, results for conflict behaviors toward mothers indicated that conflict frequency predicted more engagement, withdrawal and compliance, and less positive problem solving one year later. Positive problem solving predicted fewer conflicts and maladaptive conflict management behaviors over time, pointing to the potential protective role of positive problem solving against a conflictual climate and maladaptive management behaviors. Results were largely replicated in the father model. Ancillary multi-group analyses revealed no moderation by gender or age. Suggestions and implications for theory and practice are discussed.status: publishe

Parental Illness Intrusiveness and Youth Glycaemic Control in Type 1 Diabetes: Intergenerational Associations and Processes

Objective: This study examined associations between the functioning of youth with type 1 diabetes and their parents, including parenting dimensions as intervening mechanisms. The study adds to the existing literature by focusing on (1) the concept of parental illness intrusiveness; (2) the (understudied) periods of adolescence and emerging adulthood; and (3) maternal and paternal functioning. Design: Questionnaires were completed by 317 patient-mother dyads and 277 patient-father dyads. All patients (aged 14–25) had type 1 diabetes. The hypothesised model was compared to an alternative model using structural equation modelling. Main Outcome Measures: Youth reported on depressive symptoms and treatment adherence; Physicians provided HbA1c-values. Parents reported on illness intrusiveness, depressive symptoms, and their child’s treatment adherence. Patients and parents reported on psychological control and overprotection. Results: The hypothesised path model had a good fit to the data. Parental illness intrusiveness was positively associated with depressive symptoms and both were positively related to overprotection and psychological control. Psychological control was positively related to patients’ depressive symptoms and negatively to treatment adherence. Poorer treatment adherence was associated with worse HbA1c-values. Conclusion: These findings underscore the relevance of parental illness intrusiveness and emphasise the importance of mothers’ and fathers’ roles throughout adolescence and emerging adulthood.status: publishe