Self-Reported Psychosocial Stress in Parents With Small Children

Abstract

sychosocial stress, especially adverse childhood experiences, is disproportionately likely to influence child development in negative ways and often leads to risky health behavior, such as substance abuse, increased burden of disease and increased healthcare costs (1). In Germany, a retrospective survey showed that difficulties in the parental home as well as violence and deprivation experiences were associated with an increased likelihood of depression, anxiety, physical aggression, and low life satisfaction as an adult (2). While international studies identified several additional types of psychosocial stress associated with an increased risk of developmental abnormalities (3-8), reliable prevalence estimates for Germany are available only for a few of these stressors and risks (9).Knowledge of the significance of individual adverse psychosocial factors in the highly sensitive first period of life may be useful to develop approaches to prevention strategies. Currently, there is no reliable data on how many of the families with children who participate in the statutory child development checks suffer from psychosocial stress. On the side of the child, these characteristics can, for example, include negative emotionality, and on the side of the parents, parenting stress or, with regard to the family, frequent quarrels. In terms of targeting prevention services to young parents, this is important information. Parents' subjective experience of psychosocial stress is a key criterion when it comes to taking the initiative for participating in prevention programs; thus, prevalence rates can be used to estimate the need for prevention. Over 99% of parents attend the child development checks (10), reflecting their high level of trust in pediatricians. Therefore, child development checks do not only provide an opportunity to detect biomedical diseases and monitor progress in the child's development, but also to gain a first impression of the overall situation in the family (11)(12)(13)(14). While in the United States an overall concept for pediatricians has already been developed and evaluated which is designed to enable early identification and support of families experiencing psychosocial stress (15), in Germany a pediatric assessment form for the evaluation of psychosocial support needs ("pädiatrischer Anhaltsbogen") is available to be used during the U3 to U6 child development checks SummaryBackground: Psychosocial stress in early childhood can impair children's health and development. Data on the prevalence of psychosocial stress in families with infants and toddlers in Germany are lacking. Such data could be used to determine the need for prevention and to plan the appropriate preventive measures.Methods: In 2015, a representative cross-sectional study called Kinder in Deutschland-KiD 0-3 was conducted by questionnaire in pediatricians' practices across Germany. Parents taking their children to the U3-U7a child development checks were asked to self-report information about stress in their families. The data were an...

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