Risk factors for mental health difficulties in parents of children with cerebral palsy: a systematic review and meta-analysis

ABSTRACT

Objective

Parents of children with Cerebral Palsy (CP) experience heightened rates of psychological difficulties compared to parents of typically-developing children. There is a lack of understanding of the risk factors for poor parental mental health specific to the early and middle childhood periods. The aim of this review and meta-analysis was to evaluate studies examining risk factors for depression, anxiety and stress in parents of children with CP from birth to 12 years.

Method

Searches of CINAHL, Cochrane Library, InformIT, MEDLINE, PROSPERO and PsycINFO were conducted. Twenty-four studies met inclusion criteria for the review and seven for the meta-analysis

Results

Results highlighted a range of child, family and social risk factors for poor parental mental health. Overall, the quality of studies included was found to be poor and heterogeneity was high. Meta-analytic procedures identified significant relationships between parental stress and child motor functioning (Fisher’s Z = –0.21; log odd ratio = –.54), cognitive functioning (Fisher’s Z = –.32) and social support available to the parent (Fisher’s Z = –.32).

Conclusions

The mental health of parents of children with CP is influenced by child and parent factors, as well as clinical, community and social factors in the early to middle childhood period.

KEY POINTS

(1) The severity of child motor functioning impairments is positively linked to parental mental health in CP populations.

(2) Poor parental coping strategies, low parental self-esteem, high caregiving burden, low parental social support, and parental dissatisfaction with disclosure of diagnosis act as risk factors for poor parental mental health.

(3) The mental health of parents of children with CP is influenced by child and parent factors, as well as clinical, community and social factors in the early to middle childhood period.

KEYWORDS:

• Cerebral palsy
• parental mental health
• risk factors

Disclosure statement

The Deakin Child Study Centre receives philanthropic funding from the Ferrero Group Australia as part of its Kinder Joy of Moving pillar of Corporate Social Responsibility initiatives, MECCA Brands, Wenig Family, Geelong Community Foundation, and Grace & Emilio Foundation and industry partner funding from the Victorian Department of Education, to conduct research in the field of neurodevelopmental disorders and inclusion. The Deakin Child Study Centre has also previously received scholarship funding from the Australian Football League and industry partner funding from the NDIS. NR has received donations from Vic Health and Bus Association Victoria; is a previous speaker honorarium from Novartis (2002), Pfizer (2006), and Nutricia (2007); and is a Director of the Amaze Board (Autism Victoria). None of the companies, industry partners, or organizational bodies listed above had a role in this research including the collection, analysis, and interpretation of data; in writing of the manuscript; and/or in the decision to submit the article for publication.

Additional information

Funding

This work was supported by the Geelong Community Foundation [GCF].