title: Parental stress and growth outcome in growth-deficient children.
abstract: OBJECTIVE
  In order to examine the relationship between parental stress, child psychosocial factors, anemia, lead poisoning, and growth deficiency (GD), 48 children attending a GD referral program were recruited consecutively and matched with 50 comparison subjects from a primary care program.
  
  
  METHODS
  Parents completed the Parenting Stress Index (PSI) with subscales and provided demographic data. Children received developmental screening, hemoglobin levels, Pb levels, and growth evaluation. They also received medical evaluation for GD. T tests were used to evaluate group differences. Spearman Rho correlation analyses were computed between group coefficients and PSI scales, Pb, and hemoglobin levels.
  
  
  RESULTS
  No differences were found on the PSI with regard to overall parental stress. GD parents perceived themselves as less competent (P < .001), and their children as less adaptable (P < .006). They also reported more social isolation (P < .05). The GD group had more anemia and Pb poisoning (P < .002 and P < .001, respectively); however, these variables were not related to differences in child adaptability or growth outcome. A high sense of parental competence and high child adaptability were associated with improved growth outcomes (P < .001 and P < .02, respectively).
  
  
  CONCLUSIONS
  We conclude that parents of GD children seen in an outpatient referral setting show no difference in overall perceived stress levels versus comparison subjects. Increased parental competence and child adaptability are strongly associated with improved growth outcome. Decreased child adaptability may contribute to GD pathology. These findings challenge the traditional view of GD etiology.
authors.affiliation: Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
authors.forename: W G
authors.initials: WG
authors.lastname: Bithoney
authors.forename: M M
authors.initials: MM
authors.lastname: Van Sciver
authors.forename: S
authors.initials: S
authors.lastname: Foster
authors.forename: S
authors.initials: S
authors.lastname: Corso
authors.forename: C
authors.initials: C
authors.lastname: Tentindo
mesh_terms: D000223:Adaptation, Psychological; D000740:Anemia / Q000150:complications; D016022:Case-Control Studies; D002648:Child; D006130:Growth Disorders / Q000150:complications / Q000523:psychology*; D006801:Humans; D007855:Lead Poisoning / Q000150:complications; D010290:Parents / Q000523:psychology*; D011446:Prospective Studies; D012934:Social Isolation; D013315:Stress, Psychological