title: Parental stress and parent-rated child behavior in relation to otitis media in the first three years of life.
abstract: OBJECTIVE
  As part of a long-term study of possible effects of early-life otitis media on speech, language, cognitive, and psychosocial development, we tested relationships between parents' ratings of parent-child stress at ages 1, 2, and 3 years, and of their children's behavior problems at ages 2 and 3 years, and the children's cumulative duration of middle-ear effusion (MEE) in their first 3 years of life.
  
  
  METHODS
  We enrolled healthy infants by age 2 months who presented for primary care at 1 of 2 urban hospitals or 1 of 2 small-town/rural and 4 suburban private pediatric practices. We obtained standardized baseline measures of parental stress; we intensively monitored the children's middle-ear status by pneumatic otoscopy, supplemented by tympanometry, throughout their first 3 years of life; we monitored the validity of the otoscopic observations on an ongoing basis; and we treated children for otitis media according to specified guidelines. We obtained parent ratings of parental stress using the Parenting Stress Index/Short Form when the children reached ages 1, 2, and 3 years, and parent ratings of children's behavior using the Child Behavior Checklist when the children reached ages 2 and 3 years.
  
  
  RESULTS
  In 2278 children we found no substantial relationships between parents' ratings of parent-child stress when the children reached ages 1, 2, and 3 years, or of their children's behavior problems at ages 2 and 3 years, and the cumulative duration of the children's MEE during antecedent periods. On the other hand, ratings both of parent-child stress and of behavior problems were consistently highest among the most socioeconomically disadvantaged children and lowest among the most socioeconomically advantaged children. Ratings also tended to be highest among children whose parents' baseline stress scores were highest.
  
  
  CONCLUSIONS
  Parent-child stress and children's behavior problems in the first 3 years of life, as rated by parents, bear little or no relationship to the children's previous cumulative duration of MEE.
authors.affiliation: Department of Pediatrics, University of Pittsburgh School of Medicine. PA, USA. jpart@pitt.edu
authors.forename: J L
authors.initials: JL
authors.lastname: Paradise
authors.forename: H M
authors.initials: HM
authors.lastname: Feldman
authors.forename: D K
authors.initials: DK
authors.lastname: Colborn
authors.forename: T F
authors.initials: TF
authors.lastname: Campbell
authors.forename: C A
authors.initials: CA
authors.lastname: Dollaghan
authors.forename: H E
authors.initials: HE
authors.lastname: Rockette
authors.forename: J E
authors.initials: JE
authors.lastname: Janosky
authors.forename: M
authors.initials: M
authors.lastname: Kurs-Lasky
authors.forename: B S
authors.initials: BS
authors.lastname: Bernard
authors.forename: C G
authors.initials: CG
authors.lastname: Smith
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002652:Child Behavior / Q000523:psychology*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation; D010033:Otitis Media / Q000523:psychology* / Q000628:therapy; D010290:Parents / Q000523:psychology*; D010414:Pennsylvania; D011446:Prospective Studies; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000523:psychology*; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents