title: The Role of Maternal Distress in the Report of Behavioral and Emotional Problems among Children with Chronic Disabilities.
abstract: BACKGROUND
  Assessments of psychological symptoms in children often rely on caregivers' (usually mothers') reports. However, the reliability may be affected by the caregivers' own emotional distress (ED). The main objectives of this study were to assess the variability in ED of mothers of children with chronic physical disabilities, and its association with the ratings of their children's emotional and behavioral problems.
  
  
  METHODS
  Medical data of children diagnosed with chronic disabilities were analyzed (N = 72). Mothers completed the 12-item General Health Questionnaire (12-GHQ) to measure ED and the Child Behavior Checklist (CBCL) to assess children's emotional and behavioral problems Mothers' ED scores were compared with communitybased counterparts with similar socio-demographic characteristics (N = 657) from the Israel National Health Survey (INHS).
  
  
  RESULTS
  Mothers of children with chronic physical disabilities had higher levels of ED compared to mothers in the general population. About 20% of the sample mothers had 12-GHQ scores compatible with DSM- IV depression or anxiety disorders. No differences in ED were found according to the type of child's disability or IQ score. Marked differences in CBCL scores were reported by mothers with high versus low ED, controlling for baseline maternal and child characteristics.
  
  
  CONCLUSIONS
  High levels of maternal ED were associated with mothers' reports on child's behavioral and emotional problems.This may contaminate the reliability of parental reports on their child's psychological state.
authors.affiliation: Department of Psychology, Bar-Ilan University, Ramat Gan, Israel School of Behavioral Sciences, Tel Aviv-Yaffo Academic College, Israel.
authors.forename: Tamar
authors.initials: T
authors.lastname: Silberg
authors.affiliation: Edmond and Lily Safra Children's Hospital, Tel Hashomer Medical Center, Ramat Gan, Israel.
authors.forename: Amichai
authors.initials: A
authors.lastname: Brezner
authors.affiliation: School of Behavioral Sciences, Tel Aviv-Yaffo Academic College, Israel.
authors.forename: Gilad
authors.initials: G
authors.lastname: Gal
authors.affiliation: Edmond and Lily Safra Children's Hospital, Tel Hashomer Medical Center, Ramat Gan, Israel.
authors.forename: Jaana
authors.initials: J
authors.lastname: Ahonniska-Assa
authors.affiliation: Edmond and Lily Safra Children's Hospital, Tel Hashomer Medical Center, Ramat Gan, Israel Child Development Center, Kupat Holim Leumit, Jerusalem, Israel.
authors.forename: Miriam
authors.initials: M
authors.lastname: Levav
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology*; D002648:Child; D002653:Child Behavior Disorders / Q000523:psychology*; D016241:Child of Impaired Parents / Q000523:psychology*; D003866:Depressive Disorder / Q000523:psychology*; D019988:Children with Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D009035:Mothers / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*