Separating the Effects of Child Problems and Parent-Child Interactions on Caregiver Strain

We used questionnaire data collected at intake from 979 parents and guardians of 6-year-old children to 18-year-old children referred to a private outpatient mental health clinic to build on and extend current views of caregiver strain and its relationship to children's behavioral and emotional problems. First, we offered evidence for the validity of a measure of attachment strain, referring to strains in caregivers' positive feelings towards their child; and second, we assessed whether parent-child interactions might help to account for robust relationships between child problems and caregiver strain identified in prior studies. Findings were consistent with our conceptualization of attachment strain as distinct from but related to dimensions of strain identified in prior research, and as an especially severe, outwardly directed form of subjective strain associated with caring for a child with especially severe problems in behavioral and emotional regulation. Multiple regression analysis showed that child problems and parent-child interactions accounted for 31 to 42 % of the total variance in caregiver strain. Commonality analysis indicated that approximately half of the explained variance in each dimension was "shared." The unique contribution of child problems, however, overshadowed the unique contribution of parent-child interactions in predicting objective and subjective internalized strain whereas the opposite was true for subjective externalized and attachment strain. We suggest that child-problem-focused treatment strategies may be especially helpful in addressing caregivers' objective and subjective internalized strain whereas strategies designed to improve the quality of parent-child interactions may be especially helpful in alleviating caregivers' subjective, outwardly directed experiences of strain.