Family Stress Associated with Cerebral Palsy

Abstract

The caregiving demands faced by parents of children with cerebral palsy may elevate their risk of stress-related health outcomes. We reviewed 44 empirical studies of family stress in the context of cerebral palsy that were published from 1987 to 2017. We examined the relationship of caregiver status and child disability severity with caregiver stress and stress-related outcomes such as mental and physical health. Compared to parents of typically developing children, parents of children with cerebral palsy experienced greater stress, lower psychological well-being, and worse physical health. Disability severity was not as clearly linked with stress outcomes as expected, suggesting that important moderator variables may play a role in this relation. Several moderator and mediator variables emerged across studies, including characteristics of the child (e.g., social, physical, and behavioral factors), parent (e.g., personal and social resources), and family resources (e.g., coping norms, socioeconomic status, and access to respite care services). Although little research currently exists examining the effectiveness of psychosocial interventions for parents of children with cerebral palsy, the existing evidence suggests that the greatest benefits caregivers derive from support groups may stem primarily from the provision of practical and informational support and by facilitating self-efficacy and social network size. Future research should further elucidate the essential qualities of effective psychosocial interventions and should utilize longitudinal rather than cross-sectional designs when possible in order to better understand how caregiver health, coping, and family adaptation processes unfold over time.