The study enrolled 214 clinically referred young people between the ages of 12 and 24, with an average age of just under 17, along with one of their parents. Nearly three-quarters of the youth participants were female, a composition that reflects the well-documented overrepresentation of girls in clinical settings treating self-harm and suicidality. What distinguishes this work from much of the existing literature is its multi-informant design: researchers gathered data from both the young people and their parents rather than relying on a single perspective. This matters because adolescents and parents often perceive the same relationship in strikingly different ways, and cross-checking reports provides a more robust foundation for statistical modeling than either voice alone.

The team focused on two core dimensions of relationship quality drawn from the Network of Relationships Inventory, a validated instrument that measures behavioral systems within close relationships: negative interactions, encompassing conflict, criticism, and antagonism, and perceived support, the sense of being cared for and understood. Their central question was whether suicidal behavior in youth tracks with these relational dynamics, and whether parental sense of competence, assessed with a validated parenting questionnaire, moderates the association. Statistically, the researchers employed a moderated moderation model, a form of multiple regression within the conditional process analysis framework that allows one variable to change the strength of a relationship that is itself conditioned on another. This approach, popularized in the methodological literature by Andrew Hayes, permits researchers to detect conditional effects that would be invisible in simpler correlational analyses.

The first headline finding is sobering but perhaps unsurprising: youth suicidal behavior was positively associated with negative interactions in the parent-child relationship. In other words, the more conflict, criticism, and friction young people experienced at home, the more likely they were to report suicidal thoughts and behaviors. This aligns with a substantial body of theory, most notably the interpersonal theory of suicide developed by Thomas Joiner and colleagues, which posits that thwarted belongingness, the feeling of being disconnected from meaningful relationships, is a proximal driver of suicidal desire. The family is typically the most important belongingness context in adolescence, so it makes theoretical sense that corrosive interactions within it would be tightly linked to suicidal processes.

The second finding was more unexpected. Suicidal behavior was not associated with perceived support in relationship quality. Many clinicians and family theorists have assumed that low support is a key relational correlate of youth suicidality, but in this clinical sample, the data did not bear that out. The authors suggest this may reflect the complexity of support dynamics in families dealing with suicidal behavior: parents of suicidal youth often intensify their supportive efforts, while distressed adolescents may struggle to perceive or absorb that support even when it is offered. Support, in other words, may be necessary but not sufficient, and its absence may matter less than the presence of active negativity.

The most striking result, however, concerned moderation, and it came with a twist involving parental gender. For mothers, parental sense of competence significantly moderated the association between youth suicidal behavior and negative interactions. When mothers reported low confidence in their parenting abilities, the link between their child’s suicidal behavior and negative interactions was markedly stronger. When mothers felt more competent, that link was attenuated, suggesting that a mother’s self-assurance can dampen, though not eliminate, the corrosive coupling between suicidality and family conflict. For fathers, no such moderation emerged, a gender difference the researchers flag as an important consideration for future work. The authors interpret this pattern as evidence that parental sense of competence may function as a buffer, protecting the parent-child relationship from spiraling into escalating negativity even under the enormous stress of a child’s suicidal crisis.

The theoretical logic behind this buffering effect draws on decades of research into parental self-efficacy, a construct rooted in Albert Bandura’s social cognitive theory. Studies stretching back to the 1990s have shown that parents with higher self-efficacy persist longer in the face of child difficulties, respond to misbehavior with less hostility, and experience less emotional distress themselves. Conversely, parents who doubt their competence are more prone to guilt, shame, and withdrawal, responses that qualitative studies of parents of self-harming adolescents have documented in painful detail. In families navigating suicidality, a mother who doubts herself may react to conflict with escalating criticism or helpless disengagement, feeding a feedback loop in which the child’s distress intensifies family negativity, which in turn deepens the mother’s sense of failure. A confident mother, by contrast, may absorb conflict without letting it define the relationship.

The clinical implications of these findings are potentially significant. If maternal sense of competence buffers the suicidality-conflict link, then interventions designed to strengthen that competence, rather than focusing solely on the adolescent, could meaningfully alter family dynamics in high-risk households. Existing evidence-based programs such as Triple P, the Positive Parenting Program, and video-feedback interventions like VIPP-SD have already been shown to raise parental sense of competence, and prior research has identified it as a mechanism of change in preventive parenting programs. Earlier work by Elizabeth Czyz and colleagues similarly found that parents’ self-efficacy in supporting teens during a suicidal crisis predicted fewer future emergency department visits and suicide attempts, lending convergent support to the idea that bolstering parental confidence is not merely a comfort but a clinically measurable protective factor.

Several caveats deserve emphasis. The study is cross-sectional, meaning it captured a single moment in time and cannot determine whether negative interactions drive suicidal behavior, whether suicidal behavior generates conflict, or whether both are downstream of shared risk factors such as family stress or adolescent psychopathology. The sample consisted entirely of clinically referred youth, so the findings may not generalize to community populations, and the predominance of female participants limits conclusions about boys. The father subsample was also smaller, which may explain the null moderation finding. The authors themselves stress that their results illuminate contributing factors rather than causal pathways, and they call for longitudinal designs to disentangle the directionality of these associations.

Even with those limitations, the study adds an important and humane dimension to the science of youth suicide prevention. It shifts attention, at least in part, from the adolescent in crisis to the parent standing beside them, suggesting that how confident that parent feels may shape whether family conflict compounds the risk or is contained. For clinicians working with suicidal youth, the message is to assess and support the parent-child relationship and the parent’s own sense of competence together, rather than treating the family as mere background to the young person’s treatment. For the millions of parents lying awake wondering whether they are failing their children, the research offers a measured but genuine note of hope: the belief that you can handle this, and the support to genuinely build that belief, may itself be part of what keeps a fragile relationship, and the young person within it, from breaking.

Subject of Research: The association between youth suicidal behavior, parent-child relationship quality, and the moderating role of parental sense of competence

Article Title: Youth Suicidal Behavior and Parent-Child Relationship Quality: The Role of Parental Sense of Competence

Article References: Laschen, S., Deutz, M. H., Schuiringa, H. D., Hessels, C. J., & Laceulle, O. M. (2026). Youth Suicidal Behavior and Parent-Child Relationship Quality: The Role of Parental Sense of Competence. Journal of Child and Family Studies. https://doi.org/10.1007/s10826-026-03377-z

Image Credits: AI Generated

DOI: 10.1007/s10826-026-03377-z

Keywords: youth suicidal behavior, parent-child relationship, parental sense of competence, negative interactions, perceived support, maternal self-efficacy, clinical sample, suicide prevention, family conflict, moderation analysis, adolescent mental health, Youth

The research, led by Sasha Aronson and Margaret H. Bublitz of Brown University and their colleagues, set out to answer a deceptively simple question: does the social support a pregnant woman perceives bear any relationship to her actual, measured blood pressure? To find out, the team recruited 150 pregnant individuals who were less than 20 weeks into gestation and already considered at elevated risk for developing hypertensive disorders of pregnancy. Rather than relying on the single readings taken during a routine prenatal visit, the researchers used 24-hour ambulatory blood pressure monitoring, a technique that captures blood pressure repeatedly throughout a full day and night as participants go about their ordinary lives.

Ambulatory monitoring matters because blood pressure is not a fixed number. It rises and falls with activity, sleep, stress, and time of day, and clinical guidelines have long recognized that patterns captured over 24 hours predict pregnancy complications better than isolated office measurements. In this study, each participant wore a monitor that recorded systolic pressure, the peak force produced when the heart contracts, and diastolic pressure, the resting pressure between beats, across daytime hours, nighttime hours, and the entire 24-hour cycle. This gave the researchers a rich, physiologically meaningful portrait of each woman’s cardiovascular state during early and mid-pregnancy, well before hypertensive disorders typically declare themselves.

To measure social support, the team used the Prenatal Social Support Instrument – Revised, a validated questionnaire developed for pregnant populations. Crucially, the instrument assesses perceived support, meaning how satisfied women feel with the emotional and practical help available to them, rather than simply counting how many friends or relatives they have. Perceived support is considered the psychologically potent ingredient in the social support literature: decades of research suggest that what protects health is not the mere existence of a social network, but the confidence that the network will respond when needed.

The results were striking in their consistency. Across the linear regression models the researchers employed, higher satisfaction with overall social support was associated with lower blood pressure on multiple ambulatory measures. Women who reported greater perceived support showed significantly lower 24-hour diastolic blood pressure, with each unit increase in support corresponding to a decrease of roughly a third of a millimeter of mercury. The associations extended to daytime systolic blood pressure, daytime diastolic blood pressure, and nighttime diastolic blood pressure, with the strongest coefficient observed for daytime diastolic pressure. In other words, the link between feeling supported and lower cardiovascular load was not confined to a single measurement window; it appeared throughout the day and persisted into the night.

From a biological standpoint, these findings fit neatly into what scientists know about how social relationships get under the skin. Perceived support is thought to buffer the body’s stress response, damping activity in the hypothalamic-pituitary-adrenal axis, the hormonal system that mobilizes cortisol during psychological strain. When support is low, everyday stressors are processed with less hormonal restraint, promoting sympathetic nervous system activation, vasoconstriction, and sustained elevations in blood pressure. Prior research outside of pregnancy has documented exactly this pattern: meta-analytic evidence shows that people who perceive more support exhibit lower ambulatory blood pressure during daily life, and systematic reviews have linked stronger support to healthier nocturnal blood pressure dipping, the nighttime decline widely regarded as cardioprotective. The new study extends this evidence into a population whose cardiovascular system is working under the extraordinary demands of gestation.

Pregnancy, in this sense, is a uniquely sensitive window. Blood volume rises steeply, vascular function is remodeled, and the endothelium, the inner lining of blood vessels, must adapt to perfuse both mother and placenta. When that adaptation falters, hypertensive disorders emerge, and their consequences can be severe: hypertensive disorders of pregnancy contribute substantially to maternal morbidity and mortality and are associated with elevated risks of premature cardiovascular disease later in the mother’s life, as well as early-onset cardiovascular risk in her offspring. Studies have also shown that psychosocial factors such as depression, anxiety, and chronic stress are associated with increased risk of these disorders, while social support has been tied to better pregnancy outcomes ranging from lower postpartum depression to reduced preterm birth in meta-analytic work. What remained unexplored until now was whether support is connected to the most fundamental physiological marker of risk, blood pressure itself, in women already identified as vulnerable.

The researchers are careful about interpretation. Because the study is observational, it cannot prove that low social support raises blood pressure; it is possible that women with higher blood pressure perceive their relationships more negatively, or that unmeasured factors such as socioeconomic strain shape both. Yet the plausibility of a causal pathway is strengthened by the specificity of the ambulatory measures and by converging evidence from other fields, including randomized trials in general hypertension care showing that adding social support components to remote blood pressure monitoring can improve outcomes. The authors argue that if the association proves causal, psychosocial interventions designed to cultivate support, from group prenatal care to partner involvement programs to phone-based mindfulness training currently under investigation, could become meaningful tools for protecting the cardiovascular health of pregnant women.

The implications reach beyond the clinic. Public health data show that hypertensive disorders in pregnancy have been rising steadily for decades, that their burden falls unevenly across racial and socioeconomic groups, and that maternal mortality linked to hypertension remains a persistent crisis. Support networks, doulas, community programs, and even online communities have all been studied as buffers, and the new findings give those efforts a concrete physiological target: keeping antenatal blood pressure lower during the critical first half of pregnancy. For a condition long managed primarily through monitoring and medication after the fact, the possibility that something as human and modifiable as perceived support could shift early cardiovascular trajectories is a finding worth amplifying. Future research, the authors note, should test whether interventions that genuinely increase a pregnant woman’s sense of being supported can translate these cross-sectional associations into lower blood pressure, fewer hypertensive complications, and healthier pregnancies for the women and families who need it most.

Subject of Research: The relationship between perceived social support and 24-hour ambulatory blood pressure in pregnant women at risk for hypertensive disorders of pregnancy.

Article Title: Perceived social support and antenatal blood pressure in pregnant women at risk for hypertensive disorders

Article References: Aronson, S., Salmoirago-Blotcher, E., Bourjeily, G., Ayala, N. K., Nugent, N. R., Desmarattes, A. N., & Bublitz, M. H. (2026). Perceived social support and antenatal blood pressure in pregnant women at risk for hypertensive disorders. Journal of Behavioral Medicine. https://doi.org/10.1007/s10865-026-00713-y

Image Credits: AI Generated

DOI: 10.1007/s10865-026-00713-y

Keywords: pregnancy, hypertensive disorders of pregnancy, preeclampsia, social support, blood pressure, ambulatory blood pressure monitoring, maternal cardiovascular health, psychosocial stress, prenatal care, behavioral medicine, diastolic blood pressure, perceived support

Parental burnout differs fundamentally from work-related burnout, despite sharing some surface symptoms. Unlike employment, parenting offers no clock-out boundary, no weekend, and no formal resignation procedure. The role is continuous, ever-present, and often takes precedence over every other responsibility in adult life. Occupational scientists have noted that the parenting role encompasses more than one hundred distinct occupations, spanning the fulfilment of children’s fundamental, developmental and social needs. When these overlapping demands are frequently interrupted and never fully discharged, perceived health suffers. Chronic stress within the parental role can accumulate until it produces the four dimensions that define parental burnout: exhaustion in one’s parental role, a contrast with one’s previous parental self, feelings of being fed up with the parental role, and emotional distancing from one’s children.

The Parental Burnout Assessment, originally developed by Roskam and colleagues on the basis of testimonies from burned-out parents, measures these dimensions through 23 items rated on a seven-point Likert scale from never to every day, yielding a maximum score of 138 points. Established cut-off scores allow clinicians to distinguish risk from diagnosis: a score of 53 or higher indicates a parent at risk, while 86 or above suggests burnout. The instrument’s four-factor structure has been validated in numerous countries and translated into languages including Finnish, Swedish, Polish and Chinese. The Icelandic team followed a rigorous cross-cultural adaptation protocol, obtaining permission from the original authors, conducting independent forward translations by two occupational therapists and an expert with more than two decades of field experience, reconciling the drafts, back-translating into English with native speakers, and consulting the National Queer Organisation of Iceland to ensure culturally sensitive terminology.

The translation process also incorporated cognitive interviews with five parents deliberately selected to represent diverse family structures, including mothers and fathers, single-parent households, families with one to four children of varying ages, different educational levels, and both working and non-working parents. Because all participants comprehended the items similarly, no additional interviews were required. The final Icelandic version preserved all 23 items in their original order. Data collection then proceeded through two convenience sampling channels: paediatric nurses at ten child health centres across Iceland distributed study information with a QR code for a web-based questionnaire, and the study was promoted through Icelandic social media groups. Data were gathered over four weeks in March and April 2023, and the study received approval from the National Bioethics Committee of Iceland.

After applying inclusion criteria requiring at least one child living at home and residence in Iceland, the final analytical sample comprised 1,063 parents, of whom 88.9 percent were mothers. Most participants were married or cohabiting, nearly half lived in the capital region, and more than two-thirds held university degrees. The mean age was 35.3 years for women and 37.3 years for men. The researchers assessed structural validity using confirmatory factor analysis with a diagonally weighted least squares estimator, chosen because tests of multivariate skewness and kurtosis indicated that normality could not be assumed. They compared a one-factor model, a four-factor model and a second-order model in which an overall burnout factor explains the relationships among the four subscales.

The results provided strong support for the original four-factor structure. The comparative fit index and Tucker-Lewis index exceeded 0.95 for both the four-factor and second-order models, and post-hoc modification of residual covariances brought the root mean square error of approximation down to 0.059 and the standardised root mean square residual to 0.044. Standardised factor loadings for the first-order model ranged between 0.7 and 0.9, while second-order loadings reached between 0.90 and 0.96, all significant at the 0.001 level. Internal consistency was excellent, with Cronbach’s alpha reaching 0.96 for the total scale and values above 0.9 for the exhaustion and contrast subscales, though the three-item distancing subscale showed the lowest reliability. One item concerning lost direction in the parental role showed cross-loadings with the exhaustion dimension, which the authors attribute to nuances in translation and suggest could be improved with slight rephrasing.

Prevalence estimates from the Icelandic sample were striking. Using the recommended cut-offs, 10.1 percent of parents scored between 53 and 85 points, placing them at risk of parental burnout, while 3.8 percent scored 86 or higher, meeting the threshold for burnout. This overall rate is lower than figures reported in some other European countries such as Finland and Poland. Notably, the gap between mothers and fathers was smaller than in much of the previous international literature, with burnout rates of 3.6 percent among mothers and 2.7 percent among fathers. The researchers suggest this may reflect Iceland’s progressive family policies, which promote active father involvement in early childcare through generous parental leave arrangements. Older parents also exhibited lower burnout levels, consistent with the idea that accumulated life experience fosters a more balanced perspective on parenting challenges.

The study went beyond validation to explore which factors predict burnout, drawing on the Value and Meaning in Occupation model, a framework used in Scandinavian burnout rehabilitation that examines how personal factors, environment and the perceived value of daily activities shape occupational engagement. A hierarchical three-step regression analysis revealed that demographic variables alone explained only 1.6 percent of the variance in burnout scores. Adding the number of children at home and the presence of a child with special needs raised explained variance to 7.7 percent. The decisive contribution came from perceived support, personal causation and parental diagnosis, which together lifted the final model to 43.9 percent of explained variance. Personal causation, a core concept in occupational therapy referring to an individual’s sense of self-efficacy and perceived capacity, correlated strongly and positively with burnout, meaning that parents who doubted their own abilities scored substantially higher on the burnout measure.

The findings carry practical weight for clinical practice. Single parents, non-working parents receiving disability benefits or rehabilitation pensions, parents of children with special needs, and parents with diagnoses such as ADHD, ADD or autism all showed elevated burnout levels, while perceived support emerged as a clear protective factor. The authors argue that occupational therapists are uniquely positioned to help, because parental burnout rarely arises from a single cause but from a complex accumulation of occupational imbalances that compound over time. By assessing individual, task and environmental factors holistically, therapists can help parents reduce stressors, strengthen coping skills and rebuild their sense of capacity within the parenting role. The PBA-IS now enables early identification in Icelandic clinical settings, supporting interventions that reduce stress, promote mental health and enhance wellbeing for entire families. Future research, the team suggests, should pursue more diverse samples, validate a shorter five-item screening scale for use in child health services, and develop occupational therapy-specific instruments for measuring personal causation in parents.

Subject of Research: Cross-cultural translation and psychometric validation of the Parental Burnout Assessment for Icelandic parents

Article Title: Icelandic translation, adaptation and validation of the Parental Burnout Assessment (PBA-IS)

Article References: Pétursdóttir, H. S., Halapi, E., & Thordardottir, B. (2025). Icelandic translation, adaptation and validation of the Parental Burnout Assessment (PBA-IS). Scandinavian Journal of Occupational Therapy, 32(1), Article 2453479. https://doi.org/10.1080/11038128.2025.2453479

Image Credits: AI Generated

DOI: 10.1080/11038128.2025.2453479

Keywords: parental burnout, Parental Burnout Assessment, psychometric validation, Iceland, occupational therapy, confirmatory factor analysis, personal causation, parental stress, cross-cultural adaptation, mental health, perceived support, Scandinavian Journal of Occupational Therapy