Parental stress linked to lower self-esteem in children with MS, study finds

Parental stress may help explain the link between disease-related difficulties and lower self-esteem in children with MS, a study suggests.

Researchers found that greater fatigue, slower information processing and more severe disease were associated with higher parental stress.

Higher stress was also linked to lower self-esteem among children and adolescents with paediatric-onset multiple sclerosis (POMS), suggesting that parents’ emotional health may play a role in how young people adjust to the condition.

The study, conducted in Israel, involved 30 children and adolescents aged 10 to 18 with POMS, a rare form of MS in which symptoms begin before adulthood.

MS is an autoimmune condition in which the immune system damages myelin, the protective coating around nerve fibres. This can cause movement difficulties, fatigue and cognitive problems.

In children and adolescents, these symptoms can occur during an important period for developing identity and self-esteem.

Parents may also experience psychological distress and greater caring responsibilities because of the disease’s unpredictable course and possible physical and cognitive effects.

The researchers examined whether parental stress and psychological well-being could help explain the relationship between children’s disease burden and self-esteem.

Participants had first experienced symptoms at an average age of 13.93 years and had been living with the condition for an average of 1.53 years.

Although overall disease severity was relatively low, 67 per cent experienced clinically significant fatigue and 33 per cent had significant difficulties with processing speed, the ability to process information quickly.

All participants scored in the low self-esteem range on the Rosenberg Self-Esteem Scale, a questionnaire assessing how people view themselves.

Among parents, 43 per cent scored above the clinical threshold for significant stress. The same proportion scored below the threshold for psychological well-being, indicating poor well-being.

Further analysis found that greater disease severity was significantly associated with higher parental stress and poorer well-being.

Children with faster processing speeds tended to have parents reporting less stress and better well-being, while greater fatigue was linked to increased parental stress.

Statistical analysis found that parental stress significantly mediated the associations between all three disease-related factors and children’s self-esteem.

In other words, disease-related difficulties were linked to self-esteem partly through their association with parental stress.

For example, lower fatigue and faster processing speed were associated with less parental stress, which was in turn linked to higher self-esteem among children.

Parental stress also appeared to play a role in the relationship between disease severity and self-esteem, although the association between stress and self-esteem was weaker in this analysis.

The researchers separately examined parental psychological well-being, but found a significant mediating role only for processing speed.

Faster processing was associated with better parental well-being, which was itself linked to higher self-esteem among children.

The findings suggest that parents’ emotional health could be an important consideration in psychological care for children with MS.

The researchers said: “Addressing parent emotional state may improve outcomes and promote resilience in youth with POMS.”

They suggested involving parents in psychological and social support services as part of wider care for children with the condition.

However, the study involved only 30 participants and assessed them at a single point in time.

It therefore cannot establish cause and effect, including whether parental stress directly contributes to lower self-esteem.

The findings may also be less applicable to children with more advanced disability.

The researchers called for larger, more diverse studies to confirm the associations and better understand the role of parental emotional health in paediatric MS.