Background: The purpose of the present study was to identify and evaluate possible determinants of wellbeing and psychological adjustment in parents raising children with disabilities. Two studies drawing from the same sample of participants were conducted. Method: One-hundred and forty parents raising children with disabilities participated in this investigation. Participants completed a survey consisting of basic demographic characteristics of the parent, child-disability characteristics, parent problem solving ability, access to information and resources, environmental/social supports, appraisals of threat and growth, and measures of life satisfaction and physical/mental health. The purpose of study one was to evaluate possible determinants of parent wellbeing using a contextual model. The purpose of study two was to identify factors that predict depression risk status for parents raising children with disabilities. Results: Study one used structural equation modeling to test a hypothesized contextual model of parent wellbeing. Results of study one indicated strong model fit. In addition, after controlling for the contribution of parent demographic variables, the largest contributors to parent wellbeing were parent problem solving ability, access to resources, environmental/social supports, and parent appraisals of threat. Child functional impairment was not significantly associated with parent wellbeing. Study two found that 19 percent of participants were at risk for depression. Moreover, using tests of mean differences and hierarchical logistic regression, study two found that parents at-risk for depression were significantly more likely to report physical health problems, ineffective problem solving abilities, lower family satisfaction, and more appraisals of threat compared to parents not at-risk for depression. These factors combined to predict significantly depression risk status with the at-risk group being identified with 83.3 percent accuracy. Conclusion: Implications related to the importance of resources and environmental/social supports, appraisals of threat and growth, and problem solving abilities on the overall wellbeing and emotional health of parents raising children with disabilities are discussed.

Phenylketonuria is a rare genetic disorder that causes cognitive impairment unless treated with a strict, protein-restricted diet. Due to the challenges of treatment adherence, caring for a child with PKU may affect parental wellbeing, and many children and adolescents have poor metabolic control. The overall aim of the thesis was to examine influences on parental wellbeing and treatment adherence. Paper 1 is a systematic literature review of the demographic and psychosocial influences on blood phenylalanine concentration for children and adolescents with PKU. The aim was to identify factors that were robustly linked with metabolic control and could potentially be used to inform clinical practice. Findings from 29 identified studies indicated that whilst a number of demographic and psychosocial factors were related to metabolic control, the most reproducible association was with child age. Quality assessment of the studies indicated some methodological limitations, and a paucity of research in some areas highlighted the need for further research. The limitations of the evidence-base, clinical implications, and directions for future research are discussed. Paper 2 presents an investigation of the psychological impact of parenting a child with PKU, the determinants of parental wellbeing, and the association between parental wellbeing and treatment adherence. Forty-six caregivers of children with PKU completed questionnaires examining psychological distress, parenting stress related to caring for a child with an illness, resilience, perceived social support, and child dependency. The proportion of blood phenylalanine concentrations within target range in the preceding year was used a measure of treatment adherence. Results showed that more than half of caregivers had clinical levels of psychological distress, which was predicted by their parenting stress and resilience. Whilst treatment adherence was not associated with parental distress, it was predicted by child age and caregiver perceived support from family. The limitations of the study, implications for clinical practice, and future research directions are discussed. Paper 3 provides a critical evaluation of Papers 1 and 2 and a personal reflection of the research process.

Aims: Parents of children with intellectual and developmental disabilities tend to illustrate and report higher levels of stress and lower wellbeing than parents of typically developing children. This thesis aimed to explore the aspects of this relationship between parental wellbeing and raising a child with heterogeneous intellectual and developmental disability. Firstly, the thesis aimed to review the current literature and evidence base for mindfulness-based group and individual interventions and their effect on psychological outcomes for parents of children with intellectual and developmental disabilities. Secondly, a research study aimed to explore the role of overall parental locus of control and particular sub-domains of locus of control on parent reported wellbeing. Furthermore, the role of child compliant and social behaviour, child problem behaviour, diagnostic groups, level of functioning, and demographic variables were explored. Method: A systematic review of the literature was conducted to address the first aim of this thesis. Within the research study, a single sample of parents and family carers (n = 114) completed an online anonymous survey consisting of demographic information and three self-report measures; a modified version of the Parental Locus of Control Scale, the Warwick-Edinburgh Mental Wellbeing Scale, and the Nisonger Child Behaviour Rating Form. Results: The systematic review illustrated that mindfulness-based interventions appear to have a significant effect on a number of parent psychological outcomes; such as wellbeing, stress, mental health, compassion, and mindfulness. A further four papers indicated a significant impact on child behavioural outcomes from parental mindfulness interventions. The research study indicated parental locus of control, in particular the two sub-domains of child control, and parent efficacy significantly mediated the relationship between child problem behaviour and parental wellbeing. Conclusions: There is a need to further explore the effectiveness of mindfulness interventions on parental distress and child behaviour, in particular in comparison to well-established interventions and groups. The research study results highlight the importance of parental attributions in influencing the wellbeing of parents of children with intellectual and developmental disabilities. However, it is clear from these findings that there is a complex relationship between parent cognitive attributions and broader social and societal factors. These findings may inform future practice with these families, although further research to explore these complex relationships is required.