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Article

Examining the Associations Between Parental Distress in Caregivers of Children Accessing Outpatient Psychiatry with Caregiver Ratings of Child Symptom Severity, Family Functioning, Financial Hardship, Social Support and Self-Care

by
Michèle Preyde
1,*,
Shrenik Parekh
2 and
John Heintzman
3
1
College of Social and Applied Human Sciences, University of Guelph, 50 Stone Road, Guelph, ON N1G 2W1, Canada
2
Waterloo Regional Health Centre, Waterloo, ON N2J 4V3, Canada
3
Sault Area Hospital, Sault Ste. Marie, ON P6B 0A8, Canada
*
Author to whom correspondence should be addressed.
Adolescents 2025, 5(3), 43; https://doi.org/10.3390/adolescents5030043
Submission received: 30 June 2025 / Revised: 13 August 2025 / Accepted: 14 August 2025 / Published: 18 August 2025
Versions Notes

Abstract

Psychiatric illness during childhood and adolescence is a serious public health concern. Caregivers are critical for their child’s enactment of psychiatric interventions, though caregiver distress can have serious impacts on caregivers and their child’s outcomes. The purpose of this study was to explore the associations of caregiver distress with child symptom severity, family functioning, and caregiver social support and self-care at the time of their child’s referral to outpatient psychiatry. Caregiver distress was most strongly associated with parent self-care (higher distress for parents associated with less self-care), child symptoms (higher distress associated with higher severity), and parent age (higher distress associated with younger caregivers). These findings shed light on important and evolving characteristics of caregivers, which could be considerations for child and family interventions in outpatient psychiatry, and the importance of a family approach for improving overall health.

1. Introduction

Mental illness during childhood and adolescence is an increasing concern for parents, families, and care providers. The severity of mental illness during childhood is associated with poor academic achievement, poor interpersonal relationships, and poor health behaviours [1,2,3] and can have lasting and profound impacts in adulthood, such as reduced employment, psychopathology, and dysfunction [4,5]. Moreover, there have been notable increases in referrals to child and adolescent outpatient mental health care, especially for emotional disorders [6,7] and notable complexities arising from somatic comorbidities [8]. Caregivers are the principal agent for implementing mental health care for children with psychiatric illness [9], such as assisting with adherence to psychotropic medication, which many adolescents find very difficult [10]. However, it has been reported that mental and physical health-related quality of life are statistically lower in caregivers of children with psychiatric illness than the Canadian norm [11], which could affect their role as the primary agent of mental health care and their child’s outcomes. Thus, an exploratory focus on caregiver distress in caregivers of children accessing outpatient psychiatry may inform practice in the outpatient unit.
The caregiver and the family environment can have considerable influences on the developing child, including the quality of attachments [12] and the dynamics within the family [13], both of which are associated with child mental health. Caregiver distress plays a critical role in children’s development and mental health [14]. Psychological distress in caregivers that exceeds their coping abilities can lead to adverse affective, behavioural, and cognitive reactions to stress [15]. Psychological distress has been defined as “a set of painful mental and physical symptoms that are associated with normal fluctuations of mood in most people.” [16]. Psychological distress can include symptoms of anxiety, depression and irritability, and can impede cognitive abilities such as misinterpreting obvious cues or recalling known facts [17]. Children with psychiatric illness can perceive parental stress and often feel that they are to blame [18]. Furthermore, caregiver stress has been shown to be associated with poor child mental health outcomes [19]. Since the influence of caregiver distress on child wellbeing can be highly consequential, understanding the factors that contribute to caregiver distress, especially for caregivers of children with psychiatric illness, may be crucial for caregiver and family health and child outcomes.
Caregivers of youth with psychiatric illness have a critical role in their child’s life; thus, understanding caregiver experiences is important for providing family-centred care. Caregivers of children and adolescents with psychiatric illness have reported considerable challenges related to the symptoms their children were experiencing, which impacted caregiver burden and adversely influenced the family context [20]. The severity of children’s internalizing and externalizing symptoms has been shown to be associated with greater caregiver distress [21]. Caregiver experiences, including psychological distress and poor family functioning, are associated with increased mental health symptoms in children [22,23]. While the impacts of childhood psychiatric illness on parents and families can be distressing, a profound reciprocal relationship between caregiver distress and child internalizing and externalizing behaviours and symptoms has been reported [23,24,25,26] Caregiver and child characteristics influence one another, which is a key focus of the transactional model of development [27]. With this theoretical model, the dynamic influences of caregiver, child, and family functioning have been shown to impact caregiver distress. While there has been considerable documentation of these associations for children with medical conditions, there is a dearth of reports on children with psychiatric illness.
Caregiver distress experienced when their child has a mental illness may also be affected by broad contextual factors, including family functioning and caregiver wellbeing. For example, poorer family functioning is associated with lower caregiver mental wellbeing [11] and implicated in the transmission of mental illness [19]. In fact, caregivers of children with special mental health care needs experience considerable psychological distress, which has also been associated with financial challenges and social isolation [28]. Family environments including the relationships and the adverse impacts of poverty have been shown to be highly important to children’s physical and mental health [29,30].
Caregivers of children experiencing mental health crises have also reported a need for greater social support, emotional comfort, and self-care skills to help them manage psychological distress [31]. Importantly, the social support caregivers perceive and experience has been shown to help protect against child psychopathology [32]. In addition, parental self-care is emerging as an important component in parenting and family wellbeing. Caregiver self-care may foster parental overall health, contribute to positive parent–child relationships [33], and be associated with psychological distress in caregivers. Understanding factors associated with caregiver psychological distress may inform supportive interventions for caregivers, which may ultimately enhance child and adolescent outcomes.
While empirical research on the influences of child symptom severity, family functioning, financial hardships, social isolation, and poor self-care on caregiver distress exists, there is a dearth of research focused on all these factors together and their relative contributions to caregiver psychological distress. Furthermore, no studies in which these factors were explored with caregivers of children with psychiatric illness could be located. Moreover, these factors were considered important in the clinical context (i.e., child and adolescent outpatient psychiatry) of this study. The purpose of this study was to explore the associations and relative contributions of caregiver-perceived child symptom severity, family functioning, social support, financial hardship, and caregiver self-care to caregiver psychological distress. This report is focused on caregiver baseline surveys, completed shortly after their child’s referral to outpatient psychiatry, and is part of a larger exploratory study with caregivers, clinicians, and youth with psychiatric illness.

2. Methods

The study was conducted in a child and adolescent outpatient psychiatry clinic in a community hospital serving local cities and rural areas with an overall population of about 800,000. All caregivers of child and adolescent patients referred to and accessing outpatient psychiatry with the ability to communicate in English were invited to participate in this study. To maintain privacy and confidentiality, caregivers were informed by hospital staff about this research opportunity; staff members asked caregivers if they would like to learn about the study from a research assistant (RA). For caregivers who agreed, the RA contacted the caregiver by telephone at the hospital, engaged in the consent process, and administered the survey to caregivers who provided informed consent.
Research ethics approval was obtained from the Waterloo Wellington Research Ethics Board (WWREB #: 2022−0750) and the University of Guelph (REB# 22−08−033) in accordance with the Declaration of Helsinki.
A survey questionnaire was developed that included demographic questions, standardized measures, and open-ended questions. Psychological distress was measured with the English version of the l’Indice de détresse psychologique de Santé Québec [34]. This psychological distress index comprises 14 items, scored on a 4-point scale from 0 (never) to 3 (very often). Representative items include the following: During the past week, did you feel tense or under pressure? Feel easily annoyed or irritated? Total sum scores can range from 0 to 42, with higher scores indicating greater distress. It is based on the validated psychiatric symptom index [35] and has been shown to be valid and reliable [36]. Cronbach’s alpha for the present study (0.90) suggests excellent internal consistency.
The DSM−5-TR Parent/Guardian-Rated Level 1 Cross-Cutting Symptom Measure (DSM-CR-CCSM) of children aged six to 17 years [37] was used to capture child symptoms. This measure was designed by the American Psychiatric Association for assessment of patients’ symptoms across common areas of mental health problems. Caregivers were asked to rate 25 items based on the past 2 weeks. Nineteen items were designed to assess 10 psychiatric domains, including depression, anger, irritability, mania, anxiety, somatic symptoms, inattention, psychosis, sleep disturbance, and repetitive thoughts and behaviours, rated on a 5-point scale from 0 (not at all) to 4 (severe, nearly every day). Representative items include the following: In the past two weeks, has your child had problems sleeping—that is, trouble falling asleep, staying asleep, or waking up too early? Seemed sad or depressed for several hours? This tool has been shown to be valid and reliable [37,38,39]. The six items designed to assess two domains, suicide attempt/ideation and substance use, and are rated on a “Yes, No, or Don’t Know” scale were not used in this report. Cronbach’s alpha for the 19 items rated on the 5-point scale (0.848) suggests excellent internal consistency.
Family functioning was assessed with the Family Assessment Device (FAD), specifically the six-item version [40] of the McMaster FAD [41,42], which has been shown to be valid and reliable [43]. The six-item tool has been demonstrated to have sound psychometric properties and to be an effective and quick tool to assess overall family functioning [40]. Representative items include the following: In times of crisis we can turn to each other for support, and we can express feelings to each other. It is rated on a 4-point scale (1 for strongly agree and 4 strongly disagree), with total mean scores ranging from 1 (best functioning) to 4 (worse functioning). Cronbach’s alpha (0.868) suggests excellent internal consistency.
Social support was captured with the Multidimensional Scale of Perceived Social Support [44], which is a 12-item measure with 7-point response options, ranging from very strongly agree to very stronly disagree. Representative items are as follows: There is a special person around when I am in need, and I can talk about problems with friends. Higher scores indicate greater support. Sound validity and reliability have been reported for this PSS scale [44]. Cronbach’s alpha (0.932) suggests excellent internal consistency.
Self-care was assessed with 10 items from the Self-Care Assessment [45], rated on a 5-point scale (1 = It never even occurred to me, 2 = never, 3 = sometimes, 4 = occasionally, and 5 = frequently). The items included eating regularly and healthfully, exercising or going to the gym, getting medical care when needed, sleeping enough, engaging in fun activities, getting away from stressful technology, spending time with others, staying in contact with people, and treating oneself kindly (e.g., using supportive inner dialogue). The Cronbach’s alpha (0.798) suggests good internal consistency.
Financial hardship was captured with two items: How often could you and your household cover an unexpected expense today of 500 (CAD) from your own resources? Are you and your household currently able to pay your bills on time? Caregivers rated these two items on a 4-point scale, ranging from 0 = never to 3 = very often. Cronbach’s alpha (0.774) computed for this study suggests good internal consistency.

3. Statistical Analyses

SPSS version 26 was used to perform analyses. Descriptive statistics including means, standard deviations, and frequencies were used to present caregiver characteristics and patient (i.e., child) age and sex gleaned from intake forms. With power = 0.80, α = 0.05, and a medium effect size, the estimated sample size was 97 [46]. Pearson’s correlation coefficient (r) was used to present pairwise correlation analyses between the dependent variable, caregiver psychological distress, independent variables, and control variables (i.e., child age and sex, caregiver age and gender, household income, and caregiver education). The strength and direction of these associations can be interpreted as ≥ 0.50—large, between 0.50 and 0.30—medium, and 0.10—small strength of association [46]. Given the exploratory nature of the study (e.g., first study to include caregiver distress, self-care, and child symptoms, etc., in the same analysis for caregivers of youth accessing outpatient psychiatry) and that the intent was not to determine the best fit or a complicated model [47] but associations that might be helpful to practitioners, multiple regression was chosen. Multiple linear regression was used to examine the association between caregiver psychological distress and the severity of child symptoms of mental illness, family functioning, perceived social support, financial hardship, and self-care. Control variables, child age and child sex, caregiver age and caregiver gender, household income, and caregiver education, were entered into the first block. Independent variables, child symptom severity, family functioning, social support, financial hardship, and self-care, were entered into the second block. Child sex and caregiver gender were not statistically significant in their association with psychological distress and were removed in the regression model. The assumption, normality, was confirmed with the Shapiro–Wilk test (p values above 0.05), and linearity was confirmed with scatterplots. Multicollinearity was evaluated using Variance Inflation Factors (VIFs); all VIFs were <2.5, suggesting parameter stability. A complete case analysis was undertaken, since the proportion of missing data was small [48].

4. Results

One hundred and nineteen caregivers completed baseline surveys shortly after their child was referred to an outpatient mental health clinic. Hospital staff obtained caregiver consent to speak with an RA for 256 patients referred to the clinic, and RAs obtained informed consent from 134 caregivers (52.3%), of which 119 (88%) caregivers completed baseline surveys. The reasons for not obtaining consent to speak with an RA were as follows: too overwhelmed, too busy, the child did not want the parent to participate, not interested, and not comfortable. The reason for not completing surveys was scheduling difficulty (i.e., not enough time). Of the 114 caregivers who provided this information, most were mothers (n = 94, 82.5%) and fathers (n = 14, 12.3%), three were grandmothers (2.6%), two were sisters (1.8%), and one was an adoptive father (0.9%). Their mean age was 43.8 years (SD 7.6), and most identified as female (n = 102, 85.7%) (Table 1). While fifteen caregivers chose not to report their ethnicity, eighty-nine (81.7%) reported White/European ethnicity, four (3.7%) reported East Asian ethnicity, two (1.8%) reported Indigenous ethnicity, two (1.8%) reported Black African/Caribbean ethnicity, and the remainder reported ethnicities from across the globe. Ninety-three (78.15%) reported that a family member of the child also had a mental illness (Table 1).
Bivariate analyses (Table 2) revealed statistically significant correlations between caregiver psychological distress and child symptom severity, family functioning, caregiver social support, financial hardship, and caregiver self-care. There was also a statistically significant correlation between caregiver psychological distress and caregiver age and household income but not caregiver education, child age or sex, or caregiver gender.
The multiple linear regression allowed for the control of demographic variables (i.e., child and caregiver age, household income, and caregiver education) to test the association of child symptom severity, family functioning, caregiver social support, financial hardship, and caregiver self-care with the dependent variable, caregiver psychological distress. The results revealed that 13.3% (Adjusted R2) of the variance was explained by control variables (F (4,86) 4.14; p = 0.004). With the addition of the independent variables, 63.5% of the variance was explained (F (5,86) 16.82; p < 0.001). In addition, the multiple linear regression revealed that only caregiver age (Standardized Beta = −0.296), child symptom severity (standardized beta = 0.321), and caregiver self-care (Standardized Beta = −0.395) were significantly associated with caregiver distress (Table 3) in the overall model. The standardized beta coefficients reveals the relative contribution: the higher the beta, the stronger the association.

5. Discussion

Psychological distress in caregivers can have considerable influences on the developing child, especially a child with psychiatric illness. Families with children with psychiatric illness experience multiple stressors, including managing their child’s psychiatric symptoms. Factors (i.e., child symptom severity, family functioning, financial hardship, caregiver social support, and self-care) known to affect psychological distress were explored in a multiple regression analysis for caregivers of children and adolescents accessing outpatient psychiatry. When taking all the factors into consideration, parental distress was most strongly associated with parental self-care (higher distress for parents associated with less self-care), child symptoms (higher distress associated with higher severity), and parent age (higher distress associated with younger parents/caregivers) in that order, and not the other variables. These findings have appreciable implications for practice and future research.
The correlation between caregiver distress and self-care is intriguing and a novel finding in this context. It is not clear if caregivers with less distress are able to engage in healthy habits (e.g., exercise, healthy diet, adequate sleep) or if healthy habits help caregivers manage the distress. There have been few studies focused on health habits of caregivers of children with psychiatric illness. For example, the presence of healthy caregiver habits has been associated with less self-stigma in caregivers of children with severe mental disorders [49]. However, there is considerable evidence for the benefits of lifestyle interventions that promote healthy habits on the physical and mental health of patients with mental illness [50]. There is also considerable scientific evidence [51,52,53] and theoretical research [27,54] on the intergenerational transmission of health behaviours, though most of the research has been focused on risky behaviours and not healthy habits. These findings support the importance of a family approach [55] to encouraging or improving self-care. Additional research is needed to explore how best to incorporate the encouragement of healthy habits for caregivers of children with moderate-to-severe mental illness and enhance the wellbeing of caregivers and their children either through modelling (Bandura) [54] or transactional (Sameroff) [27] processes. Another theoretical and practical area that aligns with the present study concerns family resilience [13]. In the present study, caregiver self-care may be considered a “strength” on which to build to help foster family resilience. In the future, the importance of supportive relationships and family capacities may also be explored, in particular as they relate to the key transactional processes that foster family resilience.
The association between caregiver psychological distress and the severity of child psychiatric symptoms has been reported (e.g. [56]), though often alongside other factors, such as family/caregiver (e.g. [57]) and financial factors (e.g., [58]). The findings from the present study reveal that caregiver emotional responses to child symptomatology may be important in conducting thorough assessments of the family unit. Since caregivers are germane to child wellbeing and to enacting treatments in the home, it is important to understand parents’ strengths and weaknesses, their capacity and ability for distress tolerance, and knowledge of mental health. Ordinarily, child mental health assessments do involve parents, but the assessment is often focused on parents’ health, and how they are coping may not be addressed, which may have direct and remarkable impacts on the child’s outcome in treatment. It is very important to consider caregivers’ psychological distress and coping capabilities, since a lack of ability to manage by the caregiver can suggest a greater need to advocate for such supports, rather than just focusing on their child’s presentation.
Caregiver psychological distress was associated with younger caregiver age in this study. The evidence on the impacts of parental age on child physical and mental health is still in the process of development. For example, some researchers have reported adverse impacts on children of older maternal age [59] and paternal age [60]. However, several population-based studies suggest protective effects of older maternal age for child academic and employment success and physical and mental health [61,62,63]. These findings support targeted preventive outreach for younger caregivers to help them manage their distress.
Hospital or agency resources, including both human and financial, need not be a barrier to addressing caregiver psychological distress. For example, Cartwright-Hatton and colleagues [64] tested the feasibility of a one-session, group-based parent intervention to address caregiver anxiety and reduce the risk of transmission to their children in a randomized controlled trial (n = 100). One year later, the children of parents in the intervention group were 16.5% less likely to have an anxiety disorder. The investigators reported that this one session was very inexpensive and highly acceptable to parents, though additional research is needed to increase accessibility and replication with a larger sample. This type of intervention could be easily adapted with a focus on caregiver psychological distress. Even though there are currently considerable resource difficulties in many hospitals around the globe, such a low0resource intervention may incur future savings by preventing escalation of illness and recurring outpatient visits.

6. Limitations

This study makes important contributions to the understanding of the evolving factors affecting caregivers of adolescents with psychiatric illness, though there are limitations. The study may have been affected by social desirability and non-response bias. Though great effort to systematically approach every caregiver and offer the study opportunity was made, some caregivers were missed. The sample size was adequate for the statistical analyses completed in this report; however, in the future, a larger sample size could support the analysis of a greater number of factors. While great effort was undertaken by the RAs to foster survey completion and minimize missing data, it should be noted that the study was undertaken in a strained environment (outpatient hospital) at a time of stress for caregivers (their child’s referral to outpatient psychiatry), and there was a small amount of missing data. At the beginning of the study, COVID−19 was still a global pandemic, and pandemic protocols were in place, so if an RA scheduled to be at the hospital developed cold symptoms, they were not permitted to go to the study site. The reliance on self-reports may be considered another limitation: all the caregiver and family variables were obtained through self-reported measures, and it is not known if objective assessments would result in different findings. The caregiver, family, and child factors explored in this study and factors not included in the study, such as adolescent adherence to psychotropic medication, may present contextual limitations and confounders in the analysis and affect clinical interpretations. To minimize participant burden, some factors, such as caregiver employment status, were not collected, though they could be an important contributor to distress. Lastly, the cross-sectional survey design can only reveal associations. This exploratory study was focused on caregiver distress and the relative contributions of child symptoms, family functioning, caregiver support, and self-care because caregivers are considered central to their child’s treatment; further research with this population could be focused on child symptoms and include other factors such as adolescent adherence to treatment.

7. Conclusions

This study importantly aligns with the need for continuous assessment, especially after the COVID−19 pandemic, to ensure that clinical practices are adapting to changing needs [65]. The findings from the present study lend support for the concept that caregiver psychological distress is intertwined with the severity of children’s mental health difficulties, caregiver self-care challenges, and caregiver age. Interventions for adolescent psychiatric illness may have a greater impact if they are designed to address caregiver responses to child symptoms and caregiver wellbeing, with special attention given to younger caregivers.

Author Contributions

Conceptualization, M.P., S.P. and J.H.; methodology, M.P.; formal analysis, M.P.; investigation, M.P.; resources, M.P.; data curation, M.P.; writing—original draft, M.P.; writing—review and editing, S.P. and J.H.; supervision, M.P.; project administration, M.P. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Research ethics approval was obtained from the Waterloo Wellington Research Ethics Board (WWREB #: 2022−0750) and the University of Guelph (REB# 22−08−033) in accordance with the Declaration of Helsinki.

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

The datasets presented in this article are not available because the participants did not provide consent and the data are part of an ongoing study.

Conflicts of Interest

The authors declare no conflicts of interest.

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Table 1. Caregiver and child characteristics (n = 119).
Table 1. Caregiver and child characteristics (n = 119).
VariableValue
Caregiver age, M (SD)43.8 (7.6)
Child age, M (SD)13.71 (2.98)
Household income, M (SD), n = 93119,329.80 (120, 640.89) *
Number of children, M (SD)2.45 (1.0)
Caregiver gender, n (%)
  Woman102 (85.7)
  Man16 (13.4)
  Other1 (0.8)
Child sex, n (%) **
  Female70 (58.9)
  Male49 (41.1)
Relationship status, n (%)
  Married63 (52.9)
  Single23 (19.3)
  Common law19 (16.0)
  Separated7 (5.9)
  Divorced5 (4.2)
  Widowed2 (1.7)
Highest education completed, n (%)
  University45 (38.8)
  College43 (37.1)
  High school22 (18.9)
  Middle school7 (5.2)
Family member with mental illness, n (%), n = 93
  Mother34 (36.6)
  Father21 (22.6)
  Sibling18 (19.4)
  Grandparent10 (10.7)
  Multiple10 (10.7)
Note: * One caregiver reported an annual household income of USD 1,000,000.00. With this outlier removed, the mean income was USD 110,241.76 (SD 79,049.54). ** Child age and sex were reported by intake worker.
Table 2. Bivariate correlations.
Table 2. Bivariate correlations.
123456789
1. Psychological distress—
2. Child symptoms0.544 *—
3. Family functioning0.381 *0.090—
4. Social support−0.478 *−0.188 *0.526 *—
5. Financial hardship−0.313 *−0.217 *0.0060.163—
6. Self-care−0.637 *−0.358 *−0.274 *0.522 *0.202 *—
7. Child age−0.178−0.148−0.0080.0350.0180.161—
8. Caregiver age−0.335 *0.091−0.001−0.0740.320 *−0.0050.233 *—
9. Caregiver education−0.1170.079−0.0010.0340.387 *0.0620.0640.102—
10. Household income−0.310 *−0.217 *−0.0030.1660.442 *0.199 *0.0640.266 *−0.449 *
* p < 0.05, bolded.
Table 3. Regression analyses examining associations between caregiver psychological distress and child symptoms, family functioning, social support, financial hardship, and self-care.
Table 3. Regression analyses examining associations between caregiver psychological distress and child symptoms, family functioning, social support, financial hardship, and self-care.
95% Confidence Interval
ControlStandardized B CoefficientsStd. ErrortSig.Lower BoundUpper Bound
Age−0.1060.347−10.0020.319−10.0400.343
Caregiver age−0.2460.136−20.2490.027−0.578−0.035
Caregiver highest level of education0.02610.2170.2290.819−20.14520.703
Caregiver household income−0.2490.001−20.0950.0390.0100.030
Model 70.45280.453<0.001480.135770.837
Age0.0100.2320.1470.884−0.4280.496
Caregiver age−0.2960.094−30.920<0.001−0.556−0.181
Caregiver highest level of education−0.0020.823−0.0260.979−10.66210.619
Caregiver household income−0.0500.001−0.6110.5430.0100.030
Child symptoms0.3210.05640.387<0.0010.1340.356
Family functioning−0.17010.500−20.1350.036−60.194−0.213
Social support −0.1320.719−10.4500.151−20.4750.390
Financial Hardship −0.0240.382−0.2880.774−0.8710.651
Self-care −0.3950.125−40.720<0.001−0.840−0.341
p < 0.001, bolded.
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Preyde, M.; Parekh, S.; Heintzman, J. Examining the Associations Between Parental Distress in Caregivers of Children Accessing Outpatient Psychiatry with Caregiver Ratings of Child Symptom Severity, Family Functioning, Financial Hardship, Social Support and Self-Care. Adolescents 2025, 5, 43. https://doi.org/10.3390/adolescents5030043

AMA Style

Preyde M, Parekh S, Heintzman J. Examining the Associations Between Parental Distress in Caregivers of Children Accessing Outpatient Psychiatry with Caregiver Ratings of Child Symptom Severity, Family Functioning, Financial Hardship, Social Support and Self-Care. Adolescents. 2025; 5(3):43. https://doi.org/10.3390/adolescents5030043

Chicago/Turabian Style

Preyde, Michèle, Shrenik Parekh, and John Heintzman. 2025. "Examining the Associations Between Parental Distress in Caregivers of Children Accessing Outpatient Psychiatry with Caregiver Ratings of Child Symptom Severity, Family Functioning, Financial Hardship, Social Support and Self-Care" Adolescents 5, no. 3: 43. https://doi.org/10.3390/adolescents5030043

APA Style

Preyde, M., Parekh, S., & Heintzman, J. (2025). Examining the Associations Between Parental Distress in Caregivers of Children Accessing Outpatient Psychiatry with Caregiver Ratings of Child Symptom Severity, Family Functioning, Financial Hardship, Social Support and Self-Care. Adolescents, 5(3), 43. https://doi.org/10.3390/adolescents5030043

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