From Burnout to Parental Burnout: How Does Caregiving Become a Burden?

Year 2024, , 185 - 202, 31.03.2024

Sena Çakmak , Gızem Arıkan

https://doi.org/10.18863/pgy.1267097

Abstract

Parenting, traditionally associated with positive feelings, simultaneously presents formidable challenges that can be detrimental to both families and children. The emergence of parental burnout as a contemporary construct describes the complex array of issues and hardships faced by parents. In recent years, there has been a notable increase in the prevalence of parental burnout and its consequences. Accordingly, this review critically examines the evolution of burnout as a concept, particularly within the realm of caregiving, and subsequently delves into the genesis of parental burnout. This comprehensive exploration includes an analysis of the primary determinants contributing to parental burnout and its multifaceted effects on parents, children, and family relationships. Finally, this review culminates in an outline of prospective implications and interventions designed to mitigate parental burnout, thereby providing valuable insights for professionals involved in the support and guidance of families and children.

Keywords

Parenting, burnout, child, mental health

Tükenmişlikten Ebeveyn Tükenmişliğine: Bakım Vermek Nasıl Bir Yük Haline Gelir?

Abstract

Geleneksel olarak olumlu duygularla ilişkilendirilen ebeveynlik, aynı zamanda hem aileler hem de çocuklar için zararlı olabilecek önemli zorlukları da beraberinde getirmektedir. Modern bir kavram olarak ebeveyn tükenmişliği, ebeveynlerin karşılaştığı karmaşık sorunlar ve zorluklar dizisini tanımlamaktadır. Son yıllarda, ebeveyn tükenmişliğinin yaygınlığında ve sonuçlarında belirgin bir artış olmuştur. Bu doğrultuda, bu derleme tükenmişliğin bir kavram olarak evrimini, özellikle de bakım verme alanında eleştirel bir şekilde incelemekte ve ardından ebeveyn tükenmişliğinin oluşumunu araştırmaktadır. Bu kapsamlı araştırma, ebeveyn tükenmişliğine katkıda bulunan temel belirleyicilerin ve ebeveynler, çocuklar ve aile ilişkileri üzerindeki çok yönlü etkilerinin bir analizini içermektedir. Son olarak, bu inceleme, ebeveyn tükenmişliğini azaltmak için tasarlanan ileriye dönük çıkarımlar ve müdahalelerin bir özetini sunarak, ailelerin ve çocukların desteklenmesi ve yönlendirilmesinde yer alan profesyoneller için değerli bakış açıları sağlamaktadır.

Keywords

Ebeveynlik, tükenmişlik, çocuk, zihin sağlığı

References

• Abidin RR (1990) Introduction to the special issue: The stresses of parenting. J Clin Child Psychol, 19:298-301.
• Adelman RD, Tmanova LL, Delgado D, Dion S, Lachs MS (2014) Caregiver burden: A clinical review. JAMA, 311:1052-1060.
• Aguiar J, Matias M, Braz AC, César F, Coimbra S, Gaspar MF et al. (2021) Parental burnout and the COVID-19 pandemic: How Portuguese parents experienced lockdown measures. Fam Relat, 70:927-938.
• Ahmadabadi MS, Ahmadabadi AB (2022) Effectiveness of Pennsylvania Resiliency Program on parental burnout and child abuse due to the Covid-19 pandemic in mothers of primary school students. Journal of Consulting Excellence and Psychotherapy, 43:39-51.
• An YS, Kim HJ, Lee HJ, Ha YJ (2016) The factors influencing mental health of married career women: Focuising on the sociodemographic factors, home factors, office worker. Journal of Humanities and Social Sciences, 7:157-186.
• Anclair M, Lappalainen R, Muotka J, Hiltunen AJ (2018) Cognitive behavioural therapy and mindfulness for stress and burnout: A waiting list controlled pilot study comparing treatments for parents of children with chronic conditions. Scand J Caring Sci, 32:389‑396.
• Angermeyer MC, Bull N, Bernert S, Dietrich S, Kopf A (2006) Burnout of caregivers: A comparison between partners of psychiatric patients and nurses. Arch Psychiatr Nurs, 20:158-165.
• APA (2022) Diagnostic and Statistical Manual of Mental Disorders 5th edition Text Revision (DSM-V-TR). Washington, American Psychiatric Association.
• Arikan G, Üstündağ-Budak AM, Akgün E, Mikolajczak M, Roskam I (2020) Validation of the Turkish version of the Parental Burnout Assessment (PBA). New Dir Child Adolesc Dev, 2020:15-32.
• Armstrong-Stassen M, Al-Ma’Aitah R, Cameron S, Horsburgh M (1994). Determinants and consequences of burnout: A cross-cultural comparison of Canadian and Jordanian nurses. Health Care Women Int, 15:413-421
• Aunola K, Sorkkila M, Tolvanen A, Tassoul A, Mikolajczak M, Roskam I (2021) Development and validation of the Brief Parental Burnout Scale (BPBS). Psychol Assess, 33:1125-1137.
• Bahmani M, Aryamanesh S, Bahmani M, Gholami S (2013) Equity and marital satisfaction in Iranian employed and unemployed women. Procedia Soc Behav Sci, 84:421-425.
• Bakker AB, Demerouti E, Euwema MC (2005) Job resources buffer the impact of job demands on burnout. J Occup Health Psychol, 10:170-180.
• Barroso NE, Mendez L, Grazian PA, Bagner DM (2018) Parenting stress through the lens of different clinical groups: A systematic review & meta-analysis. J Abnorm Child Psychol, 46: 449-461.
• Basaran A, Karadavut KI, Uneri SO, Balbaloglu O, Atasoy N (2013) The effect of having a children with cerebral palsy on quality of life, burn-out, depression and anxiety scores: A comparative study. Eur J Phys Rehabil Med, 49:815-822.
• Beheshtipour N, Nasirpour P, Yektatalab S, Karimi M, Zare N (2016) The effect of educational-spiritual intervention on the burnout of the parents of school age children with cancer: A randomized controlled clinical trial. Int J Community Based Nurs Midwifery, 4:90‑97.
• Bianchi R, Schonfeld IS, Laurent E (2017) Physician burnout is better conceptualised as depression. Lancet, 389:1397-1398.
• Blanchard MA, Heeren A (2020) Why we should move from reductionism and embrace a network approach to parental burnout. New Dir Child Adolesc Dev, 2020:159-168.
• Blanchard MA, Roskam I, Mikolajczak M, Heeren A (2021) A network approach to parental burnout. Child Abuse Negl, 111:104826.
• Bocéréan C, Dupret E, Feltrin M (2019) Maslach Burnout Inventory-General Survey: French validation in a representative sample of employees. SCIREA Journal of Health, 3:24-61.
• Bom J, Bakx P, Schut F, van Doorslaer E (2019) The impact of informal caregiving for older adults on the health of various types of caregivers: A systematic review. Gerontologist, 59:e629-e642.
• Borsboom D (2017) A network theory of mental disorders. World Psychiatry, 16:5-13.
• Borsboom D, Cramer AOJ (2013) Network analysis: An integrative approach to the structure of psychopathology. Annu Rev Clin Psychol, 9:91-121.
• Boudoukha AH, Hautekeete M, Abdellaoui S, Abdelaoui S, Groux W, Garay D (2011) Burnout and victimisation: Impact of inmates' aggression towards prison guards. Encephale, 37:284-292.
• Braithwaite M (2008) Nurse burnout and stress in the NICU. Adv Neonatal Care, 8:343-347.
• Brasseur S, Gregoire J, Bourdu R, Mikolajczak M (2013) The profile of emotional competence (PEC): Development and validation of a self-reported measure that fits dimensions of emotional competence theory. PLoS One, 8:e62635.
• Brianda ME, Mikolajczak M, Bader M, Bon S, Déprez A, Favez N et al. (2023) Optimizing the assessment of parental burnout: A multi-informant and multimethod approach to determine cutoffs for the Parental Burnout Inventory and the Parental Burnout Assessment. Assessment, doi:10.1177/10731911221141873.
• Brianda ME, Roskam I, Gross JJ, Franssen A, Kapala F, Gérard F et al. (2020) Treating parental burnout: Impact of two treatment modalities on burnout symptoms, emotions, hair cortisol, and parental neglect and violence. Psychother Psychosom, 89:330-332.
• Bringmann LF, Vissers N, Wichers M, Geschwind N, Kuppens P, Peeters F et al. (2013) A network approach to psychopathology: New insights into clinical longitudinal data. PLoS One, 8:e60188.
• Buunk BP, Schaufeli WB (1993) Burnout: A perspective from social comparison theory. In Professional Burnout: Recent Developments in Theory and Research, 1st ed. (Eds WB Schaufeli, C Maslach, T Marek):53-66. Washington, DC, Taylor & Francis.
• Buunk BP, Ybema JF, van der Zee K (2001) Affect generated by social comparisons among nurses high and low in burnout. J Appl Soc Psychol, 31:1500-1520.
• Carbonneau H, Caron C, Desrosiers J (2010) Development of a conceptual framework of positive aspects of caregiving in dementia. Dementia, 9:327-353.
• Chen BB, Qu Y, Yang B, Chen X (2022) Chinese mothers’ parental burnout and adolescents’ internalizing and externalizing problems: The mediating role of maternal hostility. Dev Psychol, 58:768-777.
• Chen ML, Liu XH, Guo J (2022) Relationship between social support and parental burnout in COVID-19 among Chinese young parents. Beijing Da Xue Xue Bao Yi Xue Ban, 54:520-525.
• Cheng H, Wang W, Wang S, Li Y, Liu X, Li Y (2020) Validation of a Chinese version of the Parental Burnout Assessment. Front Psychol, 11:321.
• Cherniss C (1980) Staff Burnout: Job Stress in the Human Services. London, Sage Publications.
• Chirico F (2016) Adjustment disorder as an occupational disease: Our experience in Italy. Int J Occup Environ Med, 7:52-57.
• Chirico F (2017) Is burnout a syndrome or an occupational disease? Instructions for occupational physicians. Epidemiol Prev, 41:294-298.
• Coleman PK, Karraker KH (1998) Self-efficacy and parenting quality: Findings and future applications. Dev Rev, 18:47-85.
• Cooley WC, American Academy of Pediatrics Committee on Children With Disabilities (2004) Providing a primary care medical home for children and youth with cerebral palsy. Pediatrics, 114:1106-1113.
• Crnic K, Low C (2002) Everyday stresses and parenting. In Handbook of Parenting: Practical Issues in Parenting, 2nd ed. (Eds MH Bornstein):243-267. Lawrence Erlbaum Associates Publishers.
• Cross AJ, Garip G, Sheffield D (2018) The psychosocial impact of caregiving in dementia and quality of life: A systematic review and meta-synthesis of qualitative research. Psychol Health, 33:1321-1342.
• Çildan B (2022) Otizmli çocuğa sahip ebeveynlerin anksiyete ve tükenmişlik durumlarının farklı değişkenler açısından incelenmesi (Yüksek lisans tezi). İstanbul, Fatih Sultan Mehmet Vakıf Üniversitesi.
• Dagenais L, Hall N, Majnemer A, Birnbaum R, Dumas F, Gosselin J et al. (2006) Communicating a diagnosis of cerebral palsy: Caregiver satisfaction and stress. Pediatr Neurol, 35:408-414.
• Deater-Deckard K (1998) Parenting stress and child adjustment: Some old hypotheses and new questions. Clin Psychol (New York), 5:314-332.
• Deater-Deckard K (2014) Family matters: Intergenerational and interpersonal processes of executive function and attentive behavior. Curr Dir Psychol Sci, 23:230-236.
• Demirhan E, İçağasıoğlu A, Eriman EÖ, Tezel CG, Baklacıoğlu HŞ, Haliloğlu S et al. (2011) Burnout of primary caregivers of children with cerebral palsy. Nobel Medicus, 7:22-27.
• Dugani S, Afari H, Hirschhorn LR, Ratcliffe H, Veillard J, Martin G et al. (2018) Prevalence and factors associated with burnout among frontline primary health care providers in low- and middle-income countries: A systematic review. Gates Open Res, 2:4.
• Duygun T, Sezgin N (2003) The effects of stress symptoms, coping styles and perceived social support on burnout level of mentally handicapped and healthy children’s mothers. Türk Psikoloji Dergisi, 18:37-52.
• Edwards ER (2019) Assessment of third wave therapy assumptions about the relation between emotional schemas and psychoemotional functioning (Doctoral dissertation). New York, City University of New York.
• Ekberg JY, Griffith N, Foxall MJ (1986) Spouse burnout syndrome. J Adv Nurs, 11:161-165.
• Festinger L (1954) A theory of social comparison processes. Hum Relat, 7:117-140.
• Figueiredo-Ferraz H, Gil-Monte PR, Queirós C, Passos F (2014) Validacao fatorial do “Spanish Burnout Inventory” em policiais Portugueses. Psicol Reflex Crit, 27:291-299.
• Finzi-Dottan R, Harel G (2014) Parents’ potential for child abuse: An intergenerational perspective. J Fam Violence, 29:397-408.
• Fisher SD (2017) Paternal mental health: Why is it relevant? Am J Lifestyle Med, 11:200-211.
• Fortson BL, Klevens J, Merrick MT, Gilbert LK, Alexander SP (2016) Preventing child abuse and neglect: A technical package for policy, norm, and programmatic activities. Atlanta, GA, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
• Freudenberger HJ (1974) Staff burn-out. J Soc Issues, 30:159-165.
• Freudenberger HJ (1977) Burnout: The organizational menace. Train Dev J, 31:26-27.
• Furutani K, Kawamoto T, Alimardani M, Nakashima K (2020) Exhausted parents in Japan: Preliminary validation of the Japanese version of the Parental Burnout Assessment. New Dir Child Adolesc Dev, 2020:33-49.
• García-Arroyo JA, Osca Segovia A, Peiró JM (2019) Meta-analytical review of teacher burnout across 36 societies: The role of national learning assessments and gender egalitarianism. Psychol Health, 34:733-753.
• Gato J, Fontaine AM, César F, Leal D, Roskam I, Mikolajczak M (2022) Parental burnout and its antecedents among same-sex and different-sex families. Int J Environ Res Public Health, 19:7601.
• George C, Solomon J (2011) Caregiving helplessness. In Disorganized Attachment & Caregiving, (Eds. J Solomon, C Georg):133-166. New York, Guilford Press.
• Gérain P, Zech E (2018) Does informal caregiving lead to parental burnout? Comparing parents having (or not) children with mental and physical issues. Front Psychol, 9:884.
• Gérain P, Zech E (2019) Informal caregiver burnout? Development of a theoretical framework to understand the impact of caregiving. Front Psychol, 10:1748.
• Gil-Monte PR (2011) CESQT Cuestionario para la evaluación del síndrome de quemarse por el trabajo. Madrid, España: TEA Ediciones.
• Gillis A, Gabriel B, Galdiolo S, Roskam I (2019) Partner support as a protection against distress during the transition to parenthood. J Fam Issues, 40:1107-1125.
• Gillis A, Roskam I (2019) Daily exhaustion and support in parenting: Impact on the quality of the parent–child relationship. J Child Fam Stud, 28:2007-2016.
• Gleichgerrcht E, Decety J (2013) Empathy in clinical practice: How individual dispositions, gender, and experience moderate empathic concern, burnout, and emotional distress in physicians. PLoS One, 8:e61526.
• Goodger K, Gorely T, Lavallee D, Harwood C (2007) Burnout in sport: A systematic review. Sport Psychol, 21:127-151.
• Goodman SH, Rouse MH, Connell AM, Broth MR, Hall CM, Heyward D (2011) Maternal depression and child psychopathology: A meta-analytic review. Clin Child Fam Psychol Rev, 14:1-27.
• Goodwin J, McCormack L, Campbell LE (2017) “You don’t know until you get there”: The positive and negative ‘lived’ experience of parenting an adult child with 22q11.2 deletion syndrome. Health Psychol, 36:45-54.
• Griffith AK (2022) Parental burnout and child maltreatment during the COVID-19 pandemic. J Fam Violence, 37:725-731.
• Grossi G, Perski A, Osika W, Savic I (2015) Stress-related exhaustion disorder–clinical manifestation of burnout? A review of assessment methods, sleep impairments, cognitive disturbances, and neuro-biological and physiological changes in clinical burnout. Scand J Psychol, 56:626-636.
• Guidetti G, Viotti S, Gil-Monte PR, Converso D (2018) Feeling guilty or not guilty. Identifying burnout profiles among Italian teachers. Curr Psychol, 37:769-780.
• Haj-Yahia MM, Sokar S, Hassan-Abbas N, Malka M (2019) The relationship between exposure to family violence in childhood and post-traumatic stress symptoms in young adulthood: The mediating role of social support. Child Abuse Negl, 92:126-138.
• Hansotte L, Nguyen N, Roskam I, Stinglhamber F, Mikolajczak M (2021) Are all burned out parents neglectful and violent? A latent profile analysis. J Child Fam Stud, 30:158-168.
• Herba CM, Glover V, Ramchandani PG, Rondon MB (2016) Maternal depression and mental health in early childhood: An examination of underlying mechanisms in low-income and middle-income countries. Lancet Psychiatry, 3:983-992.
• Holmes EA, Mathews A (2010) Mental imagery in emotion and emotional disorders. Clin Psychol Rev, 30:349-362.
• Hormozi BK, Khosravi Z, Sabzi N (2022) Parental burnout and sleep problems in Iranian mothers of primary school-aged children: Exploring the mediation effect of emotional schemas. Brain Behav, 12:e2688.
• Hu Q, Schaufeli WB (2009) The factorial validity of the Maslach Burnout Inventory-Student survey in China. Psychol Rep, 105:394-408.
• Hubbell L, Hubbell K (2002) The burnout risk for male caregivers in providing care to spouses afflicted with Alzheimer’s disease. J Health Hum Serv Adm, 25:115-132.
• Hubert S, Aujoulat I (2018) Parental burnout: When exhausted mothers open up. Front Psychol, 9:1021.
• Ibtissam S, Hala S, Sanaa S, Hussein A, Nabil D (2012) Burnout among Lebanese nurses: Psychometric properties of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Health, 4:644-652.
• Jamal M (2005) Burnout among Canadian and Chinese employees: A cross-cultural study. European Management Review, 2:224-230.
• Johnston C, Mash EJ (1989) A measure of parenting satisfaction and efficacy. J Clin Child Psychol, 18:167-175.
• Jones PJ, Heeren A, McNally RJ (2017) Commentary: A network theory of mental disorders. Front Psychol, 8:1305.
• Jordan DG, Winer ES, Salem T (2020) The current status of temporal network analysis for clinical science: Considerations as the paradigm shifts? J Clin Psychol 76:1591-1612.
• Jovanović N, Podlesek A, Volpe U, Barrett E, Ferrari S, Rojnic Kuzman M et al. (2016) Burnout syndrome among psychiatric trainees in 22 countries: Risk increased by long working hours, lack of supervision, and psychiatry not being first career choice. Eur Psychiatry, 32:34-41.
• Kagitcibasi C (2007) Family, Self, and Human Development Across Cultures: Theory and Applications, 2nd ed. Mahwah, NJ, Routledge.
• Kagitcibasi C, Ataca B (2005) Value of children and family change: A three‐decade portrait from Turkey. Appl Psychol, 54:317-337.
• Kalkışım K (2019) The relationship of children behavioral problems, parental burnout, emotion regulation strategies and mental health problems with each other (Master’s thesis). Istanbul, Bahcesehir University.
• Kaschka WP, Korczak D, Broich K (2011) Burnout: A fashionable diagnosis. Dtsch Arztebl Int, 108:781-787.
• Kawamoto T, Furutani K, Alimardani M (2018) Preliminary validation of Japanese version of the Parental Burnout Inventory and its relationship with perfectionism. Front Psychol, 9:970.
• Kerr ML, Rasmussen HF, Fanning FA, Braaten SM (2021) Parenting during COVID-19: A study of parents’ experiences across gender and income levels. Fam Relat, 70:1327-1342.
• Khammissa RAG, Nemutandani S, Feller G, Lemmer J, Feller L (2022) Burnout phenomenon: Neurophysiological factors, clinical features, and aspects of management. J Int Med Res, 50:3000605221106428.
• Khattak JK, Khan MA, Haq AU, Arif M, Minhas AA (2011) Occupational stress and burnout in Pakistan’s banking sector. African Journal of Business Management, 5:810-817.
• Kinney JM, Stephens MA (1989) Hassles and uplifts of giving care to a family member with dementia. Psychol Aging, 4:402-408.
• Kobos E, Imiela J, Leńczuk-Gruba A (2017) Diabetes, child care, and performance of family functions. Medical Studies, 1:17-25.
• Korbin JE, Krugman RD (2022) Handbook of Child Maltreatment. Dordrecht, Springer.
• Le Vigouroux S, Scola C (2018) Differences in parental burnout: Influence of demographic factors and personality of parents and children. Front Psychol, 9:887.
• Le Vigouroux S, Scola C, Raes ME, Mikolajczak M, Roskam I (2017) The big five personality traits and parental burnout: Protective and risk factors. Pers Individ Dif, 119:216-219.
• Lebert-Charron A, Dorard G, Boujut E, Wendland J (2018) Maternal burnout syndrome: Contextual and psychological associated factors. Front Psychol, 9:885.
• Lebert-Charron A, Wendland J, Vivier-Prioul S, Boujut E, Dorard G (2022) Does perceived partner support have an impact on mothers’ mental health and parental burnout? Marriage Fam Rev, 58:362-382.
• Lee J, Lim N, Yang E, Lee SM (2011) Antecedents and consequences of three dimensions of burnout in psychotherapists: A meta-analysis. Prof Psychol Res Pr, 42:252-258.
• Lesener T, Gusy B, Wolter C (2019) The job demands-resources model: A meta-analytic review of longitudinal studies. Work Stress, 33:76-103.
• Leyser Y, Heinze A, Kapperman G (1996) Stress and adaptation in families of children with visual disabilities. Fam Soc, 77:240-249.
• Lin GX, Szczygieł D, Hansotte L, Roskam I, Mikolajczak M (2023) Aiming to be perfect parents increases the risk of parental burnout, but emotional competence mitigates it. Curr Psychol, 42:1362-1370.
• Lin SH, Huang YC (2014) Life stress and academic burnout. Active Learning in Higher Education, 15:77-90.
• Lindström C, Åman J, Anderzén-Carlsson A, Norberg AL (2016) Group intervention for burnout in parents of chronically ill children - A small-scale study. Scand J Caring Sci, 30:678-686.
• Lindström C, Åman J, Norberg AL (2010) Increased prevalence of burnout symptoms in parents of chronically ill children. Acta Paediatr, 99:427-432.
• Lindström C, Åman J, Norberg AL (2011) Parental burnout in relation to sociodemographic, psychosocial and personality factors as well as disease duration and glycaemic control in children with Type 1 diabetes mellitus. Acta Paediatr, 100:1011-1017.
• Liu Y, Chee JH, Wang Y (2022) Parental burnout and resilience intervention among Chinese parents during the COVID-19 pandemic. Front Psychol, 13:1034520.
• Love R (2021) Keeping the torch held high: Single parents’ journey to prevent parental burnout (Doctoral dissertation). Crete, Doane University.
• Lubbadeh T (2020) Job burnout: A general literature review. International Review of Management and Marketing, 10:7-15.
• Marchetti D, Fontanesi L, Mazza C, Di Giandomenico S, Roma P, Verrocchio MC (2020) Parenting-related exhaustion during the Italian COVID-19 lockdown. J Pediat Psychol, 45:1114-1123.
• Martin CA, Papadopoulos N, Chellew T, Rinehart NJ, Sciberras E (2019) Associations between parenting stress, parent mental health and child sleep problems for children with ADHD and ASD: Systematic review. Res Dev Disabil, 93:103463.
• Maslach C (1982) Burnout: The Cost of Caring. Englewood Cliffs, NJ, Prentice-Hall.
• Maslach C, Goldberg J (1998) Prevention of burnout: New perspectives. Appl Prev Psychol, 7:63-74.
• Maslach C, Jackson SE (1981) The measurement of experienced burnout. J Organ Behav, 2:99-113.
• Maslach C, Jackson S (1984) Burnout in organization settings. Applied Social Psychology Annual, 5:133-153.
• Maslach C, Schaufeli WB, Leiter MP (2001) Job burnout. Annu Rev Psychol, 52:397-422.
• Mayer JD, Salovey P (1997) What is emotional intelligence? In Emotional Development and Emotional Intelligence: Educational Implications. (Eds P Salovey, DJ Sluyter):3-31. New York, Basic Books.
• Meadow-Orlans KP (1994) Stress, support, and deafness: Perceptions of infants’ mothers and fathers. J Early Interv, 18:91-102.
• Meier ST (1983) Toward a theory of burnout. Hum Relat, 36:899-910.
• Merlo G, Rippe J (2020) Physician burnout: A lifestyle medicine perspective. Am J Lifestyle Med, 15:148-157.
• Michon A, Weber K, Rudhard-Thomazic V, Giannakopoulos P (2005) Dynamic process of family burden in dementia caregiving: A new field for psychotherapeutic interventions. Psychogeriatrics, 5:48-54.
• Mikolajczak M, Brianda ME, Avalosse H, Roskam I (2018) Consequences of parental burnout: Its specific effect on child neglect and violence. Child Abuse Negl, 80:134-145.
• Mikolajczak M, Gross JJ, Roskam I (2019) Parental burnout: What is it, and why does it matter? Clin Psychol Sci, 7:1319-1329.
• Mikolajczak M, Gross JJ, Roskam I (2021) Beyond job burnout: Parental burnout! Trends Cogn Sci, 25:333-336.
• Mikolajczak M, Gross JJ, Stinglhamber F, Norberg AL, Roskam I (2020) Is parental burnout distinct from job burnout and depressive symptoms? Clin Psychol Sci, 8:673-689.
• Mikolajczak M, Raes ME, Avalosse H, Roskam I (2017) Exhausted parents: Sociodemographic, child-related, parent-related, parenting and family-functioning correlates of parental burnout. J Child Fam Stud, 27:602-614.
• Mikolajczak M, Roskam I (2018) A theoretical and clinical framework for parental burnout: The balance between risks and resources (BR2). Front Psychol, 9:886.
• Mikolajczak M, Roskam I (2020) Parental burnout: Moving the focus from children to parents. New Dir Child Adolesc Dev, 2020:7-13.
• Misiołek A, Gorczyca P, Misiołek H, Gierlotka Z (2014) The prevalence of burnout syndrome in Polish anaesthesiologists. Anaesthesiol Intensive Ther, 46:155-161.
• Misra J, Moller S, Strader E, Wemlinger E (2012) Family policies, employment and poverty among partnered and single mothers. Res Soc Stratif Mobil, 30:113-128.
• Mobarak R (2000) Predictors of stress in mothers of children with cerebral palsy in Bangladesh. J Pediatr Psychol, 25:427-433.
• Mrosková S, Reľovská M, Schlosserová A (2020) Burnout in parents of sick children and its risk factors: A literature review. Central European Journal of Nursing and Midwifery, 11:196-206.
• Mulder RH, Rijlaarsdam J, Van IJzendoorn MH (2017) DNA methylation: A mediator between parenting stress and adverse child development? In Parental Stress and Early Child Development: Adaptive and Maladaptive Outcomes. (Eds K Deater‐Deckard, R Panneton):157-180. Switzerland, Springer.
• Norberg AL (2007) Burnout in mothers and fathers of children surviving brain tumour. J Clin Psychol Med Settings, 14:130-137.
• Norberg AL (2010) Parents of children surviving a brain tumor: Burnout and the perceived disease-related influence on everyday life. J Pediatr Hematol Oncol, 32:e285-e289.
• Norberg AL, Steneby S (2009) Experiences of parents of children surviving brain tumour: A happy ending and a rough beginning. Eur J Cancer Care, 18:371-380.
• Norman RE, Byambaa M, De R, Butchart A, Scott J, Vos T (2012) The long-term health consequences of child physical abuse, emotional abuse, and neglect: A systematic review and meta-analysis. PLoS Med, 9:e1001349.
• Nowland R, Thomson G, McNally L, Smith T, Whittaker K (2021) Experiencing loneliness in parenthood: A scoping review. Perspect Public Health, 141:214-225.
• Nyanamba JM, Liew J, Li D (2022) Parental burnout and remote learning at home during the COVID-19 pandemic: Parents’ motivations for involvement. Sch Psychol, 37:160-172.
• Ones K, Yilmaz E, Cetinkaya B, Caglar N (2005) Assessment of the quality of life of mothers of children with cerebral palsy (primary caregivers). Neurorehabil Neural Repair, 19:232-237.
• Palma-Gudiel H, Córdova-Palomera A, Eixarch E, Deuschle M, Fañanás L (2015) Maternal psychosocial stress during pregnancy alters the epigenetic signature of the glucocorticoid receptor gene promoter in their offspring: A meta-analysis. Epigenetics, 10:893-902.
• Peden AR, Rayens MK, Hall LA, Grant E (2004) Negative thinking and the mental health of low-income single mothers. J Nurs Scholarsh, 36:337-344.
• Perroud N, Rutembesa E, Paoloni-Giacobino A, Mutabaruka J, Mutesa L, Stenz L et al. (2014) The Tutsi genocide and transgenerational transmission of maternal stress: Epigenetics and biology of the HPA axis. World J Biol Psychiatry, 15:334-345.
• Phipps S, Long A, Hudson M, Rai SN (2005) Symptoms of post-traumatic stress in children with cancer and their parents: Effects of informant and time from diagnosis. Pediatr Blood Cancer, 45:952-959.
• Pines AM (1993) Burnout: An existential perspective. In Professional Burnout: Recent Developments in Theory and Research. (Eds WB Schaufeli, C Maslach, T Marek):33-51. Taylor & Francis.
• Pinquart M (2018) Parenting stress in caregivers of children with chronic physical condition-A meta-analysis. Stress Health, 34:197-207.
• Piotrowski K (2020) How good it would be to turn back time: Adult attachment and perfectionism in mothers and their relationships with the processes of parental identity formation. Psychol Belg, 60:55-72.
• Piotrowski K (2021) How many parents regret having children and how it is linked to their personality and health: Two studies with national samples in Poland. PLoS One, 16:e0254163.
• Poghosyan L, Clarke SP, Finlayson M, Aiken LH (2010) Nurse burnout and quality of care: Cross-national investigation in six countries. Res Nurs Health, 33:288-298.
• Porto M, Lanes M, Guedes T, Paiva AC, de Sena RM (2017) Parents of children with cancer: Integrative review of questionnaires to assess their quality of life. IOSR Journal of Nursing and Health Science, 6:35-38.
• Price ML, Surr CA, Gough B, Ashley L (2020) Experiences and support needs of informal caregivers of people with multimorbidity: A scoping literature review. Psychol Health, 35:36-69.
• Prinzie P, Stams GJ, Dekovic M, Reijntjes AH, Belsky J (2009) The relations between parents’ big five personality factors and parenting: A meta-analytic review. J Pers Soc Psychol, 97:351-362.
• Quin S (2004) The long-term psychosocial effects of cancer diagnosis and treatment on children and their families. Soc Work Health Care, 39:129-149.
• Rone-Adams SA, Stern DF, Walker V (2004) Stress and compliance with a home exercise program among caregivers of children with disabilities. Pediatr Phys Ther, 16:140-148.
• Roskam I, Aguiar J, Akgun E, Arikan G, Artavia M, Avalosse H et al. (2021) Parental burnout around the globe: A 42-country study. Affect Sci, 2:58-79.
• Roskam I, Brianda ME, Mikolajczak M (2018) A step forward in the conceptualization and measurement of parental burnout: The parental burnout assessment (PBA). Front Psychol, 9:758.
• Roskam I, Mikolajczak M (2020) Gender differences in the nature, antecedents and consequences of parental burnout. Sex Roles, 83:485-498.
• Roskam I, Mikolajczak M (2021) The slippery slope of parental exhaustion: A process model of parental burnout. J Appl Dev Psychol, 77:101354.
• Roskam I, Mikolajczak M (2023) Parental burnout in the context of special needs, adoption, and single parenthood. Preprints.org, doi:10.20944/preprints202306.0317.v1.
• Roskam I, Philippot P, Gallée L, Verhofstadt L, Soenens B, Goodman A et al. (2022) I am not the parent I should be: Cross-sectional and prospective associations between parental self-discrepancies and parental burnout. Self Identity, 21:430-55.
• Roskam I, Raes ME, Mikolajczak M (2017) Exhausted parents: Development and preliminary validation of the Parental Burnout Inventory. Front Psychol, 8:163.
• Ryan R, O’Farrelly C, Ramchandani P (2017) Parenting and child mental health. London J Prim Care, 9:86-94.
• Sabzi N, Khosravi Z, Kalantar-Hormozi B (2023) Parental burnout and depression among Iranian mothers: The mediating role of maladaptive coping modes. Brain Behav, 13:e2900.
• Sairanen E, Lappalainen R, Lappalainen P, Kaipainen K, Carlstedt F, Anclair M et al. (2019) Effectiveness of a web-based Acceptance and Commitment Therapy intervention for wellbeing of parents whose children have chronic conditions: A randomized controlled trial. J Contextual Behav Sci, 13:94‑102.
• Saloviita T, Italinna M, Leinonen E (2003) Explaining the parental stress of fathers and mothers caring for a child with intellectual disability: A Double ABCX Model. J Intellect Disabil Res, 47:300-312.
• Sánchez-Rodríguez R, Ablana C, Boureau-Guérinière M, Séjourné N (2019) The ordinary educational violence: Parent-child attachment and the mediating role of parental competence and parental burnout. In the 1st International Conference on Parental Burnout, 6-7 December 2019, Leuven, Belgium.
• Sarrionandia-Pena A (2019) Effect size of parental burnout on somatic symptoms and sleep disorders. Psychother Psychosom, 88:111-112.
• Schaufeli WB, Desart S, De Witte H (2020) Burnout Assessment Tool (BAT)-development, validity, and reliability. Int J Environ Res Public Health, 17:9495.
• Schmittmann VD, Cramer AOJ, Waldorp LJ, Epskamp S, Kievit RA, Borsboom D (2013) Deconstructing the construct: A network perspective on psychological phenomena. New Ideas in Psychol, 31:43-53.
• Schulz R, Tompkins CA (2010) Informal caregivers in the United States: Prevalence, caregiver characteristics, and ability to provide care. In The Role of Human Factors in Home Health Care: Workshop Summary. (Eds S Olson):117-144. National Academies Press.
• Seah CK, Morawska A (2016) When mum is stressed, is dad just as stressed? Predictors of paternal stress in the first six months of having a baby. Infant Ment Health J, 37:45-55.
• Séjourné N, Sanchez-Rodriguez R, Leboullenger A, Callahan S (2018) Maternal burn-out: An exploratory study. J Reprod Infant Psychol, 36:276-288.
• Shaw ZA, Starr LR (2019) Intergenerational transmission of emotion dysregulation: The role of authoritarian parenting style and family chronic stress. J Child Fam Stud, 28:3508-3518.
• Shirom A (2009) Burnout and health: Expanding our knowledge. Stress Health, 25:281-285.
• Skok A, Harvey D, Reddihough D (2006) Perceived stress, perceived social support, and wellbeing among mothers of school‐aged children with cerebral palsy. J Intellect Dev Disabil, 31:53-57.
• Son S, Bauer JW (2010) Employed rural, low-income, single mothers’ family and work over time. J Fam Econ Issues, 31:107-120.
• Stern JA, Borelli JL, Smiley PA (2015) Assessing parental empathy: A role for empathy in child attachment. Attach Hum Dev, 17:1-22.
• Stuber ML, Kazak AE, Meeske K, Barakat L (1998) Is posttraumatic stress a viable model for understanding responses to childhood cancer? Child Adolesc Psychiatr Clin N Am, 7:169-182.
• Taris TW, Le Blanc PM, Schaufeli WB, Schreurs PJ (2005) Are there causal relationships between the dimensions of the Maslach Burnout Inventory? A review and two longitudinal tests. Work Stress, 19:238-255.
• Thompson R, Kerr M, Glynn M, Linehan C (2014) Caring for a family member with intellectual disability and epilepsy: Practical, social and emotional perspectives. Seizure, 23:856-863.
• Thorson-Olesen SJ, Meinertz N, Eckert S (2019) Caring for aging populations: Examining compassion fatigue and satisfaction. J Adult Dev, 26:232-240.
• Tröster H (2001) Sources of stress in mothers of young children with visual impairments. J Vis Impair Blind, 95:623-637.
• Truzzi A, Valente L, Ulstein I, Engelhardt E, Laks J, Engedal K (2012) Burnout in familial caregivers of patients with dementia. Braz J Psychiatry, 34:405-412.
• Tuna HM, Olgun N (2010) İnmeli hastalara bakım veren hasta yakınlarında görülen tükenmişlik durumunda algılanan sosyal desteğin rolü. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi, 17:41-52.
• Tunçel A (2017) Çocuklarında otizm spektrum bozukluğu olan annelerin depresyon, tükenmişlik ve umutsuzluk düzeylerinin çocuktaki otizmin ağırlık derecesine göre karşılaştırılması (Yüksek lisans tezi). Gaziantep, Hasan Kalyoncu Üniversitesi.
• Uludağ F (2016) Kanser hastaları ve bakım veren yakınlarının tükenmişlik durumları ve stresle başa çıkma tarzları (Doktora tezi). Aydın, Adnan Menderes Üniversitesi.
• Urbanowicz AM (2022) Preventing and reducing parental burnout: A clinical trial of three interventions based on cognitive behavioural therapy, second wave positive psychology, and informal mindfulness practices (Doctoral dissertation). Swansea, Swansea University.
• Urbanowicz AM, Shankland R, Rance J, Bennett P, Leys C, Gauchet A (2023) Cognitive behavioral stress management for parents: Prevention and reduction of parental burnout. Int J Clin Health Psychol, 23:100365.
• Valente LE, Truzzi A, Souza WF, Alves GS, Alves CE, Sudo FK et al. (2011) Health self-perception by dementia family caregivers: Sociodemographic and clinical factors. Arq Neuropsiquiatr, 69:739-744.
• Van Bakel HJ, Van Engen ML, Peters P (2018) Validity of the Parental Burnout Inventory among Dutch employees. Front Psychol, 9:697.
• Van der Klink JJ, van Dijk FJ (2003) Dutch practice guidelines for managing adjustment disorders in occupational and primary health care. Scand J Work Environ Health, 29:478-487.
• Van Dongen-Melman JE, Van Zuuren FJ, Verhulst FC (1998) Experiences of parents of childhood cancer survivors: A qualitative analysis. Patient Educ Couns, 34:185-200.
• Varghese RT, Venkatesan S (2013) A comparative study of maternal burnout in autism and hearing impairment. International Journal of Psychology and Psychiatry, 1:101-108.
• Vlăduţ CI, Kállay É (2010) Work stress, personal life, and burnout. Causes, consequences, possible remedies-a theoretical review. Cogn Brain Behav, 14:261-280.
• Vrijmoet-Wiersma CM, van Klink JM, Kolk AM, Koopman HM, Ball LM, Maarten Egeler R (2008) Assessment of parental psychological stress in pediatric cancer: A review. J Pediatr Psychol, 33:694-706.
• Weiss JA, Lunsky Y (2011) The brief family distress scale: A measure of crisis in caregivers of individuals with autism spectrum disorders. J Child Fam Stud, 20:521-528.
• Wicks-Nelson R, Israel AC (2006) Behavior Disorders of Childhood, 6th ed. New Jersey, Pearson.
• WHO (2022) International Classification of Diseases for Mortality and Morbidity Statistics, 11th ed. Geneva, World Health Organization.
• Yang B, Chen BB, Qu Y, Zhu Y (2021) Impacts of parental burnout on Chinese youth’s mental health: The role of parents’ autonomy support and emotion regulation. J Youth Adolesc, 50:1679-1692.