Gender-specific insights on parenting children with rare diseases through multiple mediation analyses within the double ABCX model.
Moms' anxiety is driven by coping and stress, dads' by stress alone—so gender-tailored parent support is essential.
01Research in Context
What this study did
Boettcher et al. (2025) asked 312 moms and dads of kids with rare diseases to fill out one big online survey.
The survey measured stress pile-up, coping style, and anxiety or depression symptoms.
Researchers then ran two mediation models to see if moms and dads travel different paths from stress to mental health.
What they found
For mothers, both coping skills and stress level carried the effect from stress pile-up to anxiety and depression.
For fathers, only stress level mattered; coping did not act as a go-between.
In plain words: moms' mood hinges on how they cope, while dads' mood hinges on how much stress hits them.
How this fits with other research
Dai et al. (2025) extend these findings. Their RCT shows that teaching parents DTT at home cuts parenting stress medium-strong. Johannes says tailor support by gender; Dai shows parent training actually works.
Manor-Binyamini (2011) seems to disagree. Bedouin moms of kids with developmental disorders reported poor coping and high burden, while Johannes' Western moms used coping as a buffer. The clash is cultural, not methodological. Collectivist settings may block coping resources that individualist settings allow.
D'Agostino et al. (2025) line up nicely. They found mindful parenting eases daily hassles less for ASD moms than for DD or FXS moms. Together with Johannes, this tells us both gender and diagnosis shape which psychological lever you should push.
Why it matters
Stop giving one-size-fits-all parent support. If you run caregiver workshops, add a mom track that builds coping skills like problem-solving and self-compassion. Run a dad track that cuts external stress: respite vouchers, chore help, or flexible work letters. Check both tracks for cultural fit; Bedouin families may need community-level fixes before individual coping can work. One quick move: open your next parent meeting with a two-minute survey on stress versus coping style, then split the room by gender for targeted discussion.
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02At a glance
03Original abstract
BACKGROUND: While the double ABCX model has been evaluated in various contexts, large-scale studies on gender among parents of children with rare diseases remain scarce. OBJECTIVE: To examine the applicability of the double ABCX model within a large-scale sample of mothers and fathers of children diagnosed with rare diseases. METHODS: The potential predictors of parental mental health in a multicenter study of n = 668 mothers and n = 461 fathers of children with rare diseases were investigated. Factors contributing to parental adaptation (GAD-7 and PHQ-9) within the double ABCX model were investigated cross-sectionally using multiple mediation modeling. RESULTS: In mothers, relevant associations were found among stressor pile-up, social support, parental relationships, coping, stress, and mental health. Similar relevant associations were observed in fathers, except for coping. For mothers, the association between stressor pile-up and symptoms of anxiety was fully mediated by coping and stress. In contrast, the association with symptoms of depression was fully mediated by social support, coping, and stress. For fathers, the association between stressor pile-up and symptoms of anxiety as well as depression was complementary mediated through stress. CONCLUSION: Our findings contribute to the existing literature by illuminating gender-specific differences in parental symptoms of anxiety and depression, suggesting that tailored emotion regulation programs could effectively alleviate these issues. By emphasizing these dynamics, we highlight the importance of personalized approaches in addressing the unique challenges faced by parents of different genders.
Research in developmental disabilities, 2025 · doi:10.1016/j.ridd.2025.105160