There's a disconnect between what children say they're worrying about and what their parents think is stressing them, a gap that could have long-term implications for children's mental and physical health, according to APA's latest Stress in America research.

2010-01-stress-change-graphChildren age 8 to 17 say they worry about doing well in school, getting into good colleges and their family's finances. They also report suffering headaches, sleeplessness and upset stomachs.

But these stresses and symptoms are going largely unnoticed by parents, survey findings show.

In fact, more than one in three children report experiencing headaches in the past month, but only 13 percent of parents think their children experience headaches as a result of stress. In addition, while 44 percent of children report sleeping difficulties, only 13 percent of parents think their kids have trouble sleeping.

The survey also found that about one-fifth of children reported they worry a great deal or a lot, but only 3 percent of parents rate their children's stress as extreme (an 8, 9 or 10 on a 10-point scale). In addition, almost 30 percent of children worried about their families' financial difficulties, but just 18 percent of parents thought that was a source of worry for their children.

The findings are troubling because chronic stress left untreated can contribute to psychological problems as well as physical conditions, says Katherine Nordal, PhD, APA's executive director for professional practice. She says parents need to make themselves available and let their children know it's OK to approach them if they're worried about something.

“Parents need to be intentional about setting aside time to be available to their children,” she says. “If parents aren't receptive, kids may feel like they're being an additional burden on their parents by talking about their problems.”

The online survey, conducted by Harris Interactive for the third consecutive year for the Practice Directorate's ongoing Mind/Body Health public education campaign, polled a nationally representative sample of 1,568 adults in July and August. Results for children age 8 to 17 were drawn from a YouthQuery survey of 1,206 young people conducted online by Harris in August.

Women still more stressed

The findings for adults are also troubling:

  • Stress levels are high, with 42 percent of adults indicating their stress worsened in the past year. A total of 24 percent said they had an extreme level of stress (8, 9 or 10 on a 10-point scale) over the past month, and 51 percent report moderate stress levels (4 to 7 on a 10-point scale).

  • About two-thirds of respondents said they've been diagnosed by a physician with a chronic condition, most commonly high blood pressure or high cholesterol. Seventy percent said a health-care provider recommended lifestyle or behavior changes. That data also show that adults who were advised to make lifestyle changes may not have received enough support from their physicians to do so. In fact, fewer than half were told by their physicians why the changes were important; only 35 percent were given tips or shown techniques for making changes; and only 5 percent to 10 percent were referred to another health-care provider for follow-up.

  • Similar to last year's results, women report having experienced more stress symptoms than men, such as irritability or anger, fatigue and depression.

  • Among parents of 8- to 17-year-olds, mothers reported higher levels of stress than fathers. On a scale of 1 to 10 (with 10 being the highest level), 15 percent of moms rated their stress as a 10, compared with only 3 percent of dads. Mothers were also more likely to report lying awake at night, eating unhealthy foods, overeating or skipping a meal because of stress.

Such findings underscore the need for psychologists to work within the nation's health-care system to help people make needed lifestyle and behavioral changes, Nordal says.

“The key in managing stress effectively for both physical and mental well-being is having effective coping strategies, a combination of relaxation strategies along with exercise, combined with good sleep habits and good eating habits,” she says.

This is particularly important for women who often face a “second shift” of caring for children and running a household when they get home from work, says Helen Coons, PhD, a Philadelphia-based clinical health psychologist who works primarily with women. “The reality is, so many women are just too tired. They're running on empty.”

That calls for change at several levels to support women, says Coons. Workplaces should offer better access to day care and more flexibility to allow women time for medical checkups and exercise breaks. Spouses or partners need to watch the kids while mom goes out for a run or a brisk walk, and neighborhood families can rotate babysitting to give parents more flexibility.

“There's that African saying, it takes a village to raise a child. I think it takes a community to support women and families” for healthier lifestyles, she says.

Mile-high stress

This year's survey also took snapshots of how Americans are faring with stress in eight metropolitan areas — Atlanta, Chicago, Denver, Detroit, Los Angeles, New York, Seattle and Washington, D.C. — comparing results with national findings.

Faring the worst was Denver, where more than 75 percent of residents report that work and money are significant sources of stress, and 35 percent rated their stress as extreme over the prior month.

That distress sounds familiar to Stephanie Smith, PsyD, public education coordinator for the Colorado Psychological Association and a Denver-based practitioner. Although the city's unemployment rate isn't as high as the national average, many of her clients tell her they feel trapped at their jobs. They're working harder for less money because of layoffs and pay cuts, but they're unable to find better jobs and frightened of losing their health insurance.

Smith works with her clients to identify things they can do to relieve stress, such as spending more quality time with family and exercising. “We talk about the things you can control in your life,” she says.

In Los Angeles, 71 percent of respondents said they've been told by a health provider they have a chronic condition, compared with 66 percent nationally.

“To me, that's absolutely frightening, because we know the role stress plays in wearing our bodies down,” says Michael Ritz, PhD, co-chair of the California Psychological Association's public education steering committee.

Psychologists can help people manage their stress and live healthier lifestyles, Ritz says.

“That underscores so much why psychologists need to be part of our health-care team,” he says.

To read more about the 2009 results, go online to www.apa.org/news/press/releases/2009/11/stress.aspx.


Getting the results out

APA presented the results of the Stress in America survey on Nov. 3 at a New York press conference. Nationally, the research was featured on cable and broadcast news programs, newspapers, radio programs, news and health Web sites, and blogs with local psychologists from the Practice Directorate's Public Education Campaign reaching out to local reporters. Coverage of the results reached almost 28 million people.

Outlets that featured articles and discussion of APA's stress survey included:

  • NBC, ABC and FOX local affiliates.

  • NBC's “Today Show.”

  • CNN en Espanol.

  • “Dr. Nancy” on MSNBC.

  • Wall Street Journal's The Juggle blog.

  • USA Today.

  • The New York Times' Motherlode blog.

  • Newsweek.com's “Her Body” column.

  • The Washington Post Express.