Parental Stress and Behavioral Problems in Children Aged 1.5–5 Years Attending a Well Child Clinic: A Cross-Sectional Observational Study

Background: Parenting stress may influence emotional and behavioral functioning in preschool children, but Indian data from well-child populations are limited. Objectives: To estimate the hospital-based prevalence of parental stress and behavioral abnormalities among children aged 1.5–5 years and assess their association. Material and Methods: This cross-sectional observational pilot study enrolled 50 child–parent dyads attending the Department of Pediatrics, S.V.R.R. Government General Hospital, Tirupati, from 21 November 2022 to 20 November 2023. Enrolled patients completed cbsl check list. Demographic variables were recorded, and associations with high parental stress were evaluated using logistic regression. Correlation between PSS and CBCL scores was assessed using Pearson correlation. Results: High parental stress was present in 23/50 (46%) parents. Behavioral abnormalities were identified in 21/50 (42%) children; 22% were in the clinical range and 28% in the borderline range for total problems. Fifteen of 23 children of parents with high PSS scores had behavioral abnormalities compared with 6 of 27 children of parents with low scores. Mean CBCL score was 32.36 (SD 9.65). Nuclear family status was associated with high parental stress in univariable analysis (OR 3.54, 95% CI 1.10–12.49; p=0.039); the reported multivariable estimate was OR 3.83 (95% CI 1.04–16.05; p=0.051). PSS and CBCL scores showed a modest positive correlation (r=0.321, 95% CI 0.046–0.550; p=0.023). Conclusion: Parental stress was common in this small well-child clinic sample and correlated positively with child behavioral problem scores. Screening parental stress alongside child behavior may help identify families who could benefit from early support; larger prospective studies are required.

Keywords: Parental stress; child behavior; preschool children; Child Behavior Checklist; well child clinic.