AUTHOR=Boettcher Johannes , Hohmann Sarah , Daubmann Anne , Denecke Jonas , Muntau Ania C. , Wiegand-Grefe Silke , Zapf Holger 

TITLE=The Family Stress Model in families of children with rare diseases: a cross-sectional multilevel path analysis for understanding family dynamics

JOURNAL=Frontiers in Public Health

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1713613

DOI=10.3389/fpubh.2025.1713613

ISSN=2296-2565

ABSTRACT=BackgroundTheoretical frameworks, such as the Family Stress Model, have been evaluated in various contexts; however, there is a lack of large-scale studies specifically focusing on families of children with rare diseases.ObjectiveTo examine the applicability of the Family Stress model within a large-scale sample of families of children with rare diseases.MethodsThe potential predictors of children’s mental health in a multicenter study of n = 872 parents of children with rare diseases were investigated. Factors contributing to children’s mental health within the Family Stress Model were investigated via cross-sectional multilevel path model.ResultsRelevant associations were found among all variables. The multilevel model based on our data only partially supported the Family Stress Model. In our model, the quality of the parental relationship was not relevantly associated with stress and depressive symptoms.ConclusionOur findings show that the Family Stress Model is not supported entirely in a multilevel analysis of families of children with rare diseases. Nevertheless, the results underscore the importance of focusing on alleviating parental stress, which could diminish intra-family psychopathology.Clinical trial registrationThe study was registered on September 21, 2024, with the identifier number NCT04382820 at ClinicalTrials.gov.