Introduction
Emotional/social problems in childhood are associated with delinquency in adolescence, violence in adulthood, and anxiety disorders. In infants and toddlers, social-emotional development is one of their developmental needs, and its delay can increase the parental stress level [1], which is among the risk factors of family conflicts [2]. Higher level of parental stress is associated with occurrence of behavioral problems in children, including aggression, impulsivity, and emotion dysregulation [3]. Parents with high stress often engage in ineffective parenting styles [4]. Pregnancy can be stressful for individuals and families [5]. The amount of stress in young parents, especially mothers and in the postpartum period, has negative effects on healthy functioning of the family and children [6]. This study aims to investigate the role of parents’ stress and perceived social support in predicting children’s emotional/social problems.
Materials and Methods
This is a descriptive-correlational study. The statistical population includes all parents and their children referred to health centers in Pardis, Tehran, Iran in 2020 who had children under 5 years of age. Of these, 230 people were selected by a convenience sampling method. The assessment tools were the Parental Stress Index (PSI) developed by Abidin (1990), Multidimensional Scale of Perceived Social Support (MSPSS) developed by Zimmet et al. (1988), and the Child Behaviour Questionnaire-Parent form (CBQ-P) developed by Rutter et al. (1975). The PSI has 101 items and measures the degree of stress in the parent-child relationship. The MSPSS has 12 items rated on a seven-point scale. The CBQ-P is used to distinguish children with normal behaviors and those with behavioral problems. For data analysis, multiple regression analysis was used in SPSS software, version 25.
Results
It was reported that 42.6% of the participants were employed and 57.4% were housekeeper (Table 1).




The mean age of participants was 28.42±12.5 years. The results showed that parental stress and perceived social support had a significant role in predicting children’s emotional/social problems; 44.7% and 8.9% of variance in children’s emotional/social problems were explained by parental stress and perceived social support, respectively. Moreover, the effects of adaptability, mood, distractibility/hyperactivity, reinforcement, depression, attachment, competence, social isolation, spouse/parenting partner relationship, and health dimensions of PSI on children’s emotional/social problems were significant. Furthermore, the value of F statistic which shows the significance of parental stress in linear regression model, was significant (P<0.001). According to the coefficient of determination, 44.7% and 8.9% of the variance of children’s emotional/social problems were explained by parental stress and perceived social support. The effect of support from friends on children’s emotional/social problems was significant (t=2.85, P<0.05). The regression coefficient for the support from friends (β=-0.209) was significant and this component could significantly predict children’s emotional/social problems. 
Discussion
In this study, in examining the hypothesis that children’s emotional/social problems can be predicted based on perceived social support in parents, the results showed that the effect of support from friends was significant and it was able to explain 8.9% of the variance in children’s emotional/social problems. Regarding the effect of parental stress, results showed that the effect of its components of adaptability, mood, distractibility/hyperactivity, reinforcement, depression, attachment, competence, social isolation, spouse/parenting partner relationship was significant in predicting children’s emotional/social problems such that they could together explain 44.7% of the variance in children’s emotional/social problems. It can be concluded that parental stress and support from friends can be effective in predicting children’s emotional/social problems. The results can be used to design interventions for the families with children suffering from emotional/social problems.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the ethics committee of Islamic Azad University, Sciences and Research Branch, Tehran, Iran (Code: 99527).

Funding
This study was extracted from the PhD thesis of the first author.

Authors' contributions
Conceptualization, methodology, data analysis, writing: Azam Nazemi-Harandi, Shadi Jazayeri, editing & review: Haeideh Saberi.

Conflicts of interest
The authors declare no conflict of interest.

Acknowledgements
The authors would like to thank all parents who participated in this research.


References

1. Cooper CE, McLanahan SS, Meadows SO, Brooks-Gunn J. Family structure transitions and maternal parenting stress. J Marriage Fam. 2009; 71(3):558-74. [DOI:10.1111/j.1741-3737.2009.00619.x] [PMID] [PMCID]
2. Barboza-Salerno GE. Cognitive readiness to parent, stability and change in postpartum parenting stress and social-emotional problems in early childhood: A second order growth curve model. Children and Youth Services Review. 2020; 113:104958. [DOI:10.1016/j.childyouth.2020.104958]
3. Vierhaus M, Lohaus A, Schmitz AK, Schoppmeier M. Relationships between maternal parenting stress and reports on children’s internalizing and externalizing problems: A cross-lagged structural equation model. J Educ Dev Psychol. 2013; 3(1):39-50. [DOI:10.5539/jedp.v3n1p39]
4. Anthony LG, Anthony BJ, Glanville DN, Naiman DQ, Waanders C, Shaffer S. The relationships between parenting stress, parenting behaviour and preschoolers’ social competence and behaviour problems in the classroom. Infant Child Dev. 2005; 14(2):133-54. [DOI:10.1002/icd.385]
5. Morris AS, Robinson LR, Hays-Grudo J, Claussen AH, Hartwig SA, Treat AE. Targeting parenting in early childhood: A public health approach to improve outcomes for children living in poverty. Child Dev. 2017; 88(2):388-97. [DOI:10.1111/cdev.12743] [PMID] [PMCID]
6. Combs-Orme T, Cain DS, Wilson EE. Do maternal concerns at delivery predict parenting stress during infancy? Child Abuse Neglect. 2004; 28(4):377-92. [DOI:10.1016/j.chiabu.2003.09.019] [PMID]
7. Lee LC, Halpern CT, Hertz-Picciotto I, Martin SL, Suchindran CM. Child care and social support modify the association between maternal depressive symptoms and early childhood behaviour problems: A US national study. J Epidemiol Community Health. 2006; 60(4):305-10. [DOI:10.1136/jech.2005.040956] [PMID] [PMCID]
8. Perren S, Von Wyl A, Bürgin D, Simoni H, Von Klitzing K. Depressive symptoms and psychosocial stress across the transition to parenthood: Associations with parental psychopathology and child difficulty. J Psychosom Obstet Gynaecol. 2005; 26(3):173-83. [DOI:10.1080/01674820400028407] [PMID]
9. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Washington: American Psychiatric Association. 2013. [DOI:10.1176/appi.books.9780890425596]
10. Rasouli A, Rahedeh S. [Predicting sleep quality based on stress, anxiety and depression variables in students of Kermanshah University of Medical Sciences (Persian)]. Rooyesh. 2019; 8(9):77-84. [Link]
11. Leahy-Warren P, McCarthy G, Corcoran P. First-time mothers: Social support, maternal parental self-efficacy and postnatal depression. J Clin Nurs. 2012; 21(3-4):388-97. [DOI:10.1111/j.1365-2702.2011.03701.x] [PMID]
12. Haslam DM, Pakenham KI, Smith A. Social support and postpartum depressive symptomatology: The mediating role of maternal self-efficacy. Infant Ment Health J. 2006; 27(3):276-91. [DOI:10.1002/imhj.20092] [PMID]
13. Balmer DH, Gikundi E, Billingsley MC, Kihuho FG, Kimani M, Wang’Ondu J, et al. Adolescent knowledge, values, and coping strategies: Implications for health in Sub-Saharan Africa. J Adolesc Health. 1997; 21(1):33-8. [DOI:10.1016/S1054-139X(96)00293-5] [PMID]

14. Li Y, Cui N, Kok HT, Deatrick J, Liu J. The relationship between parenting styles practiced by grandparents and children’s emotional and behavioral problems. J Child Fam Stud. 2019; 28(7):1899-913. [DOI:10.1007/s10826-019-01415-7]
15. Williford AP, Calkins SD, Keane SP. Predicting change in parenting stress across early childhood: Child and maternal factors. J Abnorm Child Psychol. 2007; 35(2):251-63. [DOI:10.1007/s10802-006-9082-3] [PMID]
16. Rutter M. A children’s behaviour questionnaire for completion by teachers: Preliminary findings. J Child Psychol Psychiatry. 1967; 8(1):1-11. [DOI:10.1111/j.1469-7610.1967.tb02175.x] [PMID]
17. Mehryar, A. H. & Yousefi,F . Factor Structure of Ratter’s Child Behavior Questionnaire for Completion by Teacher in Iran; 2011. (Persian)
18. Farshidnejad A. Epidemiological study of behavioral disorders in primary school students in Isfahan in 2001. J Behav Sci Res. 2001; 2(1):34-40. (Persian).
19. Abidin RR. Parenting stress index: PSI-4; Professional manual. Lutz: PAR: Psychological Assessment Resources; 2012. [Link]
20. Dadsetan P, Ahmadi Azghandi A, Hassanabadi HR. [Parenting stress and general health: A research on the relation between parenting stress and general health among housewife-mothers and nurse-mothers with young children (Persian). J Dev Psychol. 2006; 2(7):171-84. [Link]
21. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. J Personal Assess. 1988; 52(1):30-41. [DOI:10.1207/s15327752jpa5201_2]
22. Bruwer B, Emsley R, Kidd M, Lochner C, Seedat S. Psychometric properties of the multidimensional scale of perceived social support in youth. Compr Psychiatry. 2008; 49(2):195-201. [DOI:10.1016/j.comppsych.2007.09.002] [PMID]
23. Besharat M. Psychometric properties and factor structure of the multidimensional scale of perceived social support. Research Report, University of Tehran; 2005
24. Fischer M. Parenting stress and the child with attention deficit hyperactivity disorder. J Clin Child Psychol. 1990; 19(4):337-46. [DOI:10.1207/s15374424jccp1904_5]
25. Rodriguez A, Bohlin G. Are maternal smoking and stress during pregnancy related to ADHD symptoms in children? J Child Psychol Psychiatry. 2005; 46(3):246-54. [DOI:10.1111/j.1469-7610.2004.00359.x] [PMID]
26. Beernink AE, Swinkels SHN, Van der Gaag RJ, Buitelaar JK. Effects of attentional/ hyperactive and oppositional/ aggressive problem behaviour at 14 months and 21 months on parenting stress. Child Adolesc Ment Health. 2012; 17(2):113-120. [DOI:10.1111/j.1475-3588.2011.00616.x] [PMID]
27. Anderson LS. Predictors of parenting stress in a diverse sample of parents of early adolescents in high-risk communities. Nurs Res. 2008; 57(5):340-50. [DOI:10.1097/01.NNR.0000313502.92227.87] [PMID] [PMCID]
28. Farrace D, Tommasi M, Casadio C, Verrotti A. Parenting stress evaluation and behavioral syndromes in a group of pediatric patients with epilepsy. Epilepsy Behav. 2013; 29(1):222-7. [DOI:10.1016/j.yebeh.2013.07.020] [PMID]

29. Farmer JE, Deidrick KM, Gitten JC, Fennell EB, Maria BL. Parenting stress and its relationship to the behavior of children with Joubert syndrome. J Child Neurol. 2006; 21(2):163-7. [DOI:10.1177/08830738060210020401] [PMID]
30. Hilliard ME, Monaghan M, Cogen FR, Streisand R. Parent stress and child behaviour among young children with type 1 diabetes. Child Care Health Dev. 2011; 37(2):224-32. [DOI:10.1111/j.1365-2214.2010.01162.x] [PMID]
31. Deater-Deckard K. Parenting stress and children’s development: Introduction to the special issue. Infant Child Dev. 2005; 14(2):111-5. [DOI:10.1002/icd.383]
32. DuPaul GJ, McGoey KE, Eckert TL, VanBrakle J. Preschool children with attention-deficit/hyperactivity disorder: Impairments in behavioral, social, and school functioning. J Am Acad Child Adolesc Psychiatry. 2001; 40(5):508-15. [DOI:10.1097/00004583-200105000-00009] [PMID]
33. Cappa KA, Begle AM, Conger JC, Dumas JE, Conger AJ. Bidirectional relationships between parenting stress and child coping competence: Findings from the pace study. J Child Fam Stud. 2011; 20(3):334-42. [DOI:10.1007/s10826-010-9397-0] [PMID] [PMCID]
34. Goodman SH, Rouse MH, Long Q, Ji S, Brand SR. Deconstructing antenatal depression: What is it that matters for neonatal behavioral functioning? Infant Ment Health J. 2011; 32(3):339-61. [DOI:10.1002/imhj.20300] [PMID]
35. Huot RL, Brennan PA, Stowe ZN, Plotsky PM, Walker EF. Negative affect in offspring of depressed mothers is predicted by infant cortisol levels at 6 months and maternal depression during pregnancy, but not postpartum. Ann NY Acad Sci. 2004; 1032(1):234-6. [DOI:10.1196/annals.1314.028] [PMID]
36. Tronick EZ, Gianino AF. The transmission of maternal disturbance to the infant. New Dir Child Dev. 1986; (34):5-11. [DOI:10.1002/cd.23219863403] [PMID]
37. Sanson A, Oberklaid F, Pedlow R, Prior M. Risk indicators: Assessment of infancy predictors of pre-school behavioural maladjustment. J Child Psychol Psychiatry. 1991; 32(4):609-26. [DOI:10.1111/j.1469-7610.1991.tb00338.x] [PMID]
38. Beardslee WR, Wright EJ, Gladstone TR, Forbes P. Long-term effects from a randomized trial of two public health preventive interventions for parental depression. J Fam Psychol. 2007; 21(4):703-13. [DOI:10.1037/0893-3200.21.4.703] [PMID]
39. Shonkoff JP, Garner AS, Siegel BS, Dobbins MI, Earls MF, McGuinn L, et al. The lifelong effects of early childhood adversity and toxic stress. Pediatrics. 2012; 129(1):e232-46. [DOI:10.1542/peds.2011-2663] [PMID]
40. Ahlborg T, Berg S, Lindvig J. Sense of coherence in first-time parents: A longitudinal study. Scand J Public Health. 2013; 41(6):623-9. [DOI:10.1177/1403494813484992] [PMID]