Parenting psychological flexibility and its associations with prosocial and problem behaviors in children with leukemia: a latent profile analysis

This study aimed to identify latent profiles of parenting psychological flexibility (PPF) among parents of children with leukemia and to examine their associations with children's behavioral outcomes and clinical and sociodemographic characteristics. A cross-sectional survey was conducted in three Grade A Tertiary Hospitals in Henan Province, China, with 223 parents of children with leukemia (mean parent age = 36.83 years; mean child age = 7.99 years). Latent profile analysis identified three latent classes of PPF: Class 1 (Low Cognitive Defusion-High Emotional Acceptance, 32.7%), Class 2 (High Cognitive Defusion-Low Emotional Acceptance, 41.3%), and Class 3 (High Parenting Flexibility, 26%). Children of parents in Class 1 exhibited more problem behaviors and fewer prosocial behaviors than those in Classes 2 and 3. Multinomial regression indicated that unmarried parents were more likely to belong to Class 1 (OR = 0.211, p = 0.007) or Class 2 (OR = 0.003, p < 0.001) than to Class 3. In addition, parents of male children showed a higher likelihood of belonging to Class 1 compared with Class 3 (OR = 0.440, p = 0.049).These findings underscore the importance of tailored psychological interventions for different PPF profiles to strengthen parental flexibility, which are linked to better behavioral outcomes in children with leukemia.