Beyond illness severity: transdiagnostic cognitive vulnerabilities as independent predictors of psychological distress in parents of children with rare genetic disorders.

Introduction: Parents of children with rare genetic disorders are at increased risk of depression, anxiety, and stress symptoms. While previous research has primarily focused on illness-related factors, less is known about the contribution of transdiagnostic cognitive vulnerabilities to parental psychological distress. Aim: This study examined whether intolerance of uncertainty, distress tolerance, and tendency to worry predict parental depression, anxiety, and stress symptoms beyond the severity of the child's health status. Methods: The study included 184 parents (92 mother-father dyads) of children with rare genetic disorders and 94 parents of healthy children (14 mother-father dyads and 66 unpaired parents). Measures assessed child health status severity, intolerance of uncertainty, distress tolerance, tendency to worry, and symptoms of depression, anxiety, and stress. Results: Parents of children with rare genetic disorders, particularly mothers, reported higher levels of depression, anxiety, and stress symptoms compared with parents of healthy children. Greater severity of the child's health condition was associated with higher levels of psychological distress. Lower distress tolerance and greater tendency to worry independently predicted depression, anxiety, and stress symptoms beyond the severity of the child's health status. Conclusion: Transdiagnostic cognitive vulnerabilities, particularly lower distress tolerance and greater tendency to worry, together with female gender, were independently risk factors for parental psychological distress beyond the severity of the child's health status severity. These findings suggest that preventive interventions and counseling programs for parents of children with rare genetic disorders should address not only illness-related burden but also modifiable cognitive vulnerabilities.