Parents' Stress and Coping with Their Children's Attention Deficit Hyperactivity Disorder
Mitchell, Mary Moser
Beck, Kenneth H
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In a previous study, the National Institute of Mental Health enrolled 579 children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) in a randomized controlled trial to test the efficacy of a stimulant medication. ADHD affects 3-5% of children before age 7 and is characterized by difficulties in controlling impulsive and hyperactive behaviors and/or paying attention. Studies of children with ADHD indicate that the disorder can be extremely disruptive to family functioning. While the original NIMH study examined the children's outcomes, this investigation explored quality of life among the parents of these children. Quality of life was considered in terms of emotional well-being and social functioning. Various studies within the health psychology discipline have suggested that coping strategies, social support, and stress appraisal significantly influence and predict quality of life. It was hypothesized that stress appraisal, social support, coping skills, and symptom severity would predict quality of life indicators (i.e. spouse relationship, parent/child relationship, and psychological/emotional functioning) for parents. This main effects hypothesis was tested using baseline data and using longitudinal data, while controlling for baseline measures. The second set of hypotheses proposed that social support and coping skills would moderate the relationship between stress appraisal and quality of life. These relationships were tested using the baseline data as well as the longitudinal data, while controlling for baseline measures and a variety of covariates (i.e. demographic variables). In addition, the relationship between objective stressors and stress appraisal was tested, as well as the direct effects of objective stressors on the quality of life outcomes. A combination of structural equation modeling and multiple regression analyses were used to analyze the data. Stress appraisal was the most consistent and strongest predictor of quality of life outcomes for parents. Social support, coping, and symptom severity played significant, yet modest roles in prediction. Objective stressors significantly predicted stress appraisal as well as the quality of life indicators. These results indicated support for both the main effects and moderating hypotheses. Recommendations for health educators seeking to develop intervention programs for this population of parents were offered.