The Association Between Parenting Stress, Parenting Self-Efficacy, and the Clinical Significance of Child ADHD Symptom Change Following Behavior Therapy

Abstract

We examined parenting stress (PST) and self-efficacy (PSE) following participation in behavioral parent training (BPT) with regard to child treatment response. Forty-three families of children diagnosed with ADHD participated in a modified BPT program. Change in PST and PSE was evaluated using a single group, within-subjects design. Parenting outcomes based on child treatment response were evaluated based upon (1) magnitude and (2) clinical significance of change in child symptom impairment. Parents reported significant improvements in stress and self-efficacy. Parents of children who demonstrated clinically significant reduction in ADHD symptoms reported lower stress and higher self-efficacy than those of children with continued impairments. Magnitude of child impairment was not associated with parent outcomes. Clinical implications for these results include extending treatment duration to provide more time for symptom amelioration and parent-focused objectives to improve coping and stress management.

The Children’s Attention-Deficit Hyperactivity Disorder Telemental Health Treatment Study: Caregiver Outcomes

“…Our results contribute to the small body of research showing the beneficial effects for caregivers of improvement in children’s ADHD symptoms (Accurso, Garland, Haine-Schlagel, Brookman-Frazee, & Baker-Ericzen, 2015; Heath et al, 2015), and the study is the first to formally test these indirect effects. The findings suggest that effective treatment of child ADHD may counter the well-documented detrimental effects of child ADHD on caregiver mental health (Accurso, et al, 2015).…”

“…Caregivers of children with ADHD in both community and clinical samples have described high levels of depression, anxiety, and substance use problems (Anastopoulos, Guevremont, Shelton, & DuPaul, 1992; Baldwin, Brown, & Milan, 1995; Bussing et al, 2003; Chronis et al, 2003; Chronis-Tuscano et al, 2013; Evans, Sibley, & Serpell, 2008; Hinshaw, 2007; Rockhill, Violette, Vander Stoep, Grover, & Myers, 2013) and decreased quality of life (Harpin, 2005; Heath, Curtis, Fan, McPherson, 2015; van den Hoofdakker et al, 2010). The stress and strain of raising children with ADHD have shown persistence for follow-up periods of up to eight years (Barkley, Fischer, Edelbrock, & Smallish, 1990; Barkley, Fischer, Edelbrock, & Smallish, 1991).…”

“…Parenting stress adversely affects child-rearing practices and child disruptive behaviors (Barry, Dunlap, Cotten, Lochman, & Wells, 2005; Kazdin & Whitley, 2003; Podolski & Nigg, 2001; Qi & Kaiser, 2003) that may improve with parent behavior training (Anastopoulos, Shelton, DuPaul, & Guevremont, 1993; Pisterman et al, 1992; Wells et al, 2000). Conversely, child ADHD and disruptive behaviors may affect both parent functioning and their response to interventions (Heath at al., 2015; van den Hoofdakker et al, 2010). Thus, there is some indication of reciprocity in parent-child functioning and foci for intervention.…”

Effect of Parent Management Training on Attention, Response Prevention, Impulsivity and Vigilance of Boys with Attention Deficient/Hyperactive Disorder

“…Although parents of children with ADHD experience a higher level of stress related to parenting and frequently feel inefficient (7), negative parenting styles influence symptoms, comorbidities, and long-term outcomes of ADHD (8). Parent management training (PMT) has been introduced as one of the main interventions for these children (9).…”

Cumulative family risks across income levels predict deterioration of children’s general health during childhood and adolescence

“…Eight risk factors that have been identified to predispose children to suboptimal health are under consideration of the current study: poverty [16, 24], single parenthood [25, 26], family stress [27–29], unstable employment [30, 31], large families [32, 33], poor maternal health [34], emotional health[35–37] and education [38, 39]. They can be managed as two segments: distal and proximal.…”