Research on parental stress

There has been a movement from research on the epidemiology of ADHD to the parents and caregivers of children with ADHD. However, there is yet to be substantial research concentrated on the stress and more specifically tackling the approaches parents have utilized to cope with the stress they experience from their child's disorder.

Current research on parenting and ADHD has revealed that ADHD has important consequences to the sufferers, as well as their parents and siblings (Anderson and Werry, 1994; cited in Swensen et al, 2003). More specifically there has been discovery that parents experience greater stress than other parents with children without ADHD, because of the additional parenting challenges they face (Rabiner, 2002).

Research has also revealed findings that parental experiences with a child with ADHD leads to:

mood and anxiety disorders (Biederman et al, 1987; cited in Swensen et al, 2003),
lower sense of parenting competence (Mash and Johnston, 1983; cited in Podolski and Nigg, 2001),
less satisfaction as parents (Podolski and Nigg, 2001),
financial burden (Swensen et al, 2003), and
increased alcohol consumption (Chronis et al, 2003; and Pelham and Lang, 1999).

Kazdin and Whitley (2003) found that the stress of the parent influences parent disciplinary practices which directly promotes and escalates aggressive and oppositional child behaviour. That is, the stress of parents appear to increase parent irritability and attention towards deviant behaviour as well as negatively influencing increased deviant behaviour.

According to Barkley (2000), stressed parents of children with ADHD move through several steps in their efforts to control their child's disruptive behaviour. When a strategy fails to work, they more on to the next step in the sequence, prolonging their stress.

Initially, parents try to ignore or withhold attention from their child when the child demonstrates disruptive behaviour. in doing this, parents believe that the disruptive behaviour is intended merely to get attention, and so believe that ignoring it will decrease the problem. But, such behaviour from a child with ADHD is not the result of attempts for attention, and thus ignoring the behaviour will not work.
As the behaviour continues or intensifies, parents move on to give more commands and directives, especially those aimed at controlling the child's impulses. These commands are often restrictive requiring the child to stop what they are doing, and parents will find themselves repeating them frequently.
At some point however, annoyance and frustration may result in threats made. And, when this approach fails to motivate the child with ADHD to listen and obey, parents may move to the use of physical discipline or other forms of punishment such as time-out, or loss of privileges.
At this point, some parents simply give up with frustration and increased distress.

Children with ADHD who are unable to sit still, talk excessively, and behave in an undesirable manner, can put a serious dent in a parent's patience and create great stress, making day-to-day coping a unique challenge. Barkley (2000) makes a very valid and important statement, that is, one of the most difficult aspects of ADHD for parents and caregivers is that it evolves ass a child grows up, and therefore, what worked at age 6, may not work at age 16. This makes stress and coping that much more difficult.

Barkley (2000) has presented parents with ways they can cope with the stress they endure. He proposes techniques such as:

delaying intense impulsive responses when emotionally aroused,
practicing relaxation,
taking a holiday,
taking up a hobby, and
sharing parenting responsibilities, to name a few.

Some of the suggestions could be quite useful, however, there is a lack of evidence to suggest that these techniques are being exercised by parents who are stressed, and whether they are useful or not.

Podolski and Nigg (2001) are one of the few researchers that have explored coping techniques attempted by parents. Positive reframing and the use of social support were techniques examined related to the stress and coping of parents with children with ADHD.

Positive reframing:
- stressful experiences are redefined in order to make them more manageable,
- demonstrated to be a frequent technique used by parents, and
- resulted in:
  - lower levels of parental distress, and
  - lower levels of child behaviour problems.
Social support:
- parents of ADHD children had fewer extended family contacts, and the family contacts they did have were perceived as less helpful, causing more, rather than less, stress, and
- was associated with more maternal distress.

Weinberg (1999) studied the use of Parent Training (PT) as a treatment option, but more so as a coping technique.

Parent Training:
- enhanced knowledge and understanding of ADHD,
- improved behaviour management techniques, and
- experienced a reduction in stress levels.