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Predictors of stress-related growth in parents of children with ADHD

Ricky Finzi-Dottan
a,b,
*, Yael Segal Triwitz
b,1
, Pavel Golubchik
b,c,1
a
Bar Ilan University, School of Social Work, Ramat Gan 52900, Israel
b
Child & Adolescence Outpatient Clinic, Geha Mental Health Center, Petah Tiqva, P.O. Box 102, 49100, Israel
c
Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel
1. Introduction
Many studies describe the distress of parents whose children are diagnosed with attention decit/hyperactive disorder
(ADHD), whereas conspicuously few report positive effects such as stress-related growth. The present study was aimed at
investigating growth and its predictors in parents of children with ADHD compared to parents of non-clinical children.
1.1. Parenting children with ADHD
Attention decit/hyperactivity disorder (ADHD) is a chronic and debilitating disorder affecting 35% of all school-aged
children (American Psychiatric Association, 2000). Children with ADHD exhibit persistent and developmentally
inappropriate levels of inattention, impulsivity and hyperactivity that place them at risk for academic failure, social
interaction difculties and signicant behavioral disturbances (Barkley, 2006). These children are usually less compliant,
more negative, stubborn and bossy, have temper outbursts and lowfrustration tolerance, and are less able to followparental
Research in Developmental Disabilities 32 (2011) 510519
A R T I C L E I N F O
Article history:
Received 16 December 2010
Accepted 23 December 2010
Available online 20 January 2011
Keywords:
Children with ADHD
Emotional intelligence
Perceiving parenthood
Social support
Stress-related growth
A B S T R A C T
This study was designed to investigate stress-related growth in 71 parents of children with
ADHD, compared with 80 parents of non-clinical children. Adopting Tedeschi and
Calhouns (2004) theoretical framework for predicting personal growth, the study
investigated the contribution of emotional intelligence (individual characteristics), social
support (environmental factors), parental self-efcacy and perceptions of parenting as a
challenge vs. a threat (cognitive processing). Results indicated that emotional intelligence
was the main predictor of stress-related growth, particularly for parents of ADHDchildren,
emphasizing that this personal trait is especially relevant to coping with on-going parental
strain; whereas social support made a greater contribution to growth for the control group
than for parents of children with ADHD. Path analysis conrmed our research model,
suggesting that parents sense of competence and of parenthood as a challenge vs. a threat
mediates between emotional intelligence and social support on the one hand, and growth
on the other.
2010 Elsevier Ltd. All rights reserved.
* Corresponding author at: Bar Ilan University, School of Social Work, Ramat Gan 52900, Israel. Tel.: +972 3 5491044/9258419;
fax: +972 3 7384042/9258546.
E-mail addresses: rikifnz@biu.013.net.il (R. Finzi-Dottan), orisegal@netvision.net.il (Y.S. Triwitz), pavelgo@gmail.com (P. Golubchik).
1
Tel.: +972 3 9258419; fax: +972 3 9258546.
Contents lists available at ScienceDirect
Research in Developmental Disabilities
0891-4222/$ see front matter 2010 Elsevier Ltd. All rights reserved.
doi:10.1016/j.ridd.2010.12.032
instructions and adhere to family rules than other children their age (Segal, 2001; Whalen et al., 2006). In response, their
parents may use over-reactive, inconsistent and punitive disciplinary methods. The parents display more disapproval, give
their children fewer rewards, and show more overall negative behavior than parents of children without ADHD
(Anastopoulos, Shelton, DuPaul, & Guevremont, 1993; Johnston, 1996; Stormshak, Bierman, McMahon, & Lengua, 2000).
Studies indicate a growing awareness that ADHDnegatively affects the functioning of parents of children with this disorder,
and describe decreased parenting esteemand satisfaction, heightened parental distress and discord, reduced parental sense
of competence, lowexpectancies for success in managing their children, and increased levels of parenting stress and parental
psychopathology, particularly when ADHD is co-morbid with conduct problems (Johnson & Reader, 2002; Johnston & Mash,
2001; Maniadaki, Sonuga-Barke, Kakouros, & Karaba, 2005; Podolski & Nigg, 2001; Shelton et al., 1998; Sobol, Ashbourne,
Earn, & Cunningham, 1989; Whalen et al., 2006).
Parents beliefs regarding their self-efcacy or sense of competence were identied as a core construct within the
constellation of parental cognitions related to difcult and challenging behaviors of children. Parents beliefs about their own
effectiveness at dealing with difcult behaviors have been related to positive vs. negative parental emotions and behaviors.
Negative parental emotions seemto inuence the cognitive appraisal process that creates self-competence perceptions, and
both emotions and self-competence beliefs seem to affect parenting jointly (Coleman & Karraker, 1998; Maniadaki et al.,
2005; Rogers, Wiener, Marton, & Tannock, 2009). Thus we may hypothesize that parents of children with ADHD perceive
parenting as more threatening and less challenging due to their daily parenting stress and negative emotions towards their
childs behavior.
Research has shown social support to be one of the main resources of individuals coping with stress in general (Williams
&Galliher, 2006), and of parents dealing with unique situations in particular, such as parenting children with ADHD(Bussing
et al., 2003). Social support is dened as an interpersonal transaction involving an emotional, an informational, a social and
an instrumental dimension (Cohen, 2004). A widely accepted method of supporting parents of children with ADHD and
improving their sense of competence has been either some formof behavioral parent training (e.g., Chronis, Chacko, Fabiano,
Wymbs, &Pelham, 2004; Danforth, 1998; Erhardt &Baker, 1990; Sonuga-Barke, Daley, Thompson, Laver-Bradbury, &Weeks,
2001) or psycho-educational interventions focusing on adopting effective methods of managing child behavior (Pelham,
Wheeler, & Chronis, 1998; Treacy, Tripp, & Baird, 2005). Our study hypothesized that social support (by professionals and
family members) has the potential not only to assist these parents in their daily task of managing their ADHD children, but
also to promote an experience of growth while improving parental coping.
Although there is much research describing the burden and distress involved in parenting children with ADHD and the
patterns of negative parenting that develop as a result, little is known about positive effects such as personal growth. In a
qualitative study, Segal (2001), who interviewed 25 mothers of children with ADHD, reported that some mothers said they
felt they had become more mature, independent, and sensitive to the pain of others as a result of the experience of raising a
child with ADHD. In some ways they had become tougher and more confrontational, ready to do battle to help their child.
Many felt their value systems and priorities had changed (Segal, 2001).
Breaking with the tradition of focusing on what is wrong with people, positive psychology asks what else, besides the
amelioration of psychological suffering, contributes to doing well, being happy and thriving, and experiencing personal
growth (Folkman & Moskowitz, 2000; Janoff-Bulman, 2006; Joseph & Linley, 2008; Seligman & Csikszentmihalyi, 2000).
1.2. Stress-related growth
Stress-related growth (Park, 2004; Park & Helgeson, 2006) refers to the positive life changes that people make as a result
of their struggles to cope with negative life events and adverse situations. This concept has also been termed post traumatic
growth, or perceived benets (Calhoun & Tedeschi, 2004), and growth following adversity (Joseph & Linley, 2006). These
changes can include improved relationships with family and friends, a clearer sense of ones own strengths and resilience,
and changed priorities and values (Joseph & Linley, 2006; Linley & Joseph, 2004).
Although traumatic and life-threatening events have provided the focus for most of the research to date, Aldwin and
Levenson (2004) have argued that stress can result in change even with relatively small stressors, depending on the stressor
characteristics, individual resources and coping strategies. Joseph and Linley (2008) emphasize that growth can arise
through events that are not necessarily life-threatening to oneself. In this vein, Folkman and Moskowitz (2000) reported that
caregivers of people with severe diseases described experiencing growth through coping with their work (Folkman &
Moskowitz, 2000). There is also a growing body of research on stress-related growth and benecial effects among parents of
disabled children (Hastings et al., 2005; Hastings & Taunt, 2002; King & Patterson, 2000; Scorgie & Sobsey, 2000; Taunt &
Hastings, 2002).
Tedeschi and Calhoun (2004) used the term rumination to signify the cognitive-emotional process that leads to growth
following a struggle with a stressful event or situation and the negative changes it has wrought. According to Tedeschi and
Calhouns (2004) model, individual characteristics predispose one to engage in constructive cognitive processing.
Environmental inuences, such as the level of emotional support within the social network, can also increase the likelihood
of post traumatic growth by reducing emotional distress, preventing it from overwhelming the distressed individual and
allowing him or her to sustain cognitive engagement with the trauma or stressful situation.
Joseph (2009) describes the personality characteristics and ways of coping with distressing emotions that were
investigated as possible predictors of growth. These include intelligence, determination, exible attitudes, extraversion,
R. Finzi-Dottan et al. / Research in Developmental Disabilities 32 (2011) 510519 511
openness to experience, agreeability, conscientiousness, emotional stability, optimism, ability to actively cope with
problems, seeking support from others, and positive reinterpretation.
In the present study we examined the concept of emotional intelligence as a personality characteristic predicting growth
in parents of children with ADHD.
1.3. Emotional intelligence
Salovey, Mayer, Caruso, and Lopes (2003) dene emotional intelligence (EI) as the ability to perceive emotion, integrate
emotion to facilitate thought, understand emotions, and to regulate emotions to promote personal growth (p. 251).
Whereas Petrides, Perez-Gonzalez, and Furnham (2007) consider emotional intelligence to be a personality trait, Salovey
et al. (2003) view EI as a set of mental abilities or competencies, which can be trained and promoted (Zeidner, Roberts, &
Matthews, 2002). They conceive of EI as consisting of four components: (1) the ability to identify emotions in oneself and
others; (2) using emotion to facilitate thought necessary to communicate feelings; (3) understanding emotions and their
meaning through relationships; (4) managing and regulating emotions. EI may predict stress responses and coping strategies
in a variety of applied settings (Matthews et al., 2006); it enables and enhances empathic perspective-taking and responding
to others feelings, self-regulation, and the development of coping skills in conictual situations (Matthews, Roberts, &
Zeidner, 2004; Salovey, Caruso, & Mayer, 2004; Schutte et al., 2001), and is therefore relevant to parenting in general and to
parents of children with ADHD in particular.
1.4. The present study
The study sought to examine factors contributing to growth in parents of children with ADHD, conceiving of their daily
coping as an ongoing stressful situation. We relied on Tedeschi and Calhouns (2004) model of growth, postulating that
individual characteristics, style of managing distressful emotions, and social support all play an important role in the
cognitive processing of the stressful event that predicts growth. The cognitive processing of parenting children with ADHD
was assessed by using parents perception of their parenting as challenging vs. threatening, and by their perceptions of their
own competence. EI serves as individual characteristics, which promote the managing of distressing emotions, and coping
skills. Environmental inuence was assessed by examining the social support parents reported they received from family
members, friends and professionals.
Our research model postulated that emotional intelligence and social support affect the cognitive processing involved in
parenting children with ADHD, thus serving as a predictor of growth. We hypothesized that, since parents of children with
ADHD are subject to greater stress than parents of non-clinical children, they would exhibit lower levels of parental
competency, perceive parenting more as a threat than a challenge, and report higher levels of personal growth.
2. Method
2.1. Participants
One hundred and fty one parents participated in the study, including 71 parents of children diagnosed with ADHD (P-
ADHD) and 80 parents of non-clinical children (P-NC) (a typically developing control group). The groups were matched
according to parents gender, age and childrens age. The P-ADHD group included 18.3% fathers and 81.7% mothers
(Mage = 40.86, 6.79 SD) and the P-NC group included 18.2% fathers and 81.8% mothers (Mage = 39.86, 6.17 SD). Of the P-
ADHD group, 77.1% were married and 22.9% were divorced or single-parent mothers, while 81% of the P-NC group were married
and 19% divorced or single-parent mothers. No signicant difference was found between groups regarding the mean age of the
children (t(1, 149) = 1.66; p >.05): childrens ages in the P-ADHD group ranged from8.22 to 13.91 years, and from7.80 to 13.3 in
the P-NC group.
Among the children with ADHD, 48.5% were reported by parents as having behavior problems (e.g., oppositional deant
disorder or conduct disorder); 50% of the parents in the P-ADHD group reported that other children in family were also
diagnosed with ADHD.
The parents of the children with ADHD were asked whether they saw any resemblance between their child and
themselves in childhood. Thirty-two percent answered yes, 3% answered somewhat and 64% answered no.
2.2. Assessment measures
2.2.1 Growth was assessed using the 21-itempost-traumatic growth inventory (PTGI; Tedeschi &Calhoun, 1996), adapted
for parenthood (Spielman &Taubman-Ben-Ari, 2009). Participants were asked to address the various changes in their lives as
a result of their daily parenting task (e.g., I changed my priorities about what is important in life; Knowing I can handle
difculties), on a scale from 0 (not at all) to 5 (a great deal). Tedeschi and Calhoun (1996) reported a general internal
reliability of a= .90 for the global score, indicating that the PTGI has good construct validity, as well as concurrent and
discriminant validity. In the present study, internal reliability was a= .88. Each participant was therefore assigned a score
equal to the mean of his or her scores on all items, with higher scores indicating a greater sense of growth.
R. Finzi-Dottan et al. / Research in Developmental Disabilities 32 (2011) 510519 512
Although the PTGI was developed specically for the purpose of measuring growth following trauma, its developers
suggest that growth might also result from other kinds of experiences, and that the PTGI might be a suitable measure of
growth regardless of the nature of precipitating events (Tedeschi & Calhoun, 2004). Anderson and Lopez-Baez (2008) used
the PTGI to measure growth in university students. Comparing their results with those of trauma studies indicated that the
PTGI can serve as a general measure of growth, suitable for non-trauma studies.
2.2.2 Emotional Intelligence (EI) was assessed using the emotional intelligence inventory (EIS), a 33-item questionnaire
(Schutte et al., 1998) in which respondents are asked to rate each item using a 5-point scale ranging from 1 (strongly
disagree) to 5 (strongly agree). Items were sampled equally from the three domains of the original Salovey and Mayer
(1990) model of EI: emotional appraisal, emotion regulation and utilization of emotions (e.g., I am aware of my non-verbal
messages; I can identify other peoples feelings by observing their facial expressions; I can easily identify my own
feelings while I am feeling them). Validity was supported by the scales correlation with theoretically related constructs,
including mood awareness, clarity of feelings, mood repair, optimism and impulse control, interpersonal functioning, and
cognitive task persistence (Schutte et al., 1998, 2001; Schutte, Schuettpelz, & Malouff, 2000).
In our study the alpha coefcient reliabilities were .81 for emotional appraisal, .84 for emotion regulation, and .77 for
utilization of emotions. Pearson correlations between all items ranged from r = .48 (p <.001) to r = .64 (p <.001), thus an
overall score with high internal consistency (a= .92) was used. Each participant was therefore assigned a score equal to the
mean of his or her scores on all items, with higher scores indicating greater sense of growth.
2.2.3 Social support was assessed using the multidimensional scale of perceived social support (MSPSS; Zimet, Dahlem,
Zimet, & Farley, 1988; Zimet, Powell, Farley, Werkman, & Berkoff, 1990). The MSPSS is a 12-item self-report instrument
measuring perceived support fromthree domains: family, friends, and a signicant other. Respondents use a 7-point Likert-
type scale (ranging from very strongly disagree to very strongly agree) for each item. Zimet et al. (1988,1990) reported
internal reliability estimates of .88 for total score and .87, .85, and .91 for the family, friends, and signicant other subscales.
Factor analysis of the MSPSS conrmed the three-factor structure of the measure, with no indication of a social desirability
bias (Dahlem, Zimet, & Walker, 1991). In the present study, signicant other was changed to mental health professional,
and the alpha coefcient reliability was .93 for the total score. Each participant was assigned a score equal to the mean of his
or her scores on all items, with higher scores indicating greater social support.
2.2.4 Parenting sense of competence was measured using Johnston and Mashs (1989) version of Gibaud-Wallston and
Wandersmans (1978, as cited in Johnston & Mash, 1989) parenting sense of competence scale (PSCS). This parental self-
report instrument is a 17-item questionnaire assessing how condent parents feel in their ability to handle their childs
problems. It yields two subscales: knowledge/skill, addressing parents self-perceptions regarding the skills and
understanding required to be a good parent (9 items; e.g., A difcult problem in being a parent is not knowing whether
you are doing a good job or a bad one); and (b) valuing/comfort, i.e., the degree to which respondents feel comfortable and
capable in their role as parents and the value they assign to the parental role (8 items; e.g., I meet my own personal
expectations for expertise in caring for my children). Respondents use a 6-point Likert-type scale (ranging from strongly
disagree to strongly agree).
Mash and Johnston (1983) examined parents of hyperactive children and found consistent inverse relationships between
parental self-efcacy and perceptions of child behavior problems. Adequate psychometric properties were reported by
Johnston and Mash (1989), i.e. a coefcient alpha of .76. In our study the alpha coefcient reliabilities for the skills subscale
was .70, and .74 for the valuing subscale. Each participant was assigned a score on each factor equal to the sum of his or her
relevant scores, with higher scores indicating more positive perceived parental competence.
2.2.5 Cognitive appraisal of parenting as a challenge and/or threat was assessed using a modication of the Folkman and
Lazarus (1985) Cognitive Appraisal Questionnaire for parenthood (Dimitrovsky, Levy-Shiff, & Perl, 2000). The modied
questionnaire measures the degree to which parenting is viewed as a challenge, or as positive in its implications (e.g., To
what extent does being a parent give meaning to your life?), and the degree to whichit is viewed as a threat, or as negative in
its implications (e.g., To what extent does being a parent jeopardize your independence?). The questionnaire is composed
of 19 items, 10 referring to threat and 9 to challenge. Respondents rate each items on a 6-point scale (1 = not at all, 6 = very
much). For each participant a score for challenge and a score for threat were calculated by averaging their ratings of the
items. In our study, Cronbachs alpha was .82 for threat and .80 for challenge in parenthood.
2.3. Procedure
Participants were recruitedfromthe Child &Adolescence Outpatient Clinic of the Geha Mental Health Center inIsrael inthe
course of three months (JanuaryMarch 2009). The childrens ADHD diagnosis was established according to accepted
procedures as described in the literature (Cantwell, 1996) and included: a thorough anamnesis taken by psychiatric interview
and based on DSM-IV-TR criteria; a psychiatric examination; the Abbreviated Conners Rating Scale for parents and teachers
(Conners, 1998); and the Test of Variables of Attention (T.O.V.A.). The T.O.V.A., one the diagnostic tools for ADHD, is a
computerized test performed by the child, with sensitivity and specicity of approximately 80%. Its advantages are objectivity
andits abilitytoevaluate attention(Greenberg&Waldman, 1993; Schatz, Ballantyne, &Trauner, 2001). All childrenwereunder
medication. All parents were receiving psycho-educational therapy, focusedonparental coping and management of the childs
disorder. The study complied with the World Medical Association Code of Ethics (Helsinki declaration) and followed the
guidelines of the local ethics committee, and informed consent was obtained from all participants.
R. Finzi-Dottan et al. / Research in Developmental Disabilities 32 (2011) 510519 513
2.4. Data analysis
To examine group differences in emotional intelligence, social support, parenting sense of competence, parenthood as
challenge vs. threat, and growth, multivariate analyses of variance (MANOVA) and univariate analyses of variance (ANOVA)
were performed. Pearson analyses were conducted to examine correlations between the research variables. The contribution
of the independent variables to growth was predicted via hierarchical regression, the main goal of which was to examine the
interactions with groups (P-ADHD vs. P-NC), which were analyzed following the standard procedure of Baron and Kenny
(1986). Path analysis (by AMOS 7) was performed to examine the possibility of a mediating model, including parenting sense
of competence and parenthood as challenge vs. threat, as mediating between emotional intelligence and social support on
the one hand, and personal growth on the other.
3. Results
3.1. Differences between groups
MANOVAs indicated signicant differences between the P-ADHDand P-NC groups, F(7, 141) = 4.40; p <.001; h
2
p
:18. As
can be seen in Table 1, ANOVAs indicated signicant differences between groups in social support, parental sense of
competence (with P-NC scoring higher than P-ADHD), and parenthood as threat (with P-ADHD scoring higher than P-NC);
non-signicant differences were found between groups in EI, parenthood as a challenge, and growth.
ANOVAs were also performed to see whether differences would be found in the research variables between P-ADHD
parents reporting that their children had behavior problems (such as oppositional deant disorder or conduct disorders),
that other children in the family were also diagnosed with ADHD, or that they saw a resemblance between themselves in
childhood and their child, and those who did not. The only signicant difference found was as regards parenthood as a
challenge: parents whose children did not display behavior problems reported viewing parenthood as more a challenge than
a threat than parents whose children did have behavior problems (F(1, 64) = 3.99; p <.05; h
2
= .06).
3.2. Correlations between the research variables
As can be seen in Table 2, signicant correlations were found between all research variables except parenthood as threat
and parenting sense of competence.
3.3. Hierarchical regression analysis for predicting growth
A hierarchical regression analysis was performed to investigate the contribution of a series of independent variables and
interactions with the subject groups (P-ADHD vs. P-NC) to the prediction of growth. As seen in Table 3, regression analysis
Table 1
Differences between groups.
P-ADHD
n = 71
P-NC n = 80 F (1, 147) h
2
p
M SD M SD
Emotional intelligence 3.89 .53 3.90 .44 NS
Social support 4.85 1.33 5.34 1.23 5.36
*
.04
Parenting sense of competence 66.85 14.10 73.60 11.74 10.08
**
.07
Parenthood as challenge 4.00 .58 4.06 .47 NS
Parenthood as threat 2.81 .72 2.59 .66 3.60 .03
Growth 3.48 .71 3.44 .54 NS
Note: P-ADHD= parents of ADHD children; P-NC = parents of non-clinical children.
*
p <.05.
**
p <.01.
Table 2
Correlations between the research variables (n = 151).
1 2 3 4 5
Emotional intelligence (1)
Social support (2) .42
***
Parenting sense of competence (3) .39
***
.40
***
Parenthood as challenge (4) .48
***
.37
***
.28
***
Parenthood as threat (5) .26
***
.40
***
.13 .19
**
Growth (6) .46
***
.37
***
.38
***
.46
***
.19
**
**
p <.01.
***
p <.001.
R. Finzi-Dottan et al. / Research in Developmental Disabilities 32 (2011) 510519 514
revealed that the predictors explained 46% of the variance of growth. The rst step of the analysis introduced gender, age,
education, economic status, and religiosity to control for their impact on the predictors. Of these, age, education and
economic status contributed signicantly to the explained variance (14%). The b coefcient indicated that the lower the
education level and economic status and the younger the age of the parents, the more growth could be predicted. In the
second step, when groups were introduced (P-ADHD vs. P-NC), subject group did not contribute to the prediction. Based on
our research model, we introduced emotional intelligence and social support in the third step of the regression equation.
Emotional intelligence and social support added 20% to the explained variance of growth. Thus higher levels of emotional
intelligence and social support led to greater psychological growth. In the fourth step the cognitive variables entered:
parenting sense of competence, and parenthood as challenge or threat; only parenthood perceived as a challenge
contributed signicantly, adding 7% to the prediction; according to the b coefcient, the more parenthood is perceived as a
challenge, the more growth occurs. The fth and nal step consisted of the interactions between the predictors and the
groups, which entered according to the signicance of their contribution (p <.05). Two signicant interactions emerged:
group emotional intelligence, and group social support, adding 5% more to the prediction of growth. To clarify these
interactions, we calculated separately the correlation between growth on the one hand, and each group (P-ADHD and P-NC)
with emotional intelligence and social support, on the other.
Analysis of the interaction group emotional intelligence revealed a signicant correlation between growth and
emotional intelligence in the P-ADHD group (r = .67, p <.001), but not in the P-NC group (r = .17, NS); in other words,
emotional intelligence contributed to growth for parents of children with ADHD, but not for parents of non-clinical children.
Analysis of the interaction group social support revealed a higher correlation between growth and social support in the
P-NC group (r = .51, p <.001) than in the P-ADHDgroup (r = .25, p <.01). This nding suggests that social support contributed
to growth in the control group more than it did for parents of children with ADHD.
3.4. Path analysis: Examining the role of parenting sense of competence and parenthood as challenge vs. threat in mediating
between emotional intelligence and social support on the one hand, and growth on the other
We used AMOS 7 path analysis to examine the research model, positing that parental sense of competence and perception
of parenting as a challenge vs. a threat could mediate between emotional intelligence and social support on the one hand and
growth on the other. The exogenous variables were emotional intelligence, social support, and groups; the mediating
variables were parental sense of competence and perception of parenting as challenge vs. threat; the dependent variable was
growth.
This analysis yielded good adjusted goodness of t: x
2
= 2.28; df = 2; p = .13; CFI = .99; NFI = .99; RMSEA= .07. The target
variable was growth; its explained variance was 30%. Fig. 1 presents only the b coefcients that were found to be signicant
(p <.05 and higher). The gure shows that both emotional intelligence and social support have an indirect effect on growth,
while emotional intelligence also has a direct effect on growth. Group has an indirect effect on growth; according to the b
Table 3
Hierarchical regression analysis for predicting growth (n = 151).
Predicting variables B SE B Beta t DR
2
Step 1 .14
***
Gender .00 .13 .02 .00
Age .02 .01 .23
**
2.94
**
Education .07 .04 .17
*
2.02
*
Economic status .15 .07 .18
**
.2.20
*
Religiosity 1.02 .07 .13 1.56
Step 2 .00
Groups 1 (P-ADHD vs. P-NC) .02 .09 .02 .23
Step 3 .20
***
Emotional intelligence .50 .09 .41
***
5.61
***
Social support .10 .04 .22
**
2.74
**
Step 4 .07
**
Parenting sense of competence .01 .00 .09 1.10
Parenthood as challenge .28 .10 .25
**
2.90
**
Parenthood as threat .07 .07 .08 1.10
Step 5 .05
*
Group emotional intelligence .16 .05 .26
**
3.45
***
Group social support .10 .05 .16
*
2.13
*
Note: 1 = = fathers; 2 = + = mothers; 1 = = parents of ADHD children; 2 = + = parents of non-clinical children.
*
p <.05.
**
p <.01.
***
p <.001.
R. Finzi-Dottan et al. / Research in Developmental Disabilities 32 (2011) 510519 515
coefcients and the ANOVA analysis (presented in Table 1), the P-ADHD group contributed to parenthood as a threat,
whereas signicant but lower b coefcients indicated that the P-NC group contributed to parenthood as a challenge and to
parental sense of competence. The gure shows that emotional intelligence made a signicant negative contribution to
threat and a positive contribution to parenting as challenge and to parental sense of competence; this besides a direct
positive contribution to growth. Social support made a signicant negative contribution to threat and a positive contribution
to parenting as a challenge, and to parental sense of competence. Parenthood as a threat made a signicant negative
contribution to growth, and parenting as a challenge and parenting sense of competence made signicant contributions to
growth.These ndings conrm our hypothesis that high levels of emotional intelligence and social support contribute to
personal growth via the mediation of high parental sense of competence and perception of parenting more as a challenge
than as a threat.
4. Discussion
The present study examined the potential for personal growth inherent in the stressful daily coping faced by parents of
ADHDchildren, compared with the more routine coping required of parents of non-clinical children. Following Tedeschi and
Calhouns (2004) model of growth, we examined the following variables for this purpose: cognitive processing of the
stressful situation (perception of parenting as challenging vs. threatening, and parents perception of their competence),
individual characteristics predisposing one to engage in constructive cognitive processing (emotional intelligence) and
environmental inuence (social support).
In line with our hypotheses, parents of children with ADHD reported perceiving parenthood as more of a threat than
parents of non-clinical children, as well as reporting lower levels of parenting sense of competence in comparison to the
controls. Contrary to expectations, however, non-signicant differences were found in personal growth between the two
groups, and the interaction found in the regression analysis indicated that social support contributed to growth more
strongly for the control group than for parents of children with ADHD. The path analysis supported our research model,
though emotional intelligence also had a direct effect on growth. According to the path model, emotional intelligence had
both a direct and an indirect effect, and social support had an indirect effect on growth; the contribution of both these
variables to the prediction of growth was mediated by parental sense of competence and perception of parenting as a
challenge vs. a threat.
Emotional intelligence had the strongest predictive power for personal growth; this nding is in line with Tedeschi and
Calhouns (2004) model, which suggests that individual characteristics predispose one to engage in constructive cognitive
processing for promoting growth. The interaction found in the regression analysis indicated that emotional intelligence
contributed to growth in parents of children with ADHD and not for parents of non-clinical children, suggesting that
emotional intelligence is not just an ordinary ability promoting growth but one that comes especially into effect under
stressful circumstances.
The literature tends to emphasize parental difculties and adverse psychological effects when there is a child with ADHD
in the family. Most parents perceive the daily coping with their ADHD children as a burden, and report higher levels of role
distress, dissatisfaction in their parenting, and damaged sense of parental competence than parents of non-clinical children
(Harrison & Sofronoff, 2002; Johnston & Mash, 2001; Podolski & Nigg, 2001). The role of parental self-attribution in the way
parents perceives their childs behavior is essential especially for parents of children with ADHD. Whereas parents self-

Fig. 1. Examination of path model of growth.


R. Finzi-Dottan et al. / Research in Developmental Disabilities 32 (2011) 510519 516
attributions as being unsuccessful in controlling the behavior of their ADHD child contributed to their distress (Harrison &
Sofronoff, 2002), parents who perceived problems as challenges that might be overcome, and who employed more positive
reframing, were described as enjoying higher role satisfaction (Podolski & Nigg, 2001), and this parental attitude in turn
mitigated the severity of the childs ADHD disorder (Segal, 2001). Our results emphasized the essential role of emotional
intelligence in perceiving the childs behavior as thinkable and manageable, thus promoting parental growth. Although the
parents of children with ADHD in our study reported a greater sense of threat in their parenting and less parental
competence (in line with other studies; e.g. Johnston & Mash, 2001), emotional intelligence had the potential for promoting
growth in these parents (but not in the controls, as found by the regression analysis). We suggest that these parents need
special abilities for experiencing growth in their daily stressful coping with their children. Similarly, Segal (2001) noted that
a mother of a child with ADHDhas to be a different kind of mother . . . a professional mother (p. 268). Such qualities enabled
the mothers in Segals study to experience the struggle as personally strengthening, and reported positive feelings and joy in
their parenting; we may say that these mothers were describing stress-related growth. In our study, high levels of emotional
intelligence enabled parents of children with ADHD to regulate their emotions towards their children (in most cases these
were ambivalent emotions; Johnston &Mash, 2001; Singh, 2004) and to promote the use of empathic perspective-taking and
coping skills in conictual or stressful situations; thus they could perceive the benets inherent in the challenges they faced
as parents, namely perceived personal growth.
To date, none of the studies inthe eldof stress-related growthexamined the role of emotional intelligence as anindividual
resource conducive to engaging in constructive cognitive processing and its associations with personal growth. Salovey et al.
(2003), in their four-branched model of emotional intelligence, posited that EI is the ability to be open to feelings, to regulate
themin oneself and others and to promote personal understanding and growth (p. 252), but the associations between EI and
parenthood in general, and parenthood of children with ADHD in particular, have not yet been studied.
Individuals who are high in emotional intelligence perceive and appraise their mental state clearly and know how and
when to express their emotions and regulate them, so that they are not overwhelmed in times of stress. Their high self-
awareness and clear perception of the stressful situation enable better handling of problems, without denying or ignoring
their existence or ruminating over them and becoming engrossed in negative emotions (Matthews et al., 2004). Zeidner,
Roberts, and Matthews (2004) have pointed to the paucity of empirical studies investigating the link between emotional
intelligence and coping. Our ndings support Salovey et al.s (2003) suggestion as to the role of emotional intelligence in
experiencing growth and benets while coping with stressful life situations.
Another resource for growth examined in our study was social support. Path analysis revealed that the effect of social
support on growth was mediated by parental sense of competence and perception of parenting as a challenge and not a
threat. This result is in line with the theoretical models for stress-related growth emphasizing the role of social support in
modulating constructive cognitive processing of stress leading to growth. Social support networks may provide sources of
comfort and relief, as well as new options for the construction of new schemas for coping (Joseph & Linley, 2006). Yet it is
important to emphasize that according to the interaction found in our regression analysis, social support contributed more
strongly to growth in the control group than in the group of parents of children with ADHD. Research evidence points to a
diminishing of support for these parents, and several studies indicate dissatisfaction with family and professional support
among parents of children with ADHD(Lange et al., 2005; Podolski & Nigg, 2001). Singh (2004) and Segal (2001) point to the
phenomenon of mother-blame: the mothers they interviewed reported being criticized and blamed for their childs disorder
and misbehavior, resulting in diminishing support from the social milieu. Similarly, Bussing et al. (2003) described that
parents of children at risk for ADHD reported a diminishing in the assistance they received from family members and
professionals. The researchers recommend the strengthening of support networks for these parents as part of an
intervention program to ease their strain.
We also found that the younger, the less educated and the less economically stable the parents, particularly if non-
religious, the more personal growth they experienced. It seems that when parents have less personal resources, in
circumstances in which they do not necessarily anticipate effective coping and good adjustment, parents have a higher
chance of discovering new aspects of their abilities and strengths. Taubman-Ben-Ari et al. (2010) found similar results
among mothers of pre-term twins. This proposed explanation should be further explored in future studies.
4.1. Limitations
Several possible limitations of this study should be noted. First, it relies exclusively on self-reports. Self-report of personal
growthraises the question whether participants perceived growthas associatedwithpositive reinterpretation of their coping,
whereas actual growth is related to decreased distress and reects actual life change (Frazier et al., 2009). Thus, in order to
provide a more comprehensive picture of parents experience of growth, future studies might include measures derived from
other relevant sources (e.g., husbands/wives, other familymembers, or professionals suchas psychiatrists), andemployfollow-
up longitudinal studies. Secondly, the current study focused solely on personal growth. It might be interesting to link this
experience with additional adaptational aspects, such as parents mental health, social adjustment, and so on. Thirdly, the
current study populationwas mainly mothers; future studies should recruit anequal number of fathers and mothers. Fourthly,
the data for the current study was gathered from one clinic; this might limit the external validity of the ndings, and such
studies should be replicated in other locations in Israel and other countries using larger populations. Finally, future studies
should compare stress-related growth in parents of children with varying clinical disorders.
R. Finzi-Dottan et al. / Research in Developmental Disabilities 32 (2011) 510519 517
5. Conclusions and clinical implications
This study makes two main contributions. The rst is the importance of emotional intelligence for parents psychological
growth in general, and for parents of ADHD children in particular. Our results emphasize that this personality characteristic
is especially relevant when coping with on-going parental strain. The second important nding is that parents of non-clinical
children benet from social support, leading to personal growth, more than parents of ADHD children. This nding may
warrant the promotion of group interventions for parents of ADHDchildren, where they could benet fromnon-judgmental
peer support. Also, it is recommended that the construction of such intervention programs include enhancing these parents
emotional intelligence, thus increasing their self-monitoring abilities and their empathic response and thereby promoting a
reframing of their coping, from perceiving it as a strain to observing their positive feelings and growth as well.
Acknowledgement
We would like to thank Ina Averbuh-Cohen for her assistance in with the data collection of the control group.
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