Psychometric properties of the Caregiver Strain Questionnaire among Chinese parents of children with ADHD or ASD

Abstract

Background: There is an urgent need in clinical practice to measure the stress of parenting. The Caregiver Strain Questionnaire (CGSQ) was found to be useful to measure parenting stress, but it has not been validated among the Chinese population.

Aims: To assess the reliability and construct validity of the Chinese version of CGSQ among Chinese parents.

Methods: From 2016 to 2017, 266 parents (patient group) with a child having DSM-5-defined attention deficit hyperactivity disorder (ADHD) (n=107) or autism spectrum disorder (ASD) (n=159) and 268 parents of healthy children (control group) were recruited to the present study in Kunming, Yunnan province. All the parents were asked to fill out the Chinese version of CGSQ. We conducted exploratory factor analysis and confirmatory factor analysis (CFA) to verify construct validity of CGSQ in both patient and control groups. Cronbach's α coefficient as an index of internal consistency was assessed for each subscale. Fourteen days later, 23 subjects filled out the scale again. Intra-class correlation coefficient was calculated to evaluate the test-retest reliability.

Results: (1) Cronbach's alpha of the global scale was 0.901 for the control group and 0.952 for the patient group. The test-retest reliability for the whole scale was 0.890; (2) CFA indicated that the three-factor model had better fitting indices compared with the two-factor model in both groups. Besides, the fitting indices in the patient group were more favourable than those of the control group, with χ²/df=1.564, Goodness-of-Fit Index=0.841, Comparative Fit Index=0.954, and root mean square error of approximation=0.065 for the patient group at three-factor model; (3) The caregiver strain of ASD parents was statistically higher than that of ADHD parents, and caregiver strain of ADHD parents was higher than that of control group.

Conclusion: These findings provide initial evidence to support the construct validity and reliability of CGSQ as a parenting stress measurement tool for Chinese parents, especially for parents of children with ADHD or ASD.

Keywords: attention deficit disorder with hyperactivity; autism spectrum disorder; factor analysis; psychometrics; statistical; surveys and questionnaires.

Figure 1

Flowchart of the study. ADHD, attention deficit hyperactivity disorder; ASD, autism spectrumdisorder; CGSQ, caregiver strain questionnaire.

Figure 2

Scree plot of the CGSQ for patient group, representing the result of EFA. The horizontal axis indicates potential factor numbers, which determined by the Eigenvalue(the vertical axis), the final factor numbers of EFA is the Factor when the Eigenvalue＞1.

Figure 3

Scree plot of the CGSQ for control group, representing the result of EFA. The horizontal axis indicates potential factor numbers, which determined by the Eigenvalue(the vertical axis), the final factor numbers of EFA is the Factor when the Eigenvalue＞1.