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. 2024 Apr 19;12(1):10-22.
doi: 10.2478/sjcapp-2024-0002. eCollection 2024 Jan.

Psychometric Properties of the Parental Stress Scale in Swedish Parents of Children with and without Neurodevelopmental Conditions

Therese Lindström  1 , Tiina Holmberg Bergman  1 , Mathilde Annerstedt  1 , Martin Forster  2 , Sven Bölte  1 , Tatja Hirvikoski  1
Affiliations

Psychometric Properties of the Parental Stress Scale in Swedish Parents of Children with and without Neurodevelopmental Conditions

Therese Lindström et al. Scand J Child Adolesc Psychiatr Psychol. .

Abstract

Background: Parents of children with neurodevelopmental conditions (NDC) are at risk of experiencing elevated levels of parental stress. Access to robust instruments to assess parental stress is important in both clinical and research contexts. Objective: We aimed to evaluate the psychometric properties of a Swedish version of the Parental Stress Scale (PSS), completed by parents of 3- to 17-year-old children, with and without NDCs.

Method: Main analyses were conducted on data from three independent samples: a community sample (n=1018), a treatment-seeking sample of parents of children with various disabilities (n=653), and a sample of parents of children with Attention-Deficit/Hyperactivity Disorder (ADHD) who themselves reported varying ADHD symptom severities (n=562). Additional analyses were enabled by the use of data from a complementary test-retest sample (n=337).

Results: The internal consistency of the PSS was good (Cronbach's alpha, α=.87) and its test-retest reliability moderate (ICC=.66). The scale correlated in the expected direction with related constructs (r=.50-.56 in the community sample). An exploratory factor analysis found its internal structure to reflect two aspects of parental stress: Lack of Parental Rewards and Role Satisfaction (factor 1, α=.90) and Parental Stressors and Distress (factor 2, α=.85). The treatment-seeking parents of children with disabilities reported higher parental stress than community reference parents (p<.001; Cohen's d=1.17). Moreover, we found that parents with high ADHD symptom severity reported higher parental stress than parents with low ADHD symptom severity (p<.001; d=0.39).

Conclusion: In summary, we found evidence in support of the reliability and validity of the PSS, which overall was judged to be useful as a measure of parental stress in a Swedish context. In addition, our results underline the importance of considering parental stress and related needs in assessments and intervention planning involving families of children with NDCs.

Keywords: Parental stress; assessment; caregiver burden; neurodevelopmental condition; parental ADHD.

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Conflict of interest statement

Conflict of interest The authors declare no conflicts of interest related to this article. Although not related to this study, the authors do for transparency disclose that: Hirvikoski receives royalties for treatment manuals from Hogrefe and textbooks from Studentlitteratur. Bölte has in the last 3 years acted as an author, consultant, or lecturer for Medice, Roche, and LinusBio. Bölte receives royalties for textbooks and diagnostic tools from Hogrefe, UTB, Ernst Reinhardt, Kohlhammer, and Liber. Bölte is partner NeuroSupportSolutions International AB. Holmberg Bergman receives royalties for co-authorship of two popular science books from Natur & Kultur. Lindström receives royalties for co-authorship of a treatment manual from Hogrefe and this article is part of her doctoral project.

Figures

FIGURE 1a–1c.
FIGURE 1a–1c.
PSS Scores for Parents in the Low (n = 294), Middle (n = 144), and High (n = 105) ADHD Strata. Note. Mean scores are depicted as rombs, surrounded by 95% confidence intervals shown as error bars. Violin plots show the overall spread of scores, with quantiles marked. ADHD = Attention Deficit/Hyperactivity Disorder; PSS = Parental Stress Scale; PSS F1 LPRS = PSS Factor 1 Lack of parental rewards and role satisfaction; PSS F2 PSD = PSS Factor 2 Parental stressors and distress. *p < .05, i.e., significant difference as indicated by linear regression analyses, using the low ADHD strata as reference.
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