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

	Community sample (n = 1018)			Distressed parent sample (n = 653)			ADHD sample (n = 562)
	M	SD	min-max	M	SD	min-max	M	SD	min-max
Age	40.96	8.34	19–63	43.43	6.54	24–68	43.24	6.66	26–73
Number of children < 18 years of age	1.78	0.80	1–6	2.05	0.80	1–6
	n	%		n	%		n	%
Female gender	554	54.42		555	84.99		339	60.32
Working	825	81.04		509	77.95		483	85.94
Highest education
Elementary	42	4.13		21	3.22		13	2.31
Upper secondary	491	48.23		177	21.77		231	41.10
University	485	47.64		344	52.68		274	48.75
Other				110	16.85		25	4.45
ADHD	29	2.85		29	4.44		20	3.56
Autism w/wo ADHD	18	1.77		24	3.68		n/a ^a	n/a ^a
HADS-Anx
normal (≤ 7)	587	57.66		77	11.79
mild (8–10)	197	19.35		141	21.59
≥ moderate (≥ 11)	234	22.99		431	66.00
HADS-Dep
normal (≤ 7)	775	76.13		258	39.51
mild (8–10)	170	16.7		191	29.25
≥ moderate (≥ 11)	73	7.17		199	30.47

Note. For each of the main samples separately, percentages were calculated as proportion of the total sample. In the community sample, parental age was missing for n = 9 [0.9 %]; in the distressed parent sample, values were missing for n = 0 to 5 [0–0.8%]; in the ADHD sample, values were missing for n = 0 to 19 [0–3.4%]). ADHD = Attention-Deficit/Hyperactivity Disorder; HADS-Anx = Hospital Anxiety and Depression Scale Anxiety; HADSDep = HADS Depression; w/wo = with or without.

a Not reported for the sake of participant integrity (n < 5)

TABLE 2.

Characteristics of the Study Participants’ Children^a

	Community sample (n = 1018)			Distressed parent sample (n = 653)			ADHD sample (n = 562)
	M	SD	min-max	M	SD	min-max	M	SD	min-max
Age	10.59	4.55	3–17	10.12	3.88	3–17	10.42	2.86	3–17
	n	%		n	%		n	%
Female gender	496	48.72		211	32.31		164	29.18
NDC
ADHD	35	3.44		76	11.64		547	97.33
Autism	21	2.06		218	33.38		0	0.00
ADHD and autism	14	1.38		173	26.49		12	2.14
ID w/wo autism or ADHD	n/a^b	n/a^b		138	21.13		n/a^b	n/a^b
Other disability^c	15	1.47		48	7.35
Any disability	87	8.55		653	100		562	100

Note. For each of the main samples separately, percentages were calculated as proportion of the total sample. In the distressed parent sample, values were missing for n = 0 to 7 [0–1.1%]; in the ADHD sample, values were missing for n = 0 to 19 [0–3.4%]). ADHD = Attention-Deficit/Hyperactivity Disorder; ID = Intellectual Disorder; NDC = Neurodevelopmental Condition; w/wo = with or without.

a For the community sample, figures are shown for the participants’ first-born child. For the two clinical samples, figures apply to the child for whom the parents had enrolled in the intervention study they participated in.

b Not reported for the sake of participant integrity (n < 5)

c Including for example motor impairment and other disabilities that may give children access to habilitation services

TABLE 3.

PSS Sum Scores and Internal Consistency Estimates

PSS sum scores
	Community sample (n = 1018)				Distressed parent sample (n = 653)				ADHD sample (n = 562)
	n	M	SD	min-max	n	M	SD	min-max	n	M	SD	min-max
Total sample	1018	37.57	10.61	18–73	653	48.81	9.73	27–78	562	41.00	9.60	21–76
Mother ratings	554	36.85	10.41	18–73	555	48.79	9.53	27–78	339	41.62	9.95	22–76
Father ratings	464	38.43	10.79	18–72	97	49.01	10.86	29–73	206	39.80	8.94	21–66
Parent w/o NDC^a	971	37.25	10.53	18–73	596	48.66	9.71	27–78	521	40.83	9.61	21–76
Parent w/NDC^a	47	44.13	10.36	26–61	53	50.51	9.91	31–71	22	42.50	9.23	27–64
Child: daughter	496	37.19	10.90	18–69	211	48.38	10.06	27–76	164	41.23	9.38	21–66
Child: son	521	37.91	10.33	18–73	435	49.00	9.56	28–78	381	40.90	9.71	22–76
PSS internal consistency
	Community sample (n = 1018)				Distressed parent sample (n = 653)				ADHD sample (n = 562)
Cronbach’s alpha	.87				.82				.83
Average inter-item correlation (min, max)	.28 (−.21, .71)				.20 (−.13, .63)				.22 (−.16, .62)

Note. NDC = Neurodevelopmental condition; PSS = Parental Stress Scale; w/ = with; w/o = without

a Refers to reports of a parental Attention-Deficit/Hyperactivity Disorder diagnosis and/or an autism spectrum disorder diagnosis

TABLE 4.

PSS Item Characteristics, Including Item Means, Variances (s²), Difficulties (diffic.), Corrected Item-Total Correlations (r_it), and Validities

	Community sample (n = 1018)				Distressed parent sample (n = 653)				ADHD sample (n = 562)				Item validities (Kruskal-Wallis H tests between samples, N = 2,233)
Items	M	s²	diffic.	r_it	M	s²	diffic.	r_it	M	s²	diffic.	r_it	Test statistic (df)	Dunn’s post hoc tests
1 (r)	1.59	0.84	0.32	.55	2.34	1.37	0.47	.64	1.85	0.92	0.37	.65	221.01 (2) ^**	distressed > adhd > community ^**
2 (r)	1.30	0.52	0.26	.42	1.18	0.22	0.24	.20	1.14	0.17	0.23	.15	15.51 (2) ^**	community > distressed = adhd ^*
3	3.50	1.56	0.70	.34	4.74	0.33	0.95	.22	4.17	1.06	0.83	.39	580.82 (2) ^**	distressed > adhd > community ^**
4	3.66	1.43	0.73	.22	4.45	1.01	0.89	.07	4.28	0.87	0.86	.22	303.70(2)^**	distressed > adhd > community ^**
5 (r)	1.39	0.64	0.28	.46	1.49	0.65	0.30	.31	1.48	0.54	0.30	.40	20.42 (2) ^**	adhd = distressed > community ^**
6 (r)	1.41	0.63	0.28	.53	1.81	0.84	0.36	.59	1.49	0.54	0.30	.57	133.51 (2) ^**	distressed > adhd > community ^**
7 (r)	1.49	0.68	0.30	.39	1.76	1.09	0.35	.37	1.69	0.89	0.34	.30	33.31(2) ^**	distressed = adhd > community ^**
8 (r)	2.00	1.09	0.40	.32	2.76	1.41	0.55	.44	2.21	1.19	0.44	.33	177.57 (2) ^**	distressed > adhd > community ^**
9	2.42	1.53	0.48	.58	3.75	1.25	0.75	.35	2.98	1.72	0.60	.52	394.87 (2) ^**	distressed > adhd > community ^**
10	2.77	1.59	0.55	.56	3.45	1.61	0.69	.47	2.64	1.61	0.53	.51	142.57 (2) ^**	distressed > adhd = community ^**
11	2.42	1.64	0.48	.47	2.08	1.60	0.42	.28	2.20	1.53	0.44	.31	32.10 (2) ^**	community > distressed = adhd ^*
12	2.57	1.53	0.51	.60	3.53	1.39	0.71	.44	2.83	1.46	0.57	.51	227.03 (2) ^**	distressed > adhd > community ^**
13	1.85	1.31	0.37	.61	3.13	1.74	0.63	.39	2.62	1.52	0.52	.45	405.68 (2) ^**	distressed > adhd > community ^**
14	1.50	1.11	0.30	.60	1.70	1.23	0.34	.44	1.31	0.63	0.26	.45	52.18 (2) ^**	distressed > community > adhd ^*
15	2.50	1.74	0.50	.39	3.02	1.73	0.60	.39	2.35	1.75	0.47	.37	90.14 (2) ^**	distressed > community = adhd ^**
16	2.14	1.41	0.43	.67	2.73	1.69	0.55	.58	1.95	1.13	0.39	.54	129.09 (2) ^**	distressed > community > adhd ^*
17 (r)	1.68	0.72	0.34	.56	2.98	1.30	0.60	.57	2.19	1.21	0.44	.60	516.61 (2) ^**	distressed > adhd > community ^**
18 (r)	1.38	0.50	0.28	.55	1.91	1.09	0.38	.46	1.61	0.77	0.32	.49	147.35 (2) ^**	distressed > adhd > community ^**
Min	1.30	0.50	0.26	0.22	1.18	0.22	0.24	0.07	1.14	0.17	0.23	0.15
Max	3.56	1.74	0.73	0.67	4.74	1.74	0.95	0.64	4.28	1.75	0.86	0.65
Median	1.92	1.21	0.38	0.54	2.75	1.28	0.55	0.41	2.19	1.10	0.44	0.45

Note. Reverse-scored items are denoted with an (r). PSS = Parental Stress Scale.

* = Statistically significant at the p < .05 level (with post hoc tests adjusted for multiple tests),

** = Statistically significant at the p ≤ .001 level (with post hoc tests adjusted for multiple tests)

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.

TABLE 5.

Factor Loadings (Item-Factor Associations), Communalities and Eigenvalues for the Two Factors Identified in an Exploratory Factor Analysis of Community Sample data (n = 1018)

	F1	F2	h²
Factor 1 Lack of Parental Rewards and Role Satisfaction
5. I feel close to my child(ren) (r)	0.86^*	−0.09	0.71
6. I enjoy spending time with my child(ren) (r)	0.86^*	−0.01	0.73
2. There is little or nothing I wouldn’t do for my child(ren) if it was necessary (r)	0.81^*	−0.11	0.62
18. I find my child(ren) enjoyable (r)	0.80^*	0.04	0.66
7. My child(ren) is an important source of affection for me (r)	0.77^*	−0.12	0.55
1. I am happy in my role as a parent (r)	0.69^*	0.13	0.53
17. I am satisfied as a parent (r)	0.60^*	0.20	0.46
8. Having child(ren) gives me a more certain and optimistic view for the future (r)	0.50^*	−0.01	0.25
Factor 2 Parental Stressors and Distress
10. Having child(ren) leaves little time and flexibility in my life	−0.03	0.75^*	0.55
12. It is difficult to balance different responsibilities because of my child(ren)	0.01	0.74^*	0.56
16. Having child(ren) has meant having too few choices and too little control over my life	0.16	0.70^*	0.57
9. The major source of stress in my life is my child(ren)	0.06	0.68^*	0.48
3. Caring for my child(ren) sometimes takes more time and energy than I have to give	−0.22	0.63^*	0.38
11. Having child(ren) has been a financial burden	0.05	0.55^*	0.32
4. I sometimes worry whether I am doing enough for my child(ren)	−0.29	0.53^*	0.29
13. The behavior of my child(ren) is often embarrassing or stressful to me.	0.28	0.51^*	0.41
15. I feel overwhelmed by the responsibility of being a parent	0.03	0.48^*	0.23
Item not included in factor interpretation
14. If I had it to do over again, I might decide not to have child(ren)
% of Variance	30.65	18.17
Correlation between factors: r	.25

Note. Reverse-scored items are denoted with (r).

* Coefficients ≥ 0.45.

h² = extraction communalities; F1 = Factor 1; F2 = Factor 2.

TABLE 6.

Correlations^a Between Scores on the PSS and Related Constructs (General perceived stress, Anxiety, and Depression)

Community sample (n = 1018)
	M	SD	PSS	PSS Factor 1	PSS Factor 2	HADS-Anx	HADS-Dep	PSS-4
PSS	37.57	10.61	1.00	.69 ^**	.86 ^**	.55 ^**	.56 ^**	.50 ^**
PSS Factor 1	12.23	5.10		1.00	.23 ^**	.32 ^**	.43 ^**	.29 ^**
PSS Factor 2	23.83	7.44			1.00	.52 ^**	.45 ^**	.47 ^**
HADS-Anx	7.08	4.38				1.00	.71 ^**	.71 ^**
HADS-Dep	4.84	3.63					1.00	.67 ^**
PSS-4	5.59	2.94						1.00
Distressed parent sample (n = 653)
	M	SD	PSS	PSS Factor 1	PSS Factor 2	HADS-Anx	HADS-Dep
PSS	48.81	9.73	1.00	.82 ^**	.84 ^**	.22 ^**	.30 ^**
PSS Factor 1	16.23	5.23		1.00	.39 ^**	.09^*	.24 ^**
PSS Factor 2	30.88	5.79			1.00	.30 ^**	.26 ^**
HADS-Anx	12.29	3.87		.		1.00	49 ^**
HADS-Dep	8.75	3.61					1.00

Note. HADS-Anx = Hospital Anxiety and Depression Scale Anxiety; HADS-Dep = HADS Depression; PSS = Parental Stress Scale; PSS Factor 1 = PSS Factor 1 Lack of Parental Rewards and Role Satisfaction; PSS Factor 2 = PSS Factor 2 Parental Stressors and Distress; PSS-4 = Perceived Stress Scale four-item version.

* statistically significant at the p < .05 level (2-tailed),

** statistically significant at the p < .001 level (2-tailed).

a For the sake of consequence, we report Pearson’s correlation coefficients for all measures. For parents in the community sample, Spearman rank correlation was run on the positively skewed HADS-D, with similar results.

Articles in this issue

DOI: https://doi.org/10.2478/sjcapp-2024-0002 | Journal eISSN: 2245-8875

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Language: English

Page range: 10 - 22

Published on: Apr 19, 2024

Published by: Center for Evidence-based Psychiatry

In partnership with: Paradigm Publishing Services

Publication frequency: 1 issue per year

Keywords:

Parental stress,

assessment,

caregiver burden,

neurodevelopmental condition,

parental ADHD

Related subjects:

Medicine,

Basic medical science,

Basic medical science, other

© 2024 Therese Lindström, Tiina Holmberg Bergman, Mathilde Annerstedt, Martin Forster, Sven Bölte, Tatja Hirvikoski, published by Center for Evidence-based Psychiatry
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Volume 12 (2024): Issue 1 (January 2024)

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

Figures & Tables

TABLE 1.

TABLE 2.

TABLE 3.

TABLE 4.

FIGURE 1a–1c.

TABLE 5.

TABLE 6.

Paradigm

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