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Parenting Stress, Readiness to Change, and Child Externalizing Behaviors in Families of Clinically Referred Children

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Abstract

We investigated relationships among parenting stress, parental readiness to change, and child externalizing behaviors in a sample of clinically referred families. Additionally, parenting stress was investigated as a potential moderator of the relationship between parental readiness to change and child externalizing behaviors. Sixty-nine parents of clinically referred children completed measures of parenting stress, readiness to change, and child externalizing behaviors. We found that child externalizing behaviors, specifically hyperactivity/impulsivity and oppositionality, had a significant positive relationship with parental readiness to change and parenting stress. Child conduct disorder symptoms did not significantly relate to parental readiness to change. Parenting stress emerged as a significant moderator of the relationship between child externalizing behaviors and parental readiness to change, such that at low levels of parenting stress, readiness to change increased as level of child externalizing behaviors increased. However, at high levels of parenting stress, parental readiness to change remained high and constant irrespective of level of child externalizing behaviors. The findings from this small pilot study have significant implications for clinicians and researchers. The parents most ready to engage in child mental health services may be those with high levels of parenting stress, regardless of the severity of the child’s behaviors. These parents may benefit from learning stress management strategies in addition to receiving intervention services for their children. Researchers should further examine the clinical utility of measuring readiness to change in families of children with behavior problems.

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References

  • Abidin, R. R. (1986). Parenting Stress Index. 2nd ed. Charlottesville, VA: Pediatric Psychology Press.

    Google Scholar 

  • Abidin, R. R. (1995). Parenting Stress Index: Test manual. Charlottesville, VA: Pediatric Psychology Press.

    Google Scholar 

  • Achenbach, T. M. (1991). Manual for the Child Behavior Checklist/4-18 and 1991 Profile. Burlington, VT: University of Vermont Department of Psychiatry.

    Google Scholar 

  • Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage.

    Google Scholar 

  • Andrade, B. F., Browne, D. T., & Nabor, A. R. (2015). Parenting skills and parent readiness for treatment are associated with child disruptive behavior and parent participation in treatment. Behavior Therapy, 46, 365–378.

    Article  PubMed  Google Scholar 

  • Beernink, A. ‐C. E., Swinkels, S. H. N., Van der Gaag, R. J., & Buitelaar, J. K. (2012). Effects of attentional/hyperactive and oppositional/aggressive problem behaviour at 14 months and 21 months on parenting stress. Child and Adolescent Mental Health, 17(2), 113–120.

    Article  Google Scholar 

  • Borrelli, B., McQuaid, E. L., Novak, S. P., Hammond, S. K., & Becker, B. (2010). Motivating Latino caregivers of children with asthma to quit smoking: A randomized trial. Journal of Consulting and Clinical Psychology, 78, 34–43.

    Article  PubMed  Google Scholar 

  • Brestan, E. V., Ondersma, S. J., Simpson, S. M., & Gurwitch, R. (1999). Application of stage of change theory to parenting behavior: Validating the Parent Readiness to Change Scale. In Poster presented at the Florida Conference on Child Health Psychology, Gainesville, FL.

  • Briesch, A. M., Ferguson, T. D., Volpe, R. M., & Briesch, J. M. (2013). Examining teachers’ perceptions of social-emotional and behavioral referral concerns. Remedial and Special Education, 34, 2499–2256.

    Article  Google Scholar 

  • Burke, J. D., Loeber, R., & Birmaher, B. (2002). Oppositional defiant disorder and conduct disorder: A review of the past 10 years, part II. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1275–1293.

    Article  PubMed  Google Scholar 

  • Bussing, R., Zima, B. T., Gary, F. A., & Garvan, C. W. (2003). Barriers to detection, help-seeking, and service use for children with ADHD symptoms. Journal of Behavioral Health Services and Research, 30, 176–189.

    Article  PubMed  Google Scholar 

  • Capone, C., & Wood, M. D. (2009). Thinking about drinking: Need for cognition and readiness to change moderate the effects of brief alcohol interventions. Psychology of Addictive Behaviors, 23, 684–488.

    Article  PubMed  PubMed Central  Google Scholar 

  • Chacko, A., Wymbs, B. T., Chimiklis, A., Wymbs, F. A., & Pelham, W. E. (2012). Evaluating a comprehensive strategy to improve engagement to group-based behavioral parent training for high-risk families of children with ADHD. Journal of Abnormal Child Psychology, 40(8), 1351–1362.

    Article  PubMed  Google Scholar 

  • Conners, C. K. (2008). Conners 3rd edition manual. Toronto, Ontario, Canada: Multi-Health Systems.

    Google Scholar 

  • DuPaul, G. J., McGoey, K. E., Eckert, T. L., & VanBrakle, J. (2001). Preschool children with attention-deficit/hyperactivity disorder: Impairments in behavioral, social, and school functioning. Journal of the American Academy of Child and Adolescent Psychiatry, 40(5), 508–515.

    Article  PubMed  Google Scholar 

  • Eyberg, S. M., Nelson, M. M., & Boggs, S. R. (2008). Evidence-based psychosocial treatments for children and adolescents with disruptive behavior. Journal of Clinical Child & Adolescent Psychology, 37, 215–237.

    Article  Google Scholar 

  • Ezpeleta, L., Granero, R., Osa, N., Trepat, E., & Domenech, J. M. (2016). Trajectories of oppositional defiant disorder irritability symptoms in preschool children. Journal of Abnormal Child Psychology, 44(1), 115–128.

    Article  PubMed  Google Scholar 

  • Friars, P. M., & Mellor, D. J. (2007). Dropout from behavioral management training programs for ADHD: A prospective study. Journal of Child & Family Studies, 16, 427–444.

    Article  Google Scholar 

  • Frick, P. J. (1998). Conduct disorders and severe antisocial behavior. New York: Plenum Press.

    Book  Google Scholar 

  • Graziano, P. A., McNamara, J. P., Geffken, G. R., & Reid, A. (2011). Severity of children’s ADHD symptoms and parenting stress: A multiple mediation model of self-regulation. Journal of Abnormal Child Psychology, 39(7), 1073–1083.

    Article  PubMed  Google Scholar 

  • Greene, R. W., Beszterczey, S. K., Katzenstein, T., Park, K., & Goring, J. (2002). Are students with ADHD more stressful to teach? Patterns of teacher stress in an elementary school sample. Journal of Emotional and Behavioral Disorders, 10(2), 79–89.

    Article  Google Scholar 

  • Greene, R. W., Biederman, J., Zerwas, S., Monuteaux, M. C., Goring, J. C., & Faraone, S. V. (2002). Psychiatric comorbidity, family dysfunction, and social impairment in referred youth with oppositional defiant disorder. American Journal of Psychiatry, 159, 1214–1224.

    Article  PubMed  Google Scholar 

  • de Haan, A. M., Boon, A. E., de Jong, J. T. V. M., Hoeve, M., & Vermeiren, R. R. J. M. (2013). A meta-analytic review on treatment dropout in child and adolescent outpatient mental health care. Clinical Psychology Review, 33, 698–711.

    Article  PubMed  Google Scholar 

  • Hollingshead, A. B. (1975). Four-factor Index of Social Status. New Haven, CT: Yale University Department of Sociology.

    Google Scholar 

  • Johnston, C. (1996). Parent characteristics and parent-child interactions in families of nonproblem children and ADHD children with higher and lower levels of oppositional-defiant behavior. Journal of Abnormal Child Psychology, 24(1):85–104.

    Article  PubMed  Google Scholar 

  • Johnston, C., & Mash, E. J. (2001). Family of children with Attention-Deficit/Hyperactivity Disorder: Review and recommendations for future research. Clinical Child and Family Psychology Review, 4, 183–207.

    Article  PubMed  Google Scholar 

  • Kazdin, A. E. (1995). Conduct disorders in childhood and adolescence. 2nd ed Thousand Oaks, CA: Sage Publications, Inc..

    Book  Google Scholar 

  • Kazdin, A. E., Mazurick, J. L., & Bass, D. (1993). Risk for attrition in treatment of antisocial children and families. Journal of Clinical Child Psychology, 22, 2–16.

    Article  Google Scholar 

  • Landau, S., Milich, R., & Diener, M. B. (1998). Peer relations of children with attention-deficit hyperactivity disorder. Reading & Writing Quarterly: Overcoming Learning Difficulties, 14(1), 83–105.

    Article  Google Scholar 

  • Mash, E. J., & Johnston, C. (1983). Parental perceptions of child behavior problems, parenting self-esteem, and mothers' reported stress in younger and older hyperactive and normal children. Journal of Consulting and Clinical Psychology, 51(1), 86–99.

    Article  PubMed  Google Scholar 

  • Mendenhall, A. N. (2012). Predictors of service utilization among youth diagnosed with mood disorders. Journal of Child and Family Studies, 21(4), 603–611.

    Article  Google Scholar 

  • Morrissey-Kane, E., & Prinz, R. J. (1999). Engagement in child and adolescent treatment: The role of parental cognitions and attributions. Clinical Child and Family Psychology Review, 2(3), 183–198.

    Article  PubMed  Google Scholar 

  • Murphy, R. T., & Rosen, C. S. (2006). Addressing readiness to change PTSD with a brief intervention: A description of the PTSD motivation enhancement group. Journal of Aggression, Maltreatment, & Trauma, 12, 7–28.

    Article  Google Scholar 

  • Pelham, W. E., Wheeler, T., & Chronis, A. (1998). Empirically-supported psychosocial treatments for attention deficit hyperactivity disorder. Journal of Clinical Child Psychology, 27, 190–205.

    Article  PubMed  Google Scholar 

  • Pfiffner, L. J., McBurnett, K., Rathouz, P. J., & Judice, S. (2005). Family correlates of oppositional and conduct disorders in children with Attention-Deficit/Hyperactivity Disorder. Journal of Abnormal Child Psychology, 33, 551–563.

    Article  PubMed  Google Scholar 

  • Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change in smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 5, 390–395.

    Article  Google Scholar 

  • Stein, L. A., Minugh, P. A., Longabaugh, R., Wirtz, P., Baird, J., & Nirenberg, T. D., et al. (2009). Readiness to change as a mediator of the effect of a brief motivational intervention on post-treatment alcohol-related consequences of injured emergency department hazardous drinkers. Psychology of Addictive Behaviors, 23, 185–195.

    Article  PubMed  PubMed Central  Google Scholar 

  • Stormshak, E., Bierman, K., McMahon, R., & Lengua, L. (2000). Parenting practices and child disruptive behavior problems in early elementary school. Journal of Clinical Child Psychology, 29, 17–29.

    Article  PubMed  PubMed Central  Google Scholar 

  • Véronneau, M. -H., Dishion, T. J., Connell, A. M., & Kavanagh, K. (2016). A randomized, controlled trial of the family check-up model in public secondary schools: examining links between parent engagement and substance use progressions from early adolescence to adulthood. Journal of Consulting and Clinical Psychology, 84(6), 526.

    Article  PubMed  Google Scholar 

  • Wade, M., & Andrade, B. F. (2015). Validation of a measure of parental readiness for treatment in a clinical sample of children with disruptive behavior. Journal of Psychopathology and Behavioral Assessment, 37, 184–195.

    Article  Google Scholar 

  • Webster-Stratton, C. (1990). Stress: A potential disruptor of parent perceptions and family interactions. Journal of Clinical Child Psychology, 19, 302–312.

    Article  Google Scholar 

  • Wells, K. C., Epstein, J. N., Hinshaw, S. P., Conners, C. K., Klaric, J., & Abikoff, H. B., et al. (2000). Parenting and family stress treatment outcomes in attention deficit hyperactivity disorder (ADHD): An empirical analysis in the MTA study. Journal of Abnormal Child Psychology, 28, 543–553.

    Article  PubMed  Google Scholar 

  • Wergeland, G. J., Fjermestad, K. W., Marin, C. E., Haugland, B. S. -M., Silverman, W. K., Öst, L. -G., Havik, O. E., & Heiervang, E. R. (2015). Predictors of dropout from community clinic child CBT for anxiety disorders. Journal of Anxiety Disorders, 31, 1–10.

    Article  PubMed  Google Scholar 

  • Whalen, C. K., Odgers, C. L., Reed, P. L., & Henker, B. (2011). Dissecting daily distress in mothers of children with ADHD: An electronic diary study. Journal of Family Psychology, 25, 402–411.

    Article  PubMed  Google Scholar 

  • Wymbs, F. A., Cunningham, C. E., Chen, Y., Rimas, H. M., Deal, K., Waschbusch, D. A., & Pelham, W. E. (2016). Examining parents' preferences for group and individual parent training for children with ADHD symptoms. Journal of Clinical Child & Adolescent Psychology, 45(5), 614-631.

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Funding

Dr. Heather A. Jones was funded by a small internal research grant from Akron Children’s Hospital Medical Center (foundation grant).

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Correspondence to Heather A. Jones.

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Jones, H.A., Putt, G.E., Rabinovitch, A.E. et al. Parenting Stress, Readiness to Change, and Child Externalizing Behaviors in Families of Clinically Referred Children. J Child Fam Stud 26, 225–233 (2017). https://doi.org/10.1007/s10826-016-0547-x

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  • DOI: https://doi.org/10.1007/s10826-016-0547-x

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