The Relationship Between Attitude Towards Oneself, the World and the Future, and Parental Stress in Mothers of Children With Learning Disabilities

1. Background

Nowadays, parents are challenged with different types of stress in daily life and this stress influences parental duties and the relationship between family members, especially the mother and father. External factors including economic and social issues or internal factors including the presence of a patient or a child with special needs force high stress on the family. According to several studies, regulatory problems are associated with maternal stress, whereas externalizing behaviors are generally associated with paternal stress (1). Parenting creates high levels of stress, and parental stress results from the pressures of parenting, role-playing and economical issues. While many experiences with young children are the source of happiness and pride for parents, children’s behavior, and paternal and maternal daily duties, which can be confusing, dissatisfying and trouble making, change parenting to a stressful experience (2). Families of children with special needs showed higher levels of stress than families with normal children (3). In these families, mothers are more responsible for physical care, treatment and education of their children while fathers are not that involved, despite of the change that has occurred in maternal and paternal roles, in the recent decade. Thus, mothers feel more stress and anxiety in these families because they are more involved with their children’s problems (4).

Parental stress is described as stress perceived by parents and formed by the combination of the child, parent, and the family system’s characteristics, and the evaluation of parents of their parental role as a father and mother (5). Broadly speaking, stress is a process including an environmental event, the individual’s assessment, organism’s answers, reassessment of answers and change in the stressful factor (6). In this regard, having a child with learning disability brings a lot of negative parental experiences especially for the mother and one of the most important and obvious results of having a child with learning disability is an increase in the mother’s parental stress. Dysfunctional attitudes are beliefs and attitudes, which reinforce and increase risk of disorders, such as depression (7-9), mental confusion and anxiety, and those who obtain higher scores in dysfunctional attitudes during the previous year, are more likely to suffer from mental disorders (10).

Dysfunctional attitudes in fact, result from the individual’s experiences in connection with themself and the world, and lead to extreme negative and dysfunctional interpretations from life’s certain situations. Dysfunctional attitudes are attributed to inflexibility and perfectionism, which affect the individual’s judgments of themself and others, and they become extremists and inflexible; thus are considered as dysfunctional and infertile (8). Mothers of children with learning disabilities face a set of problems such as educational expenses, aggravation of marital discords, fear of having another child with the same problem, and feeling guilt and isolation (11). Research findings have illustrated that there is a relationship between the judgment of parents with mentally retarded children and their attitude towards events (10).

Other researches have shown that people with positive attitudes towards the world show less mental confusion (8, 12). Positive attitudes and beliefs about the world help the individual apply more effective strategies when faced with life’s events. Such strategies protect the person against stress (13). Multiple research findings show that irrational beliefs in mothers of exceptional children are significantly more than normal children (14). According to the need for research in this field, the present study aimed to determine whether there is a relationship between attitudes towards oneself, the world and the future, and parental stress in mothers of children with learning disability.

2. Objectives

In the present study, we used the parental stress scale and cognitive triad inventory to find the relationship between parental stress and the cognitive triad. Also we intended to find if the cognitive triad could predict parental stress. We expected to find a significant power of prediction for the cognitive triad.

3. Methods

The current study was a descriptive correlation study. The statistical population was all mothers of children with learning disabilities in Ahvaz, whose children were screened when entering the school by the educational talent assessment method and enrolled as a child with learning disability in learning disabilities special primary schools of Ahvaz during academic year 2014 to 2015. Inclusion criteria for this study were being literate for reading, writing and perceiving the questionnaires, accepting to fill in the questionnaires and the presence of children for at least one academic year in learning disabilities special schools. Using the Cochran formula, a sample of 103 mothers of children with learning disability, who agreed to participate in the research, were selected by ‘counting all’ sampling method and 98 mothers completed the questionnaires and returned them to the researcher. Data were then analysed by statistical methods including Pearson correlation coefficient and multiple regression analysis, using the SPSS-16 software with significance level of 0.05. The data was collected through the parental stress scale and Beck cognitive triad inventory. In order to collect data, the following tools were applied:

3.1. Parental Stress Scale

Parental stress scale is a self-reported pen and paper scale, which includes 18 items that show enjoyable or positive parenting factors (emotional advantages, self-enrichment and individual growth) as well as negative issues (the need of sources, opportunity costs, and limitations). For each item, a five-point scale was considered: from 1) completely disagree to 5) completely agree. Eight positive items were scored reversely. Higher scores on the scale indicated greater stress. This scale was applied for assessing parenting stress in clinical and non-clinical populations. This scale was created and validated by Berry and Jones (15). The scale’s validity was estimated as 0.39, by applying the construct validity coefficient, and the internal validity was between 0.84 and -0.56, in Iran (16). This scale also showed 0.83 internal validity and 0.81 test-retest validity (15). In Iran the validity of this scale was also estimated as 0.71, by applying Cronbach’s alpha (16).

3.2. Cognitive Triad Inventory

Cognitive triad inventory is a questionnaire that includes 36 questions. This inventory is formed from three subscales to measure the individual’s attitude toward themself, the world and the future (17).

The mentioned inventory is scored based on a seven-point Likert scale from (1) completely agree to (7) completely disagree and some questions are scored reversely. Higher scores in this questionnaire show negative attitude and lower scores show positive attitude. The validity of the mentioned inventory obtained for the whole scale was 0.95, for subscales of attitude towards oneself was 0.91, the world 0.81, and the future 0.93 by applying Cronbach’s alpha. The simultaneous validity of the cognitive triad inventory was 0.77, through significant correlation with Beck’s depression inventory (18). The mentioned inventory showed good validity and reliability in Iran and its Cronbach’s alpha was 0.85 for the whole inventory, and 0.80, 0.73 and 0.81 for subscales of the attitude toward oneself, the world and the future, respectively (19).

4. Results

Table 1 shows minimum and maximum of all research variables. This table also shows the mean and the standard deviation for cognitive triad and parental stress were 74.81 ± 17.12 and 70.57 ± 7.06, respectively. The mean and standard deviation was 24.71 ± 7.09 for attitude towards oneself, 25 ± 6.14 for attitude towards the world, and 25.09 ± 7.55 for attitude towards the future. Table 2 illustrates correlation coefficients between attitudes towards oneself, the world and the future with parental stress.

As it can be seen in Table 2, attitude towards oneself and the future had a positive significant relationship (r = 0.33, P < 0.05 and r = 0.41, P < 0.01, respectively) with parental stress while there was no significant relationship between attitudes towards the world (r = 0.26, P < 0.09) with parental stress. Cognitive triad total score also had a positive significant relationship (r = 0.41, P < 0.01). To show the multiple correlation and the predictor subscale of cognitive triad among all variables, results of the multivariate regression in stepwise method is illustrated in Tables 3 and 4. Table 3 shows the results of stepwise multivariate regression analysis.

Results of the variance analysis of regression showed that among the research variables at least one of the variables has a significant power to predict parental stress (F = 8.040, P < 0.01).

As presented in Table 4, attitude toward the future is the only predictor among three subscales of cognitive triad. Standardized Beta was 0.409 for attitude towards the future. This means that only a unit increase in positive attitude towards the future can result 0.409 decrease in parental stress.

5. Discussion

The results obtained from the present study showed that there is a significant relationship between perception of mothers of children with learning disabilities about the future and parental stress. The most important finding of the study was the predictive role of the attitude towards the future regarding parental stress. According to this study, negative attitude towards the future can cause 0.409 of the parental stress in mothers of children with learning disabilities. Thus, the point of view about the future is a considerable factor that could lead them to experience less or more parental stress. Therefore, the research hypothesis, based on existence the relationship between the cognitive triad and parental stress in mothers of children with learning disabilities, was confirmed. These evidences show that having a negative attitude towards the future increases parental stress. In other words, the more the negative attitude of an individual towards the future, the more stress they will experience. This finding showed a significant concordance with a number of studies that indicated that there is a negative relationship between positive attitude and mental confusion, anxiety and stress (7-10, 12).

A child with learning disability is a source of stress and worry for family members, especially for mothers, who are the main caregivers of children, despite of mass improvements that have occurred in fathers’ role as an active participant in children’s daily issues including education, upbringing, medical issues and problems. In such situations, parents do a lot to assist their children but they do not achieve as much as they wish, thus they perceive themselves as unable mothers or fathers and they feel hopelessness about the future. Spending long time periods for treatment, providing required care for the child in the house, confronting school and behavioral problems of the disable child, all lead to parents’ hopelessness and anxiety (18, 19). They are not able to participate in social activities due to the negative feedback they receive from others about their child. They cannot enjoy many public programs, because of the same problems. Generally these mothers are deprived of many pleasures, which mothers without a child with specific needs have. After all, the main and most important factor that increases these mothers’ stress is having no clear view of the future. They have no specific knowledge of their children’s intellectual function, because of the conflicting results they achieve at school. Therefore, they are always worried about the stage to which their children can progress, whether they can finish school and if they will have the opportunity to get married. A combination of all these factors makes mothers frustrated and lead to negative beliefs about life and the future because they find their and their children’s future destroyed. Negative and irrational thoughts about the future and hopelessness about getting positive results and consequences in the future stop them from making efforts in order to reach their goals and solve problems, effectively. In fact, having an unreasonable attitude towards the future, hopelessness and frustration on the one hand and ineffective strategies on the other hand, results passive and aggressive behaviors towards the child most of the time and increases the child’s emotional and behavioral problems. Furthermore, more problems faced by the child cause more stress and mental health problems for parents and this acts as a vicious cycle. Therefore, extreme anxiety about the future and having a negative attitude about acquisition of positive results, moves parents away from living here and now and making efforts for positive outcomes. Dysfunctional beliefs indeed steal the possibility of enjoyment of life from mothers of children with learning disabilities and increase their anxiety and stress. Regarding previous studies, those who have more positive beliefs, show more effective strategies when faced with life’s events (12) and encounter more positive consequences and feedbacks, so they experience less emotional confusion. Likewise, the present study’s findings are strongly confirmed, by previous researches in this regard, in which researchers examined the effectiveness of training effective coping strategies on mothers of children with learning disabilities; the findings emphasized that training positive thinking and appropriate solutions to mothers of children with learning disabilities such as stress management training can lead to a change in their attitude towards life and a decline in their parental stress in addition to providing a sense of calm (16).

In conclusion, more negative attitude towards the future could foreshow the measure of parental stress in this sample. This means that declining parental stress and its negative consequences required raising positive thinking about the future.

This research was associated with limitations including; low sample size, using available sample that limits generalization of findings, lack of control groups for comparison. Performing pilot projects in order to decrease parental stress and mental health problems by changing these mothers’ attitudes can be performed by other researchers.