Parenting practices in families with ADHD children : the roles of parenting cognitions and parenting stress

Abstract

Parenting practices play a critical role in the daily functioning and long-term development of children with ADHD. It is therefore imperative to understand and address the factors impacting parenting practices. The social cognitive approach highlights the importance of parenting cognitions in contributing to parents’ reactions whereas the parenting stress model pinpoints the significance of parenting stress in determining parenting behaviors. Consistent with these theoretical propositions, empirical evidence has indicated the probable roles of both parenting cognitions (attributions and affiliate stigma) and parenting stress in mediating the relationship between ADHD children’s problems and parenting practices. There is, however, a lack of integrative research to examine the interplay of these constructs. To address the research gap, two studies were included in the present research. The first study elucidated a serial mediation model, indicating that parenting stress partially mediated the impacts of ADHD children’s problems on parenting cognitions, which in turn predicted parenting practices. After taking into account the mediating effects of parenting cognitions and parenting stress, the direct effect of ADHD children’s problems on parenting practices was small and not significant. Complete mediation was indicated. That is, ADHD children’s problems exerted their influence on parenting practices mainly through their negative impacts on parenting cognitions and parenting stress. Results render support to the integration of the social cognitive approach and parenting stress model in understanding parenting behaviors in families of children with ADHD. Theoretical and clinical implications are discussed. The second study tested the above theoretical propositions in clinical practice. It provided preliminary evidence of the benefits of a brief ADHD-focused parenting program, Cognitive Behavior Therapy for Parents of Children with ADHD (CBT-P-ADHD), which augmented traditional behavioral parent training with additional intervention on parenting stress and parenting cognitions. The program substantially increased parents’ knowledge about ADHD as well as skill proficiency in managing their ADHD child’s difficulties, their own stress, and their cognitions about their ADHD child; and these treatment effects were maintained at 4-week follow-up. The minimum exclusion criteria render support to the generalizability of results to ADHD families of diverse background. Despite the program’s limitations and need for further refinement, its positive findings suggest that the online mode of program delivery is feasible.