Open Access

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

Therese Lindström
Therese Lindström
, 
Tiina Holmberg Bergman
Tiina Holmberg Bergman
, 
Mathilde Annerstedt
Mathilde Annerstedt
, 
Martin Forster
Martin Forster
, 
Sven Bölte
Sven Bölte
 and 
Tatja Hirvikoski
Tatja Hirvikoski
   | Apr 19, 2024
Scandinavian Journal of Child and Adolescent Psychiatry and Psychology's Cover Image
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Article Category: Research Article
Published Online: Apr 19, 2024
Page range: 10 - 22
DOI: https://doi.org/10.2478/sjcapp-2024-0002
Keywords
© 2024 Therese Lindström et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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.
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.

Characteristics of the Study Participants’ Childrena

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/ab n/ab 138 21.13 n/ab n/ab
Other disabilityc 15 1.47 48 7.35
Any disability 87 8.55 653 100 562 100

Characteristics of the Study Participants in the Main Samples

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

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

PSS Item Characteristics, Including Item Means, Variances (s2), Difficulties (diffic.), Corrected Item-Total Correlations (rit), 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. rit M s2 diffic. rit M s2 diffic. rit 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

Correlationsa 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

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 NDCa 971 37.25 10.53 18–73 596 48.66 9.71 27–78 521 40.83 9.61 21–76
Parent w/NDCa 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)
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