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Parenting stress in mothers of children with an intellectual disability: The

effects of parental cognition in relation to child characteristics and family
support

Article  in  Journal of Intellectual Disability Research · July 2005

DOI: 10.1111/j.1365-2788.2005.00673.x · Source: PubMed

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 Journal of Intellectual Disability Research doi: 10.1111/j.1365-2788.2005.00673.x
405
    pp  –   

Blackwell Science, LtdOxford, UKJIRJournal of Intellectual Disability Research-Blackwell Publishing Ltd, 6405418Original ArticleParental cognitions and stress in mothers of children with disabilities R. Hassall et al.

Parenting stress in mothers of children with an

intellectual disability: the effects of parental cognitions in
relation to child characteristics and family support
R. Hassall,1 J. Rose2 & J. McDonald1
1 Oxfordshire Learning Disability NHS Trust, Oxford, UK
2 School of Psychology, University of Birmingham, Birmingham, UK

Abstract analysis. The results indicated that most of the vari-

ance in parenting stress was explained by parental
Background Recent theories of stress and coping in
locus of control, parenting satisfaction and child
parents of children with intellectual disabilities (ID)
behaviour difficulties. Whilst there was also a strong
emphasize the importance of cognitive appraisals in
correlation between family support and parenting
influencing parents’ levels of stress and their adapta-
stress, this was mediated by parental locus of control.
tions to difficulties presented by the children. This
Conclusions The results demonstrate the potential
study investigated the relationships between parental
importance of parental cognitions in influencing
cognitions, child characteristics, family support and
parental stress levels. It is argued that these results
parenting stress. The aspects of cognitions studied
have implications for clinical interventions for pro-
were: parenting self-esteem (including efficacy and
moting parents’ coping strategies in managing chil-
satisfaction) and parental locus of control.
dren with ID and behavioural difficulties.
Methods The group studied consisted of  mothers
of children with ID. The Vineland Adaptive Behavior Keywords behaviour problems, family support,
Scales and Maladaptive Behavior Domain were intellectual disability, parental locus of control,
administered by interview. Mothers also completed parenting satisfaction, stress
four questionnaires: the Family Support Scale, the
Parenting Sense of Competence Scale, a shortened
form of the Parental Locus of Control Scale and the Introduction
Parenting Stress Index (Short Form).
Many studies have demonstrated that parents of a
Results Data were analysed using Pearson’s correla-
child with an intellectual disability (ID) are likely to
tion coefficients, partial correlations and a regression
experience significantly higher levels of parenting
stress than are parents of nondisabled children (e.g.
Rodrigue et al. ; Dyson , ; Roach et al.
Correspondence: Richard Hassall, Psychology Department,
Oxfordshire Learning Disability NHS Trust, Slade House,
). However despite these broad findings, it is also
Horspath Driftway, Headington, Oxford OX JH, UK acknowledged that parents of children with a disabil-
(e-mail: Richard.Hassall@oldt.nhs.uk). ity vary considerably in the levels of stress they expe-
©  Blackwell Publishing Ltd
 Journal of Intellectual Disability Research
406
R. Hassall et al. • Parental cognitions and stress in mothers of children with disabilities
rience and that their stress levels are associated with
a wide range of variables (e.g. Frey et al. ; Quine
& Pahl ; Baxter et al. ). A few studies have
found that parenting stress is associated with the
severity of the child’s ID (e.g. Minnes ),
although others have failed to find any similar asso-
ciations (e.g. Beckman ; Walker et al. ).
Generally, it seems that specific characteristics asso-
ciated with the disability are more important corre-
lates of parental stress (Minnes ). These include
the child’s communication skills (Frey et al. )
and particularly the level of the child’s behavioural
difficulties (e.g. Friedrich et al. ; Konstantareas
& Homatidis ; Quine & Pahl ).
In addition, social support in the form of marital
happiness and family social climate has been found
to be associated with more effective coping strategies
(Friedrich et al. ). Other forms of social support,
including social networks, are also associated with
reduced stress levels in parents (e.g. Frey et al. ;
Krauss ).
Researchers have increasingly adopted the view
that families with a disabled child are not generally
characterized by high levels of pathology and that
families may employ various strategies to adapt suc-
cessfully to the demands posed by the child (Hodapp
; Stoneman ). The cognitive model of stress
and coping (Lazarus & Folkman ) has frequently
served as the basis for research into parental stress
and coping in families of children with disabilities
(Frey et al. ; Quine & Pahl ; Sloper et al.
; Miller et al. ; Sloper & Turner ; Grant
& Whittell ). A distinctive feature of this model
is the importance assigned to the individual’s
appraisal of the stressor in affecting her or his adap-
tation to a stressful situation. For example, Quine &
Pahl () in a study of  mothers reported that
the mothers’ cognitive appraisals, particularly their
adjustment to and acceptance of the child, acted as
variables mediating the influence of the child’s behav-
iour problems on consequent parenting stress.
In parallel with this interest in the effects of cogni-
tive processes on the adaptation of parents of children
with disabilities, there has been increasing recogni-
tion of the relationships between parental cognitions
and various parent and child outcomes for children
in general (Grusec & Mammone ; Coleman &
Karraker ; Bugental & Johnston ). Typi-
cally, researchers have studied how parental cogni-
©  Blackwell Publishing Ltd, Journal of Intellectual Disability Research , –
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tions are associated with parental stress, affect and
behaviour, and how these outcomes might be related
to their children’s behaviour. Research in this area
suggests there may be some potential for addressing
these cognitions as an adjunct to clinical interven-
tions involving behavioural parent training for chil-
dren’s behaviour problems (Johnston ; Coleman
& Karraker ; Bugental & Johnston ).
Mash & Johnston () proposed a model which
includes three categories of variables, conceptualized
as ‘child characteristics’, ‘parent characteristics’ and
‘environmental characteristics’. These may interact in
various ways to influence parent–child interactive
stress. Similarly these variables may be influenced
reciprocally by parenting stress. Applying this model
to parents of hyperactive children, Mash & Johnston
() suggest that parent–child interactive stress
may arise from a combination of difficult child char-
acteristics and parental cognitions. Although they do
not explicitly apply the model to parents of children
with an ID, the main features of it correspond closely
with other multidimensional approaches to the study
of stress in parents of children with disabilities (e.g.
Frey et al. ).
Parental cognitive processes play a key role in the
Mash and Johnston model, as well as in other models
of parenting stress. Recent reviews of research (e.g.
Coleman & Karraker ; Bugental & Johnston
) have also highlighted various forms of parental
cognition as being potentially capable of predicting
parent and child outcomes, although relatively few
such studies have looked at parents of children with
disabilities. Some studies have focused on parental
self-esteem (Johnston & Mash ; Coleman & Kar-
raker ), whilst others have focused on parental
locus of control (e.g. Roberts et al. ; Hagekull
et al. ).
Parental self-esteem
The concept of parental self-esteem or efficacy rep-
resents the degree to which parents view themselves
as effective in their parenting role. This is frequently
measured using the Parenting Sense of Competence
Scale (PSOC) (Johnston & Mash ), which com-
prises two subscales measuring ‘parenting satisfac-
tion’ and ‘parenting efficacy’, respectively, and which
provides a composite score referred to as ‘parental
self-esteem’. In a study using the PSOC with 
 Journal of Intellectual Disability Research
407
R. Hassall et al. • Parental cognitions and stress in mothers of children with disabilities
mothers and  fathers of school-age children, Ohan
et al. () found negative correlations for both
mothers and fathers between parenting satisfaction
scores and their children’s externalizing and internal-
izing behaviour problems. For parenting efficacy, no
association with child problems was found for moth-
ers and only a weak association was evident for
fathers.
Other studies of parenting efficacy and self-esteem
have been conducted with mothers of infants in the
first year of life (Teti & Gelfand ), parents of
hyperactive children (Mash & Johnston ;
Johnston & Patenaude ) and parents of children
with diabetes (Rodrigue et al. ). There have been
some studies of self-efficacy in parents of children
with ID which indicate that this may be predictive of
parental stress (e.g. Friedrich et al. ; Frey et al.
), although this is typically measured by individ-
ually tailored rating scales with little supporting psy-
chometric data. One recent study found that self-
efficacy mediated the effects of child behaviour prob-
lems on anxiety and depression in mothers of chil-
dren with autism (Hastings & Brown ). There
appear to be few published studies of parenting effi-
cacy in parents of children with disabilities using the
PSOC.
Parental locus of control
The Parental Locus of Control Scale (PLOC) was
developed by Campis et al. (), based on the con-
cept of generalized locus of control (Rotter ).
They found that parents of children with behaviour
difficulties had a more external locus of parenting
control on the PLOC, compared with parents of chil-
dren without identified problems. Subsequent
research with the PLOC has shown that mothers of
children with behavioural difficulties who success-
fully completed a parent training programme demon-
strated a more internal locus of control following the
programme (Roberts et al. ). In a longitudinal
study, using the Parental Control subscale of the
PLOC, Hagekull et al. () found that parents
reporting more external control tended to have chil-
dren with more behavioural difficulties. They also
found that the Parental Control assessments for par-
ents when their children were  months old pre-
dicted externalizing behaviour problems in the
children at  years of age.
©  Blackwell Publishing Ltd, Journal of Intellectual Disability Research , –
     
Some studies (e.g. Friedrich et al. ; Frey et al.
; Wiggs & Stores ) have used general locus
of control measures, such as Rotter’s () scale,
with parents of children with ID. Generally, the
results of these show that low personal control is
associated with higher parenting stress and psycho-
logical distress. In one study, successful behavioural
treatment for sleep disorders in their children was
associated with a greater sense of internal control in
the mothers (Wiggs & Stores ).
The present study
The main aim of the present study was to test the
Mash & Johnston () model of parenting stress
with mothers of children with an ID, and specifically
to examine the effects of parental cognitions on
parenting stress. The particular aspects of parental
cognitions to be examined were parental self-esteem
and locus of control. A further aim was to assess the
relative associations between these variables and
parenting stress, compared with the effects of other
variables reflecting child and environmental charac-
teristics as predicted by the Mash and Johnston
model. In view of the range of variables which could
be considered, particularly in relation to environmen-
tal characteristics (e.g. Frey et al. ), this was con-
sidered to be an exploratory study of the possible
contributions to parenting stress of different types of
variable. A measure of child behaviour difficulties was
therefore selected to reflect child characteristics, and
a measure of family and social support was chosen to
reflect environmental characteristics.
Several hypotheses were formulated for this study.
The first two were intended to replicate findings from
previous research in relation to the effects of child
and environmental characteristics, whilst the remain-
ing hypotheses were concerned with the effects of
parental cognitions on parenting stress. The study
also allowed for an exploration of possible relation-
ships between the severity of the child’s disability and
parenting stress within the group of mothers studied,
although no specific hypotheses were formed because
of contrasting results in previous studies of this
relationship.
The following specific hypotheses were therefore
examined:
 Mothers of children with an ID and higher lev-
els of behavioural difficulties would experience
 Journal of Intellectual Disability Research
408
R. Hassall et al. • Parental cognitions and stress in mothers of children with disabilities
higher levels of parenting stress compared with
those of disabled children with fewer behavioural
difficulties.
 Mothers who reported higher levels of social sup-
port would experience lower levels of parenting
stress.
 Levels of parenting stress in mothers would be
inversely related to their sense of parenting effective-
ness and satisfaction. Specifically, higher levels of
perceived effectiveness and satisfaction would be
associated with lower stress levels.
 Mothers with a more external locus of control for
parenting would display higher levels of parenting
stress.
In addition, it was intended to explore relationships
between these parental cognitive variables, and to
examine the extent of any measurement overlap
between them. The study was also designed to permit
the exploration of any mediating effects shown by
these variables, although specific hypotheses were dif-
ficult to formulate due to the limited number of pub-
lished studies in this area.
Method
Participants
The participants were mothers of children with an
ID who were recruited through six special schools
serving a predominantly rural middle-class area in
southeast England. Head-teachers at the schools
contacted a total of  mothers and sent each of
them a leaflet about the research, a letter inviting
them to participate, a consent form and a stamped
addressed envelope. Of these,  returned the con-
sent form agreeing to take part. Full data sets could
not be obtained for six of the mothers for various
reasons. Two could not participate because of per-
sonal or family health problems, one was never
present at the prearranged times when the
researcher visited, two could not be contacted to
arrange interviews and one participated in the inter-
views but did not return the other questionnaires
despite several requests. This left  participants for
whom full data sets were obtained and on whom the
subsequent analysis is based.
The ages of mothers in the sample ranged from 
to  years old, with a mean of . and standard
deviation of .. The ages of the children with dis-
©  Blackwell Publishing Ltd, Journal of Intellectual Disability Research , –
     
abilities ranged from  to  years old, with a mean
of . and standard deviation of .. Of these chil-
dren,  were boys and  were girls. The adaptive
behaviours of the children were measured using the
Vineland Adaptive Behavior Scales (Survey Form)
and the Adaptive Behavior Composite scores for the
children ranged from  to , with a mean of .
and standard deviation of ..
Nearly all the mothers spoke English as their first
language and were of white European ethnic back-
ground, reflecting the predominant ethnic mix in
the area. The only exception was one woman origi-
nating from northern Europe who spoke English
fluently. Mothers of other ethnic groups were sent
details about the research, but none volunteered to
take part. Of the  in the final sample,  were
married, engaged or cohabiting with a long-term
partner. The remaining seven were divorced, sepa-
rated or single.
The scores for total stress on the Parenting Stress
Index (PSI) (Short Form) of the sample group
ranged from  to , with a mean of . and a
standard deviation of .. The normative sample for
the PSI (Short Form) reported by Abidin ()
consisted of  participants obtaining scores with a
mean of  and standard deviation of .. A t-test
showed that the mean for the present sample was
significantly higher than for the normative sample
(t = .; d.f. = ; P < .), suggesting that these
parents were on average experiencing higher stress
levels than were the normative sample.
Measures
Vineland Adaptive Behavior Scales (Survey Form)
(Sparrow et al. )
This was used to measure the ability levels of the
children in relation to their adaptive behaviour skills.
For children of  years and older, three domains of
skill, labelled, respectively, Communication, Daily
Living Skills and Socialization, are assessed and stan-
dard scores are calculated for each domain. The over-
all level of adaptive skills of each child is measured
by the Adaptive Behavior Composite, derived from
the sum of the standard scores on the three domains.
Evidence regarding the reliability and validity of the
scales is summarized in the Vineland manual (Spar-
row et al. ).
 Journal of Intellectual Disability Research
409
R. Hassall et al. • Parental cognitions and stress in mothers of children with disabilities
Vineland Maladaptive Behavior Domain (Sparrow
et al. )
The Vineland Maladaptive Behavior Domain (VINE-
MAL) was used as a measure of each child’s level of
behavioural difficulties. Simple raw scores on this
checklist are used in the analysis of the data. Evidence
for the reliability and validity of the Maladaptive
Behavior Domain is provided by Sparrow et al. ().
Family Support Scale (Dunst et al. )
This scale was used as a measure of the social support
available from various sources to the mothers. It pro-
vides an overall score for total level of social support,
as well as five weighted subscale scores covering par-
ents’ perceptions of helpfulness of partner/spouse
support, informal kinship support, formal kinship
support, social organizations and professional ser-
vices. In addition, the Family Support Scale (FSS)
provides a measure of the total number of sources of
support available to parents. Dunst et al. ()
report an alpha coefficient for internal consistency of
., and coefficients for test–retest reliability over a
-month interval of . for the whole scale and .
for the average of the separate items. Discriminant
and construct validity for the FSS has been demon-
strated in several studies (e.g. Frey et al. ).
Parenting Sense of Competence Scale
This is a self-report scale, which parents are asked to
rate on a six-point Likert scale ranging from ‘strongly
disagree’ to ‘strongly agree’, and which was originally
constructed by Gibaud-Wallston & Wandersman
(). The total score (PSOC-TOT) is used as a
measure of parenting self-esteem. The PSOC also
provides measures of parenting satisfaction (PSOC-
S) and efficacy (PSOC-E), the two principal factors
identified by Johnston & Mash () who confirmed
the factor structure of the initial test construction.
Johnston and Mash also reported alpha scores for
internal consistency of . for the satisfaction factor
and . for the efficacy factor. Test–retest correla-
tions over a -week interval ranging from . to .
were reported by Gibaud-Wallston & Wandersman
(). Convergent and discriminant validity for the
PSOC has been reported in a range of studies with
parents of children with differing disorders (e.g.
Johnston & Mash ; Rodrigue et al. ; Lovejoy
et al. ; Ohan et al. ). Although the full scale
©  Blackwell Publishing Ltd, Journal of Intellectual Disability Research , –
     
comprises  items, Johnston and Mash () found
that one item (‘Being a good mother/father is a
reward in itself’) did not load strongly on either of
the two identified factors. This item was therefore
omitted from the scale in this study.
Parental Locus of Control Scale (Short Form Revised)
A shortened form of the PLOC (Campis et al. )
was used for this study. The original scale used by
Campis et al. contained  items which parents were
asked to rate on a five-point Likert scale ranging from
‘strongly disagree’ to ‘strongly agree’. Their factor
analysis on these items produced five factors within
the scale, which they labelled Parental Efficacy (PE),
Parental Responsibility (PR), Child Control of Par-
ents’ Life (CC), Fate/Chance and Parental Control
of Child’s Behaviour (PC), respectively. These sub-
scales contained an unequal number of items, rang-
ing from  to . Campis et al. () reported alpha
coefficients for internal consistency ranging from
. to . for the five subscales and . for the
total scale. Test–retest reliability for the whole scale
has been demonstrated with a correlation of .
over an interval of between  and  days (Roberts
et al. ). Good construct and discriminant validity
for the scale has been demonstrated with parents of
children with no reported difficulties and parents of
children with behavioural problems (Campis et al.
; Roberts et al. ).
To reduce the burden on participants in this study,
it was felt necessary to shorten the original PLOC.
This was carried out by removing one of the original
subscales (Fate/Chance) which was found to lack dis-
criminant validity in the study by Campis et al.
(), who recommended that it should be omitted
by future researchers. One item (‘My child usually
ends up getting his/her way, so why try’) from the
original PE subscale was also omitted, again follow-
ing a recommendation by Campis et al. (), as this
item reduced the alpha coefficient for that subscale
and was felt to have ambiguous meanings. The
remaining four subscales (and the remaining items
on the Parental Efficacy subscale) were shortened by
selecting the six items with the highest factor loadings
on each subscale in the Campis et al. () study.
This followed a similar procedure adopted by Love-
joy et al. (), who produced a shortened version
of the five-factor PLOC, which they labelled ‘PLOC-
SF’. The resultant scale for this study, which used
 Journal of Intellectual Disability Research
410
R. Hassall et al. • Parental cognitions and stress in mothers of children with disabilities
four subscales and consisted of  items, was labelled
‘PLOC-SFR’.
Half of all items in the full scale were reverse
scored. High scores on the scale indicate an external
locus of parenting control and low scores indicate an
internal locus.
Parenting Stress Index (Short Form)
The Short Form of the PSI (rd edition) (Abidin
) was used as the dependent variable. The Short
Form yields a total score for parenting stress (PSI-
TOT) and three subscale scores labelled, respec-
tively, Parental Distress (PD), Parent–Child Dys-
functional Interaction (P/CDI) and Difficult Child
(DC). Detailed reliability and validity data for the
PSI are reported in the PSI manual (Abidin ).
Procedure
For each mother who agreed to participate, the Vine-
land Adaptive Behavior Scales (including the Mal-
adaptive Behavior Domain) were completed by
interview. The other four questionnaires (FSS,
PSOC, PLOC-SFR and PSI) were left with her to fill
in independently and were collected by the inter-
viewer subsequently. In a few cases, administration of
the Vineland proved to be very lengthy and an extra
visit a short time later had to be arranged to allow
this to be completed.
Results
Analysis
The scores on each of the variables in the study were
found to approximate to a normal distribution on a
one-sample Kolmogorov-Smirnoff test. The hypoth-
eses were therefore all tested by a correlational anal-
ysis using Pearson’s correlational coefficients, with
the assumption that associations were linear. The
variables that were found to be strongly associated
with the total scale score on the PSI were then
entered into a step-wise regression analysis to deter-
mine which of these accounted for most of the vari-
ance in the dependent variable (PSI-TOT).
Parenting stress and children’s adaptive skills
Examining Pearson’s correlation coefficients, there
were no significant correlations between the Adaptive
©  Blackwell Publishing Ltd, Journal of Intellectual Disability Research , –
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Behavior Composite and either PSI-TOT or two
of its subscales, PSI-PD and PSI-DC. There was,
however, a small inverse correlation (r = -.,
P = .) between the Adaptive Behavior Composite
and one subscale, PSI-P/CDI. There were similar
inverse correlations between PSI-P/CDI and the
Vineland subscales (Communication: r = -.,
P = .; Daily Living Skills: r = -., P = .;
Socialization: r = -., P = .).
For all the remaining results, the pattern of
correlations of variables with PSI-TOT was similar
to the pattern of correlations with the individual
PSI subscales. Therefore, only the correlations
with PSI-TOT will be reported for the following
results.
Hypothesis 1
The results provided confirmation of an association
between children’s behavioural difficulties and
parenting stress. There was a significant correlation
between the VINE-MAL and the PSI-TOT
(r = ., P = .).
Hypothesis 2
In confirmation of the hypothesis that social support
is inversely related to parenting stress in parents, a
number of significant inverse correlations were
obtained between PSI-TOT and the FSS and its sub-
scales measuring informal kinship, formal kinship
and social organization supports. These results are
shown in Table .
The correlation of PSI-TOT with the total scale
score of the FSS was stronger than with any of the
FSS subscales. Consequently, all subsequent presen-
tations of results with the FSS will just refer to the
total scale score.
Hypothesis 3
In confirmation of the hypothesis that parenting
self-esteem would be inversely related to parenting
stress, there were significant inverse correlations
between parenting stress (PSI-TOT) and the PSOC
(see Table ). Of the two subscales of the PSOC,
the satisfaction subscale (S) of the PSOC showed
the strongest inverse correlation with parenting
stress.
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Table 1 Pearson’s correlation coefficients for the FSS and its sub- Table 3 Pearson’s correlation coefficients for the PLOC-SFR and
scales with PSI-TOT its subscales with PSI-TOT

Correlations Correlations

FSS – total -0.485; P = 0.001** PLOC-SFR 0.673; P < 0.001**

FSS – partner/spouse -0.144; NS PE 0.210; NS
FSS – informal kinship -0.397; P = 0.006** PR -0.106; NS
FSS – formal kinship -0.292; P = 0.049* CC 0.713; P < 0.001**
FSS – social organizations -0.411; P = 0.005** PC 0.692; P < 0.001**
FSS – professional services -0.249; NS
FSS – No. of support sources 0.136; NS **P < ..
NS, not significant; PLOC-SFR, Parental Locus of Control Scale
*P < .; **P < .. (Short Form Revised); PE, Parental Efficacy; PR, Parental
NS, not significant; FSS, Family Support Scale; PSI-TOT, total Responsibility; CC, Child Control of Parents’ Life; PC, Parental
score for Parenting Stress Index. Control of Child’s Behaviour; PSI-TOT, total score for Parenting
Stress Index.

Table 2 Pearson’s correlation coefficients for PSOC with PSI-TOT

Correlations
PSOC-S -0.636; P < 0.001**
PSOC-E -0.383; P = 0.009**
PSOC-TOT -0.624; P < 0.001**
**P < ..
PSOC, Parenting Sense of Competence Scale; PSOC-S, parenting
satisfaction subscale of PSOC; PSOC-E, parenting efficacy subscale
of PSOC; PSOC-TOT, total score for PSOC; PSI-TOT, total score
for Parenting Stress Index.
Hypothesis 4
This hypothesis stated that mothers with a more
external locus of parenting control would display
higher levels of parenting stress. The internal consis-
tency of the PLOC-SFR, which was used to test the
hypothesis, was checked and an alpha coefficient of
. was obtained. The results (see Table ) sup-
ported the hypothesis, showing that mothers with an
external locus of control were more likely to experi-
ence higher stress levels.
Relationships between PLOC-SFR, PSOC and
other variables
As both parenting locus of control and parenting self-
esteem (including efficacy and satisfaction) are
strongly correlated with parenting stress, and both
represent parental cognitive variables, the correla-
©  Blackwell Publishing Ltd, Journal of Intellectual Disability Research , –
tions between these variables were examined. Table 
gives the correlation coefficients between these and
their respective subscales.
There was a strong inverse correlation between
PLOC-SFR and PSOC-TOT scores, implying that
mothers with higher levels of parenting self-esteem
were likely to have a more internal locus of parenting
control. Similar patterns of correlations were
observed for three of the PLOC-SFR subscales (PE,
CC and PC), but there was no such association
between the PR subscale and any of the PSOC scales.
As the two subscales of the PSOC are regarded as
being conceptually distinct dimensions of parenting
self-esteem (Johnston & Mash ), it is possible
that they may have different relationships with
parenting stress (PSI-TOT) and may interact differ-
ently with PLOC-SFR in accounting for the variance
in parenting stress. In particular, at least part of the
effect of the PSOC on parenting stress could be
accounted for by correlations with PLOC-SFR. To
test these possibilities, partial correlations were car-
ried out, in which parenting stress was correlated
with the subscales and total score of the PSOC whilst
controlling for PLOC-SFR.
When PLOC-SFR was controlled, there was no
significant correlation between the efficacy (E) sub-
scale of the PSOC and parenting stress (PSI-TOT),
suggesting that the zero-order correlation between
PSOC-E and PSI-TOT is wholly attributable to the
correlation between PSOC-E and PLOC-SFR. How-
ever, there was a strong first-order correlation
between the satisfaction (S) subscale of the PSOC
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Table 4 Pearson’s correlation coefficients

PSOC-TOT PSOC-S PSOC-E between PSOC and PLOC-SFR scores

PLOC-SFR -0.674; P < 0.001** -0.529; P < 0.001** -0.602; P < 0.001**
PE -0.492; P = 0.001** -0.335; P = 0.023* -0.500; P < 0.001**
PR -0.026; NS 0.121; NS -0.192; NS
CC -0.514; P < 0.001** -0.567; P < 0.001** -0.267; NS
PC -0.626; P < 0.001** -0.473; P = 0.001** -0.580; P < 0.001**

*P < .; **P < ..

NS, not significant; PSOC, Parenting Sense of Competence Scale; PSOC-TOT, total score
for PSOC; PSOC-S, parenting satisfaction subscale of PSOC; PSOC-E, parenting efficacy
subscale of PSOC; PLOC-SFR, Parental Locus of Control Scale (Short Form Revised); PE,
Parental Efficacy; PR, Parental Responsibility; CC, Child Control of Parents’ Life; PC,
Parental Control of Child’s Behaviour.

Table 5 Model summary for regression analysis with PSI-TOT as subscales and the Vineland Adaptive Behavior scores.
dependent variable Therefore, there was no relationship between the
mothers’ locus of parenting control and the level of
Model 1 Model 2 Model 3 ability of their children. There was a small, but sig-
nificant correlation for the VINE-MAL with the
R 0.673* 0.749† 0.787‡ PLOC-SFR (r = ., P = .), and a stronger
R square 0.452 0.561 0.619 correlation with one of the PLOC-SFR subscales,
Adjusted R square 0.440 0.541 0.592 PC, representing parental control over the child’s
R square change 0.452 0.109 0.058
behaviour (r = ., P = .). This suggests that
Significance <0.001 0.002 0.015
mothers of children with higher levels of maladaptive
*Predictors: (Constant), PLOC-SFR.
behaviour were more likely to have an external locus
†
Predictors: (Constant), PLOC-SFR, PSOC-S. of parenting control. There were no significant corre-
‡
Predictors: (Constant), PLOC-SFR, PSOC-S, VINE-MAL. lations with the other PLOC-SFR subscales.
PSI-TOT, total score for Parenting Stress Index; PLOC-SFR, For the relationship of the PLOC-SFR and the
Parental Locus of Control Scale (Short Form Revised); PSOC,
FSS, there was a significant inverse correlation
Parenting Sense of Competence Scale; PSOC-S, parenting
satisfaction subscale of PSOC; VINE-MAL, Vineland Maladaptive
between these measures (r = -.; P = .), indi-
Behavior Domain. cating that mothers with greater levels of social sup-
port tended also to have a more internal locus of
parenting control. This association was particularly
strong between FSS and the PC subscale of the
and PSI-TOT (r = -.; P = .), suggesting that PLOC-SFR (-.; P < .).
this subscale fully accounted for the correlation
between parenting self-esteem and parenting stress,
Regression analysis
and might therefore contribute some unique variance
in the present model. There was also a significant From the above results, four main variables
first-order correlation between PSOC-TOT and PSI- emerged which were strongly associated with total
TOT (r = -.; P = .). These results suggest parenting stress (PSI-TOT), these being: the VINE-
that there may be some measurement overlap MAL score, the FSS score, the PSOC-S and the
between the efficacy (E) subscale of the PSOC and PLOC-SFR. The criterion for selecting these was
PLOC-SFR. that they all displayed strong correlations with PSI-
Examining the relationship between the PLOC- TOT at a significance level of at least .. The
SFR scores and the Vineland Scales revealed no sig- PSOC-S was selected in preference to the PSOC-
nificant correlations between the PLOC-SFR or its TOT as this accounted for all of the association
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R. Hassall et al. • Parental cognitions and stress in mothers of children with disabilities
between PSOC-TOT and PSI-TOT. These four
variables were entered into a step-wise regression
analysis with PSI-TOT as the dependent variable,
with the order of entry being determined by the
amount of additional variance for which each vari-
able accounts. The PLOC-SFR was entered first,
followed by PSOC-S and finally VINE-MAL. No
variables were removed at any stage. The model
summary is given in Table . Using the figures for
‘adjusted R square’, parental locus of control
(PLOC-SFR) accounted for % of the variance in
parenting stress (PSI-TOT) in model . When
parenting satisfaction (PSOC-S) was added in
model , % of the variance was accounted for by
these two variables. Adding child behaviour prob-
lems (VINE-MAL) to these variables accounted for
% of the variance in parenting stress in model .
The results of the regression analysis indicated that
parental cognitive variables (locus of control and
parenting satisfaction) were both significant predic-
tors of parenting stress and that child behaviour dif-
ficulties also made a significant contribution to the
variance in parenting stress. However, family support
did not contribute significantly to explaining any of
this variance. Therefore, it was inferred that the pre-
viously noted correlation between family support and
parenting stress (see Table ) appeared to be medi-
ated by another intervening variable. To test this
inference, partial correlations were calculated
between family support (FSS) and parenting stress
(PSI-TOT) controlling for parental locus of control
(PLOC-SFR), parenting satisfaction (PSOC-S) and
child behaviour difficulties (VINE-MAL), respec-
tively (see Table ). These are compared with the
zero-order correlation of r = -. (P = .)
between the FSS and PSI-TOT. These first-order
correlations indicate that the association between
FSS and PSI-TOT is largely unaffected by PSOC-S
or by VINE-MAL. However, the correlation between
FSS and PSI-TOT is greatly reduced, and no longer
significant, when PLOC-SFR is controlled.
Discussion
In accordance with the Mash & Johnston ()
model of parenting stress, the results of this study
appeared to demonstrate the importance of all three
sets of characteristics described by the model for
©  Blackwell Publishing Ltd, Journal of Intellectual Disability Research , –
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Table 6 First-order correlations between family support (FSS) and
parenting stress (PSI-TOT) with other variables controlled
First-order correlations – Variable
FSS vs. PSI-TOT controlled
R = -0. 251; NS PLOC-SFR
R = -0.453; P = 0.002** PSOC-S
R = -0.381; P = 0.010* VINE-MAL
***P < .; P < ..
NS, not significant; FSS, Family Support Scale; PSI-TOT, total
score for Parenting Stress Index; PLOC-SFR, Parental Locus of
Control Scale (Short Form Revised); PSOC, Parenting Sense of
Competence Scale; PSOC-S, parenting satisfaction subscale of
PSOC; VINE-MAL, Vineland Maladaptive Behavior Domain.
parents of children with ID. With regard to child
characteristics, there was clear evidence of an associ-
ation between child behaviour difficulties and parent-
ing stress, which is consistent with the results of
previous research (e.g. Quine & Pahl ). However,
there was little association between the child’s level
of skills and parenting stress in the mothers, which is
consistent with other research in this area (e.g.
Walker et al. ).
The association of environmental characteristics
with parenting stress is also demonstrated by the
present results showing a strong inverse correlation
between the FSS and the PSI. This indicates that
mothers with greater levels of social support experi-
ence lower levels of parenting stress, and this finding
is consistent with much previous research (e.g. Frey
et al. ). This was the only measure of environ-
mental characteristics included in the present study,
and it is possible that it includes an element of paren-
tal characteristics in that it measures parents’ percep-
tions of the support they receive. Interestingly, the
subscale of the FSS measuring the number of sources
of support available for mothers showed no correla-
tion with parenting stress (nor with any other variable
in this study). The critical variable, therefore, seems
to be the perceived helpfulness of the support
received by mothers rather than the range of supports
available.
The present study provided clear evidence of strong
associations between mothers’ cognitive states and
their parenting stress, in confirmation of the role of
parental characteristics in the Mash & Johnston
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R. Hassall et al. • Parental cognitions and stress in mothers of children with disabilities
() model. This was especially evident for the
PSOC and the PLOC-SFR.There were strong inverse
correlations between the PSOC and the PSI indicat-
ing that mothers with higher levels of parenting self-
esteem experienced lower parenting stress. The
PSOC dimension for which this was strongest was
parenting satisfaction (PSOC-S), which is considered
to reflect an affective dimension of parenting
(Johnston & Mash ). The other PSOC dimension
(PSOC-E), reflecting parents’ sense of their efficacy
in parenting, demonstrated significant, but weaker,
inverse correlations with the PSI and its subscales.
There were strong positive correlations between
the PLOC-SFR and the PSI and its subscales. These
indicated that mothers with a more internal locus of
parenting control tended to experience lower levels
of parenting stress. This result reflects other findings
using general locus of control measures which have
shown that similar groups of parents with more inter-
nal control experience lower levels of stress and psy-
chological distress (e.g. Friedrich et al. ; Frey
et al. ).
Two subscales of the PLOC-SFR showed high cor-
relations with PSI scores, these being CC and PC.
The correlations between the remaining two sub-
scales PE and PR and the PSI subscales were all
either insignificant or very low. The CC and PC sub-
scales therefore were those with the greatest value in
predicting parenting stress in this study, reflecting
similar findings regarding the validity of these sub-
scales reported by Campis et al. () and Hagekull
et al. ().
From the correlational analysis, parental locus of
control (PLOC-SFR) and parental self-esteem
(PSOC) emerged as strong predictors of parenting
stress. There was also a strong correlation between
these two variables and their subscales, raising the
possibility of some conceptual overlap between them.
Examining the partial correlations of the PSOC sub-
scales with PSI-TOT showed that the efficacy sub-
scale had no association with parenting stress
independently of the effect of parental locus of con-
trol. This finding is consistent with previous research
reporting some convergent validity between parental
locus of control and parenting efficacy (Lovejoy et al.
). In contrast, the satisfaction dimension of the
PSOC continued to demonstrate a significant associ-
ation with parenting stress independently of parental
locus of control, suggesting that parenting satisfac-
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tion and parental locus of control are conceptually
more distinct.
The results of the regression analysis and the par-
tial correlations between FSS and PSI-TOT further
clarify the manner in which parental cognitive vari-
ables are associated with parenting stress in this
group of mothers. The regression analysis showed
that parental locus of control and parenting satisfac-
tion, together with child behaviour difficulties,
accounted for more than half the variance in parent-
ing stress, and that family support was not a signifi-
cant predictor in this model. However, parental locus
of control and parenting satisfaction appeared to be
associated in different ways with the other variables
in the model. The first-order correlation between FSS
and PSI-TOT, controlling for parental locus of con-
trol, was small and nonsignificant, implying that
parental locus of control accounted for most of the
zero-order correlation between these two variables. It
appears therefore that parental locus of control acts
as an intervening variable mediating the effect of FSS
on PSI-TOT, and hence accounting for the failure of
FSS to contribute significantly to the variance in PSI-
TOT in the regression analysis. However, when
parenting satisfaction was controlled, a significant
first-order correlation remained between FSS and
PSI-TOT, indicating that the variance in parenting
satisfaction had little effect on this relationship. The
first order correlations between child behaviour prob-
lems and PSI-TOT also remained significant, when
either parental locus of control or parenting satisfac-
tion was controlled, thus confirming the finding of
the regression analysis that child behaviour problems
had a direct association with parenting stress.
In summary, this study provides evidence that
parenting stress in mothers of children with ID is
associated with the level of behavioural difficulties of
their children, their locus of parenting control and
their sense of satisfaction with parenting. Whilst their
stress levels are also inversely correlated with family
support, this association appears to be mediated by
their locus of parenting control. This result would
suggest that the direct effect of family support
appears mainly to be in contributing to a more inter-
nal locus of control in the mothers. Further research
with a larger and more representative sample would
be required to clarify how far this can be generalized.
However, Beresford () cites earlier research sug-
gesting that social support is viewed as an effective
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R. Hassall et al. • Parental cognitions and stress in mothers of children with disabilities
coping resource by individuals with a more internal
locus of control compared with those with an external
locus of control. The direction of causality in the
present result is therefore unclear. Furthermore, it
appears that locus of control beliefs may interact with
other coping resources and with previous coping
experiences to influence various outcomes for the
parents (Beresford ), and this also would be a
fruitful area for further research.
There may also be more general theoretical
grounds supporting the importance of parental locus
of control in this model. Locus of control can be seen
as one expression of Bandura’s () concept of
‘self-efficacy’, which according to Bandura is a cen-
tral motivating influence in human behaviour, with
effects on other cognitive processes, emotional reac-
tions and the behaviour of the individual.
Methodological limitations
There are some methodological constraints in this
study which limit the conclusions that can be drawn.
First, the absence of a longitudinal design prevented
clear conclusions being reached about the directions
of the observed associations. Second, the mothers
were drawn from a largely rural middle-class area and
therefore do not adequately reflect the ethnic and
socio-economic diversity of parents in the UK. Addi-
tionally, fathers were not included in the study and
one cannot infer that similar results would be
obtained for them.
Third, the number of participants was too small to
allow any meaningful analysis of subgroups of moth-
ers, where possible differences in results could
emerge. For example, mothers of an only child with
a disability may experience lower parenting satisfac-
tion and a more external locus of control than do
mothers with other children without disabilities.
However, there were only seven mothers of only chil-
dren in this study, which is insufficient to establish
any reliable group differences. Similarly, it was not
possible to test for the effects of different syndromes
or disabilities which could account for different levels
of parenting stress and differential effects on parental
cognitions (Hodapp ).
Finally, all the measures used here depend on
parental report and some of the associations found
might therefore result from source variance. Never-
theless, this may be difficult to avoid when parents’
©  Blackwell Publishing Ltd, Journal of Intellectual Disability Research , –
     
perceptions are the principal subject of study. One
alternative would be use to a measure of children’s
behaviour problems based on teacher observations,
although not all children who display behavioural
difficulties at home have similar problems at school.
Another alternative to relying on self-report for
parenting stress would be to measure spouses’ per-
ceptions of their partners’ stress levels. However,
this would involve an assumption that spouses have
an accurate perception of their partners’ experi-
ences, and would also be inapplicable for single
parents.
Clinical implications
An area for future research with potential clinical
implications would be the links between the parental
cognitions analysed above and parents’ coping styles,
following the Lazarus & Folkman () model of
cognitive appraisals and coping styles. Previous
research with parents of children with disabilities has
shown that the use of emotion-focused coping styles
is associated with higher levels of distress and parent-
ing stress, whereas problem-focused styles are asso-
ciated with lower stress levels (Miller et al. ;
Hastings & Johnson ). It would therefore be
valuable to study the relationships between parental
locus of control, parenting satisfaction and adaptive
coping styles, and to clarify further any mediating
effects between these variables and parental stress
and distress. This might have particular implications
for cognitive interventions with parents aimed at
ameliorating the stress associated with raising a child
with a disability (Weiss ).
Further research could also examine the potential
buffering effects of positive experiences of caring for
a disabled child on the parents’ emotional state.
There is some recent evidence that mothers’ posi-
tive perceptions of caring for a child with a disability
are associated with reframing coping strategies and
that the use of social support resources contributes
to some aspects of these positive perceptions (Hast-
ings et al. ). These positive aspects of parenting
may therefore have significant implications for sup-
porting families of children with ID (Hastings et al.
).
Furthermore, the evidence that adaptive coping
styles and beliefs in the efficacy of behavioural inter-
ventions are associated with lower parenting stress
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R. Hassall et al. • Parental cognitions and stress in mothers of children with disabilities
could have implications for how such interventions
are delivered and the nature of the support that par-
ents need when implementing them (Hastings &
Johnson ). Generally it would seem that if par-
ents are to implement interventions for children with
behavioural difficulties, then they need to view these
interventions as acceptable (Reimers et al. ) and
to have some beliefs in their potential efficacy and
appropriateness to the problem (Cross Calvert &
Johnston ). Therefore, behavioural interventions
for children with challenging behaviours need also to
include components that address the parents’ coping
styles and beliefs about their own parenting capaci-
ties, when faced with the demands of a child whose
problems may be attributed to causes viewed as
largely outside parental control. It seems likely that
the success of such interventions could be enhanced
by attention to these issues.
Finally, other aspects of parental cognitions and
beliefs also appear to be important in influencing
parental reactions. There is accumulating evidence of
the importance of parents’ attributions for their chil-
dren’s behaviour in affecting parental outcomes
(Miller ; Bugental et al. ). Specifically,
mothers who attribute more control to their children
for their negative behaviour are more likely to expe-
rience angry feelings towards their children and to
use over-assertive disciplinary practices (e.g. Dix
et al. ; Smith Slep & O’Leary ). Whilst few
studies have been performed with parents of children
with ID, one such study found that mothers who
attribute responsibility to their children for behaviour
problems are more likely to experience negative emo-
tional reactions and to employ harsh disciplinary
methods (Chavira et al. ). Further studies of
parental attributions with this group of parents could
therefore contribute an additional perspective to the
understanding of the role of parental cognitions and
to the design of therapeutic interventions for child
behaviour problems.
Acknowledgements
The authors would like to thank the parents who
agreed to take part in this study. We would also like
to thank the staff at the schools in Oxfordshire who
assisted in recruiting participants. Thanks are also
due to managers in the two employing National
©  Blackwell Publishing Ltd, Journal of Intellectual Disability Research , –
     
Health Service (NHS) trusts who allowed time for
the preparation of the project and for the research to
be undertaken.
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