Parental Characteristics and Characteristics of Children with ADHD
The analyzed findings regarding the sociodemographic characteristics of the measured sample of ADHD-diagnosed children and their parents are displayed in
Table 1.
According to the GAD7 scale, 18.6% of parents were considered to have moderate anxiety, and 20.5% had high anxiety levels (
Figure 1). Moreover, the PHQ9 scale showed that 23.1% of parents were considered to have mild depression, and 15.4% had a moderate depression level, while 10.3% and 10.3% were found to have high and severe depression levels, respectively (
Figure 2).
The study’s bivariate correlations unveiled several noteworthy insights concerning parents’ perceived quality of life (WHOQOL-Brief) scores and their relationships with various factors, as illustrated in
Table 2.
The findings highlighted that parents’ perceived quality of life scores exhibited positive correlations with the subscale scores of physical, psychological, social, and environmental well-being. Additionally, parents’ general life and health satisfaction scores demonstrated positive and significant associations with their mean perceived quality of life scores.
Conversely, significant negative correlations were observed between parents’ mean perceived quality of life scores and their perceived generalized anxiety and depression scores (rho = −0.541, p < 0.010, rho = −0.725, p-value < 0.010, respectively). These findings suggest that as anxiety levels and depression increased, perceived quality of life scores tended to decrease.
Furthermore, the study revealed that a higher utilization of maladaptive coping strategies among parents of children with ADHD predicted lower perceived quality of life (rho = −0.426, p-value < 0.010). Interestingly, no significant correlation was found between parents’ perceived adaptive coping scores and their mean perceived quality of life scores.
Moreover, parents’ mean perceived depression scores exhibited positive correlations with their mean perceived maladaptive and adaptive coping scores (p-value < 0.010), indicating that as depression levels increased, both maladaptive and adaptive coping strategies tended to increase.
To gain a deeper understanding of the factors influencing parents’ perceived quality of life, standard multivariable Linear Regression Analysis was employed to regress the parents’ mean perceived overall WHOQOL-Brief score against various sociodemographic characteristics, the outcomes of children with ADHD, and other relevant factors. The resulting findings, presented in
Table 3, unveiled several significant correlations.
Firstly, parents’ household monthly income level exhibited a significant and positive correlation with their mean perceived quality of life score. Specifically, parents with a household monthly income of ≥SAR 5000/Month reported significantly higher mean perceived quality of life scores compared to those with a household income of <SAR 5000/Month, with a beta coefficient of 2.482 and a p-value < 0.001.
Additionally, parents’ employment status emerged as a significant factor correlated with their mean perceived quality of life score. Employed individuals reported significantly higher mean perceived quality of life scores compared to unemployed individuals, with a beta coefficient of 3.748 and a p-value of 0.030.
Unsurprisingly, parents’ mean perceived depression scores (PHQ9) demonstrated a significant negative correlation with their mean perceived quality of life score. Higher levels of depression among parents of ADHD-diagnosed children predicted significantly lower mean perceived quality of life scores, with a beta coefficient of −1.091 and a p-value < 0.001.
Furthermore, the parental mean perceived adaptive coping score exhibited a significant and positive correlation with their mean perceived quality of life score. Greater utilization of adaptive coping strategies among parents of ADHD-diagnosed children predicted significantly higher mean perceived quality of life scores, with a beta coefficient of 4.982 and a p-value ≤ 0.001.
The number of siblings in the household also demonstrated a significant positive correlation with parents’ mean perceived quality of life score, with a beta coefficient of 0.874 and a p-value of 0.035.
In a Multivariable Generalized Linear Gamma Regression analysis examining parental perceived anxiety scores (GAD7), several significant correlations emerged, as detailed in
Table 4. Parents’ age and educational attainment displayed significant negative correlations with their mean perceived anxiety (GAD7) scores. With each additional year of parental age, anxiety tended to decrease by a factor of 2.68% on average (
p-value < 0.001). Moreover, parents holding a diploma degree or higher education reported significantly lower mean perceived anxiety (GAD7) scores, which was 36.4% less than the score of those with a high school or lower education level (
p-value < 0.001). A noteworthy correlation was observed between parents’ gender. Fathers, on average, reported 19.8% lower mean perceived anxiety (GAD7) scores compared to mothers (
p-value = 0.030). Interestingly, households with a monthly income below SAR 5000/Month were associated with a 28.5% lower mean perceived anxiety (GAD7) score compared to those earning ≥SAR 5000/Month (
p-value = 0.003). The severity of ADHD symptoms in children exhibited a significant correlation with parental mean perceived anxiety (GAD7) scores. Parents of children diagnosed with severe ADHD reported significantly higher mean perceived anxiety (GAD7) scores, which was 26.5% higher than the score of those with moderate or less severe ADHD (
p-value = 0.002). A significant positive correlation was found between parental mean perceived depression scores and their mean perceived anxiety (GAD7) scores.
When applying Gamma Analysis to the parents’ mean perceived depression score (PHQ9), the results presented in
Table 5 revealed several significant findings. There was no significant correlation found between parents’ mean perceived maladaptive coping score and their mean perceived depression score (PHQ9). However, a significant positive correlation was observed between parents’ mean perceived adaptive coping score and their mean perceived depression score. On average, for every one-point increase in the mean perceived adaptive coping score, the mean predicted depression score increased by 30.9% (
p-value < 0.001). A significant negative correlation was found between parents’ mean perceived quality of life score and their mean perceived depression score (PHQ9). For each additional one-point rise in parents’ mean perceived quality of life score, their mean perceived depression score declined by a factor equal to 2.9%, on average (
p-value < 0.001).
These findings highlight the intricate relationship between coping mechanisms, quality of life, and parental depression levels, shedding light on factors influencing parental mental well-being in the context of raising children with ADHD.
A Gamma Regression employing the generalized multivariate model was utilized to explore parental coping strategies using the mean maladaptive coping score. The findings derived from the analysis, as presented in
Table 6, yielded several significant insights. Fathers of children diagnosed with ADHD reported a significantly higher mean maladaptive coping score compared to mothers, measuring 9.7% higher on average (
p-value = 0.019). Furthermore, parents diagnosed with a history of mental or psychological illness demonstrated significantly higher mean maladaptive coping scores compared to parents without a known history of mental illness. Specifically, their scores were 14.5% higher on average (
p-value = 0.024). Interestingly, parental perceived anxiety exhibited a significant and positive correlation with their mean perceived maladaptive coping score (
p-value = 0.004). Higher levels of parental anxiety predicted significantly higher levels of maladaptive coping in general.
The analysis of parents’ mean adaptive coping score (
Table 7) revealed several significant findings. The parents’ mean perceived quality of life score (QoL) exhibited a positive and significant correlation with their mean adaptive coping score (
p-value < 0.001). Higher perceived quality of life among parents predicted significantly higher perceived adaptive coping.
Interestingly, household income did not correlate with parents’ mean perceived adaptive coping. However, their educational level showed a positive correlation, with parents holding a diploma or a higher educational level reporting significantly higher mean perceived adaptive coping scores (13.2% higher) compared to those with a high school or lower educational level, on average (p-value = 0.017).
Furthermore, parents’ mean perceived maladaptive coping score positively correlated with their mean perceived adaptive coping score. This suggests that parents may utilize both adaptive and maladaptive coping strategies simultaneously. For each additional one-point increase in parents’ maladaptive coping score, their mean predicted adaptive coping score tended to rise by 30.9%, on average (p-value < 0.001).
Additionally, parents’ mean perceived activities of daily living (ADL) difficulties associated with anxiety positively and significantly correlated with their mean perceived adaptive coping score. As parents’ mean perceived ADL difficulties due to anxiety increased by one point, on average, their mean adaptive coping tended to rise incrementally by a factor equal to 11.4%, on average (p-value < 0.001).
The findings also indicated that parents of children with comorbid learning difficulties had significantly lower average maladaptive coping scores compared to parents whose children did not have learning difficulties, with a p-value of 0.012. Similarly, parents of children exhibiting autistic traits had significantly lower maladaptive coping scores than parents of children without such traits, with a p-value of 0.013.
These findings underscore the complex interplay between various factors, such as parental perceived quality of life, education level, maladaptive coping, and ADL difficulties associated with anxiety, shaping parents’ adaptive coping strategies in the context of raising children with ADHD.