Chronic Parenting Stress: Moderating Versus ...

Journal of Personality and Social Psychology 1990, Vol. 59, No. 6,1266-1278

Copyright 1990 by the American Psychological Association, Inc. 0022-3514/90/$00.75

Chronic Parenting Stress: Moderating Versus Mediating Effects of Social Support Robert L. Glueckauf

Alexandra L. Quittner

Purdue School of Science Indiana University-Purdue University at Indianapolis

Indiana University

Douglas N. Jackson

This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

University of Western Ontario London, Ontario, Canada The present study contrasted the widely cited "buffer" model of social support with an alternative mediator model. Distinctions were drawn between the functions of social support under chronic vs. acute stress conditions, and between situation-specific stressors and major life events. Ongoing parenting stress was assessed in 96 mothers of deaf children and 118 matched controls. Tests of the competing models showed no moderating effects for social support. However, path analyses suggested that social support mediated the relationship between stressors and outcomes. Chronic parenting stress was associated with lowered perceptions of emotional support, and greater symptoms of depression and anxiety. Furthermore, parenting stress accounted for a substantial proportion of the variance in psychological distress scores in contrast to life event stress, which was only weakly related to psychological outcomes. The implications of mediational models for understanding adaptation to chronic stress are discussed.

The role of social support variables in protecting and maintaining physical and psychological health has been well-established across a variety of studies (Cobb, 1976; Cohen & Wills, 1985; Kessler & McCleod, 1985). However, the specific psychological and interpersonal processes that account for the mitigating effects of social support on stressful events remain poorly understood. One of the reasons for confusion about the mechanisms linking stressors, sources of support, and outcomes has been a lack of contextual specificity (Coyne & DeLongis, 1986; Heller, Swindle, & Dusenbury, 1986). Many studies continue to assess stressful life events rather than situationally defined stressors, and fail to differentiate between acute and chronic stress processes. A second major shortcoming of prior research has been a focus on tests of main or "buffering" effects, rather

The research was supported in part by Grant 949-86-88 from the Ontario Mental Health Foundation to Alexandra L. Quittner and Robert L. Glueckauf and a grant to Alexandra L. Quittner from the Centre for Communicative and Cognitive Disabilities, University of Western Ontario, London, Ontario, Canada. In addition, Alexandra L. Quittner was supported by a Canadian Social Sciences and Humanities Research Council doctoral fellowship and an Ontario Ministry of Health postdoctoral fellowship. We would like to thank Kenneth Heller, Peggy Thoits, Laurie Chassin, and two anonymous reviewers for their helpful comments on an earlier version of this article. We would like to acknowledge the statistical input of Francis Stage and Richard Viken. Thanks also to Beatrice Goffin for her assistance in interviewing subjects. Finally, we are particularly grateful for the time and effort put forth by the 214 mothers who participated in this study. Correspondence concerning this article should be addressed to Alexandra L. Quittner, Department of Psychology, Indiana University, Bloomington, Indiana 47405

than the formulation of specific casual links. These emphases have led to widely held notions about the role of social support, and premature recommendations that increased support will be beneficial to those under high levels of stress (Lieberman, 1986). A more plausible view of social support might result from careful consideration of temporal and contextual factors, such as the severity and duration of the stressor, sources of support provision (e.g., spouse vs. professional helper), and the primary social roles (e.g, parental) affected by the stressful event (Pearlin, Lieberman, Menaghan, & Mullin, 1981; Pearlin & Turner, 1987). In addition, studies that test alternatives to main and buffering effects may increase understanding of how and under what conditions social support is effective (e.g., Norris & Murrell, 1984). The purpose of the current study was to compare a mediating model of social support with the widely cited buffer model, within a context of chronic parenting stress.

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Social Support Models In attempting to describe the mechanisms by which social support modifies outcomes of stress, two models have been commonly tested—the direct effects and "buffer" models. The direct or main effects model suggests that social support exerts beneficial effects on psychological well-being regardless of the individual's level of stress (e.g., Kessler & Essex, 1982). Thus, in general, social resources may lessen the likelihood of symptom development (Norris & Murrell, 1984). In contrast, the buffer model predicts an interaction between levels ofstress and social support. Individuals reporting high levels of stress who also have well-developed, satisfying socialrelationshipswill be pro-


CHRONIC PARENTING STRESS

tected from the negative impact of stress (eg., Henderson, 1980; Wilcox, 1981). Several mechanisms for these buffering effects have been proposed, including altered appraisals of the stressor and inhibition of maladaptive coping responses (Cohen & Wills, 1985). In addition to the main effects and buffer models described above, a third possibility exists, that of an indirect effects or mediator model. In this model, social support functions as an intervening variable between the stressor and outcome. In one of the few studies examining mediating effects, Pearlin et al. (1981) found that job disruption led to increased economic strain (the mediator in this study), which in turn led to higher levels of depression. More recently, several types of coping have been assessed as mediators of stressful encounters and emotions (Folkman & Lazarus, 1988). Significant mediating effects for four types of coping were found. For example, planful problem solving during a stressful encounter led to less negative and more positive emotion. An example of social support's role as a mediator comes from Lin and Ensel's "support deterioration model" (1984). According to this model, some stressful events might elicit shunning or avoidance responses by members of the social network (Barrera, 1988). Traumatic or stigmatizing events, such as serious illness or the death of a child, might lead network members to avoid contact with individuals experiencing these events or to respond in ways that are unhelpful (Wortman & Lehman, 1985). More negative perceptions of support could, in turn, increase symptoms of anxiety and depression. Alternatively, those experiencing chronic stress conditions, and therefore engaged in frequent help-seeking behaviors, may exhaust their resources or perceive support as less helpful because its receipt magnifies feelings of inadequacy (Hobfall & Lerman, 1988). Although the terms mediator and moderator have been used interchangeably, the two terms are conceptually and statistically distinct (Baron & Kenny, 1986). A moderator variable is represented statistically by an interaction with the independent variable; on a conceptual level, it specifies the conditions under which the variable exerts its effects. In the stress-illness literature, this has led to the notion that social support is most beneficial under conditions of high stress. In contrast, a mediating variable is tested using a path-analytic model and functions to "account for the relation between the predictor and the criterion" (Baron & Kenny, 1986, p. 1176). Rather than specifying when certain effects will occur, mediators attempt to describe how effects occur. One possible reason for the absence of mediational models in the stress-illness literature is the need to specify a priori the temporal ordering of the variables. As several researchers have noted, both the larger theoretical framework and the specific causal mechanisms underlying these variables are poorly understood (Heller et al, 1986). However, if the specific processes underlying the stress-illness relationship are to be more fully understood, an alternative to static tests is needed. The development and evaluation of mediational models may increase understanding of how these variables exert their influence. Hypothetical links among stress, support, and psychological outcome variables may be tested, with the most promising models subjected to further experimentation and analysis.

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Temporal and Contextual Factors Acute Versus Chronic Stress Another important distinction to be made in specifying processes of adjustment to stress is the chronicity of the stressor. The majority of studies in thisfieldhave paid little attention to the temporal characteristics of the stressor,relyingon stressful life events checklists to delineate the stress construct (Cohen & Wills, 1985). Although stressful life events may be an important, quantifiable type of stress, they typically represent acute, time-limited events that may be less relevant for the development of support interventions or the prediction of long-term outcomes. Processes of adjustment to discrete events may also differ greatly from ongoing chronic strains (Pearlin et al, 1981; Pearlin & Schooler, 1978). For example, an infusion of social support may be beneficial for someonerelocatingto a new city and in need of information and social contact. However, that same boost of support may be viewed negatively under chronic circumstances, such as coping with ongoing illness or parenting a disabled child. Within this context, such support efforts may be viewed as intrusive or suggestive of incompetence. It should be noted that recent studies of stressful life events have attempted to look beyond the impact of discrete events to linkages between major events and daily, ongoing processes. These studies have assessed the degree of hassle and adaptation required by the life event (Caspi, Bolger, & Eckenrode, 1987; Felner, Farber, & Primavera, 1983). Felner and colleagues, for example, have provided some evidence that major life events exert their greatest impact on psychological outcomes through the day-to-day changes and adaptations required by the initial event (e.g, adjusting to the birth of a baby). Although examining hassles and daily stressors may facilitate an understanding of the sequelae of major life events, the generalizability of this theoretical framework to a more severe, chronic type of stress such as ongoing illness is questionable. The effects of severe chronic stressors are likely to be more pervasive, leading to alterations in several life domains, including marital and work roles, expectations for the future, and relationships within the larger social milieu (Kazak, 1987; Pearlin et al, 1981; Pearlin & Turner, 1987). Chronic stress in this context also implies its continuation into the future; new shifts and adaptations will need to be made inresponseto such a stressor throughout the developmental life cycle. Thus, in terms of both its scope and enduring impact, chronic stress as described above may be differentiated from both major life events and daily hassles. Although the importance of including chronicity as a variable in stress-illness research has been proposed (Cohen & Wills, 1985), only a few investigations have assessed the influence of this factor (Pagel & Becker, 1987).

Life-Stress Versus Specific Stressors In addition to considering the temporal aspects of the stressor, the inclusion of situational factors may improve predictions of adaptational outcomes and provide information about how social support may affect current support systems (Coyne & DeLongis, 1986). In this regard, the assessment of stressful life events may be considered a global rather than spe-


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cific type of stress, giving little information about the context in which these events occur or how they are likely to influence current roles (e.g., parental and marital) or dairy circumstances (e.g., increased work load andfinancialstrain). An alternative to the life-stress approach is to study stressors embedded within a particular context (Swindle, Heller, & Lakey, 1988). This approach to stress measurement may have several advantages: It provides a framework for identifying stressors tied directly to the situation (e.g., going out in public with a disabled child); it points to the relevant life roles that may be altered (e.g., parental); and it allows for the matching of types of support (e.g., information) and support providers (e.g., health care professionals) to specific needs. Such a framework is likely to facilitate an understanding of the processes underlying adjustment to stress and may lead to more effective support interventions. In an effort to compare the impact of stressful life events with chronic stressors, the current study assessed the occurrence of both major life events and stressors related to parenting a hearing impaired child. This population was chosen for several reasons. First, early childhood deafness is a significant medical problem that has major implications for parenting and family adjustment across the life span (Meadow, 1980). Parents are faced with a number of stressors, including frequent visits to speech therapists, controversies about oral versus manual communication, and decisions about educational placement (Moores, 1987). In addition, we confined our research to mothers of children 2 to 5 years of age to facilitate the composition of a well-matched control group and a contextual framework for assessing developmental stressors that were both specific (e.g., establishing bedtime routines) and chronic (e.g., communication) in nature. Second, prelingual deafness among children of normally hearing parents is a condition that is randomly distributed across the population (Brown, 1986). There is little reason to believe that the incidence of childhood deafness will be higher among parents with particular demographic characteristics (e.g., lower income), who may also be vulnerable to stressful life events or psychopathology (Thoits, 1982b). Thus, a confounding of parental stress with predisposing factors such as low income has been precluded in the present study. Finally, the chronic, inescapable nature of deafness may result in less biased estimates of stress effects because parents can neither select themselves into or out of the stressful situation. These sampling factors pose distinct advantages for untangling causal associations between the stressor and outcome variable (Kessler, 1987).

Specific Objectives of the Study The purpose of the current study was to compare the impact of chronic, contextually defined stressors with life-event stress and to test two mechanisms by which social support might modify stress outcomes: moderating versus mediating effects. In order to increase the reliability and validity of the variables examined in these models, multiple measures of each variable were used.1 The specific objectives of the study were as follows: 1. To assess the extent of parenting stress, social support, and psychological distress among mothers of hearing impaired and normally hearing children. Mothers in the clinical (hearing im-

paired) group were predicted to report higher levels of parenting stress, lower perceptions of emotional support, smaller support networks, and higher levels of depression, anxiety, and anger than mothers in the control (nonimpaired) group. 2. To compare two models of the effects of third variables on psychological adjustment. Model 1, the moderator model, predicted that perceived social support would interact with stress level to modify psychological adjustment. Mothers experiencing high levels of parenting stress who also reported high levels of perceived support would report fewer symptoms of depression and anxiety when compared with mothers experiencing high stress but less adequate emotional support. Buffering effects for network measures of support were not expected. In contrast, Model 2, the mediator model, predicted that social support would act as an intervening variable, indirectly influencing the effects of stress on psychological adjustment. Mothers reporting chronic stresses might perceive their relationships as less supportive, which would, in turn, be associated with increased symptoms of depression and anxiety. 3. To compare the impact of stresful life events and chronic stressors. Chronic parenting stressors reported by both the clinical and control group were expected to have a greater impact on perceptions of social support and reports of psychological symptoms than the occurrence of stressful life events.

Method Subjects This study was part of a larger investigation of parenting and adjustment to chronic illness. The sample for the current study consisted of 96 mothers of hearing impaired children ages 2 through S and 118 matched mothers of normally hearing children.2 A samplewise rather than a case-matching approach was used because of the difficulties of recruiting mothers of preschool-aged deaf children and the varied intervals at which subjects entered the study. Mothers in the clinical group were recruited through a variety of educational programs serving hearing impaired children in Ontario, Canada, including provincial schools for the deaf, hospital-based audiology programs, and school boards. Over 70% of the total provincial population of children in this age range, with a severe to profound hearing loss, were represented in this study (Musselman, Lindsay, & Wilson, 1985). Mothers of nonimpaired children were solicited through newspaper ads and posters in day-care centers. Mothers in the clinical and control groups were matched on maternal age, marital status, years of education, family income, and age of the child. Only mothers with an adequate reading level (i.e., sixth-grade education) and no prior psychiatric history or current psychiatric treatment were included in the study. Mothers' mean age was 30.41 years (SD = 4.71), with an average of 13.48 years of education (SD = 2.6) and

1

The mediating model was tested using both multiple regression and LISREL techniques (Baron & Kenny, 1986). However, because of the difficulties of estimating interaction terms for the buffer model using LISREL, and to facilitate comparisons of the two models, only the results of the multiple regression analyses are presented in this article. 2 Mothers who were hearing impaired themselves were excluded from the study because of both technical limitations (i.e., need for an interpreter) and strong evidence that deaf mothers rarely perceive their child's disability as problematic (Moores, 1987).



a modal family income between $20,000 and $30,000 (US. funds). A majority of mothers were married (76%), and about half were employed (55%). No significant differences between the groups were found on any of the demographic variables for the mother, spouse, or child. The mean age of children in both groups was approximately 48 months. Criteria for inclusion in the hearing impaired group was a loss of 70 dB or greater across the speaking range (American National Standards Institute, 1969) and no other physical disabilities. Forty-four percent of the children were classified as having a severe loss and 56% a profound hearing loss. All hearing impaired children had been diagnosed for a minimum of 1 year. Therefore, at the time of the interview, dealing with the child's disability represented a familiar, ongoing stressor rather than an unfamiliar, acute event.

Procedure Following an initial screening, prospective subjects were notified of the project by a letter mailed from the local school or hospital program. A 100-item structured interview was conducted in each mother's home to collect demographic and medical information, as well as ratings of child-rearing and disability-specific stress. Several standardized questionnaires were also completed to assess the following variables: parenting stress, social support, and psychological adjustment.

Instruments Parenting stress. Parenting stress was defined as the extent of child behavior problems reported by mothers, difficulties in accomplishing daily parenting tasks (e.g., bedtime routines), and maternal perceptions of role strain (e.g., competence in parenting role). Four measures of parenting stress were used: (a) the Parenting Stress Index (PSI; Abidin, 1983), (b) the Eyberg Child Behavior Inventory (ECBI; Eyberg & Ross, 1978), and (c) two scales derived from the structured interview— the Family Stress Scale (FSS) and the Parenting Routines InventoryStress scale (PRI-S). The PSI is a 126-item clinical and research questionnaire designed to identify sources of stress in parent-child subsystems. The PSI yields stress scores in three domains: Child Domain, Parent Domain, and Life Stress. Fifteen subscale scores may also be obtained. In the Child Domain, subscales measured child-related stressors such as child's adaptability (Adaptability), acceptability of child to the mother (Acceptability), demandingness, moodiness, and distractibility (Demanding, Child Mood, and Distractibility-Hyperactivity), and degree to which the mother found the child reinforcing (Reinforces Parent). In the Parent Domain, only three subscales were retained because of potential confounding among the variables in the model (Thoits, 1982a): parent attachment to the child (Attachment), restrictions imposed by the parental role (Restriction of Role), and parent's evaluation of their competence (Sense of Competence). Finally, the Life Stress scale assessed the occurrence of 19 stressful life events over the previous 12 months, weighted for their potential impact. Eleven of the 19 life events would be considered negative (e.g., death of a family member). The PSI demonstrated acceptable internal consistency, with alpha values ranging from .60 to .95, and adequate test-retest reliability ranging from .70 to .90 for a 3- to 4-week interval.' The Intensity and Problem scales from the ECBI were used to measure the frequency of 36 different child behavior problems (Intensity scale) and perceptions of whether these behaviors were problematic for parents (Problem scale). This behavior checklist was chosen because of the availability of normative data for children as young as 2 years of age. Internal consistency coefficients of .98 and test-retest reliabilities of .86 have been reported. Finally, two scales were calculated from the interview data to mea-

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sure the stress associated with family and parenting routines. The FSS consisted of 14 items assessing common stressors in families with young children on a 5-point scale (e.g., outings in the community and finances). Internal consistency coefficients of .86 and .76 were obtained for the hearing impaired and nonimpaired groups, respectively. Second, the PRI-S scale measured perceptions of stress in carrying out 11 daily parenting tasks (e.g., bedtimes and mealtimes) on a 5-point scale ranging from not at all stressful (1) to extremely stressful (5). Internal consistency coefficients of .81 for the clinical and .70 for the control sample were obtained. Social support. Three measures of social support were used (a) the Norbeck Social Support Questionnaire (NSSQ; Norbeck, Lindsey, & Carrieri, 1983), (b) the Arizona Social Support Interview Schedule (ASSIS; Barrera, 1981), and (c) the Revised Kaplan Scale (Kaplan, 1977). The NSSQ is a self-administered measure rating extent of perceived emotional support (e.g., Affect, Affirmation, and Aid) and network structure (i.e., size and frequency of contact). The NSSQ may be scored to obtain information on the sources of support and the relative contributions of friends, family members, and health care professionals to perceptions of support. Internal consistency estimates have ranged from .69 to .98. Test-retest reliabilities of .85 to .92 have been reported.4 The second measure of social support (ASSIS) was administered in an interview format consisting of 26 items rated on a 7-point scale of perceived satisfaction over the previous month. Satisfaction ratings were summed across six categories of support: material aid, physical assistance, intimate interaction, guidance, feedback, and positive social interaction. Respondents also rated their need for these six types of support over the previous month on a 5-point scale (i.e., Need for Support). Finally, network dimensions such as size (i.e., Available Network) and the number of network members with whom the respondent has frequent conflicts or arguments (i.e., Conflicted Support) may also be calculated. Test-retest reliabilities of .69 to .88 were reported over a 2-day period. Last, for the Revised Kaplan Scale, subjects read a series of "storyidentification" vignettes that described varying levels of support, and rated these stories on a 5-point scale. Internal consistency coefficients ranging from .79 to .83 have been reported (Turner, 1981). Psychological distress. Psychological distress was assessed using the Center for Epidemiological Studies Depression Scale (CES-D; Radloff, 1977) and subscales from the Symptom Distress Checklist90-Revised (SCL-90-R; Derogatis & Cleary, 1977). The CES-D is a 20-item scale designed to measure current levels of depressive symp3 The following internal consistency coefficients were obtained for the hearing impaired and nonimpaired groups: Parenting Stress Index —.56 to .82 for the hearing impaired sample and .48 to .80 for the control sample; Eyberg Child Behavior Inventory—.88 for the hearing impaired sample and .87 for the control sample; Norbeck Social Support Questionnaire—.86 to .97 for the hearing impaired group and .85 to .95 for the control group; Revised Kaplan Scale—.82 and .86 for the hearing impaired and nonimpaired groups, respectively; Center for Epidemiological Studies Depression Scale—.91 for the hearing impaired sample and .88 for the control sample; and Symptom Distress Checklist-90-Revised—.78 to .87 for the hearing impaired sample and .81 to .88 for the hearing sample. Internal consistency coefficients for the Arizona Social Support Interview Schedule could not be calculated because the data were entered on the scale rather than item level. The mean difference in internal consistency coefficients for the hearing impaired versus nonimpaired sample was 4.6 points across all measures used in this study. 4 The Norbeck Social Support Questionnaire confounds network size and ratings of perceived support. This confound was eliminated by dividing perceived support ratings by the number in the network.

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toms and mood in the general population. Several field studies have reported internal consistency coefficients of .84 to .90 (e.g., Turner, Frankel, & Levin, 1983), and there is evidence of the CES-D's convergence with other measures of depression. Selected subscales from the SCL-90-R (i.e., Depression, Anxiety, Somatization, and Interpersonal Sensitivity) were used as additional measures of maternal psychological adjustment. Internal consistency coefficients for the subscales ranged from .77 to .90, and test-retest reliabilities over a 1-week period have ranged from .78 to .90.


Statistical Approach The reliability and validity of the variables examined in this study were increased by using multiple measures of each construct. This approach has been recommended to deal with both the multidimensional nature of constructs such as social (Mitchell, Billings, & Moos, 1982) and the ubiquitous presence of measurement error in assessments of internal psychological states (Judd & Kenny, 1981). In order to use a multiple measures approach within a regression framework, a principal-components factor analysis was performed, followed by a varimax rotation (Kim, 1975). Following identification of the principal factors using the scree test (Cattell, 1966), factor scores were generated for each subject using the Anderson-Rubin method (Harris, 1967). These factor scores were used in place of raw scores for all subsequent analyses, except the tests of group differences on the independent and dependent measures. For these group difference tests, raw scores provided more information and greater interpretability. Because it was hypothesized that the process of adjustment to parenting stress might differ between the groups and might have an effect on the substantive meaning of the constructs, separate sets of factor scores were derived for each group. However, the factor structures obtained on both sets of factor analyses were similar on several dimensions: number of factors extracted, ordering of the measured variables, and size of the factor loadings (rs ranging from .86 to .99, p < .001). Therefore, the factor analyses for the combined sample only will be described below.5 Parenting stress. A factor analysis of the nine scales of the PSI, the Intensity and Problem scores on the ECBI, and the FSS and PRI-S scales derived from the structured interview yielded a two-factor solution accounting for 61% of the variance. Factor 1 was labeled Child Stressors and was defined by high loadings on measures of daily routine stress and negative characteristics of the child (e.g., hyperactive and demanding). Factor 2, labeled Maternal Stressors, was characterized by high loadings on feelings of attachment toward the child, perceptions that the child was rewarding, and maternal sense of competence. Social support. Four scales from the NSSQ, four scales from the ASSIS and the Kaplan vignette scores were factor analyzed using the principal-components method. The scales represented network, perceived support, and functional (e.g., material aid) dimensions of the construct. Three factors, accounting for 70% of the variance, were retained from the analysis and rotated to simple structure using a varimax rotation. Consistent with both theoretical and empirical formulations of social support, the scales loaded on two broad dimensions of support—network aspects of support and perceptions of emotional support (Cohen & Wills, 1985; Procidano & Heller, 1983). Factor 1 was labeled Network Support and was defined by high loadings on the network dimensions of size, frequency of contact, and duration of relationships. Factor 2, named Perceived Support, was characterized by both functional and emotional components of support from the NSSQ and the Kaplan scale. Factor 3 was difficult to define because of high positive loadings on the ASSIS Need for Support and

Satisfaction scales.6 Because of the definitional problems with this factor, it was not used in subsequent analyses. Psychological distress. Five scales from the SCL-90-R—Somatization, Interpersonal Sensitivity, Depression, Anxiety, and Hostility— and the sum score for the CES-D scale were entered into the factor analysis. One large factor with simple structure emerged, accounting for 68% of the variance in the dependent measures. This factor was labeled Psychological Distress and was defined by highest loadings on depression and anxiety.

Results Comparisons of Parenting Stress, Social Support, and Distress7 Parenting stress. The first hypothesis of this study concerned the extent of parenting stress among mothers of deaf and hearing children. Because multiple measures of stress were used, group differences were evaluated using multivariate analysis of variance (MANOVA) procedures. Significant group differences were obtained on the overall MANOV\ Hotelling's T2 = .95, F(l, 190) = 12.85, p < .001. Follow-up unrvariate analyses of variance (ANOV\) revealed significant mean differences on 11 of the 14 measures (see Table 1). Mothers in the clinical group rated their children as more hyperactive, demanding, moody, and less adaptable than did mothers in the control group. They also had more problems with family routines and rated parenting activities as more stressful. Collapsing across child stressor scales on the PSI, mothers in the hearing impaired group scored at the 90th percentile, substantially above the clinical cutoff, whereas mothers in the control group scored below the cutoff at the 50th percentile. In contrast, no differences between the groups were found on the Life Events scale. Social support. Significant group differences were predicted on measures of social support for both network and perceived support dimensions. The overall MANOVA was significant, Hotelling's T2 = .131, F(l, 189) = 2.25, p < .05. Follow-up univariate F tests revealed substantial differences in network support across various measures (see Table 2). Mothers of hearing impaired children had smaller networks (i-e., number of people in network [NSSQ] and available network [ASSIS]) and less frequent contact with family and friends (contact NSSQ). Further inspection of the individual scales showed that mothers of deaf children reported significantly fewer family members, rela5 All rotated factor loadings exceeded .50. The factor analyses may be obtained from Alexandra L. Quittner. 6 The following factor loadings were derived from the factor analysis of the social support measures: Factor 1, Network Support—Norbeck Social Support Questionnaire (NSSQ) Number in Network, .96; NSSQ Duration of Relationship, .95; NSSQ Frequency of Contact, .95; and Arizona Social Support Questionnaire Available Network, .67; Factor 2, Perceived Support—NSSQ Affirmation, .80; NSSQ Affect, .79; NSSQ Aid, .67; and Revised Kaplan Scale, .60. Note that an oblique as opposed to varimax rotation was also performed with the same results. 7 The results of the group comparison using factor scores and raw scores were identical. However, only the analyses using raw scores are presented because of their reference to scale names, which may facilitate interpretation.

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Table 1 Means, Standard Deviations, and Univariate Analyses of Variance on Parenting Stress Measures Hearing impaired


Variable Parenting Stress Index 1. Adaptability 2. Acceptability 3. Demanding 4. Child Mood 5. Distractibility-Hyperactivity 6. Reinforces Parent 7. Attachment 8. Role Restriction 9. Competence 10. Life Stress Family Stress Scale Parenting Routines Inventory-Stress Eyberg Child Behavior Inventory Intensity scale Problem scale

M

SD

Control M

SD

Significance ofF

29.87 14.73 25.31 11.30 27.57 10.46 13.75 21.61 31.68 9.17 2.45 2.52

5.57 3.76 5.69 3.27 5.54 3.13 3.49 5.49 5.80 6.91 0.75 0.73

24.54 12.73 18.81 10.12 22.48 10.17 12.26 18.05 28.48 11.08 1.71 1.78

4.57 2.95 4.12 2.97 4.92 2.74 2.97 5.00 5.98 10.40 0.41 0.43

p