Pathways to parental anxiety: effect of coping strategies for disruptive behaviors in children with attention deficit-hyperactivity disorder

Background: Disruptive behaviors are commonly found in children with attention deficit-hyperactivity disorder (ADHD) and affect the mental health of parents. However, a study of the direct and indirect effects between disruptive behaviors in children with ADHD and parental anxiety and coping strategies is apparently lacking. Objective To examine the direct and indirect relationship between disruptive behaviors in children with ADHD and parental anxiety and coping strategies as a mediator. Method: A cross-sectional study was conducted at King Chulalongkorn Memorial Hospital, Thailand between March 2015 and January 2016. Participants comprised 200 parents whose children were diagnosed with ADHD by physicians. Participants completed questionnaires regarding sociodemographic characteristics including The Thai Hospital Anxiety and Depression Scale, The Swanson, Nolan and Pelham (SNAP-IV): parent form (Thai version), and The Coping Scale Questionnaire (Thai version). Results: The direct path between disruptive behaviors and anxiety was significant (b = 0.21, P = 0.002). Moreover, a significant indirect path was found between disruptive behaviors and coping behavior with escape-avoidance (beta = 0.20, P = 0.005), and an indirect path was found between escape-avoidance and anxiety (b = 0.31, P <0.001). Conclusions: Health care professionals should evaluate the use of coping strategies by parents of children with ADHD and encourage the parents to use a positive strategy for coping with the disruptive behaviors of their children.