1. Introduction

ttention Deficit Hyperactivity Disorder (ADHD) is one of the most common childhood disorders known as neurodevelopmental disorders in children [1]. Its three main characteristics are attention deficit, hyperactivity, and impulsivity [2]. Special behaviors in affected children often lead to damage to the parent-child relationship and increase stress between the parents [5]. 

Affected children in a family may cause fatigue and discouragement in parents [6]. Therefore, parents’ sensitivity in interaction and communication with the child can be useful to improve the child’s psychological condition [1]; thus, interventions that help improve the parent-child relationship and lead to a reduction in the psychological damage of the primary caregivers of these children, i.e. their mothers, are essential. In general, this study aimed to evaluate the effectiveness of resilience training on positive and negative emotions and psychological distress of mothers of children with ADHD.

2. Materials and Methods

The present study was applied research, and the methodology was quasi-experimental with a pre-test, post-test design with a control group. The statistical population was all mothers with children with ADHD in Tabriz in 1398, from which 30 people (N=30) were selected using the available sampling method and randomly divided into two experimental and control groups (n=15 for each group).

The research tool included the Positive and Negative Emotion Scale and the Depression, Anxiety, and Stress Scale (DASS). The Positive and Negative Emotion Scale is a 20-item self-assessment tool designed to measure two mood dimensions, i.e. positive and negative emotion. The DASS questionnaire is also intended to assess psychological distress. This questionnaire is a shortened form of a 42-question questionnaire consisted of 21 phrases related to negative emotions developed by Levinda in 1995.

After performing the pre-test, the resilience components training program was applied to the experimental group in 9 sessions of 90 minutes. After completing the training sessions on the experimental group, the relevant questionnaires were administered as post-tests on both experimental and control groups. The data were analyzed using Multivariate Analysis of Covariance (MANCOVA) using SPSS software.

3. Results

The Mean±SD of the age of the subjects in the experimental group was 34.66±8.12 and in the control group was 35.86±6.64 years. As can be seen in Table 1, participants in both groups had a similar mean level before the psychological disturbance test and its components, but after the psychological disturbance test and related components, the experimental group had a lower mean level than the control group. The indicators of skewness and elongation of scores in the range (±2) and the results of the Shapiro-Wilk test (z) showed the normal distribution of data for psychological distress and its components and positive and negative emotion for both groups in the pre- and post-test stages (P<0.05). Also, the hypothesis of homogeneity of variances with the Leven test was examined and the results indicated that this hypothesis was established for psychological disorders. The default homogeneity of the regression line slope and a linear relationship between the co-variable and the default dependent variable was observed.


 

The results of Table 2 show that by considering the pre-test scores as a co-variable, resilience training to the experimental group has led to a significant difference between the scores of the experimental and control groups in the amount of positive and negative emotions. Hence, resilience education has improved the positive emotion and reduced the negative emotion of mothers with children with ADHD.



ETA coefficient or the effect of resilience training was 0.25 for positive emotion and 0.21 for negative emotion. Also, resilience training has led to a significant difference (F=70.64, η2=0.65) between the groups in the total score of psychological distress (65%). Furthermore, resilience training had a significant effect on the various components of the mothers of children with ADHD (depression: F=10.63, η2=0.233, anxiety: F=25.73, η2=0.37, and stress: F=21.24, η2=0.37).

4. Discussion and Conclusion

Childcare is one of the most important responsibilities of mothers. Meanwhile, mothers of children with ADHD are more involved in their children’s medical and treatment progression, thus, their concerns cause spending more time in medical centers. This may cause them to become more distracted and negligent from other aspects of their lives, which in the end may lead to depression.

This study aimed to evaluate the effectiveness of resilience training on the level of positive and negative emotions and reduce psychological disturbances of mothers with children with ADHD. The results showed that resilience education has improved positive emotion and reduced negative emotion as well as reduced psychological disorders in mothers with ADHD children.

As a protective factor, resilience plays an important role in the success of people and getting rid of difficult and unfortunate situations. All these make people accomplish adaptive behavior in problem-solving situations and it is easier for them to face problems. It is understood that resilient people, especially mothers with children with ADHD, acquire the necessary skills to cope with anxiety and stress, and use these skills effectively to reduce their anxiety.

The results of this study showed that resilience training was effective on mothers’ mental health and help them to be more patient. It can be suggested that resilience training, as one of the effective training on anxiety and stress, has the potential to be used in educational and clinical centers to apply resilience education package among the mothers, especially in the early stages of the diagnosis.

Ethical Considerations

Compliance with ethical guidelines

To conduct the research, the Medical Ethics Committee of the Islamic Azad University, Tabriz Branch approved it (Code: IR.IAU.TABRIZ.REC.1398.062); then a written consent was obtained and the questionnaires were completed by the subjects.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Authors' contributions

Conceptualization, writing – review & editing: Gholamreza Chalabainloo; Research method, sampling, data analysis and writing – original draft: Seyed Mahmoud Tabatabaei.

Conflicts of interest

Both authors declared no conflict of interest.