|Year : 2017 | Volume
| Issue : 3 | Page : 198-204
Relationship between stress and religious coping and mental health in mothers with normal and intellectually disabled children
Farzaneh Motamedi Sharak1, Bagher Ghobari Bonab1, Mina Jahed2
1 Department of Psychology, Tehran University, Tehran, Iran
2 Department of Psychology, Birjan University, Birjand, Iran
|Date of Web Publication||29-Nov-2017|
Dr. Farzaneh Motamedi Sharak
Psychology College, Tehran University, Tehran
Source of Support: None, Conflict of Interest: None
AIM: The purpose of present study was to investigate the relationship between stress, religious coping with mental health of mothers who have normal and intellectually disabled children.
SUBJECTS AND METHODS: To fulfill the above purpose, 383 individuals (190 mothers who had intellectually disabled children and 193 mothers who had normal children) were chosen via convenience sampling. To collect data, Religious Coping Scale (Pargament, 2000), General Health Questionnaire, (Goldberg and Hillier, 1979), and Questionnaire on Resources and Stress (GreenBerg and Crick, 1983) were utilized; the data were analyzed through regression coefficient.
RESULTS: Analysis of the data showed that while the stress of intellectually disabled children's mothers was significantly and inversely related to social function, the stress of normal children's mothers was significantly and directly related to other factors of mental health (depression, anxiety, and social function). In both groups, there was a significant and direct relationship between positive religious coping and social function and also between negative religious coping and physical function, anxiety, and depression. While there was a significant and direct relationship between the stress of intellectually disabled children's mothers and negative religious coping methods, there was no relationship between the stress and religious coping methods of normal children's mothers. Stress, physical function, anxiety, and depression of intellectually disabled children's mothers were significantly more than normal children's mothers. In addition, the comparison of the two groups showed that there is more positive religious coping among mothers with normal children.
CONCLUSION: The intervention in religious beliefs and reduction of stress among intellectually disabled children's mothers is something necessary and important. Hence, the present study suggests that it is necessary to persuade intellectually disabled children's mothers into religious beliefs and reliance on God in order to reduce their mental pressure and enhance their mental health.
Keywords: Intellectually disabled, mental health, religious coping, stress
|How to cite this article:|
Sharak FM, Bonab BG, Jahed M. Relationship between stress and religious coping and mental health in mothers with normal and intellectually disabled children. Int J Educ Psychol Res 2017;3:198-204
|How to cite this URL:|
Sharak FM, Bonab BG, Jahed M. Relationship between stress and religious coping and mental health in mothers with normal and intellectually disabled children. Int J Educ Psychol Res [serial online] 2017 [cited 2020 Oct 20];3:198-204. Available from: https://www.ijeprjournal.org/text.asp?2017/3/3/198/219422
| Introduction|| |
Intellectual disability is a complex mental condition and can problematically affect the relationships and actions of family members. Because as a member of a family, the intellectually disabled child needs special care, he/she becomes a source of stress for mothers and affects their adjustment and mental health. When an intellectually disabled child is born, the family's mental health, energy, purposefulness, and the most important psychological functions such as expression, dispute settlement, independence, progress, entertainment and pastime, religious and ethical values, structure and organization, meeting the people, union, problem-solving, and control are affected. Children health has always been one of the most important and worrying matters for parents and any chronic condition or disorder in children produce heavy tension and concern for the families. Therefore, the characteristics of a chronic condition or disorder have determined the tension-producing conditions for parents. For instance, an intellectually disabled child has some special characteristics such as learning problems, poor relationships with peers, weak social skills, rejection by peers, and problems in adjusting to the environment, all of which are excessively costly for the family and society and can make the family function face mental health problems and parent–child interactional problems.
Compared with families who have normal children, families who have intellectually disabled children have less mental health and significantly higher levels of anxiety, depression, and physical complaints and their social function is distorted.,, Likewise, some studies show that the families who have intellectually disabled children experience more anxiety, stress, and depression, less family unity, and more financial pressure and social solitude than the families with normal children. In addition, the studies about the feelings and stresses related to having intellectually disabled children confirm the hypothesis that the attitude of such mothers toward the world affects directly and indirectly their mental health, family unity, parent–child interactions, and finally child's behavior and growth.
In recent years, psychologists have paid attention to the relationship between mental health and religious coping. Studies show that religious coping has a significant effect on physical and mental health. According to Lazarus and Folkman, stressors are the events and situations which force the individuals to react and these reactions may be expressed through different physical, mental, and behavioral responses. In this theory, individual's belief system plays an important role in determining the way he/she adjusts to incompatible situations. In fact, individual's adjustment to negative situations depends on the way he/she assesses the event and his/her ability to meet the expectations related to that situation. A cognitive assessment also affects the selection of coping strategies. Therefore, a comprehensive understanding of belief systems the individual uses in difficult situations and the effect of such beliefs on individual's adjustment are important for supporting and enhancing his/her welfare. Therefore, religious belief is one of the most important well-being belief systems which the individual often relies on in difficult situations. Researchers have shown that religious beliefs and practices contribute to all stages of coping process including cognitive reconstruction of the event, selection of coping strategies, and desirable outcomes. Religious coping which is defined as a special strategy for finding meaning in difficult situations is a multidimensional source which can appear in the cognitive structure of a situation, the strategies used for achieving desirable goals, and also the goals themselves. These strategies include religious knowledge (e.g., religious attributions and beliefs), emotions (e.g., calmness and joy), behaviors (e.g., religious rites), and religious relations (e.g., religious congregations), and the desirable goals include finding meaning, feelings of control and dominance, relief, intimacy, health, and metaphysical experiences., In other words, coping strategies are behavioral and cognitive abilities utilized by the individuals exposed to stress in order to control special internal and external needs which put pressure on them and are beyond personal resources. Therefore, religious sources such as prayer and reliance on God are used in order to cope with stress. Recent findings have shown that these confrontations are either an emotional supporting source or an instrument for a positive interpretation of life events and can facilitate application of subsequent copings; hence, using them is useful for most of the individuals. The tendency toward religious coping increases especially when the individuals come to know human limitations, and also when the religious sources are available. Religious coping strategies like problem-centered strategies balance the relationship between stress and physical/mental health; these strategies are often categorized into two groups: Positive and negative religious coping strategies. Positive religious coping (tendency toward religion) which represents religious feeling, adaptive, and trusted relationship with God, belief in the meaningfulness of life, and religious relationships with other people has some positive outcomes such as higher self-esteem, better quality of life, and more psychological adjustment and religious growth at the time of stressful situations. On the other hand, negative religious coping (rejecting the religion) which represents less safe relationship with God, pessimistic and insecure perspective toward universe, and religious aggressiveness during the challenge of finding the meaning has negative outcomes such as depression, emotional confusion, low quality of life and physical health, and weakness in problem-solving. Coping strategies determine the status of the individual in mental health; appropriate application of these strategies results in true assessment of the situation, feeling of security, gaining support, flexibility, growth, and reaching an identity.,
Studies have reported a significant relationship between religion and mental health,,,,, positive effects of religion on mental health, reduction of symptoms and confusion,,,,,, relationship between negative religious coping, and higher levels of depression among the girls. After comparing three groups of mothers who had deaf children, blind children, and intellectually disabled children, Afshinmehr et al. showed that the mothers who had deaf children gained a higher score than the other two groups, but there was no difference in coping strategies of the three groups. To Pargament, religious beliefs act like a shield against the stresses of life; hence, they help individual's coping strategies. Accordingly, because of the importance of the issue and the highly effective and important role of mothers in educating the children and also because of the psychological advantages of religion and religious coping for controlling critical and pathologic situations and the role they play in mental health of mothers, the present study has investigated these relationships.
| Subjects and Methods|| |
Statistical population of the present study included all mothers living in Birjand city who had 5–14-year-old normal and intellectually disabled children. According to the statistical population, the 5–14-year-old intellectually disabled children in Birjand City were 400 people. Based on Morgan table, the sample included 190 mothers who had intellectually disabled children and 193 mothers who had normal children. Sampling method for both groups of mothers was convenience sampling type.
The present study used three instruments:
Religious Coping Scale
This scale was designed by Pargament et al. in 1998 and it has two factors including positive and negative religious coping. Each factor is assessed through seven components. The components of positive religious coping include spiritual connection, seeking spiritual support, imagination of having a benevolent and merciful God, religious purification, and religious focus. Its Likert scale is scored using 4 choices (from not at all  to very much  ). Positive religious coping is the method of facing with negative events of life, by which the individual confronts the events with the help of positive assessments and interpretations related to God's support. Pargament et al. (2000) reported the internal reliability coefficient (Cronbach's alpha coefficient) of this scale as 0.80. In order to examine the validity of the instrument, principal components analysis with oblimin rotation was utilized. Consistent with the religious coping theory, the two-factor model was obtained, and the related items to each subscale (positive and negative religious coping) had an effect on a special factor. A suitable fitness for the two-factor model was obtained according to confirmatory factor analysis. Internal consistency of positive and negative religious coping was, respectively, 0.90 and 0.87, which shows a high reliability.
General Health Questionnaire
Goldberg and Hillier designed the 28-item General Health Questionnaire in 1979. The factor analysis of this questionnaire shows four subscales, including physical symptoms, anxiety symptoms, tribulation of social functions, and depression; each subscale comprises seven questions. This test assesses symptoms and different modes of individual's health 1 month before administering the test and is adjusted based on the 4-level Likert Scale. Gaining a high score in this scale shows more symptoms and, in fact, less general health. Different studies show the high reliability of this questionnaire. In a study, the sensitivity and specificity of this questionnaire were, respectively, reported to be 84% and 8%. Bagheri Yazdi et al. (1995) reported the reliability of this test about 0.89 by using alpha coefficient method. Likewise, other studies have reported the sensitivity of this scale about 0.84–0.88, and the specificity of it around 0.79–0.82.
Questionnaire on Resources and Stress
The 52-item stress resource form by Friedrich, Greenberg, and Crnic (1983) was provided out of the revised form by Holyroyd (1974). This questionnaire has been designed to assess the stress of the families who have children with an intellectually disabled or other disabilities and chronic illnesses. It is suitable for measuring the positive and negative responses of the members of the families who have a disable member. The first scale assesses the problems of family and caretakers; the second one assesses the concern and pessimism that the caretakers have about the future of the patient; the third scale assesses behavioral characteristics of the patient as a source of stress; and the fourth scale assesses physical disabilities of the patient as a source of stress. Different studies have confirmed this scale either in long form or short form. The answers to this test are in yes/no form in which yes is Scored 1 and no is Scored 0. The total score of the subjects was calculated through the sum of the scores; high score shows high level of stress and low score shows low level of stress among the parents. Friedrich reported the reliability of the test as 0.93.
| Results|| |
In the present study, 190 individuals (46.6%) were mothers who had normal children and 193 individuals (50.4%) were mothers who had intellectually disabled children.
[Table 1] shows that stress is inversely and significantly related to social function in intellectually disabled children's mothers (P < 0.05). In other words, when the stress of intellectually disabled children's mothers increases, their social function decreases. In this group of subjects, there was no significant relationship between stress and other variables of mental health. On the other hand, there is a direct and significant relationship between stress and physical function, anxiety, and depression variables. It means that when the stress of normal children's mothers increases, their physical function, anxiety, and depression increase too.
|Table 1: Pearson's correlation coefficient between stress and mental health in both groups|
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According to [Table 2], positive religious coping is positively and significantly related to social function in the mothers who have normal and intellectually disabled children. When positive religious coping increases, social function as a component of mental health increases in mothers who have normal and intellectually disabled children. Likewise, negative religious coping was directly and significantly related to physical function, anxiety, and depression in intellectually disabled children's mothers and normal children's mothers. It means that when negative religious coping increases, physical function, anxiety, and depression increase in mothers who have intellectually disabled and normal children.
|Table 2: Pearson's correlation coefficient between religious coping and mental health in both groups|
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[Table 3] shows that stress was positively and significantly related to negative religious coping in mothers who have intellectually disabled children. The mothers who have negative coping are more stressful than the mothers who have positive coping. There is no significant relationship between stress and positive/negative religious coping methods in mothers who have normal children.
|Table 3: Pearson's correlation coefficient between coping methods and stress in both groups|
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[Table 4] and the findings resulted by comparing the level of stress in intellectually disabled and normal children's mothers show that the level of stress in normal children's mothers is significantly different with that of intellectually disabled children's mothers. Therefore, intellectually disabled children's mothers have more stress (32.21) than normal children's mothers (28.86).
In order to compare the level of religious coping methods (positive and negative) in normal and intellectually disabled children's mothers, an independent t-test was utilized. The results showed that the positive religious coping of normal children's mothers was significantly different from that of intellectually disabled children's mothers and that the positive religious coping in normal children's mothers (14.07) is more than that of intellectually disabled children's mothers (12.39). No significant difference was found between negative religious coping of normal children's mothers and that of intellectually disabled children's mothers.
According to [Table 5], physical function of intellectually disabled children's mothers was significantly different from normal children's mothers. Therefore, physical function mean in intellectually disabled children's mothers (14.21) is higher than that of normal children's mothers (12.37). Likewise, the results showed that there was a significant difference between anxiety and depression in intellectually disabled children's mothers and normal children's mothers. Anxiety and depression of intellectually disabled children's mothers are more than mean of anxiety in intellectually disabled children's mothers. Social function of the two groups was not significantly different.
|Table 5: The difference between the mean of mental health in both groups|
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| Discussion|| |
The purpose of present study was to investigate the relationship that stress and religious coping methods have with mental health in parents who have children with normal and special needs.
Findings of the present study showed that the stress of intellectually disabled children's mothers is negatively and significantly related to social function. In other words, as their stress increases, their social function decreases. Other researchers also believe that it is not easy to determine the detrimental effects that the existence of an intellectually disabled child has on the life of a family because some of the families show desirable adjustment, but some suffer from lack of adjustment.,, Findings also showed that stress is directly and significantly related to other components of mental health (depression, anxiety, and physical function) in normal children's mothers. In fact, as the stress of normal children's mothers increases, their depression, anxiety, and physical function increase too [Table 1]. Having stress endangers individual's mental health and when mental health factors are at risk, more pressure is imposed on the individual and this continuum continues in this way.
According to [Table 2], positive religious coping is directly and significantly related to social function in both groups. In other words, when positive religious coping increases, social function increases too. Likewise, negative religious coping is directly and significantly related to physical function, anxiety, and depression. It means that when negative religious coping increases, physical function, anxiety, and depression increases too in the mothers who have normal and intellectually disabled children. Tendency toward religion, religious beliefs, and religious practices such as prayer, invocation, reliance on God, and thinking about the concept of life can be effective and appropriate strategies for facing with stress and with the problems which are caused by diseases difficult to cure ,,, also reported that religion positively affects mental health, reduction of symptoms, and decrease in annoyance and confusion.
It was shown that stress is directly and significantly related to negative religious coping methods in the mothers who have intellectually disabled children. It means that when there was more negative religious coping, there is more stress too. Nevertheless, there was no relationship between stress and religious coping methods in the mothers who have normal children [Table 3]. Making use of religion is one of the most principal and effective methods for facing with stress; this point should be taken into consideration mostly in the mothers who have intellectually disabled children. In fact, religion helps the mother accept the presence of her intellectually disabled child; hence, one can say that religion decreases the stress of the mothers who have intellectually disabled children. Such findings, consistent to Pargament et al. (2000), reflect the individual's secure connection to God, trust in Him, and sense of spirituality. The literature of Islamic sources also emphasizes on the effectiveness of religious beliefs and practices as methods for confronting the problems of life. Religious teachings persuade the individuals to be patient, to pray, to have reliance on God at the times they need support and guidance. Such teachings help the individuals redefine negative events, accept the condition, and interpret the situation in a more positive way. According to these teachings, negative events have a purpose and the individuals can reach religious growth through patience. They, usually, provide sources of calmness and power, which facilitate the process of remedy and redress.
Based on [Table 4], one can find that the intellectually disabled children's mothers had more stress than normal children's mothers. According to Folkman's theory, the way that disable children's mothers assess the stresses is why they suffer from higher stress. In general, studies show that the families who have disable children suffer from more stress and this matter puts family function at risk. Since intellectually disabled children have more needs, their mothers experience more sources of stress., Such conditions negatively affect parent's mental health and his/her familial and social relationships. The effect of these children on the parents shows that the parents show different responses such as feeling embarrassed, feeling guilty, and hiding the child. Feeling embarrassed is the most frequent response that the parents show and the more the child's disability, the more the feelings of embarrassment. In such conditions, the parents usually use different coping methods such as avoidance of tension, seeking for social support, or inclining to religion and doing special religious rites or they might use negative coping methods such as alcohol and drug abuse. The findings of the present study showed that normal children's mothers make more use of positive religious coping than intellectually disabled children's mothers [Table 6].
|Table 6: The difference between the mean of religious coping methods in both groups|
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One of the strategies that can help the families accept their intellectual disability child and enhance their adjustment power versus problems is religious belief. When a child is born, the atmosphere of the family changes and if that child needs special care, the family, especially the mother, would be worried. One of the ways that can act like a shield in the hand of the mother and can help the families accept these children and enhance their adjustment power versus the problems is religious coping. This finding is consistent with the findings of Desrosier and Miller.
Religiosity is the base of most individuals' general perspective on life and is the foundation of their meaning system for understanding the world and their daily experiences and performance; it makes their world seem secure, safe, fair, logical, harmonic, and finally controllable. In general, religious coping relies on religious beliefs and practices and is defined as behavioral and cognitive attempts for controlling internal and external needs which are beyond individual's control and, through this way, helps the individual control emotional stresses and physical problems. Having meaning and purpose in one's own life, being socially and spiritually supported are some sources by which the religious individuals suffer from less injury after facing the pressuring events of life. Religious beliefs affect the initial assessment and then the way the individual face with the events; hence, the individuals assess life events in a different way. Religious beliefs also affect the secondary assessment; therefore, as a result they affect the individual's understanding and the usage of coping strategies., The comparison of the two group's mental health showed that intellectually disabled children's mothers have more physical function, anxiety, and depression than normal children's mothers. Nevertheless, there was no significant difference between the social function of the two groups [Table 5]. It seems probable that intellectually disabled children's parents have more mental and even physical problems. Different studies have proved that these parents suffer from a high level of mental pressure and stress and worry are the outcomes of this heavy load of pressure. Sharifi Daramadi believes that the families who have children with special needs endure special pressures such as being worried about the child (53%), the effect on family relationships (23%), nervousness (53.2%), and marital conflicts (18%).
| Conclusion|| |
According to the findings of the present study and previous studies, one can conclude that religion, as an effective factor for reducing the stress and enhancing the mental health, has been taken into consideration by researchers and the special condition that intellectually disabled children's mothers have necessitated the special attention this issue requires.
The authors were involved in the design of the study and contributed to and have approved the final manuscript. The authors would like to acknowledge all the participants of the study.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]
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