Correlations between appraisals, management strategies and psychological stress among children and adolescents with ADHD - A Pilot Study
Documentation files
Documentation files
Citation and access
Citation and access
Data access level:
Creator/Principal investigator(s):
Research principal:
Principal's reference number:
- SU-317-0056-23
Data contains personal data:
Yes
Type of personal data:
Medical information
Sensitive personal data:
Yes
Citation:
Method and outcome
Method and outcome
Unit of analysis:
Population:
Data were collected using the Children's Appraisals and Management of ADHD (CAM-ADHD), a questionnaire developed for the study, the questionnaire Stress in Children (SiC), and demographic and medical questions. The aim of CAM-ADHD is to collect data on how children with ADHD assess the causes of their symptoms and the strategies they use to manage them. The development of the questionnaire was based on the method suggested by Davis (1992). First, we created a pool of 80 statements describing different appraisals of symptom causes and management strategies. Based on previous studies (Ringer, 2019; Wong et al., 2018), the items covered three types of appraisals of causes—biological, environmental, and personality-related—and three types of management strategies: self-control, asking teachers for adjustments, and withdrawal. An independent group of five experts in the field (two psychologists, two special educators, and one occupational therapist), recruited through professional networks, rated the relevance of each statement for the purpose of the questionnaire on a four-point scale (1 = not relevant, 2 = somewhat relevant, 3 = quite relevant, 4 = very relevant) (Davis, 1992). In total, 24 statements that were assessed by all raters as very relevant were selected to form the initial instrument. To examine the comprehensibility of the statements, a group of five children aged 10 to 16 years, all diagnosed with ADHD, were interviewed about how they understood the statements. They were asked to explain the meaning of each statement in their own words. Statements that were unclear were reformulated. All statements refer to the school context. For example, statements describing appraisals of biological causes include “I lose my patience because of my brain” and “I am restless because of my brain”. Statements describing appraisals of environmental causes include “I am restless because the classroom is messy” and “I lose my patience because other people talk for too long”. Examples of statements describing personality-related causes include “I am restless because that is who I am as a person” and “I lose my patience because that is who I am as a person”. Statements describing self-control management strategies include, for example, “If I am restless in class, I try to control myself even more” and “If I lose focus when working in class, I make an effort to stay focused”. Statements describing management by asking teachers for help include “If I am restless in class, I ask my teacher for help” and “If I lose focus when working in class, I ask my teacher for help”. Statements describing withdrawal or releasing control include “If I am restless in class, I walk around or leave the classroom” and “If I lose focus when working in class, I leave the assignment”. The instruction for the appraisal statements is: “Here are statements that describe different ways of thinking. How common is it for YOU to think that way? Choose the option that describes you best: Never, Sometimes, Often, Always.” The instruction for the management strategies is: “Here are statements that describe different ways of reacting. How common is it for YOU to react that way? Choose the option that describes you best: Never, Sometimes, Often, Always.” SiC is a self-rating questionnaire designed to assess stress in children (Osika et al., 2007). It includes 21 items describing experiences related to stress. The questionnaire uses Likert-scale response categories with four alternatives: “never”, “sometimes”, “often”, and “always”. Participants are asked to indicate the option that best describes their experience. Items describe physical experiences (e.g., “I have a headache”, “I have a stomachache”), emotional experiences (e.g., “I get angry”, “I feel happy”), and social experiences (e.g., “When things are hard, there's an adult I can talk to”, “When things are hard, it helps to be with my friends”). SiC was developed and validated in Sweden and has been shown to have good psychometric properties (Osika et al., 2007).
Study design:
- Cross-sectional study
- Observational study
Description of study design:
Method: Data were collected via questionnaires completed by 97 children with ADHD, aged 10 to 16. The Children’s Appraisals and Management of ADHD (CAM-ADHD) questionnaire was developed for the study to assess the participants’ appraisals of causes and management strategies, and the Stress in Children (SiC) questionnaire was used to assess psychological stress. The analysis aimed to identify factors and correlations.
Sampling procedure:
Description of sampling:
The inclusion criteria for participation in the study were a formal ADHD diagnosis and the ability to read and understand the Swedish language. With the ambition of achieving variation among participants, recruitment was done via special educators at schools as well as nurses and clinical psychologists at child and youth medical clinics in the city of Stockholm. The children and their parents received written information about the study immediately upon scheduling a time to meet at the school or clinic. Parents, and children aged 15 and over, who agreed to participate gave their written consent, and the children completed the questionnaire on site. The families were assured of the participants’ anonymity, as well as the children’s right to quit or not answer questions. The completed questionnaires and the signed consent were then collected by the first author.
Variables:
60
Number of individuals/objects:
97
Description of the response rate/participation rate:
When data were not provided by the participant, the corresponding values are coded as missing in the SPSS matrix.
Data format/data structure:
Data collection - Self-administered questionnaire: Paper
Data collection - Self-administered questionnaire: Paper
Mode of collection:
Self-administered questionnaire: Paper
Description of the mode of collection:
The present study employed a correlational design in which data were collected via a paper-format questionnaire administered to children with ADHD. Recruitment procedure The inclusion criteria for participation in the study were a formal ADHD diagnosis and the ability to read and understand the Swedish language. With the ambition of achieving variation among participants, recruitment was done via special educators at schools as well as nurses and clinical psychologists at child and youth medical clinics in the city of Stockholm. The children and their parents received written information about the study immediately upon scheduling a time to meet at the school or clinic. Parents, and children aged 15 and over, who agreed to participate gave their written consent, and the children completed the questionnaire on site. The families were assured of the participants’ anonymity, as well as the children’s right to quit or not answer questions. The completed questionnaires and the signed consent were then collected by the first author. Instruments Data were collected via the Children’s Appraisals and Management of ADHD (CAM-ADHD) – a questionnaire that was developed for the study – as well as the Stress in Children (SiC) questionnaire and demographic and medical questions. CAM-ADHD The aim of the CAM-ADHD is to collect data on how children with ADHD appraise the causes of their symptoms, as well as what strategies they use to manage them. The development of the questionnaire was based on the method suggested by Davis (1992). Firstly, we created a “pool” of 80 statements describing different appraisals of what causes ADHD symptoms as well as ways of managing them. Based on the results of previous studies (Ringer, 2019; Wong et al., 2018), the items covered three types of appraisals regarding causes (biological, environmental, and personality causes) and three types of management strategies (self-control, asking teachers for adjustment, and withdrawal). An independent group of five experts in the field (two psychologists, two special educators, one work therapist), recruited through professional networks, was asked to rate the relevance of each statement for the purpose of the questionnaire, based on a four-point scale (1=not relevant, 2=somewhat relevant, 3=quite relevant, 4=very relevant) (Davis, 1992). A total of 24 statements that were assessed by all raters as very relevant were selected for the initial instrument. To examine the comprehensibility of these statements, a group of five children aged 10 to 16 years who were diagnosed with ADHD were interviewed about their comprehensibility. The children were asked to explain in their own words the meaning of every statement, and statements that were unclear were reformulated. All statements are situated within the school context. Those that describe appraisals of biological causes include, for instance, “I lose my patience because of my brain” and “I’m restless because of my brain”. Those that describe appraisals of environmental causes include “I’m restless because the classroom is messy” and “I lose my patience because other people talk for too long”. Examples of statements that describe the child’s appraisal that their personality is the cause of their ADHD include “I’m restless because that’s who I am as a person” and “I lose my patience because that’s who I am as a person”. Statements that describe management strategies of self-control include “If I’m restless in class, I try to control myself even more” and “If I lose focus when working in class, I make an effort to stay focused”. Statements that describe management by asking teachers for help include “If I’m restless in class, I ask my teacher for help” and “If I lose focus when working in class, I ask my teacher for help”. Statements that describe management by releasing control include “If I’m restless in class, I walk around or leave the classroom” and “If I lose focus when working in class, I ignore the assignment”. The instruction for statements describing appraisals is “Here are some statements that describe different ways of thinking. How often do YOU think these ways? Choose from: Never, Sometimes, Often, Always”. The instruction for statements describing management strategies is “Here are some statements that describe different ways of reacting. How often do YOU react these ways? Choose from: Never, Sometimes, Often, Always”. Stress in Children (SiC) SiC, a self-rating questionnaire for assessing stress in children (Osika et al., 2007), includes 21 items concerning experiences related to stress. The questionnaire uses Likert-scale response categories with the four alternatives “Never”, “Sometimes”, “Often” and “Always”, and participants are asked to indicate the alternative that best describes their experience. Items describe physical experiences (e.g. “I have a headache”, “I have a stomachache”), emotional experiences (e.g. “I get angry”, “I feel happy”), and social experiences (e.g. “When things are hard, there’s an adult I can talk to”, “When things are hard, it helps to be with my friends”). SiC was developed and validated in Sweden, and has been shown to have good psychometric properties (Osika et al., 2007). Data analysis Statistical analysis was performed using SPSS (version 27 for Windows, Chicago, IL). Standard statistical methods were used for identifying outliers, missing values, and descriptive statistics, and for determining the variables’ distributions. For the factor analysis of the CAM-ADHD we used exploratory principal components analysis. For identifying the relations between the participants’ characteristics and the CAM-ADHD subscales we used linear regressions, with the subscales’ scores as dependent variables. For associations between the CAM-ADHD subscales and the SiC global scores we used Spearman’s Rho. Statistical significance was set at p (two-tailed) <0.05. Cronbach’s alpha was used for the analysis of internal consistency.
Time period(s) for data collection:
2024 - 2025
Sample size:
97
Non response size:
1
Instrument
Instrument
Name:
Child's Appraisal and Coping with ADHD
Type:
Structured questionnaire
Description of the instrument:
The aim of the CAM-ADHD is to collect data on how children with ADHD appraise the causes of their symptoms, as well as what strategies they use to manage them. The development of the questionnaire was based on the method suggested by Davis (1992). Firstly, we created a “pool” of 80 statements describing different appraisals of what causes ADHD symptoms as well as ways of managing them. Based on the results of previous studies (Ringer, 2019; Wong et al., 2018), the items covered three types of appraisals regarding causes (biological, environmental, and personality causes) and three types of management strategies (self-control, asking teachers for adjustment, and withdrawal). An independent group of five experts in the field (two psychologists, two special educators, one work therapist), recruited through professional networks, was asked to rate the relevance of each statement for the purpose of the questionnaire, based on a four-point scale (1=not relevant, 2=somewhat relevant, 3=quite relevant, 4=very relevant) (Davis, 1992). A total of 24 statements that were assessed by all raters as very relevant were selected for the initial instrument. To examine the comprehensibility of these statements, a group of five children aged 10 to 16 years who were diagnosed with ADHD were interviewed about their comprehensibility. The children were asked to explain in their own words the meaning of every statement, and statements that were unclear were reformulated. All statements are situated within the school context. Those that describe appraisals of biological causes include, for instance, “I lose my patience because of my brain” and “I’m restless because of my brain”. Those that describe appraisals of environmental causes include “I’m restless because the classroom is messy” and “I lose my patience because other people talk for too long”. Examples of statements that describe the child’s appraisal that their personality is the cause of their ADHD include “I’m restless because that’s who I am as a person” and “I lose my patience because that’s who I am as a person”. Statements that describe management strategies of self-control include “If I’m restless in class, I try to control myself even more” and “If I lose focus when working in class, I make an effort to stay focused”. Statements that describe management by asking teachers for help include “If I’m restless in class, I ask my teacher for help” and “If I lose focus when working in class, I ask my teacher for help”. Statements that describe management by releasing control include “If I’m restless in class, I walk around or leave the classroom” and “If I lose focus when working in class, I ignore the assignment”. The instruction for statements describing appraisals is “Here are some statements that describe different ways of thinking. How often do YOU think these ways? Choose from: Never, Sometimes, Often, Always”. The instruction for statements describing management strategies is “Here are some statements that describe different ways of reacting. How often do YOU react these ways? Choose from: Never, Sometimes, Often, Always”.
Name:
Child in Stress
Type:
Structured questionnaire
Description of the instrument:
Stress in Children (SiC) SiC, a self-rating questionnaire for assessing stress in children (Osika et al., 2007), includes 21 items concerning experiences related to stress. The questionnaire uses Likert-scale response categories with the four alternatives “Never”, “Sometimes”, “Often” and “Always”, and participants are asked to indicate the alternative that best describes their experience. Items describe physical experiences (e.g. “I have a headache”, “I have a stomachache”), emotional experiences (e.g. “I get angry”, “I feel happy”), and social experiences (e.g. “When things are hard, there’s an adult I can talk to”, “When things are hard, it helps to be with my friends”). SiC was developed and validated in Sweden, and has been shown to have good psychometric properties (Osika et al., 2007).
Geographic coverage
Geographic coverage
Geographic description:
Stockholm
Administrative information
Administrative information
Responsible department/unit:
Department of Special Education
Contributor(s):
Ethics Review:
Swedish Ethical Review Authority - 2021-01004
Funding
Funding
Funding agency:
- Stiftelsen Clas Groschinskys Minnesfond
Opens a new window at ror.org.
ROROpens in a new tab
Award title:
Correlations between appraisals, management strategies and psychological stress among children and adolescents with ADHD- A Pilot Study
