The Parenting Stress Index, 3rd Ed. (PSI) is a norm-referenced test developed by Richard R. Abidin. The PSI assesses for dysfunction in the parent-child relationship and is based on a theory that the level of stress in the parent-child dyad is the result of child, parent, and situational characteristics. The PSI attempts to identify parental levels of stress, dysfunctional parenting dynamics, and childhood behavior problems. The measure assumes a direct interaction between parental stress and behavior problems in children. The PSI can be a useful assessment for therapists working with parents and families, abusive or at-risk families, children with adjustment or behavior disorders, and clients in forensics settings.
Description of the Instrument
The PSI is a 120-item self-report questionnaire that assesses child and parent behaviors on a number of domains. It typically takes a respondent 20 to 30 minutes to complete the questionnaire. The PSI is normed for parents of children between 1 month and 12 years of age. One unique feature of the PSI is that it starts out as a behavior checklist on which a care-giver rates a child, but in the middle of the questionnaire, it becomes a self-report checklist where the parent rates him- or herself. Consequently the PSI has subscales that compose a child domain and a parent domain.
The child domain assesses for characteristics displayed by children that make them difficult to parent. Subscales that compose the child domain include the following:
- Distractibility/hyperactivity scale (DI)—This scale assesses behaviors that are consistent with attention deficit/hyperactivity disorder (AD/HD). It is possible for a parent to rate a child highly on this scale but the child does not qualify for a diagnosis of AD/HD. In those cases, explanations for the parent’s high ranking may include the parent lacking the necessary energy to deal with a normal child, the parent being older and having difficulty adjusting to life with a child, or the parent having unrealistic expectations for the child’s behavior.
- Adaptability (AD)—This scale assesses a child’s ability to adapt to changes in his or her physical or social environment. High scores on this domain are associated with the need for routine and distress with change often seen in children with autistic spectrum disorders. Children with high scores also tend to overreact to changes in sensory stimulation, avoid interacting with others, have difficulty being calmed when upset, and have difficulty forming meaningful relationships.
- Reinforces parent (RE)—This scale assesses how reinforcing it is for a parent to be with this child. High scores suggest that the parent-child interaction fails to produce positive feelings. Possible explanations for this situation include that a child is impaired in his or her response capacity, the child is depressed, the parent is depressed and projecting negative appraisals onto the child, or the parent is misinterpreting or unable to understand the child.
- Demandingness (DE)—The demandingness scale assesses a parent’s perception that the child is placing unrealistic demands upon him or her. High scores are associated with ratings that describe a child as being unreasonable, impatient, and needy. The stress associated with perceptions of demandingness can be magnified if the parent is overly committed to being a model parent. High scores on demandingness can also be associated with separation anxiety in young children and oppositional and defiant behaviors in older children.
- Mood (MO)—The mood scale assesses symptoms associated with depression. High scores are associated with children who cry frequently, are unhappy, and appear depressed. Children who score high on demand-ingness tend to also score high on the mood scale. With extremely high scores, one also needs to consider lack of parental attachment, parents being psychologically unavailable, and parental substance abuse.
- Acceptability (AC)—The acceptability scale assesses parental expectations for the child’s physical, intellectual, or emotional adjustment. High scores basically suggest that this child is not the child that the parents had hoped for with regard to these dimensions.
The parent domain assesses sources of stress and potential dysfunction in the parent. High scores are usually associated with parents who feel overwhelmed and inadequate in the task of parenting their child. It is not uncommon for young parents or parents with limited experience working with children to have elevated scores, although they seldom score above the 90th percentile.
- Competence (CO)—Competence is associated with a parent feeling lack of acceptance and criticism from others for the way he or she parents the child. Parents of children with severe physical or mental disabilities often score high on this scale, but so do parents with limited prior parenting experience, parents who lack knowledge of normal child development, and parents who have discovered that having children is not as reinforcing as they thought it would be.
- Isolation (IS)—This scale is associated with parents who feel socially or emotionally isolated from their support systems. When this score is high, there are often relationship problems between the child’s primary caregivers. In addition, high scores are also associated with increased risk for child abuse and neglect.
- Attachment (AT)—This scale assesses the degree to which a parent feels a sense of emotional closeness with the child. High scores are usually associated with cold parent-child interactions. The parent may also be impaired in his or her ability to perceive and understand a child’s feelings and needs accurately. Low levels of parental monitoring and vigilance are also often associated with high scores.
- Health (HE)—The health scale assesses a parent’s perception that his or her physical health is deteriorating. Parents with chronic medical disorders often score higher on this scale.
- Role restriction (RO)—This scale assesses the degree to which a parent feels his or her freedom has been restricted by the child. Parents who score high have frequently been frustrated in their attempts to maintain their own identity since the child entered their lives. These parents often report feeling overly controlled or dominated by their child’s demands.
- Depression (DP)—The depression scale assesses for symptoms of depression in the parent. Parents who score high on this scale often report finding it difficult to mobilize the energy necessary to fulfill their parenting roles.
- Spouse (SP)—This scale assesses how much emotional and active support the parent feels that he or she receives from the child’s other caregivers. Individuals with high scores report feeling unsupported in their parenting roles. While a high score may reflect stereo-typic sex roles, it usually reflects dysfunction in the caregiver’s relationships.
The PSI also provides a total stress score, which is essentially an average of the stress ratings on the child and parent domains. There is also a life stress scale that is composed of 18 true-false questions related to the presence of significant life stressors in the past year. Finally the PSI has a defensiveness scale to detect parents likely to be minimizing their concerns.
The PSI was standardized on over 2,600 mothers with children between the ages of 1 month and 12 years. Only 200 fathers with children between the ages of 6 months and 6 years were included in the standardization sample. For this reason, when interpreting PSI data obtained from fathers, particular caution is recommended. The normative sample was not random or stratified and represents primarily a sample of convenience; most participants came from central Virginia. The ethnic composition of the sample was approximately 76% Caucasian, 11% African American, 10% Hispanic, and 2% Asian. Most participants were married (76%), and 60% had some education after graduating from high school.
The reported internal consistency reliabilities for the PSI appear to be adequate. The coefficient alpha for the child domain was .90, with subscales ranging from .70 to .83. The coefficient alpha for the parent domain was .93, with subscales ranging from .70 to 84. For the entire scale, the coefficient alpha was .95. The test-retest reliability for the entire scale is reported to range from .65 for a one year interval to .96 for a 1- to 3-month interval.
With regard to content-related validity, most of the stimulus items on the PSI were included because empirical research found the attribute to be related to parental stress. Items have also been modified based upon feedback from mental health professionals. Evidence for criterion-related validity suggests that the PSI correlates in the expected directions with various related measures. For example, the PSI child domain score correlated .56 with the Achenbach Child Behavior Checklist. The proposed factor structure of the PSI was not strongly supported by the factor analytic studies reported in the manual. Over half of the child domain items and almost half of the parent domain items had factor loadings below .30 for their respective subscales. For this reason, more emphasis should be placed on evaluating the total stress scores than the individual subscale scores.
The PSI has a computer scoring and interpretation program that gives the examiner unlimited uses. The interpretation provides a variety of plausible treatment recommendations for a family based upon the ratings. An additional feature that the computer interpretation provides is a comparison of a particular profile to the average profiles of individuals in various clinical groups. For example, a clinician can compare a parent’s ratings with the ratings of parents who have a child with autism, of parents who have physically abused their child, or of teenage parents living in the inner city. There are approximately 30 clinical groups to which a client’s profile can be compared.
There is also available a 36-item PSI Short Form. This abbreviated PSI measure gives different subscales but assesses both parent and child domains. Finally there is another measure that is an upward extension for older children and adolescents ages 11 to 19 called the Stress Index for Parents of Adolescents (SIPA). While the subscales are not identical to those found in the PSI, the SIPA also assesses child and parent domains.
- Abidin, R. R. (1995). Parenting stress index, Third edition: Professional manual. Odessa, FL: Psychological Assessment Resources.