ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)

Attention Deficit Hyperactivity Disorder (ADHD)



Attention Deficit Hyperactivity Disorder (ADHD)

Introduction

Lazarus and Folkman's (1984) theory of stress, appraisal, and coping is a useful framework to guide practice with parents of adolescents with ADHD. It offers greater conceptual clarity than the parenting stress models. The theory is compatible with a goal of facilitating the process of client adaptation. It has been successfully applied to social work practice with clients in similar stressful circumstances, for example, families of adults with psychiatric illness (Joughin, 2000, 975-88)

Lazarus and Folkman's (1984) theory is a cognitive model of a process of coping with stress. Essential components of the model are psychological stress, appraisal of stress, coping, and the adaptation outcomes of coping (morale, social functioning, and somatic health). Psychological stress occurs when an individual judges his or her relationship with the environment as taxing, exceeding resources, or endangering personal wellbeing (Lazarus & Folkman). Potential Stressors for parents of an adolescent with ADHD may stem from the adolescent's problems sustaining attention (for example, difficulty attending to and following instructions, losing or forgetting homework assignments, difficulty sustaining attention to schoolwork); from the social effects of ADHD behaviors (for example, taunting by other children or problems with friendships); from impulsivity and related risks to the adolescent's personal safety (for example, physical injuries or risky use of motor vehicles); or from the reactions of people outside the family (for example, frequent complaints from school). These Stressors occur in the context of other Stressors in parents' lives, including the normal stresses in the parent-adolescent relationship as developmental tasks of autonomy and individuation are worked out. (Joughin, 2000, 975-88)

Explanation

Cognitive appraisal determines whether the person-in-environment relationship is judged as stressful or not (Lazarus & Folkman, 1984) — that is, adolescent ADHD behavior may or may not be stressful, depending on how the parent appraises the behavior. One parent may find adolescent impulsivity particularly stressful, whereas another parent may find phone calls from school principals or sibling conflict more stressful.

Theoretically, cognitive appraisal is influenced by personal characteristics such as commitments, values, and beliefs; situation characteristics such as novelty, predictability, event uncertainty, imminence, duration, and temporal uncertainty of the Stressor; and timing of stressful events in the life cycle and in relation to other events (Lazarus & Folkman, 1984). For example, parents who value education would find school problems stressful and focus their coping efforts on school problems; parents who believe they can control their adolescent's behaviors would focus their coping efforts on attempts to change the behaviors. With respect to appraisal of situation characteristics, adolescent behaviors that are seen as "normal" would be less stressful. Thus, theoretically, parents' understanding of ADHD and adolescent development influences their appraisal of the situation. Finally, parents' simultaneous experiences of other Stressors, such as household moves, family care giving, or work-related Stressors, influence their appraisal of their adolescent's behaviors. For example, long-standing ADHD-related Stressors might be reappraised as more or less stressful in the context of a new Stressor, such as job ...