Category: 18 Parenting Stress Index (PSI)

Archive for the ‘18 Parenting Stress Index (PSI)’ Category

Mar 13 2015

Parenting Stress Index (PSI)

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Descriptive Information

Title:   Parenting Stress Index

Edition:          4

Dates of Publication and Revision: 1983; 2012

Author:          Richard R. Abidin, EdD

Source:         PAR Inc. 16204 North Florida Ave. Lutz, Fl 33549

Costs:            Kit-$216.00, Answer sheets- $76.00, Profile forms-$27.00, Booklet-$70.00, Manual-$76.00, Continuing education materials $25.00

Purpose        Identify parent – child problem areas

Type of Test:            Self report/screening questionnaire

Target Population and Ages:       Parents of children 0 to 12 years

Time Requirements – Administration and Scoring:   20 minutes/5 minutes


Test Administration

Administration:       individual; self report

Scoring:        plot profile analysis on scoring form; computer program is available

Type of information, resulting from testing:    raw scores, percentiles and T-scores

Environment for Testing:              medical centers, outpatient therapy, pediatric practices, treatment outcome monitoring, designing a treatment plan, setting priorities for intervention and follow up evaluation.

Equipment and Materials Needed:         paper, pencil, form

Examiner Qualifications:  Level C (bachelors or masters in psychology, school counseling, occupational therapy, speech language pathology, social work, education, or related field. If bachelors then need license or certification.)

Psychometric Characteristics: Validation studies conducted within a variety of foreign populations, including Chinese, Portuguese, French Canadian, Finnish, and Dutch, suggest that the PSI is a robust measure that maintains its validity with diverse non-English-speaking cultures. Expanded norms are organized by each year of child age

Standardization/normative data: collected from a sample of 534 mothers and 522 fathers stratified to match the demographic composition of the 2007 U.S. Census. Recommend further evaluation with parent scoring 260 or above. Recommend referral for professional services to clients with score of 17 or above on life stress analysis.

Evidence of Reliability: total-.95; Parent .75-.87; child .78-.88. test-retest – .69-.91 parent, .55-.82 child

Evidence of Validity: Factorial validity – 41% of variance on child section accounted for by 6 factors; 44% on Parent section by 7 parent factors. Low scores correlate with parents having little investment in parenting or dysfunction in parent-child system. May also be found in parents with high defensiveness, supporting importance of administrator creating safe, accepting test environment.

Discriminative yes- gives norms

Predictive     yes- determines those at risk

Summary Comments

Strengths: form written at a 5th grade reading level, multiple languages, can screen in an initial interview to determine the need for individual or family counseling. A computer software scoring program is available that can interpret responses, lists the risks for the child and makes recommendations. There is a validity index that looks at Defensive Responding.

Weaknesses: Poor support for subtest organization and profile analysis indicates that global scores should be used for screening purposes only

Clinical Applications: Can be used to screen and evaluate the parenting system and identify possible problems in a child’s or parent’s behavior. The information can then be used to create a plan for treatment, prioritize intervention and for follow-up assessment


  • PAR inc. Parenting stress index, fourth edition. 2012. , Accessed March 11, 2015.
  • Parenting stress index (PSI-4), fourth edition. 2015. Accessed March 11, 2015.
  • Parenting stress index. American Psychological Association. . Accessed March 11, 2015.

Research Article

Torowicz D, Irving SY, Hanlon AL, Sumpter DF, Medoff-Cooper B. Infant temperament and parent stress in 3 month old infants following surgery for complex congenital heart disease. J Dev Behav Pediatr. 2010; 31(3):202-208

The purpose of this study was to compare and detect temperament and maternal stress differences healthy controls and infants with complex congenital heart disease (CHD) at 3 months of age. Subjects included full term infants with a birth weight of at least 2500 grams who endured palliative or corrective surgery within six weeks of birth. Subjects were chosen from a prospective, longitudinal, observational study of infants with complex congenital heart disease. Subjects were excluded if they had congenital or acquired anomalies, gastrointestinal disorders, orofacial clefts, neurological impairments or if they had any known congenital disorder that would affect nutrition intake and growth. Parental stress, measured by the Parental Stress Index and infant temperament, measured by the Early Infancy Temperament Questionnaire were measured in 129 mothers and respective infants. Compared to biventricular physiology and healthy controls, infants with single ventricle physiology were less distractible and more negative in mood. Compared to healthy controls, infants with CHD generated more stress secondary to the demand for care. The mean PSI subscale score for the single ventricle infants were significantly higher than the control group in 5 of the 6 child domain areas, competence in the parent domain and overall total stress. Mean PSI subscales were significantly different between the biventricular and control groups. This study was limited by its use of convenience sample and lack of control of psychosocial factors. The study was strengthened by its large sample size. In conclusion, there is a need for guidance to parents before discharge to better understand, and react to the behavior style of their children, especially those with single ventricle physiology due to the higher risk of stress.

Mar 06 2016

Parenting Stress Index (PSI) Update

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*Updated information

Costs: Kit – $227.00, Answer sheets – $80.00, Profile forms – $28.00,

Booklet – $74.00, Manual – $80.00, Continuing education materials – $26.00.


  • PAR inc. Parenting stress index, fourth edition. 2012., Accessed March 6, 2016.
  • Parenting stress index (PSI-4), fourth edition. 2015., Accessed March 6, 2016.


Research Article:

Sherief, L. M., Kamal, N. M., Abdalrahman, H. M., Youssef, D. M., Alhady, M. A. A., Ali, A. S., … & Hashim, H. M. (2015). Psychological Impact of Chemotherapy for Childhood Acute Lymphoblastic Leukemia on Patients and Their Parents. Medicine94(51).

The purpose of this observational study was to assess the self-esteem of children undergoing chemotherapy treatment for acute lymphoblastic leukemia (ALL) and to assess the psychological status of their parents. The Rosenberg self-esteem scale was used to assess the psychological status of the children while the parenting stress index (PSI) was used to assess the parents. This study included 178 children who were receiving chemotherapy treatment for ALL and their parents. A cross sectional study was performed over a period of 2 years. Inclusion criteria: age 6-18, conscious, able to communicate, in complete remission, in maintenance phase of chemotherapy, and same maintenance protocol. Children and parents with a history of psychiatric illness were excluded. The results of this study indicated that 84.83% of the patients had low self-esteem. Long duration of disease was found to be the factor that most negatively impacted scores. Higher PSI scores were significantly associated with low sense of competence, negative attachment to their children, feeling of high restriction, high depression, poor relation to spouse, high social isolation, low acceptability for the parents’ domains. Higher PSI scores were significantly associated with low distraction, negative parents’ reinforcement, and low acceptability for the child’s domains. In conclusion, chemotherapy for ALL as impacts on both the parents and the child undergoing the treatment. This study shows that this treatment causes a decrease in self-esteem in the patients and an increase in stress for the parents.

Mar 07 2018

Parenting Stress Index (PSI) Update 3/7/2018

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Parenting Stress Index Update:

Cost: Kit- $262, Answer sheet (pack of 25)- $92, Profile form (pad of 25)- $32, Item Booklet (pack of 10)- $86, Manual- $92, Continuing Education Materials-$26


Information found at:


Research Article:

Li, S. T., Chiu, N. C., Kuo, Y. T., Shen, E. Y., Tsai, P. C., Ho, C. S., . . . Chen, J. C. (2017). Parenting stress in parents of children with refractory epilepsy before and after vagus nerve stimulation implantation. Pediatrics and Neonatology,58(6), 516-522. doi:10.1016/j.pedneo.2017.03.001


Literature shows that vagus nerve stimulator (VNS) implantation can decrease seizure frequency. However, parenting stress associated with VNS stimulation has not been considered. The purpose of this study was “to evaluate changes in the parenting stress level in parents of children with refractory epilepsy before and after VNS implantation.” Thirty children with refractory epilepsy who underwent VNS implantation were included in the study based on the following inclusion criteria: having received a diagnosis of refractory epilepsy from a pediatric neurologist, having undergone VNS implantation after refractory epilepsy was diagnosed, aged from 1-12 years, and parents having completed the PSI before and at least one year after VNS implantation. In regard to comorbidities, 21 patients had mental retardation, five patients had cerebral palsy, and five patients had autism.  Prior to VNS, five patients received 2 types of anticonvulsants, 15 patients received 3 types of anticonvulsants, and 10 patients received 4 or more types of anticonvulsants.  Regarding seizure frequency, eight patients had less than 10 seizures per month, 17 patients had 10-100 seizures per months, and five patients had more than 100 seizures per month.

To measure parenting stress, the authors used the Parenting Stress Index long-form (PSI), which is a 94-item questionnaire assessing parenting stress levels.  It includes a parent and child domain.  The parent domain contains 50 items on seven subscales (competence, role restriction, attachment, depression, health, social isolation, and spouse).  The child domain contains 44 items on six subscales (adaptability, mood, distractibility/hyperactivity, demandingness, reinforces parent, and acceptability).  Parents respond on a 5-point scale, with 5 representing the most stress.

The initial PSI was completed within the month pre-VNS implantation.  The second PSI was given at least 12 months post-VNS implantation. Mean time interval between first PSI measurement and VNS implantation was 14.9 days. Mean time interval between VNS implantation and second PSI measurement was 18.2 months. The highest mean scores for parent domain subscales were for spouse, role restriction, and health. The highest mean scores for the child domain subscales were for acceptability, demandingness, and distractibility/hyperactivity.  The mean total PSI scores decreased from 282.1 (which is higher than the 90th percentile of Taiwan validation sample) to 272.4 (less than 90th percentile).  This decrease was not statistically significant (p=0.193).  Scores for all parent domain subscales decreased except for competence.  Scores for four of six child domain subscales decreased. The most noticeable changes were in spouse (p = 0.034) and role restriction (p = 0.149) subscales, but did not achieve statistical significance. PSI scores decreased most in parents of males, parents of children without autism, and parents of children who did not taper off the number of anticonvulsant types.  However, no predictive factor was found for PSI score change for child’s gender, autism comorbidity, or tapering of anticonvulsants after MANOVA analysis.  After analysis, no association was found between tapering off number of anticonvulsant types and seizure reduction rate. Ratio of seizure frequency pre- to post-VNS implantation achieved a significant difference (p = 0.037), with fifteen patients having 50-100% seizure frequency reduction rate, and a 42.6% overall seizure frequency reduction rate.

Strengths of this study include the fact that it was a longitudinal prospective study, and that it provides data for changes in parental stress following VNS implantation.  This study was limited by the sample size being too small to analyze types and etiology of epilepsy. Furthermore, no association was found between reduction of seizure frequency and tapering off of anticonvulsants, as anticipated. Finally, this version was validated in 1362 Taiwanese children and may not be as applicable to western countries, as parent-child relationships and upbringings may vary.

Although not significantly different, overall PSI scores decreased 12 or more months after VNS implantation, implying that overall parental stress decreased following implantation.  This decrease in stress was seen especially in parents of: boys, children without autism, and children who did not reduce the number of anticonvulsant types used.  For the parents whose stress did not decrease as much, comorbidities or tapering off of medication types may act to negate the positive stress effects of VNS implantation. Furthermore, seizure frequency decreased following VNS implantation, leading one to believe the VNS implantation is a safe and effective method for resolving refractory epilepsy.