Assessment of stress in mothers of children with severe breath-holding spells

Background. Severe breath-holding spells (BHS) in children consist of a ste reotypical sequence of provocation to cry, noiseless expiration, color chan ge, and loss of consciousness. Parenting a child who exhibits BHS is likely more stressful than parenting a healthy child, owing to this additional me dical concern. It is also likely more stressful than parenting a child with a convulsive seizure disorder (SD), because it is often not recognized or misdiagnosed as behavioral rather than medical. Mothers of children with BH S were hypothesized to suffer significantly greater stress than mothers of children with SD or mothers of children without any significant medical con ditions. Objectives. To examine maternal stress in parenting a child who exhibits BH S, and to identify the specific areas of stress impact, compared with mothe rs of children with a convulsive SD and mothers of control children. Methods. The Parenting Stress Index and questions regarding how mothers cop ed were individually administered to 34 mothers of children with BHS, 16 mo thers of children with SD, and 16 mothers of children with no medical condi tions (controls). Results. Mothers of children with BHS or SD experience more overall stress and disruption in their attachment or understanding of their child, compare d with control mothers. These groups of mothers (BHS and SD) also perceived their child as more distractible/hyperactive, less adaptive, and more dema nding than did control mothers. However, mothers of the BHS group alone sho wed significant disruption in their sense of competence as a parent, mainta ining self-identity, and receiving positive reinforcement from their child. Mothers of children with SD showed a similar trend, but it was not signifi cant. These findings were not related to maternal health or feelings of dep ression/isolation, insufficient spousal support, child's mood, or other lif e stresses. Conclusion. Parenting a child with BHS or SD impacts a greater degree of li fe stress on mothers of these children than does parenting control children , although the stress is greater for the BHS group than for the SD group.