Personality Dimensions, Religious Tendencies and Coping Strategies as Predictors of General Health in Iranian Mothers of Children With Intellectual Disability: A Comparison With Mothers of Typically Developing Children
Abstract
Background Challenges related to rearing children with intellectual disability (ID) may cause mothers of these children to have mental health status problems.
Method A total of 124 mothers who had a child with ID and 124 mothers of typically developing children were selected using random sampling. Data were collected using General health questionnaire, NEO five-factor inventory, islamic religiosity scale and WOCQ questionnaires.
Results Mothers of children with ID had lower general health than mothers of typically developing children. Neuroticism predicted the general health of the two groups of mothers. Among religious tendencies, religiosity and religious disorganization predicted the general health of mothers of children with ID and of mothers of typically developing children, respectively. Coping strategies did not predict general health in any group of mothers.
Conclusions Compared to personality dimensions and coping strategies, religiosity seems to be a good predictor of general health of mothers with children with ID in Iran.
Introduction
Some studies suggest that mental and physical limitations of children with intellectual disability (ID) may impose considerable stress on caregivers (Ong et al. 1999; Emerson et al. 2004; Laurvick et al. 2006). Mothers of children with ID experience higher levels of financial, emotional and physical pressure in comparison with mothers of typically developing children, and there is a significant relationship between these resultant stresses and having law levels of well-being and mental health (Floyd & Gallagher 1997). Findings of some studies suggest that mothers of children with ID are more deeply involved in their child’s problem than fathers (Breslau et al. 1982; Roach et al. 1999) and that the fathers usually reported lower levels of worry about the child problems than the mothers (Luoma et al. 2004). Particularly in the Middle East, the lack of husband’s involvement in child care is prevalent (Zahr & Hattar-Pollara 1998). Also, child’s limitation in terms of physical and intellectual capacities can place extra burden on the mother as the child’s main caregiver. The lack of husband’s involvement in the child-rearing process plus the extra burden of care created by the child with ID may cause the mother to be more susceptible to psychological problems in the Middle East countries. In the other hand, varying levels of burden of care are placed on mothers of different cultures (Heller et al. 1994; Shin & Crittenden 2003). Therefore, while studying general health of mothers of children with ID, their cultural differences should also be considered. Quality, availability, efficacy and effectiveness of rehabilitation services and clients’ level of satisfaction with these services are understudied issues in Iran. Through electronic search, the present authors just identified 1 article reporting lack of social services, school nurses in the exceptional (special) schools and consultation services available to the mothers and their children with mental retardation (MR) (Kermanshahi et al. 2008). With respect to these issues and given the religious context of Iranian society, the present study tends to investigate factors expected to influence the health status of mothers of children with ID. These factors include the personality dimensions, religiosity tendencies and coping strategies.
Personality dimensions
Personality characteristics of mothers of children with ID seem to have significant effect on their mental health status (Ali et al. 1994; Glidden & Natcher 2009). It is expected that personality characteristics play an important role in the quality of care provided by caregivers and in bearing the burdens placed on them. Using the big 5 personality factors (Costa & McCrae 1992) and the Eysenck’s three personality factors (Eysenck & Eysenck 1985), it has been showed that neuroticism has a strong correlation with low levels of health status (Maltby & Day 2004). Also, other studies showed that neuroticism and extraversion are good predictors of the mental health status (Furnham & Cheng 1997; Francis et al. 2004). Mirsaleh et al. (2010) mentioned that mental health is positively correlated with extraversion and conscientiousness and is negatively correlated with neuroticism. However, few studies exist about the relationship between personality dimensions of mothers with children with ID and their health status in comparison with mothers with typically developing children, and more research is needed to extend our view in this issue.
Religious tendencies
Given the rich religious context of Iran, religious tendencies are expected to play an important role in the mental health of Iranian mothers of children with ID. Many studies show that there is a direct relationship between religion/spirituality and caregivers’ health (e.g. (Chang et al. 1998; Murray-Swank et al. 2006; Pierce et al. 2008). Nightingale (2003) reported that religion and spirituality help caregivers to deal with the hard challenges of patient’s care. However, Hebert et al. (2006) reviewed the literature on the relationship between religion/spirituality and well-being of caregivers and notified that most of the researches on this issue report a mixed and unclear relationship (e.g. a combination of positive relationship, negative relationship or nonsignificant relationship) between religion/spirituality and well-being of caregivers. They reviewed 10 studies that investigated the relationship between religion/spirituality and well-being of caregivers in miscellaneous ethnicities and came to the point that in different ethnics, there is a different relationship between religion/spirituality and well-being of caregivers. However, in general, most of the studies showed a direct relationship between religion and health status.
Muslims make up more than 98% of Iran’s 72 903 921 people (Statistical center of Iran 2010). Positive relationship between health status and religiosity in religious context of Iranian society is well documented (Bahrami 2002; Khalili et al. 2002; Bahrami & Tashk 2003). Religiosity plays an important role in Iranian people’s life. For instance, in a national representative survey of religiosity in Iranian youth, 86% of the participants reported that when facing hard challenges, they try to find peace by reliance on God’s help (Iran’s National Youth Organization, 2005). Further, another two studies in Iran showed that rehabilitation interns and nurses try to find religion-driven meaning to care they offer for needy people (Ravari et al. 2009; Mirsaleh et al. 2010). Although the relationship between religiosity and well-being is addressed in some studies, the role of religiosity in the prediction of general mental health of mothers of children with ID is not well documented.
Coping strategies
Based on many studies, parents of children with ID suffer from more stress (child-related stress) than parents of typically developing children (Dyson 1997; Sanders & Morgan 1997; Browne & Bramston 1998; Hoare et al. 1998; Roach et al. 1999). However, experiencing higher levels of stress does not necessarily lead to maladaptation or poor function of family members of children with ID (Weiss 2002; Ray 2005). Studies suggest that families that use an appropriate coping style often have better functioning (Costigan et al. 1997; Kim et al. 2003). Being in a stressful situation, people try to avoid stress induced by the situation by the use of appropriate coping strategies. Lazarus & Folkman (1984) defined two major coping strategies: problem-focused and emotion-focused. Problem-focused coping strategies include cognitive and behavioural efforts based on problem-solving that help to change or to manage the stressful situation. On the other side, emotion-focused coping strategies include cognitive and behavioural efforts that help the individual reduce the level of experienced stress but do not directly focus on solving the problem. Studies suggest that in caregivers, problem-focused coping strategies are almost always accompanied by positive adjustment outcomes (Essex et al. 1999; Patrick & Hayden 1999; Kim et al. 2003; Glidden et al. 2006) and that long-term reliance on emotion-focused coping strategies is accompanied by less positive adjustment outcomes (Essex et al. 1999; Kim et al. 2003; Hastings et al. 2005; Gavidia-Payne & Stoneman 2006; Glidden et al. 2006). Few studies exist about the coping strategies used by mothers of children with ID to cope with challenges of childbearing in Iran. Given the typical challenges that mothers of children with ID are experiencing in Iran, it appears necessary to investigate the role of coping strategies in meeting these challenges.
Theoretical framework
Löckenhoff et al. (2009) found that religiousness mediates the relationship between big five-factor personality traits and mental health. Studies suggest that basic personality traits predict religiousness and spirituality, but there is almost no evidence supporting the notion that religiousness and spirituality can predict personality traits (Wink et al. 2007; Löckenhoff et al. 2009). Likewise, religious conversion experiences have little influence on basic personality traits (Paloutzian et al. 1999). Although basic personality traits predict religiousness, some investigators consider religiousness as a type of coping strategy. Pargament (1990, 1996, 1997) considered religion as a coping process to explain the relationship between religiosity and psychological well-being. He argues that religion may become a part of coping process by enabling individuals to cope with stresses in critical life events. This religious coping model is supported by Koenig et al. (2001) who argued that religion helps individuals to avoid unnecessary stressors that can reduce well-being. Also, Fan & Gang-Hua (2006) proposed a buffering effect for religion by highlighting its influence in enhancing individual’s emotional health and helping him chose better coping strategies. Finally, religion is stronger than general coping strategies in the prediction of well-being especially in societies with religious context (Hashemzadeh 2006). According to the findings of these studies, it appears that personality traits are stronger than religiousness and coping strategies in the prediction of well-being.
Identifying effective factors related to health status of mothers of children with ID can play an important role in planning for the improvement in their health status. In the present study, the present authors aimed to investigate personality dimensions, religiosity and coping strategies as predictors of health status in Iranian mothers of children with ID and to compare them with those of mothers of typically developing children. Given these objectives, the following hypotheses were posed and will be tested in this study:
-
Hypothesis 1:
Mothers of children with ID have lower general health status than mothers of typically developing children.
-
Hypothesis 2:
Among personality dimensions, neuroticism is higher in mothers of children with ID compared to mothers of typically developing children.
-
Hypothesis 3:
Mothers of children with ID use problem-focused coping more than mothers of typically developing children.
-
Hypothesis 4:
Personality dimensions, religious tendencies and coping strategies can significantly predict general health in both groups of mothers.
-
Hypothesis 5:
Religiosity can be a better predictor of general health in mothers of children with ID than in mothers of typically developing children.
Materials and Methods
Participants
A total of 124 birth mothers each rearing at least one child with ID, who were inhabitants of one of the southern areas of Tehran, were selected by random sampling in rehabilitation centres of those areas. Studies suggest that socioeconomic status may influence health status of mothers of children with ID (Chen et al. 2001; Emerson 2004). That is why, the present authors intended to choose samples that to some extent were from the same socioeconomic level. Because, according to the culture of Iranian society, people are reluctant to answer direct questions about their socioeconomic status, having assumed that place of residence shows people’s socioeconomic status, the present authors chose the samples only from one residence. Categorization of educational institutions for children with ID is carried out based on both IQ and age level in Iran. Based on IQ level, the institutions are divided as follows: educational institutions for children with IQs below 25, those for children with IQs between 25 and 50, and those for children with IQs above 50. Based on age level, educational institutions for children with ID are divided into centres for children below 14 and above 14 years of age (State Welfare Organization 2010). Given the effect of some demographic traits on health status of mothers of children with ID (Smith et al. 1995; Olsson & Hwang 2001), only married mothers between the ages of 25 and 50 years, with children between the ages of 6 and 13 years and with intelligence quotients (IQs) between 25 and 50, were randomly selected to participate in this study. The level of intelligence of children was determined by viewing their medical profile containing the results of Wechsler Intelligence Scale for Children (WISC-III) (Jazayeri & Poorshahbaz 2003). Children below 14 years with IQ scores not in the range of 25–50 or children with IQ score between 25 and 50 and above 14 years of age were dismissed from the study. In this study, having IQ score between 25 and 50 was considered as an index of having ID, and because of financial and time limitation, the present authors did not consider what the types of intellectual disabilities were. Through visiting educational centres for children with normal development, a total of 124 mothers of children without ID who were living in the same area were selected by random sampling. Mothers of typically developing children were also selected only from married mothers between the ages of 25 and 50 years with typically developing children between the ages of 6 and 13 years. A total of 19 mothers with a child with ID and 30 mothers of typically developing children declined to participate in the study, and the present authors randomly selected another 49 mothers as alternative participants. Although Muslims make up more than 98% of Iran’s population (Statistical center of Iran 2010), all participants were asked about their religion. If they were Muslim, they could enter the study. Instead of institutionalizing children with ID, all mothers were the main caregiver of the child, and they took care of the child and also of their other family members in their own home.
Procedure
In the intended urban zone, research objectives were explained to the chiefs and trainers of educational centres for children with ID. Then, with the cooperation of educational staff of these centres, mothers between the ages of 25 and 50 years with children between the ages of 6 and 13 years and with IQs between 25 and 50 were identified, and a total of 124 mothers were randomly selected. Among clients of educational centres for children with normal development, mothers of typically developing children who had the intended qualifications were selected in the similar way the present authors did for mothers of children with ID. In a group session with participants, the aim of research and how to fill the questionnaires were explained to them, and they were assured of secrecy. About 20 mothers participated in each group session, mothers of children with ID and mothers of typically developing children did not participate in the same groups. Finally, data were analysed using multiple regression analysis and independent T-test.
Measures
Islamic religiosity scale (IRS)
This scale consisted of 64 items scored on a five-point Likert scale. The scale is saturated with these four factors: religiosity, religious disorganization, religious pretentiousness and hedonism (Bahrami 2002). Achieving high scores in each subscale is indicative of having higher tendency to the measured factor (e.g. religiosity). The religiosity factor is made of items that, directly or indirectly, assess the deep relationship with God, the relation with people based on religious teachings, doing and adoption of behaviours according to religious teachings, believe in afterlife, having religion-driven meaning for life, reliance on God’s help, and use religious beliefs to face challenges of daily life (Bahrami 2002). Religious disorganization is defined for the current study as dissatisfaction with what one has, difficulty to control one’s thoughts and feelings by relying on God’s help, and have no religious intentions to help others. People with religious disorganization do not seek God’s help for facing hard challenges of life. They do not believe in afterlife, and they do not chose their life goals based on religious teachings. The reliability of the IRS was reported to be between 0.85 and 0.91 (Bahrami & Tashk 2003). In this study, this questionnaire was completely administered, but the present authors only analysed data of the religiosity and religious disorganization subscales.
Ways of coping questionnaire (WOCQ)
Coping strategies were measured using the Persian version of Folkman and Lazarus’ ways of coping (WOC) scale (Folkman & Lazarus 1988). The scale contains 67 items, and each item was scored on a four-point scale from 0 (not used) to 3 (used a great deal), indicating the level of reliance on each styles of coping. These strategies were then grouped into eight styles of coping. Positive reappraisal, escape-avoidance, distancing and self-controlling make up the emotion-focused coping strategies. Problem-solving, seeking social support, accepting responsibility and confrontive coping make up the problem-focused coping strategies. A higher score in one coping style strategy reveals a strong trend towards that coping strategy. Cronbach’s alpha coefficient of Iranian version was 0.86 (Hashemzadeh 2006).
NEO five-factor inventory (NEO-FFI-S)
Short form of NEO-FFI-S is a 60-item instrument measuring five dimensions of the normal personality: neuroticism (N), extraversion (E), openness (O), agreeableness (A) and conscientiousness (C) (Costa & McCrae 1992). Respondents indicate their degree of agreement with each item on a five-point Likert-type scale from 0 (strongly disagree) to 4 (strongly agree). A high score on each personality trait indicates a high level of that trait. In this study, the authorized Persian translation of the NEO-FFI-S (Kiamehr 2002) was used to collect personality data of the sample. Standardization of the NEO-FFI-S was accomplished using a group of students of universities of humanity science in Tehran. Alpha estimates for Persian version were 0.79, 0.76, 0.78, 0.54 and 0.61 for N, E, O, A and C, respectively (Kiamehr 2002).
General health questionnaire (GHQ)
In this study, general health is defined as having no severe anxiety, depression or social dysfunction. Goldberg & Hillier (1979) designed the 28-item general health questionnaire. Factor analysis of this questionnaire yielded four factors: somatic symptoms, anxiety/insomnia, social dysfunctions and severe depression. Each subscale includes seven questions. Achieving high scores in this scale is indicative of less general health of the subject. This questionnaire has a reported alpha coefficient of 93%, and its degree of convergence with four subscales of scl-90 test is 69% (Alavi 2007). Also, Alavi (2007) reported test–retest reliability of this scale to be 62%.
Results
The mean and standard deviation for personality dimensions, religious tendencies, coping strategies, extraversion and GHQ scores are presented in the Table 1. An independent t-test was used to test the first study hypothesis (hypothesis 1). T-test results showed that mean GHQ score for mothers of children with ID was significantly higher than those for mothers of typically developing children (P < 0.001). The mean scores of four dimensions of personality including openness, agreeable, extraversion and conscientiousness in mothers of typically developing children were also higher than those for mothers of children with ID (P < 0.01).
| Items | Of children with ID Mean ± SD | Of typically developing children Mean ± SD | t | d.f. | Significants |
|---|---|---|---|---|---|
| Neuroticism | 22.89 ± 7.81 | 18.27 ± 5.98 | 5.23 | 246 | <0.001 |
| Extraversion | 26.75 ± 7.57 | 29.85 ± 5.64 | −3.65 | 246 | <0.001 |
| Openness | 23.89 ± 4.24 | 25.28 ± 4.04 | −2.64 | 246 | 0.009 |
| Agreeable | 30.61 ± 4.78 | 32.20 ± 4.42 | −2.71 | 246 | 0.007 |
| Conscientiousness | 35.39 ± 7.43 | 37.52 ± 5.78 | −2.51 | 246 | 0.013 |
| Religiosity | 95.93 ± 18.92 | 97.43 ± 11.55 | −0.76 | 246 | 0.450 |
| Religious disorganization | 29.38 ± 13.02 | 25.75 ± 10.62 | 2.40 | 246 | 0.017 |
| Problem-focus coping | 30.15 ± 8.68 | 29.52 ± 9.95 | 0.54 | 246 | 0.592 |
| Emotion-focused coping | 29.61 ± 7.19 | 25.25 ± 8.26 | 4.43 | 246 | <0.001 |
| Somatic symptoms | 7.06 ± 4.08 | 4.40 ± 2.95 | 5.89 | 246 | <0.001 |
| Anxiety/insomnia | 7.88 ± 4.62 | 5.56 ± 2.79 | 4.79 | 246 | <0.001 |
| Social dysfunction | 7.68 ± 3.63 | 6.10 ± 2.64 | 3.92 | 246 | <0.001 |
| Severe depression | 4.52 ± 4.98 | 1.43 ± 1.98 | 6.42 | 246 | <0.001 |
| GHQ total | 27.29 ± 14.73 | 17.49 ± 7.07 | 6.68 | 246 | <0.001 |
- GHQ, general health questionnaire; ID, intellectual disability.
To test the second hypothesis, comparison of neuroticism mean in both groups of mothers showed that the mean neuroticism scores were significantly higher in mothers of children with ID (P < 0.01). Comparison of mean scores of religious tendencies in mothers of children with ID and those with typically developing children using T-test showed that mothers of children with ID had higher religious disorganization (P < 0.05). To test the third hypothesis, comparison of mean scores of coping strategies in mothers of children with ID and those with typically developing children showed that the use of emotion-focused coping strategies was significantly higher in mothers of children with ID (P < 0.001). There was no significant difference between the mean of problem-focused coping strategies in mothers of children with ID and mothers of typically developing children (P > 0.05).
Multiple regression analysis was used to test the fourth study hypothesis (Table 2). The present authors entered all the variables into the regression equations in blocks. Using multiple regression analysis, the present authors tried to identify variable compositions stronger in predicting the GHQ scores for mothers of children with and without ID (Table 2). The results revealed that GHQ scores were predicted by neuroticism (β = 0.70, P < 0.001) and religiosity (β = −0.18, P = 0.039) among mothers of children with ID and that GHQ scores were predicted by neuroticism (β = 0.41, P < 0.001) and religious disorganization (β = 0.29, P = 0.003) among mothers of typically developing. GHQ scores were not predicted by coping strategies in both groups of mothers. To test the fifth study hypothesis, Table 2 shows that religiosity and religious disorganization were the predictors of general health in mothers of children with ID and mothers of typically developing children, respectively.
| Items | Of children with ID | Of typically developing children | ||||
|---|---|---|---|---|---|---|
| β | T | P | β | t | P | |
| Neuroticism | 0.70 | 6.74 | <0.001 | 0.41 | 4.72 | <0.001 |
| Extraversion | −0.10 | −1.14 | 0.256 | −0.11 | −1.41 | 0.162 |
| Openness | 0.09 | 1.46 | 0.147 | 0.12 | 1.62 | 0.108 |
| Agreeable | −0.04 | −0.43 | 0.665 | −0.02 | −0.25 | 0.801 |
| Conscientiousness | −0.01 | −0.08 | 0.940 | 0.04 | 0.44 | 0.664 |
| Religiosity | −0.18 | −2.14 | 0.039 | −0.15 | −1.89 | 0.052 |
| Religious disorganization | −0.05 | −0.53 | 0.600 | 0.29 | 3.07 | 0.003 |
| Problem-focus coping | 0.02 | 0.25 | 0.803 | −0.10 | −1.04 | 0.302 |
| Emotion-focused coping | 0.02 | 0.22 | 0.825 | 0.10 | 1.02 | 0.310 |
- GHQ, general health questionnaire; ID, intellectual disability.
Discussion
Comparison of personality dimensions, religious tendencies, coping strategies and GHQ mean scores in the two groups of mothers showed that the mean subscale GHQ scores are significantly higher in mothers of children with ID than in those with typically developing children (hypothesis 1, Table 1). In other words, mothers of children with ID had more general health problems than those without ID. This finding supports the view of previous studies (Floyd & Gallagher 1997; Olsson & Hwang 2001; Emerson 2003).
In testing second study hypothesis, comparison of the mean scores in two studied groups also showed that mothers of children with ID achieved higher scores in neuroticism and that they had lower scores in extraversion, openness, agreeable and conscientiousness. Given that the neuroticism is a risk factor for a variety of anxiety and depressive disorders, mothers of children with ID are expected to be more socially withdrawn and to experience anger, guilty and emotional distress more than those with typically developing children. This result was consistent with that of Dor-Shav & Horowitz (1984). Ali et al. (1994) reported that mothers of children with ID had higher neuroticism scores than those with typically developing children. This may imply that they had less emotional stability than those with typically developing children.
No significant difference was observed in the use of problem-focused coping between the two groups of mothers, but mothers of children with ID used the emotion-focused coping strategies more than those without ID (third hypothesis). This result was not consistent that obtained by Rodrigue et al. (1992). They reported that parents of children with Down syndrome used the problem-focused coping strategies significantly more than the parents of normal children and that no significant difference was found between the use of emotion-focused coping styles in the two groups. The problem-focused coping strategies are efficient only in occasions that stressful situation is manageable (Folkman 1984). Consistent involvement in the everlasting problems of their children, parents of children with ID are expected to master fulfilling their children’s needs (Seltzer et al. 1995) and therefore to use more problem-focused coping strategies to cope with their children’s problems. Probably, one of the reasons that mothers of children with ID in this study used more emotion-focused coping strategies than those with typically developing children is the lack of enough training by responsible institutions. The quality and availability of rehabilitation services are not well documented in Iran. However, Kermanshahi et al. (2008) in their phenomenological study of six Iranian mothers parenting a child with MR noted that the mothers experienced significant social, physical and emotional problems in the daily care of their children. They also found that there were not any social services, no school nurses in the exceptional (special) schools and no consultation services available to the mothers and their children with MR (Kermanshahi et al. 2008). Perhaps, mothers of children with ID in the current study relied more on emotion-focused strategies because there were few alternative options available to them to manage the challenges related to childbearing. Whereas emotion-focused coping strategies could be helpful in initial exposure to an uncontrollable stressor (e.g. a heart attack), long-lasting reliance on these strategies may put the individual at risk of development of psychological problems (Lazarus 1993).
In testing fourth study hypothesis, comparison of regression analysis results between the two groups of mothers showed that neuroticism plays the most important role in predicting the general health in both groups of mothers (Table 2). Findings of some studies indicated that experiencing challenges related to long-term taking care of children with ID may lead to emergence of special sorts of personality characteristics in the mothers of these children (Koegel et al. 1983; Wolff et al. 1988; O’Hanrahan et al. 1999).
Comparison of religiosity scores between the two groups of mothers showed that mothers of children with ID have more religious disorganization. Based on the IRS items for measuring religiosity, this may imply that they are dissatisfied with their life and have no religion-driven meaning for life. In the present authors’ experience of the religious context of Iran, some mothers who lack religious stability may consider the birth of their child with ID as a sign of divine retribution and lack of God’s mercy and therefore experience religious disorganization. Also, in testing fifth study hypothesis, results of regression analysis show that among religious tendencies, religiosity is the main predictor of the general health in mothers of children with ID and religious disorganization in mothers of typically developing children (Table 2). In the other words, based on the meaning conveyed by the items measuring the religiosity tendencies in IRS, mothers with stronger religious beliefs are expected to deal with problems based on religious instructions and spiritual beliefs in a way that they could find religion-driven meaning for taking care of their children and to have better general health. This result is consistent with Chang et al. (1998); Pierce (2001); Acton & Miller (2003); Murray-Swank et al. (2006); Pierce et al. (2008). Rogers-Dulan (1998) reported that experiencing high levels of caregiving stress, mothers of children with ID had a high level of religiousness. Ravari et al. (2009) reported that Iranian nurses consider caring for patients as a chance to worship God, and they gave meaning to their lives via this belief. Given the religious context of Iranian society, it seems that mothers of children with ID had found religion-driven meaning for their childcare using religious beliefs and hence coped with caregiving problems. Finally, the results of regression analysis showed that none of the coping strategies were the predictor of general health in mothers of children with ID. This is because, in religious context of Iran, when people face challenging problems such as having a child with ID, they may use religious beliefs more than general coping strategies to cope with those challenges. Through comparison of the relationship between coping strategies and general health in the two groups of mothers, the present authors come to conclusion that religious beliefs have an important impact on the type of coping strategies applied by the mothers of children with ID. These religious beliefs of mothers of children with ID cause them to rely less on general coping strategies in a stressful situation.
Based on the results of the present study and given the meaning of items measuring religiosity tendencies in IRS, it can be concluded that religious beliefs could be accompanied by enhanced general health. The findings of present study suggest that neuroticism has a significant negative relationship with general health of mothers of children with ID. So, in rehabilitation process, improving emotional stability of mother of child with ID and helping her reduce stressors of daily life that evoke neurotic reactions may improve her general health. Because, in comparison with mothers of typically developing children, more prevalence of religious disorganization in mothers of children with ID means more lack of religion-driven meaning of life, instruction of existential matters to parents can help them to find religion-driven meaning of their lives. Besides, given to shortcoming of educational services for parents of children with ID in Iran, more planning is required for quality improvement of educational and care services for children with ID and their mothers. One of the limitations of the present study is the overlap between emotional distress (which is one of neuroticism features) and lack of general health (like sever anxiety, depression or social dysfunction). This could lead to overlap between neuroticism scores (one of predictor variables) and general health scores (as outcome variable). Consequently, the significant role of neuroticism in the prediction of general health of both groups of mothers was expectable. In the present study, only mothers of children with ID were selected as the participants, and therefore, similar investigations of other family members of these children are necessary to be performed. Besides, all the children with ID were at the ages of 6–13 years and had intelligence quotients (IQs) between 25 and 50, and children with other intelligence quotients and age ranges were not included in the present study. Another limitation of the present study was that the type of the child’s disability (e.g. autism or cerebral palsy) was not considered. Finally, Iranian Muslims were the only participants of this study, and further similar researches are recommended to be carried out in other countries and in different religions to shed more lights on the relationship of the variables investigated in study.
Correspondence
Any correspondence should be directed to Hossein Rezai, Faculty of Rehabilitation, Department of Speech Therapy, Semnan University of Medical Sciences, 5th Km Damghan Road, Semnan, Iran (e-mail: [email protected]).
