INTRODUCTION:

Stress is a common experience every individual go through at some point of their life. Numerous researches by different authors have been carried out to understand and define stress.

In 1984, Lazarus and Folkman defined stress as “a relationship between the person and the environment that is appraised by the person as taxing or exceeding his or her resources and endangering his or her well-being.” However, in 2007, Russell elaborated this definition and defined stress as “a real or interpreted threat or concern from the outside world affecting the person when demands tax or exceed the person's resources. The individual responds to stress in ways that affect the individual as well as their environment”.

The most famous and accepted explanation of stress came from the famous endocrinologist Hans Seyle in the 1930s. According to him stress is “any nonspecific response of the body to a variety of noxious stimuli and the stimuli are termed as stressors”. He mentioned that stressor can be any type of changes in one’s life. A stressor has the potential to cause physiological arousal in the person along with enhancing his/her susceptibility to illness.

Seyle (1930s) also mentioned that stress may be experienced in three ways, stress related to disability itself, stress related to continuing dependency and stress related to the degree of vulnerability of the family.

Previous studies have shown that one of the most significant stressor is having children with intellectual disability and/or autism (Cummings, Bayley& Herbert, 1965; Sen & Yurtsever, 2006).

The terms Intellectual disability and Mental Retardation have been often used interchangeably. Numerous definitions of mental retardation have been given and they have undergone changes with time. According to ICD -10 (2004), “Mental Retardation is a condition of arrested or incomplete development of the mind, which is especially characterized by impairment of skills manifested during the developmental period - Skills which contribute to the overall level of intelligence i.e. cognitive, language, motor & social abilities.”

The ICD- 10 classifies mental retardation according to the severity;

· F70 Mild Mental Retardation ( IQ 50 – 69)

· F71 Moderate Mental Retardation (IQ 35-49)

· F72 Severe Mental Retardation (IQ 20 – 34)

· F73 Profound Mental Retardation ( IQ below 20)

Having a child with disability has been found to be affecting parent’s functioning negatively (Raina, Maureen O'Donnell et al, 2004; Bayat, Salehi, Bozorgnezhad&Asghari, 2011). Mother’s daily life seems to be affected more than that of fathers (Sen&Yurtsever, 2006). Further researches (Larson and Richards, 1994; Heller, 1997; Almeida, Wethinton& Chandler, 1999) showed that parents who have children with mental retardation experiences life changing events. Mother seems to experiences more such events because of additional child care burdens that dawns upon them. Similar findings were found by Read 1991, where mothers expressed concerns such as difficulties and amount of work increases as the child grows older which further adds on to the financial repercussions such as decrease in earning capacity of parents with time without a decrease in expenses, etc.

The gender of the child who has mental retardation has been associated with the level of parental stress (Cunninghan and Davis, 1985). Parents having female mentally retarded children have higher stress than the parents of male mentally retarded children (Baker et al., 2002; Baxter et al., 2000; Beck et al., 2004; SujataSethi et.al, 2007).

Although such findings are common from developed countries, there appears to be dearth in the understanding of stress experienced by parents in developing countries such as India. Pal and Choudhury 1998 showed that many a times, a child with disability is regarded a burden by the society. They are even considered as evil spirit and often are shown pity. Hence the present study aimed at understanding the experiences of mothers who has children with moderate mental retardation, residing in the Indian states of Maharashtra and Kerala.

AIM OF THE STUDY:

The study aimed at exploring stressors faced by mothers (residing in Maharashtra and Kerala) having children (both male and female) with moderate mental retardation.

Method:

Participants:

The sample consisted of 120 mothers falling in the age range of 20-50. The sample was divided according to the state of residence: 60 were from Maharashtra and 60 were from Kerala. The sample was further divided according to the gender of the child: 30 mothers having male children with moderate mental retardation and 30 having female children with moderate mental retardation from each state.

Tool:

Family Assessment Schedule was used for the current study. It is a semi structured interview schedule developed by Dr. Sathish Chandra Girimaji (1994), Department of Psychiatry, NIMHANS. This tool systematically elicits the perceived stress and coping by families having children with mental retardation.

As the tool is originally in English, it was translated to Hindi, Marathi and Malayalam so that it could be effectively used for the sample of the current study.

Procedure:

The investigator identified two institutions with moderate mentally retarded children in Maharashtra and Kerala with the help of the heads of the institutions. As the mothers of the moderate mentally retarded children were very hesitant to meet the investigator, he met the heads and told the purpose of the interview and requested the help of the heads for the same. The heads called a meeting of the mothers and explained about the interview and took them in to confidence and then the investigator met them and got their consent for the same. The investigator personally met all the interviewees and obtained the consent by giving the informed consent form. Once they gave their consent to be part of the study, the interview was conducted by the investigator.

Analysis of Data:

Thematic analysis was used to analyze the data. Here the focus was on emerging themes from discussions with parents of mental retarded children. Two major themes evolved from discussion which talks about mental retarded children’s parent’s psychological stress and environmental stress.

RESULTS:

To understand the nature of stress experienced by mother having children with moderate mental retardation, thematic analysis was done. Two major themes evolved from discussion which includes stress due to psychological factors and stress due to environmental factors.

Four sub-themes were also identified under major theme psychological stressors and environmental stress. Sub-themes evolved under psychological stressors includes psycho-energetic stress, macro-skills stress, values stress and bio-energetic stress. Sub-themes evolved under environmental stressors include chronic problems, daily hassles, interpersonal difficulties and major events.

DISCUSSION:

The dominant themes that emerged from the data were categorized under theorganizing themes of psychological and environmental stressors. Theme psychological stressors were related to the inherent factors in the mothers which caused stress in them. In the current study, it was found that all mothers irrespective of which state they belonged to were facing psychological stressors. Psychological stressor, as an organizing theme, was found to comprise of bio-energetic stress, macro skill stress, psycho-energetic stress and valued stress.

Bio-energetic stress dealt with stress experienced on physical body such as lack of adequate sleep and rest. Finding of the current study shows that mothers of male children with moderate mental retardation from Kerala experiences this type of stress highest. Lack of skills within the individual to manage a stressful situation gives rise to macro skill stress. The participants’ reports indicate that they were not able schedule their activities according to the demands of the situation, which led to the experience of stress. The participants facing the highest instances of macro-skill stress were Kerala mothers having male children with moderate mental retardation. Psycho-energetic stress is referred to the stress that is experienced by mothers as a result of taking care of children with mental retardation. Often this starts affecting other life situations as well, including her psychological health and well-being. According to valued stress when a person’s religious, spiritual or superstitious becomes his/her value system, it can lead them to experience more stress. This reflected in the study as some mothers, especially mothers from Kerala having male child with mental retardation viewed their children as a punishment they were facing as a result of their actions in their previous life. This is very clear from the following responses of the mothers during the interview. “It is a punishment from God for my past deeds” and “I am punished by God for the whole life”.

Second theme evolved from study is environmental stressors. Study found that mothers of children with mental retardation faces many environmental situations which increases their stress further. Environmental Stressors include interpersonal difficulties, daily hassles, major events and chronic problems. Study found that most mothers especially Kerala mothers having female children with mental retardation experienced interpersonal difficulties such as arguments; misunderstandings and being blamed for the child’s condition. It was also found that if at a daily basis an individual experiences stressful events they tend to build up steadily and become a cause major stress in the long run. Daily hassles have been found to be significant predictor of psychological symptoms relating to stress (Kanner, Coyne and Lazarus, 1981). In the current study participants often had arguments with their spouses and/or relatives leading to added stress. The participants facing the highest instances of daily hassles were Kerala Mothers having male children with mental retardation. Some of the responses from the Kerala mothers are as follows: “Due to the extra care given to the mentally retarded child my other house hold works are suffered and that becomes a reason for quarrel in the family”.

Study also reported that any events in life can also become a source of stress. Findings showed that problems relating to financial issues served as a major life event in mothers having children with mental retardation, particularly by mothers of female children from Kerala. It was also identified that most participants in the present study lived under certain strenuous conditions that made it even more difficult for them to cope with stress such as long term financial difficulties, chronic illness, etc. The participants facing the highest instances of chronic problems were mothers residing in Maharashtra Mothers and having female children with mental retardation.

CONCLUSION:

Mothers who have children with moderate mental retardation and are living in Kerala seem to have higher stress and mothers who are living in Maharashtra having children with moderate mental retardation have lesser stress. Therefore, further studies can look into strategies which can help mothers of children with moderate mental retardation living in the state of Kerala.

ACKNOWLEDGEMENT:

We thank University for supporting us in the research process and also extend our gratitude to all those who took part in the study and provided us with interesting insights.

CONFLICT OF INTEREST:

The authors declare that they have no conflict of interest.

ETHICAL APPROVAL:

“All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.”

INFORMED CONSENT:

Informed consent was obtained from all individual participants included in the study.

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Received on 12.01.2019 Modified on 16.02.2019

Res. J. Humanities and Social Sciences. 2019; 10(2):421-424.

DOI: 10.5958/2321-5828.2019.00071.8