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The Family Strain Index (FSI). Reliability, validity, and factor structure of a brief questionnaire for families of children with ADHD

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Abstract

Background

Attention-deficit/hyperactivity disorder (ADHD) in children affects every member of the family. Practical tools are needed to assess the effects of ADHD on families to better understand and address the level of stress, strain and burden that families experience.

Objective

To provide the preliminary reliability, validity and factor structure of the Family Strain Index (FSI), a 6-item parent-report questionnaire.

Methods

The FSI was completed by 1,477 parents of children with ADHD (aged 6–18 years) at the baseline visit of the ADORE study in 10 European countries (data missing for one patient).

Results

The FSI taps into an overall experience of worry and interruptions of activities in families of children with ADHD, as a single factor was identified with excellent internal consistency (α=0.87). Despite its brevity, almost no ceiling (worst score) or floor (best score) effects were observed for families of these highly symptomatic children. This score distribution and the 5-point response options suggest that the FSI will be responsive to changes in the experience of family strain associated with children's ADHD treatment.

Conclusion

The ease of completion and coherence of the underlying construct indicates that the FSI may be a practical clinical tool for monitoring changes in family strain associated with children's ADHD treatment.

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Abbreviations

ADHD:

Attention-Deficit/Hyperactivity Disorder

ADHD-RS-IV:

ADHD Rating Scale-IV

ADORE:

Attention-Deficit/Hyperactivity Disorder Observational Research in Europe

CAIA:

Child and Adolescent Impact Assessment

CGSQ:

Caregiver Strain Questionnaire

FSI:

Family Strain Index

HD:

Hyperkinetic Disorder

IOFS:

Impact on Family Scale

IOS:

Impact of the Situation Checklist

PCA:

Principal Components Analysis

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Author information

Authors and Affiliations

  1. Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room E4539, Baltimore, MD 21205, USA

    Anne W. Riley PhD & Lisa M. Lyman

  2. Landeskrankenhaus Klagenfurt, Dept. of Child and Adolescent Neuropsychiatry, Klagenfurt, Austria

    Georg Spiel

  3. Dept. of Child and Adolescent Psychiatry, University of Cologne, Cologne, Germany

    Manfred Döpfner

  4. Eli Lilly and Company, Lilly Research Centre, Windlesham, Surrey, UK

    Maria J. Lorenzo

Authors
  1. Anne W. Riley PhD
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  2. Lisa M. Lyman
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  3. Georg Spiel
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  4. Manfred Döpfner
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  5. Maria J. Lorenzo
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  6. Stephen J. Ralston**
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Consortia

ADORE Study Group

Corresponding author

Correspondence to Anne W. Riley PhD.

Additional information

* Members of the ADORE Study Group G Baldursson, D Coghill, P Curatolo, S Dalsgaard, M Döpfner, B Falissard, A Hervas, MF Le Heuzey, TS Nøvik, RR Pereira, U Preuss, S Ralston, P Rasmussen, AW Riley, A Rothenberger, G Spiel, HC Steinhausen, L Vlasveld

**Employed by Eli Lilly and Company at the time the research was performed

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Riley, A.W., Lyman, L.M., Spiel, G. et al. The Family Strain Index (FSI). Reliability, validity, and factor structure of a brief questionnaire for families of children with ADHD. Eur Child Adolesc Psychiatry 15 (Suppl 1), i72–i78 (2006). https://doi.org/10.1007/s00787-006-1010-0

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  • DOI: https://doi.org/10.1007/s00787-006-1010-0

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