Health, Spirituality and Medical Ethics

Original Article                                                                                                                    Health, Spirituality and Medical Ethics. 2021;8(1):35-43

 

Role of Spirituality and Five Personality Traits in the Prediction of Perceived Stress in Mothers of Mentally-Retarded Children
Received 01 Jun 2020; Accepted 07 Nov 2020
http://dx.doi.org/10.29252/jhsme.8.1.35
Sohrab Abdi Zarrin^1* , Maryam Asadi² , Zahra Jafari³ , Zahra Tavallaei Nezhad⁴
1 Department of Educational Sciences, Faculty of Literature and Humanities, University of Qom, Qom, Iran.
2 MA in Counseling, Islamic Azad University (Branch of Qom), Qom, Iran.
3 MA in Educational Psychology, University of Qom, Qom, Iran. 
4 MA in Clinical Psychology, Zanjan University of Medical Sciences, Zanjan, Iran.

Abstract Background and Objectives: The parents in families with a mentally retarded child tolerate psychological consequences in addition to financial and social issues. The mothers of these children are usually exposed to various harms and severe environmental stresses that can be exacerbated or facilitated by different factors. Therefore, this study aimed to predict the perceived stress of mothers with mentally retarded children based on spirituality and five personality traits. Methods: This correlational study included all mothers with mentally retarded children in Qom, Iran, in the academic year 2018-19. The study participants (n=150) were selected using the random sampling method, and the data collection was conducted using Cohen’s Perceived Stress Scale, Parsian and Dunning Spirituality Questionnaire, and NEO Personality Inventory. The obtained data were then analyzed in SPSS software (version 23) through Pearson correlation coefficient and Multivariate Linear Regression. Results: The results of the c  test revealed a significant positive correlation between perceived stress and the self-awareness component of spirituality (P=0.03; R=0.18). Moreover, there was a significant positive correlation between the perceived stress and five factors of personality, including neuroticism (P=0.001; R=0.29), extraversion (P=0.03; R=0.18;), openness to experience (P=0.02; R=0.19), agreeableness (P=0.03; R=0.17), and conscientiousness (P=0.02; R=0.19). The results of regression test indicated that self-awareness (R2=0.058) as a component of spirituality and neuroticism (R2=0.097), as a personality trait, were two predictors of perceived stress of mothers with mentally retarded children. Conclusion: Based on the results, spiritualism, especially the self-awareness factor, and five personality traits, especially neuroticism, were the good predictors of the perceived stress of mothers with mentally retarded children. Therefore, identification of personality traits that cause stress in mothers with mentally retarded children, and provision of socio-psychological supports to them, especially in form of spiritual programs, can improve the mental health of these mothers. Keywords: Five Personality Traits, Mothers of Mentally-retarded Children, Perceived Stress, Spirituality.

*Correspondence: Should be addressed to Dr. Sohrab Abdi Zarrin. Email: S.Abdizarrin@Qom.ac.ir

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International License

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Please Cite This Article As: Abdi Zarrin S, Asadi M, Jafari Z, Tavallaei Nezhad Z. Role of Spirituality and Five Personality Traits in the Prediction of Perceived Stress in Mothers of Mentally-Retarded Children. Health Spiritual Med Ethics. 2021;8(1):35-43.

 
 
 

T

he retarded child, as a source of stress in the family, endangers the physical and mental wellbeing of parents, especially the mother. On the other hand, the increase of resilience and hope improves the individual’s ability to cope with stressors (1). Mothers feel more responsibility toward their disabled child due to their caring role; therefore, they are faced with more stress and psychological problems (2). The results of studies investigating the effect of the presence of a disabled child in the family on the mothers’ stress indicated that the mothers of children with intellectual disabilities suffered from stress and mental crisis (3). Moreover, the presence of these children in the family threatens the mothers’ mental wellbeing (4).
Even the teachers of these children may be more under pressure than those of normal children (5). According to Fredrick, some families with disabled children are socially isolated (6). In general, the type of parents’ reaction to the mental retardation condition in their child varies from complete rejection to the full acceptance of their child’s special needs, and all parents have experienced moments of sadness and despair (7).
Perceived stress is the amount of stress that people perceive about situations and events, and this stress negatively affects their health, well-being, and quality of life (8). Stress occurs when real or imagined environmental needs put pressure on individuals or exceed their capacity (9). Symptoms of stress include problematic thinking, anxiety, sleep and appetite disorders, as well as difficulty with concentration and memory (10).
However, the application of some measures and interventions allows one to control the perceived stress and reduce the meta worry which in turn increases the quality of life (11). The amount of one’s experienced stress and the way  s/he deals with it depend on a
wide range of factors, such as personal characteristics, lifestyle, how to assess stressors, life events, as well as occupational and social variables (12).
The way one approaches life’s problems, such as the birth of a child with a mental disability is correlated with one’s personality type. In this regard, the Five-Factor Theory of Personality (Costa and McCrae, 1992) is one of the proposed theories of personality traits (13).
The five major personality traits include 1) Neuroticism: refers to a person’s readiness to experience anxiety, stress, hostility, impulsivity, and depression, 2) Extraversion: refers to a person’s tendency to be sociable, assertive, energetic, and excitement-seeking, 3) Openness to experience: deals with personality traits, such as curiosity, aesthetic friendliness, artistry, flexibility, and rationality, 4) Agreeableness (compatibility): refers to a person’s tendency for generosity, kindness, empathy, altruism, and trustworthiness. 5) Conscientiousness: refers to such characteristics as orderliness, efficiency, reliability, and adequacy (14).
Personality traits destroy or facilitate the process of one’s adaptation, as well as psychological and physical health by influencing the individual’s interpretation of environmental events (15). Moreover, studies suggest that there is a direct relationship between the neuroticism of mothers of mentally retarded children and level of stress, compared to mothers of normal children (16).
Spirituality is a psychological quality that goes beyond religious beliefs. The spiritual person is purposeful in life and has understood the meaning of life. Furthermore, it is considered one of the most effective psychological supports that shapes the meaning of life and saves the individual from suspension and meaninglessness by providing explanatory support when a person is faced with psychological pressures, illness, and death, or similar conditions (17). Spirituality as a coping mechanism provides a source of emotional support for individuals (18). The reason is that spirituality helps people reduce their negative emotions, thereby relieving their stress and anxiety. This way they would be able to better manage their life’s problems and employ appropriate strategies to reduce stress and maintain their mental health (19).
The results of a study showed that religious beliefs, especially religiosity and religious appreciation, play an important role in the prediction of problem-oriented coping styles in mothers with mentally retarded children, compared to those with normal children. In addition, among all personality traits, neuroticism has a major role in the prediction of emotion-centered coping styles in mothers with mentally retarded children (20).
A study was conducted on rehabilitation experts of welfare centers, and they were classified into two groups of having moderate and high stress. The results revealed a significant difference in terms of stress between the two groups. Furthermore, a significant association was found between spiritual intelligence dimensions and stress; accordingly, the average spiritual intelligence of people with high levels of stress was less than those with moderate stress levels (21).
Similarly, the results of 1a study indicated that mothers with higher levels of stress showed fewer acceptances toward their mentally retarded children. On the other hand, religious mothers and those with higher awareness of disability showed higher acceptance toward children with mental retardation. Moreover, more religious mothers and mothers with higher awareness of mental retardation experienced lower levels of stress (22). In addition, the results of another study indicated that spirituality training programs had a significant effect on the reduction of stress in mothers with mentally retarded children. Furthermore, education showed a remarkable impact on the improvement of general health and reduction of physical and depression symptoms (23).
The familial and social consequences of having a mentally retarded child are severe; therefore, it is very important to identify the factors, especially intrapersonal ones that can help these families. Accordingly, it is possible to help these children’s families and mothers, who tolerate extra pressure, through education and strengthening of intrapersonal charac-teristics. It seems that addressing personality factors and spirituality can be effective in this regard.
With this background in mind and given the importance of this issue, the present study aimed to determine whether spirituality and five personality traits could predict the perceived stress of mothers with mentally retarded children.
Methods
Statistical population, Sample, and Sampling method
This correlational study included all mothers (n=207) with educable mentally retarded children enrolled in exceptional schools of Qom, Iran, in the academic year 2018-19. The study sample was estimated at 134 participants using the Cochran formula, which was increased to 150 cases considering a 15% attrition rate. The inclusion criteria included having an educable mentally retarded child, being literate, and living in Qom, Iran. However, those who were unwilling to participate in this study and handed incomplete questionnaires were excluded from the study.
 
Instruments

1. Global Measure of Perceived Stress: This 14-item questionnaire was developed in 1983 by Cohen et al. to assess one’s general level of stress (24). The items are rated based on a Likert scale; moreover, the 4, 5, 7, 9, 10, and 13 items are scored in reverse. A high score indicates more perceived stress (25). According to the developers of the questionnaire, internal consistency (Cronbach’s alpha) of this scale was obtained at 0.84, 0.85, and 0.86 in three separate samples. Moreover, its concurrent validity was confirmed by significant positive correlations with the scores of the impact of life events, depression syndrome, and social anxiety questionnaires (24). Furthermore, Bastani et al. in their studies confirmed the content validity of the questionnaire (26), and its reliability was calculated and reported at 0.82 using Cronbach’s alpha coefficient.

 

b)NEO Five-Factor Inventory (NEO-FFI): This 60-item questionnaire evaluates five main traits of personality. This scale can be employed whenever the test time is very limited and general information about personality is sufficient. Moreover, the implementation of this test is time- and cost-effective. Its scales have high validity, and there is a significant correlation among the scales. Most importantly, this questionnaire has been less criticized, compared to other personality scales (27).

The NEO-FFI Personality Questionnaire was administered by Costa and McCrae on 208 American students with three months intervals, and the reliability coefficients ranged between 0.75 and 0.83. The long-term reliability of this questionnaire has also been evaluated. In a six-year study on the scales of neuroticism, extraversion, and openness to experience, the reliability coefficients ranged from 0.68 to 0.83 in personal as well as in couples’ reports. The reliability coefficients of agreeableness and conscientiousness were estimated at 0.79 and 0.63, respectively, with a two-year interval (27).
In the study conducted by Garusi Farshi (27) on 2000 students from Tabriz, Shiraz, and medical universities of these two cities to standardize the NEO test, the correlation coefficient of these five personality traits was obtained between 56.0 and 87.0. Moreover, Cronbach’s alpha coefficients for five personality traits, including neuroticism, extraversion, openness to experience, agree-ableness, and conscientiousness were deter-mined at 0.86, 0.73, 0.56, 0.68, and 0.87, respectively. The content validity of this test was evaluated using the correlation between two self-reports (S) and observer reports
(R) forms. The maximum and minimum correlation coefficients were calculated at 0.66 and 0.45 in the extraversion and agreeableness traits, respectively.
 
c) Parsian and Dunning Spirituality Questionnaire: This questionnaire has been developed to evaluate spirituality in people’s lives and measure its various dimensions (28). This is a 29-item self-report scale, and each item is rated based on a Likert scale from 1 to 4. This tool calculates both the overall score and the scores of the subscales of self-awareness (10 items), the importance of spiritual beliefs in life (4 items), spiritual practices (6 items), and spiritual needs (9 items) separately. The overall alpha coefficient of the test was obtained at 0.94. In addition, the alpha coefficients of self-awareness, the importance of spiritual beliefs in life, spiritual practice, and spiritual needs subscales were determined at 0.91, 0.91, 0.80, and 0.89, respectively. The results of the retest method did not show any significant difference between the scores of the first and second rounds in a 10-week interval that was indicative of the optimal reliability of the spirituality questionnaire (28).

Execution method
Explanations were given to the participants about the objectives of the research, the confidentiality of their information, and how to respond to the questionnaire after they
were distributed. Afterward, the incomplete questionnaires were discarded, and the study was conducted based on the hypothesis of a correlational study. Regarding the ethical considerations, the participation in the study and the completion of the questionnaires was voluntary and based on willingness. Moreover, the principle of confidentiality of information was fully observed, and the information of the questionnaires was only used for the study purpose. It should be noted that the present study proposal was approved by the Research Committee of Islamic Azad University, Qom Branch, Qom, Iran, before implementation. The study data were analyzed in SPSS software (version 23) through the Pearson correlation test and multiple regression analysis.
Result
The mean and standard deviation (SD) of the research variables are presented in Table 1.
Based on the data presented in Table 1, the mean±SD of perceived stress was estimated at 29.18±7.42. Out of five personality traits, the highest and lowest mean±SD scores belonged to openness to experience (30.73±5.81) and conscientiousness (28.66±6.66), respectively. Moreover, regarding different aspects of spirituality, self-awareness (26.74±4.90) and religious beliefs (10.22±2.63) obtained the highest and lowest mean±SD scores.
Pearson correlation test was used to examine the correlation among the study variables, and the results are presented in Table 2.

 
Table 1. Mean and standard deviation of the study variables

Variables	Factors	Mean	Standard Deviation
Perceived stress	Perceived stress	29.18	7.42
Factors of Spirituality	Self-awareness	26.74	4.90
	Beliefs	10.22	2.63
	Spiritual practice	13.67	2.15
	Spiritual needs	23.26	4.08
Five Personality Traits	Neuroticism	29.86	6.33
	Extraversion	29.72	6.69
	Openness to experience	30.73	5.81
	Agreeableness	29.44	5.78
	Conscientiousness	28.66	6.66

Table 2. Results of Pearson correlation coefficients of perceived stress with spirituality factors and five personality traits

Variables	Perceived Stress	Significance Level
Self-awareness	0.18	0.03
Spiritual Beliefs	0.04	0.61
Spiritual Practice	-0.01	0.85
Spiritual Needs	-0.08	0.32
Neuroticism	0.29	0.001
Extraversion	0.18	0.03
Openness to Experience	0.19	0.02
Agreeableness	0.17	0.03
Conscientiousness	0.19	0.02

 

As indicated by Table 2, the perceived stress has a positive and significant correlation only with the self-awareness variable (P=0.03; R=0.18) among the components of spiritualism. Furthermore, there is a positive and significant correlation between the perceived stress variable and five personality factors, including neuroticism (P=0.001; R=0.29), extraversion (P=0.03; R= 0.18), openness to experience (P=0.02; R=0.19), conservatism (P=0.03; R=0.17), and conscientiousness (P=0.02; R=0.19).
Multiple linear regression test was utilized to predict the perceived stress of mothers with mentally retarded children based on spirituality factors and five personality traits. The results of the multiple linear regression test are presented in Table 3.
According to Table 3, the coefficients of determination (R²) of self-awareness, as a spirituality factor, and that of neuroticism, as a personality trait, were estimated at 0.058 and 0.097, respectively. In other words, 5.8% and 9.7% of the perceived stress variance of mothers with mentally retarded children is predicted by self-awareness, as a spirituality factor, and neuroticism, as a personality trait, respectively. Therefore, only self-awareness (β=0.25) and neuroticism (β=0.40) among spirituality and personality factors could explain the criterion variable (perceived stress). It is worth mentioning that other factors and components of spirituality and personality were not able to explain the criterion variable. 

 
Table 3. Results of regression of perceived stress of mothers with mentally retarded children based on spirituality factors and five personality traits

Criterion Variable	Predicting Variable	R	R2	B	b	T	F	Standard Deviation	significance level
Perceived Stress	Self-awareness	0.24	0.058	0.37	0.25	2.54	2.25	0.145	0.012
	Spiritual beliefs			-0.13	-0.01	-0.47		0.280	0.963
	Spiritual Practice			0.23	0.07	0.66		0.351	0.512
	Spiritual Needs			-0.38	-0.21	-1.85		0.204	0.066
	Neuroticism	0.312	0.097	0.47	0.40	2.81	3.10	0.167	0.006
	Extraversion			-0.06	-0.05	-0.32		0.170	0.747
	Openness to Experience			0.11	0.08	0.86		0.124	0.392
	Agreeableness			-0.09	-0.07	-0.49		0.182	0.623
	Conscientiousness			-0.09	-0.08	-0.44		0.194	0.660

 

Discussion
This study aimed to predict the perceived stress in mothers with mentally retarded children based on spirituality factors and five personality traits. The results showed a positive and significant correlation between perceived stress and five personality traits. However, only neuroticism had a major impact on the criterion variable, and the other personality traits could not predict the perceived stress of mothers with mentally retarded children. The obtained results were in line with the findings of the studies conducted by Wood et al. (14), Grant et al. (15), Khabaz et al. (20), Nikrahan et al. (29), and Ghanei et al. (30)
Furthermore, the results of a study indicated that among the five major personality traits, extraversion and neuroticism were the predictors of the individuals’ well-being (15). In addition, the neuroticism factor was a predictor of job stress in nurses (30). Moreover, among five personality traits, there was only a positive correlation between neuroticism and stress levels of individuals; however, extraversion, agreeableness, and conscientiousness were negatively correlated with stress levels (29).
In explanation of these results, it can be said that neuroticism refers to a person’s tendency to experience anxiety, tension, compassion, hostility, impulsivity, and depression. The individuals in whom neuroticism is the strongest personality trait obtain lower scores in mental health and well-being tests. Psychotic people react to what they have, or what is happening around them with a negative view and evaluation (14).
Neurotic individuals are highly prone to feelings of anxiety, irritability, and anger toward others and have little ability to control their impulses and manage stress. On the other hand, people who are resilient to stress are creative, hopeful, open-minded, and ready to learn. They plan for the proper lifestyle, are optimistic, have control over their destiny, and play an active role in determining their destiny. Moreover, the feedback and behavior of these people are rational and they consider stressful life events as opportunities and challenges that should be handled through a problem-solving method (13).
In addition, the results of the present study showed that among all spirituality factors (self-awareness, spiritual beliefs, spiritual practice, and spiritual needs), only the self-awareness factor had a positive and significant correlation with the criterion variable. Moreover, it played a major role in the perceived stress of mothers with mentally retarded children, whereas other factors of spirituality did not predict the criterion variable. The present results were consistent with the findings of a study conducted by Grossoehme et al. (31); however, they were inconsistent with those obtained in the studies conducted by Lopez et al. (18), Bodenmann et al. (19), as well as Hosseini Some and Salami Bejestani (32).
The explanation for the positive relationship between self-awareness, as a factor of spirituality, and perceived stress is that the parents of mentally retarded children tolerate extra parenting stress other than the usual life stresses that other families normally endure. The stress of parenting has a positive association with the individuals’ higher knowledge of themselves and their current situation. Therefore, self-awareness increases the stress level of the individuals. Researchers believe that parents of these children are inclined to spirituality due to the stress of parenting and the severity of the child’s problems.
Alport, on the other hand, divided the religious orientation of individuals into two internal and external categories and believed that people with an internal religious orientation had a sense of comfort, security, usefulness, and self-adjustment. In other words, people with an internal religious orientation live in harmony with their religious beliefs and rituals, and this leads to greater social security and stability in them. Alport also believes that religion is one of the potentially important factors for mental health. Moreover, religion can be useful for mental health as a unifying principle and a great force. According to Alport, only internal religious orientation can improve individuals’ mental health (32).
Religious attitudes and beliefs in individuals are associated with a reduction of psychological stress. Religious coping helps people in stressful situations, and coping strategies are helpful in controlling chronic stress. In addition, religious coping is defined as the use of religion in finding meaning and comfort in face of stressful events. Therefore, religiosity and spirituality, as a mechanism of confrontation, provide a source of emotional support for individuals (18). The reason is that spirituality helps people to reduce their negative emotions and stress and to be able to better manage their life problems. Furthermore, they employ appropriate strategies to reduce stress and maintain their mental health (19).
The discrepancies between the findings of the present study and those of other studies may be partly due to cultural and spiritual differences, the ignorance of the mediating variables between spirituality and stress, different teachings, and lifestyles. The results of the present study emphasized the importance of personality traits in relation to stress, especially the perceived stress. On the other hand, spirituality has been one of the less considered categories in this field, and most of the researches have studied the variable of religious attitude. The results of the present study indicate that attention to spirituality can also play a positive role in relation to the perceived stress of mothers of children with mental disabilities, in addition to religion and religious attitude.
Regarding the limitations of the present study, one can refer to the type of research tools that often included self-assessment questionnaires, the completion of which is largely dependent on remembering past stressful situations that are sometimes difficult to remember and measure. In addition, the study population was limited to mothers and only mothers with mentally retarded children.
Therefore, considering the mentioned limitations of the study, it is suggested that future studies be conducted qualitatively using other research tools, such as interviews. Moreover, the sample population in future studies should include both mothers and fathers of such children. In addition, it is suggested that future research be performed on parents of the other groups of exceptional children, such as the deaf, blind, and physically disabled children. According to the results of the study and regarding the urgent need of families exposed to stress, clergymen and religious missionaries are advised to attend special care centers to teach religious and spiritual concepts to the parents and families of these types of children.
Conclusion
Many studies have shown the relationship between personality traits, especially neuro-ticism, and stress. In the present study, considering the education level (high school graduate or lower) of mothers with mentally retarded children, it seems necessary to teach illiterate or less literate people in the community the way to deal with the stress of having mentally retarded children to accept them.
Moreover, housewives constitute most of the participants in this study which indicates that unemployed people face more problems while taking care of exceptional children since they spend more time with these children. Furthermore, they compare them with normal children that lead to experiencing more levels of stress. On the other hand, attention to spirituality (especially the self-awareness factor) will help mothers with mentally retarded children to accept their child and cope better with the stress of having an exceptional child. The reason is that having a spiritual orientation and a religious view helps them to consider their work meaningful and a kind of religious worship.
Conflict of interest
The authors admit that there is no conflict of interest regarding the publication of this study.
Acknowledgements
The authors would like to thank all the mothers with mentally retarded children who helped the researchers in this study by completing the questionnaires.
References