Mixed-methods study on the associations between perceived stress, social support, personal growth, and family quality of life among parents and children with and without borderline intellectual functioning : a conservation of resources theory perspective

Background: This study focuses on a unique population within the field of intellectual disabilities: parents of children with borderline intellectual functioning (BIF). BIF is commonly defined to include individuals with an intelligence quotient (IQ) ranging from 70 to 85 (Hassiotis, 2015). This group closely relates to those with mild intellectual developmental disabilities (IDD), which is characterized by an IQ range of 55-69. Studies demonstrate that parents of children with IDD experience a lower quality of family life compared to parents of children without disabilities. The stress experienced by these parents significantly impacts their family's quality of life. An examination of the theoretical literature regarding parents of children with BIF, particularly concerning their family quality of life, reveals a significant gap in research. This population has received insufficient attention (Fernell & Gillberg, 2020; Martínez-Leal et al., 2020; Peltopuro et al., 2020), resulting in a lack of knowledge about their unique characteristics and coping mechanisms. Furthermore, researchers have emphasized the need for further exploration of this group and their families. Conservation of Resources Theory (Hobfoll, 1989, 2001; Hobfoll et al., 2016) focuses on understanding stress and the role of resources. The theory emphasizes the dynamics between resource losses and gains in stressful situations, explaining how these resources affect people's ability to manage challenges and stresses in their lives. This theory is relevant in explaining how parents of children with and without BIF cope with stressful life experiences, with social support and personal growth contributing to coping.

Objectives: The objectives of the study were to examine: a. Whether differences exist in family quality of life, perceived stress, personal growth, and social support between parents with and without BIF; b. The relationships between parents' quality of family life and their perceived stress, personal growth, and social support within each parent group; c. The unique contributions of perceived stress, personal growth, and social support in explaining family quality of life experienced by parents; d. Whether personal growth and social support moderate the relationship between parents' perceived stress and family quality of life, in light of the Conservation of Resources Theory; e. The subjective life experiences of parents of children with BIF regarding resource losses and gains processes.

Method: The study involved 75 parents (14 men and 61 women) of children aged 6-15: parents of children with BIF (N = 36, 48%) and parents of children without disabilities (N = 39, 52%). Data were collected through an online survey. To examine the first four study objectives, five measurements were used to assess the study variables. Additionally, to understand the subjective lived experience and perception of participants regarding raising their child with special needs, semi-structured in-depth interviews were conducted with 12 parents (2 men and 10 women) of children with BIF.

Results: Given the extensive findings, this section focuses on the primary results. The hypothesis that a significant difference in family quality of life would be found between the groups was confirmed. Parents of children with BIF reported lower family quality of life compared to parents of children without disabilities. In contrast, no significant differences were found in perceived stress, personal growth, and social support between the two groups. The hypotheses regarding the associations between perceived stress, personal growth, social support, and family quality of life were confirmed for both groups. As expected, higher perceived stress was associated with lower family quality of life, while higher levels of personal growth and social support correlated with higher family quality of life. Notably, the association between perceived stress and personal growth with family quality of life was stronger among parents of children with BIF.

The proposed research model suggested that social support and personal growth would moderate the association between perceived stress and family quality of life among parents of children with and without BIF. However, findings revealed that parental personal growth moderates the association between parents' perceived stress and family quality of life only among parents of children without disabilities. The qualitative findings from in-depth interviews with parents of children with BIF revealed three main themes. While acknowledging the various challenges involved in raising a child with BIF, parents presented a balanced perspective and positive parenting perceptions. They also described various coping resources that provide support, with family and friends identified as central sources of practical and emotional support in their lives.

Discussion and Implications: The study's findings present a complex picture. Per the quantitative findings, no differences were found between the parental groups in most of the study variables. However, differences were found between groups in family quality of life, likely due to the demand for additional resources in caring for a child with BIF. Several explanations were proposed for this, including: the measurements may not have been sensitive enough to detect subtle differences between groups; the lack of differences may be due to parents experiencing continuous stress rather than a single traumatic event; there is increasing social awareness of the needs of families with children who have special needs; the relatively "invisible" nature of BIF; and parents of children with BIF may adjust their expectations regarding social support similarly to parents of children without disabilities. The qualitative findings highlight the unique complexity of parenting children with BIF, and underscore the necessity for support and the development of specialized interventions tailored to the specific needs of these families. When meeting with the parents, important themes emerge related to the differences between parents of children with BIF and parents of children without BIF. This difference emphasizes the need for a unique approach to addressing the needs of these parents. This difference underscores the importance of tailoring support to address the specific needs of these parents. The current study has both theoretical and practical implications. It contributes to the body of knowledge in the field of developmental disabilities by examining the quality of family life among parents of children with BIF compared to parents of children without disabilities, based on the Conservation of Resources theory. Furthermore, this study was the first to examine how resource loss and gain contribute to the association between perceived stress and family quality of life among these groups of parents. Additionally, it provided a deeper exploration of the psychological and social aspects of the parenting experience of children with BIF that contribute to their family quality of life. Future research should investigate both protective and risk factors affecting family quality of life in this population, aiming to expand the body of knowledge and inform more effective interventions. Regarding practical implications, there is a growing need to develop social services and interventions for parents of children with BIF at young ages. Providing these services will enable parents to have easier access to treatments for their child with BIF, and to gain knowledge and tools for coping with the challenges they experience.