title: The Family Strain Index (FSI). Reliability, validity, and factor structure of a brief questionnaire for families of children with ADHD.
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 (alpha=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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room E4539, Baltimore, MD 21205, USA. ariley@jhsph.edu.
authors.forename: Anne W
authors.initials: AW
authors.lastname: Riley
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Lyman
authors.forename: Georg
authors.initials: G
authors.lastname: Spiel
authors.forename: Manfred
authors.initials: M
authors.lastname: Döpfner
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Lorenzo
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Ralston
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D015897:Comorbidity; D005060:Europe / Q000453:epidemiology; D005163:Factor Analysis, Statistical; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011594:Psychometrics / Q000379:methods / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D011795:Surveys and Questionnaires / Q000592:standards*