Document Type : Original Article


1 Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran

2 Department of Psychiatry, Faculty of Medicine, Baqiyatallah University of Medical, Tehran, Iran

3 Health Management Research Center & Department of Community Medicine, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran


Background: The birth of a child with a hearing disability is a stressful event in the family. Since consanguineous marriages are associated with the incidence of congenital hearing loss, it is expected that such parents will experience greater psychological problems.
Objective: The current study investigated and compared anxiety, depression, and stress in parents of children with severe hearing loss who have undergone cochlear implantation with a focus on the relation between parents (consanguineous vs. non-consanguineous).
Methods: This cross-sectional study was conducted on all 180 couples (360 individuals) who had become parents and attended Baqiyatallah hospital’s Cochlear Implant Center from 2007 to 2009. The participants included two groups of consanguineous (125 couples) and non-consanguineous (55 couples) parents. After providing consent to participate in this study, the participants completed the short form of the Depression and Anxiety and Stress Scale questionnaire (DASS-21). Data analysis was done using SPSS 17 and t test.
Results: The participating parents had high levels of depression, anxiety, and stress. Depression and anxiety were significantly higher among the consanguineous parents (P=0.001 and P=0.005, respectively). However, stress levels were not significantly different between the 2 groups. Moreover, compared to the fathers, the mothers had higher levels of depression, anxiety, and stress (P<0.05).
Conclusion: Based on these findings, it may be concluded that the birth of a child with hearing loss can be the source of psychological problems in parents, particularly in consanguineous parents. Furthermore, mothers are more psychologically vulnerable than fathers.


  1. Dogan M. Comparison of the parents of children with and without hearing loss in terms of stress, depression, and trait anxiety. Int J Early Child Spec Educ. 2010;2:3.
  2. Margalit M. Loneliness among children with special needs: Theory, research, coping, and intervention. Springer Science & Business Media; 2012.
  3. Weisel A, Most T, Michael R. Mothers’ stress and expectations as a function of time since child’s cochlear implantation. J Deaf Stud Deaf Educ. 2007;12(1):55-64. doi:10.1093/deafed/enl020.
  4. Liu L, Wang M. Parenting stress and children’s problem behavior in China: the mediating role of parental psychological aggression. J Fam Psychol. 2015;29(1):20-28. doi:10.1037/fam0000047.
  5. Pipp-Siegel S, Sedey AL, Yoshinaga-Itano C. Predictors of parental stress in mothers of young children with hearing loss. J Deaf Stud Deaf Educ. 2002;7(1):1-17. doi:10.1093/deafed/7.1.1.
  6. Pottie CG, Ingram KM. Daily stress, coping, and well-being in parents of children with autism: a multilevel modeling approach. J Fam Psychol. 2008;22(6):855-864. doi:10.1037/a0013604.
  7. Noohi S, Amirsalari S, Sabouri E, Moradi S, Saburi A. Prevalence of anxiety and depression in mothers of children with profound bilateral sensorineural hearing loss: A brief report. Med J DY Patil Univ. 2014;7(6):717-720. doi:10.4103/0975-2870.144855.
  8. Asberg KK, Vogel JJ, Bowers CA. Exploring Correlates and Predictors of Stress in Parents of Children Who are Deaf: Implications of Perceived Social Support and Mode of Communication. J Child Fam Stud. 2008;17(4):486-499. doi:10.1007/s10826-007-9169-7.
  9. Lederberg AR, Golbach T. Parenting stress and social support in hearing mothers of deaf and hearing children: a longitudinal study. J Deaf Stud Deaf Educ. 2002;7(4):330-345. doi:10.1093/deafed/7.4.330.
  10. Quittner AL, Barker DH, Cruz I, Snell C, Grimley ME, Botteri M. Parenting Stress among Parents of Deaf and Hearing Children: Associations with Language Delays and Behavior Problems. Parent Sci Pract. 2010;10(2):136-155. doi:10.1080/15295190903212851.
  11. Luterman D. Counseling families of children with hearing loss and special needs. Volta Rev. 2004;104(4):215-220.
  12. Hashemzadeh Chaleshtori M, Simpson MA, Farrokhi E, et al. Novel mutations in the pejvakin gene are associated with autosomal recessive non-syndromic hearing loss in Iranian families. Clin Genet. 2007;72(3):261-263. doi:10.1111/j.1399-0004.2007.00852.x.
  13. Ebermann I, Walger M, Scholl HP, et al. Truncating mutation of the DFNB59 gene causes cochlear hearing impairment and central vestibular dysfunction. Hum Mutat. 2007;28(6):571- 577. doi:10.1002/humu.20478.
  14. Najmabadi H, Kahrizi K. Genetics of deafness. J Rehabil. 2005;6:33-36. [Persian].
  15. Bener A, Abou-Saleh MT, Mohammad RM, Dafeeah EE, Ventriglio A, Bhugra D. Does consanguinity increase the risk of mental ilnesses? A population-based study. Int J Cult Ment Health. 2016;9(2):172-181. doi:10.1080/17542863.2016.115 4082.
  16. Perveen F, Rehman S. Consanguineous marriages and their malformation in F1 generation. Asian J Pharm Health Sci. 2012;2(3):406-411.
  17. Reddy MV, Bindu LH, Reddy PP, Rani PU. Role of consanguinity in congenital neurosensory deafness. Int J Hum Genet. 2006;6(4):357-358. doi:10.1080/09723757.2006.11885980.
  18. Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335-343. doi:10.1016/0005- 7967(94)00075-U.
  19. Antony MM, Bieling PJ, Cox BJ, Enns MW, Swinson RP. Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychol Assess. 1998;10(2):176-181. doi:10.1037/1040-3590.10.2.176.
  20. Samani S, Joukar B. A Study on the Reliability and Validity of the Short Form of the Depression Anxiety Stress Scale (DASS-21). Journal of Social Sciences and Humanities of Shiraz University. 2007;26(3):65-78. [Persian].
  21. Uskun E, Gundogar D. The levels of stress, depression and anxiety of parents of disabled children in Turkey. Disabil Rehabil. 2010;32(23):1917-1927. doi:10.3109/09638281003763804.
  22. Shirom A. What is Organizational Stress? A Facet Analytic Conceptualization. J Organ Behav. 1982;3(1):21-37. doi:10.1002/job.4030030104.
  23. Selye H. Stress Without Distress. School Guidance Worker. 1977;32(5):5-13.
  24. Azar M, Noohi S, Shafiee Kandjani AR. Relationship between female sexual difficulties and mental health in patients referred to two public and private settings in Tehran, Iran. J Sex Med. 2007;4(5):1262-1268. doi:10.1111/j.1743-6109.2007.00544.x.
  25. Farooqi Y, Habib M. Gender differences in anxiety, depression and stress among survivors of suicide bombing. Pak J Soc Clin Psychol. 2010;8(2):145-53.
  26. Imam SS. Depression anxiety stress scales (DASS): Revisited. Int J Behav Sci. 2008;3(1):104-16.