The Moderating Role of Maternal Distress Tolerance in the Relationship Between Maternal Emotional Intimacy and Parent–Child Interaction: The Mediating Role of Psychological Safety Among Mothers of Children with ADHD

Zahra Norouzi Foroushani; Mahnaz Hajiheydari

Authors

Zahra Norouzi Foroushani Department of Counseling, Feizoleslam Non-profit Higher Education Institute, Khomeinishahr, Isfahan, Iran. Author https://orcid.org/0000-0002-6392-5524
Mahnaz Hajiheydari Department of Counseling, Feizoleslam Non-profit Higher Education Institute, Khomeinishahr, Isfahan, Iran. https://orcid.org/0009-0003-5108-2034

Keywords:

maternal emotional intimacy, parent–child interaction, distress tolerance, psychological safety, ADHD

Abstract

Mothers of children with attention-deficit/hyperactivity disorder (ADHD) are frequently exposed to persistent parenting demands that can compromise the quality of parent–child interaction. Maternal emotional intimacy may support more adaptive interaction, but its effect may depend on intrapersonal resources. This study examined a moderated mediation model in which maternal psychological safety mediated, and maternal distress tolerance moderated, the association between maternal emotional intimacy and parent–child interaction. Methods: A quantitative, cross-sectional correlational study was conducted among 350 mothers of children with ADHD attending psychological and therapeutic centers in Isfahan, Iran. Participants were selected using convenience and purposive sampling. Measures included the Emotional Intimacy subscale of the Iranian Intimacy Questionnaire, the short-form Maslow Psychological Security Questionnaire, the Distress Tolerance Scale, the Child–Parent Relationship Scale, and the SNAP-IV for ADHD symptom screening. Structural equation modeling with robust estimation and 5,000-resample bootstrapping was used. Results: The structural model showed good fit (χ²/df = 1.94, CFI = .98, TLI = .97, IFI = .94, RMSEA = .055, SRMR = .042). In the base structural model, emotional intimacy positively predicted parent–child interaction (β = .299, p < .001) and psychological safety (β = .582, p < .001), whereas its direct path to distress tolerance was not significant (β = .105, p = .077). Psychological safety (β = .368, p < .001) and distress tolerance (β = .309, p < .001) positively predicted parent–child interaction. Psychological safety partially mediated the emotional intimacy–interaction association (indirect β = .214, 95% CI [.192, .312]), accounting for 41.71% of the total effect. The emotional intimacy × distress tolerance interaction was significant (B = .218, p < .001), with the emotional-intimacy effect increasing from low (β = .185) to mean (β = .400) and high (β = .618) distress tolerance. Conclusion: Maternal emotional intimacy appears to be linked with better parent–child interaction both directly and through psychological safety, while distress tolerance strengthens the association. Multi-component interventions for mothers of children with ADHD may benefit from jointly targeting relational intimacy, psychological safety, and distress-tolerance skills.

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