The Parents' Self-Stigma Scale: Development, Factor Analysis, Reliability, and Validity

Adaptation and validation of the Parents' Self-stigma Scale into Turkish and its association with parenting stress and parental self-efficacy

OBJECTIVES

In the present era, parents frequently stigmatize themselves for their children's negative behaviors and inadequate social skills. Parents' self-stigma (PSS) may lead to a decrease in parental self-efficacy and quality of marital and family life. In light of these reasons, the principal objective of this study to assess the validity and reliability of the Turkish version of the PSS Scale (PSSS) as developed by Eaton et al. (2019) and to investigate the indirect effect that parenting stress has on the relationship between PSS and parental self-efficacy.

METHODS

We collected data from a total of 1,118 parents via random sampling, with the first part of the study involving 645 participants (Mage = 32.64 ± 7.28) and the second part of the study involving 473 participants (Mage = 27.43 ± 9.87). In the first part of the study, we employed structural equation modeling for the confirmatory factor analysis and Pearson's correlation coefficient for the criterion-related validity, average variance extracted, and composite reliability analyses. Moreover, we calculated Cronbach's alpha, McDonald's omega, and Guttman split-half coefficients for the reliability analyses. In the second part of the study, we utilized Hayes' bootstrapping method to assess the indirect effect of parenting stress on the relationship between PSS and parental self-efficacy.

RESULTS

The first part of the study confirms the PSSS's 11-item, 3-factor structure, showing the Turkish form to have acceptable goodness-of-fit indices, and found Cronbach's alpha for the PSSS to be 0.89. Furthermore, the first part of the study demonstrates a significant negative correlation between marital life satisfaction and PSS. Meanwhile, the second part of the study has determined PSS to be positively related to parenting stress and negatively related to parental self-efficacy. The second part of the study also indicates parenting stress to have an indirect effect on the association between PSS and parental self-efficacy.

CONCLUSIONS

The study indicates the Turkish version of the PSSS to be a valid and reliable instrument in Turkish culture for measuring parents' PSS levels regarding their children, with higher scores indicating greater PSS. The scale can be effectively used in both research and clinical settings. The study also suggests parental stress to have a possible impact on the association between PSS and parental self-efficacy. Furthermore, addressing the variables of PSS and parenting stress in family-focused interviews and therapeutic interventions may contribute to increasing parental self-efficacy.

Self-Stigma of Canadian Youth With ADHD and Their Parents

OBJECTIVE

ADHD is subject to stigma from the general population. Exposure to stigma poses the risk of developing self-stigma of youth and parents, but few studies have focused on self-stigma of ADHD. Furthermore, parental factors have been implicated in self-stigma of youth, but no previous research has assessed the association between self-stigma of parents and youth. Therefore, the objective of this study was to better understand the experience of self-stigma of youth and their parents in the context of ADHD.

METHOD

Fifty-five youth with ADHD (aged 8-17) and one parent reporter per youth completed surveys to report their experiences.

RESULTS

The results of this study found that both youth and parents reported significantly lower self-stigma scores compared to most previously published research. Parents of boys reported higher self-stigma scores compared to parents of girls. Youth who reported higher self-stigma also reported lower self-esteem. Self-stigma scores in youth were predicted by inattentive symptoms but not hyperactive/impulsive symptoms or parental self-stigma.

CONCLUSION

Results emphasize the importance of understanding self-stigma of ADHD, symptom severity, and the need for interventions for families with ADHD.

The Effect of Parent-Targeted Obesity Messaging on Parental Weight Talk Intention: A Randomized Controlled Experiment

It is unknown if parent-targeted health messages about childhood obesity affect parental weight communication with children (e.g., encouraging a child to diet). This randomized, controlled, online experiment assessed the effects of exposure to different message frames on parental intentions to 1) engage in weight communication with their child and, 2) follow the health advice in the message. A diverse sample of U.S. parents (N = 452) were randomly assigned to one of three conditions: 1) a mock news article emphasizing childhood obesity (weight-framed message) with health behavior advice for parents; 2) an article with identical health behavior advice for parents, but framed within the context of improving children's school performance (school-framed message); and 3) a no-treatment control group. Following message exposure, parents completed online surveys assessing their intention to engage in weight communication and the recommended health behaviors. Hierarchical linear regression was used to assess the relationship between experimental condition and the outcome variables. Parents in the weight-frame condition were significantly more likely to report intention to engage in weight communication with their child than parents in the control group, while there was no difference between the school-frame condition and the control group. Parents in both message conditions were equally likely to report intention to adopt the health advice, but parental weight-based self-stigma moderated the relationships. Parent-targeted health advice that features childhood obesity may encourage parents to engage in weight communication with their children. Our findings can inform the development of health messages targeting parents about children's weight-related health.

Psychological well-being and needs of parents and carers of children and young people with mental health difficulties: a quantitative systematic review with meta-analyses

QUESTION

For parents of children and young people (CYP) with diagnosed mental health difficulties, what are the levels of parents' well-being and psychological need?

STUDY SELECTION AND ANALYSIS

Medline, PsycINFO, EMBASE, AMED, CINAHL, Web of Science and Cochrane Library of Registered Trials were searched from inception to June 2023.

INCLUSION CRITERIA

parents of CYP aged 5-18 years with formal mental health diagnosis. Data were extracted from validated measures of well-being or psychological needs with established cut-off points or from a controlled study.

FINDINGS

32 of the 73 310 records screened were included. Pooled means showed clinical range scores for one measure of depression, and all included measures of anxiety, parenting stress and general stress. Meta-analyses showed greater depression (g=0.24, 95% CI 0.11 to 0.38) and parenting stress (g=0.34, 95% CI 0.20 to 0.49) in parents of CYP with mental health difficulties versus those without. Mothers reported greater depression (g=0.42, 95% CI 0.18 to 0.66) and anxiety (g=0.73, 95% CI 0.27 to 1.18) than fathers. Narrative synthesis found no clear patterns in relation to CYP condition. Rates of parents with clinically relevant levels of distress varied. Typically, anxiety, parenting stress and general stress scored above clinical threshold. Quality appraisal revealed few studies with a clearly defined control group, or attempts to control for important variables such as parent gender.

CONCLUSIONS

The somewhat mixed results suggest clinical anxiety, parenting and general stress may be common, with sometimes high depression. Assessment and support for parents of CYP with mental health problems is required. Further controlled studies, with consideration of pre-existing parental mental health difficulties are required.

PROSPERO REGISTRATION NUMBER

CRD42022344453.

"I am not a good enough parent": The experience of self-stigma in parents of children with mental illness in China

PROBLEM

Self-stigma in parents of children with mental illness is an area easily overlooked by mental health providers. Many studies have shown that self-stigma in parents may result in social interaction avoidance, lower self-esteem, increased psychological pressure, and so on. However, a comprehensive picture of how parents of children with mental illness in China experience self-stigma is lacking.

METHODS

Individual semistructured face-to-face interviews were conducted with 20 parents from China during their child's psychiatric hospitalization. We followed the consolidated criteria for reporting qualitative research (COREQ) checklist.

FINDINGS

Four main themes were identified that captured the experience of self-stigma in parents of children with mental illness: (1) losing face and fear, (2) internalizing affiliate stigma, (3) feeling of self-blame and self-doubt, and (4) keeping oneself away from society.

CONCLUSIONS

These findings explain how Chinese parents of children with mental illness experience self-stigma. To better effect the treatment and rehabilitation of children with mental illness, it is necessary to recognize this self-stigma in parents and take action to improve their mental health.

An Examination of Parental Weight Stigma and Weight Talk Among Socioeconomically and Racially/Ethnically Diverse Parents

Parental communication about body weight can influence children's emotional well-being and eating behaviors. However, little is known about the role of parental self-stigma concerning weight and social position variables (ie, race/ethnicity, income, and gender) in weight communication. This study examined how parents' self-stigmatization for their own weight (ie, weight bias internalization) and self-stigmatization for their child's weight (ie, affiliate stigma) relates to weight talk frequency with their children, and whether these associations vary across parental race/ethnicity, income, and gender. Parents (n = 408) completed a cross-sectional, online survey about their weight communication and self-stigmatization. Linear regression was used to examine the relationships among these variables, including interactions between the stigma variables and social position variables in predicting weight talk. Higher levels of weight bias internalization and affiliate stigma were strongly associated with increased parental weight talk frequency; parents who endorsed higher levels of internalized bias about their own weight expressed greater affiliate stigma for their child's weight, regardless of demographic characteristics or weight status. Associations between the stigma variables and weight talk outcomes were stronger among fathers and parents of higher income. Findings highlight the importance of considering weight stigma variables in parental weight communication research.

Self-compassion mitigates the cognitive, affective, and social impact of courtesy stigma on parents of autistic children

PURPOSE

Due to the courtesy stigma of autism spectrum disorder, many parents of autistic children are devaluated and discriminated against by the public. Despite the high prevalence of this courtesy stigma, very few studies have examined its negative effects on parents of autistic children and explored the factors that may protect the parents from these negative effects. The present study utilized a 2-year, two-wave prospective longitudinal design to examine the associations of courtesy stigma with adverse cognitive (self-stigma), affective (depressive and anxiety symptoms), and social (parent-child and inter-parental conflicts) consequences for parents of autistic children and to test whether these associations would be moderated and mitigated by self-compassion.

METHODS

A total of 381 parents of autistic children completed questionnaires about courtesy stigma, self-compassion, self-stigma, depressive and anxiety symptoms, and parent-child and inter-parental conflicts at time 1 (T1) and time 2 (T2).

RESULTS

Courtesy stigma interacted with self-compassion at T1 in predicting self-stigma, depressive and anxiety symptoms, and parent-child and inter-parental conflicts at T2. Specifically, the associations of courtesy stigma with the adverse psychological consequences were weaker for parents with high self-compassion than for those with low self-compassion.

CONCLUSION

Our results demonstrate the prospective associations of courtesy stigma with adverse cognitive, affective, and social consequences for parents of autistic children, as well as the protective effects of self-compassion against such associations. These results highlight the importance of increasing parents' self-compassion to help them cope with courtesy stigma and improve their psychological well-being.

Child self-care autonomy in health (scale for parents): development, internal structure, and sex/age correlates

Autonomy in self-care practices in the health sphere is a critical characteristic for the survival of humans throughout the life span. Notably, however, the current literature lacks psychometrically sound instruments that measure this phenomenon among children without diagnosed chronic health conditions. The purpose of the present exploratory study was to develop, test, and provide data regarding the reliability and validity of the Child Self-Care Autonomy in Health (CSAH) scale. The piloted version of the CSAH yielded an 11-item instrument designed to reflect the parent's perspective in measuring the extent of autonomy in self-care actions related to health for a child, whether diagnosed with a chronic illness or not. Data were collected through an online survey of a non-random sample of Russian-speaking parents currently residing in Russia (N = 349). The analysis focused on scale structure via principal component analysis and age/sex associations. The proposed CSAH may be of interest to social workers, health professionals, and parents seeking to ascertain schoolers' autonomy in self-care practices in the health sphere and support building a stronger self-care mindset.

Investigating the experiences of family caregivers who shackle people with mental disorders

The mental health literacy gap has resulted in the shackling of people with mental illness by family caregivers. Although shackling violates human rights and impacts physical and psychological health, it still occurs in some countries, such as Indonesia. An in-depth study using the family function approach is needed to distinguish the components behind the application of shackling by families to find solutions to prevent shackling. Thus, this study aims to identify family functions in people with mental disorder (PWMD) care and to create a family care model for PWMD in accordance with the family function approach and recommendations for preventing shackling. This qualitative research used a phenomenological approach, involving eight participants who are family caregivers and live with their patients. Triangulation was conducted by applying interviews with four health cadres to confirm previous information. The process of in-depth interviews and observational data collection methods was carried out until reaching data saturation. The data analysis process used Collaizi's pattern to formulate three main themes, namely confinement as the final solution for the family, the specifics of confinement, and the family's purpose for confinement. The conclusion is that shackling occurs due to a lack of understanding of the impact of shackling and the various limitations experienced, so shackling becomes the last resort when dealing with patients. Peer support is very important for families to prevent the confinement of mentally ill family members. Technological advances are an inherent need in everyday life and must support family caregivers with mental disorders.

Rupture, repair, the loss and re-construction of identity: Seeking support in situations of adolescent-to-parent violence and abuse

Family violence is associated with life-long implications including increased vulnerability to poor mental and physical health, and increased risk of repeat victimization. When children or adolescents are the ones instigating the harm, mothers experience the compounding issues of violence, mother-blame, and stigma. In comparison to other forms of family violence, how mothers understand and interpret their experiences of adolescent-to-parent violence and abuse (APVA) is underexplored, particularly in relation to what it means for them at the emotional and individual level, and how this impacts their sense of self, and their mothering and professional identities. This brief research report uses an interpretive phenomenological approach utilising hermeneutics to explore how six mothers made-meaning of their lives and identity when their parenting journey was disrupted by APVA. Help-seeking behaviours were often met with denial, avoidance, and parent-blame from professionals, unless they were familiar with the mother through her professional identity first. Neurodivergences of the adolescents were reported, including mental illness, autism, pathological demand avoidance, and foetal alcohol spectrum disorder. and as no mother reported successful engagement with social care, youth justice, or mental health services when help-seeking, they needed to reimagine their parenting role, or hit crisis, before accessing appropriate support. Mothers could have been supported earlier if critical incidents were identified by services, and support and/or interventions provided earlier, when mothers first engaged in help-seeking behaviours.

Factors Related to Perceived Stigma in Parents of Children and Adolescents in Outpatient Mental Healthcare

Little is known about factors contributing to perceived stigma in parents of children and adolescents with behavioral and emotional problems in outpatient mental healthcare. We aimed to identify the most relevant factors related to perceived parental stigma using least absolute shrinkage and selection operator (LASSO) regression including a broad range of factors across six domains: (1) child characteristics, (2) characteristics of the primary parent, (3) parenting and family characteristics, (4) treatment-related characteristics, (5) sociodemographic characteristics, and (6) social-environmental characteristics. We adapted the Parents' Perceived Stigma of Service Seeking scale to measure perceived public stigma and affiliate stigma in 312 parents (87.8% mothers) during the first treatment year after referral to an outpatient child and adolescent clinic. We found that the six domains, including 45 individual factors, explained 34.0% of perceived public stigma and 19.7% of affiliate stigma. Child and social-environmental characteristics (social relations) explained the most deviance in public stigma, followed by parental factors. The strongest factors were more severe problems of the child (especially callous-unemotional traits and internalizing problems), mental healthcare use of the parent, and lower perceived parenting competence. The only relevant factor for affiliate stigma was lower perceived parenting competence. Our study points to the multifactorial nature of perceived stigma and supports that parents' perceived public stigma is susceptible to social influences, while affiliate stigma relates to parents' self-evaluation. Increasing parents' perceived parenting competence may help mitigate perceived stigma. Future studies should explore how stigma relates to treatment outcomes.

Longitudinal impact of public stigma and courtesy stigma on parents of children with autism spectrum disorder: The moderating role of trait mindfulness

BACKGROUND

Although the public and courtesy stigma of autism spectrum disorder (ASD) are prevalent, there are very few studies examining their adverse psychological effects on parents of children with ASD or exploring plausible factors that can alleviate these adverse effects. The present study addressed these literature gaps by investigating the longitudinal linkages of public and courtesy stigma to detrimental cognitive (i.e., self-stigma content and process) and affective (i.e., perceived stress and symptoms of depression and anxiety) consequences for parents of children with ASD and testing if these linkages would be moderated by trait mindfulness.

METHODS

At two time points separated by 12 months, 372 Hong Kong parents of children with ASD provided questionnaire data on public and courtesy stigma, mindfulness, self-stigma content and process, perceived stress, and symptoms of depression and anxiety.

RESULTS

Hierarchical regressions showed that public and courtesy stigma interacted significantly with mindfulness at baseline in predicting self-stigma content and process, perceived stress, and symptoms of depression and anxiety at follow-up. Moreover, simple slope analyses showed that the linkages of public and courtesy stigma to the five detrimental psychological consequences were weaker in parents with high mindfulness than in those with low mindfulness.

CONCLUSIONS

Our findings highlight the longitudinal linkages of public and courtesy stigma to detrimental cognitive and affective consequences for parents of children with ASD, and reveal the plausible protective effects of mindfulness against such linkages. These findings suggest the potential utility of increasing mindfulness in parents of children with ASD in coping with community stigma and improving mental health.

Vicarious Stigma and Self-Stigma Experienced by Parents of Children with Mental Health and/or Neurodevelopmental Disorders

The stigma of young children with mental health and/or neurodevelopmental disorders is experienced by their parents in at least two ways: self-stigma and vicarious stigma. Secrecy may diminish stigma through impression management or strategic disclosure. The present study explores the relationship between vicarious stigma, self-stigma, secrecy coping, depression, and quality of life. Additionally, we examine the structure of a novel measure of vicarious stigma. Fifty parents of children with mental health and/or neurodevelopmental disorders completed measures. Self-stigma and sadness due to vicarious stigma were significantly associated with greater depression and diminished quality of life. Higher secrecy coping was also associated with higher depression and lower quality of life, supporting the benefits of disclosure. This research meaningfully adds to our understanding of stigma in general, and as experienced by parents of children with mental health and/or neurodevelopmental disorders. Implications for ongoing stigma change development and evaluation are discussed.