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Salleh NS, Tang LY, Husain M, Lim Abdullah K, Kueh YC. Affiliate Stigma, Resilience and Quality of Life among Parents of Children with Autism Spectrum Disorder in Two Public Hospitals in Kelantan, Malaysia. Malays J Med Sci 2024; 31:217-228. [PMID: 38984240 PMCID: PMC11229570 DOI: 10.21315/mjms2024.31.3.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 10/07/2023] [Indexed: 07/11/2024] Open
Abstract
Background Often, the indirect impact of autism spectrum disorder (ASD) presents the family with significant challenges. One of these challenges is affiliate stigma due to parental affiliation with their child. This study aimed to explore affiliate stigma, resilience and quality of life (QoL) among parents of children with ASD. Methods Cross-sectional study of 144 parents of children with ASD were recruited from two main tertiary hospitals in Kelantan, Malaysia, a developing country in Southeast Asia. Pearson correlation was used to examine the relationship between parental affiliate stigma, resilience and QoL. Simple and multiple linear regression analyses were used to identify the significant associated factors of affiliate stigma, resilience and QoL. Results Correlational analyses revealed that perceived affiliate stigma demonstrated an inverse relationship with resilience and QoL. Additionally, resilience had a positive relationship with QoL. Regression analyses revealed that the father's employment status, the mother's level of education, having a disability card, the child's age at ASD diagnosis, comorbidities of the child and ASD severity perceived by parents were associated with parental affiliate stigma, resilience and QoL. Conclusion Study findings highlight the contribution of socio-demographic characteristics of children with ASD and their families in the determination of affiliate stigma, resilience and QoL.
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Affiliation(s)
- Noor Shuhada Salleh
- Nursing Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan Malaysia
| | - Li Yoong Tang
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Maruzairi Husain
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Khatijah Lim Abdullah
- Department of Nursing, School of Medical and Life Sciences, Sunway University, Selangor, Malaysia
| | - Yee Cheng Kueh
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
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Wang YN, Lin QH, Meng D, Wang J, Xu HP, Wei WH, Zhang JY. Relationship Between Mindfulness and Affiliate Stigma in Parents of Children with Autism Spectrum Disorder in China: The Mediating Role of Coping Styles. Asian Nurs Res (Korean Soc Nurs Sci) 2024; 18:89-96. [PMID: 38583799 DOI: 10.1016/j.anr.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/21/2024] [Accepted: 03/31/2024] [Indexed: 04/09/2024] Open
Abstract
PURPOSE This study aims to investigate the current status of affiliate stigma among parents of autistic children, analyze the influencing factors, explore the relationship among mindfulness, coping styles, and affiliate stigma, and verify the mediating role of coping styles between mindfulness and affiliate stigma in parents of children with autism in China. METHOD Between February and April 2023, the Child Development Behaviour Centre of a public hospital in China recruited 345 parents of children with autism. These parents completed the general information questionnaire, the Mindful Attention Awareness Scale, the Affiliate Stigma Scale, and the Simple Coping Style Questionnaire. We then adapted the Hayes Process Macro and Bootstrap methods to examine the mediating effects of coping styles between mindfulness and affiliate stigma. RESULTS (1) The total affiliate stigma score of parents of children with autism was 48.53 (standard deviation:: 10.74). Parents' age, monthly family income, duration of care, mindfulness, and coping styles were the influencing factors of parental affiliate stigma. (2) Mindfulness was positively correlated with positive coping style (r = 0.33, p < .01) and negatively correlated with negative coping style, affiliate stigma (r = -0.38, -0.39, p < .01), whereas affiliate stigma was negatively correlated with positive coping style (r = -0.34, p < .01) and positively correlated with negative coping style (r = 0.41, p < .01). (3) Positive coping style and negative coping style play a parallel mediating role between mindfulness and affiliate stigma of parents of autistic children. CONCLUSIONS Parents of children with autism experience significant levels of affiliate stigma. Mindfulness has a direct impact on associated stigma in parents of children with autism and also indirectly predicts associated stigma through the intermediary influence of positive and negative coping styles. Healthcare professionals could perform mindfulness interventions from an optimistic psychology viewpoint to boost parents' mindfulness and coping abilities, thereby accomplishing the objective of mitigating affiliate stigma.
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Affiliation(s)
- Ya-Nan Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Qi-Heng Lin
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Dan Meng
- Xinxiang Central Hospital, Xinxiang, Henan Province, 453000, China
| | - Jing Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Hai-Ping Xu
- Department of Child Developmental Behavior, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, 450052, China
| | - Wan-Hong Wei
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Jin-Yan Zhang
- Quality Control Office of the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, 450014, China.
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Li Y, Fuentes K, Hsu S, Ragunathan S, Lindsay S. Types and factors affecting and impact of ableism among Asian children and youth with disabilities and their caregivers: a systematic review of quantitative studies. Disabil Rehabil 2024:1-21. [PMID: 38339994 DOI: 10.1080/09638288.2024.2310755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 01/20/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE Asian children and youth with disabilities often experience multiple barriers and discrimination in education, healthcare, and social settings, which influence their well-being, especially the transition to adulthood. This review aims to explore the types, factors affecting and impact of ableism on Asian children and youth with disabilities and their caregivers. METHODS We conducted a systematic review and a narrative synthesis whereby we searched the literature from six international databases, including Healthstar, Ovid Medline, Embase, PsycInfo, Scopus, and Web of Science. RESULTS Twenty-nine studies were included in the review, and three themes were identified that related to ableism: (1) types and rates of ableism (i.e., stigma, bullying and victimization, and discrimination and inequalities); (2) factors affecting ableism (i.e. sociodemographic factors, familial factors, and societal factors); and (3) impacts of ableism (i.e. mental health, family impacts, and societal impacts). CONCLUSIONS Our review highlights that ableism has various types and can be influenced by multiple factors, influencing social and health outcomes of Asian families with children and youth with disabilities. This review also emphasizes the importance of increasing the public's awareness regarding disabilities to reduce ableism among Asian families with children with disabilities.
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Affiliation(s)
- Yiyan Li
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
| | - Kristina Fuentes
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
| | - Shaelynn Hsu
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
- Faculty of Science, York University, Toronto, Canada
| | - Sharmigaa Ragunathan
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
| | - Sally Lindsay
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
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Chen X, Tong J, Jiang B, Ma S, Wang X, Sun X, Liu Y, Yan D, Wang L. Courtesy stigma among primary caregivers of children with autism spectrum disorder in eastern China. Front Psychiatry 2023; 14:1236025. [PMID: 38045614 PMCID: PMC10690950 DOI: 10.3389/fpsyt.2023.1236025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 11/06/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction The experience and perception of stigma is a common problem among primary caregivers of children with autism spectrum disorder (ASD), and has a profound adverse impact on primary caregivers and children with ASD; however, few studies have explored courtesy stigma among primary caregivers of children with ASD in the Chinese context. The aim of this study was to explore the status of courtesy stigma among primary caregivers of children with ASD in Lianyungang, Jiangsu Province, Eastern China, and to conduct in-depth analysis of its predictors from multiple perspectives. Methods An institution-based multi-center cross-sectional survey was conducted in the rehabilitation department of a large specialized hospital and 10 rehabilitation centers for children with special needs in Lianyungang, Jiangsu Province, Eastern China, from October 2022 to February 2023. A structured questionnaire to assess child-related factors, primary caregiver-related factors, courtesy stigma, general self-efficacy, and social support, was used to collect data. Predictors of courtesy stigma among primary caregivers of children with ASD were identified by linear regression. Results A total of 428 primary caregivers of children with ASD were recruited. The mean ± standard deviation (SD) score for courtesy stigma was 7.49 ± 4.13. Multiple linear regression analysis revealed that primary caregivers of children with ASD who were not too satisfied with their current marital status (β = 1.21, 95% CI: 0.34-2.08, p < 0.05) were more likely to have a high courtesy stigma; however, significantly lower courtesy stigma was observed in primary caregivers of children with ASD who were not picky eaters (β = -1.33, 95% CI: -2.08 - -0.58, p < 0.05), and who reported low level challenge in caring for children with ASD (β = -1.16, 95% CI: -2.20 - -0.12, p < 0.05), good general self-efficacy (β = -0.16, 95% CI: -0.25 - -0.06, p < 0.05), and good social support (β = -0.04, 95% CI: -0.08 - -0.01, p < 0.05). Conclusion There is a high level of courtesy stigma among primary caregivers of children with ASD in eastern China, and it is affected by numerous factors. More resources should be directed to groups that are more likely to experience stigma.
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Affiliation(s)
- Xu Chen
- Lianyungang Maternal and Child Health Hospital, Lianyungang, China
| | - Jiao Tong
- Lianyungang Maternal and Child Health Hospital, Lianyungang, China
| | | | - Shan Ma
- Lianyungang Maternal and Child Health Hospital, Lianyungang, China
| | - Xin Wang
- Lianyungang Maternal and Child Health Hospital, Lianyungang, China
| | - Xun Sun
- Lianyungang Maternal and Child Health Hospital, Lianyungang, China
| | - Yuan Liu
- Lianyungang Maternal and Child Health Hospital, Lianyungang, China
| | - Dongmei Yan
- Lianyungang Maternal and Child Health Hospital, Lianyungang, China
| | - Leilei Wang
- Lianyungang Maternal and Child Health Hospital, Lianyungang, China
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Lockwood Estrin G, Bhavnani S, Arora R, Gulati S, Divan G. Caregiver Perceptions of Autism and Neurodevelopmental Disabilities in New Delhi, India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5291. [PMID: 37047907 PMCID: PMC10094583 DOI: 10.3390/ijerph20075291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/24/2023] [Accepted: 03/06/2023] [Indexed: 06/19/2023]
Abstract
Evidence suggests that parenting an autistic child or a child with neurodevelopmental disabilities can be more challenging than parenting a child meeting their developmental milestones, especially when there is a dearth of support services, such as in low- and middle-income countries (LMICs). Despite the majority of the world's children residing in LMICs, there are limited studies examining the understanding of developmental disorders and autism in these regions. We therefore aim to investigate perceptions of autism and developmental disabilities in caregivers of children in an urban setting in New Delhi, India. Thirteen semi-structured interviews with parents/caregivers of children were conducted in three groups: (1) caregivers with a child with a diagnosis of autism spectrum disorder (ASD); (2) caregivers with a child with a diagnosis of intellectual disability (ID); (3) and caregivers with children meeting their developmental milestones. Transcripts were analysed using framework analysis. Three themes on the impact of cultural and contextual factors on the recognition, interpretation, and reporting of autistic symptoms are discussed, and additional themes focus on the impact of diagnosis and family support. Our findings highlighted a vital need for greater community awareness and recognition of autism in India, for example through community and healthcare training, which may help to reduce stigma and facilitate wider family support.
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Affiliation(s)
- Georgia Lockwood Estrin
- School of Psychology, University of East London, Arthur Edwards Building, Water Lane, London E15 4LZ, UK
- Child Development Group, Sangath, Bardez 403501, India; (S.B.); (G.D.)
| | - Supriya Bhavnani
- Child Development Group, Sangath, Bardez 403501, India; (S.B.); (G.D.)
| | - Rashi Arora
- Child Development Group, Sangath, Bardez 403501, India; (S.B.); (G.D.)
| | - Sheffali Gulati
- Center of Excellence and Advanced Research on Childhood Neurodevelopmental Disorders, Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India;
| | - Gauri Divan
- Child Development Group, Sangath, Bardez 403501, India; (S.B.); (G.D.)
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Aušraitė M, Žardeckaitė-Matulaitienė K. The Relationship between Psychosocial Factors and Affiliate Stigma in Parents of Children with ADHD: Systematic Literature Review. PSICHOLOGIJA 2022. [DOI: 10.15388/psichol.2022.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The aim of this study is to identify the psychosocial factors which are related with affiliate stigma in parents of children with ADHD through a systematic literature review. This review includes English publications from 2008 to 2022, which present the results of quantitative studies on the relationship between psychosocial factors and affiliate stigma in parents of children with ADHD. According to eligibility criteria, 7 articles were included in the review. The results showed that higher parental affiliate stigma is associated with lower parents’ psychosocial functioning (higher expressed depression, anxiety, lower self-esteem). It was also found that higher parental affiliate stigma is related to unfavorable behavior towards a child (higher expressed negativity/ less constructive parenting). The results also showed that higher parental affiliate stigma is associated with more expressed child's difficulties (ADHD symptoms/ internalizing and externalizing difficulties).
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7
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A qualitative study on the experience of stigma for Chinese parents of children with autism spectrum disorder. Sci Rep 2022; 12:19550. [PMID: 36379973 PMCID: PMC9666461 DOI: 10.1038/s41598-022-23978-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022] Open
Abstract
Experiencing stigma related to having a child with autism spectrum disorder (ASD) can be difficult and is detrimental to parent well-being. Since the research on stigmatized experiences among parents of children with ASD in non-Western communities is limited, this qualitative study examined the experiences, reactions and impacts of stigma on parents of children with ASD in Hong Kong. In-depth interviews were conducted with 54 Chinese parents/caregivers of children with ASD aged between 35 and 73 years old. Data were analyzed using an inductive approach. The participants reported stigma which stemmed from negative labelling of their children by schools and healthcare professionals, bullying by peers, stereotypes of ASD and stigma linked to autistic children's behavior in the community. The reactions of participants towards stigmatization were classified into internalizing reactions including apologizing, ignoring and concealing ASD and externalizing reactions such as fighting back. The participants also reported impacts of stigma on both personal and emotional levels. The results point to the urgent need for the government to allocate resources and make concerted efforts to reduce stigma by educating the community to foster more positive attitudes towards individuals with ASD and offer support and counselling services to parents.
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8
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Sher DA, Gibson JL, Sher HE. 'We've come a very, very, long way' Overcoming stigma of autism: An interpretative phenomenological analysis within the UK Jewish community. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:2066-2083. [PMID: 35317657 PMCID: PMC9597152 DOI: 10.1177/13623613221075099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT Autistic people contend with high levels of stigma in a wide array of cultures worldwide. There is a scarcity of literature on stigma in relation to autism in faith communities, with some limited research on this issue in Christian, Muslim and Hindu populations. There is virtually no research focussing on this topic in Jewish communities and to our knowledge, none at all within UK Jewish contexts. In this study, we aimed to explore experiences of stigma towards autism and sought views on what steps have and can be taken to reduce such stigma. Using an interpretative phenomenological analysis approach, we conducted semi-structured interviews with 10 participants within the UK Jewish community, including parents, rabbis, SENDCos, teachers, and headmasters of autistic children in both mainstream and specialist autistic schools. Interviews were conducted over 2 months in 2020. During analysis, 5 superordinate (central) themes and 13 subordinate themes were abstracted from the data. Superordinate themes included 'Stigma not specific to the Jewish community'; 'Considerable strides made'; 'More a lack of knowledge or denial than stigma'; 'Fear of stigma is a real concern but not widely prevalent'; and 'Potent factors that reduce stigma in the Jewish community'. We recommend workshops for greater awareness and training for teachers and parents on autism and autistic children's experiences. We also recommend the formation of specialist autism schools in other communities and promotion of positive narratives concerning autistic people, as this successfully reduced stigma within the Jewish community.
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Lyu QY, Yu XX, Wang JL, Wang XY, Ke QQ, Liu D, Yang QH. Self-esteem and family functioning mediates the association of symptom severity and parental affiliate stigma among families with children with ASD. J Pediatr Nurs 2022; 66:e122-e129. [PMID: 35537979 DOI: 10.1016/j.pedn.2022.04.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 04/24/2022] [Accepted: 04/27/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To investigate the level of affiliate stigma among parents of children with autism spectrum disorder and to explore the mediating role of self-esteem and family functioning. DESIGN AND METHODS A cross-sectional study was conducted in a large regional hospital and two childhood rehabilitation centers in Guangdong, China. Data related to demographics, parental self-esteem, family functioning, and affiliate stigma were collected from 180 parents of children diagnosed with ASD. We used t-tests, analysis of variance, and correlation analysis to explore the related factors of parental affiliate stigma. Path analysis was used to determine the mediating roles of self-esteem and family functioning in the relationship between symptom severity and affiliate stigma. RESULTS Parents of children with autism spectrum disorder in China experienced low self-esteem, family functioning, and high affiliate stigma. Symptom severity was negatively correlated with self-esteem and family functioning. Self-esteem and family functioning were significantly negatively correlated with affiliate stigma. Symptom severity was positively correlated with affiliate stigma. Self-esteem and family functioning mediated the relationship between symptom severity and affiliate stigma. CONCLUSIONS Symptom severity affects parental affiliate stigma among families with children with ASD. Self-esteem and family functioning are the two mediators in the relationship. We should take steps to improve self-esteem and family functioning in order to alleviate parental affiliate stigma. PRACTICE IMPLICATIONS This study emphasizes the importance of the influence of ASD severity and family functioning on affiliate stigma. In clinical practice, psychological support should be provided for parents of children with ASD to improve their mental health.
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Affiliation(s)
- Qi-Yuan Lyu
- School of Nursing, Jinan University, Guangzhou, China
| | - Xiao-Xue Yu
- School of Nursing, Jinan University, Guangzhou, China
| | - Jia-le Wang
- School of Nursing, Jinan University, Guangzhou, China
| | - Xin-Yu Wang
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Qi-Qi Ke
- School of Nursing, Jinan University, Guangzhou, China
| | - Dan Liu
- Tianyu Education Training Center, Chancheng District, Foshan, Guangdong, China
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Ji B, Jiang X, Luo Y. Autistic children's age difference in affiliate stigma and resilience of their parents in China: A cross-sectional study. Arch Psychiatr Nurs 2022; 39:7-12. [PMID: 35688547 DOI: 10.1016/j.apnu.2022.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Parents of children with Autism Spectrum Disorders (ASD) experience high levels of stigma, especially in China where the culture is shame socialized. Resilience can help overcome stigma; while parent characteristics predict resilience, other factors may also be significant such as the child's age. OBJECTIVE The study sought to identify the differences in affiliate stigma and resilience among Chinese parents of children with ASD according to the child's age, and to determine whether the levels of resilience and experience of stigma are related. METHODS A cross-sectional survey of 184 parents of children with ASD was conducted. Affiliate stigma and resilience were measured using the Chinese version of the 22-item Affiliate Stigma Scale and the Chinese version of the Connor-Davidson Resilience Scale. Differences were examined by using regression and correlation analysis. RESULTS Parents of school-age children experienced more affiliate stigma than parents of preschoolers, but there was no difference in resilience when other factors were controlled. CONCLUSIONS Considering the child's age is important to understand affiliate stigma and resilience, particularly where resilience is protective and could inform the design of support strategies for preschooler parents.
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Affiliation(s)
- Binbin Ji
- School of Nursing, Hunan University of Chinese Medicine, Changsha, China
| | - Xiaojian Jiang
- School of Nursing, Hunan University of Chinese Medicine, Changsha, China
| | - Yaoyue Luo
- School of Nursing, Hunan University of Chinese Medicine, Changsha, China.
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Patel AD, Arya A, Agarwal V, Gupta PK, Agarwal M. Burden of care and quality of life in caregivers of children and adolescents with autism spectrum disorder. Asian J Psychiatr 2022; 70:103030. [PMID: 35180464 DOI: 10.1016/j.ajp.2022.103030] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/29/2022] [Accepted: 02/11/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Autism spectrum disorder is a neurodevelopmental disorder which is increasing across the globe. The disorder in children not only creates burden of care in caregivers but also leads to impaired quality of life of families. OBJECTIVE To study the burden of care and quality of life in caregivers of children and adolescents with ASD. METHODOLOGY Cross sectional study conducted in Child and Adolescent psychiatry outpatient services at a government centre in north India between September 2014 to August 2015. The sample consisted of 40 caregivers of children with Autism. Mean age of the caregiver's were 34.72 ± 6.32 years. Burden of care and quality of life were measured by Burden Assessment Schedule (BAS) and World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF) questionnaire respectively. RESULTS Mean burden of care on BAS was 71.73 ± 8.62 indicating quite a high degree of burden on the caregivers of ASD. Significantly higher burden was reported by caregivers belonging to low income families and caregivers of children in age group 6-12 years. A positive correlation was observed between severity of autism and burden of care in caregivers. The study also found that as the severity of symptom increases the QoL in caregiver worsens. CONCLUSION Caregivers of children with ASD suffer from high burden of care and impaired QoL.
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Affiliation(s)
- Amar Deep Patel
- Department of Psychiatry, Maharaja Suhel Dev Autonomous State Medical College, Bahraich, Uttar Pradesh, India.
| | - Amit Arya
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India.
| | - Vivek Agarwal
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India.
| | - Pawan Kumar Gupta
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India.
| | - Manu Agarwal
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India.
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12
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Kumari R, Ranjan JK, Verma S, Asthana HS. Hindi Adaptation and Psychometric Validation of the Affiliate Stigma Scale. Indian J Psychol Med 2022; 44:167-172. [PMID: 35655969 PMCID: PMC9120987 DOI: 10.1177/0253717620939253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The Affiliate Stigma Scale (ASS) is a widely used tool to measure affiliate stigma in the caregivers of individuals with various types of mental illnesses. However, the Hindi adaptation of this scale with evident psychometric properties is not available. This study aimed to adapt the ASS in the Hindi language and, further, to validate it in the Indian setting. METHODS Translation and back-translation methods were used to translate the original items of the ASS to the Hindi language. After completion of translations and linguistic adaptation process, the Hindi translated version of the ASS, WHO Quality of Life-BREF (WHOQOL-BREF), General Health Questionnaire-12 (GHQ-12), and Hospital Anxiety and Depression Scale (HADS) were administered to 140 caregivers of persons with mental illness. Purposive sampling method was adopted. The age range of the participants was 17-60 years. Psychometric properties, as well as the factor structures of the scale, were evaluated. RESULTS The Hindi version of the ASS has adequate internal consistencies (r = 0.87-0.93) and test-retest reliability (r = 0.78, P < 0.001). The concurrent validity of this scale was also high, as the correlation coefficients among the Hindi version of the ASS, WHOQOL-BREF, GHQ-12, and HADS were ranging from 0.23 to 0.35. The exploratory factor analysis revealed three underlying factors, namely, cognition, affect, and behavior. CONCLUSIONS The Hindi version of the ASS is a reliable and valid psychometric tool to measure affiliate stigma in caregivers of patients with mental illness.
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Affiliation(s)
- Rajbala Kumari
- Dept of Psychology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Jay Kumar Ranjan
- Dept of Psychology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Saroj Verma
- Dept of Psychology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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13
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Papadopoulos A, Tafiadis D, Tsapara A, Skapinakis P, Tzoufi M, Siafaka V. Validation of the Greek version of the Affiliate Stigma Scale among mothers of children with autism spectrum disorder. BJPsych Open 2022; 8:e30. [PMID: 35045904 PMCID: PMC8811780 DOI: 10.1192/bjo.2021.1083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/24/2021] [Accepted: 12/10/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Caregivers of children with autism spectrum disorder (ASD) are sensitive to the internalisation of the stigma, known as affiliate stigma, resulting in reduced self-esteem, isolation and poor psychological well-being. AIMS This study aims to validate the Greek version of the Affiliate Stigma Scale (ASS) among mothers of children with ASD. METHOD The translated version of ASS in Greek was administered to 53 mothers of children newly diagnosed with ASD in two time periods: 1-6 months from diagnosis (time point 1) and 12 months from the initial assessment (time point 2). The control group consisted of 62 mothers of typically developing children. RESULTS The ASS total mean score revealed a moderate level of stigma to the ASD group in both assessments. The reliability measures by item showed a satisfactory composite reliability (affective 0.828, cognitive 0.833, behaviour 0.857). Cronbach's alpha revealed that the estimated internal consistency was excellent (α = 0.888), and it found a high positive item-total correlation. Receiver operating characteristic analysis results indicated a statistically significant positive discrimination (area under the curve 0.849, P = 0.000) between the groups. The cut-off point was 31.00, with a sensitivity of 0.849 and a 1 - sensitivity of 0.258. CONCLUSIONS The proposed version of the ASS has good psychometric properties and is valid and reliable for measuring affiliate stigma among caregivers of children with ASD in Greece. Health professionals can use it to assess and understand the stigma experienced by caregivers of children with ASD, and design appropriate interventions to reduce their affiliate stigma.
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Affiliation(s)
| | - Dionysios Tafiadis
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Greece
| | - Angeliki Tsapara
- Faculty of Medicine, School of Health Sciences, University of Patras, Greece
| | - Petros Skapinakis
- Faculty of Medicine, School of Health Sciences, University of Ioannina, Greece
| | - Meropi Tzoufi
- Faculty of Medicine, School of Health Sciences, University of Ioannina, Greece
| | - Vassiliki Siafaka
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Greece
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14
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Gabra RH, Hashem DF. Comparison of caregivers’ characteristics, stigma, and disease burden of children with autism spectrum disorder and attention-deficit disorder in Egypt. MIDDLE EAST CURRENT PSYCHIATRY 2021. [DOI: 10.1186/s43045-021-00162-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Studies show that autism spectrum disorder and attention-deficit hyperactivity disorder place a significant stigma and burden on caregivers, economically as well as socially, psychologically, and emotionally. The current study aims to assess caregivers of those children with reference to stigma and disease burden, evaluation of different psychiatric symptoms, and quality of life. Also, it aims to compare the extent of such disruption related to the type of the disorder (ASD versus ADHD). A cross-sectional, analytical study was designed including 72 caregivers {38 caregivers of autism versus 34 caregivers of ADHD}; all of them were assessed for (1) stigma; (2) disease burden; (3) depression, anxiety, and sensitivity; and (4) quality of life.
Results
The current results show that caregivers of ASD and ADHD have a higher score of stigmas, burden, depression, anxiety, and a poorer QoL than normal; all these variables are worse in ASD caregivers than ADHD caregivers.
Conclusion
This study supports the notion that both ADHD and ASD pose a great challenge for their caregivers which is higher in ASD than ADHD caregivers.
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15
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Turlapati S, Krishna S, Deepak KU, Kanagaraja B, Gayathri KA, Jahagirdar D. A Cross-Sectional Study: Are Myths on Cleft Lip and Palate Still Prevalent? Cureus 2021; 13:e19579. [PMID: 34926050 PMCID: PMC8671751 DOI: 10.7759/cureus.19579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2021] [Indexed: 11/18/2022] Open
Abstract
Background The etiology of cleft lip and palate (CL/P) remains largely unidentified. Evidence-based research shows a strong association with genetics, environmental factors, nutritional deficiency, smoking, alcohol, and drug misuse. Despite the increase in knowledge and widespread access to medical care beliefs contrary to science, folklores on CLP still occur in most developing countries. Methodology The study design was cross-sectional in nature and involved a sample of 136 parents of children with cleft lip and palate reporting to Smile Train Cleft Centers. It was conducted by using a self-structured questionnaire from December to March 2019. Results The highest recorded response was holding sharp objects, such as knives, scissors, or needles, during pregnancy (40.4%) and the least recorded response was for pregnant women going out on an auspicious day (3.7%). Conclusion The current study demonstrated that a majority of the parent’s socioeconomic status was upper lower class. Some parents still believe in the myths around the etiology of CLP despite the advances in medicine and technology.
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Affiliation(s)
- Sravya Turlapati
- Public Health Dentistry, Government Dental College & Hospital, Hyderabad, IND
| | - Sai Krishna
- Preventive & Community Dentistry, S.B. Patil Dental College, Bidar, IND
| | - Korutla U Deepak
- Department of Public Health, University of Huddersfield, West Yorkshire, England, GBR
| | | | | | - Divya Jahagirdar
- Dental Surgery, Government Dental College & Hospital, Hyderabad, IND
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16
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Čolić M. Clarification of stigma concepts in research with families of individuals with neurodevelopmental disabilities. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 69:621-627. [PMID: 37346251 PMCID: PMC10281341 DOI: 10.1080/20473869.2021.1989978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/28/2021] [Accepted: 09/28/2021] [Indexed: 06/23/2023]
Abstract
Stigma concepts among families of individuals with neurodevelopmental disabilities have received increased attention from researchers in the past decade. With a growing number of studies published, there are also notable discrepancies in conceptualizations and uses of stigma terms among scholars. These variations may result in inadequate comparisons of findings across studies and a failure to generalize the results. Therefore, I have compared various stigma concepts and offered key features of each term as well as suggested methodology for facilitating stigma research.
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Affiliation(s)
- Marija Čolić
- Department of Special Education, University of Hawaiʻi at Mānoa, Honolulu, HI, USA
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17
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Abstract
PURPOSE OF REVIEW Children and adolescents with mental health difficulties, and people associated with them, can experience stigma as a result of these difficulties. This article aims to provide an update on the literature pertaining to mental health-related stigma in children and adolescents. RECENT FINDINGS Recent studies have investigated public stigma, self-stigma and affiliate stigma related to child and adolescent mental health difficulties. Research has typically employed a cross-sectional design. Significant variation was identified in both study methodology and study findings. Qualitative studies offer a unique perspective of stigma from the point of view of the stigmatized individual. Significantly, quantitative analysis has found different variables to be associated with stigma in different geographical locations, even when similar measures are used. SUMMARY Stigma can have a significant detrimental impact on the quality of life for those affected. Careful attention should therefore be paid to stigma in the assessment and treatment of children and adolescents with mental health difficulties. Furthermore, its impact on their caregivers should not be overlooked. Further research is needed to understand the role of social and cultural factors in the development and impact of stigma, and may aid production of antistigma interventions.
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18
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Jagannathan A, Kurhade C, Muniraju SR. Do children receiving mental health treatment understand the concept of self-stigma? Asian J Psychiatr 2020; 51:102016. [PMID: 32247878 DOI: 10.1016/j.ajp.2020.102016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/04/2020] [Accepted: 03/19/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Aarti Jagannathan
- Psychiatric Rehabilitation Services, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, India.
| | - Chhaya Kurhade
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, India.
| | - S R Muniraju
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, India.
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19
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Jahan S, Araf K, Griffiths MD, Gozal D, Mamun MA. Depression and suicidal behaviors among Bangladeshi mothers of children with Autism Spectrum Disorder: A comparative study. Asian J Psychiatr 2020; 51:101994. [PMID: 32146143 DOI: 10.1016/j.ajp.2020.101994] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 02/25/2020] [Indexed: 12/28/2022]
Affiliation(s)
- Sharmin Jahan
- Undergraduate Research Organization, Savar, Dhaka, Bangladesh; Department of Food and Nutrition, College of Home Economics, University of Dhaka, Dhaka, Bangladesh.
| | - Kazi Araf
- Department of Food and Nutrition, National College of Home Economics, Dhaka, Bangladesh
| | - Mark D Griffiths
- Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, UK
| | - David Gozal
- Department of Child Health and the Child Health Research Institute, The University of Missouri School of Medicine, Columbia, MO, United States
| | - Mohammed A Mamun
- Undergraduate Research Organization, Savar, Dhaka, Bangladesh; Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh.
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20
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Masiran R, Ibrahim N, Awang H, Lim PY. Improving multicultural parenting program for children with emotional and behavioral problems: An integrated review. Asian J Psychiatr 2020; 51:101851. [PMID: 31711780 DOI: 10.1016/j.ajp.2019.101851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/16/2019] [Accepted: 10/16/2019] [Indexed: 01/13/2023]
Abstract
Children with emotional and behavioral problems are often managed using medications or behavioral therapy, but in some countries, there is no structured parenting intervention to equip parents from different cultural backgrounds with adequate parenting skills to help these children. This paper aims to synthesize key findings from previous research on multicultural parenting programs and produce a comprehensive integrated view by looking into three separate themes: effective multicultural parenting programs, ethnocultural groups and cultural adaptation process. Literature search through Scopus and Google Scholar from 1999 to 2019 was conducted using the terms "effective parenting program", "effective parenting intervention", "effective multicultural parenting program", "effective multicultural parenting intervention", "multicultural parenting program", "multicultural parenting intervention", "parenting program and ethnic groups", "parenting intervention and ethnic groups", "adapted parenting program", "adapted parenting intervention", "cultural adaptation of parenting program'' and "cultural adaptation of parenting intervention". By applying the "Literature Review Synthesis Process", authors conducted cross-analysis, integrated possibilities, and prioritized the synthesized information gearing towards highly probable solutions for improving multicultural parenting programs to manage emotional and behavioral problems in children better. Development of a culturally fit parenting intervention and its implications on existing parenting programs are also discussed. The findings highlight the need 1) to engage with ethnocultural groups of parents during development of a new multicultural parenting program, and 2) to incorporate specific measures for engaging with parents during multicultural parenting program implementation. This paper contributes in acknowledging cultural components in future parenting intervention programs. Finally, recommendations are made for future directions of research.
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Affiliation(s)
- Ruziana Masiran
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
| | - Normala Ibrahim
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
| | - Hamidin Awang
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
| | - Poh Ying Lim
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
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21
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Ng CKM, Lam SHF, Tsang STK, Yuen CMC, Chien CW. The Relationship between Affiliate Stigma in Parents of Children with Autism Spectrum Disorder and Their Children's Activity Participation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051799. [PMID: 32164271 PMCID: PMC7084220 DOI: 10.3390/ijerph17051799] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/08/2020] [Accepted: 03/09/2020] [Indexed: 12/27/2022]
Abstract
Children with autism spectrum disorder (ASD) are reported to participate less in everyday activities, and their parents face stigma on account of having a child with ASD, which they often internalize as affiliate stigma. Studies have examined the impact of affiliate stigma on parents’ psychological well-being and social behaviors, but little is known about how affiliate stigma impacts their children’s activity participation. This study aimed to investigate the relationship between parents’ affiliate stigma and activity participation of their children with ASD. Sixty-three parents of children with ASD (aged 2–6 years) were recruited. They completed questionnaires, which captured affiliate stigma, their child’s participation (frequency and involvement) in home, preschool, and community activities, and demographic characteristics. Results indicated that these parents had a moderate level of affiliate stigma, which did not correlate with the frequency of their children’s participation in activities. However, the parents’ affiliate stigma was found to have negative impacts on their children’s involvement in overall community participation and participation in one particular activity at home. The findings highlight the importance of destigmatization of parents of children with ASD in order to promote their children’s participation in community activities.
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Affiliation(s)
| | | | | | | | - Chi-Wen Chien
- Correspondence: ; Tel.: +852-2766-6703; Fax: +852-2330-8656
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22
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Liao X, Lei X, Li Y. Stigma among parents of children with autism: A literature review. Asian J Psychiatr 2019; 45:88-94. [PMID: 31542694 DOI: 10.1016/j.ajp.2019.09.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 09/04/2019] [Accepted: 09/05/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This literature review aims to summarize current findings from studies examined experiences of stigma among parents of children with autism. METHOD A systematic literature search was carried out to identify relevant studies. Two reviewers independently screened each records based on the selection criteria. Discrepancies were resolved through discussions. Included articles were classified by social-cultural settings. RESULT 25 studies were identified and included in the review, including 15 qualitative, 8 quantitative, and 2 mixed method studies. Parents do in fact experience courtesy stigma which subsequently develop into affiliate stigma. The study of stigma has not received enough attention for parents of children with autism. There lacked large prevalence studies and longitudinal studies examining stigma among parents of children with autism. CONCLUSION Parents of children with autism perceived and experienced stigma and various consequences which were varied with behaviors of autism and the severity of symptoms. Further studies should focus on developing intervention that help to erase stigma among parents of children with autism.
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Affiliation(s)
- Xiaoli Liao
- The Second Xiangya Hospital, Central South University, XiangYa Nursing School of Central South University, Changsha, Hunan, China.
| | - Xianyang Lei
- The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Yamin Li
- The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
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