The Mediating Effects of Positive Cognitions on Autism Caregivers' Depression and Their Children's Challenging Behaviors

Bouncing Back: Resilience as a Protective Factor for the Impact of Child Problem Behavior on Caregiver Depressive Cognitions Among Youth with Autism Spectrum Disorder

Caregivers of children with autism spectrum disorder (ASD) often report higher rates of depression and the related negative thought patterns that may precede a clinical diagnosis. These negative thought patterns are referred to as depressive cognitions. Depressive cognitions are exacerbated by child problem behaviors (CPB) but may be impacted by parental resilience. The current study examines relations between CPB and depressive cognitions and the role of resilience as a moderator among caregivers of children with ASD (n = 287) and a sample of caregivers of children who are typically developing (n = 207). Significant positive associations were found between CPB and depressive cognitions for caregivers of children with ASD and who are typically developing. A moderation analysis revealed that, among the ASD sample, the model accounted for 33% of the variance in caregiver depressive cognitions (R2 = 0.33, SE = 35.52, p < 0.001). The interaction of child problem behaviors and caregiver resilience on caregiver depressive cognitions was statistically significant (B = - 0.016, SE = 0.007, p = 0.037), thus resilience was a significant moderator, for caregivers of children with ASD. Resilience serves as a protective factor in the relationship between child problem behavior and caregiver depressive cognitions for caregivers of children with ASD only. This finding highlights the importance of assessing and supporting resilience among caregivers of children with ASD. Interventions addressing child behavior would benefit from additional components to bolster caregiver resilience to enhance caregiver mental health and protect against depressive cognitions.

Co-occurrence of Neurodevelopmental Disorders Predict Caretaker Mental Health in a Latinx Sample

Caretakers to children and adults with neurodevelopmental disorders (NDDs) experience more emotional distress compared to community control samples. Risk factors for poorer mental health among this population include symptom severity and an autism spectrum disorder diagnosis. This study aimed to ascertain a relationship between NDD severity and caretakers' mental health. It was hypothesized that co-occurrence of multiple diagnoses would predict higher anxiety and depressive symptomatology and suicidality. Data was collected from a sample of 93 Latinx caregivers to a child or adult with at least one NDD. Multiple NDDs predicted higher levels of anxiety and depression compared to the symptom severity endorsed by caregivers to those with a single NDD diagnosis, but did not predict increased suicidality endorsement. Because caregivers to those with multiple NDDs are at an elevated risk for depression and anxiety, clinicians should consider screening for internalizing disorders in caregivers when treating individual with an NDD.

The Mediating Role of Positive Thinking on the Relationship Between Depression and Functional Recovery in Community-Dwelling People With Schizophrenia

Functional recovery as a consumer-centered approach is critical to recovery for community-dwelling people with schizophrenia. The current study investigated the mediating role of positive thinking in the relationship between depression and functional recovery in community-dwelling people with schizophrenia in South Korea. Depression, positive thinking, and functional recovery measures were completed by 158 people with schizophrenia in the community with self-reported questionnaires. Depression had a significantly negative influence on functional recovery. Positive thinking fully mediated the relationship between depression and functional recovery. An effective intervention strategy for functional recovery in this population may reinforce positive thinking and depression management. [Journal of Psychosocial Nursing and Mental Health Services, 61(2), 44-52.].

The significant mediators between depression and mental health recovery among community-dwelling people with a diagnosed mental disorder

To investigate the mediating roles of community integration and positive thinking on the relationship between depression and mental health recovery among community dwelling people with mental disorders in South Korea. A cross-sectional, descriptive study was utilized. Data were collected from 167 community-dwelling people with mental disorders who did not use the day program at community mental health centers. Data were collected from November 20, 2018, to February 15, 2019. Both community integration and positive thinking were found to mediate the effects of depression on mental health recovery. The mediating effect of positive thinking was significantly greater than that of community integration. This study added evidence for a significant multiple mediating effect of community integration and positive thinking on the relationship between depression and mental health recovery in community-dwelling people with mental disorders. Although the consumer-centered recovery paradigm of people with mental health difficulties is of global importance, little research has been conducted on mental health recovery among community-dwelling people with mental disorders who do not use the day program at community mental health centers. It was found that community integration and positive thinking mediated the effects of depression on mental health recovery, with positive thinking mediating this relationship the most. Thus, these results suggest a specific direction of community mental health services to promote mental health recovery for people with mental disorders who do not have access to community mental health services.

Predictors of the Quality of Life of Informal Carers of Adults on the Autism Spectrum

Carers of adults on the autism spectrum often experience high levels of stress, worry, and caregiver burden. There are few studies identifying the predictors of carer mental well-being and none have been conducted in Australia. Data from the Autism Cooperative Research Centre for Living with Autism's Australian Longitudinal Study of Autism in Adulthood was used to test the conceptual model by Sonido et al. (Rev J Autism Dev Disord, 2019, https://doi.org/10.1007/s40489-019-00177-8 ) by (a) identifying the predictors of mental well-being for carers of adults on the spectrum, (b) using model selection to determine which predictors contribute to the model of best fit, and (c) testing for mediating relationships between the predictors. Several predictors were directly associated with carer psychological quality of life, including carer age, care recipient intellectual disability, and carer intolerance of uncertainty. Model selection strongly supported the inclusion of most clusters from the conceptual model. Some mediating relationships were found, such as care recipient depressive behaviours mediating the relationships between caregiver burden and psychological quality of life. Future studies of the conceptual model will improve understanding of the predictors of carer mental well-being and enable tailored interventions to improve the psychological health of carers of adults on the autism spectrum.

Exploring the Moderating Role of Benefit Finding on the Relationship Between Child Problematic Behaviours and Psychological Distress in Caregivers of Children with ASD

Caregivers of children with ASD often find benefits associated with their caregiving role, and benefit finding predicts lower distress. Child problematic behaviours (CPB), which positively predict caregivers' distress, are perceived to be being less problematic, or more manageable, by caregivers who find benefits. Benefit finding therefore might mitigate the negative psychological impact of CPB. A sample of n = 158 caregivers of children with ASD completed an online survey assessing benefit finding, CPB, and psychological distress. CPB positively, and benefit finding negatively, predicted caregivers' distress. Moderation effects however were not observed. Findings implicate increased CPB and lower benefit finding as risk factors for caregivers' psychological distress. Findings provide clearly definable targets for intervention.

Stress Experiences and Mental Health of Pregnant Women: The Mediating Role of Social Support

Stress in pregnancy is an exceedingly common issue that impacts the mother's mental health and the health of her baby. Yet, women with a supportive network of friends and family may experience lower stress and improved mental health. Therefore, the aims of this secondary analysis were to (a) examine relationships between stress experiences (i.e. perceived stress, pregnancy-specific stress) and indicators of mental health (i.e. absence of depressive symptoms and resourcefulness), (b) determine the effects of social support on stress experiences and indicators of mental health, and (c) determine if social support mediates the relationship between stress experiences and indicators of mental health. A convenience sample of 82 women in their second and third trimester of pregnancy participated in the parent study. Findings indicate that stress experiences were moderately correlated with indicators of mental health and social support predicted stress experiences and indicators of mental health. All social support mediation models were not significant with the exception of social support mediating the relationship between pregnancy-specific stress and resourcefulness. This was the first study to investigate the mediating role of social support on the relationship between pregnancy-specific stress and resourcefulness. Pregnant women may benefit from social support interventions to meaningfully reduce their stress and promote mental health. Such interventions may be physical activity, group prenatal care, or even peripartum home visits.

The Association Between Emotional and Behavioral Problems in Children with Autism Spectrum Disorder and Psychological Distress in Their Parents: A Systematic Review and Meta-analysis

This review (Prospero Registration Number: CRD42017057915) aimed to systematically identify and summarize existing research on the relationship between additional emotional and behavioral problems (EBP) in children with autism, and parenting stress (PS) and mental health problems (MHP) in their parents. Sixty-seven studies met criteria for inclusion in the review, 61 of which were included in the meta-analysis. Pooled correlation coefficients were in the low to moderate range ([Formula: see text]). Some evidence for moderation by measurement characteristics was found. Narrative review of concurrent adjusted associations showed some evidence for shared relationships with other factors, most notably ASD severity and parent perception of own parenting. Longitudinal studies showed mixed evidence for bidirectional predictive relationships between child EBP and parent psychological distress variables.

Perceptions of Family Problems and Pessimism Among Latina and Non-Latina White Mothers Raising Children with Autism Spectrum Disorder

To address the limited research on diverse families of children with ASD, we examined the impact of ASD on 46 Latina and 56 non-Latina White mothers from a resiliency perspective. We explored perceptions of family problems, optimism and pessimism among mothers of child with ASD between 1 and 22 years old. Mothers were recruited through support groups and listservs. Univariate and multivariate analyses were conducted. Results indicated fewer perceived family problems and less pessimism about the child's future among Latina mothers. We found maternal optimism and family cohesion were associated with perceived family problems and mother's pessimism about the child's future. Understanding the impact of ASD among diverse families will aid in developing appropriate services that enhances family strengths.

Positive Thinking Training Intervention for Caregivers of Persons with Autism: Establishing Fidelity

More than 3.5 million in the US are diagnosed with autism spectrum disorder (ASD) and caregivers experience stress that adversely affects their well-being. Positive thinking training (PTT) intervention can minimize that stress. However, before testing the effectiveness of PTT, its fidelity must be established. This pilot intervention trial examined fidelity of an online PTT intervention for ASD caregivers with a random assignment of 73 caregivers to either the online PTT intervention or to the control group. Quantitative data [Positive Thinking Skills Scale (PTSS)] and qualitative data (online weekly homework) were collected. The mean scores for the PTSS improved for the intervention group and decreased for the control group post intervention. Evidence for use of PTT was found in caregivers' online weekly homework. The findings provide evidence of the implementation fidelity of PTT intervention and support moving forward to test PTT effectiveness in promoting caregivers' well-being.

Online Positive Thinking Training Intervention for Caregivers of Individuals with ASD: Necessity, Acceptability and Feasibility

BACKGROUND

More than 3.5 million people in the United States are diagnosed with autism spectrum disorder (ASD). Caring for children with ASD can be stressful and can be detrimental to the well-being of the caregivers (CGs). However, the adverse effects of caregiving on the well-being of CGs may be avoided with appropriate interventions. CGs of persons with ASD might benefit from a positive thinking training (PTT) intervention to help them cope with the stress of caregiving. However, the necessity, acceptability and feasibility for PTT in ASD CGs have not been studied.

OBJECTIVE

To examine the necessity, acceptability and feasibility of a six-week online PTT intervention designed to improve the well-being of the CGs.

DESIGN

Random assignment of ASD CGs to one of two conditions: (1) PTT online intervention or (2) Control group.

RESULTS

The mean score on the depressive cognition scale (DCS) was 20, indicating a high need of PTT to all enrolled CGs. High depressive cognitions in ASD CGs were associated with lower positive thinking (r = -.39; p <.001). Regarding acceptability, CGs indicated that the different strategies and references to real life were the most interesting parts of the intervention. Regarding feasibility, CGs mentioned that listening to the voice-over PowerPoint and visualization was the easiest part of the PTT.

CONCLUSIONS

Examination of the fidelity and effectiveness of the PTT are the next steps in the refinement of this intervention.