Autistic children's age difference in affiliate stigma and resilience of their parents in China: A cross-sectional study

Racial and ethnic group differences in service utilization in children with autism spectrum disorder: The role of parental stigma

Racial and ethnic disparities in service utilization in autism are widely documented. Autism-related parental stigma may play a role if parents from racial/ethnic minoritized backgrounds experience dual stigma from autism and from membership in a marginalized group. This study examines racial/ethnic differences in autism-related stigma and compares the impact of stigma on service utilization in a large, diverse sample of US-based parents of autistic children (final sample = 764; White 41.6%, Black 16.6%, Latino/a/x/Hispanic 20.9%, Asian 7.5%, Multiracial 9.6%, Native American 1.8%, Pacific Islander 0.5%, Middle Eastern 0.2%, and Other 0.2%). Parents completed online surveys assessing affiliate and community stigma, service utilization, and perceived unmet treatment needs. Small but significant racial/ethnic group differences emerged in some aspects of stigma and service utilization. Specifically, Asian and Latino/a/x parents were less likely to fully engage in recommended services; Asian parents endorsed less service availability; Latino/a/x and multiracial parents reported more unmet needs; and Asian and White parents reported significantly more affiliate stigma. There was little indication that stigma contributed to racial/ethnic differences in service utilization, except for Asian families. Results indicate that socioeconomic factors interact with race/ethnicity to impact service use and stigma.

Types and factors affecting and impact of ableism among Asian children and youth with disabilities and their caregivers: a systematic review of quantitative studies

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.

Courtesy stigma among primary caregivers of children with autism spectrum disorder in eastern China

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.

The effect of internalized stigmatization on care burden in adolescent psychiatric patients and their parents

Introduction

The purpose of this study was to determine the effect of internalized stigma perceived by adolescents with mental disorders and their families, on the burden of care on their families.

Methods

The study was conducted in a descriptive and correlational desing with adolescents and their parents who applied to the child and adolescent psychiatry outpatient clinic between March 1 and June 1, 2022. A total 101 adolescents and 101 parents who met the sampling criteria and agreed to participate in the study. Only 1 parent per adolescent was included in the study.

Results

It was found that the mean age of the adolescents was 15.05  ±  (1.80), 57.4% were female and 56.4% were secondary school graduates, and 26.7% of the adolescents, all of whom were unemployed, were diagnosed with a mood disorder, 50.5% had received outpatient treatment previously, and 22.8% had chronic diseases. It was found that the mean age of the parents who participated in the study was 45.53  ±  (6.48), 77.1% were female and 28.7% were secondary school graduates. Also, 22.8% of the parents had a chronic disease, 28.7% had a chronic disease in their family and 32.7% had another family member in need of care, and 17.0% of the parents had received training on mental disorders previously. It was found that the parents' total means ZBI score was 42.74  ±  (11.92). When the ZBI total scores were examined in terms of sociodemographic variables, no significant differences were found between the groups according to the variables. There was only a weak, positive and significant relationship between the age of the parents and in the present study, it was found that adolescents with mental disorders and their families experienced internalized stigmatization and this stigmatization increased the care burden on parents.

Discussion

Mental health and psychiatric nurses can facilitate this population's access to treatment by planning and implementing psychosocial interventions to reduce the internalized stigma of children and adolescents and their families.

The mediating role of perceived social support: alexithymia and parental burnout in parents of children with autism spectrum disorder

Background

Parental burnout is a concept that reflects the emotional exhaustion and emotional distance of parents from children due to their inability to cope with the pressure of parenting. It has been confirmed that parents of autistic children are at higher risk for parental burnout. Additional research has suggested a relationship between parental burnout and parents' personality traits. However, the relationship between alexithymia, an independent personality factor, with parental burnout is little to none.

Objective

To look into the connection between parental burnout and alexithymia among parents of autistic children.

Method

Three hundred and one parents were approached for recruitment and data were collected from 203 parents through a cross-sectional survey assessing parental burnout, alexithymia status, and perceived social support. Because the data is not normally distributed, Spearman's rank correlation coefficient rho(p) was used to assess the correlation between the variables; and then using AMOS to analyze the mediating effects of perceived social support and the moderating effect of gender.

Result

The result showed that (1) There is a negative association between alexithymia with parental burnout (β = 0.6, p < 0.01), while perceive social support was the negative predictor of alexithymia (β = -0.45, p < 0.01) and parental burnout (β = -0.26, p < 0.01); (2) perceive social support partially mediated the relationship between alexithymia and parental burnout of parents of autistic children, which can explain 16.3% of the total effect; (3) Gender plays a moderating role in the first half of the indirect effect of alexithymia on parental burnout, as evidenced by the significant difference in path coefficients between the male and female models (male: β = -0.10, p < 0.05; female: β = -0.60, p < 0.05).

Conclusion

Health professionals and policymakers should be aware of parental burnout among parents of autistic children in China and take early intervention steps. Furthermore, they should recognize the negative impact of alexithymia and the positive impact of social support when developing plans to alleviate parental burnout in children with autism, with a particular focus on mothers with alexithymia, who are more likely to experience low social support and burnout than fathers with alexithymia.

Study subnetwork developing pattern of autism children by non-negative matrix factorization

BACKGROUND

As a developmental disorder, the brain networks of autism children show abnormal patterns compared with that of typically developing. The differences between them are not stable due to the developing progress of children. It has become a choice to study the differences of developing trajectories between autistic and typically developing children by investigating the change of each group respectively. Related researches studied the developing of brain network by analyzing the relationship between network indices of the entire or sub brain networks and the cognitive developing scores.

METHODS

As a matrix decomposition algorithm, non-negative matrix factorization (NMF) was applied to decompose the association matrices of brain networks. By NMF, we can obtain subnetworks in an unsupervised way. The association matrices of autism and control children were estimated by their magnetoencephalography data. NMF was applied to decompose the matrices to obtain common subnetworks of both groups. Then we calculated the expression of each subnetwork in each child's brain network by two indices, energy and entropy. The relationship between the expression and the cognitive and development indices were investigated.

RESULTS

We found a subnetwork with left lateralization pattern in α band showed different expression tendency in two groups. The expression indices of two groups were correlated with cognitive indices in autism and control group in an opposite way. In γ band, a subnetwork with strong connections on right hemisphere of brain showed a negative correlation between the expression indices and development indices in autism group.

CONCLUSION

NMF algorithm can effectively decompose brain network to meaningful subnetworks. The finding of α band subnetworks confirms the results of abnormal lateralization of autistic children mentioned in relevant studies. We assume the results of decrease of expression of the subnetwork may relate to the dysfunction of mirror neuron. The decrease expression of γ subnetwork of autism may be related to the weaken process of high-frequency neurons in the neurotrophic competition.

The Relationship between Psychosocial Factors and Affiliate Stigma in Parents of Children with ADHD: Systematic Literature Review

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).