Child behavior problems and parental psychological distress in Chinese families of children with autism: The putative moderating role of parental social support and cultural values

The wellbeing of parents of children with autism residing in mainland China remains understudied. We aimed to examine whether and how parental perceived social support, individualism, and collectivism acted together to moderate the relationships between child behavior problems and parental psychological distress in Chinese parents of children with autism. With convenience and snowball sampling, data on 268 primary caregiver parents of children with autism were collected from an online cross-sectional survey. Linear regression analysis indicated that child behavior problems were significantly associated with increased psychological distress in Chinese parents of children with autism. There was no evidence to support the stress-buffering model of social support in moderation analysis of the association between child behavior problems and parental psychological distress. Nonetheless, increased social support was associated with lower levels of parental psychological distress. Moderated moderation analyses did not support a role for individualism or collectivism as a moderator of the putative buffering role of social support. However, there was evidence that parental individualism was associated with increased parental psychological distress. Our findings highlight that child behavior problems are a robust correlate of parental psychological distress, and parental social support may act as a compensatory factor promoting less psychological distress rather than having a protective role. The role of social support and cultural values in the wellbeing of parents of children with autism in China requires additional exploration, including longitudinal research designs.

Cognitive-Based Interventions for Improving Psychological Health and Well-Being for Parents of Children with Developmental Disabilities: A Systematic Review and Meta-analysis

This review aims to systematically summarize existing evidence to determine the effectiveness of cognitive-based interventions (CBIs) on psychological health and well-being among parents of children with developmental disabilities (DD). Six databases were searched to identify eligible randomized controlled trials (RCTs) from their inception to April 2023. The revised Cochrane Risk of Bias tool for RCTs was applied to assess the risk of bias and the certainty of evidence was evaluated using the Grading of Recommendation, Assessment, Development and Evaluation. Meta-analyses were conducted using a random-effects model. Twenty-five RCTs involving 1915 participants were identified. The results indicated that CBIs reduced parental stress levels (Hedges' g = - 0.69), depressive symptoms (g = - 0.95), anxiety levels (g = - 0.78), and parental distress (g = - 0.29), and improved parental well-being (g = 0.62) and parent‒child relationships (g = 0.43) postintervention compared with the active/inactive control groups. Subgroup analysis of the effectiveness of interventions using mindfulness-based interventions and cognitive behavioural therapy showed positive effects. The favourable intervention duration and participant targets were also identified in this review. Furthermore, the effects of CBIs were impacted by the different types of DD among the children. This review highlighted the positive effects of CBIs on parental stress levels, depressive symptoms, anxiety levels, parental distress levels, parental well-being levels, and parent‒child relationships. Future well-designed RCTs are needed to further investigate the effects of MBIs and CBT interventions on children with DD and their parents, as well as the factors and mechanisms of action affecting the efficacy of these interventions.

Interventions to Improve Outcomes for Parents of Children with Autism Spectrum Disorder: A Meta-Analysis

This meta-analysis examines the impact of parent interventions on outcomes for parents of children with ASD. A systematic review of the literature produced 37 studies that met inclusion criteria. Random-effects models revealed small but significant impacts of intervention on parental outcomes, primarily in parenting confidence and mental health. No improvements were observed in caregiving burden, family adjustment, physical health, or stress. Significant heterogeneity was observed; however, no moderation effects were detected for intervention or sample characteristics. These findings suggest parent interventions improve parenting confidence and, to a lesser degree, mental health. More work is needed to develop interventions that address a wider range of outcomes for parents of children with ASD. Limitations and implications for future research are discussed.

Posttraumatic Growth Among Parents of Children with Autism Spectrum Disorder in China and Its Relationship to Family Function and Mental Resilience: A Cross-Sectional Study

OBJECTIVE

This study was conducted to examine the posttraumatic growth (PTG) of parents of children with autism spectrum disorder (ASD) and the association among family function, mental resilience and PTG.

DESIGN AND METHODS

This descriptive cross-sectional study was conducted with 205 parents of children with ASD in the clinical department of a university-affiliated hospital in Guangzhou from January to October 2019. The Posttraumatic Growth Inventory, Family Assessment Device, and Connor-Davidson Resilience Scale were employed for data collection.

RESULTS

The mean PTG score of parents was 59.56±18.46; and 24.63%, 43.84%, and 32.51% of parents exhibited a high level, moderate level and low level, respectively, of PTG. The problem-solving dimension of family function (p = 0.005) and the strength dimension of mental resilience (p ≤0.001) were positively related to PTG.

CONCLUSIONS

Parents of children with ASD experienced moderate PTG overall. The problem-solving dimension of family function and the strength dimension of mental resilience were significant predictors of PTG.

PRACTICAL IMPLICATIONS

Interventions to improve family function and the mental resilience of parents with ASD children could contribute to improving the PTG of parents.

Psychological well-being of fathers with and without a child with intellectual disability: a population-based study

BACKGROUND

Few studies have explored the well-being of fathers of children with intellectual disability (ID), despite the significant role that they play in their children's lives. The current study compared fathers of children with and without a child with ID on measures of psychological well-being (life satisfaction, work-family balance and general health) and dimensions of parenting (parenting self-efficacy and parent-child closeness) and then examined whether the presence of a child with ID in the family was a significant predictor of paternal well-being when controlling for a number of father (age, education, employment and residency), child (ID status, gender, behavioural and emotional problems) and family (income poverty and number of children in the household) variables.

METHODS

Data were drawn from the third wave of the Millennium Cohort Study, a UK population-representative and cohort study, where the cohort child was 5 years of age; 256 fathers were identified as having a child with ID, with data available for 10 187 fathers without a child with ID. Fathers were compared on the four well-being and parenting outcomes and then multiple regression models were conducted to explore associations between these outcomes and variables identified as potential correlates of well-being.

RESULTS

Initial group comparisons showed that there were differences in the well-being of fathers, with fathers of children with ID reporting poorer life satisfaction and general health. However, these differences were small. Regression analyses showed that child behavioural and emotional problems, living in income poverty and paternal employment were more important than disability status in predicting fathers' well-being.

CONCLUSIONS

These works add to the limited amount of research on fathers using population-representative data. The current findings are consistent with rejecting a general simplistic and negative narrative that raising a child with ID puts fathers at risk of poorer outcomes. However, some fathers, such as those with children with behavioural problems and living in poverty, may require greater support. Future longitudinal research that explores the impact of paternal well-being on the long-term outcomes of children with and without ID is warranted.