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Buffering Effect of Spousal Support on Stress Levels in Mothers of Children with a Diagnosis of Autism Spectrum Disorder in Kerala, IndiaFunding This research was part of the MPH dissertation work of Prinu Jose and did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Objectives Bringing up a child with the diagnosis of autism spectrum disorder (ASD) can be highly stressful. This study aimed to assess perceived stress, level of spousal support, emotion-focused coping styles, and other potentially associated factors among mothers accompanying children diagnosed with ASD for care from selected institutions in Kerala, India.
Materials and Methods Consenting parents accompanying children to therapeutic programs in selected institutions were administered a semi structured interview schedule incorporating questions of the vernacular version of the Perceived Stress Scale (PSS-10), emotion-based coping strategies, spousal support in care of the child diagnosed with ASD, and possible-associated factors. Since internal consistency of stress and coping questionnaires were low, principal component analysis was used to extract composite variables with reasonable psychometric characteristics for stress and coping.
Statistical Analysis Ordinal logistic regression was performed with a three-level stress category as the outcome variable.
Results High stress was significantly associated with low spousal support (adjusted odds ratio or AOR: 2.80; 95% confidence intervals or CI 1.28–6.11), having a completely dependent child (AOR 4.24 [95% CI 1.92–9.38]), and low acceptance levels (AOR 2.60 [95% CI 1.14–5.89]). Unlike mothers with high spousal support, mothers with low spousal support were likely to have difficulty in interacting with others (p = 0.02) and a low level of acceptance (p = 0.05).
Conclusion Spousal support is important to preserve psychological health in mothers of children diagnosed with ASD. Mothers with low spousal support may need interventions that help increase acceptance levels or decrease avoidant behavior.
16 June 2021 (online)
© 2021. Association for Helping Neurosurgical Sick People. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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- 1 Kuhaneck HM, Madonna S, Novak A, Pearson E. Effectiveness of interventions for children with autism spectrum disorder and their parents: a systematic review of family outcomes. Am J Occup Ther 2015; 69 (05) p1-p14
- 2 Christensen DS, Flensborg-Madsen T, Garde E, Hansen ÅM, Pedersen JM, Mortensen EL. Parental socioeconomic position and midlife allostatic load: a study of potential mediators. BMC Public Health 2018; 18 (01) 1029
- 3 Fávero-Nunes MA, dos Santos MA. Depression and quality of life in mothers of children with pervasive developmental disorders. Rev Lat Am Enfermagem 2010; 18 (01) 33-40
- 4 Olsson MB, Hwang CP. Socioeconomic and psychological variables as risk and protective factors for parental well-being in families of children with intellectual disabilities. J Intellect Disabil Res 2008; 52 (12) 1102-1113
- 5 Diehl M, Hay EL, Chui H. Personal risk and resilience factors in the context of daily stress. Annu Rev Gerontol Geriatr 2012; 32 (01) 251-274
- 6 Lindström B, Eriksson M. Salutogenesis. J Epidemiol Community Health 2005; 59 (06) 440-442
- 7 Friedli L, World Health Organization. Mental health, resilience and inequalities. (No. EU/08/5087203) Copenhagen: WHO Regional Office for Europe; 2009. Accessed January 26, 2021 at: https://apps.who.int/iris/bitstream/handle/10665/107925/E92227.pdf
- 8 Benson PR, Kersh J. Marital quality and psychological adjustment among mothers of children with ASD: cross-sectional and longitudinal relationships. J Autism Dev Disord 2011; 41 (12) 1675-1685
- 9 Rini C, Manne S, DuHamel K. et al. Social support from family and friends as a buffer of low spousal support among mothers of critically ill children: a multilevel modeling approach. Health Psychol 2008; 27 (05) 593-603
- 10 Bristol MM, Gallagher JJ, Schopler E. Mothers and fathers of young developmentally disabled and nondisabled boys: adaptation and spousal support. Dev Psychol 1988; 24: 441-451
- 11 Thresia CU, Mohindra KS. Gender bias in health research: implications for women’s health in Kerala (India) and Sri Lanka. Crit Public Health 2011; 21: 327-337
- 12 Sarrett JC. Custodial homes, therapeutic homes, and parental acceptance: parental experiences of autism in Kerala, India and Atlanta, GA USA. Cult Med Psychiatry 2015; 39 (02) 254-276
- 13 Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983; 24 (04) 385-396
- 14 Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol 1989; 56 (02) 267-283
- 15 Indian Council of Medical Research. National ethical guidelines for biomedical and health research involving human participants. New Delhi: Indian Council of Medical Research; 2017. Accessed January 26, 2021 at: https://ethics.ncdirindia.org//asset/pdf/ICMR_National_Ethical_Guidelines.pdf
- 16 Office of the Drugs Controller General (India). Re-registration of Ethics Committees. 2017. New Delhi: Central Drugs Standard Control Organization. Accessed January 26, 2021 at: https://cdsco.gov.in/opencms/opencms/system/modules/CDSCO.WEB/elements/download_file_division.jsp?num_id=MjY3Mg==
- 17 Jones L, Totsika V, Hastings RP, Petalas MA. Gender differences when parenting children with autism spectrum disorders: a multilevel modeling approach. J Autism Dev Disord 2013; 43 (09) 2090-2098
- 18 Masefield SC, Prady SL, Sheldon TA, Small N, Jarvis S, Pickett KE. The caregiver health effects of caring for young children with developmental disabilities: a meta-analysis. Matern Child Health J 2020; 24 (05) 561-574
- 19 Benson PR. The impact of child symptom severity on depressed mood among parents of children with ASD: the mediating role of stress proliferation. J Autism Dev Disord 2006; 36 (05) 685-695
- 20 Soltanifar A, Akbarzadeh F, Moharreri F. et al. Comparison of parental stress among mothers and fathers of children with autistic spectrum disorder in Iran. Iran J Nurs Midwifery Res 2015; 20 (01) 93-98
- 21 Benson PR. The longitudinal effects of network characteristics on the mental health of mothers of children with ASD: the mediating role of parent cognitions. J Autism Dev Disord 2016; 46 (05) 1699-1715
- 22 Weiss JA, Cappadocia MC, MacMullin JA, Viecili M, Lunsky Y. The impact of child problem behaviors of children with ASD on parent mental health: the mediating role of acceptance and empowerment. Autism 2012; 16 (03) 261-274
- 23 Bromley J, Hare DJ, Davison K, Emerson E. Mothers supporting children with autistic spectrum disorders: social support, mental health status and satisfaction with services. Autism 2004; 8 (04) 409-423
- 24 Montes G, Halterman JS. Psychological functioning and coping among mothers of children with autism: a population-based study. Pediatrics 2007; 119 (05) e1040-e1046
- 25 Sim A, Vaz S, Cordier R. et al. Factors associated with stress in families of children with autism spectrum disorder. Dev Neurorehabil 2018; 21 (03) 155-165
- 26 Lucyshyn JM, Irvin LK, Blumberg ER, Laverty R, Horner RH, Sprague JR. Validating the construct of coercion in family routines: expanding the unit of analysis in behavioral assessment with families of children with developmental disabilities. Res Pract Persons Severe Disabl 2004; 29 (02) 104-121
- 27 Pattini E, Carnevali L, Troisi A. et al. Psychological characteristics and physiological reactivity to acute stress in mothers of children with autism spectrum disorder. Stress Health 2019; 35 (04) 421-431
- 28 Da NS Paz, Siegel B, Coccia MA, Epel ES. Acceptance or despair? Maternal adjustment to having a child diagnosed with autism. J Autism Dev Disord 2018; 48 (06) 1971-1981
- 29 Dunn ME, Burbine T, Bowers CA, Tantleff-Dunn S. Moderators of stress in parents of children with autism. Community Ment Health J 2001; 37 (01) 39-52
- 30 Lavenda O, Kestler-Peleg M. Parental self-efficacy mitigates the association between low spousal support and stress. Psychiatry Res 2017; 256: 228-230