The Relationship Between Internalized Stigma And Psychological Distress Among Caregivers Of Children With Autism:a Chain Mediation Model

Objective: To study the autistic caregivers joint internalized stigma,psychological distress,grasp the present situation of the social support and coping styles and explore joint internalized stigma influence on psychological distress,and understand the role of social support and coping styles in it,in order to further improve the mental health of caregivers,improving the quality of care provides a new train of thought.Methods: A questionnaire survey was conducted among the caregivers of children with autism in the rehabilitation center of a hospital in Zhengzhou and the autism rehabilitation group.The general information questionnaire was used to collect the basic information of the subjects;the Associated Internalized Stigma Scale,the Psychological Distress Scale,the Simple Coping Style Scale and the Perceived Social Support Scale were used to evaluate the caregivers’ associated internalized stigma,psychological distress,coping styles,and perceived levels of social support.This time,232 questionnaires were distributed and 197 were recovered.The effective recovery rate of 25 invalid questionnaires was 74.1%.SPSS25.0 statistical software was used for data entry,sorting and statistical analysis.The statistical methods included t test,one-way analysis of variance,Pearson correlation analysis and multiple regression analysis.Finally,chain mediation analysis was carried out with PROCESS.Results:(1)The internalized stigma and psychological distress of the caregivers of children with autism are at the upper-middle level.The caregivers of children with autism prefer to adopt positive coping methods,and they are at the medium level of understanding social support.(2)Independent sample T-test and one-way ANOVA were performed on the associated internalized stigma,perception of social support and coping style to psychological distress,and found that the associated internalized stigma was independent(t=-3.87,p <0.001),occupation or not(t=4.16,p <0.001),degree of illness(F=16.69,p <0.001),and annual income(F=11.21,p <0.001);there were significant differences in the gender of caregivers(t=-2.22,p<0.05),occupation(t=7.49,p <0.001),recovery time(F=3.70,p <0.01),degree of illness(F=16.43,p <0.001),annual income(F=9.89,p <0.001),there were significant differences;perceived social support was significantly different in caregiver gender(t=-2.13,p<0.05),occupation(t=-2.53,p <0.01),degree of illness(t=-2.13,p<0.05)There is a significant difference in degree of illness in children(F=3.98,p <0.05);there is a significant difference in the degree of illness(F=19.20,p <0.001)and annual income(F=7.70,p<0.001)of active coping style.(3)There was significant correlation between associated internalization of stigma,perceived social support,positive coping style and psychological distress.Associated internalization of stigma and perceived social support(r =-0.32,p <0.01),associated internalization of stigma and perceived social support(r =-0.58,p <0.01),associated internalization of stigma and psychological distress(r=0.77,p <0.01),perceived social support and positive coping styles(r=0.49,p <0.01).(4)The results showed that social support partially mediated the association between stigma and psychological distress,accounting for 8.19% of the total effect.Positive coping style partially mediated the association between stigma and psychological distress,accounting for 7.31% of the total effect.(5)Understanding that social support and positive coping styles play a chain mediating role in the association between internalized stigma and psychological distress,and the chain mediating effect accounts for 1.75% of the total effect.Conclusions: Caregivers with autism internalized stigma,perceived social support and coping styles have significant predictive effects on psychological distress.Associated internalization of stigma can not only directly predict the psychological distress of caregivers with autism,but also indirectly predict the psychological distress of caregivers with autism through understanding social support and coping styles.Associated internalized stigma can indirectly predict the psychological distress of caregivers with autism through a chain of social support and positive coping styles.