Affiliate stigma of mental illness in family caregivers of persons with mental illness in Hong Kong

Background: Affiliate stigma of family caregivers may severely influence family caregiving, early treatment, and recovery of people with mental illness (PMI), and it may be impacted by the knowledge of mental illness and contact with PMI. However, little is known about the correlation between affiliate stigma of family caregivers of PMI and contact in Hong Kong. Aims: This study aimed to investigate affiliate stigma and its influencing factors among family caregivers of PMI in Hong Kong. Methods: A total of 106 family caregivers in Hong Kong participated in the study. The measurements included affiliate stigma, contacts (quantity, quality, and level), knowledge, prejudice, and discriminatory behaviors. Multiple regression analyses were employed. Results: The mean score of affiliate stigma scale (ASS) in family caregivers was 2.17 ( SD = 0.65). In regression analyses, the results showed that contact quantity and contact level were significantly associated with higher affiliate stigma and its cognitive domain, while contact quality (e.g. positive contact) were significantly associated with lower affiliate stigma and its all domains among family caregivers. The positive relationship between prejudicial attitudes and affiliate stigma was also found. Conclusions: Affiliate stigma is severe among family caregivers of PMI in Hong Kong. The results of this study indicate that contact, especially positive contact, contributes to reducing affiliate stigma among family caregivers of PMI. The results of this study are important for development of health policy on reducing stigma in family caregivers of PMI. The effectiveness of Enhancing Contact Model (ECM) should be examined in future anti-stigma interventions.

Familism and Parenting Stress in Latinx Caregivers of Young Children with Developmental Delays

Several studies have documented the difficult experience of raising a child with a developmental delay (DD; DeGrace et al., 2014) but the majority of research has focused on non-Latinx White families and their experiences in childrearing and interacting with service providers (Hayes & Watson, 2013; Blanche et al., 2015). Additionally, stigma associated with mental illness and DD disproportionally affects Latinx communities (Burke et al., 2019). Familism plays a unique role among families of Latinx backgrounds (Moore, 1970; Coohey, 2001) and may act as a buffer to caregiver mental health. The current study aims to (1) determine the association between affiliate stigma and parenting stress among Latinx parents of young children with DD and (2) test whether familism moderates the relationship between affiliate stigma and parenting stress. Results revealed that the relationship between affiliate stigma and parenting stress was strongest in caregivers who reported low levels of familism, suggesting that familism may act as a buffer. More research is needed to further unpack the protective factors of familism on caregiver mental health.

Affiliate Stigma in Caregivers of Children with Attention-Deficit/Hyperactivity Disorder: The Roles of Stress-Coping Orientations and Parental Child-Rearing Styles

Affiliate stigma may increase the risks of negative parenting and psychological and depressive problems in caregivers of children with attention-deficit/hyperactivity disorder (ADHD). Evaluating affiliate stigma and determining how to reduce it are crucial to promoting mental health in caregivers and their children with ADHD. The aim of this study was to examine the associations of stress-coping orientations and parental child-rearing styles with the risk of high affiliate stigma in caregivers of children with ADHD in Taiwan. Affiliate stigma, stress-coping orientations, and parental child-rearing styles were assessed. The results of univariate logistic regression analysis indicated that caregivers’ gender, depressive symptoms, four orientations of stress coping, and two parenting styles, and children’s high severities of internalizing, externalizing, and ADHD symptoms were significantly associated with high affiliate stigma. The results of multivariate logistic regression analysis indicated that after controlling for caregivers’ gender, depressive symptoms, and children’s severity of internalizing, externalizing, and ADHD symptoms, caregivers with high orientation of seeking social support were less likely to have high affiliate stigma than those with low orientation of seeking social support; the caregivers with high care and affection parenting were less likely to have high affiliate stigma than those with low care and affection parenting, whereas the caregivers with high overprotection parenting were more likely to have high affiliate stigma than those with low overprotection parenting. Intervention programs targeting caregiver affiliate stigma must consider various coping orientations and parental child-rearing styles in their approach.

Psychometric investigation of the affiliate stigma scale in Mexican Parkinson’s disease caregivers: Development of a short form

BACKGROUND: Parkinson’s disease (PD) caregivers, particularly in Latin America, may experience high levels of affiliate stigma due to their association with a person having a disability. The most common measure used of this construct in the literature, the Affiliate Stigma Scale, was validated using non-standard and questionable methods. OBJECTIVE: The purpose of this study was to investigate the factor structure and psychometric properties of the Spanish version of the Affiliate Stigma Scale with PD caregivers in Mexico using more widely accepted psychometric approaches including confirmatory and exploratory factor analyses (confirmatory factor analyses (CFAs) and exploratory factor analyses (EFAs)). METHODS: A sample of 148 PD caregivers from Mexico completed this measure, as well as indices of caregiver burden and anxiety. RESULTS: Initial CFAs revealed that the data did not fit either the originally proposed one-factor or three-factor structures. An EFA was then conducted which was unable to discern any factor structure. Upon instituting a stepwise removal alpha-if-item-deleted process, a 5-item Affiliate Stigma Scale Spanish Short Form was retained with an adequate Cronbach’s alpha, good convergent validity, and a Short Form CFA generally indicating adequate fit. CONCLUSIONS: The new Spanish Affiliate Stigma Scale Short Form holds promise for more appropriately measuring affiliate stigma likely in general but particularly in Spanish and among PD caregivers. The Short Form can assist not only in assessing levels of caregiver affiliate stigma, but in creating novel interventions to help support caregivers and decrease stigma.

Did Affiliate Stigma Predict Affective and Behavioral Outcomes in Caregivers and Their Children with Attention-Deficit/Hyperactivity Disorder?

The aim of this follow-up study was to examine the predictive values of caregivers’ affiliate stigma at baseline for depression in caregivers and internalizing and externalizing symptoms in children with attention-deficit/hyperactivity disorder (ADHD) 1 year later. The Study on Affiliate Stigma in Caregivers of Children with ADHD surveyed the levels of affiliate stigma and depression in 400 caregivers and the behavioral problems of their children with ADHD. The levels of the caregivers’ depression and children’s behavioral problems were assessed 1 year later. The associations of caregivers’ affiliate stigma at baseline with depression in caregivers and internalizing and externalizing symptoms in children with ADHD at follow-up were examined using stepwise multiple regression. The results indicated that before caregivers’ depression and children’s behavioral problems at baseline were controlled, caregivers’ affiliate stigma at baseline positively predicted caregivers’ depression and all children’s behavioral problems. After caregivers’ depression and children’s behavioral problems at baseline were controlled, caregivers’ affiliate stigma at baseline still positively predicted children’s affective and somatic problems. Parenting training and cognitive behavioral therapy should be provided to caregivers with intense affiliate stigma to prevent emotional problems and difficulties in managing their children’s behavioral problems.

Parkinson’s Symptoms and Caregiver Affiliate Stigma: A Multinational Study

Background and Objective: Research has documented the stigma that individuals with degenerative neurological diseases experience, but caregivers also experience stigma by associa- tion (i.e., affiliate stigma). In order to shed light on the stigma of caregivers of people with degener- ative neurological diseases, the current study aimed to explore cross-cultural differences in the pre- valence of Parkinson’s disease (PD) caregiver affiliate stigma, as well as the relationship between PD symptoms and caregiver affiliate stigma. Applications for Alzheimer’s disease are discussed. Method: Survey data were collected in PD clinics at public, academic medical centers. Informal caregivers of an individual with PD from the US (n = 105) and from Mexico (n = 148) participated in the study. Caregivers completed a questionnaire that included the MDS Unified PD Rating Scale to describe the symptoms of the individual with PD, as well as the Affiliate Stigma Scale and demo- graphic information. Results: A series of multiple regressions was run to examine whether PD symptoms were associat- ed with affiliate stigma and if these differed by country. These regressions suggested that different patterns of PD symptoms predicted affiliate stigma in each country. Stigma was higher in the US compared to Mexico, and the relationship between bowel/bladder symptoms and affiliate stigma was significantly stronger in the US. Conclusions: Symptoms of individuals with neurodegenerative diseases are related to affiliate stig- ma experienced by caregivers, and these relationships may differ cross-culturally. Negative public attitudes concerning bowl and bladder issues and the physical symptoms that accompany PD re- main a source of stigma for caregivers and families, particularly in the US. Interventions for care- givers of individuals with neurodegenerative diseases should include strategies for coping with stig- ma concerning bladder and bowel problems, as well as other physical and mental health issues.

Examination of Affiliate Stigma, Hopelessness and Life Satisfaction in Parents of Children with Intellectual Disabilty

Introduction. While expecting a healthy child, having a child with a disability can be quite traumatic for all family members, especially parents. The objective of the research was to evaluate affiliate stigma, hopelessness, and life satisfaction in parents of children with intellectual disability. Materials and Methods. The descriptive research included 203 parents of children with intellectual disabilities, who met the research inclusion criteria and agreed to participate in the study. The data were collected using the Personal Information Form, the Affiliate Stigma Scale, the Beck Hopelessness Scale, and the Satisfaction with Life Scale. Results. The mean age of parents included in the study was 40.74 ± 7.22 years, with 67.5% of caregiving mothers. The levels of affiliate stigma and hopelessness among parents were low, and they were satisfied with their lives. In case of increasing parental affiliate stigma, their hopelessness was found to increase, while life satisfaction was found to decrease. Conclusions. In order to increase public acceptance of people with disabilities by society, it is recommended to provide trainings and raise awareness against individuals with disabilities and their families.

The impact of caregiver stigma on real-life social experience of Taiwanese adolescents with autism spectrum disorder

Caregivers of adolescents with autism spectrum disorder commonly experience stigma. However, how stigma influences social interactions of adolescents with autism spectrum disorder is unclear. We aimed to explore the impact of caregiver stigma on real-life social experiences of Taiwanese adolescents with autism spectrum disorder. In the context of everyday activities, 76 adolescents with autism spectrum disorder who were not intellectually disabled (69 males, aged 10–16 years) carried a mobile device that prompted them 7 times, randomly, each day for 7 days to record with whom they were interacting, what they perceived, and how they felt about the interactions. Caregivers completed the Affiliate Stigma Scale to measure caregiver stigma. Multilevel analyses revealed that participants whose caregivers perceived high levels of stigma were more likely than those whose caregivers experienced less stigma to interact with family members and less likely to be interested in interacting with people at school. However, those participants also experienced more anxiety while interacting with family members. The findings shed light on ways that caregiver stigma impacted the social experiences of adolescents with autism spectrum disorder and suggest that, in promoting social participation for adolescents with autism spectrum disorder, researchers and service providers must support caregivers to manage stigma. Lay abstract Caregivers of people with autism spectrum disorder commonly experience stigma. As a result, they may avoid contact with others, in turn, influencing their child’s social participation. This study aimed to explore the impact of stigma perceived by the caregivers on the everyday social experience of Taiwanese adolescents with autism spectrum disorder. We asked 76 adolescents with autism spectrum disorder who did not have intellectual disability (69 males, aged 10–16 years) to carry a mobile device for 7 days. The device prompted them 7 times each day to record who they were interacting with, what they perceived, and how they felt about their social interactions. In addition, we asked their caregivers to complete the Affiliate Stigma Scale to measure their experience of stigma. We found that participants whose caregivers perceived high levels of stigma were more likely to spend time with family members and less likely to be interested in interacting with people at school. Those participants also were more likely to experience anxiety while interacting with family. Our study suggests that it is important for clinicians to implement support services for adolescents with autism spectrum disorder and help caregivers in managing stigma to promote their child’s social participation.