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The Mediating Effects of Psychological Flexibility and Child Behaviors on Psychopathology of Parents of Developmentally-and-Intellectually-Disabled Children during the Covid-19 Pandemic

Thu, March 23, 12:00 to 12:45pm, Salt Palace Convention Center, Floor: 1, Meeting Room 150 D-E

Abstract

Research suggests that 50% of caregivers of autistic children have a diagnosis of clinical depression (Lushin & O’Brien, 2016) and experience elevated levels of stress compared to parents of typically developing children (Pastor-Cerezuela et al., 2016). Child behaviors may increase parenting stress in parents of developmentally-disabled/intellectually-disabled (DD/ID) children (Hastings, 2003), and stress may, in turn, mediate the relationship between child maladaptive behaviors and decreased parenting self-efficacy (Singh et al., 2009). Moreover, reduced psychological flexibility (i.e., the ability to recognize and adapt to emotional or situational demands) is shown to moderate the relationship between parental and child distress (Jang et al., 2012). In order to better support parents of DD/ID children following the COVID-19 pandemic, it is important to understand factors that contribute to their psychological well-being, given the increased challenges (e.g., decreased support, routine disruption) and worsening mental health (e.g.,. increased stress) that parents experienced during the pandemic (Neece et al., 2020; Yılmaz et al., 2021).

Forty parents (87.5% female; 60% non-white; 80% ages 35- 54) of DD/ID children (72.5% ASD; 10% Down Syndrome; Mage=11.60, SDage=5.62; 77.7% male) participated in this mixed-method design study during the COVID-19 pandemic (November 2020). Parents completed a measure of parental depression (BDI-II; Beck, 1996), parenting stress (PSI-4-SF; Abidin, 1995), parental psychological flexibility (AAQ-II; Bond et al., 2011), and child externalizing behaviors (Maladaptive Behavior domain from the VABS-III; Sparrow et al., 2016). Parents also responded to open-ended questions (e.g. “What is the greatest struggle for you?”) to assess the perceived causes of stress and parental needs.

A path analysis revealed significant direct effects of parenting stress on psychological flexibility, child behaviors, and depression (Figure 1; all p<0.001). Parenting stress accounted for 27% of the variance in psychological flexibility and 58% in child behaviors, and approximately 77% of the variance in depression was explained by the parenting stress, psychological flexibility and child behaviors predictors. The effect of parenting stress on parental depression was partially mediated by psychological flexibility (indirect effect p = 0.001; 95% CI = 0.063 – 0.231), while the indirect effect of child behaviors as a mediator was not significant (p = 0.31). Qualitative analyses revealed that the main areas of struggle for parents were managing treatment schedules, child behaviors, and dearth of emotional and social support.

Overall, findings indicate that parenting stress and psychological flexibility are important contributors to parent depression reported during COVID-19 pandemic, and challenges parents of DD/ID children face relating to managing child schedules and behavior and lack of support. Crucially, this analysis underscores the importance of addressing parenting stress for parents of DD/ID children highlights a need for cost-effective and accessible psychological interventions for parents to address parenting stress and promoting psychological flexibility (e.g., support groups, individual therapy incorporating mindfulness/relaxation training). Future studies should aim to better understand various perceived causes of parenting stress and unmet needs of parents in order to better support families with DD/ID children.

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