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

Chih-Cheng Chang,Cheng-Fang Yen,Yu-Min Chen,Ray C Hsiao,Wen-Jiun Chou

doi:10.3390/ijerph18179004

Abstract

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.

Highlights

Regarding caregivers’ factors, the results indicated that male caregivers were less likely to have high affiliate stigma than females
This study demonstrated that seeking social support may be an adaptive stress-coping strategy to protect caregivers of children with attention-deficit/hyperactivity disorder (ADHD) from aggravated affiliate stigma
Adopting the parental style of care and affection may contribute to low affiliate stigma, whereas adopting the parental style of overprotection may increase the risk for caregivers perceiving public stigma and internalizing the negative attitudes

Summary

Introduction

Affiliate Stigma in Caregivers of Children with Attention-Deficit/Hyperactivity Disorder. Affiliate stigma refers to the self-stigma of caregivers of people with mental illnesses; this stigma entails a caregiver perceiving stigmatizing attitudes being directed at them from others and internalizing these negative attitudes [1]. Affiliate stigma is prevalent among caregivers of children with attention-deficit/hyperactivity disorder (ADHD) [2,3,4]. Research has demonstrated that higher affiliate stigma among caregivers of children with ADHD is associated with more negative parenting [4] and increased distress [3] and depression [5] in caregivers. Higher parental affiliate stigma was significantly associated with children’s poorer social skills and greater aggression [4]. Caregivers of children with ADHD who have high affiliate stigma are more likely to have unfavorable attitudes toward their children’s

Methods

Results

Discussion

Conclusion