Affiliate Stigma Scale Research Articles

Psychometric evaluation of the affiliate stigma scale for caregivers of people with mental illness in Uganda

BackgroundAffiliate stigma is common among caregivers of people with mental illness and impacts negatively on the caregivers’ quality of life and their ability to care for the patients. Although there is evidence of affiliate stigma in sub-Saharan Africa, the psychometric properties of commonly used tools are not available in the African context. The aim of this analysis was to evaluate the factor structure of the affiliate stigma scale among caregivers of people with mental illness in southwestern Uganda. Having a validated method to assess affiliate stigma in the Ugandan setting helps to appropriately evaluate affiliate stigma among caregivers of people with mental illnesses, which could inform the development of interventions to support such caregivers.MethodA total of 385 caregivers of people with mental illness attending outpatient psychiatry clinics in selected tertiary hospitals in southwestern Uganda were enrolled in the study. The affiliate stigma and depression were assessed using the affiliate stigma scale and the patient health questionnaire (PHQ-9) respectively. We conducted exploratory and confirmatory factor analysis to determine the factor structure, reliability and validity of the affiliate stigma scale. We also evaluated the convergent validity of the affiliate stigma scale by determining the correlation between affiliate stigma scale scores and the PHQ-9.ResultMore than half of participants were male (55.06%) and majority of caregivers were living in rural areas (80.26%). The sample size was adequate, as evidenced by the KMO of 0.91 and the inter-correlation was sufficient to conduct the factor analysis, according to the Bartlett test. Confirmatory factor analysis revealed four factors and all 22 items were retained as all of them had a factor loading > 0.4. The internal consistency of the total scale was excellent (alpha = 0.92). The affiliate stigma score correlated with depression which has been hypothesized to be associated with the stigma of mental illness.ConclusionThe study findings show the affiliate stigma scale as a valid measure of affiliate stigma among the caregivers of patients with mental illness in southwestern Uganda. Therefore, this scale provides an opportunity to mental health care providers to assess affiliate stigma and develop interventions aimed at prevention stigma among caregivers and improve outcomes among people with mental illness.

Factors associated with integration of people recovering from alcohol dependence syndrome with their family: An exploratory study

ABSTRACT Background: Alcohol is the most commonly consumed psycho-active substance in India. People who use substances and are in recovery often face societal discrimination and rejection, such as difficulty in obtaining employment, poor support for treatment, and inter-personal rejection. Aim: To find out the factors affecting the integration of people recovering from alcohol dependence syndrome with their families. Materials and Methods: A cross-sectional observational study was conducted using a purposive sampling technique among 50 pairs of alcohol-dependent people and their family members. Data were collected using self-administered Family Adaptability and Cohesion Evaluation Scale (FACES IV package), Substance Abuse Self-Stigma Scale, Affiliate Stigma scale, and A Social Support Inventory for Successful Transition. Appropriate statistical tests were used to identify correlations. Results: A negative correlation (r = -0.313, P < 0.05) was found between affiliate stigma and integration, and a positive correlation (P < 0.05) was found between social support and integration. Alcohol-dependent people from Alcoholics Anonymous reported higher levels of perceived social support than those from a tertiary hospital (mean = 47.68 vs. 39.84, P < 0.05). Conclusion: Affiliate stigma negatively impacts people with alcohol dependence and contributes to increased opportunities for interventions to address stigma. Social support has a positive impact on family integration of alcohol-dependent people with Alcoholics Anonymous participants reporting higher levels of social support compared to tertiary hospital participants. Therefore, the findings of this study highlight the need to involve families more intensively to reduce affiliate stigma.

Comparative Study of Stigma and Its Correlates in Caregivers and Patients of Schizophrenia and Bipolar Affective Disorder

Abstract Objective: Stigma is very common among patients and caregivers of patients with severe mental disorders; however, there is a lack of comparative study data between schizophrenia and bipolar affective disorder in the Indian setting. Methods: For this, caregivers of patients with schizophrenia (n = 50) or bipolar affective disorder (n = 50) were assessed on the Affiliate Stigma Scale (ASS). Patients with schizophrenia (n = 50) or bipolar affective disorder (n = 50) were assessed on the Internalized Stigma of Mental Illness Scale (ISMIS). Results: Patients and caregivers of patients with schizophrenia have significantly higher mean scores on ISMIS and ASS, respectively, as compared to patients and caregivers of patients with bipolar affective disorder. Conclusion: This study suggests that patients with schizophrenia and their caregivers experience higher stigma than the caregivers of patients with bipolar affective disorder. Higher stigma is associated with higher psychological morbidity in the patients and caregivers. Therefore, clinicians managing patients with severe mental disorders must focus on stigma and psychological distress among the patients and caregivers and plan intervention strategies to reduce stigma.

Relationship Between Mindfulness and Affiliate Stigma in Parents of Children with Autism Spectrum Disorder in China: The Mediating Role of Coping Styles

PurposeThis study aims to investigate the current status of affiliate stigma among parents of autistic children, analyze the influencing factors, explore the relationship among mindfulness, coping styles, and affiliate stigma, and verify the mediating role of coping styles between mindfulness and affiliate stigma in parents of children with autism in China. MethodBetween February and April 2023, the Child Development Behaviour Centre of a public hospital in China recruited 345 parents of children with autism. These parents completed the general information questionnaire, the Mindful Attention Awareness Scale, the Affiliate Stigma Scale, and the Simple Coping Style Questionnaire. We then adapted the Hayes Process Macro and Bootstrap methods to examine the mediating effects of coping styles between mindfulness and affiliate stigma. Results(1) The total affiliate stigma score of parents of children with autism was 48.53 (standard deviation:: 10.74). Parents' age, monthly family income, duration of care, mindfulness, and coping styles were the influencing factors of parental affiliate stigma. (2) Mindfulness was positively correlated with positive coping style (r = 0.33, p < .01) and negatively correlated with negative coping style, affiliate stigma (r = −0.38, −0.39, p < .01), whereas affiliate stigma was negatively correlated with positive coping style (r = −0.34, p < .01) and positively correlated with negative coping style (r = 0.41, p < .01). (3) Positive coping style and negative coping style play a parallel mediating role between mindfulness and affiliate stigma of parents of autistic children. ConclusionsParents of children with autism experience significant levels of affiliate stigma. Mindfulness has a direct impact on associated stigma in parents of children with autism and also indirectly predicts associated stigma through the intermediary influence of positive and negative coping styles. Healthcare professionals could perform mindfulness interventions from an optimistic psychology viewpoint to boost parents' mindfulness and coping abilities, thereby accomplishing the objective of mitigating affiliate stigma.

Relationship between affiliate stigma and family quality of life among parents of children with autism spectrum disorders: The mediating role of parenting self-efficacy

BackgroundThe parents of children with autism spectrum disorder (ASD) are under great pressure and experience discrimination in their daily lives, which affects their family quality of life (FQOL). Objective-To investigate the interrelations among affiliate stigma, FQOL and parenting self-efficacy in the parents of children with ASD.-To identify a possible direction for psychological interventions to improve FQOL. MethodsA total of 237 parents of children with ASD were recruited in a university-affiliated hospital in Guangzhou, China, from October 2020 to April 2021 by convenience sampling. The Affiliate Stigma Scale, Parenting Sense of Competence Scale and Beach Center Family Quality of Life Scale were employed for data collection. ResultsThe results showed that affiliate stigma negatively predicts total FQOL and the dimensions of FQOL through both a direct effect and an indirect effect through parenting self-efficacy. ConclusionsThe findings suggest that affiliate stigma is an important predictor of FQOL, and interventions to reduce affiliate stigma and strengthen parenting self-efficacy might be effective in improving FQOL in the parents of children with ASD.

The relationships of autistic child characteristics, metacognitive beliefs, and autistic traits with affiliate stigma among parents of children with autism spectrum conditions: A moderated mediation study

BackgroundCaregivers of children with autism spectrum conditions (ASCs) are typically affected by autism-related stigma, which is internalized to form affiliate stigma. Limited studies have explored the factors potentially associated with affiliate stigma among parents of children with ASC. The present study examined the relationships among autistic child characteristics, parental autistic traits, parental metacognitive beliefs, and parental affiliate stigma. MethodWe recruited 134 parents of children with ASC in a cross-sectional study. We assessed autistic child characteristics, parental autistic traits, parental metacognitive beliefs, and parental affiliate stigma by using the Social Responsiveness Scale (SRS), the Autism-Spectrum Quotient (AQ), the Metacognition Questionnaire 30 (MCQ-30), and the Affiliate Stigma Scale (ASS). Path analysis was performed to examine the relationships between autistic child characteristics, parental autistic traits, parental metacognitive beliefs, and parental affiliate stigma. ResultsThere were correlations among autistic child characteristics, parental metacognitive beliefs, and parental affiliate stigma. Parental metacognitive beliefs mediated the relationship between autistic child characteristics and parental affiliate stigma, whereas parental autistic traits were not a moderating factor. ConclusionsThis study revealed the factors potentially associated with the affiliate stigma of parents of children with ASC. The findings highlight the importance of considering parental metacognitive beliefs when assessing and managing parental affiliate stigma.

Affiliate Stigma among family caregivers of individuals with dementia in China: a cross-sectional study.

Affiliate stigma experienced by family caregivers of individuals with dementia may seriously affect home care and prognosis of these patients. This study aimed to explore the levels of perceived affiliate stigma and its influencing factors among family caregivers of patients with dementia in mainland China, which remains a relatively unexplored topic. In this cross-sectional study, purposive sampling was used to recruit dementia family caregivers from an online communication group between April and May 2022. A total of 727 eligible caregivers were included and asked to complete the demographic questionnaire, the affiliate stigma scale, and the caregiver burden inventory. Descriptive statistics, independent sample t-test, one-way analysis of variance, Pearson correlation analysis, and multiple linear regression were used to explore the factors that influence perceived affiliate stigma among dementia family caregivers. The mean score for affiliate stigma of dementia family caregivers was 48.09 ± 16.38 (range: 22-86). Whether there were regular breaks during patient care, time-dependent burden, developmental burden, physical burden, and social burden were significant factors influencing the affiliate stigma of dementia family caregivers. Dementia family caregivers showed a moderate to high level of affiliate stigma. Those who had regular breaks during patient care, higher time-dependent burden, developmental burden, and physical burden and lower social burden exhibited higher levels of affiliate stigma.

Patient’s disability and caregiver burden among Chinese family caregivers of individual living with schizophrenia: mediation effects of potentially harmful behavior, affiliate stigma, and social support

Evidence on the associations between patient’s disability and caregiver burden among Chinese family caregivers of individual living with schizophrenia is lacking. This study aimed at explore the underlying mechanisms between patient’s disability and caregiver burden among Chinese family caregivers of individual living with schizophrenia. A cross-sectional study was carried out in four Chinese cities (Wuhan, Changsha, Guangzhou, and Shenzhen), between April, 2021 and March, 2022. A total of 493 patients and their family caregivers were invited to report related data. The Zarit burden interview, WHODAS 2.0, the Potentially harmful behavior scale, the Affiliate Stigma Scale, and the Multidimensional Scale of perceived social support were used to collect data. Linear regression analysis and bootstrapping analysis were conducted. The adjusted regression results showed that patients’ disability (B = 0.616; 95% CI: 0.479–0.753), potentially harmful behavior on caregivers (B = 0.474; 95% CI: 0.232–0.716), and caregiver’s low social support (B = −0.079; 95% CI: −0.158– −0.002), high level of affiliate stigma (B = 13.045; 95% CI: 10.227–15.864) were associated with higher level of caregiver burden (p < 0.05). In the mediation model, the direct path from patient’s disability to caregiver burden (B = 0.428, β = 0.371, p < 0.001) was significant and positive. Patient’s disability was indirectly associated with caregiver burden through patient’s potentially harmful behavior, caregiver’s affiliate stigma, and social support, the standardized regression coefficients ranged from 0.026-0.049 (p < 0.05). Patient’s potentially harmful behavior, caregiver’s affiliate stigma, and social support mediated the relationship between patients’ disability and caregiver burden. Future intervention studies designed to target these three factors may be beneficial for family caregivers of persons living with schizophrenia.

Hopelessness in caregivers of children with attention-deficit/hyperactivity disorder: Associations with depression and anxiety and multidimensionally related factors

Hopelessness can compromise caregivers' mental health and impede their ability to take care of their child with attention-deficit/hyperactivity disorder (ADHD). The study aimed to explore the associations of hopelessness with caregiver depression and anxiety in caregivers of children with attention-deficit/hyperactivity disorder (ADHD). Additionally, the study examined the associations of child demographics, ADHD and oppositional defiance symptoms, and caregiver demographics, parenting stress, and affiliate stigma with hopelessness. The study included 213 caregivers of children with ADHD who completed various assessments. Caregiver hopelessness was assessed using the Beck Hopelessness Scale, while child ADHD and oppositional defiance symptoms were assessed using the Parent Form of the Swanson, Nolan, and Pelham Scale, Version IV. Parenting stress was measured using the Parenting Stress Index, Fourth Edition Short Form (PSI-4-SF), and affiliate stigma using the Affiliate Stigma Scale. Hierarchical regression analysis was used to investigate the multidimensional factors associated with caregiver hopelessness. Caregiver hopelessness was significantly linked to caregiver depression and anxiety. Child inattention, caregiver parenting stress, and affiliate stigma were significantly associated with caregiver hopelessness. A higher level of affiliate stigma increased the association between child inattention and caregiver hopelessness. These findings suggest that it is necessary to develop intervention programs for alleviating the sense of hopelessness among caregivers of children with ADHD. Such programs should focus on addressing child inattention, caregiver parenting stress, and affiliate stigma.

Associations between Affiliate Stigma and Quality of Life among Caregivers of Individuals with Dementia

Introduction: The associations between affiliate stigma, caregiving burden, psychological distress, and quality of life (QoL) among family caregivers of people living with dementia (PwD) have been demonstrated in the literature. However, there is a dearth of literature regarding how these factors could form a psychological mechanism. The present study proposed a theoretical model to portray the relationships between these factors. Methods: Utilizing convenience sampling and cross-sectional study design, 275 family caregivers (145 females [52.7%]; mean age = 52.71 years) were recruited from a general hospital from October 2013 to September 2014. Each participant completed the following instruments in a quiet room in the general hospital without disturbance: Caregiver Burden Inventory, World Health Organization QoL Questionnaire-Brief, Affiliate Stigma Scale, and Beck Anxiety Inventory alongside the Taiwan Depression Questionnaire (assessing psychological distress). Structural equation modeling was used to examine the proposed theoretical model. Results: Affiliate stigma (standardized coefficient [β] = −0.338; P = 0.011) and psychological distress (β = −0.538; P &lt; 0.001) were negatively associated with QoL, caregiving burden was positively associated with psychological distress (β = 0.818; P &lt; 0.001), and affiliate stigma was positively associated with caregiving burden (β = 0.793; P &lt; 0.001). Moreover, a significant mediated effect was observed between affiliate stigma and QoL via sequential mediators of caregiving burden and psychological distress (unstandardized coefficient = −1.17 and 95% confidence interval = −1.88, −0.46). Conclusion: Affiliate stigma, caregiving burden, and psychological distress are key factors contributing to low QoL among family caregivers of PwD. Health-care providers should design programs to help reduce affiliate stigma, caregiving burden, and psychological distress for family caregivers of PwD to facilitate their QoL.

Changes in family functioning among primary family caregivers of patients with schizophrenia.

Family functioning, particularly among primary family caregivers for patients with schizophrenia, is a global concern that poses unprecedented challenges. The family unit is a pivotal agent for the preservation of the integrity of individual members. Little attention has been paid to the changes in family functioning and their predictors in primary family caregivers. This study aimed to examine the changes in and the correlates of family functioning in primary family caregivers of individuals with schizophrenia over a 6-month post-discharge period. A prospective, longitudinal study was conducted. A total of 58 primary family caregivers of patients with schizophrenia were recruited from two psychiatric hospitals in Taiwan. Data were collected four times, including 1 week before hospital discharge and at 1-, 3-, and 6-month intervals post-discharge. Demographic and clinical questionnaires, the Affiliate Stigma Scale, the Family Empowerment Scale, and the General Functioning subscale were used to collect data. Generalized Estimating Equations were applied for data analysis. Approximately 59.6%-77.6% of primary family caregivers presented unhealthy family functioning during the 6-month post-discharge period. Significant reductions in family functioning of primary family caregivers were noted in the group with unhealthy family functioning; however, family functioning of primary family caregivers remained unchanged in the group with healthy family functioning over 6 months. Affiliate stigma and family empowerment significantly accounted for the changes in family functioning of primary family caregivers in the groups with unhealthy and healthy family functioning, respectively. This study highlights affiliate stigma and family empowerment as long-term predictors of changes in family functioning for primary family caregivers and as pivotal targets of mental health care. Family-centered interventions with a focus on ameliorating affiliate stigma and enhancing family empowerment are recommended to improve family functioning for primary family caregivers of patients with schizophrenia at different periods after hospital discharge.

The Mediating Effect of Internalized Shame on the Relationship between Affiliate Stigma and Interpersonal Anxiety among Adolescent Siblings of Individuals with Autism Spectrum Disorder

The study examined the mediating effect of internalized shame on the relationship between affiliate stigma and interpersonal anxiety among adolescents with siblings who had autism spectrum disorder (ASD) and the moderated mediating effect of mother-adolescent communication openness. The participants consisted of 139 adolescents (boys 48.9%, high-school students 79.8%) who had siblings with ASD. Interpersonal anxiety, affiliate stigma, internalized shame, and mother-adolescent communication openness were measured using the Social Anxiety Scale for Adolescents (La Greca &amp; Lopez, 1998), the Affiliate Stigma Scale (Mak &amp; Cheung, 2008), the Internalized Shame Scale (Cook, 1988), and the Parent-Adolescent Communication Scale (Barnes &amp; Olson, 1982), respectively. The data were analyzed using descriptive statistics and Pearson’s correlation coefficients. Process Macro Models 4 and 7 were used to examine the mediating effect and the moderated mediating effect. The results indicated that internalized shame mediated the effect of affiliate stigma on interpersonal anxiety among adolescents who had siblings with ASD. However, there was no significant moderated mediating effect of mother-adolescent communication openness on the relationship between affiliate stigma, internalized shame and interpersonal anxiety. These findings suggest that it is necessary to improve social awareness of individuals with ASD and their family members to prevent adolescents who have siblings with ASD from having affiliate stigma and to help them reduce interpersonal anxiety. The results also highlight the importance of counseling programs for adolescents with siblings with ASD as a way of preventing or alleviating their interpersonal anxiety by reducing internalized shame, even where they experience affiliate stigma.

Association of Affiliate Stigma with Parenting Stress and Its Moderators among Caregivers of Children with Attention-Deficit/Hyperactivity Disorder

Caring for children with attention-deficit/hyperactivity disorder (CADHD) is stressful for caregivers. Identifying factors related to parenting stress in caregivers of CADHD can facilitate the development of intervention programs. This study aimed to examine the associations between affiliate stigma and various domains of parenting stress among caregivers of CADHD. This study also analyzed the moderating effects of demographic characteristics and the symptoms of childhood ADHD and oppositional defiant disorder (ODD) on the associations between affiliate stigma and parenting stress. In total, 213 caregivers of CADHD participated in this study. Parenting stress was assessed using the Parenting Stress Index, Fourth Edition Short Form (PSI-4-SF). Affiliate stigma was assessed using the Affiliate Stigma Scale. ADHD and ODD symptoms were assessed using the Parent Form of the Swanson, Nolan, and Pelham Scale, Version IV. The results indicated that higher affiliate stigma was significantly associated with greater parenting stress in all three domains of the PSI-4-SF. ODD symptoms increased the magnitude of parenting stress in two domains of parenting stress among caregivers with affiliate stigma. Intervention programs for relieving parenting stress among caregivers of CADHD should take affiliate stigma and child ODD symptoms into consideration.

The affiliate stigma scale: Psychometric refinement and validation of a short form in turkish spinal cord injury/disorder caregivers.

Despite the widespread international use of the Affiliate Stigma Scale in the context of disability, much research on its psychometric properties has taken dubious statistical approaches. The aim of this study was to examine the psychometric properties of the Affiliate Stigma Scale in a sample of Turkish spinal cord injury/disorder (SCI/D) caregivers. Participants completed the Affiliate Stigma Scale, Zarit Burden Interview, and Generalized Anxiety Disorder-7. This study conducted a series of confirmatory factor analyses (CFAs) of the Turkish Affiliate Stigma Scale using its originally theorized 3-factor structure and a 1-factor structure, as well as an exploratory factor analysis (EFA) in order to refine the scale items to create a short form, with a final CFA of the items in the short form. The 3-factor and 1-factor CFAs of the 22 items from the Affiliate Stigma Scale suggested poor fit to the data across every fit index. An EFA yielded four factors, although the patterns of item loading onto the factors did not map on in any discernable way to the original subscales theorized by the scale creators. A 1-factor CFA with the six items loading onto factor 1 of the EFA showed much better goodness of fit indices, with most achieving good or adequate fit. The current study supports a 1-factor solution with a short form comprised of six items, at least in Turkish and with SCI/D caregivers.

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

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. 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 (CFAs, EFAs). A sample of 148 PD caregivers from Mexico completed this measure, as well as indices of caregiver burden and anxiety. 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. 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.

Examining the association between neuropsychiatric symptoms among people with dementia and caregiver mental health: are caregiver burden and affiliate stigma mediators?

BackgroundNeuropsychiatric disturbances are common manifestations of dementia disorders and are associated with caregiver burden and affiliate stigma. The present study investigated affiliate stigma and caregiver burden as mediators for the association between neuropsychiatric symptoms of people with dementia (PWD) and caregiver mental health such as depression and anxiety.MethodsA cross-sectional survey study was carried out with 261 dyads of PWD and informal caregivers from the outpatient department of a general hospital in Taiwan. The survey included the Caregiver Burden Inventory (CBI), the Affiliate Stigma Scale (ASS), the Taiwanese Depression Questionnaire (TPQ), and the Beck Anxiety Inventory (BAI). Mediation models were tested using the Hayes’ PROCESS macro (Model 4 for parallel mediation model; Model 6 for sequentially mediation model).ResultsCaregiver burden, affiliate stigma, caregiver depression, and caregiver anxiety were significantly associated with neuropsychiatric symptoms. After controlling for several potentially confounding variables, it was found that PWD’s neuropsychiatric symptoms, caregiver burden and affiliate stigma significantly explained 52.34% of the variance in caregiver depression and 37.72% of the variance in caregiver anxiety. The parallel mediation model indicated a significantly indirect path from PWD’s neuropsychiatric symptoms to caregiver mental health through caregiver burden and affiliate stigma, while the direct effect was not significant. Moreover, there was a directional association between caregiver burden and affiliate stigma in the sequential mediation model.ConclusionsThese findings show that it is imperative to improve caregivers’ perception of those with dementia to reduce internalized stigma and to improve caregivers’ mental health. Implementation of affiliate stigma assessment in clinical practice would allow distinctions to be made between the impact of affiliate stigma and the consequences of caregiver burden to help inform appropriate intervention.

Affiliate stigma and related factors among parents of autism spectrum condition: A pilot study from mainland China.

Autistic individuals show differences in social and behavioral performances. Autism-related stigma affects autistic children as well as their caregivers (e.g., parents). Research has shown that stigmatizing reactions from others toward caregivers of autistic children are common and that these caregivers suffer from affiliate stigma. To examine the level of affiliate stigma among parents of autistic children and its predictive factors in mainland China. This was a cross-sectional study involving parents of autistic children from mainland China. The sample consisted of 183 parents (mean age = 36.5 years). The measures assessed included demographic characteristics, and parents completed two questionnaires. The Social Responsiveness Scale (SRS) was used to evaluate the characteristics of children by their parent's subjective assessments, and the Affiliate Stigma Scale (ASS) was used to investigate the affiliate stigma level of parents. The affiliate stigma levels of parents of autistic children were high, and the mean score of the affect subscale was higher than those of the other subscales. The mean ASS score differed significantly between employed and unemployed parents, those aged under 40 and over 40, and high- and low-income parents. The hierarchical regression analysis showed that parents' age, monthly household income, and mean SRS score were significant predictors of the mean ASS score. The results indicated that parents of autistic children and their children need more social support and inclusion in mainland China. The present study confirms the importance of studying primary caregivers (i.e., parents) in the context of traditional mainland Chinese culture. Although preliminarily, findings showed that the affiliate stigma levels of parents are high in mainland China, probably due to the influence of traditional cultural values. Moreover, considering the importance of autistic child characteristics, our results suggest that we should increase public knowledge of autism, enrich the general understanding of autism, and reduce the autism-related stigma of parents in mainland Chinese societies.

The relationship between affiliate stigma, stress, and quality of life for parents of individuals with cerebral palsy in Malaysia

Objective To examine the relationship between affiliate stigma, stress, and perceived quality of life among parents of children with cerebral palsy (CP). Method Surveys (Study 1) and semi-structured interviews (Study 2) were used to collect data. Thirty-eight respondents completed the Affiliate Stigma Scale (ASS), Caregiver Burden Inventory (CBI), and Care-related Quality of Life (CarerQol) scales (GMFCS). Eleven respondents took part in semi-structured interviews, which were then thematically evaluated. Results Parents did not feel stigmatized because they had a child with CP. However, parents needed some form of short-term relief from caregiving. After controlling for demographics, high stress respondents experienced high affiliate stigma whereas low stress respondents had better quality of life. Although the respondents with less stigma had a better quality of life, this effect was moderate. Three major themes emerged from the interviews. Conclusion Counseling, support groups, and helper services should be offered to parents. Also, healthcare professionals participating in CP rehabilitation, community-based rehabilitation, and health institutions should be educated on how to better help parents of children with CP.

The Effect of Psycho-education on the Affiliate Stigma in Family Caregivers of People with Bipolar Disorder.

IntroductionPaying attention to stigma among caregivers to provide proper care for patients is necessary, and promoting awareness (about mental illness and mental health) to taking care of the caregivers’ health, is crucial.ObjectiveThis study aimed to investigate the effect of psycho-education on the affiliate stigma in family caregivers of people with bipolar disorder.MethodThis study is a quasi-experimental research with an experimental and control groups. 64 family caregivers of people with bipolar disorder participated in this study (32 in each group). Data was collected using the demographic questionnaire and Affiliate Stigma Scale before and after intervention (with 4 weeks gap). The experimental group received a psycho-education program for four weeks. The control group carried on their normal routine lifestyle.ResultsThe mean scores of the affiliate stigma of both control and experimental groups before the intervention did not show a statistically significant difference (P = .36), however after the intervention the results were statistically significant and increased in the experimental group (P < .001).ConclusionAccording to the findings of this study psycho-education is an effective intervention that can reduce the affiliate stigma among family caregivers of people with bipolar disorder and it can be considered as one of the de-stigmatization strategies for them.

'I bring her up with love:' Perspectives of caregivers of children with neurodevelopmental delays in western Kenya.

This study aims to understand the challenges and perspectives of caregivers with neurodevelopmental delays (NDD) in rural Kenya. Semi-structured interviews and the Affiliate Stigma Scale were administered to the primary caregivers of children with NDDs recruited from the communities near Eldoret, Kenya. Constant comparison and triangulation methods were used to inductively develop relevant themes and concepts. Sixteen caregivers participated. Challenges, which included hardships related to safety and supervision, challenging emotions and financial difficulties, were compounded by a lack of social support and community stigma towards these children. However, caregivers still felt deep love for their children, desired acceptance from the community and found sources of strength from faith and religious institutions. The study uncovered crucial insights into the perspectives of caregivers within this population and revealed a paucity of disability awareness and understanding within the community, possibly informing future programmes and intervention policies.