Date of Award
12-2024
Document Type
Campus Access Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Clinical Psychology
First Advisor
Alice S. Carter
Second Advisor
Abbey Eisenhower
Third Advisor
Laurel Wainwright
Abstract
Autism is a stigmatized identity, meaning that autistic people often experience stereotyping, prejudice and/or discrimination because of their autistic identity and their behaviors that are characteristic of autism such as social communication differences and restricted and repetitive behaviors. Parents of autistic children and youth report that their children are frequently stigmatized however little is known about how experiences of stigma are associated with child mental health problems, despite the fact that co-occurring mental health problems are common among autistic youth and that mental health problems are also stigmatized in society. The current study quantitatively and qualitatively explored associations between autism characteristics, mental health problems, parent-perceived stigma, and unmet child mental health service needs. Parent-perceived stigma was defined as parent perceptions of their own and their child’s experiences of rejection, judgement, prejudice or disapproval from members of their community. Eighty-five parents responded to the online survey. Surveys were administered in English (92%) and Spanish (8%). A majority of parents were mothers (93%), identified as non-White or White, Hispanic (60%), and had a college education or greater (60%). By parent report, the majority of children in the sample identified as non-White or White, Hispanic (68%), a boy (72%), spoke English as their primary language (81%), and was an average of 10.6 years of age. Sixty percent of children in this sample fell into the “Clinical” range on a parent-report measure of mental health symptoms (CBCL) and 39% of parents fell into the “Moderate” or “Severe” ranges on a parent affective distress scale (K10). Overall, parents reported moderate levels of parent-perceived stigma. Results from step 1 and step 2 of hierarchical linear regression analyses indicated that greater autism characteristics and greater mental health symptoms were associated with greater parent-perceived stigma. These effects were additive. In step 3, greater parent affective distress was associated with greater parent-perceived stigma whereas child age was not. Results from a logistic regression predicting to unmet child mental health needs found that greater parent-perceived stigma was associated with greater child unmet mental health needs. Child autism characteristics, child and parent mental health problems, and child age did not contribute significantly to unmet child mental health needs. Qualitative analysis of parent responses to four open-ended questions highlighted the stigma that they face (e.g., judged for parenting and disciplinary style) and their child faces (e.g., lack of interest or respect from peers, lack of understanding from teachers or community members). Parent responses about stigma and mental health service engagement were mixed. Findings from this study underscore the importance of community-based initiatives that aim to increase autism awareness and reduce autism and mental health stigma, as well as the importance of accessible, neurodiversity affirming care for autistic youth with a range of developmental and mental health needs.
Recommended Citation
Troxel, Mary E., "Compounded Stigma?: Understanding Experiences of Parent-Perceived Stigmatization of Autistic Children and Its Association with Mental Health Problems and Unmet Mental Health Needs" (2024). Graduate Doctoral Dissertations. 1021.
https://scholarworks.umb.edu/doctoral_dissertations/1021
Comments
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