Archives of Psychiatric Nursing xxx (2016) xxx–xxx
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Archives of Psychiatric Nursing journal homepage: www.elsevier.com/locate/apnu
Psychological Distress in Jordanian Parents of Children with Autism Spectrum Disorder: The Role of Positive Reappraisal Coping Ahmad Rayan a,⁎, Muayyad Ahmad b a b
Zarqa University/The Faculty of Nursing, Psychiatric and Mental Health Nursing, Zarqa, Jordan University of Jordan/The Faculty of Nursing, Clinical Nursing Department, Amman, Jordan
a b s t r a c t Background: Parents of children with autism spectrum disorder (ASD) frequently report poor psychological wellbeing. Positive reappraisal coping (PRC) is a coping strategy which offers a protective effect from anxiety and depression. However, the association between PRC and the psychological distress in parents of children with ASD has yet to be established. Aim: This study examines the association between PRC and the psychological distress in parents of children with ASD. Method: In this descriptive correlational study, 104 parents of children with ASD completed measures of psychological distress and PRC. Hierarchical multiple regression analysis was used to examine the association between PRC and the psychological distress in parents after controlling the influence of parental age and gender. Results: The PRC was associated with the psychological distress in parents above and beyond the variance accounted for by parental age and gender. After controlling for parental age and gender, PRC had significant negative correlation with the levels of anxiety, stress, and depression in parents (Anxiety: β = −0.36, p b 0.001; Stress: β = −0.21, p = 0.03; Depression: β = − 0.37, p b 0.001). Conclusion: Using positive reappraisal coping strategy may help to reduce psychological distress in parents of children with ASD. © 2016 Elsevier Inc. All rights reserved.
Parents of children with autism spectrum disorder (ASD) frequently report poor psychological well-being (Falk, Norris, & Quinn, 2014; Firth & Dryer, 2013; Merkaj, Kika, & Simaku, 2013). Literature revealed that parents of children with ASD report higher levels of psychological distress stress than both parents of typically developing children and parents of children with other disabilities (Almansour, Alzahrani, & Algeffari, 2013; Hayes & Watson, 2013). Some parents have reported positive experiences about raising a child with ASD such as finding a greater sense of meaning in their lives, and having intense pride for accomplishments of their children (Kourkoutas, Langher, Caldin, & Fountoulaki, 2012). Despite these positive experiences, substantial research evidence indicates that raising a child with ASD can impose a severe burden on parents (Almansour et al., 2013; BakerEriczén, Brookman-Frazee, & Stahmer, 2005; Hayes & Watson, 2013).
Conflict of Interest: The authors declare that they have no conflict of interest. Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent: “Informed consent was obtained from all individual participants included in the study.” ⁎ Corresponding Author: Ahmad Rayan, Zarqa University/The Faculty of Nursing, Psychiatric and Mental Health Nursing, Zarqa, Jordan. E-mail addresses:
[email protected] (A. Rayan),
[email protected] (M. Ahmad).
In Jordan, few special services have been specialized to include children with ASD. Further, these services are child-focused, with little attention paid to the needs of parents of children with ASD (Al-Khalaf, Dempsey, & Dally, 2014). In addition, referring to the Jordanian context, parents of children with ASD have many stressful experiences, including stigma, lack awareness about ASD, a diagnostic delay for their children, and face difficulties in educating them (Abu-Hamour & Muhaidat, 2014; Jabery, Arabiat, Khamra, Betawi, & Jabbar, 2014; Masri, Al Suluh, & Nasir, 2013). The same challenges were reported by parents of children with ASD in other Arab countries and found high levels of self-reported anxiety, stress, and depression in these parents (Al-Farsi, Al-Farsi, Waly, Al-Sharbati, et al., 2014; Almansour et al., 2013; Fido & Al Saad, 2013). Symptoms' deficits which include deficits social interaction (DSI), and restricted interests and repetitive behaviors (RIRB), in addition to difficulties in dealing with children with ASD are likely to cause psychological exhaustion in parents. The complexity of ASD, lack of an available cure, and challenging symptoms characterized by deficits in communication and restricted behaviors are factors that may exacerbate stress in parents of children with the disorder (Anagnostou et al., 2014; de Bruin, Blom, Smit, Steensel, & Bögels, 2014). Other sources of parental stress in parents of children with ASD include difficulty in interaction with the child, marital conflicts resulting from difficulty meeting the child's needs, conflicts between other family members, lack of professional support services, and stigma in society (Al-Khalaf et al., 2014; Dardas & Ahmad, 2014; Zeedyk, Cohen, & Blacher, 2014).
http://dx.doi.org/10.1016/j.apnu.2016.07.017 0883-9417/© 2016 Elsevier Inc. All rights reserved.
Please cite this article as: Rayan, A., & Ahmad, M., Psychological Distress in Jordanian Parents of Children with Autism Spectrum Disorder: The Role of Positive Reappraisal Coping, Archives of Psychiatric Nursing (2016), http://dx.doi.org/10.1016/j.apnu.2016.07.017
A. Rayan, M. Ahmad / Archives of Psychiatric Nursing xxx (2016) xxx–xxx
Acknowledgment The authors acknowledge the partial funding from the University of Jordan.
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Please cite this article as: Rayan, A., & Ahmad, M., Psychological Distress in Jordanian Parents of Children with Autism Spectrum Disorder: The Role of Positive Reappraisal Coping, Archives of Psychiatric Nursing (2016), http://dx.doi.org/10.1016/j.apnu.2016.07.017