Subjective Burden and Depressive Symptoms in Mothers of Children with Autism Spectrum Disorder in India: Moderating Effect of Social Support (WITHDRAWN)

Background and Purpose: The cross-sectional quantitative study assessed the impact of subjective burden on the depressive symptoms experienced by mothers of children with Autism Spectrum Disorder (ASD), and the role of social support in buffering the impact of subjective burden on caregiver depressive symptoms. The study uses a generalized stress and coping model, which to our understanding is the first quantitative study in the context of India to understand caregiver stress process especially among mothers of children with ASD.

Methods: The study used a purposive sample of 70 mothers of children with ASD. Data was collected using a structured interview schedule. In addition to demographic data, the study included three valid and reliable scales: Zarit Burden Scale, Centre of Epidemiologic Studies- Depression Scale and Multidimensional Scale of Perceived Social Support, each to measure subjective burden, depressive symptoms and social support respectively. The measure of Social support had three sub-scales, each of which measured support from family, friend or significant other. The analytic strategy used was descriptive statistics and hierarchical regression analysis with interaction terms.

Results: Mothers in the study had a mean score of 19.01 on subjective burden. For depressive symptoms the mean score was 16.2. Almost half of the mothers had a cut-off score of 16 or above, which according to the CES-D scale qualified for clinical depression. Of all the sub-types of social support, mothers reported the highest mean score on support from family. Further, regression analysis showed higher subjective burden to significantly predict higher depressive symptoms. Results also showed the negative impact of subjective burden on depressive symptoms was greater for mothers with lower social support from family, compared to mothers with higher social support from family. Of the three forms of social support only support from family was found to significantly moderate the relationship between subjective burden and depressive symptoms.

Conclusions and Implications: The findings from the study contributes significantly to social work research and practice especially in the context of India. Most of the existing research on Autism and caregiving from India are qualitative, and the quantitative studies are descriptive, sans the use of any theoretical model. Although the current study used a purposive sample, to the best of our knowledge this is first study to address the existing knowledge gaps, thus paving way for future studies.

The findings from the study have significane to shape social work practice. They warrant assessing psychological health of mothers, as almost half of them experienced depressive symptoms of clinical significance. Counselors and special educators could work to address the mental health of caregivers. The study also showed the important role of family support for mothers, compared to support from friends and significant others. In the context of India, disability in a child is a significant source of stigma specifically for mothers. Therefore, it is not surprising that support from family had a significant buffering impact on mother’s mental health. The findings call for family based therapies and interventions.