Patterns of Caregiver Burden and Psychosocial Coping Resources Associated with Depression Among Parents of Children with Developmental Disabilities in South Korea: A Latent Profile Analysis

Background and Purpose:

Depression is known as the most common mental health outcome among parents of children with developmental disabilities (DD), but not all of them experience this problem. Some parents feel the process of raising a child with a disability is burdensome and difficult, whereas others successfully adapt to the situation and even experience positive outcomes. Previous research has paid more attention to the fact that parents of children with DD often use passive stress coping (e.g., avoiding, denying, or withdrawing), which results in exacerbating burden and depression. Meanwhile, there are considerable evidences that parents of children with DD are more likely to use methods of active-based stress coping, such as seeking social support and positive reappraisal than do parents of children without disability. Also, giving birth or raising a child with DD could lead to positive changes such as PTG or family cohesion. These show that even among parents of children with DD who experience a caregiver burden, there could be various heterogeneous groups. Accordingly, this study applies latent profile analysis (LPA) to investigate heterogeneity in the pattern of caregiver burden and psychosocial coping resources (e.g., coping strategies, PTG, family cohesion, and social support) among parents of children with DD, further confirm the relationship between the emerged profiles and depression in South Korea.

Methods:

Sample: Data were collected from 610 parents of people with DD through a survey from October 2017 to November 2018. We used convenience sampling to recruit parents of people with DD.

Measures: LPA was used to identify latent subgroups based on six indicators: caregiver burden measured by the Caregiver Strain Questionnaire Scale, coping strategies, PTG measured by the Korean version of the post-traumatic growth Inventory, social support measured by MSPSS, and family support services use. Family cohesion was measured by a subfactor of the Resilience Scale for Adults. Control variables included factors related to parents, such as gender, age, education, marital status, and monthly household income, as well as factors related to DD, such as gender, age, presence of multiple disabilities, and disability level. Finally, logistic regression analysis examined the relations between latent subgroups and depression (PHQ-9).

Results:

A five-profile model emerged: 1) dysfunctional coping strategies & limited social support (5.6%), 2) low caregiver burden & low PTG (21.8%), 3) high caregiver burden & average coping strategies (11.1%), 4) low caregiver burden & high PTG (40.5%), 5) positive coping strategies & high social support (21.0%). Logistic regression analysis revealed that compared to parents with “positive coping strategies & high social support,” parents with “dysfunctional coping strategies & low social support” (OR=14.872, CI=5.036-43.916), parents with “high caregiver burden & average coping strategies” (OR=7.071, CI=2.811-17.786), parents with “low caregiver burden & low PTG” (OR=3.946, CI=1.623-9.595) are more likely to be depressed.

Conclusions:

We captured a vulnerable subgroup characterized by dysfunctional coping and limited social support with severe depression and unique subgroups. Our findings suggest a need to pay attention to various coping strategies according to caregiver burden level to provide targeted interventions.