Predictors of parental burnout in women raising children with autism spectrum disorders

Kuzmina Anna Sergeevna PhD in Psychology Associate Professor, Department of Clinical Psychology, Altai State University 656049, Russia, Altai Krai, Barnaul, Lenin str., 61, office 302 annakuz87@yandex.ru Other publications by this author     Krivoshei Kristina Olegovna Postgraduate Student, Department of Clinical Psychology, Altai State University 656000, Russia, Altai Territory, Barnaul, Lenin str., 61, office 302 03fomina@mail.ru Other publications by this author

Golovanova Larisa Valer'evna Senior Lecturer, Department of Clinical Psychology, Federal State Budgetary Educational Institution of Higher Education "Altai State University" 656000, Russia, Altai Krai, Barnaul, Lenin str., 61, office 302 botanik126@mail.ru

The prevalence of children with autism spectrum disorders among the population is rapidly increasing. According to the data of the Federal State Statistics Service of Russia for 2021, the child population is more than 30 million, of which more than 300 thousand children are diagnosed with ASD. Statistics on the prevalence of autism spectrum disorders among the child population in Russia and in the world indicate that this disease represents a real catastrophe of the XXI century.

Consequently, a special category of families is becoming more and more numerous – families that raise a child with autism spectrum disorders, the psychological specificity of which is determined by the experience of prolonged stress associated with a complex and difficult to correct diagnosis. Most families where children with autism spectrum disorders grow up are faced with the fact that parents do not have a clear plan of action after diagnosis, are left alone with their worries, questions and an absolute misunderstanding of further actions. This leads to the development of symptoms of parental burnout and emotional exhaustion, especially in mothers of such children ^{[1, 2, 3, 4, 5]}.

However, this problem is currently insufficiently developed, in particular, there is a shortage of data contributing to a systematic understanding of the features of psychological support for women raising children with autism spectrum disorders.

Insufficient research aimed at studying the role of family, parents, and relatives in the development of children with autism spectrum disorders makes this problem excessively relevant.

The phenomenon of burnout, as an independent unit of study, has been considered in Russian science since the 1990s. Such scientists as N.E. Vodopyanova, V.V. Boyko, E.S. Starchenkova, M.V. Borisova have been dealing with this issue ^[6].

N.E. Vodopyanova and E.S. Starchenkova define burnout as a complex concept that includes various negative psychological experiences and maladaptive behavior caused by prolonged stress. V.V. Boyko by burnout means a variant of psychological protection of the individual, manifested in partial or absolute rejection of the manifestation of emotional reactions in traumatic conditions ^[6].

There are a number of concepts that consider the structure of burnout.

The two-factor model presented by D. V. Dierendonck and W.B. Schaufeli defines burnout as a construct consisting of two dimensions: emotional exhaustion and depersonalization. The emotional component of burnout manifests itself in the form of nervous tension, deterioration of physical health. The second component of burnout is an installation one, which affects a change in attitude towards oneself ^[6].

According to the concept proposed by K. Maslach, the phenomenon of burnout includes: emotional exhaustion, depersonalization and reduction of professional achievements.  Emotional exhaustion is understood as a decrease in the emotional background, loss of strength, energy. Depersonalization is a defensive reaction that implies overly detached communication. By reduction, we mean a decrease in productivity and a sense of self-competence. This phenomenon manifests itself through nervous, physical and emotional exhaustion ^[6].

Based on the data on the phenomenon of burnout, the phenomenon of parental burnout has been actively studied. A number of Russian researchers have highlighted this phenomenon in their works: L.A. Bazaleva, I. N. Efimova, N. N. Koroleva, T.Y. Fadeeva ^[7,8].

L. A. Bazaleva considers parental burnout based on the theory of stress by G. Selye. The experience of emotional burnout occurs gradually and goes through several stages. At the initial stage, cognitive symptoms prevail – anxiety, anxiety and decreased motivation. The second phase of resistance is when the affective component appears and the economy of emotions is turned on. And the last stage is exhaustion, manifested by psychosomatic symptoms ^[7].

I.N. Efimova defines parental burnout syndrome as several aspects, which is a complex complex of negative psychological states and unsuitable behavioral reactions of parents that arise in the process of upbringing, communication with a child ^[9].

Many researchers emphasize the importance of the influence of stress on the development of the phenomenon of parental burnout. Household chores, homework, extra classes, acute stressors (child injury), chronic stressors (chronic diseases), have a negative impact on the emotional well-being of parents, deterioration of child-parent relations, and the development of the child himself ^{[10, 11, 12, 13, 14]}.

The uncertainty of the child's prospects, the dynamics of his development, and the failure to implement parental attitudes provoke anxiety in parents, which occupies the dominant characteristic of the family situation in the upbringing of children with autism spectrum disorders (N.O. Kerre, L.L. Mikaelian, O.S. Nikolskaya, U.A. Mamokhina,). In such families, the level of stress and tension is higher than in families that raise children with other developmental disabilities (N.O. Kerre).

Families raising children with autism spectrum disorders often experience low self-efficacy and lack of confidence in the correctness of raising a child. This causes feelings of guilt, helplessness, and depressive symptoms ^{[15, 16,17]}.

Mothers raising children with autism spectrum disorders experience severe restrictions on their free time due to their children's over-dependence. There are also specific communication difficulties associated with the peculiarities of behavior and cognitive functions of children with the autism spectrum. Parents of such children need to choose an individual approach to parenting and interaction with children to help them cope with these difficulties. Due to such features, mothers may feel guilty about possible violations of their children's behavior and consider themselves responsible for their difficulties. ^{[18, 19, 20, 21, 22]}.

The aim of the study was to identify predictors of parental burnout in women raising children with autism spectrum disorders.

The subject of the study is parental burnout of women raising children with autism spectrum disorders.

The scientific novelty of the research. The symptoms of parental burnout of women raising children with autism spectrum disorders have been identified. It is theoretically justified and empirically proven that parental burnout of women raising children with autism spectrum disorders is interrelated with the peculiarity of emotional relationships with a child and a spouse.

Research methodology: theories of parental burnout in parents raising children with autism spectrum disorders (V. V. Boyko, L. A. Bazaleva, O.S. Nikolskaya); provision on general and specific patterns of development of children with various types of dysontogenesis (L.S. Vygotsky, V.V. Lebedinsky, V.I. Lubovsky); approaches to the study of the characteristics of childhood-parental relations (A. Ya. Varga, R.V. Ovcharova, V. V. Stolin, A. S. Spivakovskaya, etc.).

The hypothesis of the study: It is likely that the symptoms of parental burnout in women raising children with autism spectrum disorders are interrelated with the emotional attitude towards the child and the peculiarities of the relationship with the spouse.

The empirical study was conducted on the basis of the KGB "Altai Regional Center for Psychological, Pedagogical, medical and Social Assistance". 54 mothers raising children with autism spectrum disorders participated in the study on a voluntary basis. The age of the respondents is from 32 to 43 years, the average age is 38.6 years, 40 of them are married, 15 are divorced, 25 women have secondary vocational education, 29 women have higher education.

Research methods and techniques:

The questionnaire "Parental burnout" by I. N. Efimova was used to study the level of parental burnout and its symptoms: emotional exhaustion, depersonalization, reduction of parental achievements. The "Questionnaire of child-parent emotional interaction" by E.I. Zakharova (the ODRAV method) was used to study the emotional interaction of mother and child, including three blocks: a block of sensitivity, a block of emotional acceptance, a block of behavioral manifestations of emotional interaction. Methods of mathematical and statistical data processing: Mann-Whitney U-test, regression analysis using the statistical package "SPSS Statistics 23.0".

The results of the study

To identify differences in parental burnout rates among women raising children with autism spectrum disorders, with different marital status and satisfaction with their spouse, the Mann-Whitney U-test was applied (see Table 1, 2).

Table 1

The results of the Mann-Whitney U-test to identify differences in rates of parental burnout in women with different marital status

Significant differences were obtained in terms of emotional exhaustion, depersonalization and reduction of parental achievements in two groups of subjects.  Women raising children with autism spectrum disorders and being divorced have significantly higher levels of emotional exhaustion (Z=3,862; p=0.01), depersonalization (Z=3,698; p=0.01). They are characterized by a reduction in parental achievements (Z=3.41; p=0.01).

In the questionnaire provided to the respondents, there was a question regarding women's satisfaction with their relationship with their spouse. According to this parameter, two groups were identified: women who are satisfied and dissatisfied with their relationship with their spouse. Table 2 presents an analysis of the differences in the two groups in terms of parental burnout.

Table 2

The results of the Mann-Whitney U-test to identify differences in rates of parental burnout in women with different satisfaction with their relationship with their spouse

Significant differences in indicators of parental burnout were revealed in groups of women who differ in satisfaction and dissatisfaction with their relationship with their spouse. Thus, significant differences were obtained in the parameter emotional exhaustion (Z=2.95; p=0.003), depersonalization (Z=2.97; p=0.003), reduction of parental achievements, depersonalization (Z=2.81; p=0.005).

For women raising children with autism spectrum disorders and dissatisfied with marital relationships, a higher level of emotional exhaustion is characteristic, which manifests itself in feelings of emotional overstrain, loss of interest in their own children and in the environment as a whole, in indifference or emotional oversaturation, in a feeling of emptiness, exhaustion of their own emotional resources.

Women raising children with autism spectrum disorders and dissatisfied with marital relationships are characterized by a higher level of depersonalization. A parent's contacts with children may be impersonal, formal in nature. Taking care of children begins to be formal – to clothe, to feed. During depersonalization, parents may have negative and not always objective attitudes towards their own children, they may manifest themselves in internal pent-up irritation, which eventually breaks out in the form of outbursts of irritation or conflict situations.

The reduction of parental achievements manifests itself as a decrease in the sense of competence in fulfilling one's parental role ("I'm a bad mother", "I'm not trying hard enough"), dissatisfaction with oneself (and children as the "results" of parental success, a decrease in the value of one's activities ("a housewife is ridiculous, no one appreciates taking care of children"), negative self-perception of fulfilling one's parental responsibilities.

Thus, marital satisfaction is an important parameter influencing the indicators of parental burnout of women raising children with autism spectrum disorders. High satisfaction and stability of the relationship with the spouse is a factor that increases resistance to the development of symptoms of parental burnout.

A linear regression analysis was applied, in which the scales of the child-parent emotional interaction questionnaire (PDE) were included as independent variables, and the parameters of genitive burnout were included as dependent variables.  As a result, three reliable regression models of parental burnout were obtained for women raising children with autism spectrum disorders (see Tables 3, 4, 5).

Table 3.

Predictors of emotional exhaustion (n=54)

As can be seen from table 3, the predictor of emotional exhaustion of women raising children with autism spectrum disorders is such characteristics of an emotional relationship with a child as "Feelings that arise in a mother in interaction with a child", and the anti—predictors are "Unconditional acceptance", "Desire for bodily contact".

Table 4.

Predictors of depersonalization (n=54)

Table 4 shows that the predictor of the reduction of parental achievements of women raising children with autism spectrum disorders is such a characteristic of an emotional relationship with a child as "Lack of emotional support" and the anti—predictors are "Unconditional acceptance". "Feelings that arise in a mother in interaction with a child."

Table 5.

Predictors of parental achievement reduction (n=54)

Since the scale of reduction of parental achievements has inverse values, we will describe the results taking into account this fact.

As can be seen from table 5, the predictor of the reduction of parental achievements of women raising children with autism spectrum disorders is such a characteristic of an emotional relationship with a child as "Lack of emotional support" and the anti—predictors are "Unconditional acceptance", "Feelings that arise in a mother in interaction with a child"

Thus, emotional exhaustion, depersonalization, and reduction of parental achievements in women raising children with autism spectrum disorders are associated with rejection of the child, the desire to change it, and a sense of shame for the child. Women often get tired of communicating with their child and the child's behavior often requires a lot of emotional costs from them. In addition, due to the peculiarities of the child's disease, mothers often do not understand whether their child loves them or not. The disadvantage is the limitations of physical contact with the child, the inability to give the child emotional support.

The study obtained three regression models for the symptoms of parental burnout: emotional exhaustion, depersonalization, and reduction of parental achievements. Predictors of emotional exhaustion are: a) negative feelings that arise when interacting with a child; b) rejection of a child; and c) limited physical contact. Predictors of depersonalization are: a) negative feelings that arise when interacting with a child; b) lack of emotional support. Predictors of the reduction of parental achievements are: a) negative feelings that arise when interacting with a child; b) lack of emotional support, c) rejection of the child.

The paper draws the following conclusions:

1.                 Marital satisfaction is an important parameter influencing the development of symptoms of parental burnout in women raising children with autism spectrum disorders. Let's assume that high satisfaction and stability of relations with a spouse is a factor that increases resistance to the development of symptoms of parental burnout.

2.                 Parental burnout of women raising children with autism spectrum disorders is interrelated with the peculiarities of emotional relationships with a child. Thus, the predictors of symptoms of parental burnout are the feelings that arise in a mother's relationship with a child, acceptance of the child's behavior, and the presence of bodily contact.

The data obtained in the research indicate the need for psychological support for women raising a child with autism spectrum disorders, and can be used as a basis in the development of a psychological counseling algorithm.

The results of this study may be useful for medical psychologists and educational psychologists in the organization of psychological and pedagogical support for families raising children with autism spectrum disorders.