OTİZM SPEKTRUM BOZUKLUĞU TANISI OLAN ÇOCUKLARIN ANNELERİNİN ALGILADIKLARI SOSYAL DESTEK VE PSİKOLOJİK SIKINTI DÜZEYLERİNİN İNCELENMESİ

Öz

Otizm Spektrum Bozukluğu (OSB) yaygınlığı yıllar içerisinde artarak hem tanı alan bireyi hem de ailesini etkileyen bir rahatsızlıktır. Ebeveynlerin süreçte stres yaşadıkları, depresyon ve anksiyete rapor ettikleri görülmektedir. Bu çalışmada OSB tanılı çocuğu olan annelerin psikolojik sıkıntı düzeyleri, bu sıkıntılar ile algılanan sosyal desteğin (ASD) ilişkisi ve stresin depresyon üzerindeki etkilerinde ASD’nin koruyucu rolünün incelenmesi amaçlanmıştır. Bu amacı gerçekleştirmek için çalışmaya çocuğu OSB tanısı almış 156 anne katılmıştır. Katılımcılara Demografik Bilgi Formu, Depresyon Anksiyete Stres 21 Ölçeği (DASS-21) ve Çok Boyutlu Algılanan Sosyal Destek Ölçeği (MSPSS) uygulanmıştır. Araştırmanın sonucunda, stres, depresyon ve anksiyetenin pozitif ilişkileri olduğu bulunurken, ASD’nin ve farklı kaynaklardan ASD’nin de bu belirtilerle ilişkileri incelenmiştir. Yalnızca özel birinden ASD depresyon ile negatif ilişkili olarak bulunmuştur. Ayrıca, stres ve depresyon ilişkisinde ASD’nin ve farklı kaynaklardan ASD’nin düzenleyici rolüne ilişkin hipotezler desteklenmemiştir. Sonuç olarak, ASD’nin stresin depresyon üzerindeki etkilerinde koruyucu rolünün olmadığı sonucuna ulaşılmıştır. Alanyazın bağlamında da çelişkili bulguların olduğu görülürken, OSB tanılı çocuğu olan anneler açısından sosyal desteğe dair algılarının, beklentilerinin değerlendirilmesinin fayda sağlayacağı düşünülmektedir. Son olarak, çalışmanın kısıtlılıkları ve gelecek çalışmalar için öneriler yer almaktadır.

Anahtar Kelimeler

• OSB Tanılı Çocuğu Olan Anneler
• Depresyon
• Anksiyete
• Stres
• Algılanan Sosyal Destek.

EXAMINATION OF PERCEIVED SOCIAL SUPPORT AND PSYCHOLOGICAL DISTRESS LEVELS OF MOTHERS OF CHILDREN DIAGNOSED WITH AUTISM SPECTRUM DISORDER

Öz

Autism Spectrum Disorder (ASD) is a disorder whose prevalence has increased over the years and affects both the diagnosed individual and his/her family. It is observed that parents experience stress in the process and report depression and anxiety. This study aims to investigate the relationships between these symptoms and perceived social support (PSS) and the protective role of PSS in the effects of stress on depression. To achieve this aim, 156 mothers whose children were diagnosed with ASD participated in the study. Demographic Information Form, Depression Anxiety Stress 21 Scale (DASS-21) and Multidimensional Scale of Perceived Social Support (MSPSS) were applied to the participants. As a result of the study, it was found that stress, depression and anxiety had positive relationships with each other, while the relationships of PSS and PSS from different sources with these symptoms were also examined. As a consequence, only PSS from a significant other was found to have a negative relationship with depression. Additionally, the moderating role of PSS and PSS from different sources in the relationship between stress and depression was not found. As a result, it was concluded that PSS does not have a protective role in the effects of stress on depression. While there are conflicting findings in the literature, it is thought that it would be beneficial to evaluate the perceptions and expectations of mothers with children diagnosed with ASD regarding social support. Finally, the limitations of the present study and suggestions for future research were mentioned.

Anahtar Kelimeler

• Mothers of Children Diagnosed with ASD
• Depression
• Anxiety
• Stress
• Perceived Social Support.

Kaynakça

1. Aksakoğlu, G. (2001). Sağlıkta araştırma teknikleri ve analiz yöntemleri. Dokuz Eylül Üniversitesi Yayınları, İzmir.
2. Alibekova, R., Chan, C. K., Crape, B., Kadyrzhanuly, K., Gusmanov, A., An, S., ... & Rakhimova, M. (2022). Stress, anxiety and depression in parents of children with autism spectrum disorders in Kazakhstan: prevalence and associated factors. Global Mental Health, 9, 472-482.
3. Almansour, M. A., Alateeq, M. A., Alzahrani, M. K., Algeffari, M. A., & Alhomaidan, H. T. (2013). Depression and anxiety among parents and caregivers of autistic spectral disorder children. Neurosciences, 18 (1), 58-63.
4. Alwhaibi, M., & Al Aloola, N. A. (2023). Associations between Stress, Anxiety, Depression and Sleep Quality among Healthcare Students. Journal of Clinical Medicine, 12 (13), 4340.
5. American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Association Publishing.
6. Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment, 10 (2), 176-181.
7. Bitsika, V., & Sharpley, C. F. (2004). Stress, anxiety and depression among parents of children with autism spectrum disorder. Journal of Psychologists and Counsellors in Schools, 14 (2), 151-161.
8. Broady, T. R., Stoyles, G. J., & Morse, C. (2017). Understanding carers’ lived experience of stigma: The voice of families with a child on the autism spectrum. Health & Social Care in the Community, 25 (1), 224-233.

9. Bromley, J., Hare, D. J., Davison, K., & Emerson, E. (2004). Mothers supporting children with autistic spectrum disorders: Social support, mental health status and satisfaction with services. Autism, 8 (4), 409-423.
10. Cai, R. Y., Uljarević, M., & Leekam, S. R. (2020). Predicting mental health and psychological wellbeing in mothers of children with autism spectrum disorder: Roles of intolerance of uncertainty and coping. Autism Research, 13 (10), 1797-1801.
11. Cohen, J. (1992). Statistical power analysis. Current Directions in Psychological Science, 1 (3), 98-101.
12. Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98 (2), 310.
13. Coşkun, Y., & Akkaş, G. (2009). Engelli çocuğu olan annelerin sürekli kaygi düzeyleri ile sosyal destek algilari arasindaki ilişki. Ahi Evran Üniversitesi Kırşehir Eğitim Fakültesi Dergisi, 10 (1), 213-227.
14. Dabrowska, A. & Pisula, E. (2010). Parenting stress and coping styles in mothers and fathers of pre‐school children with autism and Down syndrome. Journal of Intellectual Disability Research, 54 (3), 266-280.
15. Demsar, A. & Bakracevic, K. (2023). Depression, anxiety, stress, and coping mechanisms among parents of children with autism spectrum disorder. International Journal of Disability, Development and Education, 70 (6), 994-1007.
16. Derguy, C., M’Bailara, K., Michel, G., Roux, S. & Bouvard, M. (2016). The need for an ecological approach to parental stress in autism spectrum disorders: the combined role of individual and environmental factors. Journal of Autism and Developmental Disorders, 46 (6), 1895-1905.
17. Drogomyretska, K., Fox, R., & Colbert, D. (2020). Brief report: stress and perceived social support in parents of children with ASD. Journal of Autism and Developmental Disorders, 50, 4176-4182.
18. Eker, D. & Arkar, H. (1995). Çok Boyutlu Algılanan Sosyal Destek Ölçeği’nin faktör yapısı, geçerlik ve güvenirliği. Türk Psikoloji Dergisi, 34, 45-55.
19. Eker, D., Arkar, H. & Yaldız, H. (2001). Çok Boyutlu Alg›lanan Sosyal Destek Ölçeği’nin Gözden Geçirilmiş Formunun Faktör Yapısı, Geçerlik ve Güvenirliği. Türk Psikiyatri Dergisi, 12 (1), 17- 25.
20. Falk, N. H., Norris, K., & Quinn, M. G. (2014). The factors predicting stress, anxiety and depression in the parents of children with autism. Journal of Autism and Developmental Disorders, 44, 3185-3203.
21. Flett, G. L., Hewitt, P. L., Blankstein, K. R. & Mosher, S. W. (1995). Perfectionism, life events, and depressive symptoms: A test of a diathesis-stress model. Current Psychology, 14 (2), 112-137.
22. Gray, D. E. & Holden, W. J. (1992). Psycho-social well-being among the parents of children with autism. Australia and New Zealand Journal of Developmental Disabilities, 18, 83–93.
23. Haber, M. G., Cohen, J. L., Lucas, T. & Baltes, B. B. (2007). The relationship between self-reported received and perceived social support: A meta-analytic review. American Journal of Community Psychology, 39, 133-144.
24. Hayes, A. F. (2012). PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling [pdf]. http://www.afhayes.com/ public/process2012.pdf, Erişim Tarihi: 20.10.2023).
25. Hsiao, Y. J. (2016). Pathways to mental health-related quality of life for parents of children with autism spectrum disorder: roles of parental stress, children’s performance, medical support, and neighbor support. Research in Autism Spectrum Disorders, 23, 122-130.
26. Karasar, N. (2011). Bilimsel Araştırma Yöntemleri. Ankara: Nobel Yayınları.
27. Kayfitz, A. D., Gragg, M. N. & Robert O., R. (2010). Positive experiences of mothers and fathers of children with autism. Journal of Applied Research in Intellectual Disabilities, 23 (4), 337-343.
28. Lakey, B. & Cohen, S. (2000). Social Support and Theory. S. Cohen, L. G. Underwood, & B. H. Gottlieb (Eds.), Social support measurement and ıntervention: a guide for health and social scientists içinde (ss. 29-52). New York: Oxford University Press.
29. Lamers, F., van Oppen, P., Comijs, H. C., Smit, J. H., Spinhoven, P., van Balkom, A. J., ... & Penninx, B. W. (2011). Comorbidity patterns of anxiety and depressive disorders in a large cohort study: the Netherlands Study of Depression and Anxiety (NESDA). The Journal of Clinical Psychiatry, 72 (3), 341-348.
30. Lamminen, L. (2008). Family functioning and social support in parents of children with Autism Spectrum Disorders, (Yayınlanmamış Doktora Tezi). University of Kentucky, Lexington, Kentucky.
31. Lecavalier, L., Leone, S. & Wiltz, J. (2005). The impact of behaviour problems on caregiver stress in young people with autism spectrum disorders. Journal of Intellectual Disability Research, 3, 172–183.
32. Li, W., Zhao, Z., Chen, D., Peng, Y. & Lu, Z. (2022). Prevalence and associated factors of depression and anxiety symptoms among college students: a systematic review and meta‐analysis. Journal of Child Psychology and Psychiatry, 63(11), 1222-1230.
33. Likhitweerawong, N., Boonchooduang, N. & Louthrenoo, O. (2022). Parenting styles, parental stress, and quality of life among caregivers of Thai children with autism. International Journal of Disability, Development and Education, 69 (6), 2094-2107.
34. Liwag, M. E. C. D. (1989). Mothers and fathers of autistic children: an exploratory study of family stress and coping. Philippine Journal of Psychology, 22 (2), 3-16.
35. Lovibond, P. F. & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33 (3), 335-343.
36. Ludlow, A., Skelly, C. & Rohleder, P. (2012). Challenges faced by parents of children diagnosed with autism spectrum disorder. Journal of Health Psychology, 17 (5), 702- 711.
37. Machado Junior, S. B., Celestino, M. I. O., Serra, J. P. C., Caron, J. & Ponde, M. P. (2016). Risk and protective factors for symptoms of anxiety and depression in parents of children with autism spectrum disorder. Developmental Neurorehabilitation, 19 (3), 146-153.
38. Maenner, M. J., Warren, Z., Williams, A. R., Amoakohene, E., Bakian, A. V., Bilder, D. A., ... & Shaw, K. A. (2023). Prevalence and characteristics of autism spectrum disorder among children aged 8 years—Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2020. MMWR Surveillance Summaries, 72 (2), 1-14.
39. Ogston, P. L., Mackintosh, V. H. & Myers, B. J. (2011). Hope and worry in mothers of children with an autism spectrum disorder or Down syndrome. Research in Autism Spectrum Disorders, 5 (4), 1378-1384.
40. Olsson, M. B. & Hwang, C. P. (2001). Depression in mothers and fathers of children with intellectual disability. Journal of Intellectual Disability Research, 45 (6), 535-543.
41. Öz, B., Yüksel, T. & Nasiroğlu, S. (2020). Depression-anxiety symptoms and stigma perception in mothers of children with autism spectrum disorder. Archives of Neuropsychiatry, 57 (1), 50.
42. Özturk, Y., Riccadonna, S. & Venuti, P. (2014). Parenting dimensions in mothers and fathers of children with Autism Spectrum Disorders. Research in Autism Spectrum Disorders, 8 (10), 1295-1306.
43. Padden, C. & James, J. E. (2017). Stress among parents of children with and without autism spectrum disorder: a comparison involving physiological indicators and parent self-reports. Journal of Developmental and Physical Disabilities, 29 (4), 567-586.
44. Papadopoulos, A., Siafaka, V., Tsapara, A., Tafiadis, D., Kotsis, K., Skapinakis, P. & Tzoufi, M. (2023). Measuring parental stress, illness perceptions, coping and quality of life in families of children newly diagnosed with autism spectrum disorder. BJPsych Open, 9 (3), e84.
45. Phetrasuwan, S. & Shandor Miles, M. (2009). Parenting stress in mothers of children with autism spectrum disorders. Journal for Specialists in Pediatric Nursing, 14 (3), 157-165.
46. Pisula, E. (2007). A comparative study of stress profiles in mothers of children with autism and those of children with Down's syndrome. Journal of Applied Research in Intellectual Disabilities, 20 (3), 274-278.
47. Ramadianto, A. S., Kusumadewi, I., Agiananda, F. & Raharjanti, N. W. (2022). Symptoms of depression and anxiety in Indonesian medical students: association with coping strategy and resilience. BMC Psychiatry, 22, 92.
48. Reed, P., & Osborne, L. A. (2012). Diagnostic practice and its impacts on parental health and child behaviour problems in autism spectrum disorders. Archives of Disease in Childhood, 97 (10), 927-931.
49. Rivard, M., Terroux, A., Parent-Boursier, C. & Mercier, C. (2014). Determinants of stress in parents of children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 44, 1609-1620.
50. Robinson, S. & Weiss, J. A. (2020). Examining the relationship between social support and stress for parents of individuals with autism. Research in Autism Spectrum Disorders, 74, 101557.
51. Sarıçam, H. (2018). The psychometric properties of Turkish version of Depression Anxiety Stress Scale-21 (DASS-21) in health control and clinical samples. Journal of Cognitive-Behavioral Psychotherapy and Research, 7 (1), 19-30.
52. Sit, S. & Erkan, N. S. (2024). The Relationship between Social Support and Stress and Burnout Levels of Mothers of Children Diagnosed with Autism Spectrum Disorder. Theory and Practice in Child Development, 4 (1), 76-95.
53. Soytaç, E., Kahraman, T. & Genç, A. (2022). Pain, anxiety, depression, fatigue, sleep quality, and health-related quality of life in the mothers of children with autism spectrum disorder and the mothers of typically developing children: A Case-control study. Cyprus Journal of Medical Sciences, 7 (6), 774-779.
54. Taylor, J. L., & Warren, Z. E. (2012). Maternal depressive symptoms following autism spectrum diagnosis. Journal of Autism and Developmental Disorders, 42, 1411-1418.
55. Tohum Otizm Vakfı (2020). Down Sendromu, Otizm ve Diğer Gelişim Bozukluklarının Yaygınlığının Tespiti ile İlgili Bireylerin ve Ailelerinin Sorunlarının Çözümü için Alınması Gereken Tedbirlerin Belirlenmesi Amacıyla Kurulan Meclis Araştırması Komisyon Raporu. https://www.tohumotizmportali.org/files/Kaynaklar/Raporlar/1.Meclis%20Ara%c5%9ft%c4%b1rma%20Komisyon%20Raporu.pdf (Erişim tarihi 28.07.2024).
56. Tsioka, E., Zacharia, D., Soulis, S., Mantas, C., Petrikis, P., Koullourou, I., ... & Kotsis, K. (2022). Posttraumatic growth: the role of perceptions, coping and depressive symptoms among mothers of children with Autism Spectrum Disorder in Greece. International Journal of Developmental Disabilities, 1-10.
57. Wayment, H. A. & Brookshire, K. A. (2018). Mothers’ reactions to their child’s ASD diagnosis: Predictors that discriminate grief from distress. Journal of Autism and Developmental Disorders, 48 (4), 1147-1158.
58. Whitman, T. L. (2004). The development of autism: A self-regulatory perspective. Jessica Kingsley Publishers.
59. Woolfson, L. & Grant, E. (2006). Authoritative parenting and parental stress in parents of pre‐school and older children with developmental disabilities. Child: Care, Health and Development, 32 (2), 177-184.
60. Zimet, G. D., Dahlem, N. W., Zimet, S. G. & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52 (1), 30-41.