Factors Related to Perceived Stigma in Parents of Children and Adolescents in Outpatient Mental Healthcare
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Sample and Design
2.2. Outcome Measures
2.3. Predictors
2.3.1. Child Characteristics
2.3.2. Characteristics of the Primary Parent
2.3.3. Parenting and Family Characteristics
2.3.4. Treatment-Related Characteristics
2.3.5. Sociodemographic Characteristics
2.3.6. Social-Environmental Characteristics
2.4. Statistical Analyses
3. Results
3.1. Sample Descriptives
Mean/n | SD/% | Range | ||
---|---|---|---|---|
Outcome variables | ||||
Perceived public stigma by the primary parent (PPSSS) a | 1.77 | 0.91 | 1−6 | |
Affiliate stigma in the primary parent (PPSSS) a | 1.73 | 0.91 | 1−6 | |
Child characteristics | ||||
Female gender | 109 | 34.9% | ||
Age | 9.50 | 3.62 | 2−17 | |
General school functioning | 3.98 | 0.71 | 1−5 | |
Presence of learning difficulties | 128 | 41.0% | ||
Presence of mental illness diagnosis of the child during the course of the study a | 230 | 73.7% | ||
Level of callous and unemotional traits (ICU) | 2.24 | 0.43 | 1−4 | |
Severity of externalizing problem behavior (SDQ) | 1.93 | 0.40 | 1−3 | |
Severity of internalizing problems (SDQ) | 1.79 | 0.39 | 1−3 | |
Clinical cut-off externalizing and internalizing problems (SDQ) b | No severe mental health problems | 26 | 8.33% | |
Externalizing problems | 110 | 35.3% | ||
Internalizing problems | 33 | 10.6% | ||
Mixed (both externalizing and internalizing) | 143 | 45.8% | ||
Characteristics of the primary parent | ||||
Female gender | 274 | 87.8% | ||
Age | 40.6 | 6.50 | 25−65 | |
Physical illness | 84 | 26.9% | ||
Previous or current mental healthcare use | 150 | 48.1% | ||
Mental health (MHI) | 4.68 | 0.83 | 1–6 | |
Presence of ADHD (ASRS) | 26 | 8.33% | ||
Parenting and family characteristics | ||||
Level of involved parenting (APQ) | 3.88 | 0.45 | 1−5 | |
Degree of corporal punishment (APQ) | 1.57 | 0.46 | 1−5 | |
Perceived parenting competence (PSOC) | 4.32 | 0.65 | 1−6 | |
Parental stress (PSS) | 2.02 | 0.49 | 1−5 | |
Family functioning (VGFO) | 3.27 | 0.39 | 1−6 | |
Treatment expectancy of the primary parent (CEQ) | 3.83 | 0.69 | 1−5 | |
Belief in usefulness of treatment of the primary parent (CEQ) | 4.10 | 0.68 | 1−5 | |
Pretreatment motivation of the primary parent (PMI) | 3.83 | 0.49 | 1−5 | |
Treatment-related characteristics | ||||
Previous mental healthcare use of child | 123 | 39.4% | ||
Current medication use at baseline (non-/psychotropic) | 56 | 17.9% | ||
Source of referral | Parents or child | 192 | 61.5% | |
School | 55 | 17.6% | ||
Professional | 65 | 20.8% | ||
Type of treatment received by child or parents during the course of the study a | None | 105 | 33.7% | |
Behavioral | 114 | 36.5% | ||
Medication | 53 | 17.0% | ||
Combination of behavioral and medication | 40 | 12.8% | ||
Number of appointments a | 10.3 | 12.8 | 0−60 | |
Behavioral improvement of the child a | 3.99 | 0.97 | 1−5 | |
Mean/n | SD/% | Range | ||
Sociodemographic characteristics | ||||
Single parent household | 44 | 14.4% | ||
Other children in the household | 267 | 85.6% | ||
Financial problems | No | 68 | 21.8% | |
Yes | 216 | 69.2% | ||
No answer | 28 | 8.97% | ||
Socio-economic status | −0.36 | 0.54 | −2.25−1.23 | |
Socio-economic status c | Low | 37 | 11.9% | |
Medium | 229 | 73.4% | ||
High | 46 | 14.7% | ||
Urbanicity | 63,869 | 48,915 | 7500−195,418 | |
Urbanicity categorized in three categories | Small-sized city (<40,000 inhabitants) | 152 | 48.7% | |
Middle-sized city (40,000–100,000 inhabitants) | 90 | 28.8% | ||
Large-sized city (>100,000 inhabitants) | 70 | 22.4% | ||
High risk behavior families c | Low risk | 22 | 7.05% | |
Normal risk | 244 | 78.2% | ||
High risk | 46 | 14.7% | ||
Social–environmental characteristics | ||||
Contact with neighbors | 256 | 82.1% | ||
Contact via social media | 243 | 77.9% | ||
Playing sports with others | 110 | 35.3% | ||
Volunteer work | 68 | 21.8% | ||
Religious denomination | 199 | 63.8% | ||
Intergenerational closure in the neighborhood (SCN) | 3.78 | 0.84 | 1−6 | |
Deviant behavior and neglect in neighborhood | 2.00 | 1.16 | 1−6 |
3.2. LASSO Regression
3.3. Child Characteristics
3.4. Characteristics of the Primary Parent
3.5. Parenting and Family Characteristics
3.6. Treatment-Related Characteristics
3.7. Sociodemographic Characteristics
3.8. Social-Environmental Characteristics
4. Discussion
4.1. Strengths and Weaknesses
4.2. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Perceived Public Stigma b | Affiliate Stigma b | |||
---|---|---|---|---|
Explained Deviance | β (%) | Explained Deviance | β (%) | |
Child characteristics | ||||
Age | 1.17 | −0.15 | - | 0.00 |
Level of callous–unemotional traits (ICU) | 1.85 | 0.13 | - | 0.00 |
Severity of internalizing problems (SDQ) | 1.32 | 0.10 | - | 0.00 |
Characteristics of the primary parent | ||||
Previous or current mental healthcare use | 1.72 | 0.13 | - | 0.00 |
Parenting and family characteristics | ||||
Perceived parenting competence (PSOC) | 1.54 | −0.20 | 1.00 | −0.15 |
Social–environmental characteristics | ||||
Religious denomination | 1.02 | −0.09 | - | 0.00 |
Intergenerational closure in neighborhood (SCN) | 1.01 | −0.09 | - | 0.00 |
Deviant behavior and neglect in neighborhood | 1.05 | 0.07 | - | 0.00 |
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Drent, H.M.; van den Hoofdakker, B.; Buitelaar, J.K.; Hoekstra, P.J.; Dietrich, A. Factors Related to Perceived Stigma in Parents of Children and Adolescents in Outpatient Mental Healthcare. Int. J. Environ. Res. Public Health 2022, 19, 12767. https://doi.org/10.3390/ijerph191912767
Drent HM, van den Hoofdakker B, Buitelaar JK, Hoekstra PJ, Dietrich A. Factors Related to Perceived Stigma in Parents of Children and Adolescents in Outpatient Mental Healthcare. International Journal of Environmental Research and Public Health. 2022; 19(19):12767. https://doi.org/10.3390/ijerph191912767
Chicago/Turabian StyleDrent, Halewijn M., Barbara van den Hoofdakker, Jan K. Buitelaar, Pieter J. Hoekstra, and Andrea Dietrich. 2022. "Factors Related to Perceived Stigma in Parents of Children and Adolescents in Outpatient Mental Healthcare" International Journal of Environmental Research and Public Health 19, no. 19: 12767. https://doi.org/10.3390/ijerph191912767