This study aimed to explore in depth the experiences of social exclusion in public settings among parents and primary caregivers of autistic children. In this descriptive phenomenological study, semi-structured in-depth interviews were conducted with 17 participants caring for 16 children (14 individual-parent interviews, one joint mother-father interview, and one interview with a primary caregiver/grandmother). Data were analysed using steps 1–6 of Colaizzi’s phenomenological analysis procedure; participant validation (step 7) was not undertaken in view of the sample’s high caregiving burden and emotionally demanding circumstances reported by participants. Reporting followed the COREQ guidelines. Seven main themes were identified: (1) Invisible Difference and a Crisis of Credibility, (2) Moral Judgement of the Parent, (3) The Exclusionary and Protective Roles of Institutions, (4) Invisible Care Work, Self-Sacrifice, and the Narrowing/Dissolution of Identity Within the Caregiving Role, (5) Coping Strategies Between Avoidance and Deliberate Exposure, (6) The Protective Role of Material Resources, Social Capital, and Social Embeddedness, and (7) Persistent Future Anxiety: “What Will Happen After I Am Gone?” Two additional findings were also identified: effects on siblings, and a temporary easing of exclusion in seaside settings. The findings reveal a multidimensional experience of exclusion in which parents and primary caregivers of autistic children are repeatedly required to explain their child’s invisible difference in public settings, face the risk of moral judgement, and cope with unpredictable institutional responses. The intensity of this experience varies according to the resources available to the family and is lived under the shadow of persistent anxiety about the child’s future. These findings provide a context-specific, empirical basis that can inform public awareness and institutionally inclusive policies.
Family members who provide daily care for people with chronic mental illness often carry substantial emotional, social and financial strain. This study examined caregiver burden, anxiety and depression among primary caregivers of patients with chronic mental illness, and tested whether burden was related to anxiety and depression and whether these outcomes differed by age, gender and relationship to the patient. A cross-sectional correlational design was used with a purposive sample of primary caregivers recruited through psychiatric outpatient and community rehabilitation settings in Bengaluru (planned n = 100; 105 complete records analysed). Burden was assessed with the 22-item Zarit Burden Interview (ZBI), and anxiety and depression with the Hospital Anxiety and Depression Scale (HADS). Because scores departed from normality, Spearman correlations, permutation-based Mann-Whitney and Kruskal-Wallis tests and Holm-adjusted Dunn comparisons were used. The mean ZBI score was 32.37 (SD = 15.96); 77.1% of caregivers scored in at least the mild-to-moderate burden band, 59.0% had HADS anxiety scores of 8 or higher and 60.0% had HADS depression scores of 8 or higher. Burden correlated strongly with anxiety (rs = .810) and depression (rs = .816), Holm-adjusted ps < .001. Relationship to the patient was significantly associated with burden, anxiety and depression (adjusted ps < .001), with parent caregivers scoring highest, whereas age and gender differences did not survive correction for multiple testing. Findings are provisional because of an unresolved sample-size discrepancy and the cross-sectional, self-report, non-probability design. The results support routine screening of caregivers? psychological health, with particular attention to parent caregivers, alongside caregiver-focused psychoeducation and counselling.
Adolescent depression and anxiety symptoms are major health concerns, and the family environment plays a critical role. This study aimed to investigate the relationship between parental mental health literacy (PMHL) and adolescent depression and anxiety scores. Based on cross-sectional data from the 2023 Guangdong Adolescent Mental Health Survey, the study included 4,697 pairs of adolescents and their primary caregivers. Questionnaires were used to assess PMHL and adolescents’ levels of depression and anxiety, and weighted linear regression, restricted cubic splines, and subgroup analyses were employed. For every 1-point increase in PMHL, adolescents’ depression scores decreased by 0.033 and anxiety scores by 0.034 (both P < 0.05). The high PMHL group had significantly lower depression and anxiety scores than the low PMHL group. The dose-response relationship was linear. Subgroup analysis revealed interaction effects involving boarding status, mobile phone usage duration, and educational level. Higher PMHL is significantly associated with a lower risk of depression and anxiety among adolescents. Enhancing PMHL may help prevent and intervene in adolescent emotional problems; longitudinal studies are needed to verify the causal relationship.
علائم افسردگی و اضطراب در نوجوانان از نگرانیهای عمده سلامت محسوب میشوند و محیط خانواده نقش حیاتی ایفا میکند. هدف این مطالعه بررسی رابطه بین سواد سلامت روانی والدین (PMHL) و نمرات افسردگی و اضطراب نوجوانان بود. بر اساس دادههای مقطعی حاصل از پیمایش سلامت روان نوجوانان گوانگدونگ ۲۰۲۳، مطالعه حاضر شامل ۴٬۶۹۷ جفت نوجوان و مراقب اصلی آنها بود. برای ارزیابی PMHL و سطوح افسردگی و اضطراب نوجوانان از پرسشنامه استفاده شد و رگرسیون خطی وزنی، اسپلاین مکعبی محدود و تحلیلهای زیرگروه به کار گرفته شد. به ازای هر افزایش یک واحدی در PMHL، نمره افسردگی نوجوانان به میزان ۰٫۰۳۳ و نمره اضطراب به میزان ۰٫۰۳۴ کاهش یافت (هر دو P < 0.05). گروه دارای PMHL بالا به طور معناداری نمرات افسردگی و اضطراب پایینتری نسبت به گروه دارای PMHL پایین داشتند. رابطه دوز-پاسخ خطی بود. تحلیل زیرگروهها اثرات متقابل وضعیت شبانهروزی بودن، مدت زمان استفاده از تلفن همراه و سطح تحصیلات را نشان داد. PMHL بالاتر به طور معناداری با کاهش خطر افسردگی و اضطراب در نوجوانان مرتبط است. ارتقای PMHL میتواند به پیشگیری و مداخله در مشکلات هیجانی نوجوانان کمک کند؛ مطالعات طولی برای بررسی رابطه علّی مورد نیاز است.
