Abstract
This study examines emotional disclosure through the activity of journaling as a means of coping with maternal stress associated with parenting a child with disruptive behaviors. Through a randomized control and pre-test post-test study design of an online journal writing intervention, change to maternal stress and quality of mother–child relationship for children with ASD, ADHD and SPD was addressed. Behavioral symptoms were found to be the primary source of parenting stress for mothers and a significant relationship between child characteristics and maternal stress was identified. Emotional disclosure through the online journal writing program (especially in the presence of high disclosure of negative emotions) was shown to reduce maternal stress and improve the quality of mother–child relationship. These findings suggest cost-effective telehealth interventions may support maternal health. Important clinical implications are discussed.
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References
Abidin, R. R. (1995). Parenting stress index manual (3rd ed.). Lutz, FL: Psychological Assessment Resources Inc.
Adams, K. (1996). Journal writing as a powerful adjunct to therapy. Journal of Poetry Therapy, 10(1), 31–37.
Adams, K. (1999). Writing as therapy. Counseling and Human Development, 31(5), 1–16.
Al-Yagon, M., & Cinamon, R. G. (2008). Work–family relations among mothers of children with learning disorders. European Journal of Special Needs Education, 23(2), 91–107. doi:10.1080/08856250801946202.
Antonovsky, A. (1996). The salutogenic model as a theory to guide health promotion. Health Promotion International, 11(1), 11–18.
Antshel, K. M., & Joseph, G. R. (2006). Maternal stress in nonverbal learning disorder: A comparison with reading disorder. Journal of Learning Disabilities, 39(3), 194–205.
Ben-Sasson, A., Soto, T. W., Martinez-Pedraza, F., & Carter, A. S. (2013). Early sensory over-responsivity in toddlers with autism spectrum disorders as a predictor of family impairment and parenting stress. Journal of Child Psychology and Psychiatry, 54(8), 846–853.
Boyd, B. A. (2002). Examining the relationship between stress and lack of social support in mothers of children with autism. Focus on Autism and Other Developmental Disabilities, 17(4), 208–215.
Bromley, J., Hare, D. J., Davidson, K., & Emerson, E. (2004). Mothers supporting children with autistic disorders: Social support, mental health status and satisfaction with services. Autism, 8(4), 409–423.
Cacioppo, J., & Patrick, W. (2009). Loneliness: Human nature and the need for social connection. NY: W.W. Norton & Company.
Centers for Disease Control and Prevention (CDC). (2014a). Attention-Deficit/Hyperactivity Disorder (ADHD) Data and Statistics. Retrieved from http://www.cdc.gov/ncbddd/adhd/
Centers for Disease Control and Prevention (CDC). (2014b). Prevalence of Autism Spectrum Disorders Autism and Developmental Disabilities Monitoring Network, Eleven Sites, United States, 2010. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6302a1.htm
Cook, J., & Doyle, C. (2002). Working alliance in online therapy as compared to face-to-face therapy: A preliminary result. CyberPsychology & Behavior, 5(2), 95–105.
Cronin, A. (2004). Mothering a child with hidden impairments. American Journal of Occupational Therapy, 58(1), 83–92.
Davis, N. O., & Carter, A. S. (2008). Parenting stress in mothers and fathers of toddlers with autism spectrum disorders: Associations with child characteristics. Journal of Developmental Disorders, 38, 1278–1291.
Estes, A., Munson, J., Dawson, G., Koehler, E., & Zhou, X. H. (2009). Parenting stress and psychological functioning among mothers of preschool children with autism and developmental delay autism. Autism, 13(4), 375–387. doi:10.1177/1362361309105658.
Fivush, R., & Sales, J. M. (2006). Coping, attachment, and mother-child narratives of stressful events. Palmer Quarterly, 52(1), 125–150.
Fleischmann, A. (2005). The hero’s story and autism: Grounded theory study of websites for parents of children with autism. Autism, 9(3), 299–316.
Folkman, S. (1997). Positive psychological states and coping with severe stress. Social Science and Medicine, 45(8), 1207–1221.
Griffith, G. M., Hastings, R. P., Nash, S., & Hill, C. (2010). Using matched groups to explore child behavior problems and maternal well-being in children with down syndrome and autism. Journal of Autism and Developmental Disorders, 40, 610–619.
Haskett, M. E., Ahern, L. S., Ward, C. S., & Allaire, J. C. (2006). Factor structure and validity of parenting stress index-short form. Journal of Clinical Child and Adolescent Psychology, 35(2), 302–312.
Heiman, T., & Berger, O. (2008). Parents of children with Asperger syndrome or learning disabilities: Family environment and social support. Research in Developmental Disabilities, 29, 289–300.
Hoffman, C., Sweeney, D., Hodge, D., Lopez-Wagner, M., & Looney, L. (2009). Parenting stress and closeness: Mothers of typically developing children and mothers of children with autism. Focus on Autism and Other Developmental Disabilities, 24(3), 178–187.
Koenig, M. A., & Jaswal, V. K. (2011). Characterizing children’s expectations about expertise and incompetence: Halo or pitchfork effects? Child Development, 82(5), 1634–1647. doi:10.1111/j.1467-8624.2011.01618.x.
Kuhlthau, K., Orlich, F., Hall, T. A., Sikora, D., Kovacs, E. A., Delahaye, J., & Clemons, T. E. (2010). Health related quality of life in children with autism spectrum disorders: Results from the autism treatment network. Journal of Autism and Developmental Disorders, 40(6), 721–729.
Lange, L., Rietdijk, D., Hudcovicova, M., Van de Ven, J. P., Schrieken, B., & Emmelkamp, P. M. G. (2003). Interapy: A controlled randomized trial of the standardized treatment of posttraumatic stress through the internet. Journal of Consulting and Clinical Psychology, 71(5), 901.
Lawlor, M. C. (2006). Mothering work: Negotiating health care, illness and disability, and development. In S. A. Esdaile & J. A. Olson (Eds.), Mothering occupations: Challenge, agency, and participation. Philadelphia: F.A. Davis.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.
Lee, L., Harrington, R., Louie, B., & Newschaffer, C. (2008). Children with autism: Quality of life and parental concerns. Journal of Autism and Developmental Disorders, 38(6), 1147–1160.
Lee, G., Lopata, C., Volker, M., Thomeer, M., Nida, R., Toomey, J., et al. (2009). Health-related quality of life of parents of children with high-functioning autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 24(4), 227–239.
Lepore, S. J., & Smyth, J. M. (Eds.). (2002). The writing cure: How expressive writing promotes health and emotional well-being. Washington, DC: American Psychological Association.
Little, L. (2002). Differences in stress and coping for mothers and fathers of children with Asperger’s syndrome and nonverbal learning disorders. Pediatric Nursing, 28(6), 565–570.
Liu, J. (2004). Childhood externalizing behavior: Theory and implications. Journal of Child and Adolescent Psychiatric Nursing, 17(3), 93–103.
National Alliance for Caregivers Executive Report (2009). Caregiving in the U.S. Retrieved from http://www.caregiving.org/research/general-caregiving
Osborne, L. A., McHugh, L., Saunders, J., & Reed, P. (2008). Parenting stress reduces the effectiveness of early teaching interventions for autistic spectrum disorders. Journal of Autism Developmental Disorders, 38, 1092–1103.
Osborne, L., & Reed, P. (2009). The relationship between parenting stress and behavior problems of children with autistic spectrum disorders. Council for Exceptional Children, 76(1), 54–73.
Park, J., Hoffman, L., Marquis, J., Turnbull, A. P., Poston, D., Mannan, H., et al. (2003). Toward assessing family outcomes of service delivery: Validation of a family quality of life survey. Journal of Intellectual Disability Research, 47(4/5), 367–383.
Pennebaker, J. (2007). Emotion, disclosure and health (5th ed.). Washington, DC: American Psychological Services.
Pennebaker, J. W., Chung, C. K., Ireland, M., Gonzales, A., & Booth, R. J. (2007). The LIWC 2007 Manual. Austin, Texas: LIWC.net.
Quintron, N., & McIntyre, L. L. (2010). Sibling adjustment and maternal well-being: An examination of families with and without a child with and autism spectrum disorder. Focus on Autism and Other Developmental Disorders, 25(1), 37–46.
Schaaf, R. C., Toth-Cohen, S., Johnson, S. L., Outten, G., & Benevides, T. W. (2011). The everyday routines of families of children with autism: Examining the impact of sensory processing difficulties on the family. Autism, 15(3), 373–389. doi:10.1177/1362361310386505.
Smyth, J. (1998). Written emotional expression: Effect sizes, outcome types, and moderating variables. Journal of Consulting and Clinical Psychology, 66(1), 174–184.
Thorndike, E. L. (1920). A constant error in psychological ratings. Journal of Applied Psychology, 4(1), 25–29. doi:10.1037/h0071663.
Tomchek, S., & Dunn, W. (2007). Sensory processing in children with and without autism: A comparative study using the short sensory profile. American Journal of Occupational Therapy, 61(2), 190–200.
Tunali, B., & Power, T. G. (2002). Coping by redefinition: Cognitive appraisals in mothers of children with autism and children without autism. Journal of Autism and Developmental Disorders, 32, 25–34.
U. S. Bureau of the Census. (2010). Fertility of American Women: 2010. Retrieved from www.census.gov/population/www.socdemo/fertility.html
Vando, J., Rhule-Louie, D. M., McMahon, R. J., & Spieker, S. J. (2008). Examining the link between infant attachment and child conduct problems in grade 1. Journal of Child and Family Studies, 17, 615–628. doi:10.1007/s10826-007-9173-y.
Vitanza, S. A., & Guarnaccia, C. A. (1999). A model of psychological distress for mothers of children with attention-deficit hyperactivity disorder. Journal of Child and Family Studies, 8(1), 27–45.
Yochman, A., Parush, S., & Ornoy, A. (2004). Responses of preschool children with and without autism. Journal of Autism and Developmental Disabilities, 74(3), 445–545.
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This research was funded in part from support from the California Occupational Therapy Foundation.
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Whitney, R.V., Smith, G. Emotional Disclosure Through Journal Writing: Telehealth Intervention for Maternal Stress and Mother–Child Relationships. J Autism Dev Disord 45, 3735–3745 (2015). https://doi.org/10.1007/s10803-014-2332-2
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DOI: https://doi.org/10.1007/s10803-014-2332-2