Abstract
Parents of children with autism spectrum disorder (ASD) frequently report poor psychological well-being. Previous research has supported mindfulness-based interventions to enhance psychological well-being in parents of children with ASD, but studies about this topic are still rare. The purpose of this study was to examine the effectiveness of brief mindfulness-based intervention (MBI) on perceived stress, anxiety, and depression among parents of children with ASD in Jordan. A quasi-experimental pretest–posttest design with a comparison group was used. A sample of 104 parents of children with ASD has completed the study. Parents were matched on measures of age, gender, and level of severity of ASD in their children based on DSM-V criteria and randomized to one of the two groups. The intervention group participated in 5-week mindfulness-based intervention program, while participants in the comparison group had not attended the program between pretest and posttest measures. Participants in both groups had poor psychological well-being before the intervention program. After the intervention program, the one-way analyses of covariance (ANCOVA) indicated that parents in the intervention group had better outcomes on the measures of psychological well-being and mindfulness than those in the comparison group (P < 0.01). Furthermore, results of paired samples t test indicated that parents in the intervention group demonstrated significant improvements in measures of stress, anxiety, depression, and mindfulness scores with medium to large effect size (Cohen d between 0.42 and 0.85, P < 0.01). Although the comparison group demonstrated small improvement in measures of the dependent variables, these improvements were much less than improvements in the intervention group. The MBIs are culturally adaptable, feasible, and effective interventions to improve psychological well-being in parents of children with ASD.
Similar content being viewed by others
References
Abu-Hamour, B., & Muhaidat, M. (2014). Parents' attitudes towards inclusion of students with autism in Jordan. International Journal of Inclusive Education, 18(6), 567–579.
Ahmad, M., & Dardas, L. (2016). Jordan: aspiration for a culturally sensitive nursing model. In J. J. Fitzpatrick & A. L. Whall (Eds.), Conceptual models of nursing: global perspectives. Upper Saddle: Pearson.
Al-Khalaf, A., Dempsey, & Dally, K. (2014). The effect of an education program for mothers of children with autism spectrum disorder in Jordan. International Journal for the Advancement of Counselling, 36(2), 175–187.
Al-Krenawi, A. (2005). Mental health practice in Arab countries. Current Opinion in Psychiatry, 18(5), 560–564.
American Psychiatric Association (APA). (2013a). Diagnostic and statistical manual of mental disorders, (DSM-5®). American Psychiatric Pub.
American Psychiatric Association. (2013b). The clinician-rated severity of autism spectrum and social communication disorders scale. Retrieved from http://www.psychiatry.org/File%20Library/Practice/DSM/DSM-5/ClinicianRatedSeverityOfAutismSpectrumAndSocialCommunicationDisorders.pdf.
Athari, P., Ghaedi, L., & Kosnin, M. (2013). Mothers' depression and stress, severity of autism among children and family income. International Journal of Psychological Research, 6(2), 98–106.
Baker, J. K., Seltzer, M. M., & Greenberg, J. S. (2011). Longitudinal effects of adaptability on behavior problems and maternal depression in families of adolescents with autism. Journal of Family Psychology, 25(4), 601–609.
Bazzano, A., Wolfe, C., Zylowska, L., Wang, S., Schuster, E., Barrett, C., & Lehrer, D. (2015). Mindfulness-based stress reduction (MBSR) for parents and caregivers of individuals with developmental disabilities: a community-based approach. Journal of Child and Family Studies, 24, 298–308.
Beer, M., Ward, L., & Moar, K. (2013). The relationship between mindful parenting and distress in parents of children with an autism spectrum disorder. Mindfulness, 4(2), 102–112.
Benn, R., Akiva, T., Arel, S., & Roeser, R. W. (2012). Mindfulness training effects for parents and educators of children with special needs. Developmental Psychology, 48(5), 1476.
Bitsika, V., & Sharpley, C. F. (2004). Stress, anxiety and depression among parents of children with autism spectrum disorder. Australian Journal of Guidance and Counselling, 14(2), 151–161.
Blackledge, J. T., & Hayes, S. C. (2006). Using acceptance and commitment training in the support of parents of children diagnosed with autism. Child & Family Behavior Therapy, 28(1), 1–18.
Bögels, S., & Restifo, K. (2013). Mindful parenting: a guide for mental health practitioners. Springer.
Brislin, R. W. (1970). Back translation for the cross-cultural research. Journal of Cross Cultural Research, 1(13), doi:10.1177/135910457000100301.
Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: mindfulness and its role in psychological well-being. Journal of Personality and Social Psycholog, 84(4), 822–848.
Cachia, R. L., Anderson, A., & Moore, D. W. (2016). Mindfulness, stress and well-being in parents of children with autism spectrum disorder: a systematic review. Journal of Child and Family Studies, 25, 1–14. doi:10.1007/s10826-015-0193-8.
Carmody, J., & Baer, R. A. (2009). How long does a mindfulness‐based stress reduction program need to be? A review of class contact hours and effect sizes for psychological distress. Journal of Clinical Psychology, 65(6), 627–638.
Carmody, J., Reed, G., Kristeller, J., & Merriam, P. (2008). Mindfulness, spirituality, and health-related symptoms. Journal of Psychosomatic Research, 64(4), 393–403.
Chapman, D. W., & Carter, J. F. (1979). Translation procedures for the cross cultural use of measurement instrument. Education Evaluation and Public Analysis, 1(3). doi:10.3102/01623737001003071.
Conner, C. M., & White, S. W. (2014). Stress in mothers of children with autism: trait mindfulness as a protective factor. Research in Autism Spectrum Disorders, 8(6), 617–624.
de Bruin, E. I., Blom, R., Smit, F. M., Steensel, V., & Bögels, S. M. (2014). MYmind: mindfulness training for youngsters with autism spectrum disorders and their parents. Autism, 19, 906–911.
Deng, Y. Q., Li, S., Tang, Y. Y., Zhu, L. H., Ryan, R., & Brown, K. (2012). Psychometric properties of the Chinese translation of the mindful attention awareness scale (MAAS). Mindfulness, 3(1), 10–14.
Dykens, E. M., Fisher, M. H., Taylor, J. L., Lambert, W., & Miodrag, N. (2014). Reducing distress in mothers of children with autism and other disabilities: a randomized trial. Pediatrics, 134(2), e454–e463.
Ellis-Jones, I. (2013). Mindfulness and Islam. Retrieved 11 1, 2014, from https://www.google.jo/?gfe_rd=cr&ei=uSlVVPbUCe2q8wfejYHAAg#q=mindfulness+and+islam.
Epstein, B. J. (2010). Effects of a mindfulness based stress reduction program on fathers of children with developmental disability. Hofstra University.
Fakhr El-Islam, M. (2008). Arab culture and mental health care. Transcultural Psychiatry, 45, 671–682.
Faul, F., Erdfelder, E., Lang, A., & Buchner, A. (2007). G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175–191.
Ferraioli, S. J., & Harris, S. L. (2013). Comparative effects of mindfulness and skills-based parent training programs for parents of children with autism: feasibility and preliminary outcome data. Mindfulness, 4(2), 89–101.
Firth, I., & Dryer, R. (2013). The predictors of distress in parents of children with autism spectrum disorder. Journal of Intellectual and Developmental Disability, 38(2), 163–171.
Flückiger, C., Del Re, A. C., Wampold, B. E., Symonds, D., & Horvath, A. O. (2012). How central is the alliance in psychotherapy? A multilevel longitudinal meta-analysis. Journal of Counseling Psychology, 59(1), 10.
Gunaratana, H. (2011). Mindfulness in plain English. USA: Wisdom Publications. Retrieved 10 15, 2014, from http://www.urbandharma.org/pdf2/Mindfulness%20in%20Plain%20English%20Book%20Preview.pdf.
Hayes, S., & Watson, S. (2013). The impact of parenting stress: a meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder. Journal of Autism and Developmental Disorders, 43(3), 629–642.
Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: a meta-analytic review. Journal of Consulting and Clinical Psychology, 78(2), 169–183.
Hwang, Y. S., Kearney, P., Klieve, H., Lang, W., & Roberts, J. (2015). Cultivating mind: mindfulness interventions for children with autism spectrum disorder and problem behaviours, and their mothers. Journal of Child and Family Studies, 24(10), 3093–3106.
Iacoviello, B. M., McCarthy, K. S., Barrett, M. S., Rynn, M., Gallop, R., & Barber, J. P. (2007). Treatment preferences affect the therapeutic alliance: implications for randomized controlled trials. Journal of Consulting and Clinical Psychology, 75(1), 194.
Jabery, M. A., Arabiat, D. H., Khamra, H. A., Betawi, I. A., & Jabbar, S. K. (2014). Parental perceptions of services provided for children with autism in Jordan. Journal of Child and Family Studies, 23(3), 475–486.
Jones, L., Hastings, R. P., Totsika, V., Keane, L., & Rhule, N. (2014). Child behavior problems and parental well-being in families of children with autism: the mediating role of mindfulness and acceptance. American Journal on Intellectual and Developmental Disabilities, 119(2), 171–185.
Kabat-Zinn, J. (1990). Full catastrophe living: using the wisdom of your body and mind to face stress, pain and illness. New York: Delacorte.
Kabat-Zinn, J. (1994). Wherever you go, there you are: mindfulness meditation in everyday life. New York: Hyperion.
Kabat-Zinn, J. (2011). Mindfulness for beginners: reclaiming the present moment—and your life. Sounds True.
Kwan, B. M., Dimidjian, S., & Rizvi, S. L. (2010). Treatment preference, engagement, and clinical improvement in pharmacotherapy versus psychotherapy for depression. Behaviour Research and Therapy, 48(8), 799–804.
Lai, W. W., & Oei, T. P. S. (2014). Coping in parents and caregivers of children with autism spectrum disorders (ASD): a review. Review Journal of Autism and Developmental Disorders, 1(3), 207–224.
Lecavalier, L., Leone, S., & Wiltz, J. (2006). The impact of behavior problems on caregiver stress in young people with autism spectrum disorders. Journal of Intellectual Disability Research, 50, 172–183. doi:10.1111/j.1365-2788.2005.00732.x.
Lengua, L., & Kerns, S. (2014). Whole U 'Mindful parenting' seminar. USA: Center for Child and Family Well-Being. Retrieved 10 16, 2014, from http://www.youtube.com/watch?v=cq1yDKhlpbw.
Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the depression anxiety stress scales. Sydney: Psychology Foundation.
Mak, W. W., & Ho, G. S. (2007). Caregiving perceptions of Chinese mothers of children with intellectual disability in Hong Kong. Journal of Applied Research in Intellectual Disabilities, 20(2), 145–156.
Manikam, R. (2014). Psychology of meditation. Mindfulness, 5(5), 613–616.
Masri, A. T., Al Suluh, N., & Nasir, R. (2013). Diagnostic delay of autism in Jordan: review of 84 cases. The Libyan Journal of Medicine, 8. doi:10.3402/ljm.v8i0.21725.
Morgan, J. R., Masuda, A., & Anderson, P. L. (2013). A preliminary analysis of the psychometric properties of the mindful attention awareness scale among African American college students. Mindfulness, 5(6), 639–645.
Nyklíček, I., Dijksman, S. C., Lenders, P. J., Fonteijn, W. A., & Koolen, J. J. (2014). A brief mindfulness based intervention for increase in emotional well-being and quality of life in percutaneous coronary intervention (PCI) patients: the MindfulHeart randomized controlled trial. Journal of Behavioral Medicine, 37(1), 135–144.
Pepping, C. A., O’Donovan, A., & Davis, P. J. (2013). The positive effects of mindfulness on self-esteem. The Journal of Positive Psychology, 8(5), 376–386.
Phang, C., & Oei, T. (2012). From mindfulness to meta-mindfulness: further integration of meta-mindfulness concept and strategies into cognitive-behavioral therapy. Mindfulness, 3, 104–116.
Pourhoseingholi, M. A., Baghestani, A. R., & Vahedi, M. (2012). How to control confounding effects by statistical analysis. Gastroenterology and Hepatology from Bed to Bench, 5(2), 79.
Rayan, A., & Jaradat, A. (2016). Stigma of mental illness and attitudes toward psychological help-seeking in Jordanian university students. Research in Psychology and Behavioral Sciences, 4(1), 7–14.
Retso, J. (2002). Arabs in antiquity: their history from the Assyrians to the Umayyads. Florence: Routledge. 9780700716791. ISBN 0-7007-1679-3.
Segal, Z. V., Williams, J. M., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. New York: The Guilford Press.
Singh, N. N., Lancioni, G. E., Winton, A. S., Singh, J., Curtis, W., Wahler, R. G., & McAleavey, K. M. (2007). Mindful parenting decreases aggression and increases social behavior in children with developmental disabilities. Behavior Modification, 31(6), 749–771.
Taouk, M., Lovibond, P., & Laube, R. (2001). Psychometric properties of an Arabic version of the Depression Anxiety Stress Scales (DASS21). Report for New South Wales Transcultural Mental Health Centre, Cumberland Hospital, Sydney
Uchino, B. N. (2006). Social support and health: a review of physiological processes potentially underlying links to disease outcomes. Journal of Behavioral Medicine, 29(4), 377–387.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or National Research Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Conflict of Interest
The authors declare that they have no conflict of interest.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Funding
The authors acknowledge the partial funding from the University of Jordan.
Rights and permissions
About this article
Cite this article
Rayan, A., Ahmad, M. Effectiveness of Mindfulness-Based Intervention on Perceived Stress, Anxiety, and Depression Among Parents of Children with Autism Spectrum Disorder. Mindfulness 8, 677–690 (2017). https://doi.org/10.1007/s12671-016-0595-8
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12671-016-0595-8