Factors of parental burnout of mothers raising a child with autism spectrum disorders

Krivoshei Kristina Olegovna ORCID: 0009-0002-2948-2245 Postgraduate student, Altai State University 656049, Russia, Altai Krai, Barnaul, Lenin Avenue, 61 krivosheypsy@yandex.ru

Recently, the number of children with autism spectrum disorder has been growing, and accordingly the number of families in which a special child is being raised is growing. According to a University of Wisconsin study, parents of children with special needs experience stress levels comparable to those experienced by a soldier in a combat zone. Parents, and especially mothers raising a child, experience chronic stress, which determines the development of parental burnout syndrome. In families with special children, life turns into a struggle. Parents are experiencing constant stress because they worry about the child and take care of him 24 hours a day.

Identification of the factors of development of parental burnout will help to identify the target symptoms for the prevention and correction of this syndrome.

This study is of particular importance due to the urgent need to develop effective psychological support measures for mothers raising a child with autism spectrum disorder.

N.O. Kerre, O.S. Nikolskaya, L.L. Mikaelyan, U.A. Mamokhina, O.N. Pervushina, O.V. Kiseleva and others studied the family situation of the development of children with autism spectrum disorders. Such families are characterized by high stress and increased anxiety due to the uncertainty of the child's prospects and his further state of health. The usual ideas of parenting are not suitable for children with autism spectrum disorders because of the distinctive behavior in interacting with them. In this case, an individual approach is required, which complicates the situation of parents, who are already exhausted by the whole situation ^[1-3].

Psychological features of the climate in families where there is a child with autism spectrum disorder can be found in the works of T.N. Volkova, V.V. Tkacheva, Yu.A. Blinkov, M.V. Ippolitova, E.M. Mastyukova, M.M. Semago, etc. It is possible to identify common signs that characterize these families: a feeling of fatigue, neuropsychic stress; irritation, dissatisfaction with parents that the child does not meet expectations; deterioration of the relationship between spouses due to difficulties and accumulated fatigue; a decrease in social status, due to a lack of understanding of the society's internal picture of the situation, lack of support; often one of the parents have to give up work in order to meet the special needs of the child ^[4-6].

The current special family situation is extremely difficult. Being in such conditions leads mothers to parental burnout. The phenomenon of parental burnout was studied by such Russian scientists as T.Y. Fadeeva, L.A. Bazaleva, N.N. Koroleva, I.N. Efimova, L.V. Petranovskaya and others. Parental burnout is defined as a specific syndrome that has arisen due to prolonged exposure to a stressful situation, which is associated with the upbringing of a child. Parental burnout is based on three components: emotional exhaustion, emotional alienation and a feeling of not being successful in the parental role ^[7-12].

I.N. Efimova has advanced the three-component structure of the phenomenon of parental burnout. The first thing a mother experiences is emotional exhaustion. A feeling of exhaustion of emotions, loss of interest in what is happening around, possible emotional outbursts. Next, depersonalization occurs, in which the mother's contact with the child loses its emotional coloring, and the level of empathy decreases. It all comes down to the mechanical maintenance of important needs. And the last step is the reduction of parental achievements, when there is no longer even the strength to meet the basic needs of the child, a decrease in their parental efforts and dissatisfaction with themselves as a parent ^[13].

L. A. Bazaleva compares parenthood with work, but which will not end and from which you can not just leave. This is a painstaking, irregular daily activity, which in itself is a factor in the development of burnout. The researcher also identified the personality traits of mothers who are more prone to parental burnout. These are highly anxious mothers, overly trusting, prone to depression, very self-critical, and quickly respond emotionally to stimuli ^{[14, 15]}.

Foreign researchers have also contributed to the study of the phenomenon of parental burnout. This is I. Roscam, M. Mikolajczak, T. Kawamoto, K. Aunola, M. Raes, A. Lebert-Charron, and others M. Burisch identified six successive stages of parental burnout. The first phase is a warning one: sacrificing one's interests in favor of taking care of a child. Sleep disorders appear, anxiety and exhaustion increase. The second phase is a decrease in the level of self-participation, a weakening of interest in the child and the expectation of "convenient behavior" from the child. In the third phase, the parent avoids spending time with the child. There is a feeling of guilt and anger at yourself. The fourth phase is destructive behavior, the "falling out" of the parent from the parenting process, and the satisfaction of basic needs "on the machine." Then there are psychosomatic reactions and decreased immunity. And the final stage is disappointment and a negative life attitude. There is a feeling of helplessness, loss of the meaning of life, indifference to everything ^[16-18].

M. Mikolajczak, I. Roskam in their research found that parental burnout is often underestimated, but it can be destructive. In this condition, suicidal thoughts appear, an increase in the risk of dependent behavior, sleep disorders, health disorders, an increase in the frequency of conflicts in the family and the possibility of using violent behavior towards a child ^{[19, 20]}.

Parental burnout has a multifactorial origin. This always happens in response to a long-term imbalance between stressors and the parent's resources. No factor by itself can lead to parental burnout, but raising a child with special needs is a risk factor ^[21].

The procedure and methodology of the study

The aim of the study is to determine the factors determining the development of symptoms of parental burnout of mothers raising a child with autism spectrum disorder.

The subject of the study is a comparative analysis of the severity of symptoms of parental burnout of mothers raising a child with autism spectrum disorder.

The scientific novelty of the study is to determine the role of marital satisfaction in the development of symptoms of parental burnout of mothers raising a child with autism spectrum disorders.

Research methodology: theories of parental burnout in parents raising children with autism spectrum disorders (V. V. Boyko, L. A. Bazaleva, O.S. Nikolskaya); the provision on general and specific patterns of development of children with various types of dysontogenesis (L.S. Vygotsky, V.V. Lebedinsky, V.I. Lubovsky).

The hypothesis of the study: presumably parental burnout in mothers raising a child with autism spectrum disorders has differences depending on the availability of help with the child, on the availability of free time, availability of work, satisfaction with the relationship with parents and satisfaction with family relations with a spouse.

The empirical study was conducted on the basis of the KGB "Altai Regional Center for Psychological, Pedagogical, medical and Social Assistance". The survey included information about age and marital status. 127 mothers with children with ASD participated in the initial survey on a voluntary basis. The children had an official diagnosis, confirmed by an entry in the medical record, and were sent to the center for psychocorrection classes with a psychologist. Women with more than 3 children, as well as women who are in a civil marriage, or additionally have a child with other diseases, were excluded from the sample. In addition, mothers whose children suffered from ASD for less than 1 year were excluded, since a short period of the disease could affect the results of the study. The final sample consisted of 54 mothers aged 36.52±6.54 years with a child with autism spectrum disorder of preschool age, the age of children was 6.1±1.72.

Research methods and techniques:

The questionnaire "Parental burnout" by I. N. Efimova was used to study the level of parental burnout and its symptoms: emotional exhaustion, depersonalization, reduction of parental achievements.

Methods of mathematical and statistical data processing: one-factor analysis of variance, Mann-Whitney U-test, Spearman correlation analysis using the statistical package "SPSS Statistics 23.0".

The results of the study

Table 1.

Characteristics of the levels of development of symptoms of parental burnout

The most pronounced symptom of parental burnout is emotional exhaustion. The least pronounced symptom in the group of mothers raising a child with autism spectrum disorder is a reduction in parental achievements.

Table 2.

Characteristics of symptoms of parental burnout in mothers with different numbers of children

Table 2 presents an analysis of the average values of symptoms of parental burnout in mothers with different numbers of children. The use of single-factor analysis of variance revealed no differences in the severity of symptoms depending on the number of children. But the analysis of average values shows a more pronounced development of symptoms of emotional exhaustion in women with three children, symptoms of depersonalization and reduction of parental achievements in mothers with an only child.

To identify differences in the indicators of parental burnout in women raising children with autism spectrum disorders, with different marital status and satisfaction with relationships with their spouse, the Mann-Whitney U-test was applied, with the help of it significant differences in the indicators of emotional exhaustion, depersonalization and reduction of parental achievements in two groups of subjects were obtained. Women raising children with autism spectrum disorders and being divorced have significantly higher levels of emotional exhaustion (Z=3.862; p=0.01), depersonalization (Z=3.698; p=0.01), reduction of parental achievements (Z=3.41; p=0.01).

Table 3.

The difference in symptoms of parental burnout in mothers with different marital status

We suggested that an important factor in the development of symptoms of maternal parental burnout may be the characteristics of the system of relationships of a mother raising a child with autism spectrum disorder with her husband, parents, as well as the factor of having a job, having help with a child, having free time.

Table 4.

Factors of parental burnout of mothers raising a child with autism spectrum disorders

The analysis of the questionnaire showed that the acute issue is the availability of assistance in raising a child. The results showed that 43% of women do not receive assistance in raising a child, 57% receive assistance in raising a child, and only 10% receive this assistance from their husbands. More often, grandmothers, older children and other relatives help mothers raise a child with autism.

Of the total number of participants in the study, 33 women, which is 61%, described their relationship with their spouse as satisfactory, and 21 women, 39%, were not satisfied with their relationship with their partner. Women who are satisfied with their relationship with their spouse are less susceptible to parental burnout.

The application of the Mann-Whitney U-test showed that an important factor in the development of symptoms of parental burnout is satisfaction with the relationship with the spouse and the mother's personal time. Significant differences were obtained in the severity of symptoms of parental burnout, emotional exhaustion (Z=2.952; p=0.003), depersonalization (Z=2.978; p=0.003), reduction of parental achievements, depersonalization (Z=2.81; p=0.005) in the group of mothers satisfied and dissatisfied with marital relations according to the I. N. Efimova questionnaire (see table 5).

Table 5.

The difference in symptoms of parental burnout in women who are satisfied and dissatisfied with marital relations

A group of mothers who are dissatisfied with their relationship with their spouse have higher rates of emotional exhaustion, characterized by a feeling of emptiness, detachment from the outside world. The resources of the mother's relationship to the child are exhausted. It is characterized by anger at the undesirable behavior of the child, loss of interest in the child. The emotional background of such mothers is accompanied by irritability, fatigue, and depressive symptoms.

Mothers who are dissatisfied with their relationship with their spouse also have higher symptoms of depersonalization. With depresonalization, the mother's desire to spend time outside the house increases, attention becomes focused on solving household issues, cleaning the house, cooking. Spending time with a child is limited to serving basic needs without emotional impact. The reduction of parental achievements of women raising a child with autism and dissatisfied with marital relations is manifested in a decrease in parental competence, a sense of indifference to household issues, the child's achievements and a decrease in self-esteem.

Significant differences in the presence or absence of personal time were revealed when applying the Mann-Whitney U-test. Women who have personal time have a lower level of emotional exhaustion (Z=3.432; p=0.01) (see Table 6)

Table 6.

The difference in symptoms of parental burnout in mothers with and without personal time

Personal time makes it possible to switch the focus of attention to yourself, find a resource for normal functioning, and the realization of needs. The lack of personal time of the mother is a factor in the occurrence of parental burnout. Accumulated fatigue, chronic stress, lead to impaired interaction with the child. The quality time that a mother can devote to a child is reduced to meeting the basic needs of the child, without the emotional impact that is so important for the full development of the child.

There were no significant differences in the parameters of assistance with a child, job availability, and satisfaction with relationships with parents.

To identify the relationships between the symptoms of parental burnout, Spearman's correlation analysis was used, which showed the presence of reliable relationships. A positive correlation was revealed between the parameters emotional exhaustion and depersonalization (r=0.621; p=0.01). The higher the mothers' emotional exhaustion, expressed in feelings of emotional overstrain, loss of interest in their own children and the environment in general, in indifference or emotional oversaturation, the higher the manifestations of parental depersonalization.

Emotional exhaustion (r=-0.817; p=0.01) and depersonalization (r=-0.618; p=0.01) are interrelated with the development of symptoms of reduction of parental achievements, manifested in a decrease in the sense of competence in fulfilling one's parental role, dissatisfaction with oneself, a decrease in the value of parenthood and a negative self-perception of fulfilling one's parental duties.

The obtained relationships indicate the relationship of the symptoms of parental burnout with each other, an increase in one symptom of parental burnout will contribute to an increase in other symptoms.

The paper draws the following conclusions:

1. Emotional exhaustion is the most common symptom of parental burnout in mothers raising a child with autism spectrum disorder.
2. Women who are married and satisfied with marital relations have less pronounced symptoms of parental burnout, satisfaction with marital relations acts as a resource to curb the development of symptoms of parental burnout of mothers raising a child with autism spectrum disorder.
3. The lack of free time for a mother raising a child with an autism spectrum disorder is a factor contributing to the development of emotional exhaustion.
4. The number of children, job availability, and satisfaction with relationships with parents do not affect the development of symptoms of parental burnout of mothers raising a child with autism spectrum disorder.

The data obtained in the study clarify scientific ideas about the features of parental burnout of mothers raising a child with autism spectrum disorders that have not been studied before. The conclusions of the work can serve as motivation to continue and expand the study of families, to formulate new hypotheses on parental burnout, and, consequently, to new scientific research and significant results.