Affiliate stigma is associated with caregiver burden through reduced self-efficacy among caregivers of preschool children with autism spectrum disorder: a moderated mediation study
Year: 2026
Type: article
Abstract: Objective Family caregivers of children with autism spectrum disorder (ASD) are vulnerable to affiliate stigma and caregiver burden, yet the psychological pathway linking stigma to burden and the family-level conditions that may buffer this pathway remain insufficiently understood. This study examined whether self-efficacy mediated the association between affiliate stigma and caregiver burden and whether caregiver support availability moderated this indirect association. Methods In this cross-sectional study, 456 primary family caregivers of children aged 3–7 years with ASD were recruited from tertiary hospitals in Shandong Province, China. Participants completed the Zarit Burden Interview, General Self-Efficacy Scale, Affiliate Stigma Scale, and a demographic and caregiving questionnaire. Correlation analysis, hierarchical regression, bootstrap mediation analysis, and conditional process analysis were performed. Results Affiliate stigma was positively correlated with caregiver burden (ρ = 0.28, p < 0.001) and negatively correlated with self-efficacy (ρ = -0.16, p < 0.001). Self-efficacy partially mediated the association between affiliate stigma and caregiver burden, accounting for 12.6% of the total effect (indirect effect = 0.031, 95% CI: 0.011-0.057). Caregiver support availability moderated the mediated pathway. The indirect effect was significant among caregivers with low support availability (effect = 0.044, 95% CI: 0.018-0.078) but not among those with high support availability (effect = 0.003, 95% CI: -0.029 to 0.033). Conclusion Affiliate stigma was associated with greater caregiver burden partly through lower self-efficacy, while higher co-caregiving support availability was associated with an attenuated indirect association. Stigma reduction, self-efficacy enhancement, and family support mobilization should be integrated into mental health support for caregivers of preschool children with ASD.
Source: Frontiers in Psychiatry
Authors: Runyu Chai, Yaru Dong, Yi Li, Rong Chai
Institution: Qilu Hospital of Shandong University
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7225833503