The relation of ASD symptom severity and typically-developing sibling behaviors through parental expressed emotion Affiliate stigma as a moderator

Caregivers of children with ASD experience greater stress, psychopathology, and social isolation than caregivers of typically-developing (TD) children or those with other disorders. They also may be more likely to experience expressed emotion (EE), which is characterized by criticism/hostility and emotional overinvolvement toward their child, as well as affiliate stigma (e.g., marginalization, devaluation, discrimination), as a result of having a child with ASD. TD siblings of children with ASD often experience more negative functioning than siblings of individuals without a developmental disorder, particularly in the presence of certain moderators or mediators. The current study examined ASD symptom severity, parental affiliate stigma (affective, behavioral, and cognitive), parental expressed emotion (criticism and emotional overinvolvement), and TD sibling behaviors (externalizing and internalizing) using a moderated mediation model. Data from a larger completed study was used that included 120 caregivers of a child with ASD, with 55 of the caregivers also having at least one TD child. Caregivers completed a demographic questionnaire and measures assessing their own affiliate stigma and EE as well as ASD symptom severity of their child with ASD and behavior of their TD child. It was hypothesized that ASD symptom severity would be positively correlated with parental EE and with TD sibling externalizing and internalizing behaviors and that affiliate stigma would be positively correlated with EE. These hypotheses were supported. It was also hypothesized that affiliate stigma would exacerbate the relation between ASD symptoms severity and parental EE. This hypothesis was not supported. It was expected that ASD symptom severity would relate to TD sibling externalizing and internalizing behaviors through parental EE and that the magnitude of this mediation would depend on levels of affiliate stigma. These hypotheses were not supported. Findings from this study may increase understanding of factors that affect psychosocial functioning in families with children with ASD and TD children to allow clinicians to improve outcomes for all family members. Limitations of the current study included self-report data, limited diversity in the sample, and the use of cross-sectional data. Future research will help further understand how affiliate stigma and expressed emotion affect families of children with ASD

Shifting the Discourse on Disability: Moving to an Inclusive, Intersectional Focus

Individuals with disabilities comprise one of the largest marginalized groups in the United States and experience systemic barriers in healthcare. In Westernized communities, disability has historically been conceptualized via the medical model, which considers disability an individual-level deficit in need of correction. Although other models of disability (e.g., social model) have been developed to address the medical model’s ableist shortcomings, these fail to consistently acknowledge intersectionality. Specifically, these models fail to consider that (a) a disabled individual may hold other marginalized or oppressed identities and (b) these intersecting oppressions may exacerbate health inequities. Intersectionality, which originates from Black feminist literature, describes the ways that systems of power and oppression (e.g., racism, sexism) interact to form an individual’s unique experience. To date, the intersection of disability and other marginalized identities has been neglected in psychology and related fields, leaving little guidance for how scholars, clinicians, and other stakeholders can address disability via an intersectional lens. The current paper discusses how a disability-affirmative, intersectional approach can serve as a strategy for challenging and reforming oppressive systems across the field of psychology. We assert that, ultimately, this approach has the potential to optimize and expand access to equitable, inclusive mental health care, and we propose actionable steps psychologists can take in research, practice, and training in pursuit of this aim