Pathways to Self-Stigma in Parents of Children with a Mental Health Disorder

Objectives Self-stigma in parents of children with a mental health disorder is a painful experience, yet the process by which it is formed is poorly understood. A model of this process would improve our understanding and inform intervention development. The two existing models of self-stigma have not been tested with parents of children with a mental health disorder specifically, and are inconsistent with qualitative research findings suggesting an alternative explanation. Thus, this study aimed to test a model of parents' self-stigma drawn from qualitative research, in which parents' awareness of stigma predicts parents' self-doubt about their parenting, self-doubt predicts self-stigma, which in turn predicts affective distress. Methods Parents of children with a mental health disorder (n = 424) completed measures representing each of these model components. Results Using structural equation modelling and after controlling for child symptoms and demographics, significant direct pathways were found from awareness of stigma to self-doubt, self-doubt to self-stigma, and self-stigma to affective distress. Conclusions These findings suggest that self-doubt is an important step in internalising stigma as self-stigma. Furthermore, self-stigma is related to serious consequences for parents' psychological wellbeing and hence, the parent-child relationship. Findings are discussed in terms of their implications for theory and self-stigma interventions.