• Parents of children with ASD may internalize societal stigma as self-stigma.

• Self-stigma has two dimensions: content and process.

• Both the content and process of self-stigma affect mental health.

• Both the content and process of self-stigma affect caregiving experiences.

• The STARS is a reliable and valid measure of self-stigma process.

Parents of children with autism spectrum disorder (ASD) vary in not only the extent to which they endorse their self-stigmatizing thoughts, referred to as self-stigma “content”, but also the extent to which they think about their self-stigmatizing thoughts repetitively and automatically as a mental habit, referred to as self-stigma “process”. Existing measures of self-stigma, however, focus almost solely on self-stigma content. No measures are available for assessing self-stigma process among parents of children with ASD. The present study examined the psychometric properties of a recently developed measure of self-stigma process, the Self-Stigmatizing Thinking’s Automaticity and Repetition Scale (STARS), among parents of children with ASD.

Cross-sectional, questionnaire data were collected from 424 parents of children with ASD residing in Hong Kong, China.

Confirmatory factor analyses supported the originally proposed, two-factor model of the STARS. The entire scale, as well as its two subscales, had excellent internal consistency. The STARS demonstrated construct validity by being correlated with self-stigma content. It also showed criterion validity by being correlated with mental health (as indicated by life satisfaction and depression) and caregiving experiences (as indicated by caregiving gain and caregiving burden). Furthermore, the STARS exhibited incremental validity by explaining life satisfaction, depression, caregiving gain, and caregiving burden, even after adjusting for self-stigma content.

Our findings provided evidence for the reliability, and the factorial, construct, criterion, and incremental validity, of the STARS among parents of children with ASD. Our findings highlighted the content-process distinction of self-stigma, and provided important insights on the design of effective anti-self-stigma interventions.

Kevin Ka Shing Chan, Chun Bun Lam
Research in Autism Spectrum Disorders, Volume 48, April 2018