Book Description

Parenting a child with a developmental disability can be a profoundly stressful experience. Although caregiving is an expected part of becoming a parent, those raising children with developmental disabilities face several unique challenges. The prolonged exposure to caregiving stress can take a toll on parents' well-being and is associated with poor physical and mental health outcomes. With an observed uptick in the prevalence of developmental conditions in the United States, there is growing awareness that caregiver morbidity poses a significant threat to public health. Most research on coping in parents of children with developmental disabilities has focused on the protective role of intra-individual factors. However, there is increasing recognition that the capacity to flourish is as much a social process as it is an individual one. Because human lives are fundamentally interdependent, it is useful to examine how relational resources can be marshalled to facilitate resilience in people exposed to chronic stress. Guided by the convoy model of social relations and a network theoretical perspective, this dissertation considers the extent to which social connectedness promotes well-being in parents of children with developmental disabilities. The first project utilized data from the Midlife in the United States (MIDUS) study to develop a social network typology for parents of children with and without developmental disabilities. The social network typology was derived from an array of social-relational characteristics--community participation, social support, relationship strain--to approximate the broader person-environment system in which parents were embedded. A k-means analysis and several validation indices suggested that an optimal solution partitioned the parents into two clusters: a "diverse and supported" network type and a "restricted and unsupported" network type. Though there was considerable heterogeneity, parents of children with developmental disabilities were more likely to have restricted and unsupported networks, whereas parents of children without developmental disabilities were more likely to have diverse and supported networks. A permutation and misclassification simulation identified the relative importance of the social-relational characteristics to determining respondents' network types. Social support received from kin and friends was paramount for parents of children with developmental disabilities, while measures of community participation mattered most for parents of children without developmental disabilities. Drawing on the same data and sample as used in Project #1, the second dissertation project compared parents of children with and without developmental disabilities across an extensive set of health outcomes; assessed the effect of the social network typology on parents' well-being; and analyzed whether having a diverse and supported network buffered the putative health impacts of parenting a child with a developmental disability. On every indicator that was considered, parents of children with developmental disabilities exhibited worse mental and physical health than parents of children without disabilities. Among all respondents, being embedded in a diverse and supported network was associated with greater well-being. However, on select mental health outcomes (major depression, self-rated mental health, and negative affect), there was a differentially beneficial effect of having a well-resourced network for parents of children with developmental disabilities. That is, there was some evidence to suggest that social network resources serve a compensatory function in the context of caregiving. Moderating effects on both the additive and multiplicative scales were identified. In contrast, the social network typology did not buffer the adverse physical health consequences associated with parenting a child with a developmental disability. The second dissertation project provided cross-sectional evidence that social network resources are associated with greater well-being among parents of children with developmental disabilities. The third dissertation project tests competing mechanisms that could explain these associations: social causation (i.e., networks affect health) and social selection (i.e., health affects networks). Project #3 examined longitudinal egocentric network data collected on a sample of mothers of adolescents and adults with autism. The analysis considered relationships between support network characteristics and maternal mental health over 5 waves, or a 12-year period of time. Structural equation models with maximum likelihood estimation and random effects were used to test the causal direction between networks and health. The results supported both social causation and selection hypotheses: kin support was beneficial for depression; anxiety and depression were detrimental to mothers' level of contact with network members; the linkages between network diversity and both anxiety and depression were bidirectional; a similar bidirectional pattern was observed between network size and maternal mental health. Like all people, parents of children with developmental disabilities are "sociosyncratic"--actively shaping and shaped by the networks to which they belong. The resources that flow through social ties, and the nature of ties themselves, have the potential to buffer against caregiving stress and promote family resilience. This dissertation provides a greater understanding of how, and under what conditions, positive social relationships benefit parents' health. The evidence from the three projects can be used to design network interventions and support programs to better assist parents with prolonged and intensive caregiving responsibilities.