Journal of Shandong University (Health Sciences) ›› 2026, Vol. 64 ›› Issue (3): 65-77.doi: 10.6040/j.issn.1671-7554.0.2024.1411

• “Psychological Health in Children and Adolescents” Key Topics • Previous Articles    

Relationship between stigma and family resilience in adolescents with emotional disorders and their caregivers: an actor-partner interdependence model

SHEN Jun1, ZHOU Shuang2, DU Miao1, JIANG Ying1   

  1. 1. School of Nursing and Health Management, Shanghai University of Medicine &
    Health Sciences, Shanghai 201318, China;
    2. Second Nursing Department, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
  • Published:2026-03-19

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Abstract: Objective To understand the current status of stigma and family resilience in adolescents with emotional disorders and their caregivers, and to explore the relationship between stigma and family resilience in both groups. Methods A total of 281 pairs of adolescents with emotional disorders and their caregivers were recruited using conve-nience sampling during follow-up visits to the Child and Adolescent Psychiatry Outpatient Department of a tertiary specialty psychiatric hospital in Shanghai between December 2023 and July 2024. Data were collected using a general information questionnaire, the Chinese version of the Family Resilience Assessment Scale(FRAS-C), and the Perceived Devaluation-Discrimination Scale(PDD). Independent two-sample t-test, one-way analysis of variance(ANOVA), paired samples t-test, and Pearson correlation analysis were employed for statistical analysis. The actor-partner interdependence model(APIM)was constructed using Mplus 8.3 to analyze the pathways of influence between stigma and family resilience among patients and their caregivers. Results Family resilience scores were significantly lower for adolescents with emotional disorders(86.98±18.05)than for their caregivers(95.31±9.71)(t=-7.442, P<0.001). However, no significant difference was found between patients(29.04±6.87)and caregivers(29.69±5.26)PDD scores(t=-1.423, P>0.05). Pearson correlation analysis revealed that patients family resilience scores were positively correlated with caregivers family resilience scores(r=0.192, P<0.01)and negatively correlated with patients and caregivers PDD scores(r=-0.442 and r=-0.240, both P<0.01). Caregivers family resilience scores were negatively correlated with their own and the patients PDD scores(r=-0.314 and r=-0.204, both P<0.01). Patients PDD scores were positively correlated with caregivers PDD scores(r=0.238, P<0.01). The actor-partner interdependence model revealed that for the actor effects, both the patients and the caregivers perceived devaluation-discrimination significantly negatively predicted their own family resilience scores(β=-0.328 and β=-0.273, both P<0.001). For partner effects, patients perceived devaluation-discrimination significantly negatively predicted their caregivers family resilience scores(β=-0.138, P<0.05), and caregivers perceived devaluation-discrimination significantly negatively predicted patients family resilience scores(β=-0.143, P<0.01). Equality constraint tests revealed that the actor and partner effects of stigma on family resilience were similar for patients and caregivers. Conclusion The levels of stigma experienced by adolescents with emotional disorders and their caregivers significantly affect family resilience and interact with each other. To improve overall family resilience, clinical interventions should take a family-centered, comprehensive approach that addresses the needs of patients and caregivers alike and reduces stigma for both.

Key words: Emotional disorders, Adolescents, Caregivers, Parents, Stigma, Family resilience, Actor-partner interdependence model

CLC Number: 

  • R749.94
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