American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). 2013.

Agarwal R, Wuyke G, Sharma U, Burke SL, Howard M, Li T et al. Stress and anxiety among parents of transition-aged children with Autism Spectrum Disorder: a systematic review of interventions and scales. Rev J Autism Dev Dis. 2022:1–23.

Alibekova R, Kai CC, Crape B, Kadyrzhanuly K, Gusmanov A, An S, et al. Stress, anxiety and depression in parents of children with autism spectrum disorders in Kazakhstan: prevalence and associated factors. Global Mental Health. 2022;9:472–82.

Article  PubMed  PubMed Central  Google Scholar 

Jahan S, Araf K, Griffiths MD, Gozal D, Mamun MA. Depression and suicidal behaviors among Bangladeshi mothers of children with Autism Spectrum disorder: a comparative study. Asian J Psychiatry. 2020;51:101994.

Article  Google Scholar 

Shtayermman O, Zhang Y. Attachment style and Mental Health Profiles of Parents Caring for a child with autism: suicidal ideation, depression and anxiety. J Autism Dev Disord. 2022;52(11):4872–82.

Article  PubMed  Google Scholar 

Pearlman AT, Murphy MA, Raiciulescu S, Johnson N, Klein DA, Gray JC, et al. Longitudinal associations between perceived discrimination and suicidality in youth. J Pediatr-Us. 2023;262:113642.

Cheref S, Talavera D, Walker RL. Perceived discrimination and suicide ideation: moderating roles of anxiety symptoms and ethnic identity among Asian American, African American, and hispanic emerging adults. Suicide Life-Threat. 2019;49(3):665–77.

Mak WWS, Kwok YTY. Internalization of stigma for parents of children with autism spectrum disorder in Hong Kong. Soc Sci Med. 2010;70(12):2045–51.

Campbell JA, Walker RJ, Garacci E, Dawson AZ, Williams JS, Egede LE. Relationship between adverse childhood experiences and perceived discrimination in adulthood. J Affect Disorders. 2020;277:999–1004.

Pascoe EA, Smart RL. Perceived discrimination and health: a meta-analytic review. Psychol Bull. 2009;135(4):531–54.

Schmitt MT, Branscombe NR, Postmes T, Garcia A. The consequences of perceived discrimination for psychological well-being: a meta-analytic review. Psychol Bull. 2014;140(4):921–48.

Article  PubMed  Google Scholar 

Chan KKS, Leung DCK, Fung WTW. Longitudinal impact of parents’ discrimination experiences on children’s internalizing and externalizing symptoms: a 2-year study of families of autistic children. Autism. 2023;27(2):296–308.

Article  PubMed  Google Scholar 

Ban Y, Sun J, Liu J. Social Support and Subjective Well-being in Chinese parents of children with Autism Spectrum Disorder: the mediating role of Perceived discrimination. Front Psychol. 2021;12:781794.

Article  PubMed  PubMed Central  Google Scholar 

Chan KKS, Yip CCH, Wang Z. Nonattachment alleviates the longitudinal impact of experienced and anticipated discrimination on parents of children with Autism Spectrum Disorder. Mindfulness. 2022;13(7):1733–44.

Article  Google Scholar 

Chan KKS, Yip CCH, Leung DCK. Longitudinal impact of self-stigma content and process on parental warmth and hostility among parents of children with autism spectrum disorder. J Autism Dev Disord. 2023;53(7):2728–36.

Article  PubMed  Google Scholar 

Oduyemi AY, Okafor IP, Eze UT, Akodu BA, Roberts AA. Internalization of stigma among parents of children with autism spectrum disorder in Nigeria: a mixed method study. BMC Psychol. 2021;9(1).

Mak WWS, Cheung RYM. Affiliate Stigma among caregivers of people with intellectual disability or Mental Illness. J Appl Res Intellect. 2008;21(6):532–45.

Article  Google Scholar 

Salleh NS, Abdullah KL, Yoong TL, Jayanath S, Husain M. Parents’ experiences of Affiliate Stigma when caring for a child with Autism Spectrum disorder (ASD): a Meta-synthesis of qualitative studies. J Pediatr Nurs. 2020;55:174–83.

Article  PubMed  Google Scholar 

Chan KKS, Lam CB. Self-stigma among parents of children with autism spectrum disorder. Res Autism Spect Dis. 2018;48:44–52.

Article  Google Scholar 

Büşra ÖZ, Tuğba YÜKSEL. NASIROĞLU S. Depression-anxiety symptoms and stigmatization perception in mothers of children diagnosed with Autism Spectrum Disorder. Archives Neuropsychiatry. 2020;(57):50–5.

Salleh NS, Tang LY, Jayanath S, Lim Abdullah K. An explorative study of affiliate stigma, resilience, and quality of life among parents of children with autism spectrum disorder (ASD). J Multidisciplinary Healthc. 2022;15:2053–66.

Zhang L, Li W, Liu B, Xie W. Self-esteem as mediator and moderator of the relationship between stigma perception and social alienation of Chinese adults with disability. Disabil Health J. 2014;7(1):119–23.

Hou Y, Kim SY, Hazen N, Benner AD. Parents’ perceived discrimination and adolescent Adjustment in Chinese American families: mediating family processes. Child Dev. 2017;88(1):317–31.

Pascual-Sanchez A, Jenaro C, Montes JM. Understanding social withdrawal in euthymic bipolar patients: the role of stigma. Psychiat Res. 2020;284:112753.

Article  Google Scholar 

Ruijne RE, Zarchev M, van Weeghel J, Henrichs J, Garofalo C, Bogaerts S, et al. Experiencing discrimination mediates the relationship between victimization and social withdrawal in patients suffering from a severe mental illness: a cross-sectional study. J Psychiatr Res. 2022;148:14–20.

Article  PubMed  CAS  Google Scholar 

Chen W, Chen S, Zhong B. Sense of alienation and its associations with depressive symptoms and poor sleep quality in older adults who experienced the Lockdown in Wuhan, China, during the COVID-19 pandemic. J Geriatr Psych Neur. 2022;35(2):215–22.

Moore KE, Tangney JP. Managing the concealable stigma of criminal justice system involvement: a longitudinal examination of Anticipated Stigma, Social Withdrawal, and Post-release Adjustment. J Soc Issues. 2017;73(2):322–40.

Article  PubMed  PubMed Central  Google Scholar 

Wagstaff MF, Del Carmen Triana M, Kim S, Al-Riyami S. Responses to discrimination: relationships between Social Support seeking, core Self-Evaluations, and Withdrawal behaviors. Hum Resour Manage-Us. 2015;54(4):673–87.

Article  Google Scholar 

Van Orden KA, Witte TK, Cukrowicz KC, Braithwaite SR, Selby EA, Joiner TE. The interpersonal theory of suicide. Psychol Rev. 2010;117(2):575–600.

Article  PubMed  PubMed Central  Google Scholar 

Osman A, Bagge CL, Gutierrez PM, Konick LC, Kopper BA, Barrios FX. The suicidal behaviors Questionnaire-revised (SBQ-R): validation with clinical and nonclinical samples. Assessment. 2001;8(4):443–54.

Article  PubMed  CAS  Google Scholar 

Chodkiewicz J, Gruszczyńska E. The Polish adaptation of the suicide behaviors Questionnaire-revised by A. Osman et al. Psychiatr Pol. 2020;54(1):101–11.

Article  PubMed  Google Scholar 

Aloba O, Ojeleye O, Aloba T. The psychometric characteristics of the 4-item suicidal behaviors questionnaire-revised (SBQ-R) as a screening tool in a non-clinical sample of Nigerian university students. Asian J Psychiatry. 2017;26:46–51.

Article  Google Scholar 

Zhao QJ. Relationship Among Perceived Discrimination, social anxiety and perceived social support of parents of children with autism spectrum disorder. Zhangzhou: Master, Minnan Normal University; 2018.

Zhou T, Wang Y, Yi C. Affiliate stigma and depression in caregivers of children with Autism Spectrum disorders in China: effects of self-esteem, shame and family functioning. Psychiat Res. 2018;264:260–5.

Article  Google Scholar 

Jessor R, Jessor S. Problem Behavior and Psychosocial Development. 1977.

Hayes AF, Rockwood NJ. Regression-based statistical mediation and moderation analysis in clinical research: observations, recommendations, and implementation. Behav Res Ther. 2017;98:39–57.

Article  PubMed  Google Scholar 

Schermelleh-Engel K, Moosbrugger H, Müller H. Evaluating the fit of structural equation models: tests of significance and descriptive goodness-of-fit measures. Methods Psychol Res. 2003;8(2):23–74.

Google Scholar 

Chiu MY, Yang X, Wong FH, Li JH, Li J. Caregiving of children with intellectual disabilities in China–an examination of affiliate stigma and the cultural thesis. J Intellect Disabil Res. 2013;57(12):1117–29.

Article  PubMed  CAS  Google Scholar 

Holroyd J, Brown N, Wikler L, Simmons J. Stress in families of institutionalised and non-institutionalised autistic children. J Community Psychol. 1975;1(3):26–31.

Article  Google Scholar 

Cohrs AC, Leslie DL. Depression in parents of children diagnosed with Autism Spectrum disorder: a claims-based analysis. J Autism Dev Disord. 2017;47(5):1416–22.

Article  PubMed  Google Scholar 

Wong CCY, Mak WWS, Liao KY. Self-Compassion: a potential buffer against Affiliate Stigma experienced by parents of children with Autism Spectrum disorders. Mindfulness. 2016;7(6):1385–95.

Article  Google Scholar 

Ludwig W, Huber D, Schmidt S, Bender W, Greil W. Assessment of compliance-related attitudes in psychiatry. A comparison of two questionnaires based on the Health Belief Model. Soc Psych Psych Epid. 1990;25(6):298–303.

Article  CAS  Google Scholar