Effect of Emotional Disclosure Through Online Journal Writing on Maternal Stress and Quality of Mother-Child Relationship Among Mothers of Children with ASD or Related Disorders

Background: The nature of autism spectrum disorders (ASD) uniquely impacts a mother’s ability to cope with daily occupations and strains the mother-child relationship.^1-2 Decades of research on maternal stress, distress and mother-child relationship in the circumstance of raising a child with a developmental disability, especially related to difficult child behaviors, have yet to generate effective, easy to access interventions. Meanwhile, there are two decades of empirical support that emotional disclosure through journal writing provides predictable dampening effect on stress³. It is unknown if the nature of maternal stress associated with ASD is malleable to emotional disclosure through journal writing nor whether the promise of internet-based intervention^4-5 can transfer to improved quality of mother-child relationship or reduce maternal stress.

Objectives: This study compared the effect of emotional disclosure via an 8-week online journal writing intervention on maternal stress, maternal distress and quality of mother-child relationship for mothers raising children with psychopathologies.

Methods: Multivariate stepwise regression was used to examine the effect of emotional disclosure on maternal stress and quality of mother-child relationship. A two-group randomized, repeated measures design was used in this study.  Mothers were recruited almost exclusively from online parent communities like the Interactive Autism Project (IAN);child ages fell between 3 and 18 years. Mothers completed the PSI-SF before and after intervention to assess maternal total stress, maternal distress, difficult child behaviors and dysfunction in the quality of the mother-child relationship. Initial demographics data allowed for analysis of covariance; the Linguistic Inventory of Word Count (LIWC) was used to calculate emotionally laden disclosure⁶.

Results: Participants (N = 113) reported average maternal total stress (M = 98.32), maternal distress (M=33.80), and dysfunction in the mother-child relationship (M = 37.32) each at clinically significant levels (> 85^th percentile). Bivariate analysis showed a moderate but significant correlation (r =.557, p =.001) between Difficult Child behaviors and Poor Quality of mother-child relationship. Emotional disclosure through journal writing did reduce maternal stress post intervention with the greater the number of negative emotion laden words showing greatest lowering of total stress.  Negative emotion laden words accounted for 22.8% of the variance in parental distress (F(1, 34) = 10.060, B = -6.948,  p = .003).Negative emotion laden words also accounted for 17.6% of the total variance in total stress (F(1, 34) = 7.252, B = -14.894,  p = .011). A strong and significant correlation was found between Difficult Child behaviors and Total Maternal Stress, both before (r =.810; p= .001) and after the intervention (r = .891; p=.001).

Conclusions:  Emotional disclosure through journal writing did reduce stress when mothers used rich emotionally disclosive language. Mothers are stressed at clinically significant levels with a positive correlation shown between socially disruptive behaviors, maternal stress and mother-child relationship. This study suggests emotional disclosure through online journal writing may be a cost efficient, non-invasive intervention regardless of socioeconomic or geographic barriers for reduction of maternal stress for raising a child with ASD or related disorders. Future study regarding length of intervention and greater specificity of journal prompts is recommended.