Association Between Affiliate Stigma and Depression and Its Moderators in Caregivers of Children with Attention-Deficit/Hyperactivity Disorder

Abstract Background This study aimed to determine the association between affiliate stigma and depression in caregivers of children with attention-deficit/hyperactivity disorder (ADHD) in Taiwan and evaluated the moderating effects of perceived family support, self-esteem, and children's behavioral problems on the association. Methods The affiliate stigma and depressive symptoms of 400 caregivers of children with ADHD were assessed using the Affiliate Stigma Scale and Center for Epidemiological Studies Depression Scale, respectively. A general linear model (GLM) was used to examine the association between affiliate stigma and depression symptoms. The interaction models of the GLM and the Johnson–Neyman technique were used to examine the moderating effects of caregivers’ family support and self-esteem and children's internalizing problems and ADHD symptoms on the association. Results Affiliate stigma was positively associated with the depression level in caregivers of children with ADHD. The level of the association between affiliate stigma and depression symptoms was negatively associated with the levels of family support and self-esteem but positively associated with the levels of child's internalizing problems and ADHD symptoms. Limitations The cross-sectional design limited the possibility of determining the causal relationships among the variables. Conclusions Prevention and intervention strategies should aim to reduce affiliate stigma and depression symptoms, as well as to target the moderators of the association.