Stricher-Stern Hadas, Shalev Anat, Lahav Yael
Department of Occupational Therapy, The Stanley Steyer School of Health Professions, Faculty of Medical and Health Sciences, Tel Aviv University, Israel.
Faculty of Social Work, Ashkelon Academic College, Ashkelon, Israel.
Soc Sci Med. 2025 Sep;381:118289. doi: 10.1016/j.socscimed.2025.118289. Epub 2025 May 31.
Mothers of children with autism or mental health disorders may be at risk for anxiety symptoms and posttraumatic stress symptoms (PTSS) following exposure to traumatic events that relate to their children's upbringing. Furthermore, according to the trauma betrayal theory, mothers' experience of institutional betrayal that result from institutions' failure to fulfill their obligations may take another toll on their well-being and may exacerbate their symptomatology. Yet, thus far no study has explored institutional betrayal among parents of children with disabilities in general, nor among mothers of children with autism or mental health disorders, in particular. Bridging this knowledge gap, this study explored the unique contribution of institutional betrayal in explaining anxiety symptoms and PTSS among mothers of children with autism or mental health disorders.
An online survey was conducted among Israeli parents using self-report measures. The sample consisted of 178 mothers: 58 mothers of children with autism and 120 mothers of children with mental health disorders.
Results indicated that institutional betrayal was associated with elevated levels of PTSS and anxiety symptoms. Moreover, institutional betrayal among the mothers explained anxiety symptoms, as well as intrusion and negative alterations in mood and cognitions symptoms, above and beyond the effects of mothers' age and education, type of disability of the child, and number of traumatic events related to the child's upbringing.
The present results suggest that institutions' failure to fulfill their obligations may increase vulnerability to posttraumatic distress among mothers of children with neuropsychiatric disorders.