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International Journal of Developmental Disabilities logoLink to International Journal of Developmental Disabilities
. 2019 Mar 1;66(4):282–288. doi: 10.1080/20473869.2019.1573000

Analysis of the self-compassion and cognitive flexibility with marital compatibility in parents of children with autism spectrum disorder

Bahareh Shahabi 1,✉, Rana Shahabi 2, Elham Foroozandeh 3
PMCID: PMC7952048  PMID: 34141390

Abstract

Purpose: Parents of children with autism spectrum disorder (ASD) face many problems in their marital lives. Autism is a developmental disorder, emerging during childhood that affects development across various domains. Studies suggest that autism prevalence rates are increasing, and research shows that parents of children with ASD frequently experience high levels of parenting stress. Marital compatibility is fulfilled when couples have the sense of satisfaction and contentment from each other. This study was done to analyze self-compassion and cognitive flexibility in relation with marital compatibility in parents having children with ASD.

Methods: A sample size with 100 married couples, who referred to autism centers, was selected after clinical interviews. The research tools included structural clinical interview (DSM SCID), self-compassion scales questionnaire, cognitive flexibility inventory questionnaire, and marital compatibility test questionnaire, which were completed by the participants.

Results: The research is a correlational descriptive study. Data analysis was done by the path analysis method. The findings showed that there was a significant relation between self-compassion, cognitive flexibility, and marital compatibility.

Conclusions: In this study, it could be concluded that compassion via flexibility can have indirect positive effects on marital compatibility as two features of self-compassion and cognitive flexibility can help parents of children with ASD to be more compatible and flexible in their marital lives.

Keywords: Self-compassion, cognitive flexibility, marital compatibility, autism, autism spectrum disorder

Introduction

Family is a social association, in which mental health is of great importance. Parents having a child with ASD encounter many problems that may expose their mental health to considerable risks (such as depression, stress, anxiety, pessimism, etc.). Parents of children with ASD face with difficult and unique daily stressors associated with their child’s disorder (Neff and Faso 2015). Autism is a mental disorder influencing growth in childhood (Diagnostic 2000).

Children with ASD have difficulties in controlling their emotions, and perform weakly in both verbal and non-verbal actions. They do not also make social interactions with other people. According to the studies, the trend of this disorder is gradually increasing (Boonsuchat 2015). Their parents often experience enormous stress in their roles (Anastopoulos et al. 1992). Investigations show that the quality of life of the parents of children with ASD is lower and pessimism and depression about future in them are higher as compared to the parents having normal children (Cappe et al. 2011, Johnson et al. 2011). Moreover, the parents of children with ASD have a sense that they have caused the existing conditions of their children, and hence, they blame themselves for that (Fernández and Arcia 2004). Although the relationship between the child and the parent’ performance appears bidirectional, parental stress seems to can even reduce or eliminate positive outcomes of intervention for children with ASD.

In fact, high parent stress can lead to increased external-behavioral problems over time in children with ASD (Karst and Van Hecke 2012).

One point that is quite important about the parents of children with ASD is marital compatibility (Fallahchai et al. 2017). This structure may face fluctuations by having children with ASD. Marital compatibility is a condition in which most of the time couples have the sense of satisfaction and contentment for each other. Couples’ compatibility can be measured via mutual affection, the rate in taking care of each other, and also accepting and understanding each other (Sinha and Mukerjee 1990). In fact, marital compatibility provides a general evaluation of the existing relational condition. One of the most common concepts of marital consent and compatibility is determining and showing the rate of happiness and stability of relationship (Weigel and Ballard-Reisch 1999). Marital relationship is always described as the most important and principle human relationship since it provides a primary structure for constructing family relationship and developing the future generation (Larson and Holman 1994). According to Sternberg and Hojjat (1997) marital compatibility is a very important and complex aspect of a marital relationship. In other words, one of the vital aspects of a marriage is the consent that couples experience and feel in their relationship.

Marital compatibility is a process that is created during the couples’ life, having four domains of physical and sexual attraction, understanding, attitude, and investment (Kiani et al. 2010). In fact, various variables affect the couples’ relationship with each other during the common life, and these variables have the consent and dissatisfaction of the couples from their marital relations. Some of these variables include income, employment, children, sexual satisfaction, and especial diseases (Floyd et al. 1998). Quality of marital relationship is positively related to public health, higher rate of safety, physiologic safety, and existence of antibodies against viral factors, and proper functioning of the cardiovascular system (Whitson and El-Sheikh 2003). In Laurenceau et al. (2005) research, one of the effective factors on marital compatibility is the couple’s self-compassion. The rates in the compatibility of individuals in coping with stress and problems in marital life and social difficulties are not similar. In a social environment, some people lose their ability in dealing with problems, but others can tolerate it with such conditions and eliminate the problems without any hindrances. One of the factors that help the parents to be more compatible in their marital life, and despite the problems their child confronting, is cognitive flexibility (Dennis and Vander Wal 2010). Flexibility is defined as ability and inclination to conform to the life changes that require understanding of different views for the ability of compatibility, understanding new situations, changing the moving routes in case of necessity, and inclination to learn and grow. Increasing cognitive flexibility causes individuals to show positive conforming behaviors in crises, tragic events, threats, and stress (Folke et al. 2010). Psychology of health has considered proper importance for coping with stress and life problems in improving social and mental health conditions in individuals, and assumes that the most direct intervention method is to reinforce confronting responses and the cognitive capabilities (Alloy and Riskind 2006). Dennis and Vander Wal (2010) in their study concluded that increasing cognitive flexibility reduces signs of anxiety. In another study, Martin and Anderson (1998) showed that there is a positive relationship between cognitive flexibility and assertiveness. The other structure that can help the healthy relationship with the self and others is self-compassion. Self-compassion means sincere information about the pains and discomforts by the person and others inclining to reduce them (Germer and Neff 2013). Neff regards self-compassion, i.e. sincere knowledge of pains and discomfort by the person himself as a structure with three components including self-kindness against self-judgment, human commonalities against seclusion and mind-knowledge against extravagant identifications. Combination of the three related components indicates the specification of a person who has self-compassion. The structure of self-compassion with confrontation and adjusting emotions styles is referred to the processes by which individuals adjust the intensity and duration of the impulsion of their emotions by deviating their attention towards their emotions, and change the characteristics and concepts of emotional states in dealing with stressful and annoying conditions (Neff 2003a, 2003b). Thus, self-compassion is related to confrontation styles and emotional compatibility (Brenner and Salovey 1997). In addition to preserving individuals against mental conditions, self-compassion has great roles in emotional states, such as happiness, optimism, and marital satisfaction. For instance, self-compassion is related to the feelings such as social relations and life satisfaction (Hollis-Walker and Colosimo 2011, Neff et al. 2008). Researches have shown that self-compassion is related to consequences of psychology, such as higher motivation for solving inter-personal contradictions, solving constructive problems, stability of marital life, less anxiety, depression and stress, and less neurotic perfectionism and higher life satisfaction (Baker and McNulty 2011, Brenner and Salovey 1997, MacBeth and Gumley 2012). Moreover, self-compassion is accompanied significantly with intimacy to others (Neff and Pommier 2013). On the other hand, Bögels et al. (2010) did a research, the results of which showed that increasing self-compassion can be the main key of knowledge mechanism and effective action for the parents of children with ASD, and self-compassion had significant relation with the stress of the parents with autistic children. Thus, marital compatibility affects many criteria in the individual and social lives of human beings. In the families having children with ASD, marital consistencies are very effective on the mental conditions of the parents and also the progresses or regressions of their children with ASD. Since according to the research, children with ASD get more nervous and more aggressive in stressful conditions, and their performances in different fields are affected by the inappropriate conditions, and so a prominent regression can be observed in these children (Karst and Van Hecke 2012). Therefore, healthy and sincere family conditions, and with no stress, are effective on the mental health of couples and their children with ASD. Hence, due to the importance of this subject, the structures such as self-compassion and flexibility cognition are essential in the communities of parents’ of children with ASD. Hence, according to what was stated, the present study tries to find out whether self-compassion and cognitive flexibility have relations with marital compatibility, or not. Two research questions are proposed to examine the relationships between self-compassion and cognitive flexibility with marital compatibility in parents of children with autism spectrum disorder (ASD): (a) What is the relationship between self-compassion and marital compatibility? (b) What are the relationships between cognitive flexibility and marital compatibility?

Methods

Participant

Since the statistical population of the research includes all the both parents of children with ASD, who had referred to autism centers during spring 2016, 115 couples volunteered, although 15 couples were dismissed due to lack of cooperation in the study (Failure to complete questionnaires’) and 100 couples were selected on the basis of available samples. Most parents also had an average economic level, and according to inclusion criteria: (1) age range between 20 and 40 years of age, (2) primarily Persian-speaking, (3) minimum of high school education, (4) lived in the city, (5) having an autistic child, (6) one year after diagnosing the disorder in their child, and the exclusion criteria: (1) parents with chronic physical illnesses, (2) parents with mental disorders, and (3) parents on the verge of getting divorced, they were invited for this study.

Procedure

After sending the participants from the relevant centers to the researchers and doing administered clinical interviews with them on the inclusion or exclusion criteria, especially on in lack of depression. The questionnaires were filled after the required explanations about inviting the participants for voluntary cooperation and obtaining their consents. After completing the questionnaires, the obtained answers were coded and the collected data was being extracted. Analyzing the findings was done by the path analysis method.

Measures

(1) Administered clinical interview according to DSM SCID: SCID is an administered structural clinical interview for evaluating different disorders, axis I and II. This diagnosing interview was developed for the first time in 1990s for diagnostic evaluations according to DSM-III-R, and its present version is updated according to DSM-IV, having two versions of SCID-I for the I-axis disorders and SCID-II for II-axis disorders.

SCID-I includes seven diagnosed groups of Axis-I disorders that are temperamental disorder, psychosis, addiction to drugs, anxiety and physical disorders, eating and compatibility, and SCID-II includes all the ten DSM-IV personality disorders. Analysis of the psychological features of these tools indicates that reliability of it for more intensive disorders is better than mild disorders, and its validity is reported in the range 0.81–0.84. However, due to better conformity and comprehensiveness, SCID with DSM criteria is more valid than other clinical scales, and it is a diagnostic standard and comprehensive evaluation in research, legal and clinical fields, which is used extensively(First et al. 1996).

(2) Self-compassion scale (SCS): Self-Compassion Participants were given the SCS (Neff 2003a), a self-reported, 26-item measure with responses ranging from 1 (almost never) to 5 (almost always). It contains six subscales: self-kindness (e.g. I try to be loving toward myself when I’m feeling emotional pain), self-judgment (e.g. I’m disapproving and judgmental about my own flaws and inadequacies), common humanity (e.g. When things are going badly for me, I see the difficulties as part of life that everyone goes through), isolation (e.g. When I think about my inadequacies, it tends to make me feel more separate and cut off from the rest of the world), mindfulness (e.g. When I’m feeling down I try to approach my feelings with curiosity and openness), and over identification (e.g. When I’m feeling down I tend to obsess and fixate on everything that’s wrong). The subscales of the SCS may be examined separately, or else a total self-compassion score can be used given that a single higher order factor of ‘self-compassion’ has been found to explain the intercorrelations between subscales (Neff 2003a). Note that the self-judgment, isolation, and over identification subscales of the SCS are reverse coded so that higher scores indicate higher levels of self-compassion. The scale demonstrates convergent validity (e.g. correlates with partner ratings), discriminate validity (e.g. no correlation with social desirability), and good test-retest reliability 0.86 (Neff 2003a, Neff and Beretvas 2013).

(3) Cognitive flexibility index (CFI): This questionnaire is made by Dennis and Vander Wal (2010). It is a short self-reporting tool with 20 questions, used for measuring a type of cognitive flexibility, which is necessary for the success in replacing inefficient thoughts to more efficient thoughts. Method of grading is based on a 7-scale Likert criterion trying to measure three aspects of cognitive flexibility: (a) desire to understand hard conditions as controllable situations, (b) ability to understand a number of replaced justifications for life events and human behaviors, and (c) potential to create some replacing solutions in creating flexible thoughts for hard situations. This questionnaire is used in clinical and non-clinical cases and for evaluating the individual’s progress in creating flexible thoughts in cognitive/behavioral treatment of depression and other psychological illnesses. In a study, Dennis and Vander Wal showed that this questionnaire had appropriate operating, convergent validity, and simultaneous validity (Dennis and Vander Wal 2010). The researchers showed that the two factors of understanding different alternatives and understanding the behavioral justification were the same, and the control factor was considered as the second subscale. Simultaneous validity of this questionnaire with Depression-I questionnaire (BDI-II) was equal to –0.39, and convergent validity of that with Martin-Robin cognitive flexibility scale was 0.75. These researchers obtained validity (by Alpha-Cronbach method) for the general scale, controllability understanding and understanding different alternatives to be 0.91, 0.91, and 0.84, respectively, and obtained it by the trial method to be 0.81, 0.75, and 0.77, respectively.

(4) Marital compatibility test (MAT) (Locke and Wallace 1959): This questionnaire is based on inter-personal concept about marital relationships, measuring the success of the couples in activities involved in marital compatibilities with 15 questions. In this test, the score of 100 or higher indicates marital satisfaction and the score <100 indicate stress in marital relations. Estimating internal consistency was very good by using Spearman-Brown formula, and the correlation coefficient between its two halves was 0.90. Locke-Wallace MAT for identified groups has high validity with distinctive scores for agreeable and disagreeable couples. The scores of this test ‘Locke-Wallace marital prediction’ has high correlation.

Analysis

The study was a cross-sectional design using correlational descriptive and path analyses to measure the relationships between self-compassion and cognitive flexibility with marital compatibility in parents of children with ASD.

Results

Correlation coefficients: compassion, flexibility, and compatibility

Correlation coefficients between the research variables are given in Table 1. According to Table 1, Pearson correlation coefficient is significant and positive between compassion, flexibility and compatibility (p < 0.001), and also between flexibility and compatibility (p < 0.001). Path analysis method was used to analyze the hypothesized model of the research, the results of which are indicated in Table 2 and Figure 1.

Table 1.

Correlation coefficients between research variables

No. Variables 1 2 3
1 Compassion –    
2 Flexibility 0.39** –  
3 Compatibility 0.75** 0.28** –
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*p < 0.05.

**p < 0.01.

Figure 1.

Figure 1

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Hypothesized model of the relations between the research variables

Figure 2.

Figure 2

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Fitted model of the relation between the research variables

Coefficients of direct standard effects

According to Table 2, all the hypothesized direct standard effects between the research variables are significant (p < 0.001). Thus, fitness of the hypothesized model of the research was analyzed in different fitness indices, without eliminating or adding any specific paths, the results of which are seen in Table 3.

Table 2.

Coefficients of direct standard effects of the paths between the research variables

Paths Estimate Standard error Significance
Compassion 0.39 0.07 0.00
Flexibility      
Flexibility 0.75 0.04 0.00
Compatibility      
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Table 3.

Conditions of hypothesized fitness model indices of the research

Fitness indices Research statistic values Acceptable level Model situation
CMIN 0.13* Table chi-square value Fitness
NFI 0.99 0 (no fitness) to 1 (complete fitness) Fitness
TLI 1 0 (no fitness) to 1 (complete fitness) Fitness
CFI 1 0 (no fitness) to 1 (complete fitness) Fitness
RMSEA 0.00 <0.05 Fitness
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*p = 0.71.

Conditions of hypothesized fitness model indices of the research

According to Table 3, lack of significance of χ2, values >0.90 for the normalized fit index (NFI), Tucker-Lewis index (TLI), comparative fit index (CFI) and a value <0.05 for the root mean square error of approximation (RMSEA) indicate the appropriate fitness of the hypothesized model. Thus, the indirect effect between the variables in the model is also approved. Table 4 shows the indirect standard effect related to the indirect path of the model, and Figure 2 shows the fitted model of the research together with the path coefficients.

Table 4.

Indirect standard effect about the fitted model of the research

Paths Estimate
Compassion compatibility (via flexibility) 0.29
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Indirect standard effect

According to Table 4 and Figure 2, it can be seen that compassion via flexibility can have positive indirect effect on compatibility (p < 0.001). In other words, according to the obtained model in this research, flexibility is considered as an intermediary variable in the relation between compassion and compatibility.

Discussion

The aim of the present research is to analyze the relation of self-compassion and cognitive flexibility with marital compatibility in parents of children with ASD. The results of the study showed that self-compassion and cognitive flexibility have positive relations with marital compatibility (p < 0.00).

Self-compassion can have indirect positive effect on compatibility via flexibility. The present study is in conformity with the results of the studies by Neff and Faso (2015) for the works done about the communities of parents of children with ASD, and the positive effects of compassion that are observed on such parents. Moreover, in another study by Bögels et al. (2010) the results showed that increasing self-compassion can be the main key to the knowledge mechanism and effective actions for the parents of children with ASD. Bögels et al. (2010) study is also in conformity with the present study for the positive effects of compassion on the parents of children with ASD. According to the results of this study, the relation between self-compassion and cognitive flexibility with marital compatibility can be emphasized in parents’ children with ASD. In other words, parents with children with ASD continuously blame themselves wrongly for the autism of their children (Fernández and Arcia 2004), and they usually experience depression, stress, confusion, despair, feelings of failure, etc. in their lives (These feelings are usually due to the untreatable nature of the ASD and the lack of understanding of the community and the withdrawal from society and the detachment from society). This, in turn, will have devastating emotional effects on the marital relationship of parents of a child with ASD such as conflict, anger, aggression, stress, anxiety, incompatibility, and sometimes even divorce. Even in an intact family, a diagnosis of autism can place a heavy strain on the household. In addition to emotional stress, there can be significant financial consequences. A parent may have to leave his or her career to take care of the child or to be available to transport the child to therapy sessions. The other parent might have to work extended hours in order to help pay for the cost of private therapy. Both parents must likely forgo leisure time to learn therapy reinforcement techniques and then apply them on a scheduled basis with the child (Schopler et al. 1982). Unfortunately, these unforeseen pressures can have fractious impact on a sound relationship leading or in part contributing to separation and argument unexpectedly.

Therefore, this issue is important in the community, especially among parents with a child with ASD. If these consequences are not managed, many damages come into the family as one of the most important structure in formation of a community.

The results of this study showed that self-compassion and cognitive flexibility are positively correlated with marital compatibility. It seems that these results can be used as an effective way to prevent maladaptation among couples with children with ASD because we can inform parents that they would deal with kindness and compassion with themselves and their spouses by understanding this difficult situation. And they can also be more aware of several solutions to these difficult conditions, solutions such as a conversation about challenges, resilience, management of negative emotions, get help from advisers and experts. Moreover, if they fail in a solution, they will experiment with the flexibility of another solution. These data are consistent with results of Dennis and Vander Wal (2010) who showed that there is a positive correlation between cognitive flexibility and solving the problem. Another important point is how parents of a child with ASD can correctly justify these conditions and prevent the controversy and conflict in their lives; they should realize having a child with ASD is not exclusive to them and it can happen for everyone for example, parents of children with ASD can have a close and friendly relationship with other parents in the same situation to perceive and accept their own situation better and they can learn from each other’s experience, and they should also try to rebuild their thinking framework positively. In stressful situations, they deal more flexible using two variables of self-compassion and cognitive flexibility because research has shown that individuals with higher cognitive flexibility as a consequence have a greater resiliency in their life (Phillips 2011).

It should be noted that parents of a child with ASD are often associated with reduced quality of life, high stress, depression, and anxiety due to the ongoing nature of care. Therefore, this study is important in this regard that self-compassion via flexibility can have a positive indirect effect on marital compatibility and help these couples to overcome the unpleasant emotions with more compassion and flexibility. In addition, they can resolve conflicts and differences in marital life, and also experience more satisfaction and adaptability in their lives; this leads to improve mental health and sustainability of their lives. As a result, children with ASD experience a healthier and more relaxed environment.

Limitations

Every research is inevitably confronted with limitations. One of the limitations for the present study is that we are not sure about the best measuring method for the structure of flexibility cognition via questionnaires. Further suggestions are required for the future studies on this subject by the researchers. In this regard, another limitation could be correlational design.

Acknowledgement

We thank the couples who participated in this project. We are grateful the autism institute for support.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Disclosure statement

The authors declare that there is no conflict of interest.

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