Parental Stress and Marital Satisfaction among Parents of Children with Special Needs: The Mediating Role of Moral Injury

Abstract

Parents of children with special needs often have to deal with ongoing concerns of care, finances, social and emotional support, which can impact personal health and relationships. Marital satisfaction may be related to moral injury, which is defined as a violation of one's deeply-held values, resulting in guilt, shame, betrayal, self-condemnation, and spiritual distress. This was a cross-sectional study that focused on the relationships between parental stress, moral injury, marital satisfaction, and the indirect effect of moral injury. A convenience sample of 60 currently married parents of children with special needs (30 mothers and 30 fathers) was selected from special education schools, autism centres and rehabilitation centres from Rawalpindi and Islamabad, Pakistan. The participants were asked to fill out the Parental Stress Scale, Locke-Wallace Marital Adjustment Test, and Moral Injury Symptom Scale-Civilian Version-Short Form. Descriptive statistics, reliability analysis, Pearson correlations, multiple regression, group comparisons and mediation analysis were performed. Marital satisfaction (r = .55, p < .01) and moral injury (r = .51, p < .01) were positively related to parental stress, and moral injury was also positively related to marital satisfaction (r = .45, p < .01). The adjusted regression model revealed that parental stress accounted for a significant prediction of marital satisfaction, but moral injury did not. The indirect effect using the pathway of moral injury was small and not quite statistically significant, suggesting preliminary evidence of mediation. There were no significant differences based upon parental status, family system, number of children with disabilities or the diagnostic category. Interestingly positive associations may be due to shared coping, interdependence of partners, religious meaning-making or social desirability in a collectivistic cultural context. Results further expand the concept of moral injury to family care-giving and should be interpreted with some caution and replicated with larger, dyadic, and longitudinal samples.