Edinburgh Napier University

  Mediators of coping in caregivers of children with complex needs and factors associated with coping has rarely been investigated in the past. A systematic review of the quantitative caregiver coping literature indicated that previous research had a specific focus on individual conditions with inconsistent approaches towards participants, conditions and coping measures. A quantitative online questionnaire was created which incorporated tools to measure Coping and potential mediators of coping: Adult Attachment, Emotion Regulation and Cognitive Fusion. Data were also collected on type, severity and the number of children and types of conditions. Sample consisted of 121 caregivers from the UK and ROI with an average age of 39.12. Caregivers children were classified as either no additional need (n=41), Non-Physical conditions (n=39), Physical conditions (n=12) or complex needs (n=29). The sample was categorised into a complexity group (n=56) or a non-complexity group (n=65) for analysis.

The aims were to investigate the common Coping strategies used by caregivers of children with complex needs and to explore mediators of coping in caregivers of children in complex need. Mediation analysis was carried out to investigate whether there was an association between Adult Attachment, Emotion Regulation and Cognitive Fusion, coping and complexity of need. Cognitive Fusion and Attachment Avoidance were found to mediate coping strategy usage. When Cognitive Fusion and Attachment Avoidance scores were high, Self-Punishment and Coping Avoidance usage increased. Lower scores in Cognitive Fusion significantly increased the use of Accommodation and Approach coping strategy use. A decrease in Attachment Avoidance scores was also associated with an increase in Self-Help coping strategy usage.

Results indicate that reduced Cognitive Fusion and attachment avoidance can enhance adaptive coping strategies of Accommodation and Approach. Reduction of Cognitive Fusion and Attachment Avoidance can lead to more adaptive and helpful coping strategies for caregivers of children with complex needs. Suggestions are made on how interventions addressing high Cognitive Fusion and attachment avoidance could improve adaptive coping in caregivers of children with complex needs. This research concludes that coping strategy choice is influenced by specific mediators in caregivers of children with complex needs and further study into coping mediators and complex needs and how it impacts on carers is highly recommended.