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Cited by 44Mindfulness and Compassion InterventionsFamily and Disability Support ResearchPsychological Well-being and Life Satisfaction

The Effect of Mindfulness-Based and Acceptance Commitment Therapy-Based Interventions to Improve the Mental Well-Being Among Parents of Children with Developmental Disabilities: A Systematic Review and Meta-Analysis.

Open access
Chua, Joelle Yan Xin, Shorey, Shefaly·2022·Journal of Autism and Developmental Disorders
DOI 10.1007/s10803-021-04893-1PMC PMC8237545
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Abstract

Parents of children with developmental disabilities are susceptible to mental health problems. Mindfulness-based and acceptance and commitment therapy (ACT)-based interventions can improve their mental well-being. This review examined the effectiveness of mindfulness-based and ACT-based interventions in improving mental well-being and mindfulness among parents of children with developmental disabilities. Six electronic databases were searched, resulting in the inclusion of ten studies published between 2014 and 2020. Meta-analysis was conducted using the random-effect model. The results suggest that mindfulness-based and ACT-based interventions were effective in decreasing parental stress, anxiety and depression, however, the effectiveness of these interventions in increasing parental mindfulness was inconclusive. Based on these findings, we discussed considerations for implementing interventions and identified areas which warrant further research.

Integrity signals

Registry

Crossref · 10.1007/s10803-021-04893-1

Cites

79 of 79 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

20 of 77 cited sources checked · 5 supported · 1 flagged · accuracy not yet measured

  • Study design and conductcitation

    Publication bias was not assessed because no forest plot had at least ten studies.

    “publication bias was not assessed in this review because there was no forest plot with at least ten studies (Sterne et al. 2011).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Sterne et al. 2011 source

      Box 2 recommends against tests for funnel plot asymmetry when a meta-analysis has fewer than 10 studies, because such tests usually have too little power. It does not say that publication bias cannot be assessed by other means, and the citing review’s study counts are its own finding, not a finding of this source. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
  • Premisecitation

    Compassionate and non-judgmental self-view improves parents' interactions with their children.

    “Moreover, learning to view themselves and others in a compassionate and non-judgmental manner will greatly improve their interactions with their children (Duncan et al. 2009).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Duncan et al. 2009 source

      In “Compassion for Self and Child” (page not provided), the paper says self-compassion may foster a more forgiving view of parenting efforts and that mindful parents’ children may feel more affection and support. “Nonjudgmental Acceptance of Self and Child” describes practicing an accepting stance in parenting interactions. These passages support the proposed benefit, but not the citing sentence’s certainty or its claim that interactions will improve greatly. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
  • Premisecitation

    Prior systematic reviews on this topic had either too narrow or too broad focus.

    “The focus of these reviews were either very narrow, that is, only involving parents of children with ASD (Hartley et al. 2019), or too broad when parents of children from the general population who do not have any clinical conditions as well as children with clinical diagnoses such as depression and developmental disabilities were engaged (Burgdorf et al. 2019; Byrne et al. 2020; Townshend et al.”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites Hartley et al. 2019 source
    • cites Burgdorf et al. 2019 source
    • cites Byrne et al. 2020 source
  • Findingcitation

    An increase in attrition rate from around 9% at immediate post-intervention to over 50% at six-month follow-up for the intervention group was observed in one included study with the longest follow-up (Whittingham et al. 2016).

    “An increase in attrition rate from around 9% at immediate post-intervention timepoint to over 50% at the six-month follow-up for the intervention group was observed in one of the included studies which conducted the longest follow-up time period (Whittingham et al. 2016).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Whittingham et al. 2016 source

      The Preliminary Analysis and Assumption Testing section reports less than 10% missing data at postintervention and significant attrition at six months. The Statistical Analysis section reports 11 of 23 originally allocated SSTP + ACT families completing follow-up, consistent with over 50% attrition in that group. But the paper does not identify the postintervention missing-data figure as an approximately 9% attrition rate for that intervention group. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
  • Premisecitation

    Other studies have reported marked improvement in mindfulness scores only at follow-up timepoints.

    “This is further substantiated by other studies which reported marked improvement in mindfulness scores at follow-up timepoints only (Gould et al. 2018; Kohtala et al. 2017).”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites Gould et al. 2018 source
    • cites Kohtala et al. 2017 source

      The Results report significant improvement in several mindfulness subscales from pre-intervention to the five-year follow-up, but not from pre- to post-intervention. However, general mindfulness skills improved significantly by post-intervention, so improvement in mindfulness scores was not confined to follow-up. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
  • May combine two claims. 48
  • Classified as probably not a substantial claim. 35
  • The quote only partly states this claim. 4

  • May combine two claims.

    Premisecitation

    Burgdorf et al. meta-analyzed parental stress but included uncontrolled studies, so could not isolate intervention effects.

    “Burgdorf et al. (2019) conducted meta-analyses for the parental stress outcome but included data from studies without control groups and hence did not isolate the impact of the independent variable such as mindfulness-based interventions on parental stress (Hunter et al. 2016).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Burgdorf et al. 2019 source

      The Methods (Data Analysis) and Results (Parenting Stress) show that the review included within-group analyses, which could include studies without controls. But the Results (Parenting Stress, Between-Group Differences) also report a separate meta-analysis of five controlled studies comparing mindfulness with control groups. The claim that the review therefore did not isolate an intervention effect overlooks that controlled comparison. (LLM, conf=0.90)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
    • cites Hunter et al. 2016 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The review followed PRISMA guidelines.

    “This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (Moher et al. 2009).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Moher et al. 2009 source
      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Parents of children with developmental disabilities are more likely to experience high stress and mental health problems.

    “Parents of children with developmental disabilities are susceptible to mental health problems.”
    • Also stated in: § Background · plain
      “The significant challenges associated with raising a child with a developmental disability cause parents of this group of children to experience higher stress levels and place them at higher risks of developing mental health problems (Carroll 2013; Estes et al. 2012).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Carroll 2013
    • cites Estes et al. 2012 source

      The introductory passage says parents of children with ASD may be at increased risk of depression and anxiety, and the Discussion links child behavior problems to stress and psychological distress in mothers of children with ASD and non-ASD developmental delays. But the study found no significant difference in psychological distress between those mothers and mothers of typically developing toddlers. It therefore does not establish a generally higher risk of mental health problems for parents of children with developmental disabilities. (LLM, conf=0.84)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Greater mindfulness gives parents more emotional awareness and self-regulation, improving mental health.

    “Being more mindful will allow them to have greater emotional awareness and self-regulation, hence improving their mental health.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Duncan et al. 2009 source

      The “Emotional Awareness of Self and Child” section identifies emotional awareness and self-regulation as parts of mindful parenting. The “Mindful Parenting and Parent-Child Relationships” section describes mindfulness as a potential resource for coping with stress and protecting parents’ psychological well-being. The claim overstates that proposed benefit as a definite improvement in mental health. (LLM, conf=0.84)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisereasoning

    There is limited literature on the effectiveness of mindfulness and ACT-based interventions for parental mental well-being, and existing literature has methodological flaws.

    “There is limited literature that examined the effectiveness of mindfulness and ACT-based interventions on parental mental well-being. In addition, there are methodological flaws in the available literature.”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites Burgdorf et al. 2019 source

      The Discussion’s Methodological Limitations section says the number of mindfulness studies was small, and the Assessment of Study Quality section reports serious risks of bias. However, the Methods’ Eligibility Criteria explicitly excluded interventions incorporating acceptance and commitment therapy (ACT), so the review does not establish the claim about ACT-based interventions. (LLM, conf=0.90)

      Experimental — accuracy not yet measured
    • cites Byrne et al. 2020 source
    • cites Osborn et al. 2020 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Duncan and colleagues theorized that increased parental mindfulness improves mental well-being and parenting skills.

    “Duncan and colleagues theorized that when parents become more mindful, their mental well-being as well as their parenting skills will improve (Duncan et al. 2009).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Duncan et al. 2009 source

  • May combine two claims.

    Findingcitation

    Whittingham et al. (2016) and Zody (2018) found no statistically significant increases in stress, anxiety, and depression scores in their intervention groups at six-month and three-month follow-up, respectively, compared to post-intervention.

    “Both Whittingham et al. (2016) and Zody (2018) reported that their respective intervention groups did not show any statistically significant increase in stress, anxiety, and depression scores at the six-month and the three-month follow-up respectively, compared to post-intervention.”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites Whittingham et al. 2016 source
    • cites Zody 2018

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Recent studies have reported that mindfulness practices need to be conducted regularly to bring about optimum mental health benefits.

    “Recent studies have reported that for mindfulness practices to bring about optimum mental health benefits, they need to be conducted regularly (Chiam et al. 2020; Seabrook et al. 2020).”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites Chiam et al. 2020 source
    • cites Seabrook et al. 2020 source

      The Introduction (Background; page unavailable) says mindfulness practice benefits mental health, but it does not say regular practice is necessary to obtain optimum benefits. The Methods record participants’ practice frequency without testing that requirement. (LLM, conf=0.83)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Previous reviews have reported similar results for the effect of mindfulness-based interventions on stress among parents of children with developmental disabilities.

    “Similar results have been reported by previous reviews that analyzed the effect of mindfulness-based interventions on stress among parents of children with developmental disabilities (Burgdorf et al. 2019; Rayan and Ahmad 2018).”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites Burgdorf et al. 2019 source

      The Introduction reports reduced parenting stress after mindfulness-based interventions among parents of preschool children with autism spectrum disorder or other developmental delays. The Discussion reports a reduction across the review’s broader parent population, but the Results analyze clinical versus non-clinical youth rather than parents of children with developmental disabilities as a distinct group. Thus, the review reports relevant findings but does not specifically analyze the effect for the population named in the claim. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites Rayan and Ahmad 2018 source

  • May combine two claims.

    Premisecitation

    The previous review analyzed parents of children with and without clinical diagnoses such as depression and developmental disabilities, so direct comparisons could not be drawn.

    “However, as the review analyzed parents of children with and without clinical diagnoses such as depression and developmental disabilities, direct comparisons could not be drawn (Burgdorf et al. 2019).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Burgdorf et al. 2019 source

      The Results (Youth Psychological Outcomes; page unavailable) say there were too few studies to compare outcomes by parent or youth clinical status. But the Results (Parenting Stress; page unavailable) do compare parenting-stress effects for parents of clinical versus non-clinical youth and find no significant difference. Thus, the claim that direct comparisons could not be drawn is too broad. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Interpretationcitation

    Participants' inadequate understanding of mindfulness before intervention could have led them to score themselves higher, and after intervention they scored more accurately, contributing to lower post-intervention mindfulness scores.

    “Moreover, their inadequate understanding of mindfulness pre-intervention could have resulted in them scoring themselves higher. After undergoing the intervention, they would have acquired a better understanding of mindfulness and hence scored themselves more accurately (Coatsworth et al. 2015).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Coatsworth et al. 2015 source

      The Discussion reports that several mothers thought their post-intervention questionnaire scores would look worse because they viewed their parenting differently and noticed more missed opportunities for mindful parenting. The authors suggest the mothers may therefore have reported its challenges more accurately, but say their data cannot answer that question. The paper does not establish that participants initially had an inadequate understanding of mindfulness or that this caused lower post-intervention scores. (LLM, conf=0.83)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A previous review reported no relationship between the duration of mindfulness-based intervention and parenting stress.

    “This is in contrast with a previous review that reported no relationship between the duration of the mindfulness-based intervention and parenting stress (Burgdorf et al. 2019).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Burgdorf et al. 2019 source

  • May combine two claims.

    Findingown data

    Two studies had unclear overall risk of bias, while the rest had high risk.

    “The overall bias was rated as unclear for two studies and high for the remaining studies (Hilkey 2019; Lo et al. 2017).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Four included studies used ACT-based interventions, the rest used mindfulness-based interventions, and none combined both.

    “Four studies conducted ACT-based interventions, while the rest conducted mindfulness-based interventions (Corti et al. 2018; Hilkey 2019; Whittingham et al. 2016; Zody 2018). No study conducted a combination of mindfulness-based and ACT-based interventions.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Ten studies, from seven countries, analyzed 614 parents.

    “The ten included studies were conducted in seven different countries—Iran (n = 1), Jordan (n = 1), Hong Kong (n = 2), Thailand (n = 1), Italy (n = 1), Australia (n = 1), and the United States of America (n = 3)—that collectively analyzed 614 parents of children with developmental disabilities.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    Mindfulness-based and ACT-based interventions decrease parental depression.

    “The results suggest that mindfulness-based and ACT-based interventions were effective in decreasing parental stress, anxiety and depression”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data

    Mindfulness-based and ACT-based interventions decrease parental anxiety.

    “The results suggest that mindfulness-based and ACT-based interventions were effective in decreasing parental stress, anxiety and depression”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The search and screening process identified ten relevant articles from 1,753 records.

    “A total of 1,753 articles were found from the six listed electronic databases and relevant reference lists. After removing 561 duplicates and excluding 1,101 articles based on their titles and abstracts, 91 articles were left for full-text screening. The full-text screening excluded another 81 articles, leaving ten relevant articles to be included in this review.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Seven included studies were RCTs and three were CCTs.

    “There were seven RCTs and three CCTs.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Seven included studies focused on parents of children with specific conditions (ADHD, autism/ASD, cerebral palsy), while three recruited parents of children with mixed developmental disabilities.

    “Seven studies focused on parents of children with specific conditions—ADHD (n = 2), autism or ASD (n = 4), and cerebral palsy (n = 1)—while three studies recruited parents of children with a mixture of ASD, ADHD, and other developmental disabilities such as developmental delays and intellectual disabilities (Lo et al. 2017; Neece 2014; Petcharat 2018).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Lo et al. 2017

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Neece 2014 source
    • cites Petcharat 2018

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Findingown data

    The Middle Eastern and Asian subgroups for parental depression each had only one study, so heterogeneity could not be measured.

    “while the Middle Eastern countries subgroup and the Asian countries subgroup only had one study each hence heterogeneity levels could not be measured”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Seven included studies were peer-reviewed primary studies and three were unpublished dissertations.

    “Seven were peer-reviewed primary studies (Behbahani et al. 2018; Corti et al. 2018; Lo et al. 2017, 2020; Neece 2014; Rayan and Ahmad 2017; Whittingham et al. 2016), while three were unpublished dissertations (Hilkey 2019; Petcharat 2018; Zody 2018).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Behbahani et al. 2018
    • cites Corti et al. 2018 source
    • cites Lo et al. 2017

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing). The quote only partly states this claim.

    Findingown data

    The Middle Eastern subgroup for parental depression had a statistically significant very large effect.

    “the Middle Eastern countries subgroup had a statistically significant very large effect”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Significant improvements in parental stress, anxiety, and depression were reported for the 'up to one month' intervention duration category, while other duration categories reported non-significant results.

    “However, significant improvements in parental stress, anxiety and depression were reported for the ‘up to one month’ category, while the other intervention duration categories reported non-significant results.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The current review did not show significant improvement for either interpersonal mindfulness in parenting or parental mindfulness awareness post-intervention.

    “However, the current review did not show significant improvement for both outcomes of parental mindfulness (interpersonal mindfulness in parenting and parental mindfulness awareness) post-intervention.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). The quote only partly states this claim.

    Findingown data

    The Asian subgroup for parental depression had a statistically non-significant very small effect.

    “the Asian countries subgroup had a statistically non-significant very small effect”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Although subgroup analyses for parental anxiety showed non-significant subgroup differences, the Middle Eastern subgroup reported a statistically significant large effect while the Western and Asian subgroups reported non-significant results.

    “Although subgroup analyses according to geographical location for parental anxiety showed non-significant subgroup differences, the Middle Eastern countries subgroup reported a statistically significant large effect while the Western countries and Asian countries subgroups reported statistically non-significant results.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Three of the four follow-up studies did not provide control-group follow-up data, so meta-analyses could not be conducted.

    “However, three out of four did not provide follow-up data for the control group, hence meta-analyses could not be conducted (Petcharat 2018; Whittingham et al. 2016; Zody 2018).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Petcharat (2018) found no statistically significant increase in stress and anxiety scores or decrease in mindfulness awareness scores in the intervention group at two-week follow-up compared to post-intervention.

    “Petcharat (2018) reported that the intervention group did not show any statistically significant increase in stress and anxiety scores, or decrease in mindfulness awareness scores at the two-week follow-up compared to post-intervention.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Petcharat 2018

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Findingcitation

    Neece (2014) found that at post-intervention the intervention group reported statistically significantly lower stress levels than the control group, with a medium effect size of 0.70.

    “At post-intervention, the intervention group reported statistically significantly lower stress levels compared to those of the control group. A medium effect size of 0.70 was reported.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Neece 2014 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The review protocol was registered on PROSPERO.

    “A protocol can be found on PROSPERO (CRD42020191783).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Inter-rater agreement for risk-of-bias assessment was about 97%, with Cohen's kappa 0.95.

    “Inter-rater agreement among both reviewers was approximately 97%, and the Cohen’s kappa value was 0.95.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Sohmaran and Shorey's subgroup analysis had only one mindfulness study, so mindfulness-based intervention effect on parental stress was undetermined.

    “On the other hand, Sohmaran and Shorey (2019) conducted subgroup analysis to analyze the effect of type of psychological intervention on parental stress. As there was only one study in the mindfulness subgroup, the effectiveness of mindfulness-based interventions on parental stress could not be determined.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Sohmaran and Shorey 2019 source

  • May combine two claims.

    Premisecitation

    Three prior reviews analyzed parental mental well-being and mindfulness but did not meta-analyze, weakening their findings.

    “Three reviews analyzed the outcomes of parental mental well-being and mindfulness but failed to conduct meta-analyses (Byrne et al. 2020; Osborn et al. 2020; Rayan and Ahmad, 2018), hence compromising the strength of their findings (Impellizzeri and Bizzini, 2012).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Byrne et al. 2020 source
    • cites Osborn et al. 2020 source
    • cites Rayan and Ahmad, 2018 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Study selection was done independently by two reviewers, with discussion to resolve disagreements.

    “This study selection process was conducted independently by two reviewers, and discussions were held to resolve any discrepancies that arose.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Both reviewers performed quality appraisal independently, resolving disagreements by discussion.

    “Both reviewers conducted the quality appraisal process independently and disagreements were resolved via discussions.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Psychoeducation and CBT are not suitable for reducing stress in caregivers of people with developmental disabilities and may increase stress.

    “However, evidence has suggested that these methods are not appropriate for reducing the stress of those caring for people with developmental disabilities and can increase their stress levels instead (Devereux et al. 2009; Noone and Hastings 2010).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Devereux et al. 2009 source
    • cites Noone and Hastings 2010 source

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Heterogeneity was assessed using I2 and Cochran Q.

    “The heterogeneity of the results was assessed using the I2 statistics and Cochran Q chi-squared test.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Higgins and Green 2011

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Children of depressed parents are at increased risk of depression, with estimated rates of 20-40%.

    “For instance, children of depressed parents are prone to developing depression themselves and the estimated rates of depression among children of depressed parents range from 20 to 40% (Goodman 2007).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Goodman 2007 source

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Practicing mindfulness improves attention and tolerance for unpleasant thoughts and emotions, aiding coping with stressors.

    “Practicing mindfulness can improve one’s attention and tolerance for unpleasant thoughts and emotions, hence allowing one to cope with life stressors better (Baer 2003).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Baer 2003 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Data extraction was done independently by two reviewers, with disagreements resolved by discussion.

    “This process was performed independently by two reviewers and disagreements were resolved via discussions.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Some parents who received CBT reported that their daily concerns were dismissed as invalid, which increased frustration.

    “For instance, some parents of children with developmental disabilities who underwent CBT, reported that their daily concerns were dismissed and termed as ‘invalid’, hence adding to their frustrations (Singer et al. 2007).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Singer et al. 2007 source

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    An estimated 99% of Iranians and 92% of Jordanians are Muslims.

    “As an estimated 99% of Iranians and 92% of Jordanians are Muslims (The Embassy of the Hashemite Kingdom of Jordan 2020; World Population Review 2020)”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites The Embassy of the Hashemite Kingdom of Jordan 2020

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites World Population Review 2020

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Study design and conductown data

    Due to the limited number of included studies (10 total, 8 in meta-analysis) and not all studies assessing stress, anxiety, and depression, some subgroup analyses had only one or two studies, potentially affecting reliability and validity.

    “Due to the limited number of overall included studies (only 10 included studies and eight included in meta-analysis), and the fact that not all studies assessed outcomes of parental stress, anxiety and depression, some subgroup analysis ended up having only one or two studies in each subgroup. This could potentially affect the results’ reliability and validity.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    All studies used self-report to assess parental mental well-being and mindfulness, which can result in risks of social desirability bias.

    “All studies utilized the self-report method to assess the outcomes of parental mental well-being and mindfulness, and this can result in risks of social desirability bias.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The self-report measures used by the included studies validly capture parental mental well-being and mindfulness despite the risk of social desirability bias.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    A depressed Christian client who underwent mindfulness-based therapy said that the non-judgmental and self-compassionate principles of mindfulness reflected God's nature and that this connection helped her recover from depression better.

    “In an another study, a depressed Christian client who underwent mindfulness-based therapy said that the non-judgmental and self-compassionate principles of mindfulness reflected God’s nature and that this connection helped her to recover from depression better (Hathaway and Tan 2009).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hathaway and Tan 2009 source

  • May combine two claims.

    Study design and conductnone given

    Only trials and dissertations published in English were included, which may pose potential publication bias.

    “Only trials and dissertations published in English were included, which may pose potential publication bias.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Publication bias from including only English-language trials and dissertations does not substantially alter the review's effect estimates.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    A previous study that integrated Buddhist teachings in an ACT program for patients with chronic major mood and anxiety disorders reported positive changes, and one patient remitted shortly after the program.

    “A previous study that integrated Buddhist teachings in an ACT program for patients with chronic major mood and anxiety disorders reported positive changes in patients’ conditions, and one patient even remitted shortly after the program (Fung 2015).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Fung 2015 source

  • May combine two claims.

    Study design and conductown data

    Only four studies conducted follow-up assessments, and only one assessed both intervention and control groups, limiting the review's ability to examine durability of intervention effects.

    “Only four studies conducted follow-up assessments, and only one out of the four conducted follow-up assessments on both the intervention and control groups, limiting the review’s ability to examine the durability of the intervention effects.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    The review's meta-analyses showed that mindfulness-based and ACT-based interventions were effective in decreasing stress, anxiety, and depression among parents of children with developmental disabilities.

    “The results from the meta-analyses showed that both mindfulness-based and ACT-based interventions were effective in decreasing stress, anxiety and depression among parents of children with developmental disabilities.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    Parents in group-based interventions might have reported improved mental well-being post-intervention due to social support from contact with other parents facing similar challenges.

    “Since almost all the studies conducted group-based interventions, the parents might have reported improvement in mental well-being post-intervention due to the social support that they received by being in contact with other parents who were facing similar parenting challenges (Zody 2018).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Zody 2018

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Baseline disparities between intervention and control groups were not considered because only endpoint data were extracted for meta-analyses instead of mean differences.

    “Baseline disparities between the intervention and control groups were not considered in this review as only endpoint data were extracted for meta-analyses instead of mean differences.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Baseline disparities between intervention and control groups did not materially affect the meta-analytic effect estimates.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    All these limitations may limit the accuracy of the review's findings.

    “All these limitations may limit the accuracy of this review’s findings.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Mindfulness and ACT share similar links of self-compassion and acceptance with the principles of Buddhism.

    “Mindfulness and ACT also share similar links of self-compassion and acceptance with the principles of Buddhism (Santiago and Gall 2016; Semple and Hatt, 2012).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Santiago and Gall 2016 source
    • cites Semple and Hatt, 2012 source

  • May combine two claims.

    Study design and conductown data

    Four out of five outcomes were rated very low quality via GRADE, indicating that the true effect size is likely to be significantly different from the review's effect size estimates.

    “Four out of five outcomes were rated as very low quality via the GRADE approach, indicating that the true effect size is likely to be significantly different from this review’s effect size estimates.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Rayan and Ahmad (2018) did not conduct meta-analysis and analyzed data from trials without control groups, so direct comparisons with the current review could not be drawn.

    “As Rayan and Ahmad (2018) did not conduct meta-analysis and analyzed data from trials without control groups, direct comparisons could not be drawn.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Rayan and Ahmad 2018 source

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    The similar effectiveness of mindfulness-based and ACT-based interventions could be due to the same mindfulness principle used in both types.

    “This could be due to the same mindfulness principle used in both types of interventions.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Seven out of ten included studies had small sample sizes, which may have compromised the results' reliability and validity.

    “Seven out of the ten included studies had small sample sizes, and this may have compromised the results’ reliability and validity.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    GRADE quality appraisal rated parental stress, parental anxiety, parental depression, and parental mindfulness awareness as very low quality.

    “The following outcomes were rated as very low quality: (1) parental stress, (2) parental anxiety, (3) parental depression, and (4) parental mindfulness awareness.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    The review found no significant difference in parental stress, anxiety, and depression between mindfulness-based and ACT-based subgroups, indicating that both types might be similarly effective.

    “The results showed no significant difference in parental stress, anxiety, and depression between the scores of mindfulness-based and ACT-based subgroups, indicating that both types of interventions might be similarly effective in promoting mental well-being among parents of children with developmental disabilities.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    Middle Eastern studies could have reported greater improvements because Muslim participants were able to integrate mindfulness practices into their daily lives more easily.

    “Studies conducted in the Middle Eastern countries could have reported greater improvements in parental mental well-being because the Muslim participants were able to integrate mindfulness practices into their daily lives more easily.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Thomas et al. 2016 source
    • Rests on an assumption: The participants in the Middle Eastern studies were predominantly Muslim.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Rayan and Ahmad (2018) reported improvements in parental mindfulness at post-intervention for five out of six trials.

    “The findings from this study differed from those reported by Rayan and Ahmad (2018) which reported improvements in parental mindfulness at post-intervention for five out of six trials.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Rayan and Ahmad 2018 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Participants in Rayan and Ahmad (2017) could have found it even easier because their mindfulness program included elements from Islamic teachings.

    “The participants of the included study in this review (Rayan and Ahmad 2017) could have found it even easier as their mindfulness program included elements from Islamic teachings.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Rayan and Ahmad 2017 source
    • Rests on an assumption: The participants in the Middle Eastern studies were predominantly Muslim.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationcitation

    Lower post-intervention mindfulness scores may demonstrate an increase in psychological awareness brought about by the intervention and indicate possible future improvements.

    “Another previous study suggested that the lower post-intervention mindfulness scores demonstrated an increase in psychological awareness brought about by the intervention, and indicated the possibility of improvements in the future (Corti et al. 2018).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Corti et al. 2018 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Subgroup analyses based on ethnicity and religion could not be conducted because each trial was conducted on a mixture of ethnic groups and religions.

    “Although a subgroup analysis according to geographical distribution was conducted, subgroup analyses based on ethnicity and religion could not be conducted as each trial was conducted on a mixture of ethnic groups and religions.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Evidence suggests that parents' stress levels are affected by their child's age and type of developmental disability.

    “As evidence suggests that parents’ stress levels are affected by their child’s age and type of developmental disability, future research should seek to explore these variables (DePape and Lindsay 2015).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites DePape and Lindsay 2015 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    A monk was engaged by a psychiatrist to conduct Buddhist teachings as part of a hybrid ACT program, and participants both enjoyed and benefitted from his teachings.

    “For instance, a monk was engaged by a psychiatrist to conduct Buddhist teachings as part of a hybrid ACT program, and the participants both enjoyed and benefitted from his teachings (Fung 2015).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Fung 2015 source

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Interpretationcitation

    This may help make mindfulness-based practices more meaningful and relatable for parents of children with developmental disabilities, allowing them to integrate these practices more seamlessly and bringing greater improvements to mental well-being.

    “This may help to make mindfulness-based practices more meaningful and relatable for parents of children with developmental disabilities, and allow them to integrate these practices in their daily lives more seamlessly, hence bringing about greater improvements to their mental well-being.”
    Quote in the paperNot a substantial claim
68 of 68

  • The paper relies on this without support.

    The participants in the Middle Eastern studies were predominantly Muslim.

    “the Muslim participants were able to integrate mindfulness practices into their daily lives more easily”
    “As an estimated 99% of Iranians and 92% of Jordanians are Muslims (The Embassy of the Hashemite Kingdom of Jordan 2020; World Population Review 2020)”

  • The paper relies on this without support.

    Baseline disparities between intervention and control groups did not materially affect the meta-analytic effect estimates.

    “Baseline disparities between the intervention and control groups were not considered in this review as only endpoint data were extracted for meta-analyses instead of mean differences.”

  • The paper relies on this without support.

    The self-report measures used by the included studies validly capture parental mental well-being and mindfulness despite the risk of social desirability bias.

    “All studies utilized the self-report method to assess the outcomes of parental mental well-being and mindfulness, and this can result in risks of social desirability bias.”

  • The paper relies on this without support.

    Publication bias from including only English-language trials and dissertations does not substantially alter the review's effect estimates.

    “Only trials and dissertations published in English were included, which may pose potential publication bias.”
4 of 4

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Consistentz = 2.51reported p = .01 · recomputed p = .012

    “Z = 2.51, p = .01”

  • Consistentz = 4.17reported p < .0001 · recomputed p < .001

    “Z = 4.17, p < .0001”

  • Consistentz = 2.26reported p = .02 · recomputed p = .024

    “Z = 2.26, p = .02”

  • Consistentz = 0.06reported p = .96 · recomputed p = .952

    “Z = 0.06, p = .96”

  • Consistentz = 0.49reported p = .62 · recomputed p = .624

    “Z = 0.49, p = .62”

5 of 5

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Self-check results appear here once an independent check has confirmed them.

Cites

Flagged first, then by citations

Research works printed but not linked: 3

  1. Petcharat, M. (2018). The Effects of a Brief Culturally Tailored Thai Mindfulness Intervention on Stress, Anxiety, and Mindfulness in Thai Parents of Children with Developmental Disabilities. Boca Raton: Florida Atlantic University.
  2. World Population Review. (2020). Iran Population 2020. World Population Review. https://worldpopulationreview.com/countries/iran-population/ Accessed 15 June, 2020.
  3. Zody, M. C. (2018). Acceptance and Commitment Therapy (ACT) as a one-day workshop for parents of children with an Autism Spectrum Disorder. Wright Institute Graduate School of Psychology.

Cited by

Sorted by citations

Related

Authors
Chua, J. Y. X., & Shorey, S.
Affiliations
  • KK Women's and Children's Hospital (SG)
  • National University of Singapore (SG)
Corresponding author
Shorey, Shefaly
ORCID
Venue
Journal of Autism and Developmental Disorders
Publisher
Springer Science and Business Media LLC
Published
2021-06-28
Volume
52
Issue
6
Pages
2770-2783
ISSN
  • 0162-3257 (ISSN-L)
  • 1573-3432
DOI
10.1007/s10803-021-04893-1
PMC
PMC8237545
OpenAlex
W3173181183
Cited by
44
References
79
Citations by year
2026: 6 · 2025: 12 · 2024: 17 · 2023: 6 · 2022: 3
FWCI
0.86
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Autism and Developmental Disorders (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National University Health System
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
  • Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
Keywords
mindfulness-based interventions, acceptance and commitment therapy, parents of children with developmental disabilities, parental stress, parental anxiety, parental depression, psychological intervention
MeSH terms
Autism Spectrum Disorder, Child, Developmental Disabilities, Humans, Mental Health, Parents, Mindfulness, Acceptance and Commitment Therapy

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read under definition version 3 (extract-v3) on 2026-09-28.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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