The effect of alienation on depression among Chinese caregivers of children with autism: family resilience as a moderator

Background Caregivers of children with autism spectrum disorder (ASD) in China often encounter stigma and social isolation, which may heighten alienation and increase depression risk. Family resilience—the strengths and resources within the family system, may help protect caregiver mental health. This study examined the association between alienation and depression among Chinese caregivers of children with ASD and tested whether family resilience moderates this relationship. Methods A cross-sectional survey of 205 caregivers in Jilin Province assessed alienation, depressive symptoms, and family resilience using validated Chinese instruments. Exploratory factor analysis was used to confirm the structure of the Family Resilience (FaRE) Questionnaire for this population. Hierarchical regression analyses examined the association between alienation and depression and the moderating effects of family resilience subdimensions, controlling caregiver demographics. Results Alienation was positively associated with depression (β = 0.61, p < 0.001). Three dimensions of family resilience—communication/cohesion, perceived social support, and faith/spiritual beliefs—significantly weakened this association (interaction p < 0.05). The family coping dimension did not show a moderating effect. Conclusion Alienation is a significant risk factor for depression among Chinese caregivers of children with ASD, but specific resilience processes within families can buffer this impact. Interventions aimed at reducing caregiver alienation and strengthening communication, support networks, and shared belief systems may help mitigate depression in this population.