Abstract
Caring for a child diagnosed with Autism Spectrum Disorder (ASD) can be challenging for parents. Many of parent’s challenges are related to the spectrum of symptoms associated with the condition. Because one of the most pivotal changes made in the DSM–5 relates to ASD concerns the symptoms’ impact on social communication aspects of functioning we sought to assess symptoms of autism in relation to parents’ mental health. Specifically, this investigation assessed the association between diagnoses of autism spectrum disorders and the mental health profile of parents. In our study, we used two measures for assessment of autism. The first was DSM5 diagnosis of autism and the second was The Krug Aspeger Disorder Index (KADI). A sample of 184 parents was used to evaluate the above association. Of the sample collected, 154 parents indicated that their child met the diagnostic criteria for Asperger Syndrome. The main findings in this study suggested that a DSM 5 diagnosis of autism was associated with an elevated level of depression of the parents. A higher chance of a diagnosis of Asperger Syndrome was associated with higher levels of suicidal ideation among parents. Finally, parents who indicated that their child would have a high to very high chance of being diagnosed with Asperger Syndrome received a higher score on the anxiety and depression measures compare with parents of a child who would have an extremely low chance of being diagnosed. The implication for practice, assessment, and research are presented.
Highlights
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A comprehensive review of symptoms specific to individuals on the spectrum and their impact on the presentation of mental health-related conditions and symptomatology.
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The current investigation is the first to include both the DSM–5 ASD diagnosis and AS diagnosis in a comparison to determine the impact on the mental health of parents caring for a child on the spectrum.
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Inclusion of multiple risk factors for mental health.
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References
Al-Farsi, O. A., Al-Farsi, Y. M., Al-Sharbati, M. M., & Al-Adawi, S. (2016). Stress, anxiety, and depression among parents of children with autism spectrum disorder in Oman: a case–control study. Neuropsychiatry Disability and Treatment, 12, 1943–1951. https://doi.org/10.2147/NDT.S107103
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Ang, K. Q. P., & Loh, P. R. (2019). Mental health and co** in parents of children with autism spectrum disorder (ASD) in Singapore: an examination of gender role in caring. Journal of Autism and Developmental Disorders, 49, 2129–2145. https://doi.org/10.1007/s10803-019-03900-w
Barnhill, G., Hagiwara, T., Myles, B. S., & Simpson, R. L. (2000). Asperger syndrome: a study of the cognitive profiles of 37 children and adolescents. Focus on Autism and Other Developmental Disabilities, 15(3), 146–153. https://doi.org/10.1177/108835760001500303
Bauer, S. (1996). Asperger syndrome. New York: Developmental Unit of Genesee Hospital.
Beck, A., Hastings, R., & Daley, D. (2004). Pro-social behavior and behavior problems independently predict maternal stress. Journal of Intellectual and Developmental Disability, 29(4), 339–349. https://doi.org/10.1080/13668250400014509
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893–897. https://doi.org/10.1037/0022-006X.56.6.893
Beck, A. T., Steer, R. A., & Brown, G. (1996). Beck Depression Inventory–II [Database record]. APA PsycTests. https://doi.org/10.1037/t00742-000
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4(6), 561–571. https://doi.org/10.1001/archpsyc.1961.01710120031004
Bowlby, J. (1969). Attachment. Attachment and loss: Vol. 1. Loss. Basic Books.
Bowlby, J. (1973). Attachment and loss: Vol. 2. Separation. Basic Books.
Brennan, K. A., Clark, C. L., & Shaver, P. R. (1998). Self-report measurement of adult attachment: an integrative overview. In J. A. Simpson, & W. S. Rholes (Eds.), Attachment theory and close relationships (pp. 46–76). The Guilford Press.
Brobst, J. B., Clopton, J. R., & Hendrick, S. S. (2009). Parenting children with autism spectrum disorders: the couple’s relationship. Focus on Autism and Other Developmental Disabilities, 24(1), 38–49. https://doi.org/10.1177/1088357608323699
Busch, E. C. (2009). Using acceptance and commitment therapy with parents of children with autism: The application of a theory. ProQuest Dissertations and Theses 0622 (0971). University Dissertation Publishing.
Campbell, J. M. (2005). Diagnostic assessment of Asperger’ s disorder: A review of five third-party rating scales. Journal of Autism and Developmental Disorders, 35, 25–35.
Cohrs, A. C., & Leslie, D. L. (2017). Depression in parents of children diagnosed with autism spectrum disorder: a claims-based analysis. Journal of Autism and Developmental Disorders, 47(5), 1416–1422. https://doi.org/10.1007/s10803-017-3063-y
Collins, N. L., & Read, S. J. (1990). Adult attachment, working models, and relationship quality in dating couples. Journal of Personality and Social Psychology, 58(4), 644–663. https://doi.org/10.1037/0022-3514.58.4.644
Dabrowska, A., & Pisula, E. (2010). Parenting stress and co** styles in mothers and fathers of pre-school children with autism and Down syndrome. Journal of Intellectual Disabilities Research, 54(3), 266–280. https://doi.org/10.1111/j.1365-2788.2010.01258.x
Davaji, R., Valizadeh, S., & Nikamal, M. (2010). The relationship between attachment styles and suicide ideation: the study of turkmen students, Iran. Procedia - Social and Behavioral Sciences, 5, 1190–1194. https://doi.org/10.1016/j.sbspro.2010.07.259
Duarte, C. S., Bordin, I. A., Yazigi, L., & Mooney, J. (2005). Factors associated with stress in mothers of children with autism. Autism, 9(4), 416–427.
Duvekot, J., van der Ende, J., Constantino, J. N., Verhulst, F. C., & Greaves-Lord, K. (2016). Symptoms of autism spectrum disorder and anxiety: Shared familial transmission and cross-assortative mating. Journal of Child Psychology and Psychiatry and Allied Disciplines, 57(6), 759–769. https://doi.org/10.1111/jcpp.12508
Falk, N. H., Norris, K., & Quinn, M. G. (2014). The factors predicting stress, anxiety and depression in the parents of children with autism. Journal of Autism and Developmental Disorders, 44(12), 3185–3203. https://doi.org/10.1007/s10803-014-2189-4
Glazebrook, K., Townsend, E., & Sayal, K. (2015). The role of attachment style in predicting repetition of adolescent self-harm: a longitudinal study. Suicide & Life-Threatening Behavior, 45(6), 664–678. https://doi.org/10.1111/sltb.12159
Gona, J. K., Newton, C. R., Rimba, K. K., Mapenzi, R., Kihara, M., Vijver, F. V., & Abubakar, A. (2016). Challenges and co** strategies of parents of children with autism on the kenyan coast. Rural and remote health, 16(2), 3517.
Gong, Y., Du, Y., Li, H., Zhang, X., An, Y., & Wu, B. L. (2015). Parenting stress and affective symptoms in parents of autistic children. Science China Life Sciences, 58(10), 1036–1043. https://doi.org/10.1007/s11427-012-4293-z
Grunebaum, M. F., Galfalvy, H. C., Mortenson, L. Y., Burke, A. K., Oquendo, M. A., & Mann, J. J. (2010). Attachment and social adjustment: Relationships to suicide attempt and major depressive episode in a prospective study. Journal of Affective Disorders, 123(1–3), 123–130. https://doi.org/10.1016/j.jad.2009.09.010
Halfon, N., & Kuo, A. A. (2013). What DSM-5 could mean to children with autism and their families. JAMA Pediatrics, 167(7), 608–613. https://doi.org/10.1001/jamapediatrics.2013.2188
Harris, J. (2018). Leo Kanner and autism: a 75-year perspective. International Review of Psychiatry, 30(1), 3–17. https://doi.org/10.1080/09540261.2018.1455646
Hoefman, R., Payakachat, N., van Exel, J., Kuhlthau, K., Kovacs, E., Pyne, J., & Tilford, J. M. (2014). Caring for a child with autism spectrum disorder and parents’ quality of life: application of the CarerQol. Journal of autism and developmental disorders, 44(8), 1933–1945. https://doi.org/10.1007/s10803-014-2066-1
Hunt, Q. A., & Hertlein, K. M. (2015). Conceptualizing suicide bereavement from an attachment lens. The American Journal of Family Therapy, 43(1), 16–27. https://doi.org/10.1080/01926187.2014.975651
Ilias, K., Cornish, K., Kummar, A. S., Park, M. S. A., & Golden, K. J. (2018). Parenting stress and resilience in parents of children with autism spectrum disorder (ASD) in Southeast Asia: a systematic review. Frontiers in psychology, 9, 280.
Ilias, K., Liaw, J. H. J., Cornish, K., Park, M. S. A., & Golden, K. J. (2017). Wellbeing of mothers of children with “AUTISM” in Malaysia: an interpretative phenomenological analysis study. Journal of Intellectual & Developmental Disability, 42(1), 74–89.
Jellett, R., Wood, C. E., Giallo, R., & Seymour, M. (2015). Family functioning and behavior problems in children with autism spectrum disorders: the mediating role of parent mental health. Clinical Psychologist, 19(1), 39–48. https://doi.org/10.1111/cp.12047
Keenan, B. M., Newman, L. K., Gray, K. M., & Rinehart, N. J. (2016). Parents of children with ASD experience more psychological distress, parenting stress, and attachment-related anxiety. Journal of Autism and Developmental Disorders, 46(9), 2979–2991. https://doi.org/10.1007/s10803-016-2836-z
Konstantareas, M. M., & Papageorgiou, V. (2006). Effects of temperament, symptom severity and level of functioning on maternal stress in greek children and youth with ASD. Autism, 10, 593–607. https://doi.org/10.1177/1362361306068511
Krug, D. A., & Arick, J. R. (2003). Krug Asperger’s disorder index. Pro-Ed Inc.
Lai, W. W., Goh, T. J., Oei, T. P. S., & Sung, M. (2015). Co** and well-being in parents of children with autism spectrums disorders (ASD). Journal of Autism and Developmental Disabilities, 45(8), 2582–2983. https://doi.org/10.1007/s10803-015-2430-9
Lazarus, R. S. (1991). Emotion and adaptation. Oxford University Press.
Lessard, J. C., & Moretti, M. M. (1998). Suicidal ideation in an adolescent clinical sample: attachment patterns and clinical implications. Journal of Adolescence, 21(4), 383–395. https://doi.org/10.1006/jado.1998.0169
Lizardi, D., Grunebaum, M. F., Burke, A., Stanley, B., Mann, J. J., Harkavy-Friedman, J., & Oquendo, M. (2011). The effect of social adjustment and attachment style on suicidal behaviour. Acta Psychiatrica Scandinavica, 124(4), 295–300. https://doi.org/10.1111/j.1600-0447.2011.01724.x
Maenner, M. J., Shaw, K. A., Baio, J., Washington, A., Patrick, M., DiRienzo, M., Christensen, D., Wiggins, L. D., Pettygrove, S., Andrews, J. G., Lopez, M., White, T., Rosenberg, C. R., Lee, L., & Harrington, B. A. (2020). Hudson A., Baroud, T., Schwenk Y., White, T., Rosenberg, C. R., Lee, L., & Harrington, B. A., Huston M., Hewitt, A., et al. Prevalence of autism spectrum disorder among children aged 8 years — Autism and developmental disabilities monitoring network, 11 sites, United States, 2016. MMWR Surveill Summ;69 (No. SS-4):1–12. https://doi.org/10.15585/mmwr.ss6904a1external
Orbach, I. (2007). From abandonment to symbiosis: a developmental reversal in suicidal adolescents. Psychoanalytic Psychology, 24, 150–166. https://doi.org/10.1037/0736-9735.24.1.150
Papadopoulos, D. (2021). Mothers’ Experiences and Challenges raising a child with Autism Spectrum disorder: a qualitative study. Brain sciences, 11(3), 309. https://doi.org/10.3390/brainsci11030309
Pozo, P., Sarriá, E., & Brioso, A. (2014). Family quality of life and psychological well-being in parents of children with autism spectrum disorders: a double ABCX model. Journal of Intellectual Disability Research, 58(5), 442–458. https://doi.org/10.1111/jir.12042
Rayan, A., & Ahmad, M. (2017). Effectiveness of mindfulness-based intervention on perceived stress, anxiety, and depression among parents of children with autism spectrum disorder. Mindfulness, 8, 677–690. https://doi.org/10.1007/s12671-016-0595-8
Reynolds, W. M. (1991a). Psychometric characteristics of the adult suicidal ideation questionnaire in college students. Journal of Personality Assessment, 56(2), 289–307.
Reynolds, W. M. (1991b). Adult suicide ideation questionnaire: Professional manual. Psychological Assessment Resources.
Rivard, M., Terroux, A., Parent-Boursier, C., & Mercier, C. (2014). Determinants of stress in parents of children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 44(7), 1609–1620. https://doi.org/10.1007/s10803-013-2028-z
Rourke, B. P., & Tsatsanis, K. D. (2000). Nonverbal learning disabilities and Asperger syndrome. In A. Klin, F. R. Volkmar, & S. S. Sparrow (Eds.), Asperger syndrome (pp. 231–253). The Guilford Press.
Rozga, A., Hesse, E., Main, M., Duschinsky, R., Beckwith, L., & Sigman, M. (2018). A short-term longitudinal study of correlates and sequelae of attachment security in autism. Attachment & Human Development, 20(2), 160–180. https://doi.org/10.1080/14616734.2017.1383489
Rutgers, A. H., van Ijzendoorn, M. H., Bakermans-Kranenburg, M. J., Bakermans-Kranenburg, M. J., Swinkels, S. H., van Daalen, E., Dietz, C., Naber, F. B. A., Buitelaar, J. K., & van Engeland, H. (2007). Autism, attachment and parenting: a comparison of children with autism spectrum disorder, mental retardation, language disorder, and non-clinical children. Journal of Abnormal Child Psychology, 35, 859–870. https://doi.org/10.1007/s10802-007-9139-y
Schiltz, H. K., McVey, A. J., Magnus, B., Dolan, B. K., Willar, K. S., Pleiss, S., Karst, J., Carson, A. M., Caiozzo, C., Vogt, E., & Van Hecke, A. V. (2018). Examining the links between challenging behaviors in youth with ASD and parental stress, mental health, and involvement: applying an adaptation of the family stress model to families of youth with ASD. Journal of Autism and Developmental Disorders, 48(4), 1169–1180. https://doi.org/10.1007/s10803-017-3446-0
Sheftall, A. H., Mathias, C. W., Furr, R. M., & Dougherty, D. M. (2013). Adolescent attachment security, family functioning, and suicide attempts. Attachment & Human Development, 15(4), 368–383. https://doi.org/10.1080/14616734.2013.782649
Shtayermman, O. (2008). Suicidal ideation and comorbid disorders in adolescents and young adults diagnosed with Asperger’s syndrome: a population at risk. Journal of Human Behavior in the Social Environment, 18(3), 301–328. https://doi.org/10.1080/10911350802427548
Shtayermman, O. (2013). Stress and marital satisfaction of parents to children diagnosed with autism. Journal of Family Social Work, 16(3), 243–259. https://doi.org/10.1080/10522158.2013.786777
Shtayermman, O., (2017). Suicide and Autism In Encyclopedia of Social Work. New York, NY. Oxford University Press. https://doi.org/10.1093/acrefore/9780199975839.013.1220
Sikora, D., Moran, E., Orlich, F., Hall, T. A., Kovacs, E. A., Delahaye, J., Clemons, T. E., & Kuhlthau, K. (2013). The relationship between family functioning and behavior problems in children with autism spectrum disorders. Research in Autism Spectrum Disorders, 7(2), 307–315. https://doi.org/10.1016/j.rasd.2012.09.006
Stepp, S. D., Morse, J. Q., Yaggi, K. E., Reynolds, S. K., Reed, I., & Pilkonis, P. A. (2008). The role of attachment styles and interpersonal problems in suicide-related behaviors. Suicide and Life-Threatening Behavior, 38, 592–607. https://doi.org/10.1521/suli.2008.38.5.592
Su, X., Cai, R. Y., & Uljarević, M. (2018). Predictors of mental health in chinese parents of children with autism spectrum disorder (ASD). Journal of Autism and Developmental Disorders, 48(4), 1159–1168. https://doi.org/10.1007/s10803-017-3364-1
Teague, S. J., Newman, L. K., Tonge, B. J., Gray, K. M., & MHYPeDD team. (2018). Caregiver mental health, parenting practices, and perceptions of child attachment in children with Autism Spectrum Disorder. Journal of Autism Developmental Disorders, 48(8), 2642–2652. https://doi.org/10.1007/s10803-018-3517-x
Vanbergeijk, E. O., & Shtayermman, O. (2005). Asperger’s syndrome: an enigma for social work. Journal of Human Behavior in the Social Environment, 12(1), 23–37. https://doi.org/10.1300/J137v12n01_02
Uljarević, M., Lane, A., Kelly, A., & Leekam, S. R. (2016). Sensory subtypes and anxiety in older children and adolescents with autism spectrum disorder. Autism Research, 9(10), 1073–1078. https://doi.org/10.1002/aur.1602
Van der Kolk, B. A., Perry, J. C., & Herman, J. L. (1991). Childhood origins of self-destructive behavior. The American Journal of Psychiatry, 148(12), 1665–1671. https://doi.org/10.1176/ajp.148.12.1665
Van Esch, L., O’Nions, L., Hannes, H., Ceulemans, E., Van Leeuwen, K., & Noens, I. (2018). Parenting children with autism spectrum disorder before and after the transition to secondary school. Advances in Neurodevelopmental Disorders, 2, 179. https://doi.org/10.1007/s41252-018-0058-4
Venta, A., & Sharp, C. (2014). Attachment organization in suicide prevention research: preliminary findings and future directions in a sample of inpatient adolescents. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 35(1), 60–66. https://doi.org/10.1027/0227-5910/a000231
Wing, L. (1981). Asperger’s syndrome: a clinical account. Psychological Medicine, 11(1), 115–129. https://doi.org/10.1017/S0033291700053332
Woodward, L., Fergusson, D. M., & Belsky, J. (2000). Timing of parental separation and attachment to parents in adolescence: results of a prospective study from birth to age 16. Journal of Marriage & Family, 62, 162–174. https://doi.org/10.1111/j.1741-3737.2000.00162.x
Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52(1), 30–41. https://doi.org/10.1207/s15327752jpa5201_2
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Shtayermman, O., Zhang, Y. Association between autism symptomatology and DSM–5 symptoms and parents’ mental health. Curr Psychol 43, 2337–2347 (2024). https://doi.org/10.1007/s12144-023-04427-1
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DOI: https://doi.org/10.1007/s12144-023-04427-1