Background Depression is a common psychiatric problem associated with autism spectrum disorder (ASD) across the lifespan. Objective We sought to identify medical and behavioral problems associated with a history of a parent reported diagnosis of depression in a large sample of school-aged children and adolescents with ASD. Methods A sample of 1272 participants (age 6–17 years, M=9.56, SD=2.79) from the Autism Speaks-Autism Treatment Network (AS-ATN) consortium was divided into “Ever-Depressed” (n=89) and “Non-Depressed” (n=1183) groups based on caregiver endorsement of children’s current or previous diagnoses of depression. Results 7.0% of children with ASD (4.8% of those aged 6–12 and 20.2% of those aged 13–17) were reported to have a history of a depression diagnosis. Positive depression history was associated with greater chronological age, higher IQ, and Asperger’s Disorder diagnosis. After controlling for age, IQ, and DSM-IV ASD diagnostic subtype, the Ever-Depressed group exhibited significantly greater rates of seizure disorders (OR= 2.64) and gastrointestinal problems (OR=2.59), and trend level differences in aggression, somatic complaints, and social impairments. The groups did not differ in autism severity, repetitive and compulsive behaviors, sleep problems, eating problems, self-injurious behavior, or use of behavior, social, or educational interventions or therapies. Conclusions Co-occurring depression is a particularly common problem in higher-functioning, older children within the AS-ATN. Our findings indicate that children with ASD who have a parent reported history of a depression diagnosis are more likely to also have co-occurring medical problems, although the presence and direction of causality is unclear.
Theory and research on the general population suggest that parents’ marital relationship quality is associated with children’s emotional and behavioral functioning directly, as well as indirectly, by affecting parenting attitudes and behaviors. However, little has been done to investigate the potential connection among parent marital satisfaction, parenting styles, and outcomes for autistic children. Using longitudinal data collected from 188 couples parenting an autistic child, this study tested the time‐ordered indirect effect of parent marital satisfaction (assessed at Time 1) on the internalizing and externalizing symptoms (assessed at Time 3) of autistic children (originally aged 5–12 years) via parenting styles (assessed at Time 2) using actor–partner interdependence modeling extended to mediation. Results indicated that a lower level of marital satisfaction at Time 1 predicted impaired child outcomes at Time 3 via its impact on parenting style at Time 2. For both parents, lower marital satisfaction predicted more child externalizing symptoms via reports of more authoritarian parenting style. Lower marital satisfaction in mothers at Time 1 was also associated with higher levels of child internalizing symptoms at Time 3 via increased authoritarian parenting in mothers. No partner effects were found. A family‐wide approach that includes support for the parent marital relationship, which may have downstream effects on parenting, is important for promoting optimal emotional and behavioral health in autistic children.
Discrepancies often exist between self-reported and parent-reported symptoms when assessing youth psychosocial functioning. Parent-child discrepancies in ratings may be important for understanding psychopathology and patterns of family functioning, particularly during adolescence and for youth with chronic illness. This study examined patterns of multirater reporting discrepancies in a pediatric asthma population. Adolescents ( = 707; 11-17 years old) and their primary caregivers completed ratings of adolescents' psychological symptoms. Latent profile analysis identified five profiles of parent-adolescent discrepancies, including one group with highly discordant ratings, two groups in agreement, and two groups with slightly discordant ratings. Adolescents who agreed with their parents on the presence of elevated symptoms and those who had significant discrepancies in ratings, such that parents reported elevated symptoms compared to youth self-report, had poor pulmonary functioning and elevated reports of parent-rated family conflict. Results suggest the need to assess internalizing and externalizing symptoms in adolescents with asthma using a multirater approach while also highlighting the complexity in interpreting patterns of discrepancies. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Purpose This study aimed to compare primary and secondary caregiver QOL within families of children with asthma and determine the potential importance of including secondary caregiver QOL in clinical and research settings. Methods Participants included 118 families of children with asthma that had primary and secondary caregivers. Families completed measures in a single research session. Caregivers reported on QOL, psychological functioning, and family burden; children completed a measure of QOL. Child lung function was determined from objective spirometry. Adherence to prescribed controller medication was measured for 6 weeks following the research visit. Results Primary caregiver QOL was significantly lower than secondary caregiver QOL (Mean overall QOL of 5.85 versus 6.17, p < .05). Better medication adherence was associated with higher primary caregiver QOL (ρ = .22, p = .02); secondary caregiver QOL, not primary caregiver QOL, was positively associated with child QOL (ρ = .20, p = .03). Families with discrepant QOL scores between caregivers (difference in scores of at least .50) were characterized by more family burden and primary caregiver psychological symptoms. Conclusions Differences in QOL scores between caregivers may be a reflection of primary caregivers’ greater investment in daily asthma management. In families reporting low burden and few psychological difficulties in the primary caregiver, QOL assessments from either caregiver may may be informative and representative of how parents are adapting to child asthma. In families experiencing high levels of burden or more primary caregiver psychological difficulties, QOL reports from secondary caregivers may not be as clinically meaningful.
Parents of children with autism spectrum disorder (ASD) are at increased risk for unsatisfying and conflict‐ridden couple relationships (i.e., marital or romantic partner relationships). There is a critical need to identify the couple‐level processes that contribute to this risk. The current study examined the use of dyadic coping, defined as the appraisals and behaviors that partners in relationships use and receive to manage stressors, and to examine whether dyadic coping mediated the association between parenting stress and couple relationship satisfaction in parents who have a child with ASD and in parents who do not have a child with ASD. In total, 184 couples that had a child with ASD (aged 5–12 years) and comparison group of 183 couples who have a child without a neurodevelopmental condition participated in the study. A multivariate analysis of covariance indicated that parents of children with ASD reported less positive and more negative dyadic coping than did parents in the comparison group. Hierarchical linear modeling indicated that dyadic coping mediated the association between parenting stress and couple relationship satisfaction. Findings have important implications for programs aimed at enhancing parent couple relationship in families of children with ASD.
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