Adolescents and Adults with Autism with and without Co-morbid Psychiatric Disorders: Differences in Maternal Well-Being

Abstract

This study investigated the associations between the characteristics of adolescents and adults with autism spectrum disorders (ASD) and maternal well-being. Two groups were compared: mothers of adolescents and adults with ASD and co-morbid psychiatric disorders (n = 142) and mothers whose sons or daughters had a single diagnosis of ASD (n = 130). Individuals with co-morbid psychiatric disorders had higher levels of repetitive behaviors, asocial behavior, and unpredictability of behavior than their counterparts with ASD only. They also had poorer rated health as well as more frequent gastrointestinal problems and sleep problems. Mothers of sons and daughters with ASD and comorbid psychiatric disorders reported higher levels of burden and a poorer quality parent-child relationship than mothers of sons and daughters with ASD only. Higher levels of asocial behavior, unpredictability of behavior, and poorer health in sons and daughters with ASD were predictive of greater burden in mothers and a poorer quality parent-child relationship. Keywordsautism; co-morbidity; psychiatric disorders; adolescents and adults; burden There is accumulating evidence that mothers of children with autism spectrum disorders (ASD) experience higher levels of stress and mental health symptoms than mothers of typically developing children and children with other types of disabilities (Abbeduto et al., 2004;Blacher & McIntyre, 2006;Eisenhower, Baker, & Blacher, 2005;Greenberg, Seltzer, Krauss, Chou, & Hong, 2004;Weiss, 2002). Mothers of adults with mental illness experience a similar pattern of compromised well-being (Greenberg, Seltzer, & Greenley, 1993;Greenberg, Seltzer, Krauss, & Kim, 1997;Pruchno, Patrick, & Burant, 1996;Seltzer, Greenberg, Floyd, Pettee, & Hong, 2001). Although a number of studies report high rates of co-morbid psychiatric disorders (e.g., depression, anxiety, etc.) in individuals with ASD (Bradley, Summers, Wood, & Bryson, 2004;de Bruin, Ferdinand, Meester, de Nijs, & Verheij, 2007;Ghaziuddin, Weidmer-Mikhail, & Ghaziuddin, 1998;Leyfer et al., 2006;Tsakanikos et al., 2006), little is known about the effects of such co-morbidity on maternal well-being. Kim, Szatmari, Bryson, Streiner, and Wilson (2000) found that mothers who had children with ASD and anxiety or depression reported greater isolation and worried more about their child's future compared to mothers who had children with ASD only. Apart from the Kim et al. report, no other study has examined the well-being of mothers whose sons or daughters had both ASD and co-morbid psychiatric disorders. Therefore, this study compared mothers of adolescents and adults who have ASD and co-morbid psychiatric disorders with mothers of individuals who have ASD without other psychiatric disorders. We examined differences in the characteristics of the adolescents and adults with respect to autism symptoms, behavior problems, and physical health and evaluated the relative impact of these differences on maternal well-being. PREVALENCE OF PSYCHIATRIC CO-MORBIDITY IN ASDStu...

The Roles and Needs of Families of Adolescents With ASD

“…Past research has explored possible reasons for the elevated levels of psychological distress observed among parents of children with ASD, documenting several contributing factors including the core symptoms of autism (e.g., social difficulties, communication difficulties, and repetitive behaviors), delays in adaptive behavior, and co-occuring physical and mental health problems (Bishop et al, 2007; Cadman et al, 2012; Kring et al, 2008, 2010; Tomanik, Harris, & Hawkins, 2004). The majority of studies have consistently found that challenging behavior problems are among the most significant sources of stress for families (Hastings et al, 2005; Herring et al, 2006; Lounds, Seltzer, Greenberg, & Shattuck, 2007), highlighting how educational interventions to address child behavior likely will have cascading benefits for family life and parent stress.…”

Medical and Behavioral Correlates of Depression History in Children and Adolescents With Autism Spectrum Disorder

“…Co-occurrence of sleep problems in ASD is high, 29–30 with some evidence linking sleep problems to high rates of hyperactivity, anxiety, depression, mood swings, or aggression in ASD. 31 High rates of GI problems also have been documented in children with ASD 32 and have been linked to psychiatric comorbidity 33 , anxiety, irritability, social withdrawal, and rigid-compulsive symptoms. 34–35 Self-injurious behavior (SIB) and aggressive behavior have also been linked to the co-occurrence of mood disorders in ASD.…”

Child, Parent, and Service Predictors of Psychotropic Polypharmacy Among Adolescents and Young Adults with an Autism Spectrum Disorder

“…For example, when faced with aggressive behaviour, parents may have a greater sense of burden and be more likely to use multiple medications. It is well known that parents report greater distress in the presence of child behaviour and mental health problems (Cadman et al 2012;Kring et al 2008;Lin 2011;Schieve et al 2007), and that mental health problems are associated with greater medication use. It remains an intriguing possibility that parent burden may influence the decision to medicate, but more refined measures of aggressive behaviour, behaviours targeted with medication, and the decision to medicate are required to better understand the inter-relationships between these child and parent variables.…”

“…Parent circumstance may also play a role in prescription patterns. Research suggests that parents of children with ASD face significant caregiving burden (Cadman et al 2009;Kring et al 2008;Lin 2010), and that when families are in crisis they, and healthcare providers, may turn to medication as a solution (Mackintosh et al 2012;Weiss et al 2009). There are a number of possible parent factors that could contribute to this decision, including parent demographic variables (e.g., marital status, age, education) and parent psychological functioning (e.g., burden, crisis).…”