Factors associated with self-rated mental health in mothers of children and adolescents with autism spectrum disorder

Yanan ZHAO; Huiyun FAN; Rong ZHANG; Xiaoying ZHENG

doi:10.1631/jzus.B2300874

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Research Article | Updated：2024-12-03

Factors associated with self-rated mental health in mothers of children and adolescents with autism spectrum disorder
Factors associated with self-rated mental health in mothers of children and adolescents with autism spectrum disorder
孤独症谱系障碍儿童和青少年母亲自我汇报心理健康程度的相关因素
Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology) Vol. 25, Issue 11, Pages: 1020-1030(2024)
Affiliations：

1.School of Public Health, Peking University, Beijing100191, China
2.Faculty of Health and Wellness, City University of Macau, Macau999078, China
3.Institute of Population Research, Peking University, Beijing100871, China
4.Neuroscience Research Institute, Peking University, Beijing100191, China
5.Department of Neurobiology, School of Basic Medical Sciences, Peking University, Beijing100191, China
6.Key laboratory for Neuroscience, Ministry of Education / National Health and Family Planning Commission, Beijing100191, China
7.Autism Research Center, Peking University Health Science Centre, Beijing100191, China
8.School of Population Medicine and Public Health, Chinese Academy of Medical Sciences / Peking Union Medical College, Beijing100730, China
Funds：
DOI：10.1631/jzus.B2300874
CLC：
CSTR：
Published： 15 November 2024 ，

Received： 04 December 2023 ，

Revised： 03 June 2024 ，
Accepted：

赵亚楠,范慧芸,张嵘等.孤独症谱系障碍儿童和青少年母亲自我汇报心理健康程度的相关因素[J].浙江大学学报（英文版）（B辑：生物医学和生物技术）,2024,25(11):1020-1030.

YANAN ZHAO, HUIYUN FAN, RONG ZHANG, et al. Factors associated with self-rated mental health in mothers of children and adolescents with autism spectrum disorder. [J]. Journal of zhejiang university-science b (biomedicine & biotechnology), 2024, 25(11): 1020-1030.
赵亚楠,范慧芸,张嵘等.孤独症谱系障碍儿童和青少年母亲自我汇报心理健康程度的相关因素[J].浙江大学学报（英文版）（B辑：生物医学和生物技术）,2024,25(11):1020-1030. DOI： 10.1631/jzus.B2300874.

YANAN ZHAO, HUIYUN FAN, RONG ZHANG, et al. Factors associated with self-rated mental health in mothers of children and adolescents with autism spectrum disorder. [J]. Journal of zhejiang university-science b (biomedicine & biotechnology), 2024, 25(11): 1020-1030. DOI： 10.1631/jzus.B2300874.

摘要

日益增长的儿童照料需求给孤独症谱系障碍（ASD）儿童的父母，尤其是母亲，带来了较大压力。本研究调查了ASD儿童和青少年母亲的自我汇报心理健康情况，并探讨了与母亲心理健康相关的因素。一共5077名0至17岁ASD儿童和青少年（包含4892个双亲家庭、185名单身母亲家庭和150名为单身父亲情况）的父母完成了一项全国在线调查，其中28.0%的母亲报告心理健康状况不佳。与0~2岁孩子的母亲相比，10~13岁孩子的母亲心理健康状况不佳的可能性更低（比值比（OR）为0.63，95% 置信区间（CI）为0.43–0.91）；与低功能ASD儿童母亲相比，高功能ASD儿童母亲有不良心理健康状况的可能性更低（OR 0.76，95% CI 0.62–0.94）。共病儿童的母亲更易有较差的心理健康状况（OR 1.56，95% CI 1.35–1.81），当母亲与其他家庭成员存在冲突（OR 1.44，95% CI 1.22–1.70）和提供全职照料（OR 1.22，95% CI 1.06–1.41）时，她们也更容易有较差的心理健康状况。有高于平均水平的家庭收入情况下，母亲更不容易有较差的心理健康状况（OR 0.70，95% CI 0.58–0.82）。综上所述，与儿童和家庭相关的因素以及提供全职照料方面对母亲心理健康状态有显著影响。减少阻碍母亲外出工作和社会交往的障碍，以及解决抚养孤独症ASD儿童的经济负担，可能有助于改善母亲福祉。

Abstract

The rising demand for child care is putting a strain on parents of children with autism spectrum disorder (ASD)

particularly the mothers. This study investigated Chinese mothers of children with ASD and examined the factors associated with maternal mental health. An online national survey was completed by the parents of 5077 ASD children and adolescents aged 0‍‒‍17 years. A total of 28.0% of the mothers reported poor mental health status. Mothers with children aged 10‍‒‍13 years had a lower chance of having poor mental health status than mothers with children aged 0‒2 years (odds ratio (OR) 0.63

95% confidence interval (CI) 0.43‍‒‍0.91). Mothers of children with high-functioning autism were less likely to have poor mental health status than those of children with low-functioning autism (OR 0.76

95% CI 0.62‍‒‍0.94). Having children with comorbidities was related with a higher risk of poor mental status (OR 1.56

95% CI 1.35‒1.81)

as were having conflicts with other family members (OR 1.44

95% CI 1.22‍‒‍1.70) and providing full-time care (OR 1.22

CI 1.06‍‒‍1.41). A higher-than-average family income was associated with lower risk of having poor mental health status (OR 0.70

95% CI 0.58‍‒‍0.82). Factors related to the children and family

and providing full-time care

have a significant effect on mothers’ mental health status. Reducing obstacles to work and social interaction

as well as tackling the financial burden of raising an ASD child

may help improve the well-being of mothers.

关键词

孤独症谱系障碍母亲心理健康状态影响因素

Keywords

Autism spectrum disorder (ASD)MotherMental health statusInfluencing factor

references

Adler BA, Wink LK, Early M, et al., 2015. Drug-refractory aggression, self-injurious behavior, and severe tantrums in autism spectrum disorders: a chart review study. Autism, 19(1):102-106. https://doi.org/10.1177/1362361314524641https://doi.org/10.1177/1362361314524641

American Psychiatric Association, 2013. Diagnostic and Statistical Manual of Mental Disorders (DSM-5TM), 5th Ed. American Psychiatric Publishing, Arlington, USA. https://doi.org/10.1176/appi.books.9780890425596https://doi.org/10.1176/appi.books.9780890425596

Barroso NE, Mendez L, Graziano PA, et al., 2018. Parenting stress through the lens of different clinical groups: a systematic review & meta-analysis. J Abnorm Child Psychol, 46(3):449-461. https://doi.org/10.1007/s10802-017-0313-6https://doi.org/10.1007/s10802-017-0313-6

Bayat M, 2007. Evidence of resilience in families of children with autism. J Intellect Disabil Res, 51(9):702-714. https://doi.org/10.1111/j.1365-2788.2007.00960.xhttps://doi.org/10.1111/j.1365-2788.2007.00960.x

Bourke‑Taylor HM, Joyce KS, Grzegorczyn S, et al., 2022. Profile of mothers of children with a disability who seek support for mental health and wellbeing. J Autism Dev Disord, 52(9):3800-3813. https://doi.org/10.1007/s10803-021-05260-whttps://doi.org/10.1007/s10803-021-05260-w

Buescher AVS, Cidav Z, Knapp M, et al., 2014. Costs of autism spectrum disorders in the United Kingdom and the United States. JAMA Pediatr, 168(8):721-728. https://doi.org/10.1001/jamapediatrics.2014.210https://doi.org/10.1001/jamapediatrics.2014.210

Cardelle-Pérez F, Banacloig-Delgado C, García-García L, 2024. Resilience and family quality of life in parents of children with autism spectrum disorders. Clin Child Psychol Psychiatry, 29(1):245-258. https://doi.org/10.1177/13591045231208577https://doi.org/10.1177/13591045231208577

Celia T, Freysteinson W, Fredland N, et al., 2020. Battle weary/battle ready: a phenomenological study of parents’ lived experiences caring for children with autism and their safety concerns. J Adv Nurs, 76(1):221-233. https://doi.org/10.1111/jan.14213https://doi.org/10.1111/jan.14213

Chawarska K, Klin A, Paul R, et al., 2007. Autism spectrum disorder in the second year: stability and change in syndrome expression. J Child Psychol Psychiatry, 48(2):‍‍128-138. https://doi.org/10.1111/j.1469-7610.2006.01685.xhttps://doi.org/10.1111/j.1469-7610.2006.01685.x

Chen YR, Lian R, 2022. Relationship between family socioeconomic status and family quality of life among parents of ASD: the mediating effects of perceived discrimination and the moderating role of parenting sense of competence. Disabil Res, 2022(3):79-87(in Chinese).

Chiu MYL, Yang X, Wong HT, et al., 2015. The mediating effect of affective stigma between face concern and general mental health – the case of Chinese caregivers of children with intellectual disability. Res Dev Disabil, 36:‍437-446. https://doi.org/10.1016/j.ridd.2014.10.024https://doi.org/10.1016/j.ridd.2014.10.024

Chou YC, Kröger T, Pu CY, 2018. Underemployment among mothers of children with intellectual disabilities. J Appl Res Intellect Disabil, 31(1):152-158. https://doi.org/10.1111/jar.12336https://doi.org/10.1111/jar.12336

Davis NO, Carter AS, 2008. Parenting stress in mothers and fathers of toddlers with autism spectrum disorders, associations with child characteristics. J Autism Dev Disord, 38(7):1278-1291. https://doi.org/10.1007/s10803-007-0512-zhttps://doi.org/10.1007/s10803-007-0512-z

Diener E, Oishi S, Tay L, 2018. Advances in subjective well-being research. Nat Hum Behav, 2(4):253-260. https://doi.org/10.1038/s41562-018-0307-6https://doi.org/10.1038/s41562-018-0307-6

Eiser C, Eiser JR, Stride CB, 2005. Quality of life in children newly diagnosed with cancer and their mothers. Health Qual Life Outcomes, 3:29. https://doi.org/10.1186/1477-7525-3-29https://doi.org/10.1186/1477-7525-3-29

Estes A, Olson E, Sullivan K, et al., 2013. Parenting-related stress and psychological distress in mothers of toddlers with autism spectrum disorders. Brain Dev, 35(2):133-138. https://doi.org/10.1016/j.braindev.2012.10.004https://doi.org/10.1016/j.braindev.2012.10.004

Estes A, Munson J, Dawson G, et al., 2009. Parenting stress and psychological functioning among mothers of preschool children with autism and developmental delay. Autism, 13(4):375-387. https://doi.org/ 10.1177/1362361309105658https://doi.org/10.1177/1362361309105658

Falk NH, Norris K, Quinn MG, 2014. The factors predicting stress, anxiety and depression in the parents of children with autism. J Autism Dev Disord, 44(12):3185-3203. https://doi.org/10.1007/s10803-014-2189-4https://doi.org/10.1007/s10803-014-2189-4

Fletcher PC, Markoulakis R, Bryden PJ, 2012. The costs of caring for a child with an autism spectrum disorder. Issues Compr Pediatr Nurs, 35(1):45-69. https://doi.org/10.3109/01460862.2012.645407https://doi.org/10.3109/01460862.2012.645407

Gau SSF, Chou MC, Chiang HL, et al., 2012. Parental adjustment, marital relationship, and family function in families of children with autism. Res Autism Spectr Disord, 6(1):263-270. https://doi.org/10.1016/j.rasd.2011.05.007https://doi.org/10.1016/j.rasd.2011.05.007

Gatzoyia D, Kotsis K, Koullourou I, et al., 2014. The association of illness perceptions with depressive symptoms and general psychological distress in parents of an offspring with autism spectrum disorder. Disabil Health J, 7(2):173-180. https://doi.org/10.1016/j.dhjo.2013.10.008https://doi.org/10.1016/j.dhjo.2013.10.008

Guthrie W, Swineford LB, Nottke C, et al., 2013. Early diagnosis of autism spectrum disorder: stability and change in clinical diagnosis and symptom presentation. J Child Psychol Psychiatry, 54(5):582-590. https://doi.org/10.1111/jcpp.12008https://doi.org/10.1111/jcpp.12008

Haber MG, Cohen JL, Lucas T, et al., 2007. The relationship between self-reported received and perceived social support: a meta-analytic review. Am J Community Psychol, 39(1-2):133-144. https://doi.org/10.1007/s10464-007-9100-9https://doi.org/10.1007/s10464-007-9100-9

Hall HR, Graff JC, 2010. Parenting challenges in families of children with autism: a pilot study. Issues Compr Pediatr Nurs, 33(4):187-204. https://doi.org/10.3109/01460862.2010.528644https://doi.org/10.3109/01460862.2010.528644

Hastings RP, 2003. Child behaviour problems and partner mental health as correlates of stress in mothers and fathers of children with autism. J Intellect Disabil Res, 47(4-5):231-237. https://doi.org/10.1046/j.1365-2788.2003.00485.xhttps://doi.org/10.1046/j.1365-2788.2003.00485.x

Hauge LJ, Nes RB, Kornstad T, et al, 2015. Maternal sick leave due to psychiatric disorders following the birth of a child with special health care needs. J Pediatr Psychol, 40(8):804-813. https://doi.org/10.1093/jpepsy/jsv034https://doi.org/10.1093/jpepsy/jsv034

Hayes SA, Watson SL, 2013. The impact of parenting stress: a meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder. J Autism Dev Disord, 43(3):629-642. https://doi.org/10.1007/s10803-012-1604-yhttps://doi.org/10.1007/s10803-012-1604-y

Higgins DJ, Bailey SR, Pearce JC, 2005. Factors associated with functioning style and coping strategies of families with a child with an autism spectrum disorder. Autism, 9(2):125-137. https://doi.org/10.1177/1362361305051403https://doi.org/10.1177/1362361305051403

Ide K, Jeong S, Tsuji T, et al., 2022. Suggesting indicators of age-friendly city: social participation and happiness, an ecological study from the JAGES. Int J Environ Res Public Health, 19(9):5096. https://doi.org/10.3390/ijerph19095096https://doi.org/10.3390/ijerph19095096

Ivarsson B, Lindström L, Malm U, et al., 2011. The self-assessment perceived global distress scale-reliability and construct validity-perceived global distress scale. Psychology, 2(4):283-290. https://doi.org/10.4236/psych.2011.24045https://doi.org/10.4236/psych.2011.24045

Kaczmarek L, 2021. Supporting young children with disabilities: the role of grandparents. In: Jalongo MR, Crawford PA (Eds.), Intergenerational Bonds. Springer, Cham, p.144-167. https://doi.org/10.1007/978-3-030-81965-1_8https://doi.org/10.1007/978-3-030-81965-1_8

Kim G, DeCoster J, Chiriboga DA, et al., 2011. Associations between self-rated mental health and psychiatric disorders among older adults: do racial/ethnic differences exist?Am J Geriatr Psychiatry, 19(5):416-422. https://doi.org/10.1097/JGP.0b013e3181f61edehttps://doi.org/10.1097/JGP.0b013e3181f61ede

Lazarus RS, Folkman S, 1984. Stress: Appraisal, and Coping. Springer, New York. https://doi.org/10.1007/978-1-4419-1005-9_215https://doi.org/10.1007/978-1-4419-1005-9_215

Lee CF, Hwang FM, Chen CJ, et al., 2009. The interrelationships among parenting stress and quality of life of the caregiver and preschool child with very low birth weight. Fam Community Health, 32(3):228-237. https://doi.org/10.1097/FCH.0b013e3181ab3b6ahttps://doi.org/10.1097/FCH.0b013e3181ab3b6a

Lee M, Gardner JE, 2010. Grandparents’ involvement and support in families with children with disabilities. Educ Gerontol, 36(6):467-499. https://doi.org/10.1080/03601270903212419https://doi.org/10.1080/03601270903212419

Limbers CA, McCollum C, Greenwood E, 2020. Physical activity moderates the association between parenting stress and quality of life in working mothers during the COVID-19 pandemic. Ment Health Phys Act, 19:100358. https://doi.org/10.1016/j.mhpa.2020.100358https://doi.org/10.1016/j.mhpa.2020.100358

McStay RL, Trembath D, Dissanayake C, 2014. Stress and family quality of life in parents of children with autism spectrum disorder: parent gender and the double ABCX model. J Autism Dev Disord, 44(12):3101-3118. https://doi.org/10.1007/s10803-014-2178-7https://doi.org/10.1007/s10803-014-2178-7

Miller JE, Nugent CN, Russell LB, 2015. Risk factors for family time burdens providing and arranging health care for children with special health care needs: lessons from nonproportional odds models. Soc Sci Res, 52(7):602-614. https://doi.org/10.1016/j.ssresearch.2015.04.003https://doi.org/10.1016/j.ssresearch.2015.04.003

Myers BJ, Mackintosh VH, Goin-Kochel RP, 2009. “My greatest joy and my greatest heart ache:” parents’ own words on how having a child in the autism spectrum has affected their lives and their families’ lives. Res Autism Spectr Disord, 3(3):670-684. https://doi.org/10.1016/j.rasd.2009.01.004https://doi.org/10.1016/j.rasd.2009.01.004

Nahar S, Zambelli Z, Halstead EJ, 2022. Risk and protective factors associated with maternal mental health in mothers of children with autism spectrum disorder. Res Dev Disabil, 131:104362. https://doi.org/ 10.1016/j.ridd.2022.104362https://doi.org/10.1016/j.ridd.2022.104362

Pisula E, Porębowicz-Dörsmann A, 2017. Family functioning, parenting stress and quality of life in mothers and fathers of polish children with high functioning autism or Asperger syndrome. PLoS ONE, 12(10):e0186536. https://doi.org/10.1371/journal.pone.0186536https://doi.org/10.1371/journal.pone.0186536

Rosenthal DG, Learned N, Liu YH, et al., 2013. Characteristics of mothers with depressive symptoms outside the postpartum period. Matern Child Health J, 17(6):‍1030-1037. https://doi.org/10.1007/s10995-012-1084-xhttps://doi.org/10.1007/s10995-012-1084-x

Schieve LA, Boulet SL, Kogan MD, et al., 2011. Parenting aggravation and autism spectrum disorders: 2007 National Survey of Children’s Health. Disabil Health J, 4(3):‍‍143-152. https://doi.org/10.1016/j.dhjo.2010.09.002https://doi.org/10.1016/j.dhjo.2010.09.002

Sullivan A, Winograd G, Verkuilen J, et al., 2012. Children on the autism spectrum: grandmother involvement and family functioning. J Appl Res Intellect Disabil, 25(5):484-494. https://doi.org/10.1111/j.1468-3148.2012.00695.xhttps://doi.org/10.1111/j.1468-3148.2012.00695.x

Sun X, Allison C, Matthews FE, et al., 2013. Prevalence of autism in mainland China, Hong Kong and Taiwan: a systematic review and meta-analysis. Mol Autism, 4:7. https://doi.org/10.1186/2040-2392-4-7https://doi.org/10.1186/2040-2392-4-7

Vernhet C, Dellapiazza F, Blanc N, et al., 2019. Coping strategies of parents of children with autism spectrum disorder: a systematic review. Eur Child Adolesc Psychiatry, 28(6):747-758. https://doi.org/10.1007/s00787-018-1183-3https://doi.org/10.1007/s00787-018-1183-3

Wei H, Liu YF, Liu J, 2018. Analyzing the life quality of mothers of children with autism spectrum disorder and its influencing factors. Chin Health Serv Manag, 35(12):934-937(in Chinese).

Whitehead AL, 2016. Neighborhoods, family functioning, and mothers’ mental health for families with a child with an autism spectrum disorder. Appl Res Qual Life, 12(3):633-651. https://doi.org/10.31235/osf.io/w4tbdhttps://doi.org/10.31235/osf.io/w4tbd

Whitmore KE, 2016. Respite care and stress among caregivers of children with autism spectrum disorder: an integrative review. J Pediatr Nurs, 31(6):630-652. https://doi.org/10.1016/j.pedn.2016.07.009https://doi.org/10.1016/j.pedn.2016.07.009

Wu SQ, Li ZZ, Yang NB, 2023.Correlation between psychological well-being and parenting stress among mothers of preschool children with autism spectrum disorder. Mil Nurs, 40(7):61-64, 97(in Chinese). https://doi.org/10.3969/j.issn.2097-1826.2023.07.014https://doi.org/10.3969/j.issn.2097-1826.2023.07.014

Yang X, Byrne V, Chiu MYL, 2016. Caregiving experience for children with intellectual disabilities among parents in a developing area in China. J Appl Res Intellect Disabil, 29(1):46-57. https://doi.org/10.1111/jar.12157https://doi.org/10.1111/jar.12157

Yorke I, White P, Weston A, et al., 2018. The association between emotional and behavioral problems in children with autism spectrum disorder and psychological distress in their parents: a systematic review and meta-analysis. J Autism Dev Disord, 48(10):3393-3415. https://doi.org/10.1007/s10803-018-3605-yhttps://doi.org/10.1007/s10803-018-3605-y

Zablotsky B, Bradshaw CP, Stuart EA, 2013. The association between mental health, stress, and coping supports in mothers of children with autism spectrum disorders. J Autism Dev Disord, 43(6):1380-1393. https://doi.org/10.1007/s10803-012-1693-7https://doi.org/10.1007/s10803-012-1693-7

Zhao YN, Luo YN, Zhang R, et al., 2023. Direct and indirect costs for families of children with autism spectrum disorder in China. Autism, 27(8):2337-2347. https://doi.org/10.1177/13623613231158862https://doi.org/10.1177/13623613231158862

Zhou H, Xu X, Yan WL, et al., 2020. Prevalence of autism spectrum disorder in China: a nationwide multi-center population-based study among children aged 6 to 12 years. Neurosci Bull, 36(9):961-971. https://doi.org/10.1007/s12264-020-00530-6https://doi.org/10.1007/s12264-020-00530-6

Zhou SY, Da S, Guo H, et al., 2018. Work-family conflict and mental health among female employees: a sequential mediation model via negative affect and perceived stress. Front Psychol, 9(4):544. https://doi.org/10.3389/fpsyg.2018.00544https://doi.org/10.3389/fpsyg.2018.00544

Zhou WS, Liu D, Xiong XY, et al., 2019. Emotional problems in mothers of autistic children and their correlation with socioeconomic status and the children’s core symptoms. Medicine, 98(32):e16794. https://doi.org/10.1097/MD.0000000000016794https://doi.org/10.1097/MD.0000000000016794

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