Factors associated with depressive symptoms in parents of children with autism spectrum disorders

doi:10.1016/j.rasd.2010.05.001

Research in Autism Spectrum Disorders

Volume 5, Issue 1, January–March 2011, Pages 361-367

https://doi.org/10.1016/j.rasd.2010.05.001 Get rights and content

Abstract

Parents of children with autism spectrum disorders (ASDs) have higher rates of depressive symptoms than parents of typically developing (TD) children or parents of children with other developmental disorders. The purpose of this study was to examine child and parent sleep as factors associated with depressive symptoms in parents of children with ASDs. Participants included 34 families (17 ASD, 17 TD, 17 mothers and 11 fathers per group). Both objective sleep quantity (actigraphy) and subjective sleep quality were obtained, along with measures of parent depressive symptoms and child daytime behavior. Child sleep quantity was a significant predictor of maternal depressive symptoms, controlling for group and child behavior. Fathers sleep quality was a significant predictor of paternal depressive symptoms, controlling for child behavior and child sleep disturbances. This study suggests that along with child behavior, parent and child sleep variables are associated with parental depressive symptoms. Future studies should continue to use a multi-method measurement approach for sleep, and interventions that target child sleep should include parent sleep and parent daytime functioning as outcome variables.

Section snippets

Depressive symptoms in parents of children with autism spectrum disorders

Multiple studies have reported elevated levels of depressive symptoms and psychological distress in parents of children with autism spectrum disorders (ASDs). These differences have been found in parents of children with ASDs compared to parents of children with Down syndrome (Abbeduto et al., 2004, Piven et al., 1991), mental retardation (Weiss, 2002), fragile X syndrome (Abbeduto et al., 2004), developmental delay (Estes et al., 2009), as well as children who are typically developing (Hoffman

Sleep in children with ASDs and their parents

Sleep problems are common among children with autism spectrum disorders (ASDs), including prolonged sleep onset, frequent and/or prolonged night wakings (Honomichl et al., 2002, Patzold et al., 1998, Souders et al., 2009, Wiggs and Stores, 2004, Williams et al., 2004), and/or early morning sleep termination (Hering et al., 1999, Patzold et al., 1998, Wiggs and Stores, 2004). For families who have children with ASDs, parent sleep may be disturbed due to the increased supervision required when a

A multi-method assessment approach for sleep

The most commonly used methods for assessing sleep are questionnaires and sleep diaries. Questionnaires provide a retrospective report on sleep quantity and quality, while sleep diaries ask participants to prospectively report on sleep quantity and quality. However, as mentioned, both types of measures can result in reporter bias when examining the relationship between sleep and another self-report measure such as depression. In the case of children, questionnaires and sleep diaries are also

Participants

Families of children with ASDs and families of TD children were included in the study if they had a child ages 4–10 years (inclusive). Children with an ASD were required to have a documented diagnosis from a physician or psychologist, as well as a score of >15 (cutoff point for children likely to have autism) on the Social Communication Questionnaire (SCQ) (Rutter, Bailey, & Lord, 2003), a well-validated parent-report screener for autism symptoms. Children in the TD group were required to have

Preliminary analyses

No significant differences were found between groups for any of the demographic variables (Table 1). A statistically significant difference between children with ASDs and TD children was not found for sleep quantity. However, children with ASDs slept 30 min less than TD children. One-way ANOVAs found significant difference in depressive symptoms for mothers, but not fathers, suggesting that mothers of children with ASDs report more depressive symptoms than mothers of TD children (Table 2).

Discussion

This study is one of the first to utilize a multi-method approach to examine the relationship between child sleep, parent sleep, and parent depressive symptoms. As expected, after controlling for child behavior, sleep variables provided an additional factor that may contribute to increased depression in parents of children with ASDs. Although the generalizability of the study findings are limited by the small sample size, there were several strengths of this exploratory study, including the

Acknowledgments

This study was supported by the Sleep Research Society Foundation. I would like to thank the families who participated in this study, and my research assistants, Kelly Ann Davis, Christine Leas, Lisa Levandoski, Raymond Morris, and Allison Reamy, who helped with data collection and entry. In addition, I thank the network of primary care physicians for their contribution to clinical research through the Pediatric Research Consortium (PeRC) at The Children's Hospital of Philadelphia.

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Factors associated with depressive symptoms in parents of children with autism spectrum disorders

Abstract

Section snippets

Depressive symptoms in parents of children with autism spectrum disorders

Sleep in children with ASDs and their parents

A multi-method assessment approach for sleep

Participants

Preliminary analyses

Discussion

Acknowledgments

Biological Psychiatry

Journal of the American Academy of Child and Adolescent Psychiatry

Journal of the American Academy of Child and Adolescent Psychiatry

Sleep Medicine Reviews

Psychological well-being and coping in mothers of youths with autism, Down syndrome, or fragile X syndrome

American Journal on Mental Retardation

Manual for the ASEBA school-age forms & profiles

Health-related quality of life in parents of school-aged children with Asperger syndrome or high-functioning autism

Health and Quality of Life Outcomes

The role of actigraphy in the study of sleep and circadian rhythms

Sleep

Child sleep disorders: Associations with parental sleep duration and daytime sleepiness

Journal of Family Psychology

Sleep problems of children with pervasive developmental disorders: Correlation with parental stress

Developmental Medicine and Child Neurology

The Developmental Behavior Checklist: The development and validation of an instrument to assess behavioral and emotional disturbance in children and adolescents with mental retardation

Journal of Autism and Developmental Disorders

Parenting stress and psychological functioning among mothers of preschool children with autism and developmental delay

Autism: The International Journal of Research and Practice

The relationship of presenting physical complaints to depressive symptoms in primary care patients

Journal of General Internal Medicine

Child behaviour problems and partner mental health as correlates of stress in mothers and fathers of children with autism

Journal of Intellectual Disability Research

Sleep patterns in autistic children

Journal of Autism and Developmental Disorders

Behaviour and emotional problems in toddlers with pervasive developmental disorders and developmental delay: Associations with parental mental health and family functioning

Journal of Intellectual Disability Research

Sleep problems in children with autism and in typically developing children

Focus on Autism and Other Developmental Disabilities