CLC number:
On-line Access: 2024-12-03
Received: 2023-12-04
Revision Accepted: 2024-06-03
Crosschecked: 2025-01-02
Cited: 0
Clicked: 646
Yanan ZHAO, Huiyun FAN, Rong ZHANG, Xiaoying ZHENG. Factors associated with self-rated mental health in mothers of children and adolescents with autism spectrum disorder[J]. Journal of Zhejiang University Science B, 2024, 25(11): 1020-1030.
@article{title="Factors associated with self-rated mental health in mothers of children and adolescents with autism spectrum disorder",
author="Yanan ZHAO, Huiyun FAN, Rong ZHANG, Xiaoying ZHENG",
journal="Journal of Zhejiang University Science B",
volume="25",
number="11",
pages="1020-1030",
year="2024",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B2300874"
}
%0 Journal Article
%T Factors associated with self-rated mental health in mothers of children and adolescents with autism spectrum disorder
%A Yanan ZHAO
%A Huiyun FAN
%A Rong ZHANG
%A Xiaoying ZHENG
%J Journal of Zhejiang University SCIENCE B
%V 25
%N 11
%P 1020-1030
%@ 1673-1581
%D 2024
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B2300874
TY - JOUR
T1 - Factors associated with self-rated mental health in mothers of children and adolescents with autism spectrum disorder
A1 - Yanan ZHAO
A1 - Huiyun FAN
A1 - Rong ZHANG
A1 - Xiaoying ZHENG
J0 - Journal of Zhejiang University Science B
VL - 25
IS - 11
SP - 1020
EP - 1030
%@ 1673-1581
Y1 - 2024
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B2300874
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.
[1]AdlerBA, WinkLK, EarlyM, 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.
[2]American Psychiatric Association, 2013. Diagnostic and Statistical Manual of Mental Disorders (DSM-5TM), 5th Ed. American Psychiatric Publishing, Arlington, USA.
[3]BarrosoNE, MendezL, GrazianoPA, 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.
[4]BayatM, 2007. Evidence of resilience in families of children with autism. J Intellect Disabil Res, 51(9):702-714.
[5]Bourke‑TaylorHM, JoyceKS, GrzegorczynS, 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.
[6]BuescherAVS, CidavZ, KnappM, et al., 2014. Costs of autism spectrum disorders in the United Kingdom and the United States. JAMA Pediatr, 168(8):721-728.
[7]Cardelle-PérezF, Banacloig-DelgadoC, García-GarcíaL, 2024. Resilience and family quality of life in parents of children with autism spectrum disorders. Clin Child Psychol Psychiatry, 29(1):245-258.
[8]CeliaT, FreysteinsonW, FredlandN, 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.
[9]ChawarskaK, KlinA, PaulR, et al., 2007. Autism spectrum disorder in the second year: stability and change in syndrome expression. J Child Psychol Psychiatry, 48(2):128-138.
[10]ChenYR, LianR, 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).
[11]ChiuMYL, YangX, WongHT, 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.
[12]ChouYC, KrögerT, PuCY, 2018. Underemployment among mothers of children with intellectual disabilities. J Appl Res Intellect Disabil, 31(1):152-158.
[13]DavisNO, CarterAS, 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.
[14]DienerE, OishiS, TayL, 2018. Advances in subjective well-being research. Nat Hum Behav, 2(4):253-260.
[15]EiserC, EiserJR, StrideCB, 2005. Quality of life in children newly diagnosed with cancer and their mothers. Health Qual Life Outcomes, 3:29.
[16]EstesA, OlsonE, SullivanK, et al., 2013. Parenting-related stress and psychological distress in mothers of toddlers with autism spectrum disorders. Brain Dev, 35(2):133-138.
[17]EstesA, MunsonJ, DawsonG, et al., 2009. Parenting stress and psychological functioning among mothers of preschool children with autism and developmental delay. Autism, 13(4):375-387.
[18]FalkNH, NorrisK, QuinnMG, 2014. The factors predicting stress, anxiety and depression in the parents of children with autism. J Autism Dev Disord, 44(12):3185-3203.
[19]FletcherPC, MarkoulakisR, BrydenPJ, 2012. The costs of caring for a child with an autism spectrum disorder. Issues Compr Pediatr Nurs, 35(1):45-69.
[20]GauSSF, ChouMC, ChiangHL, et al., 2012. Parental adjustment, marital relationship, and family function in families of children with autism. Res Autism Spectr Disord, 6(1):263-270.
[21]GatzoyiaD, KotsisK, KoullourouI, 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.
[22]GuthrieW, SwinefordLB, NottkeC, 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.
[23]HaberMG, CohenJL, LucasT, 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.
[24]HallHR, GraffJC, 2010. Parenting challenges in families of children with autism: a pilot study. Issues Compr Pediatr Nurs, 33(4):187-204.
[25]HastingsRP, 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.
[26]HaugeLJ, NesRB, KornstadT, 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.
[27]HayesSA, WatsonSL, 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.
[28]HigginsDJ, BaileySR, PearceJC, 2005. Factors associated with functioning style and coping strategies of families with a child with an autism spectrum disorder. Autism, 9(2):125-137.
[29]IdeK, JeongS, TsujiT, 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.
[30]IvarssonB, LindströmL, MalmU, et al., 2011. The self-assessment perceived global distress scale-reliability and construct validity-perceived global distress scale. Psychology, 2(4):283-290.
[31]KaczmarekL, 2021. Supporting young children with disabilities: the role of grandparents. In: Jalongo MR, Crawford PA (Eds.), Intergenerational Bonds. Springer, Cham, p.144-167.
[32]KimG, DeCosterJ, ChiribogaDA, 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.
[33]LazarusRS, FolkmanS, 1984. Stress: Appraisal, and Coping. Springer, New York.
[34]LeeCF, HwangFM, ChenCJ, 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.
[35]LeeM, GardnerJE, 2010. Grandparents’ involvement and support in families with children with disabilities. Educ Gerontol, 36(6):467-499.
[36]LimbersCA, McCollumC, GreenwoodE, 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.
[37]McStayRL, TrembathD, DissanayakeC, 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.
[38]MillerJE, NugentCN, RussellLB, 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.
[39]MyersBJ, MackintoshVH, Goin-KochelRP, 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.
[40]NaharS, ZambelliZ, HalsteadEJ, 2022. Risk and protective factors associated with maternal mental health in mothers of children with autism spectrum disorder. Res Dev Disabil, 131:104362.
[41]PisulaE, Porębowicz-DörsmannA, 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.
[42]RosenthalDG, LearnedN, LiuYH, et al., 2013. Characteristics of mothers with depressive symptoms outside the postpartum period. Matern Child Health J, 17(6):1030-1037.
[43]SchieveLA, BouletSL, KoganMD, et al., 2011. Parenting aggravation and autism spectrum disorders: 2007 National Survey of Children’s Health. Disabil Health J, 4(3):143-152.
[44]SullivanA, WinogradG, VerkuilenJ, et al., 2012. Children on the autism spectrum: grandmother involvement and family functioning. J Appl Res Intellect Disabil, 25(5):484-494.
[45]SunX, AllisonC, MatthewsFE, et al., 2013. Prevalence of autism in mainland China, Hong Kong and Taiwan: a systematic review and meta-analysis. Mol Autism, 4:7.
[46]VernhetC, DellapiazzaF, BlancN, et al., 2019. Coping strategies of parents of children with autism spectrum disorder: a systematic review. Eur Child Adolesc Psychiatry, 28(6):747-758.
[47]WeiH, LiuYF, LiuJ, 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).
[48]WhiteheadAL, 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.
[49]WhitmoreKE, 2016. Respite care and stress among caregivers of children with autism spectrum disorder: an integrative review. J Pediatr Nurs, 31(6):630-652.
[50]WuSQ, LiZZ, YangNB, 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).
[51]YangX, ByrneV, ChiuMYL, 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.
[52]YorkeI, WhiteP, WestonA, 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.
[53]ZablotskyB, BradshawCP, StuartEA, 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.
[54]ZhaoYN, LuoYN, ZhangR, et al., 2023. Direct and indirect costs for families of children with autism spectrum disorder in China. Autism, 27(8):2337-2347.
[55]ZhouH, XuX, YanWL, 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.
[56]ZhouSY, DaS, GuoH, 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.
[57]ZhouWS, LiuD, XiongXY, 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.
Open peer comments: Debate/Discuss/Question/Opinion
<1>