The Contribution of the Broader Autism Phenotype to Well-Being In Mothers of Adolescents and Adults with An Autism Spectrum Disorder

Background: Research on parental well-being has largely emanated from a family stress perspective, assuming that the child with an autism spectrum disorder (ASD) poses challenges to the family system.  Research from a family genetics perspective has shown that family members of individuals with ASD often show sub-threshold characteristics associated with the condition, labeled the broader autism phenotype (BAP).  In this study, we unite these two approaches, and examine the combined contribution of child characteristics and parental BAP characteristics to maternal well-being.

Objectives: Our aims were to (1) describe broader autism phenotype characteristics in mothers and fathers, and (2) to examine the contribution of these characteristics to maternal well-being.

Methods: Data were available from 192 biological mothers (ages 41-84) of adolescents and adults with ASD participating in an ongoing longitudinal study.  Mothers participated in interviews and completed self-report measures.  Outcome measures of well-being included depressive symptoms (CES-D; Radloff, 1977) and anxiety symptoms (POMS; McNair et al., 1981). Broader autism phenotype characteristics were measured by mother report on herself and her spouse (or biological father of the child) with the Broader Autism Phenotype Questionnaire (BAPQ; Hurley et al., 2007).  Child behavior problems were measured using the maladaptive behaviors subscale of the Scales of Independent Behavior-Revised (SIB-R; Bruininks et al., 1996).

Results: One-quarter of mothers and one-third of fathers had BAPQ scores above the cut-off on at least one subscale. Only 2 mothers and 4 fathers scored above the cut-off on all three subscales. Mothers were most likely to score above the cut-off on Aloof (11.5%); fathers were most likely to score above the cut-off on Rigid (17.7%).  Paternal BAP characteristics had a direct negative effect on maternal depressive and anxiety symptoms, controlling for maternal age, income, marital status, whether the son or daughter was living at home, gender of child with ASD, life stage of child with ASD, other children in the family with disability, and child behavior problems. The interaction between maternal BAPQ characteristics and child behavior problems was significantly associated with both maternal depressive and anxiety symptoms, such that mothers with higher BAPQ scores who had a son or daughter with more severe behavior problems reported the most depressive and anxiety symptoms.

Conclusions: Our findings suggest that in about one-quarter to one-third of families a parent exhibits at least some characteristics of the broader autism phenotype.  Mothers and father appear to have slightly different profiles of BAP characteristics.  BAP characteristics in the father appear to have a direct negative impact on the well-being of mothers, seemingly acting as an environmental stressor.  However, BAP characteristics in the mother appear to put her at risk of experiencing more negative outcomes when she is faced with greater stress, such as when her son or daughter has more severe behavior problems. These findings are consistent with a diathesis-stress interpretation of the effects of BAP characteristics for an individual. The presence of such characteristics in mothers appears to put them at risk for adverse personal outcomes, particularly when their son or daughter poses challenges.