Exploring the Mediating Role of Parenting Stress in the Association between Adolescent Depressive Symptoms in ASD and Disruption in the Home Environment: Does Parenting Efficacy Ameliorate Spillover?

Background: Co-morbidities are common among youth with ASD (Leyfer et al., 2006). It is unclear, however, whether co-occurring symptoms have implications for global levels of family functioning over and above autism severity alone. Previous research has identified links between child characteristics and level of parenting stress (McStay, Dissanayake, Scheeren, Koot, & Begeer, 2014). This raises the possibility that levels of co-occurring symptoms may amplify parenting stress and, in turn, increase family disruption. Moreover, parents’ efficacy and perception of parenting competence is known to play an important role in family functioning (Giallo, Wood, Jellett, & Porter, 2013), and therefore may buffer the impact of their child’s difficulties on the home environment.

Objectives: To address the aforementioned possibilities, the present study explored 1) whether depressive symptoms contribute to environmental disruption in the home, controlling for ASD severity, 2) if parenting stress mediates the relation between depressive symptoms and disruption in the home, and 3) a moderated meditation model to determine whether parenting efficacy acts as a moderator of these effects.

Methods: Caregivers of 92 adolescents with ASD completed the questionnaires used in this sub-study as part of a larger RCT of the PEERS® social skills intervention; only pre-intervention data was used in the analyses. ASD was confirmed using the ADOS-G and all participants had an IQ greater than or equal to 70 on the Kaufman Brief Intelligence Test. The Confusion, Hubbub, and Order Scale (CHAOS) was used to measure global levels of disruption in the home environment, the Stress Index for Parents of Adolescents (SIPA) was used to measure parenting stress, and the Parent Sense of Competence Scale (PSOC) was used to assess parents’ perception of their parenting efficacy. The Social Responsiveness Scale (SRS) was employed as a proxy of autism severity and the Short Mood and Feelings Questionnaire (SMFQ) as an index of adolescent depressive symptoms.

Results: A multiple linear regression predicting CHAOS from SRS and SMFQ was significant F(2,89) = 5.57, p < 0.01 and revealed a significant main effect of SMFQ b = 0.36, p = 0.001, controlling for SRS. A PROCESS mediation model was used to test the mediating role of SIPA and revealed a significant indirect effect b = 0.79, [CI: 0.45, 1.26]. Follow up conditional PROCESS analyses were employed to test the moderating role of PSOC on the previous mediation model. No significant interaction effects were identified and, thus, the mediation model does not differ at varying levels of parent efficacy.

Conclusions: Findings from this study suggest that heightened depressive symptoms are linked with increased disruption in the home environment, beyond the effect of autism severity. Moreover, this association appears to be driven by an increase in parenting stress. Lack of interaction effects suggests that parent efficacy may not buffer the impact of child depressive symptoms on environmental disruptions, although it likely operates in other ways to facilitate positive family functioning that are not captured in these analyses. Overall, both autism symptoms and mental health may be important targets for intervention and avenues to enhance family functioning.