Parental Psychological Distress and Health-Related Quality of Life: The Impact of Autism Spectrum Disorder and Parental Counseling

Background: Parenting children with Autism Spectrum Disorder (ASD) constitutes a challenging task which puts extreme demands on families’ financial, social, cognitive and emotional resources. In this respect, parents of ASD children frequently suffer from somatic and psychological complaints and report low levels of health-related quality of life (HRQOL).

Objectives: The primary aim of the current study was to measure anxiety and depressive symptoms and health-related quality of life (HRQOL) in parents of children diagnosed with ASD and determine their demographic correlates. A secondary aim was to evaluate the impact of systematic counseling on parental psychosocial functioning.

Methods: The Hospital Anxiety and Depression Scale (HADS) and the Short Form-36 Health Survey (SF-36) were used to assess anxiety, depression and HRQOL, respectively. All participants were administered these questionnaires at baseline. Moreover, a sub-group of parents were re-evaluated after 6-12 months of systematic counseling.

Results: 81 parents participated to the study, 54 with a child diagnosed with ASD according to DSM-V criteria and standardized evaluations(CARS, SCQ, ADOS-2) and 27 with mentally and physically healthy children. Parents of ASD children reported increased levels of anxiety (p=0.040) and depression (p=0.001) and lower scores in social functioning (p=0.004) compared to parents of healthy children. Among parents of ASD children, parents with younger children reported lower anxiety scores (r=0.359, p=0.010) and higher vitality (r=-0.389, p=0.006), social functioning (r=-0.389, p=0.006) and mental health (r=-0.484, p=0.000) scores. In addition, employed parents scored significantly lower (p=0.017) in the general health sub-domain of HRQOL. Twenty-three (23) parents of ASD children were prospectively followed-up and re-administered the above questionnaires after 6-12 months. Seventeen (17) of these parents had received regular parental counseling sessions, while 6 parents had not. Parents which had received counseling reported significant improvement in the mental health sub-domain of the SF36 (p=0.027) compared to parents which were not engaged in parental counseling.

Conclusions: Parenting ASD children is associated with significant psychological distress and disturbed social functioning. Systematic parental counseling may lessen parents’ psychosocial burden by improving mental health-related HRQOL.