Trajectories of Maternal Depressive Symptoms Following ASD Diagnosis
Objectives: The purpose of this study was two-fold: 1) to investigate longitudinal depressive symptom trajectories among mothers following children's ASD diagnosis, using Latent Growth Mixture Modelling (LGMM); and 2) to examine correlates of depressive symptom trajectories, including children's autism symptom severity, behavior problems, and mothers' coping resources.
Methods: Data were drawn from the Canadian Pathways in ASD study and included 247 children with ASD and their mothers. Mothers' depressive symptoms were assessed at four time points between ASD diagnosis (T1; children’s mean age was 39.02 months, SD=8.7) and when the children were between 7 and 8 years old (T4).
Measures: Maternal depressive symptoms were assessed with the Symptom Checklist-90-R (Derogatis, 1994). To assess coping resources, we used the Ways of Coping Scales (Folkman & Lazarus, 1988) and the Social Support Survey (NLSCY, 2008-2009). Children's behavior problems were measured with the Child Behavior Checklist (Achenbach & Rescorla, 2001). In addition, to assess autism symptom severity, we used the Social Responsiveness Scale (SRS; Constantino & Gruber, 2005) and the severity metric of the Autism Diagnosis Observation Schedules (ADOS; Lord et al., 2000).
Analysis: LGMM was employed to examine trajectories of depressive symptoms using LatentGold software. Predictors of membership of the identified trajectories (classes) were examined using a multinomial logit model.
Results: LGMM identified four discrete latent trajectory classes of depressive symptoms, including: No impact (no depressive symptoms across time; 33%), Minimal impact (low depressive symptoms across time; 36%), Moderate - Improved (medium depressive symptoms that decreased slightly across time, 25%), and High - Worsen (high symptoms that increased over time; 6%). Overall, trajectories were mostly stable across time (see Figure 1). Children's externalizing behavior, mothers' social support, and mothers’ utilization of coping strategies predicted membership in depressive symptom trajectories. Autism symptom severity and internalizing behavior problems were not significant predictors.
Conclusions: Trajectories of depression symptoms are heterogeneous and are relatively stable in mothers of children with ASD. Findings emphasize the importance of screening for mothers' well-being, making coping resources available, and early treatment addressing children's behavior problems.