Negative Affectivity As a Mediator of the Association between Caregiver Psychological Distress and Psychopathology in Infants with Early Signs of Autism Spectrum Disorder (ASD)

Background: Individuals with an Autism Spectrum Disorder (ASD) diagnosis experience higher rates of internalizing and externalizing symptoms/disorders than the general population. However, little is known about the pathways towards the development of co-morbid psychopathology in this population. Children’s negative affectivity (i.e., propensity towards negative emotions) and caregiver psychological distress are established risk factors for psychopathology in non-autistic children. Further, there is evidence linking early caregiver psychological distress to subsequent variation in child temperament. Bringing together these lines of evidence, a recent study (Allen, Oshri, Rogosch, Toth, & Cicchetti, 2018) found that negative affectivity mediates the association between caregiver psychological distress and psychopathology among non-autistic children. It remains unclear whether this pathway extends to individuals with ASD symptoms; yet, two separate strands of research provide evidence for heightened caregiver psychological distress and negative affectivity in the ASD population.

Objectives: To explore whether the pathway identified in non-autistic children – from caregiver psychological distress to child negative affectivity to child psychopathology – is also observed among a cohort of infants presenting with varying levels of ASD features.

Methods: Participants were a community-referred sample of 103 infants (68% male) aged 9-16 months (M = 12.39, SD = 1.97) showing early signs of ASD, and a primary caregiver (96% biological mothers). Caregivers completed a series of questionnaires. Psychological distress was measured using the Depression Anxiety Stress Scale (DASS-21), infant negative affectivity was measured using the Infant Behavior Questionnaire-Revised (IBQ-R), and infant internalizing and externalizing symptoms were assessed via the Infant-Toddler Social and Emotional Assessment (ITSEA). Infant ASD features were assessed using the Autism Observation Schedule for Infants (AOSI), a semi-structured observational measure. An SPSS macro was used to estimate the total and indirect effects of caregiver psychological distress on infant internalizing and externalizing (modelled separately) via infant negative affectivity (mediator) at varying levels of ASD features (moderator).

Results: Caregiver psychological distress, infant negative affectivity, and infant internalizing and externalizing symptoms were positively interrelated. Infant ASD features were positively associated with internalizing symptoms (only). The model explained a large proportion of the variance in infant internalizing and externalizing symptoms (44% and 24%, respectively). Infant negative affectivity fully mediated the association between caregiver psychological distress and infant psychopathology in both models. No interaction terms involving the AOSI were significant, indicating that the significance of direct and indirect effects did not vary as a function of infant ASD features.

Conclusions: These results – showing temperamental negative affectivity to mediate the link between caregiver psychological distress and infant psychopathology – are consistent with findings in non-autistic children, with effects in this community-referred cohort of infants not moderated by level of ASD features. While these results require replication and longitudinal validation, they suggest that interventions designed to mitigate internalizing and externalizing psychopathology should apply irrespective of infant ASD symptom presentation.