Mothers with a History of Anxiety/Depression Report Higher Prevalence of Behaviors and Sensory Sensitivities: A Group-Matched Study Comparing Maternal Reporting of ASD Symptoms

Background: Parent report is central to clinical assessment of ASD, yet the influence of parent characteristics, such as depression and anxiety, on report of symptomatology is poorly understood. Maternal depression has been associated with increased symptoms on parent report measures but not clinician-administered measures (Bennett et. al., 2012). Parental psychiatric symptoms negatively correlate with parental expectations for children with ASD (Thomas et al.; 2017). Given heightened prevalence of depression and anxiety among parents of children with ASD and the reliance on parent report in clinical evaluation, it is essential to understand the influence of maternal anxiety and depression on parental report of presenting concerns and clinical and behavioral features of ASD.

Objectives: To investigate the relationship between maternal anxiety and depression and parent reporting in terms of frequency of reporting specific behaviors and symptoms.

Methods: The study entailed chart abstraction of 40 individuals with ASD, aged 3-18, seen at an autism clinic. Twenty mothers self-reported a history of anxiety and/or depression (mean child age=7±2.3years), and twenty did not report anxiety or depression (mean child age=7±2.5years). Child clinical characteristics included age, ADOS severity score, IQ, and Vineland Adaptive Behavior Scales-II (VABS). A parent intake questionnaire, completed by the mother or both parents, provided information on family history, sensory function (avoids/seeks loud noises, bright lights, being touched, or certain food textures), maladaptive behaviors (screaming, hitting, biting, tantrums, self-injury, elopement), autism-related behaviors, and presenting concerns.

Results: The two groups did not differ significantly on age, ADOS calibrated severity score, IQ, or VABS subdomains or adaptive behavior composite. Mothers with a history of anxiety and/or depression reported more problem behaviors (M=2.90, SD=1.52) than mothers without anxiety and/or depression (M=1.75, SD=1.77; t=2.10, p=.048). In addition, mothers with a history of anxiety and/or depression (M=5.95, SD=2.91) endorsed more sensory sensitivities than mothers with no anxiety and/or depression (M=3.8, SD=2.21; t=2.39, p=.023). To further examine sensory sensitivities, we analyzed a parent report of autism-related behaviors, which used a 5-point Likert scale. Mothers with a history of anxiety and/or depression indicated their children were more frequently upset by loud noises (M=2.70, SD=1.22) than mothers without anxiety or depression (M=1.20, SD=.775; t=4.439, p<.001). Additionally, mothers in the anxiety and/or depression group reported their children were more frequently overly preoccupied with details (M=2.00, SD=1.41) than mothers in the control group (M=1.07, SD=1.1; t=2.12, p=.042).

Conclusions: There have been few studies to examine the relationship between maternal anxiety and depression and parent report of ASD symptoms. In the current study, despite comparable ratings on clinician-administered and structured parent interviews, parental report on a questionnaire indicated increased report of autism symptoms among parents with anxiety or depression. This topic requires further investigation in studies designed to tease out potential influencing factors, such as reporting bias or enhanced attention to detail, that may account for these differences. Ongoing qualitative analysis of open-ended responses in the current sample will provide additional information about use of emotional language in parent report.