Anxiety and depressive symptoms in parents of children with autism spectrum disorders: a clinical and psychopathological analysis

Abstract

Background. Autism spectrum disorder in a child constitutes a significant chronic psychosocial factor affecting the entire family and may be accompanied by an increased psycho-emotional burden among parents. Investigating anxiety and depressive symptoms in parents of children with ASD, taking into account gender-specific features and the clinical and psychopathological structure of their responses, is of particular clinical relevance. Purpose – to characterize anxiety and depressive symptoms in parents of children with ASD as a basis for identifying specific targets for subsequent medical, psychological, and psychotherapeutic support for these families. Materials and Methods. The study employed a comparative cross-sectional design. A total of 75 families comprising 150 respondents were examined. The study group included 50 families raising a child with ASD, totaling 100 parents: 50 mothers and 50 fathers. The comparison group included 25 families raising a child without mental or behavioral disorders, totaling 50 respondents: 25 mothers and 25 fathers. Clinical history-taking, clinical and psychopathological assessment, psychodiagnostic testing, and statistical analysis were used. Anxiety and depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). Results. Parents of children with ASD had a statistically significantly higher level of anxiety symptoms than the comparison group: the mean HADS-A score was 6.96 ± 5.37 versus 5.16 ± 3.80, respectively (p = 0.009). Subclinical or clinically significant anxiety symptoms were identified in 63.0% of respondents in the study group versus 42.0% in the comparison group (p = 0.023); clinically significant anxiety was recorded in 28.0% of parents of children with ASD and was not detected in the comparison group. Depressive symptoms were also statistically significantly more pronounced in the study group: the mean HADS-D score was 7.14 ± 7.49 versus 4.12 ± 3.85 in the comparison group (p = 0.029). Subclinical or clinically significant depressive symptoms were identified in 45.0% of parents of children with ASD versus 26.0% in the comparison group (p = 0.032), while clinically significant depressive symptoms were found in 18.0% versus 2.0%, respectively (p = 0.004). Gender-stratified analysis revealed more pronounced anxiety and depressive symptoms in mothers of children with ASD: the mean HADS-A score was 8.04 ± 4.57 in mothers versus 5.88 ± 5.92 in fathers (p = 0.021), and the mean HADS-D score was 8.00 ± 5.86 versus 6.28 ± 8.80, respectively (p = 0.001). Clinical and psychopathological analysis showed that the predominant psycho-emotional response pattern among parents of children with ASD was an anxious-depressive pattern with anxiety predominating. In mothers, it more often had anxious-ruminative and anxious-agitated features, whereas in fathers it was characterized by anxious-somatized, asthenic, and partly dysphoric features. Conclusions. Parents of children with ASD are at increased risk of developing anxiety and depressive symptoms, with anxiety being the predominant psycho-emotional phenomenon. Mothers of children with ASD constitute the subgroup most vulnerable to pronounced anxious-depressive responses. The identified clinical and psychopathological features indicate promising targets for medical, psychological, and psychotherapeutic support: anxious anticipation, rumination, catastrophizing, guilt, reduced parental self-efficacy, emotional exhaustion, sleep disturbances, somatized tension, difficulties with emotional self-regulation, impaired family communication, and insufficient social support.