This study explored whether ASD phenotypes in the child were associated with a history of anxiety or depression in the mother. We hypothesized that an ASD profile in children characterized by mild delays and increased rates of dysregulation would be associated with preexisting maternal anxiety or depression. Participants were 672 preschool children with ASD and their mothers. Children were classified as ASD after a comprehensive developmental evaluation. Mothers reported whether a healthcare provider ever diagnosed them with anxiety or depression before the birth of their child. Four child ASD phenotypes were derived from latent class analysis: Mild Language Delay with Cognitive Rigidity (Type 1), Significant Developmental Delay with Repetitive Motor Behaviors (Type 2), General Developmental Delay (Type 3), and Mild Language and Motor Delay with Dysregulation (i.e., aggression, anxiety, depression, emotional reactivity, inattention, somatic complaints, and sleep problems) (Type 4). Type 2 ASD served as the referent category in statistical analyses. Results showed that 22.6% of mothers reported a diagnosis of anxiety or depression before the birth of their child. Maternal anxiety or depression was associated with 2.7 times the odds (95% confidence interval: 1.4, 5.3) of Type 4 or Dysregulated ASD in the child; maternal anxiety and depression was associated with 4.4 times the odds (95% confidence interval: 1.4, 14.0) of Type 4 or Dysregulated ASD in the child. Our findings suggest an association between Dysregulated ASD in the child and anxiety and depression in the mother. These findings can enhance screening methods and inform future research efforts.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Achenbach, T. (1992). Child behavior checklist. Burlington: Achenbach System of Empirically Based Assessment.
Allen, C. W., Silove, N., Williams, K., & Hutchins, P. (2007). Validity of the social communication questionnaire in assessing risk of autism in preschool children with developmental problems. Journal of Autism and Developmental Disorders, 37(7), 1272–1278.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington: American Psychiatric Publishing.
Bolton, P. F., Pickles, A., Murphy, M., & Rutter, M. (1998). Autism, affective, and other psychiatric disorder: Patterns of familial aggregation. Psychiatric Medicine, 28, 385–395.
Bora, E., Aydin, A., Sarac, T., et al. (2016). Heterogeneity of subclinical autistic traits among parents of children with autism spectrum disorder: Identifying the broader autism phenotype with a data-driven method. Autism Research, 10, 321–326.
Briggs-Gowan, M. J., Carter, A. S., Irwin, J. R., Wachtel, K., & Cicchetti, D. V. (2004). The brief infant –toddler social and emotional assessment: Screening for social-emotional problems and delays in competence. Journal of Pediatric Psychology, 29(2), 143–155.
Chilcoat, H. D., & Breslau, N. (1997). Does psychiatric history bias mothers’ reports? An application of a new analytic approach. Journal of the American Academy of Child and Adolescent Psychiatry, 36(7), 971–979.
Cohen, I. L., & Tsiouris, J. A. (2006). Maternal recurrent mood disorders and high-functioning autism. Journal of Autism and Developmental Disorders, 36, 1077–1088.
Colvert, E., Tick, B., McEwen, F., Stewart, C., Curran, S. R., Woodhouse, E., Gillan, N., Hallett, V., Lietz, S., Garnett, T., Ronald, A., Plomin, R., Rijsdijk, F., Happé, F., & Bolton, P. (2015). Heritability of autism spectrum disorder in a UK population-based twin sample. JAMA Psychiatry, 72(5), 415–423.
Constantino, J. N. (2002). Social Responsiveness Scale. Los Angeles: Western Psychological Services.
Constantino, J. N., & Todd, R. D. (2005). Intergenerational transmission of subthreshold autistic traits in the general population. Biological Psychiatry, 57, 655–660.
Corsello, C., Hus, V., Pickles, A., Risi, S., Cook, E. H., Leventhal, B. L., & Lord, C. (2007). Between a ROC and a hard place: Decision making and making decisions about using the SCQ. Journal of Child Psychology and Psychiatry, 48(9), 932–940.
Daniels, J., Forssen, U., Hultman, C. M., Cnattingius, S., Savitz, D., Feychting, M., et al. (2008). Parental psychiatric disorder associated with autism spectrum disorders in the offspring. Pediatrics, 121(5), e1357–e1362.
De la Torre-Ubieta, L., Won, H., Stein, J. L., & Geshwind, D. (2016). Advancing the understanding of autism disease mechanisms through genetics. Nature Medicine, 22, 345–361.
De Los Reyes, A., & Kazdin, A. E. (2005). Informant discrepancies in the assessment of childhood psychopathology: A critical review, theoretical framework, and recommendations for further study. Psychological Bulletin, 131, 483–509.
DeLong, R. G. (2004). Autism and familial major mood disorder: Are they related? The Journal of Neuropsychiatry and Clinical Neurosciences, 16(2), 199–213.
DeLong, R. G., & Dwyer, J. T. (1988). Correlation of family history with specific autistic subgroups: Asperger’s syndrome and bipolar affective disease. Journal of Autism and Developmental Disorders, 18, 593–600.
Eaves, L. C., Wingert, H. D., Ho, H. H., & Mickelson, E. C. (2006). Screening for autism spectrum disorders with the social communication questionnaire. Journal of Developmental & Behavioral Pediatrics, 27(2), S95–S103.
Gartstein, M. A., Bridgett, D. J., Dishion, T. J., & Kaufman, N. K. (2009). Depressed mood and maternal report of child behavior problems: Another look at the depression-distortion hypothesis. Journal of Applied Developmental Psychology, 30(2), 149–160.
Geschwind, D. (2011). Genetics of autism spectrum disorders. Trends in Cognitive Sciences, 15(9), 409–416.
Gotham, K., Risi, S., Pickles, A., & Lord, C. (2007). The autism diagnostic observation schedule: Revised algorithms for improved diagnostic validity. Journal of Autism and Developmental Disorders, 37, 613–627.
Gray, K., Tonge, B., & Sweeney, D. (2008). Using the autism diagnostic interview-revised and the autism diagnostic observation schedule with young children with developmental delay: Evaluating diagnostic validity. Journal of Autism and Developmental Disorders, 38, 657–667.
Jokiranta, E., Brown, A. S., Heinimaa, M., Cheslack-Postava, P., Suominen, A., & Sourander, A. (2013). Parental psychiatric disorders and autism spectrum disorders. Psychiatry Research, 207, 203–211.
Joshi, G., Petty, C., Wozniak, J., , Henin, A., Fried, R., Galdo, M., Kotarski M., Walls S., Biederman J. (2010). The heavy burden of psychiatric comorbidity in youth with autism spectrum disorders: A large comparative study of a psychiatrically referred population. Journal of Autism and Developmental Disorders, 40, 1361–1370.
Ko, J. Y., Farr, S. L., Dietz, P. M., & Robbnis, C. L. (2012). Depression and treatment among U.S. pregnant and nonpregnant women of reproductive age, 2005-2009. Journal of Womens Health, 21(8), 830–836.
Lajiness-O’Neil, R., & Menard, P. (2008). Brief report: An autistic spectrum subtype revealed through familial psychopathology coupled with cognition in ASD. Journal of Autism and Developmental Disorders, 38, 982–987.
Larsson, H. J., Eaton, W. W., Madsen, K. M., Vestergaard, M., Vingaard Olesen, A., Agerbo, E., et al. (2005). Risk factors for autism: Perinatal factors, parental psychiatric history, and socioeconomic status. American Journal of Epidemiology, 161, 916–925.
Lord, C., Rutter, M., & Le Couteur, A. L. (1994). Autism diagnostic interview-revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659–685.
Lord, C., Rutter, M., DiLavore, P. C., & Risi, S. (1999). Autism diagnostic observation schedule. Los Angeles: Western Psychological Services.
Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., et al. (2000). The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the Spectrum of autism. Journal of Autism and Developmental Disorders, 30, 205–223.
Lyall, K., Constantino, J. N., Weisskopf, M. G., Roberts, A. L., Ascherio, A., & Santangelo, S. L. (2014). Parental social responsiveness and risk of autism spectrum disorder in offspring. JAMA Psychiatry, 71, 936–942.
Mathews, T.J. & Hamilton, B.E. (2016) Mean age of mothers is on the rise: United States, 2000–2014. NCHS Data Brief, no 232. Hyattsville: National Center for Health Statistics.
Mullen, E. (1995). Mullen Scales of Early Learning. San Antonio: Pearson.
Nakai, N., Nagano, M., Saitow, F., Watanabe, Y., Kawamura, Y., Kawamoto, A., Tamada, K., Mizuma, H., Onoe, H., Watanabe, Y., Monai, H., Hirase, H., Nakatani, J., Inagaki, H., Kawada, T., Miyazaki, T., Watanabe, M., Sato, Y., Okabe, S., Kitamura, K., Kano, M., Hashimoto, K., Suzuki, H., & Takumi, T. (2017). Serotonin rebalances cortical tuning and behavior linked to autism symptoms in 15q11-13 CNV mice. Science Advances, 3(6), e1603001.
Nordquist, N., & Oreland, L. (2010). Serotonin, genetic variability, behavior, and psychiatric disorders – A review. Upsala Journal of Medical Sciences, 115, 2–10.
Piven, J., & Palmer, P. (1999). Psychiatric disorder and the broad autism phenotype: Evidence from a family study of multiple-incidence autism families. American Journal of Psychiatry, 156, 557–563.
Rubenstein, E., Wiggins, L. D., Schieve, L., Bradley, C., DiGuiseppi, C., Moody, E., et al. (2018). Associations between parental broader autism phenotype and child autism spectrum disorder phenotype in the study to explore early development. Autism. https://doi.org/10.1177/1362361317753563.
Rutter, M. A., Bailey, A., & Lord, C. (2003). The social communication questionnaire. Los Angeles: Western Psychological Services.
Sandin, S., Lichtenstein, P., Kuja-Halkola, R., Larssen, H., Hutman, C., & Reichenberg, A. (2014). The familial risk of autism. JAMA, 311(17), 1770–1777.
Sasson, N. J., Lam, K. S., Parlier, M., Daniels, J., & Piven, J. (2013). Autism and the broad autism phenotype: Familial patterns and intergenerational transmission. Journal of Neurodevelopmental Disorders, 5, 11.
Schendel, D., DiGuiseppi, C., Croen, L., Fallin, M. D., Reed, P., Schieve, L., et al. (2012). The study to explore early development (SEED): A multi-site epidemiologic study of autism by the centers for autism and developmental disabilities research and epidemiology (CADDRE) network. Journal of Autism and Developmental Disorders, 42, 2121–2140.
Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 921–929.
Snow, A. V., & Lecavalier, L. (2008). Sensitivity and specificity of the modified checklist for autism in toddlers and the social communication questionnaire in preschoolers suspected of having pervasive developmental disorders. Autism, 12(6), 627–644.
Sparrow, S., Balla, D., & Cicchetti, D. (2005). Vineland Adaptive Behavior Scales (2nd ed.). San Antonio: Pearson.
Squires, J., Bricker, D., & Twombly, E. (2005). Ages and stages questionnaires: Social-emotional. Baltimore: Brookes Publishing.
Sucksmith, E., Roth, I., & Hoekstra, R. A. (2011). Autistic traits below the clinical threshold: Re-examining the broader autism phenotype in the 21st century. Neuropsyhology Review., 21, 360–389.
Sullivan, P. F., Magnusson, C., Reichenberg, A., Boman, M., Dalman, C., Davidson, M., Fruchter, E., Hultman, C. M., Lundberg, M., Långström, N., Weiser, M., Svensson, A. C., & Lichtenstein, P. (2012). Family history of schizophrenia and bipolar disorder as risk factors for autism. Archives of General Psychiatry, 69(11), 1099–1103.
Vasa, R. A., Anderson, C., Marvin, A. R., Rosenberg, R. E., Law, J. A., Thorn, J., et al. (2012). Mood disorder in mothers of children on the autism spectrum are associated with higher functioning autism. Autism Research and Treatment, 2012, 1–8. https://doi.org/10.1155/2012/435646.
Vermunt, J. K. (2010). Latent class modeling with covariates: Two improved three-step approaches. Political Analysis, 18, 450–469.
Verweij, K. H., Derks, E. M., Hendriks, E. J., & Cahn, W. (2011). The influence of informant characteristics on the reliability of family history interviews. Twin Research and Human Genetics, 14, 217–220.
Wiggins, L. D., Bakeman, R., Adamson, L., & Robins, D. (2007). The utility of the social communication questionnaire in screening for autism in children referred for early intervention. Focus on Autism and Other Developmental Disabilities, 22(1), 33–38.
Wiggins, L. D., Reynolds, A., Rice, C., Moody, E. J., Bernal, P., Blaskey, L., et al. (2015). Using standardized diagnostic instruments to classify children with autism in the study to explore early development. Journal of Autism and Developmental Disorders, 45, 1271–1280.
Wiggins, L. D., Tian, L., Levy, S., Rice, C., Lee, L.-C., Schieve, L., et al. (2017). Homogeneous subgroups of young children with autism improve phenotypic characterization in the study to explore early development. Journal of Autism and Developmental Disorders, 47, 3634–3645.
Yap, M. B., Pilkington, P. D., Ryan, S. M., & Jorm, A. F. (2014). Parental factors associated with depression and anxiety in young people: A systematic review and meta-analysis. Journal of Affective Disorders, 156, 8–23.
The investigators acknowledge the contributions made to this study by project staff and enrolled families. Other author contributions were as follows: study concept (Lisa Wiggins), study design and methods (all authors), statistical plan (Eric Rubenstein, Lisa Wiggins, and Lin Tian), statistical analysis (Eric Rubenstein, Lin Tian, and Katherine Sabourin), statistical review and interpretation (all authors), manuscript preparation and/or review (all authors). This publication was supported by six cooperative agreements from the Centers for Disease Control and Prevention (CDC): Cooperative Agreement Number U10DD000180, Colorado Department of Public Health; Cooperative Agreement Number U10DD000181, Kaiser Foundation Research Institute (CA); Cooperative Agreement Number U10DD000182, University of Pennsylvania; Cooperative Agreement Number U10DD000183, Johns Hopkins University; Cooperative Agreement Number U10DD000184, University of North Carolina at Chapel Hill; and Cooperative Agreement Number U10DD000498, Michigan State University and the Health Services and Resources Administration (HRSA) Maternal Child Health Bureau, Leadership Education in Neurodevelopmental Disabilities (LEND) Grant Award #T73MC11044. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC.
Conflict of Interest
There are no conflicts of interest to report.
This research was reviewed and approved by Institutional Review Boards at the Centers for Disease Control and Prevention (CDC) and each study site.
Informed consent was obtained by all families that participated in the study.
About this article
Cite this article
Wiggins, L.D., Rubenstein, E., Daniels, J. et al. A Phenotype of Childhood Autism Is Associated with Preexisting Maternal Anxiety and Depression. J Abnorm Child Psychol 47, 731–740 (2019). https://doi.org/10.1007/s10802-018-0469-8