Child temperament and caregiver psychological distress have been independently associated with social-emotional difficulties among individuals with autism. However, the interrelationship among these risk factors has rarely been investigated. We explored the reciprocal interplay between child temperament (surgency, negative affectivity, and self-regulation) and caregiver psychological distress in the development of child internalizing and externalizing symptoms, in a cohort of 103 infants showing early autism traits. Caregivers completed questionnaires when children were aged around 12-months (Time 1 [T1]), 18-months (Time 2 [T2]), and 24-months (Time 3 [T3]). Cross-lagged path models revealed a significant pathway from T1 caregiver psychological distress through lower T2 child self-regulation to subsequently greater T3 child internalizing symptoms. No such caregiver-driven pathway was evident through T2 child negative affectivity or in the prediction of T3 child externalizing symptoms. Further, no support was found for temperament-driven pathways through caregiver psychological distress to child social-emotional difficulties. Child surgency was mostly unrelated to caregiver psychological distress and social-emotional difficulties. These findings implicate the need to support the mental health of caregivers with an infant with autism traits in order to enhance the emotion regulation and social-emotional development of their infants.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price includes VAT (USA)
Tax calculation will be finalised during checkout.
Aktar, E., & Bögels, S. M. (2017). Exposure to Parents’ Negative Emotions as a Developmental Pathway to the Family Aggregation of Depression and Anxiety in the First Year of Life. Clinical Child and Family Psychology Review, 20(4), 369–390.
Aktar, E., Colonnesi, C., de Vente, W., Majdandžić, M., & Bögels, S. M. (2017). How do parents’ depression and anxiety, and infants’ negative temperament relate to parent–infant face-to-face interactions? Development and Psychopathology, 29(3), 697–710.
Allen, T. A., Oshri, A., Rogosch, F. A., Toth, S. L., & Cicchetti, D. (2018). Offspring Personality Mediates the Association between Maternal Depression and Childhood Psychopathology. Journal of Abnormal Child Psychology.
Baker, J. K., Seltzer, M. M., & Greenberg, J. S. (2011). Longitudinal Effects of Adaptability on Behavior Problems and Maternal Depression in Families of Adolescents with Autism. Journal of Family Psychology : JFP : Journal of the Division of Family Psychology of the American Psychological Association (Division 43), 25(4), 601–609.
Barbaro, J., & Dissanayake, C. (2013). Early markers of autism spectrum disorders in infants and toddlers prospectively identified in the Social Attention and Communication Study. Autism, 17(1), 64–86.
Behrendt, H. F., Wade, M., Bayet, L., Nelson, C. A., & Enlow, M. B. (2019). Pathways to social-emotional functioning in the preschool period: The role of child temperament and maternal anxiety in boys and girls. Development and Psychopathology, 1–14.
Bent, C. A., Barbaro, J., & Dissanayake, C. (2017). Change in autism diagnoses prior to and following the introduction of DSM-5. Journal of Autism and Developmental Disorders, 47(1), 163–171.
Bischof, N. L., Rapee, R. M., Hudry, K., & Bayer, J. K. (2018). Acceptability and caregiver-reported outcomes for young children with autism spectrum disorder whose parents attended a preventative population-based intervention for anxiety: A pilot study. Autism Research, 11(8), 1166–1174.
Bridgett, D. J., Laake, L. M., Gartstein, M. A., & Dorn, D. (2013). Development of Infant Positive Emotionality: The Contribution of Maternal Characteristics and Effects on Subsequent Parenting. Infant and Child Development, 22(4), 362–382.
Briggs-Gowan, M., & J., Carter, A. S., Bosson-Heenan, J., Guyer, A. E., & Horwitz, S. M. . (2006). Are Infant-Toddler Social-Emotional and Behavioral Problems Transient? Journal of the American Academy of Child & Adolescent Psychiatry, 45(7), 849–858.
Brooker, R. J., Neiderhiser, J. M., Leve, L. D., Shaw, D. S., Scaramella, L. V., & Reiss, D. (2015). Associations Between Infant Negative Affect and Parent Anxiety Symptoms are Bidirectional: Evidence from Mothers and Fathers. Frontiers in Psychology. Expanded Academic ASAP.
Bryson, S. E., Zwaigenbaum, L., McDermott, C., Rombough, V., & Brian, J. (2008). The Autism Observation Scale for Infants: Scale development and reliability data. Journal of Autism and Developmental Disorders, 38(4), 731–738.
Burrows, C. A., Usher, L. V., Schwartz, C. B., Mundy, P. C., & Henderson, H. A. (2016). Supporting the spectrum hypothesis: Self-reported temperament in children and adolescents with high functioning autism. Journal of Autism and Developmental Disorders, 46(4), 1184–1195.
Calkins, S. D., & Hill, A. (2007). Caregiver influences on emerging emotion regulation. Handbook of emotion regulation, 229248.
Carter, A. S., & Briggs-Gowan, M. J. (2006). ITSEA: Infant-Toddler Social and Emotional Assessment Examiner’s Manual. PsychCorp.
Chetcuti, L., Uljarević, M., Ellis-Davies, K., Hardan, A. Y., Whitehouse, A. J., Hedley, D., ... & Prior, M. R. (2021). Temperament in individuals with Autism Spectrum Disorder: A systematic review. Clinical Psychology Review, 101984.
Chetcuti, L., Uljarević, M., & Hudry, K. (2019). Editorial Perspective: Furthering research on temperament in autism spectrum disorder. Journal of Child Psychology and Psychiatry, 60(2), 225–228.
Chetcuti, L., Uljarević, M., Varcin, K. J., Boutrus, M., Wan, M. W., Slonims, V., Green, J., Segal, L., Iacono, T., Dissanayake, C., Whitehouse, A. J. O., Hudry, K. (2020). The Role of Negative Affectivity in Concurrent Relations Between Caregiver Psychological Distress and Difficulties in Infants With Early Signs of Autism. Autism Research 13 (8):1349-1357
Choe, D. E., Shaw, D. S., Brennan, L. M., Dishion, T. J., & Wilson, M. N. (2014). Inhibitory control as a mediator of bidirectional effects between early oppositional behavior and maternal depression. Development and Psychopathology, 26(4pt1), 1129–1147.
Clifford, S. M., Hudry, K., Elsabbagh, M., Charman, T., Johnson, M. H., & the BASIS Team. (2013). Temperament in the first 2 years of life in infants at high-risk for autism spectrum disorders. Journal of Autism and Developmental Disorders, 43(3), 673–686.
De Bolle, M., Beyers, W., De Clercq, B., & De Fruyt, F. (2012). General Personality and Psychopathology in Referred and Nonreferred Children and Adolescents: An Investigation of Continuity, Pathoplasty, and Complication Models. Journal of Abnormal Psychology, 121(4), 958–970.
De Bolle, M., De Clercq, B., Caluwé, E. D., & Verbeke, L. (2016). Exploring the complexity of the childhood trait–psychopathology association: Continuity, pathoplasty, and complication effects. Development and Psychopathology, 28(1), 139–148.
De Pauw, S. S. W., Mervielde, I. (2010). Temperament, Personality and Developmental Psychopathology: A Review Based on the Conceptual Dimensions Underlying Childhood Traits. Child Psychiatry & Human Development 41 (3):313-329
De Pauw, S. S. W., Mervielde, I., Leeuwen, K. G. V., & De Clercq, B. J. (2011). How temperament and personality contribute to the maladjustment of children with autism. Journal of Autism and Developmental Disorders, 41(2), 196–212.
Dix, T., & Yan, N. (2014). Mothers’ depressive symptoms and infant negative emotionality in the prediction of child adjustment at age 3: Testing the maternal reactivity and child vulnerability hypotheses. Development and Psychopathology, 26(1), 111–124.
Eisenberg, N., Cumberland, A., & Spinrad, T. L. (1998). Parental Socialization of Emotion. Psychological Inquiry, 9(4), 241–273.
Estes, A., Munson, J., Dawson, G., Koehler, E., Zhou, X.-H., & Abbott, R. (2009). Parenting stress and psychological functioning among mothers of preschool children with autism and developmental delay. Autism, 13(4), 375–387.
Estes, A., Olson, E., Sullivan, K., Greenson, J., Winter, J., Dawson, G., & Munson, J. (2013). Parenting-related stress and psychological distress in mothers of toddlers with autism spectrum disorders. Brain and Development, 35(2), 133–138.
Feng, X., Shaw, D. S., Skuban, E. M., & Lane, T. (2007). Emotional exchange in mother-child dyads: Stability, mutual influence, and associations with maternal depression and child problem behavior. Journal of Family Psychology, 21(4), 714–725.
Forbes, E. E., Shaw, D. S., Silk, J. S., Feng, X., Cohn, J. F., Fox, N. A., & Kovacs, M. (2008). Children’s Affect Expression and Frontal EEG Asymmetry: Transactional Associations with Mothers’ Depressive Symptoms. Journal of Abnormal Child Psychology, 36(2), 207–221.
Garon, N., Bryson, S. E., Zwaigenbaum, L., Smith, I. M., Brian, J., Roberts, W., & Szatmari, P. (2009). Temperament and its relationship to autistic symptoms in a high-risk infant sib cohort. Journal of Abnormal Child Psychology, 37(1), 59–78.
Gartstein, M. A., & Hancock, G. R. (2019). Temperamental Growth in Infancy: Demographic, Maternal Symptom, and Stress Contributions to Overarching and Fine-Grained Dimensions. Merrill - Palmer Quarterly; Detroit, 65(2), 121–157.
Gartstein, M. A., Putnam, S. P., & Rothbart, M. K. (2012). Etiology of preschool behavior problems: Contributions of temperament attributes in early childhood. Infant Mental Health Journal, 33(2), 197–211.
Gartstein, M. A., & Rothbart, M. K. (2003). Studying infant temperament via the revised infant behavior questionnaire. Infant Behavior and Development, 26(1), 64–86.
Goodman, S. H., Rouse, M. H., Connell, A. M., Broth, M. R., Hall, C. M., & Heyward, D. (2011). Maternal Depression and Child Psychopathology: A Meta-Analytic Review. Clinical Child and Family Psychology Review, 14(1), 1–27.
Hanington, L., Ramchandani, P., & Stein, A. (2010). Parental depression and child temperament: Assessing child to parent effects in a longitudinal population study. Infant Behavior and Development, 33, 88–95.
Hayes, S. A., & Watson, S. L. (2013). The Impact of Parenting Stress: A Meta-analysis of Studies Comparing the Experience of Parenting Stress in Parents of Children With and Without Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 43(3), 629–642.
Hendry, A., Jones, E. J. H., Bedford, R., Andersson Konke, L., Begum Ali, J., Bӧlte, S. the Eurosibs Team. (2020). Atypical Development of Attentional Control Associates with Later Adaptive Functioning, Autism and ADHD Traits. Journal of Autism and Developmental Disorders.
Iverson, S. L., & Gartstein, M. A. (2018). Applications of Temperament: A Review of Caregiver-Focused Temperament-Driven Interventions. Early Education and Development, 29(1), 31–52.
Joshi, G., Petty, C., Wozniak, J., Henin, A., Fried, R., Galdo, M., & 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(11), 1361–1370.
Kasari, C., & Sigman, M. (1997). Linking parental perceptions to interactions in young children with autism. Journal of Autism & Developmental Disorders, 27(1), 39–57.
Konstantareas, M. M., & Papageorgiou, V. (2006). Effects of temperament, symptom severity and level of functioning on maternal stress in Greek children and youth with ASD. Autism, 10(6), 593–607.
Lawrence, P. J., Murayama, K., & Creswell, C. (2018). Anxiety and Depressive Disorders in Offspring of Parents with Anxiety Disorders: A Meta-Analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 0(0).
Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335–343.
Lundström, S., Chang, Z., Kerekes, N., Gumpert, C. H., Råstam, M., Gillberg, C., Lichtenstein, P., & Anckarsäter, H. (2011). Autistic-like traits and their association with mental health problems in two nationwide twin cohorts of children and adults. Psychological Medicine, 41(11), 2423–2433.
Mertesacker, B., Bade, U., Haverkock, A., & Pauli-Pott, U. (2004). Predicting maternal reactivity/sensitivity: The role of infant emotionality, maternal depressiveness/anxiety, and social support. Infant Mental Health Journal, 25(1), 47–61.
Mozolic-Staunton, B., Donelly, M., Yoxall, J., & Barbaro, J. (2020). Early detection for better outcomes: universal developmental surveillance for autism across health and early childhood education settings. Research in Autism Spectrum Disorders. 71.
Mundy, P. C., Henderson, H. A., Inge, A. P., & Coman, D. C. (2007). The modifier model of autism and social development in higher functioning children. Research & Practice for Persons with Severe Disabilities, 32(2), 124–139.
Muthén, L.K. and Muthén, B.O. (1998–2017). Mplus User’s Guide. Eighth Edition. Los Angeles, CA: Muthén & Muthén.
Muthén, B. and Asparouhov, T. (2002) Using Mplus Monte Carlo Simulations in Practice: A Note on Non-Normal Missing Data in Latent Variable Models. Mplus Web Notes: No. 2.
Neece, C. L., Green, S. A., & Baker, B. L. (2012). Parenting Stress and Child Behavior Problems: A Transactional Relationship Across Time. American Journal on Intellectual and Developmental Disabilities; Washington, 117(1), 48–66.
Nigg, J. T. (2006). Temperament and developmental psychopathology. Journal of Child Psychology and Psychiatry, 47(3–4), 395–422.
Olino, T. M., Lopez-Duran, N. L., Kovacs, M., George, C. J., Gentzler, A. L., & Shaw, D. S. (2011). Developmental trajectories of positive and negative affect in children at high and low familial risk for depressive disorder. Journal of Child Psychology and Psychiatry, 52(7), 792–799.
Özyurt, G., Eliküçük, Ç. D., Tufan, A. E., & Baykara, B. (2018). Are language features and emotion regulation related to maternal depression in autism and language delay? Pediatrics International, 60(10), 931–937.
Paterson, S. J., Wolff, J. J., Elison, J. T., Winder-Patel, B., Zwaigenbaum, L., Estes, A., & the IBIS Network. . (2019). The Importance of Temperament for Understanding Early Manifestations of Autism Spectrum Disorder in High-Risk Infants. Journal of Autism and Developmental Disorders, 49(7), 2849–2863.
Pauli-Pott, U., Mertesacker, B., Bade, U., Bauer, C., & Beckmann, D. (2000). Contexts of relations of infant negative emotionality to caregiver’s reactivity/sensitivity. Infant Behavior and Development, 23(1), 23–39.
Paulussen-Hoogeboom, M. C., Stams, G. J. J. M., Hermanns, J. M. A., & Peetsma, T. T. D. (2007). Child negative emotionality and parenting from infancy to preschool: A meta-analytic review. Developmental Psychology, 43(2), 438–453.
Pesonen, A.-K., Räikkönen, K., Heinonen, K., Komsi, N., Järvenpää, A.-L., & Strandberg, T. (2008). A Transactional Model of Temperamental Development: Evidence of a Relationship between Child Temperament and Maternal Stress over Five Years. Social Development, 17(2), 326–340.
Peters-Scheffer, N., Didden, R., & Korzilius, H. (2012). Maternal stress predicted by characteristics of children with autism spectrum disorder and intellectual disability. Research in Autism Spectrum Disorders, 6(2), 696–706.
Pijl, M. K. J., Bussu, G., Charman, T., Johnson, M. H., Jones, E. J. H., Pasco, G. the BASIS Team. (2019). Temperament as an Early Risk Marker for Autism Spectrum Disorders? A Longitudinal Study of High-Risk and Low-Risk Infants. Journal of Autism and Developmental Disorders, 49(5), 1825–1836.
Putnam, S. P., Gartstein, M. A., & Rothbart, M. K. (2006). Measurement of fine-grained aspects of toddler temperament: The Early Childhood Behavior Questionnaire. Infant Behavior and Development, 29(3), 386–401.
Putnam, S. P., Rothbart, M. K., & Gartstein, M. A. (2008). Homotypic and heterotypic continuity of fine-grained temperament during infancy, toddlerhood, and early childhood. Infant and Child Development, 17(4), 387–405.
Roman, G. D., Ensor, R., & Hughes, C. (2016). Does executive function mediate the path from mothers’ depressive symptoms to young children’s problem behaviors? Journal of Experimental Child Psychology, 142, 158–170.
Sameroff, A. J., & Chandler, M. J. (1975). Reproductive risk and the continuum of caretaking casualty. Review of child development research, 4, 187-244.
Shephard, E., Bedford, R., Milosavljevic, B., Gliga, T., Jones, E. J. H., Pickles, A., & Charman, T. (2019). Early developmental pathways to childhood symptoms of attention-deficit hyperactivity disorder, anxiety and autism spectrum disorder. Journal of Child Psychology and Psychiatry, 60(9), 963–974.
Shiner, R., & Caspi, A. (2003). Personality differences in childhood and adolescence: Measurement, development, and consequences. Journal of Child Psychology and Psychiatry, 44(1), 2–32.
Shi, D., Lee, T., & Maydeu-Olivares, A. (2019). Understanding the model size effect on SEM fit indices. Educational and Psychological Measurement, 79(2), 310–334.
Simonoff, E., Jones, C. R. G., Baird, G., Pickles, A., Happé, F., & Charman, T. (2013). The persistence and stability of psychiatric problems in adolescents with autism spectrum disorders. Journal of Child Psychology and Psychiatry, 54(2), 186–194.
Sugawara, M., Kitamura, T., Toda, M. A., & Shima, S. (1999). Longitudinal relationship between maternal depression and infant temperament in a Japanese population. Journal of Clinical Psychology, 55(7), 869–880.
Totsika, V., Hastings, R. P., Emerson, E., Lancaster, G. A., Berridge, D. M., & Vagenas, D. (2013). Is There a Bidirectional Relationship Between Maternal Well-Being and Child Behavior Problems in Autism Spectrum Disorders? Longitudinal Analysis of a Population-Defined Sample of Young Children. Autism Research, 6(3), 201–211.
Vismara, L., Rolle, L., Agostini, F., Sechi, C., Fenaroli, V., Molgora, S. Tambelli, R. (2016). Perinatal Parenting Stress, Anxiety, and Depression Outcomes in First-Time Mothers and Fathers: A 3- to 6-Months Postpartum Follow-Up Study. Frontiers in Psychology.
Whitehouse, A. J., Varcin, K. J., Alvares, G. A., Barbaro, J., Bent, C., Boutrus, M., & Hudry, K. (2019). Pre-emptive intervention versus treatment as usual for infants showing early behavioural risk signs of autism spectrum disorder: A single-blind, randomised controlled trial. The Lancet Child & Adolescent Health, 3(9), 605–615.
Yorke, I., White, P., Weston, A., Rafla, M., Charman, T., & Simonoff, E. (2018). The Association Between Emotional and Behavioral Problems in Children with Autism Spectrum Disorder and Psychological Distress in Their Parents: A Systematic Review and Meta-analysis. Journal of Autism and Developmental Disorders, 48(10), 3393–3415.
Zaidman-Zait, A., Mirenda, P., Duku, E., Szatmari, P., Georgiades, S., Volden, J., & the Pathways in ASD Study Team. (2014). Examination of Bidirectional Relationships Between Parent Stress and Two Types of Problem Behavior in Children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 44(8), 1908–1917.
Zwaigenbaum, L., Bryson, S., Rogers, T., Roberts, W., Brian, J., & Szatmari, P. (2005). Behavioral manifestations of autism in the first year of life. International Journal of Developmental Neuroscience, 23(2–3), 143–152.
We would like to thank families for their participation. Thanks also to Sarah Fritsche, Natalie Mizzi, Ashley Rattenbury, Maddy Russell-Maynard, and Megan Harrap for their research assistance.
This study formed part of LC’s PhD research, supported by scholarships from La Trobe University and the Cooperative Research Centre for Living with Autism (Autism CRC), established and supported under the Australian Government’s Cooperative Research Centres Program. The larger trial from which these data were available was funded by grants from the Telethon-Perth Children’s Hospital, Autism CRC, La Trobe University Understanding Disease Research Focus Area, and the Angela Wright Bennett Foundation. MU is supported by a Discovery Early Career Researcher Award from the Australian Research Council (DE180100632) and AJOW is supported by an Investigator Grant from the National Health and Medical Council (#APP1173896). JG is a UK NIHR Senior Investigator, the views expressed are not necessarily those of the NIHR or the UK Department of Health.
Conflicts of Interest
The authors have no conflicts of interest to declare that are relevant to the content of this article.
This study was approved by the Child and Adolescent Health Services Committee (2016008EP, June 8, 2016) and performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.
Consent to Participate
Written informed consent was obtained from the parents/caregivers.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Chetcuti, L., Uljarević, M., Varcin, K.J. et al. Caregiver Psychological Distress Predicts Temperament and Social-Emotional Outcomes in Infants with Autism Traits. Res Child Adolesc Psychopathol 49, 1669–1681 (2021). https://doi.org/10.1007/s10802-021-00838-5
- Caregiver psychological distress