Parents raising children with autism spectrum disorders (ASDs) have been shown to experience high levels of stress and report a lower quality of life. The current study examined the association between child autism symptomatology, mother’s quality of life, and mother’s risk for depression in a sample of 1,110 mothers recruited from a web-based registry of families with children with an ASD. Higher autism symptomatology and a greater number of co-occurring psychiatric disorders in the child were associated with an increased risk for current treatment of maternal depression and a lower maternal quality of life. The results highlight the importance of screening for depression, particularly in mothers of children with ASD and mental health and behavioral challenges.
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.
Abbeduto, L., Seltzer, M. M., Shattuck, P., Krauss, M. W., Orsmond, G., & Murphy, M. M. (2004). Psychological well-being and coping in mothers of youths with autism, down syndrome, or fragile X syndrome. AJMR, 109(3), 237–254.
Allik, H., Larsson, J. O., & Smedje, H. (2006). Health-related quality of life in parents of school-age children with asperger syndrome or high-functioning autism. Health and Quality of Life Outcomes, 4, 1.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., rev.). Washington, DC: American Psychiatric Association.
Autism and Developmental Disabilities Monitoring Network Surveillance Year 2008 Principal Investigators. (2012). Prevalence of autism spectrum disorders—Autism and developmental disabilities monitoring network, 14 Sites, United States, 2008. Morbidity and Mortality Weekly Report, 61(3), 1–19.
Baker-Ericzen, M. J., Brookman-Frazee, L., & Stahmer, A. (2005). Stress levels and adaptability in parents of toddlers with and without Autism Spectrum Disorders. Research & Practice for Persons with Severe Disabilities, 30(4), 194–204.
Bebbington, A., Anderson, A., Ravine, D., Fyfe, S., Pineda, M., de Klerk, N., et al. (2008). Investigating genotype-phenotype relationships in Rett syndrome sing an international data set. Neurology, 70(11), 868–875.
Benjak, T. (2011). Subjective quality of life for parents of children with autism spectrum disorders in Croatia. Applied Research Quality Life, 6, 91–102.
Benson, P. R. (2006). The impact of child symptom severity on depressed mood among parents of children with autism spectrum disorder: The mediating role of stress proliferation. Journal of Autism and Developmental Disorders, 36, 685–695.
Benson, P. R., & Karlof, K. L. (2009). Anger, stress proliferation, and depressed mood among parents of children with ASD: A longitudinal replication. Journal of Autism and Developmental Disorders, 39, 350–362.
Blacher, J., & McIntyre, L. L. (2006). Syndrome specificity and behavioural disorders in young adults with intellectual disability: Cultural differences in family impact. Journal of Intellectual and Disability Research, 50, 184–198.
Boot, C. L. R., & Frans, J. M. (2010). The public and the Internet: Multifaceted drives for seeking health information. Health Informatics Journal, 16, 145.
Boyd, B. A. (2002). Examining the relationship between stress and lack of social support in mothers of children with autism. Focus on Autism and Other Developmental Disabilities, 17(4), 208–215.
Boyer, K. K., Olson, J. R., Calantone, R. J., & Jackson, E. C. (2002). Print versus electronic surveys: A comparison of two data collection methodologies. Journal of Operations Management, 20, 357–373.
Bradley, B., & Matthews, A. (1983). Negative self-schemata in clinical depression. British Journal of Clinical Psychology, 3, 173–181.
Bristol, M., Gallager, J., & Schopler, E. (1988). Mothers and fathers of young developmentally disabled and nondisabled boys: Adaptation and spousal support. Developmental Psychology, 24, 441–451.
Brobst, J. B., Clopton, J. R., & Hendrick, S. S. (2009). Parenting children with autism spectrum disorders: The couple’s relationship. Focus on Autism and Other Developmental Disabilities, 24(1), 38–49.
Bromley, J., Hare, D. J., Davison, K., & Emerson, E. (2004). Mothers supporting children with autistic spectrum disorders: Social support, mental health status and satisfaction with services. Autism, 8(4), 409–423.
Browne, G., & Bramston, P. (1998). Stress and the quality of life in the parents of young people with intellectual disabilities. Journal of Psychiatry and Mental Health Nursing, 5, 415–421.
Chandler, S., Charman, T., Baird, G., Simonoff, E., Loucas, T., Meldrum, D., et al. (2007). Validation of the social communication questionnaire in a population cohort of children with autism spectrum disorders. JAACAP, 46(10), 1324–1332.
Cohen, I. L., & Tsiouris, J. A. (2006). Maternal recurrent mood disorders and high-functioning autism. Journal of Autism and Developmental Disorders, 36(8), 1077–1088.
Constantino, J. N. (2002). The social responsiveness scale. Los Angeles: Western Psychological Services.
Constantino, J. N., Davis, S. A., Todd, R. D., Schindler, M. K., Gross, M. M., Brophy, S. L., et al. (2003). Validation of a brief quantitative measure of autistic traits: Comparison of the social responsiveness scale with the autism diagnostic interview-revised. Journal of Autism and Developmental Disorders, 33(4), 427–433.
Constantino, J. N., Lajonchere, C., Lutz, M., Gray, T., Abbacchi, A., McKenna, K., et al. (2006). Autistic social impairment in the siblings of children with pervasive developmental disorders. The American Journal of Psychiatry, 163(2), 294–296.
Cook, E. H., Charak, D. A., Arida, J., Spohn, J. A., Roizen, N. J., & Leventhal, B. L. (1994). Depressive and obsessive-compulsive symptoms in hyperserotonemic parents of children with autistic disorder. Psychiatry Research, 52(1), 25–33.
Corsello, C., Hus, V., Pickles, A., Risi, S., Cook, E. H., Jr., Leventhal, B. L., et al. (2007). Between a ROC and a hard place: decision making and making decisions about using the SCQ. The Journal of Child Psychology and Psychiatry, 48(9), 932–940.
Daly, J. J., Prudic, J., Devanand, D., Nobler, M. S., Lisanby, S. H., Peyser, S., et al. (2001). ECT in bipolar and unipolar depression: Differences in speed of response. Bipolar Disorders, 3(2), 95–104.
Daniels, J. L., Forssen, U., Hultman, C. M., Cnattingius, S., Savitz, D. A., Feychting, M., et al. (2008). Parental psychiatric disorders associated with autism spectrum disorders in offspring. Pediatrics, 121(5), e1357–e1362.
Daniels, A. M., Rosenberg, R. E., Anderson, C., Law, J. K., Marvin, A. R., & Law, P. A. (2012). Verification of parent-reported of child autism spectrum disorder diagnosis to a web-based autism registry. Journal of Autism and Developmental Disorders, 42(2), 257–265.
Dave, S., Petersen, I., Sherr, L., & Nazareth, I. (2010). Incidence of maternal and paternal depression in primary care: A cohort study using a primary care database. Archives of Pediatrics and Adolescent Medicine, 164(11), 1038–1044.
Davis, N. O., & Carter, A. S. (2008). Parenting stress in mothers and fathers of toddlers with autism spectrum disorders: Associations with child characteristics. Journal of Autism and Developmental Disorders, 38(7), 1278–1291.
DeLong, R. (2004). Autism and familial major mood disorder: Are they related? Journal of Neuropsychiatry and Clinical Neuroscience, 16(2), 199–213.
Evans, J. R., & Mathur, A. (2005). The value of online surveys. Internet Research, 15(2), 195–219.
Fiscella, K., Franks, P., Doescher, M. P., & Saver, B. (2002). Disparities in health care by race, ethnicity, and language among the insured: Findings from a national sample. Medical Care, 40(1), 52–59.
Ford, D. V., Jones, K. H., Middleton, R. M., Lockhart-Jones, H., Maramba, I. D. C., Noble, G. J., et al. (2012). The feasibility of collecting information from people with multiple sclerosis for the UK MS Register via a web portal: characterizing a cohort of people with MS. BMC Medical Informatics and Decision Making, 12(73), 1–8.
Forty, L., Smith, D., Jones, L., Jones, I., Caesar, S., Cooper, C., et al. (2008). Clinical differences between bipolar and unipolar depression. British Journal of Psychiatry, 192(5), 388–389.
Ghaziuddin, M., Ghaziuddin, N., & Greden, J. (2002). Depression in persons with autism: Implications for research and clinical care. Journal of Autism and Developmental Disorders, 32(4), 299–306.
Ghaziuddin, M., & Greden, J. (1998). Depression in children with autism/pervasive developmental disorders: A case-control family history study. Journal of Autism and Developmental Disorders, 28(2), 111–115.
Good, A., Stokes, S., & Jerrams-Smith, J. (2007). Elderly, novice users and health information websites: Issues of accessibility and usability. Journal of Healthcare Information Management, 21(3), 72–79.
Gosling, S. D., Vazire, S., Srivastava, S., & John, O. P. (2004). Should we trust web-based studies? A comparative analysis of six preconceptions about internet questionnaires. American Psychologist, 59(2), 93–104.
Gunlicks, M. L., & Weissman, M. M. (2008). Change in child psychopathology with improvement in parental depression: A systematic review. JAACAP, 47(4), 379–389.
Hammen, C. (1992). Cognitive, life stress, and interpersonal approaches to a developmental psychopathology model of depression. Development and Psychopathology, 4, 189–206.
Hammen, C., & Brennan, P. A. (2003). Severity, chronicity, and timing of maternal depression and risk for adolescent offspring diagnoses in a community sample. Archives of General Psychiatry, 60, 253–258.
Hastings, R. P. (2003). Child behaviour problems and partner mental health as correlates of stress in mothers and fathers of children with autism. Journal of Intellectual Disability Research, 47(4–5), 231–237.
Hofvander, B., Delorme, R., Chaste, P., Nyden, A., Wentz, E., Stahlberg, O., et al. (2009). Psychiatric and psychosocial problems in adults with normal-intelligence autism spectrum disorders. BMC Psychiatry, 9, 35.
Hollandare, F., Andersson, G., & Engstrom, I. (2010). A comparison of psychometric properties between internet and paper versions of two depression instruments (BDI-II and MADRS-S) administered to clinic patients. Journal of Medical Internet Research, 12(5), e49.
Huang, H. (2006). Do print and web surveys provide the same results? Computers in Human Behavior, 22, 334–350.
Järbrink, K., Fombonne, E., & Knapp, M. (2003). Measuring the parental, service, and cost impacts of children with autistic spectrum disorder: A pilot study. Journal of Autism and Developmental Disorders, 33, 395–402.
Jones, K. H., Ford, D. V., Jones, P. A., John, A., Middleton, R. M., Lockhart-Jones, H., et al. (2012). A large-scale study of anxiety and depression in people with multiple sclerosis: a survey via the web portal of the UK MS Register. PLoS ONE, 7(7), e41910.
Joseph, G., & Dohan, D. (2009). Diversity of participants in clinical trials in an academic medical center: The role of the ‘Good Study Patient?’. Cancer, 115(3), 608–615.
Kendler, K. S., Myers, J. M., Maes, H. H., & Keyes, C. L. (2011). The relationship between the genetic and environmental influences on common internalizing psychiatric disorders and mental well-being. Behavioral Genetics, 45(5), 641–650.
Lecavalier, L., Leone, S., & Wiltz, J. (2006). The impact of behavior problems on caregiver stress in young people with Autism Spectrum Disorders. Journal of Intellectual Disability Research, 50, 172–183.
Lee, L. C., Harrington, R. A., Louie, B. B., & Newschaffer, C. J. (2008). Children with autism: Quality of life and parental concerns. Journal of Autism and Developmental Disorders, 38, 1147–1160.
Lee, G. K., Lopata, C., Volker, M. A., Thomeer, M. L., Nida, R. E., Toomey, J. A., et al. (2009). Health-related quality of life of parents of children with high-functioning autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 24(4), 227–239.
Lee, H., Marvin, A. R., Watson, T., Piggot, J., Law, J. K., Law, P. A., et al. (2010). Accuracy of phenotyping of autistic children based on internet implemented parent report. American Journal of Medical Genetics, Part B, 153B, 1119–1126.
Leyfer, O. T., Folstein, S. E., Bacalman, S., Davis, N. O., Dinh, E., Morgan, J., et al. (2006). Comorbid psychiatric disorders in children with autism: Interview development and rates of disorders. Journal of Autism and Developmental Disorders, 36(7), 849–861.
Moller, H., Bottlender, R., Grunze, H., Strauss, A., & Wittmann, J. (2001). Are antidepressants less effective in the acute treatment of bipolar I compared to unipolar disorder? Journal of Affective Disorders, 67(1–3), 141–146.
Montes, G., & Halterman, J. S. (2008a). Child care problems and employment among families with pre-school aged children with autism in the United States. Pediatrics, 122, e202–e208.
Montes, G., & Halterman, J. S. (2008b). Association of childhood autism spectrum disorders and loss of family income. Pediatrics, 121, e821–e826.
Mori, K., Ujiie, T., Smith, A., & Howlin, P. (2009). Parental stress associated with caring for children with asperger’s syndrome or autism. Pediatrics International, 51(3), 364–370.
Mugno, D., Ruta, L., D’Arrigo, V. G., & Mazzone, L. (2007). Impairment of quality of life in parents of children and adolescents with pervasive developmental disorder. Health and Quality of Life Outcomes, 6(22), 1–9.
Munk-Olsen, T., Laursen, T. M., Pederson, C. B., Mores, O., & Mortensen, P. B. (2006). New parents and mental disorders. JAMA, 296(21), 2582–2589.
Olsson, M. B., & Hwang, C. P. (2001). Depression mothers and fathers of children with intellectual disability. Journal of Intellectual Disability Research, 45(6), 535–543.
Ottman, R., Lipton, R. B., Ettinger, A. B., Cramer, J. A., Reed, M. L., Morrison, A., et al. (2011). Comorbidities of epilepsy: results from the epilepsy comorbidities and health (EPIC) study. Epilepsia, 52(2), 308–315.
Ozonoff, S., Iosif, A. M., Baguio, F., Cook, I. C., Hill, M. M., Hutman, T., et al. (2010). A prospective study of the emergence of early behavioral signs of autism. JAACAP, 49(3), 256–266.
Pitkow, J. E., & Recker, M. M. (1995). Using the Web as a survey tool: Results from the second WWW user survey. Computer Networks and ISDN Systems, 27, 809–822.
Ponde, M. P., Novaes, C. M., & Losapio, M. F. (2010). Frequency of symptoms of attention deficit and hyperactivity disorder in autistic children. Arquivos de Neuropsiquiatria, 68(1), 103–106.
Rao, P. A., & Beidel, D. C. (2009). The impact of children with high-functioning autism on parental stress, sibling adjustment, and family functioning. Behavior Modification, 33(4), 437–451.
Riva, G., Teruzzi, T., & Anolli, L. (2003). The use of the Internet in psychological research: comparison of online and offline questionnaires. CyberPsychology & Behavior, 6(1), 73–80.
Rodrigue, J., Morgan, S., & Geffken, G. (1992). Psychosocial adaptation of fathers of children with Autism, Down Syndrome, and normal development. Journal of Autism and Developmental Disorder, 22, 249–263.
Rutter, M., Bailey, A., & Lord, C. (2003). Social Communication Questionnaire (SCQ). Los Angeles: Western Psychological Services.
Sanchez-Villegas, A., Schlatter, J., Ortuno, F., Lahortiga, F., Pla, J., Benito, S., et al. (2008). Validity of a self-reported diagnosis of depression among participants in a cohort study using the Structured Clinical Interview for DSM-IV (SCID-I). BMC Psychiatry, 17(8), 43.
Singer, G. H. S. (2006). Meta-analysis of comparative studies of depression in mothers of children with and without developmental disabilities. AJMR, 111(3), 155–169.
Smith, B., Smith, T., Gray, C. G., & Ryan, M. A. K. (2007). When epidemiology meets the Internet: Web-based surveys in the Millennium Cohort Study. Practice of Epidemiology, 166(11), 1345–1354.
Stanton, J. M. (1998). An empirical assessment of data collection using the Internet. Personnel Psychology, 51(3), 709–726.
Sullivan, P. F., Neale, M. C., & Kendler, K. S. (2000). Genetic epidemiology of major depression: A review and meta analysis. American Journal of Psychiatry, 157, 1552–1562.
Teti, D. M., Gelfand, D. M., & Pompa, J. (1990). Depressed mothers’ behavioral competence with their infants: Demographic and psychosocial correlates. Development and Psychopathology, 2, 259–270.
Tobin, L. E., & Glenwick, D. S. (2002). Relation of the Childhood Autism Rating Scale-Parent version to diagnosis, stress, and age. Research in Developmental Disabilities, 23, 211–233.
Vega, W. A., Kolody, B., Valle, R., & Weir, J. (1991). Social networks, social support, and their relationship to depression among immigrant Mexican women. Human Organization, 50(1), 154–162.
Weiss, M. J. (2002). Harrdiness and social support as predictors of stress in mothers of typical children, children with autism, and children with mental retardation. Autism, 6(1), 115–130.
Wong, J. G. W. S., Cheung, E. P. T., Chan, K. K. C., Ma, K. K. M., & Tang, S. W. (2006). Web-based survey of depression, anxiety and stress in first-year tertiary education students in Hong Kong. Australian and New Zealand Journal of Psychiatry, 40(9), 777–782.
Woodgate, R. L., Ateah, C., & Secco, L. (2008). Living in a world of our own: the experiences of parents who have a child with autism. Qualitative Health Research, 18, 1075–1083.
Zlomke, K. R. (2008). Psychometric properties of internet administered versions of Penn State Worry Questionnaire (PSWQ) and Depression, Anxiety and Stress Scales (DASS). Computers in Human Behaviors, 25, 841–843.
This work was supported by Autism Speaks (to P. Law).
About this article
Cite this article
Zablotsky, B., Anderson, C. & Law, P. The Association Between Child Autism Symptomatology, Maternal Quality of Life, and Risk for Depression. J Autism Dev Disord 43, 1946–1955 (2013). https://doi.org/10.1007/s10803-012-1745-z
- Parental depression
- Autism spectrum
- Parent stress
- Quality of life