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Clinical Correlates of Parenting Stress in Children with Autism Spectrum Disorder and Serious Behavioral Problems

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Abstract

Objectives

We examined associations between parent-reported stress on the Parenting Stress Index (PSI) and clinical characteristics in children with autism spectrum disorder (ASD) and serious behavioral problems.

Methods

The 298 children (259 males, 39 females; mean age 5.8 ± 2.2 years) were participants in one of two multisite randomized trials. The pre-treatment evaluation included standardized assessments of cognitive and adaptive functioning (Vineland Adaptive Behavior Scales) and parent ratings such as the Aberrant Behavior Checklist (ABC).

Results

Parents of children above the median on disruptive behavior (ABC Irritability) and social disability (ABC Social Withdrawal) reported higher levels on PSI Parent–Child Interaction than children below the median (Irritability 33.0 ± 7.7 vs 28.4 ± 7.3; Social Withdrawal 33.4 ± 7.5 vs 27.9 ± 7.2, p < .05). Similar findings were observed for the PSI Difficult Child subscale. Bivariate logistic regression identified that these measures as well as greater adaptive functioning deficits (≤median on Vineland Daily Living) predicted parental membership in the upper quartile on the PSI. Stepwise logistic regression models showed that greater severity on ABC Social Withdrawal and greater deficits on Vineland Daily Living uniquely predicted parental membership in the highest quartile on the Parent–Child Interaction PSI subscale (ABC Social Withdrawal odds ratio = 3.4 (95% CI 1.82–6.32); p < .001; Vineland Daily Living odds ratio = 2.6 (95% CI = 1.34–4.87; p < .001).

Conclusions

In addition to disruptive behavior, higher levels of social disability and lower levels of adaptive functioning are associated with parental stress on the PSI.

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Acknowledgements

We thank Dr. Courtney McCracken for assistance in preparing the RUPP and the RUBI datasets for the present study.

Funding

This work was funded by the following grants and support: National Institute of Mental Health, R01MH081148, U10MH66764 (Scahill) Johnson & Johnson Pharmaceutical Research & Development (provided medication); Marcus Foundation and Children’s Healthcare of Atlanta Trust (financial support to Scahill, Bearss and Postorino).

Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Colorado, Anschutz Medical Campus, School of Medicine, Aurora, CO, USA

    Valentina Postorino

  2. Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA

    Scott Gillespie

  3. Nisonger Center and Department of Psychology, Ohio State University, Columbus, OH, USA

    Luc Lecavalier

  4. University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA

    Tristram Smith

  5. Cleveland Clinic Center for Autism, Cleveland, OH, USA

    Cynthia Johnson

  6. Indiana University Riley Hospital for Children, Indianapolis, IN, USA

    Naomi Swiezy

  7. Ohio State University, Columbus, OH, USA

    Michael G. Aman

  8. Departments of Psychiatry and Pediatrics, Massachusetts General Hospital, Harvard Medical School, Lurie Center for Autism, Boston, MA, USA

    Christopher J. McDougle

  9. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle Children’s Autism Center, Seattle, WA, USA

    Karen Bearss

  10. Ohio State University, College of Public Health, Columbus, OH, USA

    Rebecca R. Andridge

  11. Division of Child and Adolescent Neuropsychiatry, University of Turin, Turin, Italy

    Benedetto Vitiello

  12. Department of Pediatrics, Emory University School of Medicine, Marcus Autism Center, Atlanta, GA, USA

    Lawrence Scahill

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  1. Valentina Postorino
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  2. Scott Gillespie
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  3. Luc Lecavalier
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  7. Michael G. Aman
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  9. Karen Bearss
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  12. Lawrence Scahill
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Correspondence to Lawrence Scahill.

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Conflict of Interest

Over the past two years, Dr. Scahill has served as a consultant to Roche, Shire, Suupernus, Neurocrine, Janssen, Yamo, and the Tourette Association of America; royalties from Guilford, Oxford, American Psychological Association. Dr. Aman has received research contracts, consulted with, served on advisory boards, or done investigator training for Aevi Genomic Medicine; Bracket Global; Hoffman-La Roche; MedAvante, Inc.; MedAvante-Prophase; Ovid Therapeutics; and Zynerba Pharmaceuticals. He receives royalties from Slosson Educational Publications received research. The remaining authors declare that they have no conflict of interest.

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Postorino, V., Gillespie, S., Lecavalier, L. et al. Clinical Correlates of Parenting Stress in Children with Autism Spectrum Disorder and Serious Behavioral Problems. J Child Fam Stud 28, 2069–2077 (2019). https://doi.org/10.1007/s10826-019-01423-7

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