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Cognitive control and cognitive flexibility predict severity of depressive symptoms in parents of toddlers with autism spectrum disorder

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Abstract

Having a toddler with autism spectrum disorder (ASD) can be challenging for parents and may negatively impact on parents’ mental health. This study examined the relationship between parental depressive symptoms and their cognitive control and cognitive flexibility, and toddlers' ASD symptoms. A total of 68 parents with toddlers with ASD participated in this cross-sectional study. Parents completed a series of questionnaires covering the toddlers’ symptoms of ASD (Gilliam Autism Rating Scale (GARS-2), and their symptoms of depression (Beck Depression Inventory (BDI-II)) and their cognitive control and cognitive flexibility (Cognitive Control and Flexibility Questionnaire (CCFQ)). Pearson correlation coefficient and linear regression were used to analyze the data. Toddlers’ greater severity of ASD symptoms (r = 0.33; p < 05), parents’ a lower ability of cognitive control (r = -0.62; p < 01) and cognitive flexibility (r = -0.33; p < 05) were associated with parents’ greater severity of depressive symptoms. Toddlers’ severity of ASD (11%) and parents’ cognitive control (39%) and cognitive flexibility (11%) explained significant changes of the variance of parents’ depressive symptoms. Parents’ cognitive control, but less so toddlers’ severity of ASD, predicted the severity of their depressive symptoms. Interventions to improve cognitive control among parents of toddlers with ASD might favorably impact on parents’ symptoms of depression.

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References

  • Ahmadi, S. J., Safari, T., Hemmatian, M., & Khalili, Z. (2011). The psychometric properties of Gilliam Autism Rating Scale (GARS). Research in Cognitive and Behavioral Sciences, 1(1), 87–104. https://cbs.ui.ac.ir/article_17282_1a9454b924308ae195c549dd9fd2ab4b.pdf. Accessed 24 Jan 2022

  • Akram, B., Batool, M., & Bibi, A. (2019). Burden of care and suicidal ideation among mothers of children with autism spectrum disorder: perceived social support as a moderator. JPMA, 69(504).

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub. Author.

  • Aqdassi, L., Pouretemad, H. R., Fathabadi, J., & Sadeghi, S. (2019). Family-based tele-intervention of SPARK program on motor proficiency and severity of autism symptoms in children with high functioning autism spectrum disorder: A pilot study [Research]. Razi Journal of Medical Sciences, 25(11), 61–71. http://rjms.iums.ac.ir/article-1-5184-fa.html

  • Bal, V. H., Leventhal, B. L., Carter, G., Kim, H., Koh, Y.-J., Ha, M., Kwon, H.-J., Hong, P., & Kim, Y. S. (2021). Parent-reported suicidal ideation in three population-based samples of school-aged Korean children with autism spectrum disorder and autism spectrum screening questionnaire screen positivity. Archives of Suicide Research, 1–18.

  • Baldessarini, R. J., Innamorati, M., Erbuto, D., Serafini, G., Fiorillo, A., Amore, M., Girardi, P., & Pompili, M. (2017). Differential associations of affective temperaments and diagnosis of major affective disorders with suicidal behavior. Journal of Affective Disorders, 210, 19–21.

    Article  PubMed  Google Scholar 

  • Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck depression inventory (BDI-II) (Vol. 10). Pearson.

  • Brosius, F. (2018). SPSS; Umfassendes Handbuch zu Statistik und Datenanalyse - Comprehensive textbook for statistics and data analysis. mitp Verlags GmBH & Co.

  • Carter, A. S., Martínez-Pedraza, Fd. L., & Gray, S. A. (2009). Stability and individual change in depressive symptoms among mothers raising young children with ASD: Maternal and child correlates. Journal of Clinical Psychology, 65(12), 1270–1280.

    Article  PubMed  Google Scholar 

  • Craig, F., Operto, F. F., De Giacomo, A., Margari, L., Frolli, A., Conson, M., Ivagnes, S., Monaco, M., & Margari, F. (2016). Parenting stress among parents of children with neurodevelopmental disorders. Psychiatry Research, 242, 121–129.

    Article  PubMed  Google Scholar 

  • Dajani, D. R., & Uddin, L. Q. (2015). Demystifying cognitive flexibility: Implications for clinical and developmental neuroscience. Trends in Neurosciences, 38(9), 571–578.

    Article  PubMed  PubMed Central  Google Scholar 

  • De Lissnyder, E., Koster, E. H., Everaert, J., Schacht, R., Van den Abeele, D., & De Raedt, R. (2012). Internal cognitive control in clinical depression: General but no emotion-specific impairments. Psychiatry Research, 199(2), 124–130.

    Article  PubMed  Google Scholar 

  • Disner, S. G., Beevers, C. G., Haigh, E. A., & Beck, A. T. (2011). Neural mechanisms of the cognitive model of depression. Nature Reviews Neuroscience, 12(8), 467–477.

    Article  PubMed  Google Scholar 

  • Dixon, M. L. (2015). Cognitive control, emotional value, and the lateral prefrontal cortex. Frontiers in Psychology, 6, 758.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dubreucq, J., Plasse, J., Gabayet, F., Faraldo, M., Blanc, O., Chereau, I., Cervello, S., Couhet, G., Demily, C., & Guillard-Bouhet, N. (2020). Self-stigma in serious mental illness and autism spectrum disorder: Results from the REHABase national psychiatric rehabilitation cohort. European Psychiatry, 63(1).

  • Falk, N. H., Norris, K., & Quinn, M. G. (2014). The factors predicting stress, anxiety and depression in the parents of children with autism. Journal of Autism and Developmental Disorders, 44(12), 3185–3203.

    Article  PubMed  Google Scholar 

  • Feng, Y., Zhou, X., Liu, Q., Deng, T., Qin, X., Chen, B., & Zhang, L. (2022). Symptom severity and posttraumatic growth in parents of children with autism spectrum disorder: The moderating role of social support. Autism Research, 15(4), 602–613.

    Article  PubMed  Google Scholar 

  • Gabrys, R. L., Tabri, N., Anisman, H., & Matheson, K. (2018). Cognitive control and flexibility in the context of stress and depressive symptoms: The cognitive control and flexibility questionnaire. Frontiers in Psychology, 2219.

  • Ghassemzadeh, H., Mojtabai, R., Karamghadiri, N., & Ebrahimkhani, N. (2005). Psychometric properties of a Persian-language version of the Beck Depression Inventory-Second edition: BDI-II-PERSIAN. Depression and Anxiety, 21(4), 185–192. https://doi.org/10.1002/da.20070

    Article  PubMed  Google Scholar 

  • Gilliam, J. E. (2006). Gilliam autism rating scale: GARS 2. Pro-ed.

  • Grahek, I., Everaert, J., Krebs, R. M., & Koster, E. H. (2018). Cognitive control in depression: Toward clinical models informed by cognitive neuroscience. Clinical Psychological Science, 6(4), 464–480.

    Article  Google Scholar 

  • Grahek, I., Shenhav, A., Musslick, S., Krebs, R. M., & Koster, E. H. (2019). Motivation and cognitive control in depression. Neuroscience & Biobehavioral Reviews, 102, 371–381.

    Article  Google Scholar 

  • Grawe, K. (2004). Psychological therapy. Hogrefe Publishing.

    Google Scholar 

  • Grawe, K., & Bernauer, F. (1994). Development of pychotherapy—from the confession to profession. Hogrefe.

    Google Scholar 

  • Grawe, K. (2007). Counseling and psychotherapy investigating practice from scientific, historical, and cultural perspectives. Neuropsychotherapy: How the neurosciences inform effective psychotherapy. In: Lawrence Erlbaum Associates, Mahwah.

  • Hair, J. F., Black, C. W., Babin, B. J., & Anderson, R. E. (2014). Multivariate data analysis (7th ed.). Pearson Education Limited.

    Google Scholar 

  • Hamidi, R., Fekrizadeh, Z., Azadbakht, M., Garmaroudi, G., Taheri Tanjani, P., Fathizadeh, S., & Ghisvandi, E. (2015). Validity and reliability Beck Depression Inventory-II among the Iranian elderly Population. Journal of Sabzevar University of Medical Sciences, 22(1), 189–198. http://jsums.sinaweb.net/article_550_c326338d69b115a13f8996b01613b38f.pdf. Accessed 23 Jan 2022

  • Harvey, P.-O., Fossati, P., Pochon, J.-B., Levy, R., LeBastard, G., Lehéricy, S., Allilaire, J.-F., & Dubois, B. (2005). Cognitive control and brain resources in major depression: An fMRI study using the n-back task. NeuroImage, 26(3), 860–869.

    Article  PubMed  Google Scholar 

  • Healy, O., O’Connor, J., Leader, G., & Kenny, N. (2008). Three years of intensive applied behavior analysis: A case study. Journal of Early and Intensive Behavior Intervention, 5(1), 4.

    Article  Google Scholar 

  • Hoorelbeke, K., & Koster, E. H. (2017). Internet-delivered cognitive control training as a preventive intervention for remitted depressed patients: Evidence from a double-blind randomized controlled trial study. Journal of Consulting and Clinical Psychology, 85(2), 135.

    Article  PubMed  Google Scholar 

  • Hoorelbeke, K., & Koster, E. (2018). Ten years of cognitive control training for depression: An overview of findings and challenges. Tijdschrift Voor Psychiatrie, 60(6), 403–410.

    PubMed  Google Scholar 

  • Jahan, S., Araf, K., Gozal, D., Griffiths, M., & Mamun, M. A. (2020). Depression and suicidal behaviors among Bangladeshi mothers of children with Autistic Spectrum Disorder: a comparative study. Asian Journal of Psychiatry.

  • Kanfer, F., Reinecker, H., & Schmelzer, D. (2011). Selbstmanagement-therapie [Self-management therapy]. Springer.

    Google Scholar 

  • Kanfer, F., & Hagerman, S. (1987). A model of self-regulation. In Motivation, intention, and volition (pp. 293–307). Springer.

  • Koster, E. H., Hoorelbeke, K., Onraedt, T., Owens, M., & Derakshan, N. (2017). Cognitive control interventions for depression: A systematic review of findings from training studies. Clinical Psychology Review, 53, 79–92.

    Article  PubMed  Google Scholar 

  • Kütük, M. Ö., Tufan, A. E., Kılıçaslan, F., Güler, G., Çelik, F., Altıntaş, E., Gökçen, C., Karadağ, M., Yektaş, Ç., & Mutluer, T. (2021). High depression symptoms and burnout levels among parents of children with autism spectrum disorders: A multi-center, cross-sectional, case-control study. Journal of Autism and Developmental Disorders, 51(11), 4086–4099.

    Article  PubMed  Google Scholar 

  • Lanyi, J., Mannion, A., Chen, J. L., & Leader, G. (2021). Relationship between comorbid psychopathology in children and adolescents with autism spectrum disorder and parental well-being. Developmental Neurorehabilitation, 1–11.

  • Lazarus, R. S. (1993). From psychological stress to the emotions: A history of changing outlooks. Annual Review of Psychology, 44(1), 1–22.

    Article  PubMed  Google Scholar 

  • Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer.

    Google Scholar 

  • Lord, C., Elsabbagh, M., Baird, G., & Veenstra-Vanderweele, J. (2018). Autism spectrum disorder. The Lancet, 392(10146), 508–520.

    Article  Google Scholar 

  • Maramis, M. M., Mahajudin, M. S., & Khotib, J. (2021). Impaired cognitive flexibility and working memory precedes depression: A rat model to study depression. Neuropsychobiology, 80(3), 225–233.

    Article  PubMed  Google Scholar 

  • Mills, F., Bartlett, T. E., Dissing-Olesen, L., Wisniewska, M. B., Kuznicki, J., Macvicar, B. A., Wang, Y. T., & Bamji, S. X. (2014). Cognitive flexibility and long-term depression (LTD) are impaired following β-catenin stabilization in vivo. Proceedings of the National Academy of Sciences, 111(23), 8631–8636.

    Article  Google Scholar 

  • Miranda, A., Mira, A., Berenguer, C., Rosello, B., & Baixauli, I. (2019). Parenting stress in mothers of children with autism without intellectual disability. Mediation of behavioral problems and coping strategies. Frontiers in Psychology, 10, 464.

    Article  PubMed  PubMed Central  Google Scholar 

  • Paulus, M. P. (2015). Cognitive control in depression and anxiety: Out of control? Current Opinion in Behavioral Sciences, 1, 113–120.

    Article  Google Scholar 

  • Pisula, E. (2007). A comparative study of stress profiles in mothers of children with autism and those of children with Down’s syndrome. Journal of Applied Research in Intellectual Disabilities, 20(3), 274–278.

    Article  Google Scholar 

  • Pouretemad, H. R., Fathabadi, J., Sadeghi, S., & Shalani, B. (2016). The effectiveness of social skills training on autism spectrum disorder symptoms in adolescents: A Quasi-experimental study. Journal of Research In Rehabilitation Sciences, 12(4), 216–220. https://doi.org/10.22122/jrrs.v12i4.2751

    Article  Google Scholar 

  • Pouretemad, Fathabadi, J., Sadeghi, S., & Shalani, B. (2017). The effectiveness of social skills training on autism spectrum disorder symptoms in adolescents: A Quasi-experimental study. Journal of Research in Rehabilitation Sciences, 12(4), 216–220.

    Google Scholar 

  • Rodriguez, G., Hartley, S. L., & Bolt, D. (2019). Transactional relations between parenting stress and child autism symptoms and behavior problems. Journal of Autism and Developmental Disorders, 49(5), 1887–1898.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sadeghi, S., & Pouretemad, H. R. (2022a). Cognitive predictors of behavioral inflexibility in young children with autism spectrum disorder symptoms [Research]. Advances in Cognitive Sciences, 23(4), 117–129. https://doi.org/10.30514/icss.23.4.117

    Article  Google Scholar 

  • Sadeghi, S., & Pouretemad, H. R. (2022b). Executive functions predict restricted and repetitive behaviors in toddlers under 36 months old with autism spectrum disorder. Infant Behavior and Development, 67, 101721. https://doi.org/10.1016/j.infbeh.2022.101721

  • Sadeghi, S., Pouretemad, H. R., & Fathabadi, J. (2017). Effectiveness of social skills training on behavioral problems and social skills in high-functioning adolescents with autism spectrum disorder (ASD). Quarterly of Applied Psychology, 10(4), 477–499.

    Google Scholar 

  • Sadeghi, S., Pouretemad, H., Khosrowabadi, R., Fathabadi, J., & Nikbakht, S. (2019a). Behavioral and electrophysiological evidence for parent training in young children with autism symptoms and excessive screen-time. Asian Journal of Psychiatry, 45, 7–12.

    Article  PubMed  Google Scholar 

  • Sadeghi, S., Pouretemad, H. R., Khosrowabadi, R., Fathabadi, J., & Nikbakht, S. (2019b). Effects of parent–child interaction training on children who are excessively exposed to digital devices: A pilot study. The International Journal of Psychiatry in Medicine, 54(6), 408–423. https://doi.org/10.1177/0091217419837070

    Article  PubMed  Google Scholar 

  • Sadeghi, S., Pouretemad, H. R., Khosrowabadi, R., Fathabadi, J., & Nikbakht, S. (2021a). Parent–child interaction effects on autism symptoms and EEG relative power in young children with excessive screen-time. Early Child Development and Care, 191(6), 827–836.

    Article  Google Scholar 

  • Sadeghi, S., Pouretemad, H. R., & Shalani, B. (2021b). Internet-based versus face-to-face intervention training for parents of young children with excessive screen-time and autism spectrum disorder–like symptoms: a comparative study. International Journal of Developmental Disabilities, 1–12.

  • Schnabel, A., Youssef, G. J., Hallford, D. J., Hartley, E. J., McGillivray, J. A., Stewart, M., Forbes, D., & Austin, D. W. (2020). Psychopathology in parents of children with autism spectrum disorder: A systematic review and meta-analysis of prevalence. Autism, 24(1), 26–40.

    Article  PubMed  Google Scholar 

  • Solano, P., Ustulin, M., Pizzorno, E., Vichi, M., Pompili, M., Serafini, G., & Amore, M. (2016). A Google-based approach for monitoring suicide risk. Psychiatry Research, 246, 581–586.

    Article  PubMed  Google Scholar 

  • Soltani, E., Shareh, H., Bahrainian, S. A., & Farmani, A. (2013). The mediating role of cognitive flexibility in correlation of coping styles and resilience with depression. Pajoohandeh Journal, 18(2), 88–96.

    Google Scholar 

  • Stange, J. P., Alloy, L. B., & Fresco, D. M. (2017). Inflexibility as a vulnerability to depression: A systematic qualitative review. Clinical Psychology : A Publication of the Division of Clinical Psychology of the American Psychological Association, 24(3), 245–276. https://doi.org/10.1111/cpsp.12201

    Article  PubMed  Google Scholar 

  • Vervaeke, J., Van Looy, J., Hoorelbeke, K., Baeken, C., & Koster, E. H. (2018). Gamified cognitive control training for remitted depressed individuals: User requirements analysis. JMIR Serious Games, 6(2), e8609.

    Article  Google Scholar 

  • Wolkenstein, L., & Plewnia, C. (2013). Amelioration of cognitive control in depression by transcranial direct current stimulation. Biological Psychiatry, 73(7), 646–651.

    Article  PubMed  Google Scholar 

  • World Medical Association. (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053

    Article  Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • Yu, Y., Yu, Y., & Lin, Y. (2020). Anxiety and depression aggravate impulsiveness: The mediating and moderating role of cognitive flexibility. Psychology, Health & Medicine, 25(1), 25–36.

    Article  Google Scholar 

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Acknowledgements

We thank all the participants in this study. We also greatly appreciate the support from Tehran Autism Center (https://ctad.ir/en/).

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Authors and Affiliations

  1. Institute for Cognitive and Brain Sciences (ICBS), Shahid Beheshti University (SBU), Tehran, Iran

    Saeid Sadeghi & Hamid Reza Pouretemad

  2. Center of Excellence in Cognitive Neuropsychology, Shahid Beheshti University, Tehran, Iran

    Saeid Sadeghi & Hamid Reza Pouretemad

  3. Psychiatric Clinics (UPK), Center of Affective, Stress and Sleep Disorders (ZASS), University of Basel, Basel, Switzerland

    Serge Brand

  4. Faculty of Medicine, Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, Basel, Switzerland

    Serge Brand

  5. Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran

    Serge Brand

  6. Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran

    Serge Brand

  7. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Serge Brand

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  1. Saeid Sadeghi
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  2. Hamid Reza Pouretemad
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  3. Serge Brand
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Contributions

The authors confirm contribution to the paper as follows: study conception and design: SS and HRP; data collection: SS; analysis and interpretation of results: SS; draft manuscript preparation: SS and SB.

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Correspondence to Saeid Sadeghi or Serge Brand.

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All study procedures were performed after the study was approved by the Ethics Committee of the Shahid Beheshti University (SBU.ICBS 96/1020).

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Sadeghi, S., Pouretemad, H.R. & Brand, S. Cognitive control and cognitive flexibility predict severity of depressive symptoms in parents of toddlers with autism spectrum disorder. Curr Psychol 42, 25594–25601 (2023). https://doi.org/10.1007/s12144-022-03682-y

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