Family Functioning and Maternal Depression: A Latent Growth Curve Analysis

Background: Families of children diagnosed with autism spectrum disorders (ASD) may experience considerable disruptions in family functioning. Elevated levels of depressive symptoms among mothers of children with ASD have been well established (Montes & Halterman, 2007) and are likely to present additional stress to the family system. The simultaneous examination of parental depressive symptoms and family functioning over time would likely yield a more complete understanding of the family system.

Objectives: The purpose of this study was two-fold: 1) to examine the simultaneous trajectories of maternal depression and family functioning over a 3-year period in a large inception cohort of young children with ASD; and, 2) to examine the impact of autism severity, maternal coping strategies, and social support on those trajectories.

Methods: Data were drawn from the Canadian Pathways in ASD study and included 163 children. Data were collected within 4 months of diagnosis (T1; mean age = 36.5 months, SD = 6.6), 24 months later (T2); and when the child was 6 years old (T3). Mothers completed the General Family Functioning subscale of the McMaster Family Assessment Device (Byles, Byrne, Boyle, & Offord, 1988), the Symptom Checklist-90-R (Derogatis, 1994) to assess maternal depression, the Ways of Coping Scales (Folkman & Lazarus,1988) to assess coping strategies, the Social Support Survey (NLSCY, 2008-2009), and the Social Responsiveness Scale (SRS; Constantino & Todd, 2000) to measure ASD severity.  Latent growth curve analysis was employed to examine trajectories and predictors. The model employed maximum likelihood estimation with robust standard errors using Mplus Version 6.11. 

Results: Tests of model fit revealed a well-fitting model (RMSEA = 0.01; Chi-square = 25.54; p = 0.43). Results indicated significant inter-individual variation around the intercepts of both depression and family functioning. No significant changes were found for either family functioning or mothers’ depressive symptoms over time in the group as a whole (Estimate = 0.013, p = 0.85; estimate = -0.02, p = 0.61, respectively). However, results documented a negative covariance between the intercept and the slope of family functioning, implying that families with high levels of family dysfunction at T1 tended to show improved functioning over time, whereas those with better functioning tended to worsen (estimate = -0.05, p = 0.01). In addition, significant covariation was found between family dysfunction and maternal depression at both T1 and over time. Regarding correlates at T1 (intercept), both use of a positive reappraisal coping strategy and social support were associated with lower levels of both family dysfunction and maternal depression. Conversely, an escape avoidance coping strategy was associated with higher levels of both family dysfunction and maternal depression. In addition, a confrontive coping strategy was associated with a higher level of family dysfunction. No significant associations were found with autism severity, as measured by the SRS.

Conclusions: Overall, both depressive symptoms and family functioning were stable over a 3-year period in mothers of young children with ASD. The results emphasize the importance of early intervention that addresses family well-being and that encourages the use of positive coping strategies.