Disassociation of Maternal Stress in Autism, Fragile X, and Fragile X with Autism

Background:  Elevated parenting stress in mothers of children with developmental disabilities has been linked to a range of negative outcomes including increased maladaptive parenting behaviors, greater incidence of maternal psychopathology, failure to engage with services, and less beneficial outcomes for children (Osborne et al., 2008). Though high levels of parenting stress have been reported for mothers across various clinical populations, maternal adaptation has been found to vary significantly according to the nature of a child’s disability. Results of efforts to understand the association between certain child characteristics and maternal stress have indicated a strong positive relationship between child problem behaviors and mothers’ stress (Hastings, 2003). Fragile X syndrome (FXS) and autism spectrum disorder (ASD) are two developmental disabilities marked by high levels of maladaptive behavior and associated maternal stress. Recent investigations have suggested that child maladaptive behavior may serve as the most salient predictor of maternal stress in both of these populations (Ekas & Whitman, 2010; Johnston et al., 2003). To date, no studies have examined the dissociation of maternal stress across these two groups of mothers whose children often share a number of behavioral characteristics.  

Objectives:  Due to the significant negative effect of maternal parenting stress on the child and family system, we investigated the relationship between child problem behavior and multiple dimensions of maternal parental stress among 3 high risk maternal groups, those with: a child with idiopathic (non-FXS) autism (IA), a child with FXS only (FXS), and a child diagnosed with FXS and autism (FXSA).

Methods:  Participants were 102 biological mothers of sons with FXS (n=48), IA (n=19), and FXSA (n=19).  Children were between the ages of 11 months and 14.5 years.  Mothers completed the Wechsler Abbreviated Scale of Intelligence (WASI; mean=104), Child Behavior Checklist (CBCL; measure of child problem behavior), and Parenting Stress Index (PSI) as part of a larger study.  The PSI yields three scales: Parental Distress (PD), Parent-Child Dysfunctional Interaction (P-CDI), and Difficult Child (DC).  Each subscale served as a dependent variable in this study due to our interest in dimensions of maternal parenting stress.

Results:  Three hierarchical regression models were constructed. Covariates (maternal IQ and age) were entered first, followed by group status, then CBCL scores, then the interaction between group and CBCL. In the P-CDI and PD models, child problem behavior significantly predicted parenting stress (β = .601, t = 3.228, p = .002; β= .579, t = 3.103, p = .003, respectively), but this relationship did not vary by group. The overall model for DC was significant (R = .795, R² = .632, F(5,93) =31.88, p < .001) in addition to the interaction between CBCL and group (β = 1.326, t = 2.719, p = .008) indicating that maternal parenting stress was lowest for children with FXS when child problem behavior was low.

Conclusions:  Findings replicate previous research indicating a significant relationship between child problem behaviors and parenting stress and indicate that there are differences when taking a dimensional approach to stress.