Mental Stress in Parents of Autistic Children: A Pilot Study of the Related Psychological Dimensions

Background: Parental mental stress is clinically common in families of autistic children and adversely affects the care of the child. Moreover, parents of autistic children frequently experience feelings of guilt, maladaptive coping styles, lack of ability to forgive himself and the partner, and low mindfullness ability. However, is unclear which of these dimensions is predominant in these families and if it their associations are symmetrical in presence of high or low values.

Objectives:  The aims of this pilot study are: 1) to evaluate the most predominant dimensions in parents of autistic children and to establish the hierarchy of their relationship; 2) to evaluate if psychological dimensions works in different way when they are high or low; 3) to establish if psychological dimensions in parents of autistic children are related to the severity of the Autism Spectrum Disorder (ASD).

Methods:  Demographic and psychological information about mental stress, feelings of guilt, ability to forgive, mindfullness ability and coping styles were collected through clinical interviews and self-report questionnaires in 28 parents (mean age 43.5 yrs; 22 mothers; 6 fathers) of autistic children (mean age: 12.2 yrs; 3 females; 25 males). Severity of the ASD was assessed through Autism Diagnostic Observation Schedule (ADOS). Artificial Neural Networks (Auto-CM system) were applied to highlight the associations among variables under study. Auto-CM is fourth generation Artificial Neural Network developed at Semeion Research Institute (Rome) and successfully applied in many complex chronic degenerative diseases, able to find out consistent trends and associations among variables creating a semantic connectivity map. The matrix of connections, visualized through minimum spanning tree filter, takes into account nonlinear associations among variables and captures connection schemes among clusters.

Results:  Predominant dimensions in parents of autistic children were low feelings of guilt for himself and the partner, high levels of forgiveness of himself and the partner, and low levels of maladaptive coping responses. These three main dimensions are strictly related among themselves. While high parental mental stress was strictly related to high parental distress subscales, high maladaptive coping styles, and low self-forgiveness ability, conversely, low mental stress appeared to be marginal in relation to the other psychological dimensions. This behavior is typical of complex nonlinear systems. The severity of the ASD was not  related to parental psychological dimensions. The ADOS scores, both low and high, were in fact marginal in the connectivity map in relation to the other dimensions.

Conclusions:  The interplay of psychological factors related to parental stress is complex. Understanding these relationships is the starting point to activate and enhance parental resources essential to the wellbeing of both children and caregivers. Due to the complexity of these relationships and the lack of symmetry between associations of the same dimension when high or low, the approach with advanced neural networks is essential for the analysis of the patterns of relationships.