The Longitudinal Impact of Marital Adjustment and Social Support on Stress in Primary Caregivers of Children with ASD
Objectives: The current study examined the cross-sectional and longitudinal relationships among general and contextual social support, marital adjustment, and outcomes in primary caregivers of children with ASD shortly after receiving the diagnosis. Specifically, we examined whether there is a compensatory or additive mechanism among sources of social support in their impact on caregiver outcomes.
Methods: Primary caregivers of children diagnosed with ASD within the past six months (N = 79) were first recruited at baseline and again 12 months later (N = 65). Participants were assessed on caregiver outcomes using predictors within the double ABCX model (McCubbin & Patterson, 1983), e.g., life demands, social support, marital adjustment.
Results: At baseline, marital adjustment correlated with caregiver burden (r =-.56, p<.001 ), family burden (r =-.48, p<.001 ), and mental health-related quality of life (r = .25, p =.04 ). Multivariately, marital adjustment (Beta = -.26, p = .02) and general social support (Beta = -.46, p<.001) predicted baseline caregiver stress, R2 = .59, F (6, 58) = 13.69, p<.001; life demands (Beta = .33, p = .005) and general social support (Beta = -.33, p = .012) predicted family burden, R2 = .51, F (6, 58) = 10.19, p< .001. Longitudinally, controlling for baseline caregiver outcomes, as well as parent, family, and child factors at baseline and changes in those variables, the results showed that interactions between contextual social support from the ASD community and providers and marital adjustment (Beta =-.32, p = .024) predicted caregiver stress at follow-up, R2 =.74, F (20, 58)= 8.38, p< .001.
Conclusions: An additive model was supported. When caregivers perceive low contextual social supports from the ASD community and ASD providers, the level of their marital adjustment does not impact their long term caregiver stress level; however, when they perceive high levels of contextual social support, better marital adjustment predicted decreased stress long term.