What Contributes to Parenting Stress and Challenges in the Parent-Adolescent Dyad?: Consideration of Both Parent and Adolescent Factors.

Background: Parents of adolescents with ASD face unique challenges. Unsurprisingly, there is ample evidence suggesting that these parents experience increased stress and challenges in parent-adolescent dynamics, especially for those with more severe ASD symptoms. Moreover, many parents also have an increased proclivity to be affected by intra-individual challenges, including psychopathologies such as anxiety and depression. Such predispositions may exacerbate and be exacerbated by parenting struggles. However, research has yet to examine the relative impact of adolescent and parent factors on parenting stress and parent-adolescent relationships in families of adolescents with ASD, nor the potential malleability of parental depression through a social skills intervention for adolescents with ASD.

Objectives: This study examined the relative importance of parent depression, adolescent ASD symptomology, and adolescent physiological regulation on parenting stress and the parent-adolescent relationship, as well as the effect of the PEERS^®social skills intervention on parent depression.

Methods: Sixty-four adolescents (Age: M=13.67, SD=1.5; IQ: M=99.64, SD=17.72) with ASD participated in this study. ASD was confirmed using the ADOS. Participants were randomly assigned to an experimental (n=32) or waitlist group (n=32) for participation in the PEERS^®(Laugeson & Frankel, 2010) social skills intervention. All parents completed questionnaires assessing their own depressive symptoms (Beck Depression Inventory), parenting stress (Stress Index for Parents of Adolescents), parent-adolescent relationship quality (Parenting Relationship Questionnaire and Parent-Child Relationship Inventory), and their adolescent’s social abilities (Social Responsiveness Scale) during the intake appointment. Parents also reported on their depressive symptoms 15 weeks after the initial intake (post intervention for the experimental group). Respiratory Sinus Arrhythmia (RSA) was measured using Porges and Bohrer’s (1990) technique via the Cardioedit and Cardiobatch programs (Porges: Chicago, IL) at intake.

Results: Parent Depression and Adolescent ASD Symptoms were related to, and each explained unique variance in, multiple dimensions of parenting stress and parent-adolescent relationship dynamics in families of youth with ASD (Table 1 and 2). Of note, when considered together, Parent Depression but not Child ASD Symptoms explained unique variance in the parent-domain of the parenting stress measure (Table 2). Adolescent RSA was related to specific components of parenting stress and parent-adolescent relationship factors (Table 1) such that higher RSA (less dysregulation) was related to less stress in the parent-adolescent relationship domain and better communication. Importantly, Parent Depression decreased from pre- to post-intervention for the experimental group (t(29)=2.07, p=0.05), while no such decrease was evident in the waitlist group (t(32)=-0.32, p=0.75).

Conclusions:  Parents suffering from depressive symptoms and those parenting an adolescent with more severe ASD symptomology or greater physiological dysregulation were likely to experience heightened parenting stress and greater struggles in the parent-adolescent relationship. An alternate interpretation of these findings may be that depressed parents were more likely to perceive the challenges of parenting as more stressful and the parent-adolescent relationship as less optimal. Furthermore, receiving a social skills intervention for their adolescent may ameliorate depressive symptoms in parents of adolescents with ASD. Regardless, this study demonstrates the importance of considering individual differences among parents of adolescents with ASD in future research.