Institute of Education, University of London.
J Am Acad Child Adolesc Psychiatry. 2013 Oct;52(10):1057-1065.e1. doi: 10.1016/j.jaac.2013.07.011. Epub 2013 Jul 26.
Children with autism spectrum disorder (ASD) are reported to have high rates of co-occurring psychopathology. Little is known about risk factors that might contribute to this psychopathology. This study modeled the effect of family poverty on psychopathology trajectories in young children with ASD, and examined whether home organization and maternal warmth and involvement could buffer the effect of poverty on children's psychopathology.
The sample comprised 209 children with ASD who participated in the UK's Millennium Cohort Study, a population birth cohort study. Individual trajectories of psychopathology at ages 3, 5, and 7 years were analyzed using growth curve models. Psychopathology was assessed with the Strengths and Difficulties Questionnaire.
Children with ASD exhibited increasingly high rates of psychopathology over time. Family poverty was associated with broad and specific (emotional and conduct problems) psychopathology, but not with changes in psychopathology over time. Warmth, involvement, and home organization did not buffer the association of family poverty with psychopathology. However, low warmth explained the relationship between poverty and broad psychopathology, and predicted annual changes in broad psychopathology. Warmth was associated with fewer conduct problems and less hyperactivity, and with an annual decrease in peer and conduct problems. Household chaos was a risk factor for conduct problems, as was maternal involvement for peer problems.
Family poverty, low maternal warmth, and household chaos are risk factors for externalizing problems in children with ASD. Maternal warmth may be a key target for intervention, particularly in poorer families of children with ASD.
自闭症谱系障碍（ASD）儿童报告存在较高的共患精神病理学发生率。对于可能导致这种精神病理学的风险因素知之甚少。本研究通过模型来分析家庭贫困对 ASD 儿童精神病理学轨迹的影响，并探讨家庭组织以及母亲的温暖和投入是否可以缓冲贫困对儿童精神病理学的影响。
该样本包括 209 名参加英国千禧年队列研究的 ASD 儿童，这是一项人口出生队列研究。使用增长曲线模型分析儿童在 3、5 和 7 岁时的精神病理学个体轨迹。使用《长处和困难问卷》评估精神病理学。
ASD 儿童的精神病理学发生率随时间推移呈逐渐升高的趋势。家庭贫困与广泛的和特定的（情绪和行为问题）精神病理学相关，但与精神病理学随时间的变化无关。温暖、投入和家庭组织并不能缓冲家庭贫困与精神病理学之间的关联。然而，低温暖解释了贫困与广泛精神病理学之间的关系，并预测了广泛精神病理学的年度变化。温暖与较少的行为问题和较少的多动有关，并且与同伴和行为问题的年度减少有关。家庭混乱是行为问题的危险因素，而母亲投入是同伴问题的危险因素。
家庭贫困、母亲温暖度低和家庭混乱是 ASD 儿童外化问题的危险因素。母亲的温暖可能是干预的关键目标，尤其是在 ASD 儿童的贫困家庭中。
