Stefanie Zavodny Jackson, PhD, RN, University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Jennifer A. Pinto-Martin, PhD MPH, University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
J Am Psychiatr Nurses Assoc. 2024 Apr;30(2):300-312. doi: 10.1177/10783903221104147. Epub 2022 Jun 16.
Parents of children with autism spectrum disorder (ASD) face unique challenges in raising their children, and they are at higher risk for depression compared to parents of children with typical development (TD) and other disabilities.
(1) To compare prevalence of depressive symptoms among mothers of children with ASD ( = 101), Down syndrome (DS, = 101), and TD ( = 43) and (2) to describe the relationships among depression, self-efficacy, and family functioning, and describe the mediating role of maternal child care self-efficacy between depressive symptoms and child behavior.
In this cross-sectional study, mothers completed the Social Communication Questionnaire, Aberrant Behavior Checklist, Patient Health Questionnaire-9 (PHQ-9), Family Assessment Device General Functioning Scale, and Maternal Self-Efficacy Scale.
Mothers of children with ASD had significantly higher mean PHQ-9 scores ( < .001), higher proportion of positive depression screening ( < .001), and lower family functioning ( < .001). Better family functioning is associated with less depression, better self-efficacy, and less severe ASD symptoms and behaviors. Self-efficacy mediated the relationship between depression and child ASD symptoms, and problematic behavior.
The rates of reported history of depression and low family functioning in mothers of children with ASD are twice the rate in mothers of children with DS and TD. Maternal child care self-efficacy is protective against maternal depression, even in the presence of severe child problematic behaviors and ASD symptoms. Interventions that increase child care self-efficacy and family functioning may be helpful in addressing depression in mothers of children with ASD.
自闭症谱系障碍(ASD)儿童的父母在养育子女方面面临着独特的挑战,与发育正常(TD)儿童和其他残疾儿童的父母相比,他们患抑郁症的风险更高。
(1)比较 ASD(n=101)、唐氏综合征(DS,n=101)和 TD(n=43)儿童母亲抑郁症状的患病率;(2)描述抑郁、自我效能感和家庭功能之间的关系,并描述母亲照顾孩子的自我效能感在抑郁症状和儿童行为之间的中介作用。
在这项横断面研究中,母亲完成了社会沟通问卷、异常行为检查表、患者健康问卷-9(PHQ-9)、家庭评估设备一般功能量表和母亲自我效能感量表。
ASD 儿童的母亲 PHQ-9 得分(<0.001)、阳性抑郁筛查比例(<0.001)和家庭功能(<0.001)显著更高。更好的家庭功能与更少的抑郁、更好的自我效能感以及更轻微的 ASD 症状和行为有关。自我效能感在抑郁与 ASD 症状和行为问题之间起中介作用。
ASD 儿童母亲报告的抑郁史和家庭功能受损的发生率是 DS 和 TD 儿童母亲的两倍。照顾孩子的自我效能感对母亲的抑郁有保护作用,即使孩子有严重的行为问题和 ASD 症状。增加儿童照顾自我效能感和家庭功能的干预措施可能有助于解决 ASD 儿童母亲的抑郁问题。