A population-based investigation of behavioral and emotional problems and maternal mental health: Associations with autism spectrum disorder and intellectual disability

School of Psychology, Bangor University, Penrallt Road, Bangor, Gwynedd, Wales, UK.
Journal of Child Psychology and Psychiatry (Impact Factor: 6.46). 01/2011; 52(1):91-9. DOI: 10.1111/j.1469-7610.2010.02295.x
Source: PubMed


While research indicates elevated behavioural and emotional problems in children with autism spectrum disorders (ASD) and decreased well-being in their parents, studies do not typically separate out the contribution of ASD from that of associated intellectual disabilities (ID). We investigated child behavioural and emotional problems, and maternal mental health, among cases with and without ASD and ID in a large population-representative sample.
Cross-sectional comparison of child behavioural and emotional problems and maternal mental health measures among 18,415 children (5 to 16 years old), of whom 47 had an ASD, 51 combined ASD with ID, 590 had only ID, and the remainder were the comparison group with no ASD or ID.
The prevalence of likely clinical levels of behavioural and emotional problems was highest among children with ASD (with and without ID). After controlling for age, gender, adversity, and maternal mental health, the presence of ASD and ID significantly and independently increased the odds for hyperactivity symptoms, conduct, and emotional problems. Emotional disorder was more prevalent in mothers of children with ASD (with or without ID). The presence of ASD, but not ID, significantly increased the odds for maternal emotional disorder. As has been found in previous research, positive maternal mental health was not affected by the presence of ASD or ID.
ASD and ID are independent risk factors for behavioural and emotional problems. ASD (but not ID) is positively associated with maternal emotional disorder. Approaches to diagnosing hyperactivity and conduct problems in children with ASD may need to be reconsidered.

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Available from: Gillian A Lancaster
    • "Children diagnosed with autism spectrum disorder (ASD) have difficulty with sociocommunicative functioning and restricted or repetitive behaviors or interests (American Psychiatric Association 2013) and often present with significant levels of emotional difficulties. For example, in a sample of 5–16-year-olds with ASD and no intellectual disability, 74 % had clinically significant emotional difficulties , such as anger, sadness or anxiety, compared to 18 % of typically developing peers (Totsika et al. 2011). Approximately 40–50 % of youth with ASD (as per DSM- IV-TR criteria) are estimated to meet criteria for two or more psychiatric disorders, often combining externalizing problems, such as ADHD, with internalizing problems, such as anxiety disorders (Leyfer et al. 2006; Simonoff et al. 2008), leading many to conceptualize emotional problems as involving underlying difficulties with emotion regulation (Mazefsky et al. 2013; Mazefsky and White 2014). "
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    ABSTRACT: Children with autism spectrum disorder (ASD) often present with comorbid psychopathology including problems with emotion regulation. The goal of the present research was to investigate the feasibility of a multicomponent manualized cognitive behavior therapy treatment program for improving emotion regulation in youth with ASD 8-12 years of age. Thirteen males and their parents participated in the intervention, reporting high satisfaction with the activities and program overall, and attending all sessions. Preliminary outcomes regarding emotion regulation and psychopathology, and feasibility of the intervention, are summarized and discussed.
    No preview · Article · Apr 2015 · Journal of Autism and Developmental Disorders
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    • "To be included in the study, all individuals received a clinical diagnosis of ID by a registered health professional, verified through parent report of intellectual functioning and report of etiology. Although we cannot ensure the diagnostic status of participants beyond parent report, similar processes have been used to ascertain developmental disability in large-scale parent report surveys of youth with ASD and ID (Daniels et al. 2011; Kogan et al. 2008, 2009; Lin et al. 2012; Totsika et al. 2011), and to be eligible to participate in Special Olympics, caregivers indicate that individuals have an ID at the point of registration . Further, Special Olympics Ontario (SOO) is described as a sport organization for individuals with ID, and caregivers indicated that their children had ID at the point of registration, after reading the following definition of ID: Persons with an ID are eligible to participate in Special Olympics. "
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    ABSTRACT: Most research on mental health in individuals with autism spectrum disorder (ASD) and intellectual disability (ID) has focused on deficits. We examined individual (i.e., sociocommunicative skills, adaptive behavior, functional cognitive skills) and contextual (i.e., home, school, and community participation) correlates of thriving in 330 youth with ID and ASD compared to youth with ID only, 11-22 years of age (M = 16.74, SD = 2.95). Youth with ASD and ID were reported to thrive less than peers with ID only. Group differences in sociocommunicative ability and school participation mediated the relationship between ASD and less thriving. Research is needed to further elucidate a developmental-contextual framework that can inform interventions to promote mental health and wellness in individuals with ASD and ID.
    Full-text · Article · Mar 2015 · Journal of Autism and Developmental Disorders
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    • "In the present study, we measured parental psychological distress, rather than parenting stress, which may partially account for the differences. One large study demonstrated a link between parental psychopathology/psychological distress and the presence of ASD in contrast to typical development (Totsika et al. 2011) and an earlier meta-analysis demonstrated considerable inconsistency among studies but an overall relationship with parental psychopathology that was moderated by the child's level of functioning (Yirmiya and Shaked 2005). More research is needed to disentangle these relationships and understand the link to additional psychopathology as opposed to ASD characteristics. "
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    ABSTRACT: We employed a clinical sample of young children with ASD, with and without intellectual disability, to determine the rate and type of psychiatric disorders and possible association with risk factors. We assessed 101 children (57 males, 44 females) aged 4.5-9.8 years. 90.5 % of the sample met the criteria. Most common diagnoses were: generalized anxiety disorder (66.5 %), specific phobias (52.7 %) and attention deficit hyperactivity disorder (59.1 %). Boys were more likely to have oppositional defiant disorder (OR 3.9). Higher IQ was associated with anxiety disorders (OR 2.9) and older age with agoraphobia (OR 5.8). Night terrors was associated with parental psychological distress (OR 14.2). Most young ASD children met the criteria for additional psychopathology.
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