Caractéristiques cliniques et individuelles associées au stress maternel chez les jeunes adolescents avec un diagnostic de "trouble du spectre de l'autisme"

Aperçu: G.M.

Les parents de personnes avec un diagnostic de "trouble du spectre de l'autismeé vivent à la fois des événements stressants négatifs et positifs. Plusieurs caractéristiques cliniques et sociodémographiques des enfants autistes ont été associées au stress parental dans leur famille. Cependant, peu d'études se sont concentrées sur les adolescents et le rôle de la déficience cognitive a rarement été abordé.
L'objectif principal de la présente recherche est d'explorer les associations entre les symptômes de l'autisme, les troubles cognitifs, les problèmes émotionnels et comportementaux, les caractéristiques sociodémographiques et le stress maternel chez un échantillon de jeunes adolescents avec un diagnostic de "trouble du spectre de l'autisme" avec et sans troubles cognitifs.
La déficience cognitive et les problèmes émotionnels et comportementaux sont associés au stress maternel, tandis que les symptômes de l'autisme semblent jouer un rôle mineur.
L'éducation et la profession de la mère ne sont associées au stress maternel que dans le groupe ayant une déficience cognitive, tandis que l'âge maternel est associé au stress dans le groupe d'adolescentes sans déficience cognitive. 

Les implications liées à l'âge pour l'intervention et les orientations futures de la recherche sont discutées.

. 2021 May 20.  doi: 10.1002/aur.2539. 

Clinical and individual features associated with maternal stress in young adolescents with autism spectrum disorder

Francesco Scibelli  ¹ , Elisa Fucà  ¹ , Silvia Guerrera  ¹ , Elisabetta Lupi  ¹ , Paolo Alfieri  ¹ , Giovanni Valeri  ¹ , Stefano Vicari  ^{1   2}

Affiliations

• PMID: 34013607
• DOI: 10.1002/aur.2539

Abstract

Parents of people with autism spectrum disorder experience both negative stressful and positive events. Several clinical and socio-demographic features of children on the autism spectrum have been associated with parenting stress in their families. However, there have been few studies that focus on adolescents and the role of cognitive impairment has rarely been addressed. The main aim of the present research is to explore associations between autism symptoms, cognitive impairment, emotional and behavioral problems, socio-demographic features, and maternal stress in a sample of young adolescents with Autism Spectrum Disorder with and without cognitive impairment. Cognitive impairment and emotional and behavioral problems are associated with maternal stress, while autism symptoms seem to play a minor role. Maternal education and occupation are only associated with maternal stress in the group with cognitive impairment, while maternal age is stress-associated in the group of adolescents without cognitive impairment. Age-related implications for intervention and future research directions are discussed. LAY SUMMARY: Parents of individuals on the autism spectrum are exposed to both negative stressful and enriching experiences during their parenthood. While the influence of several child characteristics and socio-demographic features on parental stress during childhood has been widely explored in past studies, studies on teenagers are limited. The aim of the present research is to explore the influence of several characteristics on maternal stress levels in families with teenagers on the autism spectrum. We found that cognitive impairment and emotional and behavioral problems are associated with maternal stress, while autism symptoms seem to play a minor role. Socio-demographic features are not associated with maternal stress. Broadly speaking, the subjective perception of parental distress in both groups is less related to teenagers' characteristics then the perception of having a difficult interaction with the teenagers. We divided our participants into two groups (one group with cognitive impairment and the other group without). We found that mothers of teenagers with cognitive impairment are generally more stressed compared to the other group. Furthermore, we confirm that emotional and behavioral problems seem to play a major role in maternal stress (especially in the group without cognitive impairment), while autism symptoms seem to play a minor role. Furthermore, we found that maternal education/occupation and maternal age are associated with maternal stress in the group with and the group without cognitive impairment respectively. This research highlights the association between several variables and stress in mothers of adolescents on the spectrum. Results are discussed in the framework of previous findings highlighting the lack of adequate care and support services for families, especially for those of adolescents on the spectrum with cognitive impairment.

Keywords: adolescence; autism symptoms; cognitive; emotional and behavioral problems; maternal stress; parent mediated therapy; socio-demographic features.

© 2021 International Society for Autism Research and Wiley Periodicals LLC.

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Stress maternel prénatal et risque de troubles neurologiques du développement de la progéniture: revue systématique et méta-analyse

Aperçu: G.M.

OBJET:
On a signalé que l'exposition au stress prénatal avait une incidence sur le risque de développement neurologique défavorable chez la progéniture; Cependant, il n’existe actuellement aucun consensus clair. Le but de cette revue systématique et de cette méta-analyse était d'examiner la littérature existante sur l'association entre le stress prénatal et les "troubles du spectre de l'autisme" (TSA) et le trouble de déficit de l'attention avec hyperactivité (TDAH) chez la progéniture.
MÉTHODES:
Sur la base d'un protocole enregistré, nous avons recherché dans plusieurs bases de données électroniques des articles conformément à une stratégie de recherche détaillée. Nous avons effectué cette étude en suivant les éléments de rapport préférés pour les examens systématiques et les méta-analyses (PRISMA).
RÉSULTATS:
Le stress prénatal était associé de manière significative à un risque accru de TSA (OR groupé 1,64 [IC 95% 1,15-2,34], I2 = 90%, 15 articles) et de TDAH (OR groupé 1,72 [IC 95% 1,27-2,34]; I2 = 85%; 12 articles).
CONCLUSIONS:

Cette étude suggère que le stress prénatal peut être associé aux TSA et au TDAH; Toutefois, il convient de noter plusieurs limitations dans la littérature examinée, notamment une hétérogénéité significative, et des études futures soigneusement contrôlées dans ce domaine sont nécessaires.

Soc Psychiatry Psychiatr Epidemiol. 2019 Jul 20. doi: 10.1007/s00127-019-01745-3.

Prenatal maternal stress and risk of neurodevelopmental disorders in the offspring: a systematic review and meta-analysis

Manzari N^1,2, Matvienko-Sikar K³, Baldoni F¹, O'Keeffe GW^4,5, Khashan AS^6,7,8.

Author information

1

Department of Psychology, University of Bologna, Bologna, Italy.

2

The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland.

3

School of Public Health, University College Cork, Cork, Ireland.

4

Department of Anatomy and Neuroscience and Cork Neuroscience Centre, University College Cork, Cork, Ireland. g.okeeffe@ucc.ie.

5

University College Cork, Room 4.119, Western Gateway Building, Western Road, Cork, Ireland. g.okeeffe@ucc.ie.

6

The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland. a.khashan@ucc.ie.

7

School of Public Health, University College Cork, Cork, Ireland. a.khashan@ucc.ie.

8

University College Cork, Room 4.11, Western Gateway Building, Western Road, Cork, Ireland. a.khashan@ucc.ie.

Abstract

PURPOSE:

Exposure to prenatal stress has been reported to affect the risk of adverse neurodevelopmental outcomes in the offspring; however, there is currently no clear consensus. The aim of this systematic review and meta-analysis was to examine the existing literature on the association between prenatal stress and autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) in the offspring.

METHODS:

Based on a registered protocol, we searched several electronic databases for articles in accordance with a detailed search strategy. We performed this study following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA).

RESULTS:

Prenatal stress was significantly associated with an increased risk of both ASD (pooled OR 1.64 [95% CI 1.15-2.34]; I² = 90%; 15 articles) and ADHD (pooled OR 1.72 [95% CI 1.27-2.34]; I² = 85%; 12 articles).

CONCLUSIONS:

This study suggests that prenatal stress may be associated with ASD and ADHD; however, several limitations in the reviewed literature should be noted including significant heterogeneity and there is a need for carefully controlled future studies in this area.

KEYWORDS:

Attention-deficit/hyperactivity disorder; Autism spectrum disorder; Mental health; Pregnancy; Prenatal maternal stress

PMID:31324962

DOI:10.1007/s00127-019-01745-3

[Réduction du stress parental maternel des enfants avec un diagnostic de trouble du spectre de l'autisme: implication du père]

Aperçu: G.M.

L'objectif de la recherche était d'explorer la relation entre le temps de soins des pères et le stress parental maternel des enfants avec un diagnostic de trouble du spectre de l'autisme (dTSA).  

Les mères de 98 enfants avec dTSA qui ont été diagnostiqués pour la première fois dans le département des soins pédiatriques de l'Université de Fudan entre juin 2015 et janvier 2016 ont été inclus dans le groupe TSA, avec 92 mères d'enfants au développement typique. 

L'évaluation du stress parental, le temps de soins des parents et d'autres facteurs connexes ont été analysés de façon transversale.

Le stress parental maternel des enfants autistes a une corrélation négative significative avec le temps de soins du père sur le score de stress total parental, alors qu'aucune corrélation de ce type n'a été trouvée dans le groupe témoin en termes de temps de soins du père (P = 0,22, 0,42, 0,06).  

Le test de Wilcoxon Rank-Sum a montré que chez les 62 familles dTSA (63,3%) à double revenu et 72 (78,3%) familles sans dTSA à double revenu, il y avait des différences significatives entre les pères TSA et les mères dTSA et le temps de pères typique (2,0 (0,5, 2,1) contre 3,5 (2,4, 6,0) contre 3,0 (2,0, 4,7) h, t = -86,32, -49,65, tous P <0,01).  

L'absence de participation des pères était courante chez les familles d'enfants autistes. L'augmentation du temps de soin des pères, ainsi que leur enthousiasme et leur initiative dans l'intervention familiale pourraient soulager le stress parental maternel et améliorer le mode d'intervention des enfants autistes.

Zhonghua Er Ke Za Zhi. 2017 May 4;55(5):355-359. doi: 10.3760/cma.j.issn.0578-1310.2017.05.009.

[Reducing maternal parenting stress of children with autism spectrum disorder: father's involvement]

[Article in Chinese; Abstract available in Chinese from the publisher]

Hu CC¹, Li Y, Zhou BR, Liu CX, Li CY, Zhang Y, Xu Q, Xu X.

Author information

1

Department of Child Health Care, Children's Hospital of Fudan University, Shanghai 201102, China.

Abstract

in English, Chinese

Objective: To explore the relationship between fathers' nursing time and maternal parenting stress of children with autism spectrum disorder(ASD). Method: Mothers of 98 ASD children who were first diagnosed in the department of Child Health Care, Children's Hospital of Fudan University during June 2015 to January 2016 were included in the ASD group, with mothers of 92 typical children from a Community Maternal and Child Health Hospital and a kindergarten in the control group. The evaluation of parenting stress, parents' nursing time and other related factors were cross-sectionally analyzed. Interview was conducted with the following tools: Parental Stress Index-Short Form(PSI-SF)for maternal parenting stress, and self-made General Parenting Information Questionnaire for nursing time of both parents and other related factors. The relationships were analyzed by Multiple Linear Regression analysis and Wilcoxon Rank-Sum test. Result: Maternal parenting stress of ASD children had a significant negative correlation with father's nursing time in total score of parenting stress, PCDI domain and PD domain (t=-2.76, -2.98, -2.79; P=0.007, 0.004, 0.006), within which PD domain also included family annual income and mothers' nursing time (R(2)=0.22, 0.24, 0.25); while no such correlation was found in control group in terms of father's nursing time(P=0.22, 0.42, 0.06). Wilcoxon Rank-Sum test showed that in 62 (63.3%) double-income ASD families and 72(78.3%) double-income typical families, there were significant differences between ASD fathers' and ASD mothers'and typical fathers'nursing time(2.0(0.5, 2.1)vs. 3.5(2.4, 6.0)vs. 3.0(2.0, 4.7)h, t=-86.32、-49.65, all P<0.01). Conclusion: Lack of fathers' involvements was common in ASD children's families. Increasing these fathers' nursing time, as well as their enthusiasm and initiative in the family intervention could relieve maternal parenting stress and improve the intervention pattern of ASD children.

PMID:28482386