The relationship between the clinical characteristics of children with autism spectrum disorder and parental levels of depression, anxiety, stress, and difficulties in emotion regulation

Objective: In this study, we aimed to investigate the relationship between the clinical characteristics of children diagnosed with autism spectrum disorder (ASD) and parental psychological problems and difficulties in emotion regulation, as well as the potential role of parental emotion regulation difficulties in the association between parental mental health measures and the severity of autism symptoms. Material and Methods: The sample consisted of a total of 153 cases aged 3–15 years diagnosed with ASD and their mothers. The Sociodemographic Data Form, Autism Behavior Checklist (ABC), Strengths and Difficulties Questionnaire (SDQ)–parent form, Depression Anxiety Stress Scale-21 (DASS-21), and Difficulties in Emotion Regulation Scale (DERS) were administered. Results: Maternal depression, anxiety, and stress scores showed positive correlations with ABC-total and SDQ-total scores. ABC-total and SDQ-total scores were positively correlated with the DERS-total score. In the relationship between maternal depression score and ABC-total score, the DERS-awareness subscale was identified as a moderator, while in the relationship between maternal anxiety score and ABC-total score, the DERS-acceptance, awareness, and strategies subscales acted as moderators. In the relationship between maternal stress score and ABC-total score, the DERS-awareness and strategies subscales were moderators. In the relationships between anxiety and stress scores and the SDQ-total difficulties score, the DERS-acceptance, impulse, awareness, and strategies subscales were found to be moderators. A full mediating role of the DERS-total score was identified in the relationship between maternal stress score and the SDQ-attention deficit/hyperactivity score. Conclusion: Our study demonstrated that mothers' difficulties in emotion regulation influence the association between maternal depression, anxiety, and stress symptoms and the clinical manifestations of children with autism, playing both moderating and mediating roles. Highlighting the close relationship between parental mental health and autism symptomatology, our findings suggest that interventions targeting parental mental health may have beneficial effects for both the child and the parent, and that parental emotion regulation difficulties should be considered an important focus of such interventions. Keywords: Anxiety, Depression, Difficulties in Emotion Regulation, Autism Spectrum Disorder, Stress