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Adams D, Dargue N, Paynter J. Longitudinal studies of challenging behaviours in autistic children and adults: A systematic review and meta-analysis. Clin Psychol Rev 2023; 104:102320. [PMID: 37515997 DOI: 10.1016/j.cpr.2023.102320] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 02/23/2023] [Accepted: 07/12/2023] [Indexed: 07/31/2023]
Abstract
Autistic children and adults are at increased risk of showing behaviours that may be described as challenging, however, little is known about whether or how these behaviours may change over time. Given the profound impact that challenging behaviour can have on both the autistic individual and their support network, it is critical that the trajectory of challenging behaviours be better understood. This systematic review and meta-analysis identified and synthesised observational longitudinal studies of challenging behaviour in autistic individuals. Fifty-six studies were included in the systematic review, and the effect sizes of 37 independent samples arising from 34 of these reports were examined through meta-analysis. Crucially, across the 37 samples, scores on the measures of challenging behaviour reduced by a small, yet significant, extent over time. Although age of the sample at baseline assessment did not moderate the effect, the time between the baseline assessment and final follow-up and age at final follow-up both moderated the magnitude of the effect, with challenging behaviour scores reducing to a larger extent in (a) studies with longer intervals between baseline and final follow-up and (b) studies with older samples at follow-up. The results from the current systematic review and meta-analysis have both theoretical and practical implications for understanding challenging behaviour over time in autistic individuals. Avenues for future research are also highlighted that may allow better understanding, and therefore support of, challenging behaviour in autistic individuals.
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Affiliation(s)
- Dawn Adams
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia.
| | - Nicole Dargue
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia
| | - Jessica Paynter
- Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; School of Applied Psychology and Hopkins Centre, Griffith University, Gold Coast, QLD 4222, Australia
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Muniandy M, Richdale AL, Arnold SRC, Trollor JN, Lawson LP. Brief Report: Longitudinal Role of Coping Strategies on Mental Health Outcomes in Autistic Youth and Adults. J Autism Dev Disord 2023:10.1007/s10803-023-05953-4. [PMID: 37017862 DOI: 10.1007/s10803-023-05953-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 04/06/2023]
Abstract
The stress literature suggests that coping strategies are implicated in mental health outcomes. However, the longitudinal relationship between coping strategies and mental health in the autistic adult population has not yet been examined. This 2-year longitudinal study examined the predictive role of both baseline and change in coping strategy use over time (i.e., an increase or decrease) on anxiety, depression, and well-being after 2-years in 87 autistic adults aged 16 to 80 years. Controlling for baseline mental health, both baseline and increase in disengagement coping strategies (e.g., denial, self-blame) predicted higher anxiety and depression, and lower well-being, while an increase in engagement coping strategies (e.g., problem solving, acceptance) predicted higher well-being. These findings extend the current coping literature in autistic adults, offering insight into mental health support and intervention options.
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Affiliation(s)
- Melanie Muniandy
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, 3086, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia
| | - Amanda L Richdale
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, 3086, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia
| | - Samuel R C Arnold
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia
- Department of Developmental Disability Neuropsychiatry (3DN), UNSW Sydney, 34 Botany St, Sydney, NSW, 2052, Australia
| | - Julian N Trollor
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia
- Department of Developmental Disability Neuropsychiatry (3DN), UNSW Sydney, 34 Botany St, Sydney, NSW, 2052, Australia
| | - Lauren P Lawson
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, 3086, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
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Trajectories of Behavioral Problems and Predictors in Children Aged 4 to 7 Years: a Growth Mixture Model Analysis. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2022. [DOI: 10.1007/s10862-022-09953-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Gallagher S, Daynes-Kearney R, Bowman-Grangel A, Dunne N, McMahon J. Life satisfaction, social participation and symptoms of depression in young adult carers: evidence from 21 European countries. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2022. [DOI: 10.1080/02673843.2021.2025115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Stephen Gallagher
- Department of Psychology, Study of Anxiety Stress and Health, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Rosemary Daynes-Kearney
- Department of Psychology, Study of Anxiety Stress and Health, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Aoife Bowman-Grangel
- Department of Psychology, Study of Anxiety Stress and Health, Health Research Institute, University of Limerick, Limerick, Ireland
| | | | - Jennifer McMahon
- Department of Psychology, Study of Anxiety Stress and Health, Health Research Institute, University of Limerick, Limerick, Ireland
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O’Neill A, Gallagher S, Hannigan A, Robinson K. Association between work status and depression in informal caregivers: a collaborative modelling approach. Eur J Public Health 2021; 32:59-65. [PMID: 34849725 PMCID: PMC8807115 DOI: 10.1093/eurpub/ckab178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Care is regularly provided on an informal basis by family and friends and it is well established that caregivers experience high rates of depression. The majority of research on caregivers tends to focus on older, full-time caregivers, with less attention paid to working caregivers (in paid employment). The aim of this study is to explore the impact of work status on depression in caregivers. Methods A sample of individuals from the 2014 European Social Survey dataset, aged 18 and older, who reported being a caregiver, were investigated (n = 11 177). Differences in sociodemographic, mental and physical health and social network variables, between working and non-working caregivers, were investigated. Hierarchical logistic regression models were used to investigate associations between the caregivers’ work status and depression. This study was developed in partnership with a panel of caregivers who contributed to the conceptualization and interpretation of the statistical analysis. Results Findings showed that 51% of caregivers reported being in paid employment. Non-working caregivers were more likely to be female, older, widowed, have lower education levels and provide intensive caring hours. They were also more likely to report depressive symptoms than working caregivers after controlling for sociodemographic, social networks and intensity of caring (adjusted odds ratio = 1.77, 95% confidence interval = 1.54–2.03). The panel considered policies to support continued work important as a means of maintaining positive mental health for caregivers. Conclusions Supportive policies, such as flexible working and care leave, are recommended to allow caregivers to continue in paid work and better manage their health, caring and working responsibilities.
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Affiliation(s)
- Aoife O’Neill
- Ageing Research Centre, School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- Correspondence: Aoife O’Neill, HS3-034, Ageing Research Centre, School of Allied Health, Health Sciences Building, University of Limerick, Ireland, Tel: +35361 213370, e-mail:
| | - Stephen Gallagher
- Health Research Institute, University of Limerick, Limerick, Ireland
- Department of Psychology, University of Limerick, Limerick, Ireland
| | - Ailish Hannigan
- Health Research Institute, University of Limerick, Limerick, Ireland
- Public and Patient Involvement Research Unit, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Katie Robinson
- Ageing Research Centre, School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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Stephen G, Kate M B. Caregiving and allostatic load predict future illness and disability: A population-based study. Brain Behav Immun Health 2021; 16:100295. [PMID: 34589788 PMCID: PMC8474636 DOI: 10.1016/j.bbih.2021.100295] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 07/04/2021] [Indexed: 11/30/2022] Open
Abstract
Background Caring for sick or disabled relatives is a key model for understanding the effects of chronic stress on immunity/inflammation; biomarkers which are part of an index of allostatic load. Here, we examine whether caring and allostatic load are predictive of future illness/disability and if the association between caring and illness/disability is mediated by allostatic load. Method Using data from the Understanding Society Wave 2 (2011) and Wave 9 (2017–2019) datasets in the UK, a sample of 471 of caregivers and 2,151 non-caregivers (all initially healthy) were compared on allostatic load and future illness/disability. Results Caregivers had higher allostatic risk scores, for total as well as immune and non-immune biomarkers, and were more likely (23.3% vs 17.4%) to have an illness/disability in the future compared to non-caregivers. Moreover, caregiving was responsible for a 33% future illness/disability risk. Further, allostatic load was also predictive of excess risk (OR = 1.18, 95% CI = 1.08 – 1.26; p < .001); higher allostatic load was associated with increased risk of illness/disability in the future. In an unadjusted mediation model, allostatic load mediated the association between caregiving and future illness/disability. However, after controlling for confounding, the mediation became non-significant. Conclusions These results confirm that caregiving and allostatic load are damaging for future health. Results are also discussed in relation to public health aspects of caregiving. Caregivers have a greater risk of future illness and disability relative to non-caregivers. Allostatic load is higher among caregivers. Risk of illness and disability continued beyond cessation of caring. Caregiving and allostatic load predicted future illness and disability.
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Affiliation(s)
- Gallagher Stephen
- Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Castletroy, Limerick, Ireland
| | - Bennett Kate M
- School of Psychology, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, UK
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Persistence in the Face of Ecological Challenges: A Phenomenological Study of Parents of Children With Disabilities in Turkey. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2021. [DOI: 10.1007/s10447-021-09453-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Baker K, Devine RT, Ng-Cordell E, Raymond FL, Hughes C. Childhood intellectual disability and parents' mental health: integrating social, psychological and genetic influences. Br J Psychiatry 2021; 218:315-322. [PMID: 32157975 DOI: 10.1192/bjp.2020.38] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Intellectual disability has a complex effect on the well-being of affected individuals and their families. Previous research has identified multiple risk and protective factors for parental mental health, including socioeconomic circumstances and child behaviour. AIMS This study explored whether genetic cause of childhood intellectual disability contributes to parental well-being. METHOD Children from across the UK with intellectual disability due to diverse genetic causes were recruited to the IMAGINE-ID study. Primary carers completed the Development and Well-being Assessment, including a measure of parental distress (Everyday Feeling Questionnaire). Genetic diagnoses were broadly categorised into aneuploidy, chromosomal rearrangements, copy number variants (CNVs) and single nucleotide variants. RESULTS Compared with the UK general population, IMAGINE-ID parents (n = 888) reported significantly elevated emotional distress (Cohen's d = 0.546). Within-sample variation was related to recent life events and the perceived impact of children's difficulties. Impact was predicted by child age, physical disability, autistic characteristics and other behavioural difficulties. Genetic diagnosis also predicted impact, indirectly influencing parental well-being. Specifically, CNVs were associated with higher impact, not explained by CNV inheritance, neighbourhood deprivation or family structure. CONCLUSIONS The mental health of parents caring for a child with intellectual disability is influenced by child and family factors, converging on parental appraisal of impact. We found that genetic aetiologies, broadly categorised, also influence impact and thereby family risks. Recognition of these risk factors could improve access to support for parents, reduce their long-term mental health needs and improve well-being of individuals with intellectual disability.
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Affiliation(s)
- Kate Baker
- Programme Leader Track and Honorary Consultant in Clinical Genetics, MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - Rory T Devine
- Lecturer in Developmental Psychology, School of Psychology, University of Birmingham, UK
| | - Elise Ng-Cordell
- Research Assistant, MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| | - F Lucy Raymond
- Professor of Medical Genetics and Neurodevelopment, Cambridge Institute for Medical Research, University of Cambridge, UK
| | | | - Claire Hughes
- Professor and Deputy Director, Centre for Family Research, Department of Psychology, University of Cambridge, UK
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Bourke-Taylor HM, Cotter C, Joyce KS, Reddihough DS, Brown T. Fathers of children with a disability: health, work, and family life issues. Disabil Rehabil 2021; 44:4441-4451. [PMID: 33896319 DOI: 10.1080/09638288.2021.1910739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE Fathers in families raising children with disabilities are under-researched. Fathers' perspectives can be better accommodated in childhood disability services that operate on a family-centred paradigm if their perspectives are understood. This study aimed to investigate the perspectives of fathers on caring and family life, work, and health. METHODS A mixed-methods design with an online questionnaire included open-ended questions and three instruments: Depression Anxiety Stress Scales (DASS); Health Promoting Activities Scale (HPAS-M); Fathers of Children with Developmental Challenges (FCDC) Scale. RESULTS Fathers (n = 33) reported high depressive (58%), anxiety (37%), and stress symptoms (61%). Fathers reported low participation in health-promoting activity with less than weekly: planning health activities (58%); solo physical activity (26%); social activity (3%); time relaxing (16%). Sixty-four percent worked full-time, although work was reported to be challenged by family responsibilities. Fathers described directly caring for their children although service interactions were low and delegated to mothers. CONCLUSIONS Fathers in this study reported stress, mental health issues, and low participation in healthy activity. Fathers experienced challenges related to career progression and job choices due to family responsibilities. Providing individualised and responsive support to fathers of a child with a disability would better support the family unit.IMPLICATIONS FOR REHABILITATIONFathers of children with a disability in this study experienced high mental health symptoms.Fathers were involved with their child's care at home but had low service interactions suggesting that service providers need to discover new ways to better engage fathers.Fathers experienced challenges to participation in paid work secondary to care responsibilities for their child with a disability and resulting needs of their family.Services that better support fathers are important to promote better health and wellbeing and support families.
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Affiliation(s)
- Helen M Bourke-Taylor
- Faculty of Medicine Nursing and Health Sciences, Occupational Therapy Department, School of Primary and Allied Health Care, Monash University, Frankston, Australia
| | - Claire Cotter
- Cerebral Palsy Education Centre, Glen Waverley, Australia
| | - Kahli S Joyce
- Faculty of Medicine Nursing and Health Sciences, Occupational Therapy Department, School of Primary and Allied Health Care, Monash University, Frankston, Australia
| | - Dinah S Reddihough
- Department of Paediatrics, Murdoch Children's Research Institute, Royal Children's Hospital, University of Melbourne, Parkville, Australia
| | - Ted Brown
- Faculty of Medicine Nursing and Health Sciences, Occupational Therapy Department, School of Primary and Allied Health Care, Monash University, Frankston, Australia
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