Mental Stress in Parents and Siblings of Autistic Children: Review of the Literature and Original Study of the Related Psychological Dimensions

Parental mental stress is clinically common in families of autistic children and adversely affects the care of the child. Moreover, parents of autistic children frequently experience feelings of guilt, maladaptive coping styles, a lack of ability to forgive themselves and variations in mindfulness. However, it is unclear which of these dimensions is predominant in these families and their pattern of association with other components of this complex picture. While most notable in parents, this is also true of healthy siblings who intrinsically perceive more responsibility and often receive less attention than their afflicted brothers or sisters. The evidence available in the literature on the topic is quite controversial, revealing both positive and negative effects deriving from growing up with ASD siblings. Demographic and psychological information on mental stress, feelings of guilt, ability to forgive, mindfulness and coping styles were collected through clinical interviews and self-report questionnaires in parents and siblings of autistic children. Artificial Neural Networks (Auto-CM system) were applied to parents data to highlight the associations among the variables under investigation. Predominant dimensions in parents of autistic children indcluded low feelings of guilt, high levels of forgiveness and low levels of maladaptive coping responses. These three main dimensions were strictly related among themselves. While high parental mental stress was strictly related to high parental distress subscales, to high maladaptive coping styles, and to low self-forgiveness ability, conversely, low mental stress appeared to be marginal in relation to the other psychological dimensions. This behavior is typical of complex nonlinear systems. The severity of the ASD was not related to parental psychological dimensions. The ADOS scores, both low and high, were in fact marginal in the connectivity map in relation to the other dimensions. In siblings, the average distress scores level was extremely high irrespectively of ASD severity or family size. About one third of them were at risk of developing major depression. Distress appeared to be mainly related to difficulties in building a meaningful relationship with the ASD child and in managing the child’s behavioral problems. In conclusione the interplay of psychological factors related to stress in parents and siblings of ASD children is complex. Understanding these relationships is the starting point to activating and enhancing parental resources essential to the wellbeing of both children and caregivers.