Parental Stress and Coping in Autism Spectrum Disorder: A Network Analysis of Internalizing and Externalizing Symptoms in Children With Autism Spectrum Disorder

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy Pub Date : 2025-06-14 DOI:10.1002/cpp.70100

Mahmoud Gharaibeh, Mohammad Nayef Ayasrah, Ayoub Hamdan Al-Rousan, Yusra Jadallah Abed Khasawneh, Mohamad Ahmad Saleem Khasawneh

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引用次数: 0

Abstract

Introduction

Parental stress and coping strategies play a pivotal role in shaping mental health outcomes for children with Autism Spectrum Disorder (ASD). While traditional research has examined linear relationships, network analysis offers a novel lens to uncover dynamic interactions between parental factors and child psychopathology. This study employs advanced network modeling to map how specific stress dimensions and coping mechanisms differentially associate with internalizing (e.g., anxiety) and externalizing (e.g., aggression) symptoms. Our findings provide clinically actionable insights into targeted intervention points within the parent–child stress-coping system.

Method

Parents of children aged 6–12 years (age _{mean ± SD} 8.84 ± 1.86, with 78 female participants (41.94%)) with the ASD diagnosis completed online questionnaires that incorporated the Autism Parenting Stress Index (APSI), the Child Behavior Checklist (CBCL), and the Brief COPE scale. Network modeling techniques were employed, utilizing a Multivariate Gaussian Model (MGM) with a gLASSO regularization parameter (γ = 0.1) and bootstrapping with 1000 resamples to ensure the precision of edge weights and centrality indices.

Results

The network analysis revealed a significant edge weight of 0.332 between core autism-related stress (APSI.T1) and affective problems (CBCL1) and a robust connection of 0.414 between conduct problems (CBCL4) and oppositional defiant behaviors (CBCL5). Notably, adaptive coping strategies (C.1) exhibited high centrality values (betweenness = 1.537; closeness = 1.552; strength = 1.297), indicating their pivotal role in buffering the impact of parental stress on psychiatric outcomes. In contrast, maladaptive coping strategies (C.2) demonstrated negative centrality measures (betweenness = −1.132; closeness = −1.899; strength = −1.677), suggesting a limited protective effect.

Conclusion

Adaptive coping strategies served as protective factors, while maladaptive ones intensified the stress cycle. These findings emphasize the need for targeted interventions focusing on both symptom management and strengthening parental resilience.

Summary

Emotional regulation skill development through techniques like CBT and mindfulness should be the primary focus of interventions for children with ASD to tackle their psychiatric profile's core affective issues.
Parental training in adaptive coping methods, such as problem-solving and positive reframing, helps protect child outcomes from the effects of parenting stress.
Clinical assessments of parental stress should be conducted regularly with ASD-specific tools like APSI while examining their connections to children's internalizing and externalizing behaviors.
Schools and clinical services should incorporate parent-focused stress-management programs, such as structured parenting workshops, to enhance parental resilience and improve children's emotional and behavioral health.
Clinicians can optimize treatment outcomes by applying a network perspective to pinpoint and address key symptoms, such as affective and oppositional behaviors, and coping nodes specific to each family.

查看原文本刊更多论文

自闭症谱系障碍的父母压力与应对：自闭症谱系障碍儿童内化与外化症状的网络分析

父母压力和应对策略在自闭症谱系障碍（ASD）儿童心理健康结果的形成中起着关键作用。虽然传统研究已经检查了线性关系，但网络分析提供了一个新的视角来揭示父母因素与儿童精神病理之间的动态相互作用。本研究采用先进的网络模型来描绘特定的压力维度和应对机制与内化（如焦虑）和外化（如攻击）症状之间的差异。我们的研究结果为亲子压力应对系统中的针对性干预点提供了临床可操作的见解。方法6 ~ 12岁儿童（年龄平均±SD 8.84±1.86，其中女性78例（41.94%））的家长通过在线问卷的形式填写自闭症家长压力指数（APSI）、儿童行为检查表（CBCL）和简易COPE量表。采用网络建模技术，利用具有gLASSO正则化参数（γ = 0.1）的多元高斯模型（MGM）和1000个样本的bootstrapping来确保边缘权值和中心性指数的精度。结果网络分析显示，核心自闭症相关应激（APSI.T1）与情感问题（CBCL1）之间的边权值为0.332，行为问题（CBCL4）与对立违抗行为（CBCL5）之间的边权值为0.414。值得注意的是，适应性应对策略（C.1）的中心性值较高(中间值= 1.537；接近度= 1.552；强度= 1.297)，表明它们在缓冲父母压力对精神结局的影响中起着关键作用。相反，适应不良应对策略（C.2）的中心性为负(中间值= - 1.132；close =−1.899；强度= - 1.677)，表明保护作用有限。结论适应性应对策略起保护作用，而不适应应对策略则加剧了应激循环。这些发现强调需要有针对性的干预措施，侧重于症状管理和加强父母的恢复力。通过CBT和正念等技术发展情绪调节技能应该是ASD儿童干预的主要重点，以解决他们的精神病学特征的核心情感问题。父母在适应性应对方法方面的培训，如解决问题和积极重建，有助于保护儿童免受父母压力的影响。父母压力的临床评估应定期使用自闭症特定工具，如APSI，同时检查其与儿童内化和外化行为的联系。学校和临床服务应纳入以家长为中心的压力管理项目，如有组织的育儿研讨会，以增强父母的适应能力，改善孩子的情绪和行为健康。临床医生可以通过应用网络视角来确定和解决关键症状，如情感和对立行为，以及每个家庭特有的应对节点，从而优化治疗结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-

CiteScore

6.30

自引率

5.60%

发文量

106

期刊介绍： Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.