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Parenting Stress, Salivary Biomarkers, and Ambulatory Blood Pressure: A Comparison Between Mothers and Fathers of Children with Autism Spectrum Disorders

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Abstract

Parents of children with autism spectrum disorders (ASD) may experience higher levels of stress and health problems than parents of children with typical development. However, most research has focused on mothers, with emphasis on parent-reported stress and wellbeing. This study compared parenting responsibility, distress, anxiety, depression, cortisol, alpha-amylase, and cardiovascular activity between 19 mother–father dyads of children with ASD. Mothers reported higher parenting responsibility, distress, anxiety, and depression than fathers, while fathers had higher blood pressure and heart rate variability. Mothers and fathers had lower than average morning cortisol levels, suggesting stress effects on the hypothalamic–pituitary–adrenal-axis. Parents of children with ASD may benefit from routine health screening (particularly adrenal and cardiovascular function) and referral for stress reduction interventions or supports.

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References

  • Abidin, R. R. (1995). Manual for the parenting stress index. Odessa, FL: Psychological Assessment Resources.

    Google Scholar 

  • Adam, E. K., & Kumari, M. (2009). Assessing salivary cortisol in large-scale, epidemiological research. Psychoneuroendocrinology, 34, 1423–1436.

    Article  PubMed  Google Scholar 

  • Algra, A., Tijssen, J. G., Roelandt, J. R., Pool, J., & Lubsen, J. (1993). Heart rate variability from 24-hour electrocardiography and the 2-year risk for sudden death. Circulation, 88, 180–185.

    Article  PubMed  Google Scholar 

  • Blackledge, J. T., & Hayes, S. C. (2006). Using acceptance and commitment training in the support of parents of children diagnosed with autism. Child & Family Behavior Therapy, 28, 1–18.

    Article  Google Scholar 

  • Boyd, B. A. (2002). Examining the relationship between stress and lack of social support in mothers of children with autism. Focus on Autism and Other Developmental Disabilities, 17, 208–215.

    Article  Google Scholar 

  • Casey, L. B., Zanksas, S., Meindl, J. N., Parra, G. R., Cogdal, P., & Powell, K. (2012). Parental symptoms of posttraumatic stress following a child’s diagnosis of autism spectrum disorder: A pilot study. Research in Autism Spectrum Disorders, 6, 1186–1193.

    Article  Google Scholar 

  • Clow, A., Thorn, L., Evans, P., & Hucklebridge, F. (2004). The awakening cortisol response: Methodological issues and significance. Stress, 7, 29–37.

    Article  PubMed  Google Scholar 

  • Cooper, L., & Bright, J. (2001). Individual differences in reactions to stress. In F. Jones & J. Bright (Eds.), Stress: Myth, theory and research (pp. 111–131). Essex: Pearson Education Ltd.

    Google Scholar 

  • Davis, N. O., & Carter, A. S. (2008). Parenting stress in mothers and fathers of toddlers with autism spectrum disorders: Associations with child characteristics. Journal of Autism and Developmental Disorders, 38, 1278–1291.

    Article  PubMed  Google Scholar 

  • Dillenburger, K., Keenan, M., Doherty, A., Byrne, T., & Gallagher, S. (2010). Living with children diagnosed with autistic spectrum disorder: Parental and professional views. British Journal of Special Education, 37, 13–23.

    Article  Google Scholar 

  • Duarte, C. S., Borden, I. A., Yazigi, L., & Mooney, J. (2005). Factors associated with stress in mothers of children with autism. Autism, 9, 416–427.

    Article  PubMed  Google Scholar 

  • Eisenhower, A. S., Baker, B. L., & Blacher, J. (2005). Preschool children with intellectual disability: Syndrome specificity, behavior problems, and maternal well-being. Journal of Intellectual Disability Research, 49, 657–671.

    Article  PubMed Central  PubMed  Google Scholar 

  • Estes, A., Munson, J., Dawson, G., Koehler, E., Zhou, X.-H., & Abbott, R. (2009). Parenting stress and psychological functioning among mothers of preschool children with autism and developmental delay. Autism, 13, 375–387.

    Article  PubMed  Google Scholar 

  • Ewing, D. J., Neilson, J. M. M., Shapiro, C. M., Stewart, J. A., & Reid, W. (1991). Twenty four hour heart rate variability: Effects of posture, sleep, and time of day in healthy controls and comparison with bedside tests of autonomic function in diabetic patients. British Heart Journal, 65, 239–244.

    Article  PubMed Central  PubMed  Google Scholar 

  • Foody, C., James, J. E., & Leader, G. (2014). Parenting stress, salivary biomarkers, and ambulatory blood pressure in mothers of children with Autism Spectrum Disorders. Research in Autism Spectrum Disorders, 8, 99–110.

    Article  Google Scholar 

  • Frattola, A., Parati, G., Cuspidi, C., Albini, F., & Mancia, G. (1993). Prognostic value of 24-hour blood pressure variability. Journal of Hypertension, 11, 1133–1137.

    Article  PubMed  Google Scholar 

  • Fries, E., Hesses, J., Hellhammer, J., & Hellhammer, D. H. (2005). A new view on hypocortisolism. Psychoneuroendocrinology, 30, 1010–1016.

    Article  PubMed  Google Scholar 

  • Gallagher, S., & Whiteley, J. (2012). Social support is associated with blood pressure responses in parents caring for children with developmental disabilities. Research in Developmental Disabilities, 33, 2099–2105.

    Article  PubMed  Google Scholar 

  • Garcia-Vera, M. P., Sanz, J., & Labrador, F. J. (2004). Blood pressure variability and stress management training for essential hypertension. Behavioral Medicine, 30, 53–62.

    Article  PubMed  Google Scholar 

  • Goodwin, J., Bilous, M., Winship, S., Finn, P., & Jones, S. C. (2007). Validation of the Oscar 2 oscillometric 24-h ambulatory blood pressure monitor according to the British Hypertension Society protocol. Blood Pressure Monitoring, 12, 113–117.

    Article  PubMed  Google Scholar 

  • Granger, D. A., Kivlighan, K. T., El-Sheikh, M., Gordis, E. B., & Stroud, L. R. (2007). Salivary α-amylase in biobehavioral research: Recent developments and applications. Annals of the New York Academy of Sciences, 1098, 122–144.

    Article  PubMed  Google Scholar 

  • Gray, D. E., & Holden, W. J. (1992). Psycho-social well-being among the parents of children with autism. Journal of Intellectual and Developmental Disability, 18, 83–93.

    Article  Google Scholar 

  • Hastings, R. P. (2003). Child behavior problems and partner mental health as correlates of stress in mothers and fathers of children with autism. Journal of Intellectual Disability Research, 47, 231–237.

    Article  PubMed  Google Scholar 

  • Hayes, S. A., & Watson, S. L. (2013). The impact of parenting stress: A meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder. Journal of Autism and Developmental Disorders, 43, 629–642.

    Article  PubMed  Google Scholar 

  • Heim, C., Ehlert, U., & Hellhammer, D. H. (2000). The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders. Psychoneuroendocrinology, 25, 1–35.

    Article  PubMed  Google Scholar 

  • Heller, T., Hsieh, K., & Rowitz, L. (1997). Maternal and paternal caregiving of persons with mental retardation across the lifespan. Family Relations, 46, 407–415.

    Article  Google Scholar 

  • Hoffman, C. D., Sweeney, D. P., Hodge, D., Lopez-Wagner, M. C., & Looney, L. (2009). Parenting stress and closeness: Mothers of typically developing children and mothers of children with autism. Focus on Autism and Other Developmental Disabilities, 24, 178–187.

    Article  Google Scholar 

  • Hoshide, Y., Kario, K., Schwartz, J. E., Hoshide, S., Pickering, S., & Shimada, K. (2002). Incomplete benefit of antihypertensive therapy on stroke reduction in older hypertensives with abnormal nocturnal blood pressure dipping (extreme-dippers and reverse-dippers). American Journal of Hypertension, 15, 844–850.

    Article  PubMed  Google Scholar 

  • Jones, F., & Kinman, G. (2001). Approaches to studying stress. In F. Jones & J. Bright (Eds.), Stress: Myth, theory and research (pp. 18–46). Essex: Pearson Education Ltd.

    Google Scholar 

  • Kario, K., & Pickering, T. G. (2000). Does extreme dipping of nocturnal blood pressure in elderly hypertensive patients confer high risk of developing ischemic target organ damage from antihypertensive therapy? Archives of Internal Medicine, 160, 1378.

    Article  PubMed  Google Scholar 

  • Kario, K., Pickering, T. G., Matsuo, T., Hoshide, S., Schwartz, J. E., & Shimada, K. (2001). Stroke prognosis and abnormal nocturnal blood pressure falls in older hypertensives. Hypertension, 38, 852–857.

    Article  PubMed  Google Scholar 

  • Kario, K., & Shimada, K. (2004). Risers and extreme-dippers of nocturnal blood pressure in hypertension: Antihypertensive strategy for nocturnal blood pressure. Clinical and Experimental Hypertension, 26, 177–189.

    Article  PubMed  Google Scholar 

  • Kikuya, M., Hozawa, A., Ohokubo, T., Tsuji, I., Michimata, M., Matsubara, M., et al. (2000). Prognostic significance of blood pressure and heart rate variabilities: The Ohasama study. Hypertension, 36, 901–906.

    Article  PubMed  Google Scholar 

  • Klaver, C. H. A. M., de Geus, E. J. C., & de Vries, J. (1994). Ambulatory monitoring system. In F. J. Maarse (Ed.), Applications, methods and instrumentations (pp. 254–268). Lisse: Swets & Zeitlinger.

    Google Scholar 

  • Konstantareas, M. M., & Homatidis, S. (1992). Mothers’ and fathers’ self-report of involvement with autistic, mentally delayed, and normal children. Journal of Marriage and Family, 54, 153–164.

    Article  Google Scholar 

  • Lovallo, W. R. (2005). Stress and health: Biological and psychological interactions (2nd ed.). London: Sage Publications.

    Google Scholar 

  • Lovell, B., Moss, M., & Wetherell, M. A. (2012). With a little help from my friends: Psychological, endocrine and health corollaries of social support in parental caregivers of children with autism or ADHD. Research in Developmental Disabilities, 33, 682–687.

    Article  PubMed  Google Scholar 

  • Lovell, B., Moss, M., & Wetherell, M. A. (2014). The psychophysiological and health corollaries of child problem behaviors in caregivers of children with autism and ADHD. Journal of Intellectual Disability Research. doi:10.1111/jir.12081.

  • Mancia, G., Ferrari, A., Gregorini, L., Parati, G., Pomidossi, G., Bertinieri, G., et al. (1983). Blood pressure and heart rate variabilities in normotensive and hypertensive human beings. Circulation Research, 53, 96–104.

    Article  PubMed  Google Scholar 

  • McBride, B. A., & Mills, G. (1993). A comparison of mother and father involvement with their preschool age children. Early Childhood Research Quarterly, 8, 457–477.

    Article  Google Scholar 

  • McConachie, H., & Diggle, T. (2007). Parent implemented early intervention for young children with autism spectrum disorder: A systematic review. Journal of Evaluation in Clinical Practice, 13, 120–129.

    Article  PubMed  Google Scholar 

  • Moes, D., Koegel, R. L., Schreibman, L., & Loos, L. M. (1992). Stress profiles for mothers and fathers of children with autism. Psychological Records, 71, 1272–1274.

    Google Scholar 

  • Moorey, S., Greer, S., Watson, M., Gorman, C., Rowden, L., Tunmore, R., et al. (1991). The factor structure and factor stability of the hospital anxiety and depression scale in patients with cancer. The British Journal of Psychiatry, 158, 255–259.

    Article  PubMed  Google Scholar 

  • Mykletun, A., Stordal, E., & Dahl, A. A. (2001). Hospital Anxiety and Depression (HAD) scale: Factor structure, item analyses and internal consistency in a large population. British Journal of Psychiatry, 179, 540–544.

    Article  PubMed  Google Scholar 

  • O’Brien, E., Coats, A., Owens, P., Petrie, J., Padfield, P. L., Littler, W. A., et al. (2000). Use and interpretation of ambulatory blood pressure monitoring: Recommendations of the British Hypertension Society. British Medical Journal, 320, 1128–1134.

    Article  PubMed Central  PubMed  Google Scholar 

  • Phares, V. (1992). Where’s poppa? The relative lack of attention to the role of fathers in child and adolescent psychopathology. American Psychologist, 47, 656–664.

    Article  PubMed  Google Scholar 

  • Phares, V., Lopez, E., Fields, S., Kamboukos, D., & Duhig, A. M. (2005). Are fathers involved in paediatric psychology research and treatment? Journal of Pediatric Psychology, 30, 631–643.

    Article  PubMed  Google Scholar 

  • Pickering, T. G., & James, G. D. J. (1994). Ambulatory blood pressure and prognosis. Journal of Hypertension, 12, S29–S33.

    Article  PubMed  Google Scholar 

  • Pruessner, J. C., Kirschbaum, C., Meinlschmid, G., & Hellhammer, D. H. (2003). Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change. Psychoneuroendocrinology, 28, 916–931.

    Article  PubMed  Google Scholar 

  • Rao, P. A., & Beidel, D. C. (2009). The impact of children with high-functioning autism on parental stress, sibling adjustment, and family functioning. Behavior Modification, 33, 437–451.

    Article  PubMed  Google Scholar 

  • Rohleder, N., Chen, E., Wolf, J. M., & Miller, G. E. (2008). The psychobiology of trait shame in young women: Extending the social self-preservation theory. Health Psychology, 27, 523–532.

    Article  PubMed  Google Scholar 

  • Rohleder, N., & Nater, U. M. (2009). Determinants of salivary alpha-amylase in humans and methodological considerations. Psychoneuroendocrinology, 34, 469–485.

    Article  PubMed  Google Scholar 

  • Romanczyk, R. G., & Gillis, J. M. (2006). Autism and the physiology of stress and anxiety. In M. G. Baron, J. Groden, G. Groden, & L. P. Lipsitt (Eds.), Stress and coping in autism (pp. 277–301). New York, NY: Oxford University Press.

    Google Scholar 

  • Ruiz-Robledillo, N., Bono, E. G., & Albiol, L. M. (2014). Lack of institutional support entails disruption in cortisol awakening response in caregivers of people with high-functioning autism. Journal of Health Psychology. doi: 10.1177/1359105313496444.

  • Salimetrics. (2010). Salivary α-amylase assay kit. State College, PA: Salimetrics LLC.

    Google Scholar 

  • Sapolsky, R. M. (2004). Why zebras don’t get ulcers: The acclaimed guide to stress, stress-related diseases, and coping (3rd ed.). New York, NY: Holt Paperbacks.

    Google Scholar 

  • Seltzer, M. M., Greenberg, J. S., Hong, J., Smith, L. E., Almeida, D. M., Coe, C., et al. (2010). Maternal cortisol levels and behavior problems in adolescents and adults with ASD. Journal of Autism and Developmental Disorders, 40, 457–469.

    Article  PubMed Central  PubMed  Google Scholar 

  • Shimada, S., & Kario, K. (1997). Altered circadian rhythm of blood pressure and cerebrovascular disease. Blood Pressure Monitoring, 2, 333–338.

    PubMed  Google Scholar 

  • Simmerman, S., Blacher, J., & Baker, B. L. (2001). Fathers’ and mothers’ perceptions of father involvement in families with young children with a disability. Journal of Intellectual & Developmental Disability, 26, 325–338.

    Article  Google Scholar 

  • Smith, G. C. (1997). Aging families of adults with mental retardation: Patterns and correlates of service use, need, and knowledge. American Journal on Mental Retardation, 102, 13–26.

    Article  PubMed  Google Scholar 

  • Snaith, R. P. (2003). Commentary: The Hospital Anxiety and Depression Scale. Health and Quality of Life Outcomes, 1, 29.

    Article  PubMed Central  PubMed  Google Scholar 

  • Tehee, E., Honan, R., & Hevey, D. (2009). Factors contributing to stress in parents of individuals with autistic spectrum disorders. Journal of Applied Research in Intellectual Disabilities, 22, 34–42.

    Article  Google Scholar 

  • Tomanik, S., Harris, G. E., & Hawkins, J. (2004). The relationship between behaviours exhibited by children with autism and maternal stress. Journal of Intellectual & Developmental Disabilities, 29, 16–26.

    Article  Google Scholar 

  • Tsuji, H., Venditti, F. J., Manders, E. S., Evans, J. C., Larson, M. G., Feldman, C. L., et al. (1994). Reduced heart rate variability and mortality risk in an elderly cohort. The Framingham Heart Study. Circulation, 90, 878–883.

    Article  PubMed  Google Scholar 

  • Vedhara, K., Shanks, N., Anderson, S., & Lichtman, S. (2000). The role of stressors and psychosocial variables in the stress process: A study of chronic caregiver stress. Psychosomatic Medicine, 62, 374–385.

    Article  PubMed  Google Scholar 

  • Verdecchia, P., Borgioni, C., Ciucci, A., Gattobigio, R., Schillaci, G., Sacchi, N., et al. (1996). Prognostic significance of blood pressure variability in essential hypertension. Blood Pressure Monitoring, 1, 3–11.

    PubMed  Google Scholar 

  • WHO. (2013). Global health estimates summary tables: Deaths by cause, age and sex, by MDG region. Geneva, Switzerland: World Health Organization. Retrieved 29 November 2013 from http://www.who.int/healthinfo/global_burden_disease/en/.

  • Wust, S., Wolf, J., Hellhammer, D. H., Federenko, I., Schommer, N., & Kirschbaum, C. (2000). The cortisol awakening response—Normal values and confounds. Noise Health, 2, 79–88.

    PubMed  Google Scholar 

  • Xu, T., Zhang, Y., & Tan, X. (2013). Estimate of nocturnal blood pressure and detection of non-dippers based on clinical or ambulatory monitoring in the inpatient setting. BMC Cardiovascular Disorders, 13, 37–42.

    Article  PubMed Central  PubMed  Google Scholar 

  • Zaidman-Zait, A., Mirenda, P., Zumbo, B. D., Wellington, S., Dua, V., & Kalynchuk, K. (2010). An item response theory analysis of the Parenting Stress Index-Short Form with parents of children with Autism Spectrum Disorders. The Journal of Child Psychology and Psychiatry, 51, 1269–1277.

    Article  Google Scholar 

  • Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370.

    Article  PubMed  Google Scholar 

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Correspondence to Jack E. James.

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The research was conducted by the first author under the supervision of the second and third authors in partial fulfilment of the requirements for her PhD in Applied Behaviour Analysis at NUI, Galway.

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Foody, C., James, J.E. & Leader, G. Parenting Stress, Salivary Biomarkers, and Ambulatory Blood Pressure: A Comparison Between Mothers and Fathers of Children with Autism Spectrum Disorders. J Autism Dev Disord 45, 1084–1095 (2015). https://doi.org/10.1007/s10803-014-2263-y

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