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Associations between Parental Anxiety/Depression and Child Behavior Problems Related to Autism Spectrum Disorders: The Roles of Parenting Stress and Parenting Self-Efficacy
Open accessAbstract
Parents of children with autism spectrum disorders (ASDs) have been shown to experience increases in stress, depression, and anxiety, which are also associated with child behavior problems related to ASDs. Literature-examining potential mechanisms that underlie the relationship of child behavior problems and parental anxiety/depression in this population are scarce. The current study sought to examine the roles of parenting stress and parenting self-efficacy as mediators between child behavior problems and parental anxiety/depression. Using a sample of 134 mothers, these potential mediators were tested. Hypotheses were supported, indicating that parenting stress mediated the relationship between child behavior problems and decreased parenting self-efficacy, and decreased parenting self-efficacy in turn partially mediated the relationship between parenting stress and increased depression/anxiety.
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“It is well known that parental competence and problem-solving skills are influenced by the disruptive behavior of their kids [47,48].”
From The effect of acceptance and commitment therapy for improving psychological well‐being in parents of individuals with autism spectrum disorders: A randomized controlled trial (2021) · cites this paper as [48]
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“anxiety and depression (Rezendes & Scarpa, 2011).”
From Mindfulness Parenting and Childish Play: A Clinical Trial With Parents of Children With Autism Spectrum Disorders (2023) · cites this paper as Rezendes & Scarpa, 2011
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“Similarly, a study conducted in the United States indicated that parenting self-efficacy was negatively associated with depres - sion and anxiety symptoms among mothers of children with ASD (Rezendes & Scarpa, 2011).”
InfluentialRaising a Child with Autism Spectrum Disorder: Examining Parental Factors
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BackgroundResultWhat impact does the child development assessment process have on parental self-efficacy?
Smart, G. (2019) · Advances in Mental Health · doi:10.1080/18387357.2019.1633936 · Cited by 5
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Effects of Partnerships between Adolescents with Developmental Disabilities and Service Dogs
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Psychopathology of the Parents of Autistic Children Based on the Clinical Personality Disorders
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“Their lower self-efficacy could have a negative impact on children’s growth [31-33].”
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Hughes, R., Curley, K., & Kotera, Y. (2024) · Psychiatry International · doi:10.3390/psychiatryint5030026 · Cited by 8
“However, while some participants expressed relief on gaining a formal diagnosis [38], all participants reported heightened and sustained levels of stress and anxiety once autism became a factor in their parenting, a finding that supports previous studies [27,30].”
BackgroundResultResilience Within Families of Young Children with ASD
Neijs, L. D.-D., Swaab, H., van Berckelaer‐Onnes, I. A., & Ester, W. A. (2025) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-025-06773-4 · Cited by 8
“…stress that can have major psychological and physical consequences in parents of young children with ASD and that may influence family functioning (Fairthorne et al., 2014; Hayes & Watson, 2013; Rezendes & Scarpa, 2011; Riahi & Izadi-Mazidi, 2012; van der Lubbe et al., 2022; Zhou et al., 2019).”
Yang, T., Wang, Y., Xu, P., & Tao, Y. (2025) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-025-06790-3 · Cited by 4
“Increased parenting stress is associated with child behavioral problems, and in turn, heightened stress further reduces parenting self-efficacy, potentially creating a bidirectional dynamic between parents and children (Chan et al., 2018 ; Rezendes & Scarpa, 2011 ).”
Tong, J., Xu, C., Wang, B., Wang, T., Wang, X., Ma, S., Shi, D., Wang, X., & Yan, D. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1454004 · Cited by 4
Painting Therapy in Improvement of the Symptoms of Children with Autism Spectrum Disorder
Moghaddam, K., Ravarian, A., & Ershadi, F. S. (2019) · Psychology and Behavioral Sciences · doi:10.11648/j.pbs.20190803.14 · Cited by 4
“The purpose of many of these studies has been applying the so-called family-centered interventions and approaches that by using them and by involving the parent in these programs actively and dynamically, we can reduce not only problems of these children, but also create greater interaction between family members, esp…”
BackgroundZampini, L., Zanchi, P., Riva, P., & Tobia, V. (2022) · International Journal of Developmental Disabilities · doi:10.1080/20473869.2022.2062841 · Cited by 5
“2009, Rezendes and Scarpa 2011, Valicenti-McDermott et al .”
BackgroundDukmak, S. J., Mousa, A., & Gharaibeh, M. (2022) · Journal of Mental Health Research in Intellectual Disabilities · doi:10.1080/19315864.2022.2098434 · Cited by 4
“…with an increase in parental stress, which decreased when the disabilities were mild (Miranda et al., 2019; Nathwani et al., 2021), and with the finding of Rezendes and Scarpa (2011) that increased severity of behavioral problems among children with autism led to increased stress in parents.”
BackgroundClark, M., & Dissanayake, C. (2022) · Journal of Intellectual & Developmental Disability · doi:10.3109/13668250.2022.2112509 · Cited by 4
“…for their child, combined with the di ffi culties navigating the complexities of the NDIS system in its current form, are likely adding to the already elevated levels of stress and anxiety associated with parenting an autistic child (Kalb et al. 2021; Lichtlé et al., 2019; Rezendes & Scarpa, 2011).”
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Family Impact During the Time Between Autism Screening and Definitive Diagnosis
Hickey, E., Feinberg, E., Kuhn, J., Cabral, H., & Broder‐Fingert, S. (2021) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05354-5 · Cited by 5
“Previous research has shown that having a child with ASD is related to higher stress and lower parent well-being relative to parents of children with other types of developmental conditions (Dabrowska & Pisula, 2010; Hayes & Watson, 2013; Rezendes & Scarpa, 2011).”
BackgroundKanwal, M., & Asad, S. (2018) · PJPPRP · doi:10.62663/pjpprp.v9i1.125 · Cited by 4
“Parental self-efficacy acts as a mediator between child‟s behavioral issues and increased depressive symptoms in mothers (Rezendes & Scarpa, 2011).”
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Yang, C.-J., Jin, J.-Y., & Sun, Y.-W. (2022) · Journal of Mental Health Research in Intellectual Disabilities · doi:10.1080/19315864.2022.2070809 · Cited by 3
“Challenging behaviors of children with ASD bring much difficulties and stress to their parents, thus increasing the risk of parental depression and anxiety (Rezendes & Scarpa, 2011).”
BackgroundBrief Report: Investigating Temporal Factors in the Context of Parenting an Autistic Child
Meads, J., Shepherd, D., Landon, J., & Goedeke, S. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-022-05642-8 · Cited by 4
“Some research (Tomanik et al., 2004; Rezendes & Scarpa, 2011) suggests that older parental ages are associated with higher overall stress.”
Menurunkan stres pengasuhan pada ibu dengan anak berkebutuhan khusus
Suwoto, A. N. (2023) · Procedia Studi Kasus dan Intervensi Psikologi · doi:10.22219/procedia.v11i2.24345 · Cited by 3
Bogavac, I., Jeličić, L., Đorđević, J., Veselinović, I., Marisavljević, M., & Subotić, M. (2023) · Children · doi:10.3390/children10081292 · Cited by 3
“They noted that they experienced more parenting stress [77–80] and excessive anxiety [81,82] than parents of typically developing children [79] or parents of children with other developmental disabilities [83,84].”
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Gobrial, E. S., & Shoeib, A. M. (2022) · Social Sciences · doi:10.3390/socsci12010017 · Cited by 3
Autism spectrum disorders: weighing the risk of SSRI exposure in pregnancy
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“This is probably the case in this study, as epidemiological data suggested that maternal depression might indeed be a risk factor for developing ASD (Rezendes & Scarpa, 2011; Rai et al. 2013).”
ResultAutism Spectrum Disorder Traits and Parental Stress: The moderating role of parental self-efficacy
Factor, R. S. (2016) · VTechWorks (Virginia Tech) · Cited by 3
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“…more dependent children (Xiong et al., 2022a), more hours spent caregiving (Ren et al., 2024), children ’ s behavioural problems (Cheng and Lai, 2023; Hou et al., 2018; Rezendes and Scarpa, 2011), increased parental burnout (Ren et al., 2024), and marital dissatisfaction (Robinson and Neece, 2015).”
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Depression, Anxiety and Stress in Formal and Informal Caregivers of Autistic Children in Karachi
Zehra, A., Ahmer, Z., Qadri, U., & Ovais, M. (2024) · Iranian Rehabilitation Journal · doi:10.32598/irj.22.2.2025.1 · Cited by 2
“They are more prone to depression, stress, and anxiety as compared to mothers of children with mild intellectual disability and normal developmental children [4, 5, 10].”
InfluentialMcAuliffe, T., Dimech, S., & Setchell, J. (2024) · International Journal of Disability Development and Education · doi:10.1080/1034912x.2024.2362319 · Cited by 2
“Given the known relationship between parental self-efficacy and their mental health (Higgins et al., 2022; Rezendes & Scarpa, 2011, this finding suggests that RDI offers a way to support parental experiences.”
Haque, M., Bhagat, V., Simbak, N., & Jaalam, K. (2017) · Advances in Human Biology · doi:10.4103/aihb.aihb_17_17 · Cited by 2
“had found higher negative impact having ASD child; these mothers were found with less perceived social support.[120] This”
Background(2023) · INTERNATIONAL JOURNAL OF PSYCHOLOGICAL AND BEHAVIOURAL RESEARCH (IJPBR) · doi:10.37605/ijpbr/v3i1/.34 · Cited by 2
Grosvenor, L. P., Whitney, D. G., Volk, H. E., & Fallin, M. D. (2021) · Autism Research and Treatment · doi:10.1155/2021/2981383 · Cited by 2
“It is well-established that parents of children with ASD experience more symptoms of depression and anxiety than those of children without [9, 10, 19], which was reflected in this study by a higher prevalence of reports of “Fair or Poor” mental health in mothers of children with ASD as compared to controls.”
ResultKousha, M., Eslamdoust-Siahestalkhi, F., Rafieian, R. S., & Shoar, Y. (2021) · SRPH Journal of Medical Sciences and Healthcare Management · doi:10.47176/sjmshm.3.3.1 · Cited by 2
“Several studies indicate more stress, anxiety and depression in these parents [7-10].”
Background(2023) · INTERNATIONAL JOURNAL OF PSYCHOLOGICAL AND BEHAVIOURAL RESEARCH (IJPBR) · doi:10.37605/ijpbr.v3i1.34 · Cited by 2
Stipanicic, A., Couture, G., Rivest, C., & Rousseau, M. (2019) · Annales Médico-psychologiques revue psychiatrique · doi:10.1016/j.amp.2019.04.016 · Cited by 2
Susumaningrum, L. A., Juliningrum, P. P., & Rahmadiar, V. S. (2019) · JPI (Jurnal Pendidikan Inklusi) · doi:10.26740/inklusi.v2n2.p65-71 · Cited by 2
“Autis dapat mempengaruhi Parenting Self-Efficacy sebanyak 80%, terutama dalam hal stres yang terkait dengan membesarkan anak dengan autis dan pengaruh stres tersebut pada persepsi ibu tentang kompetensi orang tua (Reszendes dan Scarpa, 2011:8).”
BackgroundHuang, Y. (2022) · Polish Psychological Bulletin · doi:10.24425/ppb.2021.139169 · Cited by 1
“Besides, the results repeat the previous opinions from empirical studies that demonstrated parent’s emotional problems, such as depression and anxiety, exacerbate parenting stress (Huizink et al., 2017; Misri et al., 2010; Rezendes & Scarpa, 2011).”
ResultWallisch, A. M., Little, L. M., Dunn, W., & Tomchek, S. D. (2024) · Autism · doi:10.1177/13623613241232467 · Cited by 1
“Research suggests that the efficacy of parent-implemented interventions is partially dependent on parent characteristics, such as parental stress, competence, and intervention expectations (Estes et al., 2019; Rezendes & Scarpa, 2011; Shalev et al., 2020).”
Bingöl, H., Taşar, N., Bümen, Ş., & Günel, M. K. (2023) · Medical Science and Discovery · doi:10.36472/msd.v10i6.958 · Cited by 1
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Suthar, S., & Sethi, S. (2025) · Industrial Psychiatry Journal · doi:10.4103/ipj.ipj_481_24 · Cited by 1
“[2] The additional time and effort required to address the needs of a child with ASD, along with the necessary adjustments in parental roles, contribute to elevated stress levels.”
Parenting stress and family relationships: analysis of modern research
Александровна, Л. А. (2025) · Вестник Костромского государственного университета им. Н.А. Некрасова. Серия: Педагогика. Психология. Социальная работа. Ювенология. Социокинетика · doi:10.34216/2073-1426-2025-31-1-92-99 · Cited by 1
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Depression in parents of children with disability
Dimoski, S., & Grbović, A. (2020) · Specijalna edukacija i rehabilitacija · doi:10.5937/specedreh19-26208 · Cited by 1
Mental health of parents as a factor in dealing with Autism
Tümlü, C., Akdoğan, R., & Diken, İ. H. (2020) · The Social Science Journal · doi:10.1080/03623319.2020.1848291 · Cited by 2
“…of an individual with special needs (Çimşir, 2017b), and the fact that ASD is a chronic condition for which there is no medical treatment, can lead to an increase and continuation of the psychological difficulties of parents of a child with ASD (Burrell & Borrego, 2012; Rezendes & Scarpa, 2011).”
PARENTS' VIEWS OF THE EFFECT OF COVID-19 ON INDIVIDUALS WİTH SPECIAL NEEDS: THE CASE OF TURKEY
ERDEM, H. Ş., SELİMOĞLU, H., Fazlıoğlu, Y., & AKYÜREK, S. M. (2023) · Trakya Üniversitesi sosyal bilimler dergisi/Trakya Üniversitesi Sosyal Bilimler dergisi · doi:10.26468/trakyasobed.1169642 · Cited by 1
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“…the pertinent scholarly literature is examined, it reveals that the relationship between psychological resilience and self-efficacy of parents whose children have been diagnosed with cerebral palsy and autism spectrum disorder has been examined (Çiğdem, 2022; Rezendes & Scarpa, 2011; Uçar, 2021).”
BackgroundAndoni, L. Y., Eisenhower, A., Poon, C. Y. S., Joseph, K., Blacher, J., & Carter, A. S. (2023) · Research in Autism · doi:10.1016/j.rasd.2023.102291 · Cited by 1
A descriptive study on the depression, anxiety, and stress levels of mothers with autistic children
Al-Graiti, R. H. A., & Öz, H. S. (2024) · Journal of Nursing Care Research · doi:10.51271/jncr-0002 · Cited by 1
Tilson, C., Khawar, S., & Griffith, A. K. (2025) · Journal of Child and Family Studies · doi:10.1007/s10826-025-03045-8 · Cited by 2
“Additionally, there is existing literature on the relationship between autism severity, parenting behaviors, and child maladaptive behaviors (Jang et al., 2011; Lindsey et al., 2020; Rezendes & Scarpa, 2011).”
Familles et trouble du spectre de l'autisme
Krieger, A.-E., & Derguy, C. (2019) · Dunod eBooks · doi:10.3917/dunod.dergu.2019.01.0267 · Cited by 1
As repercussões emocionais em pais com filhos do Transtorno do Espectro Autista
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Relation between Age and Anxiety Level of Autistic Children's Mother
Akhter, S., Nandi, S. R., & Akhter, T. (2015)
Marital Adjustment in Parents of Multiple Children with Autism Spectrum Disorders
Mills, R. (2014) · Journal of International Crisis and Risk Communication Research
The Moderating Role of Mindfulness on the Relationship between Parental Stress and Response to Child
Swain, D. M. (2015) · VTechWorks (Virginia Tech)
Quality of life experiences of parents of children with autism in Scotland
Kuriachan, D. (2018) · ERA
Making Visible The Lived Experiences of Mothers of Children with Autism Spectrum Disorder
Baird-Bate, K. (2019) · Queensland University of Technology · doi:10.5204/thesis.eprints.128644
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Chung, K.-S., & Kim, M. (2020) · Korean Journal of Child Studies · doi:10.5723/kjcs.2020.41.5.1
“Previous research on parental anxiety and anger has mainly targeted children with disabilities and their parents (Rezendes & Scarpa, 2011), and there are insufficient empirical studies on the expression of anger due to inadequate parenting experience or parenting anxiety.”
BackgroundΗ ψυχοκοινωνική υγεία των οικογενειών με παιδιά με διαταραχές αυτιστικού φάσματος
Ευστρατοπούλου, Μ., Μιλτσακάκη, Σ., & Πλιόγκου, Β. (2020) · Psychology the Journal of the Hellenic Psychological Society · doi:10.12681/psy_hps.23277
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Resilience in Parents of Children with Autism Spectrum Disorder
Ekas, N. V., & Rafferty, D. (2021) · Springer eBooks · doi:10.1007/978-3-319-91280-6_102418
برنامج إرشادی انتقائی فی تحسین الشفقة بالذات وخفض الضغوط النفسیة لدى أمهات أطفال اضطراب التوحد
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مفهوم الذات وعلاقته ببعض المشكلات السلوكیة والأسریة لدى عینة من أطفال طیف التوحد
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Conceptualisations of wellbeing: Through the eyes of primary carers of autistic children
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“Research suggests the period of time at diagnosis may be particularly stressful for parents with children with ASD, relative to other developmental disabilities (Dabrowska & Pisula, 2010; Hayes & Watson, 2013; Rezendes & Scarpa, 2011).”
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“The presence of psychiatric and behavioral problems in autistic youth is associated with a host of negative outcomes, including lower quality of life, increased parenting stress, and psychiatric hospitalization (Hwang et al., 2019; Kalb et al., 2018; Leader et al., 2021; Rezendes & Scarpa, 2011).”
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Metadata
- Authors
- Rezendes, D. L., & Scarpa, A.
- Affiliations
- Virginia Tech (US)
- Corresponding author
- Scarpa, Angela
- ORCID
- Scarpa, Angela
- Venue
- Autism Research and Treatment
- Publisher
- Wiley
- Published
- 2011
- Volume
- 2011
- Pages
- 1-10
- ISSN
- 2090-1925 (ISSN-L)
- 2090-1933
- PMC
- PMC3420762
- OpenAlex
- W2141827715
- Semantic Scholar
- e3a6f1ef6c6003ea7bede8ea47c665339617e31a
- Cited by
- 212
- References
- 43
- Citations by year
- 2026: 14 · 2025: 17 · 2024: 24 · 2023: 33 · 2022: 28 · 2021: 22 · 2020: 18 · 2019: 12 · 2018: 9 · 2017: 6 · 2016: 11 · 2015: 7 · 2014: 6 · 2013: 4 · 2012: 1
- FWCI
- 3.80
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Autism Research and Treatment (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- VTechWorks (Virginia Tech) (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- autism spectrum disorder, parental anxiety, parental depression, child behavior problems, parental stress, parental self-efficacy, mediation, mothers, maternal mental health
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