Effectiveness of parent training in improving stress-coping capability, anxiety, and depression in mothers raising children with autism spectrum disorder

Naoko Iida; Yoshihisa Wada; Tatsuhisa Yamashita; Michiko Aoyama; Kiyoshi Hirai; Jin Narumoto

doi:10.2147/NDT.S188387

Effectiveness of parent training in improving stress-coping capability, anxiety, and depression in mothers raising children with autism spectrum disorder

Neuropsychiatr Dis Treat. 2018 Dec 7:14:3355-3362. doi: 10.2147/NDT.S188387. eCollection 2018.

Authors

Naoko Iida^{1

2}, Yoshihisa Wada^{1

3}, Tatsuhisa Yamashita^{1

2

4}, Michiko Aoyama^{5

6}, Kiyoshi Hirai^{5

6}, Jin Narumoto¹

Affiliations

¹ Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan, n-iida@koto.kpu-m.ac.jp.
² Department of Child Psychiatry, Kyoto Prefectural Child Development Support Center, Kyoto, Japan, n-iida@koto.kpu-m.ac.jp.
³ Fuchu-mikumari Hospital, Hiroshima, Japan.
⁴ Department of Child and Adolescent Psychiatry, Yamashita Mental Health Clinic, Kyoto, Japan.
⁵ Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
⁶ Department of Pediatrics, Kyoto Prefectural Child Development Support Center, Kyoto, Japan.

Abstract

Purpose: Raising a child with autism spectrum disorder (ASD) can be a stressor, and mothers of ASD children often present with high levels of stress and depression. Interventional steps to enhance parental coping skills and resiliency are more important for parental mental health and the family-centered care of children with ASD than merely reducing parental stress. Although the importance of stress-coping skills is well established, only a few studies have investigated interventional steps to improve parental coping or resiliency. Parent training (PT) is known to improve a mother's mental health. Here, we aimed to assess the effectiveness of PT in improving the stress-coping style of mothers raising children with ASD.

Patients and methods: Thirty mothers of children with ASD aged 4-11 years participated in this study. The mothers underwent PT based on the Hizen Parenting Skills Training in Japan, which comprised seven sessions. Each session included education on behavior therapy, individual consultation, and workshops in small groups. Sixteen mothers completed psychological assessment, including the Stress Coping Inventory, the Beck Depression Inventory Second Edition, the State-Trait Anxiety Inventory, and the Child Behavior Checklist conducted before and after 2 months of PT.

Results: The outcomes before and after the PT program were compared using the paired t-test and Pearson's correlation. After the PT program, the mothers' stress-coping strategy "positive appraisal" significantly increased (P<0.01) and "escape/avoidance" significantly decreased (P<0.01). The Beck Depression Inventory Second Edition (P<0.05) and the trait anxiety scores (P<0.01) also significantly decreased. The change in the stress-coping strategy "distancing" had a significantly negative correlation with the change in the externalizing Child Behavior Checklist T-scores of children with ASD (Pearson r=-0.518, P<0.05).

Conclusion: PT may be effective for mothers of children with ASD to improve their stress-coping style and to decrease their depression and trait anxiety.

Keywords: anxiety; autism spectrum disorder; depression; parent training; parents’ stress coping.