Interpersonal relationship and its associated factors mong parents of children with Autism Spectrum Disorder

Abstract

Background: Raising children with autism spectrum disorder (ASD) causes tremendous stress for parents that may lead to marital conflict, which, in turn, could affect the quality of caring for their children. Interpersonal relationships are an important factor contributing to the couple's satisfaction. Interpersonal relationships, especially based on interpersonal circumplex between parents, has not been sufficiently investigated among this population. The primary purpose of this study was investigate the relationship between individual interpersonal style and other associated factors and couple satisfaction among parents of children with ASD. The second objective was to investigate the relationship between interpersonal style and couple satisfaction and parental negative mental health outcomes, such as stress, anxiety, and depression. ghts reserved Methods: Seven hundred ninety-four (397 pairs) Chinese parents of children aged 7-14 years with ASD participated in the study. Demographic information and questionnaires were completed about (a) relationships between husbands and wives, and (b) child caretaking. Couple satisfaction, level of autistic behavior, parents' perceived stress, perceived social support, and interpersonal styles or problems were assessed. Interpersonal complementarity was evaluated using Carson's Similarity and Wiggin's models. The Actor Partner Interdependence Model (APIM) estimated by multilevel modeling was used for dyadic analysis. Results: Mean age of mothers and fathers was 36.33 (SD 3.4), and 35.36 (SD3.1), most had earned at least a bachelor's degree (43.2%), were employed (88.4%), and resided in urban areas (68.3%). Mothers were the main caregiver of the children with ASD. Vindictive and cold interpersonal types were the most common, with 80.9% of couples having similar interpersonal styles. More severe ASD was correlated with lower couple satisfaction (r = -.22, p <.01), but not with parental perceived stress (p >.05), anxiety (p >.05), or depression (p >.05). Higher perceived social support was associated with higher couple satisfaction (p <.01) and parental stress (p <.01) but with lower parental perceived anxiety (p <.01) and depression (p <.01). Having greater similar interpersonal complementarity was associated with higher couple satisfaction (r = .15, p <.01) and parental stress (r = .16, p <.01), but with lower parental perceived anxiety (r= -.14, p <.01) and depression (r= -.15, p <.01). Couple satisfaction was moderate to high in both groups (mean 65.81 (SD, 11.5) and 65.40 (SD, 10.9) for husbands and wives respectively, and no significant difference was observed regarding relationship satisfaction between them. In the APIM results, employment, time spent in childcare, severity of autistic symptoms and perceived social support all significantly predicted couple satisfaction (p <.006), but only the participants' own couple satisfaction could be predicted. However, residence area, monthly income and type of marriage did not predict couple satisfaction (p >.006). However, perceived social support tended to have a partner effect from husbands to wives (B = 0.159, p = .058). Interpersonal complementarity did not predict couple satisfaction.Conclusion: Consistent with related studies, the more time spent in childcare and severity of autistic symptoms predicted lower couple satisfaction, whereas higher perceived social support predicted higher couple relationship satisfaction. Despite the fact that most couples exhibited similar interpersonal styles, no evidence was found that this related to the relationship quality. Most couples had relatively long relationships and their level of satisfaction indicated they adjusted well. However, social support deems to be the key factor for both their relationship and parental negative mental health outcomes, and perceived social support tended to have partner effects as well. The effect of interpersonal complementarity on couple satisfaction should be further explored in depth. Other complementary models should be examined. In addition, intervention regarding providing emotional support should be further investigated.