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Caregiver Psychological Distress Predicts Temperament and Social-Emotional Outcomes in Infants with Autism Traits

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Abstract

Child temperament and caregiver psychological distress have been independently associated with social-emotional difficulties among individuals with autism. However, the interrelationship among these risk factors has rarely been investigated. We explored the reciprocal interplay between child temperament (surgency, negative affectivity, and self-regulation) and caregiver psychological distress in the development of child internalizing and externalizing symptoms, in a cohort of 103 infants showing early autism traits. Caregivers completed questionnaires when children were aged around 12-months (Time 1 [T1]), 18-months (Time 2 [T2]), and 24-months (Time 3 [T3]). Cross-lagged path models revealed a significant pathway from T1 caregiver psychological distress through lower T2 child self-regulation to subsequently greater T3 child internalizing symptoms. No such caregiver-driven pathway was evident through T2 child negative affectivity or in the prediction of T3 child externalizing symptoms. Further, no support was found for temperament-driven pathways through caregiver psychological distress to child social-emotional difficulties. Child surgency was mostly unrelated to caregiver psychological distress and social-emotional difficulties. These findings implicate the need to support the mental health of caregivers with an infant with autism traits in order to enhance the emotion regulation and social-emotional development of their infants.

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Acknowledgments

We would like to thank families for their participation. Thanks also to Sarah Fritsche, Natalie Mizzi, Ashley Rattenbury, Maddy Russell-Maynard, and Megan Harrap for their research assistance.

Funding

This study formed part of LC’s PhD research, supported by scholarships from La Trobe University and the Cooperative Research Centre for Living with Autism (Autism CRC), established and supported under the Australian Government’s Cooperative Research Centres Program. The larger trial from which these data were available was funded by grants from the Telethon-Perth Children’s Hospital, Autism CRC, La Trobe University Understanding Disease Research Focus Area, and the Angela Wright Bennett Foundation. MU is supported by a Discovery Early Career Researcher Award from the Australian Research Council (DE180100632) and AJOW is supported by an Investigator Grant from the National Health and Medical Council (#APP1173896). JG is a UK NIHR Senior Investigator, the views expressed are not necessarily those of the NIHR or the UK Department of Health.

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Authors and Affiliations

  1. Department of Psychology and Counseling, School of Psychology and Public Health, La Trobe University, Melbourne, Australia

    Lacey Chetcuti, Stefanie Dimov & Kristelle Hudry

  2. Cooperative Research Centre for Living With Autism (Autism CRC), Brisbane, Australia

    Lacey Chetcuti, Maryam Boutrus, Josephine Barbaro, Cheryl Dissanayake & Andrew J. O. Whitehouse

  3. Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, School of Medicine, Stanford University, Stanford Autism Center, Stanford, California, USA

    Mirko Uljarević

  4. School of Psychological Sciences, Faculty of Medicine, The University of Melbourne, Dentistry and Health Sciences, Melbourne, Australia

    Mirko Uljarević

  5. School of Allied Health Sciences, Griffith University, Brisbane, Australia

    Kandice J. Varcin

  6. Telethon Kids Institute, University of Western Australia, Nedlands, Australia

    Maryam Boutrus, Sarah Pillar & Andrew J. O. Whitehouse

  7. Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Australia

    Josephine Barbaro & Cheryl Dissanayake

  8. Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK

    Jonathan Green

  9. Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester Mental Health NHS Trust, Manchester, UK

    Jonathan Green

  10. Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK

    Ming Wai Wan

  11. Australian Centre for Precision Health, Division of Health Sciences, University of South Australia, Adelaide, Australia

    Leonie Segal

  12. Evelina Children’s Hospital / Institute of Psychiatry, Psychology, and Neuroscience, King’s College, London, UK

    Vicky Slonims

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  1. Lacey Chetcuti
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Consortia

The AICES Team

  • Teresa Iacono
  • , Murray Maybery
  • , Michelle Renton
  • , Nancy Sadka
  • , Leonie Segal
  • , Scott Wakeling
  •  & John Wray

Contributions

LC conceived the study, collected data, conducted statistical analyses, and drafted the manuscript under supervision of MU and KH. MB, SP, and SD collected data and KJV, JB, CD, JG, MWW, LS, VS, AJOW, and KH conceived and coordinated the larger trial. All authors revised the manuscript for critical intellectual content and approved its final version. The AICES Team were involved in aspects of the larger trial beyond the focus of the current study. The AICES team in alphabetical order: Teresa Iacono, Murray Maybery, Michelle Renton, Nancy Sadka, Leonie Segal, Scott Wakeling, and John Wray.

Corresponding author

Correspondence to Lacey Chetcuti.

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Conflicts of Interest

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Ethical Approval

This study was approved by the Child and Adolescent Health Services Committee (2016008EP, June 8, 2016) and performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

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Written informed consent was obtained from the parents/caregivers.

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Chetcuti, L., Uljarević, M., Varcin, K.J. et al. Caregiver Psychological Distress Predicts Temperament and Social-Emotional Outcomes in Infants with Autism Traits. Res Child Adolesc Psychopathol 49, 1669–1681 (2021). https://doi.org/10.1007/s10802-021-00838-5

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