Reciprocal Associations Between Parental Anxiety/Depression and Emotional/Behavioral Difficulties in Autistic Children Following Their Diagnosis

Abstract

Emotional and behavioral difficulties (EBD) are common in autistic children, while anxiety and depressive symptoms (ADS) are prevalent in their parents. However, the bidirectional relationship between the parents' and children's symptoms remains unclear, especially in the years following the child's autism diagnosis. Addressing this gap, our study investigates the bidirectional association between parental ADS and two subdomains of EBD (internalizing and externalizing difficulties) in autistic children from diagnosis (T0) to 3 years later (T1). Data from the French ELENA cohort were analyzed using two-wave cross-lagged panel models (CLPM). At the time of diagnosis, 55.2% of mothers and 42.7% of fathers among 315 parents exhibited clinically significant ADS, while 61.3% of children experienced clinical EBD. The CLPMs did not reveal any directional association between parental ADS and children's EBD. However, we observed significant autoregressive effects for parental ADS and children's EBD, with a moderate positive correlation between the two at the time of diagnosis. Our findings highlight significant psychological distress in both parents and children at the time of diagnosis and therefore recommend suitable interventions for families requiring social, financial, or psychological support. Future longitudinal studies with greater representation of girls, using continuous-time models could clarify whether parent–child associations are time-lag dependent (including identifying potential peak lags) and whether they differ across parent–child sex dyads.