An Initial Examination of Post‐Traumatic Stress Disorder in Mothers of Children with Autism Spectrum Disorder: Challenging Child Behaviors as Criterion A Traumatic Stressors

Abstract

Parenting a child with autism spectrum disorder (ASD) is associated with high levels of stress. Several studies have conceptualized this as a traumatic stress response to challenging child behaviors such as self‐harm, suicidal ideation, and physical aggression toward caregivers. In the present study, we explored the relevance of a trauma‐based diagnostic framework to a sample of 30 mothers (M age = 42.97, SD = 5.82) of children with ASD (M age = 12.43, SD = 3.15). Participants were interviewed using the Clinician‐Administered PTSD Scale for DSM‐5 (CAPS‐5) for post‐traumatic stress disorder (PTSD) and an abbreviated Mini International Neuropsychiatric Interview to assess for comorbidity. Three participants were excluded as they met criteria for PTSD from a traumatic event unrelated to their parenting experience. Of the remaining 27 participants, 6 (22.2%) met criteria for PTSD in the context of traumatic parenting experiences. Descriptions of traumatic events experienced are summarized. Results suggest that, for some parents, challenging child behaviors such as physical violence toward the caregiver from the child, self‐injurious behaviors, and suicidal behaviors function as traumatic stressors as per Criterion A of PTSD (American Psychiatric Association [2013]. Diagnostic and statistical manual of mental disorders [DSM‐5]. Arlington, VA). This has implications for health professionals engaged with parents of children with ASD, who should consider the possibility of PTSD when challenging behaviors of a potentially traumatic nature are present. Autism Res 2020. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary This study found that some challenging behaviors exhibited by children with autism spectrum disorder can be traumatic for parents and lead to the development of post‐traumatic stress disorder. Some of these behaviors included self‐harming behaviors like head banging, expressing suicidal urges, and becoming physically aggressive toward parents during meltdowns. Autism Res 2020, 13: 1527–1536. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.

Psychological distress among caregivers raising a child with autism spectrum disorder during the COVID‐19 pandemic

“…Positive responses to this item could indicate vulnerability to COVID‐related trauma. Prior research has suggested greater levels of trauma, particularly Post Traumatic Stress Disorder, in parents of children with ASD who have severe challenging behavior (Schnabel, Hallford, et al, 2020 ; Stewart et al, 2020 ). Unfortunately, no measures of child‐level behavior were available in the present study.…”

Post-Traumatic Stress Reactions in Caregivers of Children and Adolescents/Young Adults with Severe Diseases: A Systematic Review of Risk and Protective Factors

“…The last ones are a range of not socially acceptable conduct that can be physi-cally dangerous to the child or the family, and which have been associated with elevated parenting stress [104,105]. Challenging behaviors that place the child and/or the parent at risk of harm include physical aggression and self-injurious behaviors, suicidal behaviors, elopement, and pica [106][107][108][109]. These behaviors can have a greater physical and emotional impact on parents than core ASD symptoms, bringing a high risk of PTSD [71].…”

Commentary on “Brief report on six clinical cases of trauma in families who have children and adults who have a learning disability and/or are autistic”

“…A loss of self-identity and crisis management (for example, where a relative with learning disabilities had been at risk of harm to self or others) were identified as themes in a literature review of the perspectives of family carers of people with learning disabilities and behaviour that challenges (Griffith and Hastings, 2014). A study in Australia recommended that health and care professionals consider the possibility of trauma-related mental health conditions in parents of autistic children when their child presented with self-injurious and/or suicidal behaviour (Schnabel et al , 2020b). In a mixed-methods study of the experiences of mothers of autistic children, social support was identified as important for post-traumatic growth (Wayment et al , 2019).…”