Date of Award
Doctor of Philosophy
School of Arts & Humanities
Dr Elizabeth Kaczmarek
Dr Craig Harms
Research has shown that adolescents with Autism Spectrum Disorder (ASD) are at an increased risk for experiencing depressive symptoms (DS) resulting in poor quality of life and further vulnerability for the recurrence of DS in adulthood. Adolescence is a complex developmental period marked by dynamic social contexts that must be effectively navigated for the maturation processes associated with psychological wellbeing. This period is particularly challenging for individuals with ASD due to deficits in social communication skills leading to atypical social functioning. Consequently, psychosocial risk factors of DS for ASD adolescents are likely to be multiple and complex, and prominent risk factors need to be identified to address their role in the development of DS. Whilst many factors, including the impact of multiple psychosocial causes, may play an ongoing role in the trajectory of DS, what is unique to ASD adolescents when it comes to accessing formal support is their reliance upon maternal help-seeking. Mothers are considered the drivers for accessing treatment for their ASD adolescent due to their age-based dependency and the complexity of their ASD symptomatology. However, due to symptom overlap between ASD and DS, as well as the biopsychosocial challenges associated with adolescence, identification of DS can be difficult for mothers. In order to understand the experience of DS for ASD adolescents, the overall focus of the current project was to examine, in the context of two quantitative investigations, the impact of multiple psychosocial risk factors of DS as well as assess the role of mothers as help-seekers for adolescent’s DS. With a focus on understanding the link between psychosocial risk factors and DS and mothers’ help-seeking behaviour, it is hoped that the current research will minimise the occurrence of DS and expedite recognition and subsequent treatment when symptoms present.
The objective of Investigation 1 was to explore the relationship between a number of psychosocial risk factors and adolescent’s self-report of DS. An initial review of the literature identified that the most commonly researched psychosocial risk factors of DS in adolescents with ASD (age 12-17) were life events, peer victimisation (lack of recipient of pro-social behaviour, overt and relational), attributional style, and ASD symptoms. When the effect of these factors were examined concurrently using multiple regression analysis on DS for a sample of 102 adolescents (age 12-17), it was found that the adolescents who experienced higher frequency of life events in the 3-months prior to completing the survey and who experienced fewer examples of pro-social behaviour from peers were more likely to develop higher levels of DS when controlling for age, medication and anxiety symptoms. Whilst the impact of life events and pro-social behaviour from peers on DS was anticipated, what was not expected was the lack of impact of ASD symptoms, attributional style and overt and relational peer victimisation on DS.
The overall aim of Investigation 2 was to understand the impact of mother’s helpseeking behaviour on the adolescent’s experience of DS using the same adolescent sample and their mothers from Investigation 1. The aims of Investigation 2 were to examine a mother’s capacity to recognise DS and the factors linked with how mothers sought formal services. Based on a correlational analysis it was found that there was moderate agreement between mother and adolescent rated DS with mothers over-reporting DS. Of those mothers who identified DS, a frequency analysis revealed that less than half of mothers sought help for their adolescent. A further frequency analysis identified that mother’s opted not to access formal services if they held views that their own support was sufficient in meeting their adolescents’ mental health needs. A logistical regression revealed that mothers were more likely to help-seek if they had a family history of mental health disorder and elevated levels of stress. It was also found that more than half of mothers reported low levels of satisfaction for services their adolescent had finished.
Overall, Investigation 1 and 2 highlight that the experience of DS for adolescents with ASD is associated with both psychosocial influences and mother’s help-seeking behaviour. Based on the findings of Investigation 1, parents may be mindful that youth with ASD may be at greater risk of developing DS if they experience an increase in life events and peer’s lack of pro-social behaviour. The findings of Investigation 2 indicate that it would be useful to provide support to mothers so that they can better recognise DS in their adolescent and assist them to more effectively seek-help from formal services. Overall, it is concluded that multiple psychosocial risk factors influence the mental health of adolescents with ASD and preventative programs require the inclusion of mothers. Moreover, a multi-level biopsychosocial approach regarding the mental health of adolescents with ASD is warranted.
Gallagher, R. (2020). Adolescents with autism spectrum disorder: Understanding the influence of psychosocial risk factors and mothers’ help-seeking behaviour on the experience of depressive symptoms. https://ro.ecu.edu.au/theses/2343