Exploring the Moderating Role of Benefit Finding on the Relationship Between Child Problematic Behaviours and Psychological Distress in Caregivers of Children with ASD

  • Brian LovellEmail author
  • Mark A. Wetherell
Original Paper


Caregivers of children with ASD often find benefits associated with their caregiving role, and benefit finding predicts lower distress. Child problematic behaviours (CPB), which positively predict caregivers’ distress, are perceived to be being less problematic, or more manageable, by caregivers who find benefits. Benefit finding therefore might mitigate the negative psychological impact of CPB. A sample of n = 158 caregivers of children with ASD completed an online survey assessing benefit finding, CPB, and psychological distress. CPB positively, and benefit finding negatively, predicted caregivers’ distress. Moderation effects however were not observed. Findings implicate increased CPB and lower benefit finding as risk factors for caregivers’ psychological distress. Findings provide clearly definable targets for intervention.


ASD Benefit finding Child problematic behaviours Moderation Psychological distress 



This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author Contributions

BL and MAW ceonceptualised the study, collected and analysed data, and penned the manuscript.

Compliance with ethical standards

Conflict of interest

Authors declare that they no conflict of interest.


  1. Al-Farsi, O. A., Al-Farsi, Y. M., Al-Sharbati, M. M., & Al-Adawi, S. (2015). Stress, anxiety, and depression among parents of children with autism spectrum disorder in Oman: A case–control study. Neuropsychiatric Disease and Treatment,12, 1943–1951.CrossRefGoogle Scholar
  2. Andersen, P. N., Hovik, K. T., Skogli, E. W., & Øie, M. G. (2017). Severity of autism symptoms and degree of attentional difficulties predicts emotional and behavioral problems in children with high-functioning autism: A two-year follow-up study. Frontiers in Psychology. Scholar
  3. Bayat, M. (2007). Evidence of resilience in families of children with autism. Journal of Intellectual Disability Research,51(9), 702–714.PubMedCrossRefPubMedCentralGoogle Scholar
  4. Bekhet, A. K. (2013). Effects of positive cognitions and resourcefulness on caregiver burden among caregivers of persons with dementia. International Journal of Mental Health Nursing,22, 340–346.PubMedCrossRefPubMedCentralGoogle Scholar
  5. Bekhet, A. K. (2016). The mediating effects of positive cognitions on autism caregivers’ depression and their children’s challenging behaviours. Archives of Psychiatric Nursing,30, 13–18.PubMedCrossRefPubMedCentralGoogle Scholar
  6. Bekhet, A. K. (2017). Positive thinking training intervention for caregivers of persons with autism: Establishing fidelity. Archives of Psychiatric Nursing,31, 306–310.PubMedCrossRefPubMedCentralGoogle Scholar
  7. Bekhet, A. K., & Garnier-Villarreal, M. (2018). Depression, positive thinking, personal and social resourcefulness among caregivers of persons with autism spectrum disorders. Archives of Psychiatric Nursing,32(6), 823–827.PubMedCrossRefPubMedCentralGoogle Scholar
  8. Bekhet, A. K., Johnson, N. L., & Zauszniewski, J. A. (2012). Resilience in family members of persons with autism spectrum disorder: A review of the literature. Issues in Mental Health Nursing,33(10), 650–656.PubMedCrossRefPubMedCentralGoogle Scholar
  9. Bekhet, A. K., & Matel-Anderson, D. (2017). Risk and protective factors in the lives of caregivers of persons with autism: Caregivers’ perspectives. Perspectives in Psychiatric Care,53(3), 199–207.PubMedCrossRefPubMedCentralGoogle Scholar
  10. Benson, P. R. (2014). Coping and psychological adjustment among mothers of children with ASD: An accelerated longitudinal study. Journal of Autism and Developmental Disorders,44(8), 1793–1807.PubMedCrossRefPubMedCentralGoogle Scholar
  11. Benson, P. R., & Karlof, K. L. (2008). Anger, stress proliferation, and depressed mood among parents of children with ASD: A longitudinal replication. Journal of Autism and Developmental Disorders,39(2), 350–362.PubMedCrossRefPubMedCentralGoogle Scholar
  12. Brockman, M., Hussain, K., Sanchez, B., & Turns, B. (2016). Managing child behavior problems in children with autism spectrum disorders: Utilizing structural and solution focused therapy with primary caregivers. American Journal of Family Therapy,44(1), 1–10.CrossRefGoogle Scholar
  13. Campbell, J. M. (2003). Efficacy of behavioral interventions for reducing problem behavior in persons with autism: A quantitative synthesis of single-subject research. Research in Developmental Disabilities,24(2), 120–138.PubMedCrossRefPubMedCentralGoogle Scholar
  14. Carver, C. S., & Antoni, M. H. (2004). Finding benefit in breast cancer during the year after diagnosis predicts better adjustment 5 to 8 years after diagnosis. Health Psychology,26, 595–598.CrossRefGoogle Scholar
  15. Cassidy, T., Giles, M., & McLaughlin, M. (2014). Benefit finding and resilience in child caregivers. British Journal of Health Psychology,19, 606–618.PubMedCrossRefPubMedCentralGoogle Scholar
  16. Cheng, S. T., Mak, E. P. M., Fung, H. H., Kwok, T., Lee, D. T. F., & Lam, L. C. W. (2017). Benefit-finding and effect on caregiver depression: A double-blind randomized controlled trial. Journal of Consulting and Clinical Psychology,85(5), 521–529.PubMedCrossRefPubMedCentralGoogle Scholar
  17. Cheshire, A., Barlow, J., & Powell, L. (2010). Coping using positive reinterpretation in parents of children with cerebral palsy. Journal of Health Psychology,15, 801–810.PubMedCrossRefPubMedCentralGoogle Scholar
  18. Ekas, N. V., Timmons, L., Pruitt, M., Ghilain, C., & Alessandri, M. (2015). The power of positivity: Predictors of relationship satisfaction for parents of children with autism spectrum disorder. Journal of Autism and Developmental Disorders,45(7), 1997–2007.PubMedCrossRefPubMedCentralGoogle Scholar
  19. Feldman, M. A., & Werner, S. E. (2002). Collateral effects of behavioral parent training on families of children with developmental disabilities and behavior disorders. Behavioral Interventions,17, 75–83.Google Scholar
  20. Foo, M., Yap, P. M. E. H., & Sung, M. (2015). The experience of Singaporean caregivers with a child diagnosed with autism spectrum disorder and challenging behaviours. Qualitative Social Work,14(5), 634–650.CrossRefGoogle Scholar
  21. Freuler, A. C., & Baranek, G. T. (2016). Military spouses caring for a child with autism: Exploring risk and protective factors department of allied health sciences. Journal of Family Medicine,3(1), 1049–1056.Google Scholar
  22. Gardner, M. H., Mrug, S., Schwebel, D. C., Phipps, S., Whelan, K., & Madan-Swain, A. (2017). Benefit finding and quality of life in caregivers of childhood cancer survivors: The moderating roles of demographic and psychosocial factors. Cancer Nursing,40(5), 28–37.CrossRefGoogle Scholar
  23. Glidden, L. M., & Schoolcraft, S. A. (2003). Depression: Its trajectory and correlates in mothers rearing children with intellectual disability. Journal of Intellectual Disability Research,47(4–5), 250–263.PubMedCrossRefPubMedCentralGoogle Scholar
  24. Goodman, R. (1997). The strengths and difficulties questionnaire: A research note. Journal of Child Psychology and Psychiatry,38, 581–586.PubMedPubMedCentralCrossRefGoogle Scholar
  25. Hayes, A. F. (2012). PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modelling. Retrieved June 5, 2019, from
  26. Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: The Guilford Press.Google Scholar
  27. Hayes, S. A., & Watson, S. L. (2013). The impact of parenting stress: A meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder. Journal of Autism and Developmental Disorders,43, 629–642.PubMedCrossRefPubMedCentralGoogle Scholar
  28. Helgeson, V. S., Reynolds, K. A., & Tomich, P. L. (2006). A meta-analytic review of benefit finding and growth. Journal of Consulting and Clinical Psychology,74, 797–816.PubMedCrossRefPubMedCentralGoogle Scholar
  29. Hillman, J. L., & Anderson, C. M. (2019). It’s a battle and a blessing: The experience and needs of custodial grandparents of children with autism spectrum disorder. Journal of Autism and Developmental Disorders,49, 260–269.PubMedCrossRefPubMedCentralGoogle Scholar
  30. Hutchison, L., Feder, M., Abar, B., & Winsler, A. (2016). Relations between parenting stress, parenting style, and child executive functioning for children with ADHD or autism. Journal of Child and Family Studies,25, 3644–3656.CrossRefGoogle Scholar
  31. Kayfitz, A. D., Gragg, M. N., & Orr, R. R. (2010). Positive experiences of mothers and fathers of children with autism. Journal of Applied Research in Intellectual Disabilities,23, 337–343.CrossRefGoogle Scholar
  32. Keenan, B. M., Newman, L. K., Gray, K. M., & Rinehart, N. J. (2016). Parents of children with ASD experience more psychological distress, parenting stress, and attachment-related anxiety. Journal of Autism and Developmental Disorders,46(9), 2979–2991.PubMedCrossRefPubMedCentralGoogle Scholar
  33. Kim, K., Kim, J., Voight, A., & Ji, M. (2018). Listening to the screaming whisper: A voice of mother caregivers of children with autistic spectrum disorder (ASD). International Journal of Qualitative Studies on Health and Well-being,13, 1–8.Google Scholar
  34. Kuhaneck, H. M., Burroughs, T., Wright, J., Lemanczyk, T., & Darragh, A. R. (2010). A qualitative study of coping in mothers of children with an autism spectrum disorder, physical & occupational therapy. Pediatrics,30(4), 340–350.Google Scholar
  35. Lai, W. W., & Oei, T. P. S. (2014). Coping in parents and caregivers of children with autism spectrum disorders (ASD): A review. Review Journal of Autism and Developmental Disorders,1(3), 207–224.CrossRefGoogle Scholar
  36. Lovell, B., Elliot, H., Liu, C. C. S., & Wetherell, M. A. (2014). Memory failures for everyday tasks in caregivers of children with autism spectrum disorder. Research in Developmental Disabilities,35, 3057–3061.PubMedCrossRefPubMedCentralGoogle Scholar
  37. Lovell, B., Moss, M., & Wetherell, M. A. (2012). With a little help from my friends: Psychological, endocrine and health corollaries of social support in parental caregivers of children with autism or ADHD. Research in Developmental Disabilities,33, 682–687.PubMedCrossRefGoogle Scholar
  38. Lovell, B., Moss, M., & Wetherell, M. A. (2015). The psychophysiological and health corollaries of child problem behaviours in caregivers of children with autism and ADHD. Journal of Intellectual and Disability Research,59(2), 150–157.CrossRefGoogle Scholar
  39. Lovell, B., Moss, M., & Wetherell, M. A. (2016). Assessing the feasibility and efficacy of written benefit-finding for caregivers of children with autism: A pilot study. Journal of Family Studies,22(1), 32–42.CrossRefGoogle Scholar
  40. Lovell, B., & Wetherell, M. A. (2015). Child behaviour problems mediate the association between coping and perceived stress in caregivers of children with autism. Research in Autism Spectrum Disorders,20, 17–23.CrossRefGoogle Scholar
  41. Ludlow, A., Skelly, C., & Rohleder, P. (2011). Challenges faced by parents of children diagnosed with autism spectrum disorder. Journal of Health Psychology,17(5), 702–711.PubMedCrossRefPubMedCentralGoogle Scholar
  42. McStay, R. L., Dissanayake, C., Scheeren, A., Koot, H. A., & Begeer, S. (2013). Parenting stress and autism: The role of age, autism severity, quality of life and problem behaviour of children and adolescents with autism. Autism,18(5), 502–510.PubMedCrossRefPubMedCentralGoogle Scholar
  43. Mei, Y., Wilson, S., Lin, B., Li, Y., & Zhang, Z. (2018). Benefit finding for Chinese family caregivers of community-dwelling stroke survivors: A cross-sectional study. Journal of Clinical Nursing,27(7–8), e1419–e1428.PubMedCrossRefPubMedCentralGoogle Scholar
  44. O’Nions, E., Happé, F., Evers, K., Boonen, H., & Noens, I. (2018). How do parents manage irritability, challenging behaviour, non-compliance and anxiety in children with autism spectrum disorders? A meta-synthesis. Journal of Autism and Developmental Disorders,48(4), 1272–1286.PubMedCrossRefPubMedCentralGoogle Scholar
  45. Pakenham, K. I., Sofronoff, K., & Samios, C. (2004). Finding meaning in parenting a child with Asperger syndrome: Correlates of sense making and benefit finding. Research in Developmental Disabilities,25, 245–264.PubMedCrossRefPubMedCentralGoogle Scholar
  46. Phelps, K. W., Hodgson, J. L., McCammon, S. L., & Lamson, A. L. (2009). Caring for an individual with autism disorder: A qualitative analysis. Journal of Intellectual & Developmental Disability,34(1), 27–35.CrossRefGoogle Scholar
  47. Ping Ang, K. Q., & Loh, P. R. (in press). Mental health and coping in parents of children with autism spectrum disorder (ASD) in Singapore: An examination of gender role in caring. Journal of Autism and Developmental Disorders. Google Scholar
  48. Rosenberg, R. E., Law, J. K., Yenokyan, G., McGready, J., Kaufmann, W. E., & Law, P. A. (2009). Characteristics and concordance of autism spectrum disorders among 277 twin pairs. Archives of Paediatrics & Adolescent Medicine,163(10), 907–914.CrossRefGoogle Scholar
  49. Ruiz-Robledillo, N., & Moya-Albiol, L. (2013). Self-reported health and cortisol awakening response in parents of people with Asperger syndrome: The role of trait anger and anxiety, coping and burden. Psychology & Health,28(11), 1246–1264.CrossRefGoogle Scholar
  50. Salomone, E., Leadbitter, K., Aldred, C., Barrett, B., Byford, S., Charman, T., et al. (2018). The association between child and family characteristics and the mental health and wellbeing of caregivers of children with autism in mid-childhood. Journal of Autism and Developmental Disorders,48, 1189–1198.PubMedCrossRefPubMedCentralGoogle Scholar
  51. Samios, C., Pakenham, K. I., & Sofronoff, K. (2009). The nature of benefit finding in parents of a child with Asperger syndrome. Research in Autism Spectrum Disorders,3(2), 358–374.CrossRefGoogle Scholar
  52. Sim, A., Cordiera, R., Vaza, S., & Falkmera, T. (2019). “We are in this together”: Experiences of relationship satisfaction in couples raising a child with autism spectrum disorder. Research in Autism Spectrum Disorders,58, 39–51.CrossRefGoogle Scholar
  53. Slattery, É., McMahon, J., & Gallagher, S. (2017). Optimism and benefit finding in parents of children with developmental disabilities: The role of positive reappraisal and social support. Research in Developmental Disabilities,65, 12–22.PubMedCrossRefPubMedCentralGoogle Scholar
  54. Stewart, M., Knight, T., McGillivray, J., Forbes, D., & Austin, D. W. (2017). Through a trauma-based lens: A qualitative analysis of the experience of parenting a child with an autism spectrum disorder. Journal of Intellectual & Developmental Disability,42(3), 212–222.CrossRefGoogle Scholar
  55. Walker, R. V., Powers, S. M., & Bisconti, T. L. (2016). Positive aspects of the caregiving experience: Finding hope in the midst of the storm. Women & Therapy,39, 354–370.CrossRefGoogle Scholar
  56. Wang, Y., Zhu, X., Yi, J., Tang, L., He, J., Chen, G., et al. (2015). Benefit finding predicts depressive and anxious symptoms in women with breast cancer. Quality of Life Research,24(11), 2681–2688.PubMedCrossRefPubMedCentralGoogle Scholar
  57. Woodman, A. C., & Hauser-Cram, P. (2013). The role of coping strategies in predicting change in parenting efficacy and depressive symptoms among mothers of adolescents with developmental disabilities. Journal of Intellectual Disability Research,57(6), 513–530.PubMedCrossRefPubMedCentralGoogle Scholar
  58. Yorke, I., White, P., Weston, A., Rafla, M., Charman, T., & Simonof, E. (2018). The association between emotional and behavioural problems in children with autism spectrum disorder and psychological distress in their parents: A systematic review and meta-analysis. Journal of Autism and Developmental Disorders,48, 3393–3415.PubMedPubMedCentralCrossRefGoogle Scholar
  59. Zhou, T., & Yi, C. (2014). Parenting styles and parents’ perspectives on how their own emotions affect the functioning of children with autism spectrum disorders. Family Process,53, 67–79.PubMedCrossRefPubMedCentralGoogle Scholar
  60. Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica,67, 361–370.PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of PsychologyNorthumbria UniversityNewcastle upon TyneUK

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