Elizabeth Roof, Elisabeth Dykens, Tara Lerner, and Liam Solus 

Vanderbilt Kennedy Center, Nashville, TN 

Introduction: Parenting children with intellectual disabilities, like PWS, is consistently associated with heightened stress. Several parent and child factors are associated with stressful outcomes, including: coping styles, depression, anxiety, perceptions of stress, etiology of child’s disability, and child maladaptive behavior. It is unclear how these variables relate to maternal physical health status, and to cortisol, a biomarker of stress. It is also unclear how mother’s differ in their positive perceptions of raising children with disabilities, and with their sense of satisfaction and meaning in life. We compared coping styles, depression, anxiety, positive perceptions, health and cortisol levels across mothers of offspring with Prader-Willi syndrome, Williams syndrome, and Autism Spectrum Disorder. We also examined relations between cortisol and maternal health, mental health and well-being within each diagnostic group.   

Methods: Participants included mothers of offspring with either Prader-Willi syndrome (PWS, n = 34) Williams syndrome (WS, n = 27) or Autism Spectrum Disorders (ASD, n = 56). Mothers ranged from 30 to 62 years, mothers of children with ASD were younger (M = 38 years) compared to mothers of children with PWS or WS (M’s = 43 years). Means offspring ages were similar across groups (M’s from 9 to 11 years). Mothers completed a packet of questionnaires tapping health, mental health, stress, coping, and positive perceptions. Salivary samples were collected 6 times (Sarstedt kits) during a typical 8 hour day for each mother and analyzed for cortisol by the VUMC Endocrinology Core lab.  

Results: No significant differences were found across mothers of children with ASD, WS, or PWS in depression, anxiety, history of psychiatric diagnoses, life satisfaction or  meaning, positive parenting, or coping styles. Mothers of children with PWS reported a significant, 2-fold increase in distress on the PSI than remaining groups. Cortisol levels in mothers in the PWS group were positively associated with maternal anxiety on the Beck, maternal anxiety disorders, an avoidant coping style (r’s range .51 to .64; p’s < .05 and .01), and with offspring compulsive behaviors, skin-picking, inattention, and verbal perseveration (r’s ranged from .49 to .73, p’s < .05 and .01). 

Discussion: Cortisol levels associated in PWS with maternal anxiety, and with salient features of the PWS behavioral phenotype, e.g., compulsivity, verbal perseveration, skin-picking. Salivary cortisol sampling is an easy,  noninvasive way to measure stress responses and to identify parents at higher risk for medical and stress related illnesses. We are now examining risk factors that relate to cortisol and the medical and health status of parents, who may care for offspring with PWS over a lifespan.

Edited: 02/09/2012