Caregiver depression in families living with autism spectrum disorder: A meta-analysis based on ecological systems theory

Abstract

Background: Depressive symptoms in family caregivers of persons with autism spectrum disorder are highly prevalent, however the impact of family and social support systems on caregivers’ mental health outcomes is unclear. Aim: To review and map correlates of caregivers’ depressive symptoms using an ecological systems framework. Methods: Thirty-four studies, comprising a pooled sample of 4,968 caregivers, were identified from the Embase, PsycINFO and PubMed databases. Study reporting quality was assessed using the QualSyst tool. Pearsons r, along with fail-safe Ns and heterogeneity, were calculated using random effects modelling. The moderating effect of informal support (perceived, received, network characteristics) was examined. Results: Studies provided good to excellent methodological detail. Weak-to-moderate associations (rw range = -.199 to -.406) were noted between lowered depressive symptoms with positive family unit functioning, relationship quality (marital and parent-child), and informal support (from partners, family, friends). These results were not moderated by the operationalisation of informal support. Conclusions: Clinicians should assess the social and family networks of caregivers to identify those most vulnerable to developing depression. Intervention effectiveness can be enhanced by involving relevant family members in treatment.