Abstract
Background Oppositional behaviors are often an important issue for parents who have a child with autism spectrum disorder (ASD), and have been shown to be related to their Quality of Life (QoL). The present study examines the possible mediation and moderation effects of parenting stress and coping in the relationship between oppositional behaviors in the child with ASD and parental QoL. Method Parental stress, coping strategies, parental QoL and children's challenging behaviors (CBCL oppositional problem domain) were studied through parent‐report (335 mothers and 230 fathers) over two occasions in a cohort of 485 children and adolescents with ASD (398 boys and 87 girls) with a mean age of 6.14 years (SD = 3.46) at baseline. Mediation and moderation effects were examined using structural equation modeling. Results Strong associations between child behaviors, parental stress and parental QoL were evidenced. Parental stress mediated the relationship between opposition in the child and parental QoL at diagnosis, but this effect was much smaller 3 years after diagnosis. Surprisingly, problem solving and social support, two commonly recommended coping strategies, had little or no effect on reducing impact on QoL 3 years later. Conclusions Longitudinal analysis allowed us to estimate the causal pathway between child oppositional behaviors, parental stress and impact on parental QoL. Our findings emphasize the crucial role of parental stress, which can mediate the impact of the children's oppositional behaviors on parental QoL. They argue for the need to develop specific interventions for parents focusing on parental stress and child's behavior management.