“They don’t understand how bad I feel”: Inconsistencies between mother-rated and self-rated symptoms of depression in autistic girls

Abstract

BackgroundMost previous reports of the level of agreement between parents’ and their autistic children’s self-reports of the latter’s depression have used the total score from a scale. However, depression is a heterogeneous disorder, comprised of 10 discrete symptoms. This study examined carer-reports versus self-reports of depressive symptomatology in autistic girls. MethodFifty-three autistic girls and their mothers completed the Major Depressive Disorder subscale of the Child and Adolescent Symptom Inventory (4th ed). Data were examined at the individual symptom level, and also in terms of whether mothers under- or over-rated their daughter’s self-reports. ResultsAlthough about 15% of the mothers and daughters gave the same total score ratings, nearly 38% of mothers over-rated their daughters’ ratings, and more than 47% under-rated their daughters’ severity of depression scores. The autistic girls rated their change in activity and their change in sleeping more severely than their mothers did, but the mothers rated their daughters’ anhedonia more severely. ConclusionsAssessment of autistic girls depression symptom profiles may be less than completely accurate when based solely upon mothers’ information. The pattern of mother-daughter depression symptom inconsistencies suggests that individualised treatment planning for depression in autistic girls may be partially impeded by the possibility that these girls seek to disguise some of their depressive symptomatology, and that mothers’ ratings may also be influenced by their own depressive state.