Parental Psychological Distress Research Articles

Linking child externalising problems to psychological distress in parents: Mobile phone use by children as a mediator.

Child externalising problems, such as acting out and hostility, have been found to be significant stressors for parents, leading to increased distress levels. This cross-sectional study examined the mediating role of parents' use of mobile phones to soothe or engage children in the association between child externalising problems and distress in parents. Altogether 937 parents of children aged 5-12 reported their child's externalising problems, child's mobile phone use, and their distress through an online survey. The findings indicated that parents of children with high externalising problems are more likely to use mobile phones to soothe their children and keep them engaged in daily activities, which, in turn, is associated with higher distress in parents. Child externalising problems and distress in parents remained significantly and positively associated even after accounting for the mediating effect. The results highlight the child-driven effect on distress in parents through parenting behaviours, indicating the importance of providing alternative parenting strategies to cope with child externalising behaviours, in order to promote parental emotional well-being.

How much do adverse childhood experiences contribute to adolescent anxiety and depression symptoms? Evidence from the longitudinal study of Australian children.

This study aims to: (i) examine the association between adverse childhood experiences (ACEs) and elevated anxiety and depressive symptoms in adolescents; and (ii) estimate the burden of anxiety and depressive symptoms attributable to ACEs.Data were analyzed from 3089 children followed between Waves 1 (age 4-5 years) and 7 (16-17 years) of the Longitudinal Study of Australian Children. Logistic regression was used to estimate the associations between ACEs and child-reported elevated anxiety and depressive symptoms at age 16-17. Anxiety and depressive symptoms were measured using the Children's Anxiety Scale and Short Mood and Feelings Questionnaire, respectively. The punaf command available in STATA 14 was used to calculate the population attributable fraction (PAF).Before the age of 18 years, 68.8% of the children had experienced two or more ACEs. In the analysis adjusted for confounding factors, including co-occurring ACEs, both history and current exposure to bullying victimisation and parental psychological distress were associated with a statistically significant increased likelihood of elevated anxiety and depressive symptoms at age 16-17. Overall, 47% of anxiety symptoms (95% CI for PAF: 35-56) and 21% of depressive symptoms (95% CI: 12-29) were attributable to a history of bullying victimisation. Similarly, 17% (95% CI: 11-25%) of anxiety and 15% (95% CI: 4-25%) of depressive symptoms at age 16-17 years were attributable to parental psychological distress experienced between the ages of 4-15 years.The findings demonstrate that intervention to reduce ACEs, especially parental psychological distress and bullying victimisation, may reduce the substantial burden of mental disorders in the population.

'My child could have died': counterfactual thoughts and psychological distress in parents of trauma survivors.

Background: After exposure to a potentially traumatic event, survivors may experience thoughts about 'what could have happened', referred to as counterfactual thoughts (CFTs). CFTs have been found to have a negative impact on survivors' mental health. This is the first study to investigate whether parents of trauma survivors experience CFTs and the association with psychological distress in this group.Objective: The main aim of the present study is to investigate CFTs in parents of trauma survivors and the relationship between the frequency and vividness of CFTs and psychological distress.Method: The participants (N = 310, 191 females) were parents of the youths targeted in the terror attack on Utøya island, Norway, in 2011. Frequency and vividness of CFTs, posttraumatic stress reactions (PTSR), and symptoms of anxiety and depression were measured 8.5-9 years post-terror.Results: The majority of the parents (74%) reported having experienced CFTs at some time point since the attack. For almost one-third of the parents, CFTs were still present more than eight years after the attack. Higher frequency and vividness of CFTs were uniquely associated with higher levels of PTSR, anxiety, and depression.Conclusion: The present findings suggest that frequent and vivid CFTs may contribute to mental health problems in parents of trauma survivors and should be addressed in therapy.

Maternal decentering and child maladjustment: a mediated maternal psychological distress and parenting model

Negative parenting, which exacerbates children’s maladjustment, could result from poor mental health in parents. Therefore, factors that improve parental mental health may also facilitate positive parenting. One such factor is decentering (i.e., the capacity to observe internal experiences as passing mental phenomena that do not reflect self or reality). However, little research has examined the indirect association between parental decentering and children’s maladjustment. This cross-sectional study investigated whether parental decentering was associated with child maladjustment through the mediation of parental psychological distress and parenting quality. Japanese mothers (N = 2522) participated in an online survey assessing parenting quality, maternal decentering levels, maternal psychological distress, and the oldest child’s maladjustment level as reported by the mothers. A parallel mediation analysis revealed a significant indirect effect. Mothers with greater decentering demonstrated lower psychological distress and more positive and less negative parenting. These characteristics were related to lower maladjustment in their children as reported by the mothers. This is the first study to demonstrate the link between decentering and positive maternal parenting. Therefore, decentering may be a possible factor to promote better parenting.

Child behavior problems and parental psychological distress in Chinese families of children with autism: The putative moderating role of parental social support and cultural values.

The wellbeing of parents of children with autism residing in mainland China remains understudied. We aimed to examine whether and how parental perceived social support, individualism, and collectivism acted together to moderate the relationships between child behavior problems and parental psychological distress in Chinese parents of children with autism. With convenience and snowball sampling, data on 268 primary caregiver parents of children with autism were collected from an online cross-sectional survey. Linear regression analysis indicated that child behavior problems were significantly associated with increased psychological distress in Chinese parents of children with autism. There was no evidence to support the stress-buffering model of social support in moderation analysis of the association between child behavior problems and parental psychological distress. Nonetheless, increased social support was associated with lower levels of parental psychological distress. Moderated moderation analyses did not support a role for individualism or collectivism as a moderator of the putative buffering role of social support. However, there was evidence that parental individualism was associated with increased parental psychological distress. Our findings highlight that child behavior problems are a robust correlate of parental psychological distress, and parental social support may act as a compensatory factor promoting less psychological distress rather than having a protective role. The role of social support and cultural values in the wellbeing of parents of children with autism in China requires additional exploration, including longitudinal research designs.

Neurodevelopmental Outcomes for Individuals With Congenital Heart Disease: Updates in Neuroprotection, Risk-Stratification, Evaluation, and Management: A Scientific Statement From the American Heart Association.

Over the past decade, new research has advanced scientific knowledge of neurodevelopmental trajectories, factors that increase neurodevelopmental risk, and neuroprotective strategies for individuals with congenital heart disease. In addition, best practices for evaluation and management of developmental delays and disorders in this high-risk patient population have been formulated based on literature review and expert consensus. This American Heart Association scientific statement serves as an update to the 2012 statement on the evaluation and management of neurodevelopmental outcomes in children with congenital heart disease. It includes revised risk categories for developmental delay or disorder and an updated list of factors that increase neurodevelopmental risk in individuals with congenital heart disease according to current evidence, including genetic predisposition, fetal and perinatal factors, surgical and perioperative factors, socioeconomic disadvantage, and parental psychological distress. It also includes an updated algorithm for referral, evaluation, and management of individuals at high risk. Risk stratification of individuals with congenital heart disease with the updated categories and risk factors will identify a large and growing population of survivors at high risk for developmental delay or disorder and associated impacts across the life span. Critical next steps must include efforts to prevent and mitigate developmental delays and disorders. The goal of this scientific statement is to inform health care professionals caring for patients with congenital heart disease and other key stakeholders about the current state of knowledge of neurodevelopmental outcomes for individuals with congenital heart disease and best practices for neuroprotection, risk stratification, evaluation, and management.

Intergenerational effects of child maltreatment on adolescents’ anxiety and depression in Ethiopia: the important mediating and moderating roles of current psychological distress

BackgroundChild abuse is widespread around the world, and one continent with particularly high rates is Africa. Research in high- and middle-income countries shows the cascading effect of parental history of child abuse and neglect on adolescents’ maltreatment and, in turn, on mental health problems. This cascade has been reported in young children but has rarely been studied in parent-adolescent dyads or in low-income countries (LICs). The goal of this study was to test intergenerational associations of child abuse and neglect and to examine how these experiences are in turn associated with youth anxiety and depression in an LIC.MethodsA total of 231 adolescents (age: 13–21 years) and 185 of their parents (n = 90 fathers and n = 95 mothers) were recruited from secondary schools in Addis Abeba, Ethiopia. Using a cross-sectional design, participants completed a set of questionnaires assessing child maltreatment (in adolescence and own past history in parents), parental psychological distress, youth depression and anxiety, and sociodemographic factors.ResultsThe frequencies of child maltreatment exposure were 68% for adolescents and 65% for their parents (when they were a child). Fifty-one percent and 42% of adolescents had borderline to clinical levels of anxiety and depression symptoms, respectively. Adolescents of parents with a history of child abuse and neglect also reported higher exposure to maltreatment themselves (p < 0.001). Current paternal, but not maternal, psychological distress mediated this intergenerational association of maltreatment experiences (95% CI [1.164, 9.467]). We further found parents’ psychological distress to be a significant moderator of the indirect pathways of the intergenerational effect of child maltreatment on adolescents’ anxiety and depression (95% CI [− 0.770, − 0.012]).ConclusionsWe found child maltreatment to be intergenerationally associated, and this effect subsequently affected adolescents’ anxiety and depression through different pathways supporting the cascading effects across generations. Intervention plans may be effective through an array of possible indirect pathways and encourage the implementation of multiple access points to facilitate change in the lives of affected youth in Africa.

Perceived Parental Rejection as a Predictor of Psychological Distress in LGBQ + Adults and the Moderating Effects of Self-Acceptance of Sexuality

As a marginalized group, individuals who identify as lesbian, gay, bisexual, or queer (LGBQ+) may be particularly at risk for experiencing parental rejection and related negative outcomes. Few studies have focused on parental rejection as experienced in adulthood. Investigators used the Perceived Parental Reactions Scale (PPRS), the Self-Acceptance of Sexuality Inventory (SASI), and the short-form Depression, Anxiety, and Stress Scale (DASS-21) to examine the relationship between present-day perceived parental rejection of sexual identity, self-acceptance of sexuality, and psychological distress in a sample of LGBQ+ adults aged 18–60+ (n = 309). Results found that perceived parental rejection was positively correlated with levels of depression, anxiety, and stress and inversely correlated with self-acceptance of sexuality. Self-acceptance of sexuality also was found to be inversely correlated with psychological distress. Moreover, study results revealed that self-acceptance of sexuality moderated the relationship between present-day perceived parental rejection and psychological distress in LGBQ+ adults. Future directions and clinical implications for these findings are discussed, including expanding diversity in future studies and incorporating considerations for the entire family system, including multigenerational homes.

Reciprocal prospective effects among parental psychological distress, family cohesion, and child socioemotional behavior within families.

This study explores the dyadic longitudinal interplay among parents' psychological distress, family cohesion, children's internalizing/externalizing behaviors, and peer-related social competence within individual and dyadic relationships. Data came from a nationally representative longitudinal cohort study of children in South Korea. The analyses included 1,779 families across three annual timepoints. Children were 4 years old (48.6% girls) and the mean ages of mothers and fathers were 34.8 and 37.3 years, respectively, at baseline. At each assessment point, mothers completed questionnaires regarding their psychological distress, cohesion, and their child's internalizing/externalizing behaviors, while fathers provided information on their psychological distress and family cohesion. Preschool teachers also evaluated children's peer social competence at each measurement timepoint. The results revealed bidirectional associations between maternal ratings of psychological distress and children's internalizing/externalizing behaviors as well as between maternal ratings of cohesion and children's internalizing/externalizing behaviors. Paternal ratings of psychological distress were longitudinally related to maternal ratings of children's internalizing behaviors. Teacher ratings of children's peer social competence were associated with maternal ratings of internalizing/externalizing behaviors and paternal ratings of psychological distress and cohesion. Teacher ratings of peer social competence and maternal ratings of internalizing and externalizing behaviors were reciprocally associated. Maternal and paternal ratings of psychological distress and cohesion were prospectively and bidirectionally associated. The findings demonstrate prospective transactions among family subsystems, some of which were moderated by child sex, while highlighting the importance of obtaining data on each family member and considering interactive effects of both parent and child sex in this line of inquiry. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Assessing the Prevalence of Psychological Distress in Parents of Special Children

Assessing the Prevalence of Psychological Distress in Parents of Special Children

Parental Psychological Control, Alexithymia, Social Avoidance and Distress, and Coping Style among Chinese College Students

Parental Psychological Control, Alexithymia, Social Avoidance and Distress, and Coping Style among Chinese College Students

Parental Awareness Regarding Shaken Baby Syndrome and Associated Factors in Jordan

Background: Shaken Baby Syndrome (SBS) is a serious public health issue believed to result from non-accidental trauma by violently shaking the baby. Purpose: To evaluate the awareness about SBS among parents in Jordan. Risk factors associated with SBS including psychological distress and age were investigated. Methods: A descriptive questionnairebased study consisting of demographic characteristics, SBS knowledge, and parental selfreported psychological distress was conducted. The questionnaire was conducted online between September and October 2022. Descriptive analysis of frequency and percent distribution was used for demographic analysis. Contingency table (Cross Tabulation and Chi-square) along with frequency analysis was used to describe the associations among the frequency distributions of the categorical variables. Results: Over two-thirds (67.65%) of parents (a total of 306 participants) were unaware of SBS and 68.30% of them reported shaking their children. Aging was significantly associated with less SBS knowledge and more self-reported psychological distress. Self-reported psychological distress was significantly associated with increased shaking incidents (p&lt;0.05). Most parents who had shaken their children and were unaware of the syndrome reported psychological distress at an ages of 30 and above. Conclusion: A serious lack of SBS awareness exists among parents in Jordan. Parents’ characteristics including age and self-reported psychological distress are important factors to formulate a logical understanding of the SBS phenomenon. The triad of SBS knowledge, age and psychological distress should be essential components of successful educational programs. Implications for Nursing: The study supports the need for SBS interdisciplinary education and training programs for parents and professionals caring for babies in pediatrics units. Keywords: Shaken baby syndrome, Knowledge, Psychological distress, Abusive head trauma.

Longitudinal associations between parental early psychological distress and children’s emotional and behavioural problems during early childhood and self-reported social functioning in 11-year-old children born very preterm

ABSTRACT This study examined longitudinal associations between parental psychological distress (stress and depression) when the child was 2 to 4 years and a child’s emotional and behavioural problems at ages 3 to 4, and social functioning (loneliness and social competence) at age 11 in very preterm born children. The participants were Finnish families of 172 very preterm infants (gestational age < 32 weeks and/or birth weight ≤ 1500 g). In girls, higher levels of maternal depression were associated with higher levels of social and emotional loneliness. Furthermore, higher levels of maternal stress and children’s externalizing problems were associated with lower levels of experienced empathy. In boys, higher levels of paternal depression were associated with lower levels of social loneliness and impulsive behaviour. In conclusion, early parental psychological distress is associated with early socioemotional development and the later experienced social functioning in former very preterm infants. The sex of the child moderates these associations.

Parent psychological distress and parent-child relationships two years into the COVID-19 pandemic: Results from a Canadian cross-sectional study.

Mental health impacts of the COVID-19 pandemic have not been felt equally within populations. Parents with children living at home were early on identified as a population at heightened mental health risk, with concerns about the potential long-term impacts of the pandemic on parents' mental health, family functioning, and children's well-being. This study investigates impacts of the pandemic on parents' psychological distress, contextual sources of distress, and associations with family functioning nearly two years into the pandemic. Data were drawn from a national cross-sectional survey of adults living in Canada in November and December 2021 that was representative by age, gender, household income, and region. Parents with children < 18 years old living at home (N = 553) reported their experiences of psychological distress, pandemic-related stressors, coping mechanisms, and family functioning (changes in parent-child interactions, children's anxiety). Chi-square tests, logistic regression, and linear regression analyses examined sociodemographic inequities in parents' levels of psychological distress, sources and mitigating mechanisms of distress, and associations between psychological distress and family functioning. Nearly two years into the pandemic, parents with children at home reported nearly double pre-pandemic population estimates of moderate to severe psychological distress. Psychological distress was more frequently reported among parents with pre-existing mental health conditions, disabilities, and financial stressors. Parents with greater psychological distress reported increases in negative parent-child interactions due to the pandemic and higher anxiety among their children. This study identifies sustained negative impacts of the pandemic on parents' mental health and family functioning in Canada nearly two years into the pandemic, despite high vaccine uptake and declining infection rates. Disparities in financial stress, social support structures, and pre-existing mental health were identified as underlying sources of psychological distress. These results highlight that meaningful responses to promote mental health among parents and families must address social and structural inequities.

The mediating role of resilience in the relationship between stress and psychological distress in parents of children with cancer.

Caring for children with cancer is stressful for parents and leads to psychological distress, which is mainly manifested as depressive symptoms and anxiety. This study explored the mediating role of resilience in the relationship between stress and psychological distress in parents of children with cancer. We recruited 258 parents of children with cancer in three tertiary hospitals in Mainland China. The results revealed that the mediating effect of resilience for the relationships between stress and depressive symptoms and between stress and anxiety accounted for 23.4% and 11.4%, respectively, of the total effect. Resilience was confirmed as a protective factor that can be incorporated into future intervention programmes to improve the psychological well-being of parents of children with cancer. Future studies could develop resilience training programmes to enhance the resilience of parents of children with cancer to alleviate parents' psychological distress.

Psychological Distress Among Parents of Children With Chronic Health Conditions and Its Association With Unmet Supportive Care Needs and Children's Quality of Life.

To assess parent psychological distress in families of children with common chronic health conditions (CHC) and to explore relationships between parent psychological distress, unmet supportive care needs and children's quality of life (QoL). Cross-sectional study involving parents of children diagnosed with a common CHC between 0 and 12 years of age and who had received treatment within the last 5 years. Eligible parents completed an online survey, that included the Depression Anxiety Stress Scale (DASS-21) assessing distress in parents and a 34-item assessment of unmet supportive care needs across 6 domains. Parents completed ratings of their child's current functioning (QoL) using the 23-item PedsQL. Multivariable regression models examined the relative association between unmet needs, children's QoL and parents' depression, anxiety, and stress. The sample consisted of 194 parents of children with congenital heart disease (n=97; 50%), diabetes (n=50; 26%), cancer (n=39; 20%), and asthma (n=8; 4%). A significant proportion of parents had moderate-severe symptoms of depression (26%), anxiety (38%), and stress (40%). Of the PedsQL scales, the poorest outcomes were found for emotional and school functioning. Multivariable analyses showed that both higher unmet needs and poorer child emotional functioning were associated with parent depression, anxiety, and stress symptoms. Evidence linking parent distress symptoms to higher unmet needs and poorer child emotional functioning suggests these factors may be targets for interventions to alleviate parent distress. Longitudinal research using larger samples is required to replicate findings, and clarify the magnitude and direction of associations.

Emotional behavioral outcomes of children with unilateral and mild hearing loss.

Deaf and hard-of hearing (DHH) children often experience emotional/behavioral difficulties. The impact of unilateral/mild hearing loss (HL) on children's emotion and behavior are unclear. We aimed to describe emotional/behavioral, health related quality-of-life (HRQoL) and parent psychological distress outcomes of school-age children with unilateral/mild HL, compared to children with moderate to profound HL, and in relation to population norms; and identify predictive factors of emotional/behavioral difficulties. Data of 339 DHH children, 5-12 years, enrolled in the Victorian Childhood Hearing Longitudinal Databank (VicCHILD), which include demographics, early development, medical/audiological characteristics and parent rated questionnaires of emotion/behavior, HRQoL and parental psychological distress collected at various stages of child's life were analyzed. We used Cohen's d to investigate the outcomes by measuring the mean score differences of both groups with published norms and logistic regression to analyze the factors predictive of emotional/behavioral difficulties. The proportion of children with unilateral/mild HL and moderate to profound HL who experienced emotional/behavioral difficulties was similar (18.3% vs. 20.6%), with hyperactivity and poor prosocial behavior reported as the predominant symptoms in both groups. Mean emotional/behavioral scores of both groups were comparable and substantially higher than normative population scores. This was also the case for HRQoL and levels of parent distress. Among children with unilateral/mild HL, additional health needs were the strongest predictive factor, demonstrating an approximately 1.7-fold increase in odds of emotional/behavioral difficulties (OR = 1.67; 95% CI 1.29-2.17, p < 0.001) with every additional health need. Early developmental concerns, other than communication milestone and attending mainstream schoolshowed weaker evidence of association. Children with unilateral/mild HL were just as likely as those with moderate to profound HL to experience more emotional/behavioral difficulties, poorer HRQoL and higher parental distress scores compared to population norms. Our findings justify the provision of early intervention, support and medical services for all DHH children to identify those at risk of poorer outcomes.

Recalled Parental Emotion Socialisation and Psychological Distress: The Role of Emotional Schemas.

Recalled parental emotion socialisation has been associated with psychological distress in adulthood. Since emotional schemas develop from interpersonal interaction and can result in pathological reactions, they can be an important mechanism. The present study analyses the mediator role of emotional schemas in the relationship between recalled parental emotion socialisation and psychological distress. A community sample of 246 Portuguese adults, between 18 and 73 years old (M = 34.3, SD = 13.32), completed the following self-report measures: Emotional (In)Validation Experiences Scale; Leahy Emotional Schema Scale; and Brief Symptom Inventory 18. Two mediation models were estimated, one for each parent. Emotional schemas mediated the relationship between recalled parental emotion socialisation and psychological distress. Negative evaluation of emotion was the strongest mediator in the relationship between emotional invalidation and psychological distress while difficulties in reappraisal was the strongest mediator in the relationship between emotional validation and psychological distress. Differences were observed between the mother's and father's models. Results highlight the importance of emotional schemas in understanding the role of parental emotion socialisation in psychological distress, which may have important implications for intervention and prevention.

Comparing Pediatric Surgeons' and Palliative Care Pediatricians’ Palliative Care Practices and Perspectives in Pediatric Surgical Patients

PurposeThe nature of interactions between surgical and pediatric palliative care (PPC) teams caring for seriously ill children is unknown. This study compares pediatric surgeons' and PPC physicians’ perspectives and practices regarding PPC in surgical patients. MethodsA survey was administered to members of the American Pediatric Surgical Association and Pediatric Interest Group of the American Academy of Hospice and Palliative Medicine. ResultsOne hundred twenty-four pediatric surgeons (31% female, 17.2 mean years of experience) and 71 PPC physicians (69% female, 10.1 mean years of experience) participated. Forty-three percent of surgeons reported consulting PPC often for children with serious illnesses. However, most PPC physicians (67%), said they are rarely/never consulted by surgeons (p = 0.002). PPC physicians were more likely to report that PPC involvement was too late (43% vs 21%, p = 0.005). More surgeons than PPC physicians felt that an appropriate time for PPC consultation was during serious illness deterioration (30% vs 7%, p = 0.05), whereas PPC physicians preferred consultation at diagnosis (54% vs 34%, p = 0.05). More PPC physicians (67%) than surgeons (17%) agreed that invasive interventions could be considered a form of PPC (p = 0.002). The most reported barrier to PPC consultation by surgeons (29%) was concern that parents would think the surgical team was giving up. PPC physicians were more likely to perceive barriers to consultation by surgeons than surgeons themselves (p < 0.001). ConclusionWhile pediatric surgeons value PPC involvement, surgical culture and misperception of parental resistance to PPC involvement lead to palliative care consultation only when illness acuity and severity are high, the possibility of curability is low, and death seems imminent. Seeking to understand patient and family priorities in care, managing patient and parental psychological distress, and treating non-surgical symptoms are areas where PPC can improve patient care. Barriers to PPC use and self-reported knowledge gaps in PPC provision may be mitigated by formalized PPC training for surgeons and intentional collaboration between the two groups. Type of StudySurvey. Level of EvidenceN/A.

Association of physical activity with psychological distress and happiness in mothers of children with autism spectrum disorders during the COVID-19 pandemic

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic may have severely impacted the psychological status of mothers of children with autism spectrum disorder (ASD). Although a previous study reported that physical activity (PA) moderated psychological distress in parents of children with ASD during the COVID-19 pandemic, the effect of PA on the happiness levels of such parents during the pandemic remains unclear. This study investigated the associations among PA, psychological distress, and happiness in mothers of children with ASD during the COVID-19 pandemic.MethodsThis cross-sectional study was designed to evaluate mothers of children with disabilities. Questionnaires were collected from mothers living in Yamaguchi and Okayama Prefectures, Japan, between February and December 2022. During this period, three large waves of the COVID-19 pandemic occurred in Japan. Of the 601 respondents, 334 mothers had children with ASD and offered valid data. PA was assessed using the short form of the International Physical Activity Questionnaire. Psychological distress and happiness were assessed using the six-item Kessler Psychological Distress Scale (K6) and the Subjective Happiness Scale (SHS).ResultsThe mothers had markedly higher K6 scores (6.49) and more than half of them had moderate-to-severe psychological distress, whereas the SHS scores (4.46) were similar to that of the general Japanese population. In a multivariable-adjusted model based on the analysis of covariance, the K6 score was not associated with any PA items. In contrast, SHS scores were positively associated with moderate-intensity PA (MPA) and total moderate- to vigorous-intensity PA (MVPA), independent of K6. In the post-hoc test, mothers who did some (4.52) or enough (≥ 150 min/week) MPA (4.56) had a higher SHS score than those who did not (4.09). Similarly, mothers who engaged in sufficient (≥ 600 MET-min/week) total MVPA had higher SHS scores (4.57) than those who did not engage in MVPA (4.12).ConclusionsThe mothers of children with ASD during the COVID-19 pandemic had markedly higher psychological distress, though none of the PA items were associated with stress levels. However, PA was positively associated with happiness in mothers of children with ASD independent of their stress levels.