Chronic Parenting Stress in Parents of Children with Autism: Associations with Chronic Stress in Their Child and Parental Mental and Physical Health.

The study is cross-sectional, so it cannot determine causality or direction of association between stress, health outcomes, and child characteristics. The sample was recruited from mental health care providers in the Netherlands, which may limit generalizability to families not engaged in clinical services or to other cultural contexts. Hair cortisol measurements can be influenced by factors such as hair treatment, medication use (e.g., glucocorticoids), and hair length, though sensitivity analyses suggested these did not alter key results. There was a discrepancy between self-reported stress and physiological stress markers, suggesting that subjective experience and biological response do not always align in this population. The study did not measure potential moderators such as social support, living conditions, or parenting strategies, which could influence the observed associations.

Funded by the Korczak Foundation for Autism and Related Disorders and Stichting tot Steun Vereniging tot Christelijke Verzorging van Geestes- en Zenuwzieken. No specific conflicts of interest for individual authors were declared in the provided text.

Do not assume that high reported parenting stress indicates high physiological stress (hair cortisol). In this study, mothers with higher reported stress actually had lower hair cortisol levels, suggesting a complex relationship between subjective experience and biological stress response that should not be treated as equivalent.