Psychophysiological measures of stress in caregivers of individuals with autism spectrum disorder: a systematic review

Purpose: Parents of children with autism spectrum disorder (ASD) often self-report heightened levels of stress and physical health problems. This paper reviewed studies assessing physiological measures of stress among parents of children with ASD. Methods: Systematic database searches identified 15 studies meeting inclusion criteria. Studies were reviewed to determine: (a) control group characteristics; (b) caregiver and care recipient characteristics; (c) setting; (d) physiological measures employed; (e) physiological outcomes; and (f) stressor type. A measure of methodological quality was also applied. Results: Salivary cortisol was the most common physiological measure employed. A pattern of blunted physiological activity emerged within the reviewed studies, though some studies reported normal or even higher physiological activity among this population. Conclusions: Findings suggested dysfunction of the hypothalamic-pituitary-adrenal-axis and autonomic nervous system for some, but not all, parents of children with ASD. Further research is warranted.