The association between parenting difficulties in children with autism and parental anxiety and the moderating role of parenting stress

This study explores the impact of parenting difficulties in children with autism on parental anxiety, and analyzes the moderating role of parenting stress. A total of 207 primary caregivers of autistic children from 13 rehabilitation institutions in Nantong City were selected as subjects, covering the period from May 2024 to May 2025. Data was collected using the Strengths and Difficulties Questionnaire (SDQ), the Self-Rating Anxiety Scale (SAS), and the Chinese version of the Parenting Stress Index-Short Form (PSI-SF). The hypothesized model was tested through correlation analysis and hierarchical regression analysis. The parenting difficulties of children with autism were significantly positively correlated with the level of parental anxiety (r = 0.56, p < 0.01), and the parental anxiety level increased by 1.08 points for each increase of 1 point (β = 0.56, p < 0.001), which verified the direct predictive effect of parenting difficulties on parental anxiety. Parenting stress had a significant moderating effect on the relationship between the two (interaction term β = 0.13, p < 0.05), and the predictive effect of parenting difficulties on anxiety in the high parenting stress group (β = 1.33) was significantly higher than that in the low stress group (β = 0.77). The parenting stress factors in parenting stress had a significant moderating effect on the relationship between the two (interaction term β = 0.58, p < 0.05), and the predictive effect of parenting difficulties on anxiety in the high parenting stress group (β = 6.58) was significantly higher than that in the low stress group (β = 5.76). Parental anxiety was generally at an upper middle level (M = 51.14), while parenting stress (M = 2.34/5) and parenting difficulties (M = 0.80/2) were at a lower middle level, suggesting that the cumulative effect of stress perception may exacerbate psychological risk. Parenting difficulties in children with autism can positively predict parental anxiety; parenting stress plays a significant moderating role between parenting difficulties and parental anxiety, with greater parenting stress amplifying the impact of parenting difficulties in children with autism on parental anxiety levels.