Associated Factors of Parental Stress: Child Repetitive Behaviour and Cognitive Emotional Regulation in Parents of Children with Autism Spectrum Disorder in Kelantan

Abstract

INTRODUCTION: Restricted and Repetitive behaviour (RRB) is one of the main features in autism spectrum disorder (ASD). This behaviour may disrupt children’s routines and adaptability, contributing to significant parental stress. Good coping strategies are important for parents in handling this stress. This study aims to study the parents' stress levels, children’s restricted and repetitive behaviour, and cognitive-emotional regulation among parents of ASD children in Kelantan and its associations. MATERIALS & METHODS: A cross-sectional study was conducted from December 2023 to May 2024, involving 177 parents, selected through purposive sampling. Data were collected using the Malay versions of the Perceived Stress Scale, Repetitive Behaviour Scale-Revised, and Cognitive Emotional Regulation Questionnaire. Descriptive statistics and linear regression analyses were performed using SPSS to identify significant predictors. RESULTS: Among the respondents, 80.2% were mothers. The mean perceived stress score was slightly high at 16.86 (6.26). Positive Reappraisal had the highest cognitive strategy score with a mean 15.30 (3.89). The most common RRB was Sameness with a mean 7.95 (6.38). Factors significantly associated with parental stress included being a mother, having mental illness, Rumination, Positive Refocusing, Positive Reappraisal, Stereotyped, and Sameness behaviour (all p<0.05). CONCLUSION:  Parental stress was moderately high among those with ASD children in Kelantan. Major stressors included being a mother, having mental illness, rumination, and children's stereotyped and sameness behaviours, while positive refocusing and reappraisal acted as protective factors. These findings highlight the need to promote effective cognitive emotional regulation strategies to alleviate stress in parents of children with ASD.