Multidimensional Correlates of Mental Health and Quality of Life in Chinese Caregivers of Preschool-Aged Autistic Children.

PURPOSE: We examined correlates of mental health and quality of life (QoL) among Chinese caregivers of preschool-aged autistic children (aged 18-59 months), using baseline data collected prior to intervention enrollment at a specialist autism center. METHODS: In this cross-sectional study, 424 caregivers (84.2% mothers) attending an urban autism center in Guangzhou completed measures of child characteristics, parental factors, and environmental variables. Hierarchical regression identified independent correlates of five outcomes (mental health and four QoL domains). RESULTS: Parental distress was the strongest independent correlate of all outcomes (β = 0.384 for mental health symptoms; β = -0.327 to - 0.466 for QoL domains; all P < 0.01). At the Bonferroni-corrected threshold, positive coping was associated with better psychological QoL (β = 0.176, P < 0.001), and social motivation difficulties with poorer psychological and environmental QoL. Having more than one child was associated with better psychological, social and environmental QoL. In exploratory analyses, social motivation difficulties showed indirect associations with poorer outcomes through parental distress; positive reframing was associated with fewer mental health symptoms and better environmental QoL; self-blame and religious coping each amplified the distress-mental health association (both P < 0.01). CONCLUSION: Parental distress was the most consistently associated factor across caregiver mental health and all QoL domains. Self-blame and religious coping amplified the distress-mental health association, while adaptive coping was associated with better outcomes in psychological QoL. These findings underscore the need for further investigation into parental distress and self-blame as key correlates of caregiver well-being in this population.