Background: Caring for children with neurodevelopmental disorders such as Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) poses significant psychological challenges for mothers. Global literature consistently shows elevated levels of perceived stress and anxiety in this population. However, limited research in Pakistan directly compares these outcomes between mothers of children with autism and ADHD. Understanding the differential impact in this cultural context is essential for tailoring mental health interventions and support systems for caregivers. Objective: To compare levels of perceived stress and anxiety among mothers of children with autism and ADHD in Pakistan and to examine the mediating role of anxiety in the relationship between stress and depression. Methods: A cross-sectional, correlational study design was employed with a stratified sampling approach. A total of 200 mothers (n=100 autism, n=100 ADHD) were recruited from special education institutions across six cities in Pakistan. Data were collected using the 10-item Perceived Stress Scale (PSS-10) and the 7-item Anxiety subscale of the Depression Anxiety Stress Scale (DASS-21). Hayes Process Macro 4.2 was applied to test mediation. Descriptive statistics, independent t-tests, and mediation analysis were performed using SPSS version 27. Results: Mothers of children with autism scored higher on perceived stress (M=13.54) and anxiety (M=12.59) than mothers of children with ADHD (stress M=9.70; anxiety M=9.66), though the group difference was not statistically significant (p>.05). Mediation analysis revealed that anxiety significantly mediated the relationship between stress and depression (β=0.23, p<.001). Conclusion: This study highlights the compounded mental health burden on mothers of children with neurodevelopmental disorders and emphasizes the critical need for awareness, institutional support, and culturally appropriate psychological interventions in Pakistan.
Zahra et al. (Tue,) studied this question.