Parenting Stress, Parental Attitudes, and Parent-Reported Autism Symptoms of Children and Adolescents With Autism Spectrum Disorder: A Network Analysis and Subgroup Comparison by Severity.

Autism spectrum disorder (ASD) presents substantial challenges for individuals and families, particularly through elevated parenting stress. Previous research has established that parenting stress is influenced by multiple interrelated factors, including parental attitudes toward ASD and parent-reported autism symptoms. Yet, the structural relations among these factors remain poorly understood. This study applied network analysis to delineate the interconnections among parenting stress, parental attitudes, and parent-reported autism symptoms in 997 parents of children and adolescents with ASD (aged 1-18 years). Network structures were compared across subgroups defined by mild, moderate, and severe levels of autism symptoms. Using Gaussian Graphical Models with EBICglasso, the analysis identified central and bridge nodes. In the overall network, "Difficult Child" showed the highest node and bridge strength. Network structure, global strength, and node strength did not differ significantly across severity subgroups after correction for multiple comparisons, which is consistent with a broadly stable network organization of parenting stress across autism severity levels. Across all severity groups, "Difficult Child" consistently emerged as the most central node, highlighting it as a potentially shared intervention-relevant target for supporting families of children with ASD across the autism severity spectrum.