Relations among co-occurring psychopathology in youth with autism spectrum disorder, family resilience, and caregiver coping

•Youth with autism and co-occurring conduct problems or depression were more likely to be cared for by adults who were not coping very well.•High family resilience was a compensatory factor and directly associated with lower odds of poor caregiver coping.•Co-occurring conduct problems or depression were associated with worse caregiver coping even after accounting for family resilience. Co-occurring mental health problems are common in youth with autism spectrum disorder (ASD) and are associated with greater caregiver stress; however, it is not known whether such challenges overwhelm caregivers’ ability to cope. Research has demonstrated that families of children with ASD are able to demonstrate resilience; yet, whether family resilience functions as a compensatory or protective factor in ASD families has not been investigated. This study aimed to examine the relations among family resilience, co-occurring psychopathology in youth with ASD, and caregiver coping. Data from this study were obtained from the 2016–2018 National Survey of Children’s Health (NSCH). Multiple binary logistic regression was run to examine the associations among commonly co-occurring psychiatric disorders in youth with ASD (i.e., anxiety, depression, attention-deficit/hyperactivity disorder, and behavioral/conduct problems) and caregiver coping. Another multiple binary logistic regression was run to examine whether family resilience moderates the aforementioned relationships. Youth with ASD and co-occurring conduct problems or depression were significantly more likely to be cared for by adults who were not coping well. High family resilience was directly associated with lower odds of poor parental coping; nonetheless, co-occurring conduct problems and depression were still associated with worse coping of caregivers after accounting for family resilience. Findings indicate that co-occurring depression and conduct problems in ASD youth may overwhelm their caregivers’ coping resources. Results also suggest that interventions targeting family resilience may improve the coping of adults caring for children and adolescents with ASD.