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Journal of Autism and Developmental Disorders

Gepubliceerd in:

26-04-2019 | Original Paper

Mood Disorders in High-Functioning Autism: The Importance of Alexithymia and Emotional Regulation

Auteurs: Kristen P. Morie, Scott Jackson, Zu Wei Zhai, Marc N. Potenza, Barbara Dritschel

Gepubliceerd in: Journal of Autism and Developmental Disorders | Uitgave 7/2019

Abstract

Individuals with autism spectrum disorder (ASD) often have co-morbid anxiety and depression. Alexithymia and emotion regulation difficulties are commonly seen in individuals with ASD and in mood disorders. We hypothesized that alexithymia and emotional regulation would mediate the relationship between autistic features and anxiety/depression symptom severity. We collected data about emotional regulation, alexithymia, autistic symptoms and depression/anxiety in a sample of 64 young adults with ASD. We constructed two serial multiple mediator models, using autistic features as the independent variable and anxiety/depression symptoms as outcome variables. The serial relationship between alexithymia and emotional regulation mediated associations between autistic features and depression and anxiety, separately. The findings suggest that targeting alexithymia may benefit therapies designed to alleviate mood disorders in ASD.

vorige artikel “They don’t have a good life if we keep thinking that they’re doing it on purpose!”: Teachers’ Perspectives on the Well-Being of Students with Autism

volgende artikel Atypical Response to Caregiver Touch in Infants at High Risk for Autism Spectrum Disorder

Ainslie Rosbrook, K. W. (2010). Autistic traits in the general population: What mediates the link with depressive and anxious symptomatology? Research in Autism Spectrum Disorders, 4, 415–424.CrossRef

Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the depression anxiety stress scales in clinical groups and a community sample. Psychological Assessment, 10(2), 176–181.CrossRef

APA. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.

Armstrong, A. R., Galligan, R. F., & Critchley, C. R. (2011). Emotional intelligence and psychological resilience to negative life events. Personality and Individual Differences, 51(3), 331–336. https://doi.org/10.1016/j.paid.2011.03.025.CrossRef

Ashburner, J., Ziviani, J., & Rodger, S. (2010). Surviving in the mainstream: Capacity of children with autism spectrum disorders to perform academically and regulate their emotions and behavior at school. Research in Autism Spectrum Disorders, 4(1), 18–27. https://doi.org/10.1016/j.rasd.2009.07.002.CrossRef

Aust, S., Hartwig, E. A., Heuser, I., & Bajbouj, M. (2013). The role of early emotional neglect in alexithymia. Psychological Trauma-Theory Research Practice and Policy, 5(3), 225–232. https://doi.org/10.1037/a0027314.CrossRef

Bagby, R. M., Ayearst, L. E., Morariu, R. A., Watters, C., & Taylor, G. J. (2014). The internet administration version of the 20-item Toronto alexithymia scale. Psychological Assessment, 26(1), 16–22. https://doi.org/10.1037/a0034316.CrossRefPubMed

Bagby, R. M., Parker, J. D., & Taylor, G. J. (1994). The twenty-item Toronto alexithymia scale–I. Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38(1), 23–32.CrossRef

Barnhill, G. P., & Smith-Myles, B. (2001). Attributional style and depression in adolescents with Asperger syndrome. Journal of Positive Behaviour Interventions, 3, 175–183.CrossRef

Becerra, R., Cruise, K., Murray, G., Bassett, D., Harms, C., Allan, A., et al. (2013). Emotion regulation in bipolar disorder: Are emotion regulation abilities less compromised in euthymic bipolar disorder than unipolar depressive or anxiety disorders? Open Journal of Psychiatry, 3, 1–7.CrossRef

Bernhardt, B. C., Valk, S. L., Silani, G., Bird, G., Frith, U., & Singer, T. (2014). Selective disruption of sociocognitive structural brain networks in autism and alexithymia. Cerebral Cortex, 24(12), 3258–3267. https://doi.org/10.1093/cercor/bht182.CrossRefPubMed

Berthoz, S., & Hill, E. L. (2005). The validity of using self-reports to assess emotion regulation abilities in adults with autism spectrum disorder. European Psychiatry, 20(3), 291–298. https://doi.org/10.1016/j.eurpsy.2004.06.013.CrossRefPubMed

Bilotta, E., Giacomantonio, M., Leone, L., Mancini, F., & Coriale, G. (2015). Being alexithymic: Necessity or convenience. Negative emotionality x avoidant coping interactions and alexithymia. Psychology and Psychotherapy, 4, 5. https://doi.org/10.1111/papt.12079.CrossRef

Bird, G., & Cook, R. (2013). Mixed emotions: The contribution of alexithymia to the emotional symptoms of autism. Translational Psychiatry, 3, e285. https://doi.org/10.1038/tp.2013.61.CrossRefPubMedPubMedCentral

Bolte, S., Poustka, F., & Constantino, J. N. (2008). Assessing autistic traits: Cross-cultural validation of the social responsiveness scale (SRS). Autism Research, 1(6), 354–363. https://doi.org/10.1002/aur.49.CrossRefPubMed

Brown, T. A., Chorpita, B. F., Korotitsch, W., & Barlow, D. H. (1997). Psychometric properties of the depression anxiety stress scales (DASS) in clinical samples. Behaviour Research and Therapy, 35(1), 79–89.CrossRef

Campbell, D. W., & McKeen, N. A. (2011). Alexithymia tendencies and mere exposure alter social approachability judgments. Journal of Personality, 79(2), 335–358. https://doi.org/10.1111/j.1467-6494.2010.00687.x.CrossRefPubMed

Connelly, M., & Denney, D. R. (2007). Regulation of emotions during experimental stress in alexithymia. Journal of Psychosomatic Research, 62(6), 649–656. https://doi.org/10.1016/j.jpsychores.2006.12.008.CrossRefPubMed

Constantino, J. N., & Gruber, C. P. (2012). Social responsiveness scale-second edition (SRS-2). Torrance: Western Psychological Services.

Cook, R., Brewer, R., Shah, P., & Bird, G. (2013). Alexithymia, not autism, predicts poor recognition of emotional facial expressions. Psychological Science, 24(5), 723–732.CrossRef

Corden, B., Chilvers, R., & Skuse, D. (2008). Avoidance of emotionally arousing stimuli predicts social-perceptual impairment in Asperger’s syndrome. Neuropsychologia, 46(1), 137–147. https://doi.org/10.1016/j.neuropsychologia.2007.08.005.CrossRefPubMed

Crawford, J. R., & Henry, J. D. (2003). The depression anxiety stress scales (DASS): Normative data and latent structure in a large non-clinical sample. British Journal of Clinical Psychology, 42(Pt 2), 111–131. https://doi.org/10.1348/014466503321903544.CrossRefPubMed

Dalbudak, E., Evren, C., Aldemir, S., Coskun, K. S., Yildirim, F. G., & Ugurlu, H. (2013). Alexithymia and personality in relation to social anxiety among university students. Psychiatry Research, 209(2), 167–172. https://doi.org/10.1016/j.psychres.2012.11.027.CrossRefPubMed

Fernandez-Berrocal, P., Alcaide, R., & Extremera, N. (2006). The role of emotional intelligence in anxiety and depression among adolescents. Individual Differences Research, 4, 1.

Gotham, K., Pickles, A., & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(5), 693–705. https://doi.org/10.1007/s10803-008-0674-3.CrossRefPubMed

Grabe, H. J., Frommer, J., Ankerhold, A., Ulrich, C., Groger, R., Franke, G. H., et al. (2008). Alexithymia and outcome in psychotherapy. Psychotherapy and Psychosomatics, 77(3), 189–194. https://doi.org/10.1159/000119739.CrossRefPubMed

Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54.CrossRef

Gross, J. J. (2015). Emotion regulation: Current status and future prospects. Psychological Inquiry, 26(1), 1–26. https://doi.org/10.1080/1047840x.2014.940781.CrossRef

Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85(2), 348–362. https://doi.org/10.1037/0022-3514.85.2.348.CrossRefPubMed

Harms, M. B., Martin, A., & Wallace, G. L. (2010). Facial emotion recognition in autism spectrum disorders: A review of behavioral and neuroimaging studies. Neuropsychology Review, 20(3), 290–322. https://doi.org/10.1007/s11065-010-9138-6.CrossRefPubMed

Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: The Guilford Press.

Hayes, A. F., & Matthes, J. (2009). Computational procedures for probing interactions in OLS and logistic regression: SPSS and SAS implementations. Behavior Research Methods, 41(3), 924–936. https://doi.org/10.3758/BRM.41.3.924.CrossRefPubMed

Helles, A., Gillberg, I. C., Gillberg, C., & Billstedt, E. (2017). Asperger syndrome in males over two decades: Quality of life in relation to diagnostic stability and psychiatric comorbidity. Autism, 21(4), 458–469. https://doi.org/10.1177/1362361316650090.CrossRefPubMed

Hill, E., Berthoz, S., & Frith, U. (2004). Brief report: Cognitive processing of own emotions in individuals with autistic spectrum disorder and in their relatives. Journal of Autism and Developmental Disorders, 34, 229–235.CrossRef

Hogeveen, J., Bird, G., Chau, A., Krueger, F., & Grafman, J. (2016). Acquired alexithymia following damage to the anterior insula. Neuropsychologia, 82, 142–148. https://doi.org/10.1016/j.neuropsychologia.2016.01.021.CrossRefPubMedPubMedCentral

Honkalampi, K., Hintikka, J., Tanskanen, A., Lehtonen, J., & Viinamaki, H. (2000). Depression is strongly associated with alexithymia in the general population. Journal of Psychosomatic Research, 48(1), 99–104. https://doi.org/10.1016/S0022-3999(99)00083-5.CrossRefPubMed

Karukivi, M., Hautala, L., Kaleva, O., Haapasalo-Pesu, K. M., Liuksila, P. R., Joukamaa, M., et al. (2010). Alexithymia is associated with anxiety among adolescents. Journal of Affective Disorders, 125(1–3), 383–387. https://doi.org/10.1016/j.jad.2010.02.126.CrossRefPubMed

Laloyaux, J., Fantini, C., Lemaire, M., Luminet, O., & Laroi, F. (2015). Evidence of contrasting patterns for suppression and reappraisal emotion regulation strategies in alexithymia. The Journal of Nervous and Mental Disease, 203(9), 709–717. https://doi.org/10.1097/NMD.0000000000000353.CrossRefPubMed

Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Jr., Leventhal, B. L., DiLavore, P. C., et al. (2000). The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205–223.CrossRef

Lougheed, J. P., & Hollenstein, T. (2012). A limited repertoire of emotion regulation strategies is associated with internalizing problems in adolescence. Social Development, 21(4), 704–721.CrossRef

Loveland, K. A., Tunalikotoski, B., Pearson, D. A., Brelsford, K. A., Ortegon, J., & Chen, R. (1994). Imitation and expression of facial affect in autism. Development and Psychopathology, 6(3), 433–444. https://doi.org/10.1017/S0954579400006039.CrossRef

Lovibond, P. F., & Lovibond, S. H. (1995a). The structure of negative emotional states: Comparison of the depression anxiety stress scales (DASS) with the Beck depression and anxiety inventories. Behaviour Research and Therapy, 33(3), 335–343.CrossRef

Lovibond, S. H., & Lovibond, P. F. (1995b). Manual for the depression anxiety stress scales. Sydney: Psychology Foundation.

Lugnegard, T., Hallerback, M. U., & Gillberg, C. (2011). Psychiatric comorbidity in young adults with a clinical diagnosis of Asperger syndrome. Research in Developmental Disabilities, 32(5), 1910–1917. https://doi.org/10.1016/j.ridd.2011.03.025.CrossRefPubMed

Lyall, K., Croen, L., Daniels, J., Fallin, M. D., Ladd-Acosta, C., Lee, B. K., et al. (2017). The changing epidemiology of autism spectrum disorders. Annual Review of Public Health, 38, 81–102. https://doi.org/10.1146/annurev-publhealth-031816-044318.CrossRefPubMed

Mankus, A. M., Boden, M. T., & Thompson, R. J. (2016). Sources of variation in emotional awareness: Age, gender, and socioeconomic status. Personality and Individual Differences, 89, 28–33. https://doi.org/10.1016/j.paid.2015.09.043.CrossRefPubMedPubMedCentral

Mazefsky, C. A., Herrington, J., Siegel, M., Scarpa, A., Maddox, B. B., Scahill, L., et al. (2013). The role of emotion regulation in autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 52(7), 679–688. https://doi.org/10.1016/j.jaac.2013.05.006.CrossRefPubMedPubMedCentral

Naghavi, F., & Redzuan, M. (2012). The theoretical framework and application on the relationships between family functioning, alexithymia and emotional intelligence among early adolescents. Life Science Journal-Acta Zhengzhou University Overseas Edition, 9(1), 764–770.

Onur, E., Alkin, T., Sheridan, M. J., & Wise, T. N. (2013). Alexithymia and emotional intelligence in patients with panic disorder, generalized anxiety disorder and major depressive disorder. Psychiatric Quarterly, 84(3), 303–311. https://doi.org/10.1007/s11126-012-9246-y.CrossRefPubMed

Panayiotou, G., Leonidou, C., Constantinou, E., Hart, J., Rinehart, K. L., Sy, J. T., et al. (2015). Do alexithymic individuals avoid their feelings? Experiential avoidance mediates the association between alexithymia, psychosomatic, and depressive symptoms in a community and a clinical sample. Comprehensive Psychiatry, 56, 206–216. https://doi.org/10.1016/j.comppsych.2014.09.006.CrossRefPubMed

Pandey, R., Saxena, P., & Dubey, A. (2011). Emotion regulation difficulties in alexithymia and mental health. Europe’s Journal of Psychology, 7(4), 604–623.CrossRef

Parker, J. D. A., Taylor, G. J., & Bagby, R. M. (2001). The relationship between emotional intelligence and alexithymia. Personality and Individual Differences, 30(1), 107–115. https://doi.org/10.1016/S0191-8869(00)00014-3.CrossRef

Parker, J. D., Taylor, G. J., & Bagby, M. (2003). The 20-Item Toronto alexithymia scale III. Reliability and factorial validity in a community population. Journal of Psychosomatic Research, 55, 269–275. https://doi.org/10.1016/S0022-3999(02)00578-0.CrossRefPubMed

Petrides, K. V., Mikolajczak, M., Mavroveli, S., Sanchez-Ruiz, M. J., Furnham, A., & Perez-Gonzalez, J. C. (2016). Developments in trait emotional intelligence research. Emotion Review, 8(4), 335–341. https://doi.org/10.1177/1754073916650493.CrossRef

Poquerusse, J., Pastore, L., Dellantonio, S., & Esposito, G. (2018). Alexithymia and autism spectrum disorder: A complex relationship. Frontiers in Psychology, 9, 1196. https://doi.org/10.3389/fpsyg.2018.01196.CrossRefPubMedPubMedCentral

Reszka, S. S., Boyd, B. A., McBee, M., Hume, K. A., & Odom, S. L. (2014). Brief report: Concurrent validity of autism symptom severity measures. Journal of Autism and Developmental Disorders, 44(2), 466–470. https://doi.org/10.1007/s10803-013-1879-7.CrossRefPubMed

Ritschel, L. A., Tone, E. B., Schoemann, A. M., & Lim, N. E. (2015). Psychometric properties of the difficulties in emotion regulation scale across demographic groups. Psychological Assessment, 27(3), 944–954. https://doi.org/10.1037/pas0000099.CrossRefPubMed

Rosbrook, A., & Whittingham, K. (2010). Autistic traits in the general population: What mediates the link with depressive and anxious symptomatology? Research in Autism Spectrum Disorders, 4(3), 415–424.CrossRef

Ruganci, R. N., & Gencoz, T. (2010). Psychometric properties of a Turkish version of the difficulties in emotion regulation scale. Journal of Clinical Psychology, 66(4), 442–455. https://doi.org/10.1002/jclp.20665.CrossRefPubMed

Rusch, S., Westermann, S., & Lincoln, T. M. (2012). Specificity of emotion regulation deficits in social anxiety: an internet study. Psychology and Psychotherapy, 85(3), 268–277. https://doi.org/10.1111/j.2044-8341.2011.02029.x.CrossRefPubMed

Samson, A. C., Hardan, A. Y., Lee, I. A., Phillips, J. M., & Gross, J. J. (2015). Maladaptive behavior in autism spectrum disorder: The role of emotion experience and emotion regulation. Journal of Autism and Developmental Disorders, 45(11), 3424–3432. https://doi.org/10.1007/s10803-015-2388-7.CrossRefPubMed

Samson, A. C., Huber, O., & Gross, J. J. (2012). Emotion regulation in Asperger’s syndrome and high-functioning autism. Emotion, 12(4), 659–665. https://doi.org/10.1037/a0027975.CrossRefPubMed

Sifneos, P. E. (1994). Affect deficit and alexithymia. New Trends in Experimental & Clinical Psychiatry, 10(4), 193–195.

Swain, D., Scarpa, A., White, S., & Laugeson, E. (2015). Emotion dysregulation and anxiety in adults with ASD: Does social motivation play a role? Journal of Autism and Developmental Disorders, 45(12), 3971–3977. https://doi.org/10.1007/s10803-015-2567-6.CrossRefPubMed

Swart, M., Kortekaas, R., & Aleman, A. (2009). Dealing with feelings: Characterization of trait alexithymia on emotion regulation strategies and cognitive-emotional processing. PLoS ONE, 4(6), e5751. https://doi.org/10.1371/journal.pone.0005751.CrossRefPubMedPubMedCentral

Taylor, G. J. (1984). Alexithymia: concept, measurement, and implications for treatment. American Journal of Psychiatry, 141(6), 725–732.CrossRef

Venta, A., Hart, J., & Sharp, C. (2013). The relation between experiential avoidance, alexithymia and emotion regulation in inpatient adolescents. Clinical Child Psychology and Psychiatry, 18(3), 398–410. https://doi.org/10.1177/1359104512455815.CrossRefPubMed

Volkmar, F. R., Jackson, S. L. J., & Hart, L. (2017). Transition issues and challenges for youth with autism spectrum disorders. Pediatric Annals, 46(6), e219–e223. https://doi.org/10.3928/19382359-20170519-03.CrossRefPubMed

Wigham, S., Barton, S., Parr, J. R., & Rodgers, J. (2017). A systematic review of the rates of depression in children and adults with high-functioning autism spectrum disorder. Journal of Mental Health Research in Intellectual Disabilities, 10(4), 267–287. https://doi.org/10.1080/19315864.2017.1299267.CrossRef

Zlomke, K. R. (2009). Psychometric properties of internet administered versions of Penn State Worry Questionnaire (PSWQ) and depression, anxiety, and stress scale (DASS). Computers in Human Behavior, 25(4), 841–843. https://doi.org/10.1016/j.chb.2008.06.003.CrossRef

Titel: Mood Disorders in High-Functioning Autism: The Importance of Alexithymia and Emotional Regulation
Auteurs: Kristen P. Morie
Scott Jackson
Zu Wei Zhai
Marc N. Potenza
Barbara Dritschel
Publicatiedatum: 26-04-2019
Uitgeverij: Springer US
Gepubliceerd in: Journal of Autism and Developmental Disorders / Uitgave 7/2019
Print ISSN: 0162-3257
Elektronisch ISSN: 1573-3432
DOI: https://doi.org/10.1007/s10803-019-04020-1

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