(PS3-B44) Associations Between Parent-reported Childhood Adversity and Emotion Dysregulation in Autistic Youth

Background

Exposure to adversity is a major risk factor for psychosocial and medical impairment. Autistic individuals experience higher rates, and a potentially distinct range, of adversities than the general population, including traditional (e.g. maltreatment, life-threatening accidents) and autism-related (e.g. stigma, change-related and sensory-related stress) adversities. Exposure to traditional (but not yet autism-related) adversities is linked to poorer mental health in autistic youth. Emotion dysregulation (ED) is proposed to be a central feature of autism, as well as a transdiagnostic mechanism that underlies mental health outcomes. We hypothesized that traditional and autism-related adversities may play a role in ED amongst autistic youth.

Objectives

To examine associations between exposure to traditional and autism-related adversities (see above) –and ED in autistic youth.

Methods

US-based parents of 730 verbally communicative, autistic youth (M_Age=13.11, SD=2.69, N_Female=147; 92% White) were enrolled through the Interactive Autism Network, an online research registry, and completed a range of questionnaires, including the Child Adversity and Social Stress Scale (CASS), a of traditional and autism-related adversities, and the Emotion Dysregulation Index, which assesses 2 indices of ED in autistic individuals, emotional reactivity and dysphoria. Hierarchical linear regressions, controlling for child age and sex, examined the contributions of traditional and autism-related adversities to levels of ED.

Results

Participants were exposed to a median of two (M=2.02, SD=1.84) traditional and two (M=2.17, SD=1.67) autism-related adversities. Traditional adversities significantly predicted emotional reactivity (β=.33, t=8.86, p< .001; R²=.14, F(3,645)=33.45, p< .001) and dysphoria (β=.31, t=8.49, p< .001; R²=.11, F(3,664)=27.14, p< .001). When autism-related adversities were added to the models, they independently predicted emotional reactivity (β=.38, t=9.87, p< .001; R²=.25, F(4,644)=53.20, p< .001; ΔR²=.11, ΔF= 97.46, p< .001) and dysphoria (β=.36, t=9.07, p< .001; R²=.21, F(4,663)=43.38, p< .001; ΔR²=.10, ΔF= 82.17, p< .001).

Discussion

Adversity is linked to ED in autistic youth as has been documented in the general population; this suggests existing theories of the complex and bidirectional relationships between adversity and ED are applicable, at least in part, to autistic populations. At the same time, autism-related adversities were associated with ED independent of traditional adversities, lending support to an autism-focused conceptualization of adversity that includes an expanded understanding of what may constitute an adverse event, and the prognostic utility of measures that are tailored to, and inclusive of autistic people’s experiences. Further research is needed to examine the contributions of specific adversities and their characteristics (e.g., severity, chronicity, development timing) to ED and whether ED mediates or moderates links between different forms of adversity and mental health outcomes. This in turn may highlight how ED could be targeted therapeutically to prevent exposure to, and promote resilience following adversity for autistic people.