(PS3-B36) The Impact of Social Anxiety on the Relationship Between Post-event Processing and Depressive Symptoms in Autistic Adults

Post-event processing (PEP) refers to reviewing a previous social interaction or event, including one’s own behavior, in detail within one’s mind (Clark & Wells, 1995). In the general population, PEP tends to be highly associated with social anxiety (Dannahy & Stopa, 2007); socially anxious participants are also more likely to process a social event in a negative manner, including anxiety or self-loathing (Stopa & Clark, 2000). Autistic adults tend to report high rates of social anxiety and depressive symptoms, respectively (White et al., 2014; Gotham et al., 2018), and indeed one study of PEP in an autistic sample found that previous social events were interpreted highly negatively, with harsh self-criticism (Black et al., 2023). However, autistic individuals may be likely to engage in PEP for multiple reasons -- e.g., in an effort to process or make sense of a social interchange, given the impairments in reciprocal social interaction that characterize this population (APA, 2013). It is unclear whether PEP represents a negative and potentially depressing exercise in a majority of autistic adults, versus primarily in those who also experience social anxiety. We aimed to examine whether a relation between PEP and depressive symptoms was moderated by social anxiety scores.

Our sample was N=677 autistic adults collected from Simons Foundation Powering Autism Research for Knowledge (SPARK), an online autism registry. We used a subset of negatively-skewed items from the Positive Beliefs about Post-Event Processing Questionnaire (PBPEPQ; Rachman et al., 2000) to survey frequency and reason for PEP (e.g., “To know if I hurt someone’s feelings”). The Brief Fear of Negative Evaluation (BFNE; Leary, 1983) operationalized social anxiety; the Beck Depression Inventory (BDI-II; Beck, 1996) indexed depressive symptoms. We used multiple linear regression in IBM-SPSS with the PROCESS macro (Hayes, 2022) to assess the main effects and interactions of PEP and social anxiety on depressive symptoms, as well as the indirect effect of PEP on BDI scores through social anxiety.

PEP was a significant predictor of depressive symptoms in the absence of social anxiety (β=.33, t(675)=8.72, p< .001). PEP was significantly associated with social anxiety (β=.64, t(675)=23.82, p< .001), and social anxiety significantly predicted depression scores when controlling for PEP (β=.50, t(674)=9.90, p< .001). However, when controlling for social anxiety, PEP was no longer a significant predictor of depressive symptoms (β=.01, t(674)=.18, p=.85). Per Sobel test, the full effect of PEP on depressive symptoms was explained via the path through social anxiety (z=9.14, p< .001).

PEP was related to depressive symptoms solely via the indirect effect of social anxiety. This suggests that, within the autistic community, reflecting afterward on one’s own behavior during social interactions may not necessarily be maladaptive, but is associated with depressive symptoms in the context of anxiety about what others think. Given this finding in cross-sectional data, a mediation model should be tested in longitudinal data to better understand causal processes, support adaptive post-event processing of social events, and identify inroads to treating social anxiety and depression.