Predictors of Severity and Change in Emotion Dysregulation among Children and Adolescents with ASD

ABSTRACT

Objective

Emotion dysregulation problems are prevalent and disruptive for many with autism spectrum disorder (ASD). This study compared severity and perceived change in emotion dysregulation in youth with and without ASD and probed correlates of emotion dysregulation (including possible two-way interactions) among youth with ASD.

Method

Participants were drawn from two large online samples (mean age = 12; range: 6–17) with (N = 1323) and without (N = 921) ASD. The study used the Emotion Dysregulation Inventory (EDI), a parent-report measure designed for youth with ASD. The EDI asks parents about current severity and perceived change (i.e. how current severity compares to lifetime severity) in emotion dysregulation, and includes two factors: Reactivity (rapidly escalating, intense negative affect) and Dysphoria (poorly upregulated positive affect, general unease).

Results

Results indicated that youth with ASD had greater Reactivity severity and also greater positive change in Reactivity than non-ASD peers. Furthermore, differences between youth with and without ASD in the relationship between Reactivity and Dysphoria suggest a distinct profile of emotion dysregulation in ASD. Within the ASD sample, age and severity of stereotyped behavior predicted Reactivity and Dysphoria severity and Reactivity change. Female gender, lower parent education, and fluent verbal ability were additional predictors of increased Reactivity severity, while intellectual disability predicted lower Dysphoria severity.

Conclusions

This study provides new insight into predictors of emotion dysregulation in youth with ASD and represents a first step toward identifying which children with ASD may be most vulnerable to severe emotion dysregulation problems.

Acknowledgments

Subjects were recruited and data obtained in partnership with the Interactive Autism Network (IAN) Research Database at the Kennedy Krieger Institute, Baltimore, MD. IAN collaborating investigators and staff included: Paul H. Lipkin, MD, J. Kiely Law, MD, MPH, Alison R. Marvin, PhD. We are also grateful to YouGov for their support in data collection. We thank the study staff for the time and energy they dedicated to this work. Finally, we would like to extend a special thank you to IAN and YouGov families for making this study possible.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Data Availability Statement

The data that support the findings of this paper are openly available in the National Database for Autism Research: https://nda.nih.gov/edit_collection.html?id=2203.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of Pittsburgh Institutional Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in this study.

Additional information

Funding

This study was supported with funding from NICHD R01 HD079512 (C.M.) and the Ritvo-Slifka Award for Innovation in Autism Research (C.M.). IAN is a partnership project of the Kennedy Krieger Institute and the Simons Foundation. IAN is also partially funded through a Patient-Centered Outcomes Research Institute (PCORI) Award for development of the National Patient-Centered Clinical Research Network, known as PCORnet. During the preparation of this manuscript, Dr. Northrup received support through a T32 training grant from the National Institute of Mental Health (T32 MH018269).