Cognitive emotion regulation difficulties increase affective reactivity to daily-life stress in autistic adolescents and young adults

Abstract

Increased reactivity to minor stressors is associated with mental health issues, which are common in individuals with autism spectrum disorder (ASD). We investigated affective reactivity to daily-life stress, emotion regulation (ER), and their link with comorbid mental health symptoms in adolescents and young adults with ASD. A 6-day Ecological Momentary Assessment (EMA) protocol was used to assess different types of daily stress (event-related, activity-related and social stress) as well as negative affects (NA) in participants with ASD (n=39, age=18.4) and typically developing youth (TD; n=55, age=18.1). Psychopathology, social functioning and ER were assessed with questionnaires and clinical evaluations. Youth with ASD showed higher levels of perceived stress related to their daily social context and activities, as well as an increased affective reactivity to activity-related stressors compared to TD. Moreover, they reported using less adaptive and more non-adaptive ER, the latter increasing their affective response to daily stress. Our findings demonstrate high subjective daily-life stress in adolescents and young adults with ASD. To minimize the negative effects of stress on affective states and clinical evolution, interventions should focus on effective stress management and reduction of non-adaptive ER, such as ruminations.

Diurnal cortisol profiles in autistic adolescents and young adults: Associations with social difficulties and internalizing mental health symptoms

“…Finally, a potential explanation could be that women with autism may be more exposed to stressful events than men (Haruvi-Lamdan et al, 2020), making them more sensitive to stress in general. Indeed, increased affective reactivity to daily-life stress was recently observed in autistic females, which was a possible vulnerability marker for internalizing symptoms (Ilen et al, 2022). In conclusion, our findings suggest that females with autism might be particularly vulnerable to develop stress-related mental health difficulties, and that investigating cortisol might provide important clues to understand that vulnerability.…”

“…Data were collected between October 2018 and September 2022. Details of recruitment and criteria for participation are provided elsewhere (Ilen et al, 2022). The study was approved by the Cantonal Research Ethics Committee of Geneva (CCER) (2018-01117).…”

“…Indeed, considering the importance of routines for certain autistic individuals (Cuccaro et al, 2003), it is possible that the cortisol sampling protocol, which might have altered daily routine, contributed to increased perceived stress and feelings of anxiety in some participants. Moreover, it was recently shown that autistic adolescents and adults show high levels of perceived daily-life stress (Ilen et al, 2022;van der Linden et al, 2021), which might explain elevated cortisol levels during the day. Future studies could investigate whether perceived daily-life stress in autistic individuals is associated with total cortisol secretion during the day.…”