Self-reported social impairments predict depressive disorder in adults with autism spectrum disorder

Abstract

In adults with autism spectrum disorder, co-occurring psychiatric conditions are prevalent, and depression is one of the most common co-occurring disorders. This study examined the relationship between depression and cognitive ability, autism symptom severity, and self-reported social impairments in autism spectrum disorder. A total of 33 adults with autism spectrum disorder and 28 adults with typical development completed a standardized psychiatric interview, cognitive test, measure of clinician-rated autism symptom severity, and self-report of social impairments. Nine participants with autism spectrum disorder (27%) met the criteria for a depressive disorder (autism spectrum disorder + depressive disorder). Relatively more females with autism spectrum disorder had a co-occurring depressive disorder. The typical development group had a higher intelligence quotient than the autism spectrum disorder group, but the autism spectrum disorder + depressive disorder group did not differ from the typical development or autism spectrum disorder group. While the autism spectrum disorder + depressive disorder group had lower clinician-rated autism symptom severity than the autism spectrum disorder group, the autism spectrum disorder + depressive disorder group reported more social impairments than the autism spectrum disorder group. Self-reported social impairments predicted depression in adults with autism spectrum disorder when accounting for symptom severity and cognitive ability. These findings suggest that more self-perceived social impairments are related to depressive disorders in autism spectrum disorder, and may help clinicians identify individuals who are vulnerable in developing a co-occurring depressive disorder. Future directions include follow-up studies with larger cohorts and longitudinal designs to support inferences regarding directionality of these relationships.

Identifying Predictors of Momentary Negative Affect and Depression Severity in Adolescents with Autism: An Exploratory Ecological Momentary Assessment Study

“…The development of screening tools that evaluate subjective social experiences for this population may thus be an important step in identifying those at risk for depression. Social experiences play a significant role in the manifestation of depression for individuals on the autism spectrum (Day et al, 2019). While negative social experiences can be a risk factor for depression, we found that positive social experiences can serve as protective factors in preventing depressive symptomatology by leading to positive affect.…”

“…Social experiences play a significant role in the manifestation of depression for individuals on the autism spectrum (Day et al, 2019 ). While negative social experiences can be a risk factor for depression, we found that positive social experiences can serve as protective factors in preventing depressive symptomatology by leading to positive affect.…”

“…For example, when autistic individuals experience game-related trade offers they deem to be unfair, they experience more negative moods than their non-autistic peers, suggesting that ER is linked to perceived social experiences (Tei et al, 2018 ). Autistic individuals who are aware of their social deficits demonstrate increased depression (Day et al, 2019 ) suggesting that social experiences, such as those that increase one’s awareness of social deficits, may be implicated in psychopathology. While increasing ASD symptom severity has been linked to depression, loneliness and satisfaction with social support mediate this relationship (Hedley et al, 2018 ), further implicating social experiences in the severity of depression.…”

“…The constellation of potential factors impacting depressive symptomatology in this population indicates there is likely no singular cause of depressive symptomatology in ASD. However, theoretical and empirical research aligns in implicating social experiences in the onset of depression (Day et al, 2019 ; Picci & Scherf, 2015 ). Recently, researchers investigating depressive symptomatology have challenged monolithic research approaches (i.e., those that examine only a singular cause of depression) and suggested that network approaches better identify the constellation of factors that increase the risk for depressive symptomatology (Koval et al, 2013 ).…”

Depression symptoms in adolescents with autism spectrum disorder: A contextual approach to mental health comorbidities

“…impairments in social functioning, may act as risk factors for mental health comorbidities. For instance, more severe social impairment, poorer social skills, and higher self-perceived social incompetence have been associated with increased depression symptoms in children, adolescents, and adults with ASD (Chang et al, 2012;Day et al, 2020;Duan et al, 2020;Pouw et al, 2013;Vickerstaff et al, 2007). However, there remains a gap in our knowledge regarding how individual characteristics confer risk for mental health outcomes in different contexts for individuals with ASD.…”