Self-Perception, Theory of Mind, and Psychopathology in Youths with and without Autism Spectrum Disorders

Background: Previous research suggests that some high-functioning people with ASD have poor insight into their autistic symptoms. There is some evidence to suggest that individuals with ASD who are more aware of their differences have greater levels of negative mood and depressive symptoms. However, this potential relationship has not been systematically investigated. It has been proposed that the level of awareness of one's autism symptoms may be related to Theory of Mind (ToM) abilities, but this potential relationship has not been examined. Objectives: To determine if there are relationships between self-awareness and psychopathology (i.e., depression and anxiety symptoms), and between self-awareness and ToM ability, in youths with and without ASD. Methods: The Autism Spectrum Quotient (AQ; Baron Cohen, et al., 2006), a measure of autism symptom severity, was completed by 13 youths with an ASD and an accompanying parent, and by 13 typically developing youths (TD) and a parent. Participants were 9 – 19 years old. To measure self-awareness, we calculated a discrepancy score that represented the difference between parent- and self-reported AQ scores. Parents and participants also completed the Behavior Assessment System for Children-2nd edition (BASC-II; Reynolds & Kamphaus, 2004), a measure of behaviours and emotions associated with child psychopathology. Analyses focused on self-reported internalizing problems (e.g., depression, anxiety). ToM ability was measured using a brief version of the Strange Stories (Happe, 1994) that had been adapted for children. Data collection is ongoing. Results: Preliminary results indicate that parents of participants with ASD reported significantly more autistic features (higher AQs) than parents of TD participants. Parent vs. self-report AQ scores (i.e., discrepancy scores) revealed that ASD participants reported fewer autism symptoms relative to their parents. In contrast, for the TD group, parent- and self-reports did not differ on the AQ. Medium-sized, but non-significant, correlations were found between AQ discrepancy scores and the BASC-2 ‘Internalizing Problems' composite for both ASD (r = .40) and TD (r = .33) participants. In a separate sample of 6 youths with ASD and 7 TD participants, there was no significant difference between ToM scores for the ASD and TD group (t = .69, p = .54). However, the ASD group demonstrated preliminary evidence of a positive relationship between self-perception and theory of mind ability. That is, individuals with ASD who provided self-ratings on the AQ that were more similar to their parent's rating also performed better on the ToM task (r = .77, p = .07). Conclusions: Preliminary results suggest that greater self-perception of autism-related symptoms may be associated with more overall internalizing symptoms for individuals both with and without ASD. This relationship requires further examination as it may have important implications for understanding aspects of co-morbid psychopathology in ASD. The positive trend between self-awareness and ToM ability for ASD participants suggests that those who are better at attributing mental states to others may also have more insight into their symptoms. This suggests that there may be important links between theory of others' minds and theory of one's own mind.