Internalizing Problems and Emotion Dysregulation In Children with ASD

Background: Internalizing problems are common among children with ASD. An important factor in the development of depression and social anxiety in TD children is emotion regulation (Wright et al., 2009). However, based on previous studies (Pouw et al., submitted), we propose that both dysregulation of the own emotions and over-arousal while witnessing others’ emotions (empathy) might contribute to internalizing symptoms in children with ASD.

Objectives: With this study, we examined the extent to which different coping strategies and different aspects of empathy contributed to the prediction of internalizing symptoms (social anxiety and depression) in children with and without ASD.

Methods: The study included 136 children and young adolescents (68 with ASD, 68 TD, Mean Age 139 months), who filled out self-report questionnaires about coping strategies (problem solving, seeking social support, externalizing, internalizing, distraction, and trivializing) and empathy (contagion, personal distress, and understanding).

Results: Coping strategies contributed differentially to symptoms of depression and anxiety, but this pattern was equal in both groups. Only distraction and trivializing were negatively related to depression in children with ASD uniquely. However, the aspects of empathy showed quite a distinct pattern between the two groups: contagion (i.e. being emotionally aroused while witnessing another person’s distress) contributed to more symptoms of depression and anxiety, but only in children with ASD as predicted.

Conclusions: This study shows that unlike TD children, understanding the emotions of others is not a protective factor in the development of internalizing symptoms in children with ASD. Additionally, distracting themselves from negative events or trivializing the event seem beneficial tactics for children with ASD in the protection of depressive symptoms in particular.