Differential Consequences of Bullying on Internalizing Symptoms in Adolescents with High-Functioning Autism

Background: Researchers have documented high prevalence of internalizing symptoms in individuals with HFA relative to controls (Ghaziuddin et al., 1998).  Separate studies demonstrated specific social difficulties associated with HFA, such as higher rates of victimization, fewer close relationships, and less perceived social support (Shtayermman, 2007; Bauminger & Kasari, 2000). Yet virtually no studies have examined the relationship between social experiences and internalizing symptoms in autism. In this study, we hypothesized those with HFA to experience lower prosocial behavior, higher peer victimization, and higher internalizing symptoms than TD participants. Moreover, we expected higher peer victimization and lower prosocial behavior to predict higher internalizing symptoms across groups, but that this effect would be stronger for individuals with HFA.

Objectives: This study examines effects of positive and negative social experiences on internalizing symptoms in adolescents with and without HFA.

Methods: Twenty-one TD (19 male, 2 female) and 19 adolescents with ADOS-confirmed HFA (17 male, 2 female), matched on gender and mental age, participated as part of a larger ongoing study. Mental age in months was not significantly different between groups (M_TD=191.63, M_HFA=198.55). Participants completed the Behavior Assessment System for Children (BASC-2 SRP adolescent or college; Reynolds & Kampaus, 2004), yielding Internalizing Symptoms T-scores. They also completed the Social Experiences Questionnaire (Crick & Bigbee, 1998), yielding Overt Victimization, Relational Victimization, and Recipient of Prosocial Behavior scores.

Results: Independent t-tests revealed that those with HFA had higher Internalizing (t(38)=-3.01, p<.01), higher Relational Victimization (t(36)=-2.40, p<.05), and lower Recipient of Prosocial Behavior scores (t(36)=2.90, p<.01).  Overt Victimization scores approached significance as higher in those with HFA (t(36)=-1.93, p=.06).  Three step-wise linear regressions revealed higher Relational Victimization, higher Overt Victimization, and lower Recipient of Prosocial Behavior scores each predicting higher Internalizing (see Table 1). There was a significant interaction between Overt Victimization and diagnosis; the effect of Overt Victimization as a predictor of Internalizing symptoms was stronger in HFA.

Conclusions: These preliminary results support previous findings of higher peer victimization, higher internalizing symptoms, and lower positive social experiences in individuals with HFA. They also provide new insight into the extent to which internalizing symptoms are predicted by overt and relational victimization in adolescents and young adults with and without HFA. Furthermore, these findings indicate that the relationship between overt victimization and internalizing symptoms like depression is exacerbated for individuals with HFA. Thus, those with HFA are not only at higher risk for being victimized, but may also suffer more severe consequences as a result. These findings warrant further exploration of the potential protective influence of positive social experiences, which we plan to conduct via ongoing data collection. 

Table 1.  

Regression Analyses

	R Square	Beta	p-value
Internalizing Symptoms      Diagnosis      Relational Victimization      Diagnosis x Relational Victimization	.56	.163         .747**      .178	.000   .176   .000   .294
Internalizing Symptoms      Diagnosis      Overt Victimization      Diagnosis x Overt Victimization	.57	.226         .439*       .363*	.000   .064   .014   .040
Internalizing Symptoms      Diagnosis      Recipient of Prosocial Behavior      Diagnosis x Recipient of Prosocial Behavior	.28	.230        -.531**   .176	.001   .145   .001   .220

*p<.05, **p < .01