The Association of Emotion Dysregulation to Core Features of the Autism Spectrum Disorder

Background : Autism Spectrum Disorder (ASD) is a severe neurodevelopmental disorder characterized by impairments in social communication/interaction, restricted interest, and repetitive behavior. While emotion dysregulation is not typically considered a core deficit in ASD, there is an increased recognition of the frequency of the associated severe emotional disturbances. Evidence suggests that maladaptive emotional responses are common in ASD and there are hints that it might impair functioning. However, limited information is available on the potential relationship between emotion regulation difficulties and clinical deficits in ASD.

Objectives :The aim of the present study was to examine the relationship of emotion dysregulation in children and adolescents with ASD and several clinical features such as social/communication deficits, sensory abnormalities, cognitive functioning and adaptive abilities.

Methods : An emotion dysregulation index (EDI) was developed on the basis of expert ratings of the Child Behavior Checklist (CBCL) items. Eighteen items were determined to best represent emotion dysregulation and were included in the index. To examine the association between emotion dysregulation and clinical features of autism, the relationships between the EDI and the Social Responsiveness Scale (SRS), the Sensory Profile Questionnaire (SPQ), the Stanford Binet, and the Vineland Adaptive Behavior Scale were assessed in a sample of children and adolescents (6-18 years) with ASD, and typically developing (TD) controls. Data from 51 youth with ASD and 32 controls were included in the current analyses. ASD (41 males, 10 females) and TD participants (20 males, 12 females) did not differ in age (F(1,82)=.03, ns) and gender (X²(1)=3.21, ns). ASD diagnosis was established based on the administration of the Autism Diagnostic Interview-Revised, the Autism Observation Schedule, and expert clinical opinion.

Results : The computed EDI had good psychometric properties (Cronbach’s alpha: .89). The EDI did not correlate with age (r=.05, ns), and did not differ between males and females (F(1,81=3.36, ns). As expected, differences were observed between ASD and TD on several scales including the EDI, IQ, and SRS. Within the ASD participants, the EDI correlated with SRS (e.g, total score: r=.51, p<.01), and several of the Vineland domains (e.g., coping skills, r=-.48, p<.01; sum of socialization, r=-.39, p<.05) and sensory factors (e.g., sensory seeking, r=-.62, p<.001; auditory processing, r=-.50, p<.01). No association was found between the EDI and cognitive functioning.

Conclusions : To our knowledge, this is the first study to bridge emotion dysregulation and deficits in core features as well as cognitive and adaptive functioning in children and adolescents with ASD. Our findings indicate that social deficits, coping skills, and sensory sensitivities may be related to emotion dysregulation. Emotion dysregulation might be related to certain core features of ASD warranting the development of effective therapeutic strategies targeting these emotional deficits to optimize long-term outcome.