Associations Between ASD Symptoms, Internalizing Symptoms, Empathy, and Social Loneliness in Young Adults with ASD

Background:  Autism Spectrum Disorder (ASD) is a persistent and debilitating condition which is frequently accompanied by comorbid psychopathology. Problems with comorbid psychopathology are well-documented in children and adolescents with ASD, specifically in regards to anxiety and social loneliness (Mazurek & Kanne, 2009; White & Roberson-Nay, 2009), as well as impaired empathy in adults with ASD (Baron-Cohen & Wheelwright, 2004). More specifically, researchers have found high-functioning individuals with ASD report higher levels of anxiety, more loneliness than typically developing individuals (White & Roberson-Nay, 2009). However, little is known about these specific associations in young adults with ASD. 

Objectives:  The authors sought to examine associations between self- and caregiver-report of ASD impairment and internalizing symptoms, as well as self-reported empathy and social loneliness in young adults with ASD. 

Methods:  Twenty-one adults diagnosed with ASD ages 18- to 35-years-old (M = 22.57, SD = 4.03) were enrolled in a 16-week social skills intervention. 91% were male and 95% were Caucasian. Prior to beginning the intervention, ASD diagnosis was confirmed via the Checklist for Autism Spectrum Disorders (CASD, M = 22.67, SD = 3.17) and verbal intelligence was estimated through administration of the Kaufman Brief Intelligence Scale, Second Edition (KBIT 2; M = 93.40, SD = 18.84). Additionally, the participants and a primary caregiver completed the Achenbach Adult Self-Report (ASR) or Adult Behavior Checklist (ABCL), as well as the Social Responsiveness Scale, Second Edition (SRS 2). Participants completed the Social and Emotional Loneliness Scale for Adults (SELSA), Empathy Quotient (EQ), and the Social Phobia Inventory (SPIN). 

Results:  Bivariate correlations were completed to identify significant associations between the variables of interest. Higher self- and other-reported ASD symptoms were associated with higher self-reported internalizing symptoms [r = .62 (self), .64 (other), p < .01] and higher self-reported social anxiety symptoms [r = .67 (self), .41 (other), p < .01]. Additionally, higher other-reported internalizing symptoms were associated with higher empathy (r = .45, p < .05). Finally, in regards to social loneliness, higher social loneliness was associated with older age (r = .56, p < .01), ASD symptoms (r = .57, p < .01) and lower empathy (r = .57, p < .01). Higher family emotional loneliness was associated with higher impairment in ASD symptoms (r = .47, p < .01). 

Conclusions:  Findings contribute to the ASD literature supporting a significant association between level of ASD impairment and internalizing symptoms, including social anxiety in young adults. However, it was found that higher internalizing symptoms are also associated with more empathy in young adults with ASD. In regards to social loneliness, it was found that this was associated with older age, more ASD impairment, and less empathy. More specifically, young adults with more impairing ASD reported higher family emotional loneliness.