Associations Between Emotional Problems and Cognition in Autism Spectrum Disorders
Depression and anxiety disorders are seen far more in individuals with autism spectrum disorders (ASD) than in the background population, and the estimated prevalence of these co-morbid diagnoses in ASD sums up to 80%. It is unknown why individuals with ASD have a higher prevalence of these disorders, but both depression and anxiety have been associated with ASD symptomatology, and it is possible that this increased risk derive from underlying causes, such as cognitive dysfunctions.
We aimed to study these co-morbid problems in a prospective design, where we examined the associations between depression and anxiety, and the three most prominent cognitive theories of ASD; Theory of Mind (ToM), Executive Functions (EF) and a Local processing Bias (LB). Additionally, we investigated the correlations to ASD symptomatology.
We examined these objectives in a group of high-functioning children (IQ>70) with ASD (N=22) and a matched group with neurotypical development (NTD, N=30) at baseline and three years later. At both time points, a comprehensive battery of cognitive tasks were applied and co-morbid problems as well as ASD symptomatology were assessed with questionnaires. Additionally, the ASD group was examined with ADOS and ADI at baseline.
We found strong correlations between the parent-rated co-morbidity and the parent-rated ASD symptomatology although very few of these correlations held in the groups individually. Clinically observed symptoms (ADOS) and parental interviews (ADI) of ASD symptomatology was barely correlated to depressive or anxious symptoms.
A general relationship between Theory of Mind (ToM) and symptoms of depression and anxiety was found at Time 1 and across time, but not at Time 2. Interestingly those individuals in the ASD group who showed persistently high levels of anxiety had a different trajectory of ToM performance; their ToM performance decreased, while the individuals with persistent low levels of anxiety improved their ToM performance.
The results suggest that the level of anxiety is important in the development of ToM.