Deficits in Social Awareness & Social Motivation Associated with Increase in Aggression in ASD

Background:  Aggressive behaviors, directed either toward the self or others, can cause severe psychological and physical damage to an affected individual, family, and others in the affected individual’s environment (De Giacomo et al 2016). Prior research has shown that, in individuals with ASD, language skills and cognitive functioning are associated with these behaviors (Dominick et al, 2007). Research has also noted that individuals with ASD show deficits in their ability to notice and act on social cues (Vivanti et al, 2011) and that they engage in reduced social interactions. No study to date has looked at the relationship between aggressive behaviors in children with ASD and these two social domains.v

Objectives:  We used two scales of the Social Responsiveness Scale (SRS): Social Awareness, which measures the ability to pick up on social cues, and Social Motivation, which measures the extent to which an individual is motivated to engage in social-interpersonal behavior (Constantino and Gruber, 2005), to assess whether deficits in either of these areas are associated with increased presence and level of aggressive behavior. We hypothesize that children with higher Social Awareness scores will present with increased aggressive behaviors, and that Social Motivation is not necessarily associated with aggressive behaviors.

Methods: A sample of 307 children (53.7% male) with research confirmed ASD diagnosis using ADOS and ADI-R were examined. Participant ages ranged from 46 months to 224 months (Mean= 124.38, SD= 40.481). IQ was measured with the Differential Ability Scales. Pearson correlations between Social Motivation, Social Awareness (SRS) and Aggressive Behaviors (Child Behavior Checklist, CBCL) were examined. We fit a regression model to examine the relationship between Social Motivation, Social Awareness, and Aggressive behaviors controlling for NVIQ and Age.

Results:  Both Social Awareness and Social Motivation were correlated with Aggressive Behaviors (Social Awareness r=.364, p<.000; Social Motivation r=.304, p<.00). There was a significant, positive relationship between Aggressive Behaviors and Social Awareness (p<0.000) but not between Aggressive Behaviors and Social Motivation (p>0.05), after controlling for age and IQ. Specifically, for every additional point on the Social Awareness scale on the SRS, there is, on average, a .26 increase in the CBCL Aggressive total (Awareness Beta = .267, p<.000), after controlling for Age, NVIQ, and Social Motivation. Social Motivation, Social Awareness, Age, and IQ, taken together, account for approximately 21% of the variation in Aggressive behaviors (Adjusted R Square =.209). Age has a negative relationship with the Aggressive Behaviors total of the CBCL, indicating that for each additional month of age, an individual's aggression level decreases by .067 points, on average, after taking into account our other variables.

Conclusions:  Our findings indicate that it may be the reduced capacity to notice social cues and not the lack of motivation to engage in reciprocal social motivation that is associated with increased aggressive behaviors. We believe that future research is needed to discover additional variables that account for the remaining variation in aggression.