Livingston Lucy A, Waldren Lucy H, Walton Esther, Shah Punit
Neuroscience and Mental Health Research Institute Cardiff University Cardiff UK.
Institute of Psychiatry, Psychology and Neuroscience King's College London London UK.
JCPP Adv. 2022 Aug 21;2(3):e12096. doi: 10.1002/jcv2.12096. eCollection 2022 Sep.
The male preponderance in autism diagnoses is widely reported, yet the psychological mechanisms (e.g., emotion processing) underlying this sex difference are poorly understood. Contributing to this gap in knowledge, most research has not been designed to investigate the intermediary (i.e., mediating) role of psychological processes in the relationship between sex and autism. Compounding this issue, concerns that autism measures are not reliably measuring the same constructs in males and females, and bias against females in clinical samples, make it difficult to investigate the psychological mechanisms underlying sex differences in autism.
Over two cross-sectional studies, 1656 young adults from the general population reported their sex (as assigned at birth) and completed questionnaires indexing their emotion processing differences, as well as a measure of autistic traits suggested to tap into the same psychometric construct in males and females.
Emotion processing differences mediated the relationship between sex and autistic traits, whereby being male was associated with more emotion processing differences, which were subsequently linked with greater levels of autistic traits. There remained a direct effect of sex on autistic traits after accounting for emotion processing differences.
Emotion processing differences are a potential psychological mechanism underpinning higher prevalence of autism in males, which may serve a compensatory function in females; for example, females may seek out emotion-inducing experiences to help compensate for social-emotional difficulties. These findings inform our understanding of autism-related sex differences and have potential implications for clinical practice, where the need for sex-specific support and diagnostic processes is increasingly being recognised.
广泛报道了自闭症诊断中男性占优势的情况，但对于这种性别差异背后的心理机制（如情绪加工）了解甚少。造成这种知识差距的原因在于，大多数研究并非旨在调查心理过程在性别与自闭症关系中的中介作用。使问题更加复杂的是，人们担心自闭症测量方法无法在男性和女性中可靠地测量相同的结构，以及临床样本中对女性的偏见，这使得难以研究自闭症性别差异背后的心理机制。
在两项横断面研究中，1656名来自普通人群的年轻人报告了他们的性别（出生时指定），并完成了索引其情绪加工差异的问卷，以及一项旨在测量男性和女性相同心理测量结构的自闭症特征测量。
情绪加工差异介导了性别与自闭症特征之间的关系，即男性与更多的情绪加工差异相关，而这些差异随后与更高水平的自闭症特征相关。在考虑情绪加工差异后，性别对自闭症特征仍有直接影响。
情绪加工差异是男性自闭症患病率较高的潜在心理机制，这可能在女性中起到补偿作用；例如，女性可能会寻求引发情绪的体验来帮助弥补社交情感困难。这些发现增进了我们对自闭症相关性别差异的理解，并对临床实践具有潜在意义，在临床实践中，对针对性别的支持和诊断过程的需求日益得到认可。
