Barnes Georgina L, Ozsivadjian Ann, Baird Gillian, Absoud Michael, Hollocks Matthew J
South London & Maudsley NHS Foundation Trust, Bethlem Royal Hospital, London, UK.
Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
J Autism Dev Disord. 2025 Mar;55(3):969-980. doi: 10.1007/s10803-024-06246-0. Epub 2024 Mar 4.
Internalising symptoms are elevated in autism compared to the general population. Few studies have investigated emotional dysregulation (ED) as a potential mediator between specific transdiagnostic processes and anxiety and depression symptoms in autistic youth. In a sample of 94 autistic young people aged 5-18 years referred to a specialist clinic for an autism evaluation, we tested the effects of ED as a mediator between cognitive inflexibility (CI), intolerance of uncertainty (IU) and alexithymia with anxiety and depression symptoms, using structural equation modelling. Effect sizes were compared to a non-autistic comparison group (n = 84). CI and alexithymia did not significantly predict depression symptoms in autistic young people, directly nor via ED. Relationships between CI/alexithymia and depression were fully mediated by ED in the non-autistic sample. There was a direct effect of CI on anxiety in the non-autistic group but not in those with a diagnosis. IU predicted depression symptoms in the autism group; and ED mediated this relationship only in those who did not receive a diagnosis. IU directly predicted anxiety in both groups and this relationship did not occur via ED. The finding of a direct pathway from IU to anxiety and depression in autistic youth is consistent with the literature. The finding that CI did not predict anxiety or depression in those with autism is novel, as was the finding that ED mediated relationships between alexithymia and anxiety/depression symptoms in both samples. The findings may have important implications for the delivery of psychological interventions for autistic youth.
与普通人群相比，自闭症患者的内化症状更为严重。很少有研究将情绪失调（ED）作为特定跨诊断过程与自闭症青少年焦虑和抑郁症状之间的潜在中介因素进行调查。在一个由94名年龄在5至18岁之间、因自闭症评估而转诊至专科诊所的自闭症青少年组成的样本中，我们使用结构方程模型测试了ED作为认知灵活性（CI）、不确定性不耐受（IU）和述情障碍与焦虑和抑郁症状之间中介因素的作用。效应量与一个非自闭症对照组（n = 84）进行了比较。CI和述情障碍在自闭症青少年中，无论是直接还是通过ED，都没有显著预测抑郁症状。在非自闭症样本中，CI/述情障碍与抑郁之间的关系完全由ED介导。在非自闭症组中，CI对焦虑有直接影响，但在自闭症诊断组中没有。IU在自闭症组中预测抑郁症状；并且ED仅在未接受诊断的个体中介导这种关系。IU在两组中都直接预测焦虑，并且这种关系不是通过ED发生的。自闭症青少年中从IU到焦虑和抑郁的直接路径这一发现与文献一致。CI在自闭症患者中不能预测焦虑或抑郁这一发现是新颖的，同样新颖的是ED在两个样本中介导了述情障碍与焦虑/抑郁症状之间的关系。这些发现可能对为自闭症青少年提供心理干预具有重要意义。
