Hollocks Matthew J, McQuaid Goldie A, Lee Nancy R, Wallace Gregory L
Department of Child & Adolescent Psychiatry, King's College London, London, UK.
Department of Psychology, George Mason University, Fairfax, Virginia, USA.
Autism Res. 2025 Jun 3. doi: 10.1002/aur.70061.
Autistic people are at an elevated risk of experiencing co-occurring anxiety and depression. The contributors to this are likely multifaceted and complex and remain poorly understood. Cognitive flexibility, social camouflaging, and perceived stress provide useful indices of the interacting neurocognitive, behavioral, and environmental factors that have been associated with anxiety and depression in autistic individuals. Here, we test if cognitive flexibility, as the factor most closely related to individual differences in thinking styles, mediates the relationships between social camouflaging, perceived stress, and anxiety/depression. This study included 806 autistic individuals aged between 18 and 83 years (Mean age = 40.2), recruited through the Research Match service of the Simons Powering Autism Research (SPARK) participant registry. Participants completed an online battery of questionnaires measuring cognitive and social flexibility, social camouflaging, perceived stress, anxiety, and depression. Parallel mediation analyses were used to test the mediating effect of cognitive and social flexibility. Across separate parallel mediation analyses, cognitive flexibility was found to significantly mediate the relationships between both social camouflaging and perceived stress with anxiety and depression. This was contrasted with social flexibility, which showed a lower magnitude mediating effect for perceived stress and no mediating effect of social camouflaging. Cognitive flexibility plays an important mediating role between the impact of both perceived stress and social camouflaging on greater symptoms of both anxiety and depression in autistic adults.
自闭症患者同时出现焦虑和抑郁的风险较高。造成这种情况的原因可能是多方面且复杂的，目前仍知之甚少。认知灵活性、社交伪装和感知压力为与自闭症个体的焦虑和抑郁相关的相互作用的神经认知、行为和环境因素提供了有用的指标。在此，我们测试作为与思维方式个体差异最密切相关的因素的认知灵活性是否介导社交伪装、感知压力与焦虑/抑郁之间的关系。本研究纳入了806名年龄在18至83岁之间的自闭症个体（平均年龄 = 40.2岁），通过西蒙斯推动自闭症研究（SPARK）参与者登记处的研究匹配服务招募。参与者完成了一系列在线问卷，测量认知和社交灵活性、社交伪装、感知压力、焦虑和抑郁。采用并行中介分析来测试认知和社交灵活性的中介作用。在单独的并行中介分析中，发现认知灵活性显著介导社交伪装和感知压力与焦虑和抑郁之间的关系。这与社交灵活性形成对比，社交灵活性对感知压力的中介作用较小，对社交伪装没有中介作用。在自闭症成年人中，认知灵活性在感知压力和社交伪装对焦虑和抑郁症状加重的影响之间起着重要的中介作用。
