Self-reported social skills impairment explains elevated autistic traits in individuals with generalized social anxiety disorder

The Relationship Between Autistic Traits and Quality of Life: Investigation of Indirect Effects Through Self-Determination

Background

Self-determination, described broadly as experiencing causal agency, is positively associated with quality of life (QoL) and increases through satisfaction of three basic psychological needs: autonomy (feeling able to make choices free from pressure), competence (perceived self-efficacy), and relatedness (social connection). Both unsupportive environments and challenges with social interaction can interfere with satisfaction of psychological needs. Social challenges are a key trait for autism diagnosis, and unsupportive environments are also known to adversely affect QoL for autistic people. Autistic people report, on average, lower self-determination than non-autistic people. Therefore, it is hypothesized that higher levels of autistic traits may reduce opportunities to develop self-determination, affecting QoL.

Methods

We tested a parallel indirect effects model where we hypothesized that the relationships between autistic traits and four domains of QoL (psychological, social, physical, and environmental) would be indirectly influenced through self-determination (represented through satisfaction of the basic psychological needs for autonomy, competence, and relatedness). This study drew participants from the general population (N = 262; M AGE = 37.6, standard deviation = 11.92; 1.9% reported an autism diagnosis and 2.7% identified as autistic without a diagnosis). Participants completed an online survey.

Results

Higher levels of autistic traits were associated with lower levels of self-determination and lower levels of QoL, and there was a significant indirect effect between autistic traits and QoL via self-determination. More specifically, we found a significant indirect effect between autistic traits and all QoL domains via competence; between autistic traits and the environmental, social, and psychological QoL domains via relatedness; and between autistic traits and the physical and environmental QoL domains through autonomy.

Conclusions

Our results suggest that supporting satisfaction of the needs for autonomy, competence, and relatedness may represent an important element in designing effective programs to support the development of self-determination in people with higher levels of autistic traits (potentially including autistic individuals) and also to support these people to improve their QoL.

Autism spectrum disorder in ICD-11-a critical reflection of its possible impact on clinical practice and research

This perspective article compares and contrasts the conceptualization of Autism Spectrum Disorder (ASD) in ICD-11 and DSM-5. By guiding the user through the ICD-11 text, it is argued that, in contrast to DSM-5, ICD-11 allows a high variety in symptom combinations, which results in an operationalization of ASD that is in favor of an extreme diverse picture, yet possibly at the expense of precision, including unforeseeable effects on clinical practice, care, and research. The clinical utility is questionable as this conceptualization can hardly be differentiated from other mental disorders and autism-like traits. It moves away from an observable, behavioral, and neurodevelopmental disorder to a disorder of inner experience that can hardly be measured objectively. It contains many vague and subjective concepts that lead to non-falsifiable diagnoses. This bears a large danger of false positive diagnoses, of further increased prevalence rates, limitations of access to ASD-specific services and of increasing the non-specificity of treatments. For research, the hypothesis is that the specificity of ASD will be reduced and this will additional increase the already high heterogeneity with the effect that replication of studies will be hampered. This could limit our understanding of etiology and biological pathways of ASD and bears the risk that precision medicine, i.e., a targeted approach for individual treatment strategies based on precise diagnostic markers, is more far from becoming reality. Thus, a more precise, quantitative description and more objective measurement of symptoms are suggested that define the clinical ASD phenotype. Identification of core ASD subtypes/endophenotypes and a precise description of symptoms is the necessary next step to advance diagnostic classification systems. Therefore, employing a more finely grained, objective, clinical symptom characterization which is more relatable to neurobehavioral concepts is of central significance.

Self-reported autistic traits and psychosocial outcomes among university students in Malaysia

LAY ABSTRACT

Most research on autism spectrum conditions is done on young children and not as much on young adults with autism spectrum conditions. Because of this, not much is known about how common autism spectrum conditions are in young adults and how they affect their mental and social health, especially in Southeast Asia. Based on self-reports, 2.8% of the 2732 university students we looked at in Malaysia might have been diagnosed or thought to have an autism spectrum condition. Students who said they had or thought they had autism spectrum conditions had lower self-efficacy, more stress and a lower quality of life than students who said they did not have autism spectrum conditions. The results showed that university students with autism spectrum condition are more likely to have bad psychological and social outcomes than their peers without autism spectrum condition. Also, the link between autistic traits and psychosocial outcomes could depend on the culture.

Autistic traits heighten sensitivity to rejection-induced social pain

Autistic traits-subclinical forms of characteristics associated with autism spectrum disorders-are associated with poor social interactions and high risks for mental health disorders. We hypothesized that altered sensitivity to social rejection is an important contributor to psychological distress observed among individuals with high autistic traits. Experiment 1 adopted a social-judgment task and compared behavioral and neural activity in response to social rejection between participants exhibiting either high or low autistic traits (HAT and LAT, respectively). Rejection-induced hurt feelings, P3 amplitudes, and θ-oscillation magnitudes were greater in the HAT group than in the LAT group. Mediation analysis indicated that autistic traits heighten rejection-induced social pain through increasing frontal-midline θ-oscillations. Responses to nonsocial feedback in the age-judgment task were comparable, confirming that the between-group differences were specific to social negative feedback. Experiment 2 assessed the association between autistic traits, rejection sensitivity, and psychological distress among randomly recruited participants. Results showed that autistic traits affected depressive/anxious symptomatology partially through heightened rejection sensitivity. Therefore, autistic traits heighten sensitivity to rejection-induced social pain that leads to psychological distress. This finding will help facilitate the development of strategies for coping with social pain and improving mental health for individuals with high autistic traits.

Social anxiety tendency and autism spectrum disorder in Japanese adolescence

BACKGROUND

In Japanese high schools, understanding of school non-attendance and students with developmental disabilities, including autism spectrum disorder (ASD), is gradually improving. On the other hand, few people recognize social anxiety disorder (SAD), the onset of which commences during youth. Social anxiety disorder and ASD share various overlapping characteristics but have different diagnostic criteria. The anxiety caused by these disorders sometimes appears as school non-attendance. This study examines the relationship between SAD, ASD, and history of school non-attendance in high school students.

METHODS

One hundred and fifty-eight students at one Japanese high school that accepts school non- attending students were investigated. To understand the features of ASD and how it relates to SAD tendencies, the Liebowitz Social Anxiety Scale - Japanese (LSAS-J) and Autism-Spectrum Quotient - Japanese (AQ-J) were used. Based on the LSAS-J cutoff point, participants were divided into high and low anxiety groups and then data were compared between the two groups. Potential factors associated with a high-SAD trend were evaluated using multivariate logistic regression.

RESULTS

The results showed that students with high ASD scores were more likely to have SAD and that a lack of "social skill," a subscale of ASD, was closely associated with a social anxiety trend. However, the relationship between school non-attendance and social anxiety could not be confirmed.

CONCLUSIONS

Focusing on the lack of social skills in ASD may provide an opportunity to identify students with high SAD tendencies. This study will contribute to the understanding of high school students with high SAD tendencies in Japan.

I Have a Fear of Negative Evaluation, Get Me Out of Here! Examining Latent Constructs of Social Anxiety and Autistic Traits in Neurotypical and Autistic Young People

Understanding shared and unique constructs underlying social communication difficulties in autism spectrum disorder (ASD) and social anxiety disorder (SAD) can address potential diagnostic overshadowing when evaluating SAD in the context of autism. Using self-report measures, factor analyses examined constructs underlying autistic traits, social anxiety, internalising symptoms and wellbeing amongst 267 neurotypical (17-19 years) and 145 autistic (15-22 years) students in the UK. Shared constructs across measures assessed general social communication competency (e.g., social distress in new situations and peer relationships). Fear of Negative Evaluation (FNE) was identified in both samples as a stable construct unique to social anxiety. Adapting interventions targeting SAD in autism should target FNE during adolescence which marks a period of heightened peer interaction and social vulnerability.

Autism trait prevalence in treatment seeking adolescents and adults attending specialist gender services

Background.

To assess the prevalence of autism traits in individuals accessing gender affirming treatments, we conducted a cross-sectional survey in the regional specialist gender services in Northern Ireland.

Methods.

One hundred and twenty-three individuals (38 adolescents and 69 adults) currently attending or who previously attended specialist gender services in Northern Ireland were recruited. Fifty-six individuals assigned male at birth (AMAB) and 66 individuals assigned female at birth (AFAB) took part in the study. Main outcome measures: Autism Quotient (AQ), Cambridge Behavior Scale (EQ), and RAADS-14.

Results.

Autism trait prevalence rates of 19.5% (AQ); 25.4% (RAADS-14); and 35.8% (poor empathy traits). A combined measure comprising all three provided a prevalence of 17.2%. There were no mean differences in the scores between AMAB (assigned male at birth) individuals and AFAB (assigned female at birth) individuals.

Conclusions.

Autism traits present additional challenges during the assessment and treatment of individuals with gender dysphoria. Autism screening tools can aid in the identification of individual with additional needs.

Autistic Traits in Treatment-Seeking Transgender Adults

The present study aimed to compare prevalence of autistic traits measured by the self-reported autism spectrum quotient-short (AQ-short) in a transgender clinical population (n = 656) matched by age and sex assigned at birth to a cisgender community sample. Results showed that transgender and cisgender people reported similar levels of possible autistic caseness. Transgender people assigned female were more likely to have clinically significant autistic traits compared to any other group. No difference was found between those assigned male. High AQ scores may not be indicative of the presence of an autism spectrum condition as the difference between groups mainly related to social behaviours; such scores may be a reflection of transgender people’s high social anxiety levels due to negative past experiences.