Executive Functioning Is Linked to Internalizing Symptoms in Autistic Adults With Higher Support Needs.
Ethan Greenstein, Nancy Raitano Lee, Goldie A McQuaid and 1 others
Among 486 autistic adults with higher support needs, caregiver-reported emotion regulation and flexibility difficulties were each linked to more severe anxiety and depression, while inhibitory control was not.
These two domains are the most relevant EF targets for mental health in this group.
Key findings
1Greater caregiver-reported emotion regulation difficulties were significantly associated with both higher depression and higher anxiety symptoms.
2Greater caregiver-reported flexibility difficulties were significantly associated with both higher depression and higher anxiety symptoms.
3Inhibitory control difficulties showed no significant association with either anxiety or depression symptoms.
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What it does not show
The study is cross-sectional, so it cannot show that poor emotion regulation or flexibility causes anxiety and depression — the relationship could run in either direction or be driven by a third factor. All EF and mental health data come from caregiver reports, not from the autistic adults themselves. Caregivers may see different patterns than the adults experience, and the authors note this provides only one lens on daily life. The sample was recruited from a volunteer research registry and was 79% White and non-Hispanic, which may limit how well the findings apply to other groups. Only three EF domains were examined; working memory, planning, and self-monitoring were not tested. Only anxiety and depression were measured as mental health outcomes; externalizing symptoms and other conditions were not examined.
Declared interests
The authors declare no conflicts of interest related to the research, authorship, or publication of this work. No funding source is named in the text provided.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →