Insistence on sameness, repetitive negative thinking and mental health in autistic and non-autistic adults.

The sample was a convenience sample, so results may not apply to the wider autistic or non-autistic adult population. Most participants were White, and the non-autistic community group was highly educated, with 66% having an undergraduate or postgraduate degree. The study measured adults at one time point, so it cannot show that insistence on sameness or repetitive negative thinking caused depression and anxiety. The analysis was not pre-registered. No autistic individuals were involved in the research. The clinical autistic group all had moderate-to-severe depression, so their scores do not represent autistic adults without depression. Incomplete data were handled by pairwise deletion, so different analyses may use different participant numbers. The obsessing measure came from an OCD symptom subscale, and OCD symptoms themselves were not analysed as an outcome.

The authors declared no potential conflicts of interest. The ADEPT study was funded by the National Institute for Health Research Health Technology Assessment programme, and Kate Cooper was funded by an NIHR Fellowship. The named funder is the National Institute for Health and Care Research.

Do not read the mediation results as proof that insistence on sameness causes repetitive negative thinking, or that repetitive negative thinking causes depression and anxiety. The study measured variables at one time point and did not test treatment effects.