Mood Disorders in High-Functioning Autism: The Importance of Alexithymia and Emotional Regulation.
Kristen P Morie, Scott Jackson, Zu Wei Zhai and 2 others
PMID 31028592WHAT IT FOUND
In adults with autism, autistic symptoms were not directly linked to depression, but were linked to depression and anxiety through difficulty identifying emotions and poorer emotion regulation.
This is association, not proof of treatment.
Key findings
01Autistic symptoms were associated with alexithymia, and alexithymia was associated with emotion regulation difficulties.
02Autistic symptoms were linked to depression and anxiety through a chain from alexithymia to emotion regulation, and this indirect path was significant.
03For depression, autistic symptoms were not directly associated with depression, and the indirect paths through alexithymia alone or emotion regulation alone were not significant.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The analysed sample was 64 adults, so the findings are limited to adults with autism who completed online self-report measures. 84% were female, and the authors note this makes generalisation to the broader autism population less secure. ASD diagnosis was self-reported and not confirmed by clinical assessment because the study was online. All data were collected at one time point, so the study cannot show that alexithymia or emotion regulation came before mood symptoms. Some direct and single indirect paths were not significant, and the significant finding was a serial indirect path, not a tested treatment effect. Alexithymia may have made self-report of emotions and mood symptoms harder to interpret. Unmeasured factors such as socio-economic status may have influenced the results.
Declared interests
The authors declared no competing interests.
The easy way to misread this
Do not read the significant serial mediation as evidence that treating alexithymia will improve mood. The study measured associations at one time point and did not test any therapy.