A pivotal study highlights unique emotional challenges

Recent research has found that young individuals with autism not only experience heightened daily stress but also tend to employ less effective emotional regulation strategies compared to their non-autistic peers. This study, published in the journal Autism, provides a deeper understanding of the daily emotional landscape faced by those with autism.

Earlier studies have consistently shown that individuals with autism often report higher levels of stress and are more likely to encounter adverse experiences, such as bullying, compared to non-autistic individuals. These increased levels of stress can contribute to a range of mental health issues, including anxiety and mood disorders. Recognizing these challenges, researchers aimed to delve deeper into how autistic adolescents and young adults react to daily stressors, particularly focusing on their emotional responses and coping strategies.

“Autistic individuals are shown to have increased likelihood of developing mental health difficulties during the lifespan, so possible risk and protective factors are important to identify,” said study author Laura Ilen, a PhD student in clinical psychology at the University of Geneva.

“Increased affective reactivity to daily-life stress has been shown to be a vulnerability factor for negative evolution in several clinical populations, which is why we were interested in investigating the topic in adolescents and young adults with autism too. Moreover, to better understand the role of emotion regulation and how clinical interventions could be targeted, one of the study’s interests was to investigate the link between cognitive emotion regulation and affective responses to daily-life stress.”

The study involved a meticulous and detailed methodology to gather accurate data. A total of 94 participants were involved, comprising 39 autistic individuals aged between 12 and 29 years and 55 non-autistic individuals aged between 12 and 26 years. The autistic participants were recruited through clinical centers and family associations in Switzerland and France, ensuring a diverse and representative sample. On the other hand, the non-autistic participants were sourced from the local community in Geneva and from an ongoing study of typically developing individuals.

To measure stress and emotional responses, the study used a technique called Ecological Momentary Assessment (EMA). This involved participants receiving notifications on their smartphones eight times a day for six consecutive days to complete questionnaires about their current feelings and the stressfulness of their activities. This method provided real-time data on the participants’ emotional states in their natural environments, offering a more nuanced understanding of their daily experiences.

The results showed that autistic participants reported higher levels of negative emotions, such as sadness and anxiety, in their day-to-day lives. They also experienced significantly higher levels of stress related to social interactions and daily activities, although there was no significant difference in stress related to specific events. Interestingly, the study revealed that autistic individuals found social events less pleasant than non-social events, suggesting a heightened sensitivity to social stressors.

A particularly notable finding was the increased reactivity of autistic participants to stress related to daily activities. This suggests that routine tasks and obligations may be more emotionally taxing for individuals with autism. Additionally, autistic females exhibited higher stress reactivity to these daily activities and events than autistic males, pointing to possible gender differences in stress responses within the autistic population.

The researchers also explored cognitive emotion regulation – the strategies individuals use to manage and respond to their emotions. Cognitive emotion regulation strategies are mental techniques that people use to manage and influence their emotional responses to situations.

It was found that autistic participants used less adaptive strategies, like positive refocusing and planning, and more non-adaptive strategies, such as rumination and self-blame. This pattern could contribute to the higher levels of stress and negative emotions observed in this group.

“We showed that autistic adolescents and young adults report increased perceived stress in the flow of their daily lives compared to their non-autistic peers, which highlights the importance of reducing stressors in the context of daily life, for example through environmental adjustments,” Ilen told PsyPost. “Autistic participants also reported more difficulties in regulating their emotions (e.g., more frequent use of rumination).”

“These emotion regulation difficulties increased negative emotions in relation to daily stressors and might contribute to the severity of mental health symptoms. Therefore, our results suggest that to prevent stress-related negative emotions and mental health symptoms in young people with autism, clinical interventions could focus on stress management skills and strategies that youth use to manage their emotions when faced with daily stressors.”

Positive refocusing involves shifting one’s focus away from a negative or stressful situation and directing attention towards positive aspects or experiences, while planning as a cognitive emotion regulation strategy involves thinking about how to cope with a stressor or challenge in a constructive way. On the other hand, rumination is a maladaptive cognitive emotion regulation strategy that involves repeatedly thinking about distressing situations, feelings, or thoughts, while self-blame involves attributing personal responsibility, often unfairly or irrationally, for negative events or outcomes.

For participants without autism, the use of adaptive emotion regulation strategies was found to weaken the link between event-related stress and negative emotions. However, this moderating effect of adaptive emotion regulation strategies was not observed in participants with autism.

“We showed that the use of ‘non-adaptive’ emotion regulation strategies increased autistic participants’ negative emotions in relation to daily stressors, as expected,” Ilen explained. “In contrast, more frequent use of ‘adaptive’ emotion regulation was not associated with affective reactivity to stress and was therefore not a protective factor against negative emotions when faced with stress, as might have been expected. This could possibly be explained by the fact that we only investigated cognitive emotion regulation, and not other types of strategies that youth with autism might use.”

While the study offers valuable insights, it’s important to approach these findings with some considerations in mind. One limitation of the study is its reliance on subjective self-reports, which can vary significantly from person to person. Also, the study’s participants were verbally fluent and mostly had average or above-average intellectual functioning, which means the results may not apply to all individuals on the autism spectrum. Moreover, the study’s cross-sectional design means that it can highlight correlations but cannot conclusively prove cause-and-effect relationships.

“As the study design was cross-sectional, we could not make any causal interpretations about the association between affective reactivity to stress and mental health symptoms,” Ilen said. “Future longitudinal studies are needed to determine whether increased stress reactivity can predict later mental health difficulties in autistic youth and adults.”

The study, “Cognitive emotion regulation difficulties increase affective reactivity to daily-life stress in autistic adolescents and young adults“, was authored by Laura Ilen, Clémence Feller, and Maude Schneider.

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