Anxiety, depression, and well‐being in autistic adults and adults with other developmental disabilities: A longitudinal cross‐lagged analysis

Abstract

Autistic people and people with other developmental disabilities (DD) are at high likelihood for anxiety and depression, which can negatively affect adult life. Therefore, this study sought to understand temporal links between anxiety and depression over time in autistic adults and adults with DDs, and how these conditions impact specific aspects of positive well-being. A sample of 130 adults with autism or other DDs and their caregivers were drawn from a longitudinal study. Participants complete measures of anxiety (Adult Manifest Anxiety Scale), depression (Beck Depression Inventory, 2nd Edition), and well-being (Scales of Psychological Well-Being). Cross-lagged panel analyses revealed significant autoregressive effects for anxiety and depressive symptoms over time, based on both caregiver and self-report (all p < 0.01). Additionally, although findings differed across reporter, cross-lagged links between anxiety and depression emerged over time. Based on caregiver-report, anxiety symptoms predicted later depressive symptoms (p = 0.002) but depressive symptoms did not predict later anxiety (p = 0.10); the opposite pattern was identified for self-report. Aspects of positive well-being (purpose in life, self-acceptance, personal growth) demonstrated differential links with anxiety and depression (p = 0.001-0.53). These findings highlight the utility of a transdiagnostic approach to mental health services for autistic adults and adults with DDs, and the need to monitor for anxious or depressive symptoms in autistic adults and adults with DDs presenting with depression or anxiety, respectively. Lay SummaryAutistic people and people with DDs often experience mental health challenges. This study highlights the connections between anxiety, depression, and well-being among autistic adults and adults with DDs. These results suggest there is a need for treatment approaches that target commonalities across multiple mental health conditions in autistic adults and adults with DDs.