Does the gender matter?: Anxiety symptoms and emotion dysregulation in adults with autism and intellectual disabilities

Sáez-Suanes, Gema P.; García-Villamisar, Domingo; Armentia, Araceli del Pozo

doi:10.1002/aur.2839

Cited by 7 publications

(8 citation statements)

References 74 publications

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“…Indeed, the BPD group scored the highest compared to both autistic women and men. This result is inconsistent with ndings supporting a heightened ED in autistic women compared to both autistic men [24,25,27] and women with BPD [27]. However, studies comparing ED in autistic women and people with BPD are scarce [27] and those comparing ED across genders in autistic adults have focused on individuals attending psychiatric facilities, unlike our study [25,27,52].…”

Section: Discussioncontrasting

confidence: 90%

The biosocial correlates and predictors of emotion dysregulation in autistic adults compared to borderline personality disorder and nonclinical controls

Bemmouna,

Lagzouli,

Weiner

2023

Preprint

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Background Emotion dysregulation (ED) is a core symptom of borderline personality disorder (BPD), whose etiology has been attributed to biosocial factors. In autism spectrum disorder (ASD), although ED is prevalent and is associated with decreased well-being (e.g., self-harm, suicidality), it has been understudied, especially in adults. It is therefore crucial to further understand ED in autistic adults to improve its treatment. Our study investigates ED, its behavioural correlates (e.g., self-harm, suicidality) and biosocial predictors in autistic adults relative to BPD and nonclinical controls (NC). Methods 724 participants (ASD = 154; BPD = 111; NC = 459) completed 11 self-reported questionnaires assessing ED, ASD and BPD traits, co-occurring disorders, alexithymia, emotional vulnerability and invalidating experiences (e.g., bullying, autistic camouflaging). The occurrence of ED behavioural correlates (i.e., self-harm, history of suicide attempts, and psychiatric hospitalizations) was collected. In addition, between-groups analyses, linear regressions and machine learning models (ML) were used to identify ED predictors in each group. Results ED and its behavioural correlates were higher in ASD compared to NC, but milder than in BPD. While gender did not predict ED scores, autistic women had increased risk factors to ED, including sexual abuse and camouflaging. Interestingly, BPD traits, emotional vulnerability, and alexithymia strongly predicted ED scores across the groups. Using ML models, sensory sensitivity and autistic camouflaging were associated with ED in ASD, and ADHD symptoms with ED in BPD. Limitations: ASD and BPD diagnoses were self-reported, which did not allow us to check their accuracy. Additionally, we did not explore the transactional and the moderating/mediating relationships between the different variables. Moreover, our research is cross-sectional and cannot draw conclusions regarding the direction and causality of relationships between ED and other clinical dimensions. Conclusions ED and its behavioural correlates are heightened in BPD compared to ASD and nonclinical controls. In the ASD group, there were no gender differences in ED, despite the heightened exposure of autistic women to ED risk factors. BPD traits, emotional vulnerability, and alexithymia are core to ED regardless of diagnosis. Although less central, sensory sensitivity and autistic camouflaging seem to be specific predictors of ED in autistic adults.

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Section: Discussioncontrasting

confidence: 90%

The biosocial correlates and predictors of emotion dysregulation in autistic adults compared to borderline personality disorder and nonclinical controls

Bemmouna,

Lagzouli,

Weiner

2023

Preprint

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“…Indeed, the BPD group scored the highest compared to both autistic women and men. This result is inconsistent with findings supporting a heightened ED in autistic women compared to both autistic men [ 24 , 25 , 27 ] and women with BPD [ 27 ]. However, studies comparing ED in autistic women and people with BPD are scarce [ 27 ] and those comparing ED across genders in autistic adults have focused on individuals attending psychiatric facilities, unlike our study [ 25 , 27 , 53 ].…”

Section: Discussioncontrasting

confidence: 80%

“…increased use of camouflaging) and biological (e.g. heightened sensory sensitivity) factors [ 24 , 116 , 117 ].…”

Section: Discussionmentioning

confidence: 99%

“…This suggests that ED is a risk factor for suicidality and self-harm in ASC, and that autistic people may develop capability for suicide through self-harm [ 14 , 23 ]. Autistic women in particular have been reported to be at greater risk of developing severe ED compared to autistic men [ 24 – 26 ], which suggests that gender-related factors might be involved in ED in ASC [ 27 ]. Beyond the fact that ASC and BPD may share ED and ED-related dysregulated behaviours, it is worth noting that ASC and BPD may also co-occur with a pooled prevalence of BPD in ASC of 4% [95% CI 0–9%] and of 3% [95% CI 1–8%] for ASC in BPD [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

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The biosocial correlates and predictors of emotion dysregulation in autistic adults compared to borderline personality disorder and nonclinical controls

Bemmouna,

Lagzouli,

Weiner

2023

Molecular Autism

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Background Emotion dysregulation (ED) is a core symptom of borderline personality disorder (BPD), whose aetiology has been attributed to biosocial factors. In autism spectrum condition (ASC), although ED is prevalent and is associated with decreased well-being (e.g. self-harm, suicidality), it has been understudied, especially in adults. It is therefore crucial to further understand ED in autistic adults to improve its treatment. Our study investigates ED, its behavioural correlates (e.g. self-harm, suicidality) and biosocial predictors in autistic adults relative to BPD and nonclinical controls (NC). Methods A total of 724 participants (ASC = 154; BPD = 111; NC = 459) completed 11 self-reported questionnaires assessing ED, ASC and BPD traits, co-occurring disorders, alexithymia, emotional vulnerability and invalidating experiences (e.g. bullying, autistic camouflaging). The occurrence of ED behavioural correlates (i.e. self-harm, history of suicide attempts, and psychiatric hospitalizations) was collected. In addition, between-groups analyses, linear regressions and machine learning (ML) models were used to identify ED predictors in each group. Results ED and its behavioural correlates were higher in ASC compared to NC, but milder than in BPD. While gender did not predict ED scores, autistic women had increased risk factors to ED, including sexual abuse and camouflaging. Interestingly, BPD traits, emotional vulnerability and alexithymia strongly predicted ED scores across the groups. Using ML models, sensory sensitivity and autistic camouflaging were associated with ED in ASC, and ADHD symptoms with ED in BPD. Limitations ASC and BPD diagnoses were self-reported, which did not allow us to check their accuracy. Additionally, we did not explore the transactional and the moderating/mediating relationships between the different variables. Moreover, our research is cross-sectional and cannot draw conclusions regarding the direction and causality of relationships between ED and other clinical dimensions. Conclusions ED and its behavioural correlates are heightened in BPD compared to ASC and nonclinical controls. In the ASC group, there were no gender differences in ED, despite the heightened exposure of autistic women to ED risk factors. BPD traits, emotional vulnerability, and alexithymia are core to ED regardless of diagnosis. Although less central, sensory sensitivity and autistic camouflaging seem to be specific predictors of ED in autistic adults.

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“…These di culties were related to communication and executive functions, as indicated by the VABS-3 assessment. Surprisingly, anxiety problems were found to be more prevalent in boys, which is in contrast to the general population [30], to the described in intellectual disability groups [31], and to a recently reported PMM2-CDG series [27], all showing more risk of developing anxiety in the female group.…”

Section: Discussioncontrasting

confidence: 61%

Untangling adaptive functioning of PMM2-CDG across age and its impact on parental stress: a cross-sectional study

Epifani,

Pujol,

Llorens

et al. 2023

Preprint

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Phosphomannomutase deficiency (PMM2-CDG) causes cerebellar atrophy and presents with ataxia, dysmetria, and intellectual deficits. Despite ongoing therapy development and clinical trials, limited knowledge exists regarding the cognitive and adaptive profile. We evaluated a large cohort assessing the adaptive profile and its association with parental stress, clinical, and molecular characteristics. We recruited 37 individuals, and used validated scales to assess disease severity, behavioral and adaptive functioning, psychopathology and parental stress. Results were compared with clinical features. No significant differences were found based on age or gender. "Daily living skills" was the most affected domain. Patients clinically classified as severe had significantly lower adaptive skill values, as did those with lipodystrophy and inverted nipples. Learning difficulties and scholastic problems were consistently observed. Greater severity in motor cerebellar syndrome, behavioral disturbances and the presence of comorbidities such as hyperactivity, autistic features and moderate-to-severe intellectual disability correlate with higher scores in parental stress. Although not longitudinal, our study indicates either stabilization or no progression in adaptive abilities. Our findings offer validated tools to assess adaptive deficits in PMM2-CDG patients, emphasizing the importance of addressing communication, executive function, daily living skills, autonomy, and their impact on parental stress in clinical monitoring and future therapies.

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Does the gender matter?: Anxiety symptoms and emotion dysregulation in adults with autism and intellectual disabilities

Cited by 7 publications

References 74 publications

The biosocial correlates and predictors of emotion dysregulation in autistic adults compared to borderline personality disorder and nonclinical controls

The biosocial correlates and predictors of emotion dysregulation in autistic adults compared to borderline personality disorder and nonclinical controls

The biosocial correlates and predictors of emotion dysregulation in autistic adults compared to borderline personality disorder and nonclinical controls

Untangling adaptive functioning of PMM2-CDG across age and its impact on parental stress: a cross-sectional study

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