Gender Differences in Emotion Dysregulation in an Autism Inpatient Psychiatric Sample

Abstract

There is a wide range of emotion regulation (ER)‐related impairment observed in autism spectrum disorder (ASD), which is associated with both internalizing and externalizing problems. Although the importance of ER is widely acknowledged in the ASD literature, little is known about factors associated with variability in ER impairment. Given the identified gender differences in ASD, gender may be a potential contributor to ER. This study examined gender differences in ER in an ASD inpatient psychiatric sample (n = 722; 146 females) aged 4–20 years, collected as part of the Autism Inpatient Collection. In addition, the study investigated whether age, nonverbal intelligence quotient (NVIQ), or verbal ability moderate the association between ER and gender. While both male and female inpatients with ASD presented with clinically elevated emotion dysregulation compared to general population norms, results suggest that female psychiatric inpatients have more severe dysregulation, including higher reactivity and dysphoria, than inpatient males. NVIQ and verbal ability did not moderate the association between gender and ER. Age moderated the association between gender and ER, with greater gender difference seen in older individuals, but only for dysphoria. However, overall, these effects were small. Improved understanding of ER presentation in males and females with ASD is critical, as these symptoms may differentially impact individuals with ASD and may warrant a different treatment emphasis. Lay Summary Previous research has identified several gender differences in presentation of autism spectrum disorder (ASD) symptoms, as well as difficulties with emotion regulation in individuals with ASD. In order to better understand the factors that may contribute to emotion regulation in ASD, this study examined whether psychiatrically hospitalized males and females with ASD differed in emotion regulation and what factors influenced the differences. Results suggest that females with ASD have slightly but significantly more difficulty with emotion regulation compared to males. Autism Res 2020, 13: 1343–1348. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.

Emotion Dysregulation is Substantially Elevated in Autism Compared to the General Population: Impact on Psychiatric Services

“…Importantly, both manifestations may relate to poor ER and very little research has looked at sex as it relates to ER in particular. One prior study reported higher EDI Reactivity scores in female inpatients with ASD as compared to male inpatients, but the effect size was small [Wieckowski, Luallin, Pan, Righi, & Gabriels, 2020]. Our findings are consistent with prior research on hospitalization and emergency service utilization in ASD that also did not identify sex as a significant predictor [Kalb et al, 2012;Mandell, 2008;Righi et al, 2018;Turcotte et al, 2018].…”

Emotional Dysregulation and Adaptive Functioning in Preschoolers With Autism Spectrum Disorder or Other Neurodevelopmental Disorders

“…This could be due to the rather small representation of females in the study sample and/or to referral bias whereby females with high ED might have been more likely to be clinically referred. Few data on sex differences in emotional regulation among ASD people are available, but scarcely comparable to our population ( 55 , 73 ). Further studies on sex differences in preschoolers with ASD are needed to evaluate different trajectories of development, and so identify vulnerable children.…”

Proof of Concept: A Brief Psycho-Educational Training Program to Increase the Use of Positive Emotion Regulation Strategies in Individuals With Autism Spectrum Disorder

“…Differences between males and females in the use of ER strategies have also been found in typically developing populations ( Cai et al, 2018 ). To date, only one study has examined this topic and found that females with ASD had slightly more emotion regulation difficulties compared to males with ASD: They were more prone to experience dysphoria and faced more impairments related to high emotional intensity ( Trubanova Wieckowski et al, 2020 ). Future studies should explore the efficacy of such interventions in female individuals with ASD.…”