Socio-emotional determinants of depressive symptoms in adolescents and adults with autism spectrum disorder: A systematic review

Abstract

Co-occurring problems with mood and anxiety among adolescents and adults on the autism spectrum are highly prevalent and contribute to poor outcomes and diminished quality of life. The current study’s principal aim was to evaluate variation in the presentation of depression symptomatology among adolescents and adults with autism spectrum disorder, specifically to determine if social motivation may be implicated in an autism spectrum disorder–specific subtype of depression. A systematic review was conducted, with an initial search conducted in February 2018 and a search update conducted in November 2019, yielding 48 articles which met inclusion criteria. Results support other recent work indicating that symptoms of depression are highly prevalent among adolescents and adults with autism spectrum disorder. Coding of study variables related to core autism spectrum disorder symptoms provided initial evidence for the proposition of a conceptual model implicating social motivation in the etiology of depression among a subset of individuals with autism spectrum disorder. Lay abstract Many adolescents and adults with autism spectrum disorder experience difficulty with symptoms of depression. These symptoms can contribute to poor quality of life and lack of independence for adolescents and adults. To better understand these symptoms, we conducted a review of articles that examined the presentation of depression specific to autism spectrum disorder. Our goals in conducting this study were (1) to examine whether depression may be associated with symptoms that are common among people with autism spectrum disorder, such as loneliness or poor social motivation; (2) to determine whether people with autism spectrum disorder experience depression in a different way than the general population; and (3) to add to other recent studies that have examined how common depression is in autism spectrum disorder and how it is typically measured. Our study reviewed 48 papers on this topic. Results showed that a substantial proportion of people with autism spectrum disorder experience significant symptoms of depression. We related our results to social factors commonly studied in this field (i.e. social motivation) and proposed a new model for the development of depression in this population.

Autism and the double empathy problem: Implications for development and mental health

“…However, associations between social difficulties and mental health in autism are supported by research. For example, (Smith & White, 2020) proposed a model of depression in autistic people on the basis of a systematic review of the available literature in this area. In this model, depression is more likely to develop in autistic people who are socially motivated, alongside pronounced social and communication difficulties that prevent development of meaningful social relationships.…”

Autism in Adulthood: Clinical and Demographic Characteristics of a Cohort of Five Hundred Persons with Autism Analyzed by a Novel Multistep Network Model

“…may arise. Furthermore, this represents the level of autism in which the diagnostic evaluation is often lacking, as shown by those children mistaken for "little geniuses", whose socio-relational deficit is seen as a side effect of academic excellence [51,52]. With regard to the severity of the ASD, since we are a public health assessment center, our PWA sample included all forms of autism, with 39% of minor forms, i.e., ASD level 1 DSM 5, including previously defined forms of high-functioning autism and Asperger's syndrome-27.1% of level 2 autism (DSM 5), and 18% of severe forms of autism (ASD level 3 DSM 5) [1].…”

Depressive symptoms of autism spectrum disorder children’s siblings in Greece: Associations with parental anxiety and social support

“…In addition to the higher rate of psychiatric disorders and depression among family members of children with autism, certain personality traits known as the “Broad Autism phenotype” (Bolton et al, 1994) which are regarded as genetically based (Sandin et al, 2017) have also been found to be present more often among the family members (Cruz et al, 2013) and siblings of individuals with autism (Pisula & Ziegart-Sadowska, 2015). Another finding that seems to provide further support to the hypothesis of a common biological substrate is the high rate of co-occurrence of depression in autistic children themselves (Smith & White, 2020; Stewart et al, 2006; Wigham et al, 2017) since both depression and autism are considered heritable to a certain degree (Franić et al, 2010; Gotlib & Colich, 2014; Tick et al, 2016). On the other hand, recent research that has been carried out on the general population using children-of-twins (CoT) design suggests that there is a direct environmental transmission of parental anxiety (Eley et al, 2015) and depression (McAdams et al, 2015) to the offspring.…”