(PS11-73) Examining Maladaptive Pediatric Overcontrol in Autism: A Transdiagnostic Approach

Overcontrol, a personality phenotype defined by elevated self-control and rigidity, has only recently been parsed from behavioral inhibition, a temperament that is widely implicated in childhood anxiety (Gilbert et al., 2022; Sandstrom et al., 2020). Little empirical research investigates the potential maladaptive role of elevated self-control in youth mental health, even though it is a putative transdiagnostic risk factor for internalizing symptoms (Lynch et al., 2015). For autistic youth, given their elevated levels of internalizing disorders (e.g., anxiety; Bougeard et al., 2021) and clinical challenges similar to those conferred by overcontrol (e.g., increased levels of inflexibility; Uljarević et al., 2017), it is clinically important to examine the role of overcontrol in this population’s mental health. This study investigated psychopathology correlates of pediatric overcontrol in a youth sample enriched for autism.

Fifty-two parents completed reports of their children’s (M_age=12.49(2.85) years, M_IQ =107.15(21.52), 57% autistic males, 54% White) overcontrol (OCYC; Gilbert et al., 2020), anxiety (MASC-2; March, 1997; ASC-ASD; Rodgers, 2016), depressive and eating disorder symptoms (CASI-5; Gadow & Sprafkin, 2013), and autistic traits (SRS-2; Constantino et al., 2003). Youth’s autism classification (i.e., autistic or non-autistic) were assigned using standardized observational assessment (ADOS-2; Lord et al., 2012).

Independent samples t-tests suggested that overcontrol was elevated in autistic youth compared to non-autistic peers, t(50)=2.09, p=.042. Overcontrol was positively correlated with overarching anxiety (both MASC-2 & ASC-ASD; rs > 0.46, ps < .01), as well as with binge eating disorder, anorexia, bulimia, and avoidant restrictive food intake disorder symptoms (rs=0.34, ps < .05), but not with depressive (i.e., major depression, persistent dysthymia) symptoms.

Moderated regressions (PROCESS v. 4.2) suggested that autism indices (i.e., autism group classification, autistic traits) did not moderate relationships between overcontrol and anxiety nor eating disorder symptoms.

Taken together, findings suggest that autistic individuals may be at risk for maladaptive mental health outcomes linked to elevated self-control (i.e., overcontrol). Specifically, the current study found that overcontrol may relate to increased anxiety and eating disorder symptoms across neurotypes in youth. To our knowledge, this study is one of the first investigations of overcontrol including autistic individuals. Findings contribute to prior literature on transdiagnostic risk factors for pediatric internalizing disorders, particularly for co-occurring anxiety in pediatric autism (Greenway et al., 2010), and provide initial evidence that overcontrol robustly predicts anxiety similarly in autistic and allistic youth. Overall, to maximize treatment effects for populations at elevated risk for varying mental health issues (e,g., autistic individuals; Mannion et al., 2015), overcontrol may be an important transdiagnostic therapy target in future cognitive-behavioral interventions.