1 - (SYM 35) Impacts of Emotion Dysregulation on Multiple Mental Health Disorders in Autistic Youth

Emotion dysregulation (ED) is a transdiagnostic construct defined as difficulty regulating emotional and behavioral expressions in response to triggering environments (Gross, 2007). ED is elevated and has long-term mental health implications for autistic people (Dell’Osso et al., 2023). Recent conceptualizations have begun to parse the day-to-day mood changes (emotional dysphoria; ED-D) and behavioral reactions (emotional reactivity; ED-R) in ED (Mazefsky, et al., 2014). However, it is unclear how ED subtypes may differentially predict co-occurring mental health conditions in autistic youth. This project used modelling approaches to explore the relationship amongst ED dysphoria and reactivity and multiple mental health conditions in a community sample of autistic youth.

Forty-eight autistic youth (M_age=11.17, SD_age=3.75; M_IQ=99.13, SD_IQ=25.24; 47% White, 23% Asian/MENA/South Asian; 6% Black; 20% Multi-racial; 72% male) participated in this study. Parents completed measures of ED (EDI; Mazefsky et al., 2014) and broadband mental health (CASI-5; Gadow et al., 2013).

A path analysis examined the direct effects of ED-R and ED-D on oppositional defiant disorder (ODD), dysthymia, attention deficit hyperactivity disorder (ADHD; all subtypes), generalized anxiety (GAD), social anxiety (SAD), separation anxiety (SEP) and conduct disorder (CD). Greater ED-D predicted increased severity of ODD (Β =.34, p< .01), GAD (Β =.35, p< .05), and dysthymia (Β =.49, p< .01). Greater ED-R predicted greater severity of all ADHD subtypes symptoms (all Β>.38, p< .01), ODD (Β=.38, p< .01), GAD (Β =.32, p< .05). CD, SEP, and SAD were not uniquely predicted by either ED domain (all p</em>s > .05).

Overall, emotional reactivity and dysphoria may differentially predict mental health outcomes in autistic youth, with some overlapping relationships to GAD and ODD. Conditions related to changes in mood and increased irritability were associated with ED-D, while conditions associated with behavioral reactions and disruptions were related to ED-R. Consistent with the DSM-5-TR criteria, ODD was more evenly distributed between emotions (anger and irritation) and behaviors (argumentativeness and defiance). Surprisingly, GAD was associated with not only dysphoria but also reactivity, which may relate to the muscle tension and physical symptoms. These findings provide empirical support for examining ED subtypes more carefully, which can lead to a better understanding of impact ED may have on mental health conditions in autistic people.