Friendship and Depression Among Children with ASD

Background: Friendship quality and quantity is associated with a range of positive functions among typically developing children. These included, but are not limited to: buffering against depression and anxiety (e.g., Bukowski, Laursen, & Hoza, 2010) and fostering self-esteem and school achievement (e.g. Hartup, 1996; Newman-Kingery, Erdley, & Marshall, 2011). However, children with Autism Spectrum Disorders (ASD) struggle to form reciprocal friendships , and have been found to describe their friendships differently than do typically developing children (e.g. Bauminger & Kasari, 2000; Carrington et al., 2003; Marks et al., 2000). To date, only one study has examined the relation between participation in a reciprocal friendship and commonly associated outcomes among individuals with ASD (Mazurek & Kanne, 2010), with findings unexpectedly suggesting that individuals with ASD and at least one friendship are at elevated risk for anxiety. However, no investigation has yet examined the relationship of depression to friendship quality in this population.

Objectives:  To examine associations between friendship quality (Friendship Quality Questionnaire; FQQ; Parker & Asher, 1993), with depression (Child Depression Inventory; CDI; Kovacs, 2004).  It was hypothesized that, as in typically-developing populations, higher quality friendships overall would predict lower levels of depression.

Methods:  The FQQ and the CDI were administered to 30 boys aged 8-16 (mean=12) who presented for a screening prior to participation in a social skills based day camp for children with ASD.  All participants were reported to have received a diagnosis of ASD through a community provider, and diagnosis was confirmed using the Gilliam Asperger’s Disorder Scale (Gilliam, 2001). The FQQ consists of 6 subscales measuring positive and negative aspects of friendship.

Results: FQQ total scores correlated positively with CDI scores (r = .39, p = .035) This relation was driven by the Conflict and Betrayal (r = .46, p = .011) and Intimate Exchange (r = .43, p = .017).

Conclusions: Contrary to hypotheses, friendship quality predicted higher depression, with the Conflict and Betrayal and Intimate Exchange subscales driving the relation. Findings suggest that conflict and betrayal and intimate exchange in friendships may actually predict depression among children with ASD. This suggests that, while friendship has been found to serve an important buffering role among typically-developing children primarily through its function as a source of positive affective exchange (e.g., Newcomb & Bagwell, 1995), this role may be different for children with ASD, who struggle to comprehend affective cues.  However, difficulty describing internal states has traditionally been associated with a diagnosis of ASD (e.g., Bauminger & Kasari, 2000). Because children with ASD may not be as perceptive of positive affective cues, findings suggest that those who were more adept at describing their feelings may also be more sensitive to negative cues from the social environment (which may be delivered more concretely, such as in the form of bullying). Thus, findings may actually relate to a third variable of ability to describe one’s own inner state, such that children who were better able to describe their friendships were also better able to describe feelings of depression.