Examining the Roles of Affective Theory of Mind and Social Problem-Solving in the Expression of Depressive Symptomology in High-Functioning Autistic Adults and the Broader Autism Phenotype

Background: Elevated rates of depression have been reported in High-Functioning Autism Spectrum Disorders (HFASD) populations. Two recent studies have found social problem-solving deficits to play the role of a significant partial-mediator between high autistic trait (AT) expression and elevated levels of depressed mood in neurotypical adults. Unfortunately, of these two studies, the only one that reported detailed results regarding the subscale relationships of the measured variables had a limited sample size. Furthermore, as neither study included a clinical sample, the implications for HFASD populations are unclear.

Objectives: This study aims to confirm and expand upon these findings by examining: (i) will the subscale relationships previously detailed remain with the use of a larger sample size; (ii) will the mediating role of social problem-solving exist with the inclusion of a clinical (HFASD) sample; (iii) what role, if any, does the ability to recognize the feelings/emotions of others (affective Theory of Mind; aToM), a common area of deficit in HFASD populations, play in the relationships between these variables.

Methods: This study will consist of 175 university/college students, divided into three groups: Group 1 (HFASD) will be comprised of 25 adults with HFASD; Group 2 (High AT) will consist of 25 neurotypical participants who are identified as reporting elevated AT levels (mean +1 SD); and Group 3 (Control) will consist of 125 neurotypical participants. All participants will be assessed on AT expression (Autism-Spectrum Quotient), depressive symptomology (Beck’s Depression Inventory–II) social problem-solving abilities (Social Problem-Solving Inventory–Revised, and Means Ends Problem-Solving test), and aToM (Reading the Mind in the Eyes Test-Revised).

Results: Preliminary results (n=135) produced findings confirming previous findings of higher AT expression being significantly associated with higher levels of depressive symptomology (r=.36, p<.001), deficits in social problem-solving (r=-.30, p<.001), and poorer aToM (r=-.15, p<.05).  However, as no significant relationships were discovered between aToM and depressive symptomology or social problem-solving, this variable was not included in latter analyses (this issue will be readdressed once all data has been collected). The previously reported significant partial mediation was confirmed (p<.05), with social problem-solving ability accounting for 66.2% of the variance in depressive symptomology scores originally predicted by AT expression level. Assessment subscale analyses suggest that the specific social problem-solving deficits of assuming a negative orientation toward the problem and its outcome, producing less effective solutions when confronted with a problem, and a preference for avoiding confrontation of social conflict scenarios play key roles in the association between high AT expression and depressed mood. Between group analyses will be conducted at the completion of the study.

Conclusions : Estimates suggest that roughly 37-43% of individuals with HFASD will suffer from depression at some point in their life. Determining social problem-solving’s role in this phenomenon may provide proactive treatment options for depressive vulnerability in this population. Making use of the findings from this study, future research should examine the efficacy of targeted therapies directed at the improvement of social problem-solving skills/attitudes in the treatment of depressed mood for individuals with HFASD and in the Broader Autism Phenotype.