Maladaptive Behavior in Autism Spectrum Disorder: The Role of Emotion Experience and Emotion Regulation

Background:    Autism Spectrum Disorder (ASD) is a pervasive neurodevelopmental disorder that is characterized by abnormalities in social and communication abilities, as well as restricted interests, repetitive behavior, and sensory deficits. In addition, maladaptive behavior including irritability, poor anger control, temper tantrums, self-injurious behavior, and aggression are commonly observed in ASD and recent studies suggest that more than 50% of children and adolescents exhibit one or more of these symptoms. Interestingly, a few studies have investigated emotion dysregulation in ASD and suggested that children and adolescents with ASD less frequently and less effectively use adaptive emotion regulation strategies (such as cognitive reappraisal), but tend to more frequently use maladaptive strategies (such as expressive suppression). Therefore, there is a great need to increase our understanding of the pathophysiological mechanisms underlying emotion dysregulation and related behaviors, such as irritability and aggression, since maladaptive emotional responses may contribute to impaired functioning and could affect long-term outcome. 

Objectives:   The factors that give rise to maladaptive behavior are not yet well understood in individuals with ASD. The present project examined the role of emotion experience and regulation in maladaptive behavior in individuals with ASD.   

Methods:   The present study examined the role of emotion experience and emotion regulation in maladaptive behavior in individuals with ASD and typically developing (TD) participants. Thirty-one individuals with ASD and 28 TD participants and their parents completed questionnaires assessing emotion experience (Positive and Negative Affect Schedule), regulation (Emotion Regulation Questionnaire), and maladaptive behavior (subscale of the Vineland Adaptive Behavior Scales, 2nd Edition). The relationships among group, emotion experience, emotion regulation, and maladaptive behavior were examined via path analyses of 2- and 3-path mediation designs. Four 2-path models were tested to examine whether group membership was linked to maladaptive behaviors via positive emotion, negative emotion, cognitive reappraisal, and expressive suppression. In addition, two 3-path models were tested to examine the sequence of effects as indicated from the 2-path model results.

Results:   This is the first study to examine the sequential effects of emotion experience and regulation on maladaptive behavior in children and adolescents with ASD. More specifically, we wanted to better understand whether patterns in positive and negative emotion experience as well as adaptive and maladaptive emotion regulation function as a link between group (ASD vs. TD) and maladaptive behavior. The findings suggest that individuals with ASD use cognitive reappraisal less frequently, which is an adaptive emotion regulation strategy, resulting in increased negative emotions, and in turn leading to elevated levels of maladaptive behavior. By decreasing negative emotions, treatments targeting adaptive emotion regulation may therefore reduce maladaptive behaviors in individuals with ASD.

Conclusions: The current study suggests that interventions targeting the ability to use cognitive reappraisal may improve emotion experience as well as decrease maladaptive behavior in individuals with ASD. Novel interventions that target emotional experience and regulation are crucial to decrease maladaptive behaviors and improve long-term outcome.