Underlying Mechanisms of Deficient Social Problem-Solving Abilities in Adults with High-Functioning Autism: Exploring the Roles of Alexithymia, Emotion Dysregulation, and Executive Dysfunction

Background:

Adults with HFASD are reported to be a particularly susceptible population to episodes of depression. A recent study found deficits in social problem-solving (SPS) to account for a significant proportion of the association between ASD-related social impairments and depressive symptomology. This finding would suggest that psychosocial interventions designed to develop SPS skills may prove a valuable resource for treatment of depressed mood in adults with HFASD. A number of areas of impairment associated with ASD may play important underlying roles in the SPS deficits found in this population.  Knowledge of these roles could provide instrumental insight for interventions designed to develop this area of social functioning.   

Objectives:

The current study aims to better understand the underlying mechanisms resulting in SPS deficits for adults with HFASD by exploring the specific impacts of alexithymia, emotion dysregulation, and executive dysfunction on the different components of the SPS process.  

Methods:  

The study sample consists of 54 HFASD adults (39 female, 15 male) with an age range of 19-65 (M=32.61, SD=10.50). Participants were assessed on SPS ability (SPSI-R), alexithymia (TAS-20), emotion dysregulation (DERS), and executive dysfunction (BRIEF). Age, gender, educational attainment, ASD-related social deficits (SRS-2), and depressive/anxious symptomology (DASS) were assessed as potential confounds.

Results:

Both SRS-2 and the DASS-Depression scale were found to be potential confounds, and were thus controlled for in all analyses. Hierarchical regression analyses were performed with the SPS process components as the DV, DASS-Dep. and SRS-2 scores entered as IVs during the first step (enter-method), and TAS-20, DERS, and BRIEF entered as IVs during the second step of the analyses (stepwise-method). Results suggest difficulties with emotion dysregulation to be a significant predictor of increased utilizations of a Negative Problem Orientation (β=0.34); increases in alexithymic traits to be a significant predictor of increased use of Avoidance (β=0.38) and Impulsive/Careless (β=0.48) SPS styles, decreased use of a Ration Problem-Solving process in general (β=-0.46), and greater difficulties with the Generation of Alternative Solutions (β=-0.38) and Decision Making (β=-0.34) aspects of that process; and greater levels of executive dysfunction to be a significant predictor of increased use of an Impulsive/Careless Style (β=0.33), and greater difficulties with the Problem Development and Formulation (β=-0.47), Decision Making (β=-0.35), and Solution Implementation and Verification (β=-0.37) aspects of a rational problem-solving process. The inclusion of these variables to the models resulted in significant improvements in the predictive strength of all models (ΔR²=0.07-0.36, p<0.05).

Conclusions:

This study provides insight into the underlying mechanisms resulting in difficulties with different aspects of the SPS process for adults with HFASD. Problem-Solving Therapy (PST) has a history of proven utility in the treatment of depression for other populations, and a recent pilot study showed that PST can be effectively used with adults with HFASD. The current study can help improve the efficacy of future attempts to use PST for this population as it provides a more detailed understanding of why difficulties in certain aspects of SPS may be present, and thus, more insight into how to better design the intervention to work on these areas of need.