Risk and Protective Factors of Depression in Children with ASD Tendency in Japan

Background:  Children with ASD were tend to have difficulties in social communications and friendships in school, therefore they are at risk of secondary disabilities such as depression. Previous studies showed that rumination such as repetitive focus on their distress would increase depressive mood and skills of problem solving would decrease it. It is necessary to examine risk and protective factors of depression in children with ASD.

Objectives:  The present study aims to examine risk and protective factors of depression in children with ASD tendency.

Methods:  3,678 children (1,868 boys, 1,810 girls) in public schools completed the Japanese version of the Depression Self-Rating Scale for Children short-form, the Strengths and Difficulties Questionnaire (peer problems subscale), the Social Maladjustment Scales (achievement, teacher and family), the Social Support Scales (peer and adult) and the Response Style Questionnaire for Middle School Students (problem solving, rumination, avoidance and distraction), and their parents completed the Autism Spectrum Screening Questionnaire short-form.

Results:  We divided the children into two groups according to the ASSQ short-form cut-off score; 367 boys in ASD tendency group (ASDtG-boys), 1501 boys in control (control-boys), 227 girls in ASDtG (ASDtG-girls) and 1583 girls in control (control-girls). We conducted a gender × ASSQ group ANOVA on the DSRS-C total score. Main effects of gender and ASSQ group were significant, but interaction was no significant. The result showed that girls were more depressive than boys (F(1,3674) = 48.07, p < .001, η² = .013), and ASDtG was more depressive than control (F(1,3674) = 130.12, p < .001, η² = .034). Then, we conducted a multiple regression analysis to examine whether these variables affect depression in each gender and ASSQ groups. In the results, these variables explained a significant amount of the variance of depression in all groups (R² = .458–.613). In the all groups, SDQ peer problems (β = .235–.329, p < .001) and rumination (β = .227–.309, p < .001) showed positive effects on depression significantly, and peer support (β = -.247–-.166 p < .001) and distraction (β = -.229–-.125, p < .001) showed negative effects significantly. Regarding ASD tendency in the same gender, ASDtG-boys showed avoidance as a positive effect (β = .108, p < .001) significantly and adult support as no significant effect on depression. On the other hand, avoidance did not show significant effect and adult support showed a negative effect (β = -.160, p < .001) significantly in control-boys. In addition, ASDtG-girls showed that grade and problem solving were no significant, although grade was a significant positive effect (β = .118, p < .001) and problem solving was a significant negative effect (β = -.107, p < .001) in control-girls.

Conclusions:  The current study showed that children with ASD tendency would have different risk and protective factors of depression from controls, although they had the same factors partially. Peer support and distraction would decrease depression in all children, and for children with ASD, suitable coping strategy and support would be effective.