Patterns of Cognitive Reappraisal and Expressive Suppression Use and Relationship with Psychological Wellbeing in Youth on the Autism Spectrum: A Cluster Analysis Approach

Background: Emotion regulation (ER) has been proposed to be a trans-diagnostic factor in the development and maintenance of psychopathology in the general population, yet the nature of the relationships between ER strategy use and psychological wellbeing has not been comprehensively explored in individuals on the autism spectrum. Additionally, although positive and negative aspects of psychological wellbeing are distinct constructs and the habitual use of certain ER strategies has been shown to be related to both positive and negative aspects of psychological wellbeing, ER research in autism have exclusively focused on negative aspects of wellbeing (primarily anxiety and depression).

Objectives: The overall aim of this study was to assess how the individual differences in self-reported ER strategy use, specifically cognitive reappraisal and expressive suppression, relate to levels of both positive and negative psychological well-being, incorporating both hedonic and eudaimonic approaches. We first explored individual differences in patterns of self-reported reappraisal and suppression strategy use among youth on the spectrum We then examined how individual differences in ER strategy use relate to self-reported levels of positive and negative psychological wellbeing. It was hypothesised that individuals characterized by high reappraisal and low suppression would have better psychological wellbeing than those with low reappraisal and high suppression.

Methods: Fifty-six individuals aged 14 – 24 years (M_age = 18.15; SD_age = 2.30) completed the ER Questionnaire (ERQ), Diagnostic and Statistical Manual of Mental Disorders-5 Dimensional Anxiety Scales (DSM-5 DAS), Patient Health Questionnaire-9 (PHQ-9), Warwick-Edinburgh Mental Well-being Scale (WEMWBS), and Autism-Spectrum Quotient-Short (AQ-Short). Individuals were grouped into four clusters based on their ERQ subscale scores. A K-means cluster analysis was conducted in SPSS version 21 to classify participants according to their pattern of reappraisal and suppression subscale scores. The optical number of clusters was determined by plotting the within-group sum of squares for each cluster by applying the k-means procedure using R version 3.3.0 and identifying the elbow in the resulting scree plot. Further analyses were then conducted to test the hypothesis.

Results: Four clusters were chosen based on the scree plot for the K-means cluster analysis. The participant clusters were: 1) high suppressors and high reappraisers (HSHR); 2) high suppressors and low reappraisers (HSLR); 3) low suppressors and high reappraisers (LSHR); and 4) low suppressors and low reappraisers (LSLR). Individuals in the HSLR group expressed higher depressive symptoms (U = 31, z = -2.20, p = .028, r = .45) and lower positive wellbeing (mean difference via the Turkey HSD test = 16.11, p < .001) when compared with the LSHR group. Interestingly, individuals who self-reported using both high suppression and reappraisal expressed relatively high positive wellbeing and low depression symptoms.

Conclusions: Our findings demonstrate, for the first time, that individuals on the spectrum who self-reported using both high suppression and reappraisal expressed relatively high positive wellbeing and relatively low levels of depression symptoms. We suggest the maladaptive effect of habitual suppression use may be buffered by the habitual use of reappraisal, and this interaction between adaptive and maladaptive ER strategy use has clinical implications.