The Relationship between Autism and Depression and the Influence of Worry and Mastery: A Network Analysis

Background: Autism and depression often co-occur: older adults with a history of depression report more autism symptoms than those without a history of depression, and depression is a common comorbidity for people with autism. Why do we see these two constructs covary so often? Do they influence each other directly, or is there another factor that explains their co-occurrence? Based on the depression literature we hypothesize that both worry and mastery (perceived control over life’s stressors) will be of importance when trying to understand the relationship between depression and autism.

Objectives: To better understand the interrelatedness of autism and depression characteristics by investigating mastery and worry as potential bridges between autism and depression in a so called symptomatic network were the interaction between all symptoms are taken into account.

Methods: In study 1 adults with and without a previous diagnosis of depression (N= 375, age 60-90) took part. In study 2 adults with and without a previous diagnosis of autism (N= 202, age 31-89) participated. In both studies, self-report questionnaire data was collected on autism symptoms (AQ-28), depression symptoms (IDS-SR and SCL90 depression subscale, respectively), worry (Worry Scale-R) and mastery (The Pearlin Mastery Scale). A novel network approach, in which symptom interactions are taken into account, was used to create two concentration networks and the accompanying centrality indices.

Results: In the network for Study 1 we see one direct connection between autism (switching) and depression (motivation) characteristics, all other connections go through either mastery or worry nodes. Mastery has the greatest number of ties to other nodes, and the autism specific aspect of switching acts as a bridge between depression and all other autism characteristics. Worry is connected to mastery, depression and autism characteristics. The results of Study 2 differ from Study 1 in that all connections from autism to depression and worry go through mastery, i.e. mastery acts as a bridge. In addition, centrality indices show that mastery is the most central node in this network. In this network worry is no longer connected to autism.

Conclusions: In both studies mastery is an important factor between depression and autism, however it is especially important in the study with participants with autism. This suggests that when someone’s toolbox (e.g., coping mechanisms, making use of their social network) to handle perceived stressors is expanded, this could have a positive impact on their sense of mastery and, in return, decrease the risk of developing depressive symptoms.