Analyzing Behavioral Components of Social Functioning in Autistic Adults

Background: To better design treatments that target social functioning for autistic adults, it is important to improve our understanding of the various behavioral components of social functioning -- including social motivation, social anxiety, social cognition, and social skills -- and the relationships among them. Few studies have examined all of these components in the same set of adult participants. However, a recent study from our group (Pallathra et al., 2018) that included 28 autistic adult participants without intellectual disability found that impairment in social motivation was positively correlated with both social anxiety and overall autism symptoms, and negatively correlated with social skills. Pallathra and colleagues also found that social anxiety was positively correlated with overall autism symptoms, but that social cognition was not correlated with other components of social functioning.

Objectives: As the participants included in the Pallathra et al. study were modest in number (N=28) and within a limited age range of adulthood (20 – 48 years), the current study sought to test the hypothesis that the correlations reported by Pallathra et al. would be replicated in an independently recruited, larger sample of autistic adults without intellectual disability.

Methods: Forty-six autistic individuals without a history of intellectual disability (33 male, 13 female; aged 20 - 77 years; see Table 1 for additional demographic information) were recruited for participation in an autism genetics study at the University of Pennsylvania. Eligibility was determined based on a detailed clinical and developmental history, as well as Social Communication Questionnaire (SCQ) and Social Responsiveness Scale-2 (SRS-2) scores consistent with a diagnosis of autism spectrum disorder. Measures of overall autism symptoms included several self-report questionnaires -- SRS-2, Autism Quotient (AQ), and Broader Autism Phenotype Questionnaire (BAPQ) -- as well as the informant report SRS-2. Social motivation was measured using the aloof subscale of the BAPQ, while social anxiety was measured by the Liebowitz Social Anxiety Scale (LSAS). Social cognition was measured using the Penn Emotion Recognition Task (ER40), a performance-based measure of facial emotion perception (Gur et al., 2010).

Results: Impairment in social motivation was positively correlated with both social anxiety and the self-report measures of overall autistic behaviors (AQ, SRS, and BAPQ total). Additionally, the social anxiety measure was positively correlated with the self-report measures of overall autistic behaviors. The social cognition measure was not correlated with any of the other measures. (See Figure 1 for r and p-values.)

Conclusions: We found that social motivation and social anxiety are related both to each other and to overall autism symptoms, while social cognition is not related to any of the other components of social functioning measured in our sample of autistic adults. Our data largely replicate the findings of Pallathra and colleagues (2018) in a larger sample of autistic adults, with a wider age range and a higher percentage of female participants. Understanding relationships among these components of social functioning can help us to better design and target interventions aimed at improving social functioning in autistic adults.