Observed Emotion Dysregulation in Children with Autism during a Frustrating Task

Background: Emotion dysregulation (ED) is a common reason for higher rates of anxiety, depression, and anger in individuals with autism. This population has been shown to display greater ED during frustrating tasks than peers without autism (Jahromi et al., 2012). Parent report measures of ED in children with autism predict poorer adaptive skills (Uljarević et al., 2018) and more internalizing and externalizing (maladaptive) behaviours (Berkovitz et al., 2017). However, few studies look at how observed behavioural ED relates to adaptive and maladaptive behaviours in this population. To address this gap, we adapted the Emotion Dysregulation Inventory (EDI; Mazefsky et al., 2018) as an observational measure of children’s ED during a frustrating task.

Objectives: 1) Evaluate the reliability of an observational measure of ED. 2) Investigate associations between children’s behavioural ED and success during a frustrating task. 3) Examine associations between parent report of child adaptive and maladaptive behaviours, and children’s observed ED.

Methods: Preliminary findings are based on 32 children with autism aged 8-13 years (M_age = 9.6 years, Males = 31). Children completed a computerized mirror tracing persistence task (MTPT-C, Strong et al., 2003), where they attempted to trace a star with an irritating sound occurring with each tracing error. The task consisted of 3 practice phases and a test phase where children had the option to quit. Observed ED was measured via standardized observer coding of expressed reactivity and dysphoria using a coding scheme adapted from the EDI. Children’s observed reactivity and dysphoria scores were correlated with success on the MTPT-C during practice phases and persistence on the test phase. The adaptive skills, internalizing and externalizing composites of the Behaviour Assessment System for Children parent report (BASC-3) were correlated with observed ED.

Results: Coding ED observationally using the EDI demonstrates excellent inter-rater reliability (ICC= 0.94 for reactivity and ICC = 0.93 for dysphoria). Observed reactivity and dysphoria across practice phases were positively correlated with the number of times the child made errors due to being too slow (reactivity: r_s = .54, p = .002; dysphoria: r_s = .65, p < .000). Mean reactivity and dysphoria negatively correlated with persistence (reactivity: r_s = -.33, p = .07; dysphoria: r_s = - .40, p = .03) and percentage of the star traced (reactivity: r_s = - .43, p = .02; dysphoria: r_s = - .47, p = .01). Both reactivity and dysphoria negatively correlated with the adaptive skills composite (reactivity: r_s = - .36, p = .05; dysphoria: r_s = - .45, p = .01), but not indicators of maladaptive behaviour.

Conclusions: The EDI is a reliable observational measure of ED for children with autism and observed ED during a frustrating task is associated with task behaviours. Findings also highlight that higher levels of reactivity and dysphoria during a frustrating task are associated with lower levels of adaptive skills, but not maladaptive behaviours. This may reflect differences between state-level experiences of negative affect due to a frustrating task, and broader trait-level behaviours observed in naturally occurring situations.