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Cited by 347Autism Spectrum Disorder ResearchChild and Adolescent Psychosocial and Emotional DevelopmentChild Nutrition and Feeding Issues

Emotion regulation in autism spectrum disorder: Where we are and where we need to go

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Cai, Ru Ying, Richdale, Amanda L., Uljarević, Mirko, Dissanayake, Cheryl, Samson, Andrea C.·2018·Autism Research
DOI 10.1002/aur.1968
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Abstract

Emotion dysregulation is a common issue experienced by individuals with autism spectrum disorder (ASD) and has been associated with a wide range of negative mental and physical health outcomes. This commentary highlights the role emotion dysregulation plays in ASD by first considering the literature on emotion regulation (ER) in the general population and then summarizing the ER research in ASD. Based on the evaluation of previous research findings, we conclude that individuals with ASD have more ER difficulties and consistently self‐report or demonstrate a less adaptive pattern of ER strategy use. In addition, the higher prevalence of internalizing and externalizing issues seen in ASD are associated with the greater habitual use of some ER strategies and less habitual use of others. Conceptual and methodological limitations are discussed, including the use of coping measures and single‐method approaches, and ASD gender distribution. We propose a set of new directions for investigating ER in ASD, incorporating knowledge from other literatures on the role of flexibility in healthy adaptation, overlaps between flexibility and executive function deficits, the adaptive value of up‐regulation of positive emotions, and the importance of emotional self‐awareness. Increasing our capacity for identifying the mechanisms underlying co‐morbid affective disorders can ultimately inform the design of effective interventions to maximize the wellbeing of individuals with ASD. Autism Res 2018, 11: 962–978. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary: Research has shown that people diagnosed with autism tend to have difficulties with regulating their own emotions. This commentary article summarizes the main information from emotion regulation research conducted both in autism and in other populations. We make suggestions on how we can improve emotion regulation research in autism, with the ultimate goal being to use the learning gained from research to design effective interventions that can improve the wellbeing of people with autism.

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  • Emotion dysregulation is a transdiagnostic risk factor for depression in autistic and non-autistic people.

    “Emotion dysregulation, defined as difficulties in altering one’s emotions in a goal-directed manner (Aldao et al., 2010), is a transdiagnostic risk factor for depression in autistic and non-autistic people (Cai et al., 2018).”

    From Community-guided, autism-adapted group cognitive behavioral therapy for depression in autistic youth (CBT-DAY): Preliminary feasibility, acceptability, and efficacy (2024) · cites this paper as Cai et al., 2018

    The paper’s discussion of emotion regulation in the general population links maladaptive strategies with depression, and its Summary links emotion dysregulation in autistic people with psychopathology. But the Summary says further work is needed to confirm whether the same strategies play a similar role in autistic people; the paper does not establish emotion dysregulation as a shared risk factor for depression in both groups. (LLM, conf=0.85)

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  • Emotional dysregulation is related to the development and maintenance of affective and behavioral problems, and particularly to the development and maintenance of anxiety and depression.

    “La DRE se ha relacionado con el desarrollo y el mantenimiento de problemas afectivos y conductuales (Cai et al., 2018;Conner et al., 2020) y, particularmente, con el desarrollo y mantenimiento de la ansiedad (Cisler y Olatunji, 2012;White et al., 2014) y la depresión (Schäfer et al., 2017).”

    From Ansiedad y trastornos del espectro del autismo: notas para la intervención psicoeducativa (2022) · cites this paper as Cai et al., 2018

    The Abstract (page not available) associates emotion-regulation difficulties in autistic people with internalizing and externalizing problems, supporting the affective-and-behavioral-problems portion attributed to Cai et al. It does not establish that dysregulation contributes to those problems’ development or maintenance. The sentence cites other works for its more specific anxiety and depression claims, so those are not assessed here. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Identifying, processing and managing emotions can be challenging for autistic people.

    “Identifying, processing and managing emotions can be challenging (Cai et al, 2018)”

    From Autistic SPACE: a novel framework for meeting the needs of autistic people in healthcare settings (2023) · cites this paper as Cai et al, 2018

  • Poor emotion regulation is associated with psychiatric conditions in autistic people.

    “poor ER is associated with psychiatric conditions in autistic people (Cai et al., 2018; Charlton et al., 2020; Conner et al., 2023; Mazefsky, 2015).”

    From The relationship between distress tolerance and behavioral activation on anxiety and depression symptomatology in autistic youth: Leveraging self and caregiver perspectives (2024) · cites this paper as Cai et al., 2018

  • Anxiety in autism is linked to reduced use of adaptive and/or increased use of maladaptive emotion regulation strategies.

    “considerable evidence that links anxiety in autism to reduced use of adaptive and/or increased use of maladaptive emotion regulation strategies (for reviews, see Cai et al., 2018; Mazefsky et al., 2013; Weiss, 2014; White et al., 2014).”

    From Self-guided mindfulness and cognitive behavioural practices reduce anxiety in autistic adults: A pilot 8-month waitlist-controlled trial of widely available online tools. (2020) · cites this paper as Cai et al., 2018

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Research works printed but not linked: 3

  1. [23]23. Folstein, S.E. (2012). Commentary on Kerns and Kendall. Clinical Psychology: Science and Practice, 19(4), 356-357.
  2. [78]78. Mazefsky, C.A., & White, S.W. (2014). Emotion regulation: Concepts and practice in autism spectrum disorder. Child and Adolescent Psychiatric Clinics of North America, 23(1), 15-24.
  3. [131]131. Cai, R. Y., Richdale, A. L., Uljarević, M., Dissanayake, C. & Samson, A. C. (2018). Emotion regulation in autism spectrum disorder: Where we are and where we need to go.. Autism Res, 11 (7), pp.962-978. https://doi.org/10.1002/aur.1968. Persistent Link: http://hdl.handle.net/11343/284940

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Authors
Cai, R. Y., Richdale, A. L., Uljarević, M., Dissanayake, C., & Samson, A. C.
Affiliations
  • The University of Queensland (AU)
  • University of Geneva (CH)
Corresponding author
Richdale, Amanda L.
ORCID
Venue
Autism Research
Publisher
Wiley
Published
2018-07
Volume
11
Issue
7
Pages
962-978
ISSN
  • 1939-3792 (ISSN-L)
  • 1939-3806
DOI
10.1002/aur.1968
OpenAlex
W2839700533
Cited by
347
References
160
Citations by year
2026: 52 · 2025: 55 · 2024: 55 · 2023: 51 · 2022: 48 · 2021: 45 · 2020: 26 · 2019: 11 · 2018: 4
FWCI
2.88
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 5 d)
Locations
  • Autism Research (publishedVersion)
  • PubMed (publishedVersion)
  • Archive ouverte UNIGE (University of Geneva) (publishedVersion)
  • reroDoc Digital Library (submittedVersion)
  • Minerva Access (University of Melbourne) (submittedVersion)
  • Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
Funders
Cooperative Research Centre for Living with Autism (Autism CRC) (3.016)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Keywords
autism spectrum disorder, emotion regulation, emotional dysregulation, emotion regulation strategies, internalizing problems, externalizing problems, coping, executive function, emotional flexibility, emotional self-awareness, affective comorbidity, well-being interventions, gender differences
MeSH terms
Autism Spectrum Disorder, Affective Symptoms, Child, Female, Humans, Male

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