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Real-World Executive Functions in Adults with Autism Spectrum Disorder: Profiles of Impairment and Associations with Adaptive Functioning and Co-morbid Anxiety and Depression
Open accessAbstract
Although executive functioning (EF) difficulties are well documented among children and adolescents with autism spectrum disorder (ASD), little is known about real-world measures of EF among adults with ASD. Therefore, this study examined parent-reported real-world EF problems among 35 adults with ASD without intellectual disability and their correlations with adaptive functioning and co-morbid anxiety and depression symptomatology. A variable EF profile was found with prominent deficits occurring in flexibility and metacognition. Flexibility problems were associated with anxiety-related symptoms while metacognition difficulties were associated with depression symptoms and impaired adaptive functioning (though the metacognition-adaptive functioning relationship was moderated by ADHD symptoms). These persistent EF problems are predictors of broader functioning and therefore remain an important treatment target among adults with ASD.
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“Difficulties with habituation and flexibility, associated with disrupted integration between mPFC and limbic regions, can also be treated directly with benefits for anxiety and depression (Kenworthy et al., 2014; Lawson et al., 2015; Wallace et al., 2016).”
From Sensory, emotional and cognitive contributions to anxiety in autism spectrum disorders (2017) · cites this paper as Wallace et al., 2016
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Metadata
- Authors
- Wallace, G. L., Kenworthy, L., Pugliese, C. E., Popal, H. S., White, E. I., Brodsky, E., & Martin, A.
- Affiliations
- George Washington University (US)
- Children's National (US)
- National Institute of Mental Health (US)
- Corresponding author
- Wallace, Gregory L.
- ORCID
- Venue
- Journal of Autism and Developmental Disorders
- Published
- 2015-11-16
- Volume
- 46
- Issue
- 3
- Pages
- 1071-1083
- ISSN
- 0162-3257 (ISSN-L)
- 1573-3432
- PMC
- PMC5111802
- OpenAlex
- W2172314818
- Cited by
- 261
- References
- 49
- Citations by year
- 2026: 13 · 2025: 21 · 2024: 23 · 2023: 30 · 2022: 29 · 2021: 44 · 2020: 32 · 2019: 20 · 2018: 17 · 2017: 23 · 2016: 9
- FWCI
- 9.82
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Autism and Developmental Disorders (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (1-ZIA-MH002920)
- National Institutes of Health (HD046388-01A2)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Keywords
- executive function, autism spectrum disorder, autistic adults, adaptive behavior, anxiety, depression, metacognition, cognitive flexibility, ADHD comorbidity, real-world functioning
- MeSH terms
- Autism Spectrum Disorder, Adaptation, Psychological, Adolescent, Adult, Anxiety, Depression, Female, Humans, Male, Neuropsychological Tests, Comorbidity, Young Adult, Executive Function
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