Mood disorders in high-functioning autism: the importance of alexithymia and emotional regulation
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Individuals with autism spectrum disorder (ASD) often have co-morbid anxiety and depression. Alexithymia and emotion regulation difficulties are commonly seen in individuals with ASD and in mood disorders. We hypothesized that alexithymia and emotional regulation would mediate the relationship between autistic features and anxiety/depression symptom severity. We collected data about emotional regulation, alexithymia, autistic symptoms and depression/anxiety in a sample of 64 young adults with ASD. We constructed two serial multiple mediator models, using autistic features as the independent variable and anxiety/depression symptoms as outcome variables. The serial relationship between alexithymia and emotional regulation mediated associations between autistic features and depression and anxiety, separately. The findings suggest that targeting alexithymia may benefit therapies designed to alleviate mood disorders in ASD.
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Morie et al. (2019) found that alexithymia and emotion regulation fully mediated the relationship between core autism traits and anxiety, although intolerance of uncertainty was not measured in this study.
“Morie et al. (2019) also found that ALX and ER fully mediated the relationship between core autism traits and anxiety, although IU was not measured in this study.”
From Examining a model of anxiety in autistic adults (2024) · cites this paper as Morie et al. (2019)
The Results (Mediation Analysis; page not provided) report a significant serial indirect effect of autistic symptoms on anxiety through alexithymia and emotion regulation. But autistic symptoms also remained significantly associated with anxiety in that model (b = 0.08, p < 0.04), so the finding does not support *full* mediation. The Methods (Questionnaire Materials; page not provided) describe the study’s measures without identifying a measure of intolerance of uncertainty. (LLM, conf=0.91)
Experimental — accuracy not yet measuredAutistic symptoms mediated both anxiety and depression through a pathway featuring alexithymia and emotional dysregulation as intermediate steps.
“It was found that the autistic symptoms mediated both y anxiety and depression through a pathway featuring alexithymia and ED as intermediate steps.”
From Emotional dysregulation as a part of the autism spectrum continuum: a literature review from late childhood to adulthood (2023) · cites this paper as [30]
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- Authors
- Morie, K. P., Jackson, S., Zhai, Z. W., Potenza, M. N., & Dritschel, B.
- Affiliations
- Yale University (US)
- Middlebury College (US)
- University of St Andrews (GB)
- Corresponding author
- Morie, Kristen P.
- Jackson, Scott
- Venue
- Journal of Autism and Developmental Disorders
- Published
- 2019-04-26
- Volume
- 49
- Issue
- 7
- Pages
- 2935-2945
- ISSN
- 0162-3257 (ISSN-L)
- 1573-3432
- PMC
- PMC7375152
- OpenAlex
- W2940821081
- Semantic Scholar
- 0bf2e4626f790a1978811c079165783e097b5744
- Cited by
- 104
- References
- 73
- Citations by year
- 2026: 12 · 2025: 11 · 2024: 14 · 2023: 19 · 2022: 14 · 2021: 19 · 2020: 14 · 2019: 1
- FWCI
- 6.93
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Autism and Developmental Disorders (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- St Andrews Research Repository (St Andrews Research Repository) (submittedVersion)
- Funders
- National Institute on Drug Abuse (K01DA042937)
- National Institutes of Health (MH018268-31, MH018268-33)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- high-functioning autism, autism spectrum disorder, mood disorders, alexithymia, emotion regulation, anxiety, depression, autistic traits, young adults, mediation
- MeSH terms
- Autism Spectrum Disorder, Adolescent, Adult, Affective Symptoms, Aged, Anxiety, Anxiety Disorders, Depression, Emotions, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Comorbidity, Mood Disorders, Asperger Syndrome, Young Adult, Self Report
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