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The Role of Emotion Regulation in Autism Spectrum Disorder
Open accessAbstract
Objective Autism spectrum disorder (ASD) is associated with amplified emotional responses and poor emotional control, but little is known about the underlying mechanisms. This article provides a conceptual and methodologic framework for understanding compromised emotion regulation (ER) in ASD.Method After defining ER and related constructs, methods to study ER were reviewed with special consideration on how to apply these approaches to ASD. Against the backdrop of cognitive characteristics in ASD and existing ER theories, available research was examined to identify likely contributors to emotional dysregulation in ASD.Results Little is currently known about ER in youth with ASD. Some mechanisms that contribute to poor ER in ASD may be shared with other clinical populations (e.g., physiologic arousal, degree of negative and positive affect, alterations in the amygdala and prefrontal cortex), whereas other mechanisms may be more unique to ASD (e.g., differences in information processing/perception, cognitive factors [e.g., rigidity], less goal-directed behavior and more disorganized emotion in ASD).Conclusions Although assignment of concomitant psychiatric diagnoses is warranted in some cases, poor ER may be inherent in ASD and may provide a more parsimonious conceptualization for the many associated socioemotional and behavioral problems in this population. Further study of ER in youth with ASD may identify meaningful subgroups of patients and lead to more effective individualized treatments.
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“Issues in executive functioning (Corbett et al. 2009) and emotion regulation (Mazefsky et al. 2013) are also increasingly being addressed, though are not yet included as specifiers in the formal diagnostic systems.”
From The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond (2021) · cites this paper as Mazefsky et al. 2013
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“De hecho, los niños autistas tienen un mayor riesgo de sufrir episodios de DRE que sus compañeros neurotípicos (Mazefsky et al., 2013;Samson et al., 2014).”
From Ansiedad y trastornos del espectro del autismo: notas para la intervención psicoeducativa (2022) · cites this paper as Mazefsky et al., 2013
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“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 Mazefsky et al., 2013
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“Emotion dysregulation (ED), the difficulty in modulating emotions, has been identified as an important risk factor.”
From Feasibility, Acceptability and Preliminary Efficacy of Dialectical Behavior Therapy for Autistic Adults without Intellectual Disability: A Mixed Methods Study (2022) · cites this paper as Mazefsky et al., 2013
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“Although much less studied in autism spectrum disorder (ASD) than in other psychiatric disorders, disrupted ER is likely to be a significant factor in producing aberrant behavior in ASD as well.10,11”
From Emotion Regulation (2014) · cites this paper as [10]
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“Many ‘secondary’ psychiatric problems may be more accurately conceptualized as part of the ASD itself or may stem from a fundamental problem in ER.10”
From Emotion Regulation (2014) · cites this paper as [10]
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Ibrahim, K., Eilbott, J. A., Ventola, P., He, G., Pelphrey, K. A., McCarthy, G., & Sukhodolsky, D. G. (2019) · Biological Psychiatry: Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2019.01.009 · Cited by 67
Weiss, J. A. (2014) · Clinical Psychology: Science and Practice · doi:10.1111/cpsp.12084 · Cited by 73
Emotion Regulation as a Transdiagnostic Feature in Children with Neurodevelopmental Disorders
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Future Directions for Research in Autism Spectrum Disorders
Damiano, C. R., Mazefsky, C. A., White, S. W., & Dichter, G. S. (2014) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2014.945214 · Cited by 86
Self-citationEmotion regulation in autism: reappraisal and suppression interactions
Cai, R. Y., Richdale, A. L., Dissanayake, C., Trollor, J., & Uljarević, M. (2019) · Autism · doi:10.1177/1362361318774558 · Cited by 71
Singletary, W. M. (2015) · Neuropsychoanalysis · doi:10.1080/15294145.2015.1092334 · Cited by 73
Depression in adolescents with ASD: a pilot RCT of a group intervention
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Chen, Y., Lin, H., Chien, Y., Tung, Y.-H., Ni, Y., & Gau, S. S. (2022) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2022.08.015 · Cited by 71
Chen, M., Wei, H.-T., Chen, L.-C., Su, T., Bai, Y., Hsu, J.-W., Huang, K., Chang, W.-H., Chen, T., & Chen, Y.-S. (2014) · Research in Autism · doi:10.1016/j.rasd.2014.10.014 · Cited by 69
Kourtesis, P., Kouklari, E.-C., Ρούσσος, Π., Mantas, V., Papanikolaou, Κ., Skaloumbakas, C., & Pehlivanidis, A. (2023) · Behavioral Sciences · doi:10.3390/bs13040336 · Cited by 93
Goldsmith, S. F., & Kelley, E. A. (2018) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-018-3483-3 · Cited by 77
Selective Mutism and Its Relations to Social Anxiety Disorder and Autism Spectrum Disorder
Muris, P., & Ollendick, T. H. (2021) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-020-00342-0 · Cited by 81
Gallagher, S. (2023) · doi:10.1093/oso/9780198873068.001.0001 · Cited by 72
Bemmouna, D., Coutelle, R., Weibel, S., & Weiner, L. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05317-w · Cited by 64
Herrington, J. D., Miller, J. S., Pandey, J., & Schultz, R. T. (2016) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsw015 · Cited by 70
Self-citationGaigg, S. B., Flaxman, P. E., McLaven, G., Shah, R., Bowler, D. M., Meyer, B., Roestorf, A., Haenschel, C., Rodgers, J., & South, M. (2020) · Autism · doi:10.1177/1362361320909184 · Cited by 80
“Other authors have tailored CBT approaches to target a broad range of emotion-regulation skills due to the 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, 20…”
Background
Metadata
- Authors
- Mazefsky, C. A., Herrington, J., Siegel, M., Scarpa, A., Maddox, B. B., Scahill, L., & White, S. W.
- Affiliations
- University of Pittsburgh (US)
- Children's Hospital of Philadelphia (US)
- Tufts Medical Center (US)
- Virginia Tech (US)
- Emory University (US)
- Corresponding author
- Mazefsky, Carla A.
- ORCID
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2013-07
- Volume
- 52
- Issue
- 7
- Pages
- 679-688
- ISSN
- 0890-8567 (ISSN-L)
- PMC
- PMC3719386
- OpenAlex
- W2033011309
- Cited by
- 881
- References
- 107
- Citations by year
- 2026: 94 · 2025: 86 · 2024: 83 · 2023: 101 · 2022: 72 · 2021: 90 · 2020: 61 · 2019: 68 · 2018: 75 · 2017: 51 · 2016: 34 · 2015: 33 · 2014: 24 · 2013: 5
- FWCI
- 2.73
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH099021)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD060601)
- 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, autistic youth, amygdala, prefrontal cortex, cognitive inflexibility, goal-directed behavior, psychiatric comorbidity
- MeSH terms
- Brain, Child Development Disorders, Pervasive, Emotions, Humans
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