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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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The Spectrum of Autism—From Neuronal Connections to Behavioral Expression
Mazefsky, C. A., & Minshew, N. J. (2010) · The AMA Journal of Ethic · doi:10.1001/virtualmentor.2010.12.11.cprl1-1011 · Cited by 9
Self-citationNewmark, S. C. (2012) · Elsevier eBooks · doi:10.1016/b978-1-4377-1793-8.00007-8 · Cited by 9
Medical Evaluation and Comorbid Psychiatric Disorders
Lubetsky, M. J., Handen, B. L., & McGonigle, J. J. (2011) · Oxford University Press eBooks · doi:10.1093/med/9780199753857.003.0023 · Cited by 5
Neuroimaging of autism spectrum disorders
Herrington, J. D., & Schultz, R. T. (2010) · Cambridge University Press eBooks · doi:10.1017/cbo9780511782091.037 · Cited by 4
Self-citation
Flagged first, then by citations
Research works printed but not linked: 1
- Adrian, 2011, Methodological implications of the affect revolution: a 35-year review of emotion regulation assessment in children, J Exp Child Psychol, 110, 171, 10.1016/j.jecp.2011.03.009 · DOI
Cited by
Sorted by citations
Volkmar, F. R., Siegel, M. S., Woodbury‐Smith, M., King, B. H., McCracken, J. T., & State, M. W. (2014) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2013.10.013 · Cited by 938
Self-citationEmotion-focused therapy for autism spectrum
Robinson, A. (2020) · Springer eBooks · doi:10.1007/978-1-4419-1698-3 · Cited by 2
Emotion regulation in autism spectrum disorder: Where we are and where we need to go
Cai, R. Y., Richdale, A. L., Uljarević, M., Dissanayake, C., & Samson, A. C. (2018) · Autism Research · doi:10.1002/aur.1968 · Cited by 347
Co-occurring psychiatric conditions in autism spectrum disorder
Rosen, T. E., Mazefsky, C. A., Vasa, R. A., & Lerner, M. D. (2018) · International Review of Psychiatry · doi:10.1080/09540261.2018.1450229 · Cited by 325
Self-citationMazefsky, C. A., & White, S. W. (2014) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2013.07.002 · Cited by 323
Self-citation
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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