A Contextual Approach To Understanding Psychiatric Comorbidities In Adolescents With Autism Spectrum Disorder

Psychiatric comorbidities are common in youth with Autism Spectrum Disorders (ASD) and can have a negative impact on adaptive functioning and quality of life. Research has primarily focused on individual characteristics associated with internalizing problems such as age, intelligence, and social functioning. However, developmental theory supports the notion that individual level factors are necessary but not sufficient to understand the mental health of youth with ASD. Using the Family Ecology Framework as a guide, the purpose of this study was to examine how peer and family contexts are associated with anxiety and depression symptoms of adolescents with ASD. Using data from adolescents with ASD (13-17 years old) and their primary caregivers (N = 166), this study tested a conditional process model in which youths' social-communication skills were associated with their mental health symptoms indirectly via experiences of peer victimization, with family competence acting as a buffer against the negative impact of peer victimization on anxiety and depression symptoms. Results suggest that the peer context is important when considering the mental health of adolescents with ASD. Specifically, deficits in social-communication skills were associated with higher levels of parent-reported anxiety and depression symptoms through increased adolescent-reports of peer victimization; however, the hypothesized buffering effect of family competence was not statistically significant. Findings from this study suggest the benefits of utilizing developmentally sensitive, contextual approaches when examining psychiatric comorbidities in adolescents with ASD.