Emotional reactivity and emotion regulation in children with autism spectrum disorder.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication and social interaction, as well as restricted and repetitive patterns of behaviors and interests. Additionally, children with ASD often present internalizing and externalizing problems such as anxiety, depression, and conduct problems. These problems can hinder children’s social competence and development and may have repercussions into adolescence and adulthood. It is believed that internalizing and externalizing problems originate from children’s emotional difficulties such as difficulties in emotional reactivity and emotion regulation. The aim of the present thesis was therefore to examine the role of emotional reactivity and emotion regulation in children with ASD. Emotional difficulties in children with ASD may be due to several factors: ASD’s core symptoms, children’s other characteristics such as alexithymia, and parents’ characteristics. The relation between these factors to emotional difficulties in children with ASD have been integrated into a model of the emotional reactivity and emotion regulation difficulties in children with ASD. Based on the model’s assumptions different hypotheses were formulated for the present thesis: (a) ASD’s core symptoms contribute to children’s emotional difficulties by increasing emotional reactivity, decreasing emotion regulation, and increasing emotional incoherence; (b) children’s alexithymia also contributes to children’s emotional difficulties by increasing them; (c) ASD’s core symptoms are related to parents’ characteristics by decreasing parents’ emotion regulation capacity, increasing parents’ stress reaction, and decreasing parents’ frequency of interaction with their children; (d) difficulties in emotional reactivity and emotion regulation in children together with alexithymia are also related to parents’ characteristics; (e) in turn, parents’ frequency of interaction with the child also contributes to children’s difficulties in emotional reactivity and emotion regulation. Applying a multimethod approach where parents-reports, parents’ self-reports, observations, and physiological indicators were used, 37 children with ASD and 66 typically developing (TD) children and their parents were assessed. It was found that: (a) children with ASD had more emotional reactivity, less emotion regulation ability, and more emotional incoherence than TD children; (b) children’s alexithymia contributed more than ASD diagnosis to the explanation of some aspects of emotional reactivity and emotional incoherence but not of emotion regulation; (c) parents of children with ASD had more emotion regulation difficulties, more stress, and interacted less frequently with their children than parents of TD children; (d) parents’ perceptions of children’s difficulties contributed more to parents’ emotion regulation capacity and as much to parents’ stress as ASD diagnosis; moreover, children’s alexithymia also contributed more to parents’ frequency of interaction with their children than ASD diagnosis; and (e) parents’ frequency of interaction with their children contributed to more positive and negative emotional expressions and to the use of better emotion regulation strategies in children. The present findings highlight the complexity of emotional difficulties in children with ASD by suggesting that difficulties in emotional reactivity and emotion regulation are reflected at the subjective, observational, and physiological levels. Furthermore, these difficulties are influenced by different factors: children’s ASD characteristics, children’s other characteristics such as alexithymia, and parents’ characteristics. Given the relevance of emotional difficulties to internalizing and externalizing problems in children with ASD it is important that interventions include a multicomponent approach to emotional difficulties in ASD. Furthermore, interventions would benefit from integrating children’s alexithymia and parents’ characteristics such as their difficulties with emotion regulation and stress to help alleviate emotional difficulties in children with ASD. Finally, parents’ trainings on learning strategies to deal with their children’s emotional reactivity might prove beneficial both for parents and for children