(PS11-D77) Examining the Role of Pubertal Development on Emotion Dysregulation in Autistic Adolescents

Puberty (and reaching puberty earlier or later than peers, known as pubertal timing) has been associated with increased mental health difficulties.^1–4 Autistic youth are more likely to have emotion dysregulation (ED), defined as difficulties managing one’s arousal and emotional state⁵, than neurotypical youth.⁶ However, we know little about puberty’s role in autistic difficulties in ED. The aim of the study was to examine how pubertal development was associated with ED in autistic adolescents.

Eighty-eight youth (22 female) age 12-22 years with ASD in an ED-focused clinical trial completed the Pubertal Development Scale (PDS)⁷ and caregivers and adolescents completed the Emotion Dysregulation Inventory^8,9 (EDI) at baseline. EDI yields scores for Reactivity (intense and sustained emotions) and Dysphoria (sadness, anhedonia, and unease). PDS items were calculated into Tanner stages via Shirtcliff et al., 2009¹⁰ calculations. Correlations and linear regressions of pubertal stage and timing on EDI-R and EDI-D were conducted.

            Only caregiver-report EDI-R was correlated with pubertal stage (r = -.29, p = .007) and pubertal timing (r= -.25, p= .018), such that pre-pubertal participants and participants with delayed pubertal timing had higher EDI-R; EDI-D and self-report EDI scores were not significant. Similarly, linear regressions found that, after controlling for gender, age, race, and IQ, pubertal stage was the only significant predictor of caregiver-report EDI-R (B = -.31, p= .016). When pubertal timing was used in the model instead of pubertal stage, delayed pubertal timing was associated at a trending level with worse EDI-R (B= -.21, p= .055). EDI-D had no significant findings.

            Findings suggest that for autistic youth with significant ED, puberty is associated with less reactivity in caregiver-report, whereas dysphoria (negative affect and internalizing symptoms) and self-report ED do not seem to be affected by pubertal stage and timing. Pubertal development may function as a regulatory mechanism for autistic youth who have ED, contrary to neurotypical findings.^2,4 Reporter discrepancies have been noted in prior ED research in autistic youth¹¹ and may relate to a range of emotional awareness and insight in autistic individuals.¹²  More research, incorporating biological measures of pubertal changes, a larger range of autistic youth with varying levels of ED, and comparing to neurotypical samples, is needed to better understand how puberty affects ED in autistic youth. Further, reporter differences in ED, and how they relate to social and behavioral expectations of adolescents, requires additional research.