Compulsion Profile Differences Indicate Distinct Functional Mechanisms in Autistic and Non-Autistic University Students.
Autistic compulsions aim for sensory balance, not fear reduction, so tailor your intervention.
01Research in Context
What this study did
Zukerman et al. (2026) asked autistic and non-autistic university students to fill out the Y-BOCS-I checklist. The team ran a factor analysis to see which compulsions cluster together.
They wanted to know if autistic students show the same compulsion patterns as their non-autistic peers.
What they found
Autistic students scored high on sensory or body-focused items like touching, tapping, or lining things up. Non-autistic students scored high on classic anxiety items like checking locks or washing.
The data split into two clear groups: sensory-regulatory versus anxiety-relief. Autistic students lived mostly in the first group.
How this fits with other research
Liew et al. (2015) already showed that sensory issues and blocked rituals predict worry in college students with high autistic traits. Gil’s factor split backs up that link.
Noordenbos et al. (2012) found social motivation, not cognition, drives anxiety in autistic adults. Gil adds that the form of compulsion, not just the trigger, is different.
Hillier et al. (2018) ran a peer support group that cut anxiety in autistic students. Gil hints we should teach sensory-based coping skills, not just talk about feelings.
Why it matters
If you treat an autistic college student’s compulsions with standard ERP for anxiety, you may miss the real function: keeping sensory input just right. Screen for sensory triggers first, then teach replacement moves like squeeze balls, noise-canceling headphones, or movement breaks. Match the intervention to the function, not the topography.
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02At a glance
03Original abstract
Autistic individuals often exhibit high rates of obsessive-compulsive symptoms (OCS), yet traditional cognitive-behavioral therapy (CBT), especially exposure and response prevention (ERP), tends to be less effective for them. This may be due to differences in the function of compulsive behaviors: while OCD-related compulsions are typically ego-dystonic and aimed at reducing anxiety, autistic compulsions may be ego-syntonic, serving regulatory or sensory modulation purposes. This study investigated whether compulsions in autism are more aligned with regulation and sensory modulation than with anxiety reduction. Participants included 39 autistic university students, 25 non-autistic students with high OCS, and 25 non-autistic students with low OCS. A factor analysis of seven binary items from the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS-I) revealed two factors explaining 58% of the variance. The first factor showed high loadings for Repetition, Counting, and Hoarding compulsions, reflecting regulatory and sensory modulation processes. The second factor showed high loadings for checking and organizing compulsions that were previously associated with anxiety reduction. Chi-square analyses showed autistic students reported significantly more regulatory/sensory compulsions than low-OCS individuals. For anxiety-reduction compulsions, autistic students reported significantly fewer positive responses than both non-autistic groups. Trait and state anxiety correlated with OCS levels in non-autistic participants, but not in autistic individuals. These findings indicate that compulsions in autism may reflect distinct functional mechanisms compared to those in classical OCD. Specifically, the weaker association with anxiety or threat reduction suggests that ERP-based CBT, which targets anxiety-driven compulsions, may be less effective for autistic individuals. Broader implications for both diagnosis and therapeutic approaches are discussed.
Autism research : official journal of the International Society for Autism Research, 2026 · doi:10.1002/aur.70215