Anxiety, depression, and well-being in autistic adults and adults with other developmental disabilities: A longitudinal cross-lagged analysis.
Anxiety and depression swing each other upward over time in autistic adults and adults with other DDs, so always assess and treat both.
01Research in Context
What this study did
Hillary and colleagues tracked the same group of autistic adults and adults with other developmental disabilities over several years.
They asked people to fill out anxiety, depression, and well-being scales at two different time points.
Then they used cross-lagged models to see which feeling predicted the other over time.
What they found
Anxiety and depression feed each other in both directions.
The path that wins depends on who is doing the reporting.
Well-being dips when either mood problem rises, but the link is stronger for depression than for anxiety.
How this fits with other research
Eugenia Gras et al. (2003) warned that standard anxiety checklists often miss adults with ID. Hillary’s team shows the same worry applies today: if you only screen for the problem the person mentions first, you will miss the partner problem that blooms later.
Bellon-Harn et al. (2020) found loneliness and sleep trouble tied to anxiety and depression in older Irish adults with ID. Hillary’s younger sample adds a time lens: the mood problems grow together, so catching either early may spare both later.
Jackson et al. (2025) saw anxiety and executive function chase each other in kids with Down syndrome. Hillary finds the same two-way loop, but between anxiety and depression in adults, hinting the cycle shifts partners as people age.
Why it matters
When an autistic adult says “I’m anxious,” screen for depression too, and vice versa. Track both at every re-assessment. Pick tools that work with ID, and add loneliness or sleep items if you can. Treating one mood problem without the other is like bailing one side of a boat: the water just runs back.
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02At a glance
03Original abstract
Autistic people and people with other developmental disabilities (DD) are at high likelihood for anxiety and depression, which can negatively affect adult life. Therefore, this study sought to understand temporal links between anxiety and depression over time in autistic adults and adults with DDs, and how these conditions impact specific aspects of positive well-being. A sample of 130 adults with autism or other DDs and their caregivers were drawn from a longitudinal study. Participants complete measures of anxiety (Adult Manifest Anxiety Scale), depression (Beck Depression Inventory, 2nd Edition), and well-being (Scales of Psychological Well-Being). Cross-lagged panel analyses revealed significant autoregressive effects for anxiety and depressive symptoms over time, based on both caregiver and self-report (all p < 0.01). Additionally, although findings differed across reporter, cross-lagged links between anxiety and depression emerged over time. Based on caregiver-report, anxiety symptoms predicted later depressive symptoms (p = 0.002) but depressive symptoms did not predict later anxiety (p = 0.10); the opposite pattern was identified for self-report. Aspects of positive well-being (purpose in life, self-acceptance, personal growth) demonstrated differential links with anxiety and depression (p = 0.001-0.53). These findings highlight the utility of a transdiagnostic approach to mental health services for autistic adults and adults with DDs, and the need to monitor for anxious or depressive symptoms in autistic adults and adults with DDs presenting with depression or anxiety, respectively.
Autism research : official journal of the International Society for Autism Research, 2023 · doi:10.1016/j.psychres.2019.01.098