Autism traits, social withdrawal, and behavioral and emotional problems in a Norwegian cohort of adolescents with rare genetic disorders.
Social withdrawal is the active ingredient that turns autistic traits into teen anxiety and depression in rare genetic disorders.
01Research in Context
What this study did
The team asked 112 Norwegian teens with rare genetic disorders to fill out three short surveys. One measured autism traits, one measured social withdrawal, and one measured anxiety and depression.
They then used statistics to see if social withdrawal explained why autism traits predicted later emotional problems.
What they found
More autism traits predicted more anxiety and depression six months later. Social withdrawal carried most of this effect. When withdrawal was added to the model, the direct link between autism traits and emotional problems dropped by half.
In plain words, being quiet and alone is the bridge that turns autistic features into clinical worry and sadness.
How this fits with other research
The finding extends Leung et al. (2014), who first showed that emotion dysregulation is high in ASD. Johannes et al. now show the pathway: traits → withdrawal → internalizing.
It also updates Halvorsen et al. (2019). That earlier survey said "look for ADHD when you see behavior problems." The new data say "also watch for social withdrawal in genetic disorders even when ADHD is absent."
An apparent contradiction appears next to Iversen et al. (2021). Their meta-analysis linked poor executive function to repetitive behaviors, not to internalizing. The two studies differ in outcome and age. Kvisler looked at 3- to young learners and counted hand-flapping. Johannes looked at 12- to young learners and counted days the teen stayed in their room. Same traits, different windows.
Why it matters
If you serve teens with rare genetic diagnoses, score social withdrawal at intake. A simple three-item scale predicted later anxiety as well as a full autism interview. Teach peers to invite, teach staff to notice silence, and you may prevent a downstream mood disorder.
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02At a glance
03Original abstract
BACKGROUND: Adolescents with rare genetic disorders represent a population that can be at risk in psychosocial terms. Despite its importance, the association of autism traits and social withdrawal in behavioral and emotional problems in adolescents with rare genetic disorders remains understudied. AIM: The study aimed to empirically examine the clinical characteristics of adolescents with rare genetic disorders with a behavior theory-driven approach. METHOD: We investigated the behavioral and emotional problems and current and lifetime autistic traits in a sample of 93 Norwegian adolescents (Mage = 13.2 years, SDage = 2.4, rangeage 10-17, 62.4% females, 37.6% males) with various rare genetic disorders. The adolescents were investigated cross-sectionally utilizing standardized psychometric questionnaires rated by their parents. RESULTS: More current and lifetime autistic traits and social withdrawal were all associated with more internalizing problems. Further analyses demonstrated that social withdrawal partially mediated the positive association between current autistic traits and internalizing problems. In contrast, social withdrawal fully mediated the positive association between lifetime autistic traits and internalizing problems. CONCLUSION AND IMPLICATIONS: Our results demonstrate important characteristics of adolescents with rare genetic disorders that may guide clinicians and future interventions. Social withdrawal may be prodromal to internalizing problems such as anxiety and depression. Thus, clinically addressing social withdrawal can represent a means to prevent internalizing problems in adolescents with rare genetic disorders and autistic traits.
Research in developmental disabilities, 2024 · doi:10.1016/j.ridd.2024.104699