Autism & Developmental

Emotion regulation in autism: Reappraisal and suppression interactions.

Cai et al. (2019) · Autism : the international journal of research and practice 2019
★ The Verdict

Pairing reappraisal lessons with suppression practice may protect autistic teens from the usual mood dip that suppression brings.

✓ Read this if BCBAs serving autistic middle-school, high-school, or college clients who mask emotions.
✗ Skip if Clinicians focused only on preschoolers or non-speaking clients under five.

01Research in Context

01

What this study did

Cai et al. (2019) looked at how autistic teens and young adults handle feelings.

They asked how two tricks work together: reappraisal (thinking about a problem in a new way) and suppression (holding faces still).

The team used cluster math to see which mix of these tricks best predicts mood.

02

What they found

High suppression usually hurts well-being, but not when paired with high reappraisal.

In other words, kids who both rethink the scene and keep a straight face felt fine.

Low reappraisal plus high suppression gave the worst mood scores.

03

How this fits with other research

Schaaf et al. (2015) already showed autistic youth use reappraisal less than peers and act out more.

Ying’s work adds: if you can’t raise reappraisal, suppression stays risky.

Ridgway et al. (2024) report the same age group feels lousy overall; Ying shows one way to shift that—boost reappraisal while suppression is still high.

Nuebling et al. (2024) meta-analysis says always screen for dysregulation; Ying gives a clear lever to pull during that screen.

04

Why it matters

You can stop telling teens “just don’t suppress.” Instead, teach reappraisal first.

In your next session, run a quick reappraisal drill—ask the client to name one other reason the bad event happened—before you practice calm faces.

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Before a social skills block, have the client reappraise a stressful scene aloud, then role-play the same scene with a neutral face.

02At a glance

Intervention
not applicable
Design
other
Sample size
56
Population
autism spectrum disorder
Finding
mixed

03Original abstract

Emotion regulation has been proposed to be a transdiagnostic factor in the development and maintenance of psychopathology in the general population, yet the nature of the relationships between emotion regulation strategy use and psychological well-being has not been comprehensively explored in individuals with autism spectrum disorder (ASD). The aim of this study was to assess how the individual differences in self-reported emotion regulation strategy use relate to levels of both positive and negative psychological well-being. In total, 56 individuals with ASD aged 14-24 years (Mage = 18.15; SDage = 2.30) completed Emotion Regulation Questionnaire, Diagnostic and Statistical Manual of Mental Disorders-5 Generalized Anxiety Disorder Dimensional Scale, Patient Health Questionnaire-9, Warwick-Edinburgh Mental Well-being Scale and Autism-Spectrum Quotient - Short. Individuals were grouped into four clusters based on their Emotion Regulation Questionnaire subscale scores. Individuals in the high suppression and low reappraisal group expressed higher depressive symptoms and lower positive well-being when compared with the low suppression and high reappraisal group. Interestingly, individuals who self-reported using both high suppression and reappraisal expressed relatively high positive well-being and low depression symptoms. We suggest that the maladaptive effect of habitual suppression usage may be buffered by the habitual use of reappraisal, and this interaction between adaptive and maladaptive emotion regulation strategy use has clinical implications.

Autism : the international journal of research and practice, 2019 · doi:10.1177/1362361318774558