Brief Report: Alexithymia Trait Severity, Not Autistic Trait Severity, Relates to Caregiver Reactions to Autistic Children's Negative Emotions
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| Title: | Brief Report: Alexithymia Trait Severity, Not Autistic Trait Severity, Relates to Caregiver Reactions to Autistic Children's Negative Emotions |
|---|---|
| Language: | English |
| Authors: | McIntyre, Cassia L. (ORCID |
| Source: | Journal of Autism and Developmental Disorders. Oct 2023 53(10):4100-4106. |
| Availability: | Springer. Available from: Springer Nature. One New York Plaza, Suite 4600, New York, NY 10004. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-460-1700; e-mail: customerservice@springernature.com; Web site: https://link.springer.com/ |
| Peer Reviewed: | Y |
| Page Count: | 7 |
| Publication Date: | 2023 |
| Document Type: | Journal Articles Reports - Research |
| Descriptors: | Symptoms (Individual Disorders), Autism Spectrum Disorders, Severity (of Disability), Parent Child Relationship, Children, Comparative Analysis, Interpersonal Competence, Parent Attitudes, Emotional Response, Parenting Styles, Self Control |
| DOI: | 10.1007/s10803-022-05494-2 |
| ISSN: | 0162-3257 1573-3432 |
| Abstract: | Alexithymia impacts an individual's ability to recognize and understand emotions and frequently co-occurs with autism. This study investigated the relationship between children's alexithymia, autistic traits, and caregiver reactions to their child's negative emotions. Caregivers of 54 autistic and 51 non-autistic children between the ages of 7 and 12 years rated their child's alexithymia and autistic trait severity and their reactions to their child's negative emotions. Caregivers of autistic children reported greater supportive reactions and fewer restrictive/controlling reactions to their child's negative emotions when their child had more alexithymia traits. This study extends previous research by demonstrating that caregivers of autistic children with co-occurring alexithymia traits represent a specific subgroup of caregivers that respond more positively to their child's negative emotions. |
| Abstractor: | As Provided |
| Entry Date: | 2023 |
| Accession Number: | EJ1392221 |
| Database: | ERIC |
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| FullText | Links: – Type: pdflink Url: https://content.ebscohost.com/cds/retrieve?content=AQICAHj0k_4E0hTGH8RJwT4gCJyBsGNe_WN95AvKlDbXJGqwxwFZrSHR5JCw2vuyBYEr3FclAAAA4jCB3wYJKoZIhvcNAQcGoIHRMIHOAgEAMIHIBgkqhkiG9w0BBwEwHgYJYIZIAWUDBAEuMBEEDEnRzUElWGU73yljQgIBEICBmr_7IhT-A1xQBQ47XBTAp1lI93dgtEtJ1rjZ7hmCU1mMVBvXxVhws6XG7ZNlAlSwAnNJuQPSJeoBKUYOWMbJR2GhD8Yr2T592fbgDSiXSzXwUS8o8YEz9rDdqES33WoilFwvbZHRpEMbbIhvDGF-LUnze-vx0mjJvwj0Mywmc0Y80cnTYC0UU839IVPwf1AC8MnCdbSMDG5mLzI= Text: Availability: 1 Value: <anid>AN0171915517;aut01oct.23;2023Sep15.03:44;v2.2.500</anid> <title id="AN0171915517-1">Brief Report: Alexithymia Trait Severity, Not Autistic Trait Severity, Relates to Caregiver Reactions to Autistic Children's Negative Emotions </title> <p>Alexithymia impacts an individual's ability to recognize and understand emotions and frequently co-occurs with autism. This study investigated the relationship between children's alexithymia, autistic traits, and caregiver reactions to their child's negative emotions. Caregivers of 54 autistic and 51 non-autistic children between the ages of 7 and 12 years rated their child's alexithymia and autistic trait severity and their reactions to their child's negative emotions. Caregivers of autistic children reported greater supportive reactions and fewer restrictive/controlling reactions to their child's negative emotions when their child had more alexithymia traits. This study extends previous research by demonstrating that caregivers of autistic children with co-occurring alexithymia traits represent a specific subgroup of caregivers that respond more positively to their child's negative emotions.</p> <p>Keywords: Alexithymia; Autism spectrum disorder; Caregiver reactions; Children's emotions</p> <p>Supplementary Information The online version contains supplementary material available at https://doi.org/10.1007/s10803-022-05494-2.</p> <p>Alexithymia is a condition characterized by difficulties in recognizing, distinguishing, and describing the emotions of oneself and others (Costa et al., [<reflink idref="bib7" id="ref1">7</reflink>]). Alexithymia has been observed in the general population (Pellerone et al., [<reflink idref="bib18" id="ref2">18</reflink>]) as well as in individuals with psychiatric conditions such as eating disorders, schizophrenia, substance use disorders, post-traumatic stress disorders, and panic disorder (Bird &amp; Cook, [<reflink idref="bib3" id="ref3">3</reflink>]; Cuzzocrea et al., [<reflink idref="bib8" id="ref4">8</reflink>]). Compared to non-autistic individuals, autistic individuals are at an increased risk for alexithymia (Kinnaird et al., [<reflink idref="bib16" id="ref5">16</reflink>]), and it is estimated that approximately half of autistic individuals have co-occurring alexithymia (Poquérusse et al., [<reflink idref="bib20" id="ref6">20</reflink>]).</p> <p>Autistic children with or without alexithymia may encounter challenges pertaining to their social and emotional development. Autistic children experience difficulties with understanding the emotions of others (Bougher-Muckian et al., [<reflink idref="bib4" id="ref7">4</reflink>]) and exhibit more negative emotional reactivity and poorer emotional regulation compared to non-autistic children (Costa et al., [<reflink idref="bib7" id="ref8">7</reflink>]). There is evidence that the social and emotional differences observed in autistic individuals may be more related to co-occurring alexithymia than to autistic traits (Bird &amp; Cook, [<reflink idref="bib3" id="ref9">3</reflink>]; Scheerer et al., [<reflink idref="bib24" id="ref10">24</reflink>]). This may help to explain the heterogeneity in the social phenotype observed among autistic individuals. Co-occurring alexithymia may exacerbate autistic children's negative emotional expressions as their difficulty understanding emotions may make emotion regulation more challenging. However, the ways in which caregivers react to their child's emotional expressions can influence how their child learns to cope with their own emotions (Fabes et al., [<reflink idref="bib11" id="ref11">11</reflink>]). Thus, understanding how autistic children's social and emotional development can be better regulated by parents' strategies is critical to supporting healthy social and emotional development.</p> <p>Parents of autistic children report greater supportive and significantly fewer non-supportive responses to their child's anger and fear compared to parents of non-autistic children (Bougher-Muckian et al., [<reflink idref="bib4" id="ref12">4</reflink>]). Because autistic children who possess co-occurring alexithymia traits may experience increased emotional difficulties, they may need more caregiver support to help regulate and control their emotions. The goal of this study was to investigate how autistic and non-autistic children's alexithymia and autistic traits influence caregivers' reactions to their child's expressions of negative emotions. First, it was hypothesized that autistic children would exhibit higher alexithymia and autistic traits. Second, it was hypothesized that, compared to caregivers of non-autistic children, caregivers of autistic children would report greater supportive and less restrictive/controlling reactions to their child's negative emotional expressions, particularly when their child had both higher alexithymia and autistic traits.</p> <hd id="AN0171915517-2">Methods</hd> <p></p> <hd id="AN0171915517-3">Participants and Procedure</hd> <p>Children and their caregivers attended a free day camp for autistic and non-autistic youth between the ages of 7 and 12 years old. Interested families confirmed their child's age, primary language, and diagnosis by phone. Inclusion criteria for the current analysis were the absence of an intellectual disability and that caregivers were competent in speaking, reading, and writing in English. Caregivers of 54 autistic (<emph>m</emph><subs><emph>age</emph></subs> = 10.01, SD = 1.85; 39 boys) and 51 non-autistic children (<emph>m</emph><subs><emph>age</emph></subs> = 9.40, SD = 1.58; 38 boys) participated (Table 1). Prior to participation, caregivers of autistic children provided a clinical diagnostic report of autism spectrum disorder (ASD).</p> <p>Table 1 Sample Characteristics</p> <p> <ephtml> &lt;table frame="hsides" rules="groups"&gt;&lt;thead&gt;&lt;tr&gt;&lt;th align="left" /&gt;&lt;th align="left" /&gt;&lt;th align="left"&gt;&lt;p&gt;Autistic&lt;/p&gt;&lt;p&gt;n (%)&lt;/p&gt;&lt;/th&gt;&lt;th align="left" /&gt;&lt;th align="left"&gt;&lt;p&gt;Non-Autistic&lt;/p&gt;&lt;p&gt;n (%)&lt;/p&gt;&lt;/th&gt;&lt;/tr&gt;&lt;/thead&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" colspan="2"&gt;&lt;p&gt;Gender&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="2"&gt;&lt;p&gt; Male&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;38 (75%)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;39 (72%)&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="2"&gt;&lt;p&gt; Female&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;13 (25%)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;15 (28%)&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="2"&gt;&lt;p&gt;Ethnicity&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="2"&gt;&lt;p&gt; Asian&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;20 (37%)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;15 (29%)&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="2"&gt;&lt;p&gt; Caucasian&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;31 (57%)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;14 (28%)&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="2"&gt;&lt;p&gt; Mixed/Other&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;3 (6%)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;22 (43%)&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="2"&gt;&lt;p&gt;Income&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="2"&gt;&lt;p&gt; $20,000 to $49,999&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;8 (15%)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;6 (12%)&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="2"&gt;&lt;p&gt; $50,000 to $79,999&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;11 (20%)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;20 (39%)&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="2"&gt;&lt;p&gt; $80,000 to $109,999&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;18 (33%)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;12 (23%)&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="2"&gt;&lt;p&gt; $110,000 to $139,999&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;6 (11%)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;7 (14%)&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="2"&gt;&lt;p&gt; Greater than $140,000&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;10 (19%)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;6 (12%)&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="2"&gt;&lt;p&gt; Not Reported&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1 (2%)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;0&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="2"&gt;&lt;p&gt;Caregiver Highest Education Completed&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;td align="left" /&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="2"&gt;&lt;p&gt; High School&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;4 (7%)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;0&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="2"&gt;&lt;p&gt; Bachelor's degree&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;30 (56%)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;18 (35%)&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="2"&gt;&lt;p&gt; Graduate Degree&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;10 (19%)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;19 (37%)&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="2"&gt;&lt;p&gt; Professional Diploma&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;8 (15%)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;11 (22%)&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left" colspan="2"&gt;&lt;p&gt; Not Reported&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2 (4%)&lt;/p&gt;&lt;/td&gt;&lt;td align="left" /&gt;&lt;td align="left"&gt;&lt;p&gt;3 (6%)&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt; </ephtml> </p> <p> <emph>Note. N</emph> = 105</p> <hd id="AN0171915517-4">Materials</hd> <p>The Wechsler Abbreviated Scale of Intelligence, Second Edition (WASI-II; Weschler, [<reflink idref="bib27" id="ref13">27</reflink>]) was administered to all children. The WASI-II Full Scale IQ-2 (FSIQ-2), which is a composite of the Vocabulary and Matrix Reasoning subsets, was used to estimate children's cognitive ability. The Autism Quotient (AQ)-Child (4 to 11 years; Auyeung et al., [<reflink idref="bib1" id="ref14">1</reflink>]) and the AQ-Adolescent (12 to 15 years; Baron-Cohen et al., [<reflink idref="bib2" id="ref15">2</reflink>]) were used to measure autistic traits across five domains: social skills, attention switching, attention to details, communication, and imagination. The Children's Alexithymia Measure (CAM; Way et al., [<reflink idref="bib26" id="ref16">26</reflink>]) was completed by caregivers as a measure of their child's alexithymia traits. The Coping with Children's Negative Emotions Scale (CCNES; Fabes et al., [<reflink idref="bib11" id="ref17">11</reflink>]) was used to assess caregivers' reactions to their child's expressions of negative emotions. The CCNES asks caregivers to rate how they would respond in 12 hypothetical scenarios in which their child is upset or angry. Six questions per hypothetical scenario reflect a different response to their child's negative emotional expressions. Three subscales reflect supportive caregiver reactions: Expressive Encouragement (EE; acceptance and encouragement of their child's expression of negative emotions), Emotion-Focused Reactions (EF; use of strategies such as comforting or distracting their child to help their child feel better), and Problem-Focused Reactions (PF; helping their child solve the problem that has caused them to be distressed). Three subscales reflect restrictive/controlling caregiver reactions: Minimization Reactions (MR; downplaying or disregarding how serious their child's emotional reactions are), Punitive Reactions (PR; verbally or physically punishing their child for expressing negative emotions), and Distress Reactions (DR; experiencing distress themselves due to their child's negative emotional expressions). Higher scores on each of the six questions per hypothetical scenario represent an endorsement of the corresponding caregiver response to their child's negative emotions. The CCNES has shown good test-retest reliability over a four month period (<emph>r</emph>s(<reflink idref="bib33" id="ref18">33</reflink>) = 0.62, 0.83, 0.77, 0.56, 0.57, and 0.77, all <emph>p</emph>s &lt; 0.01) for DR, PR, MR, EE, EF, and PF, respectively (Fabes et al., [<reflink idref="bib11" id="ref19">11</reflink>]). Total subscale scores are reported and included in this analysis.</p> <hd id="AN0171915517-5">Analytic Approach</hd> <p>All statistical analyses were conducted using SPSS Statistics 26.0 software. Independent samples t-tests were conducted to assess differences in age, IQ, AQ, CAM, and CCNES scores between autistic and non-autistic children. Bivariate Pearson correlations were conducted to assess the relationship between IQ, AQ, CAM, and CCNES scores for autistic and non-autistic children. Hierarchical regressions were conducted separately for autistic and non-autistic children to examine whether CAM scores could significantly account for the variance in CCNES subscale scores after controlling for AQ scores.</p> <hd id="AN0171915517-6">Results</hd> <p>Independent samples t-tests on all variables found that autistic children had significantly higher AQ (<emph>t</emph>(<reflink idref="bib103" id="ref20">103</reflink>) = -11.059, <emph>p</emph> ≤.001) and CAM (<emph>t</emph>(<reflink idref="bib103" id="ref21">103</reflink>) = -5.065, <emph>p</emph> ≤.001) total scores than non-autistic children (Table 2). There were no statistically significant differences found between autistic and non-autistic children for age, IQ, or any of the CCNES subscales. For autistic children, alexithymia traits were positively correlated with the supportive subscales of the CCNES: EE (<emph>r</emph>(<reflink idref="bib52" id="ref22">52</reflink>) = 0.313, <emph>p</emph> =.021), EF (<emph>r</emph>(<reflink idref="bib52" id="ref23">52</reflink>) = 0.448, <emph>p</emph> ≤.001) and PF (<emph>r</emph>(<reflink idref="bib52" id="ref24">52</reflink>) = 0.551, <emph>p</emph> ≤.001), and negatively correlated with the restrictive/controlling subscales of the CCNES: DR (<emph>r</emph>(<reflink idref="bib52" id="ref25">52</reflink>) = − 0.391, <emph>p</emph> =.003), PR (<emph>r</emph>(<reflink idref="bib52" id="ref26">52</reflink>) = − 0.457, <emph>p</emph> ≤.001), and MR (<emph>r</emph>(<reflink idref="bib52" id="ref27">52</reflink>) = − 0.460, <emph>p</emph> ≤.001). Autistic traits were significantly correlated with alexithymia traits for non-autistic (<emph>r</emph>(<reflink idref="bib49" id="ref28">49</reflink>) = − 0.562, <emph>p</emph> ≤.001), but not for autistic children (<emph>r</emph>(<reflink idref="bib52" id="ref29">52</reflink>) = 0.193, <emph>p</emph> =.162; see Table 3). The CCNES subscales were not significantly correlated with alexithymia or autistic traits in the non-autistic sample, nor were they significantly correlated with autistic traits in the autistic sample.</p> <p>Table 2 Group Differences</p> <p> <ephtml> &lt;table frame="hsides" rules="groups"&gt;&lt;thead&gt;&lt;tr&gt;&lt;th align="left" /&gt;&lt;th colspan="4"&gt;&lt;p&gt;Autistic&lt;/p&gt;&lt;p&gt;(n = 54)&lt;/p&gt;&lt;/th&gt;&lt;th colspan="4"&gt;&lt;p&gt;Non- Autistic&lt;/p&gt;&lt;p&gt;(n = 51)&lt;/p&gt;&lt;/th&gt;&lt;/tr&gt;&lt;tr&gt;&lt;th align="left" /&gt;&lt;th align="left"&gt;&lt;p&gt;Mean&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;SD&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;Min&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;Max&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;Mean&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;SD&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;Min&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;Max&lt;/p&gt;&lt;/th&gt;&lt;/tr&gt;&lt;/thead&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;Age&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;10.01&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.85&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;7.01&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;12.96&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;9.40&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.58&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;6.68&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;12.73&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;WASI-II FSIQ-2&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;104.67&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;14.6&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;80&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;138&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;109.13&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;13.12&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;76&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;138&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;AQ Total Score *&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;30.81&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;6.96&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;15&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;48&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;16.00&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;6.75&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;4&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;32&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;CAM Total Score *&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;15.43&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;9.59&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;39&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;7.16&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;6.81&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;24&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;CCNES Distress&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;3.44&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.36&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.5&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;6.42&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;3.94&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.43&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;6.5&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;CCNES Punitive&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;3.33&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.69&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;6.83&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;3.57&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.73&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.25&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;6.75&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;CCNES Expressive Encouragement&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;4.43&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.68&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;7&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;3.82&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.65&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;6.5&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;CCNES Emotion-Focused&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;4.66&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.86&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;7&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;4.06&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.99&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;7&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;CCNES Problem-Focused&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;4.74&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2.08&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;7&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;4.02&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;2.13&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;6.83&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;CCNES Minimization&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;3.45&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.56&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.25&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;6.67&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;3.80&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.50&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;1.25&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;6.67&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt; </ephtml> </p> <p> <emph>Note.</emph> N = 105 Abbreviations: WASI-II FSIQ-2 = Wechsler Abbreviated Scale of Intelligence, 2nd Edition Full Scale IQ-2; AQ = Autism Spectrum Quotient; CAM = Children's Alexithymia Measure; CCNES = Coping with Children's Negative Emotions Scale. * p ≤ 0.001</p> <p>Table 3 Correlation Analyses</p> <p> <ephtml> &lt;table frame="hsides" rules="groups"&gt;&lt;thead&gt;&lt;tr&gt;&lt;th align="left" /&gt;&lt;th align="left"&gt;&lt;p&gt;1&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;2&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;3&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;4&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;5&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;6&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;7&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;8&lt;/p&gt;&lt;/th&gt;&lt;th align="left"&gt;&lt;p&gt;9&lt;/p&gt;&lt;/th&gt;&lt;/tr&gt;&lt;/thead&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;1. WASI-II FSIQ-2&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;-&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.049&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.171&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.012&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.163&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.102&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.064&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.118&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.225&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;2. AQ Total Score&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.259&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;-&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.562**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;-0.251&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;-0.040&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.109&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.052&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.063&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.208&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;3. CAM Total Score&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.189&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.193&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;-&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.292*&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.135&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.071&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.059&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.103&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.154&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;4. CCNES Distress&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.221&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.012&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.391*&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;-&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.770**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.604**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.664**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.637**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.663**&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;5. CCNES Punitive&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.153&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.122&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.457**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.870**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;-&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.574**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.657**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.718**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.840**&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;6. CCNES Expressive Encouragement&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.134&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.047&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.313*&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.669**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.700**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;-&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.822**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.871**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.554**&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;7. CCNES Emotion-Focused&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.029&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.051&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.448**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.710**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.799**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.789**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;-&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.932**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.517**&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;8. CCNES Problem-Focused&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.077&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.132&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.551**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.736**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.845**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.784**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.926**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;-&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.597**&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td align="left"&gt;&lt;p&gt;9. CCNES Minimization&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.187&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.169&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.460**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;0.740**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.741**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.741**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.785**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;&amp;#8722;0.551**&lt;/p&gt;&lt;/td&gt;&lt;td align="left"&gt;&lt;p&gt;-&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt; </ephtml> </p> <p> <emph>Note.</emph> N = 105. Autistic participants' correlations are on the bottom diagonal. Non-autistic participants' correlations are on the top diagonal. Abbreviations: WASI-II FSIQ-2 = Wechsler Abbreviated Scale of Intelligence, 2nd Edition Full Scale IQ-2; AQ = Autism Spectrum Quotient; CAM = Children's Alexithymia Measure; CCNES = Coping with Children's Negative Emotions Scale. *p ≤ 0.05, **p ≤ 0.001</p> <p>Given our prediction that the association between children's alexithymia and caregiver reactions would be stronger in the autistic group, we compared the correlation coefficients between the autistic and non-autistic groups, setting the <emph>z</emph> critical value to 1.64. This comparison revealed that correlations between the CAM and CCNES subscales PR (<emph>z</emph> = 1.778, <emph>p</emph> ≤.05), EF (<emph>z</emph> = 2.104, <emph>p</emph> ≤.05), PF (<emph>z</emph> = 2.568, <emph>p</emph> ≤.05), and MR (<emph>z</emph> = 1.701, <emph>p</emph><uline>≤</uline>.05) were significantly larger in the autistic group compared to the non-autistic group. None of the correlations between the CAM and the DR and EE subscales reached significance for either group (see supplemental materials).</p> <p>AQ scores entered at Step 1 of the regression model for autistic children did not account for significant variance in any of the CCNES subscales: EE (<emph>R</emph><sups><emph>2</emph></sups> = 0.002, <emph>F</emph>(<reflink idref="bib1" id="ref30">1</reflink>, 52) = 0.114, <emph>p</emph> =.737), EF (<emph>R</emph><sups><emph>2</emph></sups> = 0.003, <emph>F</emph>(<reflink idref="bib1" id="ref31">1</reflink>, 52) = 0.135, <emph>p</emph> =.714), PF (<emph>R</emph><sups><emph>2</emph></sups> = 0.017, <emph>F</emph>(<reflink idref="bib1" id="ref32">1</reflink>, 52) = 0.922, <emph>p</emph> =.341), DR (<emph>R</emph><sups><emph>2</emph></sups> = 0.0001, <emph>F</emph>(<reflink idref="bib1" id="ref33">1</reflink>, 52) = 0.008, <emph>p</emph> =.93), PR (<emph>R</emph><sups><emph>2</emph></sups> = 0.015, <emph>F</emph>(<reflink idref="bib1" id="ref34">1</reflink>, 52) = 0.780, <emph>p</emph> =.381), and MR (<emph>R</emph><sups><emph>2</emph></sups> = 0.029, <emph>F</emph>(<reflink idref="bib1" id="ref35">1</reflink>, 52) = 1.532, <emph>p</emph> =.221). However, CAM scores entered at Step 2 accounted for significant variance in almost all of the CCNES subscales: EF (<emph>R</emph><sups><emph>2</emph></sups> = 0.202, <emph>F</emph>(<reflink idref="bib2" id="ref36">2</reflink>, 51) = 6.449, <emph>p</emph> ≤.01), PF (<emph>R</emph><sups><emph>2</emph></sups> = 0.304, <emph>F</emph>(<reflink idref="bib2" id="ref37">2</reflink>, 51) = 11.148, <emph>p</emph> ≤.001), DR (<emph>R</emph><sups><emph>2</emph></sups> = 0.161, <emph>F</emph>(<reflink idref="bib2" id="ref38">2</reflink>, 51) = 4.881, <emph>p</emph> ≤.01), PR (<emph>R</emph><sups><emph>2</emph></sups> = 0.210, <emph>F</emph>(<reflink idref="bib2" id="ref39">2</reflink>, 51) = 6.775, <emph>p</emph> ≤.01), and MR (<emph>R</emph><sups><emph>2</emph></sups> = 0.219, <emph>F</emph>(<reflink idref="bib2" id="ref40">2</reflink>, 51) = 7.134, <emph>p</emph> ≤.01). CAM scores did not account for significant variance for EE (<emph>R</emph><sups><emph>2</emph></sups> = 0.098, <emph>F</emph>(<reflink idref="bib2" id="ref41">2</reflink>, 51) = 2.785, <emph>p</emph> =.71). In the regression model for non-autistic children, neither AQ nor CAM scores accounted for significant variance in CCNES subscale scores (see supplemental materials).</p> <hd id="AN0171915517-7">Discussion</hd> <p>The current study examined whether autistic and non-autistic children's alexithymia and autistic traits were significantly related to their caregiver's reactions to their negative emotional expressions. Consistent with our hypotheses, autistic children with higher alexithymia traits had caregivers who reported greater supportive, and fewer restrictive/controlling reactions to their negative emotional expressions. Caregiver reactions were not found to vary with alexithymia traits in the non-autistic sample, nor were they related to autistic traits in either group.</p> <p>The finding that autistic parents reported more supportive reactions builds upon previous research by demonstrating that higher alexithymia traits elicit more positive caregiver reactions. Caregivers of autistic children may attribute their child's negative emotional expressions to their ASD diagnosis and may expect greater negative emotions from their autistic child; in turn, this may provide an explanation for why caregivers tend to respond more supportively and with less distress (Bougher-Muckian et al., [<reflink idref="bib4" id="ref42">4</reflink>]). Previous research has indicated that caregivers of autistic children with more severe symptoms were less stressed compared to caregivers of autistic children with milder symptoms (Huang et al., [<reflink idref="bib14" id="ref43">14</reflink>]). Researchers suggest that greater ASD symptom severity in their child leads caregivers to consider their child's behaviours to be less malleable (Bougher-Muckian et al. [<reflink idref="bib4" id="ref44">4</reflink>]; Huang et al., [<reflink idref="bib14" id="ref45">14</reflink>]). However, caregivers of autistic children with milder symptoms may experience greater stress because they put more effort into helping their child change their behaviours with the belief that they are more likely to succeed in their efforts (Huang et al., [<reflink idref="bib14" id="ref46">14</reflink>]). Importantly, this would also explain why caregiver reactions were associated with alexithymia traits for autistic children, but not non-autistic children. It is possible that caregivers of autistic children with high co-occurring alexithymia traits may simply perceive these difficulties as greater ASD symptom severity. Thus, although caregiver reactions were associated with alexithymia traits, but not autistic traits, an autism diagnosis remains an important factor related to caregiver reactions. Nonetheless, our findings suggest that alexithymia may be the driving force behind these reactions.</p> <p>Both autism (Costa et al., [<reflink idref="bib7" id="ref47">7</reflink>]) and alexithymia (Dubey &amp; Pandey, [<reflink idref="bib10" id="ref48">10</reflink>]) are associated with increased negative emotional expressions. Compared to parents of autistic children without alexithymia, and parents of non-autistic children with or without alexithymia, parents of autistic children with alexithymia are likely to have the most experience with negative emotional expression management. Given this increased training and/or practice handling their child's negative emotional expressions, these caregivers may learn to react more supportively compared to caregivers who do not have children with emotion regulation difficulties. Thus, both the expectation of more negative emotional expressions, and the increased experience coping with negative emotional expressions, may contribute to the more supportive caregiver reactions reported here. A caveat, however, is the possibility that caregivers of non-autistic children who do exhibit emotion regulation difficulties may eventually gain experience handling their children's negative emotional expressions, thus leading to more supportive reactions over time. Future work is needed to examine the relative contribution of expectations and experience to caregiver reactions.</p> <p>The finding that autistic traits were not associated with caregiver reactions for either group indicates that alexithymia may be a greater predictor of caregiver reactions than autistic traits. Many of our emotions stem from social interactions, and although autistic children may struggle socially, research suggests that alexithymia traits mediate the relationship between ASD and social competence, suggesting that alexithymia traits might be a better indicator of social competence than autistic traits (Bird &amp; Cook, [<reflink idref="bib3" id="ref49">3</reflink>]; Scheerer et al., [<reflink idref="bib24" id="ref50">24</reflink>]). This provides support for the "alexithymia hypothesis" which suggests that the social difficulties observed in a subgroup of individuals with ASD may be more accurately attributed to alexithymia rather than autistic traits (Bird &amp; Cook, [<reflink idref="bib3" id="ref51">3</reflink>]). It is not surprising then that caregiver reactions are more strongly associated with alexithymia than ASD traits, as alexithymia appears to be a better indicator of emotional regulation, an important component of social competence.</p> <p>The present study has several strengths. First, this study highlights the significant role that alexithymia, rather than autistic traits, has on caregiver reactions to their autistic child's negative emotional expressions. This finding also demonstrates the growing need to tease apart the social and emotional difficulties that may be related to ASD from those that may be related to, and perhaps better explained by, alexithymia. Further, the findings provide support for the alexithymia hypothesis and emphasize the importance of conducting more research about alexithymia in order to inform the development and implementation of treatment programs designed specifically to address alexithymia in ASD. Second, the present study's inclusion of both caregivers of autistic and non-autistic children allows for direct comparisons between caregiver groups and the ability to investigate how ASD specifically influences caregiver reactions. Third, this study contributes to the literature on parent-child interactions in autistic populations by providing additional support for the finding that caregivers of autistic children respond more positively and less negatively to their child's negative emotional expressions, and by extending this finding to caregivers of autistic children with co-occurring alexithymia.</p> <p>However, the present study's sample size was small and likely does not accurately represent the broader autistic and non-autistic communities. For instance, more caregivers in the autistic sample reported income levels greater than $80,000 compared to caregivers in the non-autistic sample. As well, the majority of caregivers in both groups reported education levels that were quite high. Specifically, 75% of caregivers of autistic children and 72% of caregivers of non-autistic children reported having obtained either a Bachelor's or Master's degree as their highest level of education. This is compared to data collected on the educational attainment of caregivers in British Columbia in which 36% reported having either a Bachelor's or Master's degree (Statistics Canada, [<reflink idref="bib25" id="ref52">25</reflink>]). The link between positive parenting practices and parental educational attainment has been well established. Parents with higher educational attainment may be more inclined to seek out information regarding positive parenting or child development, which may result in their greater knowledge and implementation of positive parenting practices (Davis-Kean et al., [<reflink idref="bib9" id="ref53">9</reflink>]). It is possible then that caregivers' socioeconomic status may provide one explanation for why they reported more positive reactions. That said, we did not find more positive reactions in caregivers of non-autistic children, although they reported similarly high levels of educational attainment as caregivers of autistic children. Thus, although the influence of socioeconomic status on caregivers' reactions cannot be ruled out, other factors may be at play.</p> <p>As well, the ethnicities of caregivers differed between the autistic and non-autistic sample. A greater proportion of caregivers were Caucasian in the autistic sample, and a greater proportion of caregivers in the non-autistic sample reported their ethnicity as "mixed/other". Emotional expressiveness differs across cultures with greater expression of emotions documented in Western societies, and different cultural values and beliefs about how children should be raised have also been shown to influence parenting practices (Chen et al., [<reflink idref="bib6" id="ref54">6</reflink>]). Thus, culture and ethnicity may have contributed to caregivers' reactions in the present study.</p> <p>Another limitation is that caregivers' own alexithymia traits were not measured. Genetic factors have been found to contribute to alexithymia (Jørgensen et al., [<reflink idref="bib15" id="ref55">15</reflink>]; Mezzavilla et al., [<reflink idref="bib17" id="ref56">17</reflink>]; Picardi et al., [<reflink idref="bib19" id="ref57">19</reflink>]). It is possible that if caregivers possess alexithymia traits themselves, this may lead to difficulties interpreting their child's negative emotional expressions. Ultimately, this may influence how they react in these situations. Future studies may examine caregivers' alexithymia traits to investigate how these traits may relate to their reactions to their child's expressions of negative emotions.</p> <p>Genetic research has also revealed rare de novo (genetic variants not seen in one's parents) and inherited genetic variants related to autism, both of which have shown associations with different social, communication, and adaptive functioning indices measured in autistic individuals (Chaste et al., [<reflink idref="bib5" id="ref58">5</reflink>]; Guo et al., [<reflink idref="bib13" id="ref59">13</reflink>]; Robinson et al., [<reflink idref="bib21" id="ref60">21</reflink>]; Ruzzo et al., [<reflink idref="bib23" id="ref61">23</reflink>]). Genetic status was not available and thus, we could not determine the proportion of de novo and inherited variants present in the autistic children who participated in this study. Because different genetic variants may be associated with heterogeneity in alexithymia traits, this represents a limitation in the current study. Future studies may want to consider genetic variants in autistic individuals and how they influence alexithymia traits to provide a deeper understanding of the factors that contribute to variation in the social phenotype of autism.</p> <p>Future research may wish to include non-autistic children with alexithymia to examine how alexithymia traits alone may relate to caregiver reactions. There is also evidence that parents of children with intellectual disability react to their child with greater unsupportive reactions (Rodas et al., [<reflink idref="bib22" id="ref62">22</reflink>]). Autistic children with intellectual disability were not included in the present study, despite estimates that approximately 50% of autistic individuals have a co-occurring intellectual disability (Goldin et al., [<reflink idref="bib12" id="ref63">12</reflink>]). As such, future research should aim to utilize larger and more representative samples of caregivers and children.</p> <hd id="AN0171915517-8">Conclusions</hd> <p>By reacting more positively to their child's expressions of negative emotions, caregivers can support their child's emotional understanding and build a strong foundation for their child's healthy social development. In the present study, caregivers of autistic children with greater alexithymia traits were found to react more positively to their child's negative emotional expressions. This study extends research on caregiver reactions in autistic populations by considering the role of alexithymia. By demonstrating how alexithymia, rather than autistic traits, can influence caregiver reactions, this study also provides support for the alexithymia hypothesis of ASD. However, these results are preliminary, and replication with a larger and more representative sample including parental education, SES, and ethnicity, as well as consideration of parental alexithymia traits, is needed.</p> <hd id="AN0171915517-9">Acknowledgements</hd> <p>The authors wish to express their appreciation to the families who participated in this research; to the Social Sciences and Humanities Research Council (SSHRC), the Natural Sciences and Engineering Research Council of Canada (NSERC), and BrainsCAN for their support in funding this research project; and to the volunteers at the Autism and Developmental Disabilities Lab who helped make this research possible.</p> <hd id="AN0171915517-10">Author Contributions</hd> <p>All authors contributed to the study conception and design. Data analyses were performed by Troy Q. Boucher, Nichole E. Scheerer, and Cassia L. McIntyre. The first draft of the manuscript was written by Cassia L. McIntyre. All authors commented on previous versions of the manuscript and read and approved the final manuscript.</p> <hd id="AN0171915517-11">Funding</hd> <p>This study was supported by funds from the Social Sciences and Humanities Research Council (SSHRC) awarded to Dr. Grace Iarocci; and Dr. Nichole E. Scheerer's Natural Sciences and Engineering Research Council of Canada (NSERC) PDF Scholarship held at Simon Fraser University, as well as her BrainsCAN Postdoctoral Fellowship at Western University, funded by the Canada First Research Excellence Fund (CFREF).</p> <hd id="AN0171915517-12">Declarations</hd> <p></p> <hd id="AN0171915517-13">Conflict of Interest</hd> <p>The authors have no conflicts of interest to disclose.</p> <hd id="AN0171915517-14">Research Involving Human Participants</hd> <p>Ethics at Simon Fraser University, and all procedures involving human participants were conducted in accordance with the ethical standards of the institution and the 1964 Helsinki Declaration and its later amendments.</p> <hd id="AN0171915517-15">Informed Consent</hd> <p>Participants' informed consent to participate and for publication were obtained before data collection.</p> <hd id="AN0171915517-16">Preprint DOI</hd> <p>https://doi.org/10.31234/osf.io/t5mrb</p> <hd id="AN0171915517-17">Electronic Supplementary Material</hd> <p>Below is the link to the electronic supplementary material.</p> <p>Graph: Supplementary Material 1</p> <hd id="AN0171915517-18">Publisher's Note</hd> <p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p> <ref id="AN0171915517-19"> <title> References </title> <blist> <bibl id="bib1" idref="ref14" type="bt">1</bibl> <bibtext> Auyeung B, Baron-Cohen S, Wheelwright S, Allison C. 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| Items | – Name: Title Label: Title Group: Ti Data: Brief Report: Alexithymia Trait Severity, Not Autistic Trait Severity, Relates to Caregiver Reactions to Autistic Children's Negative Emotions – Name: Language Label: Language Group: Lang Data: English – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22McIntyre%2C+Cassia+L%2E%22">McIntyre, Cassia L.</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0002-1376-5665">0000-0002-1376-5665</externalLink>)<br /><searchLink fieldCode="AR" term="%22Boucher%2C+Troy+Q%2E%22">Boucher, Troy Q.</searchLink><br /><searchLink fieldCode="AR" term="%22Scheerer%2C+Nichole+E%2E%22">Scheerer, Nichole E.</searchLink><br /><searchLink fieldCode="AR" term="%22Gurm%2C+Mandeep%22">Gurm, Mandeep</searchLink><br /><searchLink fieldCode="AR" term="%22Iarocci%2C+Grace%22">Iarocci, Grace</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="SO" term="%22Journal+of+Autism+and+Developmental+Disorders%22"><i>Journal of Autism and Developmental Disorders</i></searchLink>. Oct 2023 53(10):4100-4106. – Name: Avail Label: Availability Group: Avail Data: Springer. Available from: Springer Nature. One New York Plaza, Suite 4600, New York, NY 10004. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-460-1700; e-mail: customerservice@springernature.com; Web site: https://link.springer.com/ – Name: PeerReviewed Label: Peer Reviewed Group: SrcInfo Data: Y – Name: Pages Label: Page Count Group: Src Data: 7 – Name: DatePubCY Label: Publication Date Group: Date Data: 2023 – Name: TypeDocument Label: Document Type Group: TypDoc Data: Journal Articles<br />Reports - Research – Name: Subject Label: Descriptors Group: Su Data: <searchLink fieldCode="DE" term="%22Symptoms+%28Individual+Disorders%29%22">Symptoms (Individual Disorders)</searchLink><br /><searchLink fieldCode="DE" term="%22Autism+Spectrum+Disorders%22">Autism Spectrum Disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Severity+%28of+Disability%29%22">Severity (of Disability)</searchLink><br /><searchLink fieldCode="DE" term="%22Parent+Child+Relationship%22">Parent Child Relationship</searchLink><br /><searchLink fieldCode="DE" term="%22Children%22">Children</searchLink><br /><searchLink fieldCode="DE" term="%22Comparative+Analysis%22">Comparative Analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Interpersonal+Competence%22">Interpersonal Competence</searchLink><br /><searchLink fieldCode="DE" term="%22Parent+Attitudes%22">Parent Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Emotional+Response%22">Emotional Response</searchLink><br /><searchLink fieldCode="DE" term="%22Parenting+Styles%22">Parenting Styles</searchLink><br /><searchLink fieldCode="DE" term="%22Self+Control%22">Self Control</searchLink> – Name: DOI Label: DOI Group: ID Data: 10.1007/s10803-022-05494-2 – Name: ISSN Label: ISSN Group: ISSN Data: 0162-3257<br />1573-3432 – Name: Abstract Label: Abstract Group: Ab Data: Alexithymia impacts an individual's ability to recognize and understand emotions and frequently co-occurs with autism. This study investigated the relationship between children's alexithymia, autistic traits, and caregiver reactions to their child's negative emotions. Caregivers of 54 autistic and 51 non-autistic children between the ages of 7 and 12 years rated their child's alexithymia and autistic trait severity and their reactions to their child's negative emotions. Caregivers of autistic children reported greater supportive reactions and fewer restrictive/controlling reactions to their child's negative emotions when their child had more alexithymia traits. This study extends previous research by demonstrating that caregivers of autistic children with co-occurring alexithymia traits represent a specific subgroup of caregivers that respond more positively to their child's negative emotions. – Name: AbstractInfo Label: Abstractor Group: Ab Data: As Provided – Name: DateEntry Label: Entry Date Group: Date Data: 2023 – Name: AN Label: Accession Number Group: ID Data: EJ1392221 |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1007/s10803-022-05494-2 Languages: – Text: English PhysicalDescription: Pagination: PageCount: 7 StartPage: 4100 Subjects: – SubjectFull: Symptoms (Individual Disorders) Type: general – SubjectFull: Autism Spectrum Disorders Type: general – SubjectFull: Severity (of Disability) Type: general – SubjectFull: Parent Child Relationship Type: general – SubjectFull: Children Type: general – SubjectFull: Comparative Analysis Type: general – SubjectFull: Interpersonal Competence Type: general – SubjectFull: Parent Attitudes Type: general – SubjectFull: Emotional Response Type: general – SubjectFull: Parenting Styles Type: general – SubjectFull: Self Control Type: general Titles: – TitleFull: Brief Report: Alexithymia Trait Severity, Not Autistic Trait Severity, Relates to Caregiver Reactions to Autistic Children's Negative Emotions Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: McIntyre, Cassia L. – PersonEntity: Name: NameFull: Boucher, Troy Q. – PersonEntity: Name: NameFull: Scheerer, Nichole E. – PersonEntity: Name: NameFull: Gurm, Mandeep – PersonEntity: Name: NameFull: Iarocci, Grace IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 10 Type: published Y: 2023 Identifiers: – Type: issn-print Value: 0162-3257 – Type: issn-electronic Value: 1573-3432 Numbering: – Type: volume Value: 53 – Type: issue Value: 10 Titles: – TitleFull: Journal of Autism and Developmental Disorders Type: main |
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