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Investigating relationships between inhibitory control challenges and anxiety symptomatology in autistic adults
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Investigating relationships between inhibitory control challenges and anxiety symptomatology in autistic adults

Meghan O'Brien
Master of Science (M.S.), Drexel University
Mar 2024
DOI:
https://doi.org/10.17918/00001953
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Abstract

Autistic people Executive functions (Neuropsychology) Inhibitory control Autism
Autism Spectrum Disorder (ASD) is associated with elevated rates of mental health difficulties and executive function (EF) challenges. However, research on these constructs and the relation between them is limited in adulthood. There is emerging evidence that EF challenges are associated with suboptimal mental health; however, the relationship between aspects of EF (e.g., inhibitory control) and mental health (e.g., anxiety) has not been explored across adulthood in ASD. The current study seeks to bridge this gap in knowledge. Drawing upon archival data from 732 autistic adults (436 females; 18.2-83.3 years) who participated in a larger study of adult outcomes in ASD, this study examined whether autistic adults experience elevated difficulties in inhibitory control (as measured via self-report on the Barkley Deficits in Executive Functioning Scale (BDEFS) Self-Restraint subscale) relative to normative expectations. It also examined whether sex and suspected co-occurring ADHD (as measured by the Adult ADHD Self-Report Scale, A-ASRS) moderate the degree of inhibitory control challenges experienced. In addition, this research examined relations between inhibitory control challenges and self-reported anxiety symptoms (as measured via self-report using the General Anxiety Disorder 7-item scale, GAD-7, a screener for generalized anxiety symptoms). Finally, sex assigned at birth and suspected ADHD status were evaluated as moderators of this relationship. Scores on the inhibitory control measure significantly diverged from normative expectations (i.e., autistic adults endorsed significantly more challenges in inhibitory control relative to published norms from the general population). Participants assigned female at birth showed more impairment in inhibitory control relative to normative expectations for their sex than participants assigned male at birth. Participants suspected to have co-occurring ADHD reported more inhibitory control challenges than those not suspected to have ADHD. Greater endorsement of inhibitory control challenges was associated with greater anxiety symptomatology, and this relationship was moderated by suspected ADHD status, but not by sex assigned at birth. These results show that inhibitory control challenges are an area of difficulty in this group and are associated with increased anxiety symptomatology, suggesting that inhibitory control may be a valuable intervention target to improve emotional well-being in autistic adults.

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