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. 2023 Mar 9;23(1):149.
doi: 10.1186/s12888-023-04635-w.

Adolescence internalizing problems as a mediator between autism diagnosis in childhood and quality of life in emerging adults with and without autism: a 10-year longitudinal study

Per Normann Andersen  1 , Stian Orm  2   3 , Ingrid Nesdal Fossum  2   3 , Merete Glenne Øie  3   4 , Erik Winther Skogli  5   2
Affiliations

Adolescence internalizing problems as a mediator between autism diagnosis in childhood and quality of life in emerging adults with and without autism: a 10-year longitudinal study

Per Normann Andersen et al. BMC Psychiatry. .

Abstract

Background: Individuals with autism tend to have a reduced quality of life across their lifespan. This reduced quality of life may be a result of autism traits, mental distress, and poor person/environment fit. In this longitudinal study, we looked at the role of adolescence internalizing and externalizing problems in mediating the relationship between having an autism diagnosis from childhood and perceived quality of life as emerging adults.

Methods: A total of 66 participants in a group of emerging adults with autism (mean age 22.2 years), and without autism (mean age 20.9 years) were assessed in three assessment waves (T1 at 12 years, T2 at 14 years, and T3 at 22 years of age). Parents filled out the Child Behavior Checklist at T2 and participants filled out the Perceived Quality of Life Questionnaire at T3. Total and indirect effects were tested in serial mediation analysis.

Results: The results showed that internalizing problems fully mediated the association between childhood autism diagnosis and the quality of life in emerging adulthood, while externalizing problems did not.

Conclusion: Our findings suggest that attention to adolescent internalizing problems is important to improve the later quality of life for emerging adults with autism.

Keywords: Autism; Externalizing, longitudinal; Internalizing; Quality of life.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Conceptual serial mediation model where c represents the total effect (direct and indirect through mediators) between the predictor (autism) and the outcome variable (Quality of Life). Paths a1 and a2 represent the relationship between the predictor and mediators (internalizing and externalizing). Path d21 represents the relationships between the two mediators. b1 and b2 represent the relationship between the mediators and outcome variables after controlling for the predictor. The c’ path is the direct effect between the predictor and the outcome variable without the effect of the mediator variables. The indirect effect (c - c’ = a1 b1 + a2 b2 + a1 d21b2) is indicated through a statistically significant (i.e. CIs does not include zero) difference between c and c’ [53].
Fig. 2
Fig. 2
Serial multiple mediation of autism relation to Quality of Life where internalizing problems is entered as the first mediator into the model and externalizing problems next. ***p < .001. The values shown are standardized coefficients
Fig. 3
Fig. 3
Serial multiple mediation of autism relation to Quality of Life where externalizing problems is entered as the first mediator into the model and internalizing problems next. ***p < .001. Values shown are standardized coefficients
Fig. 4
Fig. 4
Parallel mediation of autism relation to Quality of Life where Anxious/Depressed, Withdrawn/Depressed and Somatic Complaints subscales of Adult Self-Report are entered simultaneously as mediators into the model ***p < .001. Values shown are standardized coefficients
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