According to the current DSM-5 diagnostic criteria, Autism Spectrum Disorder (ASD) is characterized by a wide range of impairments in social communication, reciprocal interaction, and patterns of restricted and circumscribed behaviors and interests.

Autism was formerly considered as a disorder, but recent evidences suggest that autistic traits are distributed among the general population, and they may exhibit autistic traits at sub clinical levels.

Individuals with autistic traits not only show the cognitive and behavioral characteristics of people with autism spectrum disorder but are also vulnerable to psychiatric and psychological problems. Evidence suggest that about 65-80% of people with autism traits are misdiagnosed of other psychiatric illness.

Typical abnormalities are associated with autistic traits, including mood disorders, anxiety, specific phobias, obsessive-compulsive disorder, hyperactivity disorder, and attention deficit hyperactivity disorder.

Studies have shown that, among psychological disorders in the subjects with autistic traits, depression and anxiety disorder are the most contributors.

The defect in the social problem-solving components is a vulnerable factor to the symptoms of depression and anxiety in different populations, so it is a question whether the defect in the social problem-solving components in individuals with autistic traits can make these individuals vulnerable to symptoms of depression and anxiety? There are few findings that examine the relationship between the social problem-solving problems in people with autistic traits and their effect on the level of vulnerability to depression and anxiety in individuals with autistic traits.

The participants for this study were 336 young-adult students recruited from the University of Tehran in Iran. The sample included 191 men (56.8%) and 145 women (43.2%) with age ranging between 18 and 35 (M=22.66, SD=3.65). All participants gave their informed consent for this study, and the ethical approval was received from the Iran University of Medical Ethical Committee.

Baron-Cohen and colleagues designed a self-report Autism-Spectrum Quotient questionnaire (AQ50) to measure the Autistic Trait consisting of 50 questions that measure 5 areas of autistic traits, including social skills, attention change, communication, attention to detail and imagination, and covers every 10 questions in one of the domains. The AQ has reasonably good psychometric properties with reported internal reliability values of 0.67 and 0.82. The test-retest reliability of the Persian version of AQ50 (r=0.82) and internal consistency (a=0.76) was reported within the three-week study. 

The Social Problem-Solving Inventory – Revised: Short (SPSI-R:S) Form is a 25-itemed self-report instrument that evaluates the characteristics of social problem-solving, including problem-solving orientation and performance. Internal consistency and test-retest coefficients of Persian SPSI-R:S were 0.86 and 0.65, respectively. 

The BDI-II is one of the most widely used self-report instruments for assessing the symptoms of depression. The Persian version of BDI-II showed a high internal consistency (a=0.87) and acceptable test-retest reliability (r=0.74). 

The BAI is a 21-itemed self-report questionnaire, which is designed to assess the presence and degree of anxiety symptoms within the past week and distinguish them from those of depressive symptoms. Persian version of BAI showed good reliability (r=0.72) and validity (r=0.83). 

Across all participants, the mean score for the total assessment was AQ=20.75 (SD=4.55, range: 11–34), SPSI-S: F=42 (SD=7.77, range: 16–65), BAI=42 (SD=7.66, range: 0–42), and BDI-II=11.82 (SD=8.28, range: 0–39). The means, standard deviations, and intercorrelations for all variables can be viewed in Table 1.

The confirmatory factors supported the factor structure for AQ, SPSI, BDI-II, and BAI factors used in the current analyses, but the standardized coefficient of attention to detail (ATD) was not significant. Therefore, ATD factor was removed, and the measurement model was again evaluated. Fit indices (Table 2) demonstrated a good fit suggesting that this measurement model offers an acceptable representation of the latent variables (Figure 1).

Fit indices demonstrated (Table 3) the significance (P<0.01) of the model’s good fit suggesting that this structural equation modeling (SEM) approaches (Figure
2) support the relationship between autistic traits, problem-solving deficits, depression, and anxiety symptoms. The structural equation modeling along with standardized coefficients (Figure 2) suggested the autistic traits as an exogenous variable, which affected the problem-solving deficient components (Standard coefficient=0.81). Furthermore, problem-solving deficient components effected on depression (Standard coefficient=0.67) and anxiety (Standard coefficient=0.60). Ineffective social problem-solving components (Avoidance style, Impulsive/Carelessness Style, and Negative Problem Orientation) result in depression and anxiety symptoms of autistic traits (Table 4). 

The current study aimed to investigate the Structural Equation Modeling (SEM) analysis of the relationship between autistic traits, social problem-solving deficient components, and depression as well as anxiety symptoms in an Iranian student sample. Findings of the current study are in consistent with Rosbrook and Whittingham (2010) [20], Zarekar et al., (2014) [35], Liew et al., (2015) [36], and Jackson and Dritschel (2016) [13]. Furthermore, Our model was statistically confirmed.

According to the D’Zurilla & Nezu model, the social problem-solving components act as indicators of individual adequacy, and thus, can be considered as a sign of quality of life in interpersonal interactions. Individuals with autistic traits are prone to experience the symptoms of anxiety and depression during the situations of problem-solving, as a result of which they use inefficient problem-solving styles (such as negative-orientation toward the problem, avoidance style, and impulsivity/inclination style).

The social performance of people with autistic traits shows that social disruptions in them can be rooted in the perception of social inefficiency and weak self-efficacy, which gets reflected by their negative orientation of problem-solving in problematic situations. In addition, the results of decision-making investigations suggest that individuals with autistic traits are heavily distracting from the risk, which is evident from their avoidance style further leading to vulnerability to anxiety symptoms. Ultimately, comorbid Attention Deficit Hyperactivity Disorder (ADHD) in people with autistic traits, especially exhibiting a high degree of inhibition / inhibition symptoms, may make them susceptible to impulsive / unconscious style.

According to our knowledge, this study can be considered as an elementary and important study on the role of the mediating the defects in the social problem-solving components to assess the relationship between autistic traits and symptoms of depression and anxiety by using structural equations modeling. This study also has some limitations. Given that all participants of the current study were university students, therefore the results of this study are limited to student sampling method. Although SEM approach provides the possibility to test complex hypotheses, cross-sectional nature of this study precludes the causal conclusions and accurate understanding of the true nature of these relationships. Finally, only self-report instruments were used to evaluate each of the variables in this study. It is, therefore, suggested that future research should use a variety of measurement techniques to assess the social problem-solving components. 

We acknowledge the participants of this research. This article is based on the first author MSc. thesis in the Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences.

According to the authors of the article, there is no conflict of interest in this study.
 

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