Mapping the link between socio-economic factors, autistic traits and mental health across different settings

Teresa Del Bianco; Georgia Lockwood Estrin; Julian Tillmann; Bethany F. Oakley; Daisy Crawley; Antonia San José Cáceres; Hannah Hayward; Mandy Potter; Wendy Mackay; Petrusa Smit; Carlie du Plessis; Lucy Brink; Priscilla Springer; Hein Odendaal; Tony Charman; Tobias Banaschewski; Simon Baron-Cohen; Sven Bölte; Mark Johnson; Declan Murphy; Jan Buitelaar; Eva Loth; Emily J.H. Jones

doi:10.1177/13623613231200297

Mapping the link between socio-economic factors, autistic traits and mental health across different settings

Teresa Del Bianco^*, Georgia Lockwood Estrin, Julian Tillmann, Bethany F. Oakley, Daisy Crawley, Antonia San José Cáceres, Hannah Hayward, Mandy Potter, Wendy Mackay, Petrusa Smit, Carlie du Plessis, Lucy Brink, Priscilla Springer, Hein Odendaal, Tony Charman, Tobias Banaschewski, Simon Baron-Cohen, Sven Bölte, Mark Johnson, Declan MurphyJan Buitelaar, Eva Loth, Emily J.H. Jones

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

Autistic individuals experience higher rates of externalising and internalising symptoms that may vary with environmental factors. However, there is limited research on variation across settings that may highlight common factors with globally generalisable effects. Data were taken from two cohorts: a multinational European sample (n = 764; 453 autistic; 311 non-autistic; 6–30 years), and a South African sample (n = 100 non-autistic; 3–11 years). An exploratory factor analysis aggregated clinical (Verbal Comprehension and Perceptual Index), adaptive traits (Vineland Adaptive Behaviour Scale) and socio-economic variables (parental employment and education, home and family characteristics) in each cohort separately. With regression, we investigated the effect of these factors and autistic traits on internalising and externalising scores (measured with the Strengths and Difficulties Questionnaire). Cohorts showed similar four-factor structures (Person Characteristics, Family System, Parental and Material Resources). The ‘Family System’ factor captured family size and maternal factors and was associated with lower internalising and externalising symptoms in both cohorts. In the European cohort, high autistic traits reduced this effect; the opposite was found in the South Africa cohort. Our exploratory findings from two separate analyses represent consistent evidence that Family System is associated with internalising and externalising symptoms, with a context-specific impact in persons with high autism traits. Lay Abstract: Autistic individuals are more likely than non-autistic individuals to experience a mental health condition in their lifetime, and this includes externalising and internalising symptoms. We know very little about how different environments and family conditions impact these symptoms for autistic individuals. Improving our understanding of these relationships is important so that we can identify individuals who may be in greater need of support. In this article, we seek to improve our understanding of how environmental and family conditions impact externalising and internalising symptoms in autistic and non-autistic people. To do this, we conducted analyses with two cohorts in very different settings – in Europe and South Africa – to ensure our findings are globally representative. We used advanced statistical methods to establish environmental and family conditions that were similar to each other, and which could be combined into specific ‘factors’. We found that four similar ‘factors’ could be identified in the two cohorts. These were distinguished by personal characteristics and environmental conditions of individuals, and were named Person Characteristics, Family System, Parental and Material Resources. Interestingly, just ‘Family System’ was associated with internalising and externalising symptoms, and this was the same in both cohorts. We also found that having high traits of autism impacted this relationship between Family System and mental health conditions with opposite directions in the two settings. These results show that characteristics in the Family System are associated with internalising and externalising symptoms, and autistic persons are particularly impacted, reinforcing the notion that family stressors are important to consider when implementing policy and practice related to improving the mental health of autistic people.

Original language	English
Journal	Autism
DOIs	https://doi.org/10.1177/13623613231200297
Publication status	Accepted/In press - 2023

Keywords

autism spectrum disorders
environmental factors

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1177/13623613231200297

Cite this

Del Bianco, T., Lockwood Estrin, G., Tillmann, J., Oakley, B. F., Crawley, D., San José Cáceres, A., Hayward, H., Potter, M., Mackay, W., Smit, P., du Plessis, C., Brink, L., Springer, P., Odendaal, H., Charman, T., Banaschewski, T., Baron-Cohen, S., Bölte, S., Johnson, M., ... Jones, E. J. H. (Accepted/In press). Mapping the link between socio-economic factors, autistic traits and mental health across different settings. Autism. https://doi.org/10.1177/13623613231200297

@article{0575a72e4af74950a01e119d85633eaa,

title = "Mapping the link between socio-economic factors, autistic traits and mental health across different settings",

abstract = "Autistic individuals experience higher rates of externalising and internalising symptoms that may vary with environmental factors. However, there is limited research on variation across settings that may highlight common factors with globally generalisable effects. Data were taken from two cohorts: a multinational European sample (n = 764; 453 autistic; 311 non-autistic; 6–30 years), and a South African sample (n = 100 non-autistic; 3–11 years). An exploratory factor analysis aggregated clinical (Verbal Comprehension and Perceptual Index), adaptive traits (Vineland Adaptive Behaviour Scale) and socio-economic variables (parental employment and education, home and family characteristics) in each cohort separately. With regression, we investigated the effect of these factors and autistic traits on internalising and externalising scores (measured with the Strengths and Difficulties Questionnaire). Cohorts showed similar four-factor structures (Person Characteristics, Family System, Parental and Material Resources). The {\textquoteleft}Family System{\textquoteright} factor captured family size and maternal factors and was associated with lower internalising and externalising symptoms in both cohorts. In the European cohort, high autistic traits reduced this effect; the opposite was found in the South Africa cohort. Our exploratory findings from two separate analyses represent consistent evidence that Family System is associated with internalising and externalising symptoms, with a context-specific impact in persons with high autism traits. Lay Abstract: Autistic individuals are more likely than non-autistic individuals to experience a mental health condition in their lifetime, and this includes externalising and internalising symptoms. We know very little about how different environments and family conditions impact these symptoms for autistic individuals. Improving our understanding of these relationships is important so that we can identify individuals who may be in greater need of support. In this article, we seek to improve our understanding of how environmental and family conditions impact externalising and internalising symptoms in autistic and non-autistic people. To do this, we conducted analyses with two cohorts in very different settings – in Europe and South Africa – to ensure our findings are globally representative. We used advanced statistical methods to establish environmental and family conditions that were similar to each other, and which could be combined into specific {\textquoteleft}factors{\textquoteright}. We found that four similar {\textquoteleft}factors{\textquoteright} could be identified in the two cohorts. These were distinguished by personal characteristics and environmental conditions of individuals, and were named Person Characteristics, Family System, Parental and Material Resources. Interestingly, just {\textquoteleft}Family System{\textquoteright} was associated with internalising and externalising symptoms, and this was the same in both cohorts. We also found that having high traits of autism impacted this relationship between Family System and mental health conditions with opposite directions in the two settings. These results show that characteristics in the Family System are associated with internalising and externalising symptoms, and autistic persons are particularly impacted, reinforcing the notion that family stressors are important to consider when implementing policy and practice related to improving the mental health of autistic people.",

keywords = "autism spectrum disorders, environmental factors",

author = "{Del Bianco}, Teresa and {Lockwood Estrin}, Georgia and Julian Tillmann and Oakley, {Bethany F.} and Daisy Crawley and {San Jos{\'e} C{\'a}ceres}, Antonia and Hannah Hayward and Mandy Potter and Wendy Mackay and Petrusa Smit and {du Plessis}, Carlie and Lucy Brink and Priscilla Springer and Hein Odendaal and Tony Charman and Tobias Banaschewski and Simon Baron-Cohen and Sven B{\"o}lte and Mark Johnson and Declan Murphy and Jan Buitelaar and Eva Loth and Jones, {Emily J.H.}",

note = "Funding Information: This research was funded in whole, or in part, by the Wellcome Trust (Grant number 204706/A/16/Z for GLE), the Medical Research Council (Grant numbers MR/K021389/1 and MR/T003057/1 for EJHJ), UKRI (Grant number MR/S036423/1for EJHJ and TDB), EU / EFPIA / SFARI / Autistica / AUTISM SPEAKS Innovative Medicines Initiative 2 Joint Undertaking (AIMS-2-TRIALS grant n. 777394), Innovative Medicines Initiative 1 Joint Undertaking (EU-AIMS grant n. 115300, financial contributions from the European Union{\textquoteright}s Seventh Framework Programme, grant FP7/2007-2013). The writing of the manuscript was also supported by thee Birkbeck Wellcome Trust Institutional Strategic Support Fund (Career Development Award for TDB). The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. Any views expressed are those of the authors and not necessarily those of the funders.For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. Publisher Copyright: {\textcopyright} The Author(s) 2023.",

year = "2023",

doi = "10.1177/13623613231200297",

language = "English",

journal = "Autism",

issn = "1362-3613",

publisher = "Sage Publications",

}

Del Bianco, T, Lockwood Estrin, G, Tillmann, J , Oakley, BF , Crawley, D, San José Cáceres, A, Hayward, H, Potter, M, Mackay, W, Smit, P, du Plessis, C, Brink, L, Springer, P, Odendaal, H, Charman, T, Banaschewski, T, Baron-Cohen, S, Bölte, S, Johnson, M, Murphy, D, Buitelaar, J, Loth, E & Jones, EJH 2023, 'Mapping the link between socio-economic factors, autistic traits and mental health across different settings', Autism. https://doi.org/10.1177/13623613231200297

TY - JOUR

T1 - Mapping the link between socio-economic factors, autistic traits and mental health across different settings

AU - Del Bianco, Teresa

AU - Lockwood Estrin, Georgia

AU - Tillmann, Julian

AU - Oakley, Bethany F.

AU - Crawley, Daisy

AU - San José Cáceres, Antonia

AU - Hayward, Hannah

AU - Potter, Mandy

AU - Mackay, Wendy

AU - Smit, Petrusa

AU - du Plessis, Carlie

AU - Brink, Lucy

AU - Springer, Priscilla

AU - Odendaal, Hein

AU - Charman, Tony

AU - Banaschewski, Tobias

AU - Baron-Cohen, Simon

AU - Bölte, Sven

AU - Johnson, Mark

AU - Murphy, Declan

AU - Buitelaar, Jan

AU - Loth, Eva

AU - Jones, Emily J.H.

N1 - Funding Information: This research was funded in whole, or in part, by the Wellcome Trust (Grant number 204706/A/16/Z for GLE), the Medical Research Council (Grant numbers MR/K021389/1 and MR/T003057/1 for EJHJ), UKRI (Grant number MR/S036423/1for EJHJ and TDB), EU / EFPIA / SFARI / Autistica / AUTISM SPEAKS Innovative Medicines Initiative 2 Joint Undertaking (AIMS-2-TRIALS grant n. 777394), Innovative Medicines Initiative 1 Joint Undertaking (EU-AIMS grant n. 115300, financial contributions from the European Union’s Seventh Framework Programme, grant FP7/2007-2013). The writing of the manuscript was also supported by thee Birkbeck Wellcome Trust Institutional Strategic Support Fund (Career Development Award for TDB). The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. Any views expressed are those of the authors and not necessarily those of the funders.For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. Publisher Copyright: © The Author(s) 2023.

PY - 2023

Y1 - 2023

N2 - Autistic individuals experience higher rates of externalising and internalising symptoms that may vary with environmental factors. However, there is limited research on variation across settings that may highlight common factors with globally generalisable effects. Data were taken from two cohorts: a multinational European sample (n = 764; 453 autistic; 311 non-autistic; 6–30 years), and a South African sample (n = 100 non-autistic; 3–11 years). An exploratory factor analysis aggregated clinical (Verbal Comprehension and Perceptual Index), adaptive traits (Vineland Adaptive Behaviour Scale) and socio-economic variables (parental employment and education, home and family characteristics) in each cohort separately. With regression, we investigated the effect of these factors and autistic traits on internalising and externalising scores (measured with the Strengths and Difficulties Questionnaire). Cohorts showed similar four-factor structures (Person Characteristics, Family System, Parental and Material Resources). The ‘Family System’ factor captured family size and maternal factors and was associated with lower internalising and externalising symptoms in both cohorts. In the European cohort, high autistic traits reduced this effect; the opposite was found in the South Africa cohort. Our exploratory findings from two separate analyses represent consistent evidence that Family System is associated with internalising and externalising symptoms, with a context-specific impact in persons with high autism traits. Lay Abstract: Autistic individuals are more likely than non-autistic individuals to experience a mental health condition in their lifetime, and this includes externalising and internalising symptoms. We know very little about how different environments and family conditions impact these symptoms for autistic individuals. Improving our understanding of these relationships is important so that we can identify individuals who may be in greater need of support. In this article, we seek to improve our understanding of how environmental and family conditions impact externalising and internalising symptoms in autistic and non-autistic people. To do this, we conducted analyses with two cohorts in very different settings – in Europe and South Africa – to ensure our findings are globally representative. We used advanced statistical methods to establish environmental and family conditions that were similar to each other, and which could be combined into specific ‘factors’. We found that four similar ‘factors’ could be identified in the two cohorts. These were distinguished by personal characteristics and environmental conditions of individuals, and were named Person Characteristics, Family System, Parental and Material Resources. Interestingly, just ‘Family System’ was associated with internalising and externalising symptoms, and this was the same in both cohorts. We also found that having high traits of autism impacted this relationship between Family System and mental health conditions with opposite directions in the two settings. These results show that characteristics in the Family System are associated with internalising and externalising symptoms, and autistic persons are particularly impacted, reinforcing the notion that family stressors are important to consider when implementing policy and practice related to improving the mental health of autistic people.

AB - Autistic individuals experience higher rates of externalising and internalising symptoms that may vary with environmental factors. However, there is limited research on variation across settings that may highlight common factors with globally generalisable effects. Data were taken from two cohorts: a multinational European sample (n = 764; 453 autistic; 311 non-autistic; 6–30 years), and a South African sample (n = 100 non-autistic; 3–11 years). An exploratory factor analysis aggregated clinical (Verbal Comprehension and Perceptual Index), adaptive traits (Vineland Adaptive Behaviour Scale) and socio-economic variables (parental employment and education, home and family characteristics) in each cohort separately. With regression, we investigated the effect of these factors and autistic traits on internalising and externalising scores (measured with the Strengths and Difficulties Questionnaire). Cohorts showed similar four-factor structures (Person Characteristics, Family System, Parental and Material Resources). The ‘Family System’ factor captured family size and maternal factors and was associated with lower internalising and externalising symptoms in both cohorts. In the European cohort, high autistic traits reduced this effect; the opposite was found in the South Africa cohort. Our exploratory findings from two separate analyses represent consistent evidence that Family System is associated with internalising and externalising symptoms, with a context-specific impact in persons with high autism traits. Lay Abstract: Autistic individuals are more likely than non-autistic individuals to experience a mental health condition in their lifetime, and this includes externalising and internalising symptoms. We know very little about how different environments and family conditions impact these symptoms for autistic individuals. Improving our understanding of these relationships is important so that we can identify individuals who may be in greater need of support. In this article, we seek to improve our understanding of how environmental and family conditions impact externalising and internalising symptoms in autistic and non-autistic people. To do this, we conducted analyses with two cohorts in very different settings – in Europe and South Africa – to ensure our findings are globally representative. We used advanced statistical methods to establish environmental and family conditions that were similar to each other, and which could be combined into specific ‘factors’. We found that four similar ‘factors’ could be identified in the two cohorts. These were distinguished by personal characteristics and environmental conditions of individuals, and were named Person Characteristics, Family System, Parental and Material Resources. Interestingly, just ‘Family System’ was associated with internalising and externalising symptoms, and this was the same in both cohorts. We also found that having high traits of autism impacted this relationship between Family System and mental health conditions with opposite directions in the two settings. These results show that characteristics in the Family System are associated with internalising and externalising symptoms, and autistic persons are particularly impacted, reinforcing the notion that family stressors are important to consider when implementing policy and practice related to improving the mental health of autistic people.

KW - autism spectrum disorders

KW - environmental factors

UR - http://www.scopus.com/inward/record.url?scp=85174034881&partnerID=8YFLogxK

U2 - 10.1177/13623613231200297

DO - 10.1177/13623613231200297

M3 - Article

C2 - 37822256

AN - SCOPUS:85174034881

SN - 1362-3613

JO - Autism

JF - Autism

ER -

Mapping the link between socio-economic factors, autistic traits and mental health across different settings

Abstract

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this