The Role of Decision-Making in Psychological Wellbeing and Risky Behaviours in Autistic Adolescents Without ADHD: Longitudinal Evidence from the UK Millennium Cohort Study

Mariko Hosozawa,William Mandy,Noriko Cable,Eirini Flouri

doi:10.1007/s10803-020-04783-y

Mariko Hosozawa, William Mandy + Show 2 more

Open Access

https://doi.org/10.1007/s10803-020-04783-y

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Abstract

This study examined the development of decision-making and its association with psychological wellbeing and risky behaviours in adolescents with and without autism. Participants included 270 autistic and 9,713 typically developing adolescents. In both samples, those with a diagnosis of attention-deficit/hyperactivity disorder (ADHD) were excluded. Data came from the Millennium Cohort Study, a nationally representative population-based birth cohort. Decision-making was assessed using the Cambridge Gambling Task at ages 11 and 14. Psychological wellbeing (happiness, self-esteem, depressive symptoms and self-harm) and risky/antisocial behaviours were self-reported at age 14. After adjusting for sex, cognitive ability, spatial working memory, socioeconomic status and pubertal status, autistic adolescents showed comparable quality of decision-making to that of their peers at both ages but also a more deliberative decision-making style as they aged. Only in autistic adolescents was this decision-making style associated with positive outcomes.

Highlights

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulties in social interaction, communication and flexibility, as well as atypical sensory processing (American Psychiatric Association, 2013)
A recent metaanalysis of studies using the Iowa Gambling Task (IGT), a widely used gambling task in studies of both typically developing individuals and those with neurodevelopmental conditions including ASD, showed that autistic people do not differ in IGT performance (Zeif & Yechiam, 2020)
Our participants were drawn from the Millennium Cohort Study (MCS), a population-representative cohort study of 19,517 children born between September 2000 and January 2002 in the UK

Summary

Introduction

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulties in social interaction, communication and flexibility, as well as atypical sensory processing (American Psychiatric Association, 2013). Autistic children and adults, including those without intellectual impairment, self-report difficulties in decision-making (Johnson, Yechiam, Murphy, Queller, & Stout, 2006; Luke, Clare, Ring, Redley, & Watson, 2012) These difficulties have, in turn, been suggested to at least partially explain the significant challenges experienced by many autistic people in their adulthood (e.g., low likelihood of independent living, high risk of unemployment, low self-determination and poor quality of life) (Chou, Wehmeyer, Palmer, & Lee, 2016; Robic et al, 2015; Shattuck et al, 2012). We expected that it would be associated with less risky behaviour in them

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