Metacognitive awareness of affect and internalizing symptoms in autism spectrum disorder

Abstract

The present study examined the social metacognitive awareness functioning in adolescents with Autism Spectrum Disorder (ASD) and its relation to mental health with a two-part study. In the two studies, ASD and neurotypical adolescents aged between 12 to 18 years old were recruited and asked to complete a computer task. Their parents were invited to fill in a set of questionnaire measures tapping their children’s ASD symptom, peer relationship quality, and social anxiety and depression related variables. In the first study, an advanced metacognitive awareness measure was validated by participants’ performance on the computer task, which involved a facial affect recognition followed by a confidence rating task. It was found that the ASD adolescents presented impaired metacognitive awareness as compared to the typically developing controls (TD). In the second study, ASD youths with high and low metacognitive awareness functioning were compared on their internalizing problems. Data from metacognitive computer measure and parental questionnaire indicated that the high group presented elevated social anxiety as compared to the low group. Overall, the result across the two studies lent support to the hypothesis that metacognitive functioning in ASD adolescents is impaired. It also confirmed the role of metacognitive awareness functioning in ASD individuals in affecting the mental health outcomes. The results suggest that those with high level of metacognitive awareness could be at risk of developing social anxiety when they are more aware of their social deficit. The clinical implication of the results was discussed.