Investigation of the Association Between Autistic Traits and Emotion Dysregulation, Eating Behaviors and Internet Addiction in Pediatric Obesity

Abstract

Objectives: To investigate the frequency of autistic traits (ATs) among adolescents with obesity and their association with uncontrolled/ emotional eating, internet addiction, and emotion recognition/regulation skills. Materials and Methods: Among 77 adolescents with obesity (62.3% girls, 16.2±2.1 years), ATs were assessed using the social responsiveness scale (SRS) completed by their parents. Participants filled the Three-factor eating questionnaire (TFE), internet addiction test (IAT), and emotion regulation difficulties scale (DERS). Participants’ emotion recognition skill was evaluated by DANVA facial emotion recognition test-2 (DANVA-2) and reading mind in the eyes test (RMET). Results: In total, 15.6% of adolescents with obesity had mild ATs, 24.7% had moderate ATs, and 18.1% had severe ATs. Compared with the ATs group (SRS t-score <60, n=32), the ATs+ group (SRS t-score ≥60, n=45) had significantly higher standardized body mass index (BMI) (U=438,000, p=0.007), TFE-uncontrolled eating [t(74)=2.138, p=0.01], TFE-emotional eating (U=454,500, p=0.006), DERS-Total [t(74)=3.790, p<0.001] and IAT [t(69)=2.33, p=0.01] scores. However, the DANVA-2 and RMET scores did not differ between the groups. The association between SRS and IAT (direct B=0.09, p=0.4; indirect B=0.205, p=0.002; total effect B=0.301, p=0.002) and SRS and uncontrolled/emotional eating (direct B=0.178, p=0.07; indirect B=0.170, p=0.003, total effect B=0.349, p<0.001) were totally mediated by DERS. Conclusion: 58.4% of adolescents with obesity had at least mild ATs. Those with ATs showed significantly higher standardized BMI, internet addiction, and dysfunctional eating behaviors than those without. We demonstrated that these youth have more difficulty regulating emotions than understanding emotions. Emotion dysregulation fully mediated the relationship between ATs, uncontrolled eating, and internet addiction.