Compulsion Profile Differences Indicate Distinct Functional Mechanisms in Autistic and Non-Autistic University...

Area of Science:

• Neurodevelopmental Disorders
• Psychiatry
• Clinical Psychology

Background:

• Autistic individuals frequently experience obsessive-compulsive symptoms (OCS).
• Traditional cognitive-behavioral therapy (CBT), particularly exposure and response prevention (ERP), shows limited efficacy in autistic populations.
• Autistic compulsions may serve ego-syntonic functions like regulation or sensory modulation, unlike ego-dystonic, anxiety-reducing compulsions in OCD.

Purpose of the Study:

• To investigate the functional differences of compulsions in autistic individuals compared to non-autistic individuals with high and low OCS.
• To determine if autistic compulsions are primarily linked to regulation/sensory modulation or anxiety reduction.

Main Methods:

• Factor analysis of seven Yale-Brown Obsessive-Compulsive Scale items (Y-BOCS-I) in autistic students (n=39) and non-autistic students (n=50) with varying OCS levels.
• Chi-square analyses to compare the prevalence of different compulsion types across groups.
• Correlation analysis between anxiety levels and OCS in autistic versus non-autistic participants.

Main Results:

• Factor analysis identified two distinct compulsion factors: regulatory/sensory (Repetition, Counting, Hoarding) and anxiety-reduction (checking, organizing).
• Autistic students reported significantly more regulatory/sensory compulsions than low-OCS controls.
• Autistic students reported fewer anxiety-reduction compulsions than both non-autistic groups, with no significant correlation between anxiety and OCS.

Conclusions:

• Compulsions in autism appear to stem from different functional mechanisms than those in classical obsessive-compulsive disorder (OCD).
• The weaker link to anxiety suggests that standard ERP-based CBT may not be optimally suited for autistic individuals.
• Findings necessitate tailored diagnostic and therapeutic approaches for OCS in autistic populations.