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The Watson Institute
Self-report of Co-morbid Depression in Autism Spectrum Disorders
Lindsy Yarger, M.A., Julie Knapp, Ph.D., and Joseph McAllister, Jr. Ph.D.
Adolescents with autism spectrum
disorders are at greater risk for
developing depression when compared
to children without an autism spectrum
disorder (Barnhill, 2001; Ghaziuddin et
al., 1998; Tantam, 1991). Research
indicates as many as 38% of children
with autism spectrum disorders also
suffer from depression (Stewart et al.,
2006; Lainhart, 1999). As children with
autism spectrum disorders have
difficulty identifying and expressing their
emotions, they may not be able to
accurately label and interpret their
feelings on standardized measures.
Therefore, clinicians should be guarded
when using psychological instruments
that require the child to self-identify their
depressive symptomatology as a means
of diagnosing co-morbid depression.
Instead they should consider alternative
sources for diagnosing depression.
PARTICIPANTS / METHODS
Subject Group (ASD)
• Children between the ages of 6 and 17 who
had been diagnosed with an Autism
Spectrum Disorder and Depression. N=13
Control Group (NASD)
• Children between the ages of 6 and 17 that
have not been diagnosed with an Autism
Spectrum Disorder but have been
diagnosed with Depression. N=8
Assessment Measures
• Children’s Depression Inventory (CDI)
• Achenbach Child Behavior Checklist (CBCL)
RESULTS
Group Differences on CDI Mean scores
CDI Total
Negative Mood
Interpersonal/Prob
Ineffectiveness
Anhedonia
Negative Self Esteem
ASD
NASD
p Value
56.2
59.3
54.0
53.0
56.8
54.2
62.1
60.7
58.4
63.4
59.8
58.4
.25
.37
.064
.20
.40
.66
66
64
62
T-Scores
INTRODUCTION
60
ASD
58
NASD
56
54
52
HYPOTHESES
50
• Children in the ASD group will have a
lower Total CDI score than the control group
• Parents in the ASD group will report more
symptoms of depression than their children
CDI Total
Negative Mood
Interpersonal
Problems
Ineffectiveness
Anhedonia
Negative SelfEsteem
CDI Scales
Group Differences on CBCL Mean Scores
CBCL Anxious Depressed
CBCL Withdrawn/Depressed
CBCL Affective
ASD
NASD
P Value
69.8
71.4
71.2
62.1
57.9
67.9
.41
.09
.65
PURPOSE
CONCLUSIONS/FUTURE RESEARCH
The purpose of the research is to study
the ability of children with autism to
recognize their own internal state of
depression. This study attempted to
determine differences in self-report
depressive symptoms in Autism
Spectrum and Non-Autism Spectrum
groups who were independently
diagnosed with depression.
Results did not indicate statistically significant differences between the Total CDI
score for the ASD group and the NASD group. However, results did indicate that
children in the NASD group consistently received higher T-Scores across scales
on the CDI, indicating that they are more likely to report their depressive
symptoms then children with ASD. Results also indicate that parents of ASD
 Increase
the sampleonsize
children consistently reported more symptoms
of depression
the CBCL than
 Use
the parent
versionwith
of the
CDI
the NASD parents. These results may
indicate
that children
ASD
have a more
difficult time identifying their emotions on self-report measures. Future research
should include a larger sample size and the use of the Parent CDI to measure
depression rather than the CBCL.