The Role of Decision-Making in Psychological Wellbeing and Risky Behaviours in Autistic Adolescents Without ADHD: Longit
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ORIGINAL PAPER
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 Hosozawa1,2 · William Mandy3 · Noriko Cable1 · Eirini Flouri4 Accepted: 4 November 2020 © The Author(s) 2020
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 decisionmaking 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. Keywords Autism spectrum disorder · Decision-making · Gambling task · Adolescence · Psychological wellbeing · Antisocial behaviours
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10803-020-04783-y) contains supplementary material, which is available to authorized users. * Eirini Flouri [email protected] Mariko Hosozawa [email protected] William Mandy [email protected] Noriko Cable [email protected] 1
Department of Epidemiology and Public Health, University College London, London, UK
2
Department of Paediatrics and Adolescent Medicine, Juntendo University, Tokyo, Japan
3
Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
4
Department of Psychology and Human Development, UCL Institute of Education, University College London, London, UK
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, also 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). Such challen
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