Emotion Regulation and Behavioral Problems in Children with Autism Spectrum Disorder: A University Hospital Based Cross-Sectional Study

Objective: The objectives of this study were to investigate behavioral problems and emotion regulation in children with autism spectrum disorder (ASD) with and without psychiatric comorbidities, and to assess the correlation between emotion regulation and behavioral problems. Materials and Methods: Participants included 65 children with ASD (ASD group) and 65 children with ASD and psychiatric comorbidities (ASD+CPD group), aged 6 to 12, and their caretakers. Emotion regulation was assessed by the Emotion Regulation Checklist (ERC). Behavioral problems were assessed by the Strengths and Difficulties Questionnaire (SDQ). Results: An independent sample T-test revealed that the ASD+CPD group had poorer emotion regulation, greater emotion lability/negativity, and a higher total difficulty score when compared to the ASD group. The Pearson’s Correlation Coefficient indicated that emotion regulation (r = -0.47, p<0.05) and lability/negativity (r = 0.65, p<0.05) correlated with the total difficulties score of the SDQ. A multiple regression analysis revealed that lower emotion regulation and higher emotion lability/negativity predicted an increase in behavioral problems (R2 = 0.44, p<0.05). Conclusions: We found that children with ASD and psychiatric comorbidities had poorer emotion regulation and more behavioral problems than those without comorbidities, and that poorer emotion regulation predicts behavioral problems. These results indicate that children with ASD should be assessed for psychiatric comorbidities, particularly those who have emotional dysregulation and behavioral problems.