The most common comorbid disorder for adolescents with autism spectrum disorder (ASD) is depression, with more severe symptoms demonstrated in those with high cognitive ability. Feelings of loneliness are associated with depression. There is a dearth of information regarding pertinent variables for loneliness of friendship quality, friendship motivation, and social skills in high ability adolescents with ASD.
This study employs a multiple case study design with 10 twice-exceptional adolescent males with high cognitive ability and ASD (ages 13-9 to 18-11) to investigate these variables. Adolescent, parent, and teacher interviews were completed, transcribed, and analyzed using Consensual Qualitative Research (CQR).
Results describe friendship quality for these youth, with particular contributions to current understanding of companionship, security, help, closeness and balance. Findings inform friendship motivation, as well, and etiologies of amotivation are documented. Results indicate positive and negative influences of high intelligence on interpersonal functioning, along with immaturity and symptoms of rigidity affecting friendships, as well.
Pathway analyses reveal twice-exceptional youth with insecure friendships experience loneliness and introjected motivation for friendships, along with increases in peer dyadic relationships and decreases in loneliness. Those with insecure friendships and perseverative interest in peers also present with suicidal ideation and/or attempts.
Future research should expand the use of individual therapies (i.e., cognitive behavioral therapy for depression) for these twice-exceptional teens, particularly in middle school, with modifications to accommodate difficulties with perseveration on negative emotions, as well as explore coping strategies of engaging with fictional characters when lonely.