The relationship between alexithymia and self-esteem in autistic adolescents

Background: Research suggests autistic adolescents experience lower self-esteem and higher cognitive alexithymia than non -autistic adolescents. Heightened cognitive alexithymia has been associated with lower self-esteem in non -autistic adolescents but remains unexamined in autistic populations. This study aimed to examine whether autism diagnosis and alexithymia subscales significantly predicted self-esteem. Method: Data were collected from 102 participants (53 autistic and 49 non-autistic adolescents) using the Rosenberg Self -Esteem Scale, Bermond-Vorst Alexithymia Questionnaire, and the Autism Quotient. Results: Our results found that compared to non -autistic adolescents, autistic adolescents report lower self-esteem (F-(1,F- 99)= 8.79, p < .005, eta(2)= .08), and higher cognitive alexithymia (F-(1,F- 99)= 22.51, p < .001, eta(2)= .19), but not affective alexithymia (F-(1,F- 99)= .50, p = .481, eta(2)< .01). Additionally, we found evidence that autism diagnosis (b=-2.86, SE=0.99, p = .005) and cognitive alexithymia (b=-0.30, SE=0.10, p = .003), but not affective alexithymia, predicted lower self-esteem. The addition of cognitive alexithymia to the model removed the significance of diagnosis (b=-1.31, SE=1.02, p = .201). This model accounted for 26% of variance (R-2=.26, F-(7,F- 94)= 4.77, p < .001). Exploratory mediation analysis revealed that cognitive alexithymia significantly mediated the relationship between autistic traits and self-esteem (b=-0.10, SE=0.03, CI [-0.16, -0.49], p < .001), accounting for 22.93% of variance, and removing any direct effect. Conclusion: The results suggest that autistic adolescents experiencing difficulties identifying emotions are more likely to have lower self-esteem than autistic adolescents that report less difficulty identifying emotions. Assessing autistic adolescents for alexithymia and providing support to identify emotions may result in more effective support for low self-esteem.