Sex differences in the course of autistic and co-occurring psychopathological symptoms in adolescents with and without autism spectrum disorder.

This study followed teenagers with mild autism and compared them to typical teenagers from age 11 to 22. Researchers found that boys with autism initially had more repetitive behaviors and difficulty with change, but girls caught up over time. Both autistic and non-autistic girls showed more mood and anxiety problems as they got older, suggesting this is a general pattern for teenage girls rather than something specific to autism.

This longitudinal study examined sex differences in autistic symptoms and co-occurring psychiatric symptoms from ages 11-22 years, comparing adolescents with milder autism spectrum disorder to a general population control group matched for IQ and socioeconomic status. The research tracked five assessment points to understand how symptoms change over time. Key findings indicate that autism-specific sex differences are primarily confined to repetitive/stereotyped behaviors, with males showing higher initial scores in sensory/stereotypic behaviors and resistance to change. However, females with autism showed increasing resistance to change over time, eliminating this sex difference by late adolescence.

Increased mood and anxiety problems in females were observed in both autism and general population groups, suggesting this pattern is not autism-specific but reflects broader developmental trends.

Clinical assessment and intervention should consider that sex differences in core autism symptoms are subtle and primarily affect repetitive behaviors. Mental health support for autistic females should address mood and anxiety concerns that reflect broader adolescent development patterns. Ongoing monitoring during adolescence is important as symptom presentations may change over time, particularly resistance to change in females.

Sample size not reported. Study focused on milder forms of ASD, limiting generalizability to the full autism spectrum. The abstract does not specify assessment tools used or statistical methodology details, making it difficult to evaluate measurement validity and analytical rigor.

There is an ongoing debate as to whether autism spectrum disorder (ASD) is expressed differently in women than men. Studies on sex differences in autistic symptoms and symptoms of other psychiatric problems present in individuals with autism generally do not include a general population comparison group, making it unclear whether differences are specific to autism or merely reflecting development in the general population. In this study, we compared sex differences in the course of autistic and at the same time present symptoms of other psychiatric problems in adolescents with milder forms of ASD to those in a group of the general population with an equal intelligence quotient (IQ) and socioeconomic status. Data of five assessment moments from ages 11 to 22 years were analyzed using a statistic procedure that allowed us to determine which factors affect the course of symptoms over time.

We found that in adolescence, sex differences in the course of psychopathological symptoms specific for autism are confined to the repetitive stereotyped domains. Males had higher scores on the sensory/stereotypic and resistance to change domains, the latter difference disappeared during the course of adolescence due to an increase of these problems in autistic females. Other sex differences, among which an increase over time in mood and anxiety problems in females was the most outstanding, were also observed in females without autism. These sex-specific differences have relevance in the clinical care of autistic men and women, although they are subtle compared to differences between individuals with and without autism.