A Network Analysis of Alexithymia, Interoception, Empathy, Self-Awareness and Psychopathological Symptoms in Young People With Autism Spectrum Disorder.

Autism Spectrum Disorder (ASD) is associated with altered interoception, empathy, self-awareness, and alexithymia. However, limited research has been conducted to investigate the interrelationships of these constructs with psychopathological symptoms. A prior network analysis in college students examined the interrelationship of these constructs and demonstrated that cognitive empathy and alexithymia influenced interoception and autistic features. We aimed to examine the interrelationships of these constructs in people with clinical ASD using network analysis. We recruited 208 young people aged 15-25 with Autism Diagnostic Observation Schedule (ADOS-2) confirmed diagnosis of ASD and administered self-report measures for interoception, empathy, self-awareness, and alexithymia. We constructed a regularized partial correlation network. The results showed the alexithymia node of "difficulty-describing-feelings-to-others" (expected influence (EI) = 0.854), interoceptive awareness (strength = 1.273; EI = -0.084), depressive symptoms (EI = 0.537), and anxiety symptoms (EI = 0.652) were important nodes. Our findings suggested that alexithymia, depressive, and anxiety symptoms influenced empathy, self-awareness, and autistic features in people with ASD and supported the important role of interoception in the network.