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<p>Autism is characterized by marked heterogeneity in behavioral presentation and high rates of co-occurring psychiatric symptoms, which hinder diagnostic precision, personalized intervention, and long-term quality of life. Approach and withdrawal behaviors—subserved by core motivational systems underlying action and emotion—may serve as transdiagnostic processes linking autism with common co-occurring conditions in childhood. Guided by this framework, we examined how autism-related approach–withdrawal behaviors interrelate and connect to internalizing and externalizing symptoms. Using data from 280 autistic children aged 6 to 11 years enrolled in the Autism Biomarkers Consortium for Clinical Trials, we constructed a Gaussian graphical model of approach–withdrawal behaviors. Core behaviors were identified using expected influence centrality. Autism, when conceptualized as a system of interconnected approach–withdrawal behaviors, was positively associated with common co-occurring psychiatric conditions, with strongest associations observed for anxiety and attention-deficit/hyperactivity disorder. Affect regulation–related nodes were most relevant to internalizing symptoms, whereas arousal regulation and sensory nodes were uniquely related to externalizing symptoms. These findings integrate transdiagnostic theories of approach-withdrawal motivation with network analysis and highlight clinically relevant targets for diagnostic refinement and intervention.</p>

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Conceptualizing Autism as a Behavioral Network: Transdiagnostic Associations with Co-occurring Psychiatric Conditions

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年3月14日

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  • Gloria T. Han,
  • Shashwat Kala,
  • Adam Naples,
  • Geraldine Dawson,
  • Susan Faja,
  • Frederick Shic,
  • Sara Jane Webb,
  • Catherine A. Sugar,
  • Shafali Jeste,
  • Natalia Kleinhans,
  • Katarzyna Chawarska,
  • Raphael Bernier,
  • James Dziura,
  • James C. McPartland

摘要

Autism is characterized by marked heterogeneity in behavioral presentation and high rates of co-occurring psychiatric symptoms, which hinder diagnostic precision, personalized intervention, and long-term quality of life. Approach and withdrawal behaviors—subserved by core motivational systems underlying action and emotion—may serve as transdiagnostic processes linking autism with common co-occurring conditions in childhood. Guided by this framework, we examined how autism-related approach–withdrawal behaviors interrelate and connect to internalizing and externalizing symptoms. Using data from 280 autistic children aged 6 to 11 years enrolled in the Autism Biomarkers Consortium for Clinical Trials, we constructed a Gaussian graphical model of approach–withdrawal behaviors. Core behaviors were identified using expected influence centrality. Autism, when conceptualized as a system of interconnected approach–withdrawal behaviors, was positively associated with common co-occurring psychiatric conditions, with strongest associations observed for anxiety and attention-deficit/hyperactivity disorder. Affect regulation–related nodes were most relevant to internalizing symptoms, whereas arousal regulation and sensory nodes were uniquely related to externalizing symptoms. These findings integrate transdiagnostic theories of approach-withdrawal motivation with network analysis and highlight clinically relevant targets for diagnostic refinement and intervention.