Sex Differences in Autism Symptoms and Mental Health Difficulties in Adolescents with Rare Genetic Disorders

Adolescents with rare genetic disorders often display autism traits and mental health difficulties. Sex differences have been identified for mental health symptoms, including comorbidity with autism difficulties, among autistic youth. However, these sex differences may differ with rare genetic ethology and have yet to be examined in rare genetic disorders. Therefore, the aim of this study was to examine sex differences in mental health difficulties and autism symptoms among adolescents with rare genetic disorders.

Adolescents with rare genetic disorders (N = 93 M_age = 13.2 years, SD = 2.4, 60.2% females, 39.8% males) were assessed with parent-reports on the Child Behavior Checklist, the Social Communication Questionnaire, and the Social Responsiveness Scale.

Males displayed more total autism characteristics and externalizing difficulties compared with females (Hedges g = 0.44-0.71). Within autism subdomains, males displayed more restrictive and repetitive behaviors and social communication difficulties compared with females (Hedges g = 0.43-0.63). In examining interaction effects, females were found to have a stronger relationship between restrictive and repetitive behaviors and total mental health and externalizing behaviors than males on the Social Communication Questionnaire.

The sex differences typically found with idiopathic autism could be extended to a sample of adolescents with a known genetic likelihood of autism traits. Among adolescents with rare genetic conditions, autism symptoms may be more strongly associated with mental health difficulties in females compared with males.