(PS2-58) Exploring How Gender Moderates the Relationship Between Loneliness and Externalizing Behaviors in Autistic Adolescents

Abstract Text: While loneliness is widespread among adolescents globally (Kim et al., 2025), autistic teens experience elevated levels of loneliness and social isolation compared to their non-autistic peers (Deckers et al., 2017). Although loneliness is commonly connected to internalizing difficulties, such as depression, in autistic youth (Schiltz et al., 2020), research in non-autistic youth suggests a connection between loneliness and externalizing behaviors (Wang et al., 2024; Wang et al., 2025). Similarly, social difficulties predict externalizing behaviors in autistic youth (Shea et al., 2018), suggesting that emotional dysregulation and social frustration may contribute to externalizing problems, such as aggression or impulsivity. However, the direct relationship between loneliness and externalizing behaviors in autism has not yet been examined, particularly in the context of gender differences. This is critical given the presence of gender differences in both social behavior and emotion dysregulation in autistic populations (McDonald et al., 2024; Dean et al., 2023; Ee et al., 2019; Hull et al., 2019), with autistic females more likely to engage in camouflaging behaviors to minimize social differences and exhibit greater emotional dysregulation.

This study examined whether gender moderates the relationship between loneliness and externalizing behaviors in autistic adolescents.

Participants included 137 adolescents from the ages of 10 to 18 (Mage=14.06, SD=1.9; 74.5% male, 25.5% female) who attended the evidence-based PEERS® for Adolescents social skills program. Caregiver report on the externalizing subscale of the Social Skills Improvement System (SSIS-Ext; Gresham & Elliott, 2008) measured externalizing behaviors at baseline. Loneliness was assessed via self-report on the Loneliness and Social Dissatisfaction Questionnaire (L&SD; Asher & Wheeler, 1985). A multiple regression model examined gender as a moderator, using loneliness, gender, and their interaction as predictors of externalizing behaviors.

Preliminary independent samples t-tests indicated no significant differences between autistic males and females in externalizing behaviors, t(134)=0.65, p=.519, or loneliness, t(134)=0.67, p=.506. In the full sample, there was also no significant correlation between loneliness and externalizing behaviors, r=.121, p=.163. The regression model indicated a non-significant interaction between gender and loneliness, t(129)=-0.62, p=.538, showing no significant gender differences in the relationship between loneliness and externalizing behaviors.

Results indicated no significant differences in externalizing behaviors or loneliness between autistic male and female adolescents, nor a significant relationship between the two variables overall. This contrasts with existing evidence that loneliness is a significant positive predictor of externalizing behaviors among non-autistic adolescents (Wang et al., 2024; Wang et al., 2025), suggesting that experiences of loneliness and associated sequelae may differ in autistic populations. Future research should further explore these relationships to inform clinical care and recommendations for autistic youth.