Examining the Relationship Between Social Motivation and Internalizing Symptoms in Autistic People: A Systematic Review and Meta-Analysis.

This large research review looked at how social motivation (interest in social interactions) relates to mental health problems like anxiety and depression in autistic people. After combining results from 14 studies involving over 4,500 people, researchers found that autistic individuals who struggle more with social motivation tend to have higher levels of anxiety, depression, and social anxiety. This relationship was consistent across different ages and genders, suggesting that supporting social motivation could help improve mental health outcomes.

This systematic review and meta-analysis examined the relationship between social motivation and internalizing symptoms (anxiety, depression, social anxiety) in autistic individuals across the lifespan. The analysis included 14 studies with 4,590 participants. Results showed that greater difficulties with social motivation were associated with increased anxiety, depression, and social anxiety, with moderate effect sizes across all domains. The relationship remained stable regardless of age, sex, or study quality, suggesting social motivation may be a transdiagnostic target for intervention.

The findings support the social motivation theory and highlight the potential vulnerability of autistic individuals with low social motivation to developing internalizing difficulties.

Social motivation may represent a transdiagnostic intervention target for reducing internalizing difficulties in autistic individuals. The stability of findings across age and sex suggests interventions targeting social motivation could be broadly applicable across the autism spectrum and lifespan, potentially helping prevent or reduce anxiety and depression.

The abstract does not specify limitations of the included studies, heterogeneity measures, or potential publication bias. Sample characteristics and age ranges of participants are not detailed. The specific measures used to assess social motivation and internalizing symptoms across studies are not described.

The social motivation theory hypothesizes that autistic individuals' experience diminished social motivation due to reduced social reward, social orienting, and social maintaining. Low social motivation has been linked to increased vulnerability to internalizing difficulties within this population. This systematic review and meta-analysis examined the relationship between social motivation and internalizing symptoms across the lifespan in autistic individuals. Relevant research papers until February 2025 were identified by searching EMBASE, PsycINFO, PubMed, and Web of Science databases (PROSPERO protocol: CRD42024547863).

The systematic review included 14 studies (n = 4590). A total of three meta-analyses were run using Pearson's correlation coefficients between social motivation and (1) anxiety, (2) depression, and (3) social anxiety, and the moderating effect of age, sex, and study quality were assessed using meta-regressions. Sensitivity analyses were run to assess whether one study was influencing the results of the meta-analysis. Greater difficulties with social motivation are associated with increased anxiety, depression, and social anxiety, with a moderate pooled effect size across all domains.

Sensitivity analyses did not significantly alter any of the results. Age, sex, and quality of study were nonsignificant moderators. Reduced social motivation may be associated with an increased vulnerability to internalizing difficulties in autistic individuals. The stability across age, sex, and study quality highlights social motivation as a potential transdiagnostic target for intervention in autistic individuals.