Document Type


Date of Degree

Spring 2016

Degree Name

PhD (Doctor of Philosophy)

Degree In

Psychological and Quantitative Foundations

First Advisor

Susan Assouline

Second Advisor

William Liu

First Committee Member

Stewart Ehly

Second Committee Member

Kathryn Gerken

Third Committee Member

Sato Ashida

Fourth Committee Member

Todd Kopelman


The most common comorbid disorder for adolescents with autism spectrum disorder (ASD) is depression, with more severe symptoms demonstrated in those with high cognitive ability. Feelings of loneliness are associated with depression. There is a dearth of information regarding pertinent variables for loneliness of friendship quality, friendship motivation, and social skills in high ability adolescents with ASD.

This study employs a multiple case study design with 10 twice-exceptional adolescent males with high cognitive ability and ASD (ages 13-9 to 18-11) to investigate these variables. Adolescent, parent, and teacher interviews were completed, transcribed, and analyzed using Consensual Qualitative Research (CQR).

Results describe friendship quality for these youth, with particular contributions to current understanding of companionship, security, help, closeness and balance. Findings inform friendship motivation, as well, and etiologies of amotivation are documented. Results indicate positive and negative influences of high intelligence on interpersonal functioning, along with immaturity and symptoms of rigidity affecting friendships, as well.

Pathway analyses reveal twice-exceptional youth with insecure friendships experience loneliness and introjected motivation for friendships, along with increases in peer dyadic relationships and decreases in loneliness. Those with insecure friendships and perseverative interest in peers also present with suicidal ideation and/or attempts.

Future research should expand the use of individual therapies (i.e., cognitive behavioral therapy for depression) for these twice-exceptional teens, particularly in middle school, with modifications to accommodate difficulties with perseveration on negative emotions, as well as explore coping strategies of engaging with fictional characters when lonely.

Public Abstract

The most common co-occurring difficulty for adolescents with autism spectrum disorder (ASD) is depression, with more severe symptoms demonstrated in teens with high intelligence. Depression is linked with feelings of loneliness. There is not a lot known about loneliness and the influences of quality of friendship, reasons for friendships, and social skills in adolescents with high intelligence and ASD.

Multiple case studies of 10 adolescent males with high intelligence and ASD (ages 13-9 to 18-11) were used to understand these variables. Teens, a parent and a teacher were interviewed to give information about friendship and loneliness. Interviews were reviewed by a research team and auditor, until results were agreed upon, using a method of Consensual Qualitative Research (CQR).

Results describe friendship quality, with new understanding of companionship, security, help, closeness and balance. Results indicate reasons why these teens want friendships or want to be alone. They are immature and have difficulty being flexible, which affects their friendships. Their intelligence has good and bad influences on their friendships, too. Teens in the study whose friendships are not stable experience loneliness and want friends to avoid feeling bad. Then they gain friends and lower feelings of loneliness. If they also obsess about peers, they may think about hurting themselves.

There should be more research on therapies to help these teens, especially in middle school, that should be designed to help them avoid strong, upsetting feelings. One strategy to learn more about includes thinking about favorite fictional characters to keep from feeling lonely.


publicabstract, adolescent, ASD, friendship, friendship motivation, loneliness, twice-exceptional


xi, 207 pages


Includes bibliographical references (pages 186-207).


Copyright 2016 Amanda Berns