Exploring the Relationships Between Theory of Mind, Social Skills, and Friendship Quality in Adolescents and Adults With and Without Autism Spectrum Disorder Through Structural Equation Modeling

This study examined friendship quality and theory of mind (ToM) in individuals with autism spectrum disorder (ASD) compared to non-autistic peers, and the influence of ToM, social skills, and problem behaviors on friendships. Participants included adolescents/young adults with ASD (N = 104; Male: 74, M_age = 18.55 years) and without ASD (N = 192; Male: 101, M_age = 16.65 years). Data were collected using measures of ToM, autistic traits, social skills, problem behaviors, and friendship quality. Independent samples t-tests and Pearson correlations were used to characterize group differences and variable relationships. Multi-group structural equation modeling (SEM) was employed to examine the roles of social skills and problem behaviors in the relationship between ToM and friendship quality across groups. Individuals with ASD reported lower friendship quality, with less companionship, help, security, and closeness, experienced more conflicts in friendships than their non-autistic peers, and exhibited lower ToM performance. Multi-group SEM indicated significant positive effects of ToM on social skills in both groups, with a stronger effect observed in ASD. Additionally, there was a significant direct effect of ToM on friendship quality, with social skills mediating this relationship in the ASD group. Conversely, the negative direct effect of problem behaviors on friendship quality was significant only in individuals without ASD. The findings provide insights into the social cognitive and behavioral processes that influence friendship quality in individuals with ASD and emphasize the importance of targeted interventions aimed at enhancing social skills and ToM abilities in this population.