A Cross-Lagged Panel Model of Mental Health Amongst UK Undergraduates: The Role of Autism and Gender

Abstract Purpose The aims of this study were to explore the bidirectional relationships between depression, anxiety, and suicidality among autistic and non-autistic undergraduates in the UK, and the impact of gender and autism diagnosis on these relationships, over time. Method A cross-lagged panel model (CLPM) was used to explore bidirectional relationships between (i) anxiety and worry, (ii) behavioural symptoms of depression and anxiety, and (iii) suicidality across two time points. At Wave 1 (November 2022/June 2023), 747 undergraduates participated. At Wave 2 (May/December 2023), 209 participants took part, with 179 providing complete data at both waves, six months apart. Autism status was determined via self-reported clinical diagnosis, including participants who reported receiving a first diagnosis between Wave 1 and Wave 2. Autism diagnosis and gender were included as covariates. Results Cross-lagged relationships were observed over time between suicidality and anxiety and worry, and suicidality and behavioural symptoms of depression and anxiety. Mental health problems remained stable across participants over time. Although an autism diagnosis was associated to higher levels of anxiety, depression, and suicidality at baseline, neither autism diagnosis nor gender was associated with changes in mental health problems over six months. Conclusion Initially, relative to non-autistic undergraduates, autistic undergraduates had elevated (or higher) anxiety, depression, and suicidality. Elevated suicidality predicted subsequent increases in anxiety and depression six months later. However, neither an autism diagnosis nor gender had a significant impact on mental health over time. Interpretation of findings is limited by substantial attrition between waves.