# Conceptualizing Autism as a Behavioral Network: Transdiagnostic Associations with Co-occurring Psychiatric Conditions

## TL;DR

This study explores how autism can be understood as a network of behaviors linked to co-occurring psychiatric conditions like anxiety and ADHD.

## Contribution

The paper introduces a network-based framework linking autism behaviors to co-occurring psychiatric symptoms using transdiagnostic processes.

## Key findings

- Autism-related approach–withdrawal behaviors are strongly associated with anxiety and ADHD.
- Affect regulation behaviors are linked to internalizing symptoms, while arousal and sensory behaviors relate to externalizing symptoms.
- Network analysis reveals core behaviors that could improve diagnostic and intervention strategies.

## Abstract

Autism is characterized by marked heterogeneity in behavioral presentation and high rates of co-occurring psychiatric symptoms, which hinder diagnostic precision, personalized intervention, and long-term quality of life. Approach and withdrawal behaviors—subserved by core motivational systems underlying action and emotion—may serve as transdiagnostic processes linking autism with common co-occurring conditions in childhood. Guided by this framework, we examined how autism-related approach–withdrawal behaviors interrelate and connect to internalizing and externalizing symptoms. Using data from 280 autistic children aged 6 to 11 years enrolled in the Autism Biomarkers Consortium for Clinical Trials, we constructed a Gaussian graphical model of approach–withdrawal behaviors. Core behaviors were identified using expected influence centrality. Autism, when conceptualized as a system of interconnected approach–withdrawal behaviors, was positively associated with common co-occurring psychiatric conditions, with strongest associations observed for anxiety and attention-deficit/hyperactivity disorder. Affect regulation–related nodes were most relevant to internalizing symptoms, whereas arousal regulation and sensory nodes were uniquely related to externalizing symptoms. These findings integrate transdiagnostic theories of approach-withdrawal motivation with network analysis and highlight clinically relevant targets for diagnostic refinement and intervention.