Validity of a self-reported screening test on co-occurring clinical problems in autism without intellectual disability: Evidence of factorial structure and network analysis of symptom comorbidity

Background The high prevalence of co-occurring clinical problems in autism spectrum Conditions without Intellectual Disability (ASC-noID) highlights the need for screening tools that are both easy to administer and easy to understand. This study presents the final development and structural validity of APCA-sin DI , a Spanish self-report questionnaire designed to screen clinical problems that may require specialized attention. Method A total of 227 young adults with ASC-noID completed an online preliminary version of APCA-sin DI consisting of: (a) 34 items covering 11 clinical categories, rated on four-point Likert scale ("Never to Always"), plus the options "I do not know" and "Prefer not to answer"; (b) three attention control items; and (c) a five-item life satisfaction scale. Descriptive statistics and factorial analysis were conducted to examine the psychometric properties of the instrument. Results The initial factorial analysis yielded a six-factor model based on seven clinical categories (“Anxiety”; “OCD”; “Sensory disturbances”; “Agitation”; “Autolytic thoughts”; “Depression” and “Eating Disorders”). The final version of the tool (18 items, 5 factors and 5 categories) demonstrated adequate psychometric properties. Conclusions The factors identified and the potential applications of the APCA-sin DI , for both clinical and research purposes, are discussed in relation to the existing literature.