Are sensory features a subdomain of restricted and repetitive behaviors? Evaluating empirical support for the DSM-5 autism criteria

Spackman, Emily, Chetcuti, Lacey, Leekam, Susan R. ORCID: https://orcid.org/0000-0002-1122-0135, Whitehouse, Andrew, Krueger, Robert F., Hedley, Darren, Frazier, Thomas W., Hardan, Antonio Y. and Uljarević, Mirko 2026. Are sensory features a subdomain of restricted and repetitive behaviors? Evaluating empirical support for the DSM-5 autism criteria. Journal of the American Academy of Child & Adolescent Psychiatry 10.1016/j.jaac.2026.07.1224

Preview

PDF - Accepted Post-Print Version Available under License Creative Commons Attribution. Download (425kB) | Preview

Abstract

Objective Following calls to formally recognize sensory differences in the autism diagnostic criteria, the DSM-5 introduced sensory features as a subdomain of restricted and repetitive behaviors (RRBs). However, this categorization was developed based on expert consensus, rather than being empirically derived. Subsequent psychometric investigations have largely examined the structure of sensory features and RRBs separately, precluding evaluation of whether these constructs are best represented by shared or distinct latent dimensions. Method The current study used cross-measure factor analysis with items from across the Dimensional Assessment of Repetitive Behaviors (DARB) and Sensory Experiences Questionnaire (SEQ-3) to expand coverage of sensory features and compare the DSM-5 RRB structure with alternate empirically derived structures identified in the literature. The best-fitting first-order model was then operationalized to compare different general factor solutions. Results Across first-order models, the four-factor DSM-aligned model showed the poorest fit, while a 10-factor empirically derived model showed the best fit. Across bifactor models, the unidimensional general RRB/sensory model showed the poorest fit. Two alternate two-bifactor structures showed superior fit. Among those bifactor models, an exploratory model - whereby Factor 1 comprised insistence on sameness, restricted interests, unusual interests, repetitive language, obsessive-compulsive behavior, self-injurious behaviors and sensory hypersensitivity, and Factor 2 comprised repetitive motor behavior, sensory seeking and sensory hyposensitivity - showed the highest internal consistency and explained the most variance in related clinical variables. Conclusion Findings suggest the need to further revise the RRB DSM-5 criteria, indicating that a unidimensional general RRB/sensory domain may not be empirically valid.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Schools > Psychology
Additional Information:	RRS applied
Publisher:	Elsevier
ISSN:	0890-8567
Date of First Compliant Deposit:	14 August 2026
Date of Acceptance:	16 July 2026
Last Modified:	14 Aug 2026 14:30
URI:	https://orca.cardiff.ac.uk/id/eprint/188485

Actions (repository staff only)

Edit Item