Associations between coping strategies and mental health outcomes in autistic adults

The effect of the stress autism mate app on perceived stress, coping, and resilience in adults with autism: a single-case experimental design

Introduction

The mobile health application "Stress Autism Mate" (SAM) was designed to support adults with autism in identifying and managing daily stress. SAM measures stress four times daily, provides a daily and weekly stress overview, and provides personalised stress reduction advice. This study aimed to assess the effectiveness of SAM over four weeks in reducing perceived stress and internalised stigma, and enhancing coping self-efficacy, quality of life, and resilience among adults with autism.

Methods

Using an A1-B-A2 single-case experimental design, the effect of using SAM on adults with autism was assessed. The phases consisted of A1; treatment as usual (TAU), B; introducing SAM, and finally A2; follow-up with TAU and without the use of SAM. Each phase lasted four weeks, and data were collected via questionnaires before and after each phase. Linear mixed models were used for data analysis.

Results

Results show significant reductions in perceived stress levels, increased coping self-efficacy, and improved perceived health and psychological well-being after using SAM. Furthermore, increased resilience, and decreased internalised stigma were reported after follow-up.

Discussion

In conclusion, this study highlights SAM as a valuable tool for empowering adults with autism to reduce stress and internalised stigmaand to improve coping self-efficacy, psychological well-being, and resilience.

A longitudinal study of loneliness in autism and other neurodevelopmental disabilities: Coping with loneliness from childhood through adulthood

LAY ABSTRACT

We know that many autistic people feel lonely, but we don't know whether their loneliness changes over time. Our research study followed autistic people and people with other non-spectrum neurodevelopmental disabilities from childhood through young adulthood and asked them about their loneliness. While many people told us they felt lonely or very lonely, a sizable group also told us that they do not feel lonely. We found that people who reported feeling lonely earlier in life were likely to also report feeling lonely later in life. Overall, autistic people and people with other neurodevelopmental disabilities in our study became lonelier from adolescence to adulthood. People described multiple ways they cope with feeling lonely, such as distracting themselves or reaching out to connect with another person. People who used distraction tended to be lonelier than those who did not. Our findings tell us that there is a need for greater support of social connections for many autistic people as they become adults.

Measuring and validating autistic burnout

Researchers have begun to explore the characteristics and risk factors for autistic burnout, but assessment tools are lacking. Our study comprehensively examined and compared the psychometric properties of the unpublished 27-item AASPIRE Autistic Burnout Measure (ABM), and personal and work scales of the Copenhagen Burnout Inventory (CBI) to evaluate their efficacy as screening measures for autistic burnout, with a group of 238 autistic adults. Exploratory factor analyses (EFA) revealed a 4-factor structure for the ABM and a 2-factor structure for the CBI personal scale (CBI-P). Factorial validity and dimensionality were examined with four exploratory models which indicated a unidimensional structure for the ABM with an overarching 'Autistic Burnout' construct, and multidimensional CBI-P structure comprising two subscales and overarching 'Personal Burnout' construct. Other reliability and validity indicators included Spearman correlations, analysis of variance, receiver operating characteristics, sensitivity, specificity, and intra-class correlations (ICC). The ABM and CBI-P were strongly correlated with depression, anxiety, stress, and fatigue. Unexpectedly, correlations between the burnout measures and camouflaging, and wellbeing measures were moderate. Potential overlap between burnout and depression and fatigue was examined through EFA, which supported convergent validity of the ABM and depression measure, while correlations and ICC analyses revealed mixed results. We concluded that the ABM and the CBI-P Emotional Exhaustion subscale were valid preliminary screening tools for autistic burnout. Testing with larger and more diverse autistic samples is required to further examine the psychometric properties of the ABM, and to understand the relationships between autistic burnout and depression, and masking.

Associations between Autistic and ADHD Traits and the Well-Being and Mental Health of University Students

Research on autism and ADHD continues to increase, as does the research on well-being and mental health. There is a growing need to understand what factors impact mental health and well-being, and the question arises as to what factors impact mental health and well-being in autism and ADHD. The existing literature focuses on two different aspects when it comes to the well-being and mental health of autism in students. One aspect focuses on mental health and well-being in diagnosed neurodivergent individuals, and the other aspect focuses on associations between autistic and ADHD traits and mental health and well-being. In order to understand the impact on mental health in autism, an online survey using the Qualtrics platform was given to a sample of 430 university students. The survey used the well-being process questionnaire, the autism spectrum quotient, the ADHD self-report scale, and the strengths and difficulties questionnaire. The results showed significant correlations between anxiety, depression, and autistic and ADHD traits (all correlations > 0.2). These variables were also correlated with the well-being and SDQ outcomes and well-being predictors (all correlations > 0.2). The regression analyses showed significant associations between well-being outcomes and predictor variables and anxiety and depression, whereas the effects of autistic and ADHD traits were restricted to the SDQ outcomes (hyperactivity, conduct, and peer problems). Regression analyses were also conducted to determine whether a variable formed by combining autistic traits, ADHD, anxiety, and depression scores was a significant predictor of well-being and SDQ outcomes. The combined variable was associated with all outcome variables except the prosocial variable. This study provides the basis for further research for understanding the interaction between well-being, mental health, autism, and ADHD.

Stress and well-being in autistic adults: Exploring the moderating role of coping

The wider stress literature points to negative associations between stress and well-being. Similarly, the use of engagement coping strategies and disengagement coping strategies in the face of stress are related to improved and reduced well-being respectively. However, in the autistic population stress and coping research is limited to date, and the extent to which coping may moderate the relationship between stress and well-being is not known. Using data from an Australian online study, we explored the potential moderating (i.e. buffering or exacerbating) role of coping in the relationship between stress and well-being in a sample of autistic adults (N = 86). Our findings indicated that increased stress was associated with lower well-being. Further, moderation analyses showed that while both engagement coping (e.g. problem solving, positive appraisal) and disengagement coping (e.g., self-distraction, being in denial) strategies had significant positive and negative direct effects on well-being respectively; engagement coping also moderated the relationship between stress and well-being, buffering the impact of stress on well-being. Our results illustrate the different underlying mechanisms by which coping strategies may be associated with stress and well-being. They also highlight the potential protective role of engagement coping strategies, which can be incorporated into the promotion and maintenance of well-being in autistic adults.

Mental wellbeing and psychosocial working conditions of autistic veterinary surgeons in the UK

BACKGROUND

Certain autistic characteristics (such as hyper-focus and attention to detail) are valued by veterinary surgeons and autistic adults may disproportionately self-select into the profession. Links between mental wellbeing and retention in the veterinary profession highlight an imperative to profile autistic veterinary surgeons' mental wellbeing and identify protective factors. The psychosocial work environment may represent one such protective factor. We aimed to assess autistic veterinary surgeons' mental wellbeing, the extent to which their psychosocial working conditions achieved UK government management standards and links between these.

METHODS

Eighty-five autistic veterinary surgeons completed the Warwick-Edinburgh Mental Wellbeing Scale and the Health and Safety Executive's Management Standards Indicator Tool. Descriptive comparisons were drawn with normative data; correlation and linear regression analyses examined relations between mental wellbeing and psychosocial working conditions.

RESULTS

Mental wellbeing and psychosocial work environment quality were markedly below veterinary surgeon and general workforce norms. Psychosocial working conditions accounted for 44% of the unique variance in mental wellbeing, with 'control' and 'role' making a significant contribution.

LIMITATION

This exploratory study involved a small self-selecting sample, raising the possibility of response bias.

CONCLUSION

Work design centred on the enhancement of control and role clarity would likely support mental wellbeing in this population.

Brief Report: Longitudinal Role of Coping Strategies on Mental Health Outcomes in Autistic Youth and Adults

The stress literature suggests that coping strategies are implicated in mental health outcomes. However, the longitudinal relationship between coping strategies and mental health in the autistic adult population has not yet been examined. This 2-year longitudinal study examined the predictive role of both baseline and change in coping strategy use over time (i.e., an increase or decrease) on anxiety, depression, and well-being after 2-years in 87 autistic adults aged 16 to 80 years. Controlling for baseline mental health, both baseline and increase in disengagement coping strategies (e.g., denial, self-blame) predicted higher anxiety and depression, and lower well-being, while an increase in engagement coping strategies (e.g., problem solving, acceptance) predicted higher well-being. These findings extend the current coping literature in autistic adults, offering insight into mental health support and intervention options.

Coping-resilience profiles and experiences of stress in autistic adults

Emerging studies allude to high stress in autistic adults. Considering the detrimental impact of stress on health outcomes, examining individual resources which may influence the extent to which stress is experienced (e.g., coping and resilience) is vital. Using a person-focused approach, this study aimed to identify coping-resilience profiles, and examine their relations to general perceived stress and daily hassles in a sample of autistic adults (N = 86; aged 19-74 years). Cluster analysis identified four coping-resilience profiles (i.e., high cope/ low resilience, low cope/ high resilience, engage cope/ high resilience, and disengage cope/ low resilience). The high cope/ low resilience and disengage cope/ low resilience groups had significantly higher general perceived stress than the remaining groups. No significant group differences were noted in relation to daily hassles. Jointly addressing coping and resilience may be beneficial on the perceived stress experienced in autistic adults. The use of coping-resilience profiles may also allow for the personalization of stress management and support options in the autistic adult population.