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Wang YC, Tai YM, Wu YY, Chiu YN, Tsai WC, Gau SSF. A follow-up study of peer relationships in autistic and non-autistic youths: Mediating effects from autistic, emotional and behavioral symptoms. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 151:104768. [PMID: 38870673 DOI: 10.1016/j.ridd.2024.104768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 04/10/2024] [Accepted: 05/28/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Little is known about how clinical features prospectively influence peer relationships in autistic populations. AIMS This study investigated the clinical symptoms mediating the link between autism spectrum disorder (ASD) diagnosis and peer relationships at follow-up, i.e. the second time evaluation of this study. METHODS The sample consisted of 366 autistic youths and 134 non-autistic comparisons. The autistic traits and emotional/behavioral problems were measured at baseline by Social Responsiveness Scale (SRS) and Child Behavior Checklist (CBCL). The interactions and problems with peers were assessed by the Social Adjustment Inventory for Children and Adolescents (SAICA) at follow-up. RESULTS Each subscore of SRS and CBCL showed significant mediation effects. Multiple mediation analyses showed atypical social communication, social awareness problems, and delinquent behaviors mediated the link from ASD to less active peer interactions after controlling for sex, age, and IQ. Moreover, atypical social communication, social-emotional problems, and attention difficulties predicted problems with peers. After considering these mediation effects, the diagnosis of ASD still demonstrated a significantly direct effect on peer relationships at follow-up. CONCLUSIONS AND IMPLICATIONS Our findings support that social-related autistic features, attention problems, and delinquent behaviors mediated a link between ASD and peer relationships. These mediators are potential measures for improving interactions and decreasing difficulties with peers in the autistic population.
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Affiliation(s)
- Yen-Chin Wang
- Department of Psychiatry, National Taiwan University Hospital, Hsin-Chu Branch, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taiwan
| | - Yueh-Ming Tai
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taiwan
| | - Yu-Yu Wu
- Department of Psychiatry, Chang Gung Memorial Hospital, Taiwan
| | - Yen-Nan Chiu
- Department of Psychiatry, National Taiwan University Hospital, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taiwan
| | - Wen-Che Tsai
- Department of Psychiatry, National Taiwan University Hospital, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taiwan
| | - Susan Shur-Fen Gau
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taiwan.
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2
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Parenteau CI, Lampinen LA, Ghods SS, Taylor JL, Adams RE, Bishop SL, Zheng S. Self-reported Everyday Sources of Happiness and Unhappiness in Autistic Adults. J Autism Dev Disord 2024; 54:1538-1548. [PMID: 36689096 PMCID: PMC9869319 DOI: 10.1007/s10803-023-05892-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE Daily mood can be influenced by a range of experiences. Identifying everyday life experiences that make autistic adults happy and unhappy holds potential to foster positive mood and tackle mental health problems amongst this group. METHODS A total of 293 autistic adults between the ages of 18 to 35 years old (mean age of 26.51 years old (SD = 4.62); 43.3% female gender, 4.8% nonbinary) provided open-text responses regarding everyday sources of happiness and unhappiness. Using an iterative process of inductive coding, 14 happy themes and 22 unhappy themes of mood-changing life experiences were identified based on self-report qualitative data. RESULTS Common themes across the happy and unhappy domain involved social partners, social interactions, and engagement in recreational and employment activities, with additional distinct themes specific to happy or unhappy mood. Top themes identified in the happy domain emphasizes encouraging quality relationships and positive interactions with others and cultivating supportive work/societal environments to build a sense of achievement and value. Meanwhile, emotional tolls accompanied negative relationships and interactions, underscoring the necessity to provide autistic adults with conflict resolution and coping skills to increase feelings of happiness. CONCLUSION Overall, the wide range of sources of happy and unhappy everyday experiences highlights the importance of considering personal preferences in engagement with others and activities in treatment.
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Affiliation(s)
- China I Parenteau
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA.
| | - Linnea A Lampinen
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA
| | - Sheila S Ghods
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA
| | | | - Ryan E Adams
- Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Somer L Bishop
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA
| | - Shuting Zheng
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA
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Dewinter J, Onaiwu MG, Massolo ML, Caplan R, Van Beneden E, Brörmann N, Crehan ET, Croen LA, Faja S, Gassner DL, Graham Holmes L, Hughes C, Hunter M, Huysamen M, Jelonche P, Lai MC, Noens I, Pukki H, Stokes MA, Strang JF, van der Miesen AIR. Short report: Recommendations for education, clinical practice, research, and policy on promoting well-being in autistic youth and adults through a positive focus on sexuality and gender diversity. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:770-779. [PMID: 37530121 PMCID: PMC10913304 DOI: 10.1177/13623613231188349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
LAY ABSTRACT In this article, we propose recommendations on what we can do to promote that autistic people can enjoy their sexuality and gender identity, because that contributes to overall well-being.First, we briefly summarize the existing research on sexuality and gender diversity in autistic individuals.Next, we propose recommendations for how to promote sexual and gender diversity-related health and well-being. Based on what is known about sexuality, gender diversity, and relationships in autistic adolescents and adults, we convened an international group of autistic and non-autistic researchers, advocates, parents, and professionals to develop recommendations to promote sexual and gender health in autistic people.The resulting recommendations were checked through an online survey distributed to autistic people across the world. The online participants endorsed the importance of eight final recommendations related to:1. Providing education and information on sexuality, relationships, and gender diversity to autistic individuals and their families;2. Improving expertise in and accessibility to healthcare for sexuality, relationships, and gender-related questions, with specific attention to prevention of and support after sexual victimization; and3. Meaningfully including the autism community in future research that addresses well-being relating to sexuality, relationships, and gender diversity.These community-driven recommendations aim to promote sexual health and well-being in autistic individuals internationally.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Susan Faja
- Boston Children’s Hospital/Harvard Medical School, USA
| | | | | | | | | | | | | | | | | | - Heta Pukki
- European Council of Autistic People, Finland
| | | | - John F Strang
- George Washington University School of Medicine, USA
| | - Anna IR van der Miesen
- Centre for Addiction and Mental Health, Canada
- Amsterdam University Medical Centers, Location Vrije Universiteit, The Netherlands
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Torralbas-Ortega J, Roca J, Coelho-Martinho R, Orozko Z, Sanromà-Ortiz M, Valls-Ibáñez V. Affectivity, sexuality, and autism spectrum disorder: qualitative analysis of the experiences of autistic young adults and their families. BMC Psychiatry 2023; 23:858. [PMID: 37978476 PMCID: PMC10656892 DOI: 10.1186/s12888-023-05380-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 11/14/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Autistic people have communication, sensorial, and social difficulties, which on many occasions, make their adaptation on the sexual and affective levels difficult. For this reason, it is important to know the opinion of individuals with autism spectrum disorders (ASD) and their families, to offer this perspective to professionals to facilitate adapted health education programs in mental health units. METHODS This qualitative descriptive design presents the experiences of autistic individuals and their families in relation to the affective-sexual experiences from individual, family, and social perspectives. Two focus group sessions were held with eight family members and seven individual semi-structured interviews with autistic young adults. The transcripts were qualitatively analysed using content analysis. RESULTS Four themes (Family and social dynamic; Social behaviour of the autistic individual; Affective-sexual relationships; Addressing affective and sex education) and 13 related categories emerged from these results. Communication and social interaction problems act as barriers for young adults when developing affective-sexual relationships, leading to the emergence of negative feelings and experiences that reinforce avoidance behaviours, further intensifying their difficulties in interacting with others. Families, especially mothers, exhibit a poor perception of their ability to provide affective-sexual guidance, leading to anxiety and frustration. There are also reports of poor sex education and lack of support systems. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The experiences of young people and their families are sometimes conflicting when it comes to affectivity and sexuality, but the parental role emerges as relevant in the sex education process. Families play a pivotal role in sex education, which is why professionals should provide them with support and information through health education programmes, foster empathetic communication and promote sexual and emotional development that is adapted to the characteristics and interests of autistic people.
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Affiliation(s)
- Jordi Torralbas-Ortega
- Hospital de la Santa Creu i Sant Pau and Nursing care Research Group. Research Institute Sant Pau (IIB SANT PAU), Barcelona, 08041, Spain
| | - Judith Roca
- Department of Nursing and Physiotherapy and Health Education, Nursing, Sustainability and Innovation Research Group (GREISI), Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, 25199, Spain.
- Health Care Research Group (GRECS), Biomedical Research Institute of Lleida, Lleida, 25198, Spain.
| | - Ruben Coelho-Martinho
- Department of Mental Health Nursing, Nostra Senyora de Meritxell Hospital, Escaldes-Engordany, AD700, Andorra
| | - Zaloa Orozko
- Osona Salut Mental, Consorci Hospitalari de Vic, Vic, 08500, Spain
| | - Montserrat Sanromà-Ortiz
- Blanquerna School of Health Science, Ramon Llull University, Barcelona, 08025, Spain
- Departament of Nursing and Physiotherapy, University of Lleida, Campus Igualada, Lleida, 08700, Spain
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Yang X, Dekker L, Greaves-Lord K, Crehan ET. Psychometric Properties of Psychosexual Functioning Survey Among Autistic and Non-autistic Adults: Adapting the Self-Report Teen Transition Inventory to the U.S. Context. J Autism Dev Disord 2023:10.1007/s10803-023-06170-9. [PMID: 37934395 DOI: 10.1007/s10803-023-06170-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2023] [Indexed: 11/08/2023]
Abstract
Psychosexual functioning is an important aspect of human development and relationships. A previous study investigated psychosexual functioning of autistic adolescents using the Teen Transition Inventory (TTI), but there is a lack of comprehensive measurement of psychosexual functioning among autistic and non-autistic (NA) adults. To address this gap, the current study adapted the self-report TTI to the Psychosexual Functioning Survey (PSFS) and presented it to 131 autistic (n = 59) and NA adults (n = 72) in the U.S. Comparisons of psychometric properties between the original TTI and the PSFS are shared; the developmental relevancy among some items was changed, and the alphas indicated a difference in the content of certain scales. Differences emerged between autistic and NA adults in both the intra- and interpersonal domains of psychosexual functioning, but not in sexual and intimate behaviors. The findings suggest the persistence of differences from adolescence to adulthood between autistic and NA people and highlight the importance of understanding the unique experiences of adults in psychosexual functioning relative to diagnostic status.
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Affiliation(s)
- Xihan Yang
- Tufts University, 105 College Ave, Medford, MA, 02155, USA.
| | - Linda Dekker
- Department of Psychology, Education and Child Studies, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
| | - Kirstin Greaves-Lord
- Department of Psychology, Clinical Psychology and Experimental Psychopathology Unit, University of Groningen, Groningen, The Netherlands
- Department of (Youth) Mental Health and Autism of Lentis Psychiatric Institute Groningen, Autism Team Northern-Netherlands, Jonx, Groningen, The Netherlands
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6
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Munsell EGS, Coster WJ. How have Participation Outcomes of Autistic Young Adults been Measured? A Scoping Review. J Autism Dev Disord 2023; 53:4424-4437. [PMID: 36068380 DOI: 10.1007/s10803-022-05725-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2022] [Indexed: 11/26/2022]
Abstract
Autistic young adults experience challenges participating in the workforce, post-secondary schooling, and living in the community. We examined how participation outcomes have been measured in autistic young adults. Articles (n = 113) were identified through database searches and citation tracking. Guided by current models in the literature, data were extracted for each measure of participation. Results include a description of the studies in the review, the extent to which participation across life situations has been addressed, and a critical analysis of the measures used to describe participation. While there is some breadth in the investigation of participation across diverse life situations, there is limited depth in what the measures capture and many measures used lack psychometric support.
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Affiliation(s)
- Elizabeth G S Munsell
- Center for Education in Health Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA.
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, 355 E Erie St, Chicago, IL, 60611, USA.
| | - Wendy J Coster
- Occupational Therapy Department, College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA
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7
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Sala G, Hooley J, Hooley M, Stokes MA. Comparing Physical Intimacy and Romantic Relationships of Autistic and Non-autistic Adults: A Qualitative Analysis. J Autism Dev Disord 2023:10.1007/s10803-023-06109-0. [PMID: 37584763 DOI: 10.1007/s10803-023-06109-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2023] [Indexed: 08/17/2023]
Affiliation(s)
- Giorgia Sala
- Healthy Autistic Life Lab, School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC, 3220, Australia
| | - Jessica Hooley
- Dept Psychological Sciences, Swinburne University, John Street Hawthorn, VIC, Melbourne, 3122, Australia
| | - Merrilyn Hooley
- Healthy Autistic Life Lab, School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC, 3220, Australia
| | - Mark A Stokes
- Healthy Autistic Life Lab, School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC, 3220, Australia.
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8
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Yew RY, Hooley M, Stokes MA. Factors of relationship satisfaction for autistic and non-autistic partners in long-term relationships. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:13623613231160244. [PMID: 36924337 PMCID: PMC10576901 DOI: 10.1177/13623613231160244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
LAY ABSTRACT Previous research has found that autistic people report lower satisfaction in their romantic relationships compared to non-autistic people. However, the majority of this research has focused on autistic traits as barriers to relationship satisfaction, while overlooking the role of their partners in these relationships. Our study explored a range of factors in both autistic people and non-autistic partners of autistic people and how they may be linked to long-term relationship satisfaction. These factors included social and communication skills, personality traits, social loneliness, partner responsiveness, and sexual satisfaction. We found that partner responsiveness was a strong predictor of relationship satisfaction for both autistic and non-autistic partners, suggesting that rather than focusing intervention solely on the autistic person, the role of their partner should also be considered. Service providers who work with couples involving an autistic person to enhance their relationship satisfaction could focus on assisting their clients to identify each other's needs and how best to meet them.
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9
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Torralbas-Ortega J, Valls-Ibáñez V, Roca J, Sastre-Rus M, Campoy-Guerrero C, Sala-Corbinos D, Sánchez-Fernández M. Affectivity and Sexuality in Adolescents with Autism Spectrum Disorder from the Perspective of Education and Healthcare Professionals: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2497. [PMID: 36767863 PMCID: PMC9915282 DOI: 10.3390/ijerph20032497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
People with autism spectrum disorder (ASD) present several different characteristics that predispose them to greater difficulties with intimate emotional and sexual relationships. This qualitative study uncovers the perspective of education and healthcare professionals on the affective and sexual needs of young people with ASD by analysing their narratives in semi-structured focus group sessions. Professionals highlight the inadequate training they receive in this aspect of health. They consider it should be commonplace for professionals working with autistic people as it would aid their collaborative efforts when treating children and adolescents with ASD. They show that, by working together with the families to establish joint objectives, these professionals can appropriately address sex and affective education, preventing risky behaviours among young people with ASD, and improving the interactions these individuals have with others. Sex and affective education is described as an indispensable tool at this stage of development and should be specially adapted for those with ASD.
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Affiliation(s)
- Jordi Torralbas-Ortega
- Hospital de la Santa Creu i Sant Pau, Nursing Care Research Group, Sant Pau Biomedical Research Institute (IIB SANT PAU), 08041 Barcelona, Spain
| | | | - Judith Roca
- Department of Nursing and Physiotherapy, University of Lleida, 25198 Lleida, Spain
- Research Group of Health Care (GRECS), IRB Lleida, 25198 Lleida, Spain
| | - Meritxell Sastre-Rus
- Hospital de la Santa Creu i Sant Pau, Nursing Care Research Group, Sant Pau Biomedical Research Institute (IIB SANT PAU), 08041 Barcelona, Spain
| | | | - Dolores Sala-Corbinos
- Child and Adolescent Day Hospital, Sant Joan de Déu-Terres de Lleida, 25001 Lleida, Spain
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10
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Maggio MG, Calatozzo P, Cerasa A, Pioggia G, Quartarone A, Calabrò RS. Sex and Sexuality in Autism Spectrum Disorders: A Scoping Review on a Neglected but Fundamental Issue. Brain Sci 2022; 12:1427. [PMID: 36358354 PMCID: PMC9688284 DOI: 10.3390/brainsci12111427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/16/2022] [Accepted: 10/21/2022] [Indexed: 11/19/2023] Open
Abstract
ASD consists of a set of permanent neurodevelopmental conditions, which are studded with social and communication differences, limited interests, and repetitive behaviors. Individuals with ASD have difficulty reading eye gestures and expressions, and may also have stereotyped or repetitive language, excessive adherence to routines, fixed interests, and rigid thinking. However, sexuality in adolescents and young adults with ASD is still a poorly studied and neglected issue. This review aims to evaluate sexual function and behavior in individuals with ASD to foster a greater understanding of this important, although often overlooked, issue. This review was conducted by searching peer-reviewed articles published between 01 June 2000 and 31 May 2022 using the following databases: PubMed, Embase, Cochrane Database, and Web of Science. A comprehensive search was conducted using the terms: "Autism" OR "ASD" AND "Sexuality" OR "Romantic relation" OR "sexual behavior" AND/OR "sexual awareness". After an accurate revision of 214 full manuscripts, 11 articles satisfied the inclusion/exclusion criteria. This review found that, although individuals with ASD may have sexual functioning, their sexuality is characterized by higher prevalence rates of gender dysphoria and inappropriate sexual behavior. Furthermore, sexual awareness is reduced in this patient population, and the prevalence of other variants of sexual orientation (i.e., homosexuality, asexuality, bisexuality, etc.) is higher in adolescents with ASD than in non-autistic peers. Sexual health and education should be included in the care path of patients with ASD in order to improve their quality of life and avoid/reduce inappropriate and risky behaviors.
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Affiliation(s)
- Maria Grazia Maggio
- Department of Biomedical and Biotechnological Science, University of Catania, 95123 Catania, Italy
| | - Patrizia Calatozzo
- Studio di Psicoterapia Relazionale e Riabilitazione Cognitiva, 98124 Messina, Italy
| | - Antonio Cerasa
- Institute for Biomedical Research and Innovation, National Research Council of Italy (IRIB-CNR), 98164 Messina, Italy
- Sant’Anna Institute, 88900 Crotone, Italy
- Pharmacotechnology Documention and Transfer Unit, Preclinical and Traslation Pharmacology, Department of Pharmacy, Health Science and Nutrition, University of Calabria, 87036 Calabria, Italy
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation, National Research Council of Italy (IRIB-CNR), 98164 Messina, Italy
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Pellicano E, Fatima U, Hall G, Heyworth M, Lawson W, Lilley R, Mahony J, Stears M. A capabilities approach to understanding and supporting autistic adulthood. NATURE REVIEWS PSYCHOLOGY 2022; 1:624-639. [PMID: 36090460 PMCID: PMC9443657 DOI: 10.1038/s44159-022-00099-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 07/26/2022] [Indexed: 12/28/2022]
Abstract
There is little comprehensive research into autistic adulthood, and even less into the services and supports that are most likely to foster flourishing adult autistic lives. This limited research is partly because autism is largely conceived as a condition of childhood, but this focus of research has also resulted from the orthodox scientific approach to autism, which conceptualizes autistic experience almost entirely as a series of biologically derived functional deficits. Approaching autism in this way severely limits what is known about this neurodevelopmental difference, how research is conducted and the services and supports available. In this Review, we adopt an alternative research strategy: we apply Martha Nussbaum’s capabilities approach, which focuses on ten core elements of a thriving human life, to research on autistic adulthood. In doing so, we identify areas where autistic adults thrive and where they often struggle, and highlight issues to which researchers, clinicians and policymakers should respond. The resulting picture is far more complex than conventional accounts of autism imply. It also reveals the importance of engaging autistic adults directly in the research process to make progress towards genuinely knowing autism and supporting flourishing autistic lives. The focus on functional deficits in conventional autism research constrains understanding of autistic lives. In this Review, Pellicano et al. appraise research on autistic adulthood through a capabilities lens to identify areas where autistic adults thrive, and where more research and services are needed to enhance their quality of life.
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12
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Attanasio M, Masedu F, Quattrini F, Pino MC, Vagnetti R, Valenti M, Mazza M. Are Autism Spectrum Disorder and Asexuality Connected? ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2091-2115. [PMID: 34779982 DOI: 10.1007/s10508-021-02177-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 02/10/2021] [Accepted: 10/07/2021] [Indexed: 06/13/2023]
Abstract
Asexuality is a lack of sexual attraction to any gender. There is some evidence to suggest that many self-identified asexuals have a formal diagnosis of autism spectrum disorder which is characterized by deficits in social interaction and communication, as well as by restricted and repetitive interests and behaviors. Additionally, the literature shows that asexuality and lack of sexual attraction or low sexual interest is overrepresented in people with autism spectrum disorder compared with neurotypical samples. Nevertheless, no studies have been conducted to investigate the relationship between autism and asexuality in depth. We conducted a systematic review of the literature to examine whether asexuality and autism spectrum disorder are connected. We conclude that asexuality and autism share various aspects, such as a possible role of prenatal factors, reference to romantic dimensions of sexual attraction and sexual orientation, and non-partner-oriented sexual desire, but future research should explore and clarify this link.
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Affiliation(s)
- Margherita Attanasio
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Località Coppito, Italy.
- Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, L'Aquila, Italy.
| | - Francesco Masedu
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Località Coppito, Italy
| | - Fabrizio Quattrini
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Località Coppito, Italy
| | - Maria Chiara Pino
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Località Coppito, Italy
| | - Roberto Vagnetti
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Località Coppito, Italy
| | - Marco Valenti
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Località Coppito, Italy
- Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, L'Aquila, Italy
| | - Monica Mazza
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Località Coppito, Italy
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Brosnan M, Gavin J. The Impact of Stigma, Autism Label and Wording on the Perceived Desirability of the Online Dating Profiles of Men on the Autism Spectrum. J Autism Dev Disord 2021; 51:4077-4085. [PMID: 33459917 PMCID: PMC8510896 DOI: 10.1007/s10803-020-04830-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2020] [Indexed: 11/24/2022]
Abstract
Those seeking romantic relations are increasingly using online dating sites, including young men on the autism spectrum. This study presented dating profiles with and without an explicit label of autism and positive or negative wording to 306 'females seeking a male partner'. Participants assessed the men's dating profiles in terms of perceived attractiveness, trustworthiness and desire-to-date. They also completed a questionnaire on their level of stigmatisation of, and familiarity with, autism. An explicit autism label and positive wording positively impacted perceived attractiveness. With positively worded profiles, those with highly stigmatising views reported decreased desire-to-date when an explicit label of autism was present; those with low levels of stigmatising reported increased desire-to-date when an explicit autism label was present.
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Affiliation(s)
- M Brosnan
- Department of Psychology, University of Bath, Claverton Down, Bath, BA2 7AY, UK.
| | - J Gavin
- Department of Psychology, University of Bath, Claverton Down, Bath, BA2 7AY, UK
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Dugdale AS, Thompson AR, Leedham A, Beail N, Freeth M. Intense connection and love: The experiences of autistic mothers. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:1973-1984. [PMID: 33840262 PMCID: PMC8419292 DOI: 10.1177/13623613211005987] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
LAY ABSTRACT For many women, adulthood involves becoming a mother. Knowledge of how motherhood is experienced by autistic women is currently poor. Poor knowledge has a range of negative consequences and can lead to inappropriate support. In this study, nine autistic women were interviewed about their experiences of motherhood. Seven of the nine mothers had an officially diagnosed autistic child, the final two mothers also suspected at least one of their children to be autistic. Systematic in-depth analysis of interview transcripts identified a range of common themes. Participants largely experienced motherhood as joyful, rewarding, and enjoyable, though managing children's needs had a profound personal impact. Participants reflected on the need for self-care and self-acceptance, resulting in personal growth and adaptation. Participants also spoke of strong bonds, feelings of intense connection, and a range of shared experiences with their children. It was also clear that autistic motherhood is associated with a series of challenges unlikely to be experienced by non-autistic mothers, including the necessity of negotiating misunderstandings from others. The findings demonstrate that, generally, professionals need to be better educated on how autism presents in adulthood, including the fact that autistic women often engage in behaviour to mask their true self. Professionals need to know that there is potential for mismatching between emotional experience and facial expression, that autistic women have sensory needs (especially in pregnancy). Professionals frequently struggle to effectively take the needs and perspectives of autistic mothers into account, resulting in profoundly negative consequences for the mother.
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Affiliation(s)
| | - Andrew R Thompson
- University of Sheffield, UK
- Cardiff and Vale University Health Board & Cardiff University, UK
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Gray S, Kirby AV, Graham Holmes L. Autistic Narratives of Sensory Features, Sexuality, and Relationships. AUTISM IN ADULTHOOD 2021; 3:238-246. [PMID: 36605373 PMCID: PMC8992905 DOI: 10.1089/aut.2020.0049] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background Research about the experience of sexuality and intimacy for autistic people has largely excluded the potential influences of autistic sensory features, which are highly common. The aim of this study was to explore how autistic sensory features influence autistic people's experiences of sexuality and relationships, including the impact of low and high neurological threshold sensory patterns and regarding specific sensory modalities. Methods Utilizing a qualitative approach, we explored autistic people's perspectives about the influences of sensory features on their experiences of sexuality and relationships through existing publicly available narratives (5 books and 13 online forums containing messages from 72 unique usernames) and responses to an open-ended survey question (N = 49). We used deductive coding based on Dunn's model of sensory processing, as well as inductive coding to identify additional themes about autistic sensory features and sexuality. Results Our findings indicated that sexual and relationship experiences were related to both sensory sensitivity and sensation seeking (i.e., low and high threshold sensory patterns) across several sensory modalities, including touch, sight, sound, and smell. Sensory features influenced autistic people's sexual and relationship experiences in both positive and negative ways. Examined narratives revealed adaptations and strategies used by autistic people to enhance or enable engagement in sexual activity as well as implications for their sexual identity. Conclusions Sensory features and their impact on the sexuality and relationship experiences of autistic people should be considered in clinical practice and educational programming. More research is needed to further understand the impact of autistic sensory features on experiences of sexuality and relationships, and to develop effective strategies to promote safe and satisfying engagement, when desired. Lay summary Why was this study done?: Autistic people often respond to sensations differently than other people, including being more sensitive to sensations and/or wanting more intense sensations (called "autistic sensory features" in this study). Many aspects of sexuality and relationships involve sensory input. However, we do not know much about how autistic sensory features influence sexuality and relationships for autistic people.What was the purpose of this study?: The purpose of this study was to explore how autistic sensory features influence autistic people's experiences of sexuality and relationships.What did the researchers do?: For this study, we used two different sources of data. The first was existing publicly available things written by autistic people, including books and posts on online forums. The second was answers provided on a survey question asking about autistic sensory features and sexuality. Overall, we looked at things written by over 120 autistic people. We reviewed all the information to explore what kinds of sensory responses (e.g., sensitivities and sensation seeking) and sensory modalities (e.g., touches, sights, sounds, and smells) they wrote about. We also looked more generally to see how autistic people described the ways that autistic sensory features influenced their sexuality and relationship experiences.What were the results of the study?: Our findings show that in the information we accessed, autistic people did write about how sensory features influence their sexual and relationship experiences. Some people who have sensory sensitivities described confusion, distress, and frustration with sexual experiences. Despite wanting to participate, people with sensitivities described negative reactions to many of the sights, sounds, smells, and textures that were involved in dating and sexual activities. Other people indicated that they avoided sexual activity because of their sensory features. However, we also found that some autistic people seek out more intense sensations in their sexual activities, and others that enjoy intimacy that promotes calming and self-regulation. People wrote about strategies they use in response to their autistic sensory features, such as communication with partners and the use of substances to dull sensations.What do these findings add to what was already known?: There has not been much published research on this topic, so this study is a starting place. In books, as well as in online discussion boards, autistic people have been discussing the importance of sensory features to their sexuality and relationships. We accessed that information, and used theory and clinical experience to analyze their writings and help identify what other research is needed.What are potential weaknesses in the study?: We used text already written by autistic people and responses on one survey question for this study. Therefore, we may not have gained a complete understanding of the ways that autistic sensory features influence sexuality and relationship experiences.How will these findings help autistic adults now or in the future?: This study contributes to greater understanding of how autistic traits affect sexuality and relationships for autistic people. That information can be used to develop effective education and resources for autistic people, families, and service providers.
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Affiliation(s)
- Sarah Gray
- Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City, Utah, USA
| | - Anne V. Kirby
- Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City, Utah, USA.,Address correspondence to: Anne V. Kirby, PhD, OTR/L, Department of Occupational and Recreational Therapies, University of Utah, 520 Wakara Way, Salt Lake City, UT 84108, USA.
| | - Laura Graham Holmes
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
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Shuper Engelhard E, Vulcan M. The Potential Benefits of Dance Movement Therapy in Improving Couple Relations of Individuals Diagnosed With Autism Spectrum Disorder-A Review. Front Psychol 2021; 12:619936. [PMID: 33679534 PMCID: PMC7930210 DOI: 10.3389/fpsyg.2021.619936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/07/2021] [Indexed: 01/02/2023] Open
Abstract
A review of current literature indicates that adults diagnosed with autism spectrum disorder (ASD) feel the need for intimate and sexual relationships and maintain such relationships despite and alongside their difficulties in emotional communication, social interactions, reciprocity, and verbal and non-verbal expression. This understanding calls for the development of intervention programs designed to support the specific needs and address the problems of couples where one partner is diagnosed with ASD. In view of the relevance and significant part played by body and movement in emotional development and psychotherapy, the present article offers a review of studies examining the contribution of dance movement therapy to both the quality of life and functioning of adults with ASD and therapeutic processes in couple therapy. This review aims to establish an infrastructure for the construction of intervention programs and for future studies designed to enhance the quality of life and independence of adults with ASD.
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Affiliation(s)
- Einat Shuper Engelhard
- Faculty of Humanities and Social Sciences, Graduate School of Creative Art Therapies, Kibbutzim College of Education, Tel Aviv, Israel.,Faculty of Social Welfare and Health Sciences, Graduate School of Creative Art Therapies, Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa, Israel
| | - Maya Vulcan
- Faculty of Humanities and Social Sciences, Graduate School of Creative Art Therapies, Kibbutzim College of Education, Tel Aviv, Israel.,Faculty of Social Welfare and Health Sciences, Graduate School of Creative Art Therapies, Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa, Israel
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Dubreucq M, Dubreucq J. Toward a Gender-Sensitive Approach of Psychiatric Rehabilitation in Autism Spectrum Disorder (ASD): A Systematic Review of Women Needs in the Domains of Romantic Relationships and Reproductive Health. Front Psychiatry 2021; 12:630029. [PMID: 33995144 PMCID: PMC8113637 DOI: 10.3389/fpsyt.2021.630029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/15/2021] [Indexed: 01/18/2023] Open
Abstract
Later age of diagnosis, better expressive behaviors, increased use of camouflage strategies but also increased psychiatric symptoms, more unmet needs, and a general lower quality of life are characteristics often associated with female gender in autism spectrum disorder (ASD). Psychiatric rehabilitation has shown small to moderate effectiveness in improving patients' outcomes in ASD. Few gender differences have been found in the response to psychiatric rehabilitation. This might be related to the predominance of males in research samples, but also to the lack of programs directly addressing women's unmet needs. The objectives of the present paper were: (i) to review the needs for care of autistic women in romantic relationships and reproductive health; (ii) to review the existing psychosocial treatments in these domains; and (iii) to evaluate the strengths and limitations of the current body of evidence to guide future research. A systematic electronic database search (PubMed and PsycINFO), following PRISMA guidelines, was conducted on autistic women's needs for care relating to psychiatric rehabilitation in romantic relationships and reproductive health. Out of 27 articles, 22 reported on romantic relationships and 16 used a quantitative design. Most studies were cross-sectional (n = 21) and conducted in North America or Europe. Eight studies reported on interventions addressing romantic relationships; no published study reported on interventions on reproductive health or parenting. Most interventions did not include gender-sensitive content (i.e., gender variance and gender-related social norms, roles, and expectations). Autistic women and autistic gender-diverse individuals may face unique challenges in the domains of romantic relationships and reproductive health (high levels of stigma, high risk of sexual abuse, increased psychiatric symptoms, and more unmet needs). We discussed the potential implications for improving women's access to psychiatric and psychosocial treatment, for designing gender-sensitive recovery-oriented interventions, and for future research.
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Affiliation(s)
- Marine Dubreucq
- Centre référent de réhabilitation psychosociale et de Remédiation Cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France.,Fondation FondaMental, Créteil, France
| | - Julien Dubreucq
- Centre référent de réhabilitation psychosociale et de Remédiation Cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France.,Fondation FondaMental, Créteil, France.,Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon 1, Lyon, France.,Réseau Handicap Psychique, Grenoble, France
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van Schalkwyk GI, Dewinter J. Qualitative Research in the Journal of Autism and Developmental Disorders. J Autism Dev Disord 2020; 50:2280-2282. [PMID: 32219632 DOI: 10.1007/s10803-020-04466-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Gerrit Ian van Schalkwyk
- Butler Hospital and Department of Psychiatry and Human Behavior, 345 Blackstone Blvd, Providence, RI, 02860, USA.
| | - Jeroen Dewinter
- GGzE, Centre for Child and Adolescent Psychiatry, and Tranzo Scientific Centre for Care and Wellbeing, Tilburg University, PO Box 909, 5600AX, Eindhoven, The Netherlands
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Sala G, Pecora L, Hooley M, Stokes MA. As Diverse as the Spectrum Itself: Trends in Sexuality, Gender and Autism. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2020. [DOI: 10.1007/s40474-020-00190-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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