The Extent and Nature of Autistic People's Violence Experiences During Adulthood: A Cross-sectional Study of Victimisation

Post-traumatic stress disorder and experiences involving violence or sexual abuse in a clinical sample of autistic adults with intellectual disabilities: Prevalence and clinical correlates

LAY ABSTRACT

Post-traumatic stress disorder is a mental health disorder that may be triggered by the experience of events perceived as terrifying or overwhelming. Examples of such events include being the victim of violence or sexual abuse. Compared with other people, autistic people have increased risk of being exposed to violence or sexual abuse. In addition, autistic people may be more vulnerable to developing post-traumatic stress disorder following such exposure. However, knowledge is limited concerning the prevalence of experiences involving violence and sexual abuse, and post-traumatic stress disorder, in autistic people with co-occurring intellectual disabilities. Detection of these experiences, and identification of post-traumatic stress disorder, may be challenging in these individuals, and previous research indicates that post-traumatic stress disorder symptoms may be overlooked or misinterpreted. In this study, we examined prevalence of post-traumatic stress disorder, violence and sexual abuse in a clinical sample of 88 autistic adults with intellectual disabilities referred for mental health assessment. Only 3.4% were diagnosed with post-traumatic stress disorder, even if experiences involving violence (34.1%) or sexual abuse (17.0%) were common. Anxiety and affective disorders were common diagnoses among participants with these experiences. Controlling for autism characteristics, level of intellectual disability and communication skills, experiences of violence/sexual abuse were found to be associated with a measure of 'challenging' behaviours. These results indicate that potentially traumatic experiences are common in autistic adults with intellectual disabilities referred for mental health assessment, and that post-traumatic stress disorder may be under-recognised. The findings highlight the importance of trauma screening and post-traumatic stress disorder assessment, as well as the importance of trauma-informed care, in this population.

Exploring social touch in autistic and non-autistic adults via a self-report body-painting task: The role of sex, social context and body area

LAY ABSTRACT

What is already known about the topic?At least in neurotypical individuals, social touch represents an important channel for emotional communication associated with social bonding and pain/anxiety modulation. Autistic adults report to avoid social touch more and to have different tactile sensitivity than their non-autistic comparisons.What this paper adds?Few studies specifically investigated social touch in autistic individuals, and none of them examined the role of participants' sex, social context in which social touch occurs, and specific body areas being touched. In our study, adult participants reported how pleasant, erogenous and appropriate they would consider touches delivered by another person over their entire body in intimate (date), friendly (dance class) and professional (physiotherapy-massage session) social contexts. Autistic adults reported social touch to be less pleasant, erogenous and appropriate specifically in intimate and friendly social contexts and in body areas typically touched in these situations. Importantly, autistic females seem more at risk to experience unpleasant social touch as, although they considered it more unpleasant than non-autistic females and autistic males, they did consider it similarly appropriate in professional social contexts where touch is normed to be socially appropriate.Implications for practice, research or policyOur results might improve awareness and understanding about autistic adults' different, and often more discomforting, experience of social touch and thus help consider and respect it during everyday social interactions. Our results might also benefit future research investigating, for instance, the neural underpinnings of social touch differences in autism or aiming at developing support for autistic individuals seeking help in the diverse spheres of social touch.

Poly-victimization of autistic adults: An investigation of individual-level correlates

Autistic people experience high rates of violence and victimization which is largely due to structural injustices, including stigma and social attitudes. Identifying and addressing systemic and structural factors is vitally important, however effecting change in embedded social structures is likely to take some time, even with concerted efforts. In the meantime, it is important to understand whether there are other individual-level factors that may assist in developing preventative and protective strategies for autistic people. The current study investigated the role of individual-level risk factors in the victimization of autistic people. Specifically, we examined whether characteristics that are common among autistic people that is, lower social competence, higher compliance and emotion regulation difficulties or more ADHD features (inattention, impulsiveness and hyperactivity) were associated with poly-victimization in a community sample of 228 adults (118 autistic, 110 non-autistic). Our results show that only ADHD features were predictive of poly-victimization once socio-demographic background variables (age, sexual orientation) were adjusted for. Group status was not a significant predictor in the model and there were no interaction effects between any of the characteristics and group status. These findings suggest that, regardless of whether a person is autistic, ADHD features may place individuals at higher risk of experiencing multiple forms of violence in adulthood. Further research using longitudinal designs and larger, diverse samples is needed. Furthermore, the regression model only accounted for about one-third of the variance in poly-victimization which highlights the importance of looking beyond individual-level risk factors to structural and systemic factors that contribute to disproportionate victimization of autistic people.

'Maybe we just seem like easy targets': A qualitative analysis of autistic adults' experiences of interpersonal violence

LAY ABSTRACT

Research has consistently shown that autistic children are more likely to be victimised than non-autistic children. More recently, studies have also found that autistic adults report experiencing more violence than non-autistic adults however the circumstances surrounding these incidents and the reasons for this are not clear. We wanted to learn more about violence during adulthood for autistic people including what led up to these incidents and what happened afterwards. We spoke to 22 autistic adults who had experienced violence and analysed what they told us to look for common themes. They told us that violence was commonplace in their own lives and in the lives of other autistic people that they know, so much so that they had even come to expect it to happen. They also talked about the negative effect these experiences had on their mental health, the way they felt about themselves and their ability to trust people. This was made worse if people did not believe them when they disclosed what had happened to them. They told us that certain autistic characteristics might make them more vulnerable like being too trusting or going along with people just to please them. They thought that some of these characteristics had been shaped by their experiences, especially being told that that their thoughts, feelings or behaviours were wrong and being pressured to change the way they behaved to 'fit in'. These findings are important in helping us to understand how to improve the personal safety of autistic people.

'Living in a world that's not about us': The impact of everyday life on the health and wellbeing of autistic women and gender diverse people

BACKGROUND

Autistic women and gender diverse people have specific needs related to their physical and mental health. They also experience more barriers to accessing services. While there are autobiographical accounts of the 'invisible' challenges that autistic women and gender diverse people face day-to-day, there has been limited research that explores how these experiences impact health and wellbeing.

OBJECTIVES

This study aimed to understand the everyday experiences of autistic women and gender diverse people, and their impact on health and wellbeing.

DESIGN

Qualitative methods were used to elicit rich information about the unique experiences of autistic women and gender diverse people.

METHODS

We conducted semi-structured interviews with 31 autistic adults. The data were analysed using reflexive thematic analysis.

RESULTS

We identified 3 themes and 10 subthemes. Our first theme described 'all the stuff that you have to do to get through life', including managing domestic tasks, parenting, unique health needs and co-occurring physical conditions. The second theme outlined the impact of 'living in a world that's not about us', describing how navigating the neurotypical world, managing gender role expectations and trying to fit impacts on mental health. Our third theme outlined the positive impacts of 'shedding all the layers and being myself', including the importance of formal identification, exploring autistic identity and community, and including autistic people in research to support them to 'have a good life on their own terms'.

CONCLUSION

This study emphasized the importance of shifting the responsibility of health and wellbeing from the individual, and the importance of interpersonal, community, cultural, policy and societal factors in ensuring positive health outcomes for autistic women and gender diverse people. It also highlighted areas that enable autistic women and gender diverse people to flourish, including autistic community connectedness, positive relationships and autistic-affirming support from health professionals.