Autistic Traits Predict High Self-Perceived Stress and Poor Coping in High-Functioning Adults with ASD

Background:  

Despite normal intellectual capacity, autistic traits may complicate performance in many everyday situations. Thus, common everyday situations that require social interaction, communication and/or behavioural flexibility may constitute stressors for high-functioning individuals with ASD.  Internal or external stimuli that an individual perceives as threatening (i.e. stressors) disturb the dynamic equilibrium of the body (i.e. homeostasis) and elicit a stress reaction. It is not only the individual’s perception of threat/stressors that is crucial for the perception of distress, but also the individual’s subjective perception of his or her ability to cope with the specific stressor, or perception of control.

Objectives:  

The aim of the study was to describe level of subjective stress in everyday life and self-perceived ability to cope with stress in adults with high-functioning autism spectrum disorders (ASD), adults with attention-deficit/hyperactivity disorder (ADHD; i.e. another clinical group known to report high subjective stress), and controls from general population. Second aim was to study association between autistic traits and self-perceived stress and coping.

Methods:  

Seventy-four adults (25 with ASD; 21 with ADHD; 28 controls from general population) completed the Perceived Stress Scale. The results in the PSS were analysed using a two-factor solution (PSS Distress versus PSS Coping) based on a previous factor analysis. Autistic traits were assessed using the Autism Spectrum Questionnaire (AQ) that measures a variety of behaviours and characteristics typically observed in individuals with ASD, or “autistic traits”. The AQ is not only sensitive in diagnosed individuals but can also detect variance in non-clinical autistic traits. The AQ was completed by individuals with ASD and controls.

Results:  The three groups (ASD, ADHD, and controls from general population) were comparable with regard to age, within-group gender distribution, Swedish versus non-Swedish origin, as well as educational level. However, the controls more often worked or studied fulltime as compared to the groups with neurodevelopmental disorder. Both adults with ASD and ADHD reported significantly higher subjective stress and poorer ability to cope with stress in everyday life, as compared to controls (large effect sizes), while the clinical groups did not differ from each other. Autistic traits (total score of AQ) correlated with PSS Distress (r =. 64, r²=.41, p < .001) and PSS Coping (r = .63, r²=.40, p < .001). A mediator analysis revealed that also when controlling for the possible mediator role of the Coping subscale, the AQ still significantly predicted the Distress subscale scores (standardized beta coefficient = .42, p = .002).Thus, autistic traits were an independent predictor of both subjective stress/distress and coping in this cross-sectional material.

Conclusions:  

ASD is associated with high level of subjective stress and perception of poor coping ability in high-functioning individuals. Long-term consequences of chronic stress in everyday life as well as treatment intervention focusing on stress and coping, should be addressed in future research as well as in clinical management of ASD in high-functioning adults.