Romantic Relationship Experience in Autism Spectrum Disorder

Background:

Socio-sexual functioning encompasses an individual’s interests, behaviours, and understandings with respect to sexual, romantic, and social aspects of life. Previous systematic review and meta-analyses revealed differences in these areas, between typically developing (TD) individuals and individuals with ASD. It was further suggested that an individual’s understanding of these domains is developed through both experiences and sex education. However, empirical evidence for the effect of ASD on romantic relationship experience is scant.

Objectives:

A proposed theoretical model predicted that individuals with ASD would report less romantic relationship experience than typically developing (TD) individuals. The aim of this study was to measure and explore this, assessing whether the relationship between ASD status (ASD or non-ASD) and romantic relationship experience, is mediated by peer engagement.

Methods:

An online questionnaire comprising of the Sexual Behaviour Scale – third edition (SBS-III), a measure of sexual functioning validated by item response analysis was completed by 232 individuals with ASD (mean age 25) and 227 individuals without ASD (mean age 22). A mediation analysis was undertaken to assess the indirect relationship between ASD status and romantic relationship experience, as mediated by peer engagement.

Results:

Compared to those without ASD, those with ASD did not differ to the degree that they were interested in being in a relationship (p = ns), however were found to have fewer relationship opportunities, t₍₄₅₇₎=-1.76, p<.05, d=0.17, and had relationships that lasted a briefer time, t₍₃₂₁₎=‑2.79, p<.01, d=0.31. This is consistent with greater worry about not being able to build and maintain good relationships reported by individuals with ASD, compared those without such diagnosis, t₍₄₃₄₎=4.71, p<.001, d=0.44. Additionally, those without ASD had greater formal sex-education than those without, t₍₄₅₈₎=2.33, p<.05, d=0.22.

While controlling for age and gender, analyses confirmed the presence of an indirect effect between ASD and romantic relationship experience (b=0.78, 95%CI [.33, 1.40]). The effect remained evident even when not controlling for age and gender. This indicates that the relationship between ASD status and amount of romantic relationship experience, is mediated by the amount of peer engagement. Additional analyses suggested that gender was also a predictor of relationship total (b=‑3.29, 95%CI [‑1.49, ‑5.10]), with an increase in gender to female a person with ASD was likely to have had fewer relationships.

Conclusions:

It was found that the impact of an ASD diagnosis on one’s ability to establish and maintain romantic relationships is mediated by the amount of engagement that they have with peers. This supports an important part of the proposed model, that is, that having less social peer engagement, along with receiving less sex education, leaves individuals with ASD at a double disadvantage from others, who are receiving this information from both of these avenues. For clinicians, these findings suggest that interventions and supports should be focused on improving the amount of social engagement, as this will also improve the individual’s romantic relationship experiences. Such understanding and support is of particular importance given the central role of social and sexual wellbeing on one’s quality of life.