Autistic individualsoften experiencehigher rates of anxietyand depression compared to the general population. This increased prevalence may be due to several factors:
Understanding these factors is crucial for developing effective support strategies and improving quality of life for autistic individuals.
Key Points
Rationale
Quality of life (QoL) is lower in autistic adults compared to typically developing (TD) adults (Ayres et al., 2018; Graham Holmes et al., 2020).
Recent research has examined the role of depression and anxiety in reducing QoL in autistic adults, but findings have been inconsistent (Lawson et al., 2020; Mason et al., 2019; Oakley et al., 2021; Park et al., 2019).
Some studies found depressive symptoms negatively impacted all QoL domains (Lawson et al., 2020; Mason et al., 2019), while others did not find effects on social or environmental QoL (Oakley et al., 2021; Park et al., 2019).
Findings on anxiety’s impact have also varied. Additionally, most studies used English-speaking samples and did not examine autism-specific aspects of QoL.
Using validated measures for autistic adults allowed for a more comprehensive examination of how mental health symptoms relate to various facets of QoL in this population.
Method
Procedure
Cross-sectional study design. Participants completed questionnaires either on paper or online.
Sample
86 autistic adults (24.4% female; age 18-67 years) and 87 matched TD adults (24.1% female; age 18-70 years).
Groups matched on age, gender, and education status.
Measures
Statistical measures
Independent samples t-tests, Mann-Whitney U-tests, MANOVA, ANOVA, Scheffé post-hoc tests, and regression analyses.
Results
Hypothesis 1:QoL would be lower in autistic compared to TD adults.
Result:Confirmed. Autistic adults scored significantly lower on all WHOQoL-BREF domains and ASQoL total compared to TD adults.
Hypothesis 2:Depressive and anxious symptoms would negatively impact QoL in both autistic and TD adults.
Result:Partially confirmed.
Other findings:
Insight
This study provides strong evidence that depressive symptoms have a substantial negative impact on quality of life for both autistic and non-autistic adults, even more so than autism diagnosis or anxious symptoms.
The results suggest that the lower QoL often reported in autistic adults may be largely attributable to higher rates of depression in this population, rather than autism traits alone.
This highlights the importance of effectively diagnosing and treating depression in autistic adults to improve their overall well-being and life satisfaction.
The study also found that anxious symptoms primarily affected psychological QoL and autism-specific QoL.
This more circumscribed impact of anxiety compared to depression helps clarify some of the inconsistent findings in previous research regarding anxiety’s role in QoL for autistic adults.
Further research could explore:
Strengths
This study had several methodological strengths, including:
Limitations
This study also had several methodological limitations, including:
These limitations impact the generalizability of findings to autistic individuals with intellectual disabilities or to understanding how diagnosed clinical depression/anxiety in non-autistic adults compares to the impact of these symptoms in autistic adults.
The cross-sectional nature also limits our ability to determine the direction of influence between mental health symptoms and QoL.
Implications
The results have significant implications for clinical practice and support services for autistic adults. The strong negative impact of depressive symptoms on QoL suggests that:
Variables that may influence these results include the severity of autism traits, co-occurring conditions beyond depression and anxiety, and environmental factors such as social support, employment, and access to appropriate mental health services.
The strong link between depressive symptoms and QoL across both autistic and non-autistic groups also emphasizes the universal importance of mental health support for enhancing quality of life.
References
Primary reference
Thiel, T., Riedelbauch, S., Gaigg, S., Roessner, V., & Ring, M. (2024). The impact of depressive and anxious symptoms on quality of life in adults on the autism spectrum.Autism Research.https://doi.org/10.1002/aur.3144
Other references
Ayres, M., Parr, J. R., Rodgers, J., Mason, D., Avery, L., & Flynn, D. (2018). A systematic review of quality of life of adults on the autism spectrum.Autism,22(7), 774-783.https://doi.org/10.1177/1362361317714988
Graham Holmes, L., Zampella, C. J., Clements, C., McCleery, J. P., Maddox, B. B., Parish‐Morris, J., … & Miller, J. S. (2020). A lifespan approach to patient‐reported outcomes and quality of life for people on the autism spectrum.Autism Research,13(6), 970-987.https://doi.org/10.1002/aur.2275
Lawson, L. P., Richdale, A. L., Haschek, A., Flower, R. L., Vartuli, J., Arnold, S. R., & Trollor, J. N. (2020). Cross-sectional and longitudinal predictors of quality of life in autistic individuals from adolescence to adulthood: The role of mental health and sleep quality.Autism,24(4), 954-967.https://doi.org/10.1177/1362361320908107
Mason, D., Mackintosh, J., McConachie, H., Rodgers, J., Finch, T., & Parr, J. R. (2019). Quality of life for older autistic people: The impact of mental health difficulties.Research in Autism Spectrum Disorders,63, 13-22.https://doi.org/10.1016/j.rasd.2019.02.007
Oakley, B. F., Tillmann, J., Ahmad, J., Crawley, D., San José Cáceres, A., Holt, R., … & Loth, E. (2021). How do core autism traits and associated symptoms relate to quality of life? Findings from the Longitudinal European Autism Project.Autism,25(2), 389-404.https://doi.org/10.1177/1362361320959959
Park, S. H., Song, Y. J. C., Demetriou, E. A., Pepper, K. L., Norton, A., Thomas, E. E., … & Guastella, A. J. (2019). Disability, functioning, and quality of life among treatment-seeking young autistic adults and its relation to depression, anxiety, and stress.Autism,23(7), 1675-1686.https://doi.org/10.1177/1362361318823925
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Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
