Perceived Social Support in Cognitively High Functioning Adults with Autism Spectrum Disorder

Background:  The observation that perceived social support (PSS) is related to physical and mental well-being in typically developing individuals has motivated investigations of PSS in individuals with Autism Spectrum Disorder (ASD). However, prior efforts have been based on qualitative examinations in small samples without comparison groups of non-ASD adults. 

Objectives:  To provide quantitative characterization of PSS in adults with ASD we administered the Multidimensional Scale of Perceived Social Support (MSPSS), a self-report 12-item Likert scale examining PSS in three domains: friends, significant-others, and family. Secondary analyses explored the relationships between PSS and self-reported empathy and symptoms of comorbid psychopathology. 

Methods:  We obtained MSPSS scores from three groups of adults matched for age and IQ, including 41 adults with ASD (Mean age 30.5±11.2; Mean IQ 109±14), 61 with ADHD, and 69 neurotypical controls (NC). There were significantly fewer males in the ADHD group (46% vs. 73% and 73% in ADHD, NC and ASD, respectively). To measure cognitive and affective empathy, as well as comorbidity, participants completed the Interpersonal Reactivity Index (IRI) and the Symptom Checklist-90-Revised (SCL-90-R) questionnaires, respectively. Their scores were related to the MPSSS scores in the two clinical groups. 

Results:  ANOVA adjusted for sex followed by pairwise group comparisons revealed significantly lower total MSPSS scores in ASD vs. adults with ADHD and NC (F= 3.460, p=0.02). Examinations of MSPSS subscore profiles highlighted that the MSPSS total score difference was primarily driven by the friend subscore (F=7.659, p<0.001), as no significant group differences emerged for the family and significant othersubscores. MSPSS total scores were significantly and negatively related to scores on SCL-90-R global indices in adults with ADHD, indicating that lower PSS is related to higher levels of psychopathology in ADHD. This relationship was not significant in adults with ASD. Further, MPSS total scores were significantly and positively related to the empathic concern subscale score of the IRI (indexing affective empathy) in adults with ASD (r=0.545, p<0.001), but not in the ADHD group. No relationships were evident with regards to perspective taking scores indexing cognitive empathy. 

Conclusions:  Relative to both NC and individuals with ADHD, cognitively high functioning adults with ASD reported significantly lower PSS, primarily as related to friends. This finding, along with the significant correlation between PSS and affective empathy skills in the ASD group only, suggest ASD-specific mechanisms leading to poorer PSS in autism. Findings of a significant relationship between comorbid psychopathology and PSS in the ADHD but not the ASD group were unexpected. These findings need to be interpreted with caution given the exclusive reliance on self-report measures and the relatively selected sample of adults with ASD. They may suggest that the traditional relationships between social support and mental well-being may not apply in the same way to adults with ASD. Future studies with a wider range of measures from multiple informants are needed to confirm the present findings.