Loneliness and Quality of Life for the Broader Autism Phenotype

Background:

Autism-related traits vary along a wide severity continuum, including subclinical traits that are continuously distributed among the general population (commonly referred to as the broader autism phenotype; BAP). Recognition of the BAP has led to increased interest in how these milder autism characteristics may influence functional outcomes in nonclinical populations. A small body of research has found that the BAP is related to fewer and lower-quality interpersonal relationships, as well as increased loneliness. This study investigated specific associations between the BAP and relationship quality and outcomes. Clarifying these associations is critical for identifying factors impacting quality of life in individuals with both subclinical and clinically significant symptoms of autism.

Objectives:

(1) Compare loneliness, distress, quality of life, relationship status, and social support among college students with and without BAP traits. (2) For the BAP group, investigate whether loneliness is associated with negative mental and physical health outcomes, and whether it accounts for a relationship between BAP traits and lower quality of life. (3) Test whether quantity and quality of relationships influences the impact of BAP traits on loneliness.

Methods:

Participants were 736 students (18-30 years, M=20.9, 65% female, 44% in a relationship) at the University of Utah. Participants completed the Broader Autism Phenotype Questionnaire (subscales: aloofness, pragmatic language, rigidity), the UCLA Loneliness Scale, the Depression Anxiety and Stress Scale, the MOS Social Support Survey, and the WHO Quality of Life-Bref (subscales: physical health, psychological, social, and environmental).

Results:

Individuals who met criteria for BAP (n = 95) rated themselves as experiencing more loneliness (p<.001) than their non-BAP peers. Additionally, the BAP group reported higher levels of stress, depression, and anxiety (p’s<.001), and poorer quality of life across all domains (p’s<.001). Within the BAP group, greater loneliness was correlated with increased stress (p=.001), depression (p=.001), and anxiety (p=.036). Furthermore, loneliness mediated the relationship between BAP and quality of life (p<.001). The BAP group was as likely as the non-BAP group to report a current romantic relationship (p=.473), yet reported lower overall levels of social support (p=.001). Both number of significant relationships and the perceived social support provided by those relationships were predictors of loneliness (p’s<.001) within the BAP group. Of the BAPQ subscales, aloofness uniquely predicted loneliness within the BAP group, including when controlling for relationship status and gender.

Conclusions:

Individuals with subclinical autism-related traits are more likely to experience loneliness, resulting in poorer health outcomes and perceived quality of life. Quality of significant relationships predicts levels of loneliness in individuals with BAP. Additionally, the BAP trait of aloofness appears to be specifically related to loneliness. Together, these findings indicate that people with subclinical autism symptoms experience difficulty with relationships, and this difficulty is reflected in their health and quality of life. The importance of supporting healthy relationships is underscored for individuals across the autism spectrum.