Autism Severity, Social Identity and Well-Being in Autistic Young People

Background: Autistic people are more likely to struggle with mental health problems than the general population, and autistic traits are also associated with poor psychological well-being. Individuals who strongly identify as an autistic person (referred to as autism identity) and feel positively about this identity (autism collective self-esteem) have been found to have improved mental health compared to individuals who feel negatively about their autism identity. This is consistent with findings from other stigmatised groups in the social identity literature. However there has been no research to date investigating the relationship between autism traits and autism identity in autistic people, despite the importance of these two factors for psychological well-being. Developing and maintaining a sense of affiliation with in-group members, i.e. other autistic people, may be a particular challenge for individuals high in autistic traits, due to the social communication deficits characteristic of this group.

Objectives: This study aimed to investigate the impact of self-reported autism severity on autism identity and psychological well-being in autistic young people aged 17 and 18, using well validated measures. It was hypothesised that individuals with higher self-reported autism severity would have a lower sense of autism identity and collective self-esteem, lower well-being and higher social anxiety scores.

Methods: Participants (n=49) were young people with a clinical diagnosis of an Autism Spectrum Disorder (ASD). The Social Responsiveness Scale-Short was used to divide participants into high and low severity groups, based on whether they scored above or below the average score across participants. Participants also completed two self-report measures of psychological wellbeing; the Social Anxiety Scale for Adolescents and the Warwick-Edinburgh Mental Well-being Scale. Finally, participants completed measures of their autism identity and autism collective self-esteem.

Results: A one-way ANOVA with the factor group (high vs low autism severity) was conducted with the dependent variables autism identity, autism collective self-esteem, mental well-being and social anxiety. There was no significant effect of group on autism identification or autism collective self-esteem. There was a significant effect of autism severity on mental well-being F(1,47)=4.24), p=.045, with higher well-being in the low severity group (Mean=45.7, SD=1.28) compared to the high severity group (Mean = 41.67, SD=1.47). There was also a significant effect of autism severity on social anxiety F(1,47)=10.69), p=.002, with higher social anxiety in the high severity group (Mean=68.33, SD = 2.55) compared to the low severity group (Mean = 57.28, SD = 2.21).

Conclusions: In line with the hypothesis, high autism severity was associated with lower mental well-being and higher social anxiety scores. This fits with the well-established link between autism and poor mental health. We predicted that higher autism severity would decrease sense of autism identity, however it seems that autism severity does not impact on sense of identity as an autistic person. This means that autistic individuals from all parts of the spectrum are equally likely to identify (or not identify) as autistic, suggesting that severe autistic traits are not a barrier to a sense of affiliation with other autistic people.