"It's Not As Bad As All That": The Psychosocial Outcomes of Adult Autistic Women in Comparison to Their Neurotypical Peers

Background:

Research has repeatedly found that autistic individuals have worse psychosocial outcomes in adulthood than their neurotypical peers. These studies, however, have generally focused predominantly on male participants, and therefore may miss the specific experiences of autistic women, particularly women who are diagnosed later in life and have therefore had to navigate the world without the supports now often provided to young autistic people.

Objectives:

This research sought to examine the psychosocial outcomes of a group of autistic women in direct comparison to a group of neurotypical women, of similar age and intellectual ability. These outcomes included psychosocial outcomes, such as employment status and relationship closeness, alongside mental health issues and overall life satisfaction.

Methods:

We recruited 19 autistic women (M age = 30 years 2 months) and 19 neurotypical women (M age = 28 years 8 months) and assessed them on demographic factors, the Unidimensional Relationship Closeness Scale (URCS: rating their most significant relationship); the General Anxiety Disorder-7 (anxiety: GAD-&); the Patient Health Questionnaire-9 (depression: PHQ-9); the Zohar-Fineberg Obsessive Compulsive Screen (OCD: Z-FOCS); the SCOFF (disordered eating); the CAGE (problematic drinking); and the Satisfaction with Life Scale (overall life satisfaction: SWLS).

Results:

The majority of autistic women were in work or education (n=14, 74%) and enjoyed close relationships with friends and romantic partners. Indeed, there were no group significant differences in the degree of perceived closeness of their most significant relationship. The findings on mental health outcomes were more mixed, however. While autistic women were significantly more likely to have clinical levels of anxiety and depression than neurotypical women, and to screen positively for obsessive compulsive disorder, there were no significant group differences in terms of problematic drinking or disordered eating. Autistic women nevertheless rated themselves to be significantly less satisfied with their current life circumstances than neurotypical women, and this was significantly correlated with their higher depression scores.

Conclusions:

In contrast to much earlier research which has found poor adult outcomes for autistic individuals, this study shows, rather encouragingly, that late-diagnosed autistic women may achieve lives which are very like those of their neurotypical peers in terms of employment and long-term relationships. Autistic women, however, faced more mental health difficulties than neurotypical women. This latter finding may partly explain why autistic women rated themselves as less satisfied with their current life circumstances, regardless of their employment and relationship status – and suggests that improving the mental health support available for autistic women could yield concomitant improvements in their quality of life.