Self-Report of Physical Health, Sexual Well-Being, and Alcohol Use in Adults with Autism Spectrum Disorder (ASD)

Background: There is increasing evidence that individuals with ASD experience higher rates of physical health problems (e.g., gastrointestinal disorders, sleep disturbances, obesity) as compared to the general population. However, previous researcher has also found that some conditions are less commonly diagnosed in adults with ASD (e.g., alcohol abuse/dependence). To the author’s knowledge, little is known about adults self-report of their own physical health, sexual functioning, and alcohol use.

Objectives: To explore profiles of self-reported physical health, sexual interest and satisfaction, as well as alcohol use in adults with ASD.

Methods: Data was collected from adults with ASD who were enrolled in state-funded programs in Pennsylvania. Participants completed a battery of self-reported questionnaires from the Patient-Reported Outcomes Measurement Information Systems (PROMIS), which measured physical health, sleep disturbance, impairment, fatigue, sexual interest and satisfaction. Additionally, current alcohol use in the past 30 days and BMI were included. Our sample of 55 adults with ASD is predominantly male (81.3%), White (89.1%) with a mean education level of 12.89 ± 1.91 years, and a mean age of 31.17 ± 7.64 years. 51% reported currently living with their parents. Mean SRS-2 Total T-Score was 61.44 ± 8.31.

Results: 27% of BMIs fell in the overweight range while 60% fell in the obese range (30.86 ± 5.35); this is significantly higher than the BMI for average Americans (25.55; p = 0.01). 16% of participants reported physical health problems and sleep impairment in the borderline range. 8% of participants reported borderline fatigue, as well as sleep disturbance. 4% reported clinical symptoms of fatigue. 2% reported clinical symptoms in sleep impairment/disturbance. 43% of participants reported no interest in sexual activity; however, 50% of participants reported that they are not satisfied with their sex life regardless of their reported level of interest in sexual activity. 16% of participants reported having drank at least one drink of an alcoholic beverage in the last 30 days compared to the American average of 56%. Physical health was correlated with being unemployed (r = -.29, p < .05), SRS-2 Total Score (r = .33, p < .05), sexual interest (r = -.42, p < .05), fatigue (r = .68, p < .01), sleep disturbance (r = .29, p < .05), and sleep impairment (r = .42, p < .01). Sleep impairment was associated with living with parents (r = -.35, p < .01). SRS-2 Total T-Score was correlated with greater sexual interest (r = 0.36, p < .05). Finally, drinking alcohol was associated with higher sexual satisfaction (r = 0.58, p < .05).

Conclusions: Self-report of physical health problems, sexual satisfaction and interest, and alcohol use in adults with ASD using PROMIS measures parallel findings from larger studies of children with caregiver self-report or big-data research, including higher rates of obesity in adults with ASD. Future research with larger, more representative samples of adults with ASD is necessary to clarify the degree to which physical health problems, sexual interest and satisfaction, as well as alcohol use in adults with ASD impact each other.