Brosnan Mark, Adams Sally
Centre for Applied Autism Research, Department of Psychology, University of Bath, Bath, United Kingdom.
Addiction and Mental Health Group, Department of Psychology, University of Bath, Bath, United Kingdom.
Autism Adulthood. 2020 Dec 1;2(4):317-324. doi: 10.1089/aut.2020.0008. Epub 2020 Dec 11.
For autistic adults, the perceived benefits of drinking alcohol to facilitate social interaction may be particularly appealing. Alcohol may be considered "self-medication" for clinical features of autism or may be used to help cope with elevated levels of co-occurring anxiety.
We developed an online survey and 507 autistic adults responded to questions concerning their expectancies and motivations for heavy episodic drinking. The survey also included questions about ways of seeking support, if needed, and barriers to seeking support.
Over half of those who had drunk alcohol reported heavy episodic drinking in the past year (6 or more units of alcohol at one time). Heavy episodic drinkers endorsed traditional expectancies (e.g., "Alcohol generally has powerful positive effects on people") and autism-specific expectancies (e.g., "Alcohol makes verbal communication easier") to a greater degree than nonheavy episodic drinkers. Autism-specific expectancies, not traditional expectancies, related to frequency of drinking. The strongest motivations for heavy episodic drinking were for social reasons and to enhance positive feelings, rather than for conformity or coping. If support was required for problematic drinking, the internet was the most commonly chosen resource, although 45% of the participants indicated that they would not seek support. Perceived barriers to support included concern that it would take place in an unfamiliar chaotic environment and concern about being misunderstood and judged by a therapist.
This study is the first to identify the expectancies and motivations for heavy episodic drinking in autistic adults as well as identifying barriers to seeking support. There may be some autism-specific expectancies related to the nature of autism that impact upon heavy episodic drinking, as well as impacting upon seeking support. The autistic and broader autism communities can benefit from an awareness of these findings, and service providers can adapt support appropriately.
Little is known about how alcohol is used within the autistic community. One population-based study found that autistic adults were four times more likely to experience problematic drinking compared with nonautistic adults. This study identified the expectations and motivations for heavy episodic-or "binge"-drinking alcohol among autistic adults. Binge drinking is a risk factor for problematic drinking. The study also identified how autistic adults accessed support should it be needed, and what the potential barriers were to accessing support. We conducted an online survey with 507 autistic adults with formal or informal diagnoses of autism. The survey asked about the frequency of drinking alcohol and binge drinking. Participants then answered a questionnaire about why they drank alcohol. The questions asked about general reasons for drinking (such as: "Alcohol generally has powerful positive effects on people [e.g., makes you feel good or happy; future seems brighter]") as well as autism-related reasons (such as: "Alcohol makes verbal communication easier [e.g., starting conversations, responding to what other people say, or maintaining a normal back-and-forth conversation]"). Finally, participants answered questions about seeking help and potential barriers to help-seeking. Binge drinkers reported a greater number of traditional and autism-relevant expectations for drinking alcohol than nonbinge drinkers. The strongest motivations for drinking alcohol were for social reasons and to enhance positive feelings, rather than coping or to conform. The internet was the most common source of support for problematic drinking (49% of participants); however, 45% of participants indicated that they would not seek any support. Perceived barriers to support were an unfamiliar chaotic environment and being misunderstood and judged by a therapist. Around one fifth of participants self-diagnosed themselves with autism, rather than having a formal diagnosis from a clinician. These two groups were very similar to each other. This is the first study to identify the expectations and motivations for binge drinking alcohol in the autistic community. This was an online survey, and the diagnostic status of participants cannot be verified. Participants chose to take part in the study, and this may represent a bias as some people may not want to take part in online surveys or may not have access to the internet, or may not be part of networks that send out invitations to take part in research. In addition, the sample was largely female and well educated, which is not reflective of the autistic population as a whole. Better understanding the expectations and motivations for binge drinking alcohol can help inform support that is targeted at the autistic community. Alcohol support services can be better informed about how to adapt their provision for the autistic community specifically.
对于成年自闭症患者而言，饮酒在促进社交互动方面所带来的预期益处可能格外具有吸引力。酒精可能被视为针对自闭症临床特征的“自我治疗”方式，或者被用于帮助应对同时出现的焦虑情绪升高问题。
我们开展了一项在线调查，507名成年自闭症患者回答了有关他们大量饮酒的预期和动机的问题。该调查还包括有关在需要时寻求支持的方式以及寻求支持的障碍的问题。
超过一半的饮酒者报告在过去一年中有大量饮酒行为（一次饮用6个或更多酒精单位）。与非大量饮酒者相比，大量饮酒者更认同传统预期（例如，“酒精通常对人有强大的积极影响”）和特定于自闭症的预期（例如，“酒精使言语交流更容易”）。特定于自闭症的预期而非传统预期与饮酒频率相关。大量饮酒的最强烈动机是社交原因以及增强积极情绪，而非为了从众或应对。如果饮酒出现问题需要支持，互联网是最常被选择的资源，尽管45%的参与者表示他们不会寻求支持。感知到的支持障碍包括担心会在不熟悉的混乱环境中进行，以及担心会被治疗师误解和评判。
本研究首次确定了成年自闭症患者大量饮酒的预期和动机，以及寻求支持的障碍。可能存在一些与自闭症本质相关的特定于自闭症的预期，这些预期既影响大量饮酒，也影响寻求支持。自闭症群体及更广泛的自闭症社区能够从对这些发现的认识中受益，服务提供者也可以适当地调整支持措施。
关于自闭症群体中酒精的使用情况知之甚少。一项基于人群的研究发现，成年自闭症患者出现饮酒问题的可能性是非自闭症成年患者的四倍。本研究确定了成年自闭症患者大量饮酒（即“暴饮”）的预期和动机。暴饮是饮酒出现问题的一个风险因素。该研究还确定了成年自闭症患者在需要时获取支持的方式，以及获取支持的潜在障碍。我们对507名有正式或非正式自闭症诊断的成年自闭症患者进行了在线调查。该调查询问了饮酒和暴饮的频率。参与者随后回答了一份关于他们饮酒原因的问卷。问题涉及饮酒的一般原因（例如：“酒精通常对人有强大的积极影响[例如，让你感觉良好或开心；未来看起来更光明]”）以及与自闭症相关的原因（例如：“酒精使言语交流更容易[例如，开启对话、回应他人所说的话或维持正常的来回对话]”）。最后，参与者回答了关于寻求帮助以及寻求帮助的潜在障碍的问题。暴饮者报告的关于饮酒的传统和与自闭症相关的预期比非暴饮者更多。饮酒的最强烈动机是社交原因以及增强积极情绪，而非应对或从众。互联网是饮酒问题最常见的支持来源（49%的参与者）；然而，45%的参与者表示他们不会寻求任何支持。感知到的支持障碍是不熟悉的混乱环境以及被治疗师误解和评判。大约五分之一的参与者是自我诊断为自闭症，而非由临床医生进行正式诊断。这两组彼此非常相似。这是第一项确定自闭症群体中暴饮酒精的预期和动机的研究。这是一项在线调查，参与者的诊断状况无法核实。参与者选择参与研究，这可能存在偏差，因为有些人可能不想参与在线调查，或者可能无法访问互联网，或者可能不属于收到参与研究邀请的网络。此外，样本主要是女性且受教育程度高，这并不反映整个自闭症群体的情况。更好地理解暴饮酒精的预期和动机有助于为针对自闭症群体的支持提供信息。酒精支持服务可以更好地了解如何专门为自闭症群体调整其服务提供。
