Ee Dawn, Hwang Ye In Jane, Reppermund Simone, Srasuebkul Preeyaporn, Trollor Julian N, Foley Kitty-Rose, Arnold Samuel R C
Department of Developmental Disability Neuropsychiatry (3DN), UNSW Sydney, Sydney, Australia.
The Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia.
Autism Adulthood. 2019 Sep 1;1(3):182-193. doi: 10.1089/aut.2018.0038. Epub 2019 Sep 11.
BACKGROUND: Loneliness is associated with adverse psychological and physical outcomes. However, little is known about the factors contributing to loneliness in autistic adults. This study aimed to quantitatively compare levels and predictors of loneliness in autistic and nonautistic adults, and then contextualize these findings by thematically analyzing responses to open-ended questions on autistic adults' socialization experiences. METHODS: We obtained data from the Cooperative Research Centre for Living with Autism (Autism CRC) Australian Longitudinal Study of Adults with Autism (ALSAA). The sample comprised 220 autistic adults (age mean [] = 41.9 years, standard deviation [SD] = 12.24) and 146 nonautistic adults (age = 43.7 years, SD = 13.49). We measured loneliness with the University of California, Los Angeles (UCLA) loneliness scale (ULS-8). We compared the findings between these two groups of adults. Through regression models, we investigated associations between loneliness and demographics, autistic traits, social support, depression, anxiety, and self-efficacy. We adapted these determinants from De Jong-Gierveld's model of loneliness. In addition, we conducted an inductive thematic analysis of autistic participants' open-ended responses about their socialization. We used an inclusive approach utilizing an advisory panel of autistic adults in study design and interpretations. RESULTS: Autistic adults scored significantly higher on the ULS-8 than nonautistic adults ( < 0.001). The presence of autism contributed the greatest variance in the loneliness score ( = 8.11, 95% confidence interval [6.98-9.23], < 0.001, = 0.38). The autism quotient subdomains of social skills and dissatisfaction with social support were associated with greater loneliness in both autistic and nonautistic groups ( < 0.05). The thematic analysis contextualized the interpretation of quantitative findings, specifically regarding perceived loneliness and difficulties with social interaction. Satisfaction and perceptions of socialization were widely variable and both of which were shaped by experiences. Environmental factors, noise in particular, as well as social communication difficulties and past negative experiences seemed to be the barriers to socialization. CONCLUSIONS: Autistic adults have reported higher levels of loneliness. Variables associated with loneliness in both groups were dissatisfaction with social support and the autism quotient subdomain of social skills. The subjectivity of perceived loneliness, views about socialization, and their implications for social support in autistic adults warrant further study.
背景:孤独与不良的心理和生理后果相关。然而,对于导致成年自闭症患者孤独的因素知之甚少。本研究旨在定量比较成年自闭症患者和非自闭症患者的孤独程度及预测因素,然后通过对成年自闭症患者社交经历的开放式问题的回答进行主题分析,将这些发现置于具体情境中。 方法:我们从自闭症合作研究中心(自闭症CRC)澳大利亚成人自闭症纵向研究(ALSAA)中获取数据。样本包括220名成年自闭症患者(平均年龄[] = 41.9岁,标准差[SD] = 12.24)和146名非自闭症成年人(年龄 = 43.7岁,SD = 13.49)。我们使用加利福尼亚大学洛杉矶分校(UCLA)孤独量表(ULS - 8)测量孤独感。我们比较了这两组成年人的研究结果。通过回归模型,我们研究了孤独感与人口统计学、自闭症特征、社会支持、抑郁、焦虑和自我效能之间的关联。我们从德容 - 吉尔弗尔德的孤独模型中选取了这些决定因素。此外,我们对自闭症参与者关于他们社交情况的开放式回答进行了归纳主题分析。我们在研究设计和解释中采用了一种包容性方法,利用了一个成年自闭症患者咨询小组。 结果:成年自闭症患者在ULS - 8上的得分显著高于非自闭症成年人(<0.001)。自闭症的存在在孤独感得分中贡献了最大的方差(= 8.11,95%置信区间[6.98 - 9.23],<0.001,= 0.38)。社交技能和对社会支持的不满这两个自闭症商数子领域在自闭症和非自闭症群体中都与更高的孤独感相关(<0.05)。主题分析将定量研究结果的解释置于具体情境中,特别是关于感知到的孤独感和社交互动困难方面。社交满意度和社交认知差异很大,两者都受经历影响。环境因素,尤其是噪音,以及社交沟通困难和过去的负面经历似乎是社交的障碍。 结论:成年自闭症患者报告的孤独程度更高。两组中与孤独感相关的变量是对社会支持的不满和社交技能的自闭症商数子领域。成年自闭症患者感知到的孤独感的主观性、对社交的看法及其对社会支持的影响值得进一步研究。
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