Qdtua Lisa, Williams Gemma, Mulcahy James, Larsson Dennis E O, Silva Marta, Arnold Andrew J, Critchley Hugo D, Garfinkel Sarah N
Department of Clinical Neuroscience, Brighton and Sussex Medical School (BSMS), University of Sussex, Brighton, United Kingdom.
Sussex Partnership NHS Foundation Trust, Brighton, United Kingdom.
Autism Adulthood. 2024 Sep 16;6(3):284-299. doi: 10.1089/aut.2022.0062. eCollection 2024 Sep.
Rates of loneliness are substantially higher among autistic compared with nonautistic individuals. This observation refutes the persistent stereotype that autistic individuals are not motivated to seek meaningful social relationships. More plausibly, social environments systematically exclude people with higher levels of sensory differences, impeding on opportunities for autistic individuals to form meaningful relationships. In this study, we sought to quantify the level of distress associated with loneliness (Study A) and provide complementary qualitative insight into experiences of loneliness in relationship to sensory differences in autistic adults (Study B).
In Study A, = 209 participants completed a range of self-report questionnaires. In Study B, nine autistic adults took part in 10-minute unstructured dyadic conversations around the topic of loneliness. We derived a qualitative understanding of autistic individuals' experience of loneliness, enriched by inductive and deductive analyses.
In Study A, the autistic group showed significantly higher levels of loneliness, loneliness distress, anxiety, depression, and sensory reactivity. We found significant positive correlations between variables, but no group differences in differential relationships. The effect of sensory reactivity on anxiety and depression was mediated by levels of loneliness in both groups. In Study B, autistic participants described the pain of feeling lonely and socially disconnected, while simultaneously experiencing a need for restorative solitude after social overstimulation.
Our results indicate that sensory differences are related with higher loneliness and associated poor mental health in both autistic and nonautistic adults. This effect was exacerbated in autistic adults due to higher levels of sensory reactivity. First-hand reports from autistic adults on intense loneliness and the obstructive role of sensory environments refute stereotypes about a lack of social motivation in autistic adults. We conclude that to enable meaningful and inclusive social interaction, a societal effort is needed to create spaces that consider the sensory needs of all neurotypes.
与非自闭症个体相比，自闭症个体的孤独率要高得多。这一观察结果驳斥了长期以来的刻板印象，即自闭症个体没有寻求有意义社会关系的动机。更合理的解释是，社会环境系统性地排斥感官差异较大的人，阻碍了自闭症个体建立有意义关系的机会。在本研究中，我们试图量化与孤独相关的痛苦程度（研究A），并对自闭症成年人孤独体验与感官差异之间的关系提供补充性的定性见解（研究B）。
在研究A中，209名参与者完成了一系列自我报告问卷。在研究B中，9名自闭症成年人围绕孤独主题进行了10分钟的非结构化双人对话。我们通过归纳和演绎分析，对自闭症个体的孤独体验有了定性的理解。
在研究A中，自闭症组的孤独感、孤独痛苦、焦虑、抑郁和感官反应水平显著更高。我们发现各变量之间存在显著的正相关，但在差异关系上没有组间差异。在两组中，感官反应对焦虑和抑郁的影响均由孤独水平介导。在研究B中，自闭症参与者描述了感到孤独和社交脱节的痛苦，同时在社交过度刺激后又体验到恢复性独处的需求。
我们的结果表明，感官差异与自闭症和非自闭症成年人中更高的孤独感以及相关的心理健康问题有关。由于更高的感官反应水平，这种影响在自闭症成年人中更为严重。自闭症成年人关于强烈孤独感和感官环境阻碍作用的第一手报告驳斥了关于自闭症成年人缺乏社交动机的刻板印象。我们得出结论，为了实现有意义和包容性的社会互动，需要社会做出努力，创造考虑到所有神经类型感官需求的空间。
