Aller Ty B, Kelley Heather H, Juhasz Audrey, Covington Benjamin
Institute for Disability Research, Policy, and Practice, USA.
Indiana State Department of Corrections, USA.
Autism. 2025 May;29(5):1359-1363. doi: 10.1177/13623613241313403. Epub 2025 Jan 25.
The COVID-19 pandemic caused significant health distress among autistic adults in the United States. While there is considerable evidence that autistic adults' COVID-19 health distress was related to increases in mental health concerns (e.g. depression, anxiety, and stress), there is a less clear understanding of the possible mechanisms by which this process occurs. Accordingly, our participatory action research team assessed whether psychological flexibility, a strengths-based mechanism from acceptance and commitment therapy, mediated the association between COVID-19-related health distress and mental health concerns (e.g. depression, anxiety, and stress). We found that among 281 autistic adults the positive relationship between COVID-19 health distress and mental health concerns was partially mediated by values progress (a component of psychological flexibility) and values obstruction (a component of psychological inflexibility). Results provide preliminary support that the strengths-based mechanism of psychological flexibility might be a salient therapeutic target to improve mental health among autistic adults experiencing health distress.Lay AbstractIn the United States, the COVID-19 Pandemic caused many autistic adults to be fearful and worried about their health. There is a lot of research that says that when autistic adults experience health distress it can worsen their mental health. We do not know, however, what might explain how experiencing health distress negatively affects mental health. Because of this, our participatory action research team wanted to understand if there are strengths-based processes that help us understand the relationship between health distress and mental health concerns.We examined among 281 autistic adults how a strengths-based construct from acceptance and commitment therapy called psychological flexibility might explain the relationship between health distress and mental health concerns. We found that for adults that had more values progress, doing the things that mattered to them, was associated with better mental health even while experiencing health distress. We also found that values obstruction, getting stuck on uncomfortable thoughts and feelings and trying to avoid them, explained worse mental health for autistic adults experiencing health distress.The findings of this study provide initial support that psychological flexibility can explain the relationship between health distress and mental health concerns among autistic adults. Interventions that seek to improve psychological flexibility, like acceptance and commitment therapy, might be useful in improving autistic adults' mental health while they are experiencing health distress.
新冠疫情给美国的成年自闭症患者带来了巨大的健康困扰。虽然有大量证据表明成年自闭症患者的新冠健康困扰与心理健康问题（如抑郁、焦虑和压力）的增加有关，但对于这一过程发生的可能机制，人们的理解还不太清晰。因此，我们的参与式行动研究团队评估了心理灵活性（接纳与承诺疗法中一种基于优势的机制）是否介导了新冠相关健康困扰与心理健康问题（如抑郁、焦虑和压力）之间的关联。我们发现，在281名成年自闭症患者中，新冠健康困扰与心理健康问题之间的正向关系部分由价值观进步（心理灵活性的一个组成部分）和价值观阻碍（心理僵化的一个组成部分）介导。研究结果初步支持了这样一种观点，即基于优势的心理灵活性机制可能是改善处于健康困扰中的成年自闭症患者心理健康的一个重要治疗靶点。
在美国，新冠疫情使许多成年自闭症患者对自身健康感到恐惧和担忧。大量研究表明，成年自闭症患者在经历健康困扰时，其心理健康状况会恶化。然而，我们并不清楚健康困扰是如何对心理健康产生负面影响的。因此，我们的参与式行动研究团队想了解是否存在基于优势的过程，有助于我们理解健康困扰与心理健康问题之间的关系。我们在281名成年自闭症患者中进行了研究，探讨接纳与承诺疗法中一种基于优势的概念——心理灵活性，是否能够解释健康困扰与心理健康问题之间的关系。我们发现，对于那些在价值观方面有更多进步（即做对自己重要的事情）的成年人来说，即使在经历健康困扰时，他们的心理健康状况也更好。我们还发现，价值观阻碍（即陷入不舒服的想法和感受并试图回避它们）可以解释为什么经历健康困扰的成年自闭症患者心理健康状况较差。这项研究的结果初步支持了心理灵活性能够解释成年自闭症患者健康困扰与心理健康问题之间关系的观点。旨在提高心理灵活性的干预措施，如接纳与承诺疗法，可能有助于改善成年自闭症患者在经历健康困扰时的心理健康状况。
