scholarly journals Emotional self-awareness in autism: A meta-analysis of group differences and developmental effects

Autism ◽  
2020 ◽  
pp. 136236132096430
Author(s):  
Charlotte F Huggins ◽  
Gemma Donnan ◽  
Isobel M Cameron ◽  
Justin HG Williams
Keyword(s):  
Mental Health ◽  
Meta Analysis ◽  
Age Groups ◽  
Self Report ◽  
Group Differences ◽  
Self Awareness ◽  
Autistic Children ◽  
Autistic People ◽  
Mental Health Difficulties ◽  
Autistic Adults

Emotional self-awareness is increasingly suggested to be an area of difficulty in autism that may predict socioemotional outcomes for this population. However, whether emotional self-awareness is consistently diminished in autism across age and methodology remains unclear. We systematically reviewed 47 papers measuring emotional self-awareness in autistic ( n = 1387) and non-autistic ( n = 1433) participants. Most studies relied on self-report. Of studies testing for group differences, the majority (32/41) found significantly poorer emotional self-awareness in autism. Meta-analyses of self-report measures found that emotional self-awareness was significantly poorer in autism ( d = 1.16). However, when examining age groups individually, autistic children of age 12 years and under were not significantly different from their peers ( d = 0.03). Instead, difficulties emerged during adolescence ( d = 0.63) and increased with age ( d = 1.16 – 1.58). The pattern of emotional self-awareness difficulties being more common in autism, and worsening with age is similar to the development of mental health difficulties in autism. However, findings rely on self-perception and so may reflect poor self-beliefs of socioemotional competence. We propose that negative self-beliefs in autistic populations may account for findings of low emotional self-awareness. Lay abstract Autistic people are thought to have difficulties with identifying and understanding their own emotions. This is referred to as emotional self-awareness. It is important to study emotional self-awareness as people who are more able to understand their own emotions, whether they are autistic or not, are more able to respond to them appropriately, as well as to identify them in other people. It has not yet been confirmed whether autistic people have difficulties with emotional self-awareness, or if any reported difficulties are actually due to the way in which emotional self-awareness is measured in autistic people. If these difficulties do exist, it is also not known when these difficulties emerge. In this research, we reviewed 47 existing studies that measured emotional self-awareness in autistic and non-autistic adults and children. We also compared studies that measured emotional self-awareness in different ways. We found that autistic adults did seem to have poorer emotional self-awareness compared to their neurotypical peers. However, this was not the case with autistic children of age 12 years and below. Instead, differences in emotional self-awareness only seemed to emerge during adolescence. Moreover, these difficulties seemed to increase with age. These results suggest that difficulties with emotional self-awareness may not be inherent in autism. Instead, they may emerge alongside the greater social and mental health difficulties that are experienced by many autistic people during adolescence. We therefore suggest that it is important to find out more about, and subsequently support, the emotional self-awareness difficulties that autistic adolescents may encounter.

Camouflaging in non-autistic adults is associated with poorer mental health

2019 ◽  
Author(s):  
Mark Somerville ◽  
Sarah E. MacPherson ◽  
Sue Fletcher-Watson
Keyword(s):  
Mental Health ◽  
Executive Function ◽  
Autistic Traits ◽  
Self Report ◽  
Linear Regression Models ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Autistic People ◽  
Autistic Adults ◽  
The Relationship

Camouflaging is a frequently reported behaviour in autistic people, which entails the use of strategies to compensate for and mask autistic traits in social situations. Camouflaging is associated with poor mental health in autistic people. This study examined the manifestation of camouflaging in a non-autistic sample, examining the relationship between autistic traits, camouflaging, and mental health. In addition, the role of executive functions as a mechanism underpinning camouflaging was explored. Sixty-three non-autistic adults completed standardised self-report questionnaires which measured: autistic traits, mental health symptoms, and camouflaging behaviours. In addition, a subset (n=51) completed three tests of executive function measuring inhibition, working memory, and set-shifting. Multiple linear regression models were used to analyse data. Results indicated that autistic traits are not associated with mental health symptoms when controlling for camouflaging, and camouflaging predicted increased mental health symptoms. Camouflaging did not correlate with any measure of executive function. These findings have implications for understanding the relationship between autistic traits and mental health in non-autistic people and add to the growing development of theory and knowledge about the mechanism and effects of camouflaging.

scholarly journals COVID-19, social isolation and the mental health of autistic people and their families: A qualitative study

Autism ◽  
2021 ◽  
pp. 136236132110359
Author(s):  
Elizabeth Pellicano ◽  
Simon Brett ◽  
Jacquiline den Houting ◽  
Melanie Heyworth ◽  
Iliana Magiati ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Social Isolation ◽  
Real Life ◽  
Social Contact ◽  
Negative Consequences ◽  
Autistic Children ◽  
Structured Interviews ◽  
Autistic People ◽  
Autistic Adults

The COVID-19 pandemic and its policy responses have had a detrimental effect on millions of people’s mental health. Here, we investigate its impact on autistic people and their families using qualitative methods. Specifically, we addressed: how did autistic people experience an increase in social isolation during the initial lockdown? And how was their mental health impacted by lockdown? Autistic and non-autistic researchers conducted 144 semi-structured interviews with autistic adults (n = 44), parents of autistic children (n = 84) including autistic parents and autistic young people (n = 16). We deployed thematic analysis to identify key themes. The enhanced social isolation accompanying the pandemic had a serious and damaging impact on autistic people’s mental health and subjective wellbeing. They spoke of intensely missing friends and more incidental forms of social connection. They also reported intense dissatisfaction with the substitution of embodied, person-to-person connection in health services by online/telephone-based alternatives, sometimes accompanied by serious negative consequences. These findings reveal the fundamental importance of supporting autistic people to maintain direct and incidental social contact during the pandemic and beyond. They speak against established theories that downplay autistic people’s need for human connection and the extent to which they have been affected by social isolation during lockdowns. Lay abstract In this study, we show that autistic people and their families have found it very difficult to deal with the lockdowns during the COVID-19 pandemic. Autistic and non-autistic researchers spoke to 144 people, including 44 autistic adults, 84 parents of autistic children and 16 autistic young people (12–18 years old). We asked them about their everyday lives and mental health during lockdown. People told us that they enjoyed having fewer obligations and demands compared to pre-COVID-19 life. They felt that life was quieter and calmer. But people also told us again and again how much they missed meeting people in real life, especially their friends, and their therapists and support workers. People told us that their mental health suffered because they did not have contact with their friends and services. Importantly, many people (including researchers) think that autistic people do not want friends or to be around people. But our results show that is not true. Many autistic people do want friends and to be around other people. Some people’s mental health has been damaged by not being able to see people during COVID-19. Autistic people need support in many areas of life so they can keep socialising and seeing their friends even through difficult times, like pandemics.

scholarly journals Comorbid Conditions, Mental Health and Cognitive Functions in Adults with Fibromyalgia

2020 ◽  
pp. 019394592093742
Author(s):  
Sophie Taylor ◽  
Penny Furness ◽  
Simon Ashe ◽  
Sarah Haywood-Small ◽  
Kim Lawson
Keyword(s):  
Mental Health ◽  
Cognitive Function ◽  
Online Survey ◽  
Early Adulthood ◽  
Age Groups ◽  
Self Report ◽  
Group Differences ◽  
Age Group ◽  
Middle Adulthood ◽  
Comorbid Conditions

This study examined age group differences across adulthood in comorbid conditions, mental health, and cognitive function in people with fibromyalgia. Participants completed an online survey about how fibromyalgia affects their everyday life. Chi square analyses were conducted to examine associations between age groups and (a) comorbid conditions and (b) severity of anxiety and depression. ANOVA analyses examined age group differences on aspects of self-report cognitive function. The greatest prevalence of comorbid conditions was found in middle adulthood. Early adulthood was associated with more cases of severe anxiety with the lowest number of cases being in the oldest age group. Middle adulthood was associated with worse self-report pain compared to the youngest age group. Older adults showed better self-report cognitive function compared to younger adults. Distinct age profiles based on comorbid conditions, mental health, and symptom severity across adulthood in fibromyalgia have been demonstrated.

scholarly journals ‘People like me don’t get support’: Autistic adults’ experiences of support and treatment for mental health difficulties, self-injury and suicidality

Autism ◽  
2018 ◽  
Vol 23 (6) ◽  
pp. 1431-1441 ◽  
Author(s):  
Louise Camm-Crosbie ◽  
Louise Bradley ◽  
Rebecca Shaw ◽  
Simon Baron-Cohen ◽  
Sarah Cassidy
Keyword(s):  
Mental Health ◽  
Online Survey ◽  
Mental Health Problems ◽  
Well Being ◽  
Health Problems ◽  
Treatment Pathways ◽  
Self Injury ◽  
Autistic People ◽  
Mental Health Difficulties ◽  
Autistic Adults

Autistic people are at high risk of mental health problems, self-injury and suicidality. However, no studies have explored autistic peoples’ experiences of treatment and support for these difficulties. In partnership with a steering group of autistic adults, an online survey was developed to explore these individuals’ experiences of treatment and support for mental health problems, self-injury and suicidality for the first time. A total of 200 autistic adults (122 females, 77 males and 1 unreported) aged 18–67 (mean = 38.9 years, standard deviation = 11.5), without co-occurring intellectual disability, completed the online survey. Thematic analysis of open-ended questions resulted in an overarching theme that individually tailored treatment and support was both beneficial and desirable, which consisted of three underlying themes: (1) difficulties in accessing treatment and support; (2) lack of understanding and knowledge of autistic people with co-occurring mental health difficulties and (3) appropriate treatment and support, or lack of, impacted autistic people’s well-being and likelihood of seeing suicide as their future. Findings demonstrate an urgent need for autism treatment pathways in mental health services.

scholarly journals Is social camouflaging associated with anxiety and depression in autistic adults?

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Laura Hull ◽  
Lily Levy ◽  
Meng-Chuan Lai ◽  
K. V. Petrides ◽  
Simon Baron-Cohen ◽  
...  
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Social Anxiety ◽  
Online Survey ◽  
Mental Health Problems ◽  
Autistic Traits ◽  
Health Problems ◽  
Autistic People ◽  
Autistic Adults ◽  
Anxiety Depression

Abstract Background There is inconsistent evidence for a clear pattern of association between ‘camouflaging’ (strategies used to mask and/or compensate for autism characteristics during social interactions) and mental health. Methods This study explored the relationship between self-reported camouflaging and generalised anxiety, depression, and social anxiety in a large sample of autistic adults and, for the first time, explored the moderating effect of gender, in an online survey. Results Overall, camouflaging was associated with greater symptoms of generalised anxiety, depression, and social anxiety, although only to a small extent beyond the contribution of autistic traits and age. Camouflaging more strongly predicted generalised and social anxiety than depression. No interaction between camouflaging and gender was found. Limitations These results cannot be generalised to autistic people with intellectual disability, or autistic children and young people. The sample did not include sufficient numbers of non-binary people to run separate analyses; therefore, it is possible that camouflaging impacts mental health differently in this population. Conclusions The findings suggest that camouflaging is a risk factor for mental health problems in autistic adults without intellectual disability, regardless of gender. We also identified levels of camouflaging at which risk of mental health problems is highest, suggesting clinicians should be particularly aware of mental health problems in those who score at or above these levels.

scholarly journals Barriers to healthcare for autistic adults: Consequences & policy implications. A cross-sectional study

2020 ◽  
Author(s):  
Mary Doherty ◽  
Stuart D Neilson ◽  
Jane D O'Sullivan ◽  
Laura Carravallah ◽  
Mona Johnson ◽  
...  
Keyword(s):  
Mental Health ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Physical And Mental Health ◽  
Cross Sectional ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Clinic Appointment ◽  
Autistic People ◽  
Autistic Adults

AbstractBackgroundAutistic people experience significantly poorer physical and mental health along with reduced life expectancy.AimTo identify self-reported barriers to primary care by autistic adults compared to parents of autistic children and non-autistic adults and link these barriers to self-reported adverse health consequences.Design and SettingFollowing consultation with the autistic community at an autistic conference, Autscape, a quantitative and qualitative survey was developed.MethodThe self-report survey was administered online through social media platforms.ResultsThe 57-item online survey was completed by 507 autistic adults, 196 parents of autistic children and 157 control subjects. 79.7% of autistic adults, 52.8% of parents and 36.5% of controls reported difficulty visiting a GP. The highest-rated barriers by autistic adults were deciding if symptoms warrant a GP visit (72.2%), difficulty making appointments by telephone (61.9%), not feeling understood (55.8%), difficulty communicating with their doctor (53.1%) and the waiting room environment (50.5%).Autistic adults reported a preference for online or text based appointment booking, facility to email in advance the reason for consultation, first or last clinic appointment and a quiet place to wait.Increased adverse health outcomes reported by autistic adults correlated with difficulty attending, including untreated physical and mental health conditions, not attending specialist referral or screening programmes, requiring more extensive treatment or surgery due to late presentations, and untreated potentially life threatening conditions.ConclusionReduction of healthcare inequalities for autistic people requires that healthcare providers understand autistic perspectives and communication needs. Adjustments for autism specific needs are as necessary as ramps for wheelchair users.How this fits inAdverse health outcomes are common among autistic people and so it is important to understand how we can promote access to primary care.This cross sectional study indicates that 79.7% of autistic patients (compared to 36.5% of controls) reported difficulty visiting a GP.Common barriers were: deciding if symptoms warrant a GP visit, difficulty using the telephone to book appointments, not feeling understood and difficulty communicating with their doctor.Common suggestions to promote access included: online or text based appointment booking facility, emailing in advance the reason for consultation, providing first or last clinic appointment and having a quiet place to wait.

scholarly journals Interviewing autistic adults: Adaptations to support recall in police, employment, and healthcare interviews

Autism ◽  
2020 ◽  
Vol 24 (6) ◽  
pp. 1506-1520 ◽  
Author(s):  
Jade Eloise Norris ◽  
Laura Crane ◽  
Katie Maras
Keyword(s):  
Mental Health ◽  
Criminal Justice ◽  
Criminal Justice System ◽  
Justice System ◽  
Semantic Knowledge ◽  
Typically Developing ◽  
Employment Interviews ◽  
Open Questions ◽  
Autistic People ◽  
Autistic Adults

Recalling specific past experiences is critical for most formal social interactions, including when being interviewed for employment, as a witness or defendant in the criminal justice system, or as a patient during a clinical consultation. Such interviews can be difficult for autistic adults under standard open questioning, yet applied research into effective methods to facilitate autistic adults’ recall is only recently beginning to emerge. The current study tested the efficacy of different prompting techniques to support autistic adults’ recall of specific personal memories; 30 autistic and 30 typically developing adults (intelligence quotients > 85) were asked to recall specific instances from their past, relevant to criminal justice system, healthcare, and employment interviews. Questions comprised ‘open questions’, ‘semantic prompting’ (where semantic knowledge was used to prompt specific episodic retrieval) and ‘visual–verbal prompting’ (a pie-diagram with prompts to recall specific details, for example, who, what, and where). Half the participants received the questions in advance. Consistent with previous research, autistic participants reported memories with reduced specificity. For both groups, visual–verbal prompting support improved specificity and episodic relevance, while semantic prompting also aided recall for employment questions (but not health or criminal justice system). Findings offer new practical insight for interviewers to facilitate communication with typically developing and autistic adults. Lay abstract During many types of interviews (e.g. in employment, with the police, and in healthcare), we need to recall detailed memories of specific events, which can be difficult for autistic people in response to commonly used questions. This is especially because these tend to be open questions (i.e. very broad). Autistic people have disproportionately high rates of physical and mental health conditions, are more likely to interact with police, and are the most underemployed disability group. However, interviewers are often unsure about how to adapt their communication for autistic people. Our research tested whether different types of prompts enabled autistic people to recall specific memories (memories of a single event within one day). Participants were asked about situations relating to witnessing a crime (e.g. at the bank), physical or mental health scenarios and employment interviews (e.g. a time you’ve met a deadline). We tested the following: Open questions: basic questions only (e.g. ‘tell me about a time you went to the cinema’), Semantic prompting: a general prompt (e.g. ‘do you enjoy going to the cinema?’) before asking for a specific instance (‘tell me about a time you went to the cinema?’), Visual–verbal prompting: asking participants to recall when it happened, who was there, the actions that occurred, the setting, and any objects. With visual–verbal prompting, autistic and typically developing participants’ memories were more specific and detailed. Semantic prompting was also effective for employment questions. Our study shows that autistic people can recall specific memories when they are appropriately prompted. Visual–verbal prompting may be effective across different situations.

Development and Application of a Brief Measure of Emotional Intelligence for Vocational High School Teachers

2004 ◽  
Vol 95 (3_suppl) ◽  
pp. 1207-1218 ◽  
Author(s):  
Shwu Ming Wu
Keyword(s):  
High School ◽  
Emotional Intelligence ◽  
High School Teachers ◽  
Age Groups ◽  
Self Report ◽  
Self Awareness ◽  
Vocational High School ◽  
School Teachers ◽  
Intelligence Scale ◽  
Report Measure

To develop a psychometrically sound, self-report measure of emotional intelligence and examine the scores of vocational high school teachers by sex and age, 375 Taiwanese vocational high school teachers (186 men, 189 women) completed the 25-item Emotional Intelligence Scale of five domains: Self-awareness, Managing Emotions, Self-motivation, Empathy, and Handling Relationships. Analysis indicated that these teachers reported higher scores on Self-awareness and Empathy but slightly lower on Managing Emotions. The women gave higher self-ratings on Self-awareness and Empathy than the men. There were also significant differences across age groups on Self-awareness, Self-motivation, Empathy and the Total score for the Emotional Intelligence Scale.

scholarly journals Contextual Information Modulates Pupil Size in Autistic and Non-Autistic Children.

2021 ◽  
Author(s):  
Chiara Tortelli ◽  
Antonella Pomè ◽  
Marco Turi ◽  
Roberta Igliozzi ◽  
David Charles Burr ◽  
...  
Keyword(s):  
Comparison Group ◽  
Contextual Information ◽  
Self Report ◽  
Group Differences ◽  
Clinical Samples ◽  
Clinical Group ◽  
The Sun ◽  
Autistic Children ◽  
Significant Group ◽  
Significant Difference

Abstract Background. Recent Bayesian models suggest that perception is more “data-driven” and less dependent on contextual information in autistic individuals than others. However, experimental tests of this hypothesis have given mixed results, possibly due to the lack of objectivity of the self-report methods typically employed. Here we introduce an objective no-report paradigm based on pupillometry to assess the processing of contextual information in autistic children and a comparison clinical group.Methods. After validating (in a group of neurotypical adults) a child-friendly pupillometric paradigm, in which we embedded test images within an animation movie that participants watched passively, we compared pupillary response to images of the sun and meaningless control images in children with autism versus age- and IQ-matched children presenting developmental disorders unrelated to the autistic spectrum. Results. Both clinical groups showed stronger pupillary constriction for the sun images compared with control images, like the neurotypical adults. There was no detectable difference between autistic children and the comparison group (in spite of a significant difference in pupillary light responses, enhanced in the autistic group). Limitations: Having found no statistically significant differences between groups, we cannot exclude that group differences existed but were too small to be detected – a critique that applies to most negative findings. Additional limitations concern the heterogeneous composition of the comparison group and the types of stimuli tested, which only allowed for studying the effect of context on relatively complex perceptual processes. Conclusions: Our report introduces an objective technique for studying perception in clinical samples and children. The lack of statistically significant group differences in our tests suggests that autistic children and the comparison group do not show large differences in perception of these stimuli. This opens the way to further studies testing contextual processing at other levels of perception.

scholarly journals Development and Validation of the Suicide Behaviours Questionnaire – Autism Spectrum Conditions in Autistic, Possibly Autistic and Non-Autistic Adults.

2020 ◽  
Author(s):  
Sarah Cassidy ◽  
Louise Bradley ◽  
Heather Cogger-Ward ◽  
Jacqui Rodgers
Keyword(s):  
Assessment Tool ◽  
Autistic Traits ◽  
Autism Spectrum ◽  
Assessment Tools ◽  
Self Report ◽  
Measurement Properties ◽  
Autism Spectrum Conditions ◽  
Autistic People ◽  
Autistic Adults ◽  
Development And Validation

Abstract Background: Autistic people and those with high autistic traits are at high risk of experiencing suicidality. Yet, there are no suicidality assessment tools developed or validated for these groups.Methods: A widely used and validated suicidality assessment tool developed for the general population (SBQ-R), was adapted using feedback from autistic adults. The adapted tool was refined through 9 interviews, and an online survey with 251 autistic adults, to establish clarity and relevance of the items. Subsequently, 308 autistic, 113 possibly autistic, and 268 non-autistic adults completed the adapted tool online, alongside self-report measures of autistic traits (AQ), camouflaging autistic traits (CAT-Q), depression (PHQ-9), anxiety (ASA-A), thwarted belongingness and perceived burdensomeness (INQ-15), lifetime non-suicidal self-injury, and the original version of the suicidality assessment tool (SBQ-R). Analyses explored the appropriateness and measurement properties of the adapted tool between the groups.Results: There was evidence in support of content validity, structural validity, internal consistency, convergent and divergent validity, test retest validity, sensitivity and specificity (for distinguishing those with or without lifetime experience of suicide attempt), and hypothesis testing of the adapted tool (SBQ-ASC) in each group. The structure of the SBQ-ASC was equivalent between autistic and possibly autistic adults, regardless of gender, or use of visual aids to help quantify abstract rating scales.Limitations: The samples involved in the development and validation of the adapted tool were largely female, and largely diagnosed as autistic in adulthood, which is not representative of the wider autistic population. The SBQ-ASC has been developed for use in research and is not recommended to assess risk of future suicide attempts and/or self-harm.Conclusions: The SBQ-ASC is a brief self-report suicidality assessment tool, developed and validated with and for autistic adults, without co-occurring intellectual disability. The SBQ-ASC is appropriate for use in research to identify suicidal thoughts and behaviours in autistic and possibly autistic people, and model associations with risk and protective factors.

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