The relationship between stress and social functioning in adults with autism spectrum disorder and without intellectual disability
Open accessAbstract
Adults with autism spectrum disorder (ASD) face substantial challenges accomplishing basic tasks associated with daily living, which are exacerbated by their broad and pervasive difficulties with social interactions. These challenges put people with ASD at increased risk for psychophysiological distress, which likely factors heavily into social functioning for adults with ASD, as suggested by a growing literature on stress in children that indicates that children with ASD have differential responses to stress than healthy children. We hypothesized that adults with ASD and without intellectual disability (n = 38) would experience more stress than healthy volunteers (n = 37) and that there would be an inverse relationship between stress and social functioning in individuals with ASD. Baseline, semi-structured interview data from a randomized controlled trial of two treatments for adults with ASD were used to assess differences in stress between adults with ASD and healthy volunteers and to assess the relationship between stress response and social functioning in adults with ASD. Findings indicate that adults with ASD experience greater perceived and interviewer-observed stress than healthy volunteers and that stress is significantly related to social functioning in adults with ASD. These findings highlight the role of stress in adult functioning and outcomes and suggest the need to develop and assess treatments designed to target stress and coping in adults with ASD.
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Heightened stress and anxiety, rigid-compulsive behavior, and sleep problems have been shown to be associated with GI symptoms in ASD, especially constipation.
“Heightened stress and anxiety, rigid-compulsive behavior, and sleep problems, have been shown to be associated with GI symptoms in ASD, especially constipation (6, 11, 12, 16–19).”
From The Relationship Among Gastrointestinal Symptoms, Problem Behaviors, and Internalizing Symptoms in Children and Adolescents with Autism Spectrum Disorder (2019) · cites this paper as [17]
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Cites
Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing
Benjamini, Y., & Hochberg, Y. (1995) · Journal of the Royal Statistical Society Series B: Statistical Methodology · doi:10.1111/j.2517-6161.1995.tb02031.x · Cited by 109,482 · see citing works
Statistical Power Analysis for the Behavioral Sciences
Muller, K. E., & Cohen, J. (1989) · Technometrics · doi:10.2307/1270020 · Cited by 99,588 · see citing works
Statistical power analysis for the behavioral sciences
Cohen, J. (1990) · Computers Environment and Urban Systems · doi:10.1016/0198-9715(90)90050-4 · Cited by 65,406 · see citing works
Statistical Power Analysis for the Behavioral Sciences (2nd ed.).
Lachenbruch, P. A., & Cohen, J. (1989) · Journal of the American Statistical Association · doi:10.2307/2290095 · Cited by 37,385 · see citing works
A Global Measure of Perceived Stress
Cohen, S., Kamarck, T., & Mermelstein, R. (1983) · Journal of Health and Social Behavior · doi:10.2307/2136404 · Cited by 32,807 · see citing works
An Analysis of Transformations
Box, G. E. P., & Cox, D. R. (1964) · Journal of the Royal Statistical Society Series B (Statistical Methodology) · doi:10.1111/j.2517-6161.1964.tb00553.x · Cited by 15,059 · see citing works
The Brief Psychiatric Rating Scale.
Overall, J. E., & Gorham, D. R. (1962) · Psychological Reports · doi:10.2466/pr0.1962.10.3.799 · Cited by 11,090 · see citing works
Cohen, J. (1992) · Psychological Bulletin · doi:10.1037//0033-2909.112.1.155 · Cited by 8,771 · see citing works
Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., Pickles, A., & Rutter, M. (2000) · Journal of Autism and Developmental Disorders · doi:10.1023/a:1005592401947 · Cited by 7,520 · see citing works
A Simple Test for Heteroscedasticity and Random Coefficient Variation
Breusch, T. S., & Pagan, A. R. (1979) · Econometrica · doi:10.2307/1911963 · Cited by 5,647 · see citing works
Selye, H. (1956) · Medical Entomology and Zoology · Cited by 5,224 · see citing works
The Global Assessment Scale: A Procedure for Measuring Overall Severity of Psychiatric Disturbance
Endicott, J. (1976) · Archives of General Psychiatry · doi:10.1001/archpsyc.1976.01770060086012 · Cited by 4,982 · see citing works
Measures of Multivariate Skewness and Kurtosis with Applications
Mardia, K. V. (1970) · Biometrika · doi:10.1093/biomet/57.3.519 · Cited by 4,859 · see citing works
(1988) · Cited by 4,111 · see citing works
TESTING FOR SERIAL CORRELATION IN LEAST SQUARES REGRESSION. II
Durbin, J., & Watson, G. S. (1951) · Biometrika · doi:10.1093/biomet/38.1-2.159 · Cited by 3,636 · see citing works
Structured clinical interview for DSM-IV axis I disorders : SCID-I : clinical version : scoresheet
First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1997) · American Psychiatric Press eBooks · Cited by 3,101 · see citing works
Wing, L., & Gould, J. (1979) · Journal of Autism and Developmental Disorders · doi:10.1007/bf01531288 · Cited by 2,587 · cited 2× · see citing works
“…Autism Research 8: 164–173, 2015 INSAR [Shattuck et al., 2012b; Smith, Maenner, & Seltzer, 2012; Taylor & Seltzer, 2011], which are further exacerbated by their broad and pervasive difficulties with social interactions [Gillespie-Lynch et al., 2012; Klin et al., 2007; Wing & Gould, 1979].”
BackgroundAdult outcome for children with autism
Howlin, P., Goode, S., Hutton, J., & Rutter, M. (2004) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2004.00215.x · Cited by 1,813 · see citing works
The social psychology of health
(1989) · Choice Reviews Online · doi:10.5860/choice.26-5686 · Cited by 1,797 · see citing works
Postsecondary education and employment among youth with an autism spectrum disorder
Shattuck, P. T., Narendorf, S. C., Cooper, B., Sterzing, P. R., Wagner, M., & Taylor, J. L. (2012) · PEDIATRICS · doi:10.1542/peds.2011-2864 · Cited by 1,110 · see citing works
Clinical implications of Brief Psychiatric Rating Scale scores
Leucht, S., Kane, J. M., Kissling, W., Hamann, J., Etschel, E., & Engel, R. R. (2005) · The British Journal of Psychiatry · doi:10.1192/bjp.187.4.366 · Cited by 898 · see citing works
The Role of Emotion Regulation in Autism Spectrum Disorder
Mazefsky, C. A., Herrington, J., Siegel, M., Scarpa, A., Maddox, B. B., Scahill, L., & White, S. W. (2013) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2013.05.006 · Cited by 881 · see citing works
Self-citationAftereffects of stress on human performance and social behavior: a review of research and theory.
Cohen, S. (1980) · Psychological bulletin · doi:10.1037/0033-2909.88.1.82 · Cited by 839 · see citing works
Taylor, J. L., & Seltzer, M. M. (2011) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-010-1070-3 · Cited by 735 · see citing works
TESTING FOR SERIAL CORRELATION IN LEAST SQUARES REGRESSION. I
Durbin, J., & Watson, G. S. (1950) · Biometrika · doi:10.1093/biomet/37.3-4.409 · Cited by 731 · see citing works
The Social Psychology of Health.
Gold, D. T., Spacapan, S., & Oskamp, S. (1990) · Contemporary Sociology A Journal of Reviews · doi:10.2307/2073512 · Cited by 644 · see citing works
The Small Sample Behavior of Some Statistics Which Test the Equality of Several Means
Brown, M. B., & Forsythe, A. B. (1974) · Technometrics · doi:10.1080/00401706.1974.10489158 · Cited by 639 · see citing works
Trajectory of development in adolescents and adults with autism
Seltzer, M. M., Shattuck, P. T., Abbeduto, L., & Greenberg, J. S. (2004) · Mental Retardation and Developmental Disabilities Research Reviews · doi:10.1002/mrdd.20038 · Cited by 589 · see citing works
Klin, A., Saulnier, C. A., Sparrow, S. S., Cicchetti, D. V., Volkmar, F. R., & Lord, C. (2007) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-006-0229-4 · Cited by 585 · see citing works
Regression with Dummy Variables
Hardy, M. A. (1993) · Sage eBooks · doi:10.4135/9781412985628 · Cited by 555 · see citing works
Regression with Dummy Variables
Ziegel, E. R., & Hardy, M. A. (1994) · Technometrics · doi:10.2307/1269395 · Cited by 538 · see citing works
Evidence-Based Practices in Interventions for Children and Youth with Autism Spectrum Disorders
Odom, S. L., Collet-Klingenberg, L. L., Rogers, S. J., & Hatton, D. D. (2010) · Preventing School Failure Alternative Education for Children and Youth · doi:10.1080/10459881003785506 · Cited by 537 · see citing works
Cognitive Enhancement Therapy for Schizophrenia
Hogarty, G. E., Flesher, S., Ulrich, R. F., Carter, M., Greenwald, D. P., Pogue‐Geile, M. F., Kechavan, M., Cooley, S., DiBarry, A. L., Garrett, A., et al. (2004) · Archives of General Psychiatry · doi:10.1001/archpsyc.61.9.866 · Cited by 536 · see citing works
Stanfield, A. C., McIntosh, A. M., Spencer, M. D., Philip, R., Gaur, S., & Lawrie, S. M. (2008) · European Psychiatry · doi:10.1016/j.eurpsy.2007.05.006 · Cited by 524 · see citing works
Outcomes in adolescents and adults with autism: A review of the literature
Levy, A. K., & Perry, A. (2011) · Research in Autism · doi:10.1016/j.rasd.2011.01.023 · Cited by 448 · see citing works
Evaluation of Comprehensive Treatment Models for Individuals with Autism Spectrum Disorders
Odom, S. L., Boyd, B. A., Hall, L. J., & Hume, K. (2009) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-009-0825-1 · Cited by 425 · see citing works
Marquardt, D. W. (1980) · Journal of the American Statistical Association · doi:10.1080/01621459.1980.10477430 · Cited by 376 · see citing works
Emotion regulation in Asperger’s syndrome and high-functioning autism
Samson, A. C., Huber, O., & Gross, J. J. (2012) · Emotion · doi:10.1037/a0027975 · Cited by 368 · see citing works
Services for Adults with an Autism Spectrum Disorder
Shattuck, P. T., Roux, A. M., Hudson, L. E., Taylor, J. L., Maenner, M. J., & Trani, J.-F. (2012) · The Canadian Journal of Psychiatry · doi:10.1177/070674371205700503 · Cited by 289 · see citing works
Developmental Trajectories in Adolescents and Adults With Autism: The Case of Daily Living Skills
DaWalt, L. S., Maenner, M. J., & Seltzer, M. M. (2012) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2012.03.001 · Cited by 279 · see citing works
Addressing the Needs of Adolescents and Adults with Autism: A Crisis on the Horizon
Gerhardt, P. F., & Lainer, I. (2010) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-010-9160-2 · Cited by 275 · see citing works
Cortisol circadian rhythms and response to stress in children with autism
Corbett, B. A., Mendoza, S., Abdullah, M., Wegelin, J. A., & Levine, S. (2006) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2005.05.011 · Cited by 258 · see citing works
White, S. W., Mazefsky, C. A., Dichter, G. S., Chiu, P. H., Richey, J. A., & Ollendick, T. H. (2014) · International Journal of Developmental Neuroscience · doi:10.1016/j.ijdevneu.2014.05.012 · Cited by 252 · see citing works
Self-citationEnhanced Cortisol Response to Stress in Children in Autism
Spratt, E. G., Nicholas, J. S., Brady, K. T., Carpenter, L. A., Hatcher, C. R., Meekins, K. A., Furlanetto, R. W., & Charles, J. M. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-011-1214-0 · Cited by 222 · see citing works
A Systematic Review of Psychosocial Interventions for Adults with Autism Spectrum Disorders
Bishop, L., Minshew, N. J., & Eack, S. M. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1615-8 · Cited by 221 · see citing works
Self-citationComparing cortisol, stress, and sensory sensitivity in children with autism
Corbett, B. A., Schupp, C. W., Levine, S., & Mendoza, S. P. (2009) · Autism Research · doi:10.1002/aur.64 · Cited by 202 · see citing works
Early Childhood Predictors of the Social Competence of Adults with Autism
Gillespie‐Lynch, K., Sepeta, L. N., Wang, Y., Marshall, S. N., Gomez, L., Sigman, M., & Hutman, T. (2011) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-011-1222-0 · Cited by 201 · see citing works
Overall, J. E., & Beller, S. A. (1984) · Journal of Gerontology · doi:10.1093/geronj/39.2.187 · Cited by 169 · see citing works
Variable cortisol circadian rhythms in children with autism and anticipatory stress
Corbett, B. A., Mendoza, S. P., Wegelin, J. A., Carmean, V., & Levine, S. D. (2008) · Journal of Psychiatry and Neuroscience · doi:10.1139/jpn.0823 · Cited by 149 · see citing works
Boso, M., Emanuele, E., Minazzi, V., Abbamonte, M., & Politi, P. (2007) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2006.6334 · Cited by 138 · see citing works
Physiologic arousal to social stress in children with autism spectrum disorders: a pilot study
Levine, T. P., Sheinkopf, S. J., Pescosolido, M., Rodino, A., Elia, G., & Lester, B. (2012) · Research in Autism Spectrum Disorders · doi:10.1016/j.rasd.2011.04.003 · Cited by 121 · see citing works
Jansen, L. M., Gispen-de Wied, C. C., van der Gaag, R.-J., & van Engeland, H. (2003) · Neuropsychopharmacology · doi:10.1038/sj.npp.1300046 · Cited by 118 · see citing works
Access and Service Use by Children with Autism Spectrum Disorders in Medicaid Managed Care
Ruble, L. A., Heflinger, C. A., RENFREW, J. W., & Saunders, R. C. (2005) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-004-1026-6 · Cited by 114 · see citing works
Eaves, L. C., & Ho, H. H. (1996) · Journal of Autism and Developmental Disorders · doi:10.1007/bf02172276 · Cited by 110 · see citing works
Role play for assessing the social competence of psychiatric patients.
Bellack, A. S., Morrison, R. L., Mueser, K. T., Wade, J. H., & Sayers, S. L. (1990) · Psychological Assessment · doi:10.1037/1040-3590.2.3.248 · Cited by 98 · see citing works
Verbal ability, social stress, and anxiety in children with Autistic Disorder
Lanni, K. E., Schupp, C. W., Simon, D. M., & Corbett, B. A. (2011) · Autism · doi:10.1177/1362361311425916 · Cited by 92 · see citing works
Psychiatric Hospital Treatment of Children with Autism and Serious Behavioral Disturbance
Siegel, M. S., & Gabriels, R. L. (2013) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2013.07.004 · Cited by 87 · see citing works
Psychosocial and Biobehavioral Factors and Their Interplay in Coronary Heart Disease
Williams, R. B. (2008) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.4.022007.141237 · Cited by 66 · see citing works
Hatton, C., Haddock, G., Taylor, J. L., Coldwell, J. B., Crossley, R., & Peckham, N. G. (2005) · Journal of Intellectual Disability Research · doi:10.1111/j.1365-2788.2005.00696.x · Cited by 61 · see citing works
Reliability of a standardized and expanded Brief Psychiatric Rating Scale: a replication study
Hafkenscheid, A. (1993) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1993.tb03464.x · Cited by 45 · see citing works
Assessment of Social Adjustment in Chronic Ambulatory Schizophrenics
Glazer, W. M., AARONSON, H. S., Prusoff, B. A., & Williams, D. H. (1980) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-198008000-00008 · Cited by 35 · see citing works
Community Adjustment of Chronic Schizophrenic Patients in Urban and Rural Settings
Davies, M. A., Bromet, E. J., Schulz, S. C., Dunn, L. O., & Morgenstern, M. (1989) · Psychiatric Services · doi:10.1176/ps.40.8.824 · Cited by 30 · see citing works
How Safe Is Acute High Dose Corticosteroid Therapy In Neurological Disorders? (P1.035)
Lotan, I., Fireman, L., Weizman, A., et al. (2014) · Neurology · doi:10.1212/wnl.82.10_supplement.p1.035 · Cited by 1 · see citing works
Sansone (1998) · doi:10.1002/(sici)1097-4679(199811)54:7
Flagged first, then by citations
Research works printed but not linked: 5
- Covi L Rickels K Lipman OS 1981 Effects of psychotropic agents on primary depression Psychopharmacology Bulletin 1981 100 101
- Hedlund JL Vieweg BW 1980 The Brief Psychiatric Rating Scale (BPRS): A comprehensive review Journal of Operational Psychiatry 11 48 65
- Marquardt DW 1980 You should standardize the predictor variables in your regression models Journal of the American Statistical Association 75 369 87 91
- Shattuck PT Roux AM Hudson LE Taylor JL Maenner MJ Trani JF 2012 Services for adults with an autism spectrum disorder Canadian Journal of Psychiatry 57 5 284 291 PMC3538849 22546060
- Wechsler D 2008 Wechsler Adult Intelligence Scale® 4th Edition (WAIS®-IV) Harcourt Assessment San Antonio, TX
Cited by
Sorted by citations
Identifying the lost generation of adults with autism spectrum conditions
Lai, M.-C., & Baron-Cohen, S. (2015) · The Lancet Psychiatry · doi:10.1016/s2215-0366(15)00277-1 · Cited by 756 · see citing works
Bishop-Fitzpatrick, L., Mazefsky, C. A., & Eack, S. M. (2018) · Autism · doi:10.1177/1362361317703090 · Cited by 142 · see citing works
Self-citationHeart Rate Variability in Individuals with Autism Spectrum Disorders: a Meta-analysis
Cheng, Y.-C., Huang, Y.-C., & Huang, W.-L. (2020) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2020.08.007 · Cited by 125 · see citing works
Fuld, S. (2018) · Clinical Social Work Journal · doi:10.1007/s10615-018-0649-6 · Cited by 113 · see citing works
Ferguson, B. J., Dovgan, K., Takahashi, N., & Beversdorf, D. Q. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00194 · Cited by 110 · see citing works
Ferguson, B. J., Marler, S., Altstein, L. L., Lee, E. B., Mazurek, M. O., McLaughlin, A., Macklin, E. A., McDonnell, E., Davis, D. J., Belenchia, A. M., et al. (2016) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2016.05.009 · Cited by 89 · see citing works
Lifetime and perceived stress, social support, loneliness, and health in autistic adults.
Moseley, R. L., Turner-Cobb, J. M., Spahr, C. M., Shields, G. S., & Slavich, G. M. (2021) · Health Psychology · doi:10.1037/hea0001108 · Cited by 71 · see citing works
Pallathra, A. A., Cordero, L., Wong, K., & Brodkin, E. S. (2019) · Current Psychiatry Reports · doi:10.1007/s11920-019-0989-0 · Cited by 56 · see citing works
Tomczak, M. T., Szulc, J. M., & Szczerska, M. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18094696 · Cited by 47 · see citing works
“More specifically, because the communication deficits inherent in ASD may cause adults with autism to experience more stress [34], we need tailored communication strategies around recruitment, selection, onboarding, and job retention to create the most positive outcomes for the health and well-being of individuals wit…”
BackgroundMuscatello, R. A., Vandekar, S. N., & Corbett, B. A. (2021) · Journal of Neurodevelopmental Disorders · doi:10.1186/s11689-020-09354-x · Cited by 23 · see citing works
Psychosocial therapeutic approaches for high-functioning autistic adults
Schweizer, T., Endres, D., Dziobek, I., & Tebartz van Elst, L. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1265066 · Cited by 16 · see citing works
- Authors
- Bishop‐Fitzpatrick, L., Mazefsky, C. A., Minshew, N. J., & Eack, S. M.
- Affiliations
- School of Social Work University of Pittsburgh Pittsburgh Pennsylvania
- University of Pittsburgh (US)
- Venue
- Autism Research
- Publisher
- Wiley
- Published
- 2014-12-19
- Volume
- 8
- Issue
- 2
- Pages
- 164-173
- ISSN
- 1939-3792 (ISSN-L)
- 1939-3806
- PMC
- PMC4412754
- OpenAlex
- W1930478473
- Cited by
- 127
- References
- 66
- Citations by year
- 2026: 9 · 2025: 10 · 2024: 14 · 2023: 11 · 2022: 15 · 2021: 22 · 2020: 8 · 2019: 11 · 2018: 5 · 2017: 12 · 2016: 4 · 2015: 5
- FWCI
- 3.90
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Autism Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NIH (MH-85851, MH-95783, RR-24154, HD-55748)
- Autism Speaks (5703, 8568)
- Department of Defense (AR100344)
- Pennsylvania Department of Health
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- autism spectrum disorder, stress, social functioning, autistic adults, intellectual disability, social interaction difficulties, stress response, coping, everyday problems
- MeSH terms
- Autism Spectrum Disorder, Adaptation, Psychological, Adult, Emotions, Female, Humans, Internal-External Control, Interviews as Topic, Male, Intellectual Disability, Social Behavior, Stress, Psychological, Young Adult
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