Increased Perceived Stress is Negatively Associated with Activities of Daily Living and Subjective Quality of Life in Younger, Middle, and Older Autistic Adults

Abstract

Few studies have examined self-reported perceived stress in autistic adults. Existing studies have included relatively small, predominantly male samples and have not included older autistic adults. Using a large autistic sample (N=713), enriched for individuals assigned female at birth (59.3%), and spanning younger, middle, and older adulthood, we examined perceived stress and its associations with independence in activities of daily living and subjective quality of life (QoL). Perceived stress for autistic adults designated male or female at birth was compared to their same birth-sex counterparts in a general population sample. In addition, within the autistic sample, effects of sex designated at birth, age, and their interaction were examined. Regression modeling examined effects of perceived stress in autistic adults on independence in activities of daily living and domains of subjective QoL after controlling for age, sex designated at birth and household income. Autistic adults reported significantly greater perceived stress than a general population comparison sample. Relative to autistic adults designated male at birth, those designated female at birth demonstrated significantly elevated perceived stress. Perceived stress contributed significantly to all regression models, with greater perceived stress associated with less independence in activities of daily living, and poorer subjective QoL across all domains—Physical, Psychological, Social, Environment and Autism-related QoL. Findings are contextualized within the literature documenting that autistic individuals experience heightened rates of adverse life events and increased exposure to minority stress.