Restricted accessResearch articleFirst published online 2018-8
The combined impact of social support and perceived stress on quality of life in adults with autism spectrum disorder and without intellectual disability
Identifying modifiable correlates of good quality of life in adults with autism spectrum disorder is of paramount importance for intervention development as the population of adults with autism spectrum disorder increases. This study sought to examine social support and perceived stress as potential modifiable correlates of quality of life in adults with autism spectrum disorder. We hypothesized that adults with autism spectrum disorder without co-occurring intellectual disabilities (N = 40; aged 18–44 years) would report lower levels of social support and quality of life than typical community volunteers who were matched for age, sex, and race (N = 25). We additionally hypothesized that social support would buffer the effect of perceived stress on quality of life in adults with autism spectrum disorder. Results indicated that adults with autism spectrum disorder reported significantly lower levels of social support and quality of life than matched typical community volunteers. In addition, findings showed significant direct effects of social support and perceived stress on quality of life in adults with autism spectrum disorder. Social support did not buffer the effect of perceived stress on quality of life. Interventions that teach adults with autism spectrum disorder skills to help them better manage stress and cultivate supportive social relationships have the potential to improve quality of life.
American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association.
2.
AndersonDKLiangJWLordC (2014) Predicting young adult outcome among more and less cognitively able individuals with autism spectrum disorders. Journal of Child Psychology and Psychiatry55: 485–494.
3.
Bishop-FitzpatrickLHongJSmithLE. (2016) Characterizing objective quality of life and normative outcomes in adults with autism spectrum disorder: an exploratory latent class analysis. Journal of Autism and Developmental Disorders46: 2707–2719.
4.
Bishop-FitzpatrickLMazefskyCMinshewNJ. (2015) The relationship between stress and social functioning in adults with autism spectrum disorder and without intellectual disability. Autism Research8: 164–173.
5.
Bishop-FitzpatrickLMinshewNJMazefskyC. (2017) Perception of life as stressful, not biological response to stress, is associated with greater social disability in adults with autism spectrum disorder. Journal of Autism and Developmental Disorders47: 1–16.
6.
Bishop-FitzpatrickLSmithLEGreenbergJS. (in press) Participation in recreational activities moderates the relationship between perceived stress and quality of life in adults with autism spectrum disorder. Autism Research.
7.
BuchananJ (1995) Social support and schizophrenia: a review of the literature. Archives of Psychiatric Nursing9: 68–76.
8.
CasselJ (1976) The contribution of the social environment to host resistance. American Journal of Epidemiology104: 107–123.
9.
CobbS (1976) Social support as a moderator of life stress. Psychosomatic Medicine38: 300–314.
10.
CohenJ (1988) Statistical Power Analysis for the Behavioral Sciences. Hillsdale, NJ: Lawrence Erlbaum Associates.
11.
CohenSJanicki-DevertsD (2012) Who’s stressed? Distributions of psychological stress in the United States in probability samples from 1983, 2006, and 20091. Journal of Applied Social Psychology42: 1320–1334.
12.
CohenSMcKayG (1984) Social support, stress and the buffering hypothesis: a theoretical analysis. In: BaumATaylorSESingerJE (eds) Handbook of Psychology and Health. Hillsdale, NJ: Lawrence Erlbaum, pp.253–267.
13.
CohenSWilliamsonGM (1988) Perceived stress in a probability sample of the United States. In: SpacapanSOskampS (eds) The Social Psychology of Health. Newbury Park, CA: SAGE, pp.31–67.
14.
CohenSKamarckTMermelsteinR (1983) A global measure of perceived stress. Journal of Health and Social Behavior24: 385–396.
15.
CohenSMermelsteinRKamarckT. (1985) Measuring the functional components of social support. In: SarasonIGSarasonBR (eds) Social Support: Theory, Research and Application. The Hague: Martinus Nijhoff, pp.73–94.
16.
DitzenBHeinrichsM (2014) Psychobiology of social support: the social dimension of stress buffering. Restorative Neurology and Neuroscience32: 149–162.
17.
EackSMBahorikALMcKnightSAF. (2013a) Commonalities in social and non-social cognitive impairments in adults with autism spectrum disorder and schizophrenia. Schizophrenia Research148: 24–28.
18.
EackSMGreenwaldDPHogartySS. (2013b) Cognitive enhancement therapy for adults with autism spectrum disorder: results of an 18-month feasibility study. Journal of Autism and Developmental Disorders43: 2866–2877.
19.
FirstJCheak-ZamoraNCTetiM (2016) A qualitative study of stress and coping when transitioning to adulthood with autism spectrum disorder. Journal of Family Social Work19: 220–236.
20.
FirstMSpitzerRGibbonM. (2002) Structured Clinical Interview for the DSM-IV-TR Axis I Disorders, Research Version. Patient ed. New York: Biometrics Research, New York State Psychiatric Institute.
21.
GerhardtPLainerI (2011) Addressing the needs of adolescents and adults with autism: a crisis on the horizon. Journal of Contemporary Psychotherapy41: 37–45.
22.
HellesAGillbergICGillbergC. (in press) Asperger syndrome in males over two decades: quality of life in relation to diagnostic stability and psychiatric comorbidity. Autism.
23.
HillAB (1965) The environment and disease: association or causation?Proceedings of the Royal Society of Medicine58: 295–300.
24.
HirvikoskiTBlomqvistM (2015) High self-perceived stress and poor coping in intellectually able adults with autism spectrum disorder. Autism19: 752–757.
25.
Holt-LunstadJSmithTBLaytonJB (2010) Social relationships and mortality risk: a meta-analytic review. PLoS Med7: e1000316.
26.
HonakerJKingGBlackwellM (2011) Amelia II: a program for missing data. Journal of Statistical Software45: 1–47.
27.
HongJBishop-FitzpatrickLSmithLE. (2016) Factors associated with subjective quality of life of adults with autism spectrum disorder: self-report versus maternal reports. Journal of Autism and Developmental Disorders46: 1368–1378.
28.
HowlinPGoodeSHuttonJ. (2004) Adult outcome for children with autism. Journal of Child Psychology and Psychiatry45: 212–229.
29.
HowlinPMossPSavageS. (2013) Social outcomes in mid- to later adulthood among individuals diagnosed with autism and average nonverbal IQ as children. Journal of the American Academy of Child and Adolescent Psychiatry52: 572–581.
30.
HumphreyNSymesW (2010) Perceptions of social support and experience of bullying among pupils with autistic spectrum disorders in mainstream secondary schools. European Journal of Special Needs Education25: 77–91.
31.
KirbyEDWilliamsVPHockingMC. (2006) Psychosocial benefits of three formats of a standardized behavioral stress management program. Psychosomatic Medicine68: 816–823.
32.
KlinASaulnierCASparrowSS. (2007) Social and communication abilities and disabilities in higher functioning individuals with autism spectrum disorders: the Vineland and the ADOS. Journal of Autism and Developmental Disorders37: 748–759.
33.
LandermanRGeorgeLKCampbellRT. (1989) Alternative models of the stress buffering hypothesis. American Journal of Community Psychology17: 625–642.
34.
LevyAPerryA (2011) Outcomes in adolescents and adults with autism: a review of the literature. Research in Autism Spectrum Disorders5: 1271–1282.
35.
LordCRisiSLambrechtL. (2000) The autism diagnostic observation schedule-generic: a standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders30: 205–223.
36.
LordCRutterMLecouteurA (1994) Autism Diagnostic Interview-Revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders24: 659–685.
37.
MagiatiITayXWHowlinP (2014) Cognitive, language, social and behavioural outcomes in adults with autism spectrum disorders: a systematic review of longitudinal follow-up studies in adulthood. Clinical Psychology Review34: 73–86.
38.
MarquardtDW (1980) You should standardize the predictor variables in your regression models. Journal of the American Statistical Association75: 87–91.
39.
MazurekMO (2014) Loneliness, friendship, and well-being in adults with autism spectrum disorders. Autism18: 223–232.
40.
NewschafferCJFalbMDGurneyJG (2005) National autism prevalence trends from United States special education data. Pediatrics115: e277–e282.
41.
OrsmondGIShattuckPTCooperB. (2013) Social participation among young adults with an autism spectrum disorder. Journal of Autism and Developmental Disorders43: 2710–2719.
42.
ParkJKitayamaSKarasawaM. (2013) Clarifying the links between social support and health: culture, stress, and neuroticism matter. Journal of Health Psychology18: 226–235.
43.
R Core Team (2015) R: A Language and Environment for Statistical Computing. Vienna: R Foundation for Statistical Computing.
44.
RentyJORoeyersH (2006) Quality of life in high-functioning adults with autism spectrum disorder: the predictive value of disability and support characteristics. Autism10: 511–524.
45.
SchaferJLGrahamJW (2002) Missing data: our view of the state of the art. Psychological Methods7: 147–177.
46.
SeltzerMMGreenbergJSTaylorJL. (2011) Adolescents and adults with autism spectrum disorders. In: AmaralDGDawsonGGeschwindDH (eds) Autism Spectrum Disorders. New York: Oxford University Press, pp.241–252.
47.
SkevingtonSMLotfyMO’ConnellKA (2004) The World Health Organization’s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial: a report from the WHOQOL Group. Quality of Life Research13: 299–310.
48.
SperryLAMesibovGB (2005) Perceptions of social challenges of adults with autism spectrum disorder. Autism9: 362–376.
49.
SteinhausenHCMohr JensenCLauritsenM (2016) A systematic review and meta-analysis of the long-term overall outcome of autism spectrum disorders in adolescence and adulthood. Acta Psychiatrica Scandinavica133: 445–452.
50.
SymesWHumphreyN (2010) Peer-group indicators of social inclusion among pupils with autistic spectrum disorders (ASD) in mainstream secondary schools: a comparative study. School Psychology International31: 478–494.
WHOQOL Group (1998) Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine28: 551–558.
53.
WilliamsVPBishop-FitzpatrickLLaneJD. (2010) Video-based coping skills to reduce health risk and improve psychological and physical well-being in Alzheimer’s disease family caregivers. Psychosomatic Medicine72: 897–904.
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