Exploring the suitability of the Clark and Wells (1995) model of social anxiety in autistic adults: The role of mental imagery and fear of negative evaluation.
Jiedi Lei, Juliette Attwood, Ailsa Russell
PMID 41169031WHAT IT FOUND
Autistic adults could describe anxious social mental images.
The images felt more upsetting, anxiety-provoking and hard to control than relaxed images, but were not seen more from an outside viewpoint and were not tied to fear of negative evaluation.
Key findings
0139 participants said they experience mental images in social situations that make them anxious, and 8 said this happens always.
02Social images were rated as more upsetting, more anxiety-provoking, more likely to prompt wanting to escape, and less controllable than relaxed images.
03Fear of negative evaluation and outside-viewpoint imagery were not associated with characteristics of the social images, and the social images were not more likely to be from an outside viewpoint than relaxed images.
STILL TO COME
How it was doneWhat they found
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What it does not show
There was no non-autistic comparison group, so the results cannot show whether these imagery patterns are different from non-autistic adults with similar anxiety. Participants reported their autism diagnosis themselves, and no structured diagnostic tool confirmed it. Most participants were female and received their diagnosis in adulthood, so the findings may not apply to autistic men or people diagnosed in childhood. The sample had very high social anxiety scores; 83% to 92% exceeded cut-offs for social anxiety, so it may not represent autistic adults with lower anxiety. The study did not ask about past negative social experiences, trauma, or other mental and physical health conditions, so those factors cannot be ruled out. The paper reported that 68 participants would be needed for one analysis to have an 80% chance of finding a medium-sized change; the sample was 62.
Declared interests
The authors received no external funding; the research was part of a doctoral clinical psychology study, and they declared no potential conflicts of interest.
The easy way to misread this
Do not read the finding that social images were distressing as evidence that imagery-based therapy will help autistic adults. The study did not test therapy, and it did not support the expected role of fear of negative evaluation or outside-viewpoint imagery.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →