Perception of Life as Stressful, Not Biological Response to Stress, is Associated with Greater Social Disability in Adults with Autism Spectrum Disorder.

The study is observational and measured stress and social disability at the same time, so it cannot show that stress causes social disability. The sample was modest, with 40 adults with ASD and 25 volunteers, and the power analysis was set only to detect large effects. The findings are limited to adults with ASD without intellectual disability who could take part in a group-based intervention trial. Typical community volunteers were recruited from a database of participants who had served in previous autism and schizophrenia studies. Missing data were imputed, including 12.5% missing for the social disability measure. The Social Stress Recall Task was novel for ASD research, and previous evidence for its use in ASD was limited. Continuous heart rate variability and the number of prompts used during the task were not collected. The ASD group had lower employment, college completion, and independent living than volunteers, which may itself contribute to higher stress levels. The ASD group was recruited from an active clinical trial of two psychosocial treatments, although treatment exposure was controlled.

The authors declare no conflicts of interest. The supplied text does not state a specific funding source, but the adults with ASD were recruited from a federally funded clinical trial.

Do not read this as evidence that stress causes social disability or that stress management improves it. The study measured stress and social disability at the same time and did not test an intervention; it found associations between reported stress and social disability.