Depression in autistic adults: measurement and social risk factors

Abstract

Depression appears to affect a substantial proportion of the autistic population. Yet there is a lack of evidence for reliable tools for measuring depression in autistic people, and of the factors which contribute to autistic people’s depression. This may be partly due to incorrect assumptions and concerns regarding depression and social factors of autistic people. For instance, there have questions around whether autism affects the experience and reporting of depression symptoms, and consequently whether depression measurements may operate differently for autistic people. Study 1 examined how the Beck Depression Inventory-II (BDI-II) operated for autistic and non-autistic adult samples. Mokken scaling indicated that the same symptoms which are reflective of depression severity in non-autistic adults also do so for non-autistic adults.

Another hypothesis regarding autism is the social motivation theory; that autistic people are inherently less motivated by social stimuli than non-autistic people. Study 2 examined a specific aspect of social motivation termed social desire: the conscious desires for social engagement and relationships that individuals express. Exploratory factor analysis and Mokken scaling analysis identified a restricted set of items representing social desire from a larger scale. These items were used to form the Social Desire Scale (SDS). Total scores on this scale indicated that whilst autistic adults did show significantly lower social desire than non-autistic adults on average, there was maximum variation in scores across both samples. Study 3 examined autistic adults’ social identities: psychological relationships with groups that influence our sense of self. Autistic adults were found to socially identify with a range of types and different numbers of groups. Socially identifying as autistic and with a greater number of groups was associated with less depression and more positive facets of mental health. In sum, it appears that autistic adults are similar to non-autistic adults in terms of responding to self-report instruments, variation in levels of social relationship variables, and the associations of these social variables with depression risk. The thesis’ findings indicate that contrary to many previous hypotheses, depression and social relationships are similarly experienced and important to mental wellbeing in autistic adults as in non-autistic adults. This implies the caution that should be taken when making assumptions about the social circumstances and drives of the autistic population, as they could have negative implications for autistic people’s mental well-being.