Background: 

Recognition, diagnosis and high-quality support for mental and physical health relies on the knowledge, attitudes and confidence of healthcare professionals. However, there is variability among healthcare professionals in different contexts, professions and cultures. While several studies have examined healthcare professionals’ experience of working with autistic people, no systematic review has compiled this evidence. Therefore, the present study aimed to bring together the current evidence base on healthcare professionals’ knowledge, self-efficacy (confidence) and attitudes towards working with autistic people.  

Methods:

The review of the literature was conducted following systematic review guidelines in November 2019. Studies had to look at the topic of knowledge, confidence or attitudes towards autism in healthcare professionals (e.g. doctors, nurses, medical students etc.), used quantitative methods and were published in English from 1994 to present.  

Results:

Overall, thirty-five studies were identified, spanning over many countries and occupations. The methodologies of all studies were rated as moderately good and the number of participants totalled 8,398. Of these studies, findings were inconsistent regarding the impact of characteristics such as gender, age or experience on knowledge, attitudes or self-efficacy. Six of the thirty-five studies looked at self-efficacy and found moderate confidence reported overall. It was determined that specialities (e.g., paediatrics) had better knowledge than general healthcare providers. However, of the 27 studies that investigated autism knowledge, knowledge ranged widely between poor and fair. Furthermore, two studies found attitudes of discomfort in working with autistic people moreover, and two studies linked beliefs around curses and enemies causing autism as well as poor parenting. These findings show clear room for improvement among healthcare professionals to ensure improved knowledge, self-efficacy and attitudes towards working with autistic people.  

This research has recently been accepted as a paper – watch this space!

In the meantime, check out the poster here: 

Background:

The minority stress model (MSM) suggests that marginalised minorities are exposed to excess stress resulting in health inequalities and is useful for understanding the high rate of mental illness in the autistic community. Similarly, intra-community connectedness (being connected to other autistic people) has been shown to weaken the impact of perceived stigma on both depression and suicidality. No previous research has investigated the utility of the MSM for understanding mental health and autistic community connectedness for autistic people over time. Thus, the present study aimed to answer whether exposure to exposure to minority stress is associated with worse mental health and wellbeing, and whether higher connectedness with the autistic community is associated with better mental health over time in the autistic population.   

Methods: 

Overall, 99 autistic participants took park in the longitudinal study, in which participants completed a survey on two occasions, nine months apart. The survey measured: demographics, general stress, minority stress, autistic community connectedness, wellbeing and psychological distress.  

Results:

The results found that higher exposure to minority stress reported at time one was associated with significantly worse mental health at follow-up. Conversely, higher ‘outness’ (being ‘out’ as autistic) at time one predicted significantly better wellbeing at the second time point. Furthermore, higher rates of autistic community connectedness at time one was associated with significantly higher emotional, social and psychological wellbeing at time two, as well as significantly lower psychological distress. This research demonstrates the continued utility of the MSM and community connectedness for understanding wellbeing in the autistic community.  

Check out the poster here:

Background:

Many autistic people experience difficulties in recalling personally experienced past events (episodic memory). These memory difficulties also extend to thinking about the future (episodic future thinking) and remembering to carry out tasks in the future (prospective memory). These processes require the use of mental visualisation of oneself in past or future. Visualisation skills reflect a spectrum of individual differences, from little to no mental visualisation (Aphantasia) to high clarity vivid mental imagery (Hyperphantasia). In the general population, approximately 2% of people experience Aphantasia.  

Aims:

The research investigated whether autistic people experience higher rates of Aphantasia compared to non-autistic people, and how visualisation skills might relate to episodic memory and future thinking.  

Methods: 

193 participants took part in this study, of which 98 were autistic diagnosed or self-identifying autistic adults and 93 were non-autistic adults. Participants completed the research online, answering a series of questionnaires about autistic traits, visualisation, episodic memory, and episodic future thinking.  

Results: 

The results of the study that showed a higher rate of Aphantasia in autistic adults (5.6%) compared to non-autistic adults in this study (1%) and previous research (2%). In the autistic group, mentalizing difficulties related to autistic traits were associated with less visualisation of mental images (greater levels of Aphantasia). However, visualisation difficulties, but not mentalizing difficulties, were specifically related fewer future thinking events. This was not the case for episodic memory in autistic adults. However, compared to non-autistic adults, the autistic adults in the present study made more errors, overall, and generated fewer episodic memories and future thinking events. The findings of the study offer promising insights to the pattern of cognitive variability in autistic adults. These insights could be potentially useful to inform future targeted support for every day remembering.  

Check out the poster here:

Background: 

Autism diagnosis is common in adulthood, particularly for females, and is often noted to be  emotionally impactful, with a lack of post-diagnostic support. Personal identity consists of characteristics that define an individual and differentiate them from others. Autistic personal identity is an individual’s sense of whether autism is part of who they are, as opposed to autistic social identity which involves identifying with other autistic people. The present study hypothesised that more positive personal autistic identity would relate to higher self-esteem and wellbeing, and that earlier diagnosis and longer time passed since diagnosis would relate to more positive personal autistic identity.  

Method:

The study distributed an online survey which was completed by 151 autistic adults, which measured: autistic characteristics, self-esteem, mental wellbeing and personal autistic identity. Lastly, participants were asked how receiving an autism diagnosis affected how they felt about themselves using an open qualitative question.  

Results:

The results showed that greater pride in autistic identity was linked with higher self-esteem and that greater feelings of dissatisfaction with autistic identity related to reports of lower wellbeing. In addition, as the number of years since diagnosis increased, dissatisfaction with autistic identity decreased. In response to the qualitative question, most commonly participants noted there to be an emotional adjustment and adaptation process that over time led to improved satisfaction in autistic personal identity. However, it was noted that there was a lack of external support. Therefore, the study highlighted a clear need for high-quality information and support post-diagnosis.  

This study is available as a preprint here: https://psyarxiv.com/4ns83/ 

Check out the poster here:

Background: 

Autistic people have a higher rate of mental illness compared to non-autistic population, and it is suggested by the minority stress model that marginalised minorities are exposed to a greater burden (minority stress), resulting in health inequalities. However, marginalised minorities may also have access to a unique in-group community which also provides a degree of protection. Thus, autistic community connectedness may play a role in buffering the impact of minority stress on mental health for the autistic community. Therefore, the present study aimed to test whether minority stress could predict worse mental health for the autistic sample, and whether autistic community connectedness buffers against the effects of minority stress on mental health.  

Method:

The study comprised of an online survey which recruited 195 diagnosed autistic or self-diagnosed autistic participants, the survey measured: demographics, general life stress, minority stress, autistic community connectedness and psychological distress.  

Results:

The results showed that exposure to minority stress predicted worse mental health, and that different types of autistic community connectedness moderated the relationships between different types of minority stressors. High rates of belongingness to the autistic community moderated the impact of outness (disclosure), and concealment (masking) on psychological distress. Belongingness and social connectedness were less effective at moderating the effect of internalized stigma on distress. Lastly, political connectedness moderated the impact of internalized stigma on distress more so than belongingness or social connectedness.  

Check out the poster here: 

Each year INSAR holds a research conference (their general annual meeting) which brings together researchers from all over the world. Members from the Stirling Autism Research (STAR) team will be attending the conference this year and presenting work spanning the topics of healthcare access, mental health and quality of life across the adult lifespan, the impact of COVID-19, autistic community connectedness, stigma, and episodic memory and future thinking. There will be several posters from our research group presented, and a panel on stigma co-chaired by Dr Eilidh Cage and Dr Monique Botha. We are using this as a platform for disseminating our research to a global audience, and our research topics focus on matters that can hopefully make a difference to the lives of autistic people, now and in the future.  

Having said that, we wanted to note that although we are attending INSAR to disseminate our research findings to a wider audience, we do not support or endorse the whole range of research that is being presented at INSAR. Autism research can be exceptionally problematic, dehumanizing, and marginalising. As INSAR brings together people globally from a range of disciplines, this includes research on topics such as causes and cures. We do not endorse that kind of research, which are not autistic community priorities (see Roche et al., 2021). We think it is vital that research that does represent autistic community priorities is featured at INSAR.

To promote transparency, clarity, and openness we will be making our contributions available soon, so that everyone can see what we have been researching here at STAR. We will be making accessible explanations of all of work and sharing these via Twitter and our STAR blog  Our first and foremost priority is for ethical, transparent, engaged, and socially proactive research which can make a difference for autistic people.  

If you would like to be involved in shaping or find out more about our research, please contact us by sending an email to autismresearch@stir.ac.uk