Childhood experiences of being parented, adult attachment, psychological inflexibility, social engagement, and mental health of autistic adults.
Psychological inflexibility and anxious adult attachment are the clearest survey signals that an autistic client is likely to struggle with depression, anxiety, or stress.
01Research in Context
What this study did
Lee et al. (2022) sent an online survey to autistic adults.
They asked about childhood parenting, adult attachment style, and mental health.
The team used stats to see if psychological inflexibility and attachment linked stress, anxiety, and depression.
What they found
Psychological inflexibility and anxious or avoidant adult attachment were the strongest predictors of depression, anxiety, and stress.
These two factors also carried the effect of harsh or cold parenting into current mental-health problems.
How this fits with other research
Baker et al. (2025) and Harrop et al. (2024) show the same inflexibility factor predicts depression in autistic teens and anxiety in autistic youth.
The pattern now spans childhood to adulthood, so rigidity is a life-long risk marker.
McCormick et al. (2025) adds that helping autistic adults move toward personal values softens pandemic stress, proving flexibility is changeable and protective.
Jones et al. (2014) flips the view: when parents of autistic kids learn acceptance, their own anxiety and depression drop.
Together the studies form a loop—parent acceptance lowers child stress, and later the adult’s own flexibility guards their mental health.
Why it matters
You now have a two-level action plan. First, screen adult clients for attachment anxiety and psychological inflexibility; both flags signal high risk for depression and anxiety. Second, pick interventions that build values-based flexibility—ACT modules, committed-choice drills, or parent acceptance training—because multiple studies show these skills buffer stress across age groups.
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02At a glance
03Original abstract
BACKGROUND: Autistic adults have an increased risk of poor mental health. Although parental care and overprotection in childhood influence later attachment and mental health in the general adult population, this has not been investigated in the autistic population. Likewise, the roles of psychological inflexibility and social engagement in influencing mental health outcomes for autistic adults have yet to be examined. AIMS: To examine if retrospectively recalled childhood experiences of parental care and overprotection, as well as current adult attachment, psychological inflexibility and social engagement are associated with mental health in autistic adulthood. Further, to examine mediators of the association between parental care and overprotection and mental health in autistic adults. METHODS AND PROCEDURES: A community-recruited convenience sample of 126 Australian autistic adults completed an online survey assessing childhood experiences of parental care and overprotection and current adult attachment, psychological inflexibility, social engagement, and mental health. OUTCOMES AND RESULTS: Linear regressions showed that psychological inflexibility was the strongest predictor of depression, anxiety, and stress, followed by attachment anxiety (depression, anxiety) and attachment avoidance (anxiety, stress). Mediation analyses revealed that psychological inflexibility and attachment anxiety mediated the associations between parental care and overprotection and mental health outcomes in autistic adulthood. CONCLUSIONS AND IMPLICATIONS: Psychological inflexibility and adult attachment (anxious and avoidant attachment) are important to understanding mental health of autistic adults. Psychological inflexibility and attachment anxiety mediate associations between recalled childhood experiences of parental care and overprotection and mental health in autistic adulthood.
Research in developmental disabilities, 2022 · doi:10.1016/j.ridd.2022.104343