Differences in anticipatory versus reactive stress to social evaluative threat in adults versus adolescents with autism.
Autistic adolescents stay physiologically calm before social evaluation, then react; autistic adults may start ramping up early—plan supports to match each timing pattern.
01Research in Context
What this study did
Taylor et al. (2018) compared stress hormones before and after a public-speaking task. They tested autistic adolescents and young adults in a lab setting.
The team measured saliva cortisol at three points: baseline, right before the speech, and after. This let them see anticipatory versus reactive stress.
What they found
Adults with autism showed a small cortisol rise while waiting to speak. Adolescents did not; they only shifted after the task began.
Most autistic participants still had flatter curves than typical peers. The adult group started gearing up early; the teen group did not.
How this fits with other research
Duerden et al. (2012) found autistic children mount big cortisol spikes during blood draws. Lounds shows adolescents react little to social threat. Age and stressor type explain the gap: invasive needles raise hormones in kids, social evaluation does not in teens.
McQuaid et al. (2024) extend the same lab task to younger tweens. They saw stronger cortisol and heart-rate jumps during evaluative moments, matching typical kids. Together the studies trace a curve: high reactivity in childhood, dip in adolescence, partial return in adulthood.
van den Broek et al. (2006) and Weissman-Fogel et al. (2015) also report blunted heart-rate in autistic adults, but normal cortisol. Lounds adds the timing piece: cortisol can rise early, just not always enough to match typical levels.
Why it matters
When you prep autistic clients for job interviews or class presentations, expect teens to look calm until the event starts. Provide in-the-moment supports like breaks or fidgets. Adults may show early jitters; teach advance coping such as paced breathing or brief walks. Track both anticipatory and reactive signs so your intervention matches the client's actual stress curve.
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02At a glance
03Original abstract
Social evaluative threat is a potent activator of the hypothalamic-pituitary-adrenocortical (HPA) axis in typically developing (TD) populations. Studies have shown that children and adolescents with autism spectrum disorder (ASD) show a blunted cortisol response to this type of stressor; yet, a previous study in adults with ASD reported a more prototypical stress response. The current study compared 24 adolescents and 17 adults with ASD to investigate a possible developmental lag in autism resulting in a more adaptive stress response to social evaluation with development. Participants were exposed to the trier social stress test (TSST), and salivary cortisol was collected before and after stress induction. Multilevel modeling revealed that relative to adolescents, young adults with ASD evidenced a significant increase in cortisol in response to anticipatory stress, and 23.5% were classified as anticipatory responders. Adolescents, however, had a significant change in slope in response to the TSST, with 37.5% classified as reactive responders. In both groups, the majority of participants did not have a robust stress response to the TSST as would be expected in TD participants. Findings suggest significant differences in the cortisol trajectory; adults with ASD were more likely to show an anticipatory response to being socially evaluated, which was maintained throughout the stressor, whereas the adolescents had a more reactive response pattern with no anticipatory response. Further research is needed to determine if such patterns are adaptive or deleterious, and to determine underlying factors that may contribute to distinct stress profiles and to the overall diminished stress responses. Autism Res 2018, 11: 1276-1285. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Many individuals have increased stress when being socially evaluated. The current study shows that adults with ASD have increased stress in anticipation of a task in which individuals are required to give a speech to unfamiliar raters, while adolescents with ASD tend to show a stress response only during the task itself. Further research is necessary to understand whether developmental influences on stress response in ASD have significant impacts on other areas of functioning often affected by stress.
Autism research : official journal of the International Society for Autism Research, 2018 · doi:10.1002/aur.1998