High self-perceived stress and poor coping in intellectually able adults with autism spectrum disorder.

Hirvikoski et al. (2015) asked intellectually able adults with autism how stressed they feel and how they cope. They compared answers to a same-age group without autism.

The team used surveys and interviews. They looked at everyday hassles, not crisis events.

Adults with autism rated their stress much higher. They also said they use fewer or weaker coping tools.

The gap stayed large even when both groups had similar IQ and education.

Chen et al. (2024) found the same stress-coping link in autistic teens. Poor coping again predicted higher social anxiety, showing the pattern starts early and lasts.

Han et al. (2022) reviewed dozens of papers and saw the same story: stigma keeps stress high and coping options low. Their review includes the Tatja data, so the picture is not a one-off.

Greene et al. (2019) and Bravo Balsa et al. (2024) add a twist. They measured cortisol and found some autistic adults and teens show high daily output or flat slopes, hinting at body-level stress. This seems to clash with older papers like Curin et al. (2003) that report low cortisol in autism. The gap is likely about timing: chronic daily stress can later raise cortisol even if baseline starts low.

If your client is a bright adult with autism, do not assume low support needs mean low stress. Add a quick stress screen to intake. Teach coping skills such as break cards, scheduled walks, or peer check-ins. Small boosts in coping can chip away at the chronic load Tatja’s team uncovered.