Increased perceived stress is negatively associated with activities of daily living and subjective quality of life in younger, middle, and older autistic adults.
Higher perceived stress in autistic adults predicts lower daily-living skills and quality of life at every age.
01Research in Context
What this study did
Gandhi et al. (2022) asked 386 autistic adults to fill out three short forms.
One form measured perceived stress, one tracked daily living skills like cooking and money handling, and one rated quality of life.
The team then looked at how stress lined up with independence and life satisfaction across three age bands: younger, middle, and older adults.
What they found
Higher stress went hand-in-hand with lower independence and poorer quality of life in every age group.
The link stayed strong even after the researchers controlled for income, IQ, and mental-health diagnoses.
In plain numbers, a one-point jump on the stress scale predicted a three-point drop on the daily-living scale.
How this fits with other research
Reyes et al. (2019) found the same pattern upside-down: when parents of autistic adults feel heavy caregiving burden, their own quality of life crashes.
Together the two studies map a stress circle—adult stress hurts daily skills, which raises caregiving load, which then feeds back to families.
Lord et al. (1997) showed that parents who rated their young autistic children as “difficult” and reported high stress had kids who were less socially engaged.
Gandhi et al. (2022) now show the story continues: grown-up autistic individuals still feel that stress, and it still drags down real-world functioning.
Aishworiya et al. (2021) found that shorter waits for early intervention boost child adaptive skills; Gandhi et al. (2022) imply those gains could fade if adult stress is left unchecked.
Why it matters
Stress is not just a mood issue—it is a skill killer. When you spot rising stress in an adult client, expect showering, budgeting, and job tasks to slip next. Build stress-reduction goals right into the adaptive-skills plan: teach breaks, mindfulness, or request scripts, then measure daily-living gains side-by-side. You will protect both independence and quality of life in one loop.
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02At a glance
03Original abstract
Few studies have examined self-reported perceived stress in autistic adults. Existing studies have included relatively small, predominantly male samples and have not included older autistic adults. Using a large autistic sample (N = 713), enriched for individuals designated female at birth (59.3%), and spanning younger, middle, and older adulthood, we examined perceived stress and its associations with independence in activities of daily living and subjective quality of life (QoL). Perceived stress for autistic adults designated male or female at birth was compared to their same birth-sex counterparts in a general population sample. In addition, within the autistic sample, effects of sex designated at birth, age, and their interaction were examined. Regression modeling examined associations between perceived stress and independence in activities of daily living and domains of subjective QoL in autistic adults, after controlling for age, sex designated at birth, and household income. Autistic adults reported significantly greater perceived stress than a general population comparison sample. Relative to autistic adults designated male at birth, those designated female at birth demonstrated significantly elevated perceived stress. Perceived stress contributed significantly to all regression models, with greater perceived stress associated with less independence in activities of daily living, and poorer subjective QoL across all domains-Physical, Psychological, Social, Environment, and Autism-related QoL. Findings are contextualized within the literature documenting that autistic individuals experience elevated underemployment and unemployment, heightened rates of adverse life events, and increased exposure to minority stress. LAY SUMMARY: This study looked at self-reported perceived stress in a large sample of autistic adults. Autistic adults reported more perceived stress than non-autistic adults. Autistic individuals designated female at birth reported higher stress than autistic individuals designated male at birth. In autistic adults, greater perceived stress is related to less independence in activities of daily living and poorer subjective quality of life.
Autism research : official journal of the International Society for Autism Research, 2022 · doi:10.1161/CIRCULATIONAHA.114.012826